The URL can be used to link to this page

Home My WebLink About01-28-13J EX (01-10) REV-7 5OO 1505610143 PA De artment of Revenue ~ OFFICIAL USE ONLY p pennsylvania County Code Year Bureau of Individual Taxes DEPARTMENT OF REVENUE PO 80X.280601 INHERITANCE TAX RETURN 2 1 12 Harrisburg, PA 17128-0601 RESIDENT DECEDENT File Number 00354 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Decedent's Last Name Suffix WHITE (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's Social Security Number Date of Birth 02 09 1925 Decedent's First Name MI RUTH B Spouse's First Name MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ® 1. Original Return ^ 2. Supplemental Return ^ 3. Remainder Return (date of death prior to 12-13-82) ^ 4. Limited Estate ^ 4a. Future Interest Compromise (date of death after 12-12-82) ^ 5. Federal Estate Tax Return Required ® g Decedent Died Testate (Attach Copy of Will) ^ ~ Decedent Maintained a Living Trust (Attach Copy of Trust) ~ 8. Total Number of Safe Deposit Boxes ^ 9. Litigation Proceeds Received ^ 10. Spousal Foverty Credit (date of death between 12-31-91 and 1-1-95) ^ ~ 1 • Election to tax under Sec. 9113(A) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number KEITH J STROUSE 570 875 3740 First line of address 816 CENTER STREET Second line of address City or Post Office ASHLAND State ZIP Code PA 17921 Correspondent's a-mail address: kS t rO U S e tCu1 S t rO l1 S e l a W. C O nl Under pe Itie 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, orre and omple eclaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATU E OF ER N LE F FILING RETURN DATE ,~ Jeffrey R. White ~ -- ~ `~ -~ 3 ADDRESS 4054 aissons Court nola, PA 17025 SIGNATURE OF P RESENTATIVE DATE -~' % t Keith J Strouse G /~---? ADDRESS' ~% 816 (Center Street, Ashland, PA 17921 Side 1 RE~ISTER OF W~t;S U; 0,~,~ Y -~ ~ 5°~'1 a°°°,r r-v1 ~~ ~P,} . .. ... ~ f .. .. --.J .; DATEffLED LL .. .~ `.' : ~ .e`a ~.:~ ~~:.~ ~ ~ 1505610143. 1505610143 J REV-1500 EX Decedent's Name: WHITE , RUTH B . Decedent's Social Security Number RECAPITULATION 1. Real Estate (Schedule A) .......................................................................................... 1. 115,550.00 2. Stocks and Bonds (Schedule B) ............................................................................... 2. 2 5 5, 9 9 0 0 3 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C).......... 3. 4. Mortgages & Notes Receivable (Schedule D) .......................................................... 4. 5~ Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ................ 5. 1 4 3 , 4 7 0 6 0 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ............. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ^ Separate Billing Requested ............. 7, 9 0, 7 9 8 0 1 g. Total Gross Assets (total Lines 1-7) ....................................................................... g. 6 0 5, 8 0 8 0 4 9. Funeral Expenses & Administrative Costs (Schedule H) ......................................... 9. 3 5, 5 7 2 9 8 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10. 3 , 7 0 7 2 4 11. Total Deductions (total Lines 9& 10) ...................................................................... 11. 3 9, 2 8 0 2 2 12. Net Value of Estate (Line 8 minus Line 11) ............................................................. 12. 5 6 6 , 5 2 8 4 2 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. 5 6 6 , 5 2 8 4 2 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 at lineal rate X .045 5 6 6, 5 2 8 4 2 16. 17. Amount of Line 14 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable at collateral rate X .15 18. 19. Tax Due ................................................................................................................... .. 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 1505610243 25,493.78 25,493.78 Side 2 1505610243 1505610243 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 - 12 - 00354 DECEDENT'S NAME White, Ruth B . ___ _ _ __ __ ___ __ STREET ADDRESS 2100 Wentworth Drive CITY Cam Hill P STATE ^ PA ZIP 17011 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) 25,493.78 2. Credits/Payments A. Prior Payments 2 5, 6 0 0.0 0 B. Discount 1,274.69 Total Credits (A + B) (2) 2 6 , 8 7 4.6 9 3. Interest (3) 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) 1 , 3 8 0.91 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. (5) Make Check Payable to: REGISTER OF WILLS, AGENT. .r., y'- 'X - '.,.~~C,;.~wca:,,........x, - ~ ~ ~.~4 ~w.:i'~'t..,.~ sf~•' ,~-~:~ ,._+t_x'.~.. .... ~ ,~... .. F_ ,.. ......., ..,... .. ,~,~,,;.i:a ~... .. .~,.. rr ~n•~~:. ~ .,- .,... _ .~ ~., '~a :. 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 :.................................................................................. ^ u b. retain the right to designate who shall use the property transferred or its income :.................................... ^ c. retain a reversionary interest; or .................................................................................................................. x d. receive the romise for life of either payments, benefits or care? .............................................................. [~ Ox p - 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................................................... ^ 0 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... ^ 0 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. - - -- - .. _..,.~, ------- ------------ --r---~----~ ~ ____,-~----~T- -- -_----~ - _ For dates of death on or after July 1, 1994 and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0 percent [72 P.S. §9116 (a) (1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1 )]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116 (a) (1.3)1. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, w ether by blood or adoption. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE FILE NUMBER ESTATE OF White, Ruth B. 21 - 12 - 00354 All real property owned sole)y 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 wilting seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on schedule F. Attach a copy of the settlement sheet if the property has been sold. Include a copy of the deed showing decedent's interest if owned as tenant in common. ITEM NUMBER DESCRIPTION ALL THAT CERTAIN LOT or piece of ground with the buildings and improvements thereon erected, situate in the Township of Lower Allen, County of Cumberland, and Commonwealth of Pennsylvania, bounded and described according to a Plan of Highland Estates Addition No. 2 made for Francis B.J. Branagan by D.P. Raffensperger, Registered Surveyor, Lemoyne, Pennsylvania, dated December 5, 1952, and recorded in the Recorder of Deeds Office at Carlisle, Pennsylvania in Plan Book No. 5, page 51, as follows: Beginning at a point on the north side of Wentworth Drive fifty (50) feet wide, said point being twenty four and seventy eight hundredths (24.78) feet west of intersection of the west side of Twenty First Street fifty (50) feet wide and the north side of Wentworth Drive (if both lines were extended to intersect), thence along the north side of said Wentworth Drive southwest a distance of sixty five and twenty two hundredths (65.22) feet to a point at Lct Nc. 27, thence along the line of said Lot No. 27, northwest at right angles to Wentworth Drive a distance of ninety and seventy nine hundredths (90.79) feet to a point at Lot No. 38, thence along the line of said Lot No. 38 northeast at right angles to Twenty First Street a distance of ninety and seventy nine hundredths (90.79) feet to a point on the west side of Twenty First Street, thence along the west side of said Twenty First Street southeast a distance of sixty five and twenty two hundredths (65.22) feet to a point at a curve, thence by a curve to the right having a radius of twenty five (25) feet a distance of thirty nine and twenty three hundredths (39.23) feet to a point, the place of beginning. BEING Lot No. 26 Highland Estates Addition No. 2 known as Premises No. 2100 Wentworth Drive. UNDER AND SUBJECT to certain covenants, restrictions, agreements, etc., of record. BEING FURTHER IDENTIFIED as UPI No. 13-23-0549-207 in the Tax Assessment Office of Cumberland County. Value based upon actual sales price, per attached settlement statement VALUE AT DATE OF DEATH 115,550.00 TOTAL (Also enter on Line 1, Recapitulation) ~ 115,550.00 ~~,~II~III•' A. Settlement Statement (HUD-1) s•IIIIlIII~' ....a R Tvne of I_nan OMB Approval No. 2502-0265 1. u FHA 2. ~ RHS 3. ^X CONV. UNINS. 6. File Number: 7. Loan Number: 8. Mortgage Insurance Case Number: I N ~ ~ CEN154-507 6800640311 CoNV. I S. a. vA 5. C. Note: This form is furnished to give you a statement of a ctual settlement costs. Amounts paid to and by the settlemen t agent are shown. Items marked "(p.o.c.)" were paid outside the closing; they are shown here for informational p urposes and are not included in the totals. D. Name b Address of Borrower. E. Name b Address of Seller. F. Name E Address of Lender: Susan M. Schoen, single woman Jeffrey R. White, Executor of the Estate of Members 1st F.C.U. Ruth B. White, deceased 5000 Louise Drive Mechanicsburg, Pennsylvania 17055 G. Property Location: H. Settlement Agent: I. Settlement Date: 2100 Wentworth Drive T.A. of Central PA, LLC December 6, 2012 Camp Hill, Pennsylvania 17011 530 North Lockwillow Avenue Lot 26, Highland Estates Addition 2, Book 5, Harrisburg, Pennsylvania 17112 .Page 51, Cumberland County, Pennsylvania 717-724-3724 fax: 866-858-2780 Place of Settlement: T.A. of Central PA, LLC 530 North Lockwillow Avenue Harrisburg, Pennsylvania 17112 Phone: (717) 724-3724 J. Summary of Borrower's Transaction K. Summary of Seller's Transaction 100. Gross Amount Due From Borrower: 400. Gross Amount Due To Seller: 101. Contract Sales Price 115,550.00 401. Contract Sales Price 115,550.00 102. Personal Pro a 402. Personal Pro e 103. Settlement Cha es to Borrower line 1400 5,411.59 403. Ad'ustments for Items Paid b Seller in Advance: Ad'ustments for Items Paid b Seller in Advance: 106. 2012 County /Township Taxes Dec 7, 2012 thru Dec 31, 2012 33.68 406. 2012 County /Township Taxes Dec 7, 2012 thru Dec 31, 2012 33.68 107. Coun /Parish Taxes 407. Coun !Parish Taxes 108. Assessments 408. Assessments 109 2012-13 School Taxes Dec 7, 2012 thru Jun 30, 2013 557.55 409. 2012-13 School Taxes Dec 7, 2012 thru Jun 30, 2013 557.55 110 Sewer aTrash - 4th qtr Dec 7, 2012 thru Dec 31 „ 2012 29.61 410. Sewer ~ Trash - 4th Gtr Dec 7, 2012 th; u Dec 31, 2012 29 61 , 120. Gross Amount Due from Borrower: 121,582.43 420. Gross Amount Due to Seller: 116,170.84 200. Amounts Paid b or in Behalf of Borrower: 500. Reductions in Amount Due to Seller: 201. De osit or Earnest Mone 2,000.00 501. Excess De osit see instructions 202. Princi al Amount of New Loan 92,440.00 502. Settlement Char es to Seller Line 1400 8,934.35 203. Existin Loans taken sub'ect to 503. Existin Loans taken sub'ect to 204. Seller Assist 3,400.00 504. Pa off of First Mort a e Loan N/A 205. Credit for amount aid 425.00 505. Pa off of Second Mort a e Loan 206. 506. Purchase Mone Mort a e 207, 507. Seller Assist 3,400.00 Ad'ustments for Items Un aid b Seller: Ad'ustments for Items Un aid b Seller: 210. Ci /Town Taxes 510. Ci /Town Taxes 211. Coun !Parish Taxes 511. Coun /Parish Taxes 212. Assessments 512. Assessments 220. Total Paid b /for Borrower: 98,265.00 520. Total Reductions in Amount Due Seller: 12,334.35 300. Cash at Settlement from / to Borrower: 600. Cash at Settlement to !from Seller: 301. Gross Amount due from Borrower line 120 121,582.43 601. Gross Amount due to Seller line 420 116,170.84 302. Less Amount Paid b /for Borrower line 220 98,265.00 602. Less Reductions Amount due Seller line 520 12,334.35 303. Cash From Borrower: $23,317.43 603. Cash To Seller: $103,836.49 The Public Reporting Burden for this collection of information is estimated at 35 minutes per response for collecting, reviewing; and reporting the data. This agency may not collect this information, and you are not required to complete this form, unless it displays a currently valid OMB control number. No confidentiality is assured; this disclosure is mandatory. This is designed to provide the parties to a RESPA covered transaction with information during the settlement process. I have carefully reviewed the HUD-1 Settlement Statement, and to the best of my kn wle a and belief, it is a true and accurate statement of all receipts and disbursements made on my account or by me in this transaction. 1 furt er ce i ceiv a copy of HUD-1 Settlement Statement. Borrower: rf~ ~- Seller: san M. Schoen hite, xecutor of the Estate of Ruth B. White, eceased The HUD-1 Settlement Statement which I have prepared is a true and accurate account of this transaction. I have caused or will cause the funds to be disbursed in accordance with the instructions of the parties hereto. FA I ~} Settlement Agent: ~ t I i;l ~ ~~ ° i~ Date: December 6, 2012 Abby ndel WARNING: It is a crime to knowingly make false statements to the United States on this or any other similar form. Penalties upon conviction can include a fine and imprisonment. For details see Title 18 U.S. Code Section 1001 and Section 1010. Previous editions are obsolete Page 1 of 3 HUD-1 • December 3, 2012 12:30 PM File Number: CEN154-507 Settlement Date: December 6, 2012 Loan Number: 6800640311 FA L. Settlement Charges Paid from Paid from 700. Total Sales /Broker's Commission: $6,729.00 Division of Commission line 700 as follows Borrower's Funds at Seller's Funds at 701. 3,364.50 to Coldwell Banker Homestead Grou Select Professionals Settlement Settlement 702. 3,364.50 to Keller Williams of Central PA East 703. Commission Paid at Settlement 6,729.00 704. Additional Commissions to Coldwell Banker Homestead Grou Select Professionals 300.00 705. Additional Commissions to Keller Williams of Central PA East 544.00 800. Items Pa able in Connection with Loan: 801. Our origination charge (from GFE #1) $455.00 802. Your credit or charge (points) for the specific interest rate chosen (from GFE #2) $0.00 803. Your ad'usted on ination char es from GFE #A 455.00 804. Appraisal Fee (from GFE #3) to Members 1st Federal Credit Union 425.00 805. Credit Re ort 806. Tax Service 807. Flood Certification 900. Items Re uired b Lender to be Paid in Advance: 901. Daily interest charge from Dec 6, 2012 to Jan 1, 2013 @ 8.5475 /day. for 26 days (from GFE #10) to Members 1st Federal Credit Union 222.24 902. Mort a e Insurance Premium from GFE #3 903. Homeowner's Insurance (from GFE #11) to State Farm Insurance 448.00 1000. Reserves De osited with Lender: 1001. Initial deposit for your escrow account (from GFE #9) to Members 1st Federal Credit Union 678.85 1002. Homeowner's Insurance 3 months @ $37.33 per month to Members 1st Federal Credit Union $111.99 1003. Mort a e Insurance 1004. Property Taxes 11 months @ $41.09 per month to Members 1st Federal Credit Union $451.99 1005. School Taxes 7 months $82.55 er month $577.85 1099. A re ate Ad'ustment $-462.98 1100. Title Char es: 1101. Title services and lender's title insurance from GFE #4 1,206.50 1102. Settlement or Closin Fee $ 1103. Owner's Title Insurance (First American Title Insurance Company) (from GFE #5) to T.A. of Central PA, LLC Risk Rate Premium: $980.00 118.50 1104. Lender's Title Insurance (First American Title Insurance Company) to T.A. of Central PA, LLC - Ls.^.der's Premium $861.50 - Alta Endorsement 8.1 (PA 900) $50.00 - PA 100, 300 Endorsements PAShort Form loan olic $100.00 1105. Lender's Title Polic Limit $92,440.00 1106. Owner's Title Polic Limit $115,550.00 1107. A ent's Portion of the Total Title Insurance Premium $960.50 1108. Underwriter's Portion of the Total Title Insurance Premium $169.50 1109. Tax Cert Reimbursement to T.A. of Central PA, LLC 10.00 1110. Deed Pre aration Fee n/a Estate Atrorne re ared 1111. Notary Fee to Abb F. Wendel 20.00 1200. Government Recordin and Transfer Char es: 1201. Government Recordin Char es from GFE #7 158.00 1202. Deed $62.00 Mort a e $96.00 Releases $0.00 1203. Transfer Taxes from GFE #8 1,155.50 1204. Ci /Coun tax/starn s Deed $1,155.50 Mo a e $0.00 1205. State taxJstam s Deed $1,155.50 Mort a e $0.00 1,155.50 1206. Other Tax 1 1207. Other Tax 2 1300. Additional Settlement Char es: 1301. Re uired services that ou can sho for from GFE #6 1302. Surve 1303. Pest Ins ection 1304. Home Warranty to American Home Shield 600.00 1305. 2012 County/Township Taxes to Bonnie K. Miller Tax Collector oc $493.11 b Seller 1306. 2012-13 School Taxes to Bonnie K. Miller Tax Collector oc $990.59 b Seller 1307. Sewer & Trash -4th qtr to Lower Allen Townshi 119.85 1400. Total Settlement Charges (Enter on line 103, Section J and line 502, Section K) $5,411.59 $8,934.35 Borrower Initials: ~n'1 U~usan M. Schoen / Jeffrey R. White, Executor Seller Initials: ~ of the Estate of Ruth B. White, deceased Previous editions are obsolete Page 2 of 3 HUD-1 December 3, 2012 12:30 PM COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS FILE NUMBER ESTATE OF White, Ruth B. 21 - 12 - 00354 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM j NUMBER DESCRIPTION UNIT VALUE ~ VALUE AT DATE OF ~, DEATH 1 $1,000 HH Savings Bond No. M5199943HH 1,000.00 2 i $1,000 HH Savings Bond No. M5199944HH I ~ 1,000.00 3 ~ $1,000 HH Savin s Bond No. M5199942HH g 1,000.00 4 $500 HH Savings Bond No. D3687588HH i I 500.00 i 5 i $500 HH Savings Bond No. D3687587HH ! Ii 500.00 6 24 shares Alcatel-Lucent SA (ALU) j 2.39 ; 57.36 7 ~ 569 shares AT&T, Inc. (T) 31.02 ~ 17,650.38 ' 8 360 shares BP Plc (BP) ! 47.02 j 16,927.20 9 72 shares Corncast Corporation (CMCSA) 29.57 2,129.04 27 399 60 10 354 shares ConocoPhillips (COP) , . 77.40 11 760 shares Exxon Mobil Corporation (XOM) I 85.05 ~ 64,638.00 12 ' 36 shares Frontier Communications Corporation (FTR) 4.38 I~ 157.68 13 228 shares JP Morgan Chase Co. (JPM) 40.49 ~ 9,231.72 14 6 shares LSI Corporation (LSI) 8.40 i 50.40 ~~ 15 70 shares MetLlfe, Inc. (MET) 38.14 ; 2,669.80 16 10 shares NCR Corp. (NCR) 21.04 i, 210.40 TOTAL (Also enter on line 2, Recapitulation) ~ 255,990.03 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS continued FILE NUMBER ESTATE OF White, Ruth B. 21 - 12 - 00354 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM DESCRIPTION UNIT VALUE ~ VALUE AT DATE OF NUMBER i % DEATH 17 100 shares Principal Financial Group, Inc. (PFG) 26.67 2,667.00 18 ~ 4,613 shares Susquehanna Bancshares, Inc. (SUSQ) 9.03 41,655.39 19 10 shares Teradate Corporation (TDC) 66.10. 661.00 I 20 ~ 152 shares Verizon Communications, Inc. (VZ) ~ I 39.29 I 5,972.08 21 1,273.501 shares Invesco Van Kampen Equity and Income C (ACERX) ~ 8.68 ~ 11,053.99 22. ~ 1,992.618 shares Ivy Asset Strategy C (WASCX) , 24.52 i ~ ~ 48,858.99 Page 2 of Schedule B ~ SCHEDULE E ~ CASH, BANK DEPOSITS, & MISC. COMMONWEALTH OF PENNSYLVANIA PERSONAL PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ESTATE OF White, Ruth B. 21 - 12 - 00354 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 DESCRIPTION VALUE AT DATE OF NUMBER DEATH 1 M&T Bank Money Market Account No. 15004222294081 41,961.51 Accrued interest to date of death on above account 0.06 2 M&T Bank Checking Account No. 90156277 (less uncleared outstanding check) 8,426.52 Accrued interest to date of death on above account 0.07 3 MorganStanley/SmithBarney Money Market Account No. 410-058959-003 4,934.86 MorganStanley/SmithBarney Money Market Account No. 410-058959-003, account transfer 0.47 credit 4 PSECU Savings Account No. S1 2,057.67 Accrued interest to date of death on above account 0.10 5 PSECU Money Market Account No. S7 52,907.28 Accrued interest to date of death on above account 3.48 6 PSECU CD Account No. 50 7,875.13 Accrued interest to date of death on above account 2.40 7 PSECU CD Account No. 51 7,875.14 Accrued interest to date of death on above acocunt 2.40 8 Phoenix Concierge Account No. 413-0220943 10,843.16 TOTAL (Also enter on Line 5, Recapitulation) I 143,470.6D SCHEDULE E CASH, BANK DEPOSITS, & MISC. COMMONWEALTH OF PENNSYLVANIA PERSONAL PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT continued FILE NUMBER ESTATE OF Whlte, Ruth B. 21 - 12 - 00354 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 I ~ VALUE AT DATE OF NUMBER ~ DESCRIPTION DEATH 9 Bank of America Checking Account No. 001729743371 378.11 I 10 Verizon, telephone service credit 1.85 22.65 11 ~ Discover Credit Card, overpayment of credit card '~ 12 ~ US Treasury, 2011 income tax refund 18.00 13 PA Department of Revenue, 2011 property tax rebate 250.00 i 14 '~ Commonwealth of PA, prorata share of March 2012 pension payment i 100.90 '~ 15 'Susan M. Schoen, prorata share of real estate taxes on Schedule A real estate, per attached 591.23 settlement statement i 16 '~! 2000 Buick LeSabre, 54,000 miles, fair condition, per attached Kelley Blue Book 4,119.00 I 17 ~ Lower Allen Township, prorata share of sewer and trash on Schedule A real estate, per 29.61 attached settlement statement 18 ~ PA State Employees, pension payment ~ 1,069.00 i i Page 2 of Schedule E 2000 Buick LeSabre Custom Sedan 4D "trade In Values -Kelley t31u... http:;/tivww.hbb.cam/buiclu-esaere!~uuu-rJU~cx-lesa~reicuswui-5eua... ® ~~ ZIP CODE: 17931 I Sign in (or Sign up) home ~ car values ~ cars for sale ~ car reviews ~ kbb top picks f research tools Popular at KBB.com 10 Most Comfortable Cars... advertkement .,fiy ads? Home > Car Values > Buick > LeSabre > 200G > Sty;e > Options > Custom Sedan 4D .Buick LeSabre 2000 go Trade-In/Sell Values Show Used Car Prices !- 200 Bu1C~C LeSabre ., ~,. , . --~. __ _ Style: Custom Sedan 4D edit options ~ change style Mileage: 54000 change Like 1 car Trade-In Value Private Party Value ~1 when trading in at a dealership when selling the car yourself Orr Print Report Excellent _ ___ _ __ _ _ __ $5,069 Shop for your next car price a new car Very Good $4,794 advertisement Instant Trade-In Offer i get the offer Good ~ ~ $4,694 Fair Get alerts when follow this car $4,119 values change Verify Condition VALUES FOR APR 19 2012 -APR 26 2012 (updated weekly) Helpful resources from kbb.com Write a Review Check Specs Get Advice Own it? Love it? 7eil u_s. Krn~,^r your car inside Read 10 steps to sell. ar,d uut. Used Cars for Sale Get a Used Car Report near Frackville 2000 6uick LeSabre Get the Information You Need on This 2000 Buick Before You Buy for Sale Near You ,viz,; ~ Enter VIN (optional) gc~ p Below Blue Book Value* •~~i~;; / P;o V1N? Ne Protlem! buy an 11NL1ti111ED report today and run V1Ns as you research. 'Based on the Suggested Retai Va'ue &ceknt condtpn and the base vehkle confguration / h l . ( ee AutoC advertisemeK adve rtsem ent ~+~hy ads? ti~ry ads% vhrv ad,~ I of 4 04/20/ 12 4:02 I'M < < COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF White, Ruth B. SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER 21 - 12 - 00354 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes. -- ITEM NUMBER ~ j DESCRIPTION OF PROPERTY Include the name of the transferee, their relationship to decedent and the date of transfer. Attach a copy of the deed for real estate. DATE OF DEATH VALUE OF ASSET % OF INDTERDEST ~- ;. ExcLUSION ' TAXABLE VALUE (IF APPLICABLE) I; -ll 1 ~ Allstate Variable Annuity Policy No. 087875; Jeffrey ~ 25,951.76 I 25,951.76 ~ R. White and Owen Scott White, children of decedent are beneficiaries 2 ~ Allstate Variable Annuity Policy No. 143688; Jeffrey 36,208.74 36,208.74 R. White and Owen Scott White, children of decedent ~ ~ j are beneficiaries '~ 3 ~ Hartford Variable Annuity Policy No. 710368324; 2s,637.51 i , 28,637.51 Jeffrey R. White and Owen Scott White, children of ~ i decedent are beneficiaries i i ~ ~ ~ ~ ~ i i I !~ ~ 1 '', ~ i i ~ ~ ~~ 90,798.01 TOTAL (Also enter on line 7, Recapitulation) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL D~ENSES & ADIVMNSTRA7IVE COSI~ FILE NUMBER ESTATE OF White, Ruth B. 21 - 12 - 00354 Debts of decedent must be reported on Schedule I. ITEM ~ AMOUNT NUMBER ~ DESCRIPTION FUNERAL EXPENSES: A. 1 Neill Funeral Home, funeral i 3,933.05 i ~ 2 Holiday Inn, funeral meal 1,134.00 B 1 ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Street Address 2. 3. City State Zip Year(s) Commission paid j Attorney's Fees Strouse and Strouse Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) ~ Claimant I 4 5 6 7 1 Street Address ~ City State Zip Relationship of Claimant to Decedent ~ Probate Fees Glenda Farner Strasbaugh, Register of Wills, estimated Accountant's Fees Tax Return Preparer's Fees Other Administrative Costs Susan M. Schoen, seller assist on Schedule A real estate, per attached settlement statement 10,000.00 700.00 3,400.00 TOTAL (Also enter on line 9, Recapitulation) 35,572.98 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Schedule H Funeral E~cpenses & Administrafiv~e Costs continued ESTATE OF White, Ruth B. FILE NUMBER 21 - 12 - 00354 2 Coldwell Banker Homestead Group Select Professionals, realtor's commission on Schedule A real estate, per attached settlement statement 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 Keller Williams of Central PA East, broker's commission on Schedule A real estate, per attached settlement statement TA of Central PA, LLC, tax receipts for Schedule A real estate, per attached settlement statement i Abby F. Wendel, notary fees for Schedule A real estate, per attached settlement j statement i Recorder of Deeds, 1 % realty transfer tax on Schedule A real estate, per attached ~ settlement statement i American Home Shield, home warranty on Schedule A real estate, per attached ~ settlement statement Lower Allen Township, final sewer and water on Schedule A real estate, per attached settlement statement i Tucker/Arensberg, attorney fee for probate work d new car etin cleanin walls and floors I~, Jim Wellington, removal of carpet an p g, g , painting outside trim walls and power wash outside on Schedule A real estate j W.S. Carey Electric Contractor, electrical work on Schedule A real estate i MorganStanley/SmithBarney, account fee ~I Bonnie K. Miller, Tax Collector, 2012/2013 School real estate taxes 'I Erie Insurance, homeowner's insurance premium ; ; Ashland Post Office, extraordinary postage and certified mailing I ProSeries Income Tax Program, fees to file 2011 federal and state income tax returns i Cumberland County Law Journal, estate advertisement 6,729.00 300.00 10.00 20.00 1,155.50 600.00 119.85 1,fi00.50 2,450.00 991.00 150.00 990.59 311.00 14.70 57.00 75.00 Page 2 of Schedule H COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Schedule H Funeral Expenses & Adrrr>inistrativveCosucontinued FILE NUMBER ESTATE OF White, Ruth B. 21 - 12 - 00354 18 The Sentinal Newspaper, estate advertisement ~ 221.40 19 PP&L, electric service to Schedule A real estate ~~ 16.30 20 , UGI, gas service to Schedule A real estate 30.00 21 Lower Allen Township, sewer rent to Schedule A real estate 110.00 22 Lower Allen Township, garbage rent to Schedule A real estate j 107.90 23 PAWC, water rent to Schedule A real estate ' 236.19 , 24 ; I ProSeries, filing fee for 2012 individual income tax returns 1' 45.00 ~ 25 ; ProSeries, filing fee for 2012 estate income tax returns ~ 65.00 Page 3 of Schedule H '~ ~ SCHEDULE I DEBTS OF DECEDENT, MORTGAGE COMMONWEALTH OF PENNSYLVANIA LIABILITIES, & LIENS INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ESTATE OF White, Ruth B. 21 - 12 - 00354 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM DESCRIPTION AMOUNT NUMBER __ 1 Spartan Pharmacy, outstanding balance on medicine not covered by insurance 76.74 2 ~ Sarah A. Todd Memorial Home, personal home care not covered by insurance I 1,752.91 3 ~ West Shore EMS - ALS, care for decedent not covered by insurance I 1,014.14 4 Millennium Pharmacy Systems, Inc., prescription drugs not covered by insurance 14.85 5 Holy Spirit Hospital, care for decedent not covered by insurance 188.44 6 Central Medical Equipment, wheelchair rental not covered by insurance 29.00 7 Bonnie K. Miller, Tax Collector, 2012 County/Township real estate taxes 502.91 8 ~ Jim Wellington, cleaning service bill I 80.00 9 UGI, gas service 20.00 10 PAWC, water rent 28.25 TOTAL (Also enter on Line 10, Recapitulation) I 3,707.24 REV-1513 EX+ (11-08) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER White, Ruth B. 21 - 12 - 00354 ~ RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) ' DECEDENT (Words) ($$$) RECEIVING PROPERTY Do Not List Trustee(s) I I. ~ TAXABLE DISTRIBUTIONS [include outright spousal i distributions, and transfers ~ under Sec. 9116 (a) (1.2)J 1 Jeffrey R. White ;Son 1/2 of Entire Estate 4054 Caissons Court Enola, PA 17025 2 Owen Scott White Son 1/2 of Entire Estate 405 Poplar Ridge Road Simpsonville, SC 29681 i~ i, i I i i ~I ~~ i Enter dollar amounts for distributions shown above on lines 15 through 18 on 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 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 ACRNOWLEDC~MENT Commonwealth of Pennsylvania SS County of Schuylkill I, Ruth B. White, Testatrix, whose name is signed to the attached or foregoing instrument, having been duly quailiieu according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; and that I signed it willingly as my free and voluntary act for the purposes therein expressed. Sworn to or affirmed and acknowledged before me by Ruth B . 4rhite, the testatrix, this ; ~~ day of /'}';.~i ~~t 2010. ,~ ''~ /~ ~ . ~t-r- (_ ._ Testatrix COMPJIONWEALTt-i {:~~ PEi\;iVSYLVANlA Notarial Seal Eric C.1V'innich, Notary Pu51ic Lower Allen 7wp., Cumberland Count, My Commission Expires Dec. 2, 2010 Member. Pennsylvania AsscCialicn of Notaries AFFIDAVIT Commonwealth of Pennsylvania County of Schuylkill SS ' the ' and ~ i :, ~ - ~ ~~ ~'` > ~ ` ~S witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw testatrix sign and execute the instrument as her Last Will; that the testatrix signed willingly and executed it as her free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the testatrix signed the Will as a witness; and that to the best of our knowledge the testatrix was at that time eighteen (18) or more years of age, of sound mind and under no constraint or undue influence. Sworn to or affirmed and subscribed to, before me by and /~i-~ 1,! ~ '~~,~ ~~ ~, witnesses , this / ~t day of ~"~;~,~~~~~ 2010. ~ ---. l f. ;~ ~ , i~ ~~ ' ;~ l ;% ~~ ~ f' . . Witness • ,, ~_-. ~" Witness CO~~f~,~UtaWEAL i ~-; OF PETJNSYLVANIk !' tJotarial Seal I Eric C. Minnick, Notary Public Lower Allen T•~up., Cumberland County My Cornrniseien Expires Dec. 2, 2010 i t'~1'~1??Sier. PrltrlSVE'Vtlfll~'1 ~'•,ss~~ecation of Notaries I, Ruth B. White, of the Borough of Camp Hill, County of Cumberland, and State of 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. 1. I direct that all my just debts and funeral expenses be fully paid and satisfied by my hereinafter named Executor as soon as conveniently may be after my decease. 2. I give, devise and bequeath all my stocks, bonds and other securities, and bank accounts, and I give and devise all my real estate unto my beloved husband, Roland O. White. Should my husband, Roland O. White, predecease me or die at the same time as I, then I give and bequeath all my stocks, bonds and other securities, and bank accounts, and I give and devise all my real estate unto my two sons, Jeffrey R. White and Owen Scott White, share and share alike. 3. All the rest, residue and remainder of my estate, real, personal and mixed, I give, devise and bequeath unto my beloved husband, Roland O. White. Should my husband, Roland O. white, predecease me or die at the same time as I, then all the rest, residue and remainder of my estate, real, personal and mixed, 1 give, devise and bequeath unto my two sons, Jeffery R. White and Owen Scott White, share and share alike. 4. I name, constitute and appoint my husband, Roland O. White, as Executor of this, my Last Will and Testament. Should he for any reason be unable or unwilling to act, then I name, constitute and appoint my son, Jeffery R. White, as Executor. Should he for any reason be unable or unwilling to act, then I name, constitute and appoint my son, Owen Scott White, as Executor. 5. I direct that no fiduciary acting hereunder shall be required to give any bond or enter any security in any jurisdiction in which such fiduciary may act. In witness whereof, I, Ruth B. White, the Testatrix, have to this, my Will, written on two (2) sheets of paper, set my hand and seal this i J ~ day of ~~ !~~' ~. L'( 2010. Signed, sealed, published and declared by the above named Testatrix as and for her Last Will and Testament, in the presence of us, who have hereunto subscribed our names at her request as wit- nesses thereto, in the pres- ence of the said Testatrix and of e h t e~`. ~, /i~ / ,~ -~ ;r Witness ~. ,._ witness ( SEAL ) _ ,_,~_. Testatrix 2 STROUSE AND STROUSE ATTORNEYS AT LAW 816 CENTER STREET ASHLAND, PA 17921 HARRY STROUSE (1912-2008) KEITH J. STROUSE TELEPHONE: 570-875-3740 FAX: 570-875-1424 January 24, 2013 Ms. Glenda Farner Strasbaugh Register of Wills Cumberland County Courthouse 1 Courthouse Square Room 102 Carlisle, PA 17013-3387 RE: Estate of Ruth B. White, Deceased Cumberland County File No.: 2012-00354 Dear Ms. Strasbaugh: Enclosed please find the following: Email:kstrouse@strouselaw.com W-~ A .._, f..:..~ ~~ ~. ,y.~ .. , ~``~' `~ ~ ~ ~ ~ ~ ~ °` ~=° c~'a ' ~TM::w rn " ~--, __ ~ :~ t' ~ ~ E.~w Cx~ .. ~ ~. _ . _.> ~. 1. Three (3) copies of an inheritance tax return. Please note there is no tax due. We are requesting a refund of overpayment. Please file two (2) copies of the return and time stamp one (1) copy and return to me in the self-addressed stamped envelope. 2. Three (3) copies of an estate inventory. 3. A check in the amount of $50 for additional probate. Very truly you __ ~ _~.~.~.... , . _.. _. .-°: ~'~ eith J. Strouse KJS:bs Enclosures lJ G ~-~ y ~~.;. t. ,. r ,. e Jy0 GLTJCJ~ ,hd O C7 ~ GZ r~or~H H ~ t~ to G~ ~n~~xHr roHrr~r~ r~Nx~zz oz d ~do~ ro ~ ~ ~ ~o~~ J IO ~ r ~ O CHrtTJ W ~ ~C C11 hd ~ ~ n ~ W ~ H ~' ~ ~ ~ ' ~ H C!1 O ~ ~ ~ U1 GZ r~ x `mot. ;F w < C Z v N-+ m C ~ o N ~ 9 d ~ ~ ~' C N N ~ ~ O~ I~ H ~ ~ ~ ~ ? ~~ O r N ~~ f1 C7 ~ ~ ~ cJ y y ~ ~ ~ y c1~ O ~ Zi y C N C7 O CTS ~ F-3 C ` C~ C=] i0 H C~ ®~~~~ _~ 1 ~~ ~~~~~ ~_~ 1 ° ~___ ~ ~ rn ~ _ ~~ .~.. Q ~:3 ~ r U1 o ~ __ fn ~~ can '~ '~° r N [`~`t r---- r ~_ r ~ ~ x ~ `~ ~.,, .,.~~~ ~ C!I ~~~~ Z ~." ~"~.,~ Ul ~ ~~ ~~~~ ~ ~~~ ~~ ~~~~ ~~~~ ~ G oz _ ~ ~ r m O ~ ~ N r.. ' `i m ~~ ~~ o w ~~ __ ~~~~~ ~~;~ °~~~_:~ ° 3 ~-r ~. °~, ON~I2~3~ ~ CU1CD2:~--~~ o^ ' ~, V W =i D cn ~~ .'_: m