HomeMy WebLinkAbout02-0842
Cl4.rv-.b e.r\ ~ J.
Register of Wills of DJI"lplli.t I County I Pennsylvania
PETITION FOR GRANT OF LETTERS
Estate of
Clo.rlnc.t. ~. l<t.('(
No.
~J -()~- g',/ J
also known as
, Deceased
Social Security No. l~l-oS'- Y 4 i~
Petitioner(al. who i.'ere 1 B year. of age or older, apply(ies) fa,;
(COMPLETE" A" OR "B" BELOW:)
tiI
A. Probate and Grant of letters and aver that Petitioner(at is/~ the executor named in the last Will of the
Decedent, dated ZCI F~ 01. and codicil(sl dated -
State relevant circumstances. e.g., 'enunciation, death of executor, etc.
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 end was never adjudicated incompetent:
[J
B. Grant of letters of Administration
(C.t.8., d.b.n.c.t.a.: pendente lite; durante absentia; durante minorita'e)
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the fOllowing spouse
(if any) and heirs:
I Name Relationship Residence I
I'-VIVI[ 1-1- I L. IN :) Attach additional sheets if necessary.
Decedent, then 'lo years of age, died
1./ Auc,.
, 20 D2., at m4.SSIQ.~ \J .l\~L
(locatlon
Decedent at death owned property with estimated values as follows:
(If domiciled in PAl All personal property .............................. $ I le, 000
(If not domiciled in PAl Personal property in Pennsylvania. . . . . . . . . . . . . . . . . . . . . . $
(If not domiciled in PAl Personal property in County. . . . . . . . . . . . . . . . . . . . . . . . . . $
Value of real estate in Pennsylvania ............................................... $
Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ I t.D I {) ()()
Real Estate situated as follows:
Wherefore, Petitioner(sl respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of letters in the
appropriate form to the undersigned:
Typed or printed name and residence
nu.., J-'
Gl.~
'2
Oath of Personal Representative
Commonwealth of Pennsylvania
County of ~llpAirr CIt"h ~11../' \O,..-J
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 and truly administer the estateFccording ')!.W. \/ fl
Sworn to and affirmed and subscribed __' ~
before me this 17th day of
September 2002
j}~,JJ1.~/..z~
Tbnna M. otto, 1st Deputy '~
DECREE OF REGISTER
Estate of
Clarence R. Kerr
also known as
Deceased
No. 21-2002-842
Social Security No: 181-01)-4486
Date of Death:
08/21/02
AND NOW, September 17th , 20~, in consideration of the Petition
on the reverse side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters ~ Testamentary 0 of Administration
are hereby granted to .
(c.t.a.; d.b.n.c.t.; pendente lite; durame absentia; durante minorilsre)
James E. Kroh
in the above estate and that the instrument(s), if any, dated 02/28/2002
described in the Petition be admitted to probate and filed of record as t@{iast W.ill of Decedent.
\.-'
FEES
Letters........... ...... ..........
Short Certificate(s).;3........
Renunciation................. .
Affidavit (
).................
Extra Pages ( 5 )............
CodiciL........................ .
JCP Fee........................
Inventory & Tax Forms...
Other......... ............ .......
( ,"~
$ 235.00
j)~~~dr?d-h~
Register of Wills .C":::. ~
Donna M. otto, 1st Depu1:y"
- .
9.00
$
$
$
$ 15.00
$
$
$
$
~eres4 L. S ~u..Je. Wix J ["51'
Lf 30<?Q
Lf 705 DJ<-e..- S-rf'~1
Htxrr;,h~ fA L '7104
I
111 - U :J- - <6CjSS
September 17th, 2002
5.00
Attorney:
I.D. No:
Address:
$ 264.00
Telephone:
DATE FILED:
MAILED LEITERS 10 ATIDRNEY ON09/17/02
TOTAL................
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This is to certifY that the information here given is correctly copied from an original certificate of death duly filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
No.
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U-"1:AV /( 7~_
Local Registrar
Fee for this certificate, $2.00
p
8386761
AUG 2 1 2002
Date
v.2187
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT Of HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
..
AGE(lastllo<lNlay)
UtlDEA . YEAR
- Doyo
Clarence R. Kerr
UNDER . 0IIt
- 1 .......
sex
.. Male
STAlE FILE NUMBER
SOCIAL SECURITY NUMBER
.... Cumber land
DECEDENT'S USUAl OCCUPRlON
t~-=:.:':c.~::~:r
{Ylc~.c~ 1,'111
""-S DECECEtfl E~ER IN
us. _0 fORCES?
-iii ....0
.. 181 - 05
4486
02
NAME Of oeCEDENl {hR. ~. LJII'
S.
COUNTY Of DEAlH
90
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au:rrHPlACE :c~ V.d PUreE OF OEAlH lCt><<k 01""'" Of'" . ~ ..eta rnstrur...lllOJl'S on Olher ~
5lHI 011 fCJ8J9I' CounuYJ IlAl:
Newport, PA 1__0 ER/OulpoU." 0 OOAD
7. ...
FACIUlY NAME (If I"l()lIn9'MIOO. gr.<e $fleet ~ Nmbel'I
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AACE . AmenAn tndtan. &lack. WNt.. flit.
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White
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UOTHER'S NAME that MlCde. tUaden Sulname)
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Upper Allen
-
17.. sa...
100 Mt. Allen Dr.
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lNl'llAIoIAHT'S NAME (T 'f1lOIl'tirol
Charles E.
Ruth Anne
Kerr
~ Nelle
lNf'ClNW'T'S WAIUNG AOOAESS ISO.... CoIyIbon. _.lJI> Code,
6410 Huntsmen Dr H
PUCE Of DlSPOS/TIOH. N_ ..c-..y. c._
or au..._
M. Brown
wElHOOOf IllSPOSITlON
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LICENSE N1JWlIER
mo. FD014993
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PART" OI/Iofaignillc...__.._.....
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CAUSE (DiIeMe ~...-y c.
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WOS AN AU1tlPSY WERE AU1tlPS'Y ~s .......NE.. Of DEATH
pfllFOAWED? --..aE PIlIOA 10
COMPLETION Of CAUSE Ii9. 0
Of DEAlH? - .....ocide
-- 0 "--,.... 0
Yeo 0 Na[g! _0 Nao SUicide 0 CouItl... .. dol_ O
DATE Of' INJURY
(Man.... Oav, Year)
TIWEOf\HJUAY
INJURY AT WORK' OESClllef HOW INJURY OCCUflAEO.
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T. Ihe bnl of MY kM~. dptt'I occwred due.. the cauM(.J and INnn., .. .taUtd. . . . . . . . . . . . . . . . . . . . . . . . . . . .
21.
PlACE OF tN.lURV . At horn.. 'ililm, su....lacIOfy. offic.
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LAST WILL AND TESTAMENT
01'
CLARENCE R. KERR
I, Clarence R. Kerr, presently residing in Mechanicsburg,
Cumberland county, Pennsylvania, being of sound and disposing
mind and memory, do make, publish and declare this to be my Last
Will and Testament, hereby revoking all wills and Codicils
previously made by me.
ITEM I: I direct that all inheritance and estate taxes
becoming due by reason of my death, whether such taxes may be
payable by my estate or by any recipient of any property, shall
be paid by my Executor out of the property passing under this
Will, which is not specifically devised or bequeathed, as an
expense and cost of administration of my estate. My Executor
shall have no duty or obligation to obtain reimbursement for any
such tax paid by my Executor even though such tax was paid on
proceeds of insurance or other property not passing under this
will. If the assets not specifically devised or bequeathed are
not adequate for the payment of all such taxes, then the
recipients of the property specifically devised and bequeathed
shall each pay a pro rata portion of any such tax based upon the
valuation of the property received by each such recipient as
finally determined for Federal Estate Tax purposes, or if no such
determination is made, then for applicable state Inheritance Tax
purposes.
ITEM II: I hereby exercise all powers of appointment
which I may have at the time of my death in favor of my Executor,
and all property subject to all such powers of appointment shall
be included in my estate.
PAGE 1 OF 5 PAGES
ITEM III: I hereby give, devise and bequeath my entire
estate, whether real, personal or mixed, of whatsoever nature or
kind and wherever located unto the following individuals:
(a) 31% of my estate unto my niece, Ruth Ann Kroh;
(b) 31% of my estate unto my nephew, James Carnes;
(c) 31% of my estate unto my niece-in-Iaw, Carolyn
Carnes; and
(d) 7% of my estate unto my church, Zion Lutheran Church,
265 N. Enola Drive, Enola, Pennsylvania 17625
It is my intent that all of my other nieces, nephews and
relatives shall not be beneficiaries of my Estate.
ITEM IV: In addition to such other powers as my Executor
may be granted by law, or under previous portions of this Will,
they shall have the following powers:
a) To retain investments I may have at my death so long
as my Executor may deem it advisable to my estate or
to do so.
b) To vary investments, when deemed desirable by my
Executor, then to invest in such bonds, stocks,
notes, real estate mortgages, or other securities,
or in such other property, real or personal, as they
shall deem wise, without being restricted to so-
called "legal investments".
c) In order to effect a division of the principal of my
estate or of any trust or for any other purpose,
including any final distribution, my Executor is
authorized to make said divisions or distributions
of the personalty and realty partly or wholly in
kind. If such division or distribution is made in
kind, said assets are required to be divided or
distributed at their respective values on the date
or dates of their division or distribution.
PAGE 2 OF 5 PAGES
d) To sell either at pUblic or private sale and upon
such terms and conditions as the Executor may deem
advantageous to the estate, any or all real or
personal estate or interest therein owned by the
estate or in conjunction with other persons or
acquired after my death by my Executor, and to
consummate said sale or sales by sufficient deeds or
other instruments to the purchaser or purchasers,
conveying a fee simple title, free and clear of all
trusts and without obligation or liability of the
purchaser or purchasers to see to the application of
the purchase money or to make inquiry into the
validity of said sale or sales; also, to make,
execute, acknowledge and deliver any and all deeds,
assignments, options or other writings which may be
necessary or desirable, in carrying out any of the
powers conferred upon my Executor in this paragraph
or elsewhere in my will.
e) To mortgage real estate, and to make leases of real
estate.
f) To borrow money from any party, to pay indebtedness
of mine or of my estate, expenses of administration
or inheritance, legacy, estate and other taxes.
g) To pay all costs, taxes, expenses and charges in
connection with the administration of my estate.
My Executor shall pay the expenses of my last
illness and all funeral expenses.
h) To vote any shares of stock which form a part of the
estate, and to otherwise exercise all the powers
incident to the ownership of such stock.
PAGE 3 OF 5 PAGES
i) In the discretion of my Executor, to unite with
other owners of similar property in carrying out any
plans for the reorganization of any corporation or
company whose securities form a part of the estate.
ITEM V: Any person who shall have died at the same time
as Testator, or in a common disaster with him, or under such
circumstances that it is difficult or impossible to determine who
died first, or who shall have died less than thirty (30) days
after the death of Testator, shall be deemed to have predeceased
him.
ITEM VI: I hereby nominate, constitute and appoint my
nephew-in-Iaw, James E. Kroh, to be the Executor of this my Last
will and Testament. In the event of James E. Kroh's death,
resignation, refusal or inability to serve, I appoint my niece,
Ruth Ann Kroh, to be Executrix of this my Last will and
Testament. My Executors, are specifically relieved from the duty
or obligation of the filing of any bond or bonds in this or any
other jurisdiction.
ITEM VIII: Where appropriate throughout this my Last
Will and Testament, all references herein to the singular or the
masculine shall include the plural or the feminine, respectively.
IN WITNESS WHEREOF, I have hereunto set my hand and seal
to this my Last Will and Testament, consisting of this page, the
preceding three (3) pages and the following one (1) page, this
~ <( 1:b day of Febf'lJ...a.fl 2002.
~~ ~lQ~
C arence R. Ker
PAGE 4 OF 5 PAGES
We, the undersigned, hereby certify that the foregoing
will was signed, sealed, published and declared by the above-
named Testator, 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 hereunto set our hands and seals
the day and year above written, and we certify that at the time
of the execution thereof, the said Testator was of sound and
disposing mind and memory.
~~,~
{Y~~ ~W.Mf (SEAL)
(SEAL)
Residing at
_~vrl;sbwj
}
Residing at
l'l/ll
(SEAL)
PAGE 5 OF 5 PAGES
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA )
)
COUNTY OF )
I, Clarence R. Kerr, 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.
Sworn to or affirmed and ackno~~pdged before me by
Clarence R. Kerr, the Testator, this d..T~day of r:ebr~af'Y
2002. (
~7? /~J~I)
Clarence R. Ker
Testator
(SEAL)
31~ ~
Notary ublic
My Commission Exp'
AFFIDAVIT
Notarial Seal
Gaye Crist, No~ Public
South Hanover T!vp'., Dauphin County
My Commission EXPires Apr. 18, 2005
Member, Pennsylvania AssociatIon of Notaries
COMMONWEALTH OF PENNSYLVANIA )
)
COUNTY OF )
We, R~ f{. ~
, BUW/Ill) yJ (~tJ~
and , 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.
Sworn to or affirmed ~ subsc~i~ed to before me by
~ j{.)J->~ ,~~'lf~.W~ and
" <:? 'JJ
, witnesses, this ~ day of
(e- b !'LLo-r {
, 2002.
~t2 .-( t:J, Ai, > -
witness
\~~hRJ ~ ~ LJ~
Witness
witness
(SEAL)
N~c:;tPub~
My commission ExpiI es : Notarial Seal
Gaye Crist, Notary Public
South Hanover T~., Dauphin County
My Commission EXpires Apr. 18, 2005
Member, Pemsy\VanIa Associatlon of Notaries
c1
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: Clarence R. Kerr
Date of Death: August 21, 2002
will No.
2002-00842
Admin. No.
To the Register:
I certify that notice of beneficial interest 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
October 1, 2002
Name
Address
James Carns
4 Trout Lane, Marysville, FA 17053
1002 Franklin St., Carlisle, PA 17013
Carolyn Carns
Ruth Ann Kroh
Zion Lutheran Church
6420 Huntsmen Dr., Harrisburq, PA 17111
265 N. Enola Dr., Enola, FA 17625
Notice has now been given to all persons entitled thereto under
Rule 5.6{a) except
Date:
loJdDJ-.
l (
~~(~~.EsYJ'
Signature I
,"......,
\" ,
Name Theresa L. Shade Wix, Esq.
Wix, Wenger & Weidner
Address 4705 Duke Street
Harrisburq, FA 17109-3099
Telephone (717) 652-8455
r .
Capacity:
Personal Representative
X Counsel for Personal
Representative
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
KROH JAMES E
6410 HUNTSMEN DRIVE
HARRISBURG, PA 17111
-------- fold
ESTATE INFORMATION: SSN: 181-05-4486
FILE NUMBER: 2102-0842
DECEDENT NAME: KERR CLARENCE R
DATE OF PAYMENT: 11/21/2002
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 08/21/2002
NO. CD 001871
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $15,883.18
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TOTAL AMOUNT PAID:
$15,883.18
REMARKS:
CHECK# 5176
SEAL
INITIALS: AC
RECEIVED BY:
REGISTER OF WILLS
MARY C. LEWIS
REGISTER OF WILLS
~~ -',0,.: ~^.,,-:JO,
COMMONWEALTH OF
PENNSYLVANIA
OEPARTMENT OF REVENUE
OEPT 280601
HARRISBURG, PA 17128-06D1
REV-1500
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FILE NUMBER
1.0-c,1.. D O~~l-
INHERITANCE TAX RETURN
RESIDENT DECEDENT
NUMBER
COUNTY CODE
YEAR
DECEDENTS NAME [lAST, FIRST, AND MIDDLE INITIAL)
~rr Cl~rLn~~ ~
DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
C>~-2.I-D,- 10-04-11
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (lAST, FIRST, AND MIDDLE INITIAL)
SOCIAL SECURITY NUMBER
\<6\ ~ ClS' - Lt'\'&~
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
N A
[g'1. Original Return
o 4. Limited Es!ate
o 6. Decedent Died Testate {At\act\C();J~()(W\II"
o g. Litigation Proceeds Received
o 2. Supplemental Return
o 4a. Future Interest Compromise Idate of deatn after :2-12-82)
o 7, Decedent Maintained a living Trust (AMell copy of Trusti
o 10. Spousal Poverty Credit (date or deatl1 betwee~ 12-31-91 and ,-1-951
o 3. Remainder Return (date of death prior to 12-13-82)
o 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (A:mchScrO\
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THIS SECTION MUST BE COMPLETED_ ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME r /J COMPLETE MAILING ADDRESS
u.l'1'ltLS C - "-rll I L 0
FIRM NAME (\I Applicable) bt.t\tJ l"tll.o'J"l1Sh'll..n nv~
l-lo.rr'"6",,, I fA ill!\
TELEPHONE NUMBER
llll) 5"4,S'-751'6
Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
(1)
(2)
(3)
(4)
(5)
OFFTcIAL USE O:'-j'_Y
"t 5'~ ~IO, 1'>'
,
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule OJ
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter.Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
'" 'ii4 7;;<). 13
,
(6)
(7)
-.f f lj I (, b 1. <j /
,
8. Total Gross Assets (total Lines 1-7)
9 Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage liabilities, & liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
12 Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which a(l election to lax has not been
made (Schedule J)
(8)
(9) '/3 Sbo-~-I
,
(10) . Ill, 3lr, II..
(11)
(12)
(13)
il.s ~~(.~3
.-'1713~.()~
,
. "6. lit <j. 'iJ'l
14. Net Value Subject to Tax (Line 12 minus Line 13)
(14)
-IlolS3'/.I'1
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a}(1.21
x.O_ (15)
x.O_ (16)
x .12 (17)
x 15 (18) ~ II. 430 _ 'ii'i'
(19) /(, 19O. n
,
16. Amount of Line 14 taxable at lineal rate
17 Amount of Line 14 taxable at sibling rate
18 Amount of Line 14 taxable at collateral rate
~lo1S3~_I~
.
19_ Tax Due
2001
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
Decedent's Complete Address:
STREET ADDRESS 1M . I V \\
/II1I.SSIIV\ I Cl. 'l.
I () 0 1l1+. An
Q..J,ltni <r b <41"'
LV
CITY
STATE
PA
ZIP J 7o!"S
Tax Payments and Credits:
1. Tax Dua (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discovnt
(1)
i
It,. '{30. %8'
.
... 0(1::'. c/~
hr f&I":.J. NLr II f\\oJ
Total Credits (A+ B + C)
(2)
~ 5'17. 70
3. InteresUPenalty if applicable
D. Interest
E. Penalty
TotallnteresUPenalty ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enler the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
5. If Line 1 + Line 3 is grealer than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(5A)
(5B)
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 designale who shall vse the property transferred or ils income; ................ .......................... 0 [::;<:J
c. retain a reversionary interest; or..... ................... ......................... ........................... ............. 0 ~
d. receive the promise for life of either payments, benefits or care? ..... ................... ..................... ........... 0 IZI
2. If death occurred after December 12, 1982, did decedent Iransfer 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 L&l
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? . ............................... ...... D I:2?J
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 penalties of perjury. I declare that I have examined this return, including accompanying schedules and statements. and to the best of my knowledge and belief, it is true, correct
and complete
Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge
SIG JURE OF PER~ R S ON ISLE FOR FILING RETURN
ADDR S I
1.l{\O I*"",h""t..\ Ori.v.... harri~b....~
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
DATE
11 fIIolI 01.-
p~
!llll
DATE
ADDRESS
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 PS 99116 (a) (1.1) (i)).
For dales of dealh on or after January 1, 1995, Ihe tax rale imposed on the nel value of Iransfers to or for the use of the surviving spouse is 0% [72 P.S. 9g116 la) (1.1) (ii)].
The statute does not exemot a transfer to a surviving spouse from lax, 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 twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent,
or a stepparenl of the child is 0% [72 P.S. 99116Ia)(I.2)J
The tax rale Imposed on Ihe nel value of transfers 10 or for the use of the decedent's Imeai beneficiaries is 4.5%, except as noted in 72 P.S. 99116(1.2) [72 P.S. 99116(a)(1 II.
The tax rate imposed on the nel valve of Iransfers 10 or for the use of the decedent's siblings is 12% [72 P.S. 99116(a)(I.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.
CUrr-,bU/Cl'lJ
Register of Wills of DauphiA County, Pennsylvania
Estate of
C lo.r~l'lc.t:
INVENTORY
Q. Ka.rr
No.
loo~- 001142.
. Deceased
Date of Death ~ III 02-
Social Security No. l'il- oS' - ~ '{ If!:,
also known as
Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all
of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that
the valuation placed opposite each item of said Inventory represents its fair value as ot the date of the Decedent's death. and
that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum
at the end of this inventory. I/We verify that the statements made in this Inventory are true and correct. I/We underSTand that
false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to un~worn falsification to
authorities.
Name of
Attorney:
ThlrtS"- L. 'S'h,,!ll. W,....
"130'&"1
410S" O..k...
~Q.rr'ls bu.~ ~1\
(111) 'S'z.- ,&'lS'5
Personal Representativf'::
Ja",,'l.~ E. K'rtJ
D~;~:=:J
f.D. No.:
Address:
S"h~ltt
~1~_~
Telephone:
Description
Value
Cl~ck,'j Qc.c..."""r d. Sl-l/Vlo -'10'51
ptJ. C:. &"",k.
i "5'o5"?q
Gh"b"bos,k LtQ.. ",,1 4n"..J~ ~<ln'1
p.o .&." "~2.ll..
Pl.l-~J.'''L T.L Iooo~~ -'jLlL
,
e...Jro....\-... CrA Cl'lo<l~
1 H, [55 _L~
llr..~ sLr<l..l> "J PN.t F,~"'n""~ c'cf 'S h,J.
'15b '110, l~
,
(Attach Additional Sheets If necessary)
Total: +/'Jt. (,(,'7. 'II
NOTE: The Memorandum of real estate outside the Cornmonwealth of Pennsylvania may. at the election 01 the personal representative include
the vallie of each item. but such ligures should not be extended into the total of the Inventory
RW-8
RE"'~3"''''97).
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF r\\ 0 II
\... a.r2-Y\u. ". J..ll.rr
SCHEDULE B
STOCKS & BONDS
1'l(-0S' -l{l{llb
FILE NUMBER
tool.." ooll'{1..
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
12.(,,"!. Sho.ru ~ ~N~ F.,,~,.....,J C."rf' stoJ<.
'to 5"(", '1I0./'il
TOTAL (Also enteron line 2, Recapitulation) $ 5/0, 'lID. 1 'Ii
Ilf more space is needed, insert additional sheets of the same size)
en
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James Kroh
From:
Sent:
To:
Subject:
barbara.bemardini@pnc.com on behalf of corporate.communica\ions@pnc.com
Monday, September 23, 20029:58 AM
James Kroh
Re: Stock price I August 21, 2002
Dear Mr. Kroh:
As you requested, listed below is the price information on PNC stock for
August 21, 2002:
Date:
Open:
High:
Low:
Close:
August 21, 2002
44.91
45.72
44.40
45.69
It~ ~: L\'5. n
+ Low: 4~.'to
10.11- -'7 2 ~ of- 4':>.0 \0
x: \7.(.3 sho.c<-,>
Sincerely,
Barbara Bernardini
Shareholder Relations
The PNC Financial Services Group
-{')(,'110.11
,
"James Krohn
<jkroh@hrpartners
<corporate.communications@pncbank.com>
online. com>
To:
cc:
Subject: Stock price / August 21, 2002
09/20/2002 11:30
AM
I am the Executor of my uncle's will. For purposes of finallizing his
estate, I need to know the high and low of PNC stock for August 21, 2002.
Please call me at 717-652-9334 should you have any questions. I appreciate
your help in this regard. Thanks.
1
""".8"'1'''1.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
C b(4.I1<:J4 ~. Ktrr
l'i?l-o$'- 4'{~1o
FILE NUMBER
ZOO'l..-ClO 'rlj L--
Include tl1e proceeds 01 litigation and the date the proceeds were received by the estate. All property jointly-owned wtth the right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
C-ht.c.k''.-j D.cc.o"""t ii $1-YOlO -~OSI P1\le. 11a."k
-t~5oS.'i~
,
~, C;\~"br06~ LSl. o.~.l ~"..,,~J, ~lt"'1
P.Q.GI'k 9'lVL
~ ...\,,;h...... ,T.L (.,Ocq~ -1.{2.\ L
l""to.J- ~ vA Ol'lOq ~
t 7"6 Z5~.l'i
I
TOTAL (Also enter on line 5, Recapitulation) $ Yl{ 151. 13
(If more space is needed, insert additional sheets of the same size)
Total Banking Statement
1t
For 24-hour clIstomer service:
Call: 1-888-PNC-BANK
For the poriod 08/16/2002 to 09/16/2002
CLARENCE R KERR
Primary account number: 51-4010-9051
Page 2 of 2
Account number: 51-4010.9051 - continued
Checks
Check
number
138
Amount
794.23
Date
paid
09/03
Reference
number
022~jl5-l7
Check
number
139
Amount
5,425.55
Date
paid
08/28
Reference
number
\)250\)1~~l
Dale
08/20
Amount Description
112.-15 Direct Payn1.ent - lns. Premo
Capitalbluecross 181054-486
There were 2 checks listed totaling
$6,219.78.
There was 1 Online or Electronic Banking
Deduction totaling $112.45.
... Gap in check sequence
Online and Electronic Banking Deductions
Dale
09/16
Amount
Description
There was 1 Other Deduction totaling
$20.00.
Other Deductions
20.00 Sen/ice Charge
Daily Balance Detail
Dale
08.16
03/20
Balance
6,678.29
6,565.84
Date
08/28
09/03
Balance
1,1-10.29
3'16.06
Date
09/06
09/16
Balance
846.06
826.49
PREMIUM PLAN - Service Charge Explanation
51.401O.9051
Balance type
This Crcle Avg B<ll;mce
As of
09/17
Balance
These accounts were reviewed to meet
the balance requirements of your
Premium Plan Account. Since balance
requirements were not met this month, a
$20.00 fee was deducted from this
account.
Account type
Interest Checking
Acccur.1 number
3,013.34
Struggling to save for your child's or relative's college tuition?
Talk to a PNC Investments Financial Consultant about t~Lx-advantaged ways to prepare for the high cost of higher eduG\tion. 529
pbns var)' from state to state, but generally allow anyone--a parent, grandparent or guardian~ to save money towards a child's
college education. The Education Savings Account allows anyone to contribute up to $2000 each calendar year until the child
reaches the age of 18, QUI' Fin;:lncial Consultants will provide YOll with the professional advice you need to make an informed
decision. Call us today at 1.800-PNC-6111, yisit us online at www.pncinvestments.com or stop by your local branch office.
Glenbrook Life and Annuity Company
P.D. Box 94212
Palatine, IL 60094-4212
GLENBROOK LIFE
A Member of Allstate Financial Group
October 4, 2002
The Estate of Clarence R. Kerr
6410 Huntsmen Drive
Harrisburg, P A 17111
Re:
Contract Number:
Claim Number:
Clarence R. Kerr
GA079094
GAI9293
Dear The Estate of Clarence R. Kerr:
We, at Glenbrook Life and Annuity Company, are sorry to hear of your loss and extend our sympathy.
Your claim for beuefits under the above referenced annnity has been completed. A check has been
sent to yon under separate cover and will arrive within the next five business days.
Annuity Value as of 10/4/2002
Portion Payable to You:
Federal Withholding:
State Withholding:
Claim Interest:
Total Net Proceeds:
$78,159.29
$78,159.29
$0.00
$0.00
$0.00
$78,159.29
This annuity is subject to federal income taxes (on non-qualified annuities, only the interest earned is
taxable.) A 1099 tax statement reflecting $287.56 as your taxable income will be sent next January to
assist you in preparing your tax return for 2002.
The annuity value on the date of death, 8/21/2002 was $78,253.29. This may be necessary for estate
purposes. If you have any questions or need further assistance, please contact me at 1-877-499-6418.
Sincerely,
'jj~~
David Lezak
Life and Annuity Claims
Overnight Address: 300 North Milwaukee Avenue, Vernon Hills, IL 60061
Toll Free Fax: 1-866-635-4523
R""""""''''.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
C.lC1r ru."CI.l.. t. K Il. r r
1'ilI-c5- 4'1'3'1"
FILE NUMBER
LoaL - oo'il'l2..
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Nfl'<. P"-f'''' ~ \("1'10
P~;t ~'-'n.\ hw!"-",,, , l"i( ftt"",J't .n'l..M b(..,""S JI>.h\n'I''-fd,J... D,"V
, E"ok ,f('t
AI.\'j"lt- 2.~, WGI.. ' z.2.S.00
B. ADMINISTRATIVE COSTS
1. Personal Representative's Commissions Ja.Wle5 W t Il,ac 0
Name of Personal Representative (5) E.
Social Security Number(s) I EIN ~mber of Personal Representative(s)
Stre::r-\' ~1l0 """ts..,..... D':,\Jl.. fA 11111
City G.rrlf t.4"3 Stale Zip
Year(s) Commission Paid 2.001-
2 Attorney Fees i looo ,('0
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 " [IoLl.CO
5. Accountant's Fees
6. Tax Return Preparer's Fees e~t: ~ ZOO.DO
7. l~o.J nDt,~ , Po..t((ot-,t-l'-\>lS, \~"o<i; kl.<':7 . rA. ~. I <t, . 1,,)
~
Le~,J hct,u.. i c....."'~ltr\(""! la.w )c...c,,'~, ~~h<\,- ,fA -i 7...(1)
'&.
TOTAL (Also enter on line 9, Recapitulation) $I$$'~l>.lol
(If more space IS needed, Insert additional sheels of the same size)
RECEIPT FOR PAYMENT
-------------------
-------------------
Cumberland County - Register Of Wills
Hanover and High Street
Carlisle, PA 17013
KERR CLARENCE R
File Number 2002-00842
Remarks KROH JAMES E
SK
Receipt Date
Recetpt Time
Recelpt No.
9/17/2002
12:14:43
1030537
-_______________________ Distribution Of Receipt ------------------------
Transaction Description
PETITION FOR PROBA
SHORT CERTIFICATE
EXTRA PAGES
JCP FEE
Payment Amount
235.00
9.00
15.00
5.00
Check# 140
Total Received.........
$264.00
$264.00
Payee Name
CUMBERLAND COUNTY GENERAL FUN
CUMBERLAND COUNTY GENERAL FUN
CUMBERLAND COUNTY GENERAL FUN
BUREAU OF RECEIPTS & CNTR M.D
WIX. WENGER S WEIDNER
RICHARD H. W'IX
THOMAS L WENGER
DEAN A. WEIDNER
STEVEN C. WILDS
TIiERESA L SHADE WJX.
DAVID R. GETZ
STEPHEN J. DZUR,ANIN
STEVEN R. WILLIAMS
SEAN P. DELANEY
TRACY L UPDIKE
A PROFESSIONAL CORPORATION
ATTORNEYS AT LAW
4705 DUKE STREET
HARRISBURG. PENNSYLVANIA 17109~3099
(717) 652-8455
TELECOPIER (717) 652.6290
P. O. BOX 845
508 NORTH SECOND STREET
HARRISBURG. PA. 17108-0845
(717) 234-4182
TELECOPIER (717) 234-4224
www.wwwpalaw.com
October 18, 2002
-ALSO MEMBE'" MASSACHUSETTS liAR
Mr. James E. Kroh
6420 Huntsmen Drive
Harrisburg. PA 17111
Re: Estate of Clarence R. Kerr
Disbursements of Wix. Wenaer & Weidner
The Patriot-News Co. - Legal Advertising............................................... $ 198.67
TOTAL AMOUNT DUE $198.67
r 0:.0\ l'g 0 cr ~ 1-
THE PATRIOT NEWS
THE SUNDAY PATRIOT NEWS
Proof of Publication
Under Act No. 587, Approved May 16,1929
Commonwealth of Pennsylvania, County of Dauphin} 55
Frank J. Epler being duly sworn according to law, deposes and says:
That he is the Controller of The Patriot News Co., a corporation organized and existing under the laws of the
Commonwealth of Pennsylvania, with its principal office and place of business at 812 to 818 Market Street, in the
City of Harrisburg, County of Dauphin, State of Pennsylvania, owner and publisher of The Patriot-News and...Ihe.
Sundav Patriot-News newspapers of general circulation, printed and published at 812 to 818 Market Street, in the
City, County and State aforesaid; that The Patriot-News and The Sunday Patriot-News were established March 4th,
1854, and September 18th, 1949, respectively, and all have been continuously published ever since;
That the printed notice or publication which is secureiy attached hereto is exactly as printed and published in
their regular daily and/or Sunday/ Metro editions which appeared on the 4th, 5th and 6th day(s) of October 2002.
That neither he nor said Company is interested in the subject matter of said printed notice or advertising, and that
all of the allegations of this statement as to the time, place and character of publication are true; and
That he has personal knowledge of the facts aforesaid and is duly authorized and empowered to verify this
statement on behalf of The Patriot-News Co. aforesaid by virtue and pursuant to a resolution unanimously passed and
adopted severally by the stockholders and board of directors of the said Company and subsequently duly recorded in
the office for the Recording of Deeds in and for said County of Dauphin in Miscellaneous Book "M",
Volume 14, Page 317.
PUBLICATION
COPY
om 0 an
a
. Teny L. Russell, Notal)' Publ'
City Of Harnsburg, Dauphin Coun
My Commission Expires June 6 2006
. .' NARY PUBLIC
Member. Pennsylvania ASSOCIation Of Notari.e.s
MY commission expires June 6, 2006
Estate Notices
Letters of Testamentary on the Estate of
Clarence R. Kerr, late of the TownshIp of Up.
Pllr Allen, Cumberland County, Pennsylva-
nIa. deceased, having been granted to the un.
derslgned. aU persons Indebted to saId estate
are requested to make Immediate payment
and thOSII havIng claIms will present them for
slIttlllmentto
Jame. E. Kroh
641D Huntsmen Drive
Harrisburg, PA 17111
..to
Th....sa L. Shad. WIll, Esq.
W1K,. Wen"r & W.ldn.r
4705 Duk'SlTeet
HarrIsburg, PA 17109-3099
WIX, WENGER & WEIDNER
4705 DUKE STREET
HARRISBURG, PA. 17109
Statement of Advertising Costs
To THE PATRIOT-NEWS CO., Dr.
For publishing the notice or publication attached
hereto on the above stated dates $
Probating same Notary Fee(s) $
Total $
196.92
1.75
198.67
Publisher's Receipt for Advertising Cost
The Patriot News Co., pubiisher of The Patriot-News and The Sundav Patriot-News, newspapers of general
circulation, hereby acknowledge receipt of the aforesaid notice and publication costs and certifies that the same have
been duly paid.
By....................................................................
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RICHARD H WIX
THOMAS L. WENGER
DEAN A. WEIDNER
STEVEN C. WILDS
THERESA L SHADE wrx.
DAVID R. GETZ
STEPHEN .1. DZURANIN
STEVEN R.. WILLIAMS
SEAN P. DELANEY
TRACY L UPDIKE
WIX. WENGER 8 WEIDNER
A PROFESSIONAL CORPORATION
ATTORNEYS AT LAW
4705 DUKE STREET
HARRISBURG, PENNSYLVANIA 17109-3099
(717) 652-8455
TELECOPIER (717) 652-6290
www.wwwpalaw.com
P. O. BOX 845
508 NORTH SECOND STREET
HARRISBURG. PA.17108-0845
(717) 234.4182
TELECOPIER (717) 234.4224
November 5, 2002
"ALSO MEMBER MASSACHUSETTS BAR
Mr. James E. Kroh
6420 Huntsmen Drive
Harrisburg. PA 17111
Re: Estate of Clarence R. Kerr
Disbursements of Wix. Wenaer & Weidner
Cumberland Law Journal Advertising.. .....................................................
75.00
TOTAL AMOUNT DUE $ 75.00
p ~ to ~OJ 0'2-
CUMBERLAND LAW JOURNAL
2 LIBERTY A VENUE
CARLISLE, P A 17013
OCTOBER 18,2002
Cumberland Law Journal is published every Friday by the Cumband County Bar
Association and is designated by the Court of Common Pleas as the official legal publication for
Cumberland County and the legal newspaper for publication oflegal notices.
TO:
Theresa L. Shade Wi x, ESQUIRE
RE:
Clarence R. Kerr, ESTATE
Legal advertisements must be received by Friday Noon. All legal advertising must be
paid in advance. Make all checks payable to: Cumberland Law Journal.
---------------------------------------------------------------------
---------------------------------------------------------------
Advertisement inserted on following dates:
OCTOBER 4, 11, 18, 2002
Advertising Cost
$ 75.00
$ 0.00
$ 0.00
$ 75.00
-------------
Proof of Publication
Second Proof Request
Payment Received
Total Amount Due
$
0.00
--------
---------
Payment received OCTOBER 2. 2002
by Beckv H. Morgenthal/Executive Director
~
PROOF OF PUBLICATION OF NOTICE
IN CUMBERLAND LAW JOURNAL
(Under Act No. 587, approved May 16, 1929), P. L.1784
STATE OF PENNSYLVANIA:
55.
COUNTY OF CUMBERLAND :
Roger M. Morgenthal, Esquire, Editor of the Cumberland Law Journal, of the County
and State aforesaid, being duly sworn, according to law, deposes and says that the Cumberland
Law Journal, a legal periodical published in the Borough of Carlisle in the County and State
aforesaid, was established January 2, 1952, and designated by the local courts as the official legal
periodical for the publication of all legal notices, and has, since January 2,1952, been regularly
issued weekly in the said County, and that the printed notice or publication attached hereto is
exactly the same as was printed in the regular editions and issues of the said Cumberland Law
Journal on the following dates,
VIZ:
OCTOBER 4, II, 18,2002
Affiant further deposes that he is authorized to verify this statement by the Cumberland
Law Journal, a legal periodical of general circulation, and that he is not interested in the subject
matter of the aforesaid notice or advertisement, and that all allegations in the foregoing
statements as to time, place and character of publication are true.
~;Z~____
Rog r M. Morgenthal, EdItor
Kerr. Clarence R.t dec'd.
Late of the Township of Upper
Allen.
Executor: James E. Kroh. 6410
Huntsmen Drive. Harrisburg. PA
17111.
Attorneys: Theresa L. Shade Wix.
Esquire. WlJ(, Wenger & Weidner.
4705 Duke Street. Harrisburg.
PA 17109-3099.
SWORN TO AND SUBSCRIBED before me this
18 day of OCTOBER. 2002
d~ L. ~/A/
Notary
REV_1512EX.ll.9IJ.,~,:..
, ~~
";>.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
ESTATE OF
FILE NUMBER ., C>lI
...OOz..-OO~'l2.-
~l(j.(e-v. ~ fL. tQ.rr (~l-DS- - 4,('il..
Include unreimbursed medical expenses.
ITEM
NUMBER
1,
2-
&.
'\,
:;
AMOUNT
1 S'-llS. S'~
DESCRIPTION
I1lL-:,\.',,J, \),1\",1"_ (ro""" b"",J, serv....s)
I DO O'(t, M~4>. Dr;v<..
lYIuloa...."sb...cj ,ff\ I/D)S-
rn<.s~i~ \J ,\\C\~ \.. (sQ."'''' q, ",beJz..)
~.sSq~- 15
v\\(\(n12.n~,- lI'f\Ll.<<.J..'<Ms)
III Q...'i',,\r Dr\\J<-
t'\uvC\rl ~c [111 I
,
~1~l{,n
~\1(V \\kntcJ (50."',,-,,~ ,,\'c.J<-)
<;5'4rn
\l~C Go."\,, l .It.<'hQ de,,":!..)
Ro &,,,, "3';)2.'0
~,\\-sburJ~' PA (~25J
t
Lo,OO
TOTAL (Also enter on line 10, Recapitulation) $ I~ 31: 5 . iI.
(If more space is needed, Insert additional sheets of the same size)
MESSIAH VILLAGE STATEMENT
Resident:
CLARENCE R KERR
~J. L,l(l~&~
Resident Number Date
000109408 07/31/2002
Page Amount Due
1 5,425.55
100 Mt. Allen Drive
P.O. Box 2015
Mechanicsburg, PA 170552015
(717) 697-4666
B
I
L
L
T
o
JIM KROH
6410 HUNTSMEN DR.
HARRISBURG, PA 17111
~~~jah
Date
Description
Charges Credits Total
4,973.45
4.30 4,977.75
4.30 4,982.05
12.00 4,994.05
6.30 5,000.35
35.65 5,036.00
5,363.00 10,399.00
-4,973.45 5,425.55
07/30/2002
Beginning Balance
DRY CLEANING
DRY CLEANING
PATRIOT NEWS
SUNDAY NEWS
SPECIAL NOURISHMENTS - SP.CARE
2 OZ, 2 CAL HN
SP. CARE ROOM & BOARD SEMI-PVT
31 DAYS AT 173.00 PER DAY
PAYMENT RECEIVED - THANK YOU!
OS/2412002
06/07/2002
07101/2002
07/01/2002
07/01/2002
07/01/2002
Current Past 31-60 Days 61-90 Days 91-120 Days Over 120 Total Due
5,425.55 [ Due
0.00 0.00 0.00 5,425.55
IT 3 ,20U2 fLARENCE R KERR I
l%FIN
Statement End Date:
07/31/2002
MESSIAH VILLAGE STATEMENT
B
I
L
L
T
o
~ 0.;.\ Z I DcA OL
Resident Number Date
000109408 08/31/2002
Page Amount Due
1 3,540.15
100 Mt. Allen Drive
P.O. Box 2015
Mechanicsburg, PA 170552015
(7-17) 697-4666
Resident: CLARENCE R KERR
Discharge Date 08/21/2002
JIM KROH
6410 HUNTSMEN DR.
HARRISBURG, PA 17111
~~~jah
Date
Descri tion
Charges Credits Total
5,425.55
12.00 5,437.55
6.30 5,443.85
21.85 5,465.70
3,460,00 8,925.70
20.00 8,945.70
20.00 8,965.70
-5,425.55 3,540.15
Beginning Balance
08/01/2002
08/01/2002
08/01/2002
08/01/2002
PATRIOT NEWS
SUNDAY NEWS
SPECIAL NOURISHMENTS - SP.CARE
20z 2 CAL HN
SP. CARE ROOM & BOARD SEMI-PVT
20 DAYS AT 173.00 PER DAY
A.L. TRANSPORTATION
Dr Giesswein
A.L. TRANSPORTATION
Crumay & Parnes
PAYMENT RECEIVED - THANK YOU!
08/09/2002
08/13/2002
08/27/2002
Current Past 31-60 Days 61-90 Days 91-120 Days Over 120 Total Due
3,540.151 Due
0.00 0.00 0.00 3,540.15
ANC;~ , ;100;1 ICLARENCE R KERR I
1%FIN
Statement End Date:
08/31/2002
MESSIAH VILLAGE STATEMENT
Resident: CLARENCE R KERR
~~ Z 106102.-
Resident Number Date
000109408 08/31/2002
Page Amount Due
1 3,540.15
100 Mt. Allen Drive
P.O. Box 2015
Mechanicsburg, PA 170552015
(7.17) 697-4666
Discharge Dale 08/21/2002
B
r
L
L
T
o
JIM KROH
6410 HUNTSMEN DR.
HARRISBURG, PA 17111
~~~jah
Date
Oeser] tion
CharlJes Credits Total
5,425.55
12.00 5,437.55
6.30 5,443.85
21.85 5,465.70
3,460.00 8,925.70
20.00 8,945.70
20.00 8,965.70
-5,425.55 3,540.15
Beginning Balance
08/27/2002
PATRIOT NEWS
SUNDAY NEWS
SPECIAL NOURISHMENTS - SP.CARE
20z 2 CAL HN
SP. CARE ROOM & BOARD SEMI-PVT
20 DAYS AT 173.00 PER DAY
AL. TRANSPORTATION
Dr Giesswein
AL. TRANSPORTATION
Crumay & Parnes
PAYMENT RECEIVED - THANK YOU!
08/01/2002
08/01/2002
08/01/2002
08/01/2002
08/09/2002
08/13/2002
Current Past 31-60 Days 61-90 Days 91-120 Days Over 120 Total Due
3,540.151 Due
0.00 0.00 0.00 3,540.15
"AFTER 'Oju. ",uu", ICLARENCE R KERR l
1%FIN
Statement End Date:
08/31/2002
PMARMERICA <li~
For Comments and lor Concerns:
111 RUTHAR DRIVE
NEWARK. DE 19711-
For Payment:
PO Box 6413
Carol Stream, IL 60197-6413
IF YOU HAVE ANY QUESTIONS CONCERNING THIS STATEMENT OR WISH TO PAY WITH YOUR VISA. MASTERCARD.
AMERICAN EXPRESS. OR DISCOVER PLEASE CAll A BilliNG REPRESENTATIVE AT 800-352-9161
CUSTOMER NAME
KERR CLARENCE
FROM HRU DATE!
DATE RX NO.
06 002
7
07/01/02
PHYSICIAN NAME
ZIMMERMAN LAWRENCE B
STATEMENT
DATE ACCT. NO.
07/31/02 5711-01-01448
DOLLAR
QTY. CODE AMOUNT
2174.99
RX
60
o
39.95
RX 45
D
11.90
OTe 2
RX 30
RX 40
o
D
20.15
;25
40.85
.00
57.95
RX 30
D
PAGE 1 OF2
CV=CONVERT TA""TRANSFER CA=CREDIT RX T=TAXABLE D::DISCQUNTED N=NON-COVERED
,II~
PLEASE RETURN BOTTOM PORTION WITH PAYMENT - Retain lop portion for your records
480
PI;IARMERICA ~li~
For Comments and lor Concerns:
111 RUTHAR DRIVE
NEWARK, DE 19711-
For Payment:
PO Box 6413
Carol Stream, IL 60197-6413
IF YOU HAVE ANY QUESTIONS CONCERNING THIS STATEMENT OR WISH TO PAY WITH YOUR VISA, MASTERCARD,
AMERICAN EXPRESS, OR DISCOVER PLEASE CALL A BILLING REPRESENTATIVE AT 800-352-9161
CUSTOMER NAME
KERR CLARENCE
PHYSICIAN NAME
ZIMMERMAN LAWRENCE B
STATEMENT
DATE
07/31/02
ACCT. NO.
5711-01-01448
FROM HRU DATE! DOLLAR
DATE RXNO. ~ESCRIPTION QTY. CODE AMOUNT
07/30/02 55125 3 tlUUI VI" 2 2u.15
IL I {5.t<::;vM
I
I I
I
I I I
, I
"
- .
I . , , , ==
, , ,
=::::: ' ,
, ,
, . : ' , : t:= ~
. . I
. . . I ' ..~
, , , . .', . "
OAt:::" 2 OF ?
p oJ 2-~ fW G- 01.-
PHARMERlCA <ll~
For Payment:
PO Box 6413
Carol Stream, IL 60197-6413
IF YOU HAVE ANY QUESTIONS CONCERNING THIS STATEMENT OR WISH TO PAY WITH YOUR VISA, MASTERCARD,
AMERICAN EXPRESS, OR DISCOVER PLEASE CAll A BilLING REPRESENTATIVE AT 800-352-9161
For Comments and lor Concerns:
111 RUTHAR DRIVE
NEWARK, DE 19711-
CUSTOMER NAME
KERR CLARENCE
PHYSICIAN NAME
ZIMMERMAN LAWRENCE B
STATEMENT
DATE ACCT. NO.
08/31/02 5711 01 01448
- -
FROM trHRU DATE! DOLLAR
DATE RXNO. DESCRIPTION QTY. CODE AMOUNT
07~31/02 ~-,-,-"ARD 794.23
~~ 560;:18 1" RX 1 .0 '. ....18.45.
08/02/02 56640 LAMISIL 1% PUMP SP~ RX 30 0 93.55
08/02/02 56641 I At -125 .E-' -'fl. n 1-'T!"i0
08/05/02 55125 PRIMER 3" UNNA BOOT aTe 2 ~
. U8fU51u2 ~IU~LOL "'T FIX I 0
08105/02 56716 I~~:~~EMIDE 40MG TABLET RX 45 D 11.90
08/09/02 55677 lAX .0,'11 Vt t _ET OTe 30 4.75
08/09/02 56992 PRIMER 3" UNNA BOOT aTe 2 20.15
08113102 57159 10( ClPAGK"'1 'OTe 12 .' 13.R<;
08/13/02 57160 BACTR~ 2% CREAM ~ 15 0 36.70
08/14/02 57160 I BACTRC 2% ( AM 15 f'\ 36.70
08/19/02 53426 REMERON 30MG SOLTAB RX 30 0 85.75
08119102 56103 )(uLYN2.5 TARLET 30 D 3R.25
08/19/02 57160 BACTROBAN 2% CREAM RX 15 0 36.70
08f21 102 57159 IDOMEBO PACKET aTe 12 13.61';
08/30/02 PAYMENT - THANK YOU 794.23 CR
DisCouNT , l:;9j:;VC'R
'. ,
j --c'"
AMOUNT DUE UPON RECEIPT ^ $545.23
CV=CONVERT TR_TRANSFER CA-CREDIT RX T=TAXABLE D=DI8COUNTED N=NON-CQVERED YaJ 'h 5uC'n.. ~ ./
~__. _-.. "____. ...IIL.
PLEASE RETURN BOTTOM PORTION WITH PAYMENT - Retain top portion for your records
484
Total Banking Statement
1r
For 24.hour clIstomer service:
Call: 1-888-PNC-BANK
For the period 08/1612002 to 09/1612002
CLARENCE R KERR
Primary aCCOL/nt number: 51-4010-9051
Page 2 of 2
Account number: 51-4010-9051 - continued
Checks
Check
number
139
Amount
5,425.55
Dale
paid
08/28
Reference
number
1)2501)1~1
13,~
Amount
794.23
Date
paid
09/03
Rererence
number
iJ22.~.';.3647
Check
number
... Gap in check sequence
There were 2 checks listed totaling
$6.219.78.
There was 1 Online or Electronic Banking
Deduction totaling $112.45.
Online and Electronic Banking Deductions
Dale Amount Description
03/20 112.45 Direct P::'tyment. Ins. Prem
Capitalbluecross 181054--186
There was 1 Other Deduction totaling
$20.00.
Other Deductions
Dale
09/16
Amount
Description
20.00 Selvice Charge
Daily Balance Detail
Dale Balance
OSl16 6,678.29
08>~W 6,505.8-1
Date
08/28
09/03
Balance
l,140.29
316.06
Date
09/06
09/16
Balance
846.06
826.49
PREMIUM PLAN. Service Charge Explanation
5 HOIO-9051
Balance type
This Cycle .Avg Balance
As of
09/17
Balance
These accounts were reviewed to meet
the balance reCjuirements of your
Premium Plan Account. Since balance
requirements were not met this month, a
520.00 fee was deducted from tllis
account.
Account type
Interest Checking
Account number
3,013.34
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~E\I-1513 EX .:1-9/i
ESTATE OF
NUMBER
I.
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
c \urv\u. ~. \eur
FILE NUMBER
Loo 2. - (J 0 ~ 4 L
\~l-OS -lj,\'irl.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS (Include outright spousal distributions)
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
AMOUNT OR SHARE
OF ESTATE
1.
~J-h A"., Kroh
(.,'{IO H""",'hltJllN. Or~VL
t\o.tt\lbwj I ~fl. 11111
3\ {.
Nl'll.t.
Jo-mL$ Cc..r"s
4 Trowt Lc....tt
1Y\D.'f~rvllk \ eA 110SJ
to.ro \'1 "l to.,,, s
1001. ~r~\<..I;"1 ~T.
Co.rli~ \~ . ~I\ 11013
N~p~<tul
3\ 10
N ,'te.... (\''1 \">o.crI6~0 ~ 11.
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
LIC,", L\4~o.r"'" cJ~
2.lS N. t".o Ie.. O,'lue
C..o\... I Pf\ \11,,2.5'
-, j.
TOTAL OF PART II. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ ~2lj 'i, 8'')
(If more space is needed, Insert additional sheets of the same size)
21-2002-842
LAST WILL AND TESTl\llENT
OF
CLARENCE R. KERR
I, Clarence R. Kerr, presently residing in Mechanicsburg,
Cumberland County, Pennsylvania. being of sound and disposing
mind and memory, do make, publish and declare this to be my Last
Will and Testament, hereby revoking all wills and Codicils
previously made by me.
ITEM I: I direct that all inheritance and estate taxes
becoming due by reason of my death, whether such taxes may be
payable by my estate or by any recipient of any property, shall
be paid by my Executor out of the property passing under this
Will, which is not specifically devised or bequeathed, as an
expensu and cost of administration of my estate. My Executor
shall ~ave no duty or obligation to obtain reimbursement for any
such tax paid by my Executor even though such tax was paid on
proce~ds of insurance or other property not passing under this
Will. If the assets not specifically devised or bequeathed are
not adequate for the payment of all such taxes, then the
recipients of the property specifically devised and bequeathed
shall each pay a pro rata portion of any such tax based upon the
valuation of the property received by each such recipient as
finally determined for Federal Estate Tax purposes, or if no such
determination is made, then for applicable state Inheritance Tax
purposes.
ITEM II: I 'hereby exercise all powers of appointment
which i may have at the time of my death in favor of my Executor,
and all. property subject to all such powers of appointment shall
be inclllded in my estate.
PAGE 1 OF 5 PAGES
ITEM III: I hereby give, devise and bequeath my entire
estat~, whether real, personal or mixed, of whatsoever nature or
kind and wherever located unto the following individuals:
(a) 31% of my estate unto my niece, Ruth Ann Kroh;
(b) 31% of my estate unto my nephew, James Carnes;
(c) 31% of my estate unto my niece-in-law, Carolyn
Carnes; and
(d) 7% of my estate unto my church, Zion Lutheran Church,
265 N. Enola Drive, Enala, Pennsylvania 17625
It is my intent that all of my other nieces, nephews and
relatJ.ves shall not be beneficiaries of my Estate.
ITEM IV: In addition to such other powers as my Executor
may be granted by law, or under previous portions of this will,
they nhall have the following powers:
a) To retain investments I may have at my death so long
as my Executor may deem it advisable to my estate or
to do so.
b) To vary investments, when deemed desirable by my
Executor, then to invest in such bonds, stocks,
notes, real estate mortgages, or other securities,
or in such other property, real or personal, as they
shall deem wise, without being restricted to 50-
called "legal investments".
c) In order to effect a division of the principal of my
estate or of any trust or for any other purpose,
including any final distribution, my Executor is
authorized to make said divisions or distributions
of the personalty and realty partly or wholly in
kind. If such division or distribution is made in
kind, said assets are required to be divided or
distributed at their respective values on the date
or dates of their division or distribution.
PAGE 2 OF 5 PAGES
d) To sell either at public or p~~vate sale and upon
such terms and conditions as the Executor may deem
advantageous to the estate, any or all real or
personal estate or interest therein owned by the
estate or in conjunction with other persons or
acquired after my death by my Executor, and to
consummate said sale or sales by sufficient deeds or
other instruments to the purchaser or purchasers,
conveying a fee simple title, free and clear of all
trusts and without obligation or liability of the
purchaser or purchasers to see to the application of
the purchase money or to make inquiry into the
validity of said sale or sales; also, to make,
execute, aCknowledge and deliver any and all deeds,
assignments, options or other writings which may be
necessary or desirable, in carrying out any of the
powers conferred upon my Executor in this paragraph
or elsewhere in my will.
e) To mortgage real estate, and to make leases of real
estate.
f) To borrow money from any party, to pay indebtedness
of mine or of my estate, expenses of administration
or inheritance, legacy, estate and other taxes.
g) To pay all costs, taxes, expenses and charges in
connection with the administration of my estate.
My Executor shall pay the axpenses of my last
illness and all funeral expenses.
h) To vote any shares of stock which form a part of the
estate, and to otherwise exercise all the powers
incident to the ownerShip of such stock.
PAGE 3 OF 5 PAGES
i) In the discretion of my Executor, to unite with
other owners of similar property in carrying out any
plans for the reorganization of any corporation or
company whose securities form a part of the estate.
ITEM V: Any person who shall have died at the same time
as Testator, or in a common disaster with him, or under such
circumstances that it is difficult or impossible to determine who
died first, or who shall have died less than thirty (30) days
after the death of Testator, shall be deemed to have predeceased
him.
ITEM VI: I hereby nominate, constitute and appoint my
nephew-in-law, James E. Krah, to be the Executor of this my Last
Will and Testament. In the event of James E. Kroh's death,
resigna'cion, refusal or inability to serve, I appoint my niece,
Ruth Ann Kroh, to be Executrix of this my Last Will and
Testament. My Executors, are specifically relieved from the duty
or obligation of the filing of any bond or bonds in this or any
other juriSdiction.
ITEM VIII: Where appropriate throughout this my Last
Will and Testament, all references herein to the singular or the
masculin~ shall include the plural or the feminine, respectively.
TN WITNESS WHEREOF, I have hereunto set my hand and seal
to this my Last Will and Testament, consisting of this page, the
preceding three (3) pages and the following one (1) page, this
;l.,,/tl day of t:e.10U.a."1 2002.
rv i)T-:;J ~
\~"l,-",-,- 1\ -, C~./
c~arence R. Ker
PAGE 4 OF 5 PAGES
We, the undersigned, hereby certify that the foregoing
Will was signed, sealed, published and declared by the above-
named Testator, 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 hereunto set our hands and seals
the day and year above written, and we certify that at the time
of the execution thereof, the said Testator was of sound and
disposing mind and memory.
~fL-.{ -N. N-r-
.~~il~'ct.~WN
(SEAL)
(SEAL) Residing at [0'11
!-+ur';.,DJIj
(SEAL) Residing at
fA
I CJ/lI
PAGE 5 OF 5 PAGES
ACKNOWLEDGMENT
COMMOI4WEALTH OF PENNSYLVANIA
COUNTY OF
I, Clarence R. Kerr, 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
execut,ed the instrument as my Last will; and that I signed it
willingly and as my free and voluntary act for the purposes
thereln expressed.
Sworn to or affirmed and acknowlrdged before me by
Clarence R. Kerr, the Testator, this ;}.,'-X-:f- day of ('~'-~('l..Cl(\'1
2002.
~-J~
___;iR.~})LQ.JJ-Fr h -;n')
Clarence R. Ker
Testator
(SEAL)
~:; a,1t Gu,:t
Notary ublic
My commission Exp'
AFFIDAVIT
NOlariaJSeal
Gaye Crist, Notary Public
South Hanover T~.., Dauphin County
My Commission EXpires Apr. 18, 2005
Member, PennsyNaniaAssOOallon 01 Notaries
COMM(INWEALTH OF PENNSYLVANIA
)
)
)
R~ I{ ~
I~r. \ (! J1Jl I_
. )Ul\JJ,1Lt/--:'!-/ Y Ie Lv!-v
COUNTY OF
We,
and , 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
preSI!nt and saw the Testator sign and execute the instrument as
his Last willi that the Testator signed willingly and executed it
as r.ls free and voluntary act for the purposes therein expressed;
that. each subscribing witness, in the hearing and sight of the
Test..3.tor, 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.
~-.o
Sworn to or affirmed ~0 SUbscli~ed~ ~o befor~ me by
( -;-1...~ ,~ J~\\YVL'-' ,V.:JJ).c!J-e U)cy and
'-d
wi tnesses, this ..'I... ~;- day of
(e. 61'Ll...(.Lr {
2002.
~ I-l j~
Wltness
~1Jll/VlU l' cJ;:1[lL. iJ~<I
Witness
witness
(SEAL)
J.1Ct;jl. ~c1
Notar Public
My commission Expi
es: Nolarial Seal
Gaye Crist, Notary Public
South Hanover T~-", Dauphin Col
My Commission EX;llres Apr. 18, 2
Men"OOr,PannsylVaniaAssocialionolNot
~~K
PLEASE FILE THIS REPORT WITHIN T\VO YEARS OF DATE OF DEATH REGARDLESS OF
THE STATUS OF THE EST ATE. IF EST A TE IS NOT COMPLETED, FILE a 6.12 FORl\;I YEARLY
UNTIL COMPLETION
Date of Death:
Will No.:
C l a. re,n ~
ylZl/02..
STATUS REPORT UNDER RULE 6.12
e. Kl..rr
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Name of Decedent:
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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
No
V'
2. If the answer is No, state when the personal representative reasonably believes
that the administration will be complete: 'l..oc'L
3. If the answer to No. I is yes, state the following:
A. Did the personal representative file a final account with the court?
Yes No
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 No
D.
Copies of receipts, releases, joinders and approvals of formal or informal accounts
may be filed with the Clerk of the Orphans' Court and may be attached to this
report.
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Jt1t\1Q..S E. l(r()~
Date:
;-";ame (Please type or print)
""Ho U\W1h.,,~ Dr, 1~C'risbLl~ I fA \1J1\
Address
(:Vl.'\H:rmt/AM3 )
Q\1) Sq $'-1 S'1i
Telephone No
Capacity:
~
Personal Representative
Counsel for Personal Representative
R.\V. . 27
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~ BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT. ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
JAMES E KROH
6410 HUNTSMEN DR
HBG
::.1
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
:eqUNTY
ACN
01-13-2003
KERR
08-21-2002
21 02-0842
CUMBERLAND
101
'*
REV-1541 EX AFP (01-051
CLARENCE
R
PA 11111-0318
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=is47-E;f-AFP--foY=03Y-NOYicE--OF-YtiHEifiTANCE-'Y-A;c-A-PPRAisEifENT~--Ai:i-oWAifcE-OR-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF KERR CLARENCE R FILE NO. 21 02-0842 ACN 101 DATE 01-13-2003
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. Mortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Misc. 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
56,910.18
.00
.00
84,759.13
.00
.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitab1e/Governllenta1 Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
(10)
13.560.61
10.325.16
(11)
(12)
(13)
(14)
NOTE: If an assessment was issued previously, lines
reflect figures that include the total of ALL
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 C DI
NOTE: To insure proper
credit to your account.
subllit the upper portion
of this forll with your
tax paYllent.
141.669.91
23.885 83
117.784.08
8,244.89
109,539.19
14, 15 and/or 16, 17, 18 and 19 will
returns assessed to date.
.00 X 00 =
.00 X 045=
.00 X 12 =
109.539.19 X 15 =
(19)=
DATE
11-21-2002
+
INTEREST/PEN PAID (-)
821.54
AMOUNT PAID
15.883.18
NUMBER
CD001871
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
. IF PAID AFTER DATE INDICATED. SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
.00
.00
.00
16.430.88
16,430.88
16,704.72
273.84CR
.00
273.84CR
IF TOTAL DUE IS LESS THAN $1. NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR TN~TRII~TTnN~ 1
"'-v/?- .P9- 6
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
JAMES E KROH
6410 HUNTSMEN DR
HBG
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
'*
REV-IU1 EX AFP (01-05)
02-03-2003
KERR
08-21-2002
21 02-0842
CUMBERLAND
101
CLARENCE
R
PA/,P111
Allount Rellitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
NOTE: To insure proper credit to your account. subllit the upper portion of this forll with your tax paYllent.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV=i6"ifj-E;r-AFP--("oY=03Y------...--fNifERITANc'E--YA;r-STA-fEM'E-tiY-OF-AC-Coi:ii.-f--.-..------------------ ---
ESTATE OF KERR CLARENCE R FILE NO.21 02-0842 ACN 101 DATE 02-03-2003
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUE. APPLICATION OF ALL PAYMENTS. THE CURRENT BALANCE. AND. IF APPLICABLE.
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 01-06-2003
PR I NC I PAL TAX DUE: ................................................................................................................................................................................
...........................................
PAYMENTS (TAX CREDITS):
16.430.88
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
11-21-2002 CDOO1871 821.54 15.883.18
01-16-2003 REFUND .00 273.84-
TOTAL TAX CREDIT 16.430.88
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
. IF PAID AFTER THIS DATE. SEE REVERSE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1.
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRl.
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. l
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 "."
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STATUS REPORT UNDER RULE 6.12
Name of Decedent: Close..I\.c.e.., R. j..(e rr
Date of Death: A-.t. J u..~ 0.1, .AO Od-
Estate No.: J.-OOd-. - 00 lS Ll ')..
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:
I. State whether administration of the estate is complete:
Yes V No
2. If the answer is No, state when the personal representative reasonably believes
that the administration will be complete:
(date)
3. If the answer to No. I is yes, state the following:
A. Did the personal representative file a final account with the court?
Yes No V
B. The separate Orphans' Court No. (if any) for the personal representative's
account is: (Not Applicable in Dauphin County)
C. Did the personal representative state an account informally to the parties in
interest? Yes V No
D. Copies of receipts, releases, joinders and approvals of formal or informal
accounts may be filed with the Clerk of the Orphans' Court and may be attached
to thi s report.
Date: 11 ~ 03
~~.lL4
JfS.~es Eo ~fl>k
(MAH: rmt/ AM3)
Name (Please type or print)
to'tlO ~u.." ~~W1~ O\'LVt..
Address t-\~rrlS~L\('S \ ~A lll\\
(In) s'{{ -7$ 3Tr
Telephone No.
Capacity:
v
Personal Representative
Counsel for Personal Representative
R.W. .. BB