HomeMy WebLinkAbout01-25-111505610143
REV-1500 Ex (0,-10,
PA De artment of Revenue y OFFICIAL USE ONLY
p penns Ivania County Code Year File Number
Bureau of Individual Taxes DE?AR7MENTOF REVENUE
Po Box.2soso~ INHERITANCE TAX RETURN 21 09 0708
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
186 28 6189 07 21 2009
Decedent's Last Name Suffix
DUNCAN
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
Spouse's Social Security Number
Date of Birth
10 25 1935
Decedent's First Name MI
RAYMOND M
Spouse's First Name MI
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
1. Original Return ~ 2. Supplemental Return
4. Limited Estate ~ 4a. Future interest Compromise
(date of death after 12-12-82)
g Decedent Died Testate
(Attach Copy of Will) ~ ~• (AttacheCo a~of Trusd a Living Trust
PY )
9. Litigation Proceeds Received ~ 10. Spousal Povertyy~ Credit (date ~f death
between 12-31 zJ1 and T-1-95
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
11. Election to tax under Sec. 9113(A)
(Attach Sch. 0)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
FOREST N MYERS 717 532 9046
First line of address
137 PARK PLACE WEST
Second line of address
City or Post Office
SHIPPENSBURG
State ZIP Code
PA 172579212
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Correspondent's a-mail address: fnmyers@lawofficeforestmyers.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.
SIG TURF OF PERSON RESPONSIBLE FOR FILING RETURN DATE
ADDRESS
28 Surrev Drive, Chambersbura. PA 17201
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
~"'"~- ~---- Forest N Myers ~ r- ~.~ -- 'Zd t l
ADDRESS
137 Park Place West, Shippensburg, PA 17257-9212
Susan M HERR
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REGISTER OF V1~LX.S USE ONLY;
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Side 1
1505610143 1505610143 J
J
REV-1500 EX
Decedent's Name: DUNCAN, Raymond M
Decedent's Social Security Number
186 28 6189
RECAPITULATION
57,500.00
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.
20,310.88
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 Iy~o-Probate Property
arate Billing Requested
~^ Se
l
7
............
p
(Schedu
e G) .
8. Total Gross Assets (total Lines 1-7) ..................................................................... 8, 7 7 , 810.8 8
30,758.21
9. Funeral Expenses & Administrative Costs (Schedule H) ....................................... 9.
5,693.07
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............................. 10.
11. Total Deductions (total Lines 9 8 10) ................................................................... 11. 3 6 , 4 51.2 8
12. Net Value of Estate (Line 8 minus Line 11) .......................................................... 12.
41,359.60
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.
41,359.60
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 35 9.60
41 16.
at lineal rate X .045 ,
17. Amount of Line 14 taxable
0
0 0
17
at sibling rate X .12 . .
18. Amount of Line 14 taxable
0
0 0
18
at collateral rate X .15 . .
19. Tax Due ................................................... ............................................................... 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
Side 2
1505610243 1505610243
1505610243
0.00
1,861.18
0.00
0.00
1,861.18
J
REV-1500 EX Page 3
Decedent's Complete Address:
File Number 21-09-0708
DECEDENT'S NAME
DUNCAN, Raymond M _
STREET ADDRESS
136 Gilbert Road
CITY
Shippensburg STATE
PA ZIP
17257
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2. Credits/Payments
A. Prior Payments
B. Discount
0.00
3. Interest
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 2 Line 20 to request a refund
g. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
(1)
Total Credits (A + B) (2)
(3)
(4)
(5)
1,861.18
0.00
52.00
1,913.18
Make Check Pa able 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 :............................................................................... ^ ~x
b. retain the right to designate who shall use the property transferred or its income :.................................. [] ^x
c. retain a reversionary interest; or ...............................................................................................................
d. receive the promise for life of either payments, benefits or care? ............................................................ ^ Ox
2. If death occurred after December 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 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
[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)]. 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.
rya
Law Office of
FOREST N. MYERS
**
137 Park Place West
Shippensburg, PA 17257
.(717) 532-9046
* * LAST WILL AND TESTAMENT
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I, RAYMOND M. DUNCAN, of 136 Gilbert Road, Shippensburg, Southampton Township,
Cumberland County, Pennsylvania, revoke my prior wills and declare this to be my Last Will:
FIRST: PAYMENT OFEXPENSES - I direct that the expenses of my last illness and funeral be paid
from my estate as soon as may conveniently be done.
SECOND: BEQUEST - I give, devise and bequeath the residue of my estate, real or personal,
tangible or intangible, together with all insurance policies thereon unto my wife, JOANN G. DUNCAN,
provided she shall survive me by thirty (30) days. In the event my wife fails to survive me by thirty
(30) days, I then give, devise and bequeath all my estate whether real or personal property, tangible
or intangible, together with all insurance policies thereon to my children, SUSAN M. HERR and
CINDY LOU PARK, in as nearly equal shares as possible, per stirpes.
THIRD: RESIDUE OF ESTATE - I give, devise and bequeath aN the rest, residue and remainder of
my estate unto my wife, JOANN G. DUNCAN, provided she shall survive me by thirty (30) days. In
the event my wife fails to survive me by thirty (301 days, I then give, devise and bequeath all the rest,
residue and remainder of my estate to my children, SUSAN M. HERR and CINDY t0U PARK, provided
they shall survive me by thirty (30) days, in as nearly equal shares as possible, per stirpes.
FO RTH: PROTECTIVE PROVISION - To the greatest extent permitted by law, before actual
payment to a beneficiary, no interest in income or principal shall be ('s) assignable to a beneficiary or
(ii) available to anyone having a claim against a beneficiary.
FIFTH: DEATH TAXES -All federal, estate and other death taxes payable on the property forming
my gross estate, whether or not it passes under this will, shall be paid out of the principal of my
probate estate just as if they were my debts, and none of those taxes shall be charged against any
beneficiary. This provision shall not apply to any property over which I have a general power of
appointment for federal estate tax purposes.
SIXTH: MANAGEMENT PROVISIONS - I authorize my Executrix, as follows:
A. Retainllnvest: To retain and to invest in all forms of real estate and personal
property, including common trust funds, mutual funds and money market deposit
accounts and certificates of deposit, regardless of any limitations imposed by law
on investments by executors or any princip{e of law concerning investment
diversification;
B. Compromise: To compromise claims and to abandon any property which, in my
Executrix's opinion, is of little or no value;
C. Borrow: To borrow from and to sell property to my wife or others, and to pledge
property as security for repayment of any funds borrowed;
D. Sellllease: To sell at public or private sale, to exchange or to lease for any
period of time, any real or personal property and to give options for sales of leases;
E. Capital Changes: To join in any merger, reorganization, voting-trust plan or other
concerted action of security holders, and to delegate discretionary duties with
respect thereto;
F. Distributer To distribute in kind and to allocate specific assets among the
beneficiaries (including any custodian hereunder) in such proportions as my Trustee
may think best, so long as the total market value of any beneficiary's share is not
affected by such allocation.
These authorities shall extend to all property at any time held by my Executrix or my
Trustee and shall continue in full force until the actual distribution of all such
property. All powers, authorities and discretion granted by this Will shall be in
addition to those granted by law and shall be exercisable without court
authorization.
SEVENTH: EXECUTOR - I appoint my wife, JOANN G. DUNCAN, Executrix of my Wi1i. In the event
of the death, resignation, renunciation or inability of my wife to act as Executrix, l appoint SUSAN
M. HERB, Executrix of this, my Wi{I. Neither my Executrix, nor any successor shall be required to give
bond.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this 28th day of AUGUST, 1997.
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R OND M. DUNCAN, Testator
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In our presence, the above-named Testator signed this and declared it to be his will, and now, at his
request and in his presence and in the presence of each other, we sign as witnesses:
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COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF FRANKLIN
I, RAYMOND M. DUNCAN, having been duty qualified according to law, acknowledge that
I signed the foregoing instrument as my Will, and that 1 signed it as my free and voluntary act for the
purposes therein expressed.
~ ~
R MOND M. DUNCAN, Testator
We, RAYMOND M. DUNCAN, the Testator in and the undersigned witnesses to the Will, the
attached or foregoing instrument, who have signed the instrument, having been qualified according
to law do depose and say:
(a) that I, the Testator, do hereby acknowledge that I signed the instrument as my
Will, that I signed it willingly and as my free and voluntary act for the purposes
therein expressed; and
(b) that we, the witnesses, were present and saw the Testator sign and execute the
instrument as his Will, that he signed it willingly and executed it as his free and
voluntary act for the purposes therein expressed; that each of us in the hearing and
sight of the Testator signed the Will as witnesses and that to the best of our
knowledge, the Testator was at that time eighteen or more years of age, of sound
mind and under no constraint or undue influence.
RAY OND M. DUNCAN, Testator
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fitness
Witness
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Subscribed, sworn to or affirmed,
and acknowledged before me by the
above-named Testator and by the
witnesses whose names appear on
this 28th day of AUGUST, 1997.
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Notary Public
Nota~~ seau
Forest N. Myers, Notaty Publb
Southampiton wp.,, F Dec. 11,1
My Comm~sion Expres
Rev-1502 EX+ (11-OS)
SCHEDULE A
REAL ESTATE
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE 7AX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
DUNCAN, Raymond M _ 21-09-0708
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be
exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts.
Real property which 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
Include a copy of the deed showing decedent's interest if owned as tenant in common.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Real Estate; Parcel 1 -property located at East Creek Road, Hopewell Township, Cumberland 22,500.00
County, Pennsylvania; purchased by Dennis & Carol Wright
2 Real Estate; Parcel 2 -property located at Gilbert Road, Southampton Township, 35,000.00
Cumberland County, Pennsylvania; purchased by C. B. Jones Real Estate, LLC
TOTAL (Also enter on Line 1, Recapitulation) I 57,500.00
(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 A (Rev. 11-08)
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OMB Approval No. 2502-0265
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I~~I~ A. Settlement Statement (HUD-1)
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1. FHA 2. RHS 3. ^
^ ^ Conv. Unins. 8. File Number. 7. Loan Number. 8. Mortgage Insurance Case Number.
4. ^ VA 5. ^Conv. Ins. MC33217
C. NOte: This form is famished to give you a statement of adual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked'(p.o.c.)'vere paid outside the dosing; they are
shown here for informational purposes and are not induded in The totals.
D. Name & Address of Borrower. E. Name & Address of Seller. F. Name 8 Address of Lender.
C.B. JONES REAL ESTATE, LLC ESTATE OF RAYMOND M. DUNCAN JR. CASH
1 BARRY CIRCLE CIO FORREST MYERS, ESQUIRE
SHIPPENSBURG, PA 17257
G. Property Locatlon. H. Settlement Agent MADISON SETTLEMENT SERVICES I. Settlement Date
132 8136 GILBERT ROAD CHAMBERSBURG,LLC
946 LINCOLN WAY EAST, CHAMBERSBURG, PA
12/28/2010
SHIPPENSBURG, PA 17257 (CUMBERLAND) t72et (7t7)284~534
(39-13-0104.45 8 46A, SOUTHAMPTON TOWNSHIP) Place Of Settlement: 128 EAST KING STREET,
SHIPPENSBURG, PA L7257
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'1OtJ: ~`fQ!&AN19ul>t' Qf,~ ff01M[ BO[M9Y9r
1Q1. Contr,~ct saes $35,000.0
't02. Personal 13ipperty
143. Setfiemant C1:arge5 fzk~actovyer (lffto.1400) $932.2
1 Q4.
105.
ustments for items patdby seller in advance
1fl6. ~itylto~!ct taxes '-
107.CouMy~axes1~t281201U1v 12f31%2410 ,$~f7.091~ar ~ $1.7
1tt8.9chao) 'axes 12t28120'1~to613Q120'f1 ~~~1,140.64~'e~~ $575.01
109.
110.
111.
112.
120. Gross Amourd Qua From Bofrawer $38,509.0
Ol1,.Amos~'aid:EiY'Dr l- Behalf QtBotrower
Qf. Depos)titr~mes#.Money $500.0
2t)2~ P~tnci °, atnannt of new ban
203. Existiittg loan taken subjet;tta
204.
05.
206.
07,~~ '
208.:
Zt)9~ .
~Kdjustrr-elUt$ for items unpalckby sellea
i~; ettyn~rn taxes
z~fi., taxes
2~2:~15&sessments
21~. .: .
2""#4
215.
16.
21.7.
218
219.
220. Total Pall l~ylFor 8or[gwer $500.0
300. Caah At Settlemeaf From!'fo Borrower .
301. GrossAmquntLIue FrgmBorro+xer(Iine t20}- $36,509.0
302. LessArpount5Faitl By ~ orrowet(Ilne 224) $500.0
~~`~~J';` ~~`!l~~'~ ~" ~]To'Borrower`~~'~^~' ~-`~ $36,009.0
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4R0. Grose Amotmt Rue fie Setter
401. Cottttad sates prkx~ $35,000.00
402: P®rsonaEPro
403. ,
404.
445. :.
Adjutitm~tattor:iten-s b .tr~natixtsrr-ce
44fi: taxeB~
407: Coi,niy''taXes 12t2t~M1Q iti.}2/3,1!2010 ®$217.0,4/1'ear $1.78
4Q8: SchQo) T~x~' 12t2A(Ztt 1} t0 X2011 $1,14Ikt-AA`ear '~ $575.01
4~.
410.
411.
41.2.
429,~Grosa ,Amount Due.'~q~ap~ ; ~' $35,576.79
509. ReduFUona ln'A~atiftf Rireto Seller
5Q : E>sCes& deposal (s8e l[tstructions)
502.'Settleft~ent C Eo Seller line 1400 $3,854.31
503: Exlstit~g ipan t3ken'subjeCt ta
504. Pa off of first a e loan
505: Paygff a# second rrartg~igeloen'
50C ~amasC mo retalegd b .telex Real Estate Service LLG
50~, pisbiftsed as proceeds (554p {IO}
508... -.,
-
508, ..: -
A rrta for ltefrtE un fei b seller
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51~' ~ityltown taxes
541. • taxes..:
512'AssQssinents
51~;'
514 ~ '
518 _ „ :, .:
516. .
5~7 .,,
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529."Tat~l I,Zsductlon Amour-t Aue S~Uer
$3,854.31
600; trash At Settlement TolFrorp'SeUer ;. ' _ .
,F~3tkGnlss~~r~pue~TzSetfe~ Urie~g20) '. ~ ...: $35,576.78
02.',~.ess QedUcction lti Amy:;;Du$ ~Q ~I}er (Iina;520j . $3,854.31
. ~ ~ /~ ~ SQUer
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~.:.z.~ $31,722.48
Previous editions are obsolete Page 1 of 2 12/28/2010 08:42 AM HUD-1
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802. Your credit or charge (paints) for the specific ltlterest rate chosen (fmist GF~ ~2)
~63.`Yaur adJustedbriglriat~sit~Gfiarges ~ ~ ~ (fror~E A),~
804: Appraisal Fee , (from Gh"E#33'
8Q5. CreditRepo~t _ (from GFE#3~
06.7~ax service'to (from GFE #3)
t;0~ Flood Cer#ificatbn to CASK from GFt~#3)
I have carefully reviewed the HU0.1 Settlement Statement and to the best of my knowledge and belief it is true and accurate statement of all receipts and disbursements made on my axount or by me in this transaction.
I further certify that I have received a copy of the HUD-1 Settlement Statement.
BUYERS SELLERS
fit""
.JONES REAL ESTATE, LLC ESTATE OF RAYMOND NCAN JR.
The HU0.1 Settlement Statement which I have prepared is a true and accurate account of this transaction. I have caused or I will cause the funds to be disbursed in accordance with this statement.
Settlement nt Date
12/28/2010
Previous editions are obsolete Page 2 of 2 12/28/2010 08:42 AM HUD-1
1400. Total Settlement Charges ,enter on line 103. Section J and 502. Section KI
Rev-1508 EX+ (6-98)
SCHEDULE E
, ~ CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
DUNCAN, Raymond M 21-09-0708
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with the right of survivorship must be disclosed on schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Social Security payment -due and owing at death 1,249.10
2 Dave's Auto Salvage -deposit for scrap metal 3,720.60
3 OB #611638 - Orrstown Bank; checking account 8,450.02
4 Briary Hollow Gun Shop -sale of Rohm 22 gun and Taurus 357 gun 365.77
5 Briary Hollow Gun Shop -sale of Smith ~ Wesson gun 39.00
6 Dave's Auto Salvage -net proceeds from scrap metal 3,760.40
7 Kennys Auction -net proceeds from sale of personal property 599.55
8 Kennys Auction -net proceeds from sa{e of personal property 290.85
9 Kennys Auction -net proceeds for sale of miscellaneous tools 58.80
10 Miscellaneous -proceeds from sale of auto parts (Coovers) 200.00
11 Bruce Fulton -down-payment on property 1,000.00
12 Real Estate Taxes -Reimbursement for unrealized real estate taxes paid by estate; sale of 576.79
Real Estate Parcel No. 2
TOTAL (Also enter on Line 5, Recapitulation) I 20,310.88
(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. 6-98)
REV-1151 EX+ (10-06)
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COMMNHERITAN~E~F~ RETS RN ANIA
RESIDEN DE EDEN
ESTATE OF
DUNCAN, Raymond M
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
21-09-0708
Debts of decedent must be reported on Schedule I.
ITEM DESCRIPTION ,AMOUNT
NUMBER
q, FUNERAL EXPENSES:
See continuation schedule(s) attached 7,339.00
B.
1
ADMIN{STRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City
Yearls) Commission paid
State Zio
2. Attorney's Fees Law Office Forest N Myers 3,890.54
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zin
Relationship of Claimant to Decedent
4. I Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 19,528.67
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation) 30,758.21
Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06)
SCHEDULE H
FUNERAL EXPENSES AND ADMiNISTRATfVE COSTS
continued
ESTATE OF FILE NUMBER
DUNCAN, Raymond M 21-09-0708
ITEM
NUMBER DESCRIPTION AMOUNT
Funeral Expenses
1 Fogelsonger-Bricker -funeral bill -partial payment 3,700.00
2 Fogelsonger-Bricker -funeral bill -final payment 3,639.00
H-A 7,339.00
3 Other Administrative Costs
Adam Serino -marking of property corners
500.00
4 Century 21 Hometowne -Realtors' Commission; sale of Real Estate Parcel No. 2 1,050.00
5 Chambersburg Tire Recycling LLC -fee for collection of scrap tires 800.00
6 Chambersburg Tire Recycling LLC -fee for collection of scrap tires 400.00
7 Country Corner Rental -rental of wheel loader 2,093.40
8 Cumberland Legal Journal -Estate advertisement 75.00
9 Cumberland Co Register of Wills -Fees; Petition of Letters 260.00
10 Cumberland Co Register of Wills -Fees; filing Will 15.00
11 Cumberland Co Register of Wills -Fees; JCP Sz Automation 15.00
12 Cumberland Co Register of Wills -Fees; Short Certificates 20.00
13 Cumberland Co Register of Wills -Fees; filing Inheritance Tax Return 15.00
14 Dan Cordell -payment for cleaning up real estate; 1st half of fee 3,250.00
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
DUNCAN, Raymond M 21-09-0708
ITEM
NUMBER
DESCRIPTION
AMOUNT
15 Dan Cordell -balance due for cleaning up real estate 545.00
16 Dan Cordell -payment for cleaning up real estate; 2nd half of fee 3,250.00
17 Franklin County Recorder of Deeds -Realty Transfer Tax; sale of Real Estate Parcel No. 2 350.00
18 Harry Killian, Tax Collector -Real Estate taxes 720.87
19 JaLEX Real Estate -Realtors' Commission; sale of Real Estate Parcel No. 2 1,050.00
20 Miscellaneous fees/costs -Postage and "No Trespassing" signs 33.43
21 Navtech -survey/marking property lines 1,900.00
22 News-Chronicle -Estate advertisement 121.25
23 Real Estate; Parcel 1 -deduction for 1 °lo realty transfer tax 225.00
24 Todd Shuman, Constable -fees for accompaniment to property 175.00
25 Vivian Coy, Tax Collector -real estate taxes 1,171.22
26 Vivian Coy, Tax Collector - R/E taxes 89.19
27 Vivian Coy, Tax Collector - 2010 real estate taxes 149.61
28 Vivian Coy, Tax Collector - 2010 real estate taxes 468.61
29 Vivian Coy, Tax Collector - 2010 real estate taxes 786.09
H-B7 19,528.67
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98)
Rev-1512 EX+ (12-08)
SCHEDULE 1
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
DUNCAN, Ra mond M 21-09-0708
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 Adams Electric -utility bill 99.66
2 Alexander Springs Emergency Physicians -medical bill 34.86
3 Baxter Wellmon DO -medical bill 272.32
4 Blue Mountain Anesthesia -medical bill 50.53
5 Carlisle Ear Nose Throat -medical bill 24.25
6 Carlisle HMA Physicians -medical bill 22.57
7 Chambersburg Hospital -medical bill 50.00
8 Chambersburg Hospital -medical bill 200.00
9 Chambersburg Hospita! -payment for balance of medical bills of last illness 1,844.57
10 Checks outstanding as of date of death - # 4111, 4112, 4113 & 4114 totaling $945.39 945.39
11 Cumberland Valley Medical Services -medical bill 185.60
12 Darryl Gustwite, DO -medical bill 189.94
13 Discover Card -consumer debt 427.11
14 Embarq -final utility bill 0.47
15 Graham Medical Clinic -medical bill 52.56
16 Kinetic Imaging -medical bill 365.17
17 Medical -medical bill (bottom of invoice shows no payee) 26.28
I Total of Continuation Schedule See attached page
TOTAL (Also enter on Line 10, Recapitulation) 5,693.07
(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 I (Rev. 12-08)
Rev-1512 EX+ (6-98)
SCHEDULE 1
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA continued
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF (FILE NUMBER
DUNCAN, Raymond M 21-09-0708
REV-1513 EX+ (11-08)
,.
COMMONWR~EALT~HEQF PENN YLVANIA
IN RESIDENT D11 ~ DEN RN
SCHEDULE J
BENEFICIARIES
ESTATE OF FILE NUMBER
DUNCAN, Ra mond M ~ 21-09-07 08
NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUN T OF ESTATE
NUMBER PERSONISI RECEIVING PROPERTY DECEDENT (Words) ($$$)
r
I TAXABLE DISTRIBUTIONS [include outright spousal
• distributions, and transfers
under Sec. 9116 a 1.2
Susan M HERR Daughter One-half (1/2) 20,679.80
28 Surrey Dr share of the net
Chambersburg, PA 17201 distributable
estate
Cindy L PARK Daughter One-half (1/2) 20,679.80
211 N Hackberry Dr share of the net
Chambersburg, PA 17201 distributable
estate
Total 41,359.60
Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 15 00 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)