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Home My WebLink About07-22-14 � 1505610140 REV-1500 EX (02-11)(FI) PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes County Code Ye�� File Num �`� Po BOx 2sosoi INHERITANCE TAX RETURN 2 1 �3►--4� Harrisburq,PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 1 0 2 4 2 0 1 4 0 4 2 1 1 9 4 8 DecedenYs Last Name Suffix DecedenYs First Name MI K E N D R I C K J 0 H N L (If Applicable)Enter Surviving Spouse's information Below Spouse's Last Name Suffix Spouse's First Name MI K E N D R I C K D E B 0 R A H A Spouse's Social Security Number 2 O 5 4 4 2 2 7 3 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW � 1.Original Return � 2.Supplemental Return � 3. Remainder Return(Date of Death Prior to 12-13-82) � 4. Limited Estate � 4a. Future Interest Compromise(date of � 5. Federal Estate Tax Return Required death after 12-12-82) ❑X 6.Decedent Died Testate � 7. Decedent Maintained a Living Trust � 8.Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) � 9.Litigation Proceeds Received � 10.Spousal Poverty Credit(Date of Death � 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 T0: Name Daytime Telephone Number D A N I E L K • D E A R D 0 R F F 7 1 7 2 4 3 3 3 4 1 � REGISTER OF WILLS USE ONLY First Line of Address C7 1 0 E A S T H I G H S T R E E T �� r:,� Second Line of Address � rn ,- r ` „ , �� r--- � �� i �.� :;� rr1 � _ I � t�.? �•' � City or Post Office State ZIP Code I�-- ��FiLE� �- , _. ; -. C A R L I S L E P A 1 7 0 1 3 � � -_ =T� _.A.i ��.;'�' D"..'f � ^�_ �.:5 � �� 'Tl CorrespondenYs e-mail address: DDEARDORFFnu,MARTSONLAW.COM Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief, it is true,correct and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATU �OF PERSON RE NSIB FOR FILIMG RETURN DATE' / // ,�1.l--`v�-l— �`��r-sU?��:-�� O�-/—�`�' ADDRESS 305 HICKORY ROAD CARLISLE PA 17015 SIGN OF PR Af�R OT THAN REP SENTATI �DATE _/U � / 7 ADDR SS 10 EAST HIGHT STREET CARLISLE PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 � 1505610140 1505610140 J \� � 150561�240 REV-1500 EX(FI) DecedenYs Social Security Number �ecedent'sName: JOHN L • KENDRICK RECAPITULATION 1. Real Estate(Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . �• � . � 0 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. • 5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E). . . . . . . 5. 6 2 8 1 . � � 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested . . . . . . . 6. 0 . 0 0 7. Inter-Vivos Transfers&Miscellaneous N�n-Probate Property 6 0 0 1 . 5 6 (Schedule G) U Separate Billing Requested . . . . . . . 7. 8. Total Gross Assets(total Lines 1 through 7) . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. 1 2 2 8 2 . 5 6 9. Funeral Expenses and Administrative Costs(Schedule H) . . . . . . . . . . . . . . . . . . 9• 1 8 � 1 2 . 2 3 10. Debts of Decedent,Mortgage Liabilities,and Liens(Schedule I) . . . . . . . . . . . . . 10. 0 • � � 11. Total Deductions(total Lines 9 and 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 1 8 � 1 2 . 2 3 12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12• - 5 7 2 9 . 6 7 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J) . . . . . . . . . . . . . . . . . . . . . . 13. 2 � � � . 0 0 14. Net Value Subject to Tax(Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . . . . . 14. - � 7 2 9 . 6 � TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 (a)(�.2)x.o _ 6 0 0 1 . 5 6 �5. 0 . 0 0 16. Amount of Line 14 taxable at lineal rate X.045 � • � � 16. � • � 0 17. Amount of Line 14 taxable at sibling rate X.12 0 . 0 0 17. 0 . 0 � 18. Amount of Line 14 taxable at collateral rate X.15 0 . 0 � 18. � . 0 0 19. TAX DUE � � � � . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑ Side 2 � 1505610240 1505610240 J REV-1500 EX(FI) Page 3 File Number Decedent's Complete Address: 21 ta o2ai DECEDENT'S NAME JOHN L.KENDRICK _ _ STREETADDRESS - - --- - -— ----- CITY I STATE ZIP Tax Payments and Credits: �• Tax Due(Page 2,Line 19) (1) 0.00 2. CreditslPayments A.Prior Payments B.Discount Total Credits(A+B) (2) 0.00 3. Interest (3) 4. If Line 2 is greater than Line 1 +Line 3,enter the difference.This is the OVERPAYMENT. Fili in oval on Page 2,Line 20 to request a refund. (4) 0.00 5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 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 ...................................................................... ❑ X❑ b. retain the right to designate who shall use the property transferred or its income ............................... ❑ � c. retain a reversionary interest ..................................................................................................... ❑ ❑X d. receive the promise for life of either payments,benefits or care? ....................................................... ❑ � 2. If death occurred after December 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? ......... ❑ 0 4. Did decedent own an individual retirement account,annuity or other non-probate property,which contains a beneficiary designation?.................................................................................................. X❑ ❑ 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,antl 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 imposetl 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 decedenYs lineal beneficiaries is 4.5 percent,except as noted in p2 P.s.§s�ts(a)(��. • 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. REV-1508 EX+(08-12) pennsylvania SCHEDULE E DEPARTMENTOFREVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TAX RETURN RESIDENTDECEDENT PERSONAL PROPERTY ESTATE OF: FILE NUMBER: JOHN L.KENDRICK 21 14 0241 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. Preston S.Kendrick,personal property,per Item Third A of Will 3,978.00 2. David L.Kendrick,personal property,per Item Third A of Will 550.00 3. Whitney R.Kendrick,personal property,per Item Third A of Will 545.00 4 Kathryn K.Messelt,personal property,per Item Third A of Will 1,208.00 TOTAL(Also enter on Line 5,Recapitulation) $ 6 281.00 If more space is needed,use additional sheets of paper of the same size. REV-1510 EX+(08-09) pennsylvania SCHEDULE G DEPARTMENTOFREVENUE INTER-VIVOS TRANSFERS AND INHERITANCETAXRETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER JOHN L.KENDRICK 21 14 0241 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 INCLUDETHENAMEOFTHETRANSFEREE,THEIRRELATIONSHIPTODECEDENTAND DATEOFDEATH %OFDECD�S EXCLUSION TAXABLE NUMBER THEDATEOFTRANSFER.ATfACHACOPYOFTHEDEEDFORREALESTATE. VALUEOFASSET INTEREST (IfAPPLICABLE) VALUE 1. Bank of America IRA 68100451807825;beneficiary: Deborah A. 6,001.56 100.00 6,001.56 Kendrick, 100% TOTAL (Also enter on Line 7,Recapitulation) $ 6 001.56 If more space is needed,use additional sheets of paper of the same size. REV-1511 EX+(OS-13) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCETAXRETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER JOHN L.KENDRICK 21 14 0241 DecedenYs debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Ewing Brothers Funeral Home,Carlilse,PA 10,985.10 2. Georges'Flowers 257.58 3. St.John's Episcopal Church,funeral luncheon 423.27 4. Ft.Myers Officer's Club,Arlington Funeral dinner 1,494.78 5. Arlington National Cemetary Full Honors 1,218.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) Street Address City State ZIP Year(s)Commission Paid: 2, Attomey Fees: Martson Law Offices(estimated) 3,500.00 3, Family Exemption:(If decedenYs address is not the same as claimanYs,attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4. Probate Fees: Cumberland County Register of Wills 113.50 5 Accountant Fees: 6. Tax Retum Preparer Fees: 7. Short Certificates 20.00 TOTAL(Also enter on Line 9,Recapitulation) $ 18 012.23 If more space is needed,use additional sheets of paper of the same size. REV-1513 EX+(01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: JOHN L.KENDRICK 21 14 0241 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.9116(a)(1.2).] 1. Deborah A.Kendrick Spousal 6,001.56 305 Hickory Road Carlisle,PA 17015 2. Preston S.Kendrick Lineal 3,978.00 1135 Fox Hill Drive,Apt. 320 Monroeville,PA 15146 3. David L.Kendick Lineal 550.00 939 View Street Hagerstown,MD 21742 4. Whifiey R.Kendrick Lineal 545.00 2820 S.E.Main Street Portland,OR 97214 5. Kathryn K.Messelt Lineal 1,208.00 10003 N.E.76th Avenue Portland,OR 97213 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE. II. NON-TAXABLE DISTRIBUTIONS: A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. St.John's Episcopal Church 2,000.00 Carlisle,PA 17103 * Paid from Non-Probate Assets TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ 2 000.00 If more space is needed,use additional sheets of paper of the same size. __-- �. Last Will and Testament of John Laxton Kendrick I, JOHN LAXTON KENDRICK, of the County of Cumberland and Commonwealth of Pennsylvania, being of sound mind and memory, do make, publish and declare this to be my Last Will and Testament, hereby revoking and declaring null and void any and all Wills or Codicils by me at any time heretofore made. FIRST: I direct my Executrix to pay the expenses of my last illness and funeral from the residue of my Estate. SECOND: I direct that all Estate, Inheritance and other death taxes that may be assessed with respect to property or interest passing under my Will by whatever jurisdiction imposed, shall be paid from my residuary Estate as a part of the expense of the administration of my Estate. THIRD: I give all tangible personal property owned by me at my death and all insurance policies on such property as follows: A. To those individuals who survive me by thirty(30) days who are designated on a list or memorandum signed by me which refers to this Will or is found with a copy thereof, the items listed beside their names. If no such list is found within thirty(30) days of my death, it shall be presumed that no such list exists. B. The balance, including any item under subparagaph A., the bequest of Page 1 of 6 i � � , . which has lapsed, to my wife, DEBORAH ANN KENDRICK, if she survives me by thirty(30)days. If my wife, DEBORAH, fails to so survive me, then I give the same to the following beneficiaries: my daughter, KATHRYN LEE KENDRICK, my son, DAVID LAXTON KENDRICK, my daughter, WHITNEY ROCHELE KENDRICK, my son, PRESTON SCOTT KENDRICK, my stepson, JOHN FITZGERALD EDMONDSON, and my stepdaughter, AMY BETH BENDER, if they survive me by thirty (30) days, or to the survivors thereof who shall so survive me, to be divided among them as they may agree or, if they are unable to agree, as my Executrix may decide. Any items not so disposed of shall be sold and the proceeds distributed as part of the residue of my Estate as provided for herein. FOURTH: I give the sum of Two Thousand Dollars ($2,000.00) to ST. JOHN'S EPISCOPAL CHURCH, Carlisle, Pennsylvania, to be used over a ten (10) year period to purchase Christmas decorations valued at Two Hundred Dollars ($200.00)per year. FIFTH: I give the residue of my Estate as follows: A. To my wife, DEBORAH ANN KENDRICK, if she survives me by thirty (30)days. B. If my wife, DEBORAH, fails to so survive me, then I give the residue of my Estate in equal shares to the following beneficiaries: KATHRYN LEE KENDRICK, DAVID LAXTON KENDRICK, WHITNEY ROCHELE KENDRICK, PRESTON SCOTT KENDRICK, JOHN FITZGERALD EDMONDSON and AMY BETH BENDER, if they survive me by thirty(30) days; if not, then in equal shares to such of the beneficiaries who shall survive me by thirty(30) days; provided that if any such beneficiary fails to so survive me, but is represented by descendants who so survive me, such descendants shall receive, per stirpes, the share such deceased beneficiary would have received had he or Page 2 of 6 __ masculine and feminine. IN WITNESS WHEREOF, I have hereunto set my hand and seal this �3r� da of �� ` ,20 I�. y � (Signature) JOHN LAX N DRICK Signed, sealed and published and declared by JOHN LAXTON KENDRICK, the Testator above- named, as and for his Will, in the presence of us, who, at his request, in his presence and in the presence of each other, have hereunto subscribed our names as witnesses hereto. WITNESSES: Signature: � - fyj. � Q Signature: �� Print Name: ��ii�' /�� QG�E Print Name: Gr�� Q .� Address: /�39 �,yi�/ �. Address: / 9' D��j�'j/l �Q � �Dr�in/� ,1P�'��✓Gr l�1 /70L�� /7�' Page 5 of 6 ACKNOWLEDGEMENT COMMONWEALTH OF PENNSYLVANIA COUNTYOF C«.�i��.�4�v,� I, JOHN LAXTON KENDRICK, 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; and that I signed it willingly and as my free and voluntary act for the purposes therein expressed. Sw�rn to or affirmed and acknowledged before me by JOHN LAXTON NDRICK, the Testator, this �� day of ► of 20�. - � JOHN LAX N KEN RICK(Signature) w � � ( ign e of Notary Public) ( f Notary Public) AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA NOTARIAL SEAL COMMONWEALTH OF PENNSYLVANIA JUDITH D.KAUFFMAN,NOTARY PUBUC COLINTY OF ��li��l I��"�YZ�-�4 n�`5 CARLISLE BOROUGH,CUMBERLAND COUNTY MY COMMISSION EXPIRES MARCH 10,2011 We, ��iE �� E and G�, � Oq � , 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 his Last Will; that the Testator signed willingly and executed it as his free and voluntary act for the purposes therein expressed; that each subscribing witness 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. Swom to or affirmed and subscribed to before me by k�(�-m�' M �6-+�-C-� and le�R b��_ , witnesses, this a3 day of �P��L , 20 t v . w1t11eSS(Signature) . � W1tT1ESS(Signature) U w (S' a e of Notary Public) (S al Notary Public) Page 6 of 6 COMMOMNEALTH OF PENNSYLVANIA NOTARIAL SEAI JUDtTH D.KAUFFMAN�NOTARY PUBUC CARLISLE BOROUGH,CUMBERLAND COUNTY MY COMMISSION EXPIRES MARCH 10,2011