HomeMy WebLinkAbout02-13-08
REV-1500"r;:,X + (6-00)
'*
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
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DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
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Wooten John A
DATE OF DEATH (MM-DD-Year)
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
DATE OF BIRTH (MM-DD-Year)
07/29/2007 05/03/1933
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
OFFICIAL USE ONLY
FILE NUMBER
2 1 -0 7 0 74 3
"'CoUNTYCOOE -vEP,p:--"' - - NUMBeR- -
SOCIAL SECURITY NUMBER
2 1 1 - - 2 - 4 8 6
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
o 3. Remainder Retum (date of death prior to 12-13-82)
D 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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00 1. Original Retum
o 4. Limited Estate
00 6. Decedent Died Testate (Attach copy of Will)
o 9, Litigation Proceeds Received
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NAME
John M. Eakin
FIRM NAME (If Applicable)
TELEPHONE NUMBER
717 766-3172
o 2. Supplemental Return
o 4a. Future Interest Compromise (date of death after 12-12-82)
o 7. Decedent Maintained a Living Trust (Attach copy or Trusl)
o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
COMPLETE MAILING ADDRESS
Market Square Building
Mechanicsburg, PA 17055
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(9)
(10)
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
167,000.00 I
OFFICIAL USE ONLY
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)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
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)
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15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
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
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~~.~ 271 ,975.96
(8)
28,654.75
5,404.61
(11)
(12)
(13)
34,059.36
237,916.60
(14)
237,916.60
X _(15)
X _(16)
237,916.60 X .12 (17) 28,549.99
X .15 (18)
(19) 28,549.99
20. D
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
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Decedents omDle e ress:
STREET ADDRESS 7 Aool D'
130 e five
CITY I STATE 1 ZIP
Mechanicsburg PA 17055
I C I t Add
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1 )
28,549.99
Total Credits (A + 8 + C) (2)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
T otallnterest/Penalty ( 0 + E ) (3)
4. If Une 2 is greater than Une 1 + Une 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
5. If Une 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)
8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58)
Make Check Payable to: REGISTER OF WILLS, AGENT
0.00
28,549.99
28,549.99
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 'in 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? ....................................................................................................... 00 0
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 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 representative is based on all information of which preparer has any knowledge.
SIGNATURE OF f' SON RESPONSIBLE F....ORflLlNG RETURN DATE
. 'zJ~ /-27-01
ADDRESS 1 51 Sugar Hollow Road
Tunkhannock PA 18657
SIGNATURE OF PREPARER OTHER T~AN REPRES T'L.
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. 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 0% [72 P.S. S9116 (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. S9116(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. S9116{1 .2) [72 P.S. 99116(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. 99116(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)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Wooten. John. A 21 07 0743
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
1307 Apple Drive, Mechanicsburg, PA 17055, see attatched settlement sheet
VALUE AT DATE
OF DEATH
167,000.00
TOTAL (Also enter on line 1, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
167000.00
A. Settlement Statement
U.S. Department of HousinQ
and Urban Development A'ooo
,r
OMS No. 2502-0265
B Type of Loan
1. 0 FHA 2. 0 FmHA 3. [gI Conv. Unins I 'File Number
A06-026152-STG
4. 0 VA 5. 0 Conv. Ins. (PNC)
C. NOTE:This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown.
Items marked "p.o.c" were paid outside of closing; they are shown here for informational purposes and are not included in the totals.
Loan Number
0080792377
Mortgage Insurance Case Number
N/A
D. NAME AND ADDRESS OF BORROWER: John Gartside
50 Centralvlew Road, DI/Isburg, PA 17019
E. NAME AND ADDRESS OF SELLER:
&tate of John A. Wooten
1307 App/e Drive, Mechanlcsburg, PA 17055
F. NAME AND ADDRESS OF LENDER:
PNC Mortgage, llC
2110:'StIt. AvenueSollfb, MfnJ18ai1DIIs.MN' 55408
G. PROPERTY
LOCATION:
1307 Apple Drive
Meehan/csbury, PA 17055
H. SETTLEMENT AGENT:
PLACE OF SETTLEMENT:
TIN:
I SETTLEMENT DATE:
Law efflce ofOarrsll C. Dethlefs
2132 Market Street; Camp Hili, PA 17011
25,.1121631
12/21/2007 I RESCISSION DATE:
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 Price .~167 ono. 00 401. Contract Sales Price $167 000.00
102. Personal Property 402. Personal property
103. Selllements charges \0 borrower. 403.
(from line 1400) $9,563.06
104. 404.
105. 405.
ADJUSTMENTS FOR ITEMS PAlO BY SELLER IN ADVANCE: ADJUSTMENTS FOR ITEMS PAID BY SELLER IN ADVANCE:
106. City/town taxes to 406. City/lOwn Taxes to
107. County Taxes 12/21/2007 to 12/31/2007 $16.84 407. County Taxes 12/21/2007 to 12/31/2007 $16.84
108. Assessments 12/21/2007 to 06/30/2008 $915.22 408. Assessments 12/21/2007 to 06/30/2008 $915.22
109. Sewer: 12/21/2007 to 12/31/2007 $9.92 409. Sewer: 12/21/2007 to 12/31/2007 $9.92
110. Trash: U/21/2007 to 12/31/2007 $5.00 410. Trash: 12/21/2007 to 12/31/2007 $5.00
111. 411.
112. 412.
120. GROSS AMOUNT DUE FROM BORROWER: $177,510.04 420. GROSS AMOUNT DUE TO SELLER: $167,946.98
200. AMouNTS PAID BY OR IN BEHALF OF BORROWER: ... :500. REO\:JCTIONS IN AMOUNT DUE TO SELLER:
201. Deposit or eamest money $5,000.00 501. Excess deposit (see instructions) $5,000.00
202. Principal amount of new loan(s) $133,600.00 502. Setllement charges \0 seller (/ine 1400) $10,119.19
203. Existing loan(s) taken subject to 503. Existing loan(s) taken SUbject \0
204. 504. Payoff of first mortgage loan PNC Bank $3,717.28
205. 505. Payoff of second mortgage loan
206. 506.
207. 507.
208. 508.
209. 509.
ADJUSTMENTS FOR ITEMS UNPAID BY SELLER: ADJUSTMENTS FOR ITEMS UNPAID BY SELLER:
210. City/town taxes to 510. City/town taxes to
211. County taxes \0 511. County taxes \0
212. Assessments to 512. Assessments to
213. 513.
214. 514.
215. 515.
216. 516.
217. 517.
218. 518.
219. 519.
220. TOTAL PAID BY/FOR $138,600.00 520. TOTAL REDUCTIONS $18,836.47
BORROWER: IN AMOUNT DUE TO SELLER:
300. CASH AT SETTLEMENT FROMrrO BORROWER: 600. CASH AT SETTLEMENT TO/FROM SELLER
301. Gross amount due from borrower (line 120) $177,510.04 601. Gross amount due to seller (line 420) $167,946.98
302. Less amount paid by/for borrower (line 220) $138,600.00 .602. Less reductions in amt. due seller (line 520) $18,836.47
303. CASH ( (gJFROM) ( OTO) BORROWER: $38,910.04 603. CASH ( 0 FROM) ( (gJTO) SELLER: $149,110.51
HUD-1 (3-86) - RESPA, HB 4305.2
PAGE 1
HUD-l (Rev. 3/66)
L.
OMB No. 2502.{l265
700. TOTAL SALES/BROKER'S COMMISSION PAID FROM PAID FROM
BASED ON PRICE $167,000.00 @ 4 % = $6,680.00
BORROWER'S SELLER'S
DIVISION OF COMMISSION (LINE 700) AS FOLLOWS: FUNDS FUNDS
AT AT
701. $6.680.00 to Central Penn Av"raisal Inc. SETTLEMENT
702. to SETTLEMENT
703. to
704. 10
705. Commiasion paid at aeUlement $6,680.00
706.
BOO.ITEMS PAYABLE IN CONNECTION WITH LOAN:
801. loan origination fee % to l'NCMortgage, LLC
802. Loan discount 3.0000 % to l'NCMortgag", LLC $4,008.00
803. Appraisal fee to: ']{ELS Va~uation $335.00
804. Credit report to' 1U!JLS R..portinq $16.00
805. lender's ;nspectJon fee RNe Mortgag&, LLC
806. Mortgage insurance application foe to PNC Mortgage, LLC
807. As.\Jll\ption fee PNC Mortgag.., LLC
808. Flood Lif.. of Loan F.... to WFFS $19.00
809. ProcfllIfJing Fee to PNC Mortgage, LLC $400.00
810. Tax s..rvic.. F.... to WFFE'1!S $80.00
811. Underwriting Fe.. to PNC Mortgage, LLC $60.00
SETTLEMENT CHARGES
900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE.
901. Int.r..t from 12/21/2007 to 0.1;/01/2008 dII
902. Mortgage insurance premium for mOl. to
903. Hazard insurance premium for J.. 00 yrs. to Penn Natio.a.a~ Ins.
904. Flood Insurance premium for yrs. to
905.
$21. 50 I day
$236.50
$576.00 P.O.C.)
1001. Hazard insurance
1002. Mortgage insurance
1003. City property 'axe.
1004, County property taxes
1005. Annual $uessments
$512.16
1100.
Aggregate Accounting
A
L R:
3.00 mantho <m
months@
monthS <m
11 . 00 months @
months @
months @
8.00 month. <m
months @
Escrow Adjustment
$4 B. 00 por man'h
per month
per month
$46. 56 per month
per month
per month
$144. 63p.,manth
per month
$144.00
1000. E ER ES PO) E WI
1006. Flood insurance
1007. School Taxes
1008.
1009.
$1,157.04
($714.89)
1101. So.'oment or closing f.. to LAW OFFICE OF DARRELL C. DETHLEFS
1102. Abstract or tiUe seard1 to
1103. Title examination to
1104. Title insurance binder to
1105. Document preparation to
1106. Notary fees to
1107. Attorney's fee$lo
{includes above items Numbers:
1106. Title insurance to Security Title/Law O:Efiee
(includes above items Numbers: Basic - 4 End.
1109. Lender's coverage $133,600.00
1110. Owner's coverage $167,000-.00
1111. Closing S..rvice Lett..r F.... to
1112.
1113.
LaW' OfLlce of Dar~Qll c. Dethl.efs
$15.00
1201. Recording fe&5: Deed
1202. City/county taxlstamp.s:
1203. State taxlst8mps: Deed
1204. Recording Fee Eor Assi
1205.
$80.50
; Releases
$121.00
$1,670.00
of Darr..ll C. D..t:l1lefs
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S..curity Title
$133,600.00
$167,000.00
20 .
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; Other
$1,670.00
$28.50
13 .A 0
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MENT
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1301. Survey to
1302. Pest inspection to
1303. OVernight Fee to Law Ofric" of Darr..ll C. D<lt:hl.efs (UPS)
1304 LaW' OEfice or Darrell C. Dethlefs (email Doc Fee)
1305. Law Office ot: Darrell C. Det:hl.efs ('1!ax Cert Reimb)
1~. Barry Heckard, Tax Collector (2007-08 School Tax)
1307. Borough of MtIcban1csburg (Final Sew..r Ullage Bill)
$22.00
$25.00
$19.00
$5.00
$1,735. 5~,_
$9.60
1400. TOTAL SETTLEMENT CHARGES $9,563.06 $10,119.19
(have carefully reviewed the HUD-1 Settlement Statement and to the best of my knowledge and belief, it IS a true and accurate statement of aU receipts and disbursements made
on my account or b~ me In thl aellon. I I~~er eertl~ ~at I have :a:'V~Z2;e ;::;~.:rS7t~t~me01 c/j~ Date /2/1! /0 7
John B. Wooten, Executor
Borrower:
Date:
SeUeror
Agent:
Date:
Date:
f) _ j(...<:.(
The HU[).1 Settlement Statement which I have prepared is a true and accurate account 01 this transaction.
with this statement.
r wil cause the funds to be disbursed in accordance
Date:
Settlement Agent:
. Dethlefs, Esquire
WARNING: It is a crime to knowingly make false statements to the United States on this or any other similar form. Penalties upon conviction can include a fine and imprison-
ment. For details see: Title 18 U.S. Code Section 1001 and Section 1010.
REV-1508 EX + (6-98)
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Wooten. John A
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.
0743
ITEM
NUMBER
1.
DESCRIPTION
Household Furniture, appraised value, see attached
VALUE AT DATE
OF DEATH
2,095.00
4,000.00
600.69
1,151.07
271.31
42.00
14.44
67.00
2.
1999 Buick Century, selling price
3.
PNC Bank Account #5001885632, see attached
4.
PNC Bank account 5070087351, see attached
5.
Blue Cross - Refund
6.
Triple A - Refund
7.
Comcast - Refund
8.
Erie Insurance - homeowners Refund
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
8241.51
--- --- ---~---
.,. . ............. -' . ----....
John Eakin
Market Square Building
Mcch., Pa 17055
Fnmk Potteiger
2-69 N Middlesex Rd
Carlisle, Pa 17017
(717) 241-1388
.-. -.- ----
OctohcrR)007
Appraisal for Joh}) Wootten, 1307 Apple Dr., Mcch.
Living room;
swivel rocker
recliner chair
octagon stand
mantel <.~lock
floor lamp
lamp
swivel rocker
3pc stand set
couch
Hr IHcidel tv
portable t y
1 s1 bedroom- bedroom suite
2nd bed room-
master bcdroonl-
Dining room set (table,chairs & hutch)
drys in k
Iota t appraisal: $2095.00
Fee dne: $ 7:5 . ,.,':tk
OCT-B-2007 MOIl 1[1: cl:3Ail 10:
$l5 .00
15.00
JO.OO
20.00
1 5.00
10.00
15.00
45.00
95.00
20110
65.00
I S{) .{)O
500.00
800.00
250.00
75.00
PAGE: 1
EFORM100472.0900
o PNCBAN< Your account was DEBITED for the following reason:
o Check # posted on encoding error _ posted to Incorrect account
fXl Closed account 5001885632
B ~~: ~=:::'~branch name) CU S TOME 0
Account Number FilelD
AMOUNT $ 600.69
5001885632 040
PNC Bank. National Associ
JOHN A WOOTTEN
1307 APPLE DR
MECHANICSBURG, PA 17055-3928
FOR BANK USE ONLY
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Branch #/Dept. #
0000041
Prepared By (PRINT Name)
SHANNON MOYER
Date
08/07/200
Authorized By
I
Customer's Advice of ct
EFORM100472-0900
o PNCBAN<
Your account was DEBITED for the following reason:
o Check # posted on
fXl Closed account 5070087351
o Branch adjustment (branch name)
o Service charge error
o
encoding error _ posted to Incorrect account
CU S TOl\tl..
co
Other: I
Account Number File 10
AMOUNT $ 1,151.07
5070087351 040
PNC Bank, National ASBO'
TTEN FOR BANK USE ONLY
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B
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JOHN A WOO
1307 APPLE DR
MECHANICSBURG, PA 17055-3928
Branch #/Dept. #
0000041
Prepared By (PRINT Name)
SHANNON MOYER
Date
08/07/2
Authorized By
customer's Advice of
REV-1'510 EX + (6-98)
*'
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER.VIVOS TRANSFERS &
MISC. NON.PROBA TE PROPERTY
0743
ESTATE OF
Wooten. John. A
FILE NUMBER
21 07
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 REl.J\TIONSHIP TO OECEDENT AND DATE OF DEATH % OF DECO'S EXCLUSION TAXABLE
NUMBER THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF AFPUCA8LEJ VALUE
1. PNC Bank National Association Retirement Services 96,734.45 100. 96,734.45
Account # 6001002474, see attached
TOTAL (Also enter on line 7 Recapitulation) $ 96 734.45
(If more space is needed, insert additional sheets of the same size)
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PNC13ANK
PNC BANK, NATIONAL ASSOCIATION
RETIREMENT SERVICES
P. O. BOX 3499
PITTSBURGH,PA 15230
000040
T~l 1-888-762-4727
Bank Fin 22-}146430
JOHN A WOOTTEN
1307 APPLE DR
MECHANICSBURG PA 17055-3928
Statement Period
01-01-07 Thru 06-30-07
Ord:e
07-24-07
Page
1
Plan Type: TRAOITIONAl IRA
Plan Number: 6001002474
Social Security *XXX-XX-86l.0
Principal Balance ~s of 01-01-07
Contributions Information
Current Year
Prior Year
Rollover
Interest Credited
Distribution Informatiun
Normal
Federal Incum~ Tax With~el~
Principal Balance as of 06-30-07
Intcre~t Accrued, Not Yet Credited
96,477.40
0.00
0.00
0.00
0.00
2,657.05
2,400.00-
2,400.00
0.00
96,734.45
58.52
SUMMARY OF INVF.STMENTS
ACCO~lnt Maturity Interest Current Interest Tot~l
Number Rate Dtlte Creditnd Value Accrued Value
75000032996 5.520 08-26-07 2.657.05 96,734.45 58.52 96,792.97
-'
---------- ------------ -----_.__._- _._-_._---_._---
Summ;;lry Totals 2,657.05 96.734.45 58.52 96,792.97
NOW IS THE PERFECT lIME FOR AN IRA CHECKUP!
CALL 1-88B-PNC-IRAS (1-888-762-4727) AND HAVE ONE OF OUR
SPECIALISTS REVIEW YOUR IRA tODAY. MEMBER FDIC.
Ill^~; ~l"l 11'11:1
t-WHIVI:.lh;U1-IUllh
OCT-31-2007 WED 02: 01pr'l 10:
REV-1511 EX + (12-99)
*'
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Wooten. John. A
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
Debts of decedent must be reported on Schedule I.
21
FILE NUMBER
07
0743
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. McCune Funeral Service, Inc. 9,029.00
2. Grontkowski Monuments 752.20
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s)
Social Security Number(s)fEIN Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
2. Attomey Fees John M. Eakin 7,300.00
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 Letters Testamentary 356.00
5. Accountanfs Fees
6. Tax Retum Preparer's Fees
7. Central Penn Appraisals, Inc. , real estate appraisal 350.00
8. The Sentinel, estate notice 190.34
9. The Cumberland Law Journal, estate notice 75.00
10. Frank Potteiger, personal property appraisal 75.00
11. Dandy Mini Mart- U-haul gas 430.00
12. Cost of Selling Real Estate- 1 % Transfer Tax 1,670.00
Central Penn Appraisal, commission 6,680.00
School Tax, Overnight Fee, Tax Cert., Sewer Bill 822.21
13. Randy Neitz- lawn maintenance 325.00
14. Debbie Ward- moving and cleaning assistance 500.00
15. Leo Zapotec - moving assistance 100.00
TOTAL (Also enter on line 9, Recapitulation) $ 28654.75
(If more space is needed, insert additional sheets of the same size)
REV-1512 EX + (6-98)
.
SCHEDULE.
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Wooten. John. A
FILE NUMBER
21
07
0743
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION
VALUE AT DATE
OF DEATH
1. Verizon Wireless - telephone
19.33
2. United Water
72.37
3. Omnium Worldwide - GM Card
208.36
4. PP&L Electric Utilities
555.10
5. Scotts Landservice
54.18
6. Erie Insurance Group- homeowners insurance
84.00
7. Borough of Mechanicsburg - Sewer/Refuse
227.84
8. PNC Bank Mortgage Loan #4003048013604646
4,183.43
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets ofthe same size)
5404.61
"'."""'.'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
FILE NUMBER
John A 21 07 074~
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I. TAXABLE DISTRIBUTIONS ~nclude outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1. Delbert R. Wooten Brother entire estate
1151 Sugar Hollow Road
Tunkhannock, PA 18657
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 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)
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