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Home My WebLink About01-13-15 (2) REV-1500 EX(02-11) 1 1505610143 OFFICIAL USE ONLY PA Department of Revenue pennsylvania County Code Year File Number Bureau of Individual Taxes DEPARTMENT OF REVENUE PO BOx.280601 INHERITANCE TAX RETURN 21 14 0582 Harrisburg,PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 05 27 2014 05 11 1921 Decedent's Last Name Suffix Decedent's First Name MI KLINGER EVELYN V (if Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW X❑ 1. Original Return M 2. Supplemental Return 3. Remainder Return(Date of Death Prior to 12-13-82) 4. Limited Estate 4a.Future Interest Compromise 5. Federal Estate Tax Return Required (date ofdeathafter 12-12-82) n 8 Decedent Died Testate 7. Decade e acdheGopy of Tned)a Living Trust 0 8. Total Number of Safe Deposit Boxes (Attach Copy of will) o c 9. Litigation Proceeds Received 10.S oues.nlq !!3 i a d11(Da�S�f Death 11.Election to tax under Sec.9113(A) (Attach Schedule O) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number HUBERT X GILROY 717 243 3341 REGISTER OF WILLS USE ONLY First Line of Address 10 EAST HIGH STREET Cw O rT7 Second Line of Address M _ 171 C 1 = G7 r`DAEED~ t'T t rT City or Post Office State ZIP Code „ LT fl C-3 C') CARLISLE PA 17 013 7 W r t"r'I Correspondent's e-mail address: hailroyCcdmartsonlaw.com Under penalties of perjury,i declare that I have examined this return,including accompanying schedules and statements,and to the best of mykaamledge and"Mlief, it is true,correct and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any nowledge. SIGN E OF PERSON RESPONSIBLE FOR FILING RETURN DA ZL ( ===411- 0 - Roy E. Klinger,Jr. 2 ADDRESS 61 Half Mile Road..Gardners, PA 17324 SIGNAT rEPR HER TH EPRESENTATIVE DTE Hubert X. Gilroy ADDRESS 10 East High Street, pi/Aisle, PA 17013 Side 1 1505610143 1505610143 1505610243 REV-1500 EX Decedent's Social Security Number Decedent's Name: Klinger, Evelyn V. RECAPITULATION 1. Real Estate(Schedule A)....................................................................................... 1. 0 . 00 2. Stocks and Bonds(Schedule B)............................................................................. 2. 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C)......... 3. 4. Mortgages&Notes Receivable(Schedule D)........................................................ 4. 5. Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E)............... 5. 27 , 576. 90 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6. 7. Inter-Vivos Transfers&Miscellaneous Non Probate Property (Schedule G) U Separate Billing Requested............ 7. 8. Total Gross Assets(total Lines 1 through 7)........................................................ 8. 27 ,576 . 90 9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 7 , 152 . 96 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................ 10. 687 . 22 11. Total Deductions(total Lines 9 and 10)................................................................ 11. 7 , 840 . 18 12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 19, 736. 72 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(Line 12 minus Line 13)............................................... 14. 19, 736 . 72 TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 0 . 00 (a)(1.2)X.00 15. 16. Amount of Line 14 taxable 19, 736 . 72 16. 888 . 15 at lineal rate X .045 17. Amount of Line 14 taxable at sibling rate X.12 0 . 00 17. 0 . 00 18. Amount of Line 14 taxable at collateral rate X.15 0 . 00 18. 0 . 00 19. TAX DUE................................................................................................................ 19. 888 . 15 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ❑ Side 2 1505610243 1505610243 REV-1500 EX Page 3 File Number 21-14-0582 Decedent's Complete Address: DECEDENT'S NAME Klinger, Evelyn V. STREET ADDRESS 515 Hamilton Street CITY STATE ZIP Carlisle PA 17013 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 888.15 2. Credits/Payments A. Prior Payments 3,000.00 B. Discount 44.41 Total Credits(A +B) (2) 3,044.41 3. Interest (3) 4, If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4) 2,156.26 Check box 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) Make Check Payable to REGISTER OF WILLS AGENT. �'"wed •i? ,,: ;fir.S°t" � ..: :;. ...5,,,4.& i„�x '�..su.v �,,.. ;,. -uY!»�'aiwli/i/ 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;.................................. ❑ ❑x c. retain a reversionary interest;or.............................................................................................................. 1:1 lxl d. receive the promise for life of either payments,benefits or care?............................................................ ❑ 0 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?.................................................................................................................... ❑ 0 3. Did decedent own an"in trust for' or payable upon death bank account or security at his or her death?....... ❑ ❑x 4. Did decedent own an individual retirement account,annuity,or other non-probate property which ❑ ❑ containsa 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 January 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S.§9116(a)(1.1)(ii)]. The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1,2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent,an adoptive parent,or a stepparent of the child is 0 percent[72 P.S.§9116(a)(1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in[72 P.S.§9116(a)(1)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent[72 P.S.§9116(a)(1.3)]. A sibling is defined, under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption. Rev-1502 EX+(01.10) SCHEDULE A pennsylvania REAL ESTATE DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Klinger, Evelyn V. 21-14-0582 All real property owned solely or as a tenant In common must be reported at fair market value.Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts. Real property that is jointly-owned with right of survivorship must be disclosed on schedule F. Attach a copy of the settlement sheet if the property has been sold Include a copy of the deed showing decedent's interest if owned as tenant in common. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Residence-Real estate located on 515 Hamilton Street,Carlisle Borough,Cumberland 0.00 County,PA,known as Tax Parcel No.06-20-1800-062 and being described in Deed dated 06/21/1963 and being recorded on 06/22/1963 in Cumberland County Deed Book"W",Vol.20, Page 710,and being conveyed to Roy Edward Klinger and Evelyn Klinger, his wife. Roy Edward Klinger died 12/24/1990,leaving title solely vested in Evelyn Klinger, Decedent herein. ASSET SUSPENDED PENDING SALE OF REAL ESTATE TOTAL(Also enter on Line 1, Recapitulation) 0.00 (If more space is needed,additional pages of the same size) Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule A(Rev.01-10) Rev-1508 EX+(11.10) SCHEDULE E pennsylvania CASH, BANK DEPOSITS, & MISC. DEPARTMENT OF REVENUE INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Klinger, Evelyn V. 21-14-0582 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right ofsurvivorship must be disclosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 M&T Bank Checking Account#754943-Date of death value,see attached 26,572.54 2 M&T Bank Holiday Club Savings Account#25004920630280-Date of death value,see 700.02 attached Accrued interest on Item 2 through date of death 0.02 3 Comast-Refund 54.32 4 US Treasury-2013 Federal Income Tax Return, refund 250.00 TOTAL(Also enter on Line 5, Recapitulation) 27,576.90 (If more space is needed,additional pages of the same size) Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule E(Rev. 11-10) REV•1511EX+(10-09) SCHEDULE H pennsylvania DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERRESIDENT EDENAX TURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Klinger, Evelyn V. 21-14-0582 Decedent's debts must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s) attached 3,259.10 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Roy E. Klinger,Jr. Street Address 61 Half Mile Road city Gardners state PA zip 17324 Year(s)Commission Paid 1,378.85 2. Attorney's Fees Martson Law Offices 1,904.61 3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation) Claimant Street Address City State ZiD Relationship of Claimant to Decedent 4. Probate Fees 318.50 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 291.90 See continuation schedule(s)attached TOTAL(Also enter on line 9, Recapitulation) 7,152.96 Copyright(c)2009 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev. 10-09) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Klinger, Evelyn V. 21-14-0582 ITEM NUMBER DESCRIPTION AMOUNT Funeral Expenses 1 Hoffman Funeral Home-Funeral expenses 3,159.10 2 Pastor Dick Reese-Ministerial services 100.00 H-A 3,259.10 Other Administrative Costs 3 Deluxe Checks-Order of checks for Estate Checking account 15.74 4 Legal Advertising-Cumberland Law Journal 75.00 5 Legal Advertising-The Sentinel 201.16 H-B7 291.90 Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.6-98) Rev-1512 EX+(12-08) SCHEDULE I pennsylvania DEBTS OF DECEDENT, DEPARTMENT OF REVENUE INHERITANCE TAX RETURN MORTGAGE LIABILITIES AND LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Klinger, Evelyn V. 21-14-0582 Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Borough of Carlisle-Water/sewer,account payable 80.60 2 CenturyLink-Phone,account payable 58.12 3 CenturyLink-Phone,account payable 6.49 4 Cumberland Goodwill EMS-Account payable 83.25 5 M&T Bank Checking Account#754943-Outstanding check payable from M&T Bank 200.00 Checking Account#754943,posted after date of death 6 PPL-Electricity bill,account payable 108.09 7 West Shore EMS-Account payable 150.67 TOTAL(Also enter on Line 10, Recapitulation) 687.22 (If more space is needed,additional pages of the same size) Copyright(c)2008 form software only The Lackner Group,Inc. Form PA-1500 Schedule I(Rev. 12-08) REV-1513 EX+(01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER Klinger, Evelyn V. 21-14-0582 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S)RECEIVING PROPERTY DECEDENTDo Not List Trust e(s) (Words) ($$$) I� TAXABLE DISTRIBUTIONS [include outright spousal distributions,and transfers under Sec.9116(a)(1.2)] Laurie Marlene Chmielewski Daughter One-fourth 4,934.18 4922 Berryhill Circle residue Perry Hall, MD 21128 Lucy Marie Klinger Daughter One-fourth 4,934.18 505 Hamilton Street residue Carlisle, PA 17013 Roy E. Klinger,Jr. Son One-fourth 4,934.18 61 Half Mile Road residue Gardners, PA 17324 Stephen C. Klinger Son One-fourth 4,934.18 125 Rabbits Run residue Atmore,AL 36502 Total 19,736.72 Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet,as appropriate. NON-TAXABLE DISTRIBUTIONS: II. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule J(Rev.01-10) o [� LAST WILL AND TESTAMENT OF EVELYN V. KLINGER I, Evelyn V. Klinger, of 515 Hamilton Street, Carlisle, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, Flo hereby make and declare this as and for my last will and testament, hereby revoking all wills and codicils heretofore made by me. FIRST I direct the payment of my debts and expenses of my last illness and funeral from my estate as soon after my death as conveniently may be done. I authorize my personal representative to arrange for my interment in the cemetery lot that I currently own at Cumberland Memorial Gardens. SECOND I give, devise and bequeath all my property, both real, personal and otherwise, wherever located to my husband, Roy E. Klinger, Sr., should he survive me by thirty (30) days. Should my husband, Roy E. Klinger, Sr. , fail to survive me by thirty (30) days, then all of my property, both real and personal and otherwise shall be sold and the proceeds equally divided among my five children, per capita. . A. Ronald Lee Klinger, of 328 Westover Drive, j Woodstock, Georgia; B. Roy Edward Klinger, of R.D. #2, Box 209-3, } Gardners, Pennsylvania; C. Laurie Marlene Chmielewski, 2716, .Pelham Avenue, Baltimore, Maryland; , D. Lucy Marie Hoffenbecker, 505 Hamilton Street, Carlisle, Pennsylvania; and r. Stephen Curtis Klinger, of 704 South Main Street, Atmore, Alabama. It is specifically directed, however, that if any of my children want a particular item or items of personal property from my estate for any reason they can have the same so long as all of the other children consent. THIRD Any and all payment or payments of any sum or sums, whether in cash or in kind and whether from principal or income, payable to my beneficiaries, shall be made upon the sole receipt of the respective individual to whom the payment is made, free from anticipation, alienation, assignment, attachment, and pledge, and free from control by the creditors of any such beneficiaries, and shall not be subject to any execution or attachment. FOURTH Finally, I nominate, constitute and appoint my husband, Roy E. Klinger, Executor of this my last_ will and testament. Should he fail to survive me or be unable to serve this capacity, then I nominate, constitute and appoint my son, Ronald Lee Klinger, Executor of this my y last will and testament. I hereby relieve my Executor from the necessity �� of posting security in connection with his duties as such in any jurisdiction in which he may be called upon to act insofar as I am able by law to do so. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my last will and testament, consisting of three (3) typewritten pages, the first two (2) of which bears my signature in the margin for the purpose of identification this day of March, 1988. EVELYN V. KLINGER Signed, sealed, published and declared by the above named Testatrix, Evelyn V. Klinger, as and for her last will and testament, in the 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 as witn sses. �` clll c COMMONWEALTH OF PENNSYLVANIA . SS . COUNTY OF CUMBERLAND , We, Evelyn V. Klinger ► _ John F. Goryl , and Su,Qan J_ Otto , the Testator/Testatrix and the witnesses, respectively whose names are signed to the : attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator/ Testatrix signed and executed the instrument as his/her last will, and that he/she signed willingly, and that he/she , executed as his/her free and voluntary act for the purposes therein expressed, and- that each of the witnesses in the presence and hearing of the Testator/Testatrix, signed the will . as witnesses , and that to the best of their knowledge, the Testator/Testatrix was at the time eighteen ( 18) years of age or older, of sound mind, and under no constraint or undue influence. U- \ J Sworn or affirmed to and acknowledged before me, this day of�h 4Li k, L. 19W i --� MARIA A. BARLETTA, Notary Public Cumberland County, Carlisle, PA Notary Public My Commission Expires May 6, 1991 Q M&TBank 499 Mitchell Road.Millsboro,DE 19966 Records Management Phone 888-502-4349 F ax (302)934-2955 June 24,2014 Martson Deardorff Williams Otto Gilroy & Faller Martson Law Office 10 East High Street Carlisle,PA 17013 Re: Estate of Evelyn V. Klinger Social Security: Date of Death: May 27, 2014 Dear Sir or Madam: Per your inquiry on June 18,2014,please be advised that at the time of death,the above-named decedent had on deposit with this bank the following: 1. Type of Account Checking Account Account Number 754943 Ownership(Names of) Evelyn Y. Klinger Lucy M.Klinger(POA) Roy E.Klinger Opening Date 0110111969 Balance on Date of Death $ 26,572.54 Accrued Interest $ .00 Total $26,572.54 2. Type of Account Saving Account Account Number 25004920630280 Ownership(Names of) Evelyn Y. Klinger Opening Date 1212912004 Balance on Date of Death $ 700.02 Accrued Interest $ .02 Total $ 700.04 2_ &CoeoV LET For any additional information on the above accounts,including ownership and any changes,closures and/or reimbursement of funds, please call the High Street Carlisle at 717-1414536. We were unable to locate any safe deposit box for the above-mentioned decedent. This letter does not include any accounts in which the deceased may have been listed as Power of Attorney,Custodian of Uniform Transfers, Representative Payee,or Trustee under a Written Agreement Sincerely, Valarie Mercer Records Management Of