HomeMy WebLinkAbout11-17-14 (2) � �
� 1505610105
REV-1500 Ex�°z_ll,��,���
PA Department of Revenue pennsylvania OFFICIAL USE ONLY
°E��^*�E ^�^�•�F Coun Code Year File Number
Bureau of Individual Taxes ,_.._.._..._ry....__.: ,....._._....._.._.__ _.
INHERITANCE TAX RETURN ; __......---......._._........................,
PO BOX z8o6o1 �� � � ' O/ � O
Harrisburg,PA 1�128-o6oi RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
_ ......._....__...............:
:.._...__-----....__._._......................_
_...._._..__.......................
02/06/2014 01/19/1932
-------�___-----................_..._..----._.._._..---..........._........_.� _......------.._.._..._.._.__.......__._..._.__.._............_..__; _.._..............._...__....._.._..._.....---------.........._._..__._.;
DecedenYs Last Name Suffix DecedenYs First Name MI
, __.............._...._......: ____...................__......._. ....----_.._...._._...._..._...._.._............__............._...__..__._.
__....----._._.........---._._................ _.
,
Galbraith James ` � ;
-------.........-----..._._..........-----................... .._._........_.....__.._........._.. _._..._......................__...._....-----._.._.........._..._.._.._._.._....._....._....._..._._.__..._._..._..: :._...__.
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Su�x Spouse's First Name MI
----__...._......--------------..............._..,.._.._..__..._.
_....-----.._.._.._..........................._. _....._........_............_......_.._. _.................._...._...._......------......_...._..__...._................_...._......._..........__.._.._..____............_......;
Spouse's Social Security Number
'"`"�"����"-' ��-�- -" � �����" � -! THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
_._.; REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
� 1.Original Retum p 2.Supplemental Return p 3. Remainder Retum(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) �.��
� 6. Decedent Died Testate O 7.Decedent Maintained a Living Trust 1 8. Totai Nur�Qb r of Safe Depe`'stL'Boxes
(Attach Copy of Will) (Attach Copy of Trust.) -+- Q -� � rn
O 9.Litigation Proceeds Received O 10.Spousal Poverty Credit(Date of Death O 11. Election�o'�i'a�i�yi- nder Se�.3�13(A�� C?
Between 12-31-91 and 1-1-95) (Attach�F.,�es#pie�9j � 4— b
, _�
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOU�0.B�p1REC7EB�T0: ? �•:"�r
. f .
Name Daytime Telephone GUumber v �
_.._.__. 4 ......_......._.__. __... ... -----._ _.._... ._ __..__.... . ... T�717�..243 Q123; _� :.. 'r
Ronald E. Johnson, Es �
_._.
,i
REGISTER OF WILLS vONLX;.� ��
� _ rl
- � ��
First Line ofAddress �
---.............._...._...__.........---....._.:
78 West Pomfret Street
_...._.__..._---__.............................................._......_......._._......__......._____..._............__...._.._..........______---....___....._--......_�---..._...__......_..................___.........._.__...___...._.._.:
Second Line of Address
---__.____.__._.,_._�__._,..__�_._.._._.._.____.._._...--.-----_ _�_._._.__..___..�..._..�...____._-.�_--___.._______._.� DATE FILED
City or Post Office State ZIP Code
._.._.__-___ ,..________, _..............._......................._...._._........___.......---------._...___ _
Carlisle ; PA : 17013
CorrespondenYs e-maii address:rejohnson@pa.net
Under penalties of pery'ury,I declare that I have examined this retum,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.
SIGNATURE OF PERSON RESPONSIBLE F I T N DATE
r- i � �
ADDRESS
c/o 371 ton Avenue F rt rth,TX 76133
SI OTH E TATIVE DATE
�
D E S
c/o 8 West Pomfret reet, Carlisle, PA 17013
PLEASE USE ORIGINAL FORM ONLY
Side 1
� 150561�105 150561�105 �
h�
} t
� 1505610205
REV-1500 EX(FI)
DecedenYs Social Security Number
DecedenYs Name: James C. Galbraith
RECAPITULATION
1. Real Estate(Schedule A). ............................................ 1. ; 175,000.00 ;
2. Stocks and Bonds(Schedule B) ....................................... 2. ; 0.00 ;
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) ..... 3. i 0.00
9 9 ( )........................... 4. 0.00 '
4. Mort a es and Notes Receivable Schedule D
5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E)....... 5. : 71,039.76 ;
6. Jointly Owned Property(Schedule F) O Separate Billing Requested ....... 6. ; 0.00 ';
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property "--"""'--.'--`-___�___.�...�_.�....�_._._..._._����_.._._�._�.�._.�.;
(Schedule G) O Separate Billing Requested........ 7. ; 122,534.19 :
8. Total Gross Assets(total Lines 1 through 7)............................. 8. ; 368,573.95 '
9. Funeral Expenses and Administrative Costs(Schedule H)................... 9. 59,302.12 ;
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............... 10. ; 50,166.26
11. Total Deductions(total Lines 9 and 10)................................. 11. ; 109,468.38 ;
12. Net Value of Estate(Line 8 minus Line 11) �2. 259,105.57 ;
..............................
13. Charitable and Govemmental 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. : 259,105.57 `
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
_..__......_...................__...............__............_............_.........._.............................._............. ....................._.._...._........_....................._...._............_....__.........._....__.._....,
trans ers un er ec.9116 ; ;
(a)(1.2)X A_ 15.;
16. Amount of Line 14 taxable "�."_".""'.`."`"'�_�.�.�.�.�.�'�.w'"W.�.."_."�. ""� """`_".�" �"".".""`.._"..`....�'"
at lineal rate X.0 45 122,534.19 + 16.; 5,514.04 ;
17. Amount of Line 14 taxable �.�"�_� .._�....M._.�._.__...�._....,._.,.._.._. _.__.._...,_,._.__..�.�...V.____._____._.�....._._.._,....__
at sibling rate X.12 136,571.38 ' �7.; 16,388.57 :
18. Amount of Line 14 taxable ������� �� ���N��"�
at coilateral rate X.15 ' 18.:
19. Tax DUE......................................................... 19.: 21,902.61 ;
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O
Side 2
� 1505610205 15056102�5 �
� t
REV-1500 EX(FI) Page 3 File Number
Decedent's Complete Address:
DECEDENTS NAME
James C. Galbraith
STREETADDRESS
321 Glendale Street
CITY STATE ZIP
Carlisle PA 17013
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 21,902.61
2. CreditslPayments
A.Prior Payments 0.00
B.Discount 0.00
Total Credits(A+g) (2) 0.00
3. Interest
(3) 0.00
4. If Line 2 is greater than Line 1+Line 3,enter the difference. This is the OVERPAYMENT.
Fili 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) 21,902.61
Make check payabie to: REGISTER OF WILLS,AGENT.
°'� r , � : �z- � a � -�- �- �
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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 shail 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 properry 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.
„ x �� :: -' _ � , r -� r :
. :
�..,._.u.,a.....a.....�.......�.... .A_...«�. .�__.... ._.._._�Jr.�..:.,..�.,.c ....«�»�,,.,>..... ��.,.�.m .. .,fr.� �.. ,.�......� .�.,..., ., ,,.._„a,.e, ..........» _,�. ..AA,., ._,......�w .�.-...�.�........,s.,,�.,...„.�..:....,.a5
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 applica6le 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 chiid 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-1502 EX+(12-12)
i pennsylvania SCHEDULE A
DEPAqTMENT OFREVENUE
INHERITANCE TAX RETURN REAL E STATE
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
James C. Galbraith 21-14-0130
All real property owned solely or as a tenant in common must be reported at fair market value.Fair market value is defined as the price at which property
would be exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts.
Real property that is jointly-owned with right of survivorship must 6e disclosed on Schedule F.
Attach a copy of the settlement sheet if the property has been sold.
ITEM Include a copy of the deed shawing decedent's interest if owned as tenant in common. VALUE AT DATE
NUMBER Of DEATH
DESCRIPTION
1• ALL THAT CERTAIN pracel of land situate in the Borough of Carlisle,Cumberland County,
Pennsylvania;being Lot No. 10 on Plan of Rocky Ridges recorded in Plan Book 5,Page 25. '
Having thereon erected a two story dwelling house known and numbered as 321 Glendale
Street,Carlisle,PA 17013
' See Deed Book 113,Page 544 ;
See Settlement sheet attached 175,000.00 '
__ __
TOTAL(Also enter on Line 1, Recapitulation.) $ 175,000.00 :
If more space is needed,use additional sheets of paper ot the same size.
, ' OMB Approval No.2502-0265
`iiliiliir= A. Settlement Statement (HUD-1)
, � FINAL
1. X❑FHA 2.❑RHS 3.❑Conv.Unins. 6.File Number: 7.Loan Number: 8.Mortgage Insurance Case Number:
2014-190 0030135867 446-2197563703
4.Q VA 5.❑Conv.Ins.
C.Note:This form is furnished to give you a statement of actuai settlement costs.Amounts paid to and by the settlement agents are shown Items marked
"(p.o.c)"were paid outside the closing;they are shown here for infortnational purposes and are not included in the totals
D.Name&Address of Borrower. E.Name&Address of Seller: F.Name&Address of Lender.
W.Anthony D.Cario,Brooke E.Riley The Estate of James C.Gal6raith M&T Bank
One Fountain Plaza,Buffalo,NY 14203
G.Property Location: H.Settlement Agen� i.Settlement Date:10/2v2014
321 Glendale Street PA Real Estates SetUement Services,LLC Disbursement Date:10/2v2014
Carlisle,PA 17013 354 Alexander Spring Road,Carlisle,PA 17015
Carlisle Borough
Telephone:717-249-6333 Fax:717-249-7334
Place of Settlement: TitieExpress
354 Alexander Spring Road,Carlisle,PA 17015 Printed 10/2'V2014 at 4:26 pm
by KSC
100: Gross Amount Due from:Borrower: . ` - 400: Gross Amounf Due to:Seller ` '`
101. ConVact sales price 175,000.00 401. Contract sales price 175,000.00
102. Personal ro e 402. Personal ro e
103. Settlement charges to borrower(line 1400) 10,071.94 403.
104. 404.
105. 405.
Ad'ustments for items aid b seller in advance Ad'ustments For items aid b seller in advance
106. Cityltown taxes to 406. City/town tanes to
107. County taxes 10/21/2014to 12/31/2014 261.53 407. Countytaxes 10/21/2014to 12/31/2014 261.53
108. Assessments 10/2112014 to 06/30/2015 2,025.41 408. Assessments 10/2112014 to 06I30/2015 2,025.41
109. 409.
110. 410.
111. 411.
112. 412.
1Z�• Gross Amount Due from Borrower 187,358.88 42�. Gross Amount Due to Seller 177,286.94
200. Amounts Paid 6 'or in Behalf oE 8orrowec - 500. ReductionsJn Amount Due to Seller- -
201. Deposit or eamest money 1,000.00 501. Excess deposit(see insWctions)
202. Principal amount of new loan(s) 167,887.00 502. Settlement charges to seller(line 1400) 17,832.77
203. Existin loan s taken sub'ect to 503. Existin loan s taken sub'ect to
204. 504. Payoff of first mortgage loan to PNC Bank,N.A. 4,816.88
205. 505. Payoff of second mortgage loan to PNC Bank,N.A. 4,364.55
206. 506. Retained for settlement services 1,000.00
207. 507. payoff of third mortgage loan to USAA Federal 22,645.87
Savin s Bank
208. SellerAssistance 9,712.38 508. SellerAssistance 9,712•38
209. 509. Inheritance Tax Escrow 31,500.00
Ad'ustments for items un aid b seller Ad'ustments for items un aid b seller
210. Cityltown taxes to 510. Cityltown taxes to
211. Countytaxes to 511. County taxes to
212. Assessments to 512. Assessments to
213. 513. payoff of fourth mortgage loan to USAA Federal 25,000.00
Savin s Bank
214. 514.
215. 515.
216. 516.
217. 517.
218. 518.
219. 519.
22�• Total Paid b Ifor Borrower 178,599.38 520. Total Reduction Amount Due Seller 116,872.45
300: -Cash af3Settlement fromlto Borrower 600. Ca'sh at Settlement tolfrom Seller.
301. Gross amount due from borrower(line 120) 187,358.88 gp�, Gross amount due to seller(line 420) 177,286.94
302. Less amounts paid bylfor bortower(line 220) 178,599.38 602, Less reduc6ons in amount due seller(line 520) 116,872.45
303. Cash XQ From ❑ To Borrower 8,759.50 603. Cash X❑ To ❑ From Seller 60,414.49
�Po �v � � ��� o0 0��o�,o��:.�m . m���e:v�r resoonse co��no,m�m..�ou,m reno��o a a u.oancy m.y o�o a ���o�na�on,.n y u ar.no�.y��re o�mo<<
tlils(artn,unless II Olsybys a wrtenity veliE OMB rnnlrvl numEars No wnll0anllaliry b aaureC;lllls OLSUosun Is mm0atory.Tliu is GaipneE lo p viEe Ne prtlles lo�RESPA wvert0lrametllon wil�Inlomiallon tluAnq Ne
setllemanl pmuu
Previous editions are obsolete Page 1 of 4 HUD-1
' ' - - . .-
Z00. Total Real Estate BrakecFees $10,500.00 - Paid:From Paid From
Divisionofcommission Iine700 asfollows:' BotroweC'S Selle�'S
���• $5,250.00 to Real Estate Excel Funds at Funds at
��2• $5,250.00 to Howard Hanna Settlement Settlement
703. Commission paid at settlement 9,500.00
704, Eamest Money Deposit to Howard Hanna $1,000.00 P.O.C.B'
705. Broker Fee to Real Estate Excel
300.00
706. Add'I Commission �o Howard Hanna 225.00
800:`Items Pa able in Connection withioan -
801. Our origination charge (Includes Origination Point 0.000%or$0.00) $985.00 (from GFE#1)
802. Your credit or charge(points)for the specific interest rate chosen $-176.28 (from GFE#2)
803. Your adjusted origination charges (from GFE A) 808.72
804. Appraisal fee to Solidifi $425.00 P.O.C.B•(from GFE#3)
805. Credit report to CBC $14.00 P.O.C.B`(from GFE#3)
806. Tax service to Corelo ic $75.00 P.O.C.L'(from GFE#3)
807. Inspection Pre Closing to Solidifi (from GFE#3) 155.00
808. Flood Certification to M&T Bank (from GFE#3) 8.00
900. ItemsRe uireiib LendertobePaid'inAdvance - -
901. Daily inlerest charges from from 10/21I2014 to 11/01/2014 @$17.2500/day (from GFE#10) 189.75
902. Mortgage insurance premium for months to M&T Bank (from GFE#3) 2,887.50
903. Homeowner's insurance for 1 ears to Erie Insurance Exchan e (from GFE#11) 564.00
904. for months to
1000. Reserves De osited with'Cender �
1001. Initial deposit for your escrow account (from GFE#9) 1,440,97
1002.Homeowner's insurance 3 months $ 47.00/month $141.00
1003.Mortgage insurance months $ 17725/month $
1004. Pro ert taxes months $ Imonth
1005.County taxes 10 months $ 110.48/month $1,104.80
1006.Assessments 6 months $ 243.50/month $1,461.00
1007.Aggregate Adjustment $-1,265.83
1100.Title Char es
1101.Title services and lenders tiUe insurance from GFE#4 1,631.50
1102. Settlement or closing fee to $
1103. Owner's title insurance from GFE#5 162.50
1104. Lender's title insurance $1,515.00
1105. Lenders Gtle policy limit$167,887.00 Lenders Policy
1106. Owners tiUe policy limit$175,000.00 Owner's Policy
1107.AgenYs porfion of the total title insurance premium $1,342.12
1108. Underwriters portion of the total title insurance premium $335.38
1109. Ovemight Mail to Salzmann Hu hes,P.C. 82.00
1110.Attomey Fees to Andrews&Johnson 275.00
1111.Ovemight Mail to Andrews&Johnson 15.50
1112. Notary to Kamela Comman 15.00
1200.Government Recordin and Sransfer Char es - - -
1201.Govemment recording charges $ (from GFE#7) 174.00
�2��• Deed$79.00 Mort a e$95.00 Release$
1203.Transfer taxes $ (from GFE#8) 1,750.00
1204. CitylCounty tax/stamps Deed$1,750.00 Mort a e$
1205,State Tax/stamps Deed$1,750.00 Mort a e$ 1,750.00
1206. Deed$ Mort a e$
1207. Satisfaction of Mortgages 270.00
1300.'Additional Settlement Char es
1301.Required services that you can shop for (from GFE#6)
1302.2014 County Taxes to Chades Holt ,Tax Collector 1,458.39
1303.2014 School Taxes to Charles Holt ,Tax Collector 2,922.03
1304.Final Wtr/Swr Bill to Carlisle Borou h 64.85
1305. Painfing Bill to Patrick's Paintin and Decoratin 520.00
1306. ElecVical Bill to D K ElecUic 300.00
1307. Home Warranty to HSA 435.00
'�� � � � 10,071.94 17,632.77
"Paid outside of closing by(B)orrower,(S)eller,(L)ender,(I)nvestor,Bro(I�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
Com arison or..Good'Fsith Esti'mete GF 'and HUD-1::Char es . __� 7 __' -:S: Gootl'Faith.Estimate -. �'< -, =:'.HUD 7 `"'`
'.Char es:ThatCannoflncrease+�' " , _:HUD-1:LineNum6er -
;Ouronginationchargei' k --.�-� , ,*�,�� # 801:.=: t_� t �, 985.00 985.00
=Yourcreditorcharge;(points)forthespecifc�inferest�ate:cfiosen ;: # 802:{, ,'i -176.28 -176.28
.Youradjysted origination charges.' • ��„� � ,, �;;�# 803:��, , 80872 808.72
'Transfer=fazes n � _ .=.��1203:-- - 3,500.00 1,750.00
�Char"es`that iriSotal:`CannoElncrease More�Than 10%:-� ._ .:` _ � '"' "' :.� 'Gootl'Faith.Estimate. ` �'HUD 1 � "'
:Govemmentrecording;charges. .;; } - 5 „��,.:> �. .�#1201�y�r �..�, 242.00 174.00
,;Appraisalfee - - : �_t� �, _r __� #804�>- - 425.00 425.00
=Credi�repoi� � ,, _ -�. .�= } ,.;,#805 ,;- �.;: 14.00 14.00
'Tax service'� -'* �; �,806-„� ��� - 75.00 75.00
_Inspection:preClosing���. �, � - � =r #807 ;;,: ,� ! 155.00 155.00
Flood Ce[tification E ,�.�? F�.�_� _ ; #808 � 8.00 8.00
_,Mo�tgage;insurance;piemwm - ,:;�. �902 - � „r . _4 2,887.50 2,887.50
µ�M1�. � ,i ..,. N � . �._c r ::�.#...�' a- 4
..: . ._ .. ..�... .. _.....�,._. ......_ . ., . ....,__... ..,,.�. .
3,806.50 3,738.50
� $ -68.00 or -1.7864%
Cha� e's;.TfiatCamCfian e w�i F- : .,,.` F !�, : ��... , ;_ ' �':r:� -, r:::,»a'� . • �:'Good'Feith:Estimate ?,+• a;�:HUD•1��� , a;��
;`Initial,depositforyour'escrowaccount �-_;r' , ,,,,�� ;- �1001 =. �_f� y=,: 4,530.25 1,440.97
-:Dailyintecestcharges;from�-� , ,; _ A �.#901 _` ��$]7,r4500/da 258.75 18975
_Homeowners insurance' , ,k=+4 �- - r F= #903 ; � 660.00 564.00
LLSlt�eservices�and�Jende�stitleinsuiance ,_�� ,�,�;, i* �^ �� #1101 F= � s�fr� _ 1,570.00 1,631.50
�,Ownerstitle insurance.y.� � � r_;= �.�c�;; . r ;�# 1.103�'-; _a•�; �,. 35.00 162.50
_ „� '-4':rp ' h '� ...tir =1f _ � b'S t.'
_ �_L - tf _ `,.-y ,L'^;k -
1t
Loan Terms
Yourinihalloanamountis,,, , r.�; �� > ,.� � .':, $167,887.00
� 4 ,
1'our loan term is � _ � ;�,,p r`3 � ;';�, 'i,� 30.years
Your mihal.interest�ate is." � ':�' �i � _� �: 37500%a
Your mitial monthly amountowed for.pnnapal;ioterest znd apy modgage $95475 includes
insurance is:< � E; �` 'i �
f ,� �. QX Principal
� ` � � ; r
� �` - `' XQ Interest
} � �;
=_ � E ik ,.� � a .
'T�- � } ,ks � X❑Morlgage Insurance
,Can your mfe�est rate nsel - �` ,_;" � � ' ❑X No. ❑Yes,it can nse to a maximum of %. The first change
- � ` = , ' _ will be on I I and can change again every years after I l . Every
41 � .-: change date,your interest rate can increase or decrease by %. Over the life of
x °' `' ' '4 :` f 'i the loan,your interest rate is guaranteed to never be lower than %or higher
_ ,�
, T ,� - , y + � , ` than %.
Even if you;make payments on time'can your loan balance�rise7 ;' X❑No. ❑Yes,it can nse to a maximum of$ .
} iy � .. 'N',� ..; rtr--;'�:,, t�.
Even�f you make payments on hme can yourmoriihfy amounf owedfor =:. QX No. ❑Yes,the first increase can be on I I and the monthly
pnncipal mterest and modgage insu�ance nse� �' � x " amount owed can rise to$ .
- � ���r� w °"T .,�Z } h �'t"'`� "i + �''�� � ,
'' ; The maximum it can ever rise to is$
' - -�. .�
Does your loan have a pcepayment penalt�? F,�° �,��� ' , �-- QX No. ❑Yes,your maximum prepayment penalty is$ .
Does your loan have a balloon payment� 4 __, a } .F � XQ No. ❑Yes,you have a balloon payment of$ due in
-_ � , {x : fi �' "i r �;:� years on I l .
Total monthly'amount owed mcluding'escrow account payme��ts � { ❑You do not have a monthty escrow payment for items,such as property taxes
r ; t w F ;' _ �. , ,� + � and homeowners insurance. You must pay these items directly yourself.
` + " � ��i ' k� + _ � QX You have an additional monthly escrow payment of$400.98
4 , y r �° '- � � _,. T, that results in a total initial monthly amount owed of$1,35574. This includes pnncipal,interest,ai
� _
_ � `"fi �r = } �, ; „ ��� � moRgage insurance and any items checked below:
:�: __ `� 7 Q Property taxes Q Homeowners insurance
� k ; ❑Flood insurance ❑
_ � ; ; _
- -� : - � � . �
� �,= = '" -
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
� •
HUD CERTIFICATION OF BUYER AND SELLER
I have carefully reviewed the HU0.1 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 certiTy that I have received a copy of the HUa1 Settlement Statement
� � '
✓
W.Anthony D.Cario Brooke E.Ril y
c � � � ��
T OF JAMES C.GALB ITH
��I/����%���`!�G /
��
The HU0.1 Settlement Statement which I have prepared is a true and accurate account of this transadion.I have caused or will cause the funds to be
disbursed in accordance with this statement
�G�J�----� �� �� � ��
SETTLEMENTAGENT y 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
. �
� � �.
Name of Borrower. Name of Seiler: File Number
W.Anthony D.Cario The Estate of James C.Galbraith 2014-190
Brooke E.Riley
TitleExpress
Prepared'10/21/2014 at 427 pm
Nocc This page is furnished to give you an itemization of the amounu shown on Lines 1101, 1103 and P;elCj FfOfFI Paid From :
_ ,
110¢ o the Settlement Statement (HUD-1�. This page accompanies but is not a part of che Bbrrowe�'s sSellers .:;
settlement sWtement lf a discrepancy exists,the information shown on the Settlement Statement FUfICJS;2t ..F..UfiC�S et �:
(HUD-,)appl;�. Settlement 'Setflement;:`:`
1100 TitleCharges " ' `: : -
: Amounts;Included ;
,:�.: �..:.. _„; - t:.... . ....::.. = . :,: ;1n.Line 1101 .s ,
;.� .,. _,.
_.
. . .. .
1101. Title services and lender's title insurance 1,631.50
a.Ovemight Mail $ 20.50
b.Wire Fee 12.00
c. Processing Fee 49.00
d. Notary Fee 35.00
$ 116.50
1102. Settlement or closing fee
1103. Owner's title insurance (policy) $ 162.50 162.50
1104. Lenders title insurance (policy) 1,240.00 $ 1,515.00
a. Endorsement 900 EPL-Residential 50.00
b.Endorsement 100(No Violation) 50.00
c. Endorsement 300 Survey 50.00
d.Closing Service Letter 125.00
(Total 1103+1104)
;9105 leriders title policy limlt$167�887 00
t106. Ownerstitle pol'icy.limit$175;000.00 -
1:1D7.'Agents�portionoftheiotalfitleinsurance:premwm $ 1,342.12 :r
1108.:Underwriter's porUon of the tofal UUe insurance prem :' '335.38 '
?; (Total t107+1108) >
1109.
1110.
111t.
1112.
�
:; :; ; ;
- iotal �, Borrower Bortovrer :: Seller '
,., , ;, :
.. , _.
:1100. Title Char es'.with Pa ee : Char e `POC or Credit `Lme 1101 '. `Pa�d
1101. Title services and lender's title insurance $
a.Ovemight Mail to Salzmann Hughes,P.C. 20.50 20.50
b.Wire Fee to PA Real Estate 12.00 12.00
c. Processing Fee to PA Real Estate 49.00 49.00
d.Notary Fee to Kamela Comman 35.00 35.00
1104. Lender's title insurance to Stewart Title GuarantylPA RE SS 1,515.00 1,515.00
�'-: ': $ . ':1:;631.50 " .1,631.50:. -
THE EST TE OF JAMES C.GALBRAITH
Date 10/21/14 Date 10/21/14
W.Anthony D. ario
/(Ii)� Date 10/21/14
Bro <e E.Riley
� �
REV-15o8 EX+(o8-1z)
�' pennsylvania SCHEDULE E
DEPARTMENTOFREVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCETAXRETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
James C. Galbraith 21-14-0130
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
, 1.' Cash-safe deposit box 153.20
_ _
2. Savings account no:26642-0-Members 1st FCU(see letter attached) 103.92 '
__ _
3_ Checking account no:5140100508-PNC Bank,N.A.(see letter attached) 11,971.00
4. 1988 Jacquar automobile-proceeds from sale 2,000.00 '
' S. 1996 Corvette automobile-proceeds from sale 15,000.00
__
, g, 2006 Cadillac automobile-proceeds from sale 9,000.00
_ _
7. 2006 BMWx3 automobile-proceeds from sale 11,500.00 '
g. Furniture and personal property-net proceeds from public sale(see statement attached) 9,935.25 I
g., Dividend check-USAA 423.69 '
__ _ _ _
10. P Y .100.00 i
' Hoffman-Roth Funeral Home-refund of over a ment
11. :USAA Insurance-insurance payment forjewelry and silverware 10,387.59 '
12.I Comcast-refund 77.74 '
_ _ _ _
13. ;USAA Insurance-insurance refunds 387.37 '
: _ _ - _ _
_, _ _.
�
_ _
_ _ �',
TOTAL(Also enter on Line 5, Recapitulation) $ 71,039.76
If more space is needed,use additional sheets of paper of the same size.
St
�
MEMBERS lst
FEDERAL CREDTT iJNION
REGULAR SAVINGS ACCOUNT:
Account Number/Suffix 26642-00
Date Account Established 03/19/1981
Principai Balance at Date of Death $103.92
Accrued Interest to Date of Death $0.00
Total Principal and Accrued Interest $103.9.2
Name of Joint Owner None
VISA CREDIT CARD ACCOUNT
Account Number 4672090000474460
Date Account Established 08/27/1993
Balance at Date of Death $7,636.58
Joint Cardholder None
MEMBERS 15T FEDERAL CREDIT UNION
v�
Tessa L Klugh
Lending Insurance Support Specialist
February 28, 2014
Estate of: JAMES GALBRAITH
Date of Death: 02/06/2014
Social Security Number: 207-22-3243
5000 Louise Dxive • P.O. Box 40 • Mechanicsburg,Pennsylvania 17055 • (800) 283-2328 • wwwmemberslstorg '
����G.` ����
�',,�-�
�-'�''�.�-'t y,}
��f+J.71.�� ii.f�4Ft'�`-.�5� .
March 3, 2014
Andrews &Andrews
Attomeys at Law _
Attn: Ronald Johnson
78 W Pomfret St .
Carlisle,PA 17013
RE: James C Galbraith
SSN: 207-22-3243
DOD: 02-06-2014
Dear Mr. Johnson:
In response to your request for Date of Death(DOD)balances for the customer noted above, our
records show the following:
Checl�ng Account
Account#5140100508 Established: 09-10-1991
JAMES C GALBRAITH
DOD balance: $ 11,970.92+0.08 accrued interest
Loan Account
The decedent maintained Loan Account 4001008110110652 &4003048110126288. For further
information and assistance,please contact 1-888-762-2265. This is a voice activated system. Please �
state the word "operator" and follow the prompts to speak to a Loan Financial Service Consultant.
Safe Deposit Boz
The decedent maintained safe deposit box#OZ256
JAMES C GALBRAITH
Located at:
Carlisle Branch
105 Noble Blvd �
Carlisle,PA 17013 �
(71'� 243-6021 .
Page 1 af�2� .
' -3
� - � i � _57� ._ 1 �r� � .:� �:,,.,��a--ti. � � � ----
� ����
I�4�VE'� AZTGTI�1.\T SERVICE cR� 79L,
2505 Ritner Highway • Carlisle,PA 17015
Bill R.owe (AU 1538L) 249-1978 215-1044 574I008 Dave Rovve (AU 2295L;
Auction Is Action Call "R,owe" For Satisfccction
SELLERS NAME��� , ),�Yv�.�S � ��` t);� ��� DATE .`
ADDRESS GI�• �c���r� � �:-�-��f'��:`�-1�. _PHONE � t�� �` �� �(l-
OTHER ���,� �"��.^�C%c1 a�-1+-' �� �� �,ti���� ��AUCTIONEER % _1_7
AUCTION DATEILOCATTON 7� � �� CLERK %
DESC IPTION OF MEftCH �S�
�� n �
-� ���� �� � � - 1�
i _,�.�� � .�`� �---_� �. .,
� � - �.
� �1�.)`�c'l ��� �\O� �r� ` C
'�t v �� I r •�.'.� A '_ "�1G� r>— �-
{'��- " ^ �-- ���G' C1-�. t
��M�'J.�-._�t,�-- . � � .
I Comrnission the Auctianeers tfl sell tiie merchandise to the highest bidder by Public Auction. IVierchandise
to be sold as is & grouped as necessary to obtain bids. I certify that I am the owner or authorized represen-
tative of the merchandise,gootls and or property and have good�itIe and the right to sell and that they are free
from ail incvmbrances. I agree to accept all responsibility for providing merchantable title and for delivery of
title to the purchaser.I agree ta hold harmIess the Auctioneers against any claims of the nature xeferred to in
this agreemeat.
i
' `� 7 (�t�
AU '1�ON SIGNA URE SE RS SIG A ITRE
Total Sales {Clerking Z`ickets Attached) $ �$ s � ���
Less Sale Expense:
3� %a Commission Auctioneer $ � 3� � ���-- ��
%Commission Clerks � ��
V
OTHER,: �
TC)TAI. SAT.F FXPF.NCF 1lF.TtTTC'.mFr� c
E 'd i�LOG '9�bE 'GTB y�Fe�qIeJ H uyoC e�b0 =60 bi SO ��N
� •
REV-1510 EX+(OS-Q9)
� pennsylvania SCHEDULE G
DEPARTMENTOFREVENUE INTER-VIVOS TRANSFERS AND
INHERITANCETAXREfURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
James C. Galbraith 21-14-0130
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes.
DESCRIPTION OF PROPERTY
ITEM INCLUDE THE NAME OF THE TRANSFEREE,THEI0.RELATIONSHIP TO DECEDEM AND DATE OF DEATH %OF DECD�S EXCLUSION TAXABLE
NUMBER THE DATE OF TRANSFER. AITACH A COPY OF THE DEED F0A REAL ESTATE. VALUE OF ASSE� INTEREST (IF APPL]CABLE) VALUE
1• IRA-Oppenheimer's Co,Inc-Account No:87-0909684-128
°accountestablished 51712003
Beneficiary: Melissa McNamara,daughter
',(see letters attached) 122,534.19 100 122,534.19
TOTAL(Also enter on Line 7,Recapitulation) $ 122,534.19
If more space is needed,use additional sheets of paper of the same size.
�' • Oppenheimer&Co.Inc.
��PPENI-�IMER 1015 Mumma Road
� ` Wormleysburg,PA 17043
Phone 717-763-8200
Fax 717-763-1765
Toll Free 800-722-2294
Transacts Business on all Principal Exchanges
March 14, 2014
Andrew&Johnson
Attorneys at Law
Attn: Ronald E. Johnson
78 W. Promfret Street
Carlisle, PA 17013
RE: James Galbraith(dec'd) IRA
A87-0909684-128
Dear Ronald E. Johnson,
Please find below the date of death value for the above-referenced account for February 6, 2014:
Securi Amount Value
Advantage Bank Deposit 0.83 $ 0.83
Invesco Conservative Allocation Fund 7,548.628 $84,167.20
John Hancock Lifestyle Cons. Port. Fund 2,754.211 $38,366.16
Total Value
$122,534.19
Should you require any further infortnation,please do not hesitate to call.
Sincerely,
� - �``"
"`�—__..
Michael G. Crouse This report i�for;Ilusir�tior.purposes only:it is not and sfiauld n�Y
be ca��siru°d ,s a�i,�•'_'.i`•:i�:'��:Y���'�^P2r:heim2r&Co.lnc.account
Financial Advisor statement or�orm;;0�'�antl sho!;ir;not b�reiietl upon�or tax reporting
purposes. i•+ia;�cei nr:ce:�Fl!?Ct'U 3t'°as ot ��—and
8f8 ffORl SOUI'CP,S UP.h@V8G t�fE iCll3b!B hUt are not warrantzd by us as
to accuracy or conir��2�eness nc,7o th2y represent guaranteetl r7arl:ets
MGC/hk for ihe securities. TL;s�nirrm:::er.is subject to change. Commissions,
sales charges or d°Ti:r20 cnarg�s mm,ht apply if the acco:.�nt were to be
immediate!y IiquiCaie6 ��[�F:�li;imer& Co. inc., nor any of its
employees or�"rfilia;es d:�es n���ct;Er 12ya1 or ia�advice.
��ppENI�IME Oppenheimer&Co.Inc.
� 1015 Mumma Road
� Wormleysburg,PA 17043
Phone 717-763-8200
Fax 717-763-1765
Toll Free 800-722-2294
7'ransac[s Business on all Principal&cchanges
May 7, 2014
Ronald E.Johnson
Andrews &Johnson
Attorneys at Law
78 West Pomfret Street
Carlisle, PA 17013
RE: James C. Gaibraith (dec'd) IRA
Acct#A87-0909684-128
Dear Ronald,
The deceased's IRA account was established on May 7, 2003. The named beneficiary of the
account was his daughter, Melissa McNamara.
Respectfully,
�����
Michae G. Crouse
Financial Advisor
MGC/hk
' REV-1511 EX+(08-13)
� pennsylvania SCHEDULE H
DEPARTMENTOFREVENUE FUNERAL EXPENSES AND
INHERITANCETAXREiURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
James C. Galbraith 21-14-0130
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES: _
1' Hoffman Roth Funeral Home 3,557.18
B, ADMINISTRATIVE COSTS:
1. Personal Representative Commissions;
_ _
Name(s)of Personal Representative(s)
Street Address
City State ZIP
Year(s)Commission Paid:
_ __.
5,000.00
2, Attorney Fees:
3. Family Exemption, (If decedent's address is not the same as claimant's,attach explanation.)
Claimant
Street Address
City State ZIP
Relationship of Claimant to Decedent
4. Probate Fees: 383.50 '
5. Accountant fees
6. Tax Return Preparer Fees: ,
_ __
7. PP&L-utility bill _ . . ., _ 8.12 '
s. Paul Giass,locksmith-replace locks 15.60
_ _- _
_.
' s. UGI-utility bill 64.88
.. _
�o. USAA insurance-home and car insurance 838.63
��. PP&L-utility bill _ _ 22.02
�2. UGI-utility bill __ 26.55
TOTAL(Also enter on Line 9, Recapitulation) $
If more space is needed,use additional sheets of paper of the same size.
, �
SCHEDULE H- continued
Funeral Expenses, Administration Costs and
Miscellaneous Expenses
ESTATE OF FILE NUMBER
James C. Galbraith 21-14-0130
13. Borough of Carlisle-water/sewer bill $74.82
14. Dept of Revenue-replace certificate of title for Jaguar $50.00
15. PP&L-utility bill $25.70
16. Smith Appliances-reconstituted range and dishwasher $789.70
17. UGI-utility bill $8.51
18. PP&L-utility bill $69.10
19. USAA insurance-homeowners insurance $126.36
20. UGI-utility bill $8.62
21. USAA insurance-Jaguar insurance premium $36.74
22. PP&L-utility bill $80.59
23. PP&L-utility bill $17.13
24. Borough of Carlisle-water/sewer bill $74.82
25. PP&L-utility bill $70.35
26. UGI-utility bill $00.79
27. USAA insurance-homeowners insurance $126.68
28. PP&L-utility bill $72.27
29. UGI-utility bill $19.67
30. PP&L-utility bill $86.06
31. PP&L-utility bill $106.52
32. UGI-utility bill $61.92
33. PP&L-final utility bill $106.52
34. Becky Mentazy-house cleaning $1,400.99
35. Mark Devos-mowing and house cleaning(see bill attached) $4,265.00
, r
36. John H. Galbraith-reimbursement for expenses incurred serving as $10,624.19
Executor of the estate.
(This Executor lives in Fort Worth,Texas. It was necessary for him to come to Carlisle,PA
for 2 weeks after the decedent's death and for 3 weeks in April 2014 in order to sell
automobiles and ready the home for sale. The decedent had not lived in his home for
approximately 1 year prior to his death and was a hoarder. The home was littered with
clothing, papers and garbage; was rodent infested and absolutely uninhabitable. Among
other expenses incurred by the Executor it was necessary to incur airplane fare and hotel
rooms while in Carlisle performing his duties as Executor. In addition, please note no
claim was made for an Executors commission. The condition of the home explains the
reason for the expenses listed in Items 34 and 35 above)
37. Mark Devos-mowing, trimming (see bill attached) $1,620.00
38. PP&L-final electric bill $106.52
39. UGI-final utility bill $61.92
40. Howard Hanna-real estate commission $5,250.00
41. Real Estate Excel-real estate commission $5,250.00
42. Howard Hanna-additional real estate commission $225.00
43. Salzmann Hughes PC-overnight mail fees $82.00
44. Andrews & Johnson-attys fee and overnight mail fee $290.50
45. Kamela Cornman-notary fee $15.00
46. Recorder of Deeds- 1%transfer tax $1,750.00
47. Recorder of Deeds-mtg satisfaction fees $270.00
48. Charles Holtry, Tax Collector-2014 county real estate tax $1,458.39
49. Charles Holtry, Tax Collector-2014 county real estate tax $2,922.03
50. Borough of Carlisle-final water/sewer bill $64.85
51. Patrick's Painting-painting bill $520.00
52. D.K. Electric-electric bill $300.00
53. HAS -home warranty expense $435.00
54. W. Anthony D. Carlo and Brooke E. Riley-sellers assistance $9,712.38
(See settlement sheet attached for Items 37-51)
55. Reserve for closing and accounting $750.00
TOTAL (also enter on line 9, Recapitulation) $59,302.12
, �
_ _.. .. . . . .
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�: �rs %t'tL�?�1iITlS�Pli�REti.if�1�J�D GOa7D's�ritl5s�r A�i���9PA�liED Bi'T}i!a BiLL. oia�
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< �
REV-I512 EX+(12-12)
� pennsylvania SCHEDULE I
DEPARTMENTOFREVENUE DEBTS OF DECEDENT,
INHERITANCETAXRETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE Of FILE NUMBER
James C. Galbraith 21-14-0130
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• VISA credit card-Members 1st FCU--account no:4672090000474460(see letter attached to Sch.E) ''? 7,636.58
2. USAA secured home equity loan-account no:1128(see statement attached) 22,288.75
3. USAA secured consumer loan-account no:0568(see statement attached) 10,654.22
4. PNC account no:4001008110110652(see settlement sheet attached to Schedule A) 4,816.88
5. PNC account no:4003048110126288(see settlement sheet attached to Schedule A) 4,364.55 '
6.` UGI-utility bill 289.07 '
7.,' PP&L-utility bill 43.31
8. Borough of Carlisle-watedsewer bill 72.90 :
TOTAL(Also enter on Line 10, Recapitulation) $ '; 50,166.26
If more space is needed,insert additional sheets of the same size.
, , � •
_ __. ... . ......... . ..... ___.. __ __. _... ___.._ _.._._._ ___.. _.__ __
_ __ _ _
71'71 Mercy Road PO Box 6183 Omaha, NE 68106-0183 ' (800) 878-3317 ;
Reference: Enclosed claim by West Asset Management, Inc. for
Client Name USAA SECURED HOME EQUITY LOAN
Client Account Number X�CX1128
Balance Owing $22,288.75
Re.qardinq:
Decedent's Name JAMES C. GALBRAITH
Estate/Docket Number 21-14-0130
;
Date of_Death 2/6/2014
Social Security Number
� . , .
7171 Mercy Road PO Box 6183 Omaha, NE 68106-0183 ; (800)878-3317 " '
Reference: Enclosed claim by West Asset Management, Inc. for
Client Name USAA SECURED CONSUMER LOAN
Client Account Number X�CX XXXX 0568
Balance Owing $10,654.22
" Reqardinq;:
Decedent's Name JAMES C. GALBRAITH
Estate/Docket Number 21-14-0130
Date of Death 2/6/2014
Social Security Number
, . , J
REV-1513 EX+(O1-10)
r
g � ff�pennsylvania SCHEDULE J
' DEPARTMENT OF REVENUE
INHERITANCE TAX RENRN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
James C. Galbraith 21-14-0130
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• John H.Galbraith,3712 Fenton Avenue,Fort Worth,TX 76133 Ibrother 100% ;
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 ELEGTION TO TAX IS NOT TAKEN:
_ _ _ .
1. I
_ __. . _ _
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1. _.. _. _......_... _. _ _.. __ _ >
_ _
TOTAL OF PART II— ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ '
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