HomeMy WebLinkAbout04-01-15 (2) � 1505610105
REV-1500 EX�02_��,�F�, �
enns tvania OFFICIA�USE ONLY
PA Department of Revenue P VAq MF Y County Code Year File Number
.a��E��,�
Bureau of Individual Taxes INHERITANCE TAX RETURN � ;�-
PQ BOX z8o6o1
Harrisburg PA 17i28-o601
RESIDENT DECEDENT '='''� � �� va � 3 '
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
l�Q .-�j� - `��� 01/06/2015 07/08/1970
DecedenYs Last Name Suffix Decedeni's First Name MI
Foor ' ' ' Erin M
(If Appi�cable)Enter Surviving Spouse's Information Below
SpousB's Last Name Su�x 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
� 1.Original Return O 2.Supplemental Return O 3_ Remainder Return(Date of Death
Prior to 12-13-82)
p 4. Limited Estate O 4a. Future Interest Compromise(date of O 5. Federal Estate Tax Return Required
death after 12-12-82)
O 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust _ 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust.) �,�
O �. Litigation Proceeds Received O 10.Spousal Poverty Credit(Date of Death Q 'S1. Electio to Tax under�.911�)�
Between 12-31-91 and 1-1-95) (Attact�chedule O) � �
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE ANO CONFIDENTIAL 7AX INFORMATION OOW BE DIR D TOt—
�
Name Daytime Telephpr�Nrinnber� � c�
_ ,. � r"4,� t'�t
Andrew C. Sheely, Esquire 3 � t�, F''' �'�' `�'
__ 717-697 70^ �� v _ r,� �
_ �5C� .
FiW�;t;�S U NLY
REGISTEI�Q
+::7 -7� .'��,,.
y Y�j ~ t'��"'
First Line of Address -� �
_ _ _ _ ,,3 C,,.�
�-` (�p
127 South Market Street "
Second Line of Address
'P.O. Box 95 '
Gty or Post Office State ZIP Code DATE FILED
Mechanicsburg ' PA '17055 ,
Correspondent�s e-maii adaress:andrewc.sheely@verizon.net
Under penalties of perjury,I declare that I have examined this return,inciuding accompanying schedules and statercients,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.
SIGNATURE P SON RESPON LE FIL ETURN ��' DATE
- L'�'a.. �.. ` � �-=�'?�: _ 1-/�'
ADDR S
Rolland E. Foor, III, 2403 Rye Circle, Mechanicsburg, PA 17055
SIGN RE OF PRE AR A EP ESENTATIVE DA /
C < -•—
D RESS
Andrew C. Sheely, Esquire, 127 Market Street, P.O. Box 95, Mechanicsburg, PA 17055
PLEASE USE ORIGINAL FORM ONLY
Side 1 �
� 1505610105 ],505610105 J �
�
J 1505610205
REV-1500 EX(FI)
Decedent's Social Security Number
DecedenYs Name: FOOP, Efitl M. L ��-VlJ ��V � � '
RECAPITULATION
1. Real Estate(Schedule A). . . . .. .. . . . . . .. . . .. . . .. .. . .. . .. .. . . . . . . .. . . .. 1. i
2. Stocks and Bonds(Schedule B) .. . . .. . . . . . . . . . .. . . .. . . . . .. . . . . . . . . . . .. 2 '
3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C} . . . . . 3. i
4. Mortgages and Notes Receivable(Schedule D) . . . .. .. .. . . . .. .. . .. . . .. . .. . 4. :
5. Cash, Bank Deposits and Miscellaneous Personai Property(Schedule E}.. .. . . . 5. ; 2,596.58
6. Jointly Owned Property(Schedule F} O Separate Billing Requested . . . . . .. 6. ; 41,039.18 l
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) O Separate Biliing Requested... . . . . . 7. 0.00 :
8. Total Gross Assets(total Lines 1 through 7}. . . . . . .. . . .. . . . . .. . . . . .. . . . .. 8. ' $43,635.76 '':
9. Funeral Expenses and Administrative Costs(Schedule H).. .. . . . .. .. . . . .. . . . 9. , 5,665.60 '
10. Debts of Decedent, Mortgage�iabilikies and Liens(Schedule I}. .. .. . . . . . . .. .. 10. ' 13,663.72 +
11. Total Deductions(total Lines 9 and 10). .. . .. .. . . .. . . . . . . . . . . . . .. .. .. .. . 11. ', 19,329.32
12. Net Value of Estate(Line 8 minus Line 11) . . . .. . . . . . . . . . . .. . . . . .. . . .. .. . 12. ', $24,306.44
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which "
an election to tax has not been made(Schedule J) .. .. .. . . . . . . . . .. . . ... . . . 13. '
14. Net Value 5ubject to Tax(Line 12 minus Line 13) .. . . .. .. .. . .. . .. . . . . . . . . 14. • $24,306.44 '
TAX CALCULATION-SEE INSTRUCTIONS FOR APPUCABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec. 9116 _ _ _ _ _ _
�a)�1.2}X.0_ ' 15.
16. Amount of Line 14 taxabie ' _ _ _ I
at lineal rate X.0 45 $13,164.57 ' 16. 592.40
17. Amounk of Line 14 taxable . -
atsiblingrate X.12 $11,141.87 ' 17. ' 1,337.02 :
18. Amount of Line 14 taxable '
at collaterai rate X.15 �g '; ',
19. TAX DUE . . . . . . . . . . .. . . .. .. . . . .. .. .. . . .. .. . .. .. . . .. .. .. . . .. .. .. .. . 19. 1,929.42 '
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT �
Side 2
� 1505610205 1505610205 �
REV-1540 EX(FI) Page 3 File Number
Decedent's Complete Address: `� f^ � `� � �"�'Z � �
DECEDENT'S NAME
Erin M. Foor
STREETADDRESS
405 Delancey Court
_.......
CITY STATE 1 ZIP
Mechanicsburg PA i 17055
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19} (1} 1 929.42
2. Credits/Payments
A. Prior Payments 1 832.96
B.Discount 96.46
Total Crsdits(A+B) (2) 1,929.42
3. interest
(3)
4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT.
Fill in ovai on Page 2,Line 20 to request a refund. (4)
5. If Line 1 +Line 3 is g�eater than Line 2,enter the difference.This is the TAX DUE. (5} 1,929.42
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......................................................................................... ❑ �
b. retain the right to designate who shall use the property transferred or its income ............................................ ❑ �
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 awn an individual retirement account,annuity or other non-probate property,which
contains a beneficiary designation? ........................................................................................................................ � ❑
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
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 suNiving 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 chiid 21 years of age or younger�t death to or for the use of a natural parent, an
adoptive parent or a stepparsnt 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 Secti�n 9102,as an individual who has at least one parent in common with the decetlent,whether by blood or adoption.
REV-15o8 EX�-(ii-1o)
�r ' pennsylvania SCNEDULE E
DEPAPTMENT OF REVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Erin M. Foor 21-15-0213
Inciude the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly owned with right of survivorship must be disciosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
� PNC Bank-Checking Account#5070066892, principal of$1,252.58,accrued interest $0.00 $1,252.58
2 Decedent's vehicle-1995 Subaru Impreza,poor condition $400.00
3 2015 Federal income tax refund $819.00
4 USAAAuto Insurance refund $125.00
TOTAL (Also enter on Line 5, Recapitulation) $ 2,596.58
If more space is needed, use additional sheets of paper of the sam�size.
. ' Mar, 27. 2015 2: 04PM No, 0070 P, 1/2
����
March 27,2015
Ancirew Sheely
Attorney at Law
127 S Nlarket St
Mechanicsburg,PA 17055
RE: E�xz�N�k'ao�
SSN: 180-50-1689
DOD: 01-06-201 S
bear Mr. Sh�el�:
In response to your request�oz Date of Death(DaD}balances for the customer noted above,our
records show the following:
Chec�ing Acca��t
Accorant#5070066892 Estiablished: 0$-15-1989
ERIN M�'OOR
DOD balance: � 1,252.5$fi 4.00 accxued interest
Sa�wit►gs Accotrnt
Accorxnt#50055b4S79 Established: 01-25-2010
R.QLLAND E k'QQR�IZ
Ga�,w�aox
�xrnr��ao�
DOD balance: $3,117.56+D.00 accrued interest
Please note that thi.s office pXo�vxdes date of death balances for deposit aceounts(IR.As,CDs,Checking aud
Savit�gs}. We do not process any�inancial transactions or provide st$tements. If�pu need assistance�ith
an�of these ir�ms,please call 1-888-PNGBANK(1-888-762-22b5}or stop by your local pNC Bank branch
p�ce_
Sincerely,
National Financial Services Center
1'N�C Bank,N�.A.
Member�]�YC
Page 1 af 2
REV-iso9 EX+(01-10)
�� pennsylvania SCNEDULE F
DEPARTMENT OF REVENl1E
INHERITANCE TAX RETURN )OINTLY-OWNED PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Erin M. Foor 21-15-0213
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
q, Rolland E. Foor, III and Gail W. Foor 2403 Rye Circle, Mechanicsburg, PA 17055 Father
B.Gail W. Foor 2403 Rye Circle, Mechanicsburg, PA 17055 Mother
�•Amy N. Foor 405 Delancey Court, Mechanicsburg, PA 17055 Sister
]OINTLY OWNED PROPERTY:
LEffER DATE DESCRIPTION OF PROPERIY %OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTIfUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENT'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER.ATTACH DEED FOR JOINTLY HELD REAL ESTATE. VALUE OF ASSEf INTEREST DECEDENT'S INTEREST
i. A. 3/31/1998 405 Delancey Court,Mechanicsburg,Cumberland County,PA 17055 $120,000.00 1/3 $40,000.00
C Joint Tenants with right of Survivorship and not as Tenants in Common
1/3 with parents,113 with sister
2. A 1/2512010 PNC SavingsAcct#5005564879.3,117.56 principal,0.00 accrued interest $3,117.56 1/6 $519.59
3. B 112512010 PNC Savings Acct#5005564879.3,117.56 principal,0.00 accrued interest $3,117.56 1/6 $519.59
T07AL(Also enter on Line 6, Recapitulation) $ 41,039.18
If more space is needed, use additional sheets of paper of the same size.
Main File No.15-Delance Ct Pa e#1
APPRAISAL OF REAL PROPERTY
LOCATED AT:
405 Delancey Ct
Deed Book 174 Page 1148
Mechanicsburg,PA 17055
FOR:
Estate of Erin Foor
405 Delancey Ct,Mechanicsburg,PA 17055
AS OF:
ovosizo�s
BY:
Appraisal Solutions
Brett LecMhaler,PA Certified General Appraiser
16 San Juan Drive
Mechanicsburg,PA 17055
Form GA6—'VJinTOTAL"appraisal software by a la mode,inc.—1-800-ALAMODE
Main File No.15-Del nce Ct Pa #2
File No,15-Delance Ct
March 25, 2015
Appraisal Solutions
16 San Juan Drive
Mechanicsburg, PA 17055
717-697-1828
The accompanying Appraisal Report is based on a site inspection of
improvements, investigation of the subject neighborhood area of influence, and
review of sales, cost, and income data for similar properties.
I have perFormed no services, as an appraiser or in any other capacity, regarding
the property that is the subject of this report within the three-year period
immediately preceding acceptance of this assignment.
This appraisal has been made with particular attention paid to applicable
value-influencing economic conditions and has been processed in accordance
with nationally recognized appraisal guidelines.
The value conclusions stated herein are as of the effective date as stated in the
body of the appraisal, and contingent upon the certification and limiting conditions
attached.
Please do not hesitate to contact me if I can be of additional service to you.
Respectfully,
Brett Lechthaler,
PA State Certified General Appraiser
Form DCVR—'1NinTOTAL"appraisal software by a la mode,inc.—1-800-ALAMODE
M in File No.1 -Delanc Ct Pa e#
SUMMARY OF SALIENT FEATURES
SubjectAddress 405 Delancey Ct
Legal Description Deed Book 174 Page 1148
�j�y Mechanicsburg
County Cumberland
State PA
Zip Code 17055
Census Tract 0116.01
Map Reference ADC:3117/C-7
Sale Price $NA
Date of Sale NA
Borrower/Client NA
Lender Estate of Erin Foor
Size(Square Feet) 1,278
Pdce per Square Foot $
Locatbn ResideMial
Age 30
Condition Average
Total Rooms s
Bedrooms 2
Baths 2�
Appraiser Brett Lechthaler,PA State CeR Gen Appr
Date of Appraised Value 01/06/2015
Final Estimate of Value $ 120,000
Form SSD—"WinTOTAI"appraisal sottware by a la mode,inc.—1-800-ALAMODE
�� - � - - �p���
. _ _ _ .,.\
.. . �r����; � - . �
. � -r���. ��J PARCEL NO•
'g V �'if r� e� �� �O 20 DBE,D
THIS IltDSIiTURE, made the ___s.��_ day ,
1998.
g$TiiSS1T 8va C. Louthian, single woaan of
Cumberland County, Pennsylvania, hereinafter
referred to as GRAt�I'rOR,
AND
Rolland 8. Foor, III and Gail �T. Foor, husband
and wife and Erin M. Foor, single female and
Amy 8. Foor, single fe�ale, Joint Tenants with
Right of Survivorship aad not as Teaants ia
Co�m�n of, Cumberland County, Pennsylvania,
hereinafter referred to as GRAHTSSS.
UiITHSSSETH that the said GRANTOR, for and in
consideration of the sum of 'gIHETY-FIVE THOUSAI�D DOLLARS
($95,000.00) , lawful money of the United States of America, and
other good and valuable coasiderations, well and truly paid by the
said GRANTEES to the said GRANTOR, at or before the sealing and
delivery of these presents, the receipt whereof is hereby
acknowledged, has granted, bargained, sold, aliened, enfeoffed,
released, conveyed, and confirmed and by these presents does grant,
bargain, sell, alien, enfeoff, release, convey, and confirm unto
the sai� �RANTEES, their heirs and assigns,
ALL TgAT CgRTAIN dwelling unit situated in Delancy Court
Condominium, Upper Al1en Township, Cumberland County, Pennsylvania,:
being designated as Unit No. 405 in the Declaration and Declaration
Plans of said Condominium, recorded ia the Recorder of Deeds Office
of Cumberland County, Pennsylvania, in Misc. Hook 298, Page 856,
and Plan Book 46, Page 72, r�speativelg, and Amendments to
Declaration and Declaration Plans recorded i.n the Recorder of Deeds
Office of Cumberland County, Pennsylvania, in Misc. Book 302, Page
890, Plan Book 47, Page 36, respectively; in Misc. Book 305, Page
972, and Plan Book 47, Page 146, respectiveiy; and in Misc. Book
310, Page 579, and Plan Book 48, Page 1�.1, respectively, under the
provisions of the Uniform Condominium Act of July 2, 1980.
TOC�ETHER with all right of title and interest of, in and
to the Common Elements as more ful.ly set forth in the aforesaid
Declaration of Condominium and Declar�tion Plans, as amended from
time to time. y fAGti�,.�.�
8��.74
� BgIgG �g g�tg p�ISSS which Eva C. Louthian her deed
dated October 15, 1993 and recorded April 8, 1994 by the Recorder
of Deed in and for Cumberland County in Deed Book 103, Page 814,;,
granted and conveyed unto Eva C. Louthian Grantor herein.
�gg � SUBJgCT, nevertheless, to easemeats,
restrictions, reservations, conditions, and rights of ways of�
record or visible upon inspection of premises.
TpGETHSR with all and singular, the tenements,
hereditaments and appurtenances to the same belonging or in anywise
appertaining, and the reversion and reversions, r�o all �he
remainders, rents, issues and profits thereaf; AND
estate, right, title, interest, property, claim and demand
whatsoever, both ia law and equity, of the said GRANTOR, of, in, to
or out of the said premises, and every part and parcel thereof.
�p gApg AWD TO 80LD the said premises, with all and
singular the appurtenances, unto the said GRANTEES, their heirs,
a�signs, to and for the only proper use and behoof of the said
GRANTEES, their heirs and assigns, forever.
� � SAID GgAZITpR, for Grantor's self and Grantor's
heirs, executors, and administrators, does by these presents,
covenant, grant and a9r the saiddGRANTOR and Granto�r'sE heirshand
heirs and assigns, that remises
assigns, all and singular the hereditaments and p
hereinabove described and granted or mentioned, a�thei e he rs�and
be, with appurtenances, unto the said GRANTEES,
assigns, against the said GRANTOR and Grantor's heirs andlawfully
against all and every other persen or persons whomsoever, from or
claiming or to claim the same or any part thereof, by,
under him, her, them or any of them, shall and will by these
presents SPECIALLY WARRANT AND FOREVER DEFEND.
fim m�r��* �'�msbv� � "' �
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__ ��gg �, the said �l1TOR has to tbs�a
pregeats set his hsnd and seal da►twd th� clsy aad pe,ts first abov�
writt�a.
WITl1B88: �,� ,,
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�..__-�1�'��. � � ; G��'„��---
8va C. Louthian
soax 174 PAGEi15�
3
03�31 '98 09�26
COMl�l011NBALTH OF YANIA )
D ��.
COLi�iTY 4F ' )
O�i T�lIB, the ' day of . 1998,
betore me a 1lotary Public, tho undersigaed offices, personally
appaared Fva C. Louthiaa, Rinqls �resaa, �ingle person, knowa to me
(or ustisfaotc=ily p=ov�n} bo ba tha p�rsoa wbose na■�s is
subscrybod to the within instrnmsa�, aad ackav�ledgsd tibab she
•xecutad the saee for tbi putpose th�reia �antaiuod.
Ilt WITI�688 WABAEOF, 1 have hmrebo sat ap bspd aOd
Actarial seal.
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. .�liitii�+ll��
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T BBR�BY C!lRTIFY that the prsei8e addres� of tbQ Gr�uttees
berein is:
�lOf� �lJ+r('$�L - -
/�2c.lt...ef'�r, ��'- /76�
.l� �
Signat re
COl�KO�1Y�FEiiL�i OF PP.�BYLV�N3A
CouAty of
� m��`t�� c in and !or said
RBCORDLD ia �ho Offiee for R�eosaing of Desds, at .
;Co�atp, in Ds�d Book lio. ��� Vol. ,, � t'a9e J���
�TIT�BSs my hand aad o#ficial ssal thi� � day o� �;) ,
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REI�-1510 EX+ (OS-09j
�¢. " pennsylvania SCH E DU LE G
DEPARTMENTOFREVENUE INTER-VIVOS TRANSFERS AND
iNHER�TANCETAxRET�RN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Erin M. Foor 21-15-0213
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes.
DESCRIPTION OF PROPERTY DATE OF DEATH %OF DECD'S EXCLUSION TAXABLE
ITEM INCLUDE THE NAME OP THE TRANSfEREE,THEIR RELATIONSHIP TO DECEDENT AND
NUMBER THE DATE Of TR4NSFER. ATiACH A COPY OF THE DEED FOR REAL ESTA?E. VALUE OF ASS� INTEREST (IF APPLICABLE} VALUE
1 Wells Fargo Investment Account-Boscov's Deferred Savings 401(k)plan
35,077.00 100 100% $0.00
At time of death Decedent was 42 years old and not entitled to 401(k).
TOTAL(Also enter on Line 7, Recapitulation) $ 0.00
If more space is needed, use additional sheets of paper of the same size.
Your Retirement Savings Statement
Boscov's Profit Sharing and Deferred Savings Plan ` •
10/01/2014 to 12l31/2014
Page 1 of 6
OOS311 OCE1T12J OOOOOBOS `
� ERIN FOOR
� 405 DELANCEY CT
MECHANICSBURG PA 17055
ACCC}UNT SUMMARY News Abaut YourP�an
You can maxim¢e your contributions in
Balance on 1010U2014 $34�289'3T 2015�y contributing 25°k of y�or pa��up to
Your vested balance is based on your the IRS maximum of$18,000. If you are
account balance,years of credited Additions $�97.53 a e 50 or older(or attain age 50 in 2015),
service with your employer and the +Your Contributions g
Plan's vesting schedule. +Employe�Contributions $29.63 you can contribute an additiona!$fi,000 as
$227.16 �tch-up contribu6ons. To make a
For information about your account or Totai Additions catch-up election for 2015,you must go
for interactive planning fooJs go to Reductions oniine or call the Retirement Service Cente�
www.weltsfargo.com. -Asset Fee -$���57 at 1-800-728-3123.Please note that your
Totai Reductions -5�6-$� catch-up election will remain in piace fw
Automatic Contribution Increase $490� 2016 uniess or untii you change it or elect a
As a way to help you prepare far Dividends&Interest $s.66 Zero dopar amount or percentage rate.
re6rement,yaur plan offiers you the Capital Gains
option to sign up for autanabc Investrnent Gain/Loss ��6�
contribution increases. Automatic S35,077.76
contribution increases are an easy Ending Balance on 12l3112014
way to c,�adually save more. Yau Net Chan e in Market Value $788.39
select the increase date,the inaease P�sonal Rate af Retum 1.84%
amount,and the amount at which you
would like the increase to stop. Sign
up for the automatic contribution
inaeases any time online at
wellsfargo.com ,
ACCOUNT GR�WTH
'0��10°� �;w�;;a^;Pers�^a!Rat��f R�;icsrn
From 01l01l2014 to 12/31/2014: 4.96°Io
30� OB13012013 1213112013 0613Q12094 12l31t2014
$28,541.54 !$32,204.91 $34,326A9 $35,077.78
2�.� ���--�3�,14�v14 The growth of your accpunt ca�t be influenced by a number of facfors,including ihe specific investment options you have
selecfed,fhe diversifrcafion of your rnvesfinenf among asset classes and fhe contributions fo your account. Pasf results do
• acca�nt sar�ce nof predicf future resufts.!f you�vould like to make changes in any of fhese areas,confact your rnvesfinent advisor or go
onlir�e to www.we/lsfargo.com for more infomtafiQn•
;,
�
�
ERIN FOOR 15Q9914
OCE1T12J 005411 012181120011 YNNNN NNNNN NN NNNNN NNNNN NNM 000001
33,233
REV-1511 EX+ (14-U91
�� ' pennsylvania SCHEDULE H
DEPARTMENT OFREVENUE FU N E RAL EXP E N S ES AN D
INHERITANCE TAX REfURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Erin M. Foor 21-15-0213
DecedenYs debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES;
1� Malpezzi Funeral Home $4,000.60
2. Memorial Service $1,050.00
e. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions: $0.00
Name(s}of Personal Representative(s) R0118t1d E. F001', ill
Street Address 2403 Rye Circl
cit Mechanicsburg state PA z1P 17055
v__ ._...._ __....._ __
Year(s)Commission Paid:
2. Attorney Fees: ,A"I'2(,cr� 4.� C � �/�P�Y� �iS�C�e/'"�/ $450.00
3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation.)
Claimant
Street Address __
CitY - State - ZIP _--
Relationship of Claimant to Decedent
4. Probate Fees
5. Accountant Fees: $150.00
6. Tax Return Preparer Fees:
�. Register of Wills filing fee-Inheritance tax return $15.00
TOTAI(Also enter on Line 9, Recapitulation) $ 5,665.60
If more space is needed, use additional sheets of paper of the same size.
, Tuesday, March 31,2015 9:41 AM Malpezzi Funeral Home 7176972414 p.01
March 31,2015
Rolland Foor
2403 Rye Circle
Mechanicsburg,PA 17055 �
This is the final statement for the funeral services of Erin Michelle Foor
We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way.
PROFESSIONAL SERVICES:
Direct Cremation $2,970.00
FUNERAL HOME SERVICE CHARGES $2,970.00
SELECTED MERCHANDISE:
Blue Delphia Brass Um $125.00
Beaches Register Package $195.00
100 Additional Memorial folders $25.00
THE COST OF OUR SERVICES,EQUIPMENT,AND MERCHANDISE
THAT YOU HAVE SELECTED $3,315.00
CASH ADVANCES:
At the tzme funeral arrangements were made, we advanced certain paymants to others as an accomodation.
The following is an accounting of those charges.
Certified Death Certificates $54.00
Newspaper Notices-Patriot $257.95
Newspaper Notices-Sentinel $248.65
Flowers $125.00
TOTAL CASH ADVANCES AND SPECIAL CHARGES $685.b0
CONTRACT PRICE $4,000.60
HISTORY:
Ol/15(2015 Payment Payment $4,000.60
$0.00
TOTAL AMOUNT DUE
If you have any questions or concerns regarding this bill,please call our office at(717)697-4696.
REV-1512 E�+ (12-0�}
�-��� �-= pennsylvania SCHEDULE I
�� DEPARTMENT OF REVENUE DEBTS OF DECEDENT,
iNHeRc-raNce Tax aeruarv MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Erin M. Foor 21-15-0213
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• Appraisal Solutions-appraisal of decedenYs real estate $300.00
2. Misc.AAA car transfer fees,PennDOT fees $83.00
3. Renter's Insurance-final bill $�$2.�2
4. Wells Fargo Mortgage Account#0279270813-payoff for 405 Delancey Court, Mechanicsburg, PA $13,098.00
$39,293.00 date of death balance.Decedent's one-thirtl interest is payoff.
TOTAL(Also enter on Line 10, Recapitulation) $ 13,663.72
If more space is needed,insert additional sheets of the same size.
,y�1�.
Retum Mai!Operatia►s Satemeat date Ol/05/15
��� • PO Box f4411 L aumber 0279270813
� . Des Moines,IA 50.?OB-3411 Psoperty ess
405 DEI.ANCY COURT 405
MECIiADiICSBURG PA 17055
Customer Service�o�.
;�na�.�
�Faz � Telephoae
1-866-27&1179 1-866-234-8271
Correapoadenca Houn of opention
�••� PO Boz 10335 : Mon-Fri 6 a.m,-10 p.m.
���Iu�IIIh��iUurd�4l��l�l�ll�rula���������r�,iui��q� ' '�M�:�� �t8a.m.-2P.m.�
1AT 01574J113574/003147 0548 2 ACSGVI 708 : �7Pay�wa .
p0 Boz 11701 Purchas�or refinaace
ROLLAND E FOOR III x�k xa o�oi i-as�as�-so2s
GAIL W FOOR
2403 RYE CIRCLE We accept telecommunications relay sexvice calls
MECHANICSBURG,PA 17055-5761
Payment summary Balance summary Year to date summary
- -- Un :�d' nnci al balanee - '
Sss.29a.sa roai=e�e►� -- _ . -— --- - -ss4s.so
Principal . __ $222.88 P � P� P Princi ai $2��
Eacrovr balaace $�2�•� p g r�,�
Interest $155.54 (������er����yy�,��r�18�) Iaterest" . $��
EsCroW $267.18 �tez�s4 nt� 4.75096 Esczow
Curreatpayment �645.60 Matusitydato �/26 .���,�th.vo�ppind5mdsb.lmf�om+6.
Hdmc�sommrs�etlan
— "Yhi�lo6o�r1ma6ouidoo�b�used facta puepora IIyou h.ve
Total Paqment a645.60 ���°Of�""C0�'�`yO1ta'd"'f0G
After 02/16/15 a late charge may apply $18.92
„�.
Activity since your last statement ��pci,Ft�rtan��messaSes ,
Other '�6ta,nGxit�l.oiu's@CQtdsiac�icat°you�: �c
Date Deacri Hon Total Priaci al Tnterest Escrow �ffi���tosvithdraw .
0 os ra s Es�s.so s222.00 S�ss.az S2�.is �.: :Aiif�a�►dfareappliedwl�ea `:
� M�� �t E579.65- USAA GROUP ��'
sttffcieat fuads have accumulated to makes full
yp�t�ly paYznent a�outlined in your morc989`�
t aoke.If you are P.8Y+n5.Q�Yo�'loazs,P��
�,
�tagtusatl�t�ve,(s�days:�norko::Y?�+rPg?�
T+lu�?Afcrm4tioa
Ycu caa access a copyr of your 2014
,�,,nppttggge-related taX.document on Wella Fargo
' �?nlipe�:�E`s:�e+seetus aad free.Documents
ase;pqg4ed Taiil-.�envaijr aad rewain a•isiieble .
�qu�h�the y¢ar To�new or downloed a coPY
,t�,{�lpg�#om�t�sagn in�;en=o11 today at:.,, '
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4
REV-1513 EX+(01-10)
� ' pennsylvania SCHEDULE )
�
DEPARTMENT OFREVENUE
INHERITANCE TAX RETURN � BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
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).]
i. Rolland E. Foor, III and Gail W. Foor,2403 Rye Circle,Mechanicsburg, Parents 100%
PA, 17055.
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1590 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:
1.
TOTAL OF PART II — ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $
If more space is needed,use additional sheets of paper of the same size.