HomeMy WebLinkAbout10-02-06
REV-1600 EX + (6.00)
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OFFICIAL USE ONLY
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV.1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
II 06
COUNTY C DE YEAR
0062
NUMBER
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
o 3. Remainder Return (date of death prior to 12-13-82)
o 5. Federal Estate Tax Retum Required
1 8. Total Number of Safe Deposit Boxes
129 Market Street
Millersburg, PA 17061
o 1. Original Retum 0 2. Supplemental Retum
o 4. Limited Estate 0 4a. Future Interest Compromise (date of death after
12-12-82)
[!] 6. Decedent Died Testate (Allach 0 7. Decedent Maintained a Living Trust (Allach
~of~ ~of~~
O 9. Litigation Proceeds Received 0 10. Spousal PovertY Credit (data of death between 0 11.Election to tax under Sec. 9113(A) (Attach Sch 0)
12-31-91 and 1-'-95)
THIS'SECTlONMOSTBIt'.colllipI;.Ej:e[)...Al..t.CORa~sFfoNDENbe.~'N[):'CON~.P'EN~i::i+r~jN~6R~ttc)Nisaotil.!Di'BE}'PJREQ't~al'4i;;;<h,;:j:,~);',;,:.:;'i,;~~
NAME COMPLETE MAILING ADDRESS
Allen Shaffer
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
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5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L) 0 Separate Billing Requested
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
DATE OF BIRTH (MM-DD-YEAR)
12-24-2005
04-13-1913
(IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL)
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FIRM NAME (If applicable)
Shaffer & Engle Law Offices
TELEPHONE NUMBER
717 -692-2345
(1)
(2)
(3)
(4)
(5)
(6)
(7)
None
922,481.98
None
None
123,695.33
None
659,347.22
OFFICIAL USE ONLY
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(13)
(14)
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15.Amount of Line 14 taxable at the spousal tax rate, 0.00 x .00 (15)
z or transfers under Sec. 9116(a)(1.2)
0 (16)
i= 16. Amount of Line 14 taxable at lineal rate 1,536,803.46 x .045
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Go 17.Amount of Line 14 taxable at sibling rate 0.00 x .12 (17)
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(.) 18. Amount of Line 14 taxable at collateral rate 0.00 .15 (18)
)( x
t! 19. Tax Due
(19)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule f)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
(9)
(10)
60,751.49
7,696.66
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)
(8) 1,705,524.53
68,448.15
1,637,076.38
100,272.92
1,536,803.46
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
20. [!]
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
0.00
69,156.16
0.00
0.00
69,156.16
:j?>BE~tJRET9,AN$ViE~'Al!.Lf9UE$nOVN$ON.REVER.SE:$'ID~'i6.NDJtECHE;C8MAtH,~<".
Copyright 2002 form software only The Lackner Group, Inc.
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Form REV-1500 EX (Rev. 6-00:
Decedent's Complete Address:
STREET ADDRESS
100 Mt Allen Drive
CITY Mechanicsburg
STATE P A
ZIP 17055
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. CreditslPayments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
69,156.16
70,000.00
3,457.81
Total Credits (A + B + C)
(2)
73,457.81
3. InterestlPenalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty (D + E) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4)
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. (5)
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
4,301.65
ti', '
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;.................................................................................. ~ ;xXx
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?..................... ................................................................................................. D
~
~
D
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?..................................................................................................................... D ~
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 pe~ury, I declare that I hava 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 personal representetive Is based on aJllnfonnation of which preparer has any knowtadge.
SIGNATURE OF PERSON RESPONSIB FOR FILING RETURN ADDRESS
Ben L cher
DATE
1 Manor View Drive
Millersburg, PA 17061
9/d9/06
URN
ADDRESS
DATE
PO Box 428
Elizabethvllle, PA 17023
ADDRESS
129 Market Street
Millersburg, PA 17061
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. ~9116 (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. ~9116 (a) (1.1) (Ii)]. The statute does not exemDt 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. ~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%, except as noted in 72 P.S.
99116 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% [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-1503 EX+ (6-98)
.
SCHEDULE B
STOCKS & BONDS
COMMONWEALTH OF PENNSYlVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Kocher, Margaret M
FILE NUMBER
21-06-0062
All property jolntly-owned with right of survivorship must be disclosed on Schedule F.
ITEM CUSIP VALUE AT DATE
NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH
1 5000 shares DREYFUS MUNICIPAL INCOME INC 8.68 43.400.00
2 10 shares of AGWAY 0.00 0.00
3 25,699.543 shares of AMERIPRISE - MUTUAL FUNDS 4.3800001 112,564.00
ACCOUNT
4 384 shares of CITIGROUP INC - COMMON 49.24 18,908.16
5 17,541 shares of COMMUNITY BANKS INC 28.45 499,041.45
6 5,664 shares of COMMUNITY BANKS INC - BOOK 28.45 161,140.80
ENTRY
Accrued dividend on Item 6 through date of death 3,956.40
Accrued dividend on Item 6 through date of death 864.60
7 1,000 shares of FORD MOTOR COMPANY 7.90 7,900.00
8 98.552 shares of NUVEEN - CERTIFICATE 2.3485064 231.45
CONFISCATED - ESCHEATED 2003
9 872.14 shares of NUVEEN - CERTIFICATE 0 0.00
CONFISCATED - REPORTED LOST/REPLACED/SOLD
10 10 shares of NUVEEN - CERTIFICATE CONFISCATED- 0 0.00
REPORTED LOST/REPLACED/SOLD
11 337.118 shares of PNC - BLACKROCK PA TAX FREE- 10.2650111 3,460.52
000 VALUE
Total of Continuation Schedule(s) See attached page
TOTAL (Also enter on Line 2, Recapitulation) 922,481.98
(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 B (Rev. 6-98)
Rev-1503 EX+ (6-981
*'
SCHEDULE B
STOCKS & BONDS
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Kocher, Margaret M
FilE NUMBER
21-06-0062
ITEM CUSIP VALUE AT DATE
NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH
12 130 shares of VISTEON CORP 6.92 899.60
13 $10,000 DELAWARE CO PA AUTHORITY HIC RV 99.15 9.915.00
MRCY
14 $50,000 MONTGOMERY CNTY PA HIGHER ED 9.50% 100 50.000.00
OF 4/1/2022
15 $10,000 PHilADELPHIA PA GAS WORKS REV 7.75% 102.00 10.200.00
OF 7/1/2007
TOTAL (Also enter on Line 2, Recapitulation) 922.481.98
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA.1500 Schedule B (Rev. 6-98)
Rev-16G8 EX+ (6-98)
.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Kocher, Margaret M
FILE NUMBER
21-06-0062
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property Jolntly-owned with the right of survlvorshlp must be disclosed on schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 FUNDS APPLIED FOR THROUGH ESCHEAT SYSTEM 257.77
2 IDS LIFE INSURANCE COMPANY - REIMBURSEMENT FOR NURSING HOME 1.620.00
11/16/05 -12/15/05
3 IDS LIFE INSURANCE COMPANY - REIMBURSEMENT FOR NURSING HOME 1.860.00
10/16/05 -11/15/05
4 CITIGROUP INC - COMMON - Dividend received prior to 000 deposited after 000 168.96
5 COIN -1/2 DOLLARS - BY MISTAKE AT BOX INVENTORY WAS LISTED AS 50.50 25.50
AND SHOULD HAVE BEEN 25.50
6 COIN - SILVER DOLLARS - FROM SAFE DEPOSIT BOX 30.00
7 COMMUNITY BANKS - CHECKING -1108465506 24.383.06
8 COMMUNITY BANKS - CHECKING - Deposit 80.00
9 COMMUNITY BANKS - CHECKING - Deposit 800.00
10 COMMUNITY BANKS - CHECKING - 1152503506 1.967.39
11 COMMUNITY BANKS - CTF OF DEP 10.509.10
Accrued interest on Item 11 through date of death 58.80
12 Dreyfus - Dividend declared prior to 000 received after 000 235.00
13 Dreyfus - Dividend received prior to 000 deposited after 000 235.00
Total of Continuation Schedule(s)
See attached
paae(s)
123.695.33
TOTAL (Also enter on Line 5, Recapitulation)
(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-1608 EX+ (6-98)
ESTATE OF
*'
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
continued
COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Kocher, Margaret M
FILE NUMBER
21-06-0062
ITEM
NUMBER
VALUE AT DATE
OF DEATH
20
21
22
23
24
14
DESCRIPTION
FORD MOTOR COMPANY - Dividend received prior to DaD deposited after DaD
100.00
15
IDS LIFE INSURANCE COMPANY - REFUND FOR ANNUITY
540.00
16
ING FINANCIAL LIFELINE
29.089.96
Accrued interest on Item 16 through date of death
17.97
17
LEGG MASON 'SMITH BARNEY CASH MANAGEMENT
12.131.71
18
LEGG MASON 'SMITH BARNEY CASH MANAGEMENT - Dividend received prior to
DOD deposited after DOD
268.75
Accrued interest on Item 18 through date of death
5.18
19
MONY ACCESS ACCOUNT 9182203154
32.491.46
Accrued interest on Item 19 through date of death
53.47
PNC Advisors - Divident received prior to DaD deposited after DaD
2.031.25
PNC Bank - Checking Account 50-000-1268
1.391.35
Accrued dividend on Item 21 through date of death
8.23
RiverSource Mutual Funds - Dividend received prior to DOD deposited after DOD
393.61
RiverSource Mutual Funds - Dividend received prior to DOD deposited after DOD
943.81
DOLLS 'CRADLE - ITEM IV (F) - APPRAISAL ATTACHED
90.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule E (Rev. 6-98)
Rev-1508 EX+ (8-98)
*'
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
continued
CO~ONWEAl. TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Kocher, Margaret M
FILE NUMBER
21-06-0062
ITEM
NUMBER
25
DESCRIPTION
VALUE AT DATE
OF DEATH
JEWELRY - 14K YELLOW GOLD DIAMOND CLUSTER PENDANT BRILLIANT CT-
ITEM IV (F) - APPRAISAL ATTACHED
150.00
26
JEWELRY - 14K YELLOW GOLD RING WITH LARGE BRILLIANT CT DIAMOND -
ITEM IV (I) - APPRAISAL ATTACHED
230.00
27
JEWELRY - GOOD JEWELRY AS PER ITEM IV (J) - APPRAISAL ATTACHEO
1.360.00
28
JEWELRY - ONE STRING OF PEARLS (ALL SAME SIZE) ITEM IV (H 3) - APPRAISAL
ATTACHED
168.00
TOTAL (Also enter on Line 5, Recapitulation)
123.695.33
Copyright (c) 2002 form software only The Lackner Group. Inc.
Form PA-1500 Schedule E (Rev. 6-98)
Rev.1510 EX+ (6-98)
.
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Kocher, Margaret M
FILE NUMBER
21-06-0062
This schedule must be completed and filad if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
ITEM DESCRIPTION OF y DATE OF DEATH % OF DECO'S EXCLUSION TAXABLE
NUMBER INCLUDE NAME OF TRANSFEREE. THEIR RELATIONSHIP TO DECEDENT AND VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
THE DATE OF TRANSFER. ATTACH A COpy OF THE DEED FOR REAL ESTATE.
1 COMMUNITY BANKS TRUST ACCOUNT - 659.347.22 659.347.22
Community Banks, Tr u/w of Leon E. Kocher dtd
9/29/1997 flblo Margaret M. Kocher, upon her
death to her sons, Ben L. Kocher and Frederick
W. Kocher
Copy of Will Attached
TOTAL (Also enter on Line 7, Recapitulation) 659.347.22
(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 G (Rev. 6-98)
REV-1151 EX+ (12-99)
*'
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Kocher, Margaret M
Debts of decedent must be reported on Schedule I.
FILE NUMBER
21-06-0062
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
See continuation schedule(s) attached 10,765.50
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 24,000.00
See continuation schedule(s) attached
2. Attorney's Fees 24,000.00
See continuation schedule(s) attached
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 787.00
See continuation schedule(s) attached
5. Accountant's Fees
6. Tax Retum Preparer's Fees
7. Other Administrative Costs 1,198.99
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation) 60,751.49
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H (Rev. 6-98)
Rev-1502 EX+ (&-98)
*'
SCHEDULE H-A
FUNERAL EXPENSES
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Kocher, Margaret M
FILE NUMBER
21-06-0062
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
FUNERAL DINNER EXPENSES
500.00
2
HOOVER FUNERAL HOME
10.265.50
Subtotal
10.765.50
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-A (Rev. 6-98)
Rev.1502 EX+ (6.981
.
SCHEDULE H-B1
PERSONAL REPRESENTATIVE'S
COMMISSIONS
continued
COMMONWEALTH OF PeNNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Kocher, Margaret M
FILE NUMBER
21-06-0062
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
BEN L. KOCHER - EXECUTOR'S FEE
12.000.00
2
FREDERICK W. KOCHER - EXECUTOR'S FEE
12.000.00
Subtotal
24.000.00
Copyright (c) 2002 form software only The Lackner Group. Inc.
Form PA-1500 Schedule H-B1 (Rev. 6-98)
ReY-1502 EX+ (8.98)
*'
SCHEDULE H-B2
ATTORNEY'S FEES
continued
COMMONWEAlTH OF PENNSYlVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Kocher, Margaret M
FILE NUMBER
21-06-0062
ESTATE OF
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
SHAFFER & ENGLE LAW OFFICES - A TIORNEY'S FEE
24.000.00
Subtotal
24.000.00
Copyright (e) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B2 (Rev. 6-98)
Rev-1502 EX + (8-98)
*'
SCHEDULE H.B4
PROBATE FEES
continued
COMMONWEALTH OF PENNSYlVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Kocher, Margaret M
FILE NUMBER
21-06-0062
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
REGISTER OF WILLS, CUMBERLAND COUNTY
REGISTER OF WILLS, CUMBERLAND COUNTY - ADDITIONAL PROBATE FEE
687.00
2
100.00
.
Subtotal
787.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B4 (Rev. 6-98)
Rev.1602 EX+ (6.98)
*'
SCHEDULE H.B7
OTHER
ADMINISTRATIVE COSTS
continued
C0M\10NWEAL TH OF PENNSYlVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Kocher, Margaret M
FILE NUMBER
21-06-0062
ITEM
NUMBER DESCRIPTION AMOUNT
1 COMMUNITY BANKS - CHECKING -1152503506 -INSURANCE PREMIUM PPD 4.95
2 CUMBERLAND LAW JOURNAL - LEGAL ADVERTISEMENT 75.00
3 CUSTER, FAUST & ASSOCIATES, P.C. -INCOME TAX PREPARATION 250.00
4 MILLERSBURG POSTMASTER - CERTIFIED MAIL 4.64
5 PNC BANK - CHECKING ACCOUNT 50-000-1268 - CHARGES 55.29
6 REGISTER OF WILLS, CUMBERLAND COUNTY - SHORT FORMS 48.00
7 REGISTER OF WILLS, CUMBERLAND COUNTY - SHORT FORMS 8.00
8 REGISTER OF WILLS, CUMBERLAND COUNTY - SHORT FORMS 12.00
9 REGISTER OF WILLS, CUMBERLAND COUNTY - SHORT FORMS 16.00
10 REGISTER OF WILLS, CUMBERLAND COUNTY - FILE PA INHERITANCE TAX 15.00
RETURN
11 REGISTER OF WILLS, CUMBERLAND COUNTY - FILE INVENTORY 15.00
12 RESERVE - TAX PREPARATION 500.00
13 THE SENTINEL - LEGAL ADVERTISEMENT 195.11
Subtotal
1.198.99
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B7 (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
Kocher, Margaret M
FILE NUMBER
21-06-0062
Include unrelmbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1 ALERT PHARMACY - FINAL MEDICATION EXPENSES
VALUE AT DATE
OF DEATH
62.66
2 CAPITAL AREA HEALTH ASSOCIATION - FINAL EXPENSES
32.01
3 COMMUNITY BANKS - CHECKING -1152503506 - CK # 4825 VERIZON WRITTEN
PRIOR TO 000 CLEARED AFTER 000
17.91
4 COMMUNITY BANKS - CHECKING -1152503506 - CK # 4823 WRITTEN PRIOR TO
000 CLEARED AFTER 000
500.00
5 MESSIAH VILLAGE - HOME CARE EXPENSE
3.833.52
6 MESSIAH VILLAGE - FINAL HOME CARE EXPENSE
1,287.41
7 PA DEPARTMENT OF REVENUE - Personal Income Tax for 2005
1.380.00
8 PHILHAVEN - FINAL EXPENSE
18.94
9 UNITED STATES TREASURY - Personal Income Tax for 2005
543.00
10 VERIZON - FINAL TELEPHONE SERVICE
21.21
TOTAL (Also enter on Line 10, Recapitulation)
7,696.66
(If more space is needed. additional pages of the same size)
Copyright (c) 2002 fonn software only The Lackner Group. Inc.
Fonn PA.1500 Schedule I (Rev. 6-98)
REV.1513 EX+ (9-00)
.
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
NUMBER
Kocher, Margaret M
NAME AND ADDRESS OF
PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal
aistributionsA and transfers
under Sec. ~116(a)(1.2)]
RELATIONSHIP TO
DECEDENT
Do Not Uat Truateelal
FILE NUMBER
21-06-0062
SHARE OF ESTATE AMOUNT OF ESTATE
(Words) ($$$)
I.
See attached schedule
Total 1,536,803.47
Enter dollar amounts for distributions shown above on lines 5 through 18, as appropnate, on Rev 1500 cover sheet
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT
BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
See continuation schedule(s) attached
100,272.92
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
100,272.92
Copyright (c) 2002 form software only The Lackner Group. Inc.
Form PA-1500 Schedule J (Rev. 6-98)
SCHEDULE J
BENEFICIARIES
(Part I, Taxable Distributions)
ESTATE OF:
Margaret M Kocher 166-38-2305 12/24/2005
Item Name and Address of Person(s) Share of Estate Amount of Estate
Number Receiving Property Relationship (Words) ($$$)
1 Ben L Kocher Son $500,000.00 1,003,531.83
1 Manor View Drive SPECIFIC BEQUEST
Millersburg, PA 17061 329,673.61 1/2 OF
TRUST (SCH G)
173,858.22 50% OF
RESIDUE
2 Christopher W. Kocher Grandson 1/3 OF CHECKING 9,247.27
Rte 225 ACCOUNTS (3)
Elizabethville, PA 17023
3 Fredrick W Kocher Son 329,673.61 1/2 OF 503,531.83
PO Box 428 TRUST (SCH G)
Elizabethville, PA 17023 173,858.2250% OF
RESIDUE
4 Jacqueline Kocher Great-granddaughter JEWELRY 150.00
Rte 225
Elizabethville, PA 17023
5 Linda A. Kocher Daughter-in-Law JEWELRY GIVEN
PO Box 428 PRIOR TO DEATH
Elizabethville, PA 17023
6 Linda M. Kocher Daughter-in-Law PEARLS 168.00
1 Manor View Drive OTHER JEWELERY
Millersburg, PA 17061 GIVEN PRIOR TO
DEATH
7 Matthew B. Kocher Grandson JEWELRY 9,477.27
1 Manor View Drive 1/3 OF CHECKING
Millersburg, PA 17061 ACCOUNTS
OTHER ITEMS GIVEN
PRIOR TO DEATH
8 Rebecca L. Kocher Granddaughter DOLLS 10,697.27
1 Manor View Drive JEWELRY
Millersburg, PA 17061 OTHER JEWELRY
GIVEN PRIOR TO
DEATH
1
SCHEDULE J
BENEFICIARIES
(Part I, Taxable Distributions)
ESTATE OF:
Margaret M Kocher 166-38-2305 12/24/2005
Item Name and Address of Person(s) Share of Estate Amount of Estate
Number Receiving Property Relationship (Words) ($$$)
9 Wanda Kocher Granddaughter JEWELRY GIVEN
Rte 225 PRIOR TO DEATH
Elizabethville, PA 17023
Total 1,536,803.47
2
Rev.1502 EX+ (6-88)
*'
SCHEDULE .I.IIB
CHARITABLE AND GOVERNMENTAL
DISTRIBUTIONS
continued
COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Kocher, Margaret M
FILE NUMBER
21-06-0062
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
MESSIAH VILLAGE
48.886.46
2
OMS INTERNATIONAL
48.886.46
3
Peace United Church of Christ
Berrysburg, PA
2.500.00
Subtotal
100.272.92
Copyright (c) 2002 form software only The Lackner Group. Inc.
Form PA-1500 Schedule J-IIB (Rev. 6-98)