HomeMy WebLinkAbout10-21-11 (3)
1505610101
EX (oi-io) ~
J REV 1500
PA Department of Revenue Pennsylvania
Bureau of Individual Taxes oEOa E~, ~ INHERITANCE TAX RETURN
PO BOX 28o6oi
Harrisburg, PA i'Ji28-o6oi RESIDENT DECEDENT
OFFICIAL USE ONLY
County Code Year File Number
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
Decedents Last Name Suffix Decedent's First Name
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name
~`~f-oM ~s ~~t GENE
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
~ 1. Original Return O 2. Supplemental Return
O 4. Limited Estate O 4a. Future Interest Compromise (date of
death after 12-12-82)
~ 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust
(Attach Copy of Will) (Attach Copy of Trust)
O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death
between 12-31-91 and 1-1-95)
MI
S"
MI
O 3. Remainder Return (date of death
prior to 12-13-82)
O 5. Federal Estate Tax Return Required
1 8. Total Number of Safe Deposit Boxes
O 11. Election to tax under Sec. 9113(A)
(Attach Sch. O)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SF~6! jLD BE DIRECTELI. T0:
Name Daytime Teleph~t3-1~lumber
1n! 1 L ~- / /F !y ~S ~ ~'Y 1 ~ Ls ~~
r
First line of address
Wes- ~--- ef-i ~ ~f- s ,~
Second line of address
.~ ~. ~ ~`E ~-O S-
City or Post Office
C/~.QLJSLE-
State ZIP Code
REGIS Tw1DLLS U~ ONLY-
TEI~ :-~ i
_~~ ._
C7 ~ -~ ° -
r> _ , -
__ _.~
~.r -
DATE FILED
Correspondent's a-mail address:
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.
Side 1
1505610101 1505610101
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE
1505610105
REV-1500 EX
ww ~~++ De~ce/d~ent's Social Security/Nr_~umber
Decedent's Name: ~~/~~• ~N/L~11~ fF~ ~'`~ ,9 ~ ~ ~`~ ~ /
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 and Notes Receivable (Schedule D) ......................... .. 4. •
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)..... .. 5. ~~ ~~•
6.
Jointly Owned Property (Schedule F) O Separate Billing Requested .....
.. 6. n
~~~ ~'~C% Q'~
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property ...///
(Schedule G) O Separate Billing Requested...... .. 7. •
8. Total Gross Assets (total Lines 1 through 7) ........................... .. 8. ~L/ 1 r~ •~~
9. Funeral Expenses and Administrative Costs (Schedule H) ................ ... 9. ~l ~ ~ ~
/
/
/
10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ........... ... 10. r
~ J~~ ~
~,~
`
11. Total Deductions (total Lines 9 and 10) .............................. ... 11. ! ~
~~.. ~~
6
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. ~ ~ 9 / ~~
TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
16. at Lineal ate'nX O.j~~ ~ ~ ~JLf 7~'~ 16. ~~~ ~~
17. Amount of Line 14 taxable ~ ~J
at sibling rate X .12 17.
18. Amount of Line 14 taxable
at collateral rate X .15 18.
. .. ; -
: ,
19. TAX DUE .........................................................19. ~L--~ ~l~'
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O
Side 2
1505610105 1505610105 ,~
REV-1500 EX Page 3 File Number
Decedent's Complete Address: ZJ~ ~-.- ~~ 2/
DECEDENT'S NAME
STREETADDRESS
I CITY ~~~s~ STATE~~ ~ ZIP ~~~~
I
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2. Credits/Payments
A. Prior Payments
B. Discount
Interest
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.
Total Credits (A + B) (2)
(3)
(4)
If Line 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.
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 .................................................................................................................... ...... ^
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" 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 Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and
filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
• The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an
adoptive parent or a stepparent of the child is 0 percent [72 P.S. §9116(a)(1.2)].
• 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)]. Asibling is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
.r 1
` ~ 1 ~.._J~~~
. ~/ /~
I, WILMAJEAN H. THOMAS, of the Borough of Carlisle, Cumberland
County, Pennsylvania, declare this to be my Last Will and revoke any will previously
made by me.
I. I devise and bequeath all of my estate of every nature and wherever situate to
my son, CHARLES E. HALL, JR., providing he shall survive me by thirty days.
II.. Should my son, CHARLES E, HALL, JR, predecease me or die on or
before the thirtieth day following my death, I devise and bequeath all of my estate of
every nature and wherever situate to my sister, WANDA BERNICE SCHMITZ.
III. I make no provisions herein for my husband, EUGENE W. THOMAS,
not for lack of love and affection, but because he has been provided for otherwise.
IV. I make no provisions herein for my son, NEIL HALL, not for lack of love
and affection, but because he has been provided for otherwise.
V. All federal, state and other death taxes payable because of my death, with
respect to the property forming my gross estate for tax purposes, whether or not passing
under this will, including any interest or penalty imposed in connection with such tax,
shall be considered a part of the expense of the administration of my estate and shall be
paid out of the principal of my estate without apportionment or right of reimbursement..
VI. I appoint my son, CHARLES E. HALL, JR., executor of this my Last
Will. Should my son, Charles E. Hall, Jr., fail to qualify or cease to act as executor, I
appoint my attorney, WILLIAM S. DANIELS, executor of this my Last Will.
VII. I direct that my executor or his successor shall not be
required to give bond for the faithful performance of his duties in any jurisdiction.
7~f
IN WITNESS WHEREOF, I have hereunto set my hand this ~ 'day
of ~'~-'VlJ/~~~ , 2002:
.. ~ - (SEAL)
WILMAJE H. T OMAS
The preceding instrument, consisting of this and one other typewritten page
identified by the signature of the testatrix, WILMAJEAN H. THOMAS, was on the day
and date thereof signed, published and declared by WILMAJEAN H. THOMAS, the
testatrix therein named, as and for her last will, in the presence of us, who, at her request,
in her presence, and in the presence of each other have subscribed our :names as witnesses
hereto.
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48500041046
REV-485 EX (05-04)
SAFE DEPOSIT
BOX INVENTORY
PA Department of Revenue PLEASE USE ORIGINAL FORM ONLY
Social Security or Death Certificate Number Date of Death County Code Year File Number
2~9~8 gG~/ to l y~2oo~ Z/ oG as 92,/
Decedent's Last Name Suffix First Name MI
ADDRESS OF DECEDENT STREET: CITY: STATEN ZIP CODE:
NAME AND ADDRESS OF PERSON REQUESTING THE OPENING OF THE SAFE DEPOSIT BOX
NAME: ~. LL~~~ 1~i¢/Y,/BGf'~ ~-~i2E
STREET ADDRESS: " ~~ ~ ~ ~`,~
+r~+
• ~ ITY: ~~ STATE: ZIP CODE:
a i,
NAM ,ADDRESS AND RELATIONSHI (IF ANY) TO DECEDENT, OF PERSON(S) PRESENT AT THE BOX OPENING
a. NAME: • • RELATIONSHIP:
•S7REETADDRF,~S• i~G Ste. • .CITY: ° S A7E:.,. ZIP CODE:
'b. NAME:. , .. -
" RELATIONS~(IP:" r .. . - ,
,~
~
STR~EETADDRESSw`" ~ »• ~ ~ - CITY: ~~ .. STATE:;, `ZIP CODE:
c. NAME: RELATIONSHIP:
STREET ADDRESS: CITY: STATE: ZIP CODE:
NgMEAND ADDRESS OF FINANCIAL'1NSTITUTION WHERE TH6,SAFE DEPOSIT BOZ( IS LOCATED •.
NAME ~, _ •
a 7`' ~3 ~9N~ •
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STRE TADpR,ES=~ ^ _jJ ~i~ll• _ p~•
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T V ~ CITY ° T
ue
. ~~ ZIP CODE:
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NAME OF PERSON MAKING LAST
ENTRY ,; ~ , DATE gND
, T ME OF LAST ENTRY ,
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DATE OF CONTRA T TO•RENT BOf(~ NUMBER OFB.OX.• 1 TITLE.UNDER WHICH BOX IS {iEQUEST.ED ,
NAMEAND ADDRESS OF PERS'ON(S) HAVING dCCES§ TO BOX
a. NAME: ~ _ -
~~ ) w.0. ~ 1--~ o vv~ 'C b. NAME: o - - ~ '
STREET ADDRESS STREET ADDRESS: ~ ~ ~ '
ITY: STATE: ,ZIP CODE:
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•~' ~ CITY: ~ STATE:
.. ZIP CODE:
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N M~.AND TITLE OF EMPLO ING THE INVENTORY
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WAS A WILL IN THE BOX? '~ YES ~ NO If yes, a. Date of will: ~ ~,~ ~~. ~9
b. Name and address of personal representative, if named In the will
NAME: _`~'~ ~ /
T ~/ ~it' IYO~' C~
~~.C.Q-L•cs~.M .Sr ~ ~iV
STREET ADDRESS: r-~ CITY: STATE: ZIP CODE:
~'ti ~?.~3~/42SG
c. Name and address of attorney, if any
NAME: ., _ '
STREET AfSDRESS: , ` '' ~ ~ •• ~ ' - • CITY: • ~ STATE: ~ ° ZII~CObE:'
~. ~~ •~ +.
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48500041046 48500041046 J
REV-485 EX SAFE DEPOSIT BOX INVENTORY Page of
INSTRUCTIONS
(1) Cash: Report total only.
(2) Stocks: List in detail every common or preferred certificate, warrant or other rights found in box. Stocks are to be designated by
name of company, certificate number, date of:certificate, name in which stock is registered, and number of shares and class of stock.
(3) Obligation~q,oftU.$. Governm@nt: Numberof items, date of issue, faceaalue, games in which registered and type of ov~nerghip,;1~
"
i.e., j6iAily hsld, payable on death, etc. ~ ~ ~~ ~. ~ ~ ' "°
~ ~ ~ ~ ~ ~ .
(4) Bonds: Designate by name, amount, serial number, or other designation. (Bearer Bonds)
;(5) Bank and Savings$ncikLoan,~s~bQoks: State name of depositor, number of book, last date appearing inbpgk, narpe of.bank°
~
'
• •
~
~ ` r ~~ f
and branch, and~6alance:
(8) ~ Jewelry, Coins, Stamps, Manuscripts, etc: List and describe as fully as possible. ,
•(7) Deeds,~Mort~ages~ Current Insurance~Polioies'ef other evidences of indeBtedne'ss: List and descri~e as`fully as~~possible:
(8) All other contents.
., • , r.. { . ~ ,
(9) Return completed form to: ~ •~D@PAf~TMENT.OF REVENUE '~ ~`, ` ~ ~ ~ ~;° ` -' - . ` ~'
INHERITANCE TAX DIVISION
,- ~ ~: ~, Y~a~ r.. ,•..: •, .' . DEPT. 28060t~ , . ~ ' ~ ~ , .. c •.
~
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HARRISBURG, PA 17128-0601
INO. ITEM DESCRIPTION '
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I CERTIFY UNDER PENALTY OF PERJ THAT THE ABOVE RECORD IS PERSON RFtCEIVING COPY OF
CORRECT AND COMPLETE TO TH S OF MY KNOWLEDGE AND BELIEF. SAFE DEPOS T BOX IN~[E TORS:.,
SIGN~7tlR ~
v/!~/ ~ SIGNA
PRINT ~/ ' ~ ^~'~~ PR NAMED CHE
CSAPP~PRIAT O~ELOW:
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G-
PRINT TITLE ~ ~
• DATE CHECK APPROPRIATE BOX:
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~~~~~~ 4
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Executor(trix) ~ Administrator(trix)
/
'
~~ ~ Estate Representative ~ Joint owner of safe deposit box
N T : Attac ddi Tonal 8'/:° x 1' sheet(s) if necessary or use duplicates of this page of form.
The Department is authorized by law, 42 U.S.C. §405 (c)(2)(CKi), to require disclosure of Social Security num!>grs in connection with administering state tax laws. The Department uses the
Socal Severity number to identify the decedent and personal representatives of the estate. The Commonwealth may also use the information in exchange of tax information agreements
with Federal and local taxin authorities. The state law rohibits the Commonwealth's rsonnel from disclosin confidential tax information except for official purposes.
REV-1508 EX+(1-97)
SCHEDULE E
COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, $c MISC.
INHRESIDENTDECEDENTRN PERSONAL PROPERTY
ESTATE OF ~!`~ FILE NUMBER 2
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.
; ~' ~ ~~~~
TOTAL (Also enter on line 5, Recapitulation) I $ 1~ ~ ~'
(If more space is needed, insert additional sheets of the same size)
l~_
S-rA~r ~ ~ ~ rv,- c~~ Acc®ur,-rs
Statement Period 09/22/06 TO 10/22/06
1-877-SOV-BANK (1-877-768-2265) wwvv.sovereignbank.com GENERATION CHECKING
WILMA J THOMAS
1
Deposit Accounts Account Number Average Claily Balance Current Balance
s GENERATION~CHECKING 1671010353 $510.42 $823.23'
Total Deposit $823.23
Time Deposit Accounts Account Number.. ; Maturity Date Interest Rate .Current. Balance
f 1$~23µMONT~-{ RETIREMENT Cp , 1:67817175 - :10/25/07 294°0 $350.00}
Total $350,00
WILMA J THOMAS
Account ~ 1671010353
Balances
~B~ginnipg~~ e, 1_~~~ ,*~ `~~$4~4~36 '~CU~rent°Balance ~82~23 ,
Deposits/Credits + $388.87 Average Daily Balance $510.42
tWithd~rawals% ebits ~ y,C-'~~~*4 0~, yip
Ilnterest
EPaid'this Period * ~ '>'i _. $£0.02 ; • Annual Percentage Yield Earned :,'0.05°io `, ~
. ~~.. _r::..
Earned this Period $ 0.02 Paid Last Year $0.26
r~ fi a ~.
..~.. . .
sPa~~ lfearTo=Date E"~$ 0 13
*The interest earned and the interest paid may differ depending on when interest. is credited toyour account
page 3 of 4 1671010353
Statement Period 09/22/06 T010/22/06
1-877-SOV-BANK (1-877-768-2265). N/wN/sovereignbank.com GENERATION CNECKINC
Checks Posted
Check # Date Paid Amount .:Reference # Check # ` Date Paid Amount Reference #
_:: _ .
691 ~. 10/2 $40.00 ~ .- 626643270
1 Check(s) Posted = $40.00
An asterisk (*) indicates a skip in sequential check numbers which may be caused by one of the following:
• A check not yet received
• A check that was converted to an electronic transaction, which will be listed in the "Electronic Checks Posted"
section below. If no checks were electronically converted, this section will not appear.
Account Activity
Date Description Additions Subtractions Balance
09-22 Beginning Balance $474.36
5~0 Q2 '~;<`fIME'D~PQSIT CREDIT' ,. ,. .: `$0.85, $475,21`.;
~~ _ _
10-02 CASH CHK 691 ~ _~ -- - pan nn ~n~z~ ~~
page 4 of 4 1671010353
Rev-~sos ex, l~.sil
SCHEDULEF
COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
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 I ADDRESS I RELATIONSHIP TO DECEDENT
r ~ / "°~,.
~/~'"~ iii` ~>ff E.li* ~ :~` ~~` ! ~.~
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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 ASSET % OF
DECD'S
INTEREST DATE OF DEATH
VALUE OF
DECEDENT'S INTEREST
~,
F ~ aw.~:
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~....~
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F .r
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-
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e a
.-
J `
TOTAL (Also enter on line 6, Recapitulation) I $ ~ ~ - ,iii-,.-
(If more space is needed, insert additional sheets of the same size)
S. W. BARRETT REAL ESTATE & APPRAISAL SERVICES
Appraisals • Brokerage • Counseling
124-126 N. Hanover Street Carlisle, PA 17013-2455
Phone (717) 243-6646 FAX (717) 243-8627
Steven W. Barrett, SRPA, SRA, ASA
State Certified General Appraiser
.., _
APPRAISAL
INSTITUTE (rte
December 4, 2006
William S. Daniels, Esquire
Humer & Daniels
205 Farmers Trust Building
One West High Street
Carlisle, PA 17013
SUBJECT: Wilmajean Hall Estate
145 Lincoln Street
Carlisle, PA 17013
Dear Attorney Daniels:
The appraiser certifies that the subject property has personally been inspected, as you requested, to estimate
their present market values in accordance with the Uniform Standards of Professional Appraisal Practice
(USPAP) as a Limited Appraisal, in Restricted Use Format. The value shown has been arrived at after
careful study of the location and type of improvements, their present physical condition and their present use.
Therefore, I believe they reflect a true measure of the present-day market value "AS OF" October 17, 2006.
Values Reported: FIFTY-FOUR THOUSAND DOLLARS ($54,000)
The appraiser also certifies that there is no financial interest, present or contemplated, in this property, and that
neither the employment to make the appraisal nor the compensation therefrom is contingent upon the value
reported.
This report in its entirety includes the letter, limited analyses, Certification and Limiting Conditions, all of which
constitute this Limited Appraisal, in Restricted Use Format and; as such, it represents little or no discussion
of the data, reasoning and analyses used in the appraisal process to develop the appraiser's conclusions.
Supporting documentation will remain as confidential file data.
Sincerel}~3+ou~s, _.
STEVEN W. BARRETT, SRPA, SRA
PA CERTIFIED GENERAL APPRAISER, GA-000298-L
S. W. Barrett Real Estate b Appraisal Services
Flle No, 06-0506
v ~
12/OV2006
WIIIiam S. Daniels, Esquire
1 West Hiyh Street
Carlisle, PA 17013
File Number: 06-0508
In accordance with your request, I have appraised the real property at:
162 Lincoln Street
Carlisle, PA 17013-1939
The purpose of this appraisal is to develop an opin(on of the market value of the subject property, as improved.
The property rights appraised are the tee simple interest in the site and Improvements.
In my opinion, the market value of the property as of October 17, 2006 is:
5112,000
One Hundred Twelve Thousand Dollars
The attached report contains the description, analysis and supportive data for the conclusions,
final opinion of value, descriptive photographs, limiting conditions and appropriate certifications.
Respectfully submitted, '
. Cdw.t~
Stan A. Skowronek
Certified Residential Appraiser
REV-1511 EX+ (10-06)
SCFIEDULE H
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES &
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
7'~0~~'. GYi~~~~ ~/ ?-,'off --~~ 2/
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
1.
B.
1
DESCRIPTION
FUNERAL EXPENSES:
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
~ City
Year(s) Commission Paid:
State Zip
2. Attorney Fees /~/~ "-~~`~~ ~k~~~-~,~'~S'
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zip __.
4.
5.
6.
7.
~r
/ r
/ 4/
Relationship of Claimant to Decedent _ ~
Probate Fees ~~ ~ f ~„ ,~-~ ~- ~,,,~r ~ ~ , r~~ ff~
Accour-tant's Fees ~~ /~~°~-~- ~°~ '~'',+'
~/ 4 a~-
C L.r h-~ /'Li i~~'in^ Gr•/Prb-V Y ~i'u `°~ l /fed''
r.
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C""1:1 do ~.a .d.•-s~".aw- _/#'~ r~ir3 .s+e.r % s'' ~'~t°•'a •:.~
TOTAL (Also'enter on line 9, Recapitulation) ~ $
AMOUNT
T `."•
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(If more space is needed, insert additional sheets of the same size)
Ewing Brothers Fu Iler:,l Home, Inc. ~ >
630 South Hano~'c: Street ~'
Carlisle, P.-'~. ; "' ! 3-
(717)24" ^ I~'
October 31, 200E
F,ugene W. Thoma
162 t,111C01n St.
Carlisle, PA 1701:'
The F~nleral Ser~'~~~•~ 1'or ~~/iltna Jean Thomas
7
We sincerely ~hi~r:~ :late the confidence you have placed in us <ulcl will continue to assist you in every way we can. Please
feel free to cont;l`t ~, if you have any questions in regard to this statement. `
THG C'GLLOWING f~~ - '~.N ITEN1[ZED S"CATEMENT OF TIIE SERVICI?~; I ,~.C1LITIES, AUTOMOTIVE EQUTPMENT,
AND NIERCHANDIS '' I IAT YOU SELECTED WHEN MAK[NG TI II: ! '. I:AL ARRANG EMENTS. '
1. PRO('GSSIONAL I:RV[CCS
Services ol'Puncral (~ r. -.:~u/Sniff . $l22>.QO
Gnbalming; $525.00
Dressing, Caslretine; C~~~~ - ~iotology, $175.00
2. FACILI'TII?S `. 1;RV[CLS
huneral Ceremony, $450.00
Other 1;acilities usa~~c. .~~;~ room etc $210.00
3. AUTOMOTIV}? ' i t';~1ENT
Vehicle to transfer r.:~,, , !n funeral Home. $225.00
Hearse (Casket Cut.. i $295.00
Lead car/Cler~Yv $135.00
FU~~'I'I: ' ! ~1(? SFIZVICE CHARGES $3240.00
TI~II; ('0~~!~ ~, -i~' OURSCRVICES, EQUIPMENT, AND MI't:t:I.:~:NRISE
"I'II:~"f Yt~l' ' '.~~1.S1:LLCTED $3240.00
Cash Adv;utccs
Certi9ied Copies r,ri~ ~'i ('erl~ cite . . . . $60.00
Register haul; ~ _ .rs., $65.00
'f(~T,~ L C.-~ ` ~ UVANCES AND SPECIAL CHARGES $125.00
Total
"total Cost $3365.00
~UC3-TO"1':~L 53365.00
INITIAL PAYMENT i DISCr ' :: t' I CREDITS 0.00
TOTf1L..`,!OUNTDUE y $3365.00
-I-he unpaid balance over !> ':., a lubjc.: ted to a 1.00 % service charge per month - 1? 00'r ~ ';~, per annum. ~__ ,_,,,.,~~"
~ ~ / ~'"
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REV-1512 EX+ (12-03)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE 1
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF FILE NUMBER
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
-~/
- .-~ ~ -
~J /
a
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,~
i:~
~y r
~ ~~ ~ ~ ..
,~ ~ ` ` ~ ~
~, ~~~
/,~ ~~~ .,
~ L
.. ~-t'' +~ ~ II
~~ ~~
TOTAL (Also enter on line 10, Recapitulation) $ ~ ~~,~ ~4
(If more space is needed, insert additional sheets of the same size)
REV-1512 EX+ (12-03)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE 1
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF ~-~-- FILE NUMBER
Report debts incurred by the decec~it prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. a
/3
L~
/s'
! ,~a+
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\ +~
{ ~ -
~,- eft .~ ~~~
/ ~~
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/~ s',
,~ ~ ; ~ ~~`
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,,~. ~ ,„~ ,.,~ .~' e°°~ c~t~'a ~ I ,'mac,--'~'P,~'
TOTAL (Also enter on line 10, Recapitulation) $
2`y. 9'
~9,~2.
G ~, 25-
~~~, i Z
3, 6Z
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/; ~'~`'
/, G ~~,
,z ~, c5'
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(if more space is needed, insert additional sheets of the same size)
REV-y 504 EX+ (1-97)
a
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCNEDULE~'
CLOSELY HELD CORPORATION,
PARTNERSHIP OR
SOLE-PROPRIETORSHIP
ESTATE OF
FILE NUMBER
Schedule C-1 or C-2 (including all supporting information) must be attached for each closely-held corporation/partnership interest of the decedent, other than a
sole-proprietorship. See instructions for the supporting information to be submitted for sole-proprietorships.
ITEM NUMBER VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
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/. ~
/, ~G
-~ _
~.~~ ~1~
TOTAL (Also enter on line 3, Recapitulation) I $
(If more space is needed, insert additional sheets of the same size)
REV-1513 EX+ (9-00)
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
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)]
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THR OUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
REGISTER OF WILLS
CUMBERLAND COUNTY, PENNSYLVANIA
Name of Decedent: WILMAJEAN H. THOMAS
Date of Death: 17 October 2006
File Number: 21-06-0921
Date Letters Granted: 19 October 2006
To the Register:
I certify that Notice of Estate Administration required by Pa. O.C. Rule 5.6(a) of the Orphans' Court Rules
was served on or mailed to the following beneficiaries of the above-captioned estate on 2 April 2007:
Name Address
Charles E. Hall, Jr. 7 Beverly Ct., Carlisle, PA 17015 ~ ~~/~/ /ri
Neil R. Hall 59 N. East St., Carlisle, PA 17013
Eugene W. Thomas 162 Lincoln St., Carlisle, PA 17013
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except:
Date: 2 April 2007 ~ (~
Signature `•.-~_•
Name: WILLIAM S. DANIELS
Address: 1 West High Street, Suite 205
Carlisle, PA 17013
Telephone: 717-243 -3 8 31
Capacity: Personal Representative
X Counsel for Personal Representative
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