HomeMy WebLinkAbout01-13-06
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
BREWER RHONDA
602 SANDBANK ROAD
MT HOLLY SPRINGS, PA 17065
-------- fold
ESTATE INFORMATION: SSN: 210-40-2624
FILE NUMBER: 2105-0787
DECEDENT NAME: NICKEL LARRY
DATE OF PAYMENT: 01/13/2006
POSTMARK DATE: 01/13/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 08/23/2005
NO. CD 006203
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $1,196.46
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS: L R NICKEL
CHECK# 4958
SEAL
INITIALS: VZ
RECEIVED BY:
REGISTER OF WILLS
$1,196.46
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
OFFICIAL USE ONLY
COMMONWEALTH OF PENNSYLVANIA REV-1500 FILE NUMBER
DEPARTMENT OF REVENUE DEPT. INHERITANCE TAX RETURN
280601 HARRISBURG, PA 17128-0601 RESIDENT DECEDENT 21 2005 0787
COUNTY CODE YEAR NUMBER
I- DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
z Nickel, Larry a/kJa Nickel, Larry R 210-40-2624
W DATE OF DEATH (MM-DD-YV) DATE OF BIRTH (MM-DD-YV) THIS MUST BE FILED IN DUPLICATE
C
W 8/23/2005 12/30/1952 WITH THE REGISTER OF WILLS
U
W (IF APPLICABLE) SURVIVING SPOUSE'S NAME SOCIAL SECURITY NUMBER
C I
w Xl 1. Original Return 0 2. Supplemental Return 0 3. Remainder Return
<(
~!:::(/) :=l 4. Limited Estate 0 0
uo::~ 4a. Future interest Compromise 5. Fed. Est. Tax Return Req'd
wa..u
::cOO XJ 6. Decedent Died Testate 0
uO::-' 7. Decedent had Living Trust 0 8. Total number of SDB's
a..lD -
a.. "I 9. Lit'g'tion Proceeds Rec'd n 10. Spousal Poverty Credit n 11. Election to tax w/ Sec. 9113(A)
<(
I- m$.J~!mt~~wN~n~~tHjg$ftp'\ijlt.e.t:$.QtP'~~$.ij~Nije.)i;Nt.ft.P.Nf\ijijllflAMf#&.JijtQijMitjqij:JQ;:::ttt:tt:::::tt~:~:t~::
z NAME: COMPLETE MAILING ADDRESS:
w
0
z Ronald E. Johnson, Esquire
0 Ronald E. Johnson, Esq.
a.. FIRM NAME:
(/)
w Andrews & Johnson Andrews & Johnson
0::
0:: TELEPHONE NUMBER 78 W. Pomfret St. ,
0
u 717243-0123 Carlisle, PA 17013
1. Real Estate (Schedule A) (1 ) $84,000.00 OFFICIAL USE OI'!LY
2. Stocks and Bonds (Schedule B) (2) $3,017.40
3.Closely Held Corporation, Partnership or Sole-Prop. (3) ...
4. Mortgages & Notes Receivable (Schedule D) (4) $0.00
Z 5. Cash, Bank Deposits & Misc. Personal Prop.(Sch.E) (5) $11,251.13 -
0 "
i= 6. Jointly Owned Property (Schedule F) (6) $0.78 --
::s D Separate Billing Requested
::J 7. Inter-Vivos Transfers & Misc. Non-Propate Prop. (7)
!:: 8. Total Gross Assets (total lines 1-7) (8) $98,269.31
a.
<C 9. Funeral Expenses & Administration Costs (Sch H) (9) $10,912.74
U
w 10. Debts of Decedent, Mortgage liabilities, & Liens (10) $60,771.22
D::
11 . Total Deductions (total lines 9& 10) (11 ) $71,683.96
12. Net Value of Estate (Line 8 minus Line 11) (12) $26,585.35
13. Charitable and Governmental Bequests/Sec 9113 Trusts
for which an election to tax has not been made (13)
14. Net Value Subject to Tax (Line 12 minus Line 13) (14) $26,585.35
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
z 15. Amnt of Line 14 taxable at the spousal rate,
0
i= or transfers under Sec.9116(a)(1.2) x.O_ (15) $0.00
~ 16. Amount of Line 14 taxable at lineal rate $26,585 x.045 (16) $1,196.34
::l
a.. $0 $0.00
~ 17. Amount of Line 14 taxable at sibling rate x.12 (17)
0 $1 $0.12
() 18. Amount of Line 14 taxable at collateral rate x.15 (18)
>< $1,196.46
~ 19. Tax Due (19)
20 0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
.... .............--. .................................................................'...........................................:.:.:.:.:.:.:.:.:.:.:.:.:.:...:......:.:.:...:...:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.....................:...:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:-:.:.:.:.:.:.:.:-:.:-:.:-:.:.: ..................................................................
.......................-... .._-_......-...................-...-.................'...'...........................'...............................'...'...'...'....
~tttt~::;:;tt:r:ttt:::~t;tttttttif.l.m~~$.!l:ge::mw~jN$.:W~g~Ai!iiJ~m~mQNli.:QNJ{Smgli?~~~ilP.i~ANP.~~R~P.H~QKMA'Iijif:<i:>:::::::::~:~::::::::::::::::::::>:::~::~~:~>:~:::::;:;~:>:~>>::>;
Decedent's Complete Address:
STREET ADDRESS
17 East Pine Street
CITY STATE ZIP
Mt. Holly Springs PA 17065
Tax Payments and Credits:
1. Tax Due
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discounts
Total Credits (A+B+C)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
4.
TotallnterestJPentalty (D+E)
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
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.
(1 )
(2)
(3)
(4)
(5)
(5A)
(5B)
$1,196.46
$0.00
$0.00
$1,196.46
$1,196.46
t???????:::t:???:::tr::::':::::'??:rrr'???????:':'?::??:r::::~~:~::::~~:~:~~:::~~fu~:~~~:::~~;;',::::::i~:"::fu3:r~:~:::::::i:i:::~::::~:~:3::i::rrrrr:??::::::?:r':rr::::rttttt:::':???::?????:::???::::t?
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 transerred or its income:
c. retain a reversionary interest: or
d. retain the promise for life of either payments or care?
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 fo~' 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 disignation?
D
D
D
D
~
~
D
~
~
~
~
D
D
~
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.
c/o 78 West Pomfret Street, Carlisle, PA 17013
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
DATE /-/~ - tt!)~
c/o 78 West Pomfret Street, Carlisle, PA 17013
DATE
ADDRESS
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% [72P.S. Sec. 9116(a)(1.1)(1)].
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. Sec. 9116(a)(1.1)(ii)].
The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the
only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deseased 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. Sec. 9116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedenfs lineal beneficiaries is 4.5%, except as noted in 72 P.S. Sec. 9116(1.2) [72 P.S. Sec.9116(a)(1).
The tax rate imposed on the net value of transfers to or for the use of the decedenfs siblings is 12% [72 P.S. Sec.9116(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.
LAST WILL AND TEST AMENT
OF
LARRY NICKEL
I, LARRY NICKEL, ofMt.. Holly Springs, Cumberland County, Pennsylvania, being of
sound and disposing mind, memory and understanding, do hereby make, publish and declare this as
and for my Last Will and Testament, hereby revoking all other wills and codicils heretofore made by
me.
FIRST: I direct that all my just debts and funeral expenses, including my
grave marker, shall be paid from the assets of my estate as soon as practicable after my decease.
SECOND: I give and bequeath certain of my miscellaneous household goods,
personal effects, furniture and jewelry to the persons designated in accordance with my last-dated
memorandum prepared by me prior to my death and enclosed with this my Last Will and Testament
THIRD: I give, devise and bequeath the residue of my estate, of every nature
and wherever situate, of my estate, of every and wherever situate, to my children Equally, namely
Matthew L. Nickel and Heather Keller, provided that the share of my child who predeceases me or
dies on or before the thirtieth day following my death, shall be distributed to her issue, per stirpes,
living on the thirty-first day following my death, and in default of such then living issue.
FOURTH: I direct that all taxes that may be assessed in consequence of my death,
of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a
part of the expense of the administration of my estate.
FIFTH: I nominate, constitute and appoint, my Sister Rhonda Brewer,
Executrix of this my Last Will and
SIXTH: I direct my Executrix and her successors shall not be required to give
bond for the faithful performance of their duties in this or any other jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and
Testament, consisting oftwo (2) typewritten pages, each identified by my signature, this It lit.
day of August, 2005. ~
~~ . (SEAL)
Larry Nickel
Signed, sealed, published and declared by the above-named Testator, LARRY NICKEL, as
and for his Last Will and Testament, in the presence of us, who, at his request, in his sight and
presence, and in the sight and presence of each other, have hereunto subscribed our names as
witnesses.
(Xh(Jyt&us. 2AtJH_QA J
,4 -;( J-;j,
COUNTY OF CUMBERLAND
)
: SS.
)
COMMONWEALTH OF PENNSYLVANIA
I, LARRY NICKEL, Testator, whose name is signed to the attached or foregoing
instrument, having been duly qualified according to law, do hereby acknowledge that I signed and
executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it
as my free and voluntary act for the purposes therein expressed.
Sworn or affirmed to and '}Sknowledged before me by LARRY NICKEL, the Testator,
this JRhtdaYOf)fUj'drr ,2005. 0 _
~~ ~ (SEAL)
Larry Nickel
Notary P
fJOOG 'H HOlilt
~d "00 CNYU:J:3I:JldX~ NOISSIWWOO AW
QI1S0cl AtlY.10N ~=NOI:IOS a"JSI1Yv:)
'1Wa8 ---. Hor "I cnWNOll
~. .._~~
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA )
: SS.
COUNTY OF CUMBERLAND )
..
We, .s;Je/MI1 t. AIIctol and Jf~~ s: bt/()tY', the
witnesses whose names are signed to the attached or foregoing instrument, being duly qualified
according to law, do depose and say that we were present and saw Testator sign and execute the
instrument as his Last Will and Testament; that LARRY NICKEL, signed willingly and that he
executed it as his free and voluntary act for the purpose therein expressed; that each of us in the
hearing and sight of the Testator signed the Will as witnesses; and that to the best of our knowledge
the Testator was at that time 18 or more years of age, of sound mind and under no constraint or
undue influence.
Sworn or affirmrd to and
and s:Ael4", ~. P(/JOlet
subscribed to before me by ~tJhM s: ;.5'relt)ej/
, witnesses, this If A day of August, 2005.
cJihlfrtdtn ~~) (SEAL)
. , Witness-
~~~:r 'z'b
Wit ess
..
tary Public
eOMMONW1!! :nt OF PENNSYlVANIA
NOTARIAL SEAL
:RO\\IALD E. JOHNSON, NOTARY PUBLIC
C'~:i:);.~LE 1301-10, CUMBERLAND CO., PA
"~:"_._ i:~~'~:~;!ON EXPIRES MARCH 11,2008
(SEAL)
SCHEDULE A
REAL ESTATE
ESTATE OF
FILE NUMBER
Larry R. Nickel
21-05-0787
All real estate owned solely or as a tenant in common should be reported at fair market value with is defined as the price at which property would be
exchanged between a willing buyer and a willing seller, neither being compelled to sell, both having reasonable knowledge of the relevant facts.
Property jointly-owned with Right of Survivorship must be disclosed on Schedule F.
DESCRIPTION
ITEM
NUMBER
VALUE AT DATE
OF DEATH
ALL THAT CERTAIN tract ofland situate in the Borough ofMt. Holly
Springs, Cumberland County, Pennsylvania known and numbered as
17 East Pine Street, Mt. Holly Springs, P A 17065
See Deed Book 270, Page 2743
(See settlement sheet attached)
$84,000.00
Total (also enter on Line 1, Recap)
$84,000.00
~~
B Type of Loan
FHA - FmHA - Conv. Unins. File No. ILoan No. Mortgage Ins. Case No.
-
VA Conv. Ins. 32673295
C. This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agents are shown.
Items marked "(p.o.c.)" were paid outside the closing: They are shown for informational purposes and are not included in the totals.
D. Name and Address of Borrower E.Name and Address of Seller F. Name and Address of Lender
Matthew L. Hockley Larry Nickel Estate ERA Home Loans
2001 Bishops Gate Blvd
Mt. Laurel, NJ 08054
G. Property Location H.Settlement Agent
17 East Pine Street Ronald E. Johnson, Esquire
Mt. Holly Springs, PA 17065 Place of Settlement I. Settlement Date
78 West Pomfret Street I October 31 , 2005
Carlisle PA 17013
J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION
100. GROSS AMOUNT DUE FROM BORROWER: 400. GROSS AMOUNT DUE TO SELLER:
101. Contract sales price $84,000.00 401. Contract sales price $84,000.00
102. Personal Property 402. Personal property
103. Settlement charges to borrower(line1400) $3,342.04 403.
104. 404.
105. 405.
Adjustments for items paid by seller in advance: Adjustments for items paid by seller in advance:
106. City/town taxes to $0.00 406. City/town taxes to $0.00
107. County taxes 10/31/2005 to 12/31/2005 $58.01 407. County taxes 10/31/2005 to 12/31/2005 $58.01
108. Assessments to 408. Assessments to
109. Maintenance to 409. Maintenance to
110. School taxes 1 0/31/2005 to 6/30/2006 $651.12 410. School taxes 1 0/31/2005 to 6/30/2006 $651.12
111. to 411. Commitment fee to
112. to 412. to
120. GROSS AMOUNT DUE FROM BORROWER: $88,051.17 420. GROSS AMOUNT DUE TO SELLER: $84,709.13
200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER:
201. Deposit or earnest money $100.00 501. Excess deposit (see instructions)
202. Principal amount of new loan(s) $84,000.00 502. Settlement charges to seller (line 1400) $891.61
203. Existing loan(s) taken subject to 503. Existing loan(s) taken subject to
204. Commitment Fee 504. Payoff of first mortgage
205. Lender's credit $948.70 505. PNC Bank-4001008109571095 $56,475.42
206. 506. Payoff of second mortgage loan
207. 507.
208. 508.
209. 509.
Adjustments for items unpaid by seller: Adjustments for items unpaid by seller:
210. Cityltown taxes to $0.00 510. Cityltown taxes to $0.00
211. County taxes to $0.00 511. County taxes to $0.00
212. Assessments to 512. Assessments to
213. School taxes to $0.00 513. Maintenance to
214. to 514. School/taxes to $0.00
215. to 515. to
216. to 516. to
217. to 517. to
218. to 518. to
219. to 519. to
220. TOTAL PAID BY/FOR BORROWER $85,048.70 520. TOTAL REDUCTION AMOUNT DUE SELLER: $57,367.03
300. CASH AT SETTLEMENT FROMITO BORROWER 600. CASH AT SETTLEMENT TOIFROM SELLER:
301. Gross amount due from borrower (line 120): $88,051.17 601. Gross amount due to seller (line 420) $84,709.13
302. Less amounts paid by/for borrower (line 220) $85,048.70 602. Less total reductions in amount due seller $57,367.03
303.CASH ([ X ] FROM) ([ ] TO) BORROWER: $3,002.47 603. CASH ([X] TO) ([ ] FROM) SELLER: $27,342.10
to
$0.00 to
Commission paid at settlement
BOO. ITEMS PAYABLE IN CONNECTION WITH LOAN.
801. Loan origination fee to
802. Loan discount to
803. Appraisal Report to STARS $325.00
804. Credit Report to FNMA CBC $19.20
805. Final inspection fee to
806. Application fee to ERA Home Loans $500.00
807. Flood Cert Fee to STARS $19.50
808. Document Fee to ERA Home Loans $85.00
809. FNMA Processing Fee to
810.
811.
812. .
813.
900. ITEMS REQUIRED TO BE PAID IN ADVANCE.
901. Interest from 1 0/31/2005 to 10/31/2005 @ $15.38 per day $15.38
902. Mortgage insurance premium for mo. to
903. Hazard insurance premium for 1 yrs. to Liberty - $371.00 POC
904. Flood insurance 1 yrs. to Prudential $469 POC
905.
1000. RESERVES DEPOSITED WITH LENDER
1001. Hazard insurance 3 mo.@ $30.92 per mo. $92.76
-- 1002. Mortgage insurance - - - 2 mo.@.- .-.--- - $67720-------peF-fT10. ---- .. $0.00
1003. City property taxes 9 mo.@ $25.77 per mo. $231.93
1004. County property taxes mo.@ per mo. $0.00
1005. Annual assessments (Main!.) mo.@ per mo. $0.00
1006. School Property Taxes 4 mo.@ $80.20 per mo. $320.80
1007. Flood Insurance 3 mo.@ $39.08 permo. $117.24
1008. Aggragate Escrow Adjustment ($234.75) ~.. 'i
1009. .0
1100. TITLE CHARGES:
1101. Settlement or closing fee to
1102. Abstract or title search to
1103. Title examination to
1104. Title insurance binder to
1105. Document preparation to
to
11 06. Notary fees to cash $20.00 $10.00
1107. Attorney fees to
Attorney fees to
1108. Title insurance to Ronald E. Johnson, Agent RR $686.48
(includes above items No.: .':'~,\>A-AE . 0
1109. Lenders coverage $84,000.00 .
M
1110. Owners coverage $84,000.00 0
1111. Title Insurance Endorsements $150.00
1112. Restrictions
1113. Messenger service to Andrews & Johnson $15.50 $15.50
1114. Wire fee to Andrews & Johnson
1115. Closing Protection Letter fee to Commonwealth Land Tille $35.00
1200 GOVERNMENT RECORDING AND TRANSFER CHARGES
1201. Recording fees: Deed $38.50 Mortgage $64.50 Satis Piec $103.00
1202. City/county tax stamps: Deed $840.00 Mortgage $840.00
1203. State tax/stamps: Deed $840.00 Mortgage $840.00
1204. Tax Certificates
1205.
1300 ADDITIONAL SETTLEMENT CHARGES
1301. Survey
1302. Pestinspection
1303. Mt. Holly Springs Borough - final water/sewer $26.11
1304.
1305.
1400. TOTAL SETTLEMENT CHARGES (entered on lines 103, Section J and 502, Section K) $3,342.04 $891.61
CERTIFICATION
I direct and authorize the Company to make the distributions indicated for my account on the
attached HUD-1 Settlement Statement, approving the tax prorations indicated therein, and
understand that prorations were based on figures for the preceding year, or estimates for the
current year, and in the event of any change for the current year, all necessary adjustments
must be made between Seller and Borrower direct; likewise and DEFICIT in delinquent taxes
will be reimbursed to Title Company by the Seller.
I have carefully reviewed the HUD-1 Settlement Statement and to the best of my knowledge
and belief it is a true and accurate statement of all receipts and disbursements made on my
account or by me in this transaction. I further certify that I have received a copy of the HUD-1
Settlement Statement.
~?~C7
ew L. Hockley
~&
Rhonda Brewer, Executrix for the Est e
of Larry Nickel
Borrowers
Sellers
To the best of my knowledge, the HUD-1 Settlement Statement which I have prepared is a
true and accurate account of the funds which were received and have been or will be
disbursed by the undersigned as part of the settlement of this transaction.
/~/s/~.j~
Date / I
SCHEDULE B
STOCKS AND BONDS
ESTATE OF
FILE NUMBER
Larry R. Nickel
21-05-0787
All property jointly-owned with Right of Survivorship must be disclosed on Schedule F
ITEM DESCRIPTION
NUMBER
VALUE AT DATE
OF DEATH
1 47 shares Prudential Financial @ 64.20 per share
$3,017.40
TOTAL (also on line 2, Recapitulation)
$3,017.40
SCHEDULE E
CASH, BANK DEPOSITS AND
NITSCELLANEOUSPERSONALPROPERTY
ESTATE OF
FILE NUMBER
Larry R. Nickel 21-05-0787
Include the proceeds oflitigation 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 DESCRIPTION VALUE AT DATE
NUMBER OF DEATH
1
Checking acct no: 51400399423-PNC Bank (see letter attached)
$10,143.71
2
Prudential - disability payment
$200.00
3
Capital Tax Collection Bureau - refund
$4.18
4
Bon Ton - refund of credit
$25.00
5
Matthew L. Hockley - reimbursement for real estate taxes paid in
advance (see settlement sheet attached to Schedule A)
$709.13
6
Prudential - partial disability payment
$66.67
7
Comcast Cable - refund
$1.94
8
Travelers Ins - refund
$100.50
TOTAL (also on line 5, Recapitulation)
$11,251.13
SEP-18-2005 19:03
PNCBANV
412 768 3458
P.ell
o PNCRAN<
September 19, 2005
Ronald E Johnson
Attorney at Law
78 W Pomfret St.
Carlisle, PA 17013
sop
RE: Estate of Larry R Nickel (Deceased)
SSN: 210-40-2624
DOD: 08-23-2005
Dear Mr. Johnson:
In response to your request for Date of Death balances for the customer noted above, our
records show the following:
Cbecking Account
Account #5140399423
Established 09-19-1983
LARRY R NICKEL
DOD balance: $10.143.71 + $0.06 accrued interest
Savings Account
Account #5130321526 Established 01-09-1986
LARRY R NICKEL ITF
MAtTHEW LYNN NICKEL
DOD balance: $1,361.97 + $0.01 accrued interest
Account #5130327012
Established 10-31-1997
LARRY R NICKEL
PATSY A ZEIGLER
DOD balance: $1.56 + $0.00 accrued interest
The decedent maintained ILA loan Account # 4001008109571095 with PNC bank, For
further information, please call1-88S-762-226S. Select option 3 and then 0 (zero).
After pressin~ zero, please remain on the Line to spmk to 8 Loan Service Representative.
(We do not bave access to Loan information, you must tonta.et the Loan Area at the
above Dumber for further a.ssistance.)
Pa.ge I of 2
SCHEDULEF
JOINTLY-OWNED PROPERTY
ESTATE OF
FILE NUMBER
Larry R. Nickel 21-05-0787
if an asset was made joint within one year of the decedent's death, it must be reported on Schedule G
Surviving Joint Tenant (s):
NAME
ADDRESS
RELATIONSHIP TO
DECEDENT
A. Patsy A. Zeigler
83 Spring Garden Estate, Carlisle, P A 17013
friend
Jointly-owned property:
LETTER FOR DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF TOTAL VALUE OF DECD'S%INT. DOlLAR VALUE OF DECEDENTS
ITEM NUMBER
JOINT TENANT INSTITUTION AND BANK ACCOUNT NUMBER OR ASSET INTEREST
SIMILARIDENTIFYINGNUMBER ATTACIIDEED
FOR JOINTLY.HElD REAL EST ATE
1 A 31-0ct-97 Savings acct no:
5130327012-PNC Bank $1.56 50% $0.78
TOTAL (also on line 6, Recapitulation)
$0.78
SCHEDULE G
TRANSFERS
ESTATE OF
FILE NUMBER
Larry R. Nickel
21-05-0787
ITEM DESCRIPTION OF PROPERTY TOTAL VALUE DECD.% EXCLUSION TAXABLE
INCLUDE TIlE NAME OF TIlE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND
NUMBER TIlE DATE OF TRANSFER. ATTACH A COPY OF TIlE DEED FOR REAL ESTATE. OF ASSET !NT (if applicable) VALUE
1 1986 Ford Truck in poor condition
transferred to Matthew L. Nickel (son)
on 8/22/05 $500.00 100.0% 500.00 $0.00
2 Rowboat to Matthew L. Nickel (son) on
8/22/2005 $200.00 100.0% 200.00 $0.00
3 Larry R. Nickel ITF Matthew Lynn Nickel
(son) (see letter attached to Schedule E) $1,362.98 100.0% 1,362.98 $0.00
Tills schedule to be completed and med if the answer or the question on the reverse orthe cover is yes.
TOTAL (also on line 7, Recapitulation)
$0.00
SCHEDULE H
FUNERAL EXPENSES, ADMINISTRATIVE
COSTS AND MISCELLANEOUS EXPENSES
ESTATE OF
FILE NUMBER
Larry R. Nickel
21-05-0787
ITEM
NUMBER
A.
1
2
3
B.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
Debts of decedent must be reported on Schedule I.
DESCRIPTION
Funeral Expenses:
Mt. Holly Springs Cemetery Assn - cemetery lot
Legion Hall rental & food after memorial service
Expenses for brother (Sheldon Nickel) to attend to his brother prior
to his death and memorial services
Administrative Costs:
Personal Representive Commissions
Name of Personal Representative(s)
Social Security Number of Personal Representative:
Street Address:
City: State: Zip:
Year(s) commissions paid:
Attorney fees to Andrews & Johnson
Family Exemption
Claimant
Street:
~ ~&~
Relationship of Claimant to Decedent:
Probate Fees to Register of Wills
Accountant Fees to Patricia Rosendale, CPA
Tax Return Preparer's Fees
The Sentinel - estate advertisement
Cumberland Law Journal- estate advertisement
Traveler's Ins. - homeowners insurance
Met Ed - electric bill
Traveler's Ins. -truck insurance
Sandy Gensler - house cleaning
Mable Satterson, Tax Collector, 2005 county/twp & school taxes
Borough ofMt. Holly - trash & sewer expense
Shipley Oil - fuel oil
Met Ed - electric bill
Sprint - final phone bill
Notary fees
SUBTOTAL
AMOUNT
$400.00
$250.00
$600.00
$4,900.00
$256.00
$144.29
$75.00
$83.66
$168.07
$147.00
$130.00
$1,329.22
$97.03
$346.09
$48.47
$113.23
$10.00
$9,098.06
SCHEDULE H - continued
FUNERAL EXPENSES, ADMINISTRATIVE
COSTS AND MISCELLANEOUS EXPENSES
ESTATE OF
Larry R. Nickel
FILE NUMBER
21-05-0787
ITEM
NUMBER
Debts of decedent must be reported on Schedule I.
DESCRIPTION
AMOUNT
A.
19
20
21
22
23
Funeral Expenses:
Overnight mail fee
Recorder of Deeds - 1 % transfer tax
Mt. Holly Springs Borough - final water & sewer bill (See settlement
statement attached to Schedule A for Items 12-15 above)
Register of Wills, filing fee - P A Inheritance Tax Return
Reserve for closing and accounting
TOTAL (also on line 9, Recapitulation)
$15.50
$840.00
$26.11
$168.07
$15.00
$750.00
$10,912.74
SCHEDULE I
DEBTS OF DECEDENT
MORTGAGE LIABILITIES AND LIENS
ESTATE OF
FILE NUMBER
Larry R. Nickel 21-05-0787
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM DESCRIPTION VALUE AT DATE
NUMBER OF DEATH
1 Andrews & Johnson-attorneys fee $200.00
2 Andrews & Johnson-attorney fee, transfer taxes & recording fee $1,211.90
3 Camp Buckskin -outstanding dues $160.00
4 Sears - outstanding balance $905.15
5 Comcast - cable bill $17.85
6 Boiling Springs Animal Hospital- outstanding balance $555.13
7 VISA-outstanding balance $1,164.68
8 VISA - final payment $30.29
9 PNC Bank - outstanding mortgage balance on 17 East Pine Street,
Mt. Holly Springs, P A 17065 (see letter attached) $56,526.22
TOTAL (also on line 10, Recapitulation)
$60,771.22
o PNCBANK
December 19,2005
Estate of Larry R. Nickel
Andrews & Johnson
Attorneys at Law
78 West Pomfret St
Carlisle, Pa 17013
~
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RE: Estate of Larry R. Nickel
Acct # 40-01-8109571095
'~
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,
~
Dear Mr. Johnson :
~
~
~.
~
i:
In response to your request, this letter is to provide the following information on the
above-mentioned account. This is a real estate secured loan in the name of Larry R,
Nickel .
The payoff amount as of August 23,2005 was $56,526.22 The account is closed
If you have any questions or need any other information please feel free to contact me at
1-800-878-0027 x26774 between the hours of8:00 a.m. and 4:15 p.m. EST, Monday
through Friday.
.,
it
~
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Sinc:rel~, I
Guu /Gl~ .
Rita Kush
Senior Credit Counselor
(412) 762-6774
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A member of The PNC Financial Services Group
Consumer Loan Center 2730 Liberty Avenue Pittsburgh Pennsylvania 15222
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~
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SCHEDULE]
BENEFICIARIES
ESTATE OF
FILE NUMBER
ITEM NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR SHARE
NUMBER Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a)(1.2)]
1 Matthew L. Nickel
397 Peach Glen Road, Gardners, PA 17324 son 1/2 of residue
2 Heather Keller
33 Spring Garden Estate, Carlisle, P A 17013 daughter 1/2 of residue
II NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRiBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX is NOT BEING MADE
B. Charitable and Govenunenta! Bequests:
Larry R. Nickel
21-05-0787
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (also enter on line 13, Recapitulation)
$0