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HomeMy WebLinkAbout08-07-13 J 150561�1p5 REV-1500 EX'°�-",�`° '�' PA Depaftment of Revenue pennsylvania oPFICIAL USE ONLY BureauofIndividualTaxes ������F �INHERITANCETAXRETURN �OUntyCode Year FileNumbe� PO 80X z8o6m ��1 I I„� 1 /1� Harrisburg PAi7i28-o6oi RESIQENT DECEDENT i � �y�i f' ENTER DECEDENT INFORMATION BELOW Social Security Numher Oate of Oeath MMD�YYYY Dale of Birth MMDDYYYY _ __—I f_.—_ _'_i _' - --� ' � 10/09/2D12 -- -- 03/'14/1929 Decedenfs Last Name Suffix DecedenCs First Name MI _ ` 'i '_ I , Peters l Patricia l B � � . _ _ . ._ . _ .___. ....._ . ..--- .. ._..... -- -- ---------...__. .-- -. . _ . ...._ J �lf Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI �_.__—___.._____ .— —_—_—_._—__—___.--_._____. ___ I � �I I � �___—.__-...________—____--_ - Spouse's Social Security Number --- i THIS RETURN MUST BE FILED IN DUPLICATE WITH THE I REGISTER OF WILLS FILL IN APPROPRIATE OVA�S OELOW � 1. Original Retum � 2.Supplemental ReWm O 3. Remaintler Retum(Date of Death Priorto 12-13-82) p 4. Limited Estate O 4a. FuNre Interest Compromise(date o( p 5. Federel Estate Tax Return Required death atter 12-12-82) Cp 6. Decedent Dietl Testate O Z Decedent Maintained a Living Tmst 0 8. Total Number o(Safe Deposil Boxes (Ariach Copy of Will) (Attach Copy of Tmst.) p 9. Li[igation Proceeds Received O 10. Spousal Poverty Credit(Date of Death O 11. Election to Tax under Sec.9113(A) Behveen 1231-91 and 1-1-95) (Attach Schedule O) - CORRESPON�ENT- THIS SELTION M115T BE COMPLETED.ALL LORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECiED T0: Name Daytime 7elephone Num6er _ i Richard L. Placey, Esq. I (717) 236-9577 � REGISTER�F WILLS USE�NLY � �.. � �� °ry f5"i C O � � G7 First Line of Address __ _ � W .'L'� �'= '� Q __ "6 CJ Gh iJ i Piacey &Wright i � � � -.a w n� r� Second Line ofAddress b�.. � � 'J %�+ C-� �3621 North Front St. I t� � ��-�n1 Q -�+-��i City or Post Office State ZIP Code � � ODAT�ttLEO :`? k? _Harrisbur9— — 1 PA � i 17110 ro -�-i ` i` � �J i � t� U' �-i cn CorrespondenYs e-mail address: pWIaW@2pIX.(lEf Untler penalties ot perjury,I tlecl2re that I have examinetl this reWrn,including accompanying schedules and statemeNS,and to�he bes�of my knowletlge and bel�el, it is tme,correct and compleie.Declaration o(prepaBr other ihan the personal represenl2�ive is basetl on all information of which prepare�has any knowletlge. SIG TU E$SONR�N51 RFi ,RE7UkN'� J��G �ATE J �./UST 08/D5/2013 ADflRESS Patricia Elliott, Ex cutrix, c!o Placey ght, 3621 North Front Street, Harrisburg, PA 17110 SiGNA1URE OF PREP THER T A REPRES ATIVE DATE 08/05/2013 A➢DRE55 / Richard Li. Plac , qui P ey &W� , 3621 t Street, Harrisburg, PA 17110 PLE USE ORIGINAL FORM ONLY Side 1 � 15056101�5 15D561�105 J ��, J 1505610205 REV-1500 EX(FI) DecedenPs Social Security Number oeceaenesName. Pat�icia B, Pet2�s I RECAPITULATION . _______. ___-_-�._, 1. Real Estate(Schedule A). . .... ... .. ... .. .. . . .. . . . ..... ... .. .. ........ 1, 225,000.00 i 2. Stocks and Bonds(Schedule B) . . .. .. .. .. . ... . ........ .... .. . ... . ..... 2. . 0.00 i i 3. Closety Held Corporation, Partnership or Sole-Pmprietorship(Schedule C) ,.... 3. 0.00 , 4. Mort a es and Notes Receivable Schedule D ! 99 ( 1 ... . ..... _. . ..........._. 4. 0.00 ; _ _--- ----- - ----- --- 5. Cash, Bank Deposits and Miscellaneous Personal Propedy(Schedule E). ..... . 5. 1,543.59 � 6. Jointly Owned Pmpedy(Schedule F) O Separete Billing Requested ....... 6. 3,181.64 I 7. Inter-Vivos Transfers 6 Miscellaneous Non-Probate Property � (Schedule G) O Separate 8illing Requested........ 7. 0.00 � 8. Total Gross Assets(total Lines 1 through 7). . ... . . ..... ... .. ..... ..... .. 8. � 229,725.23 I 9. Funeral Expenses and Administrative Costs(Schedule H).. ..... . . ......... . 9. �I 46,164.42 � 10. Debts of Decedent, Mortgage Lia6ilities and Liens(Schedule I). .. . ... ..... ... 10. 14,17276 'i � 17. Total Deductions(total Lines 9 and 10).... . .... . ... .. . ..... ....... ... .. 17. � 60,337.18 ! 12. Net Value of Estate(Line 8 minus Line '11) . . . . .. . ...... .. ... . . ....... .. . 12. 169,388.05 I i 13. Charitable and Governmental Bequests/Sec 9713 Tmsts for which an election to tax has not been made(Schetlule J) . . ... ....... . ........ ... 13. - 0.00 ( 14. Net Value Subject to Tax(Line 12 minus Line 73) . . ... .... . . . . . .... ..... . 14. � �69,38$.05 �I TAX CALCLILATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable althe spousaliax rale,or transfers under Sec. 9116 - - --- --`� (a)(12)X.0 D 0.00 � 15.I 0.00 ! 16. Amount of Line 14 laxahle ; at Iineal rate X.0 45 166,206.41 i � _ ____ ___..._ -------.------- �s .-----._____._____.__._7,479_29 ,f 17. Amount o(Line 14 taxable at sibling rate X.12 3,181.64 �7. � 381.80 ; 18. Amount of Line 74 taxable ~i at collateral rale X.15 0.00 18 0.00 � I 19. TAX Dl1E .. ........ ... .. .. . .. ... . . .. . . . .... . . ... .... .. .. ... ... .... 19.i 7,$61.09 , 2�. FILL IN THE OVAL IF YOU ARE REQUESTiPlG A REFUhD OF AN OVERPAYMENT � Side 2 � 15056102p5 1505610205 J ftEV-t500 E%(FI) Pago 3 Filc Numbor DecedenYs Complete Address: DECEDENTSNAME Patricia B. Peters STREETADDRESS 55 Old Pioneer Road cin srnr� nP Camp Hill PA 17011 Tax Payments and Credits: 1. Tax Due(Page 2,li�re 19) it) 7,861.09 2. Credits/Paymenis A.Prior Payments 9,558.58 B.Dismunt 0.00 TotalCredits(A+B) (2) 9,558.58 3. Interest (3) 0.00 4. If Line 2 is greater than Line 1 +Line 3,enter the difterence. This is the OVERPAYMENT. Fill in oval on Page 2,Lfne 20 to request a refund. (4) 1,697.49 5. If Line t+Line 3 is grea�er lhan Line 2,enter the difference.This is the TA7(DUE. (5) 0.00 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 aiM: Yes No a. relain the use or income of the Property transferted.......................................................................................... ❑ � b. retain ihe righi lo designate who shall use the property transferted or ils income ............................................ ❑ � c. retain a reversionary interest.............................................................................................................................. ❑ � d. receive the promise for life of either paymenis.benefds or pre7...................................................................... ❑ � 2. If death occurred after Dec.12,1982,did decedent lranster property wilhin one year ot death wifhout receiving ade9uate ansideration?.............................................................................................................. ❑ � 3. Did decedent own an"in trust fof or pay2ble-opon-death bank accounl or sewriiy at his or her death?.............. ❑ � 4. Did decedent own an individual retirement account,annuiry or other nornprobate properry,which containsa benefiaary designation? ........................................................................................................................ ❑ � 1F THE ANSWER 10 ANY OF 1HE 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 fax rate imposed on the net value of lransfers to or for the use of the survrving spouse is 3 percent�72 P.S.g9tt6(a)(t.t)(i)]. For dates of death on or after Jan. 1, 1995, the tax rale imposed on the net value of iransiers to or for the use of the surviving spouse is 0 percent (72 P.S.§9116(a)(1.1)tii)].7he statute does not exempt a lrans(er to a surviving spouse from tax,and the sWlutory requirements Tor disclosure of assets and filing a tax retum are still applicable even if the surviving spouse is the only beneTiciary. For dates of death on or after July 1,2000: • The sax rale imposed on the net value oS transfers from a deceased child 21 years oi age or younger at death to or tor the use of a natural parent,an adoptive parent or a steppareni of the child is 0 percent(I2 P.S.§9116(a)(12)). • The Wx rafe imposed on ihe net value of transfers to orfor the use of the decedent's lineal 6eneficiaries is 4.5 percent,except as noled in[72 P.S.§9116(a)(1)]. • The tax rafe imposed on the net value of trans(ers io or ior the use of the decedenfs siblings is 12 perceni[72 P.S.§9116(a)(1.3)J.A sibling is defined, under Seclion 9102,as an individual who has at least one parent in wmmon with ihe decedent,whether by blood or adoption. REVd502 EX+ (12-12) � pennsylvania SCHEDULE A DEPAqTMEMOFftEVENUE REAL ESTATE INHERITAIJCE TNX RETUkN RESI�ENi DECE�ENT ESTATE OF: FILE NUMBER: PATRICIA B. PETERS 21-12-1139 All real property awned solely or as a tenant in common must be reported at fair market value.Fair market value is definetl as the price at which property would be exchanged 6etween a willing buyer and a willing seller,neither being compelled to buy or sell,botn having reasonable knowledge af[he relevant factr. Real property that is jointly-owned with right af survivorship must be disclosed on Schedule F. Attach a copy of the settlemen[sheet if the pmperty has 6een sald. ITEM Include a copy of the deetl showing decedent's interest if owned as tenant in common. VALUE A7 DATE NUMBER OF DEATH DESCRIPTION .._.._ . __.. . . .. _ . . _�'__, .___.� _ _.^ � � I iReal estate situate at 55 Old Pioneer Road Camp Hill Cumbedand County Pennsylvania i 3 �i` . ,_..._ ._. .._.___'__._.�..._..._ ._....__.. _... _.,... .�....__.._.____..._.__�........_ ..�.....:.: ` �„r_�-w_..�,�..gc -....v:i-s:.,.,::� i more particutarly bounded and described in Cumberland County Recorder of Deeds Office i e �; �..r ..a.e_.e=�.m�..�.�--..�e�._�.�_...m..r.�_.. i����. „�.t. �� in Deed Book 'L' Volume 29 Page 762 Valued at price for which sold. �� ? 225 000.00�' .. ..,.... ,....._, . __,_.�.__.._._�.._,...W.,_�.,,�.�..._....�,..�.�.._ I;. ; . _.... ..____...._....__.............._,.....,..a.....,_ . .,�.,_J � .���_t ....�,...��-.:.°e�: i: a :.._._�._:_a_ �,...__..__.,....._._._�.._..._._...�.....w.�.......__..... ........._....�..,, .,.._...,._�,_.. �___«..._...._.�...�.y.�,w.,� �xm�,.��...;....�_s, . ,,,.� .� , ; sF f ' E ,._..� _,_..,....._..._...._._,,......�._,......., .....�. .. ...._.. .,.,...,�.._....._ ......_._._......�.._.._..,,.... . ._.. .._„_� s�w._.�h�_a... . , _ ..��::�-. � � i � � j` , . . ... 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( . ..__...._ .......�.....,. h k�.�..,..-:�.'S .+s.-..i.-.Yc:��� y !. ._�............ ...._.-. ... :...�....,... .....,_��.... ...........�,..,.... ,.r�.:._,.... �.,...,�..,._.�.,.. ._...., ....:_-: . ...__.�.� �_ .r,ee�r� �.s_„��.:,..x:;na' I � u ,..._.._.... ..<,,..�............._..._.,......,....�«..�.�... - s � _ . ...........,«. .........................._._.�.w_....,.....,.__�,.....,.......�... ' 5�.�,_.-� .: -�-__.::ns.'f. . .__, _-_vf F �_. ......__ ..__ ... .._._.__ ...._.,,._.__.. ,._._.... ._._ . .........._ . _ ,....._....._ . _... _'_ ' ...,.._.....' �.. ... ,..r.-. ...._.. �. t TOTAL (Also enter on Line 1, Recapitulation.) $`��Y ���z25,�000.D0` [t� If more space is needed, use additional sheets of paper of[he same size. REVn5o8 E%+(o8-az) � pennsylvania SCHEDULE E oePaaTMeNroFaeveNUe CASH, BANK DEPOSITS & MISC. wHeartnNCeraxxerunn PERSONAL PROPERTY RESI�ENT DECEOENT ESTATE OF: PILE NUMBER: PATRICIA B. PETERS 21-12-1139 [nclude the proceeds oP litiqation and the date the proceeds were rereived by the estate. All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH ,__—' � _ ...... ._._'__'_.... ___'__—..._ ._�_.�_._�....I '�v_�..w,w . ��.:�,.ew«.:,,.. i m I� kCitizens Bank Checkin Account XXXX3797tl v., Yw¢WY M`� f,�.lT`4 `Y u, n`y, m.N �L �, ,��'�°�35 00 1 9 953 59� 2 �Kitchen tables and chaus a � 3 � �Family Room sofa and loveseat hvo reclining chaus,tables and N � (' p 100 OD :�...._.r.� :.. .......,�.�. M«.,�,�.....W.. ..wµ....�.,...-..- ,..,.....�...........,..�«�_,.�.. � .... _ -�...M.,..3 ...�.�.......W.�.�,�,.�.��,.� 1���;'�s4t�*�R� � q i iDining Room tabfe and chaus hutch i �i 50.00 ,..: __: � .�a.�,d, be,..� y,n. . .., m,w�.� ee..�,,_r,,= ,.n.�,_,..�, . ....,..�.. �,..,..., .,� i � � .,....�.w,. ������.�. . 5 ;Living Room sofas and tahle i ,. 50.00� ��.._.,� ....�w..�w ,,,...,...�. .,«.�_....m..-.«.:..f:.,. :�.,...�_..s.u.z,. _,,:.a��.. . ��e.,_�,.,� .����,.�:.�'.m.- �'w�,, � }��_.._�.,: a � g �Master Bedroom bed 2 dressers and chau , 75.00 � _ .._,s ., , . ...w.�_.,�.,�a��,..�e� ��:�..'�'�.603� 7 j �Bedroom 1 bed and dresser � �, 60 00, ��.�t_..�a-„' p.. . ..w.,w ...__.:,,, M..�...M,..,,Wm..�..,�»,�.w�n,,..,�,.,...,.,,�.�, �.a.,..._...� _ � �-� � g � IBedroom 2 bed idresser and chau�.v �._..Q,..r �,,.r�,=:=m:r.,�..��:.,�R �a . ,:�,...� , .�,�.t.��� ; � �...°�""_ •"2 00� -: � � g � �Bedroom 3 dresser . �,�..�..,.� .a�_.�_ �� a.�paam....:a��........�..��m,_.��.wa�.�...w���..,,, ,...2.=n.��a,�........_.�,�, � �;�.�.�:m�.�a , i , 10 ' �Bedroom 4 bed 2 dressers and chair 85 00 ` � � � �_"===� :� -...a_..... ,,...�..�.. .�, ..,..... w��,� ,.,,w ,, .�.,.,..r_. . _.d.., ,�,_,., ' 'I "_� ' " '"r_. _�? � ��,i Basement sofa � '� 40 00�' .:... ...:_.:! �......,�,�.MW..,..�.W..�...._,.. „�_..... ....,.��...,.-"...__�..,s,_�.,..�..�,��.,�..,.,.�..�,r.,��,.r....�,�.,.,.:a..,.,.y,..,��,,.......:�„�. � k . ., . , �Z � i0dds and Ends I j'� � 10 00� ' G���� *� ����.:��-� .w. .,<,.�..�w .�.�.,.., ..,,. .�,� ..... � .,�..... _.�m�. �. _n.���m `k� _� I 13 Miscellaneous Personal Effects � t�} No Vfllue � i ..,._.. ._.._..::�..:..__ ...-.._�,.._..,.,., ___�„W..._.,.:,.._.a_>��.-:w-�.. ..�_, . .... .. .. _. ... _..... .� !�`��>�"'�"r..°i.�.3"w�"a�" �'i . .. _.__.__ . , . ,...�_ - .,,� i i ��y �� .w..s...... �i� ..,.:_..�...,- �r.. ,,,.:.._,.. ..,...,�....,,.r..�...,...,.�....�..,«.,o...,,.�..nr_��,...�... �.,,......�.m. ,.-,W. .u-,�.A., .. ,. ..v.... � Svit=�4.i�'"�"� ' " k o ., .�.sx-•a4°k`�.' � I � g � . � _._._...�.. :=�,.y�„ ,a.�,.�.:,� ..,m..,,�,�. � � ����x�m,�;� �.,�� � � � � �,wm_� ..,.u, w,.w,,.�.. ., ., ..���.. .m....�vv� � �.�.�.��� � .�p��� : ' .,,, N . .,_�, � �-�,p,��,���uk,�;:�� � . . ... , _ .. ,. ... .....�_..�.,�., o.�.._.�,.� �, �.�����:�� � m � � � i ° .:.... _,.. :m.,. ,.��..r.....�„_..�_...�. �.. ��z.,�w,��m..�.�_ __�... � �.,..:�. . ...,,....m_: . e..p ,u... i ����.:?� ,�..�.x�:;�-r,� � � � "+ ,..___.. , -- __...-:- —.— a � � y�.,�.,.,.,�,._.a._e.�.m.�.�_.��..�,��.�_.�„�w..�.�..�.�,..�. _ r.-.�. R._�.,...�.�.��.��..m.-� � �,�� ��� ..m. � �-�.� � a i .,..�w....._.�..�:n.m.�.�...�..�,..:..,.. � ��� xr�.�._� �, m.� �..�. - - �. --�_ i �z,� , I � , . i�_.�.�_ r�.���.a��_,,.��,r_x�a.�.�..r���_.��,�,..e.._.�v.��__�:x¢..�v__,.�,., -,� �:����, I � � .�n.� ��.�....��..�.�_�..�.�.�..�...rn.�..._..,,�_.�..,..._:,.�.�.. �_� -� ..� .,.W ,.,.�. w F ; — .�__� _ __.... ---- - -- - --__ _— -__ _ __--- � ,...�_ 1 54359� TOTAL(Also enter on Line 5, Recapitulation) $ i � If more space is needed, use additional sheets of paper of the same size. flEV-i5o9 EX+(o1-IO) ,� ,�i pennsylvania SCHEDULE F r�y� �EPA0.TMENTOFqEVENUE �NHERRAN�ETaxR��aN ]OINTLY-OWNED PROPERTY RESIDENT OECE�ENT ESTATE OP: FILE NUMBER: PATRICIA B. PETERS 21-12-1139 � - If an asset became jointly owned within ane year of the decedenYs date of death,it must be reported on Schedule G. SURVIVING JOINT TENANT(5) NAME(S) ADDRESS � RElATIONSHIP TO DECEDENT Ar..��._.�._.�.�...�._�.........____._.r._._..� ____w �.____._ _ ______.�._....� �Teresa M. Donohoe � �3512 Walnut Street,Apt.A �' Sister i i f iCamp Hill, PA 17011 { ( i ` i � � � L---...---_...--�--..__..__._....--�--...------�---�--�----� '--�-----._....-----------'---�---�---�-----�-a �----�-------� __..__.. _----...._.._.......__�.___._—_i . __ ......____.._�_.. . _....__.___ ._____._ . ___ ..__ _._._ _._.__.___, s, � I � � il � i F ' � � i � ; . � ...._.__...._.__ � tw..._____.___.�.__._.._.__.�..__._.__�_._�..._._.�.�__.._: � � _ .� _._.__. ._. �..__�.�._.______ c -__ _ _ __ __ f _-_-- --. _ ___ r-___.�.__._.._�..��-�:��I � � i � i i ' ' ' � ; � _ .._ _ . ___ _ _ . ._._ _� . � , _ .. _ --- �_______.__________� JOINTLY OWNED PROPERTY: LETiER DATE OESCRIPTION OF PROPERN %OF �ATE OF OEATH ITEM FOR]OIM MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BHNK ACC�UM NUMBER OR SIMILAft DATE OF DEATH DECEDENT'S VAWE OF NUM9ER TENAM lOINT IDENTIhYING NUMOER.AITACH�EED FOF]OINTLV HEL�RENL ESTATE. VALUE�F NSSET ]NfERESf �ECEDEM'S INIEAFSr 1. A � .__- '�� � , :: -.� .._ 1 �.:c :.:.:u,.�� 09116/85 !PSECU Account No.201186473 Regular Shares Ot � 424 04� � 50%� 212 02� i � ___._ J� .-- _. _.._.. � .. ._,_...... _ ...._.._. . _. _.....__ .���� �.� .�,� __� ��3�__��-_� ,..._ � r, . ......,..._..� r....,..._ 9 � �._ .+m*m+ �=�ri L,_.�_!� ��w�w.M..�..-w. .�:� 2 ' A i09/16/85 � iPSECU Accaunt No 201186473 Checkin 04 �� 682 23� 50%� 341 12� _ i_ __.._ ) �.._.� �.__._�..--- -..w_..__�_.._.______� _,, � - --... ._� �..__.��__�� _, . _,.._ ;,— ��, ;,� � 3 , ' A � 2001 Honda Civic I F 5 257 00€° � 50%i � 2 628 50� � ._' �___ I . .. _ � � ._-- -- ---____.._ _,.__..,_. ___._.___._± �m:,..�,-..��:� I� .__, i ��.�� �� ..��. :_ �_, � , __ r ..__ _ __..._ ---._, . -- . . ._____ � �.. . . � � � � � � i ' � , :; i � �...__ �.___ _ ...-- --- -- ---- -- ' -.�.�.��:��� � �,�_�..�����.:� ;�..� , _ _ ._____._..__ � ��. ; �„i ! � ; � i � � i I. 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I l __.__..__. ._,.,__. ..... .. ............ . _..._..._. ._...._......_.__ 1 .:-._ a...�,��,-�" 1.....__I E�,.�.�,����,a��.u3 ; _._... � ___.___ _ ._.,._.._.. _ ...___._......_ ......... ._,....�...__ . ....._. � � �.,� . � i . �.,-;�,��--.�-s.��:,b� _. i i « ,__. __._ _...__.__._�_w.__ ._____.___.._.. _._._.�___W.___�.�..__ i �._.. _>:J.�_" �.__._; �.,�,�=�,�:�� '— � r --- - -.. __. _..._ � � ��:�. �� ��r..,� � I � � ' 1 � :... � ' r � i .... .__ � t .. .._,. ..... ,..- -- � ..� w : ' .I �"".� .'_� , _ ___ _ � �,�,��� . . ,; � i : ' _..� � .._ _ . . . ' _.�_� .._.. __. . _ . - __ ,.,:�M����� i--_.,' ��.�a��,�� � i �_ ___ I i,. _....�_.��.. .._. J ._ , _. I � .r��-. . .. � ; �£,�,�.. �,� ,' ' .��.u�.=� I ���.,�G„�„� _- — -_ ,,..___.._ .__.___�.. __ . .....__. ,.. ,__._.__ ____..___� ��, __ �_�.-.. , , - -� -r _._ ____�.___ . , __ i � .,� c ,��,,,���-.:.,� __._ ' ( � ' � I ' � _. _._ �. _-- -' �- - - ---__ __-- - _ --- ---�._..._ _. �..�a.�-�,_..�_� !�� :s -.�i , _. ' _ .. --'--._.__ �_ � _..__ ...__.._, . . _::c . i ssaw�„riw»a.cu=+� �.. . , .u�rc.� , , . i � � � �-' � � �e$ � _.. .._.... . _..__. ..._. "' ___ .... � �+erw„wn.w � ..._ ..__.._... ' ___..._____..�.__._, , _.�.:..W::.__._.�._�__._.__....,_���::-..,.�,,, . �`:� „� c sa+m �••�' Ta. I i � L�_,�_.__ ��_ ! ��vr�,�� �__ ! � �� _ _.- ' -- __...._ r__': ' ., r-._.�__..�.__�.._,..._�._._.._��____.._�� �„w., _,.__' ��?.,� , _ . ...:..�� -- � i, j ' � , ! �;. i ' I � ; �__ � _-� i .«..���: .._ .-'_.. �--.�. .. . ._._..._: --.��-------.__---__.___�._.....__�.---' �.,^,«�a�� �w�u-.,�� '� 3,181.64�+ TOTAL(Also enter on Line 6, Recapitulation) $�--------_-.-,.�,�,_ ..,�_,� If more space is needed, use additional sheets of paper of the same size. REV-isi� Ex+ �io-o9> � pennsylvania SCHEDULE H ��y�� oePnarwervroFaevervue FUNERAL EnXwPENSES AND INHERITANCETA%RETURN . ADMINISTRMTIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER PATRICIA B. PETERS 21-12-1139 DecedenYs debts must be reported on Schedule I. IiEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: ,...._.__.----------------.-_--'--...._____._.__�..�.�--'.__—.___`._........_._..____. . 1' 3.Neil1 Funeral Home � ` 10,000.52� :_...._._._.�__..�.._.._.._.�.r.___.Y..�_._..___.__v__._.....__.�._..._..�_..._...��......____�.._.._..�J 6�a�.mr:ua:r�wamc-_.....,..� ._'i ���____._.___.�._�_______ . ..�,�,.�_.._.._.._._._..__�,._.___.._.__,._.. __ y-y . _ . " - . � 2.� �Diocese of Hamsburg-gravemarker i � 3,335.00�• --- _ _. . __. � _ __--- -- __. .. .__ _._, i „�,�,�..�.y.�,,.�,�.�.m.� _ ._..._ _._.� �_..._. __W.____ - _.__...__.__.____..W_______�.......�, ; �W.���,,.�� � I ..__._1 . . .......---. _.....__... ._..---- --._...._.- -- � —� �-- -'----.._.i �r.�- _�vv. .�o.� r._" ' .... . .,.._._ ... ._... . ,._ ..., '_ _._ _ u�.�-.cF - a�.-w.��;-. �.�w�u,mz�w�....muv�.�r:m.,.o�:.� ...__ ...... . ._. ....._ ' .-. , .._. __ .�-:_ .. ., __ . � .::- ..�.� �: : �... �-.�. :- I �. . n.. n.,..s �_..I _ . _....._ ... —' " __ __ '.__ ..._.__._._ _.._._ ._...._._ .,........_._ .__._...._.�...� kresw.av-,mrwmx.w-F�suamv��� ___. .__ . .. .. . . ___ . . ..... _. . . .. ._"_ .._ .__.._... ._'- . Ae.�v�vauw�mm�rneinric ____._. ._ ;i. i � i_.___. ..___ ..__...._,�__..____.__�r._.�_.._�._..�__.�_._..._..._�.._ _� �.,�sm:.n_�ma�nneu�:m: ___._..._ .. _.__.. ._..__,._..._ ___.—�__._.r:4=.=—_.—.�_—�____l ��.. ._.__ . ... ._ _ ,._. ..._„_.. � — �_ .��.__.._.�.�"'...�..�..._.�.___._�...�..__..._................._ _..._.�.__......._...._.__........._._.._.. r.:w:_rsswu._�w,wm�.�„«�.wr.�w.nn,�� e. ADMINISTRATIVE COSTS: � � 1. Personal Representative Commissions: � �� }j��fr�������" Name(s)oF Personal Representative(s) �"���"���—`�"�—� Street Address City State_ZIP Year(s)Commission Paid: �r=,,�-_-.�.-�,�;� 6,500.00 � 2. AttorneyFees: (���,3_..�,,,,��3� -_ . M1 3. Famil Exem tion: If decedent's address is not the same as[IaimanPs,attaCh eX Ianation. �V��Y ���I' Y P ( P ) '[vu�xv,s.waau:w�n*.��.vsre�,ai=�i Claimant Street Address City State_ZIP Relationship of Claimant to Deredent 4. Probate Feer. ����:y:�^,�xuW�77.50 i; I�,�,� - 5. AccountantFees: R � ��y��l f :a�wuw�m �,ww� � ..�r�.a,-m�.+,�_�_we�..m...v�np F , � 6. Tax Retum Preparer Fees: . F z..-s����,�:y.�� . . _.___ .. ____ . _._. . ... __.. . . .___ ._.. . .___'. .__.._. .. . '_"' y,o.,._„Y ..,�. �-en, � iNet settlement expenses re sale of 55 Old Pioneer Road Camp Hill,PA � � 24,246.40 ___-- --- — ---_ _—__ �_� y__�____ a�,,,�. �..�.,�..,. � _, _ .: . -- -_ __.. __— — _� -_ i �.,„„o, ,�:�,��.��. ; e.; fCumberland County Register of Wilis disclaimer flmg fee � 5.00 ---- --- --- -- --_ __ _.._._ __.__�_ �,a.��.�,� __ _. .�.T- --- -- . .-------._:_�_ . __ _ —�.�_,� s. iReserve for future costs taxes and expenses 2,000.00 �� M � _�.�.__._ �. _._y� �� �a�..�..� -- — --_----- ----- ... —— --_ _ � � � � __.- _— — -- ---_ __.------- ----- --_� ��. ---- _._.__.__..__�,_. _.__.___.u._,.___..._____.____________�_____.____—, I.... �_...__._. .__ �.n�=�v.rmcvxs.�a�+: ^ ' � � � $ I ! '—_ `—_'__"_—"—______.�.._..—___'___"_— — "_—__ '___, w�:a+o-aes�.tirysm�e.�s.mc,�, ' "_"""_ .... . . _ _"__'____�_.���._"'____.'�'___._.'_'. . : , � !....,.. �.�.. _...... ..._.._. ..__...__..____..._..._....y_""_._..._�._..._.._...�...._ .�_ �� � � . .�.��aw�c.� � �46,164.42� TOTAL(Also enter on Line 9, Recapitulation) $_, If more space is needed,use additional sheets of paper of the same size. �� ftEV-1512 EX+ (12-12) ,�i pennsylvania SCHEDULE I �„�� DEPARTMENTOFflEVENUE DEBTS OF DECEDENT, mnea�rnNCeTrxneruaN MORTGAGE LIABILITIES & LIENS RESI�ENT DECE�ENT ESTATE OF FILE NUMBER PATRICIA B. PETERS 21-12-1139 Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses, ITEM . VALUE AT DATE NUMBER DESCRIPTION OF DEATH r �._ ..___v.._____�� �._...._ ._._�_._._ *iw+r�.r.ar�u.x� i �Gnswold Home Care-debt of decedent � � 167 00 � _____ ,��:�— . .._:.,_:_: ._. :�.____W_:..__._._._ _�—��—.__._�_.._.�:.._��_ _:_-_ ____. �.„� _ . k .�....SCt .E^`.-vS.9��',. ; 2. ,Gwen Bryant-private duty nurse � F� 120.00 Ij � � s, _-�..-- -_��_.. , -„_`_ ----_��._.�_.__� _—.__.—.,,....._.._____._._ � Jr� . ro-.-:> �roi' ._._.._ �"."__. ..._:"_ '_`"=.i Ei""z'..-''�z' _�""`---'�`—`'ar ` 3.� iLinzey Painting family room painting � !j 1,000.00„I .__ _; ___.._ _...--- ----... _.._.-- ___ ��,��! , __ __.� . --___ .. ;_.._ _._ ._.---..__ . . -_ _,. :�� _ __,_- ..:_ ..,___. �- ,;_R �.�,4y._,,'� " 4.: �Josh Haod new kitchen flooring � i� 1,255.00& ` . .._:: — - . :--_—,._ �_.__�._—_=_�.,._ �.__� .—:_ - _._� �,�-�4.•� �_.____.__ ._..---.___ 5. �Mikes One Call Plumbing � i �wmT 1,754.45� , Y .. 1 . ....._..- ,...-.._ ... ...__— .-c=._ -. .-_ .. _` 4�--w . ... � '. t . .. . .. . . �_-�—.. . _.._ . .. .._.. ._... :. .. 6; �PPL dehts of decedenUvanous billings ! � 648 00 �1 .__r _ __ ....-- --- `- �----� ---_ � .mm� ,�..a,.�,���a���,.,� �� e j �Umted Wateeof PA ed btstof decedenUvanous billings � ; ��-' 337.09�r � _ � r—_-__.._ ---- --- - ------ ° -��1 ��.a, .�„�„_���-,,��' °__...___ . �_�__._______� _�._:___ __w._ � ��.��� � 9.i iBryan Withington lawn care � � 462.00�, L �_.____.__ -==_.�__.�_ ���.�.-.� �o. —= ----A_.�-- -- .._______—�_� I � �,.�..sy�� � 11 ; iVerzonllltldebt of deeed n�edenUvarious billin s_�rv T�_�—�� �Y�W �� i � �46� � 9 , � �a �.- r ' `-- i «�:s�raz. _. . � � �Hampden Township sewedtrash/vanous biliings j $ �� 310 10� 12. � 13� IHampden Township-real estate taxes __ �N�� _ _ � JY � s���„k h�582 53 � .___w _...___ __..___._ _.._. -----------_ . _----- _...___ ___ � .'3.:...���.ru . . ; � � 14.; jErie Insurance homeowner's insurance � ` 700.0 _ r:_ � . u -- _.if �»M.�����,�.�... � t5 i �C tzens Banke equiTy line of credit XXXX7853� �� � � � ~ ! �` '� s5� 6,000.00� 16; _.._._.. _..._._...._._..._...._. _.__.....-- ------_.... ---------- ___..._.._.. .-----._._ ...._........_.... _.__----.f �v�E>>�,_�:�.,,,.��3:�.!� � . ._. , ....._.._--- �----....._..... . -�---._.._._.. �-------'- .-� -�- . . ._ ._..._ _..... ..._ 1 � � z - _ _� _ - —__�_�:,: �--___- ___�..-:�_ _- --_ .: .._ _. .�_ ..m.___:�; �.�.�.�k,� ,.a . ,� . �, �_ �.�_���m� , ; I i � " y ^� e _ i ...� . . ._ . .. .. .��:4 . . . .: .,_::......_ , _. � i ° _, .__.._.. : �-:. ..____.__.�_�,._�_�.._. _,:_ �� ��,�����, .��,��,.� r ' __.. :. ,.----__; _�_._ _� _LL._-,.;�_ �� _�._,____ �__._____._�_.�—__. � � _�:- -_�-_ I _ I � �,��. ��,�, .�� E —__ _.__ . � _. �.:, ,._ � _.,..��._� __.... _w_��._—_____._�_:e..___-_____.__.._._�...�_��._.. S � _ � --� r� ,�_�.,.__ _. .,.-�� � � ' I � ._._ -----==-_--—_..__ .� �-. n _._ :_:. ___ �:=_. _____�=�_..� � _� .�.t , v - , '_�_.� a � _.--------__-------------- -----_..--------� ` , -- ------- -------------- P�-_.��3� ._ — �.�.�- � � � ,: � r�.�,.�.�.� �_.__� �____---------------- „___ _...�.___. __,_____.__. ._.n.________.__.W----s_�.�_s-- _.._._____ � ��__ , , -- , � � �-- ---------------_____.�------- - --- ----r - TOiAL(Also enter on Line 10, Recapitulation) $� � 14 172 76�` if more space is needed,insert atlditional sheets of the same size. REV-1513 EX+(01-10) �pennsylvania SCHEDULE ] DEVAPTMENT OF NEVENIIE INHERRPNCE TA%RENRN B E N E FICIA RIES RESIDEM OECEDEHr ESTATE OF: FILE NIIMBER: PATRICIA B. PETERS 21-12-1139 RELATIONSHIP TO DECEDEKT AMOUM Oft SHAftE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE 7 TAXABLE D15TR18UTIONS�indude outright spousal dlstdbutions and transfers under Sec.9116(a)(1.2).] 1. �Kathleen Brooks,724 State Street,Lancaster,PA 17603 � [Daughter � One-Fourth Residue 2� )Patncia Ellr---ioH,602 Gale Road,Camp Hill,PA 17011 � Daughter One-Fourth Residue � 3. �Colleen Beard,5380 Barbara Drive,Mechanicsburg,PA 17050 � Daughter _� One-FouRh Residue �--` --- � 4., �Maureen M.Ness, 14181nvemess Drive,Mechanicsburg,PA 17050 � Daughter � One-Fourth Residue r �(A life eslate in real estate situate 55 Old Pioneer Road,Camp Hill,was • i_� I ; �given to decedenYs sister,Teresa M.Donohoe,under Item II of the Will.� __J �� t— � C� (She disc�_ laimed that bequest pursuant to 20 Pa.C.S A 6201,et seq � � �� �� � �Discl mer dated April 8,2013 was filed wilh the Dauphin County Register �_� ���� L�J t C io An pril 24,2013,copy attached. The same passes under the � L_—_' r residuary provisions of the Will.) �� �� ' -- `- — - - ----------- -- ENTER DOLLAR AMOUNTS FOR DIS7RIBUTIONS SHOWN ABOVE OM LINES 15 THROUGH IB OF REV-1500 COVER SHEEf,AS APPROPRIATE. I� NON-TAXABIE D(STI118UTIONS A. SPOUSAL DISTRIBlR70N5 UNDER SECfION 9113 FOR WHICH AN ELECRON TO TAX IS N0T TAKEN: �+�w+�+��� 1. (___.._� �_ � � r—'� i --'-�' —' I ! I I � , � :- _.�__--.:_,__.._�__- - - � �� r__, �� ; � �_' �.._.,......,..�.�...a.� L� -------�--- - ' 0. CHARRABLE kND GOVERNMENTAL DISTRBUTIONS: 1 : ... ......... . ....._".."'_�'_._ �_._.'_'�" '� � � j V "-_ _'-__._' _— _—'_— � �� r_ __ ' '—_ __—_ — �� , � �.... r."'_"'__—__ � �....� L_' '—'-- � �-_ - _---_ - ---1 .,. ��J TOTAL OF PART II- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-3500 COVER SHEET. $ � .00 If more space is needed,use additional sheets of paper of[he same size. � RICHARD L l. PLqCtY P�C�Y � ��GHT WILLIAM 1(. WRIGFff' A�RNEY$ AT LJ{yy t i sa3-i 9sg� 362 I NOR7}� FRO . HARRISBURG, p �S�E� OF COUNSEI ENNSYLVqNIA 171 IP1533 CH'4RLES J. DEHqR7; ��� STAN�tI'J.A. LASKOWSKI ����� Z36-9577 Fqx(7�7� 236-0843 August 5, 2013 Register of Wills CUMBERi,A�� Ca�Ty COURTHOUSE One Courthouse Square Carlisle, PA 17013 �� Estate ofPatricia B, peters Estate No. 21_12_��39 Dear Madam/Sir: caption d de edent tor e her w�fh ch�ckn�the �are, Penns lvania g amounY of$15.00 t�erafhe�j�g fee���r the Please time-starnp the additional copy of the first page and rehirn it to me in Che enclosed S�mpEd, addressed envelope. Thank you. ' Very�jy yours, PLACE & WRIG ,. ` � .__; - � RLP:hsk � ard L. Place�y� ^.1, � � n �= 4 0 � �t r: c� U� �, r A- r— ...s C.'-� Enclosures =� r`t �y i�T ,� rn -c, '� .:o v '"� r� c� � C� ..r 't) -r� rr cc: Patricia Elliott " �' '�t -=� �� �c C,7 C.. : �7 w: c� H 'D '� � IY] Z' C�,}� Cn q '�'f � �N"O . i 1 � ) �• ! y/ O�N^,. � It . . . , �.�. �- f r�ioW . : , „ . 0 ���f�R�<a - � . - - e •. • - . • . r.., . 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