Loading...
HomeMy WebLinkAbout01-0363 (!.., REV-1500 EX + (6-00) OFFICIAL USE ONLY COMMONWEALTH OF PENNSYLVANIA REV-1500 lfo ---J,),,~ -0 DEPARTMENT OF REVENUE DEPT. 280601 INHERITANCE TAX RETURN FILE NUMBER , HARRISBURG, PA 17128-0601 RESIDENT DECEDENT 21 2001 0363 COUNTY CODE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Baker, Lerov E, 550-36-6082 DECE- DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE DENT 03/25/01 05/06/1912 WITH THE REGISTER OF WILLS (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER ~ 3. Remainder Return CHECK 1. Original Return ~' Supplemental Return B (date of death prior to 12-13-82) APPRO- 4. Limited Estate 4a. Future Interest Compromise 5. Federal Estate Tax Return Required (date of death after 12-12-82) PRIATE 6. Decedent Died Testate 7. Decedent Maintained a living Trust 1 8. Total Number of Safe Deposit Boxes (Attach copy ot Will) (Attach acopyofTrust) BLOCKS 9. litigation Proceeds Received 10. Spousal PovertyCredit(date of death between 0 11. Election to tax under Sec. 9113(A) 12-31-91 and 1-1-95) (Attach Seh 0) 'fflj$$l!PTIp"Mi)$Tj;!I1PPi\W'gtl1i:!i!\li'P9t\jj~~"!;:i'ijl!;:9"fiQgi'-l'tIAlif@jIi'-lFI;!i'!MAtjQf.i$HQ\l4P~El)'l'llieti!btPi NAME COMPLETE MAILING ADDRESS COR- Philin H, Spare 44 West Main Street RE- FIRM NAME (If Applicable) Mechanicsburg, PA 17055 SPON DENT Snelbaker, BrennelT\3.Il & Spare, p,e, TELEPHONE NUMBER 717-697-8528 150,000,02-,(; OFFICIAL USE ONLY 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3,944,0e: ( 9 :Dill' Non.g. r:~ n 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) ';Q,S2' 4. Mortgages & Notes Receivable (Schedule 0) (4) Non~ c:l , "... ,: ("", 5. Cash, Bank Deposits & Miscellaneous Personal n Property (Schedule E) (5) 368,577,66 N 0 6. Jointly Owned Property (Schedule F) 0 Separate Billing Requested (6) NonEe -0 I' h) C' RECA- ""n .' 1'; 0 -- PITULA- 7. Inter-Vivos Transfers & Miscellaneous ):' N TION Non-Probate Property (Schedule G or L) (7) None 8. Total Gross Assets (total Lines 1-7) (8) 522,521,66 9. Funeral Expenses & Administrative Costs (Schedule H)(9) 23,798,11 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 8,590,04 11. Total Deductions (total Lines 9 & 10) (11) 32,388,15 12. Net Value ot Estate (Line 8 minus Line 11) (12) 490,133,51 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax (13) None has not been made (Schedule J) 14. Net Value SUbJect to Tax (Line 12 minus Une 13) (14) 490,133,51 SEE INSTRUCTIONS ON PAGE 2 FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(a)(1.2} X.O (15) TAX 16. Amount of Line 14 taxable at lineal rate 490,133,51 X .0 45 (16) 22,056.01 COMPU- 17. Amount of Line 14 taxable at sibling rate 0,00 X .12 (17) 0,00 TATION 18. Amount of Line 14 taxable at collateral rate 0.00 X .15 (18) 0,00 19. Tax Due (19) 22,056,01 20. 0 IqHilpkij~!fydi)All~Il~qQj1.siiiiQA!!~NpQfA!ilO~!l~AYMEr#1 o PAl5001 NTF 29755 : >,c.BE..SURf;TO ANsWER ALL:queS11ON$ ON PAGe" AND RECHECK MATH'" Copyright 2000 GreatlandlNelco LP- Forms Software Only PA REV-1500 EX (6-00) Decedent's Com lete Address: STREET ADDRESS Messiah Villa e, 100 Mt. Allen Road Page 2 r Allen Townshi , Cumberland Ct CITY Mechanics Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount STATE PA ZIP 17055 (1) 22,056.01 Total Credits (A + B + C) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penally (3) 0.00 (4) (5) 22,056.01 (5A) 0.00 (5B) 22,056.01 Totallnterest/Penalty (D + E) 4. If Une 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 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. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BAlANCE DUE. Make Check 1. Did decedent make a transfer and: 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: or. , . , . . . . . . . . . , . . . . . . . , . . . . . . , . , . . . . . , . . . . d. receive the promise for life of either payments, benefits or care1 , . . . . , . , . . . . , , , . . . . . . , , . . 2, If death occurred after December 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 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. 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 information of which preparer has anv knowled08. SIGN~URE OF PERSON RESPONSIBLE FOR FlUNG RETURN DATE . ~ f> ~;.D[)'~ /.;l liT 12-."..1 ADDRESS ' I See Schedule attached A ,p RER OTHER THAN REPRESENTATIVE Yes No ~ I B ~ o ~ />~U)\J\\):)?:\}):}:{?:'\t/(U:,}))}}):U({:::)))))))):U:):'~:)::::,,::>{\::U::,Y::Y\})}}::::}))))::t):?(;(:)}})}));:Y:(:\::))}}}{':})))),,((:)))))\:-::::,}))):/:,'}{}}::,n'/:/))J)t):X::':::(:: Fo'r'dates of de'at'li on or after' July 1, 1994' and before Jan'uary 1;'199'5, 1h'e tax rate 'i'mposed o'n th'e'net value of transfers to or for the' use of the surviving spouse '(5 3c/~' ' (72 P.S. II 9116 (a)(1.1)(iJl For dates of death on or after January 1, 1995, the tax rate is imposed an the net value of transfers to or for the use of the surviving spouse is 0% (72 P.S. Ii 9116 (a) (1.1)(ii)). The statute riM'''' nnt I!Xl!mrlt a tral1sfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are stillapphcable even i1 the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax ratll im?osed on the net value of transfers 1rom a deceas~d ctlild twenty-aria yaars af 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% [72 P,S.1i9116(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%, except as noted in 72.P.S. II 91 1 6(1.21 [72 P,S,1I91 16(21)(1)]. ,he tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. !i9116(a)(1.3)], Asibling is defined, under Section 9102, asan individual who has at least one parent in common with the decedent, whether tly blood oradoptlon. Main Street, Mechanicsburq, PA 17055 o PA15002 NTF 29756 Copyright 2000 Greatland/Nelco LP- Forms Software Only Estate of: Leroy E. Baker 21-2001-0363 The following person(s) are signing the return as representative(s) of the estate: Arm P. Miller 1789 Braggtown Road East Berlin, PA 17316 REV~1502 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Leroy E. Baker SCHEDULE A REAL ESTATE FILE NUMBER 21-2001-0363 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 willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which Is jointly-owned with right 01 survivorship must be disclosed on Schedule F. ITEM NO. DESCRIPTION VALUE AT DATE OF DEATH 1 Property known and numbered as 2731 Arcona Road, Upper Allen Township, Cumberland County, Mechancisburg, PA, sale value (settlement sheet attached) 150,000.00 TOTAL (Also enteron tine 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 150,000.00 7 CPA2.1 NT!" ~\)91)4 Copyright Forms Software Only, 1997 Nelco, inc. . " A. 8.1 YPE OF LOAN: U.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT 1.QFHA 2'OFmHA 3.~CONV. UNINS. 4.0VA 5'OCONV.INS. 0. t-ILI: : I f. LUAN : SETTLEMENT STATEMENT 01521 17902696 8. MORTGAGE INS CASE NUMBER: I\,;. NUIt:: ThiS form is furnished to give you a statem~nt of actual settlement costs. Amounts paid to and by the settlement agent arB shown. Items marked "[POC)" wsw paid outside the closing: they are shown hem (or informational putpDses and are not included in the totals. 1.0 3199 (Ot521101621/34) I U. NAMI: RESS OF BORROWER: E. NAME ANIJ A ; OF SELLER: F. NAME ANIJ ADORE"" ur : Eric S. Joyner and Estate of Leroy E. Baker Chase Manhattan Mortgage Jennifer C. Joyner 100 Granite Drive Media. PA 19063 . G. PROPERTY LOCATION: H. SETTLEMENT AGENT: 25-1878915 I. SETTLEMENT DATE: 2731 Arcana Road Keystone land Transfer, Ltd. Mechanlcsburg, PA 17055 December 6. 2001 Cumberland County, Pennsylvania PLACE OF SETTLEMENT 3425 Market Slreet , Camp Hill, PA 17011 J. v, .~ IIUN -I 1\. " ur IIUN 1100. H DUE FROM BuRROWER: ~ 400. -GRu:;:; ~ MOUNT DUE TO :;tOLLER: [lU1. liomracl~aest"nce 1t>U, .401. \,;ontract: 5ales pnce 150.000.00 I' Ul. ,...ersonal I ropeny I 402. Personal ropeny lUJ. ::;etuemem L;narges (Q tJorrower (Line-14QO) . 4,965.761 ,403. lU4. 404. lU,. .405. AOjUSlmenrS I'"or /lems I'"a,O By Seller In advance Adjustments rOf lCems ~81a t:fY ~ellef In aavance 100. \,;IlY" own ,axes 10 I 406. Cityrrown I axes \0 101. \,;CUnlY I axes 10 ~.N 1-407: Counly Taxes '0 "3."" 108. :;chool lax 10 "41Jl4114Ul1.SCl\00TT a. \0 \141.04 IV.. I4lllf. 110. 141U. 111. I41T. "". 1412. 120. GROSS AMOUNT DUE FROM BORROWER 155.930.89 420. GROSS AMOUNT DUE TO SELLER 150.965.13 200. PAID BY uR IN IIEHALr uF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER: I"'u- . ueposit or earnest money 5,000.00 I 501. excess ueposll {.:)ee IOSlruc 10nSl IZOZ. pnnClpa, Amount at New Loants) , J.UU I 5U2. tiettlement Charges to tieller (Line 1400) 12,131.00 ~U3. eXisting loan(s) laKen suoJecllo I 5U3. eXIS lng 10an(S) taKen suoJect to ZU4. [OU4.1'8yofTofllrst Mongage ,w,. f ~u~. ~ayonorseconulvloHgage I<uo. 1500. <Uf. I 507. (Deposit ISO. as proceea5J ZUO. 1506. ZU". I 'U". AOJUSlmems rOf /lems unpalO t1y ~ellef AdjUstments ror lIems unpaId By"eller Z1U. \,;IlYllown laxes 10 1510. Cilyllown axes 10 Zl1. \,;ounlY 'axes 10 I 511. (,;()unty Taxes to ZIZ. :scnool I ax to I 512. ~chool- ax 10 <13. 1513. <14. 1514. <15. 1515. 1<10. I5l6: 1<1/. I51T. <10. 1'18. <1.. 1519. 220. TOTAL PAID BY/FOR BORROWER 125,000.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 12.137.00 3W. \,;A:;n. ~"'" : I 600. CASH A I : 3Ul. ljross Amount uue t-rom Ilorrower (une 1Z01 105."30.89 1 601. Gross Amount uue 10 :sellequne 4Z0) .13 3UZ. Less Amount palO Ilylt-or Ilorrower (une Z20) I' 1Z5,000.00; 1 602. Less Reducuons uue :seller (une 5Z0) 12,137.00. 303. CASH ( X FROM) ( TO) BORROWER 30.930.89 603. CASH ( X TO)( FROM) SELLER 138.828.13 OMB NO 2502 0265 A-o, The undersigned hereby acknowledge receipt of a completed copy of pages 1&2 af trns statement &,aoy attachments referred to hereln. Borrower Seller [2"vV';o .h7~rn) rX ~L Estate of Leroy E. Baker ./ $ L. SETTLEMENT CHARGES @ ,- % 10,500.00 70u. TU'A~ "uMMI"",uN Based on Price IVISlon aT t,;ommlSSlon (/me I as 0 OWS: I ' U I. ;p ~..L"OJ.uu (0 KG/Max Keany ASSOCla1es, me. I/U4::. ~ O,lIO.UU 10 nawaru ranna uelWel er I (V", l"OmmlSSlon t'81U 81 o::.6memenl I ' U.... I ransacuon ae 10 Ke/Max I" BallY ASSOC. Inc. 800.ITcMS PAYABLE IN CONNE<;IIUN Wilt! LOAN I HU1. Loan unglna Ion t-ea U.UUUU 70 to I "Ul. ~oan ulscoum % to IOv.. ,ppralsa. ree '0 "ouert l:nsmlngerAppr. IOu.... ""reUII ",epoll 0 I oe Loreon ,,,elWorK I cuo. LenUer 5 InspeCllon res to 10UO. Mortgage Ins. App. "ee to I ov,. ""sumpllon "ee 0 10vo. OUU. OlU. 011. Oll. lax oervlce tlM. uocumem t"repara Ion 014. Imlla. .,000 "en 010. ",000 Coen 010. Olt. 010. OlU. IOlv, 900. ITEMS REQUIRED By LENUI:R I U BE 901. Interest From 12106/01 to 01/01/02 @ 1;IU". Mongage IOsurance t"remlum or mon 5 0 1;10". M azaru Insurance Premium for I.U years to 9U4. UUO. 1000. RE"I:RVI:" 1UU1. Hazara Insurance lUUl. Mongage nsurance 1 UUJ. l,;IIY" own I axes 1 UU4. <;ounty I axes I VVO. oCllool I ax lUUO, lUUf. 1 UUO. Aggregale Aa)US'mem 1100. T ARGES 1101. Settlement or Closing Fee 11Ul. Abstract or I ilIe "earcn 11UJ. Tille Examlnallon -I w.... Ilue msurance ~inder -11 VO. uocument Preparation I-I VD. NOlary rees nU{.1\uorneys Fees IInc uues Soave 118m numvers: 11UO, me Insurance to Keystone Land Transfer, Ltd, (lnclUoes saove nem numaers::.nClorsements 1UU, JUU, lj,l 11VU. Lenaers Cooverage ~ llV.VVV.VV 11-1 U. uwner-S t...overage ~ -IOU,UUU.UU 1-1-1-1, t...loslng ,...roleCllon LBUer 10 l'\eYSlone LanU I ransTer:LRf. Illl. . I ,.. 1200. "UVI:RNMENT R 1201. Recording Fees: Deed $ y oun y a amps:ueea l:lUJ. ~(ate I aX/~lamps: Kevenue ~Iamps lLV4. lLU'. 130U. AuDITIUNAL "Ell LEMENT 1301. Svrvey 1 JUl. ..estlnspecllon 13UJ. Hansaellon ~ee 10V4. I'JVO. 1400. TOTAL "ETTLEMENT l,;HARGE" (Enter on Lines 103, Sec!lonJ and 502, Secllon K) .y","O,"" 1 0 lh" '~"""".'" "'0'''0'' ,"o~"d,. "",pt ot, ""op'''''' oopy 0 ..,.201 ""lwo P"y;;. A-^--> 10 l,;VHI ~ 10 l,;nase Mannallan Mongage to "lfSt Amencan "'000 uata "erv. 10 .lfsl Amencan FIOOO Uata "erv. ADVANCE $ 22.190000/day ( 26 days D WII H LENUI:R 4.000 $ -$- T ~ ~ ~ 39,91 per month per month per month- 1>.Ul per moi\ll1 1<7.14 per monlll per moi\ll1 per moillfl per month months monlhs monns 11.UUU monn s 7.UUU monlllS manus monns months s to to to to to 10 <;A"H to AND TRANSFER' 25.50; Mortgage $ 53.50; I,OVU.UU; Mongage I.ov~age Releases $ ES to to 10 HowarCl Hanna Uetweiler %) ,.olley PAlO FROM BORROWER'S FUNDS AT SETTLEMENT 'lO.VI <".UU 10.OU 69.UU 100.VU ".VU ,.vu 576.94 15u.'" <75.<< BB9.9f ll.VL ) l,<<OJ ) OO.VU 79.00 I,OUU. 4,965JI IZ/ {~fiA-- Ke\l'stOne Lano I ransTer, LIO. Settlement Agent Certified to. be a true copy. PAlO FROM SELLER'S FUNDS AT SETTLEMENT lV,OW.VU lL.UU 1,5UU.UU llO.VU 12.137.00 (Ot521/01521/341 REV~1503 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Leroy E. Baker SCHEDULE B STOCKS & BONDS FILE NUMBER 21-2001-0363 All property Jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NO. DESCRIPTION VALUE AT DATE OF DEATH 1 Zapata, Inc., 200 shares of corrrron stock valued at $16.32 per share 3,264.00 2 Echo Bay, 1,000 shares of corrrron stock valued at $.68 per share 680.00 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 3,944.00 7 CPA31 NTF '0905 COPYright Forms Software Only, 1997 Nelco, Inc. REV-15GB EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF . Leroy E. Baker SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 2l-200l-0363 Include proceeds of litigation & date proceeds were received by the estate. All prop. jolntlv-owned wit... rlaht 01 survivorship must be disclosed on Sch. F. VALUE AT DATE OF DEATH ITEM NO. DESCRIPTION l Salaron Smith Barney, Inc., Investment Account # 724-l9377-l8-78l & 724-2423l-l4-789 273,859.24 2 Harris Savings Bank, Certificate of Deposit #05-64-244705 3 The Zweig Closed End Funds, Investment Account #3206 lO 35-7633 30,000.00 3,700.24 4 Postmark Credit Union, Savings Account #748-00 2,4l7.55 5 PNC Bank, N.A., Checking Account #50-7008-8266 47,994.62 6 Allfirst, Checking Account #00132-9632-9 4,376.0l 7 Household goods as appraised by Robert Ensminger Appraisers (copy of appraisal attached) 6,230.00 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 368,577.66 7 CPA81 NTF 10908 ~,'pyrtght Forms Sottware Only, 1997 Nelco. Inc ROBERT ENSMINGER APPRAISERS REAL ESTATE and PERSONAL PROPERTY 3557 _ELMERTON AVENUE HARRISBURG, PA 17109-1132 PHONE 717~52-4111 FAX 717-541-9444 June 1, 2001 E-MAIL: threecompS@PAnetworkcom Ann Patricia Miller 1789 Braggtown Road East Berlin, PA 17316 RE: Leroy E. Baker Estate Dear Ms, Miller: In accordance with your request, I have appraised the personal property of Leroy E. Baker, deceased. The property is located at 2731 Arcona Rd., Mechanicsburg, PA 17055. The values shown have been arrived at after a careful study of the property. believe it to reflect a true measure of its market value as of April 27, 2001. The date of death was March 25, 2001 and the values have remained unchanged since that time. Market value is defined as being the most reasonable or probable price in terms of money that real or personal property will bring in an open and competitive market under all conditions requisite to a fair sale, the buyer and seller each acting prudently and knowledgeably, and assuming the price is not affected by undue stimulus. Taking into account all of the factors set forth in the pages that follow, it is the opinion of the undersigned that the fair market value of the personal property is Six Thousand Two Hundred Thirty Dollars ($6,230.00.) Additionally, the value of the real estate, which is described in the attached Uniform Residential Appraisal Report, is One Hundred Fifty Thousand Dollars ($150,000.00) Employment in and compensation for making this appraisal are in no manner contingent upon the value reported and I certify that I have no financial interest in the property appraised, present or contemplated. V'~4~~~ Robert A. Ensminger Leroy E. Baker Estate Kenwood stereo $ 40.00 End tables $ 10.00 Bookcase $ 150.00 Mirror $ 20.00 Picture wI convex class $ 30.00 RCA TV $ 50.00 RCA TV $ 100.00 Wheel chair $ SO.OO Record cabinet $ 5.00 Plank bottom chair $ 35.00 Thomas oraan $ 25.00 Card table $ 10.00 Oak table $ 60.00 Floor lamp $ 20.00 Sears 8 x 12 oriental rug $ 100.00 Mirror $ 35.00 Grandfather clock $ 100.00 Coffee table $ 20.00 Lamo $ 20.00 Taoe olaver $ 10.00 Misc. in Iivina room $ 25.00 Sewina machine $ 15.00 Mahoaanv secretary $ 150.00 Bookcase $ 20.00 9 x 12 oriental ruc $ 250.00 Air conditioner $ 40.00 Misc. in den $ - 20.00 Drop leaf dininc table & 4 chairs $ 250.00 Hutch $ 150.00 File cabinet $ 15.00 Contents of hutch $ 60.00 Desk $ 35.00 Tea Waaon $ 35.00 Gossio bench $ 20.00 Misc. in Ddininc roam $ 10.00 RCA refriqerator $ 75.00 Microwave oven $ 20.00 Kitchen table & chairs $ 10.00 Misc. in kitchen $ 30.00 Hall cabinet $ 40.00 Mirror $ 10.00 Utility cabinet $ 5.00. Bedroom suite $ 150.00 Chest of drawers $ 40.00 Page 1 of 2 Leroy E. Baker Estate Bookcase $ 10.00 Desk $ 20.00 Dresser $ 50.00 Rope bed $ 250.00 Misc. in Bedroom $ 20.00 Sewing machine $ 25.00 Bench $ 75.00 Childs chair $ 60.00 Bench & stool $ 10.00 Cedar chest $ 75.00 Vacuum $ 10.00 Pineapple bed $ 75.00. Blanket chest $ 400.00 Empire chest of drawers $ 200.00 Misc. in attic area $ 50.00 Misc. in Basement $ 100.00 1949 Dodge, original, needs restoration $ 1,000.00 1991 Ford Taurus, 86,000 miles, rt. Rear door damaged $ 1,000.00 Engine hoist $ 40.00 Hedge trimmer $ 20.00 Gravley mower $ 100.00 Weed eater $ 75.00 Misc. in garage $ 100.00 Boat trailer $ 100.00 TOTAL $ 6,230.00 Page 2 of 2 REV-1511 EX + (1-97) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF . Leroy E. Baker FILE NUMBER 21-2001-0363 Debts of decedent must be reported on Schedule I. ITEM NO. DESCRIPTION A. FUNERAL EXPENSES: AMOUNT 1 Musselman Funeral Home, funeral services 6,070.00 2 Rolling Green Cemetery, opening of grave 760.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name 01 Personal Representative(s) Social Security Number(s)/EIN No. of Personal Representative(s) Street Address City State 0.00 Zip Year(s) Commission Paid: 2. 3. Attorney Fees Name: Snelbaker, BrenneITffil & Spare Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City St.te Zip Relationship of Claimant to Decedent 1,500.00 0.00 4. Probate Fees 83.00 5. Accountant's Fees 0.00 6. Tax Return Preparer's Fees 0.00 See Schedule attached Total frcrn continuation pagels) 15,385.11 TOTAL (Also enter on line 9. Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 23,798.11 7 CPA11 "JTF 10911 ':JPYrlght Forms Software Only, 199'1 Nelcp.lnc. Estate of: Leroy E. Baker . Item No. SaJEDUlE H, PART B -- Administrative Costs Description 7 Register of Wills, Curr10erland County, filing fee for Inheritance Tax Return 8 Register of Wills, Curr10erland County, short certificates 9 Patriot-News, advertising Executrix Notice 10 Curr10erland Law Journal, advertising Executrix notice 11 Sharps Landscape, lawn service 12 Archer Pest Control, treat and remove hornets nest from property 13 Derr' s Trash Hauling, removal and disposal of miscellaneous household trash items. 14 ReMax Realty Association, Inc., realtors commission paid on sale of real estate 15 Transfer Tax paid on the sale of Real Estate 16 Notary Fees and transaction fees paid on sale of real estate. 17 Reserve for filing fees, accounting costs and miscellaneous fees associated with the administration of Decedent's Estate TOTAL. (Carry forward to main schedule) . . . .N Page 2 21-2001-0363 Amount 15.00 51.00 93.81 75.00 640.00 58.30 1,315.00 10,500.00 1,500.00 137.00 1,000.00 15,385.11 REV-1512 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF - Leroy E. Baker Include unreimbursed medical exoenses. ITEM NO. DESCRIPTION SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 21-2001-0363 AMOUNT 1 Messiah Village, resident care, account payable 7,820.67 2 Saleh Malik Dentistry, dentist services, account payable 85.00 3 Pharmarica, perscriptions, account payable 149.24 4 NeurolO3j' ctr PC., medical services, account payable 100.26 5 Bc:Mmansdale Family Practice, medical services, account payable 135.07 6 PPL, electric service, account payable 23.67 7 Verizon, phone service, account payable 66.70 8 Ernest Latsha, fuel oil, account payable 209.43 7 CPA12 NTF 109'2 TOTAL (Also enter on fine 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 8,590.04 Copyright Forms Software Only. 1997 Neice. Inc. REV-1513 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES Lerov E Baker No. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1 Ann P. Miller 1789 Braggtown Road East Berlin, PA 17316 FILE NUMBER RELATIONSHIP TO DECEDENT Do Not LIst Trustee{s) Daughter 21-2001-0363 AMOUNT OR SHARE OF ESTATE 490,133.51 ENTER DOLLAR AMTS. FOR DISTRIBS. SHOWN ABOVE ON LINES 15 THROUGH 17 AS APPROPRIATE ON REV 1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE None B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS None 7 C?AIJ I'iTF 10513 TOTAL OF PART 1\ ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 0.00 r;ooyright Forms Software Only, 1997 Nelco, Inc. (If more space is fleeced. II1SQrt '::;'CC;;iCildi ';;,"'0<::1: cf :;,G Sam8 Si::e! ',.' " ,'" ')%' - 'j .t. ~ ' " ~." ","..' ! .u , . " "": .. ~ "'~I 'I" '.;: "~""'~", -" ", ,.~~ ...... " !1: 'iI- "'('<?Ii .~~.1 ,I,', l.";;:>i~"~ '"'./ It:j'', ~\j.?1 ..~' \.:!~>.: 7.; j~~,f;'~"' <,,~~','~~t,~", LAST WILL AND TESTAMENT I, LEROY E. BAKER, of the Township of Upper Allen, County of Cumberland and State of Pennsylvania, being of sound mind, memory and 1 ...'l '.j' .. I understanding, do make, publish and declare this to be my last Will and Testament, hereby revoking and making void all former wills, codicils and other testamentary dispositions by me at any time heretofore made. 1. I direct my executrix, hereinafter named, to pay as soon as practicable after my decease all my just debts and the expenses of my last illness and burial. 2. I give, devise and bequeath all of my estate - real, personal and mixed - unto my wife, June D. Baker, absolutely. 3. 1 1 Should my said wife, June D. Baker, predecease me, then and in that event I give, devise and bequeath all of my said estate unto my 'daughter, Ann P. Baker. 4. I nominate, constitute and appoint my wife, June D. Baker, executrix of this my last Will and Testament. Should my said wife fail to qualify or cease to act as executrix, I appoint my daughter, Ann P. Baker, as executrix of this my last Will. IN WITNESS WHEREOF, I, LEROY E. BAKER, the Testator, have hereunto set my hand and seal to this my last Will and Testament this /.,-z;{ day of 7 -<>6-U-Ld- , 1977. /<::/1,; C' ~ (SEAL) , / "" '"r: ',,,' o '-,' Signed, sealed, published and declared by the above named Leroy E. Baker as and for his last Will and Testament in the presence of us, who, at his request and in his presence and in the presence of each other, have hereunto subscribed our names as witnesses thereto. "."t ~~ ~ BkL0-- ) C ?~~