HomeMy WebLinkAbout05-05-06
]OHN E. SLIKE
ROBERT C. SAlDIS
]AMES D. FLOWER, JR
CAROL]. LINDSAY
MICHAEL 1. SOLOMON
BRIAN C. CAFFREY
GEORGE F. DOUGLAS, III
THOMAS E. FLOWER
MARYLOU MATAS
SUZANNE C. HIXENBAUGH
LAW OFFICES
SAIDIS, FLOWER & LINDSAY
A PROFESSIONAL CORPORATION
2109 MARKET STREET
CAMP HILL, PENNSYL VANIA 17011
TELEPHONE: (717) 737-3405 - FACSIMILE: (717) 737-3407
EMAIL: attorney@sfl-Iaw.com
www.sfl-Iaw.com
CARLISLE OFFICE:
26 WEST HIGH STREET
CARLISLE, PA 17013
TELEPHONE: (717)243-6222
FACSIMILE: (717)243-6486
REPLY TO CAMP HILL
May 3, 2006
Cumberland County Courthouse
Courthouse Square
Carlisle, P A 17013
Re: The Estate of Thomas A. Melton
File No. 21-06-0003
Dear Ladies:
Enclosed please find an original and two copies of an Inheritance Tax Return in regard to
the above estate. Also enclosed are checks for the filing fee and the tax due. Please return a
time-stamped copy ofthe return to our office in the envelope provided.
Thank you.
Very truly yours,
1
s~ /'It./LOWER & LINDSAY
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Enclosures
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OFFICIAL USE ONLY
REV.15oo EX ~ (6-00)
REV.1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
FILE NUMBER
II
06
0003
NUMBER
COUNTY CODE YEAR
SOCIAL SECURITY NUMBER
DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL)
Melton, Thomas Arthur Jr.
DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
259-18-7120
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THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
11-03-2005 12-06-1920
(IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL)
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
o 3. Remainder Retum (date of death prior to 12-13-82)
o 5. Federal Estate Tax Return Required
o 8. Total Number of Safe Deposit Boxes
o 11.Election to tax under Sec. 9113(A) (Attach Sch 0)
2. Supplemental Return
Original Return
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4a. Future Interest Compromise (date of death after
12-12-82)
7. Decedent Maintained a Living Trust (Attach
copy of Trust)
10 Spousal Povertv Credit (date of death between
. 12-31-91 and H-1l5)
Limited Estate
Decedent Died Testate (Attach
copy of Will)
Litigation Proceeds Received
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NAME
John E. Slike, Esq.
FIRM NAME (If applicable)
Said is, Flower & Lindsay
TELEPHONE NUMBER
(717) 737-3405
COMPLETE MAILING ADDRESS
2109 Market Street
Camp Hill, PA 17011
1, Real Estate (Schedule A)
(1 ) 145,000.00
(2) , 3,515.96
(3) None
(4) None
(5) 7,990.83
(6) 6,919.37
(7) None
(8)
(9) 29,403.56
(10) 6,414.52
OFFICIAL USE ONLY
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2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
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4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7 . Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L) 0 Separate Billing Requested
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
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163,426.16
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
(11 )
35,818.08
127,608.08
0.00
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)
14. Net Value Subject to Tax (Line 12 minus Line 13)
(13)
(14)
127,608.08
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15,Amount of Line 14 taxable at the spousal tax rate, 0.00 x .00 (15)
z or transfers under Sec. 9116(a){1.2)
0
i= 16. Amount of Line 14 taxable at lineal rate 127,608.08 x .045 (16)
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D. 17. Amount of Line 14 taxable at sibling rate 0.00 x .12 (17)
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0
u 18. Amount of Line 14 taxable at collateral rate 0.00 (18)
~ x .15
19. Tax Due (19)
0.00
5,742.36
0.00
0.00
5,742.36
20.0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
Copyright 2002 form software only The Lackner Group, Inc.
Form REV-1500 EX (Rev. 6-00;
\1\) V
,
.
,
Decedent's Complete Address:
STREET ADDRESS
4 Annette Dr.
CITY Enola
ISTATE PA
I ZIP 17025
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
5,742.36
4,900.00
257.89
Total Credits (A + B + C)
(2)
5,157.89
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty (0 + E)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(3)
(4)
(5) 584.47
(5A)
(5B) 584.47
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;.................................................................................. D ~
b. retain the right to designate who shall use the property transferred or its income;.................................... D ~
c. retain a reversionary interest; or.................................................................................................................. D ~
d. receive the promise for life of either payments, benefits or care?.............................................................. D ~
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration? ..... .................. ........ ..... ........... .......... ...................... ....................................... D [!]
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... D ~
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation?.............................................. ................. ......... .......................... ................... D [!]
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 pe~ury. I declare that I have examned this return, including accompanying schedules and statements. and to the best of my knowledge and belief, it is true, correct and
compiete. Declaration of preparer other than the personal representative is based on alllnforrnation of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS
Jos C. Melton
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DATE
33 Augusta Drive
Annville, PA 17003
&
ADDRESS
ADDRESS
2109 Market 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. 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 0%
[72 P.S. S9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure
of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a
natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. S9116 (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.
S9116 1.2) [72 P.S. S9116 (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. 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.
Rev-1502 EX+ (6-98)
SCHEDULE A
REAL ESTATE
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Melton, Thomas Arthur Jr.
FILE NUMBER
21-06-0003
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 jolntly-owned with right of survivorship must be disclosed on schedule F.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
1
4 Annette Drive, East Pennsboro Township, Cumberland County, PA - see
settlement sheet attached
145,000.00
TOTAL (Also enter on Line 1, Recapitulation)
145,000.00
(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)
Rev-1503 EX+ (6.9B)
*'
SCHEDULE B
STOCKS & BONDS
COMMONWEALTH OF PENNSYLVANIA
INHERrfANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Melton, Thomas Arthur Jr.
FILE NUMBER
21-06-0003
All property Jolntly-owned with right of survivorship must be disclosed on Schedule F.
ITEM CUSIP VALUE AT DATE
NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH
1 2 Series E bonds, face value $50 531.96
2 4 Series EE bonds, $500 face value 2.984.00
TOTAL (Also enter on Line 2, Recapitulation) 3,515.96
(If mDre 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)
Rev-150B EX+ (6.9B)
I*,
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTHOFPENNSYLVAN~
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Melton, Thomas Arthur Jr.
FILE NUMBER
21-06-0003
ESTATE OF
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property Jolnlly-owned with the right of survivorship must be disclosed on schedule F.
ITEM
NUMBER DESCRIPTION
1 M&T Bank, checking acct. #59540982 (Thomas Melton and Vivian Melton who
predeceased Thomas)
VALUE AT DATE
OF DEATH
5.402.83
2 1998 Buick Century automobile, 71,000 miles
2,245.00
3 Household Furnishings - items sold at yard sale
343.00
TOTAL (Also enter on Line 5, Recapitulation)
7.990.83
(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 E (Rev. 6-98)
Rev-15G9 EX+ (6-98)
*'
SCHEDULE F
JOINTLY-OWNED PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENfT
Melton, Thomas Arthur Jr.
FILE NUMBER
21-06-0003
ESTATE OF
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
A. Joseph C. Melton
ADDRESS
RELATIONSHIP TO DECEDENT
33 Augusta Dr.
Annville, PA 17003
Son
B.
C.
JOINTLY OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR VALUE OF ASSET INTEREST DECEDENTS INTEREST
JOINTLY-HELD REAL ESTATE.
1 A 4/23/2003 M&T Bank, checking acct. #951088618, 13,838.74 50.000% 6,919.37
jt. with decedent and Joseph Melton
(Vivian Melton predeceased her husband
on 10/26/05)
TOTAL (Also enter on Line 6, Recapitulation) 6.919.37
(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 F (Rev. 6-98)
REV-1151 EX+ (12-99)
*'
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Melton, Thomas Arthur Jr.
FILE NUMBER
21-06-0003
ESTATE OF
Debts of decedent must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
See continuation schedule(s) attached 11,730.01
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Social Security Number(s) / EIN Number of Personal Representative(s):
Street Address
City State Zip
-
Year(s) Commission paid 7,400.00
See continuation schedule(s) attached
2. Attorney's Fees 7,260.00
See continuation schedule(s) attached
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 347.00
See continuation schedule(s) attached
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 2,666.55
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation) 29,403.56
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
Melton, Thomas Arthur Jr.
FILE NUMBER
21-06-0003
ESTATE OF
ITEM
NUMBER DESCRIPTION
AMOUNT
1 Duke's Diner - funeral meal
1.106.31
2 Gingrich Memorials - total due
2.910.00
3
Richardson Funeral Home
7.607.70
4
Royer's Flowers - funeral flowers
106.00
Subtotal
11.730.01
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-A (Rev. 6-98)
Rev-1502 EX+ (6-98)
*'
SCHEDULE H-81
PERSONAL REPRESENTATIVE'S
COMMISSIONS
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Melton, Thomas Arthur Jr.
FILE NUMBER
21-06-0003
ESTATE OF
ITEM
NUMBER DESCRIPTION
1 Joseph C. Melton
AMOUNT
7,400.00
Subtotal
7.400.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B1 (Rev. 6-98)
Rev-1502 EX+ (6-98)
.
SCHEDULE H.82
ATTORNEY'S FEES
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Melton, Thomas Arthur Jr.
FILE NUMBER
21-06-0003
ESTATE OF
ITEM
NUMBER DESCRIPTION
1 Saidis, Flower & Lindsay
AMOUNT
7.260.00
Subtotal
7.260.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B2 (Rev. 6-98)
Rev-1502 EX+ (6-98)
SCHEDULE H-84
PROBATE FEES
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Melton, Thomas Arthur Jr.
FILE NUMBER
21-06-0003
ESTATE OF
ITEM
NUMBER DESCRIPTION
1 Register of Wills, probate costs
AMOUNT
347.00
Subtotal
347.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B4 (Rev. 6-98)
Rev-15D2 EX+ (6.98)
*'
SCHEDULE H.87
OTHER
ADMINISTRATIVE COSTS
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Melton, Thomas Arthur Jr.
FilE NUMBER
21-06-0003
ESTATE OF
ITEM
NUMBER DESCRIPTION
AMOUNT
1 Access Realty Services, house appraisal
300.00
2
Cleaning supplies, general repairs, garage sale costs, travel expenses to travel to
and from house for showings
536.12
3
Costs involved in sale of house: notary, tax certif., transfer tax - with adjustment
for pro-rated taxes
959.21
4
Cumberland law Journal, estate notice
75.00
5
house cleaning
100.00
6
lehr's Exxon, fee for marketing car for sale on their lot
200.00
7
Patriot News, estate notice
149.22
8
Postage, long distance calls
87.00
9
Register of Wills, filing fee for tax return
15.00
10
Repairs to car to pass inspection
245.00
Subtotal
2.666.55
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B? (Rev. 6-9B)
Rev-1512 EX+ (6-98)
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Melton, Thomas Arthur Jr.
FILE NUMBER
21-06-0003
ESTATE OF
Include unrelmbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1 Ambulance. transport to Good Samaritan Hospital
VALUE AT DATE
OF DEATH
58.00
2 Comcast cable
18.70
3 Cost to repair basement wall (see statement attached)
3,420.00
4 Dr. Patel
49.96
5 East Pennsboro Township, sewer and sanitation
115.00
6 Holy Spirit Hospital
31.03
7 Lebanon Imaging Assoc.
17.83
8 Neighbor Care, medications
854.12
9 PA American Water - 48.63,11.24,26.45,59.19,48.55
194.06
10 Personal property tax, 2005 (deliquent)
22.00
11 PP&L electric bill -185.85,95.66, 144.48,45.74
471.73
12 Sprint, cell phone bill
20.38
13 Verizon, phone bill
39.77
14 West Shore EMS
598.66
15 Yingst Engineers - inspection of wall at house
503.28
TOTAL (Also enter on Line 10, Recapitulation)
6,414.52
(If more space is needed, additiDnal pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule I (Rev. 6-98)
REV.1513 EX+ (9-00)
.
SCHEDULE ..
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
NUMBER
Melton, Thomas Arthur Jr.
NAME AND ADDRESS OF
PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal
Clistributions, and transfers
under Sec. 9116(a)(1.2)]
FILE NUMBER
21-06-0003
ESTATE OF
RELATIONSHIP TO
DECEDENT
Do Not List Trustee(s)
SHARE OF ESTATE AMOUNT OF ESTATE
(Words) ($$$)
I.
Arthur L. Melton
103 Iron Master Road
Cherry Hill, NJ 08034
Son
1/3 of residue
Joseph C. Melton
33 Augusta Dr.
Annville, PA 17003
Son
1/3 of residue
William C. Melton
1700 Delancey Place
Philadelphia, PA 19103
Son
1/3 of residue
Total
Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet
ll. 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 Schedule J (Rev. 6-98)
U...J{L....J{ .l.-\.J\.JW
Pm M&TBank
499 Mitchell Road. MilIsboro, DE 19966 Mail Code OE,MB-12
Phone (&88) 502-4349
Fax (302) 934-2955
Correction - March 23. 1006
Saidis, Flower & Lindsay
Attorneys At Law
2109 Market Street
Camp HilI, Pennsylvania 17011
Re: Estate of Thomas A Melton
Social Securitv: 259-18-7120
Date of Death: November 03, 2005
Dear Sir or Madam:
Per your inquiry dated January 06,2006, please be advised that at the time of death, the above-named decedent had OIl
deposit with this bank the following:
L
Type of Account
Checking Account
Account Number
59540982
Ownership (Names of)
Thomas A Melton, ViVian L MellOn ..
Joseph C Melton., POA
Opening Date
03/28/74 Closed 01/09/06
Balance On Date of Death
$5,402.67
Accrued Interest
$ 0.16
______....______r~....______..__._______............._______.._..".
Total
$5,402.83
Interest Paid YTD
--$---4_83.?A~-;;;;edtnrerest~~0i-i;;;j;;j;dr-'-------
2.
Type of A.ccount
IRA
Account Number
03500420178] 017
Ownership (Names of)
Thomas A Melton *
Opening Date
07/09/83 Closed 10/28/05
Balance on Date of Death
$ 0.00 Closed prior 10 the date of ck.ath
tJ-:lILJILUUU
3.
Type qf Account
Checking Account
Account Number
95/088618
Ownership (Names oj)
Thomas A Melton III
Vivian L Melton *'
Joseph C Melton ...
Opening Date
04/23/03
Balance 011 Date of Death
$13,826.42
Acc=ed interest
$ 12.32
Tota!
$/3,838.74
Interest Paid YTD
'''$--J65j;F7AcZ;;iidint~t;;~;;ti;'~Yudedi~'''-----
i
Please be advised, there was no safe deposit box found for the above decedent. 'I
... For further accollnt information, regaroing ownership, closures and/or reimbursement offunds, ete., please call
the Summem:aJe Plaza Office # 717-25>2261.
Sincerely,
~y~-r
Nancy Clagett
Records Management
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Drive: FWD
Mileage: 71/000
Equipment
Air Conditioning
Power Steering
Power Windows
Power Door Locks
Tilt Wheel
AM/FM Stereo
Dual Front Air Bags
ABS (4-Wheel)
Consumer Rated Condition: Good
"Good" condition means that the vehicle is free of any major defects. This vehicle has a
clean titJ~bJ$tQ[Y / the paint, body and interior have only minor (if any) blemishes, and
there are no major mechanical problems. There should be little or no rust on this
vehicle. The tires match and have substantial tread wear left. A "good" vehicle will
need some reconditioning to be sold at retail. Most consumer owned vehicles fall into
this category.
Trade-In V al uel"j$t'(QJ,.IIC;~H:EQL$.ql5!_QDJjne $2,245
Trade-in Value is what consumers can expect to receive from a dealer for a trade-in
vehicle assuming an accurate appraisal of condition. This value will likely be less than
the Private Party Value because the reselling dealer incurs the cost of safety
inspections, reconditioning and other costs of doing business.
NEXT STEP: C Get New Car Pricing
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A. Settlement Statement
u.s. Department of Housing
and Urban Development
~
,r
OMB Approval No. 2502-0265
B. Type of Loan
O 0 0 6. File Number
1. FHA 2. FmHA 3. Conv. Unins.
4. 0 VA 5. !Xl Conv. Ins.
7. Loan Number
8. Mortgage Insurance Case Number
0203065164
c. Note: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are
shown. Items marked "(p.o.c.)" were paid outside closing; they are shown here for informational purposes and not
included in the totals.
D. Name and Address of Borrower E. Name and Address of Seller F. Name and Address of Lender
MELISSA L. SMART JOSEPH C. MELTON, EXECUTOR MEMBERS 1ST
JOHN G. SMART THOMAS A. MELTON ESTATE FEDERAL CREDIT UNION
425 BROWNS LANE 5000 LOUISE DRIVE
ENOLA PA 17025 MECHAN ICSBU RG PA 17055
G. Property Localion H. Settlement Agent MEMBERS 1 ST SETTLEMENT SERVICES, LLC
TAX PARCEL NO. 09-14-0836-058
4 ANNETTE DRIVE Place of Settlement I. Settlement Date
ENOLA PA 17025 5000 LOUISE DRIVE 2/27/2006
MECHANICSBURG PA 17055 Disbursement Date
Lot Block: 2/27/2006
J. Summary of Borrower's Transaction
100. Gross Amount Due From Borrower
101. Contract sales price 145,000.00 401. Contract sales price 145,000.00
102. Personal property 402. Personal property
103. Settlement charges to borrower (line 1400) 4,779.26 403.
104. 404.
105. 405.
Adjustments for items paid by seller in advance Adjustments for items paid by seller in advance
106. City/town taxes to 406. City/town taxes to
107. County taxes to 407. County taxes to
108. Assessments to 408. Assessments to
109. SCHOOL TPV<.2/27/2006 to 6/30/2006 529.35 409. SCHOOL TPV<.2/27/2006 to 6/30/2006 529.35
110. to 410. to
111. to 411. to
112. SEWER! 2/27/2006 to 3/31/2006 40.89 412. SEWER! 2/27/2006 to 3/31/2006 40.89
113. REFUSE to 413. REFUSE to
114. to 414. to
115. to 415. to
120. Gross Amount Due From Borrower 150,349.50 420. Gross Amount Due To Seller 145,570.24
K. Summary of Seller's Transaction
400. Gross Amount Due To Seller
200. Amounts Paid By Or In Behalf Of Borrower
500. Reductions In Amount Due To Seller
201. Deposit or earnest money 2,000.00 501. Excess deposit (see instructions) 2,000.00
202. Principal amount of new loan(s) 145,000.00 502. Settlement charges to seller (line 1400\ 1,463.50
203. Existing loan(s) taken subject to 503. Existing loan(s) taken subject to
204. 504. Payoff of first mortgage loan
205. 505. Payoff of second mortgaoe loan
206. 506.
207. 507.
208. 508.
209. 509.
Adjustments for Items unpaid by seller Adlustments for items unpaid bv seller
210. City/town taxes to 510. City/town taxes to
211. County taxes 1/1/2006 to 2/27/2006 65.95 511. County taxes 1/1/2006 to 2/27/2006 65.95
212. Assessments to 512. Assessments to
213. to 513. to
214. to 514. to
215. to 515. to
216. to 516. to
217. to 517. to
218. to 518. to
219. to 519. to
220. Total Paid By/For Borrower 147,065.95 520. Total Reduction Amount Due Seller 3,529.45
300. Cash At Settlement FromlTo Borrower
600. Cash At Settlement To/From Seller
7'00. Total Sales/Broker's Commission based on price $ 145,OOO.00@ %= Paid From Paid From
Division of Commission (line 700) as follows: Borrower's Seller's
701. $ to Funds At Funds At
Settlement Settlement
702. $ to
703. Commission paid at Settlement
704.
L Settlement Charges
800 Items Payable In Connection With Loan
801. Loan Origination Fee 145,000.00 %
802. Loan Discount 145,000.00 %
803. Appraisal Fee to
804. Credit Report to
805. Lender's Inspection Fee
806. Mortgage Insurance Application Fee to
807. Assumption Fee
808. APPLICATION FEE MEMBERS 1ST ($50.00 P.O.C.) 300.00
809. UNDERWRITING FEE MEMBERS 1 ST 75.00
810. DOCUMENT PREP FEE MEMBERS 1ST 275.00
811.
812.
813.
900. Items Required By Lender To Be Paid In Advance
901. Interest from 2/27/2006 to 2/28/2006 @$ 26.1806 / day 52.36
902. Mortgage Insurance Premium for months to
903. Hazard Insurance Premium for years to
904. years to
905.
Exclude last day in cales - line 901
1000. Reserves Deposited With Lender
1001. Hazard insurance 3 months@$ 46.58 per month 139.74
1002. Mortgage insurance months@$ per month
1003. City property taxes months@$ per month
1004. County property taxes 1 months@$ 35.19 per month 35.19
1005. Annual assessments months@$ per month
1006. SCHOOL TAX 9 months@$ 130.90 per month 1,178.10
1007. months@$ per month
1008. Aggregate Accounting Adjustment -420.20
1100. Title Charges
1101. Settlement or closing fee to
1102. Abstract or title search to
1103. Title examination to
1104. Title insurance binder to
1105. Document preparation to JOHN SLlKE, ESQUIRE P.O.C.
1106. Notary fees to CASH 10.00 10.00
1107. Attomey's fees to
(Includes above items numbers: )
1108. Title insurance to MURREL R. WALTERS, III, ESQUIRE 1,158.75
(Includes above items numbers: 1101-1104,1108 PENN ATTORNEYS TITLE INS. CO. )
1109. Lender's coverage $ 145,000.00 endorsements 100, 300, 8.1
1110. Owner's coverage $ 145,000.00
1111.
1112.
1113.
1200. Government Recording and Transfer Charges
1201. Recording fees: Deed $ 38.50 ; Mortgage $ 64.50 ; Releases $ 103.00
1202. City/county tax/stamps: Deed $ 1,450.00 ; Mortgage $ 1,450.00
1203. State tax/stamps: Deed $ 1,450.00 ; Mortgage $ 1,450.00
1204.
1205.
1300. Additional Settlement Charges
1301. Survey to
1302. Pest inspection to
1303. TAX CERTIFICATION FEE DEBBIE LUPOLD 3.50
1304.2006 COUNTY/TOWNSHIP REAL ESTATE TAX DEBBIE LUPOLD 422.32
1305.
LAST WILL AND TESTAMENT
OF
THOMAS A. MELTON
If THOMAS A~ MELTON of Enolaf Cumberland County, Pennsylvania
declare this to be my Last Will and Testament, hereby revoking
any will previously made by me.
I - I direct the payment of all my just debts and
funeral expenses out of my estate as soon as may be practicable
after my death.
II - I devise and bequeath all of my estate of every
nature and wherever situate unto my wife, Vivian L. Melton.
LLI - Should my said wife predecease me, then I devise
and bequeath all of my estate of every nature and wherever situate
.;: ~f
unto my issue in equal shares per stirpes.
IV - All taxes that may be assessed in consequence of
my death of whatever nature and bywha.tever'jurisdiction imposed
shall be considered a part of the expense of the administration
of my estate, and my personal representative or representatives
shall have the absolute power in his or her discretion to pay the
same at once whether or not the law under which they are imposed
permits the postponement of all or part of them to a later time.
V - I appoint my wife, Vivian L. Melton, Executrix of
this, my Last Will and Testament. Should she fail to qualify
or cease to act as such, then I appoint Dauphin Deposit Trust
Company, Harrisburg, Pennsylvania, Executor of this, my Last
Will and Testament. Neither of my personal representatives
shall be required~~q pos~bond in this or any jurisdiction.
~N WITNESS WHEREOF, I have hereunto set my hand and seal on
this, the
2) p- day of
. b.6pr~I'I"~1(
, 1976.
~~~
Thomas A. ton
(SEAL)
Signed, sealed, published and declared by THOMAS A. MELTON, Testa-
tor therein named, on this and one (1) other sheet of paper as
and for his Last Will and Testament in our presence, who, in his
presence, at his request and in the presence of each other, have
hereunto subscribed our names as attesting witnesses.
a,.l~~~ ~
Name
At,
. .'
COMMONWEALTH OF PENNSYLVANIA)
SSe
COUNTY
OF
CUMBERLAND)
I, THOMAS A. MELTON , the testator whose name is signed
to the attached or foregoing instrument, having been duly quali-
fied according to law, do hereby acknowledge that I signed and
executed the instrument as my Last Will~ that I signed it will-
inglY1 and that I signed it as my free and voluntary act for the
purposes therein expressed~
Sworn or affirmed to and acknowledged before me, by
THOpmSJ. ~M~~TON the testator, this dJ ,"# day of
~'-Vf!/\-/ , 19 76
. 7. , ,
~4~{LLC
! " Notary Public \ '
Thelma S. McCauslin" Notary Public
My 'Commission Expires July I, 1980
(amp Hill, PA (umberland (ounly
COMMONWEALTH OF PENNSYLVANIA)
SSe
COUNTY OF CUMBERLAND)
WE, ~~~ ~L .~ C;. ~~.
the witn ses whose names are signed to the attached or foregoing
instrum , being duly qualified according to law, do depose and
say that we were present and saw the testator sign and execute
the instrument as his Last Wil11 that Thomas A. Melton
signed willingly and that Thomas A. Melton executed it
as his free and voluntary act for the purposes therein expressed;
that each of us in the hearing and sight of the testator signed
the will as witnesses; 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.
~J~
..~Yj-t ~~I Ii';!
Sworn to and subscribed befOre me
this ~/e'- dllY peL,'. _... . ...... ", 1976.
;1 ,~
, .
COMMONWEALTH OF PENNSYLVANIA)
SSe
COUNTY
OF
CUMBERLAND)
I, THOMAS A. MELTON , the testator whose name is signed
to the attached or foregoing instrument, having been duly quali-
fied according to law, do hereby acknowledge that I signed and
executed the instrument as my Last Will; that 1 signed it will-
ingly: and that I signed it as my free and voluntary act for the
purposes therein expressed.
Sworn or affirmed to and acknowledged before me, by
THOJ1ASJ./M~~TON the testator, this dJ ~~ day of
~'-Ve/'-/ , 19 76
~.
, :// . '~e-~
f Notary Public .
. Thelmil S. McCauslinr Notary Public
My Commission Expires July ,I. 1980
Camp .HiII, PA Cumberland (olml',
COMMONWEALTH OF PENNSYLVANIA)
SSe
COUNTY
OF
CUMBERLAND)
,f~~~~ r;,~
WE,
the witn ses whose names are signed to the attached or foregoing
instrum , being duly qualified according to law, do depose and
say that we were present and saw the testator sign and execute
the instrument as his Last Will; that Thomas A. Melton
signed willingly and that Thomas A. Melton executed it
as his free and voluntary act for the purposes therein expressed:
that each of us in the hearing and sighc of the testator signed
the will as witnesses: 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.
~J~
~n'i ~~II ~
Sworn to andsuhscribed before me
this 4/'?!- q<1-y.ofL ..... . 1976.
/I~
CUMMONWEALTH 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
MELTON JOSEPH C
33 AUGUSTA DRIVE
ANNVILLE, PA 17003
-------~ fold
ESTATE INFORMATION: SSN: 259-18-7120
FILE NUMBER: 2106-0003
DECEDENT NAME: MEL TON THOMAS ARTHUR JR
DATE OF PAYMENT: 05/05/2006
POSTMARK DATE: 05/05/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 11/03/2005
NO. CD 006660
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $584.4 7
I
I
I
I
,
I
I
I
TOTAL AMOUNT PAID:
$584.47
REMARKS:
CHECK#1020
SEAL
INITIALS: WZ
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS