HomeMy WebLinkAbout01-0187
REV-1500 EX (6-001
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COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
KIMMEL J HN I.
DATE OF DEATH (MM-DD-YEAR)
DATE OF BIRTH (MM-DD-YEAR)
01/21/01 03/05/11
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
g1,OriginalReturn
D 4. Limited Estate
o 6. Decedent Died Testate (,Il,ltach copy of Will)
o 9, litigation Proceeds Received
o 2. Supplemental Return
o 4a. Future Interest Compromise (dale of death after 12-12-82)
o 7. Decedent Maintained a Living Trust (Mach copy of Trust)
o 10. Spousal Poverty Credit (dateQfdeathb..,\Wee~ 12-31-91 illlt\ 1-1-95)
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OFFICIAL USE ONLY
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FILE NUMBER i -f1
&L-~.L D~_--1_
COUNTY CODE YEAR NUMBER
SOCIAL SECURITY NUMBER
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WillS
SOCIAL SECURITY NUMBER
o 3. Remainder Relurn (date 01 death {I{~ 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) (Attacl1 Sch 0)
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NAME
FIRM NAME (If Applicable)
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3_ Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedu(e D}
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly OWned Property (Schedule F}
D Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule 1)
11. Total Deductions (Iotal Lines 9 & 10)
COMPLETE MAILING ADDRESS
352 S. Sporting Hill Road
Mechanicsburg. PA 17050
(1) 13.000.00
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9) 8.021.00
(10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
16. Amount of Line 14 taxable at lineal rate
4.979.00
,0_(15)
,.045.... (16)
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rale
19. Tax Due
20.0
,12 (17)
,15 (18)
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
OFFICIAL USE ONLY
13.000.00
(11)
(12)
(13)
8.021.00
4,Q7Q.OO
(14)
4,979.00
224.06
(19)
224.06
Decedent's Complete Address:
I=m~=
CITY
I STATE
I ZIP
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19) (1)
2. Credits/Payments
A. Spousal Poverty Credit
B. Poor Payments
C. Discount
Total Credits (A+B + C) (2)
3. interesYPenally if applicable
D. Interesl
E. Penally
TotallnteresUPenally ( D + E ) (3)
4. If Line 2 is greater than line 1 + line 3, enter 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 greater than line 2, enter the difference. This is the TAX DUE, (5)
B. Enter the total of Line 5 + SA. This Is the BALANCE DUE,
, '
(SA)
(5B)
A. Enter the interest on the tax dUe.
- 'Make CheckPayable 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;.......................... ................. ............................................. D D
b. retain the right to designate who shall use the property transferred or ils income; ............................................ D D
c. retain a reversionary interest; or....................................................,.....mum........................................................ 0 0
d. receive the promise for life of either payments, benefits or care? ...................................................................... D D
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ....... ...................................................................................................... D D
3. Did decedent own an "in trust for" or payable upon death bank account or securily at his or her dealh? .............. D D
4. Did decedent own an Individual RetjrementAccount, annuity, or other non-probate property which
contains a beneficiary designation? ................. ....................... ........................ ............................... D D
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, ! declare that I have examined this return, including accompanying sched~~s 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 informalion of which preparer has any knowledge.
ADDRESS
P.O.Box 240, Shawnee-on-Delaware, PA 18356
SIGNATURE OF PREPARER OTHER TH
DATE
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ADDRESS
352 S. Sportina Hill Road. Me",han;c"hllrq. PJI
170'10
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 P.S. 99116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on Ihe net value of Iransfers to or for the use of the surviving spouse is 0% [72 P.S. 99116 (a) (1.1) (ii)].
The statute does not exemot 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 Juiy 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 stepparent of the child is 0% [72 P.S. 99116(a)(1.2)).
The tax rate Imposed on Ihe net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, excepl as noted in 72 P.S. 99116(1.2) [72 P.S. 99116(a)(1)].
The tax rale imposed on the net value of transfers to or for the use of the decedent's siblin9s is 12% [72 P.S. 99116(a)(1.3)]. A sibiing is defined, under Section 9102, as an
individual who has at least one parent in common with the decedent, whether by blood or adoption.
R~V.I502~X < (l.g71
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SCHEDULE A
REAL ESTATE
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
JOHN I. KIMMEL
All real property owned solely or as a tenant in common must be reported at fair market niue, Fair mar'Ket value is defined as the price at which property would be exchanged
between a willing buyer and a willing seifer, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Re~1I property which is jointly-owned with
right of
survlvorshiD must be disclosed on Schedule F.
ITEM
NUMBER
1.
FILE NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
Unimproved mountain land, containing approximately
10 acres, located in Hampden Township,
Tax Map ~10 04 0363 001
$ 13,000.00
TOTAL (Also enteron line 1, Recapitulation) $ 13,000.00
(If more space is needed, insert additional sheets of the same size)
RfV_1511EX+(1_97)
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SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
JOHN I. KTMMF.L
FILE NUMBER
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Malpezzi Funeral Home $ 6,341.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (5) Rose Ann Whitesell 650.00
Social Security Number(s) I EIN Number of Personal Represenlati'le{s)
Street Address P . o. Box 240
City Shawnee-on-Delaware Slate PA Zip 18356
Yea~s) Commission Paid: 2001
2. Attorney Fees - James M. Bach 780.00
3. Family Exemption: (If decedenfs address is not the same as claimant's, attach explana1ion)
Claimant
Street Address
City Slate Zip
Relationship of Claimant to Decedent
4. Probate Fees 250.00
5. Accountanfs Fees
6. Tax Return Preparer's Fees
7.
TOTAL (Also enteron line 9, Recapitulation) $ 8,021.00
(If more space is needed, insert additional sheets of the same size)
REV-1513EX+(1.97)
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SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
JOHN I. KIMMEL
FILE NUMBER
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I. TAXABLE DISTRIBUTIONS (include outright spousal distributions}
1. Richard A. Whitesell Grandson 100%
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 DtSTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $
(It more space is needed, Insert additional sheels of ll1e same size)
PETITION FOR PROBATE and GRANT OF LElfTERS
No. ~-~4J.~.0l,::-J 91
To: : I
Estute of John _1. Kimmel
also known os
Register of Wills for the
~ Deceased. CO'Jnty of<:J)JDher1 and in the
Social Security No. 1'/i'-tJl-:.;i3.2la-__ Commonwealth of Pennsylvania
The petition of the undersij;ned respectfully represents that:
Your petitioner(s). who i~/are 18 years of age or older an the ~;}(eCUl rix
in the last will of the above decedent. dated l\n~:p'9t 9
and codicil(s) dated none .___------
named
, 19-9.1--
(stale relev3nt cirl:nmstllnccs, e,g, rClluncialiol\. death of execulor, I:IC.)
Decendent was domiciled at death in Cprn!>erland County, Pennsylvania, with
h is last family or princ~residence at Mesf'd ah-Y.i 11 ;I~e, )(ecbanicIiPurq, PA
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(1t:>1 sIr",,!, 'hJmber and nl\lnclPaI1(Y)
Decendent, then years of age, died .Tanuary ~1 7001
at Messi~h Yi 11agp _ _ . .
Except as rollows. decedent did not marry, W3i nOt divorced arid did not have a cNild born or adopted
after execution of the will offered for probate; ""as not the victim of a killing and WclS never adjudicated
1 incompetent:
Oecendenr a1 death owned property with estimated values.as follows:
(If domiciled in Pa.) All personal prop~rty
i (If not domiciled in Pa.) Personal property in Pennsylvar.1ia
(If not domiciled in Pa.) Personal property in County ,
Value of real estate in Pennsylvania
situated as follows: i mprnvpt'l mmlnta in grouRd
Township, ~ax m~p .10 01 ~3 001
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$ 13,000 00
located in Ram~&eB
WHEREFORE, petitioner(s) respectfully request(s) the probate of the lasr will and codicil(s)
presented herewith and the grant of letters 'I'p~t:;"mont ary
(leSt~memar)'; at:\ministr&tion c.La.: aclllllinistrat,on d.b.n.c,t.a.)
theron.
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~E ANN WHITESELL
PO box: 240
. Shawuee--on--np1 aV;lt"e, VA 18356
OATH OF PERSONAL REPR~SENTATIVi:
COMMONWEALTH OF PENNSYLVANIA 1. ss
COUNTY OF Cumberland J "
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the fotegoing petition are
true and correct to the besl of the knowledge and belief of pet~ljon~r(s) and that a:l personal represen-
tative(s) of the above decedent petitJoner(s) will well and truly administer the esta/fe according to law.
vlka' aJ~~
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Register
REGISTER OF WILLS
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No.
21-2001-0187
Estate of
JOHN I. ~IMME'{'
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, Deceased
DECREE OF PROBATE AND GRA)~~T OF LETT:tRS
i AND NOW February 16th, 19:200 1 ~. in consideration ~f the petition on
Ithe reverse side hereof. satisfactory proof having been presented before me,
lIT IS .DECREED that the instrument(s) dated Au~st 9t!i, 1991
;described therein be admitted to probate and filed of record as the last will of
I JOHN I. KIMMEL .
:and Letters TESTAMENTARY
I ROSE ANN WHITESELL
'are hereby granted to
I FEES
i Probate. Letters. Etc. ......... $ 50.00
:Short Certificate$(~) .......... sl?OQ
I Renunciation ................ s
ix- Pages (3 $ 9.00
I
! JCP TOTAL $ 5.00
iFiled F~~~~~. :~~? . ~?~. ??~~O()-
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egisler of WilIlI. MARY C. LEWIS . , r7'
TAMES M lurR/1R7.l7 }--~ ~
'AlTORN"EY (Sup. Ct. I.D. ((0.)
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.352 SI~ SDortinq llill Rd, Mechanicsbur.
ADOIl.ESS 17050
~717~37-2033
PHONE
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MAILED LETI'ERS AND ORDER TO EXECUTRIX
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H105.805 REV 9/86
This is to certify that the information here given is correctly copied from an original certificate of dearh dl}ly filed wirh me as
Local ~gistrar. The original certificate will be forwarded to the State Vital Records Office for permanent tiling.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00
p
7120947
No.
21-2001-187
(~4W>fi< ~ i? j, '4. /f)jf'7,
Local Registrar
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Date
H105.143Rev_ :U87
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
STAlE FIll: NUMBER
SOCIAL SECURITY NUMBER
TYPE/PRINT
IN
PERMANE.NT
BJ..,ACK lHK
NAME Of DeCEDENT (FIr.. Middle. Las)
l. John I. Kinmel
sex
.. Male
Pt..ACE'OFoeATH(C~~OM ~iNtJuc!JCln&onOlhef SlOe)
HOSPITAL:
Inpa_ 0
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AGE (Lasl Bif1M8y.
UNDER 1 YEAR
........ llayo
89 v"
COUNTY OF DERH
.... Cumber land
Ie.
DECEDENT'S USUAl OCCUMlON
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".. PL' rietor ".Lumber
DECEDENT'S MAlUNG ADDRESS ($&reel, CilyllOwn, Stale. lip Code)
100 Mt. A,1,len Drive
Mechanicsburg, PA 17055
13.
n.. St... Pennsv 1 vania
tlb. Coun
Cumberland
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FATI1ER'S NAME (FirSI. Middle. Last)
... Milton D. Kinmel
1NF0RMANT'S ,NAME (ly,*Prinq
.... Mrs. Donna A. Botterbusch
METHOD Of' DlSPOSlTIOH
O 8uri.a ex Cren\alil;!ft 0 Remo"'.tromS1a'.O
Donation Other (SpeCJIy~
. fa.
. StGNATUR€ Of FU~ RvtCE
January 24 2001
lICENSE NUMBER
011667-L
22b.
To the bell of my knowledge, death OCC\lfred allhe tim41, date ancs ~ SCIII<<I.
(S1gll8l\J'.andTllIe)
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10 CONSEOUENCE Of):
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WERE AUlOPSY FINDINGS
~BLE PRIOR 10
COMPLETION OF CAUse
Of'llERH?
DUE 10 (OR AS A CONSEQUENCE Of):
CUE 10,00 AS ACO:iSEQuENCE OF).
MANNER OF DEATH
OATE OF INJURY
jMoolh. Day. 'Mar)
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21
2001
White
SURVMHG SPOUSE
{II W'IItI. ~ve ma.oen ~l
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PART U: OIhef stgniftcanl COf'ldiIjona con&ributirog 10....... buI
not~inginthll~cauMgiw_il'IPNn'l.
TIME OF INJURY
INJuRY I(J WORK?
DESCRIBE HOW INJURY OCCURRED.
Accident
Pending InveSC~lio"
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o ~CE OF INJuRV - AI ~> laml~"',lactOf'/, otftce
building. etC. (Speclly)
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Homicide
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CERTtFlEA (Check only 008)
-CERTIFYING PtiVSI(:IAN (Phy5lC1Cltl ceflllylng cause at dealh whefl aJ'101t\er pf1ys.cian has Pfonounced <:Iealh.ana" CCfflpleleo lIem 23)
To "'- bHI of my .~. ..Ih OCC'unwd due to ~ c:auH(s) and maM.' a. stated. .
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Could noJ Oe determined
Sllicide
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.pfIOHOUHClNO AND CE.ATlFYlNQ PHVstClAN (Ph'jSlC.an both pronouncIng death aM certltyll1g to cause 01 dealh)
To the ~t at my knowladie, death occurred .II the time, date, and piece, and due 10 the caud{.t and manner _ ."'ed..
.MEDICAL EXAMINER/CORONER
On the ba.i. ot examination and/or Investigation. in my opinion, death occurred allheUme, date, and place. and Ciuelo the cause(s} and
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31.1.
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LAST WILL AND TESTAMENT OF JOHN I. KIMMEL
I, JOHN I. KIMMEL, of the Township of Hampden, County of
Cumberland, and State of Pennsylvania, being in good bodily
health and of sound and disposing mind and memory, and not
acting under duress, menace, fraud, or undue influence of any
person whomsoever, merely calling to mind the frailty of human
life, and being desirous of disposing of my worldly goods while
I have the strength and capacity so to do, I do make, publish
and declare this my LAST WILL AND TESTAMENT. I hereby revoke,
cancel and annul all my former Wills and Testaments, including
codicils thereto, by me at any time made, and declare this
alone to be my LAST WILL AND TESTAMENT.
AS TO SUCH ESTATE AS IT HAS PLEASED GOD TO ENTRUST ME WITH
IN THIS LIFETIME, I DISPOSE OF THE SAME AS FOLLOWS, VIZ:
ITEM 1. I direct that my Executors hereinafter named pay
and discharge all of my just debts, funeral and testamentary
expenses.
I order and direct that I be buried in a lot
ITEM 2.
which I own, situate at the St. John's Cemetery, located in
Camp Hill, Pennsylvania.
ITEM 3. I give, devise, and bequeath thirteen (13) acres
of mountain land in the vicinity of Lambs Gap, Hampden
Township, Cumberland County, Pennsylvania, absolutely and in
fee to RICHARD A. WHITESELL.
ITEM 4. I order and direct that my estate sell as soon
as is practical four and six tenths (4.6) acres of land that I
own in York County in the vicinity of Rife Hill.
~MM~
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ITEM 5. I give, devise, and bequeath my property known
and numbered as 4827 East Trindle Road, Mechanicsburg,
Pennsylvania, to ROSE ANN WHITESELL and DONNA RUTH BOTTERBUSCH,
NEVERTHELESS IN TRUST AS TRUSTEES FOR ROSE ANN WHITESELL AND
DONNA RUTH BOTTERBUSCH. My trustees will continue to maintain
this property, and it is my intention and wish that they not
sell this property for at least ten (10) years after my death,
in order that they will enjoy income from this property. I
worked very hard to obtain this property, and it is my
intention that this serve as a source of income for my
Daughters. In the event of the death of either of my
Daughters, then this trust may terminate, and in any event, it
may terminate ten (10) years after the date of my death. All
the proceeds of the trust will be paid in equal shares to my
Daughters after expenses.
ITEM 6.
All the rest, residue and remainder of my entire
estate, wheresoever situate, and whatsoever it may consist of,
I give, devise, and bequeath, absolutely, and in fee, to my
dearly beloved Daughters, ROSE ANN WHITESELL and DONNA RUTH
BOTTERBUSCH, share and share alike, per stirpes.
ITEM 7. I nominate and appoint ROSE ANN WHITESELL, as
Executrix of this my Last Will. Should the Executrix named
fail to qualify or cease to act as Executrix, then I appoint
DONNA RUTH BOTTERBUSCH, as Executrix in her stead.
ITEM 8. I direct that my personal representatives, as
well as their successors, shall not be required to give bond
for the faithful performance of their duties in any
jurisdiction.
~~
2
ITEM 9.
I direct that all estate, succession, legacy,
inheritance or other transfer taxes, however designated that
shall become payable by reason of my death in respect of all
property comprising my gross estate for tax purposes, whether
or not such property passesunder this Last Will, shall be paid
by my Executor out of my residuary estate.
ITEM 10.
I grant to my personal representatives herein
named, in addition to, but not in limitation of those powers
vested by law, to be exercised without prior application to or
approval of any court, the power and authority to retain
indefinitely any property, to invest and reinvest any assets or
the proceeds derived from the sale of assets, although said
investments may not be of the character prescribed by law, to
sell, convey, assign, transfer and encumber any property, to
pay, settle or compromise all claims, to make distribution or
divisions in cash or in kind, and in general to exercise all
powers in the management of any property hereunder which any
individual could exercise in the management of similar property
owned in his own right, and to execute and deliver any and all
instruments and to do all acts which may be deemed necessary
and proper.
~~
JO N 1. KIMM
---------------------------------END-----------------------------
3
COMMONWEALTH OF PENNSYLVANIA
ss
COUNTY OF CUMBERLAND
I, JOHN I. KIMMEL '-,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 WILLi that I
signed it willingly~ and that I signed it as my free and
voluntary act for the purpose therein expressed.
Sworn or affirmed to and acknowledged before me,
by
JOHN 1. KIMMEL
, the TESTATOR, this 9th day
, 1991.
of AUGUST
~~4Q
ARY PUB
Mechanicsburg, PA
My Commission Expires:
The preceding instrument consisting of this and two (2)
other typewritten pages, identified by the signature of the
TESTATOR, was on the date thereof signed, published and
declared by JOHN I. KIMMEL , the TESTATOR therein named
as and for his LAST WILL AND TESTAMENT.
__ All It~~
. MES M. BACH
Residing at 352 S. Sporting Hill Road
Mechanicsburg, PA 17055
"..
/
Residing at 352 S. Sporting Hill Road
Mechanicsburg, PA 17055
A F F I D A V I T
COMMONWEALTH OF PENNSYLVANIA
ss
COUNTY OF CUMBERLAND
We JAMES M. BACH and BARBARA A. GLESSNER, the
witnesses whose names are signed to the attached or foregoing
instrument, being duly qu~lified according to law, do depose and
say that we were present and saw TESTATOR sign and execute the
instrument as his LAST WILL~ that he signed willingly and that he
executed it as his free and voluntary act for the purpose therein
expressed~ that each of us in the hearing and sight of the TESTATOR
signed the WILL as witnesses~ and that to the best of our knowledge
the TESTATOR was at the time 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 by
JAMES M. BACH and BARBARA A. GLESSNER, witnesses, this
...llJL. day of AUGUST , 193.l.
c~~~~
NOTARY PUB r
Mechanicsburg, PA
My Commission Expires:
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CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent:
JOHN I. KIMMEL
Date of Death:
January 21, 2001
Will No. c2/-cv-1J71 Admin. No.
To the Register:
I certify that notice of beneficial interest required by Rule 5 .6( a) of the Orphan's
Court Rules was served on or mailed to the following beneficiaries of the above-
captioned estate on ~ ~ ~ ~ / .
I '
Name
Address
Donna R. Botterbusch
981 East Canal Road, Dover, P A
Rose Ann Whitesell
PO Box 240, Shawnee-on-Delaware, P A 18356
Notice has now been given to all persons entitled thereto under Rule 5.6(a)
except
Date:
Signature: ~ /;;11J,..---e--
Name: {f JAMES M. BACH
ATTORNEY-AT-LAW
Address: 352 South Sporting Hill Road
Mechanicsburg, P A 17050
(717) 737-2033
Capacity: Counsel for personal representative
E
---
NOTICE OF BENEFICIAL INTEREST IN ESTATE
BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, PENNSYLVANIA
In re Estate of JOHN I. KIMMEL, deceased.
Estate No. '21-2001-0187
TO: DONNA R. BOTTERBUSCH, 981 EAST CANAL ROAD, DOVER, P A
Please take notice of the death of decedent and the grant of letters to the personal
representative (s) named below. You may have a beneficial interest in the estate as follows:
Children, share and share alike, per stirpes
Name of decedent:
John 1. Kimmel
Last known address of decedent: Messiah Village, Mechanicsburg, PA 17055
Date of death: January 21, 2001
r- -
Place of death: Messiah Village
County of grant of original letters: Cumberland
Decedent died testate (with a Will).
A copy of the will is attached. *
Name (s), address (es) and telephone number (s) ofal! personal representatives appointed
Name
ROSE ANN WHITESELL
EXECUTRIX
Address
PO Box 240
Shawnee-on-Delaware, PA 18356
Telephone
!/7tJ - 1,2'/- lidO
Name (s), address (es) and telephone number (s) ofal! counsel
Name
JAMES M. BACH
A TTORNEY-A T-LA W
Address
352 South Sporting Hill Road
Mechanicsburg, PA 17055
Telephone
(717) 737-2033
Additional information may be obtained from the undersigned.
Date:
'Z- If ') If I
f- ~ J$--.A.,
Name: JAMES M. BACH
ATTORNEY-AT-LAW
Address: 352 South Sporting Hill Road
Mechanicsburg, P A 17050
(717) 737-2033
Capacity: Counsel for personal representative
Signature:
*This has been provided to you.
j0-dlt'.j /1
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
JAMES M BACH ATTY
352 S SPORTING HIll RD
MECHANICSBURG PA 170~O
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
07-30-2001
KIMMEL
01-21-2001
21 01-0187
CUMBERLAND
101
')t*
REV-1547 EX AFP 112-00l
JOHN
I
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=is'47-E:3f-AFP-n'2=ooY-NoYicE--oF-INHEifiTANci-YA'iC-APPRAisEMENY-;-ALLOWANCi-oi-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF KIMMEL JOHN I FILE NO. 21 01-0187 ACN 101 DATE 07-30-2001
TAX RETURN WAS: (X) ACCEPTED AS FILED
) CHANGED
I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
re~lect ~igures that include the total o~ ALL returns assessed to date.
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 CREDITS:
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. Hortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
(I)
(2)
(3)
(4)
(5)
(6)
(7)
13,000.00
.00
.00
.00
.00
.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. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
(10)
8,021.00
.00
(II)
(12)
(13)
(4)
NOTE:
.00 X
4,979.00 X
.00 X
.00 X
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
13,000.00
8.071 .. 00
4,979.00
.00
4,979.00
00 =
045 =
12 =
15 =
.00
224.06
.00
.00
224.06
(19)=
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
06-04-2001 AA496680 .00 224.06
TOTAL TAX CREDIT 224.06
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
* IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE
A DCCII..n <::'1'"1'" IlFUFRSI' SIDE OF THIS FORM FOR INSTRUCTIONS.)
0;
STATUS REPORT UNDER RULE 6.12
Name of Decedent: John T. Kimmel
Date of Death: January 21, 2001
Will No. 2001- 001 87
Admin. No.
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 X No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete:
3. If the answer to No. 1 is Yes, state the following:
a. Did the personal representative file a final
account with the Court? Yes No X
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 X No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be attached to this report.
#I~
Date: December 18, 2002
James M. Bach
ame (Please type or print)
352 S. Sporting Hill Road
Mechanicsburg, FA 17050
Address
(717) 737-2033
Te 1. No.
Capacity: Personal Representative
( MAH : rm f I AM 3 )
X Counsel for personal
representative
Cumberland County - Register Of Wills
Hanover and High Street
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 12/06/2002
ROSE ANN WHITESELL
POBOX 240
SHAWNEE-ON-DELAWARE, PA 18356
RE: Estate of KIMMEL JOHN I
File Number: 2001-00187
Dear Sir/Madam:
It has come to my attention that you have not filed the Status
Report by Personal Representative (Rule 6.12) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO.
103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after
July 1, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing will become delinquent on: 1/21/2003
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
MARY C. LEWIS
REGISTER OF WILLS
cc:
JFile
Counsel
Judge
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