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Home My WebLink About02-0005REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA PETITION FOR GRANT OF LETTERS Estate of Kathryn Krause Zeiters -~. No. also known as Kath~n K. Zeiters J Raymond W. Zeiters Petitioner(s), who is/are 18 years (~z~r older, apply)ies) for: (COMPLETE "A" OR "B" BELOW:) , Deceased So"Cial Security No. 181-32-4941 A. Prob~at[~ and Gr~_nt of Letters and aver that Petitioner(s) is/are the Decedent, dated 't-.[(:::~o._~P.._~ \~J2 [ \o~ and codicil(s) dated execut o~.. '~ named in the Last Will of the I//Ill t ~ ~ ~ ~" ' State relevant circumstances, e.g., renunciation, death of executor, etc Except as follows, Decedent did not marry, was not divorced and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incapacitated: B. Grant of Letters of Administration (c.t.a., d.b.n.c.t.a.: pendente lite, durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained the Decedent left no Will and was survived by the following spouse (if any) and heirs: Name Relationship Residence (COMPLETE IN ALL CASES:) ,Atta~:h ~additional sheets if necessary. Decedent was domiciled ~t.death ir~ Cumberland County, Penn. sylvania, with his/her last family or principal residence at 325 Wesley Drive, Apartment 1~'6, Mechanicsburg, PA 17055 / ~' (Fist street, number and municipality) ..... Decedent, then 88 years of age, died December 26 ,2001 , at East Pennsboro Township~ Cumberland County - (Location) Decedent at death owned property with estimated values as follows: (if domiciled in PA All personal property ......................................... $ ~-t~C)t (,.~..~ (if not domiciled in PA " Personal property in Pennsylvania .................... $ (if not domiciled in PA Personal property in C~unty .............................. $ Value of real estate in Pennsylvani-~ ........................................................................................ $ Total ..................................................................................................................... $ Real Estate situated as follows: None 0.00 Wherefore, Petitioner(s) respectfully request(s) the probate of the Last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: i Typed or printed name and residence Signature .,,_ , / / t Raymond W. Zeiters 124 Holly Street Hummelstown, PA 17036 Oath of Personal Representative Commonwealth of Pennsylvania County~of The Petitioner(s) a,bove-named swear(s) and affirm(s) that the statements in the foregoing Petition are true and correct to the best of the ,know!edge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. Sworn to and affirmed and ~ubscriSed: C. ,Lewis) \. ,. DECREE OF REGISTER Estate of KathrYn Krause Zeiters ,~ \ also known as Kathryn K. Zeiters ~' 'Social Security No: 181-32-4941 AND NOW, January- '4 th , 2002 , reverse side.hereon;, satisfactory proof havingbeen presented before me, IT IS DECREED that Letters I~ Testamentary I~ of Administration are hereby gran[ed to Raymond W. Zeiters , 5r. Deceased No. 21-2002-0005 Date of Death: December 26, 2001 , in consideration of the Petition'on the ((c.ta., d.b.n.c.t; pendente lite; durante absentia; durante minoriate) in the above estate and that the instrument(s), if any, dated November 16, 1993 ~ ...'-; ,descr bed in the:Petition .be adm tted to probate, and filed-6f-record as the ,Last ,Will .of Dec~de~nt.. · ,:i:.. ~. ~ .... ' ~... FEES Letters .................................... $. 200.00 Short Certifi.cate;(s)'.:.'..]:..2. ................ $ 36 Renunciation .......................... $ ExtraPages ( 4 ) ............... $ 12o00 I.T.R ....................................... $ JCPFee ................................. $. 5.00 Inventory ................................$ Other ...................................... $ TOTAL ............................. $. 253.00 Signature Attorney: James Ri Clippinger, Esquire ~ I.D. No: 07159 Address: 3631 North F¢ont Street Harrisburg PA 17110 Telephone: (7.17)'232-7661 DATE FILED: ,-I'an]]a-ry '~TTI: 2f1(37 MAILED LETTERS TO A~IORNEY REGISTER OF wILLS OF CUMBERLAND COUNTY, PENNSYLVANIA (each) a subscriber hereto, (each) being duly qualified according to law, dePose(s) and say(s) that familiar with the signature of Kathryn K. 7eiters , testat rix of(one of the codicil subscribing witnesses to)th~?resented herewith and that codicil ~ lb ' [,-~"~ ~S in the handwriting of I,.,~'F¢r~,~t [,~. to the best of knowledge and belief. S wom to or affirm ed and sub- Q ~ m_.tJ .~. scribed before me this (3z~:l'dayof ~/ [~..~ 6~ · ' ~ (Address) ' ' '/" ~}"~: / "k~ ~B~~ (Address) believes the signature, on the 21-2002-0005 LAST WILL AND TESTAMENT OF KATHRYN K. ZEITERS I, KATHRYN K. ZEITERS, single woman, of the Township of Lower Allen, Cumberland County, Pennsylvania, being of sound mind, memory and understanding, do make and publish this my Last Will and Testament, hereby revoking and making void all former Wills by me at any time heretofore made. ITEM I. I. nominate, constitute and appoint my brother, Raymond W. Zeiters, Jr., as the Executor of this, my Last Will and Testament. In the event of renunciation, death, resignation or inability to act for any reason whatsoever of my brother, Raymond W.~ Zeiters, Jr-., I nominate, constitute and appoint my nephew, Jam~s R. Clippinger as the Executor of this my Last Will and Testament. My Executor shall not be required to post bond or give any other security. ITEM II. I direct that my Executor, hereinbefore named, shall pay all inheritance, estate;-' sUcCession and legacy taxes to which my estate or the transfer of any property hereunder may be subject and to charge such taxes as part of the administration of the estate, payable out of the residuary estate. I further direct that my Executor shall pay all other of my just debts as soon as ma'y cOnveniently be done after my decease. Said Executor shall also serve as the guardian of the property of any minor beneficiarY where guardianship is required under the-statutes of the Commonwealth of Pennsylvania. ITEM III. I hereby give, devise and bequeath of all of the rest, residue and remainder of my estate, whether real, personal or mixed, and wheresoever situate, unto my nieces and nephews as hereinafter provided. If any niece or nephew of mine should predecease me, leaving issue (whether born or adopted), surviving my death, that issue shall take the parents' share, per stirpes. My residuary estate shall, .therefore, be distributed as follows: a. One-eighth (1/8) share of my estatethereOf unto my nephew, Ronald L. Deck; b. One-eighth (1/8) share of my estate thereof unto my nephew, James Richard Clippinger; c. One-eighth (1/8) share of my estate thereof unto my niece, Barbara L. Clippinger Lewis; d. One-eighth (1/8) share of my estate thereof unto my nephew, John Roderick Clippinger; e. One-eighth (1/8) share of my estate thereof unto my nephew, Hamilton vanHorn; f. One-eighth (1/8) share of my estate thereof unto my niece, Stephanie J. Zeiters Nordai; e. Two-eighths (2/8) share of my estate thereof unto my niece, Kathryn E. Zeiters Giese. If a niece or nephew of mine shall predecease me without leaving issue to survive my death, the share of that niece or nephew shall be distributed among my other nieces and nephews and the issue of any deceased nieCe or nephew, per stirpes, as the case may be. ITEM IV. In the event that my Executor must also serve as-the ~guardian of the property of any minor beneficiary hereunder, my Executor shall invest and reinvest the monies coming into his hands in such investment securities as are legal under the laws of the Commonwealth of Pennsylvania. Unless otherwise provided for herein, any income or principal payable to any beneficiary who is a minor or to any beneficiary who, in the sole judgment of my Executor, is mentally or physically incapacitated, shall be held in trust by said Executor, during such minority or incapacity. Said Executor/Trustee is authorized, in his exclusive discretion, to expend from income or principal such sum or sums as maY be necessary for the proper care, maintenance and support of such minor or incapacitated beneficiary, directly, without the intervention of any other guardian or committee; or Executor may pay the same to any person having care or control of said beneficiary or with whom the beneficiary resides, without any duty on the part of the Executor to supervise or inquire into the application of the funds by any persons to whom payment is so made. Any income and principal not so expended by the Executor/Trustee shall be retained by Executor/Trustee.and paid to the beneficiary upoh the termination of the incapacity~:(or, minority), or to the estate of the beneficiary if. he or'she'dies before~reaching~the age of the' beneficiary~if he or she dies before.~reaching,.·the age of majority while still incapacitated, as the case may.be. IN WITNESS WHEREOF, I have hereunto set my hand this /6 day J t Katb~ryn .K. ~iters The preceding instrument, consisting of this, and four other typewritten pages, was on the date thereof signed, published and declared by KATHRYN K. ZEITERS, the Testatrix therein named, as and for her Last Will, in the presence of us, who at her request, in her presence and in the presence of each other, have subscribed our names as witnesses hereto. ~~ ~ ~~ Residing at G:~DATA~JRC~01698~93531~23228.1' 21;2002-0005 LAST WILL AND TESTAMENT OF KATHRYN K. ZEITERS CALDWELL & KEARNS PROFESSIONAL CORPORATION ATTORNEYS AT LAW 3631 NORTH FRONT STREET HARRISBURG, PENNSYLVANIA 17110-1533 CARL G. WASS JAMES R. CLIPPINGER CHARLES J. DEHART. III JAMES D. CAMPBELL, JR. JAMES L. GOLDSMITH STANLEY J. A. LASKOWSKI JEFFREY T. McGUlRE* DOUGLAS K. MARSICO BRETT 1,4. WOODBURN DOUGLAS E. HERMAN RAY J. MICHALOWSKI *ALSO A MEMBER OF NJ BAR CALDWELL ~. KEARNs A PROFESSIONAL CORPORATION ,,../ ATTORNEYS AT LAW 3631 NORTH FRONT STREET HARRISBURG, PENNSYLVANIA 1711'0-1533 March 5, 2002 OF COUNSEl' THOMAS D. CALDWELL, JR. RICHARD L. KEARNS 717 - 232 - 7661 FAX: 717- E32-:~766 thefirrn@caldwellkearns.corn Office of the Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013-3387 RE: Estate of Kathryn K. Zeiters No. 2002-0005 Date of Death: December 26, 2001 Dear Sir or Madam: I am enclosing herewith the following: 1. A check made payable to you in the amount of $95,000:00 advance deposit against Pennsylvania inheritance tax. as an 2. A self-addressed, stamped envelope for your conVe.n, ience returning a receipt. 'k Thank you for your cooperation. ;: Very truly yours, . .~Hart, III · CALDWELL & KEARNS CJDIII:nb /Enclosures 02-06/36920-1 in COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 171:28-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 000923 CHARLES J DEHART III ESQUIRE 3631 N FRONT STREET HARRISBURG, PA 17110-1533 ........ fold ESTATE INFORMATION: SSN: 181-32-4941 FILE NUMBER: 2102- 0005 DECEDENT NAME: ZEITERS KATHRYN K DATE OF PAYMENT: 03/05/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUM BERLAN D DATE OF DEATH: 1 2/26/2001 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $95,OOO.OO TOTAL AMOUNT PAID: $95,000.00 REMARKS: CHARLESJ DEHARTIII ESQUIRE SEAL CHECK//1 O0 INITIALS: CW .RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Katl-c'yn K. Zeiters Date of Death: 12/26/01 Will No. 2002-00005 Admin. No. PA No. 21-02-0005 To the Register: I certify that notice of (beneficial interest) estate administration 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 Febrnnry 0z~, 2002 : Name Address Hamilton William VanHorn P.O. Box 60734, Boulder City, NV 89006 Stephanie Nordai Ronald Lee Deck 56 Deller Drive, Shippensburg, PA 17257 400 Hamilton Street, State College, PA 16801 KathrynGiese Rod Clippingpr 6427 Rotunda Court, Springfield, VA 22150 30 ~ricker _r~ix~; ¥o~k Faven~ PA 17370 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except N/A Date: April 9, 2002 Address 3631 North Front Street Harrisburg, PA 17110 Telephone (71 7) 232-7661 Capacity: __ Personal Representative X Counsel for personal representative COMMONWEALTH OF PENNSYLVANIA ~PARTMENT OF REVENUE 8~JREAU OF INDIVIDUAL TAXES J~/ O ~'P~T. 280601 ~.. {, I~/ARRI,SBURG, PA 17128-O601 RECEIVED FROM: PENNSYLVANIA` INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX(11-96) NO.. CD 001458 CLIPPINGER JAMES R. 3631 NORTH FRONT STREET HARRISBURG, PA 17110 ACN -. i ~"'"" .... -'.?;-';:~S~SSMFSiT· · AMOUNT - " --' NUMBER ......... ~ ESTATE INFORMATION: SSN: 181-32~4941 FILE NUMBER: 2102-0005 DECEDENT NAME: ZEITERS KATHRYN K DATE OF PAYMENT: 07/30/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: '12/26/2001 101 $33,250.00 CHECK//20330731 '/ ' ' / INITIALS: JA SEAL / RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS VOIDED - CREDITED TO WRONG ESTATE SHOULD BE LOUISE K. JORDAN 21-2002-472 ~,. ~ .-'~,~ o~ ,,~,~,~ , DEF~8060 ~ ~ HARBISBURG PA 17128~601 RECEIVE~ FROM: PENN§~;LV/~,~i,~',' . INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD REV-1162 EX(11-96) 001480 ALLFIRST BANK & TRUST CO OF PA 213 MARKET STREET HARRISBURG, PA 17105 I ACN i ............. · ........................ -'17_ ..... 'A~SESSMENI .... ' ^M~, ,~T ..... - .... NUMBER -..' ........ fold ESTATE INFORMATION: SSN: 174-20-7446 FILE NUMBER: 2102-0472 DECEDENT NAME: JORDAN LOUISE K DATE OF PAYMENT: 08/06/2002 POSTMARK DATE: 07~30~2002 COUNTY: CUMBERLAND DATE OF DEATH: 05/03/2002 101 $33,250.00 CHECK//20330731 INITIALS: JA SEAL RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS SEE '~DID - CD 1458 WRONG ESTATE Address Page No. Estate No. 21 - Social Security No. Died 1 2- 2. Lo__- O I Paid. Postmark Date__~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA ' INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ¸NO. REV-1162 EX(11-96) CD 001457 CLIPPINGER JAMES R 3631 NORTH FRONT STREET HARRISBURG, PA 17110 ........ fold ESTATE INFORMATION: SSN: 181-32-4941 FILE NUMBER: 2102- 0005 DECEDENT NAME: ZEITERS KATHRYN K DATE OF PAYMENT: 07/30/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 12/26/2001 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $473.33 TOTAL AMOUNT PAID: $473.33 REMARKS: SEAL CHECK# 1010 INITIALS: JA RECEIVED BY: REGISTER O~ WILLS MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA INVENTORY Estate of Kathryn K. Zeiters also known as No. c~ I - 003. -,~ Date of Death DeCember 26~ 2001 , Deceased Social Security No. 181-32-4941 Personal Representative(s) of the above Estate, deceased, vedfy 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 the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I/We verify that the statements made in this inventory are true and correct. I/We understand that false statements herein made are subject to the penalties of 18 Pa. C.S. Section 4904 relating to unswom falsification to authorities. Name of Attorney: Charles J. DeHart~ II1~ Esquire I.D. No.: 15617 Address: 3631 North Front Street Harrisburg PA 17110 Personal Representative: Telephone: (717) 232-7661 1. PNC Bank Accounts: Description (a) Certificate of Deposit #31900119048 - Date of death principal balance Accumulated interest (b) Certificate of Deposit #31100152085 - Date of death principal balance Accumulated interest (c) Certificate of Deposit #31100203003 - Date of death principal balance (Attach Additional Sheets if necessary) Total Value 12,197.31 27.78 11,447.15 25.15 5,298.66 '541,922.47 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such tigur~s should not be extended into the total of the Inventory. RW.4 Kathryn K, Zeiters Description of Inventory Accumulated interest Continuation of Inventory Pa§e 1 Descdpfion (d) Checking Account #5080032354 - Date of death principal balance Accumulated interest Value 6.24 16,053.58 1.46 (e) Savings Account #5080033744 - Date of death principal balance Accumulated interest 2. Fulton Bank Accounts: (a) Certificate of Deposit #161-0058789, Date of death principal balance Accumulated interest (b) Certificate of Deposit #161-0089308, Date of death principal balance Accumulated interest 3. Allfirst Financial Accounts: (a) Certificate of Deposit #-87008001154653, Date of death principal balance Accumulated interest (b) Certificate of Deposit #87008001154769, Date of death principal balance 4,613.80 0.00 21,505.36 303.48 17,853.60 871.40 27,754.67 629.80 25,212.38 Subtotal $ 114,805.77 ,~ Continuation. of. Inventory Kathryn K. Zeiters Description of Inventory Page 2 Accumulated interest Description (c) 11,274 shares of Allied Irish Banks, p.l.c, stock, at $22.55 per share 4. Household goods 5. U.S. Savings Bonds - Gross proceeds 6. PNC Brokerage Account ~8994-4206: (a) 896.78 shares of Blackrock FDS (091027814) @ $13.90 per share 000.0275 Dividend (b) 1765.5800 shares of Blackrock FDS (091928366) @ $10.41 per share Dividend 7. Miscellaneous household goods - appraised value Subtotal Grand Total Value 476.76 254,228.70 855.00 110,821.20 12,465.24 24.66 18,379.69 14.40 855.00 $ 398,120.65 $ 541,922.47 REV-,500 EX + (600) ~ I REV-1500 PENNSYLVANIA DEPARTMENT OF REV .UE INHERITANCE TAX RETURN DEPT. 280601 HARR.SBURG. PA 1712 0601 ' RESIDENT DECEDENT DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) K. DATE OF DEATH (MM-DD-Year) I DATE OF BIRTH (MM-DD-Year)' .12/26/2001 I 10/22/1913 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) None OFFICIAL USE ONLY FILI~ ~-~MBER .... i -._o_ 5_ CouNr~Y CODE YEAR NUMBER SOCIAL SECURITY NUMBER I 8 1-3 2-4 9 4 1~ THIS RETURN MUST BE FILED IN DUPUCATE WITH THE REGISTER OF WILLS SOCIAL SECURITYNUMBER [~11. Original Return 4. Limited Estate r~16. Decedent Died Testate (Attach copy of Will) D 9. Litigation Proceeds Received D2. Supplemental Return [~4a. Future Interest Compromise (date of dea~ a~r ~2.12.82) --17. Decedent Maintained a Living Trust (Aaach copy of Tn~'t) D10. Spousal Pove~ Credit (da of ~ea~ ~ 12-31-91 and 1-1-95) ~-"~ 3. RemainderRetum (dateofdeathpri~to1243-82) [~15. Federal Estate Tax Retum Required 1__ 8. Total NuroberofSafe Deposit Boxes [-'1 11. Election to tax under Sec, 9113(A) ¢~t~h Sch O) NAME Charles J. DeHart, III, Esquire FIRM NAME (If Applicable) CALDWELL & KEARNS TELEPHONE NUMBER 232-7661 COMPLETE MAILING ADDRESS 3631 North Front Street Harrisburg 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) r~ Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Exl~enses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (8) (11) (12) (13) (14) 145;1~33.58 254,117.71 PA' 17110 795,185.18 29,4i2.35 786.60 30,198.95 764,986.23 55,425,60 709,560.63 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20. X X 198,692.01 x .12 510,868.62 x .15 (15) (16) (17) (18) .... (19) 23,843.04 76,630.29 100,473.33 Decedent's complete Address:. STREETADDRESS Mechanicsburg Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A, Spousal Poverty Credit B. Prior Payments C. Discount Interest/Penalty if applicable D. Interest E. Penalty ISTATE PA 95.000.00 5.000.00 (1) (3) (4) (5) (5A) 100,473.33 Total Credits ( A + B + C ) (2) zip 17055 Total Interest/Penalty ( D + E ) 100,000.00 4. If Une 2 is greater than Une 1 + Une 3, enter the difference. This is the OVERPAYMENT. .. Ched( box on Page 1 Une 20 to request a refund 5. If Une 1 + Une 3 is greater than Line 2, enter the difference. Thi§ is the TAX DUE. A. Enter the interest on the tax due, 0.00 473.33 473.33 B. Enter the total of Line 5 + 5A. This is *he BALANCE DUE. (5B) Make Check Payab/e 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 properly transferred; ........................................................................... [] [] retain the right to designate who shall use the property transferred or its income; [] [] c. retain a reversionary interest; or ............. · ......................................................................................... [] [~] "~t!' receive the ~rom se for fe of ether payments, benefits or care? ............................................................. . [] [] .(2.~. Jf. death.occurredafter, December 12, 1982, did decedent transfer properly within one year of death , ~ i ,,.with°ut'receiving a~e¢l, uate consideration? .............................................. [] [] 3. Did decedent own an' n 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 PART OF THE RETURN. Under penalties of penury, I declare that t have examined this return, including accompanying schedules and slatements, and to the besl of my knowledge and belief, it is line, correcl and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. ~,TURE OF PERSON RE.,..~/~~TURN DATE SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE "~ ~ CharlesJ. DeHart III ADDRESS ~' 3631 North Front Street Hr~rrisbllrO. pc, nne.¥1v~ni.~ 1'711 For dates of death on or ~er July 1, 1994 and before Janua~ 1, 1995, the t~ rate im~s~ on the net value of transfers to or for the use of the su~iving s~use is 3% F2 P.S. ~9116 (a) (1.1) (i)]. For dates of death on or after Janua~ 1, 1995, the t~ rate im~s~ on the net value of transfers to or for the use of the su~iving s~use is 0% F2 P.S. {9116 (a) (1.1) (ii)I. The statute d~ not exempt a transfer to a su~iving s~use from t~, and Be statuto~ r~uirements for disclosure of assets and filing a t~ return are s~ll applicable even if the su~iving s~use is the only ~neficia~. For dates of death on or ~er July 1, 2~0: ........ The t~ rate im~s~ on the net value of transfem from a d~as~ child ~en~ne years ¢ age or younger at death to or for the use~ natural parent, an ad~i~ parent, or a steppa~nt of the child is 0% F2 P.S. ~9116(a)(1.2)]. The t~ rate im~sed on the net value of transfem to or for the use of the d~ent's lineal beneficiad~ is 4.5%, except as not~ in72 P.S. ~9116(1.2) ~2 P.S. {9116(a)(1)]. The t~ rate im~s~ on the net value of tBnCeB to or for Be use of the d~ent's siblings is 12% F2 P.S. ~9116(a)(1.3)]. A sibling is define, under S~tion 9102, as an individual who h~ at least one parent in ~mmon with Be d~ent, whether by bl~ or adoption. REV-l~03 EX + (1-97) COMMONW~LTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DE~DEI~ SCHEDULE B STOCKS & BONDS ESTATE OF FILE NUMBER Zeiters. Kath _ryn K. All property joint¥owned wilh right of sun~ivomhip must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION 11,274 shares of common stock of Allied Irish Bank, at $22.55 per share PNC Brokerage Account #8994-4206: (See attached statement) (a) 896.78 shares of Blackrock FDS (091027814) @ $13.90 per share 000.0275 Dividend (b) 1765.5800 shares of Blackrock FDS (091928366) @ $10.41 per share Dividend U.S. Savings Bonds - See attached statement - Gross redemption proceeds TOTAL (Also enter on line 2, Recapitulation) VALUE AT DATE OF DEATH 254,228.70 12,465.24 24.66 18,379.69 14.40 110,821.20 395~933.89 (Ifmorespa~isn~d~,inse~additionalsheetsofthesamesize) REV-1508 EX + (1-97)f ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Zeiters. Kathryn K. FILE NUMBER Include the proceeds of litigation and the date the proceeds were received by the estate, All proper jointJy-owned with the right of survivorship must be disdosed on Schedule F. ITEM NUMBER DESCRIPTION PNC Bank Accounts: (See attached statement) (a) Certificate of Deposit #31900119048 - Date-of-death principal balance Accumulated interest (b) Certificate of Deposit ~h31100152085 - Date-of-death principal balance Accumulated interest (c) Certificate of DePosit #31100203003 - Date-of-death principal balance Accumulated interest (d) Checking Account #5080032354 - Date-of-death principal balance Accumulated interest (e) Savings Account #5080033744 - Date-of-death principal balance Accumulated interest Fulton Bank Accounts: (See attached statement) (a) Certificate of Deposit #161-0058789 - Date-of-death principal balance Accumulated interest (b) Certificate of Deposit #161-0089308 - Date-of-death principal balance Accumulated interest TOTAL (Also enter on line 5, Recapitulation) VALUE AT DATE Of DEATH 12,197.31 27.78 11,447.15 25.15 5,298.66 6.24 16,053.58 1.46 4,613.80 21,505.36 303.48 17,853.6O 871.40 145r133.58 (Ifmorespamisn~d~,insedadditionalsheetsofthesamesize) Continuation of REV-1500 Inheritance Tax Return Resident Decedent Zeiters, Kathryn K. ' Pa,qe 1 Schedule E - Cash, Bank Deposits, & Misc. Personal Property ITEM VALUE AT DATE NUMBER DESCRIPTION · OF DEATH 3. AIIfirst Financial Accounts: (See attached statement) (a) Certificate of Deposit #87008001154653, Date-of-death principal balance Accumulated interest (b) Certificate of Deposit #87008001154769, Date-of-death principal balance Accumulated interest Miscellaneous household goods and furnishings - appraised value (See attached statement) 27,754.67 629.80 25,212.38 476.76 855.00 SUBTOTAL SCHEDULE E 54,928.61 GRAND TOTAL SCHEDULE E $ 145,133.58 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER Zeiters. Kathryn K. If an asset was made joint within one year of the decedents date of death, it must be reported on Schedule G. · SURVIVING JOINT TENANT(S) NAME ADDRESS .-RELATIONSHIP TO DECEDENT A. None C JOINTLY-OWNED PROPERTY: LI: I I ER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH ITEM FOR JOINT MADE Include name of financial institution and bank account number or similar identi~ng number. Attach DATE OF DEATH DECD'S, VALUE OF NUMBER TENANT JOINT deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTERES TOTAL (Also enter on line 6, Recapitulation) $ (If more space ~s needed, insert additional sheets of the same size) REV-1510 EX + (1-97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF Zeiters. Kathrvn K. FILE NUMBER This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET ~s les. DESCRIPTION OF PROPERTY % OF ITEM INCt. UDE THE NAME OF ~ TRANSFEREE. THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE NUMBER ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST 1. Glenbrook Life and Annuity Company - Annuity Contract 66,649.32 100. 66,649.32 GA206164 - Beneficiary- Raymond Zeiters (brother) (see attached statement) 2. Lutheran Brotherhood Accounts, payable to Raymond Zeiters (brother) (see attached statement) (a) 403-B Plan, Account No. 6563413 11,065.22 100.. 11,065.22 (b) Individual Account No. 044499 120,977.57 100. 120,977.57 3. Wesley Affiliated Services Foundation Charitable Gift 55,425.60 100.. 55,425.60 Annuity, payable to Bethany Village Care Assurance Endow- ment Fund (see attached statement) ·. TOTAL (Also enter on line 7, Recapitulation) $ 254~117.71 (If more space is needed, insert additional sheets of the same size) EV-t511EX * (1-9Z} ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Zeiters. Kathrvn K. Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION FUNERAL EXPENSES: ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Raymond Zeiters Social Security Number(s) / EIN Number of Personal Representative(s) Street Address 124 Holly Street city Hummelstown State PA Year(s) Commission Paid: Attomey Fees Caldwell & Kearns Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Zip 17036 Sffeet Address City State Zip Relationship of Claimant to Decedent Pmbete Fees Accountant's Fees Tax Retum Preparer's Fees Carlisle Sentinel - legal advertising Cumberland Law Journal - legal advertising TOTAL (Also enter on line 9, Recapitulation) $ AMOUNT 25,000.00 3,000.00 1,250.00 87.35 75.00 29r412.35 (If more space is needed, insert additional sheets of the same size) REV-fSi2 EX ~{1-67) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF Zeiters. Kathrvn K. FILE NUMBER Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION Bethany Village Apartments - final statement TOTAL (Also enter on line 10, Recapitulation $ (If more space is needed, insert additional sheets of the same size) AMOUNT 786.60 786.60 ~-v4513 EX * (~e~ ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATEOF Zeiters. athryn K, NUMBER I.. 1. 2. 3. 4. 5. 6. 7. FILE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (include outright spousal distributions) Raymond W. Zeiters, Jr. Hummelstown, PA Hamilton W. YanHorn Boulder City, NV Stephanie Nordai Shippensburg, PA Barbara Lewis Lemoyne, PA Ronald Deck State College, PA Kathryn Giese Springfield, VA Rod Clippinger York Haven, PA RELATIONSHIP TO DECEDENT Do Not Ust Trustee(s) Brother Nephew Niece Niece Nephew Niece Nephew ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE AMOUNTORSHARE OF ESTATE 198,692.01 12.5% residuary 12.5% residuary 12.5% residuary 2.5% residuary '.5% residuary 12.5% residuary ON REV 1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE ' Bethany Village Care Assurance Endowment Fund B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART I! - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET 55,425.60 55~425.60 (Ifmorespa~isneed~,insedadditionalsheetsofthesamesize) , , · ContinUation of REV-1500 Inheritance Tax Return Resident Decedent Zeiters, Kathryn K. Schedule J - Beneficiaries - 1 Paqe 2 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Ust Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS (include outdght spousal distributions) 8. James R. Clippinger Nephew 12.5% residuary Mechanicsburg, PA BUREAU OF TNDIVTDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COHNONNEA~TH~OF PENNSYLVANXA DEPARTHENT OF REVENUE NOTXCE OF BETERH~NATZON AND ASSESSHENT OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN REV-4$$ EX AFP (01-~) '02 ~£~ 23 CHARLES J DEHART III ESQ CALDNELL & KEARNS ~:i~;i~i.... 3631N FRONT ST ~-!~,~,,:,~ HBG PA 17110 DATE ESTATE OF DATE OF DEATH FILE NUHBER COUNTY ACN 09-23-2002 ZEITERS 12-26-2001 21 02-0005 CUNBERLAND 201 Amoun~ Remi~ed KATHRYN K HAKE CHECK.PAYABLE AND REHXT PAYHENT TO: REGISTER OF HILLS CUHBERLAND CO COURT HOUSE CARLISLE,' PA 17015 NOTE: To insure proper credi~ ~o your accoun~:~ submi~ ~he upper por~ion of ~his form wi~h your ~ax payment:. CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR FXLES ~ OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN ~ ESTATE OF ZEITERS KATHRYN K FZLE HO.Z1 02-0005 ACH 201 DATE 09-25-2002 ESTATE TAX DETERHZNATZON 5. TAX Credit For State Death Taxes as Verified Pennsylvania Inheritance Tax Assessed (Excluding Discount and/or Interest) Inheritance Tax Assessed by Other Stat~s or Territories of the Un/ted States (Excluding Discount and/or Interest) Total Inheritance Tax Assessed Pennsyivan~a Estate Tax Due 95;~75.33 .00 CREDITS: PAYHENT RECEIPT DISCOUNT (+) DATE NUHBER XNTEREST/PEN PAID (-) AHOUNT PAID 19z908.~5 95~473.$$ .00 ~IF PAID AFTER THZS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. TOTAL TAX CREDIT .00 BALANCE OF TAX' DUE I . O0 INTEREST *AND PEN. I TOTAL DUE I . O0 (IF TOTAL DUE ZS LESS THAN $1, NO PAYItENT ZS REQUIRED ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: PENALTY: INTEREST: To fulfill the requirements of Section ZlqO (b) of the Inheritance and Estate Tax Act, Act Z3 of ZOO0. (7Z P.S, Section 91q0). Detach the top portion of this-Notice and submit with your payment to the Register of gills printed on the reverse side. , --.Hake check.or money order Payable to: REGISTER OF HILLS, AGENT.. A refund bfa tax credit may be requested by completing an "Application for Refund of Pennsyivania '. Inheritance and Estate Tax".(REV-1313). Applicatlions ara available at the Office of the Register of any of the 23 Revenue District Offices or fr~m'th~ Department's Z4-hour ansmering service for forms ordering: 1-BOO-36Z-Z050; services for taxpayers with special hearing and / or speaking needs:.l-8OO-4~7-3OZO (TT only). Any party in interest not satisfied with the assessment of tax as shown on this notice may object within sixty (60) days of receipt of this Notice by: --written protedt to the PA Department of Revenue, Board of'Appeals, Dept. Z81OZ1, Harrisburg, PA 17128-10Z1, --electing to have the matter determined at audit of the personal representative, OR --appeal to the Orphans' Court. OR 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, Dept. Z80601, Harrisburg, PA 171Z8-0601, Phone (717) 787-6SOS. See page S of the booklet "Instructions for inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. The 15Z 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 end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appea~ the tax and interest that has been assessed as indicated on this notice. L . .. For dates of death on or after 10-3-91, Pennsylvanla Estate Tax based on the Federal Estate Tax return becomes delinquent at the expiration of nine (09) months from the date of death. For dates of death prior to 10-3-91, Pennsylvania Estate Tax based on the Federal Estate Tax return becomes delinquent at the expiration of eighteen (18) months from the date of death. Taxes which became delinquent before January 1, 198Z bear interest at the rate of six (BZ) percent per annum calculated at a daily rate of .00016q. All taxes which became delinquent on or after January 1, 19&Z will bear interest at a rate which will vary from calendar year to caiendar year with that rate announced by the PA -- Department of Revenue. The applicable interest rates for 198Z through ZOOZ are: Year IntereSt Rate Daily Interest Factor 1982 ZOX .O00Sq8 1983 1BI .000~38 1984 llX .000301 1985 132 .000356 1986 102 .000Z74 1987 9Z .OOOZ47 1988-1991 11Z .000301 --[nterest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID Year Interest Rate 1992 92 1993-1994 7Z 1995-1998 9Z 1999 7Z ZOO0 8Z ZOO1 9Z 2002 6Z Dail'y Interest Factor .000Z47 .O0019Z .O00Zq7 .00019Z .000219 .000Z47 .000164 X NUI~BER OF DAYS DELINQUENT X DAILY INTEREST FACTOR T-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'm~st be calculated. BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DTVZSTON DEPT. 28060! HARRISBURG, PA 17118-0601 ' ":'?*"" , '~ COHHONNEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE O~ INHERITANCE TAX APPRAISEHENT,:'ALLOHANd~;bR?DISALLOHANCE OF DEDUCTIONS AND ASSESSHENT OF TAX RE¥-1547 EX &FP (01-02) CHARLES J DEHART ZZ! ESO CALDNELL & KEARNS 3631N FRONT ST HBG ~ ~*"~ ...... *"~,~ ESTATE OF DATE OF. DEATH FILE NUHBER '02 SEP 27 P 1 : UNTY ~CN 09-Z$-2002 ZEZTERS 12-26-2001 21 02-0005 CUHBERLAND 101 Amouni: Remit:ted KATHRYN K ~ HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGTSTER-OF HILLS .. CUHBERLAND CO COURT HOUSE CARLTSLE, PA 17015 CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS ~ REV-15~7 EX AFP (01-0~) NOTICE OF INHERITANCE TAX APPRAZSENENT; ALLONANCE OR BZSALLONANCE OF DEDUCTIONS AND ASSESSNENT OF TAX ESTATE OF ZETTERS KATHRYN K FILE NO. 21 02-0005 ACN 101 DATE 09-25-2002 TAX RETURN HAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGZNAL RETURN 1. Real Es~a~e (Schedule A) (1) 2. S~ocks and Bonds (Schedule B) (~) $. Closely Held S~ock/Par~nersh~p Zn~eres~ (Schedule C) ($) ~. Nortgagas/No~es Receivable (Schedule D) (~) · $. Cash/Bank Deposi~s/~isc. Personal Proper~y (Schedule E) (5) 6. Jointly O~ned Proper~y (Schedule F)* (6) 7. Transfers (Schedule G) (7) 8. To,al Assa~s ' APPROVED DEDUCTIONS AND EXENPTZONS: 9. Funeral Expenses/Adm. Cos~s/Nisc. Expenses (Schedule H) (9) 10. Dab~s/Nor~gage Liabilities/Liens (Schedule Z) (10) 11. To,al Deductions 12. Ne~ Value of Tax Ra~urn .00 $95~,935.89 .00 .00 ' lC~5~ 155.58 .00 NOTE: To insure proper credi~ ~o your account, submi~ ihs upper portion of ~his form ~i~h your ~ax payment. 25~117.71 (8) 795,185.18 29,~12.$5 786.60 13. NOTE: (11) ~0.198.9B (12) 764,986.25 Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (13) 55, ~25.60 Ne~ Value of Es~a~e Sub~ec~ t:o Tax (1~) 709,560.65 Zf an assessment ~as issued previously, 11ne~ 1~, 15 and/or 16, ~7, 18 and 19 ~11 reflect figures that include the total of ALL returns assessed to date. ASSESSNENT OF TAX: 15. Amoun~ of Line 1~ a~ Spousal ra~a (15). 16. Amoun~ of Line 1~ taxable at Lineal/Class A ra~e (16). 17. Amoun~ of Line li a~ Sibling ra~e (17). 18. Amount of Line lq taxable at Collateral/Class B rate (18) 19. Princi)al Tax Due TAX CREDITS PAYNENT DATE RECEIPT NUNBER CDO009Z$ CD001~57 DISCOUNT INTEREST/PEN PAID (-) 5,000.00 .00 · O0 x 00 = . O0 · 00 x 0~5= ;00 198,692.01 x 1Z = 25,8~3.0~ 510,868.62 X 15 = 76,6:50.29 ,. (19)= 100,~75.$$ ANOUNT PAID 03-05-Z00Z 07-50-2002 IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 95,000.00 ~73.$$ <TOTAL TAX CREDIT BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 ZF TOTAL DUE IS LESS THAN'S1, NO PAYNENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS.) RESERVATION: puRPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: ? Estates of decedents dying on or before December 12) 198Z -- 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 ar for years, .the Commonwealth hereby expressly reserves'the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. To fulflll the requirements of Section ZlqO of the Inheritance and Estate Tax Act, Act ZS of ZOO0. (72 P.S. Section 91q0). Detach the top portion of this Notice and submit With your payment to .the Register of Hills printed on the reverse side. --Hake check or money order payable to: REGISTER OF ~ILLS, AGENT A refund of a tax credit) ~hich ~as not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-ISIS). Applications are available at the Office ' of the Register of Hills, any of the ZS Revenue District Offices, or by calling the special Iff-hour answering service far forms ordering:. 1-800-S6Z-Z050; services for taxpayers ~[th special hearing and / ar speaking needs: 1-BOO-4q7-3OZO (TT only). Any party in interest not satisfied with the.appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as sho~n on this Notice must object within sixty (60) days of receipt of this Notice by: --~rittan protest to the PA Department of Revenue, Board of Appeals, Dept. Z810Z1, Harrisburg, PA 17128-1021, ' OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed, in?writing to: PA Department of Revenue,* Bureau of Individuai Taxes,' ATTN: Post Assessment Review Unit, Dept. Z80601, Harrisburg, PA 171Z&-0601 Phone (717) 787-6503. See page S of the booklet "Instructions for'Inheritance Tax Return for a Resident Decedent" (REV-1501} for an explanation of administratively correctable errors. 'If any tax due is paid within three (3) calendar months after t~a decedant's death, a five percent (5X) discount of the tax paid is allo~ed. The 1SI 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 end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period ~s you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning ~ith first day of delinquency, ar 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 (6Z) percent per annum calculated at a daily rate of .00016q. All taxes which became delinquent On and after January 1, 198Z mill bear interest at a rate ~hich will vary from calendar year to calendar year with that rate. announced ~y the PA Department of Revenue. The applicable interest rates for 198Z through ZOOZ are: Year Interest ~ate Daily Interest Factor 1982 ZOZ , .000548 1983 167. .000438 - 1984 llZ .0O0301 1985 13Z .000556 1986 lOX .000274 1987 97. . O00Zq7 1988-1991 117. --Interest is cal'culated as follo~s: INTEREST = BALANCE OF TAX UNPAID Year Interest Rate Daily Interest Factor 1992 9Z .000247 1993-1994 ..7X - .O001gz 1995-1998 97. .000Z47 1999 7Z .000192 2000 8Z .O00Z19 .2001 9Z .000247 2002 62 .O0016q X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days b~yond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. r G~_ V~ Internal Revenue Service ~~ Cincinnati, OH 45999 Mav 7, 2003 Contact Person: Brian Kaufmann Badge Number: 17-14026 Telephone: 1-866-699-4083 (Toll Freer~Ipmbery ~;:;; Estate Tax Closing Document (Not a bill for tax duep3 I ~Ry' 14 X111 '~~7 CHARLES J DEHART III ESQ 3631 N FRONT ST HARRISBURG PA 17110 Estate Name: KATHRYN K ZEITERS Social Security Number: 181-32-4941V Date of Death: 12/26/2001 We have determined the following: NET ESTATE TAX: STATE DEATH TAX CREDIT: GENERATION-SKIPPING TAX: ~.:~:;' $ 0.00 $ 13, 078.48 $ 0.00 These figures do not include any interest and penalties that may be charged. Please keep this document in your permanent records. You may need it to complete administration of the estate, such as: close probate proceedings, transfer title to property, and settle state taxes. Keep it with your cancelled check(s) to show that you have met the estate tax obligation. Proof of payment in the amount shown above releases you of personal liability (IRC 2204). If the time for payment in the amount shown above is extended under section 6161, 6163, or 6166, personal liability is not released until full payment has been received. We will not reopen this return unless you notify us of changes to the return, or there is evidence of misrepresentation of a material fact, a clearly defined substantial error based upon an established Service position or a serious administrative omission. (See IRC 7121). Field Director, Cincinnati Compliance Service Center STATUS REPORT UNDER RULE 6.12 Name of Decedent · Kathryn K. Zeiters Date of Death' 12/26/01 Will No. 2002-00005 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' State whether administration of the estate is complete' Yes ~ 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: account with the Court ? Did the personal representative file a final 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 ?q 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 - 11/18/03 Signature Charles d. DeHart, III, Esquire Name (Please type or print ) 3631 North Front Street Harrisburq PA Address 17110 ( 717 ) -2327661 Tel. No. Capacity' Personal Representative Counsel for personal representative BUREAU OF ZNDTVTDUAL TAXES INHERITANCE TAX DIVISION DEPT. 28060! HARRISBURG, PA 17128-0601 CHARLES J DEHART CALDNELL S KEARNS 3631N FRONT ST HBG CONNONNEALTN OF pENNSYLVANIA DEPARTNENT OF REVENUE NOTICE OF DETERHZNATZON AND ASSESSNENT OF PENNSYLVANZA ESTATE TAX BASED ON FEDERAL CLOSING LETTER Reg~ot, ~ WilI~-STAT£ OF DATE OF DEATH FZLE NUNBER '0~ 'FEB 25 AS-~9NTY ACN PA 17110 Gumberiand Co., P^ 12-29-2005 ZEZTERS 1Z-Z6-ZO01 21 02-0005 CUHBERLAND ZOZ Amoun~ Remi'H:ed REV-?$6 EX ~FP (01-02) KATHRYN K HAKE CHECK PAYABLE AND RENZT PAYNENT TO: REGZSTER OF NZLLS CUHBERLAND CO COURT HOUSE CARLZSLE, PA 17015 NOTE: To insure proper credi~ ~o your accoun~:~ submit: ~he upper portion of ~:his form wi~h your. ~:ax payment. CUT ALONG THZS LZNE ~ RETAZN LONER pORTZON FOR YOUR FZLES REV-736 EX AFP (01-02) ~ NOTTCE OF DETERNZNATZON AND ASSESSNENT OF PENNSYLVANZA ESTATE TAX BASED ON FEDERAL CLOSZNG LETTER ESTATE OF ZEITERS KATHRYN K FZLE N0.21 02-0005 ACN ZOZ DATE 12-29-2005 ESTATE TAX DETERHZNATZON 1. Credit For State Death Taxes as Verified 2. Pennsylvania Znheritance Tax Assessed (Excluding Discount and/or Znterest) 95,~75.$$ .00 15,078.~8 $. Inheritance Tax Assessed by Other States or Territories of the Un/ted States (Excluding Discount and/or Interest) ~. Total Znher~tance Tax ASsessed 95~73.33 5. Pennsylvania Estate Tax Due .00 .00 .00 6. Amount of Pennsylvania Estate Tax Previously Assessed Based on Federal Estate Tax Return 7. Additional Pennsylvania Estate Tax Due TAX CREDZTS PAYHENT RECEZPT DZSCOUNT (+) AHOUNT PAZD DATE NUHBER ZNTEREST/PEN PAZD C-) TOTAL TAX CREDZT · ALANCE OF TAX DUEI I ZNTEREST AND PEN. TOTAL DUE ~IF PA/D AFTER TN/S DATE~ SEE REVERSE STDE (/F TOTAL DUE TS LESS THAN 91~ NO PAYHENT TS REI~UTRED FOR CALCULATTON OF ADDTTTONAL TNTEREST. ZF TOTAL DUE TS REFLECTED AS A "CREDTT" (CR}, YOU HAY BE DUE A REFUND. SEE REVERSE S/DE OF THTS FORN FOR INSTRUCTTONS.) .00 .00 .00 .00 PURPOSE OF NOTICE: PAYMENT: To fulfill the requirements of Section 2140 *of the Inheritance and Estate Tax Act, Act Z$ of 2000. (TZ P.~. Sect/on Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on ~ha reverse side. -- Hake check er money order payable to: RESISTER .OF WILLS, AGENT. REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: PENALTY: INTEREST: A refund of a tax credit may be requested by campier[ne an "Application for Refund of Eennsylvania Inheritance and Estate Tax" (REV-1315). Applications are available at the Office of the Register of Nills, any af the Z3 Revenue Uistrict Offices or from the Department's Z4-hour ansaering service for forms ordering: 1-800-36Z-IDS0; services for taxpayers with special hearing and/or speaking needs: 1-800-447-3020 (TT enly). Any party in interest not satisfied with the assessment of tax as shown *on this notice may object within sixty (60) days of receipt of this Notice by: --aritten protest to the PA Department of Revenue, Board of'Appeals~ Dept. 281021, Harrisburg, PA 17128-10Z1, --electing to have the matter*determined at audit of the personal representative, OR --appeal to the Orphans' Court OR Factual errors discovered an this assessment should be addressed in writing to: PA Department of Revenue~ Bureau*of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. Z80601, Harrisburg, PA 171Z8-0601, Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Res[dent Decedent" (REV-1501) for an explanation of administratively correctable errors. The 15Z tax amnesty non-partlc[pat[on penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after tho end of tho tax amnesty period. This non-participation . penalty is appealable in the same manner and in the the same tiaa period as you mould appeal the tax and interest that has been assessed as indicated on this notice. Additional Pennsylvania Estate Tax assessed as a result of a change on the Federal Estate. Tax closing' letter becomes delinquent at the expiration of one (1) month fram the date the final notice of t~e increase in Federal Estate Tax is received. Taxes mhich became delinquent before January 1, 198Z bear interest at the rate of six (SI) percent per annum calcuZated at a daily rate of .000164. All taxes which became delinquent an or after January 1, 19BI Nil1 bear interest at a rate which ail1 vary from caZendar year to calendar year with thaT rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOOZ are; Year Interest Rata Daily Interest Factor Year Interest Rate Daily Interest Factor 1982 ZOZ .000548 1992 9Z .000247 1983 16Z .000438 1993-1994 7X .00019Z 1984 112 .000501 1995-1998 92 .000247 1985 ~3Z .000356 1999 7Z .000192 1986 lOZ .000Z74 ZDO0 8Z .O00219 1987 9Z .OOOZ47 2001 -- 9Z - .000Z47 1988-1991 llZ .000301 ZOOZ 6Z .000164 --Interest is.calculated as follows: r- INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR .--Any Notice issued after the tax becomes delinquent mill 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.