HomeMy WebLinkAbout04-1041 Register of Wills of Cumberland COUII~, Pennsylvania
PETITION FOR GRANT OF LETTERS
_Carole H. Harris
_, o~¢,~ ~ So~i.I Secu,-~y No, 208-24-0637
(COMPLLeTE IN ~LL CA$(?qO A~taeh addki~nal:mhem~, i ~.
or~l~e~eM 3 Du~ Circle Me a~' 17~ ~rM~a~
, ~r, a~ ~pal~)
O~,~n.. 7~..md~,~ 10-29-04_._at 3 Dubs C~e~han~c~bur~. PA 17050
O~ at ~m~ ow~ p~ w~ ~Unmled vab.s as fol~: (Loca~n) -
rem, RW-1 (l~dl)
Oath of Personal Representative
Cumberland
2004
hereby g~n~l to Candace A. Verrecchio
August 24, 1993
fi[ed of re~rd'a~ ~e hst ~fi of Decede~
ttomo~: Mark K. Emer~;~ Esquire ' ~/~//
LO. No: 72787
~dd,ess: -~l~ ~e~C~JlCL~S t r e e t
Harrisburg, PA 17101
?'mP~:.. (717) 238-9883
Form
his is to certify that the intbrmation here given is correctly copied from an original certificate of death duly filed with me as
Local Registrar. Thc original certificate will be forwarded to the State Vital Records Office fbr permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00 ,~
P 10686981
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5-26-193 r. Paletine IL
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3 Dubs Circle ~ctu~
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
z. Female ~.208 -- 24 ' 0637
Mechanicsburg PA 17050
A. Heckmiller
White
Circle
LAST WILL AND TESTAMENT
OF
CAROLE H. HARRIS
KNOW ALL MEN BY THESE PRESENTS, that I, CAROLE H.
HARRIS, presently residing
Cumberland, Cumberland
health and of sound
declare, and publish this
hereby revoking all former wills and
heretofore made by me at any time.
at 35 Drexel Place, New
County, Pennsylvania, being in good
and disposing memory, do hereby make,
I. Payment of Expenses: I direct
as my Last Will and Testament,
codicils~¥ ~ thereto
PAYMENT OF EXPENSES
that my Executrix,
hereinafter named, shall have the power, but not the duty, to
pay all my just debts, expenses of my last illness, and
funeral expenses from my estate as soon after my decease as
shall be found convenient.
REMAINS
II. I direct that my remains be cremated and that my
ashes be dispersed or disposed of in an appropriate manner at
the discretion of my daughter, SUSAN C. KISTLER.
1
GIFTS
III. Personal and Household Effects: I bequeath my
automobile, household and all other personal effects and
other tangible personalty of like nature (not including cash
or securities), together with any existing insurance thereon,
to my beloved children living at the time of my death, to be
divided among them as nearly equal in value as possible by my
Executrix, in her sole discretion, after taking into account
any preferences which any of my children may express.
IV. Residuary Estate:
A. I give, devise and bequeath the rest, residue and
remainder of my estate, whether real, personal or mixed, and of
any nature whatsoever and wherever situated, unto my beloved
children, SUSAN C. KISTLER, CANDACE A. VERRECCHIO, GUY W.
KISTLER, JR. and SCOTT A. KISTLER, in equal shares.
B. In the event that any of my said children shall have
predeceased me or shall not be living at the time of
distribution of his or her share of my residuary estate, said
share shall be divided among his or her then living siblings.
- 2 -
FIDUCIARIES
V. Executrixs:
appoint my daughter,
this, my Last Will and Testament.
daughter shall predecease me, or
act as Executrix, then I nominate,
daughter, SUSAN C. KISTLER, as
and Testament. All references
applicable to said substitute
I hereby nominate, constitute and
CANDACE A. VERRECCHIO, as Executrix of
In the event that my said
be unwilling or unable to
constitute and appoint my
Executrix of this my Last Will
to Executrix herein shall be
Executrix. No Executrix or
substitute Executrix shall be required to give bond.
ADMINISTRATIVE PROVISIONS
VI. Management Provisions: My Executrix shall have, in
addition to the powers and authority conferred upon her by
law, the following additional powers and authority:
A. Sell/Lease: To sell at public or private sale,
exchange, lease, mortgage or pledge any property, real or
personal, at any time constituting a portion of my estate,
and upon such terms and conditions as the Executrix shall
deem wise.
B. Invest: To invest any money at any time in such
3
bonds, stocks, notes, real estate, mortgages, life insurance,
annuities or other securities, or such property, real or
personal, as the Executrix shall
limited by any statute or rule of
deem wise, without being
law regarding investments
by an Executrix.
C. Retain: To retain, without incurring any liability,
as investments, any property owned by me at the time of my
death, as long as she deems it wise, and even though such
property is not the kind of property an Executrix would
purchase as an investment~ and even though to retain such
property might violate sound diversification principles.
D. Title to Property: To cause any security or other
property which may at any time constitute a portion of my
estate to be issued, held or registered in the Executrix's
own name, or in the name of a nominee, or in such form that
title will pass by delivery.
E. Capital Changes: To consent to the reorganization,
consolidation, readjustment of the financial structure, or
sale of the assets of any corporation or other organization,
the securities of which constitute a portion of my estate,
and to take any action with reference to such securities
which, in the opinion of the Executrix, is necessary to
obtain the benefit of any such reorganization, consolidation,
readjustment or sale, to exercise any conversion privilege or
6 -
subscription right given to her as the owner of any
securities constituting a portion of my estate; to accept and
hold as a portion of my estate securities resulting from any
such reorganization, consolidation, readjustment, sale,
conversion, or subscription.
F. Expenses of Estate: To pay all costs, taxes, charges
and expenses in connection with the administration of my
estate.
G. Allocate: To determine what is "Income" and what is
"Principal" hereunder, and her decision thereon shall be
final~ and to purchase securities at a premium or discount,
and to apply or charge said premium or discount against
income or principal as the Executrix may determine.
H. Borrow: To borrow money from any person, firm or
corporation, for the purpQse of protecting and preserving or
improving my estate hereunder; to execute promissory notes or
other obligations for amounts so borrowed.
I. Employ: To employ legal counsel, accountants,
brokers, investment advisors, custodians, managers and other
agents and employees and to pay them reasonable compensation
out of the funds held hereunder to which said compensation is
attributable.
J. Other: To do all other acts in the Executrix's
judgment necessary or desirable for the proper and
advantageous management, investment and distribution of my
estate.
VII. Protective Provision: To the greatest extent
permitted by law, before actual payment to a beneficiary no
interest in income or principal shall be (i) assignable to a
beneficiary or (ii) available to anyone having a claim
against a beneficiary.
VIII. Death Taxes: I direct that all transfer and
inheritance taxes, state or federal, assessed because of my
death, whether the funds, property or insurance proceeds to
which such taxes are attributable pass under this will or
not, shall be paid out of my residuary estate; that my
Executrix pay, or provide for payment of all such taxes at
such time, or times, and in such manner as my Executrix deems
best.
IX. Tax Options: I authorize my Executrix:
A. Death Taxes: To exercise any options available in
determining and paying death taxes in my estate, and to
allocate my generation-skipping tax exemption;
B. Income Taxes: To join in the filing a joint income
tax return if such would be appropriate.
IN WITNESS WHEREOF, I, CAROLE H. HARRIS, The Testatrix
of this, my Last Will and Testament, typewritten on eight (8)
sheets of paper which I have identified at the bottom of each
page by my
day of
signature, hereunto
set my hand and seal this
, 1993.
CAROLE H. HARRIS
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
We Joseph G. Skelly and Nancy L. Loper ,
and Melissa K. Basehore , the witnesses whose names are
signed to the attached or foregoing instrument, being duly
qualified according to law, do depose and say that we were
present and saw Testatrix sign and execute the instrument as
her Last Will and Testament; that she signed willingly and
that she executed it as her free and voluntary act for the
purposes therein expressed; that each of us in the hearing
and sight of the Testatrix signed the Last Will and Testament
as witnesses; and that to the best of our knowledge that
Testatrix was at that time eighteen or more years of age, of
sound mind and under no constraint or undue influence.
Sworn or affirmed to and subscribed to before me by
Joseph G. Skelly and Nancy L. Loper and
Melissa K. Basehore , witnesses, this 24th day of
August , 1993.
(SEAL)
The preceding instrument consisting of this and seven
(7) other typewritten pages, each identified by the signature
of the Testatrix, CAROLE H. HARRIS, was on this day and date
thereof signed, published and declared by, CAROLE H. HARRIS,
the Testatrix therein named, as and for her Last Will and
Testament, 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.
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
I, CAROLE H. HARRIS, Testatrix whose name is signed to
the attached or foregoing instrument, having been duly
qualified according to law, do hereby acknowledge that I
signed and executed the instrument as my Last Will and
Testament; that I signed it willingly; and that I signed it
as my free and voluntary act for the purposes therein
expressed.
CAROLE H. HARRIS
Sworn or affirmed to and acknowledged before me,
CAROLE H. HARRIS, the Testator, this 24th day of
August , 1993.
by
(SEAL)
N6tary Public
The Law Offices of
MARK K. EMERY
410 NORTH SECOND STREET
HARRISBURG, PA 17101
(717) 238-9883
CERTIFIED TRUE COPY
AITORNEY FOR
IN RE:
IN THE COURT OF COMMON PLEAS
ESTATE OF CAROLE H. HARRIS
DECEASED
OF CUMBERLAND COUNTY
ORPHANS' COURT DIVISION
: NO. 1041 OF 2004
CERTIFICATE OF NOTICE UNDER RULE 5.6(a)
NAME OF DECEDENT:
DATE O1~ DEATH:
Carole H. Harris
October 29, 2004
To the Register:
I certify that notice of estate administration required by Rule 5.6(a) of the Orphans' Court
Rules was served on or mailed to the following beneficiaries of the above-captioned estate on
December 2, 2004.
Name
1. Susan C. Kistler
Address
5900 Arlington Avenue, #3G
Riverdale, New York, 10471
2. Scott A. Kistler
2325 A. Street
Forest Grove, Oregon 97116
Guy W. Kistler, Jr.
3 Oak Grove Circle
Wichita Falls, Texas 76310
Candace A. Verrecchio
3 Dubs Circle
~t.~ ,, ~ vho ' 17050
M~,m~csburg, Pem~s~,.
Notice has been given to all persons entitled thereto under Rule 5.6(a) except:
Respectfully submitted,
LAW OFFICES OF MARK K. EMERY
Mark K. Eme~e
Supreme Court No. 72787
410 North Second Street
Harrisburg, PA 17101
(717) 238-9883
Date: December 2, 2004
N/A
Counsel for Personal Representative
LAW OFFICES OF MARK K. EMERY
410 North Second Street
Harrisburg, PA 1710 I
(717) 238-9883
Mark K. Emery, Esquire
Fax (717) 238-9884
e-mail memerylaw@aol.com
January 27,2005
Register of Wills }
Cumberland County Courthouse 0' L/ I 0+
One Courthouse Square '1
Carlisle, PA 17013-3387
Via UPS
RE: Estate of Carole H. Harris
No. 1041-2004
Dear Sir or Madam:
Enclosed please find a check in the amount of $13,000.00 payable to
Register of Wills, Agent, as payment of Inheritance Taxes at a discount. Please
return an official receipt to me in the enclosed self-addressed, stamped
envelope.
Should you have any questions, please contact me. Thank you.
Very truly yours,
LAW OFFICES OF MARK K. EMERY
MKE/vh
enclosure
F28"'~
By:~~~ ...-/
Mark K. Emery
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COMMONWEALTH OF PENNSYLVANIA
DEPA"lTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT,280601
HARRISBURG. PA 17128-0601
REV-1162 EX{11-96l
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
EMERY MARK K ESQUIRE
410 N 2ND STREET
HARRISBURG, PA 17101
----~--- fold
ESTATE INFORMATION: SSN: 208-24-0637
FILE NUMBER: 2104-1041
DECEDENT NAME: HARRIS CAROLE H
DATE OF PAYMENT: 01/28/2005
POSTMARK DATE: 01/27/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 10/29/2004
NO. CD 004897
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $13,000.00
I
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TOTAL AMOUNT PAID:
$13,000.00
REMARKS:
CHECK#104
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
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'* COMMONWEALTH OF
PENNSYLVANIA
, DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USL ONL\
FILE NUMBER
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COUNTY CODE YEAR NUMBER
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DECEDENT'S NAME (LAST, FIRST. AND MIDDLE INITIAL)
Harris, Carole H.
DATE OF DEATH (MM-DD-YEAR) jDATE DF BIRTH (MM-DD-YEAR)
10-29-04___~26-33
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
SOCIAL SECURITY NUMBER
1208 - 24 - 0673
____.___.._.._n __
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
___n_.. '_'_ __.,.___,.__,,_____ __
I SOCIAL SECURITY NUMBER
D 3, Remainder Return (da!e ofdealh prior 10 12-13--82)
o 5, Federal Estate Tax Return Required
B. Total Number of Safe Deposit Boxes
D 11. Election to tax under Sec. 9113(A) {AllachSch0)
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NAME
Mark K. Emery. Esquire
FIRM NAME (If Applicable)
j,.aw Offic~of,Mark K." EmerL__
TELEPHONE NUMBER
(717) 238-9883
COMPLETE MAILING ADDRESS
410 North Second
Harrisburg, PA 17101
(1) None
(2) None
(3) None
(4) None
(5) $263,441. 86
(6) None
(7) $ 53,460.55
(8) $316,902.41
(9) $ 14,981.00
(10) $ 2,160.46
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[i) 1. Original Return
o 4. Umiled Estate
[KJ 6. Decedent Died Testate (ANach copy of WiW)
o 9. litigation Proceeds Received
o 2. Supplemental Return
o 4a. Future Interest Compromise Ida\il Gl1lealh llfIe! 12-i2-82)
o 7. Decedent Maintained a Living Trust (Attach copy of Trust)
o 10. Spousal Poverty Credit (dale of death be1ween 12-31-91 and 1-1-95)
(II) $ 17. 141. 46
(12) $299.760.95
(13) None
(14) $299,760.95
$ 13,489.24
(19)
$ 13,489.24
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1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mongages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & MisceUaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7_ Inter-VIVos Transfers & Miscellaneous Non.Probate Property
(Schedule Gorl)
B. Total Gross Assets (total lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to lax has not been
made (Schedule J)
14, Net Value Subject to Tax (Line 12 minus line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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15. Amount dUne 14 taxable ;lllhe spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
~292.L760~~__ ,0_ (15)
____ , .04.5.. (161
16. Amount of Une 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
, .12 (171
18. Amount of Une 14 taxable at collateral rate
x .15 (18)
19, Tax Due
200
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Decedent's Complete Address:
STREET ADDRESS b' 1
'-.____~D~---.c:J.rc~__________. _ __ ____________
Mechanicsburg
---..------r--.....----.J7iD .' -.
STATE PA I ZIP-i7050-
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Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Pnor Payments
C. Discount
(1) $ 13.699.33
_!_12~_ill)Jl...O 0
..1... 699.33
Total Credits (A + B + C) (2)
3. InteresVPenalty if applicable
D. Interest
E. Penalty
4.
Totai InteresVPenalty ( 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
210.09
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 01 Line 5 + 5A. This is the BALANCE DUE,
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:
a. retain the use or income of the property transferred;.............
lliI 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.
Yes
......................................0
b. retain the nght to designate who shall use the property transferred or its income; ............................................ 0
c. retain a reverSionary interest; or............................................. ..................... ...................................................... 0
d. receive the promise for life of either payments, benefits or care? ........"............................................................ 0
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate tonsiderat\on? ........................ ..................,................... ......................
3. Did decedent own an 'in trusl for' or payabie upon death bank account or secunty al his or her death?
4. Did deredent own an lndividual Retirement Acx:ount, annuity, or other non-probate property which
contains a beneficiary designation? .......................................... ........................."... .................
..0
.0
No
iii
iii
[XJ
iii
[XJ
[XJ
Under pena\\ies of peljury, I declare !hat I have examined this return, including accompanying schedules and statements, and to the best of my krlOwIedge and belief, it is !rue, correct
and complete.
Dedaralion of pr8pa1'8l' other lhan the personal representative is based on all infonnation of which preparer has any knowledge.
S~NATU'JllfflHEJ~O?5~7J J'JJU.~-.
ADDRES~~'
_____1 Dubs__Ci!,cle ,_l'!~c:hanic:s.l2u:r:g.u 1'1\, . 17050
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
~rE II.
~/IJO/&J()S
-----
DATE
ADDRESS
For dales 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%
[12 P.S. 99116 (a) (1.1) (i)].
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 ) (ii)].
The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of as~ Nen if
the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000: n .(\ p j)
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to cUt \--\' - )arent.
or a stepparent 01 the chiid Is 0% [72 P.S. 99116(a)(1.2)].
The tax rate imposed on the net value of transfers 10 or for the use of the decedent's lineal beneficiaries is 4.5%, except as nc
The tax rate imposed on the net vatue of transfers to or for Ihe use of the decedent's siblings is 12% [12 P.S. 99116(a)(
individual who has at least one parent in common with the decedent, whether by blood or adoption.
as an
REV-1508 EX+ (&.98)
..
COMMONINEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISe.
PERSONAL PROPERTY
Carole H. Harris
FILE NUMBER
21-04-1041
ESTATE OF
lndude the proceeds of litigation and the date the proceeds were received by the estate.
AU property jointty-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
1.
50% of joint checking
Account #8130155636
account - PSECU
See attached statement
October, 2004
$ 14,396.06
2. Money Market Account - Openheimer $244,701.80
Account #200 2001382001 See attached letter of
Kaufman Financial Services
3. Miscellaneous personal property (Decedent lived $ 1,000.00
with daughter and funds obtained through 1iquidatio~
of assets before death were placed in account
identified as Item 1 above.)
4.
Refund of 2004 tax return
(See attached 1040)
$ 3,344.00
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert addilional sheets of the same size)
263,441.86
PSEO~
Pennsylvania State Employees Credit Union
II II /I "'
P.O. Box 67013 (717) 234-B484 (Harrisburg)
Harrisburg, PA 171 06-7013 (800) 237-7328 (Nationwide)
website - h"p://www.psecu.com
BUY YOUR HOLIDAY GIFTS WITH
FINANCIAL PEACE OF MIND.
USE YOUR PSECU VISA CARD.
CAROLE H HARRIS
JOINT OWNER
SUSAN C KISTLER
PAGE 2
MeMBER'N~
POST
1001
1031
EFF DESCRIPTION BALANCE
tD 01 REGULAR SHARES BEGINNING BALANCE 1011.09
PAYMENT, DIVIDEND 0.750% 108,16
ANNUAL PERCENTAGE YIELD EARNED 0.77% FROM 10/01/04 THROUGH 10/31/04
BASED ON AVERAGE DAILY BALANCE OF 108.09
ENDING BALANCE 108.16
DIVIDEND YTD, YEAR TO DATE 182,72
1031
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. .:----, ':,''''''- -:oo- .,_:.,,__:__,_ ',"-::':.:::':,- .;oo__::"": -::,_, ',:':",-: .'-::"""":,:::-,:."':0"". '-:,,:"':0"-:: _, ,,''''''''__ n.
!:::==::::!:d#:::i:===~;:~=i::i:i:i:i:=-====;i;;:i:;==l'==:#======:;::=::i,=#;;!,==::i:i:';==:;;:=~===::;==:::i::====~=::;:======:;=i::=====~::i:i==:i:!;!,=,*==
. n_ __ _ ',: __n__,___"::.':::" _no, "" __ '''' __ _ ',n,." _________,__.,"',."._".___.' ,..,.____,. """..n_,"''''',_"__,,,,,,,,,,,____ "...._..__ .'_______.. '" __'_ ___.....
- - - .. --- ---- ....... - - ----, -, - ,., ,,____ __"'''d'_ _ "....
POST EFF
1001
1031
DESCRIPTION
ID 02 VACATION SHARES BEGINNING BALANCE
ENDING BALANCE
DIVIDEND YTD, YEAR TO DATE
AMOUNT BALANCE
0.00
0.00
.0 00
.,=,::"",:;:::- .: ",'::
j
POST
1001
1001
1001
1001
- ,:,?,::::::':',::,>-//? :;tZ4:-4:LO::cr::,-lS'Ji:9tt.':9:4
.-::-':'::'--::;,:,:,::: :::::'-'-"-,;:::.::::::::.:.:::';::::,,:::';'::::-::::::::':'::':'::::::.::::::
:'::"":--'",,;,:,,:,,::,;,:),:,-,:}:,:,::::-:::;';::::,:,":::::;:::,:,:,';:,,,';::;::,::':
"':-:,::_::'::,:;,::::.:::,.:':'::_::::::,::'::::.-:::::':::
... .Hi'.55~151.8I.39 .........
156.57-15024.82
..1001
1004
03020001
2153659
PSE(!,gtlt;;,I.;;tc
"U< .':'.:.,.__._."UNU<......_..,'..
@@ ifWmW@}{
Hm ._,_,_,__',,"_'UUN.-.-.-.
,_'_'N ._.__._....____._._._Wu.-U.
_'_".,U .._._,__'_'_'_:'__'_'UUH,.
%~:: :;:;;::KA:'<";~::W
p.o. Box 67013 (717) 234.8484 (Horrisburg)
Horrisburg, PA 17106.7013 (800) 237-7328 (NlJ1ionwide)
website . http://www.psecu.com
BUY YOUR HOLIDAY GIFTS WITH
FINANCIAL PEACE OF MIND.
USE YOUR PSECU VISA CARD.
CAROLE H HARRIS
JOINT ONNER
SUSAN C KISTLER
PAGE 3
""""- NOM$l!Il STATeMENT p,m;
8130155636 10/31/04
0-- , "'" "
. POSTEFF
..,. 101.3 ...
1015
1019
1024
.,.. 1027 ...
.. ..1023..
n..,.,., _n ,..........
..'1029;
DESCRIPTION
PAYllENT. BY CHECK llAHD
CHECK 004353
CHECK 004354
WITHDRAWAL VIA SST TRANSFER TO LOAN 09
CHECK 004&57 . .
. . ,CHECK 004355 ..
. PAYMENT . DIRECT DEPOSP FA TREASURY. DEPT
TYPE, ANNUITANT 10: 1236003133
PAYMENT, DIVIDEND 0.250%
ANNUAL PERCENTAGE YIELD EARNED
. BASED ON AVERAGE DAILY BALANCE
,. 1031 . ENDING BALANCE ..
. ." DIVIDEND VTD, YEAR TO DATE
AMOUNT BALANCE
14760.43 Z8Z24 , 55
43.05-23176.50
105.75-28070.75
38.29-28032.46
. 1000.00-27032.46..
. 40.80:-,26991.66 .'.
1 T96. 15 28787. at ..
1031
4.86 28792.67
0.25% FROM 10/01/04 THROUGH 10/31/04
NUMBER AMOUNT NUMBER AMOUNT NUMBER AMOUNT NUMBER
004848 92.60 004851 156.57 004854 105.75 100201*
...,.. ",i:Hi~!Ri~K. NE~~: i~: Nu~ii:;tDICAT::::~~~ .I~~:;~~~R. SEQ~~:~~:: .. .,';"..
AMOUNT
90.00
----------------------------------------------------------------------------------
----------------------------------------------------------------------------------
*** ANNUAL PERCENTAGE RATE 12.900% *** PERIODIC RATE (DAILY) .035342%
CREDIT LIMIT 12,500.00 CREDIT AVAILABLE lZ,500.00
YTD FINANCE CHARGE, YEAR TO DATE 8.23
2153660
PSECL;
Pennsylvania State Employees Credit Union
" " " '"
PO Box 67013 (717) 234-8484 (Harrisburg)
Harrisburg, PA 17106-7013 (800) 237-7328 (Nationwide)
website - http://www.psecu.com
BUY YOUR HOLIDAY GIFTS WITH
FINANCIAL PEACE OF MIND.
USE YOUR PSECU VISA CARD.
CAROLE H HARRIS
JOINT OvVNEA
SUSAN C KISTLER
PAGE 4
81:i~:;~._n I nl~A:;;~D~--l
-. " " '" '" '" - --.
~===~~=~=~~====P~~==========~~~=~~===~~=~~*~==e=====?=~~~~=~~===~*==~~==~=~=~~~~~=
TOTAL DIVIDEND YTD, Yl'AR TO DATE
TOTAL YTD FINANCE CHARGE, YEAR TO DATE
226.90
8.23
n~n~nnn1
111;'2;10,.1
COffMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
*
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE NO. 21 04-1041
ACN 05105567
DATE 02-23-2005
IIH-1S<loS Hi ~H I~_nn
EST. OF CAROL H HARRIS
S.S. NO. 208-24-0637
DATE OF DEATH 10-29-2004
COUNTY CUMBERLAND
TYPE OF ACCOUNT
o SAVINGS
IX] CHECKING
o TRUST
o CERTIF .
SUSAN C KISTLER
3 DUBS CIR
MECHANICSBURG PA 17050-1655
REHIT PAYHENT AND FORMS TO,
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
PSECU has provided the De.part"ent with the information listed below which has been used in
calculating the potential tax due. Their records indicate that at the death of the above decedent, yoU were a joint owner/beneficiary of
this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a COPY
to this form and returl'\ it 'to 'the above address. lhis account is taxabll!l in accordance with thg Inheritanc9 Tax Laws of the COlllllonwealth
of Pennsylvania. Que$tions ~ay be answered by calling (717) 787-8327.
COMPLETE PART 1 BEL~W . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account "'0.
8130155636-54
Date
Established
05-29-1991
To insure proper credit to your account, two
(2) copies of this notice ~st accollpany your
pay~ent to the Register of Wills. Make check
payable to: "Register of Wills, Agent".
Account Balance 28 , 792 . 12
Percent Taxable X 50 . 000
Allount Subject to Tax 14,596.06
Tax Rate X . 045
Paten.tial Tax Due 647.82
PART TAXPAYER RESPONSE
[!J ~~.~!l!:',~~.'~!,l!~.~f'.~..~~~~~!!~~. ::..':f:!'~~r.!'~~i...:r~.,~i.:'..:.{~I:fl~.":'.:~.:.:~~:~~~~:l::~"J~m',~~m!g__
1ili.".),-.-......,..--,-.-iliiliili....,.J1~~~3m"~~.........)[!..,.,......mm."" . :w'" -". .~,., - ..~r~"mJ~~i.."'" .~~~:W~~~...,.,'_,_~.. ,-...,)~L~......-.:.,....-,-.-.-=...,..-.-.]2.._.-...-lS,..
-.-...c:.-.-.-l~'~~~H~
NOTE: If tax pay~ents are made within three
(3) months of the decedent's date of death,
YOU may deduct a 5% discount of the tax dUe.
Any inheritance tax due will become delinquent
nine (9) months after the date of death.
[CHECK ]
ONE
BLOCK
ONLY
A. 0 The above information and tax due is correct.
I. You may choose to rell!it paYllent to the Register of Wills with two copies- of this notice to obtain
a discount or avoid interest, or you May check box "A- and return this notice to the Register of
Wills and an official assess~ent will be issued by the PA Depart.ent of Revenue.
B. \J( The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
~ to be filed by the decedent's representative.
C. c=J The above information is incorrect and/or debts and deductions were paid by YOU.
You lIust cOllplete PART 0 and/or PART ~ below.
PART
@J
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
If you indicate a different tax rate, please state your
relationship io decedent:
PART
~
TAX RETURN - COMPUTATION
LINE 1. Date Established
2. Account Balance
3. Percent Taxable
4. A.aunt Subject to Tax
S. Debts and Deductions
&. Amount Taxable
7. Tax Rate
8. Tax Due
TAX ON JOINT/TRUST ACCOUNTS
OF
1
2
3
4
5
6
7
8
x
x
PAYEE
DESCRIPTION
AMOUNT PAID
I
OTAl (Enter on Line 5 of Tax ConputationJ
I
$
facts I have repor~ed above are true, correct
HOME Or'6) 0L/~ o. {:3
WORK {~\")....J J l/~ S s-'t
TELEPHONE NUM ER
and
l-
T
V -IY-OS--
DATE
KAUFMAN
FINANCIAL SERVICES
Richard A. Kaufman, ChFC, ClU
Certified Financial Planner™
1609 Lancaster Avenue
Reading, PA 19607-1543
Phone 610-775-1490
Fax 610-775-5007
www.kaufmanfinancial.com
Keith R. Kaufman
Account Executive
November 22, 2004
The Law Offices of Mark K. Emery
410 North Second Street
Harrisburg, PA 17101
Dear Attorney Emery:
Re: Estate of Carole H. Harris
I am in receipt of your letter asking for date-of-death values for the accounts I maintained
for Carole H. Harris. I am enclosing a copy of the Oppenheimer Funds September 30,
2004 statement on which I have updated the values as of 10/29/04.
At Carol's date-of-death, October 29th, her Money Market fund had an account balance
of$244,701.80. Her Quest Balanced Value Fund, which was part of her IRA, had an
account balance of $29,761.89 and her Limited Term Government Fund, which also was
part of her IRA, had an account balance of$23,698.66.
I have prepared the necessary Letter ofInstruction and Affidavit of Domicile for Candace
Verrecchio to have Carol's Money Market Fund reregistered to the Estate of Carole H.
Harris. I appreciate your providing me with two copies of the death certificate and I will
look forward to you providing me with the tax TD number for the estate as soon as
possible.
I have also begun the process of having Carol's IRA distributed to the four children who
are listed as the beneficiaries. Each ofthe children will have a separate IRA established
in their name with one-fourth of the proceeds and they will all make their own choices as
to how they would like distributions to occur.
I look forward to working with you to assist the beneficiaries of Carole H. Harris with the
settling of their estate. If there is anything you need from me, please let me know and I
will do likewise.
Richard A. Kaufman, ChF
Certified Financial Planner
u
RAK/mkl
Enclosure
FINANCIAL PLANNING. INVESTMENT SERVICES. INSURANCE. ESTATE PLANNING
SECURITIES BY LICENSED INDIVIDUALS OFFERED THROUGH INVESTAGORP, INC., A REGISTERED BROKER/DEALER, MEMBER NASD, slPe
FortheyearJanl - Dec 31, 2004, Of other tax year beginning ,2004, ending ,10 OMS No. 1545.0074
label Your first name MI lasiname Your sodal security number
(See instructions.) CAROLE H HARRIS 208-24-0637
If a joinl return, spouse's iirsl name MI laslname Spouse's social security number
Use the
IRS label.
Otherwise, Home address (number and slreet). If you have a P.O. box, see instruclions Apartment no .. Important! ..
please print
or type. 3 Dubs Circle You must enter your social
City, town or posl office. Ii you have a foreign address, see instructions. Stale ZIP code security number(s) above.
Presidential Mechanicsbura PA 17050
Form 1 040
Election
Campaign
(See instructions.)
Filing Status
Check only
one box.
Exemptions
If more than
four dependents,
see instructions.
Income
Attach Form(s)
W~2 here, Also
attach Forms
W-1G and 1099-R
if tax was withheld.
If you did not
get a W-2,
see instructions.
Enclose, but do
not attach, any
payment Also,
please use
Form 1040-V.
Adjusted
Gross
Income
DECEASED CAROLE H HARRIS 10/29/2004
Depar1ment of the Treasury - Internal Revenue Service
1(99)
IRS Use Only - Do not wrile 01 staple in this space
2004
U.S. Individual Income Tax Return
.... You Spouse
,... Note: Checking 'Yes' Will not change your tax or reduce your refund
Do you, or your spouse If filing a JOint return, want $3 to go to thiS fund? ~ Yes X No Yes
1 X Single 4 Head of household (with qualifying person). (See
2 instructions.) If the qualifying person is a child
Married filing jointly (even if only one had Income) but not your dependent, enter this child's
3 Married filing separately. Enter spouse's SSN above & full name here , ~
name here. ~ 5 0 QualifYing widow(er) With dependent child (see Instructions)
No
6a X Yourself. If someone can clajm you as a dependent, do not check box 6a
b Souse
-f-
Boxes checked
on Ga and 6b ..
No. of children
on 6c who:
. lived
with you
. did not
live with you
due to divorce
or separation
(seomstts) ._
Dependents
on 6c not
entered above .
Add numbers .1
on lines ..
above... ..
1
c Dependents:
(2) Dependent's
social security
number
(4) if
qualifying
child for child
lax credit
(see instrs)
(1) First name
Last name
(3) Dependent's
relationship
to you
n
11
d Total number of exemptions claimed
7 Wages, salaries, tips, etc. Attach Form(s) W-2
8a Taxable interest. Attach Schedule B if required
b Tax~exempt interest. Do not include on line 8a . I 8bl
9a Ordinary dividends. Attach Schedule B if required
b g~lfj~~t~~) . . . . . . . . .. ..1 9 bl
10 Taxable refunds, credits, or offsets of state and local income taxes (see Instructions)
11 Alimony received
12 Business income or (loss). Attach Schedule C or C-EZ .
13 Capital gain or (loss). At! Sch 0 if reqd. If not reqd, ck here.
14 Other gains or (losses). Attach Form 4797
15a IRA distributions. . ... .1 15al I bb Taxable amount (see instrs)
16a Pensions and annuities ....IJ!!J Taxable amount (see instrs)
17 Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E
18 Farm income or (loss). Attach Schedule F .
19 Unemployment compensation..... .
20a Social security benefits....... . .1 20al
21 other income
22 Add the am;u~tS in th; f~rri~ht C;;rumnfm lin;s-ith-;:o~ah 21: This is -YOUr total in~ome .-.:
23 Educator expenses (see instructions) . 23
24 Certain bUSiness expenses of reservists, performing artists, and fee. basis
government ofHcials. Attach Form 2106 or 2106.EZ
25 IRA deduction (see instructions) ..
26 Student loan interest deduction (see instructions) .
27 Tuition and fees deduction (see instructions)
28 Health savings account deduction. Attach Form 8889
29 Moving expenses. Attach Form 3903
30 One-half of self-employment tax. Attach Schedule SE.
31 Self-employed health insurance deduction (see instrs)
32 Self.employed SEP, SIMPLE, and qualified plans.
33 Penalty on early withdrawal of savings
34a Alimony paid b Recipient's SSN . . .. ~
35 Add lines 13 through 34.
36 Subtract line 35 from line 22. This is your adjusted gross income
7
8a
236_
9a
1. 025_
10
11
12
13
14
15b
16b
17
18
19
20b
21
22
.~D
44,089.
19.874_
13, 106. t b Taxable amount (see instrs)
11 140.
76,364.
24
25
26
27
28
29
30
31
32
33
34.
35
~ 36
76.364.
Form 1040 (2004)
BAA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see instructions.
FDIA0112 11110/04
Form 1040 (2004)
Tax and
Credits
Standard
Deduction
for -
. People who
checked any box
on line 38a or
38b or who can
be claimed as a
dependent, see
instructions.
. All others:
Single or Married
filing separately,
$4,850
Married filing
jointly or
Qualifying
widow(er),
$9,700
Head of
household,
$7,150
Other
Taxes
Payments
If you have a
qualifying
child, attach
Schedule EIC.
Refund
Direct deposit?
See instructions
and fill in 72b,
72c, and 72d.
Amount
You Owe
Third Party
Designee
Sign
H
CAROLE H HARRIS
208-24-0637
37
Page 2
76,364.
37 Amount from line 36 (adjusted gross income)
38a C.heck -r [Xl You were born before January 2, 1940, B Blind. Total boxes I
ff. _ 0 Spouse was born before January 2, 1940, Blind. checked" 38aU
1_ _ b If your spouse Itemizes on a separate return, or you were a dual-status
_ alien, see instructions and check here ~ 38b 0
_~9 Itemized deductions (from Schedule A) or your standard deduction (see left margin) .
40 Subtract line 39 from line 37
41 If line 37 is $107,025 or less, multiply $3,100 by the total number of exemptions claimed
on line 6d. If line 37 is over $107,025, see the worksheet in the instructions. .
42 Taxable income. Subtract line 41 from line 40.
If line 41 is more than Ime 40, enter -0-
Tax (see instrs). Check if any ta~ is from: a o Form(s) 8814 b 0 Form 4972 .
Alternative minimum tax (see instructions). Attach Farm 6251
Add lines 43 and 44
Foreign tax credit. Attach Form 1116 if required
Credit for child and dependent care expenses. Attach Form 2441
Credit for the elderly or the disabled. Attach Schedule R
Education credits. Attach Form 8863
39 6,050.
40 70,314.
41 3,100.
42 67,214.
43 9,132.
44
45 9,132.
43
44
45
46
47
48
49
50
51
52
53
54
.........
~
46
47
48
49
50
51
52
53
Retirement savings contributions credit. Attach Form 8880
Child tax credit (see instructions)
Adoption credit. Attach Form 8839 ........,
Credits from: a D Form 8396 b 0 Form 8859 .
Other credits. Check applicable box(es): a 0 Form 3800
b 0 Form c DSpecify
8801
55 Add lines 46 through 54. These are your total credits
56 Subtract line 55 from line 45. If line 55 is more than line 45, enter -0.
57 Self-employment tax. Attach Schedule SE
58 Social security and Medicare tax on tip income not reported to employer. Attach Form 4137 .
59 AddItional tax on lRAs, other Qualified retirement plans, etc. Attach Form 5329 if required.
60 Advance earned income credit payments from Form(s) W-2
61 Household employment taxes. Attach Schedule H .
62 Add lines 56-61. This is your total tax
63 Federal income tax withheld from Forms W-2 and 1099
L 64 2004 estimated tax payments and amount applied from 2003 return
65 a Earned income credit (EIC) . . . . . . . . . . _ .
1 b Nontaxable combat pay electIOn. . . . . ~l 65 bl
I 66 Excess socia! security and tier 1 RRTA tax withheld (see instructions). 66
67 Additional child tax credit. Attach Form 8812 . , . .. . .. . . . .. 67
68 Amount paid with request for extension to file (see instructions) 68
69 other pmts from: a 0 Form 2439 b D Form 4136 c 0 Form 8885 69
70 Add lines 63, 64-, 65a, and 66 through 69.
These are your total payments . , . . . . . . . . . . . . .
71 If line 70 IS more than line 62, subtract line 62 from line 70. This is the amount you overpaid.
72a Amount of line 71 you want refunded to you
~ b Routing number. . . . . . . .lxxxxxxXXX I ~ C Tvpe: . h ~h~~~I~~ .
~ d Account number ...... .lXxxxxxxXXXXXXXXXX I
73 Amount of line 71 you want applied to your 2005 estimated tax . . . . . . . . ~I 73 I
74 Amount you owe. Subtract line 70 from line 62. For details on how to pay, see instructions ..........
75 Estimated tax oenaltv (see instructions) ...........,........1 75 I
Do you want to allow another person to discuss this return with the IRS (see instructions)?
54
55
~ 56
57
58
59
60
61
~ 62
9,132.
.....
9,132.
63
64
65.
2,176.
10,300.
~ 70
71
72a
12,476.
3,344.
3,344.
~
o Savings
..... ~ 74
,. . .. ~ Yes. Complete the following. UNo
DeSignee's Phone Personal identification
name ~ Preparer no. ~ number (PIN) ~
Un~er penalties of periury, I declare that I have examined this retum and accompanying schedules and statements, and to lhe best of my knowledge and
belief, fhey are true, correc!' and complete. Declaration of preparer (other than taxpayer) IS based on aU information of which preparer has any knowledge
ere Your signature Date Your occupation Daytime phone number
Joint return?
See instructions. ~ Retired (717) 774 5797
Keep a copy Spouse's signature. If a joint refurn, both must sign. Date Spouse's occupation
for your records. ~
I,D'" 51 Preparer's SSN or PTiN
Preparer's ~ 02/18/2005 Check if self-employed Qi] POO112558
Paid signature
Preparer's Firm's name Kaufman Advisorv Services, Ine
Use Only (or yours if ~
self.employed) 1609 Lancaster Avenue EIN 23-2299053
address, and ,
ZIP code Readlnq PA 196071543 Phone no. (610) 775 1490
Form 1040 (2004)
FD1AOl12 11110/04
REV.1510 EX+ (6-98)
'*
COMMO~LTH OF PENNSY\..VANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
Carole H. Harris
FILE NUMBER
21-04-1041
ESTATE OF
This schedule must be completed and filed if the answer to any 01 questions 1 through 4 on lhe reverse side of the REV.1500 COVER SHEET is yes
ITEM
NUMBE'
1.
DESCRIPTION OF PROPERTY
lNCLUOE* tw.IE I:lF MlMNSFEREE, 1HEIR R8.ATlONSHlP TO OECalEHT ANO
T1-lE~OFTRANSFER. ATTACH A copy OF * OEEO FORREAlES1""TE.
DATE OF DEATH % OF DECO'S EXCLUSION
VALUE OF ASSET INTEREST II"''''''''''
TAXABLE
VALUE
$ 53,460.55
Oppenheimer Funds IRA 3,460.55 100
Transferred in equal amounts (25%) to
children of Decedent: Candace A.
Verrecchio, Susan C. Kistler, Guy w.
Kistler and Scott A. Kistler. See
attached letter of Kaufman Financial
Services setting forth value of date
of death.
TOTAL (Also enter on line 7 Recapitulation) $ 53, 460. 55
(If ffiOI'e space is needed, insert additional sheets of lhe same size)
REV-1511 EX+ 112-99)*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Carole H. Harris
FILE NUMBER
21-04-1041
Debts of decedent must be reported on Schedule 1.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
,. Food and refreshments during funeral $ 3,102.00
B. ADMINISTRATIVE COSTS:
,. Personal Representative's Commissions
Name 01 Personal Representative(s) Candace A. Verrecchio $ 6,000.00
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address 3 Dubs Circle
City Mechanicsburg Stale~Zip 17050
Year(s) Commission Paid: 2005
2. Attorney Fees $ 5,000.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City Stale_Zip
Relationship of Claimanllo Decedent
4. Probate Fees $ 629.00
5. Accountant's Fees $ 250.00
6. Tax Return Preparer's Fees
7.
TOTAL (Also enter on line 9, Recapitulation) $14,981.00
(If more space is needed, insert additional sheets of the same size)
REV-1512 EX+ (12.m)
..
COMMONWEALTH OF PENNSYlVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF
Carole H. Harris
FILE NUMBER
21-04-1041
Report debts Incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses,
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
Cremation Society $ 40.00
2. Reimbursement to State Employees Retirement
system for overpayment. See attached reciept $ 2,060.46
TOTAL (Also enteron line 10. Recapitulalion) $
(It more space is needed, insert additional sheets of the same size)
$ 2,160.46
c;;
. ~~~?~1r~~~~t';:;7'e~~:~___:tt.;;r~,i4~'"'fd~~t:~~~;.t~e- -"""'f"~~":~_,,-~" -:;- ~ "" ~,:;-"~
Ii:;
ESTATE OF CAROLE H. HARRIS
CANDACE A. VERRECCHIO EXE~
3 DUBS CIRCLE
MECHANICS8URG, PA 17050
103
~..) (', jll /irrv:; 60.8111/231.3
_-;-__(:1.1 I ~L..-", (j,LL.A-J,....j
I -, ) -DAlE
, $ dC(;;{), ifG
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COMMON'NEALrn OF PENNSYlVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
FilE NUMBER
21-04-1041
NUMBER
I
Carole H. Harris
NAME AND ADDRESS OF PERSON(S} RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS pndude outright spousal distributions, and transfers under
Sec. 9116 (al (12))
A. Candace A. Verrecchio
3 Dubs Circle
Mechanicsburg, PA 17050
B. Susan C. Kistler
5900 Arlington Avenue, #3G
Riverda1e, NY 10471
C. Guy W. Kistler, Jr.
3 Oak Grove Circle
Wichita Falls, TX 76310
D. Scott A. Kistler
2325 A Street
Forest Grove, OR 97116
RELATIONSHIP TO DECEDENT
Do Not llst Trustee(s)
AMOUNT OR SHARE
OF ESTATE
Daughter
25%
Daughter
25%
Son
25%
Son
25%
ENTER DOLlAR AMOUNTS FOR DISTRIBUTiONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II NON. TAXABLE DISTRIBUTIONS:
A SPOUSAL OISTRIBIJHONS UNDER SECTiON 9113 FOR WHiCH AN ELECTiON TO TAX is NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11- ENTER TOTAL NON.TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
{If mote space is needed, Insert addllJonal sheets of the same size)
LAW OFFICES OF MARK KEMERY
410 North Second Street
Harrisburg, PA 17101
(717) 238.9883
Mark K. Emery, Esquire
Fax (717) 238-9884
e-mail memerylaw@aol.com
July 29, 2005
Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013-3387
RE: Estate of Carole H. Harris
No. 1041-2004
Dear Sir or Madam:
Enclosed please find an original and one copy of a Family Settlement
Agreement. Kindly file the original, time-stamp the copy and return it to me. I
also enclose a check for $20.00 for filing fees.
I also enclose an original and one copy of a Status Report Under Rule
6.12. Please file the original, time-stamp the copy and return it to me.
Should you have any questions, please contact me. Thank you.
Very truly yours,
LAW OFFICES OF MARK K. EMERY
MKE/vh
enclosures
By: /~~-~
Mark K. Emery .. ;i'~
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IN RE: ESTATE OF
CAROLE H. HARRIS, DECEASED
: IN THE COURT OF COMMON PLEAS
: CUMBERLAND COUNTY, PENNSYLVANIA
: ORPHANS' COURT DIVISION
: NO 1041-0F-2004
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FAMILY SETTLEMENT AGREEMENT
THIS AGREEMENT, made this 29th day of July, 2005,
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WITNESSETH:
THE CIRCUMSTANCES leading up to the execution of this Agreement are as follows:
I. Carole H. Harris (the "Decedent"), died testate on October 29,2004, and Candace
A Verrecchio duly qualified as Executor (the "Executor") of her probate estate
(the "Estate").
2. Article IV of the Decedent's Last Will and Testament (the "Will") provides in
pertinent part as follows:
IV: I give, devise and bequeath the rest, residue and remainder of my
estate, whether real, personal, or mixed and of any nature whatsoever and
wherever situated, unto my beloved children, SUSAN C. KISTLER, CANDACE
A VERRECCHIO, GUY W. KISTLER, JR., and SCOTT A. KISTLER, in equal
shares.
3. The Decedent's children, Susan C. Kistler, Candace A. Verrecchio, Guy W.
Kistler, Jr., and Scott A. Kistler (collectively, the "Beneficiaries") all survived her.
The Beneficiaries desire the Executor to settle the Estate informally in order to
avoid the expense and delay involved with the formal adjudication of a First and
---
~
Final Account by the Orphans' Court Division fo the Court of Common Pleas of
Cumberland County, Pennsylvania (the "Court").
4. The Beneficiaries desire to settle and compromise any and all claims and rights
which they may possess, now or hereafter, in the Estate and to confirm their
acceptance of the Informal Account (the "Account"), attached hereto as Exhibit
"A" and incorporated herein by this reference, and the Schedule of Proposed
Distribution to Beneficiaries (the "Schedule"), attached hereto as Exhibit "B" and
incorporated herein by this reference. The Beneficiaries desire that the
distributions to them, as set forth on the Schedule, be in full satisfaction of their
rights in the Estate.
5. The Beneficiaries wish to release the Executor and to indemnify her against any
and all claims that may be asserted against the Estate or the Executor after the date
hereof.
6. The Executor is willing to settle the Estate informally in consideration of the
indemnifications hereinafter provided by the Beneficiaries.
7. The Beneficiaries acknowledge and accept that no disbursement shall be made
hereunder until all named Beneficiaries execute their Consent to Family
Settlement Agreement and return such to the executor or the Estate's counsel, and
hereby waive any time limit for distribution upon execution and return of their
individual Consents.
NOW THEREFORE, in consideration of the foregoing and intending to be legally bound,
jointly and severally, the Beneficiaries, for themselves, their successors and assigns:
a. Represent and warrant that they have read and understand this Agreement and
confirm that the facts set forth above are true and correct, to the best of their
knowledge, information and belief.
b. Declare that they have sufficient information to make an informed waiver of
their right to a formal accounting with the Court, and do hereby waive the
filing and auditing of the same.
c. Acknowledge that the distributive share or amount set forth on the Schedule
shall be in full satisfaction of their respective entitlements under the Will.
d. Release, remise, quitclaim and forever discharge the Executor, his heirs,
personal representatives, successors and assigns, from and against all claims
that they, as beneficiaries of the Estate, and in connection with the Estate, had,
now have or may in the future have in connection with the Estate.
e. Agree to refund, on Demand, all or any part of any aforesaid distribution,
which has been determined by the Executor, or by the Court, or by any Court
of Competent jurisdiction, to have been improperly made.
f. Agree to indemnify and hold harmless the Executor, his heirs, personal
representatives, successors and assigns, from and against any and all claims,
loss, liability or damage (whether or not related to the negligence of the
Executor) that may hereafter be asserted against the Estate or against the
Executor.
g. Agree to execute such other or additional documents as may be necessary to
effectuate the agreements set forth herein.
h. Acknowledge that this Agreement shall be governed by and construed in
accordance with the laws of the Commonwealth of Pennsylvania.
1. Consent to the Court exercising personal jurisdiction over them in any suit or
action arising out of the enforcement of this Agreement.
IN WITNESS WHEREOF, the Beneficiaries have placed their hands and seals on the
attached Consents to Family Settlement Agreement.
Checking Account - PSECU
EXHIBIT "A"
ACCOUNTING
RECEIPTS OF PRINCIPAL
(Values as of date of death)
14,396.06
Money Market Account - Oppenheimer
244,701.80
Refund of 2004 tax return
TOTAL RECEIPTS
3,344.00
OTHER
Refund of Inheritance Tax overpayment
$210.09
TOTAL ASSETS
$262,441.86
$262,651.95
DISBURSEMENTS OF PRINCIPAL
Debts Of Decedent
Cremation Society
Reimbursement to SERS
Total Debts
$ 40.00
2,060.40
Administration Expenses
Personal Representative Commission
Attorneys' Fees
Probate Fees
Account Fees
Total Administrative Expenses
$6,000.00
5,000.00
629.00
250.00
Funeral Expenses
Food and refreshments
Other Expenses
Publication Fees
Taxes
Inheritance Tax
TOTAL
Advancements
Candace A. Verrecchio
Susan C. Kistler
Guy W. Kistler, Jr.
Scott A. Kistler
Total Advancements
$25,000.00
25,000.00
25,000.00
25,000.00
TOTAL DISBURSEMENT
$2,100.46
$11,879.00
$3,102.00
$43.00
$12,789.91
$29,914.37
$100,000.00
$129,914.37
.'
Current Values (As of June 20, 2005)
Money Market Account - Oppenheimer
TOTAL FOR DISTRIBUTION
146.822.32
$146,822.32
,
EXHIBIT "B"
PROPOSED SCHEDULE OF DISTRIBUTION
$146,822.32/4
Candace A. V errecchio
Susan C. Kistler
Guy W. Kistler, Ir.
Scott A. Kistler
$36,705.58
36,705.58
36,705.58
36,705.58
Any increase or decrease in assets prior to distribution shall be attributed on a pro rata basis.
........
.'
CONSENT TO FAMILY SETTLEMENT AGREEMENT
AND RECEIPT FOR DISTRIBUTION
I, Susan C. Kistler, hereby acknowledge receipt of the tangible personal property of the
Decedent, and the distribution in the amount shown on the Proposed Schedule of Distribution. I
hereby consent to and join in the Family Settlement Agreement relating to the Estate of Carole H.
Harris, deceased, a copy of which Estate Settlement Agreement, including exhibits, has been
provided to me.
SP=- (! ~
Susan C. Kistler
New Ya~
STATE OF pmmS'lLVANIA
COUNTY OF f>LO tV K
SS.
1b ~
On this, the / i W' day of. , 2005, before me, the undersigned
officer, personally appeared Susan C. Ist~wn to me (or satisfactorily proven) to be the
person whose name is subscribed to the within instfUlllent, and acknowledged that she executed
the same in the capacities and for the purposes therein contained.
IN WITNESS WHEREOF, I hereunder set my hand and official seal.
a,m~ 71:
Notary Public
PAMElA M. ~ I(
Notary PublIc. Slale of New York
No. 01GA8042849
QuIItIed In Bronx County
CoIlI.,dJIIMl EllpIrM June 5. 2006
........
,.
.'
CONSENT TO FAMILY SETTLEMENT AGREEMENT
AND RECEIPT FOR DISTRIBUTION
I, Candace A. Verrecchio, hereby acknowledge receipt of the tangible personal property
of the Decedent, and the distribution in the amount shown on the Proposed Schedule of
Distribution. I hereby consent to and join in the Family Settlement Agreement relating to the
Estate of Carole H. Harris, deceased, a copy of which Estate Settlement Agreement, including
exhibits, has been provided to me.
(brdOM~(J1M1&JJM
Candace A. Ve CChlO
STATE OF PENNSYLVANIA
SS.
COUNTY OF {'u..rv> b e."..1 A-ncL:
On this, the !3 day of , 2005, before me, the undersigned
officer, personally appeared Candace A. Verrec io, known to me (or satisfactorily proven) to be
the person whose name is subscribed to the within instrument, and acknowledged that she
executed the same in the capacities and for the purposes therein contained.
IN WITNESS WHEREOF, I hereunder set my hand and official seal.
COMMONWEALTH OF PENNSYL\\
Notarial Seal
Lindsay A. Richardson. Notal")' Public
LeMoyne Boro, Cumberland CoUlltY
My Commission Expires Feb. 2, 2003
Member, Pennsylvania Association of Notarles
d.d--"-<f o::;Jcha,4--....
Notary Public
, "
CONSENT TO FAMILY SETTLEMENT AGREEMENT
AND RECEIPT FOR DISTRIBUTION
I, Guy W. Kistler, Jr., hereby acknowledge receipt of the tangible personal property of the
Decedent, and the distribution in the amount shown on the Proposed Schedule of Distribution. I
hereby consent to and join in the Family Settlement Agreement relating to the Estate of Carole H.
Harris, deceased, a copy of which Estate Settlement Agreement, inclu . 'bits, has been
provided to me. .A
STATE OF PENNSYLVANIA
SS.
COUNTY OF
On this, the 20 day of ~ v.. k( , 2005, before me, the undersigned
officer, personally appeared Guy W. Kistler, Jr., known to me (or satisfactorily proven) to be the
person whose name is subscribed to the within instrument, and acknowledged that she executed
the same in the capacities and for the purposes therein contained.
IN WITNESS WHEREOF, I hereunder set my hand and official seal.
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ANA MELIA CUBILlOS
Notary Public, State of T exes I
My Comml'slon Expires
August23,2005 ,;
, .'
CONSENT TO F AMIL Y SETTLEMENT AGREEMENT
AND RECEIPT FOR DISTRIBUTION
I, Scott A. Kistler, hereby acknowledge receipt of the tangible personal property of the
Decedent, and the distribution in the amount shown on the Proposed Schedule of Distribution. I
hereby consent to and join in the Family Settlement Agreement relating to the Estate of Carole H.
Harris, deceased, a copy of which Estate Settlement Agreement, including exhibits, has been
provided to me.
~~
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STATE OF PENNSYLVANIA
SS.
COUNTY OF
On this, the /2 ~~ day of -Su l~ ' 2005, before me, the undersigned
officer, personally appeared Scott A. Kistler, own to me (or satisfactonly proven) to be the
person whose name is subscribed to the within instrument, and acknowledged that she executed
the same in the capacities and for the purposes therein contained.
IN WITNESS WHEREOF, I hereunder set my hand and official seal.
'P~ /( /~
Notary Public
600Z 'f; ~ 3Mtlr S3H1dX3 NOrSSIWWOO ~
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NQ03l:lo-::mand AI:I'tJ.ON.. ~
OV3HSDNITlOH )4 13ltNO 1._
MS .i""f~J-:i:lC .~~:~r~~
........-...--..........-..- " ......--.......
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
Carole H. Harris
Date of Death:
October 29, 2004
Will No.
d . 2004-1041
A m~n. No.
Pursuant to Rule 6.12 of the Supreme Court Orphans'
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 XX No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete:
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 XX .
b. The separate Orphans' 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? YesXX No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be attached to this report.
29, 2005
///~2 _____
Signature ~
~---
Mark K. Emery, Esq.
~ame (Please type or print)
410 N. Second Street
Harrisburg, PA 17101
Address
C'~)
(
( 717)238-9883
Tel. No.
Capaci.ty:
Personal Representative
XX
Counsel for personal _ f)
representative cJ-^
(MAH:rmf/AM3)
08-01-2005
HARRIS
10-29-2004
21 04-1041
CUMBERLAND
101
APPEAL DATE: 09-30-2005
( See reverse side under Objections)
~ount Remitted I I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE _ RETAIN LOWER PORTION FOR YOUR RECORDS _
REY:is47-Ex-AFp-co3:osi-NOTICE-OF-INHERITANCE-TAX-APPRAIsEMENT:-ALLONANCE-OR---------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
CAROLE H FILE NO. 21 04-1041 ACN 101
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
Rt:rnpnm n::D~::DF INHERITANCE TAX
C [; ::f~l'!'ll#l;e~; ALLOWANCE OR DISALLOIlANCE
, L'~',,' CDF'lIEQl,icTIONS AND ASSESstlENT OF TAX
2005 ^UG - I
PN 12: 28
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
CLERr<
ORPH:'\\I'; (':
MARK KEMERY ESQ CU':'~" "', .
M K EMERY LAW OFFICES
410 N 2ND ST
HBG
PA 17101
ESTATE OF
HARRIS
*'
REY-1547 EX AFP (06-05)
CAROLE
H
TAX RETURN liAS: (X) ACCEPTED AS FILED
) CHANGED
DATE 08-01-2005
I~ an asses~ent was issued previously, lines 14, 15 and'or 16, 17, 18 and 19 will
reflect ~igures that include the total af ALL returns assessed to date.
ASSESSMENT OF TAX:
15. AlIDlInt of Line 14 at Spousal rat. (5)
16. A~unt of Line 14 tax8ble at Lineal/Class A rate (16)
17. A.aunt of Line 14 .t Sibling rat. (17)
18. ~ount of Line 14 taxable at Collateral/Class Brat. (18)
19. Principal Tax Due
EIT:
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R..l Est.t. ISchedul. A)
2. Stocks and Bonds (Schedul. B)
3. Closely Held Stock/Partnership Interest (Schedule Cl
4. Mortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Tr8nsfers (Schedule G)
8. Total Assets
(ll
(2)
(3)
(4)
(51
(6)
(7)
.00
.00
.00
.00
263.441. 86
.00
53,460.55
IB)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Hisc. Expenses (Schedule H)
10. Debts/Horte-ge Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Val.... of Tax Return
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
1101
14,981.00
2.160.46
Ill)
(12)
(13)
(14)
NOTE:
.00 X
299,760.95 X
.00 X
.00 X
00 =
045 =
12 =
15 =
1191=
+
INTEREST/PEN PAID 1-)
674.46
AIIDUNT PAID
13,000.00
DATE
01-27-2005
NUNBER
CD004897
~
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
NOTE: To insure proper
credit to your account,
sub.i t the upper portion
of this for. with your
tax pay.ant.
316,902,41
17.141 46
299,760.95
.00
299,760.95
.00
13,489.24
.00
.00
13,489.24
13,674.46
185.22CR
.00
185.22CR
( IF TOTAL DUE IS LESS THAN $1, NO PA~ENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR), YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS,)
BUREAU OF INDIVIDUAL TAXES'
INHERITANCE TAX DIVISION
PO BOX ZB060I
HARRISBURG PA I7IZ8-060I
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
REV-I607 EX AFP [03-05J
/'1
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
08-29-2005
HARRIS
10-29-2004
21 04-1041
CUMBERLAND
101
CAROLE
H
'...J
MARK KEMERY ESQ
M K EMERY LAW OFFICES
410 N 2ND ST
HBG PA 17101
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment.
CUT ALONG THIS LINE
--+
RETAIN LOWER PORTION FOR YOUR RECORDS
+-
---------------------------------------------------------------------------
REV-1607 EX AFP (03-05)
*** INHERITANCE TAX STATEMENT OF ACCOUNT ...
ESTATE OF HARRIS CAROLE H FILE NO.21 04-1041 ACN 101 DATE 08-29-2005
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: 07-25-2005
PRINCIPAL TAX DUE: 13,489.24
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
01-27-2005 ~ CD004897 674.46 13,000.00
08-10-2005 REFUND .00 185.22-
TOTAL TAX CREDIT 13,489.24
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
II IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
I IF TOTAL DUE IS LESS THAN $1,
NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRl,
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. l
pJ.