HomeMy WebLinkAbout03-01-13J 1505610105
REV-1500EX(oz_ii)(FI) ~
OFFICIAL USE ONLY
PA Department of Revenue Pennsylvania Coun Code Year File Number
Bureau of Individual Taxes °` ~"'"`"'°`"`°`"°` ~
PO BOX z8o6o1 ~ INHERITANCE TAX RETURN
Harrisburg, PA i~i28-06oi RESIDENT DECEDENT 21 ' 12 :0677
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
' 05/29/2012 02/27/1954 '
Decedent's Last Name Suffix Decedent's First Name MI
CEKOVICH JR. JOSEPH. _
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
_ REGISTER OF WILLS
FILL INAPPROPRIATE OVALS BELOW
QD 1. Original Return O 2. Supplemental Return O 3. Remainder Return (Date of Death
O 4. Limited Estate
OD 6. Decedent Died Testate
(Attach Copy of Will)
O 9. Litigation Proceeds Received
O 4a. Future Interest Compromise (date of
death after 12-12-82)
O 7. Decedent Maintained a Living Trust
(Attach Copy of Trust.)
O 10. Spousal Poverty Credit (Date of Death
Between 12-31-91 and 1-1-95)
Prior to 12-13-82)
O 5. Federal Estate Tax Return Required
~ 8. Total Number of Safe Deposit Boxes
O 11. Election to Tax under Sec. 9113(A)
(Attach Schedule O)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name.. _ _ Daytime~elephone Nurnb~r
„_ ~
Keith 0. Brenneman, Esq. (717) ~8~8528 ~~ ~r i
__ ..... ,a7 _ .-3 ~~ r-,
First Line of Address
44 W. Main Street
Second Line of Address
City or Post Office.
Mechanicsburg
State ZIP Code
PA + 17055
Correspondent's a-mail address:
ISxEI~'dF WIL USL'' NF~'y
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C.O n
DATE FILED
~~ ar penaiaes or pequry, i aeaare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief,
it tr rcect and corn te. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
S NA OF P~ O E ~LE FOfi~F*ING RETURN DATE
ADDRESS
8 Briarwood Court, Mechanicsburg, PA 17050
SIGCVA E OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS a~a ~~~3
44 W. Main Street, Mechanicsburg, PA 17055
PLEASE USE ORIGINAL FORM ONLY
Side 1
L 1505610105 1505610105 J
J
REV-1500 EX (FI)
decedent's Name: JOSEPH CEKOVICH, JR.
Decedent's Social Security Number
.
ZEGAPITULATION
1. Real Estate (Schedule A) ............................................. 1.
2. Stocks and Bonds (Schedule B) ....................................... 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3.
4 Mort a d N t
g ges an o es Receivable (Schedule D) ..................... ...... 4.
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E). ...... 5. 317,417.85
6. Jointly Owned Property (Schedule F) O Separate Billing Requested . ...... 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) O Separate Billing Requested.. ...... 7.
8.
Total Gross Assets (total Lines 1 through 7) .......................
...... 8. __.
317,417.85 '.
9. Funeral Expenses and Administrative Costs (Schedule H) ............. ...... 9. 14,668.11
10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) ......... ...... 10. ' 4,988.27
11. Total Deductions (total Lines 9 and 10) ........................... ...... 11. 19,656.38
12. Net Value of Estate (Line 8 minus Line 11) ........................ ...... 12. ' 297,761.47
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which i
an election to tax has not been made (Schedule J) .................. ...... 13.
14. Net Value Subject to Tax (Line 12 minus Line 13) .................. ...... 14. ' 297,761.47
TAX CALCULATION -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_
16. Amount of Line 14 taxable ~~~ ~ " ~~ ~ ~~" ~ ~ ~ ~~~
at lineal rate X .0 45 212,049.17
17. Amount of Line 14 taxable
at sibling rate X .12
18. Amount of Line 14 taxable
at collateral rate x .15 85,712.30
15.
16.
17.
18.
19. TAX DUE .........................................................19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
L 150561~~4
1505610205
1505610205
9, 542.21
12,856.85
22,399.06
O
REV-1500 EX (FI) Page 3
Decedent's Complete Address
File Number
DECEDENT'S NAME
Joseph Cekovich, Jr.
STREET ADDRESS - - ----
6010 Mockingbird Drive
CITY
Mechanicsburg STATE ZIP
PA 17050
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19) (1) 22,399.06
2. Credits/Payments
A. Prior Payments _. 21,000.00
B. Discount _ 1,105.23
Total Credits (A + g) (2) 22,105.25
3. Interest
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (3)
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) 293.81
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 .............................................................................................................................. ^
d. receive the promise for life of either payments, benefits or care? ...................................................................... ^
2. If death occurred after Dec. 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? .............. ^
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 Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
is 3 percent [72 P.S. §9116 (a) (1.1) (i)j.
For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 P.S. §9116 (a) (1.1) (ii)]. 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 21 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 0 percent [72 P.S. §9116(a)(1.2)j.
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(a)(1)j.
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. §9116(a)(1.3)j. Asibling is defined,
under Sectiee 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-i5o8 EX+ (D8-12)
Pennsylvania SCHEDULE E
ail DEPARTMENT OF REVENUE CAS~"~~ BANK DEPOSITS & MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
JOSEPH CEKOVICH, JR. 21-12-0677
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER VALUE AT DATE
DESCRIi'TION OF DEATH
1. Members 1st F.C.U. savings account 193565-00 88.65
2. Members 1st F.C.U. Investment Savings account 193565-05 59.65
3, Orrstown Bank checking account 111000839 7,629.51
4. Orrstown Bank Money Market account 111001357 10,186.91
5, Orrstown Bank Savings account 711000677 254,253.13
g, 1989 DeRose home, Vehicle Identification No. D1229312 (assessed value) 32,700.00
7. 1993 Ford conversion van
1, 500.00
g, 2008 Ford Escape
10, 000.00
g, Storage vanltrailer
1, 000.00
TOTAL (Also enter on Line 5, Recapitulation) $ I 317,417.85
If more space is needed, use additional sheets of paper of the same size.
REV-1511 EX+ (10-09)
' ~ i Pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
JOSEPH CEKOVICH, JR.
SCHEDULE H
FUNERAL EXPENSES AND
ADMINISTRATIVE COSTS
FILE NUMBER
21-12-0677
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER
A• FUNERAL EXPENSES:
I' Myers - Buhreg Funeral Home
Mechanicsburg Club -luncheon/wake
B. ADMINISTRATIVE COSTS:
i. Personal Representative Commissions:
Name(s) of Personal Representative(s) Nicholas J. Cekovich
Street Address 8 Briarwood Court
city _ Mechanicsburg state PA zIP 17050
Year(s) Commission Paid: 2013
2. Attorney Fees:
3• Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.)
Claimant
Street Address
City __ _ State
Relationship of Claimant to Decedent
4.
5.
6.
~.
ZIP
AMOUNT
4,297.00
1,651.21
3,500.00
3, 500.00
Probate Fees:
Accountant Fees;
Tax Return Preparer Fees:
Advertise Grant of Letters: Cumberland Law Journal:
Advertise Grant of Letters: The Sentinel
TOTAL (Also enter on Line 9, Recapitulation) I $
If more space is needed, use additional sheets of paper of the same size.
423.50
1,000.00
75.00
221.40
14,668.11
REV-1512 EX+ (12-08)
~l Pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDE{~4T
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
ESTATE OF
JOSEPH CEKOVICH, JR. FILE NUMBER
21-12-0677
Report debts incurred by the decedent prior to death that remained unpaid at the dat e of death, including unreimbursed medical expenses.
ITEM
NUMBER
DESCRIPTION VALUE AT DATE
OF DEATH
i. Lot Rent and water service charges
payment on account
, 719.89
2. Comcast, payment on account ~ 79 77
3. Verizon wireless, payment on account 169.85
4. PP&L - payment on account 245.27
5. Quantum Imaging, payment on account 337.00
6. Spirit physician Services - payment on account 1,470.00
7. Wright Express - payment on account 147.51
8. Verizon (land line), payment on account 33.82
9. Michael Langan Tax Collector, taxes on mobile home 222.16
10. Camp Hill Emergency Physicians, payment on account 1,243.00
11. Capital Cardiovascular Association - payment on account 220.00
TOTAL (Also enter on Line 10, Recapitulation) I $
If more space is needed, insert additional sheets of the same size.
4, 988.27
REV-1513 EX+ (01-10)
~ Pennsylvania SCHEDULE ~
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF:
JOSEPH CEKOVICH, JR.
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under
Sec. 9116 (a) (1.2).)
1• Mark Cekovich, 405 Huron Drive, Mechanicsburg, PA 17050
2. Joseph W. Cekovich, 6008 Hummingbird Drive, Mechanicsburg, PA17055
3. Jeff Cekovich, 517 Hollidaysburg, PA 16648
4. Monica J. Cekovich, 1626 Chislett Street, Pittsburgh, PA 15206
5. Brigitte Cekovich, 82 Linda Drive, Lot 42, Mechanicsburg, PA 17050
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Son
Son
Son
Daughter
Ex-wife
FILE NUMBER:
21-12-0677
AMOUNT OR SHARE
OF ESTATE
1/5 of residue
1/5 of residue
1/5 of residue
1/5 of residue
DeRose Home* and
1/5 of residue
*Schedule E.6
II
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE.
NON-TAXABLE DISTRIBUTIONS
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN;
1
I B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS;
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I$
If more space is needed, use additional sheets of paper of the same size.
-~..
LAST WIL1, AND "fESTAMF.N'f
OF
JOSEPH CEKOVICH..TR.
LAW OFFICES
SNELB AKER &
BREN NEMAN. P. C.
I, JOSEPH CEKOVICH, JR., of Hampden Township, Cumberland County,
~~
nnsylvania, being of'sound and disposing mind, memory and understanding, do hereby make,
publish and declare this as and for my Last Will and Testament, hereby revoking and making
void any and all wills by me at any lime heretofore made.
1. I direct that all my debts and funeral expenses be paid as soon as practical after my
death by my Executor or Executrix, whichever the case may be, hereinafter named.
I direct that all taxes that may be assessed as a cousequcnce of my death shall be paid
from my residuary estate as parr of the expenses of the administration of my estate.
2. I give to my former wife, BR[GffTE CEKOV]CH, my ] 989 DeRgse home which is
identified under vehicle identification No. D1229312.
3. All the rest, residue and remainder of my estate, real, personal and mixed, and
wheresoever the same may be sihiate, I give, devise and bequeath in equal shares to my
children, MARK CEKOVICH, JEFF CEKOVICH, MONICA .i. CEKOVTCH, JOSEPH W.
CEKOVICH, and my former wife, BR]G1T"fE CEKOVICI I.
Should any of the beneficiaries above named predecease me, I direct that the share and
property such deceased beneficiary would have received under this Will shall be given to and
divided among the surviving beneficiaries above named.
4. ]hereby nominate, constitute and appoint my brother, NICHOLAS L CEKOVICH as
Executor of this my Last Will and Testament. In the event he should predecease me, fail to
qualify or fail to serve in such capacity, I nominate, constitute and appoint my sister, [RENE C.
CEKOVICH, as Executrix of this my Last Will and Testament.
I direct that no person serving as Cxecutor or Executrix hereunder shall be required to
post bond to securo the faithful performance of his or her duties in the Commonwealth of
Pennsylvania or in any other jurisdictiar.
IN WITNESS WHEREOF, I have hereunto set my hand and sea] to this my Last V/ill
and Testameut written ou two (2) pages dtis Zb'~ day of October, ?010.
~:~
-~' ___~(SEAL)
~ seph ekovich,Jr.
~,
Signed, sealed, published and declared by JOSEPI-1 CEkOVICH, JR., the Testator
above named, as and for his Last Will and Testament, in our presence, who, in his presence, at
his request, and in the presence of each other, have hereunto subscribed our names as attesting
witnesses.
~~~~c~~
- _ (SEAL)
~1~~
PAL)
uw oRRicEs
SNEL9 gKER a[
BRENNEMgN, f.C.
_z_
COMMONWEALTH OF PENNSYLVANIA)
SS.
COUNTY OF CUMBERLAND
We, JOSEPII CEKOVICH, JR., KEITH O. BRENNEMAN, ESQUIRE- and SANDRA
K. SHOWERS, the Testator and the witnesses, respectively, whose names are signed to the
attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned
authority that the Testator signed and executed the instrument as his Last Will and Testamem
and drat he had signed willingly, and that he executed it as his free and voluntary act for the
purposes therein expressed, and that each of the witnesses, in the presence and hearing of the
Testator, signed the Will as witness and that to the best of his or her I:nowledge the "festator
was at that time eighteen years of age or older, of sound mind and under no constraint or undue
influence.
Testator ~-
r / q~,, %
Witness
(l1ti-~
Witness
LAW OFFICES
SNEL BAKER E<
BRENNEMAN, P. C.
Subscribed, sworn to and acknowledged before me by JOSEPH CEKOVICI[, JR., Testator, and
subscribed and swan to before me by KEITH O. BRENNEMAN, ESQUIRE and SANDRA K.
SFTOWERS, witnesses, this 26'~ day ot•October, 20]0.
Notary ubhc '
WM ili ()F P NNSYLWJJVt
Nofariy Seal
Susan L Matraxl. NWary Puh1c
erg Bo{l~o~,.,C~.unhe~larb CdrNy
C'.OIIIRIt43lM "W^e5 Nov. 2Q, ~ttti
WmMr. n.~...,....._i. •~LrM,., of NMetle~