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HomeMy WebLinkAbout11-21-08 (2)15D5607121 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 RESIDENT DECEDENT 2 1 0 8 0 9 1 1 ENTER DECEDENT INFORMATION BELOW Social 0 8 2 6 2 0 0 8 1 1 0 6 1 9 2 D Decedent's Last Name Suffix Decedent's First Name MI Z E I G L E R L E O N ,J (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW O 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ prior to 12-13-82) 5. Federal Estate Tax Return Required ® 6. Decedent Died Testate (Attach Copy of III) ~ death after 12-12-82) 7. Decedent Maintained a Living Trust A 8. Total Number of Safe Deposit Boxes . 9. Litigation Proceeds Received ~ ( ttach 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) cvRRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number R O G E R B I R W I N E S Q U I R E 7 1 7 2 4 9 rL~a 3 5 3 Firm Name (If Applicable) C7 c~..a I R W I N & M c K N I G H T REGIST WILLS UONLY=i- r;~ -a r~ = ' First line of address z_~ ~ ~ ..~ t : , -. ~ ~ N i , 6 0 W E S T P O M F R E T S T R E E T <_ -~ e~ j - , Second line of address z, ~~ `~ -'~~ ~ r~ ~~ ~ _~ ---! ~::} City or Post Office State ZIP Code O DATE FILED -~ C A R L I S L E P A 1 7 0 1 3 Correspondent's a-mail address: Under penalties of perjury, I declare that I have examined this return, includin accompanying schedules and statements, and to the best of my knowledge and belief, ft is true, correct and complete. Declaration of preparer other than the person~representaUve Is based on all information of which preparer has any knowledge. SIGNATURE QFpE~ S LE FOR_Fjfl'ING RET RN DATE ADDRESS ~ ~ ~ 300 BEVERLY ROAD CAMP HILL PA 17011 SIGNATURE OF PREP ER OTHER T N REP SENTATIVE DAT ADDRESS ~ ~'r U 60 WEST POMF T STREET CARLISLE PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 1505607121 15056D7121 J r 'C22Z09SOS'C '[22z09SOS'C Z aP!S E 6 'Q 2 S S E 1N3WA1Id213A0 Nt/ d0 dNfld321 d JNIlS3f1D321 321`d IIOA dl lyAO 3Hl NI llid •OZ 63 ................................................ and Xel'66 0 0' 0 O O E 8~ 0 0' 0 O D 0 g~• X a;e~ lea;epoo;e 2 algexe; bl aull;o;unowy 'gl, ' g 0 0. 0 LL D D D owy 'Ll algex ~b aul;o;un E 6' Q 2 S 2 E •g~ h Q' 2 h 9 2 2 Z 4b0• X a;e~ leaull;e algexel b~ aul~;o;unowy •g-. 0 0' 0 •5~ 0 0' 0 - 0' X (Z' L)(e) g~~g •oaS ~apun s,a;sues; ~o 'a;e~ xe; lesnods ay; le algexe; b~ aul~;o;unowy •gl• S31H2! 3191/Olldd~d ?JOd SNOIl~f1211SN1 33S - NOI1V1f1dW00 XVl .b~ .................. (£l aull snulw Z6 aull) xel o; loafgng anleq 3aN 'bl h Q '2 h 9 2 h L .E~ • • • • • • • ~ • • • • • • • • • (~ alnpayog) apew uaaq lou set' xe; o; uol;oala ue ' E l yolynn ao; slsn~l £L L6 oaSls;sanba8 le;uawwano0 pue a~qe;I~eyO ' ......................... (l l aul~ snulw g aui~) a;els3;o an1eA laN ~Z6 •Z~ h 2 B h 9 2 h ~. • L L ........................... (0 L 'S 6 saul~ lelol) suollonpa0 le;ol ' L L 9 E' 0 9 Q Q 2 •0~ • • • • • • • • • • • • (I alnpayog) sual~ ~ `sal;lllge1l a6e6~oW ';uapaoaa;o slgaa •01, h Z '2 Q 9 •6 • • • • • • • • ' • • ' ' ' ' ' (H alnPa4oS) s;so0 and;e~;slulwpy'8 sasuadx3 le~aun~ •g 2 9 'Z L 2 Q 2 0 2 'E O S 2 Z Z h '[ ' 'L h 2 6 2 S 9 0 '2 9 E Z 0 2 .8 ........................... (L_~ scull lelol) s;asst' sso~O lelol '8 •L • • • • • • • pa;sanba~ 6ulpl8 a;e~edag ~ (O alnpayog) ~adad a;egad- N snoauellaosllry ~ spa;sued sonin-~alu~ •L •g • • • • • • • pa;sanba~{ 6ugllg a;e~edaS ~ (~ alnPa4oS) ~(~adad paunn0 ~(gulo[` •g •g • • • • • • • (3 alnpayoS) ~t}~adad leuos~ad snoauellaosly~ ~ s;lsodaa ~lueg 'yse~ .g .b • • • • • • • • • • • • • • • • • • • • ' ' ' ' (Q alnPa4oS) algenlaoaa sa3oN '8 sa6e6~ow .b •g • • • • • (O alnpayog}~dlys~o;audad-clog ~o dlys~au~ed 'uol;e~od~o0 PIaH IClasol0 '£ .Z .................................. (8 alnPa4oS) spuog pue s~loo3S 'Z 0 ^ ~^ L ........................................ (y alnPa4oS) alelsa lean ' ~ 0 0'0 O D S E 2 NOI1~d1f111dV~321 213 l 9 I 3 Z ' (' N 0 31 ;aweN s,luapa~aQ X3 0091-n3~1 'I22Z09S05'I REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 08 0911 DECEDENTS NAME LEON J. ZEIGLER STREET ADDRESS 300 BEVERLY ROAD CITY CAMP HILL STATE PA ZIP 17011 Tax Payments and Credits: 1• Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 1,626.61 3. InteresUPenalty if applicable D. Interest E. Penalty (1) 35, 518.93 Total Credits (A + B + C) (2) 1,626.61 Total InteresUPenalty (D + E ) 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. 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. (5) 33.892.32 (5A) B. Enter the total of Line 5 +5A. This is the BALANCE DUE. (5B) 33,892.32 Make Check Payable fo: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred : ...................................................................... ^ b. retain the right to designate who shall use the property transferred or its income; ............................... ^ c. retain a reversionary interest; or ................................................................................................ ^ X^ d. receive the promise for life of either payments, benefits or care? .......:............................................... ^ ^X 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................... ^ ^X 3. Did decedent own an "intrust 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? .................................................................................................. X^ ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent (72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1,1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent (72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exemot 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-0ne 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. (3) (4) 0.00 0.00 REV-1502 EX + (6-98) SCHEDULE A COMMONWEALTH OF PENNSYLVANIA REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT 'ATE OF FILE NUMBER LEON J. ZEIGLER 21 08 0911 All real property owned solety 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 property which is jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 300 BEVERLY ROAD, CAMP HILL BOROUGH, CUMBERLAND COUNTY, 135,000.00 PENNSYLVANIA SOLD -SETTLEMENT SHEET ATTACHED TOTAL (Also enter on line 1, (If more space is needed, insert additional sheets of the same size) REV-1508 EX + (6-98) ' SCHED!!LE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER LEON J. ZEIGLER 21 08 0911 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointlyowned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. M&T BANK -CHECKING ACCOUNT #494003 26,261.59 2. M8T BANK -CHECKING ACCOUNT #16981251 125.01 3. M&T BANK -SAVINGS ACCOUNT #15004216706670 46,608.52 4. M8T BANK -CERTIFICATE OF DEPOSIT #31003911866548 31,336.94 5. PERSONAL PROPERTY -APPRAISAL ATTACHED 3,030.00 TOTAL (Also enter on line 5 Recapitulation) I $ 107 (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 LEON J. ZEIGLER 21 08 0911 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 INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH °h OFDECD'S EXCLUSION TAXABLE NUMBER THE DATE OF TRANSFER. ATTACHACOPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST )IFAPPLICABLE) VALUE 1. EDWARD JONES -ACCOUNT #896-09385-1-5 385,141.14 100. 385,141.14 CASH, STOCKS & MUTUAL FUNDS BENEFICIARY: RONALD L. ZEIGLER, SR. 2. AUGUST 2008 -GIFT TO RONALD L. ZEIGLER 75,000.00 100. 3,000.00 72,000.00 3. AUGUST 2008 -GIFT TO KATHY ZEIGLER 75,000.00100. ~ 3,000.00 72,000.00 _ TOTAL (Also enter on line 7 Recapitulation) ~ ~ 529 141 14 (If more space is needed, insert additional sheets of the same size) REV-1511 EX + (10-06) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES ~ INHERITANCE TAX RETURN RESIDENT DECEDENT ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER LEON J. ZEIGLER 21 08 0911 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. W. ORVILLE KIMMEL FUNERAL HOME B. ~ ADMINISTRATIVE COSTS: 1. I Personal Representative's Commissions Name of Personal Representative (s) 111.00 Street Address City State Zip - Year(s) Commission Paid: y, AttomeyFees IRWIN & McKNIGHT 16,500.00 3. Family Exemption: (If decedents address is not the same as claimants, attach explanation) Claimant RONALD L. ZEIGLER. SR. Street Address 300 BEVERLY ROAD City CAMP HILL State PA Zip 17011 Relationship of Claimant to Decedent SON 4• Probate Fees REGISTER OF WILLS 294.00 5 I Accountant's Fees 6. Tax Retum Preparers Fees PATRICIA A. ROSENDALE, CPA 350.00 7. REGISTER OF WILLS -FILING FEE 30.00 8. CLOSING COSTS FROM SALE OF REAL ESTATE 9,732.50 9. CUMBERLAND LAW JOURNAL -ESTATE NOTICE 75.00 10. THE SENTINEL -ESTATE NOTICE 158.62 11. CHUCK BRICKER -APPRAISAL ON PERSONAL PROPERTY 120.00 12. STEVEN W. BARRETT -APPRAISAL ON REAL ESTATE 325.00 13. VITAL RECORDS -DEATH CERTIFICATE FOR ELSIE ZEIGLER 9.00 14. NOTARY FEES 35.00 15. BRYAN WITHINGTON -LAWN CARE 437.50 TOTAL (Also enter on line 9, Recapitulation) $ 28 177.62 (If more space is needed, insert additional sheets of the same size) REV-1512 EX + (12-03) SCHEDULE COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES ~ LIENS RESIDENT DECEDENT ~ ESTATE OF FILE NUMBER LEON J. ZEIGLER 21 08 0911 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. PP&L -ELECTRIC 134.91 2. PENNSYLVANIA AMERICAN WATER -WATER UTILITY 50.73 3. COMCAST -CABLE UTILITY 71 79 4. UGI -UTILITY 131.18 5. VERIZON -TELEPHONE 169.08 6. PENN WASTE, INC. -TRASH 48.75 7. ZLOTOFF, GILFERT & GOLD -MEDICAL 37.84 8. CAMP HILL EMERGENCY PHYSICIANS -MEDICAL 38.46 TOTAL (Also enter on line 10, Recapitulation) I $ 682 74 (If more space is needed, insert additional sheets of the same size) REV-1513 EX + (9-0O) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES tS~ATE OF FILE NUMBER LEON J. ZEIGLER 21 08 0911 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. JANE K. HURLEY THOMPSON Collateral 10,000.00 1927 WALNUT BUTTOM ROAD CARLISLE, PA 17013 2. MAE S. STEES Collateral 10 000.00 765 S. MEADOWS PARKWAY SUITE 20 BOX 268 , RENO, NV 89521 3. RONALD L. ZEIGLER, JR. Lineal 10 000.00 3 E. REDMONT ROAD , WILMINGTON DE 19804-3711 4. CHERIE LEE ZEIGLER BURFORD Lineal 10,000.00 5. RONALD L. ZEIGLER, SR. Lineal 702 642.84 300 BEVERLY ROAD , REMAINDER CAMP HILL PA 17011 II. 1 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET 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 I $ {If more space is needed, insert additional sheets of the same size) LAST WILL AND TESTAMENT I, LEON J. ZEIGLER, of 300 Beverly Road, Camp Hill, Cumberland County, Pennsylvania, declare this instrument to be my Last Will and Testament, hereby expressly revoking all Wills and Codicils heretofore made by me. 1. I direct my executors to pay all of my debts, funeral and administrative expenses as soon as may be done conveniently after my decease. 2. I authorize and empower my executors to sell any realty owned by me at my death and not specifically devised or bequeathed herein, at either public or private sale, and to give good and sufficient deeds therefor, in fee simple, as I could do if living. 3. I give the sum of $10,000.00 to each of the following persons; (a) Jane K. Hurley, (b) Mae 5. Stees (c) Ronald L. Zeigler, Jr. and (d) Cherie Lee Zeigler Burford 4. I give all my furniture and personal effects to my wife, Kathryn K. Zeigler absolutely. 5. I direct that Kathryn K. Zeigler may live in my house so long as she desires to do so, and if and when she desires to do so, she is authorized to have my house sold and to divide the proceeds equally with Ronald L. Zeigler, Sr., share and share alike, (i.e. in two equal shazes). Kathryn is directed to pay the insurance and taxes, etc. and when she sells the home, she shall be entitled to recoup one-half of the amounts she has paid for insurance and taxes after my death and until the house has been sold. 6. All the rest, residue and remainder of my estate, I give, devise and bequeath to Ronald L. Zeigler, Sr. 7. I nominate and appoint Kathryn K. Zeigler and Ronald L. Zeigler, Sr. to be the executors of this my Last Will and Testament; they are to serve as such without bond. 8. I hereby suggest that my personal representative retain the services of Irwin, McKnight & Hughes, of Carlisle, Pennsylvania, as attorneys in the settlement of my estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this lsr day of May, 2001. ~~~ ,C-~ . (SEAL) LEON J. EIGLER Signed, sealed, published and declared by LEON J. ZEIGLER, the above named Testator, as and for his Last Will and Testament, in the presence of us, who at his request, in his presence and in the presence of each other have subscribed our names as witnesses hereto. 2 ACKNOWLEDGMENT AND AFFIDAVIT WE, LEON J. ZEIGLER, CIi>":RYL L. CLELAND and MARTHA L. NOEL, the testator and witnesses respectively, whose nari:°s are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigneu authority that the testator signed and executed the instrument as his Last Will, and that he had signed willingly, and that he executed it as his free and voluntary act for the purpose herein expressed, and that each of the witnesses, in the presence and hearing of the testator, signed the Will as a witness and that to the best of their knowledge the. testator was, at that time, eighteen years of age or older, of sound mind and under no constraint or undue influence. LEON J. ZEIGLER ~~ .-, ? r' ,~ CH RY L. CLELAND MAIRTHA L. NOEL COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND . SS: Subscribed, sworn to and acknowledged before me by, LEON J. ZEIGLER, the testator herein and subscribed and sworn to before me by CHERYL L. CLELAND and MARTHA L. NOEL, witnesses, this 1ST day of May, 2001. !~. c Notary Notarial Seai Roger B. Irwin, Notary Public Carlisle Boro, Cumberland County My Commission Expires Oct. 3, 2004 Member, PennsyNanla Association of Notaries . form HU61 (]166) ref Handtswk X005 2 A. Se1t~Ct17ei1t .Stc~te171Cl1t U.S. Department of Housing and Urban Development B. T of Loan OMB roust No. 2502-0265 ex fires 11/30/2009 FINAL 1. ^FHA 2. ^FmHA 3. ^Conv. Unins. 6. File Number 4 VA 7. Loan Number 8. Mortgage Insurance Case Number . 5. Conv.lns. PIFN08-059PIN is arm is mi piw you a emen u amen co s. moon C. Note: Ilene marked "(p.o e. )' wero paid outside IM doai t W WARNING: II is a aims ro know. ~• ~ Me ~1OV`'^ l'e'e for inlarmstian pury osas and ar not inducted ~ the tare. TitleExpress Settlement System wnviution md li ~y ' e s e ts p t b yy can as upon ude a Me and eon nam l Fd deleNe aae TOa a USS. Coda Ssdion IOO~ end $sdio to OtO~y D. NAME OF BORROWER: Kathleen C. Wenger Printed 10110/2008 at 11:35 BG ADDRESS: E. NAME OF SELLER: Estate of !eon J. Zeigler ADDRESS: F. NAME OF LENDER: Cash ADDRESS: G. PROPERTY ADDRESS: 300 Beverly Road, Camp Hill, PA 17011 Cam Hill Borou h H. SETTLEMENT AGENT: Pinnacle Land Transfer, LLC, Telephone 717.920-3331 Fax: 717-920-3332 PLACE OF SETTLEMENT: 4242 Carlisle Pike, Suite 191 Camp Hill PA 17011 I. SETTLEMENT DATE: 10/1412008 J. SUMMARY OF BORROWER'S TRANSACTION: K. SUMMARY OF SELLER'S TRANSACTION: 100. GROSS AMOUNT DUE FROM BORROWER 101 Conrad sales ' 400. GROSS AMOUNT DUE TO SELLER . ce 135 000.00 102. Personal Pro 401. Contract sales 'ce 135 000.00 103. Settlement ch es to borrower line 1400 662.25 402. Personal Pro 403. 104. 404 105. . 405. Ad'ustments fw items aid b seller in advance 1 O6. Ci nown taxes Ad'ustments for items aid b seller in advance 107. Coon taxes 10l1M08 to 12131108 155.02 406. CI nown taxes 407, Cow taxes 1 W1N08 to 12/31!08 155 02 108. Assessments . 408. Assessments 109. School Tax 10H 4108 td 06130/09 1068.26 110 S 409. Scholl: Tax 10114/08 to 06130109 '' 1 068 26 . ewer 10N4/08to12131l08 .'.45.08 111 . 410. Sewer 10114108to1?/31l08 45.08 . 411. 112. 120. GROSS AMOUNT DUE FROM BORROWER 138 930.61 412. 420. GROSS AMOUNT DUE TO SELLER 136 268 36 200. AMOUNTS PAID BY OR ON BEHALF OF BOR ROWER . 500. REDUCTIONS IN AMOUNT DUE TO SELLER 201. De sit or earnest mon 5000.00 501. Excess De sit see insUuctions 202. Princi al amount of new loans 203. ExisBn bans taken su ' to 502. Settlement ch es to seller line 1400 9 732.50 ~ 503. Existin loan s taken sub'ed to ' 205 504. P ff of First Mort a Loan . ~ 206 . ~. 207 . 507. 208 . 508. 209. ~. Ad'ustments for items un aid b seller Ad ustntents for items un id b seller 210. Ci nown taxes 510. Ci /town taxes 211. Count taxes 511. Coon taxes 212. Assessments 512. Assessments 213. 513. 214. 514. 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. 120. TOTAL PAID BYIFOR BORROWER 5000.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 9 732 50 300. CASH AT SETTLEMENT FROM OR TO BORROWER . 600. CASH AT SETTLEMENT TO OR FROM SELLER 301. Gross amount due from borrower line 120 138 930.61 601. Gross anrount due to seller line 420 136 268 36 302. Less amounts aid b nor borrower line 220 5000.00 . 602. Less reduction amount due seller line 520 9 732.50 303. CASH FROM BORROWER 133 930.61 603. CASH TO SELLER 126,535.86 SUBSTITUTE FORM 1099 SELLER STATEMENT: The kdormation oonleined herein is important Iew infonnaban and is Deing furnished M the Internal Revenue Service. II you are required to hie a slum, a negkgence penalty or dhM aandion wia bs impos_-d on tau if This item is npuired to be reported and the IRS rfelsrmiriea that it has not been raportetl. The Conlraut Sales Pdcs despipetl on Ina a01 show consklules the Gross Proceeds d This Iransadion. You are nsquked by law to provide the sealsmeM agent (Fed. Tar ID No: 42-1603996) wiU your ooneU uxpayar idenufi®fion number. rc you do not provide your mrted ta~ayer idenhacatlon number, you may Da suDiea to otvil ar airrvlal psnNUea imposed by law. Unden penalties of perjury, I oertiy that the number shown on Ihrt staroment is my Donee ta~eyer idsntlMauon number. TIN. -- f SELLER(S)SIGNATURE(S): 1 SELLER(S) NEW MAILING ADDRESS. SELLER(S) PHONE NUMBERS rur _._ ilMeua eW~ane ~ aEedsle loan FIl16t ryl61 M Flendeook X005.2 ' U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT File Number: PIFN08-059 FINAL PAGE 2 SETTLEMENT STaTFMFUr -- - I Illetx SS Settlement S tem L SETTLEMENT CHARGES 700. TOTAL SALES/BROKER'S COMMISSION based on rice 5135 000.00 ~ 6 100.00 Division of cDmnission line 700 as folloovs: ~ Printed 10/10/2008 a PAID FROM BORROWER'S FUNDS AT t 11:35 BG PAID FROM SELLER'S 701. 8100.00 to Keller wlliams of Central Pa SETTLEMENT FUNDS AT SETT 7oz. a tD LEMENT 703. Carrrlission aid al Settlement 8100.00 704. Transaction Fee to Keller Williams of Central Pa 225.00 225.00 800. REMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Od ination Fee ^/, 802. Loan Discount /, 803. sisal Fee 804. Credit Ae 805, Lender's Ins Uon Fee 808. Mort e A licalion Fee 807. Lion Fee 808. B09. 810. 811. 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest From to !d 902. Mort Insurance Prertlium for to 903. Hazard Insurance Premium fw to 904. 905. 1000. RESERVES DEPOSITED WITH LENDER FOR ' 1001. Hazard Insurarce ~~ !mo 1002. Mon a Irttluarlce rrp, ~ !~ 1004 Ci P Tax na. S Imo 1004. Caun Taz md. 59.85 !mo 1005. Arxxral Assessments mo. /mo 1009. ale An is Ad'uslment 0.00 0.00 1100. TITLE CHARGES 1101. Settlement w dosi fee 1102. Abstract w title search 1103. Title examirl~ion t 104. Title insurarx;e binder 1105. Docurtlent R aration t 106• Nol Fees to Pinnacle Land Transfer LLC 5 ~ t 107. Att s fees to Irwin & MCKni ht POC Seller above items No: 1108• Title Irlsllrance to Pinnacle Land Transfer LLC 1033.75 Indudes above items No: 1109. Lender's Poi' 1110. Ownefs Pd' 135 000.00 -1033.75 111 t. 1112. 1113. 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recwdn Fees Deed 48.50 • Mo e • Release 48.50 1202. G /Corm laxlstam Deed 1 350.00 • Mon 5 1350.00 1203. State iaAlst Deed 1 350.00 • Mon a 1350.00 1204. 1205. 1300. ADDITIONAL SETTLEMENT CHARGES 1301. Reinlb fw Tax Cen to Pinnacle Land Transfer LLC 5.00 1302. Od1NovlDec 2008 OV to Borou h of Ca Hill ~ 52 50 1400. TOTAL SETTLEMENT CHARGES enter on Ibres 103 Sedtion J and 502 Section K 2 662.25 9 732.50 HUD CERT0=1CA11pN OF BUYER AND SELLER 1 have ofeUN ntyiw.w! eu HU0.1 ShcNrrrrd $Iremrn end b Ihs beat d rtry Mno~Medpe xd ENie/, N ie ~ Irue end e¢yreN Ydem,nl d W new rid dehurYrtenb made on my aom+nl Ir bl' me n Ihie beneettion. I fWMr vrldy IhN I hM nphrd ~ oepy d IM HUD•1 $Ml~m~nl Snd~msnL ~ ~~ C ~,` ~- ,2~ti -~ . c~.~.-_ ~ r WARNING. IT IS A GRIME TO KNOVNtJGLY MANE FALSE STATEMENTS TO iT1E TTs FiUal Settlement Sblemenl rAlirlt I heue prepared is a hue erM emeale elmunt d Mis UMTED STATES ON TNIS OR ANY SIMILAR FORM PENALTIES UPON CONVICTION Menax1on. I have a viN Duce ere Mde b W dleWesd in eoordenw vllh tNe flMemMl. CAN INCIIx)E A FINE AND IMPRISONMENT FOR DETAILS SEE T11LE le'. U S. CODE SECTION 1001 AND SECTION 1010. SETTLEMENT AGENT. 1. MTE.~ '~ Sean Ferguson 1300 Market Street Financial Advisor Lemoyne, PA 17043 sean.ferguson ~ edwardjones.com Bus. 717-731-5432 Faz 877-222-0227 www.edwardjones.com November 7, 2008 R~LV~~~~.~ Irwin & Mcknight N®`~ .,; ~ 1_~0~ 60 West Pomfret St. Carlisle, PA 17013 dRWIN ~ iv-cKivlGii'I ~.AW OFflCES Dear Roger: Please find enclosed the information you requested. EdwardJones MAKING SENSE OF INVESTING After rev' ing this information, please feel free to contact me if you have any questions, need more details or would like t more bout this topic. Financial ~C~~C~~1C( r I~UY1 ~ ~~ ~Y. .~ O C~ W L C O t ~l~+ 0 tQ .O ^ +~+ +~+ W O O N O m ~', M a~ 0 cfl rn 0 a`> C O O U Q C O ~ W _ J m ~ = N C ~ U Z Q O J )" J W W m O 0 M O J J_ U a U O .a O ~_ ~ ~ (~ ~ U d L O ~ U U C ~ O .« - fA •- C cC w O '~ ~ "' O ( C _ 7 O .' N C ~ V , ~ U ~ O ~ y O ~ O ~ ~ ~ O ~ ~ O c~ ~ d O ~ U U ~ ,~ , ~ O O ~ RS ~O ~ O ~ j ~ _ O O ,~, ~ . ~ O ~ d cC •C O co ` F- o N m w te ~ .. 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DE 19966 Mail Code DE-MB-12 Phone (888) 502-4349 Fax (302) 934-29» September 11, 2008 Law Offices Irwin & McKnight West Pomfret Professional Building 60 West Pomfret Street Carlisle, Pennsylvania 17013-3222 Re: Estate of LeonJZeigler Social Secztrity: 183-12-2178 Date of Death: Augztst 26, 2008 Dear Sir or Madam: Per your inquiry dated September 8, 2008, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type of Account Checking Account Account Number .494003 Ownership (Names of} Kathryn K Zeigler* Leon J Zeigler* Opening Date 12/1/72 Closed 9/9/08 Balance on Date of Death $ 26,261.41 Accrzred Interest $ 0.18 Total $ 26,261..19 2. Type of Account Checking Account Account Number 169812.51 Ownership (Names of} Kathryn K Zeigler* Leon J Zeigler Opening Date 8/28/64 Closed 9/9/Ob' Balance on Dcrte of Death $ 12~. 00 Accrued Interest $ 0.01 Total $ 12.1.01 3. Type of Account Account Number Ownership (Names ofJ Opening Date Balance on Date of Death Accrued Interest Total 4. Type ofAceozmt Account Number Ownership (Names o~ Opening Date Balance on Date of Death Accrued Interest Total 5. Type of Account Account Number Ownership (.Names o~ Opening Date Balance on Date of Death Savings Account 15004216706670 Kathryn K Zeigler* Leon J Zeigler* I D/I S/07 Closed 9/9/08 $ 46,.138.34 $ 70.18 $ 46, 608.52 Certifzcate of Deposit 31003911866548 Kathryn K Zeigler* Leon JZeigler* 9/17/07 Closed 9/9/08 $ 30, 000.00 $ 1,336.94 $ 31, 336.94 Savings Accozznt 15004213564394 Kathryn K Zeigler* . ~} Leon J7.eigler* ,V(~ 8/7/06 Closed 7/28/08 ~~ $0.00 Closed prior to Date of Death * * ~~~ / ~~ A~ ~\ C 6. Type of Account Account Number Ownership (Names of} Opening Date Balance on Date of Death 7. Type of Account • Account Number Ownership (Names o~ Opening Date Balance on Date of Death Checking Account 950262979 Kathryn K Zeigler* Leon JZeigler* 4/12/00 Closed 10/15/07 ~v y\ VV v ~~ ~~~ `,;' $ 0.00 Closed prior to Date ofDeath** Certificate of Deposit \, y 3100391455402.5 r\~i r-~ ~. Kathryn K Zeigler* ~> ~~ Leon JZeigler* ,; ~,~ ~I ~ 2/13/97 Closed 8/7/08 \ ~ ' 8 0.00 Closed prior to Date ofDeath** ** Please contact the Trindle Road Branch for all additional information on accounts closed prior to the date of death. * If upon reviewing the information above, you believe there are additional accounts not referenced, please provide us with an account number and/or 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, etc., please contact our Trindle Road Branch at 3805 Trindle Road, Camp Hill, PA 17011, or # 717- 737-2308. Please be advised, there was no safe deposit box found for the above decedent. Sincerely, ~~C~.e~`~~U-1.r~.r/ Trade Hare Records Manajement APPRAISAL Personal Property of,,~Ed,~ ZEjyLE~ ~'Si~~E ~3~~r4EyEiZLY /~c/,~~f~yph`/~~. ~°/~ Appraised by Chuck E~ricker AU094-L Date ~ -~=0 ~ 1 ~ ~~i i EM VALUE ITEM VALUE / 3' ` C G L c;~2 l~~lZ % ~ U Gd d E l .2 0, G t F E ~ {Z l G G ~~ ~ ~G~ /tip S ?~ ~ ~C ~' ~ SST 5 ~ ~- / " ~ L- S G 6 ` TlC- 'N 'd E- E . 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