HomeMy WebLinkAbout07-03-06
IN THE OFFICE OF THE REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
INVENTORY
Estate of CHARLES H. CRISP
also known as CHARLES H. CRISP, JR.
No.21
06
00357
, Deceased
Date of Death 3/27/2006
Social Security No. 195-07-1881
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Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of indo
personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valualtOC!
placed opposite each item of said inventory represents its fair value as of the date of the Decedent's death, and that Decedent oWr)oo no
real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. i/We
verify that the statements made in this inventory are true and correct. I/We understand that false statements herein made are subjtfctto the
penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities.
Name of
Attorney Gerald J. Shekletski
Personal Representative:
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I.D. No.: 40486
Orpha Jean Hare, Executrix
7/.3 /to ~:
Dated
Address 414 Bridqe St., P.O. Box E
New Cumberland
PA 17070
Telephone: (717) 774-7435
Description
Value
PERSONAL PROPERTY
1. PNC Bank Certificate of Deposit, Account #21001030431
39,150.35
2. PNC Bank Certificate of Deposit, Account #31100206501
5,934.54
3. PNC Bank Certificate of Deposit, Account #31800205357
4,381.66
4. Highmark Health Insurance Premium Refund Check
436.98
REAL ESTATE
1. Kensington Drive, Camp Hill, PA 17011
157,000.00
Total
206,903.53
(Attach Additional Sheets if necessary)
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative,
include the value of each item, but such figures should not be extended into the total of the Inventory.
RW-4
Continuation of Inventory
r:HARLES H. CRISP
21
06
00357
Paqe 1
Description of Inventory
Description
Value
Subtotal $
Grand Total $
206,903.53
REV-1500 EX + i6.00)
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REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
FILE NUMBER
C";
-06 0 3 ~ 7
cc%yCCSE ~A~ - - NU75ER- -
2'
COMMONWEAL TH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
DECEDENT'S NAME (LAST FIRST, AND MIDDLE INITIAL)
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Cris , Charles H.
DATE OF DEATH (MM-DD-Year)
DATE OF BIRTH (MM-DD-Year)
SOCIAL SECURITY NUMBER
95- 0 7 - 1 881
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WillS
SOCIAL SECURITY NUMBER
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03/27/2006 05/14/1914
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MiDDLE INITIAL)
o 1 Remainder Return Icale of dealh pnor 10 12.13-82:
o 5 Federal Estate Tax Return Required
Q.. 8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (Allach Sch 01
IX] 1 Original Return
o 4. limited Estate
IX] 6. Decedent Died Testate (Allach copy of Willi
o 9. litigation Proceeds Received
o 2. Supplemental Return
o 4a. Future Interest Compromise (date of dealh after 12-12-82)
o 7. Decedent Maintained a living Trust (Altach copy at Trust)
o 10. Spousal Poverty Credit (dale of death between 12-31-91 and 1-1-95)
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THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
Gerald J. Shekletski, Es . 414 Bridge St.
FIRM NAME (If Applicable)
Stone LaFaver & Shekletski P.O. Box E
TELEPHONE NUMBER
717 774-7435 New Cumberland PA 17070
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
(1)
(2)
(3)
(4)
(5)
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157,000.00
OFFICIAL USE ONLY
1 Closely Held Corporation, Partnership or Sole-Proprietorship
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)
49,903.53
(6)
(7)
210,778.55
8. Total Gross Assets (total lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
(9)
23,294.32
10. Debts of Decedent, Mortgage liabilities, & liens (Schedule I) (10)
11. Total Deductions (total lines 9 & 10)
12. Net Value of Estate (Line 8 minus line 11)
1,865.97
--.J
2,009.05
(8)
0.00 X _(15) 0.00
187,484.23 X .045 (16) 8,436.79
0.00 X 12 (17) 0.00
0.00 X 15 (18) 0.00
(19) 8,436.79
(11)
(12)
(13)
23,294.32
187,484.23
11 Charitable and Governmental Bequests/Sec 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)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate. or transfers under Sec. 9116 (a)( 12)
(14)
187,484.23
16. Amount of Line 14 taxable at lineal rate
17 Amount of Line 14 taxable at Sieling rate
20. D
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
> > BE SURE TO ANSWER All QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
18. Amount of Line 14 taxable at collateral rate
19 Tax Due
Decedent's Complete Address:
STREET ADDRESS
1 Kensinqton Drive.
Camp Hill
I STATE
PA
ZIP
CITY
17011
Tax Payments and Credits:
1 Tax Due (Page 1 Line 19)
2. Credits/Payments
A Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
8,436.79
Total Credits ( A + B + C )
(2)
0.00
3. InterestJPenalty if applicable
D. Interest
E. Penalty
TotallnterestJPenalty ( D + E : (3)
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 (4)
5 If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (5B)
Make Check Payable to: REGISTER OF WILLS, A GENT
0.00
0.00
8,436.79
8,436.79
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; ......................................................... .................. 0 [Xl
b. retain the right to designate who shall use the property transferred or its income; ............................. ........... 0 [Xl
c. retain a reversionary interest; or ...................................................................................................... 0 [Xl
d. receive the promise for life of either payments, benefits or care? ............................................................ 0 [Xl
2. If death occurred after December 12,1982, did decedent transfer property within one year of death
without receiving adequate consideration?................................ .............................................................. [Xl 0
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ................. 0 [Xl
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ......... ........ ..... ....... ......... ................................... ............. ................. 0 [Xl
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G ANlD 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 knowiedge 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.
SIGNATURE OF R RSON RESPONSIBLE FO FILING RETURN ,
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ADDRESS Orpha J an Hare, Ex cutrix
3406 Bedfo ,Cam Hill
SIGNATURE OF PREPA
DATE
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PA 17011
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ADDRESS ~Gerald J. hekletski, Esq.
414 Bridge St., P.O. Box E, New Cumberland
PA 17070
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 PS 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 PS. 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 PS 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 PS S9116( 12) [72 PS. 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% 172 PS S9116(a)(13)]. 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.
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I declare this to be my Last Will and revoke any will or codicil previously made by me.
LAST vYiLL A:-JD TESTAMENT
OF
CHARLES H. CRKSP
I, CHARLES H. CRISP of the Township of Lower Allen, Cumberland County, Pennsylvania,
ITEM 1: I direct that upon my demise, that my body be interned at the Rolling Green
Memorial Cemetery next to my late wife, EVA S. CRISP.
ITEM 2: I direct that all my just debts and expenses be paid when practicable after my demise.
I
II ITEM 3: I give, devise and bequeath the sum of $5,000.00 unto eacb of my ll'andchildren,
I namely, CRAIG D. CHRISTIE, DANIELLE RENEE CRISP, NICOLE MARIE CRISP, and KELLY
i CHARLENE BARCLAY
ITEM 4: I give, devise and bequeath my late wife's assortment of opal jewelry to my
I
I granddaughter, DANIELLE CRISP.
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,-h.. ~I JUDrill ANN CHRISTIE and tbe other mink stole to my daughter, ORPHA JEAN BARCLAY.
J ~III ITEM 6: I give, devise and bequeath all the rest, residue and remainder of my estate ,
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y- Cf.lllwheresoever situate, together with insurance thereon, to my children, in equal shares, CHARLES H.
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~i : CRISP, III, JUDITH ANN CHRISTIE and ORPHA JEAN HARE, or to their issue per stirpes.
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ITEM 5: I give, devise and bequeath one of my late wife's mink stoles to my daughter,
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ITEM 7: I direct that all taxes that may be assessed in consequence of my death, of whatever
i nature and by whatever jurisdiction imposed, shall be paid from my n~siduary estate as a part of the
, ; expense of the administration of my Estate.
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I ITEM 8: I appoint my daughter, ORPHA lEAN HARE, Executrix, of this my Last Will. In the ·
I event my daughter, ORPHA JEAN HARE, fails to qualify or cease to act as Executrix, I appoint my son,
\
I CHARLES H. CRISP, III, Executor ofthis my Last Will.
ITEM 9: I direct that my personal representative or her successor shall not be required to give
! bond for the faithful performance of their duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and
Testament, this /~I day of }1'(auJt. , 2002.
(!jUui~ L1J (!~f~
CHARLES H. CRISP v
I Signed, sealed, published and declared by the above-named Testator as and for his Last Will and
Testament in our presence, who, at his request, in his presence and in the presence of each other, have
I \ hereunto subscribed our names as attesting witnesses.
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II COMMONWEAL 1H OF PENNSYLVANIA
, COUNTY OF CUMBERLAND
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I We, CHARLES H. CRISP, fh,rJf!. /n. DC'TW\.tV~ , and
I, t I ~A- rn Ih1 j E (C'" N €" , the Testator and the witnesses respectively, whose names are
signed to the attached 'or foregoing instrument, being first duly sworn, do hereby declare to the
I undersigned authority that the Testator signed and executed the instrument as his Last Will and that he
,had signed willingly, and that he executed it as his free and vohmtary act for the purpose therein
expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the will as
witness and that to the best of his or her knowledge, the Testator was at the time eighteen (18) years of
older, of sound mind and under no constraint or undue influ~: j, A -t.!t-- \!'I/!!t~
~. CRISP
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Subscribed, sworn and acknowledged before me 1J.e.~'.'r"i c:. C:.i 7N (; by CHARLES H.
CRISP, the Testator, and subscribed and swan: to before ~,~ l11"vi~ ~YNlS
and J4..,r. >1 ~ /!It. f) Ol" ~ , the WItnesses, thIS ].il'n.. day of ;?! ~( .... "t\.
2002.
Wu~~~
Notary Public.~:AL)
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REV-1502 EX + (6-98)
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF
FILE NUMBER
CrisD. Charles H. 21 06 0367
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 riQht of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
All that certain tract or parcel of land with the buildings and improvements thereon
erected, situate in Lower Allen Township, Cumberland County, Pennsylvania known as
1 Kensington Drive, Camp Hill, PA....Being the same premises which Country and Town
Homes, Inc., a Pennsylvania Corporation, by deed dated September 26, 19516, and
recorded September 26, 1956, in the Office of the Recorder of Deeds in and for
Cumberland County, Pennsylvania, in Book H-17, Page 371, granted and conveyed unto
Charles H. Crisp and Eva S. Crisp, his wife. Eva S. Crisp died June 3, 2001, whereby
title vested in the decedent, Charles H. Crisp, by operation of law. The property was sold
to Yong Duk Kim and Myung Suk Kim on June 30,2006 for $157,000.00. Copies of the
deed of conveyance and settlement sheet are attached hereto.
VALUE AT DATE
OF DEATH
157,000.00
TOTAL (Also enter on line 1, Recapitulation) $
(If more space is needed. insert additional sheets of the same size)
157,000.00
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PARCEL #
DEED
THIS INDENTURE made the
,( /F
day of
-,-,
.': {t~-t
in
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year 2006, between ORPHA JEAN HARE, Executrix cf the Last Will and
~estament of CHARLES H. CRISP a/k/a CHARLES H. CRISP,JR., late cf
~cwer Allen Township, Ccunty of Cumberland and Commonwealth of
Pennsylvania, cf the fi~st part, hereinafter called the Grantor,
-AND-
YONG DUK KIM and MYUNG SUK KIM, father and son, of the second
[art, hereinafter called the Grantees;
WHEREAS, the said Charles H. Crisp a/k/a Charles H. Crisp, became
~n his lifetime seised, as of fee, of and in to a certain tract of
land, together with the improvements thereon erected, situate in Lower
Allen Township, County of Cumberland, and Commonwealth of
Pennsylvania, and more particularly described hereinafter; and being
so thereof seised, died on March 27, 2006, having first made his Last
Will and Testament in writing dated March 20, 2002, duly probated and
registered in the Office of the Register of Wills of Cumberland Coun~y
=n April 24, 2006, wherei~ and whereby he appointed as ExecL~rix, the
s~~,j ~D~3 ,Jean Hare, to ~ham Letters Testa~entary ~:ere d~~~' iss~ed D~T
2~,~,~A ?e?is~e~ ~f ~Ji~ls
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in b~d by said Will and the records of said Register 0- Wills ~ore
~Llllv appears;
NOW THIS INDENTURE WITNESSETH,
that the said Grantor,
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consideration of the sum of One Hundred Fifty-Seven Thousand and
nC/I00 ($157,000.00) Dollars, which has been paid to h~r by the said
Grantees at or before the sealing and delivery hereof, receipt whereof
is hereby acknowledged, has granted, bargained, sold, aliened,
released and confirmed, and by these presents does grant, bargain,
sell, alien, release and confirm unto the said Grantees,
ALL THAT CERTAIN tract or parcel of land with the buildings and
improvements thereon erected, situate in Lower Allen Township, Cumber-
land County, Pennsylvania, more particularly bounded and
described as follows, to wit:
BEGINNING at the point on the westerly line of Slate Hill Road, which
point is 165 feet South of the southwesterly cornE:r of Slate Hill Road
and New Route No. 15 and at dividing line between Lots Nos. 1 and 2,
Block "A" on the hereinafter mentioned Plan of Lots; thence along the
westerly line of Slate Hill Road, South 42 degrees 20 minutes East,
101.07 feet to a point; thence in an arc having a radius of 20 feet in
a southwesterly directions, 26.91 feet to a point en the northerly
line ef Scarsdale Drive; thence along same South 34 degrees 45 minutes
West, 71.38 feet to a point; thence in an arc having a radius of 20
feet in a northwesterly direction 28.97 feet to a peint en the east-
erly line of Kensington Jrive; thence along same North 62 degrees 15
~inutes \~est, 79.51 feet to a point at the dividing line between Lets
~J s. 1 and .2, Blo::::1< "A" afe:::.-esaid; thence along s3.id di vidin'J line
~lo~~h 2~ degrees 45 minu~es 2ast, l44. 8 feet to a p8~nt, the Dl~ce cf
2:EC; I ~,E'T:= 1'i<:; .
BEING ~c t LJ~.
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=- :~ : ., p ~::>? f>:i ~ e ,j 0 ~t =:;.:;:'. ?~ f f 2 :'1 S I= e r- 'J s r ,
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BEING THE SAME PREMISES WHICH Country and To"m homes, ~nc., a Pennsy~-
~ar.~a corporation, by deed dated September 26, 1956, and recorded
September 26, 1956, in the Office of the Recorder of Deeds in and for
Cumberland County, Pennsylvania, in Record Book K, Volume 1~, Page
351, granted and conveyed unto Charles H. Crisp and Eva S. Crisp, his
wife. E7a S. Crisp died June 3, 2001, thus by operation of law
vesting title in Charles H. Crisp, deceased.
TOGETHER with all and singular the buildings, improvements, ways,
streets, alleys, passages, waters, water-courses, rights, liberties,
privileges, ~ereditaments and appurtenances whatsoever, thereunto
belonging or in any wise appertaining and the reversions and
remainders, rents, issues and profits thereof, and all the estate,
right, title, interest, property, claim and demand whatsoever of him,
the said Charles H. Crisp a/k/a Charles H. Crisp, Jr., at and immedi-
ately before the time of his decease, in law, equity, or otherwise
howsoever, of, in, to or out of the same.
TO HAVE AND TO HOLD the said lot or plece of ground above de-
scribed, with the buildings and improvements thereon erected,
hereditaments and premises hereby granted or mentioned, and intended
so to be, with the appurtenances unto the said Grantees, to and for
the enlv proper use and behoof or the said Grantees, forever.
~~a the said Gr3nt~r, for ~ersel~ and her respecti~e ~ei~s,
eX~C-jt8~S 3TIa a!jmiTIist~~~o~s, jces co~;e~ant, prc~lse and agree ~ ~~ A
~~i~-~ t~e said Gr3n~ees, tteir ~elrs and asslgns, ttat sne, t~e S2lQ
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wharsoever whereby the Fremlses hereby granted, or any part thereof,
~s, are, shall or may be impeached, charged, or encumbered in t~tle,
charge, estate or otherwise howsoever.
IN WITNESS WHEREOF, the said Grantor has hereunto set her hand
a~d sea~ the day and year first above written.
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~'Ji tness ",:.9
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ORP~A JEAN1HARE, Executrix of
the Last Will and Testament of
Charles H. Crisp a/k/a Charles H.
Crisp, Jr.
CCHHONWEAL7~ CFJ; p.. N~LVAN~I:, .
;t; ? 1;/. 55.
COUNTY OF ~ :
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On this, the~L> day of ~ ~
Public, the undersigned officer, personally
, 2006, before me a ~otary
appeared ORPHA JEAN HARE,
ExecJtrix of the Last Wlll and Testament of Charles H. Crisp a/Kia
Charles H. Crisp, Jr., known to me or satisfactorily proven to be the
cerson whose name is subscribed to the within instrument, and acknowl-
edged that she executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I have
CC)M,'viCNWEt,LfH C:t PEi',NSYLVANIA
I ~,..CTt\;:<!AL SEAL
DA,\;EL "-'1. r~r\riTt,1(~f~, Nctary F'~b)ic
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L'';I~ ......",111 ~).::; \l ~ i"'l ....., .... - '..',
hereto set my hand and notarial seal.
,...------
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(iC)yr--------
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-...1:-
I hereby certify that the precise address of the Grantee
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PrI::'V;011:, ei.!dlon<; drf; uuc;ulele
form fllJU~l (3,t;fj) ref H;lndbo()r 4,iU'J.2
A Settlement Statement
1. lJ FHA
4. [JVA
C. Note:
2. DFmHA 3. DConv Unins. 6. File Number
5. DConv. Ins. 28000KIM
IS onn IS urnlS e 0 give you a s a emen 0 ac ua se emen cos s moun s pal 0 an y e se emen agen are sown
!terns marked "(p_o_c,)" were paid outside the closing: they are shown here tor Information purposes and are not included in the totals
WARNING: It is a crime to knowingly make false statements to the United States on this or any other similar form. Penalties upon
conviction can include a tine and imprisonment. For details see: Title 18 U. S. Code Section 1001 and Section 1010.
1
_BcIYP~l Loan
TitleExpress Settlement System
Printed 06/30/2006 at 0845 DMH
--_._-,,~ ..~_...._--"
D. NAME OF BORROWER:
ADDRESS
~-~-"
E. NAME OF SELLER
ADDRESS
-_.~------~-
F. NAME OF LENDER:
ADDRESS
- ~.._..-._..~~-
G. PROPERTY ADDRESS
Yong Duk Kim and Myung Suk Kim
28 Blue Spruce Drive, Enola, PA 17025
Estate of Charles H. Crisp
H. SETTLEMENT AGENT
PLACE OF SETTLEMENT:
I SETTLEMENT DATE.
Wells Fargo Bank, N.A.
811 Camp Horne Road, Suite 210, Pittsburgh, PA 15237
1 Kensington Drive, Camp Hill, PA 17011
Lower Allen Township
Cedar Cliff Abstract Agency, Inc., Telephone: 717.774.7435 Fax: 717.774.3869
414 Bridge Street, New Cumberland, PA 17070
06/30/2006
I
1-
r
r-
~
[
~
J. SUMMARY OF BORROWER'S TRANSACTION: K. SUMMARY OF SELLER'S TRANSACTI
_....- -
100. GROSS AMOUNT DUE FROM BORROWER 400. GROSS AMOUNT DUE TO SELLER
101. Contract sales price 157000.00 401. Contract sales orice ~--~
-----...-..
102. Personal Property 402. Personal Prooerty
103__?e!t~rTle.IlLcharges to borrower (line 1400) 5 287.92 403.
104. 404.
-_.._~-
105. 405.
~-~--~---
.-~---_.. Adjustments for items paid bv seller in advance Adiustments for items paid by ~eII~ini3cJ\lanc
1 06~/town taxes 406. City/town taxes .-
..-.....- -- ---
J_Q7-'---~QUnty taxes 06/30/06 to 12/31/06 239.10 407. County taxes 06,/30/06 to 12/31/06
-~ ----~-~
108. School taxes 06/30/06 to 06/30/06 2.75 408. School taxes 06,/30/06 to 06/30/06
_._--_._~- ~_._-~.-
109. 409.
------ ----.----.-
110. 410. -~
----~-- ~_._~----
111. 411.
-- ~~--- - ---.- -~ --~-
112. 412.
- -
120. GROSS AMOUNT DUE FROM BORROWER 162,529.77 420. GROSS AMOUNT DUE TO SELLER
.________ _ ~u_._._~_._
200. AMOUNTS PAID BY OR ON BEHALF OF BORROWER 500. REDUCTIONS IN AMOUNT DUE TO SELLER
Excess Deoosit (see instructions) --~-~--_..-
~_l,- Deposit or earnest money 2,000.00 501.
_~Q?-,---frincipaLamount of new loans 100,000.00 502. Settlement charaes to seller (line 1400)
-- _.~_._.._.
_2Q_~_~~~~~~taken subiect to 503. Existina loanls) taken sublect to
204. 504. Payoff of First Mortaaae Loan
------...-------
205 Broker Cred for Crd Rot 33.65 505.
- --.-----.--.. --
206. 506.
I------~-
207. 507.
--.. _._-~- -
~O~___~_~_ 508.
--- ..--..--------
209. 509. ~__L-_.____._
-----~-
Adjustments for items unoaid bv seller Adiustments for items unpaidb seller
-------- _._u._
_21Q '-- C;ity"!.o..w-'!laxes 510. City/town taxes
- --
]JJ~_c:..ounty taxes 511. County taxes
-- ~_._----
212. School taxes 512. School taxes --
.~ -~-------- -..--.-.---,--
213. 513.
-.--..-.- .._"--.~.-
214. 514.
215. 515. --
---..--- --- -.---
216. 516.
-.-.-.---.- -- .-----..---
217. 517.
-------.-----
218. 518.
--- ._--------- ---
219. 519.
-- ..-.
220. TOTAL PAID BY/FOR BORROWER 102 033.65 520. TOTAL REDUCTION AMOUNT DUE SELLER
300. CASH AT SETTLEMENT FROM OR TO BORROWER 600. CASH AT SETTLEMENT TO OR FROM SELLER
301. Gross amount due from borrower (line 120\ 162,529.77 601. Gross amount due to seller (line 420) j=
_]02 Less amounts paid by/for borrower (line 220) 102,033.65 602. Less reduction amount due seller (line 520)
----~--_.-
303. CASH FROM BORROWER 60,496.12 603. CASH TO SELLER
- --------.--..-----.-
ON:
_1.57JOOO.00
e
239.10
2.75
-
-=~~-~--~----=J
u15I,241.85j
~1~8~ool
- 1
___J L580.00
__1S]12_41:?5
1,580.00_
i
__J55,661.85 !
SUBSTITUTE FORM 1099 SELLER STATEMENT: The information contained herein is important tax information and is being furnished to the Internal Revenue Service If you are rClluired to file <1 rctum
a ne~lllgence penalty or other sanction will be imposed on you if this item is required to be reported and the IRS determines that it has not been reported. The Contract Sales Price described on
I!ne 401 above constitutes the Gross Proceeds of this transaction
You are required by law to provide the settlement agent (Fed. Tax 10 No: ._) with your correct taxpayer identification number. If you do not provide your correct taxpaypr idefltllic<'llion
number, you may be subject to civil or criminal penalties imposed by law. Under penalties of perjury, I certify that the number shown on this statement is my correct taxpayer Identlficdtion llL.:mber
TIN
______ - ~ -______ SELLER(S) SIGNATURE(S)
SELLER(S) NEW MAILING ADDRESS
SELLFR(S) PHONE NUMBERS.
______________(H) ~
_____._ _(WI
, Jf '; 1 ) ~ ':' I) ) I ~ \, .
fUlrn iiLJU i \,j'I)(i; fl,1 HdlldtJof)~. 4,' I'"
File Number: 28000KIM PAGE 2
TitleExpress Settlement System Printed 06/3Q!~0~~at 0~:45[)MH
PAID FROM PAID FROM
BORROWER'S SELLER'S
FUNDS AT FUNDS AT
SETTLEMENT SETTLEMENT
US DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT
SETTLEMENT STATEMENT
-- --------~-,--- ~
L. SETTLEMENT CHARGES
-- ,---------
700. TOTAL SALE?I~ROKER'S _COMMISSION based on price $157,000.00 =
Division ofco~rT\is_sionJline 700) as follows:
701 $ to
-----~-----
702. $ to
--._------
703 Commission paidaLS~tU~ment__
800. ITEMS PAYABLE IN CONNECTION WITH LOAN
u_ ________
801. LoanOriginati()n. F~
802. Loan Discount
803. Appraisal~e~_
804. Credit RelloQ_ ____
80S. Lender's Ins2-ection[e_
806.
--"--',,--- ---
807. Mortgage Broker~om~
808. Undervvriting Fee__ .
809. Tax Service Fee
810 Flood Cert Fee
- -~----..~---
811 Processing Fe~
900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE
-- ------ -----..-. ---------..----------------- --
901 Interest Fr().m~ _Jl6/30/2006 to 07/01/2006 @$
902. MortgafLe 1n..~llran~e.Er~ml.lJ.m for to
903 Hazard Insurance Premium for to
- ---- .-----..-
904
905
------ --,,---
1000. RESERVES DEPOSITED WITH LENDER FOR
- .._-------~-
1001 Hazard Insurance 3 mo. @ $
1002. MortgafLe Insurall<:.e__ ___ mo. @ $
1003 City PropertyIax _ _____ 6 mo. @ $
1004 Countypro~rt~~_~ 6 mo. @ $
1005 School taxes ___ 12 mo. @ $
1006. Annua~AssesrTll:lnts_ 5 mo. @ $
1009 Aggregate Analysis Adlusll:D~ent to Wells Fargo Bank, N.A.
1100. TITLE CHARGES
1101 Settlemen!_ orclgsiQQ.fee
1102. Abstract or title search
-- -- .--- - -----~
1103. Title examination
1104. Title Insurance binder
- --------- ------ ~
1105. Document Prellaratiorl_ __to Stone Lafaver & Shekletski
1106 Notary Fees ~ ___ -----.-Jo Cash
1107. Attorney's fees ___ __
Uncludes above 1ll:J.fl1SJiQ:._
1108. Title Insurance . _. .___--------.-!o Ced_a.!... Cliff. Abstract Agency, Inc.
Uncludesaboye~items No
Lender's Poll(;y~__ 100,000.00-
Owner's Policy _.~~_____~__ 157,000.00 -1,143.75
End 100, End )00.J:!l.cl_ 9QQ.__!9_ Cedar Cliff Abstract Agency, Inc.
CloslngSvc_Ltr _ _____. to Cedar Cliff Abstract Agency, Inc.
-.--.-- ------
_._-~--- %
% - t---~--.- .~
.- to Diversified Appraisals (P.O.C.) 300.00 Buver
to CBY (P.O.C.) 50.00 B~r lR
--~---
e
-~--- -------"-.---
---~---- - .- ~'--'-.'~
1.891 % Community Bank $1,891.00 POC by Lender
.-----------
----- . to Wells Fargo Bank, N.A. LR 500
to Wells Fargo Real Estate Tax Srv LR 100
--..--- ~- -..----
__._~Wells Fargo Flood Service LR 19
____._~ommunity Banks 275
.00
.00
.00
.00
17.4700 /day
1 Days
I~~~l=
26.17 Imo
Imo
12.21 /mo
19.17 Imo
87.81 Imo
7.57 Imo
LR
78.51
LR 73.26
-~ 1------_. -----
LR 115.02
-----.._------
LR ho?3}~
LR 37.85
. !------".-.-- .-
LR -304.66
~100'00i ..... . ..
0.00
to Stone Lafaver & Shekletski
-~._-
.-1----
25.00
__M_'________'_____'
10.00
____'L143.J5_
1109.
1110.
1111
1112
1113
- ---_.- --.-----
1200. GOVERNMENT RECORDING AND TRANSFER CHARGES
-,-------,,--- ~--~---,,----~._--
1201 Rec.Qrding F~~ D~e~d $ 38.50 ; Mortgage $ 68.50 ; Release $
. 1202. CityICounty_@x/s~s Deed $1,570.00 ; Mortgage $
1203. State Ta~~tarn~__ Deed $1,570.00 ; Mortgage $
1204.Beco~din9..Eee_~_.EQA to Cumberland County Recorder of Deeds
1205.
-----_.._,------~
1300. ADDITIONAL SETTLEMENT CHARGES
.----" - -- -------.----
1301 Survey __________.
nO? "pest Ins(lection___~___
1303. CounerlWirefe~____~tone Lafaver & Shekletski
1304. ETF Fee _______ __J() Stone Lafaver & Shekletski
1305 Sewer/Refuse 3rd Qua~_JQ Lower Allen Township
150.00
35.00
Ui~~:W~f=
~~~QOI _ _J.S7000
r---
40.00
50.00
85.00
1400. TOTAL SETTLEMENT CHARGES
- - ---~- - -- -~ - ~-- --~-----
(enter on lines 103, Section J and 502, Section K)
HUO CERTIFICATION OF BUYER AND SELLER
_u5.L28L9~ _ _. 1,580.00
Ill.JV1! (.,m~f\lily rf~VI~~wed Ule HUD-l Settlement Statement and to the best of my knowledge and belief, it is a true and accurate statement of all receipts and disbursements made un my account
"r ;..;':;;;:;~~rther ce~rhall have receIved a copy of the HUD.1 Settlement Slateme~;0-~l.M) DC( I< ~l m Dr It- C IC;d k' 1<" ~ 11
Yonq [M ~~n l') . - . -. -7~ Myung ~uk [{,m ~c )/-_mpIY;"_ '"
((1 .. ... \ \)l\.
-'. \' ,-. -. \ t f" \,
F,LifO ell nl:"r~:~~rI~:i)'\'-...:::.:::~}~~ V t
('
V So
WARr,IN(; If IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE
UNlff [) S TAlTS 0N THIS OR ANY SIMILAR FORM. PENALTIES UPON CONVICTION
CAN INet UOE A FINE ANO IMPRISONMENT. FOR DETAilS SEE TITLE 18
I J S CuOl SLCnON 1'101 AND SECflON 1010
The HUD-1 Settlement Statement which J ~ p~ajed IS a true and accurate account uf thl~
transactIon I have caused or Will ca ~ ..fwrrI'f.S,ft:fbe dIsbursed I~~ance WIth th!~ ~tdtem'--.:nt
?:;?_~:- I /
X~~":>,. - C./I
SETTLEMENT AGENT ~__ V ~/ DA '"f / "S( ,It (
REV-15G8 EX + (6-98)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
CrisD. Charles H.
FILE NUMBER
21 06
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 SchedUlle F.
0367
ITEM
NUMBER
1.
DESCRIPTION
PNC Bank Certificate of Deposit, Account #21001030431.
VALUE AT DATE
OF DEATH
39,150.35
2.
PNC Bank Certificate of Deposit, Account #31100206501.
5,934.54
3.
PNC Bank Certificate of Deposit, Account #31800205357.
4,381.66
4.
Highmark Health Insurance Premium Refund Check
436.98
NOTE:
The personal property referenced in Items 4 and 5 of the decedent's will was given to
the beneficiaries named therein by the decedent more than one year prior to his death.
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed. Insert additional sheets of the same size)
49,903.53
~~~ (00 ~~~o ~.~l
o PNCBAN<
May 01,2006
Stone LaFaver & Shek1etski
Attn: Gerald J Shekletski
414 Bridge 5t.
POBox E
New Cumberland, P A 17070
scp
RE: Estate of Charles H Crisp (Deceased)
SSN: 195-07-1881
DOD: 03-27-2006
Dear Mr. Shekletski:
In response to your request for Date of Death balances for the customer noted above, our
records show the following:
Certificate of Deposit
Account #21001030431 Established 10-14-1993
CHARLES H CRISP JR
DOD balance: $39,115.91 + $34.44 accrued interest
Account #31100206501 Established 01-16-2001
CHARLES H CRISP JR
DOD balance: $5,929.60 + $4.94 accrued interest
Account #31500261068 Established 05-04-2005
CHARLES H CRISP
ORPHA J HARE
DOD balance: $4,997.89 + $11.16 accrued interest
Account #31800205357 Established 01 1-16-200 1
CHARLES H CRISP JR
DOD balance: $4,378.01 + $3.65 accrued interest
Checking Account
Account #5140013703 Established 08-04-2004
CHARLES H CRISP JR
ORPHA J HARE
DOD balance: $3,731.27 + 50.66 accrued interest
Page 1 of2
I I ''''''''-'1 II U'
412 768 3458
P.02
Please note that this office only provides date of death balances for deposit accounts
(!RAs) CDs) Checking and Savings accounts). We do not process any financial
transactions or provide statements. If you need assistance with any of these items,
please call 1-888-PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch
office.
Sincerely.
~;/~
Erica L Schlegel
1.800-762-1775
P7 -PFSC-04-F
500 Firs[ Ave.
Pittsburgh PA 15219
Member FDIC
Page 2 of2
TOTAL P. 02
REV-1509 EX + (6-98)
.
SCHEDULE F
JOINTLY-OWNED PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
CrisD. Charles H.
FILE NUMBER
21 06
0367
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
ADDRESS
RELATIONSHIP TO DECEDENT
A Orpha J. Hare
3406 Bedford Dr.
Camp Hill, PA 17011
Daughter
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 NUMBER OR SIMILAR DATE CF DEATH DECO'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A. 8-4-04 PNC Bank checking account #5140013703. 3,731.93 50. 1,865.97
TOTAL (Also enter on line 6, Recapitulation) $ 1,865.97
(If more space IS needed. insert additional sheets of the same size)
REV-1510 EX + (6-98)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER.VIVOS TRANSFERS &
MISC. NON.PROBA TE PROPERTY
ESTATE OF
CrisD. Charles H.
FILE NUMBER
21 06
0367
This schedule must be completed and filed If the answer to any of questions 1 through 4 on the reverse side of the F(EV-1500 COVER SHEET is yes.
DESCRIPTION OF PROPERTY
ITEM ~Jr:Ll.'CE 7HE NAME OF THE TRANSFEREE. TI-<EIR RELATiCNSHIP TO DECEDENT AND DA TE OF DEATH % OF DECD'S EXCLUSION TAXABLE
NUMBER THE DATE or; TRANSFER. ATTACH A coPy OF THE CEED FeR '<.EAL ESTATE VALUE OF ASSET INTEREST VALUE
I,j: APPLICABLE;,
1. PNC Bank Certificate of Deposit, Account #31500261068. 5,009.05 100. 3,000.00 2,009.05
Transferee - Orpha J. Hare, Daughter.
TOTAL (Also enter on line 7 Recapitulation) $ 2,009.05
(If more space is needed. insert additional sheets of the same size)
REV-1511 EX + (12-99)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
CriSD Charles H.
FILE NUMBER
21
06
0367
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES
1. Parthemore Funeral Home and Cremation Services, Inc. 8,621.20
1303 Bridge St., New Cumberland, PA 17070
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 Gerald J. Shekletski, Esq. 7,000.00
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 Letters Testamentary 302.00
5. Accountant's Fees
6. T ax Return Preparer's Fees
7. Legal Advertising - The Patriot News 123.18
8. Legal Advertising - Cumberland Law Journal 75.00
9. UGI 108.25
10. Sears Credit Card 1,674.05
11. Com cast 18.90
12. Stanley Steamer Carpet Cleaning 137.80
13. Lawn Maintenance 159.77
14. PPL 15.95
15. Pennsylvania American Water Company 18.07
16. Verizon 20.91
17. Lawn Mowing Charge 30.00
18. Advertising Fee - Sale of 1 Kensington Drive, Camp Hill, PA 17011 157.40
TOTAL (Also enter on line 9. Ftecapitulation) $ 23,294.32
(If more space is needed, insert additional sheets of the same size)
Crisp, Charles H.
Decedent's Name
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
Page 1
21 06 0367
File Number
Schedule H - Funeral Expenses & Administrative Costs - 87.
ITEM
NUMBER
DESCRIPTION
AMOUNT
19.
20.
21.
22.
23.
24.
25.
26.
27.
28
29.
Holy Spirit Hospital
Lawn Mowing Charge
Gingrich Memorials - Headstone
Lawn Mowing Charge
Lawn Mowing Charge
Pennsylvania American Water Company
PPL
Settlement Expenses - 1 Kensington Drive, Camp Hill, PA 17011. $ 1,580.00 (line 502
of settlement sheet) less $241.85 (adjustments for lines 407 and 408 of settllement
sheet) = $ 1,338.15
Filing Fees - Inheritance Tax Return $15.00 Personal Inventory $15.00
Additional Probate Fee
Reserve for Closing Expenses
122.02
30.00
2,870.00
30.00
30.00
18.57
13.10
1,338.15
30.00
50.00
300.00
SUBTOTAL SCHEDULE H-B?
4,831.84
"",~"He',(*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
FILl: NUMBER
r.risn r.h::lrlps H. 21 06 m67
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Tl'ustee(s) OF ESTATE
I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)J
1. Orpha Jean Hare a/k/a Orpha J. Hare Lineal 1/3 of R"Bidue
3406 Bedford Drive
Camp Hill, PA 17011
2. Judith Ann Christie Lineal
495 Furnace Hollow Road 1/3 of Residue
Shippensburg, PA 17527
3. Charles H. Crisp, III Lineal 1/3 of Residue
25 Shadle Drive
Fayettville, PA 17222
4. Kelly Charlene Barclay Lineal 5,000.00
2895-A Lewisberry Road
York Haven, PA 17370
5. Danielle Renee Crisp Lineal 5,000.00
PSC-76 Box 5178
APO AP 96319-003
6. Nicole Marie Crisp Lineal 5,000.00
36 I Street
Carlisle, PA 17013
7. Craig D. Christie Lineal 5,000.00
495 Furnace Hollow Road
Shippensburg, PA 17257
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
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)