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Home My WebLink About02-0092PHILIP J. MURREN RICHARD E, CONNELL MAURA K. QUINLAN TERESA R. McCORMACK THOMAS A. CAPPER LAW OFFICES BALL, MURREN ~ CONNELL 2303 MARKET STREET CAMP HILL, PENNS~fLVANIA 17011 (717) 232-873! FACSIMILE (7! 7) 232-2!42 MAILING ADDRESS: P.O. BOX 1108 HARRISBURG, PENNSYLVANIA 17108-1108 January 24, 2002 WlLUAM BENTI..E"Y BALL (1916-1999) Ms. Mary C. Lewis Register of Wills Office Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 Re; Estate of Charles A. Kiker Our File No. 2553 Dear Ms. Lewis: Enclosed for filing in connection with the Estate of Charles A. Kiker: · Petition for Probate and Grant of Letters (oath administered in Dauphin County) · Renunciation of Right to Letters Testamentary executed by Lenora B. Kiker · Oath of Subscribing Witness-signed by Attorney Richard C. Angino · Last Will and Testament of Charles A. Kiker (with copy). · Copy of Mr. Kiker's death certificate · Estate Information Sheet · Check in the amount of $53.00 for the probate fee and for five (5) short certificates Kindly forward the Letters, short certificates and receipt to me. Please call if anything further is required. Richard E. Connell REC/jjt Enclosures cc: Ms. Janice A. Kiker PETITION FOR PROBATE and GRANT OF LETTERS Estate of Charles A. Kiker No. ~e/~o ~no-~n-os- To: Social Security No. 2 b 1 - 2 B- 95 ]- 2Deceased' 21-02-92 Register of ~Will~for ~e , County of uumDeriano Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner00, who isA'~re 18 years of age or older an~the executri× in the last will of the above decedent, dated ,qop~-omho*' 30, - ar~l- c~lic~)- d~te, d- in the (al tmrnmto) named ,19 76 (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumber land County, Pennsylvania, with h is last family or princi.al residence at_4619 N. Clearview Drive ':.,--..;.tI~m.~._~__Tos~shi~ PA 3 703 '1 (list street, number and muncipality) Decendent, then _. 8/4__ years c~f age, died November 26 , -~._0_0_L at }loly ~qDi~t ~n.q~t~] ; F.~.qt Po~D.qhO~O TOX^rn~qh~n Cumhe~!ap_d Except as follows, decedent did'not marry, was not divorced and did not have a ~hi'ld born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: 3000.00 County, WHEREFORE, petitioner(x) respectfully request(s) the probate of the last will aml-~odicil(~- presented herewith and the grant of letters t e $ t nment ary (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) theron. ,]anzce A. Kiker 4619 N. C]mnrv~ew Dr~vm Camp Hill, PA 17011 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF Dauphin The petitioner~) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of :he knowledge and belief of petitioner(~ and that as personal represen- tative(~ of the above decedent petitioner(~g) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed b ' No. 21-02-92 Estate of Charles A. Kiker , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW FEBRUARY 14 ~ 200~ in consideration of the petition on the reverse side hereof, satisfactory pr°of having been presented before me, IT IS DECREED that the instrument(~j dated September 30, 1976 described therein be admitted to probate and filed of record as the last will 0f Charles A. Kiker ; and Letters are hereby granted to Testamentary Janice A. Kiker FEES Probate, Letters, Etc .......... $ 25.00 Short Certificates( ) .......... $ 15.00 Renunciation ................ $ 5 o 00 x-pages 3.00 JCP $ 5. GG TOTAL__ $ 53.00 Filed ................................... ,~----~ -- ~. y.-----~/ - _ -~ ./ R±chard E. Connell, Esq. I,D. 2156.2 ATTORNEY (Sup. Ct. 1.D. No.) 2303 Market Street, Camp H±ll, PA 1701] ADDRESS (717) 232-8731 PHONE 21-02-92 OATH OF SUBSCRIBING WITNESS RICHARD C. ANGINO, a subscribing witness to the Will presented herewith, being duly qualified according to law, deposes and says that he was present and saw Charles A. Kiker, the testator, sign the same and that he signed as a witness at the request of testator, in his presence and in the presence of the other subscribing witness. Sworn to and subscribed before me this I~day ofj(~'~ ,2002. 4503 N~ront Street Har~urg, PA 17110 Iqlotary Public 21-02-92 RENUNCIATION OF RIGHT TO I,F, TTERS TESTAMENTARY In Re: Estate of Charles A. Kiker, Deceased To: The Register of Wills of Cumberland County, Pennsylvania I, Lenora Betty Kiker, named Executrix in Item V of the Will of Charles A. Kiker, deceased, dated September 30, 1976 hereby renounce my right to administer the estate of Charles A. Kiker and respectfully ask that Letters Testamentary be issued to Janice A. Kiker who is named as my successor in said Will. WITNESS my hand this 7'~kday of ,2002. WITNESSED BY: Len~r~ Betty Kiker 4619 N. Clearview Dr. Camp Hill, PA 17011 his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as l.ocal R, egistrar. The original certificate will be forwarded to the State Vital Records Office for permanent'~filing, WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 No. ~ Date 21-02-92 Local Registrar COMMONWEALTH OF PENNSYLVANIA * DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH _~ .................. ~ i~'/~ I~'~'~ ...... I ............. ..Comgr~ ..~XsT Free. eno .. I~IT HO3Pl I~ ~ ..... ,0 ~NiT~ .... m~,~u o~*~,~ I,,~o~e~ ~s I,,. I,,. '*'~// I "'"" I,,.mt~tt9 I,,~cxn errt7 -/ LAST WILL AND TESTAMENT OF CHARLES A. KIKER 21-02-92 I, CHARLES A. KKKER, of Hampden Township, Dauphin County, Pennsylvania, do hereby make, publish and declare .t~s ~~~L~~,and Testament, hereby revoking all Wills and CodiCils heretofore made!~'b~ me. ~ iITEM I - I order Executrix, hereinafter named, my to pay all my debts and funeral expenses as soon after my death as reasonably possible. ~EM~- Ail the rest, residue and remainder of my Estate, real, personal and mixed, of whatsoever kind and wheresoever situated, I give, devise and bequeath to my Wife, Lenora B. Kiker, provided she survives me for a period of sixty (60) days. ITEM III - Should my Wife, Lenora B. Kiker, pre- decease me or die on or before the sixtieth day following my death, I give, devise and bequeath the rest, residue and remainder of my Estate, real, personal and mixed, of what- soever kind and wheresoever situated, in equal shares, to my 'children, Thomas C. Kiker and Janice A. Kiker. ITEM IV - Should either of my c~ildren predecease me, or fail to S~xvive me for a period of sixty (60) days, leaving children surviving them, then such children shall take the share of their deceased parent, per stirpes. ITEM V - I nominate, constitute and appoint my Wife, Lenora B. Kiker, to be the Executrix of this my Last Will and Testament. In the event my Wife, Lenora B. Kiker, fails or refuses to qualify as such Executrix, then I nominate, constitute and appoint my daughter, Janice A. Kiker, to be the Executrix of this My Last Will and Testament. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this My Last Will and Testament, this day of~~l~.._, 1976. (SEAL) This instrument, consisting of two (2) typewritten pages, each bearing the signature of the above-named Charles A. Kiker, was by him on the date hereof signed, published and declared by him to be his Last Will and Testament, in our presence, who, at his request and in his presence, and in the presence of each other, we, believing him to be of sound and disposing mind and memory, have hereunto subscribed our names as witnesses: PHILIP J. MURREN RICHARD E. CONNELL MAURA K. QUINLAN TERESA R. McCORMACK THOMAS A. CAPPER LAW OFFICES BALL, MURREN & CONNELL 2303 MARKET STREET HmL, PENNSYLVANIA 17011 (717) 232-873! FACSIMILE (717) 232-2142 MAILING ADDRESS: P.O. BOX 1108 HARRISBURG, PENNSYLVANIA 17108-1108 February 5, 2002 WILLIAM laENTI...EY BALL (1916-1999) Ms. Mary C. Lewis Register of Wills Office Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 Re: Estate of Charles A. Kiker Our File No. 2553 Dear Ms. Lewis: Enclosed please find a Verification signed by Lenora B. Kiker, wife of the deceased, for filing along with the documents previously provided. Kindly forward the Letters, short certificates and receipt to me. Richard E. Connell REC/jjt Enclosure cc: Ms. Janice A. Kiker VERIFICATION I, LENORA B. KIKER,, hereby verify that the signature affixed to the Will dated September 30, 1976, is the true and correct signature of the deceased, Charles A. Kiker. 'I~enc~.a B. ~e/r~ 4619 North Clearview Drive Camp Hill, PA 17011 Sworn to and subscribed before me this .~ day of ~v~-.,_~,.[ , 2002. I ~ry Public PHILIP J. MURREN RICHARD E. CONNELL MAURA K. QUINLAN TERESA R. MCCORMACK THOMAS A. CAPPER LAW OFFICES BALL, MURREN & CONNELL 2303 MARKET STREET CAMP HmL, PENNSYLVANIA 17011 (717) 232-873'1 FACSIMILE (7! 7) 232-2! 42 MAILING ADDRESS: P.O. BOX 1108 HARRISBURG, PENNSYLVANIA 17108-1108 February 12, 2002 WIllIAM BENTLEY BAll (1916-1999) Ms. Mary C. Lewis Register of Wills Office Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 Re: Estate of Charles A. Kiker Dear Ms. Lewis: Enclosed please find an Oath of Non-Subscribing Witness signed by Janice A. Kiker at the Dauphin County Register of Wills Office, for filing in the above referenced estate. This satisfies an outstanding requirement before Letters could be issued. Kindly forward the Letters Testamentary, short certificates and receipt to me as requested with earlier correspondence. Very tru Richard E. Connell REC/jjt Enclosure cc: Janice A. Kiker 21-02-92 Register of Wills of Dauphin County, Pennsylvania OATH OF NON-SUBSCRIBING WITNESS Estate of ('~~ (-~, also known as , Deceased NO. (each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that she/he/they was/were familiar with the signature codicH testator(rix) of the (~ill') c-ee~HI presented herewith, and that such subscriber(s) believes the signature on the (~ is in the handwriting of ~"),~h%o~r~h ("~. ~'~, :~_,k~ tO the best of such subscriber's knowledge and belief. (Signature) (Address) /¢# (Signature) (Address) Sworn to or affirmed and subscribed before me this I I~(¢t1 day of ~,,J~ .20 oa.,. F or0he Register (~) (~ ::'. i':': ?; RW- 12 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Charles A. Kiker Date of Death: November 24, 2001 Will No. To the Register: 21-02-092 Admin. No. Mary C. Lewis, Register of Wills Cumberland County I certi~ that notice of (beneficial interest) estate administrate, on 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 February 22~ 2002 Name Lenora B. Kiker Address 4619 North Clearview Dr., C~mp Hill, PA 17011 Janice A. Kiker 4619 North Clearview Dr., Camp Hill, PA 17011 Thomas C. Kiker 531 Simpson Street, Mechanicsbur~, PA 17055 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: February 22,2001 Name Richard E. Connell, Esc1. Address 2302 Market Street Camp Hill, PA 17011 Telephone (717) 232-8731 Capacity: 60:Zd ~;Z~]]~ ZO. X Personal Representative Counsel for personal representative OMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) Kiker, Lenora B. FILE NUMBER 21 02 COUNTY CODE YEAR 00092 HARRISBURG, PA 17128-0601 NUMBER DECEDENT'S NAME (LAST, FIRST, AND MEDDLE INITIAL) SOCIAL SECURITY NUMBER Kiker, Charles A. 261-28-9512 DATE OF DEATH (MM-OD-YEAR) DATE OF B~RTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE [11/24/2001 02/20/1917 REGISTER OF WILLS 1. Original Return 4. Limited Estate 6. Decedent Died Testate (Attach copy of Will) 9. Litigation Proceeds Received SOCIAL SECURITY NUMBER ~.oo ~IAME Richard E. Connell fIRM NAME (If applicable) Ball, Murren & Connell [] 2. Supplemental Retum ] 4a. Future Interest Compromise (date of death after 12-12-82) [] 7. Decedent Maintained a Living Trust (Attach copy of Trust) [] 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) tELEPHONE NUMBER 717/232-8731 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) ] 3. Remainder Return (date of death pdor to 12-13-82) [] 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 2303 Market Street Camp Hill, PA 17011 None? 2,669.07 None None 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) Jointly Owned Property (Schedule F) (6) [] Separate Billing Requested 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) Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 10. 11. 13. 14. Total Deductions (total Lines 9 & 10) 250.00 1,629.97 None 9,326.03 Net Value of Estate (Line 8 minus Line 11) 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) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15.Amount of Line 14 taxable at the spousal tax rate, 0.00 x .00 or transfers under Sec. 9116(a)(1.2) 16.Amount of Line 14 taxable at lineal rate 0.00 17. Amount of Line 14 taxable at sibling rate 0.00 18. Amount of Line 14 taxable at collateral rate 0.0 0 (8) 4,549.04 (11) 9,326.03 (12) insolvent (13) 0.00 ('14) 0.00 19. Tax Due (15) 0.00 x .045 (16) 0.00 x .12 (17) 0.00 x .15 (18) 0.00 (19) 0.00 20. [] Copyright 2000 form software only The Lackner Group, Inc. Form REV-I $00 EX (Rev. 6-00) DeCedent's Complete Address: STREET ADDRESS CITY Camp Hill STATE PA ZIP 17011 4619 North Clearview Drive 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 Total Credits (A + B + C) Total Interest/Penalty (D + E) (1) (3) If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) Check box on Page 1 Line 20 to request a refund 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 + 5A. This is the BALANCE DUE. (5BI Make Check Payable to: REGISTER OF WILLS, AGENT 0.00 (2) 0.0 0 0.00 0.00 0.00 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? ......... [] [] 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 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 knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN Janiee A. Kiker GNATURE OF PERSON RESP(~SI§LE F~R FILING RETURN ADDRESS DATE 4619 North Clearview Drive ~"/?- O~- ADDRESS DATE ADDRESS DATE Ric~f~d E. Connell 2303 Market Street Camp Hill, PA 17011 z_ 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 3% [72 P.S. §9116 (a) (1.1) (ii]. 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 0% [72 P.S. {}9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [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 4.5%, 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 12% [72 P.S. §9116 (a) (1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Kiker, Charles A. FILE NUMBER 21 - 02 - 00092 All property jointly-owned with right of survivomhip must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OF DEATH 1 $18.9 333.00- Mattel, Inc. CUSIP 577081 10 18 shares - common 11/23 avg 18.97 11/26 avg 18.85 18.91 37.82 2 Pepsi 47.753 shares - common High Low Avg 11/23 $49.40 $49.02 $49.21 11/26 49.50 48.35 48.63 $48.92 = .,,97.84 2 TOTAL (Also enter on line 2, Recapitulation) $48.92 2,336.07 2,669.07 SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Kiker, Charles A. FILE NUMBER I 21 - 02 - 00092 include the ~oroceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivomhlp must be disclosed on schedule F. ITEM !VALUE AT DATE OF NUMBER DESCRIPTION DEATH 1 Personal effects 250.00 TOTAL (Also enter on Line S, Recapitulation) 250.00 SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Kiker, Charles A. FILE NUMBER 21 - 02 - 00092 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 Janice Kiker 4619 North Clearview Drive daughter Camp Hill, PA 17011 JOINTLY OWNED PROPERTY: ITEM NUMBER LE'I-r'ER DATE FOR JOIN'i' MADE TENANT JOINT A 08/28/1964 DESCRIPTION OF PROPERTY ~ ................. Include name of financial institution and bank account number DATE OF DEATH % OF DATE OF DEATH ~r similar identifying number. Attach deed for jointly-held real VALUE OF ASSET IiN~T~,~T DECEDENT'S INTEREST ~=state. r-,:,-,,-,,o VALUE OF Allfnrst Checking Account 0051205475 9,779.601 16.66~0 1,629.97 (account held by husband/wife/daughter Reported amount is daughter's interest in decedent's 1/3 share) TOTAL (Also enter on line 6, Recapitulation 1,629.97 COMMONVVEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCI-IEDtJ_E H ~EXPENSES& ADM1MS'IRAT1VE COS~ ESTATE OF Kiker, Charles A. FILE NUMBER / 21 - 02 - 00092 Debts of decedent must be reported on Schedule I. ITEM - NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1 Neill Funeral Home Bo ADMINISTRATIVE COSTS: Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s): Street Address City State Zip Year(s) Commission paid Attorney's Fees 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 Probate Fees Dauphin County - Register of Wills (witness fee; oath of executrix) $30.00 Cumberland County - Register of Wills (Probate fees) $53.00 Accountant's Fees Tax Return Preparer's Fees Other Administrative Costs Cumberland Law Journal The Sentinel Total of Continuation Schedule(s) TOTAL (Also enter on line 9, Recapitulation) 9,134.16 75.00 80.87 36.00 9,326.03 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Kiker, Charles A. Schedule H Funeral Expenses & Administmlive ~ ~n~ FILE NUMBER 21 - 02 - 00092 Register of Wills, Cumberland County (additional short certificates) 36.00 Page 2 of Schedule H COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Kiker, Charles A. SCHEDULE J BENEFICIARIES I FILE NUMBER 21 - 02 - 00092 NUMBER 2 II. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (include outright spousal distributions) Lenora B. Kiker 4619 North Clearview Drive Camp Hill, PA 17011 Janice A. Kiker 4619 North Clearview Drive Camp Hill, PA 17011 RELATIONSHIP TO DECEDENT Da Not LIBt Trulteet.~.~ Wife Daughter -'nter dollar amounts for distributions shown above on lines 15 through 17, as appropriate, on Rev 1500 cover sheet NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE IB. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEETi AMOUNT OR SHARE OF ESTATE all per Will 16.667% of Joint Account reported on Schedule F LAST WILL AND TESTAMENT OF CHARLES A. KIKER I, CHARLES A. K~KER, of Hampden Township, Dauphin County, Pennsylvania, do hereby make, publish and declare this ~0 ~ie~J~L~~%and Testament, hereby revoking all Wills and codicils heretofore made by me. ITEM I ~ I order my Executrix, hereinafter named, to pay all my debts and funeral expenses as soon after my death as reasonably possible. .~TEMi~I~%~? Ail the rest, residue and remainder of my Estate, real, personal and mixed, of whatsoever kind and wheresoever situated, I give, devise and bequeath to my Wife, Lenora B. Kiker, provided she survives me for a period of sixty (60) days. ITEM III - Should my Wife, Lenora B. Kiker, pre- decease me or die on or before the sixtieth day following my death, I give, devise and bequeath the rest, residue and remainder of my Estate, real, personal and mixed, of what- soever kind and wheresoever situated, in equal shares, to my ~chi.ldren, Thomas C. Kiker and Janice A~ Kiker. ITEM IV - Should either of my Children predecease me~ or fail to ~u~vive me for a period of sixty (60) days, Wit] ~ses: (SEAL) leaving children surviving them, then such children shall take the share of their deceased parent, per stirpes. ITEM V - I nominate, constitute and appoint my Wife, Lenora B. Kiker, to be the Executrix of this my Last Will and Testament. In the event my Wife, Lenora B. Kiker, fails or refuses to qualify as such Executrix, then I nominate, constitute and appoint my daughter, Janice A. Kiker, to be the Executrix of this My Last Will and Testament. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this My Last Will and Testament, this ~ , 1976. day of (SEAL) This instrument, consisting of two (2) typewritten pages, each bearing the signature of the above-named Charles A. Kiker, was by him on the date hereof signed, published and declared by him to be his Last Will and Testament, in our presence, who, at his request and in his presence, and in the presence of each other, we, believing him to be of sound and disposing mind and memory, have hereunto subscribed our names as witnesses: residing at Register of Wills of Cumberland County, Pennsylvania INVENTORY Estate of Kiker, Charles A. also known as No. 21 ~ 02- 00092 Date of Death 11/24/2001 Social Security No. 261-28-9512 , Deceased Janice A. Kiker The Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory include all of the personal assets wherever situate and all of the real estate located 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 the Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this Inventory. I/We verify that the statements made in this Inventory are true and correct. I/We understand that false statements herein are made subject to the penalties of 18 Pa. C. S. Section 4904 relating to unsworn falsification to authorities. Attorney: I.D. No.: Address: Richard E. Connell 21542 2303 Market Street Camp Hill, PA 17011 Personal Representative S ignature:JC;V~.,cc Cdanice A. Kiker Signature: Signature: Address: 4619 North Clearview Drive Telephone: 717/232-8731 Personal Property Mattel, Inc. CUSIP 577081 10 18 shares - common 11/23 avg 18.97 11/26 avg ....18.85_ 18.91 .... 37.82 2 Pepsi 47.753 shares - common High Low Avg 11/23 $49.40 $49.02 $49.21 11/26 49.50 48.35 ..48.63_ $48.92 = _97.84 2 Personal effects Telephone: Dated: °c' -/~;- O ~ 333.00 2,336.07 Total Personal Property 250.00 $2,919.07 (Attach additional sheets if necessary) Total Personal Property and Real Estate $2,919.07 BUREAU OF TND/VTDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 171z8-060! COHHONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOT/CE OF INHERITANCE TAX APPRAISEMENT, ALLO#ANCE OR DZSALLO#ANCE OF DEDUCTIONS AND ASSESSMENT OF TAX RICHARD E CONNELL BALL ETAL 2505 HARKET ST CAHP HILL PA 17011 DATE 09-$0-2001 ESTATE OF KIKER CHARLES A DATE OF DEATH 11-24-2001 FZLE NUMBER 21 02-0092 COUNTY CUHBERLAND ACN 101 Amount Remitted I NAKE CHECK PAYABLE AND RENZT PAYNENT TO= REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THZS LINE ~ RETAIN LOWER PORTZON FOR YOUR RECORDS ~ REV-Z547 EX AFP (01-02) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DZSALLO#ANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF KIKER CHARLES AFZLE NO. 21 02-0092 ACN 101 DATE 09-$0-2002 TAX RETURN NAS: (X) ACCEPTED AS FZLED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSF APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 2. S~ocks and Bonds (Schedule B) (2) $. Closely Held S~ock/Par~nershlp In*eras* (Schedule C) (5) fi. Mortgages/No,es Receivable (Schedule D) (q) $. Cash/Bank Deposits/Misc. Personal Proper~y (Schedule E) ($) 6. Jointly Owned Propar~y (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. To,al Asse~s APPROVED DEDUCTZONS AND EXENPTZONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 10. Debts/Mortgage Liabili~/es/Liens (Schedule 1) (10) 11. To~al Deduct/ons 12. Ne~ Value of Tax Re~urn 15. 1~. Char/*able/Governmen*al Bequests; Non-elected 9115 Trusts (Schedule J) Ne* Value of Es~a~e Sub~ec~ ~o Tax · O0 NOTE: To /nsure proper 669.07 cred/~ ~o your account, · O0 subm/~ ~he upper portion · O0 of ~h/s form w/~h your 150. O0 ~ax payment. lz629.97 .00 (a) 4,549.04 $26.05 .00 (11) 9 ·326. §3 (la) 4,776.99- (13) . O0 (1,~) 4,776.99- NOTE: ASSESSMENT OF TAX: 15. Amoun~ of L/ne lq a~ Spousal ra*e 16. Amoun~ of L/ne lfi ~axable a~ Lineal~Class A rate 17. Amoun~ of Line lfi a~ Sibling ra*e 18. Amoun~ of L/ne 1~ ~axable 19. Principal Tax Due TAX CREDITS: PAYMENT RECEIP1 DISCOUNT DATE NUMBER INTEREST/PEN PAID (-) Zf an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 reflect figures that /nclude the total of ALL returns assessed to date. will (15) .00 X O0 = .00 (16) .00 X 045 = .00 (17) . O0 X 12 = . O0 (18) .00 X 15 : .00 (19)= . O0 1F PAID AFTER DATE ZND/CATED~ SEE REVERSE FOR CALCULATION OF ADDZTZONAL INTEREST. AMOUNT PAZD TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE .0O .00 .00 .00 ( 'rF TOTAL DUE TS LESS THAN $1, NO PAYMENT ]'S RE~UTRED. TF TOTAL DUE 'rs REFLECTED AS A "CRED'rT" (CR)~ YOU MAY BE DUE A REFUND. SEE REVERSE S.rDE OF TH.rS FORM FOR TNSTRUCT'rONS. ) RESERVATION: PURPOSE OF NOTICE: PAYHENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 1Z, 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 or for years, the CoamonaeaZth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class 8 (collateral) rate on any such futura interest. To fulfill the requirements of Section ZI~O of the Inheritance and Estate Tax Act, Act Z3 of ZOO0. (TI P.S. Section 9140). Detach the top portion of this Notice and submit aith your payment to the Register of Wills printed on the reverse side. --Hake check or money order payable to: REGISTER OF ~ILLS, AGENT A refund of a tax credit, which was not requested on the Tax Return, may bm requested by completing an "AppXication for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313}. Applications are available at the Office of the Register of Hills, any of the Z3 Revenue District Offices, or by calling the special Z4-hour answering service for forms ordering: Z-800-36Z-Z050; services for taxpayers with special hearing and / or speaking needs: 1-800-~7-30Z0 (TT Any party in interest not satisfied with the appraisement, alloeanca, or disallowance of deductions, or assessment of tax (including discount or interest) as sheen on this Notice must object within sixty this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. Z810Z1, Harrisburg, PA 171ZS-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 writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 171Z8-0601 Phone (717) 787-6505. 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 dacedent's death, a five percent (SI) discount of the tax paid is allowed. The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and nat paid before January 18, 1996, the first day after the and of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you could 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 free the date of death, to the date of payment. Taxes ahich became delinquent before January 1, 198Z bear interest at the rata of six (SI) percent per annum calculated at a daily rate of .00016~. All taxes which became delinquent on and after January 1, 198Z ail1 bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOO2 are: Year Interest Rate Daily Interest Factor Year Interest Rate Daily Interest Factor 198Z lOX .0005~8 199Z 9Z .0002~7 1983 16Z .000438 1995-199~ 7X .O00IgZ 198~ llZ .000301 1995-1998 9Z .000247 1985 13Z .000356 1999 7Z .00019Z 1986 IOZ .O0027~ ZOO0 8X .O00Z19 1987 9Z .O00Z~7 ZOO1 9Z ,O00Z~7 1988-1991 llZ .000301 200Z 6Z .00016~ --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINQUENT X DAILY IttTEREST FACTOR --Any Notice issued after the tax becomes delinquent ail1 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. PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF TIlE ESTATE. IF ESTATE IS NOT COMPLETED, FILE a 6.12 FORM YEARLY UNTIL COMPLETION STATUS REPORT UNDER RULE 6.12 Name of Decedent: C/~'[~ /~t ~, ~o~,-' Date of Death: ,! Will No.: ~ 1- 0 ~ ' OO ~ Aden. No.: ~ 602- O~ ~ ~su~t to Rule 6.12 of the Supreme Coug O~h~s' Cou~ Rules, I mpo~ the following with respect to completion of ~e M~nistration of the ~ove-capfioned estme: I. State whe~sgation of the estate is complete: Yes No If the answer is No, state when the personal representative reasonably believes that the administration will be complete: (MAH:rmffAM3) ~ .... If the answer to No. 1 is yes, state the following: A. Did the personal representative file a final ac~e court? Yes No. B. The separate Orphans' Court No. (if any) for the personal representative's account is: Did the personal representative state an account informally to the parties ~n interest? Yes No 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 Signature Name (Please type or print) Address /-Z,'tl , / 7 t I Telephone No. Capacity: Personal Representative .Counsel for Personal Representan ~ c RW. - 27 IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA IN RE: ESTATE OF CHARLES A. KIKER, deceased, and LENORA B. KIKER ORPHANS' COURT DIVISION NO: ORDER APPROVING SETTLEMENT AND NOW, This ~ ay of~, !002, upon consideration of the Petition of Lenora B. Kiker, individually and of Janice A. Kiker as Executrix of the Estate of Charles A. Kiker, and the affidavit of counsel, it is hereby ordered and decreed that the settlement in the captioned matter in the amount of Fifty Thousand ($50,000) Dollars is hereby approved. It is further ordered that the settlement shall be paid to Lenora B. Kiker. By the Court: IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA IN RE: ESTATE OF CHARLES A. KIKER, deceased, and LENORA B. KIKER : ORPHANS' COURT DIVISION : NO: ~_ C)~,I-- ~.~__~ PETITION TO SETTLE and APPORTION SETTLEMENT PROCEEDS in WRONGFUL DEATH ACTION and SURVIVAL ACTION THE PETITIONERS, Janice A. Kiker, Executrix of the Will of Charles A. Kiker, and Lenora B. Kiker, surviving spouse of the late Charles A. Kiker, in her own right, respectfully represent that: 1. On November 24, 2001, Charles A. Kiker died as a result of injuries sustained from a motor vehicle accident occurring on November 19, 2001. 2. The Last Will and Testament of Charles A. Kiker was admitted to probate by the Register of Wills of Cumberland County on February 14, 2002. A copy of the Will is attached hereto as Exhibit "A". 3. Janice A. Kiker, decedent's daughter, was duly qualified as Executrix under the Will of Charles A. Kiker on February 14, 2002. 4. The surviving beneficiary under the Will of Charles A. Kiker is Lenora B. Kiker, his wife, who survives him (Item II, Last Will and Testament of Charles A. Kiker). 5. Nationwide Mutual Insurance Company insuring, Janice A. Kiker, the driver of the vehicle, was contacted for the purpose of seeking payment of medical bills. No litigation was commenced for either wrongful death or survival damages. The insurance company, of its own accord, opened a file to consider a wrongful death/claim survival action. 6. The person entitled to the damages under the wrongful death action is Lenora B. Kiker, the decedent's wife as the only family member who experienced a pecuniary loss due to the decedent's death. Janice A. Kiker, his daughter, and Thomas C. Kiker, his son, both adults suffered no pecuniary loss though their respective interests could under some circumstances be available using the proportionate interests they would take in the case of intestacy (42 Pa. C.S.A. §8301 7. The accident occurred as a result of complications arising from hospitalization after the injuries were sustained by the decedent when Janice A. Kiker, the driver of the vehicle in which he was a passenger, ran into the rear of a vehicle which was stopped at a traffic light. 8. Charles A. Kiker was hospitalized with a fractured left hip late on the day of 19th of November. His breathing stopped the next morning before surgery began and he was resuscitated. His breathing was assisted by insertion of a tube. During his hospitalization and following the resuscitation he contracted pneumonia 2 and died five (5) days after the accident. At his death, Mr. Kiker was 84 years of age, having been born on February 20, 1917. 9. Under the automobile insurance policy of Charles A. Kiker and Lenora B. Kiker, Nationwide Mutual Insurance Company paid the sum of Fifteen Thousand ($15,000) Dollars to the Estate of Charles A. Kiker under the underinsured motorists coverage provision of that policy. Since payment was made to the Estate, the proceeds are distributable to the surviving spouse, Lenora B. Kiker. 10. The surviving spouse has lost the companionship and support of Charles A. Kiker and it is that loss which constitutes the principal portion of the damages represented by the wrongful death action. As earlier noted, the children of the decedent lost his companionship but did not suffer any loss of pecuniary support. 11. Lenora B. Kiker has entered into an agreement with the insurance company representing, Janice A. Kiker, the driver, to settle the wrongful death claim, subject to this Court's approval of the settlement of a survival claim pursuant to 20 Pa. C.S. §3323 00). The total amount of the proposed settlement is Fifty Thousand ($50,000) Dollars. 12. Petitioners desire that the gross settlement be allocated in the amount of Fifty Thousand ($50,000) Dollars to Lenora B. Kiker as "wrongful death" damages and that no portion be allocated as damages to decedent's estate as "survival" damages since the estate has already received the Fifteen Thousand ($15,000) Dollars underinsured coverage payment. That no additional amount is 3 sought for the survival portion relates to the short period of time between the injury and death, the age of the decedent, his retired status, the general lack of awareness of his condition following admission to the hospital and the Fifteen Thousand ($15,000) Dollars underinsured payment. 13. The estate of Charles A. Kiker was valued at $4,549.04 with deductible expenses of $9,326.03 and was characterized as an insolvent estate. The estate has no outstanding claims against it. A copy of the inheritance tax return filed within the time period allowed under Pennsylvania law shows the return to be insolvent. No funds are necessary to protect the estate or the interests of the beneficiaries named in paragraph 4 above, lien holders, other creditors or taxing authorities. 14. The settlement is in the best interest of the estate because there is no disagreement within the family as to the distribution. The taxing authorities will not be deprived of any taxes since payments to the estate would, in any event, have been free from inheritance tax since the testator's beneficiary is the surviving spouse, Lenora B. Kiker. 15. All those parties named in this petition believe that the proposed allocation is fair and reasonable and their consents are attached as Exhibit "B". 16. If this petition is granted, the settlement proceeds will be distributed as follows: wrongful death claim to Lenora B. Kiker, the statutory beneficiary with loss of pecuniary support of decedent in the sum of Fifty Thousand ($50,000) Dollars. 4 17. Petitioners retained Richard E. Connell, Esquire as counsel to investigate the case and take steps to submit documentation requested by the insurance company for wrongful death and survival claims. Petitioners and counsel recommend that the proposed distribution as set forth above be approved. The statement of counsel is attached at Exhibit "C". WHEREFORE, the Petitioners request that an Order be entered approving the proposed settlement of the survival action and the proposed allocation of the settlement proceeds for the wrongful death action, and authorize Petitioner, Janice A. Kiker, as Executrix of the Will of Charles A. Kiker, to execute all necessary releases, checks, and taxes. Date I.D. # 21542 Ball, Murren & Connell 2303 Market Street Camp Hill, PA 17011 (717) 232-8731 Attorney for Petitioners LAST WILL AND TESTAMENT OF CHARLES .A. KIKER I, CHARLES A. KiKER, of Hampden Township, Dauphin County, Pennsylvania, do hereby make, publish and declare · %h~s.~.~~L~~.~$mnd Testament, hereby revoking all Wills and Coai~i~ heretofore mad~. ~ me.~ "~'~ ...... ,~iTEM I ~ I order my Executrix, hereinafter named, to pay all my debts and funeral expenses as soon after my death as reasonably possible. ~EM~%~r Ail the rest, residue and remainder of my Estate, real, personal and mixed, of whatsoever kind and wheresoever situated, I give, devise and bequeath to my Wife, Lenora B. Kiker, provided she survives me for a period of sixty (60) days. ITEM III - Should my Wife, Lenora B. Kiker, pre- decease me or die on or before the sixtieth day following my death, I give, devise and bequeath the rest, residue and remainder of my Estate, real, personal and mixed, of what- soever kind and wheresoever situated, in equal shares, to my"'~chi.ldren, Thomas C. Kiker and Janice A. Kiker. ITEM IV - Should either of m~ C~hildren predecease me~, or fail to S~vive me for a period of sixty (60) days (SEAL) leaving children surviving them, then such children shall take the share of their deceased parent, per stirpes. ITEM V - I nominate, constitute and appoint my Wife, Lenora B. Kiker, to be the Executrix of this my Last Will and Testament. In the event my Wife, Lenora B. Kiker, fails or refuses to qualify as such Executrix, then I nominate, constitute and appoint my daughter, JaniCe A. Kiker, to be the Executrix of this My Last Will and Testament. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this My Last Will and Testament, this W~' day of .~~.~ , 1976. (SEAr,) This instrument, consisting of two (2) typewritten pages, each bearing the signature of the above-named Charles A. Kiker, was by him on the date hereof signed~ published and declared by him to be his Last Will and Testament, in our presence, who, at his request and in his presence, and in the presence of each other, we, believing him to be of sound and disposing mind and memory, have hereunto subscribed our names as witnesses: residing at -2- VERIFICATION We, JANICE A. KIKER, and LENORA B. KIKER, verify that the statements in the foregoing document are true and correct. We understand that false statements herein are made subject to the penalties of 18 Pa. C.S. §4904, relating to unsworn falsification to authorities. J~(ICE A. KIKER ~~- ' LEI~O~ B. KIKER CERTIFICATE OF EXECUTRIX I, JANICE A. KIKER, hereby certify that I am the Executrix of the Will of Charles A. Kiker and I join this Petition and pray that this Court approve the proposed settlement. J~[CE A. KIKER ~ CONSENTS OF STATUTORY BENEFICIARIE~ We the undersigned, being the statutory beneficiaries of Charles A. Kiker, agree that the distribution and allocation proposed in this petition is fair and reasonable and consent to the proposed allocation. LENORA B. KIKER E A. KIKER THOMAS C. KIKER STATEMENT OF COUNSEl, As attorney on behalf of the above-named Executrix, I, Richard E. Connell, Esquire, recommend to the Court to approve the settlement in the amount of Fifty' Thousand ($50,000) Dollars to be paid to Lenora B. Kiker as proceeds of a wrongful death action. This is a fair settlement with the circumstances set forth in the Petition. Further, it would be in the best interest of the estate to settle this claim as outlined. I.D. # 21542 Ball, Murren & Connell 2303 Market Street Camp Hill, PA 17011 (717) 232-8731 Attorney for Estate