HomeMy WebLinkAbout07-27-12f s
1505610101
REV-1500 Ex~° 1.1°~
PA Department of Revenue Pennsylvania OFFICIAL USE ONLY
Bureau of Individual Taxes
PO BOX 28o6oi °"""'"`"~°`"`"`"°` County Code Year File Number
INHERITANCE TAX RETURN -
Harrisbur PA 1 iz8-osoi RESIDENT DECEDENT °2f ! ~ !v~ ~ ~
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
....
[ ~ ! - L(.~ - g ~,a9' 10/27/11
. '.10/7/1958
Decedent's Last Name Suffix Decedent's First Name
Graser MI
'
Kimberly
K
(If Applicable) Enter Surviving Spouse's Information Bel
Spouse's Last Name ow
Suffix
Spouse's First Name
_ MI
Spouse's Social Security Number _ ,
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
- REGISTER OF WILLS
FILL INAPPROPRIATE OVALS BELOW
~ 1. Original Return O 2. Supplemental Return O 3. Remainder Return {date of death
O 4. Limited Estate O prior to 12-13-82)
4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required
death after 12-12-82)
~ 6. Decedent Died Testate O
(Attach Copy of Will) 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
(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 TO
Name :
Daytime Telephone Number
Andrew C. Sheely, Esquire '
717-697-7050
First line of address
127 South Market Street
Second line of address
P.O. Box 95
City or Post Office
Mechanicsburg
State
PA
ZIP Code
17055 .~
REGISTER ILLS USE QNLY
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TE FILED
Correspondents a-mail address:andrewc.sheely@verizon.net
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 prep rer other than the personal representative is based on all information of which preparer has any knowledge.
SIG U F P ESPON FILING RETURN
A ,~C7
' Af1f1RFSC GC.'`~
Kendall M. Drabenstadt, Executrix, 447 Stonehedge Lane, Mechanicsburg, PA 17055
~A A~ V-J-.- 1 -
SIG RE O P A TAN REPRESENTATIVE _
7~s~,
z
P ndrew C. Sheely, Esquire, 127 South Market Street, P.O. Box 95, Mechanicsburg, PA 17055
PLEASE USE ORIGINAL FORM ONLY -
1505610101
Side 1
1505610101 J
J
REV-1500 EX
nP~P~Pr,+'s Name. Graser, Kimberly K.
Decedent's Social Security Number
RECAPITULATION
$206,000.00
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.
105,465.03
5. Cash, Bank Deposits and Miscellaneous Personal Property {Schedule E)...... . 5.
6. Jointly Owned Property (Schedule F) O Separate Billing Requested ...... . 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property 535.00
$561
(Schedule G) O Separate Billing Requested....... . 7. ,
s $873,000.03,
8.
............
Total Gross Assets (total Lines 1 through 7) ............... .
.
.
9.
...........
Funeral Expenses and Administrative Costs (Schedule H) ..... .
.. 9.
11,890.90
10.
9 9 ( ) ............
Debts of Decedent, Mort a e Liabilities, and Liens Schedule I 10.
.. 44,121.95'
11. Total Deductions (total Lines 9 and 10) ............................... .. 11. 56,012.85'
12. Net Value of Estate (Line 8 minus Line 11) ............................ .. 12. $816,987.18',
13. Charitable and Governmental BequestslSec 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. $816,987.18
TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under sec. 9116
15
(a)(1.2) X .0. .
16. Amount of Line 14 +~~able $816
987.18 '
16 $36,764.42
,
at lineal rate X .045 .
17. Amount of Line 14 taxable
17
at sibling rate X .12 .
18 . Amount of Line 14 taxable
18
at collateral rate X .15 .
$36,764.42
19 . TAX DUE .............................. ....................... ... 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
1505610105
1505610105
1505610105
1 t
REV-1500 EX Page 3
Decedent's Complete Address:
~Fr:Fr1FNT'C NG~AF
Kimberly K. Graser
STOCCTnnno~cc _ _ __
551 Lexington Avenue
__ __
__.
~,T.,_
Mechanicsburg, PA 17055
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2. CreditslPayments
A. Prior Payments
B. Discount
File Number ~ `- ~/ _ /~QV
__
STATFpA
$36,000.00
$1,894.68
Total Credits (A + B) (2)
3. Interest
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (3}
Fill 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}
zi17055
$36, 764.42
$37,894.68
$1,130.26
$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 :.......................................................................................... ^
b. retain the right to designate who shall use the property transferred or its income : ............................................ ^
c. retain a reversionary interest; or .......................................................................................................................... ^ Q
d. receive the promise far 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 "in trust for" orpayable-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? .......................
................................................................................................. 0 ^
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)J.
For dates cf 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.
COMMONWEALTH OF PENNSYLVANIA
t DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1 7 1 28-0601
RECEIVED FROM:
REV-1162 EX(11-96)
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 015496
DRABENSTADT KENDALL M
447 STONEHEDGE LANE
MECHANICSBURG, PA 17055
foltl
ESTATE INFORMATION: SSN: 181-42-8229
FILE NUMBER: 211 1-1206
DECEDENT NAME: GRASER KIMBERLY K
DATE OF PAYMENT: 01 /23/201 2
POSTMARK DATE: 01 /23/201 2
COUNTY: CUMBERLAND
DATE OF DEATH: 10/27/201 1
REMARKS: RECEIPT TO ATTY
CHECK#116
SEAL
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
101 ~ 536,000.00
TOTAL AMOUNT PAID:
INITIALS: HMW
RECEIVED BY:
536,000.00
GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
TAXPAYER
~ REV-102 EX+ (11-08)
~~ Pennsylvania SCHEDULE A
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN REAL ESTATE
RESIDENT DECEDENT
c~ ~ n ~ c yr FILE NUMBER
Kimberly K. Graser 21-11-1206
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 that is jointly-owned with right of survivorship must be disclosed on Schedule F.
Attach a copy of the settlement sheet if the property has been sold.
ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common.
NUMBER VALUE AT DATE
DESCRIPTION OF DEATH
i• Decedent's real estate located at 551 Lexington Avenue, Mechanicsburg, Upper Allen Township, $206,000.00
Cumberland County. Pennsylvania 17055 Tax parcel #42-24-0792-114
Appraisal by Appraisal Solutions.
_ TOTAL (Also enter on Line 1, Recapitulation) I$ $206,000.00
If more space is needed, insert additional sheets of the same size.
Main Fle No 12-Graser PTaae #1
SUMMARY OF SALIENT FEATURES
Subject Address 551 Lebngton Ave
Legal Description Deed Book 35Y Page 364
City Mechanicsburg
County Cumberland
~~ PA
Zrp Code 17055
Census Tract 0116.01
Map Reference Metro:2847lC-8
Sale Price $ NA ,
Date of Sale NA
Borrower/CFent Nq
lender The Estate of Kimbery K Graser
Size (Square feet) 2,105
Price per Square foot $
Location Average
Age 1 a
Condition Fair
Total Rooms 6
Bedrooms 3
Batlu 2.5
Appraiser Brett Lechthaler, PA State Cert Gen Appr
Date of Appraised Value "10/27/2011
Final Estimate of Value $ 206,000
Fonn SSO - ^WinTOTAL" appraisal software by a la mode, inc. -1-800-ALAMODE
i REV-1508 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
CQTATC n~
SCHEDt~LE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
Kimberly K. Graser FILE NUMBER
21-11-1206
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.
ITEM
1. Vanguard Prime Money Market, account #0030-09928993423. $75,614.97 date of death value, $1.58
accrued interest
2. PNC Checking account #5003502332, balance at date of death
3. PNC Savings account #5005571657, principal $5,002.55, accrued interest $3.13
4. Decedent's personal property
5. 1993 Honda Accord, VIN JHMC67687PC030892, fair condition
6. Dodge & Cox Funds -Account #300442705
7. The Royce Funds -Account #88101101
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
VALUE AT DATE
OF DEATH
$75,616.55
$896.83
$5,005.68
$1, 500.00
$1,600.00
$18,487.75
$2, 358.22
105,465.03
i ~
Kimberly K. Graser
551 Lexington Ave
Mechanicsburg, PA 17055-4478
;:= Page > 1 of 1
~- Vanguards
}~ .:
~~ -
:.~.::
Client Services: 800-662-2739
Total report value: $75,616.55
(Total report value includes any accrued dividends.)
fume ` Fund & Account . 1 Date' i Price Per ~. Accrued
Numf3er Opened f Shares ~ Share ~; Value* Dividends
i
Prime Money Mkt Fund 0030-09928993423 02/24/1999 ' 75,614.970 ~ $1.00 ~ $75,614.97 $1.58
_ To4als $75,614.9.7. $.1,.58
`Doesn't include accrued dividends
0189507047 11 /17/2011 14:24:30
i~ L l ~ i J ~ L I!11Vi ~~ NL ~h~dK
E.EApit~'Tl~IE wAY
November 15, 2011
Andrew C Sheely
Attorney at Law
127 S Markct St
P 0 Box 95
Mechanicsburg, PA 17055
RE: Kimberly K Graser
SSN: 181-42-8229
DOD: 10-27-2011
Dear Mr. Sheely:
~No, 66i4 P. 1 ~
In response to your request for Date of Death (DOD) balances for the customer noted above, our
records show the following:
Checking Account
Account # 5003502332 Established: 01-18-2001
KIMBERLY K GRASER
DOD balance: $ 896.83 non interest bearing
Account # 5112833501 Established: 09-08-20I 1
KIMBERLY K ERASER
DOD balance: $ 0.00 + 0.00 accrued interest
* * This account had a Zero balance at the time of death.
Savings Account
Account # 5005571657 Established: 09-08-2011
KIMBERLY K GRASER
DQD balance: $ 5,002.55 + 3.13 accrued interest
Please note that this office provides date of death balances for deposit accounts (IRAs, CDs, Checking and
Saviztgs). We do not process any financial transactions or provide state~aents. If you need assistance with
a~ of these items, please call 1-888-PNC-SANK {1-888-762-2265) or stop by your local PNC Bank branch
office.
Sincerely,
National Financial Services Center
PNC Bank, N.A.
Member 1'DIC
Page 1 of 2
No.667c P, 2
This message is intended for the use of the individual or entity to which it is addressed and may
contain information that is privileged, confidential and exempt from disclosure under applicable law.
If the reader of this message is not the intended recipient or the employee or agent responsible for
delivering this message to the intended recipient, you are hereby noted that any dissemination,
distribution ar copying of this communications is strictly prohibited. If you have received this
communication in error, please notify me immediately by reply or by telephone at 800-76~-1775 and
immediately destroy this faxed document.
Page 2 of 2
DODGE & COX FUNDS ° Year End Statement
41/O1/2011through 12/31/2011
How to Reach Us
PT 01 08963511675E403 A"3DGT ONLINE
,J„nll,.In~Il~i,~'~'I~'I'1,~~n~l~lll~~,l'~I~'~11~II~II~I~IIi www.dodgeandcoxcom
KIMBERLY K GRASER BYPHONE
551 LEXINGTON AVE 1-800-621-3979
MECHANICSBURG PA 17055-4478 Monday through Friday,
8:00 am to 8:00 pm ET
~ BYivlnu,
~''r Dodge & Cox Funds
do Boston Financial Data Services
P.O_ Box 8422
Boston, MA 02266-8422
PORTFOLIO OVERVIEW
Total Portfolio Value as of 1213 1/20 1 1 $18,487.75
Portfolio Summary
v~,~ ~~ valve iLis Year
10/OLZOll -12/3L21111 Ol/OL2011-12131/2011
$v~"e $17,737.86 $22,001.36
Purchases $0.00 $0.00
Dividends Reinvested $467.63 $467.63
Capital Gain Distributions Reinvested $0.00 $0.00
Transfers In $0.00 $0.00
~~~~` ~ $0.00 $0.00
Redemptions/Fees $0.00 $0.00
Transfers Out $0.00 $0.00
Exchanges Out $0.00 $0.00
Chance in Mazket Value $282 26 $3 981 24
~~v~"e $18,487.75 $18,487.75
Distributions Paid in Cash $0.00 $0.00
Shareholder News
In mid January visit the Funds' video gallery at www.dodgeandcog.com to learn more about
the Funds' performance and key investment themes from 2011.
Page 1 of 3
S~O~ERS>:R~~~ ~ ~~Royce`~
THE ROYCE FUNDS v,~ww.roycefunds.com
P.O. BOX 219012 (800) 841-1180
KANSAS CTTY MO 64121-9012
CONSOLIDATED STATEMENT Page 1 of 2
Reporting Period: 01/01/2011 through 12/08/2011
~III~II~~~~~~I~~I~~I~'II'~i~~"I~I~I'~~~IIII~'IIII'I~I~ill~~ll~~~
KIMBERLY K GRASER
551 LEXINGTON AVE DDD763
MECI-iANICSBURG PA 17055-4478
Portfolio Summary
As of 12/ 8/20I I
Beginning Closing % of Share Shares
balance balance assets price owned
Royce Pennsylvania Mutual Fund (Inv Cl) $2 , 358.22 $2 , 230.51 100.0% $10.62 210.029
Total Market Value $2, 358.22 $2, 230.51 100.0%
Account Swnzmaiy
ROYCE PENNSYLVANIA MUTUAL FUND (IlW CL)
KIMBERLY K GRASER
551 LEXINGTQN AVE
MECIiANICSBURG PA 17055-4478
Fund Number. Account Number:
260 88101101
Cot firm Trade Dollar Share Total
date date Transattions amount price Shares shares
Beginning Balance $2,358.22 $11.65 202.422
12/08/2011 12/08/2011 INCOME REINVEST 0.0194 $3.93 $10.62 0.370 202.792 N
12/08/2011 12/08/2011 CAP GAIN REIIW 0.3797 $76.86 $10.62 7.237 210.029
Closing Balance $2,230.51 $10.62 210.029
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REV-1;10 EX+ (08-09j
i Pennsylvania
~~ DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS AND
MISC. NON-PROBATE PROPERTY
esrarE OF FILE NUMBER
Kimberly K. Graser
21-11-1206
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes.
ITEM DESCRIPTION OF PROPERTY
NUMBER INCLUDE ?HE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH % OF DECD~S EXCLUSION
THE DATE Of TRANSFER. pTTAC}{ p COPY DE THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST
(IF APPLICABLE)
1. Vanguard Kimberly K. Graser Trust Account -account #UA 03-10-1999 $561,535.00 100%
date of death value and accrued dividends
TOTAL (Also enter on Line 7, Recapitulation) $
If more space is needed, use additional sheets of paper of the same size.
TAXABLE
$561,535.00
561,535.00
William A. Knaub &
Andrew C. Sheely Tr
UA 03-10-1999
Kimberly K. Graser Trust
PO Box 95
Mechanicsburg, PA 17055
~,;~ ~. Page > 1 of 1
v~~~d
R~gt~ for.;E41127/2t)11 ~.
~.~..~, ~':- e . __
Client Services: 800-662-2739
Total report value: ---
_ $561,535.00
(Total report value includes any accrued dividends.)
~.:-,
UA 03-~{l ,1~,99g,.K~...lr~~ra'?~n~~;'`~`-~~~''4:k~p?tr<: ~` ;.
~~ t , r : 'r:,'r, H
Aceour'rt'iraine s[tmrraae3r
Name
Total Stock Mkt Idx Adm
Health Care Fund Inv
Tot Intl Stock Ix Admiral
U.S. Growth Fund Investor
I-T Investment-Grade Inv
Windsor II Fund Inv
Health Care Fund Adm
Prime Money Mkt Fund
Strategic Equity Fund
Long-Term Bondlndex
Inter-Term Bond Index Adm
Total Intl Stock Ix Inv
High-Yield Corp Fund Inv
Explorer Fund Investor
Energy Fundlnvestor
S-T Investment-Grade Inv
Short_Term Bond Index Adm
Fund & Account Date ~ '
Number I Opened I Shares
0585-09933151920 ! 11 /21 /2006 I, 3,465.45
0052-09933151920105/23/2005' 0.00
' 0569-09933151920 j 03/03/2011 1,196.177
1 0023-09933151920 ~ 05/14/1999 ~ 1,049.916
': 0071-09933151920 ! 05/14/1999 4,089.166
~ 0073-09933151920 ~ 05/14/1999 ~ 1,601.499
j 0552-09933151920 1 11 /05/2010 :~ 1, 037.457
0030-09933151920 1 06/04/1999 ; 2,089.240
0114-09933151920 i 05/14/1999 1,475.972
0522-09933151920 1 05114/1999 1,813.163
5314-09933151920 ' 11 /05/2010 2, 672.865
~ 0113-099331519201 05/14/1999 f 0.000
0029-09933151920 ~ 05/14!1999 i' 4,792.684
0024-09933151920 ~ l
05/14
1'
/
999 403.061
0051-09933151920 06/20/20051 660.556
0039-099331.51920 05/14/1999 3,472.404
5132-09933151920 ~ ~ m~i~n ~ n ~ ~~~ , ~~ i
Doesn't include accrued dividends.
Price Per Accrued
Share , Value" I Dividends
~ $32.10'; $111,241.04 -
I $135.32 i $0.001 -
$24.92' $29,808.73'
$18.96 ~
$19,906.41 -
$10.03' $41,014.33 $127.53
1 $26.36; $42,215.51 ! -
$57.12 $59,259.54 ~ -
I $1.Q0 $2,089.24 ~ $0.04
j $19.30 $28,486.26 ; -
1 $13.29 ~ $24,096.94 ( $78.15
~ $11.67' $31,192.331 $84.11
i $14.90 I $0.00 ~ -
$5.71 ' $27,366.23 ! $142
20
$74.95 $30,209.421 .
-
$67.47 ! $44
567.71 ~ -
,
$10.66 I $37,015.83 ~ $72.10
$10.64; $32,517.94 $43.41
$566,98'7.461 3
O
i
$547.5
1411342193 12/13/2011 14:39:41
REV-1511 EX+ (1Q-09j
~~ ~- Pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES AND
ADMINISTRATIVE COSTS
ESTATE OF
Kimberly K. Graser
Decedent's debts must be reported on Schedule I.
FILE NUMBER
21-11-1206
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1~ Stone and Murray Funeral Home $4,707.00
z. Gingrich Memorials -headstone $990.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s) of Personal Representative(s) Kendall M. Drabenstadt
street Address 447 Stonehedge Lane
c;~, _Mechanicsburg ___ state PA ZIP 17055
Year(s) Commission Paid:
2. Attorney Fees: ~i/f~~'s./ ~~ ~~j~t-~Gf~ /T~'~F'yL¢:, ~ Qy /~j/Pt+~e~~
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:
5• Accountant Fees:
6• Tax Return Preparer Fees:
~• Postage, express mail
$• Nevada Death Certificate for William A. Knaub, Trustee, deceased
s. Filing fee
~ o~ Reserves to conclude First and Final account, decedent's tax returns, etc.
TOTAL (Also enter on Line 9, Recapitulation) I $
If more space is needed, use additional sheets of paper of the same size.
$0.00
$4,200.00
$423.50
$740.00
$45.40
$20.00
$15.00
$750.00
11, 890.90
01/12/2012 16:20 Fkk 7177745924 STONE&MURRAV F.H.
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RECEIPT FOR PAYMENT
GLENDA FARNER STRASBAUGH
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17613
GRASER KIMBERLY K
Receipt Date: 11/09/2011
Receipt Time: 12:45:19
Receipt No.: 1067668
Estate File No.: 2011- 01206
Paid By Remarks: KENDALL M DRABENSTADT
DMB
------------------------ Receipt Distribution ----- -------- ------- ----
Fee/Tax Description Payment Amount Payee Name
PETITION LTRS TEST 260.00 CUMBERLAND COUNTY GENERAL FUN
WILL 15.00 CUMBERLAND COUNTY GENERAL FUN
SHORT CERTIFICATE 20.00 CUMBERLAND COUNTY GENERAL FUN
JCS FEE 23.50 BUREAU OF RECEIPTS & CNTR M.D
AUTOMATION FEE 5.00 CUMBERLAND COUNTY GENERAL FUN
Check# 198 ----------------
$323.50
Total Received......... $323.50
WAGGONER, FRUTIGER & DAUB, LLP
CERTIFIED PUBLIC ACCOUNTANTS
5006 EAST TRINDLE ROAD SUITE 200
MECHANICSBURG, PA 17050
ANDREW C SHEELY, TRUSTEE
127 SOUTH MARKET STREET
MECHANICSBURG, PA 17055
RE: KIMBERLY K GRASER TRUST UA 03/10/99
CLIENT: GWL-GRASK
APRIL 6, 2012
PROFESSIONAL SERVICES RENDERED IN THE PREPARATION OF YOUR 2011
FIDUCIARY RETURNS, INCLUDING:
FORM 1041, U.S. INCOME TAX RETURN FOR ESTATES/TRUSTS
SCHEDULE D, CAPITAL GAINS AND LOSSES
SCHEDULE I, ALTERNATIVE MINIMUM TAX
SCHEDULE K-1, BENEFICIARY'S SHARE OF INCOME, ETC.
FORM 8879-F, IRS E-FILE SIGNATURE AUTHORIZATION
TWO-YEAR COMPARISON WORKSHEET
PA 41, FIDUCIARY INCOME TAX'RETURN
PA SCHEDULE B, DIV AND CAP GAINS DISTRIBUTION INCOME
PA RK-1, RESIDENT BENEFICIARY SHARE OF INCOME
PA SCH DD, DISTRIBUTION DEDUCTION AND SALE OF PROP
TAX PREPARATION FEE
$ 475.00
~
' Mechanicsburg Main Post Office
MECHANICSBURG, Pennsylvania
~~ 170559998
7ateF 4134870055 -0096
11/16/2011 (800>275-8777 02:48:54 PM
~a'
fimeF Sales Receipt
Product Sale Unit Final
Description Qty Price Price
'lat Ra
$18.30 Bixby 1 $18.30
$18.30
Creek Bridge
= Express Mail
FROM PSA
CARSON CITY NV 89706
$18.30
'''' Zone-8 Express Mail
.-~ ~ PO-Add Flat Rate Env
'° 3.70 oz.
Label #: EI288280039US
Thu 11/17/11 12:00 PM -Guaranteed
Delivery
Signature Waived -
Issue PVI: $18 30
Total: $36.60
Paid by:
Personal Check $36.60
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FOR I/IiF.RN117fONAl DE6TINAttON3. WRRE COON17fY NAME l>ELOW. ~
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3881
•
REV-1512 EX+ (12-OS)
~:
pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
ESTATE OF FILE NUMBER
Kimberly K. Graser Page One 21-11-1206
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses.
ITEM VALUE AT DATE
1. Financial Recoveries -Decedent's final bill for Holy Spirit Hospital $17,315.40
2. Brett Lechthaler, appraisal of decedent's residence $300.00
*Decedent died unexpectedly in her residence and at the time of her death, decedent's residence was
suhstantially damaged by 9 rats and 2 dons.
3. Home improvement costs - Lowes $1,245.17
4. Blockbuster -final bill $g 49
5. Netflix -final bill $16.94
6. Spirit Physician Services, Inc. -Decedent's final bill to primary care provider $103.00
7. Holy Spirit -final outstanding medical bill $1 gg.gg
8. Health South -final outstanding medical bill $183.04
9. Silver Spring Animal clinic -final bill $72.00
10. Bay Area Credit -Camp Hill Emergency Physicians final bill $854.51
11. MKM Acquisitions LLC -Decedent's final oil bill ~ $193.89
12. Tri-County Veterinary Services -final bill $360.50
13. PA Department of Revenue - 2011 Kimberly K. Graser Trust taxes $101.00
14. Upper Allen Township final sewer bill $392.00
15. Resurgent Capital -final unpaid hospital bill $2,721.66
16. Ollies Bargain Outlet -home repairs $148.38
17. Lebanon County Humane Society -animal disposal $180.00
18. Capital Management Services -final unpaid hospital bill $325.00
19. Susquehanna Pain Clinic -final bill $41.98
20. PA Dept. of Revenue -Decedent's 2011 state taxes $365.54
21 • Mike's Painting and Remodeling -restoration of residence ~ $2,000.00
22• Republic Services -trash removal $77 70
23. Carpet Mart -replaces carpet damaged by animal urine $3,035.00
24. Comcast Cable -final bill $215.55
TOTAL (Also enter on Line 10, Recapitulation) $
If more space is needed, insert additional sheets of the same size
REV-1512 EX+ (12-08)
Pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCFIEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
ESTATE OF FILE NUMBER
Kimberly K. Graser Page Two 21-11-1206
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreim6ursed mndieal PYIfPflcGiC
~~ ~~~~~r ~Na~e is neeaeD, inser[ aoartional sheets of the same size.
~~.
November 16, 2011
ONFiR110
FINANCIAL RECOVERIES ~
PO Box 1022
Wixom MI 48393-1022 ~
8oaz2ao2so
37994027-3 664101665
I1~PIh~ll~~hi~~ilt~~ll~~ilh~hl~~4n~~l~l~~i4h~i~llllr~h
Kimberl K Graser
551 Lexington Ave
Mechanicsburg PA 17055-4478
FINANCIAL RECOVERIES
PO Box 1388
Mt Laurel NJ 08054-388
nl,,,l..1.n.~„1,l..i„ri,,,i„n,i„i,i.,~,l„i,i„i,,,,ni
Account#: 37994027
FinRec Acct: 821019!2
Tota( Due: $28745.00
• ~
"`Detach Upper Portion And Return With Payment""'
Your Account With: HOLY SPIRIT HOSPITAL
Account #: 37994027
For: Kimberly K Graser
Date of Last Charge: 09/12/10
Balance Due: $28745.00
You have not responded to our repeated attempts to contact you and the outstanding balance on this
account remains unpaid. If you do not contact this office upon receipt of this letter, we will advise our
client that you refuse to pay.
To avoid further collection activity regarding your past due obligation, return the top portion of this
notice with your payment in full.
Payments can be made by check or credit card. If you wish to pay by credit cazd, complete and return the
appropriate information on the reverse side of this letter. For prompt account resolution, credit and debit
card payments can be made by accessing our automated irlteractive telephone system at 1-800-220-0260.
For your convenience, this system is available 24 hours a day, seven days a week. Please be advised that
a transaction fee of $5.00 is chazged on all credit card payments. This transaction fee is in addition to
your actual payment and the fee will not be credited to your account.
If this debt is for medical services and you have insurance that may pay all or a portion of this debt, that
ir~'olmation can be submitted by calling 1-800-220-0260 or by completing and returning the information
on the reverse side of this letter.
This Company is a debt collector. We are attempting to collect a debt and any information
obtained will be used for that purpose.
?ONFIRfg3 ,
Financier/ Recoveries • PO Box 1388 • Mt Laure! NJ 08054-7388 • 800-220-0260
FROM:
INVOICE
Brett Lechthaler a -- u s , ~ ~~~ , ;~
16 San Juan Dr 12-Graser
Mechanicsburg, PA 17055 "~ „~-
Telephone Number: 717-697-1828
fax Number: 717-697-0220 1/22/2012
Internal Order #:
The Estate of Kimbery K Graser Lender Case #:
CIieM Fde #:
Main Fle # on form: 12-Graser
Other File # on form:
Telephone Number. Fax Number: Federal Tax ID:
ABemate Number. E-Mail: Empbyer ID:
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Lender: The Estate of Kimberly K Graser Client: The Estate of Kimbery K Graser
Purchaser/Borrower. NA
Property Address: 551 Lepngton Ave
City: Mechanicsburg
County: Cumberland State: PA Lp: 17055
Legal Description: Deed Book 35Y Page 364
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Form 1004
300.00
SUBTOTAL i 300.00
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Check #. Date:
Description: q . ~ "" , ~"-
Cheek #: Date: Deaertption:
Check #: Date: Description:
SUBTOTAL ,
TOTAL DUE $ 300.00
Fonn NNS- "WinTOTAL" appraisal software by a la mode, inc. -1-800-ALAMODE
Appraisal Solutions (717)697-1828
" t~
P.O. BOX 5932
TROY MI 48007-5932
RETURN SERVICE REQUESTED ~'
T PLEASE DO NOT SEND PAYMENTS OR T
CORRESPONDENCE TO THE ABOVE ADDRESS
..Llill~l.ul.Iqn..ml11114111h'll~l~ly,..,1.11114111114
P1QW8T00200541101623
KIMBERLY GRASER
551 LEXINGTON AVE
MECHANICSBURG PA 17055-4478
BAY AREA CREDIT
SERVICE LLC.
1901 W 10th Street, Antioch CA 94509-1380
866-562-3816
Mon -Fri: 8:OOam 9:OOpm EST
Creditor: Pendrick Capital Partners LLC
Our Account #: 10244997
Original Creditor: CAMP HILL EMERGENCY pHYSI
Account Number. CG3626
Principal: $ 1215.00
Svc.Chg.: $ 0.00
Interest: $ 0,00
Late pymt. Chg.: $ 0.00
Other: $ 0.00
TOTAL DUE: $ 1215.00
08 NOV 2011
- -- ACCOUNT N.OTIFICATION__ _
Our client, Pendrick Capital Partners LLC, has purchased your account from CAMP HILL EMERGENCY PHYSI and has assigned it
to this collection agency.
We would like io assist you in resolving this debt. Please contact our office at 866-562-3816 should you have any questions or if you
are unable to pay the balance in full at this time.
Payment in full may be mailed to: e~
BAY AREA CREDIT SERVICE LLC. '~~' ~~
P.O. BOX 467600 ~ i ~ '~
ATLANTA GA 31146 ~C~ I
or ou ma y •
Y y pay online at www.ba areacredit.comlpay
As required by law, you are hereby notified that a negative credit report reflecting on your credit record may be submitted to a credit
reporting agency if you fail to fulfill the terms of your credit obligations.
Sincere-y,
BAY AREA CREDIT SERVICE LLC.
THIS COMMUNICATION IS AN ATTEMPT TO COLLECT A DEBT.
ANY INFORMATION OBTAINED WILL BE USED FOR THAT PURPOSE.
SEE REVERSE SIDE AND ATTACHED PAGE FOR IMPORTANT CONSUMER RIGHTS INFORMATION
----
_ _ _ _ In order to credit your account properly, you must return this bottom portion with our PURP-
Call Bay Area Credit Service LLC. at 866-562-3816 to make y Payment.
- ---------------
BAY AREA CREDIT SERVICE LLC., P O BOX 4676 0 ATLANTA GA 31146r mail your payment to
If you wish to make a payment on the web go to: www.bayareacxedit.com/pay
NAME: KIMBERLY GRASER
Our Account #: 10244997
Creditor: Pendrick Capital Partners LLC
Account Number: CG3626
Balance Due: $ 1215.00
PLEASE SEND ALL PAYMENTS AND
CORRESPONDENCE TO THE ADDRESS BELOW
'14'IIIh~d~4111y.nwll.lnl~rlu.l..ll~llll.l..nyynl,l
v ~ O
BAY AREA CREDIT SERVICE LLC.
cr~aa caro # : P.O. BOX 467600
Name : ATLANTA GA 31146
Signaa,re
AMOUNT
ExP
PURP-1
S-SFHOVS30 L-PURP-1 P A_1 ~ 7gZdZR7
Di MAiornn~nnce, ,n,,,.,.,
' MK'M Acquisitions LLC
575 Underhill Blvd., Suite 224
Syosset, NY 1 1 79 1-341 6
002Z916904000U01RJM05N010932
~~~
PERSONAL & CONFIDENTIAL
„Z4DDDDZ2,8 MKM Acquisitions LLC ~
9530 575 Underhill Blvd. Suite 224
Syosset, NY 11791-3416
Fax No. (516} 714.1319
Mon-Thurs gam-6pm, Fri Sam-3pm.
January 9, 2012
'IIII'l1III"II'1'IIIII'1'lll'III'IIIIIIIII'1'111i~I"I'llll~~(II
KIMBERLY K SCHAEFFER GRASER
551 LEXINGTON AVE
MECHANICSBURG PA 17055-4478
1-888-656-7870
Access Code - 909799473176
MKM Purchased Your - TEXACO OIL CORP. ACCOUNT
TEXACO OIL ACCOUNT#- 7087236084
Your Social Security Number - 181-4X-XXXX
Balance Due - 5323.16
)ear Kimberly K Schaeffer Graser:
-s You recall, MKM Acquisitions LLC ("MKM") has purchased this account. Here are 3 ~ for you to cone:
OPPORTUNITY #1 OPPORTUNITY #3
SETTLE FOR $193.$9 i ~ "DOUBLE-CREDIT VALUE OFFER"
-'; ; ,-,
SAVE 5129.27 `'-' ~~~ ~ ~.~ _„~-;~ RECEIVE TWO TIMES THE VALUE OF EVERY PAYMENT!
BIGGEST SAVINGS! ~ i e
(A 40%oFF DISCOUNT!) MKM will match every payment dollar-for dollar
You can settle this account with a Lum Sum a ment Has anyone ever offered you credit for TWO TIMES the
p p y value of each and every payment that you send? That's
of 5193.89, a 40% discount off the balance due of
5323.16. what MKM is offering. Here's how it works:
__ SAVE. 60%. AND PAY IN MONTHLY INSTALLMENTS OF
S 25.00
SETTLE THIS ACCOUNT FOR 5129.26 IA 60%OFF DISCOUNT)
PAYABLE AT S25.00 PER MONTH
- Send MKM s~o.oo and we will "DOUBLE" your
payment and credit your account for 320.00
- __Aft_er you send us your first_payment of_ 310.00 , we
will send you a receipt showing that your balance has
been reduced by s2o.oo to 5303.16 and that
you are enrolled in M M's "DOUBLE-CREDIT VALUE"
program.
You can settle this account for $129.26, a 60% - You will continue to receive "DOUBLE-CREDIT
discount off the balance due of 5323.16, with VALUE" for all future payments you send as long as
payments of 525.00 per month. you make a payment of sto.oo each month.
!ease res nd by February 23, 2012. When you finish~aying, this account will be Satisfied in Full.
OU CAi1~ PAY BY: Check, Check by Phone, Money Order,l/ISA (Debit or Credit), American Express, MasterCard (Debit or
redit).
To pay this account over the phone, call 1-888-656-7870
his is an'xttempt to collect a debt. Any information obtained will be used for that purpose.
ee back of letter for important information.
his communication is from a debt collector.
~ Detach Here ~
Re: KIMBERLY K SCHAEFFER GRASER ~ De:acn Here
TEXACO OIL ACCOUNT#7087236084
_. _. A ----- -- J- /11~I1 -f I1I1 t1.l.. 1/.
' REG-1513 EX+ (g-p0)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
Kimberly K. Graser
FILE NUMBER
21-11-1206
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. Kendall M. Drabenstadt, 447 Stonehedge Lane, Mechanicsburg, PA 17055 Daughter 100% of Rest, residue
of Fctata
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 16, AS APPROPRIATE, ON REV-1500 COVER SHEET
II 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 I $
(If more space is needed, insert additional sheets of the same size)
LAST WILL AND TESTAMENT
of
KIMBERLY K. GRASER
A/K/A KIMBERLY K. SCHAEFFER
I, KIMBERLY K. GRASER, also known as, KIlVI[BERLY K.
SCHAEFFEIft, of 551 Lexington Avenue, Mechanicsburg, {Upper Allen
Township), Cumberland County, Pennsylvania, make, publish and declare this as
and for my L ast Will and Testament, hereby revoking all other Wills and Codicils
heretofore made by me.
FIRST: I direct that all inheritance, estate, transfer, succession and
~_
death taxes, a.s well as my just debts and funeral expenses, of any kind
whatsoever, which may be payable by reason of my death, shall be paid out of the
principal of my estate as the same can conveniently be done.
~E_ND: i give, devise and bequeath all the rest, residue and remainder
of my estate of whatever nature and wherever situate, including any property over
which I hold power of appointment and together with any insurance policies thereon
unto my daughter, KENDALL 1VI. DRABENSTADT, of Mechanicsburg, Pennsylvania,
provided that should KENDALL M. DRABENSTADT predecease me, I give and
bequeath her share unto my grandson, BRAEDON C. DRABENSTADT, of
Mechanicsbu~•g, Pennsylvania.
?e,.e: Should BRAEDON C. DRABENSTADT not have attained the
age of twenty-five (25) years at the time for distribution to him, I give, devise and
bequeath the share of such grandchild to my hereinafter named Trustee, IN
SEPARATE TRUST, to hold, manage, invest and reinvest the shares so received, and
to use and apply from time to time such portion of income and principal for the said
grandchild 's education (including college, trade school or other similar training or
. •.
education), support and welfare as my Trustee, in his sole discretion, deems advisable.
My Trustee may make the payments for the support and maintenance of my grandchild
directly to said grandchild, as required. Any payments made by my Trustee pursuant
hereto shall be made without further responsibility to the said grandchild or to any
person talcin~; care of my grandchild. The Trustee, in exercising his discretionary
authority with respect to the payment of income or principal of the within Trust to my
grandchild, shall take into consideration any income or other resources available to my
grandchild from sources outside this Trust. In addition, my hereinafter named Trustee
shall have the right, in his sole discretion, to purchase and pay for out of the principal,
as well as income, such insurance policies as will provide for the minor's medical care.
f~ny income or principal not so applied shall be distributed to BRA-EDON
C. DRA~BENSTADT when he attains the age of twenty-five (2S) yea.rs.
FO._, URTH: In addition to all powers granted to them by law and by other
provisions of this Will, I give the fiduciaries acting hereunder the following powers,
applicable to all property, exercisable without court approval and effective until actual
di stribution o ~' all property:
(A) To sell at public or private sale, or to lease, for any period. of time,
any real or personal property and to give options for sales, exchanges or leases, for
such prices and upon such terms (including credit, with or without security) or
conditions as are deemed proper. This includes the power to give legally sufficient
instruments for transfer of the property and to receive the proceeds of any disposition.
(B} To partition, subdivide, or improve real estate and to enter into
agreements concerning the partition, subdivision, improvement, zoning or management
of real estate and to impose or extinguish restrictions on real estate.
(4~) To compromise any claim or controversy and to abandon any
property which is of little or no value.
2
. ~ ~ a
(D) To invest in all forms of property, including stocks, common trust
funds and mortgage investment funds, without restriction to investments authorized for
Pennsylvania fiduciaries, as are deemed proper, without regard to any principle of
diversification, risk or productivity.
dE) To exercise any option, right or privilege granted in insurance policies
or in other investments.
F) To exercise any election or privilege given by the Federal and other
tax laws, including, but not necessarily being limited to, personal income, gift and
estate or inheritance tax laws.
(G) To make distributions to my herein named beneficiaries in cash or in
kind or partly in each.
(H) To borrow money from themselves or others in order to pay debts,
taxes, or estate or trust administration expenses, to protect or improve any property
held under tn_y will, and for investment purposes.
(I} To select a mode of payment under any qualified retirement plan
(pension plan, profit sharing plan, employee stock ownership plan, or any other type of
qualified plan) to the extent provided for by the plan or• the law.
I~ IFT ,: I nominate and appoint my son-in-law, ROBERT C.
DRABENSTADT, III, of Mechanicsburg, Pennsylvania, Trustee, of the above-
described Trust. I direct that my Trustee and his successor shall serve without bond
and shall receive fair and reasonable compensation.
SI. X~: I nominate and appoint KENDA,LL 1VI, DRABENSTADT,
Executrix, of this, my Last Will and Testament. In the event of the death, resignation
or inability to serve far any reason whatsoever of I~ENDALL M. DRABENSTADT, I
nominate and appoint my sister, CINDY L. ARNOLD-STEELE, of Mechanicsburg,
~• Pennsylvania, Executrix, of this, my Last Will and Testam
~ ent. I direct that my
:~ Executrix anal her successor shall not be required to post security or a bond for the
3
' ' -
performance of their duties in any jurisdiction.
[N WITNESS WHEREOF, I have hereunto set my hand and seal to this,
my Last Will and Testament, this ~~ ~ day of July, 2008.
~LCC~.~I~~,~~~~.~ (SEAL)
KIlVIBERLY K. GRASER.
~ .~r~ "r, / SEAL
KIMBERLY K. S EFER ®~ )
Signed, sealed, published and declared by the above-named Testatrix as and for
her Last Will and Testament in our presence, who, at her request, in her presence and
in the presen~;e of each other, have hereunto subscribed our names as attesting
witnesses.
Address Name
l %~ ~~C.~.~-~~ Name ~
4
~~ ~ ~~~
~ ~~ ~ ~
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