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HomeMy WebLinkAbout03-07-14 J 1505610101 REV-1500 °"01-'°' -� Pennsylvania OFFICIAL USE ONLY PA Department of Revenue P County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN BOX 280601 Ha Harrisburg PA 17i28-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW `• Social Security Number Date of Death MMDDYYYY Dale of Birth MMDDYYYY o907A0 / z 11 /1 0 Decedent's Last Name Suffix Decedent's First Name MI KRIE r ® / RG / Ni /# ❑ (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI 1WjjA1 I I I I I I I I ® I I I I I I rT= ❑ Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE ' REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ® 1.Original Return O 2.Supplemental Return O 3. Remainder Return(date of death L I (. prior to 12-13-82) O 4. Limited Estate O 4a.Future Interest Compromise(date of O 5. Federal Estate Tax Return Required + death after 12-12-82) ® 6. Decedent Died Testate O 7.Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes - (Attach Copy of Will) (Attach Copy of Trust) O 9. Litigation Proceeds Received O 10.Spousal Poverty Credit(date of death O 11. Election to tax under Sec.9113(A) between 12-31-91 and 1-1-95) (Attach Sch.0) CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name a ; f Daytime Telephone Number CNA � � ES SH / E4D5 / � / 7i 766 -? Y REGISTER OF WILLS USE ONLY IV First line of address 2c:) o = =0 W e0ou5EoQ QrDAD M� Second line of address m I ;-i i N/141 . �= City or Post Office State ZIP Code �:FaEO a" n M /ll Cy /t'N/ CSB' u � G Pg 170SS97 �� F Ems, r _ Correspondent's.a-mail address: 0,e-SA e/a/a3Q&91,VCti filet 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.Dedaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATt�N RESP O ING RETURN DATE ADDRESS OILC,/AU! k' KENT Z/ Oa&,Wvc1g0' SIGNATURE OF PAR OTr THA PR NTATIVE t/ DATE ADDRESS ,#,S E.� SHIELDS 7�1 " (o CIOUSPr vCS(� ���'r u^9, /7OSS- PLEASE USE ORIGINAL FORM ONLY Side 1 1505610101 1505610101 J J 1505610105 REV-1500 EX Decedent's dent's Social Security Number Decedent's Name: J1/r?1'n; L L. lee6 1. RECAPITULATION ` t /l 1. Real Estate(Schedule A). .... ...... ........ .................. .... .... 1. �1_- -1y 713J.��d�•LJ� ....... .......... Il UUi . ' 2. Stocks and Bonds(Schedule B) ... ................... 2. � A3 3. Closely Held Corporation,Partnership or Sole-Propdetorship(Schedule C) ..... 3. 4. Mortgages and Notes Receivable(Schedule D). .... ....... ............... 4. X1TL l,�-J •� 0 5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E)....... 5. 3 q,l j ,5" 1 •!2 ' . 6. Jointly Owned Property(Schedule F) p Separate Billing Requested ....... 6. ��(o��.�� p 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property - - - - - (Schedule G) p Separate Billing Requested.. ...... 7. `[yl{7 46 p 4, 8. Total Gross Assets(total Lines 1 through 7)...................... .... ... 8. f 4 l 3 7�8 . 3 g 9. Funeral Expenses and Administrative Costs(Schedule H)...... 10. Debts of Decedent, Mortgage Liabilities,and Liens(Schedule 1) . .... ... ...... 10. ! 1�1} �J'. '7�.�s�j 11. Total Deductions(total Lines 9 and 10). ... .... . ... .... ... .............. 11. -�I-- .�j �1��„�� 12. Net Value of Estate(Line 8 minus Line 11) ..... .... .... .... ...... ....... 12 3 �1 ��,'`bQ 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which JJJ.1 fj an election to tax has not been made(Schedule J) ... .... .... ....... .... .. 13. _ -_ 1- R 1X] b 14. Net Value Subject to Tax(Line 12 minus Line 13) ... ........ ....... .... .. 14. 1 3 3 O •;�+ 8 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 .00- J. 1 D 15. O O 16. Amount of Line 14 t xable at lineal rate X.0 13 1 3 U �{�: (� $ 16. 17. Amount of Line 14 taxable - - - - - - at sibling rate X.12 .. O O 17. Q 18. Amount of Line 14 taxable - -at collateral rate X.15 '0 � 18. 19. TAX DUE ... .. .... .. ... .... ... ........ .............. .... ....... .... .. 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT C Side 2 1505610105 15056101"05 REV-1500 EX Page 3 File Number 2,1-1,2 Decedent's Complete Address: DECEDENT'S NAME , l/ir :hilt L• �e�f STREETADDRESS NmF1424 /oo AM Alleh j4- CITY STATE ZIP fslec�iu�r�csd� ,o,¢ 1 7o sS' Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 7/ 2. Credits/Payments ;e A.Prior Payments 3 �?Ofo • �S B.Discount �- I6 8. 76- ; Total Credits(A+B) (2) 3 3 JS off 3. Interest �LLgeSf7M- 4. If Line 2 i greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. O Fill in oval on Page 2,Line 20 to request a refund. (4) 5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) .5,43-71 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;.......................................................................................... ❑ lK b. retain the right to designate who shall use the property transferred or its income;............................................ ❑ c. retain a reversionary interest;or.......................................................................................................................... ❑ d. receive the promise for life of either payments,benefits or care?...................................................................... ❑ 2. If death occurred 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 containsa beneficiary designalton? ........................................................................................................................ ❑ 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. For 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 [72 P.S. §9116(a)(11) (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(1.2)[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[72 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. COMMONWEALTH OF PENNSYLVANIA REV-1162 EX{11-@6) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXE$ DEPT.280601 HARRiSSUR6,PA 11128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 016888 SKILES KATHY A 1914 SAND HILL ROAD HERSHEY, PA 17033 ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 $3,206.25 ESTATE INFORMATION: SSN: 200-24-2485 FILE NUMBER: 2112- 1143 DECEDENT NAME: KEET VIRGINIA L DATE OF PAYMENT: 12/07/2012 POSTMARK DATE: 12/06/2012 COUNTY: CUMBERLAND DATE OF DEATH: 09/09/2012 TOTAL AMOUNT PAID: $3,206.25 REMARKS: RECEIPT TO ATTY CHECK# 3206.25 INITIALS: WZ SEAL RECEIVED BY: GLENDA FARMER STRASBAUGH REGISTER OF WILLS TAXPAYER REV-1502 EX+ (11-08) . pennsylvania SCHEDULE A ,DEPARTMENT OF REVENUE REAL ESTATE . INHERITANCE W RETURN ' RESIDENT DECEDENT . _ ESTATE OF FILE NUMBER Kect, 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'settlemenf 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 A// fltaf f?er�ll:/7 sf�iiNfJro✓eat lcf of laird si ake in CoaKe Torfiil5hlipr earnberland Oouniy , P;,� Trec Dr%vc, FJc a� a// Lof A/00 39 '0 fle ��n eF Lots Known as LRKe AorlL17 Es/utes, as re&rderl %ook /g, prls `[ DFFce of Nr� Reeorr�er of 17Cec�S �n awd )br eAmker1and C fen . 13c;7eerr'a � *��y descrilld M 1%af Cerfa;n deed 4" Renard aatd Chnaf frenard, h;3 w;fe, dates/ April 15,, 2X#, t Ai h,11-S: Xeef away ///.Y ik Kee,f, h:s w,fe, ",�4 is /"e&nlea! 'ca Qeeo rl/ ;&;2 , pat .960 cv; N� /�eeo/rlers oF{,�c u�o.rsa;d. 1 Keef wleakpoh .stie ,6eeame �u So% awe ,�f'fP i Sa;d Premrsu. I Cumberland Coutft /assessment Data L&lue = '�/3, 6Q0.00 (See ✓a/atahi fl mater,, (gild_ rllemo 4r i0e anW i4teI'e5fCo' larhi-4 11/049 Ghc4) I I r 60 TOTAL(Also enter on Line 1, Recapitulation.) $ L1.3 600 If more�space is needed,insert additional sheets of the same size. REV 15 Ex.n.97) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. " RESIDENT TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Ke��, V� rq,�tA L. .ZI—IZ—/lef3 Include the proceeds of litigation and the date the proceeds were received by the estate.All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH t Ro06 StAhmuruc, /oresfer Ya&6 6a 1ew 1aA'0n mah dy avers$:n,q 64ie l3mek; Fdmtod /YifO.Si 4s 4//oAls: 2a1,ao f �6,c�S f 08,/RS°O r s Rb(z•°° _�P/oy3 ' _ �7, /LD- 7S ('Set Ye/ua/sbn Waf afPach9w) PSECU. Representa/li At,I✓f, &v, O1tY9oo7zsqa(--7 (Payse ;s dau�blu, ff,,1y Skj%s) (5a✓infS) d6, gy6.oS 3. Z„t&rsf earned ✓a d,o.d_ on 1I&W 2 . . 99 ('Sec va/aehoy /fler a ll"eW) �. �nwe�ledsies=ra, C1411 d Ceerxo /y3,s7� S liVfo NarE;• �4 1I jurn;/ure lwyseklal ooa/s Caere g.'v en QAvaq or ctiS 0vw o ir/ /7iP�Jara/So/� 7�,r e�pjl//ual mytle app-ox. /{years qgv, 29 TOTAL(Also enter on line 5,Recapitulation) $ .3 151, (If more space is needed,insert additional sheets of the same size) 4V1509 EX.11a7) SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Kee*, Vlrlinla I—• FILE NUMBER If an asset was made joint within one year of the decedent's date of death,it must be reported on Schedule G. SURVIVING JOINT TENANTS)NAME ADDRESS RELATIONSHIP TO DECEDENT A. Hers/�ey, Pi¢ 17033 —9655- d P^ B. C. JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY % DATE OF DEATH ITEM FORJOINT MADE Include name of financial institution and bank account number or similar identifying number.Attach DATE OF DEATH DECO'S VALUE OF NUMBER TENANT JOINT deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST t. A. 111240 PS£cu .54k,"ifs Azi. /Yo. 3'2 61?"J3 7A X/ f/, 9/P. q6 SZlo `9s:mv �. • � f� 303 say A . a %9 PSECu Cher/ Af No. SR8110 fr724 9!. �,69S.Sd 3. A it/z%y PSEC�u �iy,�y .&,/`. ao. �26Sya�7z y �sr, BzT.go so9 X?3,? 9i3 90 (sce %. Deilt.eR 1&11, /VD r AM Mt /.3// Y-K0,' 1311 1191 and 1311Y9g2 afiched) TOTAL,(Also enter on line 6,Recapitulation) $ 33� 5i 8 9� (If more space is needed,insert additional sheets of the same size) REV-1510 EX+ (08-09) [ iT pennsylvania SCHEDULE G DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF / FILE NUMBER Keel; l/:/''9:,4,a L. 7/�f3 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. DESCRIPTION OF PROPERTY ITEM INCLUDE THE NAME OF THE TRANSFEREE,THEIR REUTIONSHIP TO DECEDENT AND DATE OF DEATH %OF DECD'S EXCLUSION TAXABLE NUMBER THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST IIFAPPUDBEEI VALUE 1. 11-4 sh. s� Common Z'tk of Pr to den�a� Pnano- "Z/, roe. rlw#) H: *57,;?a wLo PSG•39 = //3. S8 .Zr fiS6.77 6, Y71eob /00,& —0 - �6, Y744,96 Y aye %rnnS/e re is �alYiy cS<',/es, ° r(o Y791A dau�ti�ri' v{ deeedeirt See l�w�ua✓e// .Sree� Ol�4c/led) TOTAL(Also enter on Line 7, Recapitulation) $ If more space is needed, use additional sheets of paper of the same size. REV-1511 EX+(10-06) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF r FILE NUMBER z/ Debts of decedent must be reported on Schedule L ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. !`l0�1;�7�jer �Hq�� 1�omc c>~uf G'eana�'nrt. o/ h9tNaly S/�rin�s -3/SO. a0 3. CAurd? ! Ala' Faso. co B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Red Name of Personal Representative(s))y W�/�Q/7�91 /IeCG Street Address _a7 gnt;. W//OOW City i/'�e "Iel,50/?/� State Oil• zip Year(s)Commission Paid: _ ec __ / 2. Attorney Fees C44pl,,S kcc, N4ic 41s l jr S� •S�Q• pD 3. Family Exemption:(If decedent's address is not the same as claimant's,attach explanation) Claimant ND dVE FUG 13 /-4!5� Street Address City State Zip Relationship of Claimant to Decedent / 1 d 4. Probate Fees "4 Pt;r;na/ issue e�.S%i0i'f C�i?k,/ 7GQ/eS /. //3,5Z) 5. Accountant's Fees o o5h 6p&O� /,Poo/ Larr oPr CP/fi' �o/• p��p 6. Tax Return Preparer's Fees / lob/ /�A'e/�,C ems•�PSfim.� ¢3�• 7. /�dverhsi�, in �kn�,ber/acrd /�e�✓ Tearnal f�S o0 "147,,W,, le. 1Qeirn,� urSerneenf � G'ba3• �: �'hields m ,�� p�uj��' Tasv/i vfn cknri/< T•}ha ,4b sdr4c�� �;jS no (See 661hhaAA/ n 5hee.f• OAadieA/)TOTAL(Also enter on line 9, Re apitulation) $ 4 9a(y �O• /F (If more space is needed,insert additional sheets of the same size) i per;, Sehe • N, eot�tt'd. 1lQ;n ;a IVO, o71 Lei—1 113 _ I.;?.._ �'rrtt_�Xt�ertJPllt�� T�2s.�_eF1�lLir.�s_lll�{ct��c�ago, celrf%f'cd t3. /�r/ iilie�7af pr�he.le. /.f� �U/11i:33iens .i�%err --Falk /rr�-rya ( Sae- A-4. jaaa f $ *AWeVt a6c4cal REV-1512 EX+(12-03) SCHEDULE I COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES, & LIENS RESIDENT DECEDENT ESTATE OF I e [ `� �'1k FILE NUMBER e �-i t/-/z- ii 13 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 1. �. /ylcssiah l'i//aye �l, o3Zafl 3. 4te>ren X. 13,aunlyn, %.yr 61lerfor ` 47. 70 TOTAL(Also enter on line 10, Recapitulation) $ / 0if 7 S� (If more space is needed,insert additional sheets of the same size) REV-1513 EX+(11-08) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 2116(a) (1.2).] 1. Xee} prcdeceased dezedmt ,.�ooy5e. — 0 — a9 oa,(�,wooc/ /f✓e. /ylce>lian��s6u f./fors (/ 3. Teary Alen{ f/oixan / daagtibe.- /o/ S. 01&r9e St /jlechawiCSdur I� ass j9v 4eel We.s da7'Ayf r yq /9/y y rf:%/ ✓?&, llenh* % Ati�1 1/033 t/ .61 Tames F Keel son yq C/o lvi//iasw K. /(eel -Z g Oa/livoo�l /arc. , /yl,�fr4a/ts�ar�� Pssr 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 2113 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. $ If more space is needed,insert additional sheets of the same size. ell nZ 11 1 . : FAR I All,� I / /1 i I i Ij 0-4,14 X/ —44- art —---------- al If 11!15/2013 11:06 Cornerstone Land Transfer (TA)D7177309665 P.0011002 RESEARCH SOLMDIIS, LLC 4305 East Ttindle Road mechanlcsbur9, PA 13060 Phone: 313-6180-8664 FaK: 'M-330-9665 JasonStacW-d"iandsettlement.com Bill to: Charles E. Shields Date:November 15,2013 Invoice# 162 FOR SERVICES RENDERED: Assessment Search Keet TOTAL AMOUNT DUE: $25.00 PAYMENT WITHIN 30 DAYS WILL BE APPRECIATED Please return one coov of this invoice with your payment. 3323 ATTY CHARLES E SHIELDS III 3-7615/360 6 CLOUSER RD. MECHANICSBURG,PA 17055 L DAB If /.3' PAD THE a. /...1A� i( yi L`1. $taJ� .. ORDER ER OF �GGfK� ��/� Jgd��'t - Z —f�•-'cf—ii.�L/ /00 DOLLARS IM Citizens Bank° /�//Jp� �/� MEMO ✓Y -'L'ff��%o/- ___�%'S /C * 1:0 360 76 1 501: 621555124811' 3323 11115/2013 11:06 Cornerstone Land Transfer (TAX)7177309665 P.0011002 RESEARCH SO UTIMS. LLC 4305 East T"Ie Road Mechanlcsbwg,PA n060 Phone: 414-560-8664 Fai. 7R-430-9665 jasonStack n)ck(gMndsettlement com Bill to: Charles E. Shields Date: November 15,2013 Invoice# 162 FOR SERVICES RENDERED: Assessment Search Keet TOTAL AMOUNT DUE: $25.00 PAYMENT WITHIN 30 DAYS WILL BE APPRECIATED Please return one copy of this invoice with your payment. Amount Enclosed: $ Thank youl 1111512013 11:06 Cornerstone Land Transfer ffAX)7177309665 P.0021002 2009 Remarks : 4 CHANGE NOTICE ARCHIVE WEB PW: CUAACAZV PARCEL: 07-37-2571-011 . OWNER: KEET, VIRGINIA B & RICHARD S BASE MAIL DATE Why FAV LAND FAV BLDG TOTAL CG LAND TOTAL YEAR Proposed 12900 0 12900 T 2009 09/13/2012 F9 12900 0 12900 T 2009 06/09/2011 30 43600 0 43600 T PPL Historical Prices I PP&L Corporation Common Stock Stock-Yahoo!Finance 2/23/14 1:24 PM er Carnes Groups Answers Screen Fliclir Mobile I More Personal Finance Yahoo Originals CNBC __._...-------------__._._.._._.____..._------------- ._--.,_--..,__--_. Search Finance $§rt1^fl Web all Sun,Feb 23,2014,1:20pm EST-US Markets are closed Predict- _. PF OrTRA®!S' FEW AmedtrtMa O PEN AN A4C0tlEi PPL ,.,,....:.- r .... PPL Corporation(PPL) - NYSE Follow Add to Portfolio I Like �a31 31 .80t0.01 (0.03%) Feb 21,4:03PM EST I After Hours:31.80 0.00(0.00%) Feb 21,4:55PM EST Historical Prices Get Historical Prices for: �ICED Set Date Range .....___ ( Start Date: 'Sep !99 2012_t E9.Jan 1,2010 ()Weekly End Date: .Sep- 2012—� ()Monthly ODividends Only Get:PfIClS First I Previous I Next I Last Prices Date Open High Low Close Volume Adj Close' Sep 7,2012 29.26 29.35 29.14 29.24 2,542,300 27.51 "Close price adjusted for dividends and splits. First I Previous I Next I Last ADownload to Spreadsheet Currency in USD. �: a9.35 •L LD R7911(= 58, 19 ?r &yo y8••V 075; • 2 =a9.2s http://finance.yahoo.com/q/hp?a=08&b=9&c=2012&d=08&e=9&f=2012&g=d&s=PPL%2C+&ql=1 Page 1 of 2 ZIP CODE:17013 1 Sign in for Sign up) home car values cars for sale car reviews KBB top picks research tools f THE 20149EEP913ATRIOT r aUanamic,. GET auom. 0 Know Popular at KBB.com / STARTING AT MSRP'$15.995. 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A 2013 Kdley Blue Book Co.,Inc All d9hts reserved.111112013-111712013 Edition for Penesylwnla J 70J3.The sp wit,Inram)tlon re0ulrtd to determine the value for NR particular vehide was supplied by Me person generating this report.Vehkle valuations are.,Irlors and may vary hem vehlde to vehlde.Actual valuations will very based upon market corM/tlens,spedhoetlons, vehwe condition ar otherpartlNlar dr ri stInces pertlnent to this partkular vehicle or the Kansattlon or the partles to tire transaction.Thfs report it Intended for Me Indwhlual use of the Person generating N6 report only and shag not be sold or transmfftM to Gnome,party.Kelley BNB Book assumes no responsibRity roc errors or omissions.(v.131 J0) Home> Used Cars> Subaru> Foreste > 2006 Forester Waclon> JijLELwlLh OgtlipM> Prices with Options Results ADVERESEMEW sI J) JCCU'0�(.,ly Signthendrivii Ike Model Year Car Car 4 Search Type Research Comb Prong for 17007-1 UPDATE Boiling Sprino,PA Cumberland Valley Motors True Market ValueO 1,'timd I I to Trade-in Dealer Retail ................. $5,266 $6,929 1JMarc n _04�fx1s SiaY F 1117R 10-14 FOL[taybiskLCk!ktLn-fldfLr-Spoo SIE & Heated seats,mar view low- Private Party Sale $6,025 camera, HID headlights,and Blucticath,come standard for only$22,595 MSRP. 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Get the Used Car Report 4WD 4dr Laredo Powered by AU[oTrader.com Enter VtN(optional) 2013 Honda CR-V Car Buying &Selling Services 2WD Sdr EX Sell your car now on AutoTradeccom Search for cars in your local area Get up to 40%off with State Farm Get pre-approved for an auto loan 2013 Kid Sorento Instantly See Your$0 Credit Score Free new car dealer quote 2WD 4dr I4 LX xt Next:CPO Pricing 2013 Volkswagen Tiguan 2WD 4dr Auto S Homal-tali Ree.a l.t._.U.',iall F C': ....wu, t IAd,c:tis I:..inkio US! , l,w! :,Fo!'e Rt loess Piolut�)s.':narjt ''.? Ereiow Us Gl tom© CoeYd.l.-t I t. v9Ct POt v SCrana { i.- � A(1 iGi4!>�jy A4 cu.e r 2/f/,z KewiW PSECU 12,04,2012 Charles E. Shields, III Attomey-at-Law 6 Clouser Rd. Mechanicsbura, PA 17055 Re: VIRGINIA B KEET,Deceased. PSECU Reference#0449007254267 Dear Attorney Shields: The above referenced person has an account with PSECU which was opened on March 11, 2010. This Representative Payee Account is for VIRGINIA B KEET with KATHY SKILES the named Representative Payee. VIRGINIA KEET did not have a safety deposit box with PSECU. The following are the Date of Death Balances for VIRGINIA B KEET's account with PSECU: Account Date of Death Balances Interest—September 1-9 (S1) Savings $26,846.05 $0.99 Please provide us instructions on closing the decedent's account. If you have any questions, please contact me at (717) 234-8484 or toll-free at (800) 237- 7328, press 6, extension 3120: Sincerely, Sandy F J�a Member Service Representative PSECU Pennsylvania State Employees Credit Union 1 Credit Union Place, P.O. Box 67013, Harrisburg, PA 17106-7013 • 800.237.7328 • »psecu.com THIS CREDIT UNION IS FEDERALLY INSURED BY THE NATIONAL CREDIT UNION ADMINISTRATION.EQUAL OPPORTUNITY LENDER. BUREAU 28 INDIVIDUAL TAXES Penns lvania Inheritance Tax Pennsylvania PD BOX 280601 Pennsylvania REVENUE HARRISBURG PA 17128-0601 Information Notice e[rnsas And Taxpayer Response FILE NO.2112-1143 ACN 13114990 DATE 03-20-2013 Type of Account Estate of VIRGINIA L KEET Savings SSN Checking Date of Death 09-09-2012 Trust KATHY SKILES County CUMBERLAND Certificate 1914 SAND HILL RD HERSHEY PA 17033-2655 PSECU provided the department with the information below indicating that at the death of the above-named decedent you were a joint owner or beneficiary of the account identified. Remit Payment and Forms to: Account No.8268408724 Date Established 11-20.2009 REGISTER OF WILLS Account Balance $1,918.96 1 COURTHOUSE SQUARE Percent Taxable X 50 CARLISLE PA 17013 Amount Subject to Tax $959.48 Tax Rate X 0.045 NOTE': If tax payments are made within three months of the Potential Tax Due $43.18 decedent's date of death,deduct a 5 percent discount on the tax With 5%Discount(Tax x 0.95) $(see NOTE') due. Any inheritance tax due will become delinquent nine months after the date of death. PART Step 1 : Please check the appropriate boxes below. 1 A F-]No tax is due. I am the spouse of the deceased or I am the parent of a decedent who was 21 years old or younger at date of death. Proceed to Step 2 on reverse. Do not check any other boxes and disregard the amount shown above as Potential Tax Due. g The information is The above information is correct, no deductions are being taken,and payment will be sent correct. with my response. Proceed to Step 2 on reverse. Do not check any other boxes. C The tax rate is incorrect. F-I 4.5% 1 am a lineal beneficiary(parent,child,grandchild, etc.)of the deceased. (Select correct tax rate at right, and complete Part ❑ 12% 1 am a sibling of the deceased. 3 on reverse.) ❑ 15% All other relationships(including none). D ❑Changes or deductions The information above is incorrect and/or debts and deductions were paid. AEV-1500.listed. Complete Part 2 and part 3 as appropriate on the back o1 this form. E sset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax heritance tax form Return filed by the estate representative. Proceed to Step 2 on reverse. Do not check any other boxes. Please sign and date the back of the form when finished. PART Debts and Deductions 2 Allowable debts and deductions must meet both of the following criteria: A. The decedent was legally responsible for payment, and the estate is insufficient to pay the deductible items. B. You paid the debts after the death of the decedent and can furnish proof of payment if requested by the department. (If additional space is required,you may attach 81/2"x 11"sheets of paper.) Date Paid Payee Description Amount Paid Total Enter on Line 5 of Tax Calculation $ PART Tax Calculation 3 If you are making a correction to the establishment date Line 1 account balance Line 2 ,or y g ( ) ( ) percent taxable(Line 3), please obtain a written correction from the financial institution and attach it to this form. 1. Enter the date the account was established or titled as it existed at the date of death. 2. Enter the total balance of the account including any interest accrued at the date of death. 3. Enter the percentage of the account that is taxable to you. a. First,determine the percentage owned by the decedent. i. Accounts that are held "intrust for"another or others were 100%owned by the decedent. ii. ' For joint accounts established more than one year prior to the date of death,the percentage taxable is 100%divided by the total number of owners including the decedent. (For example:2 owners=50%,3 owners =33.33%,4 owners =25%,etc.) b. Next,divide the decedent's percentage owned by the number of surviving owners or beneficiaries. 4. The amount subject to tax is determined by multiplying the account balance by the percent taxable. 5. Enter the total of any debts and deductions claimed from Part 2. 6. The amount taxable is determined by subtracting the debts and deductions from the amount subject to tax. 7. Enter the appropriate tax rate from Step 1 based on your relationship to the decedent. If indicating a different tax rate,please state Official Use Only ❑AAF your relationship to the decedent: PA Department of Revenue 1. Date Established 1 2. Account Balance 2 $ PAD 3. Percent Taxable 3 X 1 4. Amount Subject to Tax 4 $ 3 5. Debts and Deductions 5 - 4 6. Amount Taxable 6 $ 5 7. Tax Rate 7 X 6 8. Tax Due 8 $ 7 8 9. With 5%Discount(Tax x .95) 9 X Step 2: Sign and date below. Return TWO completed and signed copies to the Register of Wills listed on the front of this form, along with a check for any payment you are making. Checks must be made payable to"Register of Wills,Agent." Do not send payment directly to the Department of Revenue. Under penalty of perjury, I declare that the facts I have reported above are true,correct and complete to the best of my knowledge and belief. /� r Work Y6tZ 9� 49- Home 111�� Taxpayer Signature Telephone Number Date IF YOU NEED FURTHER ASSISTANCE, CONTACT CUMBERLAND COUNTY REGISTER OF WILLS, PA DEPARTMENT OF REVENUE DISTRICT OFFICE, OR THE INHERITANCE TAX DIVISION At 717-787-8327. SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-447-3020 BUREAU OF INDIVIDUAL TAXES Penns lvania Inheritance Tax T pennsylvania PO BOX 280601 Y HARRISBURG PA 17128-0601 Information Notice DEPARTMENT OF REVENUE And Taxpayer Response FILE N0.2 112 152`Y-11443 3 (DO-1Z) ACN 13114991 DATE 03-20-2013 Type of Account Estate of VIRGINIA L KEET Savings SSN Checking Date of Death 09-09-2012 Trust KATHY SKILES County CUMBERLAND Certificate 1914 SAND HILL RD HERSHEY PA 17033-2655 PSECU,.,provided the department with the information below indicating that at the death of the above-named decedent you were a joint owner or beneficiary of the account identified. Account No.8268408724 Remit Payment and Forms to: Date Established 11-20-2009 REGISTER OF WILLS Account Balance $5,391.03 1 COURTHOUSE SQUARE Percent Taxable X 50 CARLISLE PA 17013 Amount Subject to Tax $2,695.52 Tax Rate X 0.045 Potential Tax Due $ 121.30 NOTE': If tax payments are made within three months the decedent's date of death,deduct a 5 percent discount on the tax With 5% Discount(Tax x 0.95) $(see NOTE') due. Any inheritance tax due will become delinquent nine months after the date of death. PART Step 1 : Please check the appropriate boxes below. 1 A ❑No tax is due. I am the spouse of the deceased or I am the parent of a decedent who was 21 years old or younger at date of death. Proceed to Step 2 on reverse. Do not check any other boxes and disregard the amount shown above as Potential Tax Due. B ❑The information is The above information is correct, no deductions are being taken, and payment will be sent correct. with my response. Proceed to Step 2 on reverse. Do not check any other boxes. C The tax rate is incorrect. ❑ 4.5% 1 am a lineal beneficiary(parent,child,grandchild, etc.)of the deceased. (Select correct tax rate at right,and complete Part ❑ 12% 1 am a sibling of the deceased. 3 on reverse.) ❑ 15% All other relationships (including none). D ❑Changes or deductions The information above is incorrect and/or debts and deductions were paid. listed. Complete Part 2 and part 3 as appropriate on the back of this form. E Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax inheritance tax form Return filed by the estate representative. REV-1500. Proceed to Step 2 on reverse. Do not check any other boxes. Please sign and date the back of the form when finished. PART Debts and Deductions 2 Allowable debts and deductions must meet both of the following criteria: A. The decedent was legally responsible for payment,and the estate is insufficient to pay the deductible items. B. You paid the debts after the death of the decedent and can furnish proof of payment if requested by the department. (If additional space is required,you may attach 8 1/2"x 11"sheets of paper.) Date Paid Payee Description Amount Paid Total Enter on Line 5 of Tax Calculation $ PART Tax Calculation 3 If you are making a correction to the establishment date Line 1 account balance Line 2 or Y 9 ( ) ( ), percent taxable(Line 3), please obtain a written correction from the financial institution and attach it,to this form. 1. Enter the date the account was established or titled as it existed at the date of death. 2. Enter the total balance of the account including any interest accrued at the date of death. 3. Enter the percentage of the account that is taxable to you. a. First,determine the percentage owned by the decedent. i. Accounts that are held"intrust for"another or others were 100%owned by the decedent. ii. For joint accounts established more than one year prior to the date of death, the percentage taxable is 100%divided by the total number of owners including the decedent. (For example:2 owners= 50%,3 owners =33.33%,4 owners =25%,etc.) b. Next,divide the decedent's percentage owned by the number of surviving owners or beneficiaries. 4. The amount subject to tax is determined by multiplying the account balance by the percent taxable. 5. Enter the total of any debts and deductions claimed from Part 2. 6. The amount taxable is determined by subtracting the debts and deductions from the amount subject to tax. 7. Enter the appropriate tax rate from Step 1 based on your relationship to the decedent. If indicating a different tax rate, please state Official Use Only ❑AAF your relationship to the decedent: PA Department of Revenue 1. Date Established 1 2. Account Balance 2 $ PAD 3. Percent Taxable 3 x !1 4. Amount Subject to Tax 4 $ .3 5. Debts and Deductions 5 4 6. Amount Taxable 6 $ 5 7. Tax Rate 7 x 6 8. Tax Due 8 $ 7 8 9. With 5%Discount(Tax x .95) 9 x Step 2: Sign and date below. Return TWO completed and signed copies to the Register of Wills listed on the front of this form, along with a check for any payment you are making. Checks must be made payable to"Register of Wills, Agent." Do not send payment directly to the Department of Revenue. Under penalty of perjury, I declare that the facts I have reported above are true,correct and complete to the best of my knowledge and belief. Work -717- 7GW"-0,707 Home Taxpayer Signature Telephone Number Date y A113 IF YOU NEED FURTHER ASSISTANCE, CONTACT CUMBERLAND COUNTY REGISTER OF WILLS, PA DEPARTMENT OF REVENUE DISTRICT OFFICE, OR THE INHERITANCE TAX DIVISION AT 717-787-8327. SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-447-3020 BUREAU OF INDIVIDUAL TAXES Pennsylvania Inheritance Tax - - pennsytvanla PO BOX 280601 Y HARRISBURG PA 17128-0601 Information Notice DEPARTMENT OF REVENUE And Taxpayer Response _ REV-1543 1�3 (15-12) FILE NO.2112-1143 ACN 13114992 DATE 03-20-2013 Type of Account Estate of VIRGINIA L KEET Savings SSN Checking Date of Death 09-09-2012 Trust KATHY SKILES County CUMBERLAND Certificate 1914 SAND HILL RD HERSHEY PA 17033-2655 PSECU provided the department with the information below indicating that at the death of the above-named decedent you were a joint owner or beneficiary of the account identified. Account No.8268408724 Remit Payment and Forms to: Date Established 11-20-2009 REGISTER OF WILLS Account Balance $59,827.80 1 COURTHOUSE SQUARE Percent Taxable X50 CARLISLE PA 17013 Amount Subject to Tax $29,913.90 Tax Rate X 0.045 Potential Tax Due $ 1,346.13 NOTE': If tax payments are made within three months the decedent's date of death,deduct a 5 percent discount on the tax With 5%Discount(Tax x 0.95) $(see NOTE') due. Any inheritance tax due will become delinquent nine months after the date of death. PART Step 1 : Please check the appropriate boxes below. 1 A No tax is due. I am the spouse of the deceased or I am the parent of a decedent who was 21 years old or younger at date of death. Proceed to Step 2 on reverse. Do not check any other boxes and disregard the amount shown above as Potential Tax Due. B ❑The information is The above information is correct,no deductions are being taken,and payment will be sent correct. with my response. Proceed to Step 2 on reverse. Do not check any other boxes. C F-]The tax rate is incorrect. ❑ 4.5% 1 am a lineal beneficiary (parent, child, grandchild,etc.)of the deceased. (Select correct tax rate at right,and complete Part ❑ 12% 1 am a sibling of the deceased. 3 on reverse.) ❑ 15% All other relationships(including none). D ❑Changes or deductions The information above is incorrect and/or debts and deductions were paid. listed. Complete Part 2 and part 3 as appropriate on the back of this form. E ►X1 Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax S�inheritance tax form Return filed by the estate representative. REV-1500. Proceed to Step 2 on reverse. Do not check any other boxes. Please sign and date the back of the form when finished. PART Debts and Deductions 2 Allowable debts and deductions'must meet both of the following criteria: A. The decedent was legally responsible for payment,and the estate is insufficient to pay the deductible items. B. You paid the debts after the death of the decedent and can furnish proof of payment if requested by the department. (If additional space is required,you may attach 8 1/2"x 11"sheets of paper.) Date Paid Payee Description Amount Paid Total Enter on Line 5 of Tax Calculation $ PART Tax Calculation 3 If you are making a correction to the establishment date(Line 1)account balance(Line 2), or percent taxable(Line 3), please obtain a written correction from the financial institution and attach it to this form. 1. Enter the date the account was established or titled as it existed at the date of death. 2. Enter the total balance of the account including any interest accrued at the date of death. 3. Enter the percentage of the account that is taxable to you. a. First,determine the percentage owned by the decedent. i. Accounts that are held"intrust for"another or others were 100%owned by the decedent. ii. For joint accounts established more than one year prior to the date of death,the percentage taxable is 100%divided by the total number of owners including the decedent. (For example:2 owners= 50%,3 owners =33.33%, 4 owners =25%,etc.) b. Next,divide the decedent's percentage owned by the number of surviving owners or beneficiaries. 4. The amount subject to tax is determined by multiplying the account balance by the percent taxable. 5. Enter the total of any debts and deductions claimed from Part 2. 6. The amount taxable is determined by subtracting the debts and deductions from the amount subject to tax. 7. Enter the appropriate tax rate from Step 1 based on your relationship to the decedent. If indicating a different tax rate,please state Official Use Only ❑AAF your relationship to the decedent: PA Department of Revenue 1. Date Established 1 2. Account Balance 2 $ !PAD 3. Percent Taxable 3 X 12 4. Amount Subject to Tax 4 $ i3 5. Debts and Deductions 5 14 6. Amount Taxable 6 $ i5 7. Tax Rate 7 X 6 8. Tax Due 8 $ 7 9. With 5% Discount (Tax x .95) 9 X 8 Step 2: Sign and date below. Return TWO completed and signed copies to the Register of Wills listed on the front of this form, along with a check for any payment you are making. Checks must be made payable to"Register of Wills,Agent." Do not send payment directly to the Department of Revenue. Under penalty of perjury, I declare that the facts I have reported above are true,correct and complete to the best of my knowledge and belief. pp ��,> ,�. work 717-00" �.D� o � /3 Home j� Taxpayer Signature Telephone Number Date IF YOU NEED FURTHER ASSISTANCE, CONTACT CUMBERLAND COUNTY REGISTER OF WILLS, PA DEPARTMENT OF REVENUE DISTRICT OFFICE, OR THE INHERITANCE TAX DIVISION AT; 717-787-8327. SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-447-3020 CHARLES E. SHIELDS, III ATTORNEY-AT-LAW 6 CLOUSER ROAD Corner of Trindle and Clouser Roads MECHANICSBURG,PA 17055 ! GEORGE M.HOUCK TELEPHONE (717) 766-0209 (1912-1991) FAX (717) 795-7473 April 8,2013 PA Department of Revenue Bureau of Individual Taxes Inheritance Tax Division Dept.280601 Harrisburg,PA 17128-0601 Re: Estate of Virginia L.Keeet,deceased File No.: 21-12-1143 SSN: DOD: 9/9/2012 PSECU ACN Nos.: 13114990 13114991 13114992 Dear Sir/Madam: Please find enclosed signed and dated information Notice and Taxpayer Response forms for the above-mentioned ACN's. As noted on the forms,we will be including the Potential Tax Due with the Inheritance Tax when filed. Thank you. Very truly yours, am"JZZ� Charles E. Shields,III Attorney-At-Law CES/mjj Enclosures BUREAU OF INDIVIDUAL TAXES Pennsylvania Inheritance Tax 3 i pennsylvania PO BOX 280601 y T.� DEPARTMENT OF REVENUE HARRISBURG PA 1712B-0601 Information Notice DEPARTMENT [x ENTO REV And Taxpayer Response FILE NO.2112-1143 ACN 13114990 DATE 03-20.2013 Type of Account Estate of VIRGINIA L KEET Savings SSN Checking Date of Death 09-09-2012 Trust KATHY SKILES County CUMBERLAND Certificate 1914 SAND HILL RD HERSHEY PA 17033-2655 PSECU provided the department with the information below indicating that at the death of the above-named decedent you were a joint owner or beneficiary of the account identified. Account NO.8268408724 Remit Payment and Forms to: Date Established 11-20-2009 - REGISTER OF WILLS Account Balance $1,918.96 1 COURTHOUSE SQUARE Percent Taxable X 50 CARLISLE PA 17013 Amount Subject to Tax $959.48 Tax Rate X 0.045 Potential Tax Due $43.18 NOTE`: If tax payments are made within three months the decedent's date of death, deduct a 5 percent discount on the tax With 5%Discount (Tax x 0.95) $(see NOTE') due. Any inheritance tax due will become delinquent nine months after the date of death. PART Step 1 : Please check the appropriate boxes below. 1 A F-INO tax is due. I am the spouse of the deceased or I am the parent of a decedent who was 21 years old or younger at date of death. Proceed to Step 2 on reverse. Do not check any other boxes and disregard the amount shown above as Potential Tax Due. B The information is The above information is correct, no deductions are being taken,and payment will be sent correct. with my response. Proceed to Step 2 on reverse. Do not check any other boxes. C The tax rate is incorrect. F-1 4.5% 1 am a lineal beneficiary(parent, child,grandchild,etc.)of the deceased. (Select correct tax rate at right,and complete Part ❑ 12% 1 am a sibling of the deceased. 3 on reverse.) ❑ 15% All other relationships(including none). D Changes or deductions The information above is incorrect and/or debts and deductions were paid. listed. Complete Part 2 and part 3 as appropriate on the back of this form. E Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax inheritance tax form Return filed by the estate representative. REV-1500. Proceed to Step 2 on reverse. Do not check any other boxes. Please sign and date the back of the form when finished. PART Debts and Deductions 2 Allowable debts and deductions must meet both of the following criteria: A. The decedent was legally responsible for payment, and the estate is insufficient to pay the deductible items. B. You paid the debts after the death of the decedent and can furnish proof of payment if requested by the department. (If additional space is required,you may attach 8 1/2"x 11"sheets of paper.) Date Paid Payee Description Amount Paid Total Enter on Line 5 of Tax Calculation $ PART Tax Calculation 3 If you are making a correction to the establishment date(Line 1)account balance(Line 2), or percent taxable(Line 3), please obtain a written correction from the financial institution and attach it to this form. — 1. Enter the date the account was established or titled as it existed at the date of death. 2. Enter the total balance of the account including any interest accrued at the date of death. 3. Enter the percentage of the account that is taxable to you. a. First,determine the percentage owned by the decedent. I. Accounts that are held"in trust for"another or others were 100%owned by the decedent. ii. For joint accounts established more than one year prior to the date of death,the percentage taxable is 100%divided by the total number of owners including the decedent. (For example:2 owners= 50%, 3 owners=33.33%, 4 owners =25%,etc.) b. Next,divide the decedent's percentage owned by the number of surviving owners or beneficiaries. 4. The amount subject to tax is determined by multiplying the account balance by the percent taxable. 5. Enter the total of any debts and deductions claimed from Part 2. 6. The amount taxable is determined by subtracting the debts and deductions from the amount subject to lax. 7. Enter the appropriate tax rate from Step 1 based on your relationship to the decedent. If indicating a different tax rate,please state j Official Use Only AAF your relationship to the decedent: PA Department of Revenue 1. Date Established 1 2. Account Balance 2 $ PAD 3. Percent Taxable 3 X 2 4. Amount Subject to Tax 4 $ 3 ' 5. Debts and Deductions 5 4 6. Amount Taxable 6 $ 5 7. Tax Rate 7 X 6 8. Tax Due 8 $ 7 8 9. With 59/6 Discount (Tax x .95) 9 X Step 2: Sign and date below. Return TWO completed and signed copies to the Register of Wills listed on the front of this form, along with a check for any payment you are making. Checks must be made payable to"Register of Wills,Agent." Do not send payment directly to the Department of Revenue. Under penalty of perjury, I declare that the facts I have reported above are true,correct and complete to the best of my knowledge and belief. Work Home Taxpayer Signature Telephone Number Date IF YOU NEED FURTHER ASSISTANCE, CONTACT CUMBERLAND COUNTY REGISTER OF WILLS, PA DEPARTMENT OF REVENUE DISTRICT OFFICE, OR THE INHERITANCE TAX DIVISION AT 717-787-8327. SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-447-3020 BORENU INDIVIDUAL TAXES 28 ance enns BOx 280601 y Penns lvania Inherit Tax [i� lvania HARRISBURG PA 17128-0601 Information Notice DEPARTMENT OF REVENUE And Taxpayer Response °`°" '" FILE NO.2112-1143 ACN 13114990 DATE 03-20-2013 Type of Account Estate of VIRGINIA L KEET Savings SSN Checking Date of Death 09-09-2012 Trust KATHY SKILES County CUMBERLAND Certificate 1914 SAND HILL RD HERSHEY PA 17033-2655 Psecu provided the department with the information below indicating that at the death of the above-named decedent you were a joint owner or beneficiary of the account identified. Account NO.8268408724 Remit Payment and Forms to: Date Established 11-20-2009 REGISTER OF WILLS Account Balance $ 1,918.96 1 COURTHOUSE SQUARE Percent Taxable 750 CARLISLE PA 17013 Amount Subject to Tax $959.48 Tax Rate x 0.045 Potential Tax Due $43,18 NOTE': If tax payments are made within three months the decedent's date of death, deduct a 5 percent discount on the tax With 5%Discount(Tax x 0.95) $(see NOTE') due. Any inheritance tax due will become delinquent nine months after the date of death. PART Step 1 : Please check the appropriate boxes below. 1 A F�No tax is due. I am the spouse of the deceased or I am the parent of a decedent who was 21 years old or younger at date of death. Proceed to Step 2 on reverse. Do not check any other boxes and disregard the amount shown above as Potential Tax Due. g The information is The above information is correct,no deductions are being taken,and payment will be sent correct. with my response. Proceed to Step 2 on reverse. Do not check any other boxes. C The tax rate is incorrect. 04.5% 1 am a lineal beneficiary (parent,child,grandchild,etc.)of the deceased. (Select correct tax rate at right, and complete Part F-I 12% 1 am a sibling of the deceased. 3 on reverse.) ❑ 15% All other relationships (including none). D ❑Changes or deductions The information above is incorrect and/or debts and deductions were paid. listed. Complete Part 2 and part 3 as appropriate on the back of this form. E F�Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax inheritance tax form Return filed by the estate representative. REV-1500. Proceed to Step 2 on reverse. Do not check any other boxes. Please sign and date the back of the form when finished. PART Debts and Deductions 2 Allowable debts and deductions must meet both of the following criteria: A. The decedent was legally responsible for payment,and the estate is insufficient to pay the deductible items. B. You paid the debts after the death of the decedent and can furnish proof of payment if requested by the department. (If additional space is required, you may attach 8 1/2"x 11"sheets of paper.) Date Paid Payee Description Amount Paid Total Enter on Line 5 of Tax Calculation $ PART Tax Calculation 3 If you are making a correction to the establishment date(Line 1)account balance(Line 2),or percent taxable(Line 3), please obtain a written correction from the financial institution and attach it to this form. 1. Enter the date the account was established or titled as it existed at the date of death. 2. Enter the total balance of the account including any interest accrued at the date of death. 3. Enter the percentage of the account that is taxable to you. a. First,determine the percentage owned by the decedent. i. Accounts that are held"in trust for"another or others were 100%owned by the decedent. ii. For joint accounts established more than one year prior to the date of death, the percentage taxable is 100%divided by the total number of owners including the decedent. (For example:2 owners= 50%, 3 owners=33.33%,4 owners =25%, etc.) b. Next, divide the decedent's percentage owned by the number of surviving owners or beneficiaries. 4. The amount subject to tax is determined by multiplying the account balance by the percent taxable. 5. Enter the total of any debts and deductions claimed from Part 2. 6. The amount taxable is determined by subtracting the debts and deductions from the amount subject to tax. 7. Enter the appropriate tax rate from Step 1 based on your relationship to the decedent. If indicating a different tax rate, please state Official Use Only ❑AAF your relationship to the decedent: PA Department of Revenue 1. Date Established 1 2. Account Balance 2 $ PAD 3. Percent Taxable 3 X 1 2 4. Amount Subject to Tax 4 $ 3 5. Debts and Deductions 5 4 6. Amount Taxable 6 $ 5 7. Tax Rate 7 X 6 8. Tax Due 8 $ $ 9. With 5%Discount(Tax x .95) 9 X Step 2: Sign and date below. Return TWO completed and signed copies to the Register of Wills listed on the front of this form, along with a check for any payment you are making. Checks must be made payable to"Register of Wills, Agent." Do not send payment directly to the Department of Revenue. Under penalty of perjury, I declare that the facts I have reported above are true,correct and complete to the best of my knowledge and belief. Work Home Taxpayer Signature Telephone Number Date IF YOU NEED FURTHER ASSISTANCE, CONTACT CUMBERLAND COUNTY REGISTER OF WILLS, PA DEPARTMENT OF REVENUE DISTRICT OFFICE, OR THE INHERITANCE TAX DIVISION AT 717-787-8327. SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-447-3020 BUREAU OF INDIVIDUAL TAXES Pennsylvania Inheritance Tax Pennsylvania PO BOX 280601 - Y HARRISBURG PA 17128-0601 Information Notice DEPARTMENT OF REVENUE ecvasu cs o..crzc ueuo And Taxpayer Response FILE N0.2112-1143 ACN 13114991 DATE 03-20-2013 Type of Account Estate of VIRGINIA L KEET Savings SSN Checking Date of Death 09-09-2012 Trust KATHY SKILES - County CUMBERLAND - - Certificate 1914 SAND HILL RD - HERSHEY PA 17033-2655 PSECU provided the department with the information below indicating that at the death of the above-named decedent you were a joint owner or beneficiary of the account identified. Remit Payment and Forms to: Account No.8268408724 Date Established 11-20-2009 REGISTER OF WILLS Account Balance $5,391.03 1 COURTHOUSE SQUARE Percent Taxable 750 CARLISLE PA 17013 Amount Subject to Tax $2;695.52 Tax Rate X 0.045 Potential Tax Due $121.30 NOTE': If tax payments are made within three months of the decedent's date of death,deduct a 5 percent discount on the tax With 5%Discount(Tax x 0.95) $(see NOTE') due. Any inheritance tax due will become delinquent nine months after the date of death. PART Step 1 : Please check the appropriate boxes below. 1 A No tax is due. I am the spouse of the deceased or I am the parent of a decedent who was 21 years old or younger at date of death. Proceed to Step 2 on reverse. Do not check any other boxes and disregard the amount shown above as Potential Tax Due. g The information is l The above information is correct, no deductions are being taken,and payment will be sent correct. with my response. Proceed to Step 2 on reverse. Do not check any other boxes. C The tax rate is incorrect. ❑ 4.5% 1 am a lineal beneficiary (parent,child,grandchild, etc.)of the deceased. (Select correct tax rate at right, and complete Part ❑ 12% I am a sibling of the deceased. 3 on reverse.) , ❑ 15% All other relationships (including none). 1 D ❑Changes or deductions The information above is incorrect and/or debts and deductions were paid. listed. Complete Part 2 and part 3 as appropriate on the back or this form. E F]Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax inheritance tax form Return filed by the estate representative. - REV-1500. Proceed to Step 2 on reverse. Do not check any other boxes. Please sign and date the back of the form when finished. PART Debts and Deductions 2 Allowable debts and deductions must meet both of the following criteria: A. The decedent was legally responsible for payment,and the estate is insufficient to pay the deductible items. B. You paid the debts after the death of the decedent and can furnish proof of payment if requested by the department. (If additional space is required,you may attach 8 1/2"x 11"sheets of paper.) Date Paid Payee Description Amount Paid Total Enter on Line 5 of Tax Calculation $ PART Tax Calculation 3 If you are making a correction to the establishment date(Line 1)account balance(Line 2),or percent taxable(Line 3), please obtain a written correction from the financial institution and attach it to this form. 1. Enter the date the account was established or titled as it existed at the date of death. 2. Enter the total balance of the account including any interest accrued at the date of death. 3. Enter the percentage of the account that is taxable to you. a. First,determine the percentage owned by the decedent. i. Accounts that are held"in trust for"another or others were 100%e owned by the decedent. ii. For joint accounts established more than one year prior to the date of death,the percentage taxable is 100%divided by the total number of owners including the decedent. (For example:2 owners=50%,3 owners=33.33%,4 owners =25%,etc.) b. Next,divide the decedent's percentage owned by the number of surviving owners or beneficiaries. 4. The amount subject to tax is determined by multiplying the account balance by the percent taxable. 5. Enter the total of any debts and deductions claimed from Part 2. 6. The amount taxable is determined by subtracting the debts and deductions from the amount subject to tax. 7. Enter the appropriate tax rate from Step 1 based on your relationship to the decedent. It indicating a different tax rate,please state Official Use Only ❑AAF your relationship to the decedent: PA Department of Revenue 1. Date Established 1 2. Account Balance 2 $ PAD 3, Percent Taxable 3 X 1 2 4. Amount Subject to Tax 4 $ 3 5. Debts and Deductions 5 4 6. Amount Taxable 6 $ 5 7. Tax Rate 7 X 6 8, Tax Due 8 $ $ 9. With 5°la Discount(Tax x .95) 9 X Step 2: Sign and date below. Return TWO completed and signed copies to the Register of Wills listed on the front of this form, along with a check for any payment you are making. Checks must be made payable to"Register of Wills,Agent." Do not send payment directly to the Department of Revenue. Under penalty of perjury, I declare that the facts I have reported above are true,correct and complete to the best of my knowledge and belief. Work Home Taxpayer Signature Telephone Number Date IF YOU NEED FURTHER ASSISTANCE, CONTACT CUMBERLAND COUNTY REGISTER OF WILLS, PA DEPARTMENT OF REVENUE DISTRICT OFFICE, OR THE INHERITANCE TAX DIVISION AT 717-787-8327. SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-447-3020 BUREAU OF INDIVIDUAL TAXES Pennsylvania Inheritance Tax '.] Pennsylvania PO BOX 28060] y �]' DEPARTMENT OF REVENUE HARRISBURG PA 1 7128-06 01 Information Notice l� And Taxpayer Response .FILE NO.2112-1143 ACN 13114991 DATE 03-20-2013 Type of Account Estate of VIRGINIA L KEET Savings SSN Checking Date of Death 09-09-2012 Trust KATHY SKILES County CUMBERLAND Certificate 1914 SAND HILL RD HERSHEY PA 17033-2655 PSECU provided the department with the information below indicating that at the death of the above-named decedent you were a joint owner or beneficiary of the account identified. Account No.8268408724 Remit Payment and Forms to: Date Established 11-20-2009 REGISTER OF WILLS Account Balance $5,391.03 1 COURTHOUSE SQUARE Percent Taxable 750 CARLISLE PA 17013 Amount Subject to Tax $2,695.52 Tax Rate x 0.045 Potential Tax Due $121.30 NOTE': If tax payments are made within three months of the decedent's date of death,deduct a 5 percent discount on the tax With 5%Discount(Tax x 0.95) $(see NOTE') due. Any inheritance tax due will become delinquent nine months after the date of death. PART Step 1 : Please check the appropriate boxes below. 1 A [—]No taxis due. I am the spouse of the deceased or I am the parent of a decedent who was 21 years old or younger at date of death. Proceed to Step 2 on reverse. Do not check any other boxes and disregard the amount shown above as Potential Tax Due. B The information is The above information is correct, no deductions are being taken,and payment will be sent correct. with my response. Proceed to Step 2 on reverse. Do not check any other boxes. C [:]The tax rate is incorrect. ❑ 4.5% 1 am a lineal beneficiary(parent,child,grandchild,etc.)of the deceased. (Select correct tax rate at right, and complete Part ❑ 12% 1 am a sibling of the deceased. 3 on reverse.) 15% All other relationships(including none). D ❑Changes or deductions The information above is incorrect and/or debts and deductions were paid. listed. Complete Part 2 and part 3 as appropriate on the back of this form. E ❑Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax inheritance tax form Return filed by the estate representative. REV-1500. Proceed to Step 2 on reverse. Do not check any other boxes. Please sign and date the back of the form when finished. PART Debts and Deductions 2 Allowable debts and deductions must meet both of the following criteria: A. The decedent was legally responsible for payment,and the estate is insufficient to pay the deductible items. B. You paid the debts after the death of the decedent and can furnish proof of payment if requested by the department. (If additional space is required,you may attach 8 1/2"x 11"sheets of paper.) Date Paid Payee Description Amount Paid Total Enter on Line 5 of Tax Calculation $ PART Tax Calculation 3 If you are making a correction to the establishment date Line 1 account balance Line 2 or y g ( ) ( ), percent taxable(Line 3), please obtain a written correction from the financial institution and attach it to this form. 1. Enter the date the account was established or titled as it existed at the date of death. 2. Enter the total balance of the account including any interest accrued at the date of death. 3. Enter the percentage of the account that is taxable to you. a. First,determine the percentage owned by the decedent. i. Accounts that are held"intrust for"another or others were 100%owned by the decedent. ii. For joint accounts established more than one year prior to the date of death,the percentage taxable is 100%divided by the total number of owners including the decedent. (For example:2 owners=50%, 3 owners=33.33%,4 owners =25%,etc.) b. Next,divide the decedent's percentage owned by the number of surviving owners or beneficiaries. 4. The amount subject to tax is determined by multiplying the account balance by the percent taxable. 5. Enter the total of any debts and deductions claimed from Part 2. 6. The amount taxable is determined by subtracting the debts and deductions from the amount subject to tax. 7. Enter the appropriate tax rate from Step 1 based on your relationship to the decedent. If indicating a different tax rate,please state j Official Use Only AAF your relationship to the decedent: PA Department of Revenue 1. Date Established 1 2. Account Balance 2 $ PAD 3. Percent Taxable 3 x 1 2 4. Amount Subject to Tax 4 $ 3 5. Debts and Deductions 5 - 4 6. Amount Taxable 6 $ 5 7. Tax Rate 7 x 6 8. Tax Due 8 $ 7 i 8 9. With 5% Discount (Tax x .95) 9 x _� Step 2: Sign and date below. Return TWO completed and signed copies to the Register of Wills listed on the front of this form, along with a check for any payment you are making. Checks must be made payable to"Register of Wills,Agent." Do not send payment directly to the Department of Revenue. Under penalty of perjury, I declare that the facts I have reported above are true,correct and complete to the best of my knowledge and belief. Work Home Taxpayer Signature Telephone Number Date IF YOU NEED FURTHER ASSISTANCE, CONTACT CUMBERLAND COUNTY REGISTER OF WILLS, PA DEPARTMENT OF REVENUE DISTRICT OFFICE, OR THE INHERITANCE TAX DIVISION AT 717-787-8327. SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-447-3020 pennsylvania DEPARTMENT OF REVENUE GENERAL INFORMATION INHERITANCE TAX INFORMATION NOTICE AND TAXPAYER RESPONSE You are receiving this notice because your bank or financial institution reported to the Department of Revenue that you were a joint owner or beneficiary of an account on which you may owe Pennsylvania inheritance tax. If you are a surviving spouse, you will owe no tax but must still respond to the notice. If your notice indicates a potential tax due other than zero, you must respond as follows: • In Part 1, select Box "A" to indicate that you are the decedent's spouse. No tax is due. • Sign and date the notice, and send two copies to the Register of Wills in the county indicated on the notice. At this point,you do not need to do anything'else. Joint bank accounts are taxable even if a person's name was only added to the account as a matter of "convenience". A person listed as a joint owner with the right of survivorship on an account is a legal owner of the account, and is subject to inheritance tax under Pennsylvania law. If you believe the account was titled differently than was indicated on your notice, please submit a copy of the account signature card from the financial institution. If you are a lineal beneficiary (such as a child, grandchild or parent), your tax rate is 4.5 percent. If you are a sibling, your tax rate is 12 percent. The tax rate for all others is 15 percent. See "Tax Rates and Definitions" on the reverse for additional information. If the tax rate shown on the notice is incorrect, and you are not reporting this account on the inheritance tax return (REV-1500), you must respond as follows: • In Part 1, select Box "C" to report a different tax rate. Place a check mark to the right, in the appropriate box indicating the correct tax rate. ` • In Part 3, write the correct tax rate on line 7. • If you are taking deductions, complete Part 2, and write the total in Part 3 on Line 5. • Recalculate the tax due. • Sign and date the notice, and send two copies to the Register of Wills in the county indicated on the form, along with any payment. All notices and payments should be sent to the Register of Wills in the county indicated on your notice. Payments should be made payable to "Register of Wills, Agent". Accounts held by a decedent "In Trust For" another or others are fully taxable. Bureau of Individual Taxes PO BOX 280601 1 Harrisburg PA 17128-0601 1 717.787.8327 1 (F) 717.772.0412 1 www.revenue.state.pa.us REV-1543 A(08-12) Inheritance tax is a self-reported tax. Inheritance tax becomes delinquent nine months after the decedent's date of death. Payments must be postmarked within nine months of the date of death to avoid interest. If the tax is paid within three months of the date of death, a 5 percent discount of the amount of tax paid is allowed. Accounts made joint within one year of death Accounts made joint within one year of the date of death are fully taxable, minus an exclusion of up to $3,000 per transferee per calendar year. Regardless of the value of the account or number of accounts held, the total exclusion must not exceed $3,000 per transferee per calendar year. If a double asterisk (**) appears before your first name in the address portion of the notice, the exclusion was deducted from the account balance as reported by the financial institution. Tax Rates and Definitions The lineal class of heirs includes grandparents, parents, children, grandchildren, etc. "Children" includes all children of the natural parents and their descendants, whether or not they have been adopted by others, adopted descendants and their descendants, and step-descendants. Lineal heirs are taxed at the rate of 4.5 percent. "Siblings" are defined as individuals who have at least one parent in common with the decedent, whether by blood or adoption. Siblings are taxed at the rate of 12 percent. The collateral class of heirs includes all other beneficiaries. Collateral heirs are taxed at the rate of 15 percent. Calculating the Percentage Taxable (Part 2) The percentage of the account that is taxable to each survivor is determined as follows: A. The taxable percentage of a joint account established more than one year prior to the decedent's death: 1 - (Total number of - (Total number x 100 = Percent taxable joint owners) of joint survivors) B. The taxable percentage of a joint account created within one year of the decedent's death or accounts owned by the decedent but held in trust for another individual(s) (trust beneficiaries): 1 - (Total number of surviving joint owners x 100 = Percent taxable or trust beneficiaries) BUREAU OF INDIVIDUAL TAXES Pennsylvania Inheritance Tax pennsylvania PO BOX 280601 y �.i7 HARRISBURG PA 17128-0601 Information Notice DEPARTMENT OF REVENUE,,,.,,,,,,ee<eeee And Taxpayer Response FILE NO.2112-1143 ACN 13114992 DATE 03-20.2013 Type of Account Estate of VIRGINIA L KEET Savings SSN Checking Date of Death 09-09-2012 Trust KATHY SKILES County CUMBERLAND Certificate 1914 SAND HILL RD HERSHEY PA 17033-2655 PSECU provided the department with the information below indicating that at the death of the above-named decedent you were a joint owner or beneficiary of the account identified. Account No. 6268408724 Remit Payment and Forms to: Date Established 11-20-2009 REGISTER OF WILLS Account Balance $59,827.80 1 COURTHOUSE SQUARE Percent Taxable X 50 CARLISLE PA 17013 Amount Subject to Tax $29,913.90 Tax Rate X 0.045 Potential Tax Due $ 1,346.13 NOTE': If tax payments are made within three months the decedent's date of death,deduct a 5 percent discount on n the[ax With 5% Discount(Tax x 0.95) $(see NOTE') due. Any inheritance tax due will become delinquent nine months after the date of death. PART Step 1 : Please check the appropriate boxes below. 1 A [—]No taxis due. I am the spouse of the deceased or I am the parent of a decedent who was 21 years old or younger at date of death. Proceed to Step 2 on reverse. Do not check any other boxes and disregard the amount _ shown above as Potential Tax Due. B The information is The above information is correct, no deductions are being taken,and payment will be sent correct. with my response. Proceed to Step 2 on reverse. Do not check any other boxes. C The tax rate is incorrect. ❑ 4.5% 1 am a lineal beneficiary(parent,child,grandchild, etc.)of the deceased. (Select correct tax rate at right, and complete Part ❑ 12% 1 am a sibling of the deceased. 3 on reverse.) - ❑ 15% All other relationships (including none). D F�Changes or deductions The information above is incorrect and/or debts and deductions were paid. listed. Complete Part 2 and part 3 as appropriate on the back of this form. E F�Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax inheritance tax form Return filed by the estate representative. REV-1500. Proceed to Step 2 on reverse. Do not check any other boxes. Please sign and date the back of the form when finished. T TDebts and Deductions Allowable debts and deductions must meet both of the following criteria: A. The decedent was legally responsible for payment,and the estate is insufficient to pay the deductible items. B. You paid the debts after the death of the decedent and can furnish proof of payment if requested by the department. (If additional space is required,you may attach 8 1/2"x 11"sheets of paper.) Date Paid Payee Description Amount Paid Total Enter on Line 5 of Tax Calculation $ PART Tax Calculation 3 If you are making a correction to the establishment date(Line 1)account balance(Line 2),or percent taxable(Line 3), please obtain a written correction from the financial institution and attach it to this form. 1. Enter the date the account was established or titled as it existed at the date of death. 2. Enter the total balance of the account including any interest accrued at the date of death. 3. Enter the percentage of the account that is taxable to you. a. First,determine the percentage owned by the decedent. i. Accounts that are held"in trust for"another or others were 100%owned by the decedent. ii. For joint accounts established more than one year prior to the date of death,the percentage taxable is 100%divided by the total number of owners including the decedent. (For example:2 owners=50%, 3 owners=33.33%,4 owners =25%,etc.) b. Next, divide the decedent's percentage owned by the number of surviving owners or beneficiaries. 4. The amount subject to tax is determined by multiplying the account balance by the percent taxable. 5. Enter the total of any debts and deductions claimed from Part 2. 6. The amount taxable is determined by subtracting the debts and deductions from the amount subject to tax. 7. Enter the appropriate tax rate from Step 1 based on your relationship to the decedent. If indicating a different tax rate,please state j Official Use Only El AAF your relationship to the decedent: PA Department of Revenue 1. Date Established 1 2. Account Balance 2 $ PAD 3. Percent Taxable 3 X 2 4. Amount Subject to Tax 4 $ 3 5. Debts and Deductions 5 4 6. Amount Taxable 6 $ 5 1 7. Tax Rate 7 X 6 8. Tax Due 8 $ 17 8 9. With 5% Discount(Tax x .95) 9 X Step 2: Sign and date below. Return TWO completed and signed copies to the Register of Wills listed on the front of this form, along with a check for any payment you are making. Checks must be made payable to"Register of Wills, Agent." Do not send payment directly to the Department of Revenue. Under penalty of perjury, I declare that the facts I have reported above are true,correct and complete to the best of my knowledge and belief. Work Home Taxpayer Signature Telephone Number Date IF YOU NEED FURTHER ASSISTANCE, CONTACT CUMBERLAND COUNTY REGISTER OF WILLS, PA DEPARTMENT OF REVENUE DISTRICT OFFICE, OR THE INHERITANCE TAX DIVISION AT 717-787-8327. SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-447-3020 BUREAU INDIVIDUAL TAXES 28 ance PD EAU 280601 y ((- Pennsylvania Inherit Tax nnenns tvania HARRISBURG PA 17128.0601 Information Notice DEPARTMENT OF REVENUE And Taxpayer Response vE'-'.l". °.0 111"=' FILE NO.2112-1143 ACN 13114992 DATE 03-20-2013 Type of Account Estate of VIRGINIA L KEET Savings SSN Checking Date of Death 09-09-2012 Trust KATHY SKILES County CUMBERLAND Certificate 1914 SAND HILL RD HERSHEY PA 17033-2655 PSECU provided the department with the information below indicating that at the death of the above-named decedent you were a joint owner or beneficiary of the account identified. Account No.8268408724 Remit Payment and Forms to: Date Established 11-20-2009 REGISTER OF WILLS Account Balance $59,827.80 1 COURTHOUSE SQUARE Percent Taxable X 50 CARLISLE PA 17013 Amount Subject to Tax $29,913.90 Tax Rate X 0.045 Potential Tax Due $1,346.13 NOTE': Iftax payments are made within three months of the decedent's date of death, deduct a 5 percent discount on the tax With 5%,Discount (Tax x 0.95) $(see NOTE') due. Any inheritance tax due will become delinquent nine months after the date of death. PART Ste, 1 : Please check the a 1 p appropriate boxes below. A No tax is due. 1 am the spouse of the deceased or I am the parent of a decedent who was 21 years old or younger at date of death. Proceed to Step 2 on reverse. Do not check any other boxes and disregard the amount shown above as Potential Tax Due. B The information is The above information is correct, no deductions are being taken,and payment will be sent correct. with my response. Proceed to Step 2 on reverse. Do not check any other boxes. C El The tax rate is incorrect. El 4.5% 1 am a lineal beneficiary(parent,child,grandchild, etc.)of the deceased. (Select correct tax rate at right, and complete Part F-I 120% 1 am a sibling of the deceased. 3 on reverse.) ❑ 15% All other relationships(including none). D F�Changes or deductions The information above is incorrect and/or debts and deductions were paid. listed. Complete Part 2 and part 3 as appropriate on the back of this form. E ❑Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax inheritance tax form Return filed by the estate representative. REV-1500. Proceed to Step 2 on reverse. Do not check any other boxes. Please sign and date the back of the form when finished. PART Debts and Deductions 2 Allowable debts and deductions must meet both of the following criteria: A. The decedent was legally responsible for payment,and the estate is insufficient to pay the deductible items. B. You paid the debts after the death of the decedent and can furnish proof of payment if requested by the department. (if additional space is required,you may attach 81/2"x 11"sheets of paper.) Date Paid Payee Description Amount Paid Total Enter on Line 5 of Tax Calculation $ PART Tax Calculation 3 if you are making a correction to the establishment date(Line 1)account balance(Line 2),or percent taxable(Line 3), please obtain a written correction from the financial institution and attach it to this form. 1. Enter the date the account was established or titled as it existed at the date of death. 2. Enter the total balance of the account including any interest accrued at the date of death. 3. Enter the percentage of the account that is taxable to you. a. First,determine the percentage owned by the decedent. i. Accounts that are held"in trust for"another or others were 100%owned by the decedent. ii. For joint accounts established more than one year prior to the date of death,the percentage taxable is 100%divided by the total number of owners including the decedent. (For example:2 owners=50%, 3 owners=33.33%, 4 owners =25%,etc.) b. Next,divide the decedent's percentage owned by the number of surviving owners or beneficiaries. 4. The amount subject to tax is determined by multiplying the account balance by the percent taxable. 5. Enter the total of any debts and deductions claimed from Part 2. 6. The amount taxable is determined by subtracting the debts and deductions from the amount subject to tax. 7. Enter the appropriate tax rate from Step 1 based on your relationship to the decedent. If indicating a different tax rate,please state Official Use Only ❑AAF your relationship to the decedent: PA Department of Revenue 1. Date Established 1 2. Account Balance 2 $ PAD 3. Percent Taxable 3 X 2 4. Amount Subject to Tax 4 $ 3 5. Debts and Deductions 5 - 4 6. Amount Taxable 6 $ 5 7. Tax Rate 7 X 6 8. Tax Due 8 $ 7 8 9. With 5%Discount(Tax x .95) 9 X Step 2: Sign and date below. Return TWO completed and signed copies to the Register of Wills listed on the front of this form, along with a check for any payment you are making. Checks must be made payable to"Register of Wills,Agent." Do not send payment directly to the Department of Revenue. Under penalty of perjury, I declare that the facts I have reported above are true,correct and complete to the best of my knowledge and belief. Work Home Taxpayer Signature Telephone Number Date IF YOU NEED FURTHER ASSISTANCE, CONTACT CUMBERLAND COUNTY REGISTER OF WILLS, PA DEPARTMENT OF REVENUE DISTRICT OFFICE, OR THE INHERITANCE TAX DIVISION AT 717-787-8327. SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-447-3020 PRU Historical Prices I Prudential Financial,Inc.Comm stock-Yahoo!Finance 2/23/14 1:13 PM >r Games Groups Answers Screen Flickr Mobile I More Personal Finance Yahoo Originals CNBC Search Finance S§a:kx,'h Wob !all Sun,Feb 23,2014,1:08pm EST-US Markets are closed f PEN AN ACCOV.. ..�"." "- . j Amer(teade p r....I urea nn uc Prudential Financial,Inc.(PRU) - NYSE *Follow Add.,ta Portia]io! Like ua 83.93 10.03(0.Q4%) Feb 21,4:00PM EST Historical Prices Get Historical Prices for:[ cD Set Date Range ._.—_ E)Daily Start Date: Sep. ,2012 Eg.Jan 1,2010 ()Weekly End Date: •SeD" 2012 j OMonlhly ()Dividends Only Get Prices First I Previous I Next I Last Prices Date Open High Low Close Volume Adj Close' Sep 7,2012 56.60 57.20 58.38 57.19 3,011,800 53.71 Close price adjusted for dividends and splits. First I Previous I Next I Last ADownload to Spreadsheet Nr 57•ZO yc Lo S(r'a 3 g S 1) 3. 58 z IN= �� r/7+{ 66 Currency in USD. http://finance.yahoo,com/q/hp?s-PRU&a=08&b=9&c=2012&d=08&e=9&f=2012&g=d Page 1 oft Computershare Prudential Computershare Trust Company,N.A. P.O.Box 43038 Providence Rhode Island 02940-3038 245000 1-800-586-1305 Hearing-impaired 1-800-619-2837 °= VAVW.computershare.con)[investor »"'«""AUT0"5-0IGIT 11033 S0000008971P000000001 �_ Illlr-IIIIIIIIIIIltllll111illlll111 111111-IIIIIIII1111111111111 VIRGINIA B KEET TOD KATHY A SKILES Holder Account Number SUBJECT TO STA TOD RULES,HILL RD HERSHEY PA 17033-2655 C0031518831 1 N D 1 III X1111111111111111111111 III 1 Reminder Regarding the Sales Facility at Computershare As of the close of the market on August 29, 2012, you owned 114 shares of Prudential Financial, Inc. Common Stock valued at $6,211.86. This letter is being sent as a reminder of the terms of the Sales Facility offered by Computershare, Prudential's Transfer Agent. There are three options for selling your shares. • By calling 1-800-586-1305 (For hearing-impaired, call 1-800-619-2837). • By going online at www.computershare.com/investor. • By mail, by signing the form below or submitting a signed letter of instruction. The market value will fluctuate until your sales transaction is completed and the actual sales price is determined. A check will be mailed to you within two weeks of the sale. The proceeds will reflect an $11.00 transaction fee and an 8¢ fee for each share sold. Selling your shares will not impact any policy or contract you own with Prudential. To sell all of your shares, sign the form below, detach this portion and return In the envelope provided. Sale Authorization Form for your Prudential Financial, Inc. Shares. This program is voluntary. Should you decide to sell all of your shares, sign in the box(es) below and return in the envelope provided. Additional information is listed on the back of this form and in the Sales Facility Term Sheet provided. All persons listed must sign exactly as named above Signature for sale only Please sign inside box Additional signature H needed Please sign inside box Date (maVdd/yyyy) I (we) agree to the Sales Facility Term Sheet included in this mailing. �. 111111�111111111�1I11�111111111111I11111�11111I�11I1II1�11�I111111 C0031518831 IND M � T ET 5 U C F P R U Nr,reonM+ mrkcA 14113K.SAACHN 01245A 499999 To sell ALL of your shares ... For the quickest response, call 1-800-586-1305 (for the hearing-impaired, call 1-800-619-2837) or log on to www.computershare.com/investor. Otherwise, you may sign and return the Sale Authorization Form on the reverse side. To sell only a PORTION of your shares ... You must either call 1-800-586-1305 (for the hearing-impaired, call 1-800-619-2837) or log on to www.computershare.com/investor. If you are selling your shares and you have a stock certificate ... You must return a properly completed Sale Authorization Form together with your stock certificate to Computershare. Do not sign the back of the stock certificate. For your protection, we suggest you use registered mail and insure your envelope's contents for 3% of the value of the shares represented on your certificate. Alternatively, if you choose not to use registered mail, please return your Sale Authorization Form and stock certificate in the enclosed business reply envelope. NOTE: In authorizing the sale of your shares, you are agreeing to the terms and conditions in the Sales,•Facility Term Sheet included in this mailing. RECEIPT FOR PAYMENT ------------------- ------------------- GLENDA FARNER STRASBAUGH Receipt Date : 10/25/2012 Cumberland County - Register Of Wills Receipt Time : 14 : 08 : 59 One Courthouse Sqquare Receipt No. : 1071868 Carlisle, PA 17Q13 KEET VIRGINIA L Estate File No. : 2012-01143 Paid By Remarks : ATTY CHARLES E SHIELDS III DMB ---------------- -------- Receipt' Distribution ------------------------ Descript-pon. Payment Amount Payee Name . PETITION LTRS TEST 45 . 00 CUMBERLAND COUNTY GENERAL FUN WILL 15 . 00 CUMBERLAND COUNTY GENERAL FUN RENUNCIATION 5 . 00 CUMBERLAND COUNTY GENERAL FUN SHORT CERTIFICATE 20 . 00 CUMBERLAND COUNTY GENERAL FUN JCS FEE 23 . 50 BUREAU OF RECEIPTS & CNTR M.D AUTOMATION FEE 5 . 00 CUMBERLAND COUNTY GENERAL FUN Check# 2970 5113 . 50 Total Received. . . . . . . . . $113 . 50 1111512013 11:06 Cornerstone Land Transfer ffAX)717 730%65 P.0011002 RESEARCH-1 sowrians. LLc 4405 East Trfndle Road meel,aMcsaurs, PA 14060 Phone: 4ri-580-8664 FaK: 4ri1-430-9685 JasonStacW-O&elandsettlement.com Bill to: Charles E. Shields Date:November 15,2013 Invoice# 162 FOR SERVICES RENDERED: Assessment Search Keet TOTAL AMOUNT DUE: $25.00 PAYMENT WITHIN 30 DAYS WILL BE APPRECIATED Please return one coot/ of this invoice with your payment. 3323 ATTY CHARLES E SHIELDS 111 3-76,5/J8D 6 CLOUSER RD. MECHANICSBU///R���G.PA 17055 DATE fl /.3 PAY TO THE -f B� ORDER�OF���p^�"�v'��� DOLLARS KXCitizens B'!a-nnka yU MEMO ✓ _ j - 1:0 360 76 1 501: 621SSS12481" 3323 Direct Purchase Plan Transaction Request Mail to: Wells Fargo Shareowner Services PP01 3099058621 OPTIONAL CASH PURCHASE ELECTION PPL Corporation Common Stock Direct Purchase Plan 0 wn Enclosed is a U.S.dollar check dram on a United States bank, PO Box 64856 St St Paul MN 55164A856 made payable to Shareowner Services tor. $ ElPlease change my address as indicated. T Minimum S25.0alMaximum$25,000.00 per month o All registered owners MUST sign on the back of this form. WILLIAM K KEET EX Shareowner Services will process your purchase instructions M EST VIRGINIA KEET according to your Plan prospectus/brochure upon receipt of your C/O ATTN CHARLES SHIELDS III properly completed request which includes account number and 6 CLOUSER RD company name.We will not be liable for any claim arising out of MECHANICSBURG PA 17055-9751 failure to purchase shares on a certain date or at a specific price. Requests,other than address change,submitted on this form will only affect Direct Purchase Plan shares.For Direct Registration of (book entry)shares visit us online or refer to your Direct Registration ru statement. 1— IIIP! piu!iiu iiiii nui rim ilia iiiii rim iiq IIII I Illluli liar iii pia iul IIII 020213 wPP010201S 01 tra 129 Detach hem.Forward top portion to the address shown abo4o. - - -- Direct Purchase Plan Account Statement IMPORTANT:Retain this statement for your Investment,tax.and'costbasis'records.`'.::: ' •i��- ..__ Visit shareowneronline.com anytime to access account information, obtain forms,and complete p p :•-_ transactions. U.S.telephone number. 1-800-345-3085 Local and Outside U.S.:651-453-2129 Cusi # 69351T106 Page 1 of 1 CAccount Summary PPL Corporation Common Stock Account# 3099058621 February 1, 2013 WILLIAM K KEET EX Share Balances Current EST VIRGINIA KEET Direct Purchase Plan 0.000 C/O ATTN CHARLES SHIELDS III Direct Registration- 0.000 6 CLOUSER RD Total Shares 0.000 MECHANICSBURG PA 17055.9751 Year-to-Date Amounts Federal Tax Withheld $0.00 Nonresident Alien Tax Withheld $0.00 Account Value State Tax Withheld $0.00 Markel Value Date 02/01/13 Cash Investments $0.00 Market Value Price $30.3700 Service Charges Paid by You $15.00 Account Market Value _ ,_$0.00_- . .... Commissions Paid by You $100.87 Transaction or Transaction Gross Amount of Service Net Amount of Price Shares Increased Total Shares Settlement Date Type Transaction Charge Transaction per Share or Decreased Held in Plan I BALANCE FORWARD 0.000 01/30/13 ,� Transferred In $0.00 $0 00 $0 00 $0.0000 , 2 546 'i 2.546 01/31113-'"' Certificate Deposit moo: $0.00 $0'00 $0.00001 838 000 ! 840.546 I 02!06%13 Sale $25 590.76-i $15.00 ' $25 474:894 $30.4454 t 640:546 0.000 4:The transaction(s) has beeri' processed as instructed. d r As required'bY Federal tax regulafons WeIIs Fargo Shareowner Services uses FIFO(First In First Out)as the default method of disposing of shares.To select anvbther,melhod of disposition or speafic.tax..lots you must provide your instruction In wn ing and include the aceuisitkni date and share amount IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII 'ZPP01P021611111YJYJYJY' PPL Corporation Common Stock PP01 3099058621 Transaction Request (continued) 1. Sell 0 Indicate#of shares to sell or"all"if selling full Plan position. a.Direct deposit of sale proceeds ❑ Checking or ❑ Savings Account All Registered Owners MUST Sign. ABA/Routing Number(include voided check or deposit slip) Bank Account Number 2. Deposit shares into my Plan Account You MUST submit your stock certificate(s). 3. Automatic Cash Withdrawal X ru M Discontinue ❑ or Change Amount$ o 4. Terminate from the Plan(choose only one) ❑ Move all full shares to DRS&sell fractional share. —T_ Print Shareowner Name(s) � N ❑ Sell all Plan shares. .a. ❑ Move Plan;hares to DRS&sell remaining shares. Date How to Request a Transaction a Transactions can be requested easily online. Visit shareowneronline.com.If you are a first time visitor,click Sign Up Nowl,select Authentication ID and click 1 do not have my Authentication ID. Instructions to transfer shares,investment plan materials,and forms are available online without signing into your account. With online account access you can securely and easily manage your account anytime,anywhere. •Buy shares or sign up for automatic investments •Sell Shares •Enroll in eDelivery to receive online statements •Access account details: •Update your address o Balances •Download forms and tax documents o Transaction history •Reinvest your dividends o Dividend payments •Request check replacements o Market value and stock quotes ® To request your transaction by mail,complete the request form above using these instructions. 1. Sell your shares through the mail: Complete 1 above by 3. Automatic Cash Withdrawal:Complete 3 above to either discontinue indicating the number of shares you wish tq'sell. or change the amount of your automatic withdrawal. i a. Direct deposit of sale proceeds(optional): 4. Terminate from the Plan: Complete 4 above, checking only one of • Complete 1a above. the options for termination. • Provide us your Account Type,ABA/Routing Number - - - (begins with 0, 1,2,or 3),and Bank Account Number. Note: - The transaction form above and correspondence should be sent to the Il ill °0°°°I o0o I Plan address shown on the front of this staterri Requests submitted Routing mount on this form will only affect plan shares.For Direct Registration(book "o'"o" nuioMr entry)shares,see shareowneronline.com or your Direct • Deposit requests must include a corresponding voided Registration statement. check or pre-printed savings deposit slip. o Incomplete information or bank rejects will result in - All requests will be executed in accordance with the terms and proceeds being delivered via check. - conditions defined in your plan documents.Once a sale has been submitted to Shareowner Services,it cannot be modified or cancelled. 2. Deposit stock certificates: Complete 2 above indicating the You are unable to direct the time or price at which the shares will be number of shares you wish to deposit. sold.The share price may fall or rise during the period between a o It is important that you do not endorse your certificates. request for sale,its receipt by Shareowner Services,and the actual Send the unsigned stock certificates and completed sale in the open market.This price risk is assumed by the transaction request form to Wells Fargo Shareowner shareowner(s). Services, 1110 Centre Pointe Curve,Suite 101,Mendota Heights,MN 55120-4100. View your investment plan documents at shareowneronline.com o We recommend that you use traceable mail and insure for details. the package for 2%of the current market value. To sell shares or obtain account information via the automated phone system,dial 1-800-345-3085. Please retain this statement for your investment, tax, and cost basis records. flit Is at .. _ Hollinger Funeral Home& Cremator} , Inc. Eric L.Hollinger.:Supervisor September 18, 2012 Kathy Skiles 1914 Sand Hill Rd. Hershey, Pa 17033 The Funeral Service for Virginia Keet: We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way we can. Please feel free to contact us if you have any questions in regard to this statement. THE FOLLOWING IS AN ITEMIZED STATEMENT OF THE SERVICES, FACILITIES,AUTOMOTIVE EQUIPMENT, AND MERCHANDISE THAT YOU SELECTED WHEN MAKING THE FUNERAL ARRANGEMENTS. Professional Service Cremation Package A—Direct Cremation $1850.00 Merchandise Memorial Package—Register Book, Memorial Folders, Acknowledgement Cards,Bookmarks 175.00 AT THE TIME FUNERAL ARRANGEMENTS WERE MADE,WE ADVANCED CERTAIN PAYMENTS TO OTHERS AS AN ACCOMMODATION. THE FOLLOWING IS AN ACCOUNTING FOR THOSE CHARGES. _ Cash Advances Certified Copies of Death Certificate(10 @ $6) 60.00 Cumberland County Coroner's Authorization 25.00 2 Alter Vases 53.00 Organist 75.00 Clergy 100.00 Sentinel 303.18 Patriot 509.02 Total.Charges $3150.20 v` 501 NORTH BALTIMORE AVENUE • MOUNT HOLLY SPRINGS, PENNSYi.VANIA 17065 • (717) 486-3433 • PAX (717) 486-3415 www.holf ingerfuneralhome.com . . . . . . . - . --'----'— -- -- ----------- � 14569 ALERT PHARMACY SERVICES, INC. ORRST OfN NR ER . A60-1 03-313 _ 219 NORTH BALTIMORE AVE. 60-1503-313 MT.HOLLY SPRINGS,PA 17065 10/10/2012 � fr a ORDER HE The Estate of Virginia Keet ORDER OF g $ ++7.82 2 Seven and DOLLARS The Estate of Virginia Keet c/o Kathy Skiles 8 1914 Sand Hill Rd. ? Hershey, PA 17033 ' MEMO i,•aasain=jenaaam,.ve MRHORREDSIGNA1 RE I fund fr r s o: 11.0145696• 1:0313i503C31: 10E 11025511' / ALERT PHARMACY SERVICES, INC. 14569 The Estate of Virginia Keet 10/10/2012 Date Type Reference Original Amt. Balance Due Discount Payment 10/8/2012 Bill 7.82 7.82 7.82 Check Amount 7.82 I Orrstown Checking Refund 7.82 LAST WILT_AN12 TESTAMENT OF)ggmaA B KEET I, VIRGINIA B. KEET, of the Cooke Township, Cumberland County,Pennsylvania, being of sound and disposing mind, memory and understanding,do make, publish and declare this my Last Will and Testament,hereby revoking and making void any and all prior Wills by me at any time heretofore made. 1. I direct the payment of all my just debts and funeral expenses as soon after my decease as the same can conveniently be done. 2. All the rest,residue and remainder of my Estate,real, personal and mixed,whatsoever and wheresoever situate, I give, devise and bequeath to my beloved husband, RICHARD S. KEET, to his own use and benefit absolutely. 3. In the event my said husband,RICHARD S. KEET, should predecease me or die at about the same time I do, such as in an accident or disaster common to both of us,I hereby direct all the rest,residue and remainder of my Estate to be divided and distributed among my four(4)children, as follows, to wit: WILLIAM K. KEET,TERRY KEET HOFFMAN, KATHY KEET SKILES, and JAMES F. KEET,in equal shares, per stirpes. 4. I nominate,constitute and appoint my husband, RICHARD S.KEET, to be the Executor of this my Last Will and Testament. In the event that he should predecease me or for any reason be unwilling or unable to act as such Executor,I nominate,constitute and appoint my son,WILLIAM K. KEET, my daughter,TERRY KEET HOFFMAN,and my daughter, KATHY KEET SKILES, to be Co-Executors in his place and stead. It is my intention that if my said children serve as Co- Executors that they shall split the executor's fee in three(3)equal shares. I further direct that my Executor or Co-Executors, as the case may be, shall not be required to file bond or other security in the Office of the Register of Wills for the purpose of administering my Estate. O IN WITNESS WHEREOF, I have hereunto set my hand and seal this /OTC, day of A.D. 1999. (SEAL) VIRGINIA B.KEET Signed, sealed,published and declared by the above-named VIRGINIA B.KEET as and for her Last Will and Testament, in the presence of us, who at her request and in her presence, and in the presence of each other,have hereunto subscribed our names as witnesses. -2-