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HomeMy WebLinkAbout02-0344Estate of Evelyn also known as Social Security No. 201-07-4445 PETITION FOR PROBATE and GRANT OF LETTERS R. Smith No. 21-02- X.~ q To Register of Wills for the County of Cumberland in the Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older and the ex utors in the last will of the above decedent, dated Oct. 11, 1971 and codicil(s) dated N/A named (state relevenat circumstances, e.g. renunciation, death of executor, etc.) Decedent was domiciled at death in Cumberland County, Pennsylvania, with her last family or principal residence at 48 Pine Grove Road, Dickinson Township, Cumberland County, Gardners PA 17324 (list street, number and municipality) Decedent, then 87 years of age, died Carlisle Regional Medical Center, 246 Parker Street, Boro of Carlisle, Cumberland County Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: No Exceptions March 6, 2002 Decedent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: unestimated WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters testamentary (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) thereon. Leroy D. Smith 45 Pine Grove Road Gardners PA 17324 ' -Rbs(ffia M. J~mllg~' 41 Pine Grove Road Gardners PA 17324 rt g, Smith 40 Pine Grove Road Gardners PA 17324 OATH OF PERSONAL REPRSENTATIVE COMMONWEATLH OF PENNSYLVANIA COUNTY OF CUMBERLAND The petitioner(s) above-named swear(s) or affirm(s) that the statement in the foregoing peition are true and correct w the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed before me this 3rd day of Ap_[il~. 2..002 ,.~ , ~ MaryC. Le~( -- ' Register NO. 21-02-344 Estate of Evelyn R. Smith , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW APRIL 4, 2002 in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated_ Oct. 11, 1971 described therein be admitted to probate and filed of record as the last will of Evelyn R. Smith and Letters Testamentary are hereby granted to Leroy D. Smith, Rosella M. Jumper and Robert F. Smith FEES Probate, Letters, Etc.$ 80.00 Short Certificates(1 )$ 3.00 Renunciation $ JCP $ 5. O0 Total__ $ 88.00 Filed ......... . .~...R..I.b....4. ,....2..0..0..2. .... called atty on 4-4-02 MARY C( LEtter of Wills Robert M. Frey 06274 ATTORNEY (Sup. Ct. I.D. No.) 5 South Hanover Street Carlisle, Pennsylvania 17013 ADDRESS (717) 243-5838 PHONE REGISTER OF WILLS OF CUMBERLAND COUNTY OATH OF SUBSCRIBING WITNESS 21-02- 314 ROBERT M. FREY (each) a subscribing witness to the w/Il presented herewith,., (each) being duly qualified according to law, depose(s) and say(s) that be was EVelyn R. smith present and saw the testat_rix~, sign the same and that_ he signed as a witness at the request of testat_rix in h er presence and (in the presence of each other) (in the presence of the other subscribing witness(es)). " Sworn to or affirmed and subscribed before me this 3rd day of ~l)r~ . ~X 2 M~ry C~ewis / - - -Reg~ter Robert M. Frey /Name~ 5 S. Hanover Street, CArlisle PA 17013 (Address) (Name) (Address) REGISTER OF WILLS OF CUMBERLAND COUNTY OATH OF NON-SUBSCRIBING WITNESS 21-02-344 Robert G. Frey and Stephen D. Tiley (each) a subscriber hereto, (each) being duly-qualified according to law, depose(s) and say(s) that _ they are familiar with the signature of Evelyn R. Smith testat, rix of (one that they _ Evelyn R. Smith of the subscribing witnesses to) the will presented herewith and believe:{ the signature on the will is in the handwriting of to the best of their knowledge and belief. /"'X. ~ Cq~--" ~ ---7 lVl/drY ~l~ewis ' -/ ~egister ~ dr.~.~-'7~'-~ Stephen D. Tiley (Name) 5 S. Hanover Street, Carlisle PA 17013 (Address) 2~-02-344 LAST WILL AND TESTAMENT OF EVELYN R. SMITH I, EVELYN R. SMITH, of Dickinson Township, (R. D. # 2, Gardners), Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my last Will and Testament, hereby revoking and making void any and all Wills by me at any time heretofore made. 1. I direct my hereinafter named Executors to pay all of my just debts and funeral expenses as soon after my death as may be found convenient to do so. 2. All the rest, residue and remainder of my estate, real, personal and mixed, and wheresoever the same may be situate, I give, devise and be( in equal shares to my Three (3) children, their heirs and assigns, the share of any deceased child to pass to his or her issue per stirpes. My said Three (3) children being Leroy D. Smith, Rosella M. Jumper and Robert E. Smith, all of R. D. # 2, Gardners, Pennsylvania. 3. I hereby nominate, constitute and appoint my said Three (3) children, Leroy D. Smith, Rosella M. Jumper and Robert E. Smith, or any of them, as Co-Executors of this my last Will and Testament and I further direct that none of them shall be required to post any bond to secure the faithful performance of his or her duties in the Commonwealth of Pennsylvania or in any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my last Will and Testament written on one (1) page this 11th day of October, 197 Evelyn R. Smith Signed, sealed, published and declared by Evelyn R. Smith, '~he'Testatrix above named, as and for her last Will and Testament, in our presence, who, in her presence, at her request, and in the presence of each other, have hereunto subscribed our names as attesting witnesses. CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: EVELYN R. SMITH Date of Death: MARCH 6, 2002 Will No. To the Register: Admin. No. 21-02-0344 I certify that notice of (beneficial Interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on: April 18, 2002 Name Address Leroy D. Smith Rosella M. Jumper Robert E. Smith 45 Pine Grove Road, Gardners PA 17324 41 Pine Grove Road, Gardners PA 17324 40 Pine Grove Road, Gardners PA 17324 Notice has now been given to all persons entitled thereto under Rule 5.6)a) except NO EXCEPTIONS Date: April 18, 2002 Signature Name: Robert M. Frey Address: 5 South Hanover Street Carlisle PA 17013 Capacity: Personal Representative X Counsel for personal representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-11 62 EX(11-96) CD 001 264 STEPHEN D TILEY ESQUIRE 5 S HANOVER STREET CARLISLE, PA 17013 ........ fold ESTATE INFORMATION: SSN: 201-07-4445 FILE NUMBER: 2102-0344 DECEDENT NAME: SMITH EVELYN R DATE OF PAYMENT: 06/06/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 03/06/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $1,147.60 REMARKS: TOTAL AMOUNT PAID: STEPHEN D TILEY ESQUIRE $1,147.60 SEAL CHECK# 3570 INITIALS: SK RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS REV-1500 EX (6-00) COMMONWEALTH OF PEN NSYLVAN IA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN F,LENUMB R ' RESIDENT DECEDENT ,co o01oE- ,0 2 0 I.- z LU ILl Moo I-- z ILl Z 0 z I DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Evelyn R. Smith DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 3/6/2002 5/6/1914 JF APPUCABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER 201-07-4445 REGISTER OF WILLS SOCIAL SECURITY NUMBER ~-'-~ 1. Odginal Return ~-~4. Limited Estate [~6. Decedent Died Testate (Attach copy of Will) ~-"-~ 9. Litigation Proceeds Received ["~ 2. Supplemental Retum j'-~4a. Future Interest Compromise (date of death after 12-12-82) J'-~ 7. Decedent Maintained a Living Trust (Attach copy of Trust) r-'-] 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) ['-"~ 3. Remainder Rebml (date of death palm' to 12-13-82) [~]5. Federat Estate Tax Return Required ._.~0 8. Total Number of Safe Deposit Boxes ~-~11. Election to tax under Sec. 9113(A) (Attach Sch O) NAME Robert M. Frey FIRM NAME (If Applicable) Frey & Tiley TELEPHONE NUMBER 717-243-5838 COMPLETE MAILING ADDRESS 5 South Hanover Street Carlisle, PA 17013 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Properly (Schedule E) 6. Jointly Owned Properly (Schedule F) [~] Separate Billing Requested 7. Inter-Vivos Transfer & Miscellaneous Non-Probate Property (Schedule G or L) 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) NONE 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) NONE (4) NONE (5) (6) NONE (7) NONE 8. TOTAL GROSS ASSETS (total Lines 1-7) (8) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Morlgage Liabilities, & Liens (Schedule I) 10) 11. TOTAL DEDUCTIONS (total Lines 9 & 10) (11) 12. NET VALUE OF ESTATE (Line 8 minus Line 11) (12) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election Io lax has not been made (Schedule J) (13) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 25,500 3,285 OFFICIAl. USE ONLY 28,785 3,179 4,479 7,658 21,127 0 21,127 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate ,or transfers under Sec.9116 (a)(1.2) x .0 ~ (15) 16. Amount of Line14 taxable al lineal rate 21,127 x .0 45 (16) 17. Amount of Line 14 taxable at sibling rate X , 1 2 (17) 18. Amount of Line 14 taxable at collateral rate x .15 (18) 19. Tax Due (19) 0 951 0 951 >> BE SURE TO ANSWER;ALL QUESTIONSON REVERSE SlDE AND RECHECK MATH << :: 217 Decedent's Complete Address: STREET ADDRESS 48 Pine Grove Road CITY Gardners Evelyn R. Smith 201-07-4445 STATE ZIP PA 17324 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2, Credits/Paymenls A. Spousal Poverty Credil B. Prior Payments _- C. Discount 1,148 60 951 Total Credits (A + B + C) (2) 1,208 3. ~l.nterest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT, Check box on Page I Line 20 to request a refund (4) 5. If line 1 + t/ne 3 is greater than line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (SA) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (SB) Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY' PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. relain the use or income of the properly transferred; ...................... [~ [] b. retain the right to designate who shall use the property transferred or its income; ........... r--'] F'~ c. retain a reversionary interest; or .............................. d. receive the promise for life of either payments, benefits or care? .................. [] 2. If death occurred after December 12,1982,did decedenl transfer property within one year of death without receiving adequate consideration? ............................ F"--] r-~ 3. Did decedent own an "in trust for" or payable upon death bank account or securiD/at his or her death? .... [] 4. Did decedent own an Individual Retirement Account, annuity or other non-probate property which contains a beneficiary designation? ............................... IF THc ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under pe~a;~-~ of perjury, I declare that I have exam ned this retum, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, and complete. Declarabon of preparer other than the personal representative is based on all information of which preparer has any knowled,qe. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE ADORESS / d/ South Hanover Street, Carlisle PA 17013 ~ For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. Section 9116 (a)(l.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% [72 P.S. Section 9118 (a)(l. 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 twenty-one 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%[72 P.S. Section 9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedents lineal beneficiaries is 4.5%, except as noted in 72 P.S. Section 9116(1.2) [72 P.S. Section 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% [72 P.S. Section 9116(a)(1.3)] .A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. AT REV-1502 EX + (1-97) (f) COMMONWEALTH OF PENNSYLVANt.~ INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER Evelyn R. Smith 21-02-0344 ALL g, EAL PROPERTY OWNED SOLELY 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 willing 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. ITEM NUMBER DESCRIPTION 48 Pine Grove Road, Gardners (Dickinson Township, Cumberland County), Pennsylvania See HUD-1 Settlement statement attached. TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) VALUE AT DATE OF DEATH 25,500 25,500 IHUD-1 CERTIFICATION I direct and authorize Frey & Tiley to make distributions indicated for my account on the attached HUD-[ Settlement Statement, approving the tax prorations indicated therein, and understand that prorations were based on figures for the preceding yea.r, or estimates for the current year, a~d in the event of any change for the current yem', all necessary adjustments must be made between Seller and Borrower direct; likewise any DEFICIT in delinquent taxes will be reimbursed to Frey & Tiley by Seller. [dihsa;;rsCem~ee~/~Ymr;~ewed the HUD-1 Settlement~ltatement and to the best of my knowledge and belief, it is a tree and accurate statement of all receipts and ~~f~hls transaction. I f~r~her certify that I have received a copy of ~e HUD-I Se~ement Statement. ' E. ~th, Exectors o[ Ev~yn R. S~th Estate To the bast of my ~owledge, the HUD- I Se~demem Statement which [ have pmp~d isle' ~me ~d accurate accoan~ of the ~nds which were received ~d have been or will be disbu~ed by the undersigned ~ p~ of the se~lemenr of this ~saction. ' WARNING: It is a crime to knowingly make false he United States on imprisonment. For details see: Title 18 U.S. Code Section 1001 and Section I010. June 12, 2002 Date this or any other similar form. Penalties upon conviction can include fine and INFORMATION REPORTING ON REAL ESTATE TRANSACTIONS THIS HUD SETTLEMENT STATEMENT CONTAINS IMPORTANT TAX INFORMATION (BOXES E, G, H, I, M AND LINE 401} AND IS BEING FURNISHED TO THE INTERNAL REVENUE SERVICE. IF YOU ARE R.~QUIRED TO FILt~ A RETURN, A NEGLIGENCE PENALTY OR OTHER SANCTION WILL BE IMPOSED ON YOU [F THIS ITEM IS REQUIRED TO BE REPORTED AND THE INTERNAL REVENUE SERVICE DETERMINES THAT IT HAS NOT SEEN REPORTED. FREY & TILEY PRIVACY POLICY As attorneys, we have a duty of confidentiality to our clients. As a pan of representing our clients in a real estate transaction, we collect information concerning the Buyers and Sellers. This information can include names, addresses, telephone numbers, social security numbers, account balances and account numbers with financial institutions, credit repons, appraisals, contracts, and details conceming the real estate transaction and financing for the transaction. Some or all of this information may be nonpublic personal information. We also obtain information from public records, We restrict access to nonpublic personal information to those employees who need the information to provide necessary services in connection with the transaction. We also share this informa£ion to the extent necessary to complete the transaction with others involved in the transaction. These persons may include lenders, real estate agents, and inspectors. We may also share this information with government agencies as required by law. We do not share this information with marketers or persons not connected with the transaction. Date of Pro-Ration: June 12, 2002 ASSESSMENT: Parcel No.: 08-39-2216-001 See Settlement Sheet lines 106 & 406, 110 & 410, 210 & 510, 214 & 514, and 1303 for Results of this Addendum. TAX PRO-RATION ADDENDUM SCHOOL REAL ESTATE TAX Owes:l:~~~ from July 1, 2001 to June 30, 2002 SchooJ Real Eslate Tax- Face $584.76 School Real Estate Tax- Per Day ~;out~ & MUNICf~AL TAX from Janua~ 1, 2~2 = Oec~ber 31, 2~2 CO. & Munic. Real Estate Tax- Face Co. & Munic. Real Estate Tax- Per Day $0 34058 Yes School taxes P.O.C. or charged to Seller: ~--~ School taxes P.O.C. or charged to Sorrower Co. & Munic. P.O.C. or charged to Seller: Co. & Munic. P.O.C. or charged lo Borrower 51. FHA ~manf- U. S. DeDa~rnent of HoUS~eveiooment Form US HUD- 1 2. FrnHA /6. File Number 3. Cony. Unins. I ............. 18. Mortgage Insurance 4. VA I I Case Number .Conv. Ins. C. This form is furnished to give you a sfa;e~e,~ of aclual settlement coals. Amounts paid to and by Ihe settlement agent are shown, items marked '(p.o.c.)' were paid outside of the closing: ~hey are shown here for informational purposes and are not included in the D. Name and A~4~e-.-. of Borrower:. IE. Name and A~,~s of Sellan Leroy D. Smith, Rosella M. Jumper, and Robert E. Smith, E~ectors of Evelyn 1~. S~h Estate 5 South H~over Stree~ C~llsle, PA 17013 TIN G. Prope~ ~lion William c. Trou~man 620 Lindsey Road Carlisle, PA 17013 NameandAddmssof~nder H. Sellers Setttsment Agent: TIN 25-1730538 Carlisle, PA Fray & Tiley Law Office South Hanover St. 17013 J. SUMMARY OF BORROWER'S TRANSACTION 101 Contract sa)es price 102 Pemooal property 103 Seffiemenf charges from (line 1400) 104 105 Adjus~nents for/terns paid by seller in aoYance: 106 City/town taxes 6/12/02 107 County taxes 108 Assessments 109 110 School loxes 6/12/02 111 112 120 Gross Amount Due From Borrower to 12/31/02 to 6'30/02 A8 Pine Grove Aoad Gar~ners, Pennsylvanla Dicklneon Township 08-39-2216-001 200 Amounts ~a!~ B~:~r!a ~eh~lrO ~:S orrmv~:;ii i:;~.;.'i iii i~;~ ?i ~i;.~ :~ 201 O~it or earnest ~ey 202 Pd~lp~ ~unt el new loan(e)"' 203 E~st~g Io~(s) t~an sub)ecl to 2~ 203 2~ 207 208 209 Adjus~en~ for items upaid by seller 210 Cilyltown loxes 1/1/02 to ~3~02 211 Counly I~es 212 Assessments 213 214 School laxes 7/1~1 to 6/1~02 215 216 217 218 219 220 To~l Paid By/For Borrower 301 Gross amoum due f~ ~ower (line 120) I 302 Less ~ounts paid by/for borrower (fr~ ~ne 220) [ 303 Cash (X) From ( } To Borrower I. Settlement Date: Hu=e 12, 2002 IPlaceofSe~emanf: 5 South Hanover Street ICarlisle, PA 17013 'SUMMARY OF SELLER'S TRANSAC~ON 25,500.00 401 Contract Salss pdce 402 Personal property 630.50 403 404 405 Adjustments for items paid by se#er in advance: 6'7.42 406 City/town taxes 6/12/02 to 12/31/02 407 County taxes 408 Assessments 409 2 8.2 6 410 School taxes 6/12/02 to 6/30/02 411 412 26,226.18 420 Gross Amount Due to Seller 2,5 =~ 0.0 0 501 Excess deposit (see Instructions) 502 Seltiement charges fo aall~r {tine 1400) 503 Exlsllng loan(s) takan subject to 504 Payoff of first mortgage loan 505 Payoff of second mortgage loan 5O6 5O7 509 Adjustments for gems upaid by seller 510 Cify/Iown taxes 1/1/02 to 6/12/02 511 County taxes 512 Assessments 513 514 School faxes 7/1/01 to 6/12/02 515 516 517 518 519 2, _=, 5 0.0 0 520 Total Reductions to Ant Due Seller 26,226.18 (2,550.00 23,676.18 601 Gross amounf to seller Irom (line 420) 602 Less reductions in amount due seller (from line 520): S03 Cash ( ) From (X) To Seller 25,500.00 67.42 28.26 25,595.68 2,550.00 255.00 2,805.00 25,595.68 (2,805.00) 22,790.68 L SETTLEMENT CHARGES 700: -Total~Sales/Br0k Division of Commission (line 700) as follows: ?01 to 702 to 703 704 Commission paid at Settlement 705 Auctioneer ~ s fee 8oo/'ltem$ payable,.;!~-, (Mortgage Ami: 0.00) 801 Loan Origination Fee 802 Loan Discounl 803 Appraisal Fee 804 Credit Report 805 Lender's Inspection Fee 806 Mortgage Insurance Application Fee 807 Assumption Fee 808 Tax Service Contract 809 Flood Certification fee 810 Document Preparation fee 811 · 000 ~ to .000 ~ to Io to to to to to to to N/A Total charges, Lines 801 Ihrough 8' 0.o0 to 901 Interes From 12-Jun-02 902 Mortgage Insurance Premium for to ~. 0. 00000 per day = months to years to years Io 903 Hazard Insurance Premium for 1 904 905 lOOO'Reserves! DeP0SitedWith Len.de~::! 1002 Mortgage insurance 1003 City property taxes 1004 County property taxes 1005 Annual assessmenls 1006 1007 School taxes 1008 Aggregate Settlement Adjustment 1101 Settlemenl or closing fee to 1102 Abslract or litle search Io 1103 Tills examinalion Io 1104 Tills insurance binder to 1105 Document preparation Io 11{36 Notai'y tees to 1107 Attorney's fees Io (includes above items numbers: 1108 Tilie Insurance to (includes above items numbers: 1109 Lender's Coverage 1110 Owners Coverage 1111 Closin~ Service Letter to 1112 1113 Overnight delivery fees mos. @ par month mos. ~ per month mos. e $10.36 per month mos. ~ per month mos. ~, per month mos. @ per month mos. ~ $~8.73 per month mos. ~ per month Frey & Tiley $ Endorsements= $ Commonwealth Land' Title Insurance Co. 120o Government Recording and Transfer'Ct~arg'e ~ ;~d~:~-~ ~i ili~ :!?~;:; ~:~;ili:, ~ 1201 Recording fees: Deed $25.50 ; Mortgage: $ ; Releases 1202 City/counly/stamps: Deed ~255.00 ; Mortgage: ~ 1203 State tax/stamps: Deed $255.00 ; Mortgage: $ 1204 1205 !.i~°~'=i'Addiflona Settl~enLchm. ges: i=.~ 1301 Sun, ey to 1302 Pest inspection to 1303 Current Taxes due fi'om Borrower/Seller 1304 1305 1308 1307 14oo Total Settlement Charges (enteronlines 1( Paid From Borrowers Funds al 0.00 0.00 P.O.C 0.00 0.00 350.00 N.A 25.50 255.00 630.50 Seller's Funds at ~.O.C. 255.00 255.00 Page No. 2 P.O.C. AT REV-1508 EX + (1-97) (I) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Evelyn R. Smith 21-02-0344 Include the proceeds of li~igatio~ and the date the proceeds were received by the estate. ALL PROPERTY JOINTLY-OVVNED vvm-I THE RIGHT OF SURVIVORSHIP MUST BE DISCLOSED ON SCHEDULE F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Proceeds from sale of auction, net of auctioneer's fees and costs Refund, City/Town and School Taxes Property Tax rebate from Commonwealth of Pennsylvania 2,689 96 500 TOTAL (Also enter on line 5, Recapitulation) $ 3,285 (If more space is needed, insert additional sheets of the same size) OWNER Address FINAL SETTLEMENT Date ~{ ,/ .... \ Date of Sale Auctioneer Other Sale Location Clerk Cashier PROCEEDS OF SALE: Cash ............................................... Checks ............................................ Other ............................... '_ ......................................................... ~. Miscellaneous (see attached list) ............................................ LESS SELLER'S SALE EXPENSE: Auctioneer's Fee .............. _Z_ ~'.~d_,__ _(~. _~~ _. $ .... O0 '~' Other Seller's Expenses Advanced by Auctioneer: Miscellaneous (see attached list) .............................................. DEDUCT TOTAL SELLER'S SALE EXPENSE .............................. ~-~i--~(~/~'~ N,. TOTAL NET PROOEED8 TO SELLER ............................ · . , I, (or we), the seller of goods, merchandise, and/or property sold at public auction on above date and location, acknowle~ept this settlement of proceeds of sale. I (or we) agree to accept all responsibility for providing merchantable title to all goods, merchandise, and/or property sold, and for delivery of title to the purchaser, (Date) (Seller's Signature) Auctioneer or Cashier's Signature Form No. FS Reorder from: MISSOURI AUCTION SCHOOL Phone 1-800-835-1955 (Seller's Signature) AT REV-1511 EX + (1-97) (~) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Evelyn R. Smith 21-02-0344 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT FUNERAL EXPENSES: 5. 6. 7. 8. 9. 10. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State Year(s) Commission Paid: __ Zip Attorney Fees Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address Cily State __ Zip Relationship of Claimant to Decedent Probate Fees Accountant's Fees Tax Return Preparer's Fees ~egister of Wills, File Return AucfioneeCs fees and expenses, see Auctioneer's statement attached Fees and expenses of sale or real estate, see HUD-1 settlement statement attached Final nursing home bill to United Church of Christ Homes TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 0 1,414 0 88 0 0 15 1,095 255 312 3,179 AT REV-1512 EX + (1-97) (I) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES,& LIENS ESTATE OF FILE NUMBER Evelyn R. Smith 21-02-0344 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1. Debt owed to Leroy D. Smith, Sr. for paying funeral expense, see statement attached. 4,479 4,479 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) Hollinger Funeral Home & Crematory, Inc. t~ric L. Hollingcr, Supervisor COVERAGE AMOUNT FOR EVELYN R. SMITH $ 4479.14 PAID IN FULL DATE OF DEATH MARCH 6, 2002 POLICY NUMBER 000286105 501 NORTH BALTIMORE AVI~NUt~ · MOUNT H©LLY SPRINGS, PENNSYLVANIA 17065 · (717) 486-3433 · FAX (717) 486-3215 21~7 REV-1513 EX + (9~0) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER Evelyn R. Smith 21-02-0344 NUMBER II. 1. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and Son transfers under Sec. 9116 (a) (1.2)] Leroy D. Smith 45 Pine Grove F~oad Gardners PA 17324 Rosella M. Jumper 41 Pine Grove Road Gardners PA 17324 Robert E. Smith 40 Pi~e Grove Road Gardners PA 17324 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Daughter Son AMOUNT ORSHARE OF ESTATE 1/3 of residue of estate 1/3 of residue of estate 1/3 of residue of estate ENTER DOLLAR AMOUNTS FOR' I)ISTRtBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18~ AS APPROPRIATE~ ON REV-1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET (if more space is needed, insert additional sheets of the same size) LAST WILL AND TESTAMENT OF EVELYN R. SMITH I, EVELYN R. SMITH, of Dickinson Township, (R. D. # 2, Gardners), Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my last Will and Testament, hereby revoking and making void any and all Wills by me at any time heretofore made. 1. I direct my hereinafter named Execut'ors to pay all of my just debts and funeral expenses as soon after my death as may be found convenient to do so. 2. All the rest, residue and remainder of my estate, real, personal and mixed, and wheresoever the same may be situate, I give, devise and bec in equal shares to my Three (3) children, their heirs and assigns, the share of any deceased child to pass to his or her issue per stirpes. My said Three (3) children being Leroy D. Smith, Rosella M. Jumper and Robert E. Smith, all of R. D. # 2, Gardners, Pennsylvania. 3. I hereby nominate, constitute and appoint my said Three (3) children, Leroy D. Smith, Rosella M. Jumper and Robert E. Smith, or any of them, as Co-Executors of this my last Will and Testament and I furLher direct that none of them shall be required to post any bond to secure the faithful performance of his or her duties in the Commonwealth of Pennsylvania or in any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my last Will and Testament written on one (1) page this llth day of October, 1971 Evelyn R. Smith Signed, sealed, published and declared by Evelyn R. Smith, ~he Testatrix above named, as and for her last Will and Testament, in our presence, who, in her presence, at her request, and in the presence of each other, have hereunto subscribed our names as attesting witnesses. BUREAU OF INDIVIDUAL TAXES TNHERTTANCE TAX DTVTSTON DEPT. 280601 HARRTSBURG, PA 17128-0601 CONHONHEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISENENT, ALLONANCE OR DISALLONANCE OF DEDUCTIONS AND ASSESSHENT OF TAX REV-15¢i? EX AFP (01-02) ROBERT H FREY FREY 8 TZLEY 5 S HANOVER ST CARLISLE PA 17013 DATE 09-30-2002 ESTATE OF SNITH DATE OF DEATH 05-06-Z002 FILE NUNBER 21 02-034~ COUNTY CUHBERLAND ACN 101 Amoun~ Ram/fred EVELYN R HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGTSTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-02) NOTICE OF INHERITANCE TAX APPRAZSENENT, ALLOWANCE OR DZSALLO#ANCE OF DEDUCTIONS AND ASSESSNENT OF TAX ESTATE OF SHITH EVELYN R FILE NO. 21 02-034~ ACN 101 DATE 09-30-2002 TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Stock/Partnership Interest (Schedule C) (3) 4. Nortgages/Notes Receivable (Schedule D) (4) $. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Ada. Costs/Misc. Expanses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 11. Total Deductions 12. Nat Value of Tax Return 25~500.00 .00 .00 .0O 3z285.00 .00 .00 (8) 3,179.00 4~R79.00 (11) (12) 13. NOTE: ASSESSHENT OF TAX: 15. Amount of Line 14 at SpousaZ rata 16. Aeount of Line 14 taxable et Lineal/Class A rate 17. Aeount of Line 14 at Sibling rata 18. Amount of Line 14 taxable et Collateral/Class B rata 19. Principal Tax Due TAX CREDITS: PAYMENT RECE/PT DI'SCOUNT DATE NUHBER INTEREST/PEN PAID (-) 06-06-2002 CD00126~ 47.55 Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) Net Value of Estate Subject to Tax (14) Zf an assessnent vas issued previously, 11nas 14, 15 and/or 16, 17, reflect figures that include the total of ALL returns assessed to date. (15) .00 x O0 = (16) 21,127.00 x OR5= (17) . O0 x 12 = (18) .00 x 15 = (19)= ANOUNT PAID 1,1~,7.60 IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. NOTE: To insure proper credit to your account, submit the upper portion of th~s form with your tax payment. 28,785.00 7.~8.00 21~127.00 .00 21,127.00 18 and 19 Nill .00 951.00 .00 .00 951.00 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 1,195.15 244.15CR .00 244.15CR ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYNENT IS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR ZNSTRUCTZONS.} STATUS REPORT UNDER RULE 6.12 Name of Decedent: EVELYN R. SMITH Date of Death: March 6, 2002 Will No. 21-02-344 Admin. No. Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes X No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete.: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No X b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes X No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to this report. Date: October 3, 2002 ~" ~ gnature ~ Robert G. Frey · . Name (Please type or ~rint) 5South HanoverStreet, Carlisle, PA 17013 Address (MAH: rmf/AM3) i 717 ) 243-5838 Tel. No. Capacity: X Personal Representative ~Counsel for personal representative BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG., PA 17128-0601 CONNON~/EALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEHENT OF ACCOUNT REV-i~O? IX AFP (01-02) ROBERT M FREY FREY & TILEY 5 S HANOVER ST CARLISLE PA 17015 DATE 10-28-2002 ESTATE OF SM[TH EVELYN DATE OF DEATH 05-06-2002 FILE NUHBER 210Z-OSqq /iCeUNT~iii'~i CUH~ERLAND ACN 101 Amount Rem/fred MAKE CHECK PAYABLE AND REMZT PAYMENT TO= REGISTER OF ~/TLLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 NOTE: To /nsure proper credit to your account, submit the upper portion of ~:his form w[th your ~ax payment. CUT ALONG TH'rS L'rNE ~ RETAIN LO#ER PORT[ON FOR YOUR RECORDS REV-1607 EX AFP (01-02) ~x 'rNHERZTANCE TAX STATEMENT OF ACCOUNT ESTATE OF SMITH EVELYN R FILE NO. 21 02-03q~ ACN 101 DATE 10-28-2002 THIS STATEMENT IS PROVTDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACM IN THE NAMED ESTATE. SHOHN BELO# TS A SUMHARY OF THE PRTNCIPAL TAX DUE, APPLTCATTON OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLTCABLE, A PROJECTED INTEREST F'rGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTHENT: 09-25-2002 PR[NC[PAL TAX DUE: ........................................................................................................................................................................................................................... PAYMENTS (TAX CREDITS): 951.00 PAYHENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER i[NTEREST/PEN PAID (-) q7.55 06-06-2002 10-10-2002 CDOO126q REFUND .0O 1,1q7.60 2qq.15- IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( XF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" TOTAL TAX CREDIT 951.00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 YOU MAY BE DUE A REFUND. SEE REVERSE STDE OF THIS FORM FOR INSTRUCTIONS.