HomeMy WebLinkAbout06-03-08.iEVlsoaExls~
COMMONWEALTH OF ~~~ ~ COO
~ J OFFICIAL USE ONLY
Y
DEPARTMENT
OF REVENUE INHERITANCE TAX RETURN FILI=NUMBER
DEPT. 280601
RESIDENT DECEDENT 21- 07 X779
-
--
HARRISBURG, PA 17128-0601 CALMfYCODE YEAR
r~BER
DECEDENTSNAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
F-
Z Gill, George Marlin 1Ei8-24-4609
`
~ DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THI;i RETURN MUST BE FlLED IN DUPLICATE WITH THE
W
U 07-13-2007 06-15-1928 REGISTER OF WILLS
W (IF APPLICABLE) SURVMNG SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
None
F 0 1. Original Retum ~ 2. 5upplemer>tal Retum [] 3. Remainder Return (date ordeath prat io iz13.8~
w a U ~ 4. Limited Estate ~ 4a. Future 6~terest Compromise tdata or death artar 12-1aa21 [] 5. Federal Estate Tax Retun Required
~ a m ~ 6. Decedent Died Testate (Anach copy of W~ ~ 7. Decedent Maintained a Living Trust tAttach copy or Tnst) __ 8. Total Number of Safe Deposit Boxes
9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit tdata or dean, betwe~ 1&3t-s1 and 1-1-ssl [] 11. Election to tax under Sec. 9113(A) (Attach scn of
~ ` THIS SECTLON: MUST BE COM2LETED. AL.L CORRESPONDENCE A ND CONFIDENTIAL TAX INFI~RMATION SHOULD REDIRECTED TO:
w NAME COMPLETE MAILING ADDRESS
°z SAMUEL L. ANDES
a FIRM NAME (if App6caBe) P.O. BOX 168
r
W LEMOYNE
PA 17043
~ TELEPHONE NUMBER ,
° 717-761-5361
1. Real Estate (Schedule A) (1) 127,500.00 OFFICIAL USE ONLY
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or 5ole•Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4} ~ ~^~'
5. Cash, Bank Deposits 8 Miscellaneous Persatal Property (5) 45,161.22 _
- O e°o
-- ,
~ ~ C
~:
Z (Schedule E) ~
6. Jointly Owned Pioperty (Schedule F) (6) _ ~ ~~ C
~ ?
`
SeNaa~eprown] R~t,es,ed a
•
'~~
_' -~ ~._
7. Inter-Vvos Transfers & Miscellar~ous Nor}Prob~e Property (7)
rc~,~~~rer_~i~ _ ~
~ 3 ~ ° ? rLL ~'
. ~f~
-
a
V
W
Z
a
a
0
U
8. Total Grass Assets (total Lines 1- 7)
9. Funeral Expenses 8 Administrative Costs (Schedule H) (9) 36,458.55
10. Debts of Decedent, Mortgage UabilRies, 8 Uens (Schedule I) (10) 1,975.70
11. Total Deductions (total Unes 9 810)
12 Net Value of Estate (Une 8 minus Line 11)
13. Charitable and Governmental BequestslSec 9113 Trusts for which an election to tax tras nct been
made (Schedule J)
14. Net Val ue Subject to lax (Line 12 minus Line 13)
(11) $38,434.25
(1~ $'134,226.97
(13) 0.00
(14) $'134,226.97
SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Une 14 taxable ai the spousal tax
rate, or transfers under Sec. 9116 (a}(1.2)
16. P:tYytx+! of Lne 14 taxable ?~ lute? rye
17. Amount of Une 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
$134,226.97
X .0_ (15)
X .0_ (16)
x .12 (17} $16,107.24
X .15 (18) _
19. Tax Due (19} $16,107.24
20. ~ CHECK HERE lF, YOU:ARE REQUESTING A REFUND OF AN OVERPAYMENT-
?'.BE-SURE TO ANSWER i4Ll:QUESTIONSON REVER$E'SIDE AND.RECI-IECK MATH <
--a ~.
(8) $172,661.2 ~- r~-,:
:r
STF PA42021 F.1
~ ~
/~~
n -~
\~
Decedents Complete Address:
sTizEETAaDRESS 328 Walnut Street
~~ Lemoyne STATE PA ZIP 17043
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments ~~ u,yuu.uu
C. Discount $500.00
3. Interest/Penalty if applicable
D. Interest
E Penalty
(1) $16,107.24
Total Credits (A + B + C) (2) $10,500.00
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 fax due.
B. Enter the total of Line 5 + 5A This is the BALANCE DUE (5B) $5,607.24
Make Check Payable to: REGISTER OF WILLS, AG1.NT
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 : ........................................ ^
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 properly within one year of death
without receiving adequate consideration? ........................................... . ...... ^
3. Did decedent own an ~n trust for" or payable upon death bank account or security of his or her death? ..... ^
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ....................................................... ^
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G ~JVD FILE IT AS PART OF THE RETURN.
Under penalties ~ perjury, I dedare chat I have examined this return, including accompanying schedules and statements, and to the best ~ my kncnvledge and belief, fl is true, corned and complete.
Declaration of preparer other than the personal representative is based ar all infarnatton of wtuch preparer has any knowledge.
SIGNATUR P~SON RESPON~LE 60R FLING RETURN DATE / /
ADDRESS
Nedra Schubert, Executrix, 408 Herman Avenue, Lemoyne, PA 17043
SIGNATURE -IBC\vP`R''E(P Ep(/~(/1~/~~y1 //y/`~.1j t~EPR')~~LPV1~}fNTATIVE DATE (/~\ ~,J
ADDRESS 1 '" °~ '
Samuel L. Andes, P.O. Box 168, Lemoyne, PA 17043
For dates of death on or after July 1, 1994 and before January 1, 1995, the lax rate imposed on the net value of transfers tc or for the use of the surviving spouse is 3%
[72 P.S. §9116 (a) (1.1) {i)1.
For dates of death on or after Januar~ 1, 1995, the tax rate im sed on the net value of transfers to or for the use of the surviving spouse is 0°~ [72 P.S. §9116 tia) (1.1) (i)).
Tne statute does not exemat a t: ars~er to a surviving sprtiuse t~em tax, ar2d the statutory requirements for disclosure of asse3s 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)j.
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.
S7F PA42021 F.2
REV-1502 EX + (1-97) (~
SCHEDULE A
coMIMON ~TE0~1"R.NN~S~ANIA REAL ESTATE
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
Gill, George Marlin 21- 07- 0779
Ail real property owned solely or as a tenant in common must be reported ~ fair market value. Fair market value is defined as the price at which property would be exdianged between a
willing buyer and a willing seper, ne'dher being compelled to buy or sell, both having reasonable knowledge of the relevant fads. Real property/ which isjointly-owned with right of survivorship
must be disdosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
Single family residence at 328 Walnut Street, Borough of Lemoyne, Cumberland
County, Pennsylvania, in fair condition.
Value based upon sale of the property on 11 March 2008 (copy of settlen')ent sheet
attached)
$127,500.00
TOTAL (Also enter on fine 1, Recapitulation} ~ $ 127,500.00
(If more space is needed, insert additional sheets of the same
STF PA42027 F.3
,w.., nvV i laoor,m 1',af1000QC 9JUJ.L
A. Settlement Statement U.S. Dr:partrnent of Housing and Urban Development
B. Tyne of Loan OMB Aooroval No_ 25(YL-0265 (expires 11(3nl2nn91
1. ^FIiA 2. ^FmHA 3. ^Conv. Unins. 6. File Number
4. pVA 5. ^Conv.lns. 08039 7. Loan Number 8. Mortgage Insurance Case Number
TFTarm ~ Brva you a s . em m pun pa 6~a se eTegenf are
C. Note: Nems marked'(p.aap were geld outside the closing ~Y are storm here tar Monnatian purposes and ae not trckrded n U,a totals.
WARNING: N Is a nkne to gwHtripy make false Nalemenla to the Untied Stales on tlris orary other similrrTorm. PensNies upon
corrviction can ircAsle a fine mtd'anprisorxnent For delefls sea: TNe 18 U. 5. Code Section 1001 end seGlion f of o.
Titk:Express Settlement System
Printed 0311112008 at 16:11 KS
D. NAME OF BORROWER: Scott Cady and Courtney M. Yost
ADDRESS:
E NAME OF SFILER Estate of George Martin Gill
ADDRESS:
F. NAME OF LENDER Countrywide Bank, F.S.B.
ADDRESS: 2512 Eastern Blvd, York Pa 17402
G. PROPERTY ADDRESS: 328 Walnut Street, Lemoyne, PA 17043
Lemoyne Borough
H. SETTLEMENT AGENT: 1st Advantage Settlement Services Inc., Telephone: 717-591-775:5 Fax: 717-591.7756
PLACE OF SETTLEMENT: 6375 Mercury Drive, Suite 102, Mechanicsburg, PA 17050
I. SETTLEMENT DATE: 0 311 1120 0 8
J. SUMMARY OF BORROWER'S TRANSACTION: K. SUMINARY OF SELLER'S TRANSACTION:
100. GROSS AMOUNT DUE FROM BORROWER 400. GROSS AMOIINT DUE TO SELLER
101. Contrail sales rice 127500.00 401. Contrail sales xice 127 500.00
102. Personal Pro 402. Personal Pro
103. Settlement cha es to borrower tine 1400 6 951.10 403,
104. 404.
105. 405.
Ad'ustments for items aid b seller in advance Acl'ustments for items aid b seller in advance
106. C' (town taxes 406. C' (town taxes
107. Court taxes 03111108to12131108 406.15 407. Court taxes 03111108to12131/08 406.15
106. School taxes 03111108 to06130108 351.86 408. School taxes 03N 1108 to 06130/08 351.86
109. Sewer 8 Trash 03/11108 to 03/31108 26.76 409. Sewer & Trash 03111!08 to03131108 26.76
110. 410.
111. 411.
.112. 412.
120. GROSS AMOUNT DUE FROM BORROWER 135 235.87 420. GROSS AMOUNT DUE TO SELLER 128 284.77
200. AMOUNTS PAID BY OR ON BEHALF OF BOR ROWER 500. REDUCTIONS IN AMOUNT DUE TO SELLER
201. De tl or earnest mone 1 000.00 501. Extxss De it see instructions
202. Prind amount of r>e'nrloans 126 500.00 502. Settlement than es to seller line 1400 9840.16
203. F~istin loan s taken sub'ect to 503. Existin ban s Taken sub'ect to
204. 504. P oft il First Mort. a e Loan
205. 505.
206. 506.
207. 507. Ovemi ht Delivenr-payoff
1st Advanta et Settlement Servi
208. 508.
209. 509.
Ad'ustments for items un aid b seller Ad"ustments for items un aid b seller
210. Ci own taxes 510. Ci Ncwnta^es
211. Court taxes 511. Court taxes
212. School taxes 512. School taxes
213. 513.
214. 514.
215. Seller Assist 4 900.00 515. Seller Assist 4 900.00
216. 516
217. , 517.
218. 518.
219. 519.
220. TOTAL PAtD BYIFOR BORROWER 132 400.00 520. TOTAL REDUC1fI0N AMOUNT DUE SELLER 14 740.76
300. CASH AT SETTLEMENT FROM OR TO BORROWER 600. CASH AT SETTLEMENT TO OR FROM SELLER
301. Gross amount due lxxrower line 120 135 235.87 601. G amount duffs to seller tin 420 128 284.77
302. Less amounts d b ffor borrw+er line 220 132 400.00 602. Less reduction amount due seller line 520 14 740.16
303. CASH FROM BORROWER 2 835.87 603. CASH TO SELLER 113544.61
U.S. DEPARTMENT OF HOUSING AND UROAN DEVELOPMENT
SETTLEMENT STATEMENT
File Number: 08039 PAGE 2
TrfIaFvlxt?c~: Saitltant?IIt .S'VStP.m Printer) O:il11M)t108 at tfi•11 KS
L. SETTLEMENT CHARGES PAID FROM PAID FROM
700. TOTAL SALES/BROI~R'S COMMISSION based on rice $127 500.00 6.000 = 7 650.00 BORROWER'S SELLER'S
Division of commission line 700 as follows: FUNDS AT FUNDS AT
701. 3 800.00 to Cerrtu 21 Walak & ASSOC. SETTLEMENT SETTLEMENT
702. 3847.00 to Jeanette Davis Real Estate
703. Gommission id at Sett4emen 7 647.00
704. Transaction Fee to Cantu 21 Walak & Assoc. 150.00
800. ITEMS PAYABLE IN CONNECTION WITH LOAN
801. Loan ' Ination Fee °~
802. Loan Discount %
-803. ADOraisal Fee to LandSafe Appraisal Services, Inc. LR 415.00
': 804. Credd Resort to Landsafe Credit, Inc. LR 35.00
805 Lender Fee to Countrywide Bank, F.S.B. LR 100.00
806 Tax Service Fee.. to Countrywide Tax Service Corporation LR 100.00
807. Flood Check Fee to Landsafe Flood Determination, Inc. LR 26.00
808. Aoalication Fee to Countrywide Bank, F.S.B. (P.O.C. 524.00 B er
809 FHA MIP (Upfront} to Countrywide Bank, F.S.B. LR 1 869.47
810.
811.
900. ITEMS REQUIRED BY LENDER'TO BE PAID IN ADVANCE
901. Interest From 031111200810 04!0112008 p$ 220900 Idav .21 Da s LR 463.89
902. Mortg~ Insurance Premium for to
903. Hazard Insurance Premium for to Travelers Home and Marine Company 456.00
904.
905.
1000. RESERVES DEPOSITED WRH LENDER FOR
1001. Hazard Insurance 3 mo. @ $ .38.00 /mo LR 114.00
1002. Mortgage Insurance mo, an $ 51.66 (nIo
1003. City ProoeAy Tax ma Cat $ /mo
1004. County Properly Tax 3 mo. @ $ 41.02 lrno LR 123,06
1005. School taxes 10 mo. @~ 93.91 Imo LR 939.10
1009. Aggregate Analysis Adjustment LR -395.17 0.00
1100. TITLE CHARGES
1101. Settlement or dosing fee
1102. Abstract or ti8e search
1103. Title examination
1104. Idle insurance binder
1105. Document Preoarat'loll to Samuel Andes, Esq. 200.00
1106. Notary Fees to Kristen D. Shiva 35.00 10.00
1107. Attomev's fees
(indudes above items No: )
_
1108. Tdfe Insurance to 1st Advantage Settlement Services Inc.
998.75
findudes above items No: 1101-1104 )
.1109. Lender's Policy 126,500.00 -
1110. Gwner's Policy 127,500.00 - 998.75
1111. End 100, End 300. End 900 to 1st Advantage Settlement Services Inc. 150.00
1112.
1113. ClosingSvcLtr to 1st Advantage Settlement Services Inc. 35.00
1200. GOVERNMENT RECORDING AND TRANSFER CHARGES
1201. Recording Fees Deed $ 38.50 ; Mortgage $ 52.50 • Release $ 91.00
1202. City/County tax/stamos heed $1,275.00 :Mortgage $ 1 275.00
1203. State Tax/stamps Deed 81,275.00 ;Mortgage $ 1275.00
1204. Registration Fee Deed $ :Mortgage $ :Release $
1205.
1300. ADDITIONAL SETTLEMENT CHARGES
1301. Survey
1302. 2008 CounrylTwD Taxes to Faith Nicola 492.16
1303. Wire in Fee to 1st Advantage Settlement Services Inc: 10.00
1304. Tax Cert Fee to 1st Advantage Settlement Services Inc.
1305. Overnight Delivery Fee-Pkg to 1st Advantage Settlement Services Inc. 25.00
1306. Email PkglDoc Cooy Fee to 1st Advantage Settlement Services Inc. 35.00
1307. Final SewerlTrash 1/1~3I31 to Lemoyne Borough 116.00
1400. TOTAL SETTLEMENT CHARGES (enter or1 lines 103. Section J and 507 Section K) 6 951.10 9840.16
HUD CERTIFICATION OF BUYER ANO SEt r m
1 have carafulty ed BI HU etllertrent Slalemerd and to the beat d mY krowladpa and belief, it b a bua eM acc+aele sletement rd a0 receiph and tlisbrYSernema made on my eccor+d
w by me in this 1 ceAiry that I have a copy d the HU0.1 Settlement StalemenL
0'
Lea ey T
WARNING R IS A CRIME TO IOUOWINGLY MAKE FALSE STATEMENTS TO THE The HU0.1 SedlenraM Slatemerd whkh I have prepared b a True aM acurate accord d itda
UNRED STATES ON THIS OR ANY SIMILAR FORM. PENALTIE3 UPON CONVICTION tramaUipl, I have caused a x01 Ca1158 the fulls to ba disbursed in axardattce vrith this sletemarR
CAN INCLUDE A FINE AND B.IPRISONMENT. FOR DETAILS SEE TTTLE 1B
U.S. CODE SECTION 1001 AND SECTION 1010. ~ ~~
SETTLEMENT AGENT. ~ DATE:
REV-1508 EX + (1-97) (I)
SCHEDULE E
COMMONWEALTNOFPENNSnwww CASH, BANK DEPOSITS, & MISC.
IN RESIDENT DECEDENT PERSONAL PROPERTY
ESTATE OF FILE NUMBER
Gill, George Marlin 21- 07- 0779
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jolydly-owned with the right of survivorship mud be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
~• Checking Account No. 103600000782 with Community Banks $3,623.88
2• Certificate of Deposit No. 31003914381254 with M&T Bank $20,699.98
3• 1995 Chevrolet Beretta automobile (value based upon sale price) $700.00
4• Collection of toys and model trains (value based upon sale price to collect~~r) $19,100.00
5• Refund of auto insurance overpayment from Travelers Insurance $139.20
6. Prudential Insurance Company (insurance refund) $398.16
7• Miscellaneous household furnishings and items of tangible personal property, all in
poor condition $500.00
TOTAL (Also enter on line 5, Recapitulation) I $ 45,161.22
(If more space is needed, insert additional sheets of the same s¢e)
S'rF PA42021 F.9
REV-1511 EX + (1-97) (I)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Gill, George Marlin 21- 07- 0779
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1.
Musselman's Funeral Home $6,871.58
Mechanicsburg Cemetary (grave) $725.00
Expenses for post-funeral luncheon $125.20
B. ADMINISTRATIVE COSTS:
1. Persaral Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s) ! ElN Number of Personal Representative(s)
Street Address
City State Zp
Year(s) Commission Paid:
2. AttomeyFees SAMUEL L. ANDES
$4,000.00
3. Family Exemption: (a decedent's address is not the same as claimant's, attach explanation)
Clamant
Street Address
Cily State Zp
Relationship of Claimant io Decedent
4. Prob~eFees Register of Wills $329.00
5. Accountarrt's Fees
6. Tax Retum Preparer's Fees
7.
The Sentinel (advertising) $134.68
Cumberland Law Journal $75.00
Costs to maintain house until sold (see Schedule A attached hereto) $3,174.52
Costs incurred to improve house for sale (see Schedule B attached hereto) $6,716.32
Costs incurred in sale of home (see Schedule C attached hereto) $14,307.25
TOTAL (Also enter on line 9, F;ecapitulation) I $ 36,458.55
STF PA42021 F.12
more space Is neeoea, Insert aaamonal sneers of the same slze~
Estate of Gill, George Martin
SCHEDULE A Costs to maintain house until sold
File No. 21-07-0779
PPL electric service $187.33
Leffler Energy fuel oil for heat $1,684.64
PAWC water utility $233.56
Kline Lawn Care lawn service $145.00
Lemoyne Borough sewer and trash service $116.00
Faith Nicola, Tax Collector 2008-2009 school taxes less amount paid
by purchaser at settlement on sale of
house 807.99
TOTAL $3,174.52
Estate of Gill, George Martin
SCHEDULE B Costs incurred to improve house in preparation of sale
File No. 21-07-0779
Sherwin Williams installation of new bathroom floor $302.22
Jeannette Bisk cleaning, repair, and painting $3,361.14
Paul Schubert installation of outdoor tank heat tape $24.37
Winding Hill Window
Cleaning Co. cleaning $223.76
Cropf Bros. Plumbing repair plumbing and replace sewer line $1,777.58
Richard Moul labor to clean house and yard $500.00
Robert A. Clemm plaster repairs 527.25
TOTAL $6,716.32
Estate of Gill, George Martin
SCHEDULE C Costs incurred in sale of house
File No. 21-07-0779
Jeannette Davis Real Estate
and Century 21 Walak
Associates sales commission $7,647.00
Countrywide Tax Service tax certification $100.00
Kristen D. Shive notary fees $10.00
Samuel L. Andes, Attorney deed preparation $200.00
County of Cumberland realty transfer tax $1,275.00
County of Cumberland 2008 County and municipal taxes (less
portion paid by seller in tax proration) $86.01
Borough of Lemoyne Final sewer and trash bill (less portion
paid by seller in proration) $89.24
Purchaser Payment to purchaser to assist in
settlement costs $4 900.00
TOTAL $14,307.25
REV-1512 EX + (1-97) (I)
SCHEDULEI
cor~mnoNWEAI.T)ioFPENNSYLUANIA DEBTS OF DECEDENT,
INREESDE TDECEDREiTRN MORTGAGE LIABILITIES, & LIENS
ESTATE OF FILE NIJMBER
Gill, George Marlin 21- 07- 0779
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION AMOUNT
1• Family Physicians (final medical bill net of insurance) $17.64
2. Frank DeStefano (garage rent for four months) $175.00
3. PPL (bill incurred prior to decedent's death) $29.98
4, Kelly Lawn Care (bill incurred prior to decedent's death) $25.00
5, Comcast Cable Service (cable tv service) $1.22
6. AT&T (telephone service) $21.40
7. Traveler's Insurance (auto insurance) $536.60
g. The Hartford Insurance Co. (homeowners insurance) $420.10
g. PAWC (water bill for service prior to decedent's death) $69.33
10. Borough of Lemoyne (sewer and trash bill for service prior to decedent's death) $116.00
11. Faith Nicola, Tax Collector (2007 county and municipal taxes) $563.43
STF PA42021 F.13
TOTAL (Also enter on line 10, Recapitulation) I $ 1,975.70
(If more space is needed, insert additional sheets of the same size)
REV-1513 EX + (9-00)
SCHEDULE J
COM NHERfTANtCEDTAxERETURN~~ BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF
Gill, George Marlin
FILE NUMBER
21- 07- 0779
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 [include outright spousal distributions, and transfers
under Sec. 9116 (a) (1.2}]
1• Nedra Gill Schubert Sister 100%
408 Herman Avenue
Lemoyne, PA 17043
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIA TE, ON REV-1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOTBEING MADE
1.
none
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1' none
TOTAL OFPART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER, SHEET S 0.00
tir more space is rueaea, insert auomonal sheets of the same size)
STF PA42021 F.14