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Home My WebLink About12-04-14 � 1505610105 REV-1500 EX(o2-u)(FI) j,�� OFFICIAL USE ONLY PA Department of Revenue pennsylvania County Code Year File Number Bureau of IndividualTaxes INHERITANCE TAX RETURN `� l�l �� Po Box zso6oi RESIDENT DECEDENT �� ,� �I'�[ll� Harrisburg PA 1'7i28 o6oi ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Deat MMDDYYYY Date of Birth MMDDYYYY �, �o � av�3 �%��33 DecedenYs Last Name � Suffix Decedents First Name MI /<�np�l � �r�T � (If Applicable)Enter Surviving Spouse's Information Below MI Spouse's Last Name Suffix Spouse's First Name Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW � 1.Original Return O 2.Supplemental Return O 3. Remainder Return(Date of Death Prior to 12-13-82) p 4.Limited Estate O 4a. Future Interest Compromise(date of O 5. Federal Estate Tax Return Required death after 12-12-82) p 6.Decedent Died Testate O 7.Decedent Maintained a Living Trust _ 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) p 9.Litigation Proceeds Received O 10.Spousal Poverty Credit(Date of Death O ��' Att ch Schedule O)r Sec.9113(A) Between 12-31-91 and 1-1-95) � CORRESPONDENT— THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number J � . "��e�r'►GzS�/� �/��) /�/��3�'� � �f<hc� RECZI,3TER�OF WILLS"SSE O E7 � � � C.3 %� rn s� � � � � � First Line of Address �`" ;.�,. �' r r� C'�'1 /�� ,8/� / �[.�'l/� K- r r� � �� -t � ;.3 ,i,1 4'� Q Second Line of Addr ss `'� t � � � '� � , c� -h � � �...j �.,... ,�' �. - -t7� TE FILED— S� City or Post Office State ZIP Code �.� �� N � ,/ � l�o`e µ -� ca��7,�/ Correspondent's e-mail address: �rGn��`S/�-(/ «�� Under pena�ties of peryury,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 o er than the personal representative is based on all information of which preparer has any knowledge. SIG RE OF PERSON RESP SIBL FOR FIL FUR j E'` � ,7� A�� I D/ r . C� , f SIGNATURE�F EPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 � 1505610105 1505610105 � � 1505610205 REV-1500 EX(FI) DecedenYs Social Security Number Decedent's 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. Mort a es and Notes Receivabie Schedule D 4• 9 9 � )........................... 5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E)..... .. 5. �7�,�� 6. Jointly Owned Property(Schedule F) O Separate Billing Requested ....... 6. 7. Inter-Vivos Transfers 8�Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested..... ... 7. 8. Total Gross Assets(total Lines 1 through 7)..................... . ..... . . 8. ��,�a 9. Funeral Expenses and Administrative Costs(Schedule H)................... 9. f��3�SD 10. Debts of Decedent, Mortgage Liabilities and Liens(Schedule I)............... 10. /1 J6S�� / 11. Total Deductions(total Lines 9 and 10).......................... ....... 11. a a 9 O r r � J 12. Net Value of Estate(Line 8 minus Line 11) ....................... ....... 12. 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J) ....................... . 13. 14. Net Value Subject to Tax(�ine 12 minus Line 13) ................. ....... 14. ��[�� C� 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. 16. Amount of Line 14 taxable / at lineal rate X.0� �6� a 9I'� 17. Amount of Line 14 taxable at sibling rate X.12 ��• 18. Amount of Line 14 taxable at collateral rate X.15 �$• 19. TAX DUE ........... . .. ........................................... 19. p�/�1�' 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT � Side 2 � 1505610205 1505610205 J REV-1500 EX(FI) Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME � 7• I1-� - STREETADDRESS _ 3�� ti/�/n� �• — — STATE ZIP D CITY C� Tax Payments and Credits: �1� a9�� J 1. Tax Due(Page 2,Line 19) � 2. Credits/Payments A.Prior Payments B.Discount — - Total Credits(A+B) (2) 3. Interest �3� �,�j 4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4) Fili in oval on Page 2,Line 20 to request a refund. 5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. �5) v` r�'� 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.............................................................. � b. retain the right to designate who shall use the property transferred or its income ............................................ ❑ 0 c. retain a reversionary interest.............................................................................................................................. ❑ d d. receive the promise for life of either payments,benefits or care?...................................................................... � � 2. If death occurred after Dec.12,1982,did decedent transfer property within one year of death without receiving adequate consideration?............................................................................................................. ❑ � 3. Did decedent own an'in trust for"or payable-upon-death bank account or security at his or her death?.............. ❑ � 4. Did decedent own an individual retirement account,annuity or other non-probate property,which contains a beneficiary designation? ........................................................................................................................ ❑ � 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 imposetl on the net value of transfers from a deceased chiltl 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[72 P.S.§9116(a)(1)]. . The tax rate imposed on the net value of transfers to or for the use of the decedenYs 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-iso8 EX+(o8-iz) � pennsylvania SCHEDIJLE E DEPARTMENTOFREVENUE CASH� BANK DEPOSITS & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: 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 ,. ,m��.�j I�- c��[�� 6��8 ya . � a,Uoo:oD r�e�.-�-ers I��- 5�,��s TOTAL(Also enter on Line 5, Recapitulation) $ g ��g�� If more space is needed,use additional sheets of paper of the same size. REV-1511 EX+ (08-13) �� pennsylvania SCHEDULE H DEPARTMENTOFREVENUE FUNERAL EXPENSES AND INHERITANCETAXRETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: / �n 1. � ,._.Q �/��J(/ 3 c�r� W��'�" 3 G r�L ,��..,� B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) Street Address City State ZIP Year(s)Commission Paid: 2. Attorney Fees: 3. Family Exemption: (If decedent's address is not the same as claimanYs,attach explanation.) Claimant Street Address _ City_. _ State__ZIP _ Relationship of Claimant to Decedent 4. Probate Fees; 5. Accountant Fees: 6. Tax Return Preparer Fees: 7. TOTAL(Also enter on Line 9, Recapitulation) $ If more space is needed,use additional sheets of paper of the same size. REV-1512 EX+ (12-12) � pennsylvania SCHEDULE I DEPARTMENTOFREVENUE DEBTS OF DECEDENT, INHERITANCE TAX REfURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER 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 l. � ) J �,� �S r5T r,�" W�'!S ��,� f�ill �,�� sr�..s �7,�� Qvw„+,�. ,2.,-��. �a,y� s�,��- A� s,�,� 85.aa �� P � ,��s, � � y�a�o Po � '� � 5 i��i' �y�Si c)•.r,f �'V l � �,ur� c� ��.�� ,-�es a�6,� � ��s �� 7,�f� � av�� 16�� TOTAL(Also enter on Line 10, Recapitulation) $ � ��{j 0.00 If more space is needed,insert additional sheets of the same size. . �" � REGISTER OF WILLS CERTIFICATE OF CUMBERLAND COUNTY GRANT OF LETTERS PENNSYLVANIA � No. 20�3- 01946 PA No. 21- 13- � 146 Es ta te Of: JANET T KACHNOSKIE (First,Middle,LasU La t e Of: HAMPDEN TO WNSHIP CUMBERLAND COUNTY Deceased Social Securi ty No: 200-24-8262 WHEREAS, on the 30th day of October 2013 an instrument dated July 5th 2013 was admitted to probate as the last will of JANET T KACHNOSKIE (First,Midd/e,Last1 late of HAMPDEN TOWNSH/P, CUMBERLAND County, who died on the 9th day of October 2013 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, GLENDA FARNER STRASBAUGH , Register of Wills in and for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to: FRANCES A KACHNOSKIE who has duly qualified as EXECUTOR(R/X) and has agreed to administer the estate according to law, all of which ful ly appears of record in my offi ce a t CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYL VANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my office on the 30th day of October 2013. Register of Wi s � l�W� ' e ty **NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST) ,,__ _ . . - . L 4ST��'ILL AND TEST�,�iE'��" - - - r;�� ' -' - .- . .. ;� . . ,, .. � • - - _ OF C;; � . .. .. � JANET T. KACHh'OSKIE C'�4':��..... : - _ v: I, JANET T. KACI�NOSKIE, of Camp Hill, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this my Last Will and Testament, hereby revoking any and all prior wills and codicils thereto by me at any time heretofore made. FIRST � direct that all my just debts and the expenses of my last illness and funeral shall be paid from the assets of my estate as soon as practicable after my decease. � authorize my personal representative to expend funds from my estate, in such amounts as my personal representative shall consider necessary and desirable, for the purchase, erection and inscriptgon of a suitable marker for my grave. SECOND I give and bequeath all automobiles, household effects and other tangible personal property, not including cash or securities, owned by me at my death, together with all policies of insurance thereon, to my daughter, FRANCES A. KACHNOSKIE. THIRD I give, devise and bequeath the residue of my estate, of every nature and wherever situate, to my daughter, FRANCES A. KACHNOSKIE. FOURTH All principal and income, until actual distribution to the beneficiaries, shall be free of the debts, contracts, assignments, alienations and anticipations of any beneficiary, and the same shall not be subject to any levy, attachment, execution or sequestration. � � , �wti T• � �xt,��-=-�� 1 Janet T. Kachnoskie � - 'E"'.Y �Y, 1 v�'�� .��''�'• i;T��'�.1'F �''�"4t��"�a«fi".� .z� �'��'"�y��y M'.?:. � .... ;�`�.� FIFTH I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expenses of the administration of the estate. SIXTH My personal representative shall have the foliow•inc powers in addition to those vested in them by law and by other provisions of this Will: A. To retain any or all assets of my estate, real or personal, �;ithout regard to an�� principle of diversification, risk ar productivity. B. To invest in all forms af property as my fiduciary may deem proper,«-ithout regard to any principle of diversification, risk or productivity. C. To purchase investments at a premium or discount. D. To exercise all rights of a security holder or shareholder in any corporation; to give proxies; to join in an}' merger, consolidation, reorganization, voting trust plan, or other concerted action of security holders; and to delegate discretionary duties with respect thereto. E. To sell at public or pm�at�sa1e,to exchange or to lease, for any period of time, any real or personal prap�mr-. and to give options for sales, exchanges or leases, for such prices and upon such t�rms or conditions as my fiduciary deems proper. F. To allocate receipts and e�ipenses to principal or income, or partly to each, as my personal representati��e thu�:s prt�p�r. G. To borrow money from m��e�rp�rate fiduciary or others and to mortgage or pledge any real or personal propertt as�curit�F therefore,in my fiduciary's sole discretion. H. To compromise any claim c�r ce►r��-ersy without order of court or consent of any � beneficiary. I. To exercise any option, ri�t or �i4-�lege granted in insurance policies or arising from ownership of investment�� ' �4_` . , i�'�..�..,.y`,..;<_ � `� Janet T. Kachnoskie : ,� .�. E . ,. ��,, ..,. .�, � � . � .,.. ,, , . N� .�, �. � J. To make any distribution herein provided for in cash, in kind, or partly in each, at � valuations fixed by my personal representative at the time of distribution. K. My fiduciary may, in his or her sole discretion, donate any part or all of my tangible personal property to any charitable organization(s) which would benefit from such donation. My fiduciary is tHen instructed to use the value of said donation(s)as an tax deduction for any inheritance tax return which may be required to be filed as a consequence of my death. SEVENTH I appoint my daughter, FRANCES A. KACHNOSKIE, of Camp Hill, Pennsylvania, Eaecutrix of this my Last Will atid Testament. Should my daugnter, FRANCES A. KACH'.lTOSl�I, predeceas;, m;, or for any reasan fail to qualify as such Executrix, or having qualified, fail to serve as such Executrix, then I nominate, constitute and appoint my daughter, SliSAN KACHNOSKIE, of Ocean, New Jersey, Executrix of this my Last Will and Testament. EIGHTH My Executrix shall not be required to post security in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament,consistin of four(4)ty written pages which bear my signature for the purpose of identification, this�day of 2013, , W:�'.n-�-,3� 1- L<��u�v�.�.v JAN T T. KACHNOSKIE, Testatrix Signed, sealed, published and declared by the above-named Testatrix, JANET T. KACHNOSKIE, as and for her Last Will and Testament, in the sight and presence of us, who, at her request, in her sight and presence and in the sight and presence of each other, have hereunto subscribed our names a witnesses. � Address�3l'-� ��t,rte��- �.{r,�, Q, �.�,�ll,�!}I 7cx� �9-�� Address o�3�j1 �M p�v-�e�. �, � U ��,�H-�_i l , P� i�c��i 3 � , � , µ, > ._ � ,� ..�m.�. ,. _, , „�.,. , . ..., � COMMONWEALTH OF PENNSYLVANIA ) COUNTY OF CUMBERLAND � SS: ) I, JANET T. KACHNOSKIE, the Testatrix, whose name is signed to the foregoing instrument,having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and knowledged before me by JANET T. KACHNOSHIE, the Testatrix this �` day of , 2013. co��r�r��v��,+-s��-;C}��tI�NSYLY.��u ��,-.�''- 1= f�'�,�--...1�s i! No;anal S�ai ` Tle, ��. ��HNOSHIE, Testatrix �ebo��ah L.�renn_man,fVotary Pub:�r � � Camp I-lili 8ar�,�'�!mb��land t;ourry , i t��y Ccmr;issior:��rs;i.�es]unr:'Gr;.2n14 ..V,.,-rif3^i. ..-:i�r:,,;.rr;s:>.�-�c-:�::�u.�ti^Cf`•:;�i_� No ry Public COMMONWEALTH OF PENNSYLVANIA ) COUNTy OF CUMBERLAND � SS: ) We, �c{a� t-- �3�e,� r and �ct cs �� the witnesses whose names are signed to the foregoing instrument, veing du�'y qualified accordin � to law, depose and say that we were present and saw the aforesaid Testatrix sign and execute the instrument as her Last Will and Testament; that she signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed;that each of us in the hearing and sight of the Testatrix signed the Will as witnesses; and that to the best of our knowledge the Testatrix was at the time eighteen (18) or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed to before me,this day ,2013. 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