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COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
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iZJ 1. Original Return
o 4. Limited Estate
Ig] 6. Decedent Died Testate (Attach copy of Will)
o 9. Litigation Proceeds Received
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
4. Mortgages & Notes Receivable (Schedule D)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
FILE NUMBER
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COUNTY CODE YEAR
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SOCIAL SECURITY NUMBER
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THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
o 2. Supplemental Return
o 4a. Future Interest Compromise (date of death after 12-12-82)
o 7 - Decedent Maintained a Living Trust (AIlach copy of Trust)
o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
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)
8. Total Gross Assets (total Lines 1-7)
o 3. Remainder Return (dale of death pMor to 12-13-82)
o 5. Federal Estate Tax Return Required
I 8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
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1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
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9. Funeral Expenses & Administrative Costs (Schedule H)
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COMPLETE MAILING :DRESSL ~')
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10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
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14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
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CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
(19)
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Decedent's Complete Address:
STREET ADDRESS
CITY
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
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Total Credits ( A + B + C ) (2)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty ( D + 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.
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B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
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
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? ..................... ........... .............. .............. ... ......... ........... ...... .......... ........... gJ
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
No
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IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete.
Declaration of preparer other than the personal represe . e is based on all information of which preparer has any knowledge.
DATE
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. 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 0% [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
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 paren
or a stepparent of the child is 0% [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 4.5%, 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 12% [72 P.S. 99116(a)(1.3)]. A sibling is defined, under Section 9102, as a
individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV: 1502 EX+ (6-98)
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SCHEDULE A
REAL ESTATE
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
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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 VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
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TOTAL (Also enter on line 1, Recapitulation) $ /~~ 1-foo
(If more space is needed, insert additional sheets of the same size)
0 B NO. 2502-0265 .,-~
A. .. B. TYPE OF LOAN:
U.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT 1.0FHA 2.DFmHA 3.0CONV. UNINS. 4.DVA 5.~CONV.INS.
6. FILE NUMBER: 17. LOAN NUMBER:
SETTLEMENT STATEMENT 06047CAP 6700604007
8. MORTGAGE INS CASE NUMBER:
C. NOTE: This form is furnished to give you a statement of actual settlem~'.1t costs. Amounts paid to and by the settlement agent are shown.
Items marked .(POC)" were paid outside the closing; they are sh'.lwn here for informational purposes and are not included in the totals.
'. 1.0 3198 COB047CAP.PFDI06047CAPI31)
D. NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER:
MARY C. CURTIS ESTATE OF NELLIE S. HOWARD FIRST GUARANTY
3395 Valley Road 415 Daria Road MORTGAGE CORP.
Marysville, PA 17053 Mechanicsburg, PA 17055 8180 Greensboro Drive
McLean, VA 22102
G. PROPERTY LOCATION: H. SETTLEMENT AGENT: 25-1722090 I. SETTLEMENT DATE:
415 Daria Road Barristers Land Abstract Co.
Mechanicsburg, PA 17055 June 1, 2006
Cumberland County, Pennsylvania PLACE OF SETTLEMENT
3310 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. Contract Sales Price 168,400.00 401. Contract Sales Price 168400.00 V
102. Personal Prooertv 402. Personal Prooertv
103. Settlement Charoes to Borrower (Line 140m 5,946.i' 7 403.
104. 404.
105. 405.
Adjustments For Items Paid Bv Se{{er in advance .- Adiustments For Items Paid Bv Se{{er in advance
106. CltVTaxes- to 406. CltVTaxes to "
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107. County Taxes 06/01/06 to 01/01/07 355.:.'2 407. CountV Taxes 06/01/06 to 01/01/07 355.22 V
108. School Taxes 06/01/06 to 07/01/06 138.'~!!. 408. School Taxes 06/01/06 to 07/01/06 . . 138.68 ~
109. Sewer and Refuse 06/01/06 to 07/01/06 39 :u.. 409. Sewer and Refuse 06/01/06 to 07/01/06 . 39.17
110. 410. I
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111. 411.
112. 412.
120. GROSS AMOUNT DUE FROM BORROWER 174,879.84 420..GROSS AMOUNT DUE TO SELLER 168,933.07
200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER:
201. Deoosit or earnest money I, 1,000.00 501. Excess Deoosit (See Instructions)
202. Princioal Amount of New Loan(s) 134720.00 502. Settlement Charaes to Seller (Line 1400) 18,481.40
203. Existina loan{s) taken subiect to 503. Existina 10an(5) taken subiect to ,
204. ; 504. Payoff of first Mortgage
205. 505. Payoff of second Mortaaae
205. 506.
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207. 507.
208. 0 508.
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209. 509.
Adjustments For Items Unpaid Bv Se{{er Adiustments For Items UnDaid By Se{{er
210. City Taxes . to 510. Citv Taxes to
211. CountvTaxes to 511. CountV-Taxes to ,
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212. School Taxes to .- 512. School Taxes to
213. 513.
214. 514.
215. 515. c;. .
216. '- 516.
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217. 517. ~
218. 518. I
219. 519.
220, TOTAL PAID BY/FOR BORROWER 135,720.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 18,481.40
300. CASH AT SETTLEMENT FROMrrO BORROWER: 600. CASH AT SETTLEMENT TO/FROM SELLER:
301. Gross Amount Due From Borrower (Line 120\ 174,879.8'; 601. Gross Amount Due To Seller Cline 420) ,'. 168,933.07
302. Less Amount Paid By/For Borrower (Line 220) ( 135,720.00\ 602. Less Reductions Due Seller (Line 520) ( 18,481.40
303. CASH ( X FROM)( TO) BORROWER 39,159.84 603. CASH ( X TO) ( FROM) SELLER 150,451.67
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The undersigned hereby acknowledge receipt of a completed copy of pages 1 &2 of this statement & any attachments referred to herein.
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REV-1503 E.X+ (6-98) .
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF FILE NUMBER
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All property jointly-owned with right of survivorship must be disclosed on Schedule F.
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REV-1el18 EX + (1+97)
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Nr///.c--S=; hGtU;4 ~b
FILE NUMBER
2-/-tPG, -C'/cf I
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
VALUE AT DATE
OF DEATH
7-.
3,
~
..-
~;
DESCRIPTION
H f T'hAN'k
A) c:?.c-7? T of D.c-lbSIT'
)) ,4/c; A~. C? :? I a:::;:;q /3 J/1~1'..J 9
1-) Iflc.~,/I1J' (j.3lc:}o~q/~1 ??/~1'
a) A-/c./tlb. t:J3 / c;JO J; q /1f'~~"7C?';Ic)
~) C::ff,.c!"zK/.A.lG /f/c /(0. ~~~7'38"o64r"
c/fS#
19'~? ):,t-,//c* tf~4~L
fr~;,~;J5.; ~ Y/f~p'-:J:H-/?f~I:") - h..s;#~~r
, , ~p~ ..J~;;--;-2.-z.)
, ~et:?L /.3~ r:.~
b ~P:W/:I1'~rt$~- ~7?~-r;1-~ S~d--r
3?- d,e/f-,y t/ .L/faJ/I'
d- W4' ~rllj/;<
;$- /flf /I
,"\ /N
f ~/,k/.wIj.$71.H 19/'0/ rv-:/f Co
i #/:t 75 cJt'1 / W I j,d"" At-/70 ,L;;Vs-
h ~O.N5c-?o ~~<) ~,
~ 5Pf~- ~~/4yc;:~' ~':-~-7~7~r /j;Aid
~ ,
-3: c:::bA/( C!:-A5/ c..?1;6~"
~/tft/7(//V' It} ( d/:.z;;;::s,-: ~
?I!dIH; t\ m,-t,/...':;f/fL -;Fbd#GG~~~/ ?.EME~j{'Y
/ /.31
I; (J ~
rd9179'1
7, 3~1'"
1- 711
.1'" c:o
fr/f
Y1
2-f-o
3},O
p3
10
7-/3
7--6
~o
00
~
~5rz
9].0
TOTAL (Also enter on line 5, Recapitulation) $ 1;; 91'1
(If more space is needed, insert additional sheets of the same size)
REV-1510 EX + (1.97)
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE 9F
r/1/~~.:'~--< ~ /-#tAJ It J( i.)
FILE NUMBER
;t-/ - O>G - CJ /9 /
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 %OF
ITEM INCLUDE THE NAME OF THE TRANSFEREE. THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE
ATTACH A COPY OF THE DEED FOR REAl ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE)
NUMBER
1. eAsH: ~ C7,h,v s, /to (l9 t'f I:. b (:X;N) <6, 000 / cJ'c!/ .3; COO -
bA- f~ I //,./ t? t:: p ;C'CO
TOTAL (Also enter on line 7, Recapitulation) $ ---
J1 COO
(If more space is needed, insert additional sheets of the same size)
. REV-1511"EX+ (12-99) ,',
*k
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
,/~L
!/
ESTATE OF
.de=-d/?- 57 ~wA:;<'h
FILE NUMBER
:2-1-tJ~-o/9'1
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES: ~
1 /?(JLL/"/6dh:-~;N' ~~~.eAr 1""0
7--, 6, ~, )),,414f1/ - ~#~7<.A[ c5;c7<V'/c&:$""" 1'11-
:31 ~#/lrr,c-?/T L-k'A/a-k.c:c?N /?C)
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 - )3/f-x 131t't?A'~ ffr 5#'/4'(~~/I' gg/
-JA#~2), o619R. tlc>O
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 -j?/6ff~-~~ dJrtUltL5' - 6,.,-A,..72/h-1d ~~;V'f ~~
5. Accountant's Fees - Jet' A /(/ i<. c::b ~ I c:!- ~ A ,..-
3 I 3 fr~
6. Tax Return pre:arer's Fees - ~h"tt/ I? C:C'r) d /f C;t-ifrf ~CXJ/!J'~ I;/:>;"
7. ~/7I<".c'~~~/Ca- - M-MIClT~?k~ 'rtlf
?l. c!t-/14' &-:fr' LAd/) c::fbP#t(:-- ~C;-/!L. ~ frc;~r ~
t ~c1c7{/fL ;Z#c. 77tx 1~,&-;{rA#'-ri~H /t?t0/~o.G"- /?'(
/&, ~ck-7A L. ~~A t ~K/?c~(?):;/- ~~/4/C'itf/ ~ @ffD 1~'
//r J3A-N;f 5&I€V/~ L~/11<6c- 1
TOTAL (Also enter on line 9, Recapitulation) $ ~/L ,//1
'7 #77
Debts of decedent must be reported on Schedule I.
(If more space is needed, insert additional sheets of the same size)
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RE~-1513 EX-I; (9-00)
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
. RESIDENT DECEDENT
ESTATE OF
~pL,G/.r.: s ~
NUMBER
I
1.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
Margaret H Templin 6338 Ridge Rd, Zionsville PA 18092
FILE NUMBER
~/-t16 -tJ/9/
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
Do Not List Trustee(s) OF ESTATE
Daughter '3:;'31
Son ,8;'33
Granddaughter ,1111
Granddaughter ,1111
Grandson ,((/i
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
Il NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
"7
~
John S Howard, 9 Shaftsbury Lane, Hilton Head SC 29926
;3
f.
Kendra Wilson, 143 Whetherbine Way, Tallahassee, FL 32301
Helaina Vernon, 950 Deerwood Loop, Longwood, FI 32779
;::; , Kenyon Howard, 1111 Post Place, Apt 305, Apoka, FL 32703
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
]
LAST WILL AND TESTAMENT
OF
NELLIE S. HOWARD
I, NELLIE S. HOWARD, of Mechanicsburg, Cumberland
County, Pennsylvania, make, publish and declare this as and for
my Last Will and Testament, hereby revoking all other Wills and
Codicils heretofore made by me.
FIRST: I devise and bequeath all the rest, residue and
remainder of my estate of whatever nature and wherever situate,
including any property over which I hold power of appointment and
together with any insurance policies thereon as follows:
(A) One-Third (1/3) thereof, in equal shares, to the
children of my deceased son, CHARLES G. HOWARD, JR., said chil-
dren being KENDRA WILSON, KENYON HOWARD and HELAINA VERNON,
provided that should any of these individuals predecease me, I
give their share to their issue per stirpes by representation,
and if there be a failure of same, then I give and bequeath such
deceased individual's share to their surviving siblings, as
provided herein.
(B) One-Third (1/3) thereof to my daughter, MARGARET
E. TEMPLIN, provided that should she predecease me, I give and
bequeath her share to her issue per stirpes by representation.
(C) One-Third (1/3) thereof to my son, JOHN S. HOWARD,
provided that should he predecease me, I direct that his share
pass as follows:
(i) I give and bequeath the sum of One
Thousand and NO/100 ($1,000.00) to my grandson, SCOTT
A. HOWARD, the son of JOHN S. HOWARD. In the event
that SCOTT A. HOWARD predeceases me, I direct that his
share pass as follows:
(a) One-half (1/2) thereof, in
'.
"'.~ ,...," .... ,
distribution of all property:
(A) To sell at public or private sale, or to lease,
for any period of time, any real or personal property and to give
options for sales, exchanges or leases, for such prices and upon
such terms (including credit, with or without security) or
conditions as are deemed proper. This includes the power to give
legally sufficient instruments for transfer of the property and
to receive the proceeds of any disposition of it.
(B) To partition, subdivide, or improve real estate
and to enter into agreements concerning the partition, subdivi-
sion, improvement, zoning or management of real estate and to
impose or extinguish restrictions on real estate.
(C) To compromise any claim or controversy and to
abandon any property which is of little or no value.
(D) To invest in all forms of property, including
stocks, common trust funds and mortgage investment funds, without
restriction to investments authorized for Pennsylvania fiduci-
aries, as are deemed proper, without regard to any principle of
diversification, risk or produstivity.
(E) To exercise any option, right or privilege granted
in insurance policies or in other investments.
(F) To exercise any election or privilege given by the
Federal and other tax laws, including, but not necessarily being
limited to, personal income, gift and estate or inheritance tax
laws.
.
~
~
(G) To make distributions to my herein named benefici-
aries in cash or in kind or partly in each.
(H) To borrow money from themselves or others in order
to pay debts, taxes, or estate or trust administration expenses,
to protect or improve any property held under my will, and for
investment purposes.
(I) To select a mode of paYment under any qualified
3
Signed, sealed, published and declared by the above-
named Testatrix as and for her Last Will and Testament in our
presence, who, at her request, in her presence and in the
presence of each other, have hereunto subscribed our names as
attesting witnesses.
Address
~~~
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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
TEMPLIN MARGARET H
6338 RIDGE ROAD
ZIONSVlllE, PA 18092
__~__n_ fold
ESTATE INFORMATION: SSN: 207-09-0909
FILE NUMBER: 2106-0191
DECEDENT NAME: HOWARD NELLIE SPOTTS
DATE OF PAYMENT: 07/07/2006
POSTMARK DATE: 07/05/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 02/09/2006
NO. CD 006939
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $1,386.00
I
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TOTAL AMOUNT PAID:
REMARKS: MARGARET H. TEMPLIN
CHECK#1045
SEAL
INITIALS: WZ
RECEIVED BY:
REGISTER OF WILLS
$1,386.00
GLENDA FARNER STRASBAUGH
REGISTER OF WillS