HomeMy WebLinkAbout07-08-10 (8)15D5610101
REV-1500 ~` t01-'°' l~'
PA Department of Revenue P~~Ylvanfa OFFICIAL USE ONLY
Bureau of Indtvidual Taxes °°""'"`"'°`""`"" County Code Year File Number
PO BOX28otiol INHERITANCE TAX RETURN
Harrisburg, PA i~i28-o6oi RESIDENT DECEDENT ! 21 10 i ' 0344
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
179-09-9036 01 /08/2010 ' 04/17/1915
___ _ _. __
Decedent's Last Name Suffix Decedent's First Name MI
SHIRK GILBERT : K
(tf Applicable) Enter SurvNing Spouse's !nt`o-mation Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Sociat Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
__ REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
m 1. Original Return O 2. Supplemental Return O 3. Remainder Return (date of death
prior to 12-1382)
O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required
death attar 12-12-82)
t~ 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 0 8, Total Number of Safe Deposit Boxes
(Attach Copy of Willj (Attach Copy of Trust)
O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O 11, Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. O)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name
__ Daytime Telephone Number
'
JILL M. WINEKA, ESQUIRE ~ (717) 234-4178
REGISTER OF WILLS USE ~Y
..
First line of address .~
.1719 NORTH FRONT STREET
Second line of address ~ ~
C or Post Offs _
dY ce _
State ZIP Code D ~
r~
HARRISBURG PA ..17102 ~ Girt `'r
_ ___._ ... ... _ ._.___ __.._ . . _..._.. '. __: v.
correspondent's e-mail addross: jWlnekB~pkh.COm
Under penalties of pe¢ury, I declare that I have examined this return, includ'a~g accompanying schedules and statements, and to the best of my knowledge and belief
R is true, coned and oompbte. Declaration of preparer other than the personal representatlve is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE
. ~ - •~ -solo L-soda
nuUKtJSLCVIta 11. rlcKel ~F'ord~br`, an A. Cra o~n P.O. Box 218,
Camp Hill, PA x.7011 Funkstown, NID 21134
SIGNATU~OF~PRtif~'AI~ERAT~RTHAAIREPRESENTATNE ne-rc
ADDRESS~111 M, w].nek3, Esq., 1719 N. Front St., Harrisburg, PA 17102
PLEASE USE ORIf31NAL FORM ONLY
Side 1
L 1505610101 1505610101 J
15Ei~6];01~5
REV-1500 EX
Decedent's Social Security Number
_.
Decedent's Name: .179-09-9036
RECAPITULATION
_. _ _.
_. _ _ __
1. Real Estate (Schedule A) ............................................. 1. ' 0.00 I
2. Stocks and Bonds (Schedule B) ....................................... 2. 0.00
3. Closely Held Coryoration, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 0.00 ',
4. Mortgages and Notes Receivable (Schedule D} ......... .
.................
a.
0.00 ';
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)....... 5. '. 0.00
6. Jointly Owned Property (Schedule F) O Separate Billing Requested ....... 6. ' 19,271.80 ';
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) O Separate Billing Requested..... , .. 7. ! 52,248.86
8. Total Gross Assets (total Lines 1 through 7) ... . ... . ................... . . 8. 71,520.66
9. Funeral Expenses and Administrative Costs (Schedule H) ................... 9. 3,580.90 ~'
10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) .............. 10. ' 6,424.09
11. Total Deductions (total Lines 9 and 10) ................................. 11. 10,004.99
12. Net Value of Estate (Line 8 minus Line 11) .............................. 12. 61,515.67
13. Charitable and Governmental BequestslSec 9113 Trusts for which ' ,°°° ° `"~-- -~~ -°• - •°° -~~ -- ,..~..,.._ _,...
an election to tax has not been made (Schedule J) .................. . ..... 13. 0.00
14. Net Value Subject to Tax (Line 12 minus Line 13) ........................ 14. 61,515.67
TAX CALCULATION - SEE fNSTRUCTfONS FOR APPLICABLE RATES
15. Amounl of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116 _ ;
{a)(1,2) X .0, 15. ' 0.00
16. Amount of Line 14 taxable ...,..:... .-.,.... ....~,._ ,. ... ~..m._ _.,_..~,. .,, ~ ..,,. ..,.,. ,. .._.....,... ~.~...,,..~..,......_.~.~. ,....
at lineal rate x .0 ~ 61,515.67 I; 16. ! 2,768.21
17. Amount of Line 14 taxable
at sibling rate X ,12 ' 17. 0.00
18. Amount of Line 14 taxable
at collateral rate X .15 98, j 0.00
19. TAX DUE ......................................................... 19. 2,768.21
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ~
Slde 2
1505610105 150561D105
REV-1500 EX Page 3
Decedent's Complete Address:
Flle Number
DECEDENTS NAME
GILBERT K. SHIRK
STREETADDRESS
THE WOODS AT CEDAR RUN
824 LISBURN ROAD
CITY STATE ZIP
CAMP HILL PA 17011
Tax Payments and Credits:
1. Tax Due (Pays 2, Line 19)
2. CreditsJPaymerds
A. Prior Payments 3,700.00
B. Discount 138.41
(1)
2,768.21
3. Interest
4. ff Line 2 is greater than Line 1 + Line 3, enter the diAerence. This is the OVERPAYMENT.
Fill in oval on Page 2, Line 20 to request a refund.
5. ff Line 1 + Line 3 is greater than Line 2, enter the d'rfference. This is the TAX DUE.
Total Credits (A + B) (Z) 3, 838.41
(3) 0.00
(4) 1,070.20
(5) 0.00
Make check payable to: REGISTER OF WILLS, AGENT.
:.: .. ~,
.~
,_
_~
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred :.......................................................................................... ^ ^x
b. retain the right to designate who shall use the property transferred or its income : ............................................ ^ Q
c. retain a reversionary interest; or .......................................................................................................................... ^ 0
d. receive the promise for life of either payments, benefits or care? ...................................................................... ^ x^
Z. If death occurred after Dec. 12, 1962, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. ^ ^X
3. Did decedent own an "intrust for" or payable-upon-death bank account or security at his or her death? .............. ^ Q
4. Did decedent own an individual retirement account, annuity or other non-probate property, which
contains a beneficiary designation? ~ (]
........................................................................................................................
[F THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G ANpD$~FILfE~IT AS PA~R#T7~OF THE RETURN.
',E'. ..-. ~ .- r :~ .s``~-.~.~ [k*' .-.., ..... _w. ~~'1~- by r.... t .. $~",r+ai'v'V~~i~Sr'a"1,,~~~~~.ta'~L~i~`!:.~,y y•
For dates of death on or after Jury 1, 1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is
3 percent [72 P.S. §9116 (a) (1.1) {i)].
For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 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 21 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 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 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 12 percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV 1509 EX + (8-98)
SCHEDULE F
COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FN.E NUMBER
GILBERT K. SHIRK 21 10 0344
ff an asset was made jof~rt within one year of the decedaM's date of death, it must be reported on Schedule G.
SURVMNG JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT
A. Leona M. Fickel 124 Old Ford Drive Daughter
Camp Hill, PA 17011
s Nancy A. Crampton P,O. Box 218 Daughter
Funkstown, MD 21734
c
JOINTLY-OWNED PROPERTY:
(TEM
NUMBER LETTER
FOR JOINT
TENANT DATE
MADE
JOINT DESCRIPTION OF PROPERTY
INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCDUNT 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
DECEDENTS INTEREST
1. A. 7/22/08 First National Bank Corporation 16,566.96 33.33 5,521.77
Checking Acct. No. 701702862
2. A.,B. 7/22/08 First National Bank Corporation 30,940.66 33.33 10,312.52
Certificate of Deposit No, 101090753
3. A.,B. 7122/08 First National Bank Corporation 10,313.55 33.33 3,437.51
Certificate of Deposit No. 101090816
See letter dated 4/2/10 from First National Bank
Corporation confirming joint ownership of the three
Accounts and providing the date of death values.
TOTAL (Also enter on line 6, Recapitulation) I S 19 271 80
(If more space is needed, Insert additional sheets of the same size)
REV-1510 EX + (B-8a)
COMMONWEALTH OF PENNSYWANIA
INHERfTANCE TAX RETURN
SCHEDULE G
INTER-VIVOS TRANSFERS S
MISC. NON-PROBATE PROPERTY
FILE NUMBER
GILBERT K. SHIRK 21 10 0344
This sd~edule must be completed and irked if the answer to arty of questions 1 through 4 on fhe reverse side of the REV-1500 COVER SHEET is yes.
fTEM
NUMBER DESCRIPTION OF PROPERTY
'"a+i°E'~"°""~°FTMEn~ar~,TMm+n~7~o~aw'ron~c~a~r~vo
~~~~T~ATTAg1AC0%OFT{ffOEEpFORREN.E8TATE
DATE OF DEATH
VALUE OF ASSET
9L OFDECD'S
INTEREST
EXCLUSION
~A~aucAe~~
TAXABLE
VALUE
1. MetLife Investors Annuity Contract No. 9200556061
The Decedents two daughters, Leona Fickel and Nancy
Crampton were equal beneficiaries of the annuity proceeds.
See the attached 3/29/10 letter from MetLife documenting 52,248.86 100. 52,248.86
the date of death value and named beneficiaries.
TOTAL (Also enter on tine 7 Recapitulation) , : 52 248 86
(if more space is needed, insert additlonal st-eets of the same size)
REV-1511 EX + (10-06)
COMMONWEALTH OF PENNSYLVANW
INHERRANCE TAX RETURN
SCHEDULE N
FUNERAL EXPENSES +~
ADMINISTRATIVE COSTS
ESTATE OF rac nunrocR
GILBERT K. SHIRK 21.10 0344
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Hammermill Bar 8~ Grill -post-funeral luncheon 315.90
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representatlve (s)
Street Address
Cily State Zip
Year(s) Canmfss'an Paid:
2, Attorney Fees Purcell, Krug & Haller
3, Family Exemptlor-: (If decedents address is not the same as daimaM's, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees
5. I Accountants Fees
6. I Tax Return Preparers Fees
7. I Steven W. Fahnestock, CPA -accountant's fee for 2009 Personal Income Tax Return
8. Register of Wills -fee to file PA Inheritance Tax Return
3,100.00
150.00
15.00
TOTAL (Also enteral line 9, Recapitulation) I i
(If more space Is needed, Insert additlonal sheets of the same size)
REV-1512 EX + (12-03)
SCHEDULE 1
CoNMiAONwEALTH OF PENNSYLVANIA DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES, ~ LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
GILBERT K. SHIRK 21 10 0344
Report debts incurred by the decedent prior to death wh~h remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. United States Treasury - 2009 Federal Income taxes 4,311.00
2. Lewistown Hospital -medical services 196.14
3. Alert Pharmacy -pharmacy services 34.05
4. The Woods at Cedar Run -nursing home services 40.00
5. Pharmerica -pharmacy services 1.85
6. The Woods at Cedar Run -nursing home services 1,315.63
7. Verizon -phone services 163.08
8. Alert Pharmacy -pharmacy services 240.34
9. JC Penny -pants, belt 122.00
TOTAL (Also enter on line 10, Recapitulation) I S 6,424.09
(If more space is needed, insert additional sheets of the same siae)
REV-1513 EX * (9-00)
SCHEDULE J
COMiAON4VEALTIi OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
nu o~or v cw~it 21 10 0344
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Tnustae(s) OF ESTATE
I TAXABLE DISTRIBUTIONS f ht )spousal dis6itwtlons, and transfers under
Sec.9116 a (1. ~
1. Leona M. Fickel Lineal
124 Old Ford Drive one-half of residuary
Camp Hill, PA 17011
2. Nancy A. Crampton Lineal
P.O. Box 218 one-half of residuary
Funkstown, MD 21734
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
fj, NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET ;
(If more space is needed, insert addiaa)al sheets of the same size)
IN RE: IN THE COURT OF COMMON PLEAS
CUMBERLAND CO., PENNSYLVANIA
ESTATE OF GILBERT K. SHIRK, :ORPHANS' COURT DIVISION
DECEASED NO. 2110-0344
TABLE OF CONTENTS
1. Last Will and Testament of Gilbert K. Shirk dated October 5, 1995.
2. First National Bank Corporation letter dated April 2, 2010 confirming joint ownership of
accounts and providing date of death values for Decedent's Checking Account No.
701702862; Certificate of Deposit No. 101090753 and Certificate of Deposit No.
101090816.
3. MetLife letter dated March 29, 2010 documenting date of death value of Annuity
Contract No. 9200556061 and confirming the named beneficiaries.
4. Letter dated June 17, 2010 to the PA Department of Revenue, Bureau of Individual
Taxes, requesting the refund of $1,070.20 to be made payable either to Jill M. Wineka,
Esquire or to Leona M. Fickel and Nancy A. Crampton, rather than to the Estate of
Gilbert K. Shirk, since no formal Estate was ever opened.
LABT WILL AND TESTAMENT
OF
GILSERT R. 8SIRR
I, Gilbert K. Shirk, of Ewardtown Road, Yeagertown,
Mifflin County, Pennsylvania, being of sound and disposing
mind, memory and understanding, do hereby make, publish and
declare this as and for my Last Will and Testament.
FIRST
I direct that no Executor or other fiduciary named,
nominated or appointed shall be required to post any bond or
give any security of any type for any purpose whatsoever,
any law or rule of Court of the Commonwealth of Pennsylvania
or any other jurisdiction to the contrary notwithstanding.
BECOND
I give, devise and bequeath all of my estate equally to
the fallowing individuals:
LEONA M. FICKEL, of Camp Hill, Pennsylvania
and
NANCY A. CRAMPTON, of Funkstown, Maryland
THIRD
In the event that one of the BENEFICIARIES named in
Paragraph SECOND, above, predeceases me or does not survive
me by ninety (90) days, then that BENEFICIARY'S one-half
share of my estate shall be distributed equally to that
BENEFICIARY'S children, per stirpes.
FOIIRTH
In the event that both of the BENEFICIARIES named in
Paragraph SECOND, above, predecease me or do not survive me
by ninety (90) days, then, my estate shall be divided into
five (5} equal shares and distributed equally to the five
children of said BENEFICIARIES, per stirpes.
0~
FIFTH
Any and all payment or payments of any sum or sums,
whether in cash or in kind, payable to any beneficiary,
shall be made upon the actual receipt of the payment and
shall be free from anticipation, alienation, assignment,
attachment or pledge, and shall be free from control by any
creditor of any such beneficiary and shall not be subject to
any execution or attachment.
2
s=pa
I nominate and appoint Leona M. Fickel and Nancy A.
Crampton as Co-Executors of this, my Last Will and
Testament.
IN WITNESS WI~REOF, I have hereunto set my hand and
seal to this Last Will and Testament, consisting of three
(3) typewritten pages, the first two (2) of which bear my
signature in the margin for purposes of identification, on
this _-y~~ day of - , 1995.
.,~'~~-~..~;GiGt~ ~ ~~.sZ~~`r"yl~'.~ ( Ste')
Gilbert K. Shirk
Signed, sealed, published and declared by the above
named testator, Gilbert K. Shirk, as and for his Last Will
and Testament, in the sight and presence of us, who at his
request, in his sight and presence, and in the sight and
presence of each other, have hereunto subscribed our names
as witnesses.
>~~~~_
WITH S
WITNESS
3
COMMONWEALTH OF PENNSYLVANIA
9 SS.
COUNTY OF ~/ l ~~~/ ~1
I, Gilbert R. Shirk, the 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 and
Testament; and that I signed it willingly as my free and
voluntary act for the purposes therein expressed.
Gilbert K. Shirk
Sworn to or affirmed and acknowledged before me, by
Givl~bert Ro. Shirk, the testator, this 5 ~~'' day of
lJ ~"~t~-~ , 19 9 5 .
~~ • '.~
. •,
' ' MGTARiAL SEAL
. ~ BAHBAFA A. BAKcR, t~tary Pudic
' ~ Btxrthz~~t Bono, AAi{t:in County, PA
A1~- Commiadao Exprea IiAarch 23,19GS
Notary Public
COMMONWEALTH OF PENNSYLVANIA
~^ SS.
COUNTY OF I~ i t t ~ / ~-
We, the undersigned, the witnesses whose names are
signed to the attached or foregoing instrument, being duly
qualified according to law, do depose and say than we were
present and saw the testator sign and execute the instrument
4
as his Last Will and Testament; that the testator signed it
willingly and executed it as his free and voluntary act for
the purposes therein expressed; that each subscribing
witness in the hearing and sight of the testator signed the
Last Will and Testament as a witness; and that, to the best
of our knowledge, the testator was at that time eighteen
(18) or more years of age, of sound mind and under no
constraint or undue influence.
` ,~~~~~~--Address ~~l ~~''~/~~ ~~
~~~~
/ C•LGZ• ~ Address ~•/Q • / `~~ a?3 /
Sworn to or affirmed and subscribed to before me by the
•~ ~''.a~~+v~e•. named witnesses, this -5 f2' day of d c~ ~~ ,
~, {
• 1995. '
I.s
' F.~Fy?3.1Af A. B.lKc4 Fk'sry 1"ub!!c
. 7 jF;~ rtn Eorc. ~N;~i:in r_„c.,K;. PA
`-.''J L•~ ~~Kass~na Fx?~fBS ~,ta~••n :.~, i'~
-~ '"
Notary Public
5
..~
~~ ~.~
Apri12, 2010
Purcell, Krug & Haller
ATTN: Jill M. Wineka
1719 North Front Street
Harrisburg, PA 17102-2392
RE: ESTATE OF GILBERT K. SHIRK
SSN: 179-09-9036
DOD: 1%8/10
Dear Sir or Madam,
www.fnb-online.com
Info-Line 1-800-817-8787
Customer Service 1-800-555-5455
As per your request, the following information is provided as of Date of Death:
CD # 701702862
Opened 1/1/70
Titled Gilbert K. Shirk
Nancy Crampton
Leona Fickel
Balance $16,566.48
Accrued Interest $.48
CD # 101090753
Opened 7!22/08
Titled Gilbert K. Shirk
Nancy Crampton
Leona Fickel
Balance $30,797.14
Accrued Interest $143.52
CD # 101090816
Opened 7/22/0$ ,
Titled Gilbert K. Shirk
Nancy Crampton
Leona Fickel
Balance $10,265.71
Accrued Interest $47.84
Nancy Crampton added
to account on 7/Z2/08
Leona Fickel added
to account on 7/ZZ/08
Made Joint When Opened Made Joint When Opened
Account Closed 1/13!10
Account Closed 1/13/10
If you should have any further questions, please do not hesitate to contact me at 724-983-6068.
Very truly yours
FIILST NATIONAL BANK
Deborah L. Bartosh
Metlife
P.O. Box 10366
fines IA 50306-0366
MetLife
March 29, 2010
PURCELL KRUG 8~ HALLER
ATTN JILL M WINEKA
1719 N FRONT STREET
HARRISBURG PA 17102-2392
RE: Pilf'ETLIFE INJESTORS USA INSURANCE COfiAPANY CONTRACT 9200558081
OWNER GILBERT K SHIRK
Dear Ms. Wineka:
We received your recent inquiry regarding the value of the above-referenced annuity contract as well as
the beneficiary designation on file for the contract. According to our records for the annuity, the
beneficiaries are:NANCY CRAMPTON - 50% and LEONE FICKEL - 50%.
The date of death value was:
• Value as of January 8, 2010 - $52,248.86
If you have any questions, please contact your representative or call our Customer Service Center
at 1-800-255-9448 Monday through Friday between 8:30 a.m. and 6:30 p.m., ET.
Sincerely,
Sean Herrick, FLMI, ACS
Sr. Annuity Representative -Post Issue Processing
MetLife Annuity Operations and Services
LAW OFFICES
HOWARD B. KRUG
LEON P. HALLER
JOHN W.PURCELLJR.
JILL M. WINEKA
NICHOLEM STACEY O'GORMwIa
LISA A. RYNARD
Purcell, Krug ~ Haller
1719 NORTH FRONT STREET
HARRISBURG, PENNSYLVANIA 17102-2392
TELEPHONE (717)234-4178
Fax (717)783-4939
HERSHEY
(717) 533-3836
JOHN W. PURCELL(1924-2009)
JOSEPH NISSLEY (1910-1982)
June 17, 2010
PA Department of Revenue
Bureau of Individual Taxes
P.O. Box 280601
Harrisburg, PA 17128-0601
Re: Estate of Gilbert K. Shirk
File No.: 2110-0344
Date of Death: January 8, 2010
Dear Bureau of Individual Taxes:
I have been retained by the Decedent's only two children, Leona M. Fickel and Nancy A.
Crampton to represent them with regard to their interests in their Father's non-probate assets. At the
time of his death, there were no probate assets existing in the Decedent's name alone and therefore
no formal Estate has or will be opened. The only non-probate assets consisted of three joint
accounts at First National Bank Corporation owned equally by the Decedent and his two daughters
and an Annuity with MetLife Investors owned by the Decedent in which he named his two daughters
as equal beneficiaries.
According to my calculations, Mrs. Fickel and Mrs. Crampton will be owed a refund, owing to
their prior payment of $3,700.00 made within three months of their Father's death plus the discount
they will realize for the estimated payment. I believe a refund is owed of $1,070.20. Since there is no
formal Estate of record, please issue the refund check either payable to myself, so I may distribute
the monies to my clients, or payable to Leona M. Fickel and Nancy A. Crampton. The refund check
should 4t be payable to the Estate of Gilbert K. Shirk.
Should you have any questions regarding my request regarding the refund proceeds, please
contact me directly. Thank you.
Sincerely,
/-(.
M. Wineka
JMW/bas