The URL can be used to link to this page

Home My WebLink About12-06-13 (3) � 1505610143 REV-1500 EX�o2_,,, � OFFICIAL USE ONLY PA Department of Revenue pennsylvania County Code Year File Number Bureau of Individual Taxes �P�TMEMOFREVENUE PO BOX.280601 INHERITANCE TAX RETURN 21 13 0836 Harrisburg,PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 162 10 5109 05 04 2013 10 12 1918 Decedent's Last Name Suffix DecedenYs First Name MI COBLE MARTIN J (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name M� 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 � 2. Suppiemental Return � 3. Remainder Return(Date of Death Priorto 12-13-82) 4. Limited Estate � 4a, Future Incerest Compromise � 5. Federal Estate Tax Return Required ❑ (date of death after 12-12-82) Decedent Died Testate � Decedent Maintained a Living Trust � 8. Total Number of Safe Deposit Boxes � 6' (Attach Copy of Will) ❑ (Attach Copy of Trust) � 9. Litigation Proceeds Received � �p,Spousal Povert Credit(Date�f Death � ��.Election to tax under Sec.9113(A) between 1231�J1 and T-i-ss (Attach Schedule O) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number LAUREN E KAYS 717 737 8761 n �v w R� R�:IS�R OF W4L#S U�QOILY W' --�y r^. .� C�7 Rl � � �.:� � �'1 First Line of Address � �" �' �"'' �'y [' � �-:1 �^�y (T.� ONE WEST MAIN STREET �- �? �`' �} "`�' �� '.,� r, Second Line of Address � �, '� �,� � �'� �� : -_. • -� (Xj r `'� �-�, `j DATE FILED;•- Y'�"7 City or Post Office State ZIP Code �- • C1� 1i SHIREMANSTOWN PA 17011 Correspondent's e-mail address: �bogar@bOgarlaw.com 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 personai representative is based on all information of which preparer has any knowledge. SIG ATURE OF PERSON RES ONSIBLE FOR FILING RETURN DATE ��,�,��,�v Dixie L. Smith %r �:2.5�J l3 ADDRESS 295 Church Road Shermans Dale PA 17090 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE Lauren E. Kays /�`�5 '" A SS One West Main Street, Shiremanstown, PA 17011 Side 1 L 1505610143 1505610143 � �N J 1505610243 REV-1500 EX DecedenYs Social Security Number DecedenYs Name: COI�I@� Ma1rt117 J. 162 10 510 9 RECAPITULATION 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. Mortgages&Notes Receivable(Schedule D)........................................................ 4. 5. Cash, Bank Deposits&Miscellaneous Personal Property(Schedule E)............... 5. 34 ,281 . 14 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested......:..... 6. 4 ,375 . 11 7. Inter-Vivos Transfers&Miscellaneous I�n;Probate Property (Schedule G) U Separate Billing Requested............ 7. g. Total Gross Assets(total Lines 1 through 7)........................................................ g. 3H , 656 .25 9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 4 , 555 . 19 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............................ 10. 11. Total Deductions(total Lines 9 and 10)................................................................ ��. 4 ,555 . 19 12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 3 4 , 1�1 . 0 6 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J)............................................... 13. 14. Net Value Subject to Tax(Line 12 minus Line 13)............................................... 14. 34 , 101 . 0 6 TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 � . 0 0 (a)(1.2)X.00 15. 16. Amount of Line 14 taxable 34 , 101 . 0 6 16. 1, 534 . 55 at lineal rate X .045 17. Amount of Line 14 taxable 0 . 0� at sibling rate X.12 0 . �� 17. 18. Amount-of Line 14 taxable 0 . �0 at collateral rate X.15 � . �� 18. 19. TAX DUE................................................................................................................ 19. 1 �S34 . 'rJ 'rJ 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. � Side 2 � 1505610243 150561�243 J REV-1500 EX Page 3 File Number 21-13-0836 Decedent's Complete Address: DECEDENT'S NAME Coble, Martin J. STREET ADDRESS Forest Park Health Care Center 700 Walnut Bottom Road CITY STATE ZIP Carlisle PA 17013 Tax Payments and Credits: 1. Tax Due(Page 2, Line 19) (1) 1,534.55 2. Credits/Payments A. PriorPayments 1,370.02 B. Discount 72.11 Total Credits(A +B) (2) 1,442.13 3. Interest �3� 4, �f Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4) Check box on Page 2,Line 20 to request a refund 5. If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (5) 92.42 Make Check Payable to REGISTER OF WILLS, AGENT. r� �� : � � ; r ;� � � � �a� � � � � ��?d�1.�� <� ,�,�� "� ' -�.n�'�'� �`. :r.`:"".� .rK. ..��:'!. .�� ...w .f '� ,� . �:��,�� r� ,�.i�4'�. k ..;h i � ��` . ,._., ��':- 4. . ��'._..� :..��—.m.. � 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:............................................................................... ❑ ❑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?............................................................ ❑ � 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?.................................................................................................................... ❑ ❑X 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?.................................................................................................................. X IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Rev-1508 EX+(��-10) SCHEDULE E pennsylvania CASH, BANK DEPOSITS, & MISC. DEPARTMENT OF REVENUE INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Coble, Martin J. 21-13-0836 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorehip must be disclosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 American Funds Account(held by Member's 1st)-Account No.82781341. Date of death 29,197.42 balance$29,197.42. 2 Bank of Landisburg-Checking Account No.3729664. Date of death balance$3,747.83. 3,747.83 3 Banker's Life-monthly payment 45.11 4 Chevron -final retirement payment 578.97 5 Guardian Elder Care-refund 708.03 6 Omnicare Pharmacy-refund 3.78 TOTAL(Also enter on Line 5, Recapitulation) 34,281.14 (If more space is needed,additional pages of the same size) Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule E(Rev. 11-10) � Members lst Investment Services Craig Nissley i Located at Members 1 st FCU Investment Consultant � i166 Walnut Bottom Road '+ Carlisle,PA 17015 ' � 717-249-0795 � MEMBERS 15t FAX 7I7-249-2754 ' INVSSTMENTSHRVICHS . , Dectr Ms. Balgar, ' Please be advised that lUiari'in Coble opened a non-qualified individual account with American Funds on July 31, 2007, Yhe account number is $2781341. There were no beneficiaries assigned ta the account. At date af death on May 4, 2013 the accout�t value was $29,197.42. Registered Representutive of INVEST Financ{al Corpm�ation,memUer PINRA/SIPC.INVEST and its affilinted insurance ageneies offer securities,advisory services, � and certain insura�ice products and a�•e not affiliated with Membezs lst Invostment Services or Me�vbers 1sC Federal Credit Union.Products of£ered are:*Not NCUA � iusured�Not u deposit or atl�er obligaHon of ar gnaranteed by any credit t�nion*Subject to risks including the possible loss of principal amount invested + I <secure> Martin Coble Page 1 of 2 Message From: knissley@mlinvest.com To: Lauren E. Bogar <Ibogar@bogarlaw.com> Subject: <secure> Martin Coble Sent: 08/07/2013 11:59 AM EDT Expiration Date: 08/07/2014 12:28 PM EDT Attachments: coble dod valuation .pdf Thank you, Kathleen Kathleen Nissley Registered Investment Assistant Members 1st Investment Services 1166 Walnut Bottom Road Carlisle, PA 17015 717 249-0795 Fax 717 249-2754 We put our members first ��Registered Sales Assistant of INVEST Financial Corporation, member FINRA/SIPC. INVEST and its affiliated insurance agencies offer securities, advisory services, and certain insurance products and are not affiliated with Members lst Investment Services or Members lst Federal Credit Union, Products offered are: *Not NCUA insured *Not a deposit or other obligation of or guaranteed by any credit union *Subject to risks including the possible loss of principal amount invested." ------------------------------------------------------------------------ From: Lauren E. Bogar [Ibogar@bogarlaw.com] Sent; Wednesday, August 07, 2013 11:37 AM To: Nissley, Kathleen (IFC) Subject; RE: Martin Coble Kathleen, Thank you for this information. If you could please provide this information, along with confirmation of the account number and whether Mr. Coble named any POD or TOD beneficiaries on Members 1st letterhead, we would greatly appreciate it. We attach our date of death valuation letters to the Pennsylvania lnheritance Tax Return. Thank you, Lauren From: Nissley, Kathleen (IFC) [mailto:knissley@mlinvest.com] Sent: Wednesday, August 07, 2013 11:10 AM To: Lauren E. Bogar Subject: Re: Martin Coble https://securemail.j nl.com/websafe/IFGcustom.action?cmd=printMessage&fid=3 07516&m... 8/8/2013 <secure> Martin Coble Page 2 of 2 Lauren, Mr. Coble opened his non-qualified individual account on 7/31/2007. The balance at DOD was $29,197.42 Thank you, Kathleen Kathleen Nissley Registered Investment Assistant Members 1st Investment Services 1166 Walnut Bottom Road Carlisle, PA 17015 717 249-0795 Fax 717 249-2754 We put our members first '�Registered Sales Assistant of INVEST Financial Corporation, member FINRA/SIPC. INVEST and its affiliated insurance agencies offer securities, advisory services, and certain insurance products and are not affiliated with Members 1st Investment Services or Members 1st Federal Credit Union. Products offered are: *Not NCUA insured *Not a deposit or other obligation of or guaranteed by any credit union *Subject to risks including the possible loss of principal amount invested," https://securemail.j nl.com/websafe/IFC/custom.action?cmd=printMessage&fid=3 07516&m... 8/8/2013 . �� oF Landisbur ESTABLISHFD 1903 P.O. BOX 179 • LANDISBURG, PA 17040 � August 09, 2013 Lauren E Bogar, Esquire One West Main Street Shiremanstown, PA 17011 RE: Estate of Martin J Coble Date of Death: May 04, 2013 SS#: 162-10-5109 Dear Madam: The information you requested is as follows. Please note that both accounts were non interest bearing. Date Account Account Type of Balance Prior Opened Number Account to Interest Name Ownership 07/22/2004 3711382 Checking $8,750.21 Dixie L Smith Joint 09/20/2010 3729664 Checking $3,747.83 Dixie L Smith Custodian If I can be of further assistance, please advise. Very truly yours, Connie L Welcomer cc: Decedent's folder ��{�� LANDISBURG - 717-789-3213 • 9LAIN - 536-3118 • SNERMANS DALE - 582-8511 Rev-1509 EX+�01-10) pennsylvania SCHEDULE F DEPARTMENTOFREVENUE JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Coble, Martin J. 21-13-0836 If an asset was made joint within one year of the decedenYs date of death,it must be reported on schedule G. SURVIVING JOINT TENANT(S)NAME ADDRESS RELATIONSHIP TO DECEDENT A. Dixie L. Smith 295 Church Road Daughter Shermans Dale, PA 17090 B. C. JOINTLY OWNED PROPERTY: DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM LETTER DATE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT DATE OF DEATH DECD'S DECEDENT'S NTEREST NUMBER FOR JOIN MADE NUMBER OR SIMILAR IDENTIFYING NUMBER.ATTACH DEED FOR VALUE OF ASSE INTEREST TENANT JOINT JOINTLY-HELD REAL ESTATE. 1 A 07/22/2004 Bank of Landisburg-Checking Account No. 8,750.21 50.000% 4,375.11 3711382. Date of death balance$8,750.21. TOTAL(Also enter on Line 6, Recapitulation) 4,375.11 (If more space is needed,additional pages of the same size) Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule F(Rev.01-10) �� oF Lc�nd i sbur ESTABLISHFD 1903 � � � P.O. BOX 179 • LANDISBURG, PA 17040 August 09, 2013 Lauren E Bogar, Esquire One West Main Street Shiremanstown, PA 17011 RE: Estate of Martin J Coble Date of Death: May 04, ?013 SS#: 162-10-5109 Dear Madam: The information you requested is as follows. Please note that both accounts were non interest bearing. Date Account Account Type of Balance Prior Opened Number Account to Interest Name Ownership 07/22/2004 3711382 Checking $8,750.21 Di�e L Smith Joint 09/20/2010 3729664 Checking $3,747.83 Dixie L Smith Custodian If I can be of further assistance,please advise. Very truly yours, Connie L Welcomer cc: Decedent's folder �'��-� LANDISBURG - 717-789-3213 • SLAIN - 536-3118 • SNERMANS DALE - 582-8511 REV-1511 EX+(�0-09) pennsylvania SCHEDULE H DEPARTMENT OFREVENUE F U N E RAL EXP E N S ES AN D RESIDENTDECEDENT URN ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Coble, Martin J. 21-13-0836 DecedenYs debts must be reported on Schedule I. ITEM DESCRIPTION AMOUNT N MBER q, FUNERAL EXPENSES: See continuation schedule(s)attached 472.12 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zio Year(s)Commission Paid 2. Attornev's Fees Bogar 8� Hipp Law Offices 2,940.00 3. Family Exemption: (If decedenYs address is not the same as claimanYs,attach explanation) Claimant Street Address City State Zio Relationshio of Claimant to Decedent 4. Probate Fees 178.50 5. AccountanYs Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 964.57 See continuation schedule(s)attached TOTAL(Also enter on line 9, Recapitulation) 4,555.19 Copyright(c)2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev. 10-09) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Coble, Martin J. 21-13-0836 ITEM NUMBER DESCRIPTION AMOUNT Funeral Ex ep nses 1 Neill Funeral Home-obituary fee 472.12 H-A 472.12 Other Administrative Costs 2 Banker's Life-reclamation of monthly payment 45.11 3 Camp Hill Emergency Physicians 56.31 4 Graham Medical Clinic, P.C. 13.15 5 RESERVES: -Costs to conclude administration of Estate, including preparation and filing of 850.00 final personal income tax returns and fiduciary income tax returns H-B7 964.57 Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.6-98) REV-7513 EX+(07-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES . RESIDENT DECEDENT ESTATE OF FILE NUMBER Coble, Martin J. 21-13-0836 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(Sl RECEIVING PROPERTY DECEDENT (Words) ($$$) I TAXABLE DISTRIBUTIONS [include outright spousal • distributions,and transfers under Sec.9116 a 1.2 Dixie L.Smith Daughter Rest, Residue 295 Church Road and Remainder Shermans Dale, PA 17090 of estate Total Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 1500 cover sheet,as a ro riate. NON-TAXABLE DISTRIBUTIONS: II. 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 Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule J(Rev.01-10) LAST WILL AND TESTAMENT OF MARTIN J . COBLE � I , Martin J . Coble , of the Borough of Shiremanstown , County of Cumberland and State of Pennsylvania , being of sound mind and memory , do make , publish and declare this my last Will and Testament , hereby revoking any and all wills by me heretofore made . • FIRST: I direct my just debts and funeral expenses be paid by my Executrix , hereinafter named , as soon as possible after my decease . SECOND : All the rest , residue and remainder of my estate , whether real , personal or mixed , I give, devise and bequeath to my wife , Grace M. Coble , providing she shall survive my death by sixty (60) days . THIRD : Should my wife , Grace M. Coble , predecease me or fail to survive my death by sixty (60 ) days , then I give , devise and bequeath said residue and remainder of my estate to my daughter , Dixie L . Smith . FOURTH : My personal representative shall have the follow- ing powers in addition to those vested in her by law and by other provisions of my will , whether principal or income , exercisable without court approval and effective until actual distribution of all property: 1 . To retain any or all of the assets of my estate ; real or personal , without regard to any principal of diversi - fication , risk or productivity . 5 2 . To sell at public or private sale or to lease for any period of time any real or personal property for such prices and upon such terms or conditions as she may deem proper . 3 . To compromise any claim or controversy . 4 . To exercise any option , right or privile�e granted in insurance policies or in other investments . FIFTH : I appoint my wife , Grace M. Coble , the Executrix of this my last Will and Testament . Should she fail to qualify or cease to act as Executrix , then I appoint my daughter , Dixie L . Smith , Executrix in her stead . SIXTH : I direct that my personal representative , as well as her successor shall not be required to give bond for the faithful performance of her duties in this or any jurisdiction . IN WITNESS WHEREOF , I have hereunto set my hand this �� day of , 1972 • ,� t � ,✓��r � � f � M'arti n J . ob e - l � �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 . � �,�� ;r l ��.- _ � , �� -_��,��: . -�-�