HomeMy WebLinkAbout09-15-06 (2)
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I REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG. PA 17128-0601
I DECEDENT'S NAME (LAST, FIRST. AND MIDDLE INITIAL)
I Kiker, Lenora B.
! ~;~:;~;A~~:M-DD-YEAR) - -1 ~~~~~~I~;~~M-DD-YEAR) u_~__ ----
I 'F APP"CABLEI SURVIVING SPOUSE'S NAME ( LAST, RRST AND MIDOlE INITlAW - . --- --
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\E1-:-0riginal R~~~~---------TI-2. sUPPi~mental Ret~m-~- ---~-----n-3. Remainder Return (date of death prior to 12-13-82)
I 0 4. Limited Estate 0 4a. Future Interest Compromise (date of death after D 5. Federal Estate Tax Return Required
. 12-12-82)
I 181 6. Decedent Died Testate (Attach copy 0 7. Decedent Maintained a Living Trust (Attach 0 8. Total Number of Safe Deposit Boxes
I of Will) copy of Trust)
D 9. Litigation Proceeds Received D 10. Spousal Poverty Credit (date of death between 0 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
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OFFICIAL USE ONLY
FILE NUMBER
21 06
COUNTY CODE YEAR
SOCIAL SECURITY NUMBER
0246
NUMBER
288-12-6811
THIS RETURN MUST BE FILED IN DUPUCATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
/'lAME
~ Richard E. Co~~ell, E~__
IRM NAME (If applicable)
I Ball, Murren & Connell ! 2303 Market Street
t- --------------- -I Camp Hill, PA 17011
i"ELEPHONE NUMBER- -~
_ I 2~~~~---_----~~==_____
I 1. Real Estate (Schedule A)
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2. Stocks and Bonds (Schedule B)
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None
OFFiCIAL USE ONLY
3. Closely Held Corporation, Partnership or Sole-Proprietorship
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4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o 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)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
(2)
6,762.87
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(3)
(4)
(5)
(6)
(7)
None
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None
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500.00
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156,146.56
None
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':-163 ;"-ZI0~43
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(9)
(10)
17,269.46
----~._-------_._-~----
1,244.75
(11 )
18,514.21
(12)
144,895.22
(13)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
(14)
144,895.22
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RA lES
15.Amount of Line 14 taxable at the spousal tax rate,
or transfers under Sec. 9116(a)(1.2)
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16.Amount of Line 14 taxable at lineal rate
17.Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
x .00
(15)
144,895.22 x .045
(16)
6,520.23
x .12
(17)
x .15
(18)
(19)
6,520.28
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
Copyright 2000 form software only The Lackner Group, Inc.
Form REV-1500 EX (Rev. 6-00)
0--"
Decedent's Complete Address:
STREET ADDRESS
4619 North C1earview Avenue
-
CITY
Camp Hill
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
I STATE PA T ZIP 17011
(1) 6,520.28
5,550.00
292.11
Total Credits (A + B + C) (2) 5,842.11
3. Interest/Penalty if applicable
O. Interest
E. Penalty
Total Interest/Penalty (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
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.
B. Enter the total at Line 5 + 5A. This is the BALANCE DUE.
Make Check Payable to: REGISTER OF WILLS, AGENT
(3) 0.00
(4)
(5) 678.17
(5A)
(5B) 678.17
PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and:
a. retain the use or income of the property transferred;..................................................................................
b. retain the right to designate who shall use the property transferred or its income;....................................
c. retain a reversionary interest; or..................................................................................................................
d. receive the promise tor life of either payments, benefits or care?..............................................................
2. If death occurred after December 12, 1982, did decedent transfer property within one year ot death without
receiving adequate consideration?......................................................................................................................
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?.........
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation?........................................................................... ..... .....................................
Yes No
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IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FilE IT AS PART OF THE RETURN.
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Under penalties of perjury. I declare that I have examined this return. including 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 all information of which preparer has,any knowledge. '~_'_'_~_.___
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS
Janice A. Ki~er "
DATE
4619 North Clearview Avenue
Camp Hill, PA 17011
ADDRESS
ADDRESS
2303 Market Street
Camp Hill, PA 17011
9-'~_
DATE
DATE
9-/.1-1)6
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 survivina SDnll~'" ic.o no/.
[72 P.S. ~9116 (a) (1.1) (ii)). The statute does not exemot a transfer to a surviving spouse from tax, and the statu
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 deceased child twenty-one years of age or younger at dl
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 ot the decedent's lineal beneficiaries is 4.5%, e
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 .5. ~911
under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood,
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SCHEDULE B
STOCKS & BONDS
COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIOENT DECEDENT
ESTATE OF Kik L B
er, enora .
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
I
ITEM !
NUMBER I
I
1 I Pepsi - 108 shares
I
I MatteI - 19 shares
DESCRIPTION
2
TOTAL (Also enter on line 2, Recapitulation)
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I FILE NUMBER .
21 - 06 - 0246
UNIT VALUE
59.69
16.56
VALUE AT DATE OF
DEATH
6,446.52
316.35
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6,762.87
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i SCHEDULE E
I CASH, BANK DEPOSITS, & MISC. I
J_ n_P~RSONALP_~OPE~1"Yn___n_L
I FILE NUMBER
21 - 06 - 0246
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COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATEOF .
Kiker, Lenora B.
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of
survivorship must be disclosed on schedule F.
--_.__._--~._.~.~~_..._~-_.~
ITEM
NUMBER
1
DESCRIPTION
VALUE AT DATE OF
DEATH
----.-------
500.00
Personal Possessions and Household Effects
---- ----------.-' ._~----,---~ --------_.-_.----- --
-~----~
TOTAL (Also enter on Line 5, Recapitulation)
500.00
*'
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Kiker, Lenora B.
I FilE NUMBER
I 21 - 06 - 0246
i J~_
! SCHEDULE F
L___ JOINTL Y -OWNED PROPERTY
If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G.
A Janice A. Kiker
SURVIVING JOINT TENANT(S) NAME
Daughter
ADDRESS
4619 North Clearview Drive
Camp Hill, PA 17011
RELATIONSHIP TO DECEDENT
JOINTLY OWNED PROPERTY:
I LETTER Ii DATE
ITEM FOR JOINT MADE
NUMBER I TENANT i JOINT
n_ i A --t09t07/2001
I I
I I
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DATE OF DEATH %i o~I: DATE OF DEATH
DECO'S VALUE OF
VALUE OF ASSET INTEREST DECEDENT'S INTEREST
132,000.00 --- 500/1 66,000.00
I
I DESCRIPTION OF PROPERTY
Include name of financial institution and bank account number
or similar identifying number. Attach deed for jointly-held real
estate.
i
102/22/2002: Members 1st Federal Credit Union
! I Acct. Number: 214526-00
I
, 02/25/2002 Members 1 st Federal Credit Union
Acct. Number: 214526-05
2
A
3
A
4619 Clearview Drive
Camp Hill, PA 17011
(Deed conveying tenancy in common interest to Janice
A. Kiker (attached as Exhibit 1). Charles A. Kiker,
husband of the decedent, Lenora B. Kiker, died Nov.
24,2001).
26.02
7,615.31
4
A
102/25/2002 Members 1 st Federal Credit Union
I Acct. Number: 214526-40
607.69
108/28/1964 M&T Bank
I Acct. Number: 51205475
I 02/28/1981 M&T Bank
I Aeet. Number: 51205580
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5
108/15/2000
i
108/1512000
A
6
A
7
A
8
A
Belco Community Credit Union
Acct. Number: 790370 (Savings)
7,122.62
I
69,348.961
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5,230.931
Belco Community Credit Union
Acct. Number: 790370 (Certificates)
5,546.85
Total of Continuation Schedule(s)
TOTAL (Also enter on line 6, Recapitulation)
I
50%/
I
50'/1
f
13.01
3,807.66
50%
303.85
50%
3,561.31
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50%1
I
50%1
50%1
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34,674.48
2,615.47
2,773.43
28,226.54
156,146.56
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SCHEDULE F
JOINTLY-OWNED PROPERTY
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
I
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I FILE NUMBER
21 - 06 - 0246
ESTATE OF
Kiker, Lenora B.
If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G.
10
A
11
A
12
A
01101/2000 John Hancock - Grade A - Inv. Bond
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4,105.911
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3,143.58
50%
23,030.00
JOINTLY OWNED PROPERTY
I '-" DESCRIPTION OF PROPERTY . --I Q =-r
ITEM F6~.1Jgl~T. ~~. b~ Include name of fin.anCial institution and ban.k.... account num. ber I DATE. OF DEATH D~COtS I DATE OF DEATH
NUMBER TENANT" JOINT or similar identifying number. Attach deed for jointly-held real VALUE OF ASSET 'NTEREST1~~~A~LUE OF
~'-106~ estate. DECEDENT'S INTEREST
9 A 06/27/2000 M&T Bank 28,341.61 50% 14,170.81
I Acct. Number: 950529661 I
. 10/14/1976 M&T Bank I 6,287.15 50o/~
Acct. Number: 15004208556885 I I
04/29/2005 M&T Bank 46,060.001
Acct. Number: 31003915256216
(The Executrix received a notice concerning this
account suggesting that it would be fully taxed as a
joint account created within a year of death (attached
as Exhibit 2). That appears to have been based upon
an April 1, 2006 report from M&T to the Department
concerning the certificate of deposit (attached as
Exhibit 3). Upon a further review of records at M&T,
it was determined that the funds to open the joint
certificate came from a joint M&T account created in
June of 2000 (Acct. Number: 950529661) referred to
above as Item 9. (See Exhibit 4 - a July 12,2006
letter from M&T Bank with enclosures).
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50%1
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2,052.96
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Page 2 of Schedule F
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SCI-EDUI..E H
FUNERAL. EXPENSES &
AIl\tNSTRA11VECOSTS
COMMONWEALTti OF PENNSYlVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Kiker, Lenora B.
Debts of decedent must be reported on Schedule I.
ITEM ~
NUMBE'~I~;~
~.._.--
A. FUNERAL EXPENSES:
1 Neill Funeral Home
!
DESCRIPTION
2
Gingrich Memorial
B.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
1.
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I FILE NUMBER
21 - 06 - 0246
AMOUNT
Social Security Number(s) I EIN Number of Personal Representative(s):
2.
Street Address
City State _ Zip
Year(s) Commission paid
Attorney's Fees Ball, Murren and Connell
3.
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant Janice A. Kiker
Street Address 4619 North Clearview Drive
City Camp Hill
Relationship of Claimant to Decedent
State P A
Daughter
Zip
4.
Probate Fees Cumberland Co. - Register of Wills - probate fee $ 189.00
Dauphin Co. - Register of Wills - Executrix Oath 20.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
I
Other Administrative Costs
Ball, Murren & Connell
Reimbursement for Costs advanced
2
Reserve for additional administration expenses.
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TOTAL (Also enter on line 9, Recapitulation)
17011
11,126.00
125.00
2,000.00
3,500.00
209.00
109.46
200.00
17,269.46
I SCHEDULE I I
tEEBTS OF DECEDENT, MORTGAGG~LI
LIABILITIES, & LIENS
. ~ -0 ..__
----
I FILE NUMBER
21 - 06 - 0246
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COMMONWEAlTH OF PENNSYlVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF .
Kiker, Lenora B.
Include unreimbursed medical expenses.
ITEM DESCRIPTION AMOUNT
NUMBER
1 Cumberland County Office of Aging 633.60
2 Dr. William Polaeheek 9.00
3 Jackson Gastroenterology 60.10
4 Patel & Andrews, MDs 86.52
5 John Sullivan, M.D. 77.53
6 Holy Spirit Hospital 9.40
7 Kunkel Surgical Group 68.18
8 Watkin, Freshman & Nipple, MDs 54.00
9 Bunek C. Azizkhan, M.D. 66.12
10 Pulmonary Critical Care 76.47
11 Pathology Associates of Central P A 22.25
12 Hershey Kidney Specialist 40.20
13 Pinnacle Health 41.38
--~ - --~
TOTAL (Also enter on Line 10, Recapitulation)
1,244.75
REV-1513 EX+ (9-00) ~
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COMMONWEALTH OF PENNSY~VANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
NUMBER
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
SCHEDULE J I
BENEFICIARIES ~
I FILE NUMBER
21 - 06 - 0246
RELATIONSHIP TO
DECEDENT
_ _--OnNot
ESTATE OF
Kiker, Lenora B.
AMOUNT OR SHARE
OF ESTATE
I. TAXABLE DISTRIBUTIONS (include outright spousal distributions)
Janice A. Kiker
4619 North Clearview Drive
Camp Hill, PA 17011
Daughter
100%
II.
I
! Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet
!NON-TAXABLE DISTRIBUTIONS:
I A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT
I BEING MADE
CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
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LAST WILL AND TESTAMENT
OF
LENORA B. KIKER
KNOW ALL MEN BY THESE PRESENTS, that I, LENORA B. KIKER, of
Cumberland County, Pennsylvania, do hereby make, declare, and publish this as my Last Will
and Testament, hereby revoking all former wills and codicils heretofore made by me at any time.
PAYMENT OF EXPENSES
FIRST: I direct that my Executrix, hereinafter named, shall have the power, but not the
duty, to pay all my just debts, expenses of my last illness and funeral expenses, from my estate as
soon after my decease as shall be found convenient.
GIFTS
SECOND: I bequeath my automobile and personal effects, such household goods, if
any, as may be my individual property and other tangible property of like nature (not including
cash or securities), together with any existing insurance thereon to my daughter, JANICE A.
KIKER.
I may leave a memorandum setting forth suggestions as to the distribution of certain
items and, while the memorandum is not to be legally binding, I hope the suggestions in it will
be carried out.
THIRD: I give, devise and bequeath the rest, residue and remainder of my estate, real,
personal and mixed and of any nature whatsoever and wherever situated, to my daughter,
JANICE A. KIKER, if she survives me by thirty-one (31) days.
A. If JANICE has predeceased me, or does not survive me by thirty one (31) days, I
give my real property at 4619 N. Clearview Road, Hampden Township, Cumberland County,
Pennsylvania, to my son, THOMAS C. KIKER, but ifhe has predeceased me, then to my
grandsons, CHRISTOPHER and MATTHEW, if living, as tenants in common, but if either has
predeceased me then to the grandson's descendants then living, per stirpes and not per capita.
C,~1 Ltrz.oc 13< t;fkq)
- 1 -
B. lfmy daughter, JANICE, has predeceased me or is not living thirty-one (31) days
after my death, I give the rest residue and remainder of my estate, excluding the referenced real
estate, in three (3) equal shares, to my son, THOMAS, and my grandsons, CHRISTOPHER and
MATTHEW, but if any of them predeceases m~, his share is to be distributed to his issue per
stirpes and not per capita.
FOURTH: Subject to the powers of revocation and withdrawal herein reserved, no
interest of any beneficiary hereunder shall be subject to anticipation or voluntary or involuntary
alienation.
ADMINISTRATIVE PROVISIONS
FIFTH: My Executrix (and her successor) shall have, in addition to the powers and
authority conferred upon her by law, the following additional discretionary powers and authority:
(a) To retain any property received by her.
(b) To sell at public or private sale, exchange, lease, mortgage or pledge any property,
real or personal, at any time constituting a portion of trusts herein created, and upon such terms
and conditions as the Executrix shall deem wise.
(c) To invest any money at any time in such bonds, stocks, notes, real estate,
mortgages, life insurance annuities or other securities, or such property, real or personal, as the
Executrix shall deem wise, without being limited by any statute or rule of law regarding
investments by the Executrix.
(d) To retain, without incurring any liability, as investments, any property owned by me
at the time of my death, as long as she deems it wise, and even though such property is not the
kind of property Executrix would purchase as an investment; and even though to retain such
property might violate sound diversification principles.
(e) To cause any security or other property which may at any time constitute a portion
of my estate to be issued, held or registered in her own name, or in the name of a nominee, or in
such form that title will pass by delivery.
(t) To consent to the reorganization', consolidation, readjustment of the financial
structure, or sale of the assets of any corporation or other organization, the securities of which
constitute a portion of my estate, and to take any action with reference to such securities which,
in the opinion of the Executrix, is necessary to obtain the benefit of any such reorganization,
consolidation, readjustment or sale; to exercise any conversion privilege or subscription right
given to her as the owner of any securities constituting a portion of my estate; to accept and hold
as a portion of my estate securities resulting from any reorganization, consolidation,
readjustment, sale, conversion or subscription.
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(g) To pay all costs, taxes, charges and expenses in connection with the administration
of my estate, including compensation to the Executrix.
(h) To determine what is "Income" and what is "Principal" hereunder, and her decision
thereon shall be final; and to purchase securities at a premium or discount, and to apply or charge
said premium or discount against income or principal as the Executrix may determine.
(i) To transfer, sell, exchange, partition, lease, mortgage, pledge, give options upon, or
otherwise dispose of any property at any time held by her, at public or private sale or otherwise.
G) To borrow money from any person, firm or corporation for the purpose of
protecting and preserving or improving my estate hereunder; to execute promissory notes or
other obligations for amounts so borrowed.
(k) To make distribution in cash or in kind.
(1) To execute and deliver all documents necessary or appropriate for the exercise of
their powers.
(m) To do all other acts in her judgment necessary or desirable for the proper and
advantageous management, investment and distribution of my estate.
SIXTH: And I do further direct that:
(a) No Executrix (Executor) shall be liable for any loss resulting to my estate from any
investment or reinvestment made or retained in good faith.
(b) No Executrix (Executor) shall be liable for any loss to my estate unless the same
shall occur through her (his) own gross neglect or willful malfeasance.
FIDUCIARIES
SEVENTH: I hereby designate my daughter, JANICE A. KIKER, as Executrix of the
trusts created herein. The Executrix shall be reimbursed for expenses on behalf of the estate and
shall receive reasonable compensation for services rendered to the estate. Executrix shall be
entitled to reimburse herself for any personal costs incurred in the administration of the estate
and for any of the expenses of the estate she has paid. If JANICE is unable to serve, then I
hereby appoint as the alternate, my son, THOMAS C. KIKER. No person appointed under this
paragraph shall be required to post a bond or enter security for the performance of their duties in
any jurisdiction.
TAxEs
EIGHTH: I direct that all transfer and inheritance taxes, state or federal, assessed
because of my death, whether the funds, property or insurance proceeds to which such taxes are
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attributable pass under this Will or not, shall be paid out of my residuary estate just as if they
were my debts and none of these taxes shall be charged against any beneficiary; that my
Executrix pay, or provide for payment of all such taxes at such time or times, and in such manner
as my Executrix deems best.
IN WITNESS WHEREOF, I, LENORA B. KIKER, the Testatrix to this my Last Will and
Testament, typewritten on four (4) sheets of paper which I have)dentified at the bottom of each
page by my signature, hereunto set my hand and seal this Z.s:~'-day of SJf:JJ 7'--~ l\ ......~
2005. ' IJ . ~,'YL~>-t..-L/
, (SEAL)
The preceding instrument consisting of four (4) typewritten pages, each identified by the
signature of the Testatrix, LENORA B. KIKER, was on this day and the date thereof signed,
published, and declared by LENORA B. KIKER, the Testatrix therein named, as and for her
Last Will, 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.
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-4-
COMMONWEALTH OF PENNSYLVANIA
: SS:
COUNTY OF CUMBERLAND
I, LENORA B. KIKER, the person whose name is signed to the attached or foregoing
instrument, having been qualified according to law, do hereby acknowledge that I signed the
instrument as my Will; and that I signed it willingly and as my free and voluntary act for the
purposes therein expressed.
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. LENORA/B. KIKE
Sworn or affirmed to an;hacknowledged before me, by LENORA B. KIKER, the
Testatrix, this t~ day of Okt~ ,2005.
IC
NOti\RlAt SEAL
GLORLl\ J. CO?PEHSMm'~ Notaiy PubIc
Co.rnP Hut So;o. Cwr~!&nd County .
My CtimmIoolal rJtplws June 21. 2001 '
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Tax Parcel No.
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THIS DEED,
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BETWEEN
-0 l"Y ':'-"'. ~.o
-7 day of ~ ' in the year of our Lord two th~an~p~ :. ,
a :i;;; ~.:o~
-c I C:l _~.r
CHARLES A. KIKER and LENORA B. KIKER, husband and iYife,
MADE THIS
(2001).
and,
Grantors,
CHARLES A. KIKER and LENORA B. KIKER, husband and wife,
and JANICE A. KIKER, single woman, as joint tenants with the
right of survivorship,
Grantees,
WITNESSETH, that in consideration of ONE - - - - - ($1.00) DOLLAR, in hand paid, the receipt
whereof is hereby acknowledged, the said grantors do hereby grant and convey to the said
grantees, their heirs and assigns,
ALL THAT CERTAIN parcel or tract of land situate in Hampden Township, Cumberland
County, Pennsylvania, more particularly bounded and described as follows:
BEGINNlNG at a point on the North side of Clearview Drive which point is at the diviSion
line of Lots Nos. 26 and 27 on the hereafter mentioned plan of lots and is also situate 215.82 feet
East of Hampden Drive by the northern line of Clearview Drive; thence North 1 degree 52
minutes West along said division line 111.87 feet to a point at other lands of Joseph J. and Jean
Ida Cignetto; thence South 88 degrees 20 minutes West along said lands of Joseph J. and Jean Ida
Cignetto 65 feet to a point at the division line of Lots Nos. 27 and 28 on said plan; thence South 1
degree 52 minutes East along said division line a distance of 112.10 feet to a point on the northern
side of Clearview Drive; thence North 88 degrees 08 minutes East along the northern line of
Clearview Drive 65 feet to a point, the place of BEGINNlNG.
I
BEING Lot No. 27 on the Plan of Clearview Farms as recorded in Plan Book 9, Page 6
and improved with a one-story brick dwelling with attached carport.
BEING the same premises which Joseph J. Cignetto and Jean Ida Cignetto, husband and
wife, by their deed dated July 16, 1959 and recorded in Cumberland County Deed Book lOG",
Volume 19, Page 380, granted and conveyed unto Charles A. Kiker and Lenora B. Kiker,
husband and wife, the Grantors herein.
b'o~ 249 PAGE4807
This transaction is wholly exempt from Realty Transfer Tax because it is a transfer from
father and mother to daughter (72~ 8102-C.3).
AND the said grantors hereby covenant and agree that they will warrant specially the
property hereby conveyed.
IN WITNESS WHEREOF, said grantors have hereunto set their hands and seals the day
and year first above written.
Signed, Sealed and Delivered
in the Presence of
~ .ff- jJr 1r ~.~
'f L ~ · /~
) - l;:~ ~~ .
) CHARLES A. ~ V '
)
~~ f!,~
) LE RA B. KIKER / t .
)
Commonwealth of Pennsylvania
)
ss.
County of Cumberland
)
On this, the" day of ~ ,2001, before me, the undersigned officer,
personally appeared Charles A. Kiker and Lenora B. Kiker, husband and wife, known to me (or
satisfactorily proven) to be the persons whose names are subscribed to the within instrument, and
acknowledged that they executed same for the purposes therein conta~ed. -;,~~"...~: 'Atj ti."',
IN WITNESS WHEREOF, I hereunto set my hand and OffiCIal se . ~~ :f~~"'''.~
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Notary Pu~~ NOTARIAL SEAL
MURREL R. WALTERS. I!\.. NOTARY PUBLIC
MECHANICSBURG BOROUGH. COUNTY OF CUMBERlAND
MY COMMISSION EXPIRES MARCH 21, 2005
BOOK 249 PAGE4808
I do hereby c~ that thMrecise residence_and cOI;Jplete >>O;~ ~f2.s.e ad "SS ,e WW,," (. '#1
=OOg~7 ~~1 f~rn Cilf/;. OH
~ I~
Attorney for ~
COMMONWEALTH OF PENNSYLVANIA )
ss.
COUNTY OF CUMBERLAND )
RECORDED on this day of
in the Recorder's Office of the said County, in Deed Book
Vol.
Given under my hand and the seal of the said office, the date above written.
~..-. J . .C"~, .~.1,; r;:' in hp: record eq Recorder.
;l~l-/~ri..~:-~.L ~~; ~vr:'d CG~..nrty P.A.
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800K 249 PAGr4809
A.D. 2001,
, Page
"
REV.16t9 EX (..)
DEC~ENT
INfORIIATlON
FINANCIAL
lNSTlTUTJON
INFORMA liON
ACCOUNT
INFORMATION
PLEASE ATT ACI-/
COPYOF
SIGNATURe
CA.RD
IF A\AIlM!U!
JOlttT
SUlMVORl
aENEFlCIAR,V
INFORMATION
.
NonCE OF DECEDENT
ACCOUNT STATUS
COMMONWEALtH OF HNHIYt.VANIA
D""I'01IINT 0' IlEVl!NUI
aulWAU 01 JHDMDUALTAXU
DI!PT. 210101
MARRltBURG. PA 11121oOI01
(117) 717-1S27
NAMe: (
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ACOOUNTNUMIlEI\
. \OOffi 15dS'" CRd \ LP
JOINT
- aR- a.DO~
~f~
HER ACCQUNTTHATWAS RE S RED IN
(t.tddIe InhIaI)
JOINT ADDRESS
SURVlVORl
BeNEFICIARY CITY STATE ZIP CODe
IHFORMA TlON
~TIONsHIP TQ DECEDeNT SURVIVOR'$ iOCIALSECURJTY NUMBeR
NAME (Lasl) (FiI1i) (Mlllcle 1nI~1)
JOINT ADDREss
SURVIVOR
BENI:FJCWlV C1lY STATE ZIP CODE
INFORMATION
~TIONSHIP TO DECEDENT SURVlVOR'S SOcw.seCURrrY HUMBER
~4...
NAMe (La$!) (FIr8t) (MllHelnlllll)
JOINT ADD~SS
SURVIVORI
BENEFICIARY CllY S'rAT! 2:IP CODE
JNFORMATION
~TJONSHIP TO OECEDENT SURV\VoR'S SOCIAL8ECUFtllY NUMBER
I c.nlfy thllt th. at>>ove information i. tru.. correct and cOMplete.
-OF:rrtNlV\~1 (\ l;!ffh-!){,\ f).')t'J/
OFFICIAL USE
ONLY
PERC&NTTAXABU!
TAX RAn:
OFFICIAL USE
ONLY
PfRCENTTAXABLE
TAX RATE
OFFICIAL USe
ONLY
PERCEHTTAXABLE
TAX RATE
OFRCIAL USE
. ONLY
PERCENTTAXABL!:
..::
TAX R.ATE
I DATE
. ~\-Oc..o
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. Z80601
HARRISBURG. PA 171Z8-0601
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE NO. 21 06-0246
ACN 06122127
DATE 05-18-2006
REY-154S EX UP tD9-00>
** JANICE A KIKER
4619 N CLEARVIEW DR
CAMP HILL PA 17011
TYPE OF ACCOUNT
EST. OF LENORA B KIKER 0 SAVINGS
S.S. NO. 288-12-6811 0 CHECKING
DATE OF DEATH 01-30-2006 0 TRUST
COUNTY CUMBERLAND [Xl CERTIF.
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
" & T BANK has provided the Department with the information listed. below which has been used in
calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of
this account. If YOU feel this information is incorrect. please obtain written correction froll the financial institution, attach a COpy
to this form and return it to the above eddress. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth
of Pennsylvania. Questions ~y be .nswered by callina (717) 787-83Z7.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 31003915256216 Date 04-29-2005
Established
x
38,060.40
100.00
38,060.40
.045
1,712.72
TAXPAYER RESPONSE
To insure proper credit to your account, two
(Z) copies of this notice must accollpanY your
paY8ent to the Register of Wills. Make check
payable to: "Register of Wills, Agent".
Account Balance
Percent Taxable
Amount Subject to
Tax Rate
Potential Tax Due
x
NOTE: If tax payments are lIadewithin three
(3) months of the decedent"s date of death,
you IDBY deduct a 5;( discount of the tax due.
Any inheritance tax due will become delinquent
nine (9) months after the date of death.
Tax
PART
[!]
[CHECK ]
ONE
BLOCK
ONLY
A. 0 The above inforllation and tax due is correct. . .
1. You may choose to r_it payment to the Register of Wills with two copies of this notice to obtain
a discount or avoid interest, or you may check box "A" and return this notice to the Register of
Wills and an official assessment will be issued by the PA Department of Revenue.
B. ~he above asset has bean or will be reported and tax_paid with th~ ~~nnsYlvania }nherjtance Tax retu~ r~
to be filed by the decedent"s representative. t.Vtrh (;..- ~;)J, Ju..J,.~ 'tP ~ ~ ~ ! r.
{).4 "tW lWlfA)J /PlU ,..... n,)i!7:tliN' c-d r~ fJl'I~ r1o.-.:r~
C. D The abDve infonnation is incorrect and/or debts and deductions were paid by you. (;:~rCf-rf( ~ -'~ c.... flta.a
You must cOllplete PART 0 and/or PART @] below. ~ ~ ~..~ M. ~
If you indicate a different tax rate, please state your
relationship to decedent:
x
PART
~
TAX RETURN - COMPUTATION OF
LINE 1. Date Established 1
2. Account Balance 2
3. Percent Taxable 3
4. Amount Subject to Tax 4
5. Debts and Deductions 5
6. Amount Taxable 6
7. Tax Rate 7
8. Tax Due 8
TAX ON JOINT/TRUST ACCOUNTS
x
PART
~
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCRIPTION
AMOUNT PAID
I
$
I
TOTAL (Enter on Line 5 of Tax Computation)
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
complete to the best of my knowledge and belief.
HOME ( )
WORK ( )
TELEPHONE NUMBER
DATE
TAXPAYER SIGNATURE
m MBtlBank
5528 Carlisle Pike, Mechanicsburg, PA 17050
717 766 0507 FAX 717 766 1793
July 12, 2006
Ball, Murren, & Connell
Attn: Mr. Richard Connell
2303 Market Street
Camp Hill, P A 17011
Dear Mr. Connell,
Per our phone conversation, please find the enclosed copy of the miscellaneous debit of
$40,000.00 from Lenora Kiker's checking account 950529661 as proof that her joint
certificate of deposit, number 31003915256216, was opened with money that was on
deposit with M&T Ban1e I have enclosed a copy of the checking statement as well to
show where the money was taken from to open the new account.
If you have any questions or concerns, please feel free to contact me at 7177660507 so I
may assist you further. Thank you.
Sincerely,
tJi:ndtj Ro jzJ!u
Cindy Rotolo
Branch Manager
Enclosures
071f06
I1M&I'Bank
. ..... . . . . . . . . . . .
. . . .
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. . . . - . . . . . . . . . . . . . . . . . . . . . . . . . . . - . . . . . . . . . . .
. . .
. . . .
. .
::::ACCOOO::::NO:/',::::
. . ..'
. . . . . . . . .. ......
950529661
M&T PREMIUM INTEREST
APR.20-MAY.19,2005
1 OF 1
00 0 06123M NM 017
17461
LENORA B KIKER
JANICE A KIKER
4619 N CLEARVIEW DR
CAMP HILL PA 17011-4015
INTEREST PAID YEAR TO DATE
265.39
WEST SHORE PLAZA
'><'<~~~~1:.:..i:,H':f::::: F::::.f1MrE~?AiVgI~~~':U::::)
NO I AMOUNT
68,107 26 01 0 00
ACCOUNT SUMMARY
':,',' :::::::::::::::::::::::::::: :;:.: .. ............. ::::::-:-:::-:::-:':-:-::::-OTHER':::-::-::-:::-::::"':::-:":-:'-::- :-:-::'-:~<":'::::: :-:-:-.<.:.,:-:.:~WlS<::-::::-:':':':':
~: ~ :~:~ :~:~:~:rnm6KS: :~:pilii: t~:~:~:~:~::: ~: :~::~~ :~~::~:?::~~Mc4fA~~t:~j~{~~::~~\ ~ ~~~:~RB~~)~~~B ~~~~; ~~~~~ ;~~~~:;: ~l&~ ;~;~~~: :~~}~
NO I AMOUNT NO I AMOUNT
01 0 00 1 I 40,000 00 36 27 28,143 53
:,::POSTiNG::::.. -::.:::<:::::,.::::<::::::-:::.:;.:.::-:-,:-.: :::::: :::: < :;::.:...;.:::"::::..: <:: .. .... :...:
:::::DATE::::< ,::<:.,,/:.,.:/:.,::.:>,:':>rAANSAi&.rlmf:D'Es~iili;i1iifui
ACCOUNT ACTIVITY
: :D.E.~o.s.~~$.~J:~r:~~E.~: :{;.::;:~E.~~;)t,p.m~~:>: ,.:::><:.<::<:::q~~t>>;:::;:::::::
.. ... :&::::o1ml~::::AbijIT.i'dNs: :::::::::::::SUBS&.r.:t'dNS:::;::::: ::';::::::::':':::~E::::':::::'::':':':
04-20-05 BEGINNING BALANCE
05-02-05 MISCELLANEOUS DEBIT
05-19-05 INTEREST PAYMENT
40,000 00
$68,107 26
28,107 26
28,143 53
36 27
ENDING BALANCE
$28,143 53
ANNUAL PERCENTAGE YIELD EARNED
1. 00 %
IMPRESSED BY THE SERVICE YOU RECEIVED AT M&T? IF YOU'D LIKE TO NOMINATE AN M&T
BANK EMPLOYEE FOR EXCEPTIONAL CUSTOMER SERVICE, PLEASE COMPLETE OUR M&T SERVICE
EXCELLENCE FORM AT WWW.MANDTBANK.COM/EXCELLENCE . WE APPRECIATE YOUR FEEDBACK!
Page 1 of1
1m M&I'Bank
I WE HAVE CHARGED YOUR ACCOUNT FOR THE FOLLOWING REASON:
i a: l/ 0 k. de. l . f ...c tI 'u I. C f>
, '? /60.3] I ~ :J I) t ::) J (;
\
I 8Q. 0ngIW
'11 WI'llla . CuItomIt Copy ?
2nd_. F. Copy
TRIPLICATE DEBIT
DATE 11- ol9-o ~-
OFFICE C / 6 <1
AUTHORIZED T...v........ ---
r
Lf:'" 'r., B f: 1-<:
......
6109 07 005lo~9741 1547 042905 23 OlH
DBA-DR CHK 950529661 '40000.00
1:0 ~ cOOOO ~ GI:
q5052~~~l~ ~1 ~OOO~OOOOOO~
Posting Date 2005 May 02
Research Seq # 5333969610
Account # 950529661
Check/Store # 0
DB/CR DB
Dollar Amount $40,000.00
Bank # 096
Branch # 06123
Deposit Acct # 1016109005
http://pc-ncrweb 1.firstmd.com/inquiry/servlet/inquiry
7/12/2006