HomeMy WebLinkAbout0131-06
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
GERMAN NORMA
1196 MYERSTOWN ROAD
GARDNERS, PA 17324
u_uu_ fold
EST A TE INFORMATION: SSN: 187-16-4806
FILE NUMBER: 2105-0867
DECEDENT NAME: WILSON ROBERT M
DATE OF PAYMENT: 01/31/2006
POSTMARK DATE: 01/31/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 08/31/2005
NO. CD 006262
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $4,848.67
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS: NORMA J GERMAN
CHECK#1509
INITIALS: CM
SEAL
RECEIVED BY:
REGISTER OF WILLS
$4,848.67
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 05 0867
COUNTY CODE YEAR NUMBER
I- DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
z Wilson, Robert M 187-16-4806
W DATE OF DEATH (MM-DD-YY) DATE OF BIRTH (MM-DD-YY) THIS MUST BE FILED IN DUPLICATE
C
W 8/31/2005 12/4/1921 WITH THE REGISTER OF WILLS
0
W (IF APPLICABLE) SURVIVING SPOUSE'S NAME SOCIAL SECURITY NUMBER
C I
n/a
w Xl 1. Original Return o 2. Supplemental Retum o 3. Remainder Return
<l:
::.::t:rn tJ 4. Limited Estate 0 o 5. Fed. Est. Tax Return Req'd
00::::':: 4a. Future interest Compromise
wCl,O
::cOO ~ 6. Decedent Died Testate o 7. Decedent had Living Trust
oo:::...J 0_ 8. Total number of SOB's
Cl,CD
Cl, I 9. Lifg'tion Proceeds Rec'd n 10. Spousal Poverty Credit n 11. Election to tax wi Sec. 9113(A)
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t- tmifii.tr.~mlj~1~~~iiiWiQiMmt@Ui@~Sj~&t~f@.ijijJijQ"ii~@Wf~Ml.ttmMI1IQMiWliHiMIJt@HW
z NAME: COMPLETE MAILING ADDRESS:
w
Cl
z Ronald E. Johnson, Esquire
0 Ronald E. Johnson, Esq.
Cl, FIRM NAME:
rn
w Andrews & Johnson Andrews & Johnson ^. ,
0:: ,
0:: TELEPHONE NUMBER 78 W. Pomfret st.() ,
0
0 717 243-0123 Carlisle, PA 17013
. .
1. Real Estate (Schedule A) (1 ) $118,000.00 OFFICIAL USE ONt'f
2. Stocks and Bonds (Schedule B) (2) $0.00 -
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) $5,647.28
0 ~-." !
t= 6. Jointly Owned Property (Schedule F) (6) $5,829.26
:3 D Separate Billing Requested
:;:) 7. Inter-Vivos Transfers & Misc. Non-Propate Prop. (7)
....
0: 8. Total Gross Assets (total lines 1-7) (8) $129,476.54
<C 9. Funeral Expenses & Administration Costs (Sch H) (9) $21,462.74
0
w 10. Debts of Decedent, Mortgage liabilities, & Liens (10) $265.58
0::
11. Total Deductions (total lines 9& 10) (11 ) $21,728.32
12. Net Value of Estate (Line 8 minus Line 11) (12) $107,748.22
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) $107,748.22
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
z 15. Amnt of Line 14 taxable at the spousal rate,
0
~ or transfers under Sec.9116(a)(1.2) x.O_ (15) $0.00
~
::l 16. Amount of Line 14 taxable at lineal rate $107,748.22 x.045 (16) $4,848.67
Q.
:E 17. Amount of Line 14 taxable at sibling rate $0 x.12 (17) $0.00
0
0 18. Amount of Line 14 taxable at collateral rate $0 x.15 (18) $0.00
><
~ 19. Tax Due (19) $4,848.67
20 n CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
.................... ............................................... .................................'..........................................................................._..................................................................................................................................................... '''0, ................................................... ... .....................
mlMlit~:~~:~tttt~itli~~~~MlHMimt~lJs.e.~t~t~Ni:WlmM;U~tQU.~1tG&$.:~N~~B~g$.$~@$.it~Nt.1]lg~a.a.~KMKt:at%tll~~j~~~t#~t~~~Ht1:t~~~ttt~~l
o
Decedent's Complete Address:
STREET ADDRESS
4342 Carlisle Road
CITY STATE ZIP
Gardners PA 17013
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.
TotallnteresllPentalty (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.
(1 )
(2)
(3)
(4)
(5)
(SA)
(58)
$4,848.67
$0.00
$0.00
$4,848.67
$4,848.67
B. Enter the total of Line 5 + SA. This is the BALANCE DUE.
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 transerred or its income:
c. retain a reversionary interest: or
d. retain the promise for life of either payments or care?
2. If death occumed after December 12, 1982, did decedent transfer property within one year of death
without receiVing adequate consideration?
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary disignation?
D
CJ
D
D
D
D
D
~
~
~
~
~
~
r:=J
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.
~~
rlisle, PA 17013
IVE
DATE
DATE
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 sUlviving 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 decedenrs 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 decedenrs 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 TESTAMENT OF
Robert M Wilson
I.
I, Robert M Wilson, residing'at Gardners, Pa, being of sound mind
and in the contemplation of the certainty of death, do hereby declare
this instrument to be my last will and testament.
II.
I, hereby revoke all previous. wi:Ll.s and codicils.
III.
I direct that the disposition of my remains be as follows:
burial in pre paud plot at Cumberland Valley Memorial Gardnens
IV.
I give all the rest and residue of my estate as follows:
To my wife Pearl R Wilson: 100 per cent of my estate. If she should
precede me in death, then the residue of my estate should be divided
between my surviving grandchildren & children as designated a-fter"all
--:"items are's6ld and just 'cirid final, bilS'paid:
'.. --, -~-' ......~ -T,,'granClcihildren'Angelia'w6Yfe,-'Renee 'Wise'~ ':Edward' MarKS; C6rtn'ey .,
Wilson, & Kayla Wilson: $1000 each.
To children Roberta Bell, Norma German, ~ Raymond Wilson: the balance
of the estate is to be divided equally.
In the event that none of my designated heirs survive me, I give all
the rest and residue of my estate to my heirs as determined by the laws
of the State of Pennsylvania, relating to descent and distribution.
v.
I appoint Norma German, to act as the executor of ' this wiil; to ..',
serve without bond. Should Noma German be unable or unwilling to serve,
then I appoint Roberta. Bell to act as the executor of this will.
I herewith affix my signature to this will on this
, the J'f/-1\. day of )'IN:;-y-
at, ~~.
following witnesses, who witnessed and
request, and in my presence.
, t:@.2.tJ6 I
, in the presence of the
subscribed this will at my
~~1J1 W ~
Robert M Wilson
ATTESTATION CLAUSE
On the date above written, Robert M Wilson, well known to us declared
to us, and in our presence, that this instrument,
consisting of pages, is his last will and testament, and Robert M
Wilson, then signed this instrument in our presence, and at Robert M
Wilson I s request we now sign this will as witnesses in each other I s
presence. Further that Robert M Wilson, appeared to us to be of sound
mind and lawful age, and under no undue influence.
Witness: ~ d' ,
q::~#;';,~ ~ .-
Addres s : L{~i.( ? r 8A-v-i Nt:.. /LCr_ -flz,IL 'fq'lO-s Q (f() 6- "5
Witness:
Address:
jffJL tA-- ~~-
~(l ~ 1"'--: --/-1r... fle 6HW i'-f'lfiS (J - r?3:? Y
Witness:
JJilljtr~/~
Address:
A, 86 ~ 12.'5 ~ -+l-rrl~.<t ~&.S ~ Co EO ~ ~-
STATE OF Pennsylvania
COUNTY OF Cumberland
Before me, the undersigned authority authorized to take
acknowledgments and administer oaths, personally appeared:
Robert M Wilson
~ tJ11 tAl A'~
r
who after being having duly sworn or affirmed to tell the truth,
stated:
1. That Robert M Wilson declared this instrument to be his last will
and testament to the witnesses.
2. That Robert M Wilson signed this instrument in their presence.
3. That the witnesses signed as witnesses in the presence of Robert M
Wilson and each other.
4. That Robert M Wilson is well known to the witnesses, and the
witnesses believe Robert M Wilson to be of lawful age, of sound mind and
under no undue i or constraint.
~
My Commission Expires:
t:f-2-tf-o I
...,..
.
SCHEDULE A
REAL ESTATE
ESTATE OF
FILE NUMBER
Robert M. Wilson
21-05-0867
All real estate owned solely or as a tenant in common should be reported at fair market value with is defmed 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
VALUE AT DATE
OF DEATH
ITEM
NUMBER
ALL TRA T CERTAIN tract of land with improvements thereon erected
situate in Dickinson Township, Cumberland County, Pennsylvania being
designated as Lot No. 14 on the Plan of Lots known as Mount View
Heights as recorded in the Office of the Recorder of Deeds for Cumberland
County in Plan Book 11, Page 59 and being known and numbered as
4342 Carlisle Road, Gardners, PA 17324 (See Deed Book Q, Volume 27
Page 927) .
Proceeds from sale (see settlement statement attached)
$118,000.00
Total (also enter on Line 1, Recap)
$118,000.00
A. Settlement Statement
U.S. Department of Housing and Urban Development
R TunD n': n~n f"lUR Mn ?~n?_n?~~ R;:V I-llln_1 '1/RR1
I. DFHA 2. DFmHA 3. DConv. Unins. I 6. File Number T 7. Loan Number /8. Mortgage Insurance Case Number
4 nVA ~ nrnnu 'n" S 100-382
C. Note: This form Is furnished to give you . statement o1lduallalUemenl cosls. Amounts paid 10 Ind by the setllement 108nl are shown. I
Items martced "IP.o.c.)" were piNd outskj" !he doling'; they 8"" shown here lor Informallon purpo.., end are not Induded In tn. lotlls. T1UeExpress SetUement System
WARNING: It Is . alme to knowlngty make 'als. statemenlllo ~H~"~~~' S~.I.1 on lhls ~ any other SlmHa~ form. PenalU.. upon ".,. ""'"
D. NAME OF BORROWER: John S. Keirn and Roberta M. Bell
A ""D """.
E. NAME OF SELLER: The Estate of Robert M. Wilson
A ""DC"".
F. NAME OF LENDER: Members 1st Federal Credit Union . .
AnnOl'OO. ~OOO T ouiee Orive. Mechanicsbun>_ P A 17055 -
G. PROPERTY ADDRESS: 4342 Carlisle Road, Gardners, PA 17324
Dickinson Town.hin
H. SETTLEMENT AGENT: P A Real Estate Settlement Services, LLC
n' '''u''~m 354 Alexander Snrin" Road Ste (Carlisle PA 17011
I . "....". 01/l?nOO/\
.I !':UMMARY OF BORROWER'S TRANSACTION: K ~UMMARY OF ~~I I ~R'~ TRANSACTION'
1nn ~~~~~ Ann ",or",., ,,,,.,.
'n' , nriM 118 000.00 An, 118 000,00
'M An?
1n1 3 693.38 AM
'f\A AnA
'no Ano
. ~ri. 'seller ,.du~nr-"
"'" Ano
,n. ~- ... .. An.
,nA """~I to... 01/12/06In 06/30/06 582.88 AnA r_.. ,,- 01112/06 ,. 06/30/06 582.88
,n. An.
11n A1n
'" A11
11. A1'
1::>n r:lRf"l"" AI..4f"lII,,", 122 276.26 d::>n ,<:CII co. 118 582,88
?nn .nn ".,
?n, on1 C..D..
,M 61 800.00 AM 1 180.00
,n1 "",.II"n on. --.
,nA tnA .,
'n< on.
,n. on.
.n. on.
?n. .n.
,no ono
, "nn.Wi hv ADII . ,.."..
; ..n ..n
.11 01/0i/06In 01/12/06 6.96 ." ~_..... ,---- 01/01/06'" 01/lZ/06 6.96
"" O~_~ ,____ 0" "...."n, '0...
.11 ."
.14 "A
,,. ...
..0 ...
71. on
... A..
71D "D
??n Tf"lT AI 61 806.96 ~?n T~"" , ,.... 1 186.96
1nn I':nn 1,,1=11;:
.01 _. 122 276 :26 on. 118 582.88
1n. 61 806.96 An. 1 186.96
.,n->. 60 469.30 ~M rA""'''~ ~~,.~,., 117 395. 92
SUBSTITUTE FORM 1099 SELLER STATEMeNT: The Infmnedon contained h8r1Jln Is Important tu InformlUon 8nd II being rurnlll'led to tI'IIlntemll RIVW'lJe Servtce. If you Brit requi"ad 10 HIe . return,
. negllvenc:- penlllty or of1er aancIon wi! be impoMd on you If 1111 item" required 10 be r1lport~ and the IRS delermlnes thai It lull not been reported. me Contrad Sale' Pnc. delatbed on
In. .401 IboW con,'lul.. the GI'OU Pl'OCMcM of IhIt lnin..ction.
You arw required by 1_ to provide In. Htttement agent (FIcI. TalC 10 No: .. - -, with your COfT'ed 1SXP8)'er IdentlficaUon number. Ir you do not pf'Oride yolK eorrlld 'Bllplrer klenllncaUon
number, you I'nIY be lUbject to cIYtI or c:t'\rnIn-' penltllel impaled by law. Under pen8lUes 01 perju'y, I certify that Ihe m.mber ahown on Ihla stalemenlls my comet taxpayer IdenUfical100 number.
TlN:_._,_,_._._ 5ELLER(S)5IGNAl1JRE(5):
SELLERIS, NEW MAILING ADDRESS:
SELLERI5J PHONE NUMBERS: IH)
IWl
SETTLEMENT STATEMENT R FV HI In. I rl/R6)
I N PAID FROM PAID FROM
700 TnTAI r!.A' MMI<::<::lnN b..ed on Drice $118 000.00 = BORROWER'S SELLER'S
FUNDS AT FUNDS AT
,0. < , M SETTLEMENT SETTLEMENT
,n? < ."
7n~
Rnn 'TO=MS PAvAR' F IN r.nNNo=r.TlnN WITH' nAN
0"' 1M" 0.125 'I.Members 1st Federal Credit Union LR 77.25
On? I ~o" n;.~ '"' OL
OM
AnA
An< '" Members 1st Federal .Credit Union LR 350.00
onA In Members 1st Federal Credit Union LR 75.00
on7 In Members 1st Federal Credit Union LR 275.00
AnA
O~~
Aln
."
onn I BE PAin IN AnVANr.F
Ani ,_.__. c_ 01/12/2006 I~ 02/01/2006 "". 10. 9438 ,_.. 20 Davs 218.88
On? In, In ,
on. ........ ,...__ D_......_ f~. I~
AnA
on.
Innn
1M' u...... 1...__ ~ "'" ,.;,~ ,
.nM mn 1Ill~ Im~
Inn. ~ "'" Imn
.MA mn 1I!l~ I~
.00. ~~~.._- -~ "'" Imn
.000 ' """ 0.00 0.00
11nn
11n'
11n?
"M
l1nA d """ .". - .-.
11 n. AM~~ ... I~ Salzlllann Huahe.. P.C. 250. DO, - ". ..'..... _..~.
11 nA "nfo.. .... In Salzmann Huahes P.C. 10.00
11n7 MRonald Johnaon Esa. (POCI
1
11nA In Stewart Title Guarantv/PA RE SS 948.75
11 no 61 800.00 -
..,n 118 000.00 - 948.75 ,
1111 Fn_'M c-" .nn """ OM .~ Stewart Ti.tle Guarantv/PA RE SS 150.00
"10
"" 'n Stewart Ti Ue Guarantv/PA RE SS 35.00
,...nn
10M 38.50 '''~ri~~~.'64. 50 ' ".1.... . 103.00
'1?n? no.".l 180.00 . "'n"nAna. 1 180.00
'1?n~ ~M~l 180.00 'U~ri~o..' 1 180.00
10M
'1?n<
lonn ,
..nl I~ Salzmann Ruahes P.C. 20.50
, "no "
<Ann TI"ITA' ~. .on 3 693.38 1 180.00
HUD CERTIFICATION OF BUYER AND SELLER
~ ~v: ~=~.~~~Ji~I~~:~.~-;~ t~~HeD~ ~::.=:;:~~gl~~ItJIef. ill,. true end ICCU"BhI stet.mIlnl of 11I1 receipts end di.buqements.made on my Becount o~ by me
G{~.11.~'vn /6-, ~~
. . Bet!
WARNING: rr IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE
UNITED STATES ON THIS OR ANY SIMILAR FORM. PENAL TIES UPON CONVICTION
CAN I"CLUDE A FINE AND IMPRISONMENT, FOR DETAILS SEE TrrLE 18:
U.S. CODE SeCTION 1001 AND SECTION 1010.
The HUD.' Sememem Sla!emanf whld11 have prepered is SINI end lICCUrlilla account of this ltanlldlon.
I hlV8 ClUled ~ will cau.. the funds 10 b. disbursed in ICQJfdance wilb ttiI statement.
-11.""'7 -.:- i. ~ ~ 1- I ~ - i1o.C>O I-
By: DAlE
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS PERSONAL PROPERTY
FILE NUMBER
ESTATE OF
ITEM
NUMBER
Robert M. Wilson
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
DESCRIPTION
21-05-0867
VALUE AT DATE
OF DEATH
$650.00
1
2
3
4
5
6
7
8
9
Death benefit - Fraternal organizations
Medicare reimbursement
$179.47
Proceeds from sale of 1975 Chevrolet Motor Home
Title No. A27021201
Manor Care - refund for phone
$1,100.00
$10.20
Comcast - refund
$27.03
Cent. United Ins. - refund
$18.00
Proceeds from auction of all personal property including 1995
Chevrolet Corsica automobile (see statement attached)
$3,029.00
Railroad retirement
$50.70
John S. Keim and Roberta Bell - reimbursement for real estate
taxes paid in advance
$582.88
TOTAL (also on line 5, Recapitulation)
$5,647.28"
Date: 11-05-21211215
DEHART'S AUCTION
1554 HOllY PIKE
CARLISLE, PA 1712113
717-258.-5858 717--258-5882
www.dehartsauction.com
Settlement
Seller"': 7585
Nor"'ma Ger"'man
Pa 1767551121
1196 myerstown rd
Gardners PA 17324
717-486-8859
Comm# Rate
Items Total Comm$
41211 2,51214.1210 751.2121
1 525.0121 78.75
41212 3,029.00 829.95
261ZJ.00
3. 3121.01211210
6. 15.1210121121
Adver"'tising
less adjustments:
Net due to sellet..:
Thank you for choosing DeHart's Auction Service
f~~h
1J~ (JmR-
~rv~
~1t ~/Lv'7-
Page: 14
-1,089.95
1,939.1215
elf J l!OC? ~OC)
S3?,OD
;?31/ oS-
SCHEDULEF
JOINfL Y-OWNED PROPERTY
ESTATE OF
FILE NUMBER
Robert M. Wilson
if an asset was made joint within one year of the decedent's death, it must be reported on Schedule G
Surviving Joint Tenant (5):
NAME
05-21-0867
ADDRESS
RELATIONSHIP TO
DECEDENT
A. Nonna 1. Gennan
B
C
1196 Myerstown Road, Gardners, PA 17324
daughter
Jointlv-owned propertY: -
rI'I!M NUMBER. lEI'TIlRFOR DATEMADB 10INT DESCRIPTION OF PROPBRTY INCLUDB NAMIl OF TOTAL VALUE OF DECD'S%INT. DOlLAR VALUEOF.DBCEDENT'S.' .
10INT TENANT INSnn:mON AND BANK ACCOUNT NUMBER OR SIMILAR. ASSET IN'I'ERBST
IDENTIFYlNG NUMBER ATTACH DEED FOR 10INTI.y.HI!lD
RBALESTATE
1 A 6/9/97 checking acct no: 1350137-
M&T Bank (see letter
attached) $11,658.52 50% $5,829.26
Pearl R Wilson died
October 13, 2004
TOTAL (also on line 6, Recapitulation)
$5,829.26
rl:1 M&fBank
499 Mitchell Road, MiIIsboro, DE 19966 Mail Code DE-MB-12
Phone (888) 502-4349
Fax (302) 934-2955
October 12, 2005
Andrews & Johnson
Attorneys At Law
78 West Pomfret Street
Carlisle, Pennsylvania 17013
Re: Estate of Robert MWilson
Social Securitv: 187-16-4806
Date of Death: AUJ!ust 31.2005
Dear Sir or Madam:
Per your inquiry dated October 03,2005, please be advised that at the time of death, the above-named decedent had on
deposit with this bank the following:
1.
Type of Account
Checking Account
Account Number
1350137
Ownership (Names oj)
Norma J German *
Pearl R Wilson *
Robert M Wilson *
Opening Date
06/09/97
Balance on Date of Death
$11,658.52
Accrued Interest
$
0.00
Total
$/1,658.52
Please be advised, there was no safe deposit box found for the above decedent.
For further account information, regarding ownership, closures and/or reimbursement of funds, etc., please call the
Mt Holly Springs Office # 717-486-3038.
Sincerely,
~ayI
Nancy Clagett
Records Management
SCHEDULE H
FUNERAL EXPENSES, ADMINISTRATIVE
COSTS AND MISCELLANEOUS EXPENSES
ESTATE OF
Robert M. Wilson
FILE NUl\1BER
21-05-0867
ITEM
NUMBER
A.
1
2
B.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
15
16
17
18
Debts of decedent must be reported on Schedule I.
DESCRIPTION
Funeral Expenses:
Hoffinan-Roth Funeral Home
John Keirn - funeral luncheon
Administrative Costs:
Personal Representive Commissions
Name of Personal Representative(s): Norma 1. German
Social Security Number of Personal Representative: 210-40-1375
Street Address: 1196 Myerstown Road
City: Gardners State: PA Zip: 17013
Year(s) commissions paid: 2~ot,
Attorney fees to Andrews & Johnson
Family Exemption
Claimant
Probate Fees to Register of Wills
Accountant Fees to Patricia Rosendale, CPA
Tax Return Preparer's Fees
Sprint - telephone bill
West Shore EMS
Met Ed - electric bill
Sprint - telephone bill
Continental Insurance - homeowners ins
Met Ed - electric bill
Met Ed - electric bill
Met Ed - electric bill
Dehart's Auction-auctioneer expenses
John S. Keirn and Roberta M. Bell- reimbursement for real estate
taxes paid in arrears
Recorder of Deeds - 1 % transfer tax (see settlement statement
attached to Schedule A for items 15 and 16)
Register of Wills - P A Inheritance Tax - filing fee
Reserve for closing and accounting
TOTAL (also on line 9, Recapitulation)
AMOUNT
$4,942.10
$93.00
$5,800.00
$5,800.00
$302.00
$27.62
$575.49
$115.41
$4.45
$204.83
$88.37
$86.35
$131.48
$1,089.95
$6.69
$1,180.00
$15.00
$1,000.00
$21,462.74
SCHEDULE I
DEBTS OF DECEDENT
MORTGAGE LIABlLITIES AND LIENS
ESTATE OF
FILE NUMBER
Robert M. Wilson 21-05-0867
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
NUtv1BER OF DEATH
1 Waste Management - outstanding bill $73.18
2 Sprint - telephone bill $80.57
3 Met Ed - outstanding bill $96.38
4 Moffit Heart Group - medical bill $7.34
5 Andorra Radiology - medical bill $8.11
TOTAL (also online 10, Recapitulation)
$265.58
SCHEDULE J
BENEFICIARIES
ESTATE OF
Fll..,E NUMBER
ITEM NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR SHARE
NUMBER Do Not List Trostee(s) OF ESTATE
I TAXAIIU! DISTRIBUTIONS [include oulrig/lt spousal distributions. ond tnnsfm under Sec. 9116(a)(1.2)]
1 Angelia M. Wolfe, PO Box 34, Ha1lstead, PA 18822 granddaughter $1,000.00
2 Renee L. Wise, 209 Stitt Dr, York, PA 17404 granddaughter $1,000.00
3 Edward E. Marks, 16 Center Square, New Oxford, PA 17350 grandson $1,000.00
4 Cortney N. Wilson, 349 Potato Rd, Aspers, PA 17304 granddaughter $1,000.00
5 Kayla A. Wilson, 349 Potato Rd, Aspers, PA 17304 granddaughter $1,000.00
6 Roberta M. Bell, 209 Chestnut St., Mt. Holly, P A 17065 daughter ; 1/3. of residue
7 Raymond L. Wilson, 409 Frystown Road, Myerstown, P A son 1/3 of residue
17067
8 Norma 1. German, 1196 Myerstown Road, Gardners, P A daughter 1/3 of residue
17324
II NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. Charitable and Govenunental Bequests:
Robert M. Wilson
21-05-0867
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (also enter on line 13, Recapitulation)
$0