HomeMy WebLinkAbout06-02-14 1 1505610105
-J REV-1500EX(0=1aFl) it OFFICIAL USE ONLY
PA Department of Revenue pennsytvania
Bureau of Individual Taxes INSOLVENT County Code Year File(Number
PO BOX 28o6o1INHERITANCE TAX RETURN a1 14 4a�
Harrisburg,PA 1'7128-o6o1 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
09/13/2011 12/24/1923
Decedent's Last Name Suffix Decedent's First Name MI
KUNKLE J. D
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
KUNKLE MILDRED C
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
m 1. Original Return O 2. Supplemental Return O 3. Remainder Return(Date of Death
Prior to 12-13-82)
p 4. Limited Estate (=D 4a. Future Interest Compromise(date of O 5. Federal Estate Tax Return Required
death after 12-12-82)
C@D 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 0 8. Total Number or 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 Schedule O)
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
JANE M. ALEXANDER, ESQ. (717)4324514
N
O �J
REGISTE F WILLS US€'rONLY rn m
3 ° � - o
First Line of Address 7 S �? Z _i
148 S. BALTIMORE STREET n m r -. °
r c? d
Second Line of Address c> n O 3 in
P.O. BOX 421 o c u C">
City or Post Office State ZIP Code DAT ILED co m G.) O
DILLSBURG PA 17019
Correspondent's e-mail address:
Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief.
it is true,correct and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATU E OF PERSON RES S L F N ETU IN ATE
ADORE
62 untain Road, York Springs, PA 17372
SI NA RE OF PREPARER OTHER THAN REPRESENTATIVE DATE
AD,D ESS
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610105 1505610105
1505610205
REV-1500 EX(FI)
Decedents Social Security Number
Decedents Name:
RECAPITULATION
1. Real Estate(Schedule A). ... . . . . . ... . . . . . .. . . .. . . .. . . . . . . . . . . . . . . . . . 1.
2. Stocks and Bonds (Schedule B) . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) . . . . . 3.
4. Mortgages and Notes Receivable (Schedule D) . . .. . . . .. . . .. . . . . . . . . . . . . . . 4.
S. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E). . . . . .. 5. 1,974.66
6. Jointly Owned Property(Schedule F) O Separate Billing Requested . . . . . . . 6.
7. Inter-Vivos Transfers& Miscellaneous Non-Probate Property
(Schedule G) C=) Separate Billing Requested.. . . . . . . 7.
S. Total Gross Assets (total Lines 1 through 7).. . . .. . . . . . . ._ . . .. . .. . . . . . . . 8. 1,974.66
9. Funeral Expenses and Administrative Costs(Schedule H). ... .. . . _ . . . . . . .. 9. 937.05
10. Debts of Decedent, Mortgage Liabilities and Liens(Schedule 1).. . . . . . . . . . . . 10. 32,280.24
11. Total Deductions(total Lines 9 and 10). . .. . . . . . _ . . . . .. .. . .. . . . . . . . . . . 11. 33,217.29
12, Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. -31,242.63
13. Charitable and Governments!Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J) . . . . . . . . . . . . . . . . . . . . . . . . 13. 0.00
14. Net Value Subject to Tax(Line 12 minus Line 13) . . . . . . . . . .. . . . . . . . . . .. . . 14. 0.00
TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2)X.0_ 15. 0.00
. . ... . .
16, Amount of Line 14 taxable
at lineal rate X.0_ 16,
17. Amount of Line 14 taxable
at sibling rate X.12 17.
16. Amount of Line 14 taxable
at collateral rate X.15 18.
19. TAX DUE . . . . . . . . . . . . . . . .. ... . . . . . . . . . .. . . . .. . . . .. . ... . . .. . . . . . . . . 19. 0.00
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT p
Side 2
L 1505610205 1505610205 J
REV-1500 EX(Fir Page 3 File Number
Decedent's Complete Address:
DECEDENTS NAME
J. Donald Kunkle
_ ...
STREET ADDRESS
One Longsdorf Way
. . .. __...._..._.. ............._ - _____._
CITY -..__.._._. _. - . ....... _ _._.._._........ . STATE ._....PA _.._ -___.-.......-.
i ZIP
Carlisle
17015
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 0.00
2. Credits/Payments —
A. Prior Payments
B. Discount
-------�------
3. Interest Total Credits(A+ g) (2) 0.00
—
4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (3) -
Fill in oval on Page 2,Line 20 to request a refund. (4)
5. It Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 0.00
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 ....................................................._.....,............................. ❑ 0
b. retain the right to designate who shall use the property transferred or its income ..........................................., ❑ N
c. retain a reversionary interest ....................................................................................-_...,.................,......._...... ❑ E
J. receive the promise for life of either payments, benefits or care?........................................_........................... ❑ 0
2. If death occurred after Dec. 12, 1982,did decedent transfer property within one year of death
without receiving adequate consideration?......_.........................................................................._.-...,................... ❑ 0
3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death?.............. ❑ N
4. Did decedent own an individual retirement account,annuity or other non-probate property,which
containsa beneficiary designation? ............................................_........,.............,.................,..................,.............. ❑ E
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)(1.1)(ii)].The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and
filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
• The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an
adoptive parent or a stepparent of the child is 0 percent[72 P.S. §9116(a)(1.2)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in[72 P.S.§9116(a)(1)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent[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.
Of
31. Doualb Runkle
I,J. Donald Kunkle,of the Township of Warrington,County of York and Commonwealth of
Pennsylvania,being of sound mind,memory and understanding,do hereby publish and declare this to
be my Last Will and Testament,hereby revoking and declaring null and void any and all Wills and
Codicils heretofore written by me.
ITEM I. I direct that all my just debts and funeral expenses be paid as soon after my demise as
may be convenient to the proper administration of my estate.
ITEM II. I give,devise and bequeath my entire estate remaining after payment of debts and
funeral expenses to my wife,Mildred C.Kunkle, if she be living at the time of my death and survives
me for a period of thirty(30)days.
ITEM III. If my said wife should predecease me or fail to survive me for a period of thirty
(30)days,I then order and direct my hereinafter-named Executrix to convert my entire estate into cash
at either public or private sale,whenever in her discretion it may be most expedient for the proper
administration of my estate. In the event of such conversion,I authorize my said Executrix to execute
a good and sufficient Warranty Deed to the purchase of any real estate of which I may die seized,in
the same manner and capacity as I could if living.
ITEM IV. I direct that all inheritance and estate taxes be paid on the proceeds of the above
conversion and on all the rest residue and remainder of my estate from the residue of my estate prior to
further distribution.
ITEM V. I direct that my hereinafter named Executrix distribute all the rest,residue and
remainder of my estate,including the proceeds of the above-mentioned conversion,in equal shares to
my two(2)children:Penny S.Lee and J.Donald Kunkle,Jr.,per stirpes and not per capita.
ITEM VI. I nominate,constitute and appoint my wife,Mildred C.Kunkle,as Executrix of
this my Last Will and Testament. Should she predecease me or be unable or unwilling to serve,I then
nominate,constitute and appoint Jane M.Alexander,as Executrix in her place and stead. I direct that my
Executrix shall not be required to post bond other than her personal assurance for her duties as
Executrix.
Page I oft
IN WITNESS WHEREOF,1,J.Donald Kunkle,have hereunto subscribed my hand to this
my Last Will and Testament,this day of <;�. ,2002,
J_136nald Kunkle _
SIGNED,PUBLISHED and DECLARED by the above-named J.Donald Kunkle,as and for
his Last Will and Testament in the presence of us,who at his request and in his presence and in the
presence of each other,have signed our names as attesting witnesses hereto.
ri
A' IEC:.y_./d( -a-/ll ey_C. residing at i_<<lK.�
_.s-.z...;,. residingat -7c V_;
Page 2 oft
REV-i5o8 EX+(08-12)
r.., SCHEDULE E
P ,.F pennsylvania
DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
J. Donald Kunkle 2114-0427
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Cumbelrand Crossings-RFMS refund 1,974.66
TOTAL (Also enter on Line 5, Recapitulation) $ 1,974.66
If more space is needed, use additional sheets of paper of the same size.
7� pennsylvania SCHEDULE H
'-� DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
J. Donald Kunkle 2114-0427
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Cocklin Funeral Home, Inc.-funeral expense(balance owe) 323.55
2. Baughman Memorial Works, Inc.-lettering 190.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions: 100.00
Name(s) of Personal Representative(s) Jane M. Alexander, Es Uire
Street Address 625 Mountain Road
City York Springs State PA Zip 17372
Year(s)Commission Paid: 2014
2. Attorney Fees:
140.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.)
Claimant
Street Address
City .. _.. .. ..._..... ...._---- State ZIP . ._._....-._....
Relationship of Claimant to Decedent
4. Probate Fees: 63.50
5. Accountant Fees:
6. Tax Return Preparer Fees:
Z Diana M.Fetrow-witness fee 25.00
e. NarumolAlexander-witnessfee 25.00
9. Register of Wills-fling Inheritance Tax Return and Inventory 30.00
10. Notary fees 35.00
11. Register of Wills-filing release 5.00
TOTAL (Also enter on Line 9, Recapitulation) $ 937.05
If more space is needed, use additional sheets of paper of the same size.
REV-1 i12 EH, 112-08;
pennsylvania SCHEDULE I
DEPARTMENT OF REVENUE DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
J. Donald Kunkle 2114-0427
Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1' Pennsylvania Department of Public Welfare-medical expense 27,837.11
2. Pennsylvania Department of Public Welfare-balance of claim 4,44113
TOTAL (Also enter on Line 10, Recapitulation) $ 32,280.24
If more space is needed, insert additional sheets of the same size,
REV-1513 EX+ (01-10)
pennsytvania SCHEDULE J
DEPARTMENT OF REVENUE
INnERTTANCE TAY RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
J. Donald Kunkle
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSONS) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS[Include outright spousal distributions and transfers under
Sec. 9116(a) (1.2).1
1. Mildred C. Kunkle,One Longsdorf Ways,Carlisle, PA 17015 Wife 100% of residue
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE,
II NON-TAXABLE DISTRIBUTIONS
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
I None
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
None
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $
If more space is needed, use additional sheets of paper of the same size.
00 678
CUMBERLAND CROSSINGS 68-760
RFMS PETTY CASH ACCOUNT 560
1 LONGSDORF WAY DATE lo -/ - zo
CARLISLE, PA. 17013
PAY
TO THE ALP
ORDER OF /
s Ll
DOLLARS
WACHOVIA BANK
FOR
Cocklin Funeral Home, Inc.
30 N. Chestnut St.
Dillsburg, PA 17019
(717)432-5312
January 17, 2012
Penny Sue Lee
832 S. Ridge Rd.
York Springs, PA 17372
The Funeral Service for J. Donald Kunkle
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 Services
Funeral Director&Staff 3,725.00
Total Professional Services 3,725-.if6
Merchandise
S48 Heirloom Pewter 2,465.00.
Monticello 1,390.00
Total Merchandise Selected ------------------
3,ST�SifO
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
Cemetery Charges 500.00
Newspaper Notice-Harrisburg 189.27
Newspaper Notice-York 143.10
Clergy Honorarium 75.00
Flowers 162.18
Death Certificates 30.00
Tent Rental 175.00
Total Cash Advances ---------------- f,2771-55
SALES TAX 0.00
SUB-TOTAL 8,853.55
INITIAL PAYMENT/DISCOUNT/CREDITS 8,530.00.
TOTAL AMOUNT DUE 323.55
The unpaid balance over I days is subjected to a 0%service charge per month-0%per annum.
Page
Price 19o' 00
V Memorial Works,i=
23-25 South Main Street Dover, PA 17315
Telephone (717) 292-2621 Fax (717) 292-7936
E-mail info @baughmanmemorials.com
Total Price o O
Please design and build the following memorial
Date a
For
Address
Design No. Il T
Material �Jn�l� Vl9
Die e� }vul uk
an-
Base
Markers p
Posts
Vases
Price Tax
Deposit
Balance Due r DcN R L'� )�ury KLZ
Style of Letters
Foundation to be furnished by
Material to be best selected monumental grade and to be free from imperfections and first class in every way.Work to be finished in a workmanlike
manner.
This memorial to be erected in Cemetery in or near
during the month of unless unavoidably delayed by labor
troubles and other contingencies beyond our control and then as soon as possible.Additional lettering and other work on this memorial in the future is
not included in the Contract Price.
Title and right of possession and removal of said stone,monument or appurtenances shall remain for all purposes in Baughman Memorial Works,
Inc. until work and materials ordered are fully paid by purchaser or purchasers. In consideration of the acceptance by Baughman Memorial Works,Inc.
of this order,the undersigned(hereinafter known as the purchaser)agrees to pay Baughman Memorial Works, Inc.
Dollars on or before the 15th day following
the billing of the work or job upon completion thereof by Baughman Memorial Works, Inc.Thirty(30)days from date of invoice a 1-1/2%finance charge
will be added to the unpaid balance. Said billing to be notice of completion thereof, this order shall become a contract between the purchaser and
Baughman Memorial Works, Inc.upon acceptance thereof in the space below by a duly authorized representative of said Baughman Memorial Works,
Inc.It being understood that this instrument upon such acceptance covers all of the agreement between the purchaser and Baughman Memorial Works,
Inc. and that no agent or representative of Baughman Memorial Works, Inc. has made any statements or agreements, verbal or written, modified or
adding to the terms and conditions herein set forth.
It is further understood that upon the acceptance of this order the contract so made cannot be cancelled,altered,or modified by the purchaser or
by any agent of Baughman Memorial Works,Inc.in any manner except by agreement in writing between the purchaser and Baughman Memorial Works,
Inc.and it is hereby understood and agreed by all parties involved that in case of default by purchaser or purchasers,twenty-five per cent of the total
original cost of the work or work and materials ordered,as the case may be,shall be a specified correct sum as liquidated damages which purchaser
shall owe Baughman Memorial Works,Inc.less any payment on account made prior to such default,this specification of damages to be due regardless
of removal and taking possession of stone, monument or materials from purchaser or purchasers by Baughman Memorial Works, Inc. upon following
such default.
(SEAL)
20 (SEAL)
Baughman Memorial Works, Inc.Approval By (SEAL)
— White:Office Copy;Canary:Customer Colov:Pink:Salesman Coov:Gold: Deposit Coov
0 pennsylvania
DEPARTMENT OF PUBLIC WELFARE
February 14, 2012
JANE M ALEXANDER ESQUIRE
148 S BALTIMORE ST
DILLSBURG PA 17019
Re: Donald Kunkle
CIS #: 520260971
SSN: ###-##-
Date of Death: 09/13/2011
Dear Attorney Alexander:
Please be advised that the Department of Public Welfare maintains a claim in the
amount of $32.280.24 against the above-mentioned estate. This claim is for restitution of
medical assistance granted on behalf of the decedent for which the Probate Estate is now
responsible to reimburse the Department according to Act 49, 62 P.S. 1412, effective
August 15, 1994, as amended by Act 20-95, effective June 30, 1995. Enclosed is the.
Department's itemized statement of claim.
A portion of this medical expense, namely $27,837.11, was incurred during the last
six months of the decedent's life; therefore, it is a Class 3 claim pursuant to Section 3392 of
the Decedents, Estates, and Fiduciaries Code, 20 Pa. C.S.A. 3392(3). The balance of the
claim, namely $4,443.13, is to be entered as a priority Class 5.1 claim against the estate.
Please acknowledge receipt of this letter and advise whether the Commonwealth's
claim is admitted and when payment may be expected. If the estate accounting is
complete, please provide a copy. If We estate contains real estate, please provide
copies of the deed, the latest tax assessment, and a current appraisal, if available.
Sincerely, y�
r/
Jennifer Hartman
TPL Program Investigator
717-772-6962
717-772-6553 FAX
Enclosure
Bureau of Program Integrity I Division of Third Party Liability I Recovery Section
PO Box 8486 1 Harrisburg, Pennsylvania 17105-8486