HomeMy WebLinkAbout04-0173BUREAU OF INDZVTDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG~ PA 171zB-n601
COHNONNEALTH OF PENNSYLVANZA
DEPARTMENT OF REVENUE
ZNHERZTANCE TAX
STATEMENT OF ACCOUNT
REV-160? EX ~FP (01-OS)
LINDA LEEBOV GOLDSTON
NCGUIREWOODS
625 LIBERTY AVE
PGH PA 15ZZ2
DATE 06-1q-200q
ESTATE OF KRAFSIG
DATE OF DEATH 11-26-2005
FZLE NUNDER 21 0q-0175
COUNTY CUMBERLAND
ACN 101
I Amount Remi'lcted
MARTHA F
HAKE CHECK PAYABLE AND RENZT PAYMENT TO:
REGTSTER OF MILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
NOTE: To insure proper credit to your eccount, submit the upper portion of this for. w~th your tax payment.
CUT ALONG TH/S L'rNE ~ RETA'rN LONER PORTZON FOR YOUR RECORDS -~
REV-1607 EX AFP (01-03)
ESTATE OF KRAFSIG
#~ ZNHERZTANCE TAX STATEMENT OF ACCOUNT
MARTHA F FZLE N0.21 0~-0175 ACN 101 DATE 06-1~-200q
THZS STATEMENT ZS PROVZDED TO ADVZSE OF THE CURRENT STATUS OF THE STATED ACN ZN THE NAMED ESTATE. SHONN BELON
ZS A SUMMARY OF THE PRZNCZPAL TAX DUE, APPL/CATZON OF ALL PAYHENTS, THE CURRENT BALANCE, AND, ZF APPLZCABLE,
A PROJECTED ZNTEREST FZGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTNENT: 05-10-200~
PRINCIPAL TAX DUE: ...........................................................................................................................................................................................................................
PAYMENTS (TAX CREDITS):
q,567.69
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
02-18-200q
05-2q-ZOOq
CD005588
REFUND
ZF PAZD AFTER THZS DATE, SEE REVERSE
SZDE FOR CALCULATZON OF ADDZTZONAL ZNTEREST.
( ZF TOTAL DUE ZS LESS THAN $1,
NO PAYHENT ZS REQUIRED.
ZF TOTAL DUE ZS REFLECTED AS A "CREDZT" (CR),
228.58
.00
TOTAL TAX CREDZT q,567.69
BALANCE OF TAX DUE .00
ZNTEREST AND PEN. .00
TOTAL DUE .00
YOU MAY BE DUE A REFUND. SEE REVERSE STDE OF THZS FORM FOR TNSTRUCTTONS. )
PAYHENT:
Detach the top portion of this Notice and submit with your payment made payable to the name and address
printed on the reverse side.
-- If RESIDENT DECEDENT make check or coney order payable tm: REGISTER OF NZLLS, AGENT.
-- If NON-RESIDENT DECEDENT make check or money order payable to: COHHONNEALTH OF PENNSYLVANIA.
REFUND (CR): A refund afa tax credit, which was not requested on the Tax Return, may be requested by completing an
"Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1515). Applications are available at
the Office of the Register of gills, any of the 25 Revenue District Offices or from the Department's Z4-hour
ensnaring service for forms ordering: 1-BO0-56Z-ZOSO; services for taxpayers Nith special hearing and / or
speaking needs: 1-800-447-50Z0 (TT only).
REPLY TO: Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau
of Individual Taxes, ATTN: Post Assessment RavieN Unit, Dept. 280601, Harrisburg, PA 17118-0601, phone
(717) 787-6505.
DISCOUNT: If any tax due is paid Nithin three (5) calendar months after the dacedant's death, a five percent (51) discount
of the tax paid is alloNed.
PENALTY: The 1SI tax amnesty nan-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January lB, 1996~ the first day after the end of the tax amnesty period.
INTEREST:
Interest is charged beginning Nith first day of delinquency, or nine (9) months and one (1) day from the date of
death, to the date of payment. Taxes Nhich became delinquent before January 1, 1982 bear interest at the rata of
six (BX) percent per annum calculated at a daily rate of .000164. All taxes Nhich became delinquent on and after
January l~ 1982 will bear interest at a rate Nhich Nil1 vary from calendar year to calendar year Nith that rate
announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2004 ara:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
1982 ZOZ .000548 1988-1991 llZ .000501 ZO0~ 9X .000147
1985 162 .000458 1992 92 .000247 ZOOZ 62 .000164
1984 llX .000501 1995-1994 72 .000191 2005 51 .000157
1985 15X .000356 1995-1998 92 .000247 2004 4Z .000110
1986 101 .000174 1999 71 .000191
1987 9X .000247 ZOO0 8X .O00Zi9
--Interest is calculated as follows:
/NTEREST = BALANCE OF TAX UNPAID 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
beyond the date of the assessment. If payment is made after the interest computation date shown on the
Notice, additional interest must be calculated.
McGuireWoods LLP
Dominion Tower
625 Liberty Avenue, 23rd Floor
Pittsburgh, PA 15222-3142
Phone: 412.667.6000
Fax: 412.667.6050
www. mcguirewoods.com
Linda Leebov Goldston
Direct: 412.667.7940
McGUIREWOODS
Igoldston@mcguirewoods.com
Direct Fax: 412.667.7980
March 15, 2004
Register of Wills
Cumberland County Courthouse ~ ~
One Courthouse Square /' ~
Carlisle, PA 17013 / "~
R~: Estate of Martha F. Krafsig ~
[Date of Death: 11/26/2003 ,/
Dear Sir/Madam: ~ ~
Enclosed please find an original and one copy of an Inheritance Tax Return for
filing on behalf of the above-referenced Decedent; attached to each is a copy of the
Decedent's Will. We are requesting a refund.
Please direct questions to the undersign~ /
very ~Ui~;'Y°u rs'/ ~~
~LINDA LEEBOV GOLDSTON
LLG/chg
Enclosures
Cc: Donald C. Krafsig
REV-1500 EX + (6-00)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
REV-1500
NHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
FILE NUMBER
21-04-173
COUNTY CODE YEAR NUMBER
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DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Krafsig Martha F.
DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
11/26/2003 11/07/1909
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
1. Original Return 2. Supplemental Return
4. Limited Estate 4a. Future Interest Compromise (date of death after 1Z- 1Z-BZ)
6. Decedent Died Testate 7. Decedent Maintained a Living Trust
(Attach copy of Will) (Attach copy of Trust)
[____J 9. Litigation Proceeds Received I 110. spousal Poverty Credit
(date of death between 1Z-31-91 and 1-1-95)
SOC[AL SECURITY NUMBER
181-32-2552
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOC[AL SECURITY NUMBER
H (date of death
3. Remainder Return priorto 1Z-13-8Z)
5. Federal Estate Tax Return Required
0 8. Total Number of Safe Deposit Boxes
[-~ Election to tax under Sec. 9113(A)
1
1.
(Attach Sch O)
NAME
Linda Leebov Coldston
FI RM NAME (If Applicable)
McGuireWoods LLP
TELEPHONE NUMBER
412/667- 7940
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or (3)
Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
[~ 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 Expenses & 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.
14.
COMPLETE MAILING ADDRESS
2300 Dominion Tower
625 Liberty Avenue
Pittsburgh, PA 15222-3142
None
None
1,222.71
110,811;.80
None
11,450.99
None
Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
Net Value Subject to Tax (Line 12 minus Line 13)
~ OFFICI~.~-L~ ONLY
L~J
(8) 112,955.15
(11) 11,450.99
(12) 101,504.16
(13).
(14) 101,504.16
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
101,504.16
X .0 0
x .0 45
X .12
X .15
(15) 0.00
(16) 4,567.69
(17) 0.00
(18) 0.00
(19) 4,567.69
Copyright (c) Z000 form software only The Lackner Group, Inc.
Form REV-1500 EX (Rev. 6-00)
Decal, dent's Complete Address:
STREET ADDRESS
1505 High Meadow Lane
CITY STATE
Mechanicsbur~ PA
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments 4,688.27
C. Discount 228.38
(1)
Total Credits ( A + B + C )
ZIP
17055
4,567.69
(2) 4,916.65
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty ( D + E ) (3) 0.00
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line Z0 to request a refund (4) 348.96
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00
A. Enter the interest on the tax due. (SA} 0.00
B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (SB) 0.00
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; ......................... : ~
b. retain the right to designate who shall use the property transferred or its income; ...........
c. retain a reversionary interest; or ....................................
d. receive the promise for life of either payments, benefits or care? ...................
Z. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ................................ ~ E~]
3. Did decedent own an "in trust for" or payable upon death bank account or security at his
or her death? .............................................. [~] E~]
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property
which contains a beneficiary,designation? ................................ D E~]
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, It is true,
correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any know~ed§e.
SIGNATUREOFPERSONRESPONSIBLEFORFILINGRETURN Donald C. Krafsig DATE
survivin~ spouse is 3% [72 ~.S. ~11~ (a) (1.1) (i)].
For datos of death on or a~or Janua~ 1, 1005, the tax rate imposod on tho net value of transfors to or for the uso of the survivin~ spouse
[72 ~.S. 011 $ (a) (1.1) (ii)]. lbo statute doos not ~xompt a transfer to a survivin~ spouse from tax, and the statuto~ requirements for disclosure of assets
and filin~ a tax return are still applicable evon if the survivin~ spouso is the onl~ beneficial.
For dates of death on or a~er Jul~ 1, 2000:
lhe tax rat, imposed on the net value of transfers from a deceased child twen~-one years of a~e or ~oun~or at death to or for the use of a natural
paront, an adoptive parent, or a stepparent of the child is 0% [72 ~.S. O1 lfi (a) (~.2)].
lhe tax rate imposed on the net value of transfers to or for the use of the docedent's lineal b~neficiaries is 4.5%, except as noted in 72 ~.S.
[72 ~.S.
lhe ta~ rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 ~.S. O115(a)(1.3)]. ~ siblin~ is dofined, under
Section ~102, as an individual who has at least one parent in common w~h the decedont, whether by blood or adoption.
Copyright (Q ~000 form software only The kackner Group, Inc. Form ~- ~ $00 ~X (~ev. 8-00)
REV-1503 EX + (1-'97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE B
STOCKS & BONDS
Martha F. Krafsi5 SS# 181-32-2552 11/26/2003
FILE NUMBER
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DAT~:
NUMBER DESCRIPTION UNIT VALUE OF DEATH
1 28 shares MetLife Shares 32.65 914.20
Accrued dividend on item 1 to date of death .23 6.44
TOTAL (Also enter on line 2, Recapitulation) 920.64
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1503 EX (Rev. 1-97)
REV-1508 EX + (1-~97)
COMMONWEALTH OF PEN NSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
Martha F. Krafsi5 SS# 181-32-2552 11/26/2003
Include the proceeds of litigation and the date the proceeds were received by the estate. All property joimtly-owned with the rkJht of
survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 1,222.71
Pennsylvania State Employees' Retirement System - Check dated
11/26/2003
TOTAL (Also enter on line 5, Recapitulation) $ 1,222.71
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1S08 EX (Rev. 1-97)
REV- 1509 EX + (1-97)
SCHEDULE F
COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Martha F. Krafsi~ SS# 181-32-2552 11/26/2003
FILE NUMBER
21-04-173
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT
A.Donald C. Krafsig Son
1505 High Meadow Lane
Mechanicsburg, PA 17055
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH
Include name of financial institution and bank
ITEM FOR JOINT MADE account number or similar Identi~ing number. DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT Attach deed for jointly-held realestate. VALUE OF ASSET iNTEREST DECEDENT'S INTERES
1 A 07/25/02 Fulton Bank Certificate of 125,000.00 50.00% 62,500.00
Deposit #022-0172606
joint with Donald C.
Krafsig
A 07/25/02 Accrued interest on item 18.32 50.00% 9.16
1 to date of death
2 A 07/28/97 Fulton Bank Certificate of 25,000.00 50.00% 12,500.00
Deposit #223-0026436
joint with Donald C.
Krafsig
A 07/28/97 Accrued interest on item 116.06 50.00% 58.03
2 to date of death
3 A 10/01/68 Fulton Bank checking 10,933.59 50.00% 5,466.80
Account #1068-31683 - joint,
with Donald C. Krafsig
4 A 04/09/98 PA State Employees Credit 60,000.00 50.00% 30,000.00
Certificate of Deposit
A 04/09/98 Accrued dividend on item 161.51 50.00% 80.76
~ to date of death
5 A 04/09/98 PA State Employees Credit 393.88 50.00% 196.94
Member #0181322552
regular shares
Total of Continuation Schedule(s) 0.11
TOTAL(AIsoenteronline6, Recapitulation) $ 110,811.80
(If more space is needed insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1509 EX (Rev. 1-97)
Estate of: Martha F. Krafsig
Soc Sec #: 181-32-2552
Date of Death: 11/26/2003
Continuation of Schedule F
(Jointly Owned Property)
Item Ltr for Date Description of property
# Jt Ten Joint
Total Val
of Asset
Dollar Val of
Decds Interest
A
04/09/98 Accrued dividend on item
5 to date of death
0.21
5O.O0%
0.11
0.11
REV-1511 EX * (1'97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Martha F. Krafsig SS#
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
181-32-2552 11/26/2003
FILENUMBER
21-04-173
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION
Ac
1
2
3
Bo
FUNERAL EXPENSES:
Ceo's Family Restaurant funeral meal
Giant Foods foods for funeral reception at home
Gilbert L. Dailey Funeral Home, Inc. funeral bill
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s) / EIN Number of Personal Representative(s)
Street Address
City State
Year(s) Commission Paid:
Attorney's Fees
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant Donald C. Krafsi~
Street Address 1505 High Meadow Lane
City Mechanicsbur5 State PA Zip 17055
Relationship of Claimant to Decedent S on
Probate Fees
Accountant's Fees
Tax Return Preparer's Fees
Other Administrative Costs
Pennsylvania State Employees' Retirement System - prorated refund
TOTAL (Aisc enter on line 9, Recapitulation)
AMOUNT
811.80
445.92
6,530.24
3,500.00
163.03
$ 11,450.99
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1511 EX (Rev. 1-97)
REV- 1513 EX + (9300)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Martha F. Krafsi~ SS~/ 181-32-2552
SCHEDULE J
BENEFICIARIES
11/26/2003
FILE NUMBER
NUMBER
II.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and
transfers under Sec. 9116~(1
Donald C. Krafsig
1505 High Meadow Lane
Mechanicsburg, PA 17055
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Son
AMOUNT OR SHARE
OF ESTATE
Entire estate
ENTER DOLLAR AMTS, FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $
0.00
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 2:000 form software only The Lackner Group, Inc. Form REV-1513 EX (Rev. 9-00)
LAST WILL AND TESTAMENT
OF
MARTHA KRAFSIG
I, MARTHA KRAFSIG, of Harrisburg, Pennsylvania, do make,
publish and declare this to be my Last Will and Testament hereby
revoking any and all prior Wills and Codicils.
FIRST: I direct that my just debts and the expenses of my
last illness and funeral be paid as soon as possible after my
death.
SECOND: After considerable and careful thought, and for
reasons known to my son, JOHN J. KRAFSIG, JR., I am making no
provisions whatsoever for my son, JOHN J. KRAFSIG, JR.
THIRD: I give and bequeath my tangible personal property to
my son, DONALD C. KRAFSIG.
FOURTH: Ail the rest, residue and remainder of my estate I
give, devise and bequeath to my son, DONALD C. KRAFSIG.
FIFTH: In the event my son, DONALD C. KRAFSIG does not
survive me I give the aforesaid residue to my niece, JANICE
BRESLIN, or he issue. It is my hope that she will use a portion of
the funds to enrich the life of my sister, ANNA McDONOUGH.
SIXTH: I name and appoint my son, DONALD C. KRAFSIG, as
Executor of my estate. If my son, DONALD C. KRAFSIG, is unable or
unwilling to serve or to continue to serve in that capacity I
appoint LINDA LEEBOV GOLDSTON as substitute Executrix.
No bond shall be required of any fiduciary appointed
hereunder.
SEVENTH: No interest of any beneficiary hereunder shall be
subject to assignment, alienation, pledge, attachment or claims of
any spouse or creditors of such beneficiary, nor may any interest
otherwise be voluntarily or involuntarily alienated or encumbered
by such beneficiary, except as otherwise expressly provided under
the terms hereof.
EIGHTH: In addition to the powers conferred by law, my
Executor shall have the discretionary power to retain for
distribution in kind, without duty of diversification, all property
w. TTu. soL0$To. Owned by me at my death, or to sell all or any part of such
¢^PuTo& property, upon such terms as my Executor shall deem advisable; to
POLL~K, P.C.
PITTSBURGH, PA
hold any proceeds and other cash uninvested or to invest in all
forms of property; to exchange or lease for any period of time any
real or personal property and to give options for sales, exchanges
and leases; to exercise all rights of security holders; to
compromise any claim or controversy without court approval; to
borrow money from any source; to delegate discretionary powers; and
to make distributions in case or in kind at current values, in
undivided interests or non-pro rata shares.
NINTH: Ail estate, inheritance and succession taxes,
including interest and penalties, imposed on property passing under
this Will shall be paid from principal of my residuary estate at
such times and in such manner as my Executor shall deem advisable,
without apportionment or right of reimbursement. All such taxes
imposed on any other property shall be apportioned and paid in the
manner provided by law.
WITNESS my hand this ~ day of ~/~V , 1993.
/
Martha Krafsig
Signed, published and declared by the above-named Testatrix,
as her last Will in the presence of us who at her request, in her
presence and in the presence of each other have hereunto subscribed
our names as witnesses.
WITTLIN GOLDSTON
CAPUTO &
POLLOCK, P.C.
PITTSBURGH, PA
2
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA )
-~~ ) SS:
COUNTY OF~~ )
I, MARTHA KRAFSIG, Testatrix, whose name is signed to the
attached or foregoing instrument, having been duly qualified
according to law, do hereby acknowledge that I signed and executed
the instrument as my Last Will; that I signed it willingly; and
that I signed it as my free and voluntary act for the purposes
therein expressed.
Martha Krafsig,UTes~atrix
(SEAL)
My Commission Expires:
to and acknowledged before me by
Testatrix, this ~-, day of
NoTary
WI'FI'LIN GOLDSTON
CAPUTO &
POLLOCK, P.C.
PITTSBURGH, PA
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA )
COUNTY OF )
We, /'~bQv~ ~,/~9~~- and ~/~a/ ~/. ~9~/~f_ ,
the witnesses whose names are signed to the attached or foregoing
instrument, being duly qualified according to law, do depose and
say that we were present and saw Testatrix sign' and execute the
instrument as her Last Will; that she signed willingly and that she
executed it as her free and voluntary act for the purposes therein
expressed; that each of us in the hearing and sight of the
Testatrix and of each other signed the Will as witnesses; and that
to the best of our knowledge, the Testatrix was at the time
eighteen (18) or more years of age, of sound mind and under no
constraint or undue influence.
Witness
Witness
SWORN or affirmed to and subscribed to before
witnesses, this ~4~ day of ~ ~_~~. , 1993.
~otary~u~lid_~ - \
My Commission Expires:
me by
,
WITTLIN GOLDSTON
CAPUTO &
POLLOCK, P.C.
PITTSBURGH, PA
BUREAU OF ZNDZVZDUAL TAXES
TNHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
LINDA LEEBOV GOLDSTON
HCGUZREWOODS
625 LIBERTY AVE
PGH
COHHONWEALTH OF PENNSYLVANZA
DEPARTNENT OF REVENUE
NOTZCE OF ZNHERZTANCE TAX
APPRAZSEHENT, ALLO#ANCE OR DZSALLONANCE
OF DEDUCTZONS AND ASSESSHENT OF TAX
DATE
ESTATE OF
DATE OF DEATH
FZLE NUNBER
:OBCOUNTY
ACN
CUT ALONG THZS LZNE ~
05-10-200~
KRAFSIG
11-26-2005
21 0~-0175
CUMBERLAND
101
Aaoun~ Ra, ei~od
REV-15~7 EX AFP (01-03)
HARTHA F
HAKE CHECK PAYABLE AND RENZT PAYHENT TO:
REGISTER OF WILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA I7015
RETAZN LOWER PORTZON FOR YOUR RECORDS ~
DZSALLOWANCE OF DEDUCTZONS AND ASSESSNENT OF TAX
ESTATE OF KRAFSZG HARTHA F FZLE NO. 21 0R-0175 ACN 101 DATE 05-10-200~
TAX RETURN NAS: (X) ACCEPTED AS F/LED ( ) CHANGED
RESERVATZON CONCERNZNG FUTURE ZNTEREST - SEE REVERSE
APPRAZSED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Es~a~e (Schedule A) (1)
2. S~ocks and Bonds (Schodulo B} (2)
3. Closely Held S~ock/Par~narship Interest (Schedule C) ($)
~. Nortgagos/No~os Receivable (Schedule D) (~)
$. Cash/Bank Daposits/Hisc. Personal Propor~y (Schedule E) ($)
6. Jointly Owned Propar~y (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. To~el Assa~s
APPROVED DEDUCTZONS AND EXENPTZONS:
9. Funeral Expanses/Ada. Cos~s/Hisc. Expenses (Schedule H) (9)
10. Deb~s/Hor~gago Liabilities/Liens (Schedule I) (10]
11. To,al Deductions
12. Not Value of Tax Ro~urn
15.
lq.
Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J)
Not Value of Es~a~o Subjoc~ to Tax
.00
920
.00
.00
1/222.71
110/811.80
.00
(8)
11,~50.99
.00
NOTE: To insure proper
crodi~ ~o your account,
subei~ ~he upper portion
of ~his form w/~h your
~ax payment.
112,955.15
(11) ]] .45§.99
(12) 101,50q. 16
(13) . O0
(1~) 101,50R. 16
NOTE:
Zf an assessment was issued previously, 1/nes 14, 15 and/or 16, 17, 18 and 19
reflect figures that include the total of ALL returns assessed to date.
(15) .00 x O0 = .00
(16) 101,50q.16 x Oq5 = q,567.69
(17) .00 x 12 : .00
(18) .00 x 15 = .00
(19)= q,567.69
ASSESSNENT OF TAX:
16. Amoun~ of L/ne 1~ a~ Spouse1 ra~e
16. Amount of L/no 1~ taxablo a~ Lineal/Class A ra~o
17. Amount of L/no lq at Sibling rata
18. Amount of L/no lq taxablo a~ Collateral/Class B rata
19. Principal Tax Due
TAX CREDZTS:
PAYHENT RECEIPT DZSCOUNT (+)
DATE NUNBER ZNTEREST/PEN PAZD (-)
02-18-200~ CD005588 228.58
AHOUNT PAZD
ZF PAZD AFTER DATE ZNDZCATED, SEE REVERSE
FOR CALCULATZON OF ADDZTZONAL ZNTEREST.
~,688.27
TOTAL TAX CREDZT r
BALANCE OF TAX DUE
ZNTEREST AND PEN.
TOTAL DUE
q,916.65
5~8.96CR
.00
5~8.96CR
( IF TOTAL DUE IS LESS THAN $1, NO PAYNENT ZS RE~UZRED.
ZF TOTAL DUE ZS REFLECTED AS A 'CREDZT" (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE S/DE OF THZS FORH FOR ZNSTRUCTZONS.)
RESERVATION:
PURPOSE OF
NOTICE:
PAYMENT:
REFUND (CR}:
OBJECTIONS:
ADNIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the 1aclu1 Class B (collateral} rate on any such future interest.
To fulfill the requirements of Section ZlfiO of the Inheritance and Estate Tax Act, Act Z3 of 2000. (72 P.S.
Section 91q0).
Detach the top portion of this Notice and submit with your payment to the Register of Nills printed on the reverse side.
--Make check or money order payable to: REGISTER OF HILLS, AGENT
A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance end Estate Tax" (REV-1213). Applications are available at the Office
of the Register of Hills, any of the Z2 Revenue District Offices, or by calling the special Z~-hour
enamoring service for forms ordering: 1-800-26Z-2050; services for taxpayers eith special hearing and / or
speaking needs: 1-800-~7-30Z0 (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 shown on this Notice must object within sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. Z81OZ1, Harrisburg, PA 171ZG-lOZ1, 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 ariting to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Reviee Unit, Dept. Z80601, Harrisburg, PA 171Z8-0601
Phone (717) 787-650S. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-IS01) for an explanation of administratively correctable errors.
If any tax due is paid within three (3) calendar months after the decedent's death, a five percent CSX) discount cf
the tax paid is a11oeed.
The 15X 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 appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of
death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of
six (6Z) percent per annum calculated at a daily rate of .00016~. AIl taxes which became delinquent on and after
January 1, 198Z will bear interest at a rate which will vary free calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2OOq are:
Interest Daily Interest DaiZy Interest
Daily
Year Rate Factor Year Rate Factor Year Rate Factor
~ lOX .OOO54B ~]~'8-1991 112 .000501 ~ 9X .000247
1982 162 .O00q2B 1991 92 .O00Zq7 ZOOZ 62 .000164
1964 112 .000301 1993-1994 72 .000191 1003 52 .000127
1985 132 .000256 1995-1998 9Z .000247 ZO0~ IX .000110
1986 IOZ .DOOZTq 1999 7Z .000191
1987 101 .000274 2000 7Z .000191
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUHBER 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.
McGuireWoods LLP
Dominion Tower
625 Liberty Avenue, 23rd Floor
Pittsburgh, PA 15222-3142
Phone: 412.667.6000
Fax: 412.667.6050
www. mcgu i rewoods.com
Linda Leebov Goldston
Direct: 412.667.7940
McGUIREWOODS
Igoldston @ mcguirewoods.com
Direct Fax: 412.667.7980
February 19, 2004
Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
Re: Estate of Martha F. Krafsig
Date of Death: 11/26/2003
Dear Sir/Madam:
Enclosed please find a payment on account of inheritance tax at .045% as follows:
Date of Death Value of Assets
Less Final Expenses
$109,667.19 @ .045 =
Less 5% discount
Payment enclosed
$117,455.15
- 7,787.96
$109,667.19
$ 4,935.02
246.75
$ 4,688.27
Please send receipt to the undersigned.
Very Jly you/~
I:~'NDA LEEBOV GOLDSTON
LLG/chg
Enclosure
Linda Leebov Goldston
I McG U IRE~k~¢(~(ADS~o.
jo e'
Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
CO,MM. ON':,VEALTH OF PENNSYLVANIA
· DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-O601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 0O3588
KRAFSIG DONALD C
1505 HIGH MEADOW LANE
MECHANICSBURG, PA 17055
........ fold
? ',,
ESTATE INFORMATION: SSN: 000-00-0000
FILE NUMBER: 2104-01 73
DECEDENT NAME: KRAFSIG MARTHA F
DATE OF PAYMENT: 02/20/2004
POSTMARK DATE: 02/1 8/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 00/00/0000
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 94,688.27
REMARKS:
SEAL
CHECK//7006
TOTAL AMOUNT PAID:
94,688.27
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
ESTATE OF MARTHA F. KRAFSIG,
Deceased
ORPHANS' DIVISION
No. 02-04-173
PETITION FOR SETTLEMENT OF
GROSS ESTATE UNDER $25~000
To The Honorable, The Judges of the Said Court:
The Petition of Donald C. Krafsig respectfully represents that:
1. Martha F. Krafsig died testate on November 26, 2003, at her residence
1505 High Meadow Lane, Mechanicsburg, PA 17055. The original of the decedent's
Will is attached hereto and marked Exhibit "A."
2. No application for probate has been filed.
3. Petitioner, Donald C. Krafsig, is the designated Executor in the Will of the
Decedent and the sole beneficiary under the Will.
4. Petitioner resides at 1505 High Meadow Lane, Mechanicsburg, PA 17055.
5. The items of personal property owned by the decedent at the time of her
death are:
PA SERS pension check ........................ $1,222.71
Claim for IRS refund, 2003-1040 ................. 94.00
28 shares MetLife stock ......................... 914.20
Accrued dividend on MetLife stock to date of death.. 6.44
TOTAL $2,237.35
6. To the best of Petitioner's knowledge and belief, the expenses of the estate
consist of the following:
ao
eo
Gilbert L. Dailey Funeral Home, Inc., funeral
Geo's Family Restaurant, funeral meal
Giant Foods, funeral reception at home
PA Department of Revenue
PA40-2003
Register of Wills
(1) Inheritance Tax Return filing fee
(2) Petition for Settlement of Small Estate
Filing fee
Certified Copy of Order
$ 6,530.24
811.80
445.92
275.00
15.00
15.00
2.00
TOTAL $ 8,094.96
8.
Petitioner.
9.
All of the expenses of the probate estate were advanced by the Petitioner.
There are no other claims against this decedent's estate known to your
An Inheritance Tax Return was filed and the estimated tax was paid both
on probate and non-probate assets. Copies of the Return and the Receipt are attached
hereto and marked Exhibits "B" and "C."
WHEREFORE, your Petitioner prays that the Court enter an order directing that
the assets of the estate be distributed to Donald C. Krafsig to reimburse him for expenses
advanced on behalf of the Estate in accordance with the terms of this Petition.
/
for I
,titioner
VERIFICATION
I verify that the statements made in the foregoing Petition are true and correct to
the best of my information, knowledge and belief. I understand that the statements herein
are made subject to the penalties of 18 Pa. C.S.A. Section 4904 relating to unswom
falsification to authorities.
Donald C. Krafsig~ d
LAST WILL AND TESTAMENT
OF
MARTHA KRAFSIG
I, MARTHA KRAFSIG, of Harrisburg, Pennsylvania, do make,
publish and declare this to be my Last Will and Testament hereby
revoking any and all prior Wills and Codicils.
FIRST: I direct that my just debts and the expenses of my
last illness and funeral be paid as soon as possible after my
death.
SECOND: After considerable and careful thought, and for
reasons known to my son, JOHN J. KRAFSIG, JR., I am making no
provisions whatsoever for my son, JOHN J. KRAFSIG, JR.
THIRD: I give and bequeath my tangible personal property to
my son, DONALD C. KRAFSIG.
FOURTH: Ail the rest, residue and remainder of my estate I
give, devise and bequeath to my son, DONALD C. KRAFSIG.
FIFT~: In the event my son, DONALD C. KRAFSIG does not
survive me I give the aforesaid residue to my niece, JANICE
BRESLIN, or he issue. It is my hope that she will use a portion of
the funds to enrich the life of my sister, ANNA McDONOUGH.
SIXTH: I name and appoint my son, DONALD C. KRAFSIG, as
Executor of my estate. If my son, DONALD C. KRAFSIG, is unable or
unwilling to serve or to continue to serve in that capacity I
appoint LINDA LEEBOV GOLDSTON as substitute Executrix.
No bond shall be required of any fiduciary appointed
hereunder.
SEVENTH: No interest of any beneficiary hereunder shall be
subject to assignment, alienation, pledge, attachment or claims of
any spouse or creditors of such beneficiary, nor may any interest
otherwise be voluntarily or involuntarily alienated or encumbered
by such beneficiary, except as otherwise expressly provided under
the terms hereof.
EIGHTH: In addition to the powers conferred by law, my
Executor shall have the discretionary power to retain for
distribution in kind, without duty of diversification, all property
W,~L,NGOLDSToNOWned by me at my death, or to sell all or any part of such
¢^PUTO& property, upon such terms as my Executor shall deem advisable; to
POLLOCK, P.C.
P,~s.uRGH, P^ EXHIBIT
hold any proceeds and other cash uninvested or to invest in all
forms of property; to exchange or lease for any period of time any
real or personal property and to give options for sales, exchanges
and leases; to exercise all rights of security holders; to
compromise any claim or controversy without court approval; to
borrow money from any source; to delegate discretionary powers; and
to make distributions in case or in kind at current values, in
undivided interests or non-pro rata shares.
NINTH: Ail estate, inheritance and succession taxes,
including interest and penalties, imposed on property passing under
this Will shall be paid from principal of my residuary estate at
such times and in such manner as my Executor shall deem advisable,
without apportionment or right of reimbursement. All such taxes
imposed on any other property shall be apportioned and paid in the
manner provided by law.
WITNESS my hand this ~ day of ~~q , 1993.
/
M~rtha KrafSig, ~
Signed, published and declared by the above-named Testatrix,
as her last Will in the presence of us who at her request, in her
presence and in the presence of each other have hereunto subscribed
our names as witnesses.
WITTLIN GOLDSTON
CAPUTO &
POLLOCK, P.C.
PITTSBURGH, PA
2
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA )
.~' ) ss:
CO TY oF
I, MARTHA KRAFSIG, Testatrix, whose name is signed to the
attached or foregoing instrument, having been duly qualified
according to law, do hereby acknowledge that I signed and executed
the instrument as my Last Will; that I signed it willingly; and
that I signed it as my free and voluntary act for the purposes
therein expressed.
Martha Krafsig, ~ Tes%atrix
(SEAL)
SWORN or a f firmed
My Commission Expires:
to and acknowledged bg~ore me by
Testatrix, this ~_-. day of
NoTary Pu~ l'i~J '
~
Cheq/i J. Robinson, Notary Pub~
Harrb~rg, DaupNn County
WlTTLIN GOLDSTON
CAPUTO &
POLLOCK, P.C.
PITTSBURGH, PA
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA )
COUNTY OF )
the witnesses whose names are signed to the attached or foregoing
instrument, being duly qualified according to law, do depose and
say that we were present and saw Testatrix sign and execute the
instrument as her Last Will; that she signed willingly and that she
executed it as her free and voluntary act for the purposes therein
expressed; that each of us in the hearing and sight of the
Testatrix and of each other signed the Will as witnesses; and that
to the best of our knowledge, the Testatrix was at the time
eighteen (18) or more years of age, of sound mind and under no
constraint or undue influence.
SWORN or affirmed to
witnesses, this ~4~ day of
My Commission Expires:
Ch~j. F~o~nson, ~ Pu~
.... Hanis~rg, _D~n C, eun~,
~ ~i~ ~ Ja~.-~ 1~7
Witness
Witness
and subscribed to before
:
Notary~u~lid~~-
me by
,
WITTLIN GOLDSTON
CAPUTO &
POLLOCK, P.C.
PITTSBURGH, PA
REV- 1500 EX * (6-00)
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Krafsig Martha F.
DATE OF DEATH (MM-DO-YEAR) I DATE OF BIRTH (MM-DO-YEAR)
11/26/2003 I 11/07/1909
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND M~DDLE INITIAL}
OFFICIAL USE ONLY
FILE NUMBER
21-04-173
COUNTYCODE YEAR NUMBER
SOCIAL SECURITY NUMBER
181~32-2552
THIS RE~-URN MUST BE FILED IN DUPUCATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
~ 1. Orlgll~al Returll ~C~ .~! Supplemer~tal Retum
4, Ll~t~ Estate · F~me I~ere~ ~mpromlse (date of d~th after 1g- 1Z-82)
6. D~ent DI~ T~ate D~ent Mal~l~ a LM~ Tr~ 0
(A~ach co~ of WII0 (A~ch copy of
~ 9. LlflgatlonPr~sR~elv~ ~10. S.~lPove~Cr~,t
(~te of d~th ~n 12-31-91 a~ 1-1
NAME
(data of death
3. RemalnderReturn [brlorto 12-13-8~)
5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
11. Election to tax under Sec. 9113(A)
(Attach Sch O)
COMPLETE MAILING ADDRESS
Linda Leebov Goldston
FIRM NAME (If ~pll~bl~
McGulreWoods LLP
TELEPHONE NUMBER
412/667-7940
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or (3)
Sole -Proprietorship
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
I-'-'1 Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
Total Gross Assets (total Lines 1-7)
Funeral Expenses & Administrative Costs (Schedule H)
9.
lO.
11.
13.
(9)
Debts of DecedenL Mortgage Liabilities, & Liens (Schedule I) (10)
Total Deductions (total Lines 9 & 10)
Net Value of Estate (Li.ne 8 minus Line 11 )
14.
2300 Dominion Tower
625 Liberty Avenue
Pittsburgh, PA 15222-3142
None
920.64
None
None
1,222.71
110,811.80
None
11,450.99
None
Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
Net Value Subject to Tax (Line 12 minus Line 13)
OFFICIAL USE ONLY
(8)
112,955.15
(11)
(12)
11,450.99
101,504.16
(13).
(14)
101,504.16
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116(aX1.2)
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
101,504.16
x .0 0 (is)
x .0"45 (16)
x .12 (17)
x .15 (18),
0.00
4,567.69
0.00
0.00
4,567.69
19. Tax Due (19)
Copyrfght (c) Z000 form software only The Lackner Group, Inc.
EXHIBIT
Form REV-1500 EX (Rev. 6-oo)
Decedent's Complete Address:
STREEI ADDRESS
1505 High Meadow Lane
CITY
Mechanicsbur~
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
?- Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
3o
Interest/Penalty if applicable D. Interest
E. Penalty
ISTATE
?A
4,688.27
228.38
(~)
Total Credits ( A + B + C ) (2)
Total InterestJPenalty ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference, This is the OVERPAYMENT,
Check box on Page I Line 20 to request a refund (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (SB)
ZIP
17055
4,567.69
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING GUESTIONS BY PLACING AN '"X" IN THE APPROPRIATE BLOCKS
,1. Did decedent make a transfer and: Yes No
:'~ ~ a. retain the use or income of the property transferred; ................. 'i ....... r--'l ~']
b. retain the right to designate who shall use the property transferred or its income; ........ . . .
C. retain a reversionary interest; Or. .... ' .......... , .. ' ..............
d. rece ve the promise for life of either payments, benefits or care? .... i .......... ' .... '
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ................................ ~ ~'~
3. Did decedent own an "in trust for" or payable upon death bank account or security at his
or her death? .............................................. [---'[
4. Did decedent own an Individual Retirement Account, annuity, or Other non-probate property
which contains a beneficiary,designation~
IF THE ANSWER TO ANY OF THE ABOVE GUESTIONS IS YES,
YOU MUST COMPLETE' SCHEDULE G AND FILE IT AS PART OF THE RETURN.
penalties of perjury, I declare that I have exan~h-,eG this return, Including accompanying schedules and statements, and to the best of mY knowledge and belief, It Is true
4,916.65
0.00
348.96
0.00
0.00
0.00
correct and complete. Declaration of preparer other then the personal repre~e.tat/ve is based on all Information bf which preparer has any knowledge.
SIGNATUREOFPERSON RESPONSIBLE FOR'FILING RETURN Donald C. Krafs tg ' DATE
SIGNATUR~EPAR~R OTHf ~,~.~N/~E McGutreWoods-~P DArt --
--~ .. /~ / ~/ -.- 2300 Dominion Tower _, /
~or ~les o~ aea~ on o[ aRer Ju. 1, 19,4 and before Janua. 1, 1995, the tax rate imposed on the net value of
su~vmg spouse ~s 3% [72 P S 9116 (a)(1 1) (i)~
For dates of dea~ on o~ a~er Janua~ 1, 1995, ~e ax rate imposed on ~e net value of ~a~em to or for ~e use of the su~iving spouse is 0%
[72 P.S. 9116 (a) (1.,~) (ii)~ The mtute does not exert a tra~er to a su~ving spouse from ~x, and ~e mtuto~ require~n~ for disclosure of asse~
and filing a ~x tatum am. ~ill applicabl® even E ~e su~ivi~ spouse ~ the on~ benefic~. :
For dates of death on or after Ju~ 1,~2000: -~: . , ~ ,:: : ..
The ~x rate i~osed on ~e netva ue of tran~ers from a deceased child ~en~-one yearn of age or younger at dea~ to 0r fo~ ~e u~e of a natural
pare~, an adoptive parch% or a aepparent of ~e child is 0% [72 P.S. 9116 (a) (1.2)~
The tax rate imposed on ~e net value of ~an~em to or for ~e use of the decedent's lineal beneficiages is 4.5%, except as noted in 72 P.'S.:gf16(1.2)
[72 P.S. 9116(aXl )].
~e ~x rate imposed on ~e net value of tran~ers to or for the use of the decedent's siblings is 12% [72 P.S. 9116(aX1.3)~ A sibling ~ defined, under
Scion 9102, as an i~ividual who has at lead one parent in co~n w~h ~e decedent, whether by blood or adopfio~
~rlght (c) Z~O form so.are onN The La~ Gro~. I~
REV-1503 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE B
STOCKS & BONDS
Martha F. Krafsi~ SS~/ 181-32-2552 11/26/2003
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
FILE NUMBER
ITEM
VALUE AT DATE
NUMBER DESCRIPTION UNIT VALUE
OF DEATH
1 28 shares MetLife Shares 32.65 914.20
Accrued dividend on item 1 to date of death .23 6.44
/
TOTAL (Also enter on line 2, Recapitulation) 920.64
more space is needed, insert additional sheets of the same size)
Copyright(c) 1996 form software only CPSysterns. lnc. ~___ e~et~ .~=~-, L-V
REV-1508 EX + (1-97)
COMMONWEALTH OFPENNSYLVANIA
INHERITANCETAXRETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
Martha F. Krafsi~ SS# 181-32-2552 11/26/2003
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.
FILE NUMBER
ITEM
NUMBER
DESCRIPTION
Pennsylvania State Employees' Retirement System - Check dated
11/26/2003
VALUE AT DATE
OF DEATH
1,222.71
TOTAL (Also enter on line 5, Recapitulation) $ 1,222.71
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. c.-- ,.=v_,s~na L'.v ,,_... ~
REV- 1509 EX + (1-97)
SCHEDULE F
JOINTLY-OWNED PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Martha F. Krafst~ SS# 181-32-2552 11/26/2003
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
FILE NUMBER
21-04-173
Ao
SURVIVING JOINT TENANT(S) NAME
Donald C. Krafsig
ADDRESS
1505 High Meadow Lane
Mechanicsburg, PA 17055
RELATIONSHIP TO DECEDENT
Son
JOINTLY-OWNED PROPERTY:
LE~ I~F DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH
· ITEM FOR JOINT MADE Include na~ of flna~al In~ltutlon and ~nk
account numar or slml~r Idenfl~l~ ~m~r. DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT AEachdeed forJolntly-heldr~lestate. VALUE OF ASSET INTEREST )ECEDENTS INTERES
1 A 07/25/02 Fulton Bank Certificate of 125,000.00 50.00% 62,500.00
Deposit #022-0172606 -
joint with Donald C.
Krafsig
A 07/25/02 ~ccrued interest on item 18.32 50.00% 9.16
'1 to date of death
2 A 07/28/97 Fulton Bank Certificate of 25,000.00 50.00% 12,500.00
Deposit #223-0026436
joint with Donald C.
Krafsig
A 07/28/97 ~ccrued interest on item 116.06 50.00% 58.03
2 to date of death
3 A 10/01/68 ~Fulton Bank checking 10,933~59 50.00% 5,466.80
Account #1068-31683 joint
with Donald C. Krafsig
4 A 04/09/98 PA State Employees Credit 60,000~00 50.00% 30,000;00
Certificate of Deposit
A 04/09/98 ~ccrued dividend on item 161.51 50.00% 80.76
~ to date of death
5 A 04/09/98 PA State Employees Credit 393.88 50.00% 196.94
Member #0181322552
regular shares
Tot~ 1 of Contim ation Schedule(s) 0.11
TOTAL (A~o enter on line 6, Recap~lafion) $ 110,811.80
~pace ~s needed insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSvstems. Inc.
Estate of: Martha F. Krafsig
Soc Sec #: 181'32-2552
Date of Deathi 11/26/2003
Continuation of Schedule F
(Jointly Owned Property)
.Item Ltr for Date Description of property
.# Jt Ten Joint
Total Val
of Asset
Dollar Val of
Decds Interest
A
04/09/98 Accrued dividend on item
5 to date of death
0.21
50.00Z
0.11
0.11
REV-1511 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
E$¥ATE OF
Martha F. Krafst~ SS~/
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
81-32-2552 11/26/2003
FILENUMBER
21-04-173
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
FUNERAL EXPENSES:
Geo's Family Restaurant
2
3
Bo
4o
Giant Foods foods for funeral
Gilbert L. Dailey Funeral Home,
funeral meal
reception at home
Inc. funeral bill
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Social Secur~ Number(s) / EIN Number of Personal Representative(s)
Street Address
City State
Year(s) Commission Paid:
Zip
Attorney's Fees
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant Donald C. Krafsi~
Street Address 1505 High Meadow Lane
C~y Mechanicsbur8 State PA Zip 17055
Relationship of Claimant to Decedent Son
Probate Fees
Accountant's Fees
- prorated refund
TOTAL (Also enter on line 9, Recapitulation)
811.80
445.92
6,530.24
Tax Return Preparer's Fees
Other Administrative Costs
Pennsylvania State Employees' Retirement System
3,500.00
163.03
$ 11,450.99
(If more space is needed, insert additional sheets of the same size)
Copyright (c~ 1996 form software only CPSvstems. Inc. Fc~rm RI~V-
REV-1513 EX * (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Martha F. Krafstg SS# 181-32-2552
SCHEDULE J
BENEFICIARIES
11/26/2003
RELATIONSHIP TO DECEDENT
NUMBER
II.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [l~l~e outright spou~l dl~db~lo~, and
transf~s u~er S~, 9116~1.~]
Donald C. Krafsig
1505 Hlgh Meadow Lane
Mechanicsburg, PA 17055
Do Not List Trustee(s)
Son
FILE NUMBER
AMOUNT OR SHARE
OF ESTATE
Entire estate
ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
$ 0.00
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET
(If more space is needed, insert additional sheets of the same size)
Co~vrlaht (c} 2000 form software only The Lackner Groun. In~ Farm RI=V-IS13 L=~ (n~, e_eel
BUREAU OF /ND/VTDUAL TAXES
[NHERTTANCE TAX DTV/STON
DEPT. 280601
HARRTSBURG, PA 17128-0601
LZNDA LEEBOV 60LDSTON
HCGUZRENOODS
625 LZBERTY AVE
P6H PA 15222
CONNON#EALTH OF PENNSYLVANZA
DEPARTNENT OF REVENUE
NOTZCE OF ZNHERZTANCE TAX
APPRAZSENENT, ALLO#ANCE OR DZSALLONANCE
OF DEDUCTZONS AND ASSESSNENT OF TAX
REV-I.~I7 EX AFP
DATE 05-10-200q
ESTATE OF KRAFSZG NARTHA F
DATE OF DEATH 11-26-2005
FZLE NUNBER 21 0q-0175
COUNTY CUHBERLAND
ACN 101
A~ount Rmnitted I
HAKE CHECK PAYABLE AND RENZT PAYNENT TO:
REGZSTER OF gZLLS
CUH~ERLAND CO COURT HOUSE
CARLZSLE, PA 17015
CUT ALONG THZS LZNE ~ RETAZN LO#ER PORTZON FOR YOUR RECORDS ~
· REV-IS47 EX AFP (01-03) NOTZCE OF ZNHERZTANCE TAX APPRAZSEHENT, ALLONANCE OR
DZSALLOHANCE OF DEDUCTZONS AND ASSESSNENT OF TAX
ESTATE OF KRAFSTG HARTHA F FZLE NO. 21 0~-0173 ACN 101 DATE 05-10-200~
TAX RETURN HAS: (X) ACCEPTED AS FZLED ( ) CHANGED
RESERVATZON CONCERNZNG FUTURE ZNTEREST - SEE REVERSE
APPRAZSED VALUE OF RETURN BASED ON: ORIGZHAL RETURN
1. Reel Estate (Schedule A) (1) .00
2. Stocks and Bonds (Schedule B) (2) 920.6~
3. Closely Held Stock/Partnership Znterest (Schedule C) (3) . O0
~. Nortgeges/Notes Receivable (Schedule D) (~) .00
5. Cesh/D~nkDeposits/Hlsc. Personal Property (Schedule E) (5) lz222.71 tax payment.
6. Jotntly O~ned Property (Schedule F) (6) 110;811.80
7. Transfers (Schedule 8) (7), .00
8. Tote1 Assets (8) 112,955.15
APPROVED DEDUCTZONS AND EXEHPTZONS:
11,q50.99
9. Funeral Expenses/Adm. Costs/Nisc. Expanses (Schedule H) (9),
10. Debts/Hortgege Liabilities/Liens (Schedule Z) (10) .OQ
11. Total Deductions (11) ]].450.99
12. Nat Value of Tax Return (12) 101,50q.16
13. Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (15) .00
1~. Nat VaZue of Estate Subject to Tax (1~) 101,50~.16
NOTE: Zf an assessment ~as issued previously, lines 1~, 15 and/or 16, 17~ 18 and 19 ~ill
reflect figures that include the total of ALL returns assessed to date.
ASSESSNENT OF TAX:
15. Amount of Line lq at Spousal rate (15) .00 X O0 = .00
16. Amount of Line 1~ taxable at Lineel/Clsss A rate (16) 101,50~.16 x 0~5 = ~,567.69
17. Amount of Line lq at Sibling rata (17) .00 X 12 = .00
18. Amount of Line lq taxable at Collateral/Class B rate (18) .00 X 15 = .00
19. Principal Tax Due (19)= q,567.69
rAX CREDZTS:
PAYHENT RECEZPT DZ$COUNT (+)
AHOUNT PAZD
DATE NUNBER ZNTEREST/PEN PAZD (-)
02-18-200~ CD005588 228.38 ~,688.27
C BALANCE OF TAX DUE 3~8.96CR
s ZNTEREST AND PEN. .00
TOTAL DUE 3~8.96CR
~ ZF PAZD AFTER DATE ZNDZCATED, SEE REVERSE ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYNENT ZS RE~UZRED.
FOR CALCULATZON OF ADDZTZONAL ZNTEREST. ZF TOTAL DUE ZS REFLECTED AS A 'CREDZT' (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE SZDE OF THZS FORH FOR ZNSTRUCTZONS.)
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
2004
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
ESTATE OF MARTHA F. KRAFSIG,
Deceased
ORPHANS' DIVISION
No. 0~-04-173
.~O2__~_~. OF COURT
AND NOW, to wit, thi~ da} of ~ ,2004, upon consideration of a
Petition for Settlement of Gross Estate Under $25,000 presented in open Court by Donald C. Krafsig,
Petitioner, by his attorney, Jay R. Braderman, Esquire, it is hereby ORDERED and DECREED that the
following assets:
PA SERS pension check ........................ $1,222.71
Claim for IRS refund, 2003-1040 ................. 94.00
28 shares MetLife stock ......................... 914.20
Accrued dividend on MetLife stock to date of death.. 6.44
$2,237.35
are hereby distributed to Donald C. Krafsig to reimburse him for expenses advanced on
behalf of the Estate in accordance with the terms of this Petition
All persons, individuals, corporations, transfer agents, registrars, and others
hereof unless exceptions are filed.
BY THE COURT
dealing with the property of said Martha F. Krafsig, deceased, are hereby directed
recognize Donald C. Krafsig as the distributee of said estate and are
~ ~sets
and directed to follow his instructions concerning the distribution of s
~ h~l
This Order shall become final at the expiration often (10) day m t ate