Loading...
HomeMy WebLinkAbout12-10-10 ~ ~ 1505610140 REV-1500 EX ~°'-'°' PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN 2 1 1 0 0 1 4$ Hamsbu PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYW Date of Birth MMDDYYYY 2 0 6 3 8 8 8 0 4 0 2 1 0 2 0 1 0 1 2 0 4 1 9 4 8 Decedent's Last Name Suffix Decedent's First Name MI HOWE R EDWARD E (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 D 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required death after 12-12-82) 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 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 ~ 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 eE DIKEC t Eu ~ v: Name Daytime Telephone Number MARK A MATEYA ESQUI RE 7 1 7 24 1 ~a-50 0 First line of address 5 5 W. CHURCH A V E N U E Second line of address City or Post Office CARL f S L E State PA ~- ILLS USt)~NLY ~-* ~~ .~' D C70~+ ~ :=a F' DATE FILED W ZIP Code ~ 1 7 0 1 3 Correspondent's a-mail address: MAM MATEYALAW.COM Under penalties of perjury, I declare that I have examined this return, including acx;ompanying 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. NAT FOR FILING RETURN DATE 07 BLUE GRASS AVENUE HARRISBURG PA 17112 G AT E C~ PR A~'~ER THAN REPRESENTATIVE DA~E f a ~ .u~ 1 "7 . (~ v / ~c3 l ~ 55 W. CHURCH AVENUE CARLISLE PA 17013 PLEASE USE ORIGINAL FORM ONLY L 1505610140 Side 1 1505610140 J fir, r ~' 1505610240 REV-1500 EX Decedent's Social Security Number Decedents Name: EDWARD E. ROWER 2 0 6 3 8 8 8 0 4 RECAPITULATION 2 8 3 0 0 0 0 0 1. Real Estate (Schedule A) ........................................... 1. . 2. Stocks and Bonds (Schedule B) ...................................... 2• 3. Closely Held Corporation, Partnership orSole-Proprietorship (Schedule C) ..... 3. • 4. Mortgages and Notes Receivable (Schedule D) .......................... 4. • 4 4 0 5 1 6 0 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)....... 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 6. • 7. Inter-Vivos Transfers $~ Miscellaneous No -Probate Property Billin Re uested t a S 7 2 7 1 5 0. 2 9 ....... g q epara e (Schedule G) . 3 5 4 2 0 1 8 9 8. Total Gross Assets (total Lines 1 through 7) ........................... 8. 9 3 6 8 7 0. 9 0 9. ........... Funeral Expenses and Administrative Costs (Schedule H) .... . ... ~ 7 7 1 6 9 7 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ...... .... ... 10. • 11. Total Deductions (total Lines 9 and 10) ........................ .... ... 11. 5 4 5 8 7 • 8 7 12. Net Value of Estate (Line 8 minus Line 11) ..................... .... ... 12• 2 9 9 6 1 4. 0 2 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. 2 9 9 6 1 4. 0 2 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.o 0 0 0 15. 0. 0 0 16. Amount of. Line 14 taxable 1 2 9 8 3 8 8 6 1 3 4 2 7 4 7 . at lineal rate X •045 16. . 17. Amount of Line 14 taxable 0 0 0 17 0 0 0 at sibling rate X .12 . • 18. Amount of Line 14 taxable 1 2 2 5 8 6 1 8 3 8 8 at collateral rate X .15 18. • 19. TAX DUE ............................................... .... ...19. 1 3 6 1 1 3 5 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ^ Side 2 1505610240 1505610240 REV-1500 EX Page 3 Decedent's' Complete Address: File Number 21 10 0148 DECEDENT'S NAME EDWARD E. HOWER STREET ADDRESS 18 ARLINGTON DRIVE CITY CARLISLE STATE PA ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments 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. Fiii in oval on Page 2, Line 20 to request s refund. (4) (1) 13,611.35 0.00 0.00 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 : ........................................................... i ........... ^ ^ ncome; .................... b. retain the right to designate who shall use the property transferred or its ........... c. retain a reversionary interest; or ..................................................................................... ........... ^ ^ 0 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? ............................................................................ " " ........... ^ ^ 0 0 orpayable-upon-death bank account or security at his or her death? intrust for 3. Did decedent own an ......... 4. Did decedent own an individual retirement account, annuity or other non-probate property, which contains a beneficiary designation? ....................................................................................... ........... 0 ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. .... ~H 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 i; 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)J. • 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)j. • 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)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1502 EX+ (01-10) pennsylvania SCHEDULE A DEPARTMENT OF REVENUE REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: EDWARD E. ROWER __ 21 10 0148 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 beiween a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property that is jointly-owned with right of survivorship must be disclosed on Schedule F. Attach a copy of the settlement sheet if the property has been sold. ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE NUMBER OF DEATH DESCRIPTION 1. 18 ARLINGTON DRIVE, CARLISLE, PA 17013 (283,000.00 SOLD ON 5/27/10 SEE ATTACHED SETTLEMENT SHEET TOTAL (Also enter on Line 1, Recapitulation.) ~ $ 283, 000.0 If more space is needed, use additional sheets of paper of the same size. 5127/2010 11:43:48 AM '- fiuF,rT~ ~r ~ A. Sett1E g OMB!" 'Val No, 2502-0265 at Statement (HUD-1) B. Type of loan 1.®FHA 2.^ RHS 3.^Conv. Unins, 6. File Number: 7. Loan Number: 8. Mortgage Insurance Case Number: 4.^ VA 5.0 Conv. Ins. ^ Other 20100395 0096203379 446-0180068-703 C. Note: This forth is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "(POC)" were paid outside the closing by either the: Borrower (POCB), Lender (POOL), Mortgage Broker (POCM), Other (POGO), Reat Estate Agent {POCR), or Seller (POCS); they are shown here for informational purposes and are not included in the totals. D. Name 8s Address Judith W Gook, 3630 Ash Street, Harrisburg, PA 17109 of Borrower: E. Name 8~ Addross Estate of Edward E Hower, 18 Arlington Drive, Carlisle, PA 17015 of Seater: F. Name & Address Sovereign Bank, iSAOA, ATIMA, 1130 Berkshire Blvd., Wyomissing, PA 19610, Loan: 0096203379 of Lender: G. Property Location: Property Address 18 Arlington Dr, Carlisle, Pennsylvania 17015 PIN 40-10-0636-334 H, Settlement Agent: James A. Miller, Esq., i-Great Road Settlement Services, LLC, 765 Poplar Church Road, Camp Hili, PA 17011, (717)731-1040 Place of Settlement: 785 Poplar Church Road, Camp Hill, PA 17011 1. Settlement Date: 512 712 0 1 0 Proration Rate: 5!27/2010 Disbursement Date: 5/27/2010 pN` i. ' r~ : `~ ~?Fi~ a. :. ~ . ... .... .... .. .. b.. ~. .. .n ... ..., a .. ., , . .. ,. ,, , , fsa ~` ' I` ~~ ,~ Q , r pia"': ; ~f~ a..' ~ ,~,~e'I 101. Contract sates price 5283,000.00 401. Contract sales price 5283,000.00 102. Personal property 402. Personal property 103. Settlement charges to borrower (line 1400) 515,369.90 403. 104. 404. 105. . .,: :.v :s•. :; '?..' k F .~. .~, n~,~_ `" ,AtliYstrnan~ ~itetp Y er'1n yi.. hC ~ . ~..., e ~ 1+ 9. .. Y7o y ~'a s .~l } InM'~, ~ .. ~ 405. ~ naA r e~S'-" e ,fin ~' tt ~ ~ ..I~..~r"l1~• y P, I~. . Y :.: ~ ~ i ... . ~`/Y4{o!c.4 Y ~.': S i~l`~du~Y~' , .,. " 106. City/town taxes 406. Cltyftown taxes 107. County taxes 5/27/2010 to 1!1/2011 5341.13 407. County taxes 5/27/2010 to 1/1/2011 534i.i3 108. Assessments 408. Assessments 109. School Real Estate Tax 5/2712010 to 7/1/2010 5210.02 409. School Real Estate Tax 5!27/2010 to 7/1/2010 5210.02 110. Annual HOA Dues 5/27/2010 to 1/1/2011 566.00 410. Annual HOA Dues 5/27!2010 to 111!2011 566.00 111. 411. 112. 412. 120. Gross Amount Due from Borrower 200 ..::Afnoynt3;P~ild by'or.tn 8~ahdlf+bt'SorrpM!es'.: _ . 3 - *~....:. 5298,987.05 420. Gross Amount Due to Seller 5283,817.15 ,:. , _ , , .. ; . , _. ..:= . 201. Deposit or eamast money 53,000.00 501. Excess deposit (see instructions) 202. Principal amount of new loan(s) 5277,148.00 502. Sett{ement charges to seller (line 1400) 520,526.93 203. Existing loan(s) taken subject to 503. Existing loan(s) taken subject to 204. 504. Payoff of first mortgage loan to Members 1st Federal 5144,447.98 205. 505. Payoff of send mortgage loan 206. $O6. OvarnightlWire Payoff to Great Road Settlement Ser 530.00 207. 507. 208. AppliCetlOn Fee Credit from Sovereign Bank, ISAOA, 5399.00 508. 209. Sellers Assistance ~dus'krirtRhts~`~1"ite~t~un`alii~;'~sis"lierl`~-_. `' :,. .s ~.1 a by 58,350.00 ~ ~~~ ~~"~ 509. Sellers Assistance 38,350.00 Adlust!n~pt>~:f~i~I~iuaf, °a°oli~'r~ >~~:.~.,~~r;~`ia, ~~~~~~,,.T~'f ,^~`~.~r ~' 210. City/town taxes 510. City/town taxes 211. County taxes 511. County taxes 212. Assessments 512. Assessments 2i3. 513. 214. 514. 215. 515. 216. 516. 217. 517. 218. 518. 219. 518. 220. Total Paid by/far Borrower ..., 300.. ',Cash.At`,Set~lalrnieM`,~t'gfri ower ~~ , ~,. ~ ., ~,a~ '~ ~;` ,~ 5288,897.00 ° ; ~.~'~ ' 520. Tots! Reduction Amount Dua Seller 5173,354.91 ~ 6'10, '''Cas'h.)tt~ ,.~tt`erl-ia ~b~f~rorlt tiller ,, ," r~,':~,, ~~ ~r~.~,.~. 301. Gross amount due from tmrrower (tine 120) 5298,987.05 601. Gross amount due to seller (line d20) 3283,617.15 302. Less amounts paid byHor borrower (line 220) (3288,897.00 ) 602. Less reductions in amount due seller (line 520) (5173,354.91) 303. Cash ®From DTo Borrower 510,080.05 803. Caah ®ToDFrom Seller 5110,262,24 The Public Reporting Burden for this collection of information is estimated at 35 minutes per response for collecting, reviewing, and reporting the data. This agency may not ~Ilect this infortnatton, and you tiro not required to complete this form, unless h displays a Currently valid OMB control number. No Confidentiality is assured; this disclosure is mandatory. This is designed to provide the parties to a RESPA covered transaction with information during the settlement process. Previous editions are obsolete Pape 1 of 3 HUD-1 5!27/2010 11:43:48 AM File Number: 2D100395 .~;; L` Set#lement Charges ~~' s , ~ ~~. ' ~ ~ ~ ~n,s ~; 4. > ~„ ~~,~ ~.re~? - ~ ' „;!`.~`ab , 70p. Total Reel Estate Broker Fees based on price= $16,725.0( Paid From Paid From Division of commission (line 700) as follows: Borrower's Seller's 701. $8,500.00 to Howard Hanna Company Funds at Funds at 702. $8,225.00 to Keller Williams East Settlement Settlement 703. Commission paid at settlement 316,725.00 516,725.00 704. 705. Broker Fee to Keller Wi4iams East ~4A ~tbt>~3, $l~tlt~~q 9 Q ;~ ~~,; _ 801. Our origination charge Sovereign Bank, ISAOA, AT1MA" 5749.00 (from GFE #1} 5295.00 ~.~ ~ r •xw; 802. Your credit or charge (points) for the specific interest rata chosen (from GFE #2) 803. Your adjusted origination charges to Sovereign Bank, ISAOA, ATIMA (from GFE A) 5749.00 804. Appraisal fee to Central Penn appraisers (from GFE #3) 5392.00 805. Credit report to CBC Innovis (from GFE #3) 518.33 806. Tax service (from GFE #3) 807. Flood certification to LBS National Flood (from GFE #3} 57.50 808 0,. d!~ art~lrt~`d b}%t~ie ~~Rt-i~~.......,. ,_~ f~ ~=,' .,:; ,,~;~'~, 'F '' ~w a. _.:, A ~~`.~ W. ~ ,arlb k~ ~+tr'~r. 4. (from GFE #10) 901. Daily interest charges from 5/27/10 to 6!1!10 (~ 538.4828lday $192.46 902. Mortgage insurance premium for to Sovereign Bank, ISAOA, ATIMA (from GFE #3) 56,098.63 903. Homeowner's insurance for 1 year(s) to State Farm (from GFE #11 } POCB 5793.0 904. 905 ~~000 Reberve~'D9~aaited i~}h~ender =r `: ~ :~ r 4',~~~~` ~~~ ~~m^ . '~~ , : ~' ~ ~'x ~ r' "' `~,~; '~r~ ' ,..,.,. Y. .. ,:.. . ~. ,. ,. ._ ~'~' j ;'~ ~~; ` ~ 1001. Initial deposit for your escrow account (from GFE #9) 52,190.23 1002. Homeowners insurance 3 mo. (~ $66.0800 per mo. 5198.24 1003. Mortgage insurance 0 Ma. ®5123.40IMo. 1004. City property taxes 1005. County property taxes 5 mo. (8 547.3800 per mo. 5236.90 1006. School property taxes 12 mo. ~ 5182.5200 per mo. S2,190.24 1007. 1008. 1009 Aggregate Adjustment (~ 5) .: 3Y. ~;,.~ a.,y; , . a A it~~?ir~t]aigp;' G '~; w ~`~ . '~ _ ~ ~~ 4"` ` ~,~ ,,,..#* M , ~ ,~ . ~ s~=,. '~~ _ ,~'~ w , ~'# 1.:, Y "' v ~ ~" ° ; 1101. Tftle services and lender's title insurance (from GFE #4) 5500.00 1102. Settlement or closing fee 1103. Owner's title insurance to Great Road Settlement Services, LLC (from GFE #5) 51,773.75 1104. Lender's title insurance to Great Road Settlement Services, LLC " 5200.00 1105. Lender's title policy limit S277,148.00 1106. Owner's title policy Limit $283,000.00 1107. Agent's portion of the total title insurance premium to Great Road Settlement Services, LLC 51,707.69 1108. Underwriter's portion of the total title insurance premium to Stewart Title Guaranty Company $266.06 1109. Closing Protection Letter to Stewart Title Guaranty Company 575.00 1110. Doc Prep to Great Road Settlement Services, LLC 5250.00 1111. Overnight~re Fee to Great Road Settlement Services, LLC $50.00 1112, Notary Fee to Cash 525.00 510.00 1113. " lncludes Ends 100, 300, 820, 900 1114. Deed Prep to Mateys taw Firm 5150.00 1115 yy4~ ~yy Y, ~ :~, - to kL ~. ,. ~ ~Rt~F ~~t~{„ice a4 n2 ~+. Ott „~~-'°~+ d f~vbY ~i~t'RACOFdf _~j ct~Ttlansf~t'~`~ ar'9~r~~` ~' ~> ~i~?~+ :.... ~ ~ ~ , ,~~py.,~, _ ,"h14'~f~ ~'t ;~ ,,. L 1201. Government recording charges (from GFE #7) 5163.00 1202. Deed 553.50 Mortgage 589.50 Releases $143.00 1203. Transfer taxes (from GFE #8) 52,830.0 0 1204. City/County tax/stamps Deed 52,830.00 $2,830.00 1205. State tax/stamps Deed $2,83D.00 52,830.00 1206. UPI Certification Deed 510.00 Mortgage 510.00 520.00 ~ x s ,b.;M. ~ ,.-~ ~ .6 a ,^;a ~ ~ ~ -, ~ •;.+t r ~1300~ Aiidi~fonia~ SektTemen, 14r~s- ~. ti k ~,~ ~ ~~~ g ~ i~ ~ ~, ~ 1 ~ ~,~a~ : ~ h ~ r -: ,a _ a Y .u,a~'`t ~,~$ 7~~~ y ~~,'~ ~ ~ ~, ~. f, ~ 4 r ;i~ ,.-:>. 1301. Required services that you can shop for (from GFE #6) 560.0 0 1302. 2010 County/Township Tax to Robert Cairns S580.15 1303. 2009-10 School Tax on 9111/09 to Robert Cairns POCS 52,190.2 3 1304. Final Sewer 1/1/2010 to 5!27!2010 to SMTMA 5181.78 1305. Resale Certificate to Forgedale Crossing Home Owners Association 550.00 1306. Initiation Fee to Forgedale Crossing Hom® Owners Association 550.00 1307. Aah Street Tax Cert to Great Road Settlement Services, LLC 510.00 1400. Total Settlement Charges (enter on lines 103, Section J and 502, Section K) 515,369.9 0 520,526.93 `• Includes Origination Point (5748.00). Previous editions are obsolete Page 3 of 3 HUD-1 5/27/2010 10:46:03 AM Fife Number: 20100395 SUBST{TUTE FORM 1099 SELLER STATEMENT - The information contained in Blocks E, G, H and 1 and on line 401 (or, it Tine 401 is asterisked, lines!"'•~nd 404), 406, 407 and 406-412 (applicable part of buyer's real estate tax reportable to the '`"~~""'~ important tax information and is being tumished to the tntemat Revenue ~ if you are required to file a-retum, a negligence penalty or other sanction will be it ion you if this item is required to be reported and the IRS determines that ie ~t been reported. SELLER INSTRUCTION - if this real estate was your principal reaidenct, ...e form 2118, Sale or Exchange of Prinapal Residence, for any gain, with your income tax return; for other transactions, complete the applicable parts of Corm 4797, Form 6252 and/or Schedule 0 (Form 1040). You are required to provide the Settlement Agent with your cortect taxpayer identification number. If you do not provide the Settlement Agent with your correct taxpayer identification number, you may be subject to civil of criminal penalties. The a~z r~r ~~`~~~~~~~.'~ Dawn Rice Administrix Previous editions are obsolete Page 2 of 3 HUD-1 5/27/2010 10:46:03 AM File Number: 20100395 CERTIFICATION: t have carefully reviewed the HUD-1 Settlement 5taterraent and to the best of my knowledge and belief, it is a true and accurate staterr ~ ' afi receipts and disbursements ~ade on y account or by me in this transaction. I furtht` '~! that t have received a copy of NUD-1 Settlement Statement. The Settlerr <nt does not weirrant or represent the uracy of Information provided by third pantie ding information concerning POC items and information supplied by the lent. .~thia transaction appearing on the HU ~to "Comparison of Good Faith Estimates piFE) and HUD-1 Charges' and 'Loan Terms', and the pertiea hold harmless the Settlement Agent !a t0 any InaCCUreCI 0 attefS. The Eats ~ an\d E`.~Hower ~\ ~ Dawn Rice Administrix ~f my edge, the HUD-1 Settlement Statement which i have prepared [s s true snd accurate account of the funds which were received and have been or will be by the u ¢re)gned es pert of the settlement of this transaction. Date ~,~ .~.7 ~Y o to knowingly make false statements to the United States on this or any other aimiler form. Penalties upon conviction can include a fine and see: Title 18: U. S. Code Section 1001 and Section 1010. REV-1508 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER EDWARD E. ROWER 21 10 0148 Include the proceeds of litigation and the date the proceeds were received by the estate. Ail property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. 1985 PORSCHE - 911 CARERRA -AUTOMOBILE '10,000.00 APPRAISED VALUE SEE ATTACHED 2. 2010 SUBARU FORESTER 27,709.00 3. PA DEPARTMENT OF REVENUE 30.00 2009 STATE INCOME TAX REFUND 4. US DEPARTMENT OF TREASURY 205.00 2009 FEDERAL INCOME TAX REFUND 5. PROGRESSIVE INSURANCE ,,~ 68 REFUND ON CANCELLATION OF INSURANCE POLICY POLICY NO. 50817955-0 6. CHASE CARD SERVICES ,,.7 gg REFUND ON CREDIT CARD ACCOUNT ACCOUNT NO. XX;XX XX)CX XXXX 7043 7. FRY COMMUNICATIONS, INC /1;507.40 PAYROLL CHECK DUE PRIOR TO DATE OF DEATH 8. MEMBERS 1ST FEDERAL CREDIT UNION 2,504.23 SAVINGS ACCOUNT ACCOUNT NO. ~;XX273-00 9. MEMBERS 1ST FEDERAL CREDIT UNION 219.78 CHECKING ACCOUNT ACCOUNT NO. ~;XX273-11 10. FRY COMMUNICATIONS 1,860.52 PAYROLL CHECK DUE PRIOR TO DATE OF DEATH TOTAL (Also enter on line 5, Recapitulation) ~ ~ ~,, (If more space is needed, insert additional sheets of the same size) 60 AUTOMOTIVE Il~TVENTMENT COUNSELING 225 BLACK ROAD, QUARRYVILLE,PA 17566 717-529-2025 Appraisal for: Dawn Rice c/o Mateya Law Firm 55 W Church Ave. Carlisle, PA 17013 ITEM: One 1985 Porsche 911 Cabriolet Model # 911 630 VIN:WPOZZZ91ZFS150256 Non US Spec. European model. Not imported by Porsche Cars NA, Privately imported COLOR: India Guardsman Red Code # L027 INTERIOR: VD Black ENGINE: 3.21iter flat 6, Motor# 93020-63F TRANS: 5 spd #91572-73F OPTIONS C00-Emissions, European model (NOT US SPEC) Black Leather Interior with custom red piping on seats, Air Conditioning, Power windows, Power/heated mirrors Tinted glass, Fuchs 16" light alloy wheels 6" front, 7" rear with 935 style center caps, Carrera front & rear spoiler, Autopower Roll Bar Premier Stereo system, Stable Energy Strut bar MILES: 80,919 CONDITION: Cosmetically the car is in average condition, and has been completely repainted in the original color, and appears bright and shinny. The dash is severely warped, as is common with the leather dash option, however the seats, door panels and carpets are serviceable. The top, has a small tear, but serviceable. The stereo system in inoperable. MECHANICS: Presently the vehicle is not in running condition, so we are unable to ascertain it's mechanical condition. VALUE: These mid eighty 911's are considered the best built of the classic 911 Porsches, however with this one being a Europeam spec. model (Grey Market) they are valued about 20% below the US Spec cars. VALUE in present condition--------------$10,000. October 19, 2010 JOHN J WITHER AIC REV-1510 EX+ (OS-09) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS AND MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER ~rnninRn F NnwFR 21 10 0148 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. ITEM NUMBER DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET °~ OF DECD'S INTEREST EXCLUSION pF APPUC~.E~ TAXABLE VALUE 1. WELLS FARGO ADVISORS 273.95 100.00 273.95 ROTH IRA ACCOUNT NO. XXXX-1051 2. WELLS FARGO ADVISORS 1,225.86 100.00 1,225.86 FOR BENEFIT OF SAVANNAH L OCHS ACCOUNT NO. X)CXX-1078 3. WELLS FARGO ADVISORS 4,047.19 100.00 4,047.19 ACCOUNT NO. X)CXX-1105 4. WELLS FARGO ADVISORS 21,603.29 100.00 21,603.29 1 RA ACCOUNT NO. XX;XX-1321 TOTAL (Also enter on Line 7, Recapitulation} ~ ; 27,150.29 If more space is needed, use additional sheets of paper of the same size. REV-1511 E.X+ (10-09) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF r~~~ numo~R EDWARD E. ROWER 21 10 0148 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. GILBERT L. DAILEY FUNERAL HOME 005.00 B. 1. ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City State ZIP Year(s) Commission Paid: 2, Attorney Fees: MATEYA LAW FIRM, P.C. ^12,000.00 3, Family Exemption: (If decedent's address is not the same as Gaimant's, attach explanation.) Claimant Street Address City State ZiP Relationship of Claimant to Decedent 4. Probate Fees: CUMBERLAND COUNTY REGISTER OF WILLS 370.50 5 Accountant Fees: 6. Tax Return Preparer Fees: H & R BLOCK `'207.00 7. CUMBERLAND LAW JOURNAL -LEGAL ADVERTISEMENT 75.00 8. THE SENTINEL -LEGAL ADVERTISEMENT 219.40 9. CUMBERLAND COUNTY REGISTER OF WILLS -SHORT CERTIFICATE 4.00 10. REAL ESTATE COMMISSION ON SALE OF HOME `'(6,725.00 11. OVERNIGHT DELIVERY FEE FOR REAL ESTATE CLOSING X0.00 12. MATEYA LAW FIRM -DEED PREP X50.00 13. STATE TAX/STAMPS FOR DEED x-3,830.00 14. RESALE CERTIFICATE TO FORGEDALE CROSSING HOME OWNERS ASSOC v50.00 15. AIC AUTO SALES INC -AUTO APPRAISAL FEE ,x225.00 TOTAL (Also enter on Line 9, Recapitulation} ~ 36.870.90 if more space is needed, use additional sheets of paper of the same size. REV-1512 EX+ (12-08) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, 8~ L1ENS ESTATE OF FILE NUMBER EDWARD E. HOWER 21 10 0148 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, inciuding unreimbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. OUTSTANDING COUNTY/TOWNSHIPTRX PAID TO ROBERT CAIRNS X80.15 DEDUCTED FROM SALE OF HOME 2. SOUTH MIDDLETON TOWNSHIP MUNICIPAL AUTHORITY "181.78 WATER/SEWER INVOICE ACCOUNT NO. 023056 - PAID AT REAL ESTATE SETTLEMENT 3. AMERICAN WINDOW REPAIR CO ~~~8.30 SERVICE CALL & PARTS TO REPAIR BEDROOM WINDOW 4. UGI GAS SERVICE `'457.82 HEATING BILL FOR HOME ACCOUNT NO. 10 00 28 1764 1 8 5. SUBARU MOTORS FINANCE ~l5,803.55 AUTOMOBILE LOAN ACCOUNT NO. 11002208472806 6. MET-ED x'249.66 ELECTRIC SERVICE FOR 3/17/10 TO 4/15/10 ACCOUNT NO. 10 00 28 1764 1 8 7. UGI GAS SERVICE X2.52 GAS SERVICE FROM 2/22/10 - 3/23/10 ACCOUNT NO. 209 760 5500 15 8. CENTURY LINK x''82.87 TELEPHONE SERVICE ACCOUNT NO. 717-218-0284-277 9. MET-ED ''°45.12 ELECTRIC SERVICE FROM 2/16/10 - 3/16/10 ACCOUNT NO. 10 00 28 1764 1 8 10. INTERSTATE IWS v39.30 TRASH REMOVAL SERVICE ACCOUNT NO. 034153 11. COMCAST /67.91 CABLE TELEVISION SERVICE ACCOUNT NO. 09547 297207-01-6 12. HOMEOWNERS ASSOCIATION OF FORGEDALE CROSSING 110.00 YEARLY FEE INVOICE #44 13. CHASE CREDIT CARD SERVICES °'' 7.99 CREDIT CARD ACCOUNT NO, XX)CX XXXX XXJCX 7043 14. TOTAL (Also enter on Line 10, Recapitulation) J s 17,716.97 If more space is needed, insert additional sheets of the same size. REV-1513 EX+ (01-10) Pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN ESTATE OF: FILE NUMBER: EDWARD E. ROWER 21 10 0148 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 [Indude ouu~gght spousal distributions and transfers under Sec. 91't6 (a) (1.2).) 1. DAWN RICE Lineal 298,388.16 6207 BLUE GRASS AVE HARRISBURG, PA 17112 2. SAVANNA L. OCHS Collateral 1,225.86 11624 BRIAN DRIVE FREDERICKSBURG, VA 22407 II. 1 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 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.