HomeMy WebLinkAbout06-22-15 (2) pennsytvania 1505614105
oEpaarMENroF aEVEHUE EX(03-14)(FI)
REV-1500 OFFICIAL USE ONLY
Bureau of Individual Taxes County Code Year File Number
PO BOX 280601 INHERITANCE TAX RETURN
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
l^ I6 Z 8 O t 0
Decedent's Last Name Suffix Decedent's First Name MI
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
® 1.Original Return p 2.Supplemental Return p 3. Remainder Return(date of death
prior to 12-13-82)
O 4.Agriculture Exemption(date of C:D 5.Future Interest Compromise(date of O 6. Federal Estate Tax Return Required
death on or after 7-1-2012) death after 12-12-82)
7. Decedent Died Testate O 8.Decedent Maintained a Living Trust 9. Total Number of Safe Deposit Boxes
(Attach copy of will.) (Attach copy of trust.)
C=:) 10.Litigation Proceeds Received O 11. Non-Probate Transferee Return O 12. Deferral/Election of Spousal Trusts
(Schedule F and G Assets Only)
O 13. Business Assets O 14.Spouse is Sole Beneficiary
(No trust involved)
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
I obt�i>zL � ti1-t- 'T3Z-MLI
First Line of Address
Second Line of Address
City or Post Office State_ ZIP Code o
JQ i Fi�
I F
Correspondent's email address: V11AA" �UM UP , AR-r- r1 x
T—`
REGISTERLOF WILLS USE ONLY. f>
REGISTER OF WILLS USE ONLY
DATE FILED MMDDYYYY j (D —TI .T C')
s '
r Cz)
DATE FILED STAMP
PLEASE USE ORIGINAL FORM ONLY
Side 1
6 4� �iii�iiiii iim ilii iiia
0 1505614105
1505614205
REV-1500 EX(FI)
Decedent's Social Security Number
Ke
Decedent's Name: GIIr j g
RECAPITULATION i\
1. Real Estate(Schedule A). . .................. . ..... .......... .. ........ 1. b
2. Stocks and Bonds(Schedule B) . .. ............ .............. .......... 2. 1 It
3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) ..... 3.
4. Mortgages and Notes Receivable(Schedule D).. ........ ....... .......... 4.
5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E)....... 5. O
6. Jointly Owned Property(Schedule F) O Separate Billing Requested .... ... 6.
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) O Separate Billing Requested........ 7.
8. Total Gross Assets(total Lines 1 through 7)................ I da `4(, 2(Q, ZZ
9. Funeral Expenses and Administrative Costs(Schedule H)..... .... .......... 9.
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)..... .......... 10.
11. Total Deductions(total Lines 9 and 10)...... .... .. ........... ..........
12. Net Value of Estate(Line 8 minus Line 11) .......... .................... 12. ® � ®o
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. ( �' , �` 3 t V/ !
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.0-6- 15.
16. Amount of Line 14 taxable ---
at lineal rate X.OU 1 1 `�j�-7�3, R� 16.
17. Amount of Line 14 taxable --
at sibling rate X.12 17.
18. Amount of Line 14 taxable
at collateral rate X.15 , 18.
I
19. TAX DUE ... .. ........ ...........:...................... .......... 19.E �
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Under penalties of perjury,I declare 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 person responsible for filing the return is based on all information of which preparer has
any knowledge.
SI ATURE OF PE SON PO I LE FOR FILING RETURN DATE
AD SS �
SIGNAT OF RE RE ER AN PERSON RESPONSIBLE FOR FILING THE RETURN DATE
ADD ESS 1
3OL G114..c ,_ �ilt �� Pd t.rlii4 r;a lrlrz��
1 J111111111111111111111111iJJ 1111�i�J�11111111111111 Jill Side 2
0 6 4 1505614205
REV-1500 EX (FI) Page 3 File Number
Decedent's Complete Address:
DECEDENT'S NAME
STREETADDRESS h p {
CITY F^ STATE , ZIP ��S
�U1la
Tax Payments and Credits: t1
1. Tax Due(Page 2,Line 19) (1) j ((). 2
2. Credits/Payments
A.Prior Payments
B.Discount
(See instructions.) Total Credits(A+B) (2) (�
3. Interest
(3) b
4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2,Line 20 to request a refund. (4) n
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.
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.......................................................................................... ❑ XI
b. retain the right to designate who shall use the property transferred or its income ............................................ ❑
c. retain a reversionary interest .............................................................................................................................. ❑
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 1S 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 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 step-parent 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+(02-15)
Ila
pennsylvania SCHEDULE A
' DEPARTMENT OF REVENUE
REAL ESTATE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: V l� FILE NUMBER:
c brl A 12)
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.
ITEM include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE
NUMBER OF DEATH
DESCRIPTION
1' �4Z8 q larayui�r- S4 , P.rblA p 16-1 s5 _
T 2 i B la y- tv-e 3. En thk r h i n o-3,s I q., 0,4 t)
-A -cv �Enal� -Pr if)�l�S
JE
7.
• TOTAL(Also enter on Line 1, Recapitulation.) $# q 4 -9 460321c�
If more space is needed,use additional sheets of paper of the same size.
REV-1509 EX+(02-15)
pennsytvania SCHEDULE F
DEPARTMENT OF REVENUE JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
�riyrira .� , ktm pe R
If an asset became jointly owned within one year of the decedent's date of death,it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME(S) ADDRESS RELATIONSHIP TO DECEDENT
A. bMhLp Ked" 4 X25 l�ret?rzv:li�.. �c S
(
B. br,d 4, G UTq 14D N„ E-h-tA bn tVr,
644 ?A Ip7nS7
C.
JOINTLY OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENT'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER.ATTACH DEED FOR JOINTLY HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A. Fr IiI):: M"t".1 r- Is-r CU 0CCkUrL-r 344E_ 88 s0 �1?2Z.gt4
A P, I f 1109 P%w ce �3&Z.c� 33 4 .29
TOTAL(Also enter on Line 6, Recapitulation) $ 2l r7 Q Z —&e9
If more space is needed,use additional sheets of paper of the same size.
REV-1511 EX+(02-15)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
�I b�+A
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. j Ij!I v v a n rm rx-L . }&Ys - . ) CnaLC4 Pn I'1 b2s- T5 0 . DD
Wood1wh (t(h- ril'r 2, 13(a .0(D
66irvorI-es %313 4
RnitrALSineI0Vn-?-r-dj
ny S�jr+1 Sb,to
Rtv� �t I bTr- I DO .60
FVACM L LUn�fvm $3.S'?
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s)of Personal Representative(s)
Street Address
City State ZIP
Year(s)Commission Paid:
2. Attorney Fees:
3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation.)
Claimant
Street Address
City State ZIP
Relationship of Claimant to Decedent
4. Probate Fees:
5. Accountant Fees: 17-
6.
Z6. Tax Return Preparer Fees:
7. Cul s 24$ . q
MISC, ItS Tt7f— Q!ZTS (sTAvy\f s , P cn,e�-� 2 $4 W 10
TOTAL(Also enter on Line 9, Recapitulation) $ • 3
If more space is needed,use additional sheets of paper of the same size.
REV-1513 EX+(02-15)
Q7pennsytvania SCHEDULE DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF: 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 and transfers under
Sec.9116(a)(1.2).]
1.
oSd i 2 0960-1\11w ��� K�mi�- � 1
2 Livor, V G-U,;u ob—D
3' Rvapt E , Vempeg 30 ,0
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE.
II NON-TAXABLE DISTRIBUTIONS
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
TOTAL OF PART II—ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ tJ
If more space is needed,use additional sheets of paper of the same size.
U:\lifeplanportfolio\clients\Kemper,GlodaMill.revised.doc
February 25,2014
LAST WILL AND TESTAMENT
OF
GLORIA B.KEMPER
I, GLORIA B. ]KEMPER, of Enola, 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 anytime heretofore
made.
1. FAMILY.
1.1 Identification of Family. I declare that I am a widow and that I have three (3) children
whose names are DONALD LEROY KEMPER, LINDA K. GUTH and ROBERT E.
KEMPER.
1.2 Definition of Family Terms. As used in this Will,the terms "my child" or"my children"
refers to all my natural children and adopted children, now living or hereinafter born. As used in
this Will, the term "issue" refers to all lineal descendants of the indicated person of all
generations, with the relationship of parent and child at each generation determined by the
definition of"child/children" set forth in this paragraph.
2. PAYMENT OF BURIAL EXPENSES AND DEBTS. I authorize my executor to pay all the
expenses of(1) a funeral or memorial service; (2) the interment of my remains, including the
costs of a gravesite, if necessary; and (3) the installation and inscription of a suitable marker at,
and perpetual care of, the gravesite. I further direct my executor to pay all of my debts that my
executor in his or her sole discretion may allow as claims against my estate.
3. SPECIFIC BEQUESTS. I hereby devise and bequeath the following items of personal
property:
3.1 I leave my personal residence located on Lot 1 of the Final Minor Subdivision Plan of
Gloria B. Kemper, also known as 428 Lafayette Street, East Pennsboro Township, Enola,
Cumberland County,Pennsylvania,to my son,DONALD LEROY KEMPER.
3.2 I leave Lot 2 of the Final Minor Subdivision Plan of Gloria B. Kemper, located in East
Pennsboro Township, Enola, Cumberland County, Pennsylvania, to my daughter, LINDA
K. GUTH.
1
Q.ati d
Gloria B. Kemper
` U:Uifeplanportfolio\clients\Kemper,GlodaMill.revised.doc
February 25,2014
4. DISPOSITION OF TANGIBLE PERSONAL PROPERTY. I direct my executor to divide
my tangible personal property into two parts. The first part shall contain all items that my
executor determines, to be of no present or future value or use to my children. The second part
shall contain the balance of the property. My executor shall dispose of the first part by sale,
abandonment, destruction, or gift to any charity or person. The proceeds of any sale shall be
added to my residuary estate. All property in the second part I give to my children, in
substantially equal shares, to be divided among them as they shall agree. If no agreement is
reached within (60) days after my death, all property in the second part shall be divided among
all my children in such manner as my executor shall direct. The decision of my executor shall be
conclusive and binding on all persons interested in my estate.
5. DISPOSITION OF RESIDUARY ESTATE. All of the rest, residue and remainder of the
property that I own at the time of my death, both real and personal, and of every kind and
description, wherever situated, to which I may be legally or equitably entitled at the time of my
death(my"residuary estate"),I leave as follows,per stirpes:
5.1 Forty percent(40%)to my son,DONALD LEROY KEMPER.
5.2 Thirty percent(30%)to my daughter,LINDA K. GUTH.
5.3 Thirty percent(30%)to my son, ROBERT E. KEMPER.
The distribution of my residuary estate as set above shall be adjusted further with regard to any
Florida properties that I may own at the time of my death titled along with any of my children, so
that any child not titled on the Florida properties at said time will receive their proportionate
share of the appraised value of the Florida properties that they would have received had.they also
been titled on said deeds though a distribution from my residuary estate.
6. IN TERROREM. If any devisee, legatee or beneficiary of any gift under this Will directly or
indirectly objects to the probate of this Will or contests this Will or any part thereof or exercises
or attempts to exercise any right of election to take any part of my estate against the provisions of
this Will,then any such objecting or contesting devisee, legatee or beneficiary shall be treated for
the purposes of this Will as if he or she had predeceased me, and any devise, legacy or bequest of
any kind intended for him or her shall be void and of no effect.
7. POWERS OF ADMINISTRATION.
7.1 Grant of Powers. My executor, in the administration of my estate, (my "fiduciaries")
shall have the powers and authorities set forth in this Article 7. These powers and authorities
may be exercised by my executor in his sole and absolute discretion, without the permission or
order of any court. These powers shall be supplementary to those conferred by law, including,
2
Q � ,
Gloria B. Kemper
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February 25,2014
but not limited to, those set forth in Title 20, Chapter 33, of the Pennsylvania Consolidated
Statutes.
7.2 Retention of Assets. My fiduciaries shall have the power to retain any or all property of
my estate or trust, however received and acquired, for so long as they deem appropriate. This
power may be exercised even though the property may not be of the type authorized by law for
investment, and even though the retention may leave a disproportionately large amount of the
value of my estate invested in one type of property.
7.3 Transfer of Assets. My fiduciaries shall have the power to sell,transfer, and convey any
property, of whatever nature, including real property, and wherever situated, that I may own at
the time of my death, or that may come into my estate or into the trust corpus at or after my
death. The sale, transfer, or conveyance may be by public or private sale, at such time, on such
terms and conditions, including selling price and credit, in such manner, and for any reason that
my fiduciaries deem appropriate, including, but not limited to, the purpose of obtaining net
proceeds to be distributed to my residuary beneficiaries.
If anyone is residing in any of the properties that I own at the time of my death, they
either need to vacate within three(3)months of my death or enter into a short-term lease with my
Estate and pay reasonablee market value rent until the property is sold at which time they must
vacate the property so as not to impair the marketability of the property.
7.4 Investment. My fiduciaries shall have the power to invest and reinvest any property in
my estate or in the trust corpus in preferred and common stocks, bonds, notes, common trust
funds(including any managed by any corporate fiduciary), interests in investments,trusts,mutual
funds, leases, mortgages on property wherever located, and, generally, in any property and in
proportions of property as my fiduciaries deem advisable, even though the investments are not of
the character or proportions authorized by applicable law for the investment of the funds.
7.5 Power to Borrow. My fiduciaries shall have the power to borrow money for any
purpose, for any periods of time, and on any terms and conditions as they deem advisable
(including the power to borrow from any corporate fiduciary), and to pledge, mortgage, or
otherwise encumber any property in my estate or in the trust corpus to secure repayment of any
loan, as well as the power to renew existing loans either as maker or endorser.
7.6 Power to Hold Property in Nominee Form. My fiduciaries shall have the power to
hold any property in the name of a nominee or in bearer form.
7.7 Distribution in Cash or in Kind. My fiduciaries shall have the power to make
distributions in cash or in kind, or partly in cash, in divided or undivided interests, as amended,
3
. q o +�. fov
Gloria B. Kemper
U:Uifeplanportfolio\ciients\Kemper,GloriaWILrevised.doc
February 25,2014
or other applicable law, and to determine which assets shall be sold and which shall be
distributed in kind,without notice to or consent by any beneficiary.
7.8 Distribution to Minors and Persons Under Disability. My fiduciaries shall have the
power to make distributions or payments to or for the benefit of any beneficiary who is a minor,
an incompetent, or who in the fiduciaries' judgment is incapacitated. The distributions or
payments shall be made in any one or more of the following ways: (1)directly to the beneficiary;
(2) directly to the creditor in payment of the debts or expenses of the beneficiary; (3) to the
guardian of the person or estate of the beneficiary; (4) to any custodial parent of a minor
beneficiary; (5) to a custodian for the beneficiary under any law related to gifts to minors,
including to my fiduciaries in that capacity; or (6) to any other person who shall have the care
and custody of the person of the beneficiary. There shall be no duty to see to the application of
funds so paid, provided due care was exercised in the selection of the person to whom the funds
were paid, and the receipt of the person shall be full acquittance of the fiduciaries.
7.9 Continuation or Liquidation of Business. My fiduciaries shall have the power to
continue•or to permit the continuation of any business, incorporated or unincorporated, in which I
may have any interest at the time of my death for any period of time, or to liquidate the business
on any terms as they deem appropriate. This power includes, but is not limited to (1) the power
to invest additional sums in any business, even to the extent that my estate or the trust corpus
may be invested largely or entirely in the business, without liability for any loss resulting from
lack of diversification; (2) the power to act as or to select other persons to act as directors,
officers, or employees of any business, to be compensated without regard to being a fiduciary
under this Will; and (3) the power to make any other arrangements in regard to any business as
my fiduciaries shall deem proper.
7.10 Emulovment of Agents. My fiduciaries shall have the power to employ and pay the
compensation of any and all attorneys, agents, custodians, attorneys-in-fact, experts, investment
counsel, accountants, bookkeepers, or other agents or providers of services as my fiduciaries
deem advisable in the administration of my estate.
7.11 Commissions. My fiduciaries shall have the power to take reasonable commissions on
account at any time during the administration of my estate or of the trust without the approval of
any beneficiary or of the court, but subject to allowance or disallowance on the settlement of the
final accounts of my fiduciaries.
7.12 Third Party Reliance. No person or corporation dealing with my executor shall be
required to see to the application of any property paid or delivered to my executor, or to inquire
into either the authority of my executor to enter into any transaction or the expediency or
propriety of any transaction entered into by my executor.
4
Gloria B. Kemper��
U:\Iifeplanportfolio\Gients\Kemper,Gloria\WILrevised.doc
February 25,2014
8. PAYMENT OF DEATH TAXES. I direct that all federal and Pennsylvania estate taxes
payable as a result of taxes assessed on property passing under this Will shall be paid from my
residuary estate as a part of the expenses of the administration of the estate.
9. EXECUTOR.
9.1 Appointment. I name, constitute, and appoint my son, DONALD LEROY KEMPER,
as executor of my estate.
9.2 Bond Not Required. The individual named in Section 9.1 shall be required to furnish a
bond for the faithful performance of his duties as executor.
10. PRESUMPTION IN CASE OF SIMULTANEOUS DEATH. For the purposes of this Will, in
determining whether a person has survived me, a person shall not be deemed to have survived me
or another person if he or she dies within sixty (60) days of my death or of the death of the other
person.
11. LIABILITY OF EXECUTOR. My executor shall not at any time be liable for mistake of law
or of fact, or both law and fact, or errors of judgment, nor for any loss coming to any beneficiary
under this Will, or to any other persons, except through actual fraud or willful misconduct on the
part of the executor. My executor may, from time to time, consult with counsel with respect to
the meaning, construction, and operation of this Will, particularly with respect to the
appointments, allocations, and disbursements, and may act on the advice of counsel in all matters
without incurring liability on account of his or her actions.
12. INTERPRETATION.
12.1 Successors of Fiduciaries. All pronouns referring to an executor and the term
"executor" shall be construed to mean any person acting as my executor, co-executor, or
administrator, as the case may be.
12.2 Number and Gender. If required by the context of this Will, singular language shall be
construed as plural, plural language shall be construed as singular, and the gender of personal
pronouns shall be construed as either masculine,feminine, or neuter.
12.3 Headings. All headings used in this Will to describe the contents of each article,
paragraph, or other division are provided for convenience only and shall not be construed to be a
part of this Will.
5
Gloria B. Kemper
U:Uifeplanportfolio\clients\Kemper,GloriaMill.revised.doc
February 25,2014
12.4 Governing Law. This Will shall be construed in conformity with the law of the
Commonwealth of Pennsylvania.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and
Testament, consisting .of seven (7) typewritten pages which bear my signature for the purpose of
identification,this at day of February, 2014.
GLORIA B.KEMPE , Testatrix
Signed, sealed, published and declared by the above-named Testatrix, GLORIA B. KEMPER,
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 as
witnesses.
2331 Market Street, Camp Hill, PA 17011
Witness Address
2331 Market Street, Camp Hill,PA 17011
Witness Address
6
+ U:\Iifepianportfolio\cfrents\Kemper,Gloria\Will.revised.doc
February 25,2014
COMMONWEALTH OF PENNSYLVANIA )
. SS.
COUNTY OF CUMBERLAND )
I, GLORIA B. KEMPER, 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 ACKNOWLEDGED BEFORE ME BY GLORIA B. KENIPER,
THE TESTATRIX,THIS 9T' DAY OF FEBRUARY,2014.
COMMONWEALTH OF PENNSYLVANIA GLORIA B.KEMPIER,TE TATRIX
Notarial Seal
Jennifer S.K.Gross,Notary Public
Camp Hili Boro,Cumberland County
My Commission Expires Sept 11,2016
MEMBER,PENNSYLVANIA ASSOCIATION OF NOTARIES
(:N:O:3T0BLIC
COMMONWEALTH OF PENNSYLVANIA )
SS.
COUNTY OF CUMBERLAND )
WE, 'r AND THE
WITNESSES WHOSE NAMES ARE SIGNED TO THE FOREGOING INSTRUMENT, BEING DULY
QUALIFIED ACCORDING 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 OF
FEBRUARY,2014.
,9\'0N\K\ 1�4� L-
SS
WITNESS
NO PUBLIC
COMMONWEALTH OF PENNSYLVANIA_._
Notarial Seat
Jennifer S.K.Gross,Notary Public
7 Camp Hill Soro,Cumberland Coultty
My Commission Expires Sept 11 2016
MEMBER,PENNSYLVANIA ASSOaATWN Of NWARM
BUREAU OF INDIVIDUAL TAXES Pennsylvania Inheritance Tax R _ pennSyLVanla
PO BOX 280601 DEPARTMENT OF REVENUE
HARRISBURG PA 17128-0601 Information Notice
And Taxpayer Response ------ BE"_1543 E%DocEXEL (0842)
FILE NO.21
ACN 14161017
DATE 11-10-2014
Y
Type of Account
Estate of GLORIA B KEMPER Savings
SSN Checking
Date of Death 10-28-2014 Trust
'DONALD L KEMPER i County CUMBERLAND Certificate
925 WERTZVILLE RD
ENOLA PA 17025-1837
{MEMBERS IST FCU provided the department with the information below indicating that at the death of the
above-named decedent you were a joint owner or beneficiary of the account identified.
Account No.407508 Remit Payment and Forms to:
Date Established 01-18-2011 REGISTER OF WILLS
Account Balance $3,445.88 1 COURTHOUSE SQUARE
Percent Taxable X 50 CARLISLE PA 17013
Amount Subject to Tax $ 1,722.94
Tax Rate X 0.045
Potential Tax Due $77.53 NOTE': If tax payments are made within three months of the
decedent's date of death, deduct a 5 percent discount on the tax
With 5%Discount(Tax x 0.95) $(see NOTE`) due. Any inheritance tax due will become delinquent nine months
after the date of death.
PART Step 1 : Please check the appropriate boxes below.
1
A F�No tax is due. I am the spouse of the deceased or I am the parent of a decedent who was
21 years old or younger at date of death.
Proceed to Step 2 on reverse. Do not check any other boxes and disregard the amount
shown above as Potential Tax Due.
B ❑The information is The above information is correct, no deductions are being taken, and payment will be sent
correct. with my response.
Proceed to Step 2 on reverse. Do not check any other boxes.
C El The tax rate is incorrect. ❑ 4.5% 1 am a lineal beneficiary(parent,child,grandchild,etc.) of the deceased.
(Select correct tax rate at
right, and complete Part F_� 12% 1 am a sibling of the deceased.
_ 3 on reverse.)
❑ 15% All other relationships (including none).
D F—]Changes or deductions The information above is incorrect and/or debts and deductions were paid.
listed. Complete Part 2 and part 3 as appropriate on the back of this form.
E Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax
inheritance tax form Return filed by the estate representative.
EV-1500. Proceed to Step 2 on reverse. Do not check any other boxes.
Please sign and date the back of the form when finished.
PART
2 Debts and Deductions
Allowable debts and deductions must meet both of the following criteria:
A. The decedent was legally responsible for payment,and the estate is insufficient to pay the deductible items.
B. You paid the debts after the death of the decedent and can furnish proof of payment if requested by the department.
(If additional space is required,you may attach 8 1/2"x 11"sheets of paper.)
Date Paid Payee Description Amount Paid
Total (Enter on Line 5 of Tax Calculation) $
PART Tax Calculation
3
PART
If you are making a correction to the establishment date Line 1 account balance Line 2 or percent taxable Line 3
Y 9 � ) ( )� p � ),
please obtain a written correction from the financial institution and attach it to this form.
1. Enter the date the account was established or titled as it existed at the date of death.
2. Enter the total balance of the account including any interest accrued at the date of death.
3. Enter the percentage of the account that is taxable to you.
a. First,determine the percentage owned by the decedent.
i. Accounts that are held"intrust for"another or others were 100%owned by the decedent.
ii. For joint accounts established more than one year prior to the date of death,the percentage taxable is 100%divided
by the total number of owners including the decedent. (For example:2 owners=50%, 3 owners=33.33%, 4 owners
=25%, etc.)
b. Next, divide the decedent's percentage owned by the number of surviving owners or beneficiaries.
4. The amount subject to tax is determined by multiplying the account balance by the percent taxable.
5. Enter the total of any debts and deductions claimed from Part 2.
6. The amount taxable is determined by subtracting the debts and deductions from the amount subject to tax.
7. Enter the appropriate tax rate from Step 1 based on your relationship to the decedent.
If indicatinga different tax rate, lease state I al,
g ` \\\ `
pOtfCI Use ly AAF `
your relationship to the decedent: v vis v
V �C'7c� m£le1�'nt
1. Date Established 1 gg`
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1 \
PDQ v y vy 1A
2. Account Balance 2 $ ��
3. Percent Taxable 3 X 4- 000` vvv vy
ver �` O vvv vAV v� a �� A
4. Amount Subject to Tax. 4 $ vvv vv v y ov
1 \ � AA ao ��j\ `
5. Debts and Deductions 5 - ` �vv � � `
6. Amount Taxable 6 $ vv v 10' O
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7. Tax Rate 7 X �v y� `�yt v ti0v
\\ \\ ° \ W
051 `
8. Tax Due 8 $ \\ ` \ \\ \,\\
° Discount(Tax x .95) 9 w �\ .. \ .. .. ._ JIM'—
Step
:.... \:\
9. With 5/° X v_�v., v v�� �� a� v
Step 2: Sign and date below. Return TWO completed and signed copies to the Register of Wills listed on the front of this form,
along with a check for any payment you are making. Checks must be made payable to"Register of Wills,Agent." Do not send
payment directly to the Department of Revenue.
Under penalty of perjury, I declare that the facts I have reported above are true,correct and complete to the best of my knowledge and
belief.
Work
Home
Taxpayer Signature Telephone Number Date
IF YOU NEED FURTHER ASSISTANCE, CONTACT PENNSYLVANIA DEPARTMENT OF REVENUE
DISTRICT OFFICE, OR THE INHERITANCE TAX DIVISION AT 717-787-8327. SERVICES FOR
TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-447-3020