HomeMy WebLinkAbout12-27-13 (3) G �- 7,5056101,49
REV-1 J�O EX ennsyvania OFFICIAL USE ONLY
PA Department of Revenue
Countv Code Year File Number
Bureau of Individual Taxes INHERITANCE TAX RETURN
PO BOX 280601 21 13 0493
Harrisburg,PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
03 31 2013 11 24 1927
Decedent's Last Name Suffix Decedent's First Name MI
Cover Richard E
(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 IN APPROPRIATE OVALS BELOW
1.Original Return Q 2. Supplemental Return Q 3. Remainder Return(Date of Death
Prior to 12-13-82)
Q 4.Limited Estate O 4a. Future Interest Compromise(date of Q 5. Federal Estate Tax Return Required
death after 12-12-82)
6.Decedent Died Testate Q 7. Decedent Maintained a Living Trust 1 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust.)
Q 9.Litigation Proceeds Received Q 10. Spousal Poverty Credit(Date of Death Q 11.Election to Tax under Sec.9113(A)
Between 12-31-91 and 1-1-95) (Attach Schedule 0)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Numl{e
John A. Feichtel , Esquire 717 212 5803:
� ° c-3 �
RE TE9 OF WILL *E OnY::o
rri
f'r'1
First Line of Address C/7
Saidis, Sullivan & Rogers ` C-:>
C:> C= C
Second Line of Address M C.1) t_ f
635 North 12th Street, Suite 400 _4 , a
' DATE F1 .EC -Tt
City or Post Office State ZIP Code
Lemoyne PA 17043
Correspondent's e-mail address: Jfeichtel @ssr-attorneys.com
Under penalties of penury,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 an npl e. claration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGN E PE O ES ONSIBLE FOR FILING ETURN DATE
.. e- �
ADDRESS 1817 Fox Hunt Lane
Harrisburg, PA 17110
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS 635 North 12th Street, Suite 400
Lemoyne, PA 17043
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610149 1505610149
I 1505610249
REV-1500 EX(FI)
Decedent's Social Security Number
Decedent's Name:
Richard E Cover
RECAPITULATION
1. Real Estate(Schedule A).... . .. ... . . . ... .. . ... .. . . ...... . ... .. . . .. 1. 0 . 00
2. Stocks and Bonds(Schedule B) ... .. . . . . . . . . .. . .. ..... . .. . ... . . . .. . 2. 0 . 00
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) . ... . 3. 0 • 00
4. Mortgages and Notes Receivable Schedule D 4. 0 . 00
5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E) . . .. . . 5. 2271972 • 57
6. Jointly Owned Property(Schedule F) O Separate Billing Requested ... . 6. 0 • 00
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property 411528 •2 7
(Schedule G) O Separate Billing Requested . . .. 7.
8. Total Gross Assets total Lines 1 through 7 8• 269-,500 . 8 4
9. Funeral Expenses and Administrative Costs(Schedule H) . ...... . . . . . . . ... 9. 91285 • 3 7
10. Debts of Decedent,Mortgage Liabilities and Liens Schedule I 10. 9,8 8 9 . 23
11. Total Deductions(total Lines 9 and 10) . .. . . . ... ....... ........... .. . 11. 19 -1174 . 60
12. Net Value of Estate(Line 8 minus Line 11) 12. 250,326 • 2 4
.. .. ... . .. . . . ... ... . ... . . .. .
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J) ... . . . .... . ... .. . . . . ... 13. 0 . 00
14. Net Value Subject to Tax Line 12 minus Line 13 14. 250-1326 • 2 4
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 0 0 . 00 15. 0 . 00
16. Amount X.0
ra taxable
250,326 . 24 16. 11,264 • 68
at lineal rate e X.0 45
17. Amount of Line 14 taxable
at sibling rate X.12 0 . 00 17. 0 . 00
18. Amount of Line 14 taxable
at collateral rate X.15 0 - 00 18. 0 . 00
19. TAX DUE .. . . . ... .. .. .. .. .... . . .... .. ... . . . . . . .. . .. .... . . . .. . 19. 1 1,2 6 4 . 6 8
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT l�
Side 2
1505610249 1505610249
REV-1500 EX(FI) Page 3 File Number
Decedent's Complete Address: 21 130493
DECEDENT'S NAME
Richard E. Cover
STREET ADDRESS
2100 Bent Creek Road
CITY STATE ZIP
Mechanicsburg PA 17050
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 11,264.68
2. Credits/Payments
A.Prior Payments 10,200.00
B.Discount 536.83 10,736.83
Total Credits(A+B) (2)
3. Interest (3) 0.00
4. If Line 2 is greater than Line 1 +Line 3,enter the difference.This is the OVERPAYMENT.
Fill in oval on Page 2,Line 20 to request a refund. (4)
d°
5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 527.85
Make check payable to: REGISTER OF WILLS, AGENT.
: _ :� �
: j.
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 . . . . . . . ❑ ❑X
c. retain a reversionary interest. ... . . . . . . . . ... . ... ... .. . . . . .. . . . . . . ...... . . . . . . . ❑ ❑X
d. receive the promise for life of either payments, benefits or care? . . .. . . . .. . ... . . . . . . . ❑ ❑X
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)].
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(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)].A sibling is defined,
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+ (08-12)
pennsylvania SCHEDULE E
DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Richard E. Cover 21 130493
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 DESCRIPTION VALUE AT DATE
NUMBER OF DEATH
1 Belco Community Credit Union Checking Account 19,248.14
Per letter
2 PNC Bank Checking 51-1204-4895 631.12
Per statement
3 Belco Community Credit Union Savings Account 199,948.98
Per letter
Interest on above item accrued as of decedent's death 71.61
4 Blue Cross Refund 719.58
5 Auer Cremation Services of PA Refund 486.50
6 Continental Insurance Company Long Term Health Commission Checks 1,824.03
7 Principal Life Insurance Commission Check 338.61
8 Continental Assurance Co March Long Term Health Care Check 4,704.00
TOTAL (Also enter on Line 5, Recapitulation) 227,972.57
If more space is needed, use additional sheets of paper of the same size.
- 1
BELCO'
COMMUNITY CREDIT UNION
DECEDENT ESTATE INFORM/ATION(On Date of Death)
1. Name(s)in which the account was held: I ch�.Ya E. Co V e r/ (J►"I rn(V1 ))
2. Account number:
7a,+,+sD
3. Balance as of date of death: 4 C�111`� -7.co QS � J 3�
Balance Accrued Dividends Opened
Regular Saving: S1 aGO, OasO• �,irdjdi�� i.�I' �f 3i�(3- 3�3i�13 d J��i��
Holiday Club S2
Money Market: S6 a 'g q y
Checking: S4 1 Ci �} . Iy- (� 1MEVf�Y (k�IU�_5f1nCL3�3l�13
IRA: S5 4 I�},A'X ('I nCLudLi r��3lll—,—�13i!i3� 30-119+
Certificates: Balance Accrued Dividends Certficate Number VWOWNWisaws
1
4 Name(s)in which Safe Deposit Box was held: •
5 Date the box was initially rented:,, qcj
6 Branch address at which the box is! sated: ad I e. RO-0-4
7 Loan Information: Balance Accrued Interest Per Diem Int
A. Unsecured Loans: _
L14 Classic Visa Card
B. Secured Loans:
C. Mortgage Loans: $ $
$ $ $
$ $ $
8 Miscellaneous: N A
cue .
Business Interest Checking
PNG Bank
r For the period 04/0112013 to 04130/2013 Primary account number:51-1204-4895
Page 1 of 2
Number of enclosures:0
RICHARD E COVER & ASSOCIATES For 24-hour banking sign on to
2100 BENT CREEK BLVD STE 217 �PNC Bank Online Banking on pnc.com
r_E CHANICSBURG P.D. 17050-1534 FREE Online Bill Pay
'a'For customer service call 1-877-BUS-BNKG
Monday-Friday: 7 AM-10 PM ET
Saturday&Sunday: 8 AM-5 PM ET
Para servicio en espanol.1-877-BUS-BNKG
Moving? Please contact your IOCat branch.
®Write to:Customer Service
PO Box 609
Pittsburgh,PA 15230-9738
(='Visit us at PNC.comtmybusinesst
ZM-
TDD terminal.i-BOD 531-1646
For nearing trnpalrec Clients only
Business Interest Checking Summary Richard E Cover&Associates
Account number:51-1204-4895
Overdraft Protection Provided By: XXX)ODCXXXXXX0672
~'&lane&Summary
Beginning Deposits and Checks and other Ending
balance other abditions dedUODn5 balance
633.12'_= 0.01 0.00 831.13
Average leyoer Average collected
balance balance
63112 631,12
Interest Summary
Annual Percentage Number of days average collected interest paid interest.paid
Yield Earned(APYE) in in-t pertoa balance for APYE This period year•to-date
0.020/0 30 631.12 0.01 0.06
Deposits and Other Additions Checks and Other Deductions
Other Additions 1 0.01
Total 1 0.01 Total 0 D,00
Daily Balance
Date Ledger balance Date Ledger balance
04101 631.12 04/30 631.13
REV-1510 EX+ (08-09)
pennsylvania SCHEDULE G
DEPARTMENT OF REVENUE
INTER-VIVOS TRANSFERS AND
INHERITANCE TAX RETURN
RESIDENT DECEDENT MISC. NON-PROBATE PROPERTY
ESTATE OF FILE NUMBER
Richard E. Cover 21 130493
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes.
ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF DECD'S EXCLUSION TAXABLE
NUMBER INCLUDE THE NAME OF THE TRANSFEREE,THEIR RELATIONSHIP TO DECEDENT VALUE OF ASSET INTEREST IF APPLICABLE
AND THE DATE OF TRANSFER.ATTACH COPY OF THE DEED FOR REAL ESATE. ) VALUE
1 Belco Community Credit Union IRA 41,528.27 100 41,528.27
Beneficiary: Estate of Richard Cover
Per letter
TOTAL (Also enter on Line 7, Recapitulation) 41,528.27
If more space is needed, use additional sheets of paper of the same size.
.r s �
CQ1vtMUNITY CREDIT UNION
DECEDENT ESTATE INFORMATION(On Date of Death)
1. Name(s)in which the account was held: qI oha4 a E• O V 21' I ►' 6-r"y
2. Account number:
3. Balance as of date of death:
Balance Accrued Dividends Opened
Regular Saving: S1 a�C, Oa?s0•Sq (I 1..1. 1 )l�t 3- 3J31�13) -
Holiday Club S2
Money Market: S6
Checking: S4 q a 4 I�- I r,+e Ye-,5t r�c�IVe Sl nc�313 113
�jIRA: S5 �+i�'.5.a� -�I�,c:uti-rf� PU,% 1113) 31Dt19+
Certificates: Balance Accrued Dividends Certficate Number ' Gwiie�
I
, 4 Name(s)in which Safe Deposit Box was held:
5 Date the box was initially rented:; CAPI
6 Branch address at which the box is l rated: n Road
.41 LAZA I I IPA 1"70 It
7 Loan Information: Balance Accrued Interest Per Diem Int
A. Unsecured Loans:
L14 Classic Visa Card
B. Secured Loans:
C. Mortgage Loans: $ $
8 Miscellaneous: N IA—
REV-1511 EX+ (10-09)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE
FUNERAL EXPENSE AND
RESIDENT NDECEDENT lRN ADMINSTRATIVE COSTS
ESTATE OF FILE NUMBER
Richard E. Cover 21 130493
Decedent's debts must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
1 JDK Catering, memorial service dinner 848.00
2 Malpezzi Funeral Home 4,580.57
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions:
Name(s) of Personal Representative(s)
Street Address
City State ZIP
Year(s) Commission Paid:
2. Attorney Fees: 3,000.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.)
Claimant
Street Address
City State ZIP
Relationship of Claimant to Decedent
4. Probate Fees:
5. Accountant Fees:
6. Tax Return Preparer Fees:
7 Saidis, Sullivan & Rogers, out of pocket expenses 433.50
8 Saidis, Sullivan & Rogers, out of pocket expenses 243.30
9 Saidis, Sullivan & Rogers, reserve for additional out of pocket expenses 150.00
10 Register of Wills, filing fees 30.00
TOTAL (Also enter on Line 9, Recapitulation) 9,285.37
If more space is needed, use additional sheets of paper of the same size.
REV-1512 EX+ (12-12)
Pennsylvania SCHEDULE I
DEPARTMENT OF REVENUE
DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Richard E. Cover 21 130493
Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbumed medical expenses.
ITEM DESCRIPTION VALUE AT DATE
NUMBER OF DEATH
1 Partridge &Associates 1,197.21
2 2013 final individual income taxes 6,100.00
3 Craig- Friedly Insurance Company 83.16
4 ROBC Limited (Bridges at Bent Creek) 139.14
5 West Shore EMS 150.64
6 Alert Pharmacy 225.17
7 Barclay Card US, credit card 19.30
8 Angels on Call 43.25
9 R. Viehman, re-issued commission check 297.42
10 J. Rodney Fickel Agency, re-issued commission check 39.74
11 Anchor Financial, re-issued commission check 75.40
12 Angels on Call 426.50
13 Marilyn Gehringer, re-issued commission check 184.60
14 Joseph Marrazzo, Jr., re-issued commission check 41.20
15 Silver Spring Ambulance 866.50
TOTAL (Also enter on Line 10, Recapitulation) 9,889.23
If more space is needed, insert additional sheets of the same size
REV-1513 EX+ (01-10)
tot"pennsylvania
SCHEDULE
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Richard E. Cover 21 130493
NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS[Include outright spousal distributions and
transfers under Sec.9116(a)(1.2).]
1 Michael S. Cover Son 125,163.12
1817 Fox Hunt Lane
Harrisburg, PA 17110
2 Cynthia A. Macgee Daughter 125,163.12
4069 Regiment Boulevard
Enola, PA 17025
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE.
II 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.
If more space is needed, use additional sheets of paper of the same size.
LAST WILL AND TESTAMENT
OF
RICHARD E. COVER
I, RICHARD E. COVER of the Borough of Mechanicsburg,
Cumberland County, Pennsylvania, declare this to be my Last
Will and Testament, hereby revoking any will previously made by
me.
I - I direct the payment of all my just debts and
funeral expenses out of my estate as soon as may be practical
after my death.
II - I devise and bequeath all of my estate of whatever
nature and wherever situate unto my wife, Betty L. Cover, pro-
viding she survives me by sixty (60) days.
III - Should my said wife fail to be living on the
sixty-first (61st) day following my death, then I devise and
bequeath all of my estate of whatever nature and wherever
situate unto my issue per stirpes.
IV - I appoint my wife, Betty L. Cover, Executrix
of this, my Last Will and Testament. Should my said wife fail to
qualify or cease to act as such, then I appoint my son, Plichael
S. Cover, to act in this capacity. Neither of my personal
representatives shall be required to post bond in this or any
jurisdiction_ .
IN WITNESS WHEREOF, I have hereunto set my hand and seal
on this, the �O fL day of /too c w.� 1979.
Richard E. Cover
.4RNOLD,SLIEE&BAYLE)' '
TTORrv[YS nT Lna
Page 1
Signed, sealed, published and declared by RICHARD E. COVER, Tes-
tator therein named, on this. and one (1) other sheet of paper
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.
Name Address
7 z
Name !`,/ Address 1
ARNOLD.SLIEE&HAli-
ntTllRNll'I Al 11" -
Page 2
COMMONWEALTH OF PENNSYLVANIA)
SS.
COUNTY OF' CUMBERLAND)
I, RICHARD E. COVER , the testator whose name is signed
to the attached or foregoing instrument, having been duly quali-
fied according to law, do hereby acknowledge that I signed and
executed the instrument as my Last Will; that I signed it will-
ingly; and that I signed it as my free and voluntary act for the
purposes therein expressed.
Sworn or affirmed to and acknowledged before me, by
R19AARD E. COVER, the testat or this _ � — day
of ��fjtt ,�,1�Ce�� 19 79 .
N tart' Public
Thelma S. f!kCau-;:n,
My Commission Expires iJuiy.1,1980
Camp 111,PA _,,:, Cumberland Cwmlp
COMMONWEALTH OF PENNSYLVANIA)
SS.
COUNTY OF CUMBERLAND)
WE, the undersigned,
the witnesses whose names are signed to the attached or foregoing
instrument, being duly qualified according to law, do depose and
say that we were present and saw the testator sign and execute
the instrument as his Last Will; that RICHARD E. COVER
signed willingly and that RICHARD E. COVER executed it
ashis free and voluntary act for the purposes therein expressed;
that each of us, in the hearing and sight of the testator signed
the will as witnesses; and that to the best of our 'knowledge the
testator was at that time 18 or more years of age, of sound mind
and under no constraint or undue influence.
Sworn to and subscribed before me
this a day of G� 19 79
ARNOLD,SLIKE &BAYLEY Notrdry Public
ATTORNEYS AT LAW
2109 MARKET STREET ?nbll;
CAMP HILL PENNSYLVANIA 11011 Thelma S. M11 ' :Im.NetaTY
My Commission Expires July L.1980
{amp
trill,PA Cumberland County
COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96) -
C,IFPARTgEN3 OF REVENUE
BUREAU QF INDIVIDUAL TAXES
DEPT.280601
HARRISBURG,PA 17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
N0. CD 017814
COVER MICHAEL S
1817 FOXHUNT LANE
HARRISBURG, PA 17110-3248
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
-------- fold
101 $10,200.00
ESTATE INFORMATION: SSN:
FILE NUMBER: 2113-0493
DECEDENT NAME: COVER RICHARD E
DATE OF PAYMENT: 06/28/2013
POSTMARK DATE: 06/28/2013
COUNTY: CUMBERLAND
DATE OF DEATH: 03/31/2013
TOTAL AMOUNT PAID: $10,200.00
REMARKS: RECEIPT TO ATTY
CHECK# 1 18
INITIALS: DMB
SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
TAXPAYER