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HomeMy WebLinkAbout10-10-06 -.J 15056041046 REV-1500 EX (05-04) PA Department of Revenue . Bureau of Individual Taxes . Dept. 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 Date of Birth Decedent's Last Name Suffix Decedent's First Name MI (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI 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 C) 2. Supplemental Return C) 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required C) 4. Limited Estate C) C) C) 4a. Future Interest Compromise (date of death after 12-12-82) C) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) C) 10. Spousal Poverty Credit (date of death C) 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 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received 8. Total Number of Safe Deposit Boxes C) Firm Name (If Applicable) C) "T1 o -0 ::I:: ~ +:'" CO Correspondent's e-mail address: Under penalties of pe~ury, 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 complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIB FOR FILING RETURN DATE ~' t<. ,0 10 Cla ADDRESS .LJ 2..~ l"'"'; ~ SIGNATURE OF PRE PARER OTHER TH DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056041046 15056041046 --.J --.J REV-1500 EX Decedent's Name: RECAPITULATION 15056042047 1. Real estate (Schedule A). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1. 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 2. 3. Closely Held Corporation, Partnershlp: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) c::;) Separate Bi!ling Requested . . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) c::;) 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. ,r, . 12. NetValue,~f,E$~ate(~ine8 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 4-S" 17. Amount of Line 14 tl'lxable at sibling rate X .12 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 c:::> L 15056042047 Side 2 15056042047 .--J REV-1500 EX Page 3 Decedent's Complete Address: DECEDENT'S NAME File Number STREET ADDRESS 6<. ~ W - ~ r'c..h a. """ r r 2.. E....Ma.rb\/L .s+.. CITY STATE ?A, ZIP 170.s:s- Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. CreditsJPayment~ A. Spousal Poverty Credit B. Prior Payments C. Discount ~ "707. 32- (1 ) N//>.. .q. ~C5"2 ~ ,J/A , 3. Interest/Penalty if applicable D. Interest E. Penalty f- bC.s-2.sn Total Credits ( A + B + C ) (2) 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) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. ,. SIo.s-A./-.- g- 2- B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5) (5A) (5B) A. Enter the interest on the tax due. 11& S bS 4f r 6-2- 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;.......................................................................................... 0 B. b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 ~ c. retain a reversionary interest; or.......................................................................................................................... 0 ~ d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 ~ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. 0 ~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. ~ 0 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ !8... 0 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. ~9116 (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. ~9116 (a) (1.1) (ii)]. The statute does not exemot 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. ~9116(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. ~9116(1.2) [72 P.S. ~9116(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. ~9116(a)(1.3)J. 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) " *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF Ross W. Ingraham FILE NUMBER 2006-00160 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 Home property at 112 E. Marble St. Mechanicsburg, PA 17055 VALUE AT DATE OF DEATH $ 134500.00 TOTAL (Also enter on line 1, Recapitulation) $ 1 34500 . 00 (If more space is needed, insert additional sheets of the same size) , l_r OMBN . 2502-0265 ,r .. A. B. TYPE OF LOAN: U.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT 1.I&JFHA 2.OFmHA 3.DcoNv. UNINS. 4. OVA 5. OCONv. INS. 6. FILE NUMBER: 17. LOAN NUMBER: SEITLEMENT STATEMENT 3876-1 8. MORTGAGE INS CASE NUMBER: C. NOTE: This form is furnished to give you a statement of actual settlement costs. Amounts {Jaid 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 IVALVO.PFDI3878-1133) D. NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER: David A. Valvo Estate of Ross W. Ingraham Sovereign Bank Kimberly L. Valvo William R. Ingraham, Executor P.O. Box 11059 205 E. Main Street 2120 Canterbury Drive Orange, CA 92056-8158 Shiremanstown, PA 17011 Mechanicsburg, PA 17055 G. PROPERTY LOCATION: H. SETTLEMENT AGENT: 23-2048n5 I. SETTLEMENT DATE: 112 East Marble Street James D. Bogar Law Offices PA21SO Mechanicsburg, PA 17055 June 23, 2006 PLACE OF SETTLEMENT One West Main St. Shiremanstown, 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 134.500.00 401. Contract Sales Price 134500.00 102. Personal ProDe---riV 402. PersonalProoertv 103. Settlement Charaas to Borrower (Une 1400) 1 971.75 403. 104. 404. 105. 405. Adiustments For Items Paid Bv Sel/er in advance Adiustm8l/ts For Items Paid Bv Sel/er in advance 106. CountvlTwc Taxes 06123106 to 01101107 313.37 406. CountvlTwn- Taxes 06123106 to 01101107 313.37 107. School Taxes 06f23106 to 07101106 35.64 407. School Taxes 06123106 to 07101106 35.64 108. Assessments to 408. Assessments to 109. Sewer 06f23106 to 07101106 8.62 409. Sewer 06123106 to 07101106 8.62 110. 410. 111. 411. 112. 412. 120. GROSS AMOUNT DUE FROM BORROWER 136,829.38 420. GROSS AMOUNT DUE TO SELLER 134,857.63 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER: 201. Deoosit or eamest monev 1.000.00 SOl. Excess DeoosltlSee InstrUctIons\ 202. Prlncloal Amount of New LoanCs\ 133 421.00 502. Settlement Charaes to Seller Cline 1400\ 9040.29 203. Existina I08nCs\ taken subject to 503. Existina 10ariiS\ taken subiect to 204. 504. Payoff of first Mortgage 205. 505. Payoff of second Mortaaae 206. 506. Deooslt or earnest money 207. 507. CDeooslt disb. as oroceeds) 208. · 508. . 209. 509. Adiustments For Items Unoaid Bv Seller AdJUstments For Items UnD8.id Bv Seller 210. CountvlTwoTaxes to 510. CountvlTwcTaxes to 211. School Taxes to 511. School Taxes to 212. Assessments to 512. Assessments to 213. 513. 214. 514. 215. 515. 216. 516. 217. 517. Pa. Inheritance Tax to Reaister of Wills. Aaent 6.052.50 218. 518. 219. 519. 220. TOTAL PAID BY/FOR BORROWER 134,421.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 15,092.79 300. CASH AT SETTLEMENT FROMITO BORROWER: 600. CASH AT SETTLEMENT TOIFROM SELLER: 301. Gross Amount Due From Borrower (Line 120\ 136829.38 601. Gross Amount Due To Seller (Line 420\ 134 857.63 302. Less Amount Paid BvlFor Borrower (Une 220) ( 134,421.00) 602. Less Reductions Due Seller (Une 520) ( 15,092.79 303. CASH ( X FROM) ( TO) BORROWER 2,408.38 603. CASH ( X TO)( FROM) 8.ELLER 119,764.84 o ...... The undersigned hereby acknowledge receipt of a completed copy of pages 1 &2 of this statement & any attachments referred to herein. IHAVE CAREFULLY REVIEWED THE HUD-l SETTLEMENT STATEMENT AND TO THE BEST OF MY KNOWLEDGE AND BELIEF, IT IS A TRUE AND ACCURATE STATEMENT OF L RECEIPTS AND DISBURSEMENTS MADE ON MY ACCOUNT OR BY ME IN THIS TRANSACTION. I FURTHER CERTIFY THAT I HAVE RECEIVED A '(OF TH H D- ETTLEMENT STATEMENT. Borrower Seller. Estate of Ross W. Ingraham William R. Ingraham, Davi A. Valvo Executor ~d~~ BY:Io/.;A'-.... ~~ TO THE BEST OF M~=CE~~~~ D1~ H~D-l SETTLEMENT STATEMENT WHICH I HAVE PREPA~~ AND ACCURATE A6~~~ THE FUNDS WHICH WE RE EIVE V BEEN OR WILL BE DISBURSED BY THE UNDERSIGNED AS PART OF THE SETTLEMENT OF THIS TRANSACTION. . Jam . BQ9ar Settlement Agent WARNING: IT IS A CRIME TO KNOWING MAKE FALSE STATEMENTS TO THE UNITED STATES ON THIS OR ANY SIMILAR FORM. PENALTIES UPON CONVICTION CAN INCLUDE A FINE AND IMPRISONMENT. FOR DETAILS SEE: TITLE 18 U.S. CODE SECTION 1001 & SECTION 1010. A :., L. SETTLEMENT CHARGES 700. TOTAL COMMISSION aased on Price $ @ % 1 500.00 PAID FROM PAID FROM DMslon of COmmission (line 7oo) as Follows: aoRRCMlER'S SELLER'S 701. $ 1,600.00 to ERA-NRT Inc. FUNDS AT FUNDS AT 702.$ to SETTLEMENT SETTLEMENT 703. Commission Paid at Settlement 1,500.00 704. to BOO. ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Oriaination Fee % to 802. Loan Discount % to 803. Appraisal Fee to Sovereian Bank POC $4OO.00b 804. Credit Report to Sovereign Bank . 26.00 805. RnaVConst. Insp. Fee to Sovereign Bank . 100.00 806. Mortoaoe ADD. Fee to 807. Assumption Fee to 808. Document Preparation 809. Tax Service Fee 810. Courier Fee 811. 812. 813. 814. UPSJDelivery Fee to United Parcel Service * 19.00 815. 816. Flood Certification to Transamerica Rood Hazard . 7.50 817. 818. . 819. 820. 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest From 06123106 to 07101106 @ $ 22.700101/day ( 8 days %) * 181.& 902. Mortaaae Insurance Premium for months to SoverelOn Bank 1 971.75 903. Hazard Insurance Premium for 1.0 years to Erie POC $381.00b 904. 905. . 1000. RESERVES DEPOSITED WITH LENDER 1001 . Hazard Insurance 1.000 months @ $ 31.75 oer month . . 31.75 1002. Mortoaoe Insurance months @ $ oer month 1003. Counw/TwnTaxes 3.000 months @ $ 49.64 Der month . 148.92 1004. School Taxes 11.000 months @ $ 138.25 Der month . 1 520.75 1005. Assessments months @ $ oer month 1006. months @ $ Der month 1007. months @ $ Der month 1008. Aoo.Escrow Adl. months @ ~ oer month * -262.Q1 1100. TITLE CHARGES 1101. Settlement or Closina Fee to 1102. Abstract or Title Search to 1103. TiUe Examination to 1104. TiUe Insurance Binder to 1105. Deed Preoaratlon to James D. Booar Law Offices 225.00 1106. Notarv Fees to B. Williams . 10.00 1107. Attomey's Fees to James D. Boaar Law Offices N.C. (includes above item numbers.11 01' 1105 T 1108. TiUe Insurance to James D. Bol'lar-AI'IAnt Rdelitv National TiUA . 960.31 (includes above item numbers.11 03; 1104 - End.1OQ-300-8.1-CPL ) 1109. Lender's Coverage $ 133,421.00 1110. Owner's Coverage $ 134,500.00 1111. 1112. HomelTermite Inspection to Home Spec . 300.00 1113. Radon Inspection to Home spec * 110.00 1114.2006 County /Township Tax to Barry L. Heckard, Tax Collector 655.30 1115. 1116. 1117. Home Warranty to ADn Home Warranty Services, Inc. 429.00 1118. 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recording Fees: Deed $ 38.50; Mortgage $ 54.50; Releases $ . 93.00 1202.Citv/CountvTax/StamDs:Deed 1.345.00' Mortaaae 1.345.00 1203. State Tax/Stamos: Revenue Stamps 1.345.00; Mortaaoe . 1.345.00 1204. Assionment of Mortoaoe to RAt!t\rder of Deeds . 27.00 1205. Stioulation vs. Liens Prothonotary 1300. ADOmONAL SETTLEMENT CHARGES 1301. Survev to 1302. Pest Insoectlon to 1303. Courier to United Parcel Service . 17.17 1304. Transaction Fee to ERA-NRT Inc. . 250.00 1305. 1400. TOTAL SETTLEMENT CHARGES (Enter on Lines 103. Section J end 502 Section K) 1,971.75 9,040.29 By signing page 1 at IIIIe llalement, the signatories llCIlrlo'Medge receipt at a completed copy at page 2 oIlIIill r r; I ~ ',_ A ~ ~"mes D. Bogar Offices Settlement Agent l, ..-.. Certified to be a true copy (3878-1/3878-1/33 ) REV-15OllEX+11-97) _~ . . ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF 2006-00160 FILE NUMBER Ross W. Ingraham Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of sUlVivol'lhip must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Cash $ 75.00 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. PNC Bank - Consolidated Funds Includes: Money Market Account Certificates of Deposit Savings/Checking Accounts 43221.66 PNC Bank Checking Account (for auto-withdrawals) 304.65 IDS Life Fixed Retirement Annuity Fund 26179.77 Bank Deposit - Federal Income Tax refund 739.00 Bank Deposit - refund from Verizon phone company 2.24 Bank Deposit - refund from Westfield Insurance Co. 52.75 Bank Deposit - refund from United Water Company 6.76 2004 Chevrolet Colorado Pick-Up Truck 11000.00 1979 Chevrolet Impala automobile 500.00 Household goods and furnishings 1700.00 Jewelry 150.00 83931.83 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) . ',. . . Certificate of Deposit Account Verification PNC Bank National Association EST OF ROSS W INGRAHAM DECD WILLIAM R INGRAHAM EXTR 2120 CANTERBURY DR MECHANICSBURG PA 17055 .J' , l L',,;, 1'.' 'i'-' i~t Ht(rj':.~I\ ":kf ',f~(.. .:'"f lj~ I " ..~ ., ; ,)' i;.':.-, '\ Base Interest Rate Pack.age Points 2.9960 0.2500 QPNCBAN< PNC Bank. N.A 040 Central PAl) 1< \)~) 1 \"S IIr hI,. VY\ ~\} \ \\u~" :[ ~)'c. ~,.... Es:-b~ . chQ.c.k '5 ~C'CC~h+- Page 1 of 2 ~PNCBANK c C"'W"\~ ~ \ .. ~ e."\ G~ PN <- A<"CboJr\-+:t Certificate Number 31500284466 Reference Number 3500112535 urcha88 Date 02/21/2006 M04/ri21~2t007 Purchase Amount $ 33,221.66 Term 14 MONTHS Annual Percentage Yield 3.2500 Renewal Type AUTOMATIC PREADyeArCES~~ CD L, '"<0 ' Ii ,)"../ ~. '" 'n '(1 . "", . ....,. il. j ,/h\ l'iiQ"" ;,""1(,;'.; ',:t ~ ,~,,(f j" ;,,;. :1\: ".!.J..~f/".j:'; i',-Ifl": n ti;.) IH~",::':, J,rJM ;J.::~.;-~.:...hdtI' For InformatloR, Call TB?:i;.f1 ;1' "If": :r>Hr.., q",:j. ;'",;!'f;.'i'.}O'i';,:';., 1-877-, BAN,',' K- PNC.' 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Effective'Unti}' '.J!', 3.246 04/21/2007 NEW ACCOUNT DEPOSIT TICKET DUPLICATE DATE DEPOSITS MAY NOT BE AV CURRENCY COIN CHECKS USE OTHER SIDE FOR ADDITIONAL LISTING, BE SURE EACH ITEM IS PROPERLY ENDORSED. I TOTAL ITEMS I f x~~ ~tt TOTAL fn>m ,.......... TOTAL DEPOSIT \ c O()O or) I: b ~oolll ~o i!ol: SOD ~8 ? b ~b ? III #I ~ / o PNCBAN< o PNCBAN< 040 MECHANICSBURG (041) 2 EAST MAIN STREET MECHANICSBURG PA 17055 Cashbox 02 040 MECHANICSBURG (041) 2 EAST MAIN STREET MECHANICSBURG PA 17055 Cashbox 02 * Deposit Multi Tran 13:56 FEB 21 2006 Account Number 5004876467 Tran Amount $10,000.00 Cash Amount $0.00 W/S IO WWSH0411 Sequence Number 00277 Batch 303 * Deposit Multi Tran 13:57 FEB 21 2006 Account Number 31500284466 Tran Amount $33,221.66 Cash Amount $0.00 "IS 10 WWSH0411 Sequence Number 00278 Batch 303 This dePDsit Dr paYlent is accepted subject tD uerificlltiDn IInd tD the rules and rellulatiDns Df this bank. Deposns IISY nDt be lIulIllable fDr illediete withdrllwsl. Receipt ShDUld be held until uerified with your stetelent. Thts dePDsit Dr peYlent is IIccepted subject tD verificatiDn and to the rules snd regulations of thit benk. Deposits ISY not be IUBileblefor iMedtete withdrawal. . Receipt ShDUld be held untfJ verified with YDUr stlltelent. ~'m~.,W) '* COMMONWEALTH OF PENNS\ L.VANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Ross W. Ingraham SCHEDULE F JOINTLY-OWNED PROPERTY If an asset was made joint within one year of the decedent's date of death, It must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME A Donald R. Ingraham a Robert E. Ingraham C, William R. Ingraham JOINTLY-OWNED PROPERTY: ADDRESS 2654 Wellworth Way West Friendship, MD 21794 441 Granada Ave. Hershey, PA 17033 2120 Canterbury Dr. Mechanicsburg, PA 17055 FILE NUMBER 2006-00160 RELATIONSHIP TO DECEDENT Son Son Son LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE Include name of financial institution and bank account number or similar identifying number. Attach DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT deed for joinUy-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A varield 70 Series EE Savings Bonds $ 10060.56 1/2 $ 5030.28 (see attached inventory) B. varield 5 Series EE Savings Bonds $ 36640.00 1/2 18320.00 (see attached inventory) C. varie d 5 Series EE Savings Bonds $ 23132.00 1/2 11566.00 (see attached inventoir'y) TOTAL,(Also enter on line 6, Recapitulation} $ 34916.28 (If more space is needed, insert additional sheets of the same size) 1:: o~ a. ..9 a::i '~," > ",,-c::: sa; 'c > ts ~c( c - ~\ . { ~12 ~ e pq e.gl ~\i ~ t-=I . I~ OL > 7q) \:1:>- Uj ~ d -+- oA L~ ~ o ~J jg OJ C 0 S .0 N Z 0 b '1: ("II ("II ("II ("II ("II ("II ("II ('I) ('II) ('II) ('II) ('II) ('II) ('II) ('II) ('11)('11) .! :s ~ ~ ~ ~ ~ ~ ..... ..... ...... ~ ~ ~ ~ ...... 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I lI11!i'~!5 = .8 Q)~.Q 11.. · ~aJ.gl) . w}'~.8c E .5 Z ;:;: .!j .s "0. .....:I: .5 i ~.c~ ~ ~~ ~ ~i [ Jll.s--"O E ~cll. Q) 1!~.lJi ~ ~ill~ i - 15 u.i u.i 0 rJJ C:wwc'ii "0........- t) i 0 oi 0 "!Iii ~ j1:oCO ~ i~~ I 8 .!! .!! .!l "0 1; ~~~.8 i ., 0 CI) cCf. · "'0 . ::e- c' . - aJ J9 c Q) E 8 9 o 8 .~ U.,. i:~ a..- Ui J!I (!. 1-3 Cclt) ~& ..... '0 ..... Q) C) as D. ';', ~. REV-1510 EX + (1-97) '* SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Ross W. Ingraham FILE NUMBER 2006-00160 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. ITEM NUMBER 1. 2. 3. 4. DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE . DATE OF DEATH VALUE OF ASSET IRA Account - PNC Bank Beneficiary: Donald R. Ingraham, Son $ 4888.27 $10000 Series EE Savings Bond Serial number X2171974 - issued 4/92 $10788.00 Payable at death to William Ingraham $10000 Series EE Savings Bond Serial number X2171975 - issued 4/92 $10788.00 Payable at death to William Ingraham $10000 Series EE Savings Bond Serial number X2171976 - issued 4/92 $10788.00 Payable at death to William Ingraham %OF DECO'S INTEREST EXCLUSION IF APPLICABlE 1 TAXABLE VALUE 100% $ 4888.27 100% 10788.00 100% 10788.00 100% 10788.00 TOTAL (Also enter on line 7, Recapitulation) $ 37252 . 27 (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 SCHIDULI H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Ross W. Ingraham 2006-00160 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. FUNERAL EXPENSES: DESCRIPTION AMOUNT 1. Malpezzi Funeral Home $ 8512.60 250.00 2. Mabel Strock - Catering fee for post-funeral luncheon 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. 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 310.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 9077 60 REV-1512 EX+ (12-03) . SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Ross W. Ingraham FILE NUMBER 2006-00160 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 Debts of Decedent DESCRIPTION OF DEATH 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11 . 1 . 2. 3. 4~ 5. 6. 7. 8. 9. 10. 11 . Minnich's garage (State inspection - Imapala) Comcast Cable (final bill) Penna. State Income Tax United Water Company (2/2006-6/2006) AT&T Phone Company (2/2006 - 6/2006) PPL Electric Company (2/2006 - 6/2006) Sewer bill Westfield Insurance (Homeowners Insurance) Montour Fuel Oil Verizon Phone Company (2/2006 - 6/2006) Holy Spirit Hospital bill $ 55.07 8.24 32.00 65.85 42.05 133.27 98.02 113.75 316.88 59.05 29.52 Costs of selling, repairing, and maintaining home Closing costs for sale of home property Scott Roofing company (roof replacement for house) Montour Furnace company (furnace replacement) Penn Pest termite treatment Radon Treatments Duct cleaning costs Chimney repain"costs Cleaning supplies HOP Warranty Plan Purchase of new range Delivery charge for new range 9040.29 4730.00 2725.00 524.70 900.00 356.16 1155.62 56.64 429.00 423.98 70.00 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 21365.09 "";'-1513 EX+ C..... COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF Ross W. Ingraham FILE NUMBER 2006-00160 RELATIONSHIP TO DECEDENT NUMBER NAME AND ADDRESS OF PERSON{S) RECEIVING PROPERTY Do Not List Trustee(s) I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) {1.2)J 1. Donald R. Ingraham Son 2654 Wellworth Way West Friendship, MD 21794 AMOUNT OR SHARE OF ESTATE 1/3 2. Robert E. Ingraham Son 441 Granada Ave. Hershey, PA 17033 1/3 3, William R. Ingraham Son 2120 Canterbury Dr. Mechanicsburg, PA 17055 1/3 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET n 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 IT - 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) -