HomeMy WebLinkAbout12-07-06
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT 280601
HARRISBURG, PA 17128~060 1
REV~1162 EX(11~96)
RECEIVED FROM:
PENNSYLV ANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
COYNE HENRY F
3901 MARKET STREET
CAMP Hill, PA 17011-4227
____n__ fold
ESTATE INFORMATION: SSN: 187-16-6177
FILE NUMBER: 2106-0879
DECEDENT NAME: GOULD ROBERT G
DA TE OF PAYMENT: 12/07/2006
POSTMARK DATE: 1 2/06/2006
COUNTY: CUMBERLAND
DA TE OF DEATH: 09/20/2006
NO. CD 007534
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 \ $538.05
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TOTAL AMOUNT PAID:
$538.05
REMARKS:
CHECI(# 1167
INITIALS: JA
RECEIVED BY:
SEAL
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WillS
COYNE & COYNE
A PROFESSIONAL CORPORATION
ATTORNEYS AT LAW
Henry F. Coyne
Lisa Marie Coyne
3901 Market Street
Camp Hill, Pennsylvania
17011-4227
717-737-0464
Fax: 717-737-5161
December 6, 2006
Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, P A 17013
Re: Estate of Robert G. Gould, Deceased
No. 21-06-0879
Dear Sir or Madam:
Enclosed please find an original and two (2) copies of the Inheritance Tax Return for the above-
referenced estate. Kindly docket the original and return to this office a "clocked-in" copy with the
enclosed envelope.
Also enclosed are check no. 1167 in the amount of $538.05 with represents payment of the
discounted inheritance tax and check no. 1168 in the amount of $15.00 for the filing fee for the
inheritance tax return. Kindly issue to this office the appropriate receipts for payment.
Thank you for your assistance. If you have any questions, please contact me.
Very truly yours,
COYNE & Crn:Cq
rie Coyne
LMC/jms
Enclosure
Cc: Mr. Robert L. Gould, Executor
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REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
21 06
COUNTY CODE YEAR
SOCIAL SECURITY NUMBER
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
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i DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
I GOULD, ROBERT G.
I DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR)
109/20/2006 I 01/22/1923
\ (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL)
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! ~ 1. Original Return
\ 0 4 Limited Estate
I ~ 6. Decedent Died Testate (Attach copy
of Will)
1..~$..:~~~I(:;~~;~;~;;.:;:c;:ed
NAME
Lisa Marie Coyne
IRM NAME (If applicable)
i Coyne & Coyne, P.c.
[rELEPHONE NUMBER
i 717/737-0464
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'\ 1. Real Estate (Schedule A)
I 2. Stocks and Bonds (Schedule B)
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I 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
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I 11. Total Deductions (total Lines 9 & 10)
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\ 12. Net Value of Estate (Line 8 minus Line 11)
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\1 15.Amount of Line 14 taxable at the spousal tax rate,
or transfers under Sec. 9116(a)(1.2)
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! 16. Amount of Line 14 taxable at lineal rate
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I 17.Amount of Line 14 taxable at sibling rate
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\18. Amount of Line 14 taxable at collateral rate
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I 19. Tax Due
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120. 0
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187-16-1677
~
0879
NUMBER
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
\ REGISTER OF WILLS
I SOCIAL SECURITY NUMBER
o 3. Remainder Return (date of death prior to 12-13-82)
o 5. Federal Estate Tax Return Required
2. Supplemental Return
4a. Future Interest Compromise (date of death after
12-12-82)
7. Decedent Maintained a Living Trust (Attach
copy ofTrust)
10. Spousal Poverty Credit (date of death between
1 _ - - - 5
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3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
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)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
8. Total Number of Safe Deposit Boxes
I COMPLETE MAILING ADDRESS
I
I 3901 Market Street
I Camp Hill, PA 17011-4227
(1 ) None
(2) None
(3) None
(4) None
(5) 200.00
(6) 21,128.23
(7) None
(9) 8,368.66
(10) 373.57
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13. Charitable and Governmental Bequests/Sec 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)
(14)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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12,586.00
12,586.00
566.37
566.37
Copyright 2000 form software only The Lackner Group, Inc.
(19)
Form REV-1500 EX (Rev. 6-00)
Decedent's Complete Address:
STREET ADDRESS
20 21 st Street, Apt. 124
CITY
I STATE
I PA
I ZIP 17043
Lemoyne
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
28.32
Total Credits (A + B + C)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty (0 + E)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is theOVERPAYMENT
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 theTAX DUE.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is theBAlANCE DUE.
Make Check Payable to: REGISTER OF WILLS, AGENT
(1 )
566.37
(2)
28.32
(3) 0.00
(4)
(5) 538.05
(5A)
(5B) 538.05
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;............................................................................. 0 ~
b. retain the right to designate who shall use the property transferred or its income;................................ 0 ~
c. retain a reversionary interest; or...........................................................---.............................................. 0 ~
d. receive the promise for life of either payments, benefits or care?........................................................... 0 ~
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?.......................... .................................. ............................. ........................ 0 ~
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... 0 ~
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation?................................................................................................................ 0 1:81
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 complete. Declaration
preparer other than the personal representative is based on all information of which pre parer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS
Robert L. Gould
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SIGNATURE OF PERSON RESPONSIBLE F"OR FILING RETURN
111 N. Enola Drive, Apt. 6
Enola, P A 17025
ADDRESS
DATE
/1-S-~o(,
DATE
SIGNATURE OF PRE PARER OTHER THAN REPRESENTATIVE
Lisa Marie Coyne
ADDRESS
DATE
3901 Market Street
Camp Hill, PA 17011-4227
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. 99116 (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. 99116 (a) (1.1) (Ii)]. The statutedoes 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. 39116 (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. 39116 (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. 99116 (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.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
I FILE NUMBER------
21 - 06 - 0879
ESTATE OF
GOULD, ROBERT G.
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
~_._--~.__.
1 Misc. Personal Property and Furniture
DESCRIPTION
VALUE AT DATE OF
DEATH
----~----------
200.00
TOTAL (Also enter on Line 5, Recapitulation)
200.00
.
SCHEDULE F
JOINTLY-OWNED PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
I FILE NUMBER
21-06-0879
ESTATE OF
GOULD, ROBERT G.
If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G.
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A Robert L. Gould
Son
JOINTLY OWNED PROPERTY:
DESCRIPTION OF PROPERTY %OF
ITEM LETTER DATE Include name of financial institution and bank account number DATE OF DEATH DATE OF DEATH
FOR JOINT MADE DECD'S VALUE OF
NUMBER TENANT JOINT or similar identifying number. Attach deed for jointly-held real VALUE OF ASSET INTEREST DECEDENT'S INTEREST
estate.
1 A 04/01/1991 Citizens Bank 9,619.23 50% 4,809.62
Checking Acct. No. 6100724379
2 A 05/06/2002 Citizens Bank 32,637.21 50% 16,318.61
Checking Acct. No. 6106291916
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TOTAL (Also enter on line 6, Recapitulation) 21,128.23
ziens Bank~'
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:r~ 11 H
NOV I 3 2006 m iJf
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Account Number 6100724379
Account Title ROBERT G GOULD OR ROBERT L GOULD
Date Opened 4/1/1991
Account Type Checking
Principal Balance as of DOD $9619.23
Interest from Last Postingto DOD $ .00 .
Account Balance as of DOD $9619.23
YTD Interest to DOD $6.72
tl
Account Number 6106291916
Account Title ROBERT G GOULD OR ROBERT L GOULD
Date Opened 5/6/2002
Account Type Checking
Principal Balance as of DOD $32637.21
Interest from Last Posting to DOD : $ .00 '
Account Balance as of DOD ! $32637.21
. YTD Interest to DOD i $321.25
?
.
SCHEDULE H
FUNERAl... EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
\ FILE NUMBER
21 - 06 - 0879
ESTATE OF
GOULD, ROBERT G.
Debts of decedent must be reported on Schedule I.
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ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
1.
FUNERAL EXPENSES:
Richardson's Funeral Home, Enola, Pennsylvania
4,620.00
2.
Rolling Green Cemetary
1,195.00
3.
Reception
200.00
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 Coyne & Coyne, P.C 1,500.00
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 Cumberland County Register of Wills 98.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs
1 Cumberland Law Journal 75.00
2 Patriot News 117.66
Total of Continuation Schedule(s) 563.00
-' - .-
TOTAL (Also enter on line 9, Recapitulation) 8,368.66
.
Schedule H
Funeral Expenses &
MninistratNe Cos1s continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF GOULD, ROBERT G.
-31 post~ge --
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4 I Reserves
\ FILE NUMBER
21 - 06 - 0879
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38.00
500.00
5
Inheritance Tax Return Filing Fee
15.00
6
-Toll Calls for Executor
10.00
Page 2 of Schedule H
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SCHEDULE I
DEBTS OF DECEDENT, MORTGAGE
LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIOENT DECEDENT
\ FILE NUMBER
21 - 06 - 0879
ESTATE OF GOULD, ROBERT G.
Include unreimbursed medical expenses.
ITEM
NUMBER
.--
1 Uncleared Checks
DESCRIPTION
AMOUNT
350.00
23.57
2
Verizon
_.'
TOTAL (Also enter on Line 10, Recapitulation)
373.57
REV-1513 EX+ (9-00)
COMMONWE~LTH OF PENNSYLVA=-IA 1_ _
INHERITANCE TAX RETURN
RESIDENT DECEDENT
-~~
SCHEDULE J
BENEFICIARIES
I FILE NUMBER
21 - 06 - 0879
ESTATE OF
GOULD, ROBERT G.
RELATIONSHIP TO AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY DECEDENT
n_ "_,, lIrustllli(Sl--- OF ESTATE
-~.__.-
I. TAXABLE DISTRIBUTIONS (include outright spousal distributions)
1 Robert L. Gould Son 100% of Residual
Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover shee t
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
I
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEE
..--.~
REGISTER OF WILLS
CUMBERLAND County, Pennsylvania
CERTIFICATE OF GRANT OF LETTERS
No. 2006-00879 PA No. 21-06-0879
Es ta te Of: ROBERT G GOULD
(First, Middle, Last)
Late Of:
LEMOYNE BOROUGH
CUMBERLAND COUNTY
Deceased
Social Security No: 187-16-6177
WHEREAS, on the 5th day of October 2006 an instrument dated
March 26th 1982 was admitted to probate as the last will of
ROBERT G GOULD
(First Middle, Last)
la te of LEMOYNE BOROUGH, CUMBERLAND County,
who died on the 20th day of September 2006 an
WHEREAS, a true copy of the will as probated is annexed hereto.
THEREFORE, I, GLENDA FARNER STRASBAUGH , Register of wills in and
for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby
(certify that I have? thi s day granted Letters of ADMIN/STRA nON C. T.A. to,'
ROBERT L GOULD
who has duly qualified as ADM/N/STRA TOR(R/X) C. T.A.
and has agreed to administer the estate according to law, all of which
fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE,
CARLISLE, PENNSYL VAN/A.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
of my office on the 5th day of October 2006.
~~ Ill' fii1 /!JU-.. \ 0JJJbkid:/L~
Register of Wills !Ii
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L~t[t~utfY~
**NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST)
W ILL
'" 0; \ 7
I, ROBERT G.
GOULD, of Susquehanna TOW~ship,
Dauphin County, Pennsylvania, declare this to be my
last vHll and revoke any and all wills or Codicils
previously made by me.
ITEM I:
I give, devise and bequeath all of my
estate of every nature and wherever situate to my wife,
JEAN E. GOULD, providing she shall survive me by sixty
days.
ITEM II: Should - my - . '.vi fe, Jean E. Gonldj
predecease me, or die on before the sixtieth day
following my death, I give, devise and bequeath my
estate in equal shares to my son, Robert L. Gould, of
Lemoyne, Cumberland County, Pennsylvania.
ITE~1 III:
In the event I should die survived
nei ther by my spouse nor my son, by reason of common
accident or otherwise, I devise and bequeath all of my
property, of whatever nature and wherever situate at
the time of my death to my wife r s sister and her
husband, DOROTHEA PARK and GEORGE PARK, of Coral
Springs, Florida, or the survivor of them.
ITEM IV:
All death taxes (not income taxes) that
may be assessed in consequence of my death, of whatever
nature and by whatever jurisdiction imposed, shall be
considered a part of the expense of the administration
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of my estate, and my Executrix shall have the absolute
power in her discretion to pay the same at once whether
or not the law under which they are imposed permits the
postponement of payment of all or part of them to a
later date.
I direct and empower my Executrix to
ITEM V:
sell any and all real estate of which I die seized, at
such time and upon such terms as she may deem best, and
to deliver good and sufficient deeds therefor to the
purchaser or purchasers thereof.
ITEM VI:
No interest of any beneficiary of my
estate, either in income or principal, shall be subject
to anticipation or pledge, assignment, sale or transfer
in any manner, nor shall any beneficiary have power in
any manner to change or encumber his or her interest,
either in income or principal, nor shall the interest
of any beneficiary be liable or subject in any manner
while ~n the possession of the Executrix of the
liability of such beneficiary whether such liability
arises from his or her own debts, contracts, torts or
other engagements of any type.
ITEH VII:
I hereby nominate, constitute and
appoint my 'ltlife, Jean E. Gould, Executrix of this my
last will.
Should my wife predecease me or fail to act
as Executrix of this my last vJill, I appoint -- '" 1 .
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, Executor of this my last Will.
IN WITNESS WHEREOF, I have hereunto set my hand
and seal this ~~ day of March, 1982.
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/'aL.-.~. ";.-L'-L--/ (SEAL)
ROBERT G. GOULD
'I'hepreceding instrument, consisting of this and
two other typewri tten pages, identified by the
signature of the Testator, was on the day and date
thereof signed, sealed, published and declared by
Robert G. Gould, the Testator therein named, as and for
his last Will and Testament, in the presence of us,
who, at his request, in his presence and, in the
presence of each o;t:her, have hereunto subscribed our
nameS"'as ,.vi tnesses i' . /
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