HomeMy WebLinkAbout10-31-05
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
CRIST HENRY S
2311 NORTH FRONT ST APT 918
HARRISBURG, PA 17110
u______ fold
ESTATE INFORMATION: SSN: 084-22-4170
FILE NUMBER: 2105-0740
DECEDENT NAME: CRIST RAY H
DATE OF PAYMENT: 10/31/2005
POSTMARK DATE: 1 0/31/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 07/23/2005
NO. CD 005945
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $1,486.21
I
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I
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TOTAL AMOUNT PAID:
REMARKS: H CRIST
CHECK#1003
SEAL
INITIALS: VZ
RECEIVED BY:
REGISTER OF WILLS
$1,486.21
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REV-1500 EX (6<lO)
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
N"'~N~~'~'_-"'~"'~'~'=~~__^'~WA~~~~',,*~___~W~~
FILE NUMBER
21 05 0740
COUNTY CODE
YEAR
NUMBER
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DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
CRIST, RAY H.
SOCIAL SECURITY NUMBER
084-22-4170
DATE OF BIRTH (MM-DD-YEAR)
03/08/1900
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
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D 2. Supplemental Return
D 4a. Future Interest Compromise (dale of death after 12-12-82)
D 7. Decedent Maintained a Living Trust (Attach copyofTrust)
D 10. Spousal Poverty Credit (dale of death between 12-31-91 and 1-1-95)
D 3. Remainder Retum (dale of death prior to 12-13-82)
D 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
D 11. Election to tax under Sec. 9113(A) (Attach Soh 0)
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 lax has not been
made (Schedule J)
DATE OF DEATH (MM-DD-YEAR)
07/23/2005
[!] 1. Original Return
D 4. Limited Estate
[!] 6. Decedent Died Testate (Attach copyofWUI)
D 9. Litigation Proceeds Received
NAME
Thomas E. Flower, Esquire
FIRM NAME (If Applicable)
Saidis, Shuff, Flower & Lindsay
TELEPHONE NUMBER
(717) 737-3405
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14. Net Value Subject to Tax (Line 12 minus Line 13)
COMPLETE MAILING ADDRESS
2109 Market Street
Camp Hill, PA 17011
(1)
(2)
(3)
(4)
(5)
134,440.60
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85,476.99
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(6)
4,146.30
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(7)
31,000.00
(9)
(10)
(8)
21,263.12
1,943.76
(11)
(12)
(13)
....
255,063.89
23,206.88
231,857.01
0.00
(14)
231,857.01
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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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
x .0 (15)
..?~.1.113!5Z.0_L x .0 !~_ (16)
10,433.57
'__ x .12 (17)
x .15 (18)
(19)
10,433.57
Decedent's Complete Address:
STREET ADDRESS
619 Devonshire Drive
CITY Carlisle I STATEpA I ZIP
17013
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
10,433.57
8,500.00
447.36
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Credits (A + B + C ) (2)
8,947.36
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)
0.00
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.
(SA)
(5B)
1,486.21
0.00
B. Enter the total of Line 5 + SA. This is the BALANCE DUE.
Make Check Payable to: REGISTER OF WILLS, AGENT
1,486.21
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;.......................................................................................... 0 ~
b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 ~
c. retain a reversionary interest; or..............................................................................................""""'''''''''''''''''''' 0 [K]
d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 [K]
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. ~ 0
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. 0 ~
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 OF THE RETURN.
Under penalties of pe~ury. 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 all information of which preparer has any knowledge.
SIGNATURE OF P SON RESPO~I~LU9R FILING RETURN
~~
ADDRESS
Dr. Henry S. Crist, 2311 N. Front Street, Apt 918, Harrisburg, PA 17110
slq OF PREPARER OTHER TH EP. ENTATIVE
DATE
/o/z.~ of
AD ES
Said is, Shuff, Flower & Lindsay, 2109 Market Street, Camp Hill, PA 17011
DATE ___
-O~
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 use of the surviving spouse is 0% [72 P.S. 99116 (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 retum 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 child twenty-one years of 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. 99116(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. 99116(1.2) [72 P.S. 99116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 99116(a)(1.3)]. A sibling is defined, under Section 9102, as an
individual who has at least one parent in common with the decedent, whether by blood or adoption.
~reVlr.t.lJS ecmons are aOSQlete
A. Setflement Staten
torm HUU-.l (..:S/t'lb) rer HanaOOOK q":sUO.L
t
J. Department of Housing and Urban Development
B...Type of Loan OMB Approval No. 2502-0265 (expires 9/30/2006\
1. DFHA 2. DFmHA 3. DCony. Unins. I 6. File Number I 7. Loan Number I 8. Mortgage Insurance Case Number
4. OVA 5. DCony. Ins. MT2005.238JDF
C. Note: I nls arm IS urnlsneo 10 give you aSia emen 0 aClual. selllemenl costs. Amounls palo 10 ana oy me selllemen agen are snown. I TitleExpress Settlement System
Items marked Il(p.o.c.)" were paid outside the closing; they are shown here for information purposes and are not included in the lolals.
WARNING: II is a crime to knowingly make false statements to Ihe United States on this or any other similar form. Penallles upon
conviction can include a fine and Imorisonment. For details see: Tille 18 U. S. Code Section 1001 and Section 1010. Printed 09/13/2005 at 14:29 RLM
D. NAME OF BORROWER: Robert L. Crist and Despina L. Crist
ADDRESS:
E. NAME OF SELLER: Estate of Ray H. Crist
ADDRESS:
F. NAME OF LENDER: M & T Mortgage Corporation
ADDRESS: One Fountain Plaza. Post closinQ 6th Floor. Buffalo NY 14203
G. PROPERTY ADDRESS: 619 Devonshire Drive, Carlisle, PA 17013
Borouoh of Carlisle
H, SETILEMENT AGENT: Said is, Shuff, Flower & Lindsay, Telephone: 717-243-6222 Fax: 717-243-6486
PLACE OF SETILEMENT: 26 West Hioh Street, Carlisle. PA 17013
I. SETILEMENT DATE: 09/14/2005
J. SUMMARY OF BORROWER'S TRANSACTION: K. SUMMARY OF SELLER'S TRANSACTION:
10~GROSSAMOUNTDUEFROMBORROWER 400. GROSS AMOUNT DUE TO SELLER
101. Contract sales orice 136 000.00 401. Contract sales Drice 136 000.00
102. Personal Prooerty 402. Personal Property
103. Settlement charnes to borrower (/ine 1400\ 4 300.96 403.
104. 404.
105. 405.
Adiustments for items Daid by seller in advance Adiustments for items paid by seller in advance
107. County taxes 09/14/05 to 12/31/05 212.31 407. County taxes 09/14/05 to 12/31/05 212.31
108. School Taxes 09/14/05 to 06/30/06 1.356.77 408. School Taxes 09/14/05 to 06/30/06 1 356.77
109. 409.
110. 410.
111. 411.
112. 412.
120. GROSS AMOUNT DUE FROM BORROWER 141870.04 420. GROSS AMOUNT DUE TO SELLER 137.569.08
200. AMOUNTS PAID BY OR ON BEHALF OF BORROWER 500. REDUCTIONS IN AMOUNT DUE TO SELLER
201. DeDosi! or earnest money 501. Excess Deposit (see instructions)
202. Principal amount of new loans 96 000.00 502. Settlement charaes to seller !line 1400) 3128.48
203. Existina loan(s) taken subiect to 503. Existina loan(s) taken subiect to
204. 504. Payoff o( First Mortaaae Loan
205. 505.
206. Credit for Inherit Share of 45.333.00 506. Credit for Inherit Share of 45 333.00
207. Est of Ray H. Crist:to 507. Est of Ray H. Crist to
208. Beneficiary Robert L. Crist 508. Beneficiary Robert L. Crist
209. 509.
Adiustments for items unoaid bv seller Adiustments for items unpaid bv seller
213. 513.
214. 514.
215. 515.
216. 516.
217. 517.
218. 518.
219. 519.
220. TOTAL PAID BY/FOR BORROWER 141.333.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 48 461.48
300. CASH AT SETTLEMENT FROM OR TO BORROWER 600. CASH AT SETTLEMENT TO OR FROM SELLER
301. Gross amount due from borrower (line 120\ 141.870.04 601. Gross amount due to seller (line 420\ 137569.08
302. Less amounts oaid by/for borrower (line 220\ 141.333.00 602. Less reduction amount due seller (line 520\ 48.461.48
303. CASH FROM BORROWER 537.04 603. CASH TO SELLER 89.107.60
SUBSTiTUTE FORM 1099 SELLER STATEMENT: The infonmation contained herein Is important tax information and is being fumished to the Internal Revenue Service. If you are required to file a retum,
a negligence penally or olher sanclion will be imposed on you If this item is required 10 be reported and the IRS determines that It has not been reported. The Contract Sales Price described on
line 401 above constitutes the Gross Proceeds of Ihls transaction.
SELLER INSTRUCTiONS: If this real estate was your principal residence. file Form 2119. Sale or Exchange of Principal Residence. for any gain. with your Income tax return; for other transactions.
complete the applicable parts of Form 4797. Form 6252 and/or Scheduie 0 (Form 1040).
You are required by law to proVide Ihe selllement agent (Fed. Tax 10 No: . )wilh yourcorrecltaxpayer idenlillcation number. If you. do not provide your c~rrect taxpayer idenlificatlon
number, you may be subject 10 civil or criminal penalties Imposed by law. Under penailies of perJury. t certify that the number shown on thiS slatement IS my correct taxpayer Identification number.
TIN:
SELLER(S) SIGNATURE(S):
SELLER(S) NEW MAiliNG ADDRESS:
PrevIOus editions are oDsOrete
U.S. DEPARPAENT OF HOUSI~''"' "ND URBAN DEVELOPMENT
SETTLEMENT ST A TEl T
Filr "Imber: MT2005-238
r S I
form HUU~l (:.::smb) rer HanaOOOK 4:::SUo.L
- . /, Jress ell ement System Printed 09/13/2005 at 14:29 RLM
. L. SETTLEMENT CHARGES PAID FROM PAID FROM
- 700. TOTAL SALES/BROKER'S COMMISSION based on price $136.000.00 @ 0.000 =
BORROWER'S SELLER'S
Division of commission (/ine 7001 as follows: FUNDS AT FUNDS AT
701. $ to SETTLEMENT SETTLEMENT
702. $ to
703. Commission oaid at Settlement
800. ITEMS PAYABLE IN CONNECTION WITH LOAN
801. Loan Oriaination Fee %
802. Loan Discount %
803. Aooraisal Fee to M & T Mortgaae Corooration (P.O.C.1 300.00 Buyer LA 20.00
804. Credit Reoort
805. Lender's Insoection Fee
806. Mortaaae Aoolication Fee to M & T Mortgaae CorDoration (P.O.C.1 100.00 Buyer LA
807. Assumotion Fee
808. Processina Fee to M & T Mortaaae Corooration LA 195.00
809. Tax Service Fee to M & T Mortaaae Corooration LA 76.00
810. Flood Cert Fee to M & T Mort!la!le Corporation LA 8.00
811. Doc Preo Fee to M & T Mortaaae Corooration LA 400.00
900. ITEMS REQUIRED BY LENDEA TO BE PAID IN ADVANCE
901. Interest From 09/14/2005 to 10/01/2005 @$ 15.7808/dav 17 Days LA 268.27
902. Mortaaae Insurance Premium for to
903. Hazard Insurance Premium for to
904.
905.
1000. AESERVES DEPOSITED WITH LENDER FOR
1001. Hazard Insurance 3 mo. @ $ 31.17/mo LA 93.51
1002. Mortaaae Insurance mo. @$ Imo
1003. City Prooertv Tax mo. @$ Imo
1004. County Property Tax 8 mo. @ $ 59.25 Imo LA 474.00
1005. School Taxes 4 mo. @ $ 145.21 Imo LA 580.84
1009. Aqqreqate Analvsis Adjustment to M & T Mortaaae Corporation LA -441.54
1100. TITLE CHARGES
1101. Settlement or c10sina fee
1102. Abstract or tille search
1103. Title examination
1104. Tille insurance binder
1105. Document Preparation
1106. Notary Fees to Saidis Shuff. Flower & Lindsay 14.00
1107. Attornev's fees
(includes above items No: )
1108. Tille Insurance to ACCP Inc. 934.88
(includes above items No: )
1109. Lender's Policv 96 000.00 -
1110. Owner's Policy 136000.00 . 934.88
1111. END 100 300 8.1 to ACCP. Inc. 150.00
1112. Insured Closina Letter to ACCP, Inc. 35.00
1113.
1200. GOVERNMENT RECORDING AND TRANSFER CHARGES
1201. Recordinq Fees Deed $ 38.50. . Mortaaae $ 64.50 . Release $ 103.00
1202. CitvlCountv tax/stamps Deed $1 360.00 . Mortaaqe $ 1,360.00
1203. State Tax/stamps Deed $1 360.00 . Mortqaqe $ 1 360.00
1204. 2005-06 School Taxes to Darlene Mover. tax collector 1,742.52
1205.
1300. ADDITIONAL SETTLEMENT CHARGES
1301. Su rvev
1302. Pest Insoection
1303. Wire Fee to ACCP. Inc. 10.00
1304. Airborne Packaae to Saidis Shuff. Flower & Lindsay 20.00
1305. Final Water & Sewer to Borouah of Carlisle 25.96
1306.
1307.
1308.
1400. TOTAL SETTLEMENT CHARGES (enter on lines 103 Section J and 502 Section K\ 4.300.96 3.128.48
PAGE 2
HUD CERTIFICATION OF BUYER AND SELLER
on my account or by me
7
/
WA NING: IT IS A CRIME TO KNOWINGLY MAKE FAL STAT MENTS TO THE
U ED STATES ON THIS OR ANY SIMILAR FORM. PE AL TI UPON CONVICTION
AN INCLUDE A FINE AND IMPRISONMENT. FOR DET L EE TITLE 1 B:
U.S. CODE SECTION 1001 AND SECTION 1010.
The HUD-1 Settlement Statement which I have prepared is a true and accurate account of this transaction.
aye caused or will caUse the funds to be disbursed in accordance with this statement.
q - I t/ - 0.5"--
REV-1502 EX+ (6-9*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF
CRIST, RAY H.
FILE NUMBER
21-05-0740
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 of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
Dwelling house and lot, 916 Devonshire Dr., Carlisle, PA, net proceeds per HUD-1 attached
VALUE AT DATE
OF DEATH
134,440.60
TOTAL (Also enter on line 1, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
134,440.60
REV-1508 EX+ (6-98) .-
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
CRIST, RAY H.
FILE NUMBER
21-05-0740
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
NUMBER DESCRIPTION
1 M&T Investments, securities account per attached itemized valuation
VALUE AT DATE
OF DEATH
2. Household furniture and furnishings, estimated value
80,476.99
5,000.00
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
85,476.99
Date of Death: 07/23/2005
Valuation Date: 07/23/2005
Processing Date: 08/30/2005
Shares
or Par
Security
Description
1)
2)
2787 Cash (CASH)
1535.472 MTB GROUP FDS (55376T817)
INTRM BD I I
Mutual Fund (as quoted by NASDAQ)
07/22/2005
3)
1418.84 MTB GROUP FDS (55376T221)
SHR DUR GV I I
Mutual Fund (as quoted by NASDAQ)
07/22/2005
4)
1015.746 MTB GROUP FDS (55376T189)
STRM CORP BD I I
Mutual Fund (as quoted by NASDAQ)
07/22/2005
5)
354.359 HARBOR FD (411511504)
CAP APPR INSTL
Mutual Fund (as quoted by NASDAQ)
07/22/2005
6)
2547.173 MTB GROUP FDS (55376T692)
LCP STK I I
Mutual Fund (as quoted by NASDAQ)
07/22/2005
7)
437.943 MTB GROUP FDS (55376Tl14)
SMCP ST INST I
Mutual Fund (as quoted by NASDAQ)
07/22/2005
8)
1213.51 Cash (CASH)
Total Value
Total Accrual
Total $80,476.99
Estate Valuation
High/Ask
Page 1
Estate of: Ray H. Crist
Account: 411610603
Report Type: Date of Death
Number of Securities: 8
File 10: crist
Low/Bid
Mean and/or Div and Int Security
Adjustments Accruals Value
9.95000 Mkt
9.57000 Mkt
9.79000 Mkt
30.29000 Mkt
8.92000 Mkt
9.64000 Mkt
9.950000
9.570000
9.790000
30.290000
8.920000
9.640000
2,787.00
15,277 .95
13,578.30
9,944.15
10,733.53
22,720.78
4,221. 77
1,213.51
$80,476.99
$0.00
This report was produced with EstateVal, a product of Estate Valuations & Pricing Systems, Inc. If you have questions,
please contact EVP Systems at (818) 313-6300 or www.evpsys.com. (Revision 7.0.3)
REV-1509 EX+ (6-98)
*'
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF
CRIST, RAY H.
FILE NUMBER
21-05-0740
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A.. Henry S. Crist
2311 N. Front Street
Apt. 918
Harrisburg, PA 17110
son
B.
C.
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A. 12/26/85 M&T Bank, checking account no. 651664 8,292.60 50 4,146.30
""
TOTAL (Also enter on line 6, Recapitulation) $ 4,146.30
(If more space is needed, insert additional sheets of the same size)
.M&fBank
.: .:. .:
.. .:.
.:.
651664
M&T FIRST WITH INTEREST
JUL.23-AUG.23,2005
1 OF 2
00 6 04345M M 021
RAY H CRIST
HENRY S CRIST
2311 N FRONT ST APT 918
HARRISBURG PA 17110
INTEREST PAID YEAR TO DATE
6.14
STONEHEDGE
: : BEGINNING : : :>DEP.OSI'l'S:&> >::: : : :::::::OTHER:::..::::: ::.:.'CURRENT:: .:.:::.:......=~~
:.BALANCI!: : :OTHl!:lf:ADOI'l'IONS> < . Stm1'RACTIONS: :IN'1'ltREsTl?O
NO I AMOUNT NO AMOUNT NO I AMOUNT
8 , 2 92 6 0 41 4 , 6 72 2 8 6 6 , 95 8 42 3 I 1 , 1 97 6 1 0 43 4 , 8 0 9 2 8
ACCOUNT SUMMARY
: POSTING ::..:: I)EPOSITS~:.INT:e:REST: c;HECKSilOOTHER:..
: DATI!:: >< &::'.OTHER:..AImlTIONS: SUBTRACT10NS :: .:<
07-23-05 BEGINNING BALANCE $8,292.60
07-25-05 CHECK NUMBER 1349 5,000.00 3,292.60
08-01-05 UNION CARBIDE CO PAYROLL 2,500.40
08-01-05 UCC EMPLOYEES PE PAYROLL 975.27
08-01-05 TIAA-CREF DISTR. ANNUITY 168.61 6,936.88
08-02-05 CHECK NUMBER 1350 300.00 6,636.88
08-03-05 US TREASURY 303 SOC SEC 1,028.00 7,664.88
08-04-05 CHECK NUMBER 1323 400.00
08-04-05 CHECK NUMBER 1322 1,121. 73 6,143.15
08-05-05 CHECK NUMBER 1324 97.75 6,045.40
08-08-05 CHECK NUMBER 1325 38.94 6,006.46
08-12-05 TIAA-CREF DISTR. RECLAIM 168.61 5,837.85
08-22-05 REVERSE DIRECT DEPOSIT 1,028.00 4,809.85
08-23-05 INTEREST PAYMENT 0.43
08-23-05 FEE FOR CHECK RETURN OPTION 1.00 4,809.28
ENDING BALANCE $4,809.28
ACCOUNT ACTIVITY
. ..........- .-.. ..-.......
.-.............-.,.....
. : CHECl<S:li'Mb SUMMARY:
...1
.. .
1322 08-04-05
1325 08-08-05
1,121.73
38.94
1323 08-04-05
1349* 07-25-05
400.00
5,000.00
1324 08-05-05
1350 08-02-05
97.75
300.00
ANNUAL PERCENTAGE YIELD EARNED
0.09 %
"M&rBank
.:
.:. .:
.:: . .::.. ::. .::
..: ... ........ . ..
651664
M&T FIRST WITH INTEREST
JUN.24-JUL.22,2005
1 OF 2
00 12 04345M M 021
RAY H CRIST
HENRY S CRIST
2311 N FRONT ST APT 918
HARRISBURG PA 17110
INTEREST PAID YEAR TO DATE
5.71
STONEHEDGE
: BEGINNING:: ..O'r:E~POkW'IST.I&I"It.tS....:... :::::. : .::::.. :.oTHER:: :.:::: : : : :>CURR.ENT .:.ENDING::
: BALANCE ::::: .::.. : suBTRACTIONS :.INTERES'r.:.PO BAtJu;lCE:
NO I AMOUNT NO AMOUNT NO I AMOUNT
7 , 7 54 4 9 4 I 7 , 17 1 8 8 1 2 6 , 6 3 3 53 1 I 1 0 0 0 76 8 , 2 9 2 6 0
ACCOUNT SUMMARY
POSTlNG ...... ::. DEPOSITS~..INTEREST. ...:.:~ECKS>".OTHER : ::.:::
. ....DATE> &iOTHER:MiDITIONS: :.:.. :SUB1'R1I.CTI6~s
06-24-05 BEGINNING BALANCE $7,754.49
06-28-05 CHECK NUMBER 1348 2,000.00
06-28-05 CHECK NUMBER 1309 36.64 5,717.85
06-30-05 DEPOSIT 5,000.00 10,717.85
07-01-05 US TREASURY 303 SOC SEC 1,028.00
07-01-05 UCC EMPLOYEES PE PAYROLL 975.27
07-01-05 TIAA-CREF DISTR. ANNUITY 168.61 12,889.73
07-06-05 CHECK NUMBER 1310 345.00 12,544.73
07-07-05 CHECK NUMBER 1347 2,796.37 9,748.36
07-11-05 CHECK NUMBER 1312 140.00
07-11-05 CHECK NUMBER 1315 103.36
07-11-05 CHECK NUMBER 1313 68.84 9,436.16
07-12-05 CHECK NUMBER 1314 32.45 9,403.71
07-14-05 CHECK NUMBER 1311 500.00 8,903.71
07-19-05 CHECK NUMBER 1320 43.36 8,860.35
07-21-05 CHECK NUMBER 1316 63.00 8,797.35
07-22-05 INTEREST PAYMENT 0.76
07-22-05 CHECK NUMBER 1321 504.51
07-22-05 FEE FOR CHECK RETURN OPTION 1. 00 8,292.60
ENDING BALANCE $8,292.60
ACCOUNT ACTIVITY
....................-................,......,-..........
." ...,....... .-. ---... ,.
. . . > :..CHECKSPi\ID~Y::
I
1309
1312
1315
1321
06-28-05
07-11-05
07-11-05
07-22-05
36.64
140.00
103.36
504.51
1310
1313
1316
1347*
07-06-05
07-11-05
07-21-05
07-07-05
345.00
68.84
63.00
2,796.37
1311
1314
1320*
1348
07-14-05
07-12-05
07-19-05
06-28-05
500.00
32.45
43.36
2,000.00
ANNUAL PERCENTAGE YIELD EARNED
0.10 %
REV-1510 EX+ (6-98*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF
Ray H. Crist
FILE NUMBER
21-05-0740
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV.1500 COVER SHEET is yes.
DESCRIPTION OF PROPERTY
ITEM INCLUOE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO OECEOENT AND DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE
NUMBER THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
1. cash gift to Robert Crist on or about January 15, 2005 5,000.00 100 3,000.00 2,000.00
2. cash gift to DeLanson Crist, on or about January 15, 2005 17,500.00 100 3,000.00 14,500.00
3. cash gift to Henry Crist on or about January 15, 2005 17,500.00 100 3,000.00 14,500.00
....
...
TOTAL (Also enter on line 7 Recapitulation) $ 31,000.00
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX+ (12-99>*
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
RAY H. CRIST
FILE NUMBER
21-05-0740
ITEM
NUMBER
A.
B.
1.
10.
11.
12.
Debts of decedent must be reported on Schedule I.
DESCRIPTION
AMOUNT
1.
FUNERAL EXPENSES:
MALPEZZI FUNERAL HOME, Professional Services
Casket ($2,400) and Grave Liner ($640)
Guest Register and Folders
Grave Opening ($700) and Cemetery Equipment ($110)
Obituaries ($675.50), Flowers ($318), Mass Offering ($125) & Clergy Honorarium ($300)
Death Certificates
Memorial Buffet - Allenberry Inn
ADMINISTRATIVE COSTS:
3,040.00
165.00
810.00
1,418.50
150.00
21.73
2.
3.
4.
5.
6.
7.
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.
Attorney Fees
6,675.00
3.
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
3,500.00
Claimant Robert L. Crist
Street Address 619 Devonshire Drive
City Carlisle
State PA .Zip 17013
Relationship of Claimant to Decedent
4.
Probate Fees
361.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
The Sentinel ($173.33) & Cumbo Law Joumal ($75), Publish Estate Notices
Express mail charges to over-night New York Times obituary
Trash removal
248.33
13.65
100.00
99.91
15.00
9.
UGI (44.35) and Sprint (45.56), decedent's pro-rated portion of final phone and utility bills
Inheritance tax return filing fee
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
21,263.12
REV-1512 EX+ (12-03)
'*
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
RAY H. CRIST
FILE NUMBER
21-05-0740
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
PA Academy of Science, publishing cost decedent's final paper
240.00
2.
Sprint, phone bill
45.90
3.
UGI, utility bill
44.35
4.
Comcast. tv cable
47.82
5.
Homeowners Insurance
345.00
6.
Borough of Carlisle, water bill
38.94
7.
PPL, electric bill
97.75
8.
Robert L. Crist, reimburse for cost of medications & postage to mail decedent's books to chem. depts.
400.00
9.
Thomwald Home, unreimbursed nursing care during final illness
684.00
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
1,943.76
REV-1513 EX+ (9-00) *'
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
CRIST, RAY H
FILE NUMBER
21-05-0740
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)]
1 Robert L. Crist, 619 Devonshire Dr., Carlisle, PA 17013 son 0.33
2 DeLanson R. Crist, 3611 Raymond St., Chevy Chase, MD 20815 son 0.33
3 Henry S. Crist, 2311 N. Front St., Apt. 918, Harrisburg, PA 17011 son 0.33
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, 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
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0.00
(If more space is needed, insert additional sheets of the same size)