HomeMy WebLinkAbout04-1091
PETITION FOR PROBATE and GRANT OF LETTERS
Esrat if . f :/j,IJA //I. ,faJ/.kiU/ No. II - C ~ . I C' ell
also wn as To:
Register of Wills for the
, Deceased. County of Cu",iPr/tUtd In the
Socia curiry No. /7S- a.3- .;; 37S Commonwealth of Pennsylvania
Th etition of the undersigned respectfully represents that:
Yo peritionerG6), who is/Bff 18 years of age or older an the executriX named
in the st will of the above decedent, dated /!/tJvtY1liHr 3 , )Jf2&oo
and c icil(s) dated
;, r ,s C,....j,.CO.ci,tt- 21-aq
(state relevant circ\lmstances, C.g. renunciation, death of executor, ere.)
dent was domiciled at death in t"unrber/lUld County, Pennsylvania, with
last family or principal residence at OZoS .IV. /llqrklf Sf. '&''''''''-Jh,f
;cs6urQ ,
J (list street, number and muncipalitYJ
. J4 y.ears of ajle, died wun6er.;((, ,y(..2oaO
/1/"""",.,,,/ fI.,~,ftZ/ Borou9h &f /Jfecltll/J/cs6urQ .
t as follows, decedent did not marry, ~as not divorced and did not h~ve a child born or adopted
cution of the will offered for probate; was not the victim of a killing and was never adjudicated
tent:
I
nt at death owned property with estimated values as follows:
iciled in Pa.) All personal property $ /. $CO. D"
omiciled in Pa.) Personal property in Pennsylvania $
omiciled in Pa.) Personal property in County $
f real estate in Pennsylvania $ i !
as follows: #/A
\V REFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
prese d herewith and the grant of letters -h..Sfamf'Afdrj
(testamentary; administration c.t.a.; administration d.b..n.c.t.a.)
thero
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OATH OF PERSONAL REPRESENTATIVE
CO ONWEALTH OF PENNSYLVANIA I ,~
,~ ::::::.:s
CO TY OF CUffl"MUNfJ J
Th etitioner{s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true Q correct to the bes! (~: the knowledge and belief of petitioner(s) and that as personal .cpresen-
tativ ) '.'f the above decedent petitioner(s) will well and truly admimster the est at", according to law. --...J--
'0 or affir~n?f ,:nd subscribed r y:rku./{- @~nJ ~.ftd:t~'?t.(..u:.r
m.e this _. -_ _.. _ day of. 1 /.iu;//. Mlfret d/4 Li(~i//< ~N:kft__ ~ 'I'
'\~ __~,A g
0.' ~(G\J\..lN:..'u::LLN . ~
__ iter L :2
II f-lt nr'iJUL 'J.(f--
No. ll-C'iIC~1
~state of U L LI 1-\1'4 1\\ . Kl\t.l pn 1It-N , Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
N 0 \!t1Y\ ;3\:"1': 7_ -1 :wcl
A NOW \b-. in consideration of the petition on
the rse side hereof, satisfactory proof having been presented before me,
[T I ECREED that the instrument(s) dated 1\[(\\,JChI13EJ\' 3, J,CC{i
desc ed therein be admitted to probate and filed of record as the last will of
ILL Iltni {Vi. K/\1AFin thJ
~'>TA-mE:NfA-R-'-/ ,
and tters
are r by granted to LL\.C till': rviCi\fZti A, KJ\ L ct. ( I ~ Lf:. me iZlZE-rl
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illu. :JuFc\AlU~ 'tritLU;~[{LUH\.J n
FM "f19-A' [J~
Register of Willi . ,\J)' / ' , 'L ,,,{-
FEES ~ !Mt~E ~~
Pro e, Letters, Etc. ......... 5 i . I
Sho =enificates( ).......... 5 ,,0 ATTORNEY (Sup. c:. LD. No.) ;) tS73
X.c .0.6. '>. .. .. .' 5 ,-3. c c t, (%<<5U ~d., /littJRu/CS6Mj /If /loSS'
Jep 5WOO
TOTAL _ 540 00 ADDRESS
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PHONE
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REGISIER OF WILLS OF CUM 13~LrTAlb COUNTY
OATH OF SUBSCRIBING WITNESS
Charl(.S E. Sh'e/~ JJ1
coJ~,-~1
a subscribing witness to the will presented herewith,~ being duly qualified according to
aw, depose(s) and say(s) that he was present and saw
1.'';/,'411 Ill. kalll'h1tl/1
he testatrix , sign the same and that he signed as a witness at the
equest of testat~ in he.r presence and (in the presence of each other) (in the presence of the
ther subscribing witness(es)).
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(!I,,,"/es E. g,,'dds;f? e)
~ c!-Iouser If"', ;J'},..ni~sj,""J,,pH I7DS~
(Address)
Register -
(Name)
(Address)
REGISTER OF WILLS OF COUNTY
OATH OF NON-SUBSCRIBING WITNESS
(each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that
familiar with the signature of
codicil
testat_ of (one of the subscribing witnesses to) the will presented herewith and
codicil
that believes the signature on the will is in the handwriting of
to the best of knowledge and belief.
Sworn to or affirmed and subscribed before
me this day of (Name)
19__
(Address)
Register
(Name)
(A ddress)
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,
2/- 0 4 - I 0 C; I
REGISTER OF WILLS OF C() NTY
OATH OF SUBSCRIBING WITNESS
i codicil
( C~) a subscribiClg witness to the will presented herewitb, (each) being duly qualified according to
I ,I depose(s) and say(s) that present and saw
t , sign the same and that signed as a witness at the
, . presence and (in the presence of each other) (in the presence of the
r Mest of te.st~t~ In h
. r subscnbmg wttness(es)).
rn to or affirmed and subscribed before
jhis day of (Name)
I 19_
(Address)
Register
(Name)
(Address)
I
I REGISTER OF WILLS OF C u. m Be I2.LA-1,) D COUNTY
OATH OF NON-SUBSCRIBING WITNESS
c IIle flu rfe f q.,f.t1. . Lao/Ie /hONef
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) a subscriber hereto, ~ being duly qualified according to law, depose(s) and say(s) that
is familiar with the signature of i, 'jl/"A /If. ~..J"'an
I esEiieil
tt~ of (GFH! sf tR~ Cl:l13SEfibifl1; ..imcJ......) tv) the will presented herewith and
I r'nrliril
t tj she believes the signature on the will is in the handwriting of
II/all lit. Ka u !htp."
e best of her knowledge and belief. X~(,,$~ff
qrn to or affirmed and subscribed before X ,;tL.../tdJ2r:'ZuI
this 24_ day 01 L u e ;/le fru, rre.t ~<~"me) L" e'//~ mo ra tr
. - ,)'/ $:)#0", /fve. /J1edllzn/~sj,u'J' ,oA /7~sS-
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LAST WILL AND TESTAMENT OF LILLIAN M. KAUFMAN
I, LILLIAN M. KAUFMAN, of the Borough of Mechaniesburg, Cumberland County,
P sylvania, being of sound and disposing mind, memory and understanding, do make. publish
a declare this my Last Will and Testament, hereby revoking and making void any and all prior
s by me at any time heretofore made.
l.
I
I direct the payment of all my just debts and funeral expenses as soon after my deceasc as
th 'amc c,m conveniently be done.
2.
All the rest, residue and remainder of my Estate, real, personal and mixed, whal,oever and
resoever situate, I give, devise and bequeath to my beloved husband, CHALMER H.
FMAN, to his own use and benefit absolutely.
3.
In the event my said husband, CHALMER H. KAUFMAN, should predecease me or di
at out the same time I do, sueh as in an aeeident or disaster common to both of us, then I direct
th. my said estate be divided and distributed as follows after the payment of all death taxes, fees,
eo . expenses and the like have first been dedueted therefrom:
A) Three (3'ii') per cent thereof to the Upper Strasburg Pennsylvania Methodist
Cemetery Association;
B) Seven (7%) per cent thereof to Mechanicsburg Wcsley United Methodist
Church. This is a conditional gift in that those funds so given shall only be used for
building and grounds improvement and maintenance. The acceptance of tbis
testamentary gift shall be considered an acknowledgment of and agreement to be
bound by these conditions by the recipient.
C) Ail the then remaining balancc is to be divided among my three (3)
daughters, to wit: LUCILLE MORRETT, GEORGIA HELLER, and
DOLORES BRANDT, in equal shares, oer stimes.
I 4.
I nominate, constitutc and appoint my husband, CHALMER H. KAUFMAN, to be the
E utor of this my Last Will and Testament. In the event that he should predeceasc me or for an
re' n be unwilling or unable to act as such Executor, I nominate, constitute and appoint my
da hter, LUCILLE MORRETT, to be Executrix in his place and stead. In thc event that she
sh ld be unwilling or unable to act as such Executrix. I nominate, constitute and appoint my
da hter, GEORGIA HELLER, to be Executrix in hcr place and stcad. In the event that she
~~~, {7~~
s ld bc unwilling or unable to act as such Executrix, I nominate, constitute and appoint my
d 'hter. DOLORES BRANDT, to be Executrix in her place and stcad. The order of the
al 1ates selection has been based upon the respective proximities of gcographic location as of th
d' of my will and is not to be taken as a measure of my opinion as to anyone's persona]
G bilities and abilities, believing that my said daughters arc equally capable. I furthcr dircct that
th shall not bc rcquircd to file bond or other sccurity in the Office of thc Register of Wills for the
p ose of administering my Estate,
IN WITNESS WHEREOF, I havc hereunto set my hand and seal this M day of
, A.D. 2000. ~H /7), ~r)'~w
(SEA)
LILLIAN M. KAUFMAN I
Signed. sealed, published and declared by the above.named LILLIAM M. KAUFMAN, s
a for her Last Will and Testament, in the presence of us, who at her request and in her presence
a in the presence of each other, have~sEd our nal s as witnesses.
I
2
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CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: Lillian M. Kaufman
Date of Death: December 26, 2000
Will No. Admin. No. 21-04-01091
TO THE REGISTER:
I certify that notice of beneficial interest 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
November 26, 2004:
Name Address
Lucille Morret 24 Big Horn Avenue, Mechanicsburg, P A 17055
Dolores V. Brandt P.O. Box 9269, Myrtle Beach, SC 29578
Georgia L. Heller 860 Green Springs Rd., Hanover, P A 17331
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date: November 26, 2004
('-.J r:uf.~r
..
c~;
c:,-- CHARLES E. SHIELDS, III
~ 6 Clouser Road
I Mechanicsburg, P A 17055
Telephone: (717) 766-0209
Counsel for Personal Representative
-c:j""
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-- ~..-
V
STATUS REPORT UNDER RULE 6.12
Name of Decedent: L:/t/AA ftt. IG,JII1l<n
Date of Death: 12/U/z"",,,,
Will No.: Admin. No.: .2/-0'1 -/07/
Pursuant to Rule 6.12 of the Supreme Cow-t Orphans' Cow-t 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 D No~
2. If the answer is No, state when the personal representative reasonably believes
that the administration will be complete: Iv 1/&//"" r., fVl",s.
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 - NoD
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? Yes D No D
c. Copies of receipts, releases, joinders and approval offormal or
informal accounts may be filed with the Clerk of the Orphans' Court
and may be attached to this report.
Date: ~ZLlPb ~E~~
Signature
Chark.5 E. Sk'U~ ffi-
,,:> Name
Li_ Cl C!-.MUSt''' Rd
C) (I, a.
..
LLJ ... -
C) /l!ee!tFo, ;c;sf,W;!/ f//f l;zJ n~
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LL I "- ()
c)
,'-", - ~<~ ,j) , Address
t;:~j U_:o....". .
Co:, '" lLl ..c::,_
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c..:> -) C:' Telephone No.
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Capacity: n Personal Representative
~ Counsel for personal representative J
JRD/June 30, 1992117858
JAN 1 2 200~
In Re: Estate of Lillian M. Kaufman ORPHANS' COURT DIVISION
Late of Mechanicsburg Borough COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY
Estate No.: 21-04-1091 PENNSYLVANIA
NO. 21-04-1091
NOTICE OF FAILURE TO FILE STATUS REPORT AND REQUEST TO CONDUCT A
HEARING PURSUANT TO RULE 6.12, SUPREME COURT ORPHANS' COURT RULE
Personal Representative: Lucille Morret
Counsel for Personal Representative: Charles E. Shields, III, Esquire
Date of Decedent's Death: 12/26/2000
Date of Delinquency Notice: 01/1012005
The undersigned, Glenda Farner-Strasbaugh, Clerk of Orphans' Court, in accordance
with Rule 6.12, Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court
Division, Court of Common Pleas of Cumberland County, that neither the above named personal
representative nor the above named counsel for the personal representative have filed with the
Register of Wills or Clerk of the Orphans' Court his, her or its Status Report required by Rule
6.12, Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 6.12,
Supreme Court Orphans' Court Rules, was given by the Clerk ofthe Orphans' Court on
November 10, 2004, and that the ten (10) day notice to file the Status Report has expired.
Accordingly, in accordance with Rule 6.12 the Court is hereby notified of such delinquency and
the undersigned requests that a Court conduct a hearing to determine whether sanctions should
be imposed upon the delinquent personal representative or counsel for the delinquent personal
representative.
Date: 01/13/2005 ~~#;~~f
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
Distribution: Personal Representative
Counsel for Personal Representative
Estate File
'YV\~1f, :;>.eeS' <1~30 t\M
A hearing is scheduled for at in Courtroom No.3. If the Status Report is filed prior to
the hearing date, the hearing will automatically be cancelled.
0
if'
I
CDARLES E. SHIELDS, III
ATTORNEY-AT-LAW
6 CLOUSER ROAD
r:QJner ofTrindle and Clouser Roads
l ' '.) '.MECHANICSBURG, PA 17055
GEORGE M. HOUCK TELEPHONE (717) 766-0209
(1912-1991 ) FAX (717) 795-7473
,
June 17, 2005
Via C rtified Mail
Register of Wills
Cumberland County Court House
1 Court Square
Carlisle, P A 17013
Re: Estate of Lillian M. Kaufman Estat of Chalmer Kaufman
No. 21- 04-1091 No.2 -04-0849
DOD: 12/26/2000 DOD 9/9/2004
Dear Register of Wills:
.
, Please find enclosed for filing 2 copies of the Inheritance
ax Return for the Estate of
. Lillian M. Kaufman and 2 copies of the Inheritance Tax Return D r the Estate of Chalmer
Kaufman. Additionally, we are enclosing Check No. 1453, in th amount of$5.00 for the
difference in the filing fee of Lillian M. Kaufman.
Thank you for your kind attention to this matter.
Very truly yours,
.~l!L
Carles E. Shields, II
Attorney-At-Law
CES/mjj
Enclosures
REV-1500 EX (6.{lO) REV-1500 OFFiC!AL USE 1)1'1'_"
,
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE ___~__".____.._~.__'_d..__~_'___._
INHERITANCE TAX RETUR FILE NUMBER
DEPT. 280601 2 L - J2 'i---. ~ -L.J2 _7.1
HARRISBURG, PA 17128-0601 RESIDENT DECEDENT
COUNTY CODE YEAR NUMBER
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
I- KALtFM fJrN1 Ll LLlIHJ IYI. 17S - 03 - .:l37S-
z
w DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
C
W J,2" / ~{p / 2000 II / /3/ /9/fc REGISTER OF WILLS
U
W (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
C K Ir- fA t= I1f ,+/111 CH /J-L/lJ ~ J./. 7/7 - /.2 - ;('Z8
w ~ 1. Original Return o 2. Supplemental Return o 3. Remainder Return Idate of d~alh prior to 12-13-82)
..,
~~en o 4. Limited Estate o 4a. Future Interest Compromise (date of death after 12.12.82) o 5. Federal Estate Tax Return Required
ulI::~
wc..u
:x: 00 ~ 6. Decedent Died Testate (Attach copy of Will) o 7. Decedent Maintained a Living Trust IAttach copy of Trust) o 8. Total Number of Safe Deposit Boxes
ull::...J
c..lll
c.. o 9. Litigation Proceeds Received o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-95) o 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
<(
I-
Z
W
C
Z
0
c.. FIRM NAME Ilf Applicable)
en
W
II::
II:: TELEPHONE NUMBER
0 7/7- 7'~ - C)~o 7
u
1. Real Estate (Schedule A) (1) -0 - i
2. Stocks and Bonds (Schedule B) (2) ~I p/J 1. 60 ...._,.,.
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) -0 -
4. Mortgages & Notes Receivable (Schedule D) (4) -0 -
5. Cash, Bank Deposits & Miscellaneous Personal Property (5) -0 - -
-.
Z (Schedule E)
0 -0 - _..Uj ".
!;;: 6. Jointly Owned Property (Schedule F) (6) ~"...'._o'
o Separate Billing Requested r-...:'
..J -0 -
::J 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) -----i
!:: (Schedule G or L)
Q. ~
<C 8. Total Gross Assets (total Lines 1-7) (8) J) fJfD9.60
U 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 1 7 76 S. 3t./.
w
a::: (10) -0 -
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
(11) ~ 7,5. 3rt
11. Total Deductions (total Lines 9 & 10) Z.
12. Net Value of Estate (Line 8 minus Line 11) (12) -1)-
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been (13) -0 -
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13) (14)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
Z 15. Amount of Line 14 taxable at the spousal tax
0 t9 t/
!;: rate, or transfers under Sec. 9116 (a)(1.2) x .0 (15)
() xO If (16) (/
~ 16. Amount of Line 14 taxable at lineal rate
::J (/ t)
Q. x .12 (17)
~ 17. Amount of Line 14 taxable at sibling rate
0 () 0
U 18. Amount of Line 14 taxable at collateral rate x .15 (18)
>< 19. Tax Due (19) ?J
~ --
20.0
Decedent's Complete Address:
STREET ADDRESS .
;;'08- ,v. /}fA ;eUT 57:
CITY /liE e/lAA)/CS~tlJ(I(j./ I STATE /J'I I ZIP /7oSS-
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19) (1) 0
2. Credits/Payments 0
A. Spousal Poverty Credit
B. Prior Payments 0
C. Discount t?
Total Credits ( A + B + C ) (2) 0
3. Interest/Penally if applicable
D. Interest 0
E. Penally 0
Total Interest/Penally ( D + E ) (3) tJ
4. 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 (4) 0
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0
A. Enter the interest on the tax due. (5A) C?
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 0
Make Check Payable to: REGISTER OF WILLS, AGENT
.' ..,."'......~,....)~.. .'.....,., ',,\Ilo, .....~., ..
PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred;.......................................................................................... D ~
b. retain the right to designate who shall use the property transferred or its income; ............................................ D [Z]
c. retain a reversionary interest; or.......................................................................................................................... D [RJ
d. receive the promise for life of either payments, benefits or care? ...................................................................... D [8J
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. D ~
3. Did decedent own an "in trust for" or payable upon death bank account or securily 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? ........................................................................................................................ D 00
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 pe~ury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete.
Declaration of pre parer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATU~E Of PERSO.~ 'ESPON~BJ:E FOR FILING R~URN }ATE
X ~ .~-<.). L;' ,'j /~ I t:...,.tfi. , '19/0>
.
ADDRESS 1.. LtC. L t.E7 MOIUeE7 oK" LUCILL.E mO;e~Err/ Fx6.
.2'1 ~/G HIJKAI Af'F./ /J(EeII~/C.s~tlR.6./ ,.0/1 I T~Ss-
SIGNATUR F PREPARER O~RESENTATIVE DATE
g . 71L '/IY oS--
ADDRESS IIA IlL.E=S R. S./~ ,/ ES(J,
tD C-LtJJ,tSEJt 1'lJ>. / /JI E~II /f /YI C S.8 t( /l6-} /"J'I l'7tJ sS"
J.i~i__~~~t~~~~5{j,;!t:~;_~;_~)t"g~:~~:::;~-~i,~!~h:~I~;{;~i~~:~~~i:;!S;~':~~rt~l1~f~~~~JlLIT~~~~.t~m~~;!.;":~rt~Te:t~If~~~~~~~
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 exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if
the -.- . ..
FOI ~~?])
Thl Irs from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent,
or i 3)(1.2)].
Thl ; 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)].
ThE ers 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 an
ind' 3.~ with the decedent, whether by blood or adoption.
REV-1511E;<. (1.97) .
SCHEDULE H
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES &
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF KA-UFMR-N, l-ll.LlPrN /H. FILE NUMBER
;)../-0 IJ. -/ OC! t
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. In yees FttNFlfYft. Hpll1E Or /11 E CII/lAI / C oS e. "1€'6- '7,687, SD
(S~e .sta.:fl!mellt "tta&11 eJ )
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s) 1.aclllE htPUET akA Lt Clue AfoUe- TT WAI rED
Social Security Number(s) I EIN Number of Personal Representative(s) JI/A
Street Address d'l ~/G II~RIY ~J"E.
City lJIE"e/l/lIY/e58t1~6- State ,#11- Zip / 7tJ S"S
I Year(s) Commission Paid: I()/A
2. Attorney Fees ellA-ilLES E. .5HIGU>S 11J:. WAf VcD
3. Family Exemption: (If decedenfs address is not the same as c1aimanfs, attach explanation)
Claimant f!1I/ft./1/gJ If. KA t( F/'Jf AN
Street Address O/t}!' AI. n/,lf-If/(,ET S-r.
City IJfEeHAAlIC~U~(i. State .tJ /I Zip /70SS:
Relationship of Claimant to Decedent ;S1l1(V/V/N6 Sr't:Ju Sli
Probate Fees tJ<<A' IJrij//Io,l i:;'5ue /!)f ShPrt cern'h 'ca fe.s. I ~
4. "fo. 00
5. Accountanfs Fees 1 H~R E/odt::, of 11
Ta.l1et I3rru:.kla;' (, ecnCc.)1 ;CSht4."j u.rtdtfe,.mil1t.d.
6. Tax Return Preparer's Fees)
7. Co=-+ of' SOlcl: nj sho..re cerf; f, 'c.a..te.s. by R ~ !.:stud lN1t.; I, .e.1C:. .,.
J ( . elf
1- A """n'o Ilat probo..t~ fe~ ~7. 00
1. F/ki ;J:IJhu;l-ance -r~ fee. 'io.oo
IP. II-eltI; 't>AO/ ~h/lrt ce,,//{/cafe.s ~
9,170
TOTAL (Also enterpn line 9, Recapitulation) $ ~ 7 ",s, 31/
(If more space is needed, insert additional sheets of the same size)
],\;lvers f"'uneral Home Inc.
v
~~? 'E~L,l :\.~~in .'.;i;":,~~:;:t
r":<;Ch,\l1ic:)bllr(~, P'l. i ;lJ:',i
Bl); j L. \'tYCL; Jr.. ,(:upervrs:.)1"
i,"7 t 7) ~(~If).. '3 ~:: !
A q~ND.'\RD ,,:If FXCLLLE\ii...C Sl\iCf:: i ) I Co
i\i1::r'oaj', Decefnc)er 27, :2C:G4
M Cr,ailY1E:r Kaufman
2(18 Nortn MarK~t Street
r\/!(-~ch3r':!C~3burq, P.::i -17056
D(~8r fv'1r Kaufman,
')"-:ank jCl,U for se1ecting::;Llr funel al home to provide ser\.iC8S for your farmy during )lour bereavement. !
hope tr'C(t yot.; four1'j our services to be of the :;:9hf;~[ stand,')ras and that the met your '~t;ed,s, and thuse
of/our tamil;! and Inends
1"',2 fOliowinq is 3 summary of the service :.:harges 3S prevIouSly f.;Xpialned :" r:d provided In written 10r:11
<:11',(j 1-.8;'81r1 :nd!c~~tec as P ,,",j O.i !'J .FUi~L
LHlian M. Kaufman
9UMMARY OF EXPENill
rOT AL OF SERVICE RENDERED $13,782.50
LeSS Credits grante'j ; 895.00
LESS -;- otal F'ayrnenl~" 7,G,~7.5C'
CURRENT 8.4lANCE $0.00
:~:(6d!ts 8:':~n!ed: :'~1 ,v0S,i.) ;:;'tH~k~9t;': Fri'':'li? Cis<>YJnt
~f '~:le"~ ;~(e GPV qUl213t1C1S 0" ,'.:~:"r~.errr5 t.hat (~rr)a!n unat1sw{~rGd. ole.j~~e \':~.:dl r ie,
:::' "ccfPiy
. ",-(r\~i:{')t)~~ei lv'; \/'';'l:!!3~-t~'-;
,/
,"'- " . -;.'" ,/..~ .//" ~).""
.<
........ ./ -- ,- ' "
'-'~ .. ;.,;.:. T_~>;
~..."..,,'" '* SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER .2/-t)lf - 1091
I< If- u. F IZ1/1-N, L/LLIltIJ M.
RELA TIC NSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do ot List Trustee(s) OF ESTATE
I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) /0010
s >OL{SE
1. C I-f A l. Wll:I<. H. KAuFmAJJ
J20t N. 1Jt#I<KET ST:
MECHANICS 8 u.rec;., p,+ /7055"
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROU H 17, AS APPROPRIATE, ON REV 1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS OT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
"~'":~.,,., . SCHEDULE B
STOCKS & BONDS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF )( FILE NUMBER
AttF/J1.{.IV" LlLUAN /J1. :z 1-6,/ - /09 (
All property jointly.owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. iftJ C.erf,'f'-ca.ted .sh6..Ye.S of FDof Lo~j(e r J :rite ~ P,wtmOl1 shc..j(
in ~ fvrm ef~ ~ IIDwing :
10 sl,. r. 1.0. Wool worth CD. 7/2.$ / (,7 N02 tz..? 7 tf if
10 s~. F.w. Wool worth (!e. ~1$oJIt'" BCI tr 18 lZ
..(0 sh. Wl!>ol wort/, U, "/1. G""/31 }90 Wee 5Z ILf2
7--4/ l(/) Jh.
f:: J(.I, tv~lVbr/t, &. I- W,?/)!w/)rrh (!.,)/'I" 5~~ he~ me ft;o 1- LfJ c.ke '"
-::J: #1. c,.
:l. PIa.l1 'DIvidend 'He..MestMe.nt Sha. reS of !7ct LecI U1 1rtc.~
.y. 30 .sh. CDl\1rnon.
CUStP 110. ~r 1=, w, WOlJlwurftJ &. is 98'08'jl / ?6
Cas I fJ NO. fw- WI)O/ WPfH, &rf. IS 7/ {) f'S'3 I ')2-
va...(u.a.hims 6f 51,. on d.a.d.
/1; ~/S;('3 It? ~~?9' ~ X 70 sk.~::: ~
are. I ,. 28 J J Dft, 7. b 0
(see /;/sh,,/cll) daf01leAt ~R1 ){,h~o /7"tlJ1C;a. / a#odrul)
(11Dte "'*. The h~ure of ~ sl, . W4t~ olot-a..i ne.d ~ LJ esxrrl.tpt!J14H~
-froM Cu..rre.",t ~t/l.~tl'\ent. o.MJ e.::>fimo.+;~ b(le~ w-.rds 01
~ c.tve.. ra.1L "f a (!.(!.u.m t.t.\o..h'DH ptr~.)
TOTAL (Also enter on line 2, Recapitulation) $ /, 069, (PO
(If more space is needed, insert additional sheets of the sama size)
- I
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Date Open High Low Close Volume CI J *
ose
27-Dec-00 15.00 16.00 14.88 16.00 506,400
26-Dec-00 14.94 15.63 14.94 15.13 1,778,800
* Close price adjusted for dividends and splits.
First I Prey I Next I Last
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t ..
.
.
LAST WILL AND TESTAMENT OF LILLIAN . KAUFMAN
I, LILLIAN M. KAUFMAN, of the Borough of Mechanics mg, Cumberland County,
Pennsylvania, being of sound and disposing mind, memory and und rstanding, do make, publish
and declare this my Last Will and Testament, hereby revoking and I aking void any and all prior
Wills by me at any time heretofore made.
I.
I direct the payment of all my just debts and funeral expense as soon after my decease as
the same can conveniently be done.
2.
All the rest, residue and remainder of my Estate, real, person and mixed, whatsoever and
wheresoever situate, I give, devise and bequeath to my beloved husb nd, CHALMER H.
KA UFI\-L>\N, to his own use and benefit absolutely.
3.
In the event my said husband, CHALMER H. KAUFMAN should predecease me or die
al about the same time I do, such as in an accident or disaster comm n to both of us, then I direct
thalmy said estate be divided and distributed as follows after the pay ent of all death taxes, fees,
costs. expenses and the like have first been deducted therefrom:
A) Three (3 %) per cent thereof to the Upper Strasburg P nnsylvania Methodist
Cemetery Association;
B.) Seven (7%) per cent thereof to Mechanicsburg Wesl y United Methodist
Church. This is a conditional gift in that those funds so give shall only be used for
building and grounds improvement and maintenance. The ac eptance of this
testamentary gift shall be considered an acknowledgment of' d agreement to be
bound by these conditions by the recipient.
C) All the then remaining balance is to be divided amon
daughters, to wit: LUCILLE MORRETT, GEORGIA H LLER,and
DOLORES BRANDT, in equal shares, per stirpes.
4.
I nominate, constitute and appoint my husband, CHALME H. KAUFMAN, to be the
Executor of this my Last Will and Testament. In the event that he s uld predecease me or for any
" .~
should be unwilling or unable to act as such Executrix, I nominate, c nstitute and appoint my
daughter, DOLORES BRANDT, to be Executrix in her place and s ead. The order of the
altemales selection has been based upon the respective proximities 0 geographic location as of the
date of my will and is not to be taken as a measure of my opinion as to anyone's personal
capabilities and abilities, believing that my said daughters are equall capable. I further direct that
they shall not be required to file bond or other security in the Office f the Register of Wills for the
purpose of administering my Estate.
IN WITNESS WHEREOF, I have hereunto set my hand d seal this U day of
~~ , A.D. 2000.
l.--6---z.--s--- (SEAL)
Signed, sealed, published and declared by the above-named ILLIAM M. KAUFMAN, as
and for her Last Will and Testament, in the presence of us, who at h r request and in her presence,
and in the presence of each other, have~s7d our na ~ as witnesses.
09-05-2005
KAUFMAN
12-26-2000
21 04-1091
CUMBERLAND
101
APPEAL DATE: 11-04-2005
(See reverse side under Objections)
AMount Re.ittedl 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:is4;-Ex-AFP-io3:osj-NoTICE-OF"INHERITANCE-TAX-APPRAISEMENT:-ALLOWANCE-OR---------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
LILLIAN M FILE NO. 21 04-1091 ACN 101
BUREAU OF INDIVIDIWC'" ,ffi, its'! ',"Fire
INHERITANCE TAX DIVISldN"~I\<" ",e-.J \:~'_' ':--
PO BOX 280601 ' . . .
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
"''''l~ ....rn I')
L~;'t. ,~,.,,:, -"
'".>,J'.) 'J _, "-
PH I~'. I' I
Ii'.::,'
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
CLERK
CC"',','-'
CHARLES~SHIELDS
6 CLOusER RD
MECHANICS BURG
III c.
PA 17055
ESTATE OF
KAUFMAN
'*
REV-1547 EX AFP (06-05)
LILLIAN
M
TAX RETURN WAS: I X) ACCEPTED AS FILED
) CHANGED
DATE 09-05-2005
I~ an assess_ent was issued previously, lines 14, IS and/or 16, 17, 18 and
re~lect l'igures that include the total ~ abb. returns assessed to date.
ASSESSMENT OF TAX:
15. Aooount of Line 1'" at Spousal rate ll5)
16. A.ount of Line 14 taxable .t Lineal/Class A rat. (16)
17. Amount of Line 14 at Siblinv rat. (17)
18. Amount of Line 14 taxable at Coll.teral/Class Brat. (18)
19. Principal Tax Due
R I :
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds ISchedule B)
3. Closely Held stock/Partnership Interest (Schedule Cl
4. Mortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Trensfers (Schedule Q)
8. Total Ass.ts
ll)
(2)
(3)
l<t)
(5)
(6)
(7)
.00
1.069.60
.00
.00
.00
.00
.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Ada. Costs/"isc. Expenses (Schedule H)
10. Debts/Hortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Sovernmental Bequests; Non-elected 9113 Trusts (Schedule ~)
14. Net Value of Est.t. Subject to Tax
(9)
llO)
7,765.34
.00
llll
112)
ll3)
ll"')
NOTE:
.00
.00
.00
.00
X 00 =
X 045 =
X 12 =
X 15 =
T
ANOUNT PAID
DATE
NUtlBER
INTEREST/PEN PAID (-)
~
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADOITIONAL INTEREST.
NOTE: To insure proper
credit to your account,
submit the upper portion
of this forn with your
tax payaent.
1,069.60
7.76<; ~4
6,695.74-
.00
6,695.74-
19 will
ll9)=
.00
.00
.00
.00
.00
.00
.00
.00
.00
( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED.
IF TOTAL OUE IS REFLECTEO AS A "CREOn" ICR), YOU HAY BE DUE
A REFUND. SEE REVERS~ srnF n~ TUTe ~n_ r....ro ..a___.___~__'
STATUS REPORT UNDER RULE 6.12
Name of Decedent: Lillian M. Kaufman
Date of Death:
December 26, 2000
Will No.
Admin. No.
21-04-1091
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 X 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 X .
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? Yes)( 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.
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Signature . ~
Date:
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Charles E. Shields, III, Esquire
Name (Please type or print)
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6 Clouser Road, Mechanicsburg, PA 17055
Address
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(717 ) 766-0209
Te l. No.
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Personal Representative
Capacity:
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(MAH:rmf/AM3)
x Counsel for personal
representative