HomeMy WebLinkAbout05-24-07
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15[]5b[]41147
REV-1500 EX (06-05)
PA Department of Revenue
Bureau of Individual Taxes
PO BOX.280601
Harrisburg, PA 17128-0601
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
'*
OFFICIAL USE ONLY
County Code Year
File Number
INHERITANCE TAX RETURN
RESIDENT DECEDENT 2 1 0 7
0204
Date of Birth
172050193
02132007
06301909
Decedent's Last Name
Suffix
Decedent's First Name
KIBLER
JOHN
MI
S
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name
Suffix
Spouse's First Name
MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
iii 1. Original Return 0 2. Supplemental Return 0 3. Remainder Return (date of death
prior to 12-13-82)
0 4. Limited Estate 0 4a. Future Interest Compromise 0 5. Federal Estate Tax Return Required
(date of death after 12-12-82)
iii 6. Decedent Died Testate 0 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
0 9. Litigation Proceeds Received 0 10 Spousal Poverty Credit ~date of death 0 11.Election to tax under Sec. 9113(A)
. between 12-31-91 and -1-95) (Attach Sch. 0)
~ORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
ame Daytime Telephone Number
GERALD J. BRINSER 7178386348
Firm Name (If Applicable)
BRINSER, WAGNER & ZIMMERMAN
REGISTER-qF WILLS usEbNL Y
:. ...,..",J
First line of address
~,..<
6 E. MAIN STREET
1"-,1
Second line of address
P.O. BOX 323
PA
ZIP Code
17078
j
DATE FIl.ED
City or Post Office
PALMYRA
State
(."
Correspondent's e-mail address: w. era w for d @ c h 0 ice 0 n e In ail . COIn
Under penalties of perjury, I declare that.1 have examined this return, including accompanyi(1g ~chedules and ~tatemel)ts, and te:> the best of my knowledge and belief,
it is true, correct and complete. Declaratron of preparer other than the personal representative IS based on alllnformatron of which preparer has any knowledge.
SIGNAT E OF PERSON RESPONSIBLE FOR FILING RETURN DATE
K. Kibler
,R.R. 11, Box 257C, East Waterford, PA 17021
Gerald J. Brinser
DATE
rz p-,
6 E. Main Street, Palmyra, PA 17078
L
Side 1
15[]5b[]41147
15[]5b[]41147
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j
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15[)5b[)42148
REV-1500 EX
Decedenfs Name:
KIBLER, JOHN s.
172050193
RECAPITULATION
1. Real Estate (Schedule A)........................................................................................... 1.
2. Stocks and Bonds (Schedule B)................................................................................. 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C).............. 3
4. Mortgages & Notes Receivable (Schedule D)............................................................ 4.
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E).................... 5.
6. Jointly Owned Property (Schedule F) 0 Separate Billing Requested.............. 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) 0 Separate Billing Requested.............. 7.
8. Total Gross Assets (total Lines 1-7)........................................................................ 8.
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)....................................................................... 11.
12. Net Value of Estate (Line 8 minus Line 11).............................................................. 12.
13. Charitable and Governmental Bequests/See 9113 Trusts for which
an election to tax has not been made (Schedule J).................................................... 13.
14. Net Value Subject to Tax (Line 12 minus Line 13)................................................... 14.
TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, of
transfers under Sec. 9116
(a)(1.2) X ~
16. Amount of Line 14 taxable
at lineal rate 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. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
Side 2
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15[)5b[)42148
.
Decedent's Social Security Number
118,643.65
118,643.65
6,240.50
3,901.11
10,141.61
108,502.04
108,502.04
0.00
15.
16.
17.
18.
19.
0.00
D
15[)5b[)42148
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REV-1500 EX Page 3
Decedent's Complete Address:
File Number 21 - 07 - 0204
DECEDENT'S NAME
Kibler, John S.
STREET ADDRESS
Messiah Village
100 Mt. Allen Drive
CITY I STATE IZIP
Mechanicsburg PA 17055
Tax Payments and Credits:
1 . Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Credits (A + B + C)
(2)
0.00
Total Interest/Penalty (0 + E)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(3) 0.00
(4)
(5) 0.00
(5A)
(5B) 0.00
Make Check Payable to: REGISTER OF WILLS, AGENT
:.:.:.:.:.:
...:.:.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "Xli IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred;..................................................................................... D [!]
b. retain the right to designate who shall use the property transferred or its income;......................................... D [!]
c. retain a reversionary interest; or..................................................................................................................... D [!]
d. receive the promise for life of either payments, benefits or care?................................................................. D [!]
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?........................................... ............ ................... ............................................... D [!]
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?.............. D [!]
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.
~;f~;;~;~;
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 three (3) percent [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 zero
(0) percent [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 zero (0) percent [72 P .5. ~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 four and one-half (4.5) percent,
except as noted in 72 P .5. ~9116 1 .2) [72 P .5. ~9116 (a) (1 )].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P .5. ~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.
.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF Kibler, John S.
FILE NUMBER
21 - 07 - 0204
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 DESCRIPTION VALUE AT DATE
NUMBER OF DEATH
1 Brethren In Christ Foundation - TAP Account #2709 18.622.20
(Includes accrued interest of $31.99)
2 Brethren In Christ Foundation - Certificate of Deposit #13145 86.161.25
(Includes accrued interest of $147.61)
3 PNC Bank - Checking Account #5000002228 13.860.20
(Includes accrued interest of $$.28)
(Decedent was a resident of a nursing home and had disposed of the tangible personal property
mentioned in the Will more than 1 year prior to death.)
TOTAL (Also enter on Line 5, Recapitulation) 118,643.65
tfu~~
Brethren ,i, Christ
FOUNDA.TION
h'//o / I (.to / .\('/"\ 'tn'.I);)/, Fo ttl!ji 11 . \/ ('\ \ '0 /'( /1'
POST OFFICE BOX 290
431 GRANTHAM ROAD
GRANTHAM, PA 17027
March 28, 2007
Mr. Gerald J. Brinser
Brinser, Wagner & Zimmerman
P.O. Box 323
Palmyra, P A 17078
RE: John S. Kibler
TAP - Special/Acct. No. 2709
SIC - Two Year/Acct. No. 2709-13145
Dear Mr. Brinser:
At his date of death, February 13,2007, John S. Kibler had the above-captioned investments with the
Brethren in Christ Foundation. Neither of these accounts had joint owners nor beneficiaries.
The balance of Special TAP #2709 at the date of death was $18,590.21. The accrued interest was
$31.99, and the total date of death value was $18,622.20.
The date-of-death balance of Certificate (SIC) #13145 was $86,013.64. The accured interest was
$147.61. Certificate # 13145' s total date of death value was $86,161.25.
If! can be offurther assistance, please do not hesitate to contact me at 717-697-2634, Extension
#5420, or at klehman(a)bicfoundation.org.
Rn~~~
Kimberly 1. Lehman
Account Officer
KJLlkjl
Phone (717) 697-2634 . Fax (717) 697-7714 · E-mail: blcf@messlahedu
MAR~25-2007 16:45
PNCBANK
412 768 3458
P.01/01
o PNCBAN<
March 23, 2007
Gerald J. Brinser
6 East Main Street - Second Floor
P.O. Box 323
Palmyra, PA 17078
RE: Estate of John S. Kibler, deceased
SSN: 172-O5~0193
DOD: 2/13/2007
Dear Mr. Brinser:
In response to your request for Date of Death balances for the customer noted above, our
records show the following:
Checking Account
Account #5000002228
Established 10/08/1998
JOHN S KIBLER
DOD balance: $13,859.92 + $.28 accrued interest
Please note that this office only provides date of death balances for deposit accounts
(!RAs, CDs, Checking and Savings accounts). We do not process any tinancial
transactions or provide statements. If you need assistance with any of these items,
please call 1-888-PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch
office.
Sincerely,
~~
Rachelle Wells
1~800-762-1775
P7-PFSC-04-F
500 first Ave.
Pittsburgh P A 15219
Member FDIC
TOTAL P.01
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SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNWLVANIA
INHERITANCE TAX REl1JRN
RESIDENT DECEDENT
ESTATE OF Kibler, John S.
FILE NUMBER
21 - 07 - 0204
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER FUNERAL EXPENSES:
A. Manor Brethren In Christ Church - Funeral Luncheon/Use of Church
DESCRIPTION
AMOUNT
625.00
2 Funeral Luncheon Food/Honorariums
155.00
3 Don Funck - Open Grave
378.50
4 Paul Kilheffer - Grave Marker Lettering
250.00
B.
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
John K. Kibler George K. Kibler
rity Number(s) / EIN Number of Personal Representative(s):
Street Address 2351 Franklin Road
City Columbia State PA Zip 17512
Year(s) Commission paid 2007
Attorney's Fees Brinser, Wagner & Zimmerman
2,000.00
2.
2,500.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City
Relationship of Claimant to Decedent
State
Zip
4.
Probate Fees
Register of Wills
252.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs
1
Register of Wills - Additional Cost of Letters
50.00
TOTAL (Also enter on line 9, Recapitulation)
6,240.50
.
ScI1edE H
FlI1eI3I Expenses &
Ad I it isbative Costs contiooed
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF Kibler, John S.
I FILE NUMBER
21 - 07 - 0204
2
Register of Wills - Tax Return Filing Fee
15.00
3
Register of Wills - Inventory Filing Fee
15.00
Page 2 of Schedule H
.
SCHEDULE I
DEBTS OF DECEDENT, MORTGAGE
LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF Kibler, John S.
FILE NUMBER
21 - 07 - 0204
Include unreimbursed medical expenses.
ITEM DESCRIPTION AMOUNT
NUMBER
1 Alert Drugs 74.37
2 Messiah Village 3,695.74
3 Crumay Paines Associates Medical 115.80
4 Capital Area Health 15.20
TOTAL (Also enter on Line 10, Recapitulation) 3,901.11
REY:,5,3 EX+ (9-00)
.
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
NUMBER
NAME AND ADDRESS OF PERSON(S)
RECEIVING PROPERTY
RELATIONSHIP TO
DECEDENT
Do Not List Trustee{s)
I FILE NUMBER
21 - 07 - 0204
SHARE OF ESTATE AMOUNT OF ESTATE
(Words) ($$$)
==
Kibler, John S.
I.
TAXABLE DISTRIBUTIONS[include outright spousal
distributions, and transfers
I under Sec. 9116 (a) (1.2)]
1 John K. Kibler
2351 Franklin Road
Columbia, PA 1751
Son
1/2 Personalty
0.00.
2 George K. Kibler
R.R. #1, Box 257C
East Waterford, PA 17021
Son
1/2 Personalty
0.00.
.See Notes on Schedule E.
II.
I
Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet
I NON-TAXABLE DISTRIBUTIONS:
IA. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS
! NOT BEING MADE
I
lB. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1 Brethren In Christ Foundation
P.O. Box 209, Grantham, PA 17027-0209 (Entire Residuary Estate)
108,502.04
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET'
,
108,502.04
~
WILL
OF
JOHN S. KIBLER
I, JOHN S. KIBLER, currently of Cumberland County, Pennsylvania, realizing the
uncertainty of this life, but with confidence in God and trust in His Son, my Lord and
Savior, Je$us Christ, who died for my sins upon the cross and rose again to redeem me and
give me eternal life, do hereby make, publish and declare this to be my Last Will and
Testament, hereby revoking any and all prior Wills and Codicils made by me.
I. I direct that all my just debts and funeral expenses be paid from the assets of my
estate as soon as practicable after my demise.
II. I direct that all estate and inheritance taxes that may be assessed in consequence of
my death, shall be paid out of the principal of my general estate to the same effect as ifsaid
taxes were expenses of administration and all property includable in my taxable estate
whether or not passing under this Will shall be free and clear thereof.
III. I bequeath unto my sons, John K. Kibler and George K. Kibler, all tangible personal
property which I own at my death.
IV. All the rest, residue and remainder of my estate, of whatever nature and wherever
situate, including property over which I hold a power of appointment, I devise and bequeath
unto the Brethren In Christ Foundation, Grantham, Pennsylvania, to be used for the
charitable 'purposes I intend to outline to it by separate instructions.
V. I appoint my sons, John K. Kibler and George K. Kibler, Executors, or the survivor
of them as sole Executor, of this my Will.
VI. I direct that no bond be required of my fiduciaries for the faithful performance of
their duties in any jurisdiction.
~
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r S )Ufu
IN .WITNESS WHEREOF, I, JOHN S. KIBLER, herewith set my hand to this my
Last Will, typewritten on two (2) sheets of paper including the attestation clause and
signatures of witnesses, this /z-p1 day of 1'1 A It... ~ t.I , 2002.
~ :3 J~(SEAL)
J~ S. KIBLER
Signed by JOHN S. KIBLER, by him declared to be his Will in our presence, who
have hereunto subscribed our names as witnesses in his presence and at his request, this
l.:l-A ayof /'l-?tfcfI ,2002.
residing at ~ E
-
residingat ~ t
I?~
-2-
COMMONWEALTH OF PENNSYL VANIA
COUNTYOF CUM. \o"r\6.-~
WE, JOHN S. KIBLER, ~ Ut1--LO J. L!R//Y's~~ and JAml!S A. SmiLEY ,
the testator and the witnesses, respectively, whose names are signed to the attached or
foregoing instrument, being first duly affirmed, do hereby declare to the undersigned
authority that the testator signed and executed the instrument as his Last Will and that he
signed wil.1ingly (or willingly directed 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 witnesses and that to the best of
our knowledge the testator was at that time eighteen years of age or older, of sound mind and
under no constraint or undue influence.
S/6~
J S. KIBLER
~.u.../~ ~
WITNESS /
~~
&fmESS- tf{
Subscribed, sworn or affirmed and acknowledged before me by JOHN S. KIBLER, the
testator, C E 1!.-9 L.6 J - M //V 5 ~,.< and JIll1lEj A. .>""II.EY , witnesses, this /:ld
day of Ma rt:k ,2002.
t4 )11. ~ (SEAL)
Notary Public
NoIaItII Seal
VIcky M. MkUIIa. Notary Public
Upper AIen lWp., Qmbertand Ccu1ty
My eo.hml881on ecpns Oecembet 31,2005
Merrtler. ~ Assoc:Iatlon Of NaCaries
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