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TO Register of Wills Office
Cumberland County Courthouse
1 Courthouse Square
Carlisle, PA 17013-3387
SUBJECT:
Estate of Edna C. Kimmel
No. 21-05-00486
FROM
JOHNSON, DUFFIE, STEWART & WEIDNER
Attorneys at Law
P.O. Box 109
Lemoyne, PA 17043
(717) 761-4540
Fax: (717) 761-3015
DATE: July 27,2005
Enclosed for filing in the above-captioned Estate are the following:
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1. Original Inventory.
2. Original and copy of Inheritance Tax Return.
3. Check in the amount of $30.00 filing charges.
4. Check in the amount of $346.60, Inheritance Tax balance.
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Please forward the receipts to me in the enclosed envelope.
Thank you.
SIGNED:
REV -1500 EX ~ (6-001
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I FILE NUMBER
21 05
COUN}J' C~DE -'fEAR__
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SOCIAL SECURITY NUMBER
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(FrielAL USt: OMS
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT, 280601
HARRISBURG. PA --.!!12_~6?_~_
DECEDENT'S NAME (LAST. FIRST. AND MIDDLE INITIAL)
KIMMET '. EDNA C.
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DATE OF DEATH (MM-DD-YEAR)
--DATE OF BIRTH(MM~b6:YEARj--
04/17/2005
08/14/1918
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST. FIRST AND MIDDLE INITIAL)
Original Return
2 Supplemental Return
00486
_l'JUMBEL __
266-16-7392
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
4. Limited Estate
4a Future Interest Compromise (date of death after
12-12-B2)
7. Decedent Maintained a Living Trust {A1tach
copy of Trust)
o 3 RemainderReturn(daieofdeath prior t(}~f2-13=e2)
o 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
o 11.Election to tax under Sec. 9113(A) (Attach Sch 0)
6 Decedent Died Testate (Attach copy
of Will)
9 Litigation Proceeds Received
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~ FIRM NAME (If applicable)
~ JOHNSON, DUFFIE, STEW ART & WEIDNER
TELEPHONE NUMBER
717/761-4540
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sale-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Misceilaneous PersDnal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o Separate Biiling Requested
7. Inter-Vivos Transfers & Mlsceilaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deduct/ons(total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
301 Market St.
Lemoyne,PA 17043-0109
(1) None
(2) None
(3) None
(4) 153,577.59
(5) 662.12
(6) 3,506.44
(7) None
(8)
(9) ]5,310.24
(10) 1,400.32
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157,746.15
16,710.56
141,035.59
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax(Line 12 minus Line 13)
141,035.59
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax rate,
or transfers under Sec. 9116(a)(1.2)
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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
x .00
I 4 1 ,03 5 .59 x .045
6,346.60
x .12
x .15
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
6,346.60
20. 0
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Copyright 2000 form software only The Lackner Group, Inc.
Form REV-1500 EX (Rev. 6-00)
, Decedent's Complete Address:
STREET ADDRESS
1000 CLAREMONT ROAD
CITY
CAR LISLE
,STATE PA
,ZIP 17013
----
~__l~J:
PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred;.............................__.............................................. ~ I
~: ;::::~ :h~e~;~;i~~:~s:~~e~:s~:~. ~~~I.I. .~~~. t~~. ~r~~~~~ .t~~.n.sf~~red. .o.r .it~. i.~.~.O.~~;......................~::::::.:::: ::'.'
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?............................. n............................ --. ........................... __..................... 0
o
o
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
5,700.00
300.00
Total Credits (A + B + C)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty (D + E)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is thEOVERPAYMENT.
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 theT AX DUE.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is theBAlANCE DUE
Make Check Payable to: REGISTER OF WILLS, AGENT
(1)
6,346.60
(2)
6,000.00
(3) 0.00
-- ----
(4) --,--"--.-
(5) 346.60
(5A)
(5B) 346.60
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?....................... ...... n... .............. ....... .... n............. ...............__ ....... ...........
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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, J declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge ano belief, it is true, correct and complete. Declaration
preparer other than .the personal r~p~~e.~ative i~a~d~f! ~.in-.!.~rmali~~ o~",,~!0 2!:.eparer ha~ a!]' ~~()~~.~.~e.
SIGNATUR~'()i' PERSON RESPON BlE FOR FILING RETUE,N ADDRESS
L~~K~ZJl.T ~~ -/- A;/-.oLr~,- _ ~~&A~m~~l{;~~;h 17055
SIGNA~~ PERS R SIBLE FOR F~..l;~ ADDRESS
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ADDRESS
DATE
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OATE
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301 Market St.
Lemoyne, P A 17043-0109
....i.__J';~!lJIII, L lill
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the
surviving spouse is 3% [72 P.S. 99116 (a) (1.1) (i)J.
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfer~ '
[72 P .S. !j9116 (a) (1.1) (ii)]. The statutedoes not exemDta transfer to a surviving spouse from t,
of assets and filing a tax return are still applicable even if the surviving spouse is the only benefi,
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 a[:
parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. !j9116 (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal bene
1.2) [72 P.S. !j9116 (a) (1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is
under Section 9102, as an individual who has at least one parent in common with the decedent,
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closure
f a natural
".S. !j9116
is defined,
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SCHEDULE D
I MORTGAGES & NOTES RECEIVABLE !
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
KTMMEL, EDNA C.
All property jointly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
I
DESCRIPTION
Mortgage - Face Amount - $210,000.00.
Date: 10/8/2002
Rate ofIntercst: 5.000%
Maturity date: 05/08/2011
Mortgagor: Michael A. Serluco
Cumberland County - Book 1778, Page 4778
Date of Death Balance:
I FILE NUMBER
21 - 05 - 00486
TOTAL (Also enter on Line 4, Recapitulation)
VALUE AT DATE OF
DEATH
- ~.._~._-
153,577.59
153,577.59
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
Name of Joint Owner
CHECKING ACCOUNT:
Account Number/Suffix
Date Account Established
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest
Name of Joint Owner
MONEY MANAGEMENT ACCOUNT:
Account Number/Suffix
Date Account Established
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest
Name of Joint Owner
Estate of: EDNA C. KIMMEL
Date of Death: 04/17/2005
Social Security Number: 266-16-7392
fvl-
MEMBERS 1s1
FEDERAL CREDIT UNION
CG@~w
223310 -00
10/17/2002
$25.00
$.00
$25.00
Linda K. Albert, added 10/17/2002
Fred C. Kimmel, added 11/18/2002
223310 -11
10/17/2002
$5,371.43
$.57
$5,372.00
Linda K. Albert, added 10/17/2002
Fred C. Kimmel, added 11/18/2002
223310 -05
10/17/2002
$5,225.74
$2.84
$5,228.58
Linda K. Albert, added 10/17/2002
Fred C. Kimmel, added 11/18/2002
~iB . E.. R S 1ST FEDERA. .L.CREDIT UNION
. /} ') .J
I '4!l<7~ it t:Zf4-
D nise A. Wolfe J
Insurance Services Supervisor
July 19, 2005
SOO(J LOuise Dnve . P.o. Box 40 . Mechanicsburg. Pennsylvania 17055 . (717) 697-116! . www.mernberslst.org
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
KIMMEL, EDNA C.
FILE NUMBER
21 - 05 - 00486
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
FUNERAL EXPENSES:
Myers-Hamer Funeral Home, Inc.'
2
Rolling Green Cemetery Company - intemlent charges
3
Giant Markets - food purchased for funeral lunch.
4
Hecht's - clothing purchased for burial
5
Rolling Green Cemetery - Gravemarker
6
Royer's Flowers
B.
ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
LINDA K. ALBERT
Social Security Number(s) / EIN Number of Personal Representative(s):
Street Address 911 HAWTHORN AVE.
City MECIIANICSBURG State PA
Year(s) Commission paid 2005
Zip 17055
2.
Attorney's Fees JOHNSON, DUFFIE, STEWART & WEIDNER --
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City
Relationship of Claimant to Decedent
State
Zip
4.
Register of Wills - Cumberland County
Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
7
I
Other Administrative Costs
Register of Wills - file Inventory & Inheritance Tax Return
2
Recorder of Deeds - file Satisfaction of Mortgage
Total of Continuation Schedule(s)
TOTAL (Also enter on line 9, Recapitulation)
7,160.00
995.00
333.48
118.26
1,108.00
185.50
2,500.00
2,500.00
303.00
30.00
27.00
50.00
15,310.24
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
KIMMEL, EDNA C.
3
Reserve for close-out costs
Schedule H
Funeral Expenses &
AdninistralNe CosIs continued
FILE NUMBER
I 21 _ 05 - 00486
50.00
Page 2 of Schedule H
ESTATE OF
..
SCHEDULE I
DEBTS OF DECEDENT, MORTGAGE
LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
KIMMEL, EDNA C.
Include unreimbursed medical expenses.
ITEM
NUMBER
1
2
3
4
5
DESCRIPTION
Central Penn Medical Group Emergency - decedent's account balance
Cumberland - Goodwill Fire/Rescue - decedent's account balance
P A Department of Revenue - 2004 income tax
Linda K. Albert - Reimbursement for expenses
paid for decedent prior to death.
Check that cleared after death - Members 1st Account No. 223310-11
Highmark Blue Shield - premium due.
I FILE NUMBER
21 - 05 - 00486
TOTAL (Also enter on Line 10, Recapitulation)
~
AMOUNT
12.10
53.87
279.00
476.80
578.55
1,400.32
REV.1513 EX+ (9~OO)
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
ReSIDENT DECEDENT
ESTATE OF
NUMBER
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
FILE NUMBER
21 - 05 - 00486
RELATIONSHIP To-I ;MOUNT~R-SHARE
DECEDENT OF ESTATE
___Do__Not_Lls_t Trustee(s.)_ _______
KIMMEL, EDNA C.
T.
TAXABLE DISTRIBUTIONS (include outright spousal distributions)
Lmda K. Albert
911 Hawthorn Ave., Mcchanicsburg, PA 17055
Daughter
$20,000.00 cash
bequest; one-half
residue.
2
Fred C. Kinunel
303 Quail Ridge Lane, Madison, IN 47250
I Son
$20,000.00 cash
bequest; one-half
residue.
\
; Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover she~t
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 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
--~-
Register of Wills of Cumberland County, Pennsylvania
INVENTORY
Estate of KIMMEL, EDNA C.
No. 21 - 05 - 00486
Date of Death 4/17/2005
also known as
. Deceased
Social Security No. 266-16-7392
LINDA K. ALBERT
- -'- --- ---- -- ---.----
The Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory
include all of the personal assets wherever situate and all of the real estate located in the Commonwealth of Pennsylvania
of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the
Decedent's death, and that the Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that
which appears in a memorandum at the end of this Inventory. l!We verify that the statements made in this Inventory are true
and correct I/We understand that false statements herein are made subject to the penalties of 18 Pa. C. S. Section 4904
relating to unsworn falsification to authorities.
Attorney:
JERRY R. DUFFlE
Personal Representativ~ .' ~_ ../''i/'" a "
Signature: cJf~L{LOi:..~n&i;t2P
LINDA K. AL ERT
Signature:
1.0. No.:
09601
Signature:
301 Market St.
Lemoyne, PA 17043-0109
Telephone: 717/761-4540
Address: 911 HAWTHORN AVE.
MECHANICSBURG, PA 17055
Address:
Telephone: (717) 697-1661
Dated:
7- c17- ;217OS'
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Personal Property
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Mortgage - Face Amount - $210,000.00.
Date: 10/8/2002
Rate ofInterest: 5.000%
Maturity date: 05/08/2011
Mortgagor: Michael A. Serluco
Cumberland County - Book 1778, Page 4778
Date of Death Balance:
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:~~53,571.~21
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Paragraph II of the Will- Automobile, household goods, personal
effects and other tangible personalty - Adeemed
0.00
Paragraph III - Jewelry (Engagement ring and wedding ring) - Adeemed
0.00
HighMark - premium refund - balance of April, May, June, July
662.12
Total Personal Property
$154,239.71
(Attach additional sheets if necessary)
Total Personal Property and Real Estate
$154,239.71
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
DUFFIE JERRY R
301 MARKET ST
POBOX 109
LEMOYNE, PA 17043-0109
_~n____ fold
ESTATE INFORMATION: SSN: 266-16-7392
FILE NUMBER: 2105-0486
DECEDENT NAME: KIMMEL EDNA C
DATE OF PAYMENT: 07/28/2005
POSTMARK DATE: 07/27/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 04/17/2005
REMARKS:
CHECK# 104
SEAL
ACN
ASSESSMENT
CONTROL
NUMBER
101
TOTAL AMOUNT PAID:
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
REV-1162 EX(1196)
NO. CD 005631
AMOUNT
$346.60
$346.60
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS