HomeMy WebLinkAbout02-20-15 � 15�5610105
REV-1500 EX(02-11)(FI)
OFFICIAL USE ONLY
PA De artment of Revenue pennsylvania County Code Year File Number
P DEPARTMENT OF REVENUE
Bureau of Individual Taxes INHERITANCE TAX RETURN �` ��r�
PO BOX 280601
Harrisburg,PA 17128-0601 RESIDENT DECEDENT �I / �O �
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
01152013 0726],937
DecedenYs Last Name Suffix DecedenYs First Name MI
STAIGER SUZANN S
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Nam� MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE BOXES BELOW
QX 1. Original Return Q 2. Supplemental Return Q 3. Remainder Return(Date of Death
Priorto 12-13-82)
Q 4. Limited Estate Q 4a. Future Interest Compromise(date of Q 5. Federai Estate Tax Return Required
death after 12-12-82)
Q 6. Decedent Died Testate Q 7. Decedent Maintained a Living Trust � 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust.)
Q 9. Litigation Proceeds Received Q 10. Spousal Poverty Credit(Date of Death Q 11. Election to Tax under Sec.91t3(A)
Between 12-31-91 and 1-1-95) (Attach Schedule O)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
��
SCOTT STAIGER 717-32�5776 ;::_� -��
�s-, ;:�
REGI�zE, F WILLSth6�ONI,Y� C'
C:'7 � C"''1 . �=
,,....,� -.,.:.7 � � �..::'i ;:
First Line of Address , r`�
_ ' _ C�
628 NORTH FRONT STREE � '
, - ,
Second Line of Address � --=� ...'�
.. ��_: �, �,�.:; C..,J
C� � I��'7
City or Post Office State ZIP Code DATE FILE� r,;; <;:�
WORMLEYSBURG PA 17043
CorrespondenYs e-mail address:
Under penalties of pery'ury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowiedge and belief,
it is true correct and com lete.Declaration of re arer other than the ersonal re resentative is based on all information of which re arer has an knowled e.
SIG URE O PE SON SIBLE FOR FI ING RETURN DATE
�.. • ��.� � �4�od � �
ADDRESS
628 N FRONT ST� WORMLEYSBURG, PA 17043
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
Side 1
L 1505610105 150561�1�5 �
�
� 15056102�5
REV-1500 EX(FI)
DecedenYs Social Security Number
Decedent'SName: SUZANN S STAIGER
RECAPITULATION
1. Real Estate(Schedule A).... ..... ... ..... ... ... ...... ... ... .... . . . 1. 2 O 2 7 0 0 . 0 0
2. Stocks and Bonds(Schedule B)... ..... ... ... ... ... ... ... ... .. ... ... 2. � . �0
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C). . . 3. 0 . 0 0
4. Mortgages and Notes Receivable(Schedule D). . . . . . . .. . .. . . . . . . .. . . . . . 4. 3�2 8 2 O . �8
5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E). . . . . 5. 4 61�2 . 5 8
6. Jointly Owned Property(Schedule F) �Separate Billing Requested. . . . . .. 6. 3 3 9 7 9 . 8 7
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) 0 Separate Billing Requested. . . . . . . 7. 0 . 0 0
8. Total Gross Assets(total Lines 1 through 7). . . . . . . . . . .. . . . . . . . . . . . . . . . 8. 6 S 5 6�3 . 2 3
9. Funeral Expenses and Administrative Costs(Schedule H). . .. . . . . . . .. . . . . . 9. 2�S 1 O . �0
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I). . . . . . .. . . . . .10. 113 9 O 9 . 3 9
11. Total Deductions(total Lines 9 and 10).. . . . .. . .. . . . . . . . . . . . . . . . . . . . . 11. 141419 . 39
12. Net Value of Estate(Line 8 minus Line 11).. . .. . .. . .. . . .. . . . . . . . . . . . . .12. 51418 3 . 8 4
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J). . . . . . . . . . . . . . . .. . . . .. 13. 0 . 0 0
14. Net Value Subject to Tax(Line 12 minus Line 13).. . .. . .. . .. . .. . . . . . . . . 14. 51418 3 . 8 4
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable at
the spousal tax rate,or
transfers under Sec.9116
(a)(1.2)X.0 0 15. 0 • ��
16. Amount of Line 14 taxable
at�inea�rate x.0 4 5 51418 3 . 8 4 �s. 2 313 8 . 2 7
17. Amount of Line 14
taxable at sibling rate X . 12 17. � . ��
18. Amount of Line 14 taxable
at collateral rate X . L 5 18. � . ��
19. TAXDUE... ... .. ... .. . ..... ..... ... ..... ... . ... ... ... ... ... . . . . . 19. 23I,38 . 27
20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT �x
Side 2
L 1505610205 1505610205 �
REV-1500 EX(FI) Page 3 File Number 175-30-4626
DecedenYs Complete Address: 2o�s-oo282
DECEDENT'S NAME
SUZANN S STAIGER
STREET ADDRESS
310 GLENDALE DR
CITY STATE ZIP
SHIREMANSTOWN PA 17011
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 23138.27
2. Credits/Payments
A.Prior Payments 24000.00
B.Discount 1156.91
Total Credits(A+B) (2) 25156.91
3. Interest
(3)
4. If Line 2 is greater than Line 1 +Line 3,enter the difference.This is the OVERPAYMENT.
Fill in box on Page 2,Line 20 to request a refund. (4) 2018.64
5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 0.00
Make check payable to: REGISTER OF WILLS, AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred......................................................................................... ❑ ❑X
b. retain the right to designate who shall use the property transferred or its income............................................ ❑ QX
c. retain a reversionary interest............................................................................................................................. ❑ �
d. receive the promise for life of either payments,benefits or care?..................................................................... ❑ �
2. If death occurred after Dec.12, 1982,did decedent transfer property within one year of death
without receiving adequate consideration?............................................................................................................. ❑ �
3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death?............. � �
4. Did decedent own an individual retirement account,annuity or other non-probate property,which
containsa beneficiary designation?....................................................................................................................... ❑ �
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1,1994,and before Jan.1, 1995,the tax rate imposed on the net value of transfers to or for the use of the 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 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)
pennsylvania SCHEDULE A
DEPARTMENT OF REVENUE REAL ESTATE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Suzann S Staiger 2013-00282
AII 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 wiiling seller,neither being compelled to buy or seil,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 decedenYs interest if owned as tenant in common. VALUE AT DATE
NUMBER OF DEATH
DESCRIPTION
1. 310 Glendale Drive,Shiremanstown, PA Cumberland County Tax ID#48-24-0795-028 202,700.00
TOTAL(Also enter on Line 1, Recapitulation.) $ 202,700.00
If more space is needed,use additional sheets of paper of the same size.
OMB Approval No.2502-0265
V'.�il���;�� ' A. Settlement Statement (HUD-1) FINAL
.- . ..
1.❑FHA 2.❑RHS 3.Q Conv.Unins. 64-3081NMmber: 3333317gNumber: 8.Mortgage Insurance Case Number:
4.Q VA 5.Q Conv.Ins.
C.Note:This form is furnished to give you a statement of actual setllement costs.Amounts paid fo and by the settlement agents are shown Items marked
"(p.o.c)"were paid outside the closing;they are shown here for informational purposes and are not included in the totals.
D.Name&Address of Borrower: E.Name&Address of Seller: F.Name&Address of Lender:
Mark S.Reed,Lisa A.Reed Estate of Suzann S.Staiger Metro Bank
411 Lamp Post Lane,Camp Hill,PA 17011 310 Glendale Drive,Shiremanstown PA 17011 3801 Paxton Street,Harrisburg,PA 17111
G.Property Location: H.Settlement Agent: I.Settlement Date:06/12/2014
310 Glendale Drive North Mountain Settlement Services,L.P. Disbursement Date:06/12/2014
Shiremanstown PA 17011 1250 North Mountain Road,Harrisburg,PA 17112
48-24079�028,Lower Allen Township
Telephone:717-364-3140 Fax:717-364•3144
Place of Settlement: TitleExpress
1250 North Mountain Road,Harrisburg,PA 17112 Printed 06/11I2014 at 5:23 pm
by BG
:, �
100. Gross Amount Due from Borrower 400. Gross Amount Due to Seller
101. Contract sales price 210,000.00 401. Contract sales price 210,000.00
102. Personal ro ert 402. Personal ro ert
103. Settlement charges to borrower(line 1400) 10,557.28 403.
104. 404.
105. 405.
Ad ustments for Items aid b seller in advance Ad ustments for items afd b seller in advance
106. Cityltown taxes to 406. Cityltown taxes to
107. County taxes 06112/2014 to 12/31/2014 528.98 407. County taxes O6/12/2014 to 12/3112014 528.98
108. Assessments to 408. Assessments to
109. School taxes 06I12I2014 to 06/30l2014 129.67 409. School taxes 06I12I2014 to 06/30/2014 129.67
110. Sewer&Trash 2nd 0 06112/2014 to 06/30/2014 25.62 410. Sewer 8 Trash 2nd Q 06/12/2014 to 06/3012014 25.62
111, 411.
��2, 412.
�ZD• Gross Amount Due from Borrower 221,241.55 420. Gross Amount Due to Seller 270,684.27
200. Amounts Paid b or fn Behalf of Borrower 500. Reductions In Amount Due to Seller
201. Deposit or earnest money 2,000.00 501. Excess deposit(see instruclions)
202. Principal amount ot new loan(s) 105,000.00 502. Settlement charges to seller(line 1400) 14,900.00
203. Existin loa s taken sub'ect to 503. Existin loan s taken sub'ect to
204. 504. payoft of first morigage loan#0133120279 to 102,847.37
Suntrust Mort a e,Inc.
205. 505. Payoff ofsecond mortgageloan
206. 506.
207. 507.
208. 508.
209. 509.
Ad ustments for items un ald b seller Ad ustments for items un aid b seller
210. City/town taxes to 510. Cityltown taxes to
211. County taxes to 511. Countytaxes to
212. Assessments to 512. Assessments to
213. 513.
214. 514.
215. 515.
216. 516.
217. 517.
218. 518.
p�g, 519.
Z2�• Total Paid b Ifor Borrower 107,000.00 520. Total Reduction Amount Due Seller 717,747.37
300. Cash at Setflement fromlto Borrower 600. Cash at Settlement tolfrom Seller
301. Gross amount due from borrower(line 120) 221,241.55 gp�, Gross amount due to seller(line 420) 210,684.27
302. Less amounts paid by/(or borrower(line 220) 107,000.00 602. Less reduclions in amount due seller(line 520) 117,747.37
303. Cash QX From ❑ To Borrower 114,241.55 603. Cash ❑X To ❑ From Selier 92,936.90
es ver respon or w ec up,ieviewup,an repo p e a , is apency may na w ec rs m orma ion,a you are no reQuire o
Ihis brm�unless II4 sl O�ays e curromly veIIC OMBlwnlral nwtlber.No confitlenllalky is essureE;lhis Elsclosure Is me,Walory.T�is Is tleslpneG Io provlde I�e pa�ies to e RESPA eoveretl InnsaGlon with Inbrmalion duAnp I�e
salllemen�0�ocasa.
Previous editions are obsolete Page 1 of 4 HUD-1
700. Total Real Estate 8roker Fees $12,600.00 Paid From Paid From
Divisionofcommission Iine700 asfollows: Borl'ower'S Selle�'s
��� $6,300.00 �o For Sale By Owner Plus Realtors FundS at FUndS at
7�2• $6,300.00 to Coldwell 8anker Homeslead Group Settlement Settlement
703. Commission paid at settlement 12,600.00
800. Items Pa able In Connection with Loan
801. Our origination charge (Includes Origination Point 0.000%or$0.00) $995.00 (from GFE#1)
802. Your credit or charge(points)for the specific interest rale chosen $1,050.00 (from GFE#2)
803. Your adjusted origination charges (from GFE A) 2,045.00
804. Appraisal fee to Premier A raisal Service $375.00 P.O.C.B`(from GFE#3)
805. Credit report to E uifax Mort a e Solutions (from GFE#3) 25.66
806. Tax service to from GFE#3
807. Flood certi(ication to Wolters Kluwer Financial SvcslPCl ((rom GFE#3) 6.00
808. to
900. Items Re uired b Lender to be Paid in Advance
901. Daily interest charges from from 06/12/2014 to 07/05I2014 @$14.5833/day (from GFE#10) 335.42
902. Mortgage Ins.Premium for months to (from GFE#3)
903. Homeowner's insurance for 1 ears to Erie Insurance Com an (trom GFE�11) 1,033.00
904. months to from GFE#11
1000. Reserves De osited wfth Lender
1001. Initial deposit tor your escrow account (from GFE#9) 2,865.50
1002.Homeowner's insurance 3 months $ 86.OB/month $258.24 to Metro Bank
1003.Mortgage Insurance months $ O.00lmonth $ to
1004.City Properly Tax months $ 0.00/monih $ to
1005.County Property Tax 5 months $ 80.881month $404.40 to Metro Bank
1006.School Property Tax 13 months $ 207.58Imonth $2,698.54 to Metro Bank
1007.Aggregate Adjustment $-495.68 to Meho Bank
1100.Title Char es
1101. Title services and lender's title insurance from GFE#4 1,330.00
1102. Seltlement or closing fee to $
1103. Owner's title insurance from GFE#5 525.00
1104. Lender's title insurance Old Re blic Title $1,200.00
1105. Lender's title policy limit$105,000.00 Lender's Policy
1106. Owner's title policy limit$210,000.00 Owner's Policy
1107. AgenPs portion oi�he total title insurance premium $1,452.00
to NoRh Mountain Settlement Services L.P.
1108. Underwriter's portion o(lhe total titie insurance premium $273.00
to Old Re ublic National Title Insurance Co.
1109.Overnight Fee to North Mountain Settlement; 20.00
1110. Deed Prep to Guardian Transfer,Inc. 125.00
1111. Notary Fee to Belh A.Giovanniello 20.00
1112. Tax Certification to North Mountain Seltlement: 35.00
1200. Government Recordin and Transfer Char es
1201. Government recording charges $ (from GFE#7) 169.00
�2�z. Deed$66.50 Mort a e$102.50 Release$ to Cumberland Count Recorder
1203. Transfer taxes $ (irom GFE#8) 2,100.00
1204. CitylCounry taxlslamps Deed$2,100.00 Mort a e$ to Cumberland Count Recorder
1205. State Taxlstamps Deed$2,100.00 Morf a e$ to Cumberland Count Recorder 2,100.00
t 206. Deed$ Mort a e$ to
12W. $ to
1300.Additfonal Settlement Char es
1301.Required services that you can shop for (from GFE#6)
1302. to
1303. 2013-14 School Tax to Jud Prowell,Tax Collector $2,490.98 P.O.C.S'
1304.2014 Co&Twp Tax to Bonnie Miller $951.13 P.O.C.S'
1305. 3rd�uaRer Sewer&Trash to Lower Allen Townshi �22•��
,�� i , , � 10,557.28 14,900.00
`Paid outside of closing by(B)orrower,(S)eller,(L)ender,(I)nvestor,Bro(K)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 of Good Faith Estimate GFE and HUD•1 Char es Good Faith Estimate HUD-1
Char es That Cannot Increase HUD-1 Line Number
Our origination charge # 8�� 995.00 995.00
Your credit or charge(points)for the speci(ic interesf raie chosen # 802 1,050.00 1,050.00
Your adjusted origination charges # 803 2,045.00 2,045.00
Transfertaxes g 1203 4,200.00 2,100.00
Char es 7hat in Total Cannot Increase More Than 10% Good Faith Estimate HUD-1
Government recording charges # 1201 250.00 169.00
Appraisaliee # 804 375.00 375.00
Credit report # 805 25.66 25.66
Flood certification # 807 6.00 6.00
q 1302 0.00 0.00
#
#
#
656.66 575.66
. , � $ -81.00 or -12.3352%
Char es That Can Chan e Good Faith Estimate HUD-1
Initial deposit for your escrow account # 1001 2,580.00 2,865.50
Daily interesl charges from p 901 $14.5833/da 335.42 335.42
Homeowner's insurance # 903 720.Op 1,033.00
Title services and lenders title insurance q 1101 1,390.00 1,330.00
Owner's tiUe insurance # 1103 525.00 525.00
#
#
Loan Terms
Your initial loan amount is $105,000.00
Your loan term is 30.years
Your initial interest rate is 5.0000%
Your initial monthly amount owed for principal,interest,and any mortgage $563.66 includes
insurance is XQ Principal
QX Inlerest
❑Morlgage Insurance
Can your interest rate rise? ❑No. XQ Yes,it can rise to a maximum ot 11.0000%a. The first change
will be on 07/0512019 and can change again every 12 Months after 07/0512019. Every
change date,your interest rate can increase or decrease by 2°/a. Over the life of the loan,
your interest rate is guaranteed to never be lower than 5.0000%or hfgher ihan 11.0000%.
Even if you make payments on lime,can your loan balance rise? QX No. ❑Yes,ii can rise to a maximum o($ .
Even if you make payments on time,can your monthly amount owed(or ❑No. ❑X Yes,the first increase can be on 08/05/2019 and the monihly
principat,interest,and moftgage insurance rise? amount owed can rise to$681.48.
The maximum it can ever rise to is$934.93.
Does your loan have a prepayment penalty7 QX No. ❑Yes,your maximum prepayment penalty is$ .
Does your loan have a balloon payment? ❑X No. ❑Yes,you have a balloon payment of$ due in
years on I I .
Tolal monthly amount owed including escrow account payments ❑You do not have a monthly escrow payment tor items,such as property taxes
and homeowner's insurance. You must pay these items directly yourself.
❑X You have an additional monthly escrow payment of$374.54
that results in a total initial monthly amount owed of$938.20. This includes principal,interest,any
mortgage insurance and any items checked below:
❑Propertytaxes ❑X Homeowner'sinsurance
�Flood insurance ❑X School Tax
� ❑X City Tax
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 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 the HU0.1 Settlement Statement.
M���d L' . eed
ESTATE OF SUZANN S.STAIGER
` ��v��{�'
Scott A.Staiger,Administrator
The HU0.1 Settlement Statement which I have prepared is a true and accurate account of this transactlon.I have caused or will cause the funds to be
disbursed in accordance with this statement.
�' �_ � -/� -�
SETTLE AGENT 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
BONNIE K MILLER,TREASURER TAX PAY E R'S C O PY
2233 GETTYSBURG ROAD KEEP THIS PORTION FOR YOUR RECORDS
CAMP HILL,PA 17011-7302
TEMP -RETURN SERVICE REQUESTED
� � � � . .
�Il�i�ll�l��lt���l'�Iln��l��ll�ll�"�I��Ill�llllltl�l����n�i�l�
013353"""'*"""""AUTO`*5-DIGIT 17011
SH/EMANSTOWN PA 17011-6513 (IIIIIIIIIIIIIIIIIII�III IIIIIIIIIIIIIIIII IIIIIII
To review the assessment data for this property, go to:
www.courthouseonline.com>AssessmentOffice>Cumberland>PropertyRecords.
Then enter control# 48000068 and oassM!ard C��Qv�!EW
_.............................................................................................._._.................._.............................................................................................................................. ...___ _.
� , � . . . � - � � � • � • � � �
Payable To: BONNIE K MILLER,TREASURER Office Hours: MON,TUES&THURS 9-4
2233 GETTYSBURG ROAD CLOSED WED,FRI AND
CAMP HILL,PA 17011-7302 ALL HOLIDAYS
BMILLER@LATWP.ORG Bill No: 5030
PHONE(717)737-5671 Bill Date: 3/1/13
Control No: 48000068
MAP NO: 48-24-0795-028.
Desc: 310 GLENDALE DRIVE Assessed Value: Land:55,000 Im rovement: 147,700 Total:202,700
Discount Face ena y
SHIR N MANOR
LOT�����8�1 - 81 Countv RE 2.131 $423.31 431.9 5.15
Acres 0.21 0 , ��,l� County Lib 0.143 $28.41 $28.99 $31.89
���
Munic.R/E 1.6 $317.83 $324.32 $356.75
� � � Fire Srvs 0.44 $87.41 $89.19 $98.11
$1.00 FEE DITIONAL RECEIPT
Tax Payer: ' " . ������ -� Debt Svc 0.41 $81.45 $83.11 $91.42
STRIGER,SII�AQ[��p��� -x-�����,��"�i� TAX AMOUNT DUE
310 GLENDA�E DR �{�, $938.41 $957.56 $1,053.32
SHIREMANSTOWN PA 17011-6513 If Date Of Pa ment is on 3/1/ t ru 4l30/ 5/1/13 thru 6/30/13 13 0
• � •� �� • .�� � '�� • •� �•� • ��• ���• � 1 • •
_ . . .._ _....__........__.._...._...._........_.
_ V� ��.D�-� ll�O
A ss�sscD \1��
G o�w� �v�� Rar�v l , c�c�
(?cr F��4'�'�'�/
V
a�vc.tc� Sc�e�c.1�1 t� � ��� ��
JULY 2014
PENNSYLVANIA DEPARTMENT OF REVENUE
REALTY TRANSFER TAX
COMMON LEVEL RATIO (CLR)
REAL ESTATE VALUATION FACTORS
FOR
CUMBERLAND COUNTY
The following real estate valuation factors are based on sales data compiled by the State Tax
Equalization Board. These factors are the mathematical reciprocals of the actual common level
ratios. For Pennsylvania Realty Transfer Tax purposes, these factors are applicable for
documents accepted for the periods indicated below. The date of acceptance of a document is
rebuttably presumed to be its date of execution, that is, the date specified in the body of the
document as the date of the instrument. 61 Pa. Code § 91.102
ACCEPTANCE CLR ACCEPTANCE CLR
DATE FACTOR DATE FACTOR
FROM TO FROM TO
7-2-1986 6-30-1987 9.52 7-1-2006 6-30-2007 1.14
7-1-1987 6-30-1988 10.00 7-1-2007 6-30-2008 1.22
7-1-1988 6-30-1989 10.53 7-1-2008 6-30-2009 1.26
7-1-1989 6-30-1990 11.11 7-1-2009 6-30-2010 1.26
7-1-1990 6-30-1991 12.05 7-1-2010 12-31-2011 1.25
7-1-1991 6-30-1992 12.35 (3) 1-1-2011 6-30-2011 1.00
7-1-1992 6-30-1993 12.50 (3) 7-1-20ll 6-30-2012 1.00 �
7-1-1993 6-30-1994 12.82 7-1-2012 6-30-2013 1.00
7-1-1994 6-30-1995 13.33 7-1-2013 6-30-2014 .97
7-1-1995 6-30-1996 13.70 7-1-2014 6-30-2015 .99
7-1-1996 6-30-1997 14.29
7-1-1997 6-30-1998 14.29
7-1-1998 6-30-1999 14.71
7-1-1999 6-30-2000 15.15
7-1-2000 12-31-2000 15.63
(1) 1-1-2001 6-30-2001 1.00
(1) 7-1-2001 6-30-2002 1.00
7-1-2002 6-30-2003 1.01
7-1-2003 6-30-2004 1.05
7-1-2004 l 2-31-2004 1.11
(2) 1-1-2005 6-30-2005 1.00
(2) 7-1-2005 6-30-2006 1.00
(1)Adjusted by the Department of Revenue to reflect an assessment base change effective January 1,2001.
(2)Adjusted by the Department of Revenue to reflect an assessment base change effective Januaiy 1,2005.
(3)Ad_justed by tlie Department of Revenue to reflect an assessment base change effective January l,201 l.
REV-1507 EX+(04-13)
pennsylvania SCHEDULE D
DEPARTMENT OF REVENUE MORTGAGES & NOTES
INHERITANCE TAX RETURN RE C E IVAB LE
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Suzann S Staiqer 2013-00282
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Mortgage-Christine E.Walker-Original Balance$158,000-Made October 18,2005
Date of Maturity October 2035-For property municpally known as 503 West Main St,
Borough of Mechanicsburg, Cumberland County, Mortgage Book Reference BK1927PG1809
Monthly Payment of$946.92 With interest fixed at 6%. Unpaid Balance$140,853.02 140,853.02
2. Mortgage-Kenneth S. Knowlton-Original Balance$242,250-Made June 30, 2006
Date of Maturity June 2036-For property municpally know as 1729, 1727, 1725 English
Drive, Mechanicsburg PA, Upper Allen Twp.,Cumberland Couty, Mortgage Book Reference
Bk1957PG0297-Monthly payment$1571.23 with interest fixed at 6.75%-Unpaid balance
$231,967.76 231,967.76
TOTAL(Also enter on line 4, Recapitulation) $ 372,820.78
(If more space is needed,insert additional sheets of the same size)
REV-1508EX+(OS-12) SCHEDULE E
pennsylvania CASH, BANK DEPOSITS, & MISC.
DEPARTMENTOFREVENUE pERSONAL PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Suzann S Staiger 2013-00282
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
1. Consolidated Properties Retirement Plan-MassMutual(formerly the Hartford-401(k)
Plan ID#200054 Participant-Suzann S Staiger 31,075.58
2. 2002 Lexus RX 300 VIN#JTJHF10U720285354 41,000 Miles Clean condition
Valued at private party sale per attached 8,777.00
3. Household Furniture and goods
Clothing,Living room-Sofa, Mirror,2 Chair, Piano-Dining Room-Table w/6 chrs and China Closet
Kitchen-Pots and Pans and Table w/4 chairs-Family room sofa,TV,2 Chairs,endtables, books
Bedrooms-2 Beds,Chest of drawers and nightstand,bureau,TV-Basement Washer and
Dryer, Books,Table and Nightstand-Various other household sundries-Auction estimate 5,000.00
4. Jewelry -engagement Ring and costume jewelry-Auction estimate 1,000.00
5. Cash on hand 250.00
TOTAL(Also enter on line 5, Recapitulation) $ 46,102.58
If more space is needed,use additional sheets of paper of the same size.
Plan Access https�//www3.financialtrans.com/tf/Trac?tx=SponsorParticA...
TN�.,;
HAR7FORD
CONSOLIDATED PROPER7IES P�an ID:200054
Assets by Investment Option
Employee Information . .. .
_ _
Plan Name: CONSOLIDATED PROPERTIES Plan ID: 200054
Name: SUZANN STAIGER Status: ACTIVE
Date of Hire: 1990-10-01 Date of Birth: 1937-07-26
�HARTFORD DIVI6END 8 GRTH HL5 IA
❑HARTF4RQ INDEX HLS IA
� ❑HARTFJRD STDCh HLS IA
Zi� _ , �9 Y Q HARTFORD SfdALL C�fdPANY HLS IA
'k
� �a,�:it "'�:.e: �HARTFORD BRLANGED HLS IA
\� ,...-79%
� .
� \ .��
22% °� 22%
.��
NOTE:The vdlues in ihe pie chan represent whole numbers Por illustrati�e purposes onty.Reter to�he table below tor
act yalues.Balances of less than 1 00%may�ave a placeholder but cannot be displayetl on ihe Internet In addition,
t�ey v,�ll be grouped toge�her in a category titled"Othef'
Investment Option Value `Total YTD Contribution
HARTFORD BALANCED HLS IA $2,933.23 $0 00
HARTFORD DIVIDEND&GRTH HLS IA $8,465.55 $0.00
HARTFORD INDEX HLS IA $6,928.23 $0 00
HARTFORD SMALL COMPANY HLS IA $6,057.28 $0.00
HARTFORD STOCK HLS IA $6,691.29 $0.00
Totalr. 31,075.58 _ 30.00
�Rollover contributions are not included in the YTD Coniributions column.
��
1 of 1 1/16/13 10�48
2002 Lexus RX 300 SIJV Base What Your Car is Worth http�/lwww.edmunds.com/lexus/rx-300/2002/tmv-appraise-re...
Ask the Car People."' I�Lea�aM�e I S.gn_]o I L�a�le I H�le I cier�ieiter.I Dsa��
NEW CARS I USED CARS I INVENTORY I CAR REVIEWS I TIPS&ADVICE I WHATS HOT I Search Site _
— -............_.._..._.....___--._...__..._...i
lipm2> Used Cars> Lexug> RX 300> �002 RX 300 SUV> Pricec with O ion�>
Prices with Options Results
. . . ......... .. ....... ....... .. ......... .... ..... ..... . ... ....... ......... ......... __._ ......... ......... ........ . ......... ..... ...PDVERTISEMENT
. ..... .......... :
�!J1rF'ORDAeUTICJ�iFUEAFOR NEWCNEAPER'FNAN116ED 'CNANCETOWfNAf3G6d�TC,4R�! � '��
;Find ouk how much vou can aFfard Comoare the cast of huvina p���a wttich raa5 consurners like, '
Tell Us yc�lir tkestre�f 'new vs used
� raanCl�ly�a��yn�eriFS 3� 1F�fh�curtenG�t.onorn� Piay tlr�Edn�uads �. .
ga_t a�7r)c�ra�Ti�e in�` �, �� c£irriatP,tsuyi��g i+ew 4ehicie Rating
s�",�,� `,Y�ur n�xt e.ar. �'+ may us:Sua#iy sawe Ga€r�e. .
.. .. . ,rrNi mnnw. � . �:
' Use Edmunds.com to accurately appraise your used car.
2ip Code&Style ', Colors&Options ', Condition&Mileaye True Market Value�
_ __ _
2002 Lexus RX 300 SUV - What Your Car is Worth
Tips and Advice
17�50; UPDATE�: Prking for�
I Mecnanrsbury,rn 10 Steps to Buying a New Car
, ������ i _ 1iLSteps_tn5ellina Ynu�Gaz
True Market Value�
'- c New Car B�yJIl7 Guldes
' Trade-in
° - Dealer Retail
:'..:,:. . . Fuel Economv
I ,: * ;7,949 y10,254 '
- ' Car 5afetv '
, SHOP FOR THIS CPR �, Car Technoloov �
�� Private Party Sale ;8,777 ... ..... ..... ..... . ���� noveanser�Nr,
Photgs ; Videos ' 360 !
Prlcinq Details for a 2002 Lexus RX 300 SUV '
, ease 4dr SUV
' Customized True Market Value�Prices '
Trade-In rlva Part Dealer Retail ',
National Base Price y5,773 �6,523 ;7,774
, Optfonal Equipment $645 ;722 ;944 j
', Leather and Wood Shift Knob Trim ;11 ;13 g16 '
' Leather and Wood Steering Wheel Trim ;43 ;48 #63
'�,, 16 Inch Chrome Alloy Wheels $222 $249 g325 ,'
', Leather Seating g170 g190 #249 .......... ....... ...... ......... ..... ..��.
'�, CD Changer Audio System g141 g158 ;207
', Heated Passenger Seat ;29 ;32 ;42 ' '
', Heated Driver's Seat ;29 ;32 g42 '
Color Adjustment- White ' ;35 ;39 ;47 '��.
Regional Adjustment- for Zip Code 17050 g-20 �-23 ;-27 .
, Mileage Adjustment- 41,000 miles $1,516 ;1,516 ;1,516
'�, Condition AdJustment- Clean ;0 ;0 g0 �
Total ;7,949 ;8,777 ;10.254
' Buying a Certified Used Vehicle Dealer Retail
' Certified Used Price Vehicle not ellgible for certification.
__ __ _
', AutoCheck Vehicle History Report '
_ _
' Your research isn't complete until you see the vehicle history report.
Buyan AutoCheck report now!
Enter VIN i cHecKmN ,
�� x _;
1 of 2 O1/16/13 12�14 PM
REV-1509 EX+(01-10) �
pennsylvania SCHEDULE F
DEPARTMENT OF REVENUE
JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Suzann S Staiger 2013-00282
If an asset became jointly owned within one year of the decedenYs date of death,it must be reported on Schedule G.
SURVIVING JOINT TENANT(S)NAME(S) ADDRESS RELATIONSHIP TO DECEDENT
A. Scott A.Staiger 628 N Front St,Wormleysburg, PA 17043 Son
B. JenniferA.Staiger 5524 Moreland Court, Mechanicsburg, PA 17055 Daughter
C.
JOINTLY OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTIO N AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENTS VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER.ATTACH DEED FOR JOINTLY HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A. 1981 0.00
B 1991 Metro Bank-3801 Paxton Street, Harrisburg, PA 17111 101,949.81 33.33% 33,979.87
Checking accout#32005357 Held Joint with A&B
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
TOTAL(Also enter on Line 6, Recapitulation) $ 33,979.87
If more space is needed,use additional sheets of paper of the same size.
REV-1511 EX+(08-13)
pennsylvania SCHEDULE H
DEPARTMENTOFREVENUE FUNERAL EXPENSES AND
RESIDENTDECEDENETURN ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Suzann S Staiqer 2013-00282
DecedenYs debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Malpezzi Funeral Home-8 Market Plaza Way, Mechanicsburg, PA 17055-Services,casket,
grave liner,equipment,flowers, clergy,and Death certificates 9,287.00
2. Gate of Hevean Cemetery-Grave opening and closing 1,060.00
3. Office of Catholic Cemeteries-Grave marker 2,715.00
4. Cemetery Lot 500.00
5. Memorial Dinner 250.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s)of Personal Representative(s)
Street Add ress
City State ZIP
Year(s)Commission Paid:
2. Attorney Fees:
3. Family Exemption:(If decedenYs address is not the same as claimanPs,attach explanation.)
Claimant
Street Add ress
City State ZIP
Relationship of Claimant to Decedent
4. Probate Fees: 6�3.�0
5. Accountant Fees
6. Tax Return Preparer Fees:
7. Repairs to Homestead to ready for sale 13,095.00
TOTAL(Also enter on Line 9, Recapitulation) $ 27,510.00
If more space is needed,use additional sheets of paper of the same size.
REV-1512 EX+(12-12)
pennsylvania SCHEDULE I
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN DEBTS OF DECEDENT�
RESIDENT DECEDENT MORTGAGE LIABILITIES & LIENS
ESTATE OF FILE NUMBER
Suzann S Staiger 2013-00282
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.
Mortgage-310 Glendale Drive Shiremanstown, PA, Cumberland County-SunTrust Morgage, Inc. 107,257.98
Less: Escrow balance to be refunded on sale -3,590.19
2. January 1 Mtg payment and Late Fees 1,013.13
3. Lower Allen Twp-Sewer Bill 117.70
4. PSECU-Credit Card Payment 989.62
5. Comcast-Cable Bill 70.58
6. PP&L Utilities 171.65
7. Internal Revenue Service 2012 Tax Balance Due form 1040 5,378.00
8. PA Department of Revenue-2012 Balance due Form PA 40 901.00
9. Spirit Physicians Services and Holy Spirit Hospital 1,599.92
TOTAL(Also enter on Line 10,Recapitulation) $ 113,909.39
If more space is needed,insert additional sheets of the same size.
6573-01-b2-0034495-0001-0034577
■ �
� r SunTrust Mortgage,Inc.
/,F,�
�����'�°"'�'
! ����� Client Services: 800.634.7928
--•
Monday-Friday 8 AM to 8 PM ET
S�USZ' Saturday 9 AM to 3 PM ET Statement pate 01/16/13
MORTGAGE Visit us online at suMrustmortaaae.com payment DUe Date 01/01/13
Loan Number 0133120279
#BWNDXCT oosaase sr Principal Balance* 107,257.98 �
#9429720213310011# Escrow Balance 3,590.19 �—
Unapplied Funds Balance .00
0034495 01 AB 0.371 **AUTO T7 0 6573 17011-651310 •COt rlftt@CESt Rat@ 4.7SOOO %
����II���I��II����I����1�111�1�11��1����1���11111'I��'I'il'll�l��
SUZANN STAIGER Paid Year to Date
3i0 GLENDALE RD Jnterest .00
SHIREMANSTOWN PA 17011-6513 Taxes .00
Principal' .00
'This Is Not A Payoff Amount
Pa ment Information ` Amount
'Principal 8� Interest 678.14
EscrowPayment 301.08
YOUR INFORMATION IS ALWAYS TREATED CONFIDENTIALLY. Optional Products .00
�,�������� Other .00
' � �n.' �= � �; �������;���� �J�,� Total�'Mort a e Pa ment � � 979.22
����� Past Due Payment(s) 979.22
Property Address `�'31��GLENbAL�t�t� �9��„���,�� � .r�����,�� �,��� ����Unpaid Late Charge(s) �� 33.99 � '��
"SHI�tEMANSTOWN P�4'��t��1 i�� �g��,`���,��-��j�.
,,r� � ���� f�a� ����� �Fees �� � � .00
�• � ��� � �;�� '� `�� ��� ���; � TOT
�` AL AMOUNT DUE 1 992.35
,
� . � � . ��, � �� �4 �� ��
�lccount Activity, �.� �'���� �� �� �k
r �. � „ n
� � .:� �.�����
, �� �� � � �
r, �- .�
Date C3escrlption »Arnuunf `; � �a In�etest Prinapal` �scrQwflmpound MisclFees,
O1/16 LATB CBARCiE ASSESS'MENT. ' "°� �' ^ $33.91•
`;�12J14.��:HAZf►ItD�-iN3Ul2ANC8 ,a ����, �� �.$.539:,DU-
F�
�
�
5 " � `
���.�.. . . � }
Important Messages' �� � �
., . _ _. . .. , � , , .. . ...__ .- - -, .,,.._ _,_� . . � ". . _ �. .< _ . . . ... . .. . ...
REV-1513 EX+(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BEN EFICIARI ES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Suzann S Stai er 2013-00282
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).j
� Scott A.Staiger, 628 N Front St,Wormleysburg, PA 17043
Son 25%
2 Robert M.Staiger,5141 Kylock Rd, Mechanicsburg, PA 17055
Son 25%
3 JenniferA. Staiger 5524 Moreland Court, Mechanicsubug, PA 17055
Daughter 25%
Michael C.Staiger C/O Donna L. Munro-Mother
4' 1459 Hilicrest Ct,Apt 509, Camp Hill, PA 17011 Grandson 25%
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.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
�.
TOTAL OF PART II—ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ O.00
If more space is needed,use additional sheets of paper of the same size.