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Home My WebLink About11-20-07 .....J REV-1500 EX (06-05) PA Department Df Revenue Bureau Df Individual Taxes PO BOX 280601 Harrisburg, PA 17128-0601 15056041158 ENTER DECEDENT INFORMATION BELOW INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY CDunty CDde Year 21 D7 File Nu mber 0811 Social Security Number 204-03-6448 Date of Death 08292007 Date of Birth 05011922 Decedent's Last Name BAUGHMAN Suffix Decedent's First Name NAOMI MI G (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number Future Interest Compromise (date of death after 12-12-82) Decedent Maintained a Living Trust (Attach Copy of Trust) Spousal Poverty Credit (date of death 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 RICHARD C. SNEL8AKER 717-697-8528 FILL IN APPROPRIATE BOXES BELOW [KJ 1. Original Return o ~: Limited Estate rn 6. Decedent Died Testate (Attach Copy of Will) o 9. Litigation Proceeds Received THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS o 2. 04a. 07. 010. Supplemental Return o o 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required L 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) Firm Name (If Applicable) SNEL8AKER & BRENNEMAN, P.C. City or Post Office MECHANICS8URG State ZIP Code PA 17055 f"-.) as ,:,p REGIS~0wIllS U:2:0NlYI~t!;) :':~::O 0 "'"J ,_,) "jl::tO <: ('.i t3 ))>F;; N rr iT1 3::0 0 :J-:: CJ .' u.J:;:::<::' '::''c"J 0 :P- Oll :x c . ~ 'R JZ c..:> DATE FILED .r:- First line of address 44 WEST MAIN STREET Second line of address p.o. BOX 318 Correspondent's e-mail address: Under penalties Df perjury, I declare that I have examined this return, including accDmpanying schedules and statements, and tD the best Df my knowledge and belief, it is true, correct and com plete. Declaration Df preparer other than the personal representative is based on all informatiDn of wh ich preparer has any knowledge. ~L~~ETURN 406 DARLA ROAD, MECHANICSBURG, PA n055 DATE ADDR RICHARD C. SNEL8AKER, ESQUIRE 44 WEST MAIN STREET, MECHANICSBU G SPA PLEASE USE ORIGINAL FORM ONLY L Side 1 15056041158 6M4647 2,000 15056041158 .....J --.J 15056042159 REV-1500 EX Decedent's NameBA UG HMA N NA OMI RECAPITULATION Decedent's Social Security Number 204-03-6448 G 1. Real estate (Schedule A) . 1. 128500.00 3940.72 0.00 2. Stocks and Bonds (Schedule B) . . 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . 3. 4. Mortgages & Notes Receivable (Schedule D). . . . . . . . . . . . . . 4. 0.00 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E). . 5. 188610.94 3105.12 6. Jointly Owned Property (Schedule F) 0 Separate Billing Requested . 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) 0 Separate Billing Requested . 7. 0.00 324156.78 17412.66 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. 2914.46 20327.12 11. Total Deductions (total Lines 9 & 10). . . . 11. 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. 303829.66 0.00 303829.66 14. Net Value Subject to Tax (Line 12 minus Line 13) 14. TAX COMPUTATION. SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers u~er Sec. 9116 (a)(1.2) X .0_ 16. Amount of Line 141axable at lineal rate X .O~ 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 0.00 15. 0.00 16. 13672.33 17. 0.00 18. 0.00 19. 13672.33 00 303829.66 0.00 0.00 19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 15056042159 6M4648 2.000 15056042159 --.J ece en S om pIe e ress: DECEDENT'S NAME BAUGHMAN NAOMI G STREET ADDRESS 1393 LOWTHER ROAD, LOWER ALLEN TOWNSHIP CUMBERLAND COUNTY CITY II STATE I: ZIP CAMP HILL PA 17011- REV-1500 EX Page 3 D d t' C I t Add File Number 0811 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1) 13672.33 0.00 0.00 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total Credits (A + B + C) (2) 0.00 0.00 0.00 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 box on Page 2, Line 20 to request a refund. (4) 0.00 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 13672.33 A. Enter the interest on the tax due. (5A) 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58) Make Check Payable to: REGISTER OF WILLS, AGENT 13672.33 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: a. retain the use or income of the property transferred; . . . . . . . . . . . . . . b. retain the right to designate who shall use the property transferred or its income; c. retain a reversionary interest; or . . . . . . . . . . . . . . . . . . . . . . . . d. receive the promise for life of either payments, benefits or care? ........ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? . 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes o o o o o o o No [Xl [K] [K] 00 00 00 [K] 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) percenl[72 P.S. g9116 (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. 39116 (a) (1.1) (jl)]. 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. F or 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 use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. g9116(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. 89116(1.2) [72 PS. 89116(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. 89116(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. 6M4671 1.000 REV-1502 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER Naomi G. Baughman 21 07 0811 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 hailing reasonable knooMedge of the relevant fads. Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH 128,500.00 Property known and numbered as 1393 Lowther Road, Lower Allen Twp., Cumberland County, Camp Hill, PA 17011, sale value (see attached settlement sheet) 3W46951.000 TOTAL (Also enter on line 1, Recapitulation) (If more space is needed, insert additional sheets of the same size) $ 128,500.00 Previous editions are obsolete form HUD.1 (3J8d) ref Handbook 4308.2 A. Settlement Statement u.s. Department of Housing and Urban Development OMB No. 2502-0265 (exDires 9/30/2006) adison B. TYPE OF LOAN 1. OFHA 2. DFmHA 3. DConv. Un ins. 4. OVA 5. DConv. Ins. 6. FILE NUMBER 17. LOAN NUMBER erVICeS MS1596 12367918 8. MORTGAGE INSURANCE CASE NUMBER C. Note: I ntS form Is fumlsnedto gIve you a slalemenl 0' aC1U1I1 seltlement costs. Amoun spaid. 0 and I y me sellfement ~gent are snown. I TitleExpress Settlement System Itema marked "(p.o.c.)" were paid outside the closing; they are shown here for ,"formation purposes and are not ,ncluded In the totals. WARNING: It Is a crime to knowingly make false statements to the United States on this or any other similar form. Penalties upon Printed 09/05/2007 at 12:24 OS conviction can Include a Ilne and Imorlsonmen!. For details see: Title 18 U. S. Code Section 1001 and Section 1010. D. NAME OF BORROWER: Sharon D. Woermann ADDRESS: 1393 Lowther Road. CamD Hill. PA 17011 E. NAME OF SELLER: Estate of Naomi G. Baughman ADDRESS: F. NAME OF LENDER: M& T Bank ADDRESS: One Fountain Plaza 6th Floor Buffalo NY 14203 G. PROPERTY ADDRESS: 1393 Lowther Road, Camp Hill, PA 17011 Lower Allen T ownshiD H. SETTLEMENT AGENT: Madison Settlement Services, Telephone: 717.243.2121 Fax: 717.243.2646 PLACE OF SETTLEMENT: 8 Irvine Row Carlisle. PA 17013 I. SETTLEMENT DATE: 09/05/2007 J. SUMMARY OF BORROWER'S TRANSACTION: K. SUMMARY OF SELLER'S TRANSACTION: 100. GROSS AMOUNT DUE FROM BORROWER 400. GROSS AMOUNT DUE TO SELLER 101. Contract sales Drice 128500.00 401. Contract sales Drice 128500.00 102. Personal ProDertv 402. Personal ProDertv 103. Settlement charnes to borrower !line 140m 3 912.28 403. 104. 404. 105. 405. Adiustments for items Daid bv seller in advance Adiustments for items Daid bv seller in advance 106. City/town taxes 406. City/town taxes 107. County taxes 09/05/07 to 12/31/07 181.10 407. County taxes 09/05/07 to 12/31/07 181.10 108. School taxes 408. School taxes 109. 2007 School Tax 1.265.60 409. 110. 410. 111. 411. # 112. 412. 120. GROSS AMOUNT DUE FROM BORROWER 133 858.98 420. GROSS AMOUNT DUE TO SELLER 128681.10 200. AMOUNTS PAID BY OR ON BEHALF OF BORROWER 500. REDUCTIONS IN AMOUNT DUE TO SELLER 201. DeDosit or earnest money 10000.00 501. Excess Deoosit Isee instructions) 10000.00 202. Princioal amount of new loans 102.800.00 502. Settlement charaes to seller Iline 140m 1.295.00 203. Existina loanls\ taken subiect to 503. Existina loanls) taken subiect to 204. 504. Payoff of First Mortaaae Loan 205. 505. 206. 506. 207. 507. 208. 508. 209. 509. Adiustments for items unDaid bv seller Adiustments for items unDaid bv seller 210. City/town taxes 510. City/town taxes 211. County taxes 511. County taxes 212. School taxes 07/01/07 to 09/05/07 226.23 512. School taxes 07101/07 to 09/05107 226.23 213. 513. 214. 514. 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. 220. TOTAL PAID BY/FOR BORROWER 113 026.23 520. TOTAL REDUCTION AMOUNT DUE SELLER 11.521.23 300. CASH AT SETTLEMENT FROM OR TO BORROWER 600. CASH AT SETTLEMENT TO OR FROM SELLER 301. Gross amount due from borrower !line 12m 133.858.98 601. Gross amount due to seller !line 42m 128.681.10 302. Less amounts Daid by/for borrower IIine 22m 113.026.23 602. Less reduction amount due seller lline 52m 11 521.23 303. CASH FROM BORROWER 20 832.75 603. CASH TO SELLER 117159.87 SUBSTITUTE FORM 1099 SELLER STATEMENT: The Information contained herein Is Important tax Information and Is being furnished to the Internal Revenue Service. If you are required to Ille a return, a negligence penally or other sanction will be imposed on you If this Item Is required to be reported and the IRS determines that It has not been reported. The Contract Sales Price described on Ifne 401 above constitutes the Gross Proceeds of this transaction. You are required by law to provide the seltlement agent (Fed. Tax 10 No: ) with your correct taxpayer Identification number. If you do not provide your correct taxpayer Identification number, you may be subject to civil or criminal penalties Imposed by law. Under penalties of perjury, J certify that the number shown on this statement is my correct taxpayer identification number. TIN: _ _ '_' _ SELLER(S) SIGNATURE(S): SELLER(S) NEW MAILING ADDRESS: SELLER(S) PHONE NUMBERS: (H) (W) Previous edlilons are obaoleie U,S, DE!PARTMENT OF HOUSING AND URBAN DEVELOPMENT SETTLEMENT STATEMENT File Number: MS1596 S S 'otm HUO.1/3/81J re' Handbook 43D5,2 PAGE 2 Title Express ettlement ,ystem Printed 09/05/2007 at 12:24 OS L. SETTLEMENT CHARGES PAID FROM PAID FROM 700. TOTAL SALES/BROKER'S COMMISSION based on price $128,500.00 = BORROWER'S SELLER'S Division of commission (fine 700) as follows: FUNDS AT FUNDS AT f--.... 701. $ to SETTLEMENT SETTLEMENT 702. $ to 703, Commission paid at Settlement 800. ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Oriaination Fee % 802. Loan Discount % 803. Aporaisal Fee to Kirchmeyer.com LR 350.00 804. Credit Reoort to CBC $6.25 POC by Lender 805. Lender's Insoection Fee 806. Mortaaae Aoolication Fee 807. Assumotion Fee 808. Tax Serv1721 Flood Cert(8) to First American RETS/First American FDS LR 80.00 809. Aoolication Fee to M& T Bank (P.O.C.l100.00 Buyer LR 810. Processino Fee to M&T Bank LR 195.00 811. Doc/Prep Fee to M&T Bank LR 400.00 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest From 09/05/2007 to 09/13/2007 (a)$ 16.6280 /dav 8 Days LR 133.03 902. Mortaaoe Insurance Premium for to 903. Hazard Insurance Premium for 1 year to Allstate Insurance (P.O.C.) 458.78 Buyer 904. 905. 1000. RESERVES DEPOSITED WITH LENDER FOR 1001. Hazard Insurance mo. (Q) $ 38.23 /mo LR 1002. Mortoaoe Insurance mo. (Q) $ /mo 1003. City Property Tax mo. (Q) $ /mo 1004. County Property Tax 7 mo. (Q) $ 47.60 /mo LR 333.20 1005. School taxes 3 mo. (a) $ 104.55 /mo LR 313.65 1009. Aooreoate Analysis Adiustment to M&T Bank LR -646.85 0.00 1100. TITLE CHARGES 1101. Settlement or closina fee 1102. Abstract or title search 1103. Title examination 1104. Title insurance binder 1105. Document Preoaration 1106. Notarv Fees to Dawn M. ShOOD 35.00 1107. Attornev's fees !includes aboye items No: ) 1108. Title Insurance to Lafayette Settlement Services, LLC 1 003.75 (includes above items No: ) 1109. Lender's Coyeraoe $ 102 800.00 - 1 003.75 1110. Owner's Coyeraoe $ 128500.00 - 1111. End 100 300 900 to Lafayette Settlement Services LLC 150.00 1112. ICPL to Lafayette Settlement Services LLC 35.00 1113. Proc(75)Wire(17)Courier(20l to Madison Settlement Sycs.Chambersbura. LLC 112.00 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recordino Fees Deed $ 38.50 . Mortaaae $ 70.50 . Release $ 109.00 1202. CitY/County tax/stamos Deed $1 285.00 : Mortaaoe $ 1,285.00 1203. State Tax/stamos Deed $1,285.00 . Mortaaae $ 1.285.00 1204. 1205. 1300. ADDITIONAL SETTLEMENT CHARGES 1301. Survey 1302. Pest Insoection 1303. Tax Certification to Bonnie K. Miller Treasurer 10.00 1304. Sewer Pd to 9/30/07 by Seller to Estate of Naomi G. Bauahman 9.00 1305. Trash Pd to 9/30/07 by Seller to Estate of Naomi G. Bauahman 15.50 1400. TOTAL SETTLEMENT CHARGES (enter on lines 103. Section J and 502 Section K) 3.912.28 1295.00 I hive carefully reviewed the HUD.1 Settlement Stltementlnd to the best of my knowledge Ind belief, it is I true Ind Iccurlte stltement of III receipts Ind disbursements mlde on my Iccount or by m_eln this trsnslc . ur1her r1ify thltl hive received I copy of the HUD.1 Settlement Stltement. HUD CERTIFICATION OF BUYER AND SELLER Esllte of Nloml G. Blughman g~.;~ ~~ WARNING: IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE UNITED STATES ON THIS OR ANY SIMILAR FORM. PENALTIES UPON CONVICTION CAN INCLUDE A FINE AND IMPRISONMENT. FOR DETAILS SEE TITLE 18: U.S. CODE SECTION 1001 AND SECTION 1010. The HUD-1 Settlement SII transaction. I hive cause DATE: q-5-67 SETTLEMENT AGENT: REN-1S03 EX + \6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE 8 STOCKS & BONDS FILE NUMBER Naomi G. Baughman 21 07 0811 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 3,940.72 1. MetLife 62 shares of common stock valued at $63.56 per share 3W46961.000 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 3,940.72 REV-1508 EX + (6-98) COMMONWEALTH OF PENNSYL VANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Naomi G. Bauqhman FILE NUMBER 21 07 0811 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jolntly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Masland & Barrick Advisory, Inc. investment account, #5WL909319 154,970.58 2 Pennsylvania State Employees Credit Union savings account, #0204-01 1,914.87 3 Pennsylvania State Employees Credit Union certificate of deposit, account #0204-50 10,040.04 4 Sovereign Bank checking account, #2331045623 21,326.26 5 Refunds due the decedent 359.19 3W46AD 1.000 TOTAL (Also enter on line 5, Recaoitulation\ $ (If more space is needed, insert additional sheets of the same size) 188,610.94 REV-1509 EX + (6-98) SCHEDULE F JOINTLY-OWNED PROPERTY COIViMONVIIEA L TH OF PENNSY LV ANIA II'HRITANCETAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Naomi G. Baughman 21 07 0811 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT T8IIANT(S) NAME ADDRESS RELA TIONSHIP TO a:GEDENT A Farnham, Donna J 406 DarIa Road, Mechanicsburg, PA 17055 Daughter JOINTL y-oWNED PROPERTY: LETTER DATE DESCRPTION OF PROPERTY %OF DA TE OF DEATH ITEM FOR JOINT MADE INCLUOE NAME OF FINANCIAL INSTITUTION ANO BANK ACCOUNT DA TE OF DEA TH DECO'S VALUE OF NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEEO FOR NUMBffi TENANT JOINT JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTffiEST a:GEDENrS INTffiEST 1 A 2/16/2006 Sovereign Bank 6,210.23 50.0000 3,105.12 savings account, #2334300775 TnTAI 'A'" n'''r nn lina a R""...nih.I"linn\ 1'1: 3,105.12 (W rrore space is needed, insert add~ional sheets of the same size) 3W46AE 1.000 R~V-15'1 EX +,(12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Naomi G. Baughman SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS Debts of decedent must be reported on Schedule I. FILE NUMBER 21 07 0811 ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Rolling Green Cemetery cemetery expenses 2,303.00 Total from continuation schedules 7,273.00 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 Snelbaker & Brenneman, P.C. 3,500.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 421.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. 1 Cumberland Law Journal advertising Executrix notice 75.00 2 Patriot News advertising Executrix notice 139.18 Total from continuation schedules 3,701. 48 TOTAL (Also enter on line 9, Recapitulation) $ 17,412.66 3W46AG 1.000 (If more space is needed, insert additional sheets of the same size) Estate of: Naomi G. Baughman 204-03-6448 Schedule H Part 1 (Page 2) Item No. Description Amount 2 Myers Funeral Home funeral expenses 7,273.00 Total (Carry forward to main schedule) 7,273.00 Estate of: Naomi G. Baughman 204-03-6448 Schedule H Part 7 (Page 2) 3 Recorder of Deeds filing fee for power of attorney for sale of real estate 17.00 4 Register of Wills filing fee for Inheritance Tax Return 15.00 5 Register of Wills short certificates 12.00 6 Settlement charges on property located on Lowther Road: a. School taxes - $226.23 b. Transfer tax - $1285.00 c. Tax certification - $10.00 1,521.23 7 Snelbaker & Brenneman, P.C. fees associated with the sale of property located on Lowther Road 1,136.25 8 Reserve for filing fees, accountant fees, and other miscellaneous costs associated with the administration of decedent's estate 1,000.00 Total (Carry forward to main schedule) 3,701.48 REV-1512 EX + (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RElURN RESIDENT DECEDENT ESTATE OF Naomi G. Baughman SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 21 07 0811 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. Country Meadows Retirement Home resident care expenses 62.97 2 PA American Water water service 17.69 3 PPL Electric electric service 27.34 4 UGI gas service 4.64 5 Verizon phone service 7.48 6 Visiting Angels medical expenses for 24 hour home care 2,689.25 7 West Shore EMS ambulance service 105.09 3W46AH 2.000 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 2.914.46 R~V-1513 Ex"+ (9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Naom~ G. Baucrhman NUMBER I NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] Donna J. Farnham 406 Darla Road Mechanicsburg, PA 17055 1 Sovereign Bank, joint savings account #2334300775: $3,105.12 60% of Residue: 180,434.72 2 Kimberly A. Petrides 310 Reeser Drive York Haven, PA 17370 20% of Residue: 60,144.91 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) FILE NUMBER 21 07 0811 AMOUNT OR SHARE OF ESTATE Daughter Granddaughter 183,539.84 60,144.91 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET /I NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 3W46AI 1.000 TOTAL OF PART II - 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) $ 0.00 Estate of: Naomi G. Baughman 204-03-6448 Schedule J Part 1 (Page 2) Item No. Description Relation Amount 3 Kristin C. Nickel 33 Halleck Drive East Berlin, PA 17316 20% of Residue: 60,144.91 Granddaughter 60,144.91 aDICIL TO WILL OF NA~I BADGfMAN I, NA~ BAUGHMAN, of Lower Allen Township, Cumberland County, Pennsylvania, declare this to be my sole codicil to my last will dated 18 January 1982. ITEM I. I hereby revoke and cancel ITEMS III, IV, and V of my will dated 18 January 1982. ITEM II. In all other respects, I hereby ratify, confirm and republish my last Iwi11 dated 18 January 1982, together with this sole codicil as and for my last will. IN WITNESS ~F, I have hereunto set my hand and seal this '} day of ~/~:c , , 1990. .,,} , /'/. ',,' .r ///<'t:1;[,,~,!,,",....- J~I."'i^<'Z'~~J./t...~, ~''-''(' NAOMI BAUGHMAN J Signed, published, and declared on the date hereof by the above-named testatrix as and for the sole codicil to her last will dated 18 January 1982 in the presence of us, who at her request, in her presence, and in the presence of each other, have subscribed our names as witnesses hereto. ~c~; .. ,/ /1, " . \ -- vt~i.---,,~..R ---f /' ~x_~_, ,,,.6' -,. -, Ly<..::.C I" f.' 1 l' I ~. COMMONWEALTH OF PENNSYLVANIA ) ( SS.: COUNTY OF CUMBERLAND ) The undersigned, being the testatrix whose name is signed to the attached or foregoing instrwnent, having been duly qualified according to law, does hereby acknowledge that I signed and executed the foregoing instrument as my sole codicil to my last will, that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. .,~ /)~ J " - ,-",,' "-c-' -' ... .-j -,.." .... .... i. .; " "/i.pt-.,..,... , ....-/t...,l,~'-.,. ',,1., Naomi Baughman ,} Sworn or affirmed to and acknowledged before me by tl)e testatrix-~amed apove this yft'h day ofJ1!.Cef17tJfi/"', 1990. 1 f; /./ ( O.LLl.r NOTARIAL SEAl WENDY K. STRAUB, NOTARY PUBLIC lEMOYNE BORO, CUMBERLAND CO. MY COMMISSION EXPIRES MAY 6. 1991 COMMONWEALTH OF PENNSYLVANIA ) ( COUNTY OF CUMBERLAND ) SS. : WE, GEROGE A. VAUGHN, II I, and MICHAEL L. BANGS, the wi tnesses whose names are signed to the attached or foregoing instrwnent, being duly qualified according to law, do depose and say that we were present and saw the testatrix sign and execute the instrument as her sole codicil to her last will; that she signed it willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the testatrix signed the codicil as witnesses and that to the best of our knowledge, the testatrix was at that time 18 or more years of age, of sound mind, and under no constraint or undue influence. Sworn or affirmed to and a~7Jhl~~~f~(tf~llrrJ{)~~;s 1990. II L/lJ~;J1' . ! Ii No #~ .?--- ;;t /'f Ji' ,?-/ /",F . ." ;/1.. t-c,{f..e!~:><- J ~_-./,/./ "" ~ ..::Y P''?' iV ,--"~ NOTARIAL SEAL WENDY K. STRAUB, NOTARY PUBLIC lEMOYNE BORO, CUMBERLAND CO. MY COMMISSION EXPIRES MAY 6,1991 2 ~}!Z!~,;~r:i.:.;~,;,~:rr~Dr"":'~~:Y7"_';^~""?7~t:;;'}~*~m~~~1':'~"""'""I~""'~~~=_~,_...__~.__,,~ dAOHI BAUGHMAN I, j\ AOMI BAUGH1'llAN, of Lower Allen Township, County of Cumber- land, ane state of Pennsylvania, declare this to be my last will and :Levo}e aDY will previously made by me. Item II. I give, devise, and bequeath all my posse,,;Slons I t en I. I direct that all my just debts and funeral expenses, includins my gravemarker and all expenses of my last illness, and any 2nd all taxes and assessments imposed by any governmental body as 0 result of my death, whether on property passing under this will or otherwise, shall be paid from my residuary estate as soon 03 practicable after my decease as a part of the expense of the administration of my estate. and estate of every nature and wherever situate as follows: A. sixty (60%) percent thereof to my daughter, DONNA J. FARNHM1, provided she survive my death by sixty (60) days; and B. Twenty (20%) percent thereof to my granddaughter, KIMBERLY A. FARNHAM, provided she survive lny death by sixty (60) days; and C. Twenty (20%) percent thereof to my ~,,'''!o. \ granddaughter, KRISTIN C. FARNHAM, provided she " survive my death by sixty (60) days. Should any person entitled to a share of my estate under this Item II of this my last will predecease me or be deceased on the sixty- " , ',~. fil"st~ day following my death, I give, devise, and bequeath their said share to such of their issue, per stirpes, as survive my death by sixty (60) days and, should they so die leaving no issue, then to tn.e other persons taking hereunder in the proportions in which they take. Page 1 of 4 Pages Item III. Should any of my issue entitled to a share of my estate not have attained the age of 25 years at the time for distribution to him or her, I devise' and bequeath the share of such issue to my hereinafter named trustee, IN SEPARATE TRUSTS, to hold, manage, invest, and re-invest, the shares so received, and the accumulation of income thereon, and to use and apply from time to time such portion of income and principal thereon as my trustee thinks proper for the comfortable support, maintenance, health, welfare, and education of the issue without regard to the issue's parent's ability to provide such support or education, or to make payment for such purposes, without further responsibility, directly to such issue or directly to such issue's parent, or directly to any person taking care of such issue. Any principal or income not so applied shall be distributed to such issue when he or she attains the age of 25 years, or if he or she dies prior thereto, to his or her personal representative. Item IV. I appoint DONALD A. GELBAUGH trustee of the trust ~; or trusts created by this my last will. Should my said trustee "\:: 1J..'predecease me or otherwise fail to qualify or cease to serve as '\.. ~~trustee of any trusts created by this my last will, I appoint ",,' .,DCNNA J. FARNHAM to serve as trustee of any trusts created by ,ll.,.~thhis my last will. In addition to the other powers and authorities ~anted to my trustee by Pennsylvania Law and by the preceding paragraph of this my last will, I hereby give my trustee the \ j1following special powers and authorities: H ~"f A. To retain any or all of the assets of ~~ my estate, real or personal, without regard to any ~ ~~; principle of diversification, risk, or productivity; \..: B. To invest and re-invest in all forms of ..\: ~; ;~i ~ 0'- \ property without restriction to investments authorized for Pennsylvania Fiduciaries, as my trustee deems proper, without regard to any principle of diversi- fication, risk, or productivity; c. To sell at public or private sale, to exchange or to lease, for any period of time, any real or personal property and to give options for sales, exchanges, or leases, for such prices and upon such terms or conditions as my trustee deems proper and in the best interests of the beneficiary or beneficiaries of said trusts. D. To allocate receipts and expenses to principal or income or partly to each as my trustee I from time to time deems proper in its sole discretion. 1 l; )" , II j:': ):' ~ : \' 1 ~': ~ F " n ~ 1 " ~1 j \( E. To compromise any claim or controversy. F. To exercise any option, right, or privilege granted in insurance policies or in other investments. G. My trustee may accumulate the income from this trust during the term thereof but may, from time to time, distribute from current income or from accumulated income or from principal such amounts as my trustee, in its sole discretion, deems advisable for the education, welfare, and comfort of the trust beneficiary. Item V. All of the interests of the beneficiaries hereunder j i 'J:; 1" shall not r Ilof this my last will. 0,1 Ii; .. . 11 otherw~se fa~l to qual~fy or cease to serve as executrix of this ~ I, limy last will, I appoint DCNALD A. GELBAUGH, executor of this my j,llast will. r r l;not be required to give bond for the faithful performance of their I', !lduties in any jurisdiction. ~ ' 'il Ii; I L ~ Ii !)this H I' :1" , \1 ~i Ii n r 1\ L H Ji ~\ ,j, ~ '; H 1.: !i fi ~ i l" jj It ',1' r r l' fi be subject to anticipation or to voluntary alienation. Item VI. I appoint my daughter, DON"NA J. FARNHAM, executrix Should my said daugh~er predecease me or Item VII. I direct that my personal representatives shall IN WITNESS WHEREOF, I have If day of r'l"--~ hereunto set my hand and seal , 1982. /7(~ ~i0'~-- Naomi Baughman Page 3 of 4 Pages " p The preceding instrument, consisting of this and three other typewritten pages, each identified by the signature of the testatrix was on the date thereof signed, published, and declared by Naomi Baughman, the testatrix therein named, as and for her last will, in the presence of us, who at her request, in her presence, and in the presence of each other, have subscribed our names as witnesses hereto. <~ orr;;u;~ ,~l?cl7~ page 4 of 4 Pages COMMONWEALTH OF PENNSYLVANIA ) ( SS.: COUNTY OF CUMBERLAND ) I, NAOMI BAUGHMAN, the testatrix 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, that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. .sworn or affirmed to and acknowledged before me by 'Naomi Baughman, the testatrix this 1~Jj) day of q(l.fvU ('UL1,. , 1982. (j ~ -0 1 tll t\ ~ :H-J) Notar :.)public ///7 , '&-- L ?&; C~?4-c-~ c.~A4 _ ""__,: _ . aomi Baughmant!' COUNTY OF CUMBERLAND ) SS. : ) LO'J A. z;rro. Notary Public ~;imcvne C~;n;f;e'!and COlint", P8. My' C1nlir~!i)::';.)il [^~;;r:j.5 r\o:t.,:~h 20t rn!2 COMMONWEALTH OF PENNSYLVANIA ( WE, SAMUEL L. ANDES and GEORGE A. VAUGHN, III, the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the testatrix sign and execute the instru- ment as her last will; that she signed it willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the testatrix signed the will as witnesses; and that to the best of our knowledge, the testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. ~-~ G\ . /7:;-") ~\ I I., ...._,. i j <::.. "-_.--, .~.!J ~(,t.~\t) ~ ~/ / .' .~ - u/d7~~;;z: SWorn or affirmed to and ~ acknowledged before me by samuel L. Andes and Ge9rge A. vaughn, III, this It~n day of qQfJLCu~ ' 1982. [) ~ . I tH ! . < +to Notary ~bliC wu A. ?l~(l" Notary Public '.:.;:-f1:;t;."and CountYI ?a~ .",/ ..liTU:'lhl:1 L-pP,.; "'';.'l'Ch 20, l'''''i j ~ '3lsto ,0=> PC\ SU1 0 .CD NJ\Pl:)