HomeMy WebLinkAbout95-0214o'l,l - q~- 0~.~ ~I
This is to certify that the certificate hereunto attached is a true and accurate copy of the original
death record on file with the Division of Vital Records, and that Frank Yeropoli, whose name is
subscribed thereto, was at the time of subscribing the same and now is Director, Division of Vital
Records of the Department of Health, for the Commonwealth of Pennsylvania, duly appointed
and commissioned as directed by Act 66 of the General Assembly, approved 29 June 1953, P.L.
304.
~~
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RACK M
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AUG 1 ~ 200
Date
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Fran eropoli, ct
Division of Vital Records
P.O. Box 1528
New Castle, PA 16103
COMMONWEALTN OF PENNSYUNINIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH ? 2 5 7 ~ 1
re+i-r~oo t=r+ li r-~,ti
50122500 `<~ ~~~
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"~~:Adf r! rJf, "i!t OF F'FNPtSYLVANIA
:fit ~ 41t tPnLi•'T OF R[VENUE
._ t t r7. 2H0601
F`.v. IIJCr-r.^...,!!_y .`~{l~M[ ((LAST, FIRST, Af
.~,
1i~
r;~~ Hoch
---
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11 tl'Y #VUMAEk
1
`~
_ -209-12-9651
},` X_; i. C?riginol ReWrn
li v~: r...'
~;, rC}C.p ~ .J '. i_irn;ted Estate
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.
ecedent Died Testate
-- __.__ _ {Attach copy of Willj
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~';x~Sf'tJN K AtJ
p _ - __ _.
ROGER B. IRWIN
N
^ 3. Remainder Return
(for dates of death prior to 12-13.82
^ 5. Federal Estate Tax
Return Required
~ 8. Total Number of SaFe Deposit Boxe
IRWIN, McRNIGHT ~ HUGHES
(717 ~ 249 2353 60 West Pomfret Street
- - -_..:-:~,:-.--:__.----- ------_--~.=- Carlisle, PA 17013
i
. .~
1Nl~ERITaNC~ TA,X RETURN
~tE51bfN1: DE~~;DENT
tT~ BE i~~LED IN DUPLtcaTE
WiTW REGISTER t3P WfLLSj
Paul M,
03/06/1995 ~ 04/21/1912 co~~tY
^ 2. Supplemental Return
FOR DATES Of DEATH AFTER'12/11191 H,ECIS FIk~R
IF A SPOUSAL
POVERTY CREDIT !S CLAIMED
FILE NUMBER ,
21-95-0214
32 Mont Sera Road
Carlisle, PA 17013
^ 4a. Future Interest Compromise
(for dates of death after 12-12-82)
^ 7. Decedent Maintained a Living Trust
(Attach copy of Trust)
. ~ ,r.~l, -=rate {,,cheduie A)
( 1)
none
~' `i!c~l;s and Bonds (Schedule B)
~
~''• C~:$t'.s,aiy Weld Stock/Partnership Interest (Schedule C) (2) -
( 3
) - 441.32
• .q. tt'ir,r{gages and Notes fteceivablo (Schedule D) 4
(
j None
~~~ `..:'lSh, thank Deposits 8~ Miscellaneous Personal Pro e rt
5 21 662N76e
°~ ~5. Jointer Owned Property {Schedule F)
(6)
N
~J
.. ~• Irr.~rrsr.=rrs (Schedule G) (schedule L)
. one
` rs:
~~~
'?. "fcft:ri (;toss Assets (total fines 1-7) (~
)
None
r i
' "' ~• Funeral Expenses, Administrative Costs, Miscellaneous (9)
i=xiJOnses {Schedule H) 12, 239.59 (B) 22 104.08
i(.i. t~t;k>ts, Mortgage Liabilities, Lions (Schedule I
'i 1
T
)
(10)
6 202
19
.
otal Deductions (total lines 9 & 10) .
1. h~rr1 `/alue of Estate (tine 8 minus line 11) (1 t) 18 441.7$
13, Charitable and Governmental Bequests (Schedule 1) (12) 3 662.30
_____ __ l A, h(c,t Valur--, Subject to Tax'(line 12 minus line 13) - (13) None
' 1'%. ~'„n:ouni of i;no 14 taxable at 6% rate
rlncludr, values from Schedule K or Sched
l
M
l (14)
3$
{15) ----~-'~62 ~n 3 662.30
u
e
.)
„. ~
onel LTaxab~l axoble 6X 15a/ _
x
10 87
4-~ o rate
I {inclucic' values from Schedule K or Schedule M.)
' (16) 0.00
x .15 .
0
00
17. i
rnr;c,cvi tax. c1us~ {Add t F .
•1 - ax tom hne 15 and from line 16,)
~`~ 1 fi. Cr=,r.;rir•; Spousal Poverty Credit Prior Payments Discount
~~' I __ 0.00 Interest
3, ---- - + -----0--00_ +_____5.4_9 ------~-OU
•~ 1 , ~ _-)
~ 'r S~I: 1 f3 ;s greater Than line 17, enter the difference on line 19. This is the OVERPAY1y-ENT.
'r , - -
I }rl !( 1',~~ 17 is greater than line. i8 - Y
,enter the difference on line 20• This is the TAX (JUE•
.~'•• }~rrter the interest on the balance duo on line 20A.
'3. I + t«=r thta total of i;nc~ 20 and 20A on line 208. This is the BALANCE 17UE
L- Make +Choek Pasyab}e ta: li',egister of Wills, Agent
__ ~v ~; f~E 5ili7ar T~3 A;1V
i~I rt,gr t~ iSOr!'E'' ~ '~+ c,!1!'; i iir ct:a its ttrat 1 have examined thls return,
rt !s true, ~orrc rt and cornhh.te 1 declare that ail real estate has been
hused on ail in'ormation of
- which preparer has env knewt...J,.o
SIGNAI'ltier-.rii: bcF.o..,-,.._ _
(17) -- 109 87
(t8) 5.49
(19) 0.00
(20) 104.38
(2oA) 0.00
(208) 1_U~3$_
accompanying schedules and statements, and to the best of my knowledge and belief,
at true market value. Declaration of preparer other than the personal representative is
DAT
." r--~~',~~+'~:,'~.~~; ~7~~IER THAPJ REBR[SEtJTA71 F`~"`
~~~ AUURESS Want Sera Road, Carlisle, PA 17013 E l~~i/S,
~ ,/ ~, •,~i • ~~'lY-.___. IRWIN, McKNIGHT & HUGHES
" '-` An Wt:'CT t>tnutrrnrm em DATE
iY
PLEASE AN5WER.THE FOLLOWING QUESTIONS BY PLACING A CHECK MARK (,~) IN THE
APPROPRIATE BLOCKS.
1. Did decedent make a transfer arid:
a. retain the use or income of the property transferre , .......
b. retain the right to designate who shall use the property transferred or its income,
c. retain a reversionary interest or ....................................................................
d. receive the promise for life of either payments, benefits or care? .......................
2. If death occurred on or before December 12, 1982, did decedent within two years
preceding death transfer property without receiving adequate consideration? If death
occurred after December 12, 1982, did decedent transfer property within one year of
death without receiving adequate consideration ...............................
3: Did decedent own an 'in trust for' bank account at his or her death? ......................
If THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YC~U MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
-~-_~ ~
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4a L. ~~ ~i 4~
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REV - 1503 IX + (,-85)
COM (~INt,}yyyEA~T~~~~ANIA
>TATE OF I ~~R~~~~lltt~~nn,, `~+
Paul M. Hoch
ITEM
NUMBER
1
SCHEDULE B
SS~~ 209-12-9651 03/06/1995
>~ with Riy~ht of Survivorship must tie disclosed on Schedule
DESCRIPTION
$100.00 Series E United
States Savings Bond issued
August 1969
21-95-0214
VALUE AT DATE
OF DEATH
441.32
TOTAL (Also enter on line 2, Reca itulation)
(If more space is needed, insert addhional sheets of same size.) : 441.32
Copyright (c) t994 form software only CPSystems, Inc.
Form 1500 Schedule 8 (Rev, 4-86)
~' 1
REV - 1508 EX + (2-87)
COMMt~a'p~~~
IN 11~~EE// ANIA
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
Paul M. Hoch SS~p 209-12-9651 03/06/1995
III rope ointly-owned with RF Fit of Survlvorshi must he disclosed on Schedule
ITEM
NUMBER DESCRIPTION
1 Farmers Trust Company,
checking acount ~~12-39678
(confirmation attached)
2 JC Penney Life Insurance
Company, policy cancellation
refund
3 Capital B1ueCross /
Pennsylvania Blue Shield,
poliy cancellation refund
21-95-0214
VALUE AT DATE
OF DEATH
21,423.70
10.86
228.20
TOTAL (Also enter on line 5, Reca itulation)
(Attach additional 8 1/2" x 11"sheets if more space is needed,) = 21 662.76
Copyright (c) 1991 form software only CPSystems, Inc.
Form 1500 SchedWe E (Rev.2-871
~~
REV - 1511 EX + (7-88)
COM INEAI.TO~pN,~NT N ANIA
ESTATE OF ~~~-JN T EE'FiDD~l°i.
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
Paul M. Hoch SS~~ 209-12-9651 03 06 1995
ITEM
NUMBER DESCRIPTION
A• Funeral Expenses:
1 Hoffman-Roth Funeral Home
2 Walnut Bottom Home & Garden
Center, grave monument
3 Carlisle Memorial Service,
Inc., granite memorial
w/inscription
B• Administrative Costs:
1 • Personal Representative Commissions
Social Security Number of Personal Representative: 211- 26 - 7068
Year Commissions paid WAIVED
2• Attorney Fees 1RWIN, McKNIGHT & HUGHES
3• Family Exemption
Claimant Dorothy K. Hoch Relationshi
Address of Claimant at decedent's death p --spouse
Street Address 32 Mont Sera Road
City Carlisle , State PA tip Code 17013
4• Probate Fees
or Type
ILE NU~ R
21-95-0214
AMOUNT
5,162.00
63.59
2,299.00
0.00
l,llo.oo
3,500.00
80.00
C• Miscellaneous Expenses:
1 Cumberland County Register
of Wills, filing fees
25.00
TOTAL (Also enter on line 9, Reca itulation)
(If more space Is deeded, insert additional sheets of same size.) t 12 , 239.59
Copyright (c) 1994 form software only CPSystems, Ine.
e...m ~cnn~_~_~..,_ u,.,__ ' __.
REV - 1512 EX a (1-93)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULEI
DEBTS OF DECEDENT,
iTATE OF - "` ""o
Paul M. Hoch SS~~ 209-12-9651 03/06/1995
ITEM
NUMBER DESCRIPTION
1 Leader Nursing &
Rehabilitation Center,
balance due
2 Belvedere Medical Corp.,
balance due
of Type
ILE NU~Mg p
21-95-0214
AMOUNT
6- 141 47
60.72
TOTAL (Also enter on line 10, RecapRulation)
(N more space is needed, insert additional sheets of same size.} 6 , 202.19
Copyright (c} 1994 form software only CPSystems, Ine.
_ _- Form 1500 schedule I (Rev. t-93)
REV - 1513 t:X + (z_87)
coM~1N~~EpLTH pp~~~~~~A SCHEDULE J
Paul M. Hoch SS~~ 209-12-9651 03 06 1995
ITEM
NUMBER NAME AND ADDRESS OF BENEFICIARY
A. Taxable Bequests:
1 Dorothy K. Hoch
32 Mont Sera Road
Carlisle, PA 17013
RELATIONSHIP
spouse
21-95-0214
AMOUNT OR
SHARE OF ESTATE
loox
form 1500 scneduie J (Rav. z-e7)
,.
LAST WILL AND TESTAMENT
OF
PAUL M. HOCH
I, PAUL M. HOCH, of Dickinson Township, C~miberland County, Pennsylvania,
declare this to be my Last Will
and revok
,
e any Will or Codicil previously made
by me.
IT~9 I: I direct that all my just debts, funeral expenses and
administra ion expenses
including m
ra
,
y g
ve marker, shall be paid from the assets
of my estate as soon as practicable after my decease.
ITEM II: I devise and bequeath the residue of my estate, of every
nature an~erever situate, to my wife, Dorothy K
Hoch
r
idi
`~ .
, p
ov
ng she shall
survive me by sixty (60) days.
~~~~ ITEM III: Should
before t e~ieth da follo inlfe' D°rothy K. Hoch, predecease me or die on or
Y g my death
I de
i
d
,
v
se an
. bequeath the residue of
my estate, of every nature and wherever situate, as follows:
.~ a. One-fourth 1/4 to
( ) my son, Paul D. Hoch, or his heirs;
~\
~ b. One-fourth (1/4) to my son, Ronald L. Hoch
or his heirs
~ ,
;
(~~ ~ c. One-fourth (1/4) to my son, D4ichael K. Hoch, or his heirs;
` \} ~'
-' ~ d. One-fourth (1/4) to be divided anion
g my five (5) grandchildren,
per stirpes
,
I'~1`~ IV: I nominate and appoint the Farmers Trust Company, Carlisle,
Pennsylvan Tail, rustee of any property of an
be
fi
i
y
ne
c
ar who ma be a minor.
income and/or principal of said trust may be accumulated or expended for the main
tenance, education and sup
ort of
h
p
suc
beneficiary as my Trustee, in its discre-
tion, may determine; and my Trustee, in the e
u
f
for such purposes, may, in its discretion, apply the
same
dire~tly~withoutlthepa
intervention of a guardian
or
h
,
pay t
e same to any person having the care or
control of said beneficiary or with whom the beneficiar
e
on th
id
y r
s
es, without duty
e part of the Trustee to supervise or inquire into application of the funds
by any person to whom any payment is
so made. The balance of such income .and/or
principal shall be paid to such beneficiary upon reaching majority
beneficiar
or to
'
h
,
y
suc
s estate in the event of death prior thereto.
ITEM V: I direct that all taxes that may be assessed in consequence
of my deat of whatever nature and by what
ever jurisdiction imposed, shall be
paid from my residuary estate as a part of the ex
en
f
p
se o
my estate.
the aziministration of
LAW OFFICE6
LANDIS a BLACK Last WilITEM VI. I appoint my wife, Dorothy K. Hoch, Executrix of this, my
~• ~TOUld my wife, Dorothy K. Hoch
fail
E
CARLItLE, -ENNSYLVAN~A ,
to
xecutrix, I appoint my son, Paul D. Hoch c{ualify or cease to act as
, Executor of this
my Last Will.
ITEM VII: I direct that my Executrix or Trustee, or their successors
shall not~equired to give bond for the faithful performance of their duties
~ anY jurisdiction.
~ ,,~Il~i WITNESS WHEREOF, I have hereunto set my hand this ~l'~
/~ -1 1981. day of
~~~ ~ . ~ ~'
Paul M. Hoch ~
The preceding instrument, consisting of this and one other tYPe~'ritten
page, each identified by the signature of the Testator, Paul M. Hoch, was on the
~Y and. date thereof signed, published and declared by Paul M. Hoch, the Testato
therein named, as and for his Last Will, in
the presence of us, who, at his re- ~
quest, in his presence and in the presence of each other, have subscribed our
names as witnesses thereto.
,r ~ ~
LAW OFFIC[6
LANDIS ~ BLACK
~RLIi LE, FENN6YLVA NiA
Page 2 of 2 pages
LAw orr~c[s
LAND16 Q BLACK ~I
I
~'~'~IONGVE~4LTEi OF PEt~1S7'LVANIA )
COIAV'I'Y OF C[IMBERLAND ~ SS.
We, PAUL r1. HOCH
~l1Qrv r- L. Sc ~ ~u2 ~ w-
, ~BF.RT R. BLACK
and
the Testator and. the witnesses, respective:
whose names are signed to the attached or foregoing instrument, bein f'
sworn, do hereby declare to the undersigned authority that the Tes g first duly
and executed the tator signed
instrument as his Last Will, and that he had signed willingly
(or willingly directed another to sign for him), and that he executed '
free and volunta i.t as his
ry act for the purposes therein expressed, and that each of the
witnesses, in the resence and hearin of the Testator si
P g
ness ~ fined the Will as wjt_
and that to the best of his knowledge the Testator was at the time
eighteen years of age or older, of sound mind and 1.mder no constra'
influence. int or undue
Testator au ~ ~
~ ,
Witness ~ (`~ o er
• ac
Sl
ar
RC
wi
~~~ ~
ibscribed, sworn to and acknowledged before
' by PAUL M. HOCfi
~d subscribed and sworn to before~meestator,
BERT R. BLACK d Ska.ran ~ L.
messes, this 2 y of i1~ c ~ ~`~~ .
19 81,
1 ~ ~
,, , ~
' , ,~ ~ Notary ~ lic
1
~ MAF,Y A-~~N G^. P.1AN, Notary Public
' Ca•li~le. Cu~rherland Co., Pa.
~ ~ • My Commission Expires Sept. 19, 19R'~
~~Y
r
r
REV-1547 EX AFP (12-94)
CDMMDNMEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX
BUREAU OF INDIVIDUAL TAXES APpRAISEMENT, ALLONANCE OR DISALLOWANCE
DEPT. 280601
HARRISBURG, PA 17128-0601 OF DEDUCTIONS AND ASSESSMENT OF TAX
ACN 101
~lr~w%~ '
i ,
DATE 09-12-95
DATE OF DEATH 03-06-95 ~~~~ ~ FILE N0. 2 -
000NTY CUMBERLAND
NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS FORM WITH YOUR TAX
PAYMENT TO THE REGISTER OF WILLS. MAKE CHECK PAYABLE TO "REGISTER OF WILLS, AGENT^
REMIT PAYMENT T0:
ROGER B IRWIN
IRWIN ETAL
60 W POMFRET ST
CARLISLE PA 17013
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
Amount R~Inittad
CUT ALONG THIS LINE - RETA_IN LOWER POR_TION_ FOR YOUR RECORDS ~
------------------------------- _
REU-1547 EX AFP (12-94) NOTICE OF INHERITANCE TAX APPRAI8EMENT, ALLOWANCE OR
-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF HOCH PAUL M FILE N0. 21 95-0214 ACN 101
DATE 09-12-95
TAX RETURN WAS: ( )ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Raal Estates (Schadul• A) (1) .00
2. Stocks and Bonda (Sch~dul• B) (2) 441.32
3. Closely Hold Stock/Partnership Intarast (Sch~dula C) (3l .00
4. Mortgages/Notes Recsivabl• (ScMdul• D) (4) .00
5. Cash/Bank Deposits/Misc. Personal Property (Schedule El (57 21.662.76
6. Jointly Ovlned Property (Schedule F) (6) .00
7. Transfers (Schedule Gl (7) .00
8. Total Assets
(8) 22,104.08
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Fungal Expenses/Aden. Costs/Misc. Expenses (Schedule H) (q) 12, 239.59
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10)_ 6.2 02 19
11. Total Deductions
12. Net Value of Tax Return (11) 18.441 78
13. Charitsbl•/Governmental B (12) 3,662.30
equests (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax 3,662.30
(14)
NOTE: if an assessment was issued previously, lines 14, 15 andior 16, 17 and 18 will
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate (15) 3,662.30 X .00_ .00
16. Aslount of Line 14 taxable at Lineal/Class A rate (16) . 00 X .06= . 00
17. Amount of Line 14 taxable at Collateral/Class B rst• (17) .00 X .15. .00
18. Principal Tax Due
TAX CREDITS: (1s) .00
PAYMENT RECEIPT DISCOUNT (t)
DATE NUMBER 2NTEREST (-) AMOUNT PAID
05-31-95 AA047827 .00
104.38
TOTAL TAX CREDIT 104.38
BALANCE OF TAX DUE 104.38CR
INTEREST .00
TOTAL DUE 104.38CR
* IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED.
cno rAi nu ATTnAI nc AnflTTTflNAI TNTFpFCT TF TOTAI n11F TS RFFI FCTFn AR A ^rRFOTT^ lCRI . VO11 MAV BE DUE
_. -- -.
RE V~1d70 EX 16-BBI
COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX
DEPARTMENT OF REVENUE EXPLANATION
BUREAU OF INDIVIDUAL TAXES OF CHANGES
DEPT. 280601
HARRISBURG, PA 1 7 1 2 8-060 1
DECEDENT'S NAME
j-<<iw,~_ ^' k:uCh FILE NUMBER
2i~;5--O~i~1
ACN
SCHEDULE ITEM ; ~~ ~
NO. EXPLANATION OF CHANGES
.~~ct ?1 of 1935 reduced thr tt~x rar_~.~ on transom ers to a su
1'YQ?; "~ ~c rCt?R!: t0 l) :. 7" _... rvl_plrtjs'.. SYGllSE'
c a5
~. .cent for ~'at~s of ~leatt~ on. or aft~>r J^nuary I,
}, 1'ti,- ~statc- record h;~s b~r~n
<:d~ustetl_ i;~ recaraanc~> w:.t~~ t_he chang~~G,
TAX EXAMINER: i?-ate i.ei I~_ ~„ j 1,„~,n
PAGE