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HomeMy WebLinkAbout09-12-07 --I 15056051047 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 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY County Code Year File Number J 7(3 cZ6 9Jz Date of Birth Decedent's Last Name Suffix Decedent's First Name MI K YAG'..r<. ~/< , ])A I F (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name j{ Y P ~ R. Ir1I? 5 Yo'A-Ntl MI Spouse's Social Security Number A- FILL IN APPROPRIATE OVALS BELOW _ 1. Original Return THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS C) 2. Supplemental Return C) 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required C) 4. Limited Estate C) C) 4a. Future Interest Compromise (date of death after 12-12-82) C) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) C) 10. Spousal Poverty Credit (date of death C) 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number - 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received o 8. Total Number of Safe Deposit Boxes C) CHA~LES E 5HIEL1>S I I / 7 I 7 76" 0207 Firm Name (If Applicable) tf/ A- REGISTER OF WILLS USE ONLY First line of address fa (!.L/)t/SER t!..]) Second line of address , tv/A- City or Post Office State ZIP Code OAT'E FILED '-J IIIEeNAAI/ CS$J,(f((; fJA- /70SSCj73~ c...;', Correspondent's e-mail address: t,e arne res @ e.p ix . t1 e t 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, cor ct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. ;/f/J;E ~ , fiATE fA b7 , -~ L Side 1 15056051047 15056051047 --.J .-I 15056052048 REV-1500 EX Decedents Name: }('>' fJettJ iJA J/ /1:> F: 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) c:::> Separate Billing Requested 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) c:::> 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. Decedent's Social Security Number 1& ,^g93Z~ . & () .t) 0 · 00 . f) 0 5"1.00 .00 / ?" () if 3. i".fo / S'.s- /0 ~.~(P IS. (;) 0 ~. 9 9 ~4.9 'f 1~5' 017.87 .00 /1S077.81 TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under See. 9116 (a)(12) X .0tL_ / 8' 5 0 .., 7 · f7 16. Amount of Line 14 taxable at lineal rate X.O ~ . ()O 17. Amount of Line 14 taxable at sibling rate X .12 . P 0 18. Amount of Line 14 taxable 00 at collateral rate X .15 . 19. TAX DUE. . . 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 15056052048 c:> 15056052048 ---I REV-1500 EX Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME STREET ADDRESS Ky/JER/ PAJlI.D r: 9 2 Z (;/t /111/ r/f A /J1 R,t>A-/) f?~ $OX III GU/J T# Am STATE fJ /I- ZIP 17CJ~7 CITY Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) o o o Total Credits ( A + B + C ) (2) o o 3. Interest/Penalty If applicable D. Intei'est E Penalty o o Total Interest/Penalty ( D + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This IS the OVERPAYMENT. Fill in oval on Page 2, 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) o A Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) o [) o Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 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. !f 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? ............. ................ ............ Yes ......0 o .....0 ..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. ~ No ~ ~ ~ ~ lZJ ~ o 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. S9116 (a) (1.1) (i)j. For dates of death on or after January 1, 1995, ;he tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 PS 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 zero (0) percent [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 four and one-half (4.5) percent, except as noted in 72 P.S. S9116(1.2) [72 P.S. s9116(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.S. s9116(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. , REI.L150B EX . {1-9?} ESTATE OF SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 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. 1< y P ~r<) 0 A- V J.D F. ITEM NUMBER 1. DESCRIPTION Pft.R.Ttf'rl. RG FlA iJD ~R..om CREiDIT ~ E((. VI CES i(,E: .5H/:;:U G firS OL./lJE (JAfl,b. VALUE AT DATE OF DEATH "5r.DO TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) V-1510 EX + (1-97) SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT )TATE OF J<'IP€t<J DAVID FILE NUMBER F This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY %OF oM INCLUDE THE NAME OF THE TRANSFEREE. THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. DATE OF DEATH DECO'S EXCLUSION TAXABLE VALUE ATTACH A COPY OF THE OEED FOR REAl ESTATE. VALUE OF ASSET INTEREST IF APPLICABLE \ BER C.ITIGteouf' \ $\V\I--rH Bfti<Ney If!.A-s Ir II) ;tee T. 1Vf). 701'1- 61f 4qg ~ /0010 tji' /4-8 ~D 9.11.. -o- J '+3: ;2.09- 1"- J 7:zt/-64-'1rc; r /oo~ ~ IrS) A ec-r: /II.? .5'ft" fr31 /Po -0- 310, E!3'1.6 (c5~F J/A-!AA I} It/)/I/ ~ TTA-lj/E1). j/Aiflfl-liMJJ VJEllE [}ETFI<ft1/AJP Ar'El?J16/ AI 6 mE 11/61/ A1v.l> ~uJ fJ/</eB j=O/( ?HE" ]) ~ t). I). /ftV/J I11ttL 1/;JL V/NC /fy T#E $, ~r= $11 ,;1-~es ) TOTAL (Also enter on line 7, Recapitulation) $ / J' 5; tJ~ 3~ it, 2b o (If more space is needed, insert additional sheets of the same size) Jatl-25-07 12:03pm From-Smith Bartley ~ CltlgroUpJ SlvI lTH BARNEY January 25, 2007 To: Charles Shields RE: David Kyper Acct# 724-6A498; 724-6;1.499 Date of Death: 12/05/2006 724-6A498 Date Symbol J 12/05/06 AMGN j 12/05106 AMAT j 12/05/06 CZNC V' 12/05/06 JNJ ,j 12/05/06 LOW J 12/05/06 UNH / 12/05/06 ABALX / 12/05/06 AEPGX J 12/05/06 AGTHX 724-6A499 Date Symbol 12/05/06 ABALX 12/05/06 AEPGX 12/05/06 AGTHX Srlares 100 250 175 100 150 100 1577.194 612.425 1612.691 Total Value Shares 499942 193.805 508.024 Total Value pnce 68,95 18.55 22,39 66,16 31.00 48.93 19.53 49,14 34.54 price 19.53 49.14 34,54 If YOll \lave any questioJl~, please call me at ('/17) 780-1710 \ ~a ,I m R gistered Client ervice Associate to: Wayd W, Wolgemuth First Vice President-Wealth Manaqement Financial Advisor Lrs enclosure Ciligrollp Glob.1 Mark~u lac. 717 233 2090 __I,' " , ' -- ,. ". _.' ". \ " ['1 .. '" '. ',:..... -- Value - 6,895,00 4,637,50 3,918.25 6,616.00 4,650.00 4,893,00 30,802.60 30,094 56 55,702,35 148,209.26 Value 9,763,87 9,523,58 '1 7,547. 1 5 36,834.60 ,i I"': ~. :., - ' '.. '......... . T-132 P 002/002 F-193 \1 Nc.lth 3rd Stle~[. 2nJ Floor H;lcrisburlS' PA 17101 Tel 717 780 \700 Fa~ 717 233 2090 Toll Free 800 2,\7 1700 ..' ." '. ,..-,', .. ~ -: r , ~ I 0'!;:'T/-,i';'\~D ,. ',:~ ..;r"" . '. ,i" . ~ I" ~. ! ~;~ '.;':' I , r. ",- : \' ;: - . l ,~ TO j~ .~tU/<'~_~/ ~I;J! L'.,/ :<> I (- l'--~ '.!. ',. _/ . I. . '.,1", ;':,J TI~[ INrOR.V.~1l0N SET FORIH WA5 OB11>J~tD fi\Orv. o0URI~E5 WI1JCH WI r>"'~"( ~"'I.IA~U: BUT WI' no NQT ,;I.:P.IV\I':n:E ITS !,(CUil}.<:CY llk CQlv\CLlTE.;q,j "EITHER THE INF()fl},lAIiON NOR .^,'IY OPINIOf' F.xrF-E.:;:;li) cONS'J'InrnS A S0lJC1TATION ~V uS OF rHE PUKCHASE 01\ ),~IE Qf Mil :;Eel1/UTI"'" 'IS .-\;-~'=!,-.~,;;=Il C)~ REV'1511 EX+ (.12-99) ~~~/~ '~..~..:w- COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF /(V'Pl::le., Dft-v J j) 1=. FILE NUMBER Debts of decedent must be reported on Schedule 1. ITEM NUMBER A. FUNERAL EXPENSES: 1. DESCRIPTION AMOUNT B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) .JOlf-fJlJ If I<.Yt'E7<. W,4/1l1:!1::> Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State _ Zip Year(s) Commission Paid: 2. Attorney Fees C HI1-Il L€'S E"'. S J.I f f::.-uJS 1JJ: fA NIJE'TERM /JJ.tt> 3. Farnily Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant J~A#AI /I- !<y iJt:~ Street Address ;Jo /lJo )c /11 City G/Vf-fI/ Pf/l-IJf W fl.1 VI::-'D State~Zip 17~;l7 Relationship of Claimant to Decedent toll> OW 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. FILING F~~ T1/ tCEGI$Te7t ()F jf/ I/..LS , IS: 00 TOTAL (Also enter on line 9. Recapitulation) $ / s: 00 (If more space is needed, insert additional sheets of the same size) REV~1512 EX+ (12'03) SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF J( Y fJEle, f) A-v I [) F. FILE NUMBER Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH ,(j..1I1. IllS/' OF /1-1l tHr/€c..rs / tJ4-NJC. al= A-M t:.7t? leA Cl2e:bIT Cfl-I2-D ~9.99 TOTAL (Also enter on line 10. Recapitulation) $ (If more space is needed, insert additional sheets of the same size) i.Cjq REV-1513 EX+ (9-00* SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF I K 'I P E f<, V,4 V 1.0 F. FILE NUMBER RELATIONSHIP TO DECEDENT NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not ListTrustee(s) I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. .JottNN If. KYPIER. WIDOW po roO'l.. III CStLA-tJ ~I-( It 1Yl, pfJr 17 0 ~ 7 CS€~ TilliE" /HilL) ODRReeT oFACE ClJpy 01= N~N- fJ~I3ItTtm WILL- /f r7/1-t!#Et>) AMOUNT OR SHARE OF ESTATE IOof'o 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 $ (11 more space is needed, insert additional sheets of the same size) , LAST WILL AND TESTAMENT OF DAVID F. KYPER I, DAVID F. KYPER, of Upper Allen Township, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this my Last Will and Testament, hereby revoking and making void any and all prior Wills by me at any time heretofore made. 1. I direct the payment of all my just debts and funeral expenses as soon after my decease as the same can conveniently be done. 2. All the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever and wheresoever situate, I give, devise and bequeath to my beloved wife, JOANN A. KYPER, to her own use and benefit absolutely. 3. In the event, however, that my said wife should predecease me, or should die at about the same time as I die, such as in a disaster common to both of us, I give, devise and bequeath my said estate to be divided and distributed as follows: A. Four (4%) per cent to the Shepherdstown United Methodist Church. This gift shall only be used for the following purposes in the amounts and proportions that the local board deems best and for no others: 1. Building improvements and maintenance; 2. Local missions, such as Meals on Wheels, New Hope Ministries, and the like. B. Four (4%) per cent to the United Methodist Home for Children and Family Services located in Lower Allen Township, Cumberland County, Pennsylvania. C. Two (2%) per cent to the Neighborhood Center of the United Methodist Church, currently located at 1801 North 3rd Street, Harrisburg, Dauphin County, Pennsylvania. D. The remaining ninety (90%) per cent to be divided into five (5) equal shares amongst my and my wife's children, to wit: LISA KAPP, LINDA LAMPARTER, GEOFFREY KYPER, ALEISA KYPER, and SHEILA K. GEORGE. Should any of the said five (5) children predecease me and be survived by children of hislher own, they shall take their deceased parents' share. Should any of the said five (5) children predecease me and not be survived by children of hislher own, then his/her share shall be divided proportionally amongst the survivors of the said five (5) children above- mentioned. J '. 4. 1 nominate, constitute and appoint my wife, JOANN A. KYPER, to be the Executrix of this my Last Will and Testament. In the event that she should predecease me or for any reason be VICKY ANN TRIMMER, to be Executrix in her place and stead. In the event that she should unwilling or unable to act as such Executrix, I nominate, constitute and appoint my wife's niece, predecease me or for any reason be unwilling or unable to act as such Executrix, 1 nominate, constitute and appoint Charles E. Shields, Ill, Esquire, to be Executor in her place and stead. 1 further direct that they shall not be required to file bond or other security in the Office of the Register of Wills for the purpose of administering my Estate. /1lttyJ, IN WITNESS WHEREOF, 1 have hereunto set my hand and seal this lEt.. day of , A.D. 2002. s/ ~/c1 F AA/Ju" DA VID F. KYPER (SEAL) Signed, sealed, published and declared by the above-named DAVID F. KYPER as and for his Last Will and Testament, in the presence of us, who at his request and in his presence, and in the presence of each other, have hereunto subscribed our names as witnesses. 7/ f?Jllr/~5 E. ~I ~ ZlT ( ~/ lJA?aA j ~ /