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HomeMy WebLinkAbout10-03-08J 15056041125 REV-1500 EX (06-05) PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number PO BOX 2806()1 INHERITANCE TAX RETURN ~ ( /~ Harrisbur , PA 17128-17601 RESIDENT DECEDENT V' D p~ `f 'f' ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 2 5 4 3 2 7 8 4 5 0 2 2 3 2 0 0 8 0 8 2 0 1 9 2 4 Decedent's Last Name M c C A L L Suffix Decedent's First Name F R A N C E S MI L (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI N O N E Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death 4. Limited Estate ~ prior to 12-13-82) 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required OX 6. Decedent Died Testate ~ (Attach Copy of will) death after 12-12-82) 7. Decedent Maintained a Living Trust ~ 8. Total Number of Safe Deposit Boxes 9. Litigation Proceeds Received ~ (Attach Copy of Trust) 10. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec 9113(A) . between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTE N ame D TO: Daytime Telephone Number C H A R L E S J D e H A R T I I I 7 1 7 2 3 2 T~~ 6 1 Firm Name (If Applicable) ~ ? __:~ - `~~ _ ~-REGISTERpFWILLS USwNLY ~ C A L D W E L L & K ~J ,_} £': E A R N S --8 - First line of address i I 3 6 3 1 N O R T H F C.3 R O N T S T R E E T - - Second line of address t ~ ~. _'~ ~v ;, ~ .. , City or Post Office ~' c State ZIP Code ~ _ DATE FILED ~~ J H A R R I S B U R G -- P A 1 7 1 1 0 Correspondent's a-mail address: CdeharttG7C81dwellkearnS Com 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. SIGNAT RE OF PERSON RE~N~~ FOR FIL' ~ G RETURN f~s~l/a~y,7 L'/~'~~_~. DATE ADDRESS 606 GALE ROAD SIGNATUR~ OF PREPAREg OTHER THAN REPRESENTATIVE CAMP HILL 3631 NORTH FRONT STREET HARRISBURG PLEASE USE ORIGINAL FORM ONLY Side 1 15056041125 PA 17011 DATE _3~-u~ PA 17110 15056041125 J 15056042126 REV-1500 EX Decedent's Social Security Number 2 5 4 3 2 7 8 4 5 Name: FRANCES L . MCCALL t' d en s Dece RECAPITULATION 2 0 6 0 0 0, 0 0 ....................................... 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. 2 1 0 2 3 8, 8 6 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ...... . 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ...... . 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property ^ Separate Billing Requested ...... G . 7. ) (Schedule 4 1 6 2 3 8, 8 6 8. Total Gross Assets (total Linesl-7) •~•~•~~•~•~••~•~•~~•~~~~•~ ~ 8' 3 3 0 5 2, 6 9 9. Funeral Expenses & Administrative Costs (Schedule H) .............. s. . . 6 6 2 3, 3 0 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .......... .. 10. 3 9 6 7 5, 9 9 11 • Total Deductions (total Lines 9 & 10) ......................... .. 11. 12 3 7 6 5 6 2, 8 7 12. Net Value of Estate(Line8minusLine11) .~~~~•~•~~ ~ ~•~~•~ ~~• ~• 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which 13 an election to tax has not been made (Schedule J) ~ ~ ~ • ~ • • . 3 7 6 5 6 2, 8 7 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 0 0 0 15. 0. 0 0 (a)(1.2) X ~0 16. Amount of Line 14 taxable 3 '7 6 5 6 2 8 7 16 1 6 9 4 5. 3 3 at lineal rate X .045 17. Amount of Line 14 taxable 0 0 0 17. 0 . 0 0 at sibling rate X .12 18. Amount of Line 14 taxable 0 0 0 18 0 . 0 0 at collateral rate X .15 1 6 9 4 5. 3 3 . 19. ... 19. Tax Due ............................................ 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ^ Side 2 15056042126 15056042126 J REV-1500 EX Page 3 File Number Decedent's Complete Address: 0 0 DECEDENT'S NAME FRANCES L. McCALL STREET ADDRESS - - 1914 CLARENDON STREET CITY -.._ PATE - - - 'ZIP CAMP HILL 17011 Tax Payments and Credits: ~ Tax Due (Page 2 Line 19) (1) 16,945.33 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments 18,000.00 C. Discount 847.30 Total Credits (A + B + C) (2) 18,847.30 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (D + E) (3) 0.00 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) 1,901.97 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 0.00 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS Did decedent make a transfer and: 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 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 Yes No ^ 0 ^ a ^ 0 ......... ^ 0 ......... ^ X^ contains a beneficiary designation? .................................................................................................. ^ 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 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-'502 EX + (6-98) SCHEDULE A COMMONWEALTH OF PENNSYLVANIA REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER FRANCES L. McCALL 0 0 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 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. Residential dwelling known and numbered as 1914 Clarendon Street, Borough of Camp 206,000.00 Hill, Cumberland County, Pennsylvania -Gross sale price (see attached Settlement Sheet) TOTAL (Also enter on line 1, Recapitulation) ~ $ 206.000.00 (If more space is needed, insert additional sheets of the same size) REV-1508 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER FRANCES L. McCALL 0 0 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. ITEM NUMBER DESCRIPTION 1. Members 1st Federal Credit Union Accounts: (see attached statement) a. Savings Account #183218-00 -Date-of-death value b. Investment Account #183218-05 -Date-of-death balance c. Certificate of Deposit Account #183218-40 -Date-of-death balance d. Certificate of Deposit Account #183218-41 -Date-of-death balance e. Certificate of Deposit Account #183218-42 -Date-of-death balance f. Certificate of Deposit Account #183218-43 -Date-of-death balance 2. Commerce Bank Accounts: (see attached statement) a. Checking Account #537890360 -Date-of-death balance b. Checking Account #537890477 -Date-of-death balance c. Certificate of Deposit Account #1700266 -Date-of-death balance 3. M & T Bank Accounts: (see attached statement) a. Certificate of Deposit Account #31003914378996 -Date-of-death balance b. Certificate of Deposit Account #31003915123811 -Date-of-death balance c. Certificate of Deposit Account #31003917268300 -Date-of-death balance d. Certificate of Deposit Account #31003917268326 -Date-of-death balance VALUE AT DATE OF DEATH 25.00 5,571.46 57,900.55 6,419.10 5,871.52 1,953.71 36,880.24 5,502.93 29,103.59 2,000.47 16,659.83 2,145.90 23,155.44 TOTAL (Also enter on line 5, Recapitulation) ~ $ (If more space is needed, insert additional sheets of the same size) 210,238.86 Continuation of REV-1500 Inheritance Tax Return Resident Decedent FRANCES L. McCALL Decedent's Name Page 1 File Number Schedule E -Cash, Bank Deposits, & Misc. Personal Property ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH e. Certificate of Deposit Account #31003917269340 -Date-of-death balance 3,744.83 f. Checking Account #58519408 -Date-of-death balance 4,330.41 g. Checking Account #9846286541 -Date-of-death balance 3,726.48 4. Miscellaneous household goods and furnishings -Net proceeds from sale 5,247.40 (see attached statement) SUBTOTAL SCHEDULE E 17,049.12 GRAND TOTAL SCHEDULE E $ 210,238.86 REV=509 EX+'(8-98) SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN ESTATE OF FILE NUMBER FRANCES L. McCALL 0 0 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME A. None c JOINTLY-OWNED PROPERTY: RELATIONSHIP TO DECEDENT 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 ASSET °/ OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTERESI 1. A. TOTAL (Also enter on line 6, Recapitulation) (If more space is needed, insert additional sheets of the same size) REV-1510 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE G INTER-VIVOS TRANSFERS 8~ MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER FRANCES L McCALL _ 0 0 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. ITEM NUMBER DESCRIPTION OF PROPERTY wc~uoErHENaMeorrHEraaNSFEREE,rHEiRREV~rioNSHiProoECEOENraNO -He oarE of raaNSrea arraeH a coPV of rHe oeeo roR aea~ esrare DATE OF DEATH VALUE OF ASSET %OFDECD'S INTEREST EXCLUSION ur aPPUCae~el TAXABLE VALUE 1. None TOTAL (Also enter on line 7 Recapitulation) I $ (If more space is needed, insert additional sheets of the same size) REV-1511 EX + (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE H FUNERAL EXPENSES 8r ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER FRANCES L. McCALL 0 0 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Myers-Harner Funeral Home -Funeral services 3,544.00 2. Rolling Green Cemetery -Tombstone 3,662.50 3. West Shore Country Club -Funeral luncheon 995.70 B ADMINISTRATIVE COSTS: ~, Personal Representative's Commissions Name of Personal Representative (s) W illllam T. McCall Social Security Number(s)/EIN Number of Personal Representative(s) Street Address 606 Gale Road City Camp Hill State PA Zip 17011 Year(s) Commission Paid: Waived 2, Attorney Fees Caldwell & Kearns 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant None Street Address City State Zip Relationship of Claimant to Decedent 4. ~ Probate Fees Register of Wills 5 I Accountant's Fees 6. ~ Tax Return Preparer's Fees 2006 Federal Income Tax 7. Cumberland County Law Journal -Legal advertising 8. The Carlisle Sentinel -Legal advertising 9. Residential utilities pending sale, including electric, water, sewer and lawn care 10. Real estate repair and trash hauling for sale 11. Community Land Transfer LLC -Real estate closing costs, net of real estate tax reimbursement 6,775.00 750.00 125.00 75.00 1,747.26 185.00 15,193.23 TOTAL (Also enter on line 9, Recapitulation) ~ $ 052. (If more space is needed, insert additional sheets of the same size) REV-1512 EX + (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER FRANCES L. McCALL 0 0 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Metro Medical Services - Unreimbursed medical 98.10 2. Kevin McCall -Moving truck 72.92 3. U.S. Treasury - 2006 Federal Income Tax 3,169.00 4. Church of God Home -Final nursing home bill 2,334.81 5. Janet L. Miller -Spring real estate taxes 948.47 TOTAL (Also enter on line 10, Recapitulation) I $ 6 623 30 (If more space is needed, insert additional sheets of the same size) REV-113 EX + (g_00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER FRANCES L. McCALL 0 0 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustees) OF ESTATE I TAXABLE DISTRIBUTIONS [include outright spousaldisuibutions, and transfers under Sec. 9116 (a) (1.2)] 1. William T. McCall Lineal 606 Gale Road 25% Camp Hill, PA 17011 2. James A. McCall, Jr. Lineal 16 Dawn Drive 25% Millersburg, PA 17061 3. Glenn P. McCall Lineal 47 Kingswood Terrace 25% Carlisle, PA 17013 4. Mark E. McCall Lineal 710 North Third Street 25% Reading, PA 19601 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 T HROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: 1. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS 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) ~'~``' r ~~ 'j 3 ~~ ~ ~.. ~~, ~ LAST WILL AND TESTAMENT OF FRANCES LOUISE McCALL I, FRANCES LOUISE McCALL, of Cumberland County, Pennsylvania, being of sound mind, memory and understanding, do make and publish this my Last Will and Testament, hereby revoking and making void all former Wills by me at any time heretofore made. ITEM I. I direct that all my just debts ''and funeral expenses be fully paid and satisfied as soon as conveniently may be after my decease. ITEM II. I give all of the rest, residue and remainder of my estate unto my four (4) sons, James A. McCall, Jr., William T. McCall, Glenn P. McCall and Mark E. McCall, in equal shares, or to their living issue per stirpes. ITEM III. In addition to the powers conferred by law, I authorize my Executor, in absolute discretion: A. To retain in the form received, and to sell either at public or private sale any real or personal property. B. To manage real estate. C. To invest and reinvest only in forms of property defined as legal investments according to the laws of the Commonwealth of Pennsylvania. D. To exercise any optional rights arising from ownership of investments. E. To compromise claims without court approval, and without Ithe consent of any beneficiary. ITEM IV. It is hereby directed that my I, Executor, hereinafter named, shall pay all inheritance, state, succession and legacy taxes to which my estate or the transfer of any property hereunder may be subject and to charge such tax as (part of the administration, payable out of my residuary estate. ITEM V. I nominate, constitute and appoint my son, William T. McCall, to be and act as my sole Executor of this my Last Will and Testament. In the event of renunciation, death, resignation or inability to act for any reason whatsoever of my son, William T. McCall, I nominate, constitute and appoint my son, James A. McCall, Jr., as Executor of this my Last Will and Testament. No personal representative or fiduciary 'appointed herein shall be required to post bond or give any security. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~h d a y o f _ ~~~~~~. ~ 2 0 C~ FRANCES LO ISE McCALL 2 The preceding instrument, consisting of this, and two other typewritten pages, was on the date thereof signed, published and declared by FRANCES LOUISE McCALL, the Testatrix therein named, as and for her Last Will, in the presence of us, who at her request, in her presence and in the presence of each other, have subscribed our names a~ witnesses hereto. Residing at Residing at /70'0 3 COMMONWEALTH OF PENNSYLVANIA COUNTY OF SS: The Testatrix and the witnesses whose names are subscribed to the foregoing instrument, being first duly sworn and qualified according to law, do hereby acknowledge and declare to the undersigned authority that the Testatrix signed and executed the instrument as her last Will in the presence of the witnesses, that she signed willingly or willingly directed another to sign for her, that she executed it as her free and voluntary act for the purposes therein expressed, that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witnesses, and that to the best of their knowledge, the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. estatrix Witness Witness Sworn to, subscribed and acknowledged before me by the above named Testatrix and witnesses this 7~ day of o?oo~ 2007. ' lr ~/"~ ~~~ ( SEAL ) Notary Public 07435-001/126645 CGMMONWEALTH OF PENNSYLVANIA Notarial Seal Karen W. Porn, Notary Public Susquehanna Twp., Dauphin County My Commission E~ires Oct 25, 2010 Member. Pennsvlvar?ia A..rociation ut Notaries 4 v, L,VL-VLbb B. TYPE OF LOAN: U.S. DEPARTMENT OF HOUSING 8 URBAN DEVELOPMENT 1.~FHA 2.~FmHA 3.^CONV. UNINS. 4. QVA 5. ~X CONV. INS. SETTLEMENT STATEMENT 6. FILE NUMBER: 7. LOAN NUMBER: OS-411 5000838308 8. MORTGAGE INS CASE NUMBER: C. NOTE: This form is furnished to give you a state I " ment of actual settlement costs. Amounts paid to and b the settl tems marked (POC) were paid outside y ement agent are shown. the closing; they are shown here for inf ti orma onal purposes and are not included in the totals. D. NAME AND ADDRESS OF BORROWER: 1~0 sree (GOLOVKIN.A.PFD/°8-011/22) E. NAME AND ADDRESS OF SELLER : F. NAME AND ADDRESS OF LENDER: Alexander Golovkin and Estate of F. Louise McCall Marianna Golovkina TD Bank, NA 1914 Clarendon Street 32 Chestnut Street Camp HIII, PA 17011 Lewiston, ME 04240 G. PROPERTY LOCATION: H SET 1914 Cl d . TLEMENT AGENT: 68-0510988 aren on Street I. SETTLEMENT DATE: Camp HIII, PA 17011 Community Land Transfer, LLC C b um erland County, Pennsylvania PLACE OF SETTLEMENT August 18, 2008 2331 Market Street Camp Hill, PA 17011 J. SUMMARY OF BORROWER'S TRAN SACTI 100. GROSS AMOUNT DUE FROM BORROWER: ON K. SUMMARY OF SELLER'S TRANSACTION 101. Contract Sales Price 400. GROSS AMOUNT DUE TO SELLER: 102. Personal Pro ert 206,000.00 401. Contract Sales Price 206 000 00 103. Set0ement Char es to Borrower Line 1400 , . 402. Personal Pro a 104. 6,759.91. 403. 105. 404. Ad'ustments For Items Paid B Seller in advance 405. ' 106. Ci /Town Taxes tO Ad ustments For Items Paid B Setter in advance 107. Coun Taxes 08/18/08 to 01/01109 359.63 406. Ci /Town Taxes to 407 Coun Taxes 108. School Taxes 08/18/08 to 07/01/09 109. Sewer 08/18/08 to 10/01/08 1.786.25 . 08/18/08 to 01/01!09 359.63 408. School Taxes 08/18/08 to 07/01/09 110 25.11 1,786.25 409. Sewer 08/18/08 to 10/01/08 . 111 25.11 410. 112 411. 412. 120. GROSS AMOUNT DUE FROM BORR OWER 214,930.90 420. GROSS AMOUNT DUE TO SELLER 200. AMOUNTS PAID BY OR IN BEHALF OF BOR 208,170.99 RO 201. De osit or earnest move WER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER: 202. Princi al Amount of New Loans 3,000.00 501. Excess De osit See Instructions 203. Existin loans taken sub'ect to 185,400.00 502. Settlement Char es to Seller Line 1400 17 364 22 204. 503. Existin loans taken sub'ect to , . 205. 504. Payoff of first Mortgage 206. 505. Pa off of second Mort a e 207 506. 208 507. De osit disb. as roceeds 209. 508. Ad'ustments For Items Un aid B Seller 509. ' 210. Cit /Town Taxes to Ad ustments For Items Unpaid 8 Seller 510 Cit /T 211. Count Taxes to . own Taxes to 212. School Taxes to 511. Count Taxes to 213 512. School Taxes to 214 513. 215. 514. 216 515. 217 516. 218. 517. 219. 518. 519. 220. TOTAL PAID BY/FOR BOR ROWER 188,400.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 300. CASH AT SETTLEMENT FROM/TO BORRO 17,364.22 WER: 301. Gross Amount Due From Borrower Line 120 600. CASH AT SETTLEMENT TO/FROM SELLER: 302. Less Amount Paid By/For Borrower (Line 220) 214,930.90 601. Gross Amount Due To Seller Line 420 208 170 99 ( 188,400.00) 602. Less Reductions Due Seller (Line 520 , . 303.CASH(XFROM)( TO BOR ) ( 17,364.22 ) ROWER 26,530.90 603. CASH (X TO) ( FROM) SELLER The undereinnc.l tio.e~.„ .,.,~.._..,_~-_ _ 190,806.77 -_ y •~~~~P• ~• a ~~iiiNin,eu copy or pages 1x2 of this statement & any attachments referred to herein. Borrower ~'~~~~~ Seller LAS der Golovkin Estate of F. Louise McCall / / '/ BY: Ll//~a-r-+~+ / i7•?t' inn-G~_ Marianna Golovki Page 2 ~. ~~ I I ~~mtrv I GtiAKGES 700. TOTAL COMMISSION Based on Price $ 206 OO , D.DD 6.ODOD % 12,36D.DD Division of Commission line 700 as Follows: PAID FROM PAID FROM 701. $ 12,085.00 to THE HOMESTEAD GROUP, INC. eoaaowErrs sELLERs 702. $ t0 FUNDS AT FUNDS AT 7D3. CDmmisslDn Pald at Settlement SETTLEMENT' SETTLEMENT 704. Transaction Fee to The Homestead Grou Inc 12,085.00 , . Note: Line 701 Includes Adjustment of -275.00 For Jospeh Greer 100.0 0 800. ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Ort ination Fee % to 802. Loan Discount % to 803. Appraisal Fee to The Real Estate An l t ys a s 804. Credit Report to CBC Innovis 400.0 0 805. Lender's Inspection Fee t0 17.5 0 806. Mort a e Ins. A .Fee to 807. Assumption Fee to 808. Tax Service Fee to First American Real Estate Tax Service 809. Underwriting Fee to TD Bank, NA 60.0 0 810. Flood Zone Cert. to First American Flood Dat S i 350.0 0 a erv ces 811. Courier Fee to ELYNX LTD 8.5 0 812. MERS Fee to MERS 10.0 0 813. Disbursement Fee to Capital Assurance Group POC:B4.95 814. Settlement Fee to Capital Assurance Group 50.0 0 . 815. 450.0 0 816. 817. 818. 819. 820. 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest From 08/18/08 to 09/01/08 @ $ 30 .393444/day ( 14 days %) 902 M rt I 42 . o a e nsurance Premium for 2 months to MGIC 5.51 903. Hazard Insurance Premium for 1.0 ears to Travelers 160.68 904. POC:B595.00 905. 1000. RESERVES DEPOSITED WITH LENDER 1001. Hazard Insurance 3.000 months $ 49 58 er month . 1002. Mort a e Insurance months 148.74 $ er month 1003. Cit /Town Taxes months $ er month 1004. Count Taxes 7.000 months $ 80 65 . er month 1005. School Taxes 3.000 months @ $ 171.99 per month 564.55 1006. months $ er month 1007. 514.17 months er month 1008. A r ate Adjustment ~ months $ er month 1100. TITLE CHARGES -322.49 1101. SetOement or Closin Fee to 1102. Abstractor TiBe Search to 1103. Titte Examination to 1104. Title Insurance Binder to 1105. Electronic Document Pre to Communi Land Transfer LLC , 1106. Closin Service Letter to Communi Land Transfer LLC 50.00 , 1107. Attorney's Fees to 35.00 includes above item numbers: 1108. Title Insurance to COMMUNITY LAND TRANSFER includes above item numbers.1102, 1103 & 1104 1 388.75 1109. Lender's Coverage $ 185 400 00 , . 1110. Owner's Coverage $ 206 000 00 , . 1111. Endorsements 100, 300, 8.1 1,388.75 to Community Land Transfer LLC , 1112. Notary Fee to Community Land Transfer 150.00 1113. Notary Fee to Community Land Transfer 10.00 1114. Overnight Fees & Handling to Community Land Transfer LLC 5.00 , 1115. Wire Fee to Community Land Transfer LLC 15.00 , 1116. 10.00 1117. 1118. 12D0. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recording Fees: Deed $ 39.50; Mortgage $ 64.50; Releases $ 1202. Cit /Coun Tax/Stam s: Deed 704.00 060.00 • Mort a e 2 . 1203. State Tax/Stam s: Deed 2,060.00 2,060.00; Mort a e 1204. Re airs to Jose h Greer 2,060.00 1205. Cumbedand County Recorder of Deeds 275.00 1300. ADDITIONAL SETTLEMENT CHARGES 1301. Surve to 1302. Pest Ins ection to 1303. 2008/09 School Taxes to Janet L Miller Tax C ll t . , o ec or 1304. Sewer to Cam Hill eorou h 2,056.72 1305. Radon Mitigation to Enviroquest 52.50 1400. TOTAL SETTLEMENT CHARGES Enter on Lines 103 S ti 830.00 , ec on J and 502, Section K By signing page 1 or this statement, Ne signatories acknowledge receipt of a rAmpletetl copv o(naae 2 nt Ihic tug ,.~,.e ~r~,eme_, 6,759.91 17,364.22 Certified to be a true copy. Community Land Transfer, LLC Settlement Agent ( 08-011 /0811 /23 ) From:CALDwELL DEI~ELOPMENT 717+731+0979 09/18!2008 14:32 #137 P.OD8JD08 Consignment Fees Due - By Item os~a2ooe Auctiarc 9 - 08!112008 06:00 PM To 0811 1 2008 09:00 PM Auction NameAocation: Bill McCall -1914 Clarenden Street Cons ner. AN Date R e: 01!012000 Throu h 09104!2008 !293!1277 . .~ ,_. ~ CLOWNS ,_ ,. 5.00 .... „ ,. _ .75 .. 00 t.• .25 v.K . .00 .. . ~rM~' . 5.00!1 9 !29411278 CLOWNS 10.00 1.50 .00 8.50 .OD 10.0011 9 / 295 / 1279 CD PLAYER,COKE ITEMS 6.00 .90 .00 5.10 .00 6.00! 1 9 /296 / 1280 VASES 4.00 .60 .00 3.40 .00 4.00 J 1 9 /297 / 1281 AIR CONDITIONER PURIFIER 200 .30 .00 1.70 .00 2.00 / 1 9 / 298 / 1282 CAROUSEL HORSE,BEAR 10.00 1.50 .00 8.50 .00 10.00 / 1 9 /300 / 1284 CLOWN PAPER SHREDDER 2.00. .30 .00 1.70 .00 2.00 / 1 TOTALS: 8,044.00 1206.60 .00 6837.40 .00 x . ,.~ .. ». . ' ~Y T 1 :. ~ ; PfML . ~ `J C }~ ty-; ~ i3`N~i' !...:; 2 "5,,.~; ':~•'~ ~i~ 5~ ~?.'.:.11.. 091041'1008 Advertisi se -Patriot, P a xton Harald, Guide News En le Merchandisers 1,20D.00 09/0420D8 Set u Labor 250.00 ` 09/042008 Misc. -Funds Recieved from Hand Gun 140.OD Total Bids: 8,044.OD Bu back kerns: .00 Total Fees: 1,206.60 Total B ck Fees: .00 Total Gen. uses: 1,590.00 Total Item Ex Haas: .00 Total Gross Due; 5,247.40 Total Alread Paid: .00 Total Net Due: 5,247.40 Total Invoiced Bids: 8,044.00 ~ _ ~ -- Less Bu ck !terns: .00 Tote! Fees: 1,206.60 Total Bu Fees: .00 Total Gen. Ex Haas: 1,590.00 Total Item E uses: .00 _ Total Grass Dus: 5,247.40 Total Ahead Paid: .OD Total Net Due: 5,247.40 091042008 20:16 PM (33) Kerry Pae Auctioneers Page 7 of 7 MiaR 2 1 2008 March 20, 2008 Charles J. DeHart, III Caldwell & Kearns 3631 North Front St Harrisburg, PA 17110 RE: Estate of: Frances Louise McCall Tax Identification Number: 254-32-7845 Date of Death: February 23, 2008 To Whom It May Concern: Commerce Bank This letter is in reference to decedent account information you requested for the individual listed above. We are able to provide the following: Account Type: Checking Account Number: 537890360 Date Opened: December 13, 2007 Primary Owner: Louise McCall Date of Death Balance: $36,904.48 Accrued Interest: $24.24 Principal Balance: $36,880.24 Account Type: Checking Account Number: 537890477 Date Opened: December 13, 2007 Primary Owner: Louise McCall Date of Death Balance: $5,502.98 Accrued Interest: $.05 Principal Balance: $5,502.93 Account Type: 12 Month CD Account Number: 1700266 Date Opened: March 22, 2004 Primary Owner: James A. McCall (DOD10/27/07) Secondary Owner: Louise McCall Date of Death Balance: $29,112.38 Accrued Interest: $8.79 Principal Balance: $29,103.59 Please feel free to contact me at (717) 412-6127 if I may be of further assistance. Sincerely, r ,: Commerce Bank /Harrisburg, N.A. ~'-~---}~'~ ~'-~~'~: PO Box 4999 Cindy S~ultz 3801 Paxton Street Harrisburg, PA 17111-0999 Research Associate/Deposit Services commercepc.com Commerce Bank St MEMBERS 1St FEDERAL CREDIT UNION PRIMARY OWNER: James A. McCall -date of death 10/27/2007 REGULAR SAVINGS ACCOUNT: Account Number/ Suffix 183218-00 Date Account Established 04/08/1999 Principal Balance at Date of Death $25.00 Accrued Interest to Date of Death $.00 Total Principal and Accrued Interest $25.00 Name of Joint Owner Louise McCall Date Joint Ownership Established 04/08/1999 INVESTMENT SAVINGS ACCOUNT: Account Number/ Suffix 183218-05 Date Account Established 04/08/1999 Principal Balance at Date of Death $5,565.43 Accrued Interest to Date of Death $6.03 Total Principal and Accrued Interest $5,571.46 Name of Joint Owner Louise McCall Date Joint Ownership Established 04/08/1999 CERTIFICATES OF DEPOSIT: Account Number/Suffix 183218-40 183218-41 Date Account Established 06/15/2004* 10/04/2006" Principal Balance at Date of Death $57,750.18 $6,403.35 Accrued Interest to Date of Death $150.37 $15.75 Total Principal and Accrued Interest $57,900.55 $6,419.10 Name of Joint Owner Louise McCall Louise McCall Date Joint Ownership Established 06/15/2004 10/04/2006 *Purchased by transfer of funds from 183218-05. CERTIFICATES OF DEPOSIT: Account Number/Suffix 183218-42 183218-43 Date Account Established 10/07/2006 12/09/2006 Principal Balance at Date of Death $5,857.12 $1,949.09 Accrued Interest to Date of Death $14.40 $4.62 Total Principal and Accrued Interest $5,871.52 $1,953.71 Name of Joint Owner Louise McCall Louise McCall Date Joint Ownership Established 10/07/2006 12/09/2006 M M ERS `1~sTnF~E~D~ERAL CR~E~IT~UNION Danielle A. Kline Insurance Services Specialist April 24, 2008 Estate of: Frances Louise McCall Date of Death: 02/23/2008 Social Security Number: 254-32-7845 5000 Louise Drive PO. Box 40 Mechanicsburg, Pennsylvania 17055 (800) 283-2328 w~~w.memberslst.org f~AR 2 ~ 2008 Q MsTF~~nk 499 Mitchell Street, Millsboro, DE 19966 December 27, 2007 Caldwell 8v Kearns Attorneys At Law 3631 North Front Street Harrisburg, PA 17110-1533 RE: Estate of F. Louise McCall Date of Death: February 23, 2008 Social Security Number: 254-32-7845 Dear Mr. DeHart: In response to your request, please be advised that at the time of death, the above- named decedent had on deposit with this bank the following accounts. 1. Account Type ........................... Certificate of Deposit Account Number ....................... 31003914378996 Ownership (Names off .............. F. Louise McCall, James McCall Opening Date ...........................03/05/90 (account closed 03/07/08) Balance on Date of Death.........$1,929.75 Accrued Interest $ 70.72 Total ....................................... $2000.47 2. Account Type ........................... Certificate of Deposit Account Number ....................... 3 10039 15 1238 1 1 Ownership (Names off .............. F. Louise McCall, James McCall Opening Date ...........................04/ 20/ 05 Balance on Date of Death .........$16,145.58 Accrued Interest $ 514.25 Total .......................................$16,659.83 • Page 2 3. Account Type ........................... Certificate of Deposit Account Number ....................... 31003917268300 Ownership (Names off .............. F. Louise McCall, James McCall Opening Date ...........................10 / 11 / 06 Balance on Date of Death..........$2,000.00 Accrued Interest $ 145 90 Total .......................................$2,145.90 4. Account Type ........................... Certificate of Deposit Account Number ....................... 31003917268326 Ownership (Names off .............. F. Louise McCall, James McCall Opening Date ...........................10/26/06 Balance on Date of Death..........$22,187.41 Accrued Interest $ 338 03 Total .......................................$23,155.44 5. Account Type ........................... Certificate of Deposit Account Number ....................... 31003917269340 Ownershzp (Names off .............. F. Louise McCall, James McCall Opening Date ...........................12 / 29 / 06 Balance on Date of Death..........$3,719.60 Accrued Interest $ 25 23 Total ....................................... $3, 744.8 3 March 24, 2008 • Page 3 6. Account Type ........................... Checking Account Account Number ....................... 58519408 Ownership (Names off .............. F. Louise McCall, James McCall Opening Date ...........................08/28/64 Balance on Date of Death.........$4,330.38 Accnced Interest $ 0 11 Total ....................................... $4, 33 0.41 7. Account Type ........................... Checking Account Account Number ....................... 9846286541 Ownership (Names off .............. F. Louise McCall Opening Date .......................... .11 / 19 / 07 Balance on Date of Death_ ......... $3,726.45 Accrued Interest $ 0 03 Total ....................................... $3, 726.48 The above named decedent did not have a safe deposit box. March 24, 2008 * If upon reviewing the information above, you believe there are additional accounts not referenced, please provide us with an account number and/or the name of any possible joint account holder. For any additional information on the above accounts, including ownership and any changes, closures and/or reimbursement of funds, please contact our West Shore Plaza branch at 1200 Market Street, Lemoyne, PA 17043 or # 717-255- 2271. Sincerely, . _.. ~ /~ Charlene Warrington, Records Management 1-888-502-4349 JAMES R. CLIP PINGER CALDWELL & KEARNS CHARLES J. DEHART, III OF COUNSEL JAMES L. GOLDSMITH A PROFESSIONAL CORPORATION RICHARD L. KEARNS P. DANIEL ALT LAND ATTORNEYS AT LAW CARL G. WASS JEFFREY T. MCGUIR E• JAMES D. CAMPBELL. JR. STANLEY J. A. LASKOWSKI 3631 NORTH FRONT STREET DOUGLAS K. MAR SICO THOMAS D CALDWELL BRETT M. WOODBURN HARRISBURG, PENNSYLVANIA 17110-1533 . , JR. Reza-2ooll DAVID J. LANZA ELIZABETH H. FEATHER KAREN W. MILLER •BOARD CERTIFIED CIVIL TRIAL ADVOCATE 717-232-7661 October 1, 2008 FAX: 717-232-2766 thefirm~caldwellkearns.com ;tea n z~ Office of the Register of Wills T ~ -=? `~ Cumberland County Courthouse -~-~~'' ~'' One Courthouse Square ~_:::I ~ Carlisle, PA 17013-3387 ~,,; - _~., RE: Estate of Frances Louise McCall -' ~:'~ =-; Date of Death: February 23, 2008 ~ File No. 21-08-00244 w Dear Sir or Madam: I am enclosing herewith the following documents for filing: 1. Two (2) copies of an Inventory of real and personal property. 2. Two (2) copies of the Pennsylvania Inheritance Tax Return, with attachments. 3. A check made payable to you in the amount of $25 to cover the filing fee. 4. Copy of the face page of the Inventory and the Inheritance .Tax Return to be clocked in and returned to me in the enclosed self-addressed, stamped envelope for your convenience. Thank you for your cooperation. Very truly yours, CJDIII:nb /Enclosures cc: William T. McCall 07435-002/138849 Charles J. DeHart, III CALDWELL & KEARNS -. ~.~ _ `_ '~' ~ r~! pp~~~\j ~J ~Vn~ L N tip= 3) .. ~"~ (1' -- u ~a r _ l1 *'o •- n V'~'`'.flNfl (`~ c a c_.c ,ar y ~y,• v • . •p ~.~:~, ~ . . ~-. ~~ ; -.~ :.. W Q a F m w "~ w `~ ~- o cn ~ ~ z o Q ~ ~ _ ~ ~ ~ ~ ~ 0 z N ~ ~ ~ Q m = a~ ~~ __ o ~t oo~a~o U ~ M N ~, ~ ~'? c"~n ~ Cn ch ~ p O O ~U ~~ O ~ ~ ~ O ~ O Qj ~~U ~ ~~cc`v OUOU W i~ . ~ r~ ``_ C: c ~ W ® (.~ r C. \~f ~ ii C~' t3F ~ ^+ P? ~~ ~~ a ~ ., _. `~ ~~ o ~s __ „_ ~. ~. T~4r~ P ~ a Y ~ ~ v •r~ •~~m~ ..t Q~ ~! 0 O ~ c~ U ~ ~M a~ ~ n ~(qM •~~ ~~ ~U ~~ c~ o ~ ~~~ ~ o ~ o ~ U ~ ~ ~ .n ~ c ~ OUOU Q M cn o ZZ ~- o ~ W n ~ ~ W Q a ~ a W ~ J N z a ~ ~ Q z o N ~ } J z W I~ N J _O Z ~ Z W N a ~ W 3 W p o a z ~ F ~ a Q ~ ~ U ~u0°i a JAMES R. CLIPPINGER CHARLES J. DEHART, III JAMES L. GOLDSMITH P. DANIEL ALT LAND JEFFREY T. McGUIRE• STANLEY J. A. LASKOWSKI DOUGLAS K. MARSICO BRETT M. WOODBURN DAVID J. LANZA ELIZABETH H. FEATHER KAREN W. MILLER •BOARD CERTIFIED CIVIL TRIAL ADVOCATE CALDWELL &KEARNS A PROFESSIONAL CORPORATION ATTORNEYS AT LAW 3631 NORTH FRONT STREET HARRISBURG, PENNSYLVANIA 17110-1533 October 2, 2008 Office of the Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013-3387 Att: Wanda RE: Estate of Frances Louise McCall Date of Death: February 23, 2008 File No. 21-08-00244 Dear Wanda: OF COUNSEL RICHARD L. KEARNS CARL G. WASS JAMES D. CAMPBELL. JR. THOMAS D. CALDWELL, JR. 119 2 8-20011 717-232-7661 FAX: 717 -232-2766 thef irm®caldwellkearns.com I am enclosing herewith a check in the amount of $5 to cover the additional filing fee. Thank you for your courtesy in this matter. Very truly yours, _.----- G~ ~`~f~---- C rles J. DeHart, III CALDWELL & KEARNS CJDIII:nb /Enclosure 07435-002/138941 >-~> ~~ r:? C_ © .'::, _'~ C`a 'rl C 3 ~~.) ~, :}:- r- ~ i ---! , '-? "t f =~1 --+ !J .- .. ;" ~~