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HomeMy WebLinkAbout09-17-13 (2) J 1505610140 REV-1500 EX (01-10' OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN 2 1 1 3 0 5 2 5 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW 0 4 1 1 2 0 1 3 0 8 2 5 1 9 3 1 Decedent's Last Name Suffix Decedents First Name Mt B O Y L E C H A R L E S (if Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW © 1.Original Return 2.Supplemental Return E] 3. Remainder Return(date of death prior to 12-13-82) 4, Limited Estate 4a. Future Interest Compromise(date of 5.Federal Estate Tax Return Required death after 12-12.82) 8,Decedent Died Testate 0 7.Decedent Maintained a Living Trust 8.Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 0 9.Litigation Proceeds Received 10.Spousal Poverty Credit(date of death 11.Election to tax under Sec.9113(A) between 12-31-91 and 1-1-95) (Attach Sch.0) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number R MARK THOMAS 7 1 7 7 9 6 2 1 0 0 xr FMI31BER OF W19 US(;O u ti f > CS ' G? :pa First line of address ftT > C-) ., 'a A 1-1 , t rn 1 0 1 S O U T H MARKET STREET X. x a c a Second line of address -"t �" -r1 C -q � n j C F . 7 �I �t -` r City or Post Office State ZIP Code > ---I DATE b MECHANICSBURG PA 1 7 0 5 5 co Correspondent's e-mail address: rmarkthomasftmail.cam Under penalties of perjury,I declare that I have examined this realm,including accompanying schedules and statements,and to the best of my knowledge and belief, it is true,correct and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. S OF RESPONS!1 ILINCa RETURN DATE ADDRESS 2210 SPRI G RUN IVE MECHANICSBURG PA 17055 SiG F ARE H N REPRESEN7ATtVE T 'h ADDR S M[G 101 S. MARKET STREET MECHANICSBURG A 17055 PLEASE USE ORIGINAL FORM ONLY Side I 1.505610140 1505610140 1505610240 REV-1500 EX RECAPITULATION 1. Real Estate(Schedule A) . .... . .. .. . .... . ...... .... ..- 1. 2. Stocks and Bonds(Schedule B) . .. . .... . . .. ..... .. . 2- 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) 3, 4. Mortgages and Notes Receivable(Schedule D) . . . . . . . . .. . . ... . 4. 5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E}. . .... . 5. 1 8 8 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested . 6. 2 9 4 5 2 . 7 4 7. Inter-Vivos Transfers&Miscellaneous N Probate Property (Schedule G) Separate Billing Requested . . .... T 4 9 3 5 4 6 . 8 8 8. Total Gross Assets(total Lines I through 7) . . . . . . . . . . . . . . . . . . . . . ... 8. 6 8 2 6 2 5 . 3 9 9. Funeral Expenses and Administrative Costs(Schedule H) . . . . . .. . . . .. . . . . . . 9 6 7 9 8 • 1 8 W Debts of Decedent,Mortgage Liabilities,and Liens(Schedule I) . . . . . . .. . . . . 10, 8 1 1 2 5 11. Total Deductions(total Lines 9 and 10) . - . . . . - . - - - - - - - . . - . . 11, 7 6 0 9 . 4 3 12. Net Value of Estate(Line 8 minus Line 11) . . . ... . . . . . . . . . . . . . . . . . . . . . 12. 6 7 5 0 1 5 • 9 6 11 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, 6 7 5 0 1 5 • 9 6 TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 (a)(1.2)X.0 _ 0 . 0 0 15, 0 . 0 0 I& Amount of Line 14 taxable at lineal rate X.0450 6 7 5 0 1 5 . 9 6 16. 3 0 3 7 5 . 7 2 17. Amount of Line 14 taxable at sibling rate X.12 0 . 0 0 17 0 . 0 0 . 18, Amount of Line 14 taxable at collateral rate X A 5 0 . 0. 0 18 0 . 0 0 , 19. TAX DUE ......... . ...... . . ....... . . . . . .. . . .. . . . . . . 19. 3 0 3 7 5 . 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑ - Side 2 1505610240 1505610240 REV-15005A Page 21 - File Number Decedent's Complete Address: 21 13 0525 DECEDENTS NAME CHARLES BOYLE - STREET ADDRESS 18 ANDES DRIVE --_---_-- CITY ------- --- -- ---- STATE-.�.—. T ZIP MECHANICSBURG PA 17055 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 30,375.72 2. Credits/Payments A.Prior Payments 27,000.00 B.Discount 1,421.01 7ofal Credits(A+B) (2) 28,421.01 3. Interest (3) 4. If Line 2 is greater than Line 1+Line 3,enter the difference.This is the OVERPAYMENT. Fill in oval on Page 2,Line 20 to request a refund. (4) 0.00 5. If Line 1+Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 1,954.71 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. retain the use or income of the property transferred; .................................................................I.... ❑❑ 0 b. retain the right to designate who shalt use the property transferred or its income; ..................... 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 decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................... ❑ ❑ 3. Did decedent own an*intrust far'or payable-upon-death bank account or security 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 THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994,and before Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse it 3 percent 172 P.S.§9116(a)(11)(i)]. For dates of death on or after Jan.1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent 172 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 172 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)F2 P.S.§9116(a)(1)]. • The tax rate imposed on the net value of transfers to or for the use of the decedents siblings is 12 percent 172 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,whether by blood or adoption. REV-1502 ESC (12-12) pennsylvania SCHEDULE A DEPARTMENT OF REVENUE REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: CHARLES BOYLE 21 13 0525 All real 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 that 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. ITEM Include a copy of the deed showing decedents interest if owned as tenant in common. VALUE AT DATE NUMBER OF DEATH DESCRIPTION 1. BRICK AND ALUMINUM RANCH TYPE HOUSE 151,000.00 18 ANDES DRIVE, MECHANICSBURG, PA 17055 Appraisal done July 9, 2013- CLAUSER REAL ESTATE TOTAL(Also enter on Line 1,Recapitulation.) $ 151 000.00 If more space is needed,use additional sheets of paper of the same size. REV-15M FX-(8-02) pennsylvania SCHEDULE B DEPARTMENT OF REVENUE INHERITANCE TAX RETURN STOCKS & BONDS RESIDENT DECEDENT ESTATE OF FILE NUMBER CHARLES BOYLE 21 13 0525 All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. PRUDENTIAL COMPUTER SHARES- 177 @ $57.64 6,743.88 TOTAL(Also enter on Line 2,Recapitulation) $ 6,743.88 If more space is needed,insert additional sheets of the same size REV-1509 EX-(0 8-12) pennsylvania SCHEDULE E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TAX RESIDENT DECEDENT RETURN PERSONAL PROPERTY ESTATE OF: FILE NUMBER: CHARLES BOYLE 21 13 0525 Include the proceeds of litigation and the date the proceeds were received 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 1. PERSONAL PROPERTY- 540.00 2. REFUND- HOME SERVICES 77.78 3. CITIZEN'S BANK ACCT# XXXX510-5 839.81 4. SOVEREIGN BANK ACCT#2331054452-MONEY MARKET 824.30 TOTAL(Also enter on Line 5,Recapitulation) $ 1,881.89 If more space is needed,use additional sheets of paper of the same size. REV-1509 EX+(01-10) pennsylvania SCHEDULE F DEPARTMENT pFREVENUE JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: CHARLES BOYLE 21 13 0525 It an asset was made jointly owned within one year of the decedent's date of death,it must be reported on Schedule G. SURVAANG JOINT TENANTS)NAMES) ADDRESS RELATLONSHIP TO DECEDENT A. EVELYN I SHAVER 2210 SPRING RUN DRIVE DAUGHTER MECHANICSBURG, PA 17055 B.CHARLES R. BOYLE 1311 GREENLEAF ROAD SON FARIBAULT, MN 55021 c.LINDA D. ROBERTSON 220 SOUTH HOME AVENUE DAUGHTER APT 302 PITTSBURGH, PA 15202 JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENTS VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST t. A. 02/2002 SERIES HH U.S. SAVINGS BOND V2045944HH 5,000.00 50. 2,500.00 2. A. 0212002 SERIES HH U.S. SAVINGS BOND V2045944HH 4,243.52 50. 2,121.76 DEFERREDINTEREST 3, A. 03/2001 SERIES HH U.S. SAVINGS BOND V2045943HH 5,000.00 50. 2,500.00 4. A. 03!2001 SERIES HH U.S. SAVINGS BOND V2045943HH 4,179.30 50. 2,089.65 DEFERREDINTEREST 5. A. 03/2001 SERIES HH U.S. SAVINGS BOND M11497799HH 1,000.00 50. 500.00 6. A 03/2001 SERIES HH U.S. SAVINGS BOND M11497799HH 835.86 50. 417.93 DEFERREDINTEREST 7. B. 0512004 SERIES HH U.S. SAVINGS BOND V2045942HH 5,000.00 50. 2,500.00 8. B 05/2004 SERIES HH U.S. SAVINGS BOND V2045942HH 4,250.00 50. 2,125.00 DEFERREDINTEREST 9. B 05/2004 SERIES HH U.S. SAVINGS BOND M11497795HH 1,000.00 50. 500.00 10, B 05/2004 SERIES HH U.S. SAVINGS BOND M11497795HH 850.00 50. 425.00 DEFERREDINTEREST TOTAL(Also enter on Line 6,Recapitulation) S 29,452.74 If mre space is needed,use addild ral sheets of paper of the sane size. REV-151 D EX+(08-09) pennsylvania SCHEDULE G DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER CHARLES BOYLE 21 13 0525 This schedule must be completed and fled if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. DESCRIPTION OF PROPERTY ITEM INCLUDE THE NauEOF THE TRANSFEREE,THEIR RELATIONSHIPTODECEDENT AND DATE OF DEATH % DECKS EXCLUSION TAXABLE NUMBER THE DATE OF TRANSFER.ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST AFAPfti &C) VALUE 1. WELLS FARGO IRA ACCT#0386 9,949.63 100.00 9,949.63 2. WELLS FARGO IRA ACCT#0430 15,123.18100.00 15,123.18 3. PRESIDENTIAL LIFE INS. CO. ACCT#00463816 (ANNUITY 192,924.05 100.00 192,924.05 4. LINCOLN FINANCIAL GROUP#367152174 (ANNUITY) 197,171.29 100.00 197,171.29 5. ING GUARANTEE CHOICE IRA#90348981 78,378.73 100.00 78,378.73 TOTAL(Also enter on Line 7,Recapitulabon)l $ 493 546.88 If more space is needed,use additional sheets of paper of the same size. REV-1511 tX-(10-09) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER CHARLES BOYLE 21 13 0525 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERALEXPENSES: 1. FUNERAL HOME INCORPORATED 1,895.00 8. ADMINISTRATIVE COSTS: 1, Personal Representative Commissions: Name(s)of Personal Representative(s) Street Address City Stale ZIP Years)Commission Paid: 2, Attorney Fees: R. MARK THOMAS, ESQUIRE 3,870.00 3, Family Exemption:(If decedent's address is not the same as claimants,attach explanation) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4, Probate Fees: 428.50 5 Accountant Fees: B. Tax Return Preparer Fees: 7. ADDITIONAL SHORT CERTIFICATES 30.00 8. PERSONAL PROPERTY-APPRAISAL FEE-CHUCK BRICKER ??? 100.00 9. HOUSE APPRAISAL-CLAUSER REAL ESTATE APPRAISALS 375.00 10 SOVEREIGN BANK FEE FOR DOD BALANCE 20.00 11 MAILING COSTS 79.68 TOTAL(Also enter on Line 9,Recapitulation) $ 6,798.18 If more space is needed,use additional sheets of paper of the same size. FZEV-1512 Ex*(12-12) pennsylvania SCHEDULE 1 DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES& LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER CHARLES BOYLE 21 13 0525 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 1. TAXES-ZERBE-UPPER ALLEN-PD 4/2/2013 CLEARED 4/18/13 592.25 2. BANK MAINTENANCE 10.00 3. UNITED HEALTHCARE-DEDUCTED 5/6113 209.00 TOTAL(Also enter on Line 10,Recapitulation) 5 811.25 If more space is needed,insert additional sheets of the same size. REV-1513a.(01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: CHARLES BOYLE 21 13 0525 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE 1. TAXABLE DISTRIBUTIONS Prelude whight spousal distributions and transfers under Sec.9116(a)(1.2).) 1. EVELYN I. SHAVER Lineal 33.33 2210 SPRING RUN DRIVE MECHANICSBURG, PA 17055 2. CHARLES R. BOYLE Lineal 33.33 1311 GREENLEAF ROAD FARIBAULT, MN 55021 3. LINDA ROBERTSON Lineal 33.33 220 SOUTH HOME AVENUE, APT, 302 PITTSBURGH, PA 15202 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE. U. NON-TAXABLE DISTRIBUTIONS: A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1, B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OF PART 11 -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ If more space is needed,use additional sheets of paper of the same size. REV-1500 Discount, Interest and Penalty Worksheet Discount Calculation Total Amount Paid within three calendar months of the decedents date of death: —27000,VO Discount: 1421.01 Interest Table Days Delinquent Balance Due Interest Year this time period this year this period Before 1981 1982 1983 1984 1985 1986 1987 _1988 through 1991 1992 _1993 through 1994 1995 throw h 1998 _ 1999 2000 2001 2002 2003— 2004 2005 2006 2007 2008 2009 2010 2011 through 2013 TOTALS Penalty Calculation If the decedent's date of death was on or before March 31, 1993, insert the applicable amount: Total Balance Due on January 17, 1996: Penalty: _ r COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96) DEPARTMENT OF REVENUE SUREA':C.=IND:V:DUAL TAXES DEPT.280601 HARRISBURG,PA 1]128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT N0. CD 017860 SHAVER EVELYN 1 2210 SPRING RUN DRIVE MECHANICSBURG, PA 17055 ACN ASSESSMENT AMOUNT CONTROL NUMBER -------- cola 101 $27,000.00 ESTATE INFORMATION: FILE NUMBER: 2113-0525 DECEDENT NAME: BOYLE CHARLES DATE OF PAYMENT: 07/10/2013 POSTMARK DATE: 07/10/2013 COUNTY: CUMBERLAND DATE OF DEATH: 04/11/2013 TOTAL AMOUNT PAID: $27,000.00 REMARKS: RECEIPT TO ATTY CHECK# 7494 INITIALS: WZ SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS TAXPAYER i r ■ APPRAISAL OF REAL PROPERTY LOCATED AT: 18 Andes Dr. Deed Book 28H Page 477 Mechanicsburg,PA 17055 FOR: Evelyn I.Shaver 2210 Spring Run Dr. Mechanicsburg,PA 17055 AS OF: 07/09/2013 BY: Dennis L. Stover PA Certified Residential Real Estate Appraiser Certification Number RL 138906 Clouser Real Estate Appraisals PO Box 777 Camp Hill,PA 17001-0777 Form OA1—'WinTOTAL'appraisal software by a to mode,inc.—1-800-ALAMODE Evelyn L Shaver 2210 Spring Run Dr. Mechanicsburg,PA 17055 Re: Property: 18 Andes Dr. Mechanicsburg,PA 17055 Client Evelyn I.Shaver Pile No.: 130701 R-1 In accordance with your request,we have appraised the above referenced property. The report of that appraisal is attached. The purpose of this appraisal,is to estimate the market value of the property described in this appraisal report,as improved,in unencumbered fee simple title of ownership. This report is based on a physical analysis of the site and improvements,a locational analysis of the neighborhood and city,and an economic analysis of the market for properties such as the subject. The appraisal was developed and the report was prepared In accordance with the Uniform Standards of Professional Appraisal Practice. The value conclusions reported are as of the effective date staled in the body of the report and contingent upon the certification and limiting conditions attached. 6 has been a pleasure to assist you. Please do not hesitate to contact me or any of my staff 8 we can be of additional service to you. Sincerely, Dennis L. Stover PA Slate Certified Residential Real Estate Appraiser. Certification Number RL 138906 � ^ � � Client Evelvin 1.Shaver File No. 13-0701 R-1 Property Address 18 Andes Dr city Mechanicsburg County Cumberland State PA ZipCode 17055 1 owner The Estate of Charles Boyle TABLE OF CONTENTS comPap ___---_____________--____—____—___—___--_ 1 Letterm Transmittal ... ... ................................. ............... ....................................... —..................................... —______- 2 mmwwowm '________-- ... .... .... .... ................................... .................. ........... ... .................................... o Summarym Salient Features.................................................__............ ... ........................................... — .......... ... ............_— ^ om^ mmmicaom _—___—_____--___--_—___—__—_--______—___ 5 BeResidential ........................ ........ .... ........ .... ......... __—...................................... ........ —..................................................... v m`Residential 000fmmoon,Addendum ..... ........ ..... .... .... ... ........ ... .................................._____......................................... .... v ExpandedScope m Work...... ............. .... .... ......... .....___............................ ........................................................................... .... 11 SubjectPhotos................... ........ ................... ..... ........ .... ........ ........................................................................................................ 12 InteriorPhotos ............ ................................................ ..................................... _................................................... .................................. u PlatMap ................................................................ .............. .......................... ................................. '............................... ............ 14 ComparablePhotos m—............. .... ... ........................... ....__........ ......................._............................... _....... ................. » Appraisal Addendum-Special Conditions... .............................._......... ........................... .............. _—... ... ........................... ...... w uualmmtioo _--______________—._... ........ ..................................... ................................ ... ....... 1r owmicawo ____—'--___--____—_—____________--__—__—_--' m Statement w Limiting Conditions ................................ ... ................... ............................... ................------------- * ElectronicSignature Compliance ......................................................... ............. ..................... ....................... —... .................... ............... » Certificate_........ ........ ........ ........ ... ..........................................--.................. ....... ........ ...........—....... ... —...--........... 22 Invoice ................. ......... .................................................... ........ ............. ........ ..................................... ..................................__ u BuildingSketch(Page-1)—.... .... ... .... ... .... ............................................................ ... .......................................... —...................... a LocationMap ................................... ............. ....................... ........................................ ....... ............................................... ................. o � mnmCINp—"Wil appraisal software byo*mode,Inc.—1-800-AmmODE SUMMARY OF SALIENT FEATURES Subject Address 18 Andes Dr Legal Descripfi m Deed Bock 28H Page 477 City Mechanicsburg County Cumberland Slate PA Zip Code 17055 Census Tract 42041-0118.05 Map Reference 25420 Sale Price $ NA Date of Sale NA Client Evelyn t.Shaver Owner The Estate of Charter Boyle Sin'Sgwre Feet) 1,120 Hot per Square Foot S Lacatem Suburban Age 49 CondAian Avg Total Roams 5 Bedrooms 3 Berlin Appraiser Denns I Stover Date of Appraised Value 07/09/2013 Final Estimate of Value $ 151,000 Farm SSD—"WinTOTAL'appraisal software by a Is mode,Inc.—4800-ALAMODE �..... x APTRAISAL Personal Property of Appraised by Chuck E. Bricker AU094-t_ e l ' ITEM VALUE ITEM VALUE Pc ;'f c ,r?;n, ls ,TTL` ,>L�T- fit.... i� {A f2..t - �( Ct_ C.L-�+,F5 „ D,6v nn Cr- K C:Jj I 4-7 PP �Z41 G t-1 Sovereign Bank ESTATE OF Charles Boyle SOCIAL SECURITY#: DATE OF DEATH: April 11, 2012 Account#: 2331054452 Type: Money Market Open date: 5/11/2004 In the name of: Charles Boyle (Evelyn I Shaver, POA) Date of Death Balance: $624.17 Int.(YTD) from 1/1/2013 to 3/12/2013 $0.60 Accrued interest to date of death: $0.13 Otherinfo: Account Closed 05/13/2013 Account#: 1051151414 Type: Checking Open date: 8/17/2009 In the name of: Charles Boyle or Evelyn I Shaver Date of Death Balance: Closed prior to death Int.(YTD) from to Accrued interest to date of death: Other info: Account Closed 08/30/2011 $60.89 Account#: 1684304569 Type: Savings Open date: 8/17/2009 In the name of. Charles Boyle or Evelyn I Shaver Date of Death Balance: Closed prior to death Int.(YTD) from to Accrued interest to date of death: Other Info: Account Closed 08/30/2011 $100.24 Page 1 of 1 i Court Ordered Processing\Decedents- MAl-MB3-02-10 - P.O.Box 841005 - Boston,MA 02284 July 15, 2013 R. Mark Thomas Attorney at Law 101 South Market St. FE Mechanicsburg, PA 17055-3851 a RE: Estate of Charles Boyle Date of Death: 04/11/2013 E 8 d Dear Sir or Madam: 3 Per your request, enclosed please find the account information as of the date of death for the above-named decedent. For your information, accrued interest is not included in the date of death balance. Please feel free to contact me if I can be of any further assistance. e e n Very truly yours, Donna M. Long Lead Specialist a Phone: 617-514- 189 r Fax: 617-287-082 0 L Z Z 3 V_ F 1 2 citizens Bank ­ Account Number 6100765105 Account Title Charles Boyle Date Opened 1/23/1979 Account Tye Checking Principal Balance as of DOD $639.81 Interest from Last Posting to DOD It .00 Account Balance as of DOD $639.81 YTD Interest to DOD $ .00 otozens Bank 4 One Citizens Drive ROP112 Riverside, RI 02915 July 5, 2013 R. Mark Thomas Attorney At Law 101 South Market Street Mechanicsburg PA 17055 Estate of Charles Boyle Date of Death: Apr 11,2013 SSN: 173-24-1899 Dear Sir/Madam: In accordance with your request,the attached information sheet has been provided in the above decedent's name as of his/her date of death. For Installment Loans or Line of Credit accounts, contact our Loan Department at 1-800-708-6680. For all other inquiries, please call 877-579-2667 option 2 Sincerely, a � Kristen B. Correia Decedent Account Processing REF#: 600210 ,� � i .. :.a.. �' ,n . ;� 1, ' ,}: ._� � i ' 4 .... �� j I„ u . r: � R� 1:: . . ! � � ' � r ' •. . ,� i>� , t o .. .a • .. � 1 � - J. .r .i' -1 0 l OM V N i IO i M W O O O O O COI W O. W 0ci C C ZT O V 0 W O O O ' O O , 1 o 0 m N H 00 N C N 0 N " m 00 Ot i W 00 00 V 0 m H O Oi 0) Oi C 1 ti c1 a 06 "� 1 1 N H N c I / N O \0 00 O O N N O Cl O O 00 O O 00 co =1 N ,n M 00 �o — O 00 Q\ O O O O 00 O O 00 d' w rn ,n 00 00 O l-: kn O O O ,n ,n O O O ,n M to r- v1 O M N V7 vl N M 00 N O N ct N 00 00 7 00 00 W C D1 Z 7 d' 01 lq -I 00 lzz 00 l N w K w LL W O 69 69 69 69 64 69 69 69 69 69 bf3 69 69 69 69 69 69 O O 0 O O O O O O O O O O O N N O O O N N N N N N N N N M N N N 0, vim', vi vi M O O M Q1 O O O O. O O O O O O O O O O O O 0 0 0 0 0 0 0 0 O O Cl O O O O O O O Cl O O O O O O O . . . . . . . O O O O O O O O 0 0 0 0 0 0 0 0 O O O O O O O O O O O O O O O O O O O O O O O O ,n V) O O O 0 0 0 kn O 69 69 69 b9 69 69 H9 69 69 69 69 69 69 69 69 69 69 L Lx Txi xixrT A V M � O o0 N U N C7, 01 01 01 01 OCD CD C14 c, CN Q ' CIO ►zr (� E c V1 O O x s z °' x � � CC40 ' Kylen Financials Inc 524 Front Stree ' LOU, PA 17541 717/627-6669 PROW 717/627-355o ca wwwl'ylenfinancia ls.corr q6n Fnanclalsix R. Mark Thomas Attorney at Law 101 South Market Street Mechanicsburg PA 17055 RE: Estate of Charles Boyle, DECEASED Value of accounts as of April 11, 2013 Presidential—00463876$192,924.05 Lincoln—36-7152174$197,171.29 ING-90348981$78,378.73 Should you have any questions, please feel free to contact our office. Thank you, Holly Kylen SECURITIES&INVESTMENT ADVISORY SERVICES OFFERED THROUGH: ING fflW ING FINANCIAL PARTNERS MEMBER SIPC . . Ky16nRrwndalsbc Is not a subsidiary of nor controlled by ING Financial Partners Inc. KYLEN FINANCIALS INC 524 FRONT STREET LITITZ , PA 17543 ( 717 ) 627 - 6669 PHONE ( 717 ) 627 - 3550 FAX FACSIMILE TRANSMITTAL SHEET TO: yl/�/ z mx� FROM: NICOLE CASSIDY COMPANY: �/ /G` cy DATE: FAX NUMBER l j q/(P r M TOTAL NO. OF PAGE S INCLUDING COVER: PHONE NUMBER: (JU SENDER'S PHONE NUMBER: 717-627-6669 e,\ 13 RE: (O URGENT d FOR REVIEW ❑PLEASE COMMENT ❑PLEASE REPLY ❑PLEASE RECYCLE SECURITIES AND INVESTMENT ADVISORY SERVICES OFFERED THROUGH ING FINANCIAL PARTNERS MEMBER SIPC 909 LOCUST STREET, DES MOINES, IOWA 50309-2899, KYLEN FINANCIALS INC IS NOT A SUBSIDIARY OF NOR CONTROLLED BY ING FINANACIAL PARTNERS INC. . � / \ /FF � \ _ , \ ` ƒ & CD o = R « fz / § c ) / \0 P \ ( } \ \\ [ / \ j FUNERAL HOME,INC FUNERAL HOME FUN6RAL.HOME,INC. 3125 Walnut St Hbg,.PA 17109 A&wmr ofHdrU Bitty Fumaal Homy,Bic 2100 Lingiestown Rd.,Hbg.,PA 17UO ('.Y)545-3774 Fax(717)545-,2325 325 North High St.,Doncannm PA 17020 (717)652-7701 . Nathan&Bltruec Supervisor - (717)831-4515 Vaughn boor Supervisor. Graham S.Hetrick,Rmetal Director. Matthew C ainivan,Sup visor . Ronald C L Smith,Funeral Director Funeral Expense Agreement This is an expbmation of charge s as well as a sales agreement presented in accordance with the regulations of the PA State Board Funeral Directors. TAT OF FUNERAL GOODS AND SERVICES SELECTED Charges are only for those items that you Selected or are required.If we are inquired by lard or by a cemetery or crematory to-use arty items, will explain the reasons in writing below.If you selected a funeral which may require embalming,such as a funeral with a viewing,you m have to pay for embalming. You do not have to pay for embalming you did not approve,if you selected arrangements such as direct cremah or immediate burial.If we charge for embalming we will explain why below. Legal,cemetery,crematory or other requirements compelling the purchase of any items listed below: Reason for Embalming:. 7 Funeral Services for e,�G�1>?e _j�y !E Date of Deatho�-TOli if P, 3013 Date of Service - t GOODS AND SERVICES SELECTED TYPE OF SERVICE AUTHORIZED TO BE PROVIDED j zQ9 isw BoolcMlh'S1..6��_ ❑Traditional Full Service ❑Viewing day of Service Prayer Cards.............................. $ .. . ❑Graveside service only ❑No Viewing Crucifix .. .............................'- $ Temporary Grave Marker..... .......: ..$ 0 Cremation - L1 Immediate Disposition -... Memorial Board Rental .............c:. $ ❑Public Viewing .. ❑Anatomical Gift Casket Rental........................... $ .. 13 Private Familpvewing 13 Memorial Service Clothing................................... �$ ❑Evening Viewing, ❑Shipping Service Flag Case.................................. :$ ❑Receiving Service - Other . � Total of Merchandise Selected(C).............. $ A- Pa went D. Special Charges Qi�fY i - t"/P`M;i 4� 00 Forwarding Remains to rwarding $ B. Charge for Services Selected: Receiving Remains from . L PROFESSIONAL SERVICES $ Basic Services Fee ..................... $ -:TA C_ Immediate Burial......_._-:..:....._ Embalming or Refrigt3.ation...__-_..._. $ Equipment $ - Cremation............:............... $ Direct Cremation.......................... S Other Preparation of Body Total of Special Charges(D).................... $ . $ E.Cash Advances Transfer of Rem to Funeral Home ... $ h� Opening of Grave $ Sub-Total of Professional St3dices(BI) ...... $ 1etez9 Equipment . -..: $ C1ergY/Mass Offering ....................: $ 2- ADDIIIONAI.SERVICES AND FACILITIES Flowers ................................•-: $ Visitation/ID View/Viewing ------------ $ i Hairdresser...:....__.. . Funeral Service........................ $ 1 (0Certified Copies of ejth � �, Ro7.� $ Memorial Service.........:......... ...-$ Newspaper once }CSfin po�! SJ � _. $ Graveside Service :__................ $. ! Cemetery Lot and Deed....:._..........I $ . Sub-Total of Additional Pallbearers......................... .... $ services and Facilities(B2)--_-_ -..--•--. $ : Airfare................................... $ . 3. AUTOMOTIVE EQUIPMENT' ! Vault Service Charge .................... . .$ Funeral Coadi ......................... $ Honor Guard...__._............. .._...:. $ Lead/Clergy Car/utility Car............ $ ' Organist........... .^^... ........ ....... $ Flower Car............................. $ i Other CUfuriri' r9t r Da. a� $ : For your mmve imce.we will advmn the aver of the fmcgovug mmtr Lowevne an Family Car............................ $ i cuor made by any sapplier of servies shun be the sale iuPO1L° i�l9y of itut mppra Other than1orai20 mile Transportation._ $ . l and ousftmmdhomeam3icved ofluFaliiv akaetweby arm,gmymkaagaRHetrid Equipment Bihke Ftmemt Homy Inc,Ronald r I Smith Fm oral Home and Jesse H.Ceip1 Sub-Total of Automotive tort(B3).-.- $ Furman Home. Inc'are emitted to term and m_fahm arty dismmds orfeTed MCI Total of Pmfessionai Services,Additional.Services t>urd�of a cash advakr@ items and Facilities,and Automotive Equipment(B).. $ Told of Cash Advances(E).................... $ sQD C.CHARGE FOR MERCHANDISE SELECTED A PACKAGE ARRANGEMENTS............. $ 16lqS Casket B. ADDITIONAL SERVICES/Finaxr s -- $ O1 $ C MERCHANDISE.......................... $ r Other Receptacle - �,� Mason _Creaac�rf^ �ln�n•tf k�k9�� R L!L D. SPECIAL CHARGES --.--•--------•-•----- -- Outer Sulu[Container t I Total of MM Home Charges......_...... D03#10M - $ t. C1ISHADVANC ES..., ._ $ unt t f �u { ( $ ToW of Fxmerat Home Charges and Dequipflon Cash Advances $ Acl¢toiviedgement�. ........ $ ............... Memorial Folders .- -—---- $ rS .dirt 4"ASITADVANQ3MUST SE REAfBt3Rs*pD pRIOR1LJSERVtCBDAY - -QJ.�+A•�IfJ � t v - AQtEEAff;NL`I tlat Umi dta aoaservioesseledndnbovwatdfnuadfltemMbeaonuamand 1 • agee aspcaed Scrods acooMlbtgto tMaxra,rgeemtsIi�aveac3eded-Sndnr�+viedBerea of a copy of this suft%nent of Goods and$evicts Se3txted.It fs midestnad As h e total d�shmnt above may beemimated and nefled only that agrml upon et tic tinse of f apresmoLAnyadditional hens ofsecviceffimwtdtmdisc odered or M9'r after the timeoft}os anvotgement shaII be mnsidual past rids agevmtat aetd the cost will be relit is on yymmauFinal Stoowwnt wtnch W Provide, ,.. Tt.RM5:16's is crust[uhmsmt due in foll the dap of theservim and or sII wants A mmespastduemtd.detiagnentafter the 30 daysdaW Ape udl ofl$&Pi mQuan Ojosmuil to will bec6aged for utautidp.'tted lam payme feffi Live m the 3tstday. .: WA"APTTfE"c'Aeanlp tpofda men:hwkse sold in mmadion with the agmm�ent is the express written waaady Cd mQ,prmided by the mamdatimi The�funeal air for.%kmm wat�uyy(p ressed arimpli�witlt reWed m any humml mvdandi . '. :-- . . - AtRlfauumtoN:Ierr We authorize ami WWI prior wnsent m the wha ral director to take pos ssmt of the bode,give ate m and carry tort the arum jeow its hereto gniSed a agtecd m-sor We repremd poach.as ds pa�t(s)having the IeSai right m arrm�geI f OKA dispositfonof the abun Moved demdent and dohmby Vmtautlarity to the KO disocW tosupplg stnvrax and MWA Mdse as listed abovm I or We gaarwi :e tla papmart ofdds cmdrad amud'utg to the abtmme corms,and also ague m My any atmeney ke legal jndgenmtioEndolm the abmnarne Mfa,e ent 13Ws.g=tcgeaau. Ile,V/1 , Orel l'xmdssim to Embalm the abovcnanredd �mrtQWas grmded Was[afobed by G /• J J Namc Do tm . N1 ll, /1 of app. ' (ain) (pm) 13 6Jr phm!e li lrPei rsp FINALACaP£ANCE:I or M A0!Pt and.apptuve the above selections and tomes,and Alwowledge that the general prim list effective listeffective 1/ / //3a*! t6iirlm'9 pn -Tteffective l /I.�were made av ill bl p'O t selection of service-. - Sgut¢maf — � Doe 5pubMeM(Co-P r&jw Accepted Bp 's- `/� ✓... �. !!"l - r: TMly RECEIPT FOR PAYMENT GLENDA FARNER STRASBAUGH Receipt Date : 5/06/2013 Cumberland County - Register Of Wills Receipt Time : 09 : 44 : 02 One Courthouse Square Receipt No. : 1074075 Carlisle, PA 17613 BOYLE CHARLES Estate File No. : 2013-00525 -- - Paid By Remarks : R MARK THOMAS CJ ------------------------ Receipt Distribution ---- ----------- ----- --- - Fee/Tax Description Payment Amount Payee Name PETITION LTRS TEST 310 . 00 CUMBERLAND COUNTY GENERAL FUN WILL 15 . 00 CUMBERLAND COUNTY GENERAL FUN SHORT CERTIFICATE 30 . 00 CUMBERLAND COUNTY GENERAL FUN JCS FEE 23 . 50 BUREAU OF RECEIPTS a CNTR M.D AUTOMATION FEE 5 . 00 CUMBERLAND COUNTY GENERAL FUN INH TAX RETURN 15 . 00 CUMBERLAND COUNTY GENERAL FUN INVENTORY 15 . 00 CUMBERLAND COUNTY GENERAL FUN ------ ---- - ----- Check# 3283 413 . 50 Total Received. . . . . . . . . 413 . 50 r RECEIPT FOR PAYMENT GLENDA FARNER STRASBAUGH Receipt Date : 6/19/2013 Cumberland County - Register Of Wills Receipt Time : 09 : 01 : 01 One Courthouse Square Receipt Tim 9 : 01 : 00 Carlisle, PA 17613 BOYLE CHARLES Estate File No. : 2013-00525 --- Paid By Remarks : R MARK THOMAS DMB ------------- -- - -------- Receipt Distribution ---------- -------------- Fee/Tax Description Payment Amount Payee Name SHORT CERTIFICATE 30 . 00 CUMBERLAND COUNTY GENERAL FUN Check# 4172 $30 . 00 Total Received. . . . . . . . . $30 . 00 GEORGE CLAUSER Clan Clouser Real Estate Appraisals,LLC INVOICE George C.Clauser,SRA INVOICE NUMBER P.O.Box 777 13-0701 R-1 Camp Hill,PA 17001 DATES Invoice Date: 07115/2013 Telephone Number.717-737-7300 Fax Number: 717-730.0922 on Date: REFERENCE ro' Internal Order p: 13-0701 R-1 tenduCaaep: Evelyn I.Shaver C lent Flk q: 2210 Spring Run Dr. FHA/VA Case p: Mechanicsburg,PA 17055 Mein File w on loan: 13.0701 R-1 E-Mail: Other Flleponlorm: Summary Report Telephone Number:(717)991-0221 Fax Number Federal TaxlD: 26-1647066 Alternate Number: Employer 10; DESCRIPTION Lender. NA Client: Evelyn I.Shaver Purcheser/Botrower. NA Property Address: 18 Andes Or City: Mechanicsburg County: Cumberland State: PA ZIP: 17055 Legal Description: Deed Book 28H Page 477 FEES AMOUNT Residential General Purpose 375.00 Please make check payable to: Clauser Real Estate Appraisals,and mail to: Clauser Real Estate Appraisals LLC P.O.Box 777 Camp Hill,PA 17011 Payable Upon Recelpl SUBTOTAL 375.00 PAYMENTS AMOUNT Check N:109 Date: 07/112013 Description: 375.00 Check#: Date: Description: Check#: Date: Description: SUBTOTAL 375.00 Thank You,Your Business N Appreciated] TOTAL DUE $ 0 Fotm N11450—'lVinTOTAL'appraisal software by a W mode,ft.—1.8WALAMODE