HomeMy WebLinkAbout95-0324- _ _
This is to certify that the certificate hereunto attached is a true and accurate copy of the original
death record on file with the Division of Vital Records, and that Frank Yeropoli, whose name is
subscribed thereto, was at the time of subscribing the same and now is Director, Division of Vital
Records of the Department of Health, for the Commonwealth of Pennsylvania, duly appointed
and commissioned as directed by Act 66 of the General. Assembly, approved 29 June 1953, P.L.
304.
AUG 18.200 ?
Date Fran eropoli, ct
'Division of Vital Records
P.O. Box 1528
New Castle, PA 16103
/J M105.143 Rev. T137
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COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS ~ 3 6 '~1 ~ 4
CERTIFICATE OF DEATH _ _ _
STRE P%E NUMBEA
NAME OF DECEDEM (Fwal. Midt.'b. Utn SE% SOQAL SECURffY NUMBER DATE OF DE/QH IMaMh. QuY Ner)
,. Kathleen M. Sitlinger z Female 7.180 - O1 - 1334 ~• it 15, 1995
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REOLSTRAR'S SIGNIVURE AND NUMBE - . ~ ~ DRE FlLED(MOnw,Day. )
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REV-1500 EX+ 17-94)
~ FOR DATES OF DEATH AFTER 14!31!91 CHECK HERE
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p INHERITANCE TAX RETURN IF A SPOUSAL
DIT IS CLAIMED ^
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~ RESIDENT DECEDENT FLE NUMBER
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oNwEALTH OF PENNSYLVA A
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DEPARTMENT OF REVENUE TO BE FILED IN DUPLICATE
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111 DEPT. 280601 WITH REGISTER. OF WILLS) NUMBER
COUNTY CODE ~ YEAR ~5
HARRISBU G, PA 17128-0601
DECED 'S NAME (LAST, FIRST, AN MIDDLE INITIAL) DECEDENT'S COMPLETE ADDRESS
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p IF APPLIUBLE( SURVIVING SPOUSE'S NAME (LAST, FIRST D MIDDLE INITIAII SOCIAL SECURITY NUMBER AMOUNT RECEIVED (SEE INSTRUCTIONS)
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~++ 1. Original Return ^ 2. Supplemental Return ^ 3. Remainder Return
~cH (for dates of death prior to 12-13-82)
=co ^ 4. Limited Estate ^ 4a. Future Interest Compromise ^ 5. Federal Estate Tax Return Required
~ (for dates of death after 12-12-82)
a m 6. Decedent Died Testate ^ 7. Decedent Maintained a Living Trust ~ B. Total Number of Safe Deposit Boxes
(Attach copy of Will) (Attach copy of Trust)
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les J. DeHart
III Es
3631 North ]~ront Street
V ~ EPHONE NUMBER Harr1S}JUrCJ, PA 17110
1 717 l 232-76S~t __
1. Real Estate (Schedule A) (1 )
2. Stocks and Bonds (Schedule B) (2 )
3. Closely Held Stock/Partnership Interest (Schedule C) (3 )
4. Mortgages and Notes Receivable (Schedule D) (4 )
5. Cash, Bank Deposits ~ Miscellaneous Personal Property ( 10,.638.48
(Schedule E)
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g 6. Jointly Owned Property (Schedule F) ~ 14,675.72
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7. Transfers (Schedule G) (Schedule L) (7 )
c 8. Total Gross Assets (total Lines 1-7) (8) _ 75, X14.7()
9. Funeral Expenses, Administrative Costs, Miscellaneous (9'( 7,R7f~ ~~i
Expenses (Schedule H)
10. Debts, Mortgage Liabilities, Liens (Schedule I) (~ 2,504.06
11. Total Deductions (total Lines 9 8~ 10) / (11) _ 5,382.41
12. Net Value of Estate (Line 8 minus Line 11) (12) _ 1 9~A~'( '79
13. Charitable and Governmental Bequests (Schedule J) (13) _
14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 19,931 .79
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15. Spousal Transfers (for dates of death after 6-30-94)
See Instructions for Applicable Percentage on Reverse (15) x._=
Side. (Include values from Schedule K or Schedule M.)
16. Amount of Line 14 taxable at 6% rate (16) x .06 = _
(Include values from Schedule K or Schedule M.)
17. Amount of Line 14 taxable at 15% rate (17) 19, 931 .79 15
. - 2, 989.77
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(Include values from Schedule K or Schedule M.) _
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18. Principal tax due (Add tax from Lines 15, 16 and 17.) (18) _ 2.989.77
19. Credits Spousal Poverty Credit Prior Payments Discount Interest
+ 950.00 + 50.00 _ (19) . ' ;1_~,_. (~~El 110
20. If Line 19 is greater than Line 18, enter the difference on Line 20. This is the OVERPAYMENT. (20)
21. If Line 18 is greater than Line 19, enter the difference on Line 21. This is the TAX DUE. (21) _ 1 , 989.77
A. Enter the interest on the balance due on Line 21A. (21A)
B. Enter the total of Line 21 and 21 A on Line 21 B. This is the BALANCE DUE. (21 B)
Make Check Payable to: Register of Wills, Agent
'y' ~ y 1, .~~iJ.'~~ r 'i l:. ~ .. _ ~ ~'~..~ ~iY. ~ LPL _
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Under penalties of perjury, 1 declare thot {hove examined this return, including accompanXing schedules and statements, and to the best of my knowledge and belief,
it is true, correct and complete. I declare thaT all real estate has been reported at true market value. Declaration of preparer other than the personal representative is
based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS } DATE
ATURE OF REPARER THE AN REPRESENTATIVE ADDRESS . ~1 DATE
~~~~.,; ~ 3631 North Front Street
Harrisburg, Pennsy vanla T7TTiT
Act #48 of 1994 provides for the reduction of the tax rates imposed on the net value of transfers to or for
the use of the spouse. The rates as prescribed by the statute will be:
• 3% (.03) will be applicable for estates of decedents dying on or after 7/1/94 and before 1/1/96
• 2% (.02) will be applicable for estates of decedents dying on or after 1/1/96 and before 1/1/97
• 1% (.O1) will be applicable for estates of decedents dying on or after 1/1/97 and before 1/1/98
• Spousal transfers occurring on or after 1/1/98 will be exempt from inheritance tax.
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING A CHECK MARK (~) IN THE APPROPRIATE BLOCKS.
YES NO
1. Did decedent make a transfer and:
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 promise for life of either payments, benefits or care$ .......................................
2. If death occurred on or before December 12, 1982, did decedent within two years preceding
death transfer property without receiving adequate consideration$ 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'. bank account at his or her death$ ......................................
~1F THSL ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
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REV-1508 EXf (287)
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COMMONWEALTH Of PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
DcDCnwl n 1 DDnDCDTV
Please Print or Tvpe
___
ESTATE OF FILE NUMBER
Sitlinger, Kathleen M. 21-95-0324
(All property jointly-owned with the Right of Survivorship must be disclosed on Schedule F)
ITEM DESCRIPTION VALUE AT
NUMBER DATE OF DEATH
1 Accounts held at Corestates Financial Corporation: (See
E~chibit) ,~j-'
~~ Certificate of Deposit #3632814, Date-of-death balance; 2,040.87 7
~}~' Certificate of Deposit #2122898~Date-of-death balance ' 1 , 021 .88 ~
2 Blue Ridge Haven West Nursing Home Refund j 4,333.72
3 1994 Federal income tax refund 228.69
4 Blue Cross/Blue Shield -Medical reimbursement 3,013.32
TOTAL (Also enter on line 5, Recapitulation) I $ 10, 6 .48
(Attach additional 8Y~" x Il" sheets if more space is needed.)
REV-1509 EX+ (12-88) -
-.~ ~ , SCHEDULE F
COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF ~ FILE NUMBER
Sitlinger, Kathleen M. ~ 21-95-0324
Joint tenant(s):
ITEM
NUMBE LETTER
FOR
JOINT
TENANT DATE
MADE
,JOINT
DESCRIPTION OF PROPERTY
TOTAL VALUE
OF ASSET
DECD'S
% INT.
DOLLAR VALUE OF
DECEDENT'S INTEREST
A 1993 40.597 shares Van Kampen
Merritt PA Tax Free Inc.
Account #847477-7, Date-of-
death value $17.08 r share
~
(See ~hibit) $9,233.40 50% $4,616.70
2. A 1968 Corestates Checking Account
#0061347712 (See Exhibit) $8,182.72 50% $4,091.36
3. A 1993 First Federal of Harrisburg: ~~~a9.~~
,
(a) Certificate #0329101310 P~
/°'"
(See attached) $3,805.09 50% $1,902.55
Certificate #01 341 501 31
(See exhibit)
~~"~ $8,130.21 50% $4,065.11
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TOTAL (,41so enter on line 6, Recapitulation) ;> 14, 6.72
(If more space is needed insert additional sheets of same size)
REV-1510 EX + (2-87)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
_ _ _ RESIDENT DECEDENT _
ESTATE OF
Sitlinger, Kathleen M.
SCHEDULE G
TRANSFERS
~; PLEASE PRINT OR TYPE
FILE NUMBER
21-95-0324
THIS SCHEDULE MUST BE COMPLETED AND FILED IF THE ANSWER TO ANY OF THE QUESTIONS ON THE REVERSE SIDE OF THE COVER SHEET IS YES.
DOLLAR VALUE
OF DECEDENT'S
INTEREST
TOTAL (Also enter on line 7, Recapitulation) 5
(If more space is needed, insert addilionol sheets of same size.)
REV-1511 EX+ I7~88) ~ SCHEDULE H
FUNERAL EXPENSES.,
COMMONWEALTH OF PENNSYLVANIA ADMINISTRATIVE COSTS AND
INHERITANCE TAX RETURN
RESIDENT DECEDENT MISCELLANEOUS EXPENSES
Please Print or Type
ESTATE OF FILE NUMBER
Sitlinger, Kathleen M. 21-95-0324.
ITEM DESCRIPTION AMOUNT
NUMBER
A. Funeral Expenses:
1. Gingrich Memorial -Headstone 670.00
B. Administrative Costs:
1. Personal Representative Commissions Judith Kunzman _ _ waived
Social Security Number of Personal Representative: 168-36-6231
Year Commissions paid
2. Attorney Fees
Caldwell & Kearns 1,875.00
3. Family Exemption
Claimant None Relationship
Address of Claimant at decedent's death
Street Address
City State Zip Code
4. Probate Fees
Register of Wills (estimated) 200.00
C. Miscellaneous Expenses:
1. The Sentinel -Legal advertising 72.20
2. Cumberland County Law Journal -Legal advertising 40.00
3. Judith Kunzman -Estate checks reimbursement 21.15
4.
5.
6.
7.
8.
TOTAL (Also enter on line 9, Recapitulation) $ 2, 8 .35
(If more space is needed, insert additional sheets of same size.)
REV-1512 EX+ (L93) ..
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES AND LIENS
Please Print or
ESTATE OF FILE NUMBER
Sitlinger, Kathleen M. 21-95-0324
REV-1513 E%+ ~2-87) i'
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TA% RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Sitlinger, Kathleen M. 21-95-0324
{TEM
NUMBER NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR
SHARE OF ESTATE
A- Taxable Bequests:
t. Doris Long Niece $500.00
2. Alma Campbell Niece $500.00
3. Mary Peffer Niece $500.00
4. Kathleen Henning Niece $500.00
5. Patricia Lau Niece $500.00
6. LeRoy Sitlinger Nephew $500.00
7. Sandra Ridout, Stafford, VA Niece 1/2 Residuar
8. Judith Kunzman, Camp Hill, PA Niece 1/2 Residuar
jlf more space is needed, insert additional sheets of same size)
,.,
L71ST WILL 11ND TESTl~r•1ENT
OF
KATHLEEN SITLINGER
I, K1THLEEN SITLINGER, of the City of Harrisburg, County '
~f Dauphin and State of Pennsylvania, being of sound and disposing
mind, memory and understanding, do hereby make, publish and
declare this as and for my Last Will and -Testament, hereby
revoking and making void any and all Wills by me at any time here-
ofore made.
ITEP-I I: I give, devise and bequeath my
ousehold contents, furnishings, clothing, etc., ~--~sis-ter,
e~mer. If she should fail to survive me there I give the
same in equal shares to her daughters, rlrs. Judith Kunzrnan and
rs. Sandra Ridout.
ITEM II: I direct that all of the rest,
residue and remainder of my Estate shall be distributed as follows
A. Five Hundred ($500.00) Dollars shall be given to
peach of. the following nieces and nephews:
(1) Doris Long;
(2 ) Alma Campbe 11;
(3) Mary Peffer;
(4) Kathleen Benning;
(5) Patricia Lau; and
(6) LeRoy Sitlinger.
,,.,
B. The balance of my Estate shall be distributed in
equal parts to Mrs. Judith Kwzzman and Mrs. Sandra Ridout.
ITEM III:
I nominate, constitute and
appoint to be and act as Executrix of t}zis my Last Will and
estament my niece, Judith Kunzman. If for any reason she should
e unable to serve or continue to serve as Executrix, then I
appoint in her place my niece, Sandra Ridout.
ITEM IV: I direct that all taxes that may
e assessed in consequence of my death, of whatever nature and b~~
atever jurisdiction imposed, shall be paid from my residuary
estate as a part of the cost of administration of my Estate.
IN WITNESS WHEREOF, I have hereunto set my hand and seal
this ~% day of ~i ;, ~ /~ 1981.
;~ .i --~-~ > r'
Kathleen Sitinger _
The preceding instrument, consisting of this and orie other type-
written page, was on the date thereof signed, published and
declared by KATHLEEt7 SITLIPIGER, the Testatrix therein named as ar~d
for her Last Will, in the presence of us, who, at her request, in
her presence and in the presence of each other have subscribed our
names as witnesses hereto.
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