Loading...
HomeMy WebLinkAbout01-05-091505607121 REV-1500 EX (Oti-05) OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN 2 1 0 8 0 4 2 4 _ Harrisburg PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth :L 9 5 D 7 0 6 7 2 D 4 0 4 2 D^ 8 1^ 2 8 1 9 D 5 Decedent's Last Name Suffix Decedent's First Name MI ]) A V I S I N E Z T (If ~4pplicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name Spouse's Social Security Number MI 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 prior to 12-13-82) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required death after 12-12-82) O 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust U 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 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 T0: Name Daytime Telephone Number D A V I D H S T O N E E S Q U I R E 7 1 7 7 7 4 7 4 3 5 Firm Name (If Applicable) r, REGIST~ OF WILLS USE ONLY S T O N E L A F A V E R ~ S H E K L E T S K( `~ ~~? ;" - First line of address C ~ _,__ 4 1 4 B R I D G E S T R E E T r'~'-T'+ c_`il Second line of address - ~-•~ City or Post Office State ZIP Code _.~ATE FILED [~., C~ 1 N E W C U M B E R L A N D P A 1 7 0 7 0 Correspondent's e-mail address: d S t O n e a~ S t O n e 1 d LJ • n e t 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 beliet, it is true, correct and complete. Declaration of preparer other the personal representative is based on all information of which preparer has any knowledge. IGNATU~OF E N PON ORFILI ETURN DATE 610!" SOf1MERT D VE MECHANICSBURG PA 17050 IGNATUR R THE N REPRESENTATIVE DATE 414 BRIDGE STREET NEW CUf1BERLAND PA 17070 PLEASE USE ORIGINAL FORM ONLY 15D56D7121 Side 1 1505607121 ~~ 1505607221 REV-1500 EX Decedent's Social Security Number Decedent's Name: I N E Z T D A V I S 1 9 5 0 7 0 6 7 2 I~ECAPITULATION 1. Real estate (Schedule A) ........................................ 1. 1 4 7 5 0 0 ' 0 ^ 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. 4 1 8 9 9 . 6 4 Ei. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 6• • 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ^ Separate Billing Requested ....... 7. ES. Total Gross Assets (total Lines 1-7) ........................... 8. 1 8 9 ~ 9 9 . 6 4 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• 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which 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 APP LICABLE 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 0 0 0 at lineal rate X .0 _ 16. 17. Amount of Line 14 taxable 1 5 7 4 7 6 3 17 at sibling rate X .12 . 18. Amount of Line 14 taxable 1 4 1 7 2 8 7 2 at collateral rate X .15 18. 19. Tax Due .......................................19. 20. FILL tN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 3 1 8 4 1. 0 2 8 2. 2 7 3 1 9 2 3. 2 9 1 5 7 4 7 6. 3 5 1 5 7 4 7 6, 3 5 o. o a D. 0 0 1 8 8 9. 7 2 2 1 2 5 9. 3 1 2 3 1 4 9. 0 3 Side 2 1505607221 1505607221 J REV-15Q~ EX ?age 3 Decedent's Complete Address: Fife Number 21 08 0424 DECEDENT'S NAME INEZ T. DAVIS STREET ADDRESS 48 Colgate Drive CITY - _ STATE ZIP Camp Hill PA 17011- Tax Payments and Credits: ~. Tax Due (Page 2 Line 19) (1) 23,149.03 2. Credits~Payments A. Spousal Poverty Credit B. Prior Payments 19,000.00 C. Discount 1.000.00 Total Credits (A + B + C) (2} 20,000.00 3. Interest/F'enalty if applicable D. Interest E. Penalty Total InterestlPenalty (D + E) (3) 0.00 4. If Line 2 i:> 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) 0.00 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. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5) 3,149.03 (5A) (5B) 3,149.03 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 transferretl : ................................................................. ..... ^ b. retain the right to designate who shall use the property transferred or its income; ......................... ...... X c. retain a reversionary interest; or .....................................~ .................................................... ..... ^ tl. 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? ................................................................................. ...... ^ 0 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ... ...... ^ Q 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 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 E)C ~~ (6-98) SCHEDULE A COMMONWEALTH OF PENNSYLVANfA REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER INEZ T. DAVI5 21 OS 0424 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 ro ert which is 'ointl -owned with ri ht of survivorshi must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH t Property located at 48 Colgate Dr, Lower Allen Twp., Cumberland 147,500.00 County, PA sold to Marvin Beshore and Annie Marie Beshore, his wife, on Sept. 26, 2008 TOTAL (Also enter on line 1, Recapitulation) ~ $ 147,500.00 (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, & MISC. IN f2ES DENTEDECEDENTRN PERSONAL PROPERTY ESTATE OF FILE NUMBER INEZ T. DAVIS 21 08 0424 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 VALUE AT DATE NUMBER DESCRIPTION OF DEATH i. Erie Insurance-Reimb. on homeowners insurance 350.00 2 Highmark-refund check 447.00 3 Interest check from PNC Cert of Deposit for March 7.51 4 Miscellaneous refund check 2.25 5 Myers Harner Funeral Home-overpayment refund 900.00 6 Personal property sold to Susie Houser 2,500.00 7 PNC Bank-Cert of Deposit #31900279525 32,531.26 Princ. $32,531.26, Int. $13.55 8 PNC Bank-Cert of Deposit #31900279525 -Accrued Interest 13.55 9 PNC Bank-Checking Acct #5140014925 2,861.87 Princ. $2,861.87, Int. $.02 10 PNC Bank-Checking Acct #5140014925 -Accrued Interest 0.02 11 PNC Bank-Savings Acct #5004047722 22.18 12 US Treasury-social security check for March 940.00 13 US Treasury-SSI check received 1,324.00 TOTAL (Also enter on line 5, Recapitulation) I $ 41,899.64 (If more space is needed, insert additional sheets of the same size) REV-1511 EX * (10-06) COMMONWEALTH OF PENNSYLVANIA INFIERITANCE TAX RETURN I~ESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER INEZ T. DAVIS 21 08 0424 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCR{PTION AMOUNT A. FUNERAL EXPENSES: Royers Flowers-flowers for funeral 161.87 Lyn D'Angelo-opening grave (Rolling Green Cem) 1541 Grace Evangelical Lutheran Church-luncheon 262.91 Myers Funeral Home-funeral expenses 8,954.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Ralph L. Thrush III 9,469.00 street Address 6105 Sommerton Drive c;'y Mechanicsburg state PA Z;p 17050 Year(s) Commission Paid: 2009 2 Attorney Fees David H. Stone, Esquire 9,469.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent a. Probate Fees Register of Wills-Cumberland Co. 310.00 5 Accountant's Fees 6, Tax Return Preparer's Fees ~. Erie Insurance-homeowners insurance premium 427.00 2 Mike Barber/Capitol Remodeling-sere at property 200.00 3 Home Depot-paint and mortor 26.49 4 Capitol Remodeling-services rendered at property 345.00 5 Highland Gardens-mulch for property 13.95 6 Capital Area Carpet Cleaners-servs at property 190.75 7 Lowes-supplies for property 30.74 8 Cumberland Law Journal-advertising grant of letters 75.00 9 The Patriot News Co-advertising grant of letters 134.31 10 Register of Wills-filing Inh Tax Return and Inventory 30.00 11 Reserve for closing expenses 200.00 TOTAL (Also enter on line 9, Recapitulation) $ 31,841.02 (If more space Is needed, insert additional sheets of the same size) REV-1512 EX + (12-03) SCHEDULE 1 COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES ~ LIENS f2ESlDENT DECEDENT ~ ESTATE OF FILE NUMBER INEZ T. DE~VIS 21 08 0424 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 ~ Lower Allen EMS-services rendered 25.00 2 ~Snoke Family Practice-debt of decedent ~ 57.27 TOTAL (Also enter on line 10, Recapitulation) I $ 82 27 (If more space is needed, insert additional sheets of the same size) REV-1513 EX +'x_00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER INEZ T. DAVIS 21 08 0424 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. I~alph L Thrush III Collateral 78,738.18 E3105 Sommerton Drive Mechanicsburg PA 17050- 2 Scott Allen Thrush Collateral 39,369.09 'I 111 Sandpiper Court Mechanicsburg PA 17050- 3 Denise Jorich Collateral 4,527.45 ~i437 Kramer Street harrisburg PA 17101- 4 Wendy Murdock Collateral 4,527.45 3603 Sharon Street Harrisburg PA 17111- 5 F;a{ph L Thrush Jr Sibling 7,873.81 1111 Sandpiper Court Mechanicsburg PA 17050- 6 J H Thrush Lindenberger Sibling 7,873.82 640 Geneva Drive Apt #1 Mechanicsburg PA 17055- 7 Daniel L. Pottiger Collateral 7,873.81 122 Jamestown Beach Lane Sequim WV 98382- EPJTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 T HROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NcJN-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 TONAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent INEZ T. DAMS Decedent's Name Page 1 21 08 0424 File Number Schedule ,J -Beneficiaries - 1 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT Do Not List Trustee(s) AMOUNT OR SHARE OF ESTATE t TAXABLE DISTRIBUTIONS (include outright spousal distributions) 8 ,Janis Lindenberger Collateral 4,724.29 :220 Royal Drive Mechanicsburg PA 17055- 9 Pvlarcia Newcomer Collateral 787.38 c;(o Leslie A. LaVia, POA 810 MacArthur Drive Harrisburg PA 17111- 10 .i~immy Lindenberger Collateral 1,181.07 5 West Green St Shiremanstown PA 17011- ,, -STO~TB, LAFAVEB & STONE k ~..b4 s .,~, ~ LAW ar, y4r: ~, ~~ ~a1 - r h_ ~,~ LAST WILL AND TESTAMENT OF INEZ DAVIS I, INEZ DAVIS, of Lower Allen Township, Cumberland County, Penn- s;~lvania, declare this to be my last will and revoke any will previ- ou s 1]i made by me . ITEM I: I devise and bequeath all of my estate of every nature acid wherever situate as follows: A. Fifty (50~) per cent thereof to my nephew, RALPH L. THRUSH, III. B. Twenty-five (25$) per cent thereof to my nephew, SCOTT ALLEN THRUSH. C. Five (5~) per cent thereof to my brother, RALPH L. THRUSH, JR. D. Five (5$) per cent thereof to my sister, IONE THRUSH MILLER. E. Five (5$) per cent thereof to my sister J. H. THRUSH LINDENBERGER. F. Five (5$) per cent thereof to my nephew, DANIEL L. PO7^TIGER. G. Three (3~) per cent thereof to my niece, JAMS LINDENBERGER. Page 1 of 3 H. Three-fourth (~$) per cent thereof to my niece, AUDREY FGSTER. I. One-half (~$) per cent thereof to my niece, MARCIA NEWCOMER. J. Three-fourth (~4~) per cent thereof to my nephew, JIMMY LI:NDENBERGER. ITEM II: I appoint my Executor and his successors guardian of arty property which passes, either under this will or otherwise, to a minor and with respect to which I am authorized to appoint a guardian and have not otherwise specifically done so, provided that this ap- pointment of a guardian shall not supersede the right of any fiduciary in its discretion to distribute a share where possible to the minor or to another for the minor's benefit. Such guardian shall have the power to use principal as well as income from time to time for the mi.nor's support and education (including college education, both graduate and undergraduate) without regard to his or her parent's ability to provide for such support and education, or to make payment fc-r these purposes, without further responsibility, to the minor or to the minor's parent or to any person taking care of the minor. ITEM III: I appoint my nephew, RALPH L. THRUSH, III, Executor of this my last will. Should my nephew, RALPH L. THRUSH, III, predecease me, fail to qualify or cease to act as my Executor, I appoint my brother, RALPH L. THRUSH, JR., and his wife, PAULINE THRUSH, Co- Executors of this my last will. Page 2 of 3 ITEM IV: No fiduciary acting hereunder shall be required to post bond or enter security for the faithful performance of his/her duties i.n any jurisdiction. IN WITNESS WHEREOF, I, INEZ DAVIS, have hereunto set my hand and seal this ~_ day of 1997. ~'ti0 INEZ DAV SIGNED, SEALED, PUBLISHED and DECLARED by INEZ DAVIS, the Testa- trix above named, as and for her Last Will and Testament, and in the presence of us, who at her request, in her presence and in the pres- ence of each other, have subscribed our names as witnesses. Wi ess A dress Address Page 3 of 3 F:\DOCS\RE\DED\Davis.tnez-48 Colgate Drive.wpd TAX PARCEL NO.: 13-23-0545-391. ADDRESS: 48 Colgate Drive Camp Hill, PA 17011 THIS INDENTURE made the THIS DEED (_, day of S~~!>,~~ , in the year 2008, between RALPH L. THRUSH, III, Executor of the Last Will and Testament of INEZ T. DAMS, late of the Lower Allen Township, County of Cumberland, and Commonwealth of Pennsylvania, of the first part, hereinafter called the Grantor, -AND- MARVIN BESHORE and ANNE MARIE BESHORE, husband and wife, of the second part, hereinafter called the Grantees; WHEREAS, the said INEZ T. DAMS became in her lifetime seised, as of fee, of and in to a certain tract of land, together with the improvements thereon erected, situate in the Lower Allen Township, County of Cumberland, and Commonwealth of Pennsylvania, and more particularly described hereinafter; and being so thereof seised, died on April 4, 2008, having first made her Last Will and Testament in writing dated July 29,1997, duly probated and registered in the Office of the Register Hof Wills of Cumberland County on April 15, 2008, wherein and whereby she appointed as Executor, the said Ralph L. Thrush, III, to whom Letters Testamentary were duly issued by said Register of Wills on .April 15, 2008, wherein and whereby said premises hereinafter described were not specifically devised, all as in and by said Will and the records of said Register of Wills, recourse thereunto being had, appears: -1- NOW THIS INDENTURE WITNESSETH, that the said Grantor, for and in consideration of the sum of ONE HUNDRED FORTY-SEVEN THOUSAND FIVE HUNDRED and NO/100 ($147,500.00) Dollars, which has been paid to it by the said Grantees at or before the sealing and delivery hereof, receipt whereof is hereby acknowledged, has granted, bargained, sold, aliened, released and confirmed, and by these presents does grant, bargain, sell, alien, release and confirm unto the said Grantees, ALL THAT CERTAIN piece or parcel of land situate in Lower Allen Township, Cumberland County, Pennsylvania, bounded and described as follows, to wit: BEGINNING at a point at the southwest corner of Colgate Drive and Carlisle Road; THENCE southwardly along the western side of Colgate Drive one hundred twenty-five (125) feet to a point at the northern line of Lot No. 194 on the Plan of Lots hereinafter referred to; THENCE westwardly along the northern line of Lot No. 194 aforesaid ninety and fifty-five one-hundredths (90.55) feet to a point at the eastern line of Lot No. 200 on the Plan of Lots hereinafter referred to; THENCE northwardly along the ~eastem line of Lot No. 200 aforesaid one hundred thirty-five (135) feet to a point at the southern side of Carlisle Road; THENCE eastwardly along the southern side of Carlisle Road ninety (90) feet to a point, being the place of BEGINNING. BEING Lot No. 193, on the Plan known as "Part of Plan No. 2, Cedar Cliff Manor" which Plan ,vas approved by the Commissioners of Lower Allen Township on October 6, 198 and is recorded in the Office of the Recorder of Deeds in and for Cumberland County, Pennsylvania in Plan Book 10, Page ~__. -2- BEING a part of Manor Farm, Tract No. 1, which Dauphin Deposit Trust Company, Substituted and Surviving Trustee under the Last Will and Testament of Marlin Edgar Olmsted, deceased, by Deed dated May 19, 1959 and recorded in the Office of the Recorder of Deeds aforesaid in Deed Book D Volume 19, Page 170 granted and conveyed unto Carl M. Davis and Inez T. Davis, Carl M. Davis died on September 24, 1992, thus by operation of law vesting title in Inez T. Davis, deceased. TOGETHER with all and singular ,the tenements, hereditaments and appurtenances to the same belonging or its anywise appertaining, and the reversion and reversions, remainder and remainders, rents, issues and profits thereof; AND ALSO all the estate, right, title, interest, property, claim and demand whatsoever, both in law and equity, of the said parties of the first part, of, in, to or out of the said premises, and every part and parcel thereof. TO HAVE AND TO HOLD the said premises, with all and singular the appurtenances, unto the said parties of the second part, their heirs and assigns, to and for the only proper use and behoof of the said parties of the second part, their heirs and assigns forever, as tenants by the entireties, under and subject, however, to the terms, provision, conditions, restrictions, set back line and utility easements aforesaid, AND THE SAID party of the first part, for itselves and its heirs, executors and administrators, do by these presents, covenant, grant and agree to and with the said parties of the second part, their heirs and assigns, that they it the said party of the first part, for itselves and its heirs all and singular the hereditaments and premises hereinabove described and granted or mentioned, and intended so to be, with appurtenances, unto the said parties of the second part, their heirs and assigns, against the said party of the first part and its heirs and against all and every other person or persons whomsoever, -3- lawfully claiming or to claim the same or any part thereof, shall and will, by these presents, WARRANT AND FOREVER DEFEND. IN WITNESS WHEREOF, the said Grantor has hereunto set his/her hand and seal the day and year first above written. _~ 1 .~ Witness ~ ~~ RALPH L. THRUSH, III, Executor of the Last Will and Testament of INEZ T. DAMS COMMONWEALTH OF PENNSYLVANIA j~ SS: COUNTY OF U C~ / ~'l~ ~.~Q,~ ~` On this, the c~`~ day of~ , 2008, before me a Notary Public, the undersigned officer, personally appeared RALPH L. THRUSH, III, Executor of the Last Will and Testament of INEZ T. DAMS, known to me or satisfactorily proven to be the person whose name is subscribed to the within instrument, and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereto set my ha and notarial seal. COMMONWE~1u H CF t=ENNSYLVANIA _ d NOTARIAL SEAL CHARLES I. HINSON, Notary Public City of Harrisburg, Dauphin County ota Public . My Commission Expires March 2, 2009 rY I hereby certify that the precise address of the Grantee is _~~ ~ ~~t,+aiC Kit.. r DATE: ~~ ~ ~ / .otter-~e~'e~ GRANTOR -4- PNCBANC The Thinking Behind The Money Apri117, 2008 Stone, Lalr'aver & $hekletski Attorneys at Law David Stone 414 Bridge St PO BOX E New Cumberland, pA 17070 ItE: Inez T Davis (Deceased) SSN: 195-07-0672 DC}D: 04-04-2008 Dear Mr. Stowe: In response to your request .for Date of Death balances ;far the customer noted above, our records show the following: Certificate of Deposit Account # 31900279525 Established 11-28-2005 1NEZ T DAMS DOA balance: $32,531.26 + 13.SS accrued inrterest Checking Account Account # 5140014925 Established 02-01-1970 INEZ T DAMS DOD balance: $2,861.87 + 0.02 accrued interest Savings Account Account # 5004047722 Established 07-23-2003 INEZ T DAMS DOD balance: $22.18 + 0.00 accrued interest Page 1 of 2 Please note that this offi'ice o~aly provides date of death balances for deposit accounts (IR.As, CDs, Checking and Savings accounts). We do mot process any 5nancial transactions or provide statements. you need assistance with any of these items, please caU .1-88$-PNC-BANK (1-88&762-2265) or stop by your 1oca11?'NC Bank branch office. Sincerely, Col een Craw er 1-800-762-1775 P7,PFSC-04-F 500 First Ave Pittsburgh, PA 15219 N~em~ber FDIC Page 2 of 2 n. Settlement Statement U.S. Department of Housing and Urhan Development OMB No. 2502-0265 I. ^ FH.4 2 QFmHA 3. ~]Conv. !loins. u. ruc ~.wuu=~ . r,uau ivunwn . muugage ups. i.esc rvumoer 4. ^ V.4 S. ^Conv. Ins. IA-08-065-C 5700686270 C. This form is furnished as a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked (p.oc) were paid outside the closing; they are shown for informational purposes and are not included in totals. D. ame and Address o Borrower Marvin Beshore Anne Marie Beshore 411 Curtner Road New Cumberland. PA 17070 .Name and Address o el er Ralph Thrush, Executor. Estate of Inez T. Davis F. ame and Address of Lender Fulton Bank One Penn Square Lancaster, PA 17602 G. Properly t.ocation 48 Colgate Drive H. ettlement Agent IONNI Abstract Company Camp Hill. PA 17011 Lower Alien Township. Cumberland County Place of ettlement 130 State Street Harrisburg, Pa 17101 LSettlement Date 09!26!08 L SUMMARY OF BORROWER'S TRANSACTION: K. SUMMARY OESELLER'S TRANSACTION: 1U0. GROSS AMOUNT DUE FROM BORROWER 400: GROSS AMOUNT DUE TO SELLER l Ol . Contract sales price 147, 500.00 401. Contmct sales price 147, 500.00 102. Personal property 402. Personal property 103. Settlement charges to borrower(}ine 1400) 4, 077.59 403. 104. 404. 105. 405. Adjustments for items paid by seller in advance Adjustments far items paid by seller in advance l06_ Gty/town taxes to 406. City/town taxes to 107. County taxes 09/26/08 to 12/31/08 161.28 407. County razes 09!26!08 to 12/31)08 161.28 108. Assessments to 408. Assessments to 109. School tax 9/26108 to 6130!09 1.021.67 409. School Tax 9/26/08 to 6/30/09 1.027.61 110. Sewer/trash 9/26/08 to 9/30/08 3.80 410. Sewer/trash 9/26/08 to 9/30/08 3.80 111. 4I1. 1I2 412 120. GROSS AMOUNT DUE. FROM BORROWER. 152.770.34 420.. CROSS AMOUNT DUE TO SELLER 148.692.75 200. AIv1OUNT8 PAID BY OR IN BEHALF OF BORRO WER 500. REDUCTIONS dN AMOUNT DUETO SELLER 201. Deposit or earnest money 5.000.00 501. Excess deposit(see Instructions) 202. Principal amount of new loan(s) 118, 000.00 502. Settlement charges to seller(Iine 1400) 12.130.00 203. Existing loan(s) taken subject to 503. Existing loan(s) taken subject ro 204. Seller Assitance-cl osing costs 2,500.00 504. Payoff of first mortgage loan 205. SOS. Payoff of second mortgage loan 206_ 506. Payoffs- NONE 207. 507. Seller Assistance-closing costs 2.500.00 2pg. 508. 2008 County/Township tax 672.89 2pq. 509. 2008 School Tax 1.356.73 Adjustments for items unpaid by seller Adjustments for items unpaid by seller 210. City/town taxes to 510. Citylmwn [axes to 2l 1. County taxes to 511. County taxes to 212. Assessments to 512. Assessments to ~~~ 5I3. r 514. J (tk. ~9f ~ / ~/ 7 5`C~O 515. . . Gt' 516. 517. 518. 519. ((-- CX~a!'r i St' S ~{' S y~'f (cr qSs/S~z~t~ ~ <~ ~ 3 // ~ ( ~ 125.500.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 16, 659.62 , E' /~ f 2 600. CASH AT SETTLEMENT TO/FROM SELLER t `-f trr~~7 Ci71 ILL ICs Q:~ (~ y,j,'~~ 152.710.34 601. Gross amount due to seller(line 420) 148,692.75 / _____. 125.500.00) 602. Less reduction amount due seller(line 520) ( 16.659.62 ) ~~2 J~~ ~ ~( 27,270.34 603. CASH( TO)(^ FROM) SELLER 132,033.13 I`Z' f ),r) /lk;//7-IC r cam, fsX information contained in Blocks E, G, H and I and on line 401 or, if line 401 is asterisked. ri r i~ r`, ~ ' ~ furnished m [he Internal Revenue Service. If you are required to file a return, a negligence / ~ ~:~ ~ ~ is required [o be reported and the IRS determines that it has not been reported. orrect taxpayer identification number If you do not provide [see box H} with your corzect taxpayer identification number, you may be subject to ctvll or crrmmal penalties imposed by law, and under penalties of perjury, [certify that the number shown on this statement is my corzect taxpayer identification number. Seller's Signature HUD-I SETTLEMENT STATEMENT ©Computer Services and Consultants 1-703-665-OS00 WARNING. It is a crime to knowingly make false statements to the United States SETTLEMENT STATEMENT on this or any other similar form. Penalties upon conviction can include a fine PAGE 2 and imprisonment For details see: Title 18 U.S. Code Section LOOL & 1010. L. SETTLEMENT CHARGES PAID FROM PAID FROM 700. TOTAL SALES/BROKER'S COMMISSION based on price $ ® % _ $ BORROWER'S SF.LLF,R' S Division of commission (line 700) as follows: FUNDS AT FUNDS AT 701. $ 10.150.00 m Prudential Homesale Services Group SETTLEMENT SETTLEMENT 702. $ ro 703. Commission paid a[ Settlement 10.150.00 704. Transaction fee- Prudential Homesale Services Group (8) 195.00 800. ITEMS PAYABLE IN CONNECTION W1TH.(OAN ROI. Loan Origination Fee % 802. loan Discount °h 803. Appraisal Fee ro Mark Heckman R E Apprais. f425 Pd by L fOPOC-B 804. Credit Report to Credstar 12.89 pd by L POC-B 805. Ins. Service fee- Fulton Bank (Ameritrac f13 POG by Lender 54.00 806. ~ Additional Appraisal fee- Fulton bank 75.00 807. Flood detfmon fee-Fulton Bank 11.50 808. Tax related Service fee- Fulton Bank First Amer. RE f75-L(POC) 75.00 809. Processing fee- Fulton Bank 200.00 810. Apl ication fee~FUl ton Bank EO POC-B 425.00 811. Doc prep fee-Fulton Bank 225.00 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest from 09/26/08 to 10/01/08 ®$ 22.568300 /day 112.84 902. Mortgage Insurance Premium for months m 903. Hazard Insurance Premium for 1 years to State Farm E455.00 POC-B 904. Auto underwiting fee-Fannie Mae f29 POC by lender 905. Flood Deter/monitor fee First American Flood (11.50 POC by Lender 10011. RESERVES DEPOSITED WITH LENDER_ 1001. Hazard insurance months Crd $ per month 1002. Mortgage insurance months ®$ per month 1003. City property taxes months ®$ per month 1004. County property taxes months Cg $ per month 1005. Annual assessments months Q $ per month t006. months ®$ per month 1007. months ®$ per month 1008. 1500.. TITLE CHARGES 1101. Settlement or closing fee to IONNI Abstract Company 200.00 1102. Abstract or title search to lONNl Abstract Company 125.00 1103. Title examination [o 1104. Title insurance binder to 1105. Document preparation to l 106. Notary fees to 1107. Ahomey's fees to Stone Lafever 6 Shekl etski (POC) (includes above items Numbers: ) i 108. Title insurance to Stewart Title AA Rate 481.75 (includes above items Numbers: ) 1109. Lender's coverage $ 118.OD0.00 i 110. Owner's coverage $ 147.500.00 1111. Endorsements 100/300/900- Stewart Title 15D.00 ll(2. Closing Service Letter- Stewart Title 35.00 ltl3. Overnight mail- Loan Package- Fed Ex 35.00 12W. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recording fees: Deed $ 38.50 ;Mortgage $ 76.50 ;Releases $ 115.00 L202- Citylcounty taxlstamps: Deed $ 1.475.00 ;Mortgage $ 1,475.00 1203. State tax/stamps: Deed$ 1,475.00 ;Mortgage$ 1,475.00 1204. 1205. 1300. ADDITIONAL SETTLEMENT CHARGES. 130E Survey to 1302. Pest inspection to 1303. AHS Home Warranty d95.OD 1304. Tax Cert fee• Bonnie K. Miller, treasurer 10.00 1305. Sewer/Trash- Lower Allen Twp. Auth. 10701/OB to 12!31108 87.50 1400. TOTAL SETTLEMENT CHARGES (enter on Tine 103, Section J and line 502, Section K) 4.077.59 12,130.00 CERTIFICATION I have a efully reviewed } e HUD-t Settlement Statement and m the best of my knowledge and belief, it is a [rue and accurate statement of all receipts and disb n made on my ccoun or by me in this transaction [further certify that Ihav~e~S~ec~e}ve~' co~wf thew 1 Settl nt Statement. lL~riyli os /~IZ~~ Exec-k>~~ ruin es e ~tF-TFirus x-F ecu~ to' r. C~ nrrowers one one es ore a ers state o nez avis 'The HUD-L S t ent Statement which I have prepared is a true and accurate account of this transaction. 1 have caused or will cause the funds to be disbursed in accordant this s to nt. 0 ~~w~,/ September 26, 2008 en ement gent T7b'stract ompany ate STONE LAFAVEK &SHEKLETSKI ATTORNEYS AT LAW 414 BRIDGE STREET DAVID H.:STONE POST OFFICE BOX E OF COUNSEL GERALD J. SHEKLETSKI NEW CUMBEELAND. PA 17070 CHARLES H. STONE ELIZABETH B. STONE JON F. LAFAVER www.stonelaw.net Janua r 2, 2 0 0 9 TELEPHONE (717) 774-7435 y FACSIMILE (717)774-3869 t_ Register of Wills Office ~~ ~- Cumberland County Courthouse ;;-~ ~. 1 Courthouse Square _ Carlisle, PA 17013 -_ ~~~ `~' ~~-' s, RE: Estate of Inez T. Davis - ~_ No . 21-08-0424 -'~J, tJ Greetings: Enclosed please find an original and one copy of tr,_e Inheritance Tax Return and Inventory for the above mentioned estate. Please clock in the copy of the Inventory and send it back to my office along with any receipts in the enclosed stamp addressed envelope. Also, enclosed is check #1019 in the amount of $.:,149.03 for payment of the inheritance tax and check #1020 in the amount of $30.OC for filing the return and inventory. Very truly yours, r STONE LaFAVE & SHEKLETSKI .............. ~~ r ,` ~~~yd...~-:~ tdr~e DPJ;~rmb Enclosures .~ a ;~ 7~ c„`7 ~ ~ c~ --; C t ~ . L -"') ~ ~ C.7 N ~ o o Y ~ w W W ~ 6`t- O ~ Fd.. m O U ~ W U J ~ ~ O W ~ ~ m 7 m r g Q ~ ~ a U ~ z O W 0 N~ W ~ 0~~ 6 ~ ~~ ~ ~ W 6 ~ (a"' O ~ ~ W .~, N ~ ~ H ua '~ ~ ~ Ov ~~ `_` U 0 r _. ~-. ~~ =- ~. ~: __.. _- _ ~: ~:. ~. _.,... ... k . ~~ ~E ;