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HomeMy WebLinkAbout05-11-1015056051058 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 RESIDENT DECEDENT 21 09 1010 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 221-14-9707 07/29/2009 ° 12/02/1924 Decedent's Last Name Suffix Decedent's First Name MI :Nichols James F (If Applicable) Enter Surviving 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 REGISTER OF WILLS __ _ _ __ _ _ FILL IN APPROPRIATE OVALS BELOW ~l•C~ 1. Original Return =`~ ~ 2. Supplemental Return c"",:w~ 3. Remainder Return (date of death prior to 12-13-82) ~.,~;:~ 4. Limited Estate .: "fin 4a. Future Interest Compromise (date of ";'~~ 5. Federal Estate Tax Return Required death after 12-12-82) ~~_._:: 6. Decedent Died Testate m~ 7. Decedent Maintained a Living Trust _0 _ 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) „." 9. Litigation Proceeds Received ~ . 10. Spousal Poverty Credit (date of death ~M~ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) .~- CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number _ __ Tricia D Naylor (717) 243-7437 __ _ Firm Name (If Applicable) __ _ __ .. ..-,.... ..._.... _ ..._.......__~m_ _ _.._... __ _; __ _ _ REGISTER OF WILLS USE ONLY Law Office of John C Oszustowicz __ First~ne of address c7 ti __ _ ___ _ _ , x ~ -.-,. 104 S Hanover St ;~ ~ rte, "^r-ti . " _. -_ _ _ ..... _ 1 1 1 t ) " Second line of address , r--- -~ !~ ~ .: :i _ ._ r ~ K , raj 1 '~ =~ a r l..~ S ~ """ ! ' ~ 4 ..~' .,,, ,~ City or Post Office _ _ _ State ZIP Code .. Q ~x -A` D__ ;.~ ~ __ ~J ~~ ~-._ J ` 4> ~~,~, ~ ~ Carlisle ' PA 17013 _ : ~--- ~~ ~. -, Correspondent's a-mail address: tnaylor@Carlislepalaw.com Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATU~ZE OF P~R$SJN RL~PANSIBLE FOR FILING RETURN DATE ~ ADDRESS 2151 Letterly Philadel la, A 19125 SIGN E OF PREPAR HER HA EP ATIVE DATE c- 10 ~ ~ S ~-laln ov e~----.~~--~ Car 1~5 ti e. "PA 1 ~ c~ ~ 3 PLEASE USE ORIGINAL FORM ONLY Side 1 15056051058 15056051058 J 1505610105 REV-1500 EX Decedent's Social Security Number Decedent's Name: James F Nichols 221-14-9707 RECAPITULATION 1. Real Estate (Schedule A) ............................................. 1. 2. Stocks and Bonds (Schedule B) 2. 339.86 ....................................... 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 4. Mortgages and Notes Receivable (Schedule D) ....................... .... 4. 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)... .... 5. 23,041.92 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ... .... 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested.... .... 7. 8. Total Gross Assets (total Lines 1 through 7) ............................. 8. 23,381.78 9. Funeral Expenses and Administrative Costs (Schedule H) ............... .... 9. 13,879.40 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule t) .......... .... 10. 9,061.35 11. Total Deductions (total Lines 9 and 10) ............................. .... 11. 22,940.75 12. Net Value of Estate (Line 8 minus Line 11) .......................... .... 12. 441.03 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. 441.03 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0_ 15. 16. Amount of Line 14 taxable at lineal rate X .0 45 441.03 16. 19.85 17. 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. 19.85 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 1505610105 1505610105 J REV-1500 EX Page 3 File Number Decedent's Complete Address: James F Nichols STREETADDRESS 770 N Hanover St CITY _ _. - STATE _ _ ~ ZIP Carlisle PA 17013 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) 2. CreditslPayments A. Prior Payments B. Discount Total Credits (A + B) (2) 3. Interest (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) 19.85 19.85 Make check payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain 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? ......................'............................................... ^ ^X 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. ^ 0 3. Did decedent own an "in trust for" or payable-upon-death bank account or security at his or her death? .............. ^ X^ 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 Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: • The tax rate imposed on the net value of transfers from a deceased child 21 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 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 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 12 percent [72 P.S. §9116(a)(1.3)J. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1503 EX+ (6-98) SCI~IEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER James F Nichols 21-09-1010 All property jointly-owned with right of survivorship must be disclosed on Schedule F. (If more space is needed, insert additional sheets of the same size) REV 1508 EX+ (6-98) SCHEDULE E CASH BANK DEPOSITS & MISC. COMMONWEALTH OF PENNSYLVANIA , INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER James F Nichols 21-09-1010 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. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Sovereign Bank Checking Acct # 2891043804 2 260.58 2 M&T Bank Checking Acct # 2740877034 0.54 3 Wilmington Trust Checking Acct # 1018-8326 640.85 4 Wilmington Trust Savings Acct # 9458-0110 1 100.99 5 Wilmington Trust IRA Acct 0925-4676-001 1 047.60 6 Refund from Nationwide Insurance for cancelled policy 20.73 7 Refund from AARP cancelled policy 67.80 8 Refund from the Chrysler Corp 8.90 9 2004 Chrysler Town & Country LX van 7 900.00 10 Coin collection sold at auction -See attachment A 8,454.40 11 Misc personal property sold at auction 1,532.43 12 Accrued interest on item #4 0.10 13 Refund from Federal 2009 tax return 7.00 TOTAL (Also enter on line 5, Recapitulation) S 23,041.92 (If more space is needed, insert additional sheets of the same size) ~ pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER James F Nichols 21-09-1010 Decedent's debts must be reported on Schedule i. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1' Ewing Brothers Funeral Home 8,783.96 2 Chapel Pointe -funeral luncheon 125.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City State - - ---- ZIP - _ _-___ Year(s) Commission Paid; 2. Attorney Fees: 2,000.00 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: 152.00 5. Accountant Fees: 6. Tax Return Preparer Fees: 300.00 ~• See Attachment B 2,518.44 TOTAL (Also enter on Line 9, Recapitulation) I $ 13,879.40 If more space is needed, use additional sheets of paper of the same size. R€=V-1517.. FX+ (1?..-'J8} ~ pennsylvania SCHEDULE I `. DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER James F Nichols 21-09-1010 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1' Chapel Pointe at Carlisle -room and board 3,902.00 2 Alexander Springs Emergency Physicians 76.76 3 Blue Mountain Anesthesia 14.20 4 Carlisle Digestive Disease 32.43 5 West Shore EMS (paid to Consolidated Collection Services) 84.92 6 Carlisle HMA Physicians (paid to Apex Asset Management) 88.85 7 Mira Orthopedics 181.81 8 Kinetic Imaging 8.50 9 Century Link -telephone 158.73 10 FIA Card Services (AAA credit card) 107.58 11 AT&T Universal Card (paid to Ascension Point Rec Services) 399.81 12 Wilmington Trust Visa Credit Card 4,005.76 TOTAL (Also enter on Line 10, Recapitulation) I ~ 9,061.35 If more space is needed, insert additional sheets of the same size. REV-1513 EX+ (01-10) ~ pennsylvania SCHEDULE ~ DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: FILE NUMBER: James F Nichols 21-09-1010 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1. Amy J Nichols 2151 E Letterly St., Philadelphia, PA 19125 2 Robert F Nichols, Jr. 2400 Baynard Blvd unit 3, Wilminton DE 19802 3 Timothy J Nichols 147 Lakeshore Dr. Apt 3, Lexington KY 40502 Granddaughter Grandson Grandson 1/3 1/3 1/3 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 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 $ If more space is needed, use additional sheets of paper of the same size. .~ Cordier Antiques & Fine Art 2151 Market Street Camp Hill, PA 17011 Consignor Settlement Phone: 717-731-8662 Fax: 717-731-9830 Consignor: 1248 The Estate of James F. Nichols 104 S. Hanover St Carlisle, PA 17013 Phone:717-243-7437 Auction: Estate Auction 1/29/10 4 g ~1~t7 ZI-~~ - IOf CO #: 995 Date: 1 /29/2010 Page: 1 I_~ ~ Description Quantity Unit Price Ext Price C /B 363 . omm uyBack Expenses 3 lock boxes, 2 with keys 1.00 15.00 15.00 - 3.00 0.00 . 494 -.. __ . __ - Coin lot 1 - 5 proof sets .00 - 45.00 5.00 Bid Card # 189 9.00 0.00 - - - - - - - - - 495 - _ _ _ _ - __ - Coin lot 2 - 4 proof sets _ _ 1.00 0.00 0.00 Bid Card # 146 ~B.00 0.00 - ---- ------- 6 - - --- - ------ _--- - _ - - - -- - coin lot 3 - 4 proof sets -- - -- - 1.00 0.00 - 30.00 Bid Card # 130 5.00 0.00 497 -- - - - --- - -- coin of 4.4 proof sets - --- __ 1.00 _ 37.50 ._ - 37.50 Bid Card # 130 ;x.50 0.00 98 - - - __ __.- -- _-- coin lot 5 - 5 proof sets -- _ _ - 1.00 - - 130.00 30.00 id Card # 195 -2Ei.00 0.00 - ~ ~ 499 __. - - --- - - - - - coin lot 61999 proof set _ .00 85.00 __ 185.00 Bid Card # 117 ~ ; 3i .00 0.00 - - - ._ -._. _..- com lot 7 2001 proof set .. ___ - 1.00 - - 70.00 - - - - 70.00 Bid Card # 196 - 14.00 0.00 - - - - 501 - -- -- -P - - - ~ coin lot 8 2002 roof set .00 _ _ _ _ _ - - ~ - - 47.50 7.50 Bid Card # 196 _ _ -_. _ -9.50 0.00 _. _ ._ -._. 5 2 - -- --- - - ----__ _-. p coin lot 9 3 2003 roof sets 1.00 _ _ - 60.00 60.00 Bid Card# 196 -12.00 0.00 503 - --. coin lot 10 3 proof sets .00 5.00 - 85.00 Bid Card # 196 _ __ --- -- -17.00 0.00 504 _ _ _ _ _ - coin lot 11 2 2001 proof sets _. .00 0.00 _ - 80.00 Bid Card # 195 -16.00 0.00 ~ - - 505 - - - - .__ - -- - - - com lot 12 3 2002 proof sets __ _ -__ 1.00 .50 _ 37.50 B id Card # 130 - _ - 7.,50 -. -0.00 06 - - -_. p __ __- __ coin lot 13 5 roof sets _ .00 - 5.00 _ .. 55.00 Bid Card # 130 _ -11.00 0.00 - - - 507 __ - __- _ _ _ _ _ - - com lot 14 7 proof sets - - _ 1.00 - 55.00 -. 55.00 Bid Card # 130 - -- 11.00 0.00 _.__ _ _ -__ 508 __ -- - - -.--- - - p --__ __ coin lot 15 5 2006 roof sets _ .00 2.50 - 72.50 Bid_ Card# 195 - - - 14.50 0.00 - ~ 509 _ _ - - ~ coin lot 16 3 2005 proof sets - - _ .00 0.00 - -- 50.00 Bid Card # 130 _ _ _. -10.00 0.00 __ .- -- - - - - ~ id Card # 196 Consignor Settlement Cordier Antiques & Fine Art 2151 Market Street CO #: 995 Camp Hill, PA 17011 Date: 1/29/2010 Page: 2 Phone: 717-731-8662 Fax: 717-731-9830 Lot# Description Quantity Unit Price Ext.Price Comm/BuyBack Expenses 510 coin lot 17 2 2006 proof sets 1.00 40.00 40.00 - 8.00 0.00 - - - - ___ - - - -- _ Bid Card # 196 om of 18 6 proof sets .00 5.00 - _. 5 5.00 _ - - ___ _ -11.00 0.00 - 512 ___ _.__ coin lot 19 3 2004 proof sets Bid Card # 196 1.00 3 5.00 3 5.00 - 7.00 0.00 - - - _ _ 513 -- - - - coin Iot 2013 proof sets Bid Card # 196 1.00 52.50 52.50 -10.50 0.00 14 _- _. __ _ - coin lot 21 4 proof sets Bid Card # 195 - 1.00 45.00 45.00 -9.00 0.00 - - ~ 5 -- - - - coin lot 2216 proof sets __ Bid Card # 196 1.00 100.00 100.00 -20.00 0.00 16 - - - - - - - p - - _ - --- --------- - coin lot 2316 roof sets Bid Card # 196 _ __ _ 1.00 70.00 70.00 -14.00 0.00 _ -_ - - _ - . Bid Card # 196 coin lot 24 9 proof sets .00 __ 210.00 10.00 - 42.00 0.00 ..- -- - - - - - -- - -- ----p - - coin lot 25 2 roof sets - __ -- - - _ - Bid Card # 196 - 1.00 30.00 30.00 -6.00 0.00 - - - __ . Bid Card # 195 com lot 26 5 2000 proof sets 1.00 __. 32.50 -- 32.50 -6.50 0.00 _ _ _ ~- - 520 - - - - - -- -- - -----P ---- _ coin lot 27 2 roof sets - - - -- - Bid Card # 195 _ - - 1.00 105.00 105.00 -21.00 0.00 ._ -----.--- ..- _ .-- --- - _ - -- --------- - Bid Card # 201 coin Iot 28 4 Mint sets -- 1.00 77.50 77.50 - - - - - -15.50 0.00 - ~ ~ ~ - - - --- - -- ~ - - -_ Bid Card # 198 com lot 29 3 mint sets 1.00 42.50 42.50 -8.50 0.00 - - - _ - - _ - - - _ _ _ . --- -- - Bid Card # 1 30 coin lot 30 2 mint sets 1.00 27.50 27.50 _ . -5.50 0.00 - - ~ --- com Iot 31 10 mint sets __ - __ _ _ - Bid Card # 195 - - --- 1.00 52.50 52.50 -10.50 0.00 - __..- - - ~-- _. ----- - com Iot 3210 mint sets --- - Bid Card # 196 - - - - 1.00 40.00 40.00 -8.00 0.00 com of 315 mint sets __ --- __ - - -- Bid Card # 130 - -~ - -- - - 1.00 60.00 60.00 - 12.00 0.00 - - _- - -- - - - - coin lot 34 14 mint sets __ - - - - Bid Card # 119 - - 1.00 50.00 50.00 -10.00 0.00 __-__--- 28 -- ---- ------ - coin lot 35 5 mint sets _ _ _ _ --- _ _ _ - - Bid Card#195 -- - 1.00 17.50 17.50 -3.50 0.00 - - - - ~ - - - -- - __. - -- - - - com lot 36 6 mint sets __. - - - Bid Card # 195 _ - - - 1.00 40.00 40.00 -8.00 0.00 - _ _ _ - . _ oin of 371998 American Eagle proof _- - - _. _ - --- Bid Card # 196 . 1.00 30.00 30.00 -6.00 0.00 Bid Card # 130 Consignor Settlement Cordier Antiques & Fine Art 2151 Market Street CO #: 995 Camp Hill, PA 17011 Date: 1/29/2010 Page: g Phone: 717-731-8662 Fax: 717-731-9830 Lot# Description Quantity Unit Price Ext.Price Comm/BuyBack Ex 531 penses coin lot 38 21999 proofs 1.00 60.00 60.00 -12.00 0.00 - 532 _.-_ - - - coin lot 39 2 2000 proofs .00 _ _ _ 0.00 __ 60.00 Bid Card # 130 _ _ 12.00 0.00 _ - ___ . - coin lot 40 2 2003 proofs .00 - - - 62.50 2.50 Bid Card # 117 - __ -12.50 0.00 534 - coin lot 41 2 2004 proofs __ .00 - 62.50 _ _ _- 62.50 Bid C_ and # 130 -12.50 0.00 - 535 -- - - _ __ - -- coin lot 42 lot misc 6 .00 5.00 . 35.00 Bid Card # 130 _. -7.00 0.00 6 -- - . _..- - _- - coin lot 43 lot of 10 misc 00 .00 _ - 30.00 id Card # 117 - _ __ 6.00 0.00 -- - - -- 537 - - -- - -- ----- - coin lot 44 lot of 5 coins .- 1.00 _ 50.00 0.00 Bid Card#117 10.00 0.00 ----- -~ 38 _- --- --- -- - - - -- -_ coin lot 45 2 2001 _. .00 - - 195.00 _ _ 195.00 Bid Card # 117 _ _-- -39.00 0.00 _ _-_ _ --- 539 - --- - - -- ----- - _ - -- .. -- _ coin lot 46 lot of misc 11 _ 1.00 2.50 2.50 Bid Card # 199 _.-- -4.50 0.00 _ ~ - - 0 --_ -- -- - -----p -- - - ----------------- ------ - - - - - coin lot 4711 cs. _ - - .00 - 2.50 .50 Bid_ Card_ # 195 . -_ . __ -8.50 0.00 - - 1 -- ---------- - - -- -----------------p--- ----- - ---------- coin lot 48 9 Franklin half roofs - --------------- - --- .00 _ _ _ _ _ _ _ _ - - ~ - 115.00 - - - - - - 115.00 Bid Card # 186 - -- -- _ -- -23.00 0.00 - __-_ _ --- - --------- -- --- -- ----_ - - com lot 49 7 misc. pcs. 1.00 30.00 - - 30.00 Bid Card # 1.36 - - - - - - - - -6.00 0.00 - 543 - coin lot 504 sets - - - .__-- ------- 1.00 ------_-- - 50.00 0.00 - Bid Card # 175 - - ___ _- 10.00 0.00 - - 544 - - coin lot 51 8 Silver American Ea les - -- - ----- _ -- - - .00 - - - - 50.00 _ - - - 150.00 Bid_ Card # 117 - -- -30.00 0.00 - - ~ - 545 - - - _. _ coin lot 52 5 sets - -- -- - 1.00 - 30.00 - -... 30.00 Bid Card # 199 - - -_ - -6.00 0.00 - - - - 546 - ._-- -- - - - coin lot 5315 silver Franklin halfs _ - 1.00 _ _ _ _ _ _ _ _ _ 0.00 0.00 Bid Card # 201 ---- - - - -14.00 0.00 __-- -- ---- -- - -- - - - - ------------ com lot 5410 silver halves _ .00 -- - - - - 50.00 - - - - 50.00 Bid Card#117 - -10.00 0.00 . - - - _ - - -- --- - -- - - . -- - --- - . com lot 55 3 one lb 1878 _ .00 - - - - - 10.00 - - 10.00 Bid Card # 198 __.- -2.00 0.00 549 - coin lot 56 6 pcs. - --- ---_ 1.00 - ---- - 42.50 - - - - - - - - 42.50 Bid Card # 130 _ - -8.50 0.00 - 550 -- - coin lot 57 24 silver Franklin halves ----- ----- 1.00 25.00 25.00 Bid_ C_ ard_ # 189 - _ - 25.00 0.00 - ---- .._ ..-- 551 - - ---- ---- - coin lot 581929 $10 __ _ .00 - - 42.50 2.50 Bid Card # 181 -- ---------------------- - 8.50 0.00 - - - - ~ - Bid Card # 200 Consignor Settlement Cordier Antiques & Fine Art 2151 Market Street CO #: 995 Camp Hill, PA 17011 Date: 1/29/2010 Page: 4 Phone: 717-731-8662 Fax: 717-731-9830 Lot# Description Quantity Unit Price Ext Price C /B 552 . omm uyBack Expenses coin lot 59 lot of currency 1.00 47.50 47.50 -9.50 0.00 - 553 _ _ coin lot 601arge lot misc - 1.00 75.00 75.00 Bid Card # 117 - 15.00 0.00 554 - __ coin lot 61 74 Wheat cents .00 15.00 15.00 Bid Card # 117 -23.00 0.00 555 -- com lot 62 complete Jefferson nickel set .00 7.50 _ - 27.50 Bid Card # 195 ____ __ - -5.50 0.00 556 __ coin lot 63 Misc. 18 pcs. - 1.00 05.00 _ 105.00 Bid Card # 195 --- -21.00 0.00 557 coin lot 64 14 SBA dollars - 1.00 37.50 37.50 Bid Card # 198 -7.50 0.00 58 - - - ------ -_ . -- coin lot 6518 American silver ea les g _ 1.00 0.00 0.00 id Card # 195 _ -52.00 0.00 9 - - - - - - -- - --- - _- - -- om lot 66 Misc. US coins - 1.00 .00 - 5.00 id Card # 168 13.00 0.00 560 _ _ - - - - - - coin lot 67100s of wheat cents incl steel _ _ _ --- 1.00 2.50 - 12.50 Bid Card # 195 - 2.50 0.00 - - com lot 68 45 Nickels incl. 30 V - - .00 0.00 _ 20.00 Bid Card # 200 -4.00 - 0.00 562 - -- - ----_--- - com lot 69 29 Indian cents - -- . .00 _ 20.00 - 20.00 Bid Card # 195 -4.00 0.00 -- 563 - - - - coin lot 70 32 silver dimes 7 silver uarters - - - .00 .50 .50 Bid Card # 130 _. --- --- -8.50 0.00 - 564 - - - - _ _ . _ _ _ --------- coin lot 71 31 silver half dollars -- - .00 - 45.00 --- 145.00 Bid_ Card # 175 .- _ _ -- -29.00 0.00 5 - -- --- coin lot 7215 40% silver Kenned halves y _ .00 _ _ _ _ _ _ 20.00 0.00 Bid Card # 117 -4.00 _-0.00 66 - - ._..-- _ - - - - com lot 73 5 coins incl. 1852 - - .00 __ - 47.50 _ - - 47.50 Bid Card # 130 - - - .- 9.50 0.00 567 -- - --- - _ _ _ - --- - - - com lot 7413 war nickels - ._. ___ .00 50 - - - --- 7.50 Bid Card_ # 195 - -- --- - - 1.50 0.00 568 _ -- ------_ _ _ - - - --- coin lot 75 21950D Jefferson nickels _ 00 _ 5.00 -- 15.00 Bid Card#195 - 3.00 0.00 69 -.. __ - -_ - - - - - - -- _-. coin lot 76 6 foreign coins _ - 1.00 - - 17.50 - 17.50 id Card # 130 - - -3.50 0.00 570 __ _ - - coin lot 77 22 Misc foreign coins .00 -- 10.00 - _ 10.00 Bid Card # 195 _ -2.00 - _ -0.00 571 -----_- - _ - _ _ - -- coin lot 7818 misc. medals -_ _ .00 - 5.00 - 5.00 Bid Card # 195 .__-_ -1.00 0.00 2 _ _-------_ - ---- _ _ -- - -- - _ coin lot 79 9 ancient replica colonial coins - -- - .00 _ .50 -- - - - 7.50 Bid Card#189 - -- - 1.50 ---0.00 - - Bid Card # 128 Consignor Settlement Cordier Antiques & Fine Art 2151 Market Street Camp Hill, PA 17011 CO #: Date: 995 1/29/2010 Phone: 717-731-8662 Fax: 717-731-9830 Page 5 Lot# 573 Description Quantity Unit Price Ext.Price Comm/BuyBack Expenses coin lot x01878 CC Morgan silver dollar 1.00 115.00 115.00 -2 3.00 0.00 _ 574 - - _. Coin Lot 81 1879 S Morgan Silver Dollar .00 - 25.00 5.00 Bid Card # 195 -5.00 0.00 575 _ - - - Coin Lot 821880 0 Morgan Silver Dollar 1.00 22.50 22.50 Bid Car d # 195 -4.50 0.00 576 - -- _ - - __----- Coin Lot 83 -1880 S Morgan Silver Dollar _ _ .00 0.00 0.00 Bid Card # 195 -8.00 0.00 577 _ ___ - Coin Lot 84 - 1882 Carson City Silver Dollar __ _ 1.00 _ 50.00 50.00 Bid Card # 16.8 -10.00 0.00 578 _ _ - _ _ _ _ Coin lot 85 -1881 S Morgan Silver Dollar .00 2.50 2.50 Bid Card # 154 -- -4.50 0.00 79 -- - --- -. Coin Lot 86 -1883 Carson City Morgan Silver Dollr .00 0.00 0.00 Bid Card # 195 10.00 0.00 Bid Card # 154 580 _. _ - _ --- -- _... - _ - - Coin Lot 87 -1883 0 Morgan Silver Dollar - .00 _ . - 22.50 - - __ 22.50 --- -- -4.50 0.00 581 _- - - Coin Lot 88 - 1884 0 Morgan Silver Dollar .00 - 22.50 - 22.50 Bid Card # 130 4.50 0.00 82 - - _. -- _ Coin Lot 89 -1893 Morgan Silver Dollar - - .00 40.00 40.00 - Bid Card # 193 _- 28.00 0.00 583 -- - _ - ___ -_ - Coin Lot 90 -1891 Carson Cit Mor an Silver y g Dollr _ _ .00 85.00 85.00 Bid Card # 188 7.00 0.00 - - Bid Card # 195 584 - - - - ----- - - Coin Lot 91 -1893 Carson Cit Mor an Silver g Dollr -- .00 80.00 - - 180.00 _ -. - 36.00 0.00 Bid Card # 195 585 _. _ _ - - - - Coin Lot 92 -1893 0 Morgan Silver Dollar - .00 55.00 55.00 31.00 0.00 586 Coin Lot 93 -1894 0 Morgan Silver Dollar .00 5.00 5.00 Bid Card # 188 _. -9.00 0.00 587 Coin Lot 94 -1895 0 Morgan Silver Dollar .00 -- 200.00 - 200.00 Bid Card # 195 __. -40.00 0.00 588 Coin Lot 95 -1895 S Morgan Silver Dollar .00 ._- 390.00 - __ 390.00 Bid Card # 195 --- - _ -- - 78.00 0.00 589 --------- - _ Coin Lot 96 - 1902 0 Morgan Silver Dollar -- - - - - - - -- - - .00 ---- . -- _ 2.50 - 2.50 Bid Card # 188 ___ __ - --- -- ._ - 4.50 0.00 590 - - - -------- --- --- -- --- ------ ---------- -- ~ - - - - - _ Coin Lot 97 -1903 0 Morgan Silver Dollar _ .00 _ - 410.00 ---- - 410.00 Bid Card # 154 ._ -82.00 0.00 591 Coin Lot 98 - 4 Morgan Silver Dollars 1.00 65.00 65.00 Bid Card # 188 13.00 0.00 92 __ --- _ ----__ - Coin Lot 99 - 4 Morgan Silver Dollars _ .00 _____ __ - 67.50 7.50 _ Bid Card # 195 3.50 0.00 __ _- - - -_ Bid Card # 195 Consignor Settlement Cordier Antiques & Fine Art 2151 Market Street Camp Hill, PA 17011 Phone: 717-731-8662 Fax: 717-731-9830 CO #: 995 Date: 1 /29/2010 Page: 6 Lot# Description Quantity Unit Price Ext.Price Comm/BuyBack E 593 xpenses Coin Lot 100 - 4 Morgan Silver Dollars 1.00 52.50 52.50 -10.50 0.00 594 - Coin Lot 101 - 4 Morgan Silver Dollars .00 2.50 2.50 Bid Card # 200 10.50 0.00 595 - - -_ __ - _ _ _ _ _ - .. - Coin Lot 102 - 4 Morgan Silver Dollars _ -- 1.00 _ 5.50 5.50 Bid Card # 130 15.10 0.00 596 - _ _ . _ . - . - Coin Lot 103 - 4 Morgan Silver Dollars .00 2.50 2.50 Bid Card # 130 -10.50 0.00 597 ---__ - -. - Coin Lot 104 - 4 Morgan Silver Dollars _ .00 2.50 2.50 Bid Card # 130 _ -10.50 0.00 '~ 598 _ _ Coin Lot 105 - 4 Morgan Silver Dollars .00 2.50 2.50 Bid Card # 130 -10.50 0.00 599 -- --- - - ---- - - oin Lot 106 - 4 Morgan Silver Dollars .00 2.50 2.50 Bid Card # 201 - 12.50 ~ 0.00 600 _ _ - - - __ - _ __. - om Lot 107 - 4 Morgan Silver Dollars .00 2.50 2.50 Bid Card # 181 12.50 0.00 601 - - - coin lot 108 - 4 Morgan silver dollars .00 5.00 _ . 55.00 Bid Card # 203 11.00 0.00 - - _-- coin lot 109 - 4 Morgan silver dollars .00 - 2.50 - 62.50 Bid Card # 200 - - -12.50 0.00 603 - ---- coin lot 110 - 4 Morgan silver dollars - - .00 _ 2.50 - - -- -- 62.50 Bid Card # 130 - - -12.50 - 0.00 604 _ - - - - com of 111 - 5 Morgan silver dollars -- - .00 - 72.50 ~ - - - 72.50 Bid Card # 168 - - - - - -14.50 0.00 605 - -~--. - coin lot 1121921 Peace silver dollar ._ .00 7.50 - 77.50 Bid Card # 191 - -15.50 0.00 606 -------_ - - com lot 113 1921 Peace silver dollar - - .00 _ 62.50 - 62.50 Bid Card # 195 -12.50 0.00 607 - - - - - - com lot 114 4 Peace silver dollars - . __- 1.00 - ~ 50.00 - -. 50.00 Bid Card_ # 195 _ - 10.00 0.00 - 608 - -- -- -- -- - - - - - coin lot 115 4 Peace silver dollars 00 -_ 50.00 _ --- 50.00 Bid Card # 117 -- -10.00 0.00 609 oin lot 116 4 Peace silver dollars __ _ - - - 00 - - - - - - ~ 50.00 - -- - - 50.00 Bid Card # 117 _- -- ~- - ---- - -- -10.00 0.00 610 -- ------- com lot 117 4 Peace silver dollars - - - 1.00 _ _. 57.50 _ _ 57.50 Bid Card # 117_ - -11.50 0.00 ', 611 - ~, _ . -- --- - - - coin lot 118 4 Peace silver dollars _ 1.00 0.00 0.00 Bid Card # 195 12.00 0.00 L 612 - -.. _ - coin lot 119 4 Peace silver dollars 00 - - 0.00 - ----. 60.00 Bid Card # 196 - - - ---- 12.00 0.00 13 -- _- __ --_ _ _ _ --- - - coin lot 120 4 Peace silver dollars .00 0.00 0.00 Bid Card # 195 -12.00 0.00 _ Bid Card # 195 Consignor Settlement Cordier Antiques & Fine Art 2151 Market Street Camp Hill, PA 17011 CO #: Date: 995 1/29/2010 Phone: 717-731-8662 Fax: 717-731-9830 Page. ~ Lot# 614 Description Quantity Unit Price Ext.Price Comm/BuyBack Expenses coin lot 121 3 Peace silver dollars 1.00 60.00 60.00 -12.00 0.00 615 - ___ - coin lot 122 3 Peace silver dollars - .00 _ 0.00 _ - 50.00 Bid Card # 196 - _ ._ - 10.00 0.00 16 __ _ - __ .- - -- coin lot 123 Lincoln cent collection _ .00 .00 .00 Bid Card # 196 _ 14.00 0.00 - 617 . _ _._ - _- - ~ coin lot 124 Lincoln cents .00 .50 _ 7.50 Bid Card # 196 _ - _- - 1.50 0.00 618 - - ~ coin lot 125 Nickel and dime collection .00 2.50 - 42.50 Bid Card # 168 _. - -8.50 0.00 619 coin lot 126 33 90% silver halves .00 60.00 60.00 Bid Card # 201 --- -32.00 0.00 620 -- - _ _ coin lot 127 5 Morgan silver dollars _ - - - .00 0.00 . _ 60.00 Bid Card # 117 - _-- - -- 12.00 0.00 621 _ -- - - - ----- -- -- - - - - coin lot 128 Misc. incl. 1923 Peace silver dollar __ _ __ .00 7.50 - 37.50 Bid Card # 191 - -- -7.50 0.00 622 coin lot 129 Misc. incl. 1926 Peace silver dollar .00 0.00 - - 60.00 Bid Card # 201 12.00 0.00 623 - ._ . --- - coin lot 130 Misc. incl. 10 Franklin Mint medals _ __ . .00 0.00 .. - 30.00 Bid Card # 117 6.00 0.00 624 -- - - -- ---- _ - ---- ---- --- --- -- - - - coin lot 131 Misc. incl. a 20th C coin collection - --- _ .00 ____ 5.00 -- 55.00 Bid Card # 195 _ _- -11.00 0.00 625 - - - - --- -- -- _ coin lot 132 Mexican gold 2 peso coin ~ - .00 5.00 - -- 45.00 Bid Card_ # 181 -- -- 9.00 0.00 626 __ _ - - -- - -- - coin lot 133 Mexican 1/20th oz. old coin g - - --_ - .00 - 42.50 -- -- 42.50 Bid Card # 128 -_ -- -8.50 0.00 27 _ -- -- -- coin lot 134 Isle of Man 1/25th oz old coin _ - _ _ _ _ -- --~ - 1.00 7.50 7.50 Bid Card # 189 -- -- - -. -7.50 0.00 628 _ . --- __ coin lot 1351998 American Ea le 1/10th oz old g 9 _ __ 1.00 ~ 120.00 _ _ _._ 120.00 _ Bid Card # 199 - 24.00 0.00 629 - ----- _ coin lot 1361997 American ea le 1/4th oz old 9 _ _ 1.00 60.00 60.00 Bid C_ ard_ # 189 -52.00 0.00 30 __ _ - coin lot 137 2000 American Ea le 1/4th oz old _ __ .00 _ - ------ 260.00 ------------------ 260.00 Bid Card # 117 - -52.00 0.00 631 - - - - coin lot 1381996 American Ea le 1/2oz old g 9 .00 75.00 -_ 575.00 Bid Card # 117 115.00 0.00 2 - coin lot 139 2001 American Eagle 1/10oz .00 .___ 105.00 __ 105.00 Bid Card # 117 - 21.00 0.00 633 -- .- _ -- coin lot 1401999 George Washington Comm. ---- .00 _ _ ~ - 215.00 15.00 Bid Card # 169 -43.00 0.00 634 _ - -- - - com lot 141 large lot misc. coin su lies p _ _ .00 _ _ _ - ~ - 15.00 ~ - - ~ ~ - - 15.00 Bid Card # 169 -3.00 0.00 _ . _ - - - - Bid Card # 128 Consignor Settlement Cordier Antiques & Fine Art 2151 Market Street Camp Hill, PA 17011 Phone: 717-731-8662 Fax: 717-731-9830 CO #: 995 Date: 1 /29/2010 Page: g Total Quantity: 142.00 Total Invoice Sale Price: 10, 525.50 Total Commission: ( 2 ,105.10) Total Due to Consignor: 8 420.40 Total Payments: 0.00 Balance: $8 , 420.40 Positive Balance, Monies Owed to Consignor COMMISSION SETTINGS Calculate Commission By: Each Commission Structure Type: Fixed Any Amount 20% u --BSc, ~ ~ Cc: i r~ s ~ ~~ ~-~ ~~ ~% ~ ~ ~`~ ~ ~, Estate Of James F Nichols Item # SCHEDULE H Attachment B Description Amount 8 Legal Advertising -The Sentinel 113.20 9 Legal Advertising - Cumb Co Law Journal 75.00 10 DuPont -Refund of insurance overpayment 1,254.55 11 Chapel Pointe -cleaning expense 688.46 12 John Oszustowicz -reimburse postage 35.78 13 Wilmington Trust Checking service charges 30.00 14 HARP fees 67.80 15 Nationwide Life Insurance Premium -auto deduction from checking 103.65 16 Amy Nichols -reimburse for postage, cleaning, commission fees 150.00 File Number 21-09-1010 2,518.44 ~a l~we- •4~1. A4o 1~8. ~o ~, o0 ~ '~ - ~~ ,~ ~°l83