HomeMy WebLinkAbout01-31-07 (2)
REV. 1500 EX + (6-00)
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I REV-1500
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COMMONWEAlTH OF PENNSYLVANIA I' INHERITANCE TAX RETURN NUMBER
DEPARTMENT OF REVENUE 2 1 06
HARRIS~~~~:~~~~~28_0601 I RESIDENT DECEDENT ---1~ COUNTYCOD~_YEAR_H__~f'.L~:B~~
i DECEDENT'S NAME (lAST, FIRST, AND MIDDLE INITIAL) ~- SOCIAL SECURITY NUMBER __.___ _ .
IKaUffman~un=-w.___ , . . ____+_"-~~-2~-9~~~__~____u_
DATE OF DEATH (MM-DD-YEAR) : DATE OF BIRTH (MM-DD-YEAR) , THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
~l1:p~I~~~ ~U~V1VING-SPOUSE'SNAME (ILA~T~~~S~~~; ~D~lE INITIAl)-- - ---- ---t--SOCIAl SEc~;~I~{~E~QE WILL~____
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Future Interest Compromise (date of death after
12-12-82)
Decedent Maintained a Living Trust (Attach
copy of Trust)
10. Spousal Poverty Credit (date of death between
12-31
tHI$.'$!$~tIQN.M!Jst.Be.'CPMpLetE:P,,'''''4LCPR~e$p
AME
, Stephen L. Bloom
~IRM NAME (if;;Ppllc~-bl;)--- - --- ------1
1 Stephen L. Bloom, Esquire i 2100 Longs Gap Road
~ElEPHONENUMBER--- ---------------1 Carlisle, PA 17013
- - -1 71.0'2~9-77_17 - - - - - -- ------_l..______ _ __ ___ _ _ _ __ _ _ _ _ _ _
n--,~R"IE.;;;.(S,h;d,;;.AI- (11 _ __=- Non;T-,~~~~~~-~ - -
(2) ___771~43.6~ I ;;
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o 11. Election to tax under Sec. 9113(A) (Atlach Sch 0)
1. Original Return
o 2. Supplemental Return
o 4a.
o 7,
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---'---._------------ ---.-
o 3. Remainder Return (date of death prior to 12-13-82)
o 5. Federal Estate Tax Return Required
o 8. Total Number of Safe Deposit Boxes
4. Limited Estate
6. Decedent Died Testate (Attach copy
of Will)
9. Litigation Proceeds Received
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D CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
,COMPLETE MAILING ADDRESS
-------._-- ------ -----------------------
2, Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
(3)
4. Mortgages & Notes Receivable (Schedule D)
(4)
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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)
8. Total Gross Assets (total Lines 1-7)
9, Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
(5) 107,01 t:J
-;--
.-
(6) 175,749.83 1".,)
(7) 0
None
(8) 947,500.46
(9) 34,157,33
---..------- ---------- ----
(10)
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)
-----_.-1---. ______________.________.__~ __________
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 See, 9116(a)(1.2)
x .00
16. Amount of Line 14 taxable at lineal rate
9 1 3 , 34 3. 1 3 x .045
17.Amount of Line 14 taxable at sibling rate
x .12
18. Amount of Line 14 taxable at collateral rate
x .15
19. Tax Due
20.0
Copyright 2000 form software only The Lackner Group, Inc.
Form REV-1500 EX (Rev. 6-00)
~
Decedent's Complete Address:
STREET ADDRESS
41 Greystone Road
- ---.--- - -.
CITY
--------.---------...--..-.--
I STATE PA
ZIP 17013
i
Carlisle
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1 )
41,100.44
39,000.00
2,055.02
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Credits (A + 8 + C)
(2)
41,055.02
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)
8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58)
0.00
45.42
45.42
Make Check Payable to: REGISTER OF WILLS, AGENT
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?.... .................. .......................... ...................... ............................. ......... ..........
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? .............. ............................ ............................................... ........... ..................
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
Yes No
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IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
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- ---~._._~._-_._--_.~-,.- --..-------.---..---------------- --
Under penalties of pe~ury, 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.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS
Linda H3rn.s (3
SIGNATURE~~~~~FOR~N -- ADDRESS
DATE
41 Greystone Road ell
Carlisle, PA 17013_________~--3 C!.
'J Of) 7
DATE
ADDRESS
-_.~----._--._---_...- .---- -----.'---- "-'-----
DATE
2100 Longs Gap Road
Carlisle, PA 17013
Jart~~50 ;;J..co7
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 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. 99116 (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. 99116 (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.
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'~~m"AA. II
INHERITANCE TAX RETURN
_________ RESrD_ENT_DE~EDe:T_m___ u_ L_________________
SCHEDULE B
STOCKS & BONDS
----------..---.----- _.________.m._ __ ___,.____.__._ _ ___ ___..___________.______________...___
ESTATE OF Kauffman, June W.
FILE NUMBER
I 21 - 06 - 00989
-------------------------- ----____ _ .J____
----'.--.---.-- ----- ---- -.--. ______, __00 . _____.0____.. ____ ___________, _____.,.__ _____
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
--.-----------.. ------..__..._._---_._-~--_._--
I
------.-
DESCRIPTION
114,058 shares Allied Irish Banks pic (AIB) stock at $54.89 (average of high
and low trading price on Decedent's date of death)
I UNIT VALUE
+----------- ------ T------
I 54.89i
VALUE AT DATE OF
DEATH
771,643.62
~--_._-----_._--
TOTAL (Also enter on line 2, Recapitulation)
771,643.62
*'
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF Kauffman, June W.
----.----__...._ n___ ..________.___ ______________.. __.______...________________.__.._______________________----,-____ __.__
i
_L_______________ _____ __ __ _____L
-~._~-----._-_.,-------------------._------_..__..._----'-
I FILE NUMBER
21 - 06 - 00989
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 Highmark Blue Shield - Refund
- -_._._._-~._--~~----~._---._---~._--_.._-
DESCRIPTION
VALUE AT DATE OF
DEATH
107.01
--------- ---------------.--------------- ---- -'---~
TOTAL (Also enter on Line 5, Recapitulation)
107.01
.
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SCHEDULE F
JOINTLY-OWNED PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
-----.---.----------.-.--..----..--
----L_______ _____._.______..___
I FILE NUMBER
1___~1~~ ~~~89_ _
If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G.
Kauffman, June W.
--~------._-_._._-------._._--._._--._._-.
SURVIVING JOINT TENANT(S) NAME
-- --- -- -- -----.----------..--- --
Linda H. Carns
-----~_.~-----._-----._--
ADDRESS
RELATIONSHIP TO DECEDENT
Daughter
----.-----------...-----
41 Greystone Road
Carlisle, PA 17013
A
"---..---.-- --- --. ----.-.---------- --, -',--.._-
JOINTLY OWNED PROPERTY:
I I
ITEM LETTER I DATE
NUMBER' FOR JOINT. MADE
I TENANT I JOINT
1 I A I
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DESCRIPT.IOf':J OF PROPERTY I '1'--oT OF '---DATE OF[)-EA"-H-
Include name ollinanclallnstitulion ana DanK account number I DATE OF DEATH . DECD'S ' VALUE OF
or similar identifying number. Attach deed for jointly-held re.al I VALU.E OF ASSET..IINTERESTI DECEDENT'S INTEREST
estate. I +
I Commerce Bank - Certificate of Deposit . i ~70, 126.68T---- . -- 35,063.34
#1101013 "
2
A
i M& T Bank - Savings Account #15004214054956
117,780.35
58,890.18
3
A
I M& T Bank - Checking Account #10240187
23,381.811
140,210.80[
11,690.91
4
I Raymond James Financial Services, Inc. -
I Investment Account #12492378
I
I
70,105.40
-.J_____~___
TOTAL (Also enter on line 6, Recapitulation)
J._
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175,749.83
SCHEDU..E H
RJNERAL EXPENSEs &
ADlVDNlS1RA11VE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
----------~---~._---
-------- . - T
FILE NUMBER
21 - 06 - 00989
------.--_____.__n______
ESTATE OF Kauffman, June W.
Debts of decedent must be reported on Schedule I.
- ITEM-----------------
NUMBER i FUNERAL EXPENSES: DESCRIPTION
A. 1 . Westminster Cemetery - Grave Opening/Closing
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2 I Hoffman-Roth Funeral Home & Crematory, Inc. - Funeral Service
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AMOUNT
------1-
705.00
1,984.30
B.
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Social Security Number(s) / EIN Number of Personal Representative(s):
Street Address
City
State
Zip
2.
Year(s) Commission paid
Attorney's Fees Stephen L. Bloom, Esquire -- Stephen L. Bloom
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
31,000.00
Street Address
City
Relationship of Claimant to Decedent
State
Zip
4.
Probate Fees
Cumberland County Register of Wills - Initial Probate
256.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs
Cumberland Law Journal - Publication of Legal Notices
75.00
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---.-.----------------
- --- ----_.._-._-_._-----_._----~-_.._,.._._._-_._-. ----
Total of Continuation Schedule(s)
137.03
34,157.33
TOTAL (Also enter on line 9, Recapitulation)
.
Schedule H
Fln!RII ExpeIISeS &
Adninistrative Costs cootinued
-
'--..._---------
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF Kauffman, June W.
2
-
The Sentinel - Publication of Legal Notices
! FILE NUMBER
i 21 - 06 - 00989
~---'-------"--I-'---
137.03
Page 2 of Schedule H
REV-1513 EX+ (9-00)
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COMMONWEALTH OF PENNSYLVANIA I BENEFICIARIES
INHERITANCE TAX RETURN .
RESID~NT ,?ECEDENT______L_____ _____ __ .____
SCHEDULE J
ESTATE OF
Kauffman, June W.
FILE NUMBER
21 - 06 - 00989
r-- RELATIONS-HIP TO
I DECEDENT
Do Not List Trustee(s) .. ___
-_._-_._---~-,._--._._.~---,--_.,-- "-- --~-_. --"- .._---,----
-- ~--------._._-.__._---_._._--,,-- ---
_ NUMBER__L___ NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
I. I TAXABLE DISTRIBUTIONS (include outright spousal distributions)
II.
_.~
,
1
George M. Hays, II
904 Wood crest Drive
Spring Lake Heights, NJ 07762
Son
AMOUNT OR SHARE
OF ESTATE
100,000.00
Entire Residue
2
Linda H. Carns
41 Greystone Road
Carlisle, PA 17013
Daughter
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I Enter dollar amounts for distributions shown above on lines 15 through 18, as appropria/e, on Rev 1500 cover sheet
I
; NON-TAXABLE DISTRIBUTIONS:
IA. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT
I BEING MADE
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/B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET!
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LAST WILL AND TESTAMENT
I, ,niNE W. KAIWFMAN, of North Middleton Township, Cumberland County,
Pennsylvania, being of sound and disposing mind and memory, do hereby make, publish and declare
this to be my Last Will and Testament, hereby revoking any and al] former Wills or Codicils by me
made.
I.
I direct that all my legally entorceable debts, funeral expenses, testamentary expenses and all
inheritance taxes (whether such taxes may be payable by my estate or by any recipient of any
property) shall be paid from my residuary estate as soon as practicable after my decease and as part
or tht: administration of my estate. My personal representative shall have no duty or obligation to
obtain reimbursement for any such tax so paid, even though on proceeds of insurance or other
property not passing under this Will.
..,
I give, devise and bequeath the sum of One Hundred Thousand ($100,000.00) Dollars unto
my son, GEORGE M. HA YS, II. In the event my said son, GEORGE M. HAYS, II, shall predecease
or fail to survive me by more than thirty (30) days, then this bequest shall lapse and become part of
the residue of my estate.
Page I of 4 Pages
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I give, devise and bequeath all the rest, residue and remainder of my estate, both real and
personal property. unto my daughter. LINDA H. CARNS. absolutely.
4.
In the event my said daughter. LINDA H. CARNS, shall predecease or fail to survive me by
more than thirty (30) days. then I give, devise and bequeath all the rest, residue and remainder of my
estate. both real and personal property, per stirpes unto the issue of my said daughter, LINDA H.
CARNS, absolutely.
5.
I nominate, constitute and appoint my said daughter, LINDA H. CARNS, as Executrix of my
estate. In the event she shall be unable or unwilling to serve in such capacity, then I appoint my
grandchildren, BARBARA C. SZELAG and RICI-IARD H. CARNS, as Co-Executors of my estate.
6.
I direct that my Executrix(ors) shall not be required to file a bond to secure the faithful
performance of their duties in any jurisdiction.
7.
I authorize and empower my personal representative( s), in their sole and absolute discretion,
to purchase or otherwise acquire and retain any investments of which I die seized or any real or
personal property of any nature: to sell, lease, pledge, mortgage, transfer, exchange, dispose of or
grant options in regard to any or all property of any kind forming a part of my estate for such terms
and such pnces as they may deem advisable: to borrow money for any purposes connected with the
Page 2 of 4 Pages
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protection and preservation of my estate; to mortgage or pledge any real or personal property
forming a part of my estate or to join in or secure the partition of same ; to compromise any claims or
demands of my estate against others or of others agai nst my estate; to make distribution in kind and
to cause any share to be composed of cash, property or undivided fractional shares in property
ditterent in kind from any other share; to employ agents, attorneys and proxies and to delegate to
them such power as my personal representative(s) consider desirable and to pay reasonable
compensation for such services as may be rendered by such agents, attorneys and proxies; and to
execute and deliver such instruments as may be necessary to carry out any of these powers. In
addition, I direct that my personal representative(s) shall have the power to conduct an inventory of
any safe deposit box necessary to the administration of my estate.
IN WITNESS WHEREOF I have hereunto set my hand and seal this th day of December,
1999.
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. J;/[ltitJ [J. I . Llll<~ Ih
J UtJi . Kauffman L ;
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SIGNED, SEALED, PUBLISHED AND DECLARED by the above-named Testatrix, as and
for her Last Will and Testament in the presence of us, who at her request, have hereunto subscribed
our names as witnesses thereto, in the presence of the said Testatrix and of each other.
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Page 3 of 4 Pages
COMMONWEALTH OF PENNSYLVANIA )
: SS.
COUNTY OF CUMBERLAND )
L JUNE W. KAUFFMAN, Testatrix, whose name is signed to the attached or foregoing
instrument having been duly qualitied according to law, do hereby acknowledge that I signed and
executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and
voluntary act for the purposes therein expressed.
u . iU' /{', I~. uy/ //('1 ,
June~~~n (,. v
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Sworn or affirmed to and acknowledged before me by JUNE W. KAUFFMAN, the Testatrix,
this 7'1> day of December. 1999,
JtLmJ (L1t1mtci
Notarv Public
._-~._-------------- -----
COMMONWEALTH OF PENNSYL VANIA
Notarial Seal
Sharon E. Bloom, Notary Public
North Middleton Twp., Cumberland County
My Commission Expires Aug. 5, 2002
)
: SS.
)
Member, Pennsylvania Association ot Notaries
We, {le/}fJf f}j. Ok:cm ._ and Loro%'4 P K I ;f)E.,
the witnesses whose names are signed to the attached or foregoing Instrument, bemg duly qualified
according to law, do depose and say that we were present and saw JUNE W. KAUFFMAN, the
Testatrix, sign and execute the instrument as her Last Will; that the Testatrix signed willingly and
that the Testatrix executed it as her free and voluntary act tor the purposes therein expressed; that
each of us, in the hearing and sight of the Testatrix, signed the Will as witnesses; and that to the best
of our knowledge the Testatrix was at that time 18 or more years of age, of sound mind and under no
constraint or undue influence. - '/' --0
J.....') :
-..:.- -~."- ~~ ~-1~~~
COUNTY OF CUMBERLAND
-Address
~~~ "
,'--/..~
Address
..,) / C~ L o'!.!1..i.~-1:;.s...s.'_'L_____
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Sworn or affirmed to and subscribed betor me this th da
X~(.(. I"",
Notary Public
Notanal Seal
Sharon E Bloom. Notary Public
Pa~e 4 of 4 Pall ~sNorth Middleton Twp., Cumberland County
~ 'C' My Commission Explrea Aug, 5, 2002
Mc,mber. Pennsylvania Association 01 Notartes
December 18, 2006
Commerce
t6Bank
Stephen L Bloom, Esquire
2100 Longs Gap Rd
Carlisle PA 17013
RE: Estate of: June W Kauffman
Social Security #: 186-24-9954
Date of Death: November 1, 2006
Dear Sirs:
In reference to the letter regarding the above mentioned Estate, we
would like to inform you of the information that we have researched and
found.
Type: Time Deposit
Account #: 1101013
Date Opened: 01/18/06
Primary Owner: June W Kauffman
Secondary Owner: Linda H Carns
Date of Death Balance: $70,126.68
Accrued Interest: $126.68
Principal Balance: $70,000.00
If there are any questions or additional information that is needed,
please feel free to contact me at (717) 412-6134.
SinCe~rIY___
I t, C,V0rf:- .. /~?1-{:
IMindi. '"Sprout
Levy Specialist
Commerce Bank / Harrisburg, N.A.
PO Box 4999
3801 Paxton Street
Harrisbu rg, PA 17111 -0999
commercepc.com
!1M&I'Bank
499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12
Phone (888) 502-4349
Fax (302) 934-2955
December 18,2006
Stephen L Bloom
Attorney and Counselors at Law
2100 Longs Gap Road
Carlisle, Pennsylvania 17013
R,.,.
c.
Estate of June W Kau(fman
Social Securitv: 186-24-9954
Date of Death: November 01, 2006
Dear Sir or Madam:
Per your inquiry dated December 7, 2006, please be advised that at the time of death, the above-named decedent had on
deposit with this bank: the following:
I.
Type of Account
Checking Account
Account Number
10240187
Ownership (Names of)
June W Kauffinan, Linda H Carns *
Opening Date
06/09/93
Balance on Date of Death
$23.381.43
Accrued Interest
$
0.38
Total
$23.381.81
2.
Type of Account
Savings Account
Account Numher
015004214054956
Ownership (Names of)
June W Kauffinan. Linda H Carns *
Opening Date
03/20/06
Balance on Date of Death
$117,647.22
Accrued Interest
$ 133.13
Total
$117.780.35
Please be advised, there was no safe deposit box found for the above decedent. * For further account information,
regarding ownership, closures and/or reimbursement of funds, etc., please call the Stonehedge Office # 717-240-
4524.
Sincerely,
/
- (//",./' /
;//1, /" '/: / ../'
Nancy Clagett
Records Management
RAYMOND JAMES
December 13, 2006
Stephen L. Bloom
Attorney and Counsellor at Law
2100 Longs Gap Road
Carlisle, P A 17013
RE: June W. Kauffman, Deceased
SS: 186-24-9954
Date of Death: November 1, 2006
Dear Mr. Bloom:
This letter is to advise you that there is only one account (AlC # 12492378) which is
registered as June W. Kauffman and Linda H. Cams, JTIWROS) with Raymond James
Financial Services, Inc. The account was opened on April 2, 2002 with our former
broker/dealer, Cambridge Investment Research, Inc. Attached is an account valuation
showing date of death value and accrued income.
I will be happy to assist with the shares of Allied Irish Bank. The following paperwork
will be needed to open the estate account: 1) New Account Form; 2) Death Certificate;
3) Affidavit of Domicile; and another Short Certificate.
Should you have any further questions, please feel free to contact me directly at the above
number. Thank you, and Happy Holidays.
Jo W. Carbaugh
Branch Manager
Registered Investment Advisor Representative
JWC:las
Attachment
Raymond James Financial Services, Inc.
Member NASD/SIPC
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Hollman-Roth Funeral Home & Crematory, Inc.
2 19 North Hanover Street
Carlisle, PAl 7013
(717)243-4511
November 21 , 2006
Linda H. Cams
4 J (Jreystone Rd.
CarlIsk, Pl\ ] 7()] ,
The Funeral Service for June v,:. Kauffman
14883-203
We smcerely appreciate the confidence you have placed in us and will continue to assist you in every way we can. Please
feel tYee to contact us if you have any questions in regard to this statement.
THE FOLLOWING IS AN ITEMIZED STATEMENT OF THE SERVICES, FACILITIES, AUTOMOTIVE EQUIPMENT,
.-\ 'JD MFRCHA\iDISF THA T YOU SELECTED WHEN MAKING THE FUNERAL ARRANGEMENTS.
(A) OUR SERVICE:
CREMATION PACKAGE #5. . . . . . . .
F(iNERAL HOME SERVICE CHARGf~S
$1490.00
S 1490.00
SELECTED MERCHANDISE:
Marbclon Unl\'crsalUm Rcccptacle . . . . . . . . . . . . . . . .
TilE COST OF OUR SERVICES, EQUIPMENT. AND MERCHANDISE
THAT YO{' HA VE SELECTEI> . . . . . . . . . . . . .
$340 (}()
$1830.00
Cash Advances
Newpapcr Obituary Notlce-Sentincl
Ccrtified Copies of Death ('crtlticales.
Coroner Authorization CrematIOn Fcc.
$69.30
S6000
$25.0()
TOTAl. CASH ADVANCES AND SPECIAL CIIARGF.S .
$154.30
Total
Total Cost
S1984.30
TOTAL AMOlJNT DUE
$1984.30
's statement is net and payable in full within 30 days of receipt.
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In"~"""_"",,,
STEPHEN L. BLOOM
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Invoice submitted to:
Kauffman, June W, Estate
c/o Linda H, Carns, Executrix
41 Greystone Road
Carlisle, PA 17013
January 31, 2007
In Reference To: Estate Administration
Invoice #1816
Professional Services
Preparations for Probate; Prepare Petition for Probate and Grant of Letters Testamentary, Oath of Personal
Representative, Decree of Probate and Grant of Letters, Estate Information Document, Exhibits; Appearance at
Register of Wills for presentation of same/Conference with Executrix
Administrative and estate accounting matters; Preparation of required Legal Notices for publication in
Cumberland Law Journal and Sentinel; Correspondence re same; Preparation and service of required Notice of
Beneficial Interest in Estate pursuant to PA O.C. Rule 5.6; Preparation and filing of required Certification of
Notice under PA O.C. Rule 5.6(a); Correspondence with M&T Bank and Commerce Bank; Correspondence with
Department of Public Welfare Estate Recovery Section; Correspondence with Raymond James Financial
Services Inc,; Preliminary Pennsylvania Inheritance Tax calculations and discounted payment estimate
Pennsylvania Inheritance Tax estimated discount payment calculations; Preliminary preparation of Pennsylvania
Inheritance Tax Return and Schedules; Correspondence with Executrix
Review and file Proofs of Publication of Legal Notice from The Sentinel and Cumberland Law Journal; Review
correspondence from Department of Public Welfare re estate recovery clearance; Official Receipt _
Pennsylvania Inheritance and Estate Tax Estimated Payment; Telephone conferences; Preparation of
Pennsylvania Inheritance Tax Return, Schedules and Exhibits; Preparation of Estate Inventory; Prepare for
asset disposition
Consultations with client; Post-Mortem Planning; Reserve for final matters of administration, including
Appearances at Register of Wills, Official Receipt, Miscellaneous Correspondence, Final Notices of
Administration, etc,
For professional services rendered
Amount
$31,000,00
($4,090,00)
($13,455,00)
($13,45500)
($31,000,00)
11/8/2006 Payment - thank you
12/12/2006 Payment - thank you
1/30/2007 Payment - thank you
Total payments and adjustments
PRACTICAL COUNSEL + CHRISTIAN PERSPECTIVE
Kauffman, June W. Estate
Balance due
PAYABLE UPON RECEIPT - THANK YOU
PRACTICAL COUNSEL + CHRISTIAN PERSPECTIVE
Page
2
Amount
$0.00
RECEIPT FOR PAYMENT
-------------------
-------------------
GLENDA FARNER STRASBAUGH
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17G13
Rece~pt Date:
Rece~pt Time:
Recelpt No. :
11/08/2006
14:11:19
1046281
KAUFFMAN JUNE W
Estate File No. :
Paid By Remarks:
2006-00989
CARNS LINDA H
AJW
------------------------ Receipt Distribution ________________________
Fee/Tax Description
PETITION LTRS TEST
WILL
SHORT CERTIFICATE
JCP FEE
AUTOMATION FEE
Check# 351
Total Received.........
Payment Amount
210.00
15.00
16.00
10.00
5.00
----------------
$256.00
$256.00
Payee Name
CUMBERLAND COUNTY GENERAL FUN
CUMBERLAND COUNTY GENERAL FUN
CUMBERLAND COUNTY GENERAL FUN
BUREAU OF RECEIPTS & CNTR M.D
CUMBERLAND COUNTY GENERAL FUN
CUMBERLAND LAW JOURNAL
32 SOUTH BEDFORD STREET
CARLISLE, PA 17013
January 5, 2007
Cumberland Law Journal is published every Friday by the Cumberland County Bar
Association and is designated by the Court of Common Pleas as the official legal publication for
Cumberland County and the legal newspaper for publication of legal notices.
TO:
Stephen L. Bloom, Esquire
RE:
June W. Kauffinan, ESTATE
Legal advertisements must be received by Friday Noon. All legal advertising must be
paid in advance. Make all checks payable to: Cumberland Law Journal.
--------------------------------------------------
-------------------------------------------------------
Advertisement inserted on following dates:
December 22,29,2006 & January 5, 2007
Advertising Cost
75.00
Proof of Publication
$ 0.00
$ 0.00
Second Proof Request
Payment received
$ 75.00
Total Amount Due
$ 00.00
Becky H. Morgenthal, Executive Director
REMITTANCE ADDRESS I BILL TO
THE SENTINEL - LEGAL ATTORNEY AT LAW STEPHEN L. BLO pJ
P . O. BOX 13 0 , CARLISLE, PA 17013
AD NUMBER I CLASS SALESPERSON BILLING DATE LINES
319970 10 PUBLIC NOTICES shoet 12/27/06 36 * 2
AD DESCRIPTION START DATE STOP DA TE
NOTICE LETTERS TESTAMENTARY ON THE 12/13/06 12/27/06
PUBLICA TION INSERTIONS RATE NET AMOUNT GROSS AMOUNT
3 THE SENTINEL - LEGAL 3 LGL 130.68
TOTAL AD CHARGE 130.68
3 PROOF OF PUBLICATION 01PRF 6.35
DA YS RUN
PURCHASE ORDER PA Y THIS AMOUNT 137.03 164.44*
June W. Kauffmanum
RETAIN THIS PORTION FOR YOUR RECORDS
M
. AFTER 01/26/07
MESSAGE:
Thank you for advertising with The Sentinel.
Deadlines for in-column legal advertisements: Monday is Friday at
11 a.m.; Tuesday is Friday at 4 p.m.; Wednesday is Monday at 12 Noon;
Thursday is Tuesday at 12 Noon; Friday is Wednesday at 12 Noon; Sunday
is Thursday at 12 Noon.
If you have any questions regarding your Legal bill please call
Tammy Shoemaker 717-240-7176
Fax your legals to 717-243-3754 attention Tammy Shoemaker
You can also EMAIL yourlegaltoClassifiedads:classified@cumberlink.com
Please send a cover letter including your name and address as an attachment
DETACH AND RETURN THIS PORTION WITH YOUR PAYMENT
THE SENTINEL - LEGAL
POBOX 130 CARLISLE PA 17013
June W. Kauffmanum
. . -,
AD NUMBER CLASSO START DATE STOP DATE
319970 PUBLIC NOTICES 12/13/06 12/27/06
AD DESCRIPTION BILLING DATE TELEPHONE NUMBER
NOTICE LETTERS TESTAMENTARY ON THE 12/27/06 717-249-7717
GROSS AMOUNT OF
164.44
DUE AFTER 01/26/07
TOTAL AMOUNT DUE
137.03
ATTORNEY AT LAW STEPHEN L. BLOOM
2100 LONGS GAP ROAD
CARLISLE, PA 17013
I..." 1...1" "11..111111.1..1.1
ENTER AMOUNT ENCLOSED
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -