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HomeMy WebLinkAbout03-27-06 (2) REV-1500 EX + (6-00) COMMONWEALTH OF REV-1500 PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RETURN FilE NUMBER DEPT. 280601 II HARRISBURG, PA 17128-0601 RESIDENT DECEDENT _ _______________ L-- ID~C:~~~:~~E~~S~F.IRST. AND MIDDLE INITiAl) I bATEOFDEATH (MM-DO::YEAR)----~~F BIRTH (MM-DD-YEAR) 06-27 -2005 i 11-17 -1945 I (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) I I - --~L - ---.-- ------------- w i 1)(_11- Original Return 2. Supplemental Return llC: ~ (I) II 4. limited Estate 4a. Future Interest Compromise (date of death after ~ g: ~ 12-12-82) i3 ~ ~ I I x] 6. Decedent Died Testate (Attach 7. Decedent Maintained a Living Trust (Attach a. copy of Will) copy of Trust) ~ I I 9. Litigation Proceeds Received I...-_J 10. Spousal Pove~ Credit (date of death between '_J 11. Election to tax under Sec. 9113(A) (Attach Sch 0) 12-31-91 and 1-1-95) I _ TI-IIS....SECTION/I\IIUST....BE.COMPL.ETEDWAL.t....CORRESpONDENOEiiN[)~ONFtDEITlliTAX.INEORM~TiON...SHOcJL.D....Be...[)IREC'rEO'.'Y'(): NAME COMPLETE MAILING ADDRESS __M~_~_~_~~}_ !:. B a ~Q~_____ FIRM NAME (If applicable) . . t- Z W o w U w o OFFICIAL USE ONLY 05 0619 COUNTY CODE .--Yl=AR ___. _NUM~E!L_~.__ ~----r- SOCIALSECURITv NUMBE-~--~---~--- 162-36-9506 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS ~---'----'----'~--.- --_._--.._~----~-~.- SOCIAL SECURITY NUMBER 3. Remainder Return (date of death prior to 12-13-82) 20. D I- Z W o z o 11. fI) W ex: ex: o (J TELEPHONE NUMBER 717/730-7310 5. Federal Estate Tax Return Required o 8. Total Number of Safe Deposit Boxes 429 South 18th Street Camp Hill, PA 17011 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship z o i= <( oJ :J t- o: <( u w a:: 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) ] Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) [J Separate Billing Requested 8. Total Gross Assets (total lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (1 ) 10,359.92 (2) 7,481.66 -_._~--~-~ (3) None ---~ (4) None (5) 76,215.96 (6) None (7) 7,007.04 r -, OFFICIAL )JSE ONLY I i ! I I 'I I I _ I . ': I I 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) r'" ~i c.,) (8) 101,064.58 (9) 11 ,129.99 ---------~-_.-~ (10) 24,268.89 (11 ) 35,398.88 65,665.70 (12) 13. Charitable 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) 0.00 65,665.70 (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15.Amount of line 14 taxable at the spousal tax rate, 0.00 x .00 (15) 0.00 or transfers under Sec. 9116(a)(1.2) - ._----_.__.~-- z 0 (16) i= 16. Amount of line 14 taxable at lineal rate 65,665.70 x .045 2,954.96 <( - ----"-_._-.~----~..~-- I- :J 0.. 17. Amount of line 14 taxable at sibling rate 0.00 x .12 (17) 0.00 :1!E 0 U 18. Amount of line 14 taxable at collateral rate 0.00 x .15 (18) 0.00 >< <( I- 19. Tax Due (19) 2,954.96 -----.__._,._._..._--.---_._-~-- CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Copyright 2002 form software only The Lackner Group, Inc. >> BE SUReT()ANSWeR;ALLQO@STf()N$\ONR!V!RSESlbE;ANI):~ECHECKMATH<< Form REV-1500 EX (Rev. 6-00: ~ -(.. Decedent's Complete Address: STREET ADDRESS 1014 E. Simpson Street 1 STATE PA ~ ~--~~-~~~--~~~--- !ZIP 17055 CITY Mechanicsburg Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 2,954.96 0.00 Total Credits (A + 8 + C) (2) 0.00 3. InteresUPenalty if applicable D. Interest E. Penalty TotallnteresUPenalty (D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is theOVERPAYMENT. (4) Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theT AX DUE (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is theBALANCE DUE (58) 2,954.96 2,954.96 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS No 1. Did decedent make a transfer and: Yes a. retain the use or income of the property transferred;............................................................................. 1---] b. retain the right to designate who shall use the property transferred or its income~................................ [J c. retain a reversionary interest; or............................. ..-............................ --.............................................. IJ d. receive the promise for life of either payments, benefits or care?........................................................... I J 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?............................ .... .... ...................... .--............................ --..................... I J I \--J 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?............................ .--............................ -............................. --.................... l ~ ..1 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and co~plet~. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.~~_m________ SIGNATURE OF PERSON RESPO LE FO ILlNG RETURN ADDRESS DATE ~tePh 0 --. ~~I~S~~r:.a;: ~~~~9________ _~lD /bb 8~11;' EO~e~ 1,Sj:?5TURN ADDRESS :J;~/:AT~ tGNKJ;-J5FPREPARER OTHER N REPRESENTATIVE ADDRESS ~_______~_~n____ -~-~~-I---/ DATE Michael L. Bangs 429 South 18th Street Camp Hill, PA 17011 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 statutedoes 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 siblings is 12% [72 P.S. ~9116 (a) (1.3)]. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. ... Rev-1502 EX+ (6-98) . SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Seidle, Gail E. FILE NUMBER 21-05-0619 ESTATE OF 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 NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Real Estate - Proceeds from sale of 1014 East Simpson Street, Mechanicsburg, PA (see settlement sheet attached) 10.359.92 TOTAL (Also enter on Line 1, Recapitulation) 10.359.92 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule A (Rev. 6-98) A. Settlement Statement U.S. Department of HousinQ and Urban Development ~ ,r . OMS No, 2502-0265 B. Type of Loan 1. 0 FHA 4. OVA 2. 0 FmHA 5. 0 Conv. Ins. 3. 0 Conv. Unlns File Number BO:l737-CAL'l' Loan Number UJ:1.ImOWll Mortgage Insurance Case Number N/A C. NOTE:This fonn Is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked .p.o.c" were paid outside of closing; they are shown here for Informational purposes and are not Included in the totals. D. NI\ME'~NID;I~ElIDR'~9~~~f.~.~->~~.~~~~;, . .~:~fl8:~1~t~~f#.4~M~lf'~iJ.n./~qUt:9,PA 17055 E. NAME AND ADDRESS OF SELLER: Estate of Gall E. Seidle 1014 East Simpson Street, Mechan/csburg, PA 17055 201. Deposit or eamast money 2g~;!.fiJjil@).i1Jil;f.ii9ii1.lifmtft~~&}111!~wl~~~~~2~~ 203. Existing loan(s) taken subject 10 ~64'.' 205. 206. 207. 2Q8. 209. ADJUSTMENTS FOR ITEMS UNPAID BY SELLER: QOO. 00 . (fr.pm;!.In~;~ :(\,p.or: '.." 104, 105, 1 06. ,GI.!y/tC)Wn' tax~ 107. County Taxes 1 q8..AsS~l'{Ierit.~.. 109. NO. 111. 112. ,;J9'. 09/15/:J005 to 1~/31/2005 :;,':q~%:4ilftliql'~h:i~~~i~il1)~;;r'~ 12/3J./2005 ':g.I;!;?'~P~#'pQ.i? $158.36 . $1,23J..19 120. GROSS AMOUNT DUE FROM BORROWER: 2Qaiif.\W'.d>,W~m~~~~tii$.l~ @}Dg.fl{m~~~ 420. GROSS AMOUNT DUE TO SELLER: '. s.~'r.;~' ~~!l1i~iJiwi~~]~ig?, $109,389.55 . .$1,104.00 .....$~7~,f}2S. 63 509. ADJUSTMENTS FOR ITEMS UNPAID BY SELLER: 210, City/town taxes 2j.~~(!9q'~Jiw::~~~:: \'jr 212. Assessments io 510. City/town taxes 1If~~~1~ti~~.~~~~.iil '~.' to to 512. Assessments to 214. 2f.5.:'~' ">. ..,:' :;S;~i+t:~~~~~)f:[~~\jg~~if;i 216. ....2~i:.. 216. 2:1~. 220. TOTAL PAID BY/FOR BORROWER: 3IJ~~!~~lliff,\'if~.;. 301. Gross amount due from borrower (line 120) 30-i;1.@~~~itttf~lq~ ~ 303. CASH ( t8J FROM) (0 TO) 514. 516. $99,029.63 601. Gross amount due to seller (line 420) ~":"'W~..it~ti~);j~~~)j0:;:;?<. . $1,510.11 603. CASH (D FROM) (~TO) SELLER: $109,389.55 '$99,0'29. 63 $10,359.92 HUD-1 (3-86) - RESPA, HB 4305.2 PAGE1 ..; HUO.l tHe.... JIUBl L. '. -.- ':$El111iiU6 MeNm~c.ffi~RG.e$. . @ ... 700. TOTAL SALES/BROKER'S COMMISSION BASED ON PRICE $108,000 00 DIVISION OF COMMISSION (LINE 700) AS FOLLOWS: 101. 102. 703. 704. 705. CommIssion paid 01 slllilemant 706. 10 to 10 10 800. ITEMS PAYABLE IN CONNECTION WITH LOAN: 801. L08l\ originallon fee 1 .0000 .'" . .10 "Varta.gNift:X9na~::J:l4#k: 802. Loan discount % to Vartan Na tiona~ Bank 803. Appraisal fee to: Va..rtan. ..Na ti.o~;LB.,ai:qc . .. .... 604. Credll report 10: Vartan Na tiomd Bank 805. Londer'slnspectlonfoo Vartan. Nat.i~pa~ ....s.ank 806. Mortgage InsurunCtl appllcaUon fee 10 Vartan Na tiona~ Bank 807. Assumption foe VartanNa:f;ional.. ..Ba.nJc .... ,..,. . 808. Doc Prep Fae to Vartan Na~onal Bank 809. 810. 811. Doc 812 813 814 815 816 817 818 819 820 RevieW' Fee to La.". orri:ca orDarre:rJ;m., .pe.tn;:l.;et.. S: :'.,.1. ~ '. .....:.,. ,. . - -I '" 0 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE: 901. Intmast from .09/1'!j720(J5< :to """:'1;,o.KP:1,~~q'O$:;:;" ...... 902. Mortgage Insuranca premium for :1', mos. 10 903. Hll2Bfd Insuranca premium for "~:F ..~(l.,::: . . 904. Flood Insurance premium lor yrs. to 9~. ~ . 1000. RESERVES DEPOSITED WITH. LENDER: 1001. HlIZllrd Insurance _rTIOnIl)$,'@:\"T;~;':;" ;'~:';':"<'i.:( i';' '::f: 1002. Mortgage Insurance months C 1003. City propel1y laxes _ montha;'@:. 1004. County properly Iax~ months @ 1005. Annuel assessments mon~:@:' .'.. , 1006. Flood insuranca .. months@ 1007. -T: monll)s;@ ".' '.' .',/ 1008. . . monlhs @ 1009. Aggregate Accounting:4:scrowAdl~stin.~p~';i: 1100. TITLE CHARGES: .~. .' .. . .... '.. ','.' .:.; ...;.'.'::..:......>.:.:,;..: .. :.-,-"",. .' .... ';.. .:....,.:>..'..,. . ':" '., '.: ..... c'" .. .. ". ''-'.>'. '.,' .' ,.:.... .'.c....'. ")'day '. .....'. :':.~. ....' . '> '. .:.',-'/; ..:f .:. :.;.t~:: ~:~i:.~{,~:~~:~<i' ,;~.~::' -,,' :('f;:: :::'.,i~'jj~~mbriifj\i..':.. per monlh .' .:)pl!.r:~tiji: per monlh .....;,: i4!~ii\6nUi per monlh .~' pllr'~tJ) , per month " ;',r'j"" "I:" 1101. Sattlemenl or doslng lee to CAPITAL AREA LAND TRANSFER, LLC 1102. Ablllract or tlllu88rdllo '::';::0:.:\": ......:.,. .... ..... .<.',; 1103. TIlle eJUlminallon 10 ... . ;.' .'. ,.......;..,'...,.>.'::.::.,...,. Mi.Clh.ae~ Bc?'ag.s, Esquire - POC Mi'chae~ J:::~ :._Pyk~sh_l'~S:~~'':<::'::_;':,;:;-'';'' On 1104. Tille insumnce binder 10 1105. Documenl preparallon 10 1106, Nolaly feos 10 1107. Altomey's re~ to (Includes abovll lIel1\$ Numbers: 1108.(::s~: ti:amS'NwMe:~~'i.st%":?rk't(5!.~~~:it::i;(!',..,:.;.::\,... 1109. Lender's coverdge $11;1,0003>0 ( 1110, Owner'scoversge $1.(j(J;,.OOO:1J.() .... ..' ..... 1111. Closing Service Letter Fe:' to security Ti"~le 1112. " 1113. - ~97..- ......... 00 ) ,..., .:.-..... .-:.:..:.' 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES: 1201. Racording feas: Deed' ..' .' ':$3~:~:'~D\;;:Mq~g~g~,..:;::.::.:.!';7.";,; $~;;:;";QH:':?~:" 1202. City/county lax/stamps: Deed $~, 080.00; Mortgage 1203. Stalelax/SIBmpS: . Deed .'$1,080 ;O.o'{M~rtgagB?f;"U~;':" 1204. : ":.' :,';~~~I"Ii\~~&. f()~flr' . .'>,: ..<:,:': '" ..... >, ,.,." .... 12~. ".:" :--' .::..' 1400. TOTAL SETTLEMENT CHARGES . ...:...:.,," ...:..;.;,::.:...,;...:...-....:. .....,..: '.,' . ,,":,~"'....: ;, '.,. ".': %: .' PAID FROM BORROWER'S FUNDS AT SETTLEMENT $1,120.00 $50.00 $350.00 $175. 00 , -1." . OMi:lI~o. 2502.0265 PAID FROM SELLER'S FUNDS AT SETTLEMENT $6.00 $4.00 ) '. _$1,206,56 "':':>''''::'.''':. :..C". ......-:.. $35.00 I 'C,.. ..' $93.00 $1,080.00 " $4,120.56 $1,080.00 $5.00 $15.00 $5.00 1300. ADDITIONAL SETTLEMENT CHARGES: 1301. Survey 10 1302. P~tlnspecllon 10 1'_ 1303. Overnight Eee toLa.".or~.f'Peot:.' Da.t:x:e,,L'.;t,"p;,~~~ .s:,::;fCJll.S)' 1304. LaW' OIe DBrrel~ De t:h.l ers ~;(Tax Cert Fee Reimb) 1305. F ..... 1306. __ 1307. $1,104.00 . IIdVtl ,'d,uIUlly """."'.\1,,0 IIllJ I'IUD-) ~0l!JWIl8/1l ~)lcJl"'ln0nl dnw [0 the wesl ot my 1~l\owJedgtl and utlhef, ills i:l UUti [jnd aCClW on my accounl or by 1110 in (fus transaction. I fUlther certify Ihatl have received a copy of the HUD-1 Sottleo- It State e t. Seller 0 ..~- Cf')r(fol Borrower: Da:e: Agent: Dale: Timothy C. Yeager SeUer or Borrower: Date: AgE)nt: Dale: Elenita B. Yeager Seller or Borrower: Dale: Agent: Dale: Seller or Borrower: Dale: Agent: Dale: The HUD.1 Sot1lemenl Statement which I have prepared is a true and accurate account o(th[& transaction. I have caused or will cause the funds to be disbUlsod in accordance wilh Ihis statement. Dale: SelUeMenl Agent Date: Michael J. Pykosl1, Esquire WARNING: II is a crime to knowingly make false slatements 10 the United Slatas on this or any other similar form. Penalties upon conviction can include a fine and imprison- ment For delails see: Tille 10 U.S, Code Section 1001 and Section 10'10. os Rev-1503 EX+ (6-98) . SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Seidle, Gail E. FILE NUMBER 21-05-0619 ESTATE OF All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM CUSIP VALUE AT DATE NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH 1 148 shares of Fidelity Investments - Sprint pes Stock 24.55500 3.634.14 2 11 Series EE Bonds - Redeemed for refund of 1.114.64 purchase price 3 26 Series EE Savings Bonds 2.732.88 TOTAL (Also enter on Line 2, Recapitulation) 7.481.66 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 6-98) I fA,fltllJlf~ July 20, 2005 BANGS LAW OFFICE ATTN: MICHAEL L BANGS 429 SOUTH 18TH ST CAMP HILL P A 17011 Dear Mr. Bangs: We are responding to your request for information regarding Gayle Seidle's Fidelity account. Account Number: Z19-055638 Registration: GAIL ELIZABE SEIDLE - INDIVIDUAL Value on 6/27/2005: See attached valuation report C51436 All information in the enclosed valuation report(s) is based on assets in the above-listed Fidelity account(s) as of the date indicated on the report(s). Valuation information for these accounts is provided through Evaluation Services Inc., a third party valuation service provider. Fidelity does not warranty the accuracy of this information for any particular purpose. In addition, Fidelity does not provide legal or tax advice. Consult with an attorney or tax professional regarding any specific legal or tax situation. We hope this information is helpful. For questions concerning account holdings or instructions on how to transfer the ownership of the accounts, please caJl our Inheritor Services Group at 800-544-0003 between 8:00 A.M. and 6:30 P.M. Eastern time Monday through Friday or visit our website at www.fidelity.coln. Sincerely, Fidelity Investments Our File: WO 15448-l8JUL05 Brokerage Services provided by Fidelity Brokerage Services I..LC Member NYSE, SIPC Clearing, custody, and settlement services by National Financial Services llC Member NYSE, SIrc P.O. Box 770001, Cincinnati, OH 45277.0034 , .\ \ 'jl (,,~~'J .~? { ("1" r-..{ .,(~~;, !\j I\[) L ~ ,_~)L -' -~l ,-,,,..lO <ti ti (i) H ~ .... ::t 0 11 i Ul .... ('t ~ t-J ~ 0 .... III Of B. - ~ rt r' 11 u.l 0) 2 ~~ I'd ti ~ U\ 11 0 U\ t-J (I) 11 0 .... ct \0 0 H 11 5 ~ \0 0\ I'd 0 ( ct r' t;a .... U\ " .... Ul .... .... ~ .... t1 t ~ 0 0 0 t;a " I>> ~ 0 w Ul Ul .... 0\ .... rtlt) It) G 11 r' G ~ I'd 1110 III ~m rt Of 11 t <i i~ 0 .... ~ (J) t;a ~~ . ~ \D 0) ~~ G (lo 0) ~: ....s .... 0 ~ 0 rt m.-1 G H"'t tJom tw:11'd 11 Frt ~i; ~t " Ul . tJ: H I'd ct ..,tJ: ~~~ ~~ ~ 11 . It. ~ ~ .... 0 . m p. w ~ ~ till IJ1 P. 0 en < ~ 0 ~ G U\ ~ 11 .... - p. w I'd " 0 0 .-1 ....s ~ - 0\ H t-J - 0 .... III 0 0 ~ 0 ....t tJ 0 U\ ..... ~ to.) Ul ct 0 ~lIIl 0 0 0 t1\ IJ1 ~ i~ ('t 0 t 0\ ~ ~~ 01 - ~ 11 t-J 0 ~ ....t - 0 ;! lslm w 0 0\ 0 \~ " lIII ~ 0 0\ - 0\ S~ 0 ..... 0 - U\ to.) \0 t-J ~ ~ ....s ..... .,J Q . H .., ~ .. .-1 ~ 0 ~ H 0 tJ: ~ ~~ IJ1 I'd H ~ to.) ~i td t;a t4 < H ~ ~ Q..... ~ ~~ i 0 t S 0 0 ~ G H>' m 0\ 0 ~t-i ~ - .., tH W ....t ;:\ 0 lIIIi - ;~ t-J Q to.) w 0 r 0 t;a 0 (I) 0 H- U\ 0 U\ t;a Q~ 0 .... H 0 0 tJ ~ 0 0 0 10 .., ~, 11 .... t;a ~ 0 U\ 0 U\ Q 0 0 IJ1 ('t " 0 0 " 0 0 " u " " (I) u <tsl " w u w w S% .. " .. .,J U -.1 0\ t;a " .., 0) u.l .., U t;a \0 t;a ~ " . 0\ " 0 0) .... to.) " .... ....s t;a ~~ <0 -';d .... .... H~ 0) 0 0) ~tJ 0\ .... U\ td .... ~ 0 t ~ ~ 0 l&l ~ ~ \ It. 0 lit .... (I) .... Rev-1508 EX+ (6-98) '* SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Seidle, Gail E. IFILE NUMBER 21-05-0619 ESTATE OF 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 DESCRIPTION 1 Refund from CapitalOne Auto Finance, Inc. VALUE AT DATE OF DEATH 2.75 2 Refund of Educational Expense from CISI 400.00 3 Refund of Educational Fund 400.00 4 Sale of sofa 75.00 5 Sprint - Refund from Sprint 9.44 6 Erie Insurance Group - Refund of unused premium/cancellation of policy 116.00 7 Mortgage Guaranty Insurance Corp. - Refund/cancellation of mortgage insurance 200.60 8 Refund from Comcast Cable 3.69 9 Sovereign Bank - Account 1681708116 6.701.98 10 Sovereign Bank - Account #1684003484 600.10 11 Sovereign Bank - Account #1684003476 879.16 12 Sovereign Bank - Account #16840033468 297.34 13 Automobile - Sale of 1998 Saturn Automobile 4.500.00 14 SmithBarney -IRA Account 458-6A917-12-653 62.029.90 TOTAL (Also enter on Line 5, Recapitulation) 76.215.96 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 ScheduleE (Rev. 6-98) BAN6S LAW OFFICE 429 SOUTH 18TH STREET CAMP HILL, PA 17011 E-mail: mikebanp@verizon.net PHONE: 717-730-7310 FAX: 717-730-7374 MICHAEL L. BANGS, Attorney-at-Law WENDY S. CHESBRO, Paralegal WILLIAM E. MILLER~ JR. Of Counsel July 12, 2005 Sovereign Bank A TTN: Customer Accounts Department Post Office Box 12646 Reading, PAl 9612 SOVEREIGN BANK 1) II rill t: RECORDS RESEARCH / 10 / U '.J 10-421-RS1 . 0t 525 LANCASTER AVE. L/-r! ' READING, PA 19611 ~IU ,c.~ ( RE: Estate of Gail E. Seidle Date of Death: June 27, 2005 Account No. 1681708116 Gentlemen: Our office is assisting in the administration of the above-referenced estate. At the time of death, the decedent held several accounts and/or certificates of deposit with your bank. We need to know, for purposes of administering the estate, the following information about each of the accounts and certificates of deposit: 1. The type of account. 2. Account number. 3. Name or names in which the account was maintained. 4. The date the account was opened. 5. The value, including any accrued and unpaid interest as of the date of death. If the decedent owned any other accounls or assets with your bank, either jointly or solely in her name, we will need information about those accounts as well. For any account that may have been held jointly, we need to know the names in which it was maintained and the date it was created. Also, if you could send us a copy of the signature card or document used to create or designate the joint account, that would be most helpful. If the account was created within one year of the date of death. we need to know whether it represented a rollover or extension of a pre-existing account. I f so. then we need the date that account was opened.~ (!, .v.A..~tjjV , ~~=_L_f!l2.1g~_~~~-~-QL1-7-.---..~~r~--;fj~- ~-a=/ - / ~ ~_~~_~-~~--~-__-#5i:;f}l(ii/1~J..-_:!~~-c/!J~i ~~ - / ~ t_j~~--~!_~~~~~~~k~~~~~~'--t7-~!.t~_12 l_ff , .. g L( ~'1 P ; )JV c~~~~/ ifl /', I ~--- ~~~.!!~~t7?i'---'-'-~u~:,~-,:/~- --.. foiJ_a.cl~__ ~ Page 2 July 12, 2005 In addition to the accrued and unpaid interest, we will need to know the amount of interest actually earned on the account, if any, from the beginning of the current tax year until the date of death. This should include only interest which was earned and paid or transferred to the decedent or decedent's account as of the date of death. It should not include any accrued or unpaid interest. Your attention to this matter is most appreciated. vv~' Michael L. Bangs wsc cc: Mr. Gomer L. Stephenson, III , BILL OF SALE I, GOMER L. STEPHENSON, III, Executor of the Estate of Gail E. Seidle, do hereby sell the decedent's 1998 Saturn automobile to James V. Plassio and Audrey A. Plassio for the sale price of {VC-IL fA", ""'v,,.(7 {j Je IC,^-,,~ <>>.12 ...... ($ '76<"0 2~ ) Dollars. Date: September 9, 2005 ~ ../' -----..--.-.".... .-' ~- . \\ ~~ . OMERL'~'II1 - .... SMITH BARNEy...... cltlgroupJ September 16, 2005 Michael L. Bangs, Esquire Bangs Law Office 429 South 18th Street Camp Hill, PA 17011 Re: Date of Death Valuation for Gail E. Seidle DOD: June 27,2005 - Account Number 458-6A917-12-653 Dear Attorney Bangs: As per your request, below please fil1.d the date of death valuation for the above-mentioned account. Qk Description Price Value 1,313.54 1,380.78 97.66 251.21 311.32 4,678.00 Bank Deposit Program Evergreen Mid Cap Morgan Stanley Devel. Morgan Stanley Pac. Morgan Stanley Cap. UTS Van Kampen 1.00 5.01 22.86 14.53 15.52 9.21 $ 1,313.54 6,917.70 2,232.51 3,650.08 4,831.69 43,084.38 Total Account Value as of 06/27/2005: $62,029.90 Shuuld you have any questions, or if I can be of further assistance to YOll, please feel free to give me a call at 610-395-7700. Sincerely, ,'v...... ....... Thomas R. Cichocki Second Vice President - Investments Financial Planning Specialist Best efforts have been made to reflect the true values of these figures. however. due to the element of human error, the accuracy cannot be guaranteed. The above suggestion shall not be considered accurate and complete. The infonnation supplied has been obtained from reference sources deemed reliable. No one connected WiU1 Smith Barney can ensure any tax consequences. These suggestions are intended [or your use for arriving at a reasonable. fully explained investInent decision and not as a compilation of the only possible investment vehicle. CitigrollP Glohal Markets loc. 3500 Winchester Rd Ste 100 Allentown, PA 18104 Tel 610-395-7700 Fax 610-395-0694 Toll Free 800-433-4200 THE INFORf\I/\TION SET FORTH W/\S OBTAINED FROM SOURCES WHICH WE BELIEVE RELIABLE BUT WE 00 NOT GUARANTEE ITS ACCURACY OR COMPLETENESS. NEITIII::R THE INfORMATION NOR ANY OPINION EXPRESSED CONSTITUTES A SOLICITATION BY US OF THE PURCHASE OR SALE Of ANY SECURITIES. . Rev-1510 EX+ (6-98) *' SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Seidle, Gail E. FILE NUMBER 21-05-0619 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. ITEM DESCRIPTION OF PROPERTY DATE OF DEATH % OF DECO'S EXCLUSION TAXABLE NUMBER INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE THE DATE OF TRANSFER. ATTACH A COpy OF THE DEED FOR REAL ESTATE. 1 MONY - Money Market/Annuity 7,007.04 7,007.04 TOTAL (Also enter on Line 7, Recapitulation) 7.007.04 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule G (Rev. 6-98) - I~ ~~ An AXA Financial Company 1...111".111,,"1.1..1.1,"11'11'11.11,"1.1,".11.11111.1"1 Mrs Gail E Seidle 1014 E Simpson St Mechanicsburg PA 17055 Annuitant: Contract: Issue Date: Gail E Seidle 2VA0028216 March 07, 2000 IRA Flexible Payment Variable Annuity Report Date: June 07, 2005 Summary status as of ~rt()~ Report Date: March 01, 2005 Account Janus.-Aspen Mid Cap Grwth EQ/Ent Multi-Cap Growth EO/Bear Stearns 8m Co Grwth Janus Aspen Forty Total Unit Value 7.395800 15.042200 17.130800 9.293800 Units Held 165.4248 90.1055 157.0861 215.4462 Summary status as of ~J.!rrent Report Date: June 01, 2005 Account Janus Aspen Mid Cap Grwth EO/Ent Multi-Cap Growth EO/Bear Stearns Sm Co G rwth Janus Aspen Forty Total Current Payment Allocation Account JanusAspen Mid Cap Grwth EO/Ent Multi-Cap Growth EO/Bear Stearns Sm Co Grwth Janus Aspen Forty Tolal 96001 (9/2004) Unit Value 7.252200 14.714200 15.373100 9.592300 Units Held 165.4248 90.1055 157.0861 215.4462 Allocation -~% 25% 25% 25% 100% MOlY Life of America P.O. Box 4830 Syracuse NY 13221 Financial Professional: Harold Hoch MONY 40 Monument Road Bala Cynwyd, PA 19004 (610) 660-4565 Value Held $1,223.45 $1,355.38 $2,691.01 $2,002.31 $7,272.15 Value Held -$1,199.69 $1,325.83 $2,414.90 $2,066.62 $7,007.04 Cat. #134229 (9/04) . -\-\ OJ OJ OJ OJ ~ \~ ..." - ~*~~~ s~s ~~ rn~ rn~ rnCt> rn~ - ::0 (0 0--. 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CJ'1tO;::+: CD::::I Ei t-..::>W wO ~N NCJ'1< WOO -"" 00 t-..::>N ~~~ 00 00 00 00 00 00 oo~ \< c:: ~:::::s c;::+: (0 () ~ ~ (.V ~ l'\') l'\') U1 lO (3 .:::: t-..::>N -'" ~ ~....... -" -'" CJ'1 CJ'1 tOtO (}.I 0"> (J1 CJ'l -' -J 00 ~~\C i:>:,p.. 00 '~:..... ..l> ..l> :::::s \~ ~~ 0000 00 NN;::+: 0"'>0"> (}.I 0"'> (J1 CJ'l ~~U'J Nt-..::> ~ -'" CJ'1 CJ'1 . REV-1151 EX+ (12-99) . SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Seidle, Gail E. Debts of decedent must be reported on Schedule I. FILE NUMBER 21-05-0619 ESTATE OF ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s) attached 2,535.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Number(s) I EIN Number of Personal Representative(s): Street Address City State Zip - Year(s) Commission paid 2. Attorney's Fees Michael L. Bangs 6,500.00 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 205.00 5. Accountant's Fees 500.00 6. Tax Return Preparer's Fees 7. Other Administrative Costs 1,389.99 TOTAL (Also enter on line 9, Recapitulation) 11,129.99 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) . Rev-1502 EX+ (6-98) . SCHEDULE H-A FUNERAL EXPENSES continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Seidle, Gail E. IFILE NUMBER 21-05-0619 ESTATE OF ITEM NUMBER DESCRIPTION AMOUNT 1 Myers-Harner Funeral Home, Inc. 2.535.00 Subtotal 2.535.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-A (Rev. 6-98) . Rev-1512 EX+ (6-98) *' SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Seidle, Gail E. IFILE NUMBER 21-05-0619 ESTATE OF Include unrelmbursed medical expenses. ITEM NUMBER DESCRIPTION 1 Blockbuster Video VALUE AT DATE OF DEATH 11.46 2 Borough of Mechanicsburg - Refuse 7/1/05 to 9/30/05 46.00 3 Capital One - Personal Loan Payment 525.10 4 Capital One - Payoff of personal loan 4.860.00 5 Capital One Auto Finance - July and August payments 354.90 6 Capital One Auto Finance - Payoff of automobile loan 1.575.63 7 Chase BankOne Credit Card 8.448.26 8 Comcast - Final Bill 31.39 9 Dan Alleman, D.D.S. 25.60 10 Erie Insurance - Final balance due on automobile insurance 30.00 11 Knight Boline D'Amico Urology Assoc. 86.57 12 Milton S. Hershey Medical Center 240.00 13 Pinnacle Health Hospital 126.80 14 PP&L - Final Bill 12.92 15 PP&L Electric - Services to 7/26/05 147.71 16 PP&L Electric - 7/26/05 to 8/24/05 47.33 17 Shipley Energy - Last payment for 2004 services 414.29 Total of Continuation Schedule(s) See attached page TOTAL (Also enter on Line 10, Recapitulation) 24,268.89 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98) .. Rev-1512 EX+ (6-98) *' SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER 21-05-0619 Seidle, Gail E. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 18 Sovereign Bank - payoff of line of credit 4.504.95 19 Sprint 26.86 20 The Patriot News Co. - Final Bill 6.40 21 United Water - 6/17/05 to 7/19/05 52.47 22 United Water - 7/18/05 to 8/17/05 28.40 23 United Water - Final Bill 15.41 24 Verizon - Account #717-691-6625-717-44Y 44.32 25 Verizon - Account #717-691-7528-232-03Y 32.37 26 Verizon - Final Bill for 717-691-7528 32.51 27 Verizon - Final DSL bill 38.01 28 Wells Fargo - Mortgage Payment - July 2005 940.41 29 Wells Fargo - Mortgage payment - August 2005 940.41 30 West Shore EMS 622.41 TOTAL (Also enter on Line 10, Recapitulation) 24.268.89 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98) "W . REV-1513 EX+ (9-00) . SCHEDULE .J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT NUMBER Seidle, Gail E. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a)(1.2)] RELATIONSHIP TO DECEDENT Do Not List Trustee(s) FILE NUMBER 21-05-0619 SHARE OF ESTATE AMOUNT OF ESTATE (Words) ($$$) ESTATE OF I. Jodi L. Seidle 1817 Green Street Harrisburg, PA 17102 Kelli C. Williamson 357 Old Stage Road Lewisberry, PA 17339 Daughter one-half Daughter one-half Total 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 TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 ScheduleJ (Rev. 6-98) . . MY LAST WILL AND TESTAMENT I, Gail Stephenson Sedile, of the Borough of Mechanicsburg, Cumberland County, Commonwealth of Pennsylvania, being of sound and disposing mind and memory, do hereby declare this to be my last will and testament, revoking all former wills 'by me at any time heretofore made. FIRST, I direct my hereinafter named Executrix and Executor topay all of my just debts and funeral expenses as soon after my demise as it is practical to do so, SECOND, I give, devise and bequeath all of my personal property to my two daughters, Kelli Christine and Jodi Lynn Seidle, to be disposed of amicably by them, each to receive whatever they desire from the personal property and the remaining personal property wheresoever situate to be sold or disposed of with the benefits given to them, THIRD, I give, devise and bequeath all real property to my two daughters, above named, in equal shares; or in the case of their demise, their share to go to their children in equal shares, ':'FOURTH, in the event of the demise of myself and my children, I give, devise all of the personal and real properties to my mother, Helen Elizabeth Stephenson, and my brother, Gomer Llewellyn Stephenson,III, in equal shares, FIFfH, in the event of my demise, I appoint my brother, above named, as the guardian of my two daughters, above named, and SIXTH, I name, donstitute and appoint my mother, above named, as Executrix and my brother, above named, as Executor, without bond, of this my last will and testament. IN WITNESS WHEREOF: I hereunto set my hand to this my last will and testament this d~ day of April, /976". ~ ----<f'J:t/// ~2A/:ltJ'//{ ~~~c;/ Witnesseth: -- Register of Wills, Cumberland County, Pennsylvania INVENTORY Estate of Gail E. Seidle No. 21-05-0619 also known as I Deceased Date of Death 06/27/2005 Social Security No. 162-36-9506 Gomer L. Stephenson III The 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 located 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 the Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this Inventory. IlWe verify that the statements made in this Inventory are true and correct. IlWe understand that false statements herein are made subject to the penalties of 18 Pa. C. S. Section 4904 relating to unsworn falsification to authorities. Attorney: Michael L. Bangs Signatur : 1.0. No.: 41263 Signature: --+-;!--- Signature: . ".--', c") l..:~I..' Firm: r"w..) Address: 190 Ore Bank Road Dillsburg, PA 17019 Telephone: 432-3591 Dated: . :3 )}') 117 Ie, , I --_J Address: 429 South 18th Street Camp Hill, PA 17011 Telephone: 717/730-7310 -ry " , I "j '"~ -- ~ . r.,,) C,,) ~r~ Personal Property Cash.......................... ................................. .................................... Persona I Property.............. ............................... ............................ Stoc ks/L isted................................................................................. Stocks/C losely Held.......................................... ................... ......... Bonds............................................................................................. Partnerships and Sole Proprietorships ..................................... Mortgages and Notes Receivable............................................... All Other Property.............................. ................................... ........ Total Personal Property......................................... 71,715.96 4,500.00 3,634.14 3,847.52 83,697.62 Total Real Property................................................ 10,359.92 94t051.S41 Total Personal and Real Property......................... Total Out-of-State Real Property.......................... --- ch addit ............--. BAN6S LAW OFFICE 429 SOUTH ISTH STREET CAMP HILL, P A 17011 E-mail: mikebangs@verizon.net PHONE: 717-730-7310 FAJ{: 717-730-7374 WILLIAM E. MILLER, JR. Of Counsel MICHAEL L. BANGS, Attorney-at-Law WENDY K. STRAUB, Paralegal March 24, 2006 VIA OVERNIGHT MAIL Glenda Farner Strasbaugh, Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, P A 17013 RE: Estate of Gaile E. Seidle File No. 21-05-0619 Dear Mrs. Strasbaugh: Enclosed you will find the following documents: 1. The original and one copy of the Pennsylvania Inheritance Tax Return; 2. The original Inventory; 3. A check in the amount of $2,954.96 to pay the tax shown to be due; and 4. A check in the amount of $30.00 to pay the filing fee for these documents. Please file these documents accordingly and return a paid receipt to me in the enclosed, stamped, pre- addressed envelope. If you have any questions or require anything further, please contact me. Very truly yours, ~~ wks Enclosures cc: Mr. Gomer L. Stephenson, III