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HomeMy WebLinkAbout05-12-08 (3) ..J 15D5bD41147 REV-1500 EX (06-05) PA Department of Revenue Bureau of Individual Taxes ~~ PO BOX.280601 ~ Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death OFFICIAL USE ONLY County Code Year INHERITANCE TAX RETURN RESIDENT DECEDENT 2 1 0 7 File Number 0837 Date of Birth 197221900 08242007 03221929 KNAUB INEZ MI M Decedent's Last Name Suffix Decedent's First Name (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 [!] 1. Original Return 2. Supplemental Return o o 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 9. litigation Proceeds Received o o o o 4a. Future Interest Compromise (date of death after 12-12-82) o [K] o 4. Limited Estate 6. Decedent Died Testate (Attach Copy of Will) 7 Decedent Maintained a living Trust . (Attach Copy of Trust) 8. Total Number of Safe Deposit Boxes 10 Spousal Pover\}' Credit (date of death . between 12-31.91 and 1-1-95) D 11. Election to tax under Sec. 9113(A) (Attach Sch. 0) ~ORRESPONDENT . THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: ame Daytime Telephone Number WM. D. SCHRACK III 7174329733 124 WEST HARRISBURG STREET f'-o) c;::::) .,~-) REGIST~ILLS lfi ON~ . ~~ 'n-o,...... > (0 oI~ -< (j.') .. ...) .-'.- ":t> m .-1 I J r;:> z: -..... .... ... m j .:.:... :.i5-.AJ .'-" .....'1' 6~~ ~;::' (")0." -0 . j :", C :x ~""""':D N :o~ .. ~ATE FILED +:- Firm Name (If Applicable) SCHRACK & LINSENBACH PC First line of address Second line of address P.o. BOX 310 City or Post Office DILLSBURG State PA ZIP Code 17019-0310 Correspondent's e-mail address:Schracklaw@comcast.net Under penalties of ~rjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIG T RE OF P RSON RESPONSIBLE R UN RETURN DATE Charles Paul Knaub Wm. D. Schrack III ADORE 124 West Harrisburg Street, Dillsburg, PA 17019-0310 Side 1 L 1505b041147 15056041147 ..J ~ ESTATE OF Knaub, Inez M. PA Inheritance Tax Return Signature of Additional Fiduciaries FILE NUMBER 21-07 -0837 Under penalties of perjury, I declare that I have examined this retum, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. Signature #2 Name Address1 Address2 City, State, Zip Date York, PA 17406 I ').h);7 ( --I lS05b04214ta REV-1500 EX Decedent's Name: I n e z M. K n a u b Decedent's Social Security Number 197221900 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) D Separate Billing Requested............. 7. 8. Total Gross Assets (total Lines 1-7)............................._.................................. 8. 9. Funeral Expenses & Administrative Costs (Schedule H)...................................... 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)................................ 10. 11. Total Deductions (total Lines 9 & 10)................................................................. 11. 12. Net Value of Estate (Line 8 minus Line 11 )............................._.......................... 12. 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J).............................................. 13. 14. Net Value Subject to Tax (Line 12 minus Line 13).............................................. 14. TAX COMPUTATION. SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of line 14 taxable at the spousal tax rate. of transfers under Sec. 9116 (a)(1.2) X ~ 16. Amount of line 14 taxable at lineal rate X .045 17. Amount of Line 14"iaXable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 0.00 15. 0.03 16. 96,396.60 17. 24,099.15 18. 19. Tax Due...................................... .......................................................... ............... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 L 15056042148 112,879.59 42,108.85 154,988.44 21,104.24 21,104.24 133,884.20 13,388.42 120,495.78 0.00 0.00 11,567.59 3,614.87 15,182.46 D 1505604214ta --I REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-07 -0837 DECEDENT'S NAME Inez M. Knaub STREET ADDRESS Forest Park Health Center, 700 Walnut Bottom Road CITY I STATE jZIP Carlisle PA 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 14,423.00 759.11 3. Interest/Penalty if applicable D. Interest E. Penalty Total Credits (A + B + C) (2) Total InterestlPenalty (0 + E) 4. If Line 2 is greater than Line 1 + Line 3. enter the difference. This is thEOVERPAYMENT. 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 theTAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is theBALANCE DUE 15,182.46 15,182.11 (3) (4) (5) 0.35 (5A) (58) 0.35 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS Yes o o o o receiving adequate consideration?..................... ....... .............................. n.................................................... 0 3. Did decedent own an Nin trust for" or payable upon death bank account or security at his or her death?........ 0 4. Did decedent own an Individual Retirement Account. annuity, or other non-probate property which contains a beneficiary designation?............................ ............................................................. ...................... 0 ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. No [!J ~ ~ [!J [!J ~ 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:foes not exemot 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. ~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 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)J. 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. 1fftt$t llill an~ mt$fawttt (2 ~~:;(J ::~2~ ~j~_ ?~2 . :.~ 1"--.') c::-, <::::;} -.I (.I') r~ -0 ::- 1 OF ~~~3 \~ :t:!" ". ..;'....-. --- LI\J 1.:../) :::~ INEZ M. KNAUB --::J :ii =-=t \.0 w BE IT REMEMBERED that I, INEZ M. KNAUB, single woman, of 125 West York Street, Dillsburg, York County, Pennsylvania, being of sound mind, memory, and understanding, do make, publish, and declare this as and for my Last Will and Testament, hereby revoking and tnaking null and void any and all Wills and Testaments and writings in the nature thereof by me at any time heretofore made. ITEM 1: I direct that my hereinafter named Co-Executors pay all my just debts, my funeral expenses, and the expenses of the administration of my estate. With this direction, I authorize and empower my Co-Executors to expend for my funeral expenses and interment such amounts as they may consider necessary and proper, without regard to any limit that may be prescribed by a court of law. ITEM 2: I direct my Co-Executors to pay all inheritance, estate, succession and legacy taxes of whatsoever nature and kind, to which my estate or the transfer of any property passing hereunder or -otherwise passing by reason of my demise, may be subj ect and to charge such taxes against my residuary estate, it being my intention that none of the aforesaid taxes, either federal or state, on any property required to be included in my gross estate, under the provisions of any state or federal law now 1n force or hereafter enacted, shall be prorated among the persons interested in my estate to whom such property may be transferred or to whom any benefit accrues. ITEM 3: I give and bequeath my home at 125 West York Street, Di1lsburg, Pennsylvania, unto my brother, CHARLES PAUL KNAUB, absolutely. ITEM 4: I give and bequeath my Hershey Bear Hockey Team memoribilia unto my nephew, JOHN H. KNAUB, III. ITEM 5: I give and bequeath all of my Christmas decorations to my niece, CRYSTAL LYNN KNAUB. ITEM 6: I give and bequeath a sum equal to Ten Per Cent (10%) of my net K2 residuary estate unto the UNITED METHODIST CHURCH OF DILLSBURG, at 203 Mumper !!!' Lane, Dillsburg, Pennsylvania, without limitation or restrictions imposed upon its use. ITEM 7: All the rest, residue, and remainder of my estate of whatsoever nature and wheresoever situate, whether it be real, personal, or mixed, including property over which I have a power of appointment, I direct my Co-Executors divide into six (6) equal shares, with one (1) share to be distributed to each of the enumerated individuals: (a) One (1) share unto my brother, RICHARD L. KNAUB, of 905 Sheffield Avenue, Mechancisburg, Pennsylvania; (b) One (1) share unto my brother, JOHN H. KNAUB, JR., of 3333 Roundtop Road, Eliz abethtown , Pennsylvania; (c) One (1) share unto my brother, CHARLES P. KNAUB, of 719 Range End Road, Dillsburg, Pennsylvania; (d) One (1) share unto my sister, MARGARET SHOFFNER, of 117 North York Road, Dillsburg, Pennsylvania; (e) One (1) share unto my sister, DELORES DUTILL, of 5 Cardinal Drive, PlYmouth Meeting, Pennsylvania; and (f) One (1) share unto my nephew, RODNEY KNAUB, of 719 Range End Road, Dillsburg, Pennsylvania. 2 ... In the event any of the parties enumerated should predecease me, I direct that the share of that deceased individual should lapse, and the residue be divided into as many shares as there are survivors of the individuals enumerated. ITEM 8: I nominate, constitute, and appoint CHARLES PAUL KNAUB and RODNEY KNAUB, or the survivor thereof, to serve as Co-Executors of this my Last Will and Testament. ITEM 9: I direct that my hereinbefore named Co-Executors shall not be required to give bond for the faithful performance of duties in this or any jurisdiction. IN WI~~ WHEREOF, I have hereunto set my hand and seal this day of ~ ~ , 1990. (/ / /tII ~ (L,~ ?-n ~ul!- iNiiW"KNAUB The preceding instrument, consisting of this and two (2) other typewritten pages, was on the day and date thereof ~igned, sealed, published, and declared by INEZ M. KNAUB, the Testatrix herein named, as and for her Last Will and Testament, in the presence of us, who, at her request, in her presence, and in subscribed our names as witnesses hereto. OF Jt t?~, ~/ p,t OF Il-<>>Pfdlkl19---) /1; 3 "<'"",~ .- ~~, ,,~;~,' - ,,",,-', ~-" -~'~;';;;~~:-i"'~A0:..~""",,~~...G,.; ~_;"'-, ~ COMMONWEAL TH OF PENNSYLVANIA SS. COUNTY OF YORK JIm L ~~ ~ INEZ ~.~UB' d . r- . {~y. , t~ Testatrix and the witnesses, I ' respectively, whose names are signed to the attached or foregoing instrument, and being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and Testament, and that she signed willingly, and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in. the presence and hearing of the Testatrix,. signed the Will as witnesses, and that to the best of their knowledge, the Testatrix was at the time eighteen (18) years of age or older, of sound mind, and under no constraint or undue influence. INE L ~, ?Ylce. {J _~Fk' SWORN TO AND SUBSCRIBED BEFORE ME THIS 11m DAY ~ C. .-.--.------..------ J;~r:8" ?~~~,~": :~~:.~.i.:Z~;.~. ?~::.. ~'.'~ ~,l~(~;~.:;:::::,'-.;: ~:E' ;~. :~:::r....~:: >{".I[:!!~'( ,... "'",, .,,~,". "", " ,,,. ~ ..... .... .....,.."U M';r:;~f. -j:o't.~i~'~r;.~~;k.~ is ;:;';:c,:r~;.~:\;.N;;;;_ies 4 Rev-1503 EX+ 18-98) . SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Knaub, Inez M. FILE NUMBER 21-07 -0837 ESTATE OF All property Jolntly-owned with right of survlvol1lhlp must be disclosed on Schedule F. ITEM CUSIP VALUE AT DATE NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH 1 Van Kampen High Yield Fund Class A 92.595.90 2 Van Kampen High Yield Fund Class A 20.283.69 TOTAL (Also enter on Line 2, Recapitulation) 112.879.59 (If more space is needed. additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA.1500 Schedule B (Rev. 6-98) MAs D & BARRICK -ADVISORY: INC.- INDEPENDENT FINANCIAL ADVISORS September 26, 2007 Mr. William D. Schrack III Schrack & Linsenbach Law Offices 124 W. Harrisburg St. P.O. Box 310 Dillsburg, P A 17019 Mr. Schrack, Below you will find the account information you requested for the Estate of Inez M. Knaub as of the date of her death August 24,2007. The name on her account opened May 22, 2007 is: Inez M. Knaub, Charles M. Knaub POA. Included in this account: -Cash value of -$551.24; -Metlife Bank Money Market Account value of $33,804.79; -Van Kampen High Yield Fund Class A value of$92,595.90; -VanKampen P A Tax Free Income Class A value of $20,283 .69. Please let me know if you have any questions or need this information clarified. Sincerely, ~~ Audrey Myer Sales Assistant to Stacey Gibble Barrick, CFP @ 'v Knaub, Inez Wm Schrack Sept 07 3461 Market St., Suite 102, Camp Hill, PA 17011 TeL 717-761-6606 Fax 717-761-7524 www.maslandandbarrick.com Securities offered through Walnut Street Securities, Inc. Member NASD, SIPC Masland & Barrick Advisory, Inc. and Walnut Street Securities are unaffiliated entities. Rev.15G8 EX+ (6.98) . SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Knaub, Inez M. FILE NUMBER 21-07 -0837 ESTATE OF Include the proceeds of litigation and the date the proceeds were received by the estate. All property Jolntly-owned with the right of survivorshIp must be disclosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 BELCO Community Credit Union. checking account #30120 2.356.18 2 BELCO Community Credit Union. Christmas Club #30120 828.31 3 BELCO Community Credit Union. savings account #30120 5.091.10 4 M&T Bank. checking account #1332244 28.47 5 Metlife Bank Money Market Account 33.804.79 TOTAL (Also enter on Line 5, Recapitulation) 42.108.85 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 ScheduleE (Rev. 6-98) 11 M&fBank 499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12 Phone (888) 502-4349 Fax (302) 934-2955 September 27, 2007 Schrack & Linsenbach Attorneys At Law 124 W Harrisburg Street POBox 310 Dillsburg, Pennsylvania 17019-0310 Re: Estate of: Inez M Knaub Social Security: 197-22-1900 Date of Death: AUIlUst 24. 2007 Dear Sir or Madam: Per your inquiry dated september 25, 2007, please be advised that at the time of death, the above-named decedent bad on deposit with this bank the following: 1. Type of Account Checking Account Account Number 1332244 Ownership (Names of) Inez M Knaub · Opening Date 01/03/97 Qosed 09/13/07 Balance on Date of Death $ 28.47 $ 0.00 Accrued Interest Total $ 28.47 Please be advised, there was no safe deposit box found for the above decedent. * H upon reviewing the infonnation above, you believe there are additional accounts not referenced, please provide us with an account number and/or the name of any possible joint account holder. For any additional information on the above accounts, including ownership and any changes, closures and/or reimbursement of funds, please call the Dillsburg Office # 717-432-2850. Sincerely, ~~ Nancy Clagett Records Management .' ".c./" '/' BELCO COMMUNITY CREDIT UNION 1. Name(s) in which the account was held: DECEDENT ESTATE INFORMATION INEZ M. KNAUB(PRIMARY) 2. Account number: 30120 3. Balance as of date of death: 8/24/2007 Balance Accrued Dividends YTD Dividends For 8/24/2007 Regular Savings: $ $5,091.10 $ $30.87 $ $38.96 Ch~stmas Club: $ $828.31 $ $2.94 $ $4.16 Whatever Club: $ $ $ Checking: $ $2,356.18 $ $2.28 $ $2.89 Money Market: $ $ $ IRA: $ $ $ Certificates: Balance Accrued Dividends YTD Dividends For L- Certificate Number $ $ $ $ $ $ $ $ 4. Date the account was initiated: 5/13/1963 5. Name(s) in which Safe Deposit Box was held: N/A 6. Date the box was initially rented: N/A 7. Branch address at which the box is located: 8. Loan Information: Balance Accrued Interest Per Diem Int VISA Unsecured Loans: $ $ B. Secured Loans $ $ C. Mortgage Loans: $ $ $ $ $ $ Miscellaneous: MAs D & BARRICK -ADVISORY: INC.- INDEPENDENT FINANCIAL ADVISORS - . September 26, 2007 .--- ~ .-. .,-...-....--- .. Mr. William D. Schrack III Schrack & Linsenbach Law Offices 124 W. Harrisburg St. P.O. Box 310 Dillsburg, P A 17019 -- - _.. .'-- -----,~.., .._- Mr. Schrack, _ .___ __._ .,.__ __...._______n_.___._. - - _u.. ____ ._~__ _ _ _". Below you will fmd the account information you requested for the Estate of Inez M. Knaub as of the date of her death August 24,2007. ." . _... ---.-,.. ,.---- - .------.--..-.--.------- --- - 0'- _. _._.'_"'_ .____ -- -.... --..-.. '.- -- ----. ----- - -- - - - . .. ---.< - ..,-- .- The name on her account opened May 22, 2007 is: Inez M. Knaub, Charles M. Knaub POA. .--.--.- -... - .--_.. -...-_.-.--_..-..--- Included in this account: -Cash value of -$551.24; -Metlife Bank Money Market Account value of $33,804.79; -Van Kampen High Yield Fund Class A value of $92,595.90; -Van Kampen PA Tax Free Income Class A value of $20,283.69. Please let me know if you have any questions or need this information clarified. .______ ____._____u --. - -. - _. -.., ... Sincerely, ~~ Audrey Myer Sales Assistant to Stacey Gibble Barrick, CFP @ 'v ___. - __:~a~b. Inez Wm Schrack Sept 07 _ u___ 3461 Market St., Suite 102, Camp Hill, PA 17011 Tel. 717-761-6606 Fax 717-761-7524 www.maslandandbarrick.com _ ____ ___ .___ Securities offered through Walnut Street Securities, Inc. Member NASD, SIPC Masland & Barrick Advisory, Inc. and Walnut Street Securities are unaffiliated entities. REV-1151 EX+ (12-99) . SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Knaub, Inez M. Debts of decedent must be reported on Schedule I. FILE NUMBER 21-07 -0837 ESTATE OF ITEM NUMBER A. FUNERAL EXPENSES: DESCRIPTION AMOUNT See continuation schedule(s) attached 8,314.49 1. ADMINISTRA nVE COSTS: Personal Representative's Commissions B. Charles Paul Knaub Rodney Knaub Social Security Number(s) I EIN Number of Personal Representative(s): 192-30-0287 Street Address 719 Range End Road City DIIIsburg State Year(s) Commission paid 2007 PA Zip 17019 7,200.00 2. Attomey's Fees Wm. D. Schrack III 4,500.00 3. Family Exemption: (If decedent's address is not the same as claimanfs, attach explanation) Claimant Street Address City Relationship of Claimant to Decedent State Zip 4. Probate Fees 310.00 5. Accountanfs Fees 6. Tax Retum Preparer's Fees 7. Other Administrative Costs See continuation schedule(s) attached 779.75 TOTAL (Also enter on line 9, Recapitulation) 21 ,104.24 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1502 EX+ (6-98) . SCHEDULE H.A FUNERAL EXPENSES continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Knaub, Inez M. FILE NUMBER 21-07 -0837 ESTATE OF ITEM NUMBER DESCRIPTION AMOUNT 1 Baughman Memorial - gravemarker engraving 275.00 2 Cocklin Funeral Home 8.039.49 Subtotal 8.314.49 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-A (Rev. 6-98) Rev.1502 EX+ (6.98) . SCHEDULE H-B7 OTHER ADMINISTRATIVE COSTS continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Knaub, Inez M. FILE NUMBER 21-07 -0837 ITEM NUMBER DESCRIPTION AMOUNT 1 Cumberland Law Journal - estate advertisement 75.00 2 Dillsburg Banner - estate advertisement 81.75 3 Miscellaneous expense during administration (postage, copies, etc.) 25.00 4 Register of Wills - additional Short Certificates 8.00 5 Register of Wills - filing fee 15.00 6 Reserve for future administrative expense 250.00 7 Reserve for income tax liability 250.00 8 Tax Return preparation fee 75.00 Subtotal 779.75 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 ScheduleH-B7 (Rev. 6-98) REV 1513 EX+ (9-G0) . SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX. RETURN RESIDENT DECEDENT NUMBER Knaub, Inez M. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal ctistributionsA and transfers under Sec. ~116(a)(1.2)] RELATIONSHIP TO DECEDENT Do Not List TNsteels) FILE NUMBER 214J74J837 SHARE OF ESTATE AMOUNT OF ESTATE (Words) ($$$) ESTATE OF I. Delores Dutill 5 Cardinal Drive Plymouth Meeting, PA 19462-1915 Sister Charles P. Knaub 719 Range End Road Dillsburg, PA 17019 Brother Richard L. Knaub 428 Bethany Drive Mechanicsburg, PA 17055 Brother Rodney Knaub 1791 Valley Vista Drive York, PA 17406 Nephew Margaret Shoffner 117 N. York Road Dillsburg, PA 17019 Sister Total Enter dollar amounts for distributions shown above on lines 5 through 18, as appropnate. 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 See continuation schedule(s) attached 13,388.42 TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 13,388.42 Copyright (c) 2002 form software only The Lackner Group. Inc. Form PA-1500 ScheduleJ (Rev. 6-98) Rev-1S02 EX+ (6-98) . SCHEDULE d.IIB CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS continued COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Knaub, Inez M. FILE NUMBER 21-07 -0837 ESTATE OF ITEM NUMBER 1 DESCRIPTION United Methodist Church of Dillsburg . bequest (10% of residuary estate) AMOUNT 13.388.42 Subtotal 13.388.42 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 ScheduleJ-IIB (Rev. 6-98)