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Home My WebLink About01-03-12 15056051047 REV-1500 EX (06-05) PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes Coun Code Year File Number ~ Po sox 2sosol INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 2 1 1 2 0 6 2 8 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 0 1 2 6 2 0 1 2 0 4 0 3 1 9 2 7 Decedent's Last Name Suffix Decedent's First Name MI G o r i 1 R o b e r B. (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI G'o r i 1 R o s e A. Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW 1. Original Return O 2. Supplemental Return O 3. Remainder Return (date of death ' prior to 12-13-82) O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required death after 12-12-82) ~ 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust ~ 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number A n t h o n y L." D e L u c a E s q. 7 1 7 2 5 >g; 6 8 4 4 Firm Name (If Applicable) First line of address 1 1 3 F r o n t Second line of address P O B o x 3 5 8 Ciry or Post Office B o i l i n"g S p r i n g s S t r e e t Correspondent's a-mail address State P A ZIP Code ~~ ~ G~TER OF _ S U~j ~ :.r3 ~ ~ 4'> ~'S n'1 ~ t7 n ~7 y, t" ~-'' Cf3 JC7 ...~ t~ ~, .. r e ,. ~ f ~., ,. C'.',1 " c .... . ~., ~ ' DATE FILED ¢"`" • . J '' t -~ `YT 1 7 0 0 7 Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGN E OF PERSON RESPONS E FOR FILING RETURN DATE ~j ~/J~ ~ ADDRc--SLR .////a~~"I'9'~ !/!~ ~~ ~C~y~-/, .sue-- ~G. /'>u~ 3 SIGNATUgE OF 15056051047 PL A USE ORIGINAL FORM Side 1 DATE ~ / ~?f • , LY t 15056051047 J D~ J REV-1500 EX Decedent's Name: RECAPITULATION 15056052048 Decedent's Social Security Number 1. Real estate (Schedule A) . .......................................... .. 1. 0 • 0 0 2. Stocks and Bonds (Schedule B) ..................................... .. 2 1 0 , , 7 ? 5 ' 1 4 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ... .. 3. 0 . 0 0 4. Mortgages & Notes Receivable (Schedule D) ........................... .. 4. 0 ~ 0 0 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ...... .. 5. 0 ~ 0 0 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ..... .. 6. 0 .0 0 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested...... .. 7. 0 +r 0 0 - 8. Total Gross Assets (total Lines 1-7) .................................. .. 8. 1 0 ~ 7~ 2' Sw 1 ~ 9. Funeral Expenses & Administrative Costs (Schedule H) ................... .. 9. 6 1 5 • 5 0 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............. .. 10, 0 •' 0 0 11. Total Deductions (total Lines 9 & 10) ................................ ... 11. 6 1 5 5 0 12. Net Value of Estate (Line 8 minus Line 11) ........................... ... 12. 1 O , 1 O 9. 0 4 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ..................... ... 13. 0 • 0 0 14. Net Value Subject to Tax (Line 12 minus Line 13) ..................... ... 14. 1 0 , 1 0 9 s 6 4 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0_ 1 0, 1 0 9.6 4 15. 0. 0 0 16. Amount of Line 14 taxable at lineal rate X .0 _ • 16. • 17. Amount of Line 14 taxable at sibling rate X .12 . 17. 18. Amount of Line 14 taxable at collateral rate X .15 ' ~ 8. ` 19. TAX DUE ...................................................... ...19. 0 a 0 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 15056052048 15056052048 REV•7503 E%+(1-97) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERfrANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Robert B. Goril 21-12-0628 All property jointty-owned with right of survivorshtp must be dlscbsed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 526 Shares of Sun Life Financial Common Stock $10,725.14 @ $20.39 per share TOTAL (Also enter on line 2, Recapitulation) I $ 1 0 , 7 2 5. 1 4 (If more snare is needed. insert additional sheets of the same size) REV•1511 EX+ (10-06) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF ITEM NUMBER A. FUNERAL EXPENSES: 1. B. 1 z. 3. 4. 5. 6. ~. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Sheet Address City State Year(s) Commission Paid: Attorney Fees Anthony L. DeLuca, Esquire Family Exemption: (If decedent's address is not the same as claimanl's, attach explanation) Claimant Street Address City State _ Relationship of Claimant to Decedent Probate Fees Accountant's Fees Tax Return Preparer's Fees Filing Fee Inheritance Tax Return Zip $500.00 Zip 100.50 15.00 TOTAL (Also enter on line 9, Recapitulation) $ 61 5.50 (If more space is needed, insert additional sheets of the same size) Robert B. Goril Debts of decedent must be reported on Schedule I. FILE NUMBER 21-12-0628 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-1 2-0628 DECEDENT'S NAME Robert__B, Goril - TREETADDRESS _ -- --- 30 >lcloongale Drive - - - --- -- STATE - -- ---- ZIP---...----- Carlisle, pA 17013 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) - 0 - 2. Credits/Payments A. Spousal Poverty Credit - 0 - B. Prior Payments _ ~ _ . Discount -Q- __ _ . --_ - - - - Total Credits (A + g + C) 3. Interest/Penalty if applicable (2) - 0 - D. Interest E. Penalty -- Total Interest/Penalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (3) _ 0 _ Fill in oval on Page 2, Line 20 to request a refund. (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) - 0- A. Enter the interest on the tax due. (5A) - 0 _ B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) - 0 _ Make Check Payable to: REGISTER OF WILLS, AGENT . ~ ., PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred :.......................................................................................... ^ 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 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" or payable upon death bank account or security at his or her death? .............. ^ X^ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. §9116 (a) (1.1) (ii)J. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116(a)(1.3)J. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. r•. , O ~, LAST WILL AND TESTAMENT ~St_-._.. c.- In `'~ _~ T. _.. ~~ 171 xr. ?.i J ~~ ~. !'r ~„~ b ~ ' '=i 1 ` c._: :~:.,, ~' ROBERT B. GORIL ~=y c„~ =~ %- --. .~- ~n I, ROBERT B. GORIL, a resident of Carlisle, Cumberland County, Pemisylvania being of sound mind, memory and understanding, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils heretofore made by me. ITEM 1: I direct that all my just debts, the expenses of my last illness and funeral expenses be paid as soon after my decease as the same can conveniently be done. ITEM 2: I direct that there shall be paid out of my residuary estate all estate, inheritance and like taxes together with anv interest or penalty thereon imposed by the government of the United States, or any state or territory thereof, or by any foreign government or political subdivision thereof; in respect to all property required to be included in my gross estate for estate, inheritance or like tax purposes by any of such governments, whether the property passes under this Will or otherwise, excluding, however, any property over which I have a taxable power of appointment, provided, however, that no residuary beneficiary shall by reason of this provision be denied the benef t of any deduction, credit, favorable rate of tax or other benefit which by law enures to such beneficiary. ITEM 3: I give, devise and bequeath all of the rest, residue and remainder of my estate, real, personal and mixed, of what,~oever kind and natwe, and wheresoever situate _.- ~~ . ROBERT B. GORIL 1 LAST WILL AND TESTAMENT OF ROBERT B. GORIL at the time of my death, unto my wife, ROSE ANN GORII,, provided, however, that she survives me and is living sixty (60) days after the date of my death. ITEM 4: If and in the event that my wife, ROSE ANN GORIL, does not survive me and is not living sixty (60) days after the date of my death, then and in such event, I give, devise and bequeath all of the rest, residue and remainder of my estate, real, personal and mixed, of whatsoever kind and nature, and wheresoever situate at the time of my death, in equal shares, unto my children, CHRISTINE A. LASKiN and ROBERT T. GORIL, provided however, that they survive me and are living sixty (60) days after the date of my death. ITEM 5: If and in the event that a child of mine does not survive me and is not living sixty (60) days after the date of my death, then and in such event, I give, devise and bequeath the interest in my estate, which such deceased child would have received, if living, to the issue of said deceased child, per stirpes. If and in the event that any issue of a said deceased child is a minor at the time of my death, then, and in such event, I direct that any share of my residuary estate bequeathed to said minor issue of my deceased child be placed in a restricted savings account or Certificate of Deposit at Members 1 sc Federal Credit Union until said minor ._, -~ ~~1.~,-~=~. ROBERT B. GORIL 2 LAST WILL AIV'D TESTAMENT OF ROBERT B. GORIL child attains the age of twenty-five (25) at which time the proceeds shall be disbursed to said grandchild. All interest earned until age twenty-five (25) shall be added to the principal. Invasion of the principal shall only be permitted to maintain such child in the proper station in life, including proper support, maintenance, medical care and college or higher education, including vocational school. ITEM 6: I hereby nominate, constitute and appoint my wife, ROSE ANN GORIL, Executrix of this my Last Will and Testament, with full power to do any and all things necessary for the complete administration of my estate, and direct that no bond or other surety is required of her in this or any other jurisdiction for her performance of this office. If and in the event that my wife, ROSE ANN GORIL, does not survive me and is not living sixty (60) days after the date of my death, or does not complete her duties as Executrix, then and in such event, I hereby nominate, constitute and appoint my children, CHRISTINE A. LASKIN and ROBERT T. GORIL, Co-Executors of this my Last Will and Testament, with full power to do any and all things necessary foi- the complete administration of my estate, and direct that no bond or other surety is required of them in this or any other jurisdiction for their performance of this office. ROBERT B. GORIL 3 LAST WILL AND TESTAMENT OF ROBERT B. GORIL ITEM ?: If any provision of this Will or of any Codicil hereto is held to be inoperative, invalid or illegal, it is my intention that all the remaining provisions thereof shall continue to be fully operative and effective, so far as is possible and reasonable. IN WITNESS WHEREOF, I, ROBERT B: GORIL, the Testator, have to this my Last Will and Testament, typewritten on four (4) consecutively numbered pages, subscribed my name and affixed my seal thi` day of /~'~c~~~. ~ 2008. ;~~~~~%5~,:~~~ (SEAL) ROBERT B. GORIL Signed, sealed, published and declared by the above named ROBERT B. GURIL, as and for his Last Will and Testament, in the presence of us, who have hereunto subscribed our names at his request, as witnesses hereto, in the presence of the said Testator, and of each other. /R a :~.r S s...,, ~ .. wL ~4 esidin at ,G~ t ~_ r ~ o /'~~ .~ ~ 3 u.~4<-residin at j, / ~ G' ¢.. r~ ~' ~ 4 1 ~~~ ~ ~~ ~'I Z I~ ~r