HomeMy WebLinkAbout03-01-06
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
NO. CD 006387
SNELBAKER RICHARD C
44 W MAIN STREET
MECHANICSBURG, PA 17055
_____n_ fold
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101
$2,610.00
ESTATE INFORMATION:
SSN:
202-24-5893
FILE NUMBER:
2105-0485
HOFFMAN GLORIA J
03/01/2006
03/01/2006
CUMBERLAND
05/13/2005
DECEDENT NAME:
DATE OF PAYMENT:
POSTMARK DATE:
COUNTY:
DATE OF DEATH:
TOTAL AMOUNT PAID:
$2,610.00
REMARKS:
SNELBAKER & BRENNEMAN
CHECK#139
SEAL
INITIALS: RSK
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
REV-!500 EX (B-00i
OFFICIAl USE ONLY
COMMONWEAL TH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
...lL
COUNTY CODE
05 0485 ___
YEAR NUMBER
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DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL)
Hoffman Gloria
DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
5/13/2005 6/20/1933
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
J
SOCIAL SECURITY NUMBER
202-24-5893
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
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001
04
006
09
Original Retum
Lim~ed Estate
Decedent Died Testate (Attach copy of Will)
o 2. Supplemental Retum 0 3. Remainder Retum (date of death prior to 12-13-82)
o 4a. Future Interest Compromise (date of death after 12-12-82) 0 5. Federal Estate Tax Retum Required
o 7. Decedent Maintained a Living Trust (Attach copy of Trust) L 8. Total Number of Safe Deposit Boxes
o 10. Spousal Poverty Credit (date of death between 12-31-91 and ,.'-95) 0 11. Election to tax under Sec. 9113(A) (Attach Sch a)
Litigation Proceeds Received
THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
I-
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Richard C. Snelbaker
FIRM NAME (If Applicable)
Snelbaker & Brenneman, P.C.
TELEPHONE NUMBER
44 West Main Street
Mechanicscburg, PA 17055
717-697-8528
1. Real Estate (Schedule A)
(1)
150,000.00
37,114.77
0.00
OFFICIAL USE ONLY,
2. Stocks and Bonds (Schedule B)
(2)
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E) (5)
Z 6. Jointly Owned Property (Schedule F) (6)
0 D Separate Billing Requested
i=
<C
....J 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
:::l (Schedule G or L)
!:::
a.. 8. Total Gross Assets (total Lines 1-7)
<C
()
W 9. Funeral Expenses & Administrative Costs (Schedule H) (9)
0:::
10. Debts of Decedent, Mortgage Liabil~ies, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
58,000.00
13,976.20
1,584.24
. .)
139,380.93
r''-, ~.'
(8)
38,840.47
5,273.04
400,056.14
(11)
44,113.51
355,942.63
0.00
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for lMlich an election to tax has not been
made (Schedule J)
(12)
(13)
14. Net Value Subject to Tax (Line 12 minus Lin\l13)
(14)
355,942.63
SEE INSTRUCTIONS ON REVERSE SlOE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
z rate, or transfers under Sec. 9116 (a)(1.2)
o
~ 16. Amount of Line 14 taxable at lineal rate
I-
:::l
~ 17. Amount of Line 14 taxable at sibling rate
o
U 18. Amount of Line 14 taxable at collateral rate
><
~ 19. Tax Due
20. ~
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
x .0 L(15)
x .0 45 (16)
x.12 (17)
x .15 (18)
(19)
0.00
16,017.42
0.00
0.00
16,017.42
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
3W4645 1000
Decedent's Complete Address:
S1REET ADDRESS
61 Hone suckle Drive, Silver
Cumberland County
CITY
Mechanicsbur
STA1E
PA
~, ===1
17(~
Tax Payments and Credits:
1, Tax Due (Page 1 Line 19)
2, Credits/Payments
A. Spousal Poverty Credit
8, Prior Payments
C, Discount
(1)
16,017.42
0.00
13,157.42
250.00
Total Credits (A + 8 + C) (2)
13,407.42
3, Interest/Penalty if applicable
D. Interest
E, Penalty
0.00
0.00
Total Interest/Penalty (0 + E) (3)
0.00
4, If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
0.00
5, If Line 1 + Line 3 is greater than Line 2, enter the difference, This is the TAX DUE. (5)
2,610.00
A. Enter the interest on the tax due, (5A)
0.00
8, (58)
2,610.00
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and:
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 Decem ber 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? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. IX] D
IF THE ANSWER TO ANY OF THE ABO"1E 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.
Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
Yes
No
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SIGNATU~~ON ~P~I
ADDRESS
DATE
3/1/06
C.T.A.
233 West Siddonsburg Road, Di11sburg, PA 17019
DATE
ADORE
a er, Attorney
3 1 6
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, 89916 (a) (1,1) (i)],
For dates of death on or after January 1, 1995, the lax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P,S. 89116 (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. 8 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, 89116(1,2) [72 P.S. !3 9116(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, 8 9116(a)(1 ,3)]. A sibling is defined, under Section H102, as an
individual who has at least one parent in common with the decedent, whether by blood or adoption,
3W4646 1.000
I
REV-1502 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF
FILE NUMBER
Gloria J. Hoffman
21 05 0485
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be
exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts.
Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM DESCRIPTION
NUMBER
1 Property known and n~ered as
61 Honeysuckle Drive, Silver
Spring Township, Cumberland
County, Mechanicscburg, PA,
sale value (settlement sheet
attached)
VALUE AT DATE
OF DEATH
150,000.00
3W4695 1.000
TOTAL (Also enter on line 1, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
$
150,000.00
:Conestoga Title Insurance Co.
Settlement Statement
u.s. Department of Labor and Urban Development
123 East King Street, Lancaster PA 17602
Phone 1-800-732-3555 In Lancaster 299-4805
FAX 717-295-7155
A. HUD-1 UNIFORM SETTLEMENT STATEMENT
B. Type of Loan
1. [ ] FHA 2. [ ] FmHA 3. [ ] Conv. Unins. /6. File Number: r. Loan Number: r8. Mortgage Insurance Case Number:
4. []VA 5. [ ] Conv. Ins. C. NOTE: This form furnishes a statement of settlement costs. Amouts paid to and by the settlement agent 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 & Address of Borrower: E. Name, Address and TIN of Seller: F. Name & Address of Lender:
Steven P. Hoffman Estate of Gloria J. Hoffman, c/o Ronald B. Hoffman Members 1st Federal Credit Union
61 Honeysuckle Drive 233 West Siddonsburg Road P.O. Box 40
Mechanicsburg, PA 17050 Dillsburg, PA 17019 Mechanicsburg, PA 17055
TIN of Seller: I
G. Property Location: Place of Settlement: H. Settlement Agent:
61 Honeysuckle Drive, Silver Spring Townsh~p, 44 West Main Street
Cumberland County, Pennsylvania Mechanicsburg, Pennsylvania 17055 Keith O. Brenneman
(Mechanicsburg, PA 17050) Phone: (717) 697-8528; FAX: (717) 697-7681 I September 6,2005
Date of Settlement:
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 $150,000.00 401. Contract sales price $150,000.00
102. Personal property 402. Personal property
103. Borrower's settlement charges (line 14QO) $5,061.58 403
104. Mortgage Payoff 404
105 405
Adjustments for items paid by seller in adwance Adjustments for items paid by seller in advance
106. City/town taxes 09/06/05 to 12131/05 $129.28 406. City/town taxes 09/06/05 to 12/31/05 $129.28
107. County taxes to 407. County taxes to
108. Assessments to 408. Assessments to
109. School Taxes 09/06/05 to 06130/06 $1,141.70 409. School Taxes 09/06/05 to 06/30/06 $1,141.70
110 410
111 411
112 412
113 413
120. Gross Amount Due From Borrower $156,332.56 420. Gross Amount Due to Seller $151,270.98
200. Amounts Paid by or in Behalf of Borrower 500. Reductions in Amount Due to Seller
201. Deposits or earnest money $100.00 501. Excess deposit (see instructions) $100.00
202. Principal amount of new loan(s): $100,000.00 502. Settlement charges to seller (line 1400) $3,402.50
203 503. Existing loan(s) taken subject to
204 504. Payoff of first mortgage
205. Secondary financing by Seller: 505. Payoff of second mortgage
206. See Note and Mortgage $50,000.00 506. Secondary financing by Seller $50,000.00
207 507
208 508
209 509
Adjustments for items unpaid by seller Adjustments for Items unpaid by seller
210. City/town taxes to 510. City/town taxes to
211. County taxes to 511. County taxes to
212. Assessments to 512. Assessments to
213 to 513 to
214 514
215 515
216 516
217 517
218 519
220. Total Paid By/for Borrower $150,100.00 520. Total Reduction of Amount Due to Seller $53,502.50
300. Cash at Settlement From/to Borrower 600. Cash at Settlement To/from Seller
301. Gross amount due from borrower (line 120) $156,332.56 601. Gross amount due to seller (line 420) $151,270.98
302. Less amounts paid by/for borrower (line 220) $150,100.00 602. Less reductions in amount due seller (line 520) $53,502.50
303. Cash [ X ] from [ ] to Borrower $6,232.56 603. Cash [X] to [ ] from Seller $97,768.48
OMB No. 2502-0265
Substitute Form 1099 Seller Statement
The information in Blocks E, G, H, I & line 40'1 (or if line 401 is asterisked, line 403 and 404) is important tax information and is being furnished
to the Internal Revenue Service. If you are required to file a return, a sanction will be imposed on you if this item is required to be reported and
the IRS determines that it has not been reported. If this real estate is your principal residence, file FORM 2119, Sale or Exchange of Principal
Residence, for any gain, with your income tax return; for other transactions, complete the applicable parts of Form 4797, Form 6252 and/or
Schedule D (Form 1040). You are required to provide the Settlement Agent (named above) with your taxpayer identification number. If you do
not provide the Settlement Agent with your taxpayer identification number, you may be subject to civil or criminal penalties imposed by law.
Under penalties of pe~ury, I certify that the number shown on this statement is my correct taxpayer. identification number.
Seller
Seller
L. ",tHIHiIllUlIIlelld.IJ.I,.!j .. .-. - .. .. ~-... - - - ~...- -.. . . - ---. .'-. .._.~-_.
700. Total Sales/Broker's Commission: (based on price) @ Paid from Paid from
DIvision of Commission (line 700) as follows: Borrower's SI!lIer's Funds at
701 Funds at
702 Settlement Settlement
703. Commission paid at Settlement
704
800. Items Payable in Connection with Loan
801. Loan Origination Fee 1% 1,000.00
802. PHFA Qualifying Fee 300.00
803. Appraisal Fee
804. Credit Report to
805. Lender's Inspection Fee
806. Mortgage Insurance Application Fee
807. Flood Certification Fee to
808. Tax Service Fee to
809. Document Preparation Fee
810. Plan Review to
811. Remainder of Application Fee 350.00
812
813
814
900. Items Required by Lender to Be Paid In Advance
901. Interest from 09/06/05 to 09/30/05 @ $14.04 per day 351.03
902. Mortgage Insurance Premium for
903. Hazard Insurance Premium for
904
905
1000. Reserves Deposited with Lender
1001. Hazard Insurance 3 months @ $31.08 per month 93.24
1002. Mortgage Insurance months @ per month 0.00
1003. City property taxes months @ per month 0.00
1004. County property taxes 8 months @ $33.22 per month 265.76
1005. Annual assessments months @ per month 0.00
1006. School property tax 4 months @ $114.59 per month 458.36
1007
1008
1009. Aggregate Accounting Adjustment -459.56
1100. Title Charges
1101. Settlement/closing fee
1102. Abstract/title fee
1103. Title examination
1104. Title insurance binder
1105. Document preparation
1106. Notary fees
1107 Attorney's fees to
(includes above item numbers
1108. Title insurance to Keith O. Brenneman, Agent, Conestoga Title Insurance Company
(includes above item numbers 1101-1106) 1,033.75
1109. Lender's coverage: $100,000
1110 Owner's coverage:
1111. Insured Closing Letter from Conestoga Title Insurance Co. to Members' First Federal Credit Union 35.00
1112. Endorsements 100, 300, 8.1 at $50.00
1113
1200. Government Recording and Transfer Charges
1201. Recording Fees: Deed: 38.50 Mortgage: $68.50 Releases: $27.00 134.00
1202. City/county tax/stamps Deed: $1,500.00 Mortgage: 1,500.00
1203. State tax/stamps Deed: $1,500.00 Mortgage: 1,500.00
1204
1205
1206
1300. Additional Settlement Charges
1301. Survey
1302. Tax Certification Fee to Debra Wiest, Tax Collector 5.00
1303. Silver Spring Township Authority - Sanitary sewer charge to 9/6/05 46.92
1304. Debra Wiest, Tax Collector: 2005 - County and Township taxes 447.48
1305. Debra Wiest, Tax Collector: 2005 - 2006 School Tax 1,403.10
1306
1307
1308
1400. Total Settlement Charges (This number transfers to Lines 103 & 502 Above) 5,061.58 3,402.50
Certification
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
reciepts and disbursements made on my accou t or by me in this transaction. I further certify that I have received a copy of the HUD-1 Settlement
Statement
Borrower
;:lateo~r~
Ronald B. Hoffman .
Seller
Borrower
To the best of my knowledge the HUD-1 Settlement Statement which I have prepared is true and accurate account of the funds which were received
and ha [ill disbursed by the undersigned as part of the settlement of this transaction.
Keith O. Brenneman
Settlement Agent
Date: September 6, 2005
WARNING: It is a crime to knowingly make false statements to the United States on this or any other similar form. Penalties upon conviction can
include a fine and imprisonment. For details see: Title 18 U.S. Code Section 1001 and Section 1010.
REV-1503 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE B
STOCKS & BONDS
FILE NUMBER
Gloria J. Hoffman
21 05 0485
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
DESCRIPllON
VALUE AT IJAllE
OF DEATH
13,218.21
1. Energizer Holdings, Inc.
227 shares common stock valued at
$58.23 per share
2 General Mills Inc.
22 shares common stock valued at
$49.23 per share
1,083.06
3 Ralston-Purina Company
681 shares of common stock valued
at $33.50 per share
22,813.50
TOTAL (Also enter on line 2. Recapitulation) $
37,114.77
3W4696 1000
(If more space is needed, insert additional sheets of the same size)
REV-1507 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Gloria J. Hoffman
SCHEDULE D
MORTGAGES & NOTES
RECEIVABLE
FILE NUMBER
21 05 0485
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER DESCRIPTION
1 Jeffrey S. Hoffman
note receivable for unpaid balance
of sale/purchase price for
property located at 9 East Willow
Terrace Drive, Silver Spring
Township, Cumberland County, PA
TOTAL (Also enter on line 4, Recapitulation) $
3W46AC 1000
(If more space is needed, insert additional sheets of same size)
VALUE AT DATE
OF DEATH
.58,000.00
~)8,OOO.OO
REV-150B EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Gloria J. Hoffman
ITEM
NUMBER
3W46AD 1000
FILE NUMBER
21 05 0485
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.
DESCRIPTION
VALUE AT DATE
OF DEATH
1
2001 Nissan Sentra
sale value
8,500.00
2
Agribrands International, Inc.
dividend/transfer payment due the
Decedent from 5/1/2001
54.50
3
Blue Cross
refund unused premium
104.00
4
Bricker's Auction, proceeds from
sale of household goods
4,960.75
5
Comcast Cable
refund on cable TV service
4.75
6
Commonwealth of Pennsylvania
Bureau of Unclaimed Property
unclaimed cash escheated to
commonwealth
350.00
7
Hartford Insurance Company
refund unearned premium on auto
insurance
2.20
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
13,976.20
R~V-1509 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Gloria J. Hoffman
SCHEDULE F
JOINTLY-OWNED PROPERTY
FILE NUMBER
21 05 0485
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.
Hoffman, Ronald B
233 West Siddonsburg Road,
Dillsburg, PA 17019
Son
B.
c.
JOINTLY -OWNED PROPERTY:
LEITER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE I NCLUDE NAME OF FfNAN::IAllNSTITlfTtON A!\I) BAI\I( ACCOUI\IT DATE OF DEATH DECO'S VALUE OF
!'WBER OR SIMILAR IDENTIFYING /\UMBER. ATTACH DEED FOR
NUMBER TENANT JOINT JOINTLY-HElD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENTS INTEREST
1. A.
1 A 8/26/1988 Members 1st Federal Credit
Union 1,227.76 50.0000 613.88
checking account #60593-11
2 A 8/26/1988 Members 1st Federal Credit
Union 1,940.72 50.0000 970.36
savings account #60593-00
TOTAL (Also enter on line 6, Recapitulation) $ 1,584.24
(If more space is needed, insert additional sheets of the same size)
3W46AE 1.000
REv-151O EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Gloria J. Hoffman
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
FILE NUMBER
21 05 0485
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 PROPERlY
ITEM 11\ClLOE. HE NAME OF TI--E TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT A/'.IJ DATE OF DEATH % OF DECO'S EXCLUSION TAXABLE
NUMBER Tl-EDATE OFTR.AN3FER ATT.Aa-iA COP'f OF TI-E DEED FOR REAl.. ESTATE VALUE OF ASSET INTEREST (IF APPLlCABLEI VALUE
1. Schwab Securities 69,523.77 100.0000 0.00 69,523.77
IRA, account # 44050945
2 SmithBarney 69,857.16 100.0000 0.00 69,857.16
IRA account # 724-07266-17-790
TOTAL (Also enter on line 7, Recapitulation) $ 139,380.93
(If more space is needed, insert additional sheets of the same size)
3W46AF 1000
REV-1511 EX + (12-99)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Gloria J. Hoffman
ITEM
NUMBER
A.
B.
Debts of decedent must be reported on Schedule I.
DESCRIPTION
FUNERAL EXPENSES:
1.
Gingrich Memorials
Total from continuation schedules
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s) Ronald B. Hoffman
Social Security Number(s) / EIN Number of Personal Representative(s) 185-50 -773 9
Street Address 233 West Siddonsburq Road
City Dillsburg
State PA
Zip 17019
Year(s) Commission Paid:
2.
Attorney Fees
Snelbaker & Brenneman, P.C.
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
5. Accountant's Fees
7.
6. Tax Return Preparer's Fees
1
3W46AG 1.000
Bricker's Auction
commission and expenses associated
with the sale of household goods
Total from continuation schedules
TOTAL (Also enter on line 9. Recapitulation)
(If more space is needed. insert additional sheets of the same size)
FILE NUMBER
21 05 0485
$
AMOUNT
2,585.00
7,228.75
17,000.00
5,000.00
370.00
800.00
5,856.72
38,840.47
Estate of: Gloria J. Hoffman
Item
No.
2
Description
Myers Funeral Home, Inc.
funeral services
202-24-5893
Schedule H Part 1 (Page 2)
Amount
7,228.75
Total (Carry forward to main schedule)
7,228.75
Estate of: Gloria J. Hoffman
202-24-5893
Schedule H Part 7 (Page 2)
2
Cumberland Law Journal
advertising Administrator's notice
75.00
3
Diller Disposal
removal of garbage from residence
120.30
4
L.G. Connor Real Estate Appraisers
real estate appraisal
300.00
5
Patriot News
advertising Administrator's notice
126.27
6
Postmaster
postage stamps, certified and
insured mail
97.55
7
PP&L Electric
electric service
106.60
8
Recorder of Deeds, Cumberland
County
recording fees for authorization
to sell and second mortgage
61.50
9
Register of Wills
short certificates
32.00
10 Ronald B. Hoffman
reimburse for new locks for
property and auto detailing
166.36
11
Rupperts Lawn Care
lawn service
256.52
12
Settlment charges associated with
the sale of property
a. Transfer tax- $1,500.00
b. Tax certification- $5.00
c. Silver Spring Sewer- $46.92
d. County/Twp taxes-$447.48
e. School taxes- $1,403.10
3,402.50
13 Silver Spring Authority
sewer service
83.20
14 United Water PA
water service
28.92
Total (Carry forward to main schedule)
4,856.72
Estate of: Gloria J. Hoffman 202-24-5893
Schedule H Part 7 (Page 3)
15 Reserve
for filing fees, accounting fees
and other costs associated with
the administation of Decedent's
estate
1,000.00
Total (Carry forward to main schedule)
1,000.00
REV-1512 EX+ (12-03)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Gloria J. Hoffman
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
FILE NUMBER
21 05 0485
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM
NUMBER
1.
Chem Lawn
lawn service
DESCRIPTION
2 Members 1st Federal Credit Union
visa credit card #4121449998605930
3 NCO Financial
credit card payoff
4 Pinnacle Health
medical expenses
5 PP&L Electric
electric service
6 Uni ted Water PA
water service
7 Verizon
phone service
3W46AH 2.000
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
VALUE AT DATE
OF DEATH
42.40
3,543.89
1,443.14
159.00
65.74
17.84
1. 03
5,273.04
REV,1513 EX+X9-00)
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Gloria J Hoffman
FILE NUMBER
21 05 0485
1
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers
under Sec. 9116 (a) (1.2)]
Jeffrey S. Hoffman
9 East Willow Terrace Drive
Mechanicsburg, PA 17050
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
AMOUNT OR SHARE
OF ESTATE
NUMBER
I
33.333333 of Residue:
Son
2 Ronald B. Hoffman
233 West Siddonsburg Road
Dillsburg, PA 17019
33.333333 of Residue:
Son
3 Steven P. Hoffman
61 Honeysuckle Drive
Mechanicsburg, PA 17050
33.333333 of Residue:
Son
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX is NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DiSTRIBUTIONS
3W46AI 1.000
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)
$
0.00
LAST WILL AND TESTAMENT
OF
GLORIA J. HOFFMAN
I, GLORlA 1. HOFFMAN, currently of 61 Honeysuckle Drive, Mechanicsburg Post Office,
Cumberland County, Pennsylvania, declare this to be my last Will and revoke all Wills and Codicils
previously made by me.
ITEM 1.
I direct that all my just debts and the expenses of my illness and disposition
of my remains shall be paid from my residuary estate as soon as practicable after my decease as a
part of the expense of the administration of my estate.
ITEM 2.
I give my furnishings and other tangible personal possessions in as nearly
equal shares as practicable to my three sons, RONALD B. HOFFMAN, JEFFREY S. HOFFMAN,
and STEVEN P. HOFFMAN, subject to the survival provisions of Item 4 of this Will.
ITEM 3.
I give the rest, residue, and remainder of my estate in equal shares to my
aforesaid three sons, subject to the survival provisions ofItem 4 of this Will.
ITEM 4.
If RONALD B. HOFFMAN, JEFFREY S. HOFFMAN, or STEVEN P.
HOFFMAN does not survive me by thirty days, his share shall lapse and be given to my surviving
sons in equal portions. If none of my sons survive me by thirty days, they I give my entire estate to
my issue per stirpes.
ITEM 5.
I grant my son, STEVEN P. HOFFMAN, the option to purchase my
residence at 61 Honeysuckle Drive, Mechanicsburg Post Office, Cumberland County, Pennsylvania,
at fair market value, as agreed upon by my children or as determined by appraisal in the absence of
an agreement. This right must be exercised by written notice to the estate fiduciary and to my other
Document #: 219079.1
children within sixty days following my death and closing must be held within sixty days after
serving written notice of exercise of the option. Only my children who are heirs under this Will
shall participate in tIus decision. If my son, STEVEN P. HOFFMAN, fails to exercise this right of
first refusal or fails to consummate a sale within the required period thereafter or notifies the estate
fiduciary and my otIler living children in writing of his release of such right prior to its expiration, I
give this residence as a part of my residuary estate.
ITEM 6. My Executrix shall have the following powers in addition to those vested by
law and by other provisions of my Will applicable to all property, whether principal or income,
exercisable without court approval, and effective until actual distribution of all property:
(a) Except for right of first refusal regarding my residence at
61 Honeysuckle Drive, Mechatucsburg Post Office, Cumberland County, Pennsylvatlia, to
sell at public or private sale, to exchange, to lease, to pledge, to mortgage, to transfer, to
convert, or otherwise dispose of, or grant options with respect to, any and all property, real,
personal, or mixed, at any time forming a part of my probate or trust estates, in such maImer,
at such time or times, for such purposes, for such price or prices, and upon such terms,
credits, and conditions as shall be deemed advisable or necessary under the circumstances;
(b) To retain and invest any and all assets in my estate without restriction
to investments authorized for Pennsylvania fiduciaries, as deemed proper, without regard to
aI1Y principle of diversification of risk.
(c) To allocate receipts and expenses to principal or income or partly to
each as they in their sole discretion think proper.
(d) To compromise claims.
Document #: 219079.1
(e) To distribute in cash or kind or partly each.
(f) To exercise any law given option to treat administration expenses
either as income tax or estate tax deductions, without regard to whether the expenses were
paid from pIincipal or income, and without requiring reimbursement.
(g) To disclaim inheritances.
ITEM 7.
I appoint my sister, LINDA L. BEIGH, Executrix. I direct that my Executrix
be excused from posting bond in any jurisdiction in which she may act.
ITEM 8.
For the convenience of my Executrix, I note that I have retained the
services of David H. Martineau, Esquire, and the firm of Metzger, Wickersham, Knauss & Erb,
P.C., in connection with the writing of this Will.
Executed on 10 / J-I('
/
, 2001.
h~ -'~. Jle(r~
Glorial Ho an
In our presence, GLORIA l HOFFMAN signed this Will and declared it to be her Will, and
now at her request, in her presence, and in the presence of each other, we sign as witnesses:
D7;Y~~~
;/~n,Lr.r f'tl
<? '
Residence
~.d3d!--
~~
Residence
I~
.
Document #: 219079.1
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF DAuPHIN
SS
We, GLORIAJ. HOFFMAN, and D4\.v,' J l~. M4-~ ~: nr'a, V\,. . and
.C:;f;vv8-v1 . {'. ~f-ptif . the Testatrix and the witnesses, respectively, whose
names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare
to the undersigned authority that the Testatrix signed and executed the instrument as her last Will
and that she had signed willingly (or willingly directed another to sign for her), and that she
executed it as her free and voluntary act for the purposes therein expressed, and that each of the
witnesses, in the presence and hearing of the Testatrix, signed the Will as witness and that to the
best of our knowledge the Testatrix was at that time eighteen years of age or older, of sound mind
and under no constraint or undue influence.
,Jj1M'~1 ({ M// rL~_/
Testatrix t7 ~ ~
I2//~5
Witness
<~~
Witness f/
SWORN to or affirmed and acknowledged before me by the above named Testatrix and witnesses
this ..2SIlL day of {)C.T08ER- , 2001.
/2J 12 ~-=-"
Notary Public
My Commission Expires:
(SEAL)
Document #: 2190i9.1
NOTARIAL SEAL
CAROL A. LYTER, NOTARY PUBLIC
Harrisburg, Dauphin County
My Commission Expires Dec. 28 2004