HomeMy WebLinkAbout01-0213
Estate of SHEILA L. KACHMAR
also known as
Register of Wills of CUMBERLAND County, Pennsylvania
PETITION FOR GRANT OF LETTERS
No. 21-01- ~ 13
, Deceased
Social Security No. 061-36-9758
GEORGE A. KACHMAR
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW)
[!] A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the execut or
the Decedent, dated 04/25/1980 and codicil(s) dated None
NONE
named in the last Will of
State relevant circumstances, e.g., renunciation, death of executor, etc.
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents
offered for probate; was not the victim of a killing and was never adjudicated incompetent:
NONE
o B. Grant of Letters of Administration
(c.t.a.; d.b.n.c.t.a; pendente lite; durante absentia; durante minoritate)
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and
heirs:
I
Name
Relationship
Residence
I
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in CUMBERLAND
County, Pennsylvania with his/her last family
or principal residence at 1007 ACRE DRIVE, BOROUGH OF CARLISLE
(list street, number, and municipality)
Decedent, then ~years of age, died 06/24/2000 at CARLISLE HOSPITAL, PA
(Location)
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property
(If not domiciled in PAl Personal property in Pennsylvania
(If not domiciled in PAl Personal property in County
Value of real estate in Pennsylvania
1,000.00
$
$
$
$
situated as follows:
NOT APPLICABLE
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of
letters in the a ro riate form to the undersi ned:
ture
GEORGE A. KACHMAR
1007 ACRE DRIVE, CARLISLE, PA 17013
Prepared by the Pennsylvania Bar Association
Copyright (c) 1996 form software only CPSystems, Inc.
Form RW-1 (1991)
Oath of Personal Representative
Commonwealth of Pennsylvania
County of CUMBERLAND
The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true
and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal p sentative(s) of
the Decedent, Petitioner(s) will well and truly administer the estate according to la
Sworn to or affirmed and subscribed
GEORG
before me this~day of
FEBRUARY
2001
Fo,~R'g'.re' k1&tn~
No. 21-01- 213
Estate of SHEILA L. KACHMAR
Deceased
Social Security No: 061- 36 - 9758 Date of Death: 06/24/2000
AND NOW,
FEBRUARY 23.
, ?001 ,in consideration
of the Petition on the reverse side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters ~ Testamentary D Of Administration
(c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; durante minoritate)
are hereby granted to
GEORGE A. KACHMAR
in the above estate and that the instrument(s) dated
04/25/1980
described in the Petition be admitted to probate and filed of record as the last Will of Decedent.
Letters. . . . . . .
$
18.00
---I
IlfuO W~~ et:Jm ~.
egister of Wills
FEES
Short Certificate(s). (3) $
Renunciation. $
Affidavits ( $
Extra Pages ( 2 ) . $
Codicil. $
JCP Fee. $
Inventory. $
Other $
9.00
Attorney:
ROGER M. MORGENTHAL, ESQUIRE
6.00
1.0. No: 17143
FISHMAN & MORGENTHAL
Address; SUITE 3
95 ALEXANDER SPRING ROAD
CARLISLE, PA 17013
5.00
Telephone: 717/249-6333
TOTAL. . . . . . . " $ 38.00
Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, Inc.
Form RW-1 (1991)
H105.805 REV 9/86
This is to certifY that the information here given is correctly copied from an original certificate of death duly filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00
p
6630674
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Date
H105.i43A." 2187
COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS
CERTIFICATE OF DEATH
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of
SHEILA L. KACHMAR
KNOW ALL MEN BY THESE PRESENTS:
That I, SHEILA L. KACHMAR, a legal resident of New Jersey,
being of sound and disposing mind and memory, and being over
twenty-one years of age, do hereby make, publish, and
declare this to be my Last Will and Testament, and do intend
hereby to dispose of my entire estate, inCluding, but not
limited to, property which I own or have the power to appoint,
in manner and form as follows, that is to say:
ITEM 1. I revoke all Wills, Codicils, and testamentary
gifts heretofore made by me.
ITEM 2. I direct that my funeral expenses and administration
expenses, and those of my debts which may be legally due and
owing at the time of my death, be paid as soon after my
death as is practicable.
ITEM 3. I nominate and appoint my husband, GEORGE A. KACHMAR,
as executor of this my Will. In the event my said executor
shall fail or refuse for any reason to qualify as executor
of this my Will, then I nominate and appoint as alternate
executor, my father-in-law, JOHN KACHMAR, of Waterbury,
Connecticut, and I direct that said executor or alternate
executor, as the case may be, shall serve without bond,
surety, or security.
ITEM 4. I give said executor or alternate executor, as the
case may be, the fullest power and authority in all matters
and questions, including without limitation, complete power
and authority to sell at public or private sale, for cash or
credit, with or without security, mortgage, lease, and
otherwise dispose of all property, real, personal, and
mixed, owned by me at my death, at such times and upon such
terms as said executor or alternate executor may determine,
all without court order.
ITEM 5. I give, devise, and bequeath, absolutely and forever,
all my property, real, personal, and mixed, owned by me at
my death to my beloved husband if he survives me, and if he
does not so survive me, then in equal shares to my children,
SHAWN A. KACHMAR, ALISIA E. KACHMAR, JILL V. KACHMAR, and to
any child or children that may be born to me or adopted by
me hereafter who shall survive me, and to the issue, living
at my death, of such of my children as shall predecease me,
such issue to take per stirpes and not per capita.
ITEM 6. If neither my said husband, nor any of my children
or their issue shall survive me, then and in that event
only, I give, devise, and bequeath, my entire estate in
equal shares to my husband's parents, JOHN and ANNA KACHMAR,
of Waterbury, Connecticut and my parents, MAX and fAY PERESMIK,
of Bronx, New York.
PAGE ONE OF THREE PAGES
c-h-,--..<ol.~ac~cLf-'/
PPC~Korea
ITEM 7. In the event my hus.band predeceases me or is otherwise
unable to qualify, then and in that event only, I hereby
nominate and appoint my husband's parents, JOHN and ANNA
KACHMAR as guardians of my surviving minor child or children
and as substitute guardians JULIUS and SHIRLEY PERRY, of New
Rochelle, New York, both to serve without bond, surety, or
security. I hereby charge and direct the guardians or
substitute guardians of my said child or children to pay all
sums reasonably necessary for the proper education, support,
maintenance, and welfare of said child or children.
ITEM 8. Although my husband and I are making Wills with
similar provisions, each of us does so only because we are
presently of one mind concerning the dispositions of our
estates; our Wills are not contractual, reciprocal, or
dependent upon one another; and I explicitly retain the
right to change or revoke my Will at any time, either before
or after the death of my husband.
ITEM 9. If any legatees or devisees should die simultaneously
with me or under such circumstances as to render it difficult
or impossible to determine who predeceased the other, I
declare that I should be deemed to have survived such legatee
or devisee and that this Will and all of its provisions
shall be construed upon that assumption and basis.
ITEM 10. Wherever in this my LAST WILL AND TESTAMENT it lS
provided that any person shall benefit hereunder if such
person shall survive me, such person shall be deemed not to
survive me, if he or she shall die within thirty (30) days
after my death, or at the same time as I, or in a common
disaster with me, or under such circumstances that is difficult
or impossible to determine which of us died first.
. 2/i"
IN REOr, I have at Seoul, Korea, thls I-) -
day of G' 'h..- , 1980, set my hand and seal to this
my LAST WI L AND TESTAMENT, consisting of three typewritten
pages, this included, the preceding page and the following
page hereof bearing my signature.
C-kJQ L.~JI.iL~L(-
SHEILA L. KACHMAR
The foregoing instrument, consisting of three (3)
tYJ?ewri!~n pages, this inclu<;ied, was at SeOUl? Korea,
thls 2~-- day of C'-\~Ll , 1980, slgned, sealed,
published, and declared by the above-named testatrix to be
her LAST WILL AND TESTAMENT, in the presence of all of us at
one time, and at the same time, we, at her request, and in
her presence, and in the presence of each other, have hereunto
subscribed our names as attesting witnesses, and we do
verily believe that the said testatrix is of sound and
disposing mind and memory at the date hereof.
PAGE TWO or THREE PAGES
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PAGE THREE Or THREE PAGES
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21 - 01 - 213
P:\roger\estate admin\Kachmar Estate\Nonsubscribing witness oath.doc
OATH OF NON-SUBSCRIBING WITNESS
Ge'~( ~. k4.c4tJ1/.ir r Ro1t". fL1. #1AOr)u.ft.I\./
(each) a subscriber thereto, (each) being duly qualified according to law, depose(s) and
say(s) that he/she is familiar with the signature of SHEILA L. KACHMAR, Testatrix of
the Will presented herewith, and that he/she believes the signature on the Will is in the
handwriting of SHEILA L. KACHMAR, to the best of his/her knowledge and belief.
Sworn to or affirmed and subscribed
/~~
(name)
. U OJ Itcrc I)'"'.
Ct4,,'lL/c. P'" 701 J
(address)
Before me this 9TH day of
t
REV-1500 EX + (6-00) OFFICIAL USE ONLY
COMMONWEALTH OF PENNSYLVANIA REV-1500 /c;, - :J. /:2 - II
DEPARTMENT OF REVENUE
DEPT. 260601 INHERITANCE TAX RETURN FILE NUMBER
HARRISBURG, PA 17128-0601 RESIDENT DECEDENT 21 01 00213
COUNTY CODE YEAR NUMBER
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
KACHMAR, SHIElA L. 061-36-9758
DECE- DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE
DENT
06/24/00 11/27/1945 WITH THE REGISTER OF WILLS
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LA:>T, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
KACHMAR , GEORGE A.
B 3. Remainder Return
CHECK r Original Return ~' Supplemental Return (date of death prior to 12-13-82)
APPRO- 4. Limited Estate 4a. Future Interest Compromise 5. Federal Estate Tax Return Required
(date of death after 12-12-82)
PRIATE 6. Decedent Died Testate 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes
(Attac:hcopyofWillj (Attach acopyofTrust)
BLOCKS 9. Litigation Proceeds Received 10. Spousal Poverty Credit (date of death between D 11. Election to tax under Sec. 9113(A)
12-31-91 and 1-1-95) (Attach Sch 0)
jjjl$$j;;Q'1'jPNMQ$'tIlj;;iCQM!1~tiiAUi.!Cpljljj;;$!lQ&;lj;;ij$!i.eQNFibe!ftlNiitt.Xjl-!!@IlMAnol-!lIllo!lWileblllj;;ljfl;;PTi:l!
NAME COMPLETE MAILING ADDRESS
COR- ROGER M. MORGENTHAL, ESQUIRE SUITE 3
RE- FIRM NAME (If Applicable) 95 ALEXANDER SPRING ROAD
SPON
DENT FISHMAN & MORGENTHAL CARLISLE, PA 17013
TELEPHONE NUMBER
717-249-6333
None OFFICIAL USE ONLY
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2) l'J'one
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) NOne .
4. Mortgages & Notes Receivable (Schedule D) (4) None
5. Cash, Bank Deposits & Miscellaneous Personal
Property (Schedule E) (5) 832.21
6. Jointly Owned Property (Schedule F)
D Separate Billing Requested (6) 14,308.97
RECA-
PITULA- 7. Inter-Vivos Transfers & Miscellaneous
TION Non-Probate Property (Schedule G or L) (7) None
8. Total Gross Assets (total Lines 1-7) (8) 15,141.18
9. Funeral Expenses & Administrative Costs (Schedule H}(9) 8,165.04
10. Debts of Decedent, Mortgage Liabilities, &Liens(Schedule I) (10) None
11. Total Deductions (total Lines 9 & 10) (11) 8,165.04
12. Net Value of Estate (Line 8 minus Line 11) (12) 6,976.14
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax (13) None
has not been made (Schedule J)
14. Net Value SUbJect to Tax (Line 12 minus Line 13) (14) 6,976.14
SEE INSTRUCTIONS ON PAGE 2 FOR APPLICABLE RATES
15. AmountoT Line 14taxableatthespousaltax
rate, or transfers under Sec. 9116(aX1.2) 832.21 X .0 0 (15) 0.00
TAX 16. Amount of Line 14 taxable at Imeal rate 6,143.93 X .0 60" (16) 368.64
-
COMPU- 17. Amountof Line 14taxableatsiblingrate 0.00 X .12 (17) 0.00
TATION 18. Amount of Line 14 taxable at collateral rate 0.00 x.15 (18) 0.00
19. Tax Due (19) 368.64
20. D ICHi;cKij!\.llEIFYOVAF!l!aI!Q()I!$TIij$AaeBiNPoKANPVl$a.PAYMl!I'I't!
o PA15001
NTF 29755
>> BE SURE TO ANSWER ALL QUESTIONS ON. PAGE. 2 AND RECHECK MATH~<
Copyright 2000 QreatlandfNelco LP - Forms Software Only
Estate of: SHIELA L. KACHMAR
SUMMARY OF ALLOCATIONS TO BENEFICIARIES
Taxable at lineal rate
JILL KACHMAR
ALISIA E. KACHMAR
SHAWN A. KACHMAR
2,047.98
2,047.98
2,047.97
6,143.93
21-01-00213
PA REV-1500 EX (6-00)
D ' C
Page 2
ecedent S omolete Address:
STREET ADDRESS
1007 ACRE DRIVE
CITY I STATE I ZIP
CARLISLE PA 17013
Tax Payments and Credits:
1. Tax Due (Page 1 Une 19)
2, Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
0.00
0.00
Total Credits (A + 6 + C)
(2)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
0.00
0.00
368.64
0.00
(3) 0.00
(4)
(5) 368.64
(5A) 0.00
(56) 368.64
TotallnteresVPenalty (0 + E)
4. If Une 2 is greater than Line 1 + Une 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 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.
A. Enter the interest on the tax dUB.
S. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
Make Check Payable to: REGISTER OF WillS, AGENT
~r~~~~~~~!~~+A~~8rr8!i~d8d~~+l8~~~~~tR~i~ax~:~~l;i~+~~~~~~6~~i~+~~C62~;?
1. Did decedent make a transfer and:
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; .....,...
C. retain a reversionary interest; or. . , . . . . . . . . . . . . . . . , . . . . . . . . . , . . , . . . . . . . . . . . , . . . . . . . .
d. receive the promise for life of either payments, benefits or care? .. . . . , . . . . . . . . . . . . . . . , . . .
2. If death occurred after December 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? . . . . . . . . . . . . . . , . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . , . . . . " 0
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my
knowledge and behef, it is true, correct and co I . eclaration of preparer other than the personal representative is based on information of
which re arer has an knowled e.
SIGNATURE OF PERSON RESPONSI6L 0 III RETURN DATE 'if vt! b I
ADDRESS
SIG
ADORE S
95 ALEXANDER SPRING ROAD, SUITE 3, CARLISLE, PA 17013
Yes No
~ I
B ~
~
DATE
/7/01
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~~:/~~:i~~::~:~:;:~:~~'tk~,~,;,~.t~A~/j~T/:l~;;;~;:~;~;~::~:~-;tb~f'~';~:j'~~:~:~~:/{;'\:~:~:~~:T~::~\~~:;~~~;':;'~:~:~'~:~Xg~\~:~:';~:;r~~;:~:~:'~/t;;~;n'~'f~~:~;'t~';'~'~:~'~/i'h::~:-~~:~::~:t~'h':
~:-~~;~'~i~I'~:~:'~:~:~~:~:~Y;::3~X::;':'"
(72P.S.1i 9116(a)(1.1)(i)].
For dates of death on or after January 1, 1995, the tax rate is imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. Ii 9116 (a) (1.1) (ii)].
The statute nn..", nnt .."..mnt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of asset$ and filing a tax return are still applicable even if
the surviving spouse IS the only beneficiary.
For dates of death on orafter July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent. an adoptive parent,
ora stepparent of the child isO% [72 P.S.li9116(a)(1.2)].
The tax rate imposed on the net value of transfers to or forthe use of the decedent's lineal beneficiaries is 4,5%, except as noted In 72.P.S, Ii 9116(1.2) [72 P.S.!i9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P,S. !i9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual
who has at least one parent in common with the decedent, whether by blood oradoptlon,
o PA15002
NTF 29756
Copyright 2000 GreatlandlNelco LP- Forms Software Only
1Jjant 1IIIIil1 aub IDrntamrut
uf
SHEILA L. KACHMAR
KNOW ALL MEN BY THESE PRESENTS:
That I, SHEILA L. KACHMAR, a legal resident of New Jersey,
being of sound and disposing mind and memory, and being over
twenty-one years of age, do hereby make, publish, and
declare this to be my Last Will and Testament, and do intend
hereby to dispose of my entire estate, including, but not
limited to, property which I own or have the power to appoint,
in manner and form as follows, that is to say:
ITEM 1. I revoke all Wills, Codicils, and testamentary
gifts heretofore made by me.
ITEM 2. I direct that mv funeral expenses and administration
(lye, / j/ .(:lu://;i", ~I/' residing at
j -/'.. ( /./.'~ '-
. ,(..'llll'~ ~. ~ ''')/.,...L J)it-, 1If...
/ '
,-~~i. i:r .'JL. .Acr2,e...~ residing at
v ,.
:t;2z.<-t j, BJlL.j)~/'J
/.~yf Iv)j~~~
J),.:/ /I( ;:/' Ii. / t J (> /./
SSAN
SSAN
residing at
SSAN
.,/
/ ~.. I .I, <. ..
v?s ':-'-4. - ~ ,/ l,'...----- "t.'-~( ,.'
:;2-;;'.g - I..:;; - H 4:'? ij
t.> I~ J/
..c:i.e-e.......-f" \, 6JL.'.C"_
/
::L,~c. -.r9 - II J jy1J
~ ..-
tl....~. / /6;,;,;
- ,..."
4JF-tr>//:'-lt,
Members~'"
FEDERAL CREDIT UNION
t(Q)f~
REGULAR SAVINGS ACCOUNT:
Account Number/ Suffix
Date Account Opened
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest
Name of Joint Owner
166419 -00
03/04/1997
$668.98
$1.21
$670.19
Jill Kachmar/
George Kachmar
03104/1 997
Date Joint Ownership Created
CHECKING ACCOUNT:
Account Number/Suffix
Date Account Opened
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest
Name of Joint Owner
166419 -11
03/04/1 997
$2,012.10
$.00
$2,012.10
Jill Kachmar/
George Kachmar
03/04/1997
Date Joint Ownership Created
CERTIFICATES OF DEPOSIT:
Account Number/Suffix
Date Purchased
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest
Maturity Date
Name of Joint Owner
166419 -41 18 MO
12/15/1997
$1,142.71
$3.45
$1,146.16
12/13/2000
Jill Kachmar/
George Kachmar
12/1 5/1 997
166419 -II
Date Joint Ownership Created
Certificate Purchased by Transfer
CERTIFICATES OF DEPOSIT:
Account Number/Suffix
Date Purchased
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest
Maturity Date
Name of Joint Owner
166419-46 18 MO
12/31/1998
$1,070.95
$3.27
$1,074.22
06/30/2000
Jill Kachmar/
George Kachmar
12/31/1 998
166419 -II
Date Joint Ownership Created
Certificate Purchased by Transfer
Page One
INSURANCE DEPARTMENT
5000 LOUISE DRIVE
P. O. BOX 40
MECHANICSBURG, PA 17055
1-800-283-2328or(717)697-1161
188634 -00
10/28/1 999
$3,354.24
$6.17
$3,360.41
George Kachmar
10/28/1999
166419-42 18 MO
03/02/1 998
$1,133.30
$3.66
$1,136.96
02/28/200 I
Jill Kachmar/
George Kachmar
03/02/1 998
166419-11
166419-47 18 MO
01/29/1999
$1,066.13
$3.22
$1,069.35
07/29/2000
Jill Kachmar/
George Kachmar
01/29/1999
166419 -II
Sheila Kachmar - 000 Values
Page Two
t~f1f
CERTIFICATES OF DEPOSIT:
Account Number/Suffix
Date Purchased
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest
Maturity Date
Name of Joint Owner
166419 -48 18 MO
03/04/1999
$1,061.40
$3.20
$1,064.60
09/01/2000
Jill Kachmar/
George Kachmar
03/04/1999
166419-11
Date Joint Ownership Created
Certificate Purchased by Transfer
166419 -49 18 MO
06/11/1999
$1,047.73
$3.16
$1,050.89
12/09/2000
Jill Kachmar/
George Kachmar
06/1 1/ 1999
166419 -II
MJt1BERS 1sT ~L CREDIT UNION
~a-
Denise A. Anders ---
Insurance Products Supervisor
August 2, 2000
Estate of: SHEILA KACHMAR
Date of Death: June 24, 2000
Social Security Number: 061-36-9758
tOMMQNWEAlTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO. 21
00146343
10-24-2000
REV-1S45 ElCAFP <07-DUI
EST. OF SHEILA L KACHMAR
S.S. NO. 061-36-9758
DATE OF DEATH 06-24-2000
COUNTY CUMBERLAND
TYPE OF ACCOUNT
o SAVINGS
o CHECKING
o TRUST
IX! CERTIF.
PA 17013
REHIT PAYHENT AND FORHS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
JILL
1007 ACRE
CARLISLE
KACHMAR
DR
MEMBERS 1ST Feu has provided the Depart.ent with the infonation listad below which has been used in
calculating ths potential tax due. Their records indicate that at the death of the above decedent, YOU were a joint own.r/beneficiary of
this account. If you feel this information is incorrect, please obtain written correction fr~ the financial institution, attach a copy
to this for. and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the C~onwealth
of Pennsylvania. Questions may be answered by calling (717) 787-83Z7.
COMPLETE PART 1 BELOW . .
Account No.
166419-49
. SEE REVERSE SIDE FOR
Oat. 03-04-1997
Established
FILING AND PAYMENT INSTRUCTIONS
PART
IT]
1,050.89
16.667
175.15
.06
10.51
TAXPAYER RESPONSE
,::i!i~~~g,,1'qj;I!~~~:'i'i!fJ~~~':::,~~iij;~~:ii:~:i!I.~~~.:i:i:~~~!:!:~~!mB~:i!i.::i:~~~!ili.~.!:!:!
Account Balance
Percent Taxable
Amount Subject to
Tax Rate
Potential Tax Due
x
To insure proper credit to your aCCOU"lt, two
(l) copies of this notice ~st ecco~ny your
pay.ent to the Register of Wills. Hake check
payable to: "Register of Wills, Agent".
x
NOTE: If tax pay.-nts are ..de within three
(3) _onths of the decedent's date of death,
you ..y deduct a 5X discount of the tax due.
Any inheritance tax due will bec~ delinquent
nine (9) .onths after the date of death.
Tax
[CHECK ]
ONE
BLOCK
ONLY
A. 0 The above infor.ation and tax due is correct.
1. You may choose to re.it pay.ent to the Register of Wills with two copies of this notice to obtain
a discount or avoid interest, or you _ay check box "A" and return this notice to the Register of
I Wills and an official 8SSBss~nt will be issued by the PA Depart..nt of Revenue.
B. ~:he above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
to be filed by the decedent.s representative.
c. [] The above information is incorrect and/or debts and deductions were paid by you.
You must co.plete PART [!] and/or PART ~ below.
PART
@]
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
If you indicate a different tax rate, please state your
relationship to decedent:
PART
[3J
TAX RETURN - COMPUTATION
LINE 1. Date Established
2. Account Balance
3. Percent Taxable
4. A.ount Subject to Tax
5. Debts and Deductions
6. Amount Taxable
7. Tax Rate
8. Tax Due
OF
1
2
3
4
5
6
7
8
x
TAX ON JOINT/TRUST ACCOUNTS
x
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL (Enter on Line 5 of Tax Computation)
I
$
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
cODPlete to the best of my knowledge and belief.
TAXPAYER
I y~,
SIGNATURE
/;1
HOME (
WORK (
TELEPHONE
)
)
NUMBER
10 'II":
DATE
COHMQNWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU Of INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE NO. 21
ACN 00146342
DATE 10-24-2000
REV-lS4SU ifP cU7-DDl
PA 17013
TYPE OF ACCOUNT
EST. OF SHEILA L KACHMAR 0 SAVINGS
S.S. NO. 061-36-9758 0 CHECKING
DATE OF DEATH 06-24-2000 0 TRUST
COUNTY CUMBERLAND 00 CERTIF.
RENIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
JILL
1007 ACRE
CARLISLE
KACHMAR
DR
MEMBERS 1ST Feu has provided the Depart.ant with the inforRtion listed belOtf which has been u..d in
calculating the potential tax due. Their records indicate that at the death of the above decedent, you w.re II joint owner/beneficiary of
this account. If YOU feel this information is incorrect, please obtain written corr~tion fro. the financial institution, attach a copy
to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the co..onwealth
of Pennsylvania. Questions Nay be answered by calling (717) 787-83Z7.
Date
Established
REVERSE SIDE FOR
03-04-1997
FILING AND PAYMENT INSTRUCTIONS
COMPLETE PART 1 BELOW
Account No. 166419-48
IE IE IE SEE
PART
[I]
1,064.60
16.667
177.44
.06
10.65
TAXPAYER RESPONSE
mm~~~~.jjiill!,:jl~'M,~~~!mjDII'lij)~l1ijmg!im,~~~.~m!j!!.~!:I~RIBI~"'l~.W,.~~E~[!!!:
Account Balance
Percent Taxable
Amount Subjeci io
Tax Rat.
Potential Tax Due
To insure proper credit to your account, two
(2) copies of this notice .....t ac::Cu.p8l1)' your
payqnt to the Rqister of tU11s. Make check
payabJ. to: ~egister of Wills, Agent-.
x
NOTE: If tax payeents are .-de within three
(3) .onths ~f the decedent"s dat. of death,
you _y deduct a 5"'.< discount of the tllX due.
Any inheritance tax due will beco.. delinquent
nine (9) ItOnths aftar the date of death.
Tax
x
[CHECK ]
ONE
BLOCK
ONLY
A. 0 The above infor_Uon and. tax dUe is corr~t.
1. You .ay choose to r..it pa~ent to the Register of Wills with two copies of this notIce to obtain
a discount or avoid interest, or YOU .ay check bOx wA- and return this notice to the Register of
~ Wills and an official assess.ant will be issued by the PA Depart.ant of Revenue.
B. ~~he above asset has been or will be reported and tax paid with the Pennsylvania Inheritance T8~ return
to be filed by the decedent"s representative.
C. 0 The abOVQ inforption is incorr~t and/or debts and deductions were paid by YOU.
You must complete PART ~ and/or PART [!] below.
PART
~
TAX RETURN - COMPUTATION
LINE 1. Date Established
2. Accouni Balance
3. Percent Taxable
4. Amount Subject to Tax
S. Debts and Deductions
6. Anount Taxable
7. Tax Rate
8. Tax Due
TAX ON JOINT/TRUST ACCOUNTS
If you indicate a different t.x rate, ple.se state your
relationship to decedent:
OF
1
2
3 X
4
5
6
7
8
X
PART
@]
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCRIPTION
AMOUNT PAID
I
$
I
TOTAL (Enter on Line 5 of Tax Computation)
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
complete to the best of my knowledge and belief.
/)'V14 I/'-'
TAXPAYER SIGNATURE
HOME (
WORK (
TELEPHONE
)
)
NUMBER
/~{~<(ILli}
DA E
CO"HOHWEALT~ OF PENNSYLVANIA
DEPA~THENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
'*
rNFORMATrON NOTrCE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO. 21
00146341
10-24-2000
REV-lS43 EllAFP (D7-DOl
EST. OF SHEILA L KACHMAR
S.S. NO. 061-36-9758
DATE OF DEATH 06-24-2000
COUNTY CUMBERLAND
TYPE OF ACCOUNT
o SAVINGS
o CHECKING
o TRUST
IXJ CERTIF.
PA 17013
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
JILL
1007 ACRE
CARLISLE
KACHMAR
DR
MEMBERS 1ST Feu has provided the Depart.ent with the infonation listed below which has been used in
calculating the potential tax due. Their records indicetB that at the death of the above decedent, you were a joint oNner/beneficiary of
this account. If you feel this information is incorrect, please obtain written correction f~ the financial institution, attech e copy
to this for. and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Co..onw&alth
of Pennsylvania. QUBstions may be answered by cal~ing (717) 787-8327.
COMPLETE PART 1 BELOW
Account No. 166419-47
IE IE IE SEE
Date
Established
REVERSE SIDE FOR
03-04-1997
FILING AND PAYMENT INSTRUCTIONS
Account Balance 1,069.35
Percent Taxable X 16.667
Alllount Subject to Tax 178 . 23
Tax Rata X .06
Potential Tax Due 10.69
PART TAXPAYER RESPONSE
illi'i':'~~:~!II~i'm~,.~~~.~:,j'~~~i,:;:~~j[jij~l!ji;g:i~_~~gj:jji~~~jjij~ijij..j,j!.j,ji.~~[!~_.iji~
To insure proper credit to your account, two
(2) copies of this notiCB .ust acco.pany your
pa~nt to the Register of Wills. Hake check
payable to: "Register of Wills, Agent".
NOTE: If tax pay-.nts are .ade within three
(3) ~ths of the decedent"s date of death,
YOU .ay deduct e 5% discount of the tax due.
Any inheritance tax due will bec~ delinquent
nine (9) .unths after the date of death.
A. [] The above infor.ation and tax due is correct.
1. You may choose to re.it pay.ent to the Register of Wills with two copies of this notice to obtain
a discount or avoid intBrest. or you .ay check box wAn and return this notice to the Register of
Wills and an official assess-.nt will be issued by the PA Depart.ent of Revenue.
B. ~~ above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
to be filed by the decedent"s representative.
[CHECK ]
ONE
BLOCK
ONLY
c. [] The above infor.ation is incorrect and/or debts and deductions were paid by you.
You ~ust complete PART ~ and/or PART ~ below.
If you indicate a different tax rate, please state your
relationship to decedent:
PART
~
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PART
~
TAX RETURN - COMPUTATION
LINE 1. Date Established
2. Account Balance
3. Percent Taxable
4. A~unt Subject to Tax
5. Debts and Deductions
6. Amount Taxable
7. Tax Rate
8. Tax Due
OF TAX ON JOINT/TRUST ACCOUNTS
1
2
3
4
5
6
7
8
X
X
PAYEE
DESCR I PH ON
AMOUNT PAID
I
TOTAL (Enter on Line 5 of Tax Computation)
I
$
Under penalties of perjury, I declare that the facts I have reported above .re true, correct and
co.plete to the best of my knowledge and belief.
HOME
, }j.il1 .. V ·
TAXPAY~ SIGNATURE
( )
WORK (71 7 ) ]..'11"""1> J I ?
TELEPHONE NUMBER
(2. I
DA E
till
COMMONWEALTH. OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG~ PA 171za-060l
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO. 21
00146340
10-24-2000
REY-IHS EX AFP 111-11>
EST. OF SHEILA L KACHMAR
S.S. NO. 061-36-9758
DATE OF DEATH 06-24-2000
COUNTY CUMBERLAND
TYPE OF ACCOUNT
o SAVINGS
o CHECKING
o TRUST
IX] CERTIF.
PA 17013
REHIT PAYMENT AND FORNS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
JILL
1007 ACRE
CARLISLE
KACHMAR
DR
MEMBERS 1ST FCU has provided the Deparblent with the infor_tion listed belON .....ich has been used in
calculating the potential tax due. Their records indicate that at the death of the above decedent. YOU Mere a joint owner/beneficiary of
this account. If you feel this information is incorrect. please obtain written correction fr~ the financial institution. attach a COpy
to this fore and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the C~wealth
of Pennsylvania. Questions may be ansNered by calling (717) 787-8327.
COMPLETE PART 1 BELOW
Account No. 166419-46
II II II SEE
Oat.
Established
REVERSE SIDE FOR
03-04-1997
FILING AND PAYMENT INSTRUCTIONS
PART
m
1,074.22
16.667
179.04
.06
10.74
TAXPAYER RESPONSE
;;!!;!~B~.!!;!~!;;;~m;~~~;!;!;~1!!1!;!;~I!~!g!!~.1IM1~~!.w'.~1~~~.~~.!;!!~mr,l.l!!lm!.~~!!!!!
Account Balance
Percent Taxable
/mount Subject to
Tax Rate
Potential Tax Due
x
To insure proper credit to your account. two
(2) copies of this notice .ust a~~a.r..y your
pa~t to the Register of Wills. Make check
payable to: "Register of Wills. Agentw.
x
NOTE: If tax payeents are ..me within three
(3) .onths of the decedent's date of death.
YOU ~ deduct a 5X discOU"lt of the tax due.
Any inheritance tax due will becoee delinquent
nine (9) IIOnthS after the date of death.
Tax
[CHECK ]
ONE
BLOCK
ONLY
A. 0 The above inforeation and tax due is correct.
1. You ..y choose to reeit payeant to the Register of Wills Nith two copies of this notice to obtain
. discount or avoid interest. or YOU IIIIY check box wAw and return this notice to the Register of
, Wills and an official asseSS8ent will be issued by the PA Oepart.ent of Ravenue.
B. ~he above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
to be filed by thll decedent.s reprasentative.
C. [J The above information is incorrect and/or debts and deductions were paid by you.
You must co_pIstil PART ~ and/or PART ~ below.
If you indicate a different tax rate, please stat. your
relationship to decedent:
PART
~
TAX RETURN - COMPUTATION
lINE 1. Date Established
2. Account Balance
3. Percent Taxable
4. Amount Subject to Tax
S. Debts and Deductions
6. AMount Taxable
7. Tax Rate
8. Tax Due
OF TAX ON JOINT/TRUST ACCOUNTS
1
2
3
4
5
6
7
8
x
x
PART
[!]
DATE PAID
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL
..-
(!dter on line S of Tax Co~utation)
I
$
Under penalties
co..ple~ to the best
... /f/#lff/
TAXPAYER SIGNATURE
of perjury. I declare t~at the facts I have reported above are true. correct and
of my knowledge and belief.
HOME (
WORK (
TELEPHONE
)
)
NUMBER
I;/!'f/ 0<)
D TE
'COHH9NWEAlTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. Z8060l
HARRISBURG~ PA 171Z8-0601
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO. 21
00146339
10-24-2000
REY-l&4JEIAFPl01-0D>
EST. OF SHEILA L KACHMAR
5.5. NO. 061-36-9758
DATE OF DEATH 06-24-2000
COUNTY CUMBERLAND
TYPE OF ACCOUNT
o SAVINGS
o CHECKING
o TRUST
[Xl CERTIF .
PA 17013
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
JILL
1007 ACRE
CARLISLE
KACHMAR
DR
MEMBERS 1ST Feu has provided the Deparbent with the infonation listed below Nhich has been used in
calculating the potential tax due. Their records indicate that at the death of the above dacedent~ YOU were a joint owner/beneficiary of
this account. If you feel this information is incorrect~ please obtain written correction fro. the financial institution~ attach a COpy
to this for. and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Co.-onwaelth
of Pennsylvania. Questions may be answered by calling (717) 787-8327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 166419-42 Oat. 03-02-1998
Established
To insure proper credit to your account~ two
(2) copies of this notice ~st acco.pany Your
Ptlywent to the Register of Wills. MllIke check
payable to: "Register of Wills~ Agent".
Account Balance 1} 136.96
Percent Taxable X 16 . 667
Amount Subject to Tax 189.50
Tex Rat. X .06
Potential Tax Due 11.37
PART TAXPAYER RESPONSE
[!] mm~~~~m!;~~;~~.~[.!IJ~~~[!;!;~~!!!;!~li!j.~!m~~m~!i!!l~.j!i!i_~_!i!!..!!l.~~IM~~!!!!_.!!!!j
NOTE: If tax pay.ents are .-Ie within three
(3) .onths of the decedent"s date of daath~
YOU _y deduct III 5% discount of the tlllx due.
Any inheritlllnce tlllx due will beco.e delinquent
nine (9) lIOI"Iths after the date of death.
[CHECK ]
ONE
BLOCK
ONLY
A. 0 The above infor_tion and to due is correct.
1. You .ay choose to re.it pay.ent to the Register of Wills with two copies of this notice to obtain
a discount or avoid interest~ or YOU .IlIY check box "A" and return this notice to the Register of
Wills and an official Bssess-.nt will be issued by the PA Depart.ent of Revenue.
/
B. rl/ThQ above asset has been or will be reported and tax plllid with the PennsylVl!lnia Inheritance Tax return
~ to be filed by the decedent's representative.
c. [] The above infor.ation is incorrect and/or debts and deductions were paid by you.
You must COMplete PART ~ and/or PART ~ balow.
If you indicate a different tax rate} please state your
relationship to decedent:
PART
@J
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PART
~
TAX ~ETURN - COMPUTATION
LINE 1. Date Established
2. Account Balance
3. Percent Taxable
4. Amount Subject to Tax
S. Debts and Deductions
6. Aaount Taxable
7. Tax Rate
8. Tax Due
OF
1
2
3
4
5
6
7
8
X
TAX ON JOINT/TRUST ACCOUNTS
X
PAYEE
DESCRIPTION
AMOUNT PAID
I
$
I
TOTAL (Enter on Line 5 of Tax Co~utation)
Under penalties of
COMPlete to the best of
It /1"1
TAXPAYER SIGNATURE
perjury, I decl.re that the facts I have reported above are true~ correct and
my knowledge and belief.
HOME (
WORK (
TELEPHONE
)
)
NUMBER
{lINlo"
DATE
COHHOHWEALT~ OF PENNSYLVANIA
DEPARTHENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 2:80601
HARRISBURG, PA 17128-0601
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO. 21
00146338
10-24-2000
REV-l&4SEX'''''CG7-U)
EST. OF SHEILA L KACHMAR
S.S. NO. 061-36-9758
DATE OF DEATH 06-24-2000
COUNTY CUMBERLAND
TYPE OF ACCOUNT
o SAVINGS
o CHECKING
o TRUST
IX] CERTIF.
PA 17013
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
JILL
1007 ACRE
CARLISLE
KACHMAR
DR
HEHBERS 1ST Feu has provided the Departllent with the infonRItion l1st4MI below Which has been used in
calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint ONner/beneficiary of
this account. If YOU feel this information is incorrect, pl..se obtain written correction fro. the financial institution, attach B copy
to this fon. and return it to the above address. This account is t.xable in .ccordance with the Inherit.nce T.x Laws of the eo..onwe.lth
of ~anns~lvani8. Questions ~ay be ~~s.ered by c.lling (717) 787-8327.
COMPLETE PART 1 BELOW
ACCOlmt No. 166419-41
IE IE
IE SEE REVERSE SIDE FOR
Oat. 03-04-1997
Established
FILING AND PAYMENT INSTRUCTIONS
PART
[!]
1,146.16
16.667
191. 03
.06
11. 46
TAXPAYER RESPONSE
!!!;!!~.~II!;!!~!l!l~!!!!I~~!!m..~mll~!g~~_~lIil.~.:~!_~_r:._~i!r:i
Account Balance
Percent Taxable
AlIOunt Subject to
Tax Rete
Potential Tax Due
x
To in...... proper creeli t to YOUr account, two
(l) copies of this notice ..,st ftCCOIIpBny your
p.YII....t to the Register of WHls. Hake check
payable to: "Register of WHls, Agent...
x
HOTE: If tax ~ts .re .-de within three
(3) IIDnths of the decedent's date of de.th,
YOU ..y deduct . s:c discOW1t of the tax due.
Any inheritance tax due will becu.e ~linquent
.nine (9) IIDnths after the date of death.
Tax
[CHECK ]
ONE
BLOCK
ONLY
A. 0 The .bove infor..tion ant tax: due is correct.
1. You..y choose to rHit paYllent to the Register of WHls with two copies of this notice to obt.in
a discount or avoid interest, or YOU ..y check box "A" and return this notice to the Register of
Wills and an official asse..-.nt will be issued by the PA Depart.ent of Revenue.
B. 0 The aboV8 asset ha. been Dr will be reported .nd tax paid with the Pennsylvania Inheritance Tax return
to be filed by tha decedent"s represent.tive.
C. [] The .bove information is incorrect and/or debts .nd deductions Mere paid by you.
You .ust co.plete PART ~ and/or PART [!] below.
PART
~
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
If you indicate a different tax rat., pl.... stat. your
relationship to decedent:
PART
~
TAX RETURN - COMPUTATION
LINE 1. Date Established
2. Account Balance
3. Percent Taxable
4. Amount Subject to Tax
S. Debts and Deductions
6. AMount Taxable
7. Tax Rate
8. Tax Due
OF
1
2
3
4
5
6
7
8
x
TAX ON JOINT/TRUST ACCOUNTS
x
PAYEE
DESCRIPTION
AMOUNT PAID
,
$
I
TOTAL (Enter on Line S of Tax Computation)
declare that the facts I have report.d above are true, correct and
and belie".
, ~J..c
M
IZ/iv/oo
DATE
COHHQNW~AlTR OF PENNSYLVANIA
DEPARTHENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO. 21
00146337
10-24-2000
REV-1SUEJAFP U1-0D>
EST. OF SHEILA L KACHMAR
5.5. NO. 061-36-9758
DATE OF DEATH 06-24-2000
COUNTY CUMBERLAND
TYPE OF ACCOUNT
o SAVINGS
IX] CHECKING
o TRUST
o CERTIF.
PA 17013
REHIT PAYHENT AND FORHS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
JILL
1007 ACRE
CARLISLE
KACHMAR
DR
MEMBERS 1ST Feu has provided the Depl!!lrbHant with thll infor.l!!ltion listlKl b8low which has bIIen used in
cl!!llcull!!ltlng the potential tax dUB. Their records indicate thl!!lt at the del!!lth of the above declKlent, you were a joint owner/beneficil!!lry of
this l!!lCcount. If you faBI this informl!!ltion is incorrect, please obtain written correction fr~ the financial institution, attach a copy
to this for. and return it to the above l!!lddress. This account is taxable in accordance with the Inhllritanca Tl!!l~ Ll!!lWS of the Co.-onwealth
of Pennsylvanil!!l. Questions ml!!lY be answered by calling (717) 787-8327.
COMPLETE PART 1 BELOW
Account No. 166419-11
IE IE IE SEE
o.t.
Established
REVERSE SIDE FOR
03-04-1997
FILING AND PAYMENT INSTRUCTIONS
PART
[!]
2,012.10
16.667
335.36
.06
20.12
TAXPAYER RESPONSE
'!ifj!~I~_mm!tl!i!fii~_~m'!IJ~~~if!!!~l!f!!!~I~!!.!ijl_~~g!!J!I.!fil~~_~_!II~mfl.~:II!_.I!111
Account Balance
Percent Taxable
A.aunt Subject to
Tax Rate
Potential Tax Due
x
To insure proper credit to your account, two
(2) copies of this notice .ust aCCOMpany your
pay.ent to the Register of Wills. Hl!!lke check
payable to: "Register of Wills, Agentw.
x
NOTE: If tax pay.ents are -.de within three
(3) .onths of the decedent.s dl!!lte of death,
you ..y deduct l!!l 5X discount of the tax due.
Any inheritance tax due wUI becOllB delinquent
nine (9) .wIths after the det. of death.
Tax
[CHECK ]
ONE
BLOCK
ONLY
A. 0 The above infoMl8tion and tax due is corrtK:t.
1. You .ay choose to r..it pay.ent to the Register of Wills with two capies of this notice to obtain
a discount or avoid interest, or YOU .ay check box WAR and return this notice to the Register of
Wills and an official l!!lssess.ent will be issued by the PA Depart.ent of Revenue.
8. [] The above asset has been or will be reported and tl!!lX paid with the Pannsylvl!!lnia Inheritance Tax return
to be filed by the decedent.s representative.
C. [] The above infor.ation is incorrect and/or debts and deductions were paid by you.
You must complete PART ~ and/or PART [!] below.
If you indicate a different tax rate, please state your
relationship to decedent:
PART
~
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PART
~
TAX RETURN - COMPUTATION
LINE 1. Date Established
2. Account Balance
3. Percent Taxable
4. A.ount Subject to Tax
S. Debts and Deductions
6. A.ount Taxable
7. Tax Rate
8. Tax Due
OF
1
2
3
4
5
6
7
8
x
TAX ON JOINT/TRUST ACCOUNTS
x
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL CEnter on Line 5 of Tax Computation)
,
$
Under penalties
coaplete to the best
fZ. ,14/'-1
TAXPAYER SIGNATURE
of perjury, I declare that the facts I have reported above are true, correct and
of my knOWledge and belief.
HOME (
WORK (
TELEPHONE
)
)
NUMBER
0-" 't/ t1 tJ
DA E
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL 1 AXES
DEPT. 28D6D1
HARRISBURG, PA 17128-0601
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE NO. 21
ACN 00146336
DATE 10-24-2000
U;Y-l!i4SnUp U7-DU
EST. OF SHEILA L KACHMAR
5.5. NO. 061-36-9758
DATE OF DEATH 06-24-2000
COUNTY CUMBERLAND
TYPE OF ACCOUNT
\Xl SAVINGS
o CHECKING
o TRUST
o CERTIF.
PA 17013
REHIT PAYHENT AND FORHS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
JILL
1007 ACRE
CARLISLE
KACHMAR
DR
MEMBERS 1ST FCU hes prov ided the DepartHnt with the info..-tion l1stad t.low ....ich he. bMn uNCI in
calculating the potential tax dUe. Their rllCords indicate thet lit the death of the M>>oVtI decedlInt, you Nllre a joint owner/beneficiary of
this BCCount. If you feel this Infor.etlon is incor~t, plees. obtain writt~ correction f~ the financilll institution, attech a copy
to this fo,.. and return it to the IIbove address. This account is tIIXIlb1e in accordanCe with the Inheritance Tax L....s of the Ca_an....lth
of PennsylYlll'lie. Questions IIllIY be ans...red by ceiling (717) 787-83Z7 ~
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 166419-00 o.te 03-04-1997
Esteblished
AecoW"lt Balanc.
P.r~t Taxable
A-..t Subject to
Tax Rate .
Potential Tax nu.
x
670.19
16.667
111.70
.06
6.70
To Insure proper credit to your IICCOU"lt, two
(%) copies of this notice lUSt l!IQCOllPlll1Y your
~t to ..,. Register of W!lis. ,..e cheCk
pIIyllble to: ""Register of lUlls, Aa8nt...
x
NOTE: If 'taX ~ts are.... ",ithIn three
(5) IIDnths of the cktc8dent.s ct.te of deeth,
you RY dlldUCt a S% discount of the tax due.
Atty Inheritance tax due wIll becH8 delinquent
nI... (9) IlOI1ths efter the ct.t8 of death~
Tex
[CHECK ]
ONE
BLOCK
ONLY
A. 0 Thea above infor..tIon and tax dUe is cor-recto
1. You _y choose to ,....it PII~t to the RegIste,. of WUIs Nith two copies of this notice to abte!n
a discOU1t or avoId interest, or YOU 8IIY check bOx "A" and return this notice to the R."lste,. of
/ Wills and .... offici.1 ...s....t Nll1 b8 issued by the PA D8Par-Ullnt of Revenue.
B. ~~he aboye asset hilS been or will t. repo,.ted and tax paId Nith tIMi PennsylvanIa lnhedtance Tax return
to be filed by the d8C8d8nt.s repreuntatiWi.
C. 0 The above inforation is incor-r-llCt endIor Mbts and daductions wer-_ paid by you.
You .ust cOl!Pl.te PART 0 and/or- PART ill below.
If you indicate a different tax ret., pleas. stat. your
....lationship to decedent:
PART
[!]
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PART
~
TAX RETURN - COMPUTATION
LINE 1. Dat. Established
2. Account aalance
3. Per__t Texeble
4. AItount Subject to Tax
5. Debts and Deductions
6. AIIOW'lt Taxable
7. Tax Rat.
8. Tax Due
TAX ON JOINT/TRUST ACCOUNTS
OF
1
2
3 X
4
5
6
7 X
8
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL (Enter on Line S of Tax Co~utation)
I
.
Under penaliies of perjury, I declare that the
eompl.t. to ~~.:t ~f my knOWledge and belief.
/'FVI-\tM
TAXPAVER SIbNATURE
facis I have ....ported above are true, correct and
HOME (
WORK (
TelEPHONE
)
)
NUMBER
I L(i'i/oo
DA E
'"
USAA@
USAA
INVESTMENT
MANAGEMENT
COMPANY
I
Page 1 of 1
INVESTMENT ACCOUNT STATEMENT
Statement Period: 04/01/2000 - 06/30/2000
000860 130795
Customer Service
TouchLine'"
1-800-227-1741
1-800-531-8777
SHEILA L KACHMAR
SHAWN A KACHMAR
JTWROS
1007 ACRE DR
CARLISLE PA 17013-4433
9800 Fredericksburg Road San Antonio, TX 7828
USAA NUMBER: 006589035
Access to your USAA Investment Management Company mutual fund account is available through
usaa.com. lt's a 'Iuick way to check account balances, dividend payments, and IRA contributions
at your leisure, 2~ hours a day.
This Period
Last Period
EA RNfNGS SUM M A RY
This Period Year-to-Date
Taxable $88.42 $176.14
;r!)w,~ hil'''.;'< '$88.42 >', 'il'1~.14
:'iuL'1K:;rn': .>;~ l:"" "'::;-'''''.'',',
ACCOUNT VALUE SUMMARY
USAA Income Stock Fund
$11.234.19 $11.273.31
Total Account Value
$11,234.19, :.' $11,273;31
ACCOUNT POSITIONS
Account
Type
Description
USAA Mutual Funds
Account
Symbol %
Quantity
Price
.' Market ','
Value
Cash
USAA Income Stock Fund
USISX
100.00% I
636.498
$17.65
Total
100.00%
, , $11,234.19
USAA INCOME STOCK FUND ACTIVITY
Account Number: 35900864509
Date Transaction I Description Quantity Price i Amount
i
i Ending Value Last Period , 631.558 $17.85 i $11,273.31
, i
06/28 Earnings ',Reinvested Dividend 4.940 17.90 I 88.42
l@ $O.1400/Share I
i
,
,Ending Value This Period 636.498 $17.65 $11,234.19
! Y ear-to- Date Taxable Dividends $176.14
OOOSbO 1 Wi95
IIUI~ UII~ Il~ m~ U~I m~ 1~~IIIIIIlIIIIIIIlIIIIIIIIlIIIIIIIIIIIIII~ IIIIIIII~ IIIIIIIIU ~I~ I~~ lUll 11I111I11 1m
~
USAA<!>
USAA
INVESTMENT
MANAGEMENT
COMPANY
J
Page 1 of 1
INVESTMENT ACCOUNT STATEMENT
Statement Period: 04/01/2000 - 06/30/2000
000863 130798
Customer Service
TouchLine<!>
1-800-227-1741
1-800-531-8777
SHEILA L KACHMAR
ALISIA E KACHMAR
JTWROS
1007 ACRE DR
CARLISLE PA 17013-4433
9800 Fredericksburg Road San Antonio, TX 782f
USAA NUMBER: 006589035
Access to your USAA Investment Management Company mutual fund account is available through
usaa.com. It's a lluick way to check account balances, dividend payments, and IRA contributions
at your leisure, 24 hours a day.
EARNINGS SUMMARY
USAA Income Stock Fund I
I
Total A\:CO\U!.f Value
$11.234.19
$11.273.31
This Period Year-to-Date
I
Taxable $88.42 $176.14
Tot4l, Barnings l., {' " $88.42~'~J76.14
, .$11,234.19
$11,273.31
ACCOUNT POSITIONS
Account I Account Market
I
Type Description ! Symbol % Quantity Price Vaiue
I
USAA Mutual Funds I .
Cash USAA Income Stock Fund USISX 100.00% 636.498 $17.65 $11,234.19
.
Total 100.00% , $11,234.19
. USAA INCOME STOCK FUND ACTIVITY
Account Number: 35900864523
Date ! Transaction : Description Quantity Price Amount
: Ending Value Last Period 631.558 $17.85 $11,273.31
I i
06/28 Earnings Reinvested Dividend 4.940 17.90 88.42
@ $0.1400/Share
,Ending Value This Period 636.498 I $17.65 $11,234.19
I
Year-to-Date Taxable Dividends $176.14
000863 I 30798
111111111~~~mmU~II~OOIII~~~
REV-1508 EX + (1-87)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SHIELA L. KACHMAR
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
21-01-00213
Include proceeds of litigation & date proceeds were received by the estate. All prop. lolntlv-owned with rlcht of survlvorshlc must be disclosed on $ch. F.
ITEM
NO. DESCRIPTION
VALUE AT
DATE OF DEATH
1 FOUR (4) VISA $100.00 TRAVELERS CHECKS
400.00
2 KEYSTONE SAVINGS CLUB ACCOUNT #5182-2750-3672008780, DATE OF
DEATH BALANCE
432.21
7 CPA81 NTF 109013
Copyright Forms Software Only, '997 Nelco, Inc.
TOTAL (Also enler on line 5, Rae,o;I"I.!;on) $
(If more space is needed, insert additional sheets of the same size)
832.21
REV-1509 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SHIEIA L. KACHMAR
SCHEDULE F
JOINTLY-OWNED PROPERTY
FILE NUMBER
21-01-00213
11 an asset was made Joint within one year of the decedent's date of death, It must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME
A ALISIA E. KACHMAR
ADDRESS
1007 ACRE DRIVE
CARLISLE, PA 17013
RELATIONSHIP TO DECEDENT
DAUGHTER
B SHAWN A. KACHMAR
217 HAMMOCKS VIlli
SAVANNAH, GA 31410
SON
C GEORGE A. KACHMAR
1007 ACRE DRIVE
CARLISLE, PA 17013
Surviving spouse
D JILL KACHMAR
1007 ACRE DRIVE
CARLISLE, PA 17013
DAUGHTER
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR MADE Include name of financial institution and bank DATE OF DEATH
JOINT account number or similar identifying number. DECD'S VALUE OF
NO. TENANT JOINT Attach deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENrSINTEREST
1 A 3/4/1997 INVESTMENT ACCOUNT 11,234.19 5617.09 5,617.09
#35900864523, USAA INVESTMENT
MANAGEMENT COMPANY
2 B 3/4/1997 INVESTMENT ACCOUNT 11,234.19 5617.09 5,617 .09
#35900864509, USAA INVESTMENT
MANAGEMENT COMPANY
3 CD 3/4/97 REGULAR SAVINGS ACCOUNT 670.19 111.70 223.39
#166419-00, MEMBERS 1ST FCU
4 CD 3/4/1997 CHECKING ACCOUNT #166419-11, 2,012.10 335.36 670.70
MEMBERS 1ST FCU
5 CD 3/4/1997 CERTIFICATE OF DEPOSIT 1,146.16 191. 03 382.05
#166419-41, MEMBERS 1ST FCU
6 CD 3/2/1998 CERTIFICATE OF DEPOSIT 1,136.96 189.50 378.98
#166419-42, MEMBERS 1ST FCU
7 CD 3/4/1997 CERTIFICATE OF DEPOSIT 1,074.22 179.04 358.07
#166419-46, MEMBERS 1ST FCU
8 CD 3/4/1997 CERTIFICATE OF DEPOSIT 1,069.35 178.23 356.45
#166419-47, MEMBERS 1ST FCU
Total from continuation page (s) 705.15
TOTAL (Also enter on line 6, Rec.cllul.ticnt $ 14,308.97
7 CPA91 NTF 10909
(If more space is needed, insert additional sheets of the same size)
Copyright Forms Software Only, 1997 Nelco, Inc.
Estate of: SHIElA L. KACHMAR
SCHEDULE F
Jointly-C>>Jned Property
Date
Item Joint Made
No. Tent. Joint
Description
9 CD 3/4/1997 CERTIFICATE OF DEPOSIT
#166419-48
10 CD 3/4/1997 CERTIFICATE OF DEPOSIT
#166419-49, MEMBERS 1ST FCU
% of
Date of Death Deed's
Value of Asset Interest
1,064.60 177.44
1,050.89 175.15
TOTAL. (Carry forward to main schedule) . . . . . .
Page 2
21-01-00213
Date of Death
Value of
Deed's Int.
354.86
350.29
705.15
REV-1511EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SHIELA L. KA01MAR
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
21-01-00213
Debts 01 decedent must be reDorted on Schedule I.
ITEM
NO. DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1 REESE FUNERAL HOME, INC. , HARRISBURG, PA, FUNERAL EXPENSES AS 2,150.04
BILLED
B. ADMINISTRATIVE COSTS:
1. Personal R.epresentatiVe's Commissions 0.00
Name of Personal Representative(s)
Social Security Number(s)/EIN No. of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
2. Attorney Fees Narre: FISHMAN & MORGENTIlAL 2,250.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 3,500.00
Claimant GEORGE A. KACHMAR
Street Address 1007 ACRE DRIVE
City CARLISLE State PA Zip 17013
Relationship of Claimant to Decedent HUSBAND
4. Probate Fees 0.00
5. Accountant's Fees 0.00
6. Tax Return Preparer's Fees 0.00
7 REGISTER OF WILLS, FILING INHERITANCE TAX RETURN 15.00
8 EXECUTOR, RESERVE FOR ACCOUNTING 250.00
TOTAL (Also enter on line 9, Recapitulation) $ 8,165.04
7 CPA11 NTF10S1'1
Copyright Forms Software Only, 1 997 NelcQ, Inc.
(If more space is needed, insert additional sheets of the same size)
REV-1513 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
SHIELA L. KACHMAR
No. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
I. TAXABLE DISTRIBUTIONS (include outright spousal distributions)
1 GEORGE A. KACHMAR
1007 ACRE DRIVE
CARLISLE, PA 17013
2 JILL KACHMAR
1007 ACRE DRIVE
CARLISLE, PA 17013
3 ALISIA E. KACHMAR
1007 ACRE DRIVE
CARLISLE, PA 17013
4 SHAWN A. KACHMAR
231 OLDE TOWNE ROAD
MT. PLEASANT, NC 29464
FILE NUMBER
RELATIONSHIP TO DECEDENT
Do Nol UsI Truslee(s)
Surviving spouse
DAUGHTER
DAUGHTER
SON
21-01-00213
AMOUNT OR
SHARE OF ESTATE
832.21
2,047.98
2,047.98
2,047.97
ENTER DOLLAR AMTS. FOR DISTRIBS. SHOWN ABOVE ON LINES 15 THROUGH 17 AS APPROPRIATE ON REV 1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
None
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
None
7 CPA13 NTF 10913
TOTAL OF PART II -- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $
0.00
Copyright Forms Software Only, 1997 Nelco, Inc.
(If more space is needed, insert additional sheets of the same size)
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CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: SHIELA L. KACHMAR
Date of Death: JUNE 24, 2000
Estate No.: 21-01-00213
To the Register:
I certify that notice of the 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 JULY 30, 2000
Name
Address
SEE ATTACHED LIST OF BENEFICIARIES
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
NONE
Date: MAY 31,2001
1huM~~
Signature
FISHMAN & MORGENTHAL
Name ROQer M. Morqenthal , Esquire, #17143
Address 95 Alexander Spring Road. Suite 3
Carlisle. PA 17013
Telephone (717) 249-6333
Capacity:
_ Personal Representative
..L Counsel for Personal Representative
1 GEORGE A. KACHMAR
1007 ACRE DRIVE
CARLISLE, PA 17013
2 JILL KACHMAR
1007 ACRE DRIVE
CARLISLE, PA 17013
3 ALISIA E. KACHMAR
1007 ACRE DRIVE
CARLISLE, PA 17013
4 SHAWN A. KACHMAR
231 OLDE 'TOWNE ROAD
MI'. PLEASANT, NC 29464
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~ BUREAU OF INDIVIDUAL
INHERIT~NCE T~X DIVISION
DEPT. ,80601
HARRISBURG, PA 171Z8-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TAXES
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
ROGER M MORGENTHAL ESQ
FISHMAN & MORGENTHAL
95 ALEXANDER SPG RD 3
CARLISLE PA 17013
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
06-05-2001
KACHMAR
06-24-2000
21 01-0213
CUMBERLAND
101
~*
/ REV-IS47 EX AFP (12-001
SHEILA
L
Amount Remitted
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 ~
REY=is'4j-EX-iFP-n2"=OOY-NO'TicE--OF-YNHERfiANCE-TAX-APPRAiSEME'NY-,--iLL"OWANCE-oi-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF KACHMAR SHEILA L FILE NO. 21 01-0213 ACN 101 DATE 06-05-2001
TAX RETURN WAS:
) ACCEPTED AS FILED
( X) CHANGED
SEE ATTACHED NOTICE
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. JointlY Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
U)
(2)
(3)
(4)
(5)
(6)
(7)
.00
.00
.00
.00
832.21
14,308.97
.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. 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)
UO)
5,497.25
.00
NOTE: To insure proper
credit to your account,
subllit the upper portion
of this forll with your
tax paYllent.
15,141.18
(11)
(2)
(3)
(4)
5.497 25
9,643.93
.00
9,643.93
NOTE: I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
r~lect ~igures that include the total o~ ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Allount of Line 14 at Spousal rate
16. Allount of Line 14 taxable at Lineal/Class A rate
17. Allount of Line 14 at Sibling rate
18. Allount of Line 14 taxable at Collateral/Class B rate
19. Principal Tax Due
TAX CREDITS:
US) .00 X 00 .00
(6) 12,771.58 X 06 = 766.30
(7) .00 X 00 = .00
(8) .00 X 15 = .00
(9)= 766.30
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
04-23-2001 AA478299 .00 368.64
INTEREST IS CHARGED THROUGH 06-20-2001 TOTAL TAX CREDIT 368.64
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 397.66
REVERSE SIDE OF THIS FORM INTEREST AND PEN. 11.38
TOTAL DUE 409.04
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
A RFFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG PA 17128-0601
DECEDENTS NAME
REV-1470 EX (6-88)
REVIEWED BY
SCHEDULE ITEM
NO.
F
1,2,3d
,4d,5d
,6d,7d
,8d,9d
,10d
F
3c,4c,
5c,6c,
7c,8c,
9,c
10c
H
B-3
*
INHERITANCE TAX
EXPLANATION
OF CHANGES
Kachmar, Sheila L.
FILE NUMBER
Daniel Heck
ACN
2101-0213
101
EXPLANATION OF CHANGES
Probate estate is insolvent. Jointly held assets are taxable to the survivors. No
deductions can be claimed against joint property, as it was not the responsibility of the
survivors to pay the debts.
Expenses have been used against the surviving spouse's share of these jointly held
accounts.
Reduced to $832.21. Family exemption can only be claimed against assets subject to
will or intestacy.
ROW
Page 1
"/~-;J/,:v II
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
c;t.
~/
*'
REY-1607 EX AFP elZ-OOl
ROGER M MORGENTHAL ESQ
FISHMAN 8 MORGENTHAL
95 ALEXANDER SPG RD 3
CARLISLE PA 17013 l
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
06-25-2001
KACHMAR
06-24-2000
21 01-0213
CUMBERLAND
101
SHEILA
L
Allount Relli Ued
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, subllit the upper portion of this forI! with your tax paYll8nt.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV:i&O-j-Ei-AFP-(i2:0oT------...--iNHERI'~fANCE-TAX-ST'ATEMENT-OF'-AccouiiT--...---------------------
ESTATE OF KACHMAR SHEILA L FILE NO. 21 01-0213 ACN 101 DATE 06-25-2001
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 05-29-2001
PRINCIPAL TAX DUE: ............................
766.30
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
04-23-2001 AA478299 .00 368.64
06-07-2001 AA496698 10.10- 409.04
TOTAL TAX CREDIT 767.58
BALANCE OF TAX DUE 1.28CR
INTEREST AND PEN. .00
IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE 1.28CR
IE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRJ,
u.... "AU D&: nil&: A D&:&:II..n ~a:a: Da:ua:D~a: c:.TnF OF THTc:. FORM FOR INSTRUCTIONS. J
CYJ
STATUS REPORT UNDER RULE 6 12
Name of Decedent: SHEILA L KACHMAR
Date of Death: 6/24/00
No. 2001-0213
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: xx.. Yes _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 xx No
b. The separate Orphans' Court No. (if any) for the personal
representative's account is:
c. Did the personal representative state an account informally to the
parties in interest? ...xx... Yes _ No
d. Copies of receipts, releases, joinders and approvals of formal or
informal accounts may be filed with the Clerk of Orphan's Court and
may be attached to this report.
Date: 7/12102
L..'.:
Signature
SALZMANN, DePAULlS & FISHMAN, P.C.
~~~=~-Hb
,j""'"
. ,.!
;3
95 Alexander Spring Road Suite 3
Address
Carli!;le PA 17013
City, State, Zip
(717~ 249-6333
Telep one Number
Capacity: _ Personal Representative
-1L Counsel for Personal Representative
l)\\ ~ n~
~~\i\P\bJ--
JRD/June 30, 1992/17858
JUL 0 ts lOUt 1
In Re: Estate ofShelia L. Kachmar
Late of Carlisle Borough
Estate No.: 21-2001-0213
ORPHANS' COURT DIVISION
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY
PENNSYLVANIA
NO. 21-2001-0213
NOTICE OF FAILURE TO FILE STATUS REPORT AND REQUEST TO CONDUCT A
HEARING PURSUANT TO RULE 6.12, SUPREME COURT ORPHANS' COURT RULE
Personal Representative:
Counsel for Personal Representative: Roger M. Morgenthal, Esquire
Date of Decedent's Death: 06-24-2000
Date of Delinquency Notice: 05-14-2002
The undersigned, Mary C. Lewis, Register of Wills, in accordance with Rule 6.12,
Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of
Common Pleas of Cumberland County, that neither the above named personal representative nor
the above named counsel for the personal representative have filed with the Register of Wills or
Clerk of the Orphans' Court his, her or its Status Report required by Rule 6.12, Supreme Court
Orphans' Court Rule and that the requisite notice, pursuant to Rule 6.12, Supreme Court
Orphans' Court Rules, was given by the Register of Wills on 05-14-, 2002, and that the ten (10)
day notice to file the Status Report has expired. Accordingly, in accordance with Rule 6.12 the
Court is hereby notified of such delinquency and the undersigned requests that a Court conduct a
hearing to determine whether sanctions should be imposed upon the delinquent personal
representative or counsel for the delinquent personal representative.
Date: 07-08-2002
Distribution:
Personal Representative
Counsel for Personal Representative
Estate File
P--..27-~ L.. y>,'Jd A /Jt!
A hearing is scheduled for at in Courtroom No.3. Ifthe Status Report is filed
prior to the hearing date, the hearing will automatically be cane