HomeMy WebLinkAbout07-17-14 � �
� 1505610105
REV-1500 EX(oz-11)(FI) �'
L�� OFFICIAL USE ONLY
PA Department of Revenue pennsylvania
Bureau of Individual Taxes �",pT"`"T ` County Code Year File Number
Po BoX z8o6o1 �pINHERITANCE TAX RETURN �� / � �/�
Harrisburq,PA 1'7128-0601 RESIDENT DECEDENT �
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
04/01/2013 05/07/1929
DecedenYs Last Name Suffix DecedenYs First Name MI
Spenard Lionel �
(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
FI�L IN APPROPRIATE OVALS BELOW
O 1.Original Return � 2.Supplemental Return O 3. Remainder Return(Date of Death
Prior to 12-13-82)
O 4. Limited Estate p 4a. Future Interest Compromise(date of p 5. Federal Estate Tax Return Required
death after 12-12-82)
O 6.Decedent Died Testate O 7. Decedent Maintained a Living Trust _ 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 T0:
Name Daytime Telephone Number
Kathleen Misturak-Gingrich
REGISTER O�IILLS USE ONL�'y
� -...
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First Line of Address r��,. `=-� �' �
��7 r � , +� 7
5006 E. Trindle Road �,�c': � '��z�
cr
Second Line ofAddress ��- . ~ i r�;
.-- �
Suite 203 ��� �- ;r�,'
, - -.�..
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City or Post Office State ZIP Code "04TE'FILED _ ��='
t'— � � T
Mechanicsburg PA 17050 :� `��
CorrespondenYs e-mail address: kg�Ing�iCh@pjrl2w.COm
Under penalties of perjury,I declare that I have examined this retum,inciuding 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 knowiedge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE
(3, .�'J�� , - t �-� �,
ADDRESS
�5� s1�rnn�� 4 r���L� 2� m �c�a r�N�csa ,�R�- Pn, t�u� u
SI�TURE`OF PRE�PARS OTHER THAN REPRESENTATIVE DATE
(a� I v�.. -7—1 G -l y�
ADDRESS D '
���G E• �2��d(,�. M� � S��c. 1.�3� V�-chw..-ca 4w•� �• 17�S�
PLEASE USE ORIGINAL FORM ONLY
Side 1
� 1505610105 1505610105 �
�
� 1505610205
REV-1500 EX(FI)
DecedenYs Social Security Number
DecedenYs Name: Lionel J. Spenard
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. 5,064.05
6. Jointly Owned Property(Schedule F) O Separate Billing Requested . .. . ... 6.
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) O Separate Billing Requested... . . . .. 7.
8. Total Gross Assets(total Lines 1 through 7). . ... . .... . .. ..... . .... . .... . 8. 5,064.05
9. Funeral Expenses and Administrative Costs(Schedule H)..... . .... . ..... ... 9. 16,371.08
10. Debts of Decedent, Mortgage Liabilities and Liens(Schedule I)... ..... ..... .. 10. 18,001.30
11. Total Deductions(total Lines 9 and 10).. . . .... . ....... . .... . .... . ..... . 11. 34,372.08
12. Net Value of Estate(Line 8 minus Line 11) ......... . ....... . .... . .... . .. 12. -29,308.33
13. 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. -29,308.33
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_ 15.
16. Amount of Line 14 taxable
at lineal rate X.0_ 16.
17. Amount of Line 14 taxable
at sibling rate X.12 17.
18. Amount of Line 14 taxable -29,308.33 -4,396.25
at collateral rate X.15 18.
19. TAX DUE ... ... ....... . .. .. . .... ... . .... ...... ....... . .... . .... . .. 19. -4,396.25
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT �
Side 2
� 1505610205 1505610205 J
__ _ _
REV-1500 EX(FI) Page 3 File Number
Decedent's Complete Address:
DECEDENT'S NAME
Lionel J. Spenard
STREETADDRESS
9 South Locust Lane
CITY STATE ZIP
Mechanicsburg PA 17050
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) -4,396.25
2. CreditslPayments
A.Prior Payments
B.Discount
Total Credits(A+B) (2) 0.00
3. I nterest
(3) 0.00
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) -4,396.25
5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 0.00
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.......................................................................................... ❑ �
b. retain the right to designate who shall use the property transferred or its income ............................................ ❑ �
c. retain a reversionary interest .............................................................................................................................. ❑ �
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?.............. ❑ �
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 suroiving 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 decedenYs 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 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-iso8 EX+(o8-iz)
�pennsylvania SCNEDULE E
tiT DEPARTMENTOFREVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Lionel J. Spenard 21-13-0410
Include the proceeds of litigation and the date the proceeds were received by the estate.
Ail property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
�. Sale of Firewood 250.00
2,;' ;Items sold at Auction 430.00
3,' =Sale of Plywood and Assorted Wood 350.00
4.; Items sold at auction 1,883.50
5,' ;Nationwide(refund of home insurance) 369.00
g,; ";Spirit Physician Refund 36.31
7,; `Federal Tax Retum Refund 1,732.00
g,, ;Dividend 13.24
TOTAL(Also enter on Line 5, Recapitulation) $ 5,064.05
If more space is needed,use additional sheets of paper of the same size.
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; Spirit Physician Services,�nC. gggpr�p�r5 LIONEL SPENARD, 83641 09/20/13
' 205 Grandview Ave.Suite 210
� Camp Hili, PA. 17011 Page 01 of 01
`INVOICE ,NUMBEIi::. .. ;OAT�.:: .. . .: INSIfJICE:AMOUNT:; , ;QISCOUNTAMQUNT.. .
, ...�IE'[`:AMOUN7'<. ;'',
REFUND CRITCARE 09/20l13 36.31 0.� 36.31
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REV-1511 EX+ (08-13)
� pennsylvania SCHEDULE H
DEPARTMENTOFREVENUE FUNERAL EXPENSES AND
INHERITANCETAXRETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Lionel J. Spenard 21-13-0410
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES;
1.
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions: 479.93
Name(s)of Personal Representative(s)
Street Address
City_ State ZIP
Year(s)Commission Paid:
2. Attorney Fees:
15,891.15
3. Family Exemption; (If decedenYs address is not the same as claimant's,attach explanation.)
Claimant
Street Address
City State ZIP
Relationship of Claimant to Decedent
4. Probate Fees;
5• Accountant Fees:
6. Tax Return Preparer Fees:
7.
TOTAL(Also enter on Line 9, Recapitulation) $ 16,371.08
If more space is needed,use additional sheets of paper of the same size.
�REV-1512 EX+ (12-12)
j i�pennsylvania SCHEDULE I
� DEPARTMENTOFREVENUE DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Lionel J. Spenard 21-13-0410
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• Advanced Septic Services,Inc. 205.00
2. Gary Morrow 50.00
3. PPL 42.22
4. Advanced Septic Services, Inc. 775.00
5. USPS 42.35
6. John Potteiger 180.00
7. D&D Septic&Toilet Rentals 80.30
8. USPS 17.55
9. PPL 55.47
10. Hartman and Associates, Inc. 250.00
11. Walmart 25.42
12. Office Max 52.97
13. James Holland 250.00
14. James Holland 160.00
15. Kathy Gates(Gas,letters,etc) 386.61
16. PA Department of Revnue 14.00
17. Chuck Bricker,Auctioneer 1,160.00
18. Fees from Sale of House 14,254.41
TOTAL(Also enter on Line 10, Recapitulation) $ 18,001.30
If more space is needed,insert additional sheets of the same size.
Advanced Septic Services,Inc. Invoice
65 Richard Lane
Landisburg,PA 17040
(717)789-4548
(800)250-3980
BIL�TO: 6446 JOB SITE
Dana Bushman Executrix: Kathy Gates B:
9 S. Locust Lane 9 S. Locust Lane
Mechanicsburg, PA 17050 Mechanicsburg, PA 17050
Invoice Number: 14923 Invoice Date:20-Jun-2013 Order Num: 14923 Serviced 20-Jun-2013
P.O. Number. Job Description:
Quantity ServiceType Amount Tax Warranty(Days)
1 Septic Tank Cleaning $205.00 No 0
1000 gal.
Subtotal NonTaxed: $205.00
Subtotal Taxed: $0.00 @ 0% $0.00 Pennsylvania
Tax: $0.00
Subtotal: $205.00 Payment Adjustment Late Charge
+/- PaymenUCharge: ($205.00) ($205.00) $0.00 $0.00
Please Pay: $0.00
Payment Terms: Upon Receipt
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ADVANCE� SEPTIC SERVICES, INC.
b5 Richurd Lane
Landisburg, PA 17040
(717� 789-454$
Lionel Spenard Estate,
9 South Locust Lane
Mechanicsburg, PA 17050
. June 24, 2013
Subject: Quote for Septic Work
The following is a quote for the work to be performed on the Septic system at the above stated
address as per the Septic Inspection. The cost would be $775.00 which includes the following:
1) Excavation & trip
2} Instaliation of Double Center Lid, Riser, Seal and Riser Lid on septic tank to grade
3) AH materials, and labor inciuded -- -
This amount is due at the time of service. The foliowing quote is valid for 30 days from the date of
tf�is letter.
Thank you for the opportunity to earn your business. If you have any questions please ca11 Ronda or
Mark at(717) 789-4548.
Sincerely, � �,�
� lv�
2oN�� 2.�c��cRa � �
Owv�e,� � �
� (autho ' d party) understand and agree to
payment terms as stated above.
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NEW KINGSTOWN, Pannsylvania
17072999$
4134870072 -0098
07/15/2013 (8003275-8777 12:41:41 PM
Sales Receipt
Product Sale Unit Final
Description Qty Price Price
Canada - Priority Mail $42.35
Int'1
6 lb. 10.90 oz.
Subject to content limitations,
- postage on this article includes up
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Customs Form #: CW580754377US
Issue PVI: $42 35
Total : $42.35
Paid by:
Persona1 Check $q2.35
Order stamps at usps.com/shop or cali
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Bill#: 1000203317051
Clerk: 07
All sales final on stamps and postage
Refunds for guaranteed services only
Thank you for your business
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CW580754377US firmly; you are making multiple copies. See Privacy Notice and Indemnity Coverage on Sender's Copy.
FROM:Sender's Last Name First MI Insured Amount(US$) SDR Value
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❑Documents ❑Commercial Sample Goods Lbs.&Ozs.) ❑Return to Sender N k'y\
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D&D Septic & Toilet Rentals I nVOICe
35 West North Street DATE INVOICE#
Carlisie, PA 17013 07/17/2013 g600
BILL TO
Kathy Gates
259 Sample Bridge Road
Mechanicsburg, PA 17050
P.O. NO. TERMS PROJECT
Due on receipt
QUANTITY DESCRIPTION RATE AMOUNT
JOB: Sale- 9 South Locust Lane, Mechanicsburg
1 Rental Fee 5.00 S.00T
1 Standard Unit for a public sale 75.00 75.00
State 6.00% 0.30
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Thank you for your business. Tota� $80.30
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Bill#: 1000203325500
Clerk; 03
All sales final on stamps and postage
Refunds for guaranteed servtces only
Thank you fior your business
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1-8Q0-DfAl-PPL % � • � - �. , � r
��� �A~ (1-800-34Z-5775) 85260-72004 Aug 20,2013 ; $55;47` . . ;
r�r���ui�uUUik6 M-f:8am t0 5pm
Your Electric Usage Profife Billing Surl7mary (Billing detaiis on back)
Senrice to: Balance as of Jul 30,2013 $36.96
LIONEL SPENARD Charges:
9 LOCUST LN Total PPL EnergyPlus, LLC PA Charges $7.49
MECNANICSBURG, PA 17050 Total PPL Electric Utilities Charges $11.02
Meter:10065702
Total Charges $55.47
This section helps you understand your year-to-year Amount-pue By Aug 20,`2013, ' ' _ ; $55 47
electric use by month. Meter readings are actual unless Account Balance $55.47
otherwise noted.
;;�2012 �2013 PPL Electric Utilities'price to compare for your rate is$0.08227 per kWh.
This changes the 15t of Mar,Jun,Sept,and Dec.Visit papowerswitch.com
90 or www.oca.state.pa.us for supplier offers.
Y 6o Your Message Center
m - • - • The$36.96 balance includes$0.53 in prior late
� 45 y ' payment charges.
�, '
� so � � ; � yk ; o With paperless billing,you can receive and pay your
a n � � � � E; ; PPL Electric Utilities bills online.The process is free, T
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Months saving energy are available through the Energy Library
on our Web site,pplelectrii.com.
° �' � � ' e We appreciate the opportunityto have served you. �
� �• + •� '• ' ' Because you have paid your bills within 30 days over �
Jui 2013 .17 96 6 78F the past year,you have established an excellent S l ��
payment record with PPL Electric Utilities. �, i�� _
Ju12012 29 661 23 77F � _
�� °
• •- .. •• •--� • Paym�nt Methods =
r Jui 26 Actual 31302 � Online at: �By phone:l-800-342-5775 =
Jul 9 " Actual . 31206 PP�electric.com or call BiIlMatrix(service fee applies) _
at 1-800-672-2413 to pay.using Visa, _
17 Days kWh Billed 96 MasterCard,Discover or debit card. _
� ` � � � . � � By Mail: Correspondence should be sent to: _
Au 2012-Jul 2013 11789 982 2 North 9th Street Customer Services _
g CPC-GENN1 827 Hausman Road _
Aug 2011-Jul 2012 10665 889 Allentown, PA 18101-1175 Allentown,PA 181049392 _
Other important information on the back of this bill�
rV� 1
�`��Y, k�
Hartman and Associates, Inc. ``�`� �� �
21 O1 Orchard Road I N V O I C E
Camp Hill, PA 17011
Invoice #: 1300753
717-737-3495 Fax: 717-737-2063 Invoice Date: Jul 22, 2013
www.hartmanandassoc.com Page: 1
Job#: 13057
ESTATE OF LIONEL SPENARD LEGAL- PARCEL 63-B WHITE BIRCH
C/O KATHY GATES FARMS
259 SAMPLE BRIDGE ROAD
MECHANICBURG, PA 17050
Customer PO Payment Terms
Net 30 Days
Description Fee
7/8/13: LEGAL, SIGN &SEAL LEGALS, TRANSMITTALS 250.00
��.
� � 5 � �3
��- . ��s
Total Invoice Amount 250.00
Payment/Credit Applied
AMOUNT DUE 250.00
PLEASE INCLUDE OUR INVOICE # ON YOUR REMITTANCE
Interest at 12%annual rate will be charged on accounts not paid within 30 days
i �
� � �
- ..: VALUE 1f�UR OPINION!
WE WAN7 1'0 KNOW ABUUT YUUR SHOPPING OfficeMax #39
EHPERIEN[;E TODRY AT WAL-MART. 6416 CARLISLE PIKE SUITE 2700
Please cnm�+lete a survey about MECHANICSBURG, PA 17050
foday's store visit at: (717) 766-5563
httP://w�i�.survey,welmart.com � ` �
0039 02 0223 0�/19/13 10, 3�2 29''�AM
You wi 11 n�eed ta enter the �"" " " " �" -° - - -
followlnsi �online:
ID #: 7F�IKFONFCYP SALE
IN RETURM FUR YOUR TIME YOU COULD
RECEIVE [��I� OF FIVE S10oo 883585829798 $�g,gg
WALMART :�410PPTN6 CARDS
HP Ink 564XL Cyan
Must be 1� or older and a lesa! Dedl 31775 Savl►lgS ($10,00)
resident �F the US, DC, or PR to YOU PAY
enter. No �urchase necessary to $9.99
enter or r�1n. To enter without
Purchase ,and for comPlete offlcial 883505829804 $19,99
rules vlrit
www.entr�.�urvey.walmart.com. HP �nk 56,4XL t��gertta ` '
SweepstaM:�e:s Pertod ends on the date Deal 31775 - �
shown in the official rules. 5urvey 883�85a29811 ^
must be 1•�a�Cen withln TWO weeks $19.99
of today. HP Illk 564 XL Yello<<�
Esta enaiesta tambl�n se encuentra Deal 31775
en espancil en..la_p8gina del lnternet
7'HANK You . TOTAL SAVINGS ($1.0.00)
SubTotal $49.97
,11l��►�a N nn�r t ���w Tax 6.000% $52,g7
' TOTAL
SavE�rnoney.Live better. � ` .,;
Electron�c Check`- �, $52,97
� �17 ) 6g1 - 315n Check number 0137
�NANAGER STEUEN MYERS Authorization 3852
65"e!0 CARLISLE PIKE STE 550
ST# 1886FI��#A00005866 TE#�725TR# 09194
HP 569XL .BLA 088611123429 23.98 X
T�Ax 1 65000�%AL Z1.44 96330-00001-23110-13620-24235-OOOU7
ECA CNECKTTEND 25.2
CHANGE DUE 0.00 I
When aou �.ay ba check, you authartze
us to use� tts lnforn�atton to Process I
an Electr•fl�ntc Funds Transfer (EFT) or
e draft dr:awn on your eccount, or tn
Process i•h�e Payment as a check. If - � - .. .,
Payment i.s returned unpald, aou
authortze: �collection of aour Paament
and the F;�eturn Fee below by EFT(s) or Tell us about your shopping experience
draft(s) drawn on your account. Call
sas-9os-�3$s w�th a�y yuestions and get $5 off your next $25 purchase.
RETURN FE� pH0UN7 30.0o Visit officemaxfeedback,com and enter
� :�.�TEM� SOLD 1 the follo«in9 Survey Code:
0039-02-0223-7
TG# 5�134 1251 3268 5349 3174
I(IIIIII IIIII IIII�)(I IIIIII)IIIII)III)IIIII(IIII III IIIII IIIIII IIIIII IIII IIIII)IIIII III III)
Ask a Phtir�ac� Sales Assoctate how ynu OfficeMax doesn't )ust .p.rovide great
�en sav�e money on aet medtcations! values, we also live th.e,m DfficeMax has
(1�119/13 to:�t:32 been named one of�2013s t�orl-d"s Most
Ethical Companies, For more information
_ __.._.....__. _.__.._.._____.--__ .-------._. ___ _...._. ___ visit OfficeMax.com/ethics.
f1R(1FR Rv punniG 1_077 nrrTnru.v
JAMES E. HOLLAND, CPA
� 7 West Main Street
Shiremanstown PA 17011
Phone: 717-763-6890
Fax: 717-763-6889
03/05/2014
Estate of Lionel Spenard
c/o Kathy Gates
259 Sample Bridge Road
Mechanicsburg PA
17050
Attention:
Client No: 18371
Invoice No: 351425
For miscellaneous tax services perFormed through February 28, 2014. $ 250.00
Hours
Tax Services
Assemble Tax Returns
02/24/14 0.50
Other Tax returns
02/10/14 0.75
02/22/14
Form 104•1 0.25
Out of Pocket Expense
Out of Pocket Expense Reimbursement
02/22/14
PRP-Form 1041/PA 41 54.06
$ 250.00
. . } �� -(
`� �� �►b ��►'�
� ��
C
Finance charges assessed @ 1% per month on all
open amounts. Please include your client number on
your check. Thank you.
JAMES E. HOLLAND, CPA
7 West Main Street
Shiremanstown PA 17011
Phone: 717-763-6890
Fax: 717-763-6889
03/06/2014
Spenard, Lionel J.
c/o Kathy Gates
259 Sample Bridge Road
Mechanicsburg PA
17050
Attention:
Client No: 18370
Invoice No: 361412
For preparation of the 2013 Individual Income Tax Returns. $ 160.00
Hours
Tax Services - �
Individual Income Tax Returns
02/10/14 0.75
Assemble Tax Returns
02/12/14 0.33
Scan Support Documents
02/10/14 0.13
$ 160.00
l '�
. P� � � 5
�>> ��
���
Finance charges assessed @ 1% per month on all
open amounts. Please include your client number on
your check. Thank you.
_ _
. ' "�iifl��`� A• Settlement Statement (HUD-1) OMBApprovalNo.2502-0265
,..K...
.- . ..
, 1.Q FHA 2.Q RHS 3. XQ Conv.Unins. 6.File Number: 7.Loan Number: 8.MoRgage Insurance Case Number.
13270 2099903151
4.Q VA 5.❑Conv.Ins.
C.Note:This fartn is fumished to give you a statement of aclual settlement costs.Amounts paid to and by the setllement agents are shown Items marked
"(p.o.c)"were paid outside the closing;they are shown here for tnformatlonal purposes and are nat included in the totals. .
D.Name&Address of Borrawer. E.Name 8 Address of Seller: F.Name&Address of Lender:
Dana A.Bushman,Debra J.Bushman Estate of Lionel J.Spenard Steams Lending,Ina
467 Shuler Road,Shertnans Dale,PA 17090 4 Hutton Centre Drive,l0th Floor,Santa Ana,
CA 92707-8710 �
G.Property Locatian: H.Settlement Agent I.Settlement Date:07/22/2013
9 South Locust Lane 1stAdvantage Se�lement Services Inc. Disbursement Date:07@22013
Mechantcsburg,PA 17050 6375 Mercury Drive,Suite 102,Mechanicsburg,PA 17050
Silver Spring Township
Telephone:717591-7755 Fax:717-591-7756
Place of Settlement TitleExpress
6375 Mercury Drive,Suile 102,Mechanicsburg,PA 17050 Printed 07/22/2013 at 1 t55 am
by TF
:. . , �
. . .
100. Gross Amount Due trom Bortower 400. Gross Amount Due to Seiler
101. ConUact sales price 174,900.00 401. ConVad sales price 174,900.00
102. Personal ro ert 402. Personal ro
103. Se�lemenl charges to borrower(line 1400) 7,748.63 403.
104. 404.
105. 405.
Ad ustments for items paid h seller in advance Ad ustments for items aid h seller in advanee
106. City/lown taxes to 406. Cityftown laxes to
107. County ta�ces 07/2212013 tb 1?J31/2013 210.93 407. County taxes 07/22/2013 to 12131/2013 210.93
108. Schod Taxes 07/22/2013 to 06/30/2014 1,193.00 408. Schod Taxes 07@2/2013 to 06/30/2014 1,1g3,00
109. 4�.
110. 410.
111. 411.
112. 412.
�2�• Gross Amount Due from Borrower 184,052.56 420. Gross Amount Due to Seiler 176,303.93
200. Amounts Paid b or in Behali of Borrower 500. Reductions In Amount Due to Seller
201. Deposit or eamest money 1,000.00 501. Excess deposit(see insWctioas)
202. Principal amount of new loan(s) 131,175.00 502. SetUemenl charges to seller(line 1400) 54,254.41
203. Existin lo s taken su'ecl to 503. F�ds6n lo s taken sub'ect to
204• 504. Pa off of(Irst mort a e loan
Z�• 505. Payoff of second mortgage loan
206. �.
207. 507.
208. 508.
209. 5�.
Ad ustments for ltems unpaid b seller Ad'ustments for items un aid b seiler
2to. c�rynown��ces �0 510. Clly/tovm taxes �o
211. County taxes to 511. County taxes to
212. School Taxes to 512. School Taxes to
213. 513.
214. 514.
� 215. 515.
216. 516.
217. 517.
Z�8• 518.
219. 519.
Z2�• Total Paid bylfor Borrower 132,175.00 520. Total Reduction Amount Due Seller 14,254.41
300. Cash at Settlement fromlto Borrower 600. Cash at Settlement tolfrom Seller
301. Gross amount due from bortower(Iine 120) 184,052.56 gp�, Gross amount due lo seller(Iine 420) 176,303.93
302. Less amounts paid bylFor bortower(line 220) 132,175.00 602. Less reductions in amount due seller(line 520) 14,254.41
303. Cash QX From ❑ To Borrawer 51,877.56 603. Cash QX To ❑ From Seller 162,049.52
= ua+n�m am.a.n6aq,yf.wmntlr�+rool�ieranWnvmlar.NemnMentl�Ryls�eeq�Ws�myrc�amW�• rt aaaenqmaY �m+ a
����n= kay.7NahMflpmAbqovW�qaptNUW�RESPAeawieC4�nutlbnwMNfmMbn pie �
Previous editions are obsolete Page 1 of 4 HUD-1
• 700. Total Real Eslafe Broker Fees $10,689.00 Paid F�om Paid F�om
Division of commission Iine 700 as follows: BOI'I'OWet''S Sellef'S
���• 55�24�•00 to RelMaxlstAdv�tage Funds at Funds at
702• 55,442.00 to Jadc Gaughen ERA Settlement Settlement
' 703. Commission paid at settlement 10,689.00
704. Commission �o RelMax 1st Advantage �95�
800. Items Pa abie fn Connedion with Loan
• 807. Our originazion cha�ge (Includes Origioation Point 0.00096 or 50.00) 54,404.38 (from GFE#1) .
802. Your credit or charge(pMnts)for the spedflc interest rate chosen $-2,645.80 (from GFE#2)
803. Your adjusted aigination charges (from GFE A) 1,758.58
804. Appraisal fee to T�i Mavin ibo HMR (trom GFE#3) 425.00
805. Cr�t report to Credit Plus i6o HMR ((rom GFE�3) Sp,pp
806. Tax service to from GFE#3
807. Flood certifiption to Gom GFE�3
�• to
900. items Re uired b Lender to be Paid in Advance
901. Daily interest charges from from 07/22I2013 to 08/01/2013 @$11.8400/day (from GFE#10) 118.40
902. Mo�tgage Ins.Premium fw months to (from GFE#3)
903. Homeowners insurance fa 1 ears to Erie Insurance Exchan e (from GFE#t t) 600.Op
�4• months to from GFE#1 t
1000.Reserves De osited with Lender
1001.Initial deposit for your escrmv account (from GFE�9) 389.65
1002.Hameovmers insurance 1 months S 50,pphnopth $50.00
1003.Mortgage Insurance months 5 0.00/monih E
1004.City Property Tax months $ O.00/month S
1005.County Propedy Tax 4 months $ 39.36/month 3157.44
1006.School Taxes 2 monlhs a 105.49/rtwnth $210.98
1007.Aggregate Adjustrnent $_28.��
1100.TIUe Char es
1701,TIUe services and lenders tiUe insurance from GFE k4 1,417.00
1102 SelUement or closing fee �o �
1103.Owners Gtle insurance from GFE#5 215.00
1104.Lenders Gtle insurance $��ZgS 00
1105.Lenders title policy limit$131,175.00 Lenders Palicy
7106.Owners fitle policy Gmil$174,900.00 Owners Policy
1107.Agenl's portion of the totai liUe insurance premium $�,2��,p5
1108.Undenvriter's porUon of the tolal tifle insurance premium $2gg,75
1109.
1110.Tax CertfficaGon Fee l01 st Advanta e Settlement S �p.pp
1111.Notary Fee to Tina Fullerton 15.00
1112.Wire Fee-Proceeds to 1st Advanla e Settlement S p��
1200.Government Recordin and Transfer Ch es
1201.Govemment recording charges $ (trom GFE#� 156.00
�2�2•Deed^�67.00 Mort a e$89.00 Release 5
1203.Trans(er taxes S ' (from GFE#8) 1,749.00
1204.CirylCounty ta�t/stamps Deed$1,749.00 Mort $
1205.State Taxlstamps Deed$1,749.00 MoA'a e$ 1,749.00
12�' Deed S Mort a e$
1207. $
1300.Additfonal Seltlement Char es
1301.Required services fhat you can shop for (from GFE�6)
1302 Survey �o $
1303. to
1304. to
1305. to
1306.2013/14 School Taxes to Debra Wiest ��41
1307.Septic Tank Diggin to RLB Services ��Q
1308.Septic Pertnit to Rich Musselman 5�
1309.Hydro TesUng to Eco-Tech 275.00 200,00
1310.Septic Pumping to Advanced Se tic Services,Inc. $205.00 P.O.C.S
1311.Septic lid and riser to Advanced Se Uc $775.00 P.O.C.S'
1312.Deed Prep Fee to Law Offices of Peter J.Russo,PC 150.
��� � � � " 'C° ' � • ' � 7,748.63 14,254.41
'Paid outside of dosing by(8)orrower,(S)eller,(L)ender,(I)nveslor,Bro(Iner.~Cred(t by lender shown on page 1."'Credit by seller shown on page 1.
Previous ed(tions are obsolete Page 2 of 4 HUD-1
, Com arison of Good faith EsUmate GF and HUU•1 Char es Good Faith Esllmate HU0.1
• Char es That Cannot Increase HUD�1 Line Number
Ouroriginailoncharge q 801 4,404.38 4,404.38
Your credit or charge(points)for Ihe specfic interest rale chosen # 802 -2,645.80 -2,645.80
Your adjusted origination charges g 803 1,758.58 1,758.58
� Transfertaxes # 1203 1,749.00 1,749.00
Cha es That in Total Cannot Increase More Than 1090 Good Faith EsUmate HUD�1
Govemment recording charges # 1201 120.00 156.00
Appraisal tee # 804 450,0p 425.00 '
Credit report #805 50.00 50.00
Tille services and lender's title insurance g 1101 1,660.00 1,417.00
Owners tiNe insuwnce # ��ag �0p 00 2�5 00
#
#
�
2,380.00 2,263.00
• ' �' ' � $ -117.00 a �#.9160%
Cha es That Can Chan e Good Faith Estimate HUD-7
IniGal deposit for your escrow aarount � tppl 1,9n.00 38g.�
Daily tnterest charges from #901 $11.84001d 355.20 118.40
Hameowners insurance #y� �� ��
#
N
#
Loan Terms
Your initiai loan amount is $131,175.00
Your loan term is 15.years
Your iniUal interest rate is 3,�ppo� �
Your initial monihty amount owed for principai,interest,and any moAgage 5921.73 inciudes
insurance is ❑X Prindpal
❑X Interest
❑MoAgage Insurance
Can your inlerest rate rise? QX No. ❑Yes,it can rise to a maximum of %.The flrst change
will be on I ! and can change again every years after / / .Every
change date,your inlerest rate pn increase or deaease by �o.Over ihe life of
the loan,your fnferest rate is guaranteed to never be tower fhan °k or higher
than °�.
Even'rf you make paymenLs on tlme,can your loan balance rise? ❑X No. ❑Yes,It pn rise to a maximum of$ ,
Even il you make paymenls on time,can your monthly amount owed for QX No. ❑Yes,Ihe first increase can be on / / and the monihly
prindpal,interest,and mortgage insurance rise� amount owed can rise lo$ .
The maximum it can ever dse to is$ .
Does your loan have a prepaymenl penalty7 QX No. ❑Yes,your maximum prepayment penalty is$ .
Does your loan have a ballaon payment? [�X No. ❑Yes,you have a balioon paymenl of$ due in
years on / / .
Total monlhly amounl owed including escrouv account payments ❑You do nat have a monihiy esaoxr payment for items,such as properly taxes
and homeowners insurance.You musl pay these Items directly yourseH.
QX You have an ad�tional monthly escrow payment of S
that resulls in a total inilial monthly amount owed of$ .This indudes prinapal,interest,
any mortgage insurance and any items checked below:
QX Propecty tazes QX Homeowners insurance
❑Flood insurance QX School Taxes
❑ ❑
Note: If you have any questions abaut the Se�lement Charges and Loan Terms lisled on ihis form,please contact your lender.
Previous editions are obsolete Page 3 of 4 HUD-1
�
_ ' HUD CERTIFICATION OF BUYER i4ND SELLER
1 have carefully reviewed the HUD-1 Settiement Statement and to the best of my knowledge and belief,it fs a true and accurate statement of all receipts and
disbursements made on my account or by me in this iransaction i further certify that I have received a copy of the HUQ1 Settlement StatemenL
,
Da .Bushman ' '°i ,_ �f� �"�� —�'t.
Debra J.Bushman �
ESTATE OF LIONEL J.SPENARD
� ,} �
Kalhryn B.Gates,Executrix
The HUD-1 Settlement Statement which i have prepared is a true and acarate account of this transacBort I have caused ar will cause the funds to be
disbursed in aceordance with this statement
`- �'�-/z z�(3
SE7'TLEMENT AGENT' DATE
4
WARNING IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE UNITED STATES ON THIS OR ANY SIMILAR FORM PENAITIES 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
' , • ' 1 1 • 1•
Name of Borrower: Name of Seller: File Number
� Dana A.Bushman Estate of Lionel J.Spenard 13270
Debra J.Bushman
TRIeExpress
Prepared 07/19/2013 at 11:17 am
Note: This page is furnished to give you an itemization of the amounts shown on Paid:Ft`011l, Pald FfOm
Lines 110�, 1103 and 1104 of the Settlement Statement(HUD-�),This page BOffOwet'S Selle�'s
accompanies but is not a part of the settlement statement.if a discrepancy FGnd§at �Funds:at
exists,the information shown on the SetUement Statement(HUD-1)applies. Setflement Settfement
1100. Title Charges Amount8 Included ,
inllne 1701
1101. Title services and lender's tilie insurance 1,417.00
a.Wlre In Fee 5 �Z�
b.EmaillDoc Copy fee ��
c.Ovem(ght Delivery Fee•Package 25 00
d.Notary Fee 45.00
$ 132.00
1102. Setllement ar closing fee
1103. Ovmers 6tle insurance po(icy $ 215.00 215.00
1104. Lenders title insurance (porcy) 1,060.00 $ 1,285.00
a.Endasement 900 EPL-Residential 5p,pp
b.Endorsement 100 No VolaUon) gp,pp
c. Endorsement 300 Survey gp,pp
d.Closing Service Letter 75,pp
(Total 1103+1104) �
1105. Lenders tille palicy limit 5131,175.00 5012742-42651
1106. Owners tille policy Iimit;774,900.00 5011442-46666
1107. AgenPs portion of fhe total UUe insurance premium 3 1,21125
1106. Underwritefs po�lon of the total title insurance prem. 288:75
(Tota11107+1108) g_.]5Il0:4R
1109.
1110.
1111.
1112.
.. . . . �
� Total.: �BortoweP Bo�rowec- ;Setlec
1100. TiUe Cha s with Pa ee Cha'"e POCor Credit. , Lide 11b1"' Paid
1101. Title services and lenders title insurance g
a.Wire In Fee to 1st Advantage Setllement Services Inc. 12.00 12.00
b.EmaillDoc Copy Fee to 1st Advanlage SetUement Services Inc. 5p,pp �QO
a Ovemight Delivery Fee-Package to tst Advantage Settlement Services Inc. 25.00 �5.00
d.Notary Fee to Tina Fullerton 45.00 45.00
1104. Lenders litle insurance to 1st Advantage Settlement Services inc. ��pgs,pp ��Z85 DO
$ 1,417.00 ' 1,417.00
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