HomeMy WebLinkAbout01-23-15 1505610143
REV-1500 Ex`°2_"'
OFFICIAL USE ONLY
PA Department of Revenue pennsylvania County code Year File Number
Bureau of Individual Taxes DEPARTMENT OF REVENUE
PO BOX.280601 INHERITANCE TAX RETURN 21 13 0840
Harrisburg,PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
07 28 2013 04 10 1924
Decedent's Last Name Suffix Decedent's First Name MI
SIPE LOIS J
(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
FILL IN APPROPRIATE OVALS BELOW
FXI 1. Original Return 2. Supplemental Return 3. Remainder Return(Date of Death
Prior to 12-13-82)
El 4. Limited Estate ❑ 4a.Future Interest Compromise 5. Federal Estate Tax Return Required
(date of death after 12-12-82)
g Decedent Died Testate 7. DecedheG,Maintained
da Living Trust 0 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) pY f C Trust)
9. Litigation Proceeds Received 10.between 12 31 91 and TDa95)f Death 11.Election to tax under Sec.9113(A)
(Attach Schedule O)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
EDMUND G MYERS (717) 761 4540
REGISTER O�WILLS I,�E; ILY
"+ M
C�'
`. rn o
C
First Line of Address L _ 7
301 MARKET STREET01 r\.� 'r t
:;Z) rte: . L`? 'i .. ii
Second Line of Address r"' rnf , r
PO BOX 109 -' _
'DATE FPLE6' ci
City or Post Office State ZIP Code A t : .y N. I-n
LEMOYNE PA 17043 o 0
Correspondent's e-mail address: eam@?jdsw.com
Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief,
it is true,correct and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNAJJdTgE.OF PERSON RESP IBLE FOR FILING RETURN DATE
CY-rA Robert W Sipe I ,�'Z
ADDRESS ell V
116 North 27th Street, Camp Hill, PA 17011
SIGNA7018E OF PRE�PARER OTHER THAN REPRESENTATIVE DATE
Edmund G. Myers
ADDRESS
301 MARKET STREET, Lemoyne, PA
Side 1
1505610143 1505610143 J
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1505610243
REV-1500 EX
RECAPITULATION
1. Real Estate(Schedule A)....................................................................................... 1. 145, 000 . 00
2. Stocks and Bonds(Schedule B)............................................................................. 2.
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C)......... 3.
4. Mortgages&Notes Receivable(Schedule D)........................................................ 4.
5. Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E)............... 5. 78, 983 . 15.
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6. 148,477 . 25
7. Inter-Vivos Transfers&MiscellaneousInn Probate Property
(Schedule G) LJ Separate Billing Requested............ 7.
8. Total Gross Assets(total Lines 1 through 7)........................................................ 8. 372, 460 . 40
9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 25, 619 . 92
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................ 10. 14 , 613 . 84
11. Total Deductions(total Lines 9 and 10)................................................................ 11. 40,233 . 76
12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 332 ,226. 64
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. 332 ,226. 64
TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116
(a)(1.2)X.00 15. 0 . 00
16. Amount of Line 14 taxable
at lineal rate X .045 332r226 . 64 16. 14 950 . 20
17. Amount of Line 14 taxable 0 . 00 17. 0 . 00
at sibling rate X.12
18. Amount of Line 14 taxable
at collateral rate X.15 0 . 00 18. 0 . 00
19. TAX DUE................................................................................................................ 19. 14 , 950 . 20
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ❑X
Side 2
1505610243 1505610243 J
REV-1500 EX Page 3 File Number 21-13-0840
Decedent's Complete Address:
DECEDENT'S NAME
SIPE, LOIS J
STREET ADDRESS
2102 Ridge Road
ZIP
CITY STATE
Camp Hill PA 17011
Tax Payments and Credits:
1. Tax Due(Page 2, Line 19) (1) 14,950.20
2. Credits/Payments
A. Prior Payments 15,000.00
B. Discount 747.51
Total Credits(A +B) (2) 15,747.51
3. Interest (3) 0.00
4, If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4) 797.31
Check box on Page 2,Line 20 to request a refund
5. If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (5)
Make Check Payable to REGISTER OF WILLS, AGENT
s
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;................................................................................ ❑ ❑x
b. retain the right to designate who shall use the property transferred or its income;..................................
ncome:.................................. ❑x
lil
c. retain a reversionary interest;or............................................................................................................... Eld. receive the promise for life of either payments,benefits or care?............................................................ ❑ ❑x
2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?.................................................................................................................... ❑ ❑x
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
containsa beneficiary designation?.................................................................................................................. ❑ 0
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
.M..�,�d .-F,g " Tit � 'Y,? "� sc:� z _. ,,, < •,�,g §r - tFy..;�.a a'` 'rxit ._.:k; ,.�.,, .�M,.. ,.�' _�...'., ��,zE
N:x
For dates of death on or after July 1,1994 and before Jan.1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
is 3 percent[72 P.S.§9116(a)(1.1)(i)].
For dates of death on or after January 1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 P.S.§9116(a)(1.1)(ii)]. The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and
filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1,2000:
• The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent,an
adoptive parent,or a stepparent of the child is 0 percent[72 P.S.§9116(a)(1.2)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's 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 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)
SCHEDULE A
pennsylvania REAL ESTATE
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
SIPE, LOIS J 21-13-0840
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 willingseller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts.
Real property that Isointly-ownedwith right of survivorship must be disclosed on schedule F.
Attach a copy of the settlement sheet if the property has been sold
Include a copy of the deed showing decedent's Interest if owned as tenant in common.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Real Estate located at 2102 Ridge Road,Camp Hill,Cumberland County, PA-Contracted 145,000.00
Sales Price. Real Estate sold on January 8,2015. A copy of the HUD-1 Settlement Sheet is
Attached
TOTAL(Also enter on Line 1, Recapitulation) 145,000.00
(If more space is needed,additional pages of the same size)
Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule A(Rev.01-10)
Rev-1508 EX+(11-10)
SCHEDULE E
pennsylvania CASH, BANK DEPOSITS, & MISC.
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
SIPE, LOIS J 21-13-0840
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property Jointly-owned with the right ofsurvivorship must be disclosed on schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Cash 59.51
2 Cash 72.71
3 M&T Bank Select 6 Month CD Account 31003913821293 21,463.55
4 M&T Bank Select Checking with Interest Account No.9843039117 5.01
5 Metro Bank 24 Month Certificate of Deposit Account—7000170939 41,910.22
6 PNC Bank Individual Checking Account No.5140058741 11,171.47
Accrued income on Item 6 through date of death 5.73
7 Sovereign Bank Checking Account No.2107865620 250.00
8 Personal Property -Valued and appraised by Chuck Bricker,Auctioneer AUU94-L 1,390.00
9 Blue Cross Rebate 180.70
10 Comcast-Reimbursement/Refund on Account 64.09
11 Erie Insurance-Refund on Account 375.00
12 PA Tax Rebate 750.00
13 PPL Rebate 70.00
14 Real Estate located at 2102 Ridge Road, Camp Hill,Cumberland County,PA- 1,186.01
Reimbursement to Estate for School Taxes Paid.A copy of the HUD-1 Settlement Sheet is
Attached
Total of Continuation Schedule See attached page
TOTAL(Also enter on Line 5,Recapitulation) 78,983.15
(If more space is needed,additional pages of the same size)
Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule E(Rev. 11-10)
Rev-1508 EX+(11-10)
SCHEDULE E
pennsylvania CASH, BANK DEPOSITS, & MISC.
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
continued
ESTATE OF FILE NUMBER
SIPE, LOIS J 21-13-0840
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
15 Reimbursement/Refund Check Received 29.15
7
TOTAL(Also enter on Line 5, Recapitulation) 78,983.15
Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule E(Rev. 11-10)
Rev-1509 EX+(01-10)
pennsylvania SCHEDULE F
DEPARTMENT OF REVENUE JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
SIPE, LOIS J 21-13-0840
If an asset was made joint within one year of the decedent's date of death,it must be reported on schedule G.
SURVIVING JOINT TENANT(S)NAME ADDRESS RELATIONSHIP TO DECEDENT
A. Virginia M Gardner 1303 Brandt Avenue Daughter
New Cumberland, PA 17070
B. Robert W Sipe 116 N 27th Street Son
Camp Hill, PA 17011
C.
JOINTLY OWNED PROPERTY:
DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM LETTER DATE FOR JOIN MADE (NCLUDE NAME OF NUMBER OR IMILARrIDENTIFY NG(TUTION AND BANK NUMB R.ATTACH DEED OUNT FOR DATE OF DEATH DECD'$ DECED NTS INTERESTVALUE OF
TENANT JOINT JOINTLY-HELD REAL ESTATE. VALUE OF ASSE INTEREST
1 A 10/23/2006 Fulton Bank Certificate of Deposit Account 80,764.20 50.000% 40,382.10
No.022-0245772
2 A 10/08/2008 Metro Bank 18 Month Certificate of Deposit 60,210.45 50.000% 30,105.23
Account No.102609
3 A 02/16/2005 PNC Bank Certificate of Deposit Account No. 56,873.21 50.000% 28,436.61
31600255457
4 B 03/19/1995 Sovereign Bank Certificate of Deposit 59,715.73 50.000% 29,857.87
Account No. 1055539595
5 A 06/08/1998 Sovereign Bank Certificate of Deposit 30,207.94 50.000% 15,103.97
Account No. 2335128704
A 06/08/1998 Accrued income on Item 5 through date of 4.97 50.000% 2.49
death
6 A 04/26/1983 Sovereign Bank Money Market Account No. 9,177.96 50.000% 4,588.98
2331031622
TOTAL(Also enter on Line 6,Recapitulation) 148,477.25
(If more space is needed,additional pages of the same size)
Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule F(Rev.01-10)
REV-1511 EX+(10-09)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX
RESIDENT DE E ENTTURN ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
SIPE, LOIS J 21-13-0840
Decedent's debts must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
See continuation schedule(s) attached 7,523.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State Zio
Year(s)Commission Paid
2. Attorney's Fees JOHNSON DUFFIE 9,000.00
3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation)
Claimant
Street Address
City State Zio
Relationship of Claimant to Decedent
4. Probate Fees 373.50
5. Accountant's Fees
6. Tax Return Preparer's Fees 68.00
7. Other Administrative Costs 8,655.42
See continuation schedule(s) attached
TOTAL(Also enter on line 9, Recapitulation) 25,619.92
Copyright(c)2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev. 10-09)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
SIPE, LOIS J 21-13-0840
ITEM
NUMBER DESCRIPTION AMOUNT
Funeral Expenses
1 Myers Harrier Funeral Home 7,523.00
H-A 7,523.00
Other Administrative Costs
2 Apria Healthcare 26.58
3 Camp Hill Borough -Sewer Invoice 825.00
4 Chuck Bricker,Auctioneer 120.00
5 Enviroquest 290.00
6 Erie Home Insurance 532.00
7 Handyman Steve 130.00
8 Joy Daniels Real Estate 395.00
9 Lawn Maintenance 600.00
10 PA American Water 547.07
11 PP&L Electric—Utility 493.07
12 Reserves: Additional Miscellaneous Administrative Expenses 150.00
13 Service Oil Co. 1,857.82.
14 Sherwin Williams 78.84
Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.6-98)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
SIPE, LOIS J 21-13-0840
ITEM
NUMBER DESCRIPTION AMOUNT
15 Skip's Hauling 325.00
16 Smart Clean 250.00
17 Snow Removal 200.00
18 Sovereign Bank-Fee for Date of Death Letter 20.00
19 The Cumberland Law Journal -Notice of Estate Administration 75.00
20 The Patriot News Co-Notice of Estate Administration 134.31
21 TW Insurance Company-Homeowners Insurance 1,603.00
22 Verizon 2.73
H-B7 8,655.42
Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.6-98)
Rev-1512 EX+(12-08)
SCHEDULE 1
pennsylvania DEBTS OF DECEDENT,
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN MORTGAGE LIABILITIES AND LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER .
SIPE, LOIS J 21-13-0840
Report debts incurred bythe 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 Camp Hill Borough -Sewer Invoice 170.25
2 Checks Clearing After Date of Death 2,053.98
3 Diane Naiper,Tax Collector 974.91
4 Holy Spirit Hospital 63.75
5 Neil Mun7 Check 130�Q1IVY v) \NDX) 165.00
6 PA American Water—Utility u 55.32
7 Pa Department of Revenue-Taxes due on 2013 PA Individual Income Tax Return 24.00
8 PP8r L Electric—Utility 160.27
9 Quantum Imaging 250.00
10 Real Estate located at 2102 Ridge Road,Camp Hill,Cumberland County,PA-Settlement 10,696.36
Costs at Closing. A copy of the HUD-1 Settlement Sheet is Attached
TOTAL(Also enter on Line 10, Recapitulation) 14,613.84
(If more space is needed,additional pages of the same size)
Copyright(c)2008 form software only The Lackner Group,Inc. Form PA-1500 Schedule I(Rev. 12-08)
REV-1513 EX+(01.10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
SIPE, LOIS J 21-13-0840
NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(S)RECEIVING PROPERTY DECEDENT (Words) ($$$)
Do Not List Trustee(s)
I� TAXABLE DISTRIBUTIONS [include outright spousal
distributions,and transfers
under Sec.9116(a)(1.2)]
1 Robert W Sipe,Jr. Great-grandchild $1,000.00
c/o Robert W.Sipe Specific Bequest
116 North 27th Street
Camp Hill, PA 17011
2 Zachuary Yohn Great-grandchild $1,000.00
1491 Brandt Avenue Specific Bequest
New Cumberland, PA 17070
3 Brandon Yohn Great-grandchild $1,000.00
1491 Brandt Avenue Specific Bequest
New Cumberland, PA 17070
4 David Gardner Grandson $1,000.00
2228 Berryhill Street Specific Bequest
Harrisburg, PA 17110
5 Virginia M Gardner Daughter 1/2 of Tangible
1303 Brandt Avenue Personal
New Cumberland, PA 17070 Property; 1/2 of
Residue
See continuation schedule attached Continuation
Total
Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 1500 cover sheet,as appropriate.
NON-TAXABLE DISTRIBUTIONS:
II. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule J(Rev.01-10)
SCHEDULE J
BENEFICIARIES
(Part I,Taxable Distributions)
ESTATE OF:
LOIS J SIPE 07/28/2013 179-12-3140
Item Name and Address of Person(s) Share of Estate Amount of Estate
Number Receiving Property Relationship (Words) ($$$)
6 Robert W Sipe Son 1/2 of Tangible
116 North 27th Street Personal Property; 1/2
Camp Hill, PA 17011 of Residue
7 Melissa Yohn Granddaughter $1,000.00 Specific
1491 Brandt Avenue Bequest
New Cumberland, PA 17070
1
ESTATE OF LOIS J. SIPE
SCHEDULE OF EXHIBITS
EXHIBIT A Last Will and Testament of Lois J. Sipe signed and dated
December 1, 2003
EXHIBIT B Copy of Receipt of Payment for Inheritance Tax Prepayment of
$15,000.00 made October 2013; Copy of Correspondence to PA
Department of Revenue requesting extension
EXHIBIT C HUD-1 Settlement Sheet for Real Estate located at 2102 Ridge
Road, Camp Hill, Cumberland County, PA that sold on January 8,
2015
EXHIBIT D M&T Bank Date of Death letter for Certificate of Deposit Account
and Individual Checking
EXHIBIT E Metro Bank Date of Death letter for Certificate of Deposit Account
EXHIBIT F PNC Bank Date of Death letter for Individual Checking Account
EXHIBIT G Sovereign Bank Date of Death letter for Individual Checking
Account
EXHIBIT H Personal Property Appraisal by Chuck Bricker, Auctioneer
License No. AUU94-L
EXHIBIT I Fulton Bank Date of Death letter for Certificate of Deposit Joint
Account
EXHIBIT J Metro Bank Date of Death letter for Certificate of Deposit Joint
Account
EXHIBIT K PNC Bank Date of Death letter for Certificate of Deposit Joint
Account
EXHIBIT L Sovereign Bank Date of Death letter for Certificate of Deposit
Joint Accounts and Joint Money Market Account
:674885
Rafst ME atib Teotament
OF
LOIS J.SIDE
L LOIS J. SIDE, of the Borough of Camp Hill, Cumberland County, Pennsylvania, being
of sound and disposing mind,memory and understanding, do hereby make,publish and declare this
as and for my Last Will and Testament, hereby revoking and making void any and all Wills or
Codicils at any time heretofore made by me. '
ARTICLE I
DEBTS
I direct the payment of all my legal debts and the expenses of my last illness and funeral
from my Estate as soon after my death as conveniently may be done.
ARTICLE 101
TANGIBLE PERSONAL PROPERTY
I give and bequeath my motor vehicles(s),household and personal effects and other tangible
personalty of like nature (not including cash or securities), together with any existing insurance
thereon, unto my son, ROBERT W. SIPE, and my daughter, VIRGINIA M. GARDNER, or the
survivor of them, to be divided between them with due regard for their personal preferences in as
nearly equal shares as is practicable.
ExHiBITA
ARTICLE III
SPECIFIC BEQUESTS
I give and bequeath the sum of ONE THOUSAND ($1,000.00)DOLLARS-unto each one
of my grandchildren and great grandchildren who survive me, subject to the provisions of Article V
hereof,
ARTICLE IV
REST,RE,SIDUV AND REMAINDER
I give, devise and bequeath all the rest residue and remainder of my Estate, of whatever
nature and wherever situate, in equal shares unto my son, ROBERT W. SIEPE, and my daughter,
VIRGINIA M. GARDNER. Should my son, ROBERT W. SIPE, predecease me, I give, devise
and bequeath his share unto my daughter, VIRGINIA M. GARDNER. Should my daughter,
VIRGINIA N. GARDNER,predecease me, I give, devise and bequeath her share unto her then-
living issue,per stupes.
ARTICLE V
UNIFORM TRANSFERS TO MINORS ACT
In the event any beneficiary of my Will has not reached the age of twenty-one (21) years at
the time for distribution of his or her share, distribution of said share may be made in the discretion
of my Personal Representative after considering the age and needs of the beneficiary; either directly
to the beneficiary or to a Custodian for such beneficiary until age twenty-one (21) under the
Pennsylvania Uniform Transfers to Minors Act, 20 Pa. C.S.A. § 5301 et seq., or the applicable
Uniform Gifts to Minors Act or Uniform Transfers to Minors Act in the state of residence of such
beneficiary as the case may be. My Personal Representative may designate as such Custodian any
2
institution or person,including my Personal Representative,qualified to act as a Custodian for such
beneficiary under such Act in effect at the time such distribution is made. A receipt for any
payment or distribution so made shall be a fall discharge therefor to my Personal Representative,
who shall not be responsible to see to,or be liable for,the application of such proceeds thereafter.
ARTICLE VI
PERSONAL REPRESENTATIVE
I name, constitute and appoint my son, ROBERT W. SIPE, and my daughter,
VIRGINIA M. GARDNER, Co-Executors of this my Last Will and Testament. Should either
fail to qualify or cease to so act, I direct the other shall complete the administration of my Estate
without the appointment of an additional individual Co-Executor. I direct that no fiduciary
appointed herein shall be required to post bond for the faithful administration of the duties
required in any jurisdiction.
IN WITNESS WHEREOF,I have hereunto set my hand and seal to this,my Last Will and
Testament this day of 4Z6xK/64L,-/ 2003.
i (SEAL)
L019 J.S `
Signed, sealed, published and declared by the above-named Testatrix, as and for her Last
Will and Testament,in the presence of us,who at her request,in her presence and in the presence of
each other,have hereunto subscribed our names as witnesses.
4,
V
2
3
h
AFFIDAVIT AND ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA .
: SS
COUNTY OF CUMBERLAND
We, LOIS J. SIDE, and
the Testatrix and the witnesses, respectively,
whose names are signed to the attach or foregoing instrument, being first duly sworn, do hereby
declare to the undersigned authority that the Testatrix signed and executed the instrument as her
Last Will and that she had signed willingly and that she executed it as her free and voluntary act for
the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the
Testatrix, signed the Will as witness and that to the best of his/her knowledge the Testatrix was at
that time eighteen years of age or older,of sound mind and under no constraint or undue influence.
LOIS J. S E'
Witness
Witness
Subscribed, sworn to and acknowledged before me by LOIS J. SIPE, Testatrix, and
subscribed and sworn _to before me by � .-� - _ �� and
witnesses,this 1 day of _c ,2003.
v
Notary Public
:2206022 NOTSEAL
DIANNE LENIG, Notary Public
Lemoyne Borough Cumberland Co.
My Commission Expires Dec.21,2005
4
COMMONWEALTH OF PENNSYLVANIA REV-1162 EX01-96)
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT.280601
HARRISBURG,PA 17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT -
NO. CD 018298
DUPLICATE
SIPE ROBERT W
116 NORTH 27TH ST
CAMP HILL, PA 17011
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
--- fold ---"'
101 $15,000.00
ESTATE INFORMATION: SSN: 179-12-3140
FILE NUMBER: 2113-0840
DECEDENT NAME: SIPE LOIS J
DATE OF PAYMENT: 10/23/2013
POSTMARK DATE: 10/22/2013
COUNTY: CUMBERLAND
DATE OF DEATH: 07/28/2013
TOTAL AMOUNT PAID: $15,000.00
REMARKS: RECEIPT TO ATTY
CHECK# 136
INITIALS: WZ
SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
EXHIBIT B
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fFFTY R. DUFFIE
L A W-' Ct i F I C h' S MIME B.GEERLEIN
E'h"HART)IN.STFAVART ANYTHONTY T LUCID0
F.,'I"'�I I:N 1.)CS. M Y F'I, C A R 0 1.-Y N i;.. IM C C I�A I N,
DAVID W,XU,(,.i-' ON
J01 IN A.STAT LER NNIATT 11 F.W`RIDLEY
,0ARXC,T)UF, FRE
),o I I,\. K.NI,o s E
Of COUNSEL
11
1. A JWINSON
1.CASSIDY
N1 1:1 j "k R G P F;F�V Y ROY AVEIDN
C.
WADF 1). 1914-2014
April 30,2014
VIA EMAIL RA-InheritanceTaxExtgstate.pa.us
Department of Revenue
Bureau of Individual Taxes
Inheritance Tax Division
P.O. Box 280601
Harrisburg,PA 17128-0601
RE: Estate of Lois J. Sipe
Date of Death: July 28,2013
Cumberland Co. File No. 21-13-0840
Our File No. 13474-1
Ladies and Gentlemen:
This firm. represents Robert W. Sipe, Executor of the Will of Lois J. Sipe. Ms. Sipe died July 28,
2013. The inheritance tax return is due to be filed on April 28, 2014.
The Executor is completing information necessary for the Return. We request a 6 month
extension to file the Inheritance Tax Return. We thank you in advance.
Very truly yours,
JO ON,DUFFIE, STEWART& WEIDNER
Edmund G. Myers
c: Robert W. Sipe, Executor
EGM:dlw:620939
301 MA-'11jJ'TS'j'i,,rr'r ff), BOX 109
W'1kAV-jj)S%V-00',1 711.77411.4 J0 1',31V717,e()1,3015
MAIL@)TY"WCOM
JOHNISON, DUFFIE, STEWART ExHiBIT B
1/8/201510:25:09 AM
OMB Approval No.2502-0265
* A. Settlement Statement(HUD-1)
B.Type of Loan
1.0FHA 2.0 RHS 3.®Conv.Unins.
6.File Number. 7.Loan Number. 8.Mortgage Insurance Case Number.
20141048 1411290000
COVA 5.0 Conv.Ins. ❑Other
C.Note: This form is furnished to give you a statement of actual settlement costs.Amounts paid to and by the settlement agent areshown.
Item's marked"(POC)"were paid outside the closing;they are shown here for informational purposes and are not included
in the totals.
D.Name&Address Boaz Payne,147 2nd Street,Apt 2,Highspire,PA 17034
of Borrower. Ran Liu,147 2nd Street,Highspire,PA 17034
E Name&Address Estate of Lois J.Sipe,2102 Ridge Rd.,Camp Hill,PA 17011
of Seller.
F.Name&Address Integrity Bank,3345 Market Street,Camp Hill,PA 17011,Loan:1411290000
of Lender.
G.Property.Location: Property Address
2102 Ridge Rd.Camp Hill,Pennsylvania 17011
PIN
01201854059
H.Settlement Agent: Great Road Settlement Services,LLC,6 S.17th Street,Camp Hill,PA 17011,(717)731-1040
Place of Settlement: 6 S.17th Street,Camp Hill,PA 17011
I.Settlement Date: 1/8/2015 Proration Date: 1/8/2015 Disbursement Date: 1/8/2015
J.Summary of BorrowAl's Transaction tL Summay of Seller's Transaction
160: Gross Amount Due from Borrower i 400:Gross Amount Doe.10 Seller
101. Contract sales price $145,000.00 401. Contract sales price $145,000.00
102. 'Personal property 402. Personal property
103. Settlement charges to borrower(line 1400)" $8,392.23 403.
104. 404.
105. 405.
Adjustment;for items paid by seller in,advance.: Adjustments for items paid by seller Irt advance'.
106. City/town taxes 406. Cityltown taxes
107. County taxes 407. County taxes
108. Assessments 408. Assessments
1.09. School Taxes 1/8/2015 to 6/30/2015 $1,186.01 409. School Taxes 1/8/2015 to 6/30/2015 $1,186.01
110. 410.
111. 411.
112. 412.
120. Gross Amount Due from Borrower $154,578.24 420. Gross Amount Due to Seller $146,186.01
200..Amounts Paid by orifi Behalf'of Borrower §90. Reductions In Amount Due to Sell-
er:
201. Deposit or earnest money $1,000.00 501. Excess deposit(see instructions)
202. Principal amount of new loan(s) $116,000.00 502. Settlement charges to seller(line 1400) $9,665.00
203. Existing loan(s)taken subject to 503. Existing loan(s)taken subject to
204. 504. Payoff of first mortgage loan
205. 505. Payoff of second mortgage loan
206. 506.
207. 507.
208. 508.
209. Repair Credit $1,000.00 509. Repair Credit $1,000.00
Adjustments for items unpaid by seller Adjustments for items unpaid by seller
210. City/town taxes 510. City/town taxes
211. County taxes 1/1/2015 to 1/8/2015 $18.70 511. County taxes 1/1/2015 to 1/8/2015 $18.70
212. Assessments 512. Assessments
213. Sewer 1/1/2015 to 1/8/2015 $12.66 513. Sewer 1/1/2015 to 1/8/2015 $12.66
214. 514.
215. 515.
216. 516.
217. 517.
218. 518.
219. 519.
220. Total Paid by/for Borrower $118,031.36,520. Total Reduction Amount Due Seller $10,696.36
300:Cash of Settlement`Froiri/to:Boftower600. Cash at Settlement tolfrom Seller:
301. Gross amount due from borrower(line 120) $154,578.24.601. Gross amount due to seller(line 420) $146,186.01
302. Less amounts paid by/for borrower pine 220) ($118,031.36)602. Less reductions in amount due seller(line 520) ($10,696.36)
303. Cash®From❑To Borrower $36,646.88 603. Cash M Top From Seller $135,489.65
SUBSTITUTE FORM 1099 SELLER STATEMENT- The information contained in Blocks E,G,H and I and on line 401(or, if line 401 is asterisked,lines 403 and 404),406,407
and 408-412(applicable part of buyer's real estate tax reportable to the IRS)is Important tax information and is being furnished to the Internal Revenue Service.R you are
required to file a return,a negligence penalty or other sanction will be imposed on you if this Item is required to be reported and the IRS determines that it has not been reported.
SELLER INSTRUCTION- If this real estate was your principal residence,file form 2119,Sale or Exchange of Principal Residence,for any gain,with your Income tax return;
for other transactions,complete the applicable parts of form 4797,Forth 6252 and/or Schedule D(Forth 1040).
You are required to provide the Settlement Agent with your correct taxpayer identification number.
If you do not provide the Settlement Agent with your correct taxpayer identification number,you may be subject to civil or criminal penalties.
ESTA LOIS J.SIIPE
Robert W.Sipe
The Public Reporting Burden for this collection of information is estimated at 35 minutes per response for collecting,reviewing,and repo EXHIBIT C
collect this information,and you are not required to complete this forth,unless it displays a currently valid OMB control number. No con
is mandatory. This is designed to provide the parties to a RESPA covered transaction with Information during the settlement process.
Previous editions are obsolete Page 1 HUD-1
1/6/2015 10:25:09 AM
Filt_Settlement Charges':'' a Numhec 20141048
700. Total Real Estate Broker Fees based on price=$4,350.00
Division of commission line 700 as follows: Paid From Paid From
701. $3,850.00 t0 Jo Daniels Real Estate Group Borrower's Seller's
702. $4,350.00 to Remax Rea Assodates Funds at Funds at
703. Commission aid at settlement$8,200.00 Settlement Settlement
704. Broker Fee to Remax Realty Associates $8,200.40
800:•Items Payable In Connection'with Loan.::::.;;.:.;;':.:::'....'>':' .;,: .
801. Our origination charge Integnty Bank"" $828.00{from GFE#1)
802 Your creel t-or charge(points)Por fire specific interest rate chosen (from GFE#2)
803. Your adjusted origination charges to integrity Bank (from GFE A)
804. Appraisal tee to Dart Appraisal $828.00
805. Credit report to Corelogic Credoo Brom GFE#3) $q,qp 40
806. Tax service to Everbank. {from GFE#3}
(from GFE#3) $60.26
807. Flood certification to Corelogic Credce $74.00
808. (from GFE#3) $12.00
900.Items;Required-11i)i-ender fo Be EBid.o Advance;'-';.:{' 2'::•., r,.:^. . ..,
901. Daily interest charges from 1/8/15 to 2/1/15 @$14.5000/day {from GFE#10)
902. Mortgage insurance premium for $348.00
903. Homeowner's insurance for 1 year to Allstate (tram GFE#31
904. (from GFE#11) $579.71
905.
1000:Reserves Deposited with i::e'nder."::..
1001.Initial deposit for your escrow account (from GFE#9)^ }
1002.Homeowner's insurance 3 mo.+�$49.6500 per mo. $2'166'76
1003.Mortgage insurance $148.95
1004.City property taxes
1005.County property taxes 12 mo.@$82.9000 per mo. $994.80
1006.School Taxes 8 mo. $2
1007. 12.7700 per ma. $1,742.16
1008.
1009.Aggregate Adjustment ($679.15)
1.160.1itle Charges
1101.�en
nd lenders title insurance (from GFE#4)
1102. bsing fee $765.001103. surance to Great Road Settlement Services,LLC (from GFE 95)
1104.Lender's title insurance to Great Road Settlement Services,LLC $1,126.00
PA 100 No Violation of CCRs STG$50.00 $250.00
PA 300 Mortgage Survey Exception STG$50.00
PA 900 EPL STG$50.00
PA 1100 Waiver of Arbitration STG$100.00
1105.Lender's title policy limit$116,000.00
1108.Owner s title policy limit$145,000.00
1107.Agent's portion of the total ft insurance premium to Great Road Settlement Services,LLC $1,206.25
1108.Underwriter's portion of the total title insurance premium to Stewart Title Guaranty Company 6168.75
1109.Closing Protection Letter to Stewart Title Guarerity Company $125.00
1110•Doc Prep Fea to Great Raad Settlement Services,LLC $250.00
1111.OvemighlM/ire to Great Roan Settlement Services,LLC $65 00
1112,Notary Fee to Cash $25.00
1111 ErecordingiRecarding Services Fee to Great Road Settlement Services,LLC $50.00
1114.Reimbursement far Tax Certification ftam Diane Neper to Great Road Settlement Services,
1115. LLC
$15.00
1206.Goverrimerrt Recording and TrahsfdrCtiahges
1201.Gave mmant recording charges (from GFE#7)1202. Deed$79.00 Mortgage$114.50 Releases $193.50
1203-Transfer taxes $193.50
1204.City/County tax/stamps Deed$1,450.00 (from GFE#8) $1,450.00
1205.State tax(stamps Deed$1,450.00 $.1'450.00
1206.UPI Ceruncation $1,450.00
1207.E-Recording Fee
1300:Additfonai Settlement Charges
1301.Required services that you can Shap for l ;(from GFE#6) "
1302.4th quarter Sewer to Camp Hill Borough Sewer Authority
1303.2014-15 School Taxes on 7/21/2014 to Diane Neiper POCS$165.4
1304.2014 Countyflownship Taxes on 3/1212014 to Diane Neiper POC$.$2,502.2
1305. POC$.6974.91
1400,Total Settlement Charges(enter on lines 103,Section J and 502,Section K)
In dudes Origination Point($828.00). $8,392.23 $9,665.00
hems marked"POC"were paid outside the dosing by:Borrower(POCB),Lender(POCL),Mortgage Broker(POCM),Other(POCO),Real Estate Agent(POCK),or Setter(POC$.),
Previous editions are obsalefe Paga 2
HUD-1
1/8/2015 10:25:09 AM File Number.20141048
CERTIFICATION:
" I have carefully reviewed the HUD-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 certify that I have received a copy of HIJD-1 Settlement Statement The Settlement Agent does not warrant or
represent the accuracy of information provided by any party,including information concerning POC items and infonmatlon supplied by the lender in this transaction appearing on
this HUD-1 Settlement Statement pertaining to'Comparison of Good Faith Estimate(GFE)and HUD-1 Charges'and'Loan Terms',and the parties hold harmless the
Settlement Agent as to any inaccuracies in such matters.
ESTAT F LOIS J.SIPE _
soazrPayp .��. -� �X rie
R Liu/ bert W.Sipe
To the best of my knowledd HUD-1 Settlement Statement which I have prepared is a true and accurate account of the funds which were received and have been or will be
disbursed by the igAef fined as partof the ement of this transaction.
u �
9mles,A Miller,Esq. are
ARNING: It is a crime to knowingly m e false statements to the United States on this or any r similar fo a Was upon conviction can include a fine and
imprisonment Fordetalls see:Title 10• .S.Code Section 1001 and Section 1010.
Previous editions are obsolete Page 3 HUD-1
p M8,T '
ank
499 Mitchell Road,Millsboro,DE 19966 Adjustment Services
Phone 888-502-4349
F ax (302)934-2955
September 20,2013.
Law Offices
Johnson Duffie
301 Market Street
P.O. Boz 109
Lemoyne,PA 17043-0109
Re: Estate of Lois I Sipe
Social Security: 179-12-3140
Date of Death: July 28,2013
Dear Sir or Madam:
Per your inquiry on September 16,2013,please be advised that at the time of death,the above-named decedent
C� had on deposit with this bank the following:
1. Type ofAccount Checking Account
�I AccountNumber 9843039117
Ownership(Names oJ) Virginia M Gardner(POA)
Lois J.Sipe
Opening Date 09105/2006
Balance on Date of Death $ 5.01 -
Accrued Interest $ .00
Total $5.01
2. 7jpe of Account Certificate of Deposit
Account Number 31003913821293
Ownership(Names ojq Virginia M Gardner(POA)
Lois J.Sipe
Opening Date 12102/199
Balance on Date of Death $21,461.90
Accrued Interest $ 1.65
-----------------------------------
Total $21,463.55 --
EXHIBIT D
METRO
3801 Paxton Street 888.937.0004
BANK Harrisburg, PA 17111 mymetrobank.com
September 18, 2013
Dana L. Wieseman
Law Offices Johnson Duffie
301 Market St PO Box 109
Lemoyne PA 17043-0109
RE: Estate of: Lois J Sipe
Tax Identification Number: 17912-3140
Date of Death: July 28, 2013
To Whom It May Concern:
This letter is in reference to decedent account information you requested for the
individual listed above.
We are able to provide the following:
Account Type:24 Month CD
Account Number. 7000170939
Date Opened: August 26, 2009
Sole Owner: Lois J. Sipe
Date of Death Balance: $41,910.22
Principal Balance: $411907.31
Accrued Interest: $2.91
Account Type: 18 Month CD
Account Number: 102609
Date Opened: October 8, 2008
Primary Owner: Lois J. Sipe
Secondary Owner: Virginia Mae Gardner(added at opening)
Date of Death Balance: $60,210.45
Principal Balance: $60,198.36
Accrued Interest: $12.09
Please feel free to contact me at (888) 937-0004 if I may be of further assistance.
Sincerely,
RECEIVED
Cindy Stanbery d SEP 19 2013
Support Associate/Deposit Services
Metro Bank JOHNSON. DUFFIE-
EXHIBIT E
Sep. 30. 2013 11 :30AM PNC Bank No. 5751 P. 1
. ,
September 30,2013
Dana L Wieseman
Johnson Duffie Law Offices
301 Market St
P O Boaz 109
Lemoyne,PA 17043-0109
RE: Lois J Sipe
SSN: 17912-3140
DOD: 07-28-2013
Dear Sir/Madam:
In response to your request for Date of Death(DOD)balances for the customer noted above, our
records show the following:
Certificate of Deposit
Account#31600255457 Established: 02-16-2005
LOIS J SIPE
VIRGINIA M GARDNER
DOD balance: $ 56,865.32+7.89 accrued interest
Interest paid 01-01-2013 thru 07-28-2013 $ 118.26 YTD
5C �� Checldng Account
�p Account#5140058741 Established: 08-01-1966
LOIS J SIPE
DOD balance: $ 11,171.40+0.07 accrued interest
Interest paid 01-01-2013 thru 07-28-2013 $ 0.79 YTD
Please note that this office provides date of death balances for deposit aecounrs(IRAs,CDs,Checking and
Savings). We do not process any financial transactions or provide statements. Tf you need assista2ace with
any of these items,please call 1-888-PNC-BANK(1-888-762-2265)or stop by your local PNC Bank branch
office_
Sincerely,
National Financial Services Center _
PNC Bank,N.A. RECEIVED
Member FDIC SEP 10 2013
3
JOHNSON DUFF►E
Page
EXHIBIT F
�—m
Sovereign Bank
ESTATE OF Lois J Sipe
SOCIAL SECURITY#: 179-12-3140
DATE OF DEATH: July 28, 2013
Account#: 2331031622 Type: Money Market Open date: 4/26/1983
In the name of: Lois J Sipe or Virginia Mae Gardner
Date of Death Balance: $9,177.96
Int.(YTD)from 1/1/2013 to 7/8/2013 $10.37
Accrued interest to date of death: $0.00
Other Info:
Account#: 2107865620 • Type: Checking Open date: 2/26/2013
In the name of: Lois J Sipe(Virginia Mae Gardner POA)
Date of Death Balance: $250.00
Int.(YTD) from 1/1/2013 to 7/28/2013 $0.00
Accrued interest to date of death: $0.00
Other Info:
Account#: 1055539595 Type: CD Open date: 3/19/1995
In the name of. Lois J Swipe or Robert W Sipe
Date of Death'Balance: $59,715:73
Int.(YTD)from 1/1/2013 to 7/19/2013 $99.32
Accrued interest to date of death: $5.73
Other Info:
Account#: 2335128704 Type: CD Open date: 6/8/1998
In the name of: Lois J Sipe or Virginia Mae Gardner
Date of Death Balance: $30,207.94
Int.(YTD)from 1/1/2013 to 7/8/2013 $15.73
Accrued interest to date of death: $4.97
Other Info:
Page 1 c EXHIBIT G
APPRAISAL
vmnol Era rty of k0IS v JP fs7`,+F& -.l0 A P,td 4YPHILL PA, 17611
by CMuk E.Bdclw ASF
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EXHIBIT H
Fultm Bank
LISTENING IS JUST THE BEGINNING!
September 23, 2013
Law Offices Johnson Duffle
301 Market St
PO Box 109
Lemoyne PA 17043
Dear Ms. Wieseman,
RE: Lois J Sipe, deceased 7/28/2013
In response to your recent inquiry concerning the accounts maintained in the name of
the decedent,please be advised that the following account was open at the date of death:
DATE OF DEATH ACC
✓ CD# BALANCE INT RATE OPEN ROLL OVER MATURITY
022-0245772 80763.54 .66 .05 10/23/06 4/23/13 4/23/14
(titled jointly always with Virginia M Gardner)
If you should have any further questions,please do not hesitate to contact me at 717-327-2497;
Very truly yours,
-f.
N A L
April Co
k*"T*' 0M im tW—M---t*0 v�a rne.-OW et MA Credit Confirmation Processor
WWWOF to Y17"A OW'My.arms for Y--Uf conf--Wto- 4111,11"Y
T�* '&A,
m' 'qJ9
al
RECEIVED
SEP 2 6 2013
JOHNSON, DUFFLE
1.800.FULTON.4 Cult
Fulton Bank,NA Member FDIC Member of the EXHIBIT
i
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i
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METRO
3801 Paxton Street
BANK Harrisburg, PA17111 my m t oba k.com
September 18, 2013
Dana L. Wieseman
Law Offices Johnson Duffie
301 Market St PO Box 109
Lemoyne PA 17043-0109
RE: Estate of: Lois J Sipe
Tax Identification Number: 17912-3140
Date of Death: July 28, 2013
To Whom It May Concern:
This letter is in reference to decedent account information you requested for the
individual listed above.
We are able to provide the following:
Account Type:24 Month CD
Account Number: 7000170939
Date Opened: August 26, 2009
Sole Owner: Lois J. Sipe
Date of Death Balance: $41,910.22
Principal Balance: $41,907.31
Accrued Interest: $2.91
5�� { Account Type: 18 Month CD
Account Number: 102609
Date Opened: October 8, 2008
Primary Owner: Lois J. Sipe
Secondary Owner: Virginia Mae Gardner(added at opening)
Date of Death Balance: $60,210.45
Principal Balance: $60,198.36
Accrued Interest: $12.09
Please feel free to contact me at (888) 937-0004 if I may be of further assistance.
Sincerely,
RECEIVED
Cindy Stanbery SEP 19 2013
Support Associate/Deposit Services
Metro Bank
EXHIBIT J
Sep. 30, 2013 11 :30AM PNC Bank No. 5751 P. 1
wc
September 30,2013
Dana L Wieseman
Johnson Duffie Law Offices
301 Market St
P0Box 109
Lemoyne,PA 17043-0109
RE: Lois J Sipe
SSN: 179-12-3140
DOD: 07-28-2013
Dean Sir/Madam-
In response to your request for Date of Death(DOD) balances for the customer noted above, our
records show the following:
Certificate of Deposit
Accouat#31600255457 Established:02-16-2005
LOIS J SIPE
VIRGRQA M GARDNER
DOD balance: $ 56,865.32+7.89 accrued interest
Interest paid 01-01-2013 thru 07-28-2013 $ 118.26 YTD
Checldng Account
Account#5140058741 Established: 08-01-1966
LOIS J SIDE
DOD balance: $ 11,171.40+0.07 accrued interest
Interest paid 01-01-2013 thru 07-28-2013 $ 0.79 YTD
Please note that this office provides date of death balances for deposit accounts(IRAs,CDs, Checking and
Savings). We do not process any financial transactions or provide statements. if you need assistance with
any of these items,please call 1-888-PNC-13ANK(1-888-762-2265)or stop by your local PNC Bank branch
office-
Sincerely,
National Financial Services Center
PNC Bank,N.A. RECEIVED
Member]FDIC SEP 3 0 2013
JOHNSON QUFFIE
Pagel of 2
EarHiarr K
i
i
��
Sovereign Bank
ESTATE OF Lois J Sipe
SOCIAL SECURITY#: 179-12-3140
DATE OF DEATH: July 28,2013
Account#: 2331031622 Type: Money Market Open date: 4/26/1983
In the name of. Lois J Sipe or Virginia Mae Gardner
Date of Death Balance: $9,177.96
Int.(YTD)from 1/1/2013 to 7/8/2013 $10.37
Accrued interest to date of death: $0.00
Other Info:
Account#: 2107865620 Type: Checking Open date: 2/26/2013
In the name of: Lois J Sipe(Virginia Mae Gardner POA)
Date of Death Balance: $250.00 -
Int.(YTD) from 1/1/2013 to 7/28/2013 $0.00
Accrued interest to date of death: $0.00
Other Info:
Account#: 1055539595 Type: CD Open date: 3/19/1995
In the name of Lois J Swipe or Robert W Sipe
Da a of Death Balance:-. $59,715.73 -
Lnt-(YTD)from' 1/1/2013 to 7/19/2013 $99.32
Accrued interest to date of death: $5.73 y
Other Info:
Account#: 2335128704 Type: CD Open date: 6/8/1998
--------------
-In the name of Lois J Sipe or Virginia Mae Gardner
Date of Death Balance: $30,207.94 -
Int.(YTD)from 1/1/2013 to 7/8/2013 $15.73
Accrued interest to date of death: $4.97
Other Info:
Page 1 of 1 EXHIBIT L
f
Hasler i, FIRST-�✓. � ��
01/22/2015 $4
5C
z1v
0110 17043
X11621515
First Class Mail ;..
'J�
(LL A W 0 FTFF I(C EE SST 301 Market Street
11 V JVl V P.O.Box 109
Lemoyne,Pis
DUFFIE 17043-0109
0
TO: o
REGISTER OF WILLS OFFICE
CUMBERLAND COUNTY COURTHOUSE
ONE COURTHOUSE SQUARE
CARLISLE, PA 17013
0
i
1
k
ryt
7,
JERRY R.DUFFLE L A W O F F I C E S BARRIE B.GEHRLEIN
RICHARD W.STEWARTW.DARREN POWELL
EDMUND G.MYERS JMSON
ANTHONY T.LUC1D0
DAVID W DELUCE CAROLYN B.MCCLAIN
JOHN A.STATLER JOHN A.LUCY
JEFFREY B.RETTIG FIE MATTHEW RIDLEY
DU MARK C.DUFFIE KAREN L.MASCIO
JOHN R.NINOSKY BRIAN W.CARTER
MICHAEL J.CASSIDY
MELISSA P.GREEVY WP6; ;A OF COUNSEL
WADE D.MANLEY 1914-2014 HORACE A.JOHNSON
C.ROY WEIDNER,JR.
Y"S".L'•i I::Y.L:..Iih. No. 1.14
January 22, 2015
Register of.Wills Office
Cumberland County Courthouse
One Courthouse Square «�
Carlisle, PA 17013
RE: Estate of Lois J. Sipe c- CO
Date of Death: July 28, 2013
Your File No. 21-13-0840 .'' cr> .r-'D CD
Our File No. 13474-1 :�
r• r.,J
.47
Dear Register:
ru M
Enclosed for filing, please find the following:
1. 2 Original Pennsylvania Inheritance Tax Returns. There is no inheritance tax due.
The estate will be due a refund.
2. Two (2) copies of Page 1 of the Inheritance Tax Return that we ask that you time-
stamp and return to us.
3. Inventory.
4. Two (2) copies of Page 1 of the Inventory that we ask that you time-stamp and return
to us.
Thank you for your assistance in this matter. Should you have any questions, or require any
additional information, please feel free to contact us.
Very truly yours,
JOHNSON, DUFFIE, STEWART &WEIDNER
Dana Wieseman
Estate Administration Paralegal
Enc.
c: Robert W. Sipe, Executor
:674936
301 MARKET STREET P.O,BOX 109 LEMOYNE,PENNSYLVANIA 17043-0109
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