HomeMy WebLinkAbout06-13-14 1505610143
REV-1500 EX(02-11) 16,
OFFICIAL USE ONLY
PA Department of Revenue pennsylvania County Code Year File Number
Bureau of Individual Taxes eEPPRTMEW OF REVENUE
PO BOx.280601 INHERITANCE TAX RETURN 21 14 0181
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
02 07 2014 12 11 1914
Decedent's Last Name Suffix Decedent's First Name MI
COCKLIN RUTH
(If Applicable)Enter Surviving Spouse's Information B_ elow
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 2. Supplemental Return 3, Remainder Return(Date of Death
Prior to 12-13-82)
❑ 4. Limited Estate 4a. Future Interest Compromise
(date of death after 12-12-82) 5. Federal Estate Tax Return Required
6 Decadent Died Testate 7 Decedent Maintained a Living Trust D S. Total Number Of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust) ( P
9. Litigation Pioceeds Received 10,gy oouaal Pgvg �1 andtfDa95of Death 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 Telephone Number
JENNIFER B HIPP 717 737 8761;,
m
REGISTEROFWcDILLS USFF 1`1 p
rrl C-) z C,3
First Line of Address
1 WEST. MAIN STREET CO
Second Line of Address G7 o
7 (D i
XJ CO f— TT
DATE*ILED r`
City or Post Office State ZIP Code CD T
SHIREMANSTOWN PA 17011
Correspondent's e-mail address: ihipp(cDbogarlaw.com
Under penalties of perjury,I declare that I have examined this retum,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 personal representative Is based on all information of which preparer has any knowledge.
SIGNATUR PERSON RES ONSI
;E FO A G RETURN DATE' (
�
' Eric H. Cocklin t9 (2/!U
ADDRESS —I
39 Ashburg Drive, Suite 2, Mechanicsburg, PA 17050
SIGNATURE 0 PR PAR R OT E THAN REPRESENTATIVE - DATE
Jennifer B. Hipp a L
ADDRE
1 West Ma n S reet, Shiremanstown, PA 17011
L 1505610143 Side 1 1505610143
k/J
1505610243
REV-1500 EX
Decedent's Social Security Number
Decedent's Name, COci ling Ruth
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. 173 , 765 . 49
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6.
7. Inter-Vivos Transfers&Miscellaneous tyon;Probate Property
(Schedule G) u Separate Billing Requested............ 7,
8. Total Gross Assets(total Lines 1 through 7)........................................................ 8. _ 113, 765 . 49
9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 13 ,564 . 30
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............................ 10.
11. Total Deductions(total Lines 9 and 10)................................................................ 11. 13 ,564 . 30
12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 160 ,20 1 . 19
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. 160,201 . 19 _
TAX COMPUTATION-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.00 15. 0 . 00
16. Amount of Line 14 taxable 0 . 00 16. 0 . 00
at lineal rate X .045
17. Amount of Line l4 taxable 160 201 . 19 n. - 19,224 . 14
at sibling rate X.12 r
18. Amount of Line 14 taxable
at collateral rate X.15 0 . 00 18. 0 . 00
19. TAX DUE................................................................................................................ 19. 19, 224-. 14
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. FX -
Side 2
1505610243 1505610243
REV-1500 EX Page 3 File Number 21-14-0181
Decedent's Complete Address:
DECEDENT'S NAME
Cocklin, Ruth
STREETADDRESS
39 Ashburg Drive, Suite 2 .
CITY STATE ZIP
Mechanicsburg PA 17050
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 19,224.14
2. Credits/Payments .
A. Prior Payments 18,318.76
B. Discount 961.21 '
Total Credits(A +8) (2) 19,279.97
3. Interest (3)
4, If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4) 55.83
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)
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?............................................................ ❑ Q
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 El 10
abeneficiary 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)(1)].
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 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
fling 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.
Rcv-1508 EX-(11.10)
SCHEDULE E
Pennsylvania CASH, BANK DEPOSITS, & MISC.
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Cocklin, Ruth 21-14-0181
property Ore proceetls of litlg Itth right su ilv procee uwere disclotl Ey1heestate.
' All proparry loindyownetl with the right of¢urvivorshlp must be tlisclosed on schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 PNC Bank-Checking Account No.5140238224. Date of death balance$76,595.26. 76.595.26
2 PNC Bank-Savings Account No.5005134668. Date of death balance$95,962.35. 95,962.35
3 Capital Blue Cross -Refund 1,023.12
4 Humana Refund 184.76
TOTAL(Also enter on Line 5, Recapitulation) 173,765.49
(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)
-Mar. 11. 2014 1 :41PM PNC Bank No. 8143 P. 2
G.PW
March 17, 2014
Jennifer B Hipp Esq
James D Bogar Law Firm
1 W Main St
Shiremanstown, PA 17011.
RE: Ruth Cocklin
SSN: 171-30-5830
DOD: 02-07-2014
Dear Ms_Hipp:
In response to your request for Date of Death(DOD) balances for the customer noted above, our
records show the following:
Checking Account
Account#5140238224 Established: 05-01-1979
RUTH COCKLIN
DOD balance: $76,59526+0.06 accrued interest
Interest paid 01-01-2014 thm 02-07-2014$1.42 YTD
Savings Account
Account#5005134668 Established: 05-29-2007
RUTH COCKLIN
DOD balance: $95,962.35+0.87 Accrued interest
Interest paid 01-01-2014 thru 02-07-2014 $18.22 YTD
Please note that this office provides date of death balances for deposit accounts (1RPs, CDs, Checking and
Savings). We do not process any financial transactions or provide statements. If you need assistance with
any of these items,please call 1-888-PNC-BANK(1-888-762-2265) or stop by your local PNC Bank branch
office.
Sincerely,
National Financial Services Center
PNC Bank,N.A.
Member FDIC
Page 1 oft
Mar, 11. 2014 1 :41 PM PNC Bank. No. 6143 P. 3
This message is intended for the use of the individual or entity to which it is addressed and may
contain information that is privilegeg confidential and exempt from disclosure under applicable law.
If the reader of this message is not the intended recipient or the employee or agent responsible for
delivering this message to the intended recipient,you are hereby notified that any disseminatio4
distribution or copying of this communications is strictly prohibited If you have received this
communication in error,please note me'immediately by reply or by telephone at 800-7624775 and
immediately desrroy this faxed document.
Page 2 of 2
REV-1511 EX-(10-09)
pennsylvania SCHEDULE H
DEPARTMENT OFREVENUE FUNERAL EXPENSES AND
RESIDENT DECEDENT RETURN ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Cocklin, Ruth 21-14-0181
Decedent's debts must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
See continuation schedule(s) attached 2,711.48
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s) .
Street Address
City State Zio
Year(s)Commission Paid
2. Attorney's Fees Bogar and Hipp Law Offices 6,300.00
3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation)
Claimant
Street Address
City State Zio
Relationshio of Claimant to Decedent
4. Probate Fees - 363.50
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 4,189.32
See continuation schedule(s) attached
TOTAL(Also enter on line 9, Recapitulation) 13,564.30
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
Cocklin, Ruth 21-14-0181
ITEM
NUMBER DESCRIPTION AMOUNT
Funeral Expenses
1 Cocklin Funeral Home,Inc.-funeral bill 2,335.00
2 Isaac's Restaurant-funeral luncheon 206.48
3 Judy Garee-paperproductsforfuneralluncheon 20.00
4 Paul Schreck-Pastor Honorarium 150.00
H-A - 2,711.48
Other Administrative Costs
5 Debra Basehore Wiest,Tax Collector-2014 Per Capita Tax - 9.80
6 Heartland Pharmacy of Pennsylvania, Inc. 66.69
7 Klingler&Associates -fee to prepare 2013 personal income tax returns 50.00
8 Manor Care Health Services, LLC 2,369.33
9 PerH Diagnostics - - 45.50
10 PNC Bank-Service charge 20.00
11 RESERVES: -Costs to conclude administration of the estate, including preparation and filing 750.00
of final personal income tax returns and fiduciary income tax returns
12 US Treasury-reclamation of Social Security payment 878.00
H-B7 4,189.32
Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev. 6-98)
REV 4513 EX-(;1.10) "
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT -
ESTATE OF FILE NUMBER
Cocklin, Ruth 21-14-0181
NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(S)RECEIVING PROPERTY DECEDENT
(Words) ($SS)
Do Not LIM T�MW.l I TAXABLE DISTRIBUTIONS [include outright spousal
distributions,and transfers
under Sec.9116(a)(1.2)] -
Eric H.Cocklin Brother Rest, Residue
39 Ashburg Drive, Suite 2 and Remainder
Mechanicsburg, PA 17050
Total
Enter dollar amounts for distributions shown above on lines 15 throw h 18 on Rev 1500 cover sheet,as approp 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 SHEETI
Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule J(Rev.01-10)
LAST WILL AND TESTAMENT
OF
RUTH COCKLIN
I, RUTH COCKLIN, of Mechanicsburg, Cumberland County,
Pennsylvania, make, publish and declare this as and for my Last
Will and Testament, hereby revoking all other Wills and Codicils
heretofore made by me.
FIRST: I direct that my Executor immediately upon my
death contact the Neill Funeral Home of Harrisburg, Pennsylvania,
in order that arrangements can be made for my body to be cremated
and for my remains to be disposed of pursuant to arrangements
heretofore made by me with the Neill Funeral Home, same being
that my remains would be buried at the Ft. Indian-town Gap.
SECOND: I give and devise any and all interest of
whatever nature that I may have in the Henry S . Cocklin family
farm located in Monaghan Township, York County, Pennsylvania, to
my sister, MAUDE COCKLIN. Should MAUDE COCKLIN predecease me, I
give and devise any and all interest that I may have in the Henry
S . Cocklin Family Farm unto my brother, ERIC H. COCKLIN.
THIRD: I devise and bequeath all the rest, residue and
remainder of my estate of whatever nature and wherever situate,
including any property over which I hold power of appointment and
together with any insurance policies thereon to MAUDE COCKLIN.
Should MAUDE COCKLIN predecease me, I give and bequeath all the
rest, residue and remainder of my estate to ERIC H. COCKLIN.
Should MAUDE COCKLIN AND ERIC H. COCKLIN predecease me, I give and
bequeath all the rest, residue and remainder of my estate, in
equal shares, to my nephews, ERIC JOSE COCKLIN, JOHN SAMUEL
COCKLIN and PAUL ROBERTO COCKLIN. Should any of my above specif-
ically named nephews predecease me, I give and bequeath such
deceased nephew' s share, in equal parts, to my surviving specifi-
cally named nephews .
FOURTH: In addition to all powers granted to them by
law and by other provisions of this Will, I give the fiduciaries
acting hereunder the following powers, applicable to all proper-
ty, exercisable without court approval and effective until actual
distribution of all property:
(A) To sell at public or private sale, 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 (including credit, with or without security) or
conditions as are deemed proper. This includes the power to give
legally sufficient instruments for transfer of the property and
to receive the proceeds of any disposition of it.
(B) To partition, subdivide, or improve real estate
and to enter into agreements concerning the partition, subdivi-
Sion, improvement, zoning or management of real estate and to
impose or extinguish restrictions on real estate.
(C) To compromise any claim or controversy and to
abandon any property which is of little or no value.
(D) To invest in all forms of property, including
stocks, common trust funds and mortgage investment funds, without
restriction to investments authorized for Pennsylvania fiduci-
aries , as are deemed proper, without regard to any principle of
diversification, risk or productivity.
(E) To exercise any option, right or privilege granted
in insurance policies or in other investments .
(F) To exercise any election or privilege given by the
Federal and other tax laws, including, but not necessarily being
limited to, personal income, gift and estate or inheritance tax
laws .
2
(G) To make distributions to my herein named benefici-
aries in cash or in kind or partly in each.
(H) To borrow,money from themselves or others in order
to pay debts, taxes, or estate or trust administration expenses,
to protect or improve any property held under my will, and for
investment purposes .
(I) To select a mode of payment under any qualified
retirement plan (pension plan, profit sharing plan, employee
stock ownership plan, or any other type of qualified plan) to the
extent the plan or the law permits them to do so, and to exercise
any other rights which they may have under the plan, in whatever
manner they consider advisable.
FIFTH: I direct that all inheritance, estate, trans-
fer, succession and death taxes, of any kind whatsoever, which
may be payable by reason of my death, whether or not with respect
to property passing under this Will, shall be paid out of the
principal of my residuary estate.
SIXTH: All interests hereunder, whether principal or
income, which are undistributed and in the possession of the
fiduciaries acting hereunder, even though vested or distribut-
able, shall not be subject to attachment, execution or sequestra-
tion for any debt, contract, obligation or liability of any
beneficiary, and furthermore, shall not be subject to pledge,
assignment, conveyance or anticipation.
SEVENTH: I nominate and appoint ERIC H . COCKLIN,
Executor of this, my Last Will and Testament. In the event of the
death, resignation or inability to serve for any reason whatso-
ever of the said ERIC H. COCKLIN, I nominate and appoint my
sister, MAUDE COCKLIN, Executrix of this, my Last Will and
Testament . In the event of the death, resignation or inability
to serve for any reason whatsoever of the said ERIC H. COCKLIN
and MAUDE COCKLIN, I nominate and appoint JAMES D. BOGAR, ES-
3
QUIRE, Executor of this , my Last Will and Testament. I direct
that my Executor or Executrix, as the case may be, and their
successors, shall not be required to post security or a bond for
the performance of their duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and
seal to this, my Last Will and Testament, this 7/5' day of
S{P f�vH tX 2004 . �2
(SEAL)
RUTH COCKLIN
Signed, sealed, published and declared by the above-
named Testatrix as and for her Last Will and Testament in our
presence, who, at her request, in her presence and in the
presence of each other, have hereunto subscribed our names as
attesting witnesses .
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Address
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Address
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