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Home My WebLink About11-26-07 ...J 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 OFFICIAL USE ONLY County Code Year INHERITANCE TAX RETURN RESIDENT DECEDENT File Number Date of Birth Decedent's Last Name Suffix Decedent's First Name MI (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ... 1. Original Return 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 Telepho Number 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received 8. Total Number of Safe Deposit Boxes C=> Firm Name (If Applicable) o .." :=j :-0 -, ..1.> -0 :x .::- o DATE FILED Correspondent's e-mail address: 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. N RESPONSIBLE FOR FILING RETURN - PY'/ LL-n h7 A. /<//Y. ~'/Z. /1/L~vv/ LLE /":} ~ L DME L.. --c:. ~~.PV/t2/S L-s.:f //- 2"--- A~e- /.-v, /ri'7~~J~~~f ;U:5'-J C/j/2U5'LtS /~/f /7--0/3 / PLEASE USE ORIGINAL FORM ONLY DATE Side 1 L 15056051047 15056051047 -.J ~ REV-1500 EX Decedent's Name: RECAPITULATION 15056052048 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) <=) Separate Billing Requested . . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) <=) 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, or transfers under Sec. 9116 (a)(1.2) X .0_ 16. Amount of Line 14 taxable at lineal rate X.O_ 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 Decedent's Social Security Number 15. 16. 17. 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 18. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT L 15056052048 Side 2 c::::> 15056052048 --' REV-1500 EX Page 3 File Number Decedent's Complete Address: DECEt(;;~/S --t~(/& d~()_n_/j, STRr&TLLJaa__nJ/:_~ Cn_ ~{c{._ ~~ J I CITY -- /I( Et:"V'/ LGG I STATE I ?/7 ZIP I 1--2 4 I Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount -0- 3. Interest/Penally if applicable D. Interest E. Penalty Total Credits ( A + B + C ) (2) .-0- 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. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5) (5A) (58) -C"~ A. Enter the interest on the tax due. ..-(i_ 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: 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 JK] c. retain a reversionary interest; or.......................................................................................................................... 0 ~ d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 !RI 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 IRJ 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. 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. 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 zero (0) percent [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 zero (0) percent [72 PS. 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. 99116(1.2) [72 PS. 99116(a)(1)]. The tax rate imposed on the net value of transfers to orfor the use of the decedent's siblings is twelve (12) percent [72 PS. 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. I!!tt". fI~, ~ I, RONALD A. KINER, SR., of Penn Township, Cumberland County, Pennsylvania, declare this to be my last will and revoke any wiil previously made by me. 1. I devise and bequeath all of my estate of every nature and wherever situate to my wife, PATSY M. KINER, providing she survives me by thirty days. . II. Should my wife, Patsy M. Kiner predecease or die on or'before the thirtieth day following my death, I devise and bequeath all of my estate of every nature and where situate in equal shares to such of my adult children: BETSY SUE COY; RONALD A. KINER, JR. and KARLA KINER, husband and wife, by the entirety; WILLIAM HARRY KINER; MARTHA B. EYLER; ANN KINER; and GARY A. KINER as survive me by thirty days. But should any of them predecease me or die on or before the thirtieth day following my death, I devise and bequeath their share to their respective issue per stirpes living on the thirty-first day following my death; and should any of the foregoing named beneficiaries leave no such issue living on the thirty-first day following my death, I devise and bequeath the share of such beneficiary (ies) in equal shares to my other named beneficiaries or to his or her issue per stirpes living on the thirty-first day following my death. III. All federal, state and othT death taxes payable because of my death, with respect ~ .~ ~ J< "t ~ 1 , to the property forming my gross estate for tax purposes, whether or not passing under this will, including any interest or penalty imposed in connection with such. tax, shall be considered a part of the expense of the administration of my estate and shall be paid out of the principal of my estate without apportionment or right of reimbursement. IV. I appoint my son, WILLIAM H. KINER executor of this my last will. Should my son, William H. Kiner, fail to qualify or cease to act as executor, I appoint my daughter, MARTHA B. EYLER, executrix of this my last will. V. I direct that my executor or his successor executrix shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 1st day of July, 2004. j( anJi II .k",".^-'- y- RONALD A. KINER, SR. (SEAL) The preceding instrument, consisting of this and one other typewritten page identified by the signature of the testator, RONALD A. KINER, SR. , was on the day and date thereof signed. published and declared by RONALD A. KINER, SR., the testator therein named, as and for his last will. in the presence of us, who, at his request, in his presence, and in the presence of each other have subscribed our names as witnesses hereto. c{l~ /.td IIGI1SIIJ'7T ae G CJ k2~ ~ J >>-., .-<-cz /feu J I.E( ;. A 170 13 /d~C7 h1/P"S'~..v /€L C/f/UJHen$" 1'-&-lr3V-{ REV-1503 EX+ (6-98) "k COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF {- -"'/' A / C./17 / I/ ) L1. I . ,..- ~ ~ . / Y L-/.c..... /1 d'/J/ji-/ /] _ ~/i. All p~operty jointly-owned with right of survivo"rship must be disclosed on Schedule F. FILE NUMBER ,2/0"7 - 02 ?-O .~~~ ~7/~.tYe/) !5;'c "7 C.J.i:/~zL tf. VALUE AT DATE OF DEATH ~ 4~ /L/3) 'TO ITEM NUMBER 1. DESCRIPTION TOTAL (Also enter on line 2, Recapitulation) I $ ~ /4'.3, 90 (If more space IS needed insert additional sheets 0: the same size) Edward Jones 21 West High Street Carlisle, PA 17013 (717) 258-4688 Art Amundsen Financial Advisor Patsy Kiner 377-10110-1-6 November 21, 2007 Date of death values for July 18, 2006 QTY Asset Symbol 19 All tel Corp AT 18 AT&T Corp T 5 Lucent Technologies LU 88 Sprint Corp PCS 48 Sprint Nextel S Price $54. 13 26.99 2.05 19.26 19.26 EdwardJones Totals $4143.90 Total $1028.47 485.82 10.25 1694.88 924.48 REV.1509 EX + 11.97) SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATEOF // ~/V~ R. / A?C./ /v'- /j ( j) , /l, FILE NUMBER ~/O7-- CJ2 '7-0 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. Ir, L L /~/?;J IV.. /<"/ J"l! E /Z. / 2/ ,3 C8NJ'C/<..J( / L LC:::: /<d; /V E-C'/}":j L C---€ I j/Y /'f / ~;2 ~ I <-<:: r /V B. c. JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE Include name of financial institution and bank account number or similar identifying number. Attach DATE OF DEATH DECO'S VALUE OF NUMBER TENANT JOINT deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. to.-{~ r1' ,(!IJJ c/2.> AI;:;' 7; ?' /II /f L If? .SO ~ Xv,! 29, 38f '-II, /Lf1'SY r3 i3Pf' /v ,<-. ~(lC T /Ii(/' C) c>'c;:' c/ Ie; '7- ,5'0 L/ TOTAL (Also enter on line 6, Recapitulation) $ /~ c:. '/~ 13 (If more space is needed. insert additional sheets of the same size) REV-1511 EX+ (12-99) . S\~.t '~v.:: SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF I~NE/<f ..S-/y J' FILE NUMBER ,2/0?-- (12r() /9J , /?C".;1t'l1 LO Debts of decedent must be reported on Schedule I. DESCRIPTION AMOUNT ITEM NUMBER A. FUNERAL EXPENSES: ~tf;!"07/}/"I ;.:{c 14 /,-0 /v ~"""/Z/-t- L C /2 <:.-; /r:vjZ r-c /2. r/ ~/\Ic. ". /~ /".?-J G K 1. 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 /..;;/ /7?c-~ rJ< (.,O:;::'9P"V/ e-L S- Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant //-'7- r- 5'" V /11, k/ h ~/< I Street Address /$.30 ~. ~-~ He/' 3. City /VL~.' Y... LLe- State~Zip /}....:?-Y/ Relationship of Claimant to Decedent ~-? ;Cs Probate Fees k&/ S'?'-E,-Z C'f ('.', y /.> 5. Accountant's Fees 4. 6. Tax Return Preparer's Fees 7. ;?tz-/,>r-~/.?.~ l' ~/, '/1> / r~-; r> ';;; -d/A~' r::::f7/J;7 C ,///, ;J 8.. kL-7>~~/z. Vi:.'" rr,"" # 8:38,-5"',00 I ? S?? CO _ ~ ,3(;:0. cO '- J' 1-;;: J' 00 4~GO ~~d 0(7 (I' more space is needed, insert additlona: sheets oj the same size) TOTAL (Also enter on line 9. Recapitulation) i $ I 2. / 9..3'1, (/(1 i REV-1512 EX+ (12-03) .- COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF k/ /1/1;:-/2. /7 <C-,,,.,, ,79 CO 4. ,~~. FILE NUMBER ,,2/0r -- 0 Z' ..J Report debts incurred by e decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM NUMBER 1. 7/z~t{ /) t5"7 t Aj ~,/ c(:- DESCRIPTION 0, ,./ /d;./(:~f C't'V "S'r/jl/~'/7J~''^';-- VALUE AT DATE OF DEATH ~/'o/ oCCs CQ / TOTAL (Also enter on line 10. Recapitulation) $ / ~/; c c(~. C-O (" more space I> neeo-?o. Insert addition;;' sheets of the same size) REV-1513 EX+ (9-00*, COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF ~//VE/-? I /~c/V~[j) //. I ~~. RELATIONSHIP TO DECEDENT Do Not ListTrustee(s) FILE NUMBER ;2./0?--(}27-(} NUMBER I NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)J AMOUNT OR SHARE OF ESTATE 1. !J /.f (,c; y /P:30 /17 I !<//l/C/2 I//""NE- /2/ }1//PE /JLL. /YEll;' v/ L LE.( /zv7- / 7- ;2~:I / 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 R~V-1500 COVER SHEET $ (If more space is needed. Insert additional shgets of the same size)