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Home My WebLink About06-04-09-~ REV-1 5~0 1505607120 PA Department of Revenue EX (06-05) OFFICIAL USE ONLY Bureau of Individual Taxes county coae veer File Number Po Box.2aosot Harrisburg, PA 17728-0601 INHERITANCE TAX RETURN ~~ Q n ~~~/ RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 497300964 02152009 05291933 Decedent's Last Name Suffix Decedent's First Name MI KEMP DONALD g (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI KEMP CBARLENE Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ® 1. Original Retum ^ 2. Supplemental Return ^ 3. Remainder Retum (tlate of tleath prior to 12-t3-82) ^ 4. Limitetl Estate ^ qa, Future IMareet compmmue 5. Fetlerel Estate Tax RMUm Re uiretl (dale of tleelh after 72-12-82) ~ 9 ® g pecedant Died Testate ^ (Attach Copy of NAII) ~ Decedent Memtained a Livirp Tmnt (Anech Copy of Trust) 8. Total Number of Sa(e Deposit Boxes ^ 9 Lltl tl P d . ga dn roCee S Recelvetl ^ 7 p. Spouul Poverty Credd (tlete al death 1 t, Election to tax untler Sec. 9113 A between 1231-91 eM t-1-95) ^ ( ) (Attach Sch. O) CORRESPONDENT-THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number TAOMAS S BECRLEY 7172337691 N Firm Name (If Appllgble) r o BECKLEY 6 MADDEN pp~~ ~~ 17 REGIS7ER~rpvILLSU~ONLIG r ~ -. rn v n z u. First line of address ;;-z? ~ m I r ~L7 ~7 F' , 212 NORT13 TBIRD STREET ~"'~ -, -n Second line of address ;,o-~ a ~: ,~ = - D -; rn a -- City or Post Office State Zip Code DATE FILED -' BARRISBURG, PA 17101 Correspondent's e-mail address: becks~pe.net llntler penalgee of perjury, J tledare that I have examined mle return any Charlene Kemp 244 Richland Road, Carlisle, PA 17015 Thomas S Beckley 212 North Third Street, Harrisburg„ PA 17101 Side 1 L. 1505607120 1505607120 J 1505607220 REV-1500 EX Decedent's Social Security Number oarsearrc, Nem,~ KEMP, DONALD BERRY 497300964 __ __ - _ -_ - -- -,--- RECAPITULATION 1. Real Estate (Schedule A) .................................................................................. ........ 1. 2. Stocks and Bonds (Schedule B) ........................................................................ ....... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)...... .... 3. 4. Mortgages & Notes Receivable (Schedule D) .................................................... ...... 4. 5. Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) ............ .... 5. 3 9 , 4 1 0 . 0 1 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested .......... ... 6. 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property (Schedule G) ^ Separate Billing Requested .......... ... 7, 1 2 $ , 1 9 2 . 4 0 8. Total Gross Assets (total Lines 1-7) ................................................................. ...... 8. 1 6 7, 6 0 2. 4 1 9. Funeral Expenses 8 Administrative Costs (Schedule H) .................................... ..... 9. 1 0 , 1 $ 0 . 0 0 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ........................... ..... 10. t t. Total Deductions (total Lines 9 8 10) ............................................................... .......t t. 1 0, 1 5 0. 0 0 12. Net Value of Estate (Line 8 minus Line 11) ....................................................... ......12. 1 5 7 , 4 5 2.41 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ............................................ ..... 13. 1 , 0 0 0 . 0 0 14. Net Value SubJect to Tax (line 12 minus Line 13) ............................................ -- - ..... 14. 1 5 6 , 4 5 2.41 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a>(t.z) x .o0 13 5, 9 5 2. 4 1 t s. 0. 0 0 16. Amount of Line 14 taxable at lineal rate x .045 2 0, 5 0 0. 0 0 ts. 9 2 2. 5 0 17. Amount of Line 14 taxable at sibling rate X , 72 17. 18. Amount of Line 14 taxable at collateral rate X .75 18. 1 g. lax Due .............................................................................................................. .... ts. 9 2 2. 5 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 '~ 1505607220 1505607220 J REV-1500 EX Page 3 File Number Decedent's Complete Address: Kemp, Donald Berry STREET ADDRESS - _. __ ~._ _-- - -.__ -- - - - -... - 244 Richland Road clrY - - _ TSTATE -ZIP ~ - - Carlisle PA 17015 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) 922.50 2. Credits/Payments - A. Spousal Poverty Credit B. Prior Payments 880.00 C. Discount 46.13 3. InteresVPenalty if applicable Total Credits (A + B + C) (2) 928.13 D. Interest E. Penalty Total lnteresVPenalty (D+E) (3) 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) 3 83 Check box on Page 2 Llne 20 to request arefund -- . - - .-- 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the 7AX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58) 0. ~ 0 Make Check Payable to: REGISTER OF WILLS, AGENT ~. ~ ~; .. I ` .. I.,a.. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a trensfer and: Yes No a. retain the use or income of the property transferred :............................................................................... ..f.~ b. retain the right to designate who shall use the property transferred or its income :................................... . [-i J c. retain a reversionary interest; or ....................... .. ........................................................................ L d. receive the promise for life of either payments, benefits or care ........................................................ . t~ ' ~ p p y y 2. If death occurred after December 12, 1962, did decedent transfer ro ert within one ear of death without ~ receiving adequate censideration? ................................................................................................................... ..~J L 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 beneficary designation? ........................................................._........................................................(~ IF THE ANSWER TO ANY OF THE ABOVE pUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETUR 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 exemofi 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 taz 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 taz 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)i. 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. COMMONWEALTH OF PENNSYLVgNIq ~, INHERITANCE TA%gETURN '. RESIDENT pECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY of Kemp, Donald Berry FILE NUMBER of litigation and the date the proceeds were received by the eslateQll property jointly-owned with the right of e disclosed on schedule F. R DESCRIPTION VALUE AT DATE OF __ - - - DEATH 1 - ._ _ _ Sovereign Bank Certificate of Deposit 1,295.31 2 Sovereign Bank checking account 36,114.70 3 Miscellaneous personal items 1,000.00 4 11996 Buick station wagon (100,000+ miles, poor condition) I 1,000.00 TOTAL (Also enter on Line 5, Recapitulation) I 39,470.01 COMMONVuEALTH OF PENNSYLVANIA I, INHERITANCE TAX RETURN RESIDENT DECEDENT TE OF Kemp, Donald Berry FILE NUMBER . rna scneaute must oe completetl antl Filetl if the answer to any of questions 1 through 4 on page 2 is yes. -- _ __ ~- I EM ~ DESCRIPTION OF PROPERTY DATE OF DEgTH~ %OF EXCLUSION InGutle the name of the Iransteree, (heir relationahi to tlecedent VALUE OF ASSET v NU BER DecD~s TAXABLE VALUE end the date of trensler. AtleM a copy of Na tleed for real entele _-- _ 1 ~ #2448 30 ock Indnrldual RehrementAccount 25,365.56 INTEREST nFAPPUCASLE) I I ~ 100% ~ ~ 25,385.58 2 Thrivent Financial Individual Retirement Account #03153273 3 I Thrivent Financial Individual Retirement Account #49730096411 4 Sovereign Bank Individual Retirement Account #2898148875 5 !AIM Investments Roth Individual Retirement Account #3810903561 28,014.74 ' 100% ~ 28,014.74 41,147.21 100% 41,147.21 32,368.05 I 100% i 32,368.05 1,276.82 100% 1,276.82 I SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY TOTAL (Also enter on line 7, Recapitulation) 128,192.40 NUM9ER A. B. '. OOMMONV/ERTH OF PENNSVIVANIR '. INHERITPNCE TN( RETURN RESIDENT DECEDENT ~4TE OF Kemp, Donald Berry r_... - S(~fDULE H ~FIJl~EFtALD~B~SES& P'rJr~oN 114\ I IYG V W 1 ~7 ueots or aeceaent must be reported on Schedule I. :M BER FUNERAL EXPENSES: DESCRIPTION 1 Feiser Funeral Home New Oxford, PA ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s): Street Address City State Zip Year(s) Commission paid z. Attorney's Fees Beckley & Madden 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. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Casts TOTAL (Also enter on line 9, Recapitulation) AMOUNT ___.-- 8,950.00 1,200.00 10,150.00 'nEV•is~ Fx+Isml SCHEDULE J COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT _ __ _._ _ EST TE OF _ --- - Kemp, Donald Berry FILE NUMBER NAME AND ADDRESS OF PERSON(S) RE DECEDENIT TO SHARE OF ESTATE AMOUNT OF ESTATE RECEIVING PROPERTY ~ oo Nor u.r rlu.e.a.l (Words) ($$$) DISTRIBUTIONS[include outright spousal distributions and transfers under Sec. X116 (a) (1.2)] 1 i Garry J. Kemp 800 Bottoms Road j Concord, GA 30206 2 ~ Gail Susan Kemp Dropping 3 Llnda Kay Kemp O'Connell 4 Charlene Kemp 244 Richland Road Carlisle, PA 17015 Son Daughter Daughter Wife i Remainder 500.00 10,000.00 10,000.00 Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, o Rev 1500 rover sheet nvrv-,lvoyoLC UIJ I KItlV I TUNS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1 i Humane Society TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER 1,000.00 1,000.00 ~ ~ i~-s'r ari~.>L wND TEST OF DON BERRY KEMP I, DON BERRY KEMP, of 244 Richland Road, Cazlisle, Cumberland County, Commonwealth of Pennsylvania, do hereby make, publish and declaze this to be my Last Will and hereby revoke all prior Wills and Codicils made by me. FIRST: I direct that all my just debts and funeral expenses be paid out of my estate as soon as practicable after my death. SECOND: I make the following chazitable gifts: A. I give the sum of ONE THOUSAND and No/100 DOLLARS ($1,000.00) to the HUMANE SOCIETY OF HARRISBURG AREA, INC., Sinclair and Eppley Roads, Mechanicsburg, Pennsylvania. B. I give the sum of ONE THOUSAND and No/ 100 DOLLARS ($1,000.00) to the HUMANE SOCIETY OF HARRISBURG AREA, INC., 7790 Grayson Road, Harrisburg, Pennsylvania. THIRD: I make the following individual gifts: A. The sum of TEN THOUSAND and No/ 100 DOLLARS ($10,000.00) to my daughter, GAIL SUSAN KEMP DROPPING; B. The sum of TEN THOUSAND and No/ 100 DOLLARS ($10,000.00) to my daughter, LINDA KAY KEMP O'CONNELL; C. The sum of FIVE HUNDRED and No/ 100 DOLLARS ($500.00) to my son, GARY JOSEPH KEMP; FOURTH: I give, devise and bequeath all the rest, residue and remainder of my estate, of whatever nature and wherever situate, to my wife, CHARLENE BOYD KEMP, of 244 Richland Road, Cumberland County, Pennsylvania. FIFTH: Should my wife, CHARLENE BOYD KEMP, predecease me, or should she survive me by a period of less than thirty (30) days, or should the said CHARLENE BOYD KEMP not be my wife at the time of my death, or should she die simultaneously Paga 1 of 5 Pagaa with me or in a common disaster, I then give, devise and bequeath the rest, residue and remainder of my estate, of whatever nature and wherever situate, as follows: A. I devise 115 acres of undeveloped land in Huntingdon County Pennsylvania to GAIL SUSAN KEMP DROPPING of 916 69~ Street, N.W., Bradenton, FL 34209; B. I direct that my dwelling, located at 244 Richland Road, Carlisle, Cumberland County, Commonwealth of Pennsylvania, be sold and the net proceeds be distributed to ELIZABETH ANNE FREEMAN CROW, JEFFREY ELLIOTT FREEMAN, GAIL SUSAN KEMP DROPPING and LINDA KAY KEMP O'CONNELL, share and shaze alike, per stirpes; C. I bequeath my 1994 Ford 150 truck to my stepson, JEFFREY ELLIOTT FREEMAN; D. I bequeath my 1999 Buick sedan to my daughter, GAIL SUSAN KEMP DROPPING; E. I bequeath my 1996 Buick station wagon to my stepdaughter, ELIZABETH ANNE FREEMAN; F. I bequeath all personal effects of my first wife, FRANKIE DUCKWORTH KEMP, to my daughters, GAIL SUSAN KEMP DROPPING and LINDA KAY KEMP O'CONNELL, in equal shazes, shaze and shaze alike, per stirpes, G. I bequeath all my household furnishings and personal effects to GAIL SUSAN KEMP DROPPING, JEFFREY ELLIOTT FREEMAN and ELIZABETH ANNE FREEMAN, in equal shares, share and shaze alike, per stirpes. SIXTH: All the rest, residue and remainder of my estate, of whatever nature and wherever situate, I give, devise and bequeath to my grandchildren, JENNIFER O'CONNELL, PATRICK O'CONNELL, MITCH DROPPING, NOLAN RICHARD FOYE CROW and KARA BELLE RENEE FREEMAN, in equal shares, share and share alike, per stirpes. SEVENTH: If any of my children shall have predeceased me or should survive me by a period of less than thirty (30) days, the share that otherwise would be distributed to that child shall pass instead to those of my children who shall have survived me by a period of thirty (30) days, in equal shares, per stirpes and not per capita, Paga 2 of 5 Pagers EIGHTH: In the event that the assets within my residual estate are insufficient to pay all gifts provided for in this, my will, so that it is necessary to abate the gifts herein, I direct that gifts be paid in the order in which they are set forth, so that those gifts last set forth shall be first to abate. NINTH: I nominate, constitute and appoint my wife, CHARLENE BOYD KEMP, as the Executrix of this my Will. Should she be unable or unwilling to serve for any of the reasons set forth in Pazagraph FIFTH of this my Will, then I nominate, constitute and appoint my daughter, GAIL SUSAN KEMP DROPPING, as successor Executrix of this my Will. Should she be unable or unwilling to serve for any of the reasons set forth in Paragraph FIFTH of this my Will, then I nominate, constitute and appoint my step-daughter, ELIZABETH ANNE FREEMAN CROW, as successor Executrix. My Executrix and successor Executrices shall be excused from entering Bond in all jurisdictions. TENTH: I give my Executrix and successor Executrices the fullest power and authority in all matters and questions and to do all acts which I might or could do if living, including, but without restrictions to investments permitted by law, sell, at public or private sale, for cash or credit, with or without security mortgage, lease and dispose of and distribute in kind, all real and personal property at such times and upon such terms and conditions as they deem advisable and to make any required division or distribution in cash or in kind or in both and at such values as they may fix. ELEVENTH: All inheritance, estate, succession or transfer taxes, whether State, Federal or otherwise, or any other tax in the nature thereof, which may be pay- able by reason of my death, shall not be apportioned but shall be paid, together with any interest or penalties, out of my residuary estate as if such taxes were admini- stration expenses. TWELFTH: I direct that the reasonable expense of packing, shipping, insuring and delivering any such property to a beneficiary entitled thereto shall be paid by my Executrix or successor Executrices as an administrative expense of my estate. In addition, to the' extent practical in my Executrix's discretion, I bequeath any policy of insurance on such property to the beneficiary to whom such property is bequeathed. THIRTEENTH: If any item specifically devised or bequeathed in this will is not a pazt of my estate at the time of my death, such devise or bequest shall lapse. FOURTEENTH: It is my desire and I so direct that my remains be buried with those of my first wife, FRANKIE DUCKWORTH KEMP. Paga 3 0! 5 Pagoa FIFTEENTH: It is my desire and I so direct that JOSEPH B. SOBEL, ESQUIRE, of Harrisburg, Pennsylvania, be retained by my Executrix or successor Executrices, to handle the settlement of my estate, he being acquainted with my affairs. IN WITNESS WHEREOF, I, DON BERRY KEMP, have to this my Will, written on three (3) sheets of paper, set my hand and seal at the end thereof this i (~ day of April, 2004. /9~'lJ ~CJr1 !2 y `•C L r~...O (SEAL) DON BERRY KEMP '~- SIGNED, SEALED, PUBLISHED and DECLARED by the above-named Testator, DON BERRY KEMP , as and for his Will, in the presence of us who, at his request, in hie presence, and in the presence of each other, all being present at the same time, have hereunto set our hands as witnesses. Name: Joseph B. Sobel Name: Jo-Ann I. Clemens Residing at: 1 Greenbrier Way Mechanicsburg, PA 17050 Residing at: 101 S. Second Street Harrisburg, PA 17101 COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN SS. I, DON BERRY KEMP, Testator, 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. ~lM~ ~ ~-e-ee.12 v !~f CJ~ (SEAL) DON BERRY KEMP Sworn or ed to and acknowledged before me by DON BERRY KEMP, the Testator, this day of April, 2004. (SEAT,) o No Pub is My Commission Expires: Pago 4 of 5 Pagos ~~ YIYAFMA NQfAF11AL BEN. E1IZABEfN 8. BECIO.EY, Nolan Pyle C)ty of HarYbuy. ~~~~4Y ~, ooraa.rm E>~.1~ tz wos COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN SS. We, Joseph B. Sobel and Jo-Ann I. Clemens, 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 Testator sign and execute the instrument as hia Last Will; that he signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator signed the Will as witnesses, and that to the best of our lmowledge the Testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Wrtness~ ' "~-~ V Witness Sworn or affirmed to subscribed before me by Joseph B. Sobel and Jo-Ann Clemens, witnesses, this day of April, 2004. (SEAL) Y~ Public My Commission Expires: COAi~lONM1EAliN C!F vLVNIMk ELPJIBEIH 8 BECKLEY, Noler Puhle Cp of Hs+w6~ry, Dsuphh Comgr i+ty Commieelon 6~Yss Mrdi 12, 706 Pago 5 0£ 5 Pag®s o I C m I ~ 0 0 `VdRy Q ~ " I N" w O fR ~ a lay°~° _p_°1 , N ~ ~~ i Q~ W s J ~3ilNn o o ~ ., ag ~~ W~ ~s~p> ~ s~ ~r~~ a ~~ ~~~ o~ ~. ^~' W N V `~`w~ Y, L ^~ W •~- O x H x o ~' VIU~M .-. O ~ O ~ ~ kJZFpd., cL F0.W1U~ ~~o~ BECgI.EY~L MADDEN ATTOxxaps AT LAW C8AFB88aY COVaT 814 Noaxa Taman 9TassT war osncxa~ueae FIARRIBBrJR(3. PENN9YLVAr7IA 1710 8-19 9 8 raoas: a1T asa-7ee1 rwa. 171'!1 H88-9~bo ri[S xo. s-atwa. bed~eyQp..ne 50411 June 3, 2009 Glenda Famer-Strasbaugh, Register of Wills Cumberland County Courthouse ~~ ,~, One Courthouse Square ~ ~ , `-' Carlisle, PA 17013 r~~~ x ~.', _; RE: Estate of Donald Kemp, deceased _~~;,~ ~ F- No. 21-09-0441 o„ r,jc_ z„ ~ :u~ -- Dear Register Farner-Strasbaugh: o m Enclosed herewith you will find an original and two copies of an inheritance tax return along with a check in the amount of $15.00. Please file the original and return a time-stamped copy to our office in the enclosed envelope. Thank you for your assistance, and if you need anything further, please do not hesitate to contact me. Very truly yours, BECKLEY & MADDEN GZ~ Thomas S. Beckley Enclosure Co: Charlene Kemp