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Home My WebLink About09-18-06 .. .. REV-'SOO EX (S-OO) REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY '*' COMMONWEALTH OF PENNSYLVANIA _ DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 171284:>601 w ... ~;!!;1Il oc:~ w~g J:c:...J o~1D ~ <( FILE NUMBER 21 06 0644 COUNTY COOE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) ~ Hopple, Mildred A. ~ DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) W 07/13/06 06/11/16 (.) W (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) C SOCIAL SECURITY NUMBER 182-40-7906 THIS RETURN MUST BE FILED IN DUPUCA TE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER [!] 1. Original Return o 4. Limited Estate ~ 6. Decedent Died Testate (Attach copy ofWlI) o 9. Litigation Proceeds Received o 2. Supplemental Retum D 48. Future Interest Compromise (data of death aft... 12,12-82) D 7. Decedent Maintained a Living Trust (Attach copy ofTrust) D 10. Spousal PovertyCredil (d.taofd..1hbelweon 12-31-91 and 1-1-95) o 3. Remainder Return (data of death priocto 12-13-82) D 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes o 11. Election to lax under Sec. 9113(A) (Attach Sch 0) NAME Andrew C. Sheel , Esquire FIRM NAME (~iWlcable) Andrew C. Sheely, Attorney at Law TELEPHONE NUMBER (717) 697-7050 COMPLETE MAlUNG ADDRESS Andrew C. Sheely, Esquire 127 South Market Street P.O. Box 95 Mechanicsburg, PA 17055 z o ~ ..J ~ l- ii: <( (.) W a:: 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corpomlion, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule 0) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1.7) 9. Funeral Expenses & Adminislrative Costs (Schedule H) (9) 10. Debts of Deceden~ 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 Governmental BequeslsfSec 9113 Trusts for which an election to lax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) OFFIQ6L USE ONLY c::;:::) . c::;:::) Cl'" (/) fT1 -0 -;: 5?O .:D -'-0 ..:::cO ~~:93 . (./J?::' 155,591.62 7) :--,'1 ('J (~j -:t:; f~~ '.:::J C.:> ~r; -Tl ("') ITl c~ CD 6,960.16 --(-)('"'" ... ~-) ',j ,_ is; .1 ;;:0-1 J> -0 3 N 33,007.85 0.00 \.0 195,559.63 (8) 2,769.28 7,745.20 (11) (12) (13) 10,514.48 185,045.15 (14) 185,045.15 z o ~ ~ ~ c.. :IE o (.) ~ SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal lax rate, or transfers under Sec. 9116 (8)(1.2) 17. Amount of Line 14 taxable at sibling rate x.o_ (15) 185,045.15 x.o~ (16) x .12 (17) x .15 (18) (19) 8.327.03 16. Amount of Line 14 taxable at Uneal rete 8,327.03 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 'li.! r i . "" ! "" ""'~........."."" ............-~-~-.. . . Decedent's Complete Address: STREET ADDRESS 801 North Hanover Street CITY Carlisle 1 STATEpA I ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 8,327.03 7,888.78 438.25 Total Credits ( A + B + C ) (2) 8,327.03 3. Interest/Penalty if applicable D. Interest E. Penalty TotallnterestlPenalty ( 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. 7,888.78 8. Enter the total of line 5 + SA. This is the BALANCE DUE. (5) (SA) (58) A. Enter the interest on the tax due. 7,888.78 Make Check Payable to: REGISTER OF WILLS, AGENT If PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS No ~ [i] [i] [i] o lj] 1. Did decedent make a transfer and: Ves a. retain the use or income of the property transferred;.......................................................................................... 0 b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 c. retain a reversionary interest; or.......................................................................................................................... 0 d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. iii 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. 0 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ 0 [!] 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 01 perjury, I dedare that I have examined this re\Um, induding accompanying sd1ed~es and statemenls, and to the bast 01 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 an knlM'led e. SIGN URE OF PERSON RESP SIBLE FOR FILING RETURN It r-- Terry Lee Hopple, 860 Boiling Springs Rd,Mechanicsburg,PA 17055 DATE ql5/n~ . ADDRESS Shirley L. Kimmel, 9 S.West Ave. ,Shiremanstown, PA 17011 ~I~~!~~ )RE~~R ~ESENTATIVE (;M~Y-- I\n_~!~_~_g,:__~beely, Esquire, 127 South Market Street, P.O. Box 95, Mechanicsburg, PA 17055 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 exemot 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 dales 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 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. 99116(a)(1)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. 99116(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 by blood or adoption. Decedent's Complete Address: STREET ADDRESS 801 North Hanover Street CITY C r I I STATEpA I ZIP 17013 arise Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 8,327.03 7,888.78 438.25 Total Credits ( A + B + C ) (2) 8,327.03 3. Interest/Penalty if applicable D. Interest E. Penalty TotallnterestIPenalty ( 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) A. Enter the interest on the tax due. (5) (5A) 7,888.78 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. B. Enter the total of Line S + SA. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 7,888.78 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred;.......................................................................................... 0 [iI b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 [iI c. retain a reversionary interest; or.......................................................................................................................... 0 [l] d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 [iI 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. Ii] 0 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. 0 iii 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ 0 [iI 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 pllljuty, I dedare that I have examined 1I1is retum, indud'mg acoompan~ schedues and statements, and to 1I1e best at my knowledge and belief, it is lIUe, correct and complete. Declaration of preparer other 1I1an 1I1e personal representative is based on all information at which preplWer has any knowledge. SIGN URE OF PERSON RESP SIBLE FOR FILING RETURN it r-- . ADDRESS Shirley L. Kimmel, 9 S.West Ave.,Shiremanstown,PA 17011 ~I~~~RE~~R~ESENTATIVE g'fs ~.!:!.c:l~~~~~~~Jy.! Esquire, 127 South Market Street, P.O. Box 95, Mechanicsburg, PA 17055 ..-rom 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. 99116 (a) (1.1) (i)]. For dates of death on or a1l.er 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 exemot 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 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 of the child is 0% [72 P.S. 99116(a)(1.2)]. The lax 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. ~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 by blood or adoption. Terry Lee Hopple, 860 Boiling Springs Rd,Mechanicsburg,PA 17055 DATE qli5I()~ ~=- ReV.I503 ex. (1-87) I ESTATE OF '. SCHEDULE B STOCKS'& BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESID NT DECEDENT FILE NUMBER MILDRED A. HOPPLE 21-06-0644 All property jolntly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION 1. . 1 . 2 . 3 . 4 . VALUE AT DATE OF DEATH Mildred A. Hopple died on Thursday, July 13, 2006, in Carlisle, Pennsylvania. PNC Bank Corp. Common Stock 500 shares certificate form certificate Humber 274531 total shares valued at $69.39/share at date of death $34,695.00 PNC Bank Corp. Common Stock 68 shares certificate form Certificate Humber 274532 total shares valued at $69.39/share at d,ate of death $ 4,718.52 Blackrock Stock - 1,652.40100 Shares at $10.S1/share $17,366.74 PNC Bank Corp. Common Stock c/o PHC Financial Services - 1,424 shares at $69.39/share $98,811.36 TOTAL (Also enter on line 2, Recapitulation) $ S 1 5 5 . 5 q 1 . 6 ? (If more space is needed, insert additional sheets of the same size) ~ !!I ~ ~ f&l ~ ~ ~ ~ 2: ~ !i m ~ ~ i r~ ~ ~ C') ~ ~ ~ 0 m ~om s: 0 .,,0 ~ ~t 1 ~ i t= 0",C: s: , ."",z <> ..mlil 0 ill '" > m :II C> "- I ~ z ~~ - !!l m m:ll u.. t · tf ~ Z i i Em .... ;!: .. ('j!? "- .~ .. l> t . ~;i 6 ... : ~ l ~l i z " ~ 5 t~t ~ ~r -0 0 IS ~ ,i z ., ttlt ! z.: ~ c: in ill I tJ:J l. ~~ l ~ ~ c [it. ~ . ;.~ :::So l~ ~ ~ " I n " llfi 0 ., -0 i. x for ~11 i i ~'~ ~ ,..., .. ' r i' ~ c::: ::; ! ~ ~ .. i ~ I ~ tf t ! !;l "1J i i~ C') 0 ~ i ig s: I.LI l;l ~.. s: :5 2 ~I 0 Ln z Z Ii II"" :!! o !i i Ln i ~ ~ i ~ ~~ ! r~~ ~ ~ ~i ~ t-t 1 ~ i .~~ ~ t t If ~ ~ Ii l ~ ~ll I~ i fttf i · j It 1 t ~ ~~ ~ ~ ~ ti'-l~ ~ tlf; i l- s" ~ ~ r '}}. 1 ~ t~ I t l ~ i I ~! ~ it t ! i r IF II t "'C ~ ~ = > ~ I~ i ~ o " i (!l (') ~ ~ 0 ~~l'I :s:: ~~~ s: ill; 0 ~ i! Z ~ m i ~ ~ a . '"'CJ ~< - Z ,J () i o:J v: o !~ :::J .:" """ :.. . () o .., -C ,.... .. c:: III ~ ~ "0 Ii ~ i w 0 ~ ~ t.n ~ ..... :!! C ;E 3 (J1 i "i! 0; n z~ (') z:!! 0 ~g s: cl~ s: ~~ 0 ~i z i .. j;; -~ ~. PNC1NVESTMENTS IVkwln-r N.:\SD aud ~U...C August 1, 2006 Estate of Mildred A Hopple 9 S West Avenue Shiremanstown, PA 17011 Attn: Mrs. Shirley L Kimmel and Mr. Terry L Hopple Subject: Date of Death Valuation The date of death valuation for securities held by Mildred A Hopple in her PNC Investment Account Number 4389-9709 is as follows: Date of Death - July 13, 2006 /' /' 1,652.40100 shares of Blackrock Govt Inc A (CCGAX) @ $10.51 per share 1,424 shares of PNC Finl Svcs Group Inc (PNC) @ $69.39 per share Price per share is at the close of business on July 13,2006. In the Investment Account there was a money market balance of $ 2.48 on 07/13/06. Please do not hesitate to contact me if I can provide you with further information. Sincerely, ~1..L ;?~ Charles E Little, CFP Vice President Senior Financial Consultant CEL/djp A member ofTht: PNC Financhll Services Group 2 East Main Street Mechanicsburg 'Pennsylvania 17055 www.pncinvestlllents.com .>- Important Investur Information: Senlrities ;Jnd brokeruge services are provided by PNC Investments LLC, 1I1tlllber NASD and slPe. Annuities and uthc'r insurance products are offered by PNC Insurance Services. Inc. a licensed insurance agency. I .~la)' UlI;C V.llUC I .No Bank Cl1al~l[Ce REV-1508 EX+ (6-98) '*' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF 5eHIDULI E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY MILDRED A. HOPPLE 21-06-0644 FILE NUMBER ITEM NUMBER 1. 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. DESCRIPTION PNC Bank Checking Account #5070023024 Date of Death balance 2 . PNC Bank Savings Account #5030038694 Date of Death Balance 3. Blackrock Dividend check 07/03/06 4. Blackrock Dividend Check 08/15/06 5. PNC Investment Account #4389-9709 6. PNC Investment Account #4389-9707 dividend 7. Capitol Blue Cross Refund 8. Church of God Refund VALUE AT DATE OF DEATH $ 3,244.31 $ 452.85 $ 57.94 $ 58.15 $ 2.48 $ 783.20 $ 271.31 $ 2,089.92 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed. insert additional sheets of the same size) $6,960.16 .JUL-24-2006 22:22 PNCBANK 412 768 3458 P.01 ~ PNCBAN< July 25, 2006 Andrew C Sheely Attorney at Law 127 S Market St. POBox 95 Mechanicsburg. P A 17055 scp RE: Estate of Mildred A Hopple (Deceased) SSN: 182-40-7906 DOD: 07~13-2006 Dear Mr. Sheely: In response to your request for Date of Death balances for the customer noted above, our records show the follOwing: Checkina Account Account #5070023024 Established 01-01-1979 MILDRED A HOPPLE DOD balance: $3.244.30 + $0.01 accrued interest Savings Account Account #5030038694 Established 11-24.1986 MILDRED A HOPPLE DOD balance: $452.85 + SO.OO accrued interest The decedent maintained investment Account (INV #43899709). For further information, you may call the Brokerage Department at 1-800-762-6111. Safe deposit box The decedent maintained safe deposit box #1332. It was in one name. MILDRED A HOPPLE . It is located at: MECHANICSBURGBRANCH 2 East Main St. Mechanicsburg, P A 17055 717-691-4011 ,. ~- - Page 1 of2 Cof Cof Il1 . :II H I ... .~ . tt 1;"1. I'<l ~ U1 ~ ~ l;Ijj tj ~ g b:l l;Ijj ~ tj t"lI ~ g H 8 H .~ tj ~ f-l '" VI lIJ p o ..... g~ to) tit'" ~P. OW ~: 0.' nUl ~. ~ ~ID fJ)f-l )>I ... .... ... '" ... ... ... '" U'1U'1 ...,J...,J . . \01.0 pp '- 1 t L._J ~........ l\) 0\ lIJ P '" ..... tv t....." ........J ~.......i o ...,J "- o w "- o r.--.l 1 ! I L..J r"l - I ! ! L r-, i I r1 i I I i I . L_..; . ~ 0~ PNC1NVESTMENTS r\.kllll:a'r NASD ami ~IPI,: August 1, 2006 Estate of Mildred A Hopple 9 S West Avenue Shiremanstown, PA 17011 Attn: Mrs. Shirley L Kimmel and Mr. Terry L Hopple Subject: Date of Death Valuation The date of death valuation for securities held by Mildred A Hopple in her PNC Investment Ac:count Number 4389-9709 is as follows: Date of Death - July 13, 2006 // 1,652.40100 shares of Blackrock Govt Inc A (CCGAX) @ $10.51 per share 1,424 shares of PNC Finl Svcs Group Ine (PNC) @ $69.39 per share Price per ,share is at the close of business on July 13, 2006. In the Investment Account there was a money market balance of $ 2.48 on 07/13/06. Please do not hesitate to contact me' if I can provide you with further information. Sincerely, ai-~ Charles E Litlll~, CFP Vice President Senior Financial Consultant CEL/djp A rm:lJlb~r of The PNC financial Servic~s GroUll 2 filS! Main Street Mechanicsburg 'Pennsylvalli,l 17053 www,pnei i lv~stments.c()m Impl.lrtltnt Invedur Informatiun; Secllriti<:~ JIIU hrokenlYl' St~lvices are provich::d by PNC Investments llC. rncmUl'r NI'.:m ami slPe. Anooitit's ,Inti iltht'r illSlIr:lnCe ProUUl'ts ,1O't: offer~d !ly PNC InslIr.Jlll:e Services. hlt:. n licensed I"Sllr~nce ayen,'y. I .Aolay Lose \\llu" - -J I .No&nkGuanll: t: . .~.,~'~" ~ . C-j" ';c, ~,),;: .tri.....; ,: I"d t:". ~ tr.l lr:l t::l. tIj ~ Q tII trj I-Jj o jl t::l. trj 'tI o tr.l H ~ H Z G) o-J (1;1' W "'''' 00 o o-J ........ '" lJ1 ........ o 0'1 r....... ! ! i I I L i i I i I l"m; r..m, ! ! . i i I i L...; i ! I i, ! [...... 8 o o g o "" II ~ ." ~ en m ~ ~ ~ :::; ~ en 2 m ~ ." ;0 ~ " ~ c o (') "U Z (') + "" ~ '- !:.. 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"l] s:u 3 (1) ::J - eno en "3" :z'" -.,n :::IX" :z:z OC CD 3 ~l:T ~~ CD a. o o o <0 co W -<~ CD W '" ~ ~J \!!g i g ~i ar g i5::> )>'" ti i,~ g 3 , Ul ~iii' ~~ 50 ~';;; .., ~ is ~I !~ g(') fii ie!. Ill!!! e-m t'l~ a Ul gjIA 3' !!l iif~ ii.! E~ -<! : ~: c.'" 39' 2:~ ~", ~Ii ~ )> il ~~ (II:> ~~ i~' ii i~ gill .. :> co. ~^ l!~ 8- 3 ~ '2:J: ~.~ . . ::r ' :2 . III ' '1. . i? . ~~ ~,.~~' - .. . '-al ! ~ :D .. m : i~i ~ g "Q Cf}:D iC;.1 . .. .. .. , ~ K ~ B: ~ )jo :J: -8 "C CD ~ .~ ..-...I ~ '2 ~ :D ~ :J Q. ~ o C :J r't Cf}<OC):;j!j ~~am5 ~~~~~ z~~~> 8m~~Q ~~i~' ~ -0 r- > .... ~ .... > i ~ . I . (j) :::u o oC:: o~ !tn oC: ol:D O(j) ....:::u .0 c:: "0 ~ ~I i [ ~ ~ a CfJ \'1.1 o ::I: wm 00 0" ~z oc:: CD3!: Nal COm ~ rq THE CHURCH OF G8BT<<fMt!~C.45438 801 N. HANOVER STREET CARLISLE. PA 17013 REMITTANCE TOTALS !5 .- g. Ji :i! ..... --.:- ..... ....... -c. _ cD:"an-li- ~;:~:=.~ - .. ..... IE CI_. iii~:: c~ga." -..... "Cf r+C....r+DI ::r~"'c:o~ "C. r-t'CD a -il::l Eil'e!...: ~~gS0 .-........ ....... ..n ........ n !!~:l! :+2:i...& - - ID ""-l!'" ....3-S ID......... ::r"'::!~ III_a... -a:::1 ""......S' a .... OJ ::e: QJ ........ .... en g.- o ~Ii ~ ""'" - .,.. en (I) ~ Q ::z: c: e- (I) .., o 8 o -i:l>_ * ..,. 0 - QJO..O ::J g .,.. (I) :I>::J coB ar+ en o ...... 5~ r+ ....a>o C-c:::r (I) CO) (1) ., 0 -:;ll;'" en ....., o ~ <M ....., o CO U1 coo o fSc'::i m ~ .... 2,089.92 x ~.....,x Sm~ ::z:>::E: n-CI)> QJO......::z: g:!~~~ xC")::z:;::o- -""OCI)C") o>:;ti_ _mO ....m""'" @......~ U1 .00 2,089.92 G ~ g ~ ReV-1509 EX + (1-m '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE F JOINTLY-OWNED PROPERTY MILDRED A. HOPPLE FILE NUMBER 21-06-0644 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. SHIRLEY L KIMMEL B. c. JOINTLY-OWNED PROPERTY: ADDRESS 9 South West Street Shiremanstown, PA 17011 RELATIONSHIP TO DECEDENT Daughter LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE Include name of financial institution and bank account number or sirnila" identifying number. Attach DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT deed for joinUy-he1d real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. ll6/16/03 Citizens Bank Checking Account #6204178761 Date of Death Balance $ 15,499.22 Accrued Interest $ 0.00 Date of Death Value $ 15,499.22 A Shirley L Kimmel 50% $ 7,749.61 - 2- U6/16/03 Citizens Bank Checking Account #6204178788 Date of Death Balance $ 50,314.22 Accrued Interest $ 202.27 Date of Death Value $ 50,516.49 A Shirley L. Kimmel 50% $ 25,258.24 ~. .- ",-. - TOTAL (Also enter on line 6, Recapitulation) $ 33,007.85 (If more space is needed. insert additional sheets of the same size) )tIC Citizens Bank!~ ,.<< Account Number 6204178761 Account Title MILDRED HOPLE OR SHIRLEY KIMMEL Date Opened 6/16/2003 Account Type Checking Principal Balance as of DOD $15499.22 Interest from Last Posting to DOD $.00 Account Balance as of DOD $15499.22 YTD Interest to DOD $10.23 I , I - v , " " " ~-- - .. " :s.':"__ D Citizens Bank'" Account Number 6204178788 Account Title MILDRED HOPLE OR SHIRLEY KIMMEL Date Opened 6/16/2003 Account Type Checking Principal Balance as ofDOD $50314.22 Interest from Last Posting to DaD $.00 Account Balance as of DaD $50314.22 YTD Interest to DaD $.00 ,. ..... -,- REV-1510 EX + (1-97) SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF MILDRED A. HOPPLE FILE NUMBER 21-06 -0 6 4 4 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. ITEM NUMBER 1. DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET %OF DECO'S INTEREST EXCLUSION (IF APPliCABLE) TAXABLE VALUE l. Transfer/Gift from Citizens Bank $3,500.00 .50 3,000.00 0.00 Account #6204178761-Jt. Account with Shirley Kimmel, daughter of decedent, to Peggy Hopple, transferee 2 . Transfer/Gift from Citizens Bank $3,500.00 .50 3,000.00 0.00 Account #6204178761-Jt. Account with Shirley Kimmel, daughter of decedent, to Terry Hopple, trans fe ree 3 . Transfer/Gift from Citizens Bank $3,500.00 .50 3,QOO.OO 0.00 Account #6204178761-Jt. Account with Shirley Kimmel, daughter of decedent, to Robert E. Kimmel, transferee 4 . Transfer/Gift from Citizens Bank $3,500.00 .50 3,000.00 0.00 Account #6204178761-Jt. Account with Shirley Kimmel, daughter of decedent, to Shirley Kimmel, transfeIee TOTAL (Also enter on line 7. Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 0.00 REV-1511 EX+ (12-99). COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF MILDRED A. HOPPLE SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21-06-0644 Debts of decedent must be reported on Schedule 1 ITEM NUMBER A. DESCRIPTION AMOUNT FUNERAL EXPENSES: 1. MALPEZZI FUNERAL BOME - BALANCE DUE $ 381.78 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) SBIRLEY L. KIMMEL, EXECUTRIX Social Security Number(s)/EIN Number of Personal Representative(s) 9 SOUTB WEST AVENUE $ 0.00 Street Address City SBIREMANSTOWN State ~ Zip 17011 Yea~s) Commission Paid: 2. Attorney Fees ANDREW C. SBEELY, ESQUIRE, PER AGREEMENT $1,562.50 3. Family Exemption: (If decedenfs address is not the same as claimant's, attach explanation) Claimant Street Address City State _ Zip Relationship of Claimant to Decedent 4. Probate Fees CUMBERLAND COUNTY REGISTER OF WILLS $ 310.00 5. Accountanfs Fees 6. Tax Return Preparer's Fees 7. rILING FEES FOR INBERITANCE TAX RETURN 15.00 Reserves to coaclude admiaistratioa of Estate, First aad riaal Accouatiag Accouatiag Fees, taxes, preparatioa/mailiag aad copy charges of necessary Fiduciary Returns $ 500.00 TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 2,769.28 Wo sincoroly Appreciate the oonridcncc you have placed in us and will continue to assist you in every way \A :<< m. .feel free to con'tnct liS i r you have any questions in regard to th is statement. TIlE 1~()l.l.()WIN{; IS AN ITFiMIlF.D S"fA'I1iME:o..lT OF 'r! IF, SBRVICllS, J"ACll.mm~. AUTOMOTIVE EQUll"Mf.n\Ii, AND MI-:RCIfANDISH 'tHAT YOU SI-;I./,:emn W141{l\ MAKING Tilt-: FUNERAL ^R.R.^N(;~MI~;\ITS. I. PRO,.'I!:s8,ONAL S.:RVICF...~ Servic:es oJ' ~unClUI J>il'llctor/Stal1'. . . . . . . . FUIU;R.AL HO\o1E SKltVI(:': CJIARGF,g s..:u:crr.D MERCHA~OISE: SlI:cl Pmtective C'.llskct. . . . . . . . _ . . . , S.:ntinct. . . . .. .. . . II . . . .. .. . . . Killkw.1c: RI:RillWr.Fold~. Acks. . . . .. ..... CU::Itom CU.::Ikcl PlIlel. . .. .... . . , . Tn~ COST 0.' OUR SERVICES. EOllIPME~'I'. AND Mr.RCIIAN'DISE THATVOll HAVfSEL.t<."ED ... . . . . . . . . . . . . $8110.00 A'1' '1'1m TIME PlJ1'mRAI. ARRANCgMLiN'I'S WBRr. MADE. WE AI.>VANCIlO CERTAIN PAYMHNTS TO OTl U~R.') AS AN A<.;(.;OMMOIlATlON, T111~ F01.LOWINUIS A~ ACCOllJo>.:"1NG }-'OK 'n IOSH C1'^R(iI-:~, C.o\SH ADVANCES Opening GCIlvc, . . . . CO'I'1ClL:fy Jo:qu1llment . . , CC11.111ecJ neath Certificates , ~r.."""l"f)lpcr Noticc:ol . I'aulol 2 /)eYll . ~O\\.'5paper Nnti~ - ~r,:nlind 2 Days. . CIC!'1>'lMa~ OITcrine, . (~tmiHf. . . . . Flo\\'~I'tIl. . . . . IA-VOlliA McKiflnll)' . . MoltWftUnL ~ngra'lil\f. . . . . . . . . TOTAl, CASU ADVANCES AND SPJ;CIAL CIIAKCJ!:S, . CONTRACt' PMICIl . . HISTORY 07l1412OO6/"a)'lnent - Hnmc'lfl.:lldcn; . TOTAL AMDUNT nUE . R'ue 15 06 12: 28p Mioh8@1 J. Halp~zzi 'Malpezzi Funeral Home 8 Market PI37Jl Way Mechanic!\burg, PA ] 7055 (717)697-4696 August 15, 2006 Mr~. Shirley L. Kimmel 9 South W~t Avenue Shiremanstown, PAl 70 11 The Funeral Serviee 1'01' Mildred A, Hopplo . . . .. . . . .. .. . . . . . . . . . .. " . .. . 717-697-24104 t1865.00 S38M.OO ~8SO.00 SO W80.00 $135.00 S "0 .IlO $67~.l)O $120.0Cl $72, 00 $544.48 $304.60 $200.00 575.00 $206.70 $$0,00 $123,00 wn. 78 $.048.2.78 $-IOHII.OO $3ln.78 p. 1 Please RECEIPT FOR PAYMENT =================== GLENDA FARNER 8TRASBAUGH Cumberland COU~lty - Register Of Wills One Courthouse Square Carlisle, PA 17013 HOPPLE MI:"DRED A Estate File No. : Paid By Remark:3: 2006-00644 ANDREW C SHEELY ESQ JA Receipt Date: Receipt Time: Receipt No.: 7 i.~ ~{~~g~ ] )45077 ------------------------ Receipt Distribution ----------------- -_____ Fee/Tax Description PETITION LTRS TEST WILL AUTOMATION FEE SHORT CERTIFICATE JCP FEE Check# 2873 Total Received.. ....... Payment Amount 260.00 15.00 5.00 20.00 10.00 -------------..-- $310.00 $310.00 Payee Name CUMBERLAND COUNTY GENE] ~L FUN CUMBERLAND COUNTY GENE] \L FUN CUMBERLAND COUNTY GENE} ~ FUN CUMBERLAND COUNTY GENE] \.L FUN BUREAU OF RECEIPTS & Cl ~ M.D REV-1Sl2 EX '(1.97) ESTATE OF '* SCHEDULEJ DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYI vANIA INHERITANCE TAX RETUPN RESIDENT DECEDENT_ MILDRED A. HOPPLE FILE NUMBER 21-06-01 4:4 Include unrelmbursed medical expenses. ITEM NUMBER 1. DESCRIPTION AMOUNT Outstanding check to Continuing Care RX for prescription medication, paid August 15, 2006 Outstanding check to Terry L. Hopple, deposited and cleared on July 14, 2006 Outstanding check to Peggy Hopple, deposited and cleared on July 14, 2006 Outstanding check to Continuing Care RX for prescription medication, deposited/cleared July 18, 2006 297.01 3,500.00 3, >00.00 l48.19 TOTAL (Also enter on line 10, Recapitulation) $ 7, 745.20 (If more space ;s needed, insert additional sheets of the same size) '\ \--\ \ . """"'-.I""""" ~ .....",., ,.......... ,..... III 000000000..... ('t mOOt1lCD:XJt1IU1(,J....." .. H ,.....,...........,................. , ...." '"h 0000000000 " 0- 0- 0- 0'- l)'- 0-- 0-- 0-- 0- 0-- ..... .c. ,,",0 ......c: m ;0 ;0 ;0 ;0 ;0 ::tl ::tl :::0 ::tl tI 1J 1::2 (1)..0003 .:t >C:XXXXXXXXO"':l III t1I:T :t ;r.J-4 Cl. #########(')ID III 0'111 HCO..... .... #< n ,,< ::UO::O~ ::I (J (J (J (.J W t..l (,J (,J \iJ t1I .... "':I lID mc:r::u 10 mmoomroQ.'JlDOOOO\iJo I .... 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I'D OJ c: I I -I W .c ro I , "0 IJI Ul I ,.... -bo1lJ I " t-' * /J1 I ,... flJ 000 1c1" iii .... \'\1'_1 ....O......f'lJO......OOW Ie OJ * Ul -0 '1J I'D :Jill + III n rr ..... ~~ Qr J. 1\10.... 0--...... ~ ~~ ~. ~ II t:1 ;'" :-0 !1' :-0 ~ lJ1 ~ ~ !J1 ~ PJ 3 .... ~ c 0 ~ I'll "'-JU1..Jlo..Jlo(..).f:rl/10o--......... c: IUtJUlO'"""UJtflOO...o-C :J .I c1" t- OO On on !~\J 00 00 00 '1J'U "'0 ~;J "'0"'0 l>:> J> J" J>J> '< -< -< -:- -<-< rtF ~ Q ~ ~ }. ~ REV-1513 EX.,. ~O) . ICHIDUU J BENEFICIARIES COMMO~THOFPE~N~~~ INHERITANCE.TAX RETURN RESIDENT DECEDENT ESTATE OF NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I TAXABLE DISTRIBUTIONS pnelude outrlght spousal dlsbibullona, and transfers under Sec. 9116 (I) (1.2)J SHIRLEY L. KIMMEL 9 South West Avenue Shlremanstown, P A 17011 TERRY LEE HOPPLE 860 Boll1nl Spring Road Mechanlcsburg, P A 17055 RELATIONSHIP TO DECEDENT Do Not LIlt TruatM(.) Daughter Son FILE NUMBER 50% rst,resldue & rem llnder of Estate 50 % r st,resldue & rem llnder of Estate ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, /IS APPROPRIATE, ON REV.1500 COVER SHI :T n NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL Of PART 11- ENTER TOTAl NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV.1500 COVER SHEET $ ~f more apace Is needed, Insert I.lddlUonal ah8Ills of the S8me size) ... ~ LAST WILL AND TESTAMENT I, MILDRED A. HOPPLE, of the Borough of Mechanicsburg, County of Cumberland and State of Pennsylvania, being of sound mind, memory and understanding, do make, publish and declare this to be my last Will and Testament, hereby revoking and making void all former wills, codicils and other testamentary dispositions by meat any time heretofore made. 1. I direct my executor, hereinafter named, to pay as soon as practicable after my decea~e all my just debts and the expenses of my last illness and burial. 2. I give, devise and bequeath all my estate, _ real, personal and mixed -, unto my husband, Clare B. Hopple, ab- solutely. 3. Should my said husband predecease me, then and in that event, I give, devise and bequeath all of my said estate unto my Children, Shirley H. Kimmel and Terry Lee Hopple, equally, share and share alike. 4. I hereby nominate, constitute and appoint my said husband, Clare B. Hopple, executor of this my last Will. Should my husband, Clare B. Hopple, fail to qualify or cease to act as executor I appoint my children, Shirley H. Kimmel and Terry Lee aopple, and the survivor of them, executors of .. .. to this my last Will and Testament. 5. I direct that my personal representatives shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I, MILDRED A. HOPPLE, the Testatrix, have hereunto set my hand and seal to this my last Will and Testament this 1 day of ~ 4 ' 1968. ~-".L. l.L- c. ~ (SEAL) Signed, sealed, published and declared by the above named Mildred A. Hopple as and for her last Will and Testament in the presence of us, who, at her request and in her presence and in the presence of each other have hereunto subscribed our names as witnesses thereto. ~ L~ /P ~P'/ ~~"u. ./. .L~,. . - 2 -