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HomeMy WebLinkAbout02-09-15 J 1505610143 REV-7500 "`°�,,, � OFFIGIAL USE ONLV PA�epaRmentofRevenue pennsylvania co�nqcoee v.ar wiarv�m�a, Bureau of Intlivitlual Taxes °�•'^*"°^°`^^"" PoeoX28o6a1 INHERITANCETAXRETURN 21 14 00758 Harnsburg,PA 1�128-o601 RESIDENT DECEDENT ENTEft DECEDENT INFORMATION BELOW Social Secunty Number Date of Dea�h Date o(Birth 05 21 2014 03 18 1943 DecetlenPs Last Name Suffix Decedenfs First Name MI PRESSLEY JR WILLIAM R (If Applicable)EnterSurviving Spouse's Infortnation Below Spouse's Last Name Suffix Spouse's Flrs�Name MI Spouse's Social5ecurity Number THIS RETURN MUST BE FILEO IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS 6ELOW O 1. OriginalReWm � 4 Supplemen�alReNm � 3. RemalnOerReWm(�aleot0eal� Pna�W 12-13-8P) n 4. LimiteJ Eslate � da. Fuwre NterestComv�mise I 5. Fetle21 Estate Tax ReWm Require0 �De�eolDee�M1aXe�121202) ❑ g �eceGenl�leEies�aie C �� �q°qecnCoam��ne1aLmyims� 1 B. TotalNumberot5afe�epositBoxes � (AI�eUPoOYalWill� GYa ) � B_ WlgaGonProoeetlsReoelveJ � 10. ��e�Pz��'j�a�d��Da95�IDea1M1 � ��,ElediOntoWuntl2�50C9113(Fl) (Atlac�Sc�eOule O) CORRESPONDENT-THIS SECTION MUST BE COMPLETEO.ALL CORRESPONDENCE AND GONFIDENTIAL TA%INFORMATION SHOUL�BE OIFECTEO TO: Name Daylime Telephone Number MARK A MP.TEYA 717 241 6500 REG(9}ER OF WILI.b�.USEDNpA`( : o _ri :-j C> � FirslLineotAtltlress �' c:� � _� r� 55 W CHURCH AVEN[JE ��� c� . Secontl Line otAtlCress . , � � ri � __3 't QATE FILEC � �� CityorPos[Office SG[e ZIPCotle - CARLISLE PA 17013 . . �'-_�' " � CorrespontlenPse-mailatltlress: mam�matevalaw.com 0 g��penaltle�gf per�um�le�ec�erecleration ofe eramineeM1efs�eW��incWdingl�re se tative Is bz eE on e�In�o�rma��onblwh���e bes�of my knowleUge antl oelie[ p preparero persona pre n preparerM1asanyknwvletlge. $IG UFEOFyPE $ONRESPCNS�BLEPoRFlLINGRENRN pAT f��., .;liu� Bryan Pressley G�����20 �� n'ooaess 39N Gettysburg Road, Camp Hill, PA 170N SIGNATIIRE PHEPPF OTXEQT EPRESENTATNE DP}� � •���,�� _�y�,.� Mark A. Mateya Z/ K % j nooaese � � 55 W. Church Avenue, Carlisle, PA Side 1 L 1505610143 15�5610143 J � J 15�5610243 REV-1500 EX Decedenfs Social SecurRy Number o�e��'•�eme. pressley, William RoyJr RECAPITULATION � t rteaiestate(scneauien).. ...._._ .._..... ........._ t 276, 700 . 00 2 Stocksanaeonas(ScheOWee) .......... ...._... ._____. 2. 2 , 729. 30 3. Closety Held Carporalioq PaM1nership or Sole-Proprietorship(Schetlule C).___.. 3. 4. MortgagesBNolesReceivable(Schetlule0) .._._.. ....____ 4. 5. Cash,Bank�eposits&MiscellaneousPersonalPmperty(ScheduleE)............._ 5. 82,069. 94 6. Jointly Ownetl Property(Schedule F) ❑ Separate Billing Requestetl......_.... 6. 22 . 70 ]. InterViws Transfers&Miscellaneous I�m,-Probate Pmperty (ScM1eduleG) U SepareteBillingReQuestetl......__.. �_ e, m�icrossnsser�(m�aiu�es� mro�qn�� .__.._ ..._........ s. 361,541 . 94 9. FuneralExpensesanOAtlminislrativeCosls(SchetluleH)_... .___..... 9. $7r55�. �$ 10. DebtsofDecetlen�,MohgageLiabililiesandGens(Schetlulel).__..._.________. 10. 131, 921.49 ii. rowioea�oe�o�s(ro�aiu�essa�aio).._. ......_._ _..._.._ ��. 189, 472 . 24 12. NetValueofESGte(LineBminusLinell) ..._.._. _____. �p, 1�]'2 , 069. 70 �3. CharitableantlGovemmen�alBequestslSec9113Trustsforwhich anelectiontotax�asno�beenmatle(SchetluleJ)_._._._..__................_______ 13. 14. NetValueSubjactloTax(Linel2minusLinel3).._......................___._____._ ib. 172,069. 70 TAX COMPIITATION-SEE INSTRIICTIONS FOR APPLICABLE RATES 15. Amount of Line 14laxable atthe spousal tax rele,or trans(ers undar Sen 9116 �5 0 . �� (a)(1 2)x.00 �s. Amountotune�4taxab�e 172 � 069 . 70 t5. 7 �743 . 14 at lineal rate X .045 11. AmountofLinel4taxable at sibling rate X.12 O . 00 1]. � • �� iB. Amoun[ofLinel4�axable atwllateralraleX.15 � . 0� 18. � • 00 19. TAX OUE .____._..... ..__... .____ ............ 19. 7 � 743. 14 20. FILL IN THE OVAL IF VOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. � � Side 2 L 1505610243 1505610243 J REV-1500 Ex Page 3 File Numbe� 21-'14-00758 Decedent's Complete Address: DEGE�ENT'S NAME Pressley,William Roy Jr _ _ STREETAO�RESS � 279 Ridge Hill Road, Mechanicsburg CITV � STATE ZIP Mechanicsburg PA 17050 Tax Payments and Credits: 1. Tax oue(Page 2,Line 19) (�) __ �•�43'�4 2. Cretli�s/Paymenzs A. PriorPaymen45 B. Diswunt 0.00 Total Cretlits(A t B) (2) 0.00 3. In[eres� (3) —. q_ If Line 2 is greater than Line 1 a Line 3,en�er��e tliHerence. This is lhe OVERPAYMENT. (4) Check boz on Page 2,Line 10/o requesla refund 5_ IfLineltLine315greaterihanLine2,enlerthetlifference. ThisistheTA%�OE. (5) 7�743.14 Make Check Payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Ditl tlecetlen�make a[rznster and: �es No a. relaintneuseorincomeof[hepropetlytrans(erretl ........_. ..._ _. ❑ ❑x, �. relaintM1enghttotlesignalewhoshalluselhepropeM1ytranstenedon�smcome ... __ O �� c. relain a reversionary interesl;or ............_ _.. .__ _.. x E. receivetM1epmmiseforlifeofei��erpayments,beneftsorwre'+_. . ..... . n U 2. If tlea�M1 occurtetl after Dec. 12, 1982 tlitl tlecedent lansfer property w�h n one year of deaM wNoul re�ivingatlequa�econs0eretion?...._ ._.._.. .._._. ._..._. _.... U �] 3. Dld decetlent own an"in�ms�fo�' or payable upon tleath bank account or security at his or her dealhP...._. ❑ 0 4. Ditl tlecetlent own an indivitlual ret;rement accounq annwty or o��er non proba�e property wNch C I u containsa0eneflciarytlesignation__. ____. ............ ....._.. ___._ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF TME RETURN. For da�es oi death on or afler July 1,1994 and bekre Jan. 1,1995,�he tax rdte impoud on�he nel value of transkrs lo or tor�he use aiNe sumving spause is 3 percent P�P.S.§91761a)(1.1)(i)l. For dates of death on or after January 1,7995,ihe tax 2te impose0 on t�e net value of tanskrs to or br the use oithe surviving spouse Is 0 percent p2 Pb.§911s(a)(t.i)(ii)�. The slalule does not exempt a t2nsferto a surviving spouse Imm tax,and Ihe staNtory reQuiremenislor aisdosure otassets ana filing a tav retum are sfill applioble even if ihe surviving sDouu is the onty bene(ciary. For dates of tleatb on or afier July 1,2D0��. . The lax rzte imposed on ihe nel value ottransfers from a deceased child 21 yeare of age or younger at tleath ro or forihe uu o!a naNal parent,an atloptive parent,or a s[epparent of the child is 0 perceN[12 P 5.§9116(a)(12)�. • The lax rale imposed on t�e nel value oflanskrs to or tor the use oi the EecedenYs lineal benefivanes is 4.5 percen(except as notetl in p2 P.S.§9116(a)p)�. . The lax 21e imposed on the nel value of ironsfers to or ror the use ot ihe tlecetlenCs siblings is 12 percent[�2 PS.§9116(a)(1.3)I� A sibling is Oefined under Section 9102,as an individual who has al least one paren�in wmmon with�he deceden�,whether by blood or adoplion. e..nsoa ex.�o�tol SCNEDULE A pennsylvania REAL ESTATE �EPARiMENTOF REVENOE INHERITPNCETMRETIIRN RESIOENT pFCEOENi ESTATE OF FILE NUMBER Pressley William RoyJr 21-14-00758 ai�a.i prop.m ow�.a wiaiy or.�.i.�.m���=a�.�wo m�.i o.nn�nee a r.i.m.m.e..we.ren�nn.awe���aan�ea a:ma on�a�onim p�pmv.owa oa e. na�aea oaeroa�.w�n��e e�ye�a�a a an��e=auer,�e��neroa��c=ompauee io o�yor aen,eom nem�e ream�aeia e�owiaaoe m�nareia.emra��.. a.n prop.m�n.<�.iomnyo�.aw�mnqmo�s�m.o�.n'�vm�.�wai.oio..aoo.�nea�i.r. nn.=n.copv mtn.wni.m.m an..�nin.a�oP�M nn e..n.o�e IncluEe acopy ol�he tlaeE e�owlnq EeceEenfe In�e�n�i�owneE�e lemnt in common. ITEM VA W E AT DATE NUMBER DESCRIPTION OF DEATH 1 Real Estate-1218 Market Street, Harrisburg, Dauphin Counly; Pin No. 09-012-056-000-0000- 33,600.00 AssesseC Value 2 RealEsfate-SLockwillowAve., Harrisburg, DauphinCounry-PInNo. 35-044-077-000-0000- 23,100.00 Assessed Value 3 Sale of Real EsWte-279 Ridge Hill Road -Sale to Creig Kern-See attached Settlement 220,000.00 SWtement TOTAL(Also enter on Line'1, Recapitulation� 27fi,700.00 Qt more speca Is neetletl,atltlitionel peges oi tM1e same s¢e) Copyright(c)2010�orm software only T�e Lackner Group,Inn Fortn PA-0500 Schetlule A(Rev. 0140) Nev-1501 E%�(6-98) � SCHEDULE B STOCKS 8 BONDS ESTATE OF FILE NUMBER Pressley William Roy Jr 21-14-00758 a�oropeM lo�m�yown.a wm ngnt a.urvi�orenlp rrvn be msmosea on sm.aub F. ITEM CUSIP VAWEATDATE NUMBER NUMBER DESCRIPTION UNITVALUE OFDEATH 1 E'Trede Securities-Investment Account No.nux-1433 2,729.30 TOTAL(Also enter on Line 2.Recapitulation) 2.729.30 Q(more space Is ne NeQ aEtlitional pages ol I�e same s¢e) Copyrigh[(c)20W fortn sofhvare only The Lackner Graup,Inc. Portn PA4500 SCM1edule B(Rev.&98) as.nsoa�.�n.�o� SCHEDULE E pennsylvania CASH, BANK DEPOSITS, 8 MISC. oEvnarmeHr or aEveHue ,�„ER„�„�E,a.RE,�a� PERSONAL PROPERTY aesioervr oeceoeHr ESTATE OF FILE NUMBER Pressley William RoyJr 21-14-00758 Intlutle tM1e O��s ollili8etion entl Ne 6sle t�e prrceeGavnra rewlveG Oy��e eala�a. NI propellyfolntlyawneE wl��Me tlgM al furvlvon�ip mual be OivclouE on ec�etlWe F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Cash �o.00 2 MetroBank-SavingsAccountNa. 410158452 4.953.77 3 MetroBank-CheckingAccountNo. 540003811 P72.11 4 MetroBank-CheckingaccountNo. 54008471 5.50 5 Matro Bank-Checking Account No. 540008489 7,100.00 6 Automobile-1977 Chevrolet Corvette-not in good contlition 1,000.00 7 Bentlinsky&Co Acution Services-Gross proceeds from sale of personal/household items 27,5fi2.70 B Bristol Wes[-Insurence Commission on policies written prior to date of death 156.57 9 Commissionearnetlonpreviousinsurancepolicies-Commissionsearnedakerdateof 7,938.97 death from insurance business of tlecedent 7U Commission earned on previous insurance policies-Commissions earnetl aker tlate of 2,239.02 death from insurance business of decedent 17 Foremost Insuronce Company-Commission earned on insuance policies prior to tlate of 100.46 death 72 Foremost Insurence Company-Commission eamed on insurance policies prior[o date of 72.95 tl¢ath 13 Lititz Mutual Insurence Company-Refund of Homeowners lnsurance on residence 647.00 14 Metro Bank-Refund for overpaymenl on Loan No. 930030945 19.53 Tofal of Continuation Schedule See attncnea page TOTAL(Also enter on Line 5, Re<apitulationl 82,089.94 pr more sparc�is neeeee,aeeu�onai paqes or me same size) Copyright(c)2010 form software only The Lackner Gmup,Inc Foim PA-0500 Schedule E(Rev. 114�) 0.ev-0509 El��11A0� SCHEDULE E pennsylvania CASH, BANK DEPOSITS, 8 MISC. OEPARIMEM OF RF/ENVE ���Ea�,��E,�AE.�a�+ PERSONAL PROPERTY aesioenr osceoeur eontinued ESTATE OF FILE NUMBER Pressley William Roy Jr 21-14-00758 ITEM VALUE AT�ATE NUMBER DESCRIPTION OF DEATH 15 Highmark Blue Shieltl-Proceeds Fram retirement accountfrom Sanda Pressley Estate 36,011.96 TOTAL(Also enter on Line 5, Recapitulation� 82,089.94 Copynght(c)2010 form software only The Lackner Gmup,Ina Fortn PA-0500 Schetlule E(Rev. 1140) 0.e�A60B E%��01-10� pennsylvania $CHEDULE F oeaaarmeHraraeveHoe JOINTLYAWNED PROPERTY INHERITPNLE ipX RETURN i E�ENT ESTATE OF FILE NUMBER Pressley William RoyJr 21-14-00758 n.�...ai..a�a.ioim w�mm o,�.ya.r oi ua a«.a.or.ae�e m ee.m,n m�.o na�epo,ue o�.�n.am.a. Sl1RVIVINGJOINTTENANT(S)NAME ADDRE55 RELATIONSHIPTODECEOENT A. Bryan Pressley 3911 Gettysburg Road Chiltl Camp Hill, PA 17071 B. C. JOINTLV OWNE�PROPERTV: DESCRIPTION OF PROPERTY oale oF oearH ITEM �ETTER DATE iHcwoervuneoFFi�+aucwuesrrtunoHnrvoenr+Knccoovr OATEOFDEATH DECDS �^�ueor NUMBER FORJOINT MADE HumeeaaAsiMivaioeenFrirvcrvumeeannncNoeeovoA VAWEOFASSE IMEREST oeceoeHi'si�+reaesr TENANT JOINT �ownv-ne�oaen�esinie 1 A 09/79/799fi MetroBank-CustodianSavingsAccountNo. 45.40 50.000% 22.70 410158443-Jointly owned with Bryan Pressley TOTAL(Also enter on Line 6, Recapitulation) 22.70 (If more space is neeeen,atltlitional pages o�tne same size) Copyright(c)2010 form software only The Lackner Gmup, Ina Fonn PA-0500 Schetlule F(Rev.01-10) p�,"�Ex.,,��, SCHEDULE H pennsylvania oePnr+rmEHroFaev�rvue FUNERAL EXPENSES AND '""`R'T""°E'""R"�°" pDMINISTRATIVE COSTS , ESTATE OF FILE NUMBER Pressley William RoyJr 21-14-00758 _ Decedent's debts must be reported on Schetlule I. ITEM DESCRIPTION AMOUNT N MBER p, FUNERALEXPENSES: See continuation schedule�s�attached 10,515.00 B. ADMINISTRATIVE COSTS: 1. PersonalRepresenta�ive'sCommissions Name of Personal Represenla�ive(s) Bryan Pressley StreetAtltlress 3911 Gettysburg Road ciW Camp Hill State PA zio 17011 Year(s)CommissionPaid 201582076 16,243.00 p, Attomey's Fees Mateya Law Firm 12,500.00 3_ Famity Exemption' Qf tlecetlenPs atldress is no��he same as claimanCs,attach explanation) Claimant SlreetAdtlress City State Zio Relationshio of Claimant to Decedent 4. Pmbate Fees 610.50 5. AccountanfsFees 6. Tax ReNrn Preparer's Fees ]. Other Administrative Costs 77.68225 See continuation schedule(s)attached TOTAL(Also enter on line 9,Recapitulation) 57,550.75 Capyright(c)2009 fortn software onty T�e Lackner Group,Inn Fortn PA-0500 Schedule H(Rev. 10-09) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Pressley William RoyJr 21-14-00758 ITEM DESCRIPTION AMOUNT NUMBER Funeral Exoenses 1 Musselman Funerol Home-Funeal Expense 9.020.00 2 Rolling Green Cemetery-Cemetery Expenses 1.495.00 H-A 10,515.00 Other Administrative GosL 3 Andrew Shaw-Deed preparation fee antl represenfation al real estate clasing 350.00 4 Bentlinsky 8 Co Auction Services-Expenses relatetl to auction of personal/household items 6.77fi.50 5 Cumberlantl County Register of Wills -Short CertiFcates for EsGte of Sandre Pressley for 75.00 use to lransfer tiHes to automobiles 6 Deboroh K. Bocian-Notary Fee for real estate documents 20.00 7 Etluartlo Landscaping-Lawn Maitenance at resitlence 7fi5.00 8 Eduardo Lantlscaping -Lawn Mailenance at residence 165.00 9 Eduardo Lantlscaping-Lawn Maitenance at residence 55.00 10 FirstlnsuranceFunding-WintrustCompany-Liabilirylnsurance-AccountNo. 563.61 7270500t71898176 71 Foremost Insurance Company-Homeownera Insurance premium on residence-Policy No. 526.26 36'I-0090670404-01 12 Goodwill-Shreddingexpensestoroutdatedbusinessrecords 78.00 13 MetroBank-Feeforreturningunearneticommission 15.00 Capyright(c)20�2 form software only The LacknerGroup,Inc. Fortn PA4500 Schedule H(Rev 6-98) SCREDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Pressley William RoyJr 21-14-00758 ITEM NUMBER DESCRIPTION AMOUNT 14 NorthMounWinSettlementServices-TaxCertificationFee 20.00 15 North MounWin Settlement Services-Overnight delivery fees associatetl with real es}ate 40.00 closing 16 PA American Water-Water service at resitlence �<9.4� 17 PAAmericanWater-Waterserviceatresitlence 712.53 18 PADepartmentofRevenue-Seller's'I%ofrealtytransfertax 2,200.00 79 Penn Waste-Trash service at residence-Invoice No. 0002946357 38.77 20 PennWaste-Trashserviceatresitlence-InvoiceNo. 0002946357 38.77 27 PennsylvaniaAmericanWater-Waterserviceatresidence-AccounlNo. 1024 5'1.45 -210035380P57 22 PPBL-Payment of eleclrical service at residence Account No.85740-70007 256.95 21 PP&L-Payment of electrical service at residence Account No.85740-70007 260.21 24 Scott eentlinsky-Auctioneefs commission on sale of real estate 3,300.00 25 Scott Bentlinsky-AdveRising,disposal fees and labor fees associated with auction of real 1,377.00 esfate 26 SilverSpringtownshipAuthority-FinalSewerbillforresidence 177.53 27 Suburban Propane-Tank rental 10.76 28 SuburbanPropane-Homeheatingfuel -TicketNo. 2113-175712 69.06 Copyrigh[(c)2002 fortn software only The Lackner Gmup,Inc. Fortn PA-1500 Schedule H(Rev.6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Pressley William RoyJr 21-14-00758 ITEM AMOUNT r+UMBER DESCRIPTION 29 The Patriot News-Expense for Ohituary 32�.64 30 Tri-SGte Shredding Corp-Shredding expense for business records 270.00 31 U.S. PosGl Service-Certified mail for Renunciations �9�4� 32 Vital Rewrtls-Fee foretltlitional Death Certi(cates 54.00 33 Walgreens5pecialtyPhartnacy-Prescriptionmetlication-AccountNo. 10997526389 246.53 H-B7 17.68225 Copyrighl(c)2002 form soflware only The Lackner Gmup,Ina Foim PA4500 SCM1edule H(Rev.6-98) Rev�15II FX��11M) SCHEDULE 1 pennsylvania DEBTS OF DECEDENT, oEaaarmENroF aEVEHUE �„„Ea�,a,�E,�aE,�a„ MORTGAGE LIABILITIES AND LIENS aEsioEHr oECEOErvr ESTATE OF FILE NUMBER Pressley,William Roy Jr 21-14-00758 e.�n awm'����n.a ew ma m�.a.m v�o,�o e..m m.�nm.m.a��ove.un.a.a oi a,m,�nawmy�nn�me�naa meamai e.�,.n..e. ITEM VALUE AT DATE NUMBER DESCRIPTION OFDEATH 1 Berks Credit&Collections,Inc. -Payment of Quantum Imaging outsGntling invoices 15.33 Z Berks Cretlit&Collections,Inc.-Payment of Quantum Imaging oufstantling invoices 72.04 3 BureauofAccountManagement-C011ectionforoutSWndingmetlicalbilltoPinnacleHealth 52.69 EmergencY'Acct.#29197838 4 CapiGl Region Water-Water service tor 1218 Market Streeq Harrisburg,PA Account No. 5,199.42 09072056-0000(7) 5 CapiGl Region Water-Outsfanding water bill for rental property-Account No. 09012056 1,881.38 -0000��� 6 Chase-Mortgage Accounl No. 1914513250 32,483.00 7 Cily af Harrishurg -Treasurers Office-Fee for respontling to false burglar alartns-Account 245.00 No. 027943-001 B City of Harrisburg -Liens on property located at 1218 Market Street 3,377.88 9 Cumberlantl County Register of Wills-Real estate Wxes!or 20'12-Parcel No. 64-027-778 for 860.00 Brown Street., Harrisburg, PA 70 DauphinCountyTazClaimBureau-RealESWteTaxes-2012-ParcelNo.09-048-007for700 3,300.00 5. 13th Street,Harrisburg, PA 71 Oauphin County Tax Claim Bureau-Real esfate taxes for 2072-Parcel No. 35-040-077 for S. 8�0.00 LockwillowAve.,Harrisburg, PA �2 Dauphin Counly Tax Claim Bureau-Outstanding real estate taxes on Lockwillow real estate; 832.63 Parcel No. 35-044-077-000-0000 13 IC System -Collection Agency for Spnnt Account No.800234086 438.29 14 MelroBank-MortgageAccountNo. 930030945forresidence )3,159.65 ToGI of Continuation Schetlules See anached pa9es TOTAL(Also enter on Line 10, Recapitulation) 131,921.69 pf more soace�is neeeee,aeeinonai paqes or me same s�re7 Copynght(c)2008 form soffware only The Lackner Group,Inc Fortn PA-1500 Schedule I(Rev. 12-08) qev-06IIES��4-09) SCNEDULE 1 . pennsylvania DEBTS OF DECEDENT, oernarmenl oF aEveHue ,N„Ea�,ax�E,�RE,�R„ MORTGAGE LIABILITIES AND LIENS aesioervr oECEocrvr continued ESTATE OF FILE NUMBER Pressley William RoyJr 21-14-00756 REM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 15 Metro Bank-Delinquent paymen}s an loan No. 930030945 7.P48.46 i6 PAAmericanWaterCompany-Waterserviceatresitlence 195.15 17 PadgaH Business Services-Services for prep of tax and financial reporting for insurance 3,240.00 business ownetl by decedent 18 PatientFirsl-OutstandingMedicalBillfordecedent-Acct00087675'I6 208.29 19 Penn Credil-Outstanding metlical bills for Pinnacle Heallh System 873.79 20 Pennsylvania Amencan Water-Outstantling unpaid utiliry bill 333.05 21 Pinnacle Health Medical Group-Outstanding metlical hill fordecedent 5.00 22 Pinnaclehealth Cardiovascular Inst.-Medical Services tor decedent-AwL 405452 9.32 23 PP&L-Payment of electrical service at residence Account No.85740-70007 256.97 24 PPBLUtilities-OufsWndingutililybill-AcctNo. 85740-70007 800.90 25 Quantum Imaging 8 Theapeutic Assoc-Account No. 556682-Metlical services 81.06 26 Quest Oiagnostics-Metlical Services-Account No. 2375575895 z.61 27 QuestDiagnostics-Medicalservices �0�a� 28 Safeco Liberty Mutual Group-Liability Insurance for decetlent's business Y63.31 29 SilverSpringTownshipAuthority-SewerServicesatresidence-AccountNo. 30163796 63'1.91 30 Sollenberger Colon/Rectal Surgical-Outsfanding medical services-Account No. 3867'I 3529 31 Suburban Propane-Outstantling utility bill of decedent;Account No. 2113-305989 134.37 Copyrigh�(c)2008�ortn sokware onty The LacknerGroup,Ina Foim PA-0500 Schedule I(Rev. 72-OB) Per-054 E[��II-08� SCHEDULE I pennsylvania DEBTS OF DECEDENT, OEPARIMENT OF F WENOE ,H„Ea„A„oE„xRE,�aH MORTGAGE LIABILITIES AND LIENS aesioer�r oECEoerv� continued ESTATE OF FILE NUMBER Pressley William RoyJr 21-74-00758 REM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 32 USTreasury-2011PersonallncomeTaxes �Z��» 33 Verizon -OutsGntling telephone bill of decedent;Account No. 799U00 8531013471 70 305.50 34 Verizon -Oufsfanding telephone bill of decetlent,Account No. 7506163670007 407.96 TOTAL(Also enter on Line 10,RecaDitulation) 131,9P1.49 Copynght(c)2008 fortn software onty The Lackner Gmup, Ina Foim PA-0500 Schedule I(Rev. 1208) aev isv ez.lm�o� pennsylvania SCHEDULE J oEaaalrnErvr oF aEVErvuE ���Ea�ra��E_�*aE*�A� BENEFICIARIES qesioeuroeceoervr ESTATE OF FILE NUMBER Pressle ,William Ro Jr 21-7 4-007 5 8 NAME AND ADDRESS OF RELATIONSHIPTO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(SIRECENINGPROPERTY DECEDENT (Wortls) ($$$) I TAXABLEDISTRIBUTIONS [includeoutrigh�spousal dis�ribu�ions,antl�rensfers untlerSec9116a 12 See attached schetlule Total Enler tlollar amoun4s fortlisiributians shown above on lines 15 thmu h 19 on Rev 1500 caver shee� as a ro nate. NON-TAXABLE DISTRIBIITIONS. II. q.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOTTAKEN B.CHARITABLE ANp GOV ERNMENTAL OISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LME 13 OF REV4500 COVER SHEET Copyright(c)20f 0 form software only The Lackner Group,Inc. Portn PA-0500 Schadule J(Rev.0140) SCHEDULE J BENEFICIARIES (Part I,Taxable Distributions) ESTATE OF: William Roy Pressley Jr 0512112014 206-32-0232 Item Name and Address of Person�s) Share of Estate Amount of Estate Number Receiving Property Relationship (Words) ($SS) 1 YveHe Bailey Child One-ninth(7/9)of 624 South 20th Street residual esfate Harrisbur9, PA 17704 2 Tracy Carter Child One-ninth(1/9)of 3�5 Buckley Onve residualestate Harrisburg, PA 77112 3 Lori Mitchell Child One-ninth (1/9)of 9632 Lucerne Ave#37 residual esfate Culver City,CA 90232 4 Brianna Pressley Child One-ninth(7/9)of 39N Gettysburg Road residual estate Camp Hill, PA 77071 5 Bryan Pressley Child One-ninth (1/9)of 3911 Getrysburg Road residual esWte Camp Hill, PA 17017 6 David Pressley Child One-Ninth(1/9)of 5'104 Griffendale Lane residual esfate Upper Marlboro, MD 20772 7 Heather Pressley Chiltl One-ninth(1/9)of 9'103 Joyce Lane resitlualestate Hummelstown,PA 77036 8 William Pressley Chiltl One-ninth (1/9)of 1040 Biscayne Blvtl N3105 residual esW[e Miami, FL 33132 9 Shelli Scott Chiltl One-ninlh(7/9)of 1718 Berryhill Street residual eslate Hartisburg, PA 17104 1 .��' "-`�� OMB ApP�OVBI N¢250?0265 `�,�� A. 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Grevmus e410ons are o05o ete Page 2 of 3 H00-1 FINAL SETTLEMENT - �� �� DATEOPSALE `�'= SELLER NM1E = -- - �— - ADDRE55 .. PHONE _ __ -- ZIP LOCATION OF SALE __ - - —� AUCTIONEER�.-_-�J.� ' - '.. •�_�_. ...— PHONE �, � '-y— ' '::.: . . .. . SEUER'SIXPENSES . � �.RECEIPfS . . . . PROFESSIONAI FEES � AUQIONEER $ � ��� _ .— CASH $ _--.-�---- � CtERK $_� ' - �. CHEIX$ $�. . � •,; � CASHIER $.__�!__.t__. OTH�R RKEIPT � OTHER EXPENSES �-- --�-- �-u--�� $ . --- ���: � . � ,. .. . ��6��= $.- ��' ,: ` � �;� . - � $_� = - �`r.1 - -- '`- �-- .._ ' ,-..__.___-_ ..::. �_ � . _ $'L��'--- � ._ _ _—._ $.--. 3. -'_ � �� ��� :; � �.� - ...� F�.r:.,^$. o� $ . n . . . . .. � .. . '::,, :� 9..__-'— __ ..� �.. . :�_ _.,—� �i_"�_.. $._-. ' . - u..:^T-+- ._��'_—._ . . i $ t � _ -�' S � ' � ='' �� � . -- - _, ,,: � ` 7 'F�, $- _- _ -_ , � _�i� r ;� .. �..$__ .._ F 7 Hl'..;----�—� .. ... � / " . .'1.. '��_.. ' ,. � ti Jt.Vtr,._:$__ �_� � _ . - _ _ _"_"-_.____ $ $- $ H. ✓ - g__ TOTALRECEIPTS $ `��� � `'" � __—____— _ , .,W,. . . . . : ... . 1E55 TO7ALE%PPPJSES' $ '. ?.,; S>,.. -- _._— �" — . . � � � TO7ALIXGFNSES S , � N�����PAYABLEIOSEUfR S�D ��6` ' � -� �- � ���. I (or we�, the seller, ac<ept this seMement and acknowledge receipt of the above specified net prxeeds from If�e au<fion of my goods and properly sold on Ihe above date. I accept all responsibi6ty For providing merchanfable fide to all goods, ond property sold, and kr deliyery oF title fo ihe purchaser. ' n ' � '_ .y:( { .Yl. 't y....r: � ��i''"."" —Dak ___� i.."� �`��� Aodioneer or Cashiels Signature — �� (�I(er's SignaNre� , ; :... .._.__—_—Da1e— ' �_.: �. .,< Date , � �. � (Seller's $ignaNre) AUCTIONGFWS CUaY