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FILL IN APPROPRIATE OVALS BELOW
C~7 1. Original Return
Q 4. Limited Estate
Cif 6. Decedent Died Testate
(Attach Copy of Will)
O 9. Litigation Proceeds Received
7
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER 4F WILLS
O 2. Supplemental Return
(~ 4a. Future Interest Compromise (date of
death after 12-12-82)
Q 7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
O 10. Spousal Poverty Credit (date of death
between 12-31-91 and 1-1-95)
O 3. Remainder Return (date of death
prior to 12-13-82)
O 5. Federal Estate Tax Return Required
~ 8. Total Number of Safe Deposit Boxes
Q 11. Election to tax under Sec. 9113(A)
(Attach Sch. O)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHQULD BE DIRECTED T0:
Name Daytime Telephone Number
KEITH O. BRENNEMAN ' (717) 697-8528
First line of address
44 WEST MAIN STREET
Second line of address
City or Post Office State ZIP Code
_ __ . _ __
MECHANICSBURG PA 17055
Correspondent's a-mail address:
REGIS ~F 1NILLS t~E ONLY -
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t-~ rF
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-~"~ DATE FILED*~,."w '' ~ r
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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.
SIGN URE O P S SP NSIBLE FOR FILING RETURN C)ATE
Administrator J~ °/ /p
A DRESS
40 Royal alm Drive, Mechanicsburg, PA 17050
SIG~l~ OF PREPARER OTHER THAN REPRESENTATIVE DATE
!! ,...~ l~~//~i// O
ADDRESS
44 West Main Street, Mechanicsburg, PA 17055
PLEASE USE ORIGINAL FORM ONLY
Side 1
1,50561,0101, 15056101,01,
J
1,50561,01,05
REV 1500 EX
Decedent's Sociial Security Number
~eceaent~s Name: Mary Jane Chipriano ; 211-22-719'1
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 and Notes Receivable (Schedule D) ................. . ......... 4.
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)....... 5. 49,719.18
6. Jointly Owned Property (Schedule F) O Separate Billing Requested ....... 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) O Separate Billing Requested........ 7.
8. Total Gross Assets (total Lines 1 through 7) ...................... . ...... 8. ! 49,719.1$
9. Funeral Expenses and Administrative Costs (Schedule H) ................... 9. 6,199.90
10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule 1) .............. 10. ! 179,003.72 ``
11. Total Deductions (total Lines 9 and 10) ................................. 11. ` 185,203.62
12. Net Value of Estate (Line 8 minus Line 11) .............................. 12. (135,484.44)..
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. ' 0.00
TAX CALCULATION -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 .0_ 15.
16.
Amount of Line 14 taxable .., . ...
at lineal rate X .0 _ 16.
17. Amount of Line 14 taxable
at sibling rate X .12 17,
18.
Amount of Line 14 taxable .. ..
at collateral rate X .15 18.
0.00
19. TAX DUE ......................................................... 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O
Side 2
1,50561,01,05 1,50561,01,0.5 J
REV-1500 EX Page 3 File Number
Decedent's Complete Address: 21-10-0775
DECEDENT'S NAME
Mary Jane Chipriano
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STREET ADDRESS
442 Walnut Bottom Road
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CITY
Carlisle STATE
PA ZIP
17013
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2. CreditslPayments
A. Prior Payments ____
B. Discount
3. Interest
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in oval 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.
(3)
(4)
(5)
o. o0
0.00
Make check payable to: REGISTER 4F 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 :.......................................................................................... ^ Q
b. retain the right to designate who shad use the property transferred or its income : ............................................ ^ Q
c. retain a reversionary interest; or .......................................................................................................................... ^
d. receive the promise for life of either payments, benefits or care? ...................................................................... ^ Q
2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. ^ 0
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 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.
(1)
Total Credits (A + B) (2)
REV-1508 EX+ (6-98}
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
Mary Jane Chipriano 21-10-0775
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX+ (10-09)
-~ ` pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUNf BER
Mary Jane Chipriano 21-10-0775
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. ._ _
B. ADMINISTRATIVE COSTS:
i. Personal Representative Commissions: 2,000.00
Name(s) of Personal Representative(s) Ronald J. Chipriano, Administrator
street Address _40 RoYaf Pafm Drive `________`-_____-_ ___
city __Mechanicsburg_ __________`_ ____ state PA _ ZIp 17050 _,
Year(s) Commission Paid: 2010
3,000.00
2. Attorney Fees: Sne lbaker & Brenneman , P . C .
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.)
Claimant
Street Address
City ---------_------------------------~------------------ State -____ ZIP _~ _~
Relationship of Claimant to Decedent
4. Probate Fees: Register of Wills, Cumberland County 155.50
($124.50 plus additional probate fee of $30.00)
5. Accountant Fees:, miscellaneous filing fees and reserve 750.00
6. ~5~i~rx~e~i~r~r~e~; Advertise grant of letters
a. Cumberland Law Journal: $ 75.00
~• b. The Sentinel 219.40
.:294.40..
TOTAL (Also enter on Line 9, Recapitulation) $ 6,199.90
If more space is needed, use additional sheets of paper of the same size.
REV-1512 EX+ (12-Q8)
~ ~ pennsylvan~a
' DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
ESTATE OF FILE NUMBER
Mary Jane Chipriano 21-10-0'775
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses.
If more space is needed, insert additional sheets of the same size.
REV-1513 EX+ (01-10)
~~ ` pennsylvania SCHEDULE ~
DEPARTMENT OF REVENUE
BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Mary Jane Chipriano 21-10-0775
RELATIONSHIP 70 DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List 7rustee(s~ OF ESTATE
I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under
Sec. 9116 (a) (1.2).]
1• Nancy M. Carlson, 274 East 24th Street, Idaho Falls, ID 83404 Daughter one-third (1/3)
of ,,Estate
2. Ronald J. Chipriano, 40 Royal Palm Court, Mechanicsburg
PA 17050 Son one-third (1 / 3 )
, of Estate
3. Robert G. Chipriano, 408 Garman Avenue, Galena, MD 21635 Son one-third (1 /3 )
- of Estate
II
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE.
NON-TAXABLE DISTRIBUTIONS
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
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, use additional sheets of paper of the same size.
LAST WILL AND TESTAMENT
4W OFFICES
NELBAKER,
RENNEMAN
& SPARE
I, MARY JANE CHIPRIANO, of the Township of Monroe, County of
Cumberland and Commonwealth of Pennsylvania, being of sound and
disposing mind, memory and understanding, do make, publish and
,declare this as and for my Last Will and Testament, hereby
revoking and making void all former Gtirills and codicils by me at
any time heretofore made.
FIRST. I-order and direct that all my just debts and
funeral expenses be paid by my Executor or Executrix, as the case
may be, hereinafter named, as soon as conveniently may be done
after my decease.
SECOND. T give, devise and bequeath all the rest, residue
and remainder of my Estate, real, personal and mixed, whatsoever
and wheresoever situated unto my husband, JOHN L. CHIPRIANO,
absolutely and in fee simple, if he survives me by as many as
sixty ( 6 0 ) days .
THIRD. If my husband, JOHN L. CHIPRIANO, does not survive
me by as many as sixty (60) days, then and in that event, I give,
devise and bequeath all the rest, residue and remainder of my
Estate, real, personal and mixed, whatsoever and wheresoever
situated, in equal shares unto my three children, namely, NANCY
M. CARLSON, RONALD J. CHIPRIANO and ROBERT G. CHIPRIANO, share
and share alike, absolutely and in fee simple.
If any of my said children should predecease me, I
order and direct that the foregoing share of my estate
attributable to such deceased child shall be distributed among
his or her lawful issue per stirpes by representation and not per
capita, subject, however, to the protective trust provisions as
contained in Item Fourth hereinbelow with respect to any
beneficiary who has not attained the age of twenty-two (22) years
LAW OFFICES
SNELHAKER.
BRENNEMAN
& SPARE
fat the time for distribution.
FOURTH. If any beneficiary hereinabove has not attained the
age of twenty-two (22) years at the time of distribution, I order
and direct that the distributive share of such person shall be
paid over and delivered unto PNC BANK, N.A., (or its successor by
merger, consolidation or other corporate reorganization) as my
testamentary Trustee, IN TRUST, NEVERTHELESS, to hold, manage,
invest, accumulate income and reinvest until said beneficiary
attains the age of twenty-two (22) years, at which time said
trust shall be terminated and the net proceeds thereof be paid
over to the beneficiary absolutely.
I authorize and empower my said Trustee to invest the
assets of said trust in any reasonable manner and not be limited
or restricted to so-called "legal" or statutory investments for
i f fiduciaries .
I designate any trust hereunder to be a spend-thrift
trust. The beneficiary shall have no right to invade, pledge,
assign or otherwise dispose of the assets of said trust
(including income) nor shall any creditor of a beneficiary have
any right to seize, levy or execute upon said assets by reason of
any pledge, assignment or other transfer, voluntarily or
involuntarily, made by said beneficiary.
I further authorize and empower my said Trustee to use,
consume, expend and apply from time to time such amounts of
principal and income of and from said trust which in the exercise
of its sole discretion shall be determined to be reasonable and
necessary for the beneficiary's education. The term "education"
shall be construed and interpreted to mean college or other past-
highschool training which is intended to improve the
beneficiary's productivity as an adult or enhance the quality of
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his or her life. In considering what is reasonable and
necessary, my said Trustee shall take into consideration the
primary responsibility of the beneficiary's surviving parent to
provide such education. It is my will and intention that the
foregoing discretionary provision for education shall be
supplementary to the parent's primary responsibility.
LASTLY. I nominate, constitute and appoint my husband, JOHN
L. CHIPRIANO, to be the Executor of this, my Last Will and
Testament, but if for any reason he should fail to qualify as
such Executor or cease so to serve, then and in that event, I
nominate, constitute and appoint my daughter, namely, NANCY M.
CARLSON, to be the Executrix hereof, each and both to serve
without bond or other security as a condition of qualification
hereunder.
IN WITNESS WHEREOF, I, MARY JANE CHIPRIANO, have hereunto
set my hand and seal to this, my Last Will and Testament which
consists of three (3) typewritten pages to each of which I have
~~
affixed my signature this J5' day of ~~,~~~'~~ A.D. ,
One Thousand Nine Hundred Ninety-eight (1998).
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't ~ ~ ~ T(f/ ~ ~~~.~,~'~/ (SEAL )
J;/ ~~ ry Jane C °ipriano
_AW OFFICES
iNELBAKER.
tRENNEMAN
& SPARE
The preceding instrument, consisting of this and two (2)
Bother typewritten pages, each identified by the signature of the
iTestatrix, was on the date thereof signed, sealed, published and
declared by MARY JANE CHIPRIANO, the Testatrix therein named, as
and for her Last Will and Testament, in the presence of us, who,
at her request, in her presence, and in the presence of each
other, have subscribed our names w' hereto.
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COMMONWEALTH OF PENNSYLVANIA )
SS.
COUNTY OF CUMBERLAND )
We, MARY JANE CHIPRIANO, RICHARD C. SNELBAKER and CHRISTINE
M. WHITE, the Testatrix and the witnesses, respectively, whose
names are signed to the attached or foregoing instrument, being
first duly sworn, do hereby declare to the undersigned authority
that the Testatrix signed and executed the instrument as her Last
Will and Testament and that she had signed willingly, and that
she executed it as her free and voluntary act for the purposes
therein expressed, and that each of the witnesses, in the
(presence and hearing of the Testatrix, signed the Will as a
witness and that to the best of his or her knowledge the
Testatrix was at that time eighteen years of age or older, of
sound mind and under no constraint or undue influence.
fi
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f Testatri
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Witness
4
Witness
Subscribed, sworn to and acknowledged before me by MARY JANE
CHIPRIANO, the Testatrix, and subscribed and sworn to before me
by RICHARD C. SNELBAKER and CHRISTINE M. WHITE, witnesses, this
~~ '
day of C~~'' , 1998.
~G~~f'~GGC1~
Nota y Public
LAW OFFICES
SNELBAKER,
BRENNEMAN
& SPARE
NOtaftal SQ8!
Patricl2t J. Thomson, Plotary FtRrRc
~~lta^lt~ttrg Born, Cur-~bertand Ctwn~
i~9y C~EmmlS,sfan Ea~pires Dec. 31, 1598
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