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Home My WebLink About11-26-13 J 1505611180 REV-1500 EX(02-11)(FI) OFFICIAL USE ONLY PA Department of Revenue NEEARTMENTOF REVENUE County Code Year File Number Bureau of Individual INHERITANCE TAX RETURN 2806 I + /��{ PO BOX 280601 I 1 l� Harrisburg PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 05112011 11291915 Decedent's Last Name Suffix Decedent's First Name MI GERALDINE M KENNEDY M (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE BOXES BELOW Q 1.Original Return ® 2.Supplemental Return Q 3.Remainder Return(Date of Death Prior to 12-13-82) 0 4.Limited Estate 0 4a.Future Interest Compromise(date of Q 5.Federal Estate Tax Return Required death after 12-12-82) ® 6.Decedent Died Testate 0 7.Decedent Maintained a Living Trust 1 8.Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) Q 9.Litigation Proceeds Received Q 10.Spousal Poverty Credit(Date of Death 0 11.Election to Tax under Sec.9113(A) Between 12-31-91 and 1-1-95) (Attach Schedule O) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number ROBERT G . FREY 7173545838 REGISTER OF WiaS US 50114 C) W l C C> v � i.-i 'X3 First Line of Address 1 CO .-O e: i p fT1 -"'- n N rrl 5 SOUTH HANOVER ST Y rT1 (n J �a ,1 ra Second line of Address ?b "5'1 C> CJ �JDATE FILER) t—" M City or Post Office State ZIP Code -- �"1 - t• O CARLISLE PA 17013 N N Correspondent's e-mail address: RFREY@FREYTILEY . COM Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief, it is true correct and complete Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIG URE OF PERSON ESPO S FOR FILING RETURN DATE ADDRES SIGNATUR O REPAR O THAN RE RESE AT ADDRESS 5 SOUTH HANVOER STREET CAR I LE PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 L 1505611180 1505611180 J 1505611280 REV-1500 EX(FI) Decedent's Social Security Number Decedent's Name: KENNEDY M GERALDINE M RECAPITULATION 1. Real Estate(Schedule A). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. 129700 . 00 2. Stocks and Bonds(Schedule B). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. NONE 3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C). . . 3. NONE 4. Mortgages and Notes Receivable(Schedule D). . . . . . . . . . . . . . . . . . . . . . . . 4. NONE 5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E) . . . . 5. 2252 . 00 6. Jointly Owned Property(Schedule F) =Separate Billing Requested . . . . . . . 6. NONE 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) =Separate Billing Requested . . . . . . . 7, NONE 8 Total Gross Assets(total Lines 1 through 7) . . . . . . . . . . . . . . . . . . 8. 131952 . 00 9. Funeral Expenses and Administrative Costs(Schedule H). . . . . . . . . . . . . . . . 9. 33059 • 00 10. Debts of Decedent, Mortgage Liabilities and Liens(Schedule 1). . . . . . . . . . . . t0. NONE 11. Total Deductions(total Lines 9 and 10). . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 33059 . 00 12, Net Value of Estate(Line 8 minus Line 11). . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 98893 . 00 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J). . . . . . . . . . . . . . . . . . . . . . 13. 0 • 00 14 Net Value Subject to Tax(Line 12 minus Line 13) .14. 98893 . 00 TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15.Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec.9116 (a)(1.2)X.0 0 15. 0 . 00 16.Amount of Line 14 taxable at lineal rate X.0 45 98893 . 00 16. 4450 . 19 17.Amount of Line 14 taxable at sibling rate X . 12 17. 0 • 00 18.Amount of Line 14 taxable at collateral rate x . 15 18. 0 . 00 19.TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 4450 . 19 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 1505611280 1505611280 J REV-1500 EX(FI) Page 3 File Number 183-07-0339 Decedent's Complete Address: 21-11-0596 DECEDENTS NAME KENNEDY M GERALDINE M STREETADDRESS 9 EAST MAIN ST CITY STATE ZIP NEWVILLE PA 17241 Tax Payments and Credits: 1. Tax Due(Page 2, Line 19) (1) 4450.19 2. Credits/Payments A. Prior Payments 4027.50 B.Discount Total Credits(A+B) (2) 4027.50 3. Interest (3) 238.65 4. If Line 2 is greater than Line 1 +Line 3,enter the difference.This is the OVERPAYMENT. Fill in box on Page 2,Line 20 to request a refund. (4) 0.00 5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 661.34 Make check payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred....................................................................................... ❑ b. retain the right to designate who shall use the property transferred or its income.......................................... ❑ c. retain a reversionary interest.......................................................................................................................... ❑ d. receive the promise for life of either payments,benefits or care?................................................................... ❑ 2. If death occurred after Dec. 12, 1982,did decedent transfer property within one year of death without receiving adequate consideration?.......................................................................................................... ❑ 3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death?............ ❑ 4. Did decedent own an individual retirement account,annuity or other non-probate property,which contains a beneficiary designation?..................................................................................................................... ❑ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Far dates of death on or after July 1, 1994,and before Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent[72 P.S.§9116(a)(1.1)(i)]. For dates of death on or after Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent 172 P.S.§9116(a)(1.1)(ii)].The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1,2000: ' • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent,an adoptive parent or a stepparent of the child is 0 percent[72 P.S.§9116(a)(1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in[72 P.S.§9116(a)(1)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent 172 P.S. §9116(a)(1.3)).A sibling is defined,under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption. REV-1511 EX-(10-09) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RESIDENT DECEDENT RETURN ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Geraldine M Kennedy Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. B. ADMINISTRATIVE COSTS: - 1. Personal Representative Commissions: 6,000 Name(s)of Personal Representative(s) Kimberly C. Shumaker Street Address 45 Maple Lane city Newville state PA zip 17241 Year(s)Commission Paid: 2013 2. Attorney Fees: 3. Family Exemption:(If decedents address is not the same as claimant's,attach explanation.) Claimant Street Address city State ZIP Relationship of Claimant to Decedent 4. Probate Fees: 5. Accountant Fees: 6. Tax Return Preparer Fees: 7. Expenses Associated with real estate 27,059 S. TOTAL(Also enter on Line 9, Recapitulation) $ 33,059 If more space is needed,use additional sheets of paper of the same size. REV-1502 EX+(01-10) pennsylvania SCHEDULE A DEPARTMENT OF REVENUE INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Geraldine M Kennedy 21-11-0596 All real property owned solely or as a tenant In common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts. Real property that is Jointly-owned with right of survivorship must be disclosed on Schedule F. Attach a copy of the settlement sheet if the property has been sold. ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE NUMBER OF DEATH DESCRIPTION 1. 9 East Main Street, Nevvville, Pennsylvania. Assessed value 129,700 TOTAL(Also enter on Line 1, Recapitulation.) $ 129,700 If more space is needed,use additional sheets of paper of the same size. REV-1508 EX-(11-10) SCHEDULE E pennsylvania CASH, BANK DEPOSITS, & MISC. DEPARTMENT TAX REVENUE RET URN RN PERSONAL PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Geraldine M Kennedy 21-11-0596 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Real Estate tax proration from HUD-1 settlement statement attached 1,013 2 ADT refund 48 3 Erie Insurance refund 341 4 US Dept. of Treasury tax refund 850 TOTAL(Also enter on line 5, Recapitulation) $ 2,252 If more space is needed, use additional sheets of paper of the same size. REV-1513 EX+(01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Geraldine M Kennedy 21-11-0596 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE TAXABLE DISTRIBUTIONS[Include outright spousal distributions and transfers under Sec.9118(a)(1.2).] 1 Kimberly C. Shumaker 45 Maple Lane, Newville, PA 17241 Granddaughter 50%of remainder 2 Donna Richardson 23 North Spring Street, Shippensburg, PA 17257 Granddaughter .16667%of remainder Tonya Payne 3. 1717 NW 196th St., Edmond, OK 73012 Granddaughter .16667% of remainder Darbe Clark 4. 221 Crows Road, Gladys,VA 24554 Granddaughter .16667%of remainder ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OF PART II—ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ 0.00 If more space is needed,use additional sheets of paper of the same size. Expenses of Real Estate Sharon Bonder,mash removal 250 PPL 39 Kough's Oil Service 317 Gaye Gotla,cleaning 1.482 Arlin Gotla,cleaning 886 Steve Bartell,appreisal 350 ACT 46 PPL 66 ACT 46 Newvigs Water B Sewer 105 ACT 46 Ens Insurance 477 ACT 46 PPL 230 Call Piper,Tax Collector 1,430 Pam Y.00,mowing 110 Mal Games,cleaning 250 ACT 49 Newvllle Water 6 Serer 105 PPL 35 ACT 49 PPL 38 sought,Oil 610 ACT 49 PPL 42 PPL 43 Rough's Oil 878 Hoover's Plumbing 8 Heating,clean furnace 80 Newville Borough,Water E Sewer 105 ADT 49 KougBS Oil 495 PPL 37 ACT 49 Kough's Oil 288 PP; 37 ACT 49 PPL 36 Newville Borough,Water 6 Sewer 105 ACT 49 Kough'S OA 200 ACT 49 PPL 34 ACT 49 Pam Yemen.mowing 150 ACT 49 Newville Borough,Watil Sewer 105 Kough's Oil 232 PPL 229 William M.Willer,Tax Collector 1,572 JP Wolfe Insurance 461 ACT 49 PPL 09 ACT 51 PPL 13 Nex ills Borough.Water b Sewer 105 Kough's Oil 221 PPL 19 Kough'a Oil 492 PPL 24 ACT 51 JP Wolfe Insurance 336 PPL 20 Newvllle Borough,Water 8 Sewer 105 Kough'a Oil 388 Kough's OII 196 PPL 23 Cumberland County Tax Claim Bureau 644 Kough's Oil 317 Kough's Oil 360 Wit W11egTex Collector 594 PPL 23 JP Wolfe Insurance 336 Newvllls Borough,Water 8 Sewer 105 PPL 23 PPL 23 PPL 19 JP Wells Insurance 336 PPL 29 Neh ille Bomi Water 8 Sewer 105 PPL 18 Deborah Piper,Tax Collector 1,608 PPL 20 Kough'a Oil 686 JP Wolfe Insurance 462 PPL 20 Kevin Wickland,auctioneer 1,480 PPL 19 Newvllle Borough.Water&Sower 105 PPL 19 Dwight Shumaker(1 year mowing,3 years mein 8 snow removal 2,250 Kim Shumate,cleaning once per month 2,000 Closing costs from HUD-1 Settlement Statement 900 Total 27.059 Personal Income Tax e-Services Center 11/25/13,4:53 PM Penalty and Interest Calculations CALCULATION DATES- 2/11/12 TO 11/26/2013 TAX DEFICIENCY $ 4,450.19 CALCULATED INTEREST $ 238.65 BALANCE AS OF 11/26/2013 $ 4,688.84 Start Over https://w .doreseNices.state.pa.us/pitseN!ces/Default.aspx Page 1 of 2 LAST WILL AND TESTAMENT OF GERALDINE M. KENNEDY I, GERALDINE M. KENNEDY, widow, of 10 East Main Street in the Borough of Newville,Cumberland County,Pennsylvania,being of sound and disposing mind,memory,and understanding,do hereby make,publish,and declare this as and for my Last Will and Testament, hereby revoking and making void any and all Wills by me at anytime heretofore made. 1. I direct my hereinafter named Executors to pay all of my just debts and funeral expenses as soon after my death as may be found convenient to do so. I direct that my funeral services be conducted by Egger Funeral Home, Newville, Pennsylvania, and that my body be interred on my burial lot located in Big Spring Presbyterian Church Cemetery in Newville, Pennsylvania,beside that of my late husband,Donald E.Kennedy. 2. I give and bequeath the sum of Twenty Thousand ($20,000.00) Dollars to my stepdaughter,Donna Rae Richardson,provided she shall survive me by a period of ninety (90) days,but should she fail to so survive me then to such of her children as shall survive me by a period of ninety(90)days,per stirpes. 3. All of the rest, residue and remainder of my estate, real, personal and mixed, and wheresoever the same may be situate,I give,devise,and bequeath as follows: a. One-half(12)to my son,Owen D.Clark,his heirs and assigns,provided he shall survive me by a period of ninety(90)days,but should he fail to so survive me then to such of his legitimate issue as shall survive me by a period of ninety(90)days,per stirpes;and b. One-half (12) to my granddaughter, Kimberly C. Shoemaker, her heirs Aya O assigns(she being the daughter of my deceased son,Frank F.Clark),provided she shall survi"v.8b Tr ,� me by a period of ninety(90)days but should she fail to so survive me then to such of her chil dren Z C7 a ('! as shall survive me by a period of ninety(90)days,their heirs and assigns,per stirpes,but shduld there be no such children then one-half(12)of what she would have received shall pass t .cry husband,Dwight Shoemaker,his heirs and assigns,provided he shall survive me by a period.tif ninety (90)days,and the other one-half(12)plus any lapsed legacy shall be added to the serarej O herein provided for my son,Owen D.Clark,his heirs and assigns. - Ci ccz y + 4. I hereby nominate,constitute, and appoint my said son,Owen D. Clark, and mJ d granddaughter,Kimberly C.Shoemaker,as co-Executors of this my Last Will and Testament and I �,— r'n O further direct that neither of them shall be required to post any bond to secure the faithful tr-• T performance of his or her duties in the Commonwealth of Pennsylvania or in any other jurisdiction. IN WITNESS WHEREOF,I have hereunto set my hand and seal to this my Last Will and Testament written on one(1)page,this 19th day of May, 1994. i (SEAL) eraldine M.Kenn y Signed, scaled, published and declared by GEP.ALDIItM M. KENNEDY, the Testatrix above-named, as and for her Last Will and Testament,in our presence,who,in her presence,at her request, and in the presence of each other,have hereunto subscribed our names as attesting witnesses. 1/