HomeMy WebLinkAbout12-29-11......1
REV-1500 ~` i°'-10'
PA Department of Revenue
Bureau of Individual Taxes
PO BOX 280601
1505610140
OFFICIAL t1SE ONLY
INHERITANCE TAX RETURN County C0~ Year Flle Number
RESIDE 2
ENTER DECEDENT INFORMATION BELO NT DECEDENT 1 1 1 D 4 0 1
Social Security Number W
Date of Death MMDDYYYY
1 9 5 3 2 1 3 0 8 0 3 2 1 2 0 1 1
Decedent's Last Name Suffix
W A G N E R
(tf Appllca4le) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffoc
Spouse's Social Security Number
Date of Birth MMDDyyyy
0 6 2 4 1 9 4 0
Decedent's First Name MI
D O N A L D F
Spouse's First Name MI
THIS RETURN MUST BE FILEb IN DUPLICATE WITH THE
FILL INAPPROPRIATE OVALS BELOW REGISTER OF WILLS
® 1. Original Retum ~ 2. Supplemental Retum
3. Remainder Retum (date of death
4. Limited Estate ~ prior to 12-13-82)
4a. Future Interest Compromise (date of ~ 5, Federal Estate Tax Return Required
® 6. Decedent Died Testate death after 12-12-82)
(Attach Copy of wil) ~ ~~ Decedent Maintained a Living Trust ~ 8. Total Number of Safe
(Attach Copy of Trust) DeposR Boxes
9. Litigation Proceeds Received ~ 10. Spousal Poverty Credi# (date of death
between 12-31-91 and 1-1-95) 11. Election to tax under Sec. 9i 13(A)
CORRESPONDENT -THIS SECTION MUST BE C (A~ch Sch• O)
Name ~• ALL CORRESPONDENCE AND CONfMENT1At. TAX INFORMATION SHOULD BE DIRECTED T0:
Daytime Telephone Number
E L I Z A B E T H H F E A T H E R 7 1 7 2 3 2 7 6'b 1
First line of address
3 6 3 1 N O R T H F R O N T S T R E E T
Second line Of address
City or Post Office
H A R R I S B U R G
State
P A
Z!P Code
REGISTER fJttMF~L3 USE ONLY
r
C~
~_ .
_: _~ ~_.
'_ _
1
DATE FILED
1 7 1 1 0
~.:~ ,-~
correspondent's e.man address: efeatherCc~ckiegal.net
Under penaltles of perjury, I dec~re that i have examined this return, inGudin accom
it is rtect and corn ete. aration of arer other than the 9 panyinq schedules and statements, and to the best of m kn
P personal representative is based On ail information of which preparer has any~knav!®edg~e belief,
NA RE OF PERS R ONSI OFD FI ~ ETURN
,~J ~ ~ , r. DATE
P . 0 . BO'k 38
Z NORTH FRONT
H
PLEASE USE ORIGINAL FORM ONLY
Side 9
1505610140
BOILING SPRINGS
THAN REPRESENTATIVE
~~
~ PA
0
1505610140
---- --
°~-- - __
_~
~, _
1505610240
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: DONALD F• WAGNER 1 9 5 3 2 1 3 2 8
RECAPITULATION
1
7
3
1
4
6.
5
5
1. .....................................
Real Estate (Schedule A) ......
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.
8 4 ~ 1 . 4 3
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E). ...... 5.
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested . ...... 6.
7. Inter-Vivos Transfers & Miscellaneous N -Probate Property
arate Billin
Re
uested
(Schedule G) ~ Se
7
g
q
.
p ...... .
8. Total Gross Assets (total Lines 1 through 7) ........................... 8. 8 1 6 1 7 . 9 8
9. Funeral Ex enses and Administrative Costs Schedule H
P ( ) ............
...... 9. 7 3 9 2 . 7 3
10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ....... ...... 10. 4 2 6 0 1 . 9 6
11. Total Deductions (total Lines 9 and 10) ......................... ...... 11. 4 9 9 9 4 . 6 9
12. Net Value of Estate (Line 8 minus Line 11) ...................... ...... 12. 3 1 6 2 3 . 2 9
13. Charitable and Governmental BequestslSec 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. 3 1 6 2 3 . 2 9
TAX CALCULATION -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 .o _ 0 0 0 15. 0. 0 0
16. Amount of Line 14 taxable
at lineal rate X .045 3 1 6 2 3. 2 9 16. 1 4 2 3. 0 5
17. Amount of Line 14 taxable
0 0
0
17
0
0
0
at sibling rate X .12 . .
18. Amount of Line 14 taxable
0 0
0
~
~
~
at collateral rate X .15 18. •
19. TAX DUE ...................................................... 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
1 4 2 3. 0 5
Side 2
1505610240 1505610240 J
REV-1500 EX Page 3
Decedent's Complete Address: File Number
21 11 0401
DECEDENT'S NAME
DONALD F. WAGNER
STREET ADDRESS
314 PITT STREET
CITY
E N O LA STATE
PA
Tax Payments and Credits:
~• Tax Due (Page 2, Line 19)
2. Credits/Payments
A. Prior Payments
B. Discount
3. Interest Total Credits (A + B )
ZIP
17025
(1) $1 423.05
(2) $0.00
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (3)
Fill in oval on Page 2, Line 20 to request a refund.
(4) $0.00
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
(5) $1 423.05
Make check payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent m k
a e a transfer and:
a. retain the use or income of the property transferred;
Yes
No
b. retain the right to designate who shall use the property transferred or its income; ....................
c
retai
~
X
O
.
.
n a reversionary interest; or ................................................
d. receive the promise for life of either payments
benefit ..........
,
s or care? ..............................................
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death .........
^
^
without receiving adequate consideration?
3
Did d
"
O O
X
,
ecedent own an
in trust for" or payable-upon-death bank account or security at his or her death?
4
Did d O ^
.
ecedent own an individual retirement account, annuity or other non-probate property
which .........
,
contains a beneficiary designation? .......................................................................................... ........ ^ O
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 survivin sous
3 percent [72 P.S. §9116 (a) (1.1) (i)]. g p e Is
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.
REV-1502 EX+ (01-10)
pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF:
F. WAGNE
SCHEDULE A
REAL ESTATE
FILE NUMBER:
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value isldefined 01the 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 that is jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM Attach a copy of the settlement sheet if the property has been sold.
NUMBER Include a copy of the deed showing decedent's interest if owned as tenant in common.
DESCRIPTION
'Real Estate owned solely by Donald F. Wagner, known as 314 Pitt Street, Enola, East
Pennsboro Township, Cumberland County, Pennsylvania. The property was sold on
August 2, 2011. Sale price $72,000 + $1,146.55 (County, School, tax & sewer credits) _
a total amount of $73,146.55. A copy of settlement statement is attached hereto as
Exhibit 1.
TOTAL (Also enter on Line 1, Recapitulation.)
If more space is needed, use additional sheets of paper of the same size.
VALUE AT DATE
OF DEATH
73,146.55
73,146
REV-1508 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
DONALD F. WAC~n11=R
FILE NUMBER
include the proceeds of litigation and the date the proceeds were received by the estate,l 0401
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER DESCRIPTION
~ New Cumberland Federal Credit Union Account No. 79402
Savings $ 5.00 (Account Statement attached as Exhibit 2)
Checking $935.86 (Account Statement attached as Exhibit 2)
2• Members First Federal Credit Union Savings Account No. 283563-00
(Account Statement attached as Exhibit 3)
3. Members First Federal Credit Union Checking Account No.283563-11
(Account Statement attached as Exhibit 3)
4. 2006 Dodge Magnum motor vehicle in fair condition with 52,000 miles and outstanding
loan. Value after loan paid off is $4,311.75
5. Sentinel -Refund
6• NADART -retirement
7• IRS -refund
8• Furniture
9• Haars Auction pay-off
10. State Farm Insurance -refund
11. UGI -refund
(If more space is needed, insert additional sheets of the same size)
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
TOTAL (Also enter on line 5, Recapitulation) I $
VALUE AT DATE
OF DEATH
REV-1511 EX+ (10-09)
pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FCTer[ n[
SCHEDULE H
FUNERAL EXPENSES AND
ADMINISTRATIVE COSTS
DONALD F. WAGNER FILE NUMBER
21 11 0401
Decedent's debts must be reported on Schedule I,
ITEM
NUMBER
DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1.
B, ADMINISTRATIVE COSTS:
~ • Personal Representative Commissions:
Name(s) of Personal Representative(s) Carol Kilko
Street Address $2, 500.00
City State ZIP
Year(s) Commission Paid: 2011
2, Attorney Fees: Elizabeth H. Feather, Esq., Caldwell & Kearns, P. C.
3. Family Exemption: (If decedents address is not the same as claimants, attach explanation.) $2, 500.00
Claimant
Street Address
City
State ZIP
Relationship of Claimant to Decedent
4. Probate Fees: Register of Wills -Cumberland County
257.50
5 Accountant Fees:
6• Tax Return Preparer Fees:
~• Legal Advertising
8. Estate bank account checks 248.46
9. Executrix expenses $21.25
10. State Farm- homeowner's insurance $295.65
11. Settlement Costs for sale of house $52.00
$1,517.87
TOTAL (Also enter on Line 9 Recapitulation) I $
If mare space is needed use additional sheets of paper of the same size. 7 392 73
REV-1512 EX+ (12-08)
Pennsylvania SCHEDULE I
DEPARTMENT OF REVENUE DEBTS OF DECEDENT
,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES, & LIENS
RESIDENT DECEDENT
ESTATE OF
DONALD F. WAGNER FILE NUMBER
21 11 0401
Report debts incurred by the decedent prior to death that remained unpaid at the date
f d
ITEM o
eath, including unreimbursed m edical expenses.
NUMBER DESCRIPTION VALUE AT DATE
1 ~ Holy Spirit Hospital -Medical Services OF DEATH
$3,299.73
2~ New Cumberland Federal Credit Union -Mortgage Loan Account No. 79402- Pay-off
$26,014.20
3. New Cumberland Federal Credit Union VISA
$412.00
4. United Consumer Financial Services Loan
$1,314.51
5. UGI
$972.95
6. PA American Water
$648.10
7~ East Pennsboro Township Sewer/Sanitation
$138.00
8. PPL
$768.26
9. East Pennsboro Ambulance
$170.00
10. Comcast
$381.63
11. Mason Easy Pay Credit Card
$26.58
12. Members 1st Federal Credit Union -loan pay-off
$5,231.54
13. King Size -World Financial Network Bank
$1,028.88
14. West Shore Pathology
$56.58
15. Gilbert Zlotoff
$35.00
TOTAL (Also enter on Line 10 Recapitulation) I $
If more space Is needed insert additional sheets of the same size. 42 601 96
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
DONALD F. WAGNER
Decedent's Name 21 11 0401
Page 1
File Number
Schedule I -Debts of Decedent, Mortgage Liabilities, 8~ Liens
ITEM
NUMBER
DESCRIPTION AMOUNT
16. Bureau of Account Management -Pinnacle Health Medical Services
$2,034.00
17. JSDC, LLP -ENT Surgery
$70.00
SUBTOTALSCHEDULEI $2,104.00
GRAND TOTAL SCHEDULE I $ 42,601.96
REV-1513 EX+ (Ot-10)
pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
w~n~G Vr:
DONALD F. WAGNER
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under
Sec. 9116 (a) (1.2).)
1. Anthony D. Miller -Grandson
2. Nicole Miller -Granddaughter
3. Tiffany Miller- Granddaughter
FILE NUMBER:
21 11 0401
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
AMOUNT OR SHARE
OF ESTATE
Lineal
Lineal
One-third
One-third
Lineal
One-Third
~ 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:
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I
If more space Is needed, use addltlonal sheets of paper of the same size.
LAST WILL AND TESTAMENT
OF
DONALD F , j^1AGNER
I, DONALD F. WAGNER, of Cumberland County, Pennsylvania, being
of sound mind, memory and understanding, do make and publish this
my Last Will and Testament, hereby revoking and making void all
former Wills by me at any time heretofore made.
ITEM I. I direct that all my just debts
and funeral expenses be fully paid and satisfied as soon as
conveniently may be after my decease.
ITEM II. I give all of the rest, residue
and remainder of my estate unto my three (3) grandchildren, Anthony
D. Miller, Nicole Miller and Tiffany Miller, in equal shares, or to
such of them as survive my death.
ITEM III. In addition to the powers
conferred by law, I authorize my Executor, in absolute discretion:
A. To retain in the form received, and to sell either at
public or private sale any real or personal property.
B. To manage real estate.
C. To invest and reinvest only in forms of property defined
as legal investments according to the laws of the Commonwealth of
Pennsylvania.
D. To exercise any optional rights arising from ownership of
investments.
E. To compromise claims without court approval, and without
Ithe consent of any beneficiary.
ITEM IV.
It is hereby directed that my
Executor, hereinafter named, shall pay all inheritance, state,
succession and legacy taxes to which my estate or the transfer of
any property hereunder may be subject and to charge such tax as
part of the administration, payable out of my residuary estate,
ITEM V.
Any income or principal payable
to any beneficiary who is a minor or to be a beneficiary who, in the
sole judgment of my personal representative, is mentally or
physically incapacitated, shall be held in trust by Carol Kilko,
Trustee, during such minority or incapacity. Trustee is authorized,
in her exclusive discretion, to expend from income or principal such
sum or sums as may be necessary for the proper care, maintenance and
support of such minor or incapacitated beneficiary directly, without
the intervention of a guardian or committee; or Trustee may pay the
same to any person having care or control of said beneficiary or with
2
whom the beneficiary resides, without any duty on the part of Trustee
to supervise or inquire into the application of the funds by any
person to whom payment is so made. Any income and principal not so
expended by Trustee shall be retained by Trustee and paid to the
beneficiary upon termination of the incapacity (including minority),
or to the estate of the beneficiary if he or she dies before reaching
the age of majority or while still incapacitated, as the case may be.
For purposes herein contained, the age of majority shall be twenty-
one (21) years.
ITEM VI . T r,..,... ~_ ~ _
appoint Carol Kilko to be and act as my sole Executrix of this my
Last Will and Testament. In the event of renunciation, death,
resignation or inability to act for any reason whatsoever of Carol
Kilko, I nominate, constitute and appoint Charles J. DeHart, III,
as Executor of this my Last Will and Testament. No personal
representative or fiduciary appointed herein shall be required to
post bond or give any security.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this
2 ~ day of `J~.~K9~ 2010.
~..b~~ ( SEAL }
DONALD F. WAGNER
3
The preceding instrument, consisting of this, and three other
typewritten pages, was on the date thereof signed., published and
dec)_ared by DONALD F. WAGNER, the Testator therein named, as and
for his Last Will, in the presence of us, who at his request, in
his presence and in the presence of each other, have subscribed our
names as witnesses hereto.
_~~~
Residing at
a-
Residing at
3 ~ ~ J ~ t'1 M /) C ~..V~ / \ cI C C~ / /GC!'1 Gri i G J'J ~7rt / /
4
COMMONWEALTH OF PENNSYLVANIA .
SS:
COUNTY OF ~ p ~ P N i IJ .
The Testator and the witnesses whose names are subscribed to
the foregoing instrument, being first duly sworn and qualified
according to law, do hereby acknowledge and declare to the
undersigned authority that the Testator signed and executed the
instrument as his last Will in the presence of the witnesses, that
he signed willingly or willingly directed another to sign for him,
that he executed it as his free and voluntary act for the purposes
therein expressed, that each of the witnesses, in the presence and
hearing of the Testator, signed the Will as witnesses, and that to
the best of their knowledge, the Testator was at that time eighteen
years of age or older, of sound mind and under no constraint or
undue influence.
Testat r
fitness
// r-
Witness
Sworn to, subscribed and acknowledged before me by the above
named Testator and witnesses this e2~-~/~ day of ~~4n~vrv2 2010.
' __ (SEAL )
otar_y Public
05-555/91498
L:~~`r2i~:_si)f'JWE_ ~AL7'y pE PEf~NSYLVANIA
__. Notarial Seal
Nancy L. Breski, Notary Public
Susquehanna Twp., Dauphin County
MAy Commission Expires March 16, 2012
^~mber. Pennsylvania Association of Notaries
5
A. OMB NO. 2502-0265 '7
U.S. DEPARTMENT CF HOUSING & URBAN DEVELOPMENT o. i Trt Ur LVHN: -
1•CIFHA 2.~FmHA 3.^CONV. UNINS. 4.~VA 5.~]CONV. INS.
.SETTLEMENT STATEMENT 6. FILE NUMBER: 7. LOAN NUMBER:
8, MORTGAGE IN S CASE NUMBER:
C. NOTE: This form is furnished to give you a state
Items marked '(POCJ' were paid outs/de ment of actual settlement costs. Amounts paid to and by the settlement agent are shown.
the closing; they are shown her
f
i
f
e
or
n
ormations! purposes and are not included in the totals.
D.
NAME AND ADDRESS OF BORROWER: 1.0 3198 (GEISSLER.PFD/11102-075/14)
E. NAME AND ADDRESS OF SELLER: F
. NAME AND ADDRESS OF LENDER:
George Geissler Estate of Donald F. Wagner
21 N. Humer Street
En ola, PA 17025
G. PROPERTY LOCATION: H
. SETTLEMENT AGENT: 23-2332041
314 Pitf Street
Residential-Commercial Abstra
ct
Inc I. SETTLEMENT DATE:
En
ola, PA 17025 ,
.
Cu mberland County, Pennsylvania PLACE OF SETTLEMENT August 2, 2011
3621 North Front Street
Harrisburg, PA 17110
J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION
01. Contract Sales Price 72,000.00 401. Contract Sales Price
02. Personal Pro ert
402. ~ 72,000.00
Personal Pro ert
03. Settlement Char es to Borrower (Line 1400) 2,323.68 403.
04.
05. 404.
405
A rl m l n vn .
F
06.
Cit /Town Taxes to
4 r ~ v
06. Cit !Town Taxes to
07. Count Taxes 08/03/11 to 01/01/12 139
09
08.
School Tax 08/03/11 to 07/01/12 .
918
96 407. Count Taxes 08/03/11 to 01/01/12 139.09
09.
Sewer (JullAu /Set 08/03/11 to 10/01/11 .
88.50 408.
409 School Tax 08/03/11 to 07/01/12
Sewer (Jul/Au
/Se
t) 08/03/1 1 918.96
10. .
410. g
p
to 10/01/11 88.50
11. 411.
12. 412.
120. GROSS AMOUNT DUE FROM BORROWER 75
470
23
' ,
. 420. GROSS AMOUNT DUE TO SELLER 7
.00. AMOUNTS PAID BY OR IN BEHALF OF BORROWER:
500. REDUCTIONS IN AMOUNT DUE TO SELLER: 3,146.55
?01. De osit or earnest mone 1,000.00 501. Excess De osit See Instructions
?02. Princi al Amount of New Loans 502. Settlement Char es to Seller Line 1400
?03.
Existin loans taken sub ect to 1,517.87
503. Existin loans taken sub'ect t
X04 o
. 504 Payoff of first Mort
a
t
NCF
_05. . g
ge
o
CU 23,798.52
?O6. 505. Pa off of second Mort a e
?07. 506.
?08. 507. De osit dish. as roceeds
?09. 508.
Ad ustments For Items Un aid B S
ll 509.
?10. e
er
Cit /Town Taxes to Ad ustments For Items Un aid B Seller
?11.
Count Taxes to 510. Cit /Town Taxes to
?12.
School Tax to 511. Count Taxes io
?13 512. School Tax to
. 513.
?14"
514.
15
. 515.
16.
516.
? 17
. 517
218 .
. 518.
219. 519.
220, TOTAL PAID BY/FOR BORROWER 1,000.00 520. TOTAL REDUCTION AMOUNT DUE SELLE
300
CASH AT SETTLEMENT FROMJTO BORRO R
~
25,316.39
. WER: 600. CASH AT SETTLEMENT TO/FROM SELLER:
301. Gross Amount Due From Borrower (Line 120 ~ 75,470.23 601. Gross Amount Due To Seller (Line 420
~
302. Less Amount Paid B /For Borrower Line 220
Y ( )
( 1,000.00)
602. 73,146.55
Less Reductions Due Seller (Line 52D)
303
CASH (X FROM) (
TO) BORROWE ( 25,316.39
.
TL". ,
R
. 74,470.23 603. CASH (X TO) ( FRS1A~ SELLER I a~ azn ~a
,___. _
e e` cop o pages 2 of this statement & any a ch>m is referred erein.
Borrower ~ ~, Seller
G orge Ge ~ u~ ~ Est to of Wald F. W n r
BY:
Caro Kilko, Exe trix
HUD-1 (3-861 RESPA HFasns ~
Pane 2
L. SETTLEMENT CHARGES
00. TOTAL COMMISSION B2sed on Prlce (~ °
Division of Commission line 700 as Follows: PAID FROM
' PAID FROM
'01. $ to
BORROWER
S
SELLER'S
'02. $ to
'03. Commission Paid at Settlement
FUNDS A7
SETTLEMENT
FUNDS AT
SETTLEMENT
'04. to
t0 .ITEM PAYABL IN C NNECTI N WITH L AN
101. Loan Ori ination Fee % to
SD2. Loan Discount % to
503. Appraisal Fee to
504. Credit Report to
505. Lender's Inspection Fee to
506. Mort a e Ins. A .Fee to
507. Assumption Fee to
508.
509.
510.
511.
500. ITEM RE IRED BY LENDER T BE PAID IN ADVANCE
301. Interest From to @ $ /day ( days %)
)02. Mortgage Insurance Premium for months to
303. Hazard Insurance Premium for 1.0 ears to
;'04.
305.
1000. RESERVES DEPOSITED WITH LENDER
1001. Hazard Insurance months $ er month
1002. Mort a e Insurance months $ er month
1003. Cit /Town Taxes months $ er month
1004. Count Taxes months $ er month
1005. School Tax months @ $ per month
1006. months $ er month
1007. months @ $ per month
1008. A re ate Ad'ustment months $ er month
1100. TITLE CHARGES
1101. Settlement or Closin Fee to
1102. Abstract or Title Search to
1103. Tax Certification to Residential-Commercial Abstract, Inc.
1104. Title Insurance Binder to 10.00
1105. Deed Pre aration to Residential-Commercial Abstract, Inc.
1106. Nota Fees to R
sid
ti
l
C 150.00
e
en
a
-
ommercial Abstract, Inc.
1107. Attorney's Fees to 20.00
includes above item numbers:
1108. Title Insurance to Residential-Commercial Abstract Inc.
includes above item numbers.1102, 1103, 1104 & 1108 621.68
1109. Lender's Coverage $
1110. Owner's Coverage $ 72,000.00 621.68
1111.
1112. Residential-Commercial Abstract, Inc.
1113. Courier Fees to Residential-Commercial Abstract, Inc. 20.00
1200. GOVERNMENT REC RDIN AND TRAN FER CHAR ES
1201. Recording Fees: Deed $ 62.00; Mortgage $ Releases $
1202. Cit /Count Tax/Stam s: Deed 720
00• M
t 62.00
.
or
a e
1203
State Tax/Stam s: Revenue Stam s 72 720.00
.
0.00; Mort a e
1204. 720.00
1205.
1300. ADDITIONAL SETTLEMENT CHARGES
1301. Surve to
1302. Pest Ins ection to
1303. 2011 Count /Tw Taxes to Deborah A. Lu old, Treasurer
1304. 2011/12 School Taxes to Deborah A. Lu old, Treasurer
1305. Sewer (July/Aug/Sept) to East Pennsboro Township
1400. TOTAL SETTLEMENT CHARGES (Enter on Lines 103, Section J and 502, Section K)
Rv cin Winn nano 1 of fV,lc c4.~+e...~,..~ •4... .. ~......a.-. -:,... __~.__...i_~__ ____:_.
,323.68 369.84
1,010.03
138.00
1,517.87
~~•~••~ ~_~„ ~ ~~ •~~~~ ~~w.~.~i~~.~~b ui~- ~~y~iuwiico a~nnwvicuyC ICI.C INI UI a comple[ea copy of page 2 of this two page statement.
Certified to be a true copy.
Resic(~ntial-Commercial Abstract, Inc.
Settlement Agent
19102-075 ! 9 1 9 02-075 1 14 )
New Cumberland Federal Credit Union
Your Community Credit Union
P.O. Box 658, New Cumberland, PA ] 7070-0658
Phone: (7 ] 7) 774-7706 • 1-800-716-2328 • Fax: (717) 774-7996 • Web: www.ncfcuonline.org
June 21, 2011
Caldwell & Kearns
3631 North Front Street
Harrisburg, PA 17110-1533
Re: Donald F. Wagner, Deceased
SSN #195-32-1328
Date of Death: 3/21/11
Dear Ms. Feather,
Pursuant to your letter dated June 16, 201 1, in regards to Donald F. Wagner the
information is as follows:
Account Number:
Owner(s) on Account:
Date acct opened:
Date of Death Balances:
79402
Donald F. Wagner
08/20/2001
S1 (Savings) $ 5.00
S4 (Checking) $ 935.86
L8 (2"d Mortgage) $18,479.34
Credit Card $ 6,973.02
If you need anything additional, please let me know directly at 774-7706 x 216
Si~icerely
,~~~
f ~! 1
Barbra ~:' Wright
Branch Manager
Enclosures
MEMBERS 1St
FEDERAL CREDIT UNION
SAVINGS ACCOUNT:
Account Number/Suffix
Date Account Established
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest
Name of Joint Owner
CHECKING ACCOUNT:
Account Number/Suffix
Date Account Established
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest
Name of Joint Owner
LOAN ACCOUNT:
Account Number/Suffix
Loan Type
Date Loan Established
Principal Balance at Date of Death
Interest Rate
Co-Borrower
283563-00
04/18/2006
$461.03
$.06
$461.09
None
283563-11
06/25/2009
$155.48
$.00
$155.48
None
283563-02
Unsecured
06/25/2009
$5,530.97
13.49%
None
M ERS(1's~T FED'EQRA.L C DIT U . I
nielle A. Kline
Lending Insurance Support Specialist
June 17, 2011
Estate of: DONALD F. WAGNER
Date of Death: 03/21/2011
Social Security Number: 195-32-1328
5000 Louise Drive P.O. Box 40 Mechanicsburg, Pennsylvania 17055 800 283-2328
~ ~ wu'<vmemberslst.org
CALDWELL &KEARNS
JAMES R. CLIPPINGER
JAMES L. GOLDSMITH A PROFESSIONAL CORPORATION
JEFFREY T. MCGUIRE*
STANLEY J.A. LASKOWSKI ATTORNEYS AT LAW
Doucus K. MARSICO
BRETT M. WOODBURN
MICHAEL D. REED
MICHAEL A. FARRELL 3631 NORTH FRONT STREET
THOMAS M. FRATICELLI
GREGORY D. GEI55 HARRISBURG, PENNSYLVANIA 17110-1533
THOMAS 5. LEE
ELIZABETH H. FEATHER 717-232-7661
KAREN W. MILLER FAX: 717-232-2766
DOUGLAS M. OBERHOLSER
DAVID J. EVENNUIS
THEFIRM@CKLEGAL.NET
*BOARD CERTIFIED CIVIL TRIAL ADVOCATE
December 28, 2011
Glenda Farner Strasbaugh, Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013-3387
RE: Estate of Donald F. Wagner
Cumberland County No. 21-11-401
Dear Ms. Farner-Strasbaugh:
OF COUNSEL
JAMES D. CAMPBELL, JR.
CHARLES J. DENARY. III
THOMAS D. CALDWELL, JR.
(1928-2001)
CARL G. WASS
(1937-2010)
RICHARD L. KEARNS
RETIRED
Enclosed please find a check payable to your office in the amount of $90.00 along with a
copy of your December 22, 2011 correspondence in regard to this fee. This fee represents
payment of the Inheritance Tax Return filing fee and the additional probate fee of $765.00.
I have also enclosed the original and one copy of the Pennsylvania Inheritance Tax
Return. Please file the same. Additionally, please time-stamp the enclosed copy of the front
page of the front page of the Inheritance Tax Return and return it to me in the enclosed self-
addressed, stamped envelope.
Thank you for your assistance with this matter. If you have any questions, please contact
me.
Very truly yours,
rr N
/ ~~~~
Eliz eth H. Feather
Caldwell & Kearns, P.C.
efeather@cklegal.net
EHF/se
Encs.
11101-1-185441
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