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HomeMy WebLinkAbout01-13-09J Lsos6a712a REV-1500 F>C (06-05) OFFICIAL USE ONLY PA Department of Revenue covmycoae veer File Number Bureau of Individual Taxes 2eosol Po Box INHERITANCE TAX RETURN . Harrisburg, PA 17728-0601 2 1 0 8 0 6 8 2 ~ RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 202 20 1373 06 06 2008 06 24 1928 Decedent's last Name Suffix Decedent's First Name MI ALPAUGH EARL F (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 1. Original Return ~ 2. Supplemental Return ~ 3. Remaintler Return (dale of death prior to 72-13-92) 4. Limited Estate ~ qa. Future Interest Compromise ~ 5. Federal Estate Tax Return Required (date of death after 72-12A2) X S Decedent Died Testate ` 7, Decedent Maintained a Living Tmsl e. Total Number of Safe Deposit Boxes Imtach copra rrusp IA¢ech copy or rMlq 9. Litigation Proceeds Received ~ 1g. Spousal Poveny Cretlit (tlele a deem ~ 77, Election to tax under Sec. 9113(A) between 12 31- 7 and i-1-95) - (Af1aCh SCh. 0) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD eE DIRECTED TO: Name Daytime Telephone Number FOREST N MYERS 7.17 532 9046 Firm Name (If Applicable) LAW OFFICE FOREST N MYERS First line of address 137 PARK PLACE WEST Second Ilne of address City or Post Otfice SHIPPENSBURG State ZIP Code r.> REGISTER OF1~LS USE ~LY ' ` Ss. =r_ c~ - . r- -° - .r~ ~: ~? CA /_ .: "e- - _ -' ~ ;.~ :O y DATE FILED -` PA 17257-9212 Correspondent's a-mail address: fnmyers@embargmail.com Under penalties of perjury, I declare that I have examined this return, including accompanying schedules antl statements, and to the best of my knowledge and belie(, 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. Susan A ALPAUGH l -~- ADDRESS 8802 Rice Road, Shippensburg, PA 17257 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE --a,~, Forest N Myers ~ _ F3 _ ~„y ADDRESS 137 Park Place West, Shippensburg, PA 17257-9212 Side 7 15056U712U 1505607120 ~[ ~. .4 Y~I~ -~s' ~ ~~' ~~ -~~ -- J _~- ~ _ _ `~~> o-~ ~~ ~•. J Lsos6o7220 REV-1500 EX Decedent's Social Security Number oe=~arn~sNama. Earl F ALPAUGH 202 20 1373 RECAPITULATION 1. Real Estate (Schedule A) .......................................................................................... 1. 7 5, 0 0 0. 0 0 2. Stocks and Bonds (Schedule 8) ............................................................................... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C).......... 3. 4. Mortgages 8 Notes Receivable (Schedule D) .......................................................... 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ................ 5. 2 4 , 9 6 3.01 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested ............. 6. 4 , 3 7 6 . 2 5 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested ............. 7. 8. Total Gross Assets (total Lines 1-7) ....................................................................... 8. 1 0 4, 3 3 9. 2 6 9. Funeral Expenses & Administrative Costs (Schedule H) ......................................... 9. 2 2 , 15 3 . 3 6 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10. 1 8 , 8 7 9 . 6 9 11. Total Deductions (total Lines 9 & 10) ...................................................................... 11. 4 1 , 0 3 3 . 0 5 12. Net Value of Estate (Line 8 minus Line 11) ............................................................. 12. 6 3 , 3 0 6 . 2 1 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. 6 3 , 3 0 6 . 2 1 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(tz) X .o0 0. 0 0 1 s. 0. 0 0 16. Amount of Line 14 taxable at lineal rate X .045 0. 0 0 i 6. 0. 0 0 17. Amount of Line 14 taxable at sibling rate X 12 0. 0 0 1~ 0. 0 0 18. Amount of Line 14 taxable at wllateral rate X .15 6 3, 3 0 6. 2 1 16. 9, 4 9 5. 9 3 1 s. Tax Due ..................................................................................................................... 1 s. 9, 4 9 5. 9 3 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 1505607220 1505607220 REV-1500 EX Page 3 Decedent's Complete Address: FIIe Number 21-08-0682 DECEDENT'S NAME Earl F ALPAUGH STREETADDRESS 201 South Penn Street CITY Shippensburg STATE PA ZIP 17257 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) ('I) 9,495.93 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 0,00 Total Credits (A + B + C) (2) 0.00 3. Interest/Penalty if applicable ~- - D. Interest E. Penalty Total lnterest/Penalty (D+E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) Check box on Page 2 Llne 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 9,495.93 q. Enter the interest on the tax due. (5A) B, Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 9,495.93 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred :.................................................................................. ^ ^x b. retain the right to designate who shall use the properly transferred or its income :.................................... ^ ^x c. retain a reversionary interest: or .................................................................................................................. ^ d. receive the promise for life of either payments, benefits or care? .............................................................. ^ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................................................... ^ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... ~~ 0 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which For dates o(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 i, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (o) 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 chiltl is zero (o) 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 taz rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent (72 P.S. §9116 (a) (1.3)]. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. '.'Sh u. h. Jl~p ~~„ I rt,-e~niu{`C U..uts-Aln~ rt;l i'sd L..-Ors Ill 01; Ot-41 r,i ttP i'.1:1 ~. V. UV&ii524 rau: "" ~agt ~iCI artb ~egtament ""` I, EARL F. ALPAUGH, of Shippensburg Borough, Cumberland County, Pennsylvania, revoke my prior wills and declare this to be my Last Will: FIRST: PAYMENT OF EXPENSES - I direct that the expense of my last illness and funeral be paid from my estate as soon as may conveniently be done. SECOND: BEQUEST- I give, devise and bequeath the following sums to the following named persons: 1. The sum of Two Thousand Dollars ($2,000.00) to ALICE ALPAUGH; 2. The sum of Two Thousand Dollars ($2,000.00) to TERRY YOUTZ; 3. The sum of Two Thousand Dollars ($2,000.00) to VANCE YOUTZ; 4. The sum of One Thousand Five Hundred Dollars ($1,500.00) to NANCY SWOPE; 5. The sum of One Thousand Dollars ($1,000.00) to KAY FLOWERS; 6. The sum of One Thousand Dollars ($7,000.00) to JOANNE FLOWERS. THIRD: RESIDUE OF ESTATE - I give, devise and bequeath all the rest, residue and remainder of my estate unto SUSAN ALPAUGH, to dispose of as she wishes. FOURTH: PROTECTIVE PROVISION - To the greatest extent permitted by law, before actual payment to a beneficiary, no interest in income or principal shall be (i) assignable to a beneficiary or (ii) available to anyone having a claim against a beneficiary. FIFTH: DEATH TAXES -All federal, estate and other death taxes payable on the property forming my gross estate, whether or not it passes under this will, shall be paid out of the principal of my probate estate just as if they were my debts, and none of those taxes shall be charged against any beneficiary. This provision shall not apply to any property over which I have a general power of appointment of federal estate tax purposes. SIXTH: MANAGEMENT PROVISIONS - I authorize my Executrix, as follows: A. Retain/Invest: To retain and to invest in all forms of real estate and personal property, including common trust funds, mutual funds and money market deposit accounts and certificates of deposit, regardless of any limitations imposed by law on investments by executors or any principle of law concerning investment diversification; B. Compromise: To compromise claims and to abandon any property which, in my Executrix's opinion, is of little or no value; C. Borrow: To borrow from and to sell property to others, and to pledge property as security for repayment of any funds borrowed; r r Ntl€ I'- i :'roc, ss r;`c tum[s'.f lp a qn ead i 6fl IP (1411)1-14 . i .1 P. lid; I ~ ,lb:Fr52'i. U~u: D. Sell/Lease: To sell at public or private sale, to exchange or to lease for any period of time, any real or personal property and to give options for sales of leases; E. Capital Changes: To join in any merger, reorganization, voting-trust plan or other concerted action of security holders, and to delegate discretionary duties with respect thereto; F. Distribute: To distribute in kind and to allocate specific assets among the beneficiaries (including any custodian hereunder) in such proportions as my Trustee may think best, so long as the total market value of any beneficiary's share is not affected by such allocation. These authorities shall extend to all property at any time held by my Executrix or my Trustee and shall continue in full force until the actual distribution of all such property. All powers, authorities and discretion granted by this Will shall be in addition to those granted by law and shall be exercisable without court authorization. SEVENTH: EXECUTOR - I appoint SUSAN ALPAUGH, Executor of my Will. Neither my Executrix, nor any successor shall be required to give bond. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 29"' day of MAY, 2008. -(SEAL) ARL -. QLPAU H Te, for In our prgBence, the above-named Testator signed this and declared it to be his will, and now, at~ re~uest,Andjn/ i/~esence and in the presence of each other, we sign as witnesses: .~. ~, i ,gar F, ~u~~« ~~ ~~;,i~~r.+«,~.,,r, ra,u. oen~~~+an;nn,i r,i.v~rk:a~..,no6cr,x,_d„~ STATE OF PENNSYLVANIA COUNTY OF CUMBERLAND SS I, EARL F. ALPAUGH, having been duly qualified according to law, acknowledge that I signed the foregoing instrument as my Will, and that I signed it as my freeprtd voluntary act for the purposes thereinexpresed. ~/~~ ~, We, EARL F. ALPAUGH, the Testator in and the undersigned witnesses to the Will, the attached or foregoing instrument, who have signed the instrument, having been qualified according to law do depose and say: (a) that I, the Testator, do hereby acknowledge that I signed the instrument as my Will, that I signed it willingly and as my free and voluntary act for the purposes therein expressed; and (b) that we, the witnesses, were present and saw the Testator sign and execute the instrument as his Will, that he signed it willingly and executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator signed the Will as witnesses and that to the best of our knowled ,the Testator was at that time eighteen or more years of age, of sound mind and under n c nstraint or undue influence. // // !, Witness Subscribed, sworn to or affirmed, and acknowledged before me by the above-named Testator and by the witnesses whose names appear on this 291hday of MAY, 2008. y i~-. No ar Public o BA Y Wotarlal Noatary Public Forest N. MYera~ 3hlppensburg oro, Frenklln County9 My pommisabn Expires Dec. 19, 2 Rev-7603 E%+ (B-BBJ SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERRANCE TPX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER ALPAUGH, Earl F 21-08-0682 All real property owned solely or p ~ tenant In common must M rapatlatl et hir market value. Feb market value is detinetl as the pots al which pmpwty would be exchen0etl between a willirg buyer aM a willkg seller, neither beirg compelletl to buy a sell, both hevin0 reasonable knmvled0e of the relevant tads. Real property which Is JolntlyownM wIM right or survivorMip must be dlseloead on eehadule F. (If more space is needed, additional pages of the same size) Copyright (c) 2002 form sothvare only The Lackner Group, Inc. Form PA-1500 Schedule A (Rev. 6-98) (~ p la,m lln -l lYllbl rer ry•nJbook q~p53 A. LS Ctt~O]T]C]lt 5't3te1T1011t U.S. DaparMenl of Housing and Urban Development 3.~Pe of Loan OMft Anr,m~al u~ >sm.mae re...:.e.. n i. ^FHA 2 ^FmHA 3. (]COeV, Unins. 6. Fite Number 7. Loan Number 8 Mortgage Insurance Case Numher 4, OVA S. Conv. Ins. 082021TRA0 ~ wm • een e -- C. NOte:~ilT'ams merkea-°Fe W0iw31p pu eTi•~T3 u eme cm T2 y e amen e8en er•• - IP.ny pem leee ln•tl®i,spl,°e'y.,. nm+nri:,.iwlnle,m.Ilcn Pwpe••••ne..e wl e:ewtleamma lmels. Ti11eEx ress Selllemenl System BANNING: 11ISecOme bkncwl,glPymeke l•IVS elek 1•In Me Unllad Stelae on lMe wen IM1erslmlly lwm. PenellNe upon P uw, c•n mcwtl.. en..ra lm mown.m Fwei:i 'n c ~u oae amen l t.m seengn rota _ Prlnled 11/21/2008 a109:20 ASF __ _ D, NAME OF BORROWER: TRAD Property Management - - ADDRESS: 1050 North Milford Road, Downinptown~PA 19335 E NAME OF SELLER: Estate of Earl F. Alpaugh _-, _ ADDRESS: _ F. NAME OF LENDER: Omstown Bank _-- - - _ADDRESS P 0 Boz 250 Shlppensburp PA 17257 _ G. PROPERTY ADDRESS: 201 South Penn Street, Shlppensburg, PA 17257 _ Borough of Shlppensburp H. SETTLEMENT AGENT: South Central Home Settlements, Inc., Telaphone:717.532-7387 Faz: 717.532-6552 PLACE OF SETTLEMENT: 126 East Kinp Street Shippensburp PA 17257 I. SETTLEMENT DATE: 1112112008 _ ~ - J. SUMMARY Of BORROWER'S TRANSACTION: K. SUMMARY OF SELLER'S TRANSACTION: 100_GROSS AMOUNT DUE FROM BORROWER _ 400. GROSS AMOUNT DUE TO SELLE R 101_Conlract sales rip ce 75000.00 __ _ 401. Contract sales price _ 75000.0 0 102. Personal Prooer(Y ____ _ 402. Personal Pro erl _103. Selllemenl charges to borrower line 7400 2.594.88 _ _ 403 - - 104_, _-. 404. ___. __ 105. 405. __ Adius(ments for items Dald by seller In advance Adjustments Tor items aid b seller In advance 107. Cpunty taxes 111211081012131108 40.08 407. Count taxes 11/211081011131108 __ 40 08 108. School Taxes 11/21108 IO06130109 522.05 408. School7axes_ 1112110BIO06130109 __ _ . 522.05 109. _ ___ 409. - 110. -_.. 410. -_ .- 111. _._ 411. --_.. ___. _ 172. 412. 120__GROSS AMOUNT DUE FROM BORROWER 78,157.07 _ 420. GROSS AMOUNT DUE TO SELLER 75 562 17 _ 200. AMOUNTS PAID BY OR ON BEHALF OF BOR ROWER __ , , . 500. REDUCTIONB IN AMOUNT DUE TO SELLER 2~7. Deoosll or earnest mone 1000.00 _ _ 501. Excess De Dail lsee inslruclior sl 2p2. Principal amount o7 new loans ' 60 000.00 _ _ 502. Selllemen(cbar es to seller Gne 140Q 5 39 O.OB ~J 203. Exislino loanfs taken sub ecl to 1_ I . , --- --_-_ _ 503. Existin loan s taken suh'ecl to 2~' __ 504. Pa o8 of First Modgaoe Loan __ 205. 505. ---- 206. _ -_. 506. --_- -.___- _ 207_ - ~ - .-_ -__- 507. __ -- __ 208. _-_ 508. __ 209_,_ 509. _.. Adiustments for items un aid b seller _ AAJustments for items un alp 'd by seller 213. _ 513. --- 214. -- 514. -... 215, 515. -- 216, 51fi. ~-- - 217_ 517. _-.--___ --_ _278. -_ 578. -~~ 219. 519 220. TOTAL PAID BYIFOR BORROWER 61 000.00 . 520. TOTAL REDUCTION AMOUNT DUE SELLER _ 300. CASH AT SETTLEMENT FROM OR TO BORROWER 600. CASH AT BETTLEMENT TO OR FROM SELLE 5 330.08 R 301. Gross amount due from borrower (line 1201 78157.01 302 L 601. Gross amount due to seller line 420 --~L 15 5`2 13 . ess amounts oaid bvlfor borrower Iline 2201 61 000.00 __ 602. Less reduction amount due sell line 520J_ , 5 390.08 ~ 303 CASH FROM BORROWER , 17157,01 603. CASH TO SELLER ___ 70.172.05 SU95TNUTE FORM 1099 aELLER SigTEMENT: Tl:e Inlormtllcn cmlNneU M1ertln Is Important lev Inlwmelbn erq la Eelrg lumisp•01o Ipe Inrernel flevenue Servk•. II you era requlretl to Ills • relum, f ea pdbllyar olM1er eenelbn Mil Le lmppaJmyarll lM1le llem le requM•tl 1o L•r•pwl•E entl rM1e lPS tlel•rminee NeI II M1•s nq peen reporletl. TI:e COntreq 5ele9 Pelee tle•enLeJ On une fo~:onw •w~.liwu. ln. Grw• Pmc.m. a ull• o-.n..cnon. ~m.re regWrea evl•.ao prowae lM aenlemenl.9en11res. r.aorvo: IMln yo req leep.rentlemmc•nnn n•mser.n as na bar. you may be sublecl to dull or vlmmelpmelllev 4npmeU bylaw. erQr~p~Ttg plpgnury,leeelllyll:el pq num0er•Mwn on llelB elalemBn119m prWl06 yow eerrecl l9eyeym lJenllfc•Ilon TP:, _ _ ycnrrecll•vpeynrlpen9lsel:tln nun:9er. --- r___- __-__ $ELLER($191GNq!NREISI'. I SELLERISINEW MAILING AOORE53: --- -- SELI ERISIPHONE NUMBEgS: ___1111_ -'-- -~~- U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT File Number 082021TRAD PAGE2 SETTLEMENT STATEMENT Ti1laFvnmcv caemmoel c~.lom PdnIM t IrnnnnR of no en gcc L. SETTLEMENT CHARGES PAID FROM PAID FROM _ _T00TOTALSALES/BROKER'S COMMISSION basetl o~_rlce 75000.006.000=4500.00 _ ___ BORROWER'S SELLER'S '. _ DIN_SIOfI D[COmmIS5100110E 7D9) a3IOOWS: _ FUNDS AT FUNDS AT ___ _7.01 _~ 2,250.00 to Sallhamer Real Estate SETTLEMENT SETTLEMENT _ 702. 2 250.00 to Hale Real Estate 703 Commission paid al Selllemenl ____. ___ ._ ____ 4 500.00 800. ITEMS PAYABLE IN CONNECTION WITH LOAN _ 801. Loan Origination Fee 0.500 % Orrstown Bank ___ 300.00 _____ 802. Loan Discount % _803. Appraisal Fee 1o Orrstown Bank 275.00 _ 804_Credi_1Reporl ~~_ ___ _ -~_~~ 805. Lender's Insceclion Fee _ 806. Mort a eA licalion Fee __ 807. Doc Pre Fee to Orrslown Bank _ 100.00 ___ 808. Flood Cerlilicalion Fee to Orrstown Bank _ J0.00 - 809. - - 810. -._._ ._.__ 811. - - - - _ _ _ 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE _ __901, Interest Fran to (TD$ Iday _ _ _902. Mort a elnsurance Premium for to _ 903. Hazard Insurance Premium far 10 904. -_- _-- 9(15. _ _- _1000. RESERVES DEPOSITED WITH LENDER FOR __ 1001. Hazard Insurance mo. ®$ Imo __ ___ 1002. Mort a e Insurance _ mn (al $ Imo _ __ 1003. Clly Properly Tax mo W $ Imo i004. County Properly Tax mo WS Imo 1005. School Taxes mo (lil $ _ _ Imo __ 1009. Aagreaale Analysis Adiuslmenl _ 1100. TITLE CHARGES _ 1101. Selllemenl or clgslng fee __ ____ _ 1102. Abstract or line search to Trl-County Abstract 135,00 _ _ 1103. Title examination _ 1104. Tile Insurance binder 1105. Document Preoaralion 1706. Nolarv Fees _ _ __1107. Allornev's lees _ ~inclutles above items No: 1 1108_. TiOe Insurance to SCHS Agent for Conestoga Title Ins, Co. _ _ _ 637.88 _,~ncludes above Items No: 1 11U9. Lender's Policv 60000.00 - 1110. OWner's Polic 75 000.00 - 637.88 1111. End 100. End 300 to SCHS Agent for Conestoga Title Ins Co _ 100.00 1112 End 710. End 8.1 l0 3CHS Agent for Conestoga Title Ins. Co. 100.00 ___ 1113. ClosingSvcLlr to SCHS Agent for Conestoga Title Ins. Co. 35.00 _ 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recortling Fees Deed S4B.50 ~ Mortgage $68.50 ~ Release $ 117.00 12Q2. CiIVICounly lax/slamos Deed 5750 00 ~ Mortgage $ 7 50.00 _ 1203. Stale Tadslamps Deed 5750.00_ : Mortgage $ __ _ _ _ __ _ 750,00 1204. _ 1205. 1300. ADDITIONAL SETTLEMENT CHARGES 1301. Surve 1302. Pest Ins Ilion to Chamberlins Pest Control _ 75.00 1303. Overni h Fee to South Central Home Settlements Ina 15.00 1304. Final Water Sewer Trasn Bill I Borough of Shippensburg __ 65.08 1305. _ 1300 -__________ - _ ________ ____ 1307 _ 1308. 1400. TOTAL SETTLEMENT CHARGES enter on lines 103 Section J and 502 Section K 2 594.80_ 5,390.08 NuD I nave caraully re~i.w.e m. Nuo-1 seln.re.m smeme„L~e to me o..ml my xowneege.~e eenaL a le.Irvo em eu~,.L Nalee,em ol.n reoerou.oe eisb~aem.m: mane n~ mr emo~m or bvme ei mle vuiu.alm. I Iwme! cenlry Nal I b.v. recelveJ a wpv el Pe NuD 1 senlenienl statement. TRnD Pmpanv M.na¢emem ESlale of Ean F. Alnm~en ~/ ~~ pavN gfi,Feeullix ~~~~-~a~~ WARNING'IT IS AC0.IME TO KNOWINGLY ASINE FALSE STATEMENTe TO THE IDe HUDq Selllemenl5lalemenl xfilcn lbeve prepe~ee lselnre antleccuraleeccvunt of lbb lremecllcn. UNrtEOeTATE50N iHISORpNY 51MRAR FORM PENALTIES UPON CONVICTION Iheve cev etl orwill cause lbe bees to ba ElebmseJ In xcwJeiee W011ile statement. CAN INCLUDE q FINE AND IMPRIRONMEM. FOR OETAl15 SEE TITLE 1S: Os. fOUE SECTION tOm AND SECTION 1010. ~ ~ ~ ~ ///7,.+ /% /~ av:.... ~-L%rC1L/I~C~C. WL'C~/i ./ZLZ/C I ~ Rev-1608 EX+ (B-BB) COMMONWEhLTH OF PENNSVLVNNIr~ INHERITFNCE TPJ! RENRN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER ALPAUGH, Earl F 21-08-0682 Inclutle the poceeds of IiliOSlbn antl Ua date the proceeds were received by iha estala. All property foln0yownad wIM Me dpht of aurvlvorship must be dleGOead on schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH Accrued income on Item 0 through date of death 0.21 1 M&T Bank; savings -account #015004208820418 21,299.28 Accrued interest on Item 1 through date of death 1.39 2 Automobile - 1990 Lincoln Continental 2.500.00 3 County/Borough Real Estate taxes -Refund of pro-rated share at settlement 40.08 4 School Real Estate taxes -Refund of pro-rated share at settlement 522.05 5 US Treasury -Federal retirement payment 800.00 TOTAL (Also enter on Line 5, Recapitulation) I 24,963.01 (IF more space is needed, additional pages of the samesize) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) Rev-760° E%+ (8-96) SCHEDULEF COMMONWEALTH OF PENNSYLVANW JOINTLY-OWNED PROPERTY INNERITANLE Tp% RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER ALPAUGH, Earl F 21-08-0682 It an asset wu made Joint within ons yev of the tlacetlent s tlate of death, It must ba reported on schatlula G. SURVIVING JOINT TENANT(S) NAME I ADDRESS I RELATIONSHIP TO DECEDENT A. Susan Alpaugh B. C. JOINTLY OWNED PROPERTY: Shippensburg, PA 17257 Niece 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 ASSE ~ OF DECD'S INTEREST PATE OF DEATH VALUE OF DECEDENT'S INTEREST 1 A M&T Bank; checking -joint account 8,752.50 50.000°/a 4,378.25 #97104183 TOTAL (Also enter on Line 6, Recapitulation) I 4,376.25 (If more space is neetled, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev. 6-98) REV-1151 EXt (i R-B9) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT pECEOENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER ALPAUGH, Earl F 21-08-0882 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. I FUNERAL EXPENSES: See continuation schedule(s) attached B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s): 8,505.50 Street Address City State Zip Year(s) Commission paid 2. Attorney's Fees 4,750.00 See continuation schedule(s) attached 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 4. I Probate Fees I 275.00 See continuation schedule(s) attached 5. Accountant's Fees 6. I lax Return Preparer's Fees 7. Other Administrative Costs 8,622.86 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 22,153.36 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-7500 Schedule H (Rev. 6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER ALPAUGH, Earl F 21.08-0682 I I tM NUMBER DESCRIPTION AMOUNT Funeral Expenses 1 Fogelsanger-Bricker Funeral Home -funeral bill H-A Subtotal Attornev Fees 2 Law Office Forest N. Myers -estate planning document preparation (Will & POA) 3 Law Office Forest N. Myers -Attorney fees; estate administration a 5 6 7 8 9 10 H-B2 Subtotal Probate Fees Cumberland County Register of Wills - Additional probate Cumberland County Register of Wills -filing fee for Inheritance Tax Return Register of Wills of Cumberland County -Filing Petition for Letters Testamentary Register of Wills of Cumberland County -Filing Will Register of Wills of Cumberland County -Short Certificates; 5 @ $4/each Register of Wills of Cumberland County - JCP and Automation fee Other Administrative Costs Borough of Shippensburg -water service H-B4 Subtotal 8,505.50 8,505.50 250.00 4,500.00 4,750.00 75.00 15.00 135.00 7 5.00 20.00 15.00 275.00 130.61 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-7500 Schedule H (Rev. 6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER ALPAUGH, Earl F 21-08-0882 ITEM NUMBER DESCRIPTION AMOUNT 11 Borough of Shippensburg -water service -final bill 85.08 12 Borough of Shippensburg -water service 130.61 13 Central Penn Gas -gas service 84.89 14 Chamberlin's Pest Control -pest Inspection to sell house 75.00 15 Commission -sale of real estate 4,500.00 18 Cumberland Co Legal Journal -estate advertisement 75.00 17 Donnie Rhinehart -Lawn maintenance and upkeep 150.00 18 Embarq -phone service 32.49 19 Embarq -phone service 17.20 20 Luthern Services -medical services 45.00 21 M&T Bank -home equity loan 43.43 22 Nationwide -insurance 35.48 23 News-Chronicle -estate advertisement 98.50 24 Nightingale -fix car brakes 336.98 25 Penelec -electric service 40.38 26 Penelec -electric service 17,82 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1600 Schedule H (Rev. 6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER ALPAUGH, Earl F 21-08-0682 ITEM NUMBER DESCRIPTION AMOUNT 27 Penelec -electric service 18.87 28 Penelec -electric service 14.98 29 Penelec -electric service 11.05 30 Penelec -electric service; final bill 21.29 31 PPL -gas service 118.19 32 PPL -gas service 91.29 33 PPL -gas service 44.41 34 Recorder of Deeds -transfer tax 750.00 35 Terri Youtz -cleaning @ Penn St property 350.00 36 Terri Youtz -home care 400.00 37 Terri Youtz -Cleaning and house care 500.00 38 Tom Kistler -heater repairs 283.82 39 UGI -Final gas bill 162.69 H-B7 Subtotal g,gy2,gg Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-7500 Schedule H (Rev. 6-98) Rev-7672 EX~ Isset SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONVr£PLTH OF PENNSVLVAN W INHERITANCE TA% RETURN RESIDENT OECEOENT ESTATE OF FILE NUMBER ALPAUGH, Earl F 21-08-0882 Inclutla unralm0unetl metlleel upensu. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 AT&T -consumer credit account 1,242.91 2 Carol Carmack -County/Borough real estate taxes 393.59 3 Carol Carmack -personal tax 11.00 4 Carol Carmack -School real estate taxes 704.33 5 Chambersburg Hospital -medical bill 40.00 6 M8T Bank -home equity loan 14,325.42 7 Menno Haven -medical bill 859.45 8 Sears -consumer credit account 457.84 9 WSEMS -medical bill 845.15 TOTAL (Also enter on Line 10, Recapitulation) I 18,879.89 (If more space is needetl, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-7500 Schedule I (Rev. 6-98) REV-151J E%+Iao01 SCHEDULE J COMMONWEALTH OE PENNSVIVANIA INHERITANCE TAX RETDRN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER ALPAUGH, Earl F 2~_nR_naR~ NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT SHARE OF ESTATE W d AMOUNT OF ESTATE Do Not Lbl Truats s ( or s) ($$$) I TAXABLE DISTRIBUTIONS [include outright spousal distributions and transfers under Sec. 5116(a)(1.2)] 1 Alice Alpaugh Sister-in-Law Two Thousand 2,000.00 710 Menno Village ($2,000.00) Chambersburg, PA 17201 Dollars 2 Susan Alpaugh Niece Rest, residue 71,897.55 6802 Rice Rd and remainder Shippensburg, PA 17257 of net distributable 3 Joan Flowers Niece One Thousand 1,000.00 1830 Dewrell Sq ($1,000.00) Pensacola, FL 32504 Dollars 4 Kay Flowers Niece One Thousand 1,000.00 1840 Dewrell Sq ($1,000.00) Pensacola, FL 32504 Dollars 5 Nancy Swope None One Thousand 1,500.00 6802 Rice Rd Five Hundred Shippensburg, PA 17257 ($1,500.00) Dollars See continuation schedule attached Continuation 4,000.00 Total 81,397.55 Enter dollar amounts for distributions shown above on lines 5 through 18, as appropri ate, on Rev 1500 cover sheet II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98) SCHEDULE J BENEFICIARIES (Part I, Taxable Distributions) ESTATE OF: Earl F ALPAUGH 06/06/2008 202-20-1373 Item Name and Address of Person(s) Share of Estate Amount of Estate Number Receiving Property Relationship (Words) ($$$) Terrie Youtr 6802 Rice Rd Shippensburg,PA 17257 None Two Thousand ($2,000.00) Dollars 2.000.00 Vance Youtr 6802 Rice Rd Shippensburg,PA 17257 None Two Thousand ($2,000.00) Dollars 2,000.00 Total 4.000.00