HomeMy WebLinkAbout09-20-13 � 15�561014�
REV-1500 � �02-11)(FI}
PA Department Of RBVenue OfFICiAL USE pNIY
Bureauot�ndividua�Taxes 1NHERITANCETAXRETURN �OUOryGode Year FileNumher
ao aox 2soso� 2 1 1 2 q 9 1 5
Harrisburtt PA 1712&0601 RESI4ENT DECEDENT
EkTER DECEDENT INFORMATION BELpW
Sociat Security M1lumber Date of peath MMpoW�'v Date of Birth MMDOYYYv
� 7 2 8 2 D 1 2 D 9 0 4 1 9 2 5
DeoedenYS Last Name -Suffix DeeedenYs First Name Mi
0 V E ft C A S H K E N N E T H M
itt Applicablej Enter Surviving 3pouse'e Information Baiow
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Saciai Sacurity Number
THtS RETURN MUST 8E FILED IN DUPLICATE WITH THE
REGISTER OF WiLLS
FtLI IN APPROPRIATE 4YALS BELOW
Q i.Odginai Reium � 2.Supplementa{Retum � 3.Remaintler Retum(Date of 6eath
Pnor to 12-13-82}
� 4.limited Estate � 4a.Future lnterest Compromise{date of � 5.Federai Estata Tax Reium Re�uired
� death after 12-12-82)
Q 8.DecedeM Died Testate � 7.Decedent Maintained a Llving Trust ._, 8.Total Number of Safe Deposit Boxes
{Attach Copy of Wilp (Attach Copy of Trust.)
� 9.litigatlon Proceeds Received � 10.Spousal Poverty Credit(Date of Death � t 1.Election to 7ax under Sec,9113(A�
Between 12-31-91 and 1-1•95) (Attach Scheduie O}
CORRESPONDENT-T8{S SECTION MU57 BE COMPLETED.ALL CORRESP4NDENCE AN�CONFIdENTiAL TAX INPORk1AT10X$H4llLp BE OtRECTED T0:
Name Daylime Telephone Number
M U R R E L W A l T E R S I I I E S Q 7r,1 7 6 9; 7 �:;4-`;6 5 0
c
��
��ISTERQF-WILL3tlSE�QNLY
rri -.- c'
i'J �-,> f_.. _
firet Line of Address C` �' "��` '�����? .
� ',: tn
5 4 E • M A I N S T R E E T � .� ,- ,� -
Second line of Addtess i �-' `"� � ' —} .�.
r.
- 4 C�*
�i� �
Gity or Post O�ce State ZIP Code � _ oAtEf�lEp __
M E C H A N I C S B U R G P A 1 7 Q 5 5
corres�«,aenrs e-man aadxess: murrel�walterss��llowav.com
Under penelties of perJury,l dedaro that I have examined Nls rewm,including aecrompanying schetluies aM aiatemeMS,and to Ne besi oi my k�wledpe and beNet.
it is hue,cwrect aM wmple(e.DeclaraUOn of preperor oNer than thn personai rcOregentative is based on ail informatian M which prepargr has sny knowiedge.
SIGNA pFPERS S SIB�EF Fil URN ATE
J /
ADORESS
KEN ETH HOWARH 4 ER , 3 tOLD PRIN6S RD DILLSBURG PA 1?019
SIGNATURE OF PREP T RESENTATIVE TE
- J� 't�
AD6RESS
MURREL R. W LT RS III, 54 E• MAIN ST MECHANIt38Uft6 PA 17055
P�EASE USE ORIGINAL FORM ON�Y
Slde 1
� 150561014d 15a561Q14D J
�`
�I
Continuation af REV-1508 inheritance Tax Return Resident Decedent
KEfVNETH M. OVERGASH 21 12 0915
DecetienPs Name Page 4 File Number
�i4ff83pOti{�BiitS '
Name Daytime Telephane Number
M U R R E L W A l T E R S 1 1 1 E S Q 7 1 7 6 9 7 4 6 5 d
First iina of address
5 4 E . M A i N S T R E E T
Second iine of address
Ciry or Post O�ce State ZIP Code
M E C N A N 1 G S B U R G P A 1 7 4 5 5
Correspondent�s e-man adaress:murrei�2waltersaaliawav.com
Ur�penaWes�pe�ry,l dedere U}at I have exam�ed�h4s reWm,induding accompanying schedulea aM statements,and to ihe best of my knowledge and beiief, �
it is We,correct and complete.Declaratlon of preparer other than the perspnai represenhahve�s based on a8 iniamaUon of which pieparer has any knaxiedge.
SI ' ATURE Of PERSON SP LE FOR FILING RE7URN
' sd.� ��'iYr�a�a--- ��/�
A ESS
QNNE E. RENNA $02 DOGWOOD CQURT IRNDSDAIE PA 19446
i ���i■
� 150561024�
REV-15W EX(Ef) DecedenYs Sociai Security Number
oeceeenrsName: KENNETH M� 4VERCA$H
RECAPITUTATiON
1. RealEState{Schedufe A) . . . .. . . .. . . . . . . . . .. . ..... .................. 1. 1 4 9 9 o a . � 0
2. Stocks and Bornis(Sdredule B} ..................................... . 2. 1 4 3 6 9 6 . t1 0
3. Closely Heltl Corporation,Partnership or Soie-Proprietorship(Schedule C} .... . 3. •
A. Mortgages antl Notes Reca{vabia{Sd�edule D} ...................... .... 4. 3 9 2 4 3 , � c�
5. Cash,8ank Dep4sits and Mfscelfaneous Personal Property(Scheduie E). .. . . . . 5. 2 n 7 $ Q 4 , y 7
6. JainGy Owned Properry{Schetlule F} ❑ Ssparate Bi{ttng Requested ....... 6. •
7. Intet-Vivos Transfers&Miscellaneous I�,QqProbate Property
(Schetlute G} (J 5eparate Billing Requestetl . . .. . . . 7. .
8. Total Groaa Asaets{totai Lines 1 through 7} . .. . .. . .. . .. . .. . .. . .. ...... &. S 4 0 [1 4 3 . 9 9
� 9. Fu�eral Expenses and Administrative Costs(5chedule H) .................. 9. 3 5 2 2 6 . 8 6
16. Debts of DecedeM,Mortgage LiabiliGes,a�d Liene(Schedule ij . .. . .. . .. . . .. 10. q 9 7 4 . 6 2
1 i. Total DoduCtions(tota�Unes 8 and 10j .. . . . . . .. . . . .. ..... ............ 11, u 5 2 0 1 . 4 8
52. Net Value of Estate(Line S mirxas Line t t) ............................ 12. 4 9 4 8 4 2 . 5 1
13. Charitable and Govemmental Bequests/Sec 9513 7rusts far wirich
an ek+ction to tax has not been made{Schedule J) .. . .. . .. . .. . .. . .. . . .. . i 3. •
74. Net Value SubJect io Ta�c(line 12 minus Line 13} .. . ................... 14. 4 9 4 S 4 2 . 5 1
TAX CALCULATION•3EE iNSTRUCTiONS FOR APPliCABIE RATES
15. Rmount af l.ine 14 tauable
at me spausal tax rate,or
trarrstere under Sec.9516
ia)(1.2)x.0 � 0 . 0 0 t5. 4 . � 0
18. Rmount af une 14 Wxable
at lineal rate X.Q45 4 9 4 8 4 2 . 5 1 tis. 2 2 2 6 7 . 9 1
17. Amount af Line 14 taw^�bie
at sibli�g rate x.�z � . 0 0 1z D . 0 0
18. Amo�nt pf Line i4 ta�bte
at coiiaterai rata X.15 � • 0 � i g, 0 � � n
19. TAX OUE . .. .................................. ... .. ... . . .. . .. . . 15. 2 � 2 5 � • 9 1
2Q. FlLL fN 7HE OVAL IP Y8U ARE REQUESTING A REFUNO 8F AN OYERPAYMENT ❑
Side 2
� 15L1561�24[! 150561Q244 �
REY-150p EX(Ffj Page 3 File Number
decedent's Campiete Address: 2� 12 0815
DECEDENTSNAME
KENNETH M.OVERGASH ___ � ____,,, T_`_____,._._„_
5TREETA04RESS
516 BRiGHTdN PU10E uJ_ ____._.,�� __ —___��
—---------_�_----- -------- ---------__ ,____----
GITY STATE ZIP
MEGHANlCSBURG PA 1�065
Tax Payments and Credits:
1. Tax Due{Page 2,Line 19) (1) 22 267.91
2. CreditslPayments
A.Pda Payments 2'I.500.OQ
e.Discqun/ 1.0OO.Od
Total Credits(A+8) (2) 22,508.48
3. lnterest
{3)
4. if Line 2 is greater than Lir�t+(���,�nter Ihe dafference.This is the OVERPAYMENT.
Fil!in avai on Page 2,U�20 to request a rsftind. (4) 232.09
5. If Line t+line 3 is greater than 4+ne 2,enter the difference.This is the TAX OUE. (5) O.Od
Make check payable to; REGl5TER OF WILLS, AGENT
u ,,�,�Y � _ .a , _
PLEASE ANSWER TNE FOlLOWING QUESTIONS BY PLACING AN "X" IN TNE APPRQPRIATE B�OCKS
1. Did decedent make a iransfer and: Yes No
a, retain the use or income of ths proparty hansfertad ...................................................................... ❑ �
b. retain!he�igM to designate who shall use the propedy transferred or its income ...............................
c, retain a reversionary interest ..................................................................................................... {�
d. receive the pramise for life of either paym�ts,benefts w care? ....................................................... ❑ �
2. if death occurred after December 12,1982,did decedent hansfer p�operty wEthin one year of death
withaui receiving adequate consideration? ....................................................................................... ❑ Q
3. Did decedent own an"in Wst for"or payable-upon+ieath bank acmunt or security at his or her death? ......... ❑ �
4. 4id decedent own an individual re6rement account,annuity or other non-probate property,which
canteins a berteficiary designffiion?.................................................................................................. ❑ �
IF THE ANSWER TO ANY OF THE ABOVE qUES710NS IS YES,YOU MUST COMPLETE SCHEC?ULE G AMD FILE IT AS PART OF THE RETURN.
For dates af death on or after JuVy 1,1994,and 6efore Jan. 1, 1995,the tax rate imposed on the net value of hansfers to or for the use of the surviving spouse i�
is 3 percent j�2 P.S.§9116(a}(1.1}(i)j.
For dates af death on or after Jan. 1,1995,the tau rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
(!2 P.S.§9116(a)(1.7}(ii)).The staWte does not exempt a Vansfer to a surviving spouse from tax,and the sqtutory requirements for disciosure of assets and
fi{ing a tax reNrn are stili applic�le sven if the surviving spouse is the only beneficiary.
for dates of death on or after July t,2000:
• The tax rate imposed on the�et value of Uansfers from a deceased chiid 21 years of age or younger at death to a for ihe use of a nstur�i parent,an
adoptive pareM or a stepparent of the child is 0 percent p2 P.S.§9116(a){t2}j.
• The tax rate imposed on Me net value of transfers to w fw the ase of the decedenPS lineal benefiaaries is 4.5 percent,except es noted in pz P.s.g8�i6�a)(�p.
• The t�rate imposed on the net value of transfers ta or for the use of the decedenfs siblings is 12 percent[72 P.S.§8118(a}(1.3}].A sibiing is defined,
under Section 9142,as an individual who has at least one perent in common with the decedent,wheiher by biood or adoption.
REV.7502 EX+(12-12)
pennsylvania SCHEDULE A
DEPARTAIEN7 OF REVENU@
REAL ESTATE
INHERITANCE TAX RETURN
RESIDENT�ECEOENT
ESTATE OF: Fit.E NUMBER:
KENNETH M.OVERGASH 21 12 0915
Ni real property owned solety or as a tenant tn common must 6e reparttd at fair market value.Fair mazket value is defined as Yhe price at which property
wouid be exchanged beiween a wiiflng buyer and a wilfirx3 selfer,neither being canpelled to buy or sell,both having reasonable knowledge of the reievani facts.
Rea!proparty ihat is Jointly�a�med wBh rlgM of survivarship muat be d+eclosed on Sehedule F.
Attach a copy of the settlement sheei N the property has been sold.
�T�� tndude a capy of the deed shawing decedenPs inlerest if owned as tenant in common. VA�tlE AT DATE
NUMBER OFDEATN
DESCRIPTION
1, 518 BRiGHTON PLACE 149,SOd.00
MECHAWCSBURG, PA 1�055
SALE PRICE
T87A1(Aiso er+ter on Lir�e t,RecapitWation.} S 149 904.04
!f rtrore space is needed.use additlonal sheels of paper of fhe seme size.
��MT Ni��rt ���u nw�........,.__`_"""
P �.
u^ � `�:� HUp-1
_ � � � > w A. Setttemant Skatement {HUD-1)
y' _
��q �e`�� vaqo t a 3
dtN 6c.C�'
6.Type ot loae
1.❑fna I.❑RHS 3.❑X Ca+v.Unrns. 6.file Number: �.Loan Number: 8.Mm[qage InwrorKe Case Numder:
a. YA 5.❑Cpnv.�os. 403302b43-CB 312933}�g8
MO1E: This form is hrnlsheE ro give yau a sOtement d accuai Se[Clement msts.Ampun6 ptM co enC hy SM settlemcnt agmt arc shawn.
Items merketl'(O.o.c,)'w�re Dain ovtsida th¢cbsirp;theY m shewn here kr informacional Plirpusls and src npc IncluOeG fn the
otals.
D.N�ma mG�tltlrp�M tarrow+. f.Mam�arM AGtl�ats af SUIIK F,N�m!e anU MIAr�sa o}Lend�r
?FMHA l.NFftGtAGltO KENNETN HOWAPD OVE0.GSM,C0� ERA HOME lPtNS
951 MANCOtK ORIYE EXEGUTO0.ANO YVONNE E.AENKA,CO- t MORTGAGE WAY,
GE'7"lV59U0.G,PA V]25�8959 EXECUTRi%Of ESTATE#K£NNETM M. MOtlNTlAURE4 N7 09054
6VERGSX.AjK1�KFNNEfH Mq0.QlD
QYERGSH
516 9RIGX70N GIACE
MECHANICSBU0.G,PA17055
6.hopsrCy leutbn X.9eRkmant J1p�M .
SECU0.EOtA41D fRAN5PER5,llC .
' S16 B0.IGX70N PtACE, <BS 5T,]4HN5 C+fU0.Cn RoAD, �
� MECMANiC58URG.PA 37055 SH�0.EMANSTOWN,PA 17011
ilwae:(71l)9U1-B741
TM'���p waceot5ettlemmnt 1.4Ntlemen[Oate 04f17R013
PARCfLIO:�2-29-P791-169U516
14WNSMIP:UPVEF ALLEN TOWNSMIP
19 N00.TN BAL7IMORE 5T piabufvCmint Ditt 69J1312Q33
DItl50URG,GA 1]p19-1354
l.Summa o/lanower`s Tr#nssctlon K.5umma ot Sa11ar'a Tranasetion
100,G'e`s Ameunt Dw tro�w�o,eow�r 400.GtoK 4mouM Dw m i�il�r
Oi. Si Pr _ 1sp 900.00 t03, n n iaie6 Ptice �-�i�-�-��- �348 90Q.U0
1�2. Peetwnf Vm.�er(���` 402. PorsonN ProxM1Y '_�,._,_._,,,�_„
1P3. SeMemm[Gfe a t0,bortowuil!„190��� tl 375.0� {03. ___"_ _
•a. -
105. 465.
AO u�fmu�t la�k�m� utl��in noe Wtmant f4r MIIH In idvinae
106. Own T xa 406. oWn T Mq
10�. aun T xa SBS.4� 9Ji3 2613 ta i 1 205� 17628 4�7.foun Tax � 58�.97 r 9/13/2017 to 1 3 2�30 fllfi.i4
108. Nseasmmta 408.Assessmmn
189. two�Thcss 1 64i. r 3 301 m l 1 2C a 3 l74A3 409. I Te 33 1013 to 7 261d 3 479.93
Y1d. MomhiyN6A4ues153.OWmofw4(13(2P33kn sqy,gp 430. M°�MWH �ues153.W)maM9�i3/2613to ;91.B0
] 19 I0 1 20t3
ltl. �Q�a$ewet Bi11111.0Ul4It br 9/13/291710 Y21.91 413. 3rd Quartx:reper 8iX 31I.001ptt Por 9/13f2623 W �23.43
1 201} i M33
1 . 431.
17tl. oss �0 35t fOt.47 439.6tats Dw to BNler 151 669A3
2DD.AproYrtt�P�W Or Of Ih Mhil1 pf lorrowtlr 600.R�tlucfieix Zn AmeUM Oue te S611M
2D3. Oe 1 .00 SOl. ExCRSS Dt iK
2�2. ParK !Wsrt Amount hvm ERP ome Losns 119 920.09 502. etCiemmt CYO SeNtr 12 03�.SI
20]. E.� i b�n c ukan sUE ec[m SOI. Existi �w 5 pkan tu ' tc
]04. SfM.
205. d5.
206. SO6.
207. S�T.
B. 5�@.
ZOS. 509.
• Ms hu i Ner A wdMnG ar INms u aW wllu
254.C am Taxes 510. I[ own Ta+es
2fi.Ca. Tn.p 5 . T zes
312.I1sMSmentf S3Z. ASw%mMls
213. 5lller PDiU CIO61 CostS 6 000.W 3t3. 5llkr Peiy Cfes 6 900.�Q
21s. 514.
I15. 515.
2 . Si6.
217. Sll.
218. 5 9.
219. 519.
220,7oW►�id AM Mrmw�r 116 920.00 520.T 1 A o Due 6NIa 1D OS�S3
300.csM K SYtqem�nt hemlto borrowar 6pa,tsM at Settlwrwnt telhom i�Xu
301. Grofa• C e hom bomowef N�ue 130 15190a.�1 661. G a MO fNle! 4 153 689.a]
3tl2. Leu ertquns W r Oormwv 6ro 226 f26 930.00 6pi. lass r� ' in C 11 r line 52A 18 037.51
307.Gsn X From To Bprrower t0�9l1A7 603.Cpsl� X T6 from Seqer 137�631.91
il�lPUONCR�DON^OBUNen rMLLrs4cNOnWinlwmYUnnxGMNE�t�3TinWa6Pmry�kt nx,wi+p.M6q0�kKtltedf4.TroaypnwpewY�al
wI1M Wf iIIpM1MM1M.DMI WMi MfI(IOI�H���dO M CCI�PMC1 VYf i(MM�IInIC1F M9ftW�Y�a P�t6MlY YWE OMBGOIJIN 1YII�GN.NO LO/1}�M��3MM A 89SANlE:�INS EI�CIO6W0
ii mWMCbry.TtNa K QRflfNfetl�vtOVqR pK pB(tila M a RE$PA cUwvatl Ir�nwclien will�InbmNliM EuMlp N!Np191110m ptOpsi. �!�,.
� Inrciai:��,"�`__
t SattNmsntCharges ---�
100.Tota�Rai Estin Eroker Poe S4i79.6n p��p��am Pald FrqT
pivision of Commissan iine 100 x tataws: Borrower's Funtls SeUCPS Fundz
70L 9&6].W to 0. Nax Sst A4�a S4 31)+435� At SaMement AT SetNemt�t
702. 1 12,00 ro ERA-NRT tLC <337+ 195 145.� $0 984.00
7UA.CamTasbn laaCSSMe*nenS
7tN.
800.Ytlmf PiYiCIe ih CorvneNOn with taan
801.Ouror� inaUOn dw c 601,25 rom GiE yi ,
802.Your cretlic or cira e intz for Ne s <ific mcercst rate enosm trom GfE t2
803.Yaur ' stM 6H �na[ion rnOr<s fram 6fS A .25
804.n aisa�f�e w SiAR5 from GFE k 515.00
805.Cre61t 2 to C&C lNN041$ INC. fmm GFE x3 8.31
806.Tb[$e(ViLC fmfn GF£kI
80).Fbotl Cen.Fee (ram GFE m3
soe. -
9�0.Stems IXapuircA ey teoaer to ae rota In 11dv�n[e
901.��neercst Ne�ges from 09(13/13 to 16/01/13 @ t5.11/day ERP.Home ((�om GFE xtO) 52�7�78
9G2.M e Insurance vremium irom GFE N3
401.nomeownela mxunnce pA10 TF+kOUGN NOA �mm GFE+`ll
90a. t Year to Tmvefars Ior M06 ioi vOC 68a.Q0
2aW.0.esarves OepoaiteA with lander
1003.Iruuai de osit 1or ou�escrow account from GfE�19 813.5] �
t002 6[y zro0erty Tanes B.00UO mantb(sj @ 26.13 J manM(s}m ERR?rome sibi.0a
1003.������ertV iazn 5.060C moMtr(s)�28.63 7�th{s)ro ERA Home j228 88
loans
360i.5ct�oW Tve5<.OWO mont s �154.69 month s [o EPA Home LOans 619.i6
t005. teXwvM�n afuumeateaEPAROmeLOans � 1W.93
1006.
3QOl.
5100.Titls Chat9�s �
t 161.Tiik zarncM aM krker's Ci[k inswaoee to Secuwtl l.anq Transhn LLC itam GFE aA 3 524.Qk iR.00
3102.Settkment nr � tee to Stturep�aM iransfers L�C 225.00
1 .4wMr i ft.b inswanu Co ecvretl LaiM TranslCn ll trom GF£�`5 150.Q0
23RO.lMCF'S UUG ibSUroOtt LO SKU�ld Ld�E TmPS(HS iLC 1 IOQ.W
I105.�nEeYSGtle Ik limi 119 2 .00
1106.OwMYSCitle lic lim�t 3999W.a0
ISOT.A9GnC's pORion of thC[OtLi IiUe 1�su�b�CC ptlmvm t05lWted LbM si zr$A8
TranS(M LLC
�i6b.Untlernetter's wnotthatttMHI�eimurancc miumWTRGGSaIa I35.a0
I109.irisurcb Cia5i Pmtectbn letter to TkGC 75A0
1200.Garernment RecorOinq antl Tnmfer CBaqes
t201.Ga.ernmmtrcrordi eha es from F �t7 1]6.00
1202.DeM 5 P n 69,06 Fro a c M P �z 3Q�.00 ANeaxs
1203.irdn4fer Wxe3 fmm GFE+i8 3 494.00
320i.Cit 1COUn U�itam pee0 1499.49 Mott
i3o5.5tate taz/u 4eM 1499.00 M e i a94.OQ
1306.
1300.Ad0ttfonli SeRriement G��ugas
3IU3.R aircE fGrviceA thaC oa cdn sh fpr from GFE�16 1450
IT02. LMiticatbn Fee ro STARS 519.50
1303.ApsbkCert.FSeta,tEMG tLC f����
i�M.3rd rter Sewe�9i11 to U tAllen Townfh' Nu[ho�i �LZ-�
1395.Fbme tns ' n ta SeeMO2 Home]ns ecCions POC 260.00
i�p6.HQA p�e fw 5e temher Co 7EM Grou 145.75
3307.Cs 'tai ContriOUCion to er bmn Placc Contbminium pswaatian 59.Q0
laoe_vese ms CSiO(1[O$!lMOR MOTG IpE CCO4�3 YOC i.00
1309.2013 SC�ool Taxes m Dennis 2tt6e Taz Cotl¢cwr 31 23LId
4UR.TOtalSettlemtnt CharytD(Rnler on lin�s 103�S�cUOn 7 antl.502,SaNUn Kj x6�315AI f12,M]SI
liyou Nve any quezNOm a6out He seXkme�i[targes u�tl Iean terms dslotl a�Nis brm,pkaa!wMacl you�kYpel.9NIMm4n14qeni is nPt m[panaipk iIN cantera oi
bikara meumeMi w HtlD.
t�e seMli C atb EOrcOwCYS�ignaWYes�ereoYl aCknOwIp09Q�✓BpproVN}Itl iiqMy IM1Wt�utOaYSt1l�iCifpUN1 ti%iflQ iniu�BtWC WNDllwfs&tl�easrves iie baseE en
fqures for�he p�ece0vq yeii tt suDP���Y+mers ar mtlmakE brNeturtrni yatt.�nd r+ihe M�I M anY�o�q���a+�'��Ytlar,all nerra4ary a7�usdnehia will be
ma0p Mfivaen OortawM anq slNet da8diy_Ang tlMKit tllqnqUlnt 1axeSNmo�IpipC WyCtls wIM ee ptomplly roimEUfsetl lo Np seXkment aqeM br Mb a0�er.
I IIiM GO�NullylCVliWlG Mf HU6.M1$¢tkl�iNM$t)iIIM1Q�II iM 1p VN 01t10�(!1Y�1NW1ldp8 Dlld 0!Ml1.N IY IfYC illd BCCYIi16 SIiMIMl1�01dM 190:1pb iM1 diBEYRC�M1NIIi
made on my accoun�a tly t^+in tNS I<anaaGion.l luriher cerlily Inal l nave reCeiveE a cbpy o/Ihe Ht10.1 SMieme�lt SlaPomeM.
�8 ERS / ^��ry'']} SELLERS
�,r{�%��(�f(�� EsbbdN �GfA.shJaf4p�Mtl�Haro�d0�aiWCh
Ol Mx9uBiP 9 � /� //�� // //� ` �J�
�+lK.i.. /IYO.ei.'/�f' 1....(�' tK�-I".A�P'.LYR/'
B�y:Kenr�eM Noatarop/vg/ccen.C xrec�WOr
tr�51,1i1,tP!'i .K�fiYnt$. tn`(i�,LfA.L�i.f
'.YVWMeE. anm.CO�EaMllt T
Tne NtiPt SHltemeM Siatement wnirn 1 Mvc yeWreC is a We an0 accunle acrnunt ol lhia transacGOn.i nave puaeE a wm cauaa fie Mtls ta tedisOUrsW in
actwGanw wun m�s sutsmau
A pn O�t�
_�. 9911320f�
*Any ilem4 markeC"GQC wUra paiE ouMiEC cbsinq by:BOrrAwEr PoC(9},�,tntler PpC(Lj,Mmt9a4�'8mk<r POC{M),Selle�POC(5),fteal EStnte
A9mt POC(AY,ar Omer POC(O}.
REV�1503 EX+{8-12)
pennsylvania SCHEDULE B
DEPARTF�NT OF REVFtrilE
,HHE�,�,�T��T�RN STOCKS & BONDS
RESIDENT DECEDENT
ESFATE OP FILE NUMBER
KENNETH M.OVERCASH 21' 12 0915
Ait property joinUy owned w+th rigM of survivorahip must be dlaclosed on Schedule F. �
ITEM VALUE AT DATE
NUMBER QESCRIPTION OF DEATH
t. INTEGRITY 143,09B.00
STOCK
NET SALE PRICE
TOTAL(A�so enter an Line 2,Recapituiation} S 143 896.80
If more space is needed,inaert addiNOnal sheets of the same s�ze
REV-7508 EX+{08-12)
pennsylvania SCHEDULE E
OEPARTMENT4FREVENUE �ASH� BANK DEPOSITS & MISC.
�aESioErAiNOECEa�NiTU� PERSONAI. Pi2QPERTY
ESTATE OF: FILE NUMBER:
KEHNETH M.OVERGA5H 21 12 Q915
Include the proceetls of IiUgatlon and the date the proceetls were received by the esWte.
Ati propeRy jointly owned witfi right of survivoranip must be dixiosed on 3Chedu#e f. '
ITEM YALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. C,UNS 160.00
(1)A5TRA 200 $$5.U0
{1)H&R MODEI 928 $75.00
2. PNC BANK '162,�78•42
CHECKING
3. PNC BANK 513.73
SAVINGS
4. MEMBERS 1 S7 PEDERAL CREDIT UNION 182.87
3AVINGS
5. MEMBERS 1ST FEDERAL CREOiT UNION fi,588.20
MONEY MANAGEMENT
8. MEMBERS 1 ST FEDERAL GREpiT UNION '17,010.06
GO
7. MEMBERS 137 FEOERAL CREpIT UNION 18,SSd.89
CD
S. PERSONAL PROPERTY 1,939,p0
PER APPRAI3AL 4F VICKi£L. HAROY
TOTA4(Aiso enter on�ina 5,Recapitulation} S 2d7 884.17
If more space ia needed,use additionai sheets of paper af ihe same�ize.
REV•1611 EX+(10-09)
pennsylvania SGHEDULE H
DEPARTMEKf OF AEVENUE FUNERAL EXPENSES AND
iro-iea�Tn�rr�R�ruRN qQMINISTRATIVE GOST3
RESfOENTDECEDENT
ESTATE OF fILE NUMBER
KENNETH M.OVERCASH 21 '12 0915
DeeadeM's dabts must be reported on Sahadule i.
ITEM
NUMBER QESCRIPTIQN AMOUNT
A. FUNERALEXPENSES:
t. NEit FUNERAI HdME,CAMP HItL, PA '10,406.92
2. NARPER'S TAVERN-FUNERAI LUNCHEON 915.36
8. ADMINISTRATIVE COSTS:
1. Personal Repmsentative Commissions:
Name(s)otPersanaiRepresenlative(s} KElJNETHHOWAROOVERCASH
sueet ndaress 38 COLD SPRINGS ROAO
c;ry UIIISBURf s�am PA zia 17019
Year{s}Commission Paid: (RENdUHCED?
y, atrorney Fees: MURREL R.WALTERS, III B,T00.00
3. Famiq E�cempdon:(Ii decedents address is irot ihe sama as daimants,ai�dr axph�nation.)
CleimaM
Sireet Atldress
City State 21P
Relatimiship of CiaimaM to Decadent
4. pro�Fees: CUMBERLAND COUNTY REGISTER OF WiLL3 546.50
5. pawun�nt Fees:
6. 7ax ttemm prepererFeas INCOME TAXE3-BOB PARK 3�1.40
7. VICKIE L. HARDY-APPRAISER 75.08
8. SETTLEMENT GOSTS-SAI.E OF REAL ESTATE 16,268.08
tOTAI(Also enter on Line 9,Racapitul�ion} = g5 226.8�
If rtrore space is needed,use additional sheeis of peperaithe same size.
Continuation of REY-15041nheritance Tax Return Resident Decedent
KENNETH M.OVfRCASH 21 12 Qg�S
DecedenPS Name Page 1 File hlumber
Schedule H-Funeral Expenses 8 Administrative Costs-B1
ITEM
NUMBER DESCRIP7ION AMOUNT
B. ApMINISTRATIVE COSTS:
Personal Representarive Gammissions:
2. Name(s)ofPersonalRepreSentative(s) ri��NEE. RENNA
sveetadaress 802 OOGWOOD COURT
�;ry LANDSDAtE sra�e PA na 194,46
vear(s)Commission Peid: (RENdUPiCE01
BUBTOTAL SCNBDULE H-81
REV•i 512 EX+(12-12)
pennsyivania SGHEDULE I
°EP"RT"a�"'T°F RE"E""E DEB7S OF DECEdENT,
iNHearrnNCerra�RervRN MORTGAGE LIASil1TIES 8�ItEMS
RESIDENTDECEDENT
ESTATE OF FILE NUMBER
KENNE7H M. OVERCASH 21 12 4915
Report de6ts incurred by the decadent pdor to death fhat remained unpafd at the date of deaih,inciuding unreimpuwed medicai expensas.
{TEM VALUE AT DATE
NUMBER DE5CRIPTION OF DEATH
t BRiGNTON CONDOMINiUM ASSOCIATION 1,809.65
HOMEONINERS QUES AN4 SKYIIGHT REPAIR
2. DENNlS ZERBE,TREASUREFt 2,891.69
2Q12/2013 SCHOOL TAX- 7$1699.84 2013120'14 PpRT1Al SCHOOL 7AX- $618,d8
2013 COUNTYlTOWNSHIP TAX - $573.27
3. UPPER ALIEN TOWNSHiP 342.OQ
SEWER
4. YQRK WASTE OISP{?SAL 38.85
REFUSE
5. COMCAST 12.05
TELEVISION
6. DONEGAL iNSURANCE GRC3UP 391.50
HOMEOWNERSiNSURANGE
7. HOME PARAMOUNT 118.75
PEST COIJTROI.CONTRACT
8. PPL 805.00
ELECTRIC
9. UNITED WATER 96.94
WATER
10. VERI20N 8�A8
TELEPHONE
11. RICK SAMPSON-EAGLE EYE PAiNTiNG 2,804.!?Q
HOUSE PAINTtNG
12. MCR GARPEI'CIEANINLi 422,09
CARPETS-CLEANED
13. MELISSA pOWEFt 88.04
HOUSECLEANiNG
1d. d. S. NORFORD 185.12
REPLAGE CLO5ETS LtGHTS
TOTAL(Alsa enter on Une 1{},Recapituiati�) 5 9 974.82
If more space is needed,insert addlHpnai sheets of the 5ame size.
REV-1313 EXi(0140)
pennsyivania SCHEDULE J
bEFARTMEM OF REVENUE gENEHCIARtES
�NNERITANCE TAX RE7URN
RESIDEN7 DECEOENT
ESTATE pF: FILE NUMBER:
KENN£TH M.OYERCASH 21 12 8916
RELAT�dNSHIP TO pECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON{Sj RECEIVING PR4PERTY Do Not Llat TruMee�s) OF ESTATE
I TAXABLEpISTRIBU7I0NS pndude� htspousaidisttibutiansanGtranstersurMer
pq M
Sec.91f6{a)(12).1
1. KENNETH HOWARD OVERCASH lineai
38 CC110 SPRINGS ROAD
DillSBURG, PA 17019
2. YVQNNE E. RENNR L.ineal
902 08GW000 STREET
LANDSDALE, PA 19446
3. IINDA M, BABSKI Lineat
8342 GONGORD ROAD
MEGHANICSSURG,PA 17055
4. PAMELA S.WA460RN lineal
2804 WARREN WAY
MECHANICSBURG, PA 17d50
5. MEGAN COOK Lineai
229 GORNELI.DRIVE
WQODSSORO,MD 21798
6. ANGELA FISLER lineal
4129 WILLOW BENU ROIiD
MECHANiCSBURG, PA 17055
7. JASON SHEARER lineai
1451ROQUOIS TRAIL
YORK t1AVEN,PA 17370
ENTER D(7LLAR AMOUNTS FpR D1STRIBUTIONS SHOWN ABpYE ON LINE515 THROUGH 18 pF REV-15DQ GpVER SHEE f,AS APPROPRIA7E.
II. N4N-TAXABLE DISTRI@UTIONS:
A.5POUSAI DISTRIBU710NS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX iS N6T TAKEN:
t.
B.CHARITABLE AND GOVERNMENTAL DISTRlBUTfONS:
i.
SOTtU,f1f PART II-ENTER TOTAL NON•TAXABI.E pISTRIBUTIQNS ON LME 13 OF REV-1500 COVER SHEET. $
if mae space is needed,use addition�sheets�paper of the same size.
Cantinuatian of REY•15001nheritance 7ax Return Residen# D�cedent
KENNETH M,OVERCASH 21 12 0915
Oecedenfs Name Page 2 Pile Number
Sehedule J-Senefiaiaries-1
RELATIONSH�P TO DECE6ENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSQ S ftEGEIVING PRQPERTY Dp Not List Truste e dF ESTATE
I TAXABLEDISTR18UTi0NS pnciudeouuiqM�s�pwuaidistributiarsandNenstersur�
Sec.9tj6 a 1.2j.}
8. JENNlFER l.MoKEE Line�i
15Q2 KAY STREET
HARRtSBURG,PA 17109
S. CARA ORR Uneal
2920 MEYER AVENUE
GLENSIDE, PA 19038
10. RITA QVERCASH Lineai
38 GOLD SPRlNG ROAD
DILLSSURG,PA'I7Q19
11. BRIANNA HAMSHER Lineal
1111 TIVERTON ROAD
MEGHANICSBURG, PA 17050
'12. BETHANY FISLER L(neai
4129 WIILOW BEND ROAD
MEGHANICSBIJRG, PA 17085
13. ADAM FISLER Lineat
4129 WIILOW BEND ROAD
MECHANICSBURG, PA 17055
14. BRYCE McKEE Lineal
1502 KAY STREET
HARRISBURG, PA 17109
15. BRAEIYN McKEE Lineai
1502 WAY STREET
HARRISBURG,PA 17109
i6. ELLA COOK lineal
229 CORNEI.L DRIVE
WOODSBORO, MD 2179$
17, JOSHUp 3HEARER Lineai
1451ROQU4IS TRAII.
YORK HAVEN, PA 173T0
18. COLIN SHEARER �ineal
145 IROQU4I3 TRAIL
YORI!HAVEN, PA 17370
19. liND3EY SHEARER Lineai
145 iROQUOiS FRAtI
YORK HAVEN, PA 173�0
20. R1LEY BABSKI tinaal
784 HILLCREST Di21VE
NEWPOR7,PA 17074
21. TRAVI$BABSKI Li�eaf
764 HI�ICREST DRIVE
NEWPORT, PA 17874
Cantinuation of REV-1544 lnheritance Tax Return Resident Decedent
KENNETH M.OVERCASH 21 12 d815
DecedenYs Name Page 3 File Numbw
Schedule J-Beneficiaries-1
REtATiONSH{P T6 QECE[JENT AM4UNT QR SNARE
NUMBER NAME AND ADpRE55 OF PERSQ S REGEIV{NG pROPERTY Do Not Llst Truatee s OF ESTATE
i TAl{ABLE pISTRIBUTIONS (InCude o�ht spousai distnbutions and transicrs undar
Sec.Sii6{a)(12}.)
22. BRIAN HAMSHER Lineai
i1�i TiVERTOh ROAO
MECHANICSBURG, PA 17050