HomeMy WebLinkAbout01-07-08
REV-1500 EX + (6-00)
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COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
FILE NUMBER
21 -0 7 0 6 5 2
COuNTVCOiiE ----y'EA~ - - NuMBER- -
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
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Glessner Marline J
DATE OF DEATH (MM-DD-Year)
DATE OF BIRTH (MM-DD-Year)
SOCIAL SECURITY NUMBER
1 96- 1 4 - 0 299
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
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6/27/2007 9/29/1923
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
D 3. Remainder Return (date of death prior to 12-13-82)
D 5. Federal Estate Tax Return Required
_ 8. Total Number of Safe Deposit Boxes
D 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
[XJ 1. Original Return
D 4. Limited Estate
[XJ 6. Decedent Died Testate (Attach copy of Will)
D 9. Litigation Proceeds Received
D 2. Supplemental Return
D 4a. Future Interest Compromise (date of death after 12-12-82)
D 7. Decedent Maintained a Living Trust (Attach copy of Trust)
D 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
THIS SECTION MUST BE COMPl.ETED. ALl. CORRESPONDENCE AND CONfIDEN'J'IAl..TAX INfORMA nON SHOUl.D. BE D CTED TO:
NAME COMPLETE MAILING ADDRESS
Forest M M ers 137 Park Place West
FIRM NAME (If Applicable)
Law Office Forest N M ers
TELEPHONE NUMBER
7175329046 Shi PA 17257
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1. Real Estate (Schedule A)
2, Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4, Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
D Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
(7)
(1)
(2)
(3)
(4)
(5)
OFFICIAL USE ONLY
171,335.76
69,268.68
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(6)
30,345.96
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751.34
0.00 X _(15) 0.00
242,488.95 X .045 (16) 10,912.00
0.00 X .12 (17) 0.00
0.00 X .15 (18) 0.00
(19) 10,912.00
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
12, Net Value of Estate (Line 8 minus Line 11)
13, Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
(9)
(10)
14. Net Value Subjeetto Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1 ,2)
(8)
271,701.74
16. Amount of Line 14 taxable at lineal rate
26,447.34
2,765.45
(11)
(12)
(13)
29,212.79
242,488.95
17. Amount of Line 14 taxable at sibling rate
(14)
242,488.95
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
20. D
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
> >.BE SURETOANSWERALLQUestlbNSONftI:VEftSI:SII:>f:ANDRECHECKMATH .<<
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ece en s ample e ress:
STREET ADDRESS 1460 Goodyear Rd
CITY I STATE I ZIP
Gardners PA 17324-
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
10,912.00
7.600.00
399.99
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Credits (A + B + C)
(2)
7,999.99
Total Interest/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 Payable to: REGISTER OF WILLS, AGENT
0.00
0.00
2,912.01
2,912.01
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; ........................................................................... D 00
b. retain the right to designate who shall use the property transferred or its income; ........................................ D 00
c. retain a reversionary interest; or ...................................................................................................... D 00
d. receive the promise for life of either payments, benefits or care? ............................................................. D 00
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration?.............................................................................................. D 00
3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? ................. D 00
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ....................................................................................................... D 00
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
ADDRESS
Under penalties of perjury, 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 representahve is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN
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ADDRESS Colleen G Lobaugh 2657 Airport Road
ChambersburQ
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
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Forest N ers 137 Park Place West
ShippensburQ
DATE
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PA 17201
DATE
12-lB-Ol
PA 17257
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 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 0% [72 P.S. ~9116(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 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.
LAST WILL AND TESTAMENT
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I, MARLINE J. GLESSNER, a resident of Dickinson Township,
County, Pennsylvania, being of sound mind and memory, do make, publish and declare
this my last will and testament, hereby revoking any and all wills by me heretofore
made.
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amberlahd
ITEM I. I direct my personal representative, hereinafter named, to pay my funeral
expenses as soon after my decease as may be found convenient, and also to pay all
estate, inheritance, succession and other death transfer taxes, of whatever nature and
by whatever jurisdiction imposed and interest and penalties in respect thereto,
assessed against my estate or payable by reason of my death, with respect to any and
all property, life insurance and other interests comprising my estate for death tax
purposes, whether or not such property or interests pass under this will or any codicil
thereto, without reimbursement as if such taxes were administration expenses.
ITEM II. I give, devise and bequeath all my estate, real, personal and mixed, of
whatever nature and wheresoever situate, which I may own or have the right to dispose
of at the time of my decease as follows:-
A. Twenty-five percent (25%) share to my grandson, JONATHAN P.
LOBAUGH, if he is living, but if he is not living, then in equal
shares to COLLEEN G. LOBAUGH and MICHAEL B. LOBAUGH,
if they are living.
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B. Twenty-five percent (25%) share to my grandson, MICHAEL B.
LOBAUGH, jf he is living, but if he is not living, then in equal
shares to COLLEEN G. LOBAUGH and JONATHAN P.
LOBAUGH, if they are living.
GLEN & GLEN
14 NCHtl1 M,lill SI.n'(~1 . Suite :mli
CIl<Jml){~l'shllJ'g. P^
17:.!01.IIlU:i
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GLEN & GLEN
14 NUI'IIJ MClin H(n~el." }llliW :JOO
Chamllnf'slJUl'g, PA
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C. Fifty percent (50%) share to my daughter, COLLEEN G. LOBAUGH,
jf she is living, but if she is not living, then in equal shares to
JONATHAN P. LOBAUGH and MICHAEL B. LOBAUGH, if they are
living.
ITEM Ill. I hereby nominate and appoint my daughter, COLLEEN G. LOBAUGH,
executrix of this my last will and testament, but in the event the said Colleen G.
Lobaugh is not living at the time of my decease, or fails to qualify, I nominate and
appoint my daughter's husband, PHILLIP L. LOBAUGH, executor of this my last will
and testament, and direct that no bond shall be required of said personal
representative.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this last will
and testament, this 1 st day of October, A. D. 2002.
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Marlibe J: Glessner
(SEAL)
SIGNED, SEALED, PUBLISHED AND DECLARED by the said Marline J.
Glessner to be her last will and testament in our presence, who at her request and in
her presence and in the presence of each other, we believing her to be of sound and
disposing mind and memory, have hereunto subscribed 9ur names as witnesses.
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Law Offices
GLEN & GLEN
I-I NlIl'l.h 1\.laill Hln'l'l.. ~Uih~ :lOn
Cham!w!':..;llul'g, PA
11201.IIIU:1
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA
: ss.
COUNTY OF FRANKLIN
I, Marline J. Glessner, 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; and that I
signed it willingly and as my free and voluntary act for the purposes therein expressed.
Sworn to or affirmed and acknowledged before me by Marline J. Glessner, the
testatrix, this 1 sl day of October, A. D. 2002.
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NOTARIAL SEAL ,
LLV L SHETTER, Notary Public 1
SA ,L . C , . C PA
Chambersburg,Franklm 0.: 7 2004
My Commission Expires .January .
Law Office:-;
GLEN & GLEN
J 1 North t...I.JiIl HL/'(~t.1. . Suite :HlH
ChurnheJ'~hUl'g. PA
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AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF FRANKLIN
: ss.
We, George S. Glen and Sharon L. Frank, 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
instrument as her Last Will; that the testatrix signed willingly and executed it as her free
and voluntary act for the purposes therein expressed; that each subscribing witness in
the hearing and sight of the testatrix signed the will as a witness; 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 to or affirmed and subscribed to before me by George S. Glen and
Sharon L. Frank, witnesses, this 151 day of October, A. . 2002.
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NO'l'AHlAL SEAL .
SALLY L. SHETTER, Notary Pubhc
\ChamberSbUl'g, "[<'l'anklm Co., P~7 ')004
My Commission EX[llrc3 ,January ,-
REV-1502 EX + (6-98)
'*
SCHEDULE A
REAL ESTATE
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Glessner. Marline. J 21 07 0652
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 properly 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 iointly-owned with riaht of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
Primary Residence; 1460 Goodyear Road, Garners, Dickinson Township, Cumberland
County, Pennsylvania; $185,000.00: Minus $10.00 Notary fees; $1,850.00 transfer tax;
$10,515.00 real estate commission; $2,113.50 repairs/maintenance/testing to prep
property for sale. Add back in $824.26 property tax adjustments. (See attached HUD-1.)
VALUE AT DATE
OF DEATH
171,335.76
TOTAL (Also enter on line 1, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
171,335.76
. OM. NO. 2802-0285 CI
. A. B. In4"'"
. u.s. Dl!PA"TMI!!NT OF HOUIINtI .. UR8AN DeVELOPMENT l.[]FHA 2, JFmHA 3'[X1cONV. UNINS. 4. OVA /J.DCONV.INS.
~ifCASE I 7~ LOAN :
SETTLEMENT STATEMENT :
C. NOTE: ~/a form la fu'lJJ,1J1l ':live ~u · f1r:m.nt of J,ctu.,.ttI.m.nt co.t.. 1:;ouG:I:,Id to .~. _ttlflment mnt :;, ~n.
tlfm, mtfrked . 1"" p.,d ou tfHt c/o 'fig: they ere shown here In .flona' pu . end ere not elude In IDtrI/..
. 1.0 100000NTRACV. 0,,"41'
D. NAME: AND AbDRESS OF BORROWER: E. NAME AND ADDReSS OF SELLE": F. NAME AND ADDRl:SS OF LENDE"R:
Klppln C. Garman and CoHeen G. LObeugh, ExltCutrlx .nd National City Mortgage
Tracy M. German H&W Eltet. of M.rlln. J. GI...n.r A DIvI8I0n of N.tlon.1 City
4344 C.rll.le Road 1480 OoodyMr Ro.d B.nk
Gardnere. PA 17324 Gardne,., PA 17324 3232 Newmat1< Drive
MJamleburg, OH 46342
G. PROPERTY LOCATION: H. SETTLEMENT AGENT: I. SETTLEMENT DATE:
1460 Goody.ar Road L.lndsay Dare BaIrd. Esq.
Gardn..... PA 17324 December 13. 2007
Cumberl.nd County. Penna)ltvanlll PLACE OF SETTLEMENT
37 South H.nover
,,~'::A17D" K 'LDO~"~ON
1100, . .,.n rn.... .
101. Conlr8ct Sal. r1~ 186000.00 401. Contl'l1lcl S.I. Prlce 1815 000.00
102. Perwonal Prooertv 402. Perlona' Prollertv
103. Settlement Chara" to Bonnwllr ILlne 14001 5 2150.33 403.
104. 404.
105. 405.
106. Cltlilfown Tax.. 10 408. CIIv"'-own Tax.. to
107. Counlv Texe. 12/14107 10 01101108 13.92 407. County TalC.' 12/14107 10 01101JD8 13.1112
108. SQtlool 12/14107 10 0'11011Oe 810.34 408. School 12/14101 ID ~ 810.34
109. 40D.
110. 410.
111. 411.
112. 412.
~~:_AMOUNTD~:OMBORRO~; 181.07....89 420.~UNTI)UE TO SELLER 185,824.28
1100. IIN
~01. ~o.lt or eamllllt monllV 1 000.00 501. Excn. Oel'lOait iSee Inltruedona)
202. PJ1nclDal Amount of New Loanlal 148 000.00 502. Settlement Charaell to Seller CLine 14001 14488.S0
203. Exlltlna 10lnCsI t.hn aubl8CI to 503. Exlstlna loanCsllaken subtect 10
204. 504. PeYOff of f1f'1t Mortgage
2015. 506. Pavoff of "CO age
~06. 508.
207. 507. IDeDo,lt dleb. IIl1 Droceed,l
208. 608.
209. 509.
A"IU.''"*'r'I AlfIUaM'l8r'1 S nnala IJV selle,
210. CItvfTOwn Taxa. to , 1510. CltvlTown Tax.. to
211. Countv rexe8 to 011. Countv TlKea to
212. School to 512. School to
213. 813.
214. 614.
216. 615.
210. 518.
211. 517.
218. Ci18.
219. 1510.
220. TOTAL PAID s~ ROWER 14D.000.00 /J2o. TOTALR6DUr.;tlUNAMOUN7~ 14.488.&0
1 ~ftn OAlllol . ann ' TOJFA[ .
301, Gro.. AmoLlnt Dua From Borrower Llne1~O) 1111.074.80 801. Groal Amount Due To SelleilUne 420 "1I.8a4.28
302. Lese AmOUW BvlFor Borrower Line 220) 14D.000.00 802. Le.. Reduction. Due Seller Cline 5201 1..488.iSo
303. CASH ( X ~ iTI TOJ80R 42 074 69 603. CASH ( X TO J ( FROMT BEl.LER 171,336. e
The und.,.lgned hereby .Qk~ge recelp77 pleted copy of p.gell 1 &2 of thl. at.tement & any .ltachmontt r".rr~.to herel~.
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Seller ~:'~'r.'"''''''''''_''' '" /'I..A-i~''"Y"'''(I'~''L '.!"r.i:,'
. . Ganner~ ,[1/ Co een G.lobeugh, Exeoutrlx. ,/ .'
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(__ }rpoy M. Gfmuln r ;'VI,/ "I '{;'__ ." ;~~I~ of ~rl~~'~. ~l:..~r ;'/;ii.';;(., JF' ., ZAi;t.
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-.WoEC-13-2007 03: 42 PI1 PH I LL I PL. LOBRUGH NYL
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717 263 1126
P.01
DEC-13-2007 03:42 PM
PHILLIP L. LOBAUGH NYL
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I. -YClO. ~........ Bllaad an FlrI_
DtvlaJon aI Comml..km '/Inti 100 .. Follow,:
r01. 5.2112.50 to RelM.x R.alty
02. 5,232.50 to Wolf8 & Sheerer Realtors
03. ommlallon Peld a' Settlement
~nllltlon"H
1802, LOIln bltcOunt
1803. ADDralul F..
["B04. Cr4KI1t Report
8015. ADDllcatlon FH Cradlt
eOG. Tax Service FH
807. LoanP~..mgFee
1908. UnderwriUng Fe.
1801. Flood Cart Fe.
re10.
811. ~
JAin ITlii'ulll : .AID IN ~
901. Intereat From 12/13/07 to 01/01/08 G .
902. tvtorto.a.-lnIUrIlnce PremIum tor monlha to
80~. Hazard Inaunllnoe Premium for 1.0 vetil,.. to Well. Farvo Ina. eve of PA
004.
DOS.
liMA
1001. Hazard In.urance
1002. Morta.a. In.unmce
1003. cTrI.'lTCJWn Taxes
1004. CountllTaX8s
1005. School
~
08.~iimt
ntl. .I.W.I..SiU6IIi
1101. 6et1lemenl or CIOlino Fee
1 102. Abalrect or t'lIe S.arch
1103. IMaIl
1104, TItle In,urence Binder
1105. Documenl PreDllraUon
,10e. Notllrv F...
1107. Attorney', Fees
(Include. .bow Item numb.,.;
II:
%
to
.nAN
to N.nonal City MortDaae
to National City Mortg.g.
to N. relnl Service.
to C5Cl&qUlJelC
to Natlona' OItY Mortaage
to Lend Amertca
to Nallon. e
to NaUona' C y Mortga".
to FIS Flood ervlcea
I!
/iF
CHAROI!S
'V. .n ... nn
/day ( 1Q days
3.000 month II
month.
month.
11.000 mooll1.
8.000 monlha
months
mnlllha
monihll
$
10
to Nlllen J. Baird
to LlndaavOa,. Baird ESQ.
to
to
to Niven J. Baird
to
lT1oa.
. in l/n
ealrd. Ella.
(lncJudtl$ IIbove/tern numbers:
, 1 rn . LencJii'a Coverege
111 ( . Owoer'a Covetaoe
11 1 . Endorsements,100. 300. 900
111 . CIOlIno Protection l.eUer
1113. Wired Fundi Fee
. ''''A
o Lind.. I Dare Baird, Elq.
o L1ndsa' Dare Ball'd, EICl,
~ ~alrd.E.q.
38.50 i Morta.all $ 84.50:
. MortQaae
: MortaaQe
31.16 1)8r month
par month
oer month
24.00 Der month
126.10 per month
peT month
n.r manfh
nar month
1201. RecordIng FHa: Dead $
12~. ClhlfCountv TaIC/StamOI: Oeed
1203. State TalClSl8mDe; Revenue StamDs
1204.
I~:~~:
<l.CTf'1
1301. Surv,v to
1302. PeRt InsDAclfon to Gilberta
1303. Home and Weter Ineolctlon to BI6
1304. SeDtlc SYIIlam to Peck'l Seotlc Service
130a. Se"er Credit to Klppen Garman
1400. TOTAlIIlTU!MI[NT CHAMGE8 (enter on Un.. 103, aectlon J and a02. a.clIo" 1<)
Release. $
717 263 1126
%)
poe 1381.00b
poe seO.OOb
poe t300.00b
,....ID l'ROM
8O""OW.....
I'UND. "'T
8IImJ1..NT
1.410,00
-1,480.00
35 .
-38 .
77 00
171.
20
4e1.48
\lUG
204.00
750.80
-405.7:l
60.00
2/J.00
J
1 "A~ 71!1
J
150.00
.35.00
103.00
H1.850.0l1
130.00
5,250,33
By sIgning pIg_ 1 of thIs statement, Ih_ Ilgnatorl.. acknowltldge receIpt of . completed copy of page 2 of this two ~lIige statement.
,.A ('/.~: I ~\-_.-
Certllled 10 b. it true copy. alrd. EIQ.
_nl
P.02
....n.'
PAD "~QaA
IlILLa"..
l'UNDI AT
.!!!J!:.e:'!-
~
10.00
1 8150~00
613.80
1.500.00
14.488.50
(~~MANTRACYIOARMANTAACY/'4)
REV-1503 EX + (6-98)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
Glessner. Marline. J
FILE NUMBER
21 07
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
0652
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
6,717.64
Mainstay High Yield Corp Bond *2270
2.
Mainstay Cap App Fund "A" *2270
4,854.74
3.
Mainstay Convertible Fund "A" *2270
6,916.72
4.
Mainstay Interntl Equity Fund "A" *2270
3,365.95
5.
Mainstay Global High Income Fund "A" *2270
2,722.62
6.
Mainstay Consv Alloc Fund "A" *8715
25,825.48
7.
Mainstay Total Return Fund "A" *8600
9,397.87
8.
Mainstay Value Fund "A" *2270
6,356.30
9.
Prudential Financial; 32 shares @ 97.23
3,111.36
TOTAL (Also enter on line 2, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
69268.68
REV-15G8 EX + (6-98)
'*'
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Glessner. Marline. J
FILE NUMBER
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.
0652
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
8,465.01
Members 1 st; checking #1923-11
2.
Mainstay Money Mkt Fund "B" *8715
4,019.55
3.
Mainstay Money Mkt Fund "A" *8715
1,311.50
4.
Kennys Auction; proceeds of Personal Property
3,019.25
5.
Yard Sale proceeds
668.60
6.
New York Life Annuity *4568
5,203.25
7.
2004 Chevrolet Impala automobile
7,500.00
8.
Prudential Financial; dividends
36.80
9.
Travelers Insurance, refund
122.00
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
30345.96
REV-1509 EX + (6-98)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF
Glessner. Marline. J
FILE NUMBER
21 07
0652
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 TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A. Colleen G Lobaugh
2657 Airport Road
Chambersburg PA 17201-
Daughter
B
c
JOINTL Y.OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY 0/0 OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DE CD'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENTS INTEREST
1. A. Members 1 st; reg savings #1923-00 1,502.67 50. 751.34
TOTAL (Also enter on line 6, Recapitulation) $ 751.34
(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
Glessner. Marline. J
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
21
07
0652
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Hollinger Funeral Home Inc 3,801.00
2. Mt Zion Luthern Church, Goodyear, Ladies Aux. contribution 500.00
B. ADMINISTRA T1VE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
2. Attorney Fees Law Office Forest N Myers, Forest N Myers, Esq. 12,280.00
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 Cumb Co Reg of Wills; probate fees 360.00
5. Accountant's Fees
6. Tax Return Preparers Fees
7. Traveler's Indemnity; insurance 49.00
8. Sollenberger's; transfer car 63.50
9. Michael Lobaugh; reimb. of materials for 1460 Goodyear Rd prop repairs 50.00
10 Gettysburg Times; advertise 1460 Goodyear Rd prop for sale 30.80
11 Helfin Electric; electrical work 1460 Goodyear Rd prop 1,295.88
12 Carolyn McQuillen, Tax collector; property taxes 1,482.92
13 F&M Trust; signature guarantee 5.00
14 Community of Healthcare (financial instution); checks 14.15
15 Postage; mailing correspondence & documents 8.28
16 Rebel's Construction; repair of basement wall 1460 Goodyear Rd prop 2,649.22
17 Helfin Electric; electrical work (09/01/2007) 1460 Goodyear Rd prop 199.45
18 Public Opinion; legal ad 225.19
TOTAL (Also enter on line 9, Recapitulation) $ 26447.34
(If more space is needed, insert additional sheets of the same size)
Continuation of REV.1500 Inheritance Tax Return Resident Decedent
Glessner, Marline, J
Decedent's Name
Page 1
21 07 0652
File Number
Schedule H - Funeral Expenses & Administrative Costs - 87.
ITEM
NUMBER
DESCRIPTION
AMOUNT
19
20
21
22
Mark Devos, lawn maintenance 1460 Goodyear Rd prop
Ben Smyers Excavating 1460 Goodyear Rd prop
Phillip Lobaugh, reimbursement for bark mulch 1460 Goodyear Rd prop
Lowe's, items for maintenance @ 1460 Goodyear Rd prop
1,885.00
1,500.00
39.50
8.45
SUBTOTAL SCHEDULE H.B7
3,432.95
REV-1512 EX + (6-98)
'*
SCHEDULE.
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Glessner. Marline. J
FILE NUMBER
21
07
0652
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1. Shippensburg Health Care Center; medical bill
VALUE AT DATE
OF DEATH
1,751.25
2 WSEMS - Chbg ALS; medical bill
349.79
3. Met Ed; electric
88.24
4. Embarq; telephone
182.81
5. Postal Commemorative Society; stamps
101.70
6. Sentinel; yard sale advertisement
14.00
7. Carlisle Petro, fuel
260.69
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
2 748.48
'''.''''''.'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
NUMBER
I.
SCHEDULE J
BENEFICIARIES
a. I'
FilE NUMBER
?1 07
RELATIONSHIP TO DECEDENT
Do Not list Trustee(s)
065?
AMOUNT OR SHARE
OF ESTATE
One-half (1/2)
One-fourth (1/4)
One-fourth (1/4)
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
J
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1.
Colleen G Lobaugh
2657 Airport Road
Chambersburg PA 17201-
Michael S Lobaugh
909 Saer Avenue
Hanover PA 17331
Jonathan P Lobaugh
3032-1 Mackenzi Lane
York PA 17408
Lineal
Lineal
2.
Lineal
3.
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)