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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
File Number
INHERITANCE TAX RETURN
RESIDENT DECEDENT 21 07
00941
Date of Birth
203102338
05232007
12161918
Decedent's Last Name
Suffix
Decedent's First Name
MI
KERSTETTER
ANNA
L
(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 Return
0 4 Limited Estate 0 4a. Future Interest Compromise
(date of death after 12-12-82)
181 6. Oecedent Oied Testate 0 7. Decedent Maintained a living Trust
(Attach Copy of Will) (Attach Copy of Trust)
0 9. Litigation Proceeds Received 0 10 Spousal Poverty Credit (date of death
. between 12-31-91 and 1-1-95)
3. Remainder Return (date of death
prior to 12-13-82)
o 5. Federal Estate Tax Return Required
o
8. Total Number of Safe Deposit Boxes
o
11. Election to tax under Sec. 9113(A)
(Attach Sch. 0)
CORRESPONDENT. THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Teleph,llIJe Number ::~_:
TERRENCE J. KERWIN, ESQUIRE 71736232'15:"))
J ~-n
. I
Firm Name (If Applicable)
KERWIN & KERWIN
REGISTER OF WILLS USE 0NL Y
1'.)
First line of address
4245 ROUTE 209
Second line of address
c-.
( '.~
City or Post Office
State
DATE FILED
ELIZABETHVILLE
PA
ZIP Code
17023
Correspondent's e-mail address:kk@kerwinlawfirm.com
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief,
it is true, correct and complete. Declaration of preparer other than the personai representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PER N RESPONSiBLE FOR FILING RETURN Terrence J. Kerwin, Esq. DATE
~.......-.--- ./ Kerwin & Kerwi n ;A
Terrence J. Kerwin, Esquire
:?.
4245 Route 209, Elizabethville, PA 17023
L
Side 1
15056041147
15056041147
-.J
-.J
15056042148
REV-1500 EX
Decedent's Name:
KERSTETTER, ANNA L.
203102338
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 & 1 0)...................................................................... 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.
5,259.71
16.
17.
18.
19. Tax Due.......... .................. ... ........ ..... .............................
19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT,
L
Side2
15056042148
Decedent's Social Security Number
654.32
30,569.31
31,223.63
5,620.69
6,122.53
11,743.22
19,480.41
14,220.70
5,259.71
236.69
236.69
D
15056042148
--.J
REV-1500 EX Page 3
Decedent's Complete Address:
File Number 21 - 07 - 00941
DECEDENT::; NAME
Kerstetter, Anna L.
STREET ADDRESS
100 Mount Allen Drive
CITY I STATE IllP
Mechanicsburg PA 17055
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
236.69
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Credits (A + B + C)
(2)
0.00
Total Interest/Penalty (0 + E)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 2 Line 20 to request a refund
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(3) 0.00
(4)
(5) 236.69
(5A)
(5B) 236.69
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:
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?............................................................ .............................................. ............
Yes
No
o 0
o ~
8 ~
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?..................................................................................................................... 0 0
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
o
o
o
o
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the
surviving spouse is three (3) percent [72 P.S. ~9116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero
(0) percent [72 P.S. ~9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements
for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a
natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. 99116 (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent,
except as noted in 72 P.S. ~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 twelve (12) percent [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.
.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF Kerstetter, Anna L.
FILE NUMBER
21 - 07 - 00941
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of
survivorship must be disclosed on schedule F.
ITEM DESCRIPTION VALUE AT DATE OF
NUMBER DEATH
1 Refund - Highmark premium 654.32
TOTAL (Also enter on Line 5, Recapitulation) 654.32
*'
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF Kerstetter, Anna L.
FILE NUMBER
21 - 07 - 00941
ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF EXCLUSION TAXABLE VALUE
NUMBER Include the name of the transferee. their relationship to decedent VALUE OF ASSET DECD'S (IF APPLICABLE)
and the date of transfer. Attach a copy of the deed for real estate. INTEREST
1 M& T Investment Group 30,569.31 100% 30,569.31
Trust Account #1104515105
Beneficiary: Estate of Anna L. Kerstetter
TOTAL (Also enter on line 7, Recapitulation) 30,569.31
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes.
~ M&T Investment Group
P.o. Box 1377
Buffalo, NY 14240-9828
Account Summary Section
Statement of Value and Activity
January 1, 2007 - December 31, 2007
Beginning Market Value
Cash Additions
Cash Disbursements
Income
Change in Market Value
Ending Market Value
Realized Gains/Losses
(Included in Total Above)
This Period
$68,560.07
$44,845.13
-$85,119.73
$1,937.90
$231.56
$30,454.93
$1,246.80
1/1/07 to 12/31/07
$68,560.07
$44,845.13
-$85,119.73
$1,937.90
$231.56
$30,454.93
$1,246.80
Investment Objective: Conservative: Generate returns from income and appreciation over a
long-term, investing in primarily bonds and some equities. M&T's Investment Policy Committee set
the current range percentages as Cash 0-15, Fixed Income 50-80, & Equity 15-40.
Asset Class Balance
II 100% Cash & Equivalents
100% Total Assets Value
$30,454.93
$30,454.93
Kerstetter,Anna L T/A. Account # 1104515105
Page 1 of 16
4713 -0500458
fl:1 M&I'Investment Group
Trust Operations
One M & T Plaza - 8th Floor
Buffalo NY 14203
1/11/08
157
ESTATE OF ANNA l KERSTETTER
No. 227770801
KERSTETTER,ANNA L TIA
1104515105
1/11/08
OFFICER 0299 SUE MAUERY
~ INCOME 0 PRINCIPAL
$114.38
ESTATE OF ANNA L KERSTETTER
50 FINAL INCOME- ANNA KERSTETTER TRUST
TRSCHKTRCHK I
DETACH & RETAIN FOR YOUR RECORDS
"
*'
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYlVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF Kerstetter, Anna L.
Debts of decedent must be reported on Schedule I.
FILE NUMBER
21 - 07 - 00941
ITEM
NUMBER FUNERAL EXPENSES:
A. 1 Auer Memorial Home & Cremation Services, Inc.
AMOUNT
DESCRIPTION
B. ADMINISTRATIVE COSTS:
1.
Personal Representative's Commissions
Terrence J. Kerwin, Esq.
Social Security Number(s) / EIN Number of Personal Representative(s):
Street Address 4245 Route 209
City Elizabethville
State P A
Zip 17023
2.
Year(s) Commission paid 2008
Attorney's Fees Kerwin & Kerwin -- Terrence J. Kerwin, Esquire
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City
Relationship of Claimant to Decedent
State
Zip
4.
Register of Wills
Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs
Register of Wills - additional Short Certificates
TOTAL (Also enter on line 9, Recapitulation)
79.58
1,500.00
3,500.00
134.00
12.00
5,620.69
Schedule H
Funeral Expenses &
Mninistrative Costs continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF Kerstetter, Anna L.
FILE NUMBER
21-07-00941
2 Cumberland Law Journal - estate notice
75.00
3 Register of Wills - additional renunciation
5.00
4 Register of Wills - filing fee for Petition to Probate
Photocopy of Will
50.00
5 The Sentinel - estate notice
195.11
6 Register of Wills - Releases
20.00
7 Closing costs, e.g. - photocopies, postage
50.00
*NOTE: Additional Attorney Fees charged due to inability
of Trustee Bank to locate decedent's original Will.
This resulted in need to petition court to probate
photocopy of Will and a hearing before the Register
of Wills. This procedure also involved obtaining
renunciations from all heirs and a major creditor.
Page 2 of Schedule H
*'
SCHEDULE I
DEBTS OF DECEDENT, MORTGAGE
LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF Kerstetter, Anna L.
FILE NUMBER
21-07-00941
Include unreimbursed medical expenses.
ITEM DESCRIPTION AMOUNT
NUMBER
1 Messiah Village - balance due on account 5,456.00
2 Alert Pharmacy Services - account payable 461.10
3 Verizon - account payable 173.49
4 Capital Area Health Assoc. - account payable 31.94
TOTAL (Also enter on Line 10, Recapitulation) 6,122.53
REV.1513 EX+ (9.00)
.
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Kerstetter, Anna L.
I FILE NUMBER
21-07-00941
RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER NAMEANDADDRESSOFPERSON~) DECEDENT (Words) ($$$)
RECEIVING PROPERTY Do Not List Trustee(s)
I. TAXABLE DISTRIBUTIONS [include outright Sfrousai
distributions, and ransfers
under Sec. 9116 (a) (1.2)]
1 Lucille Johnson step- 2/15
1420 Meadow Ridge daughter
Redding, CT 06896
2 Barbara Priebe step- 2/15
117 N. Vine Street daughter
Richmond, VA 23220
3 St. Peter Lutheran Church Charity 1/15
130 Nittany Drive
Mechanicsburg, PA 17055
Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS
NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1 St. Peter Lutheran Church 14,220.70
2 The Seeing Eye, Inc.
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 14,220.70
REV.1513 EX+ (9-00)
*'
SCHEDULE J
BENEFICIARIES continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Kerstetter, Anna L.
I FILE NUMBER
21 - 07 - 00941
RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ($$$)
RECEIVING PROPERTY Do Not List Trustee(s)
I. TAXABLE DISTRIBUTIONS [include outright sfrousal
distributions, and ransfers
under Sec. 9116 (a) (1.2)]
4 The Seeing Eye, Inc. Charity 1 0/15
P. O. Box 375
Morristown, NJ 07963-0375
Page 2 of Schedule J
LAST WILL AND TESTAMENT
OF
ANNA L. KERSTETTER
I, ANNA L. KERSTETTER, of the County of Cumberland, and
Commonwealth of Pennsylvania, being of sound mind, memory and
understanding,
do make and publish this,
my Last Will and
Testament, hereby revoking and maklng.vold all former wills by me
at any time heretofore made,
FIRST:
I dIrect my hereinafter named Executor to pay all my
legally enforceable
debts,
funeral
expenses,
administration
expenses, and inheritance, estate, SucceSSIon or excIse taxes,
which I owe or may become due on account of my death, as soon as
may be convenient after my decease
SECOND :
I dIrect that all my personal property be sold as
soon as may be convenient after my decease, wIth the provIsIon that
any of my relatives who want my personal property are free to
purchase the property in a method as determined to be approprIate
by my Executor,
THIRD:
I give, devise and bequeath all my property, be it
real, personal or mixed, whatsoever and wheresoever the same may be
situate at the time of my death as follows:
A, I direct that one third (1/3) of my estate is to be
divided equally among the following indivIduals and
Page 1 of 3 Pages
/ (/~vV',:..... ~ 1<~'L,j_[;z:r;.,--) (SEAL)
Anna L. Kerstetter
church:
1) one fifth (1/5) of the aforesaid one third
(1/3) share of my estate shall pass to my step daughter,
BARBARA ANN PRIEBE, if she survives me; 2) one fifth
(1/5) of the aforesaid one third (1/3) share of my estate
shall pass to my step son, DONALD W. KERSTETTER, if he
survives me: 3) one fifth (1/5) of the aforesaid one
third (1/3) share of my estate shall pass to my step
daughter, DOROTHY SEGAR, if she survives me: 4) one fifth
(1/5) of the aforesaid one third (1/3) share of my estate
shall pass to my step daughter, LUCILLE JOHNSON, if she
survives me; and 5) one fifth (1/5) of the aforesaid one
third (1/3) share of my estate shall pass to ST. PETER'S
LUTHERAN CHURCH, located in Mechanicsburg, Pennsylvania,
for general purposes. Upon the death of any of my step
Children, I direct that their share of my estate shall be
divided equally among my surviving step children, who are
listed on this my Last Will and Testament, to wit:
Barbara Ann Priebe, Donald W. Kerstetter, Dorothy Segar
and Lucille Johnson; and
8. I direct that two two thirds (2/3) of my estate shall
pass to SEEING EYE,
INC. ,
which is a non-profit
organization located at Post office Box 375, Morristown,
New Jersey.
This bequest and devise 1S to be used for
general purposes for this non-profit organization, of
which I hold in high regard.
FOURTH:
I nominate, constitute and appoint DAUPHIN DEPOSIT
BANK & TRUST COMPANY, as Executor of this, my Last Will and
Page 2 of 3 Pages
/
l-/(.{ Lo.., ,<t ;( .)! ~,
c ; ;:":-tJ.t~ t'-/c'
Anna L. Kerstetter
'(SEAL)
Testament, authorizing and empowering it to sell and convey any and
all real estate of which I may die seized and possessed.
I further direct that my Executor or personal representative
shall not be required to post bond to act in said capacity.
IN WITNESS WHEREOF, I, Anna L. Kerstetter, have hereunto set
my hand and seal, to this my Last Will and Testament, this
19th
day of July, 1995.
SIGNED, SEALED, PUBLISHED
and DECLARED by the above-
named Testatrix, ANNA L.
KERSTETTER, as and for her
Last Will and Testament, in
the presence of us, who at
her request and in the
presence of each other, have
hereunto set our names as
witnesses:
vi a~'-Q. .%. ~lkmeEAL)
Anna L. Kerstette
Page 3 of 3 Pages
c \p""k\'''lll\kl!'r!ltet~ alk
REGISTER OF WILLS OF
INVENTORY
CUMBERLAND
COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA } SS
COUNTY OF Cumberland }
File Number 21 - 07 - 00941
Terrence J. Kerwin, Esq.
Personal Representative(s) of the Estate of Kerstetter, Anna L.
deceased, depose(s) and say(s) that the items appearing in the following inventory include all of the personal assets wherever situate
and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said
inventory represents its fair value as of the date of the decedent's death, and that Decedent owned no real estate outside of the
Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory.
I verify that the statements made in this Inven- } /..~ t7 ~
tory are true and correct. I understand that false state- ". -,
ments herein are made subject to the penalties of Terren J. Kerwm, Esq.
18 Pa.C.S. 94904 relating to unsworn falsification to }
authorities.
Attorney -- (Name)
(Firm)
Terrence J. Kerwin, Esquire
Kerwin & Kerwin
(Supreme Court /.D. No.) 29922
(Address) 4245 Route 209
Elizabethville, PA 17023
(Telephone) 717/362-3215
DATE OF DEATH
5/23/2007
LAST RESIDENCE 100 Mount Allen Drive
Mechanicsburg, PA 17055
I FIGURES MUST BE TOTALED I
DECEDENTS SOC. SEC. NO.
203-10-2338
Personal Property
Refund. Highmark premium
654.32
Total Personal Property
$654.32
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(Attach additional sheets if necessary)
Total Personal Property and Real Estate
$654.32