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HomeMy WebLinkAbout02-0443 Estate of illMBERLAND Register of Wills of 1OOu/X~k1 County I Pennsylvania PETITION FOR GRANT OF LETTERS ROBERT C. KEYES ,,-11;:)0- f2"beJ't. ~ No. 21-02-443 also known as , Deceased Social Security No.162-32-2725 l'l/hIIUl'IlJlhl). wht,I./au, tlJ 'lOAf. 01 au_ Uf oIdel, all~vflu.1 101: (COMPLETE "Aft OR "B" BELOW:) ~ A. Probate and Grant of Letters and aver that Petitioner(x) is/ltlX the 6xecut...oI::- named in the Last Will of the Decedent, dated FRBRTTARY 1 2 2002 and codicil(sl dated , Sune lelc:vNlt chcumS'IWlces, tt.Q., renunciation, del'l'h f~1 exuculol. ele. Except as follows. Decedent did not marry, was not divorced. and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incompetent: Q B. Grant of Letters of Administration (C.t,A., d.h.II.C.1...: fllnulclllU hlu; dUI""lft "IINflllllll; dtlllltlllll1WIUllUItIC) Petitioner/sl after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: Name Relationship Residance Decedent was domiciled at death in CUMBERLAND residence at 264 REDWOOD T.ANF., C'ART.T!=:T,R, (In,l SIIl.!l:I, Ul'11l11l!1 IIlUlllMlIlicllll"ilyl County, Pennsylvania, with his/her last family or prinCipal PA 17013 Decedent, then 61 years of age, died M ~ RC'H 11 , 2002 at CARLISLE!. P.1\. n,tM,II'lfllll Decedent at death owned property with eSiimated values as follows: (If domiciled in PAl All personal property .............................. $ (If not domiciled in PAl Personal property in Pennsylvania. . . . . . . . . . . . . . . . . . . . . . $ (If not domiciled in PAl Personal property in County. . . , . . . . . . . . . . . . . . . . . . . . . . $ Value of real estate in Pennsylvimia ............................................... $ Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ Real Estate situated as follows: 12,500.00 12,588.88 Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicillsl presented with this Petition and the grant of letters in thtl appropriate form to the undersigned; t ~l j RW-7 /?-b/- '7 " Oath of Personal Representative Commonwealth of Pennsylvania County of .cumberland The Petitioner(s} above-named swear(s} and affirm(s} that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of Petitioner(s} and that. as personal representative(s) of the Decedent, Petitioner(s} will well an.d truly adm;nlster the estate according to law. ~ Sworn to and affirmed and subscribed ,~~~~ ........ before me this 3rd day of MAY 20...Q2 III ;'cjj/~ L P;n<<;yri ;7,u~~w'Alj~ /~/ 1(~'1 tJrh/( DECREE OF REGISTER E~t~te,ot. ROBERT c. KEYES Deceased No. 21-02-443 also known as ROBERT KEYES Social Security No:, 162-32-2725 Date of Death: MARCH 1 1, ? 0 0 ? AND NOW, MAY 3 2.Q0.2-, in, consideration of the Petition 'on the reverse side hereon. satisfactory proof having been presented befo~ffle, IT IS DECREED that Letters 6a Testamentary 0 of Administration :: ~,' p, Q.y----- (I;.I.n.; .1 11ft..; I . 1"~lllh~I.I_I'! h\.:, ,lIl1alll,! i11'~mlllll. .JIIIIIIII11 111111l1l11;U.!j are hereby granted to MICHAEL~. KIRCHHOFFRR ~ in the above estate and that the instrument(s), if any, dated described in the Petition be admitted to probate and filed of record as the la~:; Will of Decedent. 1 VJ " FEES i.:....J ~-, <.-' .~. . JI ~~".v ,P'<.J k'-<./4,.,,,'Y Registor of Wills : Letters.,....................... .. $ 50.00 Short Certificate(s).......... $ Renunciation.................. $ Affidavit ( )................. $ Extra Pages ( )............ $ Codicil..... .......... ....... .... $ JCP Fee........................ $ Inventory & Tax Forms... $ Other............. '............... $ 6.00 12.00 5.00 Attorney: ANTHONY T. MCBETH 1.0. No: 53729 Address:----4JLL.NORTH FRONT STRF.F.T HARRISBTJR~, PA 17101 Telephone: (717) 238-3686 DATE FILED: TOTAL................ $ 73.00 RW-7a LAST WILL AND TESTAJJ;/ENT . . OF ROBERT KEYES I, Robert Keyes, of Carlisle, Pennsylvania, revoke my former Wills and Codicils and declare this to be my Last Will and Testament.' , ARTICLE I IDENTIFICATION OF FAMILY I am not currently married to anyone. The failure of this Will to provide for any distributroil'to my child(ren): Susan Keyes, Robert Keyes Jr., and Melanie Keyes is intentional. ARTICLE II PAYMENTS OF DEBTS AND EXPENSES I direct that my just debts, funeral expenses, and expenses oflast illness be first paid from my estate. ARTICLE III DISI)OSITION OF PROPERTY ,I A. Specific Bequests. I direct that the following specific bequests be made from my estate. J. Real Estate Peoperty shall be distributed to Michael Kirchhoffer. If this beneficiary does not survive me, this bequest shall be distributed with my residuary estate. " 2. My remaining tangible personal property shall be distributed to Michael Kirchhoffer. If this beneficiary does not survive me, this bequest shall be distributed with my residuary estate. ~ :'i :~~ i j B. Residuary Estate. I direct that my residuary estate be distributed to Michael Kirchhoffer, of Carlisle, P A. If such beneficiary does not survive me, my residuary estate shall be distributed to Christina Leonard, ofWrightstown, New Jersey. If such beneficiary does not survive me, my residuary estate shall be distributed to my heirs-at- law, their identities and respective shares to be determined under the laws of the State of . , Pennsylvania, then in effect, as if! died intestate at the time fixed for distribution under ,~ i""( 'do: .~:: r.: . i this provision. ARTICLE IV NOMINA TION OF EXECUTOR I nominate Michael Kirchhoffer, of Carlisle, P A, as the Executor, without bond or security. If such person or entity does not serve for any reason, I nominate Christina Leonard, ofWrightstown, New Jersey, to be'the Executor, without bond or security. ARTICLE V EXECUTOR POWERS My Executor, in addition to other powers and authority granted by law or necessary or appropriate for proper administration, shall have the right find power to lease, sell, mortgage, or otherwise encumber any real or perso.n.aJ propelty that may be included in my estate, without order of court and without noti'c~to anyone. My Executor shall have the right to administer my estate using "informal", "unsupervised", or "independent" probate or equivalent legislation designed to operate without unnecessary intervention by the probate court. ARTICLE VI MISCELLANEOUS PROVISIONS A. Paragraph Titles and Gender. The titles given to the paragraphs of this Will arc inserted for reference purposes only and are not to be considered as forming a part of this Will in interpreting its provisions. All words used in this Will in any gende~ shall extend to and include all genders, and any singular words shall include the plural expression, and vice versa, specifically including "child" and "children", when the context or facts so require, and any pronouns shall be taken to refer to the person or persons intended regardless of gender or number. B. Thirty Day Survival Requirement. For the purposes of determining the appropriate distributions under this Will, no person or organization shall be deemed to have survived me unless such person or entity is also surviving on the thirtieth day after the date of my death. C. Liability of Fiduciary. No fiduciary who is a natural person shall, in the absence of fraudulent conduct or bad faith, be liable individually to any beneficiary of my estate, and my estate shall indemnify such natural person from any alld all claims or expenses in connection with or arising out of that fiduciary's good faith actions or nonactions as the fiduciary, except for such actions or nonactions which constitute fraudulent conduct or bad faith. ...~.. ," D, Intentional Exclusion. The failure of this Will to provide for any distribution to the following person(s) or organization(s) is intentional: Virginia Keyes E. Beneficiary Disputes. If any bequest requires that the bequcst bc distributed bctwcen or among two or more beneficiaries, the specific items of property comprising the respective shares shall be determined by such beneficiaries if they can agree, and ifnot, by my Executor. . j/J (L IN ~kHEREOF, I have sup~ribed my name below, this ~ day of 4/1// , ;2., tl t? c::r- . r TestatorSignature:&'oArJC. ~r~ Robe~~~ !:<.eyes , tl We, the undersigned, hereby certify that the above instrument, which consists of _ pages, including the page(s) which contain the witness signaturcs, was signcd in our sight and presence by Robert Keyes (the "Testator"), who declared this instrument to be his/her Last Will and Testament and we, at the Testator's request and in the Testator's sight and presence, and in the sight and prescnce of each other, do hereby subscribe our namcs as witnesses on the datc shown above, Witness Signature: Name: City: State: Witness Signature: Name: City: State: ~/?~ "- L.~ h a., > . fJ-.e.1C.. (!. "-/c-h. ~.~,c) PA- ,:5(t8/1I/{Y1L ...0~ o)1clt'l{ltm bi/ger J-<:!. ~ f]on 1/1 {~ J>ENNSYL VANIA Self-Proving Clause COMMONWEALTH OF PENNSYLVANIA COUNTY OF LEBANON I, Robert Keyes, the Testator, whose name is signed to the 'attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly and as my free and voluntary act for the purposes expressed in the instrument. Testator Signature S~orn~ or affirme.Q.j1pd acknowledged before me}y Rob,ert Keyes, the Testator, this /,;<1- 'lIay of --;-..6/r,u ti"'r-' ..0tJ~.- RCi:rt~'~ .~ /;jJR;L-,ut/ ~ 6eaJ Pabio(a c. ~ ~Putdlc I..ab8nOo. Lebe:nOll . . Nov. 2004 Otlicial capacity of officer 1'ilerrlI)sr;. ,..... AGsodatlon Ql Nota\:DS (Seal) AFFIDA VIT COMMONWEALTH OF PENNSYLVANIA COUNTY OF LEBANON We, CARt ."f-tJ phe.rr f UveA. and' , "')J1t1/lnOn E.. 'iJ/ L6e;e.- the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the Testator sign and execute the instrument as the Testator's Last Will; that the Testator signed willingly and executed it as the Testator's free and voluntary act for the purposes expressed in it; that each of us in the hearing and sight of the Testator signed the Will as a witness; and that to the best of our knowledge the Testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. ...- ,; . Sworn to or affirmed and subscribed to before me'by Cflt<../s Tv I/-IE..I- /JI/tJt...fI and 110 5/1lifJ{)(),J 'PILe!...!- , witnesses, this~dayof '::J-.L/r.LLI:J~ NO ?- Name: City: State: ~(!~ a Ii fl · < I-rl e a ~- )0iUC- T::t J.eJ; k1'JO ' ;OA II .j ~ 1 Witness Signature: ,., Witness Signature: t~-,{f)./lLA'LPL- 0~J() ~ Name: City: State: .tllu/]I}b/l E: all t7JC,/~ v L~~!:yv..., {J /? rA clJ~~ Notarla/3eaf PeZItlla C. Wtlltahead. ~Publlc lGtlenon,L..eOanon Seal and official cap . t!:lq)lros HeN. 2004 ~.1nt\'lbet; ~l& A~allQII ol~:es ,~ ~---.. J CERTIFICATION OF NOTICE UNDER RULE 5.6(al Name of Decedent: ROBERT C . KEYES MARCH 11, 2002 Date of Death: Will No. 2 0 0 2- 0 0 4 4 3 Admin. No. To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on AUGUST 1 5 , 2 0 0 2 Name SEE ATTACHED Address Notice has now been given to all persons entitled thereto under Rule 5.6(a) except NONE L Name ANTHONY T . MCBETH Address n n~ nTn~mu ~nnrTm emn~~m HARRISBURG, PA 17101 Telephone (71 ~/ 2 3 8- 3 6 8 6 Capacity: Personal Representative X Counsel for personal representative NOTICE OF BENEFICIAL INTEREST IN ESTATE BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND In re Estate of ROBERT C. KEYES No. 2002 of 00443 PENNSYLVANIA deceased, T0: MICHAEL P KIRCHHOFFER (beneficiary) 264 REDWOOD LANE (address) CARLISLE, PA 17013 Please take notice of the death of decedent and the grant of letters to the personal representatives} named below. You may have -~ a beneficial interest in the estate as follows: 1 0 0 ~ OE 'PHE ES'P~TE ' (if additional space is needed, use back of page) Name of decedent ROBERT C. KEYES Last known address 264 REDWOOD LANE of decedent CARLISLE PA 17013 Date of death MARCH 11 2002 Place of death CARLISLE, CUMBERLAND COUNTY, PA CUMBERLAND County of grant of original letters Decedent died X tesr_ate intestate. A copy of the will X is is not attached. Name(s), address(es) and telephone number(s) of all personal representatives appointed .j Name Address Telephone - (717) MICHAEL P. KIRCHHOFFER 264 REDWOOD LANE, CARLISLE, PA 17013 691-1545 Name(s), address(es) and telephone number(s) of all counsel Name Address Telephone ANTHONY T _ MC'RFTH 4 n 7 nTnRmr-r FR(1TT~~~DT,' ( 71 7 ) ~'~'~~A~~~-~B Ed R G-r-~~4 1 71 n 1 ~~ Q X 6 8 6 Addit' al information may be obtained from undersig Date ~b ZoO~ Signatur Name ANTUnnTV m ~R.,,,r,.,, . Address 407 NORTH HARRT. B R A PA 1 71 p 1 Telephone (717) 238-3696 Capacity: Personal Representative X Counsel for personal representative OFFICIAL USE ONLY REV-1500 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 -11 {oJ -, FILE NUMBER INHERITANCE TAX RETURN RESIDENT DECEDENT 2.L-~L ~-.O..L....1.--3.. COUNTY CODE YEAR NUMBER DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) KEYES ROBERT C. SOCIAL SECURITY NUMBER 162 - 32 I- Z W C W U W C 2725 DATE OF DEATH (MM-DD-YEAR) 3-11-2002 DATE OF BIRTH (MM-DD-YEAR) 6-1-1940 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) (X] 1. Original Return o 4.limiled Estate ~ 6. Decedent Died Testate IAttach cop)' or Will) D 9. Litigation Proceeds Received o 2. Supplemental Return o 4a. Future Interest Compromise (dale of dealh after 12.12-82) o 7. Decedent Maintained a Living Trust (AnachcopyolTru5t) o 10. Spousal Poverty Credit (dale otdealhbetween 12.31.91 aOO '.1-95) D 3. Remainder Return (daleofdllllhpricrlo 12.13-82) o 5. Federal Estate Tax Return Required ~ B. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A} [A\t&d'l Sch 0) w ... ::.:::$rn "",,,, wOo" ",00 ,,"'''' .... .. ~ ,tl'Uii; " NAME ANTHONY (IN;~IO:lTB ':CO "P.t:ETEO:',ALL.:CORRESI'ONO, -Nc'<~D:CONl'OENTIAL:;rAX IN OR~\Al:i~ 'sOIl.LO'S COMPLETE MAILING ADDRESS ... z w C z o .. '" w '" '" o " T. MCBETH 407 NORTH FRONT STREET HARRISBURG, PA 17101 FIRM NAME 1"_1 TELEPHONE NUMBER (717) 238-3686 OFFICIAL USE ONLY (1) (2) (3) (4) (5) 1, Real Eslate (5<hedule A) 2. Stocks and Bonds {Schedule BJ 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule 0) 5. Cash. Bank Deposits & Miscellaneous Personal Property (5<hedule E) 6, Jointly ONned Property (5<hedule f) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Noo.Probate Property (Schedule G Of L) 8, Tot.1 Gross Assets (tolallines 1-7) 9. Funeral Expenses & Adminislraijve Costs (Schedule H) ,. ? 11,171 nn '- t- I ~ D. z o ~ :J t:: a. <( u w a:: (6) (7) H,272.00 (8) 2,195.00 16,900.00 (9) 1'0) 10. Debts of Decedent, Mortgage Liabilities, &. Uens (Schedule I) l," (11) (1~1 (13) .' 11. Tolal Deductions (tolallines 9 & 10) 12. Net Value of Estate {Une 8 minus U~, 1_~)'\" \ _lI)1SOLVENT, ... '< '. . . ~', '.-, -._.l,;~.. 13. Charitable and GovemmentalBequeslsJSec 9113 Trusts rorwhich an election to tax has nol been made (Schedule J) 14, Net Value Subject 10 Tax (line 12 minus line 13) INSOLVENT (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o !;c I-' :J a. ~ o u ~ 15. Amount of Une 14 taxable at the spousal tax rate. or transfers under Sec. 9116 (a}(1.2) ',0_ (15) ,,0_ (16) 16. Amount of line 14 taxable allineal rate , ,12 (17) 17. Amount of line 14 taxable at sibling rate , ,15 (lB) 18, Amount of line 14 taxable at collateral rate (19) 19. Tax Due 200 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT :'i \i,,~~ ",,,..";~l~;f,~.~!~V:t;t,>:> BE5URE TO'AN5WERAL[;QUE5110NS:O 'RE\lER5E'510E'AND RECHECK MATH'<,,<, "",,;.';r;;> ,,,,,r.i, '" ~i'::"... Decedent's Complete Address: . . STREET ADDRESS 264 REDWOOD LANE CITY CARLISLE I STATE IZIP 17nl, PA Tax Payments and Credits: ,. Tax Due (Page 1 Une 19) (1) 2. CreditslPayments A. Spousal Poverty Credit 8, Plior Payments C. Discount Total Credits ( A + 8 + C ) (2) 3. InteresVPenalty if applicable 0, Interest E. Penalty TotallnteresUPenalty ( 0 + E ) (3) 4. If Une 2 is greater!han Line 1 + Une 3, enter !he difference. This is the OVERPAYMENT. Check box on Page 1 Une 20 to request a refund (4) 5. 11 Une 1 + Line 3 is greater than Une 2, enter !he difference. This is !he TAX DUE, (5) A. Enter !he interest on !he tax due. (SA) 8. Enter the total of Une 5 + SA. This is the BALANCE DUE. (58) Make Check Payable to: REGfSTER OF WILLS, AGENT -0- . _ _.' ~y , '.' ~ ._ ~ l - . " ".' . ~ "'{ ; '.' , .~ PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X"IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes a. retain !he use or income of the property lransferroo;.......................................................................................... 0 b, retain the right to designale who shall use the property transferred or its income; ............................................ 0 c. retain a reversionary interest: or...............,.......................................................................................................... 0 d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ............................",....................................."........................................ 0 3. Did dece<tent own an "in trust for" or payable upon death bank account or seculily at his or her death? .............. 0 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ................................................................................................................."..". 0 No [] [] K1 [] [] [] [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN, Under penal~es of perjury, I declare that 1 have examined !his retum, induding accompanying schedules and statements, and 10 the best of my knowledge arKI belief, it is true. correct and complele. Declaration of preparer other lhan the personal l"Elp(1lsentalive is based on aU information of wtJich preparer has any knowledge. SIG RE PERSON PONS FiLING R DATE 7- Z-- For dates of death on or after July " 1994 and before January 1, 1995, the tax rate imposed on the net value of Irans to or for the use of Ihe surviving spouse is 3% [72 P,S. ~9116 (a) (1.1) {ilJ. For dates 0/ death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S, ~9116 (a) (1.1) (iill. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for discfosure of assets and lifing a tax rerum are still applicabJe even if the surviving spouse is Ihe only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on Ihe nel value of translers from a deceased child twenty-one years of age or younger al death to or for the use of a natural parent, an adoptive parent, or a stepparenl otlhe child is 0% [72 P,S. ~9116(a)(1.211. The lax rale imposed on Ihe nel value of transfers to or for the use of the decedent's iineal beneficjanes is 4,5%, except as nolOO in 72 P,S, ~9116(1.2) [72 P.S, ~9116(a)(1)J. The lax rate imposed on /he net vaiue of transfers to or lor the use of the dece<tent's siblings is 12% [72 P,S. ~9116(a)(1.3)1. A sibling is defined, under Section 9102, as an individual who has alleast one parent in common with the decedent, whether by blood or adoption. IlEV;"e".".,.,. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 21-02-00443 KEYES, ROBERT C. Include the proceeds 01 litigation and ll1e date ll1e proceeds were received by the estate. All property jolntly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. 2. 3. 4. DESCRIPTION 1989 CADILLAC SEDAN DEVILLE (SOLD BY EXECUTOR FOR THAT PRICE) 1996 CHRYSLER SEBRING 1981 REDMON TRAILER CASH - FULTON BANK VALUE AT DATE OF DEATH $1,000.00 $7,250.00 $3,000.00 $ 22.00 TOTAL (Also enter on line 5, Recapitulation) $ 11 . 272.00 I'f more space is needed, insert additional sheets of the same size) ~l""X"''''''. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF KE~ES. ROBERT C. Debts of decedent must be reported on Schedule I. SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21-02-00443 ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. CENTRAL PENNSYLVANIA CREMEATION SOCIETY $1,372.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name at Personal Representative (s) Social Security Numba~s) I EIN Number 01 Pe"",nal Represenlalive{s) Slreet Address City Slate Zip Yea~s) Commission Paid: 2. Attorney Fees $ 750.00 3. Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation) Claimant S~eet Address City Slate Zip Relationship of Claimant to Decedent 4. Probate Fees $ 73.00 5. Accountan(s Fees 6. Tax Return Prepare(s Fees 7. TOTAL (Also enter on line 9, Recapitulation) $2.195.00 .. ::j (If more space IS needed, ,nsert add,tlonal sheets of the same Size) '''''''0 Ell 0 "'I" ~ . ~ COMMON'NEALTH OF PENN$ytVAN1A INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS ESTATE OF KEYES, ROBERT C. FILE NUMBER 21-02-00443 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION 1. FULTON BANK -LOAN ON 1996 SEBRING 2. B&B BANK & TRUST - LOAN ON 1981 REDMON TRAILER 3. SEARS - CHARGE CARD AMOUNT $6,000.00 $8,900.00 $2,000.00 TOTAL (Also enter on line 10, ReC<3pitulation) $ 1 6 900 00 , . (II more space is needed, insert additional sheelS of the same size) ~ e.../OKv . . PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE a 6.12 FORM YEARLY UNTIL COMPLETION STATUS REPORT UNDER RULE 6.12 Name of Decedent: ROBERT C. KEYES Date of Death: MARCH 11. 2002 2002-00443 Will No.: Admin. No.: Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes x No ~.i 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is yes, state the following: A. Did the personal representative file a final account with the court? Yes No X B. The separate Orphans' Court No. (if any) for the personal representative's account IS: C. Did the personal representative state an account informally to the parties in interest? Yes X No D. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the hans' Court and may be attached to this report. Date: j( ~ '~~O ~ 407 NORTH FRONT STREET HARRISBURG. FA 17101 Address (MAH:rmtlAM3) (717) 238-3686 Telephone No. Capacity: Personal Representative )( Counsel for Personal Representative R.w..27 RECEIPT AND RELEASE KNO W ALL MEN BY THESE PRESENTS that I, Michael P. Kirchhoffer, heir ofthe Estate of Robert C. Keyes, Deceased, do hereby acknowledge that I have this day had and received from Anthony T. McBeth, Counsel for the Estate of Robert C. Keyes, Deceased, the sum of zero dollars, in full and complete satisfaction and payment due me as said heir. And therefore I, the said Michael P. Kirchhoffer, do by these presents remise, release, quit- claim and forever discharge Michael P. Kirchhoffer, Executor of the Estate of Robert C. Keyes, Deceased, and the said Anthony T. McBeth, Counsel for the Estate of Robert C. Keyes, Deceased, his successors and assigns, of and from his actions as Counsel for the Estate of Robert C. Keyes, Deceased, of and from all actions, suits, payments, accounts, reckonings, claims and demands l whatsoever, for or by reason thereof, or of any other act, matter, cause or thing whatever. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ) t..; day of ~ , 2002. WITNESS: fW1€~IX1Ytll!~!J Itlq- t.lJ--- o4/a-. Social Security Number \ /"7-6/--;;; ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ANTHONY T MCBETH 407 N FRONT ST HBG DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 09-10-2002 KEYES 03-11-2002 21 02-0443 CUMBERLAND 101 '* REY-1547 EX AFP lDl-D21 ROBERT C PA 17101 Allount Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV =iS4-j-E3f-AFP--foY:02Y-NOYicE--OF-YNHEjfifAifcE-TA;C-A-PPRA-isEi"-ENT~--Ai:.rOWAifCE-(fR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF KEYES ROBERT C FILE NO. 21 02-0443 ACN 101 DATE 09-10-2002 TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Hortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets (1) (2) (3) (4) (5) (6) (7) .00 .00 .00 .00 11,272.00 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Hisc. Expenses (Schedule H) 10. Debts/Hortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) llO) 2,195.00 16.900.00 (11) (12) ll3) ll4) NOTE: If an assessment was issued previously, lines reflect figures that include the total of abb ASSESSMENT OF TAX: 15. Allount of Line 14 at Spousal rate (15) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. Allount of Line 14 at Sibling rate (17) 18. Allount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS: NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 1l,272.00 19.095 00 7,823.00- .00 7,823.00- 14, 15 and/or 1&, 17, 18 and 19 will returns assessed to date. .00 X 00 = .00 X 045 = .00 X 12 = .00 X 15 = ll9)= .00 .00 .00 .00 .00 II l + J AHOUNT PAID DATE NUHBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 · IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)