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HomeMy WebLinkAbout06-13-11,,r ~5~56b0:143 R~~~~ ~~~ EX (01-10) PA De artment of Revenue OFFICIAL USE ONLY p pennsylvania County Code Year File Number Bureau of Individual Taxes OEFARTMENTOFREVENUE Po Box.2soso~ INHERITANCE TAX RETURN 21 10 1041 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 202 46 6269 09 22 2010 03 O1 1955 Decedent's Last Name JUMPER Suffix Decedent's First Name CURTIS (If Applicable) Enter Surviving Spouse's information Below Spouse's Last Name Suffix Spouse's Social Security Number Spouse's First Name THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW D 1. Original Return ~ 2. Supplemental Return 4. Limited Estate n 4a. Future Interest Compromise lrl~}o of rin~4h ~fMcr ~ 7_17_R'~\ 6 Decedent Died Testate ~ ~• (AttacheCo aintained a Living Trust (Attach Copy of Will) py of Trust) 9. Litigation Proceeds Received ~ 1 p. Spousal Povertyy Creditl(date of death between 12-31 ~J1 and -1-95) 3. Remainder Return (date of death poor 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) MI A MI CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number GEORGE F DOUGLAS III ESQ 717 249 6333 First line of address 3 5 4 ALE~-AN'DER SPRING RO Second line of address City or Post Office State ZIP Code CARLISLE PA REGISTER OF V~LS USE ON ._.. 1_ ..~ :~'1 C.._ ~~ ~. ~r> r- ~,' - `~ ~ ~.` DAT D ~,:~; T... r";~ Correspondent's a-mail address: gdouglas cr salzmannhughes.COm ~ ~~ r...}:.~ -7=-i! r ~~:7 i.- __ ':j ..... r-n :-7 ~ 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. SIGNATURE OF P~ RESPON BLE FOR FI~~UR~ DATE Kendra C. Hatch _ .S_ ~s ~ ~~ 658 Hillcrest Drive, Carlisle. PA 17015 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE "~ George F Douglas, III Esq. S'_ 2-~-~ ADOR S 354 Alexander Spring Road, Suite 1, Carlisle, PA Side 1 15~562D143 150.5610243 J r~ PA I n h e rita n ce Tax Return Signature of Additional Fiduciaries ESTATE OF FILE NUMBER Jumper, Curtis A 21-10-1041 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. Signature #2 Name Address1 Address2 City, State, Zip Date Scott Jumper 13 W. Springville Road Boiling Springs, PA 17007 Zrf~i 150561D243 REV-1500 EX Decedent's Social Security Number Decedent's Name: .~Uf?1peC, CtIPtIS ~1 2 02 4 6 62 69 RECAPITULATION 1. Real Estate (Schedule A) ....................................................................................... 1. 12 4, 4 4 o. a o 2. Stocks and Bonds (Schedule B) ............................................................................. 2. 3. Closely Held Corporation, Partnership orSole-Proprietorship (Schedule C)......... 3. 4. Mortgages 8 Notes Receivable (Schedule D) ........................................................ 4. 5. Cash, Bark Deposits 8 Miscellaneous Personal Property (Schedule E) ............... 5. 2 6 , 681 . 5~ 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6. 1 , 674.83 7. Inter-Vivos Transfers 8 Miscellaneous -Probate Property ~ Se arate Billin Re uested S h l d G p g ............ q ( c e u e ) 7. 151 , 555.35 8. Total Gross Assets (total Lines 1-7) ..................................................................... g. 3 0 4 , 3 5 ~, . ~ 2 9. Funeral Expenses & Administrative Costs (Schedule H) ....................................... 9. ~, g , 43a . 32 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............................. 10. 12 4 , 4 2 7 . 2 6 11. Total Deductions (total Lines 9 & 10) ................................................................... 11. 143 , 85? . 58 12. Net Value of Estate (Line 8 minus Line 11) .......................................................... 12, 16 ~ , 4 94 , 14 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, 16 o , ~ 94 , 14 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 16a 4 g4 . 14 16 at lineal rate X .045 f . 17. Amount of Line 14 taxable at sibling rate X .12 0 . 0 0 17. 18. Amount of Line 14 taxable at collateral rate X .15 0 . 0 Q 18. 19. Tax Due ................................................. ................................................................ . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 2505610243 1505610243 o.ao 7,222.24 O.aO 0.a0 7,222.24 J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-10-1041 DECEDENT'S NAME Jumper, Curtis A STREET ADDRESS 13 West Springville Road CITY Boning Springs STATE PA ZIP 17007 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 3. Interest 68.88 3.82 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 5. 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) 7,222.24 72.4$ 7, 7 49.7 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 :.................................. ^ 0 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? .................................................................................................................... x 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. ~. Y, . :~ . ~_~ 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)J. 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. Rev1502 EX+ (11-08) j COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER Jumper, Curtis A 21-10-104'1 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, bcth having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on schedule F. (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) Rev-1508 EX+ (8-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Jumper, Curtis A FILE NUMBER 21-10-1041 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 NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Members 1st Federal Credit Union -Checking Account No. 37186-11 11,456.27 Accrued interest on Item 1 through date of death 0.62 2 Members 1st Federal Credit Union -Holiday Club Account No. 37186-02 520.81 Accrued interest on Item 2 through date of death 0.10 3 Members 1st Federal Credit Union -Savings Account No. 37186-00 2,618.57 Accrued interest on Item 3 through date of death 0.39 4 Members 1st Federal Credit Union -Supplemental Savings Account No. 37186-01 3,299.79 Accrued interest on Item 4 through date of death 0.57 5 2000 Dodge Neon -valued at net proceeds of sale to the salvage yard 160.00 6 2002 Ford Focus 3,000.00 7 Household goods 3,000.00 8 Bluemark Insurance -partial payment for West Shore EMS ambulance service on 9/20/2010 924.42 9 Bluemark Insurance -reimbursement for BLS Emergency Transport and mileage on 930.00 9/20/2010 10 U.S. Treasury - 2010, 1040 income tax refund 770.00 TOTAL (Also enter on Line 5, Recapitulation) I 26,681.54 (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-1509 EX+ (8-98) ,. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT scHEau~~ F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER Jumper, Curtis A 21-10-1041 If 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 ADDRESS RELATIONSHIP TO DECEDENT A. Justin C. Jumper B. Scott A. Jumper C. 21 Bragg Dr. Son East Berlin, PA 17316 13 W. Springville Rd. Son Boiling Springs, PA 17007 JOINTLY OWNED PROPERTY: 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 VALUE OF DECEDENT'S INTEREST 1 B 6/8/2005 Members 1st Federal Credit Union Checking 8.00 50.000% 4.00 Account No. 117087-11 -Primary owner is Scott A. Jumper 2 B 10/9/1990 Members 1st Federal Credit Union Savings 120.54 50.000% 60.27 Account No. 117087-00 -Primary owner is Scott A. Jumper 3 A 07112!1991 Members 1st Federal Credit Union Savings 3,221.11 50.000% 1,610.56 Account No. 121250-00 -Primary owner is Justin C. Jumper TOTAL (Also enter on Line 6, Recapitulation) 1.674.83 (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. 6-98) Rev-1510 EX+ (6-98) SCHEDULE G INTER-VIVOS TRANSFERS 8~ MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Jumper, Curtis A 21-10-1041 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER DESCRIPTION OF PROPERTY THE DATE OF TROANSFER SATTACFi A COPY OF T~E OEIED ~OREREAL ESTATE. DATE OF DEATH VALUE OF ASSET °~ OF DECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1 Thrift Savings Plan Account No. 7002953523730 - 151,555.35 100.000% 151,555.35 Justin C. Jumper, Scott A. Jumper and Kamerin P. Jumper, decedent's children are equal beneficiaries TOTAL (Also enter on Line 7, Recapitulation) I 151,555.35 (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 G (Rev. 6-98) REV-1151 EX+ (10-06) ,~ COMMONWEALTH OF PENNSYLVANIA INHFRITANl~F TeY ocr io~i SCHEDULE H FUNERAL EXPENSES & ESTATE OF FILE NUMBER Jum er, Curtis A 21-10-1041 Debts of decedent must be reported on Schedule I. ITEM N M ER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: See continuation schedule(s) attached I 5,564.52 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zio Year(sl Commission paid 2. Attorney's Fees 5,565.00 See continuation schedule(s) attached 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 3 500.00 Claimant SCOtt A. Jumper Street Address 13 West Springville Road city _ Boiling Springs state PA zio 17007 Relationshio of Claimant to Decedent SOn 4. Probate Fees 297.50 5. Accountant's Fees 6. Tax Return Preparer's Fees 297.50 7. Other Administrative Costs 4,205.80 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 19,430.32 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06) SCHEDilLE H FUNERAL EXPENSES AND ADMiNlSTRATIVE COSTS continued ESTATE OF FILE NUMBER Jumper, Curtis A 21-10-1041 ITEM NUMBER DESCRIPTION AMOUNT Funeral Ex enses 1 Hoffman-Roth Funeral Home & Crematory, Inc. -funeral services 5,564.52 H-A 5,564.52 2 Attorney Fees Irwin 8 McKnight -attorneys fees paid to assist in the administration of the Estate from 565.00 10/15/2010 to 12/21 /2010 3 Salzmann Hughes, P.C. -Attorney's fees 5,000.00 H-B2 5,565.00 4 Other Administrative Costs C8~E Auto Repair -evaluation of 2000 Dodge Neon determined not repairable; therefore, sold 26.45 as salvage 5 Century Link -phone service 89.22 6 Century Link -phone service 83.57 7 Century Link -phone service 84.20 8 Comcast -cable service 97.41 9 Comcast -cable service 97.41 10 Comcast -cable service 97.41 11 Interstate Waste Services -refuse service 39.30 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 Jumper, Curtis A 21-10-1041 ITEM NUMBER DESCRIPTION AMOUNT 12 Interstate Waste Services -refuse service 39.87 13 Irwin & McKnight -reimbursement for short certificate 4.00 14 Irwin & McKnight -reimbursement for legal advertising in the Cumberland Law Journal 75.00 15 Irwin 8~ McKnight -reimbursement for legal advertising in the The Sentinel 208,78 16 Kendra Hatch -additional death certificates 30.00 17 Kendra Hatch -short certificate 30.00 18 Members 1st Federal Credit Union -checks ordered for the estate account 13.95 19 Met-Ed -electric service 168.47 20 Met-Ed -electric service 285.31 21 Met-Ed -electric service 565.01 22 Register of Wilts -four short certificates 16.00 23 Register of Wills -filing fees 30.00 24 Salzmann Hughes, P.C. -reimbursement for additional probate fees 48.00 25 Salzmann Hughes, P.C. -closing costs and final fees for income tax preparation, postage 800.00 and miscellaneous contingencies in order to administer the estate 26 Salzmann Hughes, P.C. -reimbursement for filing fee of the Petition to appoint David C. 43.50 Hatch and Kendra C. Hatch as co-guardians for Kamerin P. Jumper, who is a minor and is a residual beneficiary under decedent's estate. 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 Jumper, Curtis A 21-10-1041 ITEM NUMBER DESCRIPTION AMOUNT 27 Scott Jumper -reimbursement for payment to SMTMA for water and sewer service 108.30 28 Scott Jumper -reimbursement for payment to Met Ed for March, April and May electric 1,016.34 service 29 SMTMA -water and sewer service 108.30 H-B7 4,205.80 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1512 EX+ (12.08) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECECENT SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER Jum er, Curtis A 21-10-1041 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 Associated Cardiologist -balance due for medical services 25.00 2 Century Link -phone service 89.88 3 Century Link -phone service 88.01 4 CitiMortgage - at date of death on Loan No. 0651514238-5 110,741.00 5 Comcast -cable service 194.83 6 Express Scripts -prescription drugs 35.00 7 Members 1st Federal Credit Union -payoff credit card balance 511.53 8 Met-Ed -electric service 228.50 9 Pinacle-Health Hospitals -balance due for medical service 300.00 10 Riverside Anesthesia -medical service on 9/20/2010 100.00 11 SMTMA -water and sewer service 125.10 1 Z South Central Bank -balance due at date of death on loan 70384034-100 10.033.99 13 West Shore EMS -ambulance service on 9/20/2010 1,024.42 14 Yellow Breeches EMS Inc. -BLS Emergency Transport and mileage on 9!20/2010 930.00 TOTAL (Also enter on Line 10, Recapitulation) ( 124,427.26 (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-1513 EX+ (11-08) SCHEDULE J COMINCHNERITANCETAxR TSURNANIA BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER Jumepr_ Curtis A 21-10-1041 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (Words) ($$$) 0 of s e I TAXABLE DISTRIBUTIONS [include outright spousal • distributions, and transfers under Sec. 9116 a 1.2 1 Justin C. Jumper Son Sch F, Item 3 54,550.33 21 Bragg Dr. Sch G, 113rd total East Berlin, PA 17316 1/3rd Residue 2 Scott A. Jumper Son Sch F, Items 1 8~ 53,004.04 13 W. Springville Rd. 2 Boiling Springs, PA 17007 Sch G, 1/3rd total 1/3rd Residue 3 Kamerin P. Jumper Daughter Sch G, 113rd total 52,939.77 658 Hillcrest Dr. 1/3rd Residue Carlisle, PA 17015 Total 160,494.14 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 FO R 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) Page 1 of 1 TatDB Result Details in the ?004 TaY Assessment Database ? 100-091 Detailed Results . -cel 40-?8- for Pai Districtro -30 Parcel ID -30-?3-? 100-091. 1~1apSuffix NouseNo 13 Direction ~'' SPRINGVILLE ROAD Street Owned JUMPER, CLiRT1S A CIO PropType R PropDesc LivArea 1.193 CurLandVal 18000 CurlmpVal 10640 CurTotVal 1?~1~-10 CurPreNal Acreage .29 CIGrnStat TaxEx 1 SaleAmt 10000 SaleNlo 12 SaleDa 15 SaleCe ~0 SaleY r OS DeedBkPage 00?72-01787 1r'earBit 1933 HF File Date 01103!2007 HF'_Approval_S tatus A SAVINGS ACCOUNT: Account Number/Suffix 37186-00 Date Account Established 03/27/1984 Principal Balance at Date of Death 52,618.57 Accrued Interest to Date of Death 5.39 Total Principal and Accrued Interest 52,618.96 Interest Earned 01/01/2010 to Date of Death $3.89 Name of Joint Owner None CHECKING ACCOUNT: Account Number/Suffix 37186-11 Date Account Established 08/23/2005 Principal Balance at Date of Death $11,456.27 Accrued Interest to Date of Death 5.62 Total Principal and Accrued Interest $11,456.89 Interest Earned 01/01/2010 to Date of Death 56.99 Name of Joint Owner None SUPPLEMENTAL SAVINGS ACCOUNT: Account Number/Suffix 37186-01 Date Account Established 08/23/2005 Principal Balance at Date of Death 53,299.79 Accrued Interest to Date of Death 5.57 Total Principal and Accrued Interest 53,300.36 Interest Earned 01/01/2010 to Date of Death 56.76 Name of Joint Owner None HOLIDAY CLUB ACCOUNT: Account Number/Suffix 37186-02 Date Account Established 08/23/2005 Principal Balance at Date of Death 5520.81 Accrued Interest to Date of Death $.10 Total Principal and Accrued Interest $520.91 Interest Earned 01/01/2010 to Date of Death 5.84 Name of Joint Owner None VISA ACCOUNT: Account Number 4672090000150896* Date Account Established 02/01/2006 Balance on Date of Death $511.53 Joint Cardholder ~Jone Paid Off 10/22/2010 ''Contractual Pledge vi Shares. LOAN ACCOUNT: Account Number/Suffix 37186-04 Date Loan Established 04/23/1986 Principal Balance at Date of Death 50.00 Loan Type Personal Service Loan Interest Rate 11.00% Name of Co-Borrower None Close Date 10/08/2010 5n~n T.rn~;cP T7r;vP P.O. Box 40 i~iecharucsbur~, Pennsylvania 17055 (800} 283-2328 wwwmemberslst.org PRIMARY OWNER: JUSTIN C. JUMPER SAVINGS ACCOUNT: Account Number/Suffix 121250-00 Date Account Established 07/12/1991 Principal Balance at Date of Death $3,220.57 Accrued Interest to Date of Death $.54 Total Principal and Accrued Interest $3,221.11 Interest Earned 01/01/2010 to Date of Death $4.95 Name of Joint Owner Curtis A. Jumper Date Joint Ownership Established 07/12/1991 PRIMARY OWNER: SCOTT A. JUMPER SAVINGS ACCOUNT: 117087.00 Date Account Established 10/09/1990 Principal Balance at Date of Death $120.52 Accrued Interest to Date of Death $.02 Total Principal and Accrued Interest $120.54 Interest Earned 01/01/2010 to Date of Death $.16 Name of Joint Owner Curtis A. Jumper Date Joint Ownership Established 10/09/1990 CHECKING ACCOUNT: Account Number/Suffix 117087-11 Date Account Established 06/08/2005 Principal Balance at Date of Death $8.00 Accrued Interest to Date of Death 5.00 Total Principal and Accrued Interest $8.00 Interest Earned 01/01/2010 to Date of Death 5.00 Name of Joint Owner Curtis A. Jumper Date Joint Ownership Established 06/08/2005 h~Eh1BEnS 1sT FE11D,E_RAL CREDIT U 'ION . (/~ll~ ~/~- eigh-A a Stallings Lending Insurance Support Specialist October 27, 2010 Estate of: Curtis A. Jumper Date of Death: 09/22/2010 Social Security Number: 202-46-6269 ~k 'k THRIFT SAVINGS PLAN February 14, 2011 Thrif t Savin s Plan g Death Benefits Processing Unit P.O. Box 4450, Fairfax, VA 22038 Fax: 703-592-0170 Salzmann Hughes, P.C. Attorneys at Law 354 Alexander Spring Rd Ste. 1 Carlisle, PA 17015 Re: Thrift Savings Plan Account of Curtis Jumper Acct: 7002953523730 This is in response to your filing of Form TSP-17, Information Relating to Deceased Participant, for the Thrift Savings Plan (TSP) account of the above-named participant. Under the law governing the TSP, Form TSP-3, Designation of Beneficiary, must be received by the TSP record keeper on or before the date of death of the participant in accordance w~ ~ e C.F.R. ~ 1651.3. If there is not a valid TSP-3 on file, benefits are paid in accordance wit statutory order of precedence established at 5 C.F.R. § 1651.2(a). First in this order of precedence is the widow or widower of the participant. If the participant was not married at the time of death, payment is made to the participant's children. If there are no children, payment is made to the participant's parents. If neither parent survives the participant, payment is made to the duly appointed executor or administrator of the participant's estate. Our records indicate the participant did not have aTSP-3 on file, therefore, the beneticiary(s) will be determined according the statutory order of precedence. TSP accounts are valued on a daily basis as of the end of each business day. On 09/22/2010, the balance in the participant's TSP account was $151,555.3. If you have questions, contact the TSP Death Benefits Processing Unit at the address on the letterhead or call 1-800-371-2365, (if you are hearing-impaired, call TDD at 1-877-847-43 85), Monday through Friday between 8:00 a.m. and 5:00 p.m. Eastern Standard Time. Callers outside the United States and Canada should call (404) 233-4400 (not atoll-free number). Documents pertaining to death benefits may be faxed anytime to (703) 592-0170. Include your daytime telephone number and the participant's Social Security number or account number on all correspondence. In addition, the TSP booklet Death Bend is is available from the TSP website (wwvv.tsp.go~'). If you do not have web access, please call or write to receive a printed copy. Note: If you are a member of the uniformed services, do not provide your Defense Switched Netyvork (DSN) telephone number. SINT303lS[NT271• DB 1 10 CitiMortgage Cltl www.citimortgage.com May 16, 2011 SALZMANN HUGHES PC ATTN: TAMERA S SIEGRIST 354 ALEXANDER SPRING RD STE 1 CARLISLE PA 17015 RE: Mortgagors Name: CURTIS A JUMPER ESTATE Property Address: 13 W SPRINGVILLE RD BOILING SPRINGS PA 17007 Dear Tamera S Siegrist: Thank you for your recent inquiry regarding the mortgage account referenced for the above customer. Below is the requested information regarding the loan balance as of the date of death 09/22/10, for Curtis A. Jumper. Principal Balance $110,741.47 If you need further assistance regarding this mortgage account, our Automated Account Information Line is accessible 24 hours a day at 1-800-283-7918*. Customer Service Associates are also available at this number Monday through Friday 7:00 a.m. to 12:00 a.m., and Saturday from 8:00 a.m. to 7:00 p.m., ET and Sunday from 12:00 p.m., to 11:00 p.m., ET. When you contact us, please refer to mortgage account number 0651514238. Thank you. Sincerely, CitiMortgage, Inc. .Q ©2010 CitiMortgage, Inc. CitiMortgage, Inc. does business as Citicorp Mortgage in NM. CitiMortgage, Inc. is an equal housing lender. Citi, Arc Design, and Citi and Arc Design are registered service ~~oEA marks of Citigroup Inc. "Calls are randomly monitored and recorded for quality assurance. CitiMortgage is a debt collector and any information obtained will be used for that purpose. ~lnf 1! ~ If 1 ![ llf ~I~ f! ~ ~i ~! ~f ~I I~ ~E~ ~~l! ~f! '~ ~~ ~"~~g~`~ m ~ ~ v N ,,,, ~ r m _ ~ ~. ~.~ Q ~[ 3 a ri "" v r .~ _ '~ 4.. - ~ ~ ~= d ~ ~ .~ ~ ~~a ~ ~ r ~~ ~ ~ ~ . m ~~ ~~ ~~~ ~ ~~ ~ ~~ ~ _ C~ ~ 3 ~ ~o o ~_ ~ _, `~ z ~ ~ ~ .~ ~_ 1rr .4~ €~~~3 z~- ~~~ ~ ~ ~ ~`` : ~ a v ~ ti ~ ~ a ~°' 3 N m ., ~ ~ ~+. ~ ~' co 0 iri ~ fl N '~gi o ~. m ~ ~ 'Q ~ ~ o N 1~~ ry ~~rr~>-~ 4~ E ~ ~ 1 m' ~ ~ ~. ~~ ~ ~~~ ~~ ~ ~~ ~~ SOUTH CENTRAL BAN K !~ ri.aYK TFIAT'$ A:.L YUUR Ow'N Apri! 20, 2011 Karen Riccardo Salzmann Hughes, P.C. 354 Alexander Spring Rd., Suite 1 Carlisle, PA 17015 Re: Curtis Jumper 13 W Springfeld Rd Boiling Springs, PA 17007 South Central Bank loan: Dear Karen- 70384034-100 Please find the requested information below for the deceased above referenced borrower. At the date-of-death the balance for the above referenced loan was; Principal: $9,977.82 Interest: $51.12 (at 8.59'0 or $2.12 per Diem) Late fee: $5.05 Total: $10,033.99 Please contact me if you have any questions or concerns. Resp SIT KOSS Assistant Vice President / Loan Servicing Manager {312 )-491-7132 jross banksouthcentral.com 525 W'. Roosevelt Road • Chicago, lllitlois G0607-4991 • (312) 491-7000 • Fax: (312) GGG-4523 z F~~ w~vw.banksouthccntraI.corn ~E.a2z