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{"ll-rJl,:IAL V~!::: UNLY
FilE THIS RETURN WITH:
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128,9601
REV.1737.A
INHERITANCE TAX RETURN
NONRESIDENT DECEDENT
FgE N9M~ER 2/- C> 2- !!. ~ 7~ _
COUNTYCOOE YEAR NUMBER
SOCIAL SECURITY NUMBER
183-07-8350
DECEDENTS ~E (LAST. FIRST, AND MIDDLE INITIAL)
Houp~ Helen G.
DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
11-13-2005 06-09-1911
(IF APPLICABLE) SURVMNG SPOUSE'S NAME (LAST. FIRST, AND MIDDLE INITIAL)
SOCIAL SECURITY NUMBER
[!] 1. Original Retum
D 4. Limited Estate
D 6. Decedent DIed Testate,(AIIBc:h copy 01 WI)
D 9. LIIigaIIon Proceeds ReoeiYed
D 2. SUpplemental Retum
D 4a. Future Interest Compromise (dIIt 01 dIIIIlllIrl2-12-82)
D 7. Decedent Maintained a Living Trust (AIIBc:h copy oITNIl)
D 10. Spousal Poverty Credit (dlltofdellh IIeIIIIlen 12-31-81111d 1-1-85)
D. 3. Remainder Retum (dIIt 01 death prior III 12-13-82)
D 5. Federal Estate Tax Return Required
_ 8. Total Number of Safe DeposIt Boxes
D 11. Election to tax II'lder Sec. 9113(A) v-cn Sc:h 0)
NAME
Jerry A. Weigle, Esquire
FIRM NAME (K AppIcIIIle)
WEIGLE & ASSOCIATES~ P.C.
TELEPHONE 7/1 !;3l- J ~r
REFER TO METHOD OF COMPUTATION IN THE NONRESIDENT DECEDENT INSTRUCTION BOOKLET (REV-1736)
Check One: ~ Aat Rate 0 Proportionate (Complete Worksheet on Reverse Side)
(1)
(2)
(3)
102~000.00
OFFI~L USE ONLY
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1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held CorporatIon, Partnership or SoIe-froprietorlp
(Schedule C)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
D Separete Billing Requested
7. Inter-VIVOS Transfers & MlsceHaneous ~robate Property (7)
(Schedule G or L)
8. TotIl Gross Auets (total Unes 1-7)
9. Funeral Expenses & Adminlslrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage UabAilies, & Uens (SchecIUe I) (10)
11.TotIl DeductIons (total Unes 9 & 10)
:;!:I'"
:x
C!J
U1
(J1
(8)
102~000.00
(11)
(12)
(13)
102,000.00
12. Net Value of Estate (line 8 minus Line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an eleclion to tax has not been
made (Schedule J)
14. . Net Value Subject to Tax (Line 12 minus line 13)
102~000.00
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPUCABlE RATES
15. Amount of line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
x .0 (15)
x.o 45 (16)
x .12 (17)
x .15 (18)
(19)
4~590.00
16. Amount of Line 14 taxable at tineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of line 14 taxable at coRateral rete
19.: Tax Due. Make check payable to Commonwealth of PA
102~000.00
4~590.00
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
NONRESIDENT DECEDENT
ESTATE OF
S~.IIEDU"E A, PART I
REAL ESTATE
IN PENNSYLVANIA
Helen G. Houp
FILE NUMBER
2.1-07-0 "7h
Part 1 must include all real property owned by the decedent individually or as a tenant in common with another party(ies), having its
situs in Pennsylvania. Property which is jolntly-owned with right of survivorship should be disclosed on Schedule F. All real estaJe
must be reported at fair market value which 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.
ITEM VALUE AT DATE Of DEATH
NUMBER DESCRIPTION
1. Real Estate in South Newton Township, Cumberland County - 102,000.lilO
3.787 acres
Mill 1 IO'I'AL
$ 102,000.00
PAIn 2
Proportionate Method Only from reverse side $
'OYAL (Also enter on line 1, Recapitulation) $
. .
(If more space IS needed, Insert additional sheets of the $atne size)..
~I
REV.1737-1EX + (9'()()) '*
REVE~SE
, . .
+ "
. COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
NONRESIDENT DECEDENT
ESTATE OF
seM.DULI..
8INIFICIARII.
Helen G. Houp '"2... 1-07_ 0" 7"
When flat rate meth d is elected, list the beneficiaries of the Pennsylvania property.
When p portionate method Is elected, list all beneficiaries.
FILE NUMBER
4702 Carol Avenue
Yakima, WA 98908
RELATIONSHIP TO
QECEQENT
Do Not lilt T I
NUMBER
L
1.
NAME AND ADDRESS OF P RSON(S) RECEMNG PROPERTY
TAXABLE DISTRIBUTIONS Pndude outright spousal distributions, and transfers under Sec. 9116 (1)(1.2))
Gloria A. Hilsinger
ENTER DOlLARAMQUNTS FOR DISTRIBUTIONS OWN ABOVE ON REV.1737 COVER SHEET OR THE PROPORTIONATE METHOD WORKSHEET ON THE REVERSE S DE
OF REV.1737 COVER SHEET, AS APPROPRIATE.
n. NON-TAXAIllE DlSTRIBU1lONS:
A.. SPOUSAl DISTRIBUTIONS UNDER SECTION 113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
$0100
B. CHARITABLE AND GOVERNMENTAl DISTRIBt.I~S
1.
I
!
TOTAL O' PAili'll
ENTER TOTAL NON- LE DISTRIBUTIONS ON LINE 13 OF REV-1737 COVER SHEET
(If more sp~ is n~~. insert additional sheets of the sa~~e)
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" ~<~ '1..1. ..:".' LAST WILL AND TEST AMENT
\~~\." :'::;:':..\)<' i 07 4 0009
,::),HELEN G. HO~P, of 50 Foreman Mill Road, Shippensburg, South Newton
Towrish!p., Cumberland Co ty, Pennsylvania, being of sound mind, memory and disposition,
do hereby make, publish an declare this my Last Will and Testament, hereby revoking and
making void all wills by m at any time heretofore made.
FIRST. lord . and direct the payment of all my legally enforceable debts and
funeral expenses as soon as may be convenient after my decease.
SECOND. I giv and bequeath a life estate interest in my residence known as
50 Foreman Mill Road, S 'ppensburg, South Newton Township, Cumberland County,
Pennsylvania (more specifi all)' described in Cumberland .county Deed Book J, Volume 28,
Page 32) to my husband, E. HOUP,.for and during his natural life.
THIRD. I giv ,.devise and bequeath all the rest and residue of my estate, real,
personal and mixed, whats ever and wheresoever situate, to my daughter, GLORIA ANN
HILSINGER, provided that she be living on the sixtieth (60lb) day following my death. In the
event that the said GLORIA ANN HILSINGER predeceases me or is not living on the sixtieth
(60th) day following my d th, I then give, devise and bequeath the rest and residue of my
estate ,to the children of my deceased son, DONALD L. HOUP, on a per stirpes distribution
basis~ namely SUZANNE . ESHELMAN, JENNIFER L. HOUP, and JEREMY J. HOUP.
I
FOURTH. I no . re, constitute and appoint my daughter, GLORIA ANN
HILSINGER, to be the Ex utrix of this my Last Will and Testament; if she be unable to
fulfill the duties of Execu , I then nominate, constitute and appoint my husband,
WARREN E. HOUP, to be the Executor of this my Last Will and Testament.
i
FIFTH. I he by direct that all federal, state and other death taxes payable
because of my death, with espect to the property formiIig my gross estate for tax purposes,
whether or not passing und r this Will, including any interest or penalty imposed in
connection with such taxes, shall be considered a part of the expense of administration of my
estate and that such be pai out of the rest and residue of my estate.
SIXTH. I dir ct that my personal representatives shall not be required to give
bond for the faithful perlo ce of their duties in any jurisdiction.
. IN WITNESS wmdREOF, I, HELEN G. ROUP, have hereunto set my hand and seal
to this my Last wm..;d .ttament this 30 day of r ' 1999.
I
I
I k-J~ .f1 ~ . (SEAL)
I
MARK. WEIGL'" AND PERKINS. _ ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG. PA 17257-1397
This instrument wJ by the Testatrix. on the date hereof, signed, published and
declared by her to be her La$ Will and Testament, in our presence, who at her request and in
the presence of each other, ~e believing her to be of sound and disposing mind and memory,
have hereunto' subscribed mf names as witnesses.
C:;d~-- ~ d~
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COMMONWEALTII ~F ~SYLV ANIA
COUNTY OF CUMBERL
SS.
I, HELEN G. HOUP the person whose name is signed to the foregoing instrument,
having been duly qualified according to law, do hereby acknowledge that I signed and
executed the instrume1it as y Last Will; that I signed it willingly; and that I signed it as my
free and voluntary act for purposes therein expressed.
Jj~ 11 .lJ ~
Sworn or affirmed to and ac owledged
before ~y HEL G. H UP, the Testatrix,
this )l1(j day of , 1999.
MARK, WEIGLE AND PERKINS -' ATTORNEYS AT. L.AW -.126 EAST I<ING STREET - SHIPPENSBURG, PA 17257-1397
COMMONWEALTHOFP NNSYLVANIA
: SS. '
: I)L j Ipci 11,
Wet&'4'~ 7~-...ahd (-([(if nlJ.:.(!-.J \i(~ fL/.) (':i{{
the witnesses whose name are signed to the foregoing instrumentt being duly q' alified
according to lawt do depos and say that we were present and saw HELEN G. HOUPt the
Testatrixt sign and execute e instrument as her Last Will; that she signed willingly and that
she executed it as her free d voluntary act for the purposes therein expressed; that each of
us in the hearing and sight fthe Testatrixt signed the will as witnesses; and that to the best
of our knowledge the Tes ix was at the time eighteen (18) or more years of age and of sound
mind and under no constrai t or undue influence.
6~ ,,4:' (~--C-~
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, 1999.
MARK, WEIGLE AND PERKINS _ ,ATTORNEYS AT LAW - 12.6 EAST KING STREET - SHIPPENS6URG. PA 17257-1397
STATE OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SHORT CERTIFICATE
.. ~.', I
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GLENDA FARNER STRASBAUGH
....'..
\.
Register for the Probate of Wills and Granting
Letters of Administration in and for
CUMBERLAND County, do hereby certify that on
the 21st day of September, Two Thousand and
Seven,
Letters of ANCILLARY TESTAMENTARY
in common form were granted by the Register of
said County, on the
, la te of SOUTH NEWTON TOWNSHIP
~.;--. ,~<_'~_r<~,,, ._
-.-' .. . .
-\
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estate of HELEN G HOUP
(Flrllt. Middle. UlIt)
in said county, deceased, to GLORIA A HILSINGER
(FNSt. MiddM. wt)
and that same has not sin e been revoked.
I have hereunto set my hand and affixed the
LISLE, PENNSYLVANIA, this 19th day of November
seal of said office at C
Two Thousand and Seven.
File No.
PA File No.
Date of Death
S.S. #
2007-00676
21- 07- 0676
11/13/2005
183-07-8350
~~~,.~
~L \\ ~ ChJ-
~ beputy
NOT VALID WITHOUT RIGINAL SIGNATURE AND IMPRESSED SEAL
".
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'}t, (f5/feat~, Jne.
494 E. King St. Sbippensburg, Pa 17257
ffk(' (71 7)582- 6059Ili~lL,,{ (717)530-5181
.sailhamer.com I info@sailhamer.com
November 25, 2005
Gloria Hilsinger
4702 Carol Avenue
Yakima, WA 98908-3735
Dear Ms Hilsinger
This analysis has not been rformed in accordance with the uniform standards of professional
practice which requires val ers to act as unbiased, disinterested third parties with impartiality,
objectivity and independen e and without accommodation of personal interest, it is not to be
construed as an appraisal d may not be used as such for any purpose.
In response to your request or a comparable market analysis of real estate at 50 Foreman Mill
Road, South Newton Town hip, Cumberland County, Shippensburg, Pennsylvania. I am sending
you my estimation on cu t market value. The parcel is served by public water and on-lot septic
of unknown type/design.
The parcel is further descri in Cumberland County Recorder of Deeds Book J28, Page 32.,
and per deed, contains 3.78 acres (more or less) of mostly forest land. The parcel is improved
with a one story home bein covered with aI uminum siding and random rock. The dwelling
contains a living room, kitc en, bedroom and full bath with laundry. The basement contains a
family room with hearth an furnace room. The heating system is an oil fired hot water boiler
with auxiliary woodstove h at and electric baseboard. Roofing material is of asphalt shingle. The
dwelling is situated on the e of a high bank overlooking a small body of water, locally known
as Big Pond and the overall condition of the dwelling appears to be good.
The location of the prope is within driving distance to work, shopping and major highways.
The neighborhood consists f similar type single family homes, weekend cabins and rural farm
land.
Based upon my personal in estigation and findings, it is my opinion that this comparable market
analysis would indicate a c rrent market value of One Hundred and Two Thousand Dollars
($102,000).
Sincerely,
~~4f
Ronald L.Sailhamer
Real Estate Broker
-.
I3iV-\737.1 EX + (9~t
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'*
2/-07.....0"7"
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG. PA 17128-0601
NON.ISIDINT DICIDINT
A..IDAYIT O' DOMICILE
This affidavit must be compl ted and sworn to by a person having personal knowledge of these
facts, preferably.b a surviving spouse or member of the decedent's family.
Name of Decedent' Date of Death
Helen G. HouR 11-13-2005
Legal Address at Time of Death:
Street Address .
4702 Carol Avenue
CitylBorough
Yakima
State
WA
Zip Code
98908
The following Information Is ubmltted In support of the statement that the above Individual was
not domiciled In he Commonwealth of Penns vania at the date of death.
1. Names and addrenes of the decedenfs su ng spouse and members of hlllher Immediate family:
Name and relationship to decedent
Street Address
- Daughter
CitylBorough
Yakima
State
WA
Zip Code
98908
4702 Carol Avenue
Name and relationship to decedent
Street Address
CitylBorough
State
Zip Code
Name and relationshlp to decedent
Street Address
CltylBorough
State
Zip Code
2. Old the dec:edlnt ever live In Penn""'anla liVes 0 No
If yes, during what periods?
1911 - 2 04
3. Did the ~ spend time In Pennsylva ia during the five years preceding death ? Yes 0 No
If yes, during what periods and at what add ?
Maintained residence un'il 2004 at 50 Foreman Mill Road
Shippensburg, PA 17257
South Newton" Township, Cumberland County
4. What was the natu.. of decedent's places ....dence during the five years Immediately pt'Icedlng death?
Indicate whether decedent resided in a or apartment and Whether it was rented or owned by the decedent, and/or whether decedent resided n a
hotel or the home of relatives or friends.
2000 - 2004 - owned home at 50 Foreman Mill Road, Shippensburg, PA 17257
2004 - 2005 - lived with daughter in daughter's home at 4702 Carol Avenue, Yakima WA'989(
. to. Was the decedent employed during the years preceding desth?
If yes, list the name and address of employe s).
o Yes
II No
6. DId the decedent leave a will? 11 Yes 0 No
If yes, state the court which admitted the will to probate, the date admitted, and attech a copy, Including all codicils, and a certificate of iss nee of
~ntesteme~~ .
Ancillary Letters Testamentary granted by Register of Wills, Cumberland County,
on 9-21-2007. Copy of Will and Short Certificate attached hereto.
7. If the decedent did. not leave a wiU, has an administrator of his estate been appointed? 0 Yes 0 No
If yes, state the court which appointed the administrator, the date of appointment, and attach a certificate of the issuance of ~ers of administratio .
8. At. any time during the last five years did the decedent execute a will, a codicil, trust Indenture, deed, mortg8@, ..... or any other document I which
the decedent was described . a ....dent of Pennsylvania? 0 Yes 0 No
If yes, describe such document.
None to my knowledge.
-
l' .eftI.1ID1II1' ........ A..IDAYI' O' DOMICIU (continued)
9. Had the decedent pIld I tIX on Income or on Intangible property to MY state, county, or munlclplllty durl~ the lilt he ,..,,?
If yes, where and when was it paid? [J Yes lllI No
10. To whit I'IalonIl otIIce of the Internll Revenue ServIce did the decedent forward his Federal Income TIX Ntuml during the lilt five
pl'lCdtg cIuth?
N/A
11. At lime 01 dMIh, lid the dectdent own, lncIvlcIuIlIy or jointly, MY InWest In rtIl propIIrty, Including leaII-hoIdI or tangible personal
located In ,......? III V. C No
If yes, describe the property in detail.
Real Estate in South Newton Township, Cumberland County, PA - 3.787 acres
12. In what ................ the deGtdent enaaaed durlnI the lilt he y.-. ......... ..?
Indicate wtleIw decedent was employed or otherwTs8 engagedln business, and state the names and the addresses of the persons, finns or
with whldl the decedent had such buslness afIiliations. ( ~ci8pt for employer I!&led in #5 )
s
Retired
13. WhIt II the IItlnIItId ... value 01 the clecedent'1 ......, whereIoIver 1ItuItId, IXcluIlve 01_ property IIICI tangible property located
of 'trI.-...II?
$102,000.00
14. At the lime of cIeIth, lid the cIeaedent own or opem. In 1UtomobIIe?
If yes, in wflIch state was it registered?
[J Yes
II No
15. At the lime of deIth, .. the decedent I member of I church or Ifty oilier orpnlzatlon ?
If yes, provide the name and address of the church or any other organization.
~ JIu,~I-~ I
16. StIle the purpose 0 11lIOII tbt decIcIent owned rill property In Pennaylvlnll.
Was a resident of Pennsylvania since 1911 to 2004
Yes [J No
~A~JA
"
17. Include MY oIher lnformIIlon you with to submit In IUpport of the conttntlon thIt the Incllvklull WII not domlc:lled In Penna,......
of deIttI. If more space Is needed, Insert additional sheets Of same size.
Name of person compIeIIng afIldavIt
Gloria A. Hilsinger
Street Address
4702 Carol Avenue
~ to decedent
Daughter
C~ ~
Yakima WA
Zip Code
98908
Under penalties of perjury, I declare that based on my personal knowledge of the decedent, the
Inform8tlon provided on this form Is true, correct and complete.
SignatU18 rson completing aftidIvIt Date
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