HomeMy WebLinkAbout01-22-08 (2)
-I
15056041125
REV-1500 EX (06-05)
PA Department of Revenue '*
Bureau of Individual Taxes INHERITANCE TAX RETURN
PO BOX 280601
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
OFFICIAL USE ONLY
County Code Year
File Number
207
1 4 2
Date of Birth
278247503
032 1 200 7
1 2 1 9 1 9 2 7
Decedent's Last Name
Suffix
Decedent's First Name
MI
Hal
G 1 a d e
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
Spouse's First Name
MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
[&I 1. Original Return
o 4. Limited Estate
00
o
2. Supplemental Return
o
o
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
4a. Future Interest Compromise (date of
death after 12-12-82)
7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
10. Spousal Poverty Credit (date of death 0 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. 0)
CORRESPONDENT. THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
6. Decedent Died Testate
(Attach Copy of Will)
9. Litigation Proceeds Received
o
o
o
o
8. Total Number of Safe Deposit Boxes
W i a m
Firm Name (If Applicable)
R
Swinehart
E s q
570 286 777 7
REGISTER OF WILLS USE.ONL Y
W i e s
First line of address
MuoloNoonSw
n e h art
y
240- 246
Ma r k e t
S t r e e t
Second line of address
City or Post Office
State ZIP Code
PA.1jE FILED [,)
,;>"
~...~
Sun bur y
PA 17801
Correspondenrs e-mail address:
Under penalties of pe~ury, I declare that I have examined this retum, including accompanying schedules and statements, and to the best of my knowledge and belief,
ij 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 PERSO RESPO LE F R FILING RETURN
D TE J.
'17/fPr
ADDRESS
716 Twin Hill Road
S T~~~REPRESENTATIVE
ADDRESS
240-246 Market Street
Sunbu
PA 17801
DATE
I"'I"}.~ ?
Sunbury
PLEASE USE ORIGINAL FORM ONLY
PA 17801
Side 1
L
15056041125
15056041125
-I
~
--.J
15056042126
REV-1500 EX
Decedenfs Name: Glade Hall
RECAPITULATION
1. Real estate (Schedule A)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ., 1.
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.
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ....... 5.
6. Jointly Owned Property (Schedule F) D Separate Billing Requested . . . . . .. 6.
7. Inter-Vivos Transfers & Miscellaneous N,2D;Probate Property
(Schedule G) U Separate Billing Requested . . . . . .. 7.
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.
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.
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 under Sec. 9116
(a}(1.2}X.O _ 0 . 0 0 15.
16. Amount of Line 14 taxable
at lineal rate X .012- 5 9 6 8 2 . 2 0 16.
17. Amount of Line 14 taxable
at sibling rate X .12 0 . 0 0 17.
18. Amount of Line 14 taxable
at collateral rate X .15 0 . 0 0 18.
19. Tax Due
... . . . .., " . . ........... . .,. . .... . ..... . . '" . " . 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
L
15056042126
~c:
~ ~:t::>
~t7
Decedent's Social Security Number
278247503
60000.00
3 6 7. 2 0
6 0 3 6 7. 2 0
6 8 5. 0 0
6 8 5. 0 0
59682.20
o . 0 0
59682.20
o . 0 0
2685.70
o . 0 0
o . 0 0
2685.70
D
15056042126
.....J
REV-1500 EX Page 3
Decedent's Complete Address:
File Number
21 07 1142
DECEDENTS NAME
Glade Hall
STREET ADDRESS
3018 Thome Road
CITY I~TE I ZIP
Seneca Falls 13148
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19) (1)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
2,685.70
Total Credits (A + B + C) (2)
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penal~,
T otallnterest/Penalty ( 0 + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in avalon Page 2, Line 20 to request a refund. (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
0.00
0.00
2,685.70
8. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(5A)
(58)
A. Enter the interest on the tax due.
2,685.70
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; ...................................................................... 0 00
b. retain the right to designate who shall use the property transferred or its income; ............................... 0 00
c. retain a reversionary interest; or ................................................................................................ 0 00
d. receive the promise for life of either payments, benefits or care? ....................................................... 0 00
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ....................................................................................... 0 00
3. Did decedent own an Oin trust for" or payable upon death bank account or security at his or her death? ......... 0 00
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? .................................................................................................. 0 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.
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
is three (3) percent [72 P.S. 99116 (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. 99116 (a) (1.1) (Ii)]. The statute does not exemot a transfer to a surviving spouse from tax, and the stEtutOry requirements for disclosure of assets and
filing a tax retum are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an
adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. 99116(a)(1.2)1.
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. ~9116(1.2) [72 P.S. 99116(a)(1)l.
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. ~9116(a)(1.3)J. 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)
*'
SCHEDULE A
REAL ESTATE
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Glade Hall 21 07 1142
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 fads.
Real DrODertv which is iointlv-owned with riaht of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
All those two (2) certain lots ofland siuate in Lower Frankford Township,
Cumberland County, Pennsylvania, as follows:
VALUE AT DATE
OF DEATH
Parcel Number 1: Containing one and Two Hundred Five Thousandths (1.205) acres,
more or less, and being described according to a subdivision plan for Francis X.
Bender, Jr. by GJ. Betz, R.S. dated February 1, 1977 and recorded in Plan Book 30
at Page 87, and being designated as lot numbered 5, Section A;
Parcel Number 2: Containing One and Two Hundred Five Thousandths (1.205) acres,
more or less, and being described according to a subdivision plan for Francis X.
Bender, Jr. by G.I. Betz, R.S. dated February 1, 1977 and recorded in Plan Book 30
at Page 87, and being designated as lot numbered 6, Section A;
60,000.00
Proceeris of Sale
(see attached settlement sheet)
;
I
TOTAL (Also enter on line 1, Recapitulation) \ $
(If more space is needed, insert additional sheets of the same size)
60,000.00
( I I. FHA SeIlI_ Sl8Iema . u s. 0 0/-'. IIId Urblll o...l Form U8 H\JD . 1
I )2.~ 8. F;1e ........... RE2lII7 7. lINn IUnbIr F'.~ No.. 1
L MaIlpgaI_
( ) 3. Comt. Ihtn. C_ ,..,.
~ l .VA
5. CcIw. .....
Co Thlllarm II bnlIIIed 10 . .......
,he .. ~....1W 1nlorm.1DnaI """"'_..... lOW not ftllld"ln 1Ie- p.o.Co _ 0...... 01
D. H_ _ Addr.-olllomJ... &. "'-... AcIdr_ 01 SdIr:
Haft' .. DLSOJr Daft ~ GLADS .. DJiL
16 'l'1. '1'0. CIJlC~ C/O 1It:LLDII.. SWIIIIDJl2
CAIlLISU, PA. 17015 2tO-24' ~ S~
5U111UU, PA. 17801
TIN
F. N_1IId AdchN 01 LoIndtr (J, ~~
U. . 137 au .ILL RoaD
RO". LO'IS 5 . . BUDD IV8DXV:tlIOIr, .. 30, PG 87
LOND t"UIID'Qa 1!01lIIIUP
CIlICInLUD ~. .....n.vum
H. SIItr'I ~I Aganr. Fau: a 'UL.~ L SIlIInwIl 0aIa: ,.. 01 ..........
9 souU IlaBOY_ 5t;. Ja1l1la1l7 11, 2001 5 SOV'l'II IWIDVa nun
TIN 25-1730531 Cadide. 'A. 17013 CULI8LIl. "'1n.VU%&
P you IIaI
01__......,.,. COlla. Amounla paid '" _ by'" ___.. _ II-... ......",......"1 )'
J. SUMMARY OF BORROWER'S TRAN9ACTtON
It. SUMMARY OF SllLLER'S TRANSAC'nOCll
100 aro. ...._llUa../IIIII ~
101 Col*___
lot F'InonaI p/lllllllr
103 SIIlIImInI c:twgeo loam II.. 1400)
104
105
40lI ............ ~To....
&0,000.00 401 ConnIISIIaa....
401 ,....... '*"*"
1,278.00 AlII
.tOe
401
~ ......."'........-
- ~.... 10:
<<IT eoo.nty ra.. IOl
401 __ 10:
U7.20 _ 'ha 'ro-Ratioa ~o IS-Jaa-OI
41D
411
411
&1, 't5. 20 ... er..".... Dua 10.....
A"-"''-pIIld",._,,_
'Do CIIy""""'_ 10:
\07 C...., _ 10:
101 __ra lD:
.08 1'0 'C'o-Rati_ to 15-010-01
tlO
III
112
120 Or-. Ant_. llUa..,.,. Bo_
-=--=--
200 _......., a... .......or___
201 DIflClIi''''___
202 F'rlnClpll_ III new~"
2113 ExIIllng laen(a) _....111
204
201
206
207
201
201
- ~1II__DuaTll'"
SOl e-.... <-lr--..)
5CII ,.....~.ID _ (11M I.
SIll e-.IOIII(aJ............ III
5CM ...,.. 01..........._
501 ...,.. 01_ .............
501
fIR
501
501
~"-upM/IlIy ,.,.,
510 ~.... 10:
511 eo.ny_ 10:
5.2 __ 10:
51'
lIUVBD 514 13S out BILL 1m ... ($275.00)
IfUVD 5/1 137 au JlILL LOt! ...., ($275.00)
51.
!IOU 511 SBCUUn D-.o8%7 135 cwr BILL
NO" 51' SBCVUn Daoarr U7 OAK BILL
51.
o . 00 520 ToIIII AoduclIan. '0 AmI Due s.lI.
~ lor _ upa/d","'"
2.0 CIIyII""",'_ 10:
21 . CounlI' ~ ro:
212 __ 10:
213
2'4 1350U OLL ~ 1lU'I ($275.00)
215 U7 OAIC .xu. un MII'1' ($275.00)
21'
217 SIlCUll:r~~ DIPOSn:' 135 OAIC IlILL
211 SECllltIn DUOSII' 137 OAIC BILL
219
220 T_ PIId ByJI'or lorroww
======~=--
300 CUll Al ''''_l'fomITo 8_
JO' G,,*.IIIOIII''''U. 'rom barro_ (fino 120)
302 L.......1lIIllI poId byIlor _ tllOlll II.. 220)
lDI Cult eX)""" ( ) To Bo~
600 eaall AI !I4IIIIonanI1'oII'rom ....
51, U5 .20 801 G'a...'_nllO..... flam (In. 420) I
/0 . 00) 802 LoIn rwluI:IonI in lUIIIU1l cMI ,.... (from 'M 520):
U, US .20 SaI C..( )1'rolII (X) ToSlllllr
I
=-=========--
pMI
'0,000.00
367.20
60,367.20
-
3,315.70
lfJU:VD
lQU:VD
NO"
BOn
3,315.70
=--=-~
60,3&7.20
/3.315.70)
57,051.50
===-:.a:::z:::::::=:2I.-
IHlJD.l
700 TOIlI Sa/eslBtobr'a Comm. based on price:
Division 0/ Commls3lon ("", 7(0) as (ollows:
10
10
L SCTTLEMENT CHARGES
60,000,00
" .
0.00
Plld From
Borrower'1
Fundi It
s._nt
701
702
703
704
ConvniSIJiOn paid at Sett1emen1
SELL2R 'HARRlUlTS NO REAL!rY COMMISSIO. DUB.
705
BOO /lems Payable In Connection With Loan:
(Morlgage AmI:
.00 ,
.00 ,
0.00)
801 Loan Originallon Fee
B02 loan Discount
803 Appraisal Fee
804 Cred,' Report
805 Lende"s Inspection F..
806 Monglgl InsurlW1C8 Applleallon Fee
807 Assumpllon F....
8ce
809
810
811
900 lIema Required By Lender To 8e Paid In Advance:
9Q 1 In'oresl From 10
0.00
0.00
'0
10
to
to
to
per day .
902 Mangag. Insu""",,, p,.mlum lor
903 Hazard Inswanc. Premium for
month, to
yells to
years 10
904
005
1000 Reserves Deposited With Lender:
1001 H...",d insurance
1 002 Morlglge insurance
1003 City propeny lax..
1004 Counly prop.ny I....
1005 Annual ....,men's
1006
1007 School 18"'"
1008
1100 Title Charges:
1101 SeI1Iem.nl orcrosng 'ee
1102 AbslraC1 or IItle..lII'Ch
mOL ,.
mos. .
mos. .
mos. t9
mos. t9
mo.. <It
mos. (f
mos.~
pQl' month
per month
por monlh
por month
pet mon..
per mortlh
per menII1
Pilr mOr11h
10
10
1103 r.u. ..aminallon
1104 Ti~"n...rance binder
1105 OocrJrl\el\l preparalion
1106 NotIory t....
1107 Anomoy'st"".
Oneludes abOve itema numbers:
II ce nae 1".",,_
(Includ.. _ i10ms numbers:
1 109 Londer's Coveragl
1110 Owner. Coverage
1111
1112
1113
1200 Government Recording and Trans!er Charges:
1201 Recortlng f_: Deed $ 7 8 . 00 ;
1202 Cltylcounly/stamps: Deed $600.00 :
1203 Stalelaxl.lamps: Deed $600.00 ;
10
10
10
10
10
FRSY ABJ) TILEY
600.00
to
Closing SlONlce Lefter (Frey & nloy lor Comw1th. Land n~el
SO
$60,000
: ReIe....
78.00
600.00
Mortgage:
Morlgego: $
Morigllgl: $
1204
1205
1300 AddlUonal Settlement Charges:
1301 Survey
10
1302 Poalln.plCllon to
1303 Current Ta.es due from a."owerlSeler
1'-
1305 fA INHERITANCE TAX - TO REGISTER OF WILLS:
1306 FILING FBE FOil INHEIUTARCE tAX RI!:TUIlH - ~ llEGISTBll OF 'HILLS
1307 FILING FEE FOil INVENTORY - TO llEGZStER OF lfILLS
1400 Total Settlement Charges (enter oollnes 103, Section J and 502, Seclion K)
1,278.00
Page No. 2
Paid f,am 700
Seu.'.
Fund. at 701
Sellle",.... 702
703
704
705
800
801
802
803
804
805
806
807
808
3
810
811
900
901
902
903
904
905
1000
fOOl
1002
1003
1004
1005
1006
1007
10ce
1100
1101
1102
1103
1104
1105
1106
P.O.C. 1107
1106
1109
1110
1111
1112
1119
1200
1201
1202
600.00 1203
1204
1205
1300
1301
1302
1303
1304
2,685.70 1305
lS,OO 1306
l5.00 1307
3,315.70 1400
/HUD-I
Pagl NQ. 31
CERTIFICATION
I direct and authorize 1Ile Comptlay 10 make cistribulions Indicated lor my acx:ounl on the attached HUD.1 SellIemanl Statemenl, approvlng the tax proralkms
indICated therain, and LI'lderstand that prorallons wala based on flgures lor the precedlng year, or esllmotas for the current year, and in the BYent 01 any change
for the ClllTen! year. all neC8ss8IY adJBS1n1enls must be made between SeJler and Borrower direct; likewise any DEFICIT In delinquent laxes will be reimbursed to
Attomeymtte by Selier.
I have carefully ravlewed 1IIe HUD-1 Setttemenl SlaIement and to !he beat of my knowledge and befoe/,Ills a true and accurate statemenl of all receipts and
disbursllIIl8nls made on my account or by me in this lransac:llOll. Ilurther certify thaI I have received a copy of the HUO-1 Selllement Slatemenl.
9
f/~
Borrower.
~k(AjLf1ftJYJ ~
Selle..
To the best 0' my knowledge, !l1e HU0-1 Settlement Statement which I have prepared Is a true and aCCIJrale account of lI1e funds whiCh were received and have
been or will be disbursed by !he undersigned lIS part 0' the settlement of !hie transaction.
#(J_7:~
S .", III
~. d C;; .J<'.tP,,9j>
Date
WARNING; tt ia a crime 10 knowingly make falsa statamenls to lI1e United Stalea on this or any other similar form. Penala.s upon conviction can Include flne and
Imprisonment. For details see: Title 18 U.S. Code Seellon 1001 and SeelIon 1010.
INFORMATION REPORnNQ ON REAL ESTATE TRANSACTIONS
THIS HUO SETilEMENT STATEMENT CONTAINS IMPORTANT TAX INFORMATION (BOXES E. G. H. I. M AND LINE 401) AND 1$ BEING FURNISHED TO
THE INTERNAL REVENUE SERVICE. IF YOU ARE RECUIRED TO FILE A RETURN. A NEGLIGENCE PENALTY OR OTHER SANCTION WILL BE IMPOSED
ON YOU IF THIS ITEM IS RECUlRED TO BE REPORTED AND THE INTERNAl REVeNUE SERVICE DETERMINes THA T IT HAS NOT BEEN REPORTED.
Solicll8llon 01 nN
Sell.r is required by law to provida the Allomey/Cornpany with hiSl!wr COlt8c:1lallpayer ldentiflcation nlImb.... If correct taxpayer identitlcaUon number Is nOI
provided, he/she may be subject 10 civ" or criminal penalties Imposed by law.
Certll\catlon 01 TIM
ItfICalion number shown in Ihls statemanlla my correcllaxpaYlr Identiflcallon number.
TAX PRO-RATION ADDENDUM
Dafe of Pro-Ration:
Borrower
Sell...
ASSESSMENT,
$51,420.00
(COMBINED)
2007-2008 Scheel Rell E.tOle Tax
2007.2008 School Rail e.lal. Tax- Face
~007-2008 School Raal e.t.... T.... POI Day
168 Day. Pre-paid =
14.194 m~ls
$829.21
52.26560
$380.62
P.O.C.
JMUlry 18. 2001
See SelIlellllnt Slleet
Line. Numbers 110,
410 _ 1303 for
Re.'hI of 111'.
Addendum.
2008 CO. & Twp./BOr. Real ESlal. Tax EST.
2008 CO. & Twp./Bor. Real Eolate Tax- Face EST.
2008 CO. 8. Twp./Bor. Real E&1a18 Tax- Per Day EST.
14 Oay. Pre-paid =
2.645 mi~s
$154.52
$0.42334
$5.93
P.O.C.
Purchaser owe!:
168 Days pro-paid School
Less 14 DaY" pr.."aid Co. 8. TwpJBor.
Lass 2~. discount
380.62
15.93)
374.69
7.49
367.20
REV-1508 EX + (6-98)
'*
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Glade Hall
FILE NUMBER
21 07 1142
Include the proceeds of litigation and the date the proceeds were received by the es';ale.
All property jointly-owned with right of sUlVivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
Adjustments for items paid for in advance in connection with the sale of
real estate, as follows:
Pro-ration of real estate taxes
VALUE AT DATE
OF DEATH
367.20
TOTAL (Also enter on line 5, Recapitulation), $
(If more space is needed, insert additional sheets of the same size)
367.20
REV-1511 EX... (12-99)
*'
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Glade Hall
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
21 07 1142
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1.
B. ADMINISTRATIVE 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. Attomey Fees i
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) I
Claimant ~
Street Address ~
City State Zip I
Relationship of Claimant to Decedent
\
4. Probate Fees Cumberland County Register of Wills 55.00
5. Accountant's Fees
,
6. Tax Retum Preparer's Fees I
7. Cumberland County Register of Wills, Agent - 1 % realty transfer tax 600.00
8. Cumberland County Register of Wills - inheritance tax return & inventory filing fee 30.00
,
I
-
TOTAL (Also enter on line 9, Recapitulation) i $
I
685.00
(If more space is needed, insert additional sheets of the same size)
""'-"" "'. '.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Glade Hall
SCHEDULE J
BENEFICIARIES
FILE NUMBER
21 07 1142
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
1. TAXABLE DISTRIBUTIONS (include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2))
1. Rebecca Rorke Lineal
716 Twin Hill Road residue of estate
Sunbury, PA 17801
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. None 0.00
B. CHARiTABLE AND GOVERNMENTAL DISTRIBUTIONS I
1. None 0.00
I
I
i
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
STATE OF NEW YORK)
SURROGATE'S COURT)
COUNTY OF SENECA)
Control# 28
EXEMPLIFICATION
FILE#: 2007-22194
FILE NAME: Glade Hall
I, Rosemarie Capozzi, Chief Clerk of the Seneca County Surrogate's Court, being a Court of Record, do hereby certify that the
copies of the documents listed below, were compared to the original records of the Court filed in the Surrogate's Office of the
County of Seneca, and in my care and custody as the Chief Clerk of the Surrogate's Court, and that the same are full, exact and
correct transcripts therefrom, and of the whole of each original record.
Last Will and Testament of Glade Hall, deceased, dated Feb. 6, 2001, late of Seneca Falls, Seneca County, New
York (Date of Death March 21,2007) (Date of Probate Oct. 25, 2007); Petition for Probate and letters
Testamentary filed Apri/10, 2007; letters Testamentary issued Oct. 25, 2007 and filed Oct. 31, 2007 and Decree
of Probate dated Oct. 25, 2007 and filed Oct. 31, 2007
STATE OF NEW YORK)
SURROGATE'S COURT)
COUNTY OF SENECA)
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IN TESTIMONY WHEREOF, f have hereunto set my hand, and
affix the seal of the Seneca Surrogate's Court on November 27,
2007.
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Rosemarie Capozzi, Chief Cler
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I, Dennis F Bender, Presiding Judge of the Surrogate's Court, do hereby certify that Rosemarie Capozzi, the person attesting the
above certificate, is Chief Clerk of the Surrogate's Court, that his/her signature to the attestation is genuine, that he/she is the legal
custodian of the records and files of the Court, and that the certificate and attestation are in due form.
STATE OF NEW YORK)
SURROGATE'S COURT)
COUNTY OF SENECA)
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IN TESTIMONY WHEREOF, I have hereunto set my hand and
affixed the seal of the Seneca Sutrogate's Court on November
27,2007. .,
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Dennis F Bender, Surrogate
I, Rosemarie Capozzi, Chief Clerk, of the Seneca County Surrogate's Court, do hereby certify that the Honorable Dennis F Bender,
is the Surrogate of Seneca County, duly commissioned and qualified, and the Presiding Judge of the Surrogate's Court, and that
his/her signature to the foregoing certifj' '" uine.
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IN TESTIMONY WHEREOF, I have hereunto set my hand and
affixed the seal of the Seneca Surrogate's Court on November
27, 2007.
Rosemarie Capozzi, Cli1ef CIeri(
(Facsimile signature may LIe used pursuant to Section 2609 of the Surrogate's Court Procedure Act)
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JLast Will anb \lCestament
3J, GLADE HALL of the Town of Seneca Falls, in the County of Seneca
and State of New York being of sound mind and memory; do make, publish and
declare this my last Wtll anb rEestament, in manner fOflowing, that IS to
say.
jf t rst.
I direct that all of my Just debts, funeral expenses, all
expenses in the administration of my estate, an all inheritance taxes, if any, be paid out
of the residue of my estate, without apportionment among the legatees and devisees
hereinafter named.
~econb.
All of the rest, residue and remainder of my estate, both
real and personal and wheresoever situate, I give, devise and bequeath to my daughter,
REBECCA LYNN HALL, absolutely and forever
ij[btrb.
For reasons personal to me, I am providing no bequest to
my four children, Glade Hall. Jr., Daryl Jean Anderson, Ellen Louise Leo and Lawrence
Andrew Hall
jfourtb.
For reasons personal to me, my former wlfe, Virginia Jean
Talcott, whom I was divorced from in the 1970's, is to receive nothing from my estate.
jfdtb.
I direct that my Executrix hereinafter named serve without
bond or other security for the faithful performance of her duties.
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JLa5tlp., I hereby appoint my daughter, REBECCA LYNN HALL, If living, If
not. my friend, Lee M. Brandt, executrix of this, my last Will and Testament, with full
power and authority to sell and convey, lease or mortgage real estate; hereby revoking
all former wills by me made.
3Jn 'Witness Wbereof, I have hereunto subscribed my name the
loTI:! day of February, in the year Two Thousand and One.
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GLADE HALL
We, whose names are hereto subscribed, 1190 ~erttf!, that on the &:,-rtftay of
February, 2001, GLADE HALL, the testator above name, subscribed his name to this
Instrument in our presence and in the presence of each of us, and at the same time, in
our presence and hearing, declared the same to be his last Will anb
mestament I and requested us, and each of us, to sign our names thereto as
witnesses to the execution thereof. which we hereby do in the presence of the testator
and of each other, on the day of the date of the said Will, and write opposite our names
our respective places of residence.
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AFFIDAVIT OF WiTNESSES
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STATE Of NEW YORK, COUNTY OF SENECA, 5S.
Each of the undersigned, Christine A. Deal'07 ,QPR 10 f' j: I
residing at 2874 County Road 121, Seneca Falls
, and Richard E. Swinehart
residing at Packwood Road, Waterloo
respectively, being individually and
severally duly sworn, did depose and say that: The foregoing last
will and testament was subscribed in our presence and sight by
Glade Hall, the Testator named therein. The undersigned witnessed
:he execution of said will of Glade Hall on ':he 6th day of February,
2001, at 54 FALL ST, PO BOX 299, SENECA FALLS, NY 13148-0299. At
the time the instrument was so subscribed, the Testator declared
said instrument to be his last will and ~estament. The undersigned
thereupon signed their names as witnesses at the end of said will
at the request of the Testator, in the presence of the Testator and
F:21ch ocher. At r:he time of so executing said will, in our
cespective opinions, the Testator was at least eighteen years of
age, and 'Nas of sound mind, memory and understanding, under no
constraint, duress, fraud or undue influence, and in no respect
incompetent to make a valid will. In our respective opinions, the
Testator was able to read, write and converse in the English
language, and was not suffering from any defect of sight, hearing
or speech, or from any other physical or mental impairment which
ItJOL:ld affect his capacity to make a valid will. Each of us 'Nas
acquainted with the Testator, and we make this affidavit at his
request. Said will was shown to us at the time this affidavit was
made, and we examined it as to the signature of the Testator and
our signatures. Said will was executed as a single, original
instrument, and not in counterparts. Said will was executed by the
Testator and witnessed by us under the supervision of RICHARD E.
SWINEHART, an attorney-at-law admitted to practice in the State of
New York, who stated that the formal requirements of the New York
Estates, Powers and Trusts Law regarding the ceremony of execL:tion
and aetestation of a will had been l~~ed_and sati3fied.
Witness
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Witness
=e'ler'ally subscribed3.nd s't/orn
February, 20Cl.
,-~",-.tIJ-L It,-el;t~ U . t::ljuJ--{>7~'
to before me this 6h
day
of
ANTOINmE D. LARSON
NOTARY PUBLIC, STATE OF NEW YORK
QUALIFIED IN SENECA CO~!'f').~O}~ 0 I
MY COMMISSION EXPIRES ~