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HomeMy WebLinkAbout01-10-11 (2)J 1505610143 REV-1500 Ex (°'-'°) PA. Gepartment of Revenue OFFICIAL USE ONLY Pennsylvania county code rear File Number Bureau of Individual Taxes DEPARTMENT OF REVENUE Po Box.zaosol INHERITANCE TAX RETURN 21 10 00530 Harrisburg. PA 171z8-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 184 64 6023 04 16 2010 12 13 1969 Decedent's Last Name Suffix Decedent's First Name MI STAGO KEVIN M (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 X,' 1. Original Return '; 2. Supplemental Return q. Limited Estate ', 48 Future Interest Compromise - -- 1-_ ~ (date of death after 12-12-82) 6 Decedent Died Testate ~ Decedent Maintained a Living Trust - ~ ;Attach Copy of Will} ,.. __~ (Attach Copy of Trust) State ZIP Code PA 17011 9. !.IUgabon Prcceeds Received 10. between i2 3i ~i a dit~datges~f death I^~ 11 Election to tax under Sec. 9113(Al (Attach Sch- O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number MICHAEL :~, BANGS 717 730 7310 First line of address 429 SOUTH 18TH STREET Second line of address City or Post Office CAMP HILL Correspondent's a-mail address 3_ Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required g. Total Number of Safe Deposit Boxes REGISTER OF WILLS USF~OfVLY C7 '_ n -- t r~l ~ r r -,1 i _ C=:i 1;` ... DE~1'~`.~jILED ~ .. ~ ~~ -, _j ~:a ___i .-.' .'i'~ -t~) ~__ a f,.i tinder 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 an: complete. Declaration of preparer other than the personal representative Is based on all information of which preparer has any knowledge. SIGNATURE OF PF;RSON R~ONSIBLE FOR F11-1NG RFTt1RN~ DATE ~ ~ a ADDF2 Thomas A. Staao Jr. 932 Wertzv_lle Road, Enola, PA 17025 ~~ RE OF PRFPARER OT TFiAN REPRESENTATIVE 0/ H DATE Michael L. Bangs o nnnu~ x+29 South 18th Street, Camp Hill, PA 17011 Side 1 1505610143 1505610143 J REV-1500 EX Decedents Name: StagO, Kevin M. 15D561D243 RECAPITULATION 1. Real Estate (Schedule A) ....................................................................................... 1. 2. Stocks and Bonds (Schedule B) ............................................................................. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)......... 3. 4. Mortgages & Notes Receivable (Schedule D) .................................................... .... 4. 5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ........... .... 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested......... ... 6. 7. Inter-Vivos Transfers & Miscellaneous Ik on,-Probate Property (Schedule G) ~J Separate Billing Requested......... ... 7, 8. Total Gross Assets (total Lines 1-7) ................................................................. .... g. 9. Funeral Expenses 8~ Administrative Costs (Schedule H) ................................... .... 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .......................... .... 10. 11. Total Deductions (total Lines 9 & 10) ............................................................... .... 11. 12• Net Value of Estate (Line 8 minus Line 11) .......................................................... 12, 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ............................................... 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ............................................... 14. Decedent's Social Security Number 184 64 6023 281.96 39,129.44 0.00 39,411.40 23,325.24 10,114.97 33,440.21 5,971.19 5,971.19 TAX COMPUTATION -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 .00 15• 16. Amount of Line 14 taxable 5 971 19 16 at lineal rate X .045 , . . 17. Amount of Line 14 taxable at sibling rate X .12 0.00 17. 18. Amount of Line 14 taxable at collateral rate X .15 0 • 0 0 18. 19. Tax Due .................................................................................................................. 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 15D561D243 15D561D243 0.00 268.70 0.00 0.00 268.70 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-10-00530 DECEDENT'S NAME Stago, Kevin M. STREET ADDRESS 104 Mountain Lane CITY STATE ZIP Enola PA 17025 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) 268.70 2. Credits/Payments A. Prior Payments B. Discount 0.00 Total Credits (A + g) (2) 0.00 3. Interest (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (q) Check box 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. (5) 268.7 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 ............................................................................................................... ~I ^ 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 "in trust 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? .................................................................................................................. 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 January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [?2 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)]. 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. Rev-1503 EX+(6-98~ scHEOU~E s STOCKS & BONDS COMMON WEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Stago, Kevin M. 21-10-00530 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER CUSIP NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OF DEATH 1 69351 T1 o6 PP&L Corporation -10.168 shares, value per mean 27,73 281.96 TOTAL (Also enter on Line 2, Recapitulation) 281.96 tlr more space is neetled, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 6-98) Rev-f 508 EX« ;6.98) SCHEDULE E ` ~ CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Sta o, Kevin M. 21-10-00530 Include the proceeds of litigation and the dale the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 2001 Load Rite Trailer 300.00 2 2002 Yamaha Jetski -Model SJ700BA 1,825.00 3 2004 Yamaha ATV -Model YFZ450 1,900.00 4 Appraisal of various guns -See sheet attached; appraisal done by Moyer's Gun Shop, 4,410.00 Carlisle, PA 5 Automobile -Sale of 2001 Ford Truck 10,000.00 6 Refund from Erie Insurance Group 159.00 7 Refund from Erie Insurance Group 962.00 8 Sale of Dyson vacuum 100.00 9 Sale of log splitter 660.00 10 Sale of pooltable 250.00 11 Sale of recliner and living room sectional 250.00 12 Sale of various animal mounts 9,600.00 13 Sale of various prints 430.00 14 Various additional personal property 1,000.00 15 Members 1st Federal Credit Union -Savings Account 2,296.57 16 Members 1st Federal Credit Union _ Checking account 4,986.87 TOTAL (Also enter on Line 5, Recapitulation j I 39,129.44 (If more space is needed: additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98j Rev-1508 EX+ {8.98) SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF LE NUMBER 21-10-00530 Kevin M. N an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME A. Tira M. Stago B. C. JOINTLY OWNED PROPERTY: 147 Torry Circle Enola, PA 17025 ADDRESS RELATIONSHIP TO DECEDENT ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSE % OF DECD'S INTEREST DATE OF DEATH DECEDENTUS NTEREST 1 Sale of Real Estate -Sale of 104 Mountain 1,985.03 50.000% 0.00 Lane, Enola (Parcel No. 38-04-0365-011A). Property was sold on December 16, 2010 (see HUD attached) and total proceeds of $1,985.03 were paid to Tira M. Stago, ex- spouse of the Decedent who had claims on the proceeds from sale of real estate per the terms of a Property Settlement Agreement (see attached applicable pages) which was incorporated into the Divorce Decree dated January 13, 2010. TOTAL (Also enter on Line 6, Recapitulation) ~ 0.00 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev. &-98) REV-1151 EX+110-06) COMMNHEyyRRyyITAN E TFq~P RETgURNANIA RESIDEN~ DECEDENT SCHEDULE H FUNERAL EXPENSES & ESTATE OF FILE NUMBER Stago, Kevin M. 21-10-00530 Debts of decedent must be reported on Schedule 1. ITEM DESCRIPTION M AMOUNT A. FUNERAL EXPENSES: See continuation schedule(s) attached B. 1 ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) 14,795.00 Street Address City State Ziq Year(sl Commission oaid 2. Attorney's Fees Michael L. Bangs 7,500.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Ziq Relationship of Claimant to Decedent 4. Probate Fees 184.50 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 845.74 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 23,325.24 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Stago, Kevin M. 21-10-00530 ITEM NUMBER DESCRIPTION AMOUNT 1 Funeral Ex e~ nses Sullivan Funeral Home 8,330.00 2 Woodlawn Memorial Gardens -opening/closing grave 1,495.00 3 Woodlawn Memorial Gardens - gravesite 4,270.00 4 Word of Grace Church 700.00 O H-A 14,795.00 5 ther Administrative Costs Boyd E. Diller -Trash removal - 11/13/10 69.07 6 Boyd E. Diller -trash removal - 11/15/10 46.05 7 Boyd E. Diller -trash removal -12/15/10 46.05 8 Cumberland Law Journal -estate advertising 75.00 9 Gateway Gallery Auction, LLC -appraisal of personal property items 447.50 10 R. F. Fager -repairs to master bath 17.01 11 The Sentinel -estate advertising 145.06 H-B7 845.74 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1512 EX+It2-08) SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Sta o, Kevin M. 21-10-00530 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 Capitol One Bank Credit Card 1,897.46 2 DCM Services, LLC -collection company for Chase Credit Card 418.50 3 Debra Basehor Wiest, Tax Collector - 2010 county/township taxes (penalty amount) 890.60 4 Debra Basehor Wiest, Tax Collector - 2010 per capita tax (penalty amount) 11.00 5 Erie Insurance -installment payment on auto insurance 159.00 6 Erie Insurance Group -installment payment on auto insurance 149.00 7 Erie Insurance Group -installment payment on auto insurance 159.00 8 Holy Spirit Hospital 1,862.00 9 NCO Financial Systems, Inc. -Collection company for Verizon 59.53 10 Penn Waste 44.35 11 Penn Waste, Inc. 44.35 12 PP&L - 3/23/10 to 5/21/10 190.94 13 PP&L - 5/21/10 to 6/22/10 50.80 14 PP8~L - 6/22/10 to 7/22/10 69.19 15 PPBL - 7/22/10 to 8/20/10 87,77 16 PP&L - 8/20/10 to 9/21/10 52.45 17 PP&L - 9/21/10 to 10/20/10 40.79 Total of Continuation Schedule See attached page TOTAL (Also enter on Line 10, Recapitulation) 10,114.97 (If more space is needed, additional pages of the same size) Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule 1 (Rev. 12-08) Rev-1512 EX+ (6-98) SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, 8~ LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN continued RESIDENT DECEDENT ESTATE OF (FILE NUMBER Stago, Kevin M. 21-10-00530 Copyright (c) 2002 form software only The Lackner Group, Inc Form PA-1500 Schedule I (Rev. 6-98) REV-1513 EX+ (11-08) ER C ,q~ ggU SCHEDULE J COMINHRESIIDAE ITEOECEDENTRNANIA BENEFICIARIES ESTATE OF Stago, Kevin M. FILE NUMBER 2~ _~ n_nns~n NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (Words) ($$$) I TAXABLE DISTRIBUTIONS [include outright spousal . distributions, and transfers under Sec. 9116 a 1.2 Kevin A. Stago Son Entire 147 Tory Circle Enola, PA 17025 Total Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 150 0 cover sheet as a r o riate. NON-TAXABLE DISTRIBUTIONS: II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 11-08) yTa~ace•q~.'~ OMB Approval No. 2502-0266 d9 ~ `rP ! Y €+ ~z A. Settlement Statement (HUD-1) 4<N DaYE~ B. Tvoa of Loan 1. ~ FHA 2. Q RHS 3. ^X Conv. Unins. 4. ~ VA 5. Q Conv. Ins. 6. File Number. 10396 7. Loan Number. 6800390067 8. Mortgage Insurance Case Number. C. Note: This /orm is furnished to give you a statement o/ actual settement ousts. Amounts paid to and by the settlement agent are shown. Items marked '(p.o.c.)' were paid outside the closing; they are shown here forinformafional purposes and ere not included in the totals. D. Name and Address of Borrower: Michael J. Burr and Vanessa G. Burt 1 Gale Circle Camp Hill, Pa. 17011 E. Name and Address of Seller: Estate of Kevin M. Stago and Tira L. Stago F. Name and Address of Lender Members 1st Federal Credit Union 5000 Louise Drive Mechanicsburg, PA 17055 G. Property Location: 104 Mountain Lana Enola, PA 17025 Cumberland County, Pennsylvania H. Settlement Agent: 25-1878915 Keystone Land Transfer, Ltd. 3421 Market Street Camp Hill, PA 17011 Ph. (717)731-4200 I. Settlement Date: December 16, 2D70 Place of Settlement 3421 Market Street Cam Hill, PA 17011 J. Summa of Borrower's transaction K. Summary of Seller's transactlon 100. Gross Amount Due from Borrower. 400. Gross Amount Due to Seller: 101. Contract sales ice 325 000.00 401. Contract sales ice 325,000.00 102. Personal art 402. Personal 103. Settlement Char s to Borrower Line 1400 10667.40 403. 104. qp4. 105. 405. Ad' slments for items id b Seller in advance Ad stmants for items aid b Seller in advance 106. Cit /Town Taxes to 406. Ci /Town Taxes to 107. Coun Taxes 12/16/10 to 01/01/11 34.78 407. Cou Taxes 12/16/10 to 01!01/11 34.78 108. School Tax 12/16/10 to 07/01/11 1183.62 408. School Tax 12H6H0 to 07/01/11 1183.62 109. qOg, 110. 410. 111. 411. 112. 412. 120. Gross Amount Due from Borrower 336,885.80 420. Gross Amount Due to Seller 326,218.40 200. Amounts Paid or in Behalf of Borrower 500. Reductions in Amount Due Seller: 201. De sd tx earnest moos 5000.00 501. Excess de It see instructions 202. Princi al amount of new loans 260 000.00 502. Settlement cha es to Seller Line 140D 23,261.00 203. Exisli bans taken sub' to 503. Existin ban a taken sub' t to 204. Lender Credit 375.00 504. Payoff First Mortgage to Wells Fargo Home Mortgage 297,985.37 205. 505. Pa Second Mort e 206. 506. 207. ~ 507. De sit disb. as seeds 208. 508, 209. Seller Assistance 2987.00 509. Seller Assistance 2gg7,00 Ad" stmants for items un d b Seller Ad stmants for items un std b Seller 210. C' Rown Taxes l0 510. Ci own Taxes to 211. Coun Taxes to _ 511. Coun Taxes to 212. School Tax to 512. Sctwol Tax to 213. 513. 214. 514. 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. 220. Total Paid b/for Borrower 268,362.00 520. Total Reduetlon Amount Due Seller 324,233.37 300. Cash at Settlement fromlto Borrower 800. Cash at settlement to/fronr Seller 301. Gross amount due from Borrower line 12~ 336 885.80 601. Gross amount due to Seller line 420 326 218.40 302. • Less amount aid b /fw Borrower line 220 ( 268 362.00 602. Less reductions due Seller line 520 ( 324,233.3 303.- Cash X^ From ~ To Borrower 68,523.80 503. Cash ~ To ~ From Seller 1,985.03 The undersigned hereby ackno lad eceipt of a completed wpy of this statement & any attachmems referred to herei Borrower Seller .e,_.~ D' ~~~,.~ Micty~l , /• J Estate of Kevin M. Sta o Vanessa G. Burr Tira L. logo Tire Pudic Repar4n0 &uden tar tds ccuectlon d irdormanon b essmebo d 35 minutes per response la cotlecenp, revfea6p, era repasnp the dw. Tds agency may not mites/ tds inormaoon, am you are not requkee to compete this brm, udaee a tisgaya • mrcerWY veto OMB mmrd mantar. No mMden6elity w erure4 thb dedouee n marWStory. Tds ie rteeigned to provide th parses b a REBPA covarea hYMeCtim wiM inlormeson duaag th settlement posses. Page 1 of 3 HUD-1 L. Settlement Char es 700. Total Real Estate Broker Faoa $19,750.00 Prd From P.id From Division of commission (line 700) as fol,'ows: 9anawan sw.ra 701. 10000.00 to Re/Max 1st Advanta a Funds a< Funh ac 70 . 9 750.00 to Re/Max Rea Associates Inc. sememen+ sememen+ 703. Commission aid at settlement 19 750 00 704. Broker Fee to Re/Max Rea Associates Inc. 295.00 705. 800. Items Pa able in Connection with Loan 801. Our or' ination char a Includes Ori ination voint (0.375% or $ 0.00) $ 830.00 (from GFE #1) 802. Yore credit or charge (points) for the specific interest rate chosen $ 975.00 (from GFE #2) 803. Your ad' steel rnation char es !u ~9 9 from GFE #A 1 bus Ou ~:: 804. A feel fee to from GFE #3 805. CredR Re rt to from GFE #3 806. Tax service to (from GFE 1'13) _ 807. Flood certification to (from GFE #3) ~ (from GFE #3) - ~ (from GFE #3) 810. (from GFE 1'13) 811- from GFE #3 900. Items Re wired b Lender to Bo Paid in Advance 901. Daily interest charges from 12/16N0 !0 01/01/11 16 $24.931510/day (from GFE #10) 398.90 902. Mort a e insurance emium for months to from GFE #3 903. Homeowners insurance for 1.0 ears to USAA from GFE #11 000464 85 38 9 1 123.95 904. from GFE #11 905. (from GFE #11) 1000. Reserves De ited with Lender 1001. Initial deposit for your escrow account (from GFE #9) 1.343 80 1002. Homeow s x+surance months 93. per month 80.98 1003. Mort a insurance months $ er month $ ~ - 1004. Property taxes $ y:, ~p County Taxes months ~ $ per month Assessments months $ r month xa~ ~ ~~ - ' 1005. S ,,f ~; .:a •. - 1006. months ~ $ per month S - 1007. County Tax 11.000 months ~ $ 66.12 per month S 727.32 1008. School Tax 7.000 _ months (c~ $ 192.75 per month S 1,349.25 1009. Aggregate Adjustment S -1,013.75 ,~,,, ~.t : , 1100. Title Char 1101. Title services and lenders the insurance (from GFE #4) ~ g; ~ ?5 1102. Settlement or clos' fee $ - 1103. Owners title insurance to First American THIe Ins. Co. from GFE #5 s2 ; 00 1104. Lenders Glb insurance to First American Title Ina. Co. S 1,808.75 „ ,' , ; ';' ;, ',,, ~ _ - 1105. Lenders title li limit $ 260 000.00 PAL#106924051 -:rr•-= - .. ~ u,r 1106. Owners title li limit $ 325 000.00 PAO#10723737 -'~ a c,r ', 1107. A ant's ion of the total title insurance remium to Ke tone Land Transfer Ltd. $ 1 813 6 ~: e' ' 1108. Undelwrders rtion of the total title insurance remium to First American TRIe Ins. Co. S 320 O6 _ ~' '" ' 1109. 1110. Tax Certification to Keystone Land Transfer, Lld. 12,00 1111. Wire Fee to Keystone Land Transfer, Ltd. 15.00 1112. 1113. Document Preparation Michael Bangs, Esq. Nc 1200. Govomllwnt Recording and Transfer Charges 1201. GovemmeM recordi cft s to Cumberland Coun Recorder of Deeds from GFE #7 +52 Oo -- 1202. Deed $ 62.00 Mort a e $ 90.00 Releases S Older $ 1203. Transfer taxes to Cumberland County Recorder of Deeds (from GFE IV9) <<~~ [~ ::_ _ ,~ 1204. City/Gown tax/stamps Deed S 3,250.00 Mort e S -- 1205. State tax/stam s Deed S 3 250.00 Mort e $ 3 25p_00 1206. 1207. 1700. Additional Settlerrlent Ch 1301. R wired services that can for _ from GFE fl6 -. ~:;~': • ' - 1302. 1303. Re airs to Dillsbur Excavaf Services 234.00 1304. 1305. 1400. Total Settlement Ch es enter on lines 103 Sectlon J and 502 Sectlon K 10667.40 23 261.00 sr ~rq aw + d ws etatamsnt dr ryumrrr eduroredye reeeip or. romFrer.d mpy a P.a. z s 3 d~J^~~o~e L ~~ ~e t IR- and Transfer, Ltd., Settlement Agent Page 2 of 3 HUD-1 HUD-1 Attachment Borrower(s): Michael J. Burr and Vanessa G. Burr Seller(s): Estate of Kevin M. Stago and Tira L. Stago 1 Gale Circle Camp Hill, Pa. 17011 Lender: Members 1st Federal Credit Union SeWement Agent: Keystone Land Transfer, Ltd. (717)731-4200 Place of Settlement: 3421 Market Street Camp Hill, PA 17011 Settlement Date: December 16, 2010 Property Location: 104 Mountain Lane Enola, PA 17025 Cumberland County, Pennsylvania Seller Loan Payoff Details Payoff First Mortgage to Wells Fargo Home Mortgage, Inc. Re:0264320328 Loan Payoff As of Total Additional Interest days Q Per Diem Total Loan Payoff 297,985.37 Adjusted Origination Charge Details Origination Charge Origination Fee to Members 1st Federal Credit Union Origination Credit/Charge (points) for the specific interest rate chosen CrediUCharge to Members 1st Federal Credit Union 830.00 Total i 830.00 975.00 Tota4 S 975.00 Adjusted Origination Charges S 1,805.00 Reserves Deposited with Lender Homeowner's Insurance 3.000 at 93.66 per month County Tax 11.000 at 66.12 per month School Tax 7.000 at182.75 per month Aggregate Adjustment at per month 280.98 727.32 1,279.25 -1,013.75 Total S 1,273.80 Title Services and Lenders Title Insurance Details BORROWER SELLER Closing Protection Letter 75.00 to Keystone Land Transfer, Ltd. Overnight 20.00 to Keystone Land Transfer, Ltd. WARNING: It is a crime to knowingly make false statements to the United States on this or any similar form. Penalties upon conviction can include a fine and imprisonment For details see: T1tle 18 U.S. Code Section 1001 and Section 1010. (10396/t0396/39) HUD-1 Attachment - Continued Document Delivery Fee 25.00 to Keystone Land Transfer, Ltd. Wire Fee 15.00 to Keystone Land Transfer, Ltd. Notary Fee 30.00 to Vickie Welker Lender's title insurance 1,808.75 to First American Title Ins. Co. Total $ 1,973.75 ; 0.00 Owner's Title Insurance BORROWER SELLER Owner's Policy Premium 325.00 to First American Title Ins. Co. Total $ 325.00 S 0.00 Lender's Title Insurance BORROWER SELLER 'fees also shown above in Title Serv@ces and Lenders Tltle Insurance Details Lender's Policy Premium 1,658.75 to First American Title Ins. moo. Lender's Endorsement Charges 150.00 Endorsement Endorsement Charge ALTA Endorsement Form 8.1 (Environmental Protection Lien) 50.00 ALTA Endorsement 100-06 Restrictions-No Apparent 50.00 ALTA Endorsement 300-06 Survey Exception Loan 50.00 Total 5 1,808.75 $ 0.00 WARNING: It is a crime to knowingly mane false statements to the United States on this or any similar form. Penalties upon conviction can include a tine and imprisonment. For details see: Title 18 U.S. Code Sectlon 1001 and Sectlon 1010. (10396!10396/39) St MEMBERS 1st FEDERAL CREDIT [JNION REGULAR SAVINGS ACCOUNT: Account Number/ Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Inte~~st Name of Joint Owner CHECKING ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner Estate of: Kevin M. Stago Date of Death: April 16, 2010 Social Security Number: 184-f4-6023 367096-00 09/11 /2009 $2,296.57 $.52 $2,297.09 None 367096-11 09/11 /2009 $4,986.87 $.10 $4,986.97 None MEMBERS 1ST FEDERAL CREDIT UNION .~~~ Leigh- nne Stallings Lending Insurance Support Specialist June 9, 2010 5000 Louise Drive P.O. Box 40 Mechanicsburg, Pennsylvania 17055 (800) 283-2328 wwwmemberslst.org 2002 Yamaha SuperJet Value - Kelley,Blue Book Page 1 of 1 ~~ Kelley Blue Boek -~ -. ;ir ~i SEARCH THE TRUSTED RESOURCE Home New Cars Certified Pre-Owned Used Cars Research Reviews 8r News Dealers & Inventory Used Cars For Sale Loans & Insurance Welcome Back I Sign In !Create Account ! My KBB ZIP Code: 17011 Free Dealer Price Quote pRDGRfII/Yf e M •roxw.yae aax.+ranro Insure your ptassiarn~ ~~' ~y~~ry~ap~1~ ~ ,w.:~. ~RcSi't:lTt7a~lcTiitll'[i~l~~ K' ~ Home > Personal Watercraft Values > Personal Watercraft > 2002 > > Super)et 2002 Yamaha Super]et Value December 27, 2010 2-Cylinders 2-Stroke 701cc Trade-In Value (Good Condition) 17825 Trade-in Value is what consumers can expect to receive from a dealer for a trade-in watercraft assuming an accurate appraisal of condition. This value will likely be less than what you would receive from a private party sale because the reselling dealer incurs the cost of safety inspections, reconditioning and other costs of doing business. Tradf:-in values are based on clean units in good condition. Hours/condition and additional eauioment may have a substantial impact on the value shown above (~ ~ j { \~ ~* ~ ` GET YOUR CREDIT SCORE NOW Copyright ®2010 by Kelley Blue Book Co., All Rights Reserved. 1/1/2011- 4I302011 Edition. The information in This report is intended for the personal use of the customer only arvl may not be sdd or Uansmilted to another parry. We assume no respaxsibility for errors or omissions. NCWS More Car News - 10 Coolest Cars Under $18,000 -.. Tips for Holiday Driving - AOL Autos Email GiBSWKi-1HRK ~! 3 ~,,,!, Shopping Tools Ge[ a Free Watercraft Price Quote Sell your Watercraft Motorcycle Store advertisement iNHILE YO.U'RE HERE... Check ©ut 8iue Book Classifieds"" 'iii t tTSxr. New and improved Used Car listings. You just might find a deapl tfiat's tyo~o good tyo pass up. ~Cllligtl:l~lail~'1:E>• On KBB.com Home New Cars Certified Pre-Owned Used Cars Research Reviews & News Dealers Used Cars For Sale Loans & Insurance KBBi*: Green KBB~M Mobile Mo[orcydes Featuring 2011 Detroit Auto Show 2011 Best Resale Value Awards 10 Comfy Cars Under $30K 10 Cool Cars Under $18K Top 10 Noliday Car Deals About KBB About Us Contact us Careers FAQ Media Advertising Linking Privacy Site Map Copyright & Trademarks Terms of Service ® 1995-2010 Kelley Blue Book Co., Inc. Business Inquiries http://www.kbb. com/personalwatercraftJtrade-in/2002/yamaha/superjet/82942 S9i~ ~~K 12/27/2010 2004 Yamaha YFZ450 Motorcycle Trade-In Value & Price -Kelley Blue Book Page 1 of 1 ~rl}`' ~; ~~~~~+~ BlU@ ilVOlt SEARCH THE TRUSTED RES~tJRCE Home New Cars Certified Pre-Owned Used Cars Research Reviews & News Dealers & Inventory Used Cars For Sale Loans & Insurance Welcome Back i Sign In I Create Account i h1y KBB ZIP Code: 17011 Free Dealer Price Quote PAOG/lEllll/E _ .t :~ hwro.ryd~t tesuranre Insure your passions ~~• ~~ ~._.. Honie > Motorcvde Values > Motorevcle > 2004 > Vamaha > YFZ450 2004 Yamaha YFZ450 Value December 27, 2010 1-Cylinders 4-Stroke 439cc Trade-In Value (Good Condition) 51900 Trade-in Value is what consumers can expect to receive from a dealer for a trade-in unit assuming an accurate appraisal of condition. This value will likely be less than you would receive from a private party sale because the reselling dealer incurs the cost of safety inspections, reconditioning and other costs of doing business. Trade-in values are based on Gean units in good condition, with all original standard equipment. Mileaoe/condition and additional eauioment may have a substantial impact on the value shown above. NEXT STEP • GET YOUR CREDIT SCORE NOW Copyright ®2010 by Kelley &ue Book Co., All Rights Reserved. 1I1/2011- 4/30/1011 Edition. The informatlon in this report is intended for the personal use of the customer only and may not be sold or trensmitted to another party. Vlfe assume no responsibility for errors or omissions. NeWS More Car News 10 Coolest Cars Under $18,000 How To Keep Your Headlights - Bright FO... - AOL AuWs -~< Email ~.:: BUOKMf1RK. ~ ' #j.,, Shopping Tools Get a Free Progressive Motorcycle Quote Get a Free Motorcycle Pnce Quote Sell Your Motorcycle Motorcycle Store advertisement WH11E YQU'RE HERE... Check ©ut Bfue Book Classifieds'"' `"_~~ IIII ~1 New and improved Used far listings. You just might find a dea] that's too good to pass up. On KBB.com riome New Can Certified I>re-Qwnzd used Cars Research Reviews & News Dealers used Cars For Sale Loans & Lisu rancz KBB^~ Green KBU`M Mobile Motorcycles FaatarinB 2011 Detroit Au[o Show 2011 Best Resale Value Awards 10 Comfy Cars Under $30K 10 Cool Cars Under $18K Top 30 Holitlay Car Deals About KBB About Us Contact Us Careers FAQ Media Advertising Linking Privacy Si[e Map Copyright & Trademarks Terms of Service ® 1995-2010 Kelley Blue Book Co., Inc. Business Inquiries http://www.kbb.com/motorcycle/trade-in/2004/yamaha/yfz450/82649 S~~a 12/27/2010 BILL OF SALE I, Thomas A. Stago Jr., Executor for the Estate of Kevin Stago sold the following item or items to: for the price of $ ~ ~ , o 0 List of Items: ~~ ~~ Seller: Thomas A. Stago Jr., for the Estate of Kevin Stago 932 Wertzville Road Enola PA 17025 ate /~ i / ~ Buyer: ~~ ~ ~~~ .., ~, Date ~a~ ~ ~„ BILL OF SALE I, Thomas A. Stago Jr., Executor for the Estate of Kevin Stago sold the following item or items to: ~~ for the price of $ ~ ~ List of Items: Log Sputter (NIDT) Seller: Thomas A. Stago 7r., for the Estate of Kevin Stago 932 Wertzville Road Enola PA 17025 ,` !°cr.--- Date B er: B„ ILI, OF SALE I, Thomas A. Stago Jr., Executor for the Estate of Kevin Stago sold the following item or items to: for the price of $ c~ ~. List of Items: ~~~~ Seller: Thomas A. Stago Jr., for the Estate of Kevin Stago 932 Wentzville Road Enola PA 17025 Date er• , Date / ~ ~ ~//~ _~ BILL OF SALE I, Thomas A. Stago Jr., Executor for the Estate of Kevin Stago sold the following item or items to: for the price of $ / ~ D , 6 y List of Items: X ~~-~o-c,-~ Y GLC~u„yh U Seller: Thomas A. Stago Jr., for the Estate of Kevin Stago 932 Werrzville Road Enola PA 17025 Date ~ L~ u r: 1 Date ~~ ~~ S'~ it ~. BILL OF SALE I, Thomas A. Stago Jr., Executor for the Estate of Kevin Stago sold the following item or items to: a,.r~n ~ Hn e;D 72 v c.~ for the price of $ ~ d 0 C~ List of Items: Seller: Thomas A. Stago Jr., for the Estate of Kevin Stago 932 Wertzville Road Enola PA 17425 Date Buyer: Q ~R n C~2 J~~~ -~~ 4 ~ rv ~ 1..` s 1 \013 Date U w BILL OF SALE I, Thomas A. Stago Jr., Executor for the Estate of Kevin Stago sold the following item or items to: for the price of 59,600 List of Items: See attached list Seller: Thomas A. Staff Jr., for flee F of Kevin Stago 932 Wentzville Road ,~~~F.nola PA 17025 ~ir-~ /~ - ~!'~- Hate ~ /0 r-- G 9e ~.~~~ G~fl~. ~'~. ,.zQ~o BILL OF SALE I, Thomas A. Stago Jr., Executor for the estate for Kevin Stago sold the following items to: have Dewees. List of Items: LIFE SIZE SHOULDER MOUNTS Turkey 8 Point Buck Mountain Lion 8 Paint Buck Clip Springer 8 Paint Buck Wart Hog 1 7 Point Buck Wart Hog 2 7 Point Buck Steen Buck 6 Point Buck Duiker 6 Point Buck Jackal Impala Baboon Spring Buck Ells Blesbuck Kudu Caribou Eland Gemsbok Water Buck Red Hartebeest RUGS HIDES Zebra Giraffe Bear Deer Jackal Eland Spring Buck MISCELLANEOUS Turkey Tail Plaque Caribou Antlers on Plaque 1 acknowledge receipt of payment in full for the above items. Date Thomas A. Stago Jr. Executor for Estate of Kevin Stago BALL OF SALE I, Thomas A. Stago Jr., Executor for the Estate of Kevin Stago sold the following item or items to: for the price of $ ~ ~. D U ---r---- List of Items: Seller: Thomas A. Stagg Jr., for the Estate of Kevin Stago 932 Wertzville Road Enola PA 17025 Date ~ I Buver: ~~ a Date J r ~~ `/~ O J- .i~ .¢dT ~~ ~ ~ ° ° w ' `I h o ~ z y , c G ~ G o d G ~ ~ ~ °~° n m ~ ~ ~ m m ~ ~ ~ > > > 0 3 ~ ~ ~ ~ m - ~ r. c ~ o c ~ o ~ c :: c c~n Q ~ ~ ~ ~ v°, ,~ ~ a ~ , ~ ~ ,.. ~ m -.,I ~ ° ~ ~ C ~ y ° W ~ O N ~. ~ 3 C O ~ ~ ~ N .P W ~ ITI X ~ t1i 3 - ~ ~ y z o W = , a , r 3 ~ ~ N .,~ -~ N _ ~ ~ tD ~ , ~ td f N Q- N N ~ N C N -~ N ~ X N Q fD p v O ~ 0 ~ N N O C~Ti ~ W N O~ ~ m ~ ~, ° ° W W ~1 cp O O (r ~J V ~ N ~' ~ ,P N N A .J Cn ~ A N CO]~ W ^I ~ OD W Op Cn ~ ~ W ~ C~J1 ~D^- ~ ~ .°P ~C (r te , ~ Cn -' O V ~ W U1 O N (n n X -I '' W ~ ~ r ~ ~ ~ ~ o m 0 vi 0 (~ on ~ o O m m~ a 3 ~~ r~. N c m D 0 C Z KEVIN M. STAGO IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA v. T1RA L. STAGO NO. 09-5382 CIVIL TERM DIVORCE DECREE AND NOW, , ~ ~y , it is ordered and decreed that KEVIN M. STAG© ,plaintiff, and TIRA L. STAGO ,defendant, are divorced from the bonds of matrimony. Any existing spousal support order shall hereafter be deemed an order for alimony pendente lite if any economic claims remain pending. The court retains jurisdiction of any claims raised by the parties to this action for which a final order has not yet been entered. Those claims are as follows: (If no claims remain indicate "None.") NONE. THE SEPARATION AND PROPERTY SETTLEMENT AGREEMENT DATED JULY 7, 20091S INCORPORATED BY REFERENCE. e Court, Attes ~ J. P othonotary Y~ ~; SEPARATION AND PROPERTY SETTLEMENT AGREEMENT 201 JAN -6 AM f i ~ 3 Q THIS AGREEMENT, made this Z day of July, 2009, by a~ ~~w~`1~ CC~JNiY AE,'VNSYI.v~t~q between Kevin M. Stago of Enola, Cumberland County, Pennsylvania, a party of the first part, hereinafter referred to as "Husband" and Tira L. Stago of Enola, Cumberland County, Pennsylvania, party of the second part, hereinafter referred to as "Wife" WITNESSETH: WHEREAS, husband and wife were married on September 21, 1991 in Marysville, Perry County, Pennsylvania; and WHEREAS, husband and wife have been living separate and apart from each other since June 12, 2009; WHEREAS, husband and wife are residents of the Commonwealth of Pennsylvania and have been so for at least the past six (6) months; and WHEREAS, Certain diverse, unhappy differences have arisen between the parties hereto which have made them desirous of continuing to living separate and apart from one another; and WHEREAS, husband and wife desire to settle and determine certain of their marital rights and obligations, and make an equitable distribution of their marital property; WHEREAS, it is the intention and purpose of this Agreement to set forth the respective rights and duties of the parties while they continue to live apart from each other and to settle all financial and property rights between them; and WHEREAS, the parties hereto have mutually entered into In the event either party contracted for or incurred any debts since the date of separation, the party who incurred said debt shall be responsible for the payment thereof regardless of the name in which the account may have been charged. Husband and Wife acknowledge and agree that they have no outstanding debts or obligations of the Husband and Wife incurred prior to the signing of this Agreement except for the following: A. There exists a note payable to Pennsylvania State Employees Credit Union on the 2007 Toyota Sequoia, which obligation is to be that solely of Wife=s. This debt is solely in wife=s name at the time of signing this agreement. Therefore, no refinancing is required. B. There exists a Credit Card with Pennsylvania Employees State Credit Union with a balance on the date of separation in the amount of approximately $9,000, which obligation is to be that solely of Wife=s unless the marital residence is sold, at which time the balance of said marital obligation will be paid off with the proceeds from the sale of the residence. Currently the credit card is in wife's name alone at the time of signing this agreement. Therefore, no refinancing is required. Husband agrees to turn over the PSECU credit card currently in his possession. C. There exists a note payable to Sleepys fora mattress set wife purchased in contemplation of separation, which obligation is to be that solely of Wife's. law or in equity, to enforce the terms of this Agreement by either Husband or Wife until it shall have begin fully satisfied and performed. The consideration for this Ag7~ement is'the mutual benefits to be obtained by both of the parties hereto and the covenants and agreements of each of the parties to the other. IN WITNESS WHEREOF, the said parties of this Agreement have hereunto set their hands and seals, intending to be bound legally hereby, the day and year first above written. Signed, sealed and delivered in the presence of: WITNESS: TNESS: ~~ I KEVIN M STA 0 TIRA L. STA r ~~~ ~~ ~~ PHONE: 717-730.7310 429 SOUTH 18~ STREET FAX: 717-730-7374 CAMP HII,L, PA 17011 E-ma0:..,;kpl+9no~venzon.net WILLIAM E. MILLER, JR. MICHAEL L. BANGS, Attorney-at-Law Of Counsel WENDy K. STRAUB, Paralegal January 7, 2011 r _; ,. !_ ~~~ P Glenda Farner Strasbaugh, Register of Wills ~ ~ -s~ . a ?; Cumberland County Courthouse ` ~ ~~ r^~~~ ~ t./ '~T~ L -~ ~ _- One Courthouse Square _ `.-~ ~ +~? .. .J ~_ ~' Carlisle, PA 17013 -°~. ~- ``n ~ RE: Estate of Kevin M. Stago File No. 21010-00530 Dear Mrs. Strasbaugh: Enclosed for filing as part of the above-referenced estate you will find the following: 1. The original and one copy of the Pennsylvania Inheritance Tax Return; 2. A check in the amount of $268.70 to pay the tax shown to be due; 3. The original Inventory; and 4. A check in the amount of $30.00 to pay the filing fee. Kindly file the return accordingly. Finally, please send me a receipt in the enclosed, stamped, pre-addressed envelope. If you require anything further, please contact me directly. Thank you for your assistance. Very truly yours, ~~~~ Michael L. Bangs wks Enclosures cc: Mr. Thomas A. Stago, Jr. M N ' a - rn t~n J-_•~F- ~Q07 OC]J-~ •2 ~f d.rr+c~f~0 tvCO ¢xr-oo °o ~i~~ +zx¢ ~o ~ ¢ -~ U ~~~ M o r` ~~~ ~~- ~~`~' o ti ~ o 4 r f 58 ~~ .- ~ , --- ~' ~ ~C~ t- ~-- ~ ~ ~ 2 .-J L.7 i_:t..r. -~~ t: 3 ~~ :~ J U t e.. [~ ~_, ~-..; .-~ O r-+ •~Q/) Fsi ~ U ~ .~ ~n o ~ U ~ ~~~a ~ ~ o c~ ~rs~U ~ ~ •~ ~ ~, 07000 ,{ 1