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Home My WebLink About09-23-05 REV-1S00 EX + (6-00) . W l- ll:: :$11) u It: ll:: Wl1.U J:OO " It:.... ~ l1.lD 11. c( COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENT'S NAME (LAST. FIRST, AND MIDDLE INITIAL) .... z w c w o w c Helwi Dean S. DATE OF DEATH (MM-DD-Year) DATE OF BIRTH (MM-DD.Year) OFFICiAl USE ONLY FILE NUMBER 2 1 -0 5 0 6 6 0 "Co'GNTY'CoiiE -VEAR- - - NUMBER- - SOCIAL SECURITY NUMBER 1 9 5 - 2 4 - 0 358 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER 8 o 3. Remainder Retum (date of death prior to 12-13-B2) 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) z o ~ :5 ::::) .... 0:: c( o w a:: z o ~ c( .... ::::) a.. :E o o >< c( .... 07/10/2005 11/29/1931 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) PA 17109 ,.------.- , OFFICIAU- USE ONLY Helwi Brenda H. [Xl 1. Original Retum o 4. Limited Estate [Xl 6. Decedent Died Testate (Attach copy of Wdl) o 9. Litigation Proceeds Received o 2. Supplemental Retum o 4a. Future I nterest Compromise (date of death after 12-12-82) o 7. Decedent Maintained a Living Trust(AtlachcopyofTrus~ o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1.1.95) 10,156.51 [ 10,156.51 (11) (12) (13) 10,156.51 I- Z W C Z o 11. II) W It: It: o U NAME Jac ueline A. Kell FIRM NAME (If Applicable) Jan L. Brown & Associates TELEPHONE NUMBER 717 -541-5550 COMPLETE MAILING ADDRESS 845 Sir Thomas Court Suite 12 Harrisbur (14) 10,156.51 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) o Separate Billing Requested 7. Inter.Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Govemmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) (8) 0.00 0.00 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under See. 9116 (a)(1.2) 10,156.51 X ~ (15) X _(16) X .12 (17) X .15 (18) (19) 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. D CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Decedent's Com lete Address: STREET ADDRESS 440 Wertz Run Road CITY Carlisle STATE PA ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1) 0.00 Total Credits (A + 8 + C) (2) 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (D + 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 refund (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. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58) Make Check Payable to: REGISTER OF WILLS, AGENT 0.00 0.00 0.00 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; ........................................................................... 0 001 b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 I&li . 0 ~,. c. retain a reversionary interest; or ...................................................................................................... IL:lJ d. receive the promise for life of either payments, benefits or care? ............................................................. 0 001 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?............................................................................................... 0 001 3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? ................. 0 001 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ....................................................................................................... 0 001 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF TIHE RETURN. Under penalties of peljury, I declare that I have examined this return, includi~ accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on alllOformalion of which preparer has any knowledge. SIGNATURE 0 PERSON RESPONSIBLE FOR F ING RETURN DATE ~ olJ. r ADDRESS PA 17109 I 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. ~9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995. the tax rate imposed on the net value of transfer~ "',', p The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirer 1.-)'.. "- - the surviving spouse is the only beneficiary. ')=t-\ For dates of death on or after July 1, 2000: ('\P;' 1. ' The tax rate imposed on the net value of transfers from a deceased child twenty-one years of af .,. .J..) t 5 C;C: or a stepparent of the child is 0% [72 P.S. ~9116(a)(1.2)]. r\, ' ,.~ The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal bene y- '<.J.::~,,-."-.3 \. U The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is individual who has at least one parent in common with the decedent, whether by blood or adoption. ~~o (>::..) ~--. ('C:::.. I ,,-" 1% [72 P.S. ~9116 (a) (1.1) (ii)]. return are still applicable even if atural parent, an adoptive parent, 99116(1.2) [72: P.S. ~9116(a)(1 )]. ned, under Section 9102, as an II REV-1503 EX + (6-98) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF Helwia. Dean S. FILE NUMBER 21 05 All property jointly-owned with right of survivorship must be disclosed on Schedule F. 0660 ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH 9,696.96 2. Prudential Financial Cusip #744320102 144.000 shares of common stock @ $67.34 MetLife, Inc. Investor ID 8064 7723 2738 10.000 shares of common stock @ $45.955 459.55 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 10156.51 "V."""" '. ' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES II FILE NUMBER HAlwin Dean S 21 Of) ORRO RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS pnclude OU~ht spousal distributions, and transfers under Sec. 9116 (a (1.2)] 1. Brenda H. Helwig spouse 100% 440 Wertz Run Road Carlisle, PA 17013 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, 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) II J ilia$l Ifill &11D [fp(staI11Pltt OF DEAN S _ HELWIG I, DEAN S. HELWIG of Cumberland County, Pennsylvania, do make, publish and declare this t:o be my Last Will and Testament ,hereby revoking all previous Wills and Codicils heretofore made by me. FIRST: 1 order my Executrix hereinafter named to pay all my debts and funeral expenses as soon after my death as is reasonably possible. SECOND: All the rest, residue and remainder of my 'estate , real, personal and mixed, of whatsoever kind and wheresoever situated, I give, devise and bequeath to my beloved wife, Brenda H. Helwig. THIRD: If my wife shall predecease me or fails to survive me by thirty (.30) days, then 1 give, devise and bequeath the rest, residue and remainder of my estate, real, personal and mixed, of whatsoever kind and wheresoever situated, to my children, Deborah Hare, Kimberly Shenk and Michael Helwig, in equal shares, per stirpes. FOURTH: I nominate, constitute and appoint my wife, Brenda H. Hehvig, as the Executrix of this my Last Will and Testament, with full power and authority to do any and all things necessary for the complete administration of my estate. Should my wife for any reason fai 1 to or refuse to qualify as such Executrix, then, in such event, I nominate, constitute and appoint Michael Helwig as Executor of this my Last Will and Testament_ ---2i) e ' ) nt/LoR QQ... /) C~:tiAj ..... /1 / A . " . /7 II COHMONWEALTH OF PENNSYLVANIA S5 COUNTY OF DAUPHIN We, DEAN S. HELWIG , and ":).)V':'-/-fb t; ;lllr/{u'u" and C'NUiy'J_ II ,(I flNlli.! testator and witn~sses, respectively, whose names are subscribed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testator signed and executed the instrument as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the testator, signed the Will as witnesses, and that to the best of their knowledge, the testator was at the time eighteen (18) years of age or older, of sound mind, and under no constraint or undue influence. ("" ) ~) t. /^ ~/eOi-V-/' ~ / / . (l~ Dean S. Helwig , ~.,------=.:t.l i----h 0.. Wifuew B~/ro-< A /1 :7 . /ffiL( 4/. ~/~._- Wltness '-.-Ji-I/':-X.:l'f. /l..,..",/ ~'...b:.~,:tjL,J'/ h I)~hn II;{: Hi"., /,,:2 fI- /1'101 1.'/:;:'1',_ N ::/:;- '--/ /\/(1". \. - - -- .-~ Notary '\ .1 / ~) ,(J c L,-;( Dated: ,://2 /~:j "~/H{f),J S. ~/r\-'Dr, :;G1i\i~\' ['UULie I~'iy CC',n:ij;:5..>(.tn E;.r'ije~ )Jn~J:i}' 'i. l'JJ~) /{arli:.l;,jJ':~, ; Ii. DJ,Jpl1m Counl}" II Should any person herein nominated as Executor qualify and at the time be a non-resident of the Commonwealth of Pennsylvania, I direct that he or she be not required to file any bond to the extent permitted by law. IN WITNESS WHEREOF, I have set my hand and seal to thip my Last Will and Testament this /2- day of JU N E-- , lP85. J)~ i iL/vt....~ DEAN S. HELWIG This instrument consisting of two (2) typewritten pag~s, each bearing the signature of the above-named, Dean S. Helwig, wcis by him on the date hereof, signed, published and declared by him td be his Last Will and Testament, in our presence, who at his requesij and in his presence and in the presence of each other, we believing him to be of sound and disposing mind and memory, have hereunto subscribed our names as witnesses. -Vf} ~n~. -~ residing at CJ. 37 G rJ~ L/i r C'Cv,-I/~J f4 17 0 ~I..s /b (/ kY./ ~-t~iding at s~ PI r !JYI'$ 4!t-{ I-in-rr/'~t.V'J' P?I- J 711d- MSN Money - US:PRU - Stock chart, Index chart , . Page] of2 MSN Home My MSN Hotmail Shopping Money People & Chat Sign In Web Search: L msn~ Money J~{...;i#~il ~f& CNBC Help Search MSN Money: I I~ Home News Banking Investing Planning Taxes My Money Investing Home Portfolio Markets Stocks Funds ETFs Commentary Brokers CNBC TV Portfolio Loans Insurance Quote, Chart, News Snapshot Company Report Quotes Charts Historical Name or Symbol: IUS:PRU I [~~ ELnd Symbol Print Report Dovmlo.:sd File shoo.-., Chart Real-Time Intraday Key Developments Recent News Research SEC Filings Advisor FYI Stock Rating Earnings Estimates Analyst Ratings Financial Results Insider Trading Ownership Community Guided Research Research Wizard Find Stocks Stock Screener Power Searches Top Rated Stocks Related Links l;Jo;~ert Picks E:-_[1lail & Alerts [PQ Center M~sage aoards C1!gital Gains Analysis Stock price data provided by Nomura Research Institute, Ltd. http://moneycentral.msn.com/investor/ charts/chartdl.asp ?Symbo ]=US %3 APR U &DateRan... 9/1 9/2005 MSN Money - MET - Stock chart, Index chart . . Page 1 of2 MSN Home My MSN Hotmail Shopping Money People & Chat Sign In Web Search: I msn~ Money -.-J~"o;i.,k~rl 1t7t& CNBC Help Search MSN Money: I Planning Taxes My Money It G~, Home News Banking Investing Portfolio Loans Insurance Investing Home Portfolio Markets Stocks Funds ETFs Commentary Brokers CNBC TV Quote, Chart, News Snapshot Company Report Quotes Charts Historical Real-Time Intraday Key Developments Recent News Research SEC Filings Advisor FYI Stock Rating Earnings Estimates Analyst Ratings Financial Results Insider Trading Ownership Community Guided Research Research Wizard Find Stocks Stock Screener Power Searches Top Rated Stocks Related Links EJ<~rt Picks I;~!llilj!'& Alerts IPQ Center Message Boards CaDita1.Gains Analysis Name or Symbol: IMET I [~_~] Find Symbol Print ReDor!; Dc.....mICl.:id File ShOIN chart Metlife Inc Date High Low Close Volume 7/29/2005 50.3000 48.5400 49.1400 4,469,900 7/28/2005 48.4900 47.5400 48.0600 2,421,800 7/27/2005 48.0600 47.1200 47.8000 2,848,300 7/26/2005 47.3900 46.4400 47.1200 2,331,800 7/25/2005 46.7800 46.3300 46.5400 1,691,000 7/22/2005 46.3900 45.2700 46.3900 1,926,600 7/21/2005 46.6500 45.9300 45.9500 1,557,500 7/20/2005 46.7700 45.8000 46.4900 3,522,000 7/19/2005 46.7700 46.3100 46.3600 1,202,100 7/18/2005 46.7300 46.3700 46.4000 1,549,100 7/15/2005 46.6000 45.8700 46.4000 2,053,000 7/14/2005 46.1900 45.2300 46.0400 2,874,300 7/13/2005 46.1300 45.5500 45.5500 2,237,900 7/12/2005 45.8900 44.9700 45.7300 2,522,800 7/11/2005 46.3000 45.5100 45.7500 3,092,900 _:\12i1 {\ L/ 5, '-1 oS 7/8/2005 46.2300 45.7800 46.1500 1,858,200 . fv,\ k2 OJ~ //(;,ooS . -...........~----_._-_.._--, \- ~--,~ ,.Y' 95~-' 2,755,000 ie, 7/7/2005 46.2000 45.0000 46.1000 .145, "li 7/6/2005 46.9700 46.3900 46.7000 2,695,400 ~__ /'--~t,. 7/5/2005 46.6900 45.5300 46.6300 2,929,700 7/1/2005 45.5400 45.0000 45.4700 1,659,900 [ Trade Now ] Stock price data provided by Nomura Research Institute, Ltd. http://moneycentral.msn. com/investor/ charts/chartdl. asp ?Symbo I=MET &DateRangeF 01111... 9/19/2005 Register of Wills, Cumberland County , II INVENTORY Estate of Dean S. Helwig No. 2005 0660 also known as Dean S. Helwig Date of Death 7/10/2005 Social Security No. 195-24-0358 , Deceased 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 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 Decedent owned, no real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. 1!We verify that the statements made in this inventory are true and correct. I/We understand that false statements herein made are subject: to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Personal Representative: Name of Attorney: Jacqueline A. Kelly 1.0. No.: 91973 Brenda H. Helwig q-~/-05 Dated PA 17109 Description Value Prudential Financial Cusip #744320 10 2 144.000 shares of common stock @ $67.34 MetLife, Inc. Investor ID 8064 7723 2738 10.000 shares of common stock @ $45.955 9,696.96 i' ,L '-r.} "j' : I !'i_) \J!) Total (Attach Additional Sheets if necessary) 1,0,156.51 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventory. RW-4 v~ 459.55