HomeMy WebLinkAbout03-16-06
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
HOFFMAN BELVA L
RR1 PO BOX 198
HESSTON, PA 16647
____un fold
ESTATE INFORMATION: SSN: 208-38-9340
FILE NUMBER: 2106-0226
DECEDENT NAME: HOFFMAN BERNICE E
DATE OF PAYMENT: 03/15/2006
POSTMARK DATE: 03/15/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 03/20/2005
NO. CD 006433
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $3,931.03
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS: BELVA L HOFFMAN
CHECK# 348
SEAL
INITIALS: CM
RECEIVED BY:
REGISTER OF WILLS
$3,931.03
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
.-I
15056041046
REV-1500 EX (05-04)
PA Department of Revenue '*
Bureau of Individual Taxes. ,~
Dept. 280601
Harrisburg, PA 17128-0601 ~
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
OFFICIAL USE ONLY
County Code Year
File Number
INHERITANCE TAX RETURN
RESIDENT DECEDENT
.,;r /
p~
DJ- ;} "'.
Date of Birth
;).'0 go 3 B q 3'1 ()
() 3 J.. (J .).. t:> () . S"
/)7 z, I 1 2. /
Decedent's Last Name Suffix
Decedent's First Name
MI
J.I 0 1= P lit A- AI In/? oS
BE" /( AJ ICE
iF
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
Spouse's First Name
MI
NfA
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
_ 1. Original Return ~
2. Supplemental Return
c:::J 3. Remainder Return (date of death
prior to 12-13-82)
c:::J 5. Federal Estate Tax Return Required
~ 4. Limited Estate ~
4a. Future Interest Compromise (date of
death after 12-12-82)
7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
10. Spousal Poverty Credit (date of death
between 12-31-91 and 1-1-95)
() 8. Total Number of Safe Deposit Boxes
~ 6. Decedent Died Testate c::J
(Attach Copy of Will)
c:::J 9. Litigation Proceeds Received ~
c::J 11. Election to tax under Sec. 9113(A)
(Attach Sch. 0)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
C /-1 A I< L. t: s
~
SIl/€LD.5
III
7/7
-j<~~J.1D
r-,,'
Of:jz 0 9
<,..,;1,"'\
en
j'
NI.4
..--,.....
REGISTER OFWILL.S USE(:lNLY
': .'.c:' :'.)
Firm Name (If Applicable)
First line of address
)""",,~
~
CLOt/SEA.
R 0 A-b
Second line of address
City or Post Office
State
ZIP Code
DATE FILED
At € ellA-IV I C 5 8'4, f( r;.
fJA
110SS-973S"
Correspondent's e-mail address: be a. mer c s @ epi x. 11 e.t
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. Decl ration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
FILING RETURN
DATE
3 / 1)0
ADD SS SOl( II/~. M :J:'AI.
7D33 UJE/l.TZVIL~E ~~.J AlEt!HA/fI~SeUJt~ ,/JA /7/)$"0
S:NA(lZo;JZA~R d/;j/IZ5r;rENTATIVE
ADDRESS C/(JI.,(U43 E: SN/EZPS 7iC
b CLDuJEl! A.b., h/EC!..IIANICf8U~G, PA ,7DSr-
PLEASE USE ORIGINAL FORM ONLY
DATE A
3 II/lOb
Side 1
L
15056041046
15056041046
---1
-.J
15056042047
REV-1500 EX
Decedent's Name:
Decedent's Social Security Number
"~aK 38 9 3 if t?
RECAPITULATION
1. Real estate (Schedule A).
. . . . . . . . . . . . . . . . . . . . . . .. 1.
2. Stocks and Bonds (Schedule B)
............................... 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)
4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . 4.
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 5.
6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) ~ Separate Billing Requested.. .
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). 11.
12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . 12.
13. Charitable and Governmental Bequests/See 9113 Trusts for which
an election to tax has not been made (Schedule J) . . . . . . . . . . . . 13.
14. Net Value Subject to Tax (Line 12 minus Line 13) . . . . . . . . . . . . 14.
TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) XO~ . () 0
16. Amount of Line 14 taxable
at lineal rate X.O!/.S
17. Amount of Line 14 taxable
at sibling rate X .12
18. Amount of Line 14 taxable
at collateral rate X .15
873.,)"./7
190
.~ .
.6"0
19. TAX DUE, . . . . . . . . . . . . . . . .
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
L
15056042047
.&ro
.0"
3.
.00
6.
7.
.,0,0
8.
'10 r,". I 7'
~ ?l.f() .'6 0
9.
10.
.00
~
37
FifO. ()O
3 S (D. I 1
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3S6./7
15.
.DO
.3 13 1.03
16.
17.
00
18.
. f) 0
3 C; .3i I . 03:
. 19.
c::::>
15056042047
.-J
REV-1500 EX Page 3
Decedent's Complete Address:
DECEDENT'S NAME
File Number
::21--0' -
&-~AI/e~ E'..
H~I="FAI jf.,f)
STREET ADDRESS
---- ---
----
7033
t()L;'1J.. TZ 1/1 /:.L..e- /lPA- /)
----
CITY
I STATE fJA-
[ZIP
,
--
1J!/Ft!H ,f-AJICS is uler;...
/7 (J so
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. Credits/Payment?
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
319..3/.. D3
.
o
~---
o
o
Total Credits ( A + B + C )
(2)
o
3. InteresVPenalty if applicable
D. Interest
E. Penally
TotallnteresVPenally ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2, 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)
A. Enter the interest on the tax due.
8. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(5A)
(58)
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACiNG AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred;........................................................................................ 0 [8
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{]
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 5a
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ........................................................................................................................ 0 ~
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
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 three (3) percent [72 P.S. S9116 (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 zero (0) percent
[72 P.S. ~9116 (a) (1.1) (ii)]. The statute does not exemDt 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 zero (0) percent [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 four and one-half (4.5) percent, except as noted in
72 P.S. ~9116(1.2) [72 PS. ~9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. s9116(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.
-,~~,,,." .-
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Ht>Fi="IJIA-tv; e€/lMeE"
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
€.
FILE NUMBER
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 VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. 5"~r ye-HHS OUJ /!Je1>Rm/J1 Sf.(. rr; ;:7t!OR &4/j)/T/o/l/ ~ ';;00, 00
~. /~ Y. YG'hfs o~/) /B-E ~S/~A:, /f e~U1L.iSL€ CbA/,) /7/&11'() ~ / e>C'~&J
Y4Fi11!!S a.LJ t!HA/.e. , At~egJrA-&€" J1'
~. /~r ~.A/4:?/T/ 4I'Y /.sz;,t::JO
,
1f /NF/1 /VolE: ~lJENr ;hr./) ~;tf;tI() ~.s fA)/,co/F a;~
U Y/N(; /IIV Slf-AtE J.i1J"SE"H~ s/N~E 191t!J_ I>E'e.D9J7
f/4D :bIS71t18uTEtJ Au. t:J 7#e1f!. ~'~Ty LDN~ ~G-4P.
TOTAL (Also enteron line 5, Recapitulation) $ ~5 0, C'(/
(If more space is needed, insert additional sheets of the same size)
~-~'I'" '*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF J..lOFF I1\A Al, &/(A)t{JG E
SCHEDULE F
JOINTLY-OWNED PROPERTY
FILE NUMBER
;2 / - oS
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. J/JHN R. J.lOF~/lJA-/V/ :E
7033 LPEle7Z VI E-L.Ei ,ej),
MG;'(!I{/hWtJs.$uIf16, I'A /70S0
B. /JEL. vA J.. IIpJ:'I=/1//p/p
70.33 ft)P/27Z VI L..Le;' /f!.1J,
/HE't!//A/JI/eS8 t..{RG., //A- /7oSo
c,
~o .11/
"])/rtl GI-I r~ - /A/-
L,;/It{) .
JOINTLY-OWNED PROPERTY:
LETTER
ITEM FOR JOINT
NUMBER TENANT
DATE DESCRIPTION OF PROPERTY
MADE Include name of financial institution and bank account number or similar identifying number. Attach
JOINT deed for jointly-held real estate.
1.
l.:2f/3//9'f1
A,
'f6
( Y:l. )
REM eS7A7E IAI SIl.VEl( SPRING 7Wr?" (!.t/.h1S.
eo., PENAI/1-. WI1"1{ AAI 4-~J)lte;s tJtC 7t?3$ Lueo:-
2Y1u..c-/f!..LJ"J Pl5~/fA/ICb iSUA!~, ,L/A.,; /70 So.
PA-IlM:L Nt? 3B'-/3 -09 8S' -07ft:>
8y VEe1> D1= bee. 15', 199' "R/S PMP&XTy ~
lifT IA! r:/()/Nr //IA-/He: pe-C!E1>~r IH.U/V/N6- ~
#JJ )/~ $PN ~/) /J"f-ttGH7la2 - /AI-L,ifw tJft)N/A/6
Y..2 /Is 7~ EJ'Vr /hYt) ;15 .T7aJlltJS' ~ ~
r~ 7#G H/l-t.V'~.
7Hk- 7P7~ MS€5S/JIENT J"A-L.uA- T/oA/ t:J,C..7.iiVE
?'/lP~E7J.7Y /$ <JI!/76." 0/". 4P0
C l(1UU!N i CkM 13. C.h CaIJ1. Lfiez DR/) = /. 0
(S#?fF ~,t1y (JI= 7>ECJJ A#.f) ~ ~.r /k;SESSMSVT
:D#7.# /l-rr;(JHez>).
,.foS"fD2. A- CCDUN-rS j1.i NlEMB~S 1st FED.~. UN.
fA) ~AVINGS A-ce[ # j'()/"7 -/)~ 'ZCf/,. /'0
::2.
11-..,.8.
J3 Y.3
(i~) CHGC~/#G ,f-{!,(!;r. tf/: ftO/~7-// ~~ 3a;. r3
(SEE" YA-t.lJ.lJ.7i~N lGT71f7l A-TrAeNliJ:1)
DATE OF DEATH
VALUE OF ASSET
<;'
/7bl 010.00
,.
9/(,,60
., ~ 3 0". '13
%OF
DECO'S
INTEREST
5o~
3 3)'~ Z
3313Z
DATE OF DEATH
VALUE OF
DECEDENT'S INTEREST
s
8&,/ ODS, /){)
f 30$.5'3
"
/ . 435'. (,'1
TOTAL (Also enter on line 6, Recapitulation) $ 0 r, 7'1', /7
(If more space is needed, insert additional sheets of the same size)
...r"'''''~'''",U'''
\.1'ti1S ~h,Q\~
'flU. ~\\ttd N~. fjJ~ /?rIJ1t81L
Made Cl~ ~....-JJLtit~dlY of
tlU:ldted nne! nlnety-rull" (1999).
tillS P~~Q
:eu~~
ill the ~Il~ Qn~ \h()lllllld ntn~ .
B~tw~n BF.R.Nlr.E. H; ttOFfMAt-1T \\t\11I1l1Wod wid'Qw, ~\ltte1\ttJ uf
SIlVllf Spnng Tt)Wl\shlP, eu,nbcrlM1d County, Pcnosylv&1WI, Or4Ill0f,
alld
the tlid IlRRN[CE II. r~OFfiMA.N') U1d het 3on, JOHN It HOflPMAN. ~I,
~a~.~!:.~ 'V ^ L. ~aR'M~~ hh w\fe, o\ln~~~1.ly oJ~, ~tntl~~YN1I!.
_,,_..,v_v_ ,,"'lI(r ~pr'':J Jf1ilMl,,? ~
'fitle ill ~nd to the protnhe~ it to bo h\\kl onc-lh\,!f (1/2) In the notrIle of l.h~ ",~d Ec:rnIC!! 13.
l{r.,fimln., ~ tk alhes: I)n~h~( (tll) Is It) bG 1\1:1(1 ai tf;n~n{~ lly thu ent4,retle~ br \he sUi John R.
HolltnllI: II and Ih~ lllJo ))dvll. L. Hoffmunl'h!~ wtCl;, Ao;, 10 the two (1) ~pe\luye halve; Uwy
!lfe to be h~ld a.~ jolnl \eiumls w\th rlBl'1 ~f $~1VivonlI1p, and llol1l5 ll:.rtt\nt~ in t001I1)on.
Wmms...<Sp':ffi, \.hilt 1n ~Mlde"(ll.1.lri~ of \hc nun tlf ONE lll1d N ~1,OO ($1.00) DOll..AR. in
hltncl pl1id, Lhtr rr:;ceipl w,hIlTeQ{is hmby l'Ic~.110wlcdgtd, t}l~ :Ilid O~tOl' doc:,> h~b.)' artllt llM
convey ~o the Ja.ld Gram eo , lhtrir hein ~d mlgru. as fol1()ws~
ALL 111';'1' CEIr-:^~ Lot ofOroiind l>lru:llc }II Sliver Sprins 1'QffllS\l\p, hI \i'e
C'GUMy o. Cumb'l!.olUld and Stllll' of P8ln3)'lvltl1i4., QQWldfxl and dt,crlbed 118
. fol1o'W:i, \0 Wl1:
BBJINNINC at ~ R.R. S~llce .In Ihe 'ccnter or lhe: :PllbUl) lto.'\d lcudina btlm 'Gonk
(0 Cac1ll1le 5ptinJl$ Indat car.ntt or oiJIcr l,ndr. now 0( (on-ne-rly or O. Mtltofl
Hllmet. of which this iB l p~ th~ by ihe. etl\~r of MiLl ~bne Hold And ~ng
other Iar\~ now or fOl'11:ll1rly of Uw ~*ld 0. MllIOn ~CI'J Sooch ~ghlY-IQYen (81)
rl{' ~~ fourtcoll {14) aUlltll!:$l!ML one hundrotl fifty (1.50) f~ 10 n R.R. Spl.k.o ill
t~ cent.ex' of 3(\ld Puh[le Road I\nd ftl' earller (If Olllcr lands now or {Qrmedy of'tho
sltid Q. MillOn Ullrr'ltt'; tbenoulon't S1l1d.l!lf.Qs SO\\th oo.c: (1) de~e !otty-follr (44)
mil1utc~ alLSt thrro nmtdred 1~l1ty-A~ ~d ~1,IC.ty-,evCfl O.t1C1.nUJlthdw (31~.~)
feet to fin tronpln I\~' ~ ~er la1ldlll).()'oV Of rornwty of the SJ.i.d a, Mllttm
H urllet: Ibcnoc: ll1on8' 5.&14 othto:r lincb tlDW or CQftDrny ot ulua1d G. Milltm
111iln<<, Soutll aov~my.dght (78)'dcJt'CC3 ~o"cn (07) II,:J~tesWOJL QIIO handrtd
fUry-one. 4n<l r.it\~ti'-t'iI(Q ofle--hllndr~th~ (l51.92) foct to J.ri iroo pln~ ~co further
:alon6 ",-J~ oHler J~lld5 nOW' Of" fom1el'ly Q! the SAW O. Ml}t()n Hunx:r, Notd, 0/)1; (1)
degrco fo~y-foUt (4.4) tcinalt;S Welt to\l1' 11Isl'IdfCd lwncen and n1Jl~'oon one--
hundredth:! (4.14,19) feet \. RJt ~lb III ale ccnw ofth(llf~f1d P'u~~c R~,
at the p lac" of DEOINNtNG; nnd ~nTAinfns: One. and thirty-nve. onc:-lumrlM:! elu
(1.3.5) Acres. of I...tnd..: '
EXCEYHNO fR.~l-mE OBSCRlP1'lON APORESAlD lhose Ctl:rW:1 ~ am pa:rceb;
of land which We~ eriU1tc.d am:! COl\V'tl)'ed by th~ sa.W BI!Tl\JCtlE. Hoftmu.. tr\d bet thm Hv~
husblL.,d. 1, Rtldll"'Y tiof':fn13.f\, by Ihoii d~ dAlcd ~c~ 11 r ~ 9lS9. to the!' COmrnonwollcl1 of
!'enn.ryi\lnnln,. Dep~l't~nt of H1~hway$, ~m'ded in ~IC RetOtOct of Dced~ O.fllcCl in llnd for
Cul'11bffiwl COU1lIy. Pl.'.n:rnylvf\l\r~, il\Det:(1 J)ook "D'", Vol limo 23, Pllge 433, per L-'R. SCfO;.
1005-[. F~. .(='roj. No. I..a 1~1(21.) "3, C.l.. 1'\0. 2102667,1$ lnl:lt"C f\illy tpp~m at bIte ~
Md llS J$ .!l1owtI on Ihe survey antched lhereto whIch ,'ItS ~ !Tom PJllt 1'(lj, 31 right of wty
plAn for Reute 'No, l00S, SeCtitlIt N(;, 1, Cul~bcrlattd Coul1Ir.
It being !lIe. gl'~lI.tt:f ponIo~ or ma Rrtlt pr(lTJ1Jsos which O. Mllton H Il~t iintl Hcnrlett1 f.
Hll!ll~r, hJ~ wife. by deed dated May 23, 19S:l. amI rceoro~ in Lllo R.crm-dtl\"lS OftiOt; Al(l~~1\!.d 11~
Pw!. Book "R.", Volu;.qts 16, Page<\.lO~onvcytd to], Rodno~ HofftnJbllltit! BerniecE.. JIof~'T
hls "'ire~ 'Thtl Jold J. Rodn~y Hoffll'~ c:lep~ tilL" owly lire 141Il.llSY 1}', 1918 whel'(\upon till:!
TItle to the !;t\d prtmiao! ~o $bsoluldY vested 1Jl thtll ~:l.k( B&:ri1lcc a lfuMt!IIJl, his widow, bv
the law of the Commonwcahh Of PC1lTlsylvall~ irJaWent CO le1l.8l1oid 'by tb~ ~tt~. ~ .
IDJS IS A TRA NSFER PROM Mc-ri-um 1'0 SON AND bA1)9I'n'gR~lN.1J. WAND
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SEP-08-04 WED 08:23 AM MEMBERS FIRST MORTGAGE
FAX NO,
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IS 1HF.IREFO)lB 'TRANSFER. TAX DXBMP'l',
AND the said 0W11ac wUl wanant lIpecl.uly ibo property hereby conveyeQ.
IN WrrNUSS Wl-IER.HOf. the said Gnunor lras nel'Cunto set her hand dl1d .eat Ult dttyand
yelU' first abovCl wrltten. . .
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Signed. sl:atcd and dcllVl;1'ed
1n me. pte~nee of:
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BERNICB E. HOFFMAN
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. COMMONWnAl:J1{ OF PENNSYL V ANlA :
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cqUNTY OF CUM1H!RLAND
On thI~, Ihe -.L:2.lk~ dAy of ~~/ . AD. 1999, before me
tho u.;dcnlg11M officer, personally appeartd UERNI----cE B: HOfFMAN, Mown w me, (or
MllsfactorHy proYen) \0 be the person whQ$$ hll!T16l$ s\Jbs~rlbed tQ the within instrumenl, and
I\clalowlcdged 1h8~ Bh" ~~ul~ the same for tho purp05M lherdn contained,
IN wrrtfES S WHEREOF, 1 hereuI1to,et my hlll1d and ofTlcliu feat.
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CERT1FICA TE OF RESIDENCE
r HERlllJY CER.TlfY that lhr. p~$e nsklenc-e of.heo Grantees Is:
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T A X I N FOR MAT ION
November 30, 2005
Cumberland County - CUMBERLAND VALLEY SCHOOL DIST - SILVER SPRING TWP.
Name as it appears in Tax Duplicate:
HOFFMAN, BERNICE E & JOHN R II
& BELVA L HOFFMAN
Acct# 38-13-0985-076
Location: 7033 WERTZVILLE ROAD & ROUTE 1
7033 WERTZVILLE ROAD
MECHANICSBURG, PA 17050
Land
Improvements
Total Assessment
39,020
136,990
176,010
T A X
S TAT U S
Tax
Year*
Taxing
Authority
Face Amt
Status
Amt Paid
Date Paid Amount Due
--------------------------------------------------------------------------------
2005
2005
2005
County
Library
Township
353.07
31.68
102.79
PAID
PAID
PAID
346.01
31.05
100.73
04/18/05
04/18/05
04/18/05
07/20/05
2005
School
1,681.60
PAID
1,647.97
----------
----------
Total Due
* The School tax year is July 1 of the year shown, through June 30 of the
following year. Both the Township and County use the calendar year.
If prior year info is needed please contact The Cumberland County
Tax Claim Bureau.
I, DEBRA BASEHORE WIEST, Tax Collector for SILVER SPRING TWP. do hereby
certify the above information to be the true and correct Tax Status
of the above listed property.
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(signed)' TAX COLLECTOR
/ /- .flJ- 0 S""
DATE
(Please return lower part with payment.)
STATEMENT
Fee for the above certification $5.00
Tax Certification for: HOFFMAN, BERNICE E & JOHN R II /
Make check payable to: DEBRA BASEHORE WIEST, SILVER SPRING TWP. Tax Collector
269 WOODS DRIVE
MECHANICSBURG, PA 17050
NEW OWNER:
MAILING ADDRESS:
** PLEASE PAY TAX CERTIFICATION WITH A SEPARATE CHECK **
THANK YOU!
,., 1m
MEMBERS 1st
FEDERAL CREDIT UNION
SAVINGS ACCOUNT:
Account Number/Suffix
Date Account Established
Principal Balance at Date of Death
Accrued I nterest to Date of Death
Total Principal and Accrued Interest
Name of Joint Owner
80167 -00
12/07/1985
$916.12
$.48
$916/60
John R. Hoffman, II - added 12/07/1985
Belva L. Hoffman - added 11/05/2002
CHECKING ACCOUNT:
Account Number/Suffix
Date Account Established
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest
Name of Joint Owner
80167 -11
12/07/1985
$4,306.37
$.56
$4,306.93
John R. Hoffman, II - added 12/07/1985
Belva L. Hoffman - added 11/05/2002
V" 1\ ~RS 1ST i=i=DERA.1 ("'QP"IT UhIIO"J
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Denise A. Wolfe ;
Insurance Services Supervisor
September 29,2005
Estate of: BERNICE E. HOFFMAN
Date of Death: 03/20/2005
Social Security Number: 208-38-9340
5000 Louise Drive · PO Box 40 · Mechanicsburg, Pennsylvania 17055 · (717) 697-1161 · www.memberslst.org
REV-1511 EX+ (12-99\ 'C.'
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATEOF H()Fr:IJ{I/~ ~E,fA//C8 c.
FILE NUMBER
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A,
DESCRIPTION
AMOUNT
1,
FUNERAL EXPENSES: 9~PAIl:>.
B. ADMINISTRATIVE COSTS:
1. Personal Representatlve's Commissions
Name of Personal Representative(s)
.::r~1I tJ R. H tJr F;# A I'f , JL
W/HVe/:).
Socia: Security Number(s)/EIN Number of Personal Representative(s)
Street Address 7033
VJEt<7ZV/U6" /f..l).
City IJ1FC!flA-A/IC S lfl{fi!&
State ?4 Zip /7050
Year(s) Commission Paid:
3.
Attorney Fees CIIIlRLES k. S/lIGZlJS '7iT ES6/.
:fEteS:> H~, €SIP, - ,
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant ,J//h'AI A'- #~~F/J1A-~;;Z:
Street Address 7D33 tv€If! 'TZ ]/IL.LG" A?P.
City fJ7E~f(/1/V/eS $U~6-
~
I, f7.s: /10
~
SOO.I#O
.
i.f.SO.OO
2,
State ;1/1 Zip
/70.>0
Relationship of Claimant to Decedent
501'1
4. Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
FILING INHEIf./rAIIICG' 7,t/.y I<.E /&ot./11
,X
/S.oo
TOTAL (Also enter on line 9, Recapitulation) $ .:(, 31/0. "f)
(If more space is needed, insert additional sheets of the same size)
~,,,,,,,.,,.,, *'
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF Hp,c,cAl/l/1/., .8~,fJ/t//eE"
SCHEDULE J
BENEFICIARIES
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
1. TAXABLE DISTRIBUTIONS (include outright spousal distributions)
1, JOJl/J /? HPJ:'FAlAAI
7~ 33 tlNF;€.7Z I/I~LE 1€1>.
f}JG;(JH,tJ/!//(!SBJI/ec;/ /l;f /70$"0
FILE NUMBER
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
~/I/
AMOUNT OR SHARE
OF ESTATE
/ t:JC /e>
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, 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)
LAST WILL AND TESTAMENT OF BERNICE E. HOFFMAN
I, BERNICE E. HOFFMAN, of the Township of Silver Springs, County of Cumberland
and Commonwealth of 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 prior Wills by me at any time heretofore made.
1.
I direct the payment of all my just debts and funeral expenses as soon after my decease as
the same can conveniently be done.
2.
I give, devise, and bequeath all the rest, residue, and remainder of my estate, real, personal,
and mixed, whatsoever and wheresoever situate, to my son, JOHN R. HOFFMAN, II. In the event
he predeceases me, then to his wife, BEL V A L. HOFFMAN. In the event she also predeceases
me, then to my grandchildren, ANGELA L. GREENWALD and NATHANIEL E. HOFFMAN,
in equal shares. In the event my said grandson is a minor at the time of my death, I appoint his said
sister, Angela L. Greenwald, as guardian of his funds which may be used for his education, medical
expenses, maintenance and support.
3.
I nominate, constitute and appoint my son, JOHN R. HOFFMAN, II, to be the Executor of
this my Last Will and Testament. In the event that he should predecease me or for any reason be
unwilling or unable to act as such Executor, I nominate, constitute and appoint my daughter-in-law,
BELV A L. HOFFMAN, to be Executrix in his in his place and stead. In the event that she should
also predecease me or for any reason be unwilling or unable to act as such Executrix, I nominate,
constitute and appoint my granddaughter, ANGELA L. GREENWALD, to be Executrix in her
place and stead. I further direct that they shall not be required to file bond or other security in the
Office of the Register of Wills for the purpose of administering my Estate.
~IN WITNESS WHEREOF, I have hereunto set my hand and seal this U
~~A.D.-!9997/h'?
~~.
j3~~ e /~~
BERNICE E. HOFFMA~
day of
(SEAL)
Signed, sealed, published and declared by the above-named BERNICE E. HOFFMAN as
and for her Last Will and Testament, in the presence of us, who at her request and in her presence,
and in the presence of each other, have ~e~e~nto s!ubscribed ,.' mes a~..'tnesses.
(.!(QCLY / ~ . I ,- ~.~
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