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HomeMy WebLinkAbout08-03-09J 15D5607120 REV-1500 Fx (06.05) OFFICU\L USE ONLY PA Department of Revenue Bureau of Individual Taxes county cave v~r Fib numoer Po Box.2eosot INHERITANCE TAX RETURN Harrisburg, PA 1712&0501 RESIDENT DECEDENT 2 1 0 9 0 0 0 2 6 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 191 26 7058 O1 02 2009 12 03 1914 Decedent's Last Name SutFlx Decedent's First Name MI BELL, JR. WHITFIELD J (H Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name Spouse's Sottial Security Number FILL IN APPROPRIATE OVALS BELOW X^ 1. Original Return ` ~ 4. Limited Estate g, Detetlen[oied Testate LJ (Attecn LOGY OI WIip MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 2. Supplemental Realm ~ 3. Remainder Retum (date of death prior to 12-13-82) ya Future Interest Compromise ~ 5. Federal Estate Tax Retum Required (tlete oPoeaN eflar 12-12-82) ~, Deadent~ lm T eE)a LiNng Trust Q B. Total Number of Sefe Deposit Bwces (Ade<h C C 9. Litigation Proceeds Received ~ 10. Spwsat Poverty Crotlit !date M tlealh 11,Eleclion tc tax under Sec. 9113(A) Oelween 12-37-97 entl 11-7-95) ~ (Alteoh SCh. O) CORRESPONDENT -THIS BECTON MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TA%INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number JAMES D. FLOWER, JR. ESQ 717 24~ 6222!v Firm Name (e Applicable) - ~~~II.. -, REGLSTERQ _ {LLB U:~ryNL1I SAIDIS r FLOWER & LII3DSAY r ~y r^ ~. First Ilne of address ~ ~ 7Crni W r ~` ~~ 26 WEST HIGH STREET ~~~ -o `-~ '"? ~~ ~ 3 Second line of adtlress ~~ N - ..' `~l W City or Post Offlee DATE FILED t,0 State ZIP Code CARLISLE PA 17013 Correspondent's e-mail address: and to the Vest of my of which preparer has Susan B. Smith James D. Flower, Jr. Esq PA 19129 West PA 17013 Side 1 L 1505607120 DATE 150560712D PA Inheritance Tax Return Signature of Additional Fiduciaries IESTATEOF 121-09-00026ER Bell, Jr., Whitfield J. Under penalties of perjury, I dedare that I have examined thls return, induding accompanying schedules and statements, and to the best of my knowledge and belief, It is true, correct and complete. Dedaredon of preparer other than the personal representative is based on all information of which preparer has any knowledge. Signature #2 Name Address1 Address2 City, State, Zip D. Flower. Jr. Date Carlisle, PA 17013 ~~°-~-- 1505607220 REV-1500 EX Decedent's Social Security Number oe~ae~rsName: Whitfield J. Bell, Jr. 191 26 7058 RECAPITULATION 1 . Real Estate (Schedule A) .................................................................................. .... 1. 1 7 7, 6 7 0. 0 0 2. Stocks and Bonds (Schedule e) ................................. - .,.,,.,.. ............................ . ,,, 2. 7 3 1, 7 2 6. 2 1 3. Closely Heid Corporation, Partnership or Sole-Proprietorship (Schedule C)...... .... 3. 4. Mortgages & Notes Receivable (Schedule D) ............................._................... .... 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............ .... 5. 4 9 , 5 0 6 . 9 7 6. Jointly Owned Property (Schedule F) ~ 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 5 8, 9 0 3. 1 8 9. Funeral Expenses & Administrative Costs (Schedule H) .................................... .. 9. 2 4 , 3 3 7 . 2 0 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ........................... ..... 10. 2 5 , 3 5 4 . 7 0 11. Total Deductions (total Lines 9 & 10) ............................................................... .. 11. 4 9 , 6 9 1 . 9 0 12. Net Value of Estate (Line 8 minus Line 11) ............................._....................... ... 12. 9 O 9 , 2 1 1 . 2 8 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ............................................ .. 13. 6 4 , 0 0 0 . 0 0 t4. Net Value Subject to Tax (Line 12 minus Line 13) ............................................ .. 14. 8 4 5 , 2 1 1 . 2 8 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.z) x .o0 0. 0 0 15. 0. 0 0 16. Amount of Line 14 taxable at lineal rate X .045 0. 0 0 16. 0. 0 0 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 8 4 5, 2 11.2 8 16. 12 6, 7 8 1. 6 9 19. Tax Due .............................................................................................................. . 19. 1 2 6, 7 8 1. 6 9 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ^ Side 2 1505607220 1505607220 J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-09-00026 DECEDENT'S NAME Whitfield J. Bell, Jr. STREET ADDRESS Apt 1E, Todd Circle CITY STATE ZIP Carlisle PA 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) 1 26,781.68 2. CrediLSlPayments A. Spousal Poverty Credit B. Prior Payments 118,500.00 C. Discount 6,238.84 TotalCredits (A +g+C) (2) 124,736.84 3. InteresVPenalty if applicable '- p. Interest E. Penalty Total InterestlPenalty (D + E) (3) 4. If Line 2 is greater than Line 7 + Line 3, enter the difference. This is theDVERPAYMENT. (4) Check box on Pape 2 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is fheTAX DUE (5) 2, 044.85 A, Enter the interest on the tax due. (SA) B. Enter the total of Line 5 + SA. This is theBALANCE DUE (SB) 2 , 944.85 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 fhe use or Income of the Properly transferred :............................................................................. [~ Ox b, retain the fight 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? ........................................................... ^ ^x 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 Wst for' or payable upon death bank account or secudty at his or her death?......... ^ [~ 4. Did decedent own an Individual Retirement Arxrount, annuity, or other non-probate property which contains a beneficiary desi9naUOn? ................................................................................................................ ^ 0 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 rata 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 attar January 1, 1995, the hex 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 statuteQQ_es not exemota 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 rete 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 adopflve parent, or a stepparent of the child is zero (0) percent [72 P.S. §9116 (a) (1.2)]. The lax 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) p2 P.S. §9116 (a) (1 )]. The tax rate imposetl on the net value of Vansfers 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. Rw-7502 FXi (B-88) SCHEDULE A l REAL ESTATE COMMONWEi1LTH OF PENN6YLVANM UiHERRPNOE TAXRETURN RE6IDENT DECEDENT ESTATE OF (FILE NUMBER Bell, Jr., Whitfield J. 21-09-00026 All real propary ownatl wbty or as a bnanl In wmmon moat ba ropartetl al hlr market value. Feir market value is tlelined as the price at which Drapery wpultl De exchan0eo between a willing buyer and a w01in8 se0er, ne0her beMg amPolied to buY or eeN, boN Ravkp reasonable know4etlBe Dribs relevant teuis. Rol propany whkh N )olntlyownatl whh n6M or survNOnhlp mutt be tllaelwstl on achetlule F. Qt more apace i6 treaded, edditlonel psge6 of the same srze) Copydght (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 ScheduleA (Rev. 6-98) Rsv150J FXi (8.98) SCHEDULE B STOCKS & BONDS DOMMDNWERLTH OF PENNSYLVANIR INHERITgNCE ~P% RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Bell, Jr., Whitfield J. 21-09-00026 All property lalndyowned with rlahl of survHOnhip mutt be dlsebsed on SchWuls F. ITEM NUMBER CUSIP NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OF DEATH 1 800 shares of South Jersey Ind, Inc. 40.265 32.212.00 2 VKM Penn Value Income Tr 8.7150 28.271.48 3 003554OX3 $1,500,000 Abington PA Sch Dist -CPN 4.05°/. Due 1.055390 15.830.85 3/15/2015 4 oo3ssase3 $1,000,000 Abington PA Sch Dist - 4.25% Due .83148 8.314.60 9/15/2028 5 o1636aan $1,500,000 Aliquippa PA Sch Dist -CPN 4.85% Due .905550 13.583.25 1210112029 5 OS873RBK8 $1,000,000 Bally Boro PA -CPN 4.55% Due 11/1512023 .84478 8.447.60 7 o845aPeG2 $1,000,000 Berks County PA VocationalTechnical Sch .93789 9.378.90 Auth Berks Career - CNP 4.00°k Due 06I01i2018 $ 184788DH7 $1,000,000 Berlin Brothers Valley Sch Dist PA -CPN .883330 8.833.30 4.200% Due 09/01/2023 9 142508HP8 $1,500,000 Carlisle PA Area Seh Dist GIO UNLTD BIE 13.438.85 OID FGIC -CPN 4.125% Due 03/01/2022 10 165573RV0 $1,500,000 Center Area Sch Dist PA G(O UNLTD 8/E .891540 13.373.10 OID FSA -CPN 4.1350°/p Due 12101/2024 11 165573RV0 $1,000,000 Chester County PA G/O UNLTD B/E OID - .930320 9.303.20 CPN 4.150% Due 11/15/2024 Total of Continuation Schedules See attached es TOTAL (Also enter on Line 2, Recapitulation) 731,726.21 (If more space is needed, additional pates of Me same size) Copyright (c) 2002 form software only The Lackner Group. Inc. Form PA-1500 Schedule B (Rev. 6-98) Rev-758] EX« (8A8) SCHEDULE B STOCKS & BONDS continued LOMMONWERLIH OF PENNSYLVgNU INNERITI.NCE TF%RETIMN RESIpENr OECEOEM ESTATE OF (FILE NUMBER Bell, Jr., Whitfield J. 21-09-00026 ITEM NUMBER CUSIP NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE pF DEATH 12 zzz283FPS $2,500,000 Couneil Rock PA S/D REGOFGIC -CPN 1.015310 25,382.75 4.75°!o Due 1 111 51201 7 13 2A6008KL9 $3,000,000 Delaware Cnty PA Auth niv Rev .906040 27,181.20 Ref-Villanova Univ B/E OID MBIA -CPN 4.20Y. Due 08/01/21 14 248008KL9 $1,500,000 Delaware Cnty PA Auth UNIV Ref-Villa .920080 13,801.20 Nova Univ OID MBIA -CPN 4.125% Due 08/01/20 15 2a6343DV6 $1,000,000 Delaware RIV JT Toll Brdge Commn .918240 9,182.40 Pennsylvania Brdg REV OID -CPN 5.00°1e Due 07101/28 18 z59gsTJV'r+ $1,500,000 Derry Penn Area School Dist REF Ser C .944780 14,171.70 GO UnLTD REG FGIC -CPN 4.50% Due 02/01/21 17 275839CH9 $1,000,000 East Whiteland Twp PA Prerefunded Ser A 1.028850 10.286.50 G/O UNLTD REG OID FSA -CPN 5.00% Due 05101/19 1g 275839CLO $1,500,000 East Whiteland Twp PA Unrefunded 1.014310 15,214.65 Balance SER A G/O UNLTD REG OID FSA -CPN 5.00% Due 09/01/19 19 395704FV8 $2,000,000 Greensburg Salem PA Sch Dist Ref G/O .979820 19.596.40 UNLTD B/Q Reg OID FSA -CPN 3.80% Due 01/01/18 20 a69393cs5 $1,500,000 Kennedy Twp PA G/O Unltd B/Q REG OID 1.002250 15,033.75 FSA -CPN 3.70% Due 09/01/16 y1 s1ao5Texs $1,000,000 Lancaster PA Solid Wast Auth Srs 98 AMT .854940 9,549.40 AMBAC -CPN 5.00% Due 12/15/14 Copyright (c) 2002 form software only The Lackner Group, Inc. Forth PA-7500 Schedule B (Rev. 6-98) SCHEDULE B STOCKS & BONDS continued LOMMOMNEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDEM DECEDEM ESTATE OF (FILE NUMBER Bell, Jr., Whitfield J. 21-09-00026 ITEM NUMBER CUSIP NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OF DEATH 22 613579Ti8 $1,000,000 Montgomery Cnty PA Ser C G/O UNLTD 8.512.10 B/E OID -CPN 4.25% Due 12/15/31 23 66sa9tMxz $3,000,000 Norristown PA Area Sch DB REF B/E OID 23,601.30 FGIC -CPN 4.375% Due 09/01/33 24 B56497MV6 $2,500,000 Norristown Penn Area Sch Dlst G/O 21,059.00 UNLTD B/E OID FGIC -CPN 4.25% Due 09/01/26 y5 7091713Ua $2,000,000 Northeastern York PA S/D G/O UNLTD B/E .862720 17.254.40 XLCA -CPN 4.5% Due 03101/26 26 100 shares of NUV TAX FR PA INSD 267 S 89.74 8.974.00 27 NUVEEN TAX EX 269 PA SA 71.16 10,674.00 28 10 shares of PA IMIT 226 S 349.83 3.498.30 29 10 shares of PA INS MUNINC TR 84 S/A 20D.7500 2,007.50 30 $1,000,000 PA ST -CPN 5.0% DUE 06/01/25 .97978 9.797.80 31 10 shares of PENN I M I T #92S SER 87.67 876.70 32 10 shares of PENNSYLVANIA IMIT 100S 119.31 1,193.10 33 70977NBU7 $1,500,000 Pennsylvania ST Higher ED FRCS AUTH .877480 13.162.20 REV YORK COLL -CPN 5.00 Due 11/01/33 34 Tosn~3ua $1,000,000 Pennsylvania St Higher EDL FACS Auth .893110 ~ 8,931.10 College & Univ Revs TR -CPN 4.625°~ Due 07/15/30 it Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 6-98) Raw150J E%~ Ieaei SCHEDULE B STOCKS & BONDS continued COMMONWEALTH OF PENNSYLVANW INHERITANCE TA%RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER Bell, Jr., Whitfield J. 21-09-00026 ITEM NUMBER CUSIP NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OF DEATH 35 To9nREn $1,000,000 Pennsylvania St Higher EDL FACS Auth .834870 8.348.70 Rev Temple Univ B/E OlD MBIA -CPN 4.500Y. Due 04/01 /2031 36 70917RNY4 §1,000,000 Pennsylvania st Higher EDL Thomas .80236 8,023.60 Jefferson Univ Ser B B/E OID AMBAC -CPN 4.125% Due 09/0112026 37 T22T40NXt $1,000,000 Pine Richland SID PA SER E REG Bi0 G/O 1.008030 10,080.30 UNLTD FGIC INSD -CPN 5.00% Due 07/15/20 3g Tzs2rs7ns ;1,500,000 Pittsburgh PA Sch Dist SER 8 G/O LTD .858540 12,878.10 B/E OID MBIA -CPN 4.40% Due 09/01/25 39 Ta5oe7oN2 $2,000,000 Punxsutawney PA Area Sch Dist Ref G/O 17,292.40 UNLTD REG OID FGIC -CPN 4.45% Due 10/15/25 40 750514RJ2 ;1,000,000 Radnor Twp PA G/O UNLTD B/E MBIA - .793750 7,937.50 CPN 4.25% Due 11/01/35 41 Ts55~UG5 51,500,000 Reading PA Sch Dlat G/O UNLTD BIE OID 13.069.65 FSA -CPN 4.450% Due 03/01/27 42 788a5TCZe 51,500,000 Ridley S/D GP PA DELA CO FGIC INSD .974560 14.618.40 REG -CPN 5.000'/e DUE 11/15/22 43 810827MS1 $1,500,000 Scranton Penn Sch Dst G/O UNLTD REG .94357 14,153.55 MBIA -CPN 5.000% due 04/01/25 44 619215ML5 $1,500,000 Shaler PA Area Sch Dist SER A G/O 16,405.95 UNLTD FSA REG OID -CPN 5.125°k DUE 09101/25 Copyright (c) 2002 Corm sotlware only The Lackner Group, Inc. Fonn PA•1500 Schedule B (Rev. 698) Rew15°] E%t IEAR) SCHEDULE 6 STOCKS & BONDS continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAY RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER Bell, Jr., WhitFleld J. 21-09-00026 ITEM NUMBER CUSIP NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE pF DEATH 45 819747A35 $1,500,000 Sharon PA San Auth Swr REV GTD B/E .847930 12,718.95 OID FSA -CPN 4.300% DUE 10/01/27 q8 a41350JL8 $5,500,000 Southeast Delco Sch Dist PA GIO UNLTD 45,689.60 B/E -CPN 4.250% DUE 10/01/25 47 843278470 $1,500,000 Southern Lehigh PA S/D SER AA GIO .876720 13.150.80 UNLTD B/E OID FSA ST AID WITHHLDG -CPN 4.500% DUE 09/01127 48 85732PBP4 $2,000,000 State Pub Sch Bidg Auth B/E OID -CPN .734740 14,694.80 4.25% DUE 10/01/32 49 709207CK8 $2,000 State Pub Sch Bldg Auth PA Ref Richland Sch 800.1 16,002.00 Dist Proj REG FGIC -CPN 4.35Yo DUE 11/15/30 50 857322P70 $2,000,000 State Pub Sch Bldg Auth PA Sch REV .890580 17,811.60 Appollo-Ridge Sch Dist B/E OID XLCA -CPN 4.400% DUE 03/01/23 51 E98417KV3 $1,500,000 Trinity Area Sch Dist PA Gi0 UNLTD REG - .958990 14,384.85 CPN 4.300% DUE 11101/19 52 901039BZ9 $1,500,000 Tussy Mountain Sch Dist PA G/O UNLTD .827480 12.412.20 B/E XLCA -CPN 4.500% DUE 04/01/29 53 s385az~r~ $1,500,000 Washington Cnty PA SER A G/O UNLTD .80838 12,125.70 B/E OID MBIA -CPN 4.400YD DUE 09101/30 Copyright ic) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 698) Revd598 FXa (6.961 SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY fb61MONWERLTH OF PENN6riVRNIR INMERITRNCE TqX RETURN RE61pENT DECEDENT ESTATE OF PILE NUMBER Bell, Jr., Whitfield J. 21-09-00026 Intlutle the proceetla of IMpatlm end the tlak the proceeds wero recNvetl by the eskk. All property lolntlyowmtl vdth the rlpht o/ eurvNOrohlp muet be dkclosad on echstluk F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Cash for Interest from the Boenning & ScaNergood, Inc. -Interest income on 1040 1.840.36 form for 2008 2 Check from Unclaimed Property -Claim #100301294 138.03 3 Citibank, N.A. -Refund of Credit Balance on Account 10.15 4 United Church of Christ Homes -Interest on Security Deposit 1.68 5 Boenning & Scattergood, inc. -Investment Aeeount #8150-3425 1,942.51 Money Market 6 Boenning & Scattergood, Inc. -Cash Account 0.39 7 M & T Bank Account #2674057480 43.672.42 Accrued interest on Item 7 through date of death 1.30 8 Household Goods 250.00 9 Carlisle Regional Medical Center -Refund for overpayment of Invoice #7837063 32.85 10 Carlisle-The Sentinel -Subscriber Refund 25.03 11 Embarq -Refund of credit on account 11.75 12 Highmark Blue Shield • Check No 0059280332 Reimbursement 16.95 13 Independence Blue Cross -Check #3104185792 Reimbursement for Medical Costs 146.73 Total of Continuation Schedule See attached page TOTAL (Also enter on Line 5, Recapitulation) 49,506.97 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWERLTH OF PENNEVLVRNI~ continued INHERITANCE TPXgETURN RESIDENT OECEOENT ESTATE OF FILE NUMBER Bell, Jr., Whitfield J. 21-09-00026 {TEM DESCRIPTION VALUE AT DATE NUMBER OF DEATH 14 Pennsylvania Department of Revenue -Refund from 2008 I 40.00 15 ~ Refund from Sarah Todd Home -Check #052063 ~ 7,335.82 15 ~ Refund from the PA Department of Revenue ~ 40.00 TOTAL (Also enter on Line 5, Recapitulation) ~ 49,506.97 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) REV-0t57 IXa (7RA9) SCHEDULE H I - COMMONWEALTH OF PENNSYLVANIA I FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENr ESTATE OF I FILE NUMBER Bell, Jr., Whitfield J. 21-08-00026 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s) attached B. ADMINISTRATIVE COSTS: 1. Personal Representa0va's Commissions Social Security Number(s) / EIN Number of Personal Representative(s): Street Address City State Zip Year(s) Commission paid 2. Attorney's Fees Saidis, Flower 8 Lindsay g, Family ExempOOn: (If decedenYS address is not the same as dalmant's, attach explanation) Claimant Street Address City State zlp RelaOOnshlp of Claimant to Decedent 2,816.14 15,000.00 4. Probate Fees 710.00 5. Accountant's Fees 500.00 6. Tax Return Preparer's Fees 7. Other Administrative Costs 5,311.06 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 24,337.20 Copydght (c) 2002 form software only The Lackner Group, Inc. Form PA•1500 Schedule H (Rev. 6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Bell, Jr., Whitfield J. 27-09-00026 ITEM NUMBER DESCRIPTION AMOUNT Funeral Expenses 1 Dickinson College -Memorial Service Refreshments and Flowers 877.94 2 Hoffman Roth Funeral Home & Creamatory, Inc. -Service ID #15509-1 1.938.20 ti-A subtotal 2.816.14 Other Administrative Costs 3 Cumberland Law Journal -Advertise Estate Notice 75.00 4 Embarq -Account No. 717-249-8731-472 27.54 5 Mallon Electrical Contracting 1.510.84 6 Mallon Electrical Contracting 127.20 7 PECO Energy -Account No. 90071-01709 21.47 8 PECO Energy -Account No. 90071-01709 25.62 9 PECO Energy -Account No. 90071-01709 18.35 10 PECO Energy -Account No. 90071-01709 19.54 11 PECO Energy -Account No. 90071-01709 12.58 12 PECO Energy -Account No. 90071-01709 14.50 13 Philadelphia Gas Works -Account No. 5122253225 58.22 Copyright (c) 2002 form sofhvare only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Bell, Jr., Whitfield J. 21-09-00026 ITEM NUMBER DESCRIPTION AMOUNT 14 Philadelphia Gas Works -Account No. 5122253225 56.12 15 Philadelphia Gas Works - Aeeount No. 5122253225 71.98 16 Philadelphia Gas Works -Account No. 5122253225 13.66 17 Philadelphia Gas Works -Account No. 5122253225 15.14 18 Recorder of Deeda -Record deed In Philadelphia County 156.50 18 State Farm -Policy No. 78-PR-3301-7 2,127.00 20 Susan B. Smith -Reimbursement for house expenditures 323.24 21 Susan B. Smith -Reimbursement for house plaque and miscellaneous supplies 126.36 22 Teleeom USA -Account #2FF91554 53.13 23 The Neighborhood, Built by MCI -Account 2K156972 54.91 24 The Neighborhood, Built by MCI -Account 2K158972 0.72 25 The Sentinel -Advertise Estate Notice 182.56 26 Thomas J. Smith -Reimbursement for Truck rental 110.78; Tolls 17.25; Gas 90.85 218.88 Clean out apartment H•87 subtotal 5.311.06 Copyright (c) 2002 form software only The Lackner Group, Inc. Forrn PA-1500 Schedule H (Rev. 698) Rav437Y FX~ (6.9e) SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS conxnorsvEUrH oR vENNSnvuan INHERRANCE TAX RERMN RESIDENT DECEDENT ESTATE OF FILE NUMBER Bell, Jr., Whitfield J. 21-09-00026 Inclutla unrolmburoatl metllesl ezpen~as. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Carlisle HMA Physician Managem - Account #568524 130.83 2 Carlisle Regional Medical Center -Patient Account #7881954 148.73 3 Cumberland Goodwill Fire Rescue - Patient #4353 48.80 Call Number CG0900014 4 Customer Service Center -History Book Club 24.89 5 Embarq - Aecount No. 717-249-8731.472 51.04 8 Millennium Pharmacy Systems East -Account No. STMH1584 8.27 7 Millennium Pharmacy Systems East -Account No. STMH 1479 738.38 8 PECO Energy -Account No. 90071-01709 15.83 9 Pennsylvania Department of Revenue - 2008 Individual Income Taxes 38.00 10 Philadelphia Gas Works -Account No. 5122253225 82.23 11 QLT • Telephone equipment 4.57 12 Richard Matkowski -Invoice dated 2l7/2009 regarding balance of work completed at 2,421.84 418 South 21st Street 13 Sarah A. Todd Memorial Home • Account No. 101635 1,517.00 14 Sarah A. Todd Memorial Home -Account No. 101835 340.93 15 Susan B. Smith -Reimbursement for NY Times 84.23 18 Susan B. Smith -Reimbursement for Repairs done by Apple Roofing 495.00 Total of Continuation Schedule Sae attached page TOTAL (Also enter on Una 10, Recapitulation) 25,354.70 (If more space is needed. additional papas of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1 S00 Schedule I (Rev. 6-98) Rev-0Eif EXi (6.98) COMMLNWEALTN OF PENNSriVpNIR INHERITPNLE TP]t RETURN RESIOEM DELELEM SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS continued ESTATE OF FILE NUMBER Bell, Jr., Whitfield J. 21-09-00026 ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 17 Susan B. Smith -Reimbursement for Invoice from Peter Gallagher regarding labor 3,200.00 and materials 18 Susan B. Smith -Reimbursement for John Leyden Statement for work at 418 S. 21st 2.628.00 Street in the amount of $2,200.00; and reimbursement for Ciayton Repair and Maintenance in the amount of $428.00 19 Telecom USA -Account #2FF91554 57.59 20 The Neighborhood, Built by MCI -Account 2K156972 121.60 21 Thomas J. Smith -Reimbursement for appliances for 418 South 21st Street 2.735.03 22 Thomas J. Smith -Reimbursement for Floor Refinishing 2,200.00 23 United States Treasury - 2008 Individual Income Tax Return 8.264.00 TOTAL (Also enter on Llne 10, Recapitulation) I 25.354.70 Copyright (c) 2002 form software only The Lackner Group, Inc. Forth PA-1500 Schedule I (Rev. 8-98) REV-0879 E%. (°-0S) SCHEDULE J COM URNANIA NXERR EO A E BENEFICIARIES X R NC T T I RESIDENT DECEDENT ESTATE OF FILE NUMBER Bell, Jr., Whitfield J. 21-09-00026 NAME AND ADDRESS OF RELATIONSHIP TO DECEDENT SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY D° Not Lue Tru.M . (yy~s) ($$$) I TAXABLE DISTRIBUTIONS [indude outright spousal • distributions and transfers under Sec. ~116(a)(t.2)] 1 D. Michael Bell Nephew $100,000 and 472,605.84 41 Tatman Street 50% of the Worcester, MA 01607 residue. 2 Susan B. Smith Niece 50% of the 372,605.64 3424 Warden Drive Residue Philadelphia, PA 19129 Total 845,211.28 Enter dollar amounts for distributions shown above on lines 15 through 16, as approp riate, on Rev 1500 cov er 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 See continuation schedule(s) attached 64,000.00 TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 73 OF REV-1500 COVER SHEET 64,000.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule) (Rev. 6.98) SCHEDULE J-11B CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS continued ESTATE OF (FILE NUMBER Bell, Jr., Whitfield J. 21-09-00026 ITEM NUMBER DESCRIPTION AMOUNT 1 American Philosophical Society 25.000.00 2 Dickinson College 25.000.00 3 The American Antiquarian Society 1.000.00 4 The Cumberland County Historial Society 5,000.00 5 The Massachusetts Historical Society 5,000.00 6 The Pennsylvania Hospital for its Friends of the Historical Library 3,000.00 Subtotal 64.000.00 Copydght (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J-IIB (Rev. 6-98) LAST WILL AND TESTAMENT W n ° o `° ` ~; OF t~~ .~ a ~:,p v~-c~ WHITFIELD J. BELL, JR. ~~~ `° ~ o _ ~ N ,,=_~ n D i;7 ~~ I, WHITFIELD J. BELL, JR., of Carlisle, Cumberland County, Pennsylva .~ nia ~7: being of sound and disposing mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void any and all former Wills, Codicils, or writings in the nature thereof, by me at any time heretofore made. FIRST: I hereby order and direct my Executrix or Executor, hereinafter named, to pay all my just debts, funeral expenses, testamentary expenses and all Inheritance, Estate, Transfer and Succession Taxes, as soon as may be conveniently done after my death, out of my residuary estate, I direct my Executor to have my remains cremated. SECOND: To my niece, SUSAN B. SMITH, and my nephew, MICHAEL BELL, I give the right to take such of my household goods and personal effects as they would like to keep and use •for theft o~ivh purposes and for the purposes of Susan's children, except as provided in Paragraph Third (g). Each shall have a choice of~one item, the choice being made by them in the order named until each has made a choice and then SUSAN shall have a second choice followed by MICHAEL and so on, in the same manner, until none of them desire any other household items. Such items as may remain shall be sold by my Executor and the proceeds added to the Estate for distribution as hereinafter provided. THIRD: I make the ~,,,, A. I give to the AMERICAN PHILOSOPI South Fifth Street, Philadelphia, Pennsylvania, the sum of ~ICAL SOCIETY;; of 104 "~ ,t~ ,~ W' 1 Twenty~five~ T~i~e~sand~ , '; ($25,000.00) Dollars, to be added to the library funds of the Society; uy~r,~ "~, B. I give to DICKINSON COLLEGE, of Carlisle, Pennsylvania;; the sum of Twenty-five Thousand ($25,000.00) Dollars, to be added to its scholarship fund given by Thomas W. Richards in my name; C. I give to THE AMERICAN ANTIQUARIAN SOCIETY, of 185 Salisbury Street, Worcester, Massachusetts, the sum of One Thousand ($1,000.00) Dollars; D. I give to THE MASSACHUSETTS HISTORICAL SOCIETY, of 1054 Boylston Street, Boston, Massachusetts, the sum of Five Thousand ($5,000.00) Dollars; E. I give to THE PENNSYLVANIA HOSPITAL fdr its Friends of the Historical Library, the sum of Three Thousand ($3,000.00) Dollars; F. I give to THE CUMBERLAND COUNTY HISTORICAL SOCIETY, of Carlisle, Pennsylvania, the sum of Five Thousand ($5,000.00) Dollars; G. I have made a list of certain items of personal property dated the same day as this Will and I direct the Executors hereinafter named to make distribution of those items of personal property to the persons indicated in the memorandum. Any and all expenses involved in the distribution of those items shall be treated as an expense and cost of administration of my Estate. 2 FOURTH: I give to *my ~f~e~jhew, MfCHAEL .~'£~ a,E w"k ~~~xifx..z >. Hundred Thousand {$100,000.00) Dollars, which gfft~lsi;~intend' ,,: .5 Trust I established in the name of Jennifer and Andrew Smithy"' FIFTH; All the rest, residue and ^f':} vy~: a . the value ofthe ~ ~,~+ `f r k ' w 'r F~' i ~r ~'•~ 4 J i' S . ""imp` estate„ of whatsoever nature and kind and wheresoever situate at the time of be distributed as follows: ,;;;ti',"',n A. !give fifty (50%) percent to my niece, SUSAN B. SMIT}-arid B. I give fifty (50%) percent to my nephew, MICHAEL BELL. LASTLY: I nominate, constitute and appoint my niece, SUSAN B. SMITH, of Philadelphia, Pennsylvania, and JAMES D. FLOWER, JR., of Carlisle, Pennsylvania, to be the Executors of this my Last Will and Testament. Should one of the aforesaid fail to survive me, the other may act alone as Executor. Should neither of the foregoing survive me, I nominate, constitute and appoint M & T BANK, or its successors, of Carlisle, Pennsylvania, to act in their place and stead. No Executor or Executrix shall be required to file bond in this or any otherjurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ,~ ~ day of ~ ~ , 2008. hitfiel .Bell, Jr. SIGNED, SEALED, PUBLISHED and DECLARED in the presence of: ~i'/,~xx~e~~ 3 ,, .-.;~ nY m~.- . ~ ., . ~p,NIA ~, ss -: ,M ~:~~~ ~ w~ ~~ N~a~* ALTH GF pENNSYL COMM©NWE ped to the g~R~'NU whose name to law, do hereb { GpUN~' OF GUM J gELL9 JR•, Testator, ed accordingill; that I signed duly qualt~ Last therein been ent as mY urposes i Yyl-IITFIEI-~ Qnt, haC~ed the instrum act for the P foregoii Seed and ex mY free and voluntary attacow edge that ned it as d1tHlTF1'E--p p. I sag e, by 2p08. ackn ,and that efore m wiUin91Y~~ and acknowledged express ~ d day of gworn or affirmed g>^,t.L, pR•, the Testator, this ge11, `f estator W kiield ~ 4 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss We tdaYnQp~L.J.~'(~r.~t-ll ~ and ~~Ce-r~,~.fJl , the witnes whose names are sigrie t~attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Testator sign and execute the instrument as his Last Will; that he signed willingly and that he 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 knowledge the Testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed to before/me by '~ ' !J . and ~~~ this c+Z1'iCl day of ~L~-tY~o_c,~, , 2008. Not y ublic NOTARIAL SEAL MERLENE J. MARHEVKA, NOTARY PUBLIC CARLISLE CUMBERLAND COUNTY, PA MY COMMISSION EXPIRES JUNE S, 2010 Tax Parcel No. 88200-00418 FIDUCIARY DEED Made the z/! day of _ ~~~~~ Two Thousand Nine (2009) Between SUSAN B. SMITH, Co-Executor and JAMES D. FLOWER, JR., Co-Executor of the ESTATE OF WHITFIELD J. BELL, JR, Deceased, late of Cumberland County, Pennsylvania ("Grantor") AND SUSAN B. SMITH, married woman of Philadelphia, Pennsylvania, an equal one-half tenant in common interest and D. MICHAEL BELL, married man of Worcester, Massachusetts an equal one-half tenant in common interest ("Grantees") WHEREAS, Whitfield J. Bell, Jr., ("Decedent") became in his lifetime seized in fee of property located in the Eighth Ward of the City of Philadelphia, Philadelphia County, Pennsylvania; and WHEREAS, the Decedent died January 2, 2009, a resident of Carlisle Borough, Cumberland County, Pennsylvania, having first made his Last Will and Testament dated October 2, 2008; and R'HEREAS, the Decedent's Last Will and Testarent was submitted to probate at the Cumberland County Register of Wills Office on January 9, 2009, under Docket No. 21-09-0026, ov which day the Register of Wills appointed Susan B. Smith and Jan1es D. Flower, Jr. as Co- Executors of The Estate of Whitfield J. Bell, Jr. as named in Paragraph LASTLY of the Decedent's Last Will and Testament. WITNESS, that in consideration of the sum of One Dollar ($1.00) in hand paid, the receipt whereof is hereby acknowledged, and intending to be legally bound hereby, the Grantor does hereby grant and convey unto the Grantees, their heirs and assigns, as equal-one half tenants in common as follows, to wit: II~~I~III~~II~If~II~I~II~I~I~III~I~I~~IIII~~I~lll~ll~~l P 90280 o96Pm This Document Recordetl Doc Itl. 62080196 06/22/2009 Stale RTT D.00 Receipt R: BOB984 03: 19PM Local RT7 0.00 Rec Fee 756.50 Doc Code: D Commissioner of Recortls, City o! Philatlel phia ALL THAT CERTAIN lot or piece of ground with the buildings and improvements thereon erected situate in the Eighth Ward of the City of Philadelphia and described accounting to a Plan made for Jacob Hoffman by Ben H. Joseph, Surveyor and Regulator of the Third District of the City of Philadelphia on the 17°i day of March A.D. 1960 as follow to wit: BEGINNING at a point on the Westerly side of Twenty-first Street (fifty feet wide) at the distance of sixty-three feet Northwardly from the Northerly side of Lombard Street (fifty feet wide); containing in front or breadth Northwardly along the said Westerly side of Twenty-first Street fifteen feet and extending of that width in length or depth Westwardly between lines parallel with Lombard Street forty-nine feet six inches. BEING known and numbered as 418 South 21s~ Street BEING the same premises which The Fidelity Bank and Erving W. Close, Trustees under the Will of Charles W. Close by their deed dated October 22, 1068 and recorded October 25, 1968 in the Philadelphia County Office of the Recorder of Deeds in Deed Book D-246, Page 500 granted and conveyed unto Whitfield J. Bell, Jr. TOGETHER with al] and singular the buildings, streets, alleys, passages, ways, water, water-courses, rights, liberties, privileges, hereditaments and appurtances, whatsoever, thereunto belonging, or in any wise appertaining, and the revisions and remainders, rents, issues and profits thereof and all the estate, right title interest, property, claim and demand whatsoever, of them and said Crrantors, in law, equity. or e±her-~~icP, hnq~gnepPr; nf, in and to the szme and..eve;~.~ port __.. _,,,,,~_,.~, hereof. TO HAVE AND TO HOLD the said lot or piece of ground with the buildings and improvements thereon erected. Hereditaments and Premises hereby granted, or mentioned and intended so to be, with the Appurtenances, unto the said Grantees, their heirs and assigns, as equal one-half tenants in common, to and for the only proper use and behoof of the said Grantees their heirs, and assigns forever, as equal one-half tenants in common. AND the said Grantors for themselves, and their heirs, executors and administrators, do covenant, promise and agree, to and with the said Grantees, and Grantees' heirs and assigns, by these presents, that they, the said Grantors, have not done, committed, or knowingly or willingly suffered to be done or committed, any act, matter or thing whatsoever whereby the premises hereby granted, or any pari thereof, is, are, shall or may be impeached, charged or encumbered, in title, charge, estate or otherwise howsoever. IN WITNESS WHEREOF, the Grantors have hereunto set their hands and seals the day and year first above written. WITNESS: Tl-IE ESTATE OF WHITFIELD J. SELL, JR. ~k ~J !'f`-'(~~ (SEAL) Susan B. Smith, Co-Executor ~INJ,/~"t/IC~~S ~~,.~~ ~~~~ (SEAL) JJ~'' mes D. Flow r, Jr., Co-Exec~o,~ COMMONWEALTH OF PENNSYLVANIA) COUNTY OF ~ ~q ~.~ ) SS On this, the~~'day of, 2009, before me, the undersigned officer, personally appeared Susan B. Smith, known to me (or satisfactorily proven) to be the person whose game is subscrihed to the withir, irrstrament, and acknrn;pledged that she ex_ecrrted the same in the..capacity therein stated and fvr the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. C MONWEALTH Of PENNSYLVANIA Notarfel Seel Carol A Dawson, Notary PubOc WestYYgtdendTwp., Cl~sterCany Mybn Expires Mar, 2. X110 bAanMer, Pennsvlvxnua Nnwdntlon of Noterke COMMONWEALTH OF PENNSYLVANIA) f SS COUNTY OF Notary Public On this, the ~~day of ~, 2009, before me, the undersigned officer, personally appeared James D. Flower, Jr., larown o me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that he executed the same in the capacity therein stated and for• the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official sea]. -__ COMMONWEALTH OF PENNSYLVANIA Jo Arm SNeleer,N~PWYIc / Notary Public C:s4npHNSao,CumbatandCaelly ' _ M!'on E~IrasJune3g2pt1 Member, PennsNvxn~a AssorAeflon of.NWeAee ADDRESS CERTIFICATION I HEREBY CERTIFY that the precise address of the Grantees is: 3424 Warden Drive. Philadelphia, Pennsylvania 19129 l ~. ttornay/Agent for the Grante~ COMMONWEALTH OF PENNSYLVANIA) :SS COUNTY OF PHILADELPHIA Recorded on this _ day of , 2009, in the Recorder's Office of the said County in Record Book, Page _. Given under my hand and the seal of the said Office, the date above written. Recorder COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SHORT CERTIFICATE I, GLENDA EARNER STRASBAUGH Register for the Probate of Wills and Granting Lettez-s of Administration in and for CUMBERLAND County, do hereby certify that on the 9th day of January, Two Thousand and Nine, Letters TESTAMENTARY in common form were granted by the Register of said County, on the estate of WH/TF/ELDJBELLJR late of CARL/SLEBOROUGH !Firs!, Mitltlle, Gastl in said county, deceased, to SUSAN 8 SMITH and JAMES D FLOWER JR (First Mitltlle, Lasr/ !first, Middle, Lastl and that same has not since been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of said office at CARLISLE, PENNSYLVANIA, this 9th day of January Two Thousand and Nine. File No. PA Fi 1 e No . Date of Death S.S. # 2009-00026 21- 09- 0026 7/02/2009 191-26-7058 NOT VALID WITHOUT ORIGINAL SIGNATURE AND IMPRESSED SEAL GENERAL AFFIDAVIT City of Philadelphia Records Department BEFORE ME, the undersigned Notary ~ 'JG /-fin f~ . ,~f~f~! J[nam a o/Notary before -_ whom affidavit is sworn], on this ~qdt day of! /77~/, vl(m onth] 20 09_, ,personalty appeared James D, Flower, Jr. (name of affianfJ known to m e to be a credible person and of lawful age, who bet rig by me first duly sworn on ; his _. ' [his or her] oath, deposes and says: In accordance with Section 2 200 of the City, of Phlladelphia Code of Ordinances, the attached deed is _.. being filed by ~ James D Flower, Jr., Esq, of Sai!dis, Flower & Lindsay ' a ^-Title Insurance company, as defined in 40 P.S. § 910-1, located at: (address of record for title insurance company) Law Firm/Individual Attorney Bar ID #_ 27742 j, located at: T. 26 West Hlgh Street, Carlisle, PA 17013 (address of record of law firm or individual attorney] The attached deed submitted for recording is for the following property address: 418 South 21st Street n I(si nature ofaffiant] 'mot James D. Flower, Jr. (typed name of affiant] _ __ 26 West High Street ___ __ _, m . __..... _ _ _...: (address of a(fiant, Ime 7J _._ _,__ Carlisle, PA 17013 _ __ _, (address of a(fiant, line 2] Subscribed and sworn to before me, this ~9~ (day of month] day of //7`1G{;(month), 20 09 (Notary S//eal.J ~// (suture ofNota~yJ Jo Ann Seker [typed mine ofNotaryJ NOTARY PUBLIC My commission expires: •Juri~ ,~0 ~ zo` it . COA71utONWEALTH OF PENNSYLVANIA NOmrfal Seal JD Am Behr, Nomry PW>op I~P111 Boo, CunberlsidOawly iwQ7111aM6ebn E~Wlree June JQ, m}1 IMember, Ponm!nvnni* nscxlefbn Of Nehrlse 52-54 Int BOOK NO. PAGE NO. PHILADELPHIA REAL ESTATE TRANSFER TAX CERTIFICATION Complete each section and Ne in duplicate with Recorder of Deeds when (1) the full consideration/value is/is not set forth in the deed, (2) when the deed is with consideration, or by gift, or (3) a tax exemption is claimed. If more space is needed, attach additional sheet(s). A. CORRESPONDENT- All In ulries ma he directed to the tollowln arson: NAME TELEPHONE NUMBER: James D. Flower, Jr Esquire c/o Saidls, Flower & Lindsay AREA CODE ; 7171 243-6222 STREET ADDRESS CITY STATE 21P CODE ,26 West Hlgh Street Carlisle PA 17013 B. TRANSFER DATA DATE OF ACCEPTANCE OF DOCUMENT: GRANTORJSyLESSORd3Z__ _ .....__. . ,........_. ....__...__ ....._.., GRANTEE(SyLESSE~~ ......___ .. _. The Estate of Whitfield J Bell Jr j ~usan B-Smith and D. Michael Bell STREET ADDRESS STREET ADDRESS ,2109 Market Street ~ ,3424 Warden Dnve CRY _. _ STATE ~~ ,21P.CODE_ CITY ,_,_____ _, STATE ZIP COpE Kamp Hill i PA' 17D11 Philadelphia ,IPA, ,19129 'I STREET ADDRESS ___„_.,,~. _ _, .,,,,___ _,,, C~TOWNB ,HIP BOROUGH ,m .418 South 21st Street I ICity of Philadelphia cQVNT?~...._. ,.._ ~...._. ~..,., $S~4QI.DL4T.9LGT ,.__ __.m _ _ ,LAx P9RpgLf+UMd4F.__.. _._ _. Philadelphia I ~ 88200 00418 i ~~ D. VALUATION DATA 1. ACTUAL CASH CONSIDERATION 2. OTHER CONSIDERATION 3. TOTAL CONSIDERATION $1.00 + _ $1.00 4 CDUNrY ASSESSED VALUE 5. COMMON LEVEL RATIO FACTOR 6. FAIR MARKET VALUE $50,048.00 - x 3.55 = _, $177,670 40 E. EXEMPTION DATA tA.. PERQ~N,TIa,~,E_OF E~SEM_PSLN _. _... _ ... iB. PERCENTAGE, OF INTEREST CONVEYED 100.0 100,0 2. Check Appropriate Box Below for Exemption Clalmad xO Will or intestate succession , , Whitfield J Bell Jr 21-09-0026 (NAAlE OF' DECEDENT/ (RSTAT£ F/LC NUM86R) ~ Transfer tolndustrialDevelopmenlAgency. p Transfer to agent or straw party. (Attach copy of agency/straw party agreement). p Transfer between principal and agent. (Attach copy ofagency/straw trust agreement). Tax paid prior deed $, _ p Transfers to the Commonwealth, the United States, and Instrumentalities by gift, dedication, condemnation or in lieu of condemnation. (Attach copy of resolution). p Transfer from mortgagor to a holder of a mortgage in default. Mortgage Book Number. _, Page Number' Mortgagee (grantor) sold property to Mortgagor (grantee) (Attach copy of prior deed). ~ Corrective deed (Attach copy of the prior deed). ~ Other (Please explain exemption claimed, If other than listed above.) Under pennhies o~/mv or adiumlm, l declmre (hat /have ezmniued !leis S(a(ernen( inchrding nccoulpmzying mp kuomledge and belief, i( is (rue, correct and conq~lele. SNATURE OF CORRESPONDENT OR RESPONSIBLE PARTY h .-.._ ! 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O w d d m A~ O m~ N Co O V a O O do O W E l0 ~ J Oo Oo O Oo 10 J W ~ (O (O c0 O V O N CT W (O O r ?~ W ~a +.] V 10 ~ V! O J V W A ' ~1 W fW ~1 O) ~-~ W ~l (A ? O O O), V W O W -P ~-+ W ? W OJ ~7 l0 01 N ,7y A W ~ Cn V rn W A O V Ol ~1 ~ J ~I Cn Ut W J 01 01 O A V ~i W 0 0 0 0 0 0 OJ O O A m 0 W W N ~7 01 H+ VI N A W W 00 ~+ 01 O O O O O O O O O O O O O O O O O O O O O O O O O O O. - d f+ ~ V N O (All J> .A W J J N O W tD W r W OD W -+ N O N N A A V W j ~ C Of !D .P i O d) m ...~ ~ W O] OJ O ~ O ~ VI ~ 001 W tNp J ~ Ot ~ p T V f0 c0 O V ~I N O O Ot Oo A O W V D) A U1 N~ A~ N O O~~ W~~ ^7 N O O N ~I t+ 10 N 0 0 0 0 0 0 0 0 Cali 0 0 0 0. Ut N O N O COn. 0 0 0 0 0 0 0 0 W 499 Mitchell Aoad, Millsboro, DE 19966 Mail Code DE-MB• 12 Saidis, Flower & Lindsay Attorneys At Law 2109 Market Street Camp I3i11,.Pennsylvania 17011 f 1,. r.. ~I1{' JAN ~ `~ '2009 Phone (888)502-4349 Fax , (302)934.2955 January 22, 2009 Re: Estate of.• Whitfield J. Bell. Jr. Social Security: 191-26-7058 Date ofDeath: Jartuary 02. 2009 Dear Sir or Madam: Per your inquiry dated Sanuary 2Q 2009, please be advised that at the tune of death, the above-named decedent had on deposit with this bank the following: 1. Type of Account Account Number Ownership (Names afl OpeningDQte Balance on Date ojDeath Accruedlnterest Total ChecktngAccount 2674057480 Yt'hi~eld JBell Jr* 1/12/90 $ 43,672.42 $. 1.30 ' ------------------------------- $ 43, 673.72 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 account 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, eta, please contact our High Strcet Carlisle Office # 717-240-4536. Sincereiy~, " ~ ~~~j~p,, ~ ~~~ '~Y1NlX/ Tracie Hare Adjustment Services