Loading...
HomeMy WebLinkAbout05-27-08'-J REV-1500 EX (06-05) PA Department of Revenue Bureau of Individual Taxes PO BOX 280601 Hamsburp, PA 17128-0601 15056051058 OFFICIAL USE ONLY County Code Year File Number INHERITANCE TAX RETURN ~~~~~~~ ~ ~~~~~ 0,~ ~~~~ RESIDENT DECEDENT Date of Birth 10/14/1921 __._..___.______ __ W ._. _ _ .__...._.___ Decedent's First: Name MI Clyde i ~ E Spouse's Social Security Number Spouse's First Name MI i_.~.~ .._.. __ ... _... _.. _-, THIS RETURN MUST BE FILED IN DUPLICATE WITH THE _ .__ ._.___ .__ _ __. ~ REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW C~ 1. Original Return ~ 2. Supplemental Return C~ 3. Remainder Return (date of death prior to 12-13-82) ~°°°Vs 4. Limited Estate C 4a. Future Interest Compromise (date of C 5. Federal Estate Tax Return Required death after 12-12-82) t'1~3 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust _,,,,,,_,_„_,_ 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) C:. 9. Litigation Proceeds Received C 10. Spousal Poverty Credit (date of death C 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) n.~ CORRESPONDENT - THIS SECTION MUST BE COMPLETED ALL CORRESPONDENCE AND CONFIDENTIAL 1'AX INFORIJiAa~SHOULD Name Daytime Teie .. _ e Numt~etr 'John M. Eakin f,717) 766 3"l~z ~ Firm Name (If Applicable) I-- • ~~ _ _ ~ REGIST~ 'TED Tt); a WILLS USE O~1LY ,.. -r7 = . *-- City or Post Office __ __ ._ Mechanicsburg Correspondent's a-mail address: i i _. .... _-_ _. _ _> 1 DATE FILED State ZIP Code t_______._.__..._...._ __.__ .............____ PA :17055 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 PERSON RESPONSIBLE FOR FILING RETURN © DATE ADDRESS - (~ ~ ~ - ~'' "`~ V ~ - ~ 119 Regency Wood North, Carlisle, PA 17015 385 Gameland Road, Newville, PA 17241 SIGNATURE OF PREPAR T~iER THAN REPRESENTATIVE DATE ~~ ADDRESS V' Market Square Building, Mechanicsburg, PA 17055 PLEASE USE ORIGINAL FORM ONLY Side 1 15056051058 15056051058 J 15056052059 REV-1500 EX oe~ede~rs Name: Clyde E Russell 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) Separate Billing Requested ....... 6. 7. Inter-~vos Transfers & Miscellaneous Non-Probate Property ~~~ (Schedule G) t: Separate Billing Requested........ 7. 8. Total Gross Assets (total Lines 1-7) .................................... 8. Decedent's Social Security Number 184-12-2695 41.09 19,704.36 126,745.45 -____ - 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/Sec 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. 22,311.54 1,472.00 23,783.54 ~; 102,961.91 102,961.91 at collateral rate X .15 18. 19. TAX DUE .........................................................19.' 4,633.29 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 .0_ 15. 16. Amount of Line 14 taxable ~'_. ..~____._ ._...__.~ .._...._ ___.._._..~ ._~ at lineal rate X .0 45 102,961.91 16. 17. Amount of Line 14 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable ___ .~......, _._.~ ~_.. ~_._. _ _.~..~.~___ 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 15056052059 Side 2 15056052059 REV-150b EX Page 3 Ilnrne~nnt~c rmm~lptp ~4tldress' ___ File Numb~sr ._ __ _,,,,__„~_ ~~ ~ 21 ~ j 07~ 0031 ..... ... ------ DECEDENT'S NAME DE(EDENT'S SOCIAL SECURITY NUMBER Clyde E Russell 184-12-2695 STREET ADDRESS Claremont Nursing Home CITY ~ Camp Hill STATE PA ZIP 17011 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) 4,633.29 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments 4,400.00 C. Discount 231.57 Total Credits (A + 8 + C) (2) 4,631.57 3. Interesf/Penalty if applicable D. Interest E. Penalty Total InterestiPenalty (D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on 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) 1.72 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56) 1.72 Make Check Payable fo: 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 :........................................................................................ .. ^ Q b. retain the right to designate who shall use the property transferred or its income : .......................................... .. ^ c. retain a reversionary interest; or ........................................................................................................................ .. ^ d. receive the promise for life of either payments, benefits or care? .................................................................... .. ^ 2. if death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ............................................................................................................ .. ^ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ............ .. ^ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ......................................... ...........,...... .. ^ ^x 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. §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 zero (0) percent [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 zero (0) percent [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 four and one-half (4.5) percent, 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 twelve (12) percent [72 P.S. §9116(a)(1.3)]. Asibling isdefined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoptiori. REV-1502 EX + (6-98) SCHEDULE A COMMONWEALTH OF PENNSYLVANIA REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Russell. Clyde. E. 2:1 08 0025 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 n:levant facts. Real roe which is 'ointl -owned with ri ht of survivorshi must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 411 S. York Street, Mechanicsburg, PA 17055, selling price 107,000.00 see attached settlement sheet TOTAL (Also enter on line 1, Recapitulation) I $ 107 (If more space is needed, insert additional sheets of the same size) -__ __--._ __ ___ _----____ --__._ __ .mm. OMB N0.2502-0265~i A. B. TYPE OF LOAN: DEPARTMENTOF HOUSING & URBAN DEVELOPMENT S U 1.QFHA 2.QFmHA 3.QX CONY. UNINS. 4.QVA 5.[]CONV. INS. . . SETTLEMENT STATEMENT 6. FILE NUMBER: WDB08-00100 7. LOAN NUMBER: ., 269063 8. MORTGAGE INS CASE NUMBER: C. NOTE: This form is famished to give you a statement of actual settlement costs. Amounts paid to anti by the settlement agent are shown. Items marked (POC]" were paid outside the closing; they are shown here for informations! purposes and are not included in the totals. 1.(1 3f98 (WDBOB.00100.PFDNVDB08.00100/34) D. NAME AND ADDRESS OF BORROWER: Jonathan P. Knickerbocker 11 S Walnut Street Mechanicsburg, PA 17055 E. NAME AND ADDRESS OF SELLER: Russell Estate 411 South York Street Mechanicsburg, PA 17055 F. NAME AND ADDRESS OF LENDER: Members 1st Mortgage Services 5000 Louise Drive Mechanicsburg, PA 17055 G. PROPERTY LOCATION: 411 South York Street Mechanicsburg, PA 17055 H. SETTLEMENT AGENT: 20-1404756 Meritage Settlement Services, LLC I. SETTLEMENT DATE: A ril 21 2008 Cumberland County, Pennsylvania PLACE OF SETTLEMENT 4206 Linglestown Road Harrisburg, PA 17112 p , ' 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 107,000.00 401. Contract Sales Price 107,000.00 102. Personal Pro ert 402. Personal Pro e 103. Settlement Char es to Borrower Line 1400 3 978.40 403. 104. 404. 105. 405. Ad'ustments For Items Paid B SeNer in advance Ad'ustments For Items Paid B Seller in advance 106. Cit !town Taxes to 406. Cit (town Taxes to 107. Coun /Boro Taxes 04/21/08 to 01/01/09 •378.47 407. Count /Boro Taxes 04121!08 to 01/01/09 378.47 108. 5chao! .04/21/08 to 07/01/08 255.69 408. School 04/21/08 'to 07/01/08 255.69 109. 409. 110. 410. 111. 411. 112. 412. 120. GROSS AMOUNT DUE FROM BORROWER .111,612.56 420. GROSS AMOUNT DUE TO SELLER 107,634.16 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER: 201. De osit or earnest mone 1 000.00 501. Excess De osit See Instructions 202. Princi al Amount of New Loans ' 103,790.00 502. Settlement Char es to Seller Line 1400 8,057.03 203. Existin loans taken sub ect to 503. Existin .loans takeni sub'ect to 204. 504. Payoff First Mortgage 205. 505. Pa off.Second Mort a e 206. 506. 207• 507. De osit disb. as roceeds 208. 508. 209. Seller's Assistance ' 3 210.00 509. Seller's Assistance 3,210.00 Ad ustments For Items Un aid B Seller Ad'ustments for Items Un aid B Seller 210. Cit /Town Taxes to 510. Cit /town Taxes to 21.1. Coun /Boro Taxes to 511, Count /Boro Taxes to 212. School to 512. School to 213. 513.' 214. 514. 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. 220. TOTAL PAID ~BY/FOR BORROWER 108,000.00 520. TOTAL.REDUCTlON ftMOUNTDUE SELLER 11,267.03 300. CASH AT SETTLEMENT FROM/TO BORROWER: 600. CASH AT SETTLEMENT TOIFROM SELLER: 301. Gross Amount Due From Borrower Line 120 111 612.56 601. Gross Amount Due To Seller Line 420 107 634.16 302. Less Amount Paid B /For Borrower (Line 220) ( 108,000.00) 602. Less Reductions Due Seller Line 520 ( 11,267.03 303. CASH(X FROM) ( TO) BORROWER 3,612.56 603. CASH(X TO) ( FROM) SELLER 96,367.13 L. SETTLEMENT CHARGES Page ISSION Based on Price $ @ % 6,420.00 PAID FROM PAID FROM ' OmmISSlOn (hne 700) aS FOI/OWS: t0 Central Penn Real Estate ~~ .00 to Weichert Realtors-First Choice BORROWER'S FUNDS AT SETTLEMENT SELLER S FUNDS AT SETTLEMENT fission Paid at Settlement 6 420.OC nsaction Fee to Weicfiert, Realtors-First Choice 125.00 EMS PAYABLE IN CONNECTION WITH LOAN Loan Ori ination Fee % to 2. Loan DiscoLint % to ' 803. Appraisal Fee to 804. Application Fee to Members 1st Mortgage Services 350.00 805. Broker's Procesing Fee to 806. Underwritin Fee to 807. Processing Fee to ' 808. Document Prep 809. Broker Fee Members 1st Mortgage Services 810. 811. 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest From 04/21/08 to 05/01/08 @ $ 1:7.061400/day ( 10 days %) 170.61 902. Mort a e Insurance Premium for 12 months to 903. Hazard Insurance Premium for 1.0 ears to 904. 905. 1000. RESERVES DEPOSITED WITH LENDER 1001. Hazard Insurance 3.000, months $ 24.92 er month 74.76 1002. Mort a e Insurance months $ er month 1003. Cit /Town Taxes months $ er month 1004. Count /Boro Taxes 3.000 months $ 45.27 er .month 135.81 1005. School 11.000 months @ $ 109.84 per month 1,208.24 1006. months @ $ per month 1007. months er month 1008. A re ate Ad'ustment months $ er month -640.84 1100. TITLE CHARGES 1101. Settlement or Closin Fee to Merita a Settlement Services LLC 295.00 1102. Abstract or Title Search to 1103. Wire Fee to 1104. Ex ress Mail Fee to Merita a Settlement Services LLC 65.00 1105. Document Pre aration to 1106. Tax Cert/Lien Letters to American Tax Re ortin 45.00 i 107. Attorney's Fees to includes above item numbers: 1108. Title Insurance to United Gerieral Title Insurance Com an 670.31 includes above item numbers: 1109. Lender's Coverage $ 103,790.00 1110. Owner's Coverage $ 107,000.00 670.31 75% of Basic 1111. END. 100,300,900 to Meritage Settlement Services, LLC 150.00 1112. Closing Protection Letter to United Generat Title Insurance Company 35.00 1113. 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recording Fees: Deed $ 38.50; Mortgage $ 74.50;. Releases $ 113.00 1202. Cit /Count Tax/Stam s: Deed 1 070.00• Mort a e 535.00 535.00 1203. State Tax/Stam s: Deed 1 070.00; Mort a e 535.00 535.00 1204. Assin ment of Mort a e to Recorder of Deeds 27.00 1205, Recorder of Deeds 1300. ADDITIONAL SETTLEMENT CHARGES 1301. Surve to 1302. Pest Ins ection to 1303. 1304. Final Utilities to Mechanics ur Borou h .?0-24-0785-405 84.51 23.81 1305. See addit'I disb. exhibit to 543.22 1400. TOTAL SETTLEMENT CHARGES (Enter on Ltnes 103, Section J and 502, Section ~ ~ ~ 3,978.40 8,057.03 rritag ettlem t Services, LLC, Settle nt Agent REV-1508 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF PILE NUMBER Russell. Clvde. E. '?1 08 0025 InGude 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. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Spirit Physician Service Inc., Refund 11.34 2. State Farm, Car Insurance Refund TOTAL (Also enter on line 5, Recapitulation) (If more space is needed, insert additional sheets of the same size) 29.75 41. REV-1509 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF n~~ nvmocn Russell Clyde F 21 08 0025 If an asset was made joint within one year of the decedents date of death, it must be reported on Schedule ~. ADDRESS SURVIVING JOINT TENANT(S) NAME A. Gary L. Russell a Mary A. Cree c JOINTLY-OWNED PROPERTY: RELATIONSHIP TO DECEDENT 385 Gameland Road I Son Newville, PA 17241 119 Regency Wood North I Daughter Carlisle, PA 17015 ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSE7 % OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENTS INTEREST 1. A & B Sovereign Bank Account # 1681711761, see attached 15,231.28 33.33333 5,077.09 2. A & B M&T Bank Account #1189190, see attached 43,881.82 33.33333 14,627.27 TOTAL (Also enter on line 6, Recapitulation) I $ 19, 704.36 (If more space is needed, insert additional sheets of the same size) ~U~. -,, ~~ SOVG'Tel~l BdYlk S l"AT E M E N T OF ACCOUNTS Statement Period 12/10/07 TO 01!07/08 1-877-768-1143 wwwsovereignbank.com SOVEREIGN PREMIER CHECKING • '- •• 1 / / 1 f' CLYDE E RUSSELL ACCOUl1 t # 1651 J1 ~76~ CARY L RUSSELL MARY A CREE Balances Deposits/Credits + $5.44 Average Daily Balance $15,231.28 ° _ _, ... ~~~~ ~ -. ~, ._.. 7 is;: - ... ~_ - - t_ ~7.. _,- _ a _.,.~ -xb-.._., _.. _~ ~ .. .:. ~.~ Interest ~,:.. ~ ~ ~ .-~~..~~,~""'~.`~~'A~~.~~~;rc ta~a< <etd~arned ~ ~~~~~ i' ~ ~ ~°o? Earned thi$ P nod. g, ~ $ 5 Paid Last Year ~-~.. $31.38 4 4 ~~ ~. _ ;~~ ,~ Qj ~t~ ~ `The interesYeamed and the interest paid may differ depending on when interest i dit d s cre e to youraccount. Account Activity -" Date Description. ~... Additions Subtractions Balance 12-10 Beginning Balance -~- ~~~~'. " `~ ~~~~~t7J~~~~.~ ~' ~~`~ ~ ~ "~~44C~.s ~,~~:~„; ~, ~ $15 231 28 ~- 01 07 Ehdmg Balance - - - $15,23x:72 ~- ~~ page 3 of 3 1 681 711 761 ;.IL~~ 00 0 04342M NM I17 6627 CLYDE E RUSSELL MARY A CREE GARY L RUSSELL 411 S YORK ST MECHANICSBURG PA 17055-6405 _-._ _- - - _ _ _ ..__ _ `~ CARLISLE PIKE ^~ ACCOUNT "SUM"MARY $ GINN,~ BALANC 44,2) DEPOSITS.. OTHER;ADDTT30NS CHECKS PAID DTHER SUBTBACTTONS C4![tRENT INFERE$T PD ENDING BALANCE N0. AMOUNT N0. AMOUNT N0. AMOUNT 1 1,203.00 8 8,808..17. 1 .15.59 0.00 36,650.60. wrrn~lA1T ArT-T\/TTV POSTING DATE TRANSACTION DESCRIPTTDN DEPDSITS;INTERFST K QTHER ADDITIONS .CHECKS:, OTHER SUBT~tACTIONS DAILY BALANCE 12-08-07 BEGINNING BALANCE 544,271.36 12-12-07 CHECK NUMBER 1599 5.76 44,265.60 12-18-07 CHECK NUMBER 1602 50.00. 12-18-07 CHECK NUMBER 1594 15..00 44,200.60 12-20-07 CHECK NUMBER 1600 13.78 12-20-07 CHECK NUMBER 1601 5.00 44 181.82 ~ 12-31-07 CHECK NUMBER 1603 300.00 43,881.82 01-03-08 US TREASURY 303 SOC SEC 1,203.00 - 01-03-OS CHECK NUMBER 1608 8,280.00 01-03-D8 VERIZON ARC CHECK PYMT 000000000001606 15.59 36,789.23 01-07-08 CHECK NUMBER 1619 138.63 36,650.60 ENDING BALANCE 536,650.60 .. ... .. CHECKS :::PAI. 1594 12-18-07 15.00 1599* 12-12-07 1601 12-20-07 5.00 1602 12-18-07 1608* 01-03-08 8,280.00 1619* 01-07-08 5.76 50.00 138.63 1600 12-20-07 13.78 1603 12-31-07 300.00 REV-1511 EX + (12-99) - SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES 8R INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF F{LE NUMBER RIICCPII ( l~(dP F 21 08 0025 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Rice Memorial 680.00 B. 2. 3. 4. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) See Attachment PaQe(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State Zip _ Year(s) Commission Paid: AtlomeyFees John M. Eakin Family Exemption: (If decedent's address is not the same as claimants, attach explanation) Claimant Street Address City State _ Relationship of Claimant to Decedent Probate Fees Letters Testamentary 5. I Acxountant's Fees 6. I Tax Return Preparers Fees 5; ~rv0, ~ D 4,000.00 306.00 7. The Cumberland Law Journal, Estate notice 75.00 8. The Sentinel, Estate notice 190.54 9. Art Calaman, Real Estate Appraisal 325.00 10. Capital City Oil, Fuel Oil 305.00 11. Scott Ramney, Trash Removal 125.00 12. W. Lenker, house cleaning 225.00 13. Joner Auction 100.00 14. C&M Accounting 200.00 15. Paul Nass,Lawn Maintenance 80.00 16 Cost of Selling Real Estate -Brokers Commission 6,420.00 17 -Transfer Tax 1,070.00 18 -Buyers Costs 3,210.00 TOTAL (Also enter on line 9, Recapitulation) $ 22,311.54 Zip (If more space is needed, insert additional sheets of the same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent ' Russell, Clyde, E. 21 08 0025 Decedent's Name Page 1 File Number Schedule H -Funeral Expenses ~ Administrative Costs - B1 ITEM NUMBER DESCRIPTION AMOUNT B. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Mary Cree 2, 500.00 Social Security Number(s)/EIN Number of Personal Representative(s) 193-24-0647 Street Address 119 Regency Wood North C;~ Carlisle State PA z;p _ 17015 Year(s) Commission Paid: 2008 2. Name of Personal Representative (s) Gary Russell 2,500.00 Social Security Number(s)lEIN Number of Personal Representatives} 197405152 Street Address 385 Gameland Road city Newville state PA zip _ 17241 Year(s) Commission Paid: 2008 SUBTOTAL SCHEDULE H-B1 5,000.00 ftEV-1512 EX + (6-98) SCHEDULE 1 COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Russell Clvde E 21 08 0025 Include unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Borough of Mechanicsburg, Sewer/Refuse 108.32 2. ~Pharmerica, medication 3. Claremont Home, Nursing Home 4. West Shore EMS, ambulance service 5. United Water Pennsylvania 6. Camp Hill Emergency Physicians 7. APP&L, Electric 8. I Verizon 71.20 900.00 227.13 17.27 32.17 84.72 31.19 TOTAL (Also enter on line 10, Recapitulation) I $ 1 (If more space is needed, insert additional sheets of the same size) REV-1513 EX + (P-~~ SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER r 71 nR nn25 ~~ 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 [indude outright spousal disfibutions, and transfers under Sec. 9116 (a) (1.2)] 1. Gary Russell Son 1/5 of net residue 385 Gameland Road Newville, PA 17241 2. Virginia M. Russell Daughter 1/5 of net residue PO Box 120 Ickesburg, PA 17037 3. Barbara Meeks Daughter 1/5 of net residue 738 Hopewell Street Madisonville, KY 42431 4. Mary Cree Step-Daughter 1/5 of net residue 119 Regency Wood North Carlisle, PA 17013 5. Betty Davis Step-Daughter 1/5 of net residue 764 Highland Street Steelton, PA 17113 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 T HROUGH 18, AS ~4PPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: 1. A, SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT BEING MADE 1. B, CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (It more space is needed, insert additional sheets of the same size) .w;e-~ /~ A ~~ r /~ ~` a.. ~ ~- ~" ~~ a .:s /~ ' ~ nr ®' {. ~' . - ~~ ~. ~. ~ ~ ~~ a ~ -~ `~ , ~ ~~ ~ ~ ~.. ~" N ~ ~ ~ ! ~: ~ ~ ~: r ~' 1 ::.. ~- o r. ~ ~, . `. ~, ~ .. ~~ ~ _ _~ ~. 1~ ~., ~ . %' c~ ~ ~. ~~. , ~• ~ ri ~~ ~~ 1- ` ~ _..~. C~f l~i~ v Ly) ~~ t c~ ~1 -._ _~ ~ ~~.._..~ ~ -~ ..~ ~J ~~ .~ ~ -- ,~ ~. ~ _> ~~ ',~iJ 9 ~`~U - ~.. { 1 41~~ ., -~ ~ ~ ~t;_ ~.: , ~'r1! ~ ~`s~°~ ~-++-i J~ ', VV I^'^~