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Home My WebLink About11-17-11 (2)~a, 1505610105 REV-1500 EX (oz-u) (FI) 1 ~1 PA Department of Revenue pennsylvartia OFFICIAL USE ONLY Bureau of Individual Taxes ~"Aa.~E~.oFa. °` County Code Year File Number Po Box 28osoi INHERITANCE TAX RETURN (+ ; . Harrisburg, PA>~>.z8-oso> RESIDENT DECEDENT .~ ~ ~ ~`/~ `> ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 527-36-2226 05/10/2011 04/12/1930 Decedent's Last Name Suffix Decedent's First Name MI Kauffroath Elizabeth ~ (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW OD 1. Original Return O 2. Supplemental Return O 3. Remainder Return (Date of Death Prior to 12-13-82} O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required death after 12-12-82) CitD 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust ~ 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (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 Schedule O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number Tim L. Kauffroath (717) 525-4367 First Line of Address 1039 W. Trindle Rd,. Second Line of Address City or Post Office Mechanicsburg State ZIP Code PA 17055 REGISTER~QA~I LLS USE 9NLY .. -_~~ ~C7 -- t_.. i i r 7 ~.. X~ ~, ,~;=: ;'`_ -~ '; C~= _.j .: -- DATE FILED -~~ -„ ~~ ~,~=, ~~~ C. -,- ~ Correspondent's a-mail address: tkroath@yahOO.COm 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 preparerothe~r t ~s~the personal representative is based on all information of which preparer has any knowledge. DATE 10/18/2011 ADDRESS 1039 W. Trindle Road, Mechanicsburg, PA 17055 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 1505610105 1505610105 1505610225 REV-1500 EX (FI) Decedent's Social Security Number Decedent's Name: Elizabeth Jean Kauffroath 527-36-2226 RECAPITULATION 1. Real Estate (Schedule A) ............................................. 1. 2. Stocks and Bonds (Schedule B) ....................................... 2. 33,879.15 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. 14,982.98 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. 48,862.13 9. Funeral Expenses and Administrative Costs (Schedule H) ................ ... 9. 7,637.00 10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) ............ ... 10. 1,437.99 11. Total Deductions (total Lines 9 and 10) .............................. ... 11. 9,074.99 12. Net Value of Estate (Line 8 minus Line 11) .............................. 12. 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. 39,787.14 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 45 39,787.14 16. 1,790.42 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. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 150561~2~5 1505610205 1,790.42 O REV-1500 EX (FI} Page 3 File Number Decedent's Complete Address: DECEDENTS NAME Elizabeth Jean Kauffroath STREETADDRESS 1039 W. Trindle Rd. CITY STATE j ZIP Mechanicsburg PA 17055 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) 1,790.42 2. Credits/Payments A. Prior Payments B. Discount Total Credits (A + B) (2) 0.00 3. Interest (3) 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fiil in oval on Page 2, Line 20 to request a refund. (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 1,790.42 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 .................................................................................... ...... ^ b. retain the right to designate who shall use the property transferred or its income ..................................... ....... ^ c. retain a reversionary interest ....................................................................................................................... ....... ^ d. receive the promise for life of either payments, benefits or care? ............................................................... ....... ^ 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................................... ....... ^ 3. Did decedent own an "intrust 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 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 Juty 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(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-153.3 EX+ {OI-10) pennsylvania SCHEDULE ~ DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Elizabeth Jean Kauffroath 21-11-0595 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1. Tim L. Kauffroath 1039 W. Trindle Rd. Mechanicsburg, PA 17055 Son 18,998.36 2. Daniel M. Kauffroath 904 Nixon Dr. Mechanicsburg, PA 17055 Son 18,998.36 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. II NON TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. 8. CHARITABLE AND 60VERNMENTAL DISTRIBUTIONS: 1 TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. I $ If more space is needed, use additional sheets of paper of the same size. Form A235 Last Wilt and Testament LAST WILL AND TESTAMENT BE IT KNOWN, that I, jetty J. Kauffroath a reside~;t of pa y s on ,County of Gila in the State of AR I~ONA , being of sound mind, do make and declare this to be my Last Will and Testament expressly revoking all my prior Wi11s and Codocils az an time ade. 1, PERSONAL REPRESENTATIVE: I appoint Anil L~~aCur~~~oath • °f 1 i r~~e, ht n . ?"~f_I1J~~- Penny . , as Personal Representative of this my Last R'i7f and Testament and pr vide tf this Personal Representative is unable or unwilling to serve then I appoint ~1~4a~1 u a h~ • ~ altemate Personal Representative. My Personal Representative shall be authorize to carry out 1 provisions of this Will and pay my just debts, obligations and funeral expenses. I further provide my Personal Representative shall not be required to post surety bond in this or any other jurisdiction, and direct that ra expert appraisal be made of my estate unless required by law. 11. GUARDIAN: In the event I shall die as the sole parent of minor children, then I appoint as Gttazdian of said minor children. If this named Guazdian is unable or tmwilling to serve, then I appoint as alternate Guardian, Ill. BEQUESTS: I direct that after payment of all my just debts, my property be bequeathed in the manner following: -~- s ,.i a, r.<q ,a'1._~? , S9 pJ n;y r .yt'~t..~,:~ s .g-r' ~ n %~j c J- f-) nCf .'ft ~~ ~ he~.Kj ~ ~ ~Piti'~ k:,t~ °i`' nJr~ ,~} ~ $< i rv /!.rn S N'~ F_ !-{z: ~s L~JTi~ ~~"c"+z. d f ,yl'l t~+J`~I/ tt Nt !f W - f '' ~-° - ,.-- _. ,~? ~ x~~y 9>!1 j i ,/. ::;fc' : r~vG'c ~'T! GL% ! h e. t a ~ ,~ ~,.. ~r4 /tl !,7t L); ` L° ~l~i-(~ ~~~'A!~ y d1G {+..'`~ t.~' :a'7S` ~' _~ ~ rr, 3rj~' 11 E.i ;- tr ~ c.~ ~" Ki9LL~-~~6~A~I ~ ~'!-'Te~ ~ rJY' is"T~l~ K',...'t~'" ` ~ '~ l " ~ "_ - - .J ---- J J ~ yr/ ~~ r ,te, t G r~ ~1~ c~,s ~ ~ _~'~,Ax c)(~t~'lw ~r ([rY~ f ~ ~C.jf: YC7 L'YJ ~//< <' r r J ~ 5~.'.:,41r'- s~+ai~4~ r-:iIJ+/`'~ fir., - <'.>ra,1 ~.,k tj%5C i ,,.~ r ~-,t r;ry -;be <5~~'t`y %~Eiejr-7 ' rJ, r-fj .J{.-: i'r` ~" - . T-'-, 1`~ rt' J I 1 C,'r~ /vr1~ / rr. / ~1 / 5 (~ ~~. f~ U ~~ _"` -may K" / ~ ~jc C1 RG~~ !-. /~. l7 C /'i 'e. r. .r+to~ Y ~ ~r l) /~ r<, Y fi71 r} +° 1 ~ ~ %J ~ ~ rd ~ ~~ __. L~ r J.j' tea- f>. !~ . .,.i- z e'er / J Uc, J e`' ;%, r s ~ -r 11 Y: ~.~~& ~ ; J ~ "; 'G% t ~ ~ ~ ty' GT" i~~~ie TE~te SCr(dr a ~ ; I u as ar;°cntzt~~. p,~fta ; ; , ~~~ 5-~.. ~ b~l~ ass ~':'7 4dt}C~t~ ~'~ = _ ..__ :~ : ~ -, . ~ :;~.l~ - ARIZONR :~3UNTY tssion Expiras ., -__ _~ntia ' ii, 2009 ~ r~ IN WITNESS 'WHEREOF, I have hereunto set my hand this 1.:J day of ~ y~ , r~Ay' , ~ ~'~ s~ to this my Last Will and Testament. ,~i~ ~ u{ Y ~lJti2~ ~, 1V. WITNESSED: This Last Will and Testament of w a s signed and declared to be his/her Last Will and Testament in our presence and at his/her request and in his/her presence and in the presence of each other, we do hereby witness same on this t ~~~~~1„~.~~, // l y} ^ad~ ~ ~sLi~. j ~} z. ~,~'s try Wimess Signature Address Ct,~ ; ; ;, ~ _~ ~' ~ -5-zf" ~ c. E-Z Legal Forms Form AZ35 Last Will and Testament LAST WILL AND TESTAMENT BE IT KNOWN, that I, Betty (Elizabeth) J. Kauffroath, a residentpf PAYSON ,County of GILA , in the State of ARIZONA ,being of sound mind, do make and declare this to be my Last Wilt and Testament expressly revoking all my prior Wills and Codocils at any time made. PERSONAL REPRESENTATIVE: Iappoint Timothy L. Kauffroath .of 1' bethtown, P ENNA . , as Personal Representative of this my ~t Will and Testament and provide if this Personal Representative is unable or unwilling to serve then I appoint ~ i ch a e l Kauffroath • ~ alternate Personal Representative. ~ P~ pal Representative C,_,sha11 be authorized to carry out all provisions of this Will and pay my just debts, obligations apd funeral (` expenses. I fovide my Personal Representative shall not be required to post surety bond in this or any otFie~' jtvisdicdan, Slid direct that no expert appraisal be made of my estate unless reauired by law ll. GUARDIAN: In the event I shall die as the sole parent of minor children, then I appoint as Guardian of said minor children. If this named Guardian i5 unable or unwilling to serve, then I appoint as alternate Guardian. lli. BEQUESTS: I direct that after payment of all my just debts, my groperty be bequeathed in the manner following: The Checking and M.M. Savings accounts at Bank of America, and mp IRA at Edward Jones Investment are in Tim's name. He is Executor of my will, and will need these monies to pay my funeral expenses. The investment accounts at Edward Jones Investments can be divided equally between my sons, Michael and Timothy Kauffroath, after any other and all debts are paid, The car belongs to Tim, the Title is in the safety deposit box at Bank of America. There is a seperate list sufF/est~i g dispersing some individual items in the safety deposit box. I know you boys will handle this with love and respect for each other and pleasing to the Lord. I have chosen to amend my former will because I do not want any hurt feelings. You can each decide if you want to give your share to a ministry in memory of your Dad if you choose. I wish I had left a more Spiritual Inheritance, as well as more material inheritance. Your Dad and I have been very proud of you both, and I `~' love you both equally. I IN WITNESS WHEREOF, I have hereunto signed this, my Last i Will and Testament, this~~day of ~c17 in the Town of Payson, State of Arizona ~ ~ .~ ~/ ~ l~y ~ Testat r STATE (?F AR2ONA COUNTY OF__~.r. ~Gc The tgrego~,;r~ i~--=-~: nsnt ~w/~as at:kr~owk~dAed bAlt>te!.;~,:r~~~~t._;j1Jf rY`/~-t L7~~. +Votary Public''`" ~- My Ctlmmission ._~ J-~ ~ Y `` ~ _ _,__,~ t_~i~~ON ~1~( ~, ?UNTY IZOMA a 5 9 6 28 a "p"°`>~n Expires <:'~';3r' l9 20pQ IN WITNESS WHEREOF, I have hereunto set my hand this day of 1~,2ao~J, to this my Last Will and Testament. Signature ,-~ IV. WITNESSED: This Last W ill and Testament of w a s signed and declared w be hisJher Last Will and Testament in our presence and at hisfier request and in hisJher ce and in the presence of each other, we do hereby witness same on this ---~y~ . ~ dvd7 --::-- - _ \ ( ...~ r- witness signature CtJ~SG'"-- -!~ ~ - ~ S SGT imess Addtesc ' .._- 1 Witness Signature Ad~ess c. E-Z Legal Forms