HomeMy WebLinkAbout11-02-07
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REV-1500 EX (06-05)
15056051058
OFFICIAL USE ONLY
PA Department of Revenue * C ty Cod Y
Bureau of Individual Taxes . INHERITANCE TAX RETURN oun e ear
POBOX 280601 RESIDENT DECEDENT
File Number
0046
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
I 043-03-9512 I I 12/22/2006 'I I 02/09/1922
Decedent's Last Name Suffix Decedent's First Name MI
I SMITH I I I I JESSE I []
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
IN/A I I I I I n
Spouse's Social Security Number
I
FILL IN APPROPRIATE OVALS BELOW
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS.
.
1. Original Return
=
2. Supplemental Retum
= 3. Remainder Return (date of death
prior to 12-13-82)
= 5. Federal Estate Tax Retum Required
=
4. Limited Estate
= 4a. Future Interest Compromise (date
of death after 12-12-82)
= 7. Decedent Maintained a Living Trust
(Attach Copy ofTrust)
= 10. Spousal Poverty Credit (date of death 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 Telepho!"8lNumber r )
I Francis A. Zulli, Esquire I (717) 232-1:4~5'
Firm Name (If Applicable)
I WION ZULLI & SEIBERT
First line of address
1109 Locust Street
Second line of address
I
.
6. Decedent Died Testate
(Attach Copy of Will)
9. Litigation Proceeds Received
8. Total Number of Safe Deposit Boxes
=
1-
REGISTeR Of WtLLS USi: ONL V
f'
L,
DATE FILED
City or Post Office
I Harrisburg
State
I I PA
ZIP Code
I 117101
Correspondent's e-mail address:
ADDRESS
turn, Including accompanying schedules and statements, and to the best of my knowledge and belief,
er tha the personal representative Is based on all infonnation of which preparer has any knowledge.
ILlNG R URN DATE
's1 e..?
223, Lemont, Pennsylvania 16851
t Street, Harrisburg, Pennsylvania 17101
PLEASE USE ORIGINAL FORM ONLY
L
Side 1
15056051058
15056051058
--.J
~
~
15056052059
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: JESSE F. SMITH
RECAPITULATION
043-03-9512
1. Real estate (Schedule A)
1.
$132,500.00
2. Stocks and Bonds (Schedule B)
2.
$ 0.00
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)
3.
$ 0.00
4. Mortgages & Notes Receivable (Schedule D)
4.
$ 0.00
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)
5.
$24,631.29
6.
$ 0.00
7.
$ 0.00
8.
$157,131.29
9. Funeral Expenses & Administrative Costs (Schedule H)
9.
$14,580.38
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
10.
$2,453.99
11. Total Deductions (total Lines 9 & 10)
11.
$17,034.37
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)
12.
13.
$140,096.92
$ 0.00
14. Net Value Subject to Tax (Line 12 minus Line 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 O.
16. Amount of Line 14 taxable
at lineal rate X 0.045 $140,096.92
17. Amount of Line 14 taxable
at sibling rate X .12
18. Amount of Line 14 taxable
at collateral rate X .15
14.
$140,096.92
15.
$ 0.00
16.
$6,304.36
17.
$ 0.00
18.
$ 0.00
19. TAX DUE
19.
$6,304.36
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
.
Side 2
15056052059
15056052059
L
REV-1500 EX Page 3
, Decedent's Complete Address:
DECEDENT'S NAME
JESSE F. SMITH
STREET ADDRESS
128 HENRY ROAD
File Number
0.0 I 0046
DECEDENT'S SOCIAL SECURITY NUMBER
043-03-9512
CITY
ENOLA
STATE
ZIP
PA
17025
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
$6,304.36
$6,000.00
$315.78
Total Credits ( A + B + C ) (2)
$6,315.78
3. InterestlPenalty if applicable
D. Interest
E. Penalty
TotallnterestlPenalty ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2, Line 20 to request a refund. (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (5A)
$ 0.00
$ 11.42
$ 0.00
B. Enter the total of Line 5 + 5A. This is the BAlANCE DUE.
(5B)
$ 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 0
b. retain the right to designate who shall use the property transferred or its income; 0 0
c. retain a reversionary interest; or 0 0
d. receive the promise for life of either payments, benefits or care? 0 0
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death 0 0
without receiving adequate consideration? 0 0
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? 0 0
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? 0 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. 39116 (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 (OJ percent[72
P.S. S9116 (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 return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an
adoptive parent, or a stepparent of the child is zero (D) 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 decedenfs 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.
METTE. EVANS & WOODSIDE
ATTORNEYS AT LAw
HARRISBURG. PENNSYLVANIA 17108-0729
-
-
-
jagt )rill roW QIe~tctnUnt
.of.
JES SE F. SMITH
I, JESSE F. SMITH, of East Pennsboro Township,
Cumberland County, Pennsylvania, do make, publish and declare
this to be my Last Will and Testament, hereby revoking all
Wills and Codicils by me at any time .made.
ITEM I: I direct that all inheritance and
estate taxes becoming due by reason of my death, whether such
taxes may be payable by my estate or by any recipient of any
property, shall be paid by the Executor out of the property
passing under ITEM IV of this Will, as an expense and cost of
administration of my estate. The Executor shall have no duty
or obligation to obtain reimbursement for any such tax so paid,
even though on proceeds of insurance or other property not
passing under this Will.
ITEM II:
expenses of my last illness
property passing under this
administration of my estate.
I direct the Executor to pay the
and funeral expenses from the
Will as an expense and cost of
ITEM III: If I predecease my wife,
KETURAH E. SMITH, I give and bequeath to her absolutely and in
fee simple all of my household furniture and furnishings,
books, pictures, jewelry, silverware, automobiles, wearing
apparel and all other articles of household or personal use or
adornment and all policies of insurance thereon. If I do not
predecease my said wife, I make said bequest to my children
living at the time of my death, to be divided among them as
they shall agree. Should there be no agreement, such property
shall be divided among them by the Executor in as nearly equal
portions as is deemed practical in the sole discretion of the
Executor, having due regard to the personal preferences of such
children.
ITEM IV: ~(j 'CC :;Igi'l{~r\r' devise and bequeath all
the rest, residue and re~~~~t~~~JU~f estate, not disposed of
Page 1
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in the preceding portions of this Will, to my wife, KETURAH E.
SMITH, if she survives me. If she does not survive me, I make
said bequest and devise to my children, in equal shares. If
any of said children are not living at my death, the share of
said deceased child shall be paid to the then living issue bf
said deceased ~hild, per stirpes.
ITEM V: In the settlement of my estate,
the Executor shall possess, among others, the following powers:
(a) To retain any investments I may have at my
death, including specifically those consisting of
stock of any bank even if I have named such bank as
the Executor herein, as long as the Executor may deem
it advisable to my estate so to do.
(b) To vary investments, when deemed desirable
by the Executor, and to invest in such bonds, stocks,
notes, real estate mortgages or other securities or in
such other property, real or personal, as the Executor
shall deem wise, without being restricted to so-called
"legal investments", and without being limited by any
statute or rule of law regarding investments by.
fiduciaries.
(c) In order to effect a division of the
principal of my estate or for any other purpose,
including any final distribution, the Executor is
authorized to make said divisions or distributions of
the personalty and realty partly or wholly in kind,
and to allocate specific assets among beneficiaries
hereunder so long as the total market value of any
share is not affected by such division., distribution
or allocation in kind. Should it appear desirable to
partition any real estate, the Executor is authorized
to make, join in and consummate partitions of lands,
voluntarily or inVOluntarily, including giving of
mutual deeds, recognizances or other obligations, with
as wide powers as an individual owner in fee simple.
(d) To sell either at public or private sale and
upon such terms and conditions as the Executor may
deem advantageous to the estate, any or all real or
personal estate or interest therein owned by the
Page 2
:/#
estate severally or in conjunction with other persons
or acquired after my death by the Executor, and to
consummate said sale or sales by sufficient deeds or
other instruments to the purchaser or purchasers,
conveying a fee simple title, free and clear of all
trust and without obligation or liability of the
purchaser or purchasers to see to the application of
the purchase money or to make inquiry into the
validity of said sale or sales; also, to make,
execute, acknowledge and deliver any and all deeds,
assignments, options or other writings which may be
necessary or desirable in carrying out any of the
powers conferred upon the Executor in this paragraph
or elsewhere in my Will.
(e) To mortgage real estate, and to make leases
of real estate.
. (f) To borrow money from any party, including
the Executor, to pay indebtedness of mine or of my
estate, expenses of administration or inheritance,
legacy ,estate and othel; taxes, .and to assign and
pledge assets of my estate therefor.
(g) To pay all costs, taxes, expenses and
charges in.connection with the administration of my
estate.
(h) To make distributions of income and of
principal to the proper beneficiaries thereofJ during
the administration of my estate, with or without court
order, in such manner and in such amounts as my
Executor deems prudent and appropriate.
(i) To vote any shares of stock which form a
part of the estate, and otherwise to exercise all the
powers incident to the ownership of such stock.
- .
(j) In the discretion of the Executor, to unite
with other owners of similar property in carrying out
any plans for the reorganization of any corporation or
company whose securities form a part of the estate.
i
~h
1?a'E,e '3
~
i~; .
(k) To disclaim any interest in property which
would devolve to me or my estate by whatever means,
including but not limited to the following means: as
beneficiary under a will, as an appointee under the
exercise of a power of appointment, as a person
entitled to take by intestacy, as a donee of an inter
vivos transfer, and as a donee under a third-party
beneficiary contract.
(1) To do all other acts in the Executor's
judgment deemed necessary or desirable for the proper
and advantageous management, investment and
distribution of the estate.
ITEM VI: Any person who shall have died at
the same time as I shall have, orin a common disaster with me,
or under such circumstances that the order of our deaths cannot
be established by proof, or within thirty (30) days of my
death, shall be deemed to have predeceased me.
ITEM VII: If at any time any child under the
age of twenty-one (21) years shall be entitled to receive any
assets hereunder, the person serving as Executor. shall receive
such assets as Custodian under the Pennsylvania Uniform Gifts
to Minors Act for that beneficiary. Such Custodian may receive
and administer all assets authorized by law, and shall have
full authority as provided in the Pennsylvania Uniform Gifts to
Minors Act to use such funds in the manner it deems advisable
for the best interests of such beneficiary. In addition, said
Custodian shall have all the rights and privileges as to the
Custodianship and its assets as are herein granted to the
Executor as to my estate and the assets therein. I also
designate said Custodian as .successor Custodian of any property
for which I am custodian under any Uniform Gifts to Minors Act.
ITEM VIII: I hereby nominate, constitute and
appoint wife, KETURAH E. SMITH, to be the Executrix, herein
referred to as "Executor". In the event of her death or her
inability or refusal to serve, I nominate, constitute and
appoint my daughter, KETURAH J. KAUFMAN, to be the Executor.
Page 4
L-~Y'
j/
The Executor and Custodian are specifically relieved from the
duty or obligation of filing any bond or other security.
IN WITNESS WHEREOF, I have set my hand and seal to
this, my Last Will ~nd Testament, consisting of this and the
preceding four'(4) pages, at the end of each page of which I
have also set my initials for greater security and better
identification this >>< day of :::rf.,~;!r , 1991.
~.~~ (SEAL)
We, the undersigned, hereby.certify that the foregoing
Will was signed, sealed, published and declared by the above-
named Testator as and for his Last Will and Testament, in the
presence of us, who, at his request and in his presence and in
the presence of each other, have hereunto set our hands and
seals the day and year first above written, and we certify that
at the time of the execution thereof, the said Testator was of
sound and disposing mind and memory.
)1mi ~. 7lf~i~i (SEAL) Re1J}ll~: 1~ [;; !(~
'tJ!P II ui/;,; '/lI"~( SEAL) R~sid ing at ~II fbAI1Jiv ~
~ p. ~a~ ~ I~$
'10? ~ (SEAL) Residing at /!.J.. /I.J,jf3~T
Ch~ Lp~~ !'~(~.
Fl'r
ACKNOWLEDGEMENT
COMMONWEALTH OF PENNSYLVANIA
COUNTYOF ~~
)
)
)
SS:
I, JESSE F. SMITH, Testator, whose name is signed to
the attached or foregoing instrument, having been duly
qualified according to 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.
L/~
JpSE F. SMITH
(SEAL)
Sworn to and subscribed
before me this :< {{ fl..day
of ~' 19'1/.
~~'
Notary Public
y Commission Expires:
(SEAL)
~Seal
.)al1alM. \-10'_ ~
l-Ian\SilUIIl. ~''''''' 29.1993
~=-t'"__1~
My =.."""'. Ot NO\aIi8S
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AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA )
ku J I ..j~AN ) SS:
COUNTY OF ,~-~~~. _ )
'we. jf.~' II 7Ili!lfJ. , ~C;u,~
and f":~5.e. n aL...') f~the Witnesses whose nam;s arf'
signed to the attac ed or foregoing instrument, being duly
qualified according to law, do depose and say that we were
present and saw Testator, JESSE F. SMITH, sign and execute the
instrument as his Last Will and Testament; that Testator signed
willingly and that he executed said Will as his free and
voluntary act for the purposes therein expressed; that each of
us in the hearing and sight of the Testator signed the Will as
Witnesses; and that to the best of our ~nowledge the Testator
waS at that time eighteen (18) or more years of age, of sound
mind and under no constraint or undue influence.
~ J. iu'~. ~~1H. ~
~f 0 ~
Witne~
Sworn to and subscribed
beforQme this c:< ~ ~ day
of ()~ ' 191/.
t "
My Commission Expires:
(SEAL)
Nolarial Seal
Janel M. Howe!, Notary P\tlIC
Harrisbug, Dauptin Counly
My Con'1IT1llsD1 expires NcPI. 29, 1993
. I\SSOCia1iOI1 of NoIadeS
~
CODICIL TO
:Iff 1. 'JI-Tltill ~ 7jf 1 ZOU.7fIAN /2 AN 11: 35
11.LCtS.l :lI:UlCtttv ~~S ct.1n:en
CLERt( OF
. ORPHAN'S COURT
CUI/SFi-:'. ,'", : r~,., P;\
OF
JESSE F. SMITH
I, JESSE F. SMITH, of East Pennsboro Township, Cumberland County,
Pennsylvania, declare this to be the sole Codicil to my Last Will and Testament dated
June 28 1991.
FIRST:
Idelete Item VIII in my Last Will and Testament and in substitution
thereof, I add the following paragraph:
Item VIII. I hereby nominate, constitute and appoint my wife, KETURAH E.
SMITH to be the Executrix of my estate., In the event she is unable or unwilling to serve,
then I nominate, constitute and appoint my daughter, PAMELA CORL and my son,
JESSE F. SMITH, JR., as Co-Executors of this my Last Will and Testament.
SECOND: In all other respects, I hereby ratify, confirm'and republish my Last
Will and Testament dated June 28, 1991, together with this sole Codicil, as and for my
last Will.
IN WIlNESS WHEREOF, I, have hereunto set my hand and seal this dJ 9 day
of July, 2003.
~~~
V JesseF.Smith
Signed, sealed, published and declared by the above-named, JESSE F. SMITH, as
and for a Codicil'to his Last Will arid Testament, in our presence, who in his presence,
and in the pres f each other, and a his request, have hereunto set our hands as
subscribi esses h
/()9~/~
Address
~/ //1
~ddress
f""
COMMONWEALTH OF PENNSYLVANIA
: SS:
COUNTY OF DAUPHIN
We, JESSE F. SMITH, ~_ ~}?,C/ d' 4. ;!fuLL' and
c:~r ,Y .AI.t:-lZ<.'.6Lf;' . the Testator and the witnesses
respectively, whose names are signed to the attached or foregoing instrument, being first
duly sworn, do hereby declare to the undersigned officer that the Testator signed the
instrument as a Codicil to his Last Will and that he signed voluntarily and that each of
the witnesses in the presence of the Testator at his request, and in the, presence of each
other, signed the Codicil to his Will as a witness and that to the best of the knowledge of
each witness, the Testator was at the time 18 or more years of age, of sound mind and
under no constraint or undue influence.
Sworn to and subscribed before
me by JESSE F. SMITH, the
Testator, and sUlcribed and sworn to
before me by../ /'t.et."1.Lz./ If zfd~f' ' an,d
...~/~-y ,:.dLLJZLb L ~. the witnesses,
-~s ,,",...r9.~dayofJuly, 2003.
(,-a_A ~~_
Not~ryblic (3
My Commission Expires:
2
REV-1502EX + (1I-98)
COMMONWEALTH OF PENNSYlVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF
JESSE F. SMITH
FILE NUMBER
21-07-0046
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
128 Henry Road, Enola, East Pennsboro Township, Cumberland County, Pennsylvania
VALUE AT DATE
OF DEATH
$132,500.00
Single family residence acquired by decedent by deed dated October 23, 1958, from Enola Homes, Inc.
Recorded in Cumberland County Recorder of Deeds, Book T-18, Page 204
Sold to Charles E. Wilson, Sr. and Mary e. Hallett on September 21, 2007 for $132,500.00
See attached settlement sheet
TOTAL (Also enter on line 1, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
$132,500.00
OMS NO. 2502.0265'-'-
I~. B. TYPE OF LOAN:
L . 1.[]FHA 2.[]FmHA 3. [~CONV. UNINS. 4.0VA 5. ]CONV. INS.
U.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT. 6. t~~EC~~,~BER:._ .17. ~?:,,~~?~~~ER:
SETTLEMENT STATEMENT
8. MORTG.I\GE INS CASE NUMBER:
C. NOTE: This form is furnished to give you e statement of actuel settlement costs. Amounts paid to and by the settlement agent ere shown.
Items marked "[POC]" were paid outside the closing; they ere shown here for informational purposes end are not included in the totals.
1.0 3198 (WILSON. 128 HENRY.PFOIWILSON. 128 HENRY/10)
D. NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER:
Charles E. Wilson, Sr. and Jesse F. Smith, Jr. and Members 1st FCU
Mary E. Hallett Pamela Corl
506 Beacon Hill Road 128 Henry Road
New Cumberland. PA 17070 Enola, PA 17070
G. PROPERTY LOCATION: H. SETTLEMENT AGENT: 23-1284840 I. SETTLEMENT DATE:
128 Henry Road Wion, Zulli & Seibert
Enola, PA 17025 September 21, 2007
Cumberland County, Pennsylvania PLACE OF SETTLEMENT
109 Locust Street
Harrisburg. PA 17101
J. sUMMARY OF B'fiOWER'S iRANSACTION K. SUMMARY :)F SELLFR'S TRANSAC ION
In~ r.l'lnss . Antf nl.lr:: rr ~r::1 r::D.
101. Contract Sales Price 132,500.00 401. Contract Sales Price 132,500.00
102. Personal Property 402. Personal Property
103. Settlement Charaes to Borrower (Line 1400) 4,534.96 403.
104. 404.
105. 405.
r r r /TAm", r CA
106. CitvfTown Taxes to 406. CitvfTown Taxes to
107. County Taxes 09/22/07 to 01/01/08 167.06 407. CountvTaxes 09/22107 to 01/01/08 167.06
108. School Taxes 09/22/07 to 07/01/08 1,462.38 408. School Taxes 09/22/07. to 07/01/08 1,462.38
109. SewerfTrash 09/22/07 to 10/01/07 12.38 409. SewerfTrash 09/22/07 to 10/01/07 12.38
110. 410.
111. 411.
112. 412. -'
120. GROSS AMOUNT DUE FROM BORROWER 138,676.78 420. GROSS AMOUNT DUE TO SELLER 134,141.82
200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER:
201. Deoosit or ealTiest money 501. Excess Deoosit (See Instructionsl
202. Principal Amount of New Loan(s) 132,500.00 502. Settlement Charaes to Seller (Line 1400) 2,595.85
203. Existina loan(s) taken subiect to 503. Existina (oan(s).taken subiect to
204. 504.' Payoff of first Mortgage
205. 505. Payoff of second Mortaaae
206. 506.
207. 507.
208. 508.
209. 509.
AdJustments F-or Items UnDeld Bv Seller .Arliustments For terns Ilnoata !jV selier
210. CitvlTown Taxes to 510. CitvfTown Taxes to
211. County Taxes to 511. Countv Taxes to
212. School Taxes to 512. School Taxes to
213. 513.
214. 514.
215. 515.
216. 516.
217. 517.
218. 518.
219. 519. I
220. TOTAL PA/D BY/FOR BORROWER 132,500.00 520. TOTAL REDUCTION AMOUNT DUE SELLER I 2,595.85
300. CASH AT SETTLEMENT FROMITO BORROWER: 600. CASH AT SETTLEMENT TOIFROM SELLER:
301. Gross Amount Due From Borrower (Line 120) 138,676.78 601. Gross Amount Due To Seller (Line 420) I 134,141.82
302. Less Amount Paid By/For Borrower (Line 220) I( 132,500.00) 602. Less Reductions Due Seller (Line 520) 1< 2,595.85
303. CASH ( X FROM) ( TO) BORROWER I 6,176.78 603. CASH ( X TO) ( FROM) SELLER I 131,545.97
~
HUD.l (3-86) RESPA. HB4305.2
.-
L. SETTLEMENT CHARGES
-700. TOTAL COMMISSION Based on Price !t rm n noon % PAID FROM PAID FROM
Division of Commission (Jjne 700) 8S Follows: BORROWER'S SElLER'S
701. $ to FUNDS AT FUNDS AT
702. $ to SETTLEMENT SETTLEMENT
703. Commission Paid at Settlement
704. to
BOO. ITE;MS PAYARI ;:: IN ~ON I NWITH lOAN
801. Loan Origination Fee 0.0000 % to
802. Loan Discount % to
B03. Appraisal Fee to
804. Credit Report to
805. Lender's Inspection Fee to
806. Mortaaae Ins. App. Fee to
807. Assumption Fee to
808. Remainder of Application Fee to Members 1st FCU 350.00
809. Underwriting Fee to Members 1 st FCU 75.00
810. Document Prep Fee to Members 1st FCU 275.00
811.
900 ITEMS BY LENDER TO BE PAID IN ADVANCE;
901. Interest From 09/21/07 to 10/01/07 @ $ 25.303800/day ( 10 days %) 253.04
902. Mortqage Insurance Premium for months to
903. Hazard Insurance Premium for 1.0 vears to
904.
905.
1000. RESERVES D1=POSITI=O WITH LENDER
1001. Hazard Insurance 3.000 months $ 43.08 oer month 129.24
1002. MortQage Insurance months ~ $ oer month
1003. CltylTown Taxes months '- $ oer month ..
1004. CountvTaxes 8.000 months '- $ 44.82 per month 358.56
1005. School Taxes 4.000 months @ $ 154.45 per month 617.80
1006. months $ oer month
1007. months $ oer month
1008. Aogregate Escrow Adiustment months $ oer month -378.43
1100. TITLE CHARGES
1101. Settlement or Closina Fee to
1102. Abstract or Title Search to
11 03. Title Examination to
1104, Title Insurance Binder to
1105. Document Preoaratlon to Wlon, Zulli & Seibert 125.00
1106. Notarv Fees to Wion, Zulli & Seibert 10.00 10.00
1107. Attorney's Fees to
(inciudes above item numbers: )
1108. Title Insurance to Commonwealth Land Title BASIC RATE 1 023.75
(includes above item numbers: )
1109. Lender's Coverage $
1110. Owner's Coverage $ 132,500.00
1111. Closing Protection Letter to Commonwealth Land Title 35.00
1112. Endorsements - 1001300/900 to Wion, Zulli & Seibert 150.00
1113. Overnight MaiVEmaillWire Fee to Wion, Zulli & Seibert 75.00
1200. GOVERNMENT R1=~ORDING AND TRANSFER CHARGE;S
1201. Recording Fees: Deed $ 41.50 ; Mortgage $ 69.50; Releases $ 111.00
1202. CIty/County Tax/Stamos: Deed 1.325.00' Mortgaqe 1,325.00
1203. State Tax/Stamos: Revenue Stamps 1,325.00; Mortaaae 1,325.00
1204.
1205.
1300. ADDITIONAl ~ETTLEMENT CHARGES
1301. Survey to
1302. Pest Inspection to
1303. 2007/08 School Taxes to Debbie Lupoid, TC POC $630.435 1,260.85
1304.
1305.
1400. TOTAL SETTLEMENT CHARGES (Enter on Lines 103, Section J and 502, Section ~ _. 4,534.96 2.595.85
By "g""" page 1 of ..too,........, ... "g"lOOes """"'od,. """'p' of, ",mp,am of p~ '"; Pii~ IBm"t
. . 1M ~:^ \
Certified to be a true copy. Wibn Z~l & Seibe~/ -
SettlelrneJi Agent
V
\ \.)
PaQe 2
(WILSON - 128 HENRY / WILSON - 128 HENRY /10 )
ACKNOWLEDGMENT OF RECEIPT OF SETTLEMENT STATEMENT
Buyer: Charles E. Wilson, Sr. and Mary E. Hallett
Seller: Jesse F. Smith, Jr. and Pamela Corl
Settlement Agent: Wion, Zulli & Seibert
(717)232-1488
Place of Settlement: 1 09 Locust Street
Harrisburg, PA 17101
Settlement Date: September 12, 2007
Property Location: 128 Henry Road
Enola, PA 17025
Dauphin County, Pennsylvania
I have carefully reviewed the HUD-1 Settlement Statement and to the best of my knowledge and belief, it is a true and
accurate statement of all receipts and disbursements made on my account or by me in this transaction. I further certify
that I have received a copy of the HUD-1 Settlement Statement.
~ '
} ,
Q) ~A~/l-~lUU~1 fJt.,
Cas E. Wilson, Sr.
"'\~ "c- ~
Mary H~
-)
By:
Pamela Carl, Co-Executor
To the best of my knowledge, the HUD-1 Settlement Statement whi
the funds which were received and have been or will be disbursed y
transaction.
WARNING: It is a crime to knowingly make false statements to th U ited States on this or ny similar form. Penalties
upon conviction can include a tine and imprisonment. For details ection 1001 and Section
1010.
HUD-1 (3-86) RESPA, HB4305.2
REV.' 508 EX + (&-98)
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COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF JESSE F. SMITH
FILE NUMBER
21-07-0046
Include the proceeds of litigation and the date the proceeds INere received by the estate. All property joInt1y-owned with the right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
BELCO Credit Union, Account #128620
Regular Savings
Checking
Certificate #30086
Certificate #36503
Certificate #40934
Certificate #42975
$5,986.11
$3,111.36
$1,288.93
$6,604.70
$1,092.06
$2,123.13
2.
2000 Nissan Frontier King Cab Truck
Fair condition - high mileage
$4,425.00
TOTAL (Also enter on line 5, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
$24,631.29
REV-1S11 EX + (12-99)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
JESSE F. SMITH
FILE NUMBER
21-07-0046
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Nelli Funeral Home - transportation services $310.00
Patriot News - Obituary $106.60
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s)
Social Security Number(s) I EIN Number of Personal Representative(s)
Street Address
City State Zip
-
Year(s) Commission Paid:
2. Attorney Fees: FRANCIS A. ZULLI, ESQUIRE $3,250.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) $3,500.00
Claimant Pamela Corl
Street Address 128 Henry Street
City Enola State PA Zip 17025
-
Relationship of Claimant to Decedent
4. Probate Fees Register of Wills $329.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Cumberland Law Journal - advertisement of Letters $75.00
8. The Sentinel - advertisement of Letters $213.26
9. Nationwide Insurance - reimbursement for overpayment $36.33
10. Erie Insurance - homeowners premium $104.00
11. Mark Heckman - real estate appraisal fee $350.00
12. Pamela Corl - reimbursement for payment of trash dumpster $575.00
13. Debbie Lupoid, TC - real estate taxes $603.75
14. BELCO Credt Union - check charge $10.70
TOTAL FROM CONTINUATION PAGE $5,116.74
TOTAL (Also enter on line 9, Recapitulation) $14,580.38
..
(If more space IS needed, Insert additional sheets of the same size)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
CONTINUATION PAGE
SCHEDULE H
ESTATE OF
JESSE F. SMITH
FILE NUMBER
21-07-0046
ITEM
NUMBER
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
DESCRIPTION
VALUE AT DATE
OF DEATH
$84.66
$294.56
$40.48
$126.50
$113.00
$630.43
$1,325.00
$1,260.65
$20.00
$40.00
$1,181.46
PPL- electric service charges
UGI - gas service charges
PA American Water - water service charges
East Pennsboro TWP - sewer service charges
Erie Insurance - homeowners premium
Debbie Lupoid, TC - real estate taxes
Recorder of Deeds - 1 % realty transfer tax
Debbie Lupoid, TC - school real estate taxes
Register of Wills - filing inventory
Wion Zulli & Seibert - notaries, copies and miscellaneous expenses
Jesse F. Smith, Jr. - reimbursement for mileage for estate business (2,436 miles @ 48.5 cents per mile)
TOTAL
$5,116.74
REV-1512 EX + (12-03)
*'
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
ESTATE OF
JESSE F. SMITH
FILE NUMBER
21-07-0046
Record debts Incurred by the decedent prior to death which remained unpaid as of the date of death, Include unrelmbursed medical expenses.
ITEM
NUMBER
1.
DESCRIPTION
AMOUNT
$2,453.99
BELCO Credit Union - auto loan
TOTAL (Also enter on line 10, Recapitulation) $2,453.99
(If more space is needed, insert additional sheets of the same size)
REV-1513 EX + (9-00))
.
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
RELATIONSHIP TO DECEDENT AMJUIlTOR
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) ~
OFESTATE
TAXABLE DISTRIBUTIONS pnclude outright spousal distributions, and
I transfers under Sec. 9116 (a) (1.2)]
1. Pamela Corl, 128 Henry Road, Enola, PA 17025 Daughter 1/6 residue
2. Sandra L. Smith, 2965 Rumson Drive, Harrisburg, PA 17104 Daughter 1/6 residue
3. Jesse F. Smith, Jr., P.O. Box 223, Lemont, PA 16851 Son 1/6 residue
4. Keturah J. Kaufman, 2965 Rumson Drive, Harrisburg, PA 17104 Daughter 1/6 residue
5. Dona Troup, 124 Keesey Street, York, PA 17402 Daughter 1/6 residue
6. Emily Mianulli, 11 South Front Street, Mifflintown, PA 17059 Granddaughter 1/18 residue
7. Jessie Reed, 3829 Durham Road, Harrisburg, PA 17110 Grandson 1/18 residue
8. Michael Smith, 27 North Main Street, Mifflintown, PA 17059 Grandson 1/18 residue
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON UNES 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
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART n. ENTER TOTAL NON- TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
0.00
(If more space IS needed, Insert additional sheets of the same size)