HomeMy WebLinkAbout04-24-07
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lSDSbDlll:L2S
REV -1500 EX (08-05)
PA~tmentatRMnlle* ' ' .'
==-T_ INHERITANCE TAX RETURN
HanIlIbulll. PA 17128-01101''''- ~ RESIDENT DECEDENT
ENTER IJECS)ENT INFORMATION BELOW
SocIal SecurItY Number 0et8 of Death
o 4 3 2 4 2 0 8 6 1 0 1 7 2 0 O' 5
OFFICIAI.. \lIE ONLY
Counly Code veer
2 1 0 5
fie NlInber
1 1 0 2
Date of 8IrIh
071 8 1 9 3 1
Decedenl's Last Name Suffix
CASE
(If AppIIc8bIe) e.-. SUrviYlng SpouM'. li1formaIIon Below
Spou88'. LaSt Name ' Sulftx
Decedent's FirIIt Name
J O,Y C E
MI
G
spouse'. First Name
MI
Spouse's SocIal Securky Number
THIS RETURN MUST BE FILED IN DUPUCATE WITH THE
REGISTER,OF WILLS
FLL.IN APPROPRIAtE OVAU BELOW
1&1 . 1. Original Return
o 2. SU~I ReIum . 0
o 4. IiniI8d Estate 0 411. Future Int8re8t COItIl"udli8e (d8IB of 0
death after 12-12-82)
o . 6. [)ecedent Died T8lIl:Me 0 7. ()eoecfent M8IntaIned a Uvlng Trust 0 8. ToCaI Number of S8f8 DeposIt 8Oll88 .
(Attach Q)py of WII) , ~ Copy of Trust) ,
o 9. UIgaIIon Proc:88ds ReceNId '0 10. Spousal PcMrty CredIt (date of death 0 '11. EIBctIon ~ t8X ....,. See. 9113(A)
between 12-31-81 and 1-1-85)' (AtIach Sc:h. 0)
CORRESPONDENT. THIS SECTDlIIISI' BE CQIREfED. ALl ~ AllDCOIIFIDEfIIW.. TAX 1IFOIIM11DII8HQW) BE QIIlECTS) TO:
Name Daytime :r~Nwnber ~.g
~.,.o --.
7 1 7 6~2~O 2 ~;2 .
._"...: (j ::-~)
3. Remainder Return (d8IB of death
prior ~ 12-13-82) ,
5. Feder8I EsIatB Tax Return RequIred
D 0 U'G LAS
Am .... (If AwftcabIe)
C .
YOHE,
E SQ.
- ,--
REOI8TER C)F.~",")y
FIrst line of address
1 7 0 0 B E NT C R E E K BLVD
second line of addre8a
SUITE 1 4 0
CIty Ot Poet 0fIlce State ZIP Code
MECHANI C S BURG PA 170 5 0
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UndlIrplllllllllll at ".1 cIecIInI tlltl..........1Ibn. =-...u.I~lIkll1""lIld .... ..... ~.. beltaf fff/ 1lnolIIIcIge'" b8IIIf,
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~~FORFI.INGRETUAN ~JJrj~7
~~~-~IVB . MOUNT VERNON ' WA 98273
. ::T~~):'_A- . y:l:j)?
1700 BENT CREEK BLVD, ,SUITB 140 MECHANICSBURG PA 17050
PLEASE USE ORIGINAL ~ ONLY
Side 1
L.
l50SbDll112S
1505bDll1125
--I
q
.....I
15056042126
REV-1500 EX
Decedent's Social Security Number
043242086
Decedent's Name: JOYCE G. CASE
RECAPITULATION
2. Stocks and Bonds (Schedule B)
.................................. 2.
131000.00
2842.22
1. Real estate (Schedule A)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1.
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) 5. 1 2 4 2 . 5 4
...... .
6. Jointly Owned Property (Schedule F) o Separate Billing Requested . . . . . . . 6. 1 2 0 1 9 . 5 3
7. Inter-Vivos Transfers & Miscellaneous NEtrobate Property
(Schedule G) Separate Billing Requested . . . . . . . 7.
11. Total Deductions (total Lines 9 & 10)
. . . . . . . . . . . . . . . . . . . . . . . . . . . 11.
147104.29
32782.71
93690.75
126473.46
20630.83
8. Total Gross Assets (total Lines 1-7)
........................... 8.
9. Funeral Expenses & Administrative Costs (Schedule H) . . . . . . . . . . . . . . .. 9.
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . . . . . . . . . . . . 10.
12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . 12.
13. Charitable and Govemmental Bequests/See 9113 Trusts for which
an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . 13.
14. Net Value Subject to Tax (Line 12 minus Line 13) ..................14. 2 0 6 3 O. 8 3
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 _ o . 0 0 15. O. 0 0
16. Amount of Line 14 taxable 2 0
at lineal rate X .042- 6 3 o . 8 3 16. 9 2 8. 3 9
17. Amount of Line 14 taxable o . 0 0
at sibling rate X .12 17. O. 0 0
18. Amount of Line 14 taxable o . 0 0
at collateral rate X .15 18. O. 0 0
19. Tax Due . .,. ., . .. .... ......... .,. .............. ..... .... 19. 9 2 8. 3 9
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
00
Side 2
L
15056042126
15056042126
--.J
REV-1500 EX Page 3
Decedent"s Complete Address:
File Number
21 05 1102
DECEDENTS NAME
JOYCE G. CASE
STREET ADDRESS
118 HOllY DRIVE
CITY \ STATE .\ ZIP
MECHANICSBURG PA 17055
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
928.39
3.750.00
187.50
Total Credits (A + B + C) (2)
3.937.50
3. Interest/Penalty if applicable
D. Interest
E. Penalty
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
0.00
3.009.11
0.00
TotallnterestlPenalty ( 0 + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill In oval on Page 2, Line 20 to request a refund. (4)
B. Enter the total of Line 5 + SA. This is the BALANCE DUE.
(SA)
(5B)
A. Enter the interest on the tax due.
0.00
Make Check Payable to: REGISTER OF WILLS, AGENT
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 00
b. retain the right to designate who shall use the property transferred or its income; ............................... 0 00
c. retain a reversionary interest; or ................................................................................................ 0 00
d. receive the promise for life of either payments, benefits or care? ....................................................... 0 00
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ....................................................................................... 0 00
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ......... 0 00
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? .................................................................................................. 0 00
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
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 three (3) percent [72 P .S. 99116 (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 zero (0) percent
[72 P.S. 99116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and
filing a tax retum 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 zero (0) percent [72 P.S. 99116(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 four and one-half (4.5) percent, except as noted in
72 P.S. 99116(1.2) [72 P.S. 99116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [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.
REV-1502 EX + (6-98)
*'
SCHEDULE A
REAL ESTATE
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
JOYCE G. CASE 21 05 1102
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be
exchanged between a willing buyer and a willing seller, neither being oompelled to buy or sell, both having reasonable knowledge of the relevant facts.
Real orooertv which is iointlv-owned with riaht of survivors hiD must be disclosed on Schedule F.
DESCRIPTION
VALUE AT DATE
OF DEATH
131,000.00
ITEM
NUMBER
1.
118 Holly Drive
Mechanicsburg, PA 17055
(Value based on Sale of Property; see attached HUD.1, Closing Statement)
TOTAL (Also enter on line 1, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
131 000.00
- . --..._...,__~__"P"~""-~'__ __.__._ ---'--_",' --- ~ r_ .. nllA Nn. 'M2-D265 .....
,-
A. 6. l' OF LOAN:
.. 1.DFHA 2. 0 !!mHA 3. [ C'-. J. UNINS. 4. OVA O.OcoN'i, INS.
U.s. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT 6. ~~'t JJA!~BER: 7. LOAN NUMBER:
SETTLEMENT STATEMENT . .
8. _MORTGAGE INS CASE NUMBER:
C. NOTE: This form is fumished to give Y9I! a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. -
Items marked "[POcr were paId outside the eIosfng;-they 818 shown here for Informational purp~es and are not included in the totals.
_ _ . 1.0 3198 118 HOllY DR1VE.PFOI118 HOLLYOR\VEltlll
D. NAME AND ADDRESS OF BUYER: E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER:
Charles R. Fields Estate of Joyce G. ~, by Lisa J. Case.
118 Holly Drive . Personal Representative
MechanlcSburg, PA 17055
G. PROPERTY LOCATION: H. SElTLEMENT AGENT: 23-1284840 I. SETTLEMENT DATE:
118 Holly Drive Wion. Zulli & Seibert
Mechamcsburg, PA 17055 May 17. 2006
Cumberland County, Penns~vanla PLACE pF SETTLEMENT
109 Locust Street
4nft ~~ HarrIsburg; PA 17101
nON . K ~ION
.Mn. .
101. Contract SaIe8 PrIce . 131.000.00 401. contract 8ales Price . 131,000.00
102.PerSOn8I 402. PeraonaI
103. SeUlement Chaiaes to BtNer nJne 1400) 2 365.88 403.
104. 404.
105. 405-
~~r
106. CountvffWPTaxes 05/18106 to 01101107 332.22 406. P Taxes ()511Ml6 to 01101107 332.22
107. Sd100ITaxes . 05118106 to .07101106 221.83 407.8ChOoITIIXes 05118106 to 07101J06 221.83
108.Asa888IT18nts to 408. AsseSsments .to
109. 409.
110. 1410.
111. 411. .
112. 412.
120. GROSS AMOUNT DUE FROM BUYER 133,919.93 420. GROSS AMOUNT DUE TOSaLER 131,554.05
!IGft. JUIOUNTS PAID BY OR IN R: 100. 0 I UNT DUE TO SELLER: .
201. rlMoRIt Qr' earnesfil'lonev 10000.00 501. Excess See In8truclons\ .
202. Princiual Amount of New LoaJllsf 502. Setllernent ChalUes 10 Seller (Line 1400) 3 638.84
2.03. EldstIna loanls} taken sublect to 503. ExIs11iiQ Ioanls} taken sublect to
204. 504. Payoff of first Mortaage to M&T Bank 54.,262.28
205. I 505. Pavoff of seconcl Mortaaae to M&T Bank 8.857.49
206. 506.
207. 507. l[)eoOSlldlsb. as
208. 1508.
209. 509.
. -Adlus r Items un I . eller r r
210. COuntvffWP Taxes to 510. eount.Vnwp Taxes. to
211. School Taxes to 511. SchooITaxes to
212. .Assessments to 612.Assessrnents to
213. Sewer Charaes 04101106 to 05/18/06 51.65 513. Sewer Charaes 04101106 to 05/1ll1(l6 51.65
214. . 514.
215. 515.
216. 516.
217. 517.
218. 518.
219. 519.
220. TOTAL PAID BYIFOR BUYER 10,051.65 :ii' TOTAL REDUCTION AMOUNT DUE SELLER 66,810.26-
iOO. I~AQIoI AT SElTLEMENT FR . O. CASH AT SETTLE NT OM SELLER:
301. Gross Amount Due From BtJ._r n 1__ 120} 133 919.93 601.' Gross Amount Due To Seller lL\ne 420) 131,554.05
3Q2. Leas Amount PaId BvIFor BiJY8f(Llne 220) ( 10,051.651 602. Less ReductionS Due Seller (Line 520) - ( 66,810.2El
303. CASH ( X FROM) ( . 10) 8tA'ER - ... 123868.28 603. CASH ( X TO ( FROM ) SEllER 64.743.791
The ......"'~7 ?/f 7. IiiJ!J oopy .........&2 01.... -' in.
/. -IA I..." ~ /1
_ Bu r;J,d'~..v SeI\er_ II. r ~I 'u 'IE.A"
__1 ~/ () il Of JO)Q G. C~
Supplement to
Schedule A
Personal Representative -
~1 (3-lllI) Rl!SPA. HB4305.2
L.
roo. TOTAL COMMISSION Based on Price S (li1 00000 % PAID FROM PAID FROM
. . Division cif eommlsslon (line TOO) 8S follows: BI.1VER'S SElLER'S
701.$ to FUNDS AT FUNOSAT .
702.$ to SETTLEMENT sETTLEMENT
703. commission paid at SetUement
*. . - ~.
_ --;;n:IIIS-PAYABLE IN~"~' ^A'" .
; .LOan OriQination Fee O.OOOO"""ljb -to
802. Loan Discount % to
803. Appraisal Fee to
804. Credit Report to
805. Lender's Inspection Fee to
806. Mortaaae Ins.AnD. Fee to
807. Assumption Fee to
808.
809. .
810. . ,
811..
gM. rt!l:US RE Di=R Tt\ill:: DAln-IN
901. Interest From to @ $ Iday ( days %)
r902. MIP Totlns. for Lif8Ql[Oan lOr - months to .
903. Hazard Insurance PremIUIn for 1.0 -vears to
904.
905.
~.tnnn.DJ:SER\lJ;S D
1001. Hazard Insunll'lC8 ~ $ -oer month
1002.MOrtaaae Insurance months $ per month
1003. CounlYlTWP Taxes ~ $ . oer month
1004. SchOOl Taxes months $ . Der month
. 1005. ASSesSmElnts months @ $ -per month
1006. months dtS oer mo--ntn
- 1001. months @ S per month
1008. months mi $ oer month
r14nn. S
1101. Settlement drCi08if\a Fee to
1102. Abstract or 1111e Search to
1103.11l1e Examln8600 to
1104. Tille Insurance Binder to
1105. ~ntPreD8raUOn to
1106. Nol8rVFees to WIon. Zul & Seibert 5.00
1107. AltOmey'sFeeS to
'(includes above Item numbers: )
1108. l1Ue Insurance to Co~lth land TIDe Insurance ~anv 912.38
nncludes above item numbers: 1
1109. Lender's Coverage $
- 1110. owner's Coverage $ 131,000.00
1111.
1112.
1113. ~RowG_
oI..nn ,,"V
1201. Recording Fees: Deed $ 38.50: Mortgage $ : . Releases $ 57.00 38.50 57.00
1202. CitvlCountVTixlStamDS: l)ied 1 310.00' Mortaa08 1 310.GO
1203. State Tax/Stamps: Revenue stamos 1.310.00: Mrniaaae - 1,310.00
1204.
1205.
........n AnOITInNAI ...........
1301. surveY to
1302. Pest InsD8ction to
1303. OvernIGht Mail Fee to W10n ZUlli & Seibert 25.00
1304. Auction Broker Fee to ChUdk BrIcker Auctionear 1.715.00
1305. See addif! dlsb. exhibit to 100.00 531.84
1400. TOTAL SETTLEMENT CHARGES 'Entler on Lines 103, Section J and 502, SectIon K1 FI 2.365.88 3.638.84
By __...., "'... -............. - -.,<"'a.......,..,.. r; ~e~ of this l
. - ~ I'JA::' ~ V J1t-v
. . u ~Vv'"
CertIfied to be. a true copy. Wlon~ & Seibert -U
Sell! n Agent
j
'__.', _,' .,_-,."___" -- -~,-~-"~,-,,,,"~;ocr""",,"T~"'--"'-'~.'.~""-'''''='-
SETTLEMENT CHARGES
( 118 HOLLY DRIVEl 118 HOLLY DRIYE I 18)
Supplement to
Schedule A
Buyer:
Seller:
Settlement Agent:
Place of Settlement:
Settlement Date:
Property Location:
PA YEElDESCRIPTION
SELLER
I
ADDITIONAL DISBURSEMENTS EXHIBIT
,
Charles R. Fields
Estate of Joyce G~ Case, by Lisa J. Case, Personal Representative
Wlon, Zulli & Seibert . .
(717}232~1488
109 Locust Street
Harrisburg. PA 17101
May 17, 2006
118 Holly Drive
Mechanicsburg, PA 17055
Cumberland County, Pennsylvania
NOTElREF NO
BUYER
100.00
Upper Allen Townsl1lp Authority
. Sewer Charges (2nd Quarter)
Marlin A. Yoho. Sr., Treasurer
2006. Countynwp Taxes
$
100.D0
Total Additional Disbursements shown on Line 1305
531.84
$
531.84
(118 HOLLY DRIVE.PFD/118 HOLLY DRIVE/16)
Supplement to
Schedule A
REV-1503 EX + (6-98)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
""W~,,-1::'V'
SCHEDULE B
STOCKS & BONDS
ESTATE OF
JOYCE G. CASE
FILE NUMBER
21 05 1102
AU property jointly-owned with right of sUNivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
Vanguard Group
PO Box 2600
Valley Forge. PA 19482
Account 09935101033
AccountType:Starrund
Number of shares: 148.56
Value per share: 19.01
DESCRIPTION
VALUE AT DATE
OF DEATH
2,842.22
TOTAL (Also enter on line 2, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
2 842.22
REV-1508 EX + (6-98)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
JOYCE G. CASE
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
21 05 1102
Indude 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.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
136.84
Members1st Federal Credit Union
P.O. Box 40, Mechanicsburg, PA 17055
Type of Account: savings
2.
County, Township and School Taxes paid in advance received on 5/17/2006
554.05
3.
Sewer charges paid in advance for 4/1/2006 to 5/18/2006
51.65
4.
Personal Property sold at auction
500.00
TOTAL (Also enter on line 5. Recapitulation) $
(If more space is needed. insert additional sheets of the same size)
1.242.54
REV-1509 EX + (6-98)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF
JOYCE G. CASE
FILE NUMBER
21 05 11 02
" an asset was made joint within one year of the decedenfs date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A. Lisa J. Case
1510 Windsor Drive
Mount Vernon, WA 98273-5659
Daughter
B
c
lETTER DATE DESCRIPTION Of PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A. PNC Bank 24,039.05 50. 12,019.53
PO Box 609, Pittsburgh, PA 15230-9738
Type of Account: checking and savings accounts
TOTAL (Also enter on line 6, Recapitulation) $ 12019.53
JOINTL V-OWNED PROPERTY:
(If more space is needed. insert additional sheets of the same size)
REV-1511 EX + (12-99)
*'
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
JOYCE G. CASE
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
21 05 11 02
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
1.
2
FUNERAL EXPENSES:
Malpezzi Funeral Home Funeral Services
Nolan's Harnden Monument Co. Gravestone Engraving
8,975.80
477.00
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative (s) Lisa J. Case
Social Security Number(s)/EIN Number of Personal Representative(s)
StreetAddress 1510 Windsor Drive
City Mount Vernon State WA Zip 98273-5659
6,000.00
B.
Year(s) Commission Paid:
7,000.00
2.
3.
AttomeyFees Latsha Davis Yohe & McKenna, P.C.
Family Exemption: (If decedenfs address is not the same as daimanfs, attach explanation)
Claimant
Street Address
City
Relationship of Claimant to Decedent
State
Zip
4.
Probate Fees Filing fees, Short Certificates, and Insurance Bond
492.00
5.
Accountants Fees
6.
Tax Retum Prepare!'s Fees
7.
8.
9.
10.
Costs associated with sale of residence - see attached supplement
Attorney Fees: Jeff Yoffee
Residence related expenses - see attached supplement
UPS Next Day Air to obtain corrected death certificates
3,653.84
485.00
5,684.73
14.34
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
32.782.71
Estate of Joyce G. Case
Schedule H Supplement
Residence Related EXDenses
Com cast - Cable Service
Donegal Insurance - House Insurance
Donegal Insurance - House Insurance
M& T Bank - Mortgage Payment
M& T Bank - Mortgage Payment
PPL Electric Utilities Corp. - electric
PPL Electric Utilities Corp. - electric
PPL Electric Utilities Corp. - electric
PPL Electric Utilities Corp. - electric
PPL Electric Utilities Corp. - electric
Tom Houth - Yard Maintenance
Tom Houth - Yard Maintenance
United Water Company - water
United Water Company - water
United Water Company - water
United Water Company - water
United Water Company - water
United Water Company - water
Upper Allen Township - Sewer
Upper Allen Township - Sewer
Verizon - Telephone
Waste Management of Central PA - Utilities
Waste Management of Central PA - Utilities
Baron Enterprises - Junk Removal
Black's Detachable - Dumpster Deposit
Black's Detachable - Final Dumpster Charges
Chuck Bricker Estate Appraisal
Merry Maids - Final House Cleaning
TOTAL:
File Number 21 051102
$62.74
$242.00
$227.00
$1,198.48
$665.24
$401.76
$251.03
$202.02
$457.67
$24.64
$50.00
$40.00
$26.50
$6.76
$6.76
$11.08
$6.76
$13.75
$205.53
$100.00
$82.96
$46.95
$46.95
$435.00
$250.00
$177.15
$75.00
$371.00
$5,684.73
REV-1512 EX + (12-O3)
'*
SCHEDULE'
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
JOYCE G. CASE
FILE NUMBER
21 05 1102
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
VALUE AT DATE
OF DEATH
11,500.00
ITEM
NUMBER DESCRIPTION
1. Giant Food Stores, LLC v. Lisa J. Case, Administratrix of the Estate of Joyce G. Case,
Court of Common Pleas, Cumberland County, Pennsylvania No. 06-5906 Civil.
2. Paul E. Stone and Barbara J. Myers as Co-Administrators of the Estate of
Kenneth E. Wallace v. Lisa J. Case, as Administratrix of the Estate of Joyce G. Case,
Court of Common Pleas, Cumberland County, Pennsylvania No. 06-2166 Civil.
3. M&T Bank Mortgage
1100 Wehrle Drive, Williamsville, NY 14221
Account: 100-930364130001
4. M& T Bank - Line of Credit
1100 Wehrle Drive, Williamsville, NY 14221
Account: 16914713-0001
5. Donegal Insurance Group - Homeowners Insurance
1195 River Road, P.O. Box 302, Marietta, PA 17547
5,000.00
54,403.51
8,829.81
242.00
6. Members 1 st Federal Credit Union - Car Loan
P.O. Box 40, Mechanicsburg, PA 17055
9,070.12
7. Comcast - Cable Service
P.O. Box 3005, Southeastern, PA 19398-3005
85.61
8. Verizon - Telephone Service
PO Box 2800 Lehigh Valley, PA 18002-8000
34.97
9. United Water of Pennsylvania - Water Service
P.O. Box 371804, Pittsburgh, PA 15250-7804
9.74
10. Waste Management - Trash Removal Service
4300 Industrial Park Road, Camp Hill, PA 17011
46.95
11. Chase Visa - Credit Card Account
P.O. Box 15153, Wilmington, DE 19886-5153
14.95
12. PP&L - Electric Service
2 North 9th Street, RPC-GENN1, Allentown, PA 18101-1175
74.69
13. Citi Cards - Credit Card Account
P.O. Box 183055, Columbus, OH 43218-3055
46.10
14. Qcard - Credit Card Account
P.O. Box 530905, Atlanta, GA 30353-0905
32.30
15. Chase Visa - Credit Card Account - Car Rental
P.O. Box 15153, Wilmington, DE 19886-5153
800.00
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed. insert additional sheets of the same size)
93.690.75
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
JOYCE G. CASE
Decedenfs Name
Page 1
21 05 11 02
File Number
Schedule I - Debts of Decedent, Mortgage Liabilities, & Liens
ITEM
NUMBER DESCRIPTION AMOUNT
16. Claim' of Snyder's of Hanover 3,500.00
SUBTOTAL SCHEDULE I 3.500.00
. GRAND TOTAL SCHEDULE I $ 93,690.75
""'."""'.-
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
JOYCE G CASE
FILE NUMBER
21 05 1102
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I. TAXABLE DISTRIBUTIONS pnclude outright ~sal distributions, and transfers under
Sec. 9116 (a)(1. )]
1. Lisa J. Case Lineal 50.00
1510 Windsor Drive
Mount Vernon, WA 98273-5659
2. Jeffrey T. Case Lineal 50.00
8404 Terrace Court
Harrisburg, PA 17111
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
ll. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART n _ ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
LATSHA DAVIS YORE
& MCKENNA, EC.
ATTORNEYS AT LAW
PLEASE REPLY TO: Mechanicsburg
WRITER'S E-MAIL: ItayIor@ldylaw.com
April 23, 2007
Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, P A 17013-3387
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Re: Estate of foyce Gustafson Case
File No.: 21-05-1102
Date of Death: October 17, 2005
Our File No.: 1158-05
Dear Clerk:
Enclosed for filing please find an original and two copies of the Inheritance Tax Return
Resident Decedent, REV-1500 on behalf of the Estate of Joyce G. Case and a check in the amount
of $15.00 for the filing fee. Please return a date-stamped copy of the Return to our office in the
enclosed self-addressed stamped envelope.
Please contact our office with any questions you may have regarding this filing.
Sincerely,
/I~ill Wfl
VLo"ne A. T:YI~~
Enclosures
cc: Lisa Case (w / enc.)
Douglas Yohe, Esq. (w /0 enc.)
1700 Bent Creek Boulevard, Suite 140 . Mechanicsburg, PA 17050 · (717) 620-2424 · FAX (717) 620-2444
350 Eagleview Boulevard, Suite 100 . Exton, PA 19341 · (610) 524-8454 · FAX (610) 524-9383
3000 Atrium Way, Suite 251 . Mt. Laurel, NJ 08054. (856) 231-5351 · FAX (856) 231-5341
Maryland Telephone: (410) 727-2810
115049
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