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HomeMy WebLinkAbout12-22-05 (2) REV-1500 EX + (6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT_ 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT t- Z W C W U W C W I- ~~(/) (.)O::~ w~(.) :1:0::9 (.) Q,,1XI Q" <( DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) HECKENDORN RICHARD L. DATE OF DEATH (MM-DD-Year) DATE OF BIRTH (MM-DD-Year) OFFICIAL USE ONLY FILE NUMBER 21 -05 0 8 7 7 COuNTY"CoiiE ---YijR'-- - - NuMsER- - SOCIAL SECURITY NUMBER 1 84- 3 8 - 0 489 THIS RETURN MUST BE FilED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER D 3. Remainder Retum (date of death priorto 12-13-82) D 5. Federal Estate Tax Retum Required _ 8. Total Number of Safe Deposit Boxes D 11. Election to tax under Sec. 9113(A) (Aftach Sch 0) THIS SECTION MUST BECOMPLETEDiAlll CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BEDlRECTED TO: NAME COMPLETE MAILING ADDRESS HAROLD S IRWIN III 64 SOUTH PITT STREET FIRM NAME (If Applicable) IRWIN LAW OFFICE CARLISLE PA 17013 TELEPHONE NUMBER 717 -243-6090 z o i= ~ ...J ::::J t- o: ~ u w 0:: z o i= ~ t- ::::J Il. :!: o U ~ t- 130,243.99 X 0.00 (15) 0.00 142,006.04 X .045 (16) 6,390.27 511.65 X .12 (17) 61.40 0.00 X .15 (18) 0.00 (19) 6,451.67 09/23/2005 10/04/1947 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) YVONNE K MALLOY ~ 1. Original Return D 4. Limited Estate ~ 6. Decedent Died Testate (AtlachcopyofWiII) D 9. Litigation Proceeds Received D 2. Supplemental Return D 4a. Future Interest Compromise (date 01 death after 12-12-82) D 7. Decedent Maintained a Living Trust (Aftachcopy ofTrust) D 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) I- Z w Q Z o Q" (/) w 0:: 0:: o (.) 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. 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 (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (1) (2) (3) (4) (5) (6) (7) (9) 14. Net Value Subjectto 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 Sec. 9116 (a)(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 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSESIDEANDRECHECKMATH < < OFFICIAL USE ONLY r"'..J (0) C) G"\ 305,172.98 272,761.68 Decedent'rS Complete Address: ---:_->':--l.'--~ STREET'ADDI1ESS ' I 13@9 MOUNTAIN ROAD I I NEW~URG I Tax paymknts and Credits: 1. Tax Due (hge 1 Line 19) 2. Credits/Payments I A. Spousal Poverty Credit B. Prior Payments C. DiscouAt 3. InteresupJnalty if applicable D. Interest! E. penaltyl I T otallnteresUPenalty ( 0 + E ) 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 CITY I STATE PA I ZIP '17240 (1) 6,45'1.67 322,58 Tolal Credits (A + B + C) (2) 322.58 (3) 0.00 (4) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. IS) 6.129.09 A. Enter ti1e interest on the tax due. (SA) B. Enter tlie total of Line 5 + SA. This Is the BALANCE DUE. (5B) 6,129.09 I Make Check Payable to: REGISTER OF WILLS, AGENT pLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS j. Did decedent make a transfer and: Yes No I a. retain the use or income of the property transferred; ........................................................................... 0 IX! I b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 IX! I c. retain a reversionary interest; or ...................................................................................................... 0 IX! I d. receive the promise for life of either payments, benefits or care? ........................ ........ .....%................ .... 0 IX! t- If death occurred after December 12, 1982, did decedent transfer property within one year of death I. ~:~h~~:::~~::;na:~:,~::;u~~:;,~:;~:y:?~;~. ~~.~~ '~~~'t;~ .~~~.~ .~.~~~~.~;.~.r. ~~~~'r;;~'~; .~;~.;; ~~; ~~~;~.~..:::::::::::::::: B ~ I' Did decedent own an Individual Retirement Account, annuity, or other non-probate property which I contains a beneficiary designation? .................................. ........................ ... ......... ................................. [RJ 0 I IF THE ANS,,\,ER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. A ESS I 64 S:nth Bitt stnEt :m 17013 I For dates of deijlth 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)]. I For dates of deijlth 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. 99116 (a) (1.1) (ii)J. 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 surviving sPlouse is the only beneficiary. For dates of derth on or after July 1, 2000: The tax rate im~osed 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 lot the child is 0% [72 P.S. 99116(a)(1.2)]. The tax rate im~osed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 99116(1.2) [72 P.S. 99116(a)(1 )J. 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. 99116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who I\as at least aile parent in common with the decedent, whether by blood or adoption. I 12 23-05 [Il~X, n(a MnIain lbd :m 17240 REV-1502 EX + (6-98) r ~ . SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER HECKENDORN. RICHARD L. 21 05 0877 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real prooertv which is iointlv-owned with riaht of survivorshiD must be disclosed on Schedule F. ITEM NUMBER 1. 2. DESCRIPTION HOUSE AND LAND AT 1369 MOUNTAIN ROAD, NEWBURG, PA 17240 Life Estate Interest Bequeathed to Spouse, Yvonne K. Malloy Value based on appraisal attached as Exhibit "B" (See also Schedule K) HOUSE AND LAND AT 1369 MOUNTAIN ROAD, NEWBURG, PA 17240 Remainder Interest to children Value based on appraisal attached as Exhibit "B" VACANT LOT ON MOUNTAIN ROAD, NEWBURG, PA 17240 Value based on appraisal attached as Exhibit "C" VALUE AT DATE OF DEATH 1 08,049.48 45,950.52 3. 18,000.00 TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 172,000.00 REV-1503 EX + (6-98) r. *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF HECKENDORN. RICHARD L. FILE NUMBER 21 05 0877 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH NONE 0.00 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 0.00 REV-1504 EX + (6-9B) ,~ *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE C CLOSELY-HELD CORPORATION, PARTNERSHIP OR SOLE-PROPRIETORSHIP ESTATE OF HECKENDORN. RICHARD L. FILE NUMBER 21 05 0877 Schedule C-1 or C-2 (including all supporting information) must be attached for each closely-held corporation/partnership interest of the decedent. other than a sole-proprietorship. See instructions for the supporting information to be submitted for sole-proprietorships. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH NONE 0.00 TOTAL (Also enter on line 3, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 0.00 REV-1507 ~X: '. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE D MORTGAGES & NOTES RECEIV ABLE ESTATE OF HECKENDORN. RICHARD L. FILE NUMBER 21 05 0877 All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH NONE 0.00 TOTAL (Also enter on line 4, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 0.00 REV-15GB EX + (6-9B) ,,* SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF HECKENDORN. RICHARD L. FILE NUMBER 21 05 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. 0877 ITEM NUMBER 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. DESCRIPTION AXA ADVISORS, LLC Investment Contract No. 2VA0036254 Value based on letter attached as Exhibit "D" ORRSTOWN BANK Checking Account No. 110000164 Value based on letter attached as Exhibit "E" PATRIOT FEDERAL CREDIT UNION Money Market Account No. 0001224400 Value based on letter attached as Exhibit "F" 1992 BUICK REGAL Value based on average between Trade-In and Private Party Values Kelley Blue Book print-out attached as Exhibit "G" 2002 HARLEY DAVIDSON MOTORCYCLE Value based on letter attached as Exhibit "H" 2003 HARLEY DAVIDSON MOTORCYCLE Value based on letter attached as Exhibit "H" HONDA RIDING LAWNMOWER Value based on verbal appraisal from Nolt's Engine Service FREY TRANSPORTATION, INC. Unpaid Wages AMERICAN LEGION Death Benefits MUTUAL OF AMERICA Tax Deferred Annuity Plan Value based on letter attached as Exhibit "I" MUTUAL OF AMERICA IRA - SEP Value based on letter attached as Exhibit "I" ADAMS ELECTRIC Refund of Patronage Capital THREE SHOTGUNS and ONE RIFLE Descriptions and Values based on appraisal attached as Exhibit "J" VALUE AT DATE OF DEATH 31,662.50 16,492.80 1,274.06 655.00 13,640.00 15,480.00 3,900.00 457.71 200.00 853.68 713.41 273.82 570.00 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 86,172.98 REV-1509 EX + (6-98) , . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF HECKENDORN. RICHARD L. SCHEDULE F JOINTLY-OWNED PROPERTY FILE NUMBER 21 05 0877 If 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. MICHAEL L. HECKENDORN B c JOINTLY.OWNED PROPERTY: ADDRESS 327 HUNTSMAN DRIVE GOOSE CREEK SC 29445 RELATIONSHIP TO DECEDENT BROTHER LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECO'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. 1/2 INTEREST IN HOUSE AND LAND AT 94,000.00 50. 47,000.00 123 STEELSTOWN ROAD, NEWVILLE, PA 17241 (Value based on appraisal attached as Exhibit "K") TOTAL (Also enter on line 6, Recapitulation) $ 47,000.00 (If more space is needed, insert additional sheets of the same size) REV-1510 EX + (6-98) '~. .., ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF HECKENDORN. RICHARD L. SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER 21 05 0877 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 ITEM INCLUDE THE NAME OF THE TRANSFEREE. THEIR RELATIONSHIP TO DECEDENT AND DATE OF OEATH % OF DECD'S EXCLUSION TAXABLE NUMBER THE DATE OF TRANSFER. ATTACH A COPY OFTHE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE 1. NONE 0.00 0.00 TOTAL (Also enter on line 7 Recapitulation) $ 0.00 (If more space is needed, insert additional sheets of the same size) REV-1511 EX + (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF HECKENDORN. RICHARD L. SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS Debts of decedent must be reported on Schedule I. FILE NUMBER 21 05 0877 ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. RONAN FUNERAL HOME - Funeral 9,642.45 2. CUMBERLAND VALLEY MEMORIAL GARDENS - Grave Opening I Closing 1,045.00 3. LADIES' AUXILLARY - Food at Funeral 250.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees IRWIN LAW OFFICE 12,905.18 3. Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation) 3,500.00 Claimant YVONNE K. MALLOY Street Address 1369 MOUNTAIN ROAD City NEWBURG State PA Zip 17240 Relationship of Claimant to Decedent SURVIVING SPOUSE 4. Probate Fees REGISTER OF WILLS 438.00 5. Accountant's Fees 6. Tax Return Pre parer's Fees 7. FRANCIS E. OILER, TAX COLLECTOR - Real Estate Taxes 1,914.04 8. FRANCIS E. OILER, TAX COLLECTOR - Personal Taxes 10.00 9. CINCINNATI INSURANCE CO. - Motor Vehicle Insurance Premium 274.00 10. M & S HARLEY DAVIDSON - Repairs to Motorcycle 500.00 11. DIVERSIFIED APPRAISAL SERVICES - Three Real Estate Appraisals 800.00 TOTAL (Also enter on line 9, Recapitulation) $ 31,278.67 (If more space is needed, insert additional sheets of the same size) REV~1512 ~X.. <>-. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE. DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS ESTATE OF HECKENDORN. RICHARD L. FILE NUMBER 21 05 0877 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION 1. WSI Trash Collection VALUE AT DATE OF DEATH 59.71 2. DISH NETWORK Satellite Account 50.86 3. ADAMS ELECTRIC COOPERATIVE, INC. Electric Bill 136.32 4. SUBURBAN ENERGY SERVICES Gas Bill 140.79 5. FAIRWAY MEDICAL ASSOCIATES PC Medical Bill 57.50 6. SPRINT Phone Bill 58.90 7. THE SENTINEL Newspaper Subscription Bill 70.32 8. U.S. BANK Outstanding Credit Account 558.23 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 1 132.63 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 [include outritt spousal distributions, and transfers under Sec. 9116 (a (1.2)] 1. DOROTHYZ.HECKENDORN Lineal 123 Steelstown Road See Exhibit "L" Newville PA 17241 2. BRETT A. HECKENDORN Lineal 12 Wren Street North See Exhibit "L" Martinsburg WV 25401 3. KIMBERLY J. HENSELL Lineal 67 Cobblestone Court See Exhibit "L" Martinsburg WV 25401 4. MICHAEL L. HECKENDORN Sibling 327 Huntsman Drive See Exhibit "L" Goose Creek, SC 29445 5. LAUREN T. HENSELL Lineal 67 Cobblestone Court See Exhibit "L" Martinsburg, WV 25401 6. BRIAN L. HENSELL Lineal 67 Cobblestone Court See Exhibit "L" Martinsburg, WV 25401 Spousal 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. YVONNE K. MALLOY 130,243.99 1369 Mountain Road Newburg PA 17240 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. NONE 0.00 TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 130,243.99 Rev"" '" .,'. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF HECKENDORN RICHARD L SCHEDULE J BENEFICIARIES (If more space is needed, insert additional sheets of the same size) FILE NUMBER 21 05 0877 I lit I..,. REV-1514 EX + (6-98) '* SCHEDULE K LIFE ESTATE, ANNUITY & TERM CERTAIN Check Box 4 on Rev-1500 Cover Sheet FILE NUMBER COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF HECKENDORN. RICHARD L. 21 05 0877 This schedule is to be used for all single life, joint or successive life estate and term certain calculations. For dates of death prior to 5-1-89, actuarial factors for single life calculations can be obtained from the Department of Revenue, Specialty Tax Unit. Actuarial factors can be found in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death on or after 5-1-89. Indicate the type of instrument which created the future interest below and attach a copy to the tax return. !XI Will D Intervivos Deed of Trust D Other LIFE ESTATE INTEREST CALCULATION NAME(S) OF LIFE TENANT(S) DATE OF BIRTH NEAREST AGE AT DATE OF DEATH TERM OF YEARS LIFE ESTATE IS PAYABLE ~ Life or D Term of Years D Life or D Term of Years D Life or D Term of Years D Life or D Term of Years YVONNE K. MALLOY 6/1/1954 51 1. Value of fund from which life estate is payable. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. Actuarial factor per appropriate table . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Interest table rate - D 31/2% D 6% D 10% !XI Variable Rate 5 % $ 0.70162 154,000.00 3. Value of life estate (Line 1 multiplied by Line 2) $ 108,049.48 ANNUITY INTEREST CALCULATION NAME(S) OF ANNUITANT(S) DATE OF BIRTH NEAREST AGE AT DATE OF DEATH TERM OF YEARS ANNUITY IS PAYABLE DLife or DTerm of Years D Life or D Term of Years D Life or D Term of Years DLife or DTerm of Years 1. Value of fund from which annuity is payable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. $ 2. Check appropriate block below and enter corresponding (number) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Frequency of payout - D Weekly (52) D Bi-weekly (26) D Monthly (12) D Quarterly (4) D Semi-annually (2) D Annually (1) D Other ( ) 3. Amount of payout per period. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. $ 4. Aggregate annual payment, Line 2 multiplied by Line 3. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. Annuity Factor (see instructions) Interest table rate - D 31/2% D 6% D 10% D Variable Rate % 6. Adjustment Factor (see instructions~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7. Value of annuity - If using 31/2%,6%, 10%, or if variable rate and period payout is at end of period, calculation is : Line 4 x Line 5 x Line 6 ............................ $ If using variable rate and period payout is at beginning of period, calculation is : (Line 4 x Line 5 x Line 6) + Line.3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ NOTE: The values of the funds which create the above future interests must be reported as part of the estate assets on Schedules A through G of this tax return. The resulting life or annuity interest(s) should be reported at the appropriate tax rate on Lines 13, 15, 16 and 17. (If more space is needed, insert additional sheets of the same size) .","'. 12-20-/05 13:35 FROM-ZULLINGER-DAVIS PROF 717-530-5222 Annuity, Life Estate. and Remainder Factors T-559 P02/02 U-002 12/20/2005 Transfer Date: ~7520 Rate: Calculation Type: Principal: Lives: Ages: Factor: Value: Life Estate 0.70162 $108,049.48 912005 5_00% Ufe $154,000 1 51 Remainder 0.29838 $45,950.52 " ~ If you are reading this letter I have passed on. I love you all and will miss my family and friends. This letter is to inform everyone of my last wishes and want everyone to respect my last will and testament. My love of my life Yvonne I want to get the house and it's contents. In the event Yvonne passes away also then the house is to be sold and divided between Brett,Kim,Norman and Jenny. As long as Yvonne is living she keeps the house. If she decides to sell the house then she should give Brett & Kim each $25,000 after the sale and Yvonne keeps the rest and then she can will Norman & Jenny her belongings of what she recieved from me when she passes away. The land beside the house can be sold and the proceeds I want to go to aii the grand children. I want Brett, Kim,Norman & Jenny to help Yvonne in any way to take care of all my arrangements. I want Yvonne in full control of my checking account to pay the car off and to pay the mower off at Nolt's Engine Repair. There is enough money in the checking to pay for both those items plus pay for my funeral expenses. All my stocks and accounts at The Mony Group in Chambersburg ( Betty Lou Hawbaker) has Yvonne, Brett & Kim as Benificiary's, so you will have to call her for that money. I would like to give my Mother (Dorothy) my Money Market Account for her to pay for wash & sets plus her perms at Helen Wagner's or wherever she wants to go. My Mother ( Dorothy) put me & my brother Michael's name as owner's of her home and it is stated that in the event of my death my share of the house shall go to my children Brett & Kim. Any other money that I should recieve from my Mother's Estate I would like to go to Yvonne. My brother ( Michael) can have all my Shotguns and Pistols.1 hope this sounds fair to everyone. I Love You All "' (J C) :2 DAD \~ "(1) ;ck" /1.4 j ~?( ~06 ~:~c/) ./~/?p,j~?- lJrtt?^- ))YL7/ / '~} )OO~) / 'l" t' ../ / '- J -...L.tj 1 _ -/"1, j'-' , (1 (' (' ,"~l \... \... J lJjL_) - ) ,II I,(y"__ '--- J \......J ~----~ SUMMARY OF IMPORTANT FACTS AND CONCLUSIONS LOCATION: 1369 Mountain Road Newburg, Pennsylvania TAX PARCEL NUMBER: 44-06-0041-077 IMPROVEMENTS: Split-level single-family dwelling. PROPERTY RIGHTS: Fee simple interest. OWNERSHIP HISTORY: The subject property is owned by Richard L. Heckendorn. The property was purchased on April 26, 1988 for a reported consideration of $7,000 and ownership transferred on deed reference 33-H-517. SCOPE OF THE ASSIGNMENT: The scope of the assignment included an analysis of the subject's area, an inspection of the subject property, an estimation of the property's highest and best use, consideration of all three approaches to value, and the application of those relevant to the valuation of the subject. OBJECTIVE: To estimate the market value of the subject property as unencumbered. EFFECTIVE DATE: September 23,2005. HIGHEST AND BEST USE: Continued use as a single-family residence. COST APPROACH: N.A. SALES APPROACH: $154,000 INCOME APPROACH: N.A. FINAL VALUE CONCLUSION: $154,000 2 SUMMARY OF IMPORTANT FACTS AND CONCLUSIONS LOCATION: Lot No.4 Mountain Road Newburg, Pennsylvania TAX PARCEL NUMBER: 44-06-0041-076 DESCRIPTION: A .68-acre tract of vacant land. PROPERTY RIGHTS: Fee simple interest. OWNERSHIP HISTORY: The subject property is owned by Richard L. Heckendorn. The property was purchased on May 15, 1995 for a reported consideration of $12,500 and ownership transferred on Deed Book 122, Page 250. . SCOPE OF THE ASSIGNMENT: The scope of the assignment included an analysis of the subject's area, an inspection of the subject property, an estimation of the property's highest and best use, consideration of all three approaches to value, and the application of those relevant to the valuation of the subject. OBJECTIVE: To estimate the market value of the subject property as unencumbered. EFFECTIVE DATE: As of September 23,2005. HIGHEST AND BEST USE: Use as a residential building lot. COST APPROACH: N.A. SALES APPROACH: $18,000 INCOME APPROACH: N.A. FINAL VALUE CONCLUSION: $18,000 2 II AXA Advisors, LLC Betty Lou Hawbaker, LUTCF, CFP'~ Financial Professional A. ~ ~_ CFP, October 5,2005 Irwin Law Office 64 South Pitt Street Carlisle, PA 17013 RE: Estate of Richard L. Heckendorn Contract No. 2V A0036254 Dear Mr. Irwin, In regards to your letter dated October 3,2005, concerning Richard L. Heckendorn, account number 2V A0036254. The Beneficiaries on this account are - Children: Brett Heckendorn, Kimberly Hensell and Friend Yvonne K. Malloy - Equally. There are no Joint Owners on this contract. The value of the account on Date of Death, September 23,2005 and approximate amount payable is $31,662.50 in which ~,662.50 is tax~hlp .. I have enclosed the necessary forms to process the death claim. * Claim Form which requires SIGNATURE from each Beneficiary. I also need Social Security and Telephone Numbers completed. * I need EACH Beneficiary to SIGN a Federal Income Tax Statement of El~ciioll lonll indi-':iiling tax pre[ucllce. ~'ou can not locate the original contract document, we need ALL . '~eneficiaries to SIGN the Certification of Loss or Destruction form. Please have the Claim Forms completed and return to me for processing. If you have any questions or concerns, please give me a call. Sincerely, M;-~~1dJ Betty Lou Hawbaker Certified Financial Planner / AXA ADVISORS 25 Penncraft Avenue. Professional Arts Building. Suite 210. Chambersburg. PA 1720 I Tel: (717) 26 J -1557 Fax: (717) 26 J -1352 betty.lou. hawbaker@axa-advisors.com Securities offered through AXIl Advisors. LLC (NY, NY 212-314-4600). member NASD. SIPC Annuity and insurance products offered through AXIl Network. LLC and its subsidiaries. www.AXAonline.com . OCT 12 2005 2:49PM CALL CENTER 717 530 2624 p. 1 I \. ",.f" ",.,-' .., ;. , . ", " ~. . ~ :.To: tn.-Vin;Law Offlce . , ...... . .; ," ;64 SOlJ~Il;r:'itt Stra~i '. CarlrsJ~.'PA17013 . ':,": - . . ";.. ,,"' ' , ~" " ", ,;.. . I. ,": ;f'~OM:Timotneal'Aoose ". '..' , .,' '.', ",' 'CustServiceSpeciafiSt,i " '.' " " "'P.O;':BOX~~O.,.<. .. ,.'>.' "', ..' :SHIPPe:NSeURGPAJ7257~02'50,> . '., . '", .. . . -' ~., . ," '". . ~:. ~. ' ".' .. . . .' . ..-.: t. ~ '. ' '.. " . . 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'.'}' . q. ., ".. ~ : ( November 14,2005 Irwin Law Office 64 South Pitt Street Carlisle, P A 17013 RE: Correction to Date of Death values for the: Estate of Richard L Heckendorn Dear Mr. Irwin, I am writing in correction to your request for date of death values on the above referenced member. This account was owned individually. Prime Share (00) Christmas Club (15) Draft Account (25) $40.01 $0.00 $1,234.0 Accrued Interest to DOD $0.05 $0.00 $0.00 Account 1224400 Date of Death Principal i 12~4.!Jb mlAL If you have any questions with regard to the above balances, or need additional information, please contact a Membership Officer at 717-263-4444. Sincerely, Patriot Federal Credit Union 800 Wayne Avenue, Chambersburg, PA. (717) 263-4444. Mailing Address: P.O. Box 778, Chambersburg, PA 17201-0778 Kelley Blue Book - Private Party Pricing Report - Buick, Century n"f?;e 1 of2 .~ ~_./ 2006 BUICK LACROSSE Kelley Blue Book THE TRUSTED RESOURCE .........0kltlU.1II The on our is the price you pay, Not a penny more. ...........U'SE'fj...CAis--" REVIEWS & RATINGS ADVICE FINANCING > Search Used Car Listings Lis BLUE BOOKw PRIVATE PARTY REPORT Pennsylvania. December 16, 2005 1992 Buick Century Custom Sedan 40 _. l -.. BLUE BOOK )w:h Ui\:d r Search Listings for This Car List Your Car For Sale Online Ql.JjQ!sJ'.J_~w J~.9LPriG.~QLJQtE:! Free CARFAX Record Check Al.JtQl..Q<Jn~frQmo.:.3~O!o.. APR Insurance Quote Prjnt:'EQLSQl~J?jgn P<JymemLG<Jlcul<Jtqr E:xt~ncl.~clVV<JrrC3ntY..QJIQt~ Q t 6 ve find exact you want. Engine: V6 3.3 Liter Trans: Automatic Drive: FWD Mileage: 123,339 ...--..--. adv I I Consumer Rated Condition: Fair I Not a pe' "Fair" condition means that the vehicle has some mechanical or cosmetic defects and I GET needs servicing but is still in reasonable running condition. This vehicle has a clean title I histqry , the paint, body and/or interior need work performed by a professional. The I tires may need to be replaced. There may be some repairable rust damage. ~! Private Party Value $~grc;h-,=-ocal Listinq~ 11..j?_tTbJ~J::MJor ~gI~ $825 PnvatN~y Vi:ilTIi:IS What a buyer can expect to pay when buying a used car rom a . private party. The Private Party Value assumes the vehicle is sold "As Is" and carries I no warranty (other than the continuing factory warranty). The final sale price may I .....~ vary depending on the vehicle's actual condition and local market conditions. This ... ..... ". ....... ~~~~~::: also be used to derive Fair Market Value for insurance and vehicle donation 1,< '. .. I Too 2006 a ,i promisos tt luxury and I innovations I" QuiotTunir I" OnStnr~ ( I 10 4 voarf 5( Air Conditioning Power Steering Power Windows Power Door Locks AM/FM Stereo Cassette Equipment 2006 l Get a Used Car Trade-In Value Get Invoice & MSRP on New Cars GetC'l1::;__MiJllJJ:eJ~&~R9-'1~e_YVhen YOI,LARR1Y.19L1'IB1ank Check@ Auto Loan http://www.kbb.comlkb/ki.dll/kw.kc.ur?kbb.P A;383554;P A041&17013;+p&723;Buick; 1... 12/16/2005 Kelley Blue Book - Trade-In Pricing Report - Buick, Century Page 1 of2 Kelley Blue Book THE TRUSTED RESOURCE -~~W_-"-~--w-'kbb.mllll advertisement Quick Dealer Price Quote III SED CARS REVIEWS ill RATINGS ADVICE iFINAN:CH-lG & I BLUE BOOK'* TRADE.! N VALUE Pennsylvania · December 20, 2005 1992 Buick Century Custom Sedan 40 BLUE BOOK CU Usl Your fiE For S Search Listings for This Car List Your Car For Sale Online 9uick New Car Price Quote Free CARFAX Record Check Auto Loans from 5.39% APR Insurance Quote Payment Calculator For price YOL appear on t kbb.com a cars.com, 175 other websites. Engine: V6 3.3 Liter Trans: Automatic Drive: FWD Mileage: 123,339 - adv Air Conditioning Power Steering Power Windows Power Door Locks AM/FM Stereo Cassette 2006 LACI Equipment Consumer Rated Condition: Fair "Fair" condition means that the vehicle has some mechanical or cosmetic defects and needs servicing but is still in reasonable running condition. This vehicle has a clean title history, the paint, body and/or interior need work performed by a professional. The tires may need to be replaced. There may be some repairable rust damage. Trade-In Valuel,J~Y9ur Car For Sale Online Trade-in Value is what consumers can expect to receive from a dealer for a tra e-in vehicle assuming an accurate appraisal of condition. This value will likely be less than the Private Party Value because the reselling dealer incurs the cost of safety inspections, reconditioning and other costs of doing business. NEXT STEP: Get New Car Pricing Tho 2006 Buick promises tho Sl luxury and teet, innovations '11m ~ QuietTul1ingH' ",. t"'l.._C"*_-O>",,,,, ,.....__ http://www.kbb.comlkb/ki.dll/kw.kc.ur?kbb.PA;735594;P A133& 1... 12/20/2005 Nov 2.2 05 0" .___ NADA! 05 04: O~fp MSrS ..J.+e. 1 e~ Dav i dson NADA Appraisal Guides - Get a Value ., 'Motot.~ycles 7177099653 Vehicle Pricing & Information nod(J9~idClu:om I:E'J Close Window November 21, 2005 Avt<u . Motorc:yd<.'s . 8Q.ut-s . (Iussle (UB . RllIcreutlon Vchldus . Monllfadurcd titOltlIU Motorcycle/ATVs 2002 HARLEY-DAVIDSON .,. Road/Street FXSTD SOFTAIL DEUCE Low Retail Average Retail Base Price TOTAL PRICE $10,370 $10,370 $13 640 ~:6~ Notes DUE TO CUSTOM FEATURES SUCH AS CHROME, PAINT, ENGINE MODIFICATIONS, AND MARKET CONDITIONS, SOME VALUES MAY INCREASE BY AS MUCH AS 10%-30%. Next Steps Motorcycle Specifications Model: Piston Displacement (CCs): Stroke: Cylinders: Speeds: Dry Weight: FXSTD SOFT AIL DEUCE 1,450 4 2 5 653 Back to Top ... Value Explanations Low Retail Value -low retail unit may have extensive wear p.2 Page lof2 ~ http://www.nadaguides.com/V alues/ValueReport.asp?UserID=O I 825b76-ea70-41 f4-9cff-f3cb5 1112 II05 .2 05 03 :'53p' MSoS Har 1 e~ Dav i dson *-" --. NADA Appraisal Guides - Get.a Value - Motorcycles 7177099653 p.2 Pagc] of2 Vehicle Pricing & Information l'I(Jd()9Uidll~_~om 1:83 Close Window November 19, 2005 Autos . MOTOT{y'd05 . Boats . Chaste Carll . Rl'c;reu,lon Vehldns . Manutuc:tumd HOfllElS we Motorcyclel A TV s 2003 HARLEY-DAVIDSON Road/Street FLSTF FAT BOY (**) Low Retail Average -Y Retail Q Base Price TOT AL PRICE $11,765 $11,765 c $15,4&Q.--~-_. $15,480 _.) ...-- ~yr'~"" Notes DUE TO CUSTOM FEATURES SUCH AS CHROME, PAINT, ENGINE MODIFICA nONS, AND MARKET CONDITIONS, SOME VALUES MAY INCREASE BY AS MUCH AS 10%-30%. Next Steps Motorcycle Specifications Model: Piston Displacement (CCs): Stroke: Cylinders: Speeds: Dry Weight: FLSTF FAT BOY (**) 1,450 4 2 5 666 (**) 100TH ANNIVERSARY EDITION MODELS. Back to Top ... http://www.nadaguides.comlValues/ValueReport.asp?UserID=O I 825b76-ea70-41 f4-9cff-f3cb5 11/19105 c.__________ MUTUAL OF AMERICA LIFE INSURANCE COMPANY MUTUAL OF AMERICA 320 PARK AVENUE NEW YORK NY 10022-6839 877 302 9104 2122242512 FAX LIFE & DISABILITY CLAIMS November 29, 2005 Mr. Harold S. Irwin, III Irwin Law Office 64 South Pitt St. Carlisle, P A 170 I 3 Re: Richard Heckendorn Claim #: 78290 Dear Mr. Irwin, Per your request, please find the following information. Please be advised that Mr. Heckendorn participated in a Tax Deferred Annuity Plan (TDA) and an Individual Retirement Annuity-Simplified Employee Pension (IRA-SEP) when he was employed by The Alliance Home d/b/a Chapel Pointe at Carlisle (Account #: 007070-A). Our records indicate that the date of Mr. Heckendorn's passing is September 23, 2005. The values of these plans, on September 23, 2005, were $853.68 and $713.41, respectively. These amounts are estimated values and are subject to daily market fluctuations. 150'" ,v1 () Mr. Heckendorn designated Ms. Yvonne Malloy, as the beneficiary under these plans. We have already contacted Ms. Malloy regarding the disbursement of these accounts. If you have any questions, please contact me, toll free, at (877) 302-9104, extension 1355. Sincerely, ~d~ r5~~.6-Y-- Georgiana Biederman Benefits Approver, Group Life == ~ ~ ~ rc I ~ ~ !1 I ~ ~ ;:s OD t-:l ,-.... 'J' 1-';0 'JO ~ '-" . 'JtJj 'JO Cf'x W I-' 'J I-' \0 tj 00 'J 0\ 'J CI':i I-' r-r ~ t::l . ro . ro ~ 'TjZ ...... ~ CIl ~ ;::..ro r-r 0 ><~ ~ ~ ,-.... :::.: ::l C ;::J;:o~ 'J - 0 ~ '-" '""d ~ 'J>o. 'J I-' > 0\ 'J Z I N 'J S; O~ WI-' I ~ ~ a - ~ l:\:) t:iF .... 0 r e ;:: Q" r SUMMARY OF IMPORTANT FACTS AND CONCLUSIONS LOCATION: 123 Stee1stown Road Newville, Pennsylvania TAX PARCEL NUMBER: 30-20-1754-006 IMPROVEMENTS: One-story detached single-family dwelling. PROPERTY RIGHTS: Fee simple interest. OWNERSHIP HISTORY: The subject property is owned by Richard L. Heckendorn. The property was purchased on November 25,2003 for a reported consideration of $1.00 and ownership transferred on Deed Book 260, Page 3428. SCOPE OF THE ASSIGNMENT: The scope of the assignment included an analysis of the subject's area, an inspection of the subject property, an estimation of the property's highest and best use, consideration of all three approaches to value, and the application of those relevant to the valuation of the subject. OBJECTIVE: To estimate the market value of the subject property as unencumbered. EFFECTIVE DATE: September 23,2005. HIGHEST AND BEST USE: Continued use as a single-family residence. COST APPROACH: N.A. SALES APPROACH: $94,000 INCOME APPROACH: N.A. FINAL VALUE CONCLUSION: $94,000 2 . I :r HAROLD S. IRWIN, III IRWIN LAW OFFICE 64 SOUTH PITT STREET CARLISLE, PENNSYLVANIA 17013 RHONDA S. IRWIN SARAH HARDESTY PARALEGALS www.irwinlawoffice.com 717-243-6090 PHONE 717-243-9200 e-mail: irwinlaw@earthlink.net FACSIMILE December 22, 2005 Commonwealth of Pennsylvania Dept. 280601 Department of Revenue Harrisburg, PA 17128-0601 RE: Richard L. Heckendorn Estate: File Number 21-05-0877 Methodology of Tax Apportionment To Whom It May Concern: Simply stated, I apportioned a credit for estate deductions to the total taxable amount of each class of beneficiaries in the identical percentage calculated by expressing each class's total taxable amounts as a part of the net value subject to tax (line 14). These taxable amounts per beneficiary class were derived from going through the entire list of estate assets and assigning to each person items specifically designated them, then adding of the residuary amount: 50 percent to Yvonne K. Malloy, and 25 percent each to Brett A. Heckendorn and Kimberly Jo Hensel!. The only beneficiary in the spousal class, obviously, is Ms. Malloy. The only beneficiary in the sibling class is Michael Heckendorn, the decedent's brother. All other beneficiaries are lineally connected to the decedent: his mother Dorothy Heckendorn, his children, Brett A. Heckendorn and Kimberly Jo Hensell, and his grandchildren. Accordingly, the following percentages apply: CLASS CLASS TAXABLE VALUE (expressed as part of total) DEDUCTION APPLIED (expressed as part of total) Spousal Lineal Sibling 47.75% 52.07 % 00.18% 47.75 52.07% 00.18% For any additional information or further clarification you may require on this estate, please contact me directly.