HomeMy WebLinkAbout04-1026PETITION FOR PROBATE and GRANT OF LETTERS
Estate of Wayne E. Ki_~ner No.
also known as To:
Deceased.
Social Security No. 185- 03 - 051'5
Register of Wills for the
County of Cumberland
Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the executor ~ ~=~rocu~trix
in the last will of the above decedent, dated March 1, 2004 ,
and codicil(s) dated
in the
_ __ named
(state relevant circnmstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in Cumber 1 and County, Pennsylvania, with
his last famil;~ or nrincipal residence at dlq39 East Trind!e ~=~ Apt 322
ff~ 'P~;/;A Mechanicsburg, PA ¥5~g0
(list street, number and muncipality)
Decendertt, then 85 y..ears of age, died October 8 2004
at Hershey Medical center ' '
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent:
Decendent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property $
(If not domiciled in Pa.) Personal property in Pennsylvania $
(If not domiciled in Pa.) Personal property in County $
Value of real estate in Pennsylvania $.
situated as follows: 509 Drexel Road, Harrisburq, PA
169,083.00
12~:000:00
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters testamentary
theron. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
ffe~rrey' ~. ~xsner
zo2 West Green Street
Shiremanstown, PA 17011
Q~Janet G. Harmafi
~5803 Stephens Crossinq
Rd
Mechanicsburg, PA 17050
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA q '-~
COUNTY OF CUMBERLAND ) ss :
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the f°regoi~petition are
true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law.
Sworn to or affirmed and subscribed
before .me this //.) P/C, day o[
~ ~gtster
Estate Of Wayne E. Kisner , Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW /d//~ ~/t~)'7~-- 2004, in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated March 1, 2004
described therein be admitted to probate and filed of record as the last will of Wayne E. Ki sner
and Letters Testamentary
are hereby granted to Jeffrey W. Kisner and Janet G. Harman
FEES
Probate, Letters, Etc ..........
Short Certificates(,5') ..........
Jq9
TOTAL
Filed ~.'ln~.. ~..I.0./.%..
Register of ' ~
Thomas D. Gould 36508 ..
ATTORNEY (Sup. Ct. I.D. No.)
2 East Main Street
Shiremanstown, PA 17011
ADDRESS
(717) 731-1461
PHONE
his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
l.ocal Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00' ~
'04 ',,{J/ l
No. 5;
Local Registrar
OCT 1 1 2004
Date
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
(Coroner)
Wayne Kisner
UNDER 1 YEAR
Dauphin
~. ~, ~'$ MAILI~ ADORE~ ~. Cffy/Town. S~te. ~ Code)
4839 E. Trind£e Rd. APT 322
,~¢chanicsburg, PA 17050
Peter Kisner
~/. Kisner
MOTHER'S NME, 1~, M~Y. Ma~te~ ~mme)
[,,.
J~__ w. u~een S~. Sh&em~o~n, PA 17011
j~&~,.,o.- ~ o,~,~, c.~ ],~.~.~.~
[E. H~rZsb~g C~y [ H~r~b~g, PA
lai*. - · lale ....
in, lO0 Jone~mn Ro~ E~q~b~, PA 17109
. ~y, ~)
"'"~°? I h~.~'~?.";I,''~°~'"~u"~ I'"~',wo.~?
~ ~ __ -- -- *, J.. ' ' Pa~iXg L. ~ J.. 4837 Cie Rd'. M~ni~burg, PA
................................ ,.. ~ =~ ~ ~.~ , Chief Deputy
............... ~'~a~'~'~'~'~')'M~"m~ ......................... ~ · ~ J,~o. ~to~r 8, 2004
· ~~ fllem27)T~Prlfll PaRy J. ~er
.............................................................. ~ 1271 South 28th Street
~__~~~ "- Harrisbur~A 17111
." ~/~,/,~1 ~~/~ ~o~
Diabetes
Hypothyroidism
Aortic Valve Replacement
3:45 AM October 8, 2004
Closed Head Injury
Fall
DUE TO (OR AS A CON~OUENCE IF):
LAST WILL AND TESTAMENT
OF
WAYNE E. KISNER
I, WAYNE E. KISNER, now of 4905 East Trindle Road, Apartment 50, Mechanicsburg,
Cumberland County, Pennsylvania 17050, do publish and declare this to be my Last Will and
Testament, hereby revoking all other prior wills and codicils made by me.
FIRST: Family Background and Appointment of Executor.
(A) Family and Background Information. I am a widower, my wife, EDITH V.
KISNER, having passed away on October 12, 2003. Our children are JANET G. HARMAN
and JEFFREY W. KISNER. Throughout this Will, EDITH V. KISNER will be referred to as
"my wife" or "my spouse", and JANET G. HARMAN and JEFFREY W. KISNER will be
referred to as "my issue" or "my children." The word "issue" will include our children as well as
our other descendants.
(B) Appointment of Executor. I appoint as my Executors and/or Co-Executors (all
hereinafter referred to as Executor or Executors under this Will), the following named persons or
corporations to serve without bond and without being required to account to any Court:
Executors: My children, JANET G. HARMAN and JEFFREY W. KISNER,
to act jointly only, or thc survivor of them.
SECOND: Funeral and Last Illness Expensesl Taxes.
(A) Expenses of Funeral and Last Illness. Notwithstanding that my spouse survives
me, I direct my Executors to pay my funeral expenses and the expenses of my last illness from
my estate.
(B) Taxes. I direct my Executors to pay any and all estate, inheritance, succession,
legacy, transfer and other death taxes or duties, by whatever name called, including any and all
LAST WILL AND TESTAMENT
OF
WAYNE E. KISNER
Page 2
interest and penalties thereon, imposed under the laws of any jurisdiction by reason of my death,
upon or with respect to any and all property included in my gross estate for the purpose of such
taxes, whether such property passes under or outside of this Will, out of my residuary estate,
without being prorated or apportioned among or charged against the respective devises, legatees,
beneficiaries, transferees, or other recipients of any such property or charged against any property
passing or which may have passed to any of them. The Executors shall not be entitled to
reimbursement for any portion of any such taxes from any such person.
THIRD: Tangible Personal Property_. Except for those items excluded below and
those items enumerated in the Letter of Instruction, I bequeath to my children living at the time
of my death, all tangible personal property, including but not limited to clothing, jewelry,
heirlooms, furniture, personal effects, motor vehicles, and all other similar articles, which I own,
and the insurance thereon, to be divided among them as they may select in as nearly equal shares
as is practical. Tangible personal property shall not include: (1) any and all property used by me
in any business, (2) cash on hand or on deposit in banks, (3) stock or securities, (4) any type of
evidence of indebtedness, and (5) any life, health or accident insurance policies.
If I have no living children at the time of my death, I leave such tangible personal
property to my closest living relative, per stirpes. If there is any disagreement as to distribution, I
direct my Executors to make such distribution. The decision of my Executors shall be final and
binding. Any items not selected or any items which my Executors consider unsuitable for my
children may be distributed or sold in the sole discretion of my Executors and, if sold, the net
proceeds therefrom shall be added to the residue of my estate. Any such article allocated to a
minor may, as my Executors deem advisable, either be delivered to the minor or to any person to
safeguard on behalf of the minor.
Notwithstanding any other provisions in this Article THIRD, I may leave a separate,
dated and unsigned Letter of Instruction, which I shall place with my Will, containing directions
as to the ultimate disposition of certain of the property bequeathed under this Article THIRD, and
such Letter of Instruction shall determine the distribution of such items.
FOURTH: Residuary Gifts.
(A) If my spouse, EDITH V. KISNER, does not survive me, I give, devise and
bequeath the sum of ONE THOUSAND AND 00/100 ($1,000.00) DOLLARS to the
LAST WILL AND TESTAMENT'
OF
WAYNE E. KISNER
Page 3
CHINESE OVERSEAS CHRISTIAN MISSION, INC., now or formerly of P.O. Box 310,
Fairfax, Virginia 22030-0310, to be used in the discretion of its governing board for the support
of Rev. Charles Shearer.
(B) If my spouse, EDITH V. KISNER, does not survive me, I give, devise and
bequeath all the rest, residue and remainder of my estate, of every kind and character, mai,
personal and mixed, tangible and intangible, and wherever situated, including any lapsed or
renounced legacies or devises (and including any property over which I may have a Power of
Appointment), as follows:
1. I give, devise and bequeath TWENTY (20%) PERCENT of the residue of my
estate to my son, JEFFREY W. KISNER, or if he predeceases me then to his surviving
issue, per stirpes.
2. I give, devise and bequeath TWENTY (20%) PERCENT of the residue of my
estate to my daughter, JANET G. HARMAN, or if she predeceases me then to my son,
per stirpes.
3. I give, devise and bequeath TWENTY (20%) PERCENT of the residue of my
estate to my daughter-in-law, SUSAN E. KISNER, or if she predeceases me then to her
surviving issue, per stirpes.
4. I give, devise and bequeath TWENTY (20%) PERCENT of the residue of my
estate to my granddaughter, CHELSEA S. KISNER, per stirpes.
5. I give, devise and bequeath TWENTY (20%) PERCENT of the residue of my
estate to my grandson, BRYAN J. KISNER, per stirpes.
(C) If my children predecease me without leaving issue, then I give, devise and
bequeath all the rest, residue and remainder of my estate, of every kind and character, real,
personal, and mixed, tangible and intangible, and wherever situated, including any lapsed or
renounced legacies or devises (and including any property over which I may have a power of
appointment), to my closest living relatives, per stirpes.
LAST WILL AND TESTAMENT
OF
WAYNE E. KISNER
Pa~e 4
(D) Distributions During Administration, Prior to final distribution of my estate,
the Executors, in their discretion, may make partial distributions to one or more beneficiaries or
Trusts. As a consequence, the Executorship and any Trusts created under this Will may exist
contemporaneously. A distribution may be made subject to any indebtedness or liability of my
estate.
FIFTH: Spendthrift Provision. No beneficiary shall have the power to anticipate,
encumber or transfer his or her interest in the estate or any trust estate in any manner other than
by the valid exercise of a power of appointment. No part of the estate or any trust estate shall be
liable for or charged with any debts, contracts, liabilities or torts of a beneficiary or subject to
seizure or other process by any creditor of a beneficiary.
SIXTH: Powers of Executors. In addition to the powers and duties as may have been
granted elsewhere in this Will, but subject to any limitations stated elsewhere in this Will, the
Executors shall have and exercise exclusive management and control of the Estate and shall be
vested with the following specific powers and discretion, in addition to the powers as may be
generally conferred from time to time upon him by law:
(A) In the management, care and disposition of the Estate, the Executors shall have
the power to do all things and to execute such deeds and instruments as may be deemed
necessary or proper, including the following powers, all of which may be exercised without order
of or report to any Court:
(1) To sell, exchange or otherwise dispose of any property, real, personal
or mixed, at any time held or acquired hereunder, at public or private sale, for
cash or on terms, without advertisement, including the right to lease for any term
notwithstanding the period of the Estate, and to grant options, including any
option for a period beyond the duration of the Estate.
(2) To invest all monies in such stocks, bonds, securities, mortgages,
notes, choses in action, real estate or improvements thereon, and any other
property as the Executors may deem best, without regard to any law now or
hereafter enforced limiting investments of fiduciaries.
LAST WILL AND TESTAMENT
OF
WAYNE E. KISNER
Page 5
(3) To retain for investment any property deposited with the Executors
hereunder.
(4) To vote in person or by proxy any corporate stock or other security
and to agree to or take any other action in regard to any reorganization, merger,
consolidation, liquidation, bankruptcy or other procedure or proceedings affecting
any stock, bond, note or other security.
(5) To use attorneys, real estate brokers, accountants and other agents, if
such employment is deemed necessary or desirable, and to pay reasonable
compensation for their services.
(6) To compromise, settle or adjust any claim or demand by or against the
Estate and to agree to any rescission or modification of any contract or agreement
affecting the Estate.
(7) To renew any indebtedness, as well as to borrow money, and to secure
the same by mortgaging, pledging or conveying any property of the Estate,
including the power to borrow at a reasonable rate of interest.
(8) To retain and carry on any business in which the Estate may acquire an
interest, to acquire additional interest in any such business, to agree to the
liquidation in kind of any corporation in which the Estate may have an interest.
(9) To register any stock, bond or other security in the name of a nominee,
without the addition of words indicating that such security is held in a fiduciary
capacity, but accurate records shall be maintained showing that such security is a
Estate asset and the Executors shall be responsible for the acts of such nominee.
01) In making distributions from the Estate to or for the benefit of any minor or other
person under a legal disability, the Executors need not require the appointment of a guardian, but
shall be authorized to pay or deliver the same to the custodian of such person, to pay or deliver
the same to such person without the intervention of a guardian, to pay or deliver the same to a
LAST WILL AND TESTAMENT
OF
WAYNE E. KISNER
Page 6
legal guardian of such person if one has already been appointed, or to use the same for the benefit
of such person.
(C) In the disbursement of the Estate and any division into separate trusts or shares,
the Executors shall be authorized to make the distribution and division in money or in kind, or
both, regardless of the basis for income tax purposes of any property distributed or divided in
kind, and the distribution and division made and the values established by the Executors shall be
binding and conclusive on all persons taking hereunder. The Executors may in making such
distribution or division allot undivided interests in the same property to several trusts or shares.
(1)) The Executors shall have discretion to determine whether items should be charged
or credited to income or principal or allocated between income and principal as the Executors
may deem equitable and fair under all circumstances, including the power to amortize or fail to
amortize any part or all of any premium or discount, to treat any part or all of the profit resulting
from the maturity or sale of any asset, whether purchased at a premium or at a discount, as
income or principal or apportion the same between income and principal, to apportion the sales
price of any asset between income and principal, to treat any dividend or other distribution of any
investment as income or principal, or apportion the same between income and principal, to
charge any expense against income or principal or apportion the same, and to provide or fail to
provide a reasonable reserve against depreciation or obsolescence on any assets subject to
depreciation or obsolescence, all as the Executors may reasonably deem equitable and just under
all the circumstances.
SEVENTH: Ri~_.hts and Liabilities of Executors.
(A) No bond or other security shall be required of any Executor.
(B) This instrument always shall be construed in favor of the validity of any act or
omission by any Executor, and any Executor shall not be liable for any act or omission except in
the case of gross negligence, bad faith or fraud. Specifically, in assessing the propriety of any
investment of the estate, the overall performance of the entire estate shall be taken into account.
LAST WILL AND TESTAMENT
OF
WAYNE E. KISNER
Page 7
(C) Each Executor shall be entitled to receive reasonable compensation for services
actually rendered to my estate, in an amount the Executor normally and customarily charges for
performing similar services during the time which he/she performs the services.
EIGHTH: Tax Elections. In determining the estate, inheritance and income tax liability
relating to my Estate, the Executors' decision as to all available tax elections shall be conclusive
on all concerned. In accordance with IRC Section 2632(a) and without regard to whether a
Federal estate tax return is actually filed, my Executors shall allocate so much of the Federal
Generation Skipping Transfer (GST) exemption amount as will fully exempt any generation
skipping transfer which may occur under this Will.
NINTH: Def'mitions and General Provisions.
(A) Survival. Any beneficiary who dies within sixty (60) days after my death shall be
considered not to have survived me.
(B) Trust Estate. "Trust Estate" means all assets, however and wherever acquired,
including income, which may belong to a Trust at any given time.
(C) Children. Except for discretionary distributions which may be made unequally
among a group of persons and distributions pursuant to a valid exercise of a Power of
Appointment, in making a distribution to the children of any person, the property to be
distributed shall be divided into as many shares as there are living children of the person and
deceased children of the person who left children who are then-living. Each living child shall
take one share and the share of each deceased child shall be divided among his then-living
descendants in the same manner. A posthumous child shall be considered as living at the death
of his parent.
(D) Code. Unless otherwise stated, all references in my Will to section and chapter
numbers are to those of the Internal Revenue Code of 1986, as amended, or the corresponding
provisions of any subsequent federal tax laws applicable to my estate.
(E) Other terms. The use of any gender includes the other genders, and the use of
either the singular or the plural includes the other.
LAST WILL AND TESTAMENT
OF
WAYNE E. KISNER
Page 8
(F) Captions. The captions set forth in this Will at the beginning of the various
divisions hereof are for convenience of reference only and shall not be deemed to define or limit
the provisions hereof or to affect in any way their construction and application.
(G) Powers of Appointment are Exercised. By this Will I exercise any Power of
Appointment which I may possess at my death.
IN WITNESS WHEREOF, I, WAYNE E. KISNER, the Testator, have to this my Last
Will and Testament, typewritten on nine (9) pages, including the Acknowledgment and Affidavit,
set my hand and seal this ! day of l~ ~-~ ,2004.
(SEAL)
WAYNE E. KISNER
Signed, sealed, published and declared by the above-named Testator, as and for his Last Will and
Testament, in the presence of us, who have hereunto subscribed our names at his request, as
witnesses hereto, in the presence of the said Testator, and in the presence of each other. Each of
us further declares that he or she believes the Testator to be of sound mind and memory. The
preceding in~q3~nent consists of this and eight (8) other consecutively numbered typewritten
p~~jclmowledgment and Affidavit.,
/ ~47W~('W'~(print hame)
~~'~, x~f~4~[~~r, esidingat ¢tzi' ct¢, PA
(print name)
ACKNOWLEDGMENT AND AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF~
SS:
The Testator and the wimesses whose names are signed and subscribed to the attached or
foregoing instrument, being first duly sworn and qualified according to law, do hereby
acknowledge, depose and say to the undersigned authority, that the Testator signed and executed
the instrument as his Last Will in the presence of the wimesses; that he signed it willingly or
willingly directed another to sign it for him; that he executed it as his free and voluntary act for
the purposes therein expressed; that each of the witnesses were present and saw the Testator sign
and execute the instrument as his Last Will; that each subscribing witness in the hearing and
sight of the Testator signed the will as witnesses; and that to the best of their knowledge the
Testator was at that time eighteen years of age or older, of sound mind and under no constraint or
undue influence.
/~estator
Witness
COMMONWEALTH OF PENNSYLVANIA ·
COUNTY OF ~-/.,r~'~7.4~ .' SS:
On this, the /,d..~day o~~_, 2004, before me, a Notary Public, the undersigned
officer, personally appeared LOWELL R. GATES, ESQUIRE, Pennsylvania Supreme Court
Identification Number 46779, known to me or satisfactorily proven to be a member of the bar of
the highest court of Pennsylvania, and certified that he was personally present when the
foregoing acknowledgment and affidavit were signed by the Testator and witnesses.
Notarial Seal
Ted L. Walker, Notary Public
rvlL~e~7,~mYr~r e Boro, Cumberland County
y mission Expires Jan. 20, 2007
Member. Pennsylvania A.~soc. iatJon Of Notaries
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
My Commission Expires:
CERTIFICATE OF NOTICE UNDER RLrLE 5.6(a)
Name of Decedent:
Date of Death:
Will No. 21-04-1026
TO THE REGISTER:
Wayne E. Kisner
October 8, 2004
I certify that notice of estate administration required by
Rule 5.6(a) of the Orphans' Court Rules was serviced on or mailed
to the following beneficiaries of the above-captioned estate on
Nover~ber 29, 2004.
Name Address
JEFFREY W. KISNER
Ji~NET G. H. ARMAN
CHINESE OVERSEAS CHRISTIA~N MISSION,
SUSAN E. KISNER
CHELSEA S. KISNER
BRYAN J. KISNER
202 WEST GREEN STREET
SHIREMANSTOWN, PA 17011
5803 STEPHENS CROSSING
MECHANICSBURG, PA 17050
INC. P.O. BOX 310
FAIRFAX, VA 22030
202 WEST GREEN STREET
SHIREMA-NSTOWN, PA 17011
202 WEST GREEN STREET
SHIREMANSTOWN, PA 17011
202 WEST GREEN STREET
SHIREMANSTOWN, PA 17011
Notice has now been given
Rule 5.6(a) .
Date: ,
to all
persons entitled thereto under
Thomas D. Gould, Esquire
I.D. # 36508
Attorney For The Estate
2 East Main Street
Shiremanstown, PA 17011
(717) 731-1461
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
KISNER JEFFREY W
202 WEST GREEN STREET
SHIREMANSTOWN, PA 17011
~__~_n_ fold
ESTATE INFORMATION: SSN: 185-03-0515
FILE NUMBER: 2104-1026
DECEDENT NAME: KISNER WAYNE E
DATE OF PAYMENT: 03/15/2006
POSTMARK DATE: 03/15/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 10/08/2004
NO. CD 006437
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $12,679.29
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS: J HARMAN
CHECK#109
SEAL
INITIALS: VZ
RECEIVED BY:
REGISTER OF WILLS
$12,679.29
GLENDA FARNER STRASBAUGH
REGISTER OF WillS
:EV.1500EX (6-0CJ
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPl 280601
HARRISBURG, PA 17128-0601
REV-1500
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FILE NUMBER
2 1 - 0 4
INHERITANCE TAX RETURN
RESIDENT DECEDENT
NUMBER
o 1
o 2
6
COUNTY CODE YEAR
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
KISNER WAYNE E.
DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR)
10/08/2004 . 04/08/1919
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
SOCIAL SECURITY NUMBER
185 -03
0515
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
~ 1 Onginal Return
o 4. limited Estate
o 6. Decedent Died Testate (Attach copy of Will)
o 9. litigation Proceeds Received
o 2. Supplemental Return
o 4a. Future Interest Compromise (date or death after 12.'2-82)
o 7 Decedent Maintained a living Trust (Altach copy of Trustj
D 10. Spousal Poverty Credit (dateofdealh belween 12-31-91 and '.'.95)
D 3. Remainder Return (dale of deal" pnor to 12.13-82)
o 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
D 11. Election to tax under Sec. 9113(A) (Mach Soh 0)
1'1iISSECT.loN..MUSTBE.p:o.MPLE.TED'ALL:CO~IlESPONOENCE'ANDCONFIDEN1J,AI.JTAX..INFORMATION.Sf\OULD,BE DIRECTED .TO:
~IAME COMPLETE MAILING ADDRESS
THOMAS D. GOULD, ESQUIRE
FIRM NAME (If App!icable)
2 EAST MAIN STREET
SHIREMANSTOWN, PA 17011
TELEPHONE NUMBER
(717) 731-1461
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
(1)
(2)
125,900.00
14,388.00
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
4. Mongages & Notes Receivabie (Schedule Dj
(4)
\..-' )
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
D Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
(5)
137,269.00
(6)
L,. I
(7)
24,000.00
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
(8)
10,760.00
20,665.00
301,557.00
(9)
(10)
10. Debts of Decedent, Mortgage liabilities, & Liens (Schedule I)
11. Total Deductions (total lines 9 & 10)
(11)
(12)
(13)
31,425.00
270.132.00
1,000.00
12. Net Value of Estate (Line 8 minus line 11)
13. Charitable and Governmental 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)
(14)
269,132.00
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
z
o
~
I-
:J
0..
:2
o
u
><
~
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
x .0 (15)
xO 45 (16)
x .12 (17)
x .15 (18)
(19)
12,111.00
16. Amount of Line 14 taxable at lineal rate
269,132.00
12,111.00
17. Amount of Line 14 taxabte at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
20. D
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
"c",-_-,;:<;-"_/;(_, ,.
> >8E SU~ETQANgWERALLQUES1l0NSONREvERSESIDEAND ilECHECKMATH <II! {:
-~'-:c./_;<i:'__>:;,,_::_\-:;:
Decedent's Complete Address:
STREET ADDRESS 4839 EAST TRINDLE ROAD
CITY
APARTMENT 322
~-_.
MECHANICSBURG
PA
STATE
Tax Payments and Credits:
1. Tex Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
12,111.00
Total Credits ( A + B + C ) (2)
3.
Interest/Penalty if applicable
D. Interest
E. Penalty
568.29
4.
Total Interest/Penalty ( D + E )
If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund
(3)
(4)
(5)
(SA)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + SA. This is the BALANCE DUE.
(5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
568.29
12,111.00
568.29
12,679.29
PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes
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; .. D
c. retain a reversionary interest; or.................. .............................................. ........ U
d. receive the promise for life of either payments, benefits or care? ...................................................................... D
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ........................... ................. .... ................... [lg
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ...... D
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ....................... ................... ..........................
.........~
No
sa
Q9
lxJ
[i]
D
[Xl
D
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
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 betlef, it is true, correct and complete
Declaration of prepar a he personal representative is based on all information of which preparer has any knowledge.
DATE .3 - lS - CS"l..Q
~
5803 STEPHENS CROSSING ROAD
MEcHANICSBURG, PA 17050
DATE 3-fS-". 2(Jt:J~
ADDRESS
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. S9116 (a) (1.1) (i)J.
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. S9116 (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
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 twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive paren
or a stepparent of the child is 0% [72 P.S. s9116(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. S9116(1.2) [72 P.S. s9116(a)( 1 )J.
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. s9116(a)(1.3)]. A sibling is defined, under Section 9102, as a
individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-i502 EX+ (6-98)
SCHEDULE A
REAL ESTATE
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
WAYNE E. KISNER
FILE NUMBER
21-04-01026
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be
exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts.
Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
1.
509 DEXEL ROAD,
HARRISBURG, PA 17109
125,900.00
TOTAL (Also enter on line 1, Recapitulation) $
125,900.00
(If more space is needed, insert additional sheets of the same size)
REV-1503 Ex -+ (1-97)
ESTATE OF
SCHEDULE 8
STOCKS & BONDS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
WAYNE E. KISNER
FILE NUMBER
21-04-01026
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
VALUE AT DATE
OF DEATH
14,388.00
DESCRIPTION
PPL 600 shares @ $23.98
14,388.00
TOTAL (Also enter on line 2, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
RE\i-150B EX... (1-97)
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
WAYNE E. KISNER
21-04-01026
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
2
3
4
5
6
7
8
9
10
11
12
13
DESCRIPTION
M&T BANK CHECKING ACCT # 515456837810
JACKSON NATIONAL CHECKING ACCT # 9350313499
JACKSON NATIONAL BANK IRA # 1000125888
ALLIANTE CHECKING ACCT # 00006725672
WAYPOINT BANK SAVINGS ACCT # 0203023820
1990 CHEVROLET TRUCK
1999 CHEVROLET VAN
MISC HOUSEHOLD GOODS
TAX PRORATION FROM SALE OF HOUSE
KEYSTONE HEALTHCARE REFUND
METLIFE INSURANCE -# 404-9019184
TRAVELERS HOME INSURANCE REFUND
JACKSON NATIONAL LIFE # 1000116994
VALUE AT DATE
OF DEATH
33,055.63
7,081.29
23,431.74
23,797.89
33,055.63
2,000.00
6,000.00
1,715.00
593.76
91.00
3,897.63
449.00
2,100.00
137,269.00
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
REV 1510 EX' (197)
SCHEDULE G
INTER.VIVOS TRANSFERS &
MISC. NON.PROBA TE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
WAYNE E. KISNER
21-04-01026
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
DESCRIPTION OF PROPERTY %OF
ITEM INCLUDE THE NAME OF THE TRANSFEREE:, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE
ATTACH A COpy OF THE: DEED FOR REAL ESTATE VALUE OF ASSET IF APPliCABLE)
NUMBER INTEREST
1. CASH TO JEFFREY, SUSAN, BRYAN AND 24,000.00 100 24,000.0
CHELSEA KISNER
SON, DAUGHTER-IN-LAW & GRANDCHILDRE IJ
TOTAL (Also enter on line 7, Recapitulation) $ 24,000
.0
o
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX+ (12-99) ~,
_~'J~:\~_
~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
WAYNE E. KISNER
FILE NUMBER
21-04-01026
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
1.
FUNERAL EXPENSES:
ZIMMERMAN FUNERAL HOME
SNYDERS FLOWERS
POT-a-LOVE
7,518.00
415.42
125.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City
_._____ State ~ Zip
Year(s) Commission Paid:
2.
Attorney Fees
2,000.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Add ress
City _______
State __ __ Zip
Relationship of Claimant to Decedent
4.
Probate Fees
348.00
5.
Accountant's Fees
150.00
6. Tax Return Preparer's Fees
7.
PUBLICATION FEES
204.77
TOTAL (Also enter on line 9, Recapitulation) $
10,760.00
(If more space is needed, insert additional sheets of the same size)
A. Settlement Statement
U.S. Department of Housing
and Urban Development
~
,r
OMB No. 2502-0265
B. Type of Loan
1.0 FHi\ 2.0 FmHA 3. 0 Com Untnsl6 Fde Number 17. Loan Number 18. Mortgage Insurance Case ]\;umber
4.0 VA 50 Com Ins I 34153 ROSS : i
C. NOTE: This fOlm is fumished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown.
Items marked "(p.o.c.)" were paid outside the closing; they are shown here for informational purposes and are not included in the totals.
D. '\TAME OF BORROWER: William J. Ross, Jr.
ADDRESS OF BORROWER: 1004 Topview Dr.. Harrisburg, PA 17112
E. NAME OF SELLER: Wayne E. Kisner Estate
ADDRESS OF SELLER:
F. NAME OF LENDER:
FUL TON BANK
ADDRESS OF LENDER:
G. PROPERTY
LOCATION:
PO BOX 5762, CINCINNATI, OH 45201-5762
509 Drexel Rd
Harrisburg, PA 17109
H. SETTLEME:\T AGENT:
SHUMAKER WILLIAMS, P.C.
3425 SIMPSON FERRY ROAD, CAMP HILL, P A 170 II
3425 SIMPSON FERRY ROAD, CAMP HILL, PA 17011
PLACE OF SETTLEMENT:
I. SETTLEMEl'IT DATE:
J. SUMMARY OF BORROWER'S TR<\NSACTION
1 OO.CiROSS AMOUNT DUE FROM BORROWER
LQI.ContUlc.uilk"-R[i~_ _ . ____
JJ)].J'o;l:s.onaLp.IQjJerty -- -- ---
10J,S~ttlemenu:ImW.l9_bp)1Q.wer (line] 400)
104.
105. ________
__Mill:>tments fQr items paid by seJI!'Liu_aJivaJ]I& ______
1 06.CitY/lQwn taxes _._______J9_ ._
II)7.CountYJa~~s_ 12/20/2004 to 12/3112004
1 08_.~\sses,,-rmm~_~_Jo ._
i O.9.Sch.ool Taxes 12120/20041Q .. 6/30/2005
: 10 ___m_ _ to .. _.-r-----
I.LL_ _ __._ _ n ___. ____to
i12.
K. SUMMARY OF SELLER'S TRANSACTION
400.GROSS AMOUNT DUE TO SELLER
__ __1 2 5,2JlQ..QQ_40U:QntracLs al e~pric:!'__
402.Personal property
4811.04 403.
404.
405.
-.---
---...AJ:1.llisJll1ents_JQL~ms]Jaid_12y seller in advance ______
406.Citv/town taxes _. ______.1.0 ___________
19.99 407.Countv taxes 12/20/20Q1!O ]2/31/2004J..9.99
408.Assessments to_I---_______.
573.77 409. School Taxes i 2/20/2004 to 6/3Q(2QQj ________J-L1..27
4]0. t9___ ___.._
411. to ______ ____.__
412. to
ll.5.,90000
-- ..--------.-
-~--I------ .-
._~--~
-.-----
to
120 GROSS AMOUNT DUE FRO:V! BORROWER
~
131,304.80 420.GROSS AMOUKT DUE TO SELLER
~
126,493.76
200.AMOUNTS PAID BY OR IN BEHALF OF BORROWliR 500.REDUCTIONS IN AMOUNT DUE TO SELLER
2Q1.])~Rosit or eameSJ.1]1Ql1_ey . __________ __ _....5.JlOJlJ2D jD1J:;,xcess deposit (see instructionsL______ ~________
202.Pling]J~lnD1ounJ.QLnm.JQ<!Il(s) _ ______ ___~OD.n_QJill. 2Q2~S.~t1s:ment chames to seIlerllind.1QQ) _....1.112.6.6.l2_
20TExlstingJQ.4n\.8 taken subiect to 503.Existilw loanls) taken subiect to .-------r---- n____
204.__ 504.Pavoff of firs; mortgnge..lOJlD
r----....
205__
.------t------.
505.Pavoff of second mortgage loan
._-
n_ ______..__
----
W.!j.Princip'iljlmountof s~ller financing
2_0.L.
208.SeIleLR_a.)'Jng Buyer Costs
209_
209Jl___.__
2090
._. . ~\9I~-stm::~~5_~~_r~1!~:!~~__unpaidT;y seller
210.C1ty/tO\Y1Lt4xes to
211.CounlYJ':l.\.eL________ to
212cE.ssessments to
2 U ___n..__ to _ _
214. .________ _______ to
2l5._~_______ ____ to
218 ____n._
219
no TOTAL AMOUNTS PAID
BY OR IN BEHALF OF BORROWER
300 CASH AT SETTLEMENT FRO:vI/TO BORROWER
30 I.Gross amount due from borrower !line 1201
302.Less amounts naid by/for borrower !line 220)
506.Principal amount of.sru~r fi!lIW..dtJg
---.--- -- .... '__ 5!2lc....____
.---___ _~__.3,E2Slli. jD~SelkL.Pi!Yi.Dg Buyer Costs
___~_.___ 5~___
509a
509b
Adjustments for ite;:;';': unpaid by seller
51 0.Citv/to\\11 taxes __ to
5] 1. County taxes to
512.Assessments _ to
51.3~.___ ____ _ . ____nO to
514. to
515. to
516. to
517. ..__ to
518. to
519. to
520.TOTAL REDUCTIONS IN
109,497.00 AMOGNT DUE SELLER
600. CASH AT SETTLEMENT TO/FROM SELLER
131304.80 601. Gr055 amount due to seller !line 420)
109497.00 602.Less reductions in amount due seller !line 520
---
_ __.3 77Ulli_
-----
-- -----
---
------
216
_21 7 ~
to
to
to
to
- ~.._-----
---~
-----~--
~
~
14,043.32
303.CASH !Xl From 0 To BORROWER ~
21,807.80 603.CASH !Xl To 0 From
SELLER ~
126.493.76
14043.32
112,450.44
PAGE 1
~2004 Display Systems. Inc. (863) 76:J-SSSS _ Laser Generated
flUD-i (3-86) RESPA, HB 4305.2
U.S. DEPARTMENT OF HOUSfNG AND URBAN DEVELOP1vIENT
SETTLEMENT STATEMENT
PAGE 2
L. Settlement Chames
700. TOJAk SALES1!iROKER'S COM. bas_~.'Lol:umCC
.__~U;IOn ofCommissionj.line 7.0.0) as follows:
.1Q~_3,8122.J2!L. _~.
J02__.1)52.aO
7Q} CorD.rnission R"id at Settlcment
704.
8.0.0. Items Payable In Connection With Loan
.80 LLomlili]g11] ati on FJ'_c__ % ._to .__ _.. _
802. Loan Dlscount .~_%__ to FUUQN BANK __._-12'i.9a-..---____==~
803._AlwraisaL&.L_______... to VincgntMinnici..S.2l.~a.O P.O C. BY LENDE.R. ~_ ~__ _____
804. Credit R~porL_ to cBLlli.aa P.OJ::cJ'.A!D BY LENDER ___ _ ._____ __~____
i-lill~'._Tax.Rclaled.s.ervice FeeJ'Qr CitimQl1g~----1Q_FUL_TON BANK 7,.nn__
J;1}_QJillc.essing l'e.e_____~__ to FULTON BANK 19.0..0.0 ___
JIO]_QvemightDelivery_f~__ to FUl.TON BANK ._ _ 15..0.0____.
~08 AppJ.ication ree __ _____ .__~__ to FULTONJ3.ANK __._. 3.0.0..0.0 ___ .__
J;,Q2._Docunl,-ut PreparationE~_.___tQ_EUL TON BANK ---.- ----.J~4i.Jo)Da- __.___ .___._
-,s'.L.o"jn",e.stor fee-psLknder forCitimor!gage. to FULTON BANK "
.1llJ.. F10pd D~ter/IYIonitor to J'irsLAmencan Flood ____ l--. ___ 1'LJlO.. _ .__.____
8J_2.J\utOl]}[\te.d UndeJ:\.vriting Fe_U'.d....hUender to FUL To1'\ BANK (Fannie Mau29..(0) p.n.c.
B.LL ____ ___ _____no to_._ __._
e-8J4.____ --~-
815. to
9.00. Items Reollired B, Lender To Be Paid [n Advance
911.1. IuterestfroUL12i20i2aa4 to lilI2aa5 (c[; 14.79153. Idav
c'-,lQ2 __"1QJ:!gllg,,JmurangoYremium fOL _----1I!Q.11Jhs to
9a3...o.lIazal<;LIDlimance Plcmlum for 1 vears to The Cincinnati Insurance Co. S4n.D~
9.04 ___. .___._ ._.J'C_ars to
905. years to
1000. Reserves Denosited With Lender
Jj2Q.L.miaUU]1SUrancc ... ..._~___.._____._______3 months@
LQQ2.)JQI\gl)gc_]]1.sY~ _ _ ___ month>@: __.
1.003. Cl1:LJ2LOpcl1YJ.a;'.~-,----_______._ months@i
I QOA._CountY-P'[QpeI1y taxg.s_~.__----L2._J!lJm1h.S@--,-
Jaili.,-.l.,mllli!La2SCSSm~_._... __ months@__
1 QQ2dch.QoLI~______~___ 8 months.@._
JJ)j)L____~__ _ __ months@
1..o.Q8,Aggregate_.Adiustme.rlt __ _ mo.nJ~(cU.
1.0.09.
11.00. Title Char!!es
.11010 Settlement orcJ.2sing fe<:___ ___------1Q ._____
1.10";:' AlJstJ:a~J or title sellrch .__ to
lJJi.:LTltlc_c2'amina1t9_n__. __. to
L1Q:;Jit]c inSLJn!llCe bin~~r to_.
11D.LOQsument RU~p'ar.a\iQlJ to
1106. Notar' fe.el__.._~____.. .___._ to Shumaker Williams P.c..
LIQL .Altomev's fees to... ..
_uncludes abovCJtcms.Jlumbers: _...
11D.8. Title inSJJLall_cc. to Shumaker Williams~E.C,___
_---1llli:!JJ_'ks..aJ2QYe items numbers: U 02l) .03 11 .04 _______________~.
HQ9~.L91cicr's Co-"-~rage:-___ __._____ ___INS AMT: 1.0.0 71.0..0.0
111.o.0'l'ner's C_overage: .___ INS AMT: 12:i,9_0_QjLO_____~__~.
11103 Endors_emelmJaa 3.0.0 8.1 .._______~__ .._ ______----15.0lJ.Q. _~_____
Ul I. Closing Service Letter to First American Title IrlS.tjLaJl~.eJ::..QmRa.uy-_____ ~.___)5.aa
.1112. Prepare Deed & Certification .___n to Thomas Gould, Esquire ..._____ ~.__ 1.0.0..0.0
1113. to
12.00. Government Recordino and Transfer Char!!es
nO!. RecQrding Fe5's;_O.e."tl44."a. L::1YlQl1gll,gl;(S) $67.5.0' S-Mortga.lr-e.(.s)_;.Re]eo,e,
12m, City/eWDIY taxist;j,ll1)2.s: Qeed 51.259..0.0: L,MQrtgage(s) S-Mortgage(s).___. _____~_
. 1,2JU--SJa te taxi stanJP.s:_D~..59~Oa..;_L- Mort ga gel s) ~_S. M oJ:1gage.(s}
1."-04__~ __.__.
1259.0.0.00 @!
6. .00_',;,.=-----'1,5,5 '1.,0.0_
Paid From
Borro\ver's
Funds At
SettlemeDL.........
Paid From
Seller's
Funds At
.__.S.cttlellJ.'-.nt
125'lQQ..
--------
to HOWARD HANNA DETWEILER REALTY
to BROKERS REALTY.COM
to
.---
1 n.5St _.__
'P.O.C.*
--.---
39.33 per month __..lll.22 _____.___
per m0111h_ ___ _ ____.. ___ _______
ner month
54.59 !lermQ.DJh___ _.__ __6.&.0.8_ __~__
ner month
RQ.32 ner month
ner month
ner month
..
(493.74)~----
714.56
_.~---I----._.-
-
---- -------. ---------~-_.-
.-~~~=--:-----==~~: :=_:~-.6!JO -~6:O0
....
Q8R 7<>
1205.
112.00
..LZ.~Qo. _______
_._.L2.5.9W
---- ~-
130.0. Additional Settlement Charges
1.30.]. Tran.s.<lcJjon Fee ___ _.__ . __.. to Howard IhU11.alktweiler
1302~!'~stJnspectiQ1L. to
,lilll.Trama.ction Fee__ to Bx-okers Realty.com_.___.
0.3.04. Tax CQ.lj_Reimbursem~lt to KJ2 Snyder
Ua5.CotlJ:ier Fec__ to Shumak,x..Rilliams P.c.
UlliU;e\I'!~LlDLLtoJ2/2a/0..4._ _____._ __.___-------.tlLLsl\ver Paxton TWlLAthv
1.30.7 2QaASchool Ta"e, _______...~___ to Patsy DQ11mQyer Tax Collector
U08. to
-----------_._--~--
1309. to
1400. Total Settlement Charges (enter on lines 103, Section J and 5.02, ScctionK)
~___l.25aa
125..0.0
__J ..0.0.
_______.--.lj.aa_ ____
_~__7232..
1 148.43
._---~--~--
~
4,811.0.4
10.,266.32
CERTlFICA TlO:" . . DATE 12120!?aa4
I have carefullv reviewed the HUD. 1 Settlement Statement and to the best of my knowledge and belief, It IS a true and accurate statement of all receipts and
dl5bursemcntsmade on my account or by me in thIS transaction. j further certify that I have received a copy of the HUD . ] Settlement Statement.
Wayne E. Kisner Estate
1/;~-;;;I~ /-__~
William J. ROSS,~..f_.
BotTower
B
SelicI'
Borrower
13
1-
Seller
The HUD.I Settlement Statement which I have pre red is a true and accurate accou of this transaction. I have caused the funds to be dIsbursed In accord.
ance With this statement SHUMAKER WILLIAMS, P.C
_____.~_ Settlement Agent
WARNING: It IS a crime to knowingly m e false statements to the United States on this or any other similar form.
fine and impnsonment. For details see: Tltle I S U.S. Code SectIOn 100.1 and SectIon 10.1 a.
12/20./20.0.4 Date
Penalties upon conviction can include a
34153 ROSS
REV 1512 EX. (1.9'i ~
~.t~/O": -'I~
n ~1
i~.>;. i;;~"'~~..
~:C>i>-~~~
.-'.~.-=-.~~... .....-
COMMONWEALTH OF PENNSYLVANii,
INHERITANCE TAX RETURfJ
f<ESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF
FILE NUMBER
WAYNE E. KISNER
21-04-01026
Include unreimbursed medical expenses.
ITEM
NUMBER
DESCRIPTION
AMOUNT
1.
2
3
4
5
FEES RELATED TO SALE OF HOUSE
UTILITIES TO MAINTAIN HOME
MAINTENANCE ON HOUSE
REPAIRS AND SERVICE TO HOUSE
MEDICAL EXPENSES
14,043-32
442 . 19
420.00
2,995.20
2,764.08
TOTAL (Also enter on line 10, Recapitulation) $ 20 , 665 . 00
(If more space is needed, Insert additional sheets of the same size)
REV-1513 EX+ (9-00) \':
.~;I~.-~
~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
WAYNE E. KISNER
FILE NUMBER
21-04-01026
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
r TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1. JEFFREY KISNER SON 20%
2 SUSAN KISNER DAUGHTER-in-L, w 20%
3 JANET HARMAN DAUGHTER 20%
4 BRYAN KISNER GRANDSON 20%
5 CHELSEA KISNER GRANDDAUGHTER 20%
I I
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
n NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1. CHINESE OVERSEAS CHRISTIAN MISSION, INC, 1,000.00
TOTAL OF PART II - ENTER TOTAL NON.TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 1,000.00
(If more space is needed, insert additional sheets of the same size)
Cumberland -County - RegiEfter at WiITS
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 9/14/2006
GOULD THOMAS D
2 E MAIN STREET
SHIREMANSTOWN, PA 17011-6309
RE: Estate of KISNER WAYNE E
File Number: 2004-01026
Dear Sir/Madam:
This notice is to serve as a reminder that the Status Report by
Personal Representative under Rule 6.12 is due on the below listed
date.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103
SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after
July 1, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing is due by: 10/08/2006
please feel free to contact this office with any questions you may
have. If you have already filed your Status Report, please disregard
this notice.
Sincerely,
~~~
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Personal Representative(s)
~
Cumberland C6i.i:hEy--=--~e~f~L:er or WLLlS----
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 9/14/2006
KISNER JEFFREY W
202 WEST GREEN STREET
SHIREMANSTOWN, PA 17011
RE: Estate of KISNER WAYNE E
File Number: 2004-01026
Dear Sir/Madam:
This notice is to serve as a reminder that the Status Report by
Personal Representative under Rule 6.12 is due on the below listed
date.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103
SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after
July 1, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
wills a Status Report of completed or uncompleted administration.
This filing is due by: 10/08/2006
please feel free to contact this office with any questions you may
have. If you have already filed your Status Report, please disregard
this notice.
Sincerely,
~~~
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Counsel
~
CUmberland CountY--=.R~glgL~r-.or .Wll..IS.
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 9/14/2006
HARMAN JANET G
5803 STEPHENS CROSSING ROAD
MECHANICSBURG, PA 17050
RE: Estate of KISNER WAYNE E
File Number: 2004-01026
Dear Sir/Madam:
This notice is to serve as a reminder that the Status Report by
Personal Representative under Rule 6.12 is due on the below listed
date.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103
SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after
July-I, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing is due by: 10/08/2006
Please feel free to contact this office with any questions you may
have. If you have already filed your Status Report, please disregard
this notice.
Sincerely,
~~~
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Counsel
~
IN THE MATTER OF THE ESTATE
OF WAYNE E. KISNER,
DECEASED
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. 21-04-1026
STATUS REPORT UNDER 6. 12
Pursuant to Rule 6.12 of the Supreme Court Orphan's Court
Rules, I report the following with respect to completion of the
administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes
No
x
2.
If the answer is no,
state when the personal
representative reasonably believes that the administration will be
complete: 60 Days
3. If the answer to No. 1 is yes, state the following:
a. Did the personal representative file a final account
with the court?
Yes
No
b. The separate Orphan's Court No. (If any) for the
personal representative's account is:
c. Did the personal representative state an account
informally to the parties in interest? Yes
No
d. Copies of receipts, releases, joinders and approvals
of formal or informal accounts may be filed with the Clerk of the
Orphans' Court and the Estate Settlement Agreement is attached to
this report.
'Vd "OJ ON't'iti.38~n8
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Date: ()d-o~,,. ~ 216'0 >18318
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Thomas D. Gould
Attorney for Co-Executors
I.D. # 36508
2 East Main Street
Shiremanstown, Pa 17011
(717) 731-1461
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%omas f)). (jou{d
2 EAST MAIN STREET
SHIREMANSTOWN,PA 17011
ATTORNEY AT LAW
(717) 731-1461
FAX 761-1974
October 9, 2006
REGISTER OF WILLS
CUMBERLAND COUNTY COURT HOUSE
HIGH AND HANOVER STREET
CARLISLE, PA 17013
Re: Estate of Wayne E. Kisner
No. 21-04-1026
Dear Register Lewis:
Enclosed please find the original and one copy of the Status
Report under 6.12 for the above reference matter. Please file the
original and time stamp the copy and return it to me in the
enclosed stamped, self-addressed envelope. Thank you for your
anticipated cooperation.
Respectfully,
~." D.~
Thomas D. Gould
enclosure
cc. Jeffrey W. Kisner
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IN RE:
ESTATE OF WAYNE E. KISNER,
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IN THE COURT OF CO~ PLE~ "
CUMBERLAND COUNTY, J?~~ij'LV~IA ~=-~
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NO. 2004-01026
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ORPHANS COURT
PETITION FOR APPROVAL
OF THE
FINAL ACCOUNT AND PROPOSED DISTRIBUTION
NOW COMES the Co-Executors of the Estate of Wayne E. Kisner
and files this Petition for approval of the Estate's final account
and to authorize the distribution of the Estate's assets.
1. The decedent, Wayne E. Kisner, widowed, late of Hampden
Township., Pennsylvania died on October 8, 2004 having a Will, duly
probated on November 10, 2004 and recorded at with Cumberland
County Register of Wills, docketed at 2004-01026, naming Jeffrey W.
Kisner and Janet G. Harman, who were granted Letters on November
10, 2004 to administer the Estate.
2. In a Decree dated December 27, 2004 Jeffrey and Susan
Kisner were appointed guardians of the estates of their son Bryan
Kisner and daughter, Chelsea Kisner.
3. Bryan Kisner, date of birth November 23, 1987, has
attained the age of 18 and an Order dated August 31, 2006, vacated
the appointment of his mother and father as his guardians.
4. At the time of death decedent had assets as set forth in
the attached Account.
5. In administering the Estate the Personal Representatives
paid expenses and debts as set forth in the attached Account.
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6. After death the Estate received dividend checks from PPL
totaling $1,341.00.
7 . The Estate has made a distribution to Janet Harman of
$6,000.00 which equals the amount each of the other heirs received
from the decedent within one year of his death.
8. The Personal Representatives request the approval of the
Account and permission to make distribution of the remaining assets
as provided in the attached Proposed Distribution.
Respectfully submitted,
......
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JaJet G. Harman
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Susan E. Kisner
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Susan E. Kisner
Kisner
~~f). Au
Thomas D. Gould, Esquire
1.0. # 36508
2 East Main Street
Shiremanstown, PA 17011
(717) 731-1461
ACCOUNT
ESTATE OF WAYNE E. KISNER
ITEM
VALUE AT DEATH
ASSETS:
Total
$ 125,900.00
$ 14,388.00
$ 78,681.63
$ 24,000.00
$ 1,341.00
$ 244,310.63
Real Estate
PPL stock
Financial deposits & personal property
Distributions within one year of death
PPL dividends
DEBITS:
Funeral & Administration Expenses
Fees related to sale of home
Maintenance on home
Repairs & service to home
Utilities related to home
Medical expenses
PA Inheritance Tax & interest
$ 10,760.00
$ 14,043.32
$ 420.00
$ 2,995.20
$ 442.19
$ 2,764.08
$ 11,030.52
Total
$ 42,455.32
Net Value of Estate for distribution
$ 201,855.32
PROPOSED DISTRIBUTION OF ASSETS
BENEFICIARY SHARE
CHINESE OVERSEAS CHRISTIAN MISSION, INC. $ 1,000.00
JEFFREY W. KISNER $ 40,571.06*
SUSAN E. KISNER $ 40,571.06*
JANET G. HARMAN $ 40,571.06*
BRYAN J. KISNER $ 40,571.06*
CHELSEA S. KISNER $ 40,571.06*
Total $ 201,855.32
* each heir will be credited with having received a $6,000.00
distribution
....
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IN RE: ESTATE OF
WAYNE E. KISNER,
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYL VANIA
ORPHANS' COURT DIVISION
NO. 04-1026 ORPHANS' COURT
ORDER OF COURT
('
AND NOW, this 13th day of November, 2006, upon consideration of the Petition
..,.
for Approval of the Final Account and Proposed Distribution, to the extent that the
petition seeks to bypass the normal procedure for confirmation of accounts, including
advertising requirements, it is denied.
BY THE COURT,
Thomas D. Gould, Esq.
2 East Main Street
Shiremanstown, P A 17011
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In Re: ESTATE OF WAYNE E. KISNER
ORPHANS' COURT DIVISION
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY
PENNSYLVANIA
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NO. 21-2004-1026
, CERTIFICATE OF SERVICE OF ORDER
ORDER DATE: 11/14/06
JUDGE'S INITIALS: JWO
TIME STAMP DATE: 11/14/2006
IN RE: ORDER OF COURT
SERVICE TO:
THOMAS D. GOULD. ESQ.
METHOD OF MAILING:
ENVELOPES PROVIDED BY:
[g1 USPS
DRRR
D HAND DELIVERED
D OTHER_
[g1 PETITIONER
D mDGE
D CLERK OF ORPHANS COURT
MAILED: 11-14-2006
SERVICE TO:
METHOD OF MAILING:
ENVELOPES PROVIDED BY:
D USPS
DRRR
D HAND DELIVERED
D OTHER_
D PETITIONER
D mDGE
D CLERK OF ORPHANS COURT
MAILED:
.-....
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IN RE:
ESTATE OF WAYNE E. KISNER,
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IN THE COURT OF CO~ p~
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NO. 2004-01026
ORPHANS COURT
PETITION FOR APPROVAL
OF THE
FINAL ACCOUNT AND PROPOSED DISTRIBUTION
NOW COMES the Co-Executors of the Estate of Wayne E. Kisner
and files this Petition for approval of the Estate's final account
and to authorize the distribution of the Estate's assets.
1. The decedent, Wayne E. Kisner, widowed, late of Hampden
Township~ Pennsylvania died on October 8, 2004 having a Will, duly
probated on November 10, 2004 and recorded at with Cumberland
County Register of Wills, docketed at 2004-01026, naming Jeffrey W.
Kisner and Janet G. Harman, who were granted Letters on November
10, 2004 to administer the Estate.
2. In a Decree dated December 27, 2004 Jeffrey and Susan
Kisner were appointed guardians of the estates of their son Bryan
Kisner and daughter, Chelsea Kisner.
3. Bryan Kisner, date of birth November 23, 1987, has
attained the age of 18 and an Order dated August 31, 2006, vacated
the appointment of his mother and father as his guardians.
4. At the time of death decedent had assets as set forth in
the attached Account.
5. In administering the Estate the Personal Representatives
paid expenses and debts as set forth in the attached Account.
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6. After death the Estate received dividend checks from PPL
totaling $1,341.00.
7 . The Estate has made a distribution to Janet Harman of
$6,000.00 which equals the amount each of the other heirs received
from the- decedent within one year of his death.
8. The Personal Representatives request the approval of the
Account and permission to make distribution of the remaining assets
as provided in the attached Proposed Distribution.
Respectfully submitted,
9!1w~i~
,~C~
Susan E. Kisner
~~
Kisner
Kisner
~."f)~ Au
Thomas o. Gould, Esquire
1.0. # 36508
2 East Main Street
Shiremanstown, PA 17011
(717) 731-1461
--, . '
~
ACCOUNT
ESTATE OF WAYNE E. KISNER
ITEM
VALUE AT DEATH
ASSETS:
Total
$ 125,900.00
$ 14 , 38 8. 0 0
$ 78,681.63
$ 24,000.00
$ 1,341.00
$ 244,310.63
Real Estate
PPL stock
Financial deposits & personal property
Distributions within one year of death
PPL dividends
DEBITS:
Funeral & Administration Expenses
Fees related to sale of home
Maintenance on home
Repairs & service to home
Utilities related to home
Medical expenses
PA Inheritance Tax & interest
$ 10,760.00
$ 14,043.32
$ 420.00
$ 2,995.20
$ 442.19
$ 2,764.08
$ 11,030.52
Total
$ 42,455.32
Net Value of Estate for distribution
$ 201,855.32
PROPOSED DISTRIBUTION OF ASSETS
BENEFICIARY SHARE
CHINESE OVERSEAS CHRISTIAN MISSION, INC. $ 1,000.00
JEFFREY w. KISNER $ 40,571.06*
SUSAN E. KISNER $ 40,571.06*
JANET G. HARMAN $ 40,571.06*
BRYAN J. KISNER $ 40,571.06*
CHELSEA S. KISNER $ 40,571.06*
Total $ 201,855.32
* each heir will be credited with having received a $6,000.00
distribution
.. . .
'..
y
OCT a 1 20061"'1
IN RE:
ESTATE OF WAYNE E. KISNER,
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 2004-01026
ORPHANS COURT
ORDER
AND NOW,
, 2006, after review of the Petition
For Approval of the Final Account and Proposed Distribution filed
by the Co-Executors and signed by heirs of the Estate of Wayne E.
Kisner, the petition is granted and the Final Account and Proposed
Distribution is approved and the co-executives are directed to make
distribution of the assets as set forth in the Final Distribution
and are authorized to close the Estate.
BY THE COURT,
IN RE:
ESTATE OF WAYNE E. KISNER,
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 2004-01026
ORPHANS COURT
FIRST AND FINAL ACCOUNT
AND PROPOSED DISTRIBUTION
JANET G. HARMAN
JEFFREY W. KISNER
PERSONAL REPRESENTATIVES
Decedent died on October 8, 2004
Letters advertised In the Cumberland Law Journal on December
10,17,24, 2004
Letters advertised in the Sentinel on December 1,8,15, 2004
The Account and Proposed Distribution of assets is attached.
I verify that the statements made In this First and Final
i~ccount . and Proposed Distribution are true and correct. I
understand that false statements herein are made subject to the
penalties of 18 Pa. C.S. 4904, relating to unsworn falsification
to authorities.
, ' .
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Thomas D. Gould, Esquire
Attorney for the Representatives
1.0. #36508
2 East Main Street
Shiremanstown, PA 17011
(717) 731-1461
lid 0(' ~U~\'d cn'v
8 \ :2 ~r v l\ i'\.J ..
ACCOUNT
ESTATE OF WAYNE E. KISNER
ITEM
VALUE AT DEATH
ASSETS:
Total
$ 125,900.00
$ 14,388.00
$ 78,681.63
$ 24,000.00
$ 1,341.00
$ 244,310.63
Real Estate
PPL stock
Financial deposits & personal property
Distributions within one year of death
PPL dividends
DEBITS:
Funeral & Administration Expenses
Fees related to sale of home
Maintenance on home
Repairs & service to home
Utilities related to home
Medical expenses
FA Inheritance Tax & interest
$ 10,760.00
$ 14,043.32
$ 420.00
$ 2,995.20
$ 442.19
$ 2,764.08
$ 11,030.52
Total
$ 42,455.32
Net Value of Estate for distribution
$ 201,855.32
PROPOSED DISTRIBUTION OF ASSETS
BENEFICIARY SHARE
CHINESE OVERSEAS CHRISTIAN MISSION, INC. $ 1,000.00
JEFFREY W. KISNER $ 40,571.06*
SUSAN E. KISNER $ 40,571. 06*
JANET G. HARMAN $ 40,571.06*
BRYAN J. KISNER $ 40,571.06*
CHELSEA S. KISNER $ 40,571.06*
Total $ 201,855.32
* each heir will be credited with having received a $6,000.00
distribution
PROOF OF PUBLICATION OF NOTICE
IN CUMBERLAND LAW JOURNAL
(Under Act No. 587, approved May 16, 1929), P. L.1784
COMMONWEALTH OF PENNSYLVANIA
ss.
COUNTY OF CUMBERLAND
Lisa Marie Coyne, Esquire, Editor of the Cumberland Law Journal, of the County and
State aforesaid, being duly sworn, according to law, deposes and says that the Cumberland Law
Journal, a legal periodical published in the Borough of Carlisle in the County and State aforesaid,
was established January 2, 1952, and designated by the local courts as the official legal
periodical for the publication of all legal notices, and has, since January 2, 1952, been regularly
issued weekly in the said County, and that the printed notice or publication attached hereto is
exactly the same as was printed in the regular editions and issues of the said Cumberland Law
Journal on the following dates,
V1Z:
DECEMBER 10, 17 ,24, 2004
Affiant further deposes that he is authorized to verify this statement by the Cumberland
Law Journal, a legal periodical of general circulation, and that he is not interested in the subject
matter ofthe aforesaid notice or advertisement, and that all allegations in the foregoing
statements as to time, place and character of publication are true. '
Kisner, Wayne E.. dec'd.
Latc of Mechanicsburg.
Personal Representative: Jeffrey
W. Kisner, 202 West Green Street,
Shiremanstown. PA 17011 and
Janet G. Harman, 5803 Stephens
Crossing, Mechanicsburg, PA
17050.
Attomey: Thomas D. Gould, Es-
quire, 2 East Main Street, Shire-
rnanstown, FA 17011.
SWORN TO AND SUBSCRIBED before me this
24 day of DECEMBER 2004
~,l.~
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~
PROOF OF PUBLICATION
State of Pennsylvania, County of Cumberland
Tammy Shoemaker, Classified Sales Mana~, of The Sentinel, of the County and State
aforesaid, being duly sworn, deposes and says that THE SENTINEL, a newspaper of
general circulation in the Borough of Carlisle, County and State aforesaid, was
established December 13th, 1881, since which date THE SENTINEL has been regularly
issued in said County, and that the printed notice or publication attached hereto is
exactly the same as was printed and published in the regular editions and issues of
THE SENTINEL on the following date(s
December 01, 08, 15, 2004
COPY OF NOTICE OF PUBLICATION
NOTICE
NOTICE IS HEREBY GIVEN that letters of testamentary
have been granted to Jeffrey W. Kisner and Janet G
Harman In the estate of WAYNE E. KISNER late Of'
Mechanicsburg, Cumberland County, Pennsylvania,
who d,ed on October 8, 2004. All persons indebted to the
said estate are required to make payment, and those
haVing claims or demands to present the same without
delay to Jeffrey W. Kisner and Janet G. Harman
Personal Representatives, c/o Thomas D. Gould
EsqUire, 2 East Main Street, Shiremanstown '
Pennsylvania 17011. '
Thomas D. Gould, Esquire
2 East Main Street
Shiremanstown, PA 17011
Affiant further deposes that he/ she is not
interested in the subject matter of the
aforesaid notice or advertisement, and that
all allegations in the foregoing statement
as to time, place and character of
pub ication are true.
. {)vYV\
Sworn to and subscribed before me this
15th day of December, 2004
0-
l /UtJ-b/,'"T
'y: I . 1 /'~t j
,/J L-l/( -IX. j
Notary tublic
My commission expires: (! /(/15';-
COMMONWEALTH OF PENNSYLVANIA
I Notarial Seal
! Chnstina L. Wolfe, Notary Public
i Cariisle BOfO, Cumberland County
My Commission Expires Sept 1, 2008
Member. Penos,!lvani3 Association Of Notaries
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
'I:NHERITANCE TAX
STATEMENT OF ACCOUNT
" .
. ,,(1
~ L! ~
REV-1607 EX AFP (03-05)
""'i:!
Lic
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
09-18-2006
KISNER
10-08-2004
21 04-1026
CUMBERLAND
101
WAYNE
E
THOMAS D GOULD ESlf'
2 E MAIN ST
SHIREMANSTOWN PA 17011
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
CUT ALONG THIS LINE
NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment.
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
REV-1607 EX AFP (03-05)
---------------------------------------------------------------------------
--+ RETAIN LOWER PORTION FOR YOUR RECORDS
+-
~~~ INHERITANCE TAX STATEMENT OF ACCOUNT ...
ESTATE OF KISNER WAYNE E FILE NO. 21 04-1026 ACN 101 DATE 09-18-2006
THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW
IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 08-23-2006
PRINCIPAL TAX DUE: 10,623.43
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
03-15-2006 CD006437 407.09- 12,679.29
08-29-2006 REFUND .00 1,648.77-
TOTAL TAX CREDIT 10,623.43
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
If IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REflECTED AS A "CREDIT" (CRJ,
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. J
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I hereby cef1Ify that written notice of the fiUng of this
Statement of Proposed DI8tJ1butIon. and of the date.
time and place when the 88Rl8 wi! be preeented to
the Court fa' Wllh_.!!.1o. J and d I1e IMt ~ to file
written objectIonI to Itid fAllla....' d Proposed
Di8lrIbution. has been gillen to fINefY unpMI claimant
and to evety other person IInown to the accountant to
have or cteim an Intere8lIn the 8III8Ie _ oredIklr.
beneflclary. heir 01' next of kin.
A copy of said Statement was Included with the notice.
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IN THE MATTER OF THE ESTATE
OF WAYNE E. KISNER,
DECEASED
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. 21-04-1026
STATUS REPORT UNDER 6.12
Pursuant to Rule 6.12 of the Supreme Court Orphan's Court
Rules, I report the following with respect to completion of the
administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes
x
No
2.
I f the
answer
lS
no,
state when
the personal
representative reasonably believes that the administration will be
complete: N/A
3. If the answer to No. 1 is yes, state the following:
a. Did the personal representative file a final account
with the court?
Yes
x
No
b. The separate Orphan's Court No. (If any) for the
personal representative's account is: N/A
c. Did the personal representative state an account
informally to the parties in interest? Yes
No
x
d. Copies of receipts, releases, joinders and approvals
of formal or informal accounts were filed with the Clerk of the
Orphans' Court.
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Ct.::: : J i J c_;
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Thomas D. Gould
Attorney for Co-Executors
LD. # 36508
2 East Main Street
Shiremanstown, Pa 17011
(717) 731-1461
Da t e: . &i S, 241.,'
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