HomeMy WebLinkAbout03-14-14 (2) 1505610105
REV-1500 EX(02-11)(R)'j!1
(.fit OFFICIAL USE ONLY
PA Department of Revenue pennsylvania
^TME� °aEVE«�E County Code Year File Number
Bureau of Individual Taxes _. .. .. .. ..
PO BOX 28o6Di INHERITANCE TAX RETURN - -
Harrisburg,PA 17128-o6o1 RESIDENT DECEDENT i 'I
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYWY Date of Birth MMDDYYYY
_... - -.. -..... __......... .....__...._........ _. .--... _._.. _......__......_....—......._ . _.-... - .......
i 03/19/2013 11/18/1955
_--......J _ ._ ...__....- .. -. -...-- _....---
Decedent's Last Name Suffix Decedent's First Name MI
Wrights j i Gloria G `
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
3 I
Spouses Social Security . _ - 1 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
! REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
CD 1.Original Return O 2.Supplemental Return O 3. Remainder Return(Date of Death
Prior to 12-13-82)
O 4.Limited Estate O 4a. Future Interest Compromise(date of O 5. Federal Estate Tax Return Required
death after 12-12-82)
OD 6. Decedent Died Testate O 7.Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust.)
O 9.Litigation Proceeds Received O 10.Spousal Poverty Credit(Date of Death O 11. Election to Tax under Sec.9113(A)
Between 12-31-91 and 1-1-95) (Attach Schedule O)
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
__. --__ _.__--- -----.---
_....__..
Thomas P Gleason, Esquire E (717) 532-3270
REGISTER O£11e:VS USE O�Y
First Line of Address ? O
T
_.._ _._.._ _.__....__ _._.._ __....._.. . ._... ___.__....-- ------ --_.— ..._..__
f..f
49 West Orange Street
_....... __.. . -___....._... __..._.......... __.
Second Line of Address �CC- C'
Suite 3
__.. . ...._....... ------ .__..........
__..__.....__...... _.. _._.... _......... ._........ f.
City or Post Office State ZIP Code DATE FILED d
-
Shlppensburg PA i 17257
f�
Correspondent's e-mail address:tomgleason @tomgleaSonlaW.Com
Under penalties of perjury,I declare that I have examined this return,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
preparre/Tr�has'Z a/nyy!�kk
n
owledge.
SIGN �O �RFILI �G RETURN DATE
ADDRE�q&
13U -7 2-
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610105 1505610105 J
1505610205
REV-1500 EX(FI) Decedent's Social Security Number
Decedent's Name: Gloria G. WrightS
RECAPITULATION
1. Real Estate(Schedule A). ....... . ........... .. .. .... . ................. 1. 169,000.00
2. Stocks and Bonds(Schedule B) .. ......... ....... .......... ......... .. 2. 0.00
3. 'Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) ••••• 3. 1� 0.00
_
4. Mortgages and Notes Receivable(Schedule D).... . ........ ........ . ..... 4. 0.00
_ 0
5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E)....... 5. 3,026.09
6. Jointly Owned Property(Schedule F) O Separate Billing Requested ....... 6. i 29,128.50
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) O Separate Billing Requested....... . 7. 0.00
8. Total Gross Assets total Lines 1 through 7 8. 1 201,154.59 1
9. Funeral Expenses and Administrative Costs(Schedule H).............. ..... 9. ; 20,352.60
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)........ ....... 10. 1 49,619.91 i
11. Total Deductions(total Lines 9 and 10). . ............. . . .. .. .......... .. 11. 1 69,972.51 ':
12. Net Value of Estate(Line 8 minus Line 11) ........ ...................... 12. 1 131,182.08
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J) . . ......... ............. 13. 0.00
14. Net Value Subject to Tax Line 12 minus Line 13 14. f 131,182.08
1 ( ) .......... .. ............. i
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116 I ....:
(a)(1.2)X.0_ ( 15. 0.00 j
16. Amount of Line 14 taxable
at lineal rate X.0 45 104,126.42 1 16. 4,685.691
17. Amount of Line 14 taxable
at sibling rate X.12 27,055.66 17. 3,246.68
18. Amount of Line 14 taxable j
at collateral rate X.15 18. 0.00
�.._.._...__.._..__.... _ ........_ -..._._..._.-...-......
19. TAX DUE ... ...... .... . ..... .............. ...... ....... ........ .... 19.
1 7,932.37
20. .FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O
Side 2
1505610205 1505610205
REV-1500 EX(FI) Page 3 File Number
Decedent's Complete Address:
DECEDENT'S NAME
Gloria G. Wrights
STREET ADDRESS
2 Willow Drive
CITY STATE ZIP
Shippensburg PA 17257
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 7,932.37
2. Credits/Payments
A.Prior Payments 0.00
B.Discount 0.00
Total Credits(A+B) (2) 0.00
3. Interest
(3) 59.50
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) 7,991.87
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.......................................................................................... ❑ 0
b. retain the right to designate who shall use the property transferred or its income ............................................ ❑ 0
c. retain a reversionary interest .............................................................................................................................. ❑ E
d. receive the promise for life of either payments,benefits or care?...................................................................... ❑ 0
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?.............. ❑
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
is 3 percent[72 P.S.§9116(a)(1.1)(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
[72 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[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)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's 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+ (12-12)
pennsylvania SCHEDULE A
DEPARTMENT OF REVENUE REAL ESTATE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Gloria G. Wrights
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 releyant 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 decedent's interest if owned as tenant in common. VALUE AT DATE
NUMBER OF DEATH
DESCRIPTION
1 Property located at 2 Willow Drive, Shippensburg,PA 17257 169,000.00
TOTAL(Also enter on Line 1, Recapitulation.) $ 169,000.00
If more space is needed,use additional sheets of paper of the same size.
OMB Approval No.2502-0265
A. Settlement Statement(HUD-1) FINAL
B.Type of Loan
I
1.❑FHA 2.F�RHS 3.Q Conv.Unins. 6.File Number.. 7.Loan Number. 8.Mortgage Insurance Case Number.
14C2454HASPER 6401020085 10-10-6-0655761
4,0VA 5.F�Conv.Ins.
C.Note:This form is furnished to give you a statement of actual settlement costs.Amounts paid to and by the settlement agents are shown;Items marked
"(p.c.c)"were paid outside the closing;they are shown here for informational purposes and are not included in the totals.
D.Name&Address of Borrower: E.Name&Address of Seller. F.Name&Address of Lender.
Joseph James Hasper,Jr.,Joni L Hasper The Estate of Gloria G.Wrights Foote Capital Mortgage Company
2 Willow Drive,Shippensburg,PA 17257 17 E.High Street,Suite 102,Cadisle,PA 1701:
G.Property Location: H.Settlement Agent: I.Settlement Date;01312014
2 Willow Drive South Central Home Settlements,Inc. Disbursement Date:01312014
Shippensburg,PA 17257 126 East King Street,Shippensburg,PA 17257
Cumberland County,Southampton Township
717-532-7387
Place of Settlement TitleExpress
126 East King Street,Shippensburg,PA 17257
J.Summalyof Borrowers Transaction K.Summary of Seller's Transaction
100. Gross Amount Due from Borrower 400. Gross Amount Due to Seller
101. Contract sales price 169,000.00 401. Contract sales price 169,000.00
102 Personal property 402. Personal pmperty
103. Settlement charges to borrower(line 1400) 13,261.17 403.
104. 404.
105. 405.
Adjustments for items paid by seller in advance Adjustments for items paid by seller in advance
106. City/town taxes to 406. City/town taxes to
107. County taxes to 407. County taxes to
108. School Taxes 01/31/2014 to 06130/2014 838.34 408. School Taxes 01/31/2014 to 06/30/2014' 838.34
109. 409.
110. 410.
111. 411.
112 412
120• Gross Amount Due from Borrower 183,099.51 420. Gross Amount Due to Seller 169,838.34
200. Amounts Paid by or in Behalf of Borrower - - .500. Reductions In Amount Due to Seller
201. Deposit or earnest money 1,000.00 501. Excess deposit(see instructions)
202. Pdncipal amount of new loan(s) 174,577.00 502 Settlement charges to seller(line 1400) 12,000.76
203. Existing loan(s)taken subject to 503. Existing loans taken subject to
204. 504. Payoff of first mortgage loan
205. 505. Payoff of second mortgage loan
206. 506.
207. SellerAssist(less Pest Inspection) 8,355.00 507. SellerAssist(less Pest Inspection) 8,355.00
208. 508.
209. 509.
Adjustments for items unpaid b seller Adjustments for items unpaid b seller
210. City/town taxes to 510. City/town taxes to
211. County taxes 01/01/2014 to 01/31/2014 39.19 511. County taxes 01/01/2014 to 01/31/2014 39.19
212. School Taxes to 512. School Taxes to
213. 513.
214. 514.
215. 515.
216. 516.
217. 517.
218. 518.
219. 519.
220• Total Paid by/for Borrower 183,971.19 520. Total Reduction Amount Due Seller 20,394.95
300. Cash at Settlement fromlto Borrower 600.' Cash'at Settlement tdfrom Seller l
301. Gross amount due from borrower(line 120) 183,099.51 601, Gross amount due to seller(line 420) 169,838.34
302, Less amounts paid by/for borrower(line 220) 183,971.19 602. Less reductions in amount due seller(line 520) 20,394.95
303. Cash [] From E] ToBorrower 871.88 603. Cash X❑ To From Seller 149,443.39
e� nl, ea cer receoRe r ,we..a,u.0 2w ry a aaa,�v oar m co vou.n m reams a
B,ie brtn,aieea t daebw a cu,er0/wfaOMB ca4ol nmeer.ab mMdertllaity is aaaueq tha Aecbeua k nauMabry.Tlia Ie Ceagrne to pmvWe the ponies b a RESPA rnwrtE hareanronwll,i,�onntion Ele�:l,ev
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I
Previous editions are obsolete Page 1 of 4 - HUD-1
- Settlement Charcles
I
700. Total Real Estate Broker Fees $10,140.00 Paid From Paid From
Division of commission(line 700)as follows: Borrower's Seller's
701. $10,140.00 to Sailhamer Real Estate Funds at Funds at
702 $0.00 to Settlement Settlement
703. Commission paid at settlement 10,140.00
800. Items Payable in Connection with Loan
801. Our origination charge (Includes Origination Point 0.000%or$0.00) $697.00 (from GFE#1)
802. Your credit or charge(points)for the specific interest rate chosen $ (from GFE#2)
803. Your adjusted origination charges (from GFE A) 697.00
804. Appraisal fee to Freeman Real Estate (from GFE#3) 375.00
805. Credit report to Foote Capital FBO UPS Credit Plus (from GFE#3) 25.34
806. Tax service to (from GFE#3)
807. Flood certification to Foote Capital FBO LPS National Flood (from GFE#3) 1 8.00
808. to (from GFE#3)
809. to (from GFE#3)
900. Items Required by Lender to be Paid in Advance
901. Daily interest charges from from 0113112014 to 0 2101/2 01 4 @$20.3300/day (from GFE#10) 20.33
902 Mortgage insurance premium months to (from GFE#3)
903. Homeowner's insurance for 1 ears to American National Insurance Company (from GFE#11) 1,171.00
904. VA Funding Fee for months to VA (from GFE#3) 5,577.00
1000.Reserves Deposited with Lender I
1001.Initial deposit for your escrow account (from GFE 99) 1,381.50
1002.Homeowner's insurance 3 months @$ 97.58/month $292.74
1003.Mortgage insurance months @$ /month
1004.Property taxes months @$ /month
1005.County taxes 12 months @$ 39.741month $476.88
1006.School Taxes 8 months @$ 181.74/month $1,453.92
1007.Aggregate Adjustment $-84204
1100.Title Charges
1101.Title services and lenders title insurance (from GFE#4) 1,527.00
1102.Settlement or closing fee to $
1103.Owners tide insurance $ (from GFE#5)
1104.Lenders title insurance $1,275.00
1105.Lenders title policy limit$174,577.00 Lenders Policy
1106.Owners tide policy limit$169,000.00 Owners Policy
1107.Agent's portion of the total tide insurance premium $1,083.75
1108.Underwriters portion of the total title insurance premium $191.25
1109.Overnight Fee to South Central Home $15.00
Settlements,Inc.
1110.Wire Fee to Onstown Bank $1200
1111.900 EPL-Res18.1 to SCHS Agent for Conestoga$50.00
Title Ins.Co.
1112.ClosingSvcMCL to SCHS Agent for Conestoga$75.00
Title Ins.Co.
1113.ALTA Short Form Loan to SCHS Agent for Conestoga$100.00
Title Ins.Co.
1200.Government Recording and Transfer Charges
1201.Government recording charges $ (from GFE#7) 164.00
1202•Deed$67.00 Mortgage$97.00 Release$
1203.Transfer taxes $ (from GFE#8) 1,690.00
1204.City/County tax/stamps Deed$1,690.00 Mortgage S
1205.StateTax/stamps Deed$1,690.00 Mortgage S 1,690.00
1206. Deed$ Mortgage$
1300:Additional SettiementCharges
1301.Required services that you can shop for (from GFE#6)
1302 to
1303.Pest Inspection to Chamberlin's Pest Control $ 95.
1304.Rent for 1 month to The Estate of Gloria G.Wri hts 625.00
1305.Final Sewer Bill to CFJMA 37.
1306.Final Water Bill to Borough of Shippensburg 38.7
i i -I rzffmil IVMXG ti 9 13,261.17 12-,000.76
'Paid outside of closing by(B)orrower,(S)elier,(L)ender,(I)nvestor,Bro(K)er."Credit by lender shown on page 1.-Credit by seller shown on page 1.
Previous editions are obsolete Page 2 of 4 HUD-1
Comparison of Good Faith Estimate.(GFE)and HUD-1 Charges Good Faith Estimate HUD-1.
Charges That Cannot increase HUD-1 Line Number
Our origination charge #.801 - 713.00 697.00
Your credit or charge(points)for the specific interest rate chosen # 802 0.00 0.00
Your adjusted-origination charges # 803 713.00 697.00
Transfer taxes # 1203 1,690.00 1,690.00
CharesThatin Total Cannot Increase More Than 10% GoodfaithEstimate.. HUD=1
Govemmentrecording charges. # 1201 160.00 164.00
Appraisal fee #8G4 475.00 375.00
Credit report. #805 60.00 25.34
Flood certification ' #807 8.00 8.00
VA Funding Fee: #904 5,577.00 5,577.00
#
#
6,280.001 6,149.34
S -130.66 or -2.0806%
Charges That.Can Change Good Faith Estimate {HUD-1
Initial deposit for your escrow account # 1001 2,807.76 1,381.50
Gaily interest charges from #901 $20.3300/da 569.17 20.33
Homeowner's insurance #903 7 600.00 1,171.00
Title-services and lenders title insurance # 1101 1,510.00 1,527.00
Owners titre Insurance #1103 0.00 0.00
Loan Terms
Your initial loan amount is',• $174,577.00
Your ldan tennis 30.years
Your initial interest rate is 4.2500%
Your initial monthly amount owed for principal,interest,and any mortgage $858.81 includes
insurance is 0 Principal
❑Interest
❑Mortgage Insurance
Can your Interest rate rise? ❑No. ❑Yes,it can rise to a maximum of %.The firstchange
will be on / / and can change again every years after / I Every
change date,your interest rate can increase or decrease by %.Over the life of
the loan,your interest rate is guaranteed to never be lower than %or higher
than %.
Even if you make payments on time,can your loan balance rise? X❑No. ❑Yes,it can rise to a maximum of$
Even if you make payments on time,can your.monthly amount owed for No. ❑Yes,the first increase can be on I I and the monthly
principal,interest and mortgage insurance rise? amount owed can rise to$
The maximum it can ever rise to is$
Does your loan have-a prepayment penalty? X❑No. [:]Yes,your maximum prepayment penalty is$
Does your loan have a balloon payment? ❑No. ❑Yes,you have a balloon payment of$ due in
years on
Total monthly amount owed including escrow account payments ❑You do not have a monthly escrow payment for items,such as property taxes
and homeowners insurance.You must pay these items directly yourself.
0 You have an additional monthly escrow payment of$319.06
that results in a total initial monthly amount owed of 51,177.87.This includes
principal,interest,any mortgage insurance and any items checked below:
X❑Property taxes Homeowners insurance
❑Flood insurance 0 Misc Impound
❑ ❑
Note: If you have any questions about the Settlement Charges and Loan Terms listed on this form,please contact your lender.
Previous editions are obsolete Page 3 of 4 .HUD-1
Signature Page
HUD CERTIFICATION OF BUYER AND SELLER
I have carefully reviewed the HUD-1 Settlement Statement and to the best of my knowledge and belief,it is a true and accurate statement of all receipts and
disbursements made on my account or by me in this transaction.I further certify that I have received a copy of the HUD-1 SetUemeni Statement
Joseph James Hasper,Jr.
Joni L Hasper
THE ESTATE OF GLORIA G.WRIGHTS
Ronald R.Elliot Sr,Co-Executor tarty L Elliot,Co-Executor
SettlementAgent
The HUD-1 Settlement Statement which I have prepared is a true and accurate account of this transaction.I have caused or will cause the funds to be
disbursed in accordance with this statement
SETTLEMENTAGENT . DATE
WARNING:IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE UNITED STATES ON THIS OR ANY SIMILAR FORM.PENALTIES UPON
CONVICTION CAN INCLUDE A FINE AND IMPRISONMENT.FOR DETAILS SEE TITLE 18:U.S.CODE SECTION 1001 AND SECTION 1010.
Previous editions are obsolete Page 4 of 4 - HUD-1
REV-15o8 EX+(o8-12)
pennsylvania SCHEDULE E
DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Gloria G. Wrights
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. Preceeds from Martin Auctions for personal property sold at public sale 1,422.75
2. Proration of 2013-14 School taxes at sale of 2 Willow Drive,Shippensburg, PA 838.34
3. Personal property sold at garage sales 765.00
TOTAL(Also enter on Line 5, Recapitulation) $ 3,026.09
If more space is needed, use additional sheets of paper of the same size.
REV-1509 EX+(o1-1o)
1167, pennsylvania SCHEDULE F
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN JOINTLY-OWNED PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Gloria G.Wrights
If an asset became jointly owned within one year of the decedent's date of death,it must be reported on Schedule G.
SURVIVING JOINT TENANT(S)NAME(S) ADDRESS RELATIONSHIP TO DECEDENT
A•April C.Wrights 2 Willow Drive Daughter
Shippensburg, PA 17257
B. Ronald R. Elliott,Sr. 1548 Orrstown Road Brother
Shippensburg, PA 17257
C.
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
1. A. 01/01/08 M&T Bank Account No.15004208517564 2,795.08 50% 1,397.54
2. A 01/01/08 Members 1st FCU Account No.420978 1,350.60 50% 675.30
3. B 01/01/08 Patriot Federal Credit Union Account No.4951096240-00 46,159.30 50% 23,079.65
4. B 01/01/08 Patriot Federal Credit Union Account No.4951096240-25 1,781.94 50% 890.97
5. B 01/01/08 Patriot Federal Credit Union Account No.0001096290-00 140.07 50% 70.04
6. B 01/01108 Patriot Federal Credit Union Account No.0001096290-25 6,030.00 50% 3,015.00
TOTAL(Also enter on Line 6, Recapitulation) $ 29,128.50
If more space is needed,use additional sheets of paper of the same size.
REV-1511 EX+(08-13)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Gloria G. Wrights
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1' Fogelsanger Bricker Funeral Home 13,202.60
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s)of Personal Representative(s)
Street Address
City State. ZIP
Year(s)Commission Paid:
2. Attorney Fees:
3,000.00
3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation.)
3,500.00
Claimant April C. Wrights
Street Address 2 Willow Drive
City Shippensburg State PA zip 17257
Relationship of Claimant to Decedent Daughter
4. Probate Fees: 378.50
5. Accountant Fees:
6. Tax Return Preparer Fees:
7. Cumberland Law Journal to publish Estate 75.00
8. New Chronicle to publish Estate 96.50
9. Additional Probate Fees to Register of Wills 100.00
TOTAL(Also enter on Line 9, Recapitulation) $ 20,352.60 ✓
If more space is needed,use additional sheets of paper of the same size.
REV-1512 EX+(12-12)
pennsylvania SCHEDULE I
DEPARTMENT OF REVENUE DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Gloria G. Wrights
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. Commission on sale of 2 Willow Drive,Shbg.to Sailhamer Real Estate 10,140.00
2. Transfer taxes on 2 Willow Drive,Shbg.to State 1,690.00
3. Pest inspection at 2 Willow Drive, Shbg.to Chamberlin's Pest Control 95.00
4. C.F.J.M.A.for sewer bills from 3/19/13 to 1/31/14 at 2 Willow Drive 395.75
5. Borough of Shippensburg for water bills from 3/19/13 to 1131/14 at 2 Willow Drive 212.50
6. Ally Bank payment on 2009 Chevy Impala before turning over to dealer 260.29
7. Chambersburg Hospital 1,337.35
8. Bank of America credit card acct.#4264289244803047 655.11
9. Oxygen supplies to CP02 67.83
10. Final cell phone bill to Verizon Wireless 230.82
11. AT&T Universal credit card acct.#ending 7116 1,190.53
12. Trash Service at 2 Willow Dr.,Shbg.3/19/13 to 1/31/14 to Southampton Township 176.88
13. Electric service at 2 Willow Dr.,Shbg.3/19/13 to 1/31/14 to Penelec 1,006.67
14, Chambersburg Imaging Associates 21.15
15. Chambersburg Gastroenterology Associates 25.50
16. Cumberland Valley Neurological Consultants 60.56
17. Summit Physicians Services 289.02
18. Seller's Assistance for sale of 2 Willow Drive 8,355.00
19. Sollenberger's Messenger Service for transfer of car title to dealership 63.50
20. Comcast Cable for outstanding cable bill for 2 Willow Dr. 645.43
21. Bauserman's Lawn Care for lawn care&maintenance at 2 Willow Dr. 2013 2,675.90
22. Payoff Home Equity Line of Credit Account No.0001096290-90 to Patriot Federal Credit Union 11,440.70
23. Car Insurance to Erie Insurance 207.00
24. Homeowner's Insurance to Erie Insurance 736.00
25. 2013 County/Twp.taxes on 2 Willow Dr.,Shbg.to Vivian Coy,Tax Collector 530.05
"ro Vc,i Soh._ 5(} •=CCent
TOTAL(Also enter on Line 10, Recapitulation) $ �gltPt�. t
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Schedule I (Continued)
Gloria G.Wrights
Item# Description Value at DOD
26 University of MD/Joseph Medical Center $20.00
27 Oxygen supplies Acct# 0008653573 to QAR $389.70
28 2013-14 School taxes-2 Willow Dr., Shbg. to Vivian Coy, Tax Coll. $2,026.44
29 Toilet& sink repairs-2 Willow Dr., Shbg. to Troy Pomeroy Plumbing $114.00
30 Commission to sell personal property to Martin's Auction Service $474.25
31 Summit Cancer&Hemotology $4,047.79
32 Vivian Coy for Prorated 2014 local taxes $39.19
Total this page $7,111.37
REV-1513 EX+ (01-10)
-1-7 pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Gloria G. Wrights
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS(Include outright spousal distributions and transfers under
Sec.9116(a)(1.2).)
1. April C.Wrights 2 Willow Drive,Shippensburg,PA 17257 Lineal-Daughter $104,126.42
2. Ronald R. Elliott,Sr. 1548 Orrstown Road,Shippensburg,PA 17257 Sibling $27,055.66
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE.
II 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 H— ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ 131,182.08
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LAST WILL AND TESTAMENT
KNOW ALL MEN BY THESE PRESENTS, that I, GLORIA G. WRIGHTS, of
Pennsylvania, being of sound and disposing mind, memory and understanding, do
make, publish and declare this my Last Will and Testament, hereby revoking all prior
wills and codicils by me at any time heretofore made.
FIRST: I direct the payment of all my legal debts, funeral expenses and all
expenses of my last illness, state, federal estate and inheritance taxes and
administration costs shall be paid as soon as may be conveniently done following my
decease leaving all specific bequests free of tax to the legatee.
SECOND: I give, devise and bequeath to my daughter,, April C. Wrights, all my
property be it real, mixed or personal.
THIRD: If any of the.beneficiaries under this my Last Will and.Testament is
under the age of Twenty One (21) years (hereinafter minor), then in that event, I give,
devise and bequeath said minor's share to Ronald R. Elliott and,Karen F,Elliott, or if
both should fail to serve or be unable to serve then to Larry L. Elliott, as Trustee of my
estate, to invest and reinvest the same during the minority of the said,minor with the
following powers in addition to those currently given under law:
a. The power to use the income from the said minor's share for the
support, health, maintenance and edLtcation-(j.ncluding-unidergraduatei----- ---
graduate or technical schools) of the said minor.
I
b. The power to use the principal if the income should prove insufficient
for the support, health, maintenance and education (including
undergraduate, graduate or technical schools) of the said minor
C. The power to distribute the then remaining principal and interest to my
daughter as follows: 50 % upon her graduation from high school and
all remaining principal and interest when she attains the age of Twenty
One (21) years, upon a good and valid release without the necessity of
adjudication by the Orphan's Court.
FOURTH: I nominate and appoint Ronald R. Elliott and Karen F. Elliott as
guardians of any minor child.
FIFTH: I nominate and appoint Ronald R. Elliott, Karen F. Elliott and Larry L.
Elliott as Executors of this my Last Will and Testament. My Executors are to serve
without bond of any nature or kind.
IN WITNESS WHEREOF, I, Gloria G. Wrights, to this my Last Will and Testament
set my hand and official seal this day of 2008.
(SEAL)
Gloria G. Wrights
I
f
I
I
Sworn to and subscribed, declared and
Published by Gloria G. Wrights, as
Her Last Will and Testament, and so
Done in the presence of we the
Witnesses, who sign at her request,
And in her presence, and in the presence
Of each other.
COMMONWEALTH OF PENNSYLVANIA:
:SS .
COUNTY OF CUMBERLAND
I, Gloria G. Wrights, whose name is signed to the foregoing instrument, having
been duly qualified according to law, do hereby acknowledge that I signed it willingly;
and that I signed it as my free and voluntary act for the purpose therein expressed.
o
Gloria G. Wrights
Sworn to and acknowledged, before me,
By Gloria G- Wrighh the Testatrix,-
This_t.'� day of 2008.
Notary Public
COMMONWEAUM OF PENNSYLVANIA
No2arla'Sea!
N Anthony Adams; -- -
Shippensburg Boro,Cumberland County
My Commission Expires May 3f,20f 0
COMMONWEALTH OF PENNSYLVANIA:
:SS
COUNTY OF CUMBERLAND
WE, Darlene M. Bigler and Sharon Coleman Adams, the witnesses whose names
are signed to the foregoing instrument, being duly qualified according to law, do depose
and say that we saw the Testatrix sign and execute the instrument as her Last Will and
Testament; that she signed willingly and that she executed it as her free and voluntary
act for the purposes therein expressed; that each of us in the hearing and sight of the
Testatrix signed the Will as witnesses, and that to the best of our knowledge and belief
the Testatrix was at the time at least eighteen (18) or more years of age and of sound
mind and under no constraint or undue influence.
Sworn to and subscribed before me by,
Darlene M. Bigler and Sharon Coleman Adams,
The.witnesses, this klf day of Lu-' 2008.
Notary Public .
COMMOI`TO.rr_rsL►rl OF PENNSYLVANIA
Notarial Seal
H.Anthony Adams,Notary Public
Shippensburg 9oro,Cumberland County
My Commission Expires May 31,2010