HomeMy WebLinkAbout06-01-10---~ REV-1500 1505607120
EX (06-05) OFFICIAL USE ONLY
PA Department of Revenue county code Year File Number
Bureau of Individual Taxes INHERITANCE TAX RETURN
Po Box.2soso~ 2 1 0 9 0 1 12 7
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
320345976 10292009 09221922
Decedent's Last Name Suffix Decedent's First Name MI
KAEMPF LLOYD yJ
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number
FILL IN APPROPRIATE OVALS BELOW
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
® 1. Original Return ^ 2. Supplemental Return ^ 3, Remainder Return (date of death
prior to 12-13-82)
^ 4. Limited Estate ^ 4a. Future Interest Compromise
(date of death after 12-12-82) ^ 5. Federal Estate Tax Return Required
0
g. Decedent Died Testate
® (Attach Copy of Will) Decedent Maintained a Livin Trust
^ ~' (Attach Copy of Trust) 9 8. Total Number of Safe Deposit Boxes
^ 9. Litigation Proceeds Received ^ 1 p. Spousal Poverty Credit (date of death
between 12-31-91 and 1-1-95)
^ 11, Election to tax under Sec. 9113 A
( )
(Attach Sch. O)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO
Name :
Daytime Telephone Number
CRAIG A. DIEHL, ESQUIRE, CPA 7177637613
~,
Firm Name (If Applicable)
LAW OFFICES OF CRAIG A. DIEHL
First tine of address
3464 TRINDLE ROAD
Second line of address
City or Post Office
CAMP HILL
State
PA
Correspondent's a-mail address: c d i e h l@ c a d i e h l l a w. c o m
ZIP Code
17011-4436
~~
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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.
SIGNAT E OF PERSON RESPONSIBLE FOR FILING R RN DATE
~, ~1 Lawrence W. Kaempf ~r 2 g Z a ~v
DDRESS
40 Nottingham Way North, Clifton Park, NY 12065
SIG~URE OF PREPARE THER THAflI REPRESENTATIVE ATE
Craig A. Diehl, Esquire, CPA ~~
ADDRESS
3464 Trindle Road, Camp Hill, PA 17011-4436
L 1505607120
Side 1
1505607120 J
~ T
1505607220
REV-1500 EX
Decedent's Social Security Number
DecedenPs Name: K A E M P F, LLOYD W. 3 2 0 3 4 5 9 7 6
RECAPITULATION
1. Real Estate (Schedule A) .......................................................................................... 1.
2. Stocks and Bonds (Schedule B) ............................................................................... 2. 7. 2 0 6 0 0
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C).......... 3.
4. Mortgages & Notes Receivable (Schedule D) .......................................................... 4.
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ................ 5. 2 1 1 , 2 8 6 . 3 3
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ............. 6. 5 , 1 9 8 9 7
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) ^ Separate Billing Requested ............. 7,
8. Total Gross Assets (total Lines 1-7) ....................................................................... g. 2 2 3, 6 9 1. 3 0
9. Funeral Expenses & Administrative Costs (Schedule H) ......................................... 9.
5,595.29
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10.
9,392.03
11. Total Deductions (total Lines 9~ 10) ...................................................................... 11. 1 4, 9 8 7 3 2
12. Net Value of Estate (Line 8 minus Line 11)
............................................................
12. 2 0 8, 7 0 3 9 8
13. Charitable and Governmental Bequests/Sec 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 0 8 , 7 0 3 9 8
TAX 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 15.
16. Amount of Line 14 taxable
at lineal rate X .045 2 0 8, 7 0 3 9 8
16,
9, 3 9 1. 6 8
17. Amount of Line 14 taxable
at sibling rate X ,12 17.
18. Amount of Line 14 taxable
at collateral rate X .15 18.
19. Tax Due ..................................................................................................................... 19. 9, 3 9 1. 6 8
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ^
Side 2
L 1505607220 1505607220 J
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REV-1500 EX Page 3
Decedent's Complete Address:
File Number 21 - 0 9 - 0112 7
Kaempf, Lloyd W.
STREET ADDRESS
100 Mount Allen Drive
CITY
Mechanicsburg STATE
PA ZIP
17055
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19) (1) 9 , 3 91.6 8
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
3.
Total Credits (A + g + C)
InteresUPenalty if applicable
(2)
0.0 0
p. 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. (4)
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. (5) 9, 3 91.6 8
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 9, 3 91.6 8
Make Check Payable to: REGISTER OF WILLS, AGENT
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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?......... ^ 0
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 th ~ ~ 7 !`
e 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 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 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 defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
CONMAONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF Kaempf, Lloyd W. FILE NUMBER
21-09-01127
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OF
DEATH
1 US Savings Bond - Series I 7,206.00
Denomination: $5,000.00
Issue Date: April 2002
TOTAL (Also enter on line 2, Recapitulation) 7,206.00
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
COMMONWEALTH OF PENNSYLVANIA PERSONAL PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
ESTATE OF Kaempf, Lloyd W. 21 - 09 - 01127
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.
ITEM
NUMBER DESCRIPTION VALUE AT DATE OF
DEATH
1 Cash on Hand 340.00
2 PNC -Certificate of Deposit 29,332.39
Account#31000286713
3 PNC -Certificate of Deposit 32,434.46
Account#31400318479
4 PNC Certificate of Deposit 72,742.34
Account#31300328295
5 PNC Checking Account 6,047.11
Account#5004708797
6 PNC Savings Account 67,481.41
Account#5002056641
7 Household Furnishings (old) 150.00
8 Verizon -Refund 6.62
9 IRS - 2009 Federal Tax Refund 2,752.00
TOTAL (Also enter on Line 5, Recapitulation) I 211,286.33
SCHEDULE F
COMMNHER TANCE TAX RETURNANIA JOINTLY-OWNED PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Kaempf, Lloyd W. 21 - 09 - 01127
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
Lawrence W. Kaempf 40 Nottingham Way North Son
A Clifton Park, NY 12065
JOINTLY OWNED PROPERTY:
ITEM
NUMBER LETTER
FOR JOINT
TENANT DATE
MADE
JOINT L~F~SCRIPT.l0~ C~F PRO~ERTY
Include name o Inanclal Ins I u Ion an bank account number
or similar identifying number. Attach deed for jointly-held real
estate.
DATE OF DEATH
VALUE OF ASSET % OF
DECD'S
INTEREST DATE OF DEATH
VALUE OF
DECEDENT'S INTEREST
1 A 10/13/2006 PNC Certificate of Deposit 10,397.94 50% 5,198.97
Account#31700304711
TOTAL (Also enter on line 6, Recapitulation) I 5,198.97
SCHEDULE H
CONMAONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN Ar1AA1\NCTp/~7'A/L ^/'1CT~
RESIDENT DECEDENT /'~L~I~N~rh7 ~ fW ~ ~YG VV~7 ~ ~7
ESTATE OF Kaempf, Lloyd W. FILE NUMBER
_. 21-09-01127
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER FUNERAL EXPENSES: DESCRIPTION AMOUNT
A• 1 Garden Bouquet -Funeral Expense 235.32
2
B. I 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
2. Attorney's Fees Law Offices of Craig A. Diehl 4,577.81
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 Register of Wills, Cumberland County 360.00
5. ~ Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs
1 The Sentinel -Estate Advertisement
187.54
TOTAL (Also enter on line 9, Recapitulation) 5,595.29
Schedule H
Funeral E~enses &
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN Adminish~ativle Costs COrY6nued
RESIDENT DECEDENT
ESTATE OF Kaempf, Lloyd W. FILE NUMBER
21 - 09 - 01127
2 Lawrence W. Kaempf -Reimbursement of Overnight Fees 24.70
3 Cumberland Law Journal -Estate Advertisement 75.00
4 Law Offices of Craig A. Diehl -Reimbursement for Certified Mail for PA Dept of Public 5.54
Welfare Letter
5 Lawrence W. Kaempf -Travel Reimbursement to Perform Executor Duties 91.88
6 Lawrence W. Kaempf -Reimbursement for ATM Fee for Estate 2.50
7 Register of Wills, Cumberland County -Filing Fee for PA Inheritance Tax Return 15.00
8 Register of Wills, Cumberland County -Filing Fee for Family Settlement Agreement 20.00
Page 2 of Schedule H
SCHEDULEI
DEBTS OF DECEDENT, MORTGAGE
COIuMAHERITANTCEOTAXRETURLNANIA LIABILITIES, & LIENS
RESIDENT DECEDENT
FILE NUMBER
ESTATE OF Kaempf, Lloyd W. 21 - 09 - 01127
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION AMOUNT
1 Messiah Village -Assisted Living Expense 9,273.92
2 ~ Alert Pharmacy Services -Prescription ~ 97.48
3 ~ Verizon Phone -Final Telephone Bill ~ 20.63
I TOTAL (Also enter on Line 10, Recapitulation) I 9,392.03
REV-153 EX+ (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Kaempf, Lloyd W.
SCHEDULE J
BENEFICIARIES
FILE NUMBER
21 -09-01127
NUMBER
NAME AND ADDRESS OF PERSON(S)
RECEIVING PROPERTY RELATIONSHIP TO
DECEDENT
Do Not Llst Trustee(s) SHARE OF ESTATE
(Words) AMOUNT OF ESTATE
($$$)
I~ TAXABLE DISTRIBUTIONS [include outright spousal
distributions, and transfers
under Sec. 9116 (a) (1.2)]
1 Lawrence W. Kaempf Son 1/3
40 Nottingham Way North
Clifton Park, NY 12065
2 Wayne D. Kaempf Son 1/3
92 Lake Avenue
Worcester, MA 01604
3 Douglas E. Kaempf Son 1/3
882 Conservation Lane
Harwood, MD 20776
Enter dollar amounts for distributions shown above on lines 1 5 through 18, as appropriate, on Rev 1500 cover sheet
II. 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 0.00
LAST WILL AND TESTAMENT
OF
LL~I'D W. KAEMPF
I, LLaYD W. KAEMPF, Social Security Number 320-34-5976, of the State of Alabama,
declare that this is m_y~ LAST WILL .AIVP TEST~'~11.~I~jT and I revel:; all ^ther vY~ills and c~ad;;l
previously made by me.
FIRST. I appoint my wife, MARGARET D. KAEMPF, as my Personal Representative
concerning this Will. If my wife is unable or fails to serve, I then appoint my son
LAWRENCE W. KAEMPF of Clifton Park, New York, to serve as my Personal Representative.
A. I request that my Personal Representative be permitted to serve without bond or
surety thereon and without the intervention of any court, except as required by law. I direct that
my Personal Representative act in unsupervised administration so as to administer my estate with
a minimum of court supervision. If it becomes necessary to have ancillary administration of my
estate in any jurisdiction where my Personal Representative is unable or does not desire to
qualify as ancillary legal representative, Iappoint as such ancillary legal representative such
individual or corporation as my Personal Representative shall designate, in writing.
B. I direct my Personal Representative to pay the expenses of my last illness, the
expenses of a funeral appropriate to my station in life and custom of living (including a suitable
monument or marker for my grave), and written charitable pledges which I have made. I grant
my Personal Representative the power to extend or renew any debt for such time as my Personal
Representative shall deem appropriate.
C. A_ll estate, inheritance, succession and other death_taxes with_res ect _t X11
. ._ .. __ __ ___ p .~ -----pr"~erty
passing under this my Will shall. be paid from and borne by the.principal,of my residuary estate,
_.
without regard to reimbursement, as if such taxes were administration expenses. My Personal
Representative may pay such taxes at any time deemed advisable, whether or not then due and
payable.
D. My Personal Representative is requested to settle my estate_ as soon _after my death as
may be practicable, and to_ a or deliver eve le ac _Qr_.be .~.e~t..tQ.m. _..benef ciaries without
P Y ..._ ._ ______ . _ _ ~'- __ g _~' q y
waiting an_y time that may be believed to be customary in probate matters.
~. , ~ Last Will and Testament ~f L,LQYh KAEMPF
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E. I have served in the Armed Forces of the ~Jnited States. Therefore, I direct rn_y
Personal Represe_n_tative to consult ~~~ith a Legal Assistance .~'~ttornt,~- at t11c r~~~aret i11-1it~ary
installation aid with the Department of~ Veterans Affairs and the Social Security Administration
to ascertain if there are any benefits to which my family members are entitled by virtue of my
military service.
F. I may leave a letter of intent with the executed copy of this Wall for the purpose of
giving guidance to my Personal Representative concerning the distribution or sale oI` certain
rter~~s ~f my property. I request, but do not require, that my Personal Representative honor niy
wishes therein expressed.
SECQND. I give, devise and bequeath, absolutely and forever, all of m~- estate ~iiicl
I~rof.-ery of which I may be seized ar possessed, or to «Tf1IGh I tiia}~ be entitled, at the tirn~~ e~f ~~ z
= death, wherever situated or of «~hatever n ature, be it real, persuiiai, ;~r mixed r_;, rri~; ~;;,~it~,
~~AI~GAR-ETD. KAEIvfPF, as her sole and absolute property if she shall survive me. v
THIRD. In the event that my spouse shall not survive me, I give, devise rind becl~.,eath,
. _ absolutely and forever, all of my estate and property ofwhich I may be wiled or j_~ossessed_ cir i;;
which I may be entitled, at the time oi~niy death, wherever situated or of whatev -
real ersonal or mixed, , er nature, be it
P to my sons, 1_,A4~RENCE V4. I+.AEI~-'fF'F, WA~'NF D. KAE>t.~C1'F and
DUU(JLAS E. I<AEIVII~F, in shares of substantially equal value to be divided as they ma ~ a rise
A. If any of my children shall not survive me, then the share of that deceased =
c,lrild shall
go to the descendants of that child, who are to take per stirpes and not ,per capita. If an of rTi
children shall not survive me and shall not be survived by any descendants, then the share of tha
deceased child shall be distributed to my surviving children and the descendants of an of m t
other children who fail to survive me, in the manner set forth above. y y
B. If they are unable to agree, .the division among my children and the descendants of
any of my children who fail to survive me shallbe made by my Personal Representative in
person's sole and absolute discretion. I empower my Personal Representative to sell any or ahaf
such properly, if such property is not distributed in kind hereunder, and to distribute the roceeds
among my said children in substantially e ual chars,. p
. q ~ _ ,4r?y determinati~~ri of riry Personal
Representative as to ~~~hat should pasC or be sold un!p
-~_ r this pai-zgruph a,id to wl"iVill 11 siiouid 1~~~~,;,,
or be delivered or at what price it should be sold shall be conclusive.
rOURTFI. Except as otherwise provided in this Will, I have intentionally failed to rovide
for any other relatives or other persons, whether claiming to be an heir of mine or not. Inpsofar as
I have failed to provide in this Will for any of my issue now livin or later born r
failure rs intentional and not occasioned by accident or mistake. g or adopted, much
FIFTH. Any beneficiary who fails to survive until One Hundred and 'Twenty (120) hours
after my death shall be deemed to have predeceased me, and the gift to that beneficiar shall he
disposed of accordingly. y
NTH. Definitions;
~/~ Last Wi11 quid Testarrient of LLOYD KAEivIF'F
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A. The term "Personal Representative" as used in this Will shall have the sane me~jning
as Executar, Executrix, Independent Executor, or any other title of like import which is used to
describe such a fiduciary.
B. The term "per stirpes" as used in this Will means that whenever a distribution is to be
made to the descendants of any person, the property to be distributed shall be divided into as
many shares as there are (1) living children of the person and (2) deceased children, who left
descendants who are then living, of the person. Each living child (if any) shall take one share
and the share of each deceased child shall be divided among his then-living descendants in the
same manner.
SEVENTH. In addition to any powers granted by the laws of the jurisdiction in which this
Will is pr~~hate:~l, I hereby authlriL~ Arid eii~p,~ -wF~- tl~e f ~~iu~~iarics nari~r.~l ire ibis W'Ii '
to ine ef~ient
of the discretion herein granted, to sell, exchange, convey, transfer, assign, mortgage, pledge,
lease or rent the whole or any part of my real or personal estate; to invest, reinvest or retain
investments of my estate; to perform all acts and to execute all documents which my .fiduciaries
may deem necessary or proper in regard to my property. If any of my fiduciaries elect to receive
compensation for services, such compensation will be that allowed by law.
EIGHTH. If any part of this Will shall be invalid, illegal, or inoperative far any reason, it is
my intention that the remaining parts, so far as possible and reasonable, shall be effective and
fully operative. My Personal Representative may seek and obtain court instructions for the
purpose of carrying out as nearly as may be possible the intention of this Will as shown by the
terms hereof, including any terms held invalid, illegal, or inoperative.
This document was prepared under the authority of Title 10 U. S. Code, section 1044, and
implementing military regulations and instructions, by Andrew J. Sinn, a member of The Judge
Advocate General's Corps, United States Arm}, who is licensed to practice law in State of
Illinois.
IN WITNESS WHEREOF, I have at Redstone Arsenal, Alabama,
one ~ .~ ~~c'~
,set my hand and seal to this my LAST WILL
AND T STAIVIENT, consisting oi~ five (5) typewritten pages, each page bearing my handwritten
signature.
~ -
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(SEAL)
LLOY . KA ~ ,
The foregoing instrument was, at Redstone Arsenal, Alabama, on
La
st Will and Testament of LLOYD KAEMPF
Page 3
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c js. ,. ~ L~ `~~n a-- ~ C~ ~ ~ ,signed, sealed, published and declared by
LLD VV. KAEMPF, the testator, to be his LAST «~ILL Ar]I~ TESTAll~LENT in the presence
of all of us at one time; and, at the same time, we, at his request and in his presence and in the
presence of each other, have hereunto subscribed our names as attesting witnesses; and we do so
verily believe that the said testator is of sound and disposing mind and memory at the date
hereof.
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' Last Will avid Testament of LLO~'D KAEMPF
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I, LLOYD W. KAEMPF, the testator, sign my name to this instrument on ~ -'~ ~`'~ - ~ ~Ci ~ C ~~
~~rid, being first duly sworn, do hereby declare to the undersigned authority that I sign an execute this instrument as'
my last will v7d that 1 sign it willingly (or willingly direct another to sign far me), that I execute it as m~ free ~md
voluntary act. for the purposes therein expressed; and that 1 am eighteen years of age or older, of sr}tend mired <<rid
under no con
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and ~'=~ ~- ~~ ~~~"- ~C.tl: o\r~c~ ,the witnesses, sign our names to this instrument, being first
duly sworn, and do hereby dec are to the undersigned authority that the testator signs and executes this instrument as
1us last will and iliac he signs it willingly (or willingly directs another to sign for lum); and that each of us, in the
presence and hearing of the testator, hereby signs this will as witnesses to the testator's signing; and that, to t.hc best
of our kno«~ledge, the testator is eighteen years of age or older, of sound mind and under no constraint or widue
influence.
STATE OF ALABAMA
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of ~~C'cJZ (.~C.C?~, , ~'~
COUNTY OF MADISON )
Subscribed, sworn to and acknowledged before me by LLOYD W. KAEMPF,
the t stator, and subscri ed and sworn to before me by M Ct_ r~~ ~. ~ C~ t,~
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--,' /';`-:C %7 .~~ i~- ~ ~/.'~lL.~ , ~-d ~ ~:~ ~ r~C~L'~ ~-~- rr ,~ ~ ,the witnesses, on
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Last Will and Testament of LLOYD KAEMPF
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Law Offices of
Craig A. Diehl
3464 Trindle Road
Camp Hill, Pennsylvania 17011
Telephone (717) 763-7613
Fax (717) 763-8293
www.cadiehllaw.com
Craig A. Diehl, Esquire, CPA
Thomas L. McGlaughlin, Esquire
May 28, 2010
In Spring Grove, Pennsylvania
119 West Hanover Street
Spring Grove, PA 17362
Telephone: (717) 225-1929
Glenda Farner Strasbaugh
Register of Wills
Cumberland County Courthouse
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One Courthouse Square ;~ ,,~v, ~
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Carlisle, PA 17013 ,
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RE: Estate of Lloyd W. Kaempf ~~ cn ~
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Estate No. 21 09 01127 ~.:~ ~ << ~= ~'
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Dear Ms. Strasbaugh: ~'~
Enclosed for filing please find the following:
1. Original and three (3) copies of the Inheritance Tax Return REV-1500;
2. Check in the amount of $9,391.68 for payment of the PA Inheritance Tax; and
3. Check in the amount of $15.00 for filing of the Inheritance Tax Return.
Please time-stamp and return the copies of the Inheritance Tax Return in the enclosed
self-addressed envelope. Should you have any questions, please feel free to contact me.
Sincerely,
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Craig A. iehl, Esquire, CPA
CAD/daf
Enclosures
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