HomeMy WebLinkAbout03-03-06
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COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
l'U1BER
OFFICIAL USE ONLY
FILE NUMBER
2 1 - 0 5
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COLMY CODE
YEAR
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DECEDENTS NAME (LAST. FIRST, AND MIDDLE INITIAL)
WEIDMAN, DOREEN E.
DATE OF DEATH (MM-DD-YEAR)
DATE OF BIRTH (MM-DD-YEAR)
195-16-2856
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
SOCIAL SECURITY NUMBER
06-09-2005 05-23-1925
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
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UJ [ZJ 1. Original Return D 2. Supplemental Return
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~::!;U) 0 4. limIted Estate D 4a. Future Interest Compromise (date of death after 12-12-82)
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IOO 6. Decedent Died Testate (Attach copy of Wi~ 7. Decedent Maintained a Living Trust (Attach copy of Trust}
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Cl. D 9. Litigation Proceeds Received D 10. Spousal Poverty Credit (date of death between 12-31-91 and H-95)
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o 3. Remainder Return (date of death prior to 12-13-82)
D 5. Federal Estate Tax Return Required
--1. 8. Total Number of Safe Deposit Boxes
o 11. Eleetion to tax under See. 9113(A) (Attach Sch 0)
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THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME
DONN L. SNYDER, ESQUIRE
FIRM NAME (If Applicable)
SAUL EWING LLP
TELEPHONE NUMBER
717.257.7524
COMPLETE MAILING ADDRESS
P.O. BOX 1291
HARRISBURG, PA 17108-1291
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
~~44 I 342 .12
96,570.04
0.00
0.00
/
Cl
(1 )
(2)
(3)
(4)
OFFICIAL USE ONLY
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3 Closely Held Corporation. Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
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5. Cash, Bank Deposits & Miscellaneolis Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
[] Separate Billing Requested
t115,078.78
(5)
14,233.98
(6)
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126,337.53
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
.........-..!
(7)
8. Total Gross Assets (total Lines 1 - 7)
796,562.45
(8)
67,774.55
3,907.34
(11) --==_=_-=:=- _-=- -=-:-==.=: -=-:c:-_-=_2:ol.-L~__~}c:~~~8=~-
9. Funeral Expenses & Aoministrative 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)
(9)
(10)
(12)
724,880.56
13. Chantable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
(13) '==:"'-:__:=-==-=:::'====--==-=-:':=--==~..:.=:C-:::=::" ..2_-" _9_0
(14)
724,880.56
SEE INSTRUCTIONS FOR APPLICABLE RATES
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15. AmolJnt of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)( 1.2)
x 0__
(15) 0 . 0 0
(16) 32,619.63
(17) 0 . 00
(18) 0.00
7 24 , 8 8 0 . 5 6 x .0 _'!.~
16. Amount of Line 14 taxable at lineal rate
17. Amoun: of Une 14 taxable at sibling rate
X '12
18. Amount of Line 14 taxable at collateral rate
X .~5
19 Tax Due
20 D ~K HERE IF YOU ARE REQUESTING A REFUNr;> OF AN OYERPAY~
:,. > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
(19) 32 , 619 . 63
STFPA42021J-=1
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Decedent's Complete Address:
STREET ADDRESS 7 0 OLD FEDERAL ROAD
CllY CAMP HILL I STATE PA I ZIP 1 7 0 11
Tax Payments and Credits: .
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
32,619.63
22,000.00
1,100.00
Total Credits (A + B + C) (2)
23,100.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty (D + E) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
0.00
0.00
9,519.63
A. Enter the interest on the tax due.
(5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
9,519.63
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; ........................................ D
b. retain the right to designate who shall use the property transferred or its income; . . . . . . . . . . . . . . . . . .. D
c. retain a reversionary interest; or .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. D
d. receive the promise for life of either payments, benefits or care? .............,................. D
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? . . . . . . . . . . .. ..................................... D
3. Did decedent own an "in trust for' or payable upon death bank account or security at his or her death? . . . ., D
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . .. ............................... D [Xl
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST CqMPLETE 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.
Declaration of preparer other than the personal representative is based on all information of which preparer has any Knowledge.
SIGNAT RE OF PERSON RESPONSIBLE F R FILING. RETURN
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ADDRESS
P.O. BOX 1291,
DATE
02- J 7 -06
CAMP HILL, PA 17011
DATE
02:lf -06
17108-1291
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. ~9116 (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. ~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 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. ~9116(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. ~9116(1.2) [72 P.S. ~9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's sibiings 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.
STF PA42021F.2
1.REV-1503 E9{ + (1-97) (I)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
DOREEN E. WEIDMAN
FILE NUMBER
21-05-00573
All property jointly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER DESCRIPTION
1.
u.s. SAVINGS BONDS
VALUE AT DATE
OF DEATH
13,436.32
2.
u.S. SAVINGS BONDS - HELD IN JOINT NAMES WITH
DAUGHTER - HELD IN DECEDENT'S SAFETY DEPOSIT BOX
19,504.32
3 .
u.S. SAVINGS BONDS - HELD IN JOINT NAMES WITH SON -
HELD IN DECEDENT'S SAFETY DEPOSIT BOX
13,707.92
4.
HAMPDEN TOWNSHIP SEWER AUTHORITY
5,587.50
5.
PNC INVESTMENTS
11,603.38
6.
AMERICAN EXPRESS
32,730.60
TOTAL (Also enter on line 2, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
96,570.04
STF PA42021F4
"REV-1508 E.~ + (1-97) (I)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
DOREEN E. WEIDMAN
FiLE NUMBER
21-05-00573
Include the proceeds of litigation and the date the p,oceeds were received by the estate. All property jointly-owned with th~ right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
2.
3 .
4.
5 .
6.
7 .
8 .
9.
10.
11.
12.
13.
14 .
15.
16.
17.
18.
19.
20.
21.
22.
23.
REFUND - SEWER AUTHORITY
AUCTION OF HOUSEHOLD ITEMS - NET
1988 CHEVROLET CORSICA
1992 CHEVROLET LUMINA
POSTMARK CREDIT UNION - SAVINGS
30 SILVER DOLLORS
CASH IN SAFE DEPOSIT BOX
CHANGE IN SAFE DEPOSIT BOX
PENNSYLVANIA STATE BANK
PNC BANK
PNC BANK
MEMBERS 1ST FEDERAL CREDIT UNION
ERIE - UNUSED HOME OWNERS PREMIUM
ERIE - UNUSED CARE INSURANCE PREMIUM
COMMUNITY BANK
CONTINENTAL CASUALTY CO.
MBNA
PNC BANK
BLUE CROSS - REFUNDS
TRAVELERS CHEQUES
PATRIOT NEWS - REFUNDS
CUNA
2004 TAX REFUND
124.00
5,351.25
500.00
500.00
86,442.23
30.00
37,000.00
88.25
110,257.47
10,303.60
65,664.44
1,245.02
346.00
787.00
53,720.11
527.11
41,607.4.5
71.13
54.91
250.00
128.35
27.52
52.94
STF PA42021F.9
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
415,078.78
\REV-1509 E" + (1-97) (I)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF
DOREEN E. WEIDMAN
FILE NUMBER
21-05-00573
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. KATHLEEN M. WEIDMAN
120 NORTH 21ST STREET, APT. 1
CAMP HILL, PA 17011
DAUGHTER
B. JOHN G. WEIDMAN, JR.
120 NORTH 21ST STREET, APT. 1
CAMP HILL, PA 17011
SON
c.
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE IncllKle name of financial institution am ba!i( accolllt runber or similar identifying number. DATE OF DEATH DECO'S VALUE OF
NUMBER TENANT JOINT Attach deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A.-B 7-02 MBNA - CD 24,568.20 33.33 8,188.58
2 . B. 5-02 PNC BANK - SAVINGS 6,045.40 50 3,022.70
3 . A. 5-02 PNC BANK - SAVINGS 6,045.40 50 3,022.70
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
TOTAL (Also enter on line 6, Recapitulation) $ 14,233.98
(If more space is needed, insert additional sheets of the same size)
STF PA42021 F.10
,REV-1510 E~ + (1-'=17) (I)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF
DOREEN E. WEIDMAN
FILE NUMBER
21-05-00573
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 INCLLDE THE NAME OF TrE TRANSFEREE, HEIR RELATIONSHP TO DECEDENT AND TrE DATE DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE
NUMBER OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE)
1. POSTMARK CREDIT UNION - IRA 3,336.21 100 3,336.21
2. POSTMARK CREDIT UNION - IRA 47,399.81 100 47,399.81
3. POSTMARK CREDIT UNION - IRA 10,861.94 100 10,861.94
4. POSTMARK CREDIT UNION - IRA 23,144.11 100 23,144.11
5 . AMERICAN EXPRESS - IRA'S 41,595.46 100 41,595.46
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
TOTAL (Also enter on line 7, Recapitulation) $ 126 337.53
(If more space is needed, insert additional sheets of the same size)
STF PA42021 F.11
1REV-1511 E): + (1-97) (I)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
DOREEN E. WEIDMAN
FILE NUMBER
21-05-00573
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
1.
FUNERAL EXPENSES:
SEE ATTACHMENT
8,574.55
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s) I EIN Number of Personal Representative(s) ____
Street Address
B.
City
State
Zip
2.
3.
Year(s) Commission Paid: __________________.__
AttorneyFees - SAUL EWING LLP
55,700.00
Family Exemption: (~decedent's address is not the same as claimant's, attach explanation)
Claimant JOHN G. WEIDMAN, III
Street Address 70 OLD FEDERAL ROAD
City CAMP HILL
Relationship of Claimant to Decedent SON
State _P A
Zip 1 7 0 11
3,500.00
4.
Probate Fees
5.
Accountant's Fees
6.
Tax Return Preparer's Fees
7.
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
67 774.55
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tREV-1512 ~ + (1-97) (I)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RES!DENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE liABiliTIES, & liENS
ESTATE OF
DOREEN E. WEIDMAN
FILE NUMBER
21-05-00573
Include unreimbursed medical expenses.
ITEM
NUMBER
DESCRIPTION
AMOUNT
3,907.34
1.
SEE ATTACHMENT
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
3,907.34
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
DOREEN E. WEIDMAN
FILE NUMBER
21-05-00573
RELATIONSHIP TO DECEDENT
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s)
I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers
under Sec. 9116 (a) (1.2)]
KATHLEEN M. WEIDMAN
1. 120 NORTH 21ST STREET, APT. 1
CAMP HILL, PA 17011 DAUGHTER
2 . JOHN G. WEIDMAN, JR.
120 NORTH 21ST STREET, APT. 1
CAMP HILL, PA 17011 SON
AMOUNT OR SHARE
OF ESTATE
1/2 RESIDUE
1/2 RESIDUE
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHO~N 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.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
SlFPA42021F 14
0.00
.- .
W ILL
I, DOREEN E. WEIDMAN, of the Township of Hampden County
of Cumberland and Commonwealth of Pennsylvania, declare this
to be my last Will and revoke any Will or Codicil previously
made by me.
ITEM I: I give and bequeath the sum of Five Thousand
and 00/100 ($5,000.00) Dollars, to my husband, JOHN G.
WEIDMAN, JR., providing he shall survive me by sixty days.
ITEM II: I give, devise and bequeath the balance of
my estate, in equal shares, to my children, KATHLEEN M.
WEIDMAN, of Hampden Township, Cumberland County, Pennsylvania,
and JOHN G. WEIDMAN, III, of Hampden Township, Cumberland
County, Pennsylvania, per stirpes.
ITEM III: I hereby authorize my Executor to sell any
and all real estate of which I die seized, at such time and
upon such terms as he may deem best, and to deliver good and
sufficient deeds therefor to the purchaser or purchasers
thereof.
ITEM IV: All death taxes (not income taxes) that may
be assessed in consequence of my death, of whatever nature
and by whatever jurisdiction imposed, shall be considered a
part of the expense of the administration of my estate and
my Executor shall have the absolute power in his discretion
to pay the same at once whether or not the law under which
they are imposed permits the postponement of payment of all
or part of them to a later date.
ITEM V: I appoint my husband, JOHN G. WEIDMAN, JR.,
Executor of this my last Will. Should my husband, JOHN G.
..
WEIDMAN, fail to qualify or cease to act as Executor I
appoint my daughter, KATHLEEN M. WEIDMAN, of Hampden
Township, Cumberland County, Pennsylvania. Should my
daughter, KATHLEEN M. WEIDMAN, fail to qualify or cease to
act as Executrix, I appoint my son, JOHN G. WEIDMAN, III,
Executor of this my last Will.
IN WITNESS WHEREOF, I have hereunto set my hand and
-- "C7L
s.eal this)4...5 day of August, 1980.
6) ~ (J-d. 0"-' E - LJJ. ~-na j~
DO EN E. WEIDMAN
(SEAL)
The preceding instrument, consisting of this and one
other typewritten page, identified by the signature of the
Testatrix, was on the day and date thereof, signed, sealed,
published and declared by DOREEN E. WEIDMAN, the Testatrix
therein named, as and for her last Will and testament, in
the presence of us, who, at her request, in her presence and
in the presence of each other, have hereunto subscribed our
names as witnesses:
k~~~/~
05/ Dl1rm j -0(j ~
i&'~J-uz;
QV~jK7J
PI}
pr:;
-
OMS NO 2502-0265 qr
A.
B. TYPE OF LOAN:
3.DcONv. UNINS. 4. OVA
17. LOAN NUMBER:
5.0CONV. INS.
1.DFHA 2.0FmHA
U.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMEN'T BER
6. FILE NUM :
SETTLEMENT STATEMENT HESS-MPF-2006
8. MORTGAGE INS CASE NUMBER:
C. NOTE: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown.
Items marked "[POC)" were paid outside the closing; they are shown here for informational purposes and are not included in the totals.
1.0 3/98 (HESS-MPF-2006.PFD/HESS-MPF-200616)
F. NAME AND ADDRESS OF LENDER:
D. NAME AND ADDRESS OF BUYER:
Brian E. Hess
64 Old Poineer Road
Camp Hill, PA 17011
E. NAME AND ADDRESS OF SELLER:
Kathleen M. Weidman, Executrix of the
Estate of Doreen E. Weidman
G. PROPERTY LOCATION:
70 Old Federal Road
Camp Hill, PA 17011
Cumberland County, Pennsylvania
H. SETTLEMENT AGENT:
Mid-Penn Abstract Co.
I. SETTLEMENT DATE:
January 6, 2006
PLACE OF SETTLEMENT
125 Locust Street
Harrisburg, Pennsylvania 17101
J. SUMMARY OF BUYER'S TRANSACTION
100. GROSS AMOUNT DUE FROM BUYER:
101. Contract Sales Price
102. Personal Property
103. Settlement Charges to Buyer (Line 1400)
104.
105.
K. SUMMARY OF SELLER'S TRANSACTION
400. GROSS AMOUNT DUE TO SELLER:
146,500.00 401. Contract Sales Price 146,500.00
402. Personal Property
2,730.98 403.
404.
405.
Adiustments For Items Paid Bv Seller in advance
106. School Taxes 01/07/06 to 07/01/06
107. County Taxes to
108. CitvTaxes to
109.
110.
111.
112.
120. GROSS AMOUNT DUE FROM BUYER
200. AMOUNTS PAID BY OR IN BEHALF OF BUYER:
201. Deposit or earnest money
202. Principal Amount of New Loan(s)
203. ExistinQ loan(s) taken subject to
204.
205.
206.
207.
208.
209.
Adjustments For Items Paid By Seller in advance
792.12 406. School Taxes 01/07/06 to 07/01/06 792.12
407. County Taxes to
408. City Taxes to
409.
410.
411.
412.
150,023.10 420. GROSS AMOUNT DUE TO SELLER 147,292.12
500. REDUCTIONS IN AMOUNT DUE TO SELLER:
5,000.00 501. Excess Deposit (See Instructions)
502. Settlement CharQes to Seller (Line 1400) 2,943.27
503. ExistinQ loan(s taken subiect to
504. Payoff of first Mortgage
505. Payoff of second MortQaQe
506.
507. (Deposit disb. as proceeds)
508.
509.
Adjustments For Items Unpaid By Seller
210. School Taxes to
211. CountVTaxes 01/01/06 to 01/07/06
212. City Taxes to
213.
214.
215.
216.
217.
218.
219.
Adjustments For Items Unpaid By Seller
510. School Taxes to
6.73 511. County Taxes 01/01/06 to 01107/06 6.73
512. City Taxes to
513.
514.
515.
516.
517.
518.
519.
220. TOTAL PAID BY/FOR BUYER 5,006.73 520. TOTAL REDUCTION AMOUNT DUE SELLER 2,950.00
300. CASH AT SETTLEMENT FROMITO BUYER: 600. CASH AT SETTLEMENT TOIFROM SELLER:
301. Gross Amount Due From Buyer (Line 120) 150,023.10 601. Gross Amount Due To Seller (Line 420) 147,292.12
302. Less Amount Paid By/For Buyer (Line 220) (5,006.73) 602. Less f,@ductions Due Seller (Line 520) (2,950.00
303. CASH ( X FROM) ( TO) BUYER 145,016.37 603. CASH ( X "10) ( FROM) SELLE~ "\ 144,342.12
The undeffiig: nnOWledge r~iPt of "LPY of pages 1&2 of fu~ stat:::~t &~t1vl~
(~ Lie. ~
Brian E. Hess Ka an, Executrix of the Estate of Doreen
E.
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, ESTATE OF DOREEN E. WEIDMAN
C~OSAULEWING, LLP
P.O. BOX 1291
HARRISBURG PA 17108-1291
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NPXX-8201-7484-1ATO CLOSE ESTATE ACCOUNT
1107219 8/31/05 11603.38
***11603.38
J.J.B. HILLIARD, W.L. LYONS, INC.
PLEASE DETACH BEFORE DEPOSITING
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American Express Funds CONFIRMATION
Minneapolis, Minnesota 55474 AXP HIGH Y I E LD TAX - EXEMPT FUND, I NC
WE HAVE RECORDED YOUR TRANSACTION AS FOLLOWS: F U L L RED E H P T ION
TRANSACTION DATE CLASS PRICE SHARES
9/22/2005 A $4.460 3,660.272-
SOLICITED ACCRUED DIVIDEND
AMOUNT
$16,324.81
$40.48
CHECK AMOUNT
$16,365.29
KATHLEEN M WEIDMAN
120 N 21ST ST APT 1
CAMP HILL PA 17011-3808
TOTAL SHARES OWNED ACCOUNT NUM8ER
.000 0101-1936,169-8
NON-NEGOTIABLE
PlEASE READ IMPORTANT EXPLANATIONS AND OlSCLOSURES
ON THE BACK OF THIS CONFIRMATION
GAIN/LOSS INFORMATION WILL BE
SENT AFTER YEAR END
KEEP THIS STUB FOR YOUR RECORDS.
OGL FOO180 (0&/2005) F327
American Express Funds AXP HIGH YIELD TAX-EXEMPT FUND, INC CONFIRMATION
Minneapolis, Minnesota 55474
WE HAVE RECORDED YOUR TRANSACTION AS FOLLOWS: F U L L RED EM P T ION
TRANSACTION DATE CLASS PRICE SHARES
9/22/2005 A $4.460 3,660.273-
SOLICITED ACCRUED DIVIDEND
AMOUNT
$16,324.82
$40.48
CHECK AMOUNT
$16,365.30
JOHN G WEIDMAN
70 DLD FEDERAL RD
CAMP HILL PA 17011-2047
TOTAL SHARES OWNED ACCOUNT NUMBER
.000 0101-1936,206-8
NON-NEGOTIABLE
PlEASE READ IMPORTANT EXPLANATIONS AND DISCLOSURES
ON THE BACK OF THIS CONFIRMATION
GAIN/LOSS INFORMATION WILL BE
SENT AFTER YEAR END
KEEP THIS STUB FOR YOUR RECORDS.
OGL FOO180 (06/2005) F321
. l , .
BRICKERS 'AUCTION
Buy & Sellon Commission - Complete Sale Service .
93 Texaco Rd., Mec'hanicsburg, PA 17055 766-5785
Persona Property 0 D DfZ~e-N E-I 4 !1/fIJ t7-ST
Address
Sold At Public Sale /0 .... 2- 2- 20 Os
Outstanding Total Sale 7,-/ 61, 2S
Total Checks 4/tJo, /J~
Total Cash
Cash After Payout /)/ 2.. s-v . ,j-V
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REViEWS & RATINGS ADVICE nNANCJNG
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P~ymeuntCC3IGlJ l~lQr
BLUE BOOK. PRIVATE PARTY REPORT
Pennsylvania. July 8, 2005
1988 Chevrolet Corsica Sedan 40
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Engine: 4-Cyl. 2.0 Liter
Trans: Automatic
Drive: FWD
Mileage: 72,230
Equipment
Air Conditioning
Power Steering
AM/FM Stereo
Consumer Rated Condition: Fair
"Fair" condition means that the vehicle has some mechanical or cosmetic defects and
needs servicing but is still in reasonable running condition. This vehicle has a clean tttle
history, the paint, body and/or interior need work performed by a professional. The
tires may need to be replaced. There may be some repairable rust damage.
Private Party Value Se.()rc:hdLQc:gtulJ$ting~ I Li~lThj~m.CgLtQrnSgl~ $575
Private Party Value is what a buyer can expect to pay when buying a used car from a
private party. The Private Party Value assumes the vehicle is sold "As Is" and carries
no warranty (other than the continuing factory warranty). The final sale price may
vary depending on the vehicle's actual condition and local market conditions. This
value may also be used to derive Fair Market Value for insurance and vehicle donation
pu rpOses.
Get a Used Car Trade-In Value
Get Invoice & MSRP on New Cars
l-Q~.K.J.n...AI)JQulQan.Ha.tes__A~_lQJ'(_As~,]5?tq_ APR
BLUE BOOK I
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r ~elley Blue Book - Private Party Pricing Report - Chevrolet, Lumina APV
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REVIEWS & RATINGS ADVlCE fiNANCING
BLUE BOOKe PRIVATE PARTY REPORT
Pennsylvania · July 8, 2005
1992 Chevrolet Lumina APV Minivan
. '>'f; :
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L.ist Y ourCC3f ForS~leOnline
Quick New Car Price Quote
free CARFAXuRecQro Check
Auto Loans from 4.75% APR
Insurance Quote
Print "For Sale" Sign
P~Ym~n!uC~!~YJ~tQ[
Engine: V6 3.1 Liter
Trans: Automatic
Drive: FWD
Mileage: 46,890
Equipment
6-] Passenger
Air Conditioning
Power Steering
AM/FM Stereo
ASS (4-Wheel)
Consumer Rated Condition: Fair
"Fair" condition means that the vehicle has some mechanical or cosmetic defects and
needs servicing but is still in reasonable running condition. This vehicle has a clean title
history, the paint, body and/or interior need work performed by a professional. The
tires may need to be replaced. There may be some repairable rust damage.
Private Party Value Search LoealL.istings I List This c:~rfor S~I~ $575
Private Party Value is what a buyer can expect to pay when buying a used car from a
private party. The Private Party Value assumes the vehicle is sold "As Is" and carries
no warranty (other than the continuing factory warranty). The final sale price may
vary depending on the vehicle's actual condition and local market conditions. This
value may also be used to derive Fair Market Value for insurance and vehicle donation
purposes.
Get a Used Car Trade- In Value
Ge.tJDYQ.i<::e~&_.M .sHPnQIJ_~_~_w..c.grs
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http://www.kbb.com/kb/ki.dll/kw.kc.ur?kbb.P A;8783 34;P A041 & 170 11 ;van+p&723;Chevr... 7/8/2005
_~2~!~~~~
POSTMARK CREDIT UNION
2630 Lingfestown Road
Harrisburg, PA. 17110-3666 Phone: 717-671-5119
for first class fina.ncial servic
No.028604
SHWI Check Withdrawal Voucher
POSTMARK CREDIT UNION
2222- 0 WEIDMAN/DOREEN E
AMT: ' -86442.23 FROM REGULAR SHARE ACCT
WITH FEES: .00 BAL: 50~OO"
06/29/05 01:57PM 12783 1 5
. EFF,;"DT:06/29/05
BLS BR:Ol
28604
UNLOCK YOUR HOME'S EQUITY! CONSO~IDATE J)EBT:MA~E'HbME"IMPROVEMENTS
FINANCE A COLLEGE EDUCATION ANDu~UC"HMO~f::,!.:."fl~E:I.J..I3H.IE'"TERMS AS LOW
AS 4.99% FOR 5 YEARS AND 5. 99~FOR'15YEARS!!"' ""APPLY TODAY
<---j~'-J?;. ::JAr~ Cy.+.
RECEIVED BY .
DETACH THIS PORTION BEFORE DEPOSITING
~POSTMARK
CREDIT UNION
2630 Unglestown Road
Harrisburg, PA · 17110-3666
. 717-671-5119 "
No. 028604
06/29/05
6(}.81 0 1/23
EXACTLY.&) 86.44ZaolsZ3cts
PAY EIGHTY-SIX THOUSAND FOUR HUNDRED FORTY-TWp AND .".
23/100 DOLLARS
$86,442.23
TO
THE
ORDER
OF .
ESTATE OF DOREEN~ WEIDMAN
VOID AFTER 90 DAYS
!i~~a.
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Balance infqnnation reflects transactions fa h 6:00 PM on that business day. Some deposits may not be available for immediate withdrawal. Checks
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PNC Bank, National Association
60-1273/313
Cashier's Check
No. 00092401
Date June 24, 2005
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Pennsylvania State Bank
Camp Hill. PA 17011
OFFICIAL CHECK
NOTICE TO CUSTOMER
THE PURCHASE OF AN INDEMNITY
BOND MAY BE REQUIRED BEFORE
ANY OFFICIAL CHECK OF THIS BANK WILL BE REPLACED
OR REFUNDED IN THE EVENT IT IS LOST, MISPLACED OR STOLEN.
104018
Date
JUNE 24, 2005
$110,257.47
5-709
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ISSUED BY: TRAVELERS EXPRESS COfvlPANY, INC., P.O. BOX 9476, MINNEAPOLIS, MN 55480
DRAWER: BOSTON SAFE DEPOSIT & TRUST CO.. BOSTON, MASSACHUSETIS
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PNC Bank. National Association
Southcentral, P A
No.
01197738
60-1273/313
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OD53. 16 uS.! 15/05 mID3
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POUCY NUMBER
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DOLLARS.:AND,.iOQCeN"TS
AGENT
AA 7172
REF. NO.
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and other items are received for deposit subject to the proviS~~~e: th:t jfomeeodeposlts r:nay not be available,for immediate withdrawal. Checks
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0255.16 08/12/05 0002
DDA DEPOSIT RCP
12: 2E;
53B848807n
$41~607.45
[}(;t.m t owr; 0 f f i C2
BR-17-HB (5/05)
MBNA America Bank, N.A.
Account Number
Date 08/09/05
Check Number 713739
Amount
40-821269-8
$41,607.45
MBNA's TOLL-FREE NUMBER:
(809)348-4632
Detach and retain this voucher. If not correct, please notify us promptly.
.
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. MBNAAmericiiBank, N.A.
. Wilmington, DE 198j()'5103
. .
BANK OFFICIAL CHECK
. 62-16
311
"MeRIC"-
DATE
08/09/05
NUMBER
713739
Member FDIC
PAY THE SUM OF:*****41 ,607 DOLLARS AND 45 CENTS
AMOUNT
$41,607.45
. '. DOREEN' EWEI])MAN ESTATE
. KATHLEEN M WEIDMA~ EXEC
CAJ.DONN L SYNDER ESQ:
PO BOX;129i ':"-:'. .' . .
HAR1USBURG PA:17108-.1291
M'
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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
WEIDMAN KATHLEEN M
120 NORTH 21 ST APT 1
CAMP HILL, PA 17011
_uu___ fold
EST A TE INFORMATION: SSN: 195-16-2856
FILE NUMBER: 2105-0573
DECEDENT NAME: WEIDMAN DOREEN E
DATE OF PAYMENT: 03/03/2006
POSTMARK DATE: 03/03/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 06/09/2005
NO. CD 006392
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $9,519.63
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS: K M WEIDMAN
CHECK#160
SEAL
INITIALS: VZ
RECEIVED BY:
REGISTER OF WILLS
$9,519.63
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
Register of Wills of Cumberland County, Pennsylvania
INVENTORY
Estate of
DOREEN E. WEIDMAN
No.
21-05-00573
Date of Death
JUNE 9, 2005
195-16-2856
also known as
, Deceased
Social Security No.
Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all
of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that
the valuation placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and
that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum
at the end of this inventory. I/We verifY. hat the statements made in this Inventory are true and correct. I/We understand that
false statemenu;s rein are made su t to the penalties of 18. Pa. C.S. Section 4904 relating to unsworn falsification to
authorities.
,
Personal Representative
Name of NN L. W J JF:"'- /
Attorney: .thLiJ~ ~ ~A.~
I.D. No.: 06858
P.O. BOX 1291
HARRISBURG, PA 17108-1291
(717) 257-7524
Address:
Dated:
~ - I 7 -0 (a
Telephone:
Description
REAL ESTATE:
See Schedule "A" Attached
PERSONAL ESTATE:
See Schedule "B" Attached
See Schedule "E" Attached
See Schedule " F" Attached
See Schedule "G" Attached
Vahje
\.....,-1,..;
144,342.12
96,570.04
415,078.78
14,233.98
126,337.53
TOTAL
(Attach Additional Sheets if necessary)
796,562.45
121736.12/13/06
~ 1:-'
REV-1502 EX + (1-97) (I)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF FILE NUMBER
DOREEN E. WEIDMAN 21-05-00573
All real property owned solely or as a tenant in common must be reported at fair market value. F air 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
70 OLD FEDERAL ROAD, CAMP HILL, PA 17011
DEED BOOK W, VOL. 24, PAGE 524
NET PROCEEDS FROM SALE OF HOME
VALUE AT DATE
OF DEATH
144,342.12
SlF PA42021F.3
TOTAL (Also enter on line 1, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
144,342.12
REV-1503 EX + (1-97) (I)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
DOREEN E. WEIDMAN
FILE NUMBER
21-05-00573
All property jointly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER DESCRIPTION
1.
u.s. SAVINGS BONDS
VALUE AT DATE
OF DEATH
13,436.32
2.
u.S. SAVINGS BONDS - HELD IN JOINT NAMES WITH
DAUGHTER - HELD IN DECEDENT'S SAFETY DEPOSIT BOX
19,504.32
3.
u.S. SAVINGS BONDS - HELD IN JOINT NAMES WITH SON -
HELD IN DECEDENT'S SAFETY DEPOSIT BOX
13,707.92
4.
HAMPDEN TOWNSHIP SEWER AUTHORITY
5,587.50
5.
PNC INVESTMENTS
11,603.38
6.
AMERICAN EXPRESS
32,730.60
STF PA42021F.4
TOTAL (Also enter on line 2, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
96,570.04
REV-1508 E)t + (1-97) (I)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
DOREEN E. WEIDMAN
FILE NUMBER
21-05-00573
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
2.
3 .
4 .
5 .
6.
7.
8.
9 .
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
DESCRIPTION
REFUND - SEWER AUTHORITY
AUCTION OF HOUSEHOLD ITEMS - NET
1988 CHEVROLET CORSICA
1992 CHEVROLET LUMINA
POSTMARK CREDIT UNION - SAVINGS
30 SILVER DOLLORS
CASH IN SAFE DEPOSIT BOX
CHANGE IN SAFE DEPOSIT BOX
PENNSYLVANIA STATE BANK
PNC BANK
PNC BANK
MEMBERS 1ST FEDERAL CREDIT UNION
ERIE - UNUSED HOME OWNERS PREMIUM
ERIE - UNUSED CARE INSURANCE PREMIUM
COMMUNITY BANK
CONTINENTAL CASUALTY CO.
MBNA
PNC BANK
BLUE CROSS - REFUNDS
TRAVELERS CHEQUES
PATRIOT NEWS - REFUNDS
CUNA
2004 TAX REFUND
VALUE AT DATE
OF DEATH
124.00
5,351.25
500.00
500.00
86,442.23
30.00
37,000.00
88.25
110,257.47
10,303.60
65,664.44
1,245.02
346.00
787.00
53,720.11
527.11
41,607.45
71.13
54.91
250.00
128.35
27.52
52.94
STF PA42021F.9
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
415,078.78
REV-150\1 EX + (1-97) (I)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF
DOREEN E. WEIDMAN
FILE NUMBER
21-05-00573
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. KATHLEEN M. WEIDMAN
120 NORTH 21ST STREET, APT. 1
CAMP HILL, PA 17011
DAUGHTER
B. JOHN G. WEIDMAN, JR.
120 NORTH 21ST STREET, APT. 1
CAMP HILL, PA 17011
SON
c.
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY -
%OF DATE OF DEATH
ITEM FOR JOINT MADE Include name of financial institution and barll accolllt number or similar IdentifYing number DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT Attach deed for Jointly-held real estate VALUE OF ASSET INTEREST DECEDENT'S INTEREST
-
1. A.-B 7-02 MBNA - CD 24,568.20 33.33 8,188.58
2. B. 5-02 PNC BANK - SAVINGS 6,045.40 50 3.,022.70
3. A. 5-02 PNC BANK - SAVINGS 6,045.40 50 3,022.70
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
, 0.00
0.00
0.00
TOTAL (Also enter on line 6, Recapitulation) $ 14,233.98
STFPA42021F10
(If more space is needed, insert additional sheets of the same size)
HEV:1510 E~ + (1-97) (I)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF
DOREEN E. WEIDMAN
FILE NUMBER
21-05-00573
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 INCLLOE T~ NAME OF T~ TRANSFEREE. T~IR RELATIONSHP TO DECEDENT AND T~ DATE DATE OF DEATH DECO'S EXCLUSION TAXABLE VALUE
NUMBER OF TRANSFER. ATTACH A COpy OF TI-E DEED FOR REAL ESTATE VALUE OF ASSET INTEREST (IF APPLICABLE)
1. POSTMARK CREDIT UNION - IRA 3,336.21 100 3,336.21
2. POSTMARK CREDIT UNION - IRA 47,399.81 100 47,399.81
3. POSTMARK CREDIT UNION - IRA 10,861.94 100 10,861.94
4. POSTMARK CREDIT UNION - IRA 23,144.11 100 23,144.11
5. AMERICAN EXPRESS - IRA'S 41,595.46 100 41,595.46
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
TOTAL (Also enter on line 7, Recapitulation) $ 126 337.53
(If more space is needed, insert additional sheets of the same size)
STF PA42021 F 11