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HomeMy WebLinkAbout11-18-14 REV-1500 ex (01.10) 1505610140 OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes INHERITANCE TAX RETURN County Code Year File Number PO BOX 280601 2 1 2 $ 8 Harrisburg,PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 1 2 0 2 2 0 1 3 0 4 2 3 1 9 6 4 Decedent's Last Name Suffix Decedent's First Name MI T A Y L 0 R D A N I E L J (if Applicable)Enter Surviving Spouse's information Below Spouse's Last Name Suffix Spouse's First Name MI T A Y L O R L 0 R I A Spouse's Social Security Number THIS RETURN MUST BE PILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW 1.Original Return 2.Supplemental Return 3.Remainder Return(date of death prior to 12-13-82) Q 4.Limited Estate 0 4a.Future Interest Compromise(date of [� 5.Federal Estate Tax Return Required death after 12-12-82) U 6.Decedent Died Testate 0 7.Decedent Maintained a Living Trust S.Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) © 9.Litigation Proceeds Received �] 10.Spousal Poverty Credit(date of death 11.Election to tax under Sec.9113(A) between 12-31-91 and 1-1-95) (Attach Sch.0) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number H A R O L D S I R W I N I I I 7 1 7 3 1 9 7 5 6 0 REG15T"OF wiLLS US_E'ONLY =-7 rri C) r ri First line of address -0:;0 -00 I R W I N L A W 0. F F I C E = rri '—' m rr7r7 Second line of address Ch co 6 4 S O U T H P I T T S T R E E T City or Post Office State ZIP Code _ 6A—TE'FILEDr`' .._i r— C A R L I S L E P A 1 7 0 1 3 Correspondents a-mail address: IrwinlawOff ce gmail.cOm _ Under penalties of perjury,I declare that I have examined this mtum,Including acoompanying schedules and statements,and to the best of my knowledge and belief, K is true,correct and complete.Della on of preparer other than the personal representative is based on all Information of which preparer has any knowledge. SIGNAWAE OF PERSON1 ONSIB FOR FILING RETURN D TE ice- cI G - 121 COVENTRY DRIVE CARLISLE PA 1?015 S RE OF PREPARER 0 E PRESENTATIVE DTE_ DR - 64 SOUTH PITT STREET CARLISLE PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 1505610140 1505610140 J 1505610240 REV-1500 EX Decedent's Social Security Number Decedent's Name: DANIEL J - TA YL OR RECAPITULATION 1.' Real Estate(Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . .. . . . . . . . . 1. 5 0 0 0 . 0. 0 2. Stocks and Bonds(Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. 0 . 0 0 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) . . .. . 3. 0 . 0 0 4. Mortgages and Notes Receivable Schedule D 4. 0 . 0 0 5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E).. .. . . . 5. 2 4 0 3 1 9 6 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested . . . . . . . 6. 0 . 0 0 7. Inter-Vivos Transfers&Miscellaneous NProbate Property 4 0 9 8 8 . 8 4 (Schedule G) Separate Billing Requested . . . . . . . 7. 8. Total Gross Assets(total Lines 1 through 7) . . . . . . . .. .. . . . . . .. . . . . . . . . . 8. 7 0 0 2 0 . 8 0 9. Funeral Expenses and Administrative Costs(Schedule H) ... . . . . . . ... . . . . . . 9• 1 4 2 9 8 . 2 4 10. Debts of Decedent,Mortgage Liabilities,and Liens Schedule I 10. 3 9 6 2 . 0 0 11. Total Deductions(total Lines 9 and 10) . . . . . . . . . . . . . . . . . . . . . . . :. . . . . . . 11. 1 8 2 6 0 . 2 4 12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 5 1 7 6 0 . 5 6 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J) .. . .. . . . . . .. . . . . . . . . . . 13. 4 7 7 9 1 . 7 0 14. Net Value Subject to Tax(Line 12 minus Line 13) . . . . . . . . . .. . . . . . . . . . . . 14. 3 9 6 8 . 8 6 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.045 3 9 6 8 . 8 6 15. 1 7 8 . 6 0 16. Amount of Line 14 taxable at lineal rate X.0_ 0 . 0 0 16. 0 . 0 0 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 0 18. 0 . 0 0 19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 1 7 8 • 6 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑X Side 2 1505610240 1505610240 J REV-1500 EX Page 3 File Number Deced,ent's Complete Address: 21 13 1288 `DECEDENT'S NAME DANIEL J. TAYLOR STREET ADDRESS 121 COVENTRY DRIVE CITY STATE ZIP CARLISLE I PA 117015 Tax Payments and Credits: I. Tax Due(Page 2,Line 19) (1) 178.60 2. Credits/Payments A.Prior Payments 1,249.00 B.Discount Total Credits(A+B) (2) 1,249.00 3. Interest (3) 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) 1,070.40 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 'rt "a'. .4 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No 121 a. retain the use or income of the property transferred; ...................................................................... Elb. retain the right to designate who shall use the property transferred or its income; ............................... ❑ IXI 121 c. retain a reversionary interest;or ................................................................................................ Eld. receive the promise for life of either payments,benefits or care? ....................................................... ❑ IZI 2. If death occurred after December 12,1982,did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................... ❑ 191 3. Did decedent own an'in trust for"or payable-upon-death bank account or security at his or her death? ......... ❑ ❑X 4. Did decedent own an individual retirement account,annuity or other non-probate property,which contains a beneficiary designation?.................................................................................................. ® ❑ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. IF 44&#t?-;4. For dates of death on or after July 1, 1994,and before Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent[72 P.S.§9116(a)(1.1)(i)]. For dates of death on or after Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S.§9116(a)(1.1)(ii)].The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1,2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent,an adoptive parent or a stepparent of the child is 0 percent[72 P.S.§9116(a)(1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in 72 P.S.§9116(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 decedent's siblings is 12 percent[72 P.S.§9116(a)(1.3)].A sibling is defined,under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption. REV-1502 EX+(01-10) pennsylvania SCHEDULE A 6 DEPARTMENT OF REVENUE REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: DANIEL J. TAYLOR 21 13 1288 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 be disclosed on Schedule F. Attach a copy of the settlement sheet if the property has been sold. ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE NUMBER OF DEATH DESCRIPTION. LONG TERM LEASE INTEREST 5,000.00 Value Based on Sale Price See HUD-1 at Exhibit"A" TOTAL(Also enter on Line 1,Recapitulation,) $ 5,000.00 If more space is needed,use additional sheets of paper of the same size. REV-1503 EX+(6-98) ` SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER DANIEL J. TAYLOR 21 13 1288 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. NONE 0.00 TOTAL(Also enter on line 2,Recapitulation) $ 0.00 (If more space is needed,insert additional sheets of the same size) REV-1504 EX+(6-98) SCHEDULE C CLOSELY-HELD CORPORATION, COMMONWEALTH OF PENNSYLVANIA PARTNERSHIP OR INHERITANCE TAX RETURN SOLE-PROPRIETORSHIP RESIDENT DECEDENT ESTATE OF FILE NUMBER DANIEL J. TAYLOR 21 13 1288 Schedule C-1 or C-2(including all supporting information)must be attached for each closely-held corporation/partnership interest of the decedent,other than a sole-proprietorship. See instructions for the supporting information to be submitted for sole-proprietorships. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. NONE 0.00 TOTAL(Also enter on line 3,Recapitulation) $ 0.00 (If more space is needed,insert additional sheets of the same size) REV-1507 EX+(6-98) SCHEDULE D COMMONWEALTH OF PENNSYLVANIA MORTGAGES & NOTES INHERITANCE TAX RETURN RECEIVABLE RESIDENT DECEDENT ESTATE OF FILE NUMBER DANIEL J. TAYLOR 21 13 1288 All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 9. NONE 0.00 TOTAL Also enter on line 4,Recapitulation $ 0.00 (If more space is needed,insert additional sheets of the same size) REV-1508 EX+(6-98) 0, SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER DANIEL J. TAYLOR 21 13 1288 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 84.00 1 MEMBERS 1ST FEDERAL CREDIT UNION Checking Account No. 0000395633- 11 Value based on attached Exhjibit"C" 306�17 2, MEMBERS 1ST FEEDERAL CREDIT UNION Savings Account No. 0000389943-00 Value based on attached Exhibit"C" 3. MEMBERS 1ST FSDERAL CREDITY UNION 1,193.05 Checking Account No. 389943 - 11 Value based on attached Exhibit"C" 15,273.74 4. MEMBERS 1ST FEDERAL CREDIT UNION Savings Account No. 395633-00 Value based on attached Exhibit"C" 1,300.00 5. 2000 BMW (In poor repair) Value based on sale price 1,100.00 6. 1988 HARLEY-DAVIDSON MOTORCYCLE Value based on sale price 7. 2002 CHEVROLET SUBURBAN 4,375.00 Value based on Kelly Blue Book value at Exhibit"D" 8. 2002 STAR UTILITY TRAILER 400.00 Value basd on sale price TOTAL(Also enter on line 5,Recapitulation) $ 24 031.96 (If more space is needed,insert additional sheets of the same size) REV-1509 EX+(01-10) m • pennsylvania SCHEDULE F DEPARTMENT OF REVENUE JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: DANIEL J. TAYLOR 21 13 1288 If an asset was made jointly owned within one year of the decedent's date of death,it must be reported on Schedule G. SURVIVING JOINT TENANT(S)NAME(S) ADDRESS RELATIONSHIP TO DECEDENT A. NONE Spouse B. C. JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENT'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. NONE 0.00 TOTAL(Also enter on Line 6,Recapitulation) $ 0.00 If more space is needed,use additional sheets of paper of the same size. REV-1510 EX+(08-09) pennsylvania SCHEDULE G DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER DANIEL J. TAYLOR 21 13 1288 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 INCLUDETHE NAME OF THETRANSFEREE,THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH %OFDECD'S EXCLUSION TAXABLE NUMBER THE DATE OF TRANSFER.ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IFAMICABLE) VALUE 1. PRINCIPAL LIFE INS. CO. 40,988.84 100.00 40,988.84 401 K Value based on statement attached as Exhibit"E" TOTAL (Also enter on Line 7,Recapitulation) 40 988.84 If more space is needed,use additional sheets of paper of the same size. REV-1511.EX+(10-09) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER DANIEL J. TAYLOR 21 13 1288 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. HOFFMAN-ROTH FUNERAL HOME- Funeral and Burial Expenses 10,024.20 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) Street Address City State ZIP Year(s)Commission Paid: 2. AttomeyFees: CUNINGHAM &CHERNICOFF PC and IRWIN LAW OFFICE 3,501.04 3, Family Exemption:(If decedents address is not the same as claimant's,attach explanation) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4. Probate Fees: CUMBERLAND COUNTY REGISTER OF WILLS- Letters Testamentary 458.00 5 Accountant Fees: 6. Tax Return PreparerFees: 7. HOFFMAN-ROTH FINERAL HOME- Death Certficates 90.00 8. CENTRAL PENN BUSINESS JOURNAL- Legal Advertising for Estate 150.00 9. CUMBERLAND LAW JOURNAL- Legal Advertising for Estate 75.00 TOTAL(Also enter on Line 9,Recapitulation) $ 14 298.24 If more space is needed,use additional sheets of paper of the same size. REV-1512 EX+(12-08) • pennsylvania SCHEDULE DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES, & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER DANIEL J. TAYLOR 21 13 1288 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. CITIBANK N.A. 639.96 Home Depot Revolving Vharge Balance 2. MET-ED 152.36 Electric Bill Balance 3. CARLISLE PEDIATRIC ASSOCIATES 27.04 Unpaid Medical Bill 4. MEDTRONIC 482.00 Unpaid Medical Bill 5. CUMBERLAND VALLEY ENDO CENTER 81:15 Medical Bill. 6. CARLISLE PHYSICIAN SERVICES LLC 340.67 Medical Bill ( 7. HOLY SPIRIT HOSPITAL 223.80, Medical Bill 8. CU,BERLAND GOODWILL FIRE RESCUE EMS INC 1,622.94 Medical Bill 9. CARLISLE NEURO CARE235.42 Medical Bill 10. QUANTUM IMAGING AND THERAPEUTIC ASSOCIATES 122.00 Medical Bill 11. SPIRIT PHYSICIAN SERVICES INC 34.66 Medical Bill l TOTAL(Also enter on Line 10,Recapitulation) $ 3,962.00 If more space is needed,insert additional sheets of the same size. REV-1513 EX+(01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: DANIEL J. TAYLOR 21 13 1288 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. AVA E. TAYLOR Lineal 658 North Hanover Street 25% Residuary Carlisle, PA 17013 2. DEVON M. TAYLOR Lineal 658 North Hanover Street 25% Residuary Carlisle, PA 17013 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE. II. NON-TAXABLE DISTRIBUTIONS: A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. LORI A. TAYLOR 47,791.70 658 North Hanover Street Carlisle, PA 17013 B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ 47 791.70 If more space is needed,use additional sheets of paper of the same size. 07/31/2014 02:53 7172495755 BARIC SCHERER LLC PAGE 02 rrevat»eeataurro aaebte rew�«uo,.{tet�r M�,anooe r; A. Settl eMent St eta]ent U.S.ospettment at Mousing ane urban ocvempn+ent B.7406 e OMB roval No.2602.0265 1. QFHA I (3Fmi4A 3. OC='Wnin& 6.Fila Number 7,'Loan Number 8.Mogoge Inauroned Case Number A. ny Ins, 20 _ O - C.hteu!? n • Tao �. woua>athecinep�tlt amp f�f�fetait loci+ aaaasseVMS Ine 'M ro tuocc cn. TideExpressSatttementSyAt Mil !#u w a tar#nOwin ntMtw tsLw ah1i #t6 t iMMO Btit�#t'rt tM�pg blTiar�kntir .- wRigw Kr`M . A (l wR0 d OOnOf1 A001 0 8 D.NAME OF BORROWER: James P.8rartgff R 196 Dau h n SM gn6la.-PA 17023 E.NAME OF SELLER: Estate of Daniel J.Taylor Mo LOd lAylgfg9 Cava t .Drtiimp,Agttisio,PA 47015 F.NAME OF LENDER: NONE. ADDRESS: G.PROPERTY ADDRESS: ..26 Sasch Island,Dauphin.PA . d nde Tcwnshl H.SETTLEMENT AGENT: Baric Scherer LLC,Telephone:717.249.6873 Fax:717.249.5755 PLACe EruemoNT,, 4"---O#�Lomma is a 013 SEMEME19 MT& 98WROM - O R WS- A T 900 GR MOU O ROWS 1400.GROSS AMOUNT DUE TO L E . jol. C n s la 00 .00 40 . Contra t n S 000.I 1t) -PC Mwal OZP 03 S t®men tit 4 638 SO t u0 ants to;hem id by tler in ativanoe ------ Mut#mnts r m9 tier In advance 1 own taxes __ Ito" 7 u 4 -_County 10$, oot % _ _ 488 - Tax 9 -+ - Ilk, 410 1 1 12 a 120.GROSS A-MOUffj2UEO 80 ROWS 58 .SO 420.GROSS AMOUNT CUE TO§ELLF, IS 000A 200.AMOUNTS PAID 4 HALF F OW _ EQU I SIN AMOUNT OU TQ SELLER 201. Qg=11 or ea mon 501 Excess D R s in e 2Q2.--f2dndpalamount of now Loans -_ 50 tt n as tis tsr itn 1d08 3 Eattati loan a titin to2n n 6 e of Merz a n _ ' Q +� -NY o!shwo-moftage loan gf Adluaftants for Itorna uncald hv, eti r - d`ustmetrtas forlorn id eller 10. CttyAMO tom510. 1 un t 11, n tax'eS —212,, Sghpol3 2 pOt 7 213, $ 9 214 - 614, S - A 45 1 _ 1 610, - - - 2191 0.T TAL PAID B JFO O O _ _ - 0. O LAL EQRICT ON AMOUNT DUE SELL. R 800.,CASF# SETTI EMENT FR M O T 800 CASH T UnLEMENT TO OR FROM SELL R- -301'. GrU&amount OU13f bo li S38 50 4 unt i1 oft ins 4 5,000.00 30 . Less amours lel r r line 002. �+ u on n tt r i'rn 20 _ 38 AS FOM]BORROWER 553960 _603 CAgJj0_fiELLr.R 0 8 y 07/32!2014 02:53 7 .72495755 BARIC SCHERER LLC PAGE 03 At"hi is WNW*pu 60"M fart+41140.1 1446)fCf"moue X 44 U.S.DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT Fite Num"r 2014iSRANOFF - PAW TI ent S atom L SETTLEMENT CNA PAID FROM PAID FROM T lk 'S C200MISSIONBORROWERS Sf!LLER'S Dbftionof KMrNspiognNn i FUNDS AT FUNDS AT 701, $$Trt.$MENT SETTWEMENI 192, 703, sevywi goo.ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan iQn F 2. Loan iaan % 003, ri -wit Relm- 1"01 808, 1 900:ITEMS RE. UIRED BY LENDER TO BE PAID IN ADVANCE --W-121014 Frw t S Infor to H 1000.RESERtiES DAPOSITEO WITH LENDERF 1001.Hazwo Inst m t0 -M i m . fto lool rdRy Immax 14A J4, _qoyn!XPrqperIj Tu 1 1 in mo. 1mQ 1 A its of A uatmen 0 0 0.01 I 100,TITLEH 1oiclaegift Sewch- 1102, i -- 1104,Title Insum-ce Binder 1105.Dccumtnt 1106,Noi Fsex 1107AIt 1 tiC$ IVC TOM InsurM nclu Imml No: 11 w t lilt 1113. 1200,G NINE T RECORDIN AND 1—RMSCER- CHAROKS 1201. F 8.50 1 0 . m S50.04 50.00 1203,stra T 50.00 M ilos. 1300.ADDITIONAL.SETTLEM CHARGES T T S I.RMENT CHAR13E3 t r 1 t sectiQr+ a rwa uxriRQRnQIr or OUMOt AND atuart tutr!CM4}1ii� w tl 1 hr ;wr�n r two*0000v a a a wiQ1=i t wu f�a rw e+�q eowtwe sntrnant a w r�sMu*nM Iiwww.o++ner+u mwe on my eaoow+t Of oy Ali!n lh s puWlWDiNO1�A►tpOgq� QLY1� 10ILtili'rRLi lii QON irMWIthe" wM #XMw tO OOMhMpiNl lNnN GMwfhQdMYnnnt u.9F.GQOIa 66G"nQ��M""IOW ANQ IE7 Ci10. 4arrL8W&4T A0PNF, QATi: MEMBERS V FWEPALCRMrf UNION REGULAR SAVINGS ACCOUNT: Account Number/Suffix 389943-00 Date Account Established 07/09/2010 Principal Balance at Date of Death $305.02 Accrued Interest to Date of Death $0.00 Total Principal and Accrued Interest $305.02 Total Interest 01/01/2013 to 12/02/2013 $1.15 Name of Joint Owner None CHECKING ACCOUNT: Account Number/Suffix 389943-11 Date Account Established 07/09/2010 Principal Balance at Date of Death $1,193.05 Accrued Interest to Date of Death $0.00 Total Principal and Accrued Interest $1,193.05 Total Interest 01/01/2013 to 12/02/2013 $0.00 Name of Joint Owner None REGULAR SAVINGS ACCOUNT: AccountNumber/Suffix 396633-00 Date Account Established 08/28/2010 Principal Balance at Date of Death $15,273.74 Accrued Interest to Date of Death $0.06 Total Principal and Accrued Interest $15,273.80 Total Interest 01/01/2013 to 12/02/2013 $31.44 Name of Joint Owner None CHECKING ACCOUNT: Account Number/Suffix 396633-11 Date Account Established 08/28/2010 Principal Balance at Date of Death $84,00 Accrued Interest to Date of Death $0.00 Total Principal and Accrued Interest $84.00 Total Interest 01/01/2013 to 12/02/2013 $0.00 Name of Joint Owner None MEMBERS 1ST FEDERAL CREDIT UNION j�Km TeKlugh Tessa L Lending Insurance Support Specialist January 10, 2014 Estate of: DANIEL J TAYLOR Date of Death: 12/02/2013 Social Security Number.- 187-52-9084 5000 Louise Drive - P.O.Box 40 * Mechanicsburg,Pennsylvania 17055 - (800)283-2328 • %rWW.Members1st.0tR 2002 Chevrolet Suburban 1504 Spon Utility Trade In Values - ... 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Fell Us About This Car Owners M;e you rated the 2002 Suburban 1300 Write your own review 9 out of 10. * r A Next Steps to SettingYour Car a"yy/ ;rY:a PWMW by Get an Instant Cash Offer Start your offer .AUtP — Find dealers ready to buy + or trade In your car-today! 11% ME 'Benc"hmarkLoca"l'PrIces See listings See what dealers and Private sellers In your area are wMng for your tar. - l — ' r I� i hap://wwvv.kbb.com/chf-vrn1pt/ciIhiirha-n_1 Snn/')nm " '�'�- QUARTERLY STATEMENT a '"PTINCIPAL LIFE INS.CO. October 1, 2013 - December 31,, 2013 P.O.BOX 9394 DES MOINES,IA 50306-9394 Location Number: 1 000976. DANIEL]TAYLOR 121 COVENTRY DR SUN ENTERPRISES,INC. CARLISLE,PA 17015-4507 SAVINGS PIAN Contract Number:439926 Need ars edge, Daniel? Simply look for this box throughout the statement. Ending Balance $40,988.84 Current Vested Balance $40,988.84 Personalized Rate of Return This Quarter 7.39% Personalized Rate of Return This Year 22.95% . Message from 'The' Principal Login—.Look around...Get the latestl Your account information can be lust a click away generally wherever you are and whenever you want it. Log in now at www.Paindpal.com/P RAlmygec aunt.With a single glance,you'll see your account balance,your personalized rate of return and any gains or losses. You can also research,view and update investment choices ava'c able under the plan0find resources,tools, calculators and much more. ..�., 704 -- t g-.{ Please review this statement carefully and notify us promptly in writing of any discrepancies within 90 mays After 90 days, corrections will be made on a current basis *-V , #JIBII •%'• G7IDtl,�p WE'LL GIVE YOU AN EDGE° Page 7 of 100 000000 ODoOTdo17169204001006 0001906 001 of 004