HomeMy WebLinkAbout06-21-06 (2)
REV-1500 EX" (6-00)
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OFfiCIAL USE ONLY
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
__ __ __N"MBEB._
I FilE NUMBER
II
05
1101
l:;QUN.1:Y COD~.'f'.E.AR
SOCIAL SECURITY NUMBER
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DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Mooney, Virginia A
__ _u .'_______ _ _____.._ ~..'_'_____'________..._____ ____..___.____._~.____. _
DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DO-YEAR)
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
206-32-1307
11-28-2005 06-29-1939
r(IFAPPLICABLE)'SURVIVINGSPOUSE'S NAME (LAST. FIRST AND MIDDLE INITIAl)
REGISTER OF WILLS
- ____....._ ..__ __ __ ---..----0_------ _______ ___..__
SOCIAL SECURITY NUMBER
:.! l 1. Original Return
_I 2 Supplemental Return
3. Remainder Return (date of death prior to 12-13-82)
4. Limited Estate
I -, 5. Federal Estate Tax Return Required
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4a. Future Interest Compromise (date of death after
12-12-82)
.!J 6. Decedent Died Testate {Attach 7. Decedent Maintained a Living Trust (Attach
~M~ ~clfu~
_~ ..c.J~='~atiCJ.nproc~~ds~ec.:'vE:<J1~ ffJ~~~I~~~~~redit ~:~of~at~betw~~n_ ___21~Ele~tl~~t~ ta~ un~er Sec. 9113(A) (Attach Sch 0)
'THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
r NAME I COMPLETE MAILING ADDRESS -
E. B~~p_l!..c;_().dfr~y-,_~~.9.'___ __ ______ 1
: F~~~~~A~~e) HUGHES PC 1 354 Alexander Spring Road, Suite 1
hELEPHONE NUMBER-- ------.-------- Car lis Ie, P A 17013
8. Total Number of Safe Deposit Boxes
717 -249-6333
- - --..--- --------- -_.~. ---
OFFICIAL USE ONLY I
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
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4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. J~intly Owned Property (Schedule F)
I~ Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L) Separate Billing Requested
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
64,043.52
.)
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10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
(11 )
34,819.10
29,224.42
0.00
12. Net Value of Estate (Line 8 minus Line 11)
(12)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has
not been made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
(13)
(14)
29,224.42
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax rate, 0.00 x .00 (15)
or transfers under Sec. 9116(a)(1.2)
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0 .045 (16)
i= 16. Amount of Line 14 taxable at lineal rate 29,224.42 x
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Q. 17. Amount of Line 14 taxable at sibling rate 0.00 x .12 (17)
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0
u 18. Amount of Line 14 taxable at collateral rate 0.00 x .15 (18)
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I- 19. Tax Due (19)
0.00
1,315.10
0.00
0.00
1,315.10
120.0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
. -
>> BE SURE TO ANSWER ALL. QUESTIONS ON REVERSE SIDE AND RECHECK MATH <~_~~_~__
Copyright 2002 form software only The Lackner Group, Inc.
Form REV-1500 EX (Rev. 6-00:
Decedent's Complete Address:
[STREET ADDRESS
69 Fickes Road
- - - -~-~- - - --- ~ ~
CITY Newville
I STATE PA
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
0.00
Total Credits (A + B + C)
3. InteresUPenalty if applicable
D. Interest
E. Penalty
TotallnteresUPenalty (0 + E)
4. If Line 2 is greater than Line 1 + line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund
5. If Line 1 + Line 3 is greater than line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
Make Check Payable to: REGISTER OF WILLS, AGENT
ZIP 17241
(1 )
1,315.10
(2)
0.00
(3)
(4)
(5)
(SA)
(58)
1,315.10
1,315.10
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation?.................. ...................... ... .... ...... ........................................ r:::'.~ [JLf
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 retum, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and
~om~i~~~,q~cla~a~orl E!J)~~_Cirer o~~r.Q:l~_~__~h~pers~~_~!~~r~_entat~~~_~~_s~9 on a~~_i~~~<:lt~~ _C?f w~!_~~ P~E~~T_er_has ~~_kr:lOwle~9~___.___ __ ,_________ ___ _n_ ____~.__
SIGW,TURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS
Leslie C~ver f)
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SIGNAfURE-ciF-PERSbNRESpbNSIBLEFORF1LlN-G--RETURN~-----~--~--- -- ADDRESS - -----~.--- ---. - --- --.-----
1. Did decedent make a transfer and:
a. retain the use or income of the property transferred;........................................ .......................
b. retain the right to designate who shall use the property transferred or its income;...................
c. retain a reversionary interest; or......................... ....................................................................
d. receive the promise for life of either payments, benefits or care?.........................................
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?.. ...................... ............. .... ....... ...... ........ ............... ........ ...... .................
810 Greenspring Road
Newville, PA 17241
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SIGN:~~-C)F PREP-
E. Ralph Go
ADDRESS
354 Alexander Spring Road, Suite 1
Carlisle, PA 17013
No
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DATE
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DATE
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t-< 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. 39116 (a) (1.1) (i)l.
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. 39116 (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
natlJral parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 99116 (a) (1.2)].
ThEi 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. 39116 (a) (1.3)]. A sibling is
defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
Rev-1502 EX+ (6-98)
*'
SCHEDULE A
REAL ESTATE
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Mooney, Virginia A
FILE NUMBER
21-05-1101
ESTATE OF
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be
exchanged between a willing buyer and a willing seUer, 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
DESCRIPTION
VALUE AT DATE
OF DEATH
1
69 Fickes Road, West Pennsboro Township, Newville - Cumberland County
(settlement sheet attached)
56.000.00
TOTAL (Also enter on Line 1, Recapitulation)
56.000.00
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule A (Rev. 6-98)
Rev-1508 EX<- (6-98)
'.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Mooney, Virginia A
FILE NUMBER
21-05-1101
ESTATE OF
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
NUMBEI~ DESCRIPTION
1 Farmers National Bank - checking account
VALUE AT DATE
OF DEATH
226.42
2 Miscellaneous personal property kept (appraisal attached)
1.575.00
3 Miscellaneous personal property sold
6.242.10
TOTAL (Also enter on Line 5, Recapitulation)
8.043.52
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule E (Rev. 6-98)
REV-1151 EX+ (12-99)
.
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Mooney, Virginia A
Debts of decedent must be reported on Schedule I.
FILE NUMBER
21-05-1101
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
--
Hoffman Roth Funeral Home 6,114.50
8. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Social Security Number(s) I EIN Number of Personal Representative(s):
Street Address
City State Zip
-
Year(s) Commission paid
2. Attorney's Fees SALZMANN HUGHES PC 3,800.00
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 219.00
5 Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 4,632.62
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation) 14,766.12
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H (Rev. 6-98)
Rev-1502 E)[~ (6-98)
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,
SCHEDULE H-B7
OTHER
ADMINISTRATIVE COSTS
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Mooney, Virginia A
FILE NUMBER
21-05-1101
ITEM
NUMBER DESCRIPTION AMOUNT
1 Chamberlin & Wingert Sanitary Service 290.00
2 Cumberland Law Journal - estate notice publication 75.00
3 Dan Hershey's Auction Service LLC - fees 3.500.92
4 News Chronicle Co. - estate notice publication 84.50
5 Settlement charges 682.20
Subtotal
4,632.62
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B7 (Rev. 6-98)
Rev-1512 EX+ (6-98)
*'
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Mooney, Virginia A
FILE NUMBER
21-05-1101
ESTATE OF
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1 Andorra Radiology
2 Carlisle Digestive Disease
3 Carlisle Propane
4 Carlisle Regional Medical Center
5 Carlisle Regional Medical Center
6 Cumberland Pathology
7 Graham Medical Clinic
8 Lanc HMA Phys Management
9 MR. T R,.nL- rnnrtn",n.. h",l,.n,... ,h ,..
10 Masland Associates
11 Moffitt Heart & Vascular Group
12 Philip D. Carey MD
13 PP&L
14 Sprint
15 Walnut Bottom Radiology
VALUE AT DATE
OF DEATH
56.71
19.19
573.10
89.62
912.00
20.77
86.96
18.90
18.055.01
1.77
10.20
34.95
121.33
34.16
18.31
TOTAL (Also enter on Line 10, Recapitulation)
20,052.98
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule I (Rev. 6-98)
REV-1513 EX+ (9-00)
.
SCHEDULE .J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
21-05-1101
NUMBER
Mooney, Virginia A
NAME AND ADDRESS OF
PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal
distributions, and transfers
under Sec. 9116(a)(1.2)]
RELATIONSHIP TO
DECEDENT
Do Not List Trustee(s)
SHARE OF ESTATE AMOUNT OF ESTATE
(Words) ($$$)
I.
Leslie Cover
810 Greenspring Road
Newville, PA 17241
Daughter
remainder
Total
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
Form PA-1500 Schedule J (Rev. 6-98)
0.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
LAW OFFICES OF
TEPHEN J. HOGG
19 S. HANOVER STREET
SUITE 101
CARLISLE, PA 17013
WILL OF
VIRGINIA A. MOONEY
I, Virginia A. Mooney, of Newville, Cumberland County,
Pennsylvania, declare this to be my last Will and hereby revoke all
prior Wills and Codicils.
1. I direct that all my just debts, funeral expenses,
gravemarker and administrative expenses shall be paid
from my residuary estate as soon as practicable after my
death.
2. I direct that all inheritance, estate, transfer, succession
and death taxes of any kind whatsoever which may be
payable by reason of my death shall be paid out of my
residuary estate.
3. I direct that my entire estate be distributed as follows:
A. I leave everything to Leslie Cover and direct that
she make distribution to my other three children
Richard M. Mooney, Christine Holmes and Juanita
Kennedy according to the instructions in my
separate notebook. If Leslie Cover predeceases
me, I then leave everything to Juanita Kennedy
and direct that she make distribution according to
the same notebook. Should any of my children
predecease me, their share shall lapse and go to
the surviving children.
4. I appoint Leslie Cover as Executrix of this my last Will. If
she should predecease me or cease to act in such
capacity, I appoint Juanita Kennedy as alternate.
5. The Executrix of this Will shall have the power to
distribute my estate in kind or in cash,
6. I direct that no Executrix acting under this Will shall be
required to enter bond in any jurisdiction.
LAW OFFICES OF
;TEPHEN J. HOGG
19 S. HANOVER STREET
SUITE 101
CARLISLE, PA 17013
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LAW OFFICES OF
TEPHEN J. HOGG
19 S. HANOVER STREET
SUITE 101
CARLISLE, PA 17013
The preceding instrument consisting of this and two other pages
was on the day and date hereof signed, published and declared by
Virginia A. Mooney, as and for her last Will in the presence of us, who
at her request, in her presence and in the presence of each other have
subscribed our names as witnesses hereto.
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WITNESS
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WITNESS
I
LAW OFFICES OF
;TEPHEN J. HOGG
19 S. HANOVER STREET
SUITE 101
CARLISLE, PA 17013
ACKNOWLEDGMENT
State of Pennsylvania
55
County of Cumberland
I, VIRGINIA A. MOONEY, the testatrix, whose name is signed to
the attached or foregoing instrument, having been duly qualified
according to law, do hereby acknowledge that I signed and executed
the instrument as my last Will; that I signed it willingly and as my free
and voluntary act for the purposes therein expressed.
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VIR NIA A. MOON Y :J
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Sworn to or affirn:ed a.nd}3J;knowledged 96fo~~bY V~GINIA
A. MOONEY, the testatrix, this ~ day of .d.'vz~4J:<<21 ,
2002.- . ." /~/
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OOTARIAlSCAL (. ./ C7;:?;:0
STEPHl::N J, HOGG, NOTA.'Y ?U3WC f " .
r.:...AAUSI.EBOAO,CUM8IENL~.NiJCC.P.A ." otary Publtc/Attor:
~ MV eOMMlSSlON EX?/RES Sl':'?Taml:R ;0, 2005
i~ ~--~(;':~l1~:..."'a!.~:m.~
AFFIDAVIT
State of Pennsylvania
ss
County of Cumberland
We,/J'5[- k? .(,,/ /';cy.f and frhii'o ~1 t . kl~ r'17t-[/1he
witnesses whose names are signed to the attached or foregoing
instrument, being duly qualified according to law, do depose and say
that we were present and saw the testatrix sign and execute the
instrument as her last Will; that the testatrix signed willingly and
executed it as her free and voluntary act for the purposes therein
expressed; that each subscribing witness in the hearing and sight of
the testatrix signed the '';viII as a witness; and that to the best of our
knowledge the testatrix was at that time 18 or more years of age, of
sounp mind and,.~nder no constraint or undue influence.
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" S.worn to or affi~~d~ ',Sub$tibe.d to. before me by witnesses,
this 2. day of "/ ,/ .~?:~?-{l~ / // ;~. , 2002.
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Notary Public/Atto
STEPHEN ~.O:~~~~y PU?'l::':J'
CARUSLE BOFlC, CUM8ERLAND CO.. PA '
.~~~=~,=~
A Settlement Statement
,ELIYlliLQf ~oa n
\ 1. OrHA 2, DrmHA 3. DCOl1\' Unins. 6. File Number
'LDYi\o__~L.QC\!m'J[1S, G U1 S [IALLQ04-06
C _ Note: ~:~~o~~r~~~J~,(~sg~d/~~~: f;~i~ ~'~lt:i~~nl~~t ~~~r~~aih~e{>)t~;~~~~onS~Ser~%~\~~i~r~~~'~~ ~~~p~Ys~~e a~~\\~~~~~: fngc~\~~:~~~7~:~ta's
W;\,RNING ills", crime 10 knowingly rn"llo:e false stalem<::nts to the Ur'ited States on this or 8.ny nth'?r similar lern' Pellaltl8s upon
__~con:tU;IIQ~ldude a fine Clnd imDLl.SQllillenL[QLct~e....Tille...le_~~_e.r;.1iQD...1Q~c1i..Qn.J.Q..ill
U,S. Department of Housing and Urban Development
MB No. 2502-0265 REV. HU -1 1861
Loan Number 8
TilleExpress Seltlement Sy'
!'ml.ll&Q1l1112006 at 14 16
D N,\MI UF BURROWER:
._.----..ill2!!KE3..s,
George L. Gutshall and Barbara A. Gutshall
545 Newville Road, Shiwensburg. PA 17257
The Estate of Virginia A. I\.1ooney
E. NAME OF SEI.1 ER:
__ ADDIu:.s.;;,
F NMdE OF L!'NDER:
-.i1lJDISJ.SS:
li I'RUPIRTY ^DURESS 69 Fickes Road. Newville. PA 17241
~._._"_ West l'enns.b.Q)JL.JoWltsllin____~_.._~...~_..._~_.
11. SET]] 1.~lINT ,\(;ENT Salzmann Hughes. P.c.. Telephone: 7] 7-249-6333 Fax: 717-249-7334
......--Cl6CL_UL"LIlLHtLNT 95 Alexander S.prit1!2. Roa0~arli~Je. PA 17013
J c~LJJJ..L.\lLij UlM~ 04/12/200(~~.~_.
[__"'_~___-L~)j,1M..MARY QF BORROW~.';:; TRANSACT10...!'L...
..J-,W~G..FlOSS"'MOUNT DUE..E.BQ.M.!2..0RRO-'IVER _
...JQL....C.Q!l\("ili.s~.'Llke ~ 56,0...Q.Q.....Q.Q I
_~LSon.9LJ::Lm.terlv ~-+---- -..
~~:=~etueme!'t:'ametlQ~=".llijm....tsOO\ t= 1, 133 .78
f--~~--. Adiustm~or item~_Qaid by._,,~~ru,-<;Jvance
~_JQL-G.!hJ-tQ'i!.oJ~~J;LS-----~~
.. _lOL...._CouoIYJaKeS 04 / 12 /06 10 12 /31 LQ.L
~~~~Uax~ 04/12/06ro06/30/06
1.Q;;._____
N/A
K. SUMMARY OF SELLER'S TRANSACTION
GROSS AMOUNT DI)J;: T05ELLER:
ContracL~a1ll.SJillc;e
56 000
Personal Prooertv
Adjustments for item~..seller in advance
I 'ijQl'!D..liI~eJ;
40 ~ctlo.olli~s
409
04/12/~oJ2n_1 06
04/1~~19_0.~nQ.LO_~
54.
--2EL
.J..L'L-C;.Q!.!.OJy...Iax Prora.ti9.n. 33.85 410 County Tax Pr.!llil~ 33.
.....1lL_S.clliloU:a, Dma.\lOO-- 49.01 1LJcb.Q.Ql.IaLErmalion 49.
_..1..12__ ____....112.
120. GEQ..SS AM..Q\.JNT DUE FRQM BOF5.B.Q..~R 5:G 350 .10 I 420. GROSS AMOUNT DUE TQ..ill_LER 56 216.
'I_"OLAM.QUJHS PAID BY QR ON BEHALF OF B08ROvY..~___ __ 50JLR~DUCTIONS IN AMOUNT DUE TO SELLER
,2Q.L....(J.epOSlJ Q[ earnest money *~_~ Lii..2.0 . 00 ~ces.s_Q.eJlQ.Sl11s.e.e.JnsJuJ.ctIQnsl ~ ~~~
l=2Q.Z~IP~...rr.1QlLn.LQfneWl0ans - 502 e:t~~1lt..J;~~e140Q) _~~2~
-2~'Enl}tw.gJQan1sJ~g..lQ__ ~~_~ ~X!~1iIl9jQpD-i.S)Ja~-1eclJQ ~ ~~---
2.04 5Q.L_.E.<WQrLQf.lJI.s1.M!Jr\Q.,,~..<ID-...._~ 10 , 919 .
M&T Bank ~
1-205 __ ____ 50__E'o.Y.o!LoLSEllil..ru;...M2rJg,agtl.oan 7,075.
.. M&T Bank ..____.
~:: ~ :'" 1__
f~:= ~ ~ Adluslments for items unp_~jQJJ'L..S.eJl~L ~~: aid b selLer ~-
2.l0~QlyllQ'<ill..ta,es ~
2.lL-Count:i.JQxes 511.
_2,1 L...~~lQ.O.Llol<..~;"::-' 51'
...2.J.L........ 0 ~-T'
2Jj
515
-5,1_6
517
1518
519
5,600. 0i,...~~2_Ll.QI6.l.B)ODUCTION AMQJ.lliLQj,L"J:;ELLER
~OO' CASH AT SEHLEMENT TO OR FROM SELLE,R
57--,-350.1.Q... B..!lL.-Gr.Q.s..<mlQu.nJ..dJ.Ie..I<LS.eller.llJnJ<.j20) i
5 0..Q.Q..,..0...Q... 1jQ2~. :&l.~ctlan am. aunt due se.U..eLl!iI1<UZQ
_2.L 750, 1. 0 Q;l~,I;;8.SH TO SELLER
18 737.
215
..216
2IL____ .
1
19
220 TOTAL PAIQ BYIFOR BORROWER
t~QQ~ChS.t:L.6LS(;TTLJ;MENT FROM OR TO BORRqWER
.JQl._GIQ..."mo~nLdJJeJIOJD..oo=-"'eLUille..12'Ol- '
_~LJ,..e~tDQJJlJ15j.Jaid by/for borrower (line 4,2-ID..-
L~3jJA~jI:3lirB...QIYI-]:).QBJW.w"R
56,216.
18 737.
37,479.
-SU8STITUTE F(JRM1098 SELLER STATEMENT Th~ inforrr<'ltionconl;:lIncrl l)er8in is important tax in!owl<ll1an and is being furnished to the Internal Revenue Servlc'? If you are r-equlred 10 file a relurl'1
a n~gligence penalty or oth~r S3nc!i(ln will be imposoed on you If tillS Ilem is reqUired to be reported and the IRS determlneslhat It ~las not been repor1ed. The Contract Sales Price described on
line 401 above co~!;litute!; the Gross Proceeds of thiS transncti:)rj
You are re11jired t,,{ I"W Ie provide the selllement ag~111 (red. T"'x 10 ~Jo ___~\wilh yCl;r cc-rred taxpayer identification number If v'ou de nel provld"! your correct ta:wpa~'er Identlfical:on
numher, you may t'c> s\JbJect to civil cr criminal penalties imposed by 18'.'1 Under penalties 01 penury. I certify Hi61 the number shown on thiS statement IS my correct taxpayer Identification number
I
Tll,) _ _ ____________
SELLER(Sl SIGNA TURE(S)
SELlEl~(S) NEW MAILlr~G ADDRESS
SEl_LER(S\ rHONE NUMBERS
(H)
iW)
U.S. UU\W r~Ir:i"T OF HuU,!.", .,J) URBAN DEVFUJI".!l:, I
SETTLEMENT STATEMENT REV.1IlJD.1IHnl
~. SEUliMENT CHARGES
700. TOTAL SALES/BROKER'S COMMISSION based on price S56~0, 00
~)on of commission (line 700) as foJJows.
Filt Number: GU j ~I
; (jU4-06
TillillWrulilliU!illlliil~rl
4/1.1I2.QQQ.A 1
PAID FROM
BORROWER'S
FUNDS AT
SETTLEMENT
PAGE 2
Hi1<.s~~____
PAID FROM
SELLER'S
FUNDS AT
SETTLEMENT
ZQj~
ffiL..L....
to
to
703 Commission paid at Settlement
800. ITEMS PAYABLE IN CONNECTION WITH LOAN
%
- -=~~~-
~_~Qfia!nation Fee
802 Loan Discount
803 Aooralsal Fee
80
%
805 Lender's Inspection Fee
~.
1.QL.___
m
000. RESERVES.QffOSITEQ.WITH LENDER FOR
_..~
~~-
r~~~~
l'---J
.- -.----.
~-~-~.
---
------r-----~~
-----t-----~
o. 00 L_---.2.~
!ill..L..... AssumDtion Fee
808
~-- ~-
e1.lL...._~__~
lli..._
900 ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE
~"SLErJl1)l
to
(ii)$
Idav
1Q2..._-.Milltaaae Insurance Premium for
::103 Hazard Insurance Prerniw:IL1Qr
10
to
Q.QLJiSlZillctlD..s..w:.ance
Q.Q2.-1J10rtgaoE fnSllrance
~ Cltv Prooertv Tax
~nty Prooerty T_ax
005 _SJ;hQQjilles.
QQ.L~1\llil!=}I..QmlrnenL___
1lliLILTLE CIiARGES
1Jll--S.elllemenLQU;lliJn,gJe,,--
lQZ~QdQltjtle search
lQ.J..._Jitle examinatIon
~1l.e..J.ns.!.!r.ance binder
LQ2_J2QgJ1IlenU'reDaral'on
l~\il.1Yf.ee~.
illLj\1lmru;ruees
------iill..ClY~~eMrrls. No'
t08 TiU.l;JW.llii!lli&
(Includes above Items No'
mo. (Q)$
_-----Ln.lO
Im~
Irn0
mo @$
mo. ca.: S
mo (fj) S
mo ((j) S
~
/n"\,"
--~~----~- --~
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~~t=-''":
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LQg t ender's Co~_L-__~
~~GJ&yerage $
56,000,00
to Salzmann Huqhes-L-p,c,
'_1..1JJ1.Qr.!JIDI.. Cerllficate
lL.....
13
'ad GO'{[;RNfylENTRECQB,QlNG AND TRANSFER CHARGES
Q.L.Be=mll.ees.Qe~~~~ S . R~~_~_.
JlLDJy!l&uIllcdllisla1Il12L__J2ee.d s 560 . 00 .. ~.~
~l>!leJ..ms",n:U>L_____ ~.<LQ()---~.Qf!lli!2l' L.. _..
~-----. --~-----_.
~--
100 ADDITIONAL SETTLEMENT CHARGES
Q.L2Q..QJi~.fues
02 2006 Coun-ll' Taxes
tQ Debra PiperL.........Tax Collector
to Debra P~L Tax Collector
00 TOTAL SETILEMENT .CHAB.QES -------.JlillW:.QnJmes..1&Sect'on J and SOLfu<~l&n.J<;~_.
HUD CERTIFICA nON OF BUyER AND SELLER
rlave
II this
Ib',i~''''eJ \I,e HUD-1 St;tl!ement Stah:lrr;ent .,nd to
I iunher Certliy ttl..! I ha'~e reseiveJ Cl ccpy 01 the
and baird, it IS i.l true and 6.CCural~ s!ij!eme, It of all receipts and oisbursements nla;je on my aCcourl! or by me
~. . .L./~~/1
~--
Jil41!,0u ~ It. 1I~ ~~
t: E'>lak orVirgillia A. Mooney
~.."" ,,-}
~ .,...r;, VwA_
' slie Co"",,- El'.eC\..\fH\
RNlNG IT \$ A CRIME TO KNOWlNCl Y MAKE FAlSE STATEMENTS TO THE
1 to STArES ON HUS OK AllY SIMILAR FORM PEt-lAUIES UPOU CONVICTIO~J
~ INCl UOE A FINE AND IMPKI~ONMENT FOR Ul:' fAILS SEE TITLE HI
COOf SECTION 10G\ AND St:CTION 1010
The HUO-1 Settlement Statement whicn I r,ave prepared is a true aild accurate .<lccount of this IrClnsacti()[l
I r~~)d"'IObe QISbUr~edll\aCCOHji:l.r\'.:''''''lJ\\\\\\W;;l>\aH:lllIl"nt
<;-~. ~. ~.-~._._._-
y .~-;:;- - ..~ ~"'" -~. . ~---
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,_'-___..,__--""..1
~..FARMERSNATIONAL BANK
OF NEWVlLLE
January 25, 2006
E. Ralph Godfrey, Esquire
Salzmann Hughes, P.C.
354 Alexander Spring Road, Suite 1
Carlisle, PA 17013
RE: Estate of Virginia A. Mooney
Dear Sir:
Mrs. Mooney had a checking account #12-490-7 with this bank which was
~n her name alone. The account was opened February 8, 1985 and has a date
of death balance of $226.42 plus .10~ accrued interest.
Sincerely yours,
~~~ .fd(g;:~
Carolyn H. Kou~h
Executive Vice President
PC} Brn:. "i')
-'.2.,~ ~.. (-1-) -;-().6:.:1" ""l
DAN HERSHEY'S AUCTION SERVICE, LLC
532-4647
Steve Ege
Cell: 717-385-5438
Chris Bream
Cell: 717-226-1920
SELLERS NAME
ADDRESS
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AUCTION DATE/LOCATION ri!~! i'-,' l., """':
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CLERK %
DESCRIPTION OF MERCHANDISE
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I Commission the Auctioneers to sell the merchandise to the highest bidder by Public Auction. Merchandise
to h~ sold as is & grouped as necessary to obtain bids. I certify that I am the owner or authorized represen-
tative of the merchandise, goods and or property and have good title and the right to sell and that they are free
from all incumbrances. I agree to accept all responsibility for providing merchantable title and for delivery of
title to the purchaser. I agree to hold harmless the Auctioneers against any claims of the nature referred to in
this agreement.
__.,..,.1.~.1 ~ ~,'." '1 t J
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AUCTION SIGNATURE
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"if
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$' ('-.--'t.-: l/'~"""L,.-/ 1
Total Sales (Clerking Tickets Attached) $
!~~ 2 Ll ~;: , /~?
~......." )
!
SELLERS SIGNATURE
Less Sale Expense:
% Commission Auctioneer
$
"~'''''''.~ .~::? ":'~'"","
% CommisSiorrclerks $
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TOTAL SALE EXPENSE DEDUCTED $~.3 5~):'" ,
SELLERS NET $
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AUCTION SIGNATURE
~RT.LRR~ ~Tr,.N A'T'TTlH'
Appraisal Report
Of
Personal Property
Of
Virginia S. Mooney, deceased
For
Richard Mooney
Leslie Cover
Christine Holmes
Juanita Kennedy
As of:
January 30, 2006
By:
Dan Hershey's Auctioneering Service
Steven Ege
Chris Bream
Appraisers
790 W. High Street
Carlisle P A 17013
71 7-226-1920
Leslie Cover
Cement Joe
1950's dinette set
N ecklacesl chains
2 Recliners
Oak side by side
Pine desk w/light
2 Aluminum pots
Basket w/linens
Sofa bed
Pine wood box
Lord Jesus picture
The Doctor picture
Milk pal
8 Jars
Rrp crock
2 Iron skillets
Brass bells
Miniature lamps
1950' s Aluminum pitcher set
Green granite cup & bucket
2 Christmas decorations
Cookbooks
Costume jewelry
Misc. kitchen ware
Misc. granite cups & pans
Dominos
2 Small irons
Misc. shot glasses
Miniature pine dresser
Pine box w/drawer
Small pine cradle
Pine coffee table
Green patio set 2 chairs & love seat
$10.00
$25.00
$10.00
$10.00
$300.00
$35.00
$5.00
$5.00
$10.00
$20.00
$10.00
$10.00
$5.00
$40.00
$10.00
$5.00
$5.00
$5.00
$20.00
$50.00
$5.00
$5.00
$5.00
$10.00
$10.00
$5.00
$5.00
$5.00
$25.00
$5.00
$5.00
$5.00
$10.00
Total
$690.00
Juanita Kennedy
Box kitchen tools & jars
Box jewelry
2 Skillets
Granite lot
Guardian ware lot
Brass bell & cow bell
Metal horses
Brush & dominos
Trough
Toys guns
Misc. local plates
Misc. china
Cookie cutters & tin cups
Shaft bells & other bells
Ohio art tin top
Parcheesi game
Cookbooks
4 Flower frogs
Misc. forest green ware
Black s & p
Tea pot Japan
Green depression juicer
3 Scottie dog glasses
Ruby vase
Kids rocker
Box linens
Group yardsticks
Watering can
Crockery jug
Barn lantern
Wooden butter bowl
Group wooden blocks
Box shot glasses
Small mirror
Button frame
Framed garden picture
Fruit picture
Framed Remington print
Milk bucket
Box Christmas decorations
Treadle sewing machine
Iron gate
$30.00
$25.00
$5.00
$5.00
$20.00
$25.00
$10.00
$5.00
$5.00
$5.00
$5.00
$5.00
$15.00
$25.00
$5.00
$5.00
$5.00
$5.00
$5.00
$15.00
$5.00
$5.00
$5.00
$5.00
$20.00
$10.00
$5.00
$5.00
$5.00
$5.00
$20.00
$5.00
$5.00
$10.00
$5.00
$10.00
$10.00
$5.00
$10.00
$10.00
$30.00
$20.00
Total
$435.00
Richard Mooney
Plymouth clock
Box jewelry
Pine hutch
Walnut cradle
2 Pictures
Lodge items
Trimmers
Gone with the wind lamp electric
Model 1957 chev. Nomad
Indian jewelry lot
2 Canes
Mug & jars
Box of drinking glasses
Bell lamp
Sailboat glasses
Bells
Small building bank
Lucky strike lighter
Misc. plates
Shot glasses
Small coffee grinder metal
Miniature kerosene lamps
Misc. flatware bone handles
$35.00
$5.00
$50.00
$100.00
$5.00
$10.00
$5.00
$25.00
$5.00
$10.00
$5.00
$5.00
$15.00
$5.00
$10.00
$5.00
$25.00
$5.00
$5.00
$5.00
$20.00
$5.00
$10.00
Total
$370.00
Christine Holmes
Picture man and kid
Jewelry copper bracelet
Toys and train
Clown picture
P A state grange cookbook
Birthday cards
Afghan
2 Press glass center plates
$5.00
$5.00
$5.00
$5.00
$5.00
$5.00
$5.00
$5.00
Total
$40.00
Pete
Howard miller clock
2 Stuffed black bears
$35.00
$5.00
Total
$40.00