HomeMy WebLinkAbout01-0638
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 2B0601
HARRISBURG" PA 17128-0601
REV-1162 EX(11-961
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
WENDELL W KEMPTON
POBOX 205
NEW KINGSTON, PA 17072
---~---- fold
EST A TE INFORMATION: SSN: 483-07-6276
FILE NUMBER: 21-2001- 0638
DECEDENT NAME: KEMPTON BEULAH L
DATE OF PAYMENT: 07/06/2001
POSTMARK DATE: 06/05/2001
COUNTY: CUMBERLAND
DATE OF DEATH: 01/23/2000
NO. CD 000020
'\
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $4,287.18
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TOTAL AMOUNT PAID:
REMARKS: WENDELL W KEMPTON
CHECK# 1195
SEAL
INITIALS: CW
RECEIVED BY:
$4,287.18
MARY C. LEWIS
REGISTER OF WILLS
REGIS'IER OF WILLS
REV."OO EX: ':971 '*
COMMONWEALTH OF PENNSYL.VANIA
DEt:'ARTMENT OF REVENUE
DEPT. 280601
HARRISBURG PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
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B E U L
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
o 2. Supplemental Return
o 4a. Future Interest Compromise (date ofdeath after 12-12-82)
[lJ 7. Decedent Maintained a Living Trust (Attach copy of Trust)
o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
.HIlItIlIii to. f
COMPLETE MAILING ADDRESS
PO BOX 205
o 3. Remainder Return (date of death prtor to 12-13-82\
o 5. Federal Estate Tax Return Required
_ 8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A}lA""hSohOI
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IZI 1. Original Return
o 4. Limned Estate
o 6. Decedent Died Testate \,6.~" copy cfW\\\)
o 9. litigation Proceeds Received
'I!!II
NAME
DONALD F. DAVIS, ESQ.
FIRM NAME (If Applicable)
ATTORNEY AND COUNSELOR AT LAW
TELEPHONE NUMBER
717 703-3439
NEW KINGSTON
(1)
(2)
(3)
(4)
(5)
(6)
(7) 7 9 1 4 9 0 0
PA 17072
OFF\Cll\l USE ONLY
1
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule Dj
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
t*OI
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabmties, & Liens (Schedule J) (10)
11. T oIal Deductions (totat Lines 9 & 10)
1 0
3 6
9 0
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
15. Amount of line 14 taxable
Z at the spousal tax rate
0 See instructions on
F 16. Amount of line 14 taxable
~~ at6%rate X .06
....=> 17. Amount of line 141axable
0.. at 15% rate X .15 (17)
:E
0
U 18. Tax Due (18) 0
Under penalties of perjury. \ declare that I have examined thiS return, including accom~nying schedules and statements, and to the best of my knowledge and belief. it is true, correct
and complete. Declaration of preparer other
than the personal representative is based on all information of which preparer has any knowled!le.
SIGNATURE ~ PERSON RESPON FOR FILING 1i7;~~w W. ADDRESS 11 DEVONSHIRE SQUARE
MECHANICSBURG PA 17055
ADDRESS PO BOX 205
NEW KINGSTON
HAN REPRESENTATIVE
J,MIY/'/ r: /j"'f4j-
PA
17072
DATE
6/22/2001
DATE
6/22/2001
A
Decedent's Complete ddress:
STREET ADDRESS CIO WENDELL W. KEMPTON
i 1 DEVONSHIRE SQUARE
CITY MECHANICSBURG I STATE PA I lIP
17055
Tax Payments and Credits:
1. Tax Due (Page 1 Line 18)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1)
4,073.10
Total Credits (A + 8 +C) (2)
3.
InteresVPenalty If applicable
D. Interest
E. Penalty
214.08
4.
TotallnteresVPenalty (D + E) (3)
If line 2 is greaterthan line 1 + line 3, enter the difference. This is the OVERPAVMENT.
Check box on Page 1 Line 19 to request a refund (4)
If line 1 + line 3 is greater than line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (5A)
8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58)
Make Check Payable to: REGISTER OF WILLS, AGENT
214.08
5.
4,287.18
4,287.18
PLEASE ANSWER THE FOLLOWING QUESTIONS
BV PLACING AN "X"'N THE APPROPRIATE BLOCKS
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 on or before December 12, 1982, did decedent within two years
preceding death transfer property without receiving adequate consideration? 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? .
Ves
........0
....0
n
n
....0
..0
...~
IF THE ANSWER TO ANV OF THE ABOVE QUESTIONS IS VES,
VOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN
No
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72 P.S. 99116 (a) (1.1) (i) provided for the reduction of the tax rate imposed on the net value of transfers to or for the use of the
surviving spouse from 6% to 3% for dates of death on or after July 1, 1994 and before January 1, 1995.
72 P.S. 99116 (a) (1.1) (ii) provided for the reduction of the rate imposed on the net value of transfers to or for the use of the surviving
spouse from 3% to 0% for dates of death on or after January 1, 1995. 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 survivin9 spouse
is the only beneficiary.
FOR DATES OF DEATH ON OR AFTER JANUARV 1, 1995 - Please answer the following question by placing an "x" in the
appropriate space.
Did the decedent create a trust or similar arrangement which is soley for the surviving spouse's benefit for his or her entire
lifetime? Ves 0 No IZl
If you answered yes to the above question, the tax on the trust or similar arrangement is postponed until the death of the second
spouse, at which time it will be fully taxable at the rate(s) applicabie to the remainder beneficiary(ies). Enter the value of the trust on
Schedule J, Part II. in order to remove it from the calculation of the tax due in this estate. Vou may wish to file Schedule 0 in order to
make the election available under Section 9113. If the eiection is made, the trust or similar arrangement is taxed in the estate of the
first decedent spouse, the portion of the trust or similar arrangement which benefits the surviVing spouse is taxed at the zero tax rate,
and the remainder is taxed at the rate(s) applicable to the remainder beneficiary(ies). If you choose to make the election, you must
attach Schedule 0 to a timely-filed tax return, along with Schedule(s) K andlor M in order to show the apportionment of the trust or
similar arrangement between the surviving spouse and the remainder beneficiary(ies).
:EV"''''''''''.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF
KEMPTON BEULAH L.
FILE NUMBER
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV~ 1500 COVER SHEET is yes.
DESCRIPTION OF PROPERTY %OF
ITEM INCLUDE THE NAME OF TKE TRANSFEREE. Tl-IEIRR~LATlONSHIPTODECEDENTANDTHEDATEOFTRANSFER DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE
NUMBER ATTACH A COPV OF Tl-IE DEED fOR REAL ESTATE. VALUE OF ASSET INTEREST (\FM'PllCAI'>LE)
1. REVOCABLE LIVING TRUST 79,149.00 100. 79,149.00
TOTAL (Also enter on line 7, Recapitulation) $ 79,149.00
(If more space is needed, insert additional sheets of the same size)
"''''''''.,,.,'.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
KEMPTON BEULAH L
FILE NUMBER
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Services and Purchases Hamilton F.H.. Saylorville, IA 5,126.00
2. Transport remains PA to IA United Airlines 600.00
3. Travel and expenses related to funeral services 1,268.00
4. Clergy and Organist 90.00
5. Headstone Hamilton Monument Co 2,000.00
B. AOMINISTRA TIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s)
Social Security Number(s) I EIN Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
2. Attorney Fees
3. Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees
5. Accountanfs Fees
6. Tax Return Preparer's Fees Donald F. Davis, Esq. 500.00
Prepare final returns
7. Personal Representative travel to Wendell Kempton 780.00
TOTAL (Also enter on line 9, Recapitulation) $ 10,364.00
(If more space is needed, insert additional sheets of the same size)
"'''''''.':.,,'*
COMMONWEALTH OF PENNSYLVANIA
INHEIm ANCETAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
ESTATE OF
KEMPTON BEULAH L.
Include unreimbursed medical expenses.
ITEM
NUMBER
1.
Bethany Village Final Bill
FILE NUMBER
DESCRIPTION
AMOUNT
900.00
TOTAL (Also enteron line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
900.00
R~''''~.r'.''.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
FILE NUMBER
Rl=llI .II.... L
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
1. TAXABLE DISTRIBUTIONS (Include outright spousai distributions)
1. WENDELL W. KEMPTON SON HALF
11 DEVONSHIRE SQUARE
MECHANICSBURG, PA 17055
2. MARDELLE CROSS DAUGHTER HALF
DALLAS CENTER, IA
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $
(If more space IS needed, insert additional sheets of the same size)
,NT BY: 'EXETER FUND SERVICES;
716423011" ;
Rt.VQC,,\i!LE TRUST
be!.ween
This trust agrccm~n~ uada this ~/~ d3Y of ~. 1990.
HARVEY W. and BEULAH to. KE.'11'TON ("Grantol'sll) and HARV!Y W.
KEMPTON nnd WENDELL W. !<DlPTON ("Co-trustees"). Reference 1n this
Trust to the "Trustee" shall be. deellled a reference to whomever 1$
se~vi~g as Trustee. Co-trustee or successor Trustee. ~I1NESSETH:
That th. Grantors transfer to the Trustee the proper~y
described in the attach.d Schedule "All, and the Trustee agreelJ to
hold. administer and distribute all of the assets (together with all
addttion$ and ~einvest~ents) in accordance with che following terms
and provIsions.
AR1'lCLE 1
The Crantors may revoke or amend thts agree~ent in ~hole or
~n part. and alter or termin~te the trust ~reated by it during their
II lifetimes by notice in vr1tl1'lg filed with the 'trustee at least thirty
(JO) days prior to t~. .IEectiva date thereof. provid~d, ho~ever.
that the duti~s and respons1b{11C:fes of the Trustee shall not be
modified or altered except upon the written CDnsenc of the Trustee.
ARTICLE II
During the lifetime of the Grantors. the Tru6tQe shall
receive, hold and Ill4nage. the trust property and apply such pare of
the income and principal as directed by the Gtantors or in its
diseretion shall be necessary for the support, comfort and welfare of
the Crantors in their accustoued m4nner of living. Auy in~ome not so
used shall be accumulated and added to principal frou time to ~i~.
1
SENT 3Y: EXETER FUND SERVICES;
7164230715;
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AitTlCLE III
Unless sooner te~inated. as provided 1n this Agr~eae~t.
upon che death of the Grantors, this crust sh311 terainate and the
asset$, tosetber with acc~ulated income, shall be distributed to the
children of the Grantors. WE~DELL w. K~~TON of Cherry Hill. New
Jetsey and MARCELLE CROSS of Dallas. Texas 1n equal shares. it
&u~vlving. and if noC, to theIr issue by representation.
ARTICLE IV
rn the event of the death of HARVEY Y. KEMPTON. or if for
~ny reason he ceases to serve ~s Co-trustee, the Grantors nominate
and appoint WEND!LL W. X~~TON to se~ve as Trustee bereunder without
the approval of any Court. The Grantors or any person serving as
Trustee' shall have the ciahe to appoint a S~ccessoT Trustee in the
event they are unable or unwilling to serve or the Trustee shall have
the rigbt ~o petition a court of competent jurisdiction to ~pp01nt a
Successor Trustee hereunder. Promptly after recetving nQttee of the
appointment of a Successor Trustee. tne Trustee shall render it~
final accounting and shall transfer and deliver to such Successor.
all trust assets together with income then held by it and have no
furtber duties under thiS agreement. Every Successor Trustee
appointed under this agreement shall possess and exercise all po~ers
and authority conferred by this agreement upon the original Tru$tee.
2
HY: cX~ltH rUNU ~tHV1~t~;
f'64~~U/1~,
ARTIC~E v
By ~ay of illustration and not of limitation and tn
addition to 1n~~~eat D~ statuto~y po~ers CQofecrcd on trustees by th~
laws of the State of ~ew Jersey or the State of Florida, the Craneo~s
expressly grant to the Trustee the follo~1ng pa~e~s. to b~ exercised
in its sole and absolute discretion:
A. to retain an7 property tectived from the Crantors or
to invest or reinvest the sa~e in its sole discretion;
B. To invest or reinvest the trust assecs and/or income
in any property or undivided intdrestS tn property. vherever located.
includln& bonds. notes (including notes of the Ycustee), stocks or
corporations. real estate. or any interest in ~eal Rstate. and
interests 1n trusts, common trust funds (in~lud1ng funds of tbe
T~stee). and to keep and maintain fund$ in saving$ or other
'accounts, vithout being limited by any statute or rule of law
concerning investments by truSteesi
c. to buy. sell and trade in sec~rities of any nature
including shore sales on ~rgin. and for such purposes may aalnrain
and operate margin accounts with brokers and may pledge any
securities held or purchased by chem ~ith such brokers as security
for loans and advances made to the t~ustees;
O. To determine the manner of ascertainment of inc~e
and principal. and tbe allocation or apportio~enc betveen 1ncom. and
principal ot all receipts and disbursements and to pay all fees
incurred by the trust out of incom~ or principal as it shall. in it$
sole d1se~etion. dererm1n~ to b~ in tbe hast interest of the
b~neficia.ies;
3
-SENT BY: EXETER FUND SERVICES;
7164230715;
MAI'v'-' ".
E. To take ~ny action and execute any !nstrum~n:5
necessary 1n the conserv1~g or realizing upon the value of any ~r4st
property;
F. To pay any bills presented on behalf af the Grantor
by the Gr~ntor or ind1v1du~ls or corporarlon$ authorized by him to
present the same from trust assets or income vithout liability for
determining their authenticity or validity; and
G. To make any distribur10n or division of the trust
property tn cash or in tind or both to the beneficiarIes named 1n
this agreeme.nt.
ARTICLE VI
The Truseee may. at any ti=Q. And fro= tl~. to cim_, or as
requested not more than quarterly by the Grantors, rende~ an ac~ount
of its transactions with respeet to the crust assets, and the
Crantors $hall have full power to settle finally any such account.
[: .md on the basis of it, to rehase the Trusue from all liability,
re3ponsib11ity or .ccoun~ability for acts or omissions as Trustee.
ARTICLE VII
The Grantors shall have the right to make additions co t~i$
trust agr_e~~nt $ubject ~o the consent of the Trustee.
ARTICLE VII I
The It'ot'rl "GrancQrs" as used herein shall be taken to
include etther Grantor or the surv1vo~ of tbem and any actions taken
or notices given by either shall be d~emed to be authorl~ed by the
other unless contrary notice 1s received by the Trustee in writing
signed by the other.
! ~
4
'SENT BY: EXETER FUND SERVICES;
7164230715;
'v.,..", ....'" _.
ARTICLE U
The agreement shall b~ construed and regulated in all
re$pects by the la~s of the State of New Jersey.
IN WITNESS WHEREOF. the parties have executed this
instrUMent in duplicate the day ~nd year written belov and to take
effect th~ day and year first above writte~.
.5',,, /r"l f ~~.I> f=.}
I
BEUlAH L. KL~tON. Gr4ntor
& ,....../. '- .
.q""J-l.l: ,Y;.t 7,,",",~)
HARVEY : KEMPTON, Cc-l'rustee
~.-A>3~/~
WE~DELL W. KEMPTON, .-Trust..
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,NT BY:,"X"l"H cUNU ~cHV1CcS;
fl b42:';jUf f:j,
STATE OF FtOR~VA
COl!:-iTY OF
r HEREBY CERTIFY t~at HARVEY W. ~nd 8EL~ L. KEMPTON. p@r$onally
known Co me to he the sam~ persons whose na.es .re subscribed to the
foregoing instrument this day. personally appeared before me and they
acknovledged that they ex~cuud the: foregoing tnscrument freely and
vol~ntarily for the uses and purpoSes therein expressad.
IN WITNESS WHEREOF. I have nereunto set my hand and official seal at
PiffrrAh".J/-?7;JA- I said County and State, this &.:ft{ day of
..j.~A.-';;:- A.D. 1990.
'la-db R d(?"{I/~,";0/
No!ary Public. State of~
f'loX:1da at Large r.~\1'1>' ~:~:!~.~.,::;;..~..r..A';~!."4~:;~_'(~'J
My commIssion expires "''' '.~'~:::~~~;::'';,.-~;.r i~"'.. C:i:.;.
l>............ .
STATE OF NEW JERSEY
COt:NTY OF C/\."fD&V
I HEaESY CERTIFY that WENDELL W. KEMPTON, personally knovn to me to
be the 5a~e person whose name is subscribed to ~be foregoing
1nsc~u~enc this day, personally appeared before me and he
ackno~ledged tha~ he executed the foregoing 1n$truoent freely and
voluncarily for ~be uses and purposes therein expressed.
IN ~tTNESS WHEREOF, I have hereunco
Che~~y Hill, said County and State.
A.D. 1990.
ser my hand and offi~e31
this ..21'4 day of
- f'
a<
..;;X/.
Nary Public, State of
w Jersey at Large
:-1y commission expires /t/)c.,y /9'0 .
6
SEN< BY: EXETER FUND SERVICeS;
7164230715;
MAY-30.01 9:34AM; PAGE 8/9
cr~(Q)[P)V
~
FIRST AMENDMENT TO TRUST
This agreement made and executed this 3 J day of m~. 1998 between
HARVEY W. KEMPTON ("Grantor") on behalf of himself and BEULAH L. KEMPTON, and
HARVEY W. KEMPTON and WENDELL W. KEMPTON ("Co-Trustees"), \V1TNESSETH:
That the Grantor wishes to amend the Revocable Trust Agreement made the 21 st day of
June, 1990 (Trust) between the above parties as authorized by Article I and Article VIII therein,
and to reduce the same to writing. Therefore:
I Article III, of the Trust is amended to correct the location of the Beneficiary,
rv1ARDELLE CROSS, who lives in Dallas Center, Iowa and not Dallas, Texas.
II. Pursuant to Article IV of the Trust, HARVEY W. KEMPTON, Grantor and Co-
Trustee exercises his right to resign as Co-Trustee and to acknowledge hereby that the remaining
Co-Trustee, WENDELL W. KEMPTON, is hereby immediately and in the future designated as
sole Trustee, exercising all the rights and powers granted in the Trust Agreement unless
otherwise designated in writing as provided in the said Article IV.
III. The situs of the Trust created by the Trust Agreement and restated by this amendment
is hereby acknowledged to be the Commonwealth of Pennsylvania. All references in the Trust
Agreement to governing law, whether in connection with a particular state (such as Florida or
New Jersey) shall be taken to refer to the Commonwealth of Pennsylvania, and its statutes shall
1
. ,SEtH BY: EXETER FUND SERVICES;
7164230715;
MAY.30.01 9:34AM;
PAGE 9/9
apply in JII r~sp~cts to the operation and interpretation of the original Trust Agreem~nt and the
Am~ndlllent.
By their signatures below the Grantor and Trustee acknowledge the changes made hereby
and are agreed that in all other respects the Trust shall remain in full force and effect as published
on the 21 st day of June, 1990.
GRANTOR/CO-TRUSTEE
TRUSTEE;
iiZ ~}({~ _~~~~4~
-HAA'N:1:r.:!e-r"",;;/ - - WENOELL~N
=>
Subscribed, sworn to and acknowledged before me by HARVEY W. KEMPTON, the
Grantor, and by HARVEY W. KEMPTON and WENDELL W. KEMPTON, Co-Trustees this
:; AD! day of March, 1998.
~A.~
Notary Pub' Commonwealth of Pennsylvania
My commission expires
Notarial Seal
\IId<y R. Biller. Notary I'ubRc
Fairview Twp.. York County
My Commissico Expir8sOcr. 15. 1998
t, nnsytyania Ass~ciaiion 01 Notar!es
,
.,j
2
DONALD F DAVIS, ESQ.
ATTORNEY AT LAW
PO BOX 205, NEW KINGSTON, PA 17072
Department of Revenue
Inheritance Tax Division
Harrisburg, P A
RE: Attached PA 1500 - Buelah Kempton
This return is being filed late due to the confusion of my client regarding filing requirements. All
the assets ofthe decedent were held at the time of her death in a revocable living trust and no
probate was necessary for distribution of those assets to the two children named as beneficiaries
under the Trust agreement. One of the beneficiaries, Wendell W. Kempton, was Trustee of the
Trust. When he came to me for preparation of the decedent's final income tax returns, I asked
him about whether he had filed an inheritance tax return. He incorrectly understood that the fact
the estate did not need probating removed the necessity of filing the return. When this was
clarified, he requested that I prepare the attached return.
I have calculated interest from the date of death to the date of filing.
Should you have any questions, my number is (717)703-3439.
Donald F. Davis, Esq.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-961
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
DAVIS DONALD F ESQ
89 BIDDLE RD
CARLISLE, PA 17013
-------- fold
ESTATE INFORMATION: SSN: 483-07-6276
FILE NUMBER: 21-2001- 0638
DECEDENT NAME: KEMPTON BEULAH L
DATE OF PAYMENT: 08/21/2001
POSTMARK DATE: 08/20/2001
COUNTY: CUMBERLAND
DATE OF DEATH: 01/23/2000
NO. CD 000178
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $4.41
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TOTAL AMOUNT PAID:
REMARKS: DONALD F DAVID ESQUIRE
CHECK#02776516470
SEAL
INITIALS: VZ
RECEIVED BY:
REGISTER OF WILLS
$4.41
MARY C. LEWIS
REGISTER OF WILLS
'v /6 -..j"?/a-I
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
.", j
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
08-13-2001
KEMPTON
01-23-2000
21 01-0638
CUMBERLAND
101
DONALD F DAVIS ESQ U
PO BOX 205
NEW KINGSTON PA 17072
l".
'*
REV-1547 EX AFP <12-00>
BEULAH
L
Anount Renitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV=isi;j-EX--AFP-fi'2-:o0Y-NO'fICE--OF-YtiHEiiiTANCE-YAic-APPRAisEiiENT~--Ai.LOWANCE-OR-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF KEMPTON BEULAH L FILE NO. 21 01-0638 ACN 101 DATE 08-13-2001
TAX RETURN WAS: (X) ACCEPTED AS FILED
CHANGED
NOTE: I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
re~lect ~igures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Anount of Line 14 at Spousal rate (15)
16. Anount of Line 14 taxable at Lineal/Class A rate (16)
17. Anount of Line 14 at Sibling rate (17)
18. Anount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
.00 X 00 = .00
67,885.00 X 06 = 4,073.10
.00 X 00 = .00
.00 X 15 = .00
(19)= 4,073.10
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
(1)
(2)
(3)
(4)
(5)
(6)
(7)
.00
.00
.00
.00
.00
.00
79,149.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adn. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governnental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
ClO)
10,364.00
900.00
Clll
Cl2)
Cl3)
(14)
NOTE: To insure proper
credit to your account,
subnit the upper portion
of this forn with your
tax paynent.
79,149.00
]] .264 00
67,885.00
.00
67,885.00
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
06-05-2001 CDOOO020 214.08- 4,287.18
BALANCE OF UNPAID INTEREST/PENALTY AS OF 06-06-2001 TOTAL TAX CREDIT 4,073.10
BALANCE OF TAX DUE .00
INTEREST AND PEN. 4.41
TOTAL DUE 4.41
* 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 RI=FlIND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
\
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BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. Z8D6Dl
HARRISBURG, PA 171Z8-D6Dl
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
:INHER:ITANCE TAX
STATEMENT OF ACCOUNT
'*
REV-liD? EX AFP 112-DD,
DONALD F DAVIS
PO BOX 205
NEW KINGSTON
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
09-17-2001
KEMPTON
01-23-2000
21 01-0638
CUMBERLAND
101
BEULAH
L
PA 17072
Allount R_i Had
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 form with your tax paYllent.
CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ~
REY:i6o-j-E3f-AFP--fi"2:ooY------.iE.-iNHERITANCE-YAX-STAyEMEN'Y-ii"F-Accouiif--.i.---------------------
ESTATE OF KEMPTON BEULAH L FILE NO. 21 01-0638 ACN 101 DATE 09-17-2001
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: 08-13-2001
P R I NCI PAL TAX DUE: .........................................................................................................................._.............................................................................................
4,073.10
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
06-05-2001 CDOOO020 214.08- 4,287.18
08-20-2001 CDOOO178 4.41- 4.41
TOTAL TAX CREDIT 4,073.10
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00
.
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" (CR),
-. -- -..- . ...........n ..~~ D~UFRSE SIDE OF THIS FORM FOR INSTRUCTIONS. )