The URL can be used to link to this page

Home My WebLink About09-02-09 15056051047 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes PO BOX 280601 INHERITANCE TAX RETURN ~ / Q .~ 0~ ~ .j Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth /9G /y /~~s o/ /~ Zoas G'3 ~~~ ~'I~ Decedent's Last Name Suffix Decedent's First Name MI s~f r~ ~N/Y~ E (If Applicable) Enter Surviving Spouse's Inform ation 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 i 1. Original Return O 2. Supplemental Return O 3. Remainder Return (date of death prior to 12-13-82) O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required death after 12-12-82) O 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O 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 DIREGTED TO: Name Daytime Telephone Number W ~~ c. ~~ M s .l> ~ N ,/ C- t_ s ~-- j ~- Z y 3 36,3~r Firm Name (If Applicable) 1~r~M~ R 'K. ~,yy> E~.s First line of address 1 lY F s JR' /7L/ C '~ S f' Second line of address City or Post Office G/L7 ,e L / S' L`E' Correspondent's a-mail address i State P ZIP C d REGISTE~'.flF~VILLS US NLY __ ' (r? ; ~,~ ,~, -~ _v -- ~ - - r~ I ~~? rv _ - - ~ - :, ___ -'" C ,, -~ ` ,~ DATE FILED t"~ oe 1 ~~ /3 Under penalties of perjury, I declare that 1 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. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE ~a,.~i~ ~ S'ir> >1/~ / G'~~7rr <<~'ns ~~L L 9 - 2 -2s~ '3 DG~~J -~/ y ,~re .-~l.~G~7'sev ~ /T J~-~ y03 Gam. h7~j7i/Y ~`.1 /O~IG S'~rr~~ fP~ / ~..3 ~~ SIGIyRTUR`~R OT T N EPRESENTATIVE DATE ADDRESS PLEAS USE ORIGINAL FORM ONLY 15056051047 Side 1 15056051047 J J REV-1500 EX curity Number ent's Social S e Deced ~ L" `"rte / ~~~ ~ ~/f// ' G ~ t ~ j r~ ~ / l ~ s Name: Decedent RECAPITULATION 1. Real estate (Schedule A) . ........................................... . 1. ~~~0 ~ • OQ 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 & Miscellaneous Personal Property (Schedule E) ....... . 5. ~~~ G • ~f 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ...... . 6. • 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property ~ ~ ~ ~/ (Schedule G) O Separate Billing Requested....... . 7. ~ • T ! 8 / / 2 ~ t- ' (~ ~ 3 ~~ 8. Total Gross Assets (total Lines 1-7) ................................... . . 9. Funeral Expenses & Administrative Costs (Schedule H) .................... . 9. 8 tr I ~ l0 a9 . 10 ' - ~ /~ ~~/ • ~ ' 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............... . , C 1 & 10 11 / ~ ~ ~ ~ ~. Z 11. ) .................................. Total Deductions (total Lines 9 . . 12 Q q j J y9 .C3~cJ 12. Net Value of Estate (Line 8 minus Line 11) ............................. . . 7 ~ 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ...................... .. 13. • 14. Net Value Subject to Tax (Line 12 minus Line 13) ...................... .. 14. • TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 16. Amount of Line 14 taxable ~~ ~ ~ ~ at lineal rate X .0 ~i r .$',~ 16. G~ Z l / ~b • r y 17. Amount of Line 14 taxable 17 at sibling rate X .12 • 18. Amount of Line 14 taxable • 18 • at collateral rate X .15 . 19 / ~'~~•~~ 19. .. TAX DUE ..................................................... .. . 15056052048 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT C ~ 15056052048 Side 2 O 15056052048 REV-15U~ EX Page 3 Decedent's Complete Address: File Number STREET ADDRESS - ~ GC v~~_ ~-_ _ _ __ -- cirv /~7`. /7~ /l S'r~~r~ s ~ STA ~ i~ P~.O G ~.~ Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments _~~_Z~~ _ ~i' C, Discount '~ ~ Total Credits (A + g + (; ) 3. Interest/Penalty if applicable D. Interest E. Penalty Total InterestlPenalty (D + E ) 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. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (1) ,5~%~ (3) (4) (5) ~ ~ (5A) (56) 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 "in trust 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 (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 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 (Oj 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) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER 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 _ ~.~- ~// .3 ~ C"am"' .S ~, -~-~ -- ~ ~/ "7'"~ ~. ~ i ~~ G ~ ~ ~ , .S~Y2+ ~ ~ G _S G~ ryjL T ~i~? ~) ~ S,S'GGrp~- ,,`t ~'~~ ~- ,f- /~i /~-. ~..°71c r_. ~ off.. ~~~rf~ /.!'/ ~""°• %~~r ~~~ ~ ~=~ TOTAL (Also enter on line 1, Recapitulation) I $~.J ~ ~d®~ ~`-~ (If more space is needed, insert additional sheets of the same size) OMB N0.2502-0265 -fir A B. TYPE OF LOAN: EVEL N OPMENT 1.QFHA 2.[]FmHA 3.QX CONY. UNINS. 4.[~VA S.QCONV. INS. D U.S. DEPARTMENT OF HOUSING & URBA SETTLEMENT STATEMENT 6. FILE NUMBER: zoo5o5o13z.PFD 7. LOAN NUMBER: 649245900 8. MORTGAGE INS CASE NUMBER: C. NOTE: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "(POC]" were pa7d outside the closlrig; they are shown here for Informatlanal purposes and are not included in the totals. • 1.0 3/98 (2005050132.PFD/2005050132.PFD/31) D. NAME AND ADDRESS OF BORROWER: Erick Sotello Dianne Sotello 224 Oxford Road Gardeners, PA 17324 SSN: 207-56-2605 206-38-7690 E: NAME AND ADDRESS OF SELLER: Estate of Anna E. Smith 4 Cedar Street Mount Holly Springs, PA 17065 F. NAME AND ADDRESS OF LENDER: ABN AMRO Mortgage Group, Inc. 6300 Interfirst Drive Ann Arbor, MI 48108 G. PROPERTY LOCATION: 4 Cedar Street PA 17065 Springs Mount Holl H. SETTLEMENT AGENT: 20-1747090 Lakeside Abstract & Settlements, LLC I. SETTLEMENT DATE: June 3, 2005 y , Cumberland County, Pennsylvania 23-22-2338-060 PLACE OF SETTLEMENT 101 Front Street, PO Box 426 Boiling Springs, PA 17007 J. SUMMARY 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 55,000.00 401. Contract Sales Price 55,000.00 102. Personal Pro a 402. Personal Pro e 103. Settlement Char es to Borrower Line 1400 4,005.44 403. 104. 404. 105. Ad'ustments For Items Paid B Seller in advance 405. Ad ustments For Items Paid B Seller in advance 106. Ci foown Taxes to 107. Coun Taxes 06/03/05 to 01/01/06 146.03 406. Ci /Town Taxes to 407. Coun Taxes 06!03/05 to 01!01/06 146.03 r 108. School Taxes 06/63/05 to 07/01/05 54.45 408. School Taxes 06/03/05 to 07/01/05 54.45 109. 409. 110. 410. 111. 411• 112. 412. 120. GROSS AMOUNT DUE FROM BORROWER 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 201. De osit or earnest mone 202. Princi al Amount of New Loans 203. Existin loans taken sub'ect to .59,205.92 2,5 0.00 5 ,000.00 420. GROSS AMOUNT DUE TO SELLER 500. REDUCTIONS IN AMOUNT DUE TO SELLER: 501. Excess De osit See Instructions 502. Settlement Char es to Seller Line 1400 503. Existin loan s taken sub'ect to 55,200.48 15.00 204. 504. Payoff of first Mortgage 205. 505. Pa ff of second Mort a e 206. 506. 207 507. De osit disb. as roceeds 208. 508. 209. Ad'ustments For Items Un aid 8 Seller 509. Ad'ustments For Items Un aid 8 Setter 210. Ci /Town Taxes to 510. Ci !Town Taxes to 211. Coun Taxes to 511. Coun Taxes to 212. School Taxes to 512. School Taxes to 213. 513. 214. 514. 215. 515. 216 516. 217. 517. 218. 518. 219. 519. 220. TOTAL PAID BY/FOR BORROWER 300. CASH AT SETTLEMENT FROM/TO BORROWER: 301. Gross Amount Due From Borrower Line 120 57,500.00 59,205.92 520. TOTAL REDUCTION AMOUNT DUE SELLER 600. CASH AT SETTLEMENT TO/FROM SELLER: 601. Gross Amount Due To Seller Line 420 15.00 55,200.48 302. Less Amount Paid B /For Bonower Line 220) ( 57,500.00) 602. Less Reductions Due Seller Line 520 ( 15.00 303. CASH (X FROM) ( TO) BORROWER 1,705.92 603. CASH (X TO) ( FROM) SELLER 55,185.48 The undersigned hereby acknowledge receipt of a completed copy of pages 1 &2 of this statement & any attachments referred to herein. Borrower rick Sotello ___ Dianne Sotello Seller ~s~~ ~ ~~ `1't~}o-(r E. Smith - Administr~atjor /vim ~ ~~4~" Gary L. mith -Administrator Pape 2 L. SETTLEMENT CHARGES 700. TOTAL' COMMISSION Based on Price $ % PAID FROM PAID FROM Division of Commission (Ins TOO aS FOIIOWS: BORROWER'S SELLER'S 701. $ t0 FUNDS AT FUNDS AT 702. $ t0 SETTLEMENT SETREMENT 703. Commission Paid at Settlement 704. to 800. ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Ori ination Fee % to 802. Loan Discount 2.0000 % to Cody Financial Mortgage Services, Inc 1,100.00 803. Appraisal Fee to Cody Financial Mortgage Services, Inc 275.00 804. Credit Report to Cody Financial Mortgage Services, Inc 50.00 805. Flood Cert Fee to Cody Financial Mortgage Services, Inc 21.50 806. Lender Admin Fee to ABN AMRO Mort a e Grou ,Inc. '475.00 807. Processing Fee to Cody Financial Mortgage Services, Inc 250.00 808. Def Prem Pd By ABN AMRO to Cody Financial Mortgage Services, Inc POC:B1237.50 809. 810. 811. 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest From 06/03/05 to 07/01/05 Q $ 9.550000/day ( 28 days %) 267.40 902. Mort a e Insurance Premiumfor months to 903. Hazard Insurance Premium for 1.0 ears to Done al Insurance Com an POC $299.00 904. 905. 1000. RESERVES DEPOSITED WRH LENDER 1001. Hazard Insurance 3.000 months $ 24.92 er month 74.76 1002. Mort a e Insurance months $ er month 1003. Ci !Town Taxes months $ er month 1004. Coun Taxes 5.000 months $ 20.96 er month 104.80 1005. School Taxes 12.000 months @ $ 59.15 per month 709.80 1006. months $ er month 1007. months er month 1008. re ate Ad'ustment months $ er month -179.57 1100. TITLE CHARGES 1101. Settlement or Closin Fee to 1102. Abstract or Title Search to 1103. Title Examination to 1104. Title Insurance Binder to 1105. Document Pre aration to 1106. Nota Fees to NO CHARGE 1107. Attorney's Fees to includes above item numbers: 1108. Title Insurance to Lakeside Abstract & Settlements LLC 588.75 includes above item numbers: 1109. Lender's Coverage $ 55,000.00 1110.Owner's Coverage $ 55,000.00 588.75 1111. ALTA Endorsements to Lakeside Abstract & Settlements, LLC 100, 300, 8.1 150.00 1112. Lakeside Abstract & Settlements, LLC 1113. 1114. 1115. Overnight Delivery to Lakeside Abstract & Settlements, LLC 15.00 1116. 1117. 1118. 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recording Fees: Deed $ 38.50; Mortgage $ 64.50; Releases $ 103.00 1202. Ci /Coun Tax/Stam s: Deed • Mort a e 1203. State Tax/Stam s: Deed ; Mort a e 1204. 1205. 1300. ADDITIONAL SETTLEMENT CHARGES 1301. Surve to 1302. Pest Ins action to 1303. Tax Cert to Mable Satteson 5.00 1304. Final Water to Mt. Holt S rin s Borou h 012 10.00 1305. 1400. TOTAL SETTLEMENT CHARGES Enter on Lines 103, Section J an Sectio K 4,005.44 15.00 By aipninp page t or this statement, the sipnatorles acknowledge receipt of a completed copy of page f ihle two p stale nt. ids Abstract ~ Settle a ts, LLC Settlement Agent Certified to be a true copy. ( 2005050132.PFD / 2005050132.PFD / 32 ) REV-1508 EX a (197) SCHEDULE E ' COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY .,rninrar nrnrnr_~iT ESTATE OF r., FILE NUMBER _ ,-, ~ 1 ~%~ ~ t~ vw .ter r~ ~ , ~~/~.:> _' %?./~ ~,..~ Include the proceeds of litigation and the date the proceeds were received by the estate. Ail property jointty•owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER /~ DESCRIPTION OF DEATH S~ ,: ;. _ ~ ;.- , ,i~J'-'A'C/~e' N , /~ .3 , l_ Ci -~"7 ~ i ?'~ ,L~ /,~ ~~ /I.-' Cam//~' C.. ~ c,G.~"'y=-"' r~~ ~ r~ ~ ~ c~-C~ ~~-- ~ S r~ , 2~G-'~"`'~ G, ~~ r '" ~ ~U~ ~ ~. ~. ~ r~ ~ ~i'.1' /~i of rr? ~. ~ = ~, ~j l ~ ~, ..~~.~ ~ ~ G 1 ~~ ~g~ ~~ ,- .. .s :,`.., ~C, D3 ~--~ pis ~, _,., ~ f A r .., TOTAL (Also enter on line 5, Recapitulation) I $ ~ ~t~~/i ~~` (If more space is needed, insert additional sheets of the same size) _ OWNER _ Address Date of Sale Auctioneer _ Other Sale Location Clerk PROCEEDS OF SALE: Cash ----------------------------------------------- $ Vic'', ~-~ Checks -------------------------------------------- ~ ~ c~ / -------------------------------------------------- ther ---------------------------------------- Miscellaneous (see attached list) ___ LESS SELLER'S SALE EXPENSE: ~, Auctioneer's Fee__~_________- Other Seller's Expenses Advancled by~A~,uctioneer: FINAL SETTLEMENT ' ,; ~- y '" L Date '~ ~ %~~ ~. ~/~t~'-~' •~ TOTAL PROCEEDS OF SALE ______________________ $ ~~ ~~(~SC"f~f~~~~ Cashier fCi ', ~) y, i~ /"" ~, / ~ ~~ ~~~~ Miscellaneous (see attached list) _____________________________________________. ~ ~~ y - _._ _. ~. ~ DEDUCT TOTAL SELLER'S SALE EXPENSE ________..______ ____ ___ __ $ - .- _ .._~ TOTAL NET PROCEEDS TO SELLER _ ¢~ __ ~~________________ $ ~' - " I, (or we), the seller of goods, merchandise, andJor property sold at public auction on above date and location, acknowledge and accept this settlement of proceeds of sale. I (or we) agree to accept all responsibility for providing merchantable title to all goods, merchandise, and(or property sold, and for delivery of title to the purchaser. (Date) Auctioneer or Cashier's Signature Form No. FS Reorder from: MISSOURI AUCTION SCHOOL Phone 1-800-835-1955 (Seller's Signature) (Seller's Signature) ° 1550 SAND HILL RD. °~ 0 ~ °~Q HUMMELSTOWN, PA 17036 VOICE: 717.533.4267 A~CT~ ~Op FAX: 717.533.2114 ^ www.zieglerauction.com ~ ... ~ , E-MAIL: infoC~3zielglerauction.com Real Estate, Commercial and Personal Property Auctions March 7, 2005 APPRAISAL To Whom It May Concern: This is to certify that we are engaged in the antiques, household furniture and household goods business. We certify that we have thoroughly reviewed the following listed and described articles belonging to: ESTATE OFAIVIVE E. SMITH c% Roger Smith 1050 6`h Avenue, Oberlin Gardens Steelton, Pa 17113 We estimate the appraised value as listed for resale or other purpose at the present current market value. In making this appraisal, we do not agree to purchase or replace the articles. Sincerely, JAY E. ZIEGLER, CAI, RARE ZIEGLER AUCTION COMPANY, LTD. appras.doc APPRAISAL ESTATE OF ANNE E. SMITH SHED Glider $ 55.00 4-hp Yard Machine (22"cut) $ 75.00 Pine Drop-leaf Table $ 20.00 Plastic Round Table & 3 Chairs $ 10.00 Shovels, Rake, Garden Tools $ 10.00 (3) Lawn Chairs $ 6.00 Miscellaneous Boxes of Household $ 20.00 ' ~ ite Drop-leaf Table $ 25.00 ~ '~` `~~ KITCHEN Bell Collection (approximately 125-150) Miscellaneous Pots & Pans, etc. Maple Hutch, Table & 6 Chairs 2) GTass Shoes w! Cats ---- Bu n & Daisy Blue Shoe Blue & White Afghan Whirlpool Microwave & Stand Family Tree Plaque Delft Shoes, Miscellaneous Dishes, etc. Bissell Upright Vacuum Window Air Conditioner 19441ntroductory to Mt. Holly Springs Wagner Fry Pan & Other Pans Whirlpool Refrigerator Whirlpool Electric Stove Whirlpool Electric Dryer Whirlpool Washer Kitchen Cabinet-Pots, Pans, Tools LIVING ROOM Sanyo Color TV ''~ Entertainment Stand Tan Lazy-boy Recliner Sofa & Loveseat Tan Recliner (2) Table Stands, 2 Small Stands, Small Shelf Blue Lights (2) Pine Night Stands (3) Oil Lamps. Misc. Metal Horses, Cups & Saucers, Misc. Vases & Glassware Ceramic Egg w/ Rabbit Oii Lamps, Clocks, Figurines, Plates (8) Pictures Pine Table Lamp ZIEGLER AUCTION COMPANY, LTD. $175.00 $ 5.00 ~' $100.00 ,~ ,~., ~~~:` $ 20:0' ~~,~ 15.00 $ 25.00 $ 20.00 _ , -~ . $ 35.00 ~ j $ 15.00 $ 15.00 $ 25.00 $ 25.00 $ 15.00 $120.00 ~- ~~`~~~~ $100.00 - ~,,::,.~, -- o $100.00 '~~~.:,,~~ $100.00 . ,,~,; $ 20.00 $ 45.00 $ 30.00 $ 60.00 $100.00 $ 75.00 $ 20.00 5.00 $ 15.00 ~' ~ ~~~ r `~~ . $ 70.00 $ $.oo $ 25.00 $ 25.00 $ 15.00 n~,,~ ~- appras.doc APPRAISAL ESTATE OF ANNE E. SMITH LIVING ROOM (continued) Blue Loveseat $ 25.00 Card Table $ 5.00 BEDROOM #1 RCA TV $ 10.00 3-Drawer Dresser $ 20.00 Miscellaneous Decorations $ 8.00 BEDROOM #2 Pine 4-Poster Bed, Dresser w/Mirror $300.00 ~ Sanyo TV $ 25.00 (2) Small Stands $ 5.00 Pitcher & Bowl Set $ 20.00 Costume Jewelry, Rings, Necklaces $ 40.00 Security Box $ 20.00 Bell South Phone $ 10.00 Mt. Holly Blanket $ 10.00 BEDROOM #3 2-Door Cabinet $ 8.00 6-Drawer Cabinet $ 10.00 3-Drawer Chest of Drawers $ 20.00 ~ cr~~ ~ (4) Folding Chairs $ 15.00 ~ 3-Tier Table $ 10.00 Miscellaneous Games & Household $ 20.00 Vases, Shelves, Bingo Items $ 20.00 Wooden Cabinet $ 10.00 OTHER ITEMS C~ 1~ =~ ` 1972 Kennedy Half Dollar $ 3.00 (34) Mercury Dimes $ 35.00 Pennies $ 10.00 Postcards (Mt. Holly Springs) $ 20.00 Railroad Lantern (in basement) $ 15.00 tote/appralsa/ $2,328.00 ZIEGLER AUCTION COMPANY, LTD. appras.doc COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER _ 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 NUMBER DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENTANOTHE OATEOFTRANSFER. ATTACH ACOPY OFTHE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST EXCLUSION IF APPLICABLE TAXABLE VALUE ~ r ~ ,~ ~ , s,-~~ , ~~ ~~c c~r~ ~-~~7~'J C~ 9 iL- Ls 4" , ..5~~'Y~~ ! Y'.~.~'~ S' GOv ~ ~ 3~ ~U OO L .f JI`19 s, j C. o.r/.JG!~ ~ ~!' .~ ~ 9 - /`_ G O Wit- 7'-c~ ~~ ~~~c . ?GiG,z` / ~ y ~. ~ f TOTAL (Also enter on line 7, Recapitulation) $ j (If more space is needed, insert additional sheets of the same size) EV-1511EX t (1-97) - SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMfNfSTRATIVE COSTS RESIDENT DECEDENT ESTATE OF ~N~ ~ FILE NUMBER Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: t' / rYI /~, TG2 ~~o L- G. r ~v G ~' 2 ~~t y~~ ~~ /fcrn ~ oc C~J~`'. , ~ ~ ~ ~ ~ 9~ ` ~~ G'/~ C/'/ZGCf l ~~, rrG. ~ .,~ C'~2/S;'~ /,~ ~ : ~... t w4 ~r~k~~- /p ~i, a ~. ~,L ,,, ~> ~.::; G . o /~GS~if~-[~/ / ~ r~,~,r;°..v ».s,. r r4.a ~`~d~' ~`;~~, l..r' ~5 F r.. ., `j. Q B. ADMINISTRATIVE COSTS: ~ , Personal Representative's Commissions Name of Personal Representative (s) ~G ~ ~= ~ ~ ' `r~'~ ~~} '~ ~'~"~'7 L ~ `sn' ~ ~~ Social Security Number(s)1 EIN Number of Personal Representative(s) l 9 ~ ' `~y' G 8/Q ~' Street Address ~~d s~~~~~ G.5' +~'''++ ,f' ~~' -'3y / c;ty Sr ~-~, ~~ / ~il3 ~ ° s%te s~ ,-, ~`~ ~ ip ~ r~3 ~-Z J~ O c~ ~ ~ c~ G Year(s) Commission Paid: ~00.~ Attorney Fees ~~~ me ,., ~ c:~AJVi~ GS ~/ ~ 3 t~ , ~U 2. 3, Family Exemption: (If decedents address is not the same as claimants, attach explanation) Claimant ~~~ Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees ~~~~,..s T1 ~ ~ ~ • ~!~~ G G' ,~ ~ ~.. ~ ~~'"r~ ~rQ ~.~ ~.. ~'z~.,,.~ ~-~ ~ U 5 Accountants Fees 6. T-a~r'flett'm°Preparer ~,, iN ~~ ~y ~ 9~` r ~ ~:; r: "" "~ ~, ,..~, c;:. 9 , s' ~, Q~~~ 7 R~=y~ c~r~ K ~,~~~~ •~~,~f sres~ ~9~~rs~is~L ,~o~ - ~~ ~~, ~ ~ , ~ ~~-P ~ G/ i ' ~ ~ ~~ l3 . ~~31E s,~ ~cs~~,,, , Cam;/~r,~ ~~ ,~ ~ ~ e ,.., ,,'c,~,~ ~: ~~ ,~`;~~~,,` ,5- J c? .r l y ~ ~ .~ ~~~~~~r, ~ l~ ~ ~~..~ s e~. s.~~. ~~ e~,~..r- - ~.~ . ~~-i B.,t rt_ d.- -fir, r~ ~_t .,~'1 /~. ~S 1.r~ r ~ ~. srs C3 „ +~? +:I1J r TOTAL (Also enter on line 9, Recapitulation) $ ~ /~ ~~'~ ~ ~~ (If more space is needed, insert additional sheets of the same size) REVd512 EX • (1-9]) SCHEDULEI COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES, & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1. ~~GCS ,.5"C~ t! G Sc-2. VJG{, f CE2Tl/~iG.4~'i~%r/ ~ C;G L°!}f1i"~/G `?~~ ~`~ ,~G ~ ,~ le2t C~L~ii~C r 1.9/iti~/ G9 •ZE ~ C-iQ 3, E'i2 i c~~ off. S,~>~~=~ c. ~~ `'/. G ~ fvCS , Ti'>/t,s' ,c3 L a e./c ~ n7~/Z7`~ i~ m! ,,~ / ~ ~ , l't3 cam/ s~.s~ ~ -~..1.~ ,P,,.,~~ ~ G. /~ ~`~~ ~, ~IjC T- Gam/ C/.~~r. G, .;,-- / / 3 . Z Z S A N T ~~.,1 Lo .v.~ ~ Z G 2 ~1 r ~, ~v ~" ~ a* .v r ~ c''"~~~ei ~' .~ t ;~;," ~; ~~ /'''~~ ~ ~ c- ~ / ~' /~ / /~"~f . ~~~sll>,,~,~ ~ ri` . ~ ~.. r r.i !~~'.-~.. ~~, rYJ 7` i ~~ /'/~ v .~ t~i /v ~ S- ~ r c'C.C~ ~ ~i ~9 //.~ r , ~~G'ee.et r- r`' <,: ,C~ 3~ ~, i /~i , _ ! ~~~2G L: Syr.., j f' i~~ ~ r, . ~ ~J/-..a C_rlct ~ M c,~s' i 1C~ ~ / > 9 /~/Z-ca/Gwc07, /y7G/~/LL= /~'~~7iE" Y ~/f~ Cr! JTC7/ 3Z' ~y ~ G ~, ~ ~ a :~ `• ~=v ~~/ ~ /(J, /O / ~/ f~. ~ d ~~ , .~ r (e i ~~ ~~ O! ~ . ~ 9 TOTAL (Also enter on line 10, Recapitulation) I $ `~~ ~ ~~ (If more space is needed, insert additional sheets of the same size) ~'~LEMENT SHEET FOR SALE, PURCHASE, AND TRANSFER CZI+ MOBILE HOME, 4 CEDAR STREET REAR. MOUNT HOLLY SPRINGS. PA 17065 June 3, 2005 This transaction is in accordance with the terms and conditions of an Agreement b.rareen 3USEE HAWBAKER and DENNIS E. HAWBAKER, and THE ESTATE OF ANNA E. SMITH, DECEASED, dated April 15, 2005; and an Agreement lxtween THE ESTA'T'E OF ANNA E. SMITH, DECEASED, send DIAiViiE SOTELLO AvD ERICK SOTELLO, husband and wife, dated April 1 S; 2005 lay the Hawbaker Agreement, the Hawbakers agreed to seli their untitled 1979 Brookwood Mobile Home, size 12' k GS', Vll`d CL 3789, Tax Parcel No. 23-32-2:i3R- OGO-TR 03733 to the Estate; and by the Sotello Agreement, the Estate included the said mobile home where it is parked with the conveyance of real estate know as and numbered 4 Cedar Street, Mount Holly Springs, to the Sotellos as was acceptable to them. This instrwnent, when fully executed by the interested parties, shall mernoriaiize the settlement of the aforcmenticned exchanges, and serve as a Bill of Sale establis;ung new ownership. A Cumberland County Mobile Home Ownership Change Form is attached hereto and incorporated herein by reference. Counterparts of the entire instrument are being executed and furnished to those concerned. ESTATE $ 2,000.00 + 5.37 + G.90 + 4.12 $ 2,016.39 42. ~2 Contract Sales Price Tax Prorations~ County) 613 to Municipal) 12/31/05 School, 613 to 6/30/05 Gross Amount Due Final Water and Sewer Account #5153 .Ex $ 2,000.00 + 5.37 + 6.90 4.1? S 2,016.39 - 42.52 ~~~~ CASH to Hawbaker ~~-9 Setttement Sheet for Transfer of Mahilc Home Tune 3, 2QUS Page 7. , The undersigned hereby acknowledge receipt of a completed counterpart of kttis instrument with all attachments referred to herein. RUG E. Sh4ITE~, .hdministratar CAR.Y I,. SMITH, Administrator 5EE HA 'BAKER, Seller ~~,,~~~~ DI~7~1?ti1IS E. HAWBAKER., Seller DIr1?~I]'3E SOTELLO, Owner ~~ -_ ERICK SOTELLO, Owner ~~ ~ ~ Gam' ~-G®~c_ ~` G~-~--~~ VvILLIAIvI S. DA]VIELS, ESQUIRE Settlement Agent . C~~T~ FC~~~'~ B..E~,p,`1~D ~~p,N{GE C~~ ~~~~5~~~ ~ ~~~~ ~ e ~$ sold .. MQb~~e Ho»: ~ d 3~~, .._- use c~,~~~ete =~ 3 ~ ~~~ ~s'~2 Parcel ~~bet ~ ~-~ ,~~~~ ~~ . old ~-u,~,c= / ~c ~'~, ----`" Date s ,~..~,,~ ~ ~' ~ ~ ~ ~~.~ 1`~ ew ~.wIIex 2 ~'~ ~' ess CCD ~ X ~ ..5 wiling p~dc~ 5~ze , ~'~ ~' -~ ~o , oa 2 ,,~.e~ ~~~.-- ase price ~"''~~._--- p~'ch Loth ~.~8.c~ ~~ # _ ~L' ,. REV-1513 EX . (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE) BENEFICIARIES "~`. ~., , %`~` r FILE NUMBER ,.,, .__. ~ ~.. RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS (include outright spousal distributions} ,r'/ -~ ,~ #~~ 1.. , ,, . ~ ~=r:: ~ ,~, _ ~ . ~~~~ ~~. ~~/ ~' r 1~ '~'~ ~ ~'. ~. Yj7 GG :>' r°~ ~. O . ~ „~ ~ ~ i7, ,~ ~ ~ r. =; z- r ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIAT E, ON REV 1500 COVER SHEET ~A.~~R~BIST~I.1T~40N&a.~idDER°SEOfi10N~1"F3 FOR-WHIEH ANEL-E•ETlald Fa~AX I~u NOT BE7NG~IGYADf_ _. ,. ~ yn.~' ~.~ltp,~, e~ ,~ ~... ~ ,,c 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II • ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ to more space Is neeaeo, Insert aaalnonal sneers of the same size) d CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: ANNA E. SMITH Date of Death: January 16, 2005 Will No. 21-05-0183 Admin. No. To the Register: I certify that notice of estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on January 28, 2005. Name Address Raymond Smith 98 Parsonage St. Newville, PA 17241 Vicki Smith P.O. Box 43 Mt. Holly Springs, PA 170b5 Diane Sotello 224 Oxford Rd. Gardners, PA 17324 Josee Hawbaker 4 Rear Cedar St. Mt. Holly Springs, PA 170b5 Jodie Galloway 418 S. Baltimore Ave. Mt. Holly Springs, PA 17065 Roger E. Smith 1050 Six Ave., Oberlin Gardens Steelton, PA 17113 Gary L. Smith 403 E. Main St. York Springs, PA 17372 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: None Date: April , 2005 Signature Name: William S. Daniels Address: 1 West High Street, Suite 205 Carlisle, PA 17013 Telephone: 717-243-3 831 Capacity: Personal Representative X Counsel for Personal Representative