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Home My WebLink About01-0602 IN RE: ESTATE OF DELMAR C. KIME, IN THE COURT OF COMMON PLEAS OF LATE OF CAMP HILL BOROUGH, CUMBERLAND COUNTY, PENNSYLVANIA CUMBERLAND COUNTY, PENNSYLVANIA, ORPHANS' COURT DIVISION DECEASED N0.21-01-00602 PETITION CONFIRMING DECLINATION, RENUNCIATION AND DISCLAIMER OF ALLFIRST TRUST COMPANY OF PENNSYLVANIA, N.A., SUCCESSOR BY MERGER WITH DAUPHIN DEPOSIT BANK AND TRUST COMPANY AS TESTAMENTARY TRUSTEE AND APPOINTMENT OF COMMUNITY TRUST COMPANY AS SUCCESSOR TESTAMENTARY TRUSTEE TO THE HONORABLE JUDGE OF THE SAID COURT: AND NOW, Mildred E. Kime, Executrix of the Estate of Delmar C. Kime a/k/a Delmar Carson Kime, deceased, through her attorneys, Johnson, Duffle, Stewart & Weidner, respectfully represents the following: 1. Petitioner is Mildred E. Kime, Executrlx of the Estate of Delmar C. Kime a/k/a Delmar Carson Kime, Deceased. 2. Said Delmar C. Kime ("Decedent") died on April 23, 2001, testate, leaving his Last Will and Testament, dated April 5, 1993, which was duly probated before the Register of Wills of Cumberland County on June 27, 2001. A copy of said Last Will and Testament is attached hereto marked Exhibit "A" and made part hereof. 3. Pursuant to the provisions of Paragraph VIII, Allfirst Trust Company of Pennsylvania, N.A., Successor by merger with Dauphin Deposit Bank and Trust Company was appointed as Testamentary Trustee of any trust created by said Will. 4. Allfirst Trust Company of Pennsylvania, N.A. has elected to decline the appointment of Testamentary Trustee pursuant to said Last Will and Testament, renounced its right to act as Testamentary Trustee and disclaims the right to receive any proceeds payable to the Testamentary Trustee pursuant to the terms and conditions of Decedent's Last Will and Testament. ?ui~~ ~,~;, ~iZ: ~~ ~~ ~ l ~H-~i Z0. -. _ `~~3 r , 5. A copy of the Declination, Renunciation and Disclaimer of Allfirst Trust Company of Pennsylvania, N.A., dated December 6, 2001, is attached hereto, marked Exhibit "B" and made part hereof. 6. Petitioner has obtained the consent of Community Trust Company to act as Successor Testamentary Trustee pursuant to the provisions of Paragraph IV(D) and Paragraph VIII of Decedent's Last Will and Testament. A copy of the Consent of Community Trust Company to act as Successor Testamentary Trustee is attached hereto marked Exhibit "C"and made part hereof. 7. The beneficiaries of said Trust are Natalie A. Kime, Douglas L. Kime and Rodney A. Kime, all adult children of the Decedent. Said Natalie A. Kime, Douglas L. Kime and Rodney A. Kime, have by consent, attached hereto, marked Exhibit "D" and made part hereof, consented to the appointment of Community Trust Company as Successor Testamentary Trustee. WHEREFOR, your Petitioner respectfully requests that your Honorable Court accept the Declination, Renunciation and Disclaimer of Allfirst Trust Company of Pennsylvania, N.A. Successor by merger with Dauphin Deposit Bank and Trust Company, and appoint Community Trust Company to act as Successor Testamentary Trustee pursuant to the provisions of the Decedent's Last Will and Testament. Respectfully submitted JOHNSON, DUFFIE, STEWART & WEIDNER By: Jerry R. ie 301 Market Street Lemoyne, PA 17043-0109 (717) 761-4540 I. D. #09601 VERIFICATION I, Mildred E. Kime, the undersigned, Executrix of the Estate of Delmar C. Kime a/k/a Delmar Carson Kime, Deceased, verify that the statements contained herein are true and correct to the best of my knowledge, information and belief. I understand that statements herein are made subject to the penalties of 18 PA.C.S.A. §4904 relating to unsworn falsification to authorities. Dated: ~.~ (~ r~~~~ ~,~.P~"h~ ~. I~~ ,~ ~~~~ - Mildred E. Kime, E~ cutri~ JRD/October 19, ~ 1992/20527 < ~. ~~~~ t11 ~trt.~ ~.~~~~.rrt~nx OF DELMAR C. KIME I, DELMAR C. KIME, of the Borough of Camp Hill, Cumberland County, Pennsylvania, declaze this to be my last will and revoke any will previously made by me. I. I direct that all my legal debts and funeral expenses, including my gravemarker and all expenses of my last illness, shall be paid from my residuazy estate as soon as practicable after my decease as a part of the expense of the administration of my estate. II. I bequeath my automobiles, household goods and personal effects and other tangible personalty of a like nature (not including cash or securities), together with any existing insurance thereon, to my sons, DOUGLAS L. KIME and RODNEY A. KIME, to be divided between them by my Executrix with due regard for their personal preferences in as nearly equal shares as practical. III. I bequeath the sum of Ten Thousand ($10,000.00) Dollars to my wife, MILDRED E. KIME, provided sloe shall survive me. Should my wife, MILDRED E. KIME, predecease me, then I direct that this pecuniary bequest shall lapse and shall be added to and made part of my residuary estate. IV. I devise and bequeath the residue of my estate of every nature and wherever situate as follows: A. Fifty (50%) percent thereof or Thirty Thousand ($30,000.00) Dollars, whichever is Less, to the Trustee, hereinafter named, for the following uses and purposes: ' I' ;• JRD/October 19,~ 1992/20527 . (1) To hold, manage and invest said share so received and to pay the net income therefrom to my wife, MILDRED E. KIME, during her lifetime in such periodic installments as Trustee shall find convenient but at least as often as quarter- annually. Trustee is not authorized to distribute principal to my wife, MILDRED E. KIME, or otherwise except as provided in Subparagraph IV-A(2) hereof. (2) Upon the death of my wife, MILDRED E. KIME, this Trust shall terminate and the then remaining principal balance shall be distributed, in equal shazes, to my children, DOUGLAS L. KIME, RODNEY A. KIME and NATALIE A. KIME, provided that the shaze to my daughter, NATALIE A. KIME, shall be distributed to the Trustee pursuant to the provisions of Paragraph IV-D hereof, and further provided if any of my said children, DOUGLAS L. KIME, RODNEY A. KIME or NATALIE A. KIME, shall not be then living then his or her share shall be distributed to his or her then living issue, per stirpes, and in default of said issue, his or her share shall be added to the share or shares of my surviving child or children or to the issue of a deceased child, per stirpes, as applicable. (3) In the event that my wife, MILDRED E. KIME, shall predecease me then this Trust shall be void. B. Thirty (30%) percent of the balance thereof to my son, DOUGLAS L. KIME. C. Thirty (~0%) percent of the balance thereof to my son, RODNEY A. KIME. D. Forty (40%) percent of the balance thereof to the Trustee, hereinafter named, for the following uses and purposes: (1) To hold, manage, invest and reinvest the share so received and to distribute the net income (not principal) from time to time as follows: -2- 7RD/October 19; 1992/20527 (a) During the lifetime of my daughter, NATALIE A. KIME, if she survives me, Trustee may pay all or so much of the income, as Trustee shall determine in its sole and absolute discretion, periodically to and for the support, maintenance, welfare and benefit of my daughter, NATALIE A. KIME, or may, in the Trustee's sole and absolute discretion, add part of all of the income to principal, to be invested as such. (b) Trustee shall have complete discretion as to how much of the income shall be used for such purposes and may pay so much of the income as Trustee shall determine, in its sole and absolute discretion, to any person or institution having the care of my daughter, NATALIE A. KIME, without liability on the part of Trustee to see to the application thereof, or directly to or for the benefit of my daughter, NATALIE A. KIME. (c) It is my intention, that the Trustee shall have sole and absolute discretion with respect to the amount and timing of income distributions and that the purpose of this Trust is to supplement governmental benefits and is not intended to replace governmental benefits or to provide what governmental benefits are intended to provide. (2) Upon the death of my daughter, NATALIE A. KIME, Trustee shall pay from any accrued and undistributed income or principal, if necessary, of this Trust, or both, the reasonable funeral expenses for my daughter and thereafter the Trust shall terminate and the then remaining principal balance together with any accrued and undistributed income shall be distributed to her then living issue, per stirpes, and in default of said issue the then remaining principal balance together with any accrued and undistributed income shall be distributed, in equal shares, to my sons, DOUGLAS L. KIME and RODNEY A. KIME. ]:n the event that either of my sons, DOUGLAS L. KIME or RODNEY A. KIME, shall not be then living, then his share shall be distributed to his then living issue, per stirpes, -3- JRD/October 19; 1992/20527 and in default of said issue, said share shall be distributed to my surviving son or his then living issue, per stirpes, as applicable. v. Should any issue entitled to a share of my estate not have attained the age of twenty-five (25) years at the time of distribution to him or her, I devise and bequeath the share of each such issue to DAUPHIN DEPOSIT BANK AND TRUST COMPANY, IN SEPARATE TRUST, to hold, manage, invest and reinvest the share so received, and any accumulation of income thereon, and to use and apply the income and principal or so much thereof as, in Trustee's sole and absolute discretion, may be necessary or appropriate for such issue's support or education (including trade school and college education, both graduate and undergraduate) without regard to his or her parent's ability to provide for such support or education, or to make payments for these purposes, without further responsibility, to such issue or to such issue's parents or to any person taking care of such issue. Any principal or income not no applied shall be distributed to such issue absolutely when he or she attains the age of twenty-five (25) years. If he or she dies before attaining the age of twenty-five (25) years, the Trust shall terminate and such share shall be distributed to his or her personal representative. VI. I duect that the interest of the beneficiaries hereunder shall not be subject to anticipation or voluntary or involuntary alienation. VII. I direct that all taxes that may be assessed in consequence of my death, of whatever nature or by whatever jurisdiction imposed, shall be paid out of my residuary esta±e as a part of the expense of the administration of my estate. VIII. I appoint DAUPHIN DEPOSIT BANK AND TRUST COMPANY, of Harrisburg, Pennsylvania, Trustee of any Trust created by this, my last Will. -4- " JRD/October 19; 1992/20527 ~ ~ , IX. I appoint my wife, MILDRED E. HIME, Executrix of this, my last Will. Should my wife, MILDRED E. KIME, fail to qualify or cease to act as Executrix, I appoint my son, DOUGLAS L. KIME, Executor of this, my Last Will. X. I direct that my Executrix or her successors shall not be required to post bond for the faithful performance of their duties in any jurisdiction. XI. I direct that my corporate fiduciary shall be entitled to compensation based on its regular schedule of fees for such services in effect from time to time during the period over which its services are performed. ~/, TNESS WHEREOF I have hereunto set m hand and seal this <:~~ day of I1V WI Y 1993. /~~; DELMAR C. KIME Signed, sealed, published and declared by 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. -5- 7RD/October 19,.1992/20527 •. ~ ~ . ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA . ss: COUNTY OF CUMBERLAND I, DELMAR C. KIME, Testator, whose name is signed to the foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Wi11 and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. .- ~r~ l -!. DELMAR C. KIME Sworn or affi ed toc a d acknowledged before me, by DELMAR C. KIME, the Testator, this l day of , 1993 . ,~Qotary Public Nottarllml Beal // Gina M. McNally, Notary PubUe Lemoyne, Boro, Cumberland County My Comrnssion Expires Dec. 28,1996 Member, PennsylvaruaAssodatlon of Notanes -6- ° ~ °` JRD/October 19, °1992/20527 AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND l We,c~~'~ ~' • ~~~~'~' andi~~~"L , u~ ,the witnesses whose names are signed to the foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the Testator sign and execute the foregoing instrument as his Last Will and Testament; that he signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator signed the Will as witnesses; and that to the best of our knowledge, the Testator was at that time at least 18 years of age, of sound mind and under no constraint or undue influence. Sywor o affirmed to and ubscrib Q~na t~ . ~' witnesses, this ~ day of Notarial Seat Gina M. McNally, Notary Pubac Lemoyne 8oro, Cumberland Courrty My Commission 6q~ires Dec. 28,1 emt~eq Pennsylvania Association of Notaries r uuii~ -7- me by ~~~ ~1~and 1993. C~Op~ IN RE ESTATE OF DELMAR C. HIME, DECEASED, LATE OF THE BOROUGH . OF CAMP HILL, CUMBERLAND COUNTY, PENNSYLVANIA COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA, ORPHANS' COURT DIVISION N0.21-01-00602 DECLINATION, RENUNCIATION AND DISCLAIMER ALLFIRST TRUST COMPANY OF PENNSYLVANIA, N.A., SU CFSSOR TO DAUPHIN DEPOSIT BANK AND TRUST COMPANY The undersigned, being a duly authorized officer, for and on behalf of Allfirst Trust Company of Pennsylvania, N.A., Successor to Dauphin Deposit Bank and Trust Company, the designated Trustee pursuant to Paragraph VIII of the Last Will and Testament of Dehnaz C. Kime, Deceased, hereby declines the appointment as Trustee pursuant, to the provisions of the decedent's Last Will and Testament. Further, Allfirst Trust Company of Pennsylvania, N.A., Successor to Dauphin Deposit Bank and Trust Company, in addition to the foregoing declination of appointment as Trustee, as described, also renounces and disclaims its right to receive the portion of the residue of the Estate, in trust, for the benefit of Mildred E. Kime and Natalie A. Kime in accordance with Pazagraph IV of the Will. IN WITNESS WHEREOF, Allfirst Trust Company of Pennsylvania, N.A., Successor to Dauphin Deposit Bank and Trust Company, by its duly authorized officer, has~aused this.Declination, Renunciation and Disclaimer to be executed and its corporate seal affixed thereto on this ~ day of December, 2001. Allfirst Trust Company of Pennsylvania, N.A. Successor to Dauphin Deppsit Bank ~/~ st Company ~ ~ //" Vice President COMMONWEALTH OF PENNSYLVANIA COUNTY OF _. :ss. On the ~ day of December, 2001, before me, the undersigned officer, personally appeazed (~~ _rn~rn,~,-e_Q.~ . ,who acknowledged himself to be the Vice President of Allfirst Trust Company of Penn lvania, N.A., and that he as such Vice President, being authorized to do so, executed the foregoing instrument for the purposes therein contained by signing the name of the corporation as Vice President. IN WITNESS WHEREOF, I hereunto set my hand and official seal. N~tarlal Seal Deanna L,.WB!!s tvt,:a:Y pwblic Harr'rstwt~, Da::~::~ ~; Guunty My Commiss'~on Expuc:: '. ~°. ~. 2004 ~~~~ PBtt~SyWan1~ ASSOC?ation al Notaries Notary Public (SEAL) IN RE: ESTATE OF DELMAR C. KIME IN THE COURT OF COMMON PLEAS OF LATE OF CAMP HILL BOROUGH CUMBERLAND COUNTY, PENNSYLVANIA CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION DECEASED NO. 21-01-00602 CONSENT OF COMMUNITY TRUST COMPANY The undersigned, being a duly authorized officer, for and on behalf of Community Trust Company, does hereby consent and agree to accept appointment as Successor Testamentary Trustee pursuant to the terms and conditions of the Last Will and Testament of Delmar C. Kime, Deceased. IN WITNESS WHEREOF, Community Trust Company, by its duly authorized officer, has caused this Consent to be executed on this day of March, 2002. COMMUNITY TRUST COMPANY Kim erly rthur-Tres er Pr ident Signed, sealed and delivered in the presence of: ~~ _\.:~~ ~. ALL-STA ~E LEGAL 80222-OS1D a ~!q!uX3 .. IN RE: ESTATE OF DELMAR C. KIME IN THE COURT OF COMMON PLEAS OF LATE OF CAMP HILL BOROUGH CUMBERLAND COUNTY, PENNSYLVANIA CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION DECEASED ~ NO. 21-01-00602 CONSENT OF NATALIE A. KIME, DOUGLAS L. KIME AND RODNEY A. KIME, BENEFICIARIES The undersigned, Natalie A. Kime, Douglas L. Kime and Rodney A. Kime, beneficiaries pursuant to the Testamentary Trust created in accordance with the terms and conditions of Paragraph IV(D) of the Last Will and Testament of Delmar C. Kime, Deceased, do hereby specifically consent to the Declination, Renunciation and Disclaimer of Allfirst Trust Company of Pennsylvania, N.A., and further specifically consent to the appointment of Community Trust Company as Successor Testamentary Trustee pursuant to the provisions of said Will. IN WITNESS WHEREOF, the undersigned, Natalie A. Kime, Douglas L. Kime and Rodney A. Kime, have hereunto set their hands and seals the ~ day of March, 2002. NATALIE A. KIME i D GLAS L. KIME RODD~'Y A. KtP01E Signed, sealed and delivered in the presence of: IN RE: ESTATE OF DELMAR C. KIME IN THE COURT OF COMMON PLEAS OF LATE OF CAMP HILL BOROUGH CUMBERLAND COUNTY, PENNSYLVANIA CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION DECEASED NO. 21-01-00602 FINAL DECREE AND NOW this ~ day of March, 2002, upon consideration of the Petition of Mildred E. Kime, Executrix of the Estate of Delmar C. Kime, Deceased, late of the Borough of Camp Hill, Cumberland County, Pennsylvania, and in consideration of the Declination, Renunciation and Disclaimer of Allfirst Trust Company of Pennsylvania, N.A., together with the Consent of Natalie A. Kime, Douglas L. Kime and Rodney A. Kime, the beneficiaries of the Testamentary Trust, it is hereby ORDERED AND DECREED, that the Declination, Renunciation and Disclaimer of Allfirst Trust Company of Pennsylvania, N.A. be and the same is hereby ORDERED AND DECREED that Community Trust Company is hereby designated as Successor Testamentary Trustee pursuant to the provisions of Paragraph IV(D) of the Last Will and Testament of Delmar C. Kime, Deceased, together with the provisions of Paragraph VIII of said Last Will and Testament. ~~''I ,. -{ ~~;~~ ~%/ PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE a 6.12 FORM YEARLY UNTIL COMPLETION. STATUS REPORT UNDER RULE 6.12 Name of Decedent: DELMAR C KIME a/kla DELMAR CARSON KIME Date of Death: April 23, 2001 Will No.: 2001-00602 Admin No.: Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes X No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete:. 3. If the answer to No. 1 is yes, state the following: A. Did the personal representative file a final account with the Court? Yes No ~ B. The separate Orphans' Court No. (if any) for the personal representative's account is:. C. Did the personal representative state an account informally to the parties in interest? Yes X No D. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: ~ 22 pL~ i ature rry R. Duffie, Esq. Johnson, Duffie, Stewart & Weidner 301 Market Street, P.O. Box 109 Lemoyne PA 17043-0109 ~-~' Address 17) 761-4540 r, Telephone No. ;~ __ Capacity: X Personal Representative X Counsel for Personal Representative ~., 'J 1 e € ~' ~ r. . ~1~ Y t ~; ~~ :~ R "N. i _----: 1. y - y •c d S_~`i ;; -' f . ~:.,.~ (; ~.. .~_ 1 1 w' w z A -~ o w o ~ ~ ~ w o w ~ ~ ~ z w Ew" w p ~ ~ ~ ~ ~ ~ w ~ ~ z w.. °'w A ~ p a Q `~ ui z z o z .~ x 0 W 0 F- U= tiUUwti LL ~' a0 OZjM ~__~~ 0 ~UWT OZ~a QO W ~ I- J f- W ~ fq ~ m ~ J W ~ O Q ~U~U ~.~ ~~ y tf TO Register of Wills Office C_ umberland County Courthouse 1 Courthouse Square Carlisle, PA 17013-3387 SUBJECT: Estate of Delmar C. Kime No. 21-01-00602 FROM JOHNSON, DUFFIE, STEWART & WEIDNER Attorneys at Law P.O. Box 109 Lemoyne, PA 17043 (717) 761-4540 DATE: December 20, 2002 Enclosed for filing in the above-captioned Estate is a SUPPLEMENTAL Inheritance Tax Return reporting an additional asset not reported on the original return. Also enclosed are the following checks: Two checks in the amount of $7.50 each in payment of the $15.00 filing charges. Two checks in the amount of $1,318.01 each in payment of the Inheritance Tax, Plus interest totaling $2,636.02. Please mail the filing receipt and Inheritance Tax receipt to this office. Thank you. ~ SIGNED: Jerry R. Duffie csh COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: DUFFIE JERRY R ESQUIRE 301 MARKET STREET P O BOX 109 LEMOYNE, PA 17043-0109 fold PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ESTATE INFORMATION: ssN: ia3-is-5o2i FILE NUMBER: 2101-0602 DECEDENT NAME: KIME DELMAR C DATE OF PAYMENT: 12/23/2002 POSTMARK DATE: 1 2/20/2002 COUNTY: CUMBERLAND DATE OF DEATH: 04/23/2001 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 ~ S 1,318.01 TOTAL AMOUNT PAID: REMARKS: DOUGLAS L KIME C/O JERRY R DUFFIE ESQUIRE CHECK# 5553 SEAL INITIALS: CW RECEIVED BY: DONNA M. OTTO S 1,318.01 DEPUTY REGISTER OF WILLS REV-1162EX111-96) N0. CD 001978 REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: DUFFIE JERRY R ESQUIRE 301 MARKET STREET P O BOX 109 LEMOYNE, PA 17043-0109 fold PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ESTATE INFORMATION: ssrv: iss-7s-5o2~ FILE NUMBER: 2101-0602 DECEDENT NAME: KIME DELMAR C DATE OF PAYMENT: 1 2/23/2002 POSTMARK DATE: 1 2/20/2002 COUNTY: CUMBERLAND DATE OF DEATH: 04/ 23/ 2001 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 ~ 51,318.01 TOTAL AMOUNT PAID: REMARKS: RODNEY A KIME C/O JERRY R DUFFIE ESQUIRE CHECK#1173 SEAL INITIALS: CW RECEIVED BY: DONNA M. OTTO 51,318.01 DEPUTY REGISTER OF WILLS REV-1162 EX111-96) NO. CD 001977 REGISTER OF WILLS l ~ -°~O~ ~~~ COMMONWEALTH OF PENNSYLVANIA BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION DEPT. 280601 INHERITANCE TAX HARRISBURG, PA 17128-0601 STATEMENT OF ACCOUNT REY-1607 E% AfP (01-03) JERRY R DUFFIE ESQ 301 MARKET ST PO BOX 109 LEMOYNE PA 17043 . +_, .__ DATE 02-24-2003 ESTATE OF KIME DELMAR C DATE OF DEATH 04-23-2001 FILE NUMBER 21 01-0602 CQUNTY CUMBERLAND ACN 101 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~ ---------------------------------------------------------------------------------------------------------------- REV-1607 EX AFP (01-03) ~** INHERITANCE TAX STATEMENT OF ACCOUNT ~~~ ESTATE OF KIME DELMAR C FILE N0. 21 01-0602 ACN 101 DATE 02-24-2003 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 01-21-2003 PRINCIPAL TAX DUE: PAYMENTS (TAX CREDITS): 10,565.63 PAYMENT DATE RECEIPT NUMBER DISCOUNT C+) INTEREST/PEN PAID (-) AMOUNT PAID *** SUMMARY OF LL 005 PAYMENTS *** 02-10-2003 342.11 .00 02-10-2003 135.49- 10,359.01 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. ^ IF PAID AFTER THIS DATE, SEE REVERSE I TOTAL DUE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN 51, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) 10,565.63 .00 .00 .00 PAYMENT: Detach the top portion of this Notice and submit with your payment made payable to the Hasa and address printed on the reverse side. -- If RESIDENT DECEDENT make check or money order payable to: REGISTER OF WILLS, AGENT. -- If NON-RESIDENT DECEDENT sake check or money order payable to: COMMONWEALTH OF PENNSYLVANIA. REFUND (CR): A refund of a tax credit, which was not requested an the Tax Return, may be requested by completing an °Applicaticn for Refund of Pennsylvania Inheritance and Estate Tax" CREV-1313). Applications are available at the Office of the Register of Nills, any of the 23 Revenue District Offices or from the Department's 24-hour answering service for forms ordering: 1-800-362-2050; services for taxpayers with special hearing and / or speaking needs: 1-800-447-3020 (TT only). REPLY T0: questions regarding errors contained an this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601, phone (717) 787-6505. DISCOUNT: If any tax due is paid within three (3) calendar nonths after the decedent's death, a five percent (5%) discount of the tax paid is allowed. PENALTY: Tha 15% tax amnesty non-participation penalty is computed an the total of the tax and interest assessed, and Hat paid before January 18, 1996, the first day after the end of the tax amnesty period. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (6%) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 will hear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2003 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1982 20% .000548 1987 9% .000247 1999 7% .000192 1983 16% .000438 1988-1991 11% .000301 2000 8% .000219 1984 11% .000301 1992 9% .000247 2001 9% .000247 1985 13% .000356 1993-1994 7% .000192 2002 6% .000164 1986 10% .000274 1995-1998 9% .000247 2003 5% .000137 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. P~~I~I~O~t FORMaR,--O`` B TE and GRANT OF LETTERS DELMAR CAR ON KIME~~(~ 6~ - ~ -~ Fstate of No. ~ ~ 0 ~ ~eZ also known as To: Register of Wills for the 21~eceased. County of CUMBERLAND in the Social Security No. - - Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut rix named in the last will of the above decedent, dated April 5 , , 19 93 and codicil(s) dated (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumberland County, Pennsylvania, with h i s last family or principal residence at 19 n 6 R u t l a n r3 S t rP P t BoroLgh of Camn Hill (list street, number and muncipality) Decendent, then 7 7 years of age, died AP r i l 2 3, 2 0 0 1 at Camp Hill Care Center Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent at death owned property with estimated. values as follows: (If domiciled in Pa.) All personal property $ 1 2 ~ , n n n _ n n (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ 110 , 0 0 0. 0 0 situated as follows: r or Roa Eas Penns oro Towns ip um er an oun y, PA WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters Testamentary (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) theron. N u c ~ v ~ .-. .~ y ~L i red E. K me ~0 1906 Rutland Street ~'v Camb Hill, PA 17011 ya -- u~ ~° m - c m OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA 1 COUNTY OF CUMBERLAND ~ SS The petitioner(s) above-named swear() or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed ..-l ~~~o before me this ?6TH day of Mi died E. Kim ~' ~ une" a fi MARY LEW Register NO. 7.1 - 01 ~- 602 DELMAR C KIME a/k/a Estate of DELMAR CARSON KIME ,Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW JUNE 27 2001, in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated Aril 5. 1993 described therein be admitted to probate and filed of record as the last will of Delmar C. Kime a/k/a Delmar Carson Kime and Letters Testamentary are hereby granted to Mildred E . Kime FEES Probate, Letters, Etc.......... $ 270.00 Short Certificates(4) .......... $ 1 ~ nn Renunciation ............... $ X-pages (6) $ 18.00 0 C P TOTAL $~ Filed .......JULY..27,. 001 rC.D Register of Wills MARY C LEWIS Jerry R. Duffie (09601) Johnson, Duffie, Stewart & Weidner ATTORNEY (Sup. Ct. l.D. No.) 301 Market St., P. O. Box 109 Lemoyne, PA 17043-0109 ADDRESS 717) 761-4540 PHONE Mailed letters to attorney on 6-27-01 aiyrnloeMaonawlamm~aibawwa~n,. bu ~aMenel Oalrraen na reeuNing YItlM W10MIWNaIN giwnnRVTr 1. LW OMy ooa celne on each inc. I onaN and scalp rrIEDIr-re cAInE (FUW ueaase «ea,0iaon ' L; / T., ~ l ~'=~J ~ .LC. ~ ~ -• ' ~ "/ _ _. renr.rgnaetml-w a. DUE TO (OR ASACONSEOUENCEOFl: ' - r ~ r r SeVIruMWYaat tarldlicrr b. DUEroIDR ASACONSEO,lENCE DFy. deny, IeaQagtlYrrted4te I oalrae. Error IIIIDEIILYn10 _ r ~ CAINE(Deree«ryury a w ediatad exNYe CUE TO lOR AS A CONSEQUENCE ~: _ l rewrWp in acrd,) LA6T a _ _ -.. , MRS AN AUTOPSY WERE AUTOPSY FWDINOS MANNER OF DERH DRE OF IWURY TIME OF IN.IURY IWURY R WOiiK7 DESCRIBE HOW INJIIiIV OCCURRED. PEAFOIUAEOi M111tABLE PwDIi ro (MOnel. Oar. rear) oFCAUSE ~«a ~ ~~ ^ Yee ^ No ^ AsciMa ^ Pendin~lmeatgatwn ^ M. 1M ^ No rM ^ No ^ ~b• ^ Ceuld pat W aetermrred ^ PLACE OF 1N.IURY - At none, fam,, enneL rectory. o111G LOCIiT10N ($asel CN/kwn, StrtN WedNrg, Nc. (Spar ty1 ~ Tab. Z!. Toe. • _ _ _ - 4LITR1Ea10.AeCkorxy an•1 •CEIITIFYWO MIY6K%AN (pnyarren caWyuxl cause d aaea+v/nan anoa,er W+YSican pas aonaricea awn and carngNea mm 23) ren,e beN Ot NY W~•I•d{••deNno«wrw dwblM Oeu••fel arrd menu.r...totd ..................................................... :~~ .~ •PRDNDLwacTra AND cERTIFru+D rHrsK~rw lPhrsicon boar a«wunurq death and ~«Irr.+g b car,a. a easel ~ To,M beN M ryr MnowMage. death occurred st tM Wae~ acre. and place. and doe 1o nu eausepl and manner n atatW .......................... ^ a+~~7 'MEDICAL EI(AMINER/COR011FJ1 OA Dte heals d eaaminatlon enNOr Inveatl{atbn, in my opinion, death aeeumd N Ule time, data, ens plus, and dud to IM wuea(p and ^ enannar a stated ......... . ....................................................................................... . TL. REDIS 'SBN3NATU~~fN~J~DN/UJM~E~R~~~ ~ ~ ~~1~ ~ ~ ~ 4URE AND TRLE OF CERTIFIER rte"- ~ ~/~-z ~S9OF PERSON~W 10 COMPLETEDpCAUSE OF DERN /, r'.~ !-j .~ Ala I 1 .~. JRD/October 19, 1992/20527 ~tt~t 3~i11 ~tt~ (7~ P~tttmrnt OF DELMAR C. KIME I, DELMAR C. KIME, of the Borough of Camp Hill, Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. I. I direct that all my legal debts and funeral expenses, including my gravemarker and all expenses of my last illness, shall be paid from my residuary estate as soon as practicable after my decease as a part of the expense of the administration of my estate. II. I bequeath my automobiles, household goods and personal effects and other tangible personalty of a like nature (not including cash or securities), together with any existing insurance thereon, to my sons, DOUGLAS L. KIME and RODNEY A. KIME, to be divided between them by my Executrix with due regard for their personal preferences in as nearly equal shares as practical. III. I bequeath the sum of Ten Thousand ($10,000.00) Dollars to my wife, MILDRED E. KIME, provided she wall survive me. Should my wife, ~~4ILDRED E. KIME, predecease me, then I direct that this pecuniary bequest shall lapse and shall be added to and made part of my residuary estate. IV. I devise and bequeath the residue of my estate of every nature and wherever situate as follows: A. Fifty (50'0) percent thereof or Thirty Thousand ($30,000.00) Dollars, whichever is less, to the Trustee, hereinafter named, for the following uses and purposes: JRD/October 19, 1992/20527 (1) To hold, manage and invest said share so received and to pay the net income therefrom to my wife, MILDRED E. KIME, during her lifetime in such periodic installments as Trustee shall find convenient but at least as often as quarter- annually. Trustee is not authorized to distribute principal to my wife, MILDRED E. KIME, or otherwise except as provided in Subparagraph IV-A(2) hereof. (2) Upon the death of my wife, MILDRED E. KIME, this Trust shall terminate and the then remaining principal balance shall be distributed, in equal shares, to my children, DOUGLAS L. KIME, RODNEY A. KIME and NATALIE A. KIME, provided that the share to my daughter, NATALIE A. KIME, shall be distributed to the Trustee pursuant to the provisions of Paragraph IV-D hereof, and further provided if any of my said children, DOUGLAS L. KIME, RODNEY A. KIME or NATALIE A. KIME, shall not be then living then his or her share shall be distributed to his or her then living issue, per stirpes, and in default of said issue, his or her share shall be added to the share or shares of my surviving child or children or to the issue of a deceased child, per stirpes, as applicable. (3) In the event that my wife, MILDRED E. KIME, shall predecease me then this Trust shall be void. B. Thirty (30%) percent of the balance thereof to my son, DOUGLAS L. KIME. C. Thirty (?0%) percent of the balance thereof to my son, RODNEY A. KIME. D. Forty (40%) percent of the balance thereof to the Trustee, hereinafter named, for the following uses and purposes: (1) To hold, manage, invest and reinvest the share so received and to distribute the net income (not principal) from time to time as follows: -2- JRD/October 19, 1992/20527 (a) During the lifetime of my daughter, NATALIE A. KIME, if she survives me, Trustee may pay all or so much of the income, as Trustee shall determine in its sole and absolute discretion, periodically to and for the support, maintenance, welfare and benefit of my daughter, NATALIE A. KIME, or may, in the Trustee's sole and absolute discretion, add part of all of the income to principal, to be invested as such. (b) Trustee shall have complete discretion as to how much of the income shall be used for such purposes and may pay so much of the income as Trustee shall determine, in its sole and absolute discretion, to any person or institution having the care of my daughter, NATALIE A. KIME, without liability on the part of Trustee to see to the application thereof, or directly to or for the benefit of my daughter, NATALIE A. KIME. (c) It is my intention, that the Trustee shall have sole and absolute discretion with respect to the amount and timing of income distributions and that the purpose of this Trust is to supplement governmental benefits and is not intended to replace governmental benefits or to provide what governmental benefits are intended to provide. (2) Upon the death of my daughter, NATALIE A. KIME, Trustee shall pay from any accrued and undistributed income or principal, if necessary, of this Trust, or both, the reasonable funeral expenses for my daughter and thereafter the Trust shall terminate and the then. remaining principal balance together with any accrued and undistributed income shall be distributed to her then living issue, per stirpes, and in default of said issue the then remaining principal balance together with any accrued and undistributed income shall be distributed, in equal shares, to my sons, DOUGLAS L. KIME and RODNEY A. KIME. In the event that either of my sons, DOUGLAS L. KIME or RODNEY A. KIME, shall not be then living, then his share shall be distributed to his then living issue, per stirpes, -3- JRD/October 19, 1992/20527 and in default of said issue, said share shall be distributed to my surviving son or his then living issue, per stirpes, as applicable. V. Should any issue entitled to a share of my estate not have attained the age of twenty-five (25) yeazs at the time of distribution to him or her, I devise and bequeath the shaze of each such issue to DAUPHIN DEPOSIT BANK AND TRUST COMPANY, IN SEPARATE TRUST, to hold, manage, invest and reinvest the shaze so received, and any accumulation of income thereon, and to use and apply the income and principal or so much thereof as, in Trustee's sole and absolute discretion, may be necessazy or appropriate for such issue's support or education (including trade school and college education, both graduate and undergraduate) without regazd to his or her pazent's ability to provide for such support or education, or to make payments for these purposes, without further responsibility, to such issue or to such issue's pazents or to any person taking Gaze of such issue. Any principal or income not no applied shall be distributed to such issue absolutely when he or she attains the age of twenty-five (25) years. If he or she dies before attaining the age of twenty-five (25) years, the Trust shall terminate and such shaze shall be distributed to his or her personal representative. VI. I direct that the interest of the beneficiaries hereunder shall not be subject to anticipation or voluntary or involuntazy alienation. VII. I direct that all taxes that may be assessed in consequence of my death, of whatever nature or by whatever jurisdiction imposed, shall be paid out of my residuary esta±e as a part of the expense of the administration of my estate. VIII. I appoint DAUPHIN DEPOSIT BANK AND TRUST COMPANY, of Harrisburg, Pennsylvania, Trustee of any Trust created by this, my last Will. -4- JRD/October 19, 1992/20527 IX. I appoint my wife, MILDRED E. KIME, Executrix of this, my last Will. Should my wife, MILDRED E. KIME, fail to qualify or cease to act as Executrix, I appoint my son, DOUGLAS L. KIME, Executor of this, my last Will. X. I direct that my Executrix or her successors shall not be required to post bond for the faithful performance of their duties in any jurisdiction. XI. I direct that my corporate fiduciary shall be entitled to compensation based on its regular schedule of fees for such services in effect from time to time during the period over which its services are performed. IN WITNESS WHEREOF, I have hereunto set my hand and seal this Cs7r~ day of Signed, sealed, published and declared by the above-named Testator, as and for his Last Will and 1993. 3 DELMAR C. I{IME 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. -5- JRD/October 19, 1992/20527 ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA . ss: COUNTY OF CUMBERLAND I, DELMAR C. KIME, Testator, whose name is signed to the foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and voluntazy act for the purposes therein expressed. DELMAR C. KIME Sworn or affi ed toc d acknowledged before me, by DELMAR C. KIME, the Testator, this .~ day of , 1993. r C., otary Public Nota-lal seal Qlna M. McNaly, Notary PubBe l.errayrre Borg, Cumberland My Commrsslon Expires Dec. 28, t Member, eru~sy Association of Notanes -6- JRD/October 19, 1992/20527 AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND We,C~~'~ ~' • ~~~~~~ and-L-~i~.~L~i~ ,the witnesses whose names y ~ are signed to the foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the Testator sign and execute the foregoing instrument as his Last Will and Testament; that he signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator signed the Will as witnesses; and that to the best of our knowledge, the Testator was at that time at least 18 years of age, of sound mind and under no constraint or undue influence. S~w/or o affirmed to and ubscrib / Cana t`Z . ~ witnesses, this ~~~ day of Nortarial seat (31na M. Mc~VaAy, Notary PubIIC Lemoyne Bono, Cumberland My Commission Fires oec. 2a, t aria of Notaries Public -e me by ~k%~I~~and ~, 1993. -7- l CERTIFICATION OF NOTICE UNDER RULE 5.6(al Name of Decedent: DELMAR C. KIME a/k/a DELMAR CARSON KIME Date of Death: April 23, 2001 Will No.: 2001-00602 To the Register: Admin. No.: I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on 7 /a D/ Name Address Douglas L. Kime 1359 Concord Rd., Mechanicsburg, PA 17050 Rodney A. Kime 208 Erford Rd., Camp Hill, PA 17011 Natalie A. Kime 820 Lisburn Road, Apartment 512 Camp Hill, PA 17011 Mildred E. Kime 1906 Rutland St., Camp Hill, PA 17011 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None. Date: "j ~ ! l7 ~ D ~ i nature ame Jerry R. Duffle, Esq. Johnson, Duffle, Stewart & Weidner Address 301 Market St. P. O. Box 109 Lemoyne, PA 17043-0109 Telephone (717) 761-4540 Capacity: Personal Representative X Counsel for personal representative ~.t /~ 41 ~ n ~ ~ m ~~ m~ '~` to _ ~, 70 "' .,opz0 ~ ~ ~ R- n ~ wQZV' w O ~,m~ ~m c~u a o N m O x o ~ ~, a ,~ o ,~ z'~~~~ Zp9 rn ~ ~O~~O ~ r ~ ~ c~i~ ~` ~ ~ ~3 Cn ~ ~ ~ W i ~ `9 "Z, CTS '~ ~, ~ _ .~ >> ,; ~ i `a,~: ..~...= ,~ ~. z. ~~ ~- ~,;;' ' ~; F i'~ R-" 'Y .i C TO Register of Wills Office Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013-3387 SUBJECT: Estate of Delmar C. Kime No. 2001-00602 DOD: Anri123.2001 FROM JOHNSON, DUFFIE, STEWART & WEIDNER Attorneys at Law P.O. Box 109 Lemoyne, PA 17043 (717) 761-4540 DATE: July 20, 2001 Enclosed is a check in the amount of $6,500.00 as a payment on account of Inheritance Tax for the above-captioned Estate, being made within the 90 days to allow for the 5% discount. I SIGNED: Jerrv R. Duffie csh I COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: DUFFIE JERRY R 301 MARKET ST P O BOX 109 LEMOYNE, PA 17043-0109 REV-1762EX(11-96) PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 000075 ACN ASSESSMENT AMOUNT CONTROL NUMBER fold ESTATE INFORMATION: ssN: is3-~s-5o2~ FILE NUMBER: 21-2001- 0602 DECEDENT NAME: KIME DELMAR C DATE OF PAYMENT: 07/23/2001 POSTMARK DATE: 07/20/2001 COUNTY: CUMBERLAND DATE OF DEATH: 04/23/2001 101 ~ S 6, 500.00 TOTAL AMOUNT PAID: REMARKS: MILDRED E KIME C/O JERRY R DUFFIE ESQUIRE SEAL CHECK#102 INITIALS: CW RECEIVED BY: MARY C. LEWIS S 6, 500.00 REGISTER OF WILLS REGZSTER._OF WrLLS 7 a ~~~ ~~- Z w ~r ° r ~ 4 a~~,W ~a a, r ~ o >~ Y N w ~.m w 0 Za Q a Z ~~a° o O W 0 N z. s 0 w N 'a ~a O U a, ~^ Ny~~~ a~a ~ 3UW~ cll ~'` W ~ ~'~Ha N 0 ~ ~~ ~ ~ ~~ ~ ~J~~~~~ I yso a!}}na •~ neap :a3NJIS I •aoue!e8 xel aoue}!aayul `OS'LZZ' 4$ ~o }unowe ay} u! ~oay~ •~ •sa6aeyo 6u!I!~ `00'52$ }o }unowe ay} u! ~{oay~ '£ •uan}a~ xel aoue}!~ayu! ~o ~(doo pue leu!6u0 'Z •tio}uanul leu!6!ap • 4 6u!nnopo~ ay} aye a}e}s3 pauo!}deo-anoge ay} u! 6u!I!} ao} paso!ou~ 4002 `£Z I!ad`d ~a04 20900-40-4Z 'oN 4002 `0£ ~aqo}o0 ~31`da Oti9ti- 691 X161) E~'OL 6 add `au~(ouaa~ 606 Xo9 'O'd nne~ ;e s~(auao};~r 213NQ13M'8121t~M31S `31ddf10 `NOSNHOf woa~ aw L8E£-£ 4014 `dd `als!lae~ a~enbS asnoy}~no~ 4 asnoy}~no~ ~(}uno~ puel~agwn~ ao!~O sll!M }o as}s!6a~ Ol _.._.. _.. _.. _ _ r _ _ _ _ i~_a3~.~~ sr. aEV.,sooextem> REV 15 0 0 (~FFICIe'aL Ua'E ~Ntv ' COMMOFdYVEALTn`OF ~ PENNSYLVANIA DEPART EPT. 28060EVENUE INHERITANCE TAX RETURN ~ FILE NuIIABER ~~~------_~____-_W.___._..___.......~._ HARRISBURG,PA17128-0601 RESIDENT DECEDENT 2 1- o i o 0_6_0 2_ COUNTY CODE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) KIME , DELMAR C . SOCIAL SECURITY NUMBER ~ a/k/a KIME, DELMAR CARSON 183 - 18 - 5021 Z W DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE W April 23, 2001 January 26, 1924 REGISTER OF WILLS U W (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER ~ Mildred E. Kime 490 - 34 - 9883 F ®1.Original Retum ~ 2. Supplemental Return ~ 3. Remainder Retum (date or deem priorto ~z•is-ez) ~ Limited Estate ~ 4a. Future Interest Compromise (date ordeam attar 12.12-ez) ~ 5. Federal Estate Tax Return Required ~ a m QX 6. Decedent Died Testate (Attach copy or wu) ~ 7. Decedent Maintained a Living Trust (Atlach copy orTrost) _ 8. Total Number of Safe Deposit Boxes a 9. Litigation Proceeds Received ~ 1 O. SpoUSal POVerty Credlt (date of death between 12.31-91 and 1-1-95) ~ 11. Election to tax under Sec. 9113(A) (Aaacb scb o) F ` THfS;SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL-TAX INFORMATION. S OULD BE DIRECTED TO: w NAME COMPLETE MAILING ADDRESS °z Jerry R. Duffie, Esq. r°. 301 Market St . FIRM NAME (tfApplicab~e) ]? , 0 . BOX 10 9 W Johnson, Duffie, Stewart & Weidner o TELEPHONE NUMBER L emOy ri e, PA 17 0 4 3- 010 9 ~ (717) 761-4540 Z O J f- a Q V W 1. Real Estate (Schedule A) (t) 10 $ , 6 0 0 , 0 0 2. Stocks and Bonds (Schedule B) (2) 4 4 , 1 8 0. 2 1 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) $1 , 13 8 . 9 5 (Schedule E) 6. Jointly Owned Property (Schedule F) (6) 1 7 , 8 0 6 . 1 8 Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) 4 , 816.7 8 (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) IAL (e) 256, 542.12 9. Funeral Expenses 8 Administrative Costs (Schedule H) (9) 3 6 , 9 4 4 . 5 2 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 2 7 2 , 8 6 11. Total Deductions (total Lines 9 & 10) (11) 3 7 , 217.3 8 12. Net Value of Estate (Line 8 minus Line 11) (12) 219 , 3 2 4 . 7 4 13. Charitable and Governmental BequestslSec 9113 Trusts for which an election to tax has not been (13) - 0 - made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 2 19 , 3 2 4 . 7 4 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES Z ~ 15. Amount of Line 14 taxable at the spousal tax 4 0 , 0 0 0 . 0 0 0. 0 0 t5 - 0 - rate, or transfers under Sec. 9116 (a)(1.2) x ( ) 1a- 16. Amount of Line 14 taxable at lineal rate 17 9 , 3 2 4 . 7 4 x o 4 5 (16) 8 , 0 6 9.61 d 17. Amount of Line 14 taxable at sibling rate x .12 (17) - 0 - ~ 18. Amount of Line 14 taxable at collateral rate x .15 (18) - 0 Q 19. Tax Due (19) 8, 0 6 9 .61 t`- 20. ^ ~ .. > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < Decedent's Complete Address: STREETADDRESS 1906 Rutland Street ` CITY Camp H i 11 STATE PA ZIP 17 011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments 6 , 5 0 0.0 0 C. Discount 4 _ 1 1 3. Interest/Penalty if applicable D. Interest E. Penalty (1) 8.069.61 Total Credits (A + B + C) (2) Total InterestlPenalty (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 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) (4) 6,842.11 -0- (5) 1,227.50 (5A) - 0 - (56) 1,227.50 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 :.......................................................................:.................. ^ 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. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. ^ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. ^ Q 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ ^ 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, wrrect and complete. DeGaretbn of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSI~B~LE/FOR FILING RE©TURN DATE ADDRESS Mildred E. Kime, xecutrix 1906 Rutland Street, Camp Hill, PA 17011 SIGNATURE OFPARHER T N REPRESENTATIVE DAT~~ ~ ADDRESS a ry u ie , s q . O1 Market St., P. O. Box 109, Lemoyne, PA 17043-0109 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 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 0% [72 P.S. §9116 (a) (1.1) (ii)j. 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 decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. aev-iwsex. ~i y~l ~, ~- SCHEDULE A COMMOPJWEALTH OF PENNSYLVP.NIA REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF KIME , DELMAR C . a /k / a FILE NUMBER KIME, DELMAR CARSON 21-01-00602 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real properly which is jointly-owned with right of survivorshi must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Real Estate - No. 208 Erford Road, East Pennsboro Township, Cumberland County, PA (Deed Book W, Volume 21, Page 975) Sale Price (Copy of Settlement Sheet attached). 108,600.00 TOTAL (Also enter on line 1, Recapitulation) I $ 10 8 , 6 0 0. 0 0 (If more space is needed, insert additional sheets of the same size) A. ~ ~U.S. DEPARTMEM OF HOUSING and URBAN DEVELOPMENT OMB No. 2502-0265 SETTLEMENT STATEMENT nTLErRo ' Laserprinl ' SECURED LAND TRANSFERS, fNC. g.TVpEOFLOAN 5006 East Trindle Road ,. t ]FHA 2. l 1 FMHA 3.ZC] CONV. UNINS. Suite 203 4. [ ) VA 5. [ j CONY. INS. Mechanicsburg, PA 17055 6. FILE NUMBER: 7. LOAN NUMBER: 502970 17902615 Phone: (717) 591-8500 FAX: (717) 591-8506 B. MORT. INS. CASE NO.: C. NOTE: This form Is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked '(p.o.c.)' were paid outside the closing; they ere shown here for informational purposes and are not included in the totals. D. NAME AND ADDRESS OF BORROWER: Glenn Gurchik E. NAME AND ADDRESS OF SELLER: Estate of Delmar C. Kime a/k/a Delmar Carson Kime F. NAME AND ADDRESS OF LENDER: Chase Manhattan Mortgage Corporation 1 Plymouth Meeting Plymouth Meeting, PA G. PROPERTY LOCATION: 208 Erford Road H. SETTLEMENT AGENT: Secured Land Transfers, Inc: 1. SETTLEMENT DATE: 09/26/01 EBSt Pennsboro TOWNSHIP CUMBERLAND County PLACE OF SETTLEMENT: 3915 Market Street Camp Hill PA 17011 J. SUMMARY OF BORROWER'S TRANSACTION: K. SUMMARY OF SELLER'S TRANSACTION: too. GROSS AMOUNT DUE FROM BORROWER 4ao.GROS3 AMOUNT DUE TO SELLER tat. Contract sates price 108 00 . 0 4o1.Contract sales price 108 00 . toz. Personal property 4o2.Personal property to3. Settlement charges to borrower (line 1400) 5353 .25 403. 104. 404. 706. 405. Adjustments for items paid by seller in advance Adjustments Tor items paid by seller in advance to6. Ciry/Town tax to 4o6.CIly/fown tax to to7.Counlylax 9 2 Olto12 31 O1 83.72 4o7.Counrytax 09 26 llol 31 0 3.72 Ias.Asaessments l0 4oa.Assessments to tos. school 09 2 ll0 0 30 02 9 7 .4 409. school 0 2 Lo 06 30 02 937 .46 1I0. l0 410. to ,t,.S R: 87.75 q en ing 9 30 .85 4It.S R: 87.75 q en ing 9 30 3.85 1 iT. 412. tzo.GROSSAMOUNTDUEFROMBORROWER - 114978..28 42o.GROSSAMOUNTDUETOSELLER 109625.03 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER 6oo.REDUCTIONS IN AMOUNT DUETO SELLER zot. Deposit or earnest money 2 00.0 0 s01.Excess deposit (see instructions) 202. Principal amount of new loan(s) 8 8 8 0 . 0 0 Soz.Settlement charges to seller (line 1400) 1 1 . 2 8 zo3. Existing loan(s) taken subject to so3.Existing loan(s) taken subject to za4. Credit Report Credit 35.50 so4.Payoff o1 First Mortgage Loan None ze5. i,r sos.Payoff of Second Mortgage Loan zes: to B Ra on Mlt . 650 .00 sob. S to B Ra on Mlt . 650. 0 zo7, sm. 209. 506. 209. so9. Adjustments for items unpaid by seller Adjustments for items unpaid by seller 2t o. Cily/rown lax to Ste.City/Town tax to 21 t. County lax to 5i 1.Counry tax to z12. Assessments to S, z. Assessments to 2f3. school 10 513. sctwol to 214. 514. 215. 515. 216. 516. 217. - 517. 21s. 518. 219. 519. zz9.TOTALPAIDBYlFORBORROWER 89565.50 52o.TOTALREDUCTIONAMOUNTDUESELLER 10666.28 300. CASH AT SETTLEMENT FROM OR TO BORROWER soo.CASH AT SETTLEMENTTO OR FROM SELLER 301. Gross amount due from borrower'(I.ine 120) 11497 S . 2 8 so,.Gross amount due to seller (line 420) 10 9 25.0 3 3p2. Less amount paid by/tor borrower (line 220) 8 95 65 .'5 0 soz.Less reduction amount due seller (line 520) 1 6 . 8 3a3. CASH (~ FROM) ([ ] TO) BORROWER 25412.78 6o3.CASH (j}q TO) ([ ]FROM) SELLER` 98958.75 Buyer or Borrower's Signature Seller's Signature ~`;i~ f` 3 ..~. C~ i~ Vii' ~ U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT OMB No. 2502-0265 .5t I I LtMtN 151 H I tIVItIV I 502970 L. SETTLEMENT CHARGES '~7tXL TOTAL SALES/BROKER'S COMMISSION based on price= 10860D .00 BORROWER'S FUNDS AT SELLER'S FUNDS AT Division of Commission(Iine700)asfollows: Total: $7,202.00 SETTLEMENT SETTLEMENT 7ot.s 7202.00 to Jack Gau hen Realtor ERA 7oz. $ to 703. Commission paid at Settlement 7202.00 7oa.Trans.Fee Jack Gau hen Realtor ERA 100.00 100.00 B00. ITEMS PAYABLE IN CONNECTION WITH LOAN 90t. Loan Origination Fee 1.000 % Chase Manhattan Mort a e 868.80 soz. LoanDlscount 2.000 ~ Chase Manhattan Mort a e 1737.60 ao3.AppraisalFeeto A r.Solutlons($250POC) aoa. credit Report to The Credit Network ( 50P0 aos. Lenders Inspection Fee sos. Mortgage Insurance Application Fea to so7. Assumption Fee eoa.Doc. Pre Chase Manhattan Mort a e 165.00 aos.Tax Serv. CVHI 69.00 at0. L>.feFld. 1st American Flood Data 11.00 att. Int. Flood 1st American Flood Data 7.00 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 9at.lnterestfrom 09 26 O1 to09 30 O1 ~$ 15.47/day 77.35 802. Mortgage Insurance Premium for mo. to so3. Hazard Insurance Premium for yrs. to g0a. yrs. to 905. 000. RESERVES DEPOSITED WITH LENDER FOR oot. Hazard Insurance mo. ®s lmo. 002. Mortgage Insurance mo. ®$ /mo. 003. City/town tax mo. ®$ /mo. ooa. County tax mo. ®s /mo. to05. Assessments - mo. ®s /mo. loos, m0. ®$ /mo. 007. mo. ®s Jmo. ooe. mo. ®$ lmo. 1100. TITLE CHARGE9 1tot. Settlement or closing fee to t02. Abstract or title search tG 103. Title examination to 1104. Title Insurance binder to - t05. Document preparation to ttos. Notary fees to Cash 8 - 00 8.00 107. Attomey'sfees to JDSW (includes above items No.:) (POC-S ) ttoe. Title Insurance to Secured Land Transfers 1023.75 (includes above itemsNo.:) Ends; 100 300 900 toe. Lender's coverages 8 6, 8 8 0 no. owner's coverages 108, 600 t1tt.ICPLtr Secured Land Transfers 35.00 ttz.'O1Sch.Tax Jame E. Biddle, T C 1235.28 113.SR10 it 12 East Pennsboro Townshi 87.75 200. GOVERNMENT RECORDING AND TRANSFER CHARGES tot. Recording fees: Deed$ 25.50 Mortgages 51.50 Misc.s 77.00 202. City/county tax/stamps: Deeds 10 8 6. 0 0 Mortgage s 10 8 6. 0 0 203.Siatetax/stamps: Deeds 1086.OOMortgages 1086.00 204. 205. 1300. ADDITIONAL SETTLEMENT CHARGES 1301. SUfVey t0 1302. Pestlnspection to Housemasters ($40POC-B) ao3.Home Ins Housemasters ($250-POC-B) 3oa.Home Wt Jack Gau hen Realtor ERA 385.00 t3os.Radon Tst. Housemasters ($100-POC-B) 1400. TOTAL SETTLEMENT CHARGES (enter on lines 103 and 502, Sections d and K) 53 53..2 5 10016 .2 8 PaAka spree that no IIablBly k assumed by Selllemenl Agent for the eccurocy of irdortnalion furnished by others as shown on the HUD-1 Selllemant Stalsrnenl. Selllement Agent hereby expressly reserves the right to depasil any amounts eolketad for disbursement Iri an interest bearing ecrount in a FaderaUy Irisurad inslUUlbn and to credit any interest ee eamad to its own account as addilsmal compenealion for Us services h Ihis Iranwctbn. HUD CERTIFICATION OF BUYERS AND SELLERS 1 have carefully reviewed the HUD-1 Settlement Statement and to the beef of my knowledge and belief, it is a Vue and accurate statement of all receipts and disbursements made on my account by me In this lransactlon. I further cerafy lhai I have received a copy of the H~~UDQ~-1 Se~~ttle~~ment S/tateme~nt.1 yy// e~ ,~~~ `_- f Buyer ar Borrowers Slgnalura SeNer's Signature Buyer's Address 6 Phone: Seser's New Address 6 Phone: Tha HU Sal meW Statement which I a prepared is a True erid accurate acwunl of This Iranseclion. 1 have caused or wUl cause Iha lands to be disbursed in accordance with Ihla statement, g/~ ~(~~ Aganl oat. ARNING: It 4 a crina owinpph make false letemenla to the Untied Slates on Ihs or any sYntNr form. PansMies upon corrvkibn can include • lino and YnprYOrtmanl. Far dNalls sae 7UM iB: U.B. Coda Saclbn 1001 and Section 1010. ~ HU61 Rw. S/146 SCHEDULE B COMMONWEALTH OF PENNSYLVANIA ST~CI(S ~ BANDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF KIME , DELMAR C . a / k / a FILE NUMBER KIME, DELMAR CARSON 21-01-00602 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH ~• $50.00 Series EE Bond dated April 1986 Date of death value. 63.66 2. 1,100 Shares ACNB Corporation Common Stock @ $15.65 per share. 17,215.00 3. 263.258 Shares - Cigna Corporation Common Stock @ $102.187 per share. 26,901.55 TOTAL (Also enter on line 2, Recapitulation) I $ 44 , 180.21 (If more space is needed, insert additional sheets of the same size) REV-7508 EX ~ (1.97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF K I ME , DE LMAR C . a / k / a FILE NUMBER KIME, DELMAR CARSON 21-01-00602 Include the proceeds of litigation and the date the proceeds were received by the estate. All propeRy jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH ~~ Salomon Smith Barney Investment Account No. 724-15305-13 Date of death value 49,974.15 2. iPNC Bank - Certificate of Deposit No. 31500198759 l Date of death balance, plus accrued interest I 31,164.80 _ TOTAL (Also enter on line 5 Recapitulation) I $ 81, 138 95 (If more space is needed, insert additional sheets of the same size) REV•1509 EX .11.97) SCHEDULEF COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF KIME, DELMAR C. a/k/a FILE NUMBER KIME DELMAR CARSON ___ 21-01-00602 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 A• Douglas L. Kime ADDRESS 1359 Concord Road Mechanicsburg, PA 17050 RELATIONSHIP TO DECEDENT Son B Rodney A. Kime C. JOINTLY-OWNED PROPERTY: 55 Ringneck Drive Harrisburg, PA 17112 Son ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY InGude name of financial Institution and bank account number or similar identifying number. Attach deed for jointly-held real estate. DATE OF DEATH VALUE OF ASSET °~ OF DECO'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1. A. & B 5/98 461 Shares - First Union Common Stock @ $32.227 per share 14,856.65 330 4,952.22 2. A&B 3/94 227.9194 Shares - American Water Works @ $26.9830 per share 6,149.95 33~ 2,049.98 3. A&B 1/97 905.861 Shares - First Union Dividend Reinvestment Account No. 3700740383 @ $32.227 per share 29,193.18 33~ 9,731.06 4. A&B 2/00 PNC Bank - Certificate of Deposit No. 31100179664 Date of death balance, plus accrued interest 3,218.75 33~ 1,072.92 TOTAL (Also enter on line 6, Recapitulation) I $ 17 , 806.18 (If more space is needed, insert additional sheets of the same size) REV-0510 EX • (tAT) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE G INTER-VIVOS TRANSFERS ~ DISC. NON-PROBATE PROPERTY ESTATE OF KIME , DELMAR C . a /k / a FILE NUPABER KIME, DELMAR CARSON 21-01-00602 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the n:verse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER DESCRIPTION OF PROPERTY u+cLUOETHENAMEOFTHETRANBFEREE,THEIRRELATIOHSHIPTOOECEOEfRANOTHE oATEOFTRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE . DATE OF DEATH VALUE OF ASSET °~ OF DECD'S INTEREST EXCLUSION IF APPLICA~E TAXABLE VALUE 1. PNC Bank - IRA Account No. 6001003486 Beneficiaries: Children of the decedent: Douglas L. Kime, Son Rodney A. Kime, Son Natalie A. Kime, Daughter Date of death value 4,816.78 4,816.78 TOTAL (Also enter on line 7, Recapitulation) I $ 4 , 816.78 (If more space is needed, insert additional sheets of the same size) EV-1511 EX+ (12-99j r . ,~.~, .~~ SCHEDULE M FUNERAL EXPENSES 8c COMMONWEALTH OF PENNSYLVAN INHERITANCE TAX RETURN IA ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF KIME , DELMAR C . a /k / a FILE NUMBER KIME, DELMAR CARSON 21-01-00602 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: t' Myers-Harner Funeral Home 5,725.00 2. Bendersville Lutheran Church - funeral brunch 80.00 3. Bendersville Cemetery - opening/closing grave 425.00 4. Pealer's Flo wers - funeral flowers 227.32 5. Lee Dugan - engraving marker 120.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Mildred E . Kime 10 , 000.00 Social Security Number(s)/EIN Representative(s) 4 9 0- 3 4- 9 8 8 3 Street Address 1906 Rutland Street City Camp Hill State PA rp 17011 Year(s) Commission Paid: 2 0 0 1 / 2 0 0 2 2. Attorney Fees - Johnson , Duf f ie , Stewart & Weidner 6 , 000.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Mildred E. Kime 3, 500.00 Street Address 1906 Rutland Street City Camp H i 11 State PA Zip 17 011 Relationship of Claimant to Decedent W i f e 4. Probate Fees - Register of Wills - Cumberland County 305.00 5. Accountant's Fees 6. Tax Return Preparer's Fees ~, Cumberland Law Journal - advertise letters 75.00 8. The Patriot-News - advertise letters 96.81 9. Register of Wills - short certificates 6.00 10. Register of Wills - file Inv. & Inheritance Tax Retur 25.00 Sub-Total from additional sheet 10,359.39 TOTAL (Also enter on line 9, Recapitulation) $ 36 , 944.52 (If more space is needed, insert additional sheets of the same size) SCHEDULE H -CONTINUED Estate of: KIME, DELMAR C. a/k/a KIME, DELMAR CARSON 21-01-00602 11. Jane Biddle, Tax Collector - County/Township real estate taxes 311.24 12. Jack Gaughen -real estate commission 7,202.00 13. Jack Gaughen -transfer fee 100.00 14. Notary Fees 8.00 15. Jane E. Biddle, Tax Collector -School district real estate taxes due at settlement. 297.82 16. Recorder of Deeds - 1 % transfer tax 1,086.00 17. Jack Gaughen Realtor -Home Warranty 385.00 18. Barlup's -dishwasher replaced per agreement 481.24 19. Barlup's -stove top replaced per agreement 338.09 20. Reserve for close-out costs 150.00 Sub-total $10.359.39 REV45R Ex,•IF97) ~''y, ~~_~-~ ~ SCHEDULE COMMONWEALTH OFPENNSYLVAhlIA DEBTS OF DECEDENT, INHRESIDENTDECEDENTRN MORTGAGE LIABILITIES, & LIENS ESTATE OF KIME , DELMAR C . a /k / a FILE NUMBER KIME, DELMAR CARSON 21-01-00602 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1' Holy Spirit Hospital - account balance not covered by insurance. 168.44 2. Dr. Ehgartner - account balance not covered by insurance. 15.09 3. Central Med. Equipment - account balance not covered by insurance. 85.13 4. Moffitt, Pease & Lim Assocs. - account balance not covered by insurance. 4.20 TOTAL (Also enter on line 10, Recapitulation) I $ 2 ~ 2 " 86 (If more space is needed, insert additional sheets of the same size) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ESTATE OF NUMBER I. ,i 4. II. SCHEDULE) BENEFICIARIES KIME, DELMAR C. a/k/a KIME, DELMAR CARSON NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (include outright spousal distributions) Douglas L. Kime 1359 Concord Road Mechanicsburg, PA 17050 Rodney A. Kime 55 Ringneck Drive Harrisburg, PA 17112 Natalie A. Kime 820 Lisburn Rd., Apt. 512 - Mallard Run Camp Hill, PA 17011 Mildred E. Kime 1906 Rutland Street Camp Hill, PA 17011 FILE NUMBER 21-01-00602 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) AMOUNT UK St1AKt OF ESTATE Son One-half tangible personalty; 30~ of the balance of the residue. Son One-half tangible personalty; 30~ of the balance of the residue Daughter 40~ of the balance of the residue in Trust. Wife $10,000.00 Cash Bequest; 50~ of the residue or $30,000.00, whichever is less, in Trust. ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET 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 TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ (If more space is needed, insert addltiona);sheets of the same ~, ' REIN 1SW E%'~8-00~ ~. _ REV-1500 ---~- ~ ~ ~ ~„~'~ =,~8' COMMONWEALTH OF PENNSYLVANIA III INHERITANCE TAX RETURN FILE NUMB ER DEPARTMENT OF REVENUE RESIDENT DECEDENT DEPT. 280801 t 21 O1 00602 HARRISBURG. PA n7z8-08oi COUNTY CODE YEAR NUMBER __- -I.-.-.___.- DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) - ----~-- SOCIAL SECURITY NUMBER KIME, DELMAR C. 183-18-5021 w D DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) j I i THIS RETURN MUST BE FILED IN DUPLICATE WITH THE W ' 04/23/2001 01/26/1924 REGISTER OF WILLS (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER -- KIME, MILDRED E. 490-34-9883 ^ 1. Original Return ® 2. Supplemental Return ^ g. Remainder Return (date of death ~ Future Interest Com romise date of death after ^ 4. Limited Estate ^ 4a. p ( ^ 5. Federal Estate Tax Return Required m u 12 12 82) ~ a m ^ 6. Decedent Died Testate (Attach copy ^ 7. Decedent Maintained a Living Trust (Attach 8. Total Number of Safe Deposit Boxes a of Wilq copy of Trust) a ', ^ 9. Litigation Proceeds Received ^ 10. Spousal Poverty Credit (date of death between ^ 11. Election to tax under Sec. 9113(A) (Attach Sch o) 12-31-91 and 1_1-951_ T IS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATI ~~ ~ ~~ ~~~ ON SHOULD BE DIRECTED TO NAME CDMPLETEMAILINGADDRESS r- Jerry R. Duffie i ~ a --- - _ - I IRM NAME (If applicable) '. 301 Market Street Johnson Duffie Stewart & Weidner , , i - - -- ~ Lemoyne, PA 17043-0109 irELEPHONE NUMBER j 717/761-4540 ~~ = = - - ~, 1. Real Estate (Schedule A) (1) - None '~~~'`°I~L. ``s' r.}r'` v ~ 2. Stocks and Bonds (Schedule B) (2) None 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) None ', 4. Mortgages & Notes Receivable (Schedule D) (4) None 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) None (Schedule E) - 6. Jointly Owned Property (Schedule F) (6) None o I ^ Separate Billing Requested 5 ! 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) 55,467.08 F (Schedule G or L) a I ~ 8. Total Gross Assets (total Lines 1-7) (8) 55,467.08 U ~ ' 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) 55,467.08 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13) made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 55,467.08 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, x .00 (15) or transfers under Sec. 9116(a)(1.2) - 16.Amount of Line 14 taxable at lineal rate 55,467.08 x .045 (16) 2,496.02 a ~ 17.Amount of Line 14 taxable at sibling rate x ,12 (17) 0 U F 18. Amount of Line 14 taxable at collateral rate x .15 (18) 19• Tax Due (19) 2,496.02 __ » BE SURE TO ANSWER ALL QUESTIONS ON'REVERSE SIDE AND RECHECK MATH « Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) f ~ Decedent's Complete Address: STREET ADDRESS 1906 Rutland Street CITY Camp Hill ,STATE PA ZIP 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) 2,496.02 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Total Credits (A + B + C) (2) 0.00 3. Interest/Penalty if applicable D. Interest 140.00 E. Penalty Total InteresUPenalty (D + E) (3) _ 140.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) 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. (5) 2,636.02 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56) 2,636.02 Make Check Payable to: REGISTER OF W1LLS, 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 :............................................................................... .^ 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. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ................................................................................................................... . ^ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... ^ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ................................................................................................................. ..~ ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PA RT 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 bel ief, it is true, correct and complete. Declaration preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS DATE Mildred E. Kime 1906 Rutland Street ~~ ~~l ~, ~~-!/Yf'tJ~-/ __ Camp Hill, PA 17011 ~ la / SI OF PERSON R S E FOR FILING RETURN ADDRESS ATE ~ZI~1/vim DA ~r~y R. nuftie 301 Market Street Lemoyne, PA 17043-0109 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 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 0% [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exemota 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 decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1 )]. The tax rate imposed on the net value of transfers to or for the use of the decedent's 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. r' ~ ~ ~, SCHEDULE G INTER-VIVOS TRANSFERS & ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER KIME, DELMAR C. 21 - O1 - 00602 --- - This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes. DESCRIPTION OF PROPERTY % OF ITEM ~ DATE OF DEATH NUMBER !i Include the name of the transferee, their relationship to decedent and the date of transfer. DECD'S EXCLUSION ! TAXABLE VALUE Attach a copy of the deed for real estate. -VALUE OF ASSET I NTEREST (IF APPUCASLE) 1 MetLife -Annuity Contract No. A2065263 ~ 55,467.08 - - - ~ ~ j -~~---~- 55,467.08 ~'~ Beneficiaries: Douglas L. Kime, Son ~ ~~, 'I ~, Rodney A. Kime, Son I i i ~ , I I I TOTAL (Also enter on line 7, Recapitulation) 55,467.08 Inventory of the real and personal estate of DELMAR C. KIME a/k/a DELMAR CARSON KIME deceased 1. Real Estate - No. 208 Erford Road, East Pennsboro Township, Cumberland County, PA (Deed Book W, Volume 21, Page 975) Sale Price 2. 263.258 Shares - Cigna Corporation @ $102.187 per/share 3. Salomon Smith Barney Investment Account No. 724-15305-13 Date of death value 4. 1,100 Shares ACNB Corporation @ $15.65 per/share 5. PNC Bank - Certificate of Deposit No. 31500198759 Date of death balance, plus accrued interest 6. $50.00 Series EE Bond dated April 1986 Date of death value 108,600 00 26,901 55 49,974 15 17,215 00 31,164 80. 63 66 TOTAL ;233, 919 ~ 16 COMMONWEALTH OF PENNSYLVANIA 1 ss: COUNTY OF CUMBERLAND MILDRED E. KIME being duly sworn according to law, deposes and says that she is Executr; x of the Estate of Delmar C. Kime a/k/a Delmar lafe of Camp Hill Borough ,Cumberland County, Pa. C~ ceased and ~at the within is an inventory made by Mildred E. Kime _, ,the said Executrix of the entire estate of said decedent, consisting of all the personal property and real estate, except real estate outside the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value as of the date of decedent's death . Sworn toy , and subscribed before me, (~~~~t~~^-~-'C/ ~~ 2 0 O l ~° Nt~TARIAL AL [IIANNE I.ENIG, Notary Public Lemoyne Boro~E;h Cumbe~lantl Co. My Commission Expires Dec. 21, 2001 Date of Death 23rd April ~1~.e~~L~-!~'~ .~~iv~.~~~ ~~' c Executor - Adm~nisfrator Mildred E. Kime, Executrix 1906 Rutland Street Camp Hill, PA. 17011 Address 2001 Day Month INSTRUCTIONS Ysar 1: An inven•~y must-be filedwithin f ~ee~montl~is after appointment of persona ~represen~ative. 2. A supplement inventory must be filed within thirty days of discovery of additional assets. 3. Additional sheets may be, attached as to personalty or realty 4. See Article IY, f=iduciaries Act of 1949. \ N ~ 'C N ~ ~ p ~o O >- ~ u.t Q ro H pq ~ ~ .~ ~ "' ~ W. ~ z ~ ° O F- Z ~ ~' ,J u_ H O O x •r-I x ,p o ~ ,.~ -r w a . , N } o Z c~ . ,~ s.~ I -Z I p o ~ ~ ~ ~ ~ Z x a ~ U Z Q ~ ~ ~ ~ a a q q o m I ~ U w N G O E N a m o ` v+ .r., m n°. 4-a ` rn ~••~. o O' Q ~~ 4, ~ 0 rx cn o N h w -o -Y m 0 u, m rn 0 0 M l0 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: JERRY R DUFFIE P O BOX 109 LEMOYNE, PA 17043 fold PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ACN ASSESSMENT CONTROL NUMBER AMOUNT ESTATE INFORMATION: ssN: 183-18-5021 FILE NUMBER: 21-2001- 0602 DECEDENT NAME: KIME DELMAR C DATE OF PAYMENT: 1 0/31 /2001 POSTMARK DATE: 10/30/2001 COUNTY: CUMBERLAND DATE OF DEATH: 04/23/2001 101 ~ S 1, 227.50 TOTAL AMOUNT PAID: REMARKS: MILDRED E KIME C/O JOHNSON DUFFIE ETAL CHECK#108 INITIALS: SK $1, 227.50 SEAL RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS REV-1162 EX~11-96) N0. CD 000463 '/~ ~`~~ 9 ~ ~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION NOTICE OF INHERITANCE TAX DEPT. 280601 APPRAISEMENT, ALLOWANCE OR DISALLOWANCE HARRISBURG, pA 17128-0601 OF DEDUCTIONS AND ASSESSMENT OF TAX REY-1547 EX AFP c12-PPl Re~iS~'> 4~ ktl~S DATE 12-17-2001 'Oi QiC 27 aIQ :i 2 JERRY R DUFFIE ESQ JOHNSON ETAL LiG~k-,~ u ~,i` Po Box 109 C~ttnb~~~r~;~~ ~,_.=,., PA LEMOYNE PA 17043 ESTATE OF KIME DELMAR DATE OF DEATH 04-23-2001 FILE NUMBER 21 01-0602 COUNTY CUMBERLAND ACN 101 Amount Remitted MAKE CHECK PAYA$LE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 C CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~ ---------------------------------------------------------------------------------------------------------------- REV-1547 EX AFP [12-00) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF KIME DELMAR C FILE NO. 21 01-0602 ACN 101 DATE 12-17-2001 TAX RETURN WAS: (X) ACCEPTED AS FILED ( l CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 108, 600.00 NOTE: To insure proper 2. Stocks and Bonds (Schedule B) (2) 44, 180.21 credit to your account, 3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 submit the upper portion 4. Mortgages/Notes Receivable (Schedule D) (4) .00 of this fora with your 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 81, 1 38.95 tax payment. 6. Jointly Owned Property (Schedule F) (6) 17, 806.15 7. Transfers [Schedule G) (7) 4, 816.7$ a. Total Assets (g) 256,542.12 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 36,944.52 (9) 10. Debts/Mortgage Liabilities/Liens (Schedule I) (101 27 2.86 11. Total Deductions (11) 37 . 1 7 _ ~A 12. Net Value of Tax Return (lp) 219,324.74 13. Charitable/Governmental Bequests; Non-elected 9113 Trus ts (Schedule J) (13) .0 0 14. Net Value of Estate Sub,iect to Tax (14) 219,324.74 NOTE: if an assessment was issued previously, lanes 14, 15 andior 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (18) 40, 000. 00 X 00 _ . 00 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 179,324.74 X 045. 8,069.61 17. Amount of Line 14 et Sibling rate (17) .00 X 12 - .00 18. Amount of Lfne 14 taxable at Collateral/Class B rate (18) .00 X 1 5 - .00 19. Principal Tax Due (19)= 8, 069.61 TeY r_Qen*r4:. DATE NUMBER I T +) INTEREST/PEN PAID (-) AMOUNT PAID 07-20-2001 CD000075 342.11 6,500.00 10-30-2001 CD000463 .00 1,227.50 TOTAL TAX CREDIT 8,069.61 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) RESERVATION: Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred in possession or enjoyment to Class B [collateral) beneficiaries of the decedent after the expiration of any estate for life or far years, the Comaonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Texas at the lawful Class B (collateral) rate on any such future interest. PURPOSE OF NOTICE: To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of 2000. (72 P.S. Section 9140). PAYMENT: Detach the top portion of this Notice and submit with your payment to the Register of Wills printed on the reverse side. --Make check or money order payable to: REGISTER OF NILLS, AGENT REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an ^Application for Refund of Pennsylvania Inheritance and Estate Tax" CREV-1313). Applications are available at the Office of the Register of Nills, any of the 23 Revenue District Offices, or 6y calling the special 24-hour answering service for forms ordering: 1-800-3b2-2050; services for taxpayers with special hearing and / ar speaking needs: 1-800-447-3020 CTT only). OBJECTIONS: Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty C60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Oept. 281021, Harrisburg, PA 17128-1021, OR --election tc have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. ADMIN- ISTRATIVE CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Oept. 280601, Harrisburg, PA 17128-0601 Phone (7177 787-6505. See page 5 of the booklet ^Instructions for Inheritance Tax Return for a Resident Decedent^ (REV-15017 for an explanation of administratively correctable errors. DISCOUNT: If any tax due is paid within three (3) calendar months after the decedent's death, a five percent CS%) discount of the tax paid is allowed. PENALTY: The 15% tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the and of the tax amnesty period. This non-participation penalty is appealable in the sane manner and in the the same ties period as you would appeal the tax and interest that has been assessed as indicated on this notice. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one C1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1962 bear interest at the rate of six C6%) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced 6y the PA Department of Revenue. The applicable interest rates for 1982 through 2002 are: Year Interest Rate Daily Interest Factor Year Interest Rate Daily Interest Factor 1982 20% .000548 1992 9% .000247 1983 16% .000438 1993-1994 7% .000192 1984 11% .000301 1995-1998 9% .000247 1985 13% .000356 1999 7% .000192 1986 10% .000274 2000 8% .000219 1987 9% .000247 2001 9% .000247 1988-1991 11% .000301 2002 6% .000164 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If paynent is wade after the interest computation date shown on the Notice, additional interest oust 6e calculated.