The URL can be used to link to this page

Home My WebLink About01-25-13--~ REV-150~~`t°'-'0l 15U561C143 PA De aAmr;;, of Revenue OFFICIAL USE ONLY p 't panttsyivdnia County Code veer Fne NUmDer Bureau of Individual Taxes ~raArarNrcFee:reerv~ PO 80X.280801 INHERITANCE TAX RETURN 2 1 12 0 4 5 8 Harrisburg, PA 17128.0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Dale of Death Date of Birth 168 24 4071 04 01 2012 11 13 1931 Decedent's Last Name Suffix Decedent's First Name MI COOPBR EVA R (ff Appiicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Stscuriy Number THIS RETURN MUS7 BE F{LED fN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ® 1. Original Return ^ 2. Supplemental Return ~] 4. Limited Estate ^ qa. Fuwre Imerest CamP~ae tdale d mam eNar 12-12-92) ® g_ Decedent Died Testate ^ n~Ma1~tT ad a LWmg Trust T, A se a innaen COPY W Will) ) h ( ^ 9. Litigation Proceeds Received ^ 10. be~np2 31-91 a Edt(tli 99j~ deaN State ZIP Coda PA 17032 CORRESPONDENT - 7HlS SECTION MUST BE COMPLETED. ALL CORRE6PONDENCE AND CONFIDENTIAL TAX INFORMATIONI,SHOULD BE DIRECTED TO: Name Daytime Telephone Number ROBERT G RADEBACH 717 896 ~:6bb _ First ilro of address 912 NORTH RIVER ROAD Second Ilne of address City Sx Post Office HALIFAX Correspanden!'s a-mail G 824 swartz5l Qaol.com 3. Remainder Return (date of death prior a 72-13-82] ^ 5. Federal Estate Taz Return Required w_ ._ 8. Total Number of Sate Deposit Bones ^ 11. Election to tax under Sec, 8113(A) t~,1,4DER OF V~.S U86tO~Y v ~ m s c> in ~r ~ ~,• r- rya rr~ r 7 D ~ 'il c.n ~ %a ~ ~= 7'c Ott l7 ti:7 ~ '~ ~ "ri . C? C _. a? -f DATE FI D C"' ~ A -~ re toed Nis raw mduding eccompanying schedules and statements, rer other than t e perawtal repreaentativa is based on all information RETURN Dianna L. Bentz PA 17043 ITATNE Robert G Radebach -~3 -/3 nooRESS ~ ~ ~ ~ 912 North River Road, Halifax, PA 17032 Side 1 1505610143 1505610143'.. // " 1505610243 REV-1500 EX Decedent's 3odal Security Number o~•.eaa,r=~~ COOPER, EVA K. 16 8 2 4 4 0 71 RECAPfTULATION 1. Real Estate (Schedule A) .......................................................................................... 1. 1 S O, 5 31.8 3 2. Stocks and Bonds (Schedule B) ............................................................................... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C).......... 3. 4. Mortgages & Notes Receivable (Schedule D) .......................................................... 4. 5. Cash, Bank Deposits i;< Miscellaneous Personal Properly (Schedule E) ................ 5. 2 0 8 , 1 8 6 . 6 4 6. Jointly Owned properly (Schedule F) ^ Separate Billing Requested ............. 8. 7. {nter-Vwos Transfers & Miscellaneous Non-Probate Property (Schedule G) ^ Separate Billing Requested ............. 7, 8, Total Grose Assets (total Lines 1-7) ....................................................................... 8. 3 5 8 , 7 18.4 7 9. Funeral Expenses & Administratlve Costs (Schedule H) ......................................... 9. 3 6 , 2 1 0 . 7 3 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule 1) ................................ 10. 2 4 , 0 6 8 . 0 2 11. Tatal Deductions (total Lines 9 & 10) ...................................................................... 11, 6 5 , 2 7 8 . 7 5 12. Net Value of Estate (Line 8 minus Line 11) ............................................................. 12. ~ 9 3 , 4 3 9 . 7 2 13. Charitable and Govemmentel Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ................................................. 13. 14. Nat Value 8ubjeet to Tax (Line 12 minus Line 13) ................................................. 14. ~ 9 3 , 4 3 9 . 7 2 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (ax1.2) X .00 15. 16. Amount of Line 14 taxable at linea~rateX .045 293, 439.72 15. 13, 204.79 17. Amount of Line 14 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable at collateral rata X .15 18. 19. Tax Due ..................................................................................................................... 19. 1 3, 2 0 4. 7 9 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 L 1505610243 150561024!3 REV-1500 EX Page 3 Decedent's Complete Address: Ftle Number Z1 - 12 - 0458 Cooper, Eva K. STREET ADDRESS 520 Orrs Bridge Road CITY Camp Hill STATE PA ZIP 17011 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. CreditslPaymenis A. Prior Payments 13,550.00 B. Discount 660.24 3. Interest 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 2 Lino 20 to regwst a refund 5. If Line 1 + Line 3 Is greater than Line 2, enter the difference. This is the TAX DUE. (1) 13,204.79 Total Credits (A + B} (2) 14, 210.24 (3) 0.00 (a) 1,005.45 (5) 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 ro P Pent transferred :.................................................................................. x b. retain the right to designate who shall use the property transferred or its income :.................................... c. retain a reversionary Interest: or .................................................................................................................. x d. receive the promise for life of either payments, benefits or care? ........................................ .. ... . ....... ... x ... 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 deattl?......... 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a benefidary designation? ..........................................................................................................:........... ^ IF THE ANSWER TO ANY OF THE ABOVE l]UESTIONS 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 Jan. 1, 1995, the tax rate imposed on the net value of transfers to br for the use of the surviving spouse is 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 urviving spouse is 0 percent p2 P.S. §9116 (a) (1.1) `ri)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory rer~uirements for disdosure of assets and filing a tax return are still applicable even if the surviving spouse is the only benefidary. For dates of death on or after July 1, 2000: • The tax rate Imposed on the net value of transfers from a deceased child 21 rs 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 0 percent p2 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 4.5 percent, except as noted in 72 P.S. §9116 1.2)172 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 12 percent [72 P.S. §91 ~6 (a) (1.3)1. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, ether y blood or adoption. COMMONWEALTH OF PENNSYLVANIA NHERRANCE TA%RETURN RESDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER Cooper, Eva K. 21 - 12 0458 All roal propeRy owned solely or as a tenant in common must be reported at fair market valor. Fair ma et value Is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on schedule F. Attach a Dopy of the settlement shcet ifthe property has been sold. Include a copy of fhe deed showing decedent's interestrf owned as tenant in common. ITEM DESCRIPTION VALUE AT DATE OF NUMBER DEATH 1 Reai Estate - 520 Orr's Bridge Road, Camp Hill, PA 17011 149,000.00 2 Real Estate Taxes -Proration to Seller from Closing of Property 1,531.83 TOTAL (Also enter on Lina t, Recapitulation) ', 150,531.83 SCHEDULE E CASH, BANK DEPOSITS, & MISC. COAfgNWEALTi of PENNSVLVANw PERSONAL PROPERTY MNERRANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ESTATE OF Cooper, Eva K. 21 - 12 - 0458 Indude the pproceeds of Iltigation and the date the proceeds were received by the estate. All property jointly-oy~rned with the right of survivonahlp must be disclosed on sehadule F. ITEM DESCRIPTION NUMBER 1 2005 Toyota Camry -Sold to Robert Huber 2 Integrity Bank Savings Account ' 3 Integrity Bank Checking Account 4 Patriot News Refund 5 AARP Refund 6 AARP Auto Insurance Refund 7 Misc. Cash 8 The Ohio National Life Insurance Company -Annuity -Contract #: E1238308 9 The Ohio National Life Insurance Company -Annuity -Contract #: E1461804 10 SunL'rfe Financial Annuity -Contract #: 77-7700-886285 11 United Healthcare Insurance Gompany 12 Cash Paid by George Bentz for Samsung TV 13 PA Rebate Refund 14 Savings Bond 15 Auction of Furniture and Personal Items 16 SunLffe Annuity Checks VALUE AT DATE OF DEATH 16,000.00 25,681.90 8,780.54 371.15 44.94 103.20 30.00 41,215.08 55,773.74 57,414.71 26.60 500.00 250.00 34.84 1,559.94 400.00 TOTAL (Also enter on Line S, Recapitulation) ', I 208,188.64 coNrAONwEUrH or aENNanvANw INHFARANCE TAx RETURN RE8IDENT DECEDENT SCFF.DULE H FUNEJiAL E~BV3ES 8~ ADAIwSTRATNE C05TS ESTATE OF Cooper, Eva K. FILE NUMBER 21 - 12 - 0458 Debts of decedent must be reported on Schedule 1. ITEM NUMBER FUNERAL EXPENSES: DESCRIPTION AMOUNT A. 1 Rolling Green Cemetery -Burial Plot 3,560.00 2 Rolling Green Cemetery -Memorial Marker 1,698.90 3 Meyer-Harner Funeral Home 11,443.00 4 Peeler's Flowers -for Services 275.55 5 West Shore Country Club -Funeral Luncheon 1,008.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Dianna L. Bentz 14,000.00 street Address 824 Indiana Avenue city Lemoyne state PA zip 17043 Year(s) Commission paid 2. Attorneys Fees Robert G. Radebach, Esquire 3. Family Exemption: (If decedent's address is not the same as Gaimant's. attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees Fee to Open Estate -Register of Wills 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 1 Advertising Fee -Cumberland Law Journal 3,500.00 435.50 75.00 TOTAL (Also enter on line 9, Recapitulation) 36,27 0.73 C St~ed~ieHH COMMONWEALTH OF PENNSYLVANIA r~'-~""`^~ INHERITANCE TAX RETURN ~ C~1~ wFCIIYUT ficrCKUi E8TATE OF Cooper, Eva K. FILE NUMBER 21 -12 -0458 2 Advertising Fee -The Sentinel 210 78 3 Register of Wills - Short Certificate 4.00 Page 2 off Schedule H SCHEDULEI DEBTS OF DECEDENT, MORTGAGE CDAIAONWE~LTH OF PENN8YLVANIA LIABILITIES, ~ LIENS INHERffANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Cooper, Eva K. 21 -12 - 0458 Report debts incun-ed by the decedent prior to death that remained unpaid at the date of death, inciuding unreirhbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1 Notary Fees from Closing of Real Estate 10.00 2 Tax Cert~cation Fees from Closing of Real Estate 50.00 3 2012 School Taxes 1,720.45 4 Sewer Charges from Closing of Real Estate 155.00 5 2012 County-Township Real Estate Taxes 440.25 6 AARP Automobile Insurance 194 20 7 Trugreen -Lawn Maintenance 119.99 8 Blue Jay Services -Lawn Maintenance 413.40 9 Comcast 25.17 10 Hampden Township -Sewer 8 Trash 155.05 11 Pennsylvania American Water Company 176.32 12 Shellys Plumbing 295.00 13 Larry Hughes -Repair Kitchen Ceiling 100.00 14 AARP Homeowners Insurance 85 ~ 15 Goodwill Shredding 6.00 16 Appraisal -Michael R. Ent 200.00 TOTAL (Also enter on Line 10, Recapitulation) , 29,06ti.02 COMADNWEILTH OF PENNSYLVANIA NNERRANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES, 8 LIENS continued ESTATE OF COOp6r, Eva K. FILE NUMBER 21-12-0458 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreiiinbursed medical expenses. ITEM NUMBER DESCRIPTION 17 Automobile Inspection -Tires Plus 18 Automobile Repair - Rahal Toyota 19 Verizon 20 PPL Utilities 21 United States Treasury for 2011 Income Tax Payment 22 Postage Paid by Executor 23 Reserve for Federal Income Tax Liability on Annuities 24 Reserve for Income Tax Preparation AMOUNT 48.88 53.58 40.63 570.95 885.00 23.15 23,000.00 300.00 Page 2 of Schedule I REV-1513 EX. (11-00) ~ SCHEDULE J COMMONWEALTH of PENNSriVANIA INHERfrANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF Cooper, Eva K. FILE NUIWBER 21 - 12 - 0458 NUMBER NAME AND ADDRESS OF PERSON(S) RELATIONSHIP TO DECEDENT SHARE OF ESTATE (Words) AMOUNT OF ESTATE ($$$) RECEIVING PROPERTY Do Not LIU Tn/~s) I, TAXABLE DISTRIBUTIONS [nGude outright spousal distnbutions, and transfers under Sec. 9116 (a) (1.2)j 1 Dianna L. Bentr Daughter 1/3 of the residue 824 Indiana Avenue Lemoyne, PA 17043 2 Debra L. Buttorff Daughter 1/3 of the residue 630 Allen Street New Cumberland, PA 17070 3 Bruce W. Bentr Son 1/3 of the residue 529 Lamp Post Lane Camp Hi11, PA 17011 Enter dollar amounts for distributions shown above on lines 1 5 through 18 on Rev 15tH) cover sheet, as appropdate. III NON-TAXABLE DISTRIBUTIONS: A SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 LAST WILL AND TESTAMENT OF EVA K. COOPER -_~ • ; ~ r- T m -- _ _ ; ' y~,.~- l.. ~T~ I, EVA K. COOPER, now domiciled in Cumberland County, Pennsylvania, declare this to be my Last Will. I revoke all other Wills and Codicils that I may have previously made. Article I My just debts and expenses of my last illness, funeral, and administration of my estate shall be paid by my Executor from the principal of my residuary estate as soon as practicable after my death. Article II All inheritance, estate, and succession taxes (including interest and penalties thereon, but not including any generation skipping tax) payable by reason of my death shall be paid out of and be charged generally against the principal of my residuary estate without reimbursement from any person. This provision is not a waiver of any right which my Executor has to claim reimbursement for any such taxes which become payable as the result of any property over which I have the power of appointment. ~ ~C Article III I give, devise and bequeath my tangible personal property in accordance with any memorandum I have either handwritten or signed, located with my Will or with my valuable papers and found within 30 days of the probate of my Will. Gifts may only be to persons who survive me or to organizations which exist at my death, and if there is a conflict, the memorandum having the latest date shall govern. To the extent no such memorandum is found, or all of my tangible personal property is not disposed of pursuant thereto, my tangible personal property shall be added to my residuary estate and pass under Article IV hereof. Article IV All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate, I give, devise and bequeath in equal shares, to my daughter, DIANNA BENTZ, of Cumberland County, Pennsylvania; my daughter, DEBRA BUTT~RFF, of Cumberland County, Pennsylvania; and, my son, BRUCE W. BENTZ, of Cumberland County Pennsylvania. However, if a beneficiary does not survive me by thirty (30) days, but leaves descendants wino survive me by thirty (30) days, those descendants shall receive, Per Stirpes, the share the beneficiary would have received had he or she survived me by thirty (30) days. The share of any deceased child who does not have living issue shall be divided and distributed to my surviving children. _z_ K~ L Article V I nominate, constitute, and appoint my daughter, DIANNA BENTZ, Executrix of my Last Will and Testament. In the event of the renunciation, death, or inability to act, for any reason whatsoever of my Executrix, I nominate, constitute and appoint my son, BRUCE W. BENTZ, successor Executor of my Last Will and Testament. I direct that my Executrix or successor Executor be permitted to serve without bond. In addition to those powers granted by law, I gent them power to distribute in cash or in kind, in like or in unlike shares, and to file any qualifieddisclaimer I could have filed if living. My Executrix or successor Executor shall receive reasonable compensation for services rendered to my estate. Article Vl In addition to the powers conferred bylaw, I authorize my Executrix or successor Executor in his/her absolute discretion: (a) to retain in the form received and to sell either at public or private sale, any real estate ar personal property except that which I speciftcally bequeath herein, (b) to manage real estate, (c) to invest and reinvest in all forms of property without being confined to legal investments, and without regard to the principal of diversification, (d) to exercise any option or right arising from the ownership of investments, {e) to compromise claims without court approval and without consent of any beneficiary, ~~ _3_ (f) to file any federal income tax return for any year for which I have not filed such return prior to my death, (g) to make distributions in cash or in kind, or in both, and to determine the value of any such property, (h} to employ any attorney, investment advisor, or other agent deemed necessary by my Executor; and to pay from my estate reasonable compensation for all their services, (i) to conduct alone or with others, any business in which I am engaged in, or have an interest in at time of my death, and (j) to receive reasonable compensation in accordance with their standard schedule of fees in effect while their services are performed. IN WITNESS WHEREOF, I, EVA K. COOPER, hereby set my hand to this my Last Will and Testament, on ~ C ~. , , 2005, at Harrisburg, Pennsylvania. EVA K. COOPER In our presence, the above-named EVA K. COOPER signed this and declared this to be her Last Will and now at her request, in her presence, and in the presence of each other, we sign as witnesses. Name Address n ~ "~ t, t 1(~~t~k.A.i;t~ Jh ~~ ~ %itil b„l~ l 2000 Linelestown Rd., Suite 202, Harrisburg, PA 17110 '~0~1~..c.c:~~~~. ~~(~~ ' _y~ 2000 LinQlestown Rd., Suite 202, Harrisburg, PA 17110 ~~~ 4 I, EVA K. COOPER, Testatrix, who signed the foregoing instrument, having been duly qua]ified according to law, acknowledge that I signed and executed this instrument as my Will, and that I signed it willingly as my free and voluntary• act for the purposes therein expressed. Sworn to or affirmed and acknowledged before me by EVA COOPER the Testatrix, on _ . _~____, 2005. ,~ otary Public l _ __.__ _ __ _...__._.-- r EVA K. COOPER F We, the undersigned witnesses who signed the foregoing instrument, being duly qualified according to law, depose and say that we were present and saw the Testatrix sign and execute this instrument as her Will; that she signed and executed it willingly as her free and voluntary act for the purposes therein expressed; that each of us in her sight and hearing signed the Will as witnesses, and that to the best of our knowledge, that she was at that time eighteen (18) years our more of age, of sound mind, and under no constraint or undue influence. Sworn to or affirmed and subs ribed to before me and; _ ~ ~CYl - ~}. ~6~~Lr~, witnesses, on C.:_.Lr,$r'~- `c~ , 2005. ~/ t Not ry Pu i r _"~ C:i)F..1`A~:;";":t,~L.'!i O: FF.P1~iS'~?V.~fllp Notarial Sea! Ml:triclle F'. Flazen, Notary Public Susquehanna Twp.. Dauphin Count• My C'ca+mission Expires Sept. 23, 206 _. i:~rr~,;;c,avti.~_~rx c; Pc~.NNSrt,i>.~,i•It~. ~~-w~~ Notariail Seat Public M11arielle F. Flaxen. Not ~ +~ n County 1 Susquehanna Twp.. ~~ t 23. 2006 M1y Com+n+ssion Exgtres P C'`~ C`,c~-~,~.~.~.-1~-~, ~-l` ~ ~~ kl~e~~ Witness i~, Witness ~~~ _5_