HomeMy WebLinkAbout08-31-15 ` '��Y 15056141�5
� pennsytvania
��, oevnnrncrvrarnevenue EX(03-14)(FI)
REV-1500 OFFICIA�USE ONLY
Bureau of Individual Taxes Couy�Code Year File Number
PO BOx 280601 INHERITANCE TAX RETURN �{' /� �� /
Harrisburg, PA 17128-0601 RESIDENT DECEDENT ��
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
' 07122014 08291932
DecedenYs Last Name Suffix DecedenYs First Name MI
LAY ELMER L
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
� 1. Original Return p 2. Supplemental Return p 3. Remainder Return (date of death
prior to 12-13-82)
p 4.Agriculture Exemption (date of p 5. Future Interest Compromise(date of 0 6. Federal Estate Tax Return Required
death on or after 7-1-2012) death after 12-12-82)
� 7. Decedent Died Testate p 8. Decedent Maintained a Living Trust 0 9. Total Number of Safe Deposit Boxes
(Attach copy of will.) (Attach copy of trust.)
p 10. Litigation Proceeds Received p 11. Non-Probate Transferee Return p 12. Deferral/Election of Spousai Trusts
(Schedule F and G Assets Only)
O 13. Business Assets 0 14. Spouse is Sole Beneficiary
(No trust involved)
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
DONALD L LAY (717)648-6242
First Line of Address
3804 BRYTTON LANE
Second Line of Address
City or Post Office State ZIP Code
..�
HARRISBURG PA 17110 � � �
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CorrespondenYs email address: y@ Y
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REGISTER OF WIL�S,,:U$E OAt�1i ; .a � �
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. REGISTER OF WILLS USE ONLY � �� � - � ��
DATE FILEO MMDDYYYY —., �i7 ,� —��
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DATE FILED STAMP �
PLEASE USE ORIGINAL FORM ONLY
Side 1
� (I�������������������5,�I���lI��,I���I1�����������I�I��II���� ],5�5 61410 5 �
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� � 1505614205
REV-1500 EX(FI)
DecedenYs Social Security Number
DecedenYs Name: ELMER L LAY �^^
RECAPITULATION
1. Real Estate(Schedule A). . . . . . . . . . .. . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. 85,000.00
2. Stocks and Bonds(Schedule B) .. . . . . . . . . . . . . . . .. . . . . .. .. . . . . . . . . . . . . . 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) . . . . . 3.
4. Mortgages and Notes Receivable(Schedule D) . . .. .. . .. .. . . . . .. .. .. .. .. .. 4.
5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E). . . . . . . 5. 33,844.85
6. Jointly Owned Property(Schedu�e F) O Separate Bifling Requested . . . . . . . 6.
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) O Separate Biliing Requested.. . . . . . . 7.
8. Total Gross Assets (total Lines 1 through 7). . . . . . . . . . . . . . . . . . . . .. . . . . . . . 8. 118,844.85
9. Funeral Expenses and Administrative Costs(Schedule H). . . . . . . . . . .. . . . . . . . 9. 28,840.35
10. Debts of Decedent, Mortgage Liabilities and Liens(Schedule I). . . . . . . . . . . . .. . 10. 3,090.59
11. Total Deductions(total Lines 9 and 10). .. . . . . .. . . . . . . . . .. .. . . . . . . . . . . . . 11. 31,930.94
12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . .. .. . . . . . . . . .. . . . . . . . . . 12. 86,913.91
13. Charitable and Governmental Bequests/Sec.9113 Trusts for which
an e�ection to tax has not been made(Schedule J) .. . . .. . . . . . . .. .. .. . . .. .. 13.
14. Net Value Subject to Tax(Line 12 minus�ine 13) . . . . . . . . . . . . . . . . . . . . . . . . 14. 86,913.91
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- , 15.
16. Amount of Line 14 taxable
at lineal rate X.0 45 86,913.91 �g. 3,911.13
17. Amount of Line 14 taxable
at sibling rate X.12 ', ��
18. Amount of Line 14 taxable
at collateral rate X .15 18
19. TAX DUE . . . . . . . . . . . . . . . . . . . . . .. . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 3,911.13
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O
Under penalties of perjury, I declare 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 person responsible for filing the return is based on all information of which preparer has
any k ge.
SIG ATUR OF PERS SP NSIB �OR FILING UR���`1 � �ATE' _ ��
a
ADDRESS
3804 BRYTTON LANE, HAR BURG, PA 17110
SIGNATURE OF PREPARER OTHER THAN PERSON RESPONSIBLE FOR FI�ING THE RETURN DATE
ADDRESS
� i iiiiii iiiii iiiii iiii5�ii��iii i4ii�i�i�iiiii iiiii iiii iiii Side 2
1505614205 �
REV-1500 EX (Flj Page 3 File N�mber
Decedent's Complete Address:
DECEDENT'S NAME
ELMER L LAY
STREETADDRESS
227 ROXBURY ROAD
— _ __
��Ty I STATE ZIP
NEWVILLE PA 17241
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 3,911.13
2. Credits/Payments
A.Prior Payments
B.Discount
_...
(See instructions.) Total Credits(A+B) (2)
3. Interest
(3) 43.93
4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2,Line 20 to request a refund. (4)
5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 3,955.38
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 own an individual retirement account,annuity or other non-probate property,which
containsa benefciary 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 applicabie 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 step-parent of the child is 0 percent[72 P.S. §9116(a)(1.2)].
• The tax rate imposetl on the net value of transfers to or for the use of the tlecetlent'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 decedenYs sibiings is 12 percent[72 P.S. §9116(a)(1.3)].A sibiing is definetl,
under Section 9102,as an individual who has at least one parent in common with the decedent,whether by biood or adoption.
Practitioner Portal Page 1 of 1
��-�1,�-. L �-/�-� �2-ll"� —DD�D�
Penalty and Interest Calculations
CALCULATION DATES-
04/13/2015 TO $/28/2015
TAX DEFICIENCY $ 3,911.13
CALCULATED INTEREST $ 43.93
BALANCE AS OF 8/28/2015 $ 3,955.06
Start Over ,
https://www.doreservices.state.pa.us/pitservices/Default.aspx 08/21/2015
REV-1502 EX+ (02-15j
� pennsylvania SCHEDULE A
DEPARTMENT OF REVENUE
1NHERITANCE TAX RETURN REAL ESTATE
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
ELMER L LAY 2114-00706
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 fads.
Real property that is jointly-owned with right of survivorship must be disciosed 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' RESIDENCE 85,000.00
227 ROXBURY ROAD.NEWVILLE,PA 17241
SOLD 4/20/2015
TOTAL(Also enter on Line 1, Recapitulation,) $ 85,000.00
If more space is needed,use additional sheets of paper of the same size.
OMB Approval No.2502-0265
`P I�I� � A. Settlement Statement(HUD-1)
+�IIIIfI�„w •
.,.,.
� B.T e of�oan
1.� FHA 2.� RHS 3.❑Conv. Unins 6.File Number: 7. Loan Number: 8. Mortgage Insurance Case Number:
4.�VA 5.❑ Conv. Ins RE15-23
C.Note:This form is furnished to give you a statement of actual settlement costs.Amounts paid to and by the settlement agent are shown. Items marked
' .o.c. "were aid outside the closin ;the are shown here for informational ur oses and are not included in the totals.
D. Name&Address of Borrower: E. Name&Address of Seiler: F. Name&Address of Lender:
JONATHAN D. REINFORD ESTATE OF ELMER L. LAY
Newville, PA 17291 227 Roxbury Road
Newville, PA 17291
G. Property Location: H.Settlement Agent: TIN: 25-1696377
227 Roxbury Road Duncan & Hartman, P.C.
Newville, PA 17241 1 Irvine Row PhOne: (717) 249-7780
Carlisle, PA 17013
Lot: Place of Settlement: I.Settlement Date: 4/20/2015
1 Irvine Row
Block: Carlisle, PA 17013 Funding Date: 4/20/2015
J.Summa of Borrower's Transaction K.Summa of Seller's Transaction
100.Gross Amount Due From Borrower 400.Gross Amount Due To Seller
101. Contract sales rice 85 000.00 401. Contract sales rice 85 000.00
102. Personal ro ert 402. Personal ro ert
103. Settlement char es to borrower line 1400 1,579.00 403.
104. 404.
105. 405.
Ad'ustments for items aid b seller in advance Ad'ustments for items aid b selier in advance
106.Cit /town taxes: 406. Cit /town taxes:
to to
107.Count taxes: 407. Count taxes:
to to
108.Assessments: 408.Assessments:
to to
109. 409.
110. School Tax 9/20/2015-6/30/2015 307.77 410. School Tax 4/20/2015-6/30/2015 307.77
111. 411.
112. 412.
120.Gross Amount Due From Borrower 86,886.77 420.Gross Amount Due To Seller 85,307.77
200.Amounts Paid B Or In Behalf Of Borrower 500.Reductions In Amount Due To Seller
201. De osit or earnest mone 5,000.00 501. Excess de osit see instructions
202. Princi al amount of new loan s 502. Settlement char es to seiler line 1400 12 387.85
203. Existin loan s taken sub'ect to 503. Existin loan s taken sub'ect to
204. 504. Pa off of first mort a e loan
205. 505. Pa off of second mort a e loan '
206. 506.
207. 507.
208. 508.
209. 509.
Ad'ustments for items un aid b seller Ad'ustments for items un aid b seller
210. Cit /town taxes: 1/1/2015-4/20/2015 91.15 510.Cit /town taxes: 1/1/2015-4/20/2015 91.15
toBarbara Cline toBarbara Cline
211.Count taxes: 511.Count taxes:
to to
212.Assessments: 512.Assessments:
to to
213. 513.
214. 514.
215. 515.
216. Taxes Current Year $302.95 516.
217, Per Diem 50.82863 517.
218. Seller Paid $0 518.
219. Seller Owes 110 da s 519.
220.Total Paid B /For Borrower 5,091.15 520.Total Reduction Amount Due Seller 12,479.00
300.Cash At Settlement From/To Borrower 600.Cash At Settlement To/From Seiler
301. Gross Amount due from borrower line 120 86 986.77 601. Gross amount due to seller line 420 85 307.77
302. Less amounts aid b /for borrower line 220 5 091.15 602. Less reductions in amount due selier line 520 12 979.00
303.Cash � From ❑To Borrower 81,795.62 603.Cash 0 To ❑From Selier 72,628."]7
The Public Reporting Burden for this collection of information is estimated at 35 mi�utes per response for collecting,reviewing,and reporting the data.This agency may not collect this
information,and you are not required to complete this form,unless it displays a currently valid OMB control number.No confidentiality is assured;this disclosure is mandatory.This is
desipned to provide the paRies to a RESPA covered transaction with information durinq the settlement process.
O 2009-2011 Easy Soft.Previous editions are obsolete. Page 1 of 3 HUD-1
L.Settlement Char es File Number:RE15-23 Loan Number: •
700.Totai Real Estate Broker Fees Paid From Paid From
Division of Commission line 700 as follows: Borrower's Seller's
701. S to Funds at Funds at
702. $ to Settlement Settlement
703.Commission aid at settlement
704.
800.Items Pa able In Connection With Loan
801.Our ori ination char e S from GFE#1
802.Your credit or char e oints for the s ecific interest rate chosen S from GFE#2
803. Your ad'usted ori ination char es from GFE A
804.A raisal fee to from GFE#3
805. Credit re ort to from GFE#3
806.Tax service to from GFE#3
807. Flood certification from GFE#3
808.
809.
810.
811.
900.Items Re uired B Lender To Be Paid In Advance
901. Dail interest char es from 9/20/2015 to 5/1/2015 @ $ /da from GFE#10
902. Mort a e insurance remium for 0 months to from GFE#3
903. Homeowner's insurance for 0 ears to from GFE#11
904.
905.
1000.Reserves De osited With Lender
1001. Initial de osit for our escrow account from GFE#9
1002.Homeowner's insurance months @ er mo $
1003.Mort a e insurance months @ er mo $
1004. Pro ert taxes months @ er mo S
1005. months @ er mo S
1006. months @ er mo S
1007.A re ate Ad'ustment S 0.00
1100.Title Char es
1101.Title services and lender's title insurance from GFE#4
1102. Settlement or closin fee
1103.Owner's title insurance from GFE#5
1104. Lender's title insurance
1105.Lender's title olic limit S
1106.Owner's title olic limit $
1107.A enYs ortion of fhe total insurance remium S
1108.Underwriter's ortion of the totai insurance remium S
1109.Attorne 's fees to Duncan & Hartman 650.00
1110.Notar fee to Joan Adams 15.00
1111.
1200.Government Recordin and Transfer Char es
1201.Government recordin char es from GFE#7 79.00
1202.Deed 579.00 Mort a e S Release
1203.Transfer taxes from GFE#8 850.00
1204.Cit /Count tax/stam s:Deed $8 5 0.0 0 Mort a e S B S o.00
1205.State tax/stam s: Deed $ Mort a e $
1206. $
1207. $
1300.Additional Settiement Char es
1301.Re uired services that ou can sho for from GFE#6
1302.Escrow fee to Duncan & Hartman 75.00
1303.Escrow for Pa. Inh. Tax to Duncan & Hartman 5,737.50
1304.Deed Pre aration to Griffie & Assoc. 150.00
1305.Auctioneers's Commission to Hurle Auctions 4,250.00
1306.Advertisin Ex enses to Hurle Auctions 1,310.35
1307.
1308.
1400.Total Settlement Char es enter on lines 103,Section J and 502 Section K 1,579.00 12,387.85
I have carefull ev�ewed th HUD=1 ttlem t Statement and to the best of my knowledge and ' ,ii is a true and accurate statement of all receipts and disbursements made on
my �ount or me �his tr saction furt certify that I have received a copy of the HUD-1 S ttlemenk Statement.
• � �
J(��ATHAN D. REINFORD G� Buyer/Boffower ESTATE OF ELMER . LAY Selier
Buyer/Borrower Seller
This S�ttlement Stateme ' h I'e pre ared is a true and accurate account of this transaction.I've caused or will cause the funds to be disbursed in accordance with this statement.
� e�. � 4/20/2015
Duncan &0&ar�i a E".C. SettlementAgent Date •
WARNING'�'It is a crime to krac winqiv make false statements to the United States on this or anv other similar form. Penalties upon conviction can include a fine or im�risonment.
O 2009-2011 Easy Soft.Previous editions are obsolete. Page 2 of 3 HUD-1
REV-15G8 EX+ (02-15)
� pennsylvania SCHEDULE E
.. .: DEPARTMENTOFREVENUE CASH, BANK DEPOSITS & MISC.
(NHER[TANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
ELMER L LAY 2114-00706
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
�� ACNB BANK CHECKING ACCOUTN#122610 400.31
2. MEMBERS FIRST FEDERAL CREDIT UNION#21816668511 281.53
3. MEMBERS FIRST FEDERAL CREDIT UNION#21816668500 10,246.41
4. REAL ESTATE TAX REFUND 307.77
5. 2005 SATURN VUE 93,000 MILES-SOLD 2,000.00
6. PROPANE GAS REFUND 144.44
7. PROCEEDS FROM SALE OF PERSONAL PROPERTY 7,834.83
8. ADAMS ELECTRIC CAPITAL RETIREMENT 792.11
9. REBATE ON AUCTION COMMISSSION 53.00
10. FRANKLIN TEMPLETON A/C#209-12463562 10,795.23
11. 2014 IRS TAX REFUND 1040 INCOME TAX RETURN 891.00
12. REBATE ON RETURN OF LEASED PROPANE GAS TANK 9$•22
TOTAL(Also enter on Line 5, Recapitulation) $ 33,844.85
If more space is needed, use additional sheets of paper of the same size.
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Account Number 122670
;nformation EIMER I.AY Bai as of 630-14 260.31
OR SETTY lAY *aeptCR 1 740.00
Heip 227 ROXBURY RD -Chks/UR 1 56.29
NEWYILIE PA 17241 Service charge .00
l.cr{7�tt +Interest paid .00
CurraM baiance 544.02
�"�54 PSt Crt xeri:xf N�ttrrtfcr .� f?+..,sc+�(xtinn ..<>;i>>T;�::tk `7.riari<+�
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, _� �� Members lst Federal Credit Union 07/01/2014 07/3112014 1 of 2 XXXXXXX685
' S000 Louise Drive
P.O.Box 40
Mechanicsbur�PA 17055-0040
m (800)237-7288
MEMBERS 15� ��17)697-5312(Hearing Impaued) � � � � r
P6DERALCRFDITUP'ION �'�'Wmemberslst.arg �
��w� �TATE M
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TICKET �IVEAVIIAY
ELMER L LAY
3804 BRY7TON LN �=y
HARRISBURG PA 17110 �
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DCardinals vs Phillies New York City - "Day an Your �wn"
S�turC�� , Au ust 23, 2014 �Saturday, December 6, 2014
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For Details: www.memberslst.orgfbus-trips
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Your current Member Loyalty Rewards level is.Gold.. Your aggregate balance as of July 1 st is$25,266.01..
An aggrega#e balance of$35,000 and having 3 products will move you to fhe Platinurn leuei.
CHECKING 0.00
SAVINGS 0.00
CERTI FICATES 0.00
LOANS 0.00
SWIPE 5 YTD REWARD 1.00
11
BEGINNING B/aLA111C'E; $0.30
Eff. Post _ _ _
Date Date Description Deposits Withdrawals Balance
07/01 07/01 Deposit Transfer From Share 0000 700.00 700.30
07/01 07/01 Withdrawal ACH CenturyLink 53.57 646.73
l'YpE: SPEEDPAY ID: 0720594776 CO: CenturyLink
07/02 07/02 Check 000130 Tracer 0000047084 90.00 556.73
07/03 07/03 Withdrawal Debit Card CHECK CARD 14.32 542.41
07/02 BIG SPRING PHARMACY INC NEWVILLE PA
07/07 07/07 Check 000131 Tracer 120Q467661 16.00 526.41
Processed Check-AARP TYPE:AARP ID: 5951985500
07/09 07/09 Withdrawal Debit Card CHECK CARD 95.69 43072
07/08 BIG SPRING PHARMACY INC NEVWILLE PA
07/11 07/11 Withdrawal ACH DISH NETWORK 59.19 371.53
TYPE: DISH NTWRK ID: C825590000 CO: DISH NET
07/14 07/14 Check 000132 Tracer 0000056098 .
07/14 07/14 Deposif Transfer From Share 0000 15.47 .
s�
M�lYl�Ei�S 151 �/ � � '��V�V� �e '. 1 � . . e � • .
' � ' "FEDERALCREDITUNiON � « 07/01/2014 07/31/2014 2 of2 XXXXXXX685
Eff. Post
Date Date Description Deposits Withdrawals Balance
07/14 07/14 Check 000133 Tracer 0000249311 297.00 0.00
07/29 CHECKING CLOSED
*This is the final statement presenting information on this product
,•�,� Please retain this final statement for#ax reporting purposes.
� ENDING BALANCE: $0.00
Check# Date Amaunt Check# Date Amount Check# Date Amount
130 07/02 90.00 131 07l07 16.00 132 07/14 90.00
133 07/14 297.00
'"Indicates check out of sequence 4 Checks Cleared for 493.00
TotaF Deposits 715.47 Totak Withdrawals 715:Z7
� � � � �� �
_ _.._,_. _:__ ...BEGINIUJN:G-.BAIAAICE;,----___.$g�639:d�
Eff.T Post----
_.. __.___ _ , � _ _
Date Date Description Deposits Withdrawais Balance
07/01 07/01 beposit ACH XXCIV SERV 2,142.94 10,782.41
ID: 3121736156 CO:XXCIV SERV
07/01 07/01 Withdrawal Transfer To Share 0011 700.00 10,082.41
07/03 07/03 Deposit ACH XXSOC SEC 164,00 , 10,246.41
ID:9031736039 CO:XXSOC SEC �'—
07/14 07/14 Withdrawal Transfer To Share 0011 15.47 10,230.94
07/29 07/29 Withdrawai 2,941.28 7,289.66
07/29 07/29 Deposit Dividend 0.78 7,290.44
Annual Percentage Yield Earned 0.100%from 07/01/14 through
07/31/14
07/29 07/29 Withdrawal 7,290.44 0.00
07/29 REGULAR SAVINGS CLOSED
�This is the final statement presenting information on this product
Please retain this final statement for tax reporting purposes.
ENDING BALANCE: $0.00
Total Deposits 2,307.72 Total Withdrawais 1-0,947.19
i - � � • Ilt
BEGINNfNG BAL9NCE: $2,925:59
Eff. Post
Date Date Description Amount Interest Fees Principal Balance
07/29 07/29 Payments -2,941.28 15.69 0.00 -2,925.59 0.00
07/29 INDIRECT USED AUTOS CLOSED
`This is the final statement presenting information on this product
Please retain this final statement for tax reporting purposes:
ENDING BALANCE: $0.00
Annual Percentage Rate 6,750°7o Daily Rate of :018493%
2013 Interest Paitl $300.45
� � -
TOTA�DIVIDENDS PAID TOTAL LOAN INTEREST PAID
0000 REGULAR SAVINGS 4.69 0001 INDIRECT USED AUTOS 128.87
0011 CHECKING 1.90
Total Yearto Date Dividends Paid (Includes Closed Shares) 6.59
R�Ev-lsii Ex+ (oz-is;
� i , pennsylvania SCHEDULE H
DEPARTMENTOFREVENUE FUNERAL EXPENSES AND
INHERITANCETAXRETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
ELMER L LAY 21-1400706
Decedent's debts must be reported on Schedule I,
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERALEXPENSES:
1' EGGER FUNERALHOME 9,807.00
2. FLOWERS FOR FUNERAL 313.70
3. MUSICIAN AT SERVICE 100.00
e. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s)of Personal Representative(s) __ __ __ _
_........._...
Street Address
City State ZIP
Year(s)Commission Paid: _
2. Attorney Fees:
3. Family Exemption: (If decedenYs address is not the same as claimant's,attach explanation.)
Claimant
Street Address __
City _ State______._ZIP____
Relationship of Claimant to Decedent
4. Probate Fees: 333.50
5. Accountant Fees:
6. Tax Return Preparer Fees: 1,579.00
7� UTILITIES TO PRESERVE REAL ESTATE FOR SALE 1,107.92
s. MAINTENANCE AND REPAIRS TO REAL ESTATE TO READY FOR SALE 970.65
9. REAL ESTATE TAXES ON REAL ESTATE TO SELL 1,687.62
�0. ADVANCE DISPOSAL-DISPOSAL OF PERSONAL PROPERTY READY HOUSE FOR SALE 309.24
��. DAY LABOR READYING REAL AND PERSONAL PROPERTY FOR SALE 2,545.00
�2 TOTALS FROM PAGE 2 10,086.72
TOTAL(Also enter on Line 9, Recapitulation) $ 28,840.35
If more space is needed, use additional sheets of paper of the same size.
PAGE 2 SCHEDULE H
ESTATE OF ELMER L LAY FILE #21-14-00706
13 COMMISSION ON SALE OF PERSONAL PROPERTY 3,436.37
14 COMMISSION ON SALE OF RESIDENCE 4,250.00
15 OTHER CLOSING COSTS ON SALE OF RESIDENCE 2,400.35
SUBTOTAL CARRIED FORWARD TO PAGE 1 10,086.72
� Rev-lsiz Ex+ �oz-is)
. pennsylvania SCHEDULE I
......� DEPARTMENT OF FEVENUE DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
ELMER L LAY 2114-00706
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� MEMBERS FIRST FEDERAL CREDIT UNION AUTO LOAN AIC#2181666850001 2,925.59
2. COMPANION CARE FOR DECEDENT PRIOR TO DATE OF DEATH 165.00
TOTAL(Also enter on Line 10, Recapitulation) $ 3,090.59
If more space is needed,insert additional sheets of the same size.
� REV-1513 EX+(02-15)
� pennsylvania SCHEDULE ]
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
ELMER L LAY 2114-00706
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
1• DONNA J(FINKEY)MORRISON DAUGHTER 20%
1A. 28450 WYNIKAKO AVENUE,MILLSBORO,DE 19966
2. DONALD L LAY,3804 BRYTTON LANE,HARRISBURG, PA 17110 SON 20%
3. TERRI S BAXTER DAUGHTER 20%
3A. 130 SALEM CHURCH RD,MECHANICSBURG,PA 17050
4. DANNY R LAY,514 MONROE STREET,STEELTON,PA 17113 SON 20%
5. TIMOTHY S LAY,309 SWAMPFOX DR,FORT MILL,SC 29715 SON 20%
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;
1,
TOTAL OF PART II- ENTER TOTAI 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.
LA9T W1LL AND TESTAIV�NT - ���� .
OF �
ELMER L.LAY �
I,ELMER L,LAY,0�227 Roxbury Road,Newvilie,Lowes M'iffi'►n Township,
Cu�berland County,:Pennsylvanis,being of sound mind,memory and disposition,do
� hereby make,publish and declare this my Last'W'ill and Testament,hereby revoking and
making void any and a1J.Wills,Cadicils,or writings in�e nature thereo�by me at any
time heretofore zuade:
I.�ST:. �A��:.N�'U�'$,Xl'ENS�S- Z d'uect that a11 my debts and fiuier�l expe�ses,
including my gravemarker and aU ex�enses of my last illness,s.hall be paid&om my
residua�y estate as soon as practicab�e after nny de�ease ss a part afthe admnaistrRtion of
my estate.
+. �31�: RESIiDU�(DF�STATE- I give,devise and bequeath.all the rest,residue
aud remainder of m�es�ate,be it rea�,personal,ox m�ixed of whatsoever kind and
r�vheresoever situ�te,uuto my wife,HETTY L.LAY,pravAded she sha11 survive me bq
�r�y E3o)�ys•
In the event my wi�e fails ta suivive me by thirty(34)days,I thez�.�ive,devise snd
bequeath all t�e rest,residue�and remainder unio my chil�ren,DONN,�7.FA�iKEY,
DONALD L. LAY,TERiZI S.BAXTER,DANNY R.LAY and'T1MO�HY S. Lt#Y.
Hov�ever,if a cYuld does not ss.uvive me and Zeaves chi�dren wlxo sa survive me,such
c}uldren shall receive,per siarpes(by representaiaoz�),tha share my child wo�zld have
received haci he�ox skxe so survived me. �
PAGE ONE OF FtJUR
i
My son, TIMOTHY S. L1�,,Y,owes ma the principal sum of$ 12,004.U0 as ofthe
date r,f this t�Vill. �e shatl xepay the princip�t balance oived either as an outrigt�.t payme�xt
to the estate ar.via a de�uction ofthe r�elevam�ac�rtion from the share to which he would
otherwise be ernitl�l.
T�:, TRUSTEE�F CH�I�DREN'S ESTATE� Any share or shares oFmy estate
which passes to a z�aor sha.il be glaced IN TRUST witta AC?�t.A.LD L.LAY,as
TRUSTEE,to se�ve without postiz�bond,on�e follawing tenrns and conditians:
So 1o�xg as the minor benefiaiary is a min+ar,the net income of the Trust
ahall be p�id to vr�.pplied far the maintena�zce,educatian or sug�sort of sueh .
beneficiary�t such time a�n.d in sucb pz�oportions as my Tr�zs�ee shall in h�r sole
discretion determa.ne. In the eveut that tke income wauld be insit�'icient to provitde
�Chhe beaefiaiary wi�adequate maiutenance,education and suppart,the Truste�
shali invade the principal€or tlris pu�pose aud 9uch inva�ions shail be according to
the needs of the beneficiary,rather t�zau acec�rdin,g to any pro rata saheme of �
distribution.
If DO�AId3 L.LAY is unable to serve as TRUSTEE, T then appoint
TERRI S. BAXTER as TRUSTEE to serve withaut posting bond
FOUI�'1'd3: TAXES R�SiJLTIlYG FR!'�M MY DE�7CH- AI1£ederal, estate and other
� deat�taxes that may be assessed as a cansaquence of my dea.th,whether or nat the assets
pass undes this Wil1,s�haU be paid froua the residuary estate o�my probate estate just as if
tbey wer�e uay debts,and none afthase taxes shall be charged against any benafir,iar3�or
joim awner.
�: EXECUTUR� I appQint m�son,DONALLI L.L.AY,E7cecuCor of my Will. In
PAf,�E TWO C}F FQUR
the event that DONALD L.LAY predeceases m�or is unwil�ing or unable to serve as
Executor,I then appoint my daughter TERRI S.BAXTER,as Executrix of my Will,
Neither my Executoz�nor any successor shall be required to give bond for the perforn�ance
af their dufies.
I grant to m.y Executor tha power to compsomise claims without court approval
and without the consent o£azry beneficiary,
�$. PRUTECTIVE PR,OVISION� Ta the greatest extent pernutted by law,
befare actual payznent to a beneficiary ar�to his ar har account, no interest in income or �
pzincipal shall be assignable by a beneficiary or av�.ilable to a�yone k�aving a cla.im aga�inst
a beneficiary,
JN W�TNESS WHEREUF,I hereunto have signed my name tq this,my Last
S�
Wil1 and Testament,consisting o:�a tatal of Ffl[TR(4)typewritten pages,this_�______
da.y of '� �'!� , 1998.
�
�sLMER L.LAY, Testato
��%�
In our presence,the above-named T'estator sign.ed this and declared it to ba his
Will, and nvw,at his request and in his presence and in the presence uf each other,we sign
as witnesses:
r
: ✓�/��C�'`�%C/!J
, PAGE THR.EE OF FOUR
STATE OF PENNSX�.V.AN�A :
: SS
CCIL�NTY UF CIIMBEItI,AND :
i,ELMER L,LA�',t�a.ving been duly qual';fied according to law,acknawledge
th$t I signed.the foregoing i�i�.uient as my WiII and that T signed it as my free an�d
voluntary act�ar the purposes therein e�rressesi.
' �
EL L. Y, r
We,haviung been d�aly qualifed ae,�ording to law,depase and say that we were
present and saw ELMER L.LAY sign xhe faregoing inatrurnent as his Will;that he signed
it as his free anc�votuntary act for the purposes therein expr$ssed;that each of us in his
sigl�and hea�ring and at his request signed the Will as witnesses;and that to the hest vf
our knowledge he was�.t the t�ime 18 oz-xnvze years of age,of saund mind and under no
constraint or undue influence. • ' j ���� _ 1
�/L�� i'-,C��1
i���
Subscribed,swazn tv or affiz.naed.,
and acknowledged befare me by the
above-named Testator and by the
, witnesses wh�se names appear opposite
a.n this 1 day of .1�1•�
1998.
-�' , �.�L-s...,;�! �
Nottuy Public
M10FAR'j�1,���
�� wes���,�r,�,�� PA4E FOUR OF FUUR
�+.+�+al.+b�..r.�,�e.r�ca�rr.p,� �
�1'�"f�e�ks AM��Y b,�D2 : � .
IR��VOCA��E�.AGIZE�ME�
`��IS AGREEh�NT�ade and.e�fered znto by E�L. I.AY, af 227 Roxbury Roa�,
Ne`vville, I.owez A�ff7an Townsha�, Cumberiand Co�aty, Pennsylvanaa 17241, l�e�eina£�e.r
refe�ed �o as H�,s'baad �d �ETTY L. I�AAY, of 227 �Zoxbury �Zoad, Newvi]le, Lower M,'fFlin
'�'awnship,�C�berla�d�unty,Fennsyivania 17241 �e�einafter referred�o as Wife,wi�esseth.:
�sT�REAS, Hvsband axkd�Tife h�.�e made or �esare to x�aake Last W�s an�d Testame�ts
�c�vhich are not�rientic�;and
�R�'�S, H�sbaud and Wife wis�to in�ure �af�er tl�e death of the firs�t spous� tl�e
su�vivor will�ot change his oz he�Last'�YiIl and Testaanen�,it b�ing the in.ten�ioa of�he parties��
pre�erve th�rights of fiheir a3�i].dren,g�andchilclre�a�d�reat�aa.dchildre�,by t�iis docu��nt
fl�OW,'�R��RE,�10W Y�,that Husbanc�.and Wife, �or and in cc��idera.tion o�the
s�of O�E DOL�,.E�.R($1.O�D)to ea�h in hand paid,a�d.in�en�.g ta be le�-ally bnund hereby, d�
hereby a�c�as fo�ows:
1. �Iusband a�es fi�at his �,�st Will and Testame�t executed.on the 1� day o�July,
1998,shall be i=revocable.
2. Wife a�grees � P�er Las�t 'Will and Tes�ent exec�ted oa� �he 9� da3� of Ju1y,
2013,shall be iaevocable.
3. �Iu.sharid an.d Wife hereby agree that each�as agreed a�d prozaaised�o each a�h�,
that their aforesai.d Last Wills an�d Testaments-shad��e-i�revoeable;and-�hat this
covenant shall be enforceable by �iae �eneficiari.es named in their Las� Wills and
Testamen#s as third party be�eficiaries to this agreement.
IN SS VJ�� �, usba�ad a�c� Wife �a.ve hereu�o affixed t]3eir hands
and seals this������day of ,2013.
�� �� � t���,,
R L.:,�AY,Husband
/„/Y � �,/y
(� 1 / � t1J�(�.�I}
�S�'T7'Y �'' ��Wlfe �—
WEIGLE & ASSOCIATES, P.C. - ATTORNEYS AT LAW - 1Z6 EAST KING STREET - SHIPPENSBURG, PA 17257-1397
`�s instn�n�ent was, on �he date �.ereo� signed, paa�blish�d and declared by EF�IV�CR I.�- �A-�.',
h��and,and BETT�L.IrAY,w�e,to b�e�eir A�eecine�t for Irr�voc�hle�'ills,i�our p�esence,
cv�o at thei� reqiies� and in the g�esence �o�each o�e�, �e be�evi.ng�hen� to be o�souaad a�d
dis�osing min�.and�emory,have��reunto s�bscribed �ames as wiinesses.
.
�
p`�,.�� � ��.�.
�
�� �
co�o��.�x o�pE�vs�.v� :
. : ss
CO�JN'1'Y OF CUMBER��ID =
We, �LIVIT� L. L�.Y aud BET� L. LAY, fi�shanr-d and wife, �.e pe�sons whose names are
sig�ted to the �ore�oing ins#rumen#, �aving be�en �.�y q�ed accorc�ing to la�, do he�eby
acknowledge fhat we si�o:ed and execute�d.the i�,sinm�ent as ous Agreeme�.t for Iaevgcalble Wi�s;
that �e si�ec� i� wi�ngly; �nd that we si�aed it as our free aaid volun.tazy act for th�e purposes
there�e�resse�..
Lr�����
ELME�L.LA�,Hus d
1� �
; � �'
�.�'T'TP LAY,Wife
Swom or a�ffiazned t�and ac�owledged.before�e by
EL� L.L�Y E'F7 L. X,husbanci an�.wi�e,
this day of 2413.
• , t
. ,
�
, � y �
,
COMMONWEALTH OF PENNSYLVANIA _
NOTARIALN EALPublic
Jerry A.Weigie, otary
My Comhmisslon Explres Oct ber 7C2014
WEIGLE & ASSOCIATES. P.C. - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 17257-1397
�zv�z���,�o���vs�,varr� :
. ss
covrrrY�F cur��u.,a�
We �( �i�� `/�.�7�ft- �C �L�/��✓ ,
,
and ���,i'��� -�-/��.,�'L�"�'� the witn.esses �ose na�es are sa�d t� �th.e
foregoir�g instr��en�, bei�g duly c�alified acca�di:u� to law, do depvse a�d say fiba� we we�e
pres�ent a�saw E�1�R�,.I��and��TT`Y L.��,Husha:nd a�d VJife, si�a.a�d execute the
i�ument as their �eement �or Irr�vo�cable 'GVills; �at they si��ed �ri.Iliugly �ad that they
execufed it as their free�d voluntary act for�e pur�oses��rsin expressed; �each of us in the
he�.ri�g and saght of the�, si�ed �e A�eemea�� as wi-�aess�s; aud that to �he �est a� our
knowlec�s they were at the-�a:me ei�.te�(18) or more years of�e ax�d of srovnd m�ud and und�
r�o constr�nt or undu�influence.
1.�{�"�'"''� c. .'����'�`�`� .
� �
���.
�.
Swo or a-�'imae�i.�o d subs��ed befare�e by
,
1—/ND�t � ��L-Ci� ,
aud��G'�'� �• f�.�'f!�✓✓�'��`�'.s�'�._.
witnesses,this��day of - 2�1�-
� ,,
�-=t ;
COMMbNWEALTH OF f��NNSY�v��?
NOTARIAL SEAL
Jerry A.Wei91e�Notary Public
City of 5hlpp�nsburg,
Cumberland County
My Commissian Exp
ires October 7,2014
WEIGLE & A550CIATES, P.C. — ATTORNEVS AT LAW — 126 EAST KING STREET — SHIPPENSBURG, PA 17257-1397
�a�e �r��
'�`��WH�U��']�`N�AY�{�I���2N:
�, B�T"�`Y L.7�A�.',presen�ty of�7 iR.oxbury Road,Nevwille,Lower Ivii��m Taz�ash�p,
C�.imberla:�.d County, Pennsylv�ia �724���rebp s�e tl�at � fully, completeiy a�d abso�u��ly
for�ive�dae repayment o�any loan that�maay bave ma.de tc� �ny san, TIl1Z0'�Y S. �AY�.#�e
pa;st i��e amount of T�elve Thausand($�.Z,��D�O.at��,
'4���sses:
�}�y't7 E �) � �r/,,t°
�,�/' `' �J�`.,.oQ,J//�j'( '�r /,.�C.�v .
. BETTY '�.L�AY
WEIGLE & ASSOCIATES, P.C. — ATTORNEYS AT LAW — 126 EAST KING STREET — SHIPPENSBURG, PA 17257-1397
�at " � � ` �
'�'�VHOlYI�IYIA�'��NC`�RN:
�, EL�VIER L. T�A�, �rese��.y of 227 Roxbu�ry �Zoad, Ne�vil.le, I,ower iN�'i�lin �ownship,
Cum'�erlaud Ct��i�►, Pen�sytvania 172��.�ereby state tt�at I fu1ly, camplete�y and a�solut��y
for�i.ve the re�ayment of�ny �oan fha���aay ha�re ma.de to �y son, 3`Il1IO�H� S. LA'�' in i3�.e
past in�e aanount of T�eT�e Thoasand���2,OQf�.t��),
Wi#�esses:
�" ��
� � '`��� �
�� �
. E��R Il.IL��'
WEIGLE & ASSOCIATES. P.C. - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 17Z57-1397