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HomeMy WebLinkAbout10-03-0815056041125 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes County Code Year File Number Po Box 2sosol INHERITANCE TAX RETURN ~ ( /~ ~ ~ ~, / Harrisburg, PA 17128-0601 RESIDENT DECEDENT U" y- ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 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 QX 6. Decedent Died Testate ~ (Attach Copy of Will) death after 12-12-82) 7. Decedent Maintained a Living Trust 0 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 DIRECTED TO: Name 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) ~~ _ ~ _ ~_-` _ ~ C A L D W E L L & K REGISTER:pF31VILLS US~NLY E A R N S '~ `~ ' First line of address I ~~ 3 6 3 1 N O R T H F R O N T S T R E E T ~_ --~-, Second line of address r~ ~ , ~ •• City or Post Office DATE FILED ~'~ State ZIP Code ~ H A R R I S B U R G P A 1 7 1 1 0 Correspondent's a-mail address: Cdehart caldwellkearns.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 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. SIGNATI~% F~ON RE~N~~ FOR FIL' ~ G RETURN ,h~V/ c/~,~_.. DATE ADDRESS 606 GALE ROAD SIGNATURE OF PREPARE OTHER THAN REPRESENTATIVE ~ /i ~.- -_ CAMP HILL 3631 NORTH FRONT STREET HARRISBURG PLEASE USE ORIGINAL FORM ONLY Side 1 15056041125 PA 17011 DATE ~'-3~-~~ PA 17110 15056041125 J Decedent's Social Security Number 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-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested ....... 7. 8. Total Gross Assets (total Lines1-7) ~•~••~••~••~~•~~•~~•~~•~~•• 8. 2 0 6 0 0 0, 0 0 2 1 0 2 3 8, 8 6 4 1 6 2 3 8, 8 6 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. Charitable and Governmental Bequests/Sec 9113 Trusts for which 13 . an election to tax has not been made (Schedule J) ... • . • .. ~ • ~ ~ ~ . • .. 13. 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. (a)(1.2) X •0 16. Amount of Line 14 taxable 3 '7 6 5 6 2 8 7 16 at lineal rate X .045 . 17. Amount of Line 14 taxable 0 0 0 17. at sibling rate X .12 18. Amount of Line 14 taxable 0 0 0 18 at collateral rate X .15 19. Tax Due ...................................... ........ 19. .. REV-1500 EX ~~~.,,o FRANCES L . McCALL 15056042126 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 15056042126 Side 2 3 3 0 5 2, 6 9 6 6 2 3, 3 0 3 9 6 7 5, 9 9 3 7 6 5 6 2, 8 7 3 7 6 5 6 2, 8 7 0. 0 0 1 6 9 4 5. 3 3 0. 0 0 0. 0 0 1 6 9 4 5. 3 3 15056042126 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 STATE CAMP HILL IPA Tax Payments and Credits: 1 Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments 18,000 00 C. Discount 847.30 Total Credits (A + B + C ) 3. InteresUPenalty if applicable D. Interest E. Penalty 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT Total Interest/Penalty (D + E ) Fill in oval on Page 2, Line 20 to request a refund. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. ZIP 17011 (1) _ 16 945.33 (2) 18,847 30 (3) 0 00 (4) 1,901 97 (5) (5A) 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 0 00 Make Check Payable fo: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLnrK~ 1. Did decedent make a transfer and: a. retain the use or income of the property transferred : .................................................................... Yes .. ^ No b. retain the right to designate who shall use the property transferred or its income; ............................. .. ^ 0 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? ....... .. ^ 0 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ................................................................................................. . ^ O 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-1502 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE A REAL ESTATE 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 NUMBER DESCRIPTION 1. Residential dwelling known and numbered as 1914 Clarendon Street, Borough of Camp Hill, Cumberland County, Pennsylvania -Gross sale price (see attached Settlement Sheet) VALUE AT DATE OF DEATH 206,000.00 TOTAL (Also enter on line 1 Recapitulation) I $ 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 VALUE AT DATE OF DEATH 1. Members 1st Federal Credit Union Accounts: (see attached statement) a. Savings Account #183218-00 -Date-of-death value 25.00 b. Investment Account #183218-05 -Date-of-death balance 5,571.46 c. Certificate of Deposit Account #183218-40 -Date-of-death balance 57,900.55 d. Certificate of Deposit Account #183218-41 -Date-of-death balance 6,419.10 e. Certificate of Deposit Account #183218-42 -Date-of-death balance 5,871.52 f. Certificate of Deposit Account #183218-43 -Date-of-death balance 1,953.71 2. Commerce Bank Accounts: (see attached statement) a. Checking Account #537890360 -Date-of-death balance 36,880.24 b. Checking Account #537890477 -Date-of-death balance 5,502.93 c. Certificate of Deposit Account #1700266 -Date-of-death balance 29,103.59 3. M & T Bank Accounts: (see attached statement) a. Certificate of Deposit Account #31003914378996 -Date-of-death balance 2,000.47 b. Certificate of Deposit Account #31003915123811 -Date-of-death balance 16,659.83 c. Certificate of Deposit Account #31003917268300 -Date-of-death balance 2,145.90 d. Certificate of Deposit Account #31003917268326 -Date-of-death balance 23,155.44 TOTAL (Also enter on line 5, Recapitulation) $ 210,238.86 (If more space is needed, insert additional sheets of the same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent FRANCES L. McCALL Decedent's Name Page 1 File Number Schedule E -Cash, Bank Deposits, 8 Misc. Personal Property ITEM NUMBER VALUE AT DATE DESCRIPTION OF DEATH e. Certificate of Deposit Account #31003917269340 -Date-of-death balance 3,744.83 f. Checking Account #58519408 -Date-of-death balance I 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 +'(6-98) SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN ESTATE OF FILE NUMBER FRANCES L. McCALL 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 RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & 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. DESCRIPTION OF PROPERTY ITEM wauoETHENaMEOFrHEraaNSFEREE,rHEiRRE~nrioNSHiProoECEOENraNO DATE OF DEATH %OFDECD'S E=XCLUSION TAXABLE NUMBER rHE onrE of rRnNSFER nrrncH a coPV of rHE oEEO Foa REa~ esrnrE VALUE OF ASSET INTEREST ~ pFaPPUCne~e VALUE 1. None TOTAL (Also enter on line 7 (If more space is needed, insert additional sheets of the same size) REV-1511 EX+(12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES 8~ ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER FRANCES L. McCALL 0 0 Debts of decedent must be reported on Schedule 1. 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 illilam 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: WalVed 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. I 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) I $ z~ (If more space is needed, insert additional sheets of the same size) 69 REV-1512 EX + (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I 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 2. I Kevin McCall -Moving truck 3. ~ U.S. Treasury - 2006 Federal Income Tax 4. (Church of God Home -Final nursing home bill 5. Janet L. Miller -Spring real estate taxes TOTAL (Also enter on line 10, Recapitulation) I $ (If more space is needed, insert additional sheets of the same size) 98.10 72.92 3,169.00 2,334.81 948.47 30 REV-1513 EX + (g-00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NIUMBER FRANCES L. McCALL 0 0 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. William T. McCall Lineal 606 Gale Road 25% Camp Hill, PA 17011 2. James A. McCall, Jr. Lineal 16 Dawn Drive 2500 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 I $ (If more space is needed, insert additional sheets of the same size) ~~ ~,~ L~ j ~ ~~ ~ .. ~ LAST WILL AND TESTAMENT OF FRANCES LOUISE McCALL I, FRANCES LOUISE McCALL, of Cumberland County, ]?ennsylvania, 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 propE=_rty 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 the consent of any beneficiary. ITEM IV. It is hereby directed that my 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 t:he event of renunciation, death, resignation or inability to act far 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 ar give any security. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 1~~~ day of _~~T'~U~~ 200~j. 1 _a~.f / ~f/!///l AL ) FRANCES L0 ISE M L 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 SS: COUNTY OF 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 U7oo~ 2007. ,~ ~ ~v (SEAL) Notary Public 07435-001/126645 CGMMONWEALTH OF PENNSYLVANIA Notarial Seal Karen W. Porn, Notary Public Susquehanna Twp., Dauphin Courrty My Commission Expires Oct. 25.2010 Memt~er. Fennsyfrar~i8 Association of Notaries 4 A. OMB NO. 2502-0265 B. TYPE OF LOAN: U.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT 1.^FHA 2.~FmHA 3.^CONV. UNINS. 4.~VA S.QX CONV. INS. SETTLEMENT STATEMENT 6. FILE NUMBER: i'. LOAN NUMBER: OS-411 5000838308 8. MORTGAGE INS CASE NUMBER: C. NOTE: This form is furnished to give you a statemenl of aclual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked '(POCJ" were paid outside the closing; they are shown here for informational purposes and are not included in the totals. D. NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: 1"0 s~se (GOLOVKIN A.PFD/OB-41722) F. NAME AND ADDRESS OF LENDER: Alexander Golovkin and Estate of F. Louise McCall Marianna Golovkina TD Bank, NA 1914 Clarendon Stree[ 32 Chestnut Street Camp HIII, PA 17011 Lewiston, ME 04240 G. PROPERTY LOCATION: H. SETTLEMENT AGENT: 68-0510988 1914 Clarendon Street I. SETTLEMENT DATE: Camp HIII, PA 17011 Community Land Transfer, LLC Cumberland County, Pennsylvania August 18, 2008 PLACE OF SETTLEMENT 2331 Market Street Camp HIII, PA 17011 J. SUMMARY r1F RnRRn~roco•c ro,..,...,._..... 104. 105. to 120. GROSS AMOUNT DUE FROM BORROWER 200. AMOUNTS PAID BY OR IN BEHALF OF BOF ?01. Deposit or earnest R,~„a„ fo to to 1215. 216. 217. 218. 219. 220. TOTAL PAID BY/FOR BORRO u.vu vu i. contract Sales Price 402. Personal Property 6, 759.91 403. 404. 405. Ad'ustments For Items Paid B Seller in 406. Cit /Town Taxes to 359.63 407. Coun Taxes 08/'18/08 to 01 1,786.25 408. School Taxes 08/18/08 to OZ 25.11 409. Sewer 08/18/08 to 10/01/08 410. 411. 412. 214,930.90 420. GROSS AMOUNT DUE TO SELLER 500. REDUCTIONS IN AMOUNT DUE TO SELL 3,000.00 501. Excess De osit See Instructions 185,400.00 SD2. Settlement Char es to Seller Line 1400 503. Existin loans taken sub'ect to 504. Payoff of first Mortgage 505. Pa off of second Mort a e 506. 507. De osit disb. as roceeds 508. 509. Ad'uslments For Items Unpaid By Sell 510. Cit !Town Taxes to 511. Count Taxes to 512. School Taxes to Wcrc I 188,400.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 300. CASH AT SETTLEMENT FROM/TO BORROWER: 301. Gross Amount Due From Borrower Line 120 600. CASH AT SETTLEMENT TO/FROM SELLER: 214,930.90 601. Gross Amount Due To Seller Line 420 302. Less Amount Paid By/For Borrower (Line 220) ( 188,400.00) 602. Less Reductions Due Seller (Line 520) 303. CASH (X FROM) ( TO) BORROWER 26,530.90 603. CASH (X TO) ( FROM) SELLER The undersigned hereby acknowledge receipt of a completed copy of pages 1&2 of this statement & any attachments referred to herein. ~' Borrower ° 208,170.99 17,364.22 208,170.99 17,364.22: 190,806.77 ~Alexa- ~d G lovkm Seller Estate of F. Louise McCall / Marianna Golovki ~. , ~, i''J , ~~~ ,~ . ( OB-411 / 08-011 / 23 ) From:CALDWELL DEVELOPMENT 717+731+0979 09/18!2008 14:32 #137 P. 008/008 Gonsianment Fees Due - By Item osroa2DD6 Auction: 9 - 08!11!2008 06:00 PM To 08/112008 09:00 PM Auction NamelLocation: Bill McCall -1914 Clarenden Street Consi ner: All Date Ra e: 01/012000 Throu h 09/042008 9 / 293 / 1277 w.~ {TiLVisbR~J-. ~ ~Tm%~Ss. CLOWNS ~ ~ ie. "J ~ 5 00 ^4''J.f4'f[ {u.- 75 ~ .. Xia. _Y~V3 f.- ~i~ 'S;~'SY.. - 9 /294 / 1278 CLOWNS . 10.00 . 1.50 .00 .OD 4.25 8.50 .00 .00 5.00 / 1 10 00 / 1 9 / 295 1 1 279 9 /296 1 1 280 CD PIAYER,COKE ITEMS V 6.00 :90 .00 5.10 .00 . 6.00 / 1 ASES 4.00 .60 .00 3.40 00 4 00 / 1 9/29711281 9 /298 AIR CONDITIONER PURIFIER 200 .3D .00 1.70 . .00 . 2.00! 1 / 1282 CAROUSEL HORSE,BEAR 10.00 1.5D .00 8.50 DO 1 O OD / 1 9 / 3D0 / 1284 CLOWN,PAPER SHREDDER 2.00. .30 .00 1.70 . .00 . 200 / 1 Total Bids: e}• 6,044.00 Bu back Items: .00 Total Fees: 1,206.60 Total B ck Fees: .00 Total Gen. uses: 1,590.00 Total Item Ex ses: .00 Total Gross Due: 5,247.40 Total Alrea Paid: .00 Total Net Due: 5,247.40 ^~ `r3 ~ ~k h5~fl .~ - ; - - `~ Total Invoiced Bids: 8,044.00 - - `-~ - - Lesa Bu ck hems: .00 Total Fees: 1,206.60 Total Bu k Fees: .00 Total Gen. E uses: 1,590.00 Totalltem uses: .00 Total Gross Due: 5,247.40 Total Ahead Paid: Total Net Due: .00 5,247.40 09!042008 20:16 PM (33) K erry Pae Auctioneers Page 7 of 7 I TOTALS: ~ 8044 00 1206 60 00 6837 401 0p 1 MAR 21 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, n ::'` Cindy S~ultz Research Associate/Deposit Services Commerce Bank Commerce Bank /Harrisburg, N.A. PO Box 4999 3801 Paxton Street Harrisburg, PA 17111-0999 commercepc.com 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 tJlcCall 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 B2 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~ST~F~E1D~ERAL CR~E~IT-UNION ~r~~e.r~ ~~~ ~ 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 P.O. Box 40 Mechanicsburg, Pennsylvania 17055 (800) 283-2328 wwwv.memberslst.org LIAR 2 ~ 2008 Q MBTF~~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 Ownersl~up (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 r • 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 Accreted Interest $ 338 03 Total .......................................$23,155.44 5. Account Type ........................... Certificate of Deposit Account Number ....................... 31003917269340 Ownership (Names off .............. F. Louise McCall, James McCall Opening Date ...........................12 / 29 / 06 Balance on Date of Death_.........$3,719.60 Accreted Interest $ 25 23 Total ....................................... $3, 744.83 March 24, 2008 •) • Page 3 6. Account Type ........................... Checking Account Account Number ....................... 58519408 Ownership (Names oj~ .............. F. Louise McCall, James McCall Opening Date ...........................08 / 28 / 64 Balance on Date of Death.........$4,330.38 Accrued Interest $ 0.11 Total ....................................... $4, 330.41 7. Account Type ........................... Checking Account March 24, 2008 Account Number ....................... 9846286541 Ownership (Names oj~ .............. 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. * 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, _ 9 ,/ .. Charlene Warrington, Records/Management 1-888-502-4349