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Home My WebLink About04-0886 JAN L. BROWN, ESQUIRE* JACQUEUNE A. KELLY, ESQUIRE *AOMffTED IN PA AND DISTRICT OF COLUMBIA JAN L. BROWN & ASSOCL TES ATTORNEYS AND COUNSELORS AT LAW OLDE ENGLISH GAP 845 S~R THOMAS COURT SUITE 12 HAPR[SSURG, PA 17109 EMA~L: jlbassoc@verizon.net TELEPHONE (717) 541-5550 FACSIMILE (717) 541-9223 September 28, 2004 oq oq-B b BRENDA F, KEPHART, LEGAL ASSISTANT PAULA K. WHITE, LEGAL ASSISTANT JUDffH A. ESERSOLE, ADMINISTRATIVE ASSISTANT Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 Re: William F. Kennedy, deceased Social Security No. 174-05-1468 Enclosed please find the following items for filing with the Regist~'of Will~ Estate Information Sheet An original and one copy of the Inheritance Tax Return together with a check payable to Register of Wills, Agent in the amount of $3,676.75 to cover the tax liability shown to be due. This check represents a 3 month payment of the Pennsylvania Inheritance Tax. Make sure the check is marked as received within the 3 month discount period. A check payable to the Register of Wills in the amount of $15 to cover the filing fee for the Inheritance Tax Retum. Gentlemen or Ladies: Please time stamp and return our file copy of the tax return. A return envelope is provided. If you have any questions, feel free to contact this office. bfk Enclosure Sincerely, Brenda F. Kephart Legal Assistant COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT 280601 HARRISBURG, PA 17~ 28-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX(11-96) NO. CD 004442 fold BROWN JAN L 845 SIR THOMAS COURT SUITE 12 HARRISBURG, PA 17109 ESTATE INFORMATION: SSN: 174-05-1468 FILE NUMBER: 2104-0886 DECEDENT NAME: KENNEDY WILLIAM F DATE OF PAYMENT: 09/29/2004 POSTMARK DATE: 09/28/2004 COUNTY: CUMBERLAND DATE OF DEATH: 07/02/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $3,676.75 REMARKS: TOTAL AMOUNT PAID: $3,676.75 SEAL CHECK//0095 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS I-- Z U,I LU LU 0 0 U,I COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 171284601 DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAl Kennedy William F DATE OF DEATH (MM-DO-Year) REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DATE OF BIRTH (MM-DO-Year) I 07/02/2004 ] 04/18/1920 (iF APPUCASLE) SURVIVING SPOUSE'S NAME {LAST, FIRST, AND MIDDLE INITIAL) OFFICIAL USE ONLY FILE NUI~IBER SOCIAL SECURITY NUMBER 1 7 4-0 5-1 4 6 8 THIS RETURN MUST BE FILED IN 0UPUCATE WffH THE REGISTER OF WILLS SOCIALSECU~TYNUMSER [] 1. Original Retum Bi4. Limited Estate -'-[6. Decedent Died Testate (~h copy ~f wa) [] 9. !.~igafion Proceeds Received [] 2. Supplemental Retum F[4a. Futura Interest Compmmise (d~ old,ah aner 12-1242) [] 7. Decedent Maintained a Living Trust {Attach copy of Tins0 F~10. Spousal Poverty Credit (d~of ~ah between 12-31-91 aM 1-1-95) ]3. RemainderRetom (dataofdea~pop~t~12.13-f12) r-J5. Federal Estate Tax Return Required ~ 8. Total Number of Sato Deposit Boxes E~I 1. Election to tax under Sec. 9113(A) (Attach SCh O) NAME Jan L Brown FIRMNAME(B~¢c~Ie) Jan L Brown & Associates TELEPHONENUMBER 717-541-5550 1. Reel Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellensous Pemonal Properly (5) (Schedule E) 6. Jointly Owned Pmpe~ (Schedule F) (6) ] Separate Billing Requested 7. Inter-Virus Transfers & Miscellaneous Non-Probate Pmperi'j (7) (Schedule G or L) COMPLETE MAILING ADDRESS 845 Sir Thomas Court I Harrisburg Suite 12 ~r~83.90 93,856.39[ PA 17109 OFFICIA~,~JSE ONLY ~ 8. Total Gross Assets (total Unes 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Modgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Govemmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (8) (11) (12) (13) (14) 8,775.66 7,658.75 102,440.29 16,434.41 86,005.88 86,005.88 '1 SEE iNSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or ~usfem under S6c. 9116 (a)(12) 16, Amount of Line 14 taxable at lineal rate 17, Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 0.00 x __ (~5) 86,005.88 x .045 0.00 x .12 (17) 0.00 x .15 (18) 0.00 3~870.26 0.00 O.O0 (19) 31870.26 ~ ~ ~ SUrE TO ~i~V~--I:R AL~ QUEStiONS ON E~ER~ SiDE ANDi REOHECK ~TH ~C Decedent's Complete Address: IST~I:~, ADORESS 1 Longsdorf Way South Middleton Township C~TY Cadisle I STATE PA I ZiP 17013 Tax Payments and Credits: 1. Ta~ Due (Page 1 Une 19) 2. Credits/Payments A, Spousal Poverty Credit B. Prior Payments C. Discount 193.51 (1) Total Credits ( A + B + C ) (2) 3. InterestJPenarty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + E ) (3) 4. If IJne 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT, Check box on Page I Line 20 to request a refund (4) 5. If Line I + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 3,870.26 193.51 0.00 0.00 3~676.75 3,676.75 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer aed: 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 premise for life of either payments, benefits or care? ............................................................. [] [] 2. if death occurred after December 12, 1982, did decedent transfer property within ene 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 Ratirement Account, annuity, or other non.probate properly which contains a beneficiary designation? ....................................................................................................... [] [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS I$ YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN, SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE ADDRESS 3(~ Kenwood A~nu~ ! Carlisle~ ,,,,,,j ~ F R A,~R~ ...... SIGNATURE(:) PEP ,~~ ADDRESS 845 ~omas Cou~ Suite 12 9/28/2004 PA 17013 DATE 9/28/2004 Hardsbur,q PA 17109 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 the use of the surviving spouse is 3% [72 P.S. §9116 (a)(1.1) 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% [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exereat 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 efta' 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 0% [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%, 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% [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. REV-1503 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Kennedv William F SCHEDULE B STOCKS & BONDS FILE NUMBER All property Jointly-owned with right of sunrivomhip must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION Prudential Financial Inc (PRU); 186 shs/$46.15 VALUE AT DATE OF DEATH 8,583.90 TOTAL (Also enter on line 2, Recapitulation) $ 8~583. (If more space is needed, Inse~t additional sheets of the same size) REV-1510 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT 8CHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER Kennedv William F This schedule rnust be completed and filed if the answer to any of quzetions 1 throu ~ 4 on the reveme side of the REV-1500 COVER SHEET ~ yze. DESCRIPTION OF PROPERTY ITEM ~"CCUOE'rHE "~E OF T~ TP,~S~E=~, THE~, ~JmOaS.,e TO ~CE~,T ~D DATE OF DEATH %OF DECD'S EXCLUSrON TAXABLE NUMBER ~E DATE 0~ ~P~*NSFER' ATTACH A COP~ O~ THE DEED FOR EF'~J' ESTA~' VALUE OF ASSET INTEREST (~F ~rUO,~L~) VALUE 1. Lincoln Financial Group Annuity 95-9650296 10,696.44 100. 10,696.4,~ Tom Kennedy, David E Kennedy and Susan J Rynard, children, beneficiaries 2 Gift to David E Kennedy and 74,043.0(~ 100. 6,000.00 68,043.0(: Susan J Rynard, children, on 4/22/04 3 M&T Bank Account 421510 3,515.41 100. 3,515.41 Made joint with Susan J Rynard, daughter, on 6/1/04 4 Orrstown Bank Account 106003254 11,601.54 100. 11,601.54 Made joint with Susan J Rynard, daughter, on 6/1/04 TOTAL (Also enter on line 7 Recapitulation) $ 93,856.3,q (If mom space is needed, insert additional sheets of the same size} REV-1511 EX + (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Kennedv William F SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER ITEM NUMBER 1, 2 3 4 Debts of decedent must be reported on Schedule DESCRIPTION FUNERAL EXPENSES: Hoffman-Roth Funeral Home Hoffrnan-Roth Funeral Home; obituary Cumberland Valley Memorial Gardens Funeral repast ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Pereonal Representative (s) Social Security Nnmben[s)/EIN Number of Personal Representa~e(s) Street Address City State Year(s) Commission Paid: AttomeyFess Jan L Brown & Associates Famiiy Exemption: (If decedenfs address is not the same as claimant's, attach explanation) Claimant Zip Street Address C~y Rela~onship of Claimant to Decedent Probate Fees Accountant's Fees Tax Retum Preparers Fees Filing fee; Inheritance Tax Return Filing fee; Petition to Settle Small Estate State . Zip TOTAL (Also enter on line 9, Recapitulation) J $ (if mom space is needed, insert add~onal sheets of the same size) 5,928.00 162.12 995.00 156.54 8~775.6~ 15.00 19.00 AMOUNT 1,500.00 REV-1512 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA iNHERITANCE TAX RETURN RESIOENT DECEDENT ESTATE OF SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES~ & LIENS FILE NUMBER Kennedv William F Include unrelmbursed medical expenses. ITEM NUMBER DESCRIPTION 1. Cumberland Crossings; outstanding balance 2 West Shore EMS TOTAL (Also enter on line 1 O, Recapitulation) (If mom space is needed, incest additional sheets of the same size) VALUE AT DATE OF DEATH 7,521,59 137,16 $ 7,658.7:, COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT OECEDENT SCHEDULE J BENEFICIARIES ESTATE OF Kenne¢ Nilliam F NUMBER [. 1. 2 3 U. 1. 1. FILE NUMBER RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(e) OF ESTATE TAXABLE DISTRIBUTIONS [include outfight spousal disbtbations, and bansfers under Sec. 9116 (a) (1.2)] Susan J Rynard 30 Kenwood Ave, Carlisle, PA 17013 Tom Kennedy 581 Dunewood Dr, Chesterton, IN 46304 David E Kennedy 999 11th Ave, Mays Landing, NJ 08330 Lineal Lineal Lineal 86,005.88 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET 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 $ (If more space is needed, inserl additional sheets of the same size) ~ ? a 2 MAILEDFROMZ~PCOOE / ', ~3 i '04 SEP 29 P2:13 JAN L. BROWN & ASSOCIATES ATTORNEYS AND COUNSELORS AT LAW OLDE ENGLISH GAP 845 SIR THO~W,S COURT, SUITE 12 HARRISBURG, PA 17109 Register of Wills Cumberland County Courthouse One Courthouse Sq Carlisle PA 17013 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY ORPHANS' COURT DIVISION Estate of William F. Kennedy, Deceased PETITION FOR SETTLEMENT OF SMALL ESTATE UNDER PENNSYLVANIA STATUTES 20 § 310~ I, SUSAN J. RYNARD, state: ~ ~ 1. William F. Kennedy, widowed, died on July 2, 2004, a resident o~cUmberl~d coUnty, Commonwealth of Pennsylvania. A death certificate is attached h~eto. 2. William F. Kennedy is the owner of one hundred eighty-six (186) ~ares of0~rudential~ Financial Inc. with a date of death value of $46.15 per share for a total value of $8,583.90. 3. The gross value of decedent's Estate does not exceed Twenty-five Thousand Dollars ($25,000). 4. The Pennsylvania Transfer Inheritance Tax Return reporting said one hundred eighty-six (186) shares of Prudential Financial Inc. has been filed with the Register of Wills, and petitioner has paid the inheritance tax shown to be due; said cover page of the Inheritance Tax Return, Schedule B and the tax receipt are attached hereto. 5. There are no Unpaid claimants of whom petitioner has notice or knowledge. -1- 6. All heirs/parties in interest of the decedent are listed below. Name Date of Birth Relationship to Decedent Tom Kennedy 12/17/1947 Son DavidE. Kennedy 8/1/1950 Son Susan J. Rynard 10/2/1951 Daughter 7. The parties in interest are entitled to the one hundred eighty-six (186) shares of Prudential Financial Inc. or the proceeds thereof as heirs of the decedent, because there are no other heirs that have preference. WHEREFORE, petitioner respectfully requests the Court to direct transfer of the one hundred eighty-six (186) shares of Prudential Financial Inc. to the decedent's heirs, Tom Kennedy, David E. Kennedy and Susan J. Rynard. IN WITNESS WHEREOF, I have hereunto set my hand and seal this r~ day of ~ ~LtO ~e fi' ,2004. Witness - ' ' / SU-SAN J. RYI~A3>,D ! COMMONWEALTH OF PENNSYLVANIA : COUNTY OF DAUPHIN : SS: SUSAN J. RYNARD, being duly swom according to law, does depose and say that she is the petitioner in the foregoing petition, and the facts set forth therein are tree and correct to the best of her knowledge, information and belief. 2004. Sworn to and subscribed before me this 7 day of (~ (~. PO]gt°~F- , -2- his is to certify that the information here given is correctly copied from an original certificate of death chdv filed x~ ith mc ~, l,ocal R[*gistrar.'The original certificate will be forwarded to thc State Vital Records Office for permanent filing.. WAFINING: It is illegal to duplicate this copy blt photostat or photograph. Fee for this certificate, $2.00 Local Registrar JUL 2 2004 No. Date COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH 2/4aleI~. 174 - 05 - 1468 ~,,pr. 18,1920 July 2, 2004 COMMONWEALTH OF PENNSYLVANIA DEPARTMENTOFREVENUE DEPT. 280601 HARRISBURG, PA 17128~601 F- Z U,I LU U.I X DECEDEN'PS NAME (LAST, FIRST, AND MIDDLE INITIAL' Kennedy William F DATE OF DEATH (MM-DD-Year} 07/02/2004 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DATE OF BIRTH (MM-DD-Year) 04/18/1920 (IF APPUCABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) OFFICIN. USE ONLY FILE NUMBER SOCIAL SECURITY NUMBER 1 7 4-0 5-1 4 6 8 THIS RE~RN MUST BE FILED IN ~UPMCATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER [] 1. O~inal Return [] 2. Supplemental Ratum [] 3. Remainder Retom {~.~,.~12-1~82) [] 4. Limited Estate [] 4a. Future Interest Compromise (da~ of dea~ a~'12-12-s2) [] 5. Federal Estate Tax Return Required ] 6. DecedentDiedTeatata (AltachcOpyofWill) [] 7. DecedentMaintainedaLivingTrust(Atach~oprofTrust) __ 8. TotalNumberofSafeDepositBoxes [] 9. Lii~gationPmeaedsReeaived [] 10. SpousalPoverb/Credit(~eofdeambet~.~lt-3t-9~a,~.~-~) [] 11.ElectiontotoxunderSec. 9113(A)~achs~o) THIS SECTION MUST BE COMPLETED; ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BEDiRECTED TO: NAME Jan L Brown FiRM NAME (if Applicable) Jan L Brown & Associates COMPLETE MAILING ADDRESS 845 Sir Thomas Court Suite 12 Harrisburg PA 17109 TELEPHONENUMBER 717-541-5550 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corpore~n, Pa~emhip or Sole-Propitetomhip (3) 4. Moilpegea & Notes Receivable (Schedule D) (4) 5. Ceeb, Bank Deposits & Miscellaneous Pemonal property (5) (Schedule E) 6. Joinl~y Owned Pmpe~ (Schedule F) (6) ] Separate Billing Requested 7. Intar-Vivea Traesfem & Miscellaneous Non-Probata Proper~ (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent. Mortgage Liabilities, & Liens (Schedule I) (1 O) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11 ) 8~583.90 93,856.39 (S) OFFICIAL USEONLY 102~440.29 (11) 8~775.66 7,658.75 16,434.41 (12) (13) 86,005.88 (14) 86,005.88 13. Charitable and Governmental Bequeats/Sec 9113 Trosts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 0.00 X __ (15) 86,005.88 X .045 (16) O.O0 x .12 (17) 0.00 x .15 (1ti) (19) 0.00 3,870.26 0.00 0.00 3,870.26 15. Amount of Line 14 taxable at the spousaltax rate, or transfers under Sec. 911 g (a)(12) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rata 18. Amount of Line 14 taxable at collataral rata 19. Tax Due 20. >> BESURETOANSWERALLQUESTIONSONR~ERSESIDEANDRECHECKMATH << REV-1503. EX + (~-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF Kennedv William F FILE NUMBER All properly jointly-owned with right of survivorship must be dl~closad on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Prudential Financial Inc (PRU); 186 shs/$46.15 8,583.90 TOTAL (Also enter on line 2, Recapitulation) $ 8,583.90 (If more space is needed, insar~ add~onal sheets of the same size) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 004442 DUPLICATE BROWN JAN L 845 SIR THOMAS COURT SUITE 12 HARRISBURG, PA 17109 ESTATE INFORMATION: FILE NUMBER: DECEDENT NAME: SS;N: 174-05.1468 2104-0886 KENNEDY WILLIAM F DA~E OF PAYMENT: Po~MARK DATE: COUNTY: DATE OF DEATH: 09/29/2004 09/28/2004 CUMBERLAND 07/02/2-004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $3,676,75 REMARKS: SEAL CHECK# 0095 TOTAL AMOUNT PAID: INITIALS: JA RECEIVED BY: $3,676.75 GLENDA FARNER STRASBAUGH REGISTER OF WILLS TAXPAYER IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY ORPHANS' COURT DIVISION Estate of William F. Kennedy, Deceased DECREE Now, this ___~ day of__~ ., 2004, upon consideration of the Petition for Settlement of Small Estate filed with the Court of Common Pleas of Cumberland County, it is hereby ordered that transfer of the one hundred eighty-six (186) shares of Prudential Financial Inc. titled to William F. Kennedy who died on July 2, 2004, be made in equal amounts to the decedent's children and heirs, Tom Kennedy, David E. Kennedy and Susan J. Rynard. By the Court: BUREAU OF TNDZVZDUAL TAXES TNHERTTANCE TAX DIVZSTDN PO BOX Z80601 HARRTSBURG, PA 171Z&-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOT/CE OF INHERITANCE TAX APPRAZSEHENT, ALLOHANCE OR D/SALLOHANCE OF DEDUCTIONS AND ASSESSHENT OF TAX RE¥-1547 EX AFP (09-04) dAN L BROWN BROWN 8 ASSOCIATES 8q5 SIR THOMAS CT 12 PA 17109 DATE 11-22-200q ESTATE OF KENNEDY WILLIAM DATE OF DEATH FZLE NUMBER 21~*0~q- 0886. COUNTY C~.BERLANt~ ACM 101 Amoun'f: HAKE CHECK PAYABLE AND ~MXT PAYMENT TO: REGTSTER OF WTLLS CUMBERLAND CO COUR~HOUSE CARLTSLE, PA 1701:5 F CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS -~ REV-15~7 EX AFP (01-03) NOTICE OF ZNHERZTANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF KENNEDY WILLIAM F FILE NO. 21 0~-0886 ACM 101 DATE 11-22-200~ TAX RETURN HAS: (X) ACCEPTED AS F/LED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRA/SED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Reel Es~a~e (Schedule A) (1} 2. S~ocks and Bonds (Schedule B) (2) S. Closely Held S~ock/Par~narshlp /n,eras* (Schedule C) ($) ~. Hor~gages/No*es Receivable (Schedule D) (~) 5. Cash/Bank Deposits/Misc. Personal Propar*y (Schedule E) 6. Jointly Owned Propar~y (Schedule F) (6) 7. Transfers (Schedule 8. To,al Assa~s APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expensas/Adm. Cos~s/HLsc. Expenses {Schedule H) (9) 10. Deb~s/Hor~gaga Liabilities/Liens (Schedule I) (10) 11. To,al Deductions 12. Nat Value of Tax Ra~urn 8~585.90 .00 NOTE: To insure proper credi~ ~o your account, .00 subei~ ~ha upper portion .00 of ~h/s form wL~h your · 00 ~ax payment. .00 95~856.:59 (B) 8,775.66 15. lq. NOTE: 7~658.75 (11) (12) Charitable/Governmental Beques*s; Non-alac~ed 911:5 Trusts (Schedule J) (1:5) Ne~c Value of Es~a~e Subjac~ 'l:o Tax (1~) ]:f an assess;ant ~as ~ssued prevAousZy, lanes 1~, 15 and/or 16, 17, reflect f~gures that ~nclude the total of ALL returns assessed to date. lOZ,~qO.Z9 86,005.88 .00 86,005.88 ASSESSMENT OF TAX: 15. Amoun~ of L/ne 1~ a~¢ Spousal ra~e 16. Amoun~ of Line lq ~axabla a~ Lineal/Class A ra~e 17. Amoun~ of Line lq a~ Sibling ra~e 18. Aeoun~ of Line lq ~axabla a~ Colla~caral/Class B ra~e 19. Pr'inc'ipal Tax Due TAX CREDZTS: PAYHENT RECETpT DTSCOUNT (+J DATE NUHBER :]:NTEREST/PEN PA:]:D (-) 09-18-Z00~ CDO0~Z 19:5.51 1F PAID AFTER DATE IND/CATED, SEE REVERSE FOR CALCULATION OF ADD/TZONAL INTEREST. 18 and 19 will (15) .00 x O0 : .00 (16) 86,005.88 x Oq5= :5,870.26 (17) .00 x 12 = .00 (18) .00 x 15 = .00 (19)= :5,870.26 AMOUNT PAID :5,676.75 TOTAL TAX CREDIT :5,870.16 BALANCE OF TAX DUEI .o0 ZNTEREST AND PEN. .00 TOTAL DUE .00 ( ZF TOTAL DUE 1S LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE ~S REFLECTED AS A 'CRED[T' (CR), YOU HAY BE DUE ; A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) ~.f---- RESERVATION: Estates of decadents dying on or before December IZ, 19BI -- if any futura interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for yearsj the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the 1aclu1 Class B (collateral) rate on any such future interest. PURPOSE OF NOTICE: PAYNENT: REFUND [CR): OBJECTIONS: ADNIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section Z140 of the Inheritance and Estate Tax Act, Act Z3 of ZOO0. (7Z P.S. Section 91~0). Detach the top portion of this Notice and submit ~ith your payment to the Register of Wilis printed on the reverse side. --Hake check or money order payable to: REGISTER OF NILLS, AGENT A refund of a tax credit, ~hich Has not requested on the Tax Return, amy be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-ISIS). Applications are available online at www.revenua.stata. Da.us, any Register of Wills or Revenue District Office, or from the Department's lq-hour ans~aring service for forms orders: 1-800-SSZ-Z050~ services for taxpayers with special hearing and/or speaking needs: 1-BOO-~7-50ZO (TT only). Any party in interest net satisfied with the appraisaent, allowance or disallowance of deductions or assessment of tax (including discount or interest) as shown on this Notice say object ~ithin 60 days of the date of receipt of this notice by filing one of the following: A) Protest to the PA Department of Revenue, Board of Appeals. You may object by filing a protest online at www.boardofappaals.state.pa.us on or before the expiration of the sixty-day appeal period. In order for an electronic protest to be valid, you must receive a confirmation number and processed date from the Board of Appeals website. You may also send a written protest to PA Department of Revenue, Board of Appeals P.O. Box zeIOZ1, Harrisburg, PA 17128-10Z1. Petitions may not ba faxad. D) Election to have the matter determined at the audit of the account of the personal representative. C) Appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, P.O. Box 280601, Harrisburg, PA 171Z8-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-IS01) for an explanation of administratively correctable errors. If any tax due is pald within three (5) calendar months after the decedent's death, a five percent (SI) discount of the tax paid is allowed. The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same tiaa period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (l) day from the date of death, to the date of payment. Taxes which became delinquent before January i, 19BI bear interest at the rate of six (BI) percent per annum calculated at a daily rate of .00016~. All taxes which became delinquent on and after January l, 19BI will bear interest at a rata ~hich will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZO0~ arm: Interest Oaily lnterast Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor ~ 20Z .000548 ~)'~-1991 llZ .000501 ~ 9Z .000247 1985 16Z .000~58 199Z 9Z .O00Z~7 ZOO2 6Z .00016~ 1984 llZ .000501 1995-1994 7Z .00019Z ZOO5 5Z .000157 1985 15Z .000556 1995-1998 9Z .000Z47 ZO0~ ~Z .000110 1986 IOZ .O00Z7q 1999 7Z .00019Z 1987 IOZ .000Z74 ZOO0 7Z .00019Z --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUIIBER OF DAYS DELINQUENT X DA/LY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Noticaj additional interest must be calculated.