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Home My WebLink About01-12-15 (2) J � pennsylvania 15 0 5 61410 5 'JlV�HTMENiOF�tVE�YUE EX(03-14)(PI) REV��JO� OFFICIAL USE ON�Y Bureau of Individual Taxes County Code Year File Number PO BOx 280601 INHERITANCE TAX RETURN � � '� Harrisburg, PA 17128-0601 RESIDENT DECEDENT ��y� ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY ' ' ' 12022012 ' 09191938 DecedenYs Last Name Su�x DecedenYs First Name MI NOSS WAYNE E (If Applicabie)Enter Surviving Spouse's Information Below Spouse's Last Name Su�x Spouse's First Name MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW � 1. Original Return p 2. Supplemental Return p 3. Remainder Return(date of death prior to 12-13-82) p 4.Agriculture Exemption(date of � 5. Future Interest Compromise(date of 0 6. Federal Estate Tax Return Required death on or after 7-1-2012) death after 12-12-82) p 7. Decedent Died Testate p 8. Decedent Maintained a Living Trust _ 9. Total Number of Safe Deposit Boxes (Attach capy of wiil.) (Attach copy of trust.) p 10. Litigation Proceeds Received p 11. Non-Probate Transferee Return p 12. Deferral/Election of Spousai Trusts (Schedule F and G Assets Only) O 13. Business Assets O 14. Spouse is Sole Beneficiary (No trust invoived) CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number _ 'TIM NOSS (717) 317-6640 First Line of Address ' 1821 FISHER ROAD Second Line of Address City or Post Offce State ZIP Code ' MECHANICSBURG PA 17055 �, � �, �a rtt tnoss1 @yahoo.com � ��`�` �' Correspondent's email address: c� �,_. G"3 G1 aa- � � � :�! REGISTER , U1( LS�TJSE ON Y � t _ �-„ �, ,:1 i REGISTER OF WILLS USE ONLY�� 'rr �f"�� N �-'"� dATE FILED MMDDYYYY ; ^,r'} �` "� �' . ' .. , ,.,Q -t~1 � J �� +;� � :�i:. �"� "'y"1 �. �"y:: ) �_» C� ;;:3 {"' . � � � � DATE FII,�D STAMP PLEQSE USE ORIGINAL FORM ONLY Side 1 (I'��II"�'III)�'�'�'lll"II')�I'�I�I�'I(��I'�I'I'�II I�'� � ],5056141,05 15�56141,05 � � � 15056�42�5 REV-1500 EX(FI) Decedent's Social Security Number �ecedent's Name: WAYNE E NOSS 204-30-6998 RECAPITULATION 1. Real Estate(Schedule A). .. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. 170,808.80 2. Stocks and Bonds(Schedule B) 2. 598,978.10 ', . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . 3. Ciosely Held Corporation, Partnership or Sole-Proprietorship(Schedule C} . . . . . 3. 4. Mortgages and Notes Receivabie(Schedule D) . . . . . . .. . .. . . . . . . .. . . . . . . . . 4. 5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E). . . . . . . 5. 15,654.50 6. Jointly Owned Property(Schedule F) O Separate Billing Requested . . . . . . . 6. 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property 56,897.65 (Schedule G) O Separate Billing Requested.. . . . . . . 7. 8. Totai Gross Assets total Lines 1 throu h 7 . . .. . . . .. . . . . 8. ' 842,339.05 ' � 9 ). . . . . . . . . . ... . .. 9. Funeral Expenses and Administrative Costs(Schedule H)... . .. . . . . . . . . . .. . . 9. , 36,285.68 10. Debts of Decedent, Mortgage Liabilities and Liens(Schedule I). . . . . . . . . . . . . . . 10. 7,182.18 11. Total Deductions(total Lines 9 and 10). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 43,467.86 12. Net Value of Estate(Line 8 minus Line 11) . .. .. . . . .. . .. . . . . . . .. . . . . . . . . . 12 798,871.19 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 7ax(Line 12 minus Line 13) . . . . . . . . . . . . . .. . . .. . . . . . 14. 798,871.19 TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICAB�E 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 35,949.20 ' at lineal rate x.0 45 798,871.19 ' 16. 17. Amount of Line 14 taxable ' at sibling rate X.12 17. _ . . 18. Amount of Line 14 taxable at collateral rate X .15 18. 19. TAX DUE . .... .. . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . 19. 35,949.20 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT � Under penalties of perjury,I declare 1 have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief, it is true, correct and complete. eclaration of preparer ther than the person responsible for filing the return is based on all information of which preparer has any knowledge. r' ,�'` SIGNATURE OF PERS SP SIBLE FO ING RETURN DATE ,.,, �'�j� �j��a,,.._ ��;zs2 01/10/2015 ADDRESS 1821 FISHER ROAD, MECHANICSBURG PA 17055 SIGNATURE OF PREPARER OTHER THAN PERSON RESPONSIBLE FOR FILING THE RETURN DATE ADDRESS �j�`�� L�� {j"Q � I��'I��II��)�I��'��I��I��'I�'��'��'��'��'�� Side 2 � � 150561,4205 150561,4205 REV-1502 EX+(12-12} � pennsylvania SCHEDULE A DEPARTMENT OF REVENUE INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT ESTATE OF: FILE NUMBER: WAYNE E NOSS 2112-1344 Ali 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 DESCRIPTION OF DEATH 1' 2845 MORNINGSIDE DRIVE,CAMP HILL PA 17011 134,000.00 10592 Horse Valley Road,East Waterfortl PA 36,808.80 TOTAL(Also enter on Line 1, Recapitulation,) $ 170,808.80 .--.._....__.._----------____... _ If more space is needed,use additional sheets of paper of the same size. � � i �i ,. �`^''��NT�� OMB Approval No.2502-0265 o`��, � �G9 �o��,= A. Settlement Statement (HUD-1) 8a�'oaJE� B. Type of Loan 1.❑FHA 2.Q RHS 3. QX Conu Unins. 6. File Number: 7. Loan Number: 8. Mortgage Insurance Case Number: 4.�VR 5.Q Conv Ins. 012504-1&3189 4214020009 C. Note: This form is furnished to give ynu a statement of actua/settlement costs. Amou»fs paid to and by the sett/ement agent are shown. Items marked"(p.o.a)"were paid outside the Gosing;they are shown here for informafional purpo.ses and are not included in the totals. D. Name and Address of Borrower: E. Name and Address of Seller: F. Name and Address of Lender: Harry T.Voorhees,Jr. New Penn Financial,LLC 4 Pocono Drive The Estate of Wayne E.Noss 4000 Chemical Road,Suite 200 Mechanicsburg,PA 17055 2845 Morningside Drive Plymouth Meeting,PA 19462 Camp Hill,PA 17011 G. Property Location: H. SettlementAgent: I. Settlement Date: 2845 Morningside Drive TuckerAresnberg Reai Estate Services Camp Hill,PA 17011 2 Lemoyne Drive,Suite 200 March 21,2014 Cumberland County,Pennsylvania Lemoyne,PA 17043 Ph. (717)2344121 Place of Settiement: Urid1riCJ Date: 2 Lemoyne Drive,Suite 200 arch 21 , 2 O l Lemo ne,PA 17043 J. Summary of Borrower's transaction K. Summary of Seller's transaction 100. GrossAmount Due from Borrower: 400. GrossAmount Due to Seller: 101. Contrad sales rice 134,000.00 401. Contrad sales rice 134,000.00 102. Personal ro e 402. Personal ro er 103. Settlement Char es to Borrower Line 1400 6,481.19 4�3. 104. 4Q4. 105. 405. Ad'ustments for items aid b Seller in advance Ad'ustments for items aid b Seller in advance 106. C' /Town Taxes 03/21/14 to 12/31/14 347.93 406. C' ffown Taxes 03/21/14 to 12/31/14 347.93 107. Coun Taxes 03/21/14 to 12/31/14 271.26 407. Coun Taues 03/21l14 to 12/31/14 271.26 108. School Taxes 03/21/14 to 06130/14 � 393.52 408. Schooi Taxes 03/21/14 to 06/30/14 393.52 109. Sewertfrash Jan-Mar 03/22/14 to 04i01174 13.34 449. S2w2r!Trash fJan-Mar1��22�14 to Q4l01/14 13.34 110. 41�. 111. 4Y;. 112. 412. 720. Gross Amount Due from Borrower 141,507.24 420. Gross Amount Due to Seller 13�.02o.Q5 200. Amounts Paid b or in Behaif of Borrower 500. Reductions in Amount Due Seller. 201. De osit or earnest mone 4,OOO.dO 501. F�ccess de osit see instructions 202. Princi al amount of new Ioan s 61,000.00 502. Settlement char es to Seller(Line 1400) ?5.698.00 2v3. _JCSt��?�h�2^:S :aKE�Si3i�e.^',. = �:;5.' -_ - - _- - = 244. _ 'Sr-=�'��,a_ _ _�`- - - 2�5. �'�.'`�i "Q �c�y�.�,..n 4�� .'.6.�.- 206. vt`i6. 207. 507. r ve cssit��s:..as^ro�ecs:• 208. 508. 209. i 509. Ad'ustments for items un aid b Seller Ad'ustments for items un aid b Seller 210. C' /Town Taxes to 510. C lTown Taxes to 211. Coun Taxes to 511. Coun Ta�ces to 212. School Taxes to 512. School Taxes to 213. 513. 214. 514. 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. 220. Total Paid b /for Borrower 65,000.00 520. Total Resluction Amount Due Seiler 15,698.00 300. Cash at Settlement fromlto Borrower 600. Cash at settlement to/from Seller 301. Gross amount due from Borrower line 120 141,507.24 601. Gross amount due to Seller line 420 135,026.05 302. Less amount aid b lfor Borrower(line 220 ( 65,000.00) 602. Less redudions due Selier(line 520) ( 15,698.00 303. Cash �From � To Borrower 76,507.24 603. Cash X�To � From Seller 119,328.05 'Paid outside of Gasing by borrv�(B),sell�(S),I�der(L).or tl%rd-party(T) The undersigned herebX adcnowledge receipt of a completed copy of this statement&any attachments referred to herein �ettlement Cha es p,- 0.Total Reat Estate Broker Fees $7,370.00 Paid From Paid From Division of commission(line 700)as follows: Borrowers Seller's Funds at Funds at 702. 3 685.b0 to ex Realtors LLC Settlemerrt Settlement 703.Commission aid at settiement 7 370.00 704. Broker Fee to Re/max 1stAdvanta e Inc. 385.00 705. 800.items Pa abie in Connection with Loan 801.Our ori ination char e $ 2,172.50 from GFE#1) 802.Your credit or charge(points)for the specit'�c interest rate chosen $ -1,055.30 (from GFE#2) 803.Your ad'usted or' ination char es from GFE#A 1,117.20 804.A raisal fee to from GFE#3 805.Credit Re ort to from GFE#3 806.Tax service to from GFE#3 807.Fiood cert�cation to from GFE#3 808.AMC Fee EstreetA raisal from GFE#3 POC B$385.00 809.AMC MNGT Fee Estreet raisal ftom GFE#3 POC B$60 8��• from GFE#3 811. (from GFE#3) 900.Items Re uired b Lenderto Be Paid in Advance 901.Dai interest char es from 03/21/14 to 04/01/14 11 $7.311600/da from GFE#10 80.43 902.Mort a e insurance remium for months to from GFE#3 903.Homeowner's insuranoe for 1.0 ears to A(IState Insurance from GFE#11 685.94 904. from GFE#11 905. (from GFE#11) 1000.Reserves De osited with Lender 1001.Initial deposit for your escrow account (from GFE#9) 938.62 1002. Homeowner's insurance 3.000 months @ $ 57.16 per month $ 171.48 1003. Mort a e insurance months er month 1004. Pro e taxes $ 1 383.34 C' lTown Taxes 3.000 months 37.13 er month Coun Taxes 3.000 months 28.95 r month School Taxes 10.000 months 118.51 er month 1005. � 1006. months $ er month S 1007. months $ er month S 1008. 5 1009. A regateAdjustment S -616.20 1100.Title Charges 1101. Title services and lender's title insurance from GFE#4 1,053.50 1102. Settlement or closin fee 1103. Owner's title insurance to First American Title Insurance Com an from GFE#5 384.50 1104. Lender's title insurance to First Ameripn Title Insuranoe Com an 835.50 1105. Lender's titie oi' limit $ &1 000.00 - - ' ":r*.� ". nce^t's or�,fon o`�;�e;o#af title insurance remium 1108. Underwriter's ortion of the total title insurance remium to FirstAmerican T�Ie ir.surance Co„.;a:^.� S �.22�.QG 1109. Estate Deed Pre aration to TudcerAresnber ,PC S 175.00 1110. S 1111. c� 1112. $ 1113. $ 1200.Government Recording and Transfer Charges 1201.Government recordin char es to Recorder's Office from GFE#7 156.00 1202.Deed 67.00 Mort a e 89.00 Releases Other 1203.Transfer t�ces to Recorder of Deeds from GFE#8 1 340.00 1204.C' ICount tax/stam s $ 1 340.00 1205.State tax/stam s $ $ 1,340.00 1,340.00 1206. 1207. 1300.Additional Settlement Charges 1301.Re uired services that ou can sho for from GFE#6 1302. 2014 Coun lTownshi to Bonnie K.Milier,Tax Colledor $ 793.00 1303. Tax Cert Reimbursement to Tudcer Arensber ,PC $ 20.00 1304. Escrow Estate Taxes to TudcerArensberg,PC $ 6,000.00 1305. Inspedion to The Inspedion Center $ 340.00 1400.Total Settiement Charges(enter on lines 103,Section J and 502,Section K) "'4 6,481.19 15,698.00 *Pad outside of closing by borrower(B),sdler(S),ler�(L),or tltirc�p�ty(T) . rn,�,,..�,.,...�,.,.«a.......i......,...«.............--•----�.__...-�----._._. . . . - -- - ... , � _ .. _ REV-i5o3 EX+(8-iz) � pennsylvania SCHEDULE B � DEPARTMENTOFREVENUE INHERITANCETAXRETURN STOCKS & BONDS RESIDENT DECEDENT ESTATE OF FILE NUMBER WAYNE E NOSS 2112-1344 Ail property jointly owned with right of survivorship must be disciosed on Schedule F. ITEM VALUE AT DRTE NUMBER DESCRIPTION OF DEATH 1' WELLS FARGO ADVISORS FUND ACCOUNT 352,521.06 AMERICHOICE 102,792.94 FIDELITY 401 K 143,664.10 TOTAL(Also enter on �ine Z, Recapitulation) $ 598,978.10 If more space is needed, insert additional sheets of the same size REV-15o8 EX+(o8-iz) r � pennsylvania SCHEDULE E DEPARTMENTOFREVENUE CASH, BANK DEPOSITS & MISC. INHERAANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: WAYNE E NOSS 2112-1344 Include the proceeds of litigation and the dake the proceeds were received by the estate. All property jointly owned with right of survivorship must be distlosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH �. PERSONAL PROPERTY 6,904.50 2006 Toyota Tacoma 8,750.00 TOTAL(Also enter an Line 5, Recapitulation) $ 15,654.50 If more space is needed, use additional sheets of paper of the same size. REV-].5I 1.EiC+ ;Of3-13� r pennsylvania SCHEDULE H DEPARTMENTOFREVENUE FUNERAL EXPENSES AND INHERITANCETAXRETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER WAYNE NOSS 2112-1344 DecedenYs debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A• FUNERAL EXPENSES: 1' FUNERAL 12,019.57 GRAVE OPENING 1,445.00 e. ADMINISTRATIVE COSTS: l. Personal Representative Commissions: Name(s)of Personal Representative(s} Street Address --- CitY_...---- ---.._ -_ _... State ZIP Year(s)Commission Paid: 2� Attorney Fees: 8,737.00 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: 590.00 5• Accountant Fees: 6• Tax Return Preparer Fees: �� HOME SALE 9,698.00 AUCTION EXPENSES 3,499.67 ADVERTISING 296.44 TOTAL(Also enter on Line 9, Recapitulation) $ 36,285.68 If more space is needed, use additional sheets o`paper of the same size. REV-1512 EX+tI2-12} � ' pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCETAXRETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER WAYNE E NOSS 2112-1344 Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses. ITEM NUMBER DESCRIPTION UALUE AT DATE OF DEATH 1' UTILITIES 2,194.01 INSURANCE 1,008.50 CREDIT CARD 634.10 TAXES-SCHOOL,COUNTY,LOCAL,INCOME 3,345.57 TOTAL(Also enter on Line 10, Recapitulation) $ 7,182.18 If more space is needed,insert additional sheets of the same size. r��j;_�.s�.o�x� taa-osa r pennsylvania SCHEDULE G DEPARTMENTOFREVENUE INTER—VIVOS TRANSFERS AND INHERITANCETAXRETURN MISC. NON—PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER WAYNE E NOSS 2112-1344 This schedule must be completed and filed if the answer to any of questions i khrough 4 on page three of the REV-1500 is yes. DESCRIPTION OF PROPERTY ITEM INCLU�ETHENAI4EOFTHETRANSFEREE,n+etaaEunohsh�FTooeceoErvrarao DATE OF DEATH %OF DECD'S EXCLUSION TAXABLE NUMBER THEDATEOF7RANSFER. ATfACHFCOPYOFTFEDEEDFORREALESTpTE. VALUEOFASSET INTEREST QFAPFLICABLE) VALUE 1• KATHLEEN MULVEY,DAUGHTER,12/02/2012 11,379.53 100 11,379.53 DONALD NOSS,SON, 12/02/2012 11,379.53 100 11,379.53 SALLIE CALLAHAN, DAUGHTER,12/02/2012 11,379.53 100 11,379.53 WAYNE NOSS,SON, 12/02/2012 11,379.53 100 11,379.53 TIM NOSS,SON, 12/02/2012 11,379.53 100 11,379.53 TOTAL(Also enter on Line 7, Recapitulation) $ 56,897.65 If more space is neetled,use additional sheets of paper of the same size.