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Home My WebLink About04-28-05 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DePT.2B0601 HARRISBURG, PA 17128-0601 REV-1162 EX{1 1-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT IRWIN & MCKNIGHT 60 WEST POMFRET ST CARLISLE, PA 17013 _n._n_ fold ESTATE INFORMATION: SSN: 209-12-5645 FILE NUMBER: 2105-0401 DECEDENT NAME: KILMORE EVELYN ROMAINE DATE OF PAYMENT: 04/28/2005 POSTMARK DATE: 04/28/2005 COUNTY: CUMBERLAND DATE OF DEATH: 02/19/2005 NO. CD 005269 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $1,384.22 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: IRWIN & MCKNIGHT CHECK# 100 SEAL INITIALS: RSK RECEIVED BY: REGISTER OF WILLS $1,384.22 GLENDA FARNER STRASBAUGH REGISTER OF WILLS ......__..,_...._,,~.._....,,-'"---- Inventory of the real an personal estate of EVELYN ROMAINE KILMORE , deceased I. Members 1st Federal Credit Union - Savings Account 165611-00 $586.09 113 interest 2. Members 1st Federal Credit Union- Certificate of Deposit -165611-43 $25,217.01 1j~ interest 3. Members 1st Federal Credit Union - Certificate of Deposit -165611-49 $3,527.10 Ih interest 4. Members 1st Federal Credit Union - Certificate of Deposit -165611-50 $4,332.92 1j~ interest 5. Sovereign Bank - Checking Account - 2891030524 $504.24 113 interest 6. Sovereign Bank - Certificate of Deposit - 2895412720 $2,522.78 1/2 interest TOTAL.................................................. $36,690.14 '.-.-, ------_.,--,._.._-._--~~-- COMMONWEALTH OF PENNSYLVANIA :SS COUNTY OF CUMBERLAND Jovce Morl!an the Estate of , late of South Middleton TownshiD , being duly sworn according to law, deposes and says that she is a Beneficiary of Evelvn R. Kilmore Pennsylvania, deceased and that the within is an inventory made by Jovce Mor~an , Cumberland County, , the said Beneficiary of the entire eSlate of said decedent, consisting of all the personal property and real eslate, except real estate outside the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value as of the date of decedent's death. Sworn and subscribed before me, ~J-~~ Joyce Mor , Beneficiary Date of Death } } } I } I PENNS )l A NotarioI Seal I Klum S. Noe~ NoI8ry PubIlc CIrliIIeBoro, Cmnberland County l'Nnmlaion ExpiRs 0... 8, 2007 Carlisle. P A 17013 Address this 27'" day of Antil, 2005. 235 York Road 02 Month 2005 Year Day (2 INSTRUCTIONS L An inventory must be filed within three months after appointment of personal representative. F~R ^ J "'-1 2. A supplement inventory must be filed within thirty days of discovery of additional assets. 3. Additional sheets may be attached as to personalty or realty. 4. See Article IV, Fiduciaries Act of 1949. ,,; " gj ~ oS " 0 u " j 0 ~ - :.2 .; ~ :><: ~ '" >< c:: oS ~ > ~ t.tl 0 >. "" - .... 0 0 .... ..: ~ t.tl '" c:: c:: g:; ~ c:: ~ :z: t.tl 0 <f .... ...:i ""' <l ~ ..: 0 '5 >. r;.il ""' gj Z :g C 0 Z " 0 >< ::E " CI til 0 z '" ;S U ~ ~ .... t.tl ~ 0 "" " "" <Il ..!:! ~ '0-< ~ 0 " .0 ~ S ...:i a ... "" .!l ii: Q " ~ "" ... o o IlQ N = '''':;:;'1 c.n ::-n f"i'1 C") (::) TI ("j r~ic;1 C:J (-) -"T'l -,., ('5 r-n ;~::./') 0 "n :,"_";:to -'0 :.;\} i',J 0::> :? _'i. r:~) ~ 'S t.tl". .5 ~ ~ S ..!:lg a:i": ~ " ~ 7+ <+: ~~\ ~ \(. ~ 2, \J"\<J.l REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT REV-1500 EX + (6-00) CAPB HpRL EplO CRAC KOTK ES C P o 0 R N R 0 E E S N T C o M P T U A T X A T I o N o E C E o E N T COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Kilmore Evel Romaine DATE OF DEATH (MM~DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 02 19 2005 02 12 1922 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) OFFICIAL USE ONLY FILE NUMBER 2.1 040L 05 YEAR NUMBER COUNTY CODE SOCIAL SECURITY NUMBER 209-12-5645 THIS RETURN MUST BE ALED IN DUPLICATE W1TH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER o 3. (date of death . Remainder Return prior to 12-13-82) 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes X 1. Original Return Z. Supplemental Return 4. Limited Estate 4a. Future Interest Compromise (date of death after 12-12-82) X 6. Decedent Died Testate 7. Decedent Maintained a living Trust (Attach copy of Will) (Attach copy of Trust) D 9. litigation Proceeds Received 010. Spousal Poverty Credit 0 11. Election to tax under Sec. 9113(A) (date of death between 12-31-91 and 1-1-95) (Attach Sch 0) ;;;:"l'fIl$$ac::I!Q8:~ill$Dl:OM~~Il'.i,l.llt!j~98R~tj!)~M:lfil~:C;i:!t{EjtlMoo;;TMc:ltj~98MAi1Q!'f$~B~'Olj:lECTEElTO' NAME COMPLETE MAlLINGADDRESS Copyright (c) 2000 form software only The LacKner Group, Inc. Ro er B. Irwin Es FIRM NAME (If Applicable) IRWIN & McKNIGHT TELEPHONE NUMBER 60 West Pomfret Street West Pomfret Professional Bldg. Carlisle, PA 17013 None None None OFFICIAL USE ONLY 24 -2353 Real Estate (Schedule A) Stocks and Bonds (Schedule B) Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash. Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) D Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property {7} (Schedule G or L) 8. Total Gross Assets (totai Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabiltties, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental BequestslSec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Sub"ect to Tax (Line 12 minus Line 13) (1) (2) (3) None None ";1 R E C A P I T U L A T I o N (4) (5) -, 36,690.14 ", ,~ C~. (6) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(aX 1.2) 16. Amount of line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20. 0.00 32,379.36 0.00 0.00 None --.:~' j (8) 36,69{l,14 3,960.40 350.38 f'v (11) (12) (13) 4.310.78 32,379.36 (14) 32,379.36 x X X X .0 0 .045 .12 .15 (15) (16) (17) (18) (19) 0.00 1,457.07 0.00 0.00 1,457.07 Form REV-l500 EX (Rev. 6*00) 4- Q.-" Decedent's Complete Address: STREET ADDRESS 231C York Road CITY I STATE I ZIP Carlisle PA 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 1,457.07 72.85 Total Credits ( A + B + C) (2) 72.85 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penally ( 0 + E) (3) 4. If Line 2 is greater than Line 1 + Line 3. enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a relund (4) 5. 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. (SA) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5Bl Make Check Payable to: REGISTER OF WILLS, AGENT pi.EA~~'i~~w~~"+~~"~~~~~W~'~~'~U~~+;~~~'~y;~i~'I~~AN 'l"kr'"'''''''''''''''''''' 1. 0.00 0.00 1,384.22 0.00 1,384.22 Did decedent make a transfer and: a. retain the use or income of the property transferred; . b. retain the right to designate who shan 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 fo{ or payable upon death bank account or security at his or her death? ,. 4. Did decedent own an Individual Retirement Account. annuity, or other non-probate property which contains a beneficiary designation? . . IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. j~":f~:~"::;~'~:6~'~:i~f~~[6:t~:g""" Yes No ~~ o o o rn rn rn Under penalties of perJury, I declare that I have examlned this return, Including accompanying schedules and statements, and to the best of my knowledge and belief. it is true. correct and complete. Declaration of pre parer other than the personal representatfve Is based. an aU informatlol\of which preparer has any k.nowledge. SIGNATUAEOF PERSON RESPONSlBLE FOR FlLlNG RETURN Joyce Morgan 235 York Road - - -c';'rrisi;;,- - PA - - i'i6i3 - -- - - - - - - - -- - -- - - - - -- - - - --- IRWIN & McKNIGHT 60 West Pomfret Street - - -carrisi,,-,- - PA -- i i6i3 - -- - - - - - - - - - - - - - - - - - - - - - - -- DATE y/~7(of DATE 1(1.o""(()~ For dates f death n or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving s 3% [72 P.S. 9116 (a) (1.1) W!. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% (72 P.S. 9116 (a) (1.1) (in], The sta.tute does not exemot a. transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after 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, or a stepparent of the child is 0"10 [72 P.S. 9116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5"1", except as noted in 72 P .5. 9116( 1.2) [72 P.S. 9116(aXl)]. The tax rate imposed on the net value of transfers to orfor the use of the decedent's siblings is 12"10 172 P.S. 9116(a)(1.3)J. A sibling is defined. under Section 9102. as an individual who has at least one parent in common with the decedent, whether by blood or adoption. CopyrIght (c) 2000 form software only The Lackner Group. Inc. 1:_._ OI:"'_1l:.l\ft I:'V l~ REV-1509 EX + (1~97) COMMONWEA.LTH OF PENNSYLVANIA, INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Evelyn Romaine Kilmore SCHEDULE F JOINTLY-OWNED PROPERTY FILE NUMBER SS!I 209-12-5645 02/19/2005 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. A. Joyce Morgan ADDRESS 235 York Road Carlisle, PA 17013 RELATIONSHIP TO DECEDENT Daughter SURVIVING JOINT TENANT(S) NAME B. Barry Kilmore 211 York Road Carlisle, PA 17013 Son c. JDINTL Y -OWNED PROPERTY, LETTER DATE DESCRIPTION OF PROPERTY "/0 OF DATE OF DEATH ITEM FOR JOINT MADE Indude name of financial institution and bank DATE OF DEATH DECO'S VALUE OF account number or similar identifying number. NUMBER TENANT JOINT Attach deed 'for jointly-held real estate. VALUE OF ASSET INTEREST ECEDENT'S INTERES 1 Members 1st Federal Credit 1,758.27 33.33% 586.09 Jnion - Savings Account 165611-00 2 Members 1st Federal Credit 50,434.01 50.00% 25,217.01 Union - Certificate of Depos it 165611-43 3 Members 1st Federal Credit 7,054.19 50.00% 3,527.10 Union - Certificate of Deposit 165611-49 4 Members 1st Federal Credit 8,665.84 50.00% 4,332.92 Union - Certificate of Deposit 165611- 50 5 Sovereign Bank - Checking 1,512.71 33.33% 504.24 . Account 2891030524 6 Sovereign Bank - 5,045.55 50.00% 2,522.78 Certificate of Deposit 2895412720 TOTAL (Also enter on line 6, Recapitulation) $ 36,690.14 T (If more space is needed insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems,lnc. 1:...._ all:'V_11C;.,,a II:'Y ID_.. ~ "'..., REV-1511 EX +(1-97) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Evelyn Romaine Ki1more SS!I 209-12-5645 02/19/2005 FILE NUMBER Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES, 1 Funeral - Funeral Expenses 215.00 2 Ronan Funeral Home 1,065.40 B. ADMINISTRATIVE COSTS, 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) I ErN Number of Personal Representative(s) Street Address City State ZIp - Year(s) Commission Paid: 2. Attorney's Fees IRWIN & McKNIGHT 2,400.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip - Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 250.00 7. Other Administrative Costs 1 Register of Wills - Filing Fee 30.00 TOTAL (Also enter on line 9, Recapitulation) $ 3,960.40 (If more space is needed, insert additional sheets of the same size) copyright (c) 1996 form software only CPSystems,lnc. r:_._ IOC:,,'_11:11 E:V'~ REV-1512 EX + (1-97) COMMONWEALTH OF PENNSYL.VANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Evelyn Romaine Kilmore SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, AND LIENS FILE NUMBER SSfl 209-12-5645 02/19/2005 Include unreimbursed medical expenses. ITEM NUMBER 1 Masland & Associates DESCRIPTION Medical AMOUNT 18.45 2 PP&L - Electric 54.00 3 Sprint Telephone 30.18 4 Stoken - Eye Exam 91. 55 5 UGI - Utility 156.20 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSvstems, Inc. 350.38 C:~._ DIC"_1c:.1'> C:V ",,_.. ~ ~~, REV-1513 EX + (9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Evelyr Romaine Kilmore SSff 209-12-5645 FILE NUMBER 02119/2005 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) NUMBER I. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS {inclUde outright spousal dlstrlbutlons, and transfers under Sec. 9116{a)(1.2)) Barry Kilmore 211 York Road Carlisle, PA 17013 Son 1 2 Joyce Morgan 235 York Road Carlisle, PA 17013 Daughter AMOUNT OR SHARE OF ESTATE 1/2 Remainder 1/2 Remainder ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18. AS APPROPRIATE. ON REV 1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS. A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- 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) Copyright (c) 2000 form software onlY The Lackner Group, Inc. 0.00 ~....... J:1I:'V_11;.1't I:'Y 10_.. .. ^^' 03130/2005 Will) 15: 45 FAX ~002!002 Sovereign Bank Evelyn R Kilmorc 209-12-5645 P ebruary 19. 2005 ESTATE or SOCIAl, SF.C.T1RTTV #: DATE OF DEATII: A.:COUDU: 289]030.524 Type: Checking Opm dAte: 3/25/1988 In tho name of: Eve]yn R Kilmore or Joyee K Morgan or BllrIY W Kilmore Date of Death Balance: $1,509.06 Int.{YTD) from 11112005 to 1125/2005 $3.00 A<<med inr..rert to dste of death: $0.65 Olh<< Inta; A."uualll: 2895412720 TyfIe: CD In Ihe name of: Evelyn R Kilmorc ar Joyce K MOIJ?;an Dare of DeRth BRlanee~ $~,0:L4.01 Int.(YTD) from 11112005 10 1/3112005 Aecnled interest to date of death: $8.95 ou.., In"" OlWn dste: lfl!1.0UU $12_51) P~9" 1 of 1 REGULAR SAVINGS ACCOUNT: Account Number/ Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Interest Eamed from 1/1/05 to Date of Death Name of Joint Owner CERTIFICATES OF DEPOSIT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Interest Eamed from 1/1/05 to Date of Death Name of Joint Owner Date Joint Ownership Established CERTIFICATES OF DEPOSIT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Interest Earned from 1/1/05 to Date of Death Name of Joint Owner Date Joint Ownership Established '" 1~ MEMBERS 1st FEDERAL CREDIT UNION ~~~~uw~~ MAR 2 6 2005 165611 -00 02/04/1997 LRWIN & i',;1cKNIGHT $1,754.76 $.87 $1,755.63 $2.64 Joyce Morgan - added 09/24/1997 Barry W. Kilmore - added 11/28/2003 165611 -43 09/25/1997 $50,000.00 $115.89 $50,115.89 $318.12 Joyce Morgan 09/25/1997 165611 -49 02/21/2002* $7,000.60 $14.40 $7,015.00 $39.19 Joyce Morgan 02/21/2002 165611 -50 04/17/2002** $8,600.00 $17.69 $8,617.69 $48.15 Joyce Morgan 04/17/2002 *Certificate established by transfer of funds from certificate 165611-47 listing Joyce Morgan as joint owner. **Certificate established by transfer of funds from savings account listing Joyce Morgan as joint owner. Estate of: EVELYN R. KILMORE Date of Death: February 19, 2005 Social Security Number: 209-12-5645 5000 Louise Drive. ro. Box 40 . Mechanicsburg, Penmylvania 17055 . (717) 697-1161 . www.rnembcrs1st.org ~. B.ERS 1ST FE9ERAL CREDIT UNION I j/r~~'( t/ dr)/' , 'nise A. Wolfe Insurance Services Sup' isor March 25, 2005