HomeMy WebLinkAbout05-18-06
--l
15056051058
REV-1500 EX (06-05)
PA Department of Revenue '*
Bureau of Individual Taxes .
PO BOX 280601
Harrisburg, PA 17128-0601
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
County Code Year
File Number
21 05
00785
Date of Birth
197 -40-6154
08/19/2005
01/25/1949
Decedent's Last Name
Suffix
Decedent's First Name
MI
McANDREW
Charles
F
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
Spouse's First Name
MI
None
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
'. 1. Original Return
2. Supplemental Return
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
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 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. 0)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
4. Limited Estate
6. Decedent Died Testate
(Attach Copy of Will)
9. Litigation Proceeds Received
8. Total Number of Safe Deposit Boxes
Robert T. Balaban, Esq.
Firm Name (If Applicable)
(717) 932-9565
REGISTER 0$= \NII.J...S USE
First line of address
630 Lowther Road
Second line of address
City or Post Office
Lewisberry
State
ZI P Code
DATE FILED
C;)
G)
PA
17339
Correspondent's e-mail address:
Under penalties of pe~ury, 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 pre parer has any knOWledge.
~TE
:;/ IS- / ~(,
~~/12,.;
DATE
D~) IS I]~al;
AD RESS
Robert T. Balaban, Esquire, 630 Lowther Road, Lewisberry, PA 17339 717.932.9565
PLEASE USE ORIGINAL FORM ONLY
Side 1
L
15056051058
15056051058
---'
--I
15056052059
REV-1500 EX
Decedent's Name:
Charles
F McANDREW
197 -40-6154
RECAPITULATION
1. Real estate (Schedule A). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1.
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.
6. Jointly Owned Property (Schedule F) Separate Billing Requested. . . . . ., 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) Separate Billing Requested.. . . . . .. 7.
8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 8.
9. Funeral Expenses & Administrative Costs (Schedule H). . . . . . . . . . . . . . . . . . . .. 9.
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . . . . . . . . . . . . . . . . 10.
11. Total Deductions (total Lines 9 & 10). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.
12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.
13. Charitable and Governmental Bequests/See 9113 Trusts for which
an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . . . . . . . 13.
14. Net Value Subject to Tax (Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . . . . . . . 14.
TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) X .0_
16. Amount of Line 14 taxable
at lineal rate X.O_
17. Amount of Line 14 taxable
at sibling rate X .12 68,640.62
18. Amount of Line 14 taxable
at collateral rate X .15
15.
16.
17.
18.
19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
15056052059
Side 2
L
Decedent's Social Security Number
82,000.00
10,657.92
11,692.68
34,913.93
139,264.53
9,778.89
60,845.02
70,623.91
68,640.62
68,640.62
8,236.87
8,236.87
15056052059
-.J
REV-1500 EX Page 3
Decedent's Complete Address:
.DECEDENT'S NAME
Charles F McANDREW
STREET ADDRESS
104 Valley Road
File Number
00785
DECEDENT'S SOCIAL SECURITY NUMBER
197 -40-6154
CITY
Summerdale
I STATE
PA
ZIP
17093
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19) (1)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
8,236.87
Total Credits (A + 8 + C ) (2)
0.00
3. Interest/Penalty if applicable
D. Interest
E. 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)
8. Enter the total of Line 5 + SA. This is the BALANCE DUE.
(5)
(SA)
(58)
8,236.87
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.
8,236.87
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 [i]
c. retain a reversionary interest; or.......................................................................................................................... D [iJ
d. receive the promise for life of either payments, benefits or care? ...................................................................... D [i]
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ...... ............... ......... ........... .......... ............... ..... ............... ........................ D [i]
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.
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. 99116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent
[72 P.S. 99116 (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. 99116(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. 99116(1.2) [72 P.S. 99116(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. 99116(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+ (6-9.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF
Charles F. McANDREW
FILE NUMBER
21-05-0785
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
1.
DESCRIPTION
104 Valley Street, Summerdale, Cumberland County, Pennsylvania 17093, Parcel No.
VALUE AT DATE
OF DEATH
82,000.00
09-12-2995-048.
TOTAL (Also enter on line 1, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
82,000.00
N . 2502-0 65 ,r
A. B. TYPE OF LOAN:
U.S. DePARTMENT OF HOUSING & URBAN DeveLoPMENT 1.0FHA 2.oFmHA 3.I!JCONV. UNINS. 4. OVA 5.0CONV. INS.
6. FILE NUMBER: 17. LOAN NUMBER:
SETTLEMENT STATEMENT 05-994 96200139
8. MORTGAGE INS CASE NUMBER: OLD MORTGAGE INS CASE NUMBER:
5181F/6.5% SKS
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 "[POCr were paid outside the closing; they are shown here for informational purposes and are not included in the totals.
1.0 3198 (ESTRIGHT.THOMAS.PFO.u5-994m
D. NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER:
Thomas l. Estright and Estate of Charles F. McAndrew Sovereign Bank
Erin E. Putt 1130 Berkshire Blvd.
104 Valley Street Wyomissing, P A 19610
Summerdale, PA 17093
G. PROPERTY LOCATION: H. SETTLEMENT AGENT: 25-1857112 I. SETTLEMENT DATE:
104 Valley Street Midstate Abstract Company
Summerdale, PA 17093 January 25, 2006
Cumberland County, Pennsylvania Pu\CE OF SETTLEMENT
2331 Market Street
CampHiII,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. Contract Sales Price 82,000.00 401. Contract Sales Price I 82,000.00
102. Personal Prooertv 402. Personal Prooertv
103. Settlement Charoes to Borrower (line 1400) 3,542.85 403.
104. 404.
105. 405.
Adiustments For Items Paid By Seller in advance Adiustments For Items Paid Bv Seller in advance
106. Citvrrown Taxes to 406. citVrrown Taxes to I -
107. Countv Taxes to 407. County Taxes to
108. School Taxes 01/25/06 to 07/01/06 493.12 408. School Taxes 01/25/06 to 07/01/06 I 493.12
109. Sewer/Refuse 01/25/06 to 04/01/06 84.33 409. Sewer/Refuse 01/25/06 to 04/01/06 84.33
110. 410. I
111. 411.
112. 412.
120. GROSS AMOUNT DUE FROM BORROWER 86,120.30 420. GROSS AMOUNT DUE TO SELLER I 82,577.45
200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER:
201. Deoosit or earnest money 2,000.00 501. Excess Deoosit (See InstructionS) I
202. Princioal Amount of New Loan(s) 82.000.00 502. Settlement Charoes to Seller (line 1400) 6.853.70
203. Existina loan(s) taken subiect to 503. Existina loan(s} taken subiect to
204. 504. Payoff of first Mortgage to PNC Bank, N.A. 32.271.07
205. 505. Pavoff of second Mortaaae
206. 506.
207. 507. 7beoosit disb. as oroceeds)
208. 508.
209. Seller Assistance 4,100.00 509. Seller Assistance I 4,100.00
Adiustments For Items Unpaid Bv Seller Adiustments For Items Unpaid By Seller
210. Citvrrown Taxes to 510. CTtVrrown Taxes to
211. County Taxes 01/01/06 to 01/25/06 19.04 511. CountY Taxes 01/01/06 to 01/25/06 19.04
212. School Taxes to 512. School Taxes to
213. 513. I
214. I 514. I
215. 515. I
216. I 516.
217. 517.
218. I 518.
219. I 519. I
220. TOTAL PAID BY/FOR BORROWER 88,119.04 520. TOTAL REDUCTION AMOUNT DUE SELLER I 43,243.81
300. CASH AT SETTLEMENT FROMlTO BORROWER: 600. CASH AT SETTLEMENT TO/FROM SELLER:
301. Gross Amount Due From Borrower (Line 120) 86,120.30 601. Gross Amount Due To Seller-(Line 420) I 82.577.45
302. Less Amount Paid BvlFor Borrower (Line 220) ( 88,119.04) 602. Less Reductions Due Seller (Line 520) I( 43.243.81
303. CASH ( FROM) ( X TO) BORROWER 1,998.74 603. CASH ( X TO) ( FROM) SELLER I 39,333.64
OMS 0 2
The un~ersigned hereby acknowledge receipt of a completed copy of pages 1 &2 of this statement & any attachments referred to herein.
I ~.
Borrower {) ~ ..t. ~
Tt)omas. L. Estright)
~4, C l~\ 1----
Erin E. Putt
r;-
Seller ') .
,.a,.., fb" state of Charles F. McAndrew
L. SETTLEMENT CHARGES
700. TOTAL COMMISSION Based on Price S @ % 4.734.00 PAID FROM PAID FROM
Division of Commission (line 700) as Follows: BORROWER'S SELLER'S
701. $ 2,392.00 to ERA-NRT, Inc. FUNDS AT FUNDS AT
702. $ 2,342.00 to The Homestead Group, Inc. SETTLEMENT SETTLEMENT
703. Commission Paid at Settlement 4,734.00
704. . to
SOO.ITEMS PAYABLE IN CONNECTION WITH LOAN
801. Loan Oriqination Fee % to
802. Loan Discount % to
803. Appraisal Fee to Central Penn Appraisals POC:Lender $350.00
804. Credit Report to cac Companies POC:Lender $12.00
805. Automated Underwriting Fee to Fannie Mae/Freddie Mac POC:Lender $20.00
806. Document Preoaration Fee to Sovereion Bank 340.00
807. Application Fee to Sovereign Bank POC:B350.00
808. Tax Service Fee to LSI Tax Services 69.00
809. UPS/Delivery Fee to UPS 25.00
810. Flood Certification Fee to Transamerica Flood Hazard 25.00
811.
900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE
901. Interest From 01/25/06 to 02101/06 @ S 14.805556/day ( 7 days %) 103.64
902. Mortgage Insurance Premium for months to
903. Hazard Insurance Premium for 1.0 years to Erie Insurance POC $236.00b
904.
905.
1000. RESERVES DEPOSITED WITH LENDER
1001. Hazard Insurance 3.000 months $ 19.67 Der month 59.01 -
1002. Mortgage Insurance months $ per month
1003. CitylTown Taxes months $ per month
1004. County Taxes 12.000 months $ 23.65 per month 283.80
1005. School Taxes 8.000 months @ $ 93.63 per month 749.04
1006. months @ $ per month
1007. months ((i) $ cer month
1008. Aggregate Adjustment months @ $ oer month -232.32
1100. TITLE CHARGES
1101. Settlement or Closinq Fee to
1102. Abstract or Title Search to
1103. Title Examination to
1104. Title Insurance Binder ' to
1105. Electronic Document Preo. to
1106. Closinq Service Letter to Midstate Abstract Company 35.00
1107. Attorney's Fees to
(includes above item numbers: )
1108. Title Insurance to MIDSTATE ABSTRACT Reissue 675.68
(includes above item numbers.11 02, 1103 & 1104 )
1109. Lender's Coverage $ 82,000.00
1110. Owner's Coverage $ 82,000.00 675.68
1111. Endorsements 100, 300, 8.1 to Midstate Abstract Company 150.00
1112. Notary Fee to Midstate Abstract Company. 10.00
1113. Notary Fee to Midstate Abstract Company 5.00
1114. Overnight Fees & Handling to Midstate Abstract Company 15.00 15.00
1115. Transaction Fee to ERA-NRT, Inc. .- 125.00
1116. 1 st Otr. Sewer/Refuse to East Pennsboro Township 115.00
1117.
1118.
1200. GOVERNMENT RECORDING AND TRANSFER CHARGES
1201. Recording Fees: Deed $ 40.50; Mortgage $ 64.50: Releases $ 105.00
1202. City/County Tax/Stamps: Deed 820.00' Mortqaqe 820.00
1203. State Tax/Stamos: Deed 820.00; Mortqaqe 820.00
1204.
1205.
1300. ADDITIONAL SETTlEMENT CHARGES
1301. Survev to
1302. Pest Insoection to Biechler & Tillery, Inc. & Home Inso. 310.00
1303. Home Warranty to AON Home Warranty Services, Inc. 409.00
1304. Pest Treatment to Bowers Pest Control 630.70
1305.
1400. TOTAL SETTLEMENT CHARGES (Enter on Lines 103, Section J and 502, Section K) ~ 3,542.851 6,853.70
By .~""'" p." 1 of.... ._ ... __""""'"""'" _pI of. """""""" _of pago 2 of INa "" _ ....~ ~
:~bstract-<:ompany
S ment Agent
Certified to be a true copY.
REV-1503 EX+ (6-98.
COMMON\NEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
Charles F. McANDREW
FILE NUMBER
21-05-0785
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
12,000 Shs. FHLMC REMIC Series 2968.
10,657.92
TOTAL (Also enter on line 2, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
10,657. 92
.J,ITHU 02:37 PM
P. 005
'-
!.tate V.luatioa
Date of Deatb~ 0'/1"2005
valuatiCD Dat@~ 08/1J/200'
~Oce99iDg Dat@: Ot/Oe/~Oos
Bsta.te af: CIWUABS ,. .~
Account: 510'0101
Repart type: nate af Death
wuaber of 8.cu~~t1e8: J
PUt m: MclRDUI, OIlRLISP
Sbar,,__
07: par
Seeurit.y
D..artptiOlL
Righ/A~
IbthiQ
...~ ~d/or Diy an~ tot Seeur~~y
ldjU8tlleDt, Aacruals Value
1,)
11000 PHLMC IBHIC 81RIBS 2'" (313JSRgQl)
Finaaei_l Tilles Jat.f~ct1ve Data
~.t: 08/15/20J. 5.250' 'aetr 0.'1111"1
08/U/~DOS
(K) McmW.
34~1'.93 MBfLIrl !NYi IWS t SKARE (6J15'8013)
\UtAm.B AMJIOJrY
ot!l,/no,
'7.4S!'OO Mkt
97..S'OOO
1.000000
10,'51.'~
~8_'9
H,'B.'~
] , 2I~ . Q2
'46.853.11
;28.69
2)
1.00000
~.ooooo
3)
1213.0' HOYIY NAIRIT (IVP01)
oafu/300S
1.00000
1.00000
1.000000
'rotal Value:
~tal Acorual t
~t~l: $4.,'.~,5G
Page 1
Th1a report wat prodQclO .itb IltateVal, a produot ot 1st..... ValU.tiOD8 , 'r.iciag SY"'ttll\S, 1M. If yau have que8WOUB.
pleua CQrltact. I:V'P S1'8t~" at (nl) 313-1300 0: WW.evp'yS. CJaI\. (1l6"iII1.an' .O.tJ
-----.,. '-_I" ... _.-.....1
..~... .---,.... I _ II I .._. _ .... . .
REV-1508 EX+ (6-98) '*
COMMONVVEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Charles F. McANDREW
FILE NUMBER
21-05-0785
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
1. PNC Bank Checking Account #5140113632.
7,904.06
500.00
2. 1992 Buick Century automobile.
3. Cash and Bank Deposits
2,006.60
1,282.02
4. Money Market.
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
11,692.68
SEP-05-2005 19:15
PNCBANV
412 768 3458
P.01
~ PNCBAN<
September 06. 2005
Robert T Balaban
Attorney at Law
630 Lowther Rd.
Lewisbeny, PA ) 7339
scp
RE: Estate of Charles P McAndrew (Deceased)
SSN: J9740-6154
DOD: 08..19-2005
Dear Mr. Balaban:
In response to your request for Date of Death balances for the customer noted above, our
records show the following:
Checking AeeouDt
Account #5140113632 Established 02..Q J -1970
CHARLES F MCANDREW
DOD balance: $7,903.73 + $0.33 accrued interest
Interest paid 01-01..05 thru 08-19-200555.77 YTD
The decedent maintained two investment accounts (INV #58090797 and
INV #58090801). For more infonnation please contact the Brokerage department at 1-
800- 762..61 J 1.
The decedent maintained ReA loan Account # 4003048109334472 with PNC bank. For
further information. please call 1-888-762-2265. Select option 3 and then 0 (zero).
After pressing zero) please remain on the line to speak to a Loan Service Representative.
(We do Dot ".ve aeees. to Loa. informatioD. you must tOBtaet the LoaD Area at the
above Dumber for funher .slist.Dec.)
Safe deposit box
The decedent maintained safe deposit box # 118. It was in one name only.
CHARLES F MCANDREW
It is located at:
ENOLA BRANCH
235 N. ENOLA ROAD
ENOLA PA 17025
717-732-4452
Page 1 of2
. i~
REV-1510 EX+ (6-98*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF
Charles F. McANDREW
FILE NUMBER
21-05-0785
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
DESCRIPTION OF PROPERTY
ITEM INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH % OF DECO'S EXCLUSION TAXABLE
NUMBER THE DATE OF TRANSFER. ATTACH A COpy OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
1. Met Life MLI Variable Annuity Class L 34,913.93 100 34,913.93
2. John Hancock Financial Services IRA 38,178.39 100 0.00
TOTAL (Also enter on line 7 Recapitulation) $ 34,913.93
(If more space is needed, insert additional sheets of the same size)
VJI 'UV VL.J/ ....
r. UUJ
V.~ate ValuatiOB
Sharea
01' Par
Becur.1ey
De.orlpti.orl
Higb/ASk
LOtI/Bid
I
Bsl:ate or~ CJCNU.." P. MaJUlDRn
Account: S'Dj~",
Repo~t !YP61 D.~b gf Death
"~et of 6ocuriti88. 1
FUe IV: McAlrDJlIW. ~
Mean aDd/or Div IIDd lilt: loeudty
A4ju8t~6nt8 Accrual. Value
Date of Death1 0,/1112005
V~\lat.iOll Datil: o8/uftoa,
Processing Date: 09/01/2DO'
1)
38178.3' ~ IANCOCl RBVOLUTOY (41~2!A~O~)
BX'1'D VARIABLI AMIrr
O'/:U/~Q05
1.00000
)..00000
1.ODOOOO
l8,178.n
Total Value:
fat:al Accrual!
Tutal: O~8,17..J'
'D.OO
'38,178.39
Pagt 1
'nli.. ~~t ..... p%CO\lc:ed. with 'IUtlVaJ., a produot or B.tal:. VlIluationt , Pricing 5y.cae, !nc. tf you have que.t10D1J,
pleaao ean~~o\ IYP &yatem8 at (818) ~13-fJOO or ~,e9p8yt.cam. (Rov13io~ 1.0.4/
REV-1511 EX+ (12-99)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Charles F. McANDREW
FILE NUMBER
21-05-0785
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
1.
FUNERAL EXPENSES:
Richardson's Funeral Home.
1,495.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
2. Attorney Fees 5,963.26
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 403.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Murray Insurance, Surety Bond. 1,110.00
8. Estate Notice publication fees to The Patriot-News. 100.95
9. Estate Notice publication fees to The Cumberland Law Journal. 75.00
10. Administrative Costs - Hotel, Rental Car, etc. 599.69
11. Miscellaneous expenses. 31.99
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
9,778.89
REV-1512 EX+ (12-03)
*'
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF
Charles F. McANDREW
FILE NUMBER
21-05-0785
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
1.
PNC Bank, Line of Credit, Account #4003048109334472, on 104 Valley St., Summerdale, PA 17093.
32,271.07
2.
Bank of America Credit Card.
410.19
3.
Capital One Bank Credit Card.
70.82
4.
Capital One Bank Credit Card.
457.99
5.
National City Bank Card.
3,600.00
6.
HSBC Credit Card Services
1,016.00
2,179.00
1,330.67
7.
Chase Cardmember Services
8.
RBS NB Credit Card Services.
9.
Citi Bank Credit Card.
2,056.83
House Cleaning/Hauling, 104 Valley Street, Summerdale, Cumberland County, PA 17093
844.83
West Shore EMS - Medical bill.
548.66
East Pennsboro Ambulance - Medical bill.
482.00
PPL Electric, 104 Valley Street, Summerdale, Cumberland County, PA 17093.
171.51
Comcast Cable, 104 Valley Street, Summerdale, Cumberland County, PA 17093.
133.77
Verizon, 104 Valley Street, Summerdale, Cumberland County, PA 17093.
72.87
PNC Bank, Line of Credit, payments.
1,520.86
300.00
Stoner Appraisals, 104 Valley Street, Summerdale, Cumberland County, PA 17093.
Biechler & Tillery Home Evaluation, 104 Valley Street, Summerdale, Cumberland County, PA 17093.
275.00
East Pennsboro Township, Sewer & Trash, 104 Valley Street, Summerdale, Cumberland, County, PA
115.00
PNC Bankcard.
1,278.39
Pennsylvania American Water Co., 104 Valley Street, Summerdale, Cumberland County, PA 17093
84.41
Sadler Oil Co., 104 Valley Street, Summerdale, Cumberland County, PA 17093
750.54
Sgrignoli Heating, 104 Valley Street, Summerdale, Cumberland County, PA 17093
479.32
HUD Settlement Statement, Sale of 104 Valley Street, Summerdale, Cumberland County, PA 17093.
10,395.29
60,845.02
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
/25/2006 1:26 PM
PPNTF011 -) Page 2 of 3
~PNCBANK
January 25, 2006
CHARLES F MCANDREW
345 LAKESIDE DR
ROSELLE, IL 60172-1447
Dear Charles F Mcandrew
Thank you for contacting PNC Bank. The information you requested about how to payoff
your Line of Credit is below.
Please keep in mind, however, that this information wilJ change if you continue to use the
account or make any payments prior to the proiected payoff date. Please mail your payment
at least five business days prior to the payoff date to ensure it arrives on time. Mailing to
any other address can affect proper processing.
Amount(s) :
Account Number:
Payoff Date:
Amount Due on Payoff Date:
Daily Amount Due After Payoff Date:
4003048109334472
01.31-2006
$32,271.07
$6.14
Where to send:
Complete the attached "Payoff Request Form" and mail it with your payoff check, made
payable to PNC Bank, along with any demand or notice to record a mortgage satisfaction (or
to record any similar inst.I1lDlent) to:
PNC Bank Consumer Loan Center
Accounts Management
PS~PCLC~Ol.M
2730 Liberty A venue
Pittsburgh, P A 15222
Thank you for the opportunity to serve your financial needs. If you have any questions or
would like a revised payoff amount as of a different date, please calJ us at 1-888-PNC-BANK
(1-888-762-2265).
Sincerely,
Isabella Dukes
Financial Services Consultant
National Financial Services Center
EFORM 11 &44 9flOCPYF/090!,
C~LJMBERLAND COUNTY PROBATE COURI'
.<\Tl'N: REC,ISTER OF WILLS, 1 COURTHOUSE SQlJARE ROOM 102
CARLISLE Pi\. 17013
In the Estate of CHARLES MCANDREW, Deceased
Case No. 21-05-0785
Release of Claim
The claim submitted in the above-captioned estate on behalf of eAPIT AL ONE in the
amount of $457.79 for account number 4305721756197666 has been otherwise settled or
been compromised for $457.79 and this release of claim is executed to acknowledge
discharge of the claim, and to release the estate and the Personal Representative of the
estate from all further liability with respect thereto.
Address: 5330 East Main Street, Suite 200,
Columbus OH 43213
Telephone: (877) 714-3739
Date of Release: 10/2 1/2005
EISI Matter No. 1307219
CS HANDLER: ADRIAN REYNOLDS
K:E RBS
Credit Card Services
PO. Box 7092
Bridgeport, CT 06601-7092
(800) 747-8155
STATEMENT AND PROOF OF CLAIM
RE: Account #5545141001942237
To: The Estate of Charles F. Mc Andrew, late of Po Box 208 Summerdale Pa 17093
File 21-2005-785
Deceased: August 19, 2005
The subscriber represents that:
1. The above-named deceased was at the time of his/her death, his/her estate is still,
justly and truly indebted to the subscriber in the sum of$ 1.330.67
2. The nature and consideration of said debt is as follows: Purchase of commodities
and/or services made under RBS branded credit card. The claim is just and that all
legal offsets, payments and credits known to the affiant have been allowed.
3. The subscriber has not nor has any person by its order, for its use, had or received any
manner of security for said debt.
WHEREFORE, the subscriber presents a claim to you. Make all payments payable to
RBS NB Credit Card Services.
RBS NB Credit Card Services.
P.O. Box 7054
Bridgeport, CT 06604
BY: ~~,. ~
Michael Kalasardo
RBS Credit Card Services
Citizens Bank of Rhode Island
Subscribed and sworn to this 13th day of October 2005, before me.
f, 1n J" ,\ 1:Z G'" r
L4v Iff. ..u I )\Il --e,,/./
Carol D. Ringel }
NOTARY PUBLIC
My Commission Expires: December 31,2005
Your credit card is ,issued by RBS National Bank., Bridgeport, CT.
INDFPENDENTHANDYMAN SERVICE
Insured Len Woodring
683 Magara Rd. · Enola, Pa 17025
(717) 728-9884
COMMERCIAL · HOME IMPROVEMENTS · REPAIRS
Remodeling, Plumbing, E1ecbic, Decks, Sump Pumps, Water Pumps,
furnace Repairs & Installation, Painting, Hauling,
Cleaning of Attics, Basements & Garages
Tear down small Sheds, Porches & Garages.
"You Name It, I'" Try to Help You. n
_amIACT
NAME
ADDRESS
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"ems Included In total cost of Job are:
Insurance, Taxe., Travel Expenses, Tools,
Hospitalization and Retirement.
Not responsible for warranties on parts
and labor.
SIGNATURE fk~
SUBlOTAL
TAX
lOT'AL
TERMS: CASH AT COMPLEnON
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Financial
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"Your Accounts Receivable Management Company"
Jan 6, 2006
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CHARLES MCANDREW
630 LOWTHER RD
LEWISBERRY PA 17339
Creditor Account #
WEST SHORE EMERGENCY MED 3049245A
Amt Owed
548.66
DEAR CHARLES MCANDREW
THIS IS OUR FINAL NOTICE REGARDING THIS MATTER. IF THIS BILL
IS NOT PAID WITHIN 15 DAYS OF THE DATE ON THIS LETTER, OUR
CLIENT HAS ADVISED US TO TAKE FURTHER COLLECTION ACTIONS. YOU
HAVE LEFT US WITH NO OTHER ALTERNATIVE BUT TO FORWARD YOUR
PAST DUE ACCOUNT TO A COLLECTION AGENCY AFTER 15 DAYS.
PLEASE REFER ALL PAYMENTS AND CORESPONDENCE TO:
WEST SHORE EMERGENCY MED SVC * 205 GRANDVIEW AVE STE 21
CAMP HILL, PA 17011 * 717-972-4727
THIS IS AN ATTEMPT TO COLLECT A DEBT. ANY INFORMATION
OBTAINED WILL BE. USED FOR THAT PURPOSE.
APPRAISAL INVOICE
Date: September 15. 2005
FileNo.:
5509006
Prepared for:
Bob Balaban
630 Lowther Rd
lewisbeTfY. PA 17339
5509006
Property Appraised:
N/A
104 Vallev Street
Enoia. PA 17093
Work. performed:
S~ Familv ADDrajsal ReDott
..___.~___ROO .00
(717) 432-3693 Tax ID# 71-O92520~
Total Amount Due: ____~OO.OO
---~~.'------~~"---~~-,_._-~---------..,~~------~--- --------~--...--
Please make checks payabfe to:
Stoner Appraisals Ltd.
129 Old Yark Road
DiIlsburQ. PA 17019
:~
INVOICE
Invoice Number
24269
Biechler & Tillery Inc.
2843 North Front Street
Harrisburg, Pa. 1 711 0
Ph (717) 221-1004
Fax (717) 221-1005
Agent Name
Bob Balaban
630 Lowther Rd
Lewisbeny, P A 17339
Date
9/16/2005
Customer Name
Charles McAndrew Estate
I 04 Valley Street
Summerdale, P A 17093
TERMS
'Rep
Access
Requested
Time
on site
TOB
Attorney
Attorney
12:30
Description
Directions
2742/ B...l
AMOUNT
275.00
Full Home Inspection
I Total
INVOICE DUE ONSITE OR 30 DAYS FROM INSPECTION
$275.001
We accept MC, VISA, DISCOVER and AMERICAN EXPRESS
Name on credit card
Account#
Expiration date
VC Code
Type of Credit Card
Signature
REV-1513 EX+ (9-00) '*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
Charles F. McANDREW
FilE NUMBER
21-05-0785
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1. Patricia A. Janis, 345 Lakeside Drive, Roselle, IL 60172. Sister 1 000/0
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 $
(If more space is needed, insert additional sheets of the same size)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX! 11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
BALABAN ROBERT T
27 N FRONT STREET
HARRISBURG, PA 17101
-------- fold
EST A TE INFORMATION: SSN: 197-40-6154
FILE NUMBER: 2105-0785
DECEDENT NAME: MCANDREW CHARLES F
DATE OF PAYMENT: 05/18/2006
POSTMARK DATE: 05/1 8/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 08/19/2005
NO. CD 006712
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $8,236.87
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$8,236.87
REMARKS:
CHECK#147
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WilLS