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HomeMy WebLinkAbout04-01-09 (2)J 1505607121 REV-1500 Ex (06.05) PA Department of Revenue Bureau of Individual Taxes INHERITANCE TAX RETURN County Code Year File Number PO BOX 280601 Harrisbu , PA 17128-0601 RESIDENT DECEDENT 2 1 0 9 0 0 2 1 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 2 0 7 0 7 7 3 7 6 1 2 2 3 2 0 0 8 0 5 2 6 1 9 1 6 Decedent's Last Name Suffix Decedent's First Name MI H I R S C H C E R M A (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 BELO W 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 QX 6. Decedent Died Testate (Attach Copy of Will) ~ death after 12-12-82) 7. Decedent Maintained a Living Trust 1 8. Total Number of Sate Deposit Boxes 9. Litigation Proceeds Received ~ (Attach Copy of Trust) 10. Spousal Poverty Credit (date of death b ~ 11. Election to tax under Sec 9113(A) etween 12-31-91 and 1-1-95) . (Attach Sch. O). CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DI N ame RECTED T0: Daytime Telephone Number G E R A L D J S H E K L E T S K I E S Q 7 1 7 7 7 4 7x.31 3 5 Firm Name (If Applicable) ~ -- ; S T O N E L A F A V E R S H E K L E T S K I REGISTELS USE~ILY , ~ -v First line of address ~~n %'O '-! ' ~=- 4 1 4 B R I D G E S T ~ ~~~ r .F-,--, Second line of address ~ C~ ~ '~ ~ P 0 B O X E Q .M ~_~ _ z~ fv ~ ~---~ f~ .~ , City or Post Office State 21P Code ~ _ D/iTE FILED tlV ~ N E W C U M B E R L A N D P A 1 7 0 7 0 Correspondent's a-mail address: Under penalties of perjury, I declare that I have ex fined this return, including acx;ompanying schedules and statements, and to the best of m know it is true, come and complete. D tioy~t pr arer othe~an the personal representative is based on all information of which preparer has any knowledge belief, SIGNA 1~ OF PERfSON RE O L OR FILI RETURN KAf~EN HI CH 809 BOSLER AVE• LEMOYN r rr~ h '~ "~11~' 0 PA 1704: ~~i ~/C~ GERALD J• SHEKLETSKI, ESQ• 414 BRIDGEST•, NEW CUMBERLAND PA 17070 PLEASE USE ORIGINAL FORM ONLY Side 1 1505607121 1505607121 J J 1505607221 REV-1500 EX Decedent's Social Security Number Decedents Name: C• E R M A H I R S C H 2 0 7 0 7 7 3? 6 RECAPITULATION 1. Real estate (Schedule A) ........................................ 1. 1 5 5 0 5 5, 6 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 b Miscellaneous Personal Property (Schedule E) ... .... 5. , 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested .... 6. 2 4 8 1 1 3 0 2 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property ... , (Schedule G) ~ Separate Billing Requested .... ... 7. 1 4 7 5 4 0, 6 6 8. Total Gross Assets (total Lines 1-7) . , , , . , • . , . , 8 5 5 0 7 0 9 , 2 8 9. Funeral Expenses & Administrative Costs (Schedule H) ............. ... 9. 2 0 4 4 6 , 4 3 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) , .. , . , , , . , .. 10 11. Total Deductions (total Lines 9 8 10) ........................ ... 11. 2 0 4 4 6, 4 3 12. Net Value of Estate (Line 8 minus Line 11) . , , , , .. • . • • , • .. , 12 5 3 0 2 6 2 8 5 13. Charitable and Governmental BequestslSec 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) ................ .. 1a. 5 3 0 c~ •6 2 , 8 5 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2)x.o 0. 0 0 16. Amount of Line 14 taxable 15. 0. 0 0 at lineal rate x .045 5 3 0 2 6 2. 8 5 16. 2 3 8 6 1 8 3 17. Amount of Line 14 taxable . at sibling rate X .12 0 0 0 17, 0 0 0 18. Amount of Line 14 taxable . at collateral rate X .15 0. 0 0 18 0 0 0 19. Tax Due .............................................. 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 1505607221 2 3 8 6 1. 8 3 1505607221 J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 09 0021 DECEDENT'S NAME C. ERMA HIRS_CH STREET ADDRESS 809 BOSLER AVENUE __--- -- --- - ------ -- - ___ _ - 1- - -- ----- ------ - CITY .STATE 'ZIP LEMOYNE PA 17043 Tax Payments and Credits: ~• Tax Due (Page 2 Line 19) (1) 23,861.83 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments 22,668.74 C. Discount 1,193.09 Total Credits (A + B + C) (2) 3 I t tlP lt if li bl 23, 861.83 . n eres ena y app ca e D. Interest E. Penalty Total Interest/Penalty (D + E) (3) 4 If Li 2 i t h Li 1 0.00 . ne s grea er t an ne + 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. (5) 0.00 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 +5A. This is the BALANCE DUE. (56) 0.00 Make Check Payable to: REGISTER OF W1LLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer antl: Yes No a, retain the use or income of the property transferred : ...................................................................... ^ 0 b. retain the right to designate who shall use the property transferred or its income; ............................... ^ X^ c. retain a reversionary interest; or .......................................................................... ^ ...................... d. receive the promise for life of either payments, benefits or care? ....................................................... ^ 0 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 "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? .................................................................................................. ~ ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PA RT 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 antl filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1502 EX + (6-98) SCHEDULE A COMMONWEALTH OF PENNSYLVANIA REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER C. ERMA HIRSCH 21 09 0021 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 property which is jointly-owned with right of survivorship must be disclosed on Schedule F ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. ALL THAT CERTAIN LOT OF LAND, WITH IMPROVEMENTS THEREON, KNOWN AS 114,017.40 809 BOSLER AVENUE, LEMOYNE, CUMBERLAND COUNTY, PENNSYLVANIA. BEING THE SAME PREMISES WHICH ALVIN H. BUSHEY AND SARAH J. BUSHEY, HIS WIFE, BY DEED DATED APRIL 23, 1948, RECORDED JANUARY 28, 1952, IN CUMBERLAND COUNTY DEED BOOK V, VOLUME 14, PAGE 300, GRANTED AND CONVEYED UNTO WILLIAM G. HIRSCH AND ERMA HIRSCH, HIS WIFE. WILLIAM G. HIRSCH DIED APRIL 2, 1987, WHEREBY TITLE VESTED IN C. ERMA HIRSCH, THE DECEDENT, BY OPERATION OF LAW. CUMBERLAND COUNTY REAL ESTATE TAX PARCEL 12-22-0824-051. 90,490 (TAX ASSESSED VALUE) X 1.26 (COMMON LEVEL RATIO) _ $114,017.40 2. ALL THAT CERTAIN LOT OF LAND, WITH IMPROVEMENTS THEREON, KNOWN AS 811-813 BOSLER AVENUE, LEMOYNE, CUMBERLAND COUNTY, PENNSYLVANIA. BEING THE SAME PREMISES WHICH NEWELL S. RYDER AND JEAN F. RYDER, HIS WIFE, BY DEED DATED MARCH 2, 1953, RECORDED AUGUST 7, 1953, IN CUMBERLAND COUNTY DEED BOOK K, VOLUME 15, PAGE 41, GRANTED AND CONVEYED UNTO WILLIAM G. HIRSCH AND C. ERMA HIRSCH, HIS WIFE. WILLIAM G. HIRSCH DIED APRIL 2, 1987, WHEREBY TITLE VESTED IN C. ERMA HIRSCH, THE DECEDENT, BY OPERATION OF LAW. CUMBERLAND COUNTY REAL ESTATE TAX PARCEL 12-22-0824-051A 32,570 (TAX ASSESSED VALUE) X 1.26 (COMMON LEVEL RATIO) _ $41,038.20 41,038.20 TOTAL (Also enter on line 1 Recapitulation)1 $ 155,055.60 (If more space is needed, insert additional sheets of the same size) REV-1509 EX + (8-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE F JOINTLY•OWNED PROPERTY C. ERMA HIRSCH FILE NUMBER 21 09 0021 If an asset was made Joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. KAREN S. HIRSCH 809 BOSLER AVE. LEMOYNE, PA 17070 DAUGHTER e c JOINTLY•OWNED PROPERTY: 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. ~ A. 2-4-00 PNC BANK CERTIFICATE OF DEPOSIT ACCOUNT #31900178352 2~ A 11-1-66 PNC BANK CHECKING ACCOUNT #5140029115 3. A 1-1-78 PNC BANK CHECKING ACCOUNT #5140029123 4. A 2-23-99 PNC BANK SAVINGS ACCOUNT #5000881576 5. A 4-14-83 PNC BANK SAVINGS ACCOUNT #5130079477 6. A 6/4/91 M&T BANK SAVINGS ACCOUNT #15004205984980 7~ A 4-11-06 METLIFE INVESTORS INSURANCE COMPANY CONTRACT 8100579900 DATE OF DEATH DE ~D S DATE OF DEATH VALUE OFASSET INTEREST DECEDENT'S NTEREST 50,089.60 50. 25,044.80 9,920.77 50. 4,960.39 36, 510.91 50. 18, 255.46 96,827.70 50. 48,413.85 30,848.85 50. 15,424.43 45,542.33 50. 22,771.17 226,485.83 50. 113,242.92 TOTAL (Also enter on line 6, Recapitulation) s (If more space is needed, insert additional sheets of the same size) 13. REV-1510 EX + (8-99) SCHEDlJLE G COMMONWEALTH OF PENNSYLVANIA INTER-VIVOS TRANSFERS 8 INHERITANCE TAX RETURN MISC. NON•PROBATE PROPERTY RESIDENT DECEDENT _STATF AF C. ERMA HIRSCH FILE NUMBER 21 09 0021 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. ITEM DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND NUMBER THE DATE OF TRANSFER. ATTACH A COW OF THE DEED FOR REAL ESTATE. DATE OF DEATH % OF DECD'S EXCLUSION 1. METLIFE INVESTORS INSURANCE COMPANY VALUE OF ASSET INTEREST )IF ApRICA%E) ANNUITY CONTRACT 11072954 147,540.66 100. TRANSFEREE -KAREN S. HIRSCH, DAUGHTER TOTAL (Also enter on line 7 Recapitulation) s 147 (It more space is needed, insert additional sheets of the same size) TAXABLE VALUE 147, 540.66 REV-1511 EX + (10-08) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES 8~ ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER C. ERMA HIRSCH 21 09 0021 Debts of decedent must be reported on Schedule I. A. B, ITEM NUMBER DESCRIPTION FUNERAL EXPENSES: ~. MUSSELMAN FUNERAL HOME 324 HUMMEL AVE., LEMOYNE, PA 17043 ADMINISTRATIVE COSTS: 1 • Personal Representative's Commissions Name of Personal Representative (s) Street Address City State Zip Year(s) Commission Paid: 2. AttomeyFees GERALD J. SHEKLETSKI, ESQ. 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. Probate Fees LETTERS TESTAMENTARY 5 ~ Accountant's Fees 6. ~ Tax Retum Preparer's Fees 7. LEGAL ADVERTISING -PATRIOT-NEWS 8. LEGAL ADVERTISING -CUMBERLAND LAW JOURNAL 9. WEST SHORE EMS 10. VERIZON 11. HOP/PSERS HEALTH INSURANCE PREMIUM 12. WEST SHORE EMS 13. PA DEPARTMENT OF REVENUE -ESTIMATED TAX 14. H.L. BOWMAN -PLUMBER 15. COMCAST 16. WEST SHORE EMS 17. PENNSYLVANIA AMERICAN WATER COMPANY 18. FILING FEES -INHERITANCE TAX RETURN ($15.00) AND INVENTORY ($15.00 TOTAL (Also enter on line 9, Recapitulation) ~ s (If more space is needed, insert additional sheets of the same size) AMOUNT 6,604.00 12,500.00 310.00 130.31 75.00 100.00 29.48 238.00 114.76 50.00 106.00 57.23 65.91 35.74 30.00 43 REV-7513 EX *19-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF C. ERMA HIRSCH NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I TAXABLE DISTRIBUTIONS [include outright spousal disfibutions, and transfers under Sec. 9116 (a) (1.2)) 1. KAREN S. HIRSCH 809 BOSLER AVE. LEMOYNE, PA 17043 FILE NUMBER 21 09 0021 RELATIONSHIP TO DECEDENT Do Not Llst Trusteelal Lineal AMOUNT OR SH OF ESTATE 530,262.85 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. SCHEDULE) BENEFICIARIES TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I s {If more space Is needed, Insert additional sheets of the same size} WI I,i, of C. EI2MA HIRSC,I3 ~N~ 8 I, C. ERIC ~g$CH, o~ the 8c?Z'qugh of I,em of ,Cuter d, ~ Dyne, County ~b~t{ .Af , P~sy.lvan~a,,fd~,e ~aFS:. t~~}st t,P.. be my last will and revoke any will previously made by me. 4 Item I. I direct that all my just debts and funeral expenses, including my gravemaxker apd all expenses o~ my last illness and any and all taxes. and .assessments imposed by any governmental body as a result of my death, whether on prgperty passing under this will or otherwise, shah be paid from my residuary estate as goon as prapticable_a~,ter my decease as a part of the expense of the administration of my estate. Item ~~. I g1Ve amd bequeath all of ~Y hpusehold goods, automobiles, jeWe1z'Y~ and all athe~ articles of hou3eho~.d and Personal us,s, ~iPment aad °irt~ together with all, insurance thexeon, and relating thereto tp a-Y husband, WILLIAM G. HZ&SCH, if he survives me hY thirty (30) days, Should my said husband predecease me or be deceased ozi the thirty-first day after my death, I ive g and bequeath all such items and insurance therepn to such of my children as are liv'n 3~ g on the thirty-first day '~' after my death, to be divided am - any them by my executors with ~~- due regard fqr their personal preferences in as nearly al shares as ~ practical. The decision of my executors with regard thereto shall be final, binding, and conclusive on all parties. Item III. I give, devise, and bequeath all the rest, residue, and remainder of my possessions and estate of every nature and wherever situate to my husband, WILLIAM G. HIRSCH. Should my said husband predecease me or be deceased on the thirty-first day following my death, I dive, devise, and bequeath all the rest, residue, and remainder of my~posaessiona and estate of every nature and wherever situate to those of my children who survive my death by thirty (30) days in equal shares. Item IV. In the event that my children are the beneficiaries of the residue of my estate in default of my husband, WILLIAM G. HIRSCH, I direct that my daughter, KAREN S. HIRSCH, of Lemoyne, Pennsylvania, shall have the privilege to continue to reside in my home at 809 Bosley Avenue, Lemoyne, Pennsylvania, for so much of her natural lifetime as she desires. Item V. I appoint my husband, WILLIAM G. HIRSCH, executor of this my last will. Should my said husband predecease me or otherwise fail to qualify or cease to serve as executor of this my last will, I appoint my daughter, KAREN S. HIRSCH, executrix of this my last will. Item VI. I direct that my personal representatives and fiduciaries shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREpF, I have h'~e`re~unto set my hand and seal this oti~.G{G day of ~J,,~,~2 Y 1980. Page 2 of 3 Pages The. preceding inetzument, cq,~si;~ti~}g of this and two other tYi~,ttsq D~4e~.', each .identified blr. -thil signature . _ r Y sad dool rf. ~ ~`~b~. `~' axmd by C. firma Hirsch, the testatr theraih namedt as and for her last will, in the presence of us, who at her request, in her presence, and~in the presence of each other, have subscribed •,qux I~ci39PS as witnesses hereto. ((~ ~--^ ..tl ;. ~.. ~ .i'I~~~$..h'4 .~ ,~'}~ I~~~.LdYGi•^~'r!M'.~~'M..N11~YIiFafn~~IF~~`+&R~.'.1.'RAkwYF~~MI 1~i 's..'1't 11 ~i1~.:i~tlMt~hr y .. _ 4. _w~ -~~mws~ lvi~6a U _ ~~ i , )r Page 3 of 3 Pages COM["10NWEALTH OF PENNSYLVANIA ) COUNTY OF CUMBERLAND ( SS.: I, C. ERMA HIRSCEi, tl~-e testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed thra insttument a$.my last-will, that I signed it willingly; " ~' +~A ~ 2 ~r ~lLir~i1~ ' X11 sworn oz affirmed to sad acknowledged before me by C. Ex'ma Hir$ch,: the ttast~trix this a~~-~ ~ ~„~: i qan, 1 I ~ /i ' ' LOU ~. ZITTO, Notary PuClic Ill lanaytta, Curnharlanti County, Pa. Otary b C My Cammiuion Expirta Nyrch 20, 1982 CQI~ffMiDNWEALTH OF PENNSYLVANIA ) ( SS.: COUNTY+OFCU~M~B+ERTLAND-~~}~yt~. ) "~t.'f 7S^'.r!~!r~!h-, +1w "!'.w"~il!i. an{'~ G~~}7it Ar . ~~I,. the Wi~i16p$~$ , (i~' ng duly 4ualified'aCCOrdinq to laws duo c'i<eppa® and say that we were present and saw the testatrix sign and execute the instru- ment as her last will; that she signed it willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in. the hearing and sight of the testatrix signed the will as witnesses; and that to the beat of our knowledge, the testatrix was at that time 18 or make. Y~ax's of aqe,,, og- sQtaad mind. a>~c~ under no constraint or unduQ infiuenlce. -~~G~~ s~vorn os .affirmed to and aclaza,~iedgQd- before tas 'this ~o~$~ `may °-f `~~1G~lJfl.~,1A{y ~ ~$~ . _(~ Notary P~ lC t0U ~ ZITfO, Notary Pu61ie lturayne, Cumberlantl County, Pa. My Commission Expires March 20, 1984 COMMONWEALTH OF PENNSYLVANIA REV-1162 EX~11-96y DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 7 71 28-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 01 1015 HIRSCH KAREN S 809 BOSLER AVENUE LEMOYNE, PA 17043 ACN ASSESSMENT AMOUNT CONTROL NUMBER ESTATE INFORMATION: SsN: 207-07-737s FILE NUMBER: 2109-0021 DECEDENT NAME: HIRSCH C ERMA DATE OF PAYMENT: 03/ 1 9/2009 POSTMARK DATE: 03/19/2009 courvTY: CUMBERLAND DATE OF DEATH: 12/23/2008 101 ~ 522, 668.74 TOTAL AMOUNT PAID: 522,668.74 REMARKS: RECEIPT GIVEN TO ATTY CHECK# 2620 INITIALS: JN sEA~ RECEIVED BY: GLENnA FARniFR cTROCRni I~~ REGISTER OF WILLS TAXPAYER Detailed Results for Parcel 12-22-0824-OS 1 A in the 2004 Tax Assessment Database DistrictNo 12 Parcel ID 12-22-0824-USIA ~tilapSuflix HouseNo g I I Direction Street BOSLER AVENUE (hvnerl HIRSCH, C ER:MA C/O PropType RO PropDesc & 8l3 BOSLER AVENUE LivArea CurLandVal 26000 CurlmpVal 6570 CurCotVal 32570 CurPreNal :acreage , 12 CIGrnStat TaxEx I SaleAmt Sale,~lo SaleDa SaleCe SaleYr UeedBkPage OOISK-00041 YearBlt FIF_F'ile_Date 01/04/2006 HF_:lpproval Status D ' ~lnis ~e~d, ¢ #~¢ Secon3 day of Aittrgh in the year of our Lord one thousand nine hundred and fifty-three BETWEEN NEWELL S. RYDER and JEAN F. RYDER, his wife, both of the Borough of Lemoyne, Cumberland County, Pa., parties of the first part, grantors, and William (3. Hirsch and his wife, '~' C. Erma Hirsch, of the same place, party of the second part i and grantee l#I[¢SSP#~, that in consideration of Seven Hundred ---------------- (~ 00.00)----------------------------------------------- Dollars in lu~n~paid, the receipt whereof is hereby acknowledlsed; the Grantor do hereby Pant and convey to the said Grantee he r Heirs and /Issi~'ns ~~ that lot of land known as Lot No. 12l}, Block "E", Lemoyne, Pennsylvania. Said lot fronting thirty-five (35j feet on the Northern side of Boller Avenue, and extelnding back the same width One Hundred Fifty (150) Peet to an alley. It being the acme property which wsa conveyed by John C. Ward and wife by deed dated August 5, 1919 and recorded in 8 "y"589 to Mary Lucretia McCurdy; and the acid 2dary Lucretia McCurdy having died testate, devised the same to Nexell 3. Ryder, grantor herein, by her last will and testament duly probated and recorded in the office of the Register of lYills in and for Cumberland County, Pa. gl:Gl ERED BY THE BC'ROUGH~F LEMOYNE, P~. .-arch„ ~~ 53 __F!L.__-__ .r....._. _.__...._. Wm. S• Eby -. _ _._ . ,,~ . . ,~ ,AnD the said Grantors Will Warrant generally the property hereby conveyed ~n witness ~Ilsreaf, said Granto~e ha ve hereunto set the!/tacnd a and seals the day and year ~lryt above written. ~Qaaunanfasalth of ~ennsgluaaia Qlauntq of Cumberland ~'$' On this, the G~~G`~"° "`'`r <lay of Mi /1. D. 19 ~~~~ ~, t~efure nee appeared Newell 3. Ryder and Jean F. Ryder,uhierSWlPe o~j'icer, personally proven) to be the erson whose names are known to me or (satisfactorily p sub8eribed to the within instrurnew.t, and racknowled~ed that they executed the same for the purposes therein contained. ,fin ~itnsss ~ttsrsaf, I hereunto set my hand and of)ieial seal. ' - CEPHAS A. WILLfS, N. P. ~~~-'~~'" Ml' CCMMIS~'iCN EXPIRES __..__..._.._.._- -- ;gyp-?~s,~-_ , la o~ O®pr ~omawatuealtl~ of ~lennsglbxnut l ~Qoua~ of j ss. I)n this, the ) dray of /1. D. 19 ,before nae appeared the undersi~aed OJjlcer, personally known to me (or Satisfactorily proven) to be ttae person whose name sub8cribed to the within instrument, and ucknowled~ed th~aE he executed the same for the purposes therein contained. ~n ~itness ~hsreof, I /aereuntn xet my hand and ofjlciul Seal. ~ r._.._ _..~..~..~„r--~l7ree. r ,. _ _ , - i '' _ __ _:._ _ _ _ _ ,__ _.. __ _ _____ _ _ f:_ _. } Mate of i ~ ss. ~a~ of On this, the day of /1. D. 19 ,before ms the undersigned officer, personally appeared known to me or (satisfactorily proven) to be the person whose name subscribed to the within instrument, and acknowledged that he executed the same for the purposes therein contained. ~n ~ifnetss ~here~, I hereunto set my hand and official seal. Title o[ 091cer ~~ ~iereltq Qlertifq, that the precise residence of the Grantee 809 eosler Ave, Lemoyne, Pa ,i ;. . i o • i ~, w: f" ~ ~^ ~ 4 ~ ~ ~ •~ a a; ~ ~ • f r ~ t.f+ : o ' ~ T ~ ~ ~ ~; ., ^ A r 1 c~ ~ V ~ ' ~; ~ ~ ~ ~ ~, `^ '~ ~~ ~ M ~ VIT ~~ ~ Y ~ f "~ W ~ r' W .~ U ti w ~ammanfnealtll of ~enttsglnatrix Qluuttt~ ~ CUMBERLAND ~ ss. Recorded on this 7TH day of AUGUST „1. D. l;l 53 , in the RPCOrder's O/~ce of the said County in Deed Book K V'olum.e 1$ Page 41 Given under m.y hand and the seal of the said UJ~ce, the date abot+e written. -` ' l ~ - CC ~ .. Recorder ~' ~ ~ rl~ __..._..._. _. _ Detailed Results for Parcel 12-22-0824-051. in the 2004 Tax Assessment Database DistrictNo 12 Parcel ID 12-22-0824-051. M1taptiuftix flouseNo goy Direction Street IiOSLER AVENUE Ownerl H[RSCH, C ERMA ('/O Prop"type R PropDesc Liv;~rea 1279 Curl.andVai 18000 CurlmpVal 72490 CurTotVal y04y0 CurPretlVal Acreage .06 CIGrnStat TaxEx I SaleAmt Sale,l9o SaleDa SaleCe SaleYr DeedBkPage 0014V-00300 YearBlt 1933 HF_H'ile_Date 11/02/2004 FIF_:lpproval_Status ~ A 202-DT-Dred-@re Simple. Henry Hell, Inc., Indlan4 Pa aCfji~ ~lnbenture, MADE THE 23rd day of April in the year of our Lord one thousand nine hundred and Fort,--eight. BETWEEN ALVIAI H. BUSHEY and SARAH J. BUSHEY, his wife, of the Borough of 1~:ormleysburg, County of Cumberland. and State of Fennsplvani , parties of the first cart, AND :"iILLIA^: G. HIP,SCH and C."RPJ:A NTRSCH, his wife, of the Township of Lower Allen, County of Cumberland and State of Fennsylvania~ parties o j the second part, WITNESSETH, that the said parties o j the first part, for and in consider- ation of the sum of One Dollar and other valuable cons iderations lawful money of the United States of America, well and trul -Dolddrs: y paid by the said parties of the second part to the said part ie s of the first part, at and before the sealing and delivery of these presents, the receipt whereof is hereby acknowledged, have granted, bargained, sold, aliened, enfeo~ed, released, conveyed and confirmed, and by these presents do grant, bargain, sell, alien, enfeo~`, release, convey and confirm unto the said parties of the second part, their heirs and assigns, axtx*zFt~x~acx-~c~~~~~~~~~~ x ~~?~+ ALL that certain lot or parcel of land situate in the Borough of Lemoyne, County of Cumberland and State of Pennsyl- vania, more T,articularly bounded and described as follovrs, to ~^,it:- BL'GID?NIA?G at a point on the northern line of Bosler Avenue, on tYi~ divding line betv~een Lots Nos. 123 and 124, Block "E", or, tb.e herein- after mentioned Plan of Lots, said point being se~.~ent;,~-five (75) feet measured westwardly from the northwest corner of Bosler .Avenue and t;i~;hth Street, formerly Blackberr} Alley; thence in an easterly direc- ion along the northern line of Bosler Avenue seventeen and one-half (17.) feet, more or less, to a point on the 1i_ne passing through the .enter of the partition ~~^.al_ of the double two and one-half stor;,r rick dwelling house erected in Y~art on the premises hereby conve,ped nd in part upon the lot adjoining on the east; thence in a northerly irection along said line, through said partition wall and beyond, one undred fifty (15Ci) feet,' more or less, to an alley; thence in a wester: direction alcng the southern line of said alley seventeen and one-half 17ti) feet, more or less, to a point on the dividin^; line cetween tots Jos. 123 and 1?.4, Block "E" on said Plan; thence in a southerly direr- ien alonFr, raid dividing line one hundred fifty (150) feet to the point) i or place of Be ;inning. BERG the western portion of Lot No, 123, Block "E", in the Offi cial Plan of the Borough of Lemoyne, said Flan ~,eing recorded in the Cumberland County Recorder's Office in Dsed Book "J°, Vol. 4, rage 40 Having thereon erected the western half of a double two and one- half story brick dwelling house, No. 809 Boller Avenue, Lemoyne, Penn Sylvania. L'~'1NG part of the premises which Eliza H. idacDonald, single, by deed dated September 5th, 1923, and recorded in the Office aforesaid in Deed Book "F"', Vol. 11, Fage 42?, granted and conveyed unto Alvin H. Bushey, one cf the grantors herein. •t ' ' - - - ~ --._ ___ . ,_.... _ . j t1V +.. :hI TOGETHER with all and singular the tenements, hereditamenta and appurtenances to the same be- longing, or in anywise apperta{ninp, and the reversion or reversion8, remainder and remainders, rents, issues and profits thereof: And also, all the estate, right, title, interest, property, claim and dema»d whatsoever, both in law and equity, of the said part ies 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 ainglar the appurtenances, unto the said part ies of the second part, their heirs and assigns, to and for the only proper arse and behoof of the said part ies of the second part, xxxbrom[s~[~gcxb~c~DtiC$3~9~i~~~t~F x their heirs and assigns forever., Ia~~C ~ ~ixacoe~em~[m7c~~rxn~..~.,,,....____--- ~` And the said parties of the first part, for themselves, their heirs, executors and administrators, do with the said part ie9 of the second ~ these presents, covenant, grant and agree to and the said part, their heirs and assigns, that the y parties of the first part, their ~ ' heirs, all and singular the hereditamenta and premises hereinabove described and granted or men- tioned and intended so to be, with the appurtenances, unto the said parE.es of the second part, heir heirs and assigns, against the said part ies of the first part, and. their heirs and against all and every other person or persona whomsoever lawfully claiming or to claim the same or any part thereof, shall and wiU by these presents, Warr¢nt and Forever Defend. IN WITNESS WHEREOF, the said part ice -a¢the~ their hands and seals ,the day and year first above w~ ~ hwe hereunto set iipusa, isaltL u~ HrlfurrsL _ '. ------•-•-- ~ - ~a~~r. ~~~~__ f _.__.--- ------------------ _ _______________________________ imAL Received the day of the date of the within or foregoing Indenture, of the said part of the second part, the sum of Witness: - - -~-- State of pennsylvan is sa County of Cumberland On this, the 3g Mildred Hoopy2S~one day °j April , 19 48, before me the undersigned oljicer, personally ¢ppeared Alvin H. Bushey and Sarah J. Buatle~t, his wife, known to me (or satisfactorily proven) to be the persons whose names are subscribed to the within instrument, and acknowledged that they executed the acme for the purposes therein contained. In witness whereof, I hereunto set my h¢nd~¢,,nd o~icf¢d seal. - --- My Coamiisaion .Expires March 30 1951 --••-•--•--•----•---•-----•-----••--•------t---------••-•---•-••-----•--- State of Title of O,¢icer. Cozmty of On this, the ss. day of the undersigned o~°icer, personally appeared 19 ,before me, l.'nown to me (or satisfactorily proven) to be the person whose name within instrument, and acknowledged that subscribed to the contained, executed the same for the purposes therein In witness whereof, I hereunto set my hand and o,$iciai seal. e~~ i o. CERTIFICATE OF RESIDENCE Title of O,~icer. do hereby certify hat the precise r 'deuce of the within named grantee is 19 ~/- Attorney fOr .._._._...._. - w [" H H P> ~' S OFFICE OF x.~ ~ ~ ~ U ,':,v ~~+ ~ ~W ax ~ ~ ~ ~a mm a xti ~ ~ W ~ ~ `U COMMONWEALTH OF PENNSYLVANIA, County of tTI-- --~s-~ aa. RECORDED on this ._.___,~~ _.~. day o f -- ------- A. D. i9~-___, in the Recorder's O.$ice of said Coun in Deed Book VoL __.,Ly __., Page --3.QQ..-----------•- Gwen under my hand and the seal of the said o$ice, the date above written. ~- -t''~~-ecorder. ~1'~VC tEAQ1N6 THE WAY February 10, 2009 Gerald J S)zekletski Esq. Attorney At Law 414 Bridge St PO Box E New Cumberland PA 17071 RE: C Erma Hersch SSN: 207-07-7376 DOD: 12-23-2008 Dear Ivir, Shekletski: In response to your request for Date of Death (DOD) balances for the customer noted about, our records show the following: Certificate of Deposit Account # 31900178352 C ERMA HIRSCH KAREN S HIltSCH DOD balance: $ 50,000.00 + 89.60 accrued interest Interest paid 01-01-2008 thru 12-23-2008 $2,074.72 YTD Checking Aeeaunt Account ~ S 14002911 S KAREN S HIItSCH C ERMA HZRSCH DOD balance: $ 9,919.63 + 1.14 accrued interest Interest paid O 1-01-2008 thru 12-23-2008 $26.17 Y'TD Accoum # S 140029123 C £RMA HIILSCH KAREN S HIRSCH DOD balance: $ 36,505.20 + 5.71 accrued interest Interest paid 01-01-2008 thru 12-23-2008 $121.65 I'TD Established: 02-04-2000 Established: 1 I -Ol -1966 Established: O l -01-1978 Page 1 of 2 Savings Account Account # 5000881576 C ERIvIA HIRSCH KAREN S HIRSCH DOD balance: $ 96,775.20 + 52.50 accrued intctcst Interest paid Ol-O1-2008 tbxu 12-23-2008 $1,552.58. YTD Account # 5130079477 C ERMA HIRSCH KAREN S HIRSCH DOD balance: $ 30,832.92 + 15.93 accrued interest Interest paid O1-Ol -2008 thru 12-23-2008 $433.62 YTD Established: 02-23 -1999 Established: 04-14-1983 Investment Account The decedent maintained Investment Account 43792269 & 68279803. For fiuther information, you may call the Brokerage Department at 1-800-762-6111. Please note that this office provides date of death balances for deposit accounts (IItAs, CDs, Checking and Savings). We do not process any IInanciai transactfions or provdde statements. If you need assistance with any of these items, please call 1-888-1'NC-BANK (1-888-762-2265} or stop by your local 1'NC Bank branch office. Sincerely, National Financial Services Center PNC Back, N.A. Member FDIC Page 2 of 2 ~~s~x 499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-l2 Stone La Favor & Shekletski Attorneys At Law 414 Bridge Street Post Office Box E New Cumberland, Pennsylvania 17070 Re: Estate of C Erma Hirsch .Social Security • 207-07 7376 Date of Death • December 23 2008 Phone (888)502-4349 Fax (302)934-2955 February 5, 2009 Dear Sir or Madam: Per your inquiry dated January 28, 2009, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1 • Type ofAceount Account Number Savings Account 15004205984980 (hvnership (Names o~ Opening Date Balance on Date of Death Accrued /nterest Total Karen S Hirsch C. L~rma Hirsch, (Removed from accountl2/29/08) 6/4/91 ~ 45, 538.78 ~ 3. SS .S' 45,542.33 Please be advised, there was no safe deposit box found for the above decedent. * If upon reviewing the information above, you believe there are additional accounts not referenced, please provide us with an acrnunt 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 West Shore Plaza Oflice # 717-255-2271. Sincerely, Tracie Hare Adjustment Services niui. IV. LVV/ T. IV~~11 it u. UJJJ ~ I ~PNC Fax ~~~~ TO Jennifer / Stone, LaFaver & Shekletskl PHONE ~ FAX 7743869 DATE M,,rch18,2~ PAGES (INCLUDING COVER) ~ FROM Jeanne fdlller PHONE 717-730.2337 FAX 717-~~0-~24~ COMMENTS: Annuity Policy Information for C. Erma Hirsch {Dates Issued Added as requested) C. Erma Hirsch and Karen S. Hunch Accotmt 6827-9803 IVletlife Annuity Contract 8100579900 Issued 4/118006 Dau of Death Value 12838008 - $22b,485.83 loo other enacts in account. Erma Hirsch Account 4379-2269 Metlife Annuity Contract I1072954 Issued 11/17/1998 Date of Death Value 12838008 - X147,540.66 No other assets in account. 'tbt informrRion diselased is intended for information proposes only. is time sensitive and is subject to change. Also cote the information is provided from somas we bolieve m be reliable, however we are aot reaponsiblc for arars ar emission. Inves~mt decision sbodd bo based on approved published t~arch_ ClieQts nod to refor to PNC Iwestnurnrs' oa~rmrdivas and statemer-ts for accurate information pertaining to tbo spociiiCS of their account ~ of the published data. This fax may contain privileged and Confidential information intended only for the use of the addresse(s) named above. If the reader of this message is net the intended recipient or the employee ar agent responsible for delivering the message to the intended recipient{sl, please note that any dissemination, distribution or copying of this communication is strictly prohibited. Anyone who receives this communication in error should notify us immediately by telephone and return the original message to us at the address above via the U.S. Mail, or destroy the message in its entirety O Hard copy to follow d Hard copy to follow upon request ~ LOAe V~tle Important Investor Information: Securities and brokerage services are provided tiyr.BNG Investments LLC, member t ~ 83IIkt.,at~dlltGt FiNIL4 and S1PC. Annuities and ether insurance products era offered by PNC Insurance Services, Inc. a licensed insurance agency. r•Owar no~asw