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HomeMy WebLinkAbout11-13-06 .. R EV"'!lOO EX (6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) ~ Hoon Carol ~ DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD- YEAR) ~ 2/23/2006 W ~F APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) C W I- :ll:::$U) u ac::ll:: wa..u x~ Ua..iil a.. 0( [X] 1. Original Retum D 4. Limned Estate D 6. Decedent Died Testate (Attach copy of WIll) D 9. Lnigetion Proceeds Received ..... z W Q Z o a.. II) ~ II: o U A OFFICIAl USE ONLY FILE NUMBER :J.L - D-fL. _ C2:LL~ COUNTY CODE YEAR IfJM8ER SOCIAL SECURIlY NUMBER 196-36-5842 THIS RETURN MUST BE FILED IN DUPUCA TEi WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER D 2. Supplemental Retum D 3. Remainder Retum (date of daath prior to 12-13-82) D 4a. Future Interest Compromise (date of deeth after 12-12-82) D 5. Federal Estate Tax Retum Required D 7. Decedent Maintained a LMng Trust (Attach copy of Trull) Q...... 8. Total Number or Safe Deposn Boxes D 10. Spousal POYlIf1y Credn (dala of daath batwaen 12-31-81 and 1-1-85) D 11. Election to tax under See. 9113(A)(AI_SdlO) COMPLETE MAILING ADDRESS 2080 Linglestown Road, Suite 201 NAME John D. Sheridan, Es . FIRM NAME (If Applicable) SERRATELLI SCHIFEMAN BROWN & CALHOON TELEPHONE NUMBER 717-540-9170 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) Harrisburg, PA 17110 (1) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank DeposM & Miscellaneous Personal Property (Schedule E) (5) 6. Jointly O\M1ed Property (Schedule F) (6) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) z o ;:: :5 ;:) I- 0:: cC o W 0::: 8. Total GraM Aaseta (total Lines 1-7) 9. Funeral Expenses & Administrative Cost. (Schedule H) (9) 11. Total Deductions (total Lines 9 & 10) 10. Debts of Decedent, Mortgage Liabimies, & Liens (Schedule I) (10) 12. Net Value of Estata (Line 8 minus Line 11) 13. Charilable and Governmental Bequests/See 9113 Trusts for v.tIich an election to tax has not been mede (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 z rate, or transfers under See. 9116 (a)(1.2) o !;i 16. Amount of Line 14 taxable at Iineel rate I- ;:) ~ 17. Amount of Line 14 taxable at Sibling rate o U 18. Amount of Line 14 taxable at collateral rate )( ~ 19. Tax Due 20. 0 x.O L (15) x.D 45 (16) x .12 (17) x.15 (18) (19) CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 3W4645 1.000 ,...., dFFICIAl USE O@ Co c::r" $::0 :z: CD-o <::) --, ::r: (") ..c: e:2 ~ Fn :5: c.fj ~ Co.) 000 -0 C') 0 -n ::It ,::;y c:: ; :;0 -0 -l J> .s:- en 78,752 49,910 28,842 o 28,842 o 1,298 o o 1,298 ~ o d 'C d ece ents omplete A dress: S1REET ADDRESS 430 State Street Cumberland CITY I STA1E I ZlP West Fairview PA 17025- Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 1,298 o o o Total Credits (A + B + C) (2) o 3. InteresVPenalty if applicable D. Interest E. Penalty o o TotallnteresVPenalty (D + E) (3) o 4. If line 2 is greater than line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Cheek box on Page 1 Line 20 to request a refund (4) o 5. If Line 1 + line 3 is greater than line 2, enter the difference. This is the TAX DUE. (5) 1,298 A. Enter the interest on the tax due. (5A) o B. Enter the total of line 5 + 5A. This is the BALANCE DUE. Make Check Pa able to: REGISTER OF WILLS, AGENT (58) 1,298 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS Yes D D D D without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . .. D 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? D 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. D [jj 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 pen.ltiel of perjury, I deClare that I have examined thll return. inCluding ac:campanylng echedulel and Ilatemenll, and to the best of my knowledge and belief, n is lNe. correc:l and complete. Declaration of prep..... other than the personal repreaentati1le i. baaed on all information of which preparer hal any knowledge. ~7~ALm"- 3610 Dw e Avenue 51 PREP R Oli-lER THAN REP 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 No ~ ~ ~ ug og og DATE \ \\oq~ Mechanicsbur , PA Linglestown Road, Suite 201 Harrisburg, PA 17110 or ates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value or transfers to or for the use or the surviving spouse is 3% P.S.~ 9916 <a) (l.l){ill. For datea of death on or after January 1, 1995, the tax rate imposed on the net value or transfers to or for the use of the surviving spouse is 0% [72 P.S. ~ 9116 (a) (1.1) (ii)J 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 lMln if the surviving spouse is the only beneficiary. For dates or death on or after July 1, 2000: The tax rate imposed on the net value of tranafers from a deeeesed child twenty-one years or age or younger at death to or for the use or a natural parent. an adoptive parent, or a stepparent or the child is 0% [72 P.S. 99116(a)(1.2)J. The tax rate imposed on the net value of transfers to or for the use or the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~ 9116(1.2) [72 P.S. 89116(a)(1)J. The tax rate imposed on the net value or transfers to or for the use or the decedent's siblings is 12% (72 P.S. 8 9116(e)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common IMth the decedent, whether by blood or adoption. 3W4646 1.000 Estate of 196-36-5842 Executors (Page 1) Name Address Tax ID James A. Petruzziello 3610 Dwayne Avenue Mechanicsburg, PA 71050- 176-56-6042 REV-1502 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE A REAL ESTATE FILE NUMBER Carol A. Hoon 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 It which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell. both hailing reasonable knowledge or the relevant facts. RlIal property which Is Jolntly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH 430 State Road West Fairview, PA 17025 (Sale Price Plus Credits) (See Attached Settlement Sheet) 76,832 3W4695 1.000 TOTAL (Also enter on line 1, Recapitulation) (If more space is needed, insert additional sheets of the same size) $ 76,832 '< , 0.. ....,J....\({ . .",~ y 08/21/2008 18:25 FAX 717 763 7480 .. WALAK 141 001 A. u.s. OEPAATMlN'\' C)F HOUSING .~d I.lRllAN DevELOPMENT SEllLEMENTSTAlCMENT T11\EPRO LIBERTY LAND SETTLEMENT l...",rInl SERVICES, INC. B. TYPE OF LOAN 4660 Trlndle Roed - Su1t$103 1.~~ 2,( lFMHA 3. [ I CONY. UNINS. Camp Hili, PA 17011 ..[ IVA q ICONV.INS. 6. ALE NUM!lER: I 7. LOAN NUMBeA: 50824 0001296583 8. MORi. INS. CASe NO.: C. NOTE: '!hi. /o~ II fumlshod to glve ~ . statement of actUal "Illement costs. AmOUI'iIt paid to and by tho sottloment SIlent are sl1own. lIoms marked (p.o.c.) w.... paid oulsldo ilia closing; thty art shown here lor InfOlmtllonel purposII and ara nOlltlcludod In the totals. O.NAME J.HO AOORE8& OF BORIIOWE1'l: E. NAME AND AOOflE$S OF S!!J.SR: F. NAME AND ADDRESS OF LENDER: BECKY ROSE ESTATE CAROL A. BOON AMERICAN HOME MORTGAGE G. PAOP:RTY lOCA'\'lON: H. SETT1.EMENT AGENT: I. SETn.EMENT ClATE: 430 STATE ROAD LIBER.TY LJ.ND SETTI..EMENT SERVICES INC 08121/06 WEST PAIRVIEW. PA. PUCE OF $iTTLEMEN!': CUMBERLAND COUNTY I PA C-21 WALAK,CED~ AVE., CAMP HILL, PA ~. SUIUIARY OF 8011l10WEII'8 TIlAH_AmON: J(.. SUlolIlAAY 01' SILLI".S TRANSAOTION: 100. GROll AMOUNT DUE FROII JORROWIR ..GROIS AMOUNT 001 TO IILI.IR 101. Contract ,ales E1r1ct 76000.00 <<It.Contract sale, IItlee 76000.00 lal. P_a111roll.rlY cot.PWSOMI E1It1Dertv IOS. Sett14mlllt cham., \0 botlO'lYet Oirnl14001 3595.48 - 11M. 4IM. las. 40$. Adlustmenll for 1111II1 DaIcl bv .eII8r kl adVance AdluIl/MlllS lorllema Dlld bv ,Iller In advanct 10&. CltvlTown DIX to 401,C\lvll"own till III 1117. Coun~'" 08/21 'o6lo1Z/31/06 79.59 4G1.CounlV ... 08/21/06lo12/31/0Ei 79.59 lae.~1a II> 401.Au11_11 III 'Of. 08/21/0610 0613010 701.97 401, 08/2110610 06130/0 701.97 110. SEW/TRASH an.l-fJ/30 50.00 410. SEW/TRASH 8121-19/30 50.00 III. 411. Ill. 41~ 1& GROSS AMOUM'T DUI 'ROM JORROWIR 80427.04 420. GROSS AMOUNT DUE TO BELLER 76831.56 tQG. AMOUNTS PAll) IT OR IN JIHALl' 01' IOIlIlOWlIl IOG.IlIOUCTtONS IN AMoUNT DUI TO 'It.LIIl :lll1. Oeooalt 01 um.ltmon;, 1000.00 101.Excus dDllOtIt r'IMIInIlruC'llons' lOt Prine/Da/ NnOUnl of MWlMrIlsI 75404.00 102.$ellltmelll-.. 10 ...tI' can.10i001 5468.31 IIlI. &1smc: Ioan(s) liken subhlCl to ...~In" 1Mnl,\ liken Il.lbhoot to - I04.P~ of FIrst Morl';)ageLD"" PAID ON ACCOUNT 295.00 GREEN TREB SERVICING LLC 10010.88 IGS. ICI.Payoff of S.ccnct Mortgage lolli SUB. MTG. - PHrA 2000.00 APO~ 6< ASSOCIATES -];'" 422~.03 lOll CLOSING COSTS BY SELLER 2681.00 IGI. CLOS ING COSTS FOR BUYER "~Il' nn :107. 107. CUMBERLAND CO. TAX CLAIM I 1304.66 201. SOl. EAST pENNSBORO TOWNSHIP 1 3259.46 '''. ICII. 101. AdJustments for Ittt:II Ull'PaIcl bY seUer AdilBllmenls for Ilem. UIllIlld bv HlIet IIQ.CUvil'OMl \all III 51a.C1lV1'l"OWll \all 10 111.C<l\IftIV\all 10 1".COUnbt lax II> 212. Aa...llI1l1ltl 10 t\2.A5le55monts III t13. ID "1. to a... au, II~ tll. 21f. 'IS. l1r. '17 211. all. 211. ,,,. Ull. TOTAL PAIl) 'VIl'OR 'OAIlOW'1I 81380.00 IZO. TOTAL IlIOUCTIOM M10UN'T out: KLL!1l 26953.34 aGO. CAlI! AT SETTlEJIENT FIlOII OR TO 80RROWliR _.CAIM AT ImlIMINT TO OR I'1I0M UI.L'R 301. Groll amounl due from bcKlow8r (11M no) 80427.04 sal.GR)U lIn10Unl duelD I.ner (line 420\ 76831.56 an. L_ amounl paid bV/Io( ~r 1I1n. W) 81380.00 IIII.L... r.duction emounl due I.a., (line 5201 26953.34 z=. CASH ([ 1 FROM) (OIl TO) BQRROWeR 952.96 lei. CASH (tXI TO) (l ) FROM) SELLeR 49878.22 v/ ~~: ~o.~~IA~ . 1I . 'I 1IlgnaG.lro HUO-I Rev. 5188 08/21/2006.16:26 FAX 717 783 7460 .. 'KALAK JaJ 002 U.S. DEPARTMENT OF HOUSING ANO URBAN OevaOPMENT SETTLEMENT STATEMENT L .!T.... .U""TCHA"O~' 50824 P.lItZ 'M TOTAL SAU!&t8ROKEIl"S COMMlsalON b...d on ,.~ce' 76000.00 ~ O~"-lon of CommIl.1011 nln. 7D01 u follows: Total: S3 040.00 FUND' AT PUNDt AT 701 S 3040.00 10 C-21 WALAK ASSOc. . Ml 7M' 10 "'-~ Co'lllnllllon !laid .\ S.tUn.nt 3040.00 7CJ.4. TRANS. PEE WALAK/WALTZ r I 250.00 800. IT,'" 'AYAaLl IN CONNECTION WITH LOAN 801. Loan Orl~iMtIon Fee ~ 802. Loan Discount " 1IlXl. Allllralllal Ft. to AMERICAN HOME MORTGAGE 34.0.00 160.00 8CJ.4. Credit Report to AMERICAN HOME MORTGAGE 8.25 '04. LenderalnlPtcUon F.. - 806. Flood H~ard Fee AMERICAN HOME MORTGA.GE 19.00 eo?, Mta.ln.. Prtm. '08. eoo. 810. 811. 100. ITEMS IllCUIRID IV LEND!R TO II PAID IN ADYANC. 1101. Int.rest/rom 08/21/06 1008/31/06 os Idsv 127.83 802. Mortaac. InsulWlce Pttmlum for mo. ID J\M!:RICAN HOME MORTGAGE 1114.35 003. Hazw Insurance Premium lor lYrll.1O NATIONWIDE 8332 POC 80'. YrII.Io 1105. goo. IlUIiRVES DEPO.me WITH LENDEIlI'OIl COl. Hazard Insul'll1Cll 3 mo.OS 27.67 ~. 83.01 002. Mottlrallelnsurlf\Ct mo.os /mo. 001I. CltvtrO\M1lax mo.os /mo, 004. CounIv tax 8 mo.OS 17.97 /rrKl. 143.76 005, AsltMl'llentl mo..' /mO, 008. SCHOOL 3 mo..s , 66.85 /mo. 200.55 .C07. mo. OS Imo, 001. AGGR. ADJ . mo..S /mo. -89.83 lCO. TmE OHARGU 10'1. EMAIl ClOSING f'ACKAae LISD,TY LAND SETr .BERV. 25.00 102. EXl'RElSS MAIL CLOSIN~ACKAGe LIBERTY LAND SETT. snv. 9.00 10$. EXPRESS MAlLf'AYOFFlo LIBERTY LAND SETT. SERV . 18.00 104. Tltle rr-_ btlcler ID hlC6. DoeUlMnI PItDar.tlon ID 105. NotalY tee. \l:l CASH 40.00 10.00 107, AtlcllMlY'8 fees ID . CII\CIude. aboIIt Illl'/lll No,:) lCl6. Tille Inslnnce \l:l LIBBRTY LAND BETT.SERV. ... (lnckld.. above ~_ No.:l 300 8.1 lot. Ltndlf'l COV'ItmI S 75 404 110, Ownet's CIClYtraae $ 76.QOO 111. END. LIBERTY LAND SETI' .SERV. 100.00 112. INS. CLOS . STEWART TITLE GUARAN"IT CO 35.001 113. I I 200. GOVERNMENT REOORDIl'IIiI AND TIlAIlWER CHARGES 201. Recordlno f...: C..d. 38 . 50 Mortallle S 50.50 Mlac,' 89.00 202. CItY/lXUllv lIDlIstnas: Oeed. 760.00MorDaeS 760.00 2OS. Stale tax/Ilamcll: D.ed S 760.00Mortaa<l" 760.00 204. SUB. M'I'G . RECORDER OF DEEDS 38.50 205. SAT .LIBNS EAST PENNSBORO "I'Wl? 150.00 300. ADDITIONAL SETTLEMENT CHAIlGE' 301. TERMlTEINSi'. \0 BIECHLER " TILLERY I 50.001 302. 2CO&SCHOOL TAXES ID DEBBIE LUPOLD TREAS . I I 242.09 3Q:II.2006 CO/TW DEBBIE LUPOLD. 'I'REAS. I 802.:l2 304. TJlJC RECI". DEBS IE LUPOLD TREAS . I 2.00 305. I '00. TOTAL lIETTLE11ENT CHAIlOU (till*' Oft IlneIl03111d 502. $oG~ J and Kl 3595.481 5468.31 -....lIoM..taI>"l'.._allyllll_IIlIAlIOnl fotllle _...",,11""- r..._.., ..h........_ .0"\1 HUll-1 _nl_lSetI_ntAllfnI.....,1ll--'Y NaII'na tftC'....1o ~ ...y........1IIIacttrd III dlltturMmtftl ft 1ft ~,.t bHdnG Ic.count in .l1derIny ilturtd inltkution .n4 ,. crAdl efl't incarnl ....."'" to 1& owa MC;4UC\ll& ...lOt\aI G;iM.tllQftCdiltt' for Is~. m u.. ........... M 8\1)"0'.' I~ SlvMhn'Q '''ff-t''J AcIdft&a &. ~".: ....... 1Ign.lu,. .5411II" Ntw Addrftl , ""01: · "'_1_1_ _Ie. Ir.. ...._.... ........ 011"'" '.......;0..1 h... fpi"'JOc'_1IoA r.....1a bo _.. __.._'hlolla,....l Ie . De.. . wAll"~~ ~~ . . c':J."='='t :..r.:l.n'~~o Itla U.lIocf -- "" Ihlo "'ooy....., I...... Fa""'" upclll_o un .....dI. Un. aIId IItp--' Fe'::'.IIIG REV-l503 EX +'(6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE B STOCKS & BONDS FILE NUMBER Carol A. Hoon All property jointly-owned with right of sUNlvorship must be disclosed on Schedule F. ITEM NUMBER 1. 31 Shares Met Life Trust Interests DESCRlPllON VAlUE AT DATE OF DEATH 1,596 3W4696 1.000 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 1,596 REV-l508 EX + (6-98) COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Carol A. Hoon FILE NUMBER Include the proceeds of litigation and the date the proceeds were receill8d by the estate. All propertY Jolntlv~wned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Commerce Bank Checking 27 2 Household Personal Property (See Attached Inventory) 297 3W46AD 1.000 TOTAL (Also enter on line 5 Recaoitulationl $ (If more space is needed, insert edditional sheets at the same size) 324 Carol Ann Hoon list of Items Towels Value 4 Bath towels $4.00 4 wash clothes $2.00 2 hand towels $2.00 Linens 3 sets of sheets $10.00 4 pillow cases $4.00 Pots and Pans 1 set ofT-Fal cookware $25.00 Furniture 1 coach $50.00 1 rocking chair $25.00 1 Lazy Boy chair $25.00 3 bedroom dressers $25.00 1 single bed $25.00 1 kitchen table with 4 chairs $25.00 Small Appliances 1 toaster $5.00 1 coffee maker $5.00 1 microwave $10.00 Clothes 10 shirts $20.00 10 pair of pants $25.00 4 pairs of pajamas $10.00 TOTAL VALUE $297.00 REV-1511 EX. (12-99) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INl-ERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Carol A. Hoon ITEM NUMBER A. B. 3W46AG 1.000 1. 2 1. 2. 3. 4. Debts of decedent must be reported on Schedule I. DESCRIPTION FUNERAL EXPENSES: Costco (Funeral Luncheon) Zimmerman-Auer Funeral Home ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) James A. Petruzziello Social Security Number(s) (EIN Number of Personal Representative(s) 176-56-6042 Street Address 3610 Dwavne Avenue City Mechanicsburg State PA Zip 17050 Year(s) Commission Paid: Attorney Fees 2007 Family Exemption: (If decedent's address is not the same as daimanfs, attach 8lCpIanation) Claimant Jessica Hoon Street Address 161 Gracedale Avenue, 2nd Floor City Mountain Top Relationship of Claimant to Decedent DAUGHTER State PA Zip 18707 Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. 1 cumberland Law Journal (Estate Advertisement) 2 pennsylvania American Water Company Total from continuation schedules . . . . . . . . . FILE NUMBER TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) AMOUNT 71 2,581 4,000 5,000 3,500 162 75 32 31,649 47.070 ~~-;,,;~#7"-:- '..'..-;., Estate of: Carol A. Hoon ~~~)~.~)~ 196-36-5842 Schedule H Part 7 (Page 2) 3 PPL 4 The Sentinel (Estate Advertisement) 5 U-Haul (Storage Boxes) 6 U .G. I. Utilities 7 Real Estate Costs of Sale (See Attached Settlement Sheet) 8 Tom's Home Services (Vinyl, Carpet, Repairs- 430 State Road) 9 Jim Schreiber (Electrical Work 430 State Road) 10 Register of wills (Add'l Short Certificates) 1~ The Home Depot (Home Repa1r- 430 State Road) 12 Lowe's (Home Repair- 430 State Road) 13 K-Mart- (Home Repair) 430 State Road) 14 Sherwin-Williams (Paint & Painting Supplies- 430 State Road) 15 Robin L. Hogan (Cleaning- 430 State Road) 16 Kreamer Brothers Glass, Inc. (window Repair- 430 State Road) Total (Carry forward to main schedule) 107 72 67 61 26,953 844 350 8 331 79 4 713 315 112 30,016 Estate of: Carol A. Hoon Schedule H Part 7 (Page 3) 17 G1assmasters (Window Repair- 430 State Road) 18 Judd Bentz (Carpet and znsta1lation- 430 State Road) Total (Carry forward to main schedule) I 1-- 196-36-5842 133 1,500 1,633 REV-1512 EX + (12-03) SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONVVEALTH OF PENNSYLVANIA IN/-ERlTANCETAX RETURN RESIDENT DECEDENT ESTATE OF Carol A. Hoon Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, Including unreimbursed medical expenses. FILE NUMBER ITEM NUMBER DESCRIPTION 1. West Shore Oil Co., Inc. VALUE AT DATE OF DEATH 2 Statewide Tax Recovery, Inc (1996-2001 Cnty K Twp Per Capita Tax) 3 Calvalry Porfolio Services, LLC. (Original Debt Owed to ATT) 4 Debbie Lupo1d, Treasurer (2006 Cnty K Twp Per Capita Tax) 5 Central pennsylvania Pulmonary Associates 6 Penn Credit Corporation (2002-2005 Cnty K Twp Per Capita Tax) 7 Green Tree Mortgage (Mortgage Payments- 430 State Road) 8 Comcast Cable 3W46AH 2.000 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 696 402 130 11 161 114 1,155 171 2,840 . f\EV.1513 EX+ (9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Carol A Hoon NUMBER I 1 NAME AND ADDRESS OF PERSON(S) RECEMNG PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] James A. Petruzziello 3610 Dwayne Avenue Mechanicsburg, PA 17050 50% of Residue: 14,421 2 Jessica Hoon 161 Gracedale Avenue, 2nd Floor Mountain Top, PA 18707 50% of Residue: 14,421 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Son Daughter FILE NUMBER AMOUNT OR SHARE OF ESTATE 14,421 14,421 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 3W46AI 1.000 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) $ o COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG. PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT SHERIDAN JOHN D ESQUIRE SERRATELLI SCHIFFMAN ET AL 2080 L1NGLESTOWN RD #201 HARRISBURG, PA 17110 -------- fold ESTATE INFORMATION: SSN: 1 96-36-5842 FILE NUMBER: 2106-0212 DECEDENT NAME: HOON CAROL ANN DATE OF PAYMENT: 11/13/2006 POSTMARK DATE: 11/08/2006 COUNTY: CUMBERLAND DATE OF DEATH: 02/23/2006 NO. CD 007424 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $1,298.00 I I I I I I I I TOTAL AMOUNT PAID: $1,298.00 REMARKS: CHECK# 22869 SEAL INITIALS: CJ RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS Glenda Farner Strasbaugh Register of Wills and Clerk of Orphans' Court Marjorie A. Wevodau First Deputy Kirk S. Sohonage, Esq Solicitor Register of Wills and Clerk of the Orphans'Court County of Cumberland One Courthouse Square Carlisle, PA 17013 (717) 240-6345 FAX (717)240-7797 INVOICE SERRATELLI SGflFFMAN BROWN & CALH 2080 LINGLESTOWN ROAD SUITE 201 InvoiceNo: Invoice Date: Estate of: Estate No: 1147 Bill To: HARRISBURG, P A 17110 Qty 1 Fee Description Additional Probate Fee Total 75.00 $75.00 Total: $75.00 Checks should be made payable to the Register of Wills. Terms: Net 30. Please return one copy of this invoice with your payment. Thank you. ~ .. .--./-~ ~:,,' - .. Ol <:) ~O'tD::~ :5~gt::c( ~ .N In ~ ~ ~II ~ ~- en I::>> ".'"H - .. d> ..;$ .<f; ~ '6~ ~ ~\\ 'C8 )~ ~ ...l ~2 ~\ \-n rn S t..) ~ ~ ~ s c ~ <!. .. .:.,... c ~ t ~ ~'. "'_ ~ cr. C\ r- r.F....-< "d, ';- ; s: ~ ~ c ~. c (' \m 8~~ ~ ~~~~~ ~ \O!" ~ ,c! 400l p. ~1 ~ {A \8 ~ .,..\ .-I i 88 ~~ -.." ." ;k,:- ~:d.J" .i\.'Tr~~~-!?-"L.'" ~ .~~.~.. .' 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