HomeMy WebLinkAbout02-24-06
'* COMMONWEALTH OF
PENNSYLVANIA
. .VIIi. DEPARTMENT OF REVENUE
. DEPT. 280601
HARRISBURG, PA 17128-0601
REV-l500 EX (6.001
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
2 1 0 5
o e 5 0 9
COUNTY CODE YEAR
NUMBER
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DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL)
MUMMERT, HAROLD L.
DATE OF DEATH (MM-DD-YEAR)
OS/26/05
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
SOCiAl SECURITY NUMBER
163
-10
- 5397
DATE OF BIRTH (MM-DD-YEAR)
10/25/1910
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
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~ 1. Original Return
o 4. Limited Estate
@ 6. Decedent Died Testate (Attach copy of Will)
o 9. Litigation Proceeds Received
o 3. Remainder Return (date of death pnorto 12-13-82)
o 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
o 2. Supplemental Retum
o 4a. Future Interest Compromise (dale of dealh after 12-12-82)
o 7. Decedent Maintained a Living Trust (Attach copy ofTrust)
o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
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THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
D. Michael CraIe 246 W. Broadway, LL
FIRM NAME (If Applicablel Red Lion, PA 17356
TELEPHONE NUMBER
(717) 246-0146
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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)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
(1) 148,000.00
(2) 4 5 , 5 1 7 . 5 2
(3)
(4)
(5)
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(..... ~
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2,123.73
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(6)
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7,071.04
(7)
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202,712.29
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)
(8)
Cf....'
18,572.77
957.27
(9)
(10)
(11) 19,530.04
(12) 183,182.25
(13) -0-
(14) 183,182.25
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subjectto Tax (Line 12 minus Line 13)
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)
x.O_ (15)
x.012 (16) 8,243.20
x .12 (17)
x .15 (18)~
(19) 8,243.20
183,182.25
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 < <
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Decedent's Complete Address:
STREET ADDRESS
37
CITYC
am
Hill
STATE
PA
ZIP
17011
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
8,243.20
(1)
&) 3O'C.VO
331.S"7
Total Credits ( A + B + C ) (2) 6, 6 3 1 . 5 7
3. Interest/Penalty if applicable
D. Interest
E. Penalty
(3) -0-
(4)
(5) 1,611.63
(SA) . -0-
(58) 1,611.63
Total Interest/Penalty ( D + E )
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
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.
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
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. 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
DATE
nk
Hill, PA 17011
NTATIVE
DATE
7 17.~
Broadway, LL, Red Lion, PA 17356
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 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 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 bv blood or adoption.
REV-1503 EX+ (6-98)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
MUMMERT, HAROLD L.
FILE NUMBER
21-05-00509
All property jointly-owned with right 01 survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
Charles Schwab Account #5140-2285
VALUE AT DATE
OF DEATH
$ 45,517.52
TOTAL (Also enter on line 2, Recapitulation) $ 45, 51 7 . 52
(If more space is needed, insert additional sheels of the same size)
REV.ISIO EX. (1.97)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER.VIVOS TRANSFERS &
MISC. NON.PROBA TE PROPERTY
FilE NUMBER
21-05-00509
ESTATE OF
MUMMERT, Harold L.
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 %OF
ITEM INCLUDE THE NAME OF THE TRANSFEREE. THEIR RElATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. DATE OF DEATH DECO'S EXCLUSION TAXABLE VALUE
NUMBER ATTACH A cOPY OF THE DEED FOR REAl ESTATl:. VALUE OF ASSET INTEREST RF APPUCAIllEI
1. Commerce Bank Checking Account II
0536882608 made joint with decedents
daughter on 1/10/2005 ~I 10,071.04 100% 3,000.0 7,071.04
TOTAL (Also enter on line 7, Recapitulation) $ 7,071.04
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX+ (12-99)
'*'
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
MUMMERT, HAROLD L.
FILE NUMBER
21-05-00509
Debts of decedent must be reported on Schedule 1.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. See Attached Addenda A 2,286.13
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. Attorney Fees
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State _Zip
Relationship of Claimant to Decedent
4. Probate Fees See Attached Addenda A 50.00
5. Accountant's Fees
6. Tax Return Pre parer's Fees
7. See Attached Addenda A 16,236.64
TOTAL (Also enter on line 9. Recapitulation) $ 18,572.77
(If more space is needed, insert additional sheets of the same size)
RE'/-lS\2 EX+ 13-86)
COMMONWEALTH OF PENNSYlVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LlABLlTIES AND LIENS
MUMMERT, HAROLD L.
FilE NUMBER
21-05-00509
ESTATE OF
ITEM
NUMBER
DESCRIPTION
AMOUNT
1.
Sonoco MasterCard
-credit card bill
283.23
2.
Holy Spirit Hospital
187.55
3.
Francis X. Perna, MD
27.76
4.
West Short Anesthesia
2.73
5.
Homeland Center
-medical bills
456.00
TOTAL (Also enter on line 10, Recapitulationl
(If more space is needed insert additional sheefs of same size)
$
957.27
REV-1513 EX. (9-00)
ESTATE OF
2
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
MUMMERT, HAROLD L.
NUMBER
I
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
FILE NUMBER
21-05-00509
RELATIONSHIP TO DECEDENT
Do Not Ust Trustee(s)
daughter
son
AMOUNT OR SHARE
OF ESTATE
50% of residue
50% of residue
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
1
Janice M. Reid
81 Fairway Dnive
Camp Hill, PA 17011
Frederic H. Mummert
7862 S. Glencoe Way
Littleton, CO 80122
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ - 0-
(If more space is needed, insert additional sheets of the same size)
------
East Will anb ~estament
OF
HAROLD L. MUMMERT
I, HAROLD L. MUMMERT, of the Township of East Pennsboro, Cumberland
County, Pennsylvania, being of sound and disposing mind, memory and understanding,
do make, publish and declare this my Last Will and Testament, hereby revoking and
making void any and all Wills by me at any time heretofore made.
FIRST: I direct my Executrix or Executor, as the case may be, to pay all my Just
Debts and funeral expenses out of the proceeds of my estate as soon after my decease as
may be deemed practical.
SECOND: It is my desire that at my decease I shall be cremated and the ashes be
buried or placed in a crypt and that there be a proper inscription or plaque placed on the
burial place.
THIRD: I give, devise and bequeath all of my property, real, personal and/or
mixed of whatever nature and wheresoever situate to be divided equally as possible
between my son, FREDERICK H. MUMMERT and my daughter JANICE M. REID,
their heirs and assigns.
FOURTH: All transfer and inheritances shall be paid out of the proceeds of my
estate and shall be considered expenses of administration.
FIFTH: I hereby nominate and appoint Janice M.Reid Executrix of this my Last
Will and Testament and if she is incapable or indisposed I then nominate and appoint
Frederick H. Mummert Executor of this my Last Will and Testament.
SIXTH: IN WITNESS WHEREOF, I have hereunto set my hand and seal
this 13thb day of January 2005.
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ESS
AWH~' j.'~~
WITNESS
p'lJv~ '1: 7nu>>VmhJ/
HAROLD L. UMMERT
COMMONWEAL TH OF PENNSYL VANIA
COUNTY OF CUMBERLAND
WE,
HAROLD L. MUMMERT
ROBERT J. TRACE
, and
SUSAN T. NEWTON
, the Testator and the witnesses,
respectively, whose names are signed to the attached or foregoing instrument, being duly
sworn, do hereby declare to the undersigned authority that the Testator signed
and executed the instrument as his Last Will and Testament and that he
executed it as his free and voluntary act for the purposes therein expressed, and that
each of the witnesses, in the presence and hearing of the Testator signed the Will as a
witness and that to the best of his or her knowledge, the Testator was at that eighteen
(18) years of age or older, of sound mind and under no constraint or undue influence, and
I, the said Testator 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.
~,:~,-ld;f~ f1lL-<fi<,/t/7 fuA f~
1/ Testator
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Witness
Subscribed, sworn to and
acknowledged before me by
Harold L. Mummert
the Testator and subscribed
and sworn to before me by
Robert J. Trace and
Susan T. Newton
witnesses, this 13 tll day of
January , A.D. 2005.
ltt~auQ'- T :ta./W
otary Public
NOTARIAL SEAL
MAAGAlt!i 1. FOSTER/Notary PIdc
amp Hill Baro.!. C~mberfand County
~ eMmIl.alon WIres Dec. 27, 2008
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OMS NO. 2502-0265 ,r
A. B. TYPE OF LOAN:
U.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT I.QFHA 2.0FmHA 3.I!JCONV. UNINS. 4.DVA 5. DCONV. INS.
6. FILE NUMBER: 17. LOAN NUMBER:
SETTLEMENT STATEMENT 05803 981638
8. MORTGAGE INS CASE NUMBER:
C. NOTE: This (ann is furnished to give you a statement o( actual sattlement costs. Amounts paid to and by the set/lement agent are shown.
Items marked "[POC]" were paid outsIde the closIng; they are shown here lor Inlonna/lonal purposes and are no/Included In the totals.
l.a 319<1 \aS8Q3ill5l103I2S)
D. NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER:
Noel Rosado and Eslale o( Harold L. Mummert Taylor Baan & Whllaker
Deanna Castano Mortgage Group
1417 North Magnolia Avenue
Ocala, FL 34475-9078
G. PROPERTY LOCATION: H. SETTLEMENT AGENT: 25-1878915 I: SETTLEMENT DATE:
37 Clrcla Drive Keystone Land Transter, Ltd.
Camp Hili, PA 17011 December 16, 2005
Cumberland County, Pennsylvania PLACE OF SETTLEMENT
3421 MarkelSlreet
Camp Hili, PA 17011
J. SUMMARY OF BORROWER'S TRANSACTION I K. SUMMARY OF SELLER'S TRANSACTION
100. GROSS AMOUNT DUE FROM BORROWER: 400. GROSS AMOUNT DUe TO seLLeR:
101. Contract Sales Pllce 148,000.00 401. Contract Sales Price 148,000.00
102. Personal Property 402. Personal Property
103. SetUamenl Charoes to Borrower (Une 1400 5,913.61 403.
104. 404.
105. 405.
Ad'ustments For Items Paid Bv Seller in advance Adjustman/s For I/ems PaId Bv SeIJer in advance
106. CllylTown Taxes 10 406. CllVlTown Taxes to
107. CounlV Taxes 12/16/05 10 01/01/06 15.96 407. County Taxes 12/16/05 to 01/01/06 15.96
108. School Tax 12/16105 to 07/01/06 777.66 406. School Tax 12/16105 10 . 07101/06 777.66
109. Sewer 12/1610510 01/01/06 20.00 409. Sewer 12/16105 to 01/01/06 20.00
110. 410.
111. 411.
112. 412.
120. GROSS AMOUNT DUE FROM BORROWER 154,72.7.23 420. GROSS AMOUNT DUE TO SELLER 148,813.62
200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER:
201. Deposit or eamesl monev 1.000.00 501. Excess DeDosl1 (See Instructlonsl
202. Principal Amount ot New Loan(s) 118,400.00 502. Selllemenl Charoes 10 Seller (LIne 1400) 12,463.79
203. Existlno /oan(s) teken subJect to 503. Exlstlno /oan(s) taken sublecllo
204. 2nd Morloaoe Proceeds 21,927.78 504. Payoff of firsl Mortgage
205. Gift Funds 3,999.45 505. Payoff of second Morloeoe
206. 506.
207. 507. (Deposit dlsb. as proceeds)
208. 508.
209. Sellar Assistance 2,000.00 509. Seller Assistance 2,000.00
Adjustments For Items Unoald Bv Seffer Ad'ustments For f1ems Unoaid Bv Seffer
210. CltylTown Taxes to 510. CllvlTown Texes to
211. County Taxes tD 511. Counlv Taxes to
212. SchoDI Tax to 512. SchoolTax to
213. 513.
214. 514.
215. 515.
216. 516.
217. 517.
218. 518.
219. 519.
220. TOTAL PAID BY/FOR BORROWER 147,327.23 520. TOTAL REDUCTION AMOUNT DUE SELLER 14,463.79
300. CASH AT SETTLEMENT FROMITO BORROWER: 600. CASH AT SETTLEMENT TOIFROM SELLER:
301. Gross Amount Due From Borrower (Une 120 154,727.23 601. Gross Amount Due To Seller (Une 420 148,813.62
302. Less Amount Paid By/For Borrower (Line 220) ( 147,327.23 602. Less Reducllons Due Seller (Une 520} ( 14,463.79
303. CASH ( X FROM) ( TO) BORROWER 7,400.00 !l03. CASH ( X TO) ( FROM) SELLER 134,349.83
"'"~'::~':;;2-."OO
. el RDsadD
opy at pages 1 &2 of this slatement & any aUachments reterred to herein.
I
eanna Castano
)?J ~1P~~~~1 the.
$
l. SETTLEMENT CHARGES
148,000.00 Ii'll 6.0000 % 8,880.00
700. TOTAL COMMISSION Based on Price
Division of Commission line 7001 8S Follows:
701. $ 4,415.00 \0 RelMax Realty AssocIates, Inc.
702. $ 4,465.00 to Exit Realty Capital Area
703. Commission Paid at Settlement
704. Transaction Fee to Re/Max Realty Associates, Inc.
aOO.ITEMS PAYABLE IN CONNECTION WITH LOAN
801. Loan OrJolnatlon Fee 0.0000 % to
802. Loan Discount % to
803. Appraisal Fee to Bentz Mortgage Group
a04. Credit Report 10
a05. lender's Inspection Fee 10
a06. Mortoaoe Ins. ADo. Fee to
a07. Assumption Fee 10
808.
809.
810.
811.
812. Tax Service Fee
813. Administration Fee
814. Processing Fee
815. Par Premium to
816.
817.
818.
619.
820.
900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE
901.lnterestFrom 12116/05 to 01/01/06 @ $ 23.520000/day ( 16 days
902. Mortoaoe Insurance Premium for months to
903. Hazard Insurance Premium for 1.0 vears to
904.
905.
1000. RESERVES DEPOSITED WITH LENDER
1001. Hazard Insurance 3.000
1002. Morloaoe Insurence
1003. CltvlTown Taxes
1004. County Taxes
1005. School Tax
1006.
1007.
1008. Aogregate Ad'usbnent
1100. TITLE CHARGES
1101. Settlement or Closlno Fee
1102. Abslract or Tltie Search
1103. TlUe Examination
1104. Title Insurance Binder
1105. Document Preoaration
1106. Notarv Fees
1107. Attorney's Fees
Includes above Ilem numbers:
110B. Title Insurance
(Includes ebove i!em numbers:
1109. lender's Coverage
1110. Owner's Coverage
1111. Endorsements 100,300,8.1
1112. Closing Protection letter
1113. Tax CertJftcetlons
1114. Overnight
1115. Retrfeve E Mall Documents
1116,
1117.
1118.
1200, GOVERNMENT RECORDING AND TRANSFER CHARGES
1201. Recording Fees: Deed $ 38.50; Mortaaoe $ 64.50;
1202. Citv/CounlV Tax/Stamos: S 1,480.00' Morlgaoe
1203. State Tax/Slamps: Revenue Stamos 1,480.00; Mortgaoe
1204. Record Power of Attorney to Cumberlend County Recorder of Deeds
1205.
1300. ADDITIONAL SETTLEMENT CHARGES
1301. Survey 10
1302. Pest Inspection 10 Blechler & Tlllerv, Inc.
1303. Home Warranty to American Home Shield
1304. Sewer-late Fee Due 10 East PennsbarD Townshla
1305. 2005-06 School Tax to Alicia D. SUne, Tax Collector
1400. TOTAL SETTLEMENT CHARGES IEnter on L1nee 103. Section J and 502. Section KI
ey .Ignlng p.ge 1 of thl. .1.lemenlthe .Ign.lori.. acknov.1edge recelpl of a oompleled oopy or page 2 01 th~ Iwo pag/l~' "Ai tJ IZ- ~ tJ At.
Kll'ys one land Transfer, Ltd.
Settlement Agent
to Taylor Bean & Whitaker Morlgage Group
to Taylor Bean & WhItaker Mortgage Group
to Bentz Mortgage Group
Bentz Mortgage-Pd by lender $3552 POC
%)
12.000
7.000
months $
months $
months $
months $
months @ $
mpnths l1il $
months rm S
months Ii'll $
36.59 per month
per month
PElf month
30.33 aElf monlh
120.07 per month
per month
aer month
- oer month
to
to
to
to
to
to CASH
10
10 Kevstone land Transfer Ltd.
)
Reissue
5 118,400.00
$ 148,000.00
to Keystone land Transfer, Ltd.
to Keystone lend Transfer, Ltd.
to Keystone lend Transfar, Ltd.
to Keystone land Transfer, Ltd.
to Keystone Land Transfer, Ltd.
P Al#l 04469923
PAO#104495878\
Releases $
Incl Home Insp.
Certified 10 be a !rue copy.
PAID FROM
BORROWER'S
FUNDS AT
SEfTLEMENl
250.00
275.00
73.00
515.00
395.00
376.32
109.77
363.96
840.49
-444.31
.
25.00
988.88
150.00
35.00
14.00
35.00
....agll :.!
PAID FROM
.SEUER'S
FUNDS AT
SETILEMtM'f
8,880,00
15.00
5.00
103.00
l,4BO.OO
1,480.00
18.50
310.00
455.00
11.50
1,617.29
5,913.61 12,463.79
( 05803 J 05803 f 26 )
ADDENDA A
SCHEDULE "H"
FUNERAL EXPENSES, ADMINISTRATIVE
COSTS & MISCELLANEOUS EXPENSES
PAGE ONE OF FOUR
Estate of
MUMMERT, Harold L.
Item No.
Description
A.I.
06/28/05
Trinity Lutheran Church
-reception
Pastor J. Stewart Hardy
-honorarium
H. Timothy Koch
-organist
07/12/05
Janice Reid
-Reimbursement for cemetery
and funeral expenses
File No.
21-05-00509
Amount
448.13
150.00
100.00
1,588.00
TOTAL A. 1. . . . . . . . . . . . . . . . . . . . .. .. . .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. $ 2 , 2 86 .. 13
B.4.
File Inventory
File Inheritance Tax Return
File Release
15.00
15.00
20.00
TOTAL B.. 4 .. .. .. .. .. .. .. .. .. .. .. .. . .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. $ 50.. 00
B.7.
Miscellaneous Expenses
06/04/05
PP&L
-electric
06/06/05
PAWC
-water
06/25/05
Sherry Greenfield
-mow grass
Verizon
-phone bill
Homeland Center
-personal items at Home
24.42
12.86
100.00
28.39
84.97
ADDENDA A
SCHEDULE "H"
FUNERAL EXPENSES, ADMINISTRATIVE
COSTS & MISCELLANEOUS EXPENSES
PAGE TWO OF FOUR
Estate of
MUMMERT, Harold L.
File No.
21-05-00509
Item No.
Description
Amount
07/01/05
PP&L
-electric
20.98
07/08/05
D. Michael Craley, Esquire
-reimburse for probate and
legal advertising
498.39
07/09/05
PAWC
-water
12.86
07/22/05
Sue Ann Apicella
-house cleaning
55.00
07/26/05
Sherry Greenfield
-mow grass
110.00
07/27/05
Patriot News
-advertising
20.60
OS/01/05
PP&L
-electric
39.23
PAWC
-water
14.03
OS/OS/05
Sherry Greenfield
-weeding, shrubbery and yard clean up
250.00
Janice Reid
-house cleaning and supplies
220.76
OS/23/05
Sherry Greenfield
-mow grass
80.00
09/21/05
PP&L
-electric
45.35
PAWC
-water
14.03
ADDENDA A
SCHEDULE "H"
FUNERAL EXPENSES, ADMINISTRATIVE
COSTS & MISCELLANEOUS EXPENSES
PAGE THREE OF FOUR
Estate of
MUMMERT, Harold L.
File No.
21-05-00509
Item No.
Description
Amount
09/21/05 Maxwell Shoop
-mow grass 84.00
09/26/05 East pennsboro Township
-trash and sewer 126.50
10/31/05 PP&L
-electric 79.15
PAWC
-water 24.24
11/02/05 Don Wagner
-clean basement 200.00
11/03/05 Sherry Greenfield
-mow grass 105.00
12/01/05 PP&L
-electric 28.54
12/05/05 East Pennsboro Township
-trash and sewer 115.00
12/08/05 PAWC
-water 13.71
12/18/05 Shirley Greenfield
-mow grass 88.00
..
ADDENDA A
SCHEDULE "H"
FUNERAL EXPENSES, ADMINISTRATIVE
COSTS & MISCELLANEOUS EXPENSES
PAGE FOUR OF FOUR
Estate of
MUMMERT, Harold L.
Item No.
Description
12/26/05
Seller's Expenses at real
estate settlement:
File No.
21-05-00509
Amount
Realtor's Commission
Notary Fees
Tax Certification Fee
1% Real Estate Transfer Tax
American Home Shield (home warranty)
East pennsboro Township (sewer late fee)
Alicia D. Stine (2005-06 School taxes)
Noel Rosado and Denna Castano
{Buyer'S closing costs}
01/22/05
PP&L
-electric
02/03/05
Fred Isopi
-snow plowing
PAWC
-water
8,880.00
15.00
5.00
1,480.00
455.00
11.50
839.63
2,000.00
20.40
20.00
14.10
TOTAL B. 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $16 , 236 . 64
.
Register of Wills of Cumberland County
INVENTORY
. Deceased
Estate No. 21 - 0 5 - 0 5 0 9
Date of Death May 26, 2005
Social Security No. 163-10-5397
Estate of Harold L. Mummert
Also known as
Janice M. Reid ,Personal Representative(s) of
the above Estate, deceased, verify that the items appearing on 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 (PEF S 3301). UWe verify that the statements made in this inventory are true and correct.
I/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 Attomey: D. Michael Craley, Esq.PersonalRepresentative: Janice M. Reid
LD. No.: #43878
Address: 81 Fairway Drive
Red Lion, PA 17356
Signature:
Address: 246 W. Broadway, LL
Telephone:
(717)
246-0146
Date:
Description
1. Lot with improvements situate at 37 Circle
Drive, Camp Hill, Pennsylvania, East pennsbo 0
Township, Cumberland County, PA as more full
set forth in Deed Book I-18, page 450.
Valuation is price received at private sale
settlement held on December 16, 2005"
Value
6. Personal property in house sold on E-Bay
and at garage sale
$148,000.00 t---_~)
$ 4 5 , 51-'l . 5 2
, \
,
$ 20~:6 7 j".
$ 530.06
$ 1 ,000.00 ~
'_,0 J
C~:
$ 573.00
2. Charles Schwab Account #5140-2285
3. Coins and cash found in house
4. Personal property in house sold at public
sale by Rentzels Auction
5. 1988 Honda
(Attach Additional Sheets if necessary)
Tota$ 1 95 , 6 4 1 . 2 5
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the
value of each item, but such figures should not be extended into the total of the Inventory.
RW-4
"~
.~
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
REID JANICE M
81 FAIRWAY DRIVE
CAMP HILL, PA 17011
u__n__ fold
ESTATE INFORMATION: SSN: 163-10-5397
FILE NUMBER: 2105-0509
DECEDENT NAME: MUMMERT HAROLD L
DATE OF PAYMENT: 02/24/2006
POSTMARK DATE: 02/24/2006
COUNTY: CUMBERLAND
DATE OF DEATH: OS/26/2005
NO. CD 006367
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $1/611.63
,
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS:
CHECK# 1160
SEAL
INITIALS: MW
RECEIVED BY:
REGISTER OF WILLS
$1/611.63
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS