HomeMy WebLinkAbout10-28-13 J 1505610143
REV-1500 �`�°��"' ��
PA Department of Revenue pennsylvania OFFICIAL USE ONLY
Bureau of Individuai Taxes �M*�*�� c���v code Year File Number
PO BOX.280601 INHERITANCE TAX RETURN 21 12 10 94
Harrisburg,PA 17128-0601 RESIDENT DECEDENT
ENl'ER DECEDENT INFORMATION BELOW
Social Secu�ity Number Date of Death Date of Birth
09 11 2012 08 12 1924
Decedent's Last Name Suffix Decedent's First Name MI
LEICHTE MEDA M
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name M�
Spouse's Sociai Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
� 1. Original Return a 2. Supplemental Retum � 3, Remainder Retum(Date of Death
Prior to 12-13-82)
� 4. Limited Estate � 4a,�utwe Interest Com�omise � 5. Federal Estate Tax Retum Required
date of death aft� 2 12-82)
� g, Decedent Died Testate � � �lecedent Mainta�'ned a Living Trust � 8. Total Number of Safe De
(Attach Copy of Will) (Attach Copy of Trust) pOSlt BOX83
� 9. Litigation Proceeds Received � �p,Spousal P Cred� (Date of Death ��,Ele�tion to tax under Sec.9113 A
beMreen 1��1�1�t-1-95) � (A��Schedule O) ( )
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Dayttme Telepl�q�e Number �,�
WM D SCHRACK III ES �' �
Q 717 432�'9,�33 � �
� � �, � �
�
, REGISTER Qld'1A�L�lSE Ot�i LY �
�.,�. =�= � � �` t`ri
First Line of Address � �? -� C�
� �.� �` �-�
12 4 W HARRI SBUR� STREET �-, �-, ��? � -�� �
� �.^ �:- R
. �� �:�.� `"
Second Line of Address �, �, �
� � � �
� � �
DATE FILED ""� �
City or Post Office State ZIP Code
I)ILLSBURG PA 170191268
Correspondent's e-mail address: schracklaw a�comcastnet
Under penalties of perjury,I declare that 1 have examined this retum,including accompanying schedules and statements,and to the best of my knowledge and belief,
it is true,conect and complete.Declaration of prepare�other than the pe�sonal representative is based on all information of which preparer has ahy knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILI G RETURN DATE
'"` � Meda G.Colson R ,
ADDRESS
2209 Orcha d Road Cam Hill PA 17011
SIGNATURE OF EPAR 0 REPRESENTATNE DATE
Wm. D.Schrack Esq. �� �
ADOR S
124 W. Harrisburg Street, Dillsburg, PA 17019-1268
Side 1
� 1505610143 15�561�143 �
J 1505610243
REV-1500 EX
DecedenYs Social Security Number
o�^�'$N�„e: Leichte, Meda M.
RECAPITULATION
1. Reai Estate(Schedule A)....................................................................................... 1. -5 3,5 0 0. ��
2. Stocks and Bonds(Schedule B)............................................................................. 2.
3. Ciosely Held Corporation,Partnership or Sole-Proprietorship(Schedule C)......... 3.
4. Mortgages 8�Notes Receivable(Schedule D)........................................................ 4.
5. Cash,Bank Deposits&Miscellaneous Personai Property(Schedule E)............... 5. 1, 6�33. 87
6. Jointly Owned Property(Schedule F) �X Separate Billing Requested............ 6.
7. Inter-Vivos Transfers 8�Miscellaneous f�aq-Probate Property
(Schedule G) �J Separate Billing Requested............ 7,
8. Total Gross Assets(total Lines 1 through 7)........................................................ g. -rj 1,8 9 6. 13
9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 1, 6 98.5 6
10. Debts of Decedent,Mortgage L.iabilities and Liens(Schedule I)............................ 10.
11. Total Deductions(totai Lines 9 and 10)................................................................ ��, 1, 6 98 . 5 6
12. Net Value of Estate(Line 8 minus Line 11).......................................................... �2, -5 3,5 94 . 6 9
13. Charitable and Govemmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J)............................................... 13.
14. Net Value Subjectto Tax(Line 12 minus Line 13)............................................... 14. -53,594 . 69
TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116
(a)(1.2)X.00 15. 0 . 0 0
� 16. Amount of Line 14 taxable
at�inea�rate x .� -5 3,5 9 4 . 6 9 �s. -2,411. 7 6
17. Amount of Line 14#axable
at sibling rate X.12 0 . 0 0 17. 0. 0 0
18. Amount of Line 14 taxable
at collateral rate X.15 0 . 0 0 18. 0. 0 0
19. Ta►x DUE................................................................................................................ �9. -2,411 . 76
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. � �
Side 2
� 1505610243 1505610243 J
F�EV-1500 EX�age 3 File Number 21-12-1094
Decedent's Complete Address:
DECEDENT'S NAME
Leichte,Meda M.
STREET ADDRESS
903 Valley Street
C�N STATE ZIP
Enola PA 17025
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) -2,411.76
2. CreditslPayments
A. Prior Payments
B. Discount
Totai Credits(A +B) (2)
3. Interest (3)
4. If Line 2 is greater than Line 1+Line 3,enter the difference. This is the OVERPAYMENT. (4) 2,41'1.76
Check box on Page 2,Line 20 to request a refund ' -
5. If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. �5�
Make Check Pa able to: REGISTER OF WILLS AGENT.
PL�ASE 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 proper'ty transfened:............................................................................... x
b. retain the right to designate who shall use the property transferred or its income:.................................. x
c. retain a reversionary interest;or............................................................................................................... x
d. receive the promise for life of either payments,benefits or care?............................................................
2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?...........................................................:........................................................ � �
3. Did decedent own an"in trust for" or payable upon death bank account or security at his or her death?....... ❑ []x
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 transfe�s to or for the use of the surviving
spouse is 3 percent(72 P.S.§9116(a)(1.1)(i)].
For dates of death on or after January 1,1995,the tax rate imposed on the net value of transfers to ar for the use of the surv'Ning spouse is 0 percent
[72 P.S.§9116(a)(1.1)(ii)J. 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 sunriving 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 yea�s of age or younger at death to or for the use of a natural parent,an
adoptive parent,or a stepparent of the child is 0 percent(72 P.S.§9116(a)(1.2)].
.The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in
[72 P.S.§9116(a)(1)l•
.The tax rate imposed on the net value of transfers to or for the use of the decedenYs siblings is 12 percent(72 P.S.§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.
Rev-1502 EX+(01-10)
SCHEDULE A
pennsylvania REAL ESTATE
DEPARTMENT OF REVENUE
INHERITANCE 7AX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Leichte, Meda M. 21-12-1094
All mal property owned solaly o�as a tenant In common must b�repoRed at fair market value.Fai�market value is def'a�ed as the pr�at which property would be
exchanged between a wiN�ng buye�and a will' seller,neither be�p compelled to buy or sell,both havirq reasonable krwwledge of the relevant facts.
Real property that is�olndy-ownad with right of aurvlvorshlp rrwst bs disclosed on schedule F.
Attach a copy of the setdement shest if the property has been sold
Include a copy of the desd showing decedanNs interest If ownsd as tsnant in cotrurwn.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Real estate situate at 903 Valley Street,Enola,Cumberland County,Pennsylvania(identified -53,500.00
by Parcel No.09-12-2991-0007)was originally valued at�168;000 on Inheritance Tax Retum
ffled on June 12,2013. IN ACTUALITY,THE PROPERTY SOLD FOR�114,500.00(see HUD-1
dated May 13,2013),CAUSING THE TOTAL�F SCHEDULE"A"TO BE REDUCED BY
$53,500.00.
TOTAL(Also enter on Line 1, Recapitulation) -53,500.00
(If more space is needed,additional pages of the same size)
Copyright(c)2010 form software only The Lackner Group,Inc. Fomn PA-1500 Schedule A(Rev.01-10)
Rev-1508 EXt(11_10)
SCHEDULE E
pennsylvania CASH, BANK DEPOSITS, & MISC.
DEPAR7MENT OF REVENUE
INHERITANCETAXRETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Leichte, Meda M. 21•12-1094
include the proceeds of lit'g ation and the dete the proceeda were roceived by the estat
All property jolnUy-ownsd wlth the right ot aurvivorshlp must be discloaed on sched�le F.
I
I
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Adjustments for items paid by setier in advance(see lines 406,407,408,409� 0 on HUD-1) 1.603.87
�
I
I
I
�
�
�
I
TOTAL(Also enter on Line 5.Reca itulationl 1.603.87
(If more space is needed,additional pages of the same size)
Copyright(c)2010 form software only The Lackner Group,Inc. � Fortn PA-1500 Schedule E(Rev.11-10)
I
�
�
REV-1511 EX+(10-09)
pennsyivania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Leichte, Meda M. 21-12-1094
Decedent's debts must be reported on Schedule 1.
ITEM
N R DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
B. ADMINISTRATIVE COSTS:
1. Persanai Representative's Commissions
Name of Personal Representative(s)
S#reet Address
��h� State Zip
Year(s)Commission Paid
2. Attornev's Fees
3. Family Exemption: (If decedent's address is not the same as claimanYs,attach explanation)
Claimant
Street Address
C�tY State �iq
Relationshin of Claimant to Decedet�t
4. Probate Fees
5. AccountanYs Fees
6. Tax Retum Prepare�'s Fees
7. Other Administrative Costs 1,698.56
See continuation schedule(s�attached
TOTAL(Also ente�on line 9,Recapitulation) 1,698.56
Copyright(c)2009 form software ot�ly The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.10-09)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Leichte, Meda M. 21-12-1094
ITEM
NUMBER DESCRIPTION AMOUNT
Other A�lministratve Cost�
1 Expenses to Seiler at settlement(see lines 1109,1302 and 1303 on HUD-1) 1,698.56
H-B7 1,698.56
Copyright(c)2402 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.6-98)
REV-1513 EX+(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITRNCE TAX RETURN B E N E FI C IA RI ES
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Leichte, Meda M. 21-12-1094
RELATIONSHIP TO
NAME AND ADDRESS OF SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSONfSI RECEIVING PROPERTY DECEDENT (y�iords) ($$$)
I TAXABLE DISTRIBUTIONS [include outright spousal
' distributions,and transfers
under Sec.9116 a 1.2
1 Meda G.Colson Child 1/3 of residue
2209 Orchard Road
Camp Hili, PA 17011
2 Sharon L.Gingrich Child 1/3 of residue
3913 Gettysburg Road
Camp Hill, PA 17011
3 Judy L.Mitchell Child 1/3 of residue
402 4th Street
Summerdale,PA 17093
Total
Enter doilar amounts for distributions shown above on lines 15 throu h 18 on Rev 1500 cover sheet,as a ro riate.
NON-TAXABLE DISTRIBUTIONS:
II• A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule J(Rev.01-10)
09-27-'13 11:50 FRO�- The Barry Group 717-846-06�$ T-165 POOO1JOOp4 F-271
�,.*�`0��`�'�b�, •� qM9 Approval No.2642-0265
. �
5� *� a Se�t�eme�t Stat�ment(HUD-1j
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,
Q.1YPe ot loon `
e.�ee Nwnoer: 7.L08�1 NurR44r. 8.Mo�e a►sur�c�H�,t�:
1.❑FFiA 2.[�RMS 3.�]Com.Unins. 167
4.�VA S.Q COdY.In�.
C.NOtl: 7hi4 form is fbmished to�hre you a stat��!�adue{xttlement oosts.Amou�a paid fo and by tM Settlement apent are shwvr�.(t+�m�nlarked
'(p.o.C)"wrr�s pald outside the dvsing;th�y�e�s sho�m hene for hdortnational purpoaes and are not tnctuded in the tal��i.
D.Nertle b Addnis d Bannwir. E Nama&A�ddress of SeNd: F.Name b Atldr�ssa oF Ler�dCr.
�W.F7rf��l��Sb+s�SielfO 903 aY lle�yMRd���
Yorlt�PA i740! Ertela,PA 470�3
G.Properry Location: H.Set#lement Agent I.SetUameM Date:
903 ViNoy Road DaMN L Grm,Es4ufr� 08H3J20i3
EnoM,PA lyd2S Pr►ane Number.T17-8�8-&100
• �2�!MRest PhiledNphhl St+�ao�Ste.4S
Cwr��0erland Cotmty York PA lT�IO�f
. PZZ?W���phJa Stroe�Sf�e.45 Rescbsion Date:
. YoAS,PA i7401 Dtabursement bate:OdM�/Z013
J. 3ummy►�Bot�!wk'�Transaction K.3ummary of SNIlr's Tnnsaction
t00.Oross Amount Due E�o�i+BorroMr�r 4q0.Grbss Amount Due To 8atl� �
10f.ConUad sAlls priCa • S=Zt,500.00 401.COMtxt sales pr+ce $12d,5oo.00
1a2.Persor►sl 402.Persvnal propert
103.3eRdement charflea to borrow�r(Tne 1400) $3 167.o0 403.
104. 4U�.
105. 406. .
Ad wtmorns for itwna paid by eNler fn a�lvsnee Adjustrnent�for items id soNor in advanc�
1 pg.�(yltiplM�1 t4bCS 08/23/2035 10 12/32/30I3 a52.17 '�.ClYy/tOW1!M74�f OB/13/8013 �0 24/3I/2033 �92.17
107. tax� os/�3/2oi3 0o Y2/3i/aosa gz2'.oe �7.��Y� oa/s�/zo=a to �rs/si/�oi.� �x��.oe
�pa,qS�ESSryfl�{g 08/13/?013 b OB/30/402� $1,g55.68 408.Acse66R�tS 01/13/SOI3 t0 06/30/201d .tI,93S.62
��, s� os Ya a ss ro os 3o aosa �.y,,. ao9. s� os/x� 20� to o� so znY3 s��.r.
��p, Ro�sso 08 �013 to 09 30 2 13 ���,26 410. RQ ss 08/3I/2tl13 to 09/90/2QY.3 �24.26
111. ' 411. .
112. 41Z.
1Z0.Gtees Arn Dua Fran 6oreower ��.z9,2�0.e7 4Z0.Grvss M�►aur►t Du�To Sdter ,SI16,103.87
Zpp,Amounlss paid Qr M B�halt Ot BorroMner 500.R1�d�tions In Amount Due To Setler
�01. or a�utnNt 601.Exceas de it sa�instructio�s)
Z02.Prf amouM Ot new s 50�,Sf��dts to seller(lina 1400 81,698..�s
203. ' loa s tskerl su �t to 503.ExiSNn loan a Mken aub�ect�
204. . ;�04.Peyoft of flratmor�age loan
205. 505.Peyaff ot second mo�ig�ye ban
206. �.
2QT. . 507.
.208. �'
209. •
A foe it�►�unpald by s*!IN' uStrrwMs fOr iLer►�i u� ki s411�r
210.Ciiyl6�1 t�s � 510.C ltOWn taues �
21i. tsxes � Sit.Cou bxes �
Z12 AssesamMti m 512.Assts3tr►ents tD
�3. 613.
214. 514.
21G. 516.
218. ' 516.
217, 617.
21 S. 518.
219. ' 519. •
?�p.Ta�al Paid ByiFor SNbr ' 320.Total Reduction Amourrt Due 3NIor SI,698.56
300.Cssh AR�etneirt FrorNTo Borrower 60d.Cesh AL Settkm�To�fFrom 3eiier
$11d,I03.8y
'301.Of0661A10101�diJ!f��R�� �12a) $Y29,270.87 801.G►oss amount dtte ta seper(�e 4�) Y 698.56
3Gx.Leas arAOw� id llor borrower line 220) B02.Less ndudbrrs in ami.due sellar 620) , ,
903.Ct�9h Frcm Q To Borto�w��
$si9,2�0.87 ��,�h '�o ❑�rOm Seller �j�a,e05.3t
The pubiic Reporttny 8urden fot thfs coltedivn of informati�on is estimsted at 35 r�in ue�sd�os�Q�this for�m,u�ess,�i d plays a
reporting the d�ts.This a9�Y�Y�t���is iMormatlon,and you are not rcq ' o m
cuRe��tly v8pd OM8 c�alttrol number.Na Confidentislity is assurtd;this�isdosure is rnendatory_This is desigrted to provide the partfes to
e RESPA c�vered transedion with infocmafton duTing the se8lement prnceas.
Pt�evious ad�s ue obsoiete
page 1 of 3 HUD-4
09-21-'13 11:50 FRD�- The Barry Graup 717-846-0646 T-165 P0002J0004 f-271
...�.....�..��,.. .��.����� �
.
L SettlemeM Cfi�lrgvs
700.Toia!Re�l Eatats Sroke�Fe�
Paicl From Peftl From
Dlvista►of ConwnissMn 700 as foqows• 8onox�ere Svllar's
701.$ tp Futds st Funds at
702.S tip ��K SdfNrt�errt
709.Corrmission id st SeiUement
70s. � v.o.c.ey �
soo.tboms tn Gondettion Wfth Lonn
a01.Our cha S (from C�E�1)
$02.YOtu�pr Ghe (ppint�)!qr thR SptNflC irnsregt rate chossn $ (from GFE 11�2)
803.You� usted originatbn ahe (from OFE A? �0.Oo
804. rni�N!ee M � a.o.c.by ?(fiqrn GF6!13)
8�.Gadit f�AOR t0 4 �.o.c.or 1(trom GFE At3)
SO6.Ta�t aetvioe E� � P.o.c.bY )(from GFE�3)
807.Flood cettMicstion � a.o.a ay }(from GFE�i)
808.
809.
810.
811.
812.
a�s.
$14.
815.
61b.
817. '
518.
819.
820_
000.Itsms uind R.�+de�'�o�s Paid in Advan�
�01.Qa (trteroet ch tFpm oB i3/Sai3� 09/o2/ZOl3 j /day(trom GFE�10)
902.Mprt� insurarx�Premium for months • (trom GFE i�3) '
to _ . .
9Q3.Homewmera insu►M�c!Pot ars tfrom C3FE�11)
W
9Q4. Ai3
to
905.
1000.Reserves YV'dl1 I..��lr
100t,tniti�l fw r ao�ount � (from GF�iF9)
100x,Hon�aawnei's i�ur�nx months = poc monih ;
1003,Mo i�swanoe months�s p�r month �
1004•P taxes nlpMhp�s moMh s
1005. months S f110�ih S
1�• moMhs�; morith S
1007. ustmertt .Z o-00
1100.Tltiv
11Q1.Titl�cervioes snd bnde�s tittk insurance {from OFE i�4) 4s8s.00
1102.Ssedement or dps tes �zz5.Do
1103.dwAl�tR4 b��+ce in�OFE#S)
1104.Lender's title insurenc+�
11Q6.Land�s titb IimR
110d.tlwn�rs tltle Ikn�
11�7, of�e cotal titk h�suranoe p�mium
1108.Urtde�tl0 of the total t�le Mawwnos ium
tiOD. �ta�7!� -Daato�t Gaza $10.00 �10.0�
7110. Ti.t.x4 C�t -Lliaial Ca�t $373.00
111L
1200.Gvvertxn�t R�coe+din�and Ttansier Charges
1201.G4�t cht! e! (irom GFE i�7) $67.00
1202.Deed a�.oo ;Mor�jage s ;Re�eases s
120.1.7tansfer tanea (irom GPE�'6) S�,290.o0
1204.CIRy tax/axa : Ds�d S s.Z�S.00 ;Mo�tgsgR�
1205.StaOs badsbmPs: • D�stl�=•x�J.00 • age; . ,
1206.
7207.
1300.Addilfon�l Settlemint Charges .
1301. s�rrioes that yvu cen�h ior (from C3FE*8)
130Q. i�s i lE�e!`a!!-��lY��lu9/8a¢►t - nast P�oas�boz'o �'o+�+shiP $S5I.�0
1�. ,qp,t+�Scboo2 Taasa -�bi� Lt�oZd � 51.536.76
1304.
1306.
�$OB.
�4pQ Total Seitlement Cha�ea(entec�r+1tn�103,Seation J and 60Z,SsetiOn K} $3,Sb7.00 $i,698.36
Ptevlous aditions aia d?tC�e Pa�e 2 Of 3 HUD-1
09-27-'13 11:50 FRO�- The Barry Graup 71J-848-4fi4fi T-165 POQ43J0004 F-271
� .
FUNDS TO BE DlSBURSED TOTAL
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TOTAL�UNDS DISTRIBUTED � � ��°1 �'� � {
09-27-'13 11:50 FR4N- The Barry Graup 717-$4fi-0646 T-165 Pd044Jd404 F-271
, .
E
Certification �
(continued from H U D-1)
i have carefuNy reviewed the HUD-1 Settlement Statement and to the besf of my knowledge and be(ief,
ft is a true and accurate statement of a!1 receipts and dtsbursements made on my account or by m�in this
transaCtiorl. 1 fu�ther oertify that I h�ve received�copy of the HUD-1$ettlement Statement
Seiler or
Borrower. ;,.��1���-= Agen� Date: �� � —�/
arbaugh � M a .Co s
Away Pro ' LLC Estate of Meda M.Leichte
221 W.Philadeiphia Stceet,Ste.110 903 Valley Road
Y�rk,PA 17401 Enofa,PA 17025
The HUD-1 Settlement which I have prepared is a true and accurate accoun this transactian. ave
caused or•will cause the funds tc be disbursed in acoordance with this sta ment.
Date: � Settlement Agent: Date: � .,,5� �
anie . am, "._. ,
WARNING: It is a crime t,4 knowi�tgiy make tafse statements to the United States on this or any othe� '
. similat fo1'rri. Penalties upon canviction C8n include a rine and imprisvnment. For details
� see:T'�le 18 U.S.Code Section 1001 and Section 1010.
F'. .
LAW OFFICE OF
WM. D. Scxx�cK III
124 WI?.ST HARRISBURG STREET
DILLSBURG,PA 17019-1268
Telephone 717-432-9733 e-mail:
Telefax 717-432-1053 Schracklaw@comcastnet
October 24, 2013
Register of Wills of Cumberland County �„a � �
Cumberland County Court House � �, � � r�
One Courthouse Square w � � �' a
Carlisle, PA 17013-3387 � � � � �
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Re: Estate of Meda M. Leicht�e � � � -� � :�
File #: 21- 12-1094 ���� � � ~�'
<.� ,� �„,;° �.,
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D/D: September 11, 2012 �r :� '--� �:. �i
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To Whom it May Concern:
You will find enclosed hexewith the original and one copy of a REV 1500, filed as a
Supplemental Return on the above-noted Estate. It is accompanied by a single cover page
stamped"COPY",which I ask that you time stamp, and return to me with the receip�
Atta,ched to the bottom of this letter is my Trust Account check for the sum of$15.00,
covering the cost of filing. Thank you for your attention to this request
Since 1 ,
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WM.D.SCHRACK III
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