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Home My WebLink About12-29-08 (2)1505607120 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN Po Box.28osoi 2 1 0 8 1 13 1 Harrisburg, PA 17128-0601 ~ RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 1512 24 6927 11 06 2008 O1 05 1921 Decedent's Last Name Suffix Decedent's First Name MI KI'MES LIZETTA P (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spou:>e's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IIV APPROPRIATE OVALS BELOW 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) '~ 4. Limited Estate ~ qa. Future Interest Compromise ~ 5. Federal Estate Tax Return Required (date of death after 12-12-82) L^ ~ g Decedent Died Testate ~,~ (Attach Copy of Will) ^ 7 Decedent Maintained a Living Trust (Attach Copy of Trust) 8. Total Number of Safe Deposit Boxes 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach SCh. O) CORRIESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number DA'~TID A MEGAY ESQUIRE 610 323 2800 {~..> Firm Name (If Applicable) O'DONNELL, WEISS & MATTEL, P.C. First line of address 41 E. HIGH STREET Second line of address City or Post Office P07"TSTOWN State ZIP Code PA 19464-5426 Correspondent'se-mail address: dmegay~OWmIaW.COm Under penalties of perjury, I declare that I ha fined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration f Qreparer other than the personal representative Is based on all information of which preparer has any knowledge. SIGNATUR F RSON RESPONSIyLE FOR FI I G RETURN / DATE l 23 E. Sixth/Street, Unit L, Gary G. Kimes /~~/,S' Pottstown, PA 19464 PREPARER OTHER THAN REPRESENTATIVE David A Megay Esquire 41 E. Hight Street, Pottstown, PA 19464-5426 l ~z /~ DATE Side 1 1505607120 1505607120 REGISTER 4F WALLS USFs:ONLY '" -~ ~ _t~ ,', ;' J %-"~ DATE FILED C:~~ 1505607220 REV-1500 EX Decedent's Name: LlZetta P. Kimes Decedent's Social Security Number 19 2 2 4 6 9 2 7 RECAPITULATION 1. Real Estate (Schedule A) .......................................................................................... 1. 2. Stocks and Bonds (Schedule B) ............................................................................... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C).......... 3. 4. Mortgages & Notes Receivable (Schedule D) .......................................................... 4. 3 1 , 0 9 8 . 1 1 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ................ 5. 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested .............. 6. 7. Inter-Vivos Transfers i~ Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested ............. 7. 8. Total Gross Assets (total Lines 1-7) ....................................................................... 8. 3 1: 0 9 8. 1 1 6 , 1 3 7 . 0 0 9. Funeral Expenses & Administrative Costs (Schedule H) ......................................... 9. 7 5 . 0 0 1U. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10. 11. Total Deductions (total Lines 9 & 10) ...................................................................... 11. 6,212.00 12. Net Value of Estate (tine 8 minus Line 11) ............................................................. 12. 2 4 , 8 8 6 . 1 1 13. Charitable and Governmental BequestslSec 9113 Trusts for which an election to tax has not been made (Schedule J) ................................................. 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ................................................. 14. 2 4 , 8 8 6 . 1 1 TAJ( COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .00 0 . 0 0 15. 16. Amount of Line 14 taxable 8 8 6. 1 1 2 4 16. at lineal rate X .045 , 17. Amount of Line 14 taxable 0 0 0 17. at sibling rate X .12 18. Amount of Line 14 taxable 0 0 0 18. at collateral rate X .15 . 19. Tax Due .................................................... ................................................................ . 19. 20. FILL IN 7HE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 0.00 1,119.87 0.00 0.00 1,119.87 Side 2 1505607220 1505607220 REV-1500 EX Page 3 Decedent's Complete Address: Fite Number 21-08-1131 DECEDE=NT'S NAME I_izetta P. Kimes STREET ADDRESS 131 Cottage Road CITY Shippensburg STATE PA ZIP 17257 Tax PaKments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credil:s/Payments ,4. Spousal Poverty Credit B. Prior Payments C. Discount 3. Interest/Penalty if applicable D_ Interest E.. Penalty 1,063.88 55.99 Total Credits (A + B + C) (1) 1,119.87 (2) 1,119.87 Total Interest/Penalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 2 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A,. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT (3) (4) (5) 0.00 (5A) (5B) ~ . Q Q PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred :.................................................................................. ^ b. retain the right to designate who shall use the property transferred or its income :.................................... ^ c. retain a reversionary interest; or .................................................................................................................. ^ d. receive the promise for life of either payments, benefits or care? .............................................................. ^ 2. if death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................................................... ^ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... ~] Ox 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. For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are stilt applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §9116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116 (a) (1.3)]. A sibling is defiined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. Rev-1608 EX+ (g_88) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, .& MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Kimes, Lizetta P. 21-08-1131 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointlyowned with tha right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE NUMBEIR DESCRIPTION OF DEATH 1 MST Bank - CD #31003913373129 30,000.00 Accrued interest on Item 1 through date of death 47.40 2 M$T Bank -Checking Acct. #913076421 1,050.67 Accrued interest on Item 2 through date of death 0.04 TOTAL (Also enter on Line 5, Recapitulation) I 31,098.11 (If more space is needed, additional pages of the same size} Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) REV-1151 Ex+ (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES 8~ ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Kimes, Lizetta P. 21-08-1131 Gebts of decedent must be reported on Schedule 1. ITEnA DESCRIPTION AMOUNT NUMBER A, FUNERAL EXPENSES: See continuation schedule(s) attached B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Gary G. Kimes Social Security Number(s) / ElN Number of Personal Representative(s): Street Address 23 E. Sixth Street, Unit 12B City Pottstown State PA zip 19464 Year(s) Commission paid None 2. Attorney's Fees O'DONNELL, WEiSS ~ MATTEI, P.C. 3, Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent _ 4. Probate Fees 5. Accountanl's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs See continuation schedule(s) attached 4,465.00 1,500.00 172.00 __.___._ Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Kimes, Lizetta P. 21-08-1131 ITEM NUMBER DESCRIPTION AMOUNT Funeral Exaenses 1 EBY Granite Works -memorial 1,775.00 2 EBY Granite Works -memorial engraving 110.00 3 Thomas L. Geisel Funeral Home, Inc. -funeral services 2,580.00 H-A subtotal 4,465.00 Other Administrative Costs 4 Register of Wills -probate 148.00 5 Thomas L. Geisel Funeral Home, inc. - 4 additional death certificates ~ $6.00 ea. 24.00 H-B7 Subtotal 172.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev1512 EX+ (8.98) SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, ~ LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Kimes, Lizetta P. 21-08-1131 Include unrelmbursed medical expenses. (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98) REV•1613 FSX+ (9-00~ SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ~ FILE NUMBER Kimes, Lizetta P. 21-08-11 31 NUME3ER NAME AND ADDRESS OF RELATIONSHIP TO r D D SHARE OF ESTATE AMOUNT OF ESTATE PERSON(S) RECEIVING PROPERTY po Notust 7n,s tee(a) (Words) ($$$) I~ TAXABLE DISTRIBUTIONS (include outright spousal distributions, and transfers under Sec. 9116(a)(1.2)] 1 Gary G Kimes Son Entire 23 E. Sixth Street, Unit 12B residuary Pottstown, PA 19464 estate Total Enter dollar amounts for distributions shown above on lines 1 5 through 18, as appropr iate, on Rev 1500 cove r sheet NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 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 ~ u.uu Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98) LAST WILL ANl? TESTAME~ ~ . ci7 ~ .~- ~ -: :._i LIZL'TTA H. DIMES ~-~_J,~ =- ~~ :,~ -'~- x~ ,- ..i q c.- I, LIZETTA H. KIMES, of Franklin County, Pennsylvania, being of soun~'' and ' ~.' disposing mind, memory, and understanding, do hereby make, publish and declare this as and fc-r my last will and testament, hereby revoking all other wills and codicils heretofore made by me. c~ FI~tST ti \c'`` ,~~ I direct the payment of my debts and expenses of my last illness and funeral from my \~~ r ~~~ estate as soon after my death as conveniently may be done. It is my wish to be cremated. ``~ ~. `~~~~ SE`COND :` ~•~ ~ 1 give and bequeath all tangible personal property owned by me at the time of my ~~ ~V death togetherwith all insurance policies thereon, unto my son, GARY G. KIMES, if he survives ~~, me by sixty (60) days. V THIRD I give, devise and bequeath all the rest, residue and remainder of my estate unto my son, GARY G. KIMES, if he survives me by sixty (60) days. In the event he fails to survive me by sixty (60} days, I give, devise and bequeath all the rest, residue and remainder of my estate, in equal shares, unto my nieces, BARBARA J. CARBAUGH, GLENDA LOWSON, and PATTY HOCKENBERRY, provided, however, that should any one of the not survive me their share is to be divided among the survivors thereof. FO~~TH I direct that any and all Inheritance, Estate and Transfer Taxes imposed upon my estate passing under my will or otherwise, shall be paid out of the principal of my residuary estate. FIFTH In addition to the powers conferred by faw, 1 authorize my Executor, in his or her absolute discretion: r ~ ,~ ~'' (a) to retain in the form received, and to sell either at public or private sale any real ~; ~._ 1 ~l, ~~ or personal property; ~~. ~ a~ ~, .~~. `' (b) to exercise any option or rights arising from ownership of investments; ~~~ . ;, 1 (c) to compromise claims without court approval, and without the consent of any ~1,1\~ .~w beneficiary, and to abandon any property which, in my Executor's opinion, is of little or no value; ~~~ ~~~_,; (d) to fife any state or federal income tax return for any year for which I have not filed 1 ~~ such, return prior to my death. ~~, ~_ SIXTH Provided always, and I do hereby declare my will to be, that if any person or persons to whom any estate or interest is given or limited by this my will shall, in any court of law or equifi~, or otherwise, controvert the same, or dispute or call in question the validity hereof, or of any of the estates, limitations, powers, provisos, or dispositions hereby limited or given, or made, or herein contained, then and in such case the estates, interests, limitations, &c., so hereby limited, &c., to or in favor of such person or persons so controverting my said will, shall cease, determine, and be absolute{y void to all intents and purposes whatsoever, as if such Page 2 of 5 person or persons was or were naturally dead. And then and from thenceforth such estates, interests, limitations, powers, provisos and dispositions shall go and belong to and be vested in the person or persons who, by virtue of this my will, shall be next in remainder after the person or persons so disputing as aforesaid: Provided he, she, or they shall not controvert or dispute the validity of this my will, or any of the devises, limitations, powers, provisos, or dispositions herein contained or hereby made. SEVENTH ~~~ ~\ ~` Any and all payment or payments of any sum or sums, whether in cash or in kind and ,~ ~ whether for principal or income, payable to the said beneficiaries or any of them, shall be made ~. \. jy. upon the sole receipt of the respective individual to whom the payment is made, and free from ~~ `~ anticipation, alienation, assignment, attachment, and pledge, and free from control by the ,, -~; ` ~. \; ~`~ creditors of any such beneficiary. All shares of principal and income herein given shall be free ~.~ ~ a ~' from anticipation, assignment, pledge, or obligations of any beneficiary, and shall not be subject i , ~-' to any execution or attachment. EIGHTH I nominate, constitute and appoint my son, GARY G. KlMES, Executor of this my fast will and testament. In the event of the renunciation, death, resignation or inability to act for any reason whatsoever of my said son, I nominate, constitute and appoint my niece, BARBARA J. CA~RBAUGH, Executrix of this my last will and testament. l hereby relieve my Executor from the necessity of posting security in connection with the Executor's duties as such in any jurisdiction in which my Executor may be called upon to act insofar as I am able by law to do so. Page 3 of 5 IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my last will and testament, consisting of five pages, the first three of which bear my signature in the margin for the purpose of identification this 29'h day of August, 2007. Lizetta'H. Kimes Signed, sea{ed, published and declared by the above named Testatrix, LIZETTA H. KIIIJIES, as and for her last will and testament, in the presence of us, who, in her sight and presence, and in the sight-~ presence of each other, have hereunto subscribed our names as wilr~ss~ ~~ ,='~/ ~~ ~I~ii~iarcYLewisr,~u`sTiman, Esquire /, ; ~~ % L~1 ; C- ~L.~ Sherry Rosenberry Lacy-J J h son 16767 Path Valley Road Spring Run, Pennsylvania 17262-0051 1257 Brechbill Road Chambersburg, Pennsylvania 17201 23632 Back Road Concord, Pennsylvania 17217 Page 4 of 5 ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA COUNTY OF FRANKLIN SS. I, LIZETTA H. KIMES, having been duly qualified according to law, acknowledge that I signed the foregoing instrument as my will, and that I signed it as my free and voluntary act for the purposes therein expressed. ,~~ i... i ,r Lizetta' H_ Kimes We, having been duly qualified according to law, depose and say that we were present and saw LIZETTA H. KIMES sign the foregoing instrument as her will; that she signed it as her free and voluntary act for the purposes therein expressed; that each of us in her sight and hearing arnd at her request signed the will as witnesses; and that to the best of our knowledge she was at ghat time eighteen (18) or more years of age, of influence. Subscribed, sworn to or affirmed, and acknowledged before me by the above- narned testatrix and by the witnesses whose names ap- pearopposite on the 29t" day of August, 2007. and under no constraint or undue , L ~ Witnes /~ ~'~ vi . Notary Pu, Ic Notarial Seal Sherry A. Rosenberry, Notary Public Fannett TVup., Franklin County My Commission Expires May 5, 2011 Page 5 of 5 O 1VI&TBank 499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12 Phone (888)502-4349 Fax (302)434-2455 December i 0, 2008 O'Donnell, Weiss & Mattel, P.C. Attorneys At Law 41 East High Street Pottstown, Pennsylvania 19464-5426 Re: Estate off: Lizetta H. Kimes Social Security 192-24-6927 Date o~Death: November 06. 2008 Dear Sir or Madam: 1'er your inquiry dated December 9, 2008, please be advised that at the time of death, the above-named decedent had on cleposit with this bank the following: ] . Type ofAccount Checking Account Account Number 913076421 Ownership (Names o~ Lizetta H Kimes Opening Date 7/2/79 Closed 11/18/08 Balance on Date of Death $1,050.67 Accrued Interest $ 0. D4 Total $ I,OSO 71 2. Type ofAccount Certifccate of Deposit Account Number 31003913373129 Ownership (Names oj7 Lizetta H Kimes* Opening Date 11/IS/04 Closed 11/17!08 Balance on Date of Death $ 30, 000. DO Accrued Interest $ 47.40 Total $ 30, 047.40 Please be advised, there was no safe deposit box found for the above decedent. * If upon reviewing the information above, you believe there are additional accounts not referenced, please provide us with an account number and/or name of any possible ,joint account holder. For any additional information on the above accounts, including ownership and any changes, closures and/or reimbursement of funds, etc., please contact our King Street Office # 717-532-4132. S' cerely, Tracie Hare Adjustment Services ~~~ ^~ ~~ a w ~ ~ N F' Q ~ ~ ~ N ~ ~ J (n d' N ~ ~' ~_ _ ~ W l.. Q ~ ~ ~ ~ ~ ~ O JQ w r- ° az W ~ o 3 ~ ° `n Z n- U o ~ oQx O H~~~cn ~ W U ~,-+ rH-7 I ~ ~ ~ O ~ WpC, U O ~' U IO ~. ~' w _~ ~1 {r.b -r; ~~ ~. ~_.~t _, :: h,._ _' J ~°~ _i J