HomeMy WebLinkAbout01-10-06
REV-1500 EX + (6-00)
'*
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
FILE NUMBER
2 1 -0 5 4 3 0
COUNTYCOOE -VEAR- - - NuMBER- -
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DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Lickel Gertrude B.
DATE OF DEATH (MM-DD-Year)
DATE OF BIRTH (MM-DD-Year)
SOCIAL SECURITY NUMBER
1 65- 2 6 - 5 2 1 8
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
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05/06/2005 02/08/1920
(IF APPliCABLE) SURVIVING SPOUSE'S NAME (LAST. FIRST, AND MIDDLE INITIAL)
IX] 1. Original Retum
o 4. Limited Estate
o 6. Decedent Died Testate (AttachcopyoIWill)
o 9. Litigation Proceeds Received
o L Supplemental Retum
o 4a. Future Interest Compromise (date 01 death after 12-12-82)
o 7. Decedent Maintained a Living Trust (Attach copyofTrusl)
o 10. Spousal Poverty Credit (date 01 death between 12-31-91 and 1-1-95)
o 3. Remainder Retum (date 01 death prior to 12-13-82)
o 5. Federal Estate Tax Retum Required
~ 8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
Wa ne F. Shade Es uire 53 West Pomfret Street
FIRM NAME (II Applicable)
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TELEPHONE NUMBER
717 -243-0220
Carlisle
153,593.84
403.80
PA 17013
OFFICIAL USE ONLY
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 Prop3rty (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)
~-'"
10,930.91
c;
4,389.32
:~,
173,648.57
r""',_~ .J
(8)
342,966.44
22,761.83
625.18
0.00 X _(15) 0.00
319,579.43 X .045 (16) 14,381.07
0.00 X .12 (17) 0.00
0.00 X .15 (18) 0.00
(19) 14,381.07
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 Sec. 9116 (a)(1.2)
16. Amount of Line 14 taxable at lineal rate
(11)
(12)
(13)
23,387.01
319,579.43
17. Amount of Line 14 taxable at sibling rate
,;' .
(14)
319,579.43
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 REVERSE SIDE AND RECHECK MATH < <
Decedent's Complete Address:
STREET ADDRESS
542 Summit Drive
CITY
Carlisle
STATE
PA
I ZIP
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)
13.000.00
684.19
Total Credits (A + B + 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. (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
14,381.07
13,684.19
0.00
0.00
696.88
696.88
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes
a. retain the use or income of the property transferred; ..... .......................... .......... ............ .............. ........ D
b. retain the right to designate who shall USE the property transferred or its income; ........................................ D
c. retain a reversionary interest; or ...................................................................................................... D
d. receive the promise for life of either payments, benefits or care? ............................................................. D
2. If death occurred after December 12, 1982, d d decedent transfer property within one year of death
without receiving adequate consideration?.............................................................................................. D
3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? ................. D
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
t. be f" d' t.? I)(l
con alns a ne IClary eSlgna Ion. ....................................................................................................... ~
No
IX]
IX]
IX]
IX]
IX]
IX]
D
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 pe~ury, I declare that I have examined this retum, including acco llpanying schedules and statements, and to the best of my knowledge and belief, It is true, correct and complete.
Deciaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RET RN DATE
/---_....
ADDRESS
T A TIVE
.r4.~
PA 19606
DATE
/-/c-t/6
PA 17013
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 transfers to or for the use of the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)].
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 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 decea~ed 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% [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%, except as noted in 72 P.S. ~9116(1.2) [72 P.S. ~9116(a)(1)].
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. ~9116(a)(1.3)]. A sibling is defined, under Section 9102, as an
individual who has at least one parent in common with the decedent. whether bv blood or adootion.
REV-1502 EX + (6-98)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Lickel Gertrude B. 21 05 430
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 property which is iointly-owned with riaht of survivorship must be disclosed on Schedule F.
SCHEDULE A
REAL ESTATE
ITEM
NUMBER
1.
DESCRIPTION
House and lot of ground known and numbered as 542 Summit Drive, Carlisle, PA valued
in accordance with net proceeds of sale to unrelated third parties
VALUE AT DATE
OF DEATH
153,593.84
TOTAL (Also enter on line 1, Recapitulation) $
(If mnrF' ~n"r.F' i~ nPF'rlF'rl in~F'rt "rlrlitinn,,1 ~hF'F'~ nf thF' ~"mF' ~i7F' \
153593.84
HUD SETTLEMENT STATEMENT
Page 1
I This formis-furnishedtogiveyoua-statementoTcidualsettlement costs. . Amol.lnts palefi6-cind by the
Is. ettlement agent are shown. Items marked (POC) were paid outside closing and are not inclu. ded in the
totals.
------- -.-._------ -.---- ".--.-----.-~-----.- ---~---_._---_.._- _._._------_._._--"----~~----- - --- -----
I .------.----~------
NAME OF BUYER:
Scott M. Panko
Julie E. Panko
~AME OF SELLER:
.. _~~~t:~ Of:=:~ Uckel
TIT[ETNS.-NO.:-~-----
P 139-970
LENDER: LOAN TYPE:
American Mortgage Network, Inc. Conventional/Fixed
dl:>'!t-_mn~!..M..Q!!9!I.9~_ ______________ Loan No. 205-439268_ __________
I PROPERTY LOCATION: SETTLEMENT AGENT:
542 Summit Drive WAYNE F. SHADE, ESQUIRE
IThird Ward 53 WEST POMFRET STREET
Borough of Carlisl~Penns Ivania CARLISLE, PENNSYLVANIA 17013
SETTLEMENT DA TE:---
25-Jul-2005
!SUMMARYOFBOYER'S TRANSACTION: -- SUMMARY OF SELLER'S TRANSACTION: -------- ---------
!fOO-GROSS AMOUNT DUE FROM BUYER: --~--~ 400 GROSS AMOUNT DUE TO SELLER:~------- -----
~g~ ~~~S~~~, ~~~;e~ce 158,000.00 :g~ ~~~:~~~, ~~~:e~ce --------1---- -. ---.--158,0 -oo.-~.-:.gg..--
103 Settlement charges to buyer 403
(from line 1400) 4,759.48404
104 ADJUSTMENTS FOR ITEMS PAIO-----------------
'105 BY SELLER IN ADVANCE:
IADJOSTMENTSFOR ITEMS PAID -- 405 Countyllocal taxes
iBYSELLER IN ADVANCE1__ 25_Jul-2oo5 to 31-Dec-2005
1106 Countyllocal taxes 406 School taxes
/25-Jul-2005 to 31~Dec-2005 305.33 25_Jul-2005 to
1107 School taxes 407 Assessments
i
125_Jul-2005 to 30-Jun-2006 1,568.25 408
! 1 08 Assessments 409
1109 420 GROSS AMOUNT DUE SELLER 159,873.58
1110 500 REDUCTIONS IN AMOUNT DUE SELLER:- ------- n___
'1.120 GROSS AMOUNT FROM BUYER 164,633.06 501 Payoff of first mortgage ---- _n_____
AMOUNTS PAID BY OR FOR BUYER: 502 Payoff of second mortgage
.201 Deposit or earnest money 503 Settlement charges to
1202 Principal amount of./oans' 126,400.00 seller (from line 1400)
I' 203 Existing loans assumed 504 Existing loans assumed
204 Buyer's dosing costs.. .. ..... 3,000.00 505 Buyer's dosing costs
1205 Lockin fee 200.00 506
!~~~~1SN~~I~O::~~~~: . . , - -------- ---------~~~J~~~~1~~~~~B~E~:~~:~~.
i~~~~~':~lIot~TIaxes---;5_J~~-2~~~--1-- 0.00 I~Ja~~~~IIO;:' taxes 25_Jul-2005
1207 School taxes 1508 School taxes
11-Jul-2005 to 25-,Jul-2005 0.00 1-Jul-2oo5 to 25-Jul-2005
i 208 Assessments 509 Assessments
:209 1510
i210 5.11
1220 TOTAL AMOUNTS PAID I 520 TOTAL REDUCTIONS
i BY OR FQRI3UY~fL__ ., ,~.:2.___________L__ .12~~{)00.OQ IN_ ~~O~.r~T Pl.IE S1=LI,.E~
1300 CASH REQUIRED FROM OR PAYABLE 600 CASH TO SELLER-
, TO BUYER AT SETTLEMENT: : FROM SETTLEMENT:
!3~~~~t~ea~~~nfdu.e frO~~b~uyer-----T--- ----;~,~33.06:6~;~~~~~e~~~~nt dueselle-r- -. -
1302 Less amounts paid by or for buyer I !602 Less total reductions in amount
. . (fr()rnJin_~ 22.QL__._,.c::.__________.+______129.!{)90.00, du~~Ue.!Jf!:()lTlline 520)____
'303 CASH FROM (TC)) ~y~!L_____,. _L_ _. 3!>,O~~_.06 !603 CASH Te>. (FR9~~~I..L~R:
305.33
30-Jun-2006
1,568.25
3,279.74
3,000.00
0.00
0.00
6,~79.74
r-
-L
159,873.58
.. ___6.?79.74
1~3,~93.84
305.33 DUE SELLER
0.00 DUE BUYER
i25-Jul-2005
'2005-06 SCHOOL TAXES
tBILL DUE:
IBILL PAID: 1,683.56
1,568.25 DUE SELLER
0.00 DUE BUYER
- ..-- _.~---_._..- ---~--.
TAX PRO-RATION
2005 COUNTY/LOCAL TAXES
BILL DUE:
BILL PAID: 700.92
SETTLEMENT CHARGES
J
: 700 TOTAL ~E,I\~tOR~~~9~6M~L~S'Ot{:.:~=~.. =-- - ..
, P1VJ~!9rl.~f~!!I!!liSSiO~,~S !()"ows~___._______ _.~__
70t~is!i!1~~1I~rl!:. ~ ~_. ~-~'~~__~n~_____~~..~ ... _~~.
79_~SeIli119_~~~j:__.... ____~_~_.___._ _______
800 ITEMS PAYABLE IN CONNECTION WITH LOAN:
~oT~jiii()rigrnati~n lee-- ~"==~==~=_ %-:===_
'802 Loan discount %
I ... .-..- __. _.__.____ _. ___ . _.._____..._______ _._.__.. .
1803 Proce~~in9J~~ tC)~Q.m'!l.c)~It\'~'th El!rl~~.9..GrolJP-'- tnc;.
i 8Q1Appr~i~~lf~~Jg ~tan ~~~!g!le~___._____._ ___
1805 Tax service fee to Amnet
i8~l:!r~~eTp~iTi~~Of $146.6~paid to Commonw~~tI!.E_lJ!l5JTr19 Group, Inc. ~ Am~_.___._-===-~--------. .______
Im~~oa~~~~~~net- --- -.. - _____-:-~_==~~g~~-:
i900iTEMSTENDER REQUIRES BE PAID IN ADVANCE: .~---~
i~I::~~u~"cel>'iniiUin-- --- - .ZOOda~~-~.:~ ::'-~05 =-=~ 133.35 --- .....
I:~=~~z.~r~in=-~~ce pre'!1ium to Erie 'n~urance $282 POC.==~-===~=---. ____=- _ ==_=_~_
i1000 RE~ERYES QEPOSITED WITH LENDER: ____ .__==___ _._____._ __. __ ____ ___
i 1 001 Hazard insurance 282.00 per year _____.__________. ___._
i ...____~.OO _mo~_~ .---.______~.~er mo. _ 70.50
11002 Mortgage insurance . peryear .________..______
, .- .._I1!Q~ @-.------ .---.------_Q<>Q..~!.!!lo. ----___.____ ---.--9.9<>__
,1003 Countyllocal taxes 700.92 per year
I f004SC~~~ ta:~~ ~ ~ .--. 58.41 per1 ~~3.60 per year
i 1665Ag~~a-:~:~~w adjustment 140.30 ~~-
i - '-..--.... ..---....---. .,.----- .. .--.-----.------- __. . "_.._ ..__.______._______~.____ .__._____.<:31~.~?!!.
! 1100 TITLE CHARGES:
I . __ _ ..__..._..__.____.~___.._.________._~_ ~.____ _.___._.~__~___~__~__ ._____________...~___.___._.__________
11.!!tL~~~L~!ee tc). __ __ .
11102 Title search to
! i1Q:3__Q~_l!~~_ntii"~~~!!9nJ.c>.f.mn~________ --------_u____.u_._~__.
! 11Q-!~~!l:lryf~~_~J.c> ..-~-----u-------.--_~__._____.__u___
i 11 Ot? ~'iorTl~fee~to.___ _____________ . _______ ___
/1100 Trtle insurance to Commonwealth Land Title u----_J,?~}~____u_______
!~:~~:~-:::-:..::~ ~:~:- - -=::~~~~:~.:::_~- --- .,
11109 E~c!<2rsement 1.9L.~ . u_ ________________
; 11'1'0 Endorsement 300
! 1111EndorsemerJ[i1Q _. __===~===-==-==~_~'.__
'1112 EridorSement 8.1
IH~~~~~~~~~~~~~l~~GES::'.-::_'..=:::~ -:::::-~~~':35l)(J
I~~~J ~:~se38.50 Mortgage u----~'-~----__._____19~:Q<! _
i 1203--Stip~l~iiori~!iai~~~~ns-:==~=-=:~=-==~= --~------------------- -_______.. . ..u. ~.___ ...~._____ _
"204 Local transfer ta<(1%) ,.500.001
i1205Pennsylvania traQ~!~rtax{1~J_u -____ 'u, ._u__._________ _ 1,.?80.oo
::~A6Dltfc>NAC S~LEME~T_CI.....RGE~: :::~ n:_ ~. :: ..- ~-_J. __ _ _- _,,~_-' . . L,-. .
i130fSurvey-to ..... ._n___. -. _ __ _ ..1 __. _ 1_"- . .--.
':~f~~~;.~"" "",to =-._ _::_. ___ ___ .'_ .+ !.
: 1364 Water an(fsewer-!~ Bo~o~gE9IG~~isT~=-U --__4. -- i
20001
1305 Feder(3' Express___ - -.---_~_._u_ j r
1306 ?b()5~~ s~h,,<>..olr~~ estat~J~~~~!9 Darlen~JJ~12}',er_[!.-.-.. .
1307_'&irin9..1~~Jg!-mnet .. .-------- 35.60 t
1400 TOTAL SETTLEMENT CHARGES: I
(entered on lines 103 and 503) I 4,759.48/
--. - --. -
i/, E~~ud(h~.1
%
PAID BY
BUYER
PAID BY
SE~L~R
0.00
---.-. -.-----.------.--- .--.-----
0.00
-- -- -._- _ . -~=:~Q.Qo--------~-- .
150.00
275.00
----.----.-.--.. - --- ----..--.-.. ___n.___
90.00
408.87
.----.- .---- -.----.---.
280.60
210.00
--..-_._--~- -.-----. ---____.u____... ___ ._..___
-------- - -- - ----. ---
. . .1----. n_'_n
--. .t--.---
L-_
16.18
. ___.1~.3~.56
.3,279.74
2-P~
~
REV-1503 EX + (6-98)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
Lickel. Gertrude B.
FILE NUMBER
21 05
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
430
ITEM
NUMBER
1.
DESCRIPTION
10 shares MetLife, Inc. common stock
VALUE AT DATE
OF DEATH
403.80
TOTAL (Also enter on line 2, Recapitulation) $
403.80
Iff morp ~n"r.p i~ nppnpn in~prt "nnition,,' ~hppt~ of thp ~"mp ~i7P\
REV-1508 EX + (6-98)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Lickel Gertrude B.
ITEM
NUMBER
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
FILE NUMBER
21 05
Include the proceejs 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.
430
DESCRIPTION
Carlisle Swim Club, membershiJ: redemption and refund
VALUE AT DATE
OF DEATH
220.00
Three burial plots at the Paxtang Cemetery
900.00
Julie A. Carson, proceeds of sale of 1993 Mercury automobile
2,000.00
M& T Bank, Checking Account #699284
4,432.92
Suburban Energy Services, heating oil refund
171.69
The Sentinel, subscription refund
35.47
Belvedere Medical Corporation, medical expense refund
13.28
Household contents
2,730.00
Public School Employees' Retirement System, final pension payment
165.12
Comcast Cable Communications, subscription refund
47.82
The Brethren Mutual Insurance Company, homeowners' insurance premium refund
33.00
Sprint, telephone service refund
16.62
Miscellaneous clothing items
153.00
Family Circle, subscription refund
11.99
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
10930.91
m1M&rBank
499 Mitchell Street, Millsboro, DE 19966
May 19,2005
Wayne F. Shade
Attorney At Law
53 West Pomfret Street
Carlisle, PA 17013
RE: Estate of Gertrude B. Lickel
Date of Death: May 6, 2005
Social Security Number: 165-26-5218
Dear Mr. Shade:
. In response to your request, please be advised that at the time of death, the above-
named decedent had on deposit with this bank the following accounts.
1. Account Type........................... Checking Account
Account Number................... ... 699284
Ownership (Names of}.............. Gertrude B. Lickel
Opening Date........................... 10 /03/ 86
Balance on Date ofDeath.........$4,432.92
Accrued Interest
$
0.00
Total....................... ............ ....$4,432.92
The above named decedent did not have a safe deposit box.
For any additional information on this account please contact our High Street
Carlisle branch at 717-240-4536.
Sincerely,
OutLtNJ zJz0~rv
Charlene Warrington, Records Management
1-888-502-4349
To: Wayne Shade, Attorney
53 West Pomfret Street
Carlisle, PA 17013
From: William G. Rowe, Appraiser
211 Old Stone House Rd.
Carlisle, PA 17013
Re: Personal Property Appraisal
Estate of Gertrude B. lickel
542 Summit Street
Carlisle, PA 17013
Date: June 6, 2005
LINDEN HALL ANTIQUES
211 OLD STONE HOUSE ROAD
CARLISLE, PA 17013
717-249-1978
LIVING ROOM
Chair/ottoman
Sofa
Upholstered chair
Coffee table
Victorian chair/rocker
T.V.
Lamps
Child's rocker
Glassware
Cups/saucers
Night stands
Spinet piano
Record player - no value
Wall hangings
HALLWAY
Desk chair
Sea shells
DINING ROOM
T able/6 chairs
Jelly cupboard
Rug
Drop leaf table
Glassware
SUNROOM
Picnic table
Cot - no value
Table/4 chairs
Oak dresser base
Upholstered chairs
Keys
Lamps
Lickel Appraisal
$30.00
$35.00
$25.00
$30.00
$80.00
$30.00
$20.00
$30.00
$10.00
$20.00
$40.00
$375.00
$0.00
$5.00
$20.00
$10.00
$75.00
$250.00
$10.00
$10.00
$10.00
$20.00
$0.00
$200.00
$40.00
$10.00
$10.00
$5.00
06/0612005
KITCHEN
Kitchen wares
Small appliances
Table
$60.00
$20.00
$10.00
BEDROOM
Dresser base
Desk
Bed
Picture - WWII
Cherry chest of drawers w/mirror
Miscellaneous household
$30.00
$5.00
$20.00
$25.00
$150.00
$10.00
BEDROOM
Maple bedroom set
Stand
$200.00
$20.00
BEDROOM
Cherry bedroom set
Jewelry
Miscellaneous household
Lamps
Pictures
$450.00
$40.00
$15.00
$10.00
$10.00
UPSTAIRS
Glassware
Boxes of household
Sea shell collection
$40.00
$90.00
$75.00
BASEMENT
Table
Freezer
Ladders
$10.00
$30.00
$10.00
TOTAL
$2,730.00
.
""----\... ....
~~
William G. Rowe
Lickel Appraisal
2
06/0612005
REV-1509 EX + (6-98)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF
Lickel. Gertrude B.
FILE NUMBER
21 05
430
If an asset was made joint within one year ofthe decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A. Trudy L. Kauffman
1451 Friedensburg Road
Reading, PA 19606
Daughter
B
c
JOINTL V-OWNED PROPERTY:
LETTER DATE DE~CRIPTION OF PROPERTY '10 OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DE CD'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A. Vanguard Prime Moneymarket Fund Account No. 8,778.64 50. 4,389.32
0030/09890573052
TOTAL (Also enter on line 6, Recapitulation) $ 4 389.32
(If more soace is needed. insert additional sheets of the same size)
THEVanguard:iROUP..
WAYNE F SHADE
53 W POMFRET ST
CARLISLE P A 17013
August 8, 2005
Estate of Gertrude B. Kickel
Gertrude B. Hickel & Trudy L. Kauffman
Jt Ten WROS-09890573052
Dear Mr. Shade:
Weare responding to your letter requesting a valuation of the above-referenced account.
We are happy to provide the information. As of May 6, 2005, the number of shares, the
price per share, the value of the fimd, and the accrued dividends were as follows:
Fund
Prime Money Mkt Fund
Shares
8,774.810
Price
$1. 00
Value
$8,774.81
Acc Divs
$3.83
If you have any questions or need further assistance, please contact a member of our
Transition Specialist Team at 1-888-237-9045. We are available Monday through Friday
from 8 a.m. to 8 p.m. Eastern time.
Sincerely,
Client Service Department
r8r
50584707
Post Office Box 2600, Valley Forge, Pennsylvania I9482-2600
(6ro) 669-rooo . www.vanguard.com
REV-1510 EX + (6-98)
.
SCHEDULE G
INTER.VIVOS TRANSFERS &
MISC. NON.PROBA TE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
21 05
430
ESTATE OF
Lickel. Gertrude B.
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 RELATIONSHP TO DECEDENT AND DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE
NUMBER THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE VALUE OF ASSET INTEREST VALUE
(IF APPliCABLE)
1. AIG Sun America, Annuity Contract #A637096822A 11,460.79 100. 11,460.79
2. Lincoln Financial Group, Annuity Contract #98-5690926 162,187.78 100. 162,187.78
TOTAL (Also enter on line 7 Recapitulation) $ 173 648.57
III mnrp ~n;lrp i~ npprlprl in~prt ;lrlrlitinn;ll ~hpp~ nl thp ~;lmp ~i7P'
SuDAmerica Life Insurance Company
Fixed Annuity Administration
P.O. Box 9006
Amarillo, TX 79105-9006
m SunAmerica
Financial
May 27,2005
Wayne F Shade
53 West Pomfret Street
Carlisle, PA 17013
Re:
Deceased:
Contract #:
Gertrude B Lickel
A637096822A
Dear Mr. Shade:
Thank you for your recent inquiry regarding the referenced annuity contract(s). It is our pleasure
to be of service to you. Below you will find the information requested in your correspondence
dated May 11,2005.
· The value of the aforementioned annuity, as of May 06,2005, was $11,460.79.
· The contract is a non-qualified annuity in which only the accumulated interest is taxable.
· The primary beneficiary listed is Trudy Coffman and the require claim forms have been
mailed to her.
We hope this information is helpful; however, should you have additional questions or require
further assistance, please feel free to contact our Client Care Center by using our toll free number
of 1-888-333-2349.
Sincerely,
~~
Gayla Walker
Claims Department
Sun America Life Insurance Company. AIG SunAmerica Life Assurance Company
First SunAmerica Life Insurance Company. Administrator for The Central National Life Insurance Company of Omaha
Administrator for John Alden Life Insurance Company
Member of American International Group, Inc.
n Lincoln
Financial Group@
PO Box 7880
Fort Wayne IN 46801
May 16, 2005
Re: 98-5690926
Gertrude Licke1, Deceased
TRUDY KAUFFMAN
1451 FRIEDENSBURG RD
READING PA 19606
Dear Ms. Kauffinan:
Lincoln Retirement has received notification of the death of Gertrude. Please accept our sincerest
condolences on your loss.
Enclosed is a Non-Qualified Claimant's Statement. This form needs to be completed by you, as the
designated beneficiary of the above mentioned contract. Once this form has been completed, please
return it along with a certified death certificate listing the cause of death in the enclosed reply
envelope. The options available to you are listed on the claimant's statement. Please note, the death
certificate will not be returned unless requested.
Any distribution of gain to the beneficiary will be taxable as regular income in the year of the
withdrawal. The cash value continues to fluctuate daily. As ofthe date of death, May 6,2005, the
cash value was $162,187.78 and the cost basis (non-taxable) of this amount is $88,000.00.
If you have questions or need assistance, please contact us at 1-800-454-6265, extension *8200,
Monday through Friday 7:00 a.m. to 5:30 p.m. EST.
Sincerely, ..
~~~~
Dawn Hartle
Claims Consultant
Enc'
Registered Representative of, and securities offered through, Lincoln National Life Insurance Company and Lincoln Financial Advisors Corp.,
broker-dealers. Lincoln Retirement is the marketing name for the annuities operation of The Lincoln National Life Insurance Company. Lincoln
Financial Group is the marketing name for Lincoln Corporation and its affiliates.
REV-1511 EX+ (12-99)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Lickel Gertrude B.
FILE NUMBER
21
05
430
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Hoffman-Roth Funeral Home, Inc., funeral service 6,942.30
2. Carlisle Memorial Service, Inc., grave monument 674.64
3. George's Flowers, funeral flowers 95.40
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, AttomeyFees Wayne F. Shade, Esquire 12,500.00
3. Family Exemption: (If decedenfs address is rot the same as claimanfs, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decede~t
4. Probate Fees Register of Wills of Cumberland County, PA 402.00
5, Accountant's Fees
6. Tax Return Prepare~s Fees
7, Borough of Carlisle, water and sewer 16.18
8. PPL, electric service 23.86
9. Cumberland Law Journal, advertise Letters Testamentary 75.00
10. Comcast Cable, TV cable service 47.82
11. J.C. Ehrlich Co., Inc., pest treatment 344.50
12. Duane E. and Julie A. Carson, lawn care 60.00
13. The Sentinel, advertise Letters Testamentary 129.77
14. Borough of Carlisle, water and sewer 16.18
15. PPL, electric service 21.82
16. Sprint, telephone service 170.69
17. PPL, electric service 17.83
18. Borough of Carlisle, water and sewer 16.18
TOTAL (Also enter on line 9, Recapitulation) $ 22761.83
(If more space is needed, insert additional sheets of the same size)
Lickel, Gertrude B.
Decedent's Name
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
Page 1
21 05 430
File Number
Schedule H - Funeral Expenses & Administrative Costs - 87.
ITEM
NUMBER
AMOUNT
19.
20.
21.
22.
23.
24.
25.
26.
DESCRIPTION
Terry R. Lindsey, labor
Duane E. and Julie A. Carson, lawn care
Sprint, telephone service
PPL, electric service
Gary L. Shulenberger, real estate appraisal
Christopher Kantner, real estate services
Register of Wills, filing inheritance tax return
Register of Wills, reserve for filing the Account, etc.
275.00
60.00
43.47
14.19
200.00
200.00
15.00
400.00
SUBTOTAL SCHEDULE H-B7
1,207.66
REV-1512 EX + (6-98)
.
SCHEDULE.
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Lickel. Gertrude B.
FILE NUMBER
21 05
430
Include unreimbursed medical expenses.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
J. Craig Jurgensen, M.D., unreimbursed medical expense
50.00
2,
Horizon Eye Care Group, P.C., unreimbursed medical expense
73.28
3.
Merrill Lynch Insurance Group Services, Inc., annuity overpayment
501.90
TOTAL (Also enter on line 10, Recapitulation) $
625.18
(If more space is needed, insert additional sheets of the same size)
'~~""".".
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
FILE NUMBER
Lickel G ~rtrude B. 21 05 430
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 outright spousal distributions, and transfers under
Sec. 9116 (a) (12)]
1. Trudy Louise Kauffman Lineal 319,579.43
1451 Friedensburg Road
Reading, PA 19606
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 11- ENTER TOTAL NON-T,l\XABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(If more s~ace is needed, insert additional sheets of the same size)
.,
~
~
WAYNEF. SHADE
Attorney at Law
53 West Pomfret Street
Carlisle, Pennsylvania
17013
LAST WILL AND TESTAMENT
I, GERTRUDE B. LICKEL, of the Borough of Carlisle, County of Cumberland,
Commonwealth of Pennsylvania, being of sound and disposing mind, memory and
understanding, do make, publish and declare this as and for my Last Will and Testament,
hereby revoking and making void all former wills and codicils by me at anytime
heretofore made.
FIRST. I order and direct that all my just debts and funeral expenses be paid by
my personal representative or representatives, hereinafter named, as soon as conveniently
may be done after my decease. I further authorize my personal representative to expend
funds from my Estate in such amounts as my personal representative shall consider
appropriate, for the disposition and memorial of my remains.
SECOND. All the rest, residue and remainder of my Estate, real, personal and
mixed, whatsoever and wheresoever situate, I give, devise and bequeath unto my
daughter, TRUDY LOUISE KAUFFMAN, if she survives me. If she should fail to
survive me, I give, devise and bequeath the said residue of my Estate unto such of her
issue who shall survive me, in equal shares, by representation and not per capita.
THIRD. For the purposes of this my Last Will and Testament, a person shall not
be deemed to have survived me unless he or she shall have survived me by more than
ninety (90) days.
.~
~
~
FOURTH. If both my said daughter and all of her issue should fail to survive me,
I give, devise and bequeath the said residue of my Estate, in equal shares, unto the
brothers and sisters of my late husband, Chester A. Lickel, ALICE A. HAAG, GENE B.
LICKEL and FRANCES J. CLARR. If any of the said siblings of my late husband
should fail to survive me, I give, devise and bequeath his or share unto such of them who
shall survive me, in equal shares.
FIFTH. I nominate, constitute and appoint M & T BANK, N.A., of Carlisle,
Pennsylvania, its successors or assigns, to serve without bond as the Trustee with respect
to any property which shall pass, either under this my Last Will and Testament or
otherwise to such minor or minors as defined herein. It is my intention that the entire
residue of my Estate be held in trust until all of the beneficiaries of this Trust are no
longer minors as defined herein. During the course of administration of the Trust,
payments may be made as provided herein without regard to equality among the various
beneficiaries; and when the youngest living beneficiary of this Trust reaches the age of
majority as defined herein, the remainder of the Trust shall be distributed among the then
living beneficiaries of this Trust, in equal shares. This appointment of Trustee shall not
supersede the right of any fiduciary in its discretion to distribute the shares to the
beneficiaries of this Trust. The said Trustee is hereby vested with the power to sell,
assign, transfer, pledge, mortgage, lease, manage, control, retain, invest and reinvest the
corpus of said Trust in such securities and other property as shall be deemed prudent
WAYNEF. SHADE
Attorney at Law without being restricted to investments known as legal investments for fiduciaries under
53 West Pomfret Street
Carlisle, Pennsylvania
17013
-2-
-~
~
~
~
the laws of the Commonwealth of Pennsylvania. The Trustee shall have the power to
manipulate the proceeds of the Trust in any manner that will guarantee maximum
conservation of the Trust funds and the greatest production of income for the
beneficiaries. I hereby authorize the said Trustee to expend any monies from principal or
interest for the beneficiaries that in the sole discretion of the Trustee is deemed necessary
for their care, health, education, maintenance and general welfare; the word "education"
shall be construed to include a pre-college course, high school education, vocational
education, college education and post-graduate education and includes provision of
adequate funds for all reasonable and related living and travel expenses. It is my
intention that the foregoing powers may be exercised by the said Trustee without prior
Court approval and without further responsibility to the beneficiaries, their parents or to
any other person or persons taking care of the minor beneficiaries. The age of majority
for all purposes concerning this my Last Will and Testament shall be deemed to be the
age of twenty-two (22) years. If any of the beneficiaries of the Trust created in this Item
Fifth should fail to survive me, or having survived me, should fail to survive to ultimate
distribution of the Trust herein, I give, devise and bequeath the -share of said beneficiary
unto such beneficiaries who shall survive to ultimate distribution, in equal shares.
SIXTH. I order and direct that any estate, inheritance or similar tax due as a result
of my death with respect to any property passing as a result of my death, shall be paid
from the residue of my Estate before its division into shares and prior to distribution as an
WAYNEF. SHADE
Attorney at Law expense of administration and that no part of the taxes should be prorated or apportioned
53 West Pomfret Street
Carlisle, Pennsylvania
17013
_'L
.1
3t
)ri
WAYNEF. SHADE
Attorney at Law
53 West Pomfret Street
Carlisle, Pennsylvania
17013
among the persons or beneficiaries receiving the taxable property. It is my express
intention that all inheritance taxes imposed as a result of my death be paid from the
residue of my Estate whether or not the property passes under my Last Will and
Testament. My personal representative shall have full power and authority to pay,
compromise or settle any such taxes at anytime whether with respect to present or future
interests.
SEVENTH. Any and all decisions, determinations or actions made or taken by a
personal representative or Trustee hereunder, ifmade in good faith, shall be final and
conclusive on all persons who are or may become interested in my Estate. No fiduciary
acting under this my Last Will and Testament shall be liable for any error in judgment or
for any depreciation or reduction in value of any Estate or Trust assets at anytime, in the
absence of willful default.
LASTLY. I nominate, constitute and appoint my daughter, TRUDY LOUISE
KAUFFMAN, to be the Executrix of this my Last Will and Testament, but if, for any
reason, she should fail to qualify as such Executrix or decline or cease so to serve, I
nominate, constitute and appoint my granddaughters, JENNIFER DEEGAN KANTNER
and KATE E. SIPPLE, as successive alternate Executrices hereof, all to serve without
bond.
IN WITNESS WHEREOF, I, GERTRUDE B. LICKEL, have hereunto set my
hand and seal to this my Last Will and Testament which consists of six (6) typewritten
-4-
WAYNEF. SHADE
Attorney at Law
53 West Pomfret Street
Carlisle, Pennsylvania
17013
pages to each of which I have affixed my signature, this 15th
day of
November
, A.D. Two Thousand (2000).
~~, d;-~ (SEAL)
--Gertrude B. Lickel
The preceding instrument, consisting of this and five (5) other typewritten pages,
each identified by the signature of the Testatrix, was on the date thereof signed, sealed,
published and declared by GERTRUDE B. LICKEL, the Testatrix therein named, as her
Last Will and Testament, in the presence of us, who, at her request, in her presence, and
in the presence of each other, have subscribed our names as witnesses hereto.
a/7u( ~~
lk&n II Aj~, /
Acknowledgment
COMMONWEALTH OF PENNSYL VANIA )
) SS:
COUNTY OF CUMBERLAND )
I, GERTRUDE B. LICKEL, the person whose name is signed to the foregoing
instrument, having been duly qualified according to law, do hereby acknowledge that I
-s-
WAYNEF. SHADE
Attorney at Law
53 West Pomfret Street
Carlisle, Pennsylvania
17013
signed and executed the instrument as my Last Will and Testament and that I signed it
willingly and as my free and voluntary act for the purposes therein expressed.
Sworn to or affirmed and acknowledged before me by GERTRUDE B. LICKEL,
this 15th day of November ,2000.
,$dLt~d1-~
Gertrude B. Lickel
C~~~~
Notary Pu lie
Affidavit
Notarial Seal
Connie J. Tritt. Notary Public
Carlisle, Cumberland County
My Commission Expires Oct. 5, 2004
COMMONWEAL TH OF PENNSYL VANIA )
) SS:
COUNTY OF CUMBERLAND )
We, Wayne F. Shade and Helen H. Shade , the
witnesses whose names are signed hereto, being duly qualified according to law, do
depose and say that we were present and saw the Testatrix sign and execute the
instrument as her Last Will and Testament; that the Testatrix signed willingly and
executed it as her free and voluntary act for the purposes therein expressed; that each
subscribing witness in the hearing and sight of the Testatrix signed the Will as a witness;
and that, to the best of our knowledge, the Testatrix was at that time eighteen or more
years of age, of sound mind and under no constraint or undue influence.
Sworn to or affirmed and subscribed to before me by
Wayne F. Shade and Helen H. Shade
15th day of November ,2000.
, witnesses, this
~~~~
l/!ftYL 1-1 ~~~/
~~:1~
Notary P he
-6-
Notarial Seal
Connie J. Tritt, Notary Public
Carlisle, Cumberland County
My Commission Expires Oct. 5, 2004
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
SHADE WAYNE F
53 WEST POMFRET ST
CARLISLE, PA 17013
n_n_h fold
ESTATE INFORMATION: SSN: 165-26-5218
FILE NUMBER: 2105-0430
DECEDENT NAME: L1CKEL GERTRUDE B
DATE OF PAYMENT: 01/10/2006
POSTMARK DATE: 01/10/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 05/06/2005
NO. CD 006189
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $696.88
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS: W SHADE ESQ
CHECK# 2889
SEAL
INITIALS: VZ
RECEIVED BY:
REGISTER OF WILLS
$696.88
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS