HomeMy WebLinkAbout08-03-07 (2)
~
15056051058
REV-1500 EX (06-05)
PA Departmenl of Revenue '*
Bureau of Individual Taxes
PO BOX 280601
Harrisburg, PA 17128-0601
ENTER DECEDENT INFORMATION BELOW
Social Number Date of Death
OFFICIAL USE ONLY
Cou~ty Code Year
INHERITANCE TAX RETURN
RESIDENT DECEDENT 21 06
File Number
00995
Date of Birth
189-09-0730
11/05/2006
06/02/1916
Decedent's Last Name
Decedent's First Name
MI
Sweezy
John
L
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name
~p()u~~:~Firstl'Jllrn~
MI
~pous~'sSocial Secu~ty.l'JulTI~~r
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
(aJ 1. Original Retum
c:::::;)
2. Supplemental Retum
c:::::;)
3. Remainder Retum (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
Cl
c:::::;) 4a. Future Interest Compromise (date of
death after 12-12-82)
c::.J 7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
Cl 10. Spousal Poverty Credit (date of death c:::::;) 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. 0)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
6. Decedent Died Testate
(Attach Copy of Will)
9. Litigation Proceeds Received
8. Total Number of Safe Deposit Boxes
c::>
4. Limited Estate
c::.J
c.t>
Daniel D. Worley, Esq.
: (717) 854-5914
Firm Name
REGISTER OF WILLS ~ ONLY
o 2;
c-- ---I
Worley & Worley
First line of address
101 E. Philadelphia St.
Second line of address
ZIP Code
17401
or Post Office
Correspondent's e-mail address:dan@worleyandworley.com
Under penalties of pe~ury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief,
it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
GNAT OF RE 0 I E F FILING RETURN DATE
08/02/07
DATE
08/02/07
AD ESS
101 E. Philadelphia St. York, PA
01
PLEASE USE ORIGINAL FORM ONLY
Side 1
L
15056051058
15056051058
--.Jqf
-I
15056052059
REV-1500 EX
Decedent's Name:
John
L Sweezy
RECAPITULATION
1. Real estate (Schedule A).
2. Stocks and Bonds (Schedule B) . . . . . . . .
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-Vivos 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 Deductions (total Lines 9 & 10).
12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . 12.
13. Charitable and Governmental 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.
TAX COMPUTATION - 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 taxable
at lineal rate X.O 45
17. Amount of Line 14 taxable
at sibling rate X .12
18. Amount of Line 14 taxable
at collateral rate X .15
179,768.58
99,201.79
19. TAX DUE. . . . . .
..10.
. . 11.
15.
16.
17.
18.
. . . . . . . . 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
15056052059
Side 2
L
189-09-0730
Decedent's Social Security Number
2
5.
6.
7.
8.
9.
166,000.00
279,475.75
0.00
0.00
38,717.26
0.00
0.00
484,193.01
99,382.30
105,840.34
205,222.64
278,970.37
0.00
278,970.37
8,089.58
14,880.26
22,969.84
.
15056052059
---I
. .
REV-1500 EX Page 3
Decedent's Complete Address:
File Number
21
06 00995
DECEDENT'S NAME DECEDENT'S SOCIAL SECURITY NUMBER
John L Sweezy 189-09-0730
STREET ADDRESS
125 Victoria Drive
CITY ! STATE I ZIP
Mechanicsburg I 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)
22,969.84
24,000.00
1,148.49
Total Credits ( A + B + C ) (2)
25,148.49
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty ( D + 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)
2,178.65
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(5)
(5A)
(5B)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
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 [i]
b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 [i]
c. retain a reversionary interest; or.......................................................................................................................... 0 [iJ
d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 [i]
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. 0 [i]
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. 0 [i]
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.
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 exemDt 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-15~2 EX+ (6-9*,
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF
John L. Sweezy
FILE NUMBER
21-06-995
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 compelled to buy or sell, both having reasonable knowledge of the relevant facts.
Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
125 Victoria Drive Mechanicsburg, PA (See Attached Settlement Sheet)
TOTAL (Also enter on line 1, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
VALUE AT DATE
OF DEATH
166,000.00
166,000.00
REV-15~3 EX+ (6-98*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
John L. Sweezy
FILE NUMBER
21-06-995
All property Jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
Vanguard Funds #09884236473 See # of shares and breakdown on Attachment
VALUE AT DATE
OF DEATH
5.
6.
Vanguard Fund 1 27,159.53
Vanguard Fund 2 14,374.70
Vanguard Fund 3 33,740.47
Vanguard Fund 4 173,315.84
Morgan Stanley Securities 30,885.21
2.
3.
4.
TOTAL (Also enter on line 2, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
279,475.75
REV-15~8 EX+ (6-98) '*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
John L. Sweezy
FILE NUMBER
21-06-995
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 VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
27.50
Checking Account # 6100891372 held at Citizens Bank 22,059.16
Personal Property (Average of 2 estimates attached hereto) 9,317.50
Colburn Insurance (return of unused malpractice Insurance 1,474.00
State Employee's Retirement System 2,134.55
6. Citizens Bank Savings Account 3,704.55
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
38,717.26
REV-1~11 EX+ (12-99>W
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
John L. Sweezy
FILE NUMBER
21-06-995
ITEM
NUMBER
A.
FUNERAL EXPENSES:
Jesse H. Geigle Funeral Home
1.
B.
1.
ADMINISTRATIVE COSTS:
Debts of decedent must be reported on Schedule I.
DESCRIPTION
Personal Representative's Commissions
Name of Personal Representative(s) Daniel T. Worley
Social Security Number(s)/EIN Number of Personal Representative(s) 197-40-5178
Street Address 178 Plank Road
City York Springs
Year(s) Commission Paid: 2007
2.
Attomey Fees
StatePA Zip 17372
3.
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City
Relationship of Claimant to Decedent
4.
Probate Fees
5.
Accountant's Fees
6.
Tax Return Preparer's Fees
7.
Advertising Cumberland County Legal Record
Carlisle Sentinel Advertising Estate
8.
State
List of Expenses are continued on list attached hereto
.Zip
TOTAL (Also enter on line 9, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
AMOUNT
14,602.00
24,209.65
24,209.65
0.00
422.00
0.00
250.00
75.00
150.00
63,918.30
J,al,n L SwN<. J
SC/""rJu. L.c fJ CJJI\~..
ITEM NUMBER DESCRIPTION
1 Staples Bags! Stamps! Boxes
2 PA American Water
3 Duty Locksmith (rekey house locks)
4 Lowes- Bags and Paper Towels
5 Verizon
6 AT&T Home Phone
7 Rupperts Lawn Care -Trim Bushes ect. On property
8 PPL Electric
9 Verizon Wireless
10 Wolfe and Shearer Property Appraisal
11 Brickers Auction Property Appraisal
12 American Home Mortgage check 997
13 American Home Mortgage check no.1014
14 Stermer Auction Service - Appraisal
15 Menallen Friends Meeting House - donation for Funeral
16 Penn American Water
17 Lower Allen Township - Taxes
18 Verizon
19 PPL Electric
20 AT&T Home Phone
21 EF Redding Memorial- Tombstone Inscription
22 American Home Mortgage Check # 1028
23 PA American Water
24 Verizon
25 AT&T Home Phone
26 Lowes- Bags
27 PPL Electric
28 American Home Mortgage check # 1035
29 PA American Water
30 Homedepot lighting fixture
31 Rupperts Lawn Care
32 AT&T Home Phone
33 PPL Electric
34 Verizon
35 Lowes Trash Bags supplies for house
36 Staples Stamps
37 Bonnie Miller Treasurer - Taxes
38 1800 got Junk
39 1800 got Junk
40 George Dimoff - Refrigerator for house
50 Sentinel Investigations (PI hired to find beneficiary)
51 All About Shredding
52 Jan Crouch Cleaning
53 American Home Mortgage Check # 1053
54 Rupperts Lawn care
55 PA American Water
56 Verizon
57 AT&T Home Phone
58 PPL Electric
59 Lower Allen Township - Taxes
60 Guun-Mowers LLC home insurance
L) -1)(, -9?!)
AMOUNT
53.43
12.03
195.18
45.89
76.39
129.16
371
274
21.24
300
125
1099.37
1099.37
301.4
200
12.62
87.5
73.76
273.58
85.89
245
1099.37
12.03
40.63
125.36
39.56
272.95
1099.37
12.03
22.48
64
26.34
184.4
41.74
49.68
31.2
592.41
1295
826
50
673.66
133.96
200
1099.37
52
12.62
44.96
59.35
184.19
87.5
549
61 George Dimoff - Air Purifier
62 PA American Water
63 AT&T Home Phone
64 PPL Electric
65 Verizon
66 Dennis Foreman - repair to House
67 PA American Water
68 American Home Mortgage Check #1070
69 Verizon
70 AT&T Home Phone
71 PPL Electric
72 Ruperts Lawn care
73 George Dimoff -Drain Doctors
74 Dennis Foreman - repair to House
75 American Home Mortgage Check #1077
76 Staples Stamps
77 PA American Water
78 AT&T Home Phone
79 Rupperts lawn care
80 Verizon
81 Expenses from Real Estate Settlement (see settlement She
37.1
13.22
27.14
184.61
44.69
1000
12.62
1099.37
41.56
27.14
92.55
33.92
30
800
1099.37
16.4
13.22
27.14
33.92
12.06
16755
35464
REV-151,2 EX+ (12-03) .
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF
John L Sweezy
FILE NUMBER
21-06-995
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unrelmbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
American Home Mortgage Servicing Account # 4100361
2.
West Shore EMS -Transportation due to final illness
103,092.55
622.22
3.
Ruperts Lawn care
97.84
6.
Idearc - Yellow Page Ad final installment
24.22
4.
Associated Cardiologists
5.
Com cast - final bill
7.72
217.00
7.
State Employees Retirement System
1,778.79
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed. insert additional sheets of the same size)
105,840.34
REV-1513 EX+ (9-00) '*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
NUMBER
I
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
flee, 9116 (a) (1.2)]
FILE NUMBER
21-06-995
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
Do Not List Trustee(s) OF ESTATE
ESTATE OF
John L. Sweezy
1.
Tami (Gena) Botelho
Grandaughter
1/3
2.
David Botelho
Grandson
1/3
3.
Carol Sweezy Hutchinson
Neice
1/3 and personal pr~
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II 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
(If more space is needed, insert additional sheets of the same size)
V IlVlIW II"V. .-.",Io;";;'--U'...;;....,. .'.w-
A. B. TYPE OF LOAN:
U.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT 1.DFHA 2.DFmHA 3. DCONV. UNINS. 4.DVA 5. DCONV. INS.
6. FILE NUMBER: 17. LOAN NUMBER:
. SETTLEMENT STATEMENT SEITZ125VICTORIAI07)
8. MORTGAGE INS CASE NUMBER:
C. NOTE: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown.
Items marked "[POC)" were paid outside the closing; they are shown here for informational purposes and are not included in the totals.
1.0 3/98 (SEITZ125VICTORIA(07). PFDISEITZ125V1CTORIA(07)J18)
D. NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER:
JOEL R. SEITZ, JR. ESTATE OF JOHN L. SWEEZY DECD BANK OF AMERICA
8 COUNTRYSIDE CT. 125 VICTORIA DRIVE 1201 MAIN STREET
CAMP HILL PA 17011 MECHANICS BURG PA 17055 DALLAS TX 75202
G. PROPERTY LOCATION: H. SETTLEMENT AGENT: 23-2386065 I. SETTLEMENT DATE:
125 VICTORIA DRIVE LEON P. HALLER ESC AGENT FIRST AMERICAN TITLE INS
MECHANICSBURG, PA 17055 June 28, 2007
CUMBERLAND County, Pennsylvania PLACE OF SETTLEMENT
1719 N. FRONT ST.
HARRISBURG, PA 17102
J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION
linn. ".:Rr 4nn ~DnC!C! 1'\111= rn C!O I "'D.
101. Contract Sales Price 166,000.00 401. Contract Sales Price 166,000.00
102. Personal Property 402. Personal Propertv
103. Settlement Charges to Borrower (Line 1400\ 8,052.34 403.
104. 404.
105. 405.
airl
106. CitylTown Taxes 06/29/07 to 01/01/08 301.89 406. CitvlTown Taxes 06/29/07 to 01/01/08 301.89
107. SCHOOL TAXES 06/29/07 to 07/01/07 6.97 407. SCHOOL TAXES 06/29/07 to 07/01/07 6.97
108. WATER/SEWER to 408. WATER/SEWER to
109. 409.
110. 410.
111. 411.
112. 412.
120. GROSS AMOUNT DUE FROM BORROWER 174,361.20 420. GROSS AMOUNT DUE TO SELLER 166,308.86
200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER:
201. Deoosit or earnest money 1,000.00 501. Excess Deposit (See Instructions)
202. Principal Amount of New Loan(s) 166,000.00 502. Settlement Charges to Seller (Line 1400) 10,755.00
203. Existing loan(s) taken subiect to 503. Existina loan(s) taken subiect to
204. 504. Payoff of first Mortgage to COLUMBIA NATIONAL C/O 100,874.37
205. 505. Payoff of second Mortgage
206. 506.
207. 507. (Deposit disb. as proceeds)
208. SELLER COSTS CONTRIBUTION 6,000.00 508. SELLER COSTS CONTRIBUTION 6,000.00
209. 509.
Adiustments For Items llnnald Bv Seller Adiustments For Items nnalrl Rv seller
210. CitvlTown Taxes to 510. CitvlTown Taxes to
211. SCHOOL TAXES to 511. SCHOOL TAXES to
212. WATER/SEWER to 512. WATER/SEWER to
213. 513.
214. 514.
215. 515.
216. 516.
217. 517.
218. 518.
219. 519.
220. TOTAL PAID BYIFOR BORROWER 173,000.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 117,629.37
300. CASH AT SETTLEMENT FROMITO BORROWER: 600. CASH AT SETTLEMENT TOIFROM SELLER:
301. Gross Amount Due From Borrower (Line 120) 174,361.20 601. Gross Amount Due To SellerCLine 420) 166,308.86
302. Less Amount Paid By/For Borrower (Line 220) ( 173,000.00) 602. Less Reductions Due Seller (Line 520) ( 117,629.37)
303. CASH ( X FROM) ( TO) BORROWER 1,361.20 603. CASH ( X TO) ( FROM) SELLER 48,679.49
The """,'",""''' he"'" .oImowledge """Ipt of . oompleted oopy of p.gos 1 &2 of 1ho "'teme~.."'me.JoJOfe~~ ,~,
.,,",.,'" ~L \L C;~ h 501""- k L d,Y/7 .f", ,o,.e or
EL R. SEITZ, R. ESTATE OF JOHN L. SWE D
[)'n I $tu?~
6'S~
(J
HUD-1 (3-86) RESPA, HB4305.2
- . -"'--
L. SETTLEMENT CHARGES
700. TOTAL COMMISSION Based on Price $ lW 00000 % HBDOOO PAID FROM PAID FROM
Division of Commission (line 700) as Follows: BORROWER'S SELLER'S
701. $ 4,025.00 to ERA JACK GAUGH EN REAL ESTATE FUNDS AT FUNDS AT
702. $ 4,775.00 to EXIT REALlY SETTLEMENT SETTLEMENT
703. Commission Paid at Settlement 8,800.00
704. TRANSACTION FEES to EXIT REALlY/JACK GAUGHEN REAL ESTATE 195.00 165.00
ann. ITEMS PAYARLE IN CONNECTION WITH LOAN
801. Loan Orioination Fee 0.0000 % to
802. Loan Discount % to
803. TAX SERVICE FEE to BANK OF AMERICA 75.00
804. Credit Report to SIGNATURE FINANCE & CONSULTI 23.98
805. MORTGAGE BROKER FEE PD BY BOFJ to SIGNATURE FINANCE & CONSULTING POC $1 ,757.94L
806. MORTGAGE BROKER FEE to SIGNATURE FINANCE & CONSULTING 830.00
807. APPLICATION FEE to SIGNATURE FINANCE 595.00
808. FLOOD DETERMINATION FEE to LSI FLOOD SERVICES 11.00
809. SATISFACTORY COMPLET ON CERIFI to CR CONSULTING & APPRAISAL 100.00
810. BROKER APPRAISAL FEE to CR CONSULTING $325.00POCB 100.00
811. ADMINISTRATIVE FEE to BANK OF AMERICA 450.00
QM An\IAUC!;
901. Interest From 06/28107 to 07/01/07 @ $ 30.130000/day ( 3 days %) 90.39
902. Mortaaoe Insurance Premium for months to
903. Hazard Insurance Premium for 1.0 vears to
904.
905.
1 nnn. RE~ERV!;S DEPn~ITED TH LENDER
1001. Hazard Insurance 3.000 months $ 41.42 per month 124.26
1002. MortCaae Insurance 81.620 months $ oer month
1003. CitvlTown Taxes 5.000 months $ 35.19 per month 175.95
1004. SCHOOL TAXES 13.000 months ( $ 106.05 per month 1,378.65
1005. WATER/SEWER months @ $ per month
1006. months $ per month
1007. months $ oer month
1008. AGGREGATE ADJUSTMENT months $ per month -233.65
11nn. TITLE CH
1101. Settlement or Closina Fee to
1102. Abstract or Title Search to
1103. Title Examination to
1104. Title Insurance Binder to
1105. Document Preoaration to WORLEY & WORLEY LAW OFFICES 90.00
1106. Notarv Fees to
1107. Attomey's Fees to
(includes above item numbers: )
1108. Title Insurance to LEON HALLER ESC AGENT FIRST AMERICAN TITLE INS 2 139.76
(includes above item numbers.11 01-11 04 )
1109. Lender's Coverage $ 166,000.00 1,069.88
1110. Owner's Coverage $ 166,000.00 1,069.88
1111. CLOSING PROTECTION LETTER to LEON P. HALLER ESC AGENT FIRST AMERICAN TITLE INS 35.00
1112. LOAN ONLY END 1001300/8.1 to LEON P. HALLER ESC AGENT FIRST AMERICAN TITLE INS 150.00
1113.~
12nn. C AND TRAN~FER C
1201. Recording Fees: Deed $ 40.50; Mortgage $ 56.50; Releases $ 97.00
1202. CitY/County Tax/Stamos: Deed 1,660.00' Mortaaae 1,660.00
1203. State Tax/Stamos: Revenue Stamps 1,660.00; Mortgage 1,660.00
1204.
1205.
1".lnn ~I=TTLEMENT CHARGES
1301. Survev to
1302. Pest Inspection to
1303.
1304.
1305. See addit'l disb. exhibit to 55.00 40.00
1400. TOTAL SETTLEMENT CHARGES (Enter on Lines 103, Section J and 502, Section K) 8,052.34 10,755.00
By sIgning page 1 of thiS statement, the signatories acknowledge receipt of a completed copy of page 2 of this two page statement.
LEON P. HALLER ESC AGENT FIRST AMERICAN TITLE
Settlement Agent
Certified to be a true copy.
(SEITZ125VICTORIA(07) / SEITZ125VICTORIA(07) /18)
ADDITIONAL DISBURSEMENTS EXHIBIT I
Borrower: JOEL R. SEITZ, JR.
Seller: ESTATE OF JOHN L. SWEEZY DECD
Lender: BANK OF AMERICA
Settlement Agent: LEON P. HALLER ESC AGENT FIRST AMERICAN TITLE INS
(717)234-4178
Place of Settlement: 1719 N. FRONT ST.
HARRISBURG, PA 17102
Settlement Date: June 28, 2007
Property Location: 125 VICTORIA DRIVE
MECHANICSBURG, PA 17055
CUMBERLAND County, Pennsylvania
PAYEE/DESCRIPTION
NOTE/REF NO
BORROWER
SELLER
CASH
NOTARY SERVICES
PURCELL KRUG & HALLER
UPS OVERNITE
TAX COLLECTOR
TAX CERTIFICATION
15.00
5.00
40.00
20.00
15.00
Total Additional Disbursements shown on Line 1305 $
55.00
$
40.00
(SEITZ125VICTORIA(07).PFD/SEITZ125VICTORIA(07)/18)
& Vanguard"
February 15, 2007
P.O. Box 2600
Valley Forge. PA 19482-2600
www.vanguard.com
DANIEL T WORLEY
178 PLANK RD
YORK SPRINGS PA 17372
All Funds
09884236473 - Indiv. Acct.
ESTATE OF JOHN L SWEEZY
Dear Mr. Worley:
We are responding to your telephone call requesting a valuation of John L.
Sweezy's above-referenced account on November 5, 2006. First, please accept
our condolences for your loss. The information that you requested is provided
below.
Since that date was a non-business day, we are providing the values for
November 3, 2006. On that date, the number of shares, price per share, and the
value of each fund were as follows:
Fund Name Shares Price Value
Intermediate-Term Tax-Exempt Fund Inv 2,037.474 $13.33 $27,159.53
PA Tax-Exempt Money Market Fund 14,374.700 $1.00 $14,374.70
Total Bond Market Index Fund Inv 3,387.597 $9.96 $33,740.47
PA Long-Term Tax-Exempt Fund Adm 15,256.676 $11.36 $173,315.84
Accrued Dividends (through the date of death, and if applicable) and the funds'
share price on November 6, 2006 (the business day following the date of death),
are listed below. Note: As of this date, the funds' share balance remained the
same.
Fund Name Accrued Share Price
Dividends
Intermediate-Term Tax-Exempt Fund Inv $15.43 $13.33
PA Tax-Exempt Money Market Fund $6.58 $1.00
Total Bond Market Index Fund Inv $23.03 $9.97
PA Lonq-Term Tax-Exempt Fund Adm $108.18 $11.36
Vanguard Marketing Corporation, Distributor.
If you have any questions or need further assistance, please contact a member
of our Transition Specialist Team at 1-888-237-9045. We are available Monday
through Friday from 8 a.m. to 8 p.m., Eastern time.
Sincerely,
Client Services Department
egm
50806547
Vanguard Marketing Corporation, Distributor.
01
(rPotletlf
~(Q)~p
JIuf ~ur
alt*-
JOHN L. SWEEZY
I, John L. Sweezy, of Mechanicsburg, Cumberland County, Pennsylvania, being
of sound and disposing mind, memory and understanding, do make, publish and
declare this to be my Last Will and Testament, hereby revoking and making void all
previous Wills and Codicils heretofore made by me.
FI RST
I order and direct my personal representative hereinafter named to pay all of my
just debts, funeral expenses and expenses involved or connected with the
administration of my estate as soon after my death as is reasonably possible. However,
my personal representative need not accelerate and pay those unmatured obligations
which, in his, her or its opinion, it might be proper and more advantageous to retain or
renew and pay as they become due and payable. If I do not own a burial plot or a grave
marker at the time of my death, I authorize my personal representative, in his, her or its
sole discretion, to purchase a burial plot and to erect a suitable marker at my grave, and
to expend sums from my estate for this purpose.
SECOND
I give, devise and bequeath all my automobile(s), household effects and other
tangible personal property, not including cash or securities or policies of insurance,
owned by me at my death, to my Niece, Carole S. Hutchinson, per stirpes. It is my
wish that the wall clock and all other tangible personal property belonging to the Sweezy
and Withrow families such as family books, records, photographs, papers, documents
mementos and other similar items be received by my niece in kind so as to remain in
the family. The remainder of my personal tangible property not taken in kind by my
niece is to be sold by my Executor at public or private sale and the proceeds of such
sale(s) be distributed to my niece, Carole S. Hutchinson, per stirpes.
THIRD
I have intentionally made no provision in this will for my daughter, Virginia
Botelho, or for any of her issue except for those provisions made to Tami Gene Botelho
McBee, and David Lyn Botelho.
FOURTH
I direct that any real estate owned by me at the date of my death be sold by
public or private sale and the proceeds of such sale shall become part of my residuary
estate.
FIFTH
I give, devise and bequeath the rest, residue, and remainder of my estate, of
every nature and wherever situate including but not limited to proceeds from the sale
of my real estate, cash or securities or policies of insurance, in equal shares, to Tami
Gene Botelho McBee, David Lyn Botelho, and Carole S. Hutchinson, per stirpes,
absolutely. In the event Tami Gene Botelho McBee, David Lyn Botelho, or Carole S.
Hutchinson dies without leaving issue, I give the rest, residue, and remainder of my
estate to the surviving beneficiaries in equal shares per stirpes.
SIXTH
I direct that all taxes that may be assessed in consequence of my death, of whatever
nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as
part of the expenses of the administration of the estate.
SEVENTH
My executor is authorized and empowered to exercise from time to time in his
sole discretion and without prior authority from any Court, in respect of any property
forming part of my estate all powers conferred by law to executors and the testator
intends that such powers be construed in the broadest possible manner.
EIGHTH
I nominate, constitute and appoint Daniel T. Worley of York Springs, Adams
County, Pennsylvania, Executor of this my Last Will and Testament. In the event Daniel
T. Worley is deceased, unable or unwilling to serve or shall cease to serve for any
reason whatsoever, then I nominate, constitute and appoint my niece, Carole S.
Hutchinson, of St. Clair, Missouri, to serve instead.
NINTH
I direct that my Executor and Trustee shall not be required to give or post bond
for the faithful performance of his/her/its duties in this or any other jurisdiction.
TENTH
I am currently unaware of the whereabouts of my grandchild David Lyn Botelho.
I direct that my Executor make a good faith attempt to determine the whereabouts of
David Lyn Botelho. If my Executor is unable to locate David Lyn Botelho I request that
a Private Investigator be retained to discover the whereabouts of David Lyn Botelho. If
said Private Investigator can not determine the whereabouts of David Lyn Botelho in a
reasonable amount of time, David Lyn Botelho is to be deemed to have predeceased
me for purposes of this will.
IN WITNESS WHEREOF, I have hereunto set my hand to this my Last Will and
Testament, consisting of six (6) typewritten pages, the first four (4) of which bear my
signature for the purpose of identification, this 10'h day of October, 2006. ~
t ,vI'_~
~4r Iv:
~. L. Sweezy
ACKNOWLEDGMENT
.
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
: SS
I, John L. Sweezy the Testator whose _ name is signed to the attached or
foregoing instrument, having been duly qualified according to the law, do hereby
acknowledge that I signed and executed the instrument as my Last Will and Testament;
that I signed it willingly, and that I signed it as my free and voluntary act for the
purposes therein expressed.
~>t.
John L. 'Sweezy
Sworn or affirmed and acknowledged before me by John L. Sweezy, the
Testator, this 10th day of October, 2006.
~c:XA~
Notary Public
NOTARIAL SEAL
:MARlA L. STRoH, NotmyPubUo
lower Anan Twp... Cumberland Ct\, PA
My CommtsslonExpires Nov. 14, 2001)
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
:ss
., '0tand gG?lleV L,cF5T;~S witnesses
whose names are attached to t foregoing document, being duly qualified according to
the law, do depose and say that we were present and saw Testator sign and execute
the instrument as his Last Will and Testament; that he signed willingly and that he
executed it as his free and voluntary act for the purposes therein expressed; that each
subscribing witness in the hearing and sight of the Testator signed the Last Will and
Testament as witnesses and that to the best of our knowledge the Testator was at the
time 18 or more years of age, of sound mind and under no constraint or undue
influence.
Swor~ or affirmed and subscribed before me by .....k/l/CL (! ,L}/br'jAf and
S~k/1 L tJnlw~ this 10th day of October, 2006.
NOTARIAl SEAL
MARlA l, STAOH, Notaly l'rJf)Uo
Lewey Allen Twp., Cumberland O!",:, Fi,\
tJ Oomm\$SlOn e<J)lres Nov. 14 aOOG
Farm Sales ... /irQ:a1f,!il$~f;\t&:.AnUques
, Uql!il~ti1!cis
.~ STERM:~RJ~~.~~.Tl~~.S~RVICE ~~
V ft)n 1 2 5 Be:rtlt;:';fi;~n ,"Ch. Rd.
~ East Berlin, Penna.
(717) 292-2855
N2
200
INVOICE
DATE 12112/06
SOLD
TO:
MIKE STERMER
Auctioneer
Nothing Too Big or Too Smsll-
We Se/l It Alii
Estate of John L. SWRRZY
Daniel T. Worley, Exec.
QUANTITY DE2CAIPTION UNIT PRICE f-T9T AL AMOUNT __
----- -...-..
Appraisal of John L. Sweezv"', state
3* J.l'rc:: ctht:; f)f) J.lr ct??7 t:;f)
Write up appraisal 55 Min ~F;q 00 J.l'r 111 Qf)
- .....1 1 n, ........~ '~" .. .....~
~~
.- "I'"""vv U~ . ...v.vv
" ..
-.."
-
~101 40
, ~ ...-
'"
...
Thank You & Happy Ho.l, days
~ .-..;.,.. ,
....
'.
".
, .
.
.,'"
;
-.
NO WARRANTY .EXPRESSED
OR IMPLIED
PLEASE PAY FRm; THIS INVOICE
PAYMENT TERMS
PAYMENT IN FULL due upon receipt of this Invoice
unless previous credit arrangements have been
made and approved.
Farm Sales. Real Estatl;. · Antiques
LiquidatiollS
STERMER'S ACCTION SERVICE
~a :,. ; .:'-./3'11-
a~D .., 29~'-+-;':0:S5':'45
DDD -
MIKE STERMER
Auctioneer
NC-;.'ling Too Big or Too Small -
We Sell It AI/!
APPRAISAL FOR THE ESTATE of JOHN L. Sv-iEEZY
Daniel T. Worley, ~Yec.
DATE: December 12, 2006
LIVING ROOM
(Elect.) "View in Broadway" sq. wal.l cLck
Rayo lamp w/shade
(2) record albums
Seve figurines on dresser
Port. sewing machine
Copper kettle w/tripod
Rival food slicer
Fine china dinner set
(2) glass jug lamps
Wiskemann (5) silver pcs. on dropleaf table
Juno lamp w/shade
2 Bibles
Wooden ship on mantle
Bird clock
Inlaid foot stool
Wicker magazine basket
6 pc. silver plate set on marble table
(2) W. Nutting pictures
Maple 3 drawer dresser w/acorn pulls
Marble top wash stand
Marble top hall stand w/mirror
Daughtry on legs
Stuffed arm chair
Hitachi TV
Caned rocker
4 leg dropleaf table w/drawer
(2) small dropleaf end tables
Upholstered arm chair
Child's caned rocker
Sq. coffee table
Painted plank rocker
Victorian style sofa
Victorian sofa, &,loveseat
(2) round end stands
Hoover upright vacuum
Oval marble top table w/gingerbread
Unique coffee table w/bottom drawer & i laid legs
Pictures in frame
"
AMOUNT
$80.00
65.00
12.00
5.00
1. 00
150.00
8.00
15.00
12.00
35.00
275.00
10.00
10.00
2.00
8.00
8.00
15.00
25.00
125.00
325.00
185.00
65.00
NIB
NIB
30.00
325.00
60.00
N/B
45.00
10.00
35.00
50.00
125.00
8.00
20.00
250.00
75.00
25.00 ea.
~toJ 11 ~ ~ 1
~~~(S)
Estate of John L. Sweezy
Page 2
'. Ki tchen
-2 wooden buckets
Fenton bowl
Rayo lamp
Lge. Majolica pitcher
Verichron clock
School. bench
5' wooden bench
Wicker bench
Hanging lamp w/glass prisms
Sev. boxes of misc. dishes
.~moun t
$ 20.00
25.00
65.00
60.00
15.00
150.00
80.00
20.00
375.00
20.00
Dining Room
NFL glasses
Spoon collect. on wall
(2) record albums
Rayo lamp w/green shade
Dec. jug lamp
5 pictures in frames
Stereo cabinet
Atlantic City 1909 ruby glass
Fluted carnival dish
Shot glasses
2 pet seats
Painted rooster tray
Brass tea kettle
Pie safe w/bottomdrawer
5 leg round oak table w/claw feet
4 plank painted chairs
Dry sink
Maple server w/drawers
5.00
20.00
12.00
50.00
225.00
35.00
NIB
35.00
~20.00
5.00
10,00
20.00
5.00
325.0.0
$450 - %650
80.00
350.00
40.00
Office
Slant top desk
Hat rack
Drop leaf table
(small) maple drop leaf
Organ
panasonic fax machine
Sippin jug
Bud vase
Bombas
(2) coffee tables
Brothers typewriter
(2) files
Office chair
(2) pictures in frame
Hallway Upstairs
Zetor
Buggy seat
1st Bedroom
(2) green painted dressers
single bed
Bookcase w/glass front
2 tier book shelf
Wall mirror W/wood frame
Quartz clock
375.00
35.00
125.00
60.00
.'20.00
20.00
15.00
10.00
12.00
5.00
15.00
8.00
NIB
20.00
85.00
125.00
20.00
5.00
20..00
12.00
50.00
5.00
-c4- J .1 f1 '\'1
- - ... "
Estate of John.L. Sweezy
Page 3
$900 ~
2~
20.00
80.00
NIB
12.00
10.00
50.00
15.00
25.00
Garage
1984 Chrysler Lebaron convertible, 2 door
Pipe vises
Long handle tools
Toro snowblower 3.25 hp
Paint & supplies
Toroleaf blower
Appliance dolly
Small hand tools
2 door cabinet
Quick start battery charger
2nd Bedroom
Hamilton pocketwatch
Wooden bucket
Maple nightstand w/drawer
1ge. secretary desk w/top bookshel:"
(2) bedroom dressers
Dec. blanket chest w/birds
Army discharge papers
Tin picture of war
50.00
10.00
30.00
750.00
75.00 ~.
$450 - $900.00 \J!!!!!:,
35.00
25.00
3rd Bedroom
Cedar blanket chest
Arm chair
Single bed
Softwood secretary desk
Wicker lounge
60.00
NIB
5.00
350.00
35.00
Guns
32 police colt pistol w/holster
Iver Johnson 12 ga. single barrel.
W. Richardson dbl. barrel, London fine twist
Japanese rifle
225.00
135.00
250.00
150.00
lotit-/ ,-/; Lfb 7 r"3
~...
~~: ~.
Mike Stermer, Auctioneer
Lic. #AU~002959L
125 Bermudian Ch. Rd.
East Berl.n, Pa. 17316
(717) 292 2855
j;'t! skeet 153
)0) 7QV
APPRAISAL
Personal Property of .1?S77JTE .7ZJIiJJ )..., Sw~t5z-y /:4~ {//cJl;J<.-/4 DI<.).ft::-C/(f\(3, PilI
AU094-L Date j,j.- ?-d
ITEM VALUE
5?) P c..
, ~) t ov
~SDtDO
17o-'()~
~ 0 tv
00t (j1J
:Lv, 6 ~
() 0
/0. ()/J
tLo. 043
/0 J I dO
.( () 0.
,ot)
36 tJd
3f;() 01>
SlJ(j
'f ()() ./.JtJ
'!-btJ,(ji)
/ () OJ 00
7S; 6d
:l1J 0,0
1.S-; () 0
:;IS: (j (J
30.611
IOb.oJ
M; Of)
16,()b
/!ili i be
50, (j)
/ :LOt 60
/~t).C0
60,4
/ 1D,6()
o 64
4Lt,~o
ItJo 00
ijo,OiJ
!O().tJi
I ~
Ot> /)}
--0 (p
Daniel T. Worley
178 Plank Road
York Springs, P A 17372-
Jesse H. Geigle Funeral Home, Inc.
2100 Linglestown Road
Harrisburg, P A 17110-
(717)652-7701
For receipt on the account of: John L. Sweezy
Date of Payment: December 20,2006
Cash/Check #: 10 16
Service Number:06-A-39-72
Balance: $
Payment Amount: $
Balance: $
14602.00
14602.00
0.00
Page 1
November 5,2006
Daniel T. Worley
178 Plank Road
York Springs, PA 17372-
The Funeral Service for John L. Sweezy
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 Funera] Director/Staff
Emba]ming
Cosmeto]ogy/DressinglCasketing
Church or Off Premises Service
Vehicle to transfer to Funera] Home
Hearse (Casket Coach)
FUNERAL HOME SERVICE CHARGES
SELECTED MERCHANDISE:
Solid Cherry Bradford
] 2 Ga Stainless Clark
Register Book
Memoria] folders
$]430.00
$495.00
$175.00
$325.00
$185.00
$294.00
$2904.00
$5625.00
$4563.00
$36.00
$42.00
THE COST OF OUR SERVICES, EQUIPMENT AND MERCHANDISE
THATYOUHAVESELECTED . . . . . . . . . . . . .
Cash Advances
Grave OpeninglRichard E. Weidner
Cemetery Equipment
Evans Clark Vault Sunday Service fee
Newspaper Notices - Patriot News
Certified Copies of the Death Certificate
F]owers/Fall Arrangement
TOTAL CASH ADVANCES AND SPECIAL CHARGES.
CONTRACT PRICE . . . . . . . . . . . .
$13170.00
$650.00
$195.00
$190.00
$178.00
$60.00
$]59.00
$1432.00
$14602.00
History
12/20/2006 Payment - Check
$-14602.00
John L. Sweezy
Page 2
SUB- TOTAL
INITIAL PAYMENT / DISCOUNT / CREDITS
ADDITIONAL PAYMENTS / CHARGES
TOTAL AMOUNT DUE
$14602.00
$14602.00
$0.00
This is a CASH TRANSACTION due in ful1 on January 4, 2007 and, in al1 events, becomes past due and
delinquent upon expiration of due date. A charge of 12% per annum for UNANTICIPATED LATE
PAYMENT will be effective after maturity.
Returning this statement with your payment is not necessary. After receiving your paymen~ a receipt will be mailed to you.
PAID IN FULL, ThankYOUj!~g~F~e, Inc.
John L. Sweezy