HomeMy WebLinkAbout10-14-11REV-1162 EX(11-96)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1 7 1 28-0601
RECEIVED FROM:
FRANCES GARMAN
30 KENNEDY RD
LANDISBURG PA, 17040
------- fold
ESTATE INFORMATION:
FILE NUMBER:
DECEDENT NAME:
DATE OF PAYMENT:
POSTMARK DATE:
COUNTY:
DATE OF DEATH:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 015068
52,697.96
SSN: 205-09-9177
2110-1169
MYERS MERVIN L
10/ 14/ 2011
1 011 4/201 1
CUMBERLAND
10/12/2009
TOTAL AMOUNT PAID:
REMARKS: RECEIPT TO ATTY
SEAL
CHECK# 2678
INITIALS: HEA
RECEIVED BY: GLE__ ARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
ACN AMOUNT
ASSESSMENT
CONTROL
NUMBER
<<.
1,5D561D1,05
~~s e' • ~ ~{ EX (oz-ii) (FI) ~y OFFICIAL USE ONLY
v 1 {~,~ enns~lvania County Code Year File Number
PA Department of Revenue p >.H..•E'y"INHERITANCE TAX RETURN
Bureau of Individual Taxes
PO BOX 280601 RESIDENT DECEDENT
Harrisburg, PA t'71z8-o6oi
ENTER DECEDENT INFORMATION BELOW MMDDYYYY Date of Birth Mt~1DDYYYY
Date of Death
Social Security Number 07115!1919
205-09-9177 10/12!2009 MI
Suffix Decedent's First Name
Decedent's Last Name L
Mervin
Myers
(If Applicable) Enter Surviving Spouse's Information Below Suffix Spouse's First Name
Spouse's Last Name
Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
MI
FILL IN APPROPRIATE OVALS BELOW O 2 Supplemental Return O 3. Remainder Return (Date of Death
O~ 1 Original Return Prior to 12-13-82)
O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required
O 4. Limited Estate death after 12-12-821
O 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
® 6. Decedent Died Testate (Attach Copy of Trust.)
(Attach Copy of Will) "i1. Election to Tax under Sec. 9113(A)
O 9. Litigation Proceeds Received t0 10. Spousal Poverty Credit (Date of Death O (Attach Schedule O)
Between 12-31-91 and 1-1-95)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX Da~/tRmeTTe ephoUr`e~NumbeECTED T0:
Name
(717) 243-01 ~-,~ r_ _,
Ronald E. Johnson, Esq -"' `
REGISTER;E9F St7#t{LS USE ON Y
_ -
- ? -}
_ ~ --: t
First Line of Address - -
78 West Pomfret Street `~ -I " ~
_Ly
Second Line of Address t
City or Post Offce
Carlisle
State ZIP Code
PA 17013
DATE FILED
'.1'7
- . , ~--,
-t ;
<~~
Correspondent's a-mail address: re~0llnSOn pa.net
Under penaoff~ect andecompleteclDeclaaationaof prepareeother than the perds nal repreeentaf9e Is basted on alltatformafon of which p epa ernhas any kgowledge lief,
it is true, c TE
SIGNfiT~JRE Of PER~R ONSIBLE FOR FILING RETURN / ~ ~ ' I
ADDRESS
c/o 78 Vest Pomfret S ee C
SIGI~I~Ir OF~RE~RE~t OTH~It~
PA 17013
ATIVE
78 West Pomf
PLEASE USE ORIGINAL FORM ONLY
Side 1
7,5D561,D7,D5
reet, Carlisle, PA 17013
],50567,01D5
1,50561,0205
REV-1500 EX (FI) Dec:edent's Social Security Number
205-09-9177
Decedents Name: Mervin i_. Myel"S ---- --
RECAPITULATION
0.00
Real Estate (Schedule A) .................................
1
1.
. 0.00
2 Stocks and Bonds (Schedule B) ................
2.
0.00
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..
3
0.00
4 Mortgages and Notes Receivable (Schedule D) ......... .
4.
0.00
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)... .. . 5.
0.00
Jointly Owned Property (Schedule F) O Separate Billing Requested ......
6
6
.
.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
O Separate Billing Requested.......
. 7. 71,697.80
(Schedule G) 71,697.80
8. Total Gross Assets (total Lines 1 through 7) .......................... ' 8
__ _
9 1,017.50
9. Funeral Expenses and Administrative Casts (Schedule H) .............. .
10,725.60
10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I). 10.
11.
11,743.17
11. Total Deductions (total Lines 9 and 10) ............. ... .
12 0.00
12 Net Value of Estate (Line 8 minus Line 11) ... . . .
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which 13 0.00
. ..... ..........
an election to tax has not been made (Schedule
59,954.70
14. Net Value Subject to Tax (Line 12 minus Line 13) ......................
14.
. .
TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
00
0
transfers under Sec. 9116 15 .
(a)(1.2) X .0 -
16. Amount of Line 14 taxable 5g
g54.70 16. 2,697.96
,
at lineal rate X .0 45
17. Amount of Line 14 taxable 1 7 0.00
at sibling rate X .12
18. Amount of Line 14 taxable
18. 0.00
at collateral rate X .15
2,697.96
...... ...19.
19. TAX DUE .......... ........................... .... ....
O
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
],50561,0205
Side 2
1,50561,0205
File Number
REV-1500 EX (FI) Page 3
Decedent's Complete Address:
Mervin L. Myers
STREET ADDRESS
700 Walnut Bottom Road
- - STATE l ZIP
aTY ---- ~ PA
Carlisle
Tax Payments and Credits: (1)
1. Tax Due (Page 2, Line 19)
2. CreditslPayments 0.00
A. Prior Payments __
B. Discount - ___ 0.00_
Total Credits (A + B) (2)
3. Interest (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (~)
Fill in oval on Page 2, Line 20 to request a refund.
5. If Llne 1 + Line 3 Is greater than Line 2, enter the difference. This is the TAX DUE. (5)
Make check payable to: REGISTER OF WILLS, AGENT.
17013
2,697.96
0.00
0.00
0.00
2,697.96
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
Yes No
1. Did decedent make a transfer and:
...............................................
. ... ^
a. retain the use or income of the property transferre .................................... .
b. retain the right to designate who shall use the property transferred or its income ............................................ ^
c. retain a reversionary interest ......................................... ^
d. receive the promise for life of either payments, benefits or care ..........................
2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. ~ ^
3. Did decedent own an ' In trust for" orpayable-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 benefciary deslgnation? ......................................................................................................................
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 cn or after Juiy 1, 1994; and before Jan. 1, 1995, the tax rate imposed or the net value of transfers to or for the use of the surviving spouse
is 3 percent [72 P.S. 59116 (a) (1.1) (i`,].
For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 P.S. §9116 (a) (1."~~) (il)]. The statute does not exempt a transfer tc a surviving spouse from tax, and the statutory requ rements 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 Juh,~ 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(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)]. Asibling is defined;
• under Section 9102: as an individual who has at least ene parent in common with the decedent, whether by blood or adoption.
rti
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LAST WILL AND TESTAMENT CO
(Pour-Over Will) ~~
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OF ~~ ~ n i ~=-; ° ~
MERVIN L. MYERS
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IDENTITY ~ -~ ~ ~~ ~~
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I, MERVIN L. MYERS, residing in the County of Cumberland, Commonwealth of Pennsylvania,
being of sound mind and memory, and not acting under duress or undue influence of any person
whomsoever, hereby declare this to be my Last Will and Testament, and I do hereby revoke all other former
Wills and Codicils to Wills heretofore made by me. My Social Security Number is 205-09-9177.
I have the following children: CH.~RLES E. MYERS born September 25, 1957 and currently
residing in Carlisle, PA 17013 and FRANCES D. GARMAN born February 9, 1948 and currently residing
in Landisburg, PA.
DEBTS, TAXES AND ADMINISTRATION EXPENSES
I have provided for the payment of all my debts, expenses of administration of property wherever
situated passing under this Will or otherwise, and estate, inheritance, transfer, and succession taxes, other
than any tax on ageneration-skipping transfer that is not a liability of my Estate (including interest and
penalties, if any) that become due by reason of my death, under THE MERVIN L. MYERS REVOCABLE
LIVING TRUST executed on even date herewith (the "Revocable Trust"). If the Revocable Trust assets
should be insufficient for these purposes, my Executor shall pay any unpaid items from the residue of my
Estate passing under this Will, without any apportionment or reimbursement. In the alternative, my Executor
may demand in a writing addressed to the Trustee of the Trust an amount necessary to pay all or part of these
items, plus claims, pecuniary legacies, and family allowances by court order.
PERSONAL AND HOUSEHOLD EFFECTS
It is my intent that all my personal and household effects were transferred to the Revocable Trust
as a result of the Declaration of Intent signed this date. If there are any questions regarding the ownership
or disposition of these assets, it is my desire that such assets pour into the Revocable Trust, signed by me this
date in accordance with the provisions of the section titled "Residue of Estate."
RESIDUE OTC' ESTATE
I give, devise and bequeath all the rest, residue and remainder of my property of every kind and
description (including lapsed legacies and devices), wherever situated and whether acquired before or after
the execution of this Will, to the Trustee under that certain Trust executed by me on the same date of the
execution ofthis Will. The Trustee shall add the property bequeathed and devised by this item to the corpus
of the above described Trust and shall hold, administer and distribute said property in accordance with the
provisions of the said Trust, including any amendments thereto made before my death.
POUR-OVER WILLS L
Page 1 (Testator)
If for any reason the said Trust shall not be in existence at the time of death, or if for any reason a
court of competent jurisdiction shall declare the foregoing testamentary disposition to the Trustee under said
Trust as it exists at the time of my death to be invalid, then I give all of my Estate including the residue and
remainder thereof to that person who would have been the Trustee under the Trust, as Trustee, and to their
substitutes and successors under the Trust, described herein above, to be held, managed, invested, reinvested
and distributed by the Trustee upon the terms and conditions pertaining to the period beginning with the date
of my death as are constituted in the Trust as at present constituted giving effect to amendments, if any,
hereafter made and for that purpose I do hereby incorporate such Trust by reference into this my Will.
EXECUTOR
I hereby nominate and appoint CHARLES E. MYERS to serve without bond as my Executor of this
my Last Will and Testament.
In the event the first named Executor shall predecease me or is unable or unwilling to act as my
Executor for any reasons whatsoever, then and in that event, I hereby nominate and appoint FRANCES D.
CARMAN to serve without bond as my Independent Executor.
Whenever the word "Executor" or any modifying or substituted pronoun therefore is used in this my
Will, such words and respective pronouns shall beheld and taken to include both the singular and the plural,
the masculine, feminine and neuter gender thereof, and shat l apply equally to the Executor named herein and
to any successor to substitute Executor acting hereunder, and such successor or substitute Executor shall
possess all the rights, powers, duties, authority, and responsibility conferred upon the Executor originally
named herein.
EXECUTOR POWERS
By way of Illustration and not of limitation and in addition to any inherent, implied or statutory
powers granted to executors generally, my Executor is specifically authorized and empowered with respect
to any property, real or personal, at any time held under any provision of this my Will: to allot, allocate
between principal and income, assign, borrow, buy, care for, collect, compromise claims, contract with
respect to, continue any business of mine, convert, deal with, dispose of, enter into, exchange, hold, improve,
incorporate any business of mine, invest, lease, manage, mortgage, grant anti exercise options with respect
to, take possession of, pledge, receive, release, repair, sell, sue for, make distributions in cash or in kind of
partly in each without regard to the income tax basis of such asset and in general, exercise all of the powers
in the management of my Estate which any individual could exercise in the management of similar property
owned in its own right upon such terms and conditions as to my Executor may seem best, and execute and
deliver any and all instruments and do all acts which n.~~ Executor may deem proper or necessary to carry
out the purpose of this my Will, without being limited in any way by the specific grants or power made, and
without the necessity of a court order.
My Executor shall have absolute discretion, but shall not be required, to make adjustments in the
rights of any Beneficiaries, or among the principal and income accounts to compensate for the consequences
of any tax decision or election, or of any investment or administrative decision, that my executor believes
has had the effect, directly or indirectly, of preferring one Beneficiary or group of Beneficiaries over others.
In determining the Federal Estate and Income Tax liabilities of my Estate, my Executor shall have discretion
POUR-OVER WILLS
Page 2 estat r)
to select The valuation date and to deternline whether any or all of the allowable administration expenses in
my Estate shall be used as Federal Estate Tax deductions or as Federal Income Tax deductions.
SPECIFIC OMISSIONS
I have intentionally omitted any and all persons and entities from this, my Last Will and Testament,
except those persons and entities specifically named herein. If any person or entity shall challenge any term
or condition of this Will, or of the Living Trust to which I have made reference in the sections "Household
and Personal Effects" and "Residue of Estate," then, to that person or entity., I give and bequeath the sum of
only one dollar ($1.00) only in lieu and in place of any other benefit, grant, bequest or interest which that
person or interest may have in my Estate or the Living Trust and its Estate.
SIMULTANEOUS DEATH
If any other Beneficiary should not survive me for sixty (60) days, then it shall be conclusively
presumed for the purpose of this my Will that said Beneficiary predeceased me.
MERV~N L. MYERS
Testator
This instrument consists of 5 typewritten pages, including the Attestation Clause, Self-Proving
Clause, signature of Witnesses, and acknowledgment of officer. I have signed my name at the botto of each
of the preceding pages. This} instrument is being signed by me on this ~ ~ `~~'~ay of
r~I/y~ ;~f'V
POUR-OVER WILLS
Page 3 Testator)
ATTESTATION CLAUSE
The Testator whose name appears above declared to us, the undersigned, that the foregoing
instrument was his Last Will and Testament, and he requested us to act as witnesses to such instrument and
to his signature thereon. The Testator thereupon signed such instrument in our presence. At the Testator's
request, the undersigned then subscribed our names to the instrument in our own handwriting in the presence
of the Testator. The undersigned hereby declare, in the presence of each of us, that we believe the Testator
to be of sound and disposing mind and memory.
Signed by us on the same day and year as this Last Will and Testament was signed by the Testator.
,,
WITl~TESSES:
=~
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-~, flr1 ~ ?i
ADDRESSES:
(Printed Name of Witness)
%:.~._
- is
(Printed Name of Witness)
~fn~ ~~'~s~~~ fi~c~
Cr ~ ,~ ~ "%~ ~~ /7~ /?~
POUR-OVER WILLS ~ ~'+
Page 4 (Testator)
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CliMBERLAND
SELF-PROVING CLAUSE
BEFORE ME, the undersigned authority, on this d,~' personally appeared MERVIN L. MYERS,
~L')~/?~jr S- .STr~je~J~..and ~,P,~~Tj /~ . a ~ ,known to me to be the
Testator and the witnesses, respectively, whose names are subscribed to the foregoing instrument in their
respective capacities, and all of them being by me duly sworn, MERVIN L. MYERS, Testator, declared to
the and to the witnesses, in my presence, that the instrument is his Will and that he had willingly made and
executed : ` ;his free act and deed for the purposes therein expressed; and the Witnesses, each on his or her
oath, state, to me in the presence and hearing of the Testator, that the Testator had declared to them that the
instrument is his Will and that he executed the same as such and wanted each of them to sign it as a witness;
and upon their oaths, each witness stated further that he did the same as a witness in the presence of the
Testator, and at his request and that he was at that time eighteen (18) years of age or over and was of sound
mind, and that each of the witnesses was then at least fourteen (14) years of age.
~ Sin ...i-,.srW~ ~ ~/" - r
M YE S ~
Testator •i,
.--.~ ( ;'
_. / '~ , /
Witness
_ s. s~,~,e,~~
(Printed Na e of Witness)
K.. '~
Witness ~~ ~~
~~~ ~
(Printed Name of Witness)
SUBSCRIBED AND ACKNOWLEDGED before me by MERVIN L. MYERS, Testat r, and
subscribed and sworn to before by ~~JQ/~~'1~ ~..~ ,5'~~ud _ /~/P~S% ~~ ~ ~0~,
witnesses, this the ~ ~U~' of ~i(_ ~j ~~ , ~ .
Vv r~ •. Vv ..
Public, Commonwealth of nnsylvania
V Notarial Seal
John N. Wight, Notary Public
Upper Merion Twp., Montgomery County
My Commission Expires Sept. 1, 2003
Member, Pennsylvania Association of Notaries
POUR-OVER WILLS
Page 5 (Testator)
~ pennsylvania SC EDULE ~
DEPARTMENT OF REVENUE INTER-ViV®S TRANSFERS AlNTD
INHERITA'JCE TAX RETURN MISC. N®N-TRfl~ATE PR®PERTY
RESIDENT D"eCEDEiJT
ESTATE OF FILE NUMBER
Mervin L. Myers 21-10-1169
Thic ~~hadulP must he completed and filed if the answer to any of questions 'through 4 on page three of the REV-1500 is yes.
ITEf~t
NUy1BER DESCRIPTION OF PROPERTY
wcwoe THE Nave o= rEe Ta,NSFere_, THE;, zeu~Torsr+rP ro oec_oad-.5r;o
THE car_ arTRaNSrE~R. ATracH ~ coPV or mE oEEO roa aEkL EsTr.TE,
DATE OF DEATH
VALUE OF ASSET
% CF DECD'S
INTEREST
EXCLUSION
(:~ nccucASrel
TAXABLE
VALUE
1. Charles E. Myers (son)
Real estate situate at 432 North Pitt Street, Carlisle, PA 17013. Transferred
by deed dated 5127/2009.
2009 assessed value: $59,580.00
common level ratio in effect between 7/1/2009 to 6130!2010: 1.26
X59,580 x, /. ~'l~ 74,692.80 100 3,000.00 71,697.80
Note: See Schedule I -balance due on mortgage of property
TOTAL ;Also enter on Line 7, Recapitulation/ ~ 71,697.80
If more space is needed, use additional sheets of paper of the same size.
i~~o~
. Joh~~
RECORDATION REQUESTED BY:
Ronald E, 7ohnson, Esquire
78 West Pomfret Street
Carlisle, PA 17013 ~
(717} 243-0123
~~-HEN RECORDED MAIL TO: OOOR05
Andrews & Johnson
78 West Pomfret Street
Carlisle, PA 17013
(717) 243-0123
TAX PARCEL NO. 06-20-1798-272
SPACE ABOVE THIS LINE 1S FOR RECORDER'S USE ONLY
DEED
MADE THE ~.1 day of ~c%~ in the year of our Lard. two thousand nerve (2009)
I~ET~~~EN iVIERVIN L. MYERS, widower, by his hereinafter named Attorney-in-Fact,
CHARLES E. MYERS, by a Durable Power of Attorney dated February 22, 2000
recorded in Misc. Book 641, Page 36
GRANTOR
CHARLES E. MYERS, single man, of Cumberland County, Pennsylvania
and
GR~.NTEE
WITNESSETFI, that in consideration of Oh~rpollaran(~ land)conveany t phedsahd Grantpees, his hews
hereby ackno~~ledged, the said Cnantors do y ~'
and assigns.
ALL THAT CERTAIN house and lot of ground being No. 432 North Pitt Street, in the Borough of
Carlisle, County of Cumberland, and State of Pennsylvania, and bounded and described as follows:
OIt THE North by property formerly of Mrs. Elizabeth Humes Hollar, now or formerly, of Mrs.
Elizabeth J. Kerns; on the East by North Pitt Street; on the South by property formerly of Mrs. Mary
Smith, now or formerly of Clayton R. Rinesmith; and on the =Jest by an alley; Containing a frontage
of 20 feet on said North Pitt Street, and running at an even width of 20 feet to said Alley 160 feet,
more or less.
HAVING thereon erected a dwelling house known and numbered as 432 Nor`~h Pitt Street, Carlisle,
PA 17013.
i„~r ~ ~nncai Cana - Parma 1
COMMONWEALTH OF PEI`TNSYLVANIA )
SS.
COUNTY OF CFJMBERLAND )
On the ~~ day of ~ 2009, before me, the undersigned officer, personally
appeared Charles E. Miller, known to e to be the person whose name is subscribed to the within
instnunent as Attorney-in-Fact for Mervin L. Myers, and acknowledged that he executed the same as
the act of their principal.
IN WITNESS WHEREOF, I here het my hand and r facial seal.
/,R~ON~11CtAl-~~ OF PENP~SYLVAt~tA (SEAL)
NOTARIAL SEAL Public otary Public
SHELLY S~XTO1~, rotary
Catiisle goro, Cumberland 6u 2 11
v Commission Expires ~
I do hereby certify that the precise residence and complete post office address of the within-
named Grantee(s) is:
Date: S ~~~G
ttorney for
i.,,.~ ~ onno~ ~Fna _ o~.,o Z ~f .t
ROBERT P. ZfE~~ER
REC~R~3ER ~~ ~EE~~
CfJI~BERLAND CC~~JI'd'I'~'
~ C~URT~~USE 5~~1~RE
C~.RI.fSLE, PEA 17413
717-24~-637
Instrument Number - 200917608
Recorded On 5/28/2009 At 1:03:08 PM
* Instrument Type -DEED
Invoice Number - 44584 User ID - KVd
* Grantor - MYERS, MEVIN L
* Grantee - MI'ERS, CHAIZI.ES E
* Customer - R JOIII~TSON
* FEES
STATE Y7RIT TAX $ 0.50
STATE JCS/ACCESS TO $10.00
JUSTICE
RECORDING FEES - $11.50
RECORDER OF DEEDS
PARCEL CERTIFICATION $10.00
FEES
AFFORDABLE HOUSING $11.50
COUNTY ARCHIVES FEE $2.00
ROD P.RCHIVES FEE $3.00
CARLISLE AREA SCHOOL $0.00
DISTRICT
CARLISLE BOROUGH $0.00
TOTAL PAID $48.50
*'lbts~l Pages - ~
CeL't6fIC~tFf1n Pa ;e
~~ NQ~~' I~~~'~C~
This page is now part
of this iegai cioc~z~ent.
I Certify this to be recorded
in Cumberland Counts' PA
Qp~.Cg,U~~
2~y I F
o (~ ~o
~ ~ - - RECORDER C} D EDS
- ,~~
~~~
-_
r~so
~ -Information denoted by an asterisk may change during
the verification process and may not be ret7ected on this page.
Illll II(I111~11f111
11111111
~__. .u ~nnne vcno n....,. ~ ,.a ~
I<,~<`l_ 1511 ' ; - ~ 10-0
r pennsylvania S~M1E®iILE
~t~;.~.~,~E~,TOr~~~~eN~~ FUNERAL EXPENSES AND
__ _
ESTATE OF FILE NUMBER
Mervin L. Myers 21-10-1169
Decedent's debts must be reported on Schedule I.
-G
NUi~13ER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1' Prepaid
g. ADMINiSTRATiVE COSTS;
i. Pzrsonal Representative Commissions:
Name(s) of Personal Representative(s) __
Street Address _
Clty _ __ State ZIP
Year(s) Commission Paid: _ -
t. Attorney Fees:
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.)
Claimant -
Strzet Address
City _ _ State ZIP
Rzlationship of Claimant to Decedent ___ __
4. Probate Fees:
5. Aaeuntant Fees:
6. Tax Return Preoarer Fees:
~ Register of Wills -filing fee
TOTAL (Also enter on Line 9, Recapitulation) I $
If morn space is needed, use additional sheets o,. paper of the same size.
850.00
152.50
15.00
1,017,50
IL"',' ' 512 E_>.- ;': ~-OS?
r pennsytvania
DEPART MEfJT OF REVENUE
?NHERITANCE TAX RE-URN
RESIDENT DEC"eDENT
~~HEDULE
DEBTS Or DECEDENT,
MORTGAGE LIABILITIES & LIENS
ESTATE OF FILE NUMBER
Mervin L. Myers 21-10-1169
Renort debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses.
If morn spacz is nzzdzd, inszrt additional shzets of thz some size.
FIVUINIi tlHLANI.t '. y z ~ •• •• •• •• v
l ~ --.. _.. ...._.... -
ALL01'fED7HS YE4R :_ - .
.._ ... v . v v
_
RECIPIENTS FEDERALIDENT.NO. PLEASE CALL THE ABOVE NUMBER IF THESE PAYER'S SOCIAL SECURITY NO. anus lrJrEHesr +
SHOHiAGE PLAID O.OD
23-1237295 LAST FOUR NUN.BERS DO NOT AGREE WITH XXY.-XX-9177 PaEPnvr.i~trPEw,~n +
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YOUR SOCIAL SECURITY Idt]tIBER
PAYER'SBORROWER'S NAf~fEAtJD ADDRESS The information in boxes 1, 2, 3, and 4 IS importznt __, _: _ __ _
tax information and is being furnished tD the
Internal Revenue Service. If you are required to file -_
~
a return, a negligence penalty or other sanction may ~
~` . , , „ 12 0 6.17
MERVIN t;YERS be imposed on You if the IRS determines that an -
AELEN L MYERS underpayment of tax results hecause you overstated 2. p01h'TS PAID
0
00
432 N PITT ST a deduction for this mortgage interest or for these ----- .
--
points or because you did not report this refund of
CARLISLE PA 1 7013-1945 interest on yourretum. 3. REFUNDDFOVEA- 00
0
`Caution: The amount shown may not be fupy PAID INTEREST .
deductible by you. Limits based on the loan amount 4. PMI/MIP
and the cost and value of the secured property may
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extent it was incurred by you, actually paid by you,
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and not reimbursed by another person. _
THIS IS A SUBSTITUTE .1098- STATEMENT. _
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- PLEASE ~-REVIEW THIS 1A98 STATI'.MENT BEGINNING BALANCE + - U•UD
-
~ :FOR ACCURACY.
:.: DISBURSEMENTS 0.00
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- AC3UUSTMEh1TS
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0.
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- - ENDING BALANCE 0
00
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ESCROW ACCOUNT 'BEGINNING BALANCE O. DO
STATEMENT PRINCIPAL+INTEREST 210.03 eeGlNNwcaALAN~E 736..86. ____
ADD INT SHORTAGE
0.00
j -. LESS INT. SHORTAGEPREPAID - 0.00
THIS NOTICE CONTAINS ESCROWAMPOUND 121.56 TOTAL ESCROW RECEIPTS 1.+89.08
BNDwGBALANCE
0.00
WFORMATION
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I REGARDING YOUR _ ~. B ~.. °' e,`~I 10 35.64
` OPTION.4LINSURANCE, 0.00 TOTAL ESCROF;DISBUSSEL+Er!TS -1791. OD T
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ID
; 0
00
:. ESCROW ACCOUNT AS- ARGE
PA
LA
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REQUIRED BY THE REAL .LnTECRAasES~uEeururaPAlD 0.00.
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ESTATE SETTLEMENT AND
ANCILLARY
0.00
ESCROW INTEREST
0.O D
OPTIONAL INSURANCE
D . D 0
ti PROCEDURES ACT I FEES PAID 0.00
(RESPA) AND IS A RECAP SERVICETTjP.NSFER 0.00
' FEES DUE BUT UNPAID 0 . DO
OF YOUR ESCROW
y
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-
? ACCOUNT. MISC. 0.00 ENDINGBALANCE !i34.94 --- -~- - ~ ~-
~~ TOTAL PAYMENT
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331.59 TOTAL OF MORTGAGE
4009.44 °;,~ ~~i `I ~ €
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- PAYtv1EN75MADE II
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TR`
CODE
DUE DATE POST
PATE Sw,r~tvan
En~mrc TRANSACTION
AMOUNT INTEREST
PAID PRINCIPAL
PAID PRINCIPAL6ALANCE
AFTEHTRANSACTION ESCROW/IMPOUND
pAlp ESGROWIIMPOUND
BAIANCEAFIERTRANS.
CDPIS~FtUCDDA Ildt RATE LATE
CHARGE oPTIDNALINSURANCE
CONSTRUCTION
UNDISR. ACCT. BAL UNAPPLIED
FUNDS 1 C
D 1
- 02/01/09 01105 33918 10581. 10[22: 1170665 12915 86601 000 000 000
03 /O1 /09 02/05 33918 10987 10516 1160199- 12915 49516 000' ODO'. 000.
v 04/01/09 03/29 33918 10393- 10610 1149539. 12915- 112431 000. 000: 000
E01 04/01/09 03/30 -15936 OTHER ESCROH T S 1149539-. -15936 96495 000 000 000.
E20 04/01/09 04!01 -49600 wnzAAD 1NSUR7~N 1149539 -59600 46895 000- 000 000 _~ ~
05/01/09 Od/20 OS/16 33918 10298 10705 1138834. 12915 59810 000 000- 000
E9S 05/01/09 04/20 -33042 BOAOUGA TAX 113HH34. -33042-- 26768 000. 000 OOOi
06/01/09 OS/OS 33159.- 10202 10801 1128033 12156 38929 000 000" OOO~ j
07/01/09 06/11 33159. 10105 10898 1117135 12156. 51080 000 000 OOOj ~
08/01/09 07/10 33159 10008 10995 1106140 12156 63236 000 000 000 1
09/01/09 08/10 33159 9909.] 11099 1095096 12156. 75392 000 000.
111111 OOOi
E92 09/01/09 08/11 -70522 SCHOOL TAX '..i 1095046. -70522 4870 000 ;
000 00 •:j ',
10/01/09 0.9/09 09/04 33159 9610 11193 1083853 i 12156 1702 6 OOOI HOC ~ GC@
11/01/09 10/OB 10/07 33159 9710-- 112931 1072560 12'_56 -9252; ODD; fCD ::~ ODD-
12/O1/09 11(10 11/06 33159 9608 11395 1061165 I 12156 F133E' COD '. _ - _
O1/OS/30 12/10 331591 9506 119971 1049oE"a~ 12156
I 53494' - 000; OBL - EOe
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_ _ i HANSAG I IUIV GUUtS UN k3AGK _ _ _ _ StE HtVtHSt SIUt FUH IAXF'AY tH INS 1 HUG I IUNti
C
REV-i~13 EX+ (Oi-?G)
pennsylvania
!.~ DEPA F-rMENT OF HEV[NI:E
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE
BENEFICIARIES
ESTATE OF: FILE NUMBER:
Mervin L. Myers 21-10-1169
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under
Sec. 9116 (a) (1.2).]
1. The Mervin L. Myers Revocable Living Trust
Note: A copy of the Trust Agreement is not attached because there were
no probate assets to be distributed to the Trust
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE.
II NON-TAXABLE DISTRIBUTIONS
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. I $
If more space is needed, use additional sheets of paper of the same size.