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HomeMy WebLinkAbout10-02-09 (2)15056051058 REV-1500 EX (Olt-05} OFFICIAL USE ONLY PA Depar'ment of Revenue County Code Year file Number Bureau of Individual Taxes INHERITANCE TAX RETURN ' Poaox2aosol 21 09 0545 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth __ 16 2 - 2 2 - 3 615: May 31, 2009 March 23, 1923 Decedents Last Name Suffix Decedent's First Name Mt R1app _ _ _. .Alyce R (If Applicable) Enter Sunelving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI _.. _ Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REG{STER OF W{LLS FILL IN APPROPRIATE CANALS BELOW ~;; 1. Original Retum ~,'a;M. 2. Supplemental Return r;;,~;;~ 3. Remainder Return (date of death prior to 12-13-82} ... 4. Limited Estate ~:"~a 4a. Future Interest Compromise (data of ~°;~.;;3 5. Federal Estate Tax Return Required death after 12-12-82) _ 6. Decedent Died Testate ~".""? 7. Decedent Maintained a Living Trust S. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received t;':.°A 10. Spousal Poverty Credit (date of death C'";'~ 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 fNfORMATION SHOULD BE DIRECTED T0; Name Daytime Telephone Number ... Andrew C. Sheely, Esquire 717-697-7050 Firm Name (If Applicable) _ _ r~ .. ~.,.. .. . ,.. ... C REGISTER OF W~LLS USE ON~Y, ,._~ - i Andrew C. Sheely, Attorney at Law ~ ~ ~ ~ ~-~ r- .`s, _~, ~ ~ `- First line of address i i. "A -'t t- _~ .127 South Market Street I t `" ~ t~ - ~ ~ ~ ~ , Second line of address € ~ .-~, ~. `~ ` ~- P. O. Box 95 `~ , A ~ ~ s `. __ --+ _. City ar Post Office ___ State ZIP Gode ~ _ . _ .. ...DATE D...._ _.. ..t.,.~ ~ "• _ . _ _ G1J Mechanicsburg ~ PA ..17055 Correspondent's a-mail aearess; andrewc.sheely@verizon.net Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to fha bast of my knrnvledge and belief, tt is true, correct and complete Declaration of preparer other then the personal representative is based on all information of which preparer has any knowledge. S! TU O~ER N ONSIBLE FOR FILING RETURN /~./'/ c~ Carol A.Huffer,602 ocklin St.Mechanicsburg,PA 17055/Canstance R. Poe,516 W.Elmwood,Mechanicsburg/PA SIGNA OF P PARE ' T R RESENTATIV - ~~ a F1 pnn Gc Q~Z( a Andrew C. Sheely, Esquir 1 South Market Street, P.O. Box 95, Mechanicsburg, PA 17055 ^ PLEASE USE ORIGINAL FORM ONLY Side 1 15056051058 15056051058 15056052059 REV-1500 EX Decedent's Social Security Number .. Decetlent'sName: Rupp, Alyce R. _ ...~._.,...__.......__..._ __..._.__._~.._.__.~.,~_.._.,._.w__......_ _ __......_.__....__ ~ 162-22-3615 .__.__~__.__~.. ~~__..__ . RECAPITULATION ,_ _. __ 1. Real estate (Schedule A) .......................................... ... 1. ! 162,500.00: 2. Stocks and Bonds (Schedule B} .................................... ti .. 2. 2,472.75' 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C} .. ... 3. i 4. Mortgages 8 Notes Receivable (Schedule D} ................ . ......... ... 4. 5. Cash, Bank De osits & Miscellaneous Personal Pro ert Schedule E p P Y( ) ..... ... 5. ' 50,285.13 6. Jointly Owned Property (Schedule F} t„ Separate Billing Requested .... ... 6. `, 150, 789.45 7, Inter-Vivos Transfers & Miscellaneous Non-Probate Property ` 609 46 2 : (Schedule G) ~ Separate Billing Requested..... ... 7. . , . 8. 7otai Gross Assets {total lines 1-7}......... ....... ... 8. 368,656.79 9. Funeral Expenses & Administrative Costs (Schedule H) .................. . .. 9. ~ 8,468.27 1Q. Debts of Decedent, Mort a e Liabilities, & Liens Schedule I 9 9 ( ) ............ , . 10. . 2,261.39 11. Total Deductions {total Lines 9 & 10) . ........ . . . . ... . .... . . . . .... . . .... 11. ` 10,729.66 12. Net Value of Estate {Line 8 minus Line 11} .... . . . .. . .... . . ..... i ... 12 357,927.13... 13. Charitable and Govemmentai BequestsJSec 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. { 357,927.13.. . , ..~w._ .._~. ,,,~. w _...~.~.M.~~~~.w_~w~~.....,~~_.., ..__._..._ ,__.__..~..~_.._ TAX COMPUTATION • SEE INSTRUCTIONS FOR APPLICABLE RATES ~_~. r,~_~_..~.,,..m_w.~w...~...~.~_..,.~... ,..w. ._._,__.~....,.__.. 15. Amount of Line 14 taxable at the spousal tax rate, or tans ers un a~ ec. (a)(1.2) X .0. 15. 16. ..,,.....e .w .,,.,.~,,... .....,__ .. .... ...._ .._. Amount of Line 1-0 ~~~eble 357,927.13. at lineal rate X .p45 _. _..... _ .. 16. 16,106.72 17. ..... _ _ ..,ti.... , Amount of Line 14 taxable at sibling rate X .12 17, 18. Amount of Line 14 taxable at collateral rate X .15 18. 19. TAX DUE ....... ............................................. ....19.` _. _._ _ 16,106.72 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ~„~;;~ ~~ 1505605~?059 Side 2 15056052059 REV-1500 EX Page 3 Decedent's Complete 10.ddress: Alyce R. Rupp STREET ADDRESS 117 East Maplewood Avenue ___ CITY STATE Mechanicsburg _ PA Tax Payments and Credits: t. Tax Due (Page 2 Line i9) (1) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments 15,000.00 C. Discount 789.45 Total Credits { A + g + C) (2) 3. InteresUPenalty if applicable D, Interest _ E. Penalty Total InteresUPenalry { D + E) {3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference, This is the OVERPAYMENT, Fill in oval on Page 2, Line 20 to request a refund. (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Lsne 5 + 5A. T'his is the BALANCE DUE. (5B) 16,106.72 15,789.45 317.27 317.27 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred :.......................................................................................... ^ b. retain the right to designate who shall use the property transferred or its income :............................................ ^ c. retain a reversionary interest; or .......................................................................................................................... ^ d. receive the promise for life of either payments, benefits or care? ...................................................................... ^ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ............................................................................... ^ 3. Did decedent own an "intrust for" or payable upon death bank account or security at his or her death? .............. ^ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ................................................................................................ ^ {F THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN For dares 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 an 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 sta!ute 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, 21)00: 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 j72 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}]. he 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}J, 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. _ _ ., ....... ~fl~ N~[P.~ar _ 21„~ Q9 ,, 0545 DECEDENT'S SOCIAL SECURITY NUMBER 162-22-3615 ZIP 17055 COMMnNWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDiV10UAL TAXES DEPT.280BOt HARRISBURG, PR 77128.0801 DECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT HUFFER CAROL A 602 COCKLIN STREET MECHANICSBURG, PA 17055 REV-1152 EX(11-96) NO. CD 011612 ACN ASSESSMENT AMOUNT CONTROL NUMBER ,o~~ ESTATE INFORMATION: SSN: ti s2-22-3s~ 5 FILE NUMBER: 2109-0545 DECEDENT NAME: RUPP ALYCE R DATE OF PAYMENT: 08/13/2009 POSTMARK DATE: 08/1312009 COUNTY: CUMBERLAND DATE OF DEATH: 05/31/2009 101 f $15,000.00 TOTAL AMOUNT PAID: REMARKS: RECEIPT TO ATTY SEAL CHECK# 39$4 INITIALS: WZ RECEIVED BY: $15,000.00 GLENDA EARNER STRASBAUGH REGISTER OF WILLS TAXPAYER REV-t5U2 EX~ (6-98) COMMONWEALTH OF PENNSYLVANIA REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Alyce R. Rupp 21-09-0545 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 wiNing buyer and a willing setter, neither being compelled to buy or sell, troth having reasonable knowledge of the relevant facts. (ff more space is needed, insert additional sheets of the same size) A. S@ttl@111@tit Scat@I1'It3tlt U.S. Department of Houame and Urban Deveiopmept r~ ~~ OMS Approval No. 202-9265 B, Type of Loan f . ^ FHA 2. ^ FmHA 8. ^ Canv. UnMs, a Ffm Numnw 7. loan Number B. Mongaga lnauraace Ceae Number 4. ^ VA 5, ^ Conv, lna. C. Note: This form is furniahad to gNe you a statement of actual stltement costa. Amounts paid 10 and by the s®tdement agent are shown. /tams marked "(p.o.c.)" were paid outside closing; they ere shown here for informational purposes and not Included fn the Sotais. b. Name and Address of 6omvver E. Name and Addraae al SaNar F. Name end Adtlreae or Lender Robert B. Buckbee, Sr. Constance R. Poe Shirley 8, Buckbee Carol A. Huffer 118 East Coover Street Mechanicsbuf PA 17055 G. PrapsrtyLace++on H. seniamertAganr JOhn M. Eakin 117 East Maplewood Avenue Place of 3errlemant ~ I. 9s61emem Gale Meehanicsbur 9 PA 17055 Market Square Bullding 9!8!2009 Mechanicsburg PA 17055 WsooreameM DaW let: slack: 9/8!2009 J. Summary of 8orrower'a Transaction K. Summary of Seller's Transaction ann [xrn.. er.,~„r,f n,m Fram Anrrnwwr dnn_ 6rnna Amount Dua Se 9ellar 101. ConVeaaalea rtca 162 500.00 401. contrectaetea rice 162 500.00 102. Personal pro a 402. Pesonal ro 103. 9attlement cha es to borrower Iina 1400 3 598.50 4c3. 10q, 404. 105. 405. Ad uatmenta !or Rems eId b aeUer In advance A uatmenta for lama aid b seller in advance toe. Cl mowntaxas 9!8/2009 to 12/31/2009 214.52 4oe. CI Rowntaxe~ 918/2009 to 12131/2009 214.52 107. Coun taxes to 407. Coun taxes to 108. Assessments ro 409. Asseasmanle to ,oe. school tax 9/8/2009 ro 6/30/2010 1 290.12 4ae. school tax 9/8/2009 to 6/30!2010 1 290.12 110. sewerltrash 9/8/2009 to 9/30!2009 3.95 ato. sewer/trash 9/8/2009 m 9/30/2009 3.95 11 L to 411. to 112. to 412. lc 113. t0 413. tc 114. to 414. to 115, to 416. to 120. Gross Amount Due From Borrower 167,607.09 420. Grose Amount Due To sailer 164,008.59 00. Amounts Pald 8 Orln Behalf Of Borrower 2 500. RaducUotss In Amount Due To 9efler _ 201. Dapoalt ar eameat mono 1 O 000.00 501. Excess ooh see Inatructlona 10 000.00 202. PnnU at amount of new loan s - 502. Sattiemerd char ea to seller tine 1400 0.00 203. Erdaltng bans taken sub act ro 503. Exist loan B taken sub act to 2pq, 504. Pa o8 offlrstmo a elaen 205. _ 5115. Pa off of second m0 8 e loan 208. 5~• 207. 607. 208. 509. 209, 5o B. AdJuatmenta for Items un std b seller Ad almond for Items a old salter 210. CI novm taxes to 510. CI Jtawn texas to 211. County taxes to 511. CAUn taxes to 212. Assessments to 512. Aeaeasmants to l0 213. 513. t0 214. ld b14. ro 215, 10 51 b. to to 218. 516. !c t0 217. 517. b 218. l0 615, tc to 219. b19. W 220. Total Peld Byffor Borrower 10,000.00 520. Total Reduction Amount Qua Seiler 10,000.00 ann r...w ar suule...en~ Lmmrr'n nnernu,nr ans. Ceah •f 9m11omant TMFrom Salver 301. Grose Amount due from borrower Ilne 120 167 607.09 501. Gross amount due to seller Nna 420 164 008.59 302. Less amount id b !tor borrower IMa 220 10 000.00 602. Less reduc0ona an amt. due seiner ina 52P 1 a aoo.oo 309. Cash ®From ^ To Borrower 157,607.09 603. Cash ®7c ^ From Seller 154,008.59 SUBSTITUTE FORM 1099 SELLER STATEMENT The intorma0on cgnteinetl in Slocka E, G, H, and i and on Iina 401 {or, Ilse 403 and 404) is hnportanl tax lnformellon and 16 being tumlehed to the internal Revenue Sarvtca. it you are required to file a return, a negligence penalty or other aencuon wlil De imposed on you it this item is required to be reported and the iR3 determines that it hea not bean reponed. if this real estate la your principal residence, fife Form 211 a, Sato or Exchange of Pnnclpal Residence, far any gain, with your income tax return; for other hanaeclions, complete U1e applicebfe parts of Form 4797, Form 6232 artaror Schedule D, Fonn 1040). You are required ro provide the Satttamant Agent (named above} with your cornea taxpayer idemtflcatlon number. it you do not prowde ina Settlement Agent with your wrrea taxpayer IQenUOcatlon number, you maybe auo)ect to dvN ar cdminal penettiee imposed by taw. Under penattlas oP per)ury, f certify Nat the number ahavn on thla statement Is my correct taxpayef IUBnOfrcaUOn number. {Saliets Signature) rue, -toter aetearrsroaera t:ommisaton uaeeg on nce s r vs; :ruu. vv -r° - ~•~~ Paid From I Paid from D3vlaion o_f Cammisebn Ilne 700 as follows: Borrower's SeBefs 701, $ to funtla At Funds Al Settlement Serilement 702. to 703. Commleslon paid at Setdament _ _ __ _ __ _. _ - ~ _ _ _. _ _ wnn Iwma Dn.uAla rn Annnacflnn Wnh Lnwn 901. Loan Orf0lnatlon Fee Y 802. loan Dlacount °f 803. ApPreisai Fee to 804. Cred{t Report to 906. Lender's lnapedlon Fee ~ 908. Mortgage inaurencs A Ifcatlon Fae 20 `v _ ~~ 807. Asaump8on Fee ~ BOB. 808. 910. r 911. ` eaz. 813. 900. Mama Aaqulred S Lander Te Be Pald In Advance ExGude leal da in caeca -line 907 907. Interest from to $ 1 da 902. Mod lnsurance Pramlum~for months to 903. Hazard Insuanca Premium for ears to 804. 88re t0 905. 1000. Reaervee Daooelted With Lender 1001. Hazard Insurance months $ er month 1002, Mortgage ~naurance months $ er month 5003. City property toxae montha~$ Aar monM 1004. Cou roe taxes moMha $ ar month 100b. Annuet assessments months $ ar month 100a. _ menthe $ ar month 7007. months $ r month 1009. A re ate AccounOn Ad stment ti00. T1Me Chataee 7101. Battlement or Gosin tea to 1102. Abstract or Bile search to 1103. Titleexaminetlon to 1104. Tlde inaurence binder to ~ 1106, Document re aretlon 20 7109. Notary fees to no7. Anomev~srnea a John M. Eakin 300A0 (klGudea above Items numbers: 1100. Title inaurenca to InGudes above llama numbers: 7109. Lenders covers e $ 7170. Owner's COVere e $ 1711. 1172. 1113. 7200. Oovamment Recording and Transfer Charges 1201. Recording tees: Dead $ 48.50 ~ Mo e $ Releases S 48.50 7202. Cltyrcounty tawatam s: Dead $ 3 250.00 Mort e e s 3 250.00 1203. Stets laxlata s: Deed $ ~ Mod a e S 1204. 1206. 1300. Addltlonet Battlement Cltargea 1301. Survey ~ to 1302. Peat Inspection to 1303, 1304. 13176. 13Da. 1307. 13pB. 1400. Total,t3attkmant Charges tenter on Ilnea 109, Section J end 802, Sactlon H) 3,598.50, 0.00 CERTIFICATION have caret ISy reviewed the HUD-1 Sehlament Sfatem t end to the beat of my krwvAedpa an laf, ft is a true antl accurst tatement f alt recsfpts and dfaburaemaMa on my a di qr by se~iln~tt7Fa kanaeclFOn rtha/r~)~~that I have received a copy of the •1 an Slate nL~ -^ ~~~ g ~ ~_ Seller '~'~/2~"f l v Borrower on lance R. Poi Robe B. Buc bee r. J --i Seller P~•-~~gon-ower Caro .~~ Shir y B. Buckbee To the beat ai my knom~• a th H D•1 ttiement Statement wblch I have preperetl 1s a true and accurate account the funds which were recelved and have been or win ba dlaburead by lire urldera rid aZ par~i~e eatijpmaM o} Ihla trenaec0on. ~ , SeglameM Agan[ Data WARNING; It Ia a crime to knowingly make false statements to Na United Stetea on rhea os any other similar Corm. Penaltlas upon convtGlon can inGude a gne antl Impnaonment, fordeta8a sea; Title 78 U.S. Code SecOon 1007 and SeGlon 1010. uaocvaaNUea:vaxmxsomce; raao-rww REV-1503 EX+ (6-98) scN~ia-u~E e COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT' DECEDE NT ESTATE f1F FILE NUM6Ei2 Aiyce R. Rupp 21-09-0545 Ali property jo}nfly-owned with right of survivorship must be disclosed an Schedule F, (it more space is needed, insert additional sheets of the same size) Historical Quotes: Charttng Tools for Looking Up a Security's .. Sponsored Links Hot Stock Alert - GAEC Alternative Green Energy Solutions. 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INHERITANCE 7AX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF Alyce R. Rupp Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. FILE NUMBER 21-09-0545 ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Decedent's personal property per public sale 13,454.50 2. Decedent's car 2007 Chrysler Sebring Convertible per sales agreement 19,000.00 3. Member`s 1st Savings Acct. #122704 5.00 4. PNC Bank Checking Acct. #5140054505, principal and accumulated interest 15,983.86 5. PNC Bank Savings Acct. #5030062248, principal and accumulated interest 1,627.25 6. Reimbursement for 2009 County/Borough taxes 214.52 TOTAL (Also enter on line 5, Recapitulation) $ I 50,285.13 (If more space is needed, insert additional sheets of the same size) r l~vA,L SETTLEMENT iELIER NAME ~~ DATE OF SALE ~ ~~r ~ !!~~ ~ - 4DDRESS L.L~ ~ ~'~~ ~(~ eCy..~' - ~r OCATION OF SALE PHONE ZIP ~7~~~ AUCTIONEER ~-t-` '~' " ~ ~ "`' ~ PHONE ~-~~'~'~ ~ 2~ __.~.- ..._-_. r.. _ _ _~ _. _ - ._ _ _ ,_ _ _. __--_ __ _ _ _ _ -- -- ___ _ _ _ __ _ _. .... _ ,~~tr~R'S ~~tP~3SES i c: -~~,c 1 ~~ ~~a~~El ~ y ~N. 5b PROFESSIONAL FEES ''' AUCTIONEER I ~~~ $ _~~~~~ ~~ CASH $ `7 Cod 3. ~a CLERIC $ CHECKS $ ~~ ~ ~' °~ ~ CASHIER $ OTHER RECEIPTS OTHER EXPENSES $ ,~~.~ ~~s~~ ~~ ~a~~~ $ 199. ~ $ l $ 3c~o.u~~ $ .--'~~ $ $ $ TOTAL RECEIPTS $ ~~ ~ ~ "• $ LESS TOTAL EXPENSES $ ~ ~ ~~ ` oZ~ ~+ ., ~ NET PRfJCI~EDS PAYABLE 1'O SELLER $ ~ ~ 1 TOTAL EXPENSES $ i (ar we}, the seller, accept this settlement and acknowledge receipt of the above specified net proceeds from the auction of my goads and property sold on the above date. I accept all responsibility For prav9ding merchantable title to ail goods, and property sold, and for delivery of tide to the purchaser, r~~~?~-~ Date .,Au~Jdi near or Cashier's Sianaivre ,~ellar' ign r /~1~~' ~ Date t~~~G~'?'~r' ; Date (Seller's Signature} REV-15C9 EX+ (G-98) COMMpNWEAL'rH pF PENNSYLVANIA INHF..RITANCE TAX RE rURN RESIUEN7 UECEDENT scN~uu« F JOINTLY OWNED PROPERTY ESTATE OF FILE NUMBER Alyce R. Rupp 21-09-Q545 It an asset was made joint wlihln one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENHNT{S) NAME ADDRESS RELATIONSHIP TO DECEDENT A Carol A. Huffer 602 Cocklin Street, Mechanicsburg, PA 17055 Daughter s. c. JOINTLY-OWNED PROPERTY: iT~M NUMBER LETTER FOR JOIIJT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLJDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER, ATTACH DEED FOR JOINTLY•HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSET °~o OF pECD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1 A. 04/17109 PNC Bank Certificate #31700292129, principal and accumulated interest $36,529.36 100% $36,529.36 2. A. 04/17!09 PNC Bank Certificate #31600286241, principal and accumulated interest $15,661.84 100% $15,661.84 3. A. 1125!08 Members 1st Holiday Club Acct. #322219-02 $ 702,48 50% $ 351.24 4. A. 1125108 MembersistSavingsAcct.#322219-0 $2,966.98 50% $1,483.49 5. A. 1!25108 Members 1st Savings Money Management Acct. #322219-05 $6,550.54 50°I° $3,275.27 6. A. 1125!08 Members 1st certificate of deposit #322219-44 $21,732.02 50% $10.866.01 7. A. 1/25108 Members 1st certificate of deposit #322219-45 $20,655.17 50% $10,327.59 8. A. 1125x08 Members 1st certificate of deposit #322219-46 $16,459.79 50% $8,229.90 9. A, 1/25108 Members 1st certificate of deposit #322219-47 $6,121.59 50°10 $3,060.80 10. A. 1125108 Members 1st celti#icate of deposit #322219-48 $13,068.85 50% $6,534.43 11. A. 1(25108 Members 1st certificate of deposit #322219-49 $34,636.78 50% $17,318,39 12. A. 04/09/07 Members 1st certificateo#deposit #122704-42 $63,689.54 50% $31,844.77 13. A. 12/03/07 Members 1st certificate of deposit #122704-46 $10,611.68 50% $5,306.36 TOTAL (Also enter on line fi, Recapitulation) ~ $ 150,789.45 (If more space is needed, insert additional sheets of the same size) ~~ MEMBERS lye FEDERAL CREDIT 1JNIOIS To Whom It May Concern: Carol A. Huffer was added as joint owner an January 25~', 2008 on Alyce R. Rupp's account X22219 and a!I certificates associated with that account. The fuial balances as of May 31, 2009 are as followed: Regu]ar Savings: $2966.98 Holiday Club: $702.48 Money Management: $6SSO.S4 Certificate 44: $21732.02 Certificate 4S: $20655.17 Cet•tificate 4b: $ I6459.79 Certificate 4~: $6I 2 ] .59 Certificate 48: $13068.85 Certificate 4~~: $34636.78 The following balances are for AIyce R. Rupp's account 122704 as of May 31.2008: Regular Savings: $5.00 Certificate 42: $63689,54 Certificate 4(: $10611.68 Certificate 48; $b109.4b Carol A. Kuffer was not a joint owner on t11e savings account of 122704 but was on all certificates. She was added as joint on CD 42 on April 9, 2007, CD 46 on December 3, 2007 attd CD 48 on December 19, 2008. If any additional information is needed please feel free to contact me at 717-697-1884 x. 70805 ar by email at heishmanGa7,members 1 st.ora. ""Tjh~ank you, V ~~ Terin L, Heisclman 5040 Louise Drive PO. Box 40 Mechanicsburg, Pennsylvania 17055 (717) 697-1101 • w~uv,;melnberslst.org ~un,'7. 2009 1.~5PM PNC BANK 412-705-2747 l~DlNs3 fiMg WAS ,, June 17, 2009 Andy 5hcely Attprnay At Law 127 S Mat'kot St 1Vlechanicsborg, PA 17055 ».E; .A,lyce R Rupp SSN° 162-22-3615 DUD: 05-31-20p9 Deax Si:rl~adazn: N~, 4936 P. 1 In response to yauz request fvr Date of Death {D+~D) balances for the customer noted shave, ous records show ~e fallowing: Cax~cate ~f Deposit AccowYt#3]600286241 Established.: U4-17-2DQ9 AI..YCE R RUFF CAROL A H-[3FFER DUD bala~ace: $15,643.80 + 1$.{}4 accrued interest Accpux~t# 3174092129 Established: 04-17-2009 ALYCE R RUFP cARaL A BUFFER DUD balance: $36,512.10 + 17.26 accrued interest Checking Account Ac~c~ount# 5140054505 Estai>lished: Q1-01-1978 ALYCE R RUFF DUD balance: $15,982.86 + 1.00 accrued interest S-avk~gs Account Accc-tuat # 54;1006224$ Established: 03-Q4-1982 ALYCE R RUFF F)OI) balance: $1,627.05 +0.20 accrued interest Wage 1 of 2 REV-151p EX+ (6-98) COMMONWEALTH QF PENNSYLVANIA INHERITANCE TAX RE TURN RESIDENT DECEDENT scNE~u~~ c~ INTER-VIVUS TRANSFERS & MISC. NC~N-PROBATE PRG~PERTY ESTATE QF Alyce R. Rupp FILE lUUMBER 21-9-0545 This schedule must be completed and tiled if the answer to any of questions 1 through 4 on the reverse side of the REV-i 50Q COVER SHEET is yes. ITEM NUMBER DESCRIPTION t?F PRQPERTY INCLUDE THE NAME QF THE TRANSFEREE, THEfR RELATIONSHIPTO DECEDENTAND THE DATF OF TRANSFER. ATTACH A COPY pF THE GEED FOR REAL ESTATE. DATE OF DEATH VALUE QF ASSET % OF DECD'S INTEREST EXCLUSIQN IF APPLICABLE TAXABLE VALUE ~. Members 1st Certificate of Deposit Acct. #122704-48 6,109.46 100% 3,500A0 2609 u TOTAL (Also enter on line 7 Recapitulation} $ {If more space is needed, insert additional sheets of the same size) 2,fi09.46 REV-1511 EX+ (12-99) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Alyce R. Rupp 21-09-0545 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: ~ Gingrich Memorial -headstone carving 150.00 2 Funeral Luncheon - St. John's Church 414.80 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) COnStanCe R. POe / Carol A. HUffer Social Security Number(s)/EIN Number of Personal Representative(s) street address 516 N. Elmwood Avenue / 602 Cocklin Street city Mechanicsburg _ state PA .zip 17055 Year(s) Commission Paid: 2. Attorney Fees!- Andrew C. Sheely, Esquire 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City. .State _Zip Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees ~_ Auctioneer and public sale related costs $ Postage 9. Filing fee ~ o. Reserves to conclude estate administration, including first and final accounting, preparation of decedents 2009 federal and state income tax return. a.0o 3,375.00 345.00 3,548.25 20.22 15.00 600.00 70TAL (Also enter on line 9, Recapitulation) $ 8,468.27 (If more space is needed, insert additional sheets of the same size) RECEIPT FOR PAYMENT GLENDA FARNER STRASBAUGH Receipt Date: 6/11/2009 Cumberland County - Register Of Wills Receipt Time: 13:47:49 One Courthouse Sgware Receipt No.: 1057103 Carlisle, PA 17613 RUPP ALYCE R Estate File No.: 2009-00545 Paid By Remarks: CONSTANCE POE AJW ------------------------ Receipt Distrib ution --------------------- --- Fee/Tax Description Payment Amount Payee Name PETITION LTRS ADM 260.00 CUMBERLAND COUNTY GENERAL FUN SHORT CERTIFICATE 20.00 CUMBERLAND COUNTY GENERAL FUN JCP FEE 10.00 BUREAU OF RECEIPTS & CNTR M.D AUTOMATION FEE 5.00 -------- CUMBERLAND COUNTY GENERAL FUN Check# 260 -------- $295.00 , Total Received......... $295.00 REV-1512 EX+ i 12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCNEDiJLE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE [1F Alyce R`Rupp FII F NItMRFR 21-09-0545 Repoli debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medlcaf expenses. (If more space is needed, insert additional shee4s of the same size) -. __ - - - - `. i ~ F-• c~ `r~. I ~~ I`__- i :. ~. ~. ~, a .-, . t. ~.. _. ~ ' ~ u~~~- v '~I ~'' C U '~ ~ ~[ , ~. ~~ O ~~~ i ~, ~ i .~ w ~o w ~, W az A t- N - - ~~ • "'~~,~, ~ ~, ~ ~~ .~ F ~ ~~ i. + t 't- f ~~~ ., ,,k.. ~a r ~i ~`. ~ he>a.~l,~ l4Y _ ~~. ~, >~` tp Kl l ,j }y^v~~~~ ` I dPWd ~f,a1i...T~ t~a., :.n:11 ~i ,I vi ?~< .' ~'i `~ 1 2 1if~~t ( f r i1 fi } r ra ~.__'_-~. (~ ri 9~~~1°1td//yf J'~ vt i~sr., ~•1 ~ ~iT, J { ~ > ~ ~a~~~'~9~' ~k ~ FF ra t:.~'~ y I,~y. L ~+ ~ t- ~ . ~ ~ r ,, ~"" u, n 1 ~ " ~ ~~ --~ ((,~ ~ 7~ c~9~. ~4 "Y i t C k f Y2~ FS~~"y"~~ " f p ~i~i ~~'/ ~ ~a~~u pijv 't y~tr~~fa.~~l.rt., ~ ~ ~ ~ ~~~ ~ _ tp, 1 (\ '(~1 ~yq~r ~ l~\b ~:~~yo~- ~ , ~ ~ i ;~0 (~~ ~ ~ t ~,,, ,r-' ~ ,~ k I f3 r ' i,. f_,_..~ ~ } ( { t K ~_..__ ~ ~ l~ ~ St~r~*t,~ r ~~a _ Y r ~ r,-, ~ I I A ~ t ~h s~ ~ ~ ~ i~a ~ ~ '~' f= a~i(`r. ,.. rs, h(r "~ 77 ,.. ~ - r it _ f, , ;, ., . . ~ - r r S• L>J~I ~ ~ ~;. ate, a~~~~.f~ ,~~ ~ ~_.. "°d,F ~~ f ~ ~ r, ~ ~ ~ ` ,- ` u. IIU~N WklO~ GS IU•CQ9-UD{?.I~TSLUliO~'1 ~ d WUNJ N3(7FJU3d _,~,_, REV-1513 EX+ (~-rp) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Alyce R. Rupp SCHEDULE J BENEFICIARIES RELATIONSHIP TO DECEDENT NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) I TAXABLE DISTRIBUTIONS {include outright spousal d+stributions, and transfers under Sec. 9116 (a) (1.2)] 1. Constance R. Poe, 516 West Elmwood Avenue, Mechanicsburg, PA 17055 Daughter 2. ~ Carol A. Huffer, 602 Cockl]n Street, Mechanicsburg, PA 17055 ~ Daughter FILE NUMBER 21-09-0545 AMOUNT OR SHARE OF ESTATE 50% Rest, Residue, Remainder of FctatP 50% Rest ,Residue, Remainder of Estate ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I $ (If more space is needed, insert additional sheets of the same size)