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HomeMy WebLinkAbout12-12-07 -1 15056041147 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 2 1 0 7 File Number 0705 Date of Birth 188324288 07132007 07281911 Decedent's Last Name Suffix Decedent's First Name KAUFHOLD KATHRYN MI M (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 181 1. Original Return 0 2. Supplemental Retum 0 3. Remainder Retum (date of death prior to 12-13-82) 0 4. Limited Estate 0 4a. Future Interest Compromise 0 5. Federal Estate Tax Retum Required (date of death after 12-12-82) 181 6. Decedent Died Testate 0 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes (Attech Copy of Will) (Attach Copy of Trust) 0 9. Litigation Proceeds Received 0 10 Spousal Poverty Credit idate 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 T~phone NunOilr .- <=> THOMAS S BECKLEY 71723~~691 ~ '-!:-9 ril 212 NORTH THIRD STREET ~~ '":) c"..} -u - Firm Name (If Applicable) BECKLEY & MADDEN - ;::..:- -=: ( '--J REGISTER 6J=fWlLLS.usE ONLY , :<~ 5fl N . I! ) First line of address Second line of address " ...:~ I~ --I w .. N CO City or Post Office HARRISBURG, State PA ZIP Code 17101 DA TE FILED Correspondent's e-mail address:becks@pa.net Under penalties of pe~ury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, . . rreet and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE NSIBLE FOR Fill RETURN DATE Jeffery Tinsman , PA 17043 Thomas S Beckley 7 DATE /1//&1/ () 7 I I 212 North Third Street, Harrisburg" PA 17101 L Side 1 15056041147 15056041147 -1 --.J 15056042148 REV-1500 EX Decedent's Name: KAUFHOLD, KATHRYN M. ----- ------.----- -~--------_..~-~-~--~----,.~- --------.--..-.---...-------.---- 188324288 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 .00 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 15. 16. 17. 754,260.09 18. 19. Tax Due.................................................................................................................. .1.9. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. L Side 2 15056042148 Decedent's Social Security Number 136,160.00 1,102,485.19 56,827.53 237,366.34 1,532,839.06 --.--..--..--------." ------ 106,108.22 9,861.57 115,969.79 1,416,869.27 662,609.18 754,260.09 113,139.01 113,139.01 D 15056042148 --.J REV-1S00 EX Page 3 Decedent's Complete Address: File Number 21 - 07 - 0705 Kaufhold, Kathryn M. ._-------._._---_._---~.._-~._-_.._-----------~----- ^--_.-.~_...._-_..__._----~----,._-- '-~'----"'~--- STREET ADDRESS 318 North Front Street CITY -.. ---_._--------'--~----_._-----.----"" I STATE PA -r~~43 --~-- Wormleysburg Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 113,139.01 -105~:OO 5,526.32 3. InteresUPenalty if applicable D. Interest E. Penalty Total Credits (A + B + C) (2) 110,526.32 TotallnteresUPenalty (D + 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 S. 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 S + SA. This is the BALANCE DUE. (3) (4) (S) (SA) (SB) 0.00 2,612.69 2,612.69 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;.................................................................................~.--:J ._~ b. retain the right to designate who shall use the property transferred or its income;.................................... tl [:!J c. retain a reversionary interest; or...............................................................................................................[] [:!J d. receive the promise for life of either payments, benefits or care?.............................................................jJ [!J 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideratiOn?....................................................................................................................D IJ(J 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... Iii 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?.................................................................................................................. ~l D IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF 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! 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 (OJ 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.S) percent, 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 twelve (12) percent [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. *' SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ~.._--- - ~iLE NUM-B~ER- 21 - 07 - 0705 ~----~- - ~--- ESTATE OF Kaufhold, Kathryn M. All real property owned solely or as a tenant in common must be reported at fair market valuefair market value is defined as the price at which property would be exchanged between a willing buyer and a wining seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts.Real property which is jointly-owned with right of survivorship must be disclosed on schedule F. ITEM NUMBER 1 VALUE AT DATE OF DEATH -,--- - - ---------,-"--,._------ 136,160.00 DESCRIPTION Real property located at 318 North Front Street, Wormleysburg, PA 17043 (see attached assessment) TOTAL (Also enter on Line 1, Recapitulation) 136,160.00 *' SCHEDULE B STOCKS & BONDS COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ------------L-_~_,_____~_____..__.. _____ ]FILE NUMBER - 21 - 07 - 0705 ----- -- -- ---- --- ---- ESTATE OF Kaufhold, Kathryn M. All property jointly-owned with right of survivorship must be disclosed on Schedule F. N~1J~R _. ----------~~~~~;---------n---r-~NIT -V~~UE._pALU~~i~~TEOF ----~-_._--- ------ ---_.-._~-,._---------.__._~,----,...._-- 1 I Franklin Tempton Tax-Free Income A Fund 10.24 106,875.38 2 Merrill Lynch Bank Deposit Account 1 i 23.00 3 . 2,421.8310 shares of Income FD Amer Inc. 21.49 52,045.15 4 793.8 shares of Capital Income BLDR FD 66.43 52,732.13 5 2,059.5790 shares of MFS SER TR VI GLB Return 15.44 31,799.90 6 12,420.6380 shares of Blackrock GLB Alloc. FD 18.96 45,895.30 7 5,891.0410 shares of American Balanced FD INC 20.33 119,764.86 8 9,732.6230 shares of Bond FD AMER Inc. 13.16 128,081.32 9 3,119.1960 shares of Capital Income BLDR Fund 66.43 207,208.19 , 10 i 3,299.2790 shares of Capital World BD FD INC 19.45 64,170.98 11 8,465.0020 shares of Intermediate DB FD AMER 13.30 112,584.53 12 8,095.9330 shares of Income FD AMER INC 21.65 175,276.95 13 PA Higher Eductional Facilities Authority College 5,000.00 Revenue Bond 14 150 Shares Zareba Systems, Inc. 6.85 1,027.50 - - --------... ---_._-_._._.~._--~--'---,--,-------------_._-----_._--- ---.-- ----- TOTAL (Also enter on line 2, Recapitulation) 1,102,485.19 *' SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYL VANIA INHERITANCE TAX RETURN RESIDENT DECEDENT _J , - ~~--_.,-___l.~~.__.___..______.~..._______ ______ ____ ... ...= ---=- -.k~L~ ;7~M;~~ -_ _ ESTATE OF Kaufhold, Kathryn M. Include the proceeds of litigation and the date the proceeds were received by the estatat:\1I property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER 1 DESCRIPTION VALUE AT DATE OF DEATH 1,918.00 Personal property (see attached appraisal) 2 Fulton Bank Burial Reserve Account (#102-0019382) (includes accrued interest of $400.70) 9,202.53 3 Diocesan Savings and Loan (Account # 01-22455) 18,972.06 4 Sovereign Bank Savings Account (including accrued interest of $51.24) Account Number 1054021215 4,206.56 5 Sovereign Bank Checking Account (including accrued interest of $2.32) Account Number 2331033617 2.32 6 Cash held for Decedent by Jeffery Tinsman 20,326.00 7 Fulton Bank Savings Account (Account # 1370-45663) 2,200.06 TOTAL (Also enter on Line 5, Recapitulation) 56,827.53 .. I SCHEDULE G COM~N~~~~;y~g~~NE~t~L~ANIA I INTER-VIVOS TRANSFERS & RESIDENT DECEDENT MISC. NON-PROBATE PROPERTY __u___u ______ ____~___________________ -------- --------- _._---'_.__..~-------,~.~_..- ---"~-------------.__.__._. '----..-..-----..------..--- ESTATE OF Kaufhold, Kathryn M. FILE NUMBER 21 - 07 - 0705 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes. NG~B~~ k~n~~~~tii~~~~~~~:;=.. nfs~::~~QT'::~'1,,~~;:~J;':;L;:~. , OJ I 21 Fort Dearborn Life Annity Policy No. F00000000840 61.018.761 100% Iii 3 Jackson National Life Insurance (Annuity) 117,920.48 100% 61,018.76 117,920.48 ---J_____iu______l_ TOTAL (Also enter on line 7, Recapitulation) I 237,366.34 . SCHEDlI.E H FUfERAL EXPENSES & ADNINSlRA11VE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT _~I __ _______~ ___ ~ - FILE NUMBER 21 - 07 - 0705 '---"'------,_.,------~--_._----~._-- ESTATE OF Kaufhold, Kathryn M. Debts of decedent must be reported on Schedule I. ~_._----_._----- ._._--~. ITEM NUMBER FUNERAL EXPENSES: ---- -----I-...-'._...~--~-_...._-_.- ------ - A. 1 ! Neumeyer Funeral Home 1334 North 2nd Street, Harrisburg, Pennsylvania 2 Evans Memorial (foot stone) -_._-'-----,..._.~._---- DESCRIPTION AMOUNT 8,865.00 395.00 B. 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Jeffery Tinsman Street Address 316 North Front Street City Wormleysburg State PA Year(s) Commission paid 50,000.00 Zip 17043 2. Attorney's Fees Beckley & Madden 45,000.00 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 Probate Fees Cumberland County Register of Wills State Zip 4. 900.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 1 Cumberland County Law Journal 75.00 TOTAL (Also enter on line 9, Recapitulation) 106,108.22 .. I Flnm~::es& COMMONWEALTH OF PENNSYLVANIA L ~ 'I INHERITANCE TAA RETURN Adniristrative Costs conIirJJed ____ __ _ _ RESIDENT DECEDENT~_ ____ _ _ ___ __ ~__ _ _ _____ _ _____ - --------'-------.------------.~- ----------~-____rr=ILE NUMBER -. ~ ---.,--------.0---- ESTATE OF Kaufhold, Kathryn M. 121 _ 07 _ 0705 -----------------------------------~---------r-------------------- 2 The Patriot News - 293.22 3 Claude C. Wolfe & Associates (appraisal) 175.00 4 Photocopying Charges 150.00 5 Postage 75.00 6 Telephone Tolls 5.00 7 Got Junk (removal of salvaged items from house) 175.00 Page 2 of Schedule H . SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT - -[FILE- NUMB-ER 21 - 07 - 0705 ------ -- -~ -- --- ESTATE OF Kaufhold, Kathryn M. Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1 Public School Employees' Retirement System (refund of August payment) 2,156.63 2 PP&L Electric Utilities 235.84 3 Vision Health Care (final invoice for caretakers) 6,500.00 4 PA Water (6 months of invoices) 691.12 5 AT&T (phone bill) 47.98 6 Wormleysburg (trash/sewer bill) 230.00 .~----~~--.._--~--_._.._._--------_.._--_..._--_.._-- TOTAL (Also enter on Line 10, Recapitulation) 9,861.57 REV-1513 EX+ (9-00) .. COMMONWEALTH OF PENNSYLVANIJ INHERITANCE TAX RETURN RESIDENT DECEDENT ---------..-. -- - - -----~~-- SCHEDULEJ i BENE~ICIA~IES _m____ L -----..-1 FIL.E NUMBER--- ------ 21 - 07 - 0705 F. A;:EUmONSHIP TO I SHAAE OF ESTArE' I. A AMOUNT-amF E..STATE DECEDENT (Words) ($$$) Do Not List Trustee(s) -..-----.-------.-..---- .--------,.------- ------.---._-------------_. ---------- : ! I Friend 1,000.00 ESTATE OF Kaufhold, Kathryn M. NUMBER +. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY "-'--- I .TAXABLE DISTRIBUTIONS[include outright spousal . I distributions, and transfers under Sec. 9116 (a) (1.2)] I Pastor/St. Patrick's Cathedral 212 State Street Harrisburg, PA 17105 2 Edmund Madden 6209 Edward Drive Clinton, MD 20735 Friend 10,000.00 3 Elizabeth Miller 464 Marsh Run Road New Cumberland, PA 17070 Friend 1,000.00 i Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet II. I 'NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1 Diocese of Harrisburg for Bishop McDevitt High School 302,091.04 2 Diocese of Harrisburg for the Cathedral School 302,091.04 3 Diocese of Harrisburg (for educational purposes - Genworth Annuity) 58,427.10 TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHE T __.n__.__~. - .--------.m-.____________.____u_ _n._______._...L 662,609.18 REV-1513 EX+ (9-00) . SCHEDULE J BENEFICIARIES continued COMMONVVEAL TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ---~-_._--- .'-------. ESTATE OF Kaufhold, Kathryn M. .__~.u._~__. ~---.-lF'iE N~1~BO~R_ 0705----- RELATIONSHIP TO --'-"~---'SHARE-OF ESTATE---- AMOU-NT-O.F"i:STATE DECEDENT + (Words) ($$$) Do Not List Trustee(s) --------- I ------- -,- -----_.~--------~--_._----------,----- NUMBER 1_ NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I .TAXABLE DISTRIBUTIONS[include outright spousal '. aistributions, and transfers under Sec. 9116 (a) (1.2)] 4 Jeffrey and Elizabeth Tinsman 316 North Front Street Wormleysburg, PA 17043 Friends Residence, personalty, 1/2 of residue _1 - - -- -- L__J_ Page 2 of Schedule J ~ LAST WILL AND TESTAMENT OF KATHRYN M. KAUFHOLD I, KATHRYN M. KAUFHOLD, a resident of Cumberland County, Pennsylvania, being of sound and disposing mind and memory, do make, publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils by me at any time made. i' ITEM I: TAXES. I direct that all inheritance and estate taxes becoming due by reason of my death, whether such taxes may be payable by my Estate or by any recipient of any prop- erty, shall be paid by my Executor out of the property passing under this Will, which is not spe- cifically bequeathed or devised, as an expense and cost of administration of my Estate. My Ex- ecutor shall have no duty or obligation to obtain reimbursement for any such tax paid by my Ex- ecutor, even though on proceeds of insurance or other property not passing under this Will. ITEM II: POWERS OF APPOINTMENT. I hereby exercise all powers of appoint- ment which I may have at the time of my death in favor of my Executor, and all property subject to all such powers of appointment shall be included in my Estate. ITEM III. SPECIFIC BEQUESTS. I hereby make the following specific bequests: (a) ONE THOUSAND DOLLARS ($1,000) to the PASTOR OF ST. PATRICK'S CATHEDRAL in Harrisburg, Pennsylvania; (b) TEN THOUSAND DOLLARS ($10,000) to EDMUND MADDEN of Fort Washington, Maryland; Page 1 of 4 Pages 'J(J;1,j( , , I (c) ONE THOUSAND DOLLARS ($1000) to ELIZABETH MILLER of New Cumberland, Pennsylvania. (d) My residence, located at 318 North Front Street, Wormleysburg, Pennsyl- vania (17043), to my neighbors, JEFFREY AND ELIZABETH TINSMAN, who, at the writing of this Will, reside at 316 North Front Street, Worn:tl~y~J>urg,.}>~nnsylvtU1ia, or the survivor of them; and (e) All of my household furniture and furnishings, books, pictures, jewelry, china, linen, silverware, wearing apparel and all other articles of house- hold or personal use and adornment not otherwise disposed of herein to my neighbors, JEFFREY AND ELIZABETH TINSMAN, or the survivor of them; and ITEM IV: RESIDUAL ESTATE. I give, devise and bequeath all of the rest, residue and remainder of my Estate as follows: (a) FIFTY PER CENTUM (50%) to my neighbors, JEFFREY AND ELIZABETH TINSMAN or the survivor of them; (b) TWENTY-FIVE PER CENTUM (25%) to the DIOCESE OF HARRISBURG to be used by the Diocese through its Secretary for Education for BISHOP McDEVITT HIGH SCHOOL; and Page 2 of 4 Pages ~}('" /11, J( r ~. ~ r ! I i (c) TWENTY-FIVE PER CENTUM (25%) to the DIOCESE OF HARRISBURG to be used by the Diocese through its Secretary for Education for the CATHEDRAL SCHOOL. ITEM V: EXECUTOR'S POWERS. In the settlement of my Estate, my Executor shall possess, among others, the following powers: (a) To sell, either at public or private sale and upon such terms and conditions as illY Executor may deemadvatttageous to my Estate, any or all real or personal estate or interest therein, whether owned by me separately or in conjunction with other persons or acquired after my death by my Executor and to consummate said sale or sales by sufficient deeds or other instru- ments to the purchaser or purchasers, conveying a fee simple title, free and clear of all trust and without liability of the purchaser or purchasers to see to the application of the purchase money or to make inquiry into the valid- ity of said sale or sales; also, to make, execute, acknowledge and deliver any and all deeds, assignments, options or other writings which may be necessary or desirable in carrying out any of the powers conferred upon my Executor in this paragraph or elsewhere in my Will. (b) To pay all costs, taxes, expenses and charges in connection with the ad- ministration of my Estate. (c) To distribute my Estate in kind or in money. In the event assets are dis- tributed in kind, such assets shall be distributed at their value(s) on the Page 3 of 4 Pages K 7r /;], -,. respective date(s) of their distribution. (d) To do all other acts in the judgment of my Executor necessary or desirable for the proper and advantageous management, investment and distribution of my Estate. impossible todete.tmine who died first, shall be deemed to have predeceased me. time as me or in a common disaster With me or under such circumstances that it is difficult or ITEM VI: SIMULTANEOUS DEATH. Any person who shall have died at the same ITEM VII: EXECUTOR. I hereby nominate, constitute and appoint JEFFREY TINSMAN, of316 North Front Street, Wonnleysburg, Pennsylvania, to be my Executor. Because I have made them familiar with my affairs, I request, but do not require, that my Executor retain the services of the law finn of Beckley & Madden, having offices in Harrisburg, Pennsylvania, to represent my Estate and my Executor. My Executor specifically is relieved from the duty or obligation offiling any bond or other security. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my last Will and Testament, consisting of this and the preceding three (3) pages, at the end of each page of which I have also set my initials fur greater security and better identification this$. day of February, 2004. Page 4 of 4 Pages K/' .lYj;~, Kathryn M. Kaufhold ~. r q/ ,". 'I r, I / f-t-V"'vz<r rl1-, J .{-dLt;)~cL (SEAL) We, the undersigned, hereby certify that the foregoing Will was signed, sealed, published and declared by the above-named Testatrix, as and for her Last Will and Testament, in the pres- ence ofus who, at her request and in her presence and in the presence of each other, have here- unto set our hands and seals the day and year above written, and we certify that at the time of the execution thereof, the said Testatrix was of sound and disposing mind and memory. ~- ;' /,), ,I) .!~ . .&~,.;_L'1/..",..u;.- tJ.;,&.. ~ 1// (SEAL) Residing at Y331/)Jv7/&:h<(?) {2~ }J/l ~/? -'./ -/ --- (SEAL) Residing at -. -...- ...;.'" - /' I '1'~<'f{j,'Jrl"" 11/ 11/.// (SEAL) Residing at tJ,' ,(j . . ;'. .J>. _,' c- .,#. / -L-: '.'. ,..{ I '>,. "' (..:::It .--.,~ ~ ~..:...---___.. ,.. "'-__ /f~" ;J.1'.:r.-' ,J/) / -'/'/ ~, ~L.__I__. -, _ /__: / / I ___j /1"-' I AFJ?IDAV.'.(' COMMQ~Tl{.QF.PENN$'Yj:.Y~ COtJN'tY.OF DAUpHIN ss: We, the undersigned Testatrix and Wi1nesses, respectively, whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and declare to the undersigned authority that: 1. The Testatrix signed and executed the instrument as the Testatrix's Last Will and Testalllellt. 2. WfI~Testa1fiXis~~and.execlltedtheWilIWiJ.liriglYas the' Testa1rlx's free . arid voluntary act for the purposes therein expressed. 3. Each of the Wi1nesses, in the presence and hearing of the Testatrix, signed the Will as a witness. 4. To the best of the knowledge of each of the undersigned, the Testatrix was at the time 18 years of age or older, of sound mind and under no constraint or undue influence. ..,:~::;;~=;~:?-~-:::.=->~/ ("Wi1ness") i - / it ( . ._, !"1 .. -" .' t.:, - I.: / ..,' / r ~~L~"-(t- i~~~kLz3>~j./. SW6m(),t11fl:it1tIec:fat1dsu1>sCrihe<lt()"befQteiIt1ebythei~b()Y~_" "00 l'estattijc.aIld Wi1nesses, this .t?Y!da.yofFebruary. , 2004. ~.'. ..II,,,.~.,.__1J.;",,,,...............r..'.'.'c.'~ ...,? . ." rL:-+~'lNcm.RfAL$t:Al MARY V. DAVIS, Notary Public City of Harrisbu.'rg, Dauphin County , My Commission Expires May 30, 2006 Notary Public (SEAL) ". ~ TaxDB Result Details Page 1 of 1 Detailed Results for Parcel 47-19-1588-142. in the 2004 Tax Assessment Database DistrictNo 47 Parcel_ill 47-19-1588-142. MapSuffix HouseNo 318 Direction N Street FRONT STREET Owner! KAUFHOLD, KATHRYN M C/O Prop Type R PropDesc Liv Area 1730 CurLandVal 24230 Curlmp V al 111930 CurTotVal 136160 CurPretVal Acreage .14 CIGrnStat TaxEx 1 SaleAmt 63000 SaleMo 05 SaleDa 19 SaleCe 19 Sale Yr 83 DeedBkPage 0030E-00687 YearBlt 1921 HF _File_Date 01/0412007 HF _Approval_Status A http://taxdb.ccpa.net/details.asp?id=47 -19-1588-142.&dbselect=1 11/7/2007 CLAUDE C. WOLFE & ASSOCIATES AUCTIONEERS & APPRAISERS FAMILY OWNED SINCE 1910 2009 LINCOLN STREET · CAMP HILL, PA 17011 717-737-0734 August, 6, 2007 Appraisal for the Estate of Kathryn Kautholb 318 N. Front Street, Wormleysburg, PA BASEMENT Hotpoint washer Hotpoint dryer Metal table 100.00 80.00 8.00 ENTRY Ironing board Fan Walker Bucket Hoover upright vacuum cleaner 1.00 2.00 1.00 1.00 10.00 Lasko air freshener Misc. pictures 4.00 4.00 LIVING ROOM Emerson TV Mahogany night stand 2-Drawer table with Queen Anne legs Wall mirror Pictures of cats 20.00 15.00 125.00 35.00 8.00 Sofa - worn Religious statue Ottoman Slant front desk with bookcase Pitcher - no lid 1.00 2.00 1.00 165.00 1.00 CLAUDE C. WOLFE & ASSOCIATES AUCTIONEERS & APPRAISERS FAMILY OWNED SINCE 1910 2009 LINCOLN STREET · CAMP HILL, PA 17011 717-737-0734 Kaufholb appraisal Page 2 of 7 LIVING ROOM - continued 2 Pairs of brass candlesticks Recliner - soiled TV table Sofa with ball & claw feet End table with Queen Anne legs Misc. contents of living room DINING ROOM French Provincial night stand & chest of drawers Cherub motif lamp Health aid Double bed - blond finish Dining room straight chair - Lyre back China closet - missing trim Assorted music boxes Assorted figurines Trash can Misc. contents of china closet Gold colored table Pewter candlesticks Van Briggle vase Misc. costume jewelry Seiko watch Wall mirror Misc. linens Misc. contents of dining room 8.00 5.00 1.00 10.00 15.00 10.00 25.00 3.00 1.00 10.00 8.00 125.00 10.00 10.00 1.00 5.00 1.00 2.00 25.00 2.00 6.00 10.00 3.00 5.00 CLAUDE C. WOLFE & ASSOCIATES AUCTIONEERS & APPRAISERS FAMILY OWNED SINCE 1910 2009 LINCOLN STREET · CAMP HILL, PA 17011 717-737-0734 Kaufholb appraisal Page 3 of 7 KITCHEN Table & 4 chairs - Oak 50.00 Trash can 1.00 Hotpoint refrigerator 20.00 Spice rack 1.00 Toaster 1.00 Electric can opener 1.00 Misc. everyday dishes 3.00 Flatware 1.00 Utensils 1.00 Sharp microwave 10.00 Carnival glass bowl 15.00 Noritake pitcher & 6 cups/saucers 20.00 2 Cast iron skillets 4.00 Occasional chair 1.00 Rocker 10.00 Hassock 1.00 Teacart 35.00 Philips 27" TV 30.00 Large picture of flowers 10.00 Trash can 1.00 Misc. figurines 4.00 Misc. contents of kitchen 20.00 ATTIC Cedar chest 35.00 Coffee table 15.00 5 Dining room chairs 5.00 Metal cabinet 5.00 Misc. pictures 35.00 CLAUDE C. WOLFE & ASSOCIATES AUCTIONEERS & APPRAISERS FAMILY OWNED SINCE 1910 2009 LINCOLN STREET · CAMP HILL, PA 17011 717-737-0734 Kaufholb appraisal Page 4 of 7 ATTIC - continued Misc. hats Misc. glassware Locked closet - no entry Misc. contents of attic BATH Trash can Baskets FRONT BEDROOM Red wingback chair Cedar chest Zenith portable TV Table Bookcase Misc. books Misc. knick-knacks Floor lamp Sofa Wall mirror V-Tech telephone Small bookcase Coffee table - glass top on brass Decorator bowl Couristan Oriental style carpet - Made in Belgium - 14 x 8.5 Misc. contents of bedroom 5.00 5.00 N/A 5.00 1.00 1.00 15.00 45.00 15.00 8.00 4.00 5.00 5.00 20.00 10.00 5.00 10.00 10.00 8.00 3.00 125.00 10.00 CLAUDE C. WOLFE & ASSOCIATES AUCTIONEERS & APPRAISERS FAMILY OWNED SINCE 1910 2009 LINCOLN STREET · CAMP HILL, PA 17011 717-737-0734 Kautholb appraisal Page 5 of 7 OFFICE 4-Drawer file cabinet Electric fan Air conditioner Misc. books Cookie jar Globes Christmas decorations Bookcase Pair of boudoir lamps Straight chair Misc. contents of office REAR SOUTH BEDROOM French Provincial dresser Wing back chair Table lamp Gold colored table Double bed Chest of drawers - Blond fInish Table lamp Pictures Trash can Whittall Oriental style rug - 9 x 12 Misc. linens 5.00 2.00 25.00 7.00 10.00 2.00 2.00 2.00 2.00 1.00 10.00 20.00 7.00 1.00 20.00 25.00 20.00 2.00 2.00 2.00 13 5 .00 3.00 CLAUDE C. WOLFE & ASSOCIATES AUCTIONEERS & APPRAISERS FAMILY OWNED SINCE 1910 2009 LINCOLN STREET · CAMP HILL, PA 17011 717-737-0734 Kaufholb appraisal Page 6 of 7 REAR NORTH BEDROOM White rocking chair Gold colored occasional chair - worn Dresser - Blond finish Painting Jewelry box Panasonic radio GE 5" TV FIRST FLOOR BATH Trash can Rack Linens REAR PORCH 3-Piece patio set Double seat GARAGE Contents belong to neighbor(Jeff Tinsman) FRONT PORCH 2 Chairs 10.00 1.00 10.00 1.00 2.00 3.00 3.00 1.00 1.00 2.00 15.00 25.00 N/A 4.00 CLAUDE C. WOLFE & ASSOCIATES AUCTIONEERS & APPRAISERS FAMILY OWNED SINCE 1910 2009 LINCOLN STREET · CAMP Hill, PA 17011 717-737-0734 Kaufholb appraisal Page 7 of 7 APPRAISAL TOTAL $ 1,918.00 This Fair Market Value appraisal is true and correct to the best of my ability as an auctioneer and appraiser with 35 years experience. Member: Certified Appraisers Guild of America CLAUDE C. WOLFE & ASSOCIATES \J ,'Y-.. g~ ~~'- w. K. Dusty Chapman, CAGA