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OFFICIAL USE ONLY
COMMONWEALTH OF PENNSYLVANIA REV-1500 FILE NUMBER
DEPARTMENT OF REVENUE DEPT. INHERITANCE TAX RETURN
280601 HARRISBURG, PA 17128-0601 RESIDENT DECEDENT 21 2005 0171
COUNTY CODE YEAR NUMBER
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
... Kissinger, Bertha J. 200~22-687 4
2
W DATE OF DEATH (MM-DD-YY) DATE OF BIRTH (MM-DD-YY) THIS MUST BE FilED IN DUPLICATE
C
W 12/28/2004 4/30/1927 WITH THE REGISTER OF WILLS
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W (IF APPLICABLE) SURVIVING SPOUSE'S NAME SOCIAL SECURITY NUMBER
C I
w tJ 1. Original Return 0 2. Supplemental Retum 0 3. Remainder Return
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~!:::(/) tJ 4. Limited Estate 0 o 5. Fed. Est. Tax Return Req'd
<.)a::~ 4a. Future interest Compromise
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:cOO t2U 6. Decedent Died Testate o 7. Decedent had Living Trust 0_
<.)a::...J 8. Total number of SDB's
Il..lD
Il.. h 9. Lit'g'tion Proceeds Rec'd n 10. Spousal Poverty Credit n 11. Election to tax w/ Sec. 9113(A)
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f- ~j~~t11;$.n$Jt~&'ijl8.$.t{Q!g.t.e.t!ltMij~8~lt_:~Ill~U:~titf.~t**ilit.M**'I&t!MfiHIiHttttmI!t:!!H
z NAME: COMPLETE MAILING ADDRESS:
w
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z Ronald E. Johnson, Esquire
0 Ronald E. Johnson, Esq.
Il.. FIRM NAME:
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w Andrews & Johnson Andrews & Johnson
a::
a:: TELEPHONE NUMBER 78 W. Pomfret St.
0
<.) 717 243-0123 Carlisle, PA 11013
....~
1. Real Estate (Schedule A) (1 ) $0.00 OFFICJA~ USE ONLY
$0.00 ~ _'0-
2. Stocks and Bonds (Schedule B) (2)
3.Closely Held Corporation, Partnership or Sole-Prop. (3) .....'-'
$0.00 __L"O.~
4. Mortgages & Notes Receivable (Schedule D) (4) " "
2 5. Cash, Bank Deposits & Misc. Personal Prop.(Sch.E) (5) $4,509.13
0 ~~
i= 6. Jointly Owned Property (Schedule F) (6) $0.00 ,. -
:5 D Separate Billing Requested ~-...-
::l 7. Inter-Vivos Transfers & Misc. Non-Propate Prop. (7) c.)
...
ii: 8. Total Gross Assets (total lines 1-7) (8) $4,509.13 \.'~ ;\
ct 9. Funeral Expenses & Administration Costs (Sch H) (9) $1,646.00
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w 10. Debts of Decedent, Mortgage liabilities, & Liens (10) $46,798.84
0:::
11. Total Deductions (total lines 9& 10) (11 ) $48,444.84
12. Net Value of Estate (Line 8 minus Line 11) (12) $0.00
13. Charitable and Governmental Bequests/See 9113 Trusts
for which an election to tax has not been made (13)
14. Net Value Subject to Tax (Line 12 minus Line 13) (14) $0.00
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
z 15. Amnl of Line 14laxable at the spousal rate,
0
~ or transfers under Sec.9116(a)(1.2) x.0_ (15) $0.00
~
~ 16. Amount of Line 14 taxable at lineal rate $0 x.045 (16) $0.00
a..
:!E 17. Amount of Line 14 taxable at sibling rate $0 x.12 (17) $0.00
0
0 18. Amount of Line 14 taxable at collateral rate $0 x.15 (18) $0.00
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~ 19. Tax Due (19) $0.00
20 D CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
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Decedent's Complete Address:
STREET ADDRESS
CITY
442 Walnut Bottom Road
STATE
Carlisle
Tax Payments and Credits:
1 . Tax Due
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discounts
. PA
Total Credits (A+B+C)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
4.
TotallnteresUPentalty (D+E)
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
5.
If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
(1 )
(2)
(3)
(4)
(5)
(5A)
(58)
ZIP
17013
$0.00
$0.00
$0.00
$0.00
8. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BYPbACING 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:
b. retain the right to designate who shall use the property transerred or its income:
c. retain a reversionary interest: or
d. retain the promise for life of either payments or care?
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration?
3. Did decedent own an "in trust fo~' or payable upon death bank account or security at his or her death?
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary disignation?
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU
Under penalties of perjury, I declare that I have examined this return, including accompanying
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ments, and to the best of my knowledge and belief, it is true, correct and complete.
Street, Carlisle, PA 17013
REPRESENTATIVE
DATE :2 ~ ) 0 ....Cl~
DATE
For dates of death on or alter 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% [72P.S. Sec. 9116(a)(1.1)O)].
For dates of death on or alter 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. Sec. 9116(a)(1.1 )(ii)].
The statute does not exempt a transfer to a surviving spouse from tax, and the staMory 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 alter July 1, 2000:
The tax rate imposed on the net value of transfers from a deseased 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. Sec. 9116(a)(1.2)J.
The tax rate imposed on the net value of transfers to or for the use of the decedenfs lineal beneficiaries is 4.5%, except as noted in 72 P.S. Sec. 9116(1.2) [72 P.S. Sec.9116(a)(1).
individual who has at least one parent in common with the deceden~ whether by blood or adoption.
The tax rate imposed on the net value of transfers to or for the use of the decedenfs siblings is 12% [72 P.S. Sec.9116(a)(1.3)]. A sibling is defined, under Section 9102, as an
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LAST WILL AND TESTAMENT
OF
BERTHA JANE KISSINGER
I, BERTHA JANE KISSINGER, of Carlisle, Cumberland
County, Pennsylvania, being of sound and disposing mind, memory
and understanding, do hereby make, publish and declare this as and
for my Last Will and Testament, hereby revoking all other wills
and codicils heretofore made by me.
FIRST
I direct the payment of my debts and expenses of my last
illness and funeral from my estate as soon after my death as
conveniently may be done. If there be no cemetery lot available
for my interment, owned by me at the time o~ my death, I authorize
my personal representative to purchase such cemetery lot with a
contract for perpetual care, using therefor funds from my estate,
in such amount as he shall consider necessary and desirable, and I
authorize my personal representative to cause title to or
ownership of such lot so purchased to be vested in such person as
my personal representative shall designate.
Further, in this connection, I authorize my personal
representative to expend funds from my estate, in such amount as
my personal representative shall consider necessary and desirable
for the purchase, erection and inscription of a suitable marker
for my grave.
And further I desire that no viewing be conducted as
part of my funeral.
SECOND
I give, devise and bequeath all my jewelry to my
granddaughter HEATHER JO RICE of Carlisle, Pennsylvania and my
entire bear collection to my grandson KRISTOFER HEINEMAN of
Carlisle, Pennsylvania.
THIRD
I give, devise and bequeath all the rest, residue and
remainder of my estate, real, personal and mixed, of whatever type
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and wherever situate to my husband, WILLIAM MAC KISSINGER, JR.,
provided he shall survive me by thirty (30) days.
If I am not so
survived I give, devise and bequeath all the rest, residue and
remainder of my estate to my children, NAOMI JANE RICE and JO ANN
HEINEMAN both of ~arlisle, Pennsylvania, per stirpes.
FOURTH
I direct that any and all Inheritance, Estate and
Transfer Taxes imposed upon my estate passing under my Will or
otherwise, shall be paid out of the principal of my residuary
estate.
FIFTH
In addition to the powers conferred by law, I authorize
my Executor, in his absolute discretion:
1. To retain in the form received, and to sell either
at public or private sale any real or personal property;
2. To manage real estate;
3. To invest and reinvest in all forms of property
without being confined to legal investments, and without regard to
the principal of diversification;
4. To exercise any option or rights arising from
ownership of investments; and
5. To compromise claims without court approval, and
without the consent of any beneficiary.
SIXTH
Any and all payment or payments of any sum or sums,
whether in cash or in kind and whether for principal or income,
payable to my heirs, or any of them, shall be made upon the sole
receipt of the respective individual to whom the payment is made,
and free from anticipation, alienation, assignment, attachment and
pledge, and free from control by the creditors of any such
beneficiary. All shares of principal and income herein given
shall be free from anticipation, assignment, pledge oi obligations
of any beneficiary, 'and shall not be subject to any execution or
attachment.
SEVENTH
I nominate; constitute and appoint my husband WILLIAM
MAC KISSINGER, JR.; Executor of this my Last will and Testament.
In the event of renunciation, death, resignation or inability to
act for any reason whatsoever of my said husband, WILLIAM MAC
KISSINGER, JR., I nominate, constitute and appoint DOUGLAS R.
HEINEMAN and EDWIN L. RICE, Co-Executors of this my Last Will and
Testament. I hereby relieve my Executor from the necessity of
posting security in connection with his duties as such in any
jurisdiction in which he may be called upon to act insofar as I am
able by law to do so.
IN WITNESS WHEREOF, I have hereunto set my hand and seal
to this my Last Will and Testament, consisting of three (3) pages,
the first two (2) of which bear my signature
purpose of identification this c:1~ day of
19St.k
in the margin for the
{ebv ULl rr I
~ ~t1nL ~.d/";;("1{!(SEALI
BERTHA JANE KISSINGER
Signed, sealed, published and declared by the above
named testatrix, BERTHA JANE KISSINGER,as and for her Last Will
and Testament, in the presence of us, who at her request, in her
sight and presence and in the sight and presence of each other,
have hereunto subscribed our names as witnesses.
~~ ADDRESS~d.~~,i?170r.j
~1C)lS~ ADDRESS (~~ MW1h~.u ~U~A
COMMONWEALTH OF PENNSYLVANIA:
SS.
COUNTY OF CUMBERLAND
We, BERTHA JANE KISSINGER, SI-.Q.~hSl-t ~)VV')
~lJ6e.l'r A. ~':t)m'^-.-the testatrix and the witnesses,
and
respectively, whose names are signed to the attached or foregoing
instrument, being first duly sworn, do hereby declare to the
undersigned authority that the testatrix signed and executed the
instrument as her last will, and that she signed willingly, and
that she executed as her free and voluntary act for the purposes
therein expressed, and that each of the witnesses, in the presence
and hearing of the testatrix, signed the will as witnesses, and
that to the best of their knowledge, the testatrix was at the time
eighteen (18) years of age or older, and of sound mind and under
no constraint or undue influence.
Sworn to and subscribed before
me this :/.S-lf-,day of J?lruuVur
19S19.. {(,.
RENEE L MURRAY. NOTARY PUBLIC
CARLISLE 60RO. CUIl8ERLAND COUNTY
MY COMMISSION EXPIRES OCT. 21. 1989
Member. Pennsylvania Association 01 Notaries
ESTATE OF
ITEM
NUMBER
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLA}ilOUSPERSONALPROPERTY
Bertha J. Kissinger
Include the proceeds oflitigation and the date the proceeds were received by the estate
All property jointly-owned with Right of Survivorship must be disclosed on Schedule F
DESCRIPTION
FILE NUMBER
21-05-0171
VALUE AT DATE
OF DEATH
$4,509.13
1
2
3
4
5
6
7
Citizens Bank checking account
TOTAL (also online S, Recapitulation)
$4,509.13
SCHEDULE H
FUNERAL EXPENSES, ADMINISTRATIVE
COSTS AND MISCELLANEOUS EXPENSES
ESTATE OF
ITEM
NUMBER
A.
1
2
B.
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
FILE NUMBER
Bertha J. Kissinger
21-05-0171
Debts of decedent must be reported on Schedule I.
DESCRIPTION
AMOUNT
Funeral Expenses:
Westminister Cemetary - footstone
$730.00
Administrative Costs:
Personal Representive Commissions
Name of Personal Representative(s)
Social Security Number of Personal Representative:
Street Address:
City: State: Zip:
Year(s) commissions paid:
Attorney fees to Andrews & Johnson
Family Exemption
Claimant
Street:
C~: S~e&Z~
Relationship of Claimant to Decedent:
Probate Fees to Register of Wills
Accountant Fees to Patricia Rosendale, CPA
Tax Return Preparer's Fees
Greenwalt & Co - tax return preparation
Bank service fees
Register of Wills - filing fee
$750.00
$64.00
$35.00
$52.00
$15.00
TOTAL (also on line 9, Recapitulation)
$1,646.00
SCHEDULE I
DEBTS OF DECEDENT .
MORTGAGE LIABILITIES AND LIENS
ESTATE OF
FILE NUMBER
Bertha J. Kissinger 21-05-0171
Report debts incurred by the decedent prior to death which. remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
1
Commonwealth of Pennsylvania - Department of Public Welfare
(See letter attached)
$46,798.84
TOTAL (also on line 10, Recapitulation)
$46,798.84
SCHEDULEJ
BENEFICIARIES
ESTATE OF
FILE NUMBER
ITEM NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR SHARE
NUMBER Do Not List Trostee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [include outright spousal distributioos, II1d IIII15fcrs under Sec. 9116(1)(1.2)]
1 Naomi Jane Rice
603 S. Bedford Street, Carlisle, PA 17013 daughter 50%
2 Jo Ann Heineman
130 Wilson Street, Carlisle, PA 17013 daughter 50%
II NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. Charitable and Govenunenta1 Bequests:
Bertha J. Kissinger
21-05-0171
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (also enter on line 13, Recapitulation)
$0