HomeMy WebLinkAbout10-31-07
REV-1500 EX t (~)
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
JFFICIAl USE ONLY
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FILE NUMBER
2 1 -0 7 0 8 5 5
'"'COONTYCOOE -rEAr- - - NU'MBER--
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
SOCIAL SECURITY NUMBER
SEIBERT
DATE OF DEATH (MM.Do.Year)
GERALDINE A.
DATE OF BIRTH (MM-Do.Year)
202-20-3416
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
08/15/2007 03/26/1928
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
SOCIAL SECURITY NUMBER
[Xl 1. Original Return
o 4. Limited Estate
o 6. Decedent Died Testate (Attach copy of Will)
o 9. Litigation Proceeds Received
o 2. Supplemental Return
o 4a. Future Interest Compromise (date of death after 12-12-82)
o 7. Decedent Maintained a Living Trust (A1lachcopyofTrust)
o 10. Spousal Poverty Credit (date of death betweeo 12-31-91 andl.I.95}
o 3. Remainder Return (date ofdealh prior to 12-13-82)
o 5. Federal Estate Tax Retum Required
_ 8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
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THIS SEcnOK MUST. BE COMPLETED. ALL CORRESPONOENCEANOCONFIOENnALTAX.INFORMATIONSHOULfl BE .OIRECTEDTO:
NAME COMPLETE MAILING ADDRESS
ROGER B. IRWIN ESQUIRE 60 WEST POMFRET STREET
FIRM NAME (If Applicable)
IRWIN & McKNIGHT
TELEPHONE NUMBER
717 249-2353 CARLISLE PA 17013
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
335,080.00
Q
OFFICIAL USE ONLY
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65,431.61
(8)
576,438.49
56,429.06
2,268.36
(11)
(12)
(13)
58,697.42
517,741.07
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
(14)
517,741.07
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
0.00 X _ (15)
517,741.07 X .045 (16)
0.00 X .12 (17)
0.00 X .15 (18)
(19)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
20.0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
> > . BE SURE TO'ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
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ece en s omple e ress:
STREET ADDRESS 195 HAIR ROAD
CITY I STATE I ZIP
NEWVILLE PA 17241
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
23,298.35
1.087.69
Total Credits (A + B + C)
(2)
1,087.69
3. Interest/Penalty if applicable
D. Interest
E. Penalty
0.00
T otallnterest/Penalty ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 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)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B)
Make Check AGENT
0.00
22,210.66
22,210.66
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 lXI
b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 lXI
c. retain a reversionary interest; or ...................................................................................................... 0 lXI
d. receive the promise for life of either payments, benefits or care? ............................................................. 0 lXI
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration?.............................................................................................. 0 lXI
3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? ................. 0 lXI
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ....................................................................................................... 0 lXI
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of peljury, 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.
SIGNATURE OF PERSON RESPONSIBLE FOR FILINg RETURN DATE
.. 0. ~ I()/~I 07
ADDRESS 60 WEST FRET STREET
CARLlSL PA
SIGNATURE OF PREP ROTHER TH N REPRESE ATIVE
\
ADDRESS
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 3%
[72 P.S. ~9116 (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 0% [72 P.S. ~9116 (a) (1.1) (ii)].
The statute does not exemot 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 s~epparent of the child is 0% [72 P.S. ~9116(a)(1.2)].
Ihe ~ rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~9116(1.2) {72 P.S. ~9116(a)(1)].
.
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. ~9116(a){1.3)]. A sibling is defined, under Section 9102, as an
individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-1502 EX + (6-98)
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
SEIBERT GERALDINE A. 21 07 0855
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 DroDertv which is iointlv-owned with riaht of survivorshiD must be disclosed on Schedule F.
SCHEDULE A
REAL ESTATE
ITEM
NUMBER
1.
DESCRIPTION
195 HAIR ROAD, PENN TOWNSHIP, NEWVILLE, PENNSYLVANIA
SOLD - SETTLEMENT SHEET ATTACHED
VALUE AT DATE
OF DEATH
286,000.00
3.
LOT ON WHICH ROY C. SEIBERT, JR. HAS MOBILE HOME (REAL ESTATE
NEVER DEEDED)
LOT ON WHICH STEVE A. SEIBERT HAS MOBILE HOME (REAL ESTATE
NEVER DEEDED)
24,540.00
2.
24,540.00
TOTAL (Also enter on line 1, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
335080.00
REV-150e EX + (6-98)
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SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
GERALDINE A 21 07
Include 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.
0855
ITEM
NUMBER
1.
DESCRIPTION
PERSONAL PROPERTY - SETTLEMENT SHEET ATTACHED
VALUE AT DATE
OF DEATH
35,352.50
2.
M& T BANK - CHECKING ACCOUNT #726397
19,591.18
3.
M&T BANK - SAVINGS ACCOUNT #015004205405788
35,495.65
4.
M&T BANK - CERTIFICATE OF DEPOSIT #031003911029568
77,377.65
5.
CASH ON HAND
515.23
6.
PRUDENTIAL FINANCIAL - ALLIANCE ACCOUNT #4352000277544
7,594.67
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
175 926.88
REV-1510 EX + (6-98)
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SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SEIBERT GERALDINE
A.
FILE NUMBER
21 07
0855
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
DESCRIPTION OF PROPERTY
ITEM INCLUDE THE NAME OF THE TRANSFEREE. THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH % OF DECO'S EXCLUSION TAXABLE
NUMBER THE DATE OF TRANSFER ATTACH ACOPV OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
1. M&T BANK -IRA #035004200307020 65,431.61 100. 65,431.61
TOTAL (Also enter on line 7 Recapitulation) $ 65 431.61
{If more space is needed, insert additional sheets of the same size)
REV-1511,EX + (12-99)
*'
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
SEIBERT
GERALDINE
A
21
07
0855
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. EWING BROTHERS FUNERAL HOME 4,242.90
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s) ROGER B. IRWIN 19,000.00
Social Security Numbe~s)/EIN Number of Personal Representative(s) 193-24-1402
Street Address 60 WEST POMFRET STREET
City CARLISLE State PA Zip 17013
Year(s) Commission Paid:
2. Attorney Fees IRWIN & McKNIGHT 20,000.00
3. Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees REGISTER OF WILLS
5. Accountanfs Fees
6. Tax Return Preparer's Fees PATRICIA A. ROSENDALE, CPA 399.00
7. NOTARY FEES 50.00
8. CUMBERLAND LAW JOURNAL - ESTATE NOTICE 75.00
9. ROWE'S AUCTION SERVICE - PUBLIC SALE 6,645.50
10. RECORDER OF DEEDS 79.00
11. THE SENTINEL - ESTATE NOTICE 155.00
12. STEVEN W. BARRETT, APPRAISALS ON REAL ESTATE 575.00
13. MELVIN SEIBERT - REIMBURSEMENT OF GAS 105.01
14. M. LOUISE KELLEY - REIMBURSEMENT 46.58
15. REGISTER OF WILLS - SHORT CERTIFICATES 8.00
16. CLOSING COSTS ON SALE OF REAL EST A TE 5,048.07
TOTAL (Also enter on line 9, Recapitulation) $ 56.429.06
(If more space is needed, insert additional sheets of the same size)
REV-1512.EX + (6-gal
'*
SCHEDULE.
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SEIBERT GERALDINE
A.
FILE NUMBER
21 07
0855
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1. CARLISLE REGIONAL MEDICAL CENTER - MEDICAL
VALUE AT DATE
OF DEATH
200.00
2. SHIPPENSBURG AREA EMS - AMBULANCE
101.53
3. FAMILY HOME MEDICAL - MEDICAL
5.80
4. EMBARQ - TELEPHONE
126.81
5. DIRECTV - CABLE
42.40
6. PP&L - ELECTRIC
206.98
7. GARRIS'S GARAGE - SERVICE ON AUTOMOBILE
77 .40
8. CUMBERLAND-GOODWILL FIRE RESCUE - AMBULANCE
455.99
9. WEST SHORE EMS - AMBULANCE
839.45
10. GILBERT LANDSCAPING - LAWN CARE
212.00
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
2.268.36
''':'''' EX ".
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
FILE NUMBER
NUMBER
1.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
AMOUNT OR SHARE
OF ESTATE
1.
STEVE A. SEIBERT
179 HAIR ROAD
NEWVILLE, PA 17241
ROY C. SEIBERT, JR.
175 HAIR ROAD
NEWVILLE, PA 17241
MARGARET LOUISE SEIBERT-KELLEY
185 HAIR ROAD
NEWVILLE, PA 17241
MELVIN L. SEIBERT
171 HAIR ROAD
NEWVILLE, PA 17241
Lineal
1/4TH REMAINDER
2.
Lineal
1/4TH REMAINDER
3.
Lineal
1/4TH REMAINDER
4.
Lineal
1/4TH REMAINDER
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
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1,
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)
..
.
LAW OFFICES A. Settlement Statement
u.s. Department of Hauling and Urban Development
IRWIN & McKNIGHT OMS No. 2502-0265 {exoires 11130/2009\
I B. TYPE OF LOAN
WEST POMFRET PROFESSIONAL BUILDING 1.DFHA 2. DFmHA 3. DConv. Unins.
4. OVA 5. DConv. Ins.
60 WEST POMFRET STREET 6. FILE NUMBER 17. LOAN NUMBER
CARLISLE, PENNSYLVANIA 17013-3222 BURKHOLDERE10.o
(717) 249-2353 8. MORTGAGE INSURANCE CASE NUMBER
C. Nole: I~~~~-=~:!~;o~~..t:':;::= :u'::::~ :~-:;.U:~=:~~~I;::;:~~~~ ;:rpl.:- ~'dm;:-~~ :~~d:~ :"::"tOtal.. I TiUeExpress SelUement System
WAAWNG: It Is a alma to kn~n?ty make fa\" ltatemenh to the Unl*'<<l $..... on thla or .n~ othar similar form. Penaltia. upon
conviction can Include I fin. and mDri6onment. Ford.talla ...: Title 18 U. 8. Coda Section 1 01 and a.cUon 1010. Printed 10/16/2007 at 14:59 JMR
D. NAME OF BORROWER: ELI G. BURKHOLDER and VERA R. BURKHOLDER
ADDRESS:
E. NAME OF SELLER: GERALDINE A. SEIBERT ESTATE
ADDRESS: 195 HAIR ROAD NEWVILLE PA 17241
F. NAME OF LENDER: N/A
ADDRESS:
G. PROPERTY ADDRESS: 195 HAIR ROAD, Newville, PA 17241
Penn Townshlll
H. SETTLEMENT AGENT: I&M REAL ESTATE SERVICES, LLC, Telephone: 717-249.2353 Fax: 717.249-6354
PLACE OF SETTLEMENT: West Pomfret Professional Blda. 60 West Pomfret Street Carlisle PA 17013
I. SETTLEMENT DATE: 10/1812007
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 orice 286 000.00 401. Contract sales nrice 286 000.00
102. Personal Prooertv 402, Personal ProMrtv
103. Settlement charoes 10 borrower (line 1400\ 4212.50 403,
104 404.
105. Countv Taxes Lot 3 10/18/071012131107 12.20 405. Counlv Taxes Lot 3 10118/071012131/07 12.20
Adiustments for items "aid bv selier in advance Adjustments for items "aid bv selier in advance
107, Countv taxes 1 0/18/07 to 12131/07 65.84 407. Countv taxes 10/18/071012/31/07 65.84
108. School Tax 1 0118/07 to 06130/08 1.290.20 408. School Tax 10/18/01 to 06/30108 1 290.20
109, School Taxes Lol 3 1 0/18/07 1006/301ll8 239.20 409. School Taxes Lot 3 10118/01 to 06/30108 239.20
110. 410.
111. 411.
112 412.
120. GROSS AMOUNT DUE FROM BORROWER 291 819.94 420. GROSS AMOUNT DUE TO SELLER 287 607.44
200. AMOUNTS PAID BY OR ON BEHALF OF BORROWER 500. REDUCTIONS IN AMOUNT DUE TO SELLER .
201. DAMsi! or earnest monev 10000.00 501. Excess Dennslt (see Instructions) 10.000.00
202. Princioai amount of new loans 502. Settlement chames to seller (line 140m 5 048.01
203. Existlnn loanls) taken subiect to 503. Existino loanisltaken sub'ect to
204. 504, Pavoff of Firsl Mortoaae Loan
205. . 505.
206. 506.
207. 507.
208. 508.
209. 509.
Adjustments for items unllilid bv seller Adiustments for items unDilid bv seller
213. 513.
214. 514.
215. 515.
216, 516,
217. 517.
218. '. 518.
219. 519.
220. TOTAL PAID BY/FOR BORROWER 10000.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 15048.07
300. CASH AT SETTLEMENT FROM OR TO BORROWER 600. CASH AT SETTLEMENT TO OR FROM SELLER
301. Gross amount due from borrower lline 120\ 291 819.94 601. Gross amount due to seller lline 420\ 287607.44
302, Less amounts oaid bv/for borrower (lIne 220\ 10000.00 602. Less reduction amount due seller lIIne 520\ 15048.07
303. CASH FROM BORROWER 281 819.94 603. CASH TO SELLER 27~ 559.37
.
)0
U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT
File Number. BURKHOLDERE10-0
. PAGE 2
SETTLEMENT STATEMENT TitleExoress Settlement SYStem Printed 10/1612007 at 14:59 JMR
L. SETTLEMENT CHARGES PAID FROM PAID FROM
700. TOTAL SALESlBROKER'S COMMISSION based on Drice $286 000.00 = BORROWER'S SELLER'S
..Division of commission lline 7001 as follows: FUNDS AT FUNDS AT
701. S to SEffiEMENT SElTLEMENT
702. S to
703. Commission naid at Settlement
SOO.ITEMS PAYABLE IN CONNECTION WITH LOAN
801. Loan Oriainalion Fee %
802. Loan Discount %
803. Aaoraisal Fee
804. Credit Rennrt
805. Lender's Insaection Fee
806. Mortoaae Aaolication Fee
607. Assumotion Fee
808.
809.
810.
811,
gOO. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE
901. Interest From to tm~ Ida"
902. Mortaaae Insurance Premium for to
903. Hazard Insurance Premium for to
904.
905.
1000. RESERVES DEPOSITED WITH LENDER FOR
1001 :~azard Insurance mo. i5l $ Imo
1002. Mortaaae Insurance mo.i5lS {me
1003. City prooertv Tax mo.i5lS Imo
1004. County Pro""rtv Tax mo. tm ~ 26.701mo
1005. School Tax mo.i5l~ 153.12 {me
1009. Aaareaate Analvsis Ad1ustment 0.00 0.00
1100. TITLE CHARGES
1101. Settlement or closina fee to IRWIN & MCKNIGHT 100.00
1102. Abstract or title search to IRWIN & MCKNIGHT 600.00
1103. Tille examination to IRWIN & MCKNIGHT 350.00
1104. Title insurance binder
1105H0ocument Preaaration
1106. Notarv Fees to Cash 14.00 10.00
1107. Attomev's fees to IRWIN & MCKNIGHT 250.00
!includes above "ems No: \
1108. Tille Insurance
!includes above items No: \
1109. Lende~s Cove""'e $
1110. Owner's Coveraae S 286 000.00 . .
1111.
1112.
1113.
1200 GOVERNMENT RECORDING AND TRANSFER CHARGES
1201. ~ecordinQ Fees Deed $ 38.50 . Mortaaae S . Release ~ 38.50
1202. CitvlCountv tax/stamas Deed ~2 860.00 . Monnooe ~ 2 860.00
1203. State Tax/stamns Deed $2 860.00 . Mo~aae $ 2 860.00
1204.
1205.
1300. ADDITIONAL SETTLEMENT CHARGES
1301. Survev .
1302. Pest InsnP.C1lon
1303
1304.
1305. SchoolT axes Lot 2 to MABEL G. STITT TAX COLLECTOR 1 837.41
1306.~chool Taxes Lot 3 to MABEL G. STITT TAX COLLECTOR 340.66
1307.
1308. ,
1400. TOTAL SETTLEMENT CHARGES (enter on lines 103 Section J and 502 Seelion KI 4.212.50 5 048.07
HUD CERnFICAnON OF BUYER AND SELLER
I h.~ carefully rev.wed the HUD-1 Settlement StMement and t:) the b..t of my know\e<lg. amS ~lei, k . . true and .ccurMI Itlltem.nt of .n receipts .nd dllburalm.nts made on my ."ount or b
In .hl. "onucllon. lfurtho' co~o received 0 cop)' 01 the HUD.l _mont'to.omonL. ". .
EL&&-:"'U~ IS.{, ~ V'K"K.15ul{;;.;L't.'R '(?:,..'-,,0<<-"~\..'\
GERAlS:l1NE A. SEIBERT ESTATE
y:
1.~
WARNING: IT IS A CRI E T KNOWINGLY MAKE FALSE STATEMENTS TO 'IliE
UNITED STATES ON T ANY SIMILAR FORM. PENAl. TIES UPON CONVICTION
CAN INCLUDE A FINE AND IMPRISONMENT. FOR OETAI\.S SEE TITLE 18:
U.S. CODE SECTION 1001 AND SECTION 1010.
~'::~~~=:~r~~~:::~:=C~lb~-:'C= ':e=-==t:: =r:~~~th. tranlaetto
By:
1~"3. ~ l,rlf/t))
DATE
./'
Rowe's Auction Service
2505 Ritner Highway
Carlisle, P A 17015
717-249-2677 249-1978 697-4794
Oct. 17, 2007
To: Roger B. Irwin, Attorney
60 W. Pomfret St.
Carlisle, P A 17013
From: Rowe's Auction Service
2505 Ritner Highway
Carlisle, P A 17015
Re: Geraldine A. Seibert Estate Auction
Total Sales $35,352.50
$26,852.50 @20% commission 5370.50
. 8500.00 @ 15% commission 1275.00
Totalcornmission $6645.50
Advertising expenses:
Carlisle Sentinel, 3 ads
Guide News, 2 ads
Newville-Shippensburg, 2 ads
D&D Septic
3 Batteries, paid to Mel
Outstanding bill, Roy Jr.
$291.38
303.80
157.50
150.60
75.00
810.00
Total expenses
$1788.78
Total Due $26,918.22
L.I. .... .. - ,--
~~ ". -
William G. Rowe
m1 M&fBank
499 Mitchell Road, Millsboro, DE 19%6 Mail Code DE-MB-12
Phone (888) 502-4349
Fax (302) 934-2955
September 6, 2007
Law Offices
Irwin &- McKnight
West Po~fret.Professional ~uiJ~ing
60 WestPomfret Street , . .
Carlisle, Pennsylvania 17013.-3222
Re. Estate of' Geraldine A Seibert
Social Securitv: 202-20-3416
Date of Death: August 15, 2007
Dear Sir or Madam:
Per your inquiry dated September 04, 2007, please be advised that at the time of death, the above-named decedent had on
deposit with this bank the following:
1. Type of Account Checking Account
Account Number 726397
Ownership (Names.oj) Geraldine A Seibert *
Opening Date. 09/01/67
Balance on Date of Dea~h $19,591.02
Accrued Interest $ 0.16
Total $19,591.18
2. Type of Account Savings Account
Account Number 015004205405788
Ownership (Namesofj Geraldine A Seibert *
Opening Date 10/21/04
Balance on Date of Death $35,458.00
Accrued Interest $ 37.65
Total $35,495.65
.'
3. Type of Account Certificate of Deposit
Account Number 031003911029568
Ownership (Names of) Geraldine A Seibert *
Opening Date 09/20/00
Balance on Date of Death $76,546.11
Accrued blterest $ 831.54
Total $77,377.65
4. Type of Account IRA
Account Number 035004200307020
Ownership (Names of) Geraldine A Seibert *
Opening Date 08/29/00
Balance on Date of Death $65,347.34
Accrued Interest $ 84.27
Total $65,43/.61
Please be advised, there was no safe deposit box found for the above decedent.
* If upon reviewing the information above, you believe there are additional accounts not referenced, please
provide us with an account number and/or the name of any possible joint account holder. For any additional
information on the above accounts, including ownership and any changes, closures and/or reimbursement of
funds, please call the High Street Carlisle Office # 717-240-4536 located at 1 West High Street, Carlisle,
Pennsylvania 17013.
Sincerely,
~
Nancy Clagett
Records Management
:6474
Prudential Alliance Account ServIces
PO Box 41582
Philadelphia, P A 19176
. .
Prudential ~ Financial
GERALDINE SEIBERT
195 HAIR ROAD
NEWVILLE PA 17241
Page 1
4352000277544
PRIMARY
ACCOUNT NUMBER
9/30/2007
STATEMENT
CLOSING DATE
TAX ID NO:
ALLIANCE ACCOUNT
BALANCE
LAST STATEMENT
7,545.31
NO. 4352000277544
NO. I
3 I
CREDITS
TOTAL AMOUNT
73.52
CHECKS AND DEBITS
NO. I TOTAL AMOUNT
o I 0.00
BALANCE
THIS STATEMENT
7,618.83
ACCOUNT TRANSACTIONS
DATE.......... . AMOUNT. ..... ...... .BALANCE... DESCRIPTION
07/31 24.67 7,569.98 CREDIT-INTEREST
08/31 24.69 7,594.67 CREDIT-INTEREST
09/29 24.16 7 ,618.83 CREDIT-INTEREST
EFF DATE 09-30-07
****** CURRENT INTEREST RATE
****** INTEREST CREDITED YEAR-TO-DATE
3.870% ******
216.71 ******
********** END OF STATEMENT **********
~tIUW(~
Octrr 2 2007
"R',
.. \.
,~':. ;~JcKNIGHT
NOTICE: See reverse side for reconciliation of this statement and important information. 803-2
.'
Ewing Brothers Funeral Home, Inc.
630 South Hanover Street
Carlisle, P A 17013-
(717)243-2421
/
Augusvzl, 2007
M. Louise Kelley
185 Hair Rd.
Newville, P A 17241
/
The Funeral Service for Geraldine A. Seibert
We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way we can. Please
feel free to contact us if you have any questions in regard to this statement.
THE FOLLOWING IS AN ITEMIZED STATEMENT OF THE SERVICES, FACILITIES, AUTOMOTIVE EQUIPMENT,
AND MERCHANDISE THAT YOU SELECTED WHEN MAKING THE FUNERAL ARRANGEMENTS.
1. PROFESSIONAL SERVICES
Services of Funeral Director/Staff. . . . . . . . . . . . . . . . .
FUNERAL HOME SERVICE CHARGES . . . . . . . . . .
THE COST OF OUR SERVICES, EQUIPMENT, AND MERCHANDISE
THATYOUHAVESELECTED . . . . . . . . . . . . .
$4100.00
$4100.00
$4100.00
Cash Advances
Certified Copies of the Death Certificate .
Flowers. . . . . . . . . . .
Sentinel with photo . . . . . . .
TOTAL CASH ADVANCES AND SPECIAL CHARGES .
$72.00
$132.50
$138.40
$342.90
Total
Total Cost.
$4442.90
SUB-TOTAL
INITIAL PAYMENT / DISCOUNT / CREDITS
TOTAL AMOUNT DUE
$4442.90
Cu ~ ber LArd.. Q:x.v.JJ{.,
100.00 :: '" ^ I
V -'"'". W II" OW o~
Ve,
10 (S ~ e..c=..c e.N ~
- 100. CCJ -=- (lOI..t.v\? V QI ~ef,r
~ r R-,
If ~02Y'd.. 90
$4342.90
The unpaid balance over 30 days is subjected to a 1.50 % service charge per month - 18.0000 % per annum.