HomeMy WebLinkAbout04-13-07
REV.' 500 EX + (6.00)
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT 280601
HARRISBURG, PA 17128-0601
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DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Krout Jr. Elmer E
DATE OF DEATH (MM-DD-Year)
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
FILE NUMBER
21 -06 08 3 7
"'"ecMiiih"Coi5E -VEAR- - - 'iMiBeR--
SOCIAL SECURITY NUMBER
DATE OF BIRTH (MM-DD-Year)
1 95- 2 8'" 0 1 6 2
THIS RETURN MUST BE FilED IN DUPLICATE WITH THE
REGISTER OF WILLS
7/11/2006 9/23/1936
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDlE INITIAL)
Krout D. Joanne
~ 1. Original Return
o 4. Limited Estate
~ 6. Decedent Died Testate (Attach copy of WiU)
~ 9. Litigation Proceeds Received
SOCIAL SECURITY NUMBER
1 80... 2 6 - 7 0 7 8
o 2. Supplemental Return
o 4a. Future Interest Compromise (date of death after 12.12-82)
o 7. Decedent Maintained a Living Trust (Attach copyofTrusli
o 10. Spousal Poverty Credit (date of death between 12-31.91 and 1-1-95)
o 3. Remainder Return (dale oldealh pnor 10 12.13-82)
o 5. Federal Estate Tax Return Required
_ 8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
David H. Stone Es uire 414 Bridge Street
FIRM NAME (If Applicable)
Stone La Faver & Shekletski
TELEPHONE NUMBER
7177747435 New Cumberland PA 17070
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1. Real Estate (Schedule A) (1)
2 Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
o Separate Billing Requested
7 Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1.7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
12 Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental BequestslSec 9113 Trusts for which an election to tax has not been
made (Schedule J)
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OFFICI.q~~SE ONLY
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(8)
170.13
3,089.35
(11)
(12)
(13)
3.089.35
-2,919.22
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
(14)
-2,919.22
15. Amount of Line 14 taxable atlhe spousal tax
rate. or transfers under Sec. 9116 (a)(1.2)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18 Amount of Line 14 taxable at collateral rate
19 Tax Due
0.00 X .:lliL (15) 0.00
0.00 X _(16) 0.00
0.00 X .12 (17) 0.00
0.00 X .15 (18) 0.00
(19) 0.00
20 0
CHECK HERE IF ','U.J ARE f\\ JUES r!NG ^ REFU'I[) OF AN OVE RPA v',1ENT
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
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ece ents omple e ress:
STRE&T ADDRESS
126 Glendale Drive
CITY I STATE I ZIP
Mechanicsburg PA 17050-
Tax Payments and Credits:
1 Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1)
0.00
Total Credits ( A + 8 + C )
(2)
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
0.00
Total Interest/Penalty ( D + E) (3)
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 (4)
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 + SA. This is the BALANCE DUE. (58)
Make Check Payable to: REGISTER OF WILLS, AGENT
0.00
0.00
0.00
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 [&]
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 of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGN'L) OF P SON RESPONSIBLE FOR FI NG RETURN
ADDRESS
SIGNA T
PA 17050
DATE
'J- 'Jo-~
PA 17070
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 PS. ~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 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. ~9116(a)(1.2)).
The tax rate imposed on the net value of transfers to or for the use of the decedenrs lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~9116(1.2) [72 PS. ~9116(a)(1 )J.
The tax rate imposed on the net value of transfers to or for the use of the decedenrs 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-1508 EX + (6-98)
'*
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Krout. Jr.. Elmer. E
FILE NUMBER
21 06
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jolntly-owned with right of survivorship must be disclosed on Schedule F.
0837
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
170.13
NGC-Net litigation proceeds
TOTAL (Also enter on line 5, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
$
170.13
REV-1511 EX + (12-99)
'*
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Krout. Jr.. Elmer. E
FILE NUMBER
21
06
0837
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Richardson Funeral Home-funeral expenses 2,316.00
2. Flowers 201.35
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
2. Attorney Fees David H. Stone, Esquire 500.00
3. Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees 72.00
5. Accountanfs Fees
6. Tax Retum Prepare~s Fees
7.
TOTAL (Also enter on line 9, Recapitulation) $ 3,089.35
(If more space is needed, insert additional sheets of the same size)
'".'':''' "-
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
FILE NUMBER
Krnllt .Ir Flmer. E 21 06 nR~7
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1. D. Joanne Krout Spousal 0.00
126 Glendale Drive
Mechanicsburg
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
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size) .
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RUPP AND MEIKLE
A PROFESSIONAL CORPORATION
lP65 NO~'IAT l!f]lEET. SUITE 206
CAMP HILL, PA 17011
-:
LAST WILL AND TESTAMENT
OF
ELMER E. KROUT, JR.
I, ELMER E. KROUT, JR., of 126 Glendale Drive, Mechanlcsburg, Sliver
Spring Township, Cumberland County, Pennsylvania 17050, being of sound
and disposing mind and memory, do hereby make, publish and declare this
for and as my Last Will and Testament hereby revoking any and all Wills or
Codicils by me at any time heretofore made.
ITEM I - I am married to D. JOANNE KROUT, and all references to my
wife In this Will are to her. I have four children: ELMER E. KROUT, III, RICKY
A. KROUT, DELORES J. DERICK and PATRICIA A. BARRICK, and they are
described In this Will collectively as "my children" and Individually as "my
child."
ITEM II - I give my tangible personal property and all Insurances
thereon to my wife, JOANNE, If she survives me by thirty (30) days. I have
complete confidence that my wife will honor any written Instructions that I
may leave with regard to said tangible personal property.
RUPP and MEIKLE 355 NORTH 21ST STREET, SUITE 205, CAMP HILL, PA 17011
,
Inltialsf/;t
Page 1 of 8
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ITEM III - I give, devise and bequeath all of my Estate, of every
nature and wherever situate, to my wife, JOANNE, If she survives me by
thirty (30) days.
ITEM IV - If my wife, JOANNE, falls to survive me by thirty (30) days, I
direct that my son, RICKY A. KROUT, may elect as part of his one-fourth
share of my estate my forty-five (45) acres of land, more or less, and hunting
cabin located In Lelgdy Township, Clinton County, Pennsylvania. If he so
elects he must do so In writing to my Executor within ninety (90) days of the
probate of my Will and the granting of letters thereon. If he so elects, the
value of the land and cabin shall be Twenty-five Thousand Dollars
($25,000.00).
ITEM V - If my wife, JOANNE, falls to survive me by thirty (30) days, I
give, devise and bequeath all of my estate, of every nature and wherever
situate, In equal shares to those of my children, ELMER E. KROUT, III, RICKY
A. KROUT, DELORES J. DERICK and PATRICIA A. BARRICK, who survive me by
thirty (30) days.
ITEM VI - In the event anyone or more of my children predecease me
or die before the thirtieth (30th) day following my death, I give, devise and
Initials ~
Page 2 of 8
bequeath the share of such deceased child to my Trustee, hereinafter
named, for his/her children (my grandchildren), per stirpes, in TRUST,
nevertheless, as follows:
(a) To payor to apply for the benefit of such child (my
grandchild) all or such parts of the net income and all or
such parts of the principal of his/her Trust as my Trustee in
his sole discretion shall determine for the maintenance,
education, health and welfare of such child until he/she
attains the age of thirty (30) years.
(b) At the time such child attains the age of twenty-five (25)
years, he/she shall receive one-third (1/3) of the balance
of the principal and any accumulated Income from his/her
Trust.
(c) At the time such child attains the age of thirty (30) years
he/she shall receive the balance of the principal of his/her
Trust and any undistributed Income, at which time the
Trust shall terminate.
ITEM VII - I name my wife, D. JOANNE KROUT, as Executrix of this, my
last Will. If my wife, JOANNE, fails to qualify or ceases to act as Executrix, I
Initials ft.'
Page 3 of 8
,
,
name my son, ELMER E. KROUT, III, as Executor of this, my last Will. If my
son, ELMER E. KROUT, III, falls to qualify or ceases to ad as Executor, I name
my son, RICKY A. KROUT, as Executor of this, my last Will.
ITEM VIII - My Executrix/Executor's commission for performance of
her/his duties In administering my estate under this Will shall be limited to
three percent (3%) of the gross value of my estate.
ITEM IX - I name as my Trustee, my son, ELMER E. KROUT, III. If my
son, ELMER E. KROUT, III, falls to qualify or ceases to ad as Trustee, I name
my son, RICKY A. KROUT, to be successor Trustee.
ITEM X - (1) I give to my Executrix/Executor and to my Trustee named
In this Will or any Codicil hereto or to any substitute Executor or Trustee all of
the powers now applicable by law to fiduciaries In the Commonwealth of
Pennsylvania and In particular, through the Pennsylvania Probate, Estates
and Fiduciaries Code, as effedive and as in effect on the date hereof, during
the administration and until the completion of the distribution of my estate,
and until the termination of all trusts created In this Will or any Codicil
hereto and until the completion of the distribution of the assets of such
trusts.
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(2) My Executrix/Executor shall have absolute discretion, but
shall not be required, to make adlustments In the rights of any beneficiaries,
or among the principal and Income accounts to compensate for the
consequences of any tax decision or election, or of any Investment or
administrative decision, that my Executrix/Executor believes have had the
effect, directly or Indirectly, of preferring one beneficiary or group of
beneficiaries over others. In determining the federal estate and Income tax
liabilities of my estate, my Executrix/Executor shall have discretion to select
the valuation date and to determine whether any or all of the allowable
administration expenses In my estate shall be used as federal estate tax
deductions or as federal Income tax deductions and shall have the discretion
to file a lolnt income tax return with my wife.
(3) If at any time any trust created hereunder shall be of such
value that, In the opinion of my Trustee,. the administration expense of
holding the assets contained therein In trust Is not lustlfled, my Trustee, In
his/her absolute discretion, may terminate such trust and distribute the trust
property to the person or persons then entitled to receive or have the benefit
of the income therefrom or the legal representative of such person.
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Page 5 of 8
(4) If there be any property located outside the Commonwealth
of Pennsylvania, In which I may have any Interest at the time of my death,
which cannot be conveniently administered as provided herein, then I
authorize, but do not require, my Executrix/Executor to appoint a bank or
trust company with trust powers, to administer such property according to
the terms of this Will.
(5) My Executrix/Executor and Trustee are authorized and
empowered to retain, either permanently or for such period of time as my
Executrix/Executor or Trustee may determine, any assets, Including the
capital stock of any closely held corporation, which at any time shall come
Into the possession of my Executrix/Executor, or my Trustee as a part of any
Trust created herein, whether such assets are or are not of the character
approved or authorized by law for investment by fiduciaries and whether
such assets do or do not represent an overconcentratlon In one investment.
ITEM XI - No Interest of any beneficiary under this Will, any Codicil
hereto, or any Trust created herein shall be sublect to anticipation or to
voluntary or involuntary alienation.
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ITEM XII - No fiduciary acting hereunder shall be required to post
bond or enter security for the faithful performance of hlsther duties In any
lurlsdictlon.
ITEM XIII - All estate, Inheritance, succession and other death taxes,
Imposed or payable by reason of my death, and Interest and penalties
thereon, with respect to all property comprising my gross estate for death
tax purposes, whether or not such property passes under this Will, shall be
paid out of the principal of my general estate, as If such taxes were
administration expenses, without apportionment or right of reimbursement.
I authorize my Executrix/Executor and Trustee to pay all such taxes at such
time or times as may be deemed advisable.
ITEM XIV - Wherever the context requires, singular and plural, and
masculine, feminine and neuter, shall be Interchangeable.
IN WITNESS WHEREOF, I have hereunto set my hand and seal thls_
day of ,jn/V1 f 10
, 2003.
e~1 .E, ~Jj4. ,
ELMER E. KROUT; JR.
(Seal)
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SIGNED, sealed, published and declared by ELMER E. KROUT, JR., the above
named testator, 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 other,
have hereunto subscribed our names as witnesses.
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Page 8 of 8
COMMONWEALTH OF PENNSYLVANIA
.
.
: SSe
COUNTY OF CUMBERLAND
.
.
,
WE, ELMER E. KROUT, JR.,. .., . ., and
L', n{)s~ L~V) ~ I . the TESTATOR and W ESSES whose
names are sl ned to the attached or 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 Testament and that
he had signed willingly (or willingly dlreded another to sign for him), 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 witness and to the best of his or her
knowledge the Testator was at that time eighteen (18) years of age or older,
of sound mind, and under no constraint or undue Influence.
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ELMERE.KROU~JR.,Te tor
WITNESSES:
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Subscribed, sworn to, and acknowledged before me by ELMER E. KROUT, JR.,
the Testator, and subscribed and sworn to befofe me by
\-\e(r~Y1 ~. ~ ;~~~ ~ .j(. and _L\ni\.sO-\j \. tljCtl I . witnesses, this ~
day of \. f\ / . 2003.
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Notary Public
NOTARIAL SEAL .
BARBARA J. KOCHER. Notary Publtc
Camp Hill Boro. Cumberland County
My Commission Expires Oct. 22, 2005
Kelley&Ferrarow
2200 Key Tower · 127 Public Square . Cleveland, OH 44114
(216) 575,0777 · Fax: (216) 575,0799 . Toll Free: (888) 839.8479
www.kelley-ferraro.com
November 22, 2006
D. Joanne Krout
126 Glendale Drive
Mechanicsburg, PAl 7055
CONFIDENTIAL INFORMA TION/
ATTORNEY CLIENT PRIVILEGE
RE: NGC Trust - Estate of Elmer E, Krout. Jr.
Dear Ms. Krout:
Enclosed please find a check in the amount of $ 170.13. This represents the net proceeds
from a gross settlement of$553.83 with the NGC Trust. You agreed to this settlement when you
signed the NGC Trust Release. The settlement breaks down as follows:
NGC Trust
Minus the following
33.33% Attorneys' Fees
Medical Records
Net Proceeds
$553.83
184.61
199.09
$170.13
Please sign one copy of the letter and return the signed copy to Kelley & Ferraro in the
enclosed stamped return envelope so that there will be proof that you received these proceeds. If
you have any questions or concerns, please contact Jennifer Parks at (888) 839-8479, est. 1925.
Sincerely,
d/J/]~
Thomas M. Wilson
TMW:jjp
Enclosure
I ackno\\ ledge receipt of the above noted check.
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D. Jc~'ne Krout Date
K&F# 208104
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