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HomeMy WebLinkAbout06-22-09J 15056051058 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes County Code Year File Number PoBOx2sosol INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 RESIDENT DECEDENT 21 09 0342 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth _ _ _ _ __._ 149-14-9809 03/28/2009 ' 11/16/1917 ___ Decedent's Last Name Suffix Decedent's First Name MI Beamer ,Margaret R __ __ (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 C 2. Supplemental Return +,;„? 3. Remainder Retum (date of death prior to 12-13-82) ~.~ ~° 4. Limited Estate a"~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required death after 12-12-82) C~~ 6. Decedent Died Testate ~...; 7. Decedent Maintained a Living Trust __.... _ 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) C ":::~ 9. Litigation Proceeds Received 10. Spousal Poverty Credit (date of death ~ '.~ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number _._., John M. Eakin (717) 766-3172 Firm Name (If Applicable) - .......REGISTER OF WILLS USE ONLY -..a ~ c:~ c_-~s ,-, First line of address __ C , ~ C_,, r = .- 7 ~,_ Market Square Building -C~ `-' ~~ +~ ~ r-- r-r-: r- J , -. Sewnd line of address ; .~7 ~_ `I ~# .. _ ~Af~~ILED -'~: i City or Post Office State ZIP Code - - _ -' ~ _ Mechanicsburg PA 17055 a --I .~- ; , ~ ~-~-~, __ _ _ _ _ :, cn Correspondent's a-mail address: Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, 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. SIG UREIO^F,PER~SON SPONSIBLR~~(LIANG~ETURN DATA 1786 North`PSleadow Drive, Mechanicsburg, PA 17055 SIGNATUR F~PREP R O{THER THAN REPRESENTATIVE DATE ADDRESS - ~ Market Square Building, Mechanicsburg, PA 17055 PLEASE USE ORIGINAL FORM ONLY Side 1 15056051058 15056051058 15056052059 REV-1500 EX Decedent's Name: Margaret RECAPITULATION ~~~~~~~~~~~ R Beamer 1. Real estate (Schedule A) ............................................. 1 2. Stocks and Bonds (Schedule B) ....................................... 2. Decedent's Social Security Number 149-14-9809 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 4. Mortgages & Notes Receivable (Schedule D) ............................. 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ........ 5. 6. Jointly Owned Property (Schedule F) tr~~ Separate Billing Requested ....... 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested........ 7. ', 8. Total Gross Assets (total Lines 1-7) .................................... 8. 9. Funeral Expenses & Administrative Costs (Schedule H) ..................... 9. 134,700.00 200.00 2,554.95 137,454.95 29,161.07 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................ 10. ! 347.61 11. Total Deductions (total Lines 9 & 10) ................................... 11. 29,508.68 12. Net Value of Estate (Line 8 minus Line 11) .............................. 12. ' 107,946.27 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which >-- - ---- .._ - . _ .. _._. . ~._..._ ._...... _ . an election to tax has not been made (Schedule J) ........................ 13. I 14. Net Value Subject to Tax (Line 12 minus Line 13) ........................ 14. ' 107,946.27 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES ~.. ~~~~~ ~ __ ~~ 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 _ _ __ i _.__ . 16. Amount of Line 14 taxable __ _ ... ~ at lineal rate X .0 45 107,946.27 ' 16, ': 4,857.58 17. Amount of Line 14 taxable at sibling rate X .12 ' ', 17. 18. Amount of Line 14 taxable at collateral rate X .15 ', 18. 19. TAX DUE ........................... ..............................19.! 4,857.58 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT r 15056052059 Side 2 15056052059 REV-1500 EX Page 3 Decedent's Complete Address: FIIe Number 2.1_-- 09 ...0342 DECEDENT'S NAME DECEDENT'S SOCIAL SECURITY NUMBER Margaret R Beamer 149-14-9809__ STREET ADDRESS 903 16th Street CITY STATE ZIP New Cumberland PA 17070 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) 4,857.57 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 255.65 Total Credits (A + B + C) (2) 255.65 3. InteresUPenalty if applicable D. Interest E. Penalty - Total InteresUPenalty (D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 4,601.92 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58) 4,601.92 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 :......................................................................................... . ^ 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 "intrust for" or payable upon death bank account or security at his or her death? ............. . ^ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ....................................................................................................................... . ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (O) percent [72 P.S. §9116 (a) (1.1) (ii)J. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or forthe use of the decedent's siblings is twelve (12j 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+ ili•G8j i Pennsylvania SCHEDULE A DEPARTMENT OF REVENUE REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Margaret R. Beamer 21-09-0342 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. If more space is needed, insert additional sheets of the same size. OMB NO. 2502-0265 ~If A. B. TYPE OF LOAN: U.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT 1.~FHA 2.QFmHA 3.^CONV.UNINS. 4.~VA 5.^CONV.INS. SETTLEMENT STATEMENT 6. FILE NUMBER: BIXLER L 7. LOAN NUMBER: 0234144558 8. MORTGAGE INS CASE NUMBER: C. NOTE: This /orm is furnished to give you a statement o/actual settlement costs. Amounts paid fo and by the settlement agent are shown. Items marked '7POCJ" were paid outside the closing; they are shown here /or informational purposes and are not included in the totals. 1.0 3I9B tBIXIER.I.p/tl/BIX~E R. V35) D. NAME AND ADDRESS OF BORROWER: LAURIE L. BIXLER and ZACHARY R. SELLERS E. NAME AND ADCRESS OF SELLER: Nancy Ann Rider, Executrix of the Estate of Margaret Beamer F. NAME AND ADDRESS OF LENDER: SUNTRUST MORTGAGE, INC. 2651 CARNEGIE ROAD YORK, PA 17402 G. PROPERTY LOCP,TION: 903 16TH STREET NEVV CUMBERLAND, PA 17070 H. SETTLEMENT AGENT: 23-2402316 PURITY ABSTRACT COMPANY I. SETTLEMENT DATE: Jun 19 2009 Cumberland County, Pennsylvania PLACE OF SETTLEMENT Cen!ury 21 Piscioneri Realty, Inc. 3315 Markel St, Camp Hill, PA e , J. SUMMP,RY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION 100. GROSS AMOUNT DUE FROM BORROWER: 400. GROSS AMOUNT DUE TO SELLER: 101. Contract Sales Price ~ 134,700.00 401. Contract Sales Price ~ 134,700.00 102. Personal Pro ert 402. Personal Pro e 103. Settlement Char es to Borrower Line 1400 3,574.59 403. 104. 404. 105. 405. Ad'ustments For Items Paid B Seller in advance Ad'ustments For Items Paid B Seller in advance 106. Count/Boro Taxes 06/19/09 to 01/01/10 242.06 406. Coun /Born Taxes 06/19/09 to 01/01/10 2q2 06 107. Gi Tax to 407. Ci Tax to 108. School Tax 06/19/09 to 07/01/09 27.36 408. School Tax 06/19/09 to 07/01;09 ~ 27.36 109. 2ND OTR TRASH 06/19/09 to 07/01/09 5.62 409. 2ND OTR TRASH C6/19/09 to 07/01/09 5.62 110. 410. 111. 411. 112. 412. 120. GROSS AMOUNT DUE FROM BORROWER 138,549.63 420. GROSS AMOUNT DUE TO SELLER 134,975.04 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER: 201. De osit or earnest mone 2,000.00 . 501. Excess De osit See Instructions 202. Princi al Amount of New Loans ' 132,259.00 502. Settlement Char es to Seller Line 1400 13,436.27 203. Existin Loans taken sub ect to 503. Existin loans taken sub ect to 204. 504. Payoff of first Mortgage 205. 505. Pa Doff of second Mort-a e r06. 506. ''-07 507. De osit disb. as roceeds '08. 508. !09. 509. Ad'ustments For Items Un aid B Seller Ad'ustments For Items Un aid B Seller ?10. Coun /Boro Taxes to 510. Coun /Boro Taxes to !11. Cit Tax to 511. Ci Tax to '.12. School Tax to 512. School Tax to !13. SELLER ASSIST/TAX PRORATION 269.42 513. SELLER ASSIST/TAX PRORATION 2gg.g2 14. 514. 15. 515. ! 15. 516. !17. 517. INHERITANCE TAX PYMT to REGISTER OF WILLS 4,601.92 !18 518. !19. 519. '20. TOTAL PAID BY/FOR BORROWER 134,528.42 520. TOTAL REDUCTION AMOUNT DUE SELLER 18,307.61 I00. CASH AT SETTLEMENT FROM/TO BORROWER: 600. CASH A'i SETTLEMENT TOIFROM SELLER: .01. Gross Amount Due From Borrower Line 120 138,549.63 601. Gross Amount Due To Seller Line 420 134,975.04 .02. Less Amount Paid By/For Borrower (Line 220) ( 134,528.42) 602. Less Reductions Due Seller (Line 520) ( 18.307.61 03. CASH(X FROM) ( TO) BORROWER 4,021.21 603. CASH(X TO) ( FROM) SELLER 116,667.43 The undersigned hereby acknowledge receipt of a completed copy of pages 1&2 of this statement & any attachments referred to herein. Borrower '' ~ 9 r _ . ~~ z NARY R.`SE L 'TOTAL SELLER ASSISTANCE 57,800.73 Seller~~ ~~~ L,y~) .~~~ NANCY ANN IDER, EXECUTRIX "`~~~CCC/// L. SETTLEMENT CHARGES Page 2 00. TOTAL COMMISSION Based on Price $ 134 700.00 @ 3.0000 % 4,041.00 Pnlo FROM Pnlo FROM Division o(Commission (line 700) as Follows: eoRROwER~s sEUER~s 01. $x,041.00 to CENTURY 21 PISCIONERI REALTY, INC. FuNOS AT FUNDS AT 02. $ to CENTURY 21 PISCIONERI REALTY, INC. seTTLEMENT ssTnEMENT 03. Commission Paid at Settlement 4,041.00 04. TRANSACTION FEE to CENTURY 21 PISCIONERI REALTY, INC. 225.00 00. ITEMS PAYABLE IN CONNECTION WITH LOAN C1. Loan Origination Fee 0.9828 % to CENTRAL PA MORTGAGE LLC 1 299 85 02. Loan Dtscounl 0.7500 % to SUNTRUST MORTGAGE, INC. 991 94 03. Appraisal Fee to RIDGE MARKETING ASSOCIATE 400 00 04. Credit Report to FAFDS . 11.05 O5. Tax Service Fee to VALUTREE SERVICES 83.00 06. Flood Cert Fee to FAFDS 8 00 07, Tax Service Fee to 08. JV Processing Fee SUNTRUST POC $500.00 09. Commitment Fee to SUNTRUST MORTGAGE, INC. 500.00 10. 11. 00. ITEMS REOUlRED BY LENDER TO BE PAID IN ADVANCE 01. Interest From 06/19/09 to 07/01/09 @ $ 15.850000/day ( 12 days %) 190 2 02. Mort a e Insurance Premium for months to HUD 2 274 74 03. Hazard Insurance Premium for 1.0 ears to STATE FARM 566.00 04. O5. 000. RESERVES DEPOSITED WITH LENGER 001. Hazard Insurance 3,000 months $ 47.33 er month 141 99 002. Mort a e Insurance months $ 59.13 er month 003. Count /Boro Taxes 5.000 months $ 36.81 er month 184.05 004. Ci Tax months $ er month 005. School Tax 13.000 months @ $ 67.95 per month 883.35 D06. months $ er month 007. months $ er month 008. AGGREGATE ADJUSTMENT months $ er month -241 79 100. TITLE CHARGES 101. Settlement or Closin Fee to 102. E-Mail Document Retrieval to PURITY ABSTRACT COMPANY 50.00 103. Title Examination to 104. Title Insurance Binder to 105. Document Preparation to ATTORNEY JOHN M. EAKIN DEED/POC 106. Nola Fees to NOTARY CLERK '$20.00 25.00 107. Attorney's Fees to includes above item numbers: 108. Title Insurance to PURITY ABSTRACT COMPANY P.09-194 1 033.75 includes above item numbers1101, 1103 -BASIC RATE 109. Lender's Coverage $ 132,259.00 106275470PASL 110. Owner's Coverage $ 134,700.00 1G6873895PAO 111. PA EiJD: i00, 300, 900 to PURITY ABSTRACT COMPANY 150.00 112. PA SHORT FORM POLICY PURI1' ABSTRACT COMPANY N/A IF NO FEES ENTERED 113. Insured Closing Letter to First American Title Insurance Company 35.00 114. Overnight Fee/package to PURITY ABSTRACT COMPANY 12 00 115. TAX CERT FEE to PURITY ABSTRACT COMPANY 10.00 116. RADON TEST to AA HOME INSPECTION 100.00 117. 118. 200. GOVERNMENT RECORDING AND TRANSFER CHARGES ?01. Recording Fees: Deed $ 49.50; Mortgage $ 66.50; Releases $ 116.00 202. Cit lCoun Tax;Stam s: Deed 1,347.00 Mort a e 1,347.00 ?03. State Tax/Slam s: Revenue Stam s 1,347.00; Mort a e 1,347.00 204. RECORDER OF DEEDS 205. RECORDER OF DEEDS 300. ADDITIONAL SETTLEMENT CHARGES 301. Surve to 302. Pest Ins ection to SUDDEN DEATH TERMITE 8 PEST CONTROL 40.00 303. PAINTING to FOP.NEYS REMODELING 575.00 304. 2ND OTR SEWER to NEW CUMBERLAN BOROUGH '$7.77 58.95 305. 2009 COUNTY/BORO TAX to ROBIN CASPERETTI, TAX COLLECTOR 450.78 100. TOTAL SETTLEMENT CHARGES (Enter on tires 103, Section J and 502, Section K) 3,574.59 13,436.27 iy signing page t of mis slalemeni, the signalone5 acknowleoge receipt of a compleleo copy of page 2 0/ this M1vo page statement / ,~~~ , PURITY TRACT CO 1PANY Settlement P.gent certified to be a true copy. ( BIxIER.I / BIXLE R.L / 36 1 REV-1508 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Margaret R. Beamer 21-09-0342 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointlyowned with right of survivorship must be disclosed on Schedule F. (Ir more space is needed, insert additional sheets of the same size) REV-1509 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY OWNED PROPERTY ESTATE OF FILE NUMBER Margaret R. Beamer 21-09-0342 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• Nancy Rider 1786 North Meadow Drive Daughter Mechanicsburg, PA 17055 B. 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. DATE OF DEATH VALUE OF ASSET k OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST ~ • A• Zt3~~ Americhoice Federal Credit Union Acct. 40500 see attached , 5,109.89 o 50 /0 2,554.95 TOTAL (Also enter on line 6, Recapitulation) I S 2,554.95 (If more space is needed, insert additional sheets of the same size) AmeriChoice ~ F E D E R A L C R E D I T U N I O N 2175 Bumble Bee Hollow Road • P.O. Box 1429 Mechanicsburg, PA 17055 ~ Phone (717) 697-3474 - (800) 240-4364' MN'CUA ___ MARGARET R BEAMER 903 16TH ST NEW CUMBERLAND PA 17070-1519 WITH 400 MEMBER REWARD POINTS YOUR NEW LEVEL WILL BE: WHITE RIBBON MEMBERS YOU CAN GET FREE UNLIMITED ATM TRANSACTIONS. ASi~ IIS HOW! Notice: See revarae side for important information regarding your right to dispute errors on your statement. ACCOUNT NUMBER: 40500 YTD DIV RECEIVED: 11.20 PAGE NIIMBER: 1 of 2 There is no shortage of Mortgagee at AmeriChoice! Find the right mortgage for your needs! SII1~IlriARY OF YOUR ACCOUNTS ~ SUFFIX O1 SENIOR SHARES ~ I SIIFFIX 16 DIVIDEND DRAFT ~ JOINT: NANCY A. RIDER I STATEMENT PERIOD 03/01/09 - 03/31/09 STATEMENT PERIOD 03/01/09 - 03/31/09 ~ BEGINNING BALANCE 20.08 BEGINNING BALANCE 5,111.86 ~ DEPOSITS 3 6,009.25 DEPOSITS 1 3.03 ) WITHDRAWALS 2 30.13 WITHDRAWALS 1 5,106.86 ~ DRAFTS CLEARED 11 597.42 ENDING BALANCE 8.03 ~ ENDING BALANCE 5,401.78 ~ DIVIDEND YEAR-TO-DATE 10.27 ~ DIVIDEND YEAR-TO-DATE .93 DIVIDEND THIS PERIOD 3.03 ~ DIVIDEND THIS PERIOD .39 AVERAGE DAILY BALANCE 4,782.39 ~ AVERAGE DAILY BALANCE 926.35 DAYS DIVIDEND EARNED 31 ~ DAYS DIVIDEND EARNED 31 ANNUAL PERCENTAGE ( ANNUAL PERCENTAGE ~ YIELD EARNED 0.758 ~ YIELD EARNED O.SOg 11408 SIIFFIX O1 SENIOR SHARES. HISTORY DATE DESCRIPTION TRANSACTION AMOUNT ACCOUNT BALANCE 3/30/09 TO 40500-16 5,106.86- 5.00 3/31/09 DIVIDEND 3.03 8:03 SIIFFIX 16 DIVIDEND DRAFT HISTORY DATE DESCRIPTION TRANSACTION AMOUNT ACCOUNT BALANCE 3/02/09 Draft Number _1238 4.77- 15.31 a/:.~/v7 .,~ TRcASiir:x 6U3 902.00 ~ 917.31 3/03/09 US TREASURY 303 SOC SEC 3/10/09 Draft Number 1241 73.29-~~'' 844.02 3/09/09 Embarq BILL PYMT 3/11/09 Draft Number 1245 150.00- / 694.02 3/11/09 HOME DEPOT/EXPO CHECK PYMT 3/11/09 Draft Number 1244 76.00- /' 618.02 3/11/09 Draft Number 1242 6.70- / 611.32 3/13/09 Draft Number 1243 6.39- v' 604.93 3/26/09 PPL EU 25.49- / 579.44 3/26/09 PPL EU ELEC SVC 3/26/09 PAWC 4.64- ~ 574.80 3/26/09 PAWC PAYMENT 3/26/09 Draft Number 1251 18.63- / 556.17 3/27/09 Draft Number 1249 89.72- / 466.45 3/27/09 HOME DEPOT/EXPO CHECK PYMT 3/27/09 Draft Number 1247 130.00- ~ 336.45 3/27/09 Draft Number 1248 12.92- '~ 323.53 3/30/09 FR 40500-0 1 5,106.86 / 5,430.39 3/30/09 Draft Number 1246 29.00- / 5,401.39 3/31/09 DIVIDEND .39 ,,/ 5,401.78 AmeriChoice ~ F E D E R A L C R E D I T U N I O N ~ 2175 Bumble Bee Hollow Road • P.O. Box 1429__. Mechanicsburg, PA 17055 Phone (717) 697-3474 - (800) 240-4364'. _ `NCVAY ~ _ __. Notice: See reverae side for important information regarding your right to dispute errors on your statement. ACCOIINT NIIMBER: YTD DIV RECEIVED PAGE NUMBER: 40500 11.20 2 of 2 11409 SUFFIX 16 DIVIDEND DRAFT (CONTINUED) DEPOSITS " DATE DESCRIPTION TRANSACTION AMOUNT LOCATION 3/03/09 US TREASURY 303 902.00 US TREASURY 303 SOC SEC 3/30/09 FR 40500-01 5,106.86 3/31/09 DIVIDEND .39 OTHER DEDUCTIONS DATE DESCRIPTION TRANSACTION AMOUNT LOCATION 3/26/09 PPL EU 25.49 PPL EU ELEC SVC .5/Lb/V7 PAwc 4.64 PAWL -- PAYMENT DRAFTS/CHECKS CLEARED (* DENOTES MISSING DRAFT SEQUENCE NUMBER) DRAFT# AMOUNT DATE DRAFT# AMOUNT DATE DRAFT# AMOUNT DATE 1238 4.77 3/02 1243 6.39 3/13 1246 29.00 3/30 1241 * 73.29 3/10 1244 76.00 3/11 1247 130.00 3/27 1242 6.70 3/11 1245 150.00 3/11 1248 12.92 3/27 3/03/09 3/26/09 3/26/09 DRAFT# AMOUNT DATE 1249 89.72 3/27 1251 * 18.63 3/26 REV-1511 EX+ (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES 8~ ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Margaret R. Beamer 21-09-0342 Debts of decedent must be reported on Schedule I, ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: t' Parthemore Funeral Home 11,394.07 2• Flowers 212.00 s. Reception 859.84 4. Gingrich Memorials, lettering monument 135.00 e. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)lEIN Number of Personal Representative(s) Street Address City .State Year(s) Commission Paid: 2. Attorney Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees ~. Cumberland Law Journal, estate notice $. The Sentinel, estate notice s. Register of Wills -Filing Fee 10. Cost of Selling Real Estate - Realtor Commission -Transfer tax -Sellers Costs Zip 2,500.00 Zip 302.00 75.00 198.16 15.00 4,041.00 1, 347.00 8,082.00 TOTAL (Also enter on line 9, Recapitulation) I $ 29,161.07 (If more space is needed, insert additional sheets of the same size) REV-.512 EX+ (12-C8~ -i, pennsylvania SCHEDULE I DEPARTMENT Of REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Margaret R. Beamer 21-09-0342 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. If more space is needed, insert additional sheets of the same size. REV-1513 EX= (11-OS) i pennsylvania SCHEDULE ~ DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Margaret R. Beamer 21-09-0342 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Nat List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1. Nancy Ann Rider formerly known as Nancy Ann Grissinger Daughter Entire Estate 1786 North Meadow Drive, Mechanicsburg, PA 17055 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, A S APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN 1. 6. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ If more space is needed, insert additional sheets of the same size. LAST WILL AND TESTAMENT OF MARGARET R. BEAMER I, MARGARET R. BEAMER, of the Borough of New Cumberland,' County of Cumberland and State of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this my Last Will and Testament, hereby revoking and making void any and all prior Wills by me at any time heretofore made. 1. I direct the payment of all my dust debts and funeral expenses as soon after my decease as the same can be conveniently done. 2. I give, devise and bequeath all the rest, residus and remainder of my estate, real, personal and mixed, whatsoever and wheresoever the same may be situate, to my daughter, NANCY ANN GRTSSINGER, absolutely, uncondtionally and in fee simple. LASTLY, I nominate, constitute and appoint my daughter, NANCY ANN GRISSINGER, Executrix of this my Last Wi11 and Testament. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~_~ day of August, A. D., 1983. ~, .~ ,.~ , r~ ~~L ~~ V ~ ~/ ~,` ti~ C` _' 4 ~• ~ ----~-~ SEAL ) l~ 4 F ar~aret R. Beamer Signed, sealed, published and declared by the ab©ve s named, Margaret R. Beamer, as and for her Last Will and Testament, in the presence of us, who have subscribed our names hereto as witnesses, at the request of said testatrix, in her presence and in the presence of each other. ,~J ~~ - - - .. ,~ ._--- ~, ,, ~ ~~