HomeMy WebLinkAbout04-20-06
.-I
15U.':J6U4.1U46
REV-1500 EX (05-04)
PA Department of Revenue
Bureau of Individual Taxes
Dept. 280601
Harrisburg, PA17128-0601
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
jL{4- 5J- 17~S
OFFICIAL USE ONLY
County Code Year
INHERITANCE TAX RETURN
RESIDENT DECEDENT
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(5 ~;
Date of Birth
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t 0 D
1(15'(;
Decedent's Last Name
Suffix
Decedent's First Name
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p, AND 1
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
Spouse's First Name
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLlCA TE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
~ 1. Original Return
File Number
o S ( 3
MI
L-
MI
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2. Supplemental Return
c::::>
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
<:::)
4. Limited Estate
c::>>
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)
C)
o
8. Total Number of Safe Deposit Boxes
c::> 11. Election to tax under Sec. 9113(A)
(Attach Sch. 0)
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CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
t.J1ND~.~ 11 fl3G ti79Y
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6. Decedent Died Testate
(Attach Copy of Will)
9. Litigation Proceeds Received
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REGISTER OF WILLS USE ONLY
Firm Name (If Applicable)
First line of address
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Second line of address
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City or Post Office
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State
ZIP Code
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Correspondent's e-mail address:
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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.
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:~E~ PRE ARER OTHER THAN ESENTATIVE ~","~!r~lQ~~"_,-,,-,,,
ADDRESS
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PLEASE USE ORIGINAL FORM ONLY
Side 1
L._,
15056041046
15056041046
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15056042047
REV-1500 EX
Decedent's Name:
_. ,_ .h..___ .._m_'~d__' ~__,,,,'_,,u_'...._.n'_. ~M ~._''''~_~__.'<'__'"~~__''''~__''~_''''"__'_'_~'__~A'_____.,~~~~~~__
Decedent's Social Security Number
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RECAPITULATION
'I, Real estate (Schedule A),
, , , , . , . . . . , . .. . , ' , . , ' , .' 1.
\ I 4--
r) l} {; t. f(;
v . '",} _
2, Stocks and Bonds (Schedule B) . ' , , , ,
2.
3, Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) 3.
4. Mortgages & Notes Receivable (Schedule D), , , . , '
4,
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E)
5,
:A ~~ f~~. :,
I) "I
I'.' 'r,
6, Jointly Owned Property (Schedule F) c:::> Separate Billing Requested, , 6,
7, Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) c:::;) Separate Billing Requested.. , , 7,
8. Total Gross Assets (total Lines 1-7).
8,
'I. () -;,~) I ~: J 'J.
~-...-.-_..------~--~.~._--"-"---_.
+ () i c L. :~ ~}
9, Funeral Expenses & Administrative Costs (Schedule H), . , ' , , , '
9.
11, Total Deductions (total Lines 9 & 10),
11,
I I ;( + () (J ,- (.
, I
l(..} . .....,.
,.-' /} 'S' 'I'
1:) C' L
-.I... L( v -'~
10, Debts of Decedent, Mortgage liabilities, & Liens (Schedule I). , , ,
10,
12, Net Value of Estate (Line 8 minus Line 11) ,
13. Charitable ami Governmental Bequests/See 9'113 Trusts for which
an election-to tax has not been made (Schedule J) , .
" . 12,
l-:J. )..2, A-. I:; :J.
" " 13.
, ,
LJ e
'/,,1. Net Value Subject to Tax (Line '12 minus Line 13) "
. , , . , , 14.
()
'l'/\X COIVIPUTATlON - SEE INSTRUCTIONS FOR APPLICABLE RATES
'15 Amount of Line 'J4 taxable
elt the spousal tax rate, or
trelllsfers under See, 9'1'16
(a)(1.2) XO__~
'J(). J\mollnt of Line '14 taxable
elt lim,al rate XO _,~.
17, Amount of Line '14 taxablE;
at sibling rate X 12
Ie 1-\lTIount of Line 14 taxable
at collateral rate X. '15
0 . 15.
(; . '16,
0 17,
() . 18,
19. TAX DUE.
"....,19,
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20, FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
C.:,
Side 2
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15056042047
15056042047
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kEV-1500 lex Page 3
File Number
Decedent's Complete Address:
DECEDENT'S NAME
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STREET ADDRESS
(ill - \ f. l\( ,I/CvIA j)(,rJe
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CITY
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STATE ('i
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Tax Payments and Credits:
1. Tax Due (Page 2 Line 19) (1)
2. Credits/Payments
J\. Spousal Poverty Credit
B. Prior Payments
C. Discount
(\,
'''"-/
Total Credits ( A + B + C ) (2)
Ie;
3. Interest/Penalty if applicable
D. Interest
I:. Penalty
Total Interest/Penalty ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2, Line 20 to request a refund. (4)
L~
'.1
I.'
13. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(5)
(5A)
(56)
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5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
J\. Enter the interest on the tax due.
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Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRI/\ TE BLOC~\S
1. Did decedent make a transfer and: Yes No
,1. 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 [gJ
c. retain a reversionary interest; or ............................. ... ..................................... ..................... .......................... D [RI
D ~
d. receive the promise for life of either payments, benefits or care? ...................................................................... ~
2 If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ......................................................................................................... D ~.
3. Did decedent own an "in tl'ust for" or payable upon death bank account or security at his or her death? .............. D 18J
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains CI beneficiary designation? ..... .......................................... ............................................... ...... D jg1
IF THE t\NSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS Pl~RT OF THE r~ETlJRN.
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. 89116 (a) (1.1) (i)].
For dates of death on or after January '\, 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. 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 zero (0) percent [72 P.S. 89116(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. 89116(1.2) [72 P.S. 89116(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. 89116(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
R ID NT ENT
ESTATE OF FILE NUMBER
FLOOD RANDY L 21 05 0863
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.
SCHEDULE A
REAL ESTATE
ITEM
NUMBER
1.
DESCRIPTION
591-18 Geneva Drive, Mechanicsburg, PA 17055 condominium unit sold to unrelated
third party for the amount shown on HUD-1 settlement statement, a true copy of which
is attached hereto, settlement occurring on 4/6/06
VALUE AT DATE
OF DEATH
114,500.00
TOTAL (Also enter on line 1, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
114,500.00
-0 o ,r
IA. B. TYPE OF LOAN:
- l.oFHA 2.0FmHA 3.00CONV. UNINS. 4.0VA 5. OCONV. INS.
U.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT
6. FILE NUMBER: 17. LOAN NUMBER:
, SETTLEMENT STATEMENT YOU64-06 126636905
8. MORTGAGE INS CASE NUMBER:
C. NOTE: -
This form is f"mislled 10 give you a slalemenf of acfuaf seff/emenf coslS. Amounfs paid fo and by the seff/ement agent are shown.
Items marked "(POC)" were paid outside the closing; they are s/JOwn here for informational purposes and are not hlcluded in the totals.
_. 1.0 3/96 !YOU6<l.06.PFDfYOU64-06f7)
D NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER:
ROBERT A. YOUNG, III ESTATE OF RANDY L. FLOOD COUNTRYWIDE HOME LONAS
5130 EAST TRINDLE ROAD 591 GENEVA DRIVE 2512 EASTERN BLVD.
MECHANICSBURG, PA 17050 MECHANICSBURG, PA 17055 YORK, PA 17402
G. PROPERTY LOCA TION: H. SETTLEMENT AGENT: 25-1619811 I. SETTLEMENT DATE:
591 GENEVA DRIVE TRI-COUNTY ABSTRACT SERVICE
MECHANICSBURG, PA 17055 April 6, 2005
CUMBERLAND County, Pennsylvania PLACE OF SETTLEMENT
3223 MARKET STREET
CAMP HILL, PA 17011
-
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. Contracl Sales Price ! 114,500.00 401. Contract Sales Price I 114,500.00
102. Personal Prooerty , 402. Personal Pro'"ertv'
I
103. Seltlemenl Charaes to Borrower (Line 1400) 6,063.66 403.
104 404.
105. I 405.
Ad"us/ments For Items Paid Bv Seller in advance Ad!Ustmenls For Items Paid Bv Seller in advance
106. CilvlTown Taxes 04/06106 10 01101107 I 275.43 406. CiiViTown Taxes 04/06106 to 01101/07 : 275.43
107. Coul1ty Taxes to I 407. CounlVTaxes 10 I
108 SCHOOL TAX 04/06106 to 07/01/06 I 303.72 408. SCHOOL TAX 04/06/06 to 07/01106 I 303.72
109 I 409. I
110. I 410.
111. I 411. I
1'12. I 412. I
, I
120. GROSS AMOUNT DUE FROM BORROWER ! 121,142.81 420. GROSS AMOUNT DUE TO SELLER 115,079.15
200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER:
201. Deposit or earnest monev- 5,72500 501. Excess Deoosil ISee Instructions) I
202. Principal Amount of New LomliSf I 84,000.00 502. Settlement Cha-roes 10 Seller (Une 1400) 9.114.63
203. Existil1n loanls\ taken sub'eelto I 503. Exislinoloai'iiSllaken subieclto
204. I 504. Payoff of first Mortgage to THE WASHINGTON SAVING 77,154.93
205. I 505. pavolt ot second Mortn'lOe
206. I 506. I
207 I 507. Deposit disb. as nroceeds I
208. I 508. I
209. I 509. I
Adllstm8nls For Ilems Unpaid Bv Seller Adiustments For Items Unoaid Bv Seller
210. Cily/Town Taxes 10 I 510. CitWTown Taxes to I
211. CounlvTaxes 10 511. CountVTaxes to I
212. SCHOOL TAX to 512. SCHOOL TAX 10 I
213. SEWER 04/01106 to 04/06/06 5.49 513. SEWER 04/01106 to 04/06/06 5.49
214. APRIL CONDO DUES 04/01106 to 04/06/06 21.67 514. APRIL CONDO DUES 04/01/06 10 04/06/06 21.67
215 515.
216. , 516.
,
217. I 517.
2t8. I 518.
219. I 519. I
220. TOTAL PAID BY/FOR BORROWER I 89.752.16 520. TOTAL REDUCTiON AMOUNT DUE SELLER I 86,296.72
300. CASH AT SETTLEMENT FROM/TO BORROWER: 600. CASH AT SETTLEMENT TO/FROM SELLER:
301. Gross Anlount Due From Borrower (Line 120) I 121,142.81 601, Gross Amount Due To Seller fLine 420\ 115,079.15
302. Less Amount Paid By/For Borrower (Une 220) I( 89,752.16} 602. Less Reductions Due Seller (Line 520) I( 86,296.72
303. CASH{ X FROM)( TO) BORROWER I 31,390.65 603. CASH ( X TO) ( FROM) SELLER I 28,782.43
OMB NO 2502 26-"'"
The undersigned r,ereby acknowledge receipl of a completed copy of pages 1 &2 of this statement & any attachments referred 10 herein.
I HAVE CAREFULLY REVIEWED THE HUD-l SETTLEMENT STATEMENT AND TO THE BEST OF MY KNOWLEDGE AND BELIEF, IT IS A TRUE AND
ACCURA TE STATEMENT OF ALL RECEIPTS AND DISBURS,EMENTS MADE ON MY ACCOUNT OR BY ME IN THIS TRANSACTION. I FURTHER CERTIFY
THAT I HAVE RECEIVED A CO, p. r OF..',~~E ~,L UD-l S::Tf.J;MENT STATEMENT. J. . '. " .,' " j (, -". A--
Borrower '."', -., f/ l~ \,.-- 'A Se"er / if., ,?;!A~ - ./tz../..--.. t-)CI! ct.t-f! l.--j
ROBERT A YOUNG, III'{ d"S ATE'OF ANDY L. FLOQ (
TO THE BEST OF MY to.w DGE. T, HE, HUD.~ETTLEM~N1 STATE, MENT WHICH I HAVE PREPARED IS A TRUE AND ACCURATE ACCOUNT OF THE
FUNDS WHICH WERE l'~'5 ED AND 'pAVE BE N 0 L~ B 9, URSED BY THE UNDERSIGNED AS PART OF THE SETTLEMENT OF THIS
TRANSACTION. '\" I.'" _ t-.t-, ,t/, . _ _ '-.
SETTLEMENT OFFICER /
Setllement Agent ()
WARNING: IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE UNITED STATES ON THIS OR ANY SIMiLAR FORM. PENALTIES UPON
CONVICTION CAN INCLUDE A FINE AND IMPRISONMENT. FOR DETAILS SEE: TITLE 18 U.S. CODE SECTION 1001 & SECTION 1010.
L. SETTLEMENT CHARGES
..IT AL COMMISSION Basad on Price $ 114,500,00 (cj) 6,0000 % 6,870,00 PAID FROM PAID FROM
-Division of Commission line 700J as FOllowS," BORROWER'S SelLER'S
/01. S 3,460.00 to REMAX REALTY PROFESSiONALS, INC. FUNDS AT FUNDS AT
702. $ 3,410.00 to TAMANINI REAL ESTATE SETTLEMENT SETTLEMENT
703. Commission Paid at Settlement 6,870.00
704. TRANSACTION FEE to REMAX REALTY PROFESSIONALS, INC. 125.00
BOO. ITEMS PAYABLE IN CONNECTION WITH LOAN
801. Loan Onoinalion Fee % to
802. Loan Discount 1.6250 % to COUNTRYWIDE HOME LONAS 1,365.00
803. Appraisal Fee to COUNTRYWIDE HOME LONAS $320 POC 160.00
804. Credit Report to COUNTRYWtDE HOME LONAS $35.00 POC
i 805. Lender's Inspection Fee to
i SOG Mort9aqe Ins. App. Fee to ,
1807, Assumption Fee to
1806. TAX SERVUCE FEE to COUNTRYWIDE TAX SERVICE 90.00
1809. FLOOD CHECK FEE to LANDSAFE FLOOD 26.00
,310. DOCUMENT PREP FEE to COUNTRYWIDE HOME LONAS 300.00
I~~__.
900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE
901. Inleresl From 04/06/06 to 05/01/06 @ $ 14.670000/day ( 25 days %) 366.75
902. Marte aqe Insurance Premium for months to
903. H~zard Insurance Premium for 1.0 vears to
904.
f-'-C
1905.
_:000. RESERVES DEPOSITED WITH LENDER
11001. Hazard Insurance months $ Der monlh
11002. Mortqaae Insurance months $ Der month
11003. Cit'lITown Taxes 4.000 months a $ 31050er month 124.20
11004. COLw,ly Taxes months a $ ner monlh
11005. SCHOOL TAX 12.000 months @ $ 107.42 per month 1,289.04
100li months (cj) $ Der month
1007 monllls a $ ner month
~AGGREGATE ESCROW ADJUSTMEI months (cj) $ ner month -124.21
1100. TITLE CHARG ES
1101 Seltlement or Closing Fee to
1102. CLOSlI~G PROTECTIOH LETTER to FIRST AMERICAN TITLE INSURANCE COMPANY 35.00
,1103. Title EXCllT1ination to
W104 Title Insurance Binder to
11105. Document Preparation to
1106. Notarv Fees 10 CASH 12.00 6.00
1107. .~lIorney's Fees to ANDREW WINDER ESQ SELLER (POC)
(includes alJove item numbers:
1108. Title InSUfC1tlCe to TRI.COUNTY ABSTRACT SERVICE AGENT REISSUE 840.38
includes above item numbers:
1109. lender's Coverage $ 84,000.00 105097963
1110. Owner's Covp-rage $ 114,500.00 840.38 104505930
1111. ENDORSEMENTS to TRI-COUNTY ABSTRACT SERVICE 100,300,8.1 150.00
1112.
1113.
f-----
c23.o0. GOVERNMENT RECORDING AND TRANSFER CHARGES Releases $
1201. Recording Fces: Deed $ 38.50; Mortgage $ 76.50; 27.00 115.00 27.00
1202. Cil'l/Counly Tax/Slamps: Deed 1,145.00' Mortoaae 1,145.00
1203. Slale Tax/Slemps: Revenue Stamps 1,145.00; MortoaOe 1,145.00
120-1. ELECTRONIC DOCUMENT RETRIEVAL to TRI-COUNTY ABSTRACT SERVICE 25.00
1205. OVERNIGHT/COURIER FEES to TRI-COUNTY ABSTRACT 14.50 14.50
1300. ADDITIONAL SETTLEMENT CHARGES
1301. Survey 10
1302. Pest Inspection to
1303. TAX CERTIFICATION FEE to TRI-COUNTY ABSTRACT SERVICE 5.00
~2006 COUt,iTY/TOWNSHIP TAXES to MARLIN A. YOHN, SR., TAX COL. 42-24-0791-163-GB7-4 365.10
1305. See addit'l disb. exhibit to 130.00 557.03
~~, TOTAL SETTLEMENT CHARGES (Enter on Lines 103, Section J and 502, Section K) 6,063.66 9,114.63
8, "9""'9 p;'y' , ,"h" ''''00'''''. ".. "Y"'"'"'' ,,'~wl"y, "'''pI ,I . "mpl",' '0" 01 P'9' 2 o"hi, 'wo p,,' ~5mkd )11~-(~--,
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I-'oge;t.
,SETTLEMENT OFFICER
Selllement Agent
(
Cel1i!ied to be a Irue copy.
I YOU6.\-C61 VOUG4.06 I 7 I
L=~._!..~~'.~~~?!,~~~.~~~~~~~~,~~~~_~~
Borrower: ROBERT A. YOUNG, III
Seller: ESTATE OF RANDY L. FLOOD
lender: COUNTRYWIDE HOME LONAS
S0ttlement Agent: TRI-COUNTY ABSTRACT SERVICE
(717)761-8870
Place of SetHement: 3223 MARKET STREET
CAMP HILL. PA 17011
S8ttlement Date: April 6. 2006
Property Location: 591 GENEVA DRIVE
MECHANICSBURG, PA 17055
CUMBERLAND County, Pennsylvania
PA YEEIDESCRIPliON
NOTE/REF NO
BORROWER
SELLER
UP[:>ER ALLEN TWP AUTHORITY
SEWER JANUARY/MARCH
PROPEfHY MANAGEMENT, INC.
RESALE CERTIFICATE
TRI-COUNTY ABSTI~ACT SERVICE
PREP;\RE SATISFACTION PIECE
SUNGUILD CONDO ASSOCIATION
APRIL CONDO DUES
BITNER ELECTRIC
ELECTRIC REPAIRS
650318
100.00
75.00
591-.18 GENEVA DR.
25.00
130.00
GARAGE & UNIT
357.03
Total Additional Disbursements shown on Line 1305
$
130.00
$
557.03
IVt'\llC:/l fie: Dcn/vnl't:'A (lei,
~,~".,'" '*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
FLOOD RANDY
L
FILE NUMBER
21 05
0863
Include the proceeds of litigation and the date the proceeds were received by the estate, All property jointly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
Washington Savings Bank - checking account date of death balance of
VALUE A T DATE
OF DEATH
2,209.79
2.
Commerce Bank - checking account date of death balance
14,431.11
3.
Providian Bank - savings account date of death balance
53.33
5.
Washington Savings Bank profit-sharing trust fund (not available to beneficiaries or
estate until September, 2007, pursuant to the terms of the employment agreement of
decedent with Washington Savings
1995 Jeep Grand Cherokee at approximate blue book value
3,017.69
4.
4,500.00
6.
Miscellaneous personal property, clothing, condo contents, etc.
1,639.90
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
25,851.82
~""..r""_
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
FLOOD
FILE NUMBER
RANDY
L
21
05
0863
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Funeral and related expenses 9,470.40
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s)
Social Security Number(s) I EIN Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
2. Attorney Fees Andrew L. Winder, Esquire - reserve for possible attorney's fees 4,000.00
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 Cumberland County Register of Wills - probate of Will, grant of letters, etc. 500.00
5. Accountant's Fees Preparation of income tax returns 150.00
6. Tax Return Preparer's Fees
7. John Fenstermacher, Esquire - attorney's fees 1,799.70
8. Washington Savings Bank - mortgage payments made after death and before settlement on condo sale 3,749.47
9. Sovereign Bank - vehicle loan payment 340.00
10. Progressive Insurance - vehicle insurance 89.33
11. Verizon - telephone/cell bill(s) 283.71
12. PPL - electricity in condo 624.20
13. Upper Allen Twp Authority - sewer rates for condo 305.49
14. Condo association fees 949.67
15. ReMax Realty Professionals, Inc. - realtor's commission and fees for condo sale 7,031.00
16. Tri-County Abstract Service - fees for condo sale 44.50
17. Cumberland County Recorder of Deeds - realty transfer tax 1,145.00
18. Bitner Electric - electrical repairs in condo 357.03
TOTAL (Also enter on line 9, Recapitulation) $ 40,106.28
(If more space is needed, insert additional sheets of the same size)
FLOOD
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
RANDY
L
21
05
0863
Paqe 1
Schedule H - Funeral Expenses & Administrative Costs - 87
ITEM
NUMBER
AMOUNT
DESCRIPTION
19.
20.
21.
22.
23.
24.
25.
Upper Allen Twp Authority - sewer rates due at settlement
Property Management Inc. - resale certificate
Marlin Yohn, Tax Collector - 2006 Co/Twp taxes due
Condo association fees for 4/1/06-4/6/06
C & Z Contractors - repairs to water damaged areas of condo
Carpet and installation to replace damaged carpet in condo
Plumbing and lock repair in condo
105.49
75.00
365.10
21.67
5,345.26
3,225.96
128.30
SUBTOTAL SCHEDULE H.B?
9,266.78
.~'"m.,,''' '*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
ESTATE OF
FLOOD
FILE NUMBER
RANDY
L
21
05
0863
Include unreimbursed medical expenses.
ITEM
NUMBER
1,
DESCRIPTION
Washington Savings Bank - balance due on mortgage as of settlement date for sale of
condo
AMOUNT
78,878,92
2,
Uninsured medical expenses due and unpaid as of decedent's date of death
3,453,39
3,
Principal amount on loan of funds from Gail McWilliams, decedent's sister, to decedent
during his final illness for miscellaneous costs of care
30,147,75
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
112,480,06
""",m.",", '*'
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
FILE NUMBER
FLOOD RANny L 21 Of) ()RR~
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
1. TAXABLE DISTRIBUTIONS (include outright spousal distributions)
1. Julia Beddia niece 25% of residue
2. Angela Sutch niece 25% of residue
3. Ryan McWilliams nephew 25% of residue
4. Nickolaus Flood nephew 25% of residue
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)
83/07/2085 15:J4
7176915<:141
FEtjSTER/I'I,I.!,CHE~:&ASSOr:: .
PAGE 0:2
LAST WILL AND TE~TAMENT
OF
RANDY L FLOG!;!
I, Randy L. Flood, now or fomlerly of Mechanic.sburg, Cumberland County,
Pennsylvania, being of sound and disposing mind and memory, <10 make, publish and
declare this to be my Last Will and Testament, hereby revok.ing i'J1I Wills and Codicils by
me at any time marJe.
lTEtvl 1: I direct that aU 1nhGritance and estate taxes becoming dw:~ by
reason of my death, whether such taxes may be payable by my Estate or by any recipient
of any property, shall be paid by my Executor out af the property p<:lssing under this Wiil.
which is not specifically devised or bequeathed, as an expense and cost of administration
of my Estate. My Executor shall have no duty or obligation to obtain reimbursement for
any such tax paid by my Executor even though on proceeds of insurance or other
property not passing under this Will.
)rEM II: I hereby exercise all powers of appointment 'Nhich I may' have at
the time of my death in favor of my Executor, and all property subject to all sllch powers
shall be included in my Estate,
ITEM Ill: I give and bequeath all my household fumiture and furnishings,
automobiles, books, pictures, jewelrf, china, linen, silver-ware, wearing apparel, and all
:~/U!!~~~5 15:44
71759154<:11
FEHSTERM!~(:HER.S',AS';O(: .
r::AGE (1~
other like articles of household or personal use and adornment to my nieces, Julie Be\jdia
and Angela Sutch, and nephews, Ryan McWilliam and Nickolau3 Flood to be distributed
to them in equal shares by my Executor.
ITEM IV: I give, devise and bequeath all of the rest, residue and remainder
of my property, real, personal and mixed, to nieces, Julie Beddia and Angela Sutct'l, and
nephews, Ryan McWilliam and Nickolaus Flood to be distributed to them in equal shares.
IT.f.M V: In the settlement of my Estate, my Executor shall possess, among
others, the following powers to be executed for the best interesi of the beneficimies:
(a) To sell, either at public or private sale and upon such terms and
conditions as my Executor may deem advantageous to my Estate, any or
all real or personal estate or interest therein, whether owned by me
severally or in conjunction with other persons or acquired after my death by
my Executor, and to consummate said sale or sales by sufficient deeds or
other instruments to the purchaser or purchasers, conveying a ree simple
title, free and clear of all trust and without obligation or liability of the
purchaser Of purchasers to see to the application of the purchase money or
to make inquiry into the validity of said sale or sales; also, to m:;ke, execute.
acknowledge and deliver any and all deeds, assignments, options or other
writings which may be necessary or desirable in carryinG out any of the
powers conferred upon my Executor in this Paragraph V (a) or elsewhere in
my Will.
Page 2 elf 8
C3/07!2005 15:44
7175915441
FEHSTERtv1ACHER&A'::~S[lC .
P~l~E Ijd
(b) To pay all costs, taxes, expenses and charges in connection with
the administration of my Estate. My Executor shall pay expenses of my last
illness and funeral expenses.
(c) To distribute my Estate in kind or in money. If any assets are
distributed in kind, they shall be distributed at their respective value(s) on
the date(s) of their distribution.
(d) To retain any investments I may have at my death so long as my
Executor may deem it advisable to my Estate so to do.
(e) To vary investments, when deemed desirable by my Exec:utor
and to invest in such bonds, stocks, notes. money markets, real estate
mortgages or other securities or in such other property, reel or personal, as
he shall deem wise, without being restricted to so-called Illegal
investments."
(f) To mortgage real estate and to make leases of real est...~ti.3.
(g) To borrow money from any party to pay indebtedness of mine or
of my Estate. expenses of administration or inheritance, legacy, estate and
other taxes.
(h) To vote any shares of stock which form a part of the Estatc-!) ~md
to otherwise exercise all the powers incident to the ownership of such stock.
Page 3 of 8
03;07/2005 15:~4
7176915441
FEt-l:3TERW,CHER&ASSOC.
F;~GE tJ5
(i) In the discretion of my Executor, to unite with other owners of
similar property in carrying out any plans for the reorganization of any
corporation or company whose securities fOml a part of the Estate.
m To distribute my personal property directly to the Guardian of the
person of any minor beneficiaries hereunder.
(k) To elect such settlement options as deemed most appropriate by
my Executor with respect to any pensIon, protit sharing or other retirement
plan in which I am a participant.
(I) To do all other acts in the judgment of my Executor necessary or
desirable for the proper and advantageous management, investment and
distribution of my Estate.
HEM VI: Any person who shall have died at the same time ~::lS Testator or
in a common disaster with him. or under such cirCl.Jrnstances that it is difficult or
impossible to determine wtlO died first, shall be deemed to have predeceased her.
JIF;:M VJ!: If, at any time, any minor child or disabled person shall be
entitled to receive any assets hereunder, Gail L. McVVilliams of Mifflintown, Pennsylv::.nia,
shall act as Guardian of the assets payable to such person. Said Gi.lardian may receive
and administer all assets authorized by law and shall have full authority to use such
assets, both principal and irlcome, in any manner said Guardian shail deem advisable for-
the best interest of such person, including college, university, pcst~graduate or other
education, without $fZlCIJring court order. Said Guardian shall have all the rights. and
Page 4 of 8
Ug!07!2885 15:4L
n 75:)1 5441
FEHS Tr::RHACHEP&t~:;SiJC .
F'l).,(,E C1h
privileges as. to the Guardianship and the assets thereof as are herein ~~ranted to my
Executor 8S to my Estate and the assets therein.
ITEM 'Jljl: I nominate, constitute and appoint my sister, Gail L. [v1cWilliams,
to be my Executrix (herein referred to as "Executor"). My Executor and Guardian ,are
specifically relieved from their duty or obligation of filing any bond or bonds.
IN WITNESS WHEREOF, I have set my hand and seal to this my Last Will
and Testament, consisting of this, the next three (3) pages and the pf"(!cedin9 five (5)
oft
pa~J€s this ( .....-. day of May, 2005.
~".~--_._,. ....
I ,.
!/.~...-'! .
. _ ( ;{ (;\ 1-1./.---
- ~--~-->----~.__._._-----
Ra9tiy L. Flood
Page 5 of 8
~9!07/2~05 15:44
7175':115441
FEHSTE.~tvlt\CHER~(~\SSOC .
F.V;[ u,
SIGNED, SEALED, PUBLISHED AND DECLARED by the above named
Testator, Randy L Flood, as and for his Will, in the presence of us, who, at his request, in
his presence and in the presence of each other, have hereunto subscribed our names as
witnesses in attestation thereof.
--0"
~...-...
..~r- '.' ..
(_;:_ct
............,i
5115 East Trindle Road
Mechanicsburg, PA 17050
~L-,tl~
I
72 South Pin Oak Drive
Boiling Springs, PA 17007
Page 6 of 8
'-~? ~rl ~.~u~ ~~.~4
n, ib':l15441
FEHSTERMACHER&I~SSOC .
P,':,GE II
AGlSNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA
88.:
COUNTY OF CUMBERLJ.\NC>
I, Randy L. Flood, the Testator whose name is signed to the attached or
foregoing instrument. having been duly qualified according to law, do hereby
acknowledge that I signed and executed the instrument as my last Will; and that I signed
it willingly and as my free and voluntary act for the purposes therein expressed.
Sworn to or affirmed and acknowledged before me by Randy L Flood. the
Testator, tt,js 9-tA day of May, 2005.
""---,
r/ / -.;1'
------f;;: -~,. L ~.-:~~~_________.
I
N~i~LR.. Jh~_--_
My Commission Expires:
(SEAL)
- ----~--._-------...----
_.._--, - NOTI~RiALSE.4L i
CONNIE R. SHULTZ. N,,!ar) P~bl>':, \
N'e:;hiiflicsb<Jrg BOlD" GumIJeri,lIv:l (;~~q;y
My Commi,s;on t:xICir8S AI~8.~_~q ~:S
~--
Paae 7 of 8
]9/07/2[05 15:44
7J. 75'j15441
FEH';TE,~r-,.:/4CHERS',ASSOC ,
F'q(iE (j':
~FFIDAVIT
COMMONWEALTH OF PENNSYLVANIA
88,:
COUNTY OF CUMBERLAND
We, John R. Fenstermacher and Robyn A Cronin, the witnesses whose
names are signed to the attached or foregoing instrument, being duly Qualified according
to law, do depose and say that we were present and saw the Testator sign and execute
the instrument as hid Last Will; that the Testator signed wiHingly and executed It as hid
free and voluntary act for the purposes therein expressed', thai each subscribing witness,
in the hearing and sight of the Testator, signed ttle Will as a witnes,s; and that to the best
of our knowledge, the Testator was at that time 18 or more years of age, of sound mind
and under no constraint or undue influence.
Sworn to or affirmed and subscri~ed to beft)m me by .John R,
Fenstermacher and Robyn A, Cronin, witnesses, this~lday of May, 2005.
\. /-.
~~-
( V~itness ___..m__W_'_,__,.
"
J f?v~ a-C.~__
Witness
.~./1.-'-~'3-1. c.__________
NbtaPj-.Public -0
My ComrilisSIOI1 Expires:
(SEAL)
---'~---l
r-u.~OT~\RiAL SEAL
GONNIf. R. S!~ULTZ, Not:<IY FI)~i1~~ , .
Mecl'1anicsttui'g Bore., CllmnC[icFld "~')~'J \
"" Commis';ii'ln E~PV<;5 Au:J\lS, 19, oO...() j
.:~~~-c~~..--._._.._-
Page 8 of 8