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Home My WebLink About09-22-091505607120 -' REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN 2 1 0 9 0 3 4 5 PO 60X.280601 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 211 01 6710 03 25 2009 10 09 1918 Decedent's Last Name HELINSKI (If Applicable) Enter Surviving Spouse's Information Beiow Spouse's Last Name Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW IX j 1. Original Return 4. Limited Estate X I 6 Decedent Died Testate ---~ (Attach Copy of Wilq ~~ Suffix Decedent's First Name MI JOSEPH p Suffix Spouse's First Name MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) 4a. Future Interest Compromise ~ 5. Federal Estate Tax Return Required (date of death after 12-12-82) ~ Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Trust) '- ~ 9. Llti ation Proceeds Received 10. Spousal Poverty Credit (date of death L _; g ~ between 12-31-91 and 1-1-95) ~~ 11. Election to tax under Sec. 9113(A) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number MICHAEL L. BANGS 717 730 7310 Firm Name (If Applicable) First line of address 429 SOUTH 18TH STREET Second line of address City or Post Office CAMP HILL Correspondent's a-mail address: State ZIP Code PA 17011 » REGISTER ~'~LLS US~NLY . ..,~ rn ;:=cn~ N r-~~ ; ~ ~-. c ~. ` ~C~~n n ~ ~~ ~;(~ - ~ ---t N D~E FILED N '_~ .. -i Under penalties of perjury, I declare that I have examined this return, including aceompanying 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. ~~,~~ /~~,,~.~'~ Andrea M. Reiser y ~ I ~ U 513 Nurse Drive South, Mechanicsbur , PA 17055 G TURE OF PREPARE OT R THAN RE E ENTATIVE DATE ~~~-~,~,,~,~ ~ '~ Michael L. Bangs ~ ~~ , ~~ ~~ 429 South 18th Street, Camp Hill, PA 17011 Side 1 1505607120 15~56Q7120 1505b07220 REV-1500 EX ~ecedent~s Name: Joseph P, H e l i n s k i RECAPITULATION 1. Real Estate (Schedule A) .......................................................................................... 1. 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. 6. Jointly Owned Properly (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) ....................................................................... g. 9. Funeral Expenses & Administrative Costs (Schedule H) ......................................... 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10. 11. Total Deductions (total Lines 9 & 10) ...................................................................... 11. 12• Net Value of Estate (Line 8 minus Line 91) ............................................................. 12. 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 APP LICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .00 0 0 0 15. 16. Amount of Line 14 taxable 3 9 3 1 6 8. 8 0 16 at lineal rate X .045 , . 17. Amount of Line 14 taxable at sibling rate X 12 0 0 0 17. 18. Amount of Line 14 taxable at collateral rate X .15 0 0 0 18. 19. Tax Due ..................................................................................................................... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Decedent's Social Security Number 211 O1 6710 168,260.94 3,950.66 256,066.10 428,277.70 25,512.93 9,595.97 35,108.90 393,168.80 393,168.80 0.00 17,692.60 0.00 0.00 17,692.60 Side 2 1505607220 1505b07220 REV-1500 EX Page 3 File Number 21-09-0345 Decedent's Complete Address: DECEDENT'S NAME Joseph P. Helinski STREET ADDRESS "~ 4723 Charles Road CITY STATE TZIP Mechanicsburg PA 17050 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 17,500.00 884.63 Total Credits (A + B + C) (1> 17,692,60 (2) 18,384.63 3. InteresUPenalty if applicable p. 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. (4) 692.03 Check box on Page 2 Line 20 to request arefund -- - - - - - 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) - -- __ A. Enter the interest on the tax due. (5A) ----__ _ B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 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 :.................................................................................. ~ j b. retain the right to designate who shall use the property transferred or its income :.................................... ~' ~ ' c. retain a reversionary interest; or .................................................................................................................. ~~ L_~ ~ -, receive the promise for ife 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?......... r ~' !' _ 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 exemat 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 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. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF (FILE NUMBER Helinski, Joseph P. 21-09-0345 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 wmpelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosetl on schetlule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH Real estate - 4723 Charles Road, Mechanicsburg, PA (see copy of settlement sheet 168,260.94 attached; $5000.00 of total proceeds to be held in escrow pending approval of inheritance tax return) TOTAL (Also enter on Line 1, Recapitulation) I 168,260.94 (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 A (Rev. 6-98) COMMONWFJILTH Of PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF (FILE NUMBER Helinski, Joseph P. 21-09-0345 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Refund from Comcast 38.66 2 Refund from Penn National Insurance 137.00 3 Automobile -1998 Toyota Camry (see Bill of Sale attached) 3,775.00 TOTAL (Also enter on Line 5, Recapitulation) (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. 3,950.66 Form PA-1500 Schedule E (Rev. 6-98) SCHEDi/LE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Helinski, Joseph P. 21-09-0345 If an asset was made Joint within one year of the tlecedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Andrea M. Reisser 513 Nursery Drive South 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 ANO BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1 A 812 811 9 7 6 M&T Bank -Checking Account 31,069.07 50.000% 15,534.54 2 A 11/22/1999 M8r,T Bank -Certificate of Deposit 35,000.00 50.000% 17,500.00 31003913921027 3 A 8/10/2000 M&T Bank -Certificate of Deposit 62.612.38 50.000% 31,306.19 31003913921499 4 A 8/11/2000 M&T Bank -Certificate of Deposit 78,929.93 50.000% 39,464.97 31003913921506 5 A 11/18/2005 M8~T Bank -Certificate of Deposit 81,858.78 50.000% 40,929.39 31003915936529 6 A 9/5/2006 MST Bank -Certificate of Deposit 102,630.46 50,000°/d 51,315.23 31003915944978 7 A 7/25/2008 M$T Bank -Certificate of Deposit 60,015.78 100,000% 60,015.78 31003918743038 TOTAL (Also enter on Line 6, Recapitulation) I 256,066.10 (If more space is needed, additional pages of the same size) Cogvright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev. 6-98) r.cv ~iai cn ,~<aa, COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHED~JLE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Helinski, Joseph P. 21-09-0345 Debts of decedent must be reported on Schedule 1. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s) attached B. ADMINISTRATIVE COSTS: 1. Personal Representative'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 Michael L. Bangs 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 14,171.87 6,000.00 4. Probate Fees 556.00 5. Accountant's Fees 700.00 6. Tax Return Preparer's Fees 7. Other Administrative Costs 4,085.06 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 25,512.93 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) SCHED ~JLE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Helinski, Joseph P. 21-09-0345 AMOUNT ITEM DESCRIPTION NUMBER Funeral Expenses 1 Malpezzi Funeral Home 14,171.87 H-A Subtotal 14,171.87 Other Administrative Costs 2 B & T Painting 3,000.00 3 Cumberland Law Journal -estate advertising 75.00 4 Gould's Carpet Cleaning 200.00 5 Kohler Roofing & Siding 140.00 6 Shirley Brown -cleaning of house for sale 275.00 7 Steven Reisser -lawn care services 250.00 8 The Sentinel -estate advertising 145.06 H-67 Subtotal 4,085.06 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) SCHED~/LE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER Helinski, Joseph P. 21-09-0345 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Brandy Barner -health care services 94.00 2 Comcast 77 25 3 DFAS -Return of annuity payment 3,618.00 4 Griswold Special Care - 3113109 290 ZO 5 Griswold Special Care - 3120109 264.60 6 Griswold Special Care - 3/25/09 192.20 7 Hampden Township 138.65 8 Jerri Martin -health care services 282.00 9 Louise Breski -health care services 410.50 10 MCI 52.32 11 MCI - (6115109 14.77 12 MCI 14.94 13 PA American Water - 3/24/09 to 4/23/09 32.39 14 PA American Water ~ 92 15 PA American Water - (6/15109) 34.52 16 PA American Water - 5123109 to 6/23109 31.67 17 PA American Water - 6123109 to 7/24109 36.75 Total of Continuation Schedule See attached page TOTAL (Also enter on Line 10, Recapitulation) 9,595.97 (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 I (Rev. 6-98) R¢V-1512 EX+ (6.9tl) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS continued ESTATE OF (FILE NUMBER Helinski, Joseph P. 21-09-0345 DESCRIPTION PA Department of Revenue - 2008 income tax due PP8~L Electric PP&L Electric PP&L Electric - 5/1/09 to 612/09 PP8~L Electric - 611/09 to 7/2/09 PP8r,L Electric - 7/1/09 to 8/3/09 United States Treasury - 2008 income tax due VALUE AT DATE OF DEATH 473.00 194.29 172.80 174.60 172.80 172.80 2,606.00 TOTAL (Also enter on Line 10, Recapitulation) I 9,595.97 Cogvright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98) REV-1513 EX+ (9.00) scHEOV~E ~ COMMONWEALrH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Helinski, Joseph P. 21-09-03 45 NAME AND ADDRESS OF RELATIONSHIP TO DECEDENT SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY Do Not List Trustee s (Words) ($$$) I, TAXABLE DISTRIBUTIONS [include outright spousal and transfers distributions , under Sec. 9116(a)(1.2)] Maureen Frances Hallett Daughter 104,542.20 930 Woodley Drive Mechanicsburg, PA 17055 David A. Helinski Son 79,542.20 501 Blue Grass Drive Canonsburg, PA 15317 Barbara Joette Philpott Daughter 104,542.20 14404 Coachway Drive Centreville, VA 22020 Andrea M. Reisser Daughter 104,542.20 513 Nursery Drive South Mechanicsburg, PA 17055 Total 393,168.80 Enter dollar amounts for distributions shown above on lines 15 through 18, as appropr iate, on Rev 1500 cove r sheet II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FO R WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS oN uivt ~ s Ur rctw~ 5uu cwtK srltt I I v.vv Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98) A. Settlement Statement B. Type of Loan U.S. Department of-lousing and Urban Development nMR Annrnu~l Nn 9F.n9_n?RF (o. n:.~,~ ~ ~ 12nlOMO~ 1. DFHA 2. []FmHA 3. QConv. Unins. 4. ^VA 5. ~iConv.lns, 6. File Number 09.01-6-10647CAP 7. Loan Number 8. Mortgage Insurance Case Number s am isTUnislieii give you a s amnad-nrecTur se rernerd cost . rr - s o m are - C. Note: a marred °tP.o ~ )-ware Pais a,lswr~ Inn ,,,,ea,g; uxry era srpwn here rw inamelion purposes and are rat incArded tin mama{,. WARNING: N is a crmle Io knawiryly mut.~ ial.., slelemeMa to Ore Unbod Steles on this or any olhar aimbar rann. Penehlas upon - rAnvictiai cwt include a fine andnrpnaaunenl I~x baleds see: Tina 10 U. 5. !;ode Sedion 1 1 erW~seaion Cato. _ Ti1leExpress Settlement System Printed 08124!2009 at 12:54 LM D. NAME OF BORROWER: Alice M. Ebert ADDRESS: 4 Delmar Ridge Criv~Wellsboro, PA 16901 _ E. NAME OF SELLER: Estate of Joseph P. Helinskl ADDRESS: 4723 Charles Road Mechanicsbur5, PA 17050 F. NAME OF LENDER: ADDRESS: _ G. PROPERTY ADDRESS: 4723 Charles Rcad, :Mechanicsburg, PA 17050 Hampden 7ownshi~i _ H. SETTLEMENT AGENT: Barristers Land Abstract Company, Telephone: 717.761-6190 Fax: 117-761.4!i72 PLACE OF SETTLEMENT: 3310 Market Street, tramp Hill, PA 17011 _ I. SETTLEMENT DATE: 0812412009 J. SUMMARY OF_BORROWEf2'S TRANSACTION: K. SUMMARY OF S ELLER'S TRANSACTION: 100. GROSS AMOUNT DUE FROM BORROWER _ 400. GROSS AMOUNT DUE TG SELLER 101. Contras sales Qice 182 700.00 401. Contract sales ~ e 182 700.00 102. Personal Property 402. Persona! Pr 103. Settlement charges to borrower (line 1400] 3 390.25 403. 104. 404. 105. 405, Ad'ushnents for items paid by seller in advance Ad ustrnenls fw items aid b seller in advance 106. Cil !town taxes 406. Cit !town taxes 107. Count taxes OB114/09to12131/09_ 136.18 407. Count taxes 08124!09to12131109 136.16 108. School taxes 08124!09 to 06130110 1 122.01 408. Scholl taxes 08!24!79 to 06/30110 1 122.41 109. SewerfSrash OB124I091o09130109 57.26 409. Sewer/Trash 08124!391009130109 57.26 110. 410. 111. 411. 112. _ 412. ' 120. GROSS AMOUNT DUE FROM BORROY~lER 187 405.70 _ 420. GROSS AMOUNT DUE TG SELLER 184 015.45 200. AMOUNTS PAID BY OR ON BEHALF OF_BOR ROWER 500. REDUCTIONS IN AMOUNT DUE TO SELLER 201. De sit or earnest more _ 10 000.00 501, Excess De it see insWctions 202. Princi al amount of new bans 502. Settlement cha es to seller line 1400 20 754.51 203. Existing loan(s) taken subject to 503. E)dst ban s taken su ' io 204. 504, Pa off of First Mort a Loan 205. 505. 206. 506. 207. 507. - 208. 508. 209. ^- 509. Ad'ustments for items unpaid by seller Ad'ustments fer items un aid b seller 210. Cit (town loxes 510. Ci /town taxes 211. Countylaxes 511. Cau taxes 212. School taxes 512. School taxes 213. 513. 214. 514. 215. 515. _ 216. 516. 217. 517. 218. 516. _ 219. 519. 220. TOTAL PAID BYIFOR BORROWER 10 000.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 20 754.51 300. CASH AT SETTLEMENT FROM OR TO BORROWER 600, CASH AT SETTLEMENT TO OR FROM SELLER 301. Gross amount due from borrower (line 120) 187405.70 601. Gross mount due to seller line 420 184 015.45 302. Less amounts paid bytfa borrower Cline 220) 10 000.00 1102. Less reduction amount due se!'sr !ine 520 20 754.51 303. CASH FROM BORROWER 177,405.70 603. CASH TO SELLER 163,260_94 SUBSTITUTE FORM 1099 SEl LER STAI EMENT: The 1Mamalian contained heron b Mnportant tau Mantea0an aM b bekg henished b the Urlernal Revenue Sryvlce. b you are requirrd to fib a velum, a negligence penally a umer sancllon vall be Inpraed m you it This item is rorprked to ba repated and We IRS rblarnbnes hat b hes not been reported. the ConUacl Sales Pdce desalbed on line 0 aluwe consblules ble Goss Proceeds W bus Irensedror:. You are reglMed bylaw to prande me selbamenl agent (Frei. Tax ID No: 1 rMN yb~r correct taxpayer Identl11ca0on rarnber. b you do net provide your coned teuPeyer bendficetbn numhrl, you may be sub)ecl to civil w crerulual pawlUes urpused by low. erperjlxY, I Carilly that ma raarOef stbwn on this slalemenl u my cmect laxpeyer idmw eon numbs. TIN: -_ r , __ SELLER(S)SIGNArURE(S): SELLER(S) NEW MAILING ADDRESS: SELLER(S) PHONE NUMBERS: CH) 1301. Home Warranty to HSA 419.00 1302. PesUHomelRadon Inspections to Inspection Center (P.O.C.) 31G 190 Bu er _ 1303. Escrow for Inheritance Taxes to MichaEll L.Bangs, Esq 5 000.00 1304. 200912010 School Taxes to Michael Langan, Treasurer 1 290.49 1305. SewedTrash -Jul -Se temher to Ham den Township _ 152.52 1306. Tax certification to Michael Langan, Treasurer 5.00 1400. TOTAL SETTLEMENT CHARGES (enter on lines 103 Section J and 502, Section Ki _ 3 390.25 20 754.51 HUD CERTIFICATION OF BUYER ANO SELLER 1 have rarelully raNevred the HUD-1 Selllemenl Slalem±nl nrl to Use best d my NnowlMFle and hdkl, N b a hrro end ecaeale slalomed d aN ~ e ~eipls and dlsbursemenb matle on rtry eccaxd or by me 1 Nish nsaclion. I rwther cerU(y Thal 1 have roc d e copy d the HUD-1 SHUemenl Statement. c ,~ - e o osep a~ ~ WARNING: 0 LS A GRIME TO KNOWINGLY MAKE FA.L.SE STATEMENTS TO THE The HU0.1 SelUen+enl SI lemknl vfi nave prepared is a We and accurate accanl d Ihls UNITED STATES ON T41S OR ANV SIMILAR FORM. PENALTIES UPON CONVICTION Iransadian. I have cause se U lands b sows actor nce vA1N this s 1. CAN INL'LUDE A FINE ANO IMPRISONMENT. FOR DEiR.ILu SEE TITLE 18: - U.S. CODE SECTION 1001 AND SECTION 1010. ./~ s (/ SETTLEMENTA T' - __ DATE: Q M8~'sank 499 Mitchell Road, Millsboro, DE 19966 Mai! Code DE-MB-12 Phone (888)502-4349 Fax (302)934-2955 April 29.2009 Bangs Law Office Michael L. Bangs 429 South 18th Street Camp Hill, PA 17011 Re: Estate o~seph P. Helinski Social Security: 211-01-6710 Date of Death: March 25, 2009 Dear Sir or Madam: Per your inquiry dated April 21, 2009, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type of Account CheekingAceount Account Number 42122007 Ownership (Names o~J Joseph P Helinski* Opening Date Balance on Date of Death Accrued Interest Total 2. Type ofAccount Account Number Ownership (Names ofJ Opening Date Balance on Date ofDeatr, Accrued Interest Total Andrea M Reisser* 8/28/76 Closed 4/17/09 $ 31,069.07 $ 1.06 $ 31 070.13 ___._ Cert~cate of Deposit 31003913921027 Joseph P Helinski Andrea MReisser* 11/22/99 Closed 4/17/09 $ 3S, 000.00 $ 1.65 __. _. _ _ - $ 3.i, 001.65 3. Type of Account (.'ertificate of Deposit Account Number 31003913921499 Ownership (Names ofJ Joseph P Helinski* Maureen F Hallett Opening Date 8/10/00 Closed 4/17/09 Balance on Date of Death $ 62, 612.38 Accrued Interest $ 276.02 , Total $ 62, 888.40 4. Type of Account Certificate of Deposit Account Number 31003913921506 Ownership (Names o~ .Ioseph P Helinski* Barbara J Philpott* Opening Date 8/11/00 Closed 4/17/09 Balance on Date of Death $ 78, 929.93 Accrued Interest $ 57.67 Total $ 78 687.60 5. Type ofAccount Certificate of Deposit Account Number 31003915936529 Ownership (Names o~ Joseph P Helinski* Andrea M Reisser* Opening Date 11/18/05 Closed 4/23/09 Balance on Date of Death $ 81,958.78 Accrued Interest $ 19.42 Total $ 81,978.20 6. Type of Account Certificate of Deposit Account Number 31003915944978 Ownership (Names ofJ Joseph P Helinski* Andrea MReisser* Opening Date 9/5/06 Closed 4/17/09 Balance on Date of Death $ 102,630.46 Accrued Interest $ 144.85 Total $102, 775.31 7. Type ofAccount Certificate of Deposit Account Number 31003918743038 Ownership (Names o~ Joseph P Helinski* Andrea M Reisser* Opening Date 7/25/08 Closed 4/17/09 Balance on Date of Death $ 60, 015.78 'Accrued Interest $ 149.38 Total $ 60,165.16 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, etc., please cont~cct our Hampden Office # 717-255-2293. Sincerely, '~li~-~~~ ~~n l~C__~ Tracie Hare Adjustment Services BILL OF Sr-1LE [, ANDREA ~. RF,I~~SF,R, Executrix of the F.,state of .foseph P. Helinski. do hercbv sell a 1998 Toyota Camay, Vehicle Identification Number (VIN) JT2B=T22KUWUI4?9''0 to Andrea M. Reiser for the sum of'I•hree "thousand Seven I-lundred Seventy-five and UU/lUU ($3,77.00) Dollars. ti _~ " .+, P / ~. ,. H ( < Date. _. , `- ~^ AN[)Rt;A M. REISSEIZ, Executrix LAST WILL AND TESTAMENT OF JOSEPH PETER HELINSRI I, JOSEPH PETER HELINSKI, Social Security Namber 211-01-6710, of the State of Pennsylvania, declare that this is any LAST WILL AND TESTAMENT and I revoke all other- wills and codicils previously made by me. ~4 nc~ rPa Y'~ • d~e`~ss~ r FIRST: I appoint my daughter, 'f?S uTT~ as myAndrPQ ~ ersonal Representative concerning this Will . I E: ;my daughter, p4.~r1RFFn 1~c',s~~''i H"r is unable or fails to serve, I t'~en appoint my daughter, ~D&~A ~!-.~Pt~~ .~r to se~ as my Persc gal Representative. au.r~ en 2~vrP~ ~~Lt' :;~; a. I request that my Personal Represe:.~tative be permitted to serve without bond or surety theareon and without~;the intervention of any court, except as required by law. I direct ~.~at my Personal Representative act in unsupervised administratio;. so as to administer my estate with a minimum of court supervision. ~:f it becomes necessary to have ancillary administration of my estate in ~::ny jurisdiction where my Personal Representative is unable or does not desire to qualify as ancillary legal representative, I appoint as suc~a~ancillary legal representative such individual or corporation as'my Personal Representative shall designate, in writing. b. I direct my Personal Representativ.~ to pay the expenses of my last illness, the expenses of a funeral ap~~ropriate to my station in life and custom of living (including a suitab.~e monument or marker for my grave), and written charitable pledges wh3_ch I have made. I grant my Personal Representative the power to ex :end or renew any debt for such time as my Personal Representative shah. deem appropriate. c. All estai.e, inher:Ltance, successic~ and other death taxes with respect to all property passing under this -:s~ Will shall be paid from and borne by the L~r.incipal of my residuary _a,tate, without regard to reimbursement, as i:~ such taxes were administ4_-~ztion expenses. My Personal Representative may pay such taxes at ar.~~~ time deemed advisable, whether or 'iiio~t then due and payable. d. My Personal Repre:entative is requF~sted to settle my estate as soon after my death as may be practica~se, and to pay or deliver every legacy or :bequest to my beneficiar.zc~s without waiting any time that may be believed to be customary in probate matters. ~~ ~ ' ~ ~ PAGE 1 _ p ~f ~~ ~~-~~~~~ L 1~c~°- ~~ OF 6 PAGES ~~ ,E-. ~~ ~- \._ v e. I have served in th.e Armed Forces of the United States. Therefore, I direct my Personal Representative t~ consult with a Legal Assistance Attorney at ..the nearest military inst~Ilation and with the Department of Veterans Affairs a.nd the Social Security Administration to ascertain if there are any benefits to which ~±y family members are entitled by virtue of my military service. f. I may leave a letter of intent with -the executed copy of this Will for the purpose of giving guidance to ry Personal Representative concerning the distribution or sa~.e of certain items of my property. I request, but do not require, tha my Personal Representative honor my wishes therein expressed: SECOND: T give, devise and bequeath, absolutely and forever, all of my estate and proper..ty of which I may be seized or possessed, or to which I may be entitled, at the time of my death, wherever situated or of whatever nature, be it real, personal, or mix.'d, to my Wife, IRENE MARGARET HELINSKI, as her sole and absolute property if she shall survive me. THIRD: In the event that my Wife, IRENE MARGARET HELINSKI shall not survive me, I hereby make the following spec:.~_fic bequests: a. To my daughter, MAUREEN FRANCES HA~~LETT, I give the sum of Twenty-Five Thousand Dollars ($25,000.00). . b. To my da~sghter, BARBARA JOETTE PHI~,FOTT, T give the sum of Twenty-Five Thousand Dollars ($25,000.00). c. To my daughter, ANDREA M. REISSER~ I give the sum of Twenty-Five Thousand Dollars ($25,000.00). FOURTH: In the event that my Wife, IRENE MARGARET HELINSKI shall not survive me, I give, devise and bequeath, absolutely and forever, all of the rest, residue and remainder of my estate and property of which I may be seized or possessed, or to which I may be entitled, at the time of my death, wherever situated or of whatever nature, be it real, personal, or mixed, to my children, MAUREE~~ FRANCES HALLETT, BARBARA JOETTE PHILPOTT, ANDREA M. REISSER and DAVID A. HELINSKI and to any child or children that have been or may be born to or adopted by me, in shares of substantially equal value to be divided as they may agree. a. If any of my children shall not survive me, then I give the share of that deceased child to my surviving children in shares of substantially equal value to be divided as they may agree. ~ PAGE 2 ~' OF 6 PAGES l,..J~--~ ~~ 1 ~~~'~-ems ~ ~_ ~~~ _._ -~ I b. If none of my children survive me, then I give, devise, and bequeath, absolutely and forever, all of my estate and property of which I may be seized or possessed, or to which I may be entitled, at the time of my death, wherever situated or of whatever natures be it real, personal, or mixed, to the descendants of my child or children, who are to take per stirpes and not per capita, in shares of substantially equal value to be divided as they may agree. In order to receive a share of my estate under this paragraph, a descendant of any child of mine must survive me. c. If they are unable to agree, the division among my children and the descendants of any of my children who fail to survive me shall be made by my Personal Representative, in that person's sole and absolute discretion. I empower my Personal Representative to sell any or all of such property, if such property is not distributed in kind hereunder, and to distribute the proceeds ~..mong my said children in substantially equal shares. Any determination of my Personal Representative as to what should pass or be sold under this paragraph and to whom it should pass or be delivered or at what price it should be sold shall be conclusive. FIFTH: If there is a complete failure of makers under the preceding paragraphs, the property undisposed of shall be distributed as follows: a. A one half share shall be distributed to my heirs determined at the time of my death, pursuant to the Statutes of Descent and Distribution in effect, in the state of my comicile, at the time of my death. b. A one half share shall be distributed to the heirs of my Wife, TRENE MARGARET HELINSKI, the identity of such heirs to be determined at the time of my death, pursuant to the Statutes of Descent and Distribution in effect, in the state of my domicile, at the time of my death. SIXTH: If any beneficiary to any share of my estate which is not subject to the provisions of ar.~y trust which may be created by this will is at the time of distribution of his or her share, a minor under the laws of his or her domiciles, I direct that the minor's share be converted into qualifying propesrty and delivered to the minor's Guardian as Custodian for the minor under the U;iiform Gifts to Minors Act or the Uniform Transfers to Minors Act as may then be in effect in either the state in which the beneficiary or the Custodian resides, or any other state of competent jurisdiction. ~' ~ - / PAGE 3 .P~~~~G~ OF 6 PAGES G~f' C_._-CJ ,~% ~,~ -7`~~'~' a. The Uniform Gifts to Minors Act or The Uniform Transfers to Minors Act, as may then be in effect in the state concerned, is hereby incorporated by reference. The property affected by the Act shall be managed, held, and distributed in accordance with the provisions of the Act. b. The financial custodian will serve without band or surety and without intervention of any court, except as required by law. c. The receipt by tha_ Custodian, for the minor, of any principal or income transferred pursuant to this paragraph shall be a full acquittance and discharge of my Personal Representative or Trustee, as applicable, from livability with resg~ct to such transfer and from further accountability for the principal or income so transferred. SEVENTH: Except as otherwise provided in this Will, I have intentionally failed to provide for any other relatives or other persons, whether claiming to be an heir of mine or not. Insofar as I have failed to provide in this Will for any of my issue now living or later born or adopted, such failure is intentional and not occasioned by accident or mistake. EIGHTH: Any beneficiary who fails to survive until one hundred twenty (120) hours after my death shall be deemed to have predeceased me, and the gift to that beneficiary shall be disposed of accordingly. NINTH : Definitions a. The term "children" as used in this Will includes adopted and afterborn persons. The term "children" as used in this Will shall not include step-children, the natural born or adopted children of a person's spouse who are not the natural born or adopted children of the person. A relationship by or through legal adoption shall be treated the same as a relationship by or through blood for purpose of succession to property under this Will. b. The term "descendants" as used in this Will means the immediate and remote lawful, lineal descendants by blood or adoption of the person referred to who are in being at the ~:ime they must be ascertained in order to give effect to the refe~e:nce to them. c. The term "Persona.l Representative`' as used in this Will means Executor, Executrix, Independent Executor. or any other title of like import which is used to de~.scribe such a fi~:uciary. (1 . _ _ _ ~ ~ ~ ~ PAGE 4 S ~ ~ ~~ \~~~, ~ -C _ OF 6 PAGE _~ { d. The term "per stirpes" as used in t:his Will means that whenever a distribution is to be made to the de.-,~cendants of any person, the property to be distributed shall be divided:~.nto as many shares as there are (1) living children of the person, an`~-(2) deceased children, who left descendants who are then living, of th~=w person. Each living child (if any) shall take one share and the sha~.:c of each deceased child shall be divided among his then living descendants in the same manner. TENTH: In addition to any powers granted Fey the laws of the state in which this Will is probated, I hereby author.~..ze and empower the fiduciaries named in this Will, to the extent o-.: the discretion herFin granted, to sell, exchange, convey, transfer, ~:;~-ign, mortgage, pledge, lease or rent the whole or any part of my real -~r personal estate, to invest, reinvest, or retain investments of my e.-sate, to perform all. acts and to execute all documents which my fidu`-~iaries may deem necessary or proper in regard t.o my property. if any of my fiduciaries elect to receive compensation for services, suc~ compensation will be that allowed by law. ELEVENTH: If any part of this Will shall -~~~, invalid, illegal, or inoperative for any reason, it is my intention --:.hat the remaining parts, so far as possible and reasonable, shall lye effective and fully operative. My Personal Representative may seek and obtain court instructions for the purpose of carrying out as nearly as may be possible the intention of this Will as shown by {,he terms hereof, including any terms held invalid, illegal, or i*~operative. IN WITNESS WHEREOF, I have at Carlisle Barracks, Pennsylvania, this I9~ day of ~A~~~~ , 19r~, set my Y~.~nd and seal to this my LAST WILL AND TESTAMENT', consisting of .:~ typewritten pages, each page bearing my handwritten signature. This document was prepared under the authority of 10 U.S.C. section 1044, and implementing military regulat.;_~ans and instructions, by Robert P. Formichelli, who ~s licensed to pr-a.-„-tice law in the State of New York. ~~ a ~. r ,~ ~ \, /' 1 ~' ~ ~'~%/ ~_ ( SEAL ) ' JO PH PETER HELIN<3KI - _.. j , QQ /i PAGE 5 , / ~-Gp~~ OF 6 PAGES ___~~ K The fr/oregoing instrument was, at Carlisle ~3arracks, Pennsylvania, /; ~` ~ ~ this ~`~ _ day of ~~ 7 , 19 ~ -~ sigtled, sealed, published and declared by JOSEPH PETER HE~LINSRI, the test:~tor, to be his LAST WILL AND TESTAMENT in the presence of all of us at one time, and at the same time we, at his request ar.~d in his presence and in the presence of each other, have hereunto subscribed our names ~s attesting witnesses, and we do so verily believe than the said testQ~;or is of sound and disposing mind and memory at the date hereof. Soc.Sec.No. OF /~~. ~~~~~~ `~ ~~ ~~ Soc.Sec.No. 17613 3oc.Sec.No. .)F ~df~~ /T _. / ~~i _~ PAGE 6 OF 6 PAGES ~ _ c_(.~c„~ ~/ ~j~ f~ COMMONWEALTH OF PENNSYLVANIA CUMBERLAND COUNTY ACR:NOWLEDGMENT I, JOSEPH PETER HELINSKI, testator, whose,iame is signed to the attached or foregoing instrument, having been daly qualified according to law, do hereby acknowledge ghat I signed and, executed the instrument as my Last Will; that I signed it willingly; an*i that I signed it as my free and voluntary act for the purposes therei .expressed. ~~C-~a'~~~~ G ~'G , (SEAL ) PETER HELINSKI IDAVIT ~ o r /~`r~~c. ~~ i r C-S ~~ C ~~ G , and _ ~LC~~~ ~ . ~T(~z ~ , the witnesses, sign our names to this instrument, being duly qualifiesd according to l.~w, do depose and say that we were present and saw the testator sign end execute the instrument as his Last Will; that the testator aigned willingly and executed it as his free and voluntary act for t'•ze purposes therein expressed; that each subscribing witness in the hearing and sight of the testator signed the will as a witness; and .hat to the best of our knowledge the testator was at i:hat time 18 or m:~r_e years of age, of so 'nd a d under no constraint or undue influence. ~~ ~ ~~O ~~ ~~ Witnes Witnessa d`'~ Witness Subscribed, sworn to and acknowledged before me by JOSEPH PETER HELINSKI, the testator, and subscribed and sworn to before me by ~~~ ~ ~ ~ic%~~i L b '~ ~ ~c~Q 6c. - and the witnesses, this ~~~~ day of ARY PUBLIC My Commis .;.ion ---- 0 Kim C. Guyer, Notary Public Carlisle Boro, Cumberland County My Commission Expires Nov. 10, 1997 hl:: ~r;l~r, Pennsyt~~ania /assoaation of No?_