HomeMy WebLinkAbout11-04-09
15056041125
REV-1500 EX (06-05) C?FFICIAL U5E ONLY
PA Department of Revenue
Bureau of Individual Taxes County Code Year File Number
PoBOx2806o1 INHERITANCE TAX RETURN 2 1 0 9 0 0 6 6 3
Harrisburc PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
0 4 8 0 5 0 5 1 8 0 7 1 1 2 0 0 9 0 7 2 3 1 9 2 0
Decedent's Last Name
W R I G H T
Suffix Decedent's First Name
THE L M A
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name
N A
Spouse's Social Security Number
FILL IN APPROPRIATE OVALS BELOW
D i. Original Retum
4. Limited Estate
® 6. Decedent Died Testate
(Attach Copy of Will)
9. Litigation Proceeds Received
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
2. Supplemental Return
4a. Future Interest Compromise (date of
death after 12-12-82)
7. Decedent Maintained a Living Trust 0
(Attach Copy of Trust)
10. Spousal Poverty Credit (date of death
between 12-31-91 and 1-1-95)
MI
L
MI
3. Remainder Retum (date of death
prior to 12-13-82)
5. Federal Estate Tax Retum Required
8. Total Number of Safe Deposit Boxes
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 T0:
Name Daytime Telephone Number
S C O T T W M O R R I S O N E S Q 7 1 7 5 8 2 2 3 0 0
Firm Name (If Applicable)
First line of address
6 W E S T M A I N S T R E E T
Second line of address
P O B O X 2 3 2
City or Post Office
N E W B L O O M F I E L D
Correspondent's e-mail address:
REGISTER OF WILLS USE ONLY
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State ZIP Code ED ~.~ r°
'
P A 1 7 0 6 8 ~ tN c n c~a
Q ' "'~4
Under penalties of perjury, I dedare that I have examined this retum,lnduding accompanying schedules and statements, and to the best of my knowledge and belief,
d ~S e, coned and complete. Dedarelion of preparer other than the personal representative is based on ali infom-ation of which preparer has any knowledge.
S TORE O PER E P FOR FILING ~IiRN DATE
157 E. Columbi~Road v Enola PA 17025
SIGNATU ER THAN REPRESENTATIVE DATE
~ l a_ Zg
ADDR S
6 West Main treet _ New Bloomfield PA 17068
PLEASE USE ORIGINAL FORM ONLY
15056041125
Side 7
15056041125 J
~~
15056042126
REV-1500 EX
Decedents Social Security Number
Decedents Name: Thelma L. Wright 0 4 8 0 5 0 5 1 8
RECAPITULATION
1. Rea! estate (Schedule A) 1 5 9 0 0 0 0 0
........................................
i 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. 3 2 8 9 7 7 6
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 6•
7. Inter-Vivos Transfers & Miscellaneous N Probate Property
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Billi
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7
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epara
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ng
eques
.......
e .
8. Total Gross Assets (total Lines 1-7)
...........................
8. 9 1 8 9 7 7 6
9. Funeral Expenses & Administrative Costs (Schedule H) ................ 9. 8 8 3 4 9 4
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 10. 4 3 9 2 8 2
11. Total Deductions (total Lines 9& 10) ........................... 11. 1 3 2 2 7 7 6
12. Net Value of Estate (Line 8 minus Line 11) ......................... 12. 7 8 6 7 0 0 0
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, 7 $ 6 7 0 0 0
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(ax1.2) x .o _ 0 0 0 15. 0 0 0
16. Amount of Line 14 taxable 7 8 6 7 0 0 0 3 5 4 0 1 5
at lineal rate X •045 16.
17. Amount of Line 14 taxable
0 0 0
0
0
0
at sibling rate X .12 17,
18. Amount of Line 14 taxable
0 0 0
0
0
0
at collateral rate X .15 18
19. Tax Due ................................................19. 3 5 4 0 1 5
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
15056042126 15056042126 J
REV-1500 EX Page 3
Decedent's Complete Address:
DECEDENTS NAME
STREET ADDRESS
17 Grant Street
CITY STATE zlp
Enola PA 17025
Tax Payments and Credits:
1~ Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments 3,500.00
C. Discount 184.21
3. InteresUPenalty if applicable
D. Interest
E. Penalty
(1) 3,540.1
Total Credits (A + B + C) (2) 3.684.21
Total InteresUPenalty (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.
(3) O.OC
(4) 144.0E
(5) 0.0C
(5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56) 0.0C
Make Check Payable fo: REGISTER OF W/LLS, 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 care7 ....................................................... ^
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? ......... ^ Q
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 Vansfers to or for the use of the surviving spouse is zero (0) percent
(72 P.S. §9116 (a) (1.1) (ii)J. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and
filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased childtwenty-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)]. Asibling isdefined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
File Numt~er
00663
REV-1502 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF FILE NUMBER
Thelma L. Wright 00663
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 wilting buyer and a wiling seller, neittrer being compelled to buy or sell, both having reasonable knowledge of the relevant facts.
°--~ -----y---~,_ _ ._,_.. .. .. - - - -
----
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. All those certain two lots situate in East Pennsboro Township, Cumberland County, PA, 59,000.0(
being Lots Nos. 5 and 6, Section F, in a Plan of Lots known as Plan No. 3, Hoopy's Addition
to Enola, recorded in Plan Book 1, Page 97. Sold to Kevin R. Biggi and Matthew M. Wall on
September 16, 2009 -see attached deed and settlement statement
TOTAL (Also enter on line 1, Recapitulation) ~ S 59 000 O(
(If more space is needed, insert additional sheets of the same size)
REV-1508 EX + (6-98)
SCHEDULE E
COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC.
IN REST DENT DECEDENTRN PERSONAL PROPERTY
ESTATE OF FILE NUMBER
Thelma L. Wright 00663
Indude 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.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. PNC Bank Checking Account #5140301422 11,651.51
2 PNC Bank Savings Account #5004803751 20,347.1:
3. Real estate taxes and sewer/trash refund 899.04
TOTAL (Also enter on line 5, Recapitulation) I S
(If more space is needed, insert additional sheets of the same size)
REV-1517 EX+02.99)
SCHEDULE H
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES ~
IN RESI DENT DECEDENTRN ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Thelma L. Wright 00663
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Richardson Funeral Home, Inc. 5,363.37
B. ADMINISTRATIVE COSTS:
~, Personal Representative's Commissions
Name of Personal Representative (s)
Sodal Security Number(suEIN Number of Personal RepresentatNe(s)
Street Address
City State Zip
Year(s) Commission Paid:
2. AttomeyFees Scott W. Morrison 1,900.0(
3. Family Exemption: (tf decedents address is not the same as daimant's, attach explanation)
Claimant
Street Address
COY State Zip
Relationship of Claimant to Decedent
4• Probate Fees Glenda Famer Strasbaugh 196.0(
5 Accountant's Fees
6. Tax Return Preparer's Fees
7. The Patriot News -estate advertising 245.51
8. Cumberland Law Journal -estate advertising 75.0(
9. Gingrich Memorials -gravestone 1,055.0(
TOTAL (Also enter on line 9, Recapitulation) I S „ ,,,, , ~ ,
(If more space ~ needed, insert additional sheets of the same size)
REV-1512 EX + (12-03)
SCHEDULE 1
COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT,
IN RES DENT DECEDENTRN MORTGAGE LIABILITIES, ~ LIENS
ESTATE OF FILE NUMBER
Thelma L. Wright 00663
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Verizon -telephone account 51.3:
2. PP&L -electric 212 7~
3. Sewer/Sanitation 116.27
4. 2009 real estate taxes to Debbie Lupold 994.04
5. Pennsylvania American Water -account 85.4E
6. costs to sell real estate -see attached settlement statement 2,540.0(
7. West Shore EMS -account 392 94
TOTAL (Also enter on line 10, Recapitulation) I =
(If more space is needed, insert additional sheets of the same size)
REV-1513 EX + Ig_ps~
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
tSTATE OF
FILE
Thelma L. Wri ht
0061
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO
I
TAXABLE DISTRIBUTIONS [ndude ou ht
l Do Not List Tru
_ spousa
distributions, and transfers under
Sec. 9116 (a (1.2)]
1. Karin L. Cobb, a/k/a, Karin Wright Willey
312 Bahama Circle Lineal
Carlisle, PA 17015
2. Darrell L. Wright Lineal
157 E. Columbia Road
Enola, PA 17025
3. Jill Henry Lineal
1940 Susquehanna Trail
Liverpool, PA 17045
iUNT OR SH
OF ESTATE
one-third
one-third
one-third
I 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
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I s
(If more space Is needed, insert addltlonal sheets of the same size)
KNOW ALL MEN BY THESE PRESENTS THAT:I. THELMA L. WRIGHT, ,
47 GRANT STREET, ENOLA, PA., 17(125, being of sound and disposing
mind and memory, do make. publish and declare the following to be
my last Will and Testament, hereby revoking all Wilis by me at any
time heretofore maade.
FIRst: I direct my Executor, hereinafter named. tp pay all my
funeral expenses administration expenses of my estate, including
Inheritances and succession taxes, State or federal, which may be
occasioned by the passage of or succession to any interest in my estate
under the terms of this instrument, and all my just debts, excepting
mortgage notes secured by mortgages upon real estate.
SECOND: All the rest,-residue and remainder of my estate, both
real and personal, of whatsoever kind or character, and wheresoever
situated shall be divided Everything to my husband, Alvaro L.
Wright. In the event of hisdemise, everything is to be sold and
equally divided among our three children:
Ms. Karin Wright Willey
Salisbury Mobile Home Park
Box 256
Salisbury, Maryland, 21801
Mr. Darrell L. Wright
Box 117J R. D. #1
Elliotsburg, Pa., 17024
J i 11 Henry :'
818 N. High St.
Duncannon, Pa., 17020
THIRD: I hereby appoint Ji1,1.Henry, 819 N. High St.
Duncannon, Pa., 17020 as Execlutrix of this my LAST WILL
AND TESTAMENT, and I direct that such person shall serve
without bond.
IN WITNESS WHEREOF, I have hereunto set my hand and seal at
Enola, Pd•, 17025 this 20th day of October, 1990.
Thelma L. Wright ~-
Signed, sealed, published and declared to be her LAST WILL
AND TESTAMENT BY THE WITHIN NAMED Testator in the presence of us,
who in her presence and at her request, and in the presence of each
other have hereunto subscribed our names as witnesses:
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NOTA?.iPL Sv>,:~
-A1ARY C. SCHP.(vc'n, P:o:zry Pub!iC
E. Perrsboro Tv+a. CumbeC>ad Cu.
?v Co?rrission fr,~iros Oct. 30.1810
~ .;:.
CU'.~~.:,,.....,_ ..,..... ;'r`,. >ro. eta
ta4 t,0+~ zo nn to Zt ~C~jt~ ~pe~
Alads ~ ~ S T daY of /~ O V £ Iy1 iO £ /(' in the year ,
one thousand nine hundred aed Eighty-Pour ,(1984)
Detwtrn SANDRA C. GULICH ST" GERNAIN and PAUL T, ST, GERMAIN, her
husband, of Mechanineburg, Cumberland County, Panaaylvaaia, Grantose
AND
ALVARO L, WRIGHT aad'THliLMA L. WRICHT, his wife, of Enola,
Cumberland County, Pennsylvania, Grantees
Witncueth, that in eonsidcration of TWENfY-EIGHT THOUSAND DOLLARS
($28,000.00) Dollars,
is hand paid, she receipt wheteoE is hereby aclcnotrLedaed, the uid Grantors do
bercby atant and eonray to ehs satd Grantee s'+
ALL those two certain Iota situated in the Township of Bast Yeanaboro,
Cumberland County, Paaneylvania, more particularly botmded and described as
follows, to w1t;
• BEGINNING st a point on the West side of Grant Street, said point being
130 feat South of the Southwestern corner of Pony gereet•and Great Serest;
ehgaca in a Westerly direction along the dividing line between Lots Nos. 4
and 5 on the hereinafter mentioned Plan of Lots 140 feet eo a 1S feet wide
alley; thence along the raid alley in s Southerly direction 60 feat; thence
in an Easterly direction along the Southern boundary line of Lot No. 6 in ,
the hereitufter mentioned Plan of Lots 140 Peet to the Wastarn aide of Great
Straat; thence in a Northerly direction along the Western aido of Grant street,
60 feet to the place of BEGINNING.
BEING Lota Nos. Sand b, Section F, is a Plan of Loi:a known as Plan No, 3,
Hoopy's Addition to Enola, raid Plan being recorded in t::e Cumberland County
Recorders Office in Plan Book 1, Page 97. r
HAVING thereon erected a one sad one-half story aluminum dwelling known
and numbered as 47 Grant Street, Etwla, Pennsylvania.
BEING the same premises which Sandra C. Gulick St. Germain by Deed dated '
December 16, 1982 and recorded in the Offlca of Lhe Recorder of Deeds !n and foe
Cumberland County, Pennsylvania 1n Deed Book Z, Volume 29, Page 692, granted and
conveyed unto Sandra C. Gulick St, Germain and Paul T, St. Germain, her husband,
Grantors herein. ~
UNDER AND SUBJECT, nevertheless, to restrictions. conditions and easements i
of prior record pertaining to said premises.
School•Ditf. Cumb" Co., Pe. ~~~ k~ ~cf~r~'a~'~'a
1 * NeN bu1~ irae.fN T~}N ~ ' -•,. +~o~. ~' P~
Z //'.'ZO d9 '/Td ~ '[l anal lids lwtar Tar
o.w? ••••••• r`"'t'•••'••"•• CUrArdUNWEALTII (IF YErJN~YlV.4N1A = 2/~/~.2D ¢ a
/~it /a i1i2~cc`~ OE~AR1MENi OF kEVENUE '- __(/~iL'i~ ~l/G. ~c
.". R[A., I P ... tw~11. G OAA Bef. Ara.
Boolt~i30 ~ 651. .
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AND the said Grantor a Will Warrant t;enarelly the property hereby tbnveyed.
iN WITNESS WHEREOF, ebe said Gcantoee ha ve Learutm sat their Fuada and seal a
ehe day aad year 5nt above written.
. Si`ncd, Scslad and DeBvend ~!]O~SIIA.._.... ._..__•... .......-.^.........._. _~..... (SEAL)
R11 C. ICN S~, CERt~~~
in presmcc of ~~T ~` _ nao-,+sa~--..,..._......_..._......._.....___.... (SEAL1
PAUL T, ST, CEttM11IN
1/_ ~ ~~~}y~.~.~/ ..._.........._..... (SL L)
_.._~ ..}SLJ[ tiw..~.M__......«_._....._..,. ..........."'-'""_.........__..................,_.... ........:......._._...... ......_...._... (SEAL)
-.___._.._..........~___........_~...___..._ ......._......_..__._..._._........_.__...____....._...._ ............. .........._._..: (SEAL)
COMMOtVWBALTH OP PENNSYLVANIA '
SSt
covrmroP cy~+bFRt.pNO 11
~ d+w ~ / s r ~>• of N o v E /N 8 ~ R A. D. t9 g~ 6eEore'me
a Notary Publie tLa uadersl ed officer, pmoriilly .
appcarsd SANDRA C..CULICN ST, GHRMAIN and PAUL T, ST, GE~(!-IN, her hudbaudt
r ~;
potvea) m bs ebe permo s wLose nudes ate aubteribod~to tube witltin(Ltserabt~nt, ~',r
ae6wwkdged tL.e they 'saveutad the sase fec the purpaes tLateia eannioed. ; i 1 ' f 0 ~i ; ,; .;
IN WITNESS WHEREOF, I Lerswtm ter ray hand urd offieLl ed.
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__....___._.._.._.._.__. 7m.~~ryL,y1W ......
' 1 HEREBY CERIIPY, tiut'tbs predse eaidteos of t6 Gnatses
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COMMONWEALTH OF P~VNSYLVANIA
. ~^-s.
. ~ ' •'lfgre~ tfid ar tL8 ~~ day of ~ ~ ~ A. D. 19~~, in the
' •~ ; ~
~R[;ootd~i''.s ~O~iee of tLe add County io Desd Book ~i Vdums .3 ~ Pap 6 SJ .
''~.. i' ~L..a.ea$es.r~y Land .ud the asap of tLe wid Office, dre date above rslerm.
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(~ ~, ~ \ ~~'s ~~'.. .Retarder
eoac7-30 ~~ce .652
lOrOSi`2005 16:13 7176977065
r~CSF1EELY PACaE 81
rum un Ara9 sea ~
A- --- 8. TYA€ OF LOAN: - --- --- --- -
U.S. DEPARTINENT OF HOUSING & URtd11N DE-~FI.OPMENT i FF1A 2.OFmrIA ~, CQiJv.11H(N$, 4. A ~, C4NY. MS.
SETTLEMENT STATEII~EN'E 6. BK3G12T5-09R' 7. 3 ~~:
8. MORTGAGE INS CASE NUN~ER:
C. NOTE: This for-n >e turrliihed to pare yvu a atahreerlt of ettwt 4ettkmeaf oasla Amourlb Fold 1v and 6y 9Io 4opkrnart agent N shorrrr
!(errs merMFd TPpCp wrre ASfd orRal7e .
Fro closUml' 81eY ere shonrr hme fir uNorrna8orrel Rrwposes end ere rat eldeded in the [WSb.
p. NAME AND ADDREB$ OF BV`~R: +.o aes
E. NAME AND ADORES9 OF SELLER: F. NAME AND ADDRESS OF LENDER:
KEVIN R_ BIGC31 and 1@STATE DF TNELMA G 1NRIC3F1'C METRO SANK
MATTFIEW M. WALt 4T GRANT STREET 3807 PAXTON STREET
~ ~~ TAIL ENOLA, PA 1TD26 HARRL~uRG
PA 1711 t
DlLLSBURC3. PA 17a19 ,
d. PR6fERTY LOCATION:
47 GRANT STREET' rl. SETTLEMtTITAGENT: I. sue, DATE:
ENOLA, PA 17023 ANplgEyy C. BHEELY, E8Q.
r
CUMBERLAND Couray, Pemt4ylurma
PtAGE OF SEiTLEMENF ber 18, 2008
48 CENTRAL BLVD.
CAMP HILL, PA 17011
BUYER'S TRANSACTION S TRAtL4ACT10N
1 OU! PROM eIUYER:
101 890. ORO88 AMOUIRT DUE
.
10Z. Personal 89000.00 401. Ceatrsa Belle 59 00
108. 8e81cmerrt b ~Uns 1
4a
28 ~. ~~I
IQl
104 . .
.
105. ~,
~.
Seep FafO Sebrb 9drsne!
1 gWgTixes Feld 9sVkr Ie edvarrCe
1A1n0
107
T 95.+)6 cwn sirs 09HBID9 11pt110
.
b
108. TAX b t7Ain4
109
SEVV6 H
7 34
~
~. Cau TaMle
108, TAX D9M6109 to 07 0 784
34
.
YSEPT. 0911 ipg
110, 18.75 .
109. SE1NEWiRA511 JULY-SEPT. 09f18100 to 10/01!08 18
75
111. 41 .
111
920
GR065
'
.
AMOtJMTO(1r:
F~7prytgUYER 82.139.29 4?0. GR095AA/OUNTDlIE717SE?LElq
200. ~ ~ d 58,889.Q1
1. orgrrrefl
202
P A 801, E>e0sss
.
meust Laa
203. s taken pp 98.000-00 802, tlat8srnplt tSre b BeNer Lhe t
2840.00
ao4, 5D3. s ~~
5W. atssrK
206. . P of aaeeee
207.
2Q8. .607.. dtsb, as
208.
508
fvllams U
S .
210. own Tsres to ~ S4tlsr
211. T b 51a, own T
to
212. ~
b 591. Tees 1e
213.
81?- TAX to
214, 513.
215. - 81
218. 515.
217. 318,
517.
?19. 518.
?7~0. TOTAL FAA) SYrPDR BIlYEFt 518.
app 81.000.00 D2Q T10TAL RlDUCTlpty AMCKMIT WE SELLER
2.540.00
1. Amour! Dw From B 1 128 t1ELLEIC
302. Less Ameunl W QYIe 220 ( 81
000 roes Amourt Due Ta 9s1ar
802
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T1iE HUD1 9ETiLEMENT STATEMENT AND TO THE BEST' CP MY kJ~tOWLEDOE AND BELB_I=, tt t6 A TRIE AND
ACCURATB ST4TEM@NT OF ALL Rl. ANp DKpURQfikAlNTB MADE OFJ MYAOCCIMT ME 94
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IE A FINE AND NIPRRONMENT. FOR OETA8.5 SEE: TRLE 18 U,6. GODE SECTION 10D1 ; 8ECTKNJ 1010.
1FT?~J512PF~9 15:23 +'175977365
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L. SETTLBAIENT CHARGES
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7 11. 8-1 b TRI.000NTY ABS
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113.00
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~~ 590
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t 301. S ~
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1 303. TAX RTIFICATION RE ro 7 At38TRACT SERVICE
1 LIR8E1A1
10.
1 305-
1 400. TOTAL SET7tE~T CNARGE$ rn Lind 1a3 Seetlorr J e19c1 leeUer
sr•~s~+nwseiartweroarM,rr+pwe,b.~.o„~wlenaiptaramnAeunmererseszerw..~..~.. ~- A0.25 2.540.00
certiriedto ba a trus aapy.
S NT OFFICER
3ettlernent Aperrt
t e~127e-OS r ers~R71m r ~2 t
_ _ _ _ _ _
_r
Sea,. 22. 2004 7:40°f~ P~1~ BANK 412-70~-274
~1 ~
LEAp18G THE VfIA'Y
September 22, 2b{}9
Scott W Morrison, Esq.
center Square
P 0 Bax 232
New Blornnfield,l'A 17068
RE: Thelma L Wright
SSN: 04~-OS-Q518
DOD: 47-11-2009
Dear Mr. Morrison:
__ _ _ _
'Vo, 95?S F. 1i? I
lu response to your request for~Date of Death (DOD} balances for the customer noted above, our
records show the following:
Checking Aunt
Account # 51403a1422
THELMA L V-~TtIGHT
DOD balance: $ 11,651.17 + p.44 accrued interest
lnterestpaid 01-01-2009thru 07-11-2049 $ 6.72 YTD.
:~
Savings Accounf
Account # 5404843751
Established: 06-01-1978
Established: 04-49-2009
. THELMA L WRIGHT
DOD balance: $ 20,327.31 + 19.84 accrued itnterest
lntez~es~t paid O l -01-2049 thru 07- l 1-2009 $ 97.66 XTD
Please pots that this office provides date of death balances for: deposit accounts (IRAs, CDs, G7g sad
Savings). We do not praceIIS any finaneial trxasstctions or provide atatemenb. If yon r assistance with
any of these items, please call 1-888-I+lYC-BANK (I-888-762 2265} or stop by your local 1'NC Bank branch
oi1~ice.
Sintceraly,
National Financial Services Center
PNC Bask, N.A.
Member FDIC
Page i of 1
1PlG_15/2009 16:13 7176977065 A~HEELV _ .PAGE 03
coM~aonvven~rfl aF PENNSYLVp-q~q
DEPARTMENT QF PIJBi,~ wFxFnRE
BUREAU OF FINANCNL OPERATIONS
DIV181pN OF TMIR4 PAg7y 6WBII.ITY
ESTATE RECOVERY PROC--RAM
PQ dOX 9468
htARRISBUR(a, PA 77105.8486
September 17, 2009
ANdREW C SHEEI,Y ESQUIRE
P 0 SOX 95
MECHANICSBURG PA 17065
Re: TxBLMA ~,. WRIGHT
SSN : 048=05=ti51.8
Dear Attorney Sh~e].y:
Fursttarit to your letter dated September 16, 2pp9, the Department of
Public plelfare• (DPW)r Estate Recovery Program, has reviewed the information
you Qrovided regarding the above-re#erenced individual.
It has IaEen determined that this individual did not receive any type of
aasi.stance during the questioned period.
Therefore,, according to the infarmatS.ola ydu provided, the Department's
Estate Recvveiy Program will not seek any recovery from thin estate. If your
client aggliec: fox NJedical Assistance and had an applzeation and/or hearing
pending at the time of Heath, please advise u5 and provide any additzanal
znfo.rma•Cian tt.at may affect a recovery by our Department,
If yvu hsve any questions, please feel free to cantaGt me.
5ince'xely,
~ f
Carole A. Procope
Recovery SECtion Manager
1717)7?2-6604
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