HomeMy WebLinkAbout03-11-13 1505610140
REV-1500 ~` ~°'-'°'
PA Department of Revenue OFFICIAL USE ONLY
Bureau of Individual Taxes
PO BOX 280601 INHERITANCE TAX RETURN County Code Year File Number
Harrisburg, PA 17128-0601
RESIDENT DECEDENT 2 1 1 3 0 1 1 1
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
1 8 3 1 2 4 0 2 5 0 1 1 4 2 0 1 3 0 4 0 1 1 9 2 1
Decedent's Last Name Suffix Decedent's First Name MI
GOC H E NA U E R S R ROBE RT J
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number
FILL IN APPROPRIATE OVALS BELOW
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
0 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Retum (date of death
4. Limited Estate
~
4a. Future Interest Compromise (date of prior to 12-13-82)
~ 5. Federal Estate Tax Retum Required
^X
6. Decedent Died Testate
~ death after 12-12-82)
7. Decedent Maintained a Living Trust
0 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 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 TO:
Name Daytime Telephone Number
J O E L R. Z U L L I N G E R 7 1 7 2 6 4 6 0 2 9
REGISTER OF WILLS USE ONLY
- ~ 7t7
First line of address ~ ~ A;
~ rn
1 4 NORTH MA I N STREET 4°~ ~ f~°
_ .. ,... .,..,~ C; J
Second line of address r r._ r _, I_ ' r~7
i r `s I-~ ; :; ~~
SUI TE 2 00 ~~
City or Post Office State ZIP Code ~ /° DATE F ED ~~~ _-r.~
CHAMB ERSB URG PA 1 72 01 ~ r,.; 1`"-~
r'-l ~) ~
;:;~ -r1
Correspondent's a-mail address:
Under penalties of perjury, I deGare that I have examined this return, inGuding accompanying schedules and statements, and to the best of my knowledge and belief,
it is true, correct and complete. DeGaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNA RE OF ERSON R PON LE FO FLING RETURN ATE
ADDRESS
30 EISE O ER DRIVE CHAMBERSBURG PA 17201
SI R OF AR O THAN REPRESENTATNE D E
DD ESS
NORTH STRE SUITE 200 CHAMBERSBURG PA 1 201
PLEASE USE ORIGINAL FORM ONLY
Side 1
L 1505610140 1505610140 J
1505610240
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: ROBERT J. GOCHENAUER SR 1 8 3 1 2 4 0 2 5
RECAPITULATION
1. Real Estate (Schedule A) ........................................ ... 1.
2. Stocks and Bonds (Schedule B) ................................... ... 2.
3. Closely Held Corporation, Partnership orSole-Proprietorship (Schedule C) .. ... 3.
4. Mortgages and Notes Receivable (Schedule D) ....................... ... 4.
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E).... ... 5. 3 7 4 0 6 . 3 5
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested .... ... 6.
7. Inter-Vivos Transfers & Miscellaneous N
-Probate Property
~
(Schedule G) Separate Billing Requested .... ... 7. ,
8. Total Gross Assets (total Lines 1 through 7) ........................ ... 8. 3 7 4 0 6 , 3 5
9. Funeral Expenses and Administrative Costs (Schedule H) ............... ... 9. 1 5 1 7. 4 5
10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) .......... ... 10.
11. Total Deductions (total Lines 9 and 10) ............................ ... 11. 1 5 1 7. 4 5
12.
13.
14. Net Value of Estate (Line 8 minus Line 11) .....................
Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) ...............
Net Value Subject to Tax (Line 12 minus Line 13) ............... ....
....
.... ... 12.
... 13.
... 14. 3 5
3 5 $
8 $
8 $ ,
,
8 . 9
~ 0
0
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.o _ 0. 0 0 15. 0. 0 0
16. Amount of Line 14 taxable
at lineal rate X .045 3 5 8 8 8 9 0 1s. 1 6 1 5. 0 0
17. Amount of Line 14 taxable
at sibling rate X .12 0 0 0 17. 0. 0 0
18. Amount of Line 14 taxable
at collateral rate X .15 0. 0 0 1 g, 0. 0 0
19. TAX DUE ............................................... ..... ..19. 1 6 1 5. 0 0
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ^
Side 2
L 1505610240 1505610240 J
REV-1500 EX Page 3
Decedent's Comalete Address:
File Number
21 13 0111
DECEDENTS NAME
ROBERT J. GOCHENAUERz SR
_
STREET ADDRESS -- - -----
129 Walnut Bottom Road
-- ---- --
CITY
--- STATE - -- - ZIP --
Shippensbur PA ~ 17257
Tax Payments and Credits:
1• Tax Due (Page 2, Line 19) (1) 1,615.00
2. Credits/Payments
A. Prior Payments
B• Discount 80.75
Total Credits (A + g) (2) 80.75
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) 0.00
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 1.534.25
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; ............................... ^ ^X
c. retain a reversionary interest; or ................................................................................................ ^ ^X
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? ....................................................................................... ^ Q
3. Did decedent own an "in trust for" or payable-upon~Jeath 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? .................................................................................................. ^ 0
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 p2 P.S. §9116 (a) (1.1) (i)].
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)].
• 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) [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 12 percent [72 P.S. §9116(a)(1.3)]. Asibling isdefined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-1508 EX+ (OS-12)
Pennsylvania SCHEDULE E
DEPARTMENT OF REVENUE CASH, BANK DEPOSITS ~ MISC.
INHERITANCE TAX RETURN
RESIDENT DECEDENT PERSONAL PROPERTY
~~ i AI t ter: FILE NUMBER:
ROBERT J. GOCHENAUER SR 21 13 0111
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 VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Checking Account #552526, Orrstown Bank 80.06
2. Savings Account #701001264, Orrstown Bank, including interest accrued I 405.08
to date of death
3. Savings Account #702000248, Orrstown Bank, including interest accrued I 19 545.40
to date of death '
4. Certificate of Deposit #5020058267, Orrstown Bank, including interest 15,846.89
accrued to date of death
5. Medicare, refund of unearned premium 2 28
6. Refund, Elmcroft 1,526.64
TOTAL (Also enter on Line 5, Recapitulation) I E 37 406 35
If more space is needed, use additional sheets of paper of the same size.
REV-1511 EX+ (10-09)
pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES AND
ADMINISTRATIVE COSTS
t~ iAt t ur FILE NUMBER
ROBERT J. GOCHENAUER SR 21 13 0111
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Parklawns, name plate 335.00
B.
ADMINISTRATIVE COSTS:
Personal Representative Commissions:
Name(s) of Personal Representatives}
Street Address
City
Years} Commission Paid:
State ZIP
2, Attorney Fees: Joel R. Zullinger
3. Famiy Exemption: (If decedent's address is not the same as claimant's, attach explanation.)
Claimant
4.
5.
6.
7
Street Address
Cdy State ZIP
Relationship of Claimant to Decedent
Probate Fees: Letters - 45.00; will - 15.00; shorts -10.00; inventory - 15.00; inheritance
return -15.00; JCS fee 23.50; automation - 5.00; additional probate - 45.00
Accountant Fees:
Tax Return Pn:parer Fees:
Fee for preparation of income tax returns for 2012
TOTAL (Also enter on Line 9, Recapitulation} ~ 3
If more space is needed, use additional sheets of paper of the same size.
995.00
173.50
13.95
7.45
REV-1513 EX+ (01-10)
pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
esrATe vF: FILE NUMBER:
ROBERT J. GOCHENAUER SR 21 13 0111
NUMBER
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT
Do Not List Trustees} AMOUNT OR SHARE
OF ESTATE
I TAXABLE DISTRIBUTIONS [Indude outs' ht usal distributions and transfers under
Sec. 91 f6 (a~(1.2).]
1. Shirley Smith Lineal
309 Eisenhower Drive one-fourth of residue
Chambersburg, PA 17201
2. Barbara Shoop Lineal
P.O. Box 354 one-fourth of residue
Dayton, WY 82836
3. Janetta Guyer Lineal
3 Katie Lane one-fourth of residue
Gardners, PA 17324
4. Robert J. Gochenauer, Jr. Lineal
215 Peebles Road one-fourth of residue
Newburg, PA 17240
II.
1
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 TAXIS NOT TAKEN:
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
a
If more space is needed, use additional sheets of paper of the same size.
'JRZ = 5.1 gochenaur.lw July 6; 200
-, is 1~ :Jiii~~ L V t I 1 v L~.~
LAST WILL AND TESTAMENT
CLEt ~
~IORP~-~Ah~' C'F~R`
I, ROBERT J. GOCHENAUR, of 201 East Burd~S~Beet~~~Shi ~ ~ ~~
ppensburg,
Pennsylvania, being of sound and disposing mind, memory and
understanding, do hereby declare this to be my will, hereby
revoking any and. all former wills and codicils thereto by me
heretofore made.
I.
I direct that all my just debts and funeral expenses,
including all expenses of my last illness, shall be paid from my
estate as soon as practicable after my decease as a part of the
expense of the administration of my estate.
II.
I give, devise and bequeath the residue of my estate of every
nature and wherever situate to my children, namely Barbara L.
Shoop, Janetta A. Guyer, Robert J. Gochenaur, Jr. and Shirley A.
Smith, in equal shares, provided that the share of any child who
predeceases me or dies on or before the thirtieth day following my
death shall be distributed to his or her issue, per stirpes, living
on the thirty-first day following my death, and in default of any
such then-living issue to my other then-living children, equally.
The term "issue" shall not be defined to include step-child.
III.
Any fiduciary under this will shall have the following powers
in addition to those vested in them by Iaw and by other provisions
of my will applicable to all property whether principal or income,
including property held for minors, exercisable without Court
.approval, and effective until actual distribution of all property:
A. To retain any and all of the assets of my estate, real or
personal, without regard to any principle of
~. diversification of risk.
B. To invest in all forms of property including stock,
common trust funds and mortgage investment funds without
restriction to investments authorized for Pennsylvania
fiduciaries as they deem proper, without regard to any
principle of diversification of risk.
C. To sell at public or private sale, to exchange or to
lease for any period of time any real or personal
property and to give options for sales, exchanges or
leases, for such prices and upon such terms or conditions
as they deem proper.
D. To allocate receipts and expenses to principal or income
or partly to each as they from time to time think proper.
E. To compromise any claim or controversy.
F. To distribute in cash or in kind or partly in each.
Page 2
G. To hold property in their names without designation of
any fiduciary capacity or in the name of a nominee or
unregistered.
IV.
I direct that all taxes that may be assessed in consequence of
my death of whatever nature and by whatever jurisdiction imposed,
shall be paid from my residuary estate as a part of the expense of
the administration of my estate.
V.
The interest of the beneficiaries hereunder shall not be
subject to anticipation or to voluntary or involuntary alienation;
and the principal and income shall be paid by the trustee or
guardian directly to or for the use of the beneficiary entitled
thereto, without regard to any assignment, order, attachment or
claim whatever.
VI.
I appoint my daughter, Shirley A. Smith as executrix of this
my will. Should my daughter, Shirley A_ Smith, predecease me, fail
to qualify or cease to act, I appoint my daughter, Janetta A.
Guyer, as executrix of this my will.
Page 3
VII.
No bond shall be required of any fiduciary hereunder in any
jurisdiction.
IN WITNESS WHEREOF, I hereunto set my hand and seal to this my
last will and testament, consisting of five typewritten pages, the
first three of which bear my signature in the margin for the
purpose of identification this _ / T{`-'~~`' day of
2/JD/n.
' ~'t-~t, (SEAL)
Signed, sealed, published and declared by the above-named
testator 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 set our hands as attesting witnesses.
• ~ a%G
~ ~ `„" '
r i
~-~ (t~ t.., ~' X72 s-7
We , ROBERT J . GOCHENAUR, L.LQ ~G ~ zuLG fib ( ~ and
~~~ ~ ups 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 testament and that he executed it as his free and
Page 4
voluntary act for the purposes therein expressed and that each of
the witnesses, in the presence and hearing of the said testator
signed the will as witnesses and to the best of their knowledge
said signer was at that time eighteen years of age or older, of
sound mind and under no constraint or undue influence.
Gr~e.~-Q/L -~/! .
Testator
Witne
Witness
Subscribed, sworn to and acknowledged
before me by the above-named signer and
subscribed and sworn to before me by the
above-named witnesses this /~%l~- day of
2 D~7~ .
Nota Publ'
COMMONWEALTH OF PE SYLVANIA
Notarial Seal
Teresa J. Burkholder, Notary Public
Shipppensburg Boro, Cumberland County
My Commission Expires Aug. 6, 2008
MOmb~', Rennsylvania a=~cietion of Notaries
Page 5
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CERTIFICATE OF DEPOSIT
Account No.-
Account Type-
Date Opened-
Joint Account (name/date)-
Balance-
Accrued Interest
5020058267
18-23 Month Growth CD.
8/1/1997
No
$15,844.35
$2.54
Best Regards,
~: (,t~c~t~. ~~
Jil R Worthington
Deposit Processing Clerk