HomeMy WebLinkAbout04-25-14 ' J 1505610143
REV-1500 EX�°,_,°, �;
PA Department of Revenue OFFICIAL USE ONLY
pennsylvania County Code Year
Bureau of Individual Taxes �P�TMENfOFHEVENUE File Number
Po Box.2soso� INHERITANCE TAX RETURN
Harrisburg, PA 17128-0601 RESIDENT DECEDENT 21 13 0900
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
Last Name Suffix DecedenYs First Name
IRVIN M�
DONALD C
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name , Suffix Spouse's First Name
IRVIN M�
MARIA E.
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
X❑ 1. Original Return � 2. Supplemental Return
� 3. Remainder Return(date of death
priorto 12-13-82)
� 4. Limited Estate � qa Future Interest Compromise
(date of death after 12-12-82) � 5. Federal Estate Tax Return Required
� g Decedent Died Testate � Decedent Maintained a Living Trust
(Atcach Copy of will) ❑ (Attach Copy of Trust) 8. Total Number of Safe Deposit Boxes
� 9. Litigation Proceeds Received � �p. Spousal Povert Credit�(date of death
benveen i2-a1�1 and -i-95) � 11.Election to ta�c under Sec.9113(A)
(Attach Sch.O)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name
Daytime Teiephone Number
JERRY A WEIGLE ESQUIRE 717 532 7388
REGISTER OF WILLS USE O�IIL�Y
ti �
First line of address � °
12 6 EAST KING STREET � ,� � � Q'
-v
Second line of address �,� � � � � �,
i� � �� N f•-.w � ;
�� ;-� ;;;,'�. "�
. �` �' > C}
City or Post Office `�� c'� TE FfRfD
State ZIP Code tl'� �
SHIPPENSBURG �� "� '
PA 172 5 7 `� � ~'.':; '
:t,, -�'i �"' � m I
.:- � cn o ;
Correspondent's e-mail address: �3 `T��
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 preparer has any knowledge.
�1aATC1RFj OF PERSON SIg�pp
C / � �-f�RN
�.Y !" _-.�. . -- DATE
lan G. Irvin —2 y/L
ADDRESS
3 Irvin Drive Shi ensbur PA 17 7
SIGNATURE OF EPARER OTHER THAN REPRES T TI �
l 7) DATE
�f � erry A.Weigle Esquire :._2(�.—�
ADDRESS
126 East Kin Street, Shi ensbur , P
Side 1
L 1505610143 1505610143
�
J 1505610243
REV-1500 EX
DecedenYs Social Security Number
Decedent'sName: ��jn� Donald C.
RECAPITULATION
1. Real Estate(Schedule A)....................................................................................... 1. 2 61 , �0 0 . 0 0
2. Stocks and Bonds(Schedule B)............................................................................. 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C)......... 3.
4. Mortgages&Notes Receivable(Schedule D)........................................................ 4.
5� Cash, Bank Deposits&Miscellaneous Personal Property(Schedule E)............... 5. 41 , 05 9. 22
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6. 54 ,242 . 0 9
7. Inter-Vivos Transfers&Miscellaneous -Probate Property
(Schedule G) � Separate Billing Requested............ 7.
8. Total Gross Assets (total Lines 1-7)..................................................................... 8. 3 S G, 3 O Z . 31
9. Funeral Expenses&Administrative Costs(Schedule H)....................................... 9. 62 , 7 4 4 . 7�
10. Debts of Decedent, Mortgage Liabilities,&Liens(Schedule I).............................. 10. 24 , 154 . �6
11. Total Deductions(total Lines 9 8�10)................................................................... 11. 8 6, 8 98 . 7 6
12. Net Value of Estate(Line 8 minus Line 11).......................................................... �2. 2 69, 4�2 . 5$
13. Charitable and Governmental BequestslSec 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)............................................... �4, 2 G 9, 4 O Z . 'rJ 5
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 10 7 ,J�$� . 23 15. Q . Q Q
16. Amount of Line 14 taxable
at lineal rate X .045 161 , 822 . 32 16. '� ,2$2 . Q Q
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.15 0 . �0 18. Q . Q Q
19. Tax Due.................................................................................................................. 19. 7 ,282 . DO
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. �
Side 2
� 1505610243 1505610243 J
REV-1500 EX Page 3 File Number 21-13-0900
Decedent's Complete Address:
DECEDENT'S NAME
Irvin, Donald C.
STREET ADDRESS
3 Irvin Drive
CITY STATE ZIP
Shippensburg PA 17257
Tax Payments and Credits:
1. Tax Due(Page 2, Line 19) (1) 7,282.00
2. Credits/Payments
A. Prior Payments 7,500.00
B. Discount 364.10
Total Credits(A +B) (2) 7,864.10
3. Interest (3)
4, If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4) 582.10
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�rable to REGISTER OF WILLS, AGENT
� r�'���`' -�� �� � .����� .g� �'"�"' �i��"'": �'i� . � ��__ �;ci�r s-� *s�� ; � - a
�,.�..�.,�...5,.:,ac,..�,....�...., �. . .,,,,.ri,;,y,�.!c�.,�.,..,�. .,�k�w�. ..., ,�,.: ..�_„�.,..�.�%:������a� s .,....,,;�,,,.. .�. .�, .t.�,:n�.s. ,�.r ....A��a'�' .,.,,,,:_,�,.Id��,�.�,,.�„«».',�f`,''.�.��, W,.,,�.
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:............................................................................... � �
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 December 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?.................................................................................................................. ❑ 0
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
rr ..:, < �,:: § � d'�'� '�`,�..�..., :� .�'�.;'`���...�..�.�..:.�A,�,�t._,.z.� .�;: ......,��»..,:.`1.� „��', � �\��"'�`� �: m :
z.��,...:.� �..�,,.��»��._.,. :����.�.,.��'� '
. .. ��...,F,..., , �".w"�. �
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 January 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 decedenYs lineal beneficiaries is 4.5 percent,except as noted in
72 P.S.§9116 1.2)[72 P.S. §9116(a)(1)].
. 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+(��-08)
� � � SCHEDULE A
i � REAL ESTATE
�m
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENTDECEDENT j
ESTATE OF FILE NUMBER
Irvin, Donald C. 21-13-0900
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 which 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
Include a copy of the deed showing decedenYs interest if owned as tenant in common.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Real Estate-located in Florida,$425,000,not taxable for PA inheritance tax 0.00
2 Real Estate known as Lot 34-Irvin Drive,Shippensburg,Southampton Township, 37,000.00
Cumberland County, PA, improved with a Morton building
3 Real Estate known as Lots 30,31,32,and 33 building lots-Irvin Drive,Shippensburg, 80,000.00
Southampton Township,Cumberland County, PA
4 Real Estate Personal Residence-3 Irvin Drive,Shippensburg,Southampton Township, 144,000.00
Cumberland County, PA
TOTAL(Also enter on Line 1, Recapitulation) 261,000.00
(If more space is needed,additional pages of the same size)
Copyright(c)2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule A(Rev. 11-08)
Rev-1508 EX+(6-98)
� �. SCHEDULE E
� CASH, BANK DEPOSITS, & MISC.
�
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
� INHERITANCE TAX RETURN
RESIDENT�ECEDENT
ESTATE OF FILE NUMBER
Irvin, Donald C. 21-13-0900
� Inctude lhe proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with the right of survivorship must be disclosed on schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 F&M Trust Checking Account 97720 741.93
2 Southampton Township,Cumberland County-return of required escrow deposit for road 37,353.29
construction
3 1998 Ford F150 Regular Cab Truck 2,964.00
TOTAL(Also enter on Line 5, Recapitulation) 41,059.22
(If more space is needed,additional pages of the same size)
Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E(Rev.6-98)
Rev-1509 EX+(6-98)
;� `
SCHEDULE F
COMMONWEALTHOFPENNSYLVANIA JOINTLY-OWNED PROPERTY �
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Irvin, Donald C. 21-13-0900
If an asset was made joint within one year of the decedent's date of death,it must be reported on schedule G.
SURVIVING JOINT TENANT(S)NAME ADDRESS RELATIONSHIP TO DECEDENT
A. lan G. Irvin 3 Irvin Drive Son
Shippensburg, PA 17257
B.
C.
JOINTLY OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY o
ITEM INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT �o OF DATE OF DEATH
NUMBER FOR JOINT MADE NUMBER OR SIMILAR IDENTIFYING NUMBER.ATTACH DEED FOR DATE OF DEATH DECD�S DECEDENTS INTEREST
TENANT JOINT JOINTLY-HELD REAL ESTATE. VALUE OF ASSE INTEREST
1 A 01/04/2006 F 8�M Trust Money Management Account 1,000.00 50.000% 500.00
71019
2 A years Invesco Account 29446-joint with lan G. 71,778.07 50.000% 35,889.04
Irvin,son
3 A years Invesco Account 52528-joint with lan G. 15,616.95 50.000% 7,808.48
Irvin,son
4 A years Invesco Account 53335-joint with lan G. 7,397.97 50.000°/a 3,698.99
Irvin,son
5 A years Invesco Account 60045-joint with lan G. 12,691.16 50.000% 6,345.58
Irvin,son
TOTAL(Also enter on Line 6, Recapitulation) 54,242.09
(If more space is needed,additional pages of the same size)
Copyright(c)2002 form software only The Lackner Group,Inc. Forrn PA-1500 Schedule F(Rev.6-98)
REV-1151 EX+(�0-06) Y�
' � SCHEDULE H
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES &
INHERITANCE TAX RETURN
RESIDENTDECEDENT ADMINISTRATIVE COSTS �
ESTATE OF
Irvin, Donald C. FILE NUMBER
21-13-0900
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
See continuation schedule(s) attached
3,935.95
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
lan G. Irvin
Street Address 3 Irvin Drive
city _ Shippensburg state PA
zin 17257
Year(s)Commission oaid 26,439.00
2. Attornev's Fees Weigle 8�Associates, P.C.
27,189.00
3. Family Exemption: (If decedenYs address is not the same as claimanYs,attach explanation)
3,500.00
Claimant Maria Fe Irvin
StreetAddress 3 11v1n Drlve
c�ty Shippensburg state PA
zio 17257
Relationshio of Claimant to Decedent SpOUSe
4. Probate Fees Register of Wills, Cumberland County
433.50
5. AccountanYs Fees
6. Tax Return Preparer's Fees
7. OtherAdministrative Costs
1,247.25
See continuation schedule(s)attached
TOTAL(Also enter on line 9, Recapitulation) 62,744.70
Copyright(c)2009 form software only The Lackner Group, Inc.
Form PA-�500 Schedule H(Rev. 10-06)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Irvin, Donald C. 21-13-0900
ITEM
NUMBER DESCRIPTION AMOUNT
Funeral Exnenses
1 Fogelsanger-Bricker Funeral Home 3,935.95
H-A 3,935.95
Other Administrative Costs
2 Cumberland Law Journal-advertising Letters Testamentary 75.00
3 Linda K. Klein -notary fee 22.00
4 News Chronicle-advertising Letters Testamentary 104.75
5 Register of Wills, Cumberland County-filing PA Inheritance Tax Return 15.00
6 Register of Wills, Cumberland County-filing Family Settlement Agreement 100.00
7 Sailhamer Real Estate-market analysis 175.00
8 Vivian Coy, Tax Collector-3-1-14 county real estate tax 680.50
9 Weigle&Associates, P.C. -reimbursement for postage,xerox copies,and long distance 75.00
telephone calls
H-B7 1,247.25
Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-7500 Schedule H(Rev.6-98)
Rev-1512 EX+(�2-08)
°� SCHEDULE 1
' .�- ' DEBTS OF DECEDENT,
�
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTHOFPENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENTDECEDENT
ESTATE OF FILE NUMBER
Irvin, Donald C. 21-13-0900
Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION VALUE AT DATE
OF DEATH
1 F�M Trust Checking Account 97720-check clearing after date of death 114.57
2 PA Depa�tment of Public Welfare-lien against estate 20,950.69
3 Vivian Coy,Tax Collector-7-1-13 school real estate tax 3,088.80
TOTAL(Also enter on Line 10, Recapitulation) 24,154.06
(If more space is needed,additional pages of the same size)
Copyright(c)2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule I(Rev. 12-08)
REV-1513 EX+(11-pg) y�
SCHEDULE J
COM�NR STDENTDE�EDENTRNAN�A
BENEFICIARIES
ESTATE OF
FILE NUMBER
Irvin, Donald C. 21-13-0900
NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(Sl RECEIVING PROPERTY DECEDENT
Do Not is T st e s (WOfdS� �$$$�
I. TAXABLE DISTRIBUTIONS [include outright spousal
distributions,and transfers
under Sec.9116 a 1.2
1 lan G. Irvin Son Joint assets plus 108,032.20
3 Irvin Drive 25%of robate
Shippensburg, PA 17257 estate p
2 Maria Fe Irvin Spouse 50%of probate 107 580.23
3 Irvin Drive ,
Shippensburg, PA 17257 estate
3 Nichelle M.Irvin Daughter 25%of probate 53 790.12
39 Montgomery Avenue estate '
Shippensburg, PA 17257
Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 1500 ov�easheet,as a ro riate. 269,402.55
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)2009 form software only The Lackner Group,Inc.
Form PA-1500 Schedule J(Rev. 11-08)
l : . _:
�lST' �ILL A�VD �ESTAMENT
I,DON�4LD C. IR YIN,presently residing at 3 Irvin Drive, Shippensburg, Cumberland
County, Pennsylvania 17257, zip being of sound mind, memory and disposition, do hereby make,
publish and declaze this my Last Will and Testament, hereby revoking and making void a11 Wills
by me at any time heretofore made.
FIRST. I order aud direct the pay�nent of all iny legally enfarceable debts arid
funeral expenses as soon as may be convenient after my decease.
SECOIVD. I give, devise and beqneath a11 my esta.te, rea1, personal and mixed,
whatsoever and whe�esoever situate, as follows:
A• FIFI'Y PERCENT(50%)of my probate estate to my wife, MARIA FE IRVIN
B• 'I'WENTY-FIVE PERCENT (2�%) of my estate to my daughter, �IC�LLE
�1'I. IRVI�i, on a per stirpes distribution basis.
C• 'TWEI�TY-FIVE PERCENT(2�°/a)of my estate to my son,IA�T G.IRVIl�, on a
per stirpes distribution basis less any amounts paid to him as the surviving joint
tenant with right of survivorship with respect to certain investment accounts that I
presently own jointly with the said IAl� G. IRVIN through Invesco Investment
Services, Inc. it being my intent to treat my danghter and son as equally as possible
under this my Last Will and Testament.
D. It is my specific intent and desire to omit my son by a former marriage, namely
JAIIZES L. IRVIN from any distribution whatsoever under this my Last Will and
Testament.
THIRD. I nomina.te, constitute and appoint my son, IAN G. IRVI�1, to be the
Executor of this my Last Will and Testament. In the event that he be una.ble to fulfill the duties of
Executor, I then nominate, constitute and appoint my wife, MARIA F'E II2VIN to be the
Executr�of this my Last Will and Testament.
FOURTH. I direct that neither my personal representa.tives shail not be required to give
bond for the faithful performance of their duties in any jurisdiction.
� � +
? � (SEAL)
� M
➢ONALD C. IR
WEIGLE & ASSOCIATES, P.G. - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 17257-1397
�
.
COMMONWEALTH OF PE1��iSYLVANIA .
: SS
COUNTY OF CUMBERLA�TD :
I, DONALD C. IRVIl�T, the person whose name is signed to the foregoing instrument, having
been duly qualif ed according to law, do hereby acknowledge that I signed and executed the
instrument as my Last Will;that I signed it willingly; and that I signed it as n�y free and voluntary
act for the purposes therein expressed.
�(i i'KLI.f%i/� 1.�, VFV"'✓�YI
DONA�D C.IRV�N
Swom or affirmed to and acknowled.ged befare
me by DONALD . VIN,the Testator,
this��day of 2013.
""'J
Q ,-
0
WEIGLE & ASSOCIATES, P.C. - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 17257-t397
IN WITNESS WHEREOF, I, DONALD C.IRVIN,have hereunto set my hand and seal to
this my Last ViTill and Testament, written on one (1) page, the first page signed for ident�cation
only,this fl� day of J Q n ti �,r .� , 2013.
�.%� .� " ,.
1 � � ,.
�DONALD C.IRYIN ��E��
This instrument was by the Testator, on the date hereof, signed, published and deciared by him to
be his Last Will and Testament, in our presence, who at his request and in the presence of each
other,we believing him to be of sound and disposing mind and memary,have hereunto subscribed
our names as witnesses.
�
�
�
WEIGLE & ASSOCIATES, P.C. - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, pA 17257_1gg7
,
COMMONWEALTH OF PENNSYLVANIA :
: SS
COUNTY OF CUMBERLAND ;
We, b�' ✓ �U�C f and r � �. l`l
,
the witnesses whose names are signed to the foregoing instrument, being duly qualif ed according
to law, do depose and say that we were present and saw DONALD C. IR`JIl�T, the Testator, sign
and execute the instrunient as his Last Will; that he sigaed v4�illlliuDly and that he execnted it as his
free and voiuntary act for the ptuposes therein expressed; that each of us in the hearing and sight
of the Testator, signed the Will as witnesses; and that to the best of our knowiedge the Testator
was at the time eighteen (18} or more years of age and of sound mi.nd and u�ader no consh�a.i.nt or
undue influence.
��
�
,
Sworn or affirmed to and subscribed before me
by �aY�nnc� J �� s � ,
and � Vrle( `'
r
ses,this��day o ,2013.
COMMONWEALTH OF PENN VANIA COMMONWEALTH OF PENNSYLVANIA
n���,s-:n; ,�-�� NOTARIAL SEAL
_:;{� Jerry A.Weigle,Notary Public
City c, ;r;,�„ ir;, :,m .:;�;�nG�ounty City of Shippensburg,Cumberland County
My Cornmission Gxpires October 7,2014 My Commission Expires October 7,2014
WEIGLE & ASSOCIATES, P.C. - ATTORNEYS AT LAW - 126 EAST KI[VG STREET - SHIPPEfVSBURG, PA 17Z57-1397
Sailhamer Real Estate, Inc.
494 E. I�iu�St� Sl�ippensbru•�, Pa, 1725�
Offic�(i'17)532-(i059/Fai (i1i')530-5181
www.sailhamer.com/info(�a,sailhamer.com
April 18, 2014
Mr.Jerry A. Weigle, Esquire '
Weigle and Associates
136 East King Street
Shippensburg, PA 17257
Mr. Weigle;
This analysis has not been performed in accordance with the uniform standards of
professional practice which requires valuers to act as unbiased, disinterested third parties with
impartiality, objectivity and independence and without accommodation of personal interest; it is
not to be construed as an appraisal and may not be used as such for any purpose.
In response to your request for a comparable market analysis of real estate for the Estate
of Donald C. Irvin, located at Irvin Drive, Shippensburg, PA 17257, Southampton Township,
Cumberland County, I am sending you my estimation of current market values of the four(4)
unimproved building lots(Lot#'s 30, 31, 32,33)and Lot#34 with the metal Morton type
building and Lot#1 with the existing log dwelling.
i
' cerel��
� ����
Ron Sailhamer
Real Estate Broker
See Attachments
Sailhamer Real Estate, Inc.
� 494 E. Ivng St. 5hipp��nsbnrg, P�. 1?'257
� Offi c,e(i 1 i)�3�-G059��,.1 (r 17)530-5181
www.sailhamer.com/info�a,sailhamer.com
The property known as Lot#34 Irvin Drive, S'hippensburg, PA, Southampton township,
Cumberland County consists of approximate .811 acre and has been improved with a 42x70 metal
(Morton)type building with '/z bath and office. The lot is served by on-lot water and public
sewer and electric. The property appears to be in good condition thus I would suggest a current
value of between Thiriy-Five Thousand Dollars($35,000)to Thirty-Nine thousand Dollars
($39,000).
The four existing building lots described as Lot#30(contains .051 acre), Lot#31 (containing .227
acre), Lot#32 (containing .298 acre)and Lot#33 (containing .240 acre)would require public
sewer tap fees and on-lot water(well)supply. The lots appear level. Verification as to whether
any of these lots are located in a flood zone should be determined.
I would suggest a current market value of between Eighteen Thousand Dollars($18,000)to
Twenty Two Thousand Dollars($22,000)each.
��// rely, ' f.ri
"7 ��-t_
R ailhamer
Real Estate Broker
��.t- .3 I L�/ �tr!�7�tn �'"' �C�r w�' ^ 3 —�� � O C}
3�ooa — 39, 00 �
�Ic�cU��� Lo.�s ��,, g,, �z, 33
/��cco — 2z-� oc� �c,c � �}-p� e o G�
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ATTACHMENT#1 �
Sailhamer Real Estate, Inc.
� 4�J4 E. I�ing St� ShippPnsbni�g, Pa� 1 r25"r
� Office(i1 i)532-6059/Fai (i1i')530-5181
www.sailhamer.com/info�,sailhamer.com
The property known as 3 Irvin Drive, Shippensburg, PA 17257, Southampton Township,
Cumberland County, described as Lot#1 containing 0.636 acres is served by public sewer and on-
lot water supply. The log home(built 1989)contains approximately 2465 square feet of living
area.The first floor offers kitchen,Den, Sitting Room, Bedroom, Living Room, '/z bath and two
(2)additional rooms. The second floor offers Three Bedrooms(3),and One Full Bath.The
overall condition of the property exterior appears to be good. The interior description was derived
from data taken from the(MRIS)Multi-List with hypothetical assumption that the interior would
be in good condition.
I would suggest a current value of between One Humdred and Forty Thousand Dollars
($140,000)to One Hundred and Forty Eight Thousand Dollars($148,000).
Since ly; '
,� � ���z�
Ron Sailhamer
Real Estate Broker
� �,.�- / r..l� �es;dPhr e � � `�t�j � o 0
����n�� _ � c�•�� �eo
ATTACHMENT#2 �
, •
www.fmtrust�����.com
TRUST
September 5, 2013
Weigle &Associates, P.C.
Attorney's-at-Law
126 East King St
Shippensburg, PA 17257-1397
RE: Donald C. Irvin
To Whom It May Concern:
In reference to the above customer, our records show the enclosed information to be
accurate as of the date of decedents death. If I may be of any further assistance, please
contact me.
Sincerely,
���
Brenda Hahn
Deposit Operations Clerk
717-261-3668
717-264-6116 888-264-6116 P.O.Box 6010 Chambersburg,PA 17201-601Q
FINANCIAL SOLUTIONS ... FROM PEO�LE YOU KNQW
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JERRYA.WEIGLE �VE��LE & ASSQCIATES� P.�l...
Attorneys-at-Law
Associates 126 EAST IaNG STREET
JOSEPH P.RUANE SHIPPENSBURG,PENNSYLVANIA 17257-1397
RICHARD L.�'VEBBER,JR.
TELEPHONE(71'�532-'7388
Of Counsel FAX(71�532-5289
THOMAS L..BRIGHT
MARK W.ALLSHOIISE
November 7,2013
Jef&ey Miller,BDO
Onstown Bank ,
77 East King Street
Shippensburg,PA 17257
Mr. Ian Irvin
3 Ian Drive
Shippensburg, PA 17257
RE: Donald C. Irvin—Letter of
Credit 08-61
' Deaz Mr. Miller and Mr. Irvin:
As you will recall, I am the Solicitor for the Board of Supervisors for Southampton
Township, Cumberland County,Pennsylvania.
� On December 20, 2012, I made a claim on behalf of the Township for the proceeds of the
above-referenced Line of Credit. On December 21, 2013, a check in the amount of
$39,778.00 was tendered by Orrstown Bank.
The purpose flf making the claim was to insure that the street known as Nichelle Lane
was completed to Township specifications and dedicated to the Township as a public
street.
The following amount have been paid from those proceeds:
Date Payee Amount
8/28/13 Alpha Space Control Co. $ 380.76
10/15/13 Blue Mtn. Exc. $2043.95
Total $2424.71
A balance of$37,353.29 therefore remains in escrow.
Jeffrey Miller,BDO
November 7, 2013
Page 2
The Township is not aware of any other outstanding bills.
The required improvements have now been completed. The only remaining items are tlie
prepazation of a Deed of Dedication in the form required by the Township, the
acceptance of the Deed for the Township, and the posting by Irvin of a mai.ntenance bond
in the amount of$7838.57. �
I was not certain whether Mr. Miller was aware that Donald C. Irvin died on July 27,
2013.
It appears that the property is owned by Irvin Industry, Inc. although the Letter of Credit
was listed under Mr. Irvin's individual name.
I will recommend to the Township that the remaining balance be released once the
obligations are completed. I will further advise that the proceeds check be issued payable
to Orrstown Bank, Irvin Industry, Inc., and the Estate of Donald C. Irvin unless
� authorized otherwise by all parties. The maintena.nce bond issue must be addressed as
well, and perhaps in conjunction with the distribution of the proceeds of the Letter of
Credit.
I am providing a copy of this letter to Jerry A. Weigle, Esquire, of this ofFice. He is the
� attomey for the Donald C. Irvin Estate. He is in the process of preparing the Deed of
Dedication.
Thank you for your attention to this matter. I will be in touch with each of you. I look
forwazd to working with you towazds the ultimate resolution of a11 of these issues. -
Sincerely,
Weigle&Associates,P.C.
, -�I' �
�
Richard L. Webber,Jr., Esquire
RLW/paf
Cc: Southampton Township Board of Supervisors .
Jerry A. Weigle, Esquire,i
William E. Green,P.E.
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Holdings by Investor
Donald C Irvin Joseph Bowden Combined Account PortFolio
3 Irvin Dr . Date: 07/27/2013
Shippensburg,PA 17257 77 East King Street Created:OS/14/2013
Shippensburg, PA
717-530-2618
Donald C Irvin
Acct Name:DONALD C IRVIN 8� IAN G IRVIN JT WR05 3 IRVIN DR SHIPPENSBURG PA 17257-8223
Acct No:00671560045 AcctType:Joint Tenants
Rep.No:11856
Asset Name Ticker AssetType Mgt.Name Quantity Price($) Value($)
INVESCO EQUITY AND INCOME ACEIX US STOCKS INVESCO 987.97 10.72 10,591.05
FUND-CLASS A INVESTMENT
SERVICES INC.
IVK AMERICAN FRANCHISE FUND- VAFAX US STOCKS ' INVESCO 141.71 14.82 2,100.11
CLASS A INVESTMENT
SERVICES INC.
Account Total: $12,691.16
Acct Name:DONALD C IRVIN& IAN G IRVIN JT WROS 3 IRVIN DR SHIPPENSBURG PA 17257-8223
Acct No:06900152528 Acct Type:Joint Tenants
Rep.No:11856
Asset Name Ticker AssetType Mgt.Name Quantity Price($) Value($)
INVESCO CONVERTIBLE CNSAX OTHER INVESCO 665.68 23.46 15,616.95
SECURtTIES FD-A INVESTMENT
� SERVICES INC.
Account Total: $15,616.95
Acct Name:DONALD C IRVIN& IAN G IRVIN JT WROS 3 IRVIN DR SHIPPENSBURG PA 17257-8223
Acct No:06900153335 Acct Type:Joint Tenants
Rep.No:11856
Asset Name Ticker AssetType Mgt.Name Quantity Pr1ce($) Value($)
IVK GROWTH AND INCOME FUND- ACGIX US STOCKS INVESCO 286.52 25.82 7,397.97
CLASS A INVESTMENT
, SERVICES WC.
Account Total: $7,397.97
�
Incomp�ete'rf presented without accompanying disclosure pages Page 1 of 3
Holdings by Investor
Donald C Irvin Joseph Bowden Combined Account Portfolio
3 Irvin Dr Date: 07/27/2013
Shippensburg, PA 17257 77 East King Street Created:08/14/2013
Shippensburg, PA
717-530-2618
Acct Name:DONALD C It2VIN& IAN G IRVIN JTWROS 3 IRVIN DR SHIPPEN58URG PA 17257-8223
Acct No:01000129446 Acct Type:Joint Tenants
Rep.No:11856
Asset Name Tidcer AssetType Mgt.Name Quantity Price($) Value($)
I�NVESCO CHARTER FUND-CLASS CHTRX US STOCKS , INVESCO 112.56 21.14 2,379.41
INVESTMENT
SERVICES INC.
INVESCO CONSTELLATION A CSTGX DOMESTIC INVESCO 56.35 28.10 1,583.31
EQUITY INVESTMENT
� SERVICES INC.
INVESCO DIVERSIFIED DIVIDEND LCEAX US STOCKS INVESCO 634.43 16.10 10,214.37
FD—CL A INVESTMENT
SERVICES INC.
INVESCO U.S.QUANTITATIVE CORE SCAUX US STOCKS INVESCO 769.81 10.38 7,990.60
FUND INVESTMENT
SERVICES INC.
INVESCO VAN KAMPEN ACCBX BONDS INVESCO 1,986.33 7.00 13,904.30
CORPORATE BOND FUND CLASS A INVESTMENT
SERVICES INC.
Account Total: $36,071.99
InvestorTotal: $71,778.07
Incomplete if presented without accompanying disclosure pages Page 2 of 3
r
Holdings by Investor
Donald C Irvin Joseph Bowden Combined Account Portfolio
3 Irvin Dr . Date: 07/27/2013
Shippensburg,PA 17257 77 East King Street Created:OS/14/2013
Shippensburg,PA
717-530-2618
Disclosure:
Registered Representative of and securities offered through Cetera Advisor Networks LLC,member SIPC..is not affiliated with Cetera Advisor
Networks LLC.Values are as of 07/27/2013 unless otherwise noted. We believe the sources to be reliabte,however,the accuracy and compieteness
of the information is not guaranteed,as it is a compilation of information from various financial sources(mutual funds,direct participation programs,
correspondent brokers,etc.). In the event of any discrepancy,the sponsor's valuation shall prevail.
Performance data quoted represents past performance and does not guarantee future results. The investment return and principal of an investment
wiil fluctuate so that an investor's shares when redeemed may be worth more or less than the original cost. TF�e values represenYed in this report
may not reflect the Vue original cost of the GienYs initial investment.
For fee-based accounts only:the figures may or may not reflect the d�duction of investment advisory fees. If the investment is being managed
through a fee-based account or agreement,the returns may be reduced by those applicable advisory fees. Refer to your Advisor's Form ADV,Part
II.
The information contained in these reports is coliected from sources believed to be reliable. However,you should always rely on your statements
received directly from product sponsors. If you have any questions regarding your report,please call your representative.
The source data for the following accounts was provided by DST FAN Mail:
00671560045
01000129446
06900152528
06900153335
Page 3 of 3
.�-------.
!•' pennsylvania
�
DEPAFTMENT OF PUBLIC WELFARE
August 29, 2013
WEIGLE &ASSOCIATES PC
JERRY A WEIGLE ESQUIRE
126 EAST KING STREET
SHIPPENSBURG PA 17257
Re: Donald Irvin
CIS #: 260190249
SSN: #.##-##-1387
Date of Death: 07/27/2013
ESTATE RECOVERY STATEMENT OF CLAIM
Dear Attorney Weigle:
Under State and Federal law, the Department of Public Welfare (the Department) is
required to recover medical assistance (MA) reimbursement from the probate estates of
deceased individuals who were over age 55 when such assistance was received. 42 U.S.C.
�1396p(b)(1). 62 P.S. § 1412. This letter sets forth the amount of the Department's claim
against the estate of the above referenced individual and explains the obligations of
executors, administrators, and persons receiving estate property.
Although the amount in the estate may be considerably less than that which
is owed to the Department, our claim is against the estate, no one else.
Statement of Claim Amount
The Department maintains a claim in the amount of �20,950.69 against the
above-mentioned estate. This claim is for repayment of MA granted on behalf of the
decedent. Enclosed is the Department's itemized statement of claim.
A portion of this medical expense, namely $13,621.41, was incurred during the last
six months of the decedent's life; therefore, it is a Class 3 claim pursuant to Section 3392 of
the Decedents, Estates, and Fiduciaries Code, 20 Pa. C.S.A. 339Z(3). The balance of the
claim, namely �7,329.28, is to be entered as a priority Class 5.1 claim against the estate.
You should refer to Section 3392 for a more complete explanation of the priority rules.
If a lawsuit is filed for injuries sustained by the decedent prior to death, then the
Department may also have a lien against the personal injury action. A statement of claim
for that injury-related lien must be requested separately.
Bureau of Program Integrity � Division of Third Party Liability � Recovery Section
PO Box 8486 � Harrisburg, Pennsylvania 17105-8486
*,<
' q�� ,�i pennsyLvania
a" ��II� DEPARTMENT OF PUBLIC WELFARE
,��
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�
�,.
Insolvent Estates and the Fiduciary Responsibility to Creditors
If there are not enough estate assets to pay the claims of all creditors in full, then
the executor or administrator has a duty to act in the best interest of creditors when
administering the estate. If you must spend the estate's money to administer it, you must
act prudently and make purchases as if the money were coming out of your own pocket.
The Department's approval is required if you expect the legal fees to exceed more than the
greater of 6% of the estate assets or $1,004. Contingent fees for estate administration will
generally not be approved. If you do not obtain approval, the Department may consider the
excessive fees to be a transfer for less than valuable and adequate consideration.
Sincerely,
�
�"���� .,-��. � �Kf.:��'�.�..��.
�
Angela D. Carter
Claims Investigation Agent
717-772-6612
717-77Z-6553 FAX
Enclosure
Bureau of Program Integrity � Division of Third Party Liability � Recovery Section
PO Box 8486 � Harrisburg, Pennsylvania 17105-8486