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Home My WebLink About09-19-1115D5610143 REV-1500 Ex (D1-'°) OFFICIAL USE ONLY PA Department of Revenue pennsylvania County Code Year File Number Bureau of Individual Taxes OEVARTMENT OF REVENUE Po Box.2aosol INHERITANCE TAX RETURN 21 1~ 0097 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death 209 12 5774 12 25 2010 Decedent's Last Name Suffix ALLEMAN (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's Social Security Number Date of Birth O1 07 1925 Decedent's First Name MI RALPH B Spouse's First Name MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW _ 1. Original Return r _~ 2. Supplemental Return 4. Limited Estate ~l 4a. Future Interest Compromise /riolo of r~le~lh nN.~. 17 17 Q'll g Decedent Died Testate ~! ~ Decedent Maintained a Living Trust i n i (Attach Copy of Will) I ~ (Attach Copy of Trust) ~~ 9. Litigation Proceeds Received [_] 1 D, Spousal PovertyY Credit (date of death between 12-31-J1 and T-1-95) _~ 3. Remainder Return (date of death prior 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) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number FOREST N MYERS 717 532 9046 First line of address 137 PARK PLACE WEST Second line of address City or Post Office State ZIP Code SHIPPENSBURG PA REGISTER OF 4'NaLLS USE ONLY _ ,-~ -- -;:'. ~_. t .. , - _:~ ~.._. ~1, - ; --} _. ' -ri _ _~~ , DATE FI~L~b ' ' c. Correspondent's a-mail address: fnmyers@lawofficeforestmyers.com -ty ~::; f - ~..•; 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. Dec ration~of preparer other than the personal representative is based on all information of which preparer has any knowledge. SI{~dtvA%UKt Uh PtKSUN RESPO~IStBLE FORIF~ING RETURN nerG 350 Strohm Rd, Shippensburp, PA 17257 Brenda KUNKLEMAN e y.- SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ~„ Forest N Myers ~ _ t~ _ ~ t ADDRESS 137 Park Place West, Shippensburg, PA 1505610143 Side 1 1505610143 [~i J 1505610243 REV-1500 EX Decedent's Social Security Number oecedenYsName: ALLEMAN, Ralph B 209 12 5774 RECAPITULATION 1. Real Estate (Schedule A) ...................................................................................... . 1. 68 , 0 0 0 . 0 0 2. Stocks and Bonds (Schedule B) ............................................................................ . 2. 102 , 044.63 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. 97 , 749.51 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6. 7. Inter-Vivos Transfers & Miscellaneous Probate Property (Schedule G) Separate Billing Requested............ ~ 7. 55 295.00 , 8. Total Gross Assets (total Lines 1-7) .................................................................... . g. 323,089.14 9. Funeral Expenses & Administrative Costs (Schedule H) ...................................... . 9. 3 7 , 3 7 7 . 7 9 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............................. . 10. 11. Total Deductions (total Lines 9 & 10) .................................................................. . 11 3 7 , 3 7 7 . 7 9 12. Net Value of Estate (Line 8 minus Line 11) .......................................................... 12. 285 , 711.35 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 85 , 711.35 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 15 0 00 (a)(1.2) X .00 . . 16. Amount of Line 14 taxable 285 711.35 at lineal rate X .045 ~ 16. 12 857 . Ol ~ 17. Amount of Line 14 taxable at sibling rate X .12 0. 0 0 17. 0. 0 0 18. Amount of Line 14 taxable at collateral rate X .15 0. 0 0 18. 0. 0 0 19. Tax Due ................................................................................................................ . 19. 12 , 857 . O1 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 1505610243 1505610243 ^ REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-10-0097 DECEDENT'S NAME ALLEMAN, Ralph B -------- --- STREET ADDRESS 324 E Fort St CITY ~TATE 'ZIP Shippensburg PA 17257 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) 12,857.01 2. CreditslPayments A. Prior Payments 12,500.00 B. Discount 642.85 Total Credits (A + g) (2) 13,142.85 3. Interest (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) 285.84 Check box on Page 2 Line 20 to request arefund - 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 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 :................................. ~ ~i 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. 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 January 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)]. 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. ` ,~ ~ . ~~ C:.... f ~J ~ ~~ . _~ ~~ -f_ - _ _ _.l7 ~ 1 - _ _ _ '\ . ~~ LAST WILL AND TESTAMENT ~~ , , ~ -~~~ ._ _ __ _ _ _~ _ \. / TJ L~~ ~~ _... T'i ~. I, RALPH B ALLEMAN, of Shippensburg Borough, Cumberland County, Pennsylvania, revoke my prior wills and declare this to be my Last Will: FIRST: PAYMENT OF EXPENSES - I direct that the expense of my last illness and funeral be paid from my estate as soon as may conveniently be done. SECOND: BEQUEST - I give, devise and bequeath my estate, real or personal, tangible or intangible, together with all insurance policies thereon unto my children, BRENDA KUNKLEMAN, GREGORY L ALLEMAN, KIM D JOHNS and BRENTON E ALLEMAN, provided they shall survive me by thirty (30) days in as nearly equal shares as possible, per stirpes. I direct that any share of my estate to which BRENTON E ALLEMAN is entitled shall be placed in a joint bank account with my son, GREGORY L ALLEMAN, requiring two (02) signatures to withdraw funds therefrom. THIRD: RESIDUE OF ESTATE - I give, devise and bequeath all the rest, residue and remainder of my estate according to the same formula as set forth in the Second paragraph of this, my Last Will and Testament. FOURTH: PROTECTIVE PROVISION - To the greatest extent permitted by law, before actual payment to a beneficiary, no interest in income or principal shall be (i) assignable to a beneficiary or (ii) available to anyone having a claim against a beneficiary. FIFTH: DEATH TAXES -All federal, estate and other death taxes payable on the property forming my gross estate, whether or not it passes under this will, shall be paid out of the principal of my probate estate just as if they were my debts, and none of those taxes shall be charged against any beneficiary. This provision shall not apply to any property over which I have a general power of appointment of federal estate tax purposes. SIXT i-il: tviiliv%~i,EiviEi~fT i•rc~rViSIONS - i auti~orize rT-~y Execi;irix, as follows: A. Retain/Invest: To retain and to invest in all forms of real estate and personal property, including common trust funds, mutual funds and money market deposit accounts and certificates of deposit, regardless of any limitations imposed by law on investments by executors or any principle of law concerning investment diversification; B. Compromise: To compromise claims and to abandon any property which, in my Executrix's opinion, is of little or no value; C. Borrow: To borrow from and to sell property to others, and to pledge property as security for repayment of any funds borrowed; D. Sell/Lease: To sell at public or private sale, to exchange or to lease for any period of time, any real or personal property and to give options for sales of leases; E. Capital Changes: To join in any merger, reorganization, voting-trust plan or other concerted action of security holders, and to delegate discretionary duties with respect thereto; F. Distribute: To distribute in kind and to allocate specific assets among the beneficiaries (including any custodian hereunder) in such proportions as my Trustee may think best, so long as the total market value of any beneficiary's share is not affected by such allocation. These authorities shat! extend to all property at any time held by my Executrix or my Trustee and shall continue in full force until the actual distribution of all such property. All powers, authorities and discretion granted by this Will shall be ire addition to those granted by law and shall be exercisable without court authorization. SEVENTH: EXECUTOR - I appoint my daughter, BRENDA KUNKLEMAN, Executrix of my Will. In the event of the death, resignation, renunciation or inability of BRENDA KUNKLEMAN to act as Executrix, I appoint my son, GREGORY L ALLEMAN, Executor of this, my Will. Neither my Executrix, nor any successor shall be required to give bond. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~t1rday of JUNE, 2004. .,E.°_ ;, ....t, I~~ t'ra'~..:<.<..~ (SEAL) ~~ RALPFi~ ALLEMAN, Testator In ou pr sence, the above-named Testator signed this and declared it to be his will, and now, ~t hj~re~uest and in hyis p~s~pce and in the presence of each other, we sign as witnesses: 2 STATE OF PENNSYLVANIA COUNTY OF ~°`~~..~+:~ SS I, RALPH B ALLEMAN, having been duly qualified according to law, acknowledge that I signed the foregoing instrument as my Will, and that I signed it as my free and voluntary act for the purposes therein expressed. RALP~i~B ALLEMAN, Testator We, RALPH B ALLEMAN, the Testator in and the undersigned witnesses to the Will, the attached or foregoing instrument, ~rvho have signcil the instrument; having be~-n qualified acccrdiE,g to law do depose and say: (a) that I, the Testator, do hereby acknowledge that I signed the instrument as my Will, that I signed it willingly and as my free and voluntary act for the purposes therein expressed; and (b) that we, the witnesses, were present and saw the Testator sign and execute the instrument as his Will, that he signed it willingly and 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 knowledge, the Testator was at that time eighteen or more years of age, of sound mind and under no constraint or undue influence. Y Y lin ~~,5 Subscribed, sworn to or affirmed, and acknowledged before me by the above-named Testator and by the witnesses whose names appear on this ~~t~day of JUNE, 2004. Notary Public NOTARIAL SEAL FOREST N..MYERS, NOTARY PUBLIC SHIPPENSBURG BOROUGH, COUNTY OF FRANKLIN MY COMMISSION EXPIRES DECEMBER 17, 2005 FIRST CODICIL OF RALPH B ALLEMAN I, RALPH B ALLEMAN, a resident of the Shippensburg Borough, Cumberland County, Pennsylvania, declare that this is the First Codicil to my Last Will and Testament, which is dated June 21, 2004. A. I revoke Paragraph SECOND of my Last Will and Testament, which reads as follows: B. "SECOND: BEQUEST - I give, devise and bequeath my estate, real or personal, tangible or intangible, together with all insurance policies thereon unto my children, BRENDA KUNKLEMAN, GREGORY L ALLEMAN, KIM D JOHNS and BRENTON E ALLEMAN, provided they shall survive me by thirty (30) days in as nearly equal shares as possible, per stirpes. I direct that any share of my estate to which BRENTON E ALLEMAN is entitled shall be placed in ajoint bank accountwith my son, GREGORY L ALLEMAN, requiring two (02) signatures to withdraw funds therefrom." In place of this revoked provision, I substitute the following: SECOND: BEQUEST - I give, devise and bequeath my estate, real or personal, tangible or intangible, together with all insurance policies thereon unto my children, BRENDA KUNKLEMAN, GREGORY L ALLEMAN, KIM D JOH NS and BRENTON E ALLEMAN, provided they shall survive me by thirty (30) days in as nearly equal shares as possible, per stirpes. A. Additionally, I further direct that the share allotted to my deceased daughter, KIM D JOHNS above be divided among her children, provided they shall survive me by thirty (30)~ays in as nearly ,~ equal shares as possible, per stirpes. ~~ ; ~_, ~ _. .,_ r7 _.l~ ~~ ~ --, ~ ~.~ -- _i ~` . _.-.... _V ~ .: _ • ~~~ d C... 4~ Page 1 of 3 I hereby confirm and republish my Will dated June 21, 2004 in all respects other than those herein mentioned. I, RALPH B ALLEMAN, being unable to sign my name because of physical infirmities, have had my name subscribed for me in my presence by~~~.~<v`k.-~c.~~r~ , and I have made my mark in the space between my name this ~~z~day of ~R, 2007. His RALPH B ~•=~ ALLEMAN On the ~•~ay of NCR, the above-named Testator, in our presence declared the preceding instrument to be his Will and, being unable to sign his name hereto because of physical infirmities directed his name to be subscribed for him, which the undersigned ~(:.r~.~ci. ~= ~-~~~k-~~r~c~.vy did subscribe as directed in the presence of the Testator and in the presence of the undersigned, whereupon the Testator in our presence unassisted made his mark or cross in the space provided between his names, and we, in the presence of the Testator, and in the presence of each other, at the regy~est of the Testator, have subscribed our names as witnesses. the G~R ~ S ~'VLa.~v~ 5'4' of C~.~ ~ hY-~ J~ l -F~~ I ` of l~S~ n~~b~c~~- ''l~~l ~ 57 On the date last above written, RALPH B ALLEMAN, known to us to be the person whose signature appears at the end of this Codicil, declared to us, the undersigned, that the foregoing instrument, consisting of three ;03) pages, including the page on which we have signed as vitnesses, was the First Codicil to his Wilf dated June 21, 2004. He then signed the Codicil in our presence, and at in his presence and in the presence of each other, we now sign our names as witnesses. ~ ~~~ S ~ ~S-~pp residing at G~q,..•. ~'`~ h`''---5 /'4 ~~ ~ 1 c 3 Z P~~ ~~-~~ ~u ~~- residing at ~,.~~~,~ ~~ l~4 ~ZZ~7 Page 2 of 3 ACKNOWLEDGEMENT COMMONWEALTH OF PENNSYLVANIA COUNTY OF FRANKLIN SS We, RALPH B ALLEMAN, ~UtQ~2. ~ ~C~Q.U~ ,and ~~CCY%~ (~-~t~S ,the Testator, in and the undersigned witnesses to the Codicil, the attached or foregoing instrument, who have signed the instrument, having been qualified according to law do depose and say: (a) that I, the Testator, do hereby acknowledge that I signed and executed the instrument as a Codicil to my lNill, that !signed it willingly and as my free and voluntary act for the purposes therein expressed; and (b) that we, the witnesses, were present and saw the Testator execute the instrument as his Codicil, that he signed it willingly and 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 Codicil as a witness and that to the best of our knowledge, the Testator was at that time eighteen (18) years or more of age, of sound mind and under no constraint or undue influence. V V Ill ICJJ Sworn to before me a Notary Public this ~~- day of N,Q, 2007. ~~~~=rr,1t~ Notary Pub is tvCyIVt~1t7~WEALTH OF PENNSYLVANIA NotarialSeal Forest N. Myyers, Notary Public Shippensburg Bono, Frankiln County My Commission Expires Aec. 79, 2... , Page 3 of 3 Rev-1502 EX+(~~-08) SCHEDULE A REAL ESTATE COMMON W EALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER ALLEMAN, Ralph B _ 21-10-0097 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on schedule F. (If more space is needed, additional pages of the same size) Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule A (Rev. 11-08) Rev-1503 EX+(6-98) SCHEDULE B STOCKS & BONDS COMMON WEALTH OF PENNSYLVAN IA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ALLEMAN, Ralph B FILE NUMBER 21-10-0097 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER CUSIP NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OF DEATH 1 3,726.2283 shares of Orrstown Financial Services -Common 27.3855013 102,044.63 stocks TOTAL (Also enter on Line 2, Recapitulation) 102,044.63 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 6-98) Rev-1508 EX+I6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF (FILE NUMBER ALLEMAN, Ralph B 21-10-0097 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 VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Citizens Bank 110121 -Interest Checking 37,130.42 Accrued interest on Item 1 through date of death 2.44 2 Citizens Bank 2209036 -Money Market 22,374.77 Accrued interest on Item 2 through date of death 2,82 3 Citizens Bank 330965 - 6 mo. CD 10,358.68 Accrued interest on Item 3 through date of death 2.05 4 Citizens Bank 443808 - 6 mo. CD 25,673.90 Accrued interest on Item 4 through date of death 4.43 5 Automobile - 1991 Chevrolet Lumina 2,200.00 TOTAL (Also enter on Line 5, Recapitulation) I 97,749.51 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) Rev-1510 EX+(6-98) SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER ALLEMAN, Ralph B 21-10-0097 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER DESCRIPTION OF PROPERTY THE DATE OF TROANSFERSATTACN A CIOPY OF TIOHE DEIED FOOR REAL ESTATDE DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1 Transamerica Life Ins Co -annuity 55,295.00 55,295.00 TOTAL (Also enter on Line 7, Recapitulation) I 55,295.00 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule G (Rev. 6-98) REV-1151 EX+(10-06) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER ALLEMAN, Ralph B 21-10-0097 _ ........................................r.,.,......,.........,.,,..., .. ITEM DESCRIPTION AMOUNT NUMBER _ A. FUNERAL EXPENSES: See continuation schedule(s) attached B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) 12,165.83 Street Address City State Zio Year(sl Commission oaid 2. Attorney's Fees Law Office Forest N Myers 16,403.40 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 3,500.00 Claimant Brenton Alleman Street Address 324 E Fort St city Shippensburg state PA zio 17257 Relationshio of Claimant to Decedent SOn 4. Probate Fees 371.38 See continuation schedule(s) attached 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 4,937.18 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 37,377.79 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER ALLEMAN, Ralph B 21-10-0097 ITEM NUMBER DESCRIPTION AMOUNT Funeral Expenses 1 Fogelsanger-Bricker Funeral Home -grave opening fee 600.00 2 Fogelsanger-Bricker Funeral Home -funeral bill 11,565.83 H-A 12,165.83 Probate Fees 3 Cumberland County Register of Wills -Petition Letters Testamentary 260.00 4 Cumberland County Register of Wills -Filing fee: Will 15.00 5 Cumberland County Register of Wills -Short Certificates 28.00 6 Cumberland County Register of Wills -JCS & Automation fee 28.50 7 Cumberland County Register of Wills -filing Inheritance Tax Return 15.00 8 Cumberland County Register of Wills -filing Codicil 15.00 9 Postage -mailing fees g,gg H-B4 371.38 Other Administrative Costs 10 Allstate -homeowners insurance premium 619.72 11 Borough of Shippensburg -utility; water/sewer 141.00 12 Century Link -utility; phone 50.73 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98i SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER ALLEMAN, Ralph B 21-10-0097 ITEM NUMBER DESCRIPTION AMOUNT 13 Century Link -utility; phone 69.29 14 Century Link -utility; phone 77.28 15 Century Link -utility; phone 49.66 16 Century Link -utility; telephone 67.68 17 Century Link -utility; phone 47.84 18 Century Link -utility; telephone 67.68 19 Century Link -utility; phone 49.56 20 Comcast -utility; cable 105.94 21 Comcast -utility; cable 29.40 22 Cumberland County Orphans' Court -certified copy of Kim's marriage certificate "Johns" to 5.00 "Baker" 23 Cumberland Legal Journal -advertise estate 75.00 24 News-Chronicle -advertise estate 96.50 25 PA Dept of Revenue -State Income Tax due 107.00 26 Penelec -utility; electric 74.48 27 Penelec -utility; electric 58.47 28 Penelec -utility; electric 93.26 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98; SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER ALLEMAN, Ralph B 21-10-0097 ITEM NUMBER DESCRIPTION AMOUNT 29 Penelec -utility; electric 257.36 30 Penelec -utility; electric 187.70 31 Penelec -utility; electric 109.86 32 Penelec -utility; electric 124.93 33 Shippensburg Area School District - 2011 real estate taxes 1,071.00 34 Tanner Energy -utility; fuel 512.76 35 Tanner Energy -utility; fuel 570.72 36 Tanner Energy -utility; fuel 156.35 37 US Treasury -Federal Income Tax due 61.00 H-B7 4,937.18 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) REV-1513 EX+(11-08) SCHEDULE J COMMNHE`RIETANCE~ ~ REN URNANIA BENEFICIARIES RESIDENT DECEDENT ESTATE OF ALLEMAN, Ralph B FILE NUMBER 21-10-0097 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(Sl RECEIVING PROPERTY DECEDENT (Words) ($$$) Do Not List Trustees I TAXABLE DISTRIBUTIONS [include outright spousal _ ~ distributions, and transfers under Sec. 9116 a 1.2 Brenton E ALLEMAN Son One-fourth (114) 71,733.27 324 E Fort St of the net Shippensburg, PA 17257 distributable estate Gregory L ALLEMAN Son One-fourth (1/4) 71,733.27 305 West Creek Rd of the net Newburg, PA 17240 distributable estate Amanda JOHNS Granddaughter One-eighth (1/8) 35,866.63 330 Charles Rd of the net Mechanicsburg, PA 17050 distributable estate Nicole A JOHNS Granddaughter One-eighth (1/8) 35,866.63 330 Charles Rd of the net Mechanicsburg, PA 17050 distributable estate Brenda E KUNKLEMAN Daughter One-fourth (1/4) 71,733.27 350 Strohm Rd of the net Shippensburg, PA 17257 distributable estate Total 286,933.07 Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 150 0 cover sheet, as a r o riate. NON-TAXABLE DISTRIBUTIONS: II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FO R WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 11-08)