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DECEDENT'S ESTATE
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
ESTATE OF
MAGDA FOGEE.,
,DECEASED
No.2005-0488
".'-.'-.)
PETITION FOR ADJUDICATION /
STATEMENT OF PROPOSED DISTRIBUTION
PURSUANT TO Pa. O.C. Rule 6.9
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This form may be used in all cases involving the Audit of the Account of a Decedent's Estate. If
space is insufficient, riders may be attached. Attach the spouse's election, if any; the papers
required under items 8-19 inclusive,. and any instrument pertinent to the adjudication.
INCLUDE ATTACHMENTS AT THE BACK OF THIS FORM.
Name of Counsel: ANTHONY T. MCBETH
,.' ,
Supreme Court LD. No.: 53729
Name of Law Firm: LAW OFFICE OF ANTHONY T. MCBETH
Address: 407 NORTH FRONT STREET, FIRST FLOOR, HARRISBURG, FA 17101
Telephone: (71 7) 238-3686
Fax: (717) 238-3575
Form DC-OJ rev. 10.13.06
Page 1 of 10
Estate of
MAGDA FOGLE
, Deceased
1. Name(s) and address(es) ofPetitioner(s):
Name: MARK A _ FOGLE
77 YELLOW WOOD DRIVE
TERRY FOGLE
Address:
EDWARD FOGLE
DOWNINGTOWN, PA 19335
Identify any executors or administrators who have not joined in the Petition for
Adjudication and Statement of Proposed Distribution and state reason:
Is this the first accounting by this fiduciary? . . . . . . . . . . . . . . . . . . . . . ~ Yes D No
If not, identify prior accountings, the accounting periods covered, and the date of
adjudication of the prior accounting.
2. Decedent died on MAY 8, 2005
[J Letters Testamentary or [!JLetters of Administration \kte-g\-anted to Petitioner(s) on
Date of Will (if applicable):
Date(s) ofCodicil(s) (if applicable):
Date of probate (if differentfrom date Letters granted):
Was a bond required? DYes I!I No If yes, state amount:
Are proofs of advertising of the grant of Letters attached? ......... D Yes III No
Dates of advertising of the grant of Letters: EST A TE NOT ADVERTISED, BUT
ALL KNOWN CREDITORS HAVE BEEN PAID
i
Form OC-OJ rev. 10.13.06
Page 2 of 10
Estate of
MAGDA FOGLE
, Deceased
3 . Was decedent survived by a spouse? . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 0 Yes []I No
If yes, name of the surviving spouse:
4. Has the surviving spouse filed to take an elective share? ............. 0 Yes 0 No
(See Section 2201 et seq. of the Probate, Estates and Fiduciaries Code)
If yes, date of election:
5. In the case of an intestacy, state the names of the decedent's surviving children or
surviving issue of deceased children (ifnone, so state): MARK A. FOGLE,
EDWARD FOGLE, TERRY FOGLE AND MICHELLE FOGLE
6. Did decedent marry after execution of Will or Codicil( s)? . . . . . . . . . .. 0 Yes [] No
Were any children born to decedent after execution of
Will or Codicil(s)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 Yes 0 No
If yes, give names and dates of birth:
Name:
Date of Birth:
7. If required by the Medical Assistance Estate Recovery Act,
62 P.S. ~ 1412, was a request for a statement of claim sent to
the Department of Public Welfare? . . . . . . ~ / A . . . . . . . . . . . . . . . . . . .. 0 Yes 0 No
Form DC-OJ rev. JO.13.06
Page 3 of 10
Estate of
MAGDA FOGLE
, Deceased
8. Written notice of the Audit as required by Pa. O.C. Rules 6.3, 6.7 and 6.8 has been or will be
given to all parties in interest listed in item 9 below, all unpaid creditors and all claimants
listed in item 10 below. In addition, notice of any questions requiring Adjudication as
discussed in item 14 below has been or will be given to all persons affected thereby.
A. If Notice has been given, attach a copy of the Notice as well as a list of the names
and addresses of the parties receiving such Notice.
B. If Notice is yet to be given, a copy of the Notice as well as a list of the names and
addresses of the parties receiving such Notice shall be submitted at the Audit
together with a statement executed by a Petitioner or counsel certifying that such
notice has been given.
C. If any person entitled to Notice is not sui juris (e.g., minors or incapacitated
persons), Notice of the Audit has been or will be given to the appropriate
representative on such party's behalf as required by Pa. o.c. Rule 5.2.
D. If any charitable interest is involved, Notice of the Audit has been or will also be
given to the Attorney General as required under Pa. O.C. Rule 5.5. In addition, the
Attorney General's clearance certificate (or proof of service of Notice and a copy
of such Notice) must be submitted herewith or at the Audit.
9. List all parties (charitable and non-charitable) of whom Petitioner(s) haslhave notice or
knowledge, having or claiming any interest in the estate as beneficiaries under the Will or
Codicil(s) or as intestate heirs if there is a complete or partial intestacy:
A. State each party's relationship to the decedent and the nature of each party's
interest( s):
Name and Address of Each Partv in Interest Relationshio and Comments, if any
Interest
MICHELLE FOGLE ADOPTED DAUGHTER
OF DECEDENT
HEIR
NOTICED PROVIDED TO MI ~HELLE FOGLE'S CO NSEL BY
CONTEMPORANEOUS MAILIN(~ OF PETITION AND ACCOUNT ON OR
ABOUT MARCH 22, 2007
Form OC-OJ rev. 10.13.06
Page 4 of 10
Estate of MAGDA FOGLE
, Deceased
Name and Address of Each Party in Interest
Relationship and Comments, if any
Interest
B. Identify each party who is not sui juris (e.g., minors or incapacitated persons).
F or each such party, give date of birth, the name of each Guardian and how each
Guardian was appointed. If no Guardian has been appointed, identify the next of
kin of such party, giving the name, address and relationship of each.
c. State why a Petition for Guardian/Trustee Ad Litem has or has not been filed for
this Audit ($ee Pa. D.C. Rule 12.4).
D. If distribution is to be made to the personal representative of a deceased party,
state date of death, date and place of grant of Letters and type of Letters granted.
Form OC-OJ rev. 10.13.06
Page 5 of 10
Estate of MAGDA FOGLE
, Deceased
10. Other than the claim for the family exemption, list the names of all known claimants and
the amount of their claims and state whether each claim is admitted.
Name and Address of Each Claimant Amount of Claim Claim Will Claim
Admitted? Be Paid In
Full?
SEE ATTACHED DYes DYes
DNo DNo
ALL KNOWN CREDITORS PAID DYes DYes
IN FULL DNo DNo
DYes DYes
DNo ONo
DYes DYes
DNo DNo
If the estate is insolvent, attach a schedule setting forth the order of preference under
20 Pa.C.S. ~ 3392 and the proposed payments.
11.
Was family exemption claimed?
DYes I!] No
DYes DNo
Was family exemption allowed?
Family exemption claimant's name and relationship:
Name:
Relationship:
Form OC-OJ rev. 10.13.06
Page 6 of 10
Estate of
MAGDA FOGLE
, Deceased
12. The amount of Pennsylvania Transfer Inheritance Tax and additional Pennsylvania Estate
Tax paid, the date(s) ofpayment(s), and the interest(s) upon which paid, are as follows:
5-1-06
Payment
$8111.54
Interest
Date
12-20-06
$85.00
SEE ATTACHED
13. On the date of death, was the decedent a fiduciary
(personal representative, trustee, guardian, agent under power
of attorney) or surety on the bond ofa fiduciary? .... . . . . . . . . . .. . ... DYes DNo
If yes, provide the name of the estate, indicate whether an account has been filed and
confirmed absolutely and all awards performed, or, in the alternative, how the
decedent's estate will be discharged for the decedent's fiduciary administration of the
estate.
14. A. Describe in detail any questions requiring adjudication and state the position of the
Petitioner(s) as to each question: WHETHER MICHELLE FOGLE IS ~.
ENTITLED TO ANY ADDITIONAL DISTRIBUTION. PETITIONERS~
BELIEVE SHE IS NOT.
B. Has notice of the question requiring adjudication been given
to the parties identified in Paragraph 9 above? .................. I!I Yes 0 No
15. If Petitioner( s) has/have knowledge that a share has been assigned, renounced, disclaimed
or attached, provide a copy of the assignment, renunciation, disclaimer or attachment,
together with any relevant supporting documentation.
Form OC-01 rev. 10.13.06
Page 7 of 10
Estate of
MAGDA FOGLE
, Deceased
16. Had the decedent been adjudicated an incapacitated person? . . . . . . . . . . 0 Ves I!J No
If yes, attach a copy of the Order if available; otherwise state the Court, term, number,
date,. and name of Hearing Judge.
17. A. List or attach a separate list of additional receipts and disbursements since the closing
date of the Account.
NONE
B. Has notice of the additional receipts and disbursements been
given to the parties identified in Paragraph 9 above? ............. 0 Ves 0 No
18. If a reserve is requested, state amount and purpose.
Amount:
Purpose:
If a reserve is requested for counsel fees, has notice of the
amount of fees to be paid from the reserve been given to the
parties in interest? ........................................ DVes DNo
If so, attach a copy of the notice.
19.
Is the Court being asked to direct
the filing of a Schedule of Distribution?
DVes []JNo
As to real estate only? ....................................... . DYes IX] No
Form DC-OJ rev. 10.13.06
Page 8 of 10
Estate of
MAGDA FOGLE
, Deceased
Wherefore, your Petitioner(s) ask(s) that distribution be awarded to the parties entitled
and suggest(s) that the distributive shares of income and principal (residuary shares being stated
in proportions, not amounts) are as follows:
A. Income: NO FURTHER DISTRIBUTIONS
Proposed Distributee(s) Amount/Proportion
B. Principal:
Proposed Distributee(s)
Amount/Proportion
Submitted By:
(All petitioners must sign.
Add additional lines if necessary):
Name of Petitioner:
Form DC-OJ rev. 10.13.06
Page 9 of 10
Estate of
MAGDA FOGLE
, Deceased
Verification of Petitioner
(Verification must be by at least one petitioner.)
The undersigned hereby verifies * [that he/she
is title
of the above-named name of corporation
and] that the facts set
forth in the foregoing Petition for Adjudication / Statement of Proposed Distribution which are
within the personal knowledge of the Petitioner are true, and as to facts based on the information
of others, the Petitioner, after diligent inquiry, believes them to be true; and that any false
statements herein are made subject to the penalties of 18 Pa. C.S. 94904 (relating to unsworn
falsification to authorities).
,
* Corporate petitioners must complete bracketed information.
Certification of Counsel
The undersigned counsel hereby certifies that the foregoing Petition for Adjudication!
Statement of Proposed Distribution is a true and accurate reproduction of the form Petition
authorized by the Supreme Court, and that no changes to the form have been made beyond the
responses herein.
Form OC-OJ rev. JO.13.06
Page 10 of 10
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
FIRST AND FINAL ACCOUNT OF THE ESTATE OF MAGDA FOGLE, DECEASED
No. 21-05-0488
Date of Death:
May 8, 2005
May 31,2005
Date of Administrators' Appointment:
Accounting for the Period:
May 31,2005 through January 5,2007
ASSETS OF THE ESTATE
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Sovereign Bank Accounts as follows:
1. Account No. 1684011222
2. Account No. 1681730847
3. Account No. 0574112637
Total Bank Accounts:
$13,700.000
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$14,826.04=~q~J
$ 229.59* I-f) >-:
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$ 4.197.99* -:=.i :;'/1
$19,253.62 ~
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Cash in Lock Box at Decedent's home
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1978 Chrysler Cordoba Automobile
$ 100.00
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1989 Lincoln Continental Automobile $ 1,400.00
Household Furniture:
Consisting of Dining Room Suite, Dinette Set,
Sofa, Loveseat, End Tables, Coffee Table and
Piano $ 4,500.00
Real Estate:
808 Cascade Road, Mechanicsburg, Pennsylvania
Sale on September 15,2005 $171.900.00*
Grand Total $210.853.62
* Summary of sale follows. A copy of Settlement Sheet attached. A copy of official checks
from Sovereign Bank, representing liquidation of bank accounts, also attached.
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
FIRST AND FINAL ACCOUNT OF THE ESTATE OF MAGDA FOGLE, DECEASED
No. 21-05-0488
Date of Death:
May 8, 2005
May 31,2005
May 31, 2005 through January 5, 2007
Date of Administrators' Appointment:
Accounting for the Period:
SUMMARY OF RECEIPTS TO ESTATE BANK ACCOUNT.
PNC BANK ACCOUNT NUMBER 50-0350-1006
CREDITS:
Opening Deposit on May 31, 2005
Reversal of Service Charge by PNC Bank on August 24, 2005
Deposit of Net Proceeds from Sale of Decedent's home
September 15,2005
$ 11,457.02*
$ 10.00
TOTAL CREDITS
$147.084.15
$158.551.17
* Opening Deposit is composed of the sum of the Decedent's Sovereign Bank Accounts
as shown previously, less payment of $7,796.60 to Malpezzi Funeral Home. Copies of
Sovereign Bank receipts showing account balances and the two official Sovereign Bank
checks comprising this transaction are attached. Copy of funeral bill is also attached.
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
FIRST AND FINAL ACCOUNT OF THE ESTATE OF MAGDA FOGLE, DECEASED
No. 21-05-0488
May 8, 2005
May 31,2005
Date of Death:
Date of Administrators' Appointment:
Accounting for the Period:
May 31,2005 through January 5,2007
SUMMARY OF SALE OF DECEDENT'S HOME. 808 CASCADE ROAD.
MECHANICSBURG. PENNSYLVANIA
Buyers:
Jon J. and Paula L. Brenneman
TOTAL CREDITS:
Sales Price
Reimbursement for County Taxes
Reimbursement for School Taxes
Reimbursement for Sewer, Third Quarter, 2005
TOTAL CREDITS
TOTAL DEBITS:
Realtor's Commission to Century 21-Piscioneri
and the Homestead Group, Inc.
Notary Fees
Escrow for Inheritance Taxes
Sewer billing to Upper Allen Township Authority
2005 School Taxes to Marlin A. Yohn, Sr., Treasurer
Realty Transfer Tax
Service Fee to Century 21-Piscioneri
Deed Preparation to Craig A. Diehl
Seller Assistance as per sales contract
TOTAL DEBITS
NET PROCEEDS
$171,900.00
$ 112.66
$ 1,549.08
$ 17.39
$173,579.13
$10,31~.OO
$ 5.00
$ 7,000.00*
$ 205.53
$ 1,956.45
$ 1,719.00
$ 195.00
$ 100.00
$ 5.000.00
$26,494.98
~147.084.15
* See separate page on Report of Inheritance Tax, attached hereto
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
FIRST AND FINAL ACCOUNT OF THE ESTATE OF MAGDA FOGLE, DECEASED
No. 21-05-0488
Date of Death:
May 8, 2005
May 31,2005
Date of Administrators' Appointment:
Accounting for the Period:
May 31,2005 through January 5,2007
SUMMARY OF TOTAL DISBURSEMENTS FROM ESTATE ACCOUNT.
PNC BANK ACCOUNT NUMBER 50..0350-1006
DISBURSEMENTS:
Filing Fees:
5/31/05
Check No. 002
Funeral Flowers:
5/31/05
Check No. 001
Mark A. Fogle
(Mr. Fogle had paid personal check
to open estate at courthouse)
Lisa Strawsbaugh
Home Maintenance, Home Owner's Insurance, Repairs and Labor in
Preparing for Sale of Decedent's Home:
5/31/05
7/01/05
Check No. 999
Check No. 012
7/08/05
7/08/05
7/08/05
7/23/05
9/08/05
9/15/05
9/15/05
9/15/05
9/22/05
9/22/05
Check No. 014
No Check No.
Check No. 021
Check No. 022
Check No. 023
Check No. 024
Check No. 025
Check No. 026
Check No. 027
Check No. 028
Check No. 029
Check No. 033
9/24/05
H.B. McClure
Mark A. Fogle
(Mr. Fogle had previously paid home
owner's insurance premium with personal check)
PP&L $
United Water PA $
~~F~~ $
Lawns Unlimited Inc. $
Terry W. Fogle $
David Fogle $
~~F~~ $
Edward Fogle $
H.B. McClure $
PP&L $
United Water PA $
Mark Fogle $
$ 314.00
$ 275.00
$ 149.00
$ 225.00
49.34
15.41
215.00
143.12
88.00
173.09
257.60
122.00
37.81
154.88
31.46
215.00
10/03/05
10/22/05
10/22/05
10/22/05
11/03/05
11/03/05
Check No. 032
Check No. 036
Check No. 037
Check No. 038
Money Order.
Money Order.
Decedent's Debts:
5/31/05
5/31/05
5/31/05
7/06/05
7/08/05
7/08/25
9/24/05
Bank Charges:
7/28/05
Check No. 007
Check No. 009
Check No. 010
Check No. 016
Check No. 019
Check No. 020
Check No. 033
No Check No.
Terry Fogle
(For work done by John and David Fogle)
Edward Fogle
Mark Fogle
Mark Fogle
Terry Fogle
Terry Fogle
TOTAL
PP&L
United Water PA
Verizon
Sears Card
Bank of America
MBNA Amercia Bank, N.A.
Mark Fogle
(To reimburse Mr. Fogle for payoff of
Decedent's MBNA Credit Card)
TOTAL
PNC Bank Service Charge
Dinner Including All Heirs for Discussion of Estate Administration:
5/31/05
7/08/05
Check No. 002
Check No. 017
ADMINISTRATOR FEES:
10/22/05
10/22/05
10/22/05
Check No. 036
Check No. 037
Check No. 040
Mark A. Fogle
Mark Fogle
(Receipt can be provided; all heirs,including
Michelle Fogle participated)
TOTAL
Edward Fogle
Mark Fogle
Terry Fogle
TOTAL
REIMBURSEMENT FROM INHERITANCE TAX
FROM PERSONAL FUNDS:
12/16/05
Check No. 043
Mark A. Fogle
(See recapitulation of Inheritance
Tax attached hereto)
$2,000.00
$7,039.00
$6,050.89
$6,000.00
$7,789.00
$1.925.00
$32,680.60
$ 28.89
$ 15.41
$ 29.12
$ 39.00
$ 51.61
$ 77.00
$2.185.00
$2,426.03
$ 10.00
$ 222.00
$ 72.00
$294.00
$3,000.00
$3,000.00
$3.000.00
$9,000.00
$1,111.54
DISTRIBUTIONS TO MICHELLE FOGLE:
5/31/05
5/31/05
10/15/05
10/31/05
Check No. 003
Check No. 011
Check No. 031
Check No. 035
Michelle Fogle
Michelle Fogle
Michelle Fogle
Michelle Fogle
TOTAL
$ 2,010.00
$ 700.00
$ 3,000.00
$ 5.000.00
$10,710.00
DISTRIBUTIONS TO TERRY FOGLE:
5/31/05
10/22/05
11/27/05
11/03/05
11/03/05
Check No. 005
Check No. 040
Check No. 041
PNC Money Order
PNC Money Order
Terry Fogle
Terry Fogle
Terry Fogle
Terry Fogle
Terry Fogle
TOTAL
$ 2,160.00
$17,000.00
$ 2,675.00
$ 5,075.00
$ 7.000.00
$33,910.00
DISTRIBUTIONS TO MARK FOGLE:
5/31/05
10/22/05
10/22/05
11/28/05
12/16/05
Check No. 006
Check No. 037
Check No. 038
Check No. 042
Check No. 043
Mark A. Fogle
Mark Fogle
Mark Fogle
Mark Fogle
Mark Fogle
TOTAL
$ 2,310.00
$12,738.11
$14,000.00
$ 2,675.00
$ 2.186.89
$33,910.00
DISTRIBUTIONS TO EDWARD FOGLE:
5/31/05
9/15/05
10/15/05
10/22/05
Check 001
Check 026
Check 035
Check 036
Lisa Stawsbuagh
Edward Fogle
Edward Lee Fogle
Edward Fogle
TOTAL
$ 2,160.00
$ 5,000.00
$15,000.00
$11.750.00
$33,910.00
$158.551.17
TOTAL DISBURSEMENTS
* The transactions of November 3, 2005 were money orders issued from PNC Bank on the
Estate account to Terry W. Fogle, per Mr. Fogle's request and per the Administrators'
agreement. Extensive work was required, both inside and outside, to prepare the
Decedent's home for sale. The Co-Administrators opted to do the work themselves (or,
in one instance, have their sons help) rather than engage professional. Extensive
testimony regarding this circumstance is available from the Co-Administrators and from the
realtor handling the sale, at the appropriate time.
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
FIRST AND FINAL ACCOUNT OF THE ESTATE OF MAGDA FOGLE, DECEASED
No. 21-05-0488
Date of Death:
May 8, 2005
May 31,2005
Date of Administrators' Appointment:
Accounting for the Period:
May 31,2005 through January 5,2007
RECAPITULATION OF INHERITANCE TAX
Copy of Inheritance Tax Return attached.
Date of Filing of Return and Payment:
May 1, 2006
$8,111.54.*
Amount of Tax:
* Payment of the tax made as follows: release of $7,000.00 of escrow by Community Land
Transfer, settlement agent for sale of Decedent's home. $1,111.54 from personal funds
of Co-Administrators. $127.71 in interest and penalty due. $85.00 of that amount has been
paid from Administrators' personal funds. The balance of $42.71 will be paid prior to
Confirmation Date. A copy of Pennsylvania Department of Revenue Tax Clearance
Certificate attached hereto.
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
FIRST AND FINAL ACCOUNT OF THE ESTATE OF MAGDA FOGLE, DECEASED
No. 21-05-0488
Date of Administrators' Appointment:
May 8, 2005
May 31,2005
Date of Death:
Accounting for the Period:
May 31, 2005 through January 5, 2007
PROPOSED ADDITIONAL DISTRIBUTIONS
There are no proposed additional distributions. Distributions to Heirs have been
made as follows:
MICHELLE FOGLE
$33,910.00
$33,910.00
$33,910.00
$33,910.00*
MARK A. FOGLE
TERRY FOGLE
EDWARD FOGLE
*Michelle Fogle's distribution composed of: $10,710.00 from estate account, $13,700.00
in cash from lockbox in Decedent's home, as reported on Inheritance Tax Return, 1989
Lincoln Continental Automobile of $1,400.00, household furniture (as reported on total
assets page) at $4,500.00 and forgiveness of rent at $900.00 per month. Michelle Fogle
lived in Decedent's home, without paying rent, for the months of May, June, July, August
and part of September, 2005.
5/2007 09:33 FAX 6106696490
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Malpezzi Funeral Home
8 Market Plaza Way
Mechanicsburg, P A 17055
(717)697 -4696
May 31,2005
Edward L. Fogle
76 Tonden Drive
York, PA 17402
The Funeral Service for Magdalene Fogle
We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way we can. Please
feel free to contact us if you have any questions in regard to this statement.
THE FOLLOWING IS AN ITEMIZED STATEMENT OF THE SERVICES, FACILITIES, AUTOMOTIVE EQUIPMENT,
AND MERCHANDISE THAT YOU SELECTED WHEN MAKING THE FUNERAL ARRANGEMENTS.
1. PROFESSIONAL SERVICES
Services of Funeral Director/Staff . . . . . .
FUNERAL HOME SERVICE CHARGES
SELECTED MERCHANDISE:
Solid Cherry Casket. .
Sentinel. . . . . . . . .
Register, Folders, Ackn.. . . .
THE COST OF OUR SERVICES. EQUIPMENT. AND MERCHANDISE
THAT YOU HAVE SELECTED . . . . . . . . . . . . . $7553.00
AT THE TIME FUNERAL ARRANGEMENTS WERE MADE, WE ADV ANCED CERTAIN PAYMENTS TO
OTHERS AS AN ACCOMMODATION. THE FOLLOWING IS AN ACCOUNTING FOR THOSE CHARGES.
CASH ADVANCES
$3545.00
$3545.00
$2900.00
$1050.00
$58.00
remetery Equipment. . . .
Certified Death Certificates
Newspaper Notices - Patriot.
Newspaper Notices - Out of Town .
TOT AL CASH ADVANCES AND SPECIAL CHARGES.
CONTRACT PRICE . . . . . . . . . . . .
HISTORY
05/31/2005 Cumbo Co. VA
05/31/2005 Payment - Sovereign Bank
TOTAL AMOUNT DUE .
$! 10.00
$36.00
$100.00
$97.60
$343.60
$7896.60
$-100.00
$-7796.60
$0.00
01/05/2007 09:33 FAX 6106696490
PBX OPS
I4I 006
.::"~~~S I iVereign Bank
I".
(XISTOMER RECEIPT
I
Milestone Banking I
Grow. Achieve. Thri';'e.
Ask fnJ' lEIais, call 1-877-SQV-BANK (l~877-76B-22Q5), orvlsitSO't'llflli&nbmlDJl.
S~ Wth Date 05/31/05 14:17 'rl~ 005
AIM 1684011221 S~~ . ~6~
A''\t $'/ A ,':t?A 1 A ' - i .~.~....,
. .~ ., WoW _-. ...t. -f
ledg~r Ba\ S 14,826.14
E~B
BA0003 (Rll'I, !W4)
. I
!
lVm1Ier roc
Milestone Bcmking I
GJoow. Achieve. Thrive.
~. debiIs, call l..an-sov-fWfK (l-877:'768--~, or visit SOVIlRliIJIbank.oom.
J
~I
'. S ~ereign ~ank
~ER RECElPT -
_ i
DV }J'th Dat.:= 05/31/05 14;;; }.5 T1 j;' 005
A/N 1681730847 5~q 01~2
168
f~M t
':~<229 II 59
L~dg~::n-' B~l
$229..59
BAOOOU (Rlw. PI04)
MerrDer FDIC
MiILestoDe Bcmking'
Grow.,Achieve. TIu-i~e.
Ask for d8Ial1s, caI1-877-SOV-BANK0-877-768-22f{s), orvlslt~
Its :iVereignBank
~ :It ",
Cl.6I01t& IEEIPf
",.., u,. '. r:-t.. v" c ,''7'' ;o~ i ',.\ . ~ 'I -r1! uflS
J..t; ~:..~~..... '~~~__~I"\",t.! ....' .l~."ttt.,1.~. ~." :~~:'\.l
i~/N ~:~i/ :~l.L:::~"::J':- ::~::: 111-;.:.
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": ~.J
~~t ~4~197~S9
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$)t~ 1.97 ,,~:"7
BR0008 (Rev. Q'04)
Merrber FDIC
. 2502-0265 "'Ir
A. ,- B. TYPE OF LOAN:
... 1.DFHA 2.DFmHA 3. OOCONV. UNINS. 4. OVA I 5. DCONv. INS.
U.S. DEPARTMENT OF HOUSING & URBAN DEVELClPMENT
6. FILE NUMBER: I I 7. LOAN NUMBER: 1
SETTLEMENT STATEMENT 05-724 0202262606
a. MORTGAGE INS CASE NUMBER: Ok,Pc MORTGAGE INS CASE NUMBER:
5.875/F1813.37 M 0
C. NOTE: Thi$ form is furnIshed to give you a statemcmt of actual settlement costs. Amounts paid to and by the settlement agent ere shpwn.
Items marked "[Pocr were paid outside thfJ closing; they B/'8 shown here fer, Informalional purpOS8JfJ and are not included i~: totals.
I 1.0 31Q8 lBRENNEMAN..JON.PFO 72~I2"'1
D. NAME AND ADDRESS OF BORROWER: I::. NAME AND ADDRESS OF SE1-LER: F. NAME AND ADDRESS OF LENDER:
JON J. BRENNEMAN and ESTATE OF MADGA FOGLE I SUNTRUST MORTGAGE IN~.
PAUI-AL.BRENNEMAN 901 SEMMES AVENUE
508 Cascade Road RICHMOND. VA 23224 .
Mechanlcsburg, PA 17055 i
G. PROPERTY LOCATION: "I. SETTLEMENT AGENT: r3-16499,55 I. 'ETTLEMENT ;:JA TE:
508 Cascade Road Community Land Transfer
'v1echanicsburg, PA 17055 September 15. 2005
::umberland County, Pennsylvania PLACE OF SETTLEMENT
__~.:r-''''::' --- . - - -.., 2~1 Market Street
_ -_ '-:::'_~~.CI'___ - - ~-- .c:amptiill, PA 17011 . -~- -', . T----.'~ .. .--.
-r...~ . .. .---
J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION
DO. GROSS AMOUNT DUE FROM BORROWER: 400. GROSS AMOUNT DUE TO SELLER:
01. Contract Sales Price 171 900.00 401. Contract Sales Price 171 900.00
02. Personal Property 402. Personal Property
J3. Settlement Charges to Borrower (Une 140Q) 5.374.61 403.
)4. 404. I
)5. 405.
Adjustments For Items Paid By Seller in advance AdJustments For Items Paid Sv Seller In adll8nce
)6. CltylTown Taxes to 406. Cltv/Town Taxes to
)7. County Taxes 09/15105 to 01/01/06 . 112.66 407. County Taxes 09/15/05 to 01/01/06 112.66
)8. School Taxes 09/15/05 to 07/01/06 1.549.08 408. Sohool Taxes 09/15105 to 07/01/06 1 549.08
)9. Sewer 3rd. Otr. 09/15/05 to 10/01/05 17.39 409. Sqwer3rd. Otr. 09/15/05 to 10/01105 17.39
10. 410. I I
11. 411.
12. 412.
20. GROSS AMOUNT DUE FROM BORROWER 178,953.74 420. GROSS AMOUNT DUE TO SELLER 173,579.13
)0. AMOUNTS PAID BY OR IN BEHALF OF BORROW'ER: 500. ReDUCnONS IN AMOUNT DUE TO SELLER:
)1. Deposit or earnest money 2 000.00 501. Excess DeDosit CSee Instructions)
)2. Principal Amount of New Loan(s) 137 500.00 502. Sdttlement Charaes to Seller (Line 140m 21494.98
}3. Existing loan(s) taken subject to 503. EJ4lsllna loahCs) taken subject to I
14. 504. Payoff of first Mortgaae
15. 505. Payoff of second Morfciaae - -
~ ~-- - ... 506.
17. 507. CDeDoslt dlsb. as Droceedsl
lB. 508.
'9. Seller Assistance 5 000.00 509. Seller Assistance I 5 000.00
Adjustments For Items Unpaid By Seller ! Adiustments For Items UnDaid Bv Seller
D. Cityrrown Taxes to 510. CItYfT'own Taxes to I
1. County Taxes to '511. Co~nty Taxes to
2. School Taxes to 512. School Taxes to
3. 513. I
4. 514. I
5. 515.
6. 516. .
7. 517.
B. 518.
9. 519.
O. TOTAL PAID BY/FOR BORROWER 144,500.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 26,494.98
O. CASH AT SETTLEMENT FROM/TO BORROWER: 600. CASH AT SETTLEMENT TOIFROM SELLER: i
1. Gross Amount Due From Borrower (Line 120) 178953.74 601. Gross Amount Due To Seller lLlne 420) 173579.13
2. Less Amount Paid BylFor Borrower (Line 220) ( 144 500.00) 602. Le$s Reductions Due SellerlWne 520) ( 26,494.98
3. CASH (X FROM) ( TO) BORROWER 34,453.74 603. CA,SH ( X TO) ( FROM) SELLER 147,084.15
he undersigned herebY/IIcknowledge receipt of 8 compl,~ted copy of pages 1&2 of this sta~ement &1 an attachments referred to herein. I
01/05/2007 09:32 FAX 6106696490
Borrower
?-.L.:. ~ f
PBX OPS
@001
OMBNO
~
y
01/05/2007 09:32 FAX 6106696490
PBX OPS
$
L. SETTLEMENT CHARGES
171,900.00 @ 6.0000 % I 10314.00
roo. TO:rA~ COl1MIS9fO'N Based on Price
DIVIsion of CommIssion (line 700) as FoJ/ows:
'01. $ 5,182.00 to C-21 PISCIONERI
'02. $ 5,132.00 to THE HOMESTEAD GROUP, INC.
'03. Commission Paid at Settlement
~. ~
100. ITEMS PAYABLE IN CONNECTION WITH LOAN
~01. loan Origination Fee % to
:02. Loan Discount % to
,03. Appraisal Fee to Teray Freeman Real Estate
.04. Credit Report to Kroll Real Estate Service
05. lender's Inspection Fea to
06. Mortgage Ins. ADP. Fee to
07. Assumption Fee to
08. Tax Service Fee to
09. Processing Fee 10
10. Doc. Coordin. Fee to
11. Up. Front Flood Cerl. to
12. LOL FlOOd Cart. to
, 3. Administrative Fee to
14. Mortgage Broker Fee to
15.
16.
17.
18.
19.
20.
aD. ITEMS REQUIRED BY LENDER TO BE PAID IN A[)VANCE
)1. Interest From 09/15105 to 10101/05 @ $ 22. 130000/day
)2. Mort!Jage Insurance Premium for months to
)3. Hazard Insurance PremIum for 1.0 years to Fir.st Commonwealth Insurance Agency
)4.
l5.
JOO. RESERVES DEPOSITED WITH LENDER
l01. Hazard Insurance 3.000
l02. Mortaaae Insurance
J03. CityITown Taxes
l04. County Taxes
l05. School Taxes
>06.
l07
l08. Aggreoate Adjustment
100. TITLE CHARGES
101. Settlement or Closlno Fee
102. Abstract or Title Search
103. TIUe Examination
I u4-. 11M Hlsurance .Binder
105. Electronic Document Prep.
106. Closing Service LeUer
107. Attorney's Fees
(mcludes above item numbers:
108. TiUe Insurance to COMMUNITY LAND TRANSFER
(Includes above Item numbers.11 02, 1103 & 11 (1.4
109. Lender's Coverage $ 137,500.00
. 10. Owner's Coverage $ 171,900.00
11. Endorsements 100, 300, 8.1 to Community Land Transfer
12. Notary Fee to Community Land TranSfer
13. Notary Fee to Community Land Transfer
14. Wire Fee to Community Land Transfer
15. Overnight Mail to Community Land Transfer
16. Escrowl1nheritance Taxes to Rea"er & Adler, PC
17. Sewer411-9130 to Uppalr Allen Township Authority
18. 2005 School Taxes to Marlin A. Yahn. Sr., Treasurer
~oo. GOVERNMENT RECORDING AND TRANSFER CtiARGES
:01. Recording Fees: Deed $ 40.50; Mortgage $ 64.50;
:02. CitvfCountv TaxlStamps: Deed 1.719.00' Mortaaoe
:03. State Tax/Stamps: Deed 1.719.00: Mortaaae
'04. Transaction Fee to The HomAAtA~rt GrauD. Inc.
:05. Service Fee to CentlJry 21 Piscioneri
-00. ADDITIONAL SETTLEMENT CHARGES
.01. Survey. .. . __. to
.02. Pesllnspection . . to
.03. Deed Prep. to Craig: Diehl ESQuire
.04. I _L
05. I I
.00. TOTAL SETTLEMENT CHARGES (Enter on Llnet. 103 Sectlon.J and 502, Section K /"./7 ~
y signing page 1 of this statement. lhe algn.tone. ecknowIedge receipt of. complalDd copy of page 2 of lhI1I two page .1II~ .Q:.-I __ ~ ~
h/VR'/~
CoMmunity Land Tninsfer
Settlement Ageht
Valutre. Real Estate Service
SUNTRUST MORTGAGE INC.
SUNTRUST MORTGAGE INC.
SUI\JTRUST MORTGAGE INC.
SUNTRUST MORTGAGE INC.
SUNTRUST MORTGAGE INC.
CE(\ITRAL PA MORTGAGE, LLC
8.000
4.000
months
mcmths
mc)nths
months
mcmths
mcmlhs
mClnths
mc.nths
$
S
$
$
$
$
s
$
36.16 per
DElr
per
31.11 oer
159.77 per
per
oer
oer
to
to
to
to
to CommunllV Land Transfer
to Communltv Land Transfer
to
;ertified to be a true copy.
I
i
300.00 POC
POC:350.ooCPAM
POC:80.0OCPAM
POC:1856.25 l
.- -r ,. .-
16 days
%)
Binder 1194
monlh
mdnlh
month
month
month
month
month
mdnth
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1,218.75
Releases $
I
I
PAID FROM
ElOAAowhrs
FUNDS A~
SE7TLEMENT
IaI 002
Page 2
PAID FROM
SELLER'5
FUNOS AT
SETTLEMENT
10,314.00
-25.00
12.41
78.00
I
5.50
1.50
420.00
- --.- -.
i
354.08
434.00
108.48
I
248.86
639.08
-315.07
I
I
50.00
35.00
I
I
1.218.75
I
150.00
10.00
I 5.00
10.00
15.00
7,000.00
205.53
1,956.45
1 Q5.00
1 719.00
1 719.00
'100.00
195.00
100.00
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I
5,3'M.61 21,494.98
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=.overeign Bank
, Ii" \.: Agent for Travelers Express
OFFICIAL CHECK
5381890
22-1676
960
Me.mo:
$*****.~****7 J 7":;6 - 60
05/.31/2005
8 ranch;; 168
TO THE
ORDER OF
Void If Amount Over
$********~-:"'>7 l' 796 _ 60
MAlPEllI FUNERAL
HOME
Drawer: Sovereign Bank
tNON NEGOTIABLE
i /. l C~ME~(CO~Y ,,)j
f-':+-'-"-1-'--:"7"~fu-ii~i?SiGt,(f~t.,i~'-'~1:.r" ~
ISSUED BY: TRAVELERS EXPRESS COMPANY, INC.
DRAWEE: ~~B~2~.~f~p~m.~~:OLlS. MN 55480
+
_Sovereign Bank
DETACH AND RETAIN FOR YOUR RECORDS
5381890
Memo:
05/31/2005 $**********7.796.60
Account Holder: ESTATE OF MAGDALENE FOGLE
Account Number:
Branch Number: 168
.-J
15056051047
REV.1500 EX (06-05)
PA Department of Revenue .
Bureau of Individual Taxes
PO BOX 280601
PA 17128-0601
County Code Year
File Number
INHERITANCE TAX RETURN
RESIDENT DECEDENT
2 t'~
'(: 0 C _ ,~-L)fqY-
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
Date of Birth
! b '1 4d
Decedent's Last Name
I <[ Z ")
D1 0- B- 'L~ ~
67Ze i9Z'Y
Suffix
Decedent's First Name
MI
ru f.. L[
ntJt,~f}-L( 0[
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
Spouse's First Name
MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
jjjjf(IJiii 1. Original Return
2 Supplemental Return
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
....._, 4a. Future Interest Compromise (date of
death after 12-12-82)
7. Decedent Maintained a Living Trust
(Attach Copy ot Trust)
10. Spousal Poverty Credit (date of death 11. Elechon to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. 0)
, ~.~,_.~ v.v._~,.......,u..~.._.,~." ~.'" _. ,_....., _ .,..,.. _'. ""~ '__,., 'J"~,,_.e-'~~, _._....e ,_...~,. _"",..,....._'.__." ""'._.'~-'-''''''''._'.'',""",.........._.".~.........__".....,.,.. _',.-~._.'~.~...' . -. ". '~.__.'W"",'_' ....-...,.... - ""'~"-.~'" "....-. ......~' ,- .,..-...... -...--~....<._, U'____ . .~..---.-......-~~,_._-.,~~.~
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
4. Limited Estate
6. Decedent Died Testate
(Attach Copy of Will)
8. Total Number of Safe Deposit Boxes
9. Litigation Proceeds Received
I"~ 1+ L IL
A
fr'J 6 CL
~~
l 5-:) ')
Cj "7
Firm Name (If Applicable)
First line of address
I')
~ (L C (j
ll.J
LJ 00 {J
Second line of address
City or Post Office
~ C\ LV (0 i (067 6 li\J (0
State
ZIP Code
11 j
... ....-/
)')
f 18
Correspondent's a-mail address
. ~_"'_'_"_"~~'_ ',_ .'_ "..~ ,,_..... ..._~..., ..,.... . .'" ~.. ...".~""_~'." ~'~'..._. .... >_~ '."._., ...." ...~ '_?_~"'_"'_" ........ ..~........._ ..~..,....~..""... ...._.. ," ...,. _' ......_.._w 'M'_..','J . ..r"'.D_'."W~"",'_,,,_,, ~.",~"_"........-...,,... "'~'.. .~ ,~,'>" ......-. '~'."'. ...-.. --...,,<. "..."......~'.,... ..... .. -,.,." "-' ._-..... ~...- - ".','- ."--~'.'.~'., . . . .
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
:,'i3~~iu7fi/;.P. -;~~~J~;,~O:E?i~~~:~~~fE~3~'~: ~~:.s~)l1~~ ::~:e:e.~~!!v~. ~.~~.~~~ ~~ ~J!'TO~~l~:~~r:..o!. ~::7rJe~:~; :~~ kJ10~~e_d~~. "
AO~~S~ ~-:tr~;. . . ..~:~:. j#kl;[l.t~((c.~~ ~'I..' I-,
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SIGNATURE OF PREPARER OTHER THA~ifEPRESENTATIVE Wi.-j.:.: ill I I ' DA~ ') , ,,--~
I 'P I\1Zl.
ADDRESS
~., ,". ~~..~...__,.."....__..~L"'~.,,~'~' .'_ ....~.. . ",~",-,~'__"'"'''''' .,...... .. .-...
PLEASE USE ORIGINAL FORM ONLY
Side 1
L
15056051047
15056051047
-.J
.-J
15056052048
REV-1500 EX
_E~~~.~,~!:~.a~_~:~p]!t:uJX3 .~.~J .tP..sl L..
RECAPITULATION ,,)
1. Real estate (Schedule A).
2. Stocks and Bonds (Schedule B) 2.
3. Closely Held Corporation. PartnershIp or Sole-Proprietorship (Schedule C) 3.
4. Mortgages & Notes Receivable (Schedule D) . 4.
5. Cash. Bank Deposits & Miscellaneous Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F) Separate Billing Requested
7. Inter-Viyos Transfers & Miscellaneous Non-Probate Property
(Schedule G) Separate Billing Requested.
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 Oeductions (total lines 9 & 10). .
12. Net Value of Estate (Line 8 minus line 11)
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 Lme 13,
TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate. or
transfers under Sec. 9116
(a}(1.2) X .0_
16. Amount of Line 14 t~x~e
at lineal rate X .04':)
17. Amount of Line 14 taxable
at sibling rate X. 12
18. Amount of Line 14 taxable
at collateral rate X .15
J 'i () z c)~ ..s- L
19. TAX DUE. .
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
L
15056052048
10.
12
13.
14.
15.
16.
17.
18.
19.
Decedent's Social Security Number
/.k.7 .~ .!rg". . L.~"?:,,i.L,
1.
j ') Z if () reD (.
5.
1~ ~T)e L L
6.
7.
r j s-.~.
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CJ r)eke
(_ '( I fc; I) l.
JJ fDL_.iL
I TO L ), · S-[
8.
9
1'1
Cl
1'6 C L T"-~~ ~l_
'f)
I e'~
~ f 1
.f~
15056052048
-I
'~. E\'- '1~:Cl2 EX. -'- :' 6-S.'2 \
~. ',', .-D,
11:": ~~
--..:- "
COf"lMc'r~VVE,"'LTH OF FEhlH,'iYL\i,.:li",Jif.,
!1,jHERITAJ)CE T.!.j F!ETUF!.I
RESIDEnT DECEOEHT
SCHEDULE A
REAL ESTATE
ESTATE OF
~1~0i1u'iVG h~ \
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 eller. neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts
Real property which is jointly-owned with right of survivorship Il'IJst be disclosed on Schedule F.
FILE NUMBER
() ~~ [tJ i_I fY
ITEM
NUMBER
1.
DESCRIPTION
)A~ >[ 1:> 15 ,O('p({
S~ 1-0 <>..V 9 frT )Z (I C <)
VALUE AT DATE
OF DEATH
/7 / 90 () ,~)
~7TL c.r--C,~
(N.f-Lur \
~ /9 II Cf Lf . 1 V
TOTAL (Also enter on line 1. Recapitulation) $ /)(, Cl (J-~- -D (:?
(If more space is needed, insert additional sheets of the same size)
.
~ E\(. 'l~':J.:S E :/, -+ i 6-~.:2 "
.
Q. :>',9-
(\
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
c;r~,r'..1M(:f,l\/JE6.L TH DF CEr'41'jSYL'./ilf-HL
iNHERIT."'d.IC.:E TA/. RErURi.l
RESiDENT DECEDENT
ESTATE OF
Include the pr c s of litigation and the date the proceeds were received by the estate.
All property join Iy-owned with right of survivorship must be disclosed on Schedule F
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
S:J~{ltlb-> l?/~ (flv.H;,~ Yk.Cr.
\0, Z)-~L(
<~
~c. C'T -
flYY 4 OJ l'Ll'L ( )
1'1 Ylt"H'
) 7 II , J .( (, 'J.7 C
Lj t)'7. Yct
1(;. 1)13 ~, (
'L31 /i 7
C II- ~ \4 ( L, ( 'I- I>.;y. I.I\J VD 1<\
\ S '6 <1 L 1""-'( O\...,I\J C
-' ev,..l'n N1v1-t.
\ ~ '}t)C tfJ
i L." (; J {;:.J
1171
C i!JLy ~l<l
(' OIU? c;{3.4
"" (~
le0
\+,,"S<-I\vWJ ~~(
O. "-'l,-/; L ~,; l'
LI S1W"
L i wJ'lI'41 Q()!'i""-. S ("7'
- A II ( L 5->,:':::} ~
. ,
Q,~v
() l v-C 'ne SC:T
l D~( ~(.4j
['vi} ((0 '(~ ~li.)
TOTAL (Also enter on line 5. Recapitulation) $ , 3>
(If more space is needed. insert additional sheets of the same size)
~E"./-1 :~11.t E><4- 1'"L.?~f:;n
.
;:'.
~.,~
~
COMIV1CHViEA.L TH OF FENI!S'(L/;iJJ!~
;bIHERIT.;';fICE TAX FETURH
RESIDEnT DECEDENT
ESTATE OF
(l ~,o,4-z CA f
SCHEDULE H
FUNERAL EXPENSES &
ADMiNISTRATiVe COSTS
(it
fJ-v /'
) Debts of decedent must be reported on Schedule 1.
FILE NUMBER
C /~() Y . rot; r?
ITEM
NUMBER DESCRIPTION AMOUNT
A FUNERAL EXPENSES:
1. 7-)c; &,
~Y'i.-l fJc ~(\f[..^, ~( k--\
..'0
-;:: 105, ':'v
,.-
~)
B. ADMINISTRATIVE COSTS:
1. Personal Representatives CommIssions
Name 01 Personal Repre5enlalive(sJ
Social Security Number(s)!EIN Number of Personal Representauveis)
Street Address
City State Zip
Year(5) Commission PaId
2. Attorney Fees
3. Family Exemption: (If decedents address is not the same as claImants. attach explanation)
Claimant
Slreet Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees )i~l~
5. Accountant s Fees
6. Tax Return Prepare(s Fees
7.
,
<Cj-
TOTAL (Also enter on line 9. Recapitulation) $ ~srr {j}
(If more space IS needed, Insert additional sheets of the same size)
REV-1512 EX + (1-97)
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF f1 h tti1t.$^-C h',Sl
Include unreimbursed medical expenses.
ITEM
NUMBER
FilE NUMBER
'11 D~r~ ~
DESCRIPTION
AMOUNT
1,
~ l)-r~_ Rc;.,"(1) a- L~,;, \J", L, ,") i'iL!) 'oP S..; 1\- Ps;: LP~ 'n)
~ 'ZP l).. "Z.. 0 At-. /)beD l}+.""...... ~ \~ ~L fL ~ ::> !'h,.(
lY's~ \~
2-..
" 0
JP-""l.t 5c '~c:;! ,'T-] ~
5t.1 ff'L{( ~
C\\CL\(.:t! z.~\
L\S- ..Q
"1
~~ '>c. \\.<..~ fh rL- St-{ fLAt ~
0. J~
'-- t{ C 4iK.. ~ t \.-(
"~I j ,(y~
1..
U'T1 Lt "Ill :> \ t ~0, ( CA.A/) rm,i'1 C'-1~
"2\ N'. 3 i
TOTAL (Also enter on line 10, Recapitulation) $ Z I ~ l, . '"S[_
(If more space is needed, insert additional sheets of the same size)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
06-19-2006
FOGLE
05-08-2005
21 05-0488
CUMBERLAND
101
APPEAL DATE: 08-18-2006
( See reverse side under Objections)
Amount Remitted I I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
9Y!_~~P~9_!~}~_~~~~______~___!!!!!~_~9~!~_~98!!9~_~g!_!9Y8_8g~9!~!__~____________________
REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISAlLDW~Nr.E OF DEDUCTIONS AND AS~ESSMENT OF TAX
MAGDA FILE NO. 21 05-0488 ACN 101
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
MARK A FOGLE
77 YELLOW WOOD DR
DOWNINGTOWN PA 19335
ESTATE OF
FOGLE
*'
REV-1547 EX AFP (06-05)
MAGDA
TAX RETURN WAS: (X) ACCEPTED AS FILED
DATE 06-19-2006
) CHANGED
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. funeral Expenses/AdM. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/GovernMental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
reTlect ~igures tha~ include ~ne total 01 ALL re~urns assessed ~o da~e.
ASSESSMENT OF TAX:
15. A.ount of Line 14 at Spousal rate (15)
16. Amount of Line 14 taxable at Lineal/Class A rate (16)
17. Aaount of Line 14 at Sibling rate (17)
18. Aaount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
TAX CREDITS:
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held S~ock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule D)
S. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
NOTE:
(1)
(2)
(3)
(4)
(5)
(6)
(7)
152,405.02
.00
.00
.00
38.953.62
.00
.00
(8)
(19)=
NOTE: To insure proper
credit to your account
subait the upper porti.
of this fora with your
tax paYMent.
1911358.64
11.102 I?
180,256.52
.00
1801256.52
.00
81111.54
.00
.00
8,111.54
r"ynt:nl J(t:l;t:~rl II l + J AHOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
05-01-2006 CD006630 .00 8,111.54
BALANCE OF UNPAID INTEREST/PENALTY AS OF 05-02-2006 TOTAL TAX CREDIT 81111.54
BALANCE OF TAX DUE .00
INTEREST AND PEN. 127.71
TOTAL DUE 127.71
. If PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
(9)
nO)
8,385.60
2.716.52
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
A aI:CII...n L'l'r'r' n~"~BI.'~ I.'''"~ nr ............. r-n....... ..".... ...........ft. ................._ ...
(11)
(12)
(3)
(14)
.00 X 00 =
180,256.52 X 045=
.00 X 12 =
.00 X 15 =