HomeMy WebLinkAbout03-05-09 (2)J 15056051058
REV-1500 Ex ros-as) OfffClAt UOE ONLY
frll DlpatltrlteM of Retwrxa
Bureau of Indlvtdual Tortes County Cads Year File Nurt~er
Po Ilex apt INHERITANCE TAX RETURN 21 08 0735
Hatnlsaxp, PA t7t2B-060t RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
t3ociel t3ecutRy Number Data of Death Date of 8irih
183-56-9225 05/28/2008 10/17h 945
Decedent's Last Name Suffix Decadence First Name MI
Vogelsong Ingrid t<
rNApplicable) EMsr Stuvlvirl® Spouse's .InrorrnaNan Below
Spouse's Last Name SuHtx Spouse's First Name wtt
Spouse's Sodal Security Number
THIS RETURN MUST 8E FlLEO IN DUPLICATE WITH THE
• REGISTER OF WILLS
FILL IN APPROPRIATE OPALS 8EL0111t
O. t. QrigirtBl Return . __ 2. Supplemental Return _:, 3. Remainder Return {date o(daath
prior b t2-13.82)
_ _.: 4..Umitad fstate 48. Ftltura Interest Catnprorhtse (date of ~: 5. Federal Estate Tax Return Raqulrad
death sitar 12-12-82)
~. M: ~ 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust G 8. Total Numtwr of Saie Deposit Boxes
(Attach Copy of MA9) (Attach Copy ai Tnrst)
9. LiGgedon Proceeds Reoaivad ,..: 10. Spousal Poverty Credit {date of death _. i t. Election to tax under Sec. 9113{A}
behveen 12-31.91 ertd f-1.95? (Attach Sch, t7)
COf2fdEf3PONDENT - TNIS SECTION MUST BE COhtPLETEO. ALL CORRESPONDENCE AND CONFlDtiNT1A1 TAX INFORAiATtOH SHOULD 9E DIRECTED T0:
Name Daytlm8 Telephone Numbex
E)'sza3beth Goldstein
FErm Nama (if;4ppjtcabie)
REGISTER 4F WiLL3 USE DNiN
Elizabeth Goldstein, PC
First line of address
365 NaRh 21st Street
Second 31ne aF address
Suike 202
City ar Post OtrlCe State ZIP Code DATE FlLa~
Damp Hill PA 17611
Correspondent's e-mail address:
Under penanlas of perjury,) dadere met I Have examined Wa real m. irtdudirtg acoompanytnp schedules and statements, and to the best of my knarxtedpe ertd bafiet,
it is true. OOtrett and . OeGafati0rl d preparer altar Than the personal tepresentalive $ based on ail Iniormatiaar OI vrhkh prepater has arty knowtedpe.
SIG tiE~PONS18 FQR FILING RETURN ~ , _ O~TF,
•~lL '.
OF PA~PARER flTHEltrT1/4N REPRESENSitTNE _ ~ DATE
ADaR>=~ 3 ss n~ . a. ~ s-~' s ~,rr~~, .5~.~;-k 2.0:x. ; CaMr, ~l ,1 ~~pAl~ ~ -1 u ~ f
sloe ~
fay 15C56C51p5A 15056051058
REV-1500 EX
Decedent's Name: ingrld
15056052059
Decedent's Social Security Number
K Vogelsong ! 1~ 93-56-9225
ftECAPiTULATION _____._.M_._.~._...._..•.,-,.._.,_„ „__,_,,...,.~-,..r...._ ..~...,..a~.~.,v~_...
1.
Real estate {Schedule A) ....................................... _ _
...... 1. .. _
145,404.00
2. Stocks and Bonds (Schedule B) ................................. ...... 2. _ '
3.
Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)
. , ... 3. .. .. r........... _
4.
Mortgages 8 Notes Receivable (Schedule D) ........................
..... 4, _.. _
5. Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) ... ..... 5. i 6,106.94
6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested .. ..... 6.
7. Inter-Vvos Transfers & Miscellaneous Non-Probate Property "" "" """""' '" '°'° - ~ ° ~ - - -
(Schedule G) t~ Separate Billing Requested... ..... 7.
8.
Total Gross Assets (total Lines 1-7) ............................... ,.v_._.._..._.__.._.._
..... 8 u..._.d.._ ._.~.......e_..°_ __- _ ._.._..
151,507.93
9. Funeral Expenses &Administrative Costs (Schedule H) ................ ..... 9
.. .__ 6,737.00
.._.__ ._
__
.
10.
Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ...........
..... 10. .
.
.w .
8,019.36
11. Total Deductions (total Lines 9 & 10) . ............................ . .. . . . 11. , 14,756.36
12. Net Value of Estate (Line 8 minus Line 11) 12. 136,751.57
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which " ' ~` "' "' "°" " °
an election to tax has not been made (Schedule J) ................... ..... 13. 0.00
14. Net Value Subject to Tax (Line 12 minus Line 13) .................... ... . 14. " 136,751.57
TAX COMPUTATION • SEE INSTRUCTIONS FOR APPLICABLE RATES __... ~~" ~~ ____."--~~_~~ ~~
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116 r_.._,~_~.,.__. _~_ __.. _...__ ~ ._... ....._.~.._. ., ___ __._ __
16. Amount of Line 14 taxable
at lineal rate X .0 45 ~ 1 g. 6,153.82
17. .-..._...,,~._.~.__.-..____.._
......._. ,.~.._.._,.,...
Amount of Line 14 taxable .... _ . : _ _.... n.
i
i __ __ _.. _ _.._ . .. _ . . _..
at sibling rate X .12 ~ 17. .
18. Amount of Line 14 taxable ~~~ -~~-
at collateral rate X .15 18,
19. TAX DUE ......................................................... 19. 6,153.$2
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ~y
15056052059 Side 2
15056052059
REV 1500 EX Page 3
Decedent's Complete Address:
Flle Number __ ,
21 - , ~ 08 ~ 0735 ,
DECEDENTS NAME DECEDEiNTS SOCIAL SECURITY NUMBER
Ingrid K Vogelsong 193-56-9225
STREET ADDRESS
4720 East Trindle Road
clrY srarE - zIP --- -._--
Mechanicsberg PA 17055
Tax Payments and Credits:
1. Tax Due (Page Z Line 19) (1) 6, ~{ 53.82
2.
redits/Payments 0
00 __ _ - -
,
A. Spousal Poverty Credit
B. Prior Payments 0.00
C. Discount 0.00
Total Credits (A + B + C) (2) 0.00
3. InteresUPenalty if applicable
0.00
D. Interest
E. Penalty 0.00
Total InteresUPenalty (D + E) (3) 0.00
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. `
Fill in oval on Page 2, Llne 20 to request a refund. (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference, This is the TAX DUE. (5) 6,153.82
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56)
Make Check Payable fo: REGISTER OF WILLS, ~3GENT
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 .......................................................................................................................... ^
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? .............. ^
Q. 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.
- ~.~: , ;. ~.~,~ti- ~ .. ~ .gym,,
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 ices 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 chid is zero (0) percent [72 P,S. §9116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in
72 P,S. §9116(1.2) [72 P.S. §9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S, §9116(a)(1.3)]. Asibling is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-1502 EX• (B•9e)
SCHEDULE A
COMMnO~NWEA~ ETAX RETURN~~ REAL ESTATE
RESIDENT DECEDENT
of ~i~E NuMe~
Ingrid K Vogolson 21-08-0735
Ail nM ptopertp owned eofNtt or p ra anent to common must a npofbd et falr msrlwf value. Fatr muket vslue b dafhed u the pdae el whkh property rvouid be
(N mare space is needed, tnsart addilbnal sheets of the same :tte)
~~ Tax Parcel No. 10-22-0527-144
L~
THIS DEED.
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MADE THE ~ ~ n °~ day of in the year of our Lord Two
Thousand Four (2004), between
DAVID C. VOGELSONG, single man, of the Borough of
Mechanicsburg, Cumberland County, Pennsylvania, party
of the first part, hereinafter called the "Grantor",
AND
INGRID K. G. VOGELSONG, single woman, of the Township of
Hampden, Cumberland County, Pennsylvania, party of the second part,
hereinafter called the "Grantee",
WITNESSETH, that in consideration of One and Nol100 ($1.00) Dollars, and other
good and valuable considerations in hand paid, the receipt whereof is hereby
acknowledged, the said Grantor does hereby grant and convey to the said
Grantee, her heirs and assigns,
ALL THAT CERTAIN tract or parcel of land situate in Hampden Township,
Cumberland County, Pennsylvania, more particularly bounded and described
according to survey of D. P. Raffer~sperger, dated September 21, 1961.
BEGINNING at an iron pin on the southerly line of the right-of-way of State
Route No. 641 (Trindle Road) which pin is 969 feet measured westwardly
along said line of State Route No. 641 from the center line of Railroad
Avenue, thence South twenty-five (25) degrees twenty-five (25) minutes East
along the westerly line of lands now or late of Eugene B. Weigard one
hundred fifty (150) feet to an iron pin; thence South sixty-eight (68) degrees
fifty-two (52) minutes West along land now or formerly of George E.
Schweitzer sixty-five (65) feet to an iron pin; thence North twenty-frve (25)
degrees twenty-three (23) minutes West along this easterly line of lands now
or late of Kenneth W. Gutshall one hundred fifty (150) feet to and iron pin in
the southerly line of right-of-way of State Route 641; thence, North sixty-eight
{68) degrees ffty-two (52) minutes East along said line of right-of-way sixty-
five (65) feet to an iron pin, the place of BEGINNING.
HAVING thereon erected a one and one-half story brick and frame dwelling
house.
LAW OFFICES
MARLIN R. McCALE6
BEING the same premises which Lawrence E. Deaton and Elsie M. Deaton,
his wife, by their deed dated September 18, 1992, and recorded in the Office
) r
CUMBERLAND COUNTY
Inst.# 200509752 -Page 1 of 3
of the Recorder of Deeds of Cumberland County, Pennsylvania, in Deed
Book "B", Volume 36, Page 1005, granted and conveyed unto David C.
Vogelsong and Ingrid K. G. Vogelsong, his wife. The said David C.
Vogelsong and Ingrid K. G. Vogelsong were thereafter divorced iy Decree of
the Court of Common Pleas of Cumberland County, Pennsylvania, entered
November 5, 2003, to No. 02-0056 Civil Term.
The within conveyance is wholly exempt from Realty Transfer Tax pursuant
to Reg. 91.193(b)(6)(F) as a transfer between persons who were husband
and wife when they acquired the real estate but who have since been
divorced.
AND the said Grantor hereby covenants and agrees that he will warrant specially
the property hereby conveyed.
IN WITNESS WHEREOF, said Grantor has hereunto set his hand and seal the day
and year first above written.
Signed, Sealed and Delivered
in the Presence of
,
.-)
/ (SEAL)
David (:~ gelsong
1 Certify this to be recorded
In Cumberland County PA
LAW OFFICES
MARLIN R. McCALEB
~'" Recorder of Deeds
~~~~~~~'
.` nr ~~
~ ni~~nnnR R•1'I.7'i AM CUMBERLAND COUNTY Inst.# 200509752 -Page 2 of 3
COMMONWEALTH OF PENNSYLVANIA)
SS.
COUNTY OF CUMBERLAND)
nd
On this, the ~.Z" day of ~• , 2004, before me, a Notary Public
in and for said State and County, the undersigned officer, personally appeared
DAVID C. VOGELSONG known to me (or satisfactorily proven} to be the person
whose name is subscribed to the within instrument, anti acknowledged that he
executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
. ~
l-r~F ~ ~J (SEAL)
Notary Public
Notarlel seal
Marlin R. Mt~'.eleb, Nomry Public
Mechanicsburg 13oro, Cumberland Caurrty
My COrTYnIS610r1 Expires DeC.14, 2006
Member Pemsyhrar>ia 4ssor~atlon OF Notaries
I do hereby certify that the precise residence and complete post office
address of the within named Grantee is: 4720 East Trindle Road, Mechanicsburg,
Pennsylvania 17050.
~~ ..
Attorney for Gr ntee
lAW OFFICES
MARLIN R. McCALEB
~~~c,. ti~~ ~sC` 356
10/22/2008 8:11:23 AM CUMBERLAND COUNTY Inst.# 200509752 -Page 3 of 3
REV-i83 EX (7-o8j (Ij
~ Pennsylvania
DEPARTMENT OF REVENUE
Bureau of Individual Taxes
PO BOX 280603
HaMsburg PA 17128-0603
REALTY TRANSFER TAX State 1
STATEMENT OF VALUE Book N
See Reverse for Instructions
Page Number
Date Recorded
Complete each section and file in duplicate with Recorder of Deeds when (1) the full value/consideration is not set forth in the deed, (2) the
deed is without consideration or by gift, or (3) a tax exemption is claimed. A Statement of Value is ncrt required if the transfer is wholly exempt
from tax based on family relationship or public utility easement. If more space is needed, attach additional sheets.
A. CORRESPONDENT -All inquiries may be directed to the following person:
Name Telephone Number:
Elizabeth Goldstein
(717 ) 724-0266
Street Address City State ZIP Code
355 N. 21st Street, Suite 202 Camp Hill PA 17011
Grantor(s)/Lessor(s) Grantee(s)/Lessee(s)
Tracy L.G. Weiss, Executrix of the Ingrid Vogelsong Estate Tracy L.G. Weiss
Street Address Street Address
201 North Hammonds Ferry Road 201 North Hammonds Ferry Road
City State ZIP Code C(ty State ZIP Code
Linthicum MD 21090 Linthicum MD 21090
C. REAL ESTATE LOCATION
Street Address City, Township, Borough
4720 East Trindle Road Hampden Township, Mechanicsburg _
County School District Ta:K Parcel Number
Cumberland Cumberland Valley 10-22-0527-144
D. VALUATION DATA
1. Actua{ Cash Consideration 2. Other Consideration 3. Total Consideration
0.00 + 0.00 =0.00 _
4. County Assessed Value 5. Common Level Ratio Factor 6. Fair Market Value
115,400 x 1.26 = 145,404
r
E. EXEMPTION DATA
ia. Amount of Exemption Claimed lb. Percentage of Grantor's Interest in Real Estate ic. Percentage of Grantor's Interest Conveyed
145,404 100°/D 100°/D
2. Check Appropriate Box Below for Exemption Claimed
® Wil{ or intestate succession. Ingrid A. G. Vogelsong _ 21-08-0735
(Name of Decedent} (Estate Fife Number)
^ Transfer to Industrial Development Agency.
^ Transfer to a trust. (Attach complete copy of trust agreement identifying all beneficiaries.)
^ Transfer between principal and agent straw party. (Attach complete copy of agency/straw party agreement.)
^ Transfers to the Commonwealth, the United States and Instrumentalities by gift, dedication, condemnation or in
lieu of condemnation. (If condemnation or in lieu of condemnation, attach copy of resolution.)
^ Transfer from mortgagor to a holder of a mortgage in default. (Attach copy of Mortgage and note/Assignment.)
^ Corrective or confirmatory deed. (Attach complete copy of the deed to be corrected or confirmed.)
^ Statutory corporate consolidation, merger or division. (Attach copy of articles.)
^ Other (Please explain exemption claimed, if other than listed above.~__
Under penalties of law, I declare that I have examined this statement, including accompanying information, and to
the best of my knowledge and belief, it is true, correct and complete.
Signatru,r1e o~Corres^ond~n~or Resp~niiblE P~,rty~ Date
~7I1 //ll .~ -3 -ate
FAILUR O COMPLETE THIS FORM PROPERLY OR ATTACH REQUESTED DOCUMENTATION MAY RESULT IN
THE RECORDER'S REFUSAL TO RECORD THE DEED.
J(JNE 2008
PENNSYLVANIA DEPARTMENT OF REVENITE
REALTY TRANSFER TAX
COMMON LEVEL RATIO (CLR)
REAL ESTATE VALUATION FACTORS
FOR
CUMBERLAND COUNTY
The following real estate valuation factors are based on sales data compiled by the State Tax
Equalization Board. These factors are the mathematical reciprocals of the actual common level
ratios. For Pennsylvania Realty Transfer Tax purposes, these factors are applicable for
documents accepted for the periods indicated below. The date of acceptance of a document is
rebuttably presumed to be its date of execution, that is, the date specifie:d in the body of the
document as the date of the instrument. 61 Pa. Code § 91.102
7-2-1986
6-30-1987
I. } i
9.52
~ ~ ~
7-1-2006
~f ~ ~~ti~ 7~
6-:30-2007 °~TOR
4~n
1.14
7-1-1987 6-30-1988 10.00 7-1-2007 6-:30-2008 1.22
7-1-1988 6-30-1989 10.53 7-1-2008 6-:30-2009 1.26
7-1-1989 6-30-1990 11.11
7-1-1990
6-30-1991
12.05 _
7-1-1991
6-30-1992
12.35 _
7-1-1992
6-30-1993
12.50 _
7-1-1993 6-30-1994 12.82
7-1-1994 6-30-1995 13.33
7-1-1995
6-30-1996
13.70 _
7-1-1996
6-30-1997
14.29 _
7-1-1997 6-30-1998 14.29
7-1-1998 6-30-1999 14.71
7-1-1999 6-30-2000 15.15
7-1-2000 12-31-2000 15.63
* 1-1-2001 6-30-2001 1.00
*7-1-2001 6-30-2002 1.00
7-1-2002 6-30-2003 1.01
7-1-2003
6-30-2004
1.05 _
7-1-2004
12-31-2004
1.11 _
**1-1-2005 6-30-2005 1.00 _
**7-1-2005 6-30-2006 1.00
• Adjusted by the Department of Revenue to reflect assessment base change effective January 1, 2001.
'* Adjusted by the Department of Revenue to reflect assessment base change effective January 1, 2005.
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SCHEDULE E
COMMONWEALTH OF PENNSYLVANUI CASH, BANK DEPOSRS, ~ MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Ingrid K Vogotson 21-OS-0735
Include the proceada of IQigetton and the date the proeeeda were received Dy the estate.
All pRipertl- jolntty.owmd rMth rlpht of aurvlvorahlp moat be dlactoaed on 8chadule F.
REM
NUMBER
DESCRIPTION VALUE AT DATE
Of DEATH
__ _
1 PSECU Regular Shares (S01) 2,153.99
2 Acaued Dividend from PSECU Regular Shares (S01) ~ , gg
3 PSECU Vacation Shares (S02) 0.00
4 PSECU Christmas-Taxes (S03) 1,119.62
5 Acaued Dividend from PSECU Christmas-Taxes (S03} 1.03
6 PSECU Checking 2 828 94
'
7 PSECU Heetingoil 1.38
TOTA1(Atsa enter on Gne 5, Reca~ituladon) i 6,106.94
(b more apeos !a needed, InaeA additional sheets of the acme alze)
PSEC~k
ELIZABEfiFI J. GOi;DSTEIN
355 N 2 t ST ~T Stl'ITG 202
CAMP 1-f]LL, PA 1.701 1
(lcar >w~lS. taC7LDSTEIN:
Fef~ntarj- 12, 2009
Account 1J 0.193X,YaXXX
The following is the sttitus of ITtCiRID. K, G. VOGIrI.SONG's account with PSECU as o1'the date of'death.
Joint Otme~'s Nance. TI(JNE
Date of Death 05.28..0003
Date o!'I3irth 10.17.1.945
Shure Description Open d.~#c Cialancc riccrucd Diaidend
S O I Regular Shares 07.14, f h9~ $2, 15;,99 51.98
S 02 Vacation Shares 08.24.:1995 0.00 0.00
S 03 Christarras-Tuxes 06.30.1998 1, 11.9.62 f.03
:S 04 Checking Q7.14.1994 2,828.94 0.54
S OS Heatingoil 116.26..1997 1,38 .0,00
The divtle7td earned from January 1,•2008 through the date of death vas 517.87. The tleCedent had no loans ~ti~ith us.
We i1o nt~t have safe deposit boxes for our members.
!f you he>,fe any questions, please call 2~4-8484 in. I~arrisburt; or our roll-free number, (800) 237-7325. At the menu
prompt, enter 6 and then' extension ?227.
Sincerely,
!
1l4eacie Fairfax
ivfember Service Repte~entatiwe
Finance Support'.Unt:
Pennsylv¢ino Steele Employees Credit Union
F,nv;n t~ddress; 1 C:.redit Jniorl Nlar.;r~, 1°7~arri5l)urg, NA 171 10-59~U ~ r1 7.23A.H48~t ~ t3ti(7.737.7;318
,.
~ 1Sa~liny A.dctress: PD fiox b7Q13, tiorrisfJUr~, r~", 1 7 1 015-10 7 3 • I I. ~~i.21GU !`1:7pt . gr~O..:12.19d1 i'raCJ,'
7hJ; [.rriilb un'ror, t5 {r~rr~rtii7r~ insuroci bf tine Ncl«,ne,! C~od,i ilnitrn;~dniia,itrutipn, E',~ui,l l'~{,F~rviuni;y C+?nder vtww.pbeCU.tom
REW1511 EX~ (1Z~98)
COMMONWEALTH Of PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCNEpWLE H
FUNERAL EXPENSES 8~
ADMINISTRATIVE COSTS
ESTATE OF FlLE NUMBER
Ingrid K Vogolson 21-0$-735
Debte of decedent meet be reported on Schedule L
REM
NU ER DESCRIPTION _ AMOUNT
A. FUNERAL EXPENSES:
~' Funeral and Gematlorl 3,031.00
B. ADMINISTRATIVE COSTS:
1. Personal Repesenletlve's ComrNsslorts
Name of Personal Representadve(s)
Socal Seam'ty Number(syEIN Number of Personal Representative(s)
Street Address
CuY ,State
Year(a} Canmisslon PaW:
2. Attorney Fees
3. Family Exsmpdon; {Ir decedent's addresa Is not the Game as daunant's, attach explanadan)
Cldmanl
SUeet Address
GTN Stale
Relatlonahip of fWmant to DeoedeM
4. Probate Fees
S. Atxxruntant'a Foes
6. Tex Return Preperer'a Fees
~. Keystone Mobile Veterinary Service (to euthanasia decedent's pets}
LD
OAO
3, 000.00
0.00
298.00
0.00
0.00
408.00
TOTAL (Also enter on line El, Recapitulation) I S 6,737.00
(M more epees is needed, inseR adddional sheets of the same size)
REV-1512 EX+ (12-08)
r Pennsylvania SCHEDULE I
DEPARTMENtOFREVENUE DEBTS OF DECEDENT,
INHERITANCE 7nx RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBEti
Ingrid K. Vogolsong
21-08-0735
_
Report debts incurred by the decedent prior to death that remained unpatd at the date of death, including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
~. PPL
21.99
2.. Camp Hill Emegency Physician 931.96
3. ~ Holy Spirit 1,424.94
4. Chesapeake Hospice House 3,075.00
5. Heritage Medical Group, LLP 275.00
6. Dioscuri Ventures, LLC 300.00
7. Travelers Insurance 327.00
8. `Pennsylvania America Water 7.41
9. .Andrews and Patel Associates, P.C. 211.00
10. Hampden Township Ambulance 465.00
11. -:Quantum Imaging 47.05
12 Sewer and Trash 138.65
13 'County and Township Real Estate Taxes 305.23
14 .West Shore EMS-BLS 397.49
15 Linthicum Pharmacy 76.69
16 Advance Home Oxygen & Medical Supply 14.95
:~
TOTAL (Also enter on Line 10, Recapitulation) # 8,019.36
If more space is needed, insert additional sheets of the same size.
REV•1513 Ex+ (1!•08)
Pennsylvania
OEMIITMENT Of nlVENUE
INNERJTANCE TAx IIEltlRN
nE5i0ENT OEC~OEJIT
SCHEDULE ~
BENEFICIARIES
ESTATE OF FILE NUMBER
Ingrid K. Vogolsong 21-08-735
RELATIONSHID TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEMNG PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [Indude outright spousal d'atribudons and transfers under
Sec. 2116 (a) (1.2).)
1. Tray Weis Daughter 100%
201 North Hattunonds Felry Road
LinWcum Heights, MD 21090
ENTER pOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV• 1500 OVER SHEET, AS APPROPRIATE.
II NON TAXABIE O15TRIBUT10N5:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 2113 FOR WHICH AN ELECTION TO TAX 15 NOT TAKEN
1.
B. CHARITABLE AND GOVERNMENTAL OISTRlBUTIONS
1.
TOTAL OF PART II -ENTER TOTAL NON TAXABLE DISTRIBUTIONS ON LINE 13 Of REV-1S00 DOVER SHEET. s
If more space is needed, Insert additlonal sheets of the same site.
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N~.~~"~~
Register of Wills of Cumberland County, Pennsylvania
INVENTORY
Estate of Ingrid K Vogolsong
also known as
No. 21.08-0736
Date of Death 06/28/08
Deceased Social Security 193-66-922b
No.
Tracy L d Weise
Personal Repraesntative(s) of the above Estate, deceased, verity that tho items appearing in the knowing inventory include all
of the personal assets wherever sitwte and ail of tbs seal estate in the Caasmoaaroalth o[ Pssmy!-asra of said Deosdent, Hutt
the valuation placed oppaaite each item of said Inventory repteasma its fair valt-e s. of the date of tea Decedee~Cs death, sad that
Decedent owned no real estate outside of the Carttwnwealth of Peaagtvaaia except t]ut which appearstr # seeseorasdvn+ at
the end of this inventory. 1lWe verity that the statements made is this Iaaeatory are tree and narret~. IIWe as~dersaud that
hlse statements herein are made enblact to the peaahies of 18 Pa. C.3. 5ectiott 8804 rooting to umaora falsification to
authorities.
Name of Paraonsl Bepreaentative:
Attorney: E ' beLh
f ~ _ Tracy i..G. Weis
I.D.IYo.: 73779 ~~ ~L. ( v!!i/Y~~
Addttiss 355 North 21" Street, Suite 202; Camp Hill, PA Dated.:~l? ~/~_
17011
TebpMne 717-?14-0256
DESCRIPTION
1. 4720 East Trindle Road; Cumberland County
2. PSECU Regular Shares Account
3. PSECU Chriatxaas-Taxes Aa;ount
4. PSECU Checking Account
5. PSECU Heatingloil AtxxaurtL
TOTAL
VALUE
$145,404.00
$ 2153.99
$ l l 19.82
$ 2828.94
$ :L38
$151,lfO7.s3
-__
tnaach A~iditiea.l sheen u I3eoeswe:) See Att~ed Sliest
NOTE: The Memorosatum oieast estate outside the Cammoawealth ait~emsylvaaia may. at the eketiou o[the personal teptesentative. iacletde the
value of each item. Dut such fisuros should not be attended it-lo the toW Mthe laventory.
corn n.. -; tli.~vs;c .~x~.;i~.=n..r~a
11927_1