HomeMy WebLinkAbout06-29-06
REV-1500 EX + (6-00'
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
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DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL)
, Hockenberry, Roy C.
! DA TE -Oi=-DEATH(MM-:i5(5~YEART ------~ -----OATE-OF BIRTH (M~Db-YEAR)
09-17-1916
APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL)
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X 1. Original Return
2 Supplemental Return
4. Limited Estate
! -, 4a. Future Interest Compromise (date of death after
12-12-82)
7. Decedent Maintained a Living Trust (Attach
copy of Trust)
10 Spousal Poverty Credit (date of death between
. 12-31-91 and 1-1-QS)
------,,',---. ~------~-_...- ,----- --- -..----" _.~~---
'x" 6. Decedent Died Testate (Attach
copy of Will)
9. Litigation Proceeds Received
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FIRM NAME (If applicable)
SALZMANN HUGHES PC
354 Alexander Spring Road, Suite 1
Carlisle, PA 17013
TELEPHONE NUMBER
--------------r-- ..__._ ..-____.___ ____. ___.___.______,_____, ____ _._.__
----.---- ~.........-, ---- '-----.--..--.,--,--.--------.- -----,,------_._- -----------
i 717-249-6333
(1) None
None
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
(2)
(3)
4. Mortgages & Notes Receivable (Schedule 0)
FILE NUMBER
OFFICIAL USE ONLY
II 05
_c;QUNJY_c;OD~ __--"'-EAR.
----..- - --
SOCIAL SECURITY NUMBER
0972
Nli'-'lBER
204-30-6814
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
3. Remainder Return (date of death pnor to 12-13-82)
5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
11. Election to tax under Sec. 9113(A) (Attach Sch 0)
(4) None
None
i THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMA nON SHOULD BE DIRECTED TO:
NAME I COMPLETE MAILING ADDRESS
Pat r i C_~~ 13....c:>>~r1.!.....Es q--'----______ ___
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5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)=-J Separate Billing Requested
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
(5) 5,295.45
(6) None
(7) None
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
(9) 3 ,275.1 4
--- .---------------..--
(10) 103,518.56
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has
not been made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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15. Amount of Line 14 taxable at the spousal tax rate,
or transfers under Sec. 9116(a)(1.2)
0.00
16 Amount of Line 14 taxable at lineal rate
0.00
17. Amount of Line 14 taxable at sibling rate
0.00
0.00
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
20. D
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
OFFICIAL USE ONLY I
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(8)
>> BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH<<
5,295.45
(11 )
106,793.70
(12) insolvent
-------- --- -
(13) 0.00
(14) 0.00
- - ---_. - -- -----
x .00 (15) 0.00
x .045 (16) 0.00
x .12 (17) 0.00
x .15 (18) 0.00
(19) 0.00
----- .----
Copyright 2002 form software only The Lackner Group, Inc.
Form REV-1500 EX (Rev. 6-~
Decedent's Complete Address:
STREET ADDRESS
442 Walnut Bottom Road
-- ~-
CITY Carlisle
STATE PA
ZIP 17013
,
Tax Payments and Credits:
1. Tax Due (Page 1 line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1) 0.00
0.00
Total Credits (A + B + C)
(2)
0.00
3. InteresUPenalty if applicable
D. Interest
E. Penalty
TotallnteresUPenalty (0 + E)
4. If line 2 is greater than Line 1 + line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 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.
(3)
(4)
B. Enter the total of line 5 + 5A. This is the BALANCE DUE.
(5)
(SA)
(58)
0.00
A. Enter the interest on the tax due.
0.00
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:
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; or..................................................... ......................................... ................
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?................ ........................................................... ...... .....................................
Yes
No
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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?........................................................ ..... . ........................... ....... .......... .... ...... J
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
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
c~~~ete. D~~I_~~ti~n of pr~~~~~t~~.!!1~n~~pers~_~! rep~~enta.tive i~~_s~_~0~_11__~_oL~~ti~.~~~~i~p~p.~~~.!1as ~~Y!~?wle:dJ~~______ ____ ~_____._____ __ _. _.______
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS DATE
D~rJene L corn~an1' 934 ~Iexander Spring Road
s&2~~~~~E~~tJ~~GRETURN _____AD6RESS_c~r~s'::~~.27~1~__ . -------- -----~?[~~. ~~E0
~L~'_~;qdvk~___ ___ _w_ ~~~;i~;~~~~~;t~e7e1\ 1 U 1J41t/&,
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE ----j\ObRE-SS------ ~----.----------------- --.----..---. DATE-'
Patr~ R. Brown, Esq, 354 Alexander Spring Road, Suite 1
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'-/ .<:-_Z-t.-..::..,....,/"-,./\. 7' ru'-c.~"Y'----/ Carlisle, PA 17013 . -..< '( u '"
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the
surviving spouse is 3% [72 P.S. S9116 (a) (1.1) (i)].
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%
[72 P.S. S9116 (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 twenty-one 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% [72 P.S. S9116 (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%, except as noted in 72 P.S.
S9116 1.2) [72 P.S. S9116 (a) (1)].
The tax rate imposed on the net value of transfers to orfor the use of the decedent's siblings is 12% [72 P.S. S9116 (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-160B EX+ (6-98/
'.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT OECEDENT
ESTATE OF
Hockenberry, Roy C.
FILE NUMBER
21-05-0972
Include the proceeds of litigation and the date the proceeds were received by the estate
All property jointly-owned with the right of survivorship must be disclosed on schedule F.
ITEM
NUMBER DESCRIPTION
1 M& T Bank - checking account #2670012752
VALUE AT DATE
OF DEATH
5,295.45
"
TOTAL (Also enter on Line 5, Recapitulation)
5.295.45
(If more space is needed. additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule E (Rev. 6-98)
REV-1151 EX+ (12-99)
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Hockenberry, Roy C.
Debts of decedent must be reported on Schedule I.
FILE NUMBER
21-05-0972
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
See continuation schedule(s) attached 2,469.59
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Social Security Number(s) I EIN Number of Personal Representative(s):
Street Address
City State Zip
-
Year(s) Commission paid
2. Attorney's Fees SALZMANN HUGHES PC 500.00
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 64.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 241.55
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation) 3,275.14
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H (Rev. 6-98)
Rev-1502 EX+ (6-98)
*'
SCHEDULE H-A
FUNERAL EXPENSES
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT OECEDENT
ESTATE OF
Hockenberry, Roy C.
FILE NUMBER
21-05-0972
ITEM
NUMBER DESCRIPTION AMOUNT
1 Good Shepherd Community Church - luncheon 75.00
2 Hoffman Roth Funeral Home 2.184.59
3 Super 8 Motel - family travel to services 83.14
4 The Bon Ton - funeral clothing 126.86
Subtotal
2,469.59
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-A (Rev. 6-98)
Rev-1502 EX+ (S-98)
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SCHEDULE H-B7
OTHER
ADMINISTRATIVE COSTS
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Hockenberry, Roy C.
FILE NUMBER
21-05-0972
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
Cumberland Law Journal - estate notice publication
75.00
2
Register of Wills - filing fee
15.00
3
The Sentinel - Legal - estate notice publication
151.55
Subtotal
241.55
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B? (Rev. 6-98)
Rev-1512 EX+ (6-98)
*'
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Hockenberry, Roy C.
FILE NUMBER
21-05-0972
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1 Commonwealth of PA, DPW
VALUE AT DATE
OF DEATH
102.276.36
2 United Church of Christ Homes
1.242.20
TOTAL (Also enter on Line 10, Recapitulation)
103,518.56
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule I (Rev. 6-98)
REV-1513 EX+ (9-00)
.
SCHEDULE ~
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
NUMBER
Hockenberry, Roy C.
NAME AND ADDRESS OF
PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal
distributions, and transfers
under Sec. 9116(a)(1.2)]
FILE NUMBER
21-05-0972
RELATIONSHIP TO
DECEDENT
Do Not List Trustee(s)
SHARE OF ESTATE AMOUNT OF ESTATE
(Words) ($$$)
I.
Darlene L. Cornman
934 Alexander Spring Road
Carlisle, PA 17013
Daughter
Barry L Hockenberry
121 Lane Street
Stephens City, VA 22655
Son
Rodney R Hockenberry
42 Clay Road
Carlisle, PA 17013
Son
Dawn D. Palmer
3317 Brisban Street
Harrisburg, PA 17111
Daughter
Robin W. Shank
435 Deerwood Drive
Fredericksburg, VA 22401
Daughter
See continuation schedule attached Continuation
Total
Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT
BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
0.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule J (Rev. 6-98)
SCHEDULE ..
BENEFICIARIES
(Part I, Taxable Distributions)
ESTATE OF:
Roy C. Hockenberry 204-30-6814 10/15/2005
Item Name and Address of Person(s) Share of Estate Amount of Estate
Number Receiving Property Relationship (Words) ($$$)
6 Joan L. Znaneick
33 High Street
Boiling Springs, PA 17007
Daughter
0.00
Total
1
LAST WILL AND TEST AJ\lIENT
OF
ROY C. HOCKENBERRY
I, ROY C. HOCKENBERRY, a resident of and domiciled at 327 Greason Road, Carlisle, West
Pennsboro Township, Cumberland County, Pelillsylvania, being of sound mind and di~posing intent, do
) . .~"-]
hereby make, publish and declare this to be my Last Will and Testament, hereby revoking' all Wi)l~ and
Codicils at anytime heretofore made by me.
.........."~:
ITEM I
I order and direct my Executrix, hereinafter named, to pay all of my debts and expenses involved
or cOIUlected with my funeral and the administration of my estate as soon after my death as is reasonably
possible. However, my Executrix need not accelerate and pay those unmatured obligations which, in
her opinion, might be proper and more advantageous to retain or renew and pay as they become due and
payable. Should any real property pass under my Will, it shall pass subject to any mortgage or lien
thereon.
ITEM II
I direct my Executrix to provide for a traditional funeral service, with burial in Cumberland
Valley Memorial Gardens.
ITEM III
I give, devise and bequeath all of the remainder of my estate, real or personal, and my property
of every lrind and description (including lapsed legacies and devises), wherever situate and whether
acquired before or after the execution of this Will, to my wife, ANNA L. HOCKENBERRY. If my
said wife shall not survive me, then I order 2nd direct that all of the remainder or rny property, to
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include my residence and any vehicles, be sold at public or private sale and the proceeds therefrom be
divided in equal shares among our six children; DARLENE L. CORNMAN, RODNEY R.
HOCKENBERRY, JOAN L. ZNANEICKI, BARRY L. HOCKENBERRY, ROBIN W. SHANK and
DAWN D. PALMER, per stirpes.
ITEM IV
.
In the event that my wife, ANNA L. HOCKENBERRY, and I should die simultaneously or
under circumstances as to render it impossible to determine who predeceased the other, or within thirty
(30) days of each other as the result of a common accident, my wife shall be deemed to have survived
me.
ITEM V
I hereby nominate, constitute and appoint as Executrix of this my Last Will and Testament my
wife, ANNA L. HOCKENBERRY, and direct that she shall serve without requirement of bond or
surety. By way of illustration and not of limitation and in addition to any inherent, implied or statutory
powers granted to executors generally, my Executrix is specifically authorized to and empowered with
respect to any property, real or personal, at any time held under any provision of this my Will, to sell
at public or private sale, allot, allocate between principal and income, assign, borrow, buy, care for,
collect, compromise claims, contract with respect to, convey, convert, deal with, dispose of, enter into,
exchange, hold, improve, invest, lease, manage, mortgage, grant and exercise options with respect to,
take possession of, pledge, receive, release, repair, sue for, to make distributions in cash or in kind or
partly in each without regard to the income tax basis of such asset, and in general to exercise all of the
powers in the management of my Estate which any L'1dividual would exercise in the management of
similar property owned in her own right, upon such temlS and conditions as to my Executrix may deem
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best, and to execute and deliver any and all instruments and to do all acts which my Executrix may deem
proper or necessary to carry out the purposes of this my Will, without being limited in any way by the
specific grants of power made, and without the necessity of a Court Order. Should my wife, ANNA L.
HOCKENBERRY be unable or unwilling to serve as Executrix, I hereby nominate and appoint my
daughters, DARLENE L. CORNMAN and DAWN D. PALMER, or the survivor of them, to serve as
Co-Executrices.
IN WITNESS WHEREOF, I have hereunto set my hand and affixed my seal this / )L..L day
of ~.a. . /.. t--t../
, 1995.
J?&;;-c-H~
ROY C. HOCKENBERRY
SIGNED, SEALED, PUBLISHED and DECLARED by the above Testator as and for his Last
Will, in the presence of us, who thereupon at his request, in his presence and in the presence of each
other, have hereunto subscribed our names as witnesses.
Address
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Witness
~,y0AI
Address
Page 3 of 4
ST A TE OF PENNSYLVANIA
SS.
COUNTY OF CUMBERLAND
< We, ROY C. <~HOCKENBERRY, --J ClIne::, J, K"'ycy < and
\~-.l .~ r ~, \~ .' -- 1N't--
GCn lvLtZ. \ . 'i------' \ 6' , the Testator and the witnesses, respectively, whose names are
signed to the 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 that he 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 witnesses and that to the best
of each witness' knowledge and belief the Testator was at that time eighteen years of age or older, of
sound mind and under no undue constraint or influence.
fio/f(}71~
Testator
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Witness
Subscribed, sworn to and acknowledged before me by ROY C. HOCKENBERRY, the Testator
and subscribed and sworn to before me by '-- ) OY"f\CS J. )<0. ~ e...V and
~ LGl" \~) ~(W\\- , witnesses, this ) 5~ay of !\J tfJ!('rY\ W , i 995
~ ------
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~..(\t1l-t=:9r) LO:VL
Notary Public
NOTARIAL SEAL
DENISE SNIDER. NOTARY PUBLIC
CARliSLE aORO, CUivi8ERLil,ND COuNTY
MY COMMISSION EXPIRES OCT. 28, 1996
Member ~ Pcn~sylvania Associatiln of Notaries
Page 4 of 4
m1M&rBank
499 Mitchell Street, Millsboro, DE 19966
November 28, 2005
Salzmann Hughes, P.C.
lOWest Pomfret Street
Carlisle, PA 17013
RE: Estate of Roy C. Hockenberry
Date of Death: October 15, 2005
Social Security Number: 204-30-6814
Dear Ms. Brown:
In response to your request, please be advised that at the time of death, the above-
named decedent had on deposit with this bank the following account.
1. Account Type........................... Checking Account
Account Number....................... 2670012752
Ownership (Names of).............. Roy C. Hockenberry, Anna L. Hockenberry
Opening Date...........................09/01/67 (account closed 11/03/05)
Balance on Date of Death........ ..$5,295.45
Accmed Interest
$
0.00
Total................................... ....$5,295.45
The above named decedent did not have a safe deposit box.
For any additional information on the above account, including ownership and
closures please contact our Spring Garden branch at 717-240-4525.
Sincerely,
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Charlene Warrington, Records Management
1-888-502-4349