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HomeMy WebLinkAbout10-19-05 II REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA INVENTORY Estate of Barbara L Crossland No.21 05 0133 also known as , Deceased Date of Death 1/25/2005 Social Security No. 186-34-0370 Alexandra M. Greenfield Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the : personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation ' placed opposite each item of said inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. IIWe verify that the statements made in this inventory are true and correct. l!We understand that false statements herein made are subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Name of Attorney: David H. Stone, Esquire 1.0. No.: 39785 ?ZWa~~ta~~/?/}//~4 Alexandra M. Greenfield I 236 Walton St. Lemoyne, PA 1704* Address: 414 Bridqe Street New Cumberland Telephone: (717) 774-7435 Dated /0- it? .:) {' PA 17070- Description Value Miscellaneous deposit 23.00 Property located at 236 Walton St. Lemoyne, Cumberland County, PA as per acquisition value from the Est. of Miriam M. Martz, # 21-05-0082, dod 01-16-05. See attached Exhibit A from ITR of Estate of Miriam M. Martz Sovereign Bank-Cert. of Deposit #0575135868 joint w/Miriam Martz who died Jan. 16,2005 to,ooo.oo ,6,000.00 ',..0 \.0 Total (Attach Additional Sheets if necessary) :76,023.00 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal represen~ative, include the value of each item. but such figures should not be extended into the total of the Inventory. RW-4 0- W I- l<: Sen uO::l<: wl'5u ::J:0::9 ultD:l <l: REV-1500 EX + (6-00) REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 DECEDENTS NAME (LAST, FIRST. AND MIDDLE INITIAL) I- Z W C W () W C Crossland, Barbara, L DATE OF DEATH (MM-DD-Year) DATE OF BIRTH (MM-DD-Year) 1n5n005 1V1~1943 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) ~ 1. Original Return D 4. Limited Estate D 6. Decedent Died Testate (Attach copy of Will) D 9. Litigation Proceeds Received D 2. Supplemental Return D 4a. Future Interest Compromise (dale of death after 12-12-82) D 7. Decedent Maintained a Living Trust (Attach copy of Trust) D 10. Spousal Poverty Credit (date o/death between 12.31.91 and 1.1-95) OFFICIAL USE ONLY FILE NUMBER 2 -05 0 3 3 "'COONTYCOOE -VEAR- - - N"i:iMaER- - SOCIAL SECURITY NUMBER 1 86- 3 4 - 0 3 7 0 THIS RETURN MUST BE FilED IN DUPLICATE WITH THE REGISTER!OF WILLS SOCIAL SECURITY NUMBER D 3. Remainder Return i (dateofdealhpriorto12-13-82) D 5. Federal Estate TaxlRetum Required I 8. Total Number of Sa'e Deposit Boxes - I D 11. Election to tax under Sec. 9113(A) (Attach SchO) I I- Z W C Z o D- en w 0:: 0:: o U THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE IRECTED TO: NAME COMPLETE MAILING ADDRESS David H. Stone Es uire 414 Bridge Street FIRM NAME (If Applicable) Stone La Faver & Shekletski TELEPHONE NUMBER 717-774-7435 New Cumberland PA 17070 0.00 X _(15) 0.00 65,851.54 x .045 (16) 2,963.32 0.00 x .12 (17) 0.00 0.00 X .15 (18) 0.00 (19) 2,963.32 z o i= c:( ..J :::::J !::: a. c:( () w a:::: 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) D Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) (8) (1) (2) (3) (4) (5) (6) (7) (9) (10) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o i= c:( I- :::::J a. :E o () X c:( I- 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20. 0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < 70,000.0.0 o IAL USE ONLY 6,023.00 "'-'''T ~q , ~1 -;:1 -.J ~ , '---1 ..EJ -~ (') I.q 76,023.00 9,348.51 822.95 (11) (12) (13) 10,171.46 65,851.54 (14) 65,851.54 , I o d t' C I t Add ece en s ample e ress: ST~EET ADDRESS 236 Walton St. CITY I STATE I ZIP Lemoyne PA 17Q43- Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 2,963.32 Total Credits (A + B + C) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty 0.00 Total Interest/Penalty ( D + E) (3) 4. If Line 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 (4) 5. If Line 1 + Line 3 is greater than line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58) Make Check Payable to: REGISTER OF WILLS, AGENT 0.00 2,963.32 2,963.32 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes a. retain the use or income of the property transferred; ...................... ....................................... .............. 0 b. retain the right to designate who shall use the property transferred or its income; .................................... .... 0 c. retain a reversionary interest; or ...................................................................................................... 0 d. receive the promise for life of either payments, benefits or care? ........ ..................................................... 0 2. :i~~:~~ :~:~:~~: :::~a:e:O~:;d:~~t~::~'. ~~~. ~.~~~~~~. ~~~~~~~~ .~~~~~~. ~~~~~~. ~~.~. ~.~~~ .~~.~~~t.~...................... 0 [g] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ................. 0 I)&J 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ....................................................................................................... 0 ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART O~ THE RETURN. PA 17043 DATE , 1-1 t# ..--J , PA 17070 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. 99116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for I 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 twenty-one years of age or youn or a stepparent of the child is 0% [72 P.S. 99116(a)(1.2)]. \)\..1 L 'Pc\ \~eD ..)10 \~5 , C~_,(::~ 00 S. ~9116 (a) (1.1) (ii)]. e still applicable even if IS (-:.,~. rent, an adoptive parent, ~ ' ~'-~Jst REV-1502 EX + (6-98) '* SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Crossland. Barbara. L 21 05 013~ 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 ro e which is 'ointl -owned with ri ht of survivorshi must be disclosed on Schedule F. ITEM NUMBER 1 DESCRIPTION Property located at 236 Walton St. Lemoyne, Cumberland County, PA as per acquisition value from the Estate of Miriam M. Martz, # 21-05-0082, date of death January 16, 2005 See attached Exhibit A from Inheritance Tax Return of Estate of Miriam M. Martz I VALUEATDATE OF DEATH 70,000.00 TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 70,000.00 REV-15G8 EX + (6-98) *' SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Crossland. Barbara. L FILE NUMBER 21 05 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. 0133 ITEM NUMBER 1 DESCRIPTION I VALUE AT DATE . OF DEATH 23.00 Miscellaneous deposit 2 Sovereign Bank-Cert. of Deposit #0575135868 joint w/Miriam Martz who died Jan. 16, 2005 6,000.00 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 6,023.00 REV-1511 EX + (12-99) *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Crossland. Barbara. L SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS Debts of decedent must be reported on Schedule I. FILE NUMBER 21 05 0133 ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Parthemore Funeral Home-funeral expenses 3,253.00 Payment on funeral expenses 350.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attomey Fees David H. Stone, Esquire 3,800.00 3. Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation) I Claimant , Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees Register of Wills 162.00 5. Accountant's Fees 6. Tax Retum Preparer's Fees 7. Cumberland Law Journal-advertising grant of letters 75.00 2 The Patriot News Co.-advertising grant of letters 113.61 3 PNC Bank-check printing fee 19.99 4 Faith A. Nicola-real estate taxes at property 390.62 , 5 PPL-services at property I 36.51 6 PAW-water service at property 31.17 7 MCI-phone service 75.10 8 PAW-water service at property 34.83 9 UGI-gas service at property 545.46 10 Borough of Lemoyne-sewer and trash at property 96.00 11 Register of Wills-filing Inheritance Tax Return & Inventory 30.00 12 Reserve for closing expenses 200.00 TOTAL (Also enter on line 9, Recapitulation) $ 9,348.51 (If more space is needed, insert additional sheets of the same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent Crossland, Barbara, L Decedent's Name Page 1 21 05 0133 File Number Schedule H - Funeral Expenses & Administrative Costs - 87. ITEM NUMBER DESCRIPTION : AMOUNT 13 Register of Wills-inh. tax due on Miriam M. Martz Estate 135.22 SUBTOTAL SCHEDULE H.B7 135.22 REV-1512 EX + (6-98) '* SCHEDULE. DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Crossland. Barbara. L FILE NUMBER 21 05 01~3 Include unreimbursed medical expenses. ITEM NUMBER 1. DESCRIPTION -, VALUE AT DATE i OF DEATH 1 42.00 Holy Spirit Hospital-debt of decedent 2. Chambers Hill Fire-ambulance service 780.95 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 822.95 "'-:'" ",. "w COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER rrosc:land B~rh~r~ L 21 O~ nH~ 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 pnclude outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. Alexandra Greenfield Lineal 65,851.54 236 Walton Street Lemoyne, PA 17043 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-151 o COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. i . I , TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ I I (If more space is needed, insert additional sheets of the same size) ~x II re\ded\MARTZCROSSLANDgreenfield-exdeed I ~Yb~ ~r-C2- - !-, :.. ,\ DEED",.., '.' ~ 'i Y 12 ' /'j't.' iJ~1~1 . flPl 8 27 THIS INDENTURE made the d-.lo -m-day of ~'L\ \- In the Yfar 2005, between PNC BANK, N.A., Executor of the Estate of the Last wiil and Testament of MIRIAM M. MARTZ, late of the Borough of Lemoyne, County of Cumberland and Commonwealth of Pennsylvania, and ALEXANDRAiM. GREENFIELD, Administratrix of the Estate of BARBARA L. CROSSL1ND, late of the Borough of Lemoyne, County of Cumberland and Commonwealth of Pennsylvania, of the first part, hereinafter called the Grant~rs, - AND - ALEXANDRA M. GREENFIELD and MICHAEL J. GREENFIELD, fuusband and wife, of the second part, hereinafter called the Grantees~ , WHEREAS, the said MIRIAM M. MARTZ became in her lifetime 'seised, as of fee, of and in to a certain tract of land, together witij the , improvements thereon erected, situate in the Borough of Lemoy~e, I , County of Cumberland, and Commonwealth of Pennsylvania, and mqre I I I particularly described hereinafter; and being so thereof seis~d, died , on January 16, 2005, having first made her Last Will and Test~ment in I , writing dated December 27, 2001, duly probated and registered :in the Office of the Register of Wills of Cumberland County I I I on Janua~y 27, I I I the said iPNC 2005, wherein and whereby she appointed as Executor, Bank, N.A., to whom Letters Testamentary were duly issued by said Register of Wills on January 27, 2005, wherein and whereby said -1- , 800K 268 PAGt4159 II j premises hereinafter described was specifically devised to BARBARA L. CROSSLAND; and WHEREAS, The said BARBARA L. CROSSLAND died intestate 0$ January 25, 2005; and I I I WHEREAS, The Register of Wills of Cumberland County granted Letters of Administration to ALEXANDRA GREENFIELD on February 9, 2005; and WHEREAS, ALEXANDRA GREENFIELD is the sole heir of BARBAR4 L. CROSSLAND; and i NOW THIS INDENTURE WITNESSETH, that the said Grantors, f~r and in consideration of the sum of ONE and NO/100 ($1.00) Dollar, wh~ch has I been paid to her by the said Grantees at or before the sealin~ and I delivery hereof, receipt whereof is hereby acknowledged, has 1ranted, bargained, sold, aliened, released and confirmed, and by thes~ pres- ents does grant, bargain, sell, alien, release and confirm unJo I I I I I the said Grantees, , I i ALL THAT CERTAIN lot of ground situate in the Borough of Lemo~ne, Cumberland County, Pennsylvania, more particularly bounded anq de- scribed as follows, to wit: I i I BEGINNING at an iron pin on the southern side of Walton Stree~ at the dividing line between Lots Nos. 46 and 47 on the hereinafter ~entioned Plan of Lots, said point being four hundred (400) feet when mdasured westwardly from a monument at the intersection of Walnut Street and Warren Street; thence along said dividing line South 36 degre~s East, a distance of two hundred seventeen and eighty hundredths (217.80) feet to an iron pin; thence South 54 degrees West, a distance lof -2- I BOOK 268 PACE416D forty-five (45) feet to an iron pin; thence North 36 degrees West, a distance of two hundred seventeen and eighty hundredths (217.80) feet to a point on the southern side of Walton Street; thence along the southern side of Walton Street, North 54 degrees East, a distance of forty-five (45) feet to a point, the place of BEGINNING. BEING the eastern forty-five (45) feet of Lot No. 46 in the Pian of Lower Walton as recorded in the Cumberland county Recorder's ~ffice in Plan Book 1 at Page 104 and having thereon erected a dwelling!house known as No. 236 Walton Street, Lemoyne, Pennsylvania. ! I BEING THE SAME PREMISES WHICH Romaine B. McGuire, widow, by E4rl W. Pyke, her attorney-in-fact, by deed dated May 25, 1983, and r~corded May 25, 1983, in the Office of the Recorder of Deeds in and fqr Cumberland County, Pennsylvania, in Record Book 30, Page 903, Igranted and conveyed unto Reynold I. Martz and Miriam M. Martz, his w~fe. Reynold I. Martz died November 28, 1983, thus vesting title in Miriam M. Martz by operation of law. ! TOGETHER with all and singular the buildings, improvementis, ways, I I I streets, alleys, passages, waters, water-courses, rights, lib~rties, , I privileges, hereditaments and appurtenances whatsoever, there~nto I I , belonging or in any wise appertaining and the reversions and remainders, rents, issues and profits thereof, and all the es~ate, i I right, title, interest, property, claim and demand whatsoever Iof them, I the said MIRIAM M. MARTZ and BARBARA L. CROSSLAND, at and imme!ctiately before the time of their decease, in law, equity, or otherwise! howso- I , ever, of, in, to or out of the same. TO HAVE AND TO HOLD the said lot or piece of ground abovel de- I scribed, with the buildings and improvements thereon erected, hereditaments and premises hereby granted or mentioned, and intended -3- , BOOK 268 PAcc41$1 I' so to be, with the appurtenances unto the said Grantees, to and for the only proper use and behoof of the said Grantees, forever.: ! I And the said Grantors, for themselves and their respective heirs, executors and administrators, does covenant, promise and agre$ to and I , I with the said Grantees, their heirs and assigns, that they, t~e said ! I I Grantors, have not heretofore done or committed any act, matt~r or I I ! thing whatsoever whereby the premises hereby granted, or any part I , thereof, is, are, shall or may be impeached, charged, or encu~bered in title, charge, estate or otherwise howsoever. IN WITNESS WHEREOF, the said Grantors have hereunto set tiheir hand and seal the day and year first above written. (~i~~~ i. ti Wi tn e s s A">'S. '\ c::. he,-,-^-,,- S-eL.\..L"d- /e....-.-'-..-..~/L W i''t"fles s ..L--~ t'o,'0 ~.~ (SEAL) PNC BANK, TIONAL ASS A !ION, Executor of the Last will ~nd of MIRIAM M. MAR~Z I , ! Estatle of ~ ALEXA ORA M. GREENFIE Administratrix of the BARBARA L. CROSSLAND -4 - BOOK 26B PAcc416:'2 II II' COMMONWEALTH OF PENNSYLVANIA: 1 SS: COUNTY OF CL////..c(.//~//~ , '/ / /t:., On thi s , the 1'_7)?L day of +:,./ , 2005, before me the undersigned officer, a Notary Public, personally appeared who acknowledged her/himself t~ be the of PNC BANK, NATIONAL ASSOCIATION a Pennsylvania corporation, and that she/he as such officer b4ing authorized to do so, executed the foregoing instrument for the purposes therein contained ~~.~:1 the name of the corporation by him/herself as _~X/- //5/L/;r{lJ/Av-;/-- . IN WITNESS WHEREOF, I have hereunto set my hand and offiqial seal the day and year first above written. ~..__... C \ "'" \ COMMONWEALTU OF PENNSYLVANIA . Notarial Seal Demse C. Sullenberger, Notary Public l'1!!mcpden.T~., Cumberland County "'1 omm.SSlon Expires Dec. 1, 2008 Member. Pennsylvania Association of Notaries -5- BOOK 268 f~\G[4163 \ I Il . COMMONWEALTH OF PENNSYLVANIA: COUNTY OF L~~!ti I~t SS: On this, the d~~ day of ~l , 2005, before me a Notary Public, the undersigned officer, personally ap- pea red ALEXANDRA M. GREENFIELD, Administratrix of the Estate Of Barbara L. Crossland, known to me or satisfactorily proven to be the person whose name is subscribed to the within instrument, and acknowl- edged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereto set my hand and notari4l seal. COMMONWEAtTH Of PeNNSYlVANIA NOTARIAL SEAL KATHLEEN KEIM. Notary Pubic New Cumberland Boro. Cumberland Co My CommlsslOfl ExpIres Dec. 5. 2006 . I hereby certify that the precise address of the Grantee is ~q- ~ ~Nf,.(., ffi{dito.wc.~bcr' R I1DSS" ~L'(;'+-. Attor~ . C) fL4.4e~ IV T: J 1 .. IS 1)' C;. I-e' ( .,") '''-1 {co. d' ".; "1,,.1. U..., r"j'n\.,,-"r1~-1'1!-1 C~O.111"'l'y PA \.../l"1.. ~.-\...I'.,,_.... 1-....-".l.;j 1\. . /y4'fl '1.<iC'."t;__ " ~ v~ Reco!~~r of Deeds Mok 2G8 p.AG[41G~ 11 COMMONWEALTH OF PENNSYLVANIA lB'ARl'MENT OF REVENUE DEPT. 280601 HARRISBURG. PA 17128-0601 REV.1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21 OS 0082 COlMlY CODE 'l'EIil IIIJM!ER DECEDENrS NAME (LAST, FIRST, AND MIDDLE INITlAL.) ~ Martz Miriam W DATE OF DEATH (MM-DD-YEAR) DAlE OF BIRTH (MM-OO-YEAR) C ~ 1/16/2005 4/9/1918 W (IF APPLICABlE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDL.E INITIAL) C SOC~L.SECU~TYNUMBER 172-Q1-6564 THIS RETURN MUST BE FILED IN DUPUCATEi Wlnl THE REGISTER OF WILLS sOOAls~jRITYNUMBER H l!:! 00 1. Original Return D 2. supplemental Return 0 3. RemaInder Return (dale of d~ath prior to 12-13-82) ~lB D 4. Limited Estate 0 4a. Futul1Ilntel8St CompromiSe (date of deB\h aller 12.'2-82) 0 5. Federal Estatlt Tax Return RJqul11ld ~~ 00 e. Decedent Died Teslate (AlIach c:opyalWilI) 0 7. Decedent Melntained a L.Mng Trust (...ttach ccPydTrusl) _ 8. Tolul Number of Safe Dep~ Soxas r D 9. LKlgatlon Proceeds Received 0 10. Spousal P<MlIty CI1Idit Idolo 01 death "!Woo. 12-31'911.."'1'HI5) D 11. E IBellon to lax under Sec. .113(A) 1"ltachScll 01 , ' "," " ,",', ,", ", - , ,,!, T~j8seCrIPN;Mu$t ~ COMPLETED, ALl,CORRESPONDT:NCltANoCONFIPSNTtAtTAX INFORMATION SHOULD BE DIRECTEOrcp: NAME COMPLETE MAlUNG ADDRESS : LiDda Lundberg P.O. Box 308 FIRM NAME (If Appncable) PRe Advi.ors TELEPHONE NUMBER 717-730-2265 ... z w i o 55 i 8 Caap Bill, PA 17001-0308 1. Real Estate (Schedule A) 2. Stocks and Bonda (Schedule B) 225,000.00 0.00 0.00 (1) (2) 0FFlClAI. USE O\'lL V 3. Closely Held COl'pOl'lltIon, Partnersl1ip or SoIe-f>JOpIIetorshIp (3) 4. Mortgaglts & HoIas ReceiYable (Schedule 0) 5. Cash, Bank 0ep0sIIs & MlsceItaneous Personal Property (Schedule E) 26,7015.501 29,591.55 13,012.00 (4) (5) z o i= :5 E Q. ~ W a: 6. J~ Owned Property (Schedule F) ~ Sepande Billing Requested 7. Inter-Vivos T/'8nef'ers & Mlscel1aneous Non-Probale property (7) (SChedule G or L) (6) 0.00 I I 291,3019.09 8. Total GI'OA .....as (total Lines 1-7) (8) 41,041.89 2,180.15 9. Funeral Expenses & Admlnlstratl... Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage UablIIIes, & liens (Sd1eduI9 I) (10) 11. Total Deductions (lOtal Lines 9 & 10) 43\,222.04 251j, 127. OS 0.00 (11) 12. Net Value af Estate (line 8 minus linEl11) 13. Charitable and Governmental Bequests/See: 9113 Trusts for which an eIectlon to tax has not been made (Schedule J) (12) (13) 14. Net Value Subject to Tax (Line 12 minus Une13) SEE INSTRUCTIONS ON ReVERSE SIDE FOR APPUCASLE RATI!S 251~127.05 (14) 15. Amount of Line 14 taxable at the spousal tax rale, or transfers under Sec. 9116 (a)(1.2) 0.00 251,127.05 0.00 0.00 x.O ~(15) x.O 45 (16) io.oo 1l,3~~ !O .00 ! z o ~ 16. Amount of Line 14 taxable at lineal rate ... ::l IL :E o U )( c[ ... 17. Amount of Line 14 taxable alslbllng rate x.12 (17) :0.00 18. Amount of Line 14 taxable at collateral rate ll.15 (18) I 11,3010.72 19. Tax Due 20. 0 (19) CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 3W4645 1.000 ).). BE SURE TO ANsWER ALL QUESTiONS ON REV~RSE SIDE AND RECHECK MATH 00( 00( \ I REV.1502 ~ + (8-98) SCHEDULE A REAL ESTATE CPMMONWEAL TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Miriam M. Martz 21 05 0082 All real property owned solely or II I tenant In common mll8t be reported at fair market vllu,. Fair market value is defined as the price at \\tIlch property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sel. both ha'ling reasonable t:nowtedge of the relevant facts. R..I property which /$ 'olntly~ned with right of survivorship must b. d1selond on Schedule F. ITEM NUMBER -l~ DESCRIPllON VALUE.h DATE OFoEATH 512 Wa~~en Street Lemoyne, Cumberland Co, PA Sales P~ice (See Statement of Settlement) ~16,OOO.oo 2 Vacant Lot '414 Adjoining 512 Wa~ren St~eet Leaoyne, PA Sales Price (Settlement Sheet attached) 39,000.00 3 236 Walton Street Lemoyne, Cuaberland Co., PA Apprai.ed By: L.G. Connor aeal Sstate Appraiser., LTD (Copy of Apprai.al attached) 70,000.00 3W4695 1.000 TOTAL (AIlSa enter on line 1. Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 225~OOO.OO 11 Court Ordered Processing / MAl MB3 02-10 P.O. Box 841005 Boston, MA 02284 March 1,2005 Stone LaFaver & Shekletski Attention: David H. Stone P.O. Box # .-New-Gumberland,- PA-17070.- RE: Estate of Barbara L. Crossland Date of Death: 1/25/05 Dear Mr. Stone: Per your request, enclosed please find the account information as of the date of death for the above-named decedent. For your information, accrued interest is not included in the date of death balance. Please feel free to contact me if I can be of any further assistance. Very truly yours, ~~D:~~ Laurie DiGiandomenico OAG Team Leader (617) 533-1789 Enclosures II Sovereign Bank ESTATE OF SOCIAL SECURITY #: DATE OF DEATH: Barbara L. Crossland 186-34-0370 January 25, 2005 Account #: 0575135868 Type: CD In the name of: Barbara L. Crossland or Miriam Martz Date of Death Balance: $6,000.00 Int.(YTD) from 1/1/2005 to 1/25/2005 Accrued interest to date of death: $16.16 Oth~r-'I1!~_:___ Closed 2/11/05 formerly Waypoint #555311192 Open date: 7/1O/~997 $0.00 Page 1 of 1