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HomeMy WebLinkAbout10-30-08 (3)15056041158 REV-1500 EX (06-05) PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN 21 0 7 0 9 2 2 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 164-24-9879 09282007 04011,925 . e Decedent's Last Name Suffix Decedent's First Name M I FULLER MARY E (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name M I Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE - - REGISTER OF WILLS FILL IN APPROPRIATE BOXES BELOW 1. Original Return ^ 4 . Limited Estate 6. Decedent Died Testate (Attach Copy of Will) ^ 9. Litigation Proceeds Received 2. Supplemental Return ^ 4a. ^ 7. ^ 10. Future Interest Compromise (date of death after 12-12-82) Decedent Maintained a Living Trust (Attach Copy of Trust) Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) ^ 3. Remainder Return (date of death ^ 5. prior to 12-13-82) Federal Estate Tax Return Required 0_. 8. Total Number of Safe Deposit Boxes ^ 1 1. Election to tax under Sec. 9113(A) (Attach Sch. O) ~,vrtrt~arvrvucrv I -THIS SECTICNJ MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number _ RICHARD C• SNELBAKER, ESQUIRE 717-697-8r5~8 s -' -~ _~ ~.~ ,., Firm Name (If Applicable) ~ SNELBAKER & BRENNEMAN, P•C• First line of address 44 WEST MAIN STREET Second line of address P • 0 • BOX 31,8 City or Post Office State ZIP Code MECHANICSBURG PA 17055 Correspondent's a-mail address: 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. ,~~ \ / 1 I~AKYI~IU SHARP EXECUTRIX 119 RIDGE ROAD, CARLISLE, PA 170 SIvNAN Tuyct yr rKJ~jaKtK7dTHER THAN REPRESENTATIVE nn,-c RICHARD C• SNELBAKER, ESQUIRE 44 WEST MAIN STREET, MECHANICSBURG,PA PLEASE USE ORIGINAL FORM ONLY 17055 15056041158 Side 1 6M4647 3.000 15056041158 '~ti 15056042159 REV-1500 EX Decedent's Social Security Number 164-24-9879 Decedent's Name F U L L E R MAR Y RECAPITULATION 1. Real estate (Schedule A) 1. 85000.00 2. Stocks and Bonds (Schedule B) .......................... 2. 3 4 9 5 • 5 0 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . 3. 0 , 0 0 4. Mortgages & Notes Receivable (Schedule D). 4. 0 • O O 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . 5. ], 3 6 8 5 • 8 0 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested 6. 3 2 5 2 3 • 2 9 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested 7. 0 • O 0 8. Total Gross Assets (total Lines 1-7) . . . . . . . . . . . . . . . . . . . . . . . . 8. 13 4 7 O 4 • 5 9 9. Funeral Expenses & Administrative Costs (Schedule H) . 9. 2 4 4 5 3 • 5 4 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I). . . . . . . . . . . 10. 1720 , 1O 11. Total Deductions (total Lines 9 & 10) . 11. 2 6 ], 7 3 • 6 4 12. Net Value of Estate (Line 8 minus Line 11) 12. ], O 8 5 3 O • 9 5 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) . 13. O • 0 0 14. Net Value Subject to Tax (Line 12 minus Line 13) 14. L O 8 5 3 0 • 9 5 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~ O , OO 15. O.OO 16. Amount of Line 14 taxable at linealratex.o4.5 108530.95 16. 4883.89 17. Amount of Line 14 taxable at sibling rate X .12 O •0 0 17. O •O O 18. Amount of line 14 taxable at collateral rate X .15 O.0 0 18. O • O O 19. TAX DUE 19. 4 8 8 3. 8 9 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 15D56D42159 6M46482.000 15056042159 REV-1500 EX Page 3 Decedent's Complete Address: File Number 0922 DECEDENTS NAME FULLER MARY E STREET ADDRESS CUMBERLAND COUNTY CITY CARLISLE STATE ZIP Tax Payments and Credits: 1 . Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 0 . 0 0 B. Prior Payments 3 0 0 0. 0 0 C. Discount 15 0 • 0 0 3. Interest/Penalty if applicable D. Interest 0 • 0 0 E. Penalty 0 . Q Q (1> . 4883.89 Total Credits (A + g + C) (2> _ 315 0 •0 0 Total Interest/Penalty (D + E) (3) _ 0 , 0 0 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in box on Page 2, Line 20 to request a refund. (4) _ 0 • 0 0 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAx DUE. (5) _ 17 3 3 • 8 9 A. Enter the interest on the tax due. (5A) 0 • 0 0 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56) _ 17 3 3 • 8 9 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ^ b. retain the right to designate who shall use the property transferred or its income; ^ X^ 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? X 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 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 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)]. 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 a3doption. 6M4671 1.000 1 REV-1502 EX+(6-98) SCHEDULE A COMMONWEALTH OF PENNSYLVANIA REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER 21 07 0922 Ma E. Fuller All real property owned solely or as a tenant in common must be reported affair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant fads. Real property which is jointlyowned with right of survivorship must be disclosed on Schedule F. VALUE AT DATE ITEM DESCRIPTION OF DEATH NUMBER 1, Property known and numbered as 300 Park Street, Borough of Cresson, County of Cambria, Cresson, PA, sale value (see attached settlement sheet) TOTAL (Also enter on line 1, Recapitulation) swasss ~ o00 (If more space is needed, insert additional sheets of the same size) 85,000.00 $ 85,000.00 A. S@ttI@111ent Stat@111ent U.S. Department of Housing OMB A _,._ pproval No. 2502-0265 ---- and Urban Development (expires 11/3012009) B. Type of Loan 6. File Number: 1. ^ FHA 2. ^ FmHA 3, ^Conv. Unins. 100-2873 4. ^ VA 5. ^Conv. Ins. 7. Loan Number: 18. Mortgage Insurance Case Number: 1560080248 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 the closing; they are shown here for informational purposes and are not included in the totals. D. Name & Address of Borrower: E. Name & Address of Seller: William J. Thomas, Jr. Mary E. Fuller Estate C/o Marylou Sharp, 928 Lower S Main Sf. Exec. Bangor, PA 18013-2834 c% Attorneyy Richard Snelbaker Crystal L. Thomas ianicsburg, PA 17055-0318 928 Lower S Main St. Bangor, PA 18013-2834 F. Name & Address of Lender: Reliance Savings Bank 1119 12th Street, Altoona, PA 16601 G. Property Location: H. Settlement Agent: 300 Park Avenue Goldstein, Heslop, Steele, Clapper & Cresson, PA 16630 Oswalt Cambria County Place of Settlement: 414 N. Logan Blvd. Altoona, PA 16602 Rescission Date: I. Settlement Date: 08/28/2008 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 $85, ooo. 00 401. Contract sales price $85, ooo. 00 102. Personal property 402. Personal property 103. Settlement charges to borrower (line 1400) $2, 301.96 403. 104. 404. 105. 405. Adjustments for items paid by seller in advance 106. City/town taxes 08/28/2008 to 01/01/2009 107. County taxes 08/28/2008 to 01/01/2009 108. Assessments 08/28/2008 to 07/01/2009 109. 110. 111. 112. 120. Gress Amount 200. Amounts Paid 201. Deposit or earn e From Borrower Or In Behalf Of Borrower 202. Principal amount of new loan(s) 203. Existing loan(s) taken subject to 204. 205. 206. 207. 208. 209. Adjustments for items unpaid 210. City/town taxes 211. County taxes 212. Assessments 213. 214. 2.15. 216. 217. 218. 219. Adjustments for items paid by seller in advance $40.64 406. City/town taxes _ 08/28/2008 to 01/01/2009 $116.84 407. County taxes 08/x.'8/2008 to 01/01/2009 $582.12 408. Assessments 08/x!8/2008 to 07/01/2009 409. 410. 411. 412. $88, 041.56 420. Gross Amount Due To Seller 500. Reductions In Amount Due To Seller SZ, ooo. 00 501. Excess deposit (see in;structions) $68, ooo. 00 502. Settlement charges to ;seller (line 1400) 503. Existing loan(s) taken subject to 504. Payoff of first mortgage loan 505. Payoff of second mortgage loan 506. 507. 508. 509. seller Adjustments for items unpaid by seller tO 510. City/town taxes to to 511. County taxes to to 512. Assessments to 513. 514. 515. 516. 517. 518. 519. 220. Total Paid By/For Borrower 300. Cash At Settlement From/To Borrower 301. Gross amount due from borrower (line 120) 302. Less amount paid by/for borrower (line 220) $69, 000. 00 520. Total Reduction Amount Due Setter 600. Cash At Settlement TolFrom Seller S88, 041.56 601. Gross amount due to seller (line 420) 69, 000. oo) 602. Less reductions in amt. clue seller (line $40.64 $116.84 $582.12 $85,739.60 $1,coc.oa $4,999.84 $5,999.84 $85, 739. 60 $5,999.84 1 30.3. Cash ®From ^ To Borrower I $19 041 561 603 Cash ®To ^From S $79 ll Section 5 of the Real Estate Settlement Procedures Act (RESPA) requires the following: HUD must develop a Special Information e er , 739. 76 Section 4(a) of RESPA mandate UD develop and prescribe thi Booklet to help persons borrowing money to finance the purchase of sid s standard form to be used a1: the time of loan settlement to provide full disclo re ential real estate to better understand the nature and costs of real estate settlement services; Each lender must provide th b sure of all charges imposed upon the borrower and seller. These are third party disclosures that are designed to id e ooklet to all applicants from whom it receives or for whom it prepares a written application to b prov e the borrower with pertinent information during the settlement process in order to be a better sho er orrow money to finance the purchase of residential real estate; Lenders must prepare and distribute with th pp . The Public Reporting Burden for thi ll e Booklet a Good Faith Estimate of the settlement costs that the borrower is likely to incur in i s co ection of information is estimated to average one hour per response, including the time for revi i connect on with the settlement. These disclosures are mandatory. ew ng instructions, searching existing data sources, gathering and maintaining the data d nee ed, and completing and reviewing the collection of information. • This agency may not collect this information, and you are not required to complete this f s orm, unle s it displays a currently valid OMB control number. The information requested doers not lend itself to confidentiality. Previous editions are obsolete Page 1 of 2 form HUD-1 (3/86) ref Handbook 4305.2 F°- . , ~~iement Charges . 00. Total Sales/Broker's Commission based on price $ $85, 000.00 @ 6 %_ $5,100.00 Paid From Paid From Division of Commission (line 700) as follows: Borrowers Seller's 701. $ to Funds at Funds at Settlement Settlement 702.$ to Century 21 Strayer & Assoc 703. Commission paid at Settlement ( $1, 000.00 P.o.c.) $1, 805.00 7pq, Joyce T. Phillips Real Estate $2,295.00 800. Items Payable In Connection With Loan 801. Loan Origination Fee % Reliance savings Baril 802. Loan Discount % Reliance Savings Ban] 803. Appraisal Fee to ciyde E Yon & Assoc ( $275.00 P.O.C.) $25.00 804. Credit Report to Fiserv Credstar ( $15.:58 P.o.c.) 805. Lender's Inspection Fee Reliance Savings Bank 806. Mortgage Insurance Application Fee to Reliance savings Bank 807. Assumption Fee Reliance Savings Bank 808. Flood Det/Cert Fee to United One Resource $25 POC 809. Application Fee to Reliance Savings Bank $150 POC 810. LP Credit Evaluation to FHLMC $22 POC 811, Document Prop Fee to Reliance Savings Bank $300.00 812. 813. 814. 815. 816. 817. 818. 819. 820. yuu. aerns Regwrea ay ~enaer r o ese rasa m Aavance 901. Interest from 08/28/2008 t0 09/01/2008 @$ $11.57 /day $39.71 902. Mortgage Insurance Premium for months to 903. Hazard Insurance Premium for 1.00 years to Travelers ( $353. 00 P.o.c.) 904. years to 905. .vvv..~c.~c.~ca ucNva~acu rrun ~.cnuc~ 1001. Hazard insurance months @$ per month 1002. Mortgage insurance months @$ per month 1003. Gity property taxes months @$ per month 1004. County property taxes months @$ per month 1005. Annual assessments months @$ per month 1006. months @$ per month 1007. wnonths @$ per month 1008. months @$ per month 1009. Aggregate Accounting Escrow Adjustment $0.00 $0.00 1101. Settlement or closing fee to 1102. Abstract or title search to -' -'- 1103. Title examination to 1104. Title insurance binder to 1105. Document preparation to 1106. Notary fees to 1107. Attorney's fees to Goldstein., Heslop, Clapper, Steele & Oswalt $50.00 (includes above items numbers: ) 1108. Title Insurance tp Goldstein, Heslop, Clapper, Steele & Oswalt $768.75 (includes above items numbers: ) 1109. Lender's coverage $ ( $68, 000.00) 1110. Owner's coverage $ $85, ooo. 00 ( $85, ooo. 00 ) 1111, PA End 100, 300, 900 @ $50 each $150.00 1112. 1113. ____. __._......_... .......,. ,.....y ...... .. a. w.c. vuu. vca ~~u~. Kecoramg tees: Deed $ $41.50 ;Mortgage $ $63.50 ;Releases $ $105.00 1202. City/county taxlstamps: Deed $ S85o. 00 ;Mortgage $ $850.00 1203. State tax/stamps: Deed $ $850.00 ;Mortgage $ $850.00 1204. 1205. ~Znn ea.~~F:.,.,.,i c,..a,....,.-. ..u----- iaui. purvey to 1302. Pest inspection to 1303. UPS Fee for RSB Closing Package $17.00 1304. Final water bill to Cresson Borough $49 84 1305. Tax Claim Cert Reimb to GHSCO $1.50 13os. 1307. 1400. Total Settlement Charges (enter on lines 103, Section J and 502, Section K) $2,301.96 $4,999.84 Previous editions are obsolete Page 2 of 2 form HUD-1 (3/86) ref Handbook 4305.2 ~. Certification (continued from HUD-1) I 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 all receipts and disbursements made on my account or by me in this transaction. I further certify that I have received a copy of the HUD-1 Settlement Statement. Borrower: ~,,~.~, a ~,,, ~,,, Date: 8 zg'~~ William JT.' Thomas Jr. Borrower. ~ ~,~r Date: Cry I L. Thomas 4~ Seller or Agent: Date: ~ ~' Q u ler Estate !o Marylou Sharp, Exec. Seller or Agent: Date: The HUD-1 Settlement which I have prepared is a true and accurate account of this transaction. I have caused or will cause the funds to be disbursed in accordance with this statement. WARNING Date: Settlement Agent: »~~~ l ~~Date: Ter dstein 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 imprisonment. For details see: Title 18 U.S. Code Section 1001 and Section 1010. Wig' 569, ooo. 00 )~ 602. Less reductions in amt. due seller (line 520) ~ ( S5, 999.84 ~ 303. Cash ®From ^ To Borrower I Sig, 041.561603. Cash ®To ^ From Seller I 579, 739.76 Section 5 of the Real Estate Settlement Procedures Act (RESPA) requires the following: HUD must develop a Special Information Booklet to help persons borrowing money to finance the purchase of residential real estate to better understand the nature and costs of real estate settlement services; Each lender must provide the booklet to all applicants from whom it receives or for whom it prepares a written application to borrow money to finance the purchase of residential real estate; Lenders must prepare and distribute with the Booklet a Good Faith Estimate of the settlement casts that the borrower is likely to incur in connection with the settlement. These disclosures are mandatory. Section 4(a) of RESPA mandates that HUD develop and prescribe this standard form to be used sat the time of loan settlement to provide full disclosure of all charges imposed upon the borrower and seller. These are third party disclosures that are designed to provide the borrower with pertinent information during the settlement process in order to be a better shopper. The Public Reporting Burden for this collection of information is estimated to average one hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. This agency may not collect this information, and you are not required to complete this form, unless it displays a currently valid OMB control number. The information requested does not lend itself to confidentiality. Previous editions are obsolete Page 1 of 2 form HUD-1 (3/86) ref Handbook 4305.2 REV-1503 EX+ (8-98) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ATE OF FILE NUMBER Mary E. Fuller 21 07 0922 All property jointly-owned with right of survivorship must be disclosed on Schedule F. 3wasss i o00 (If more space is needed, insert additional sheets of the same size) REV-1508 EX+ (6-98) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, Sr MISC. INHERITANCE TAX RETURN RESIDENT DECEDENT PERSONAL PROPERTY ESTATE OF FILE NUMBER Marv E. Fuller 21 07 0922 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM ~ VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Cash travelers checks found amoung decedent's belongings 2 Highmark refund unused medical premium 3 Household goods 4 M&T Bank checking account, #8892312888 5 Member's First Federal Credit Union savings account, #285914-00 6 The Hancock Group, Inc. investment account, #00010633380 60.00 282.92 280.00 5,937.66 25.00 7,100.22 TOTAL (Also enter on line 5, Recapitulation) $ ~ 13, 685.80 3wasnD t.ooo (If more space is needed, insert additional sheets of the same size) REV-1509 EX+(6-98j SCHEDULE F COMMONWEALTHOFPENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCETAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Mary E. Fuller ~ 21 07 0922 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule (3. SURVIVING JOINTTENANT(S) NAME ADDRESS RELATIONS HIP TO DECEDENT A Fuller, Edward 836 Cambria Street, Cresson, PA 16630 Son B Sharp, Marylou 119 Ridge Road, Carlisle, PA 17015 Daughter C Sharp, Ruth 14 Pleasant View Drive, Mechanicsburg, PA 17050 Daughter I JOINTLY-0WNED PROPERTY: P~ NUMBfft LETTER FOR JOINT TENANT DATE MADE JOINT' DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIALIN STITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH VALUEOFASSET % OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENTS INTEREST 1 A 12/19/2002 Cambria County Federal 4,120.57 'i0.0000 2,060.29 Certificate of Deposit, #0107007187 2 A 12/22/2003 Cambria County Federal 3,677.43 _'i0.0000 1,838.72 Certificate of Deposit, #0115007402 3 C 12/19/2002 Cambria County Federal 4,120.57 ..°i0.0000 2,060.29 Certificate of Deposit, #0107007188 4 B 12/19/2002 Cambria County Federal 4,120.57 ~i0.0000 2,060.29 Certificate of Deposit, #0107007189 5 B Inception Cambria County Federal 12,632.41 _°i0.0000 6,316.21 Certificate of deposit, #01-15005650 6 B 12/20/1993 F.N.B. Corporation (formerly Laurel Bank) 8,725.10 _°i0.0000 4,362.55 Checking account, #9108484 To al from co tinuation schedules 13,624.94 TOTAL (Also enter on Tine 6 Recapitulation) ~ as 32 , 523.2 9 (If more space is needed, insert additional sheets of the same size) 3W46AE 1.000 Estate of: Mary E. Fuller 164-24-9879 Schedule F Part 2 (Page 2) Item Joint DOD Value of Perc DOD Value of No. Cot. Date Description Asset Int. Interest 7 B Inception M&T Bank 3,576.04 50.0000 1,788.02 Certificate of deposit, #31003915938963 8 B Inception M&T Bank 1,706.42 50.0000 854.21 Certificate of deposit, #31003912277439 g C Inception M&T Bank 3,576.04 50.0000 1,788.02 Certificate of deposit, #31003915938955 10 C Inception M&T Bank 3,096.52 50.0000 1,548.26 Certificate of deposit, #31003912277455 11 A Inception ,M&T Bank 2,524.27 .50.0000 1,262.14 Certificate of deposit, #31003915938971 12 C 8/1/2006 Member's First Federal Credit Union 1,789.48 :50.0000 894.74 Certificate of Deposit, #285914-48 13 B Inception Member's First Federal Credit Union 3,314.10 .50.0000 1,657.05 Certificate of Deposit, #285914-46 14 B Inception Member's First Federal Credit Union 1,222.45 50.0000 611.23 Certificate of Deposit, #285914-47 15 B Inception Northwest Bank 6,842.53 50.0000 3,421.27 Certificate of deposit, #2413013216 Total (Carry forward to main schedule) 13,824.94 REV-1511 EX + (10.06) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Mary E. Fuller 21 07 0922 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: ~ A. Brugger & Sons funeral services 6,319.30 Total from continuation schedules . B. 1 ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Street Address City Year(s) Commission Paid: Zip 218.36 2. Attorney Fees Snelbaker & Brenneman, P.C. 3,000.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 3 , 500.00 Claimant Marylou Sharp Street Address 119 Ridge Road City Carlisle State PA Zip 17015 Relationship of Claimant to Decedent DAUGHTER 4. Probate Fees 95.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. 1 Cresson Borough Water water service for Cresson property 580.75 2 Cumberland Law Journal advertising Executrix Notice 75.00 Total from continuation schedules 10,665.13 TOTAL (Also enter on line 9, Recapitul<~tion) $ 24 453.54 7W46AG 1.000 (If more space is needed, insert additional sheets of the same size) State Estate of: Mary E. Fuller Schedule H Part 1 (Page 2) Item No. Description 2 Marylou Sharp funeral flowers 164-24-9879 Amount 218.36 Total (Carry forward to main schedule) 218.36 Estate of: Mary E. Fuller 164-24-9879 Schedule H Part 7 (Page 2) 3 Deluxe check printing fee 18.75 4 Dominton Peoples gas service for Cresson property 1,251.49 5 Edward Fuller reimburse for obituary costs and fridge removal 94.20 6 Marylou Sharp reimburse for paint and concrete required for repairs to real estate 214.15 7 Penelec electric service for Cresson property 93.63 8 Postage expenses 41.00 9 Register of Wills exemplified letters 40.00 10 Register of Wills filing fee for Inheritance Tax return 15.00 11 Register of Wills short certificates 4.00 12 Settlement charges on sale of real estate as follows: a. $5,100.00 - realtor commission b. $850.00 - transfer tax c. $49.84 - Cresson Borough water 5,999.84 13 The Sentinel advertising Executrix Notice 174.58 14 Truck rental, toll charges and travel expenses to prepare house for market 1,718.49 15 Reserve for filing fees, accountant fees and other miscellaneous costs associated with the administration of the decedent's estate 1,000.00 Total (Carry forward to main schedule) 10,665.13 REV-1512 EX + ~~ 2-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES, 8~ LIENS ESTATE OF FILF_ NUMBER Mary E Fuller 21 07 0922 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. swasnH z.ooo (If more space is needed, insert additional sheets of the same size) REV-1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER Ma E. Fuller Yl U/ U~lYY RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1 Edward Fuller 836 Cambria Street Cresson, PA 16630 Cambria County Federal Inventory Value: 1,838.72 Cambria County Federal Inventory Value: 2,060.29 M&T Bank Inventory Value: 1,262.14 One Third of Residue: 25,335.89 Son 30,497.04 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 T HROUGH 18, AS APPIROPRIATE, O N REV-1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER :SHEET $ 0.00 swasAi i o00 (If more space is needed, insert additional sheets of the same size) Estate of: Mary E. Fuller Schedule J Part 1 (Page 2) Item No. Description Relation 2 Marylou Sharp 119 Ridge Road Carlisle, PA 17015 Cambria County Federal Inventory Value: 2,060.29 Cambria County Federal Inventory Value: 6,316.21 F.N.B. Corporation (formerly Laurel Bank) Inventory Value: 4,362.55 M&T Bank Inventory Value: 854.21 M&T Bank Inventory Value: 1,788.02 Member's First Federal Credit Union Inventory Value: 1,657.05 Member's First Federal Credit Union Inventory Value: 611.23 Northwest Bank Inventory Value: 3,421.27 164-24-9879 Amount One Third of Residue: 25,335.89 Daughter 46,406.72 Estate of: Mary E. Fuller Schedule J Part 1 (Page 3) Item No. Description Relation 3 Ruth Sharp 14 Pleasant View Drive Mechanicsburg, PA 17050 Cambria County Federal Inventory Value: 2,060.29 M&T Bank Inventory Value: 1,788.02 M&T Bank Inventory Value: 1,548.26 Member's First Federal Credit Union Inventory Value: 894.74 164-24-9879 Amount One Third of Residue: 25,335.89 Daughter 31,627.20 ~~~t ~iI1 ~n~ C~TP~t~cm.P~Y I, MARY E. FULLER, of the Borough of Cresson, County of Cambria and State of Pennsylvania, being of sound mind, memory and understanding, do make, publish and declare this to be my Last Will and Testament, hereby revoking and making void all former Wills by me at any time heretofore made. ITEM 1. I direct that my funeral be conducted in a manner corresponding with my estate and situation in life, and that all my joist debts and funeral expenses be fully paid and satisfied as soon as conveniE~ntly may be after my decease.. ITEM 2. I give, devise and bequeath the totalii;y of my estate, of every nature and wherever situate, in equal` portions, share and share alike, to my following beloved children: A. MARYLOU SHARP, B. RUTH A. SHARP, and C. EDWARD C. FULLER, provided that none of these gifts, devises or .bequests shall. lapse but sha11 pas to the then living children of each above named beneficiary who predeceases me, said then living children to take in equal portions the share that their deceased parent would have taken, but in default of such then living children, said gift., devise or bequest shall lapse and pass to the remaining beneficiaries in proportion to their respective shares. ITEM 3. I appoint my beloved daughter, MARYLOU SHARP, as the Executrix of this Will. In the event of her death, resignation, renunciation or other inability to act, I appoint my beloved daughter, RUTH A. SHARP, as the Executrix of this Will. While serving as such, my Executrix shall not be required to file a bond or other security and shall have, without court approval, the powers, in addition to all powers granted by law: (1) to retain any and all property received for as long as such retention appears advisable and to manage, control, improve and repair the same; (2) to invest and reinvest~in every kind of property and investment which men raf prudence, discretion and intelligence acquire for their own accounts;- (3) to sell at public or private.., sale, to exchange or to lease, for any period of time, any real or personal ..~ ~:; property; (4) to give options for sales and leases; and (!~) to compromise claims or to commence or defend litigation. IN ~JITNESS WHEREOF, I, the testatrix, have to this, my Will, written on two sheets of ,paper, set my hand and seal thi s ~ day of f~;~q`cy 1983. ~~~ ~. .~,~:c-t'/~ ( SEAL ) Mar E. Fu'1 l er In our presence, MARY E. FULLER signed this and declared it to be her Will, and now at her request and in her presence, and in 'the presence of each other, we sign as witnesses. ;~ ,/ '~-r-r ~~ ~:,