The URL can be used to link to this page

Home My WebLink About12-19-06 .-J 15056041114 REV -1500 EX (06-05) PA Department of Revenue Bureau of Individual Taxes PO BOX 280601 Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death OFFICIAL USE ONLY County Code Year File Number INHERITANCE TAX RETURN RESIDENT DECEDENT ~ I os- Llll Date of Birth 180-26-5454 Decedent's Last Name 05162005 Suffix 01011932 Decedent's First Name MI STARNER (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix ALLEN N 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 IJD 1. Original Retum D 2. Supplemental Retum D 4. Limited Estate D 4a. Future Interest Compromise (date of death after 12-12-82) IJD D 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received D D 7. Decedent Maintained a Living Trust (Attach Copy of Trust) 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) D D o D 3. Remainder Retum (date of death prior to 12-13-82) 5. Federal Estate Tax Retum Required 8. Total Number of Safe Deposit Boxes 11. Election to tax under Sec. 9113(A) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number ROBERT M. FREY Firm Name (If Applicable) 717-243-5838 City or Post Office State ZIP Code REGISTER OF WILLS US~L Y (') g S;o ~ -',- :a ........ ~D -0 rt1 __:J. ::r: p C"') ; :.:: )..'> m -.' ~ :z;; :J.J \.0 .= Cf) 7' "(")0 ')011 "~t ILED o 11 __ -n ~~2~ (.1-) ,-) :::rl FREY AND TILEY First line of address 5 SOUTH HANOVER STREET Second line of address CARLISLE PA 17013 CJ1 CO ADDRESS 4063 CARLISLE ROAD, GARDNERS PA 17324 SIGNATURE OF PREPARER OTHER THAN REPRESENTATNE ADDRESS n~-- ?h." ~~ 5 SOUTH HANOVER STREET, CARLISLE, PA 17013 PLEASE USE ORIGINAL FORM ONLY DAj;} ;'1 / () It; , , Side 1 L 15056041114 15056041114 .-J -1 15056042115 REV-1500 EX Decedent's Social Security Number Decedenfs Name: ALLEN N STARNER RECAPITULATION 180-26-5454 9. Funeral Expenses & Administrative Costs (Schedule H) . . . . . . . . . . . . . . . . . . . . 1. 2. NONE 3. NONE 4. NONE 5. 6. NONE 7. 8. 9. 397000.00 1. Real estate (Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . . . 4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . . . 6. Jointly Owned Property (Schedule F) DSeparate Billing Requested . . . . . . . . 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) DSeparate Billing Requested. . . . . . . . 18559.00 8. Total Gross Assets (total Lines 1-7) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31144.00 446703.00 23891.00 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I). . . . . . . . . . . . . . . 10. 11. Total Deductions (total Lines 9 & 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 1023.00 24914.00 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) . . . . . . . . . . . . . . . . . . . . . .. 13. 421789.00 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.O ~ 16. Amount of Line 14 taxable at lineal rate X .0 ~ 17. Amount of line 14 taxable at sibling rate X . 12 18. Amount of Line 14 taxable at collateral rate X . 15 0.00 421789.00 15. 0.00 17. 18981.00 0.00 0.00 421789.00 16. 18. 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 18981.00 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT IJU Side 2 L 15056042115 15056042115 -1 REV-1500 EX Page 3 180-26-5454 Decedent's Complete Address: DECEDENTS NAME ALLEN N STARNER STREET ADDRESS File Number 4063 Carlisle Road CITY Gardners STATE PA ZIP 17324 Tax Payments and Credits: 1. Tax Due (Page 2 line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 128 18981.00 17100.00 900.00 Total Credits (A + B + C ) (2) 18000.00 3. InterestlPenalty if applicable D. Interest E. Penalty 111.00 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) 111.00 5. If line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) (5A) A. Enter the interest on the tax due. 0.00 981.00 1092.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 1. Did decedent make a transfer and: Yes a. retain the use or income of the property transferred; . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D b. retain the right to designate who shall use the property transferred or its income; . . . . . . . . . . . . . . .. D D D D D PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS No ~ ~ ~ ~ [!] [!] 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? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. lll~ ~ I - ~ j r Jil _M' 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 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 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 decedenfs 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. 217 REV-1502 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER Allen N Stamer 128 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 Jolntly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. 2. DESCRIPTION Real Estate, 4063 Carlisle Road, Dickinson Township,Cumberland County Undivided Interest, One-third (1/3) interest in farm, no buildings and approximately 100 acres VALUE AT DATE OF DEATH 147,000 250,000 TOTAL (Also enter on line 1 Recaoitulation) $ (If more space is needed. insert additional sheets of the same size) 397.000 I I 1. FHA SeWement Statement. U. S. OeoMment 01 Houslno and Urban Develooment Form US HUD. 1 Pone No. 1 I 2. FmHA 6. file Number 7. loon Number 8. Mortgage Insurance I ) 3. Cony. Unins. Case Number I )..VA RE2569 11086006 I 5. Conv. Ins. ABST#6188 Fundina #092906 AJ C. ThIs lorm Is Iumlshed to give you a stotement 01 aclual setllemenl cosls. Amounts paid to and by lhe selllement agent ore shown. lIems mar1ced "(P.o.c.1" were paid outside 01 the clos' : I as shown here lor inlormational es and ore not included i1 the totals. D. Name and Address 01 Barrower: E. Nome ond Address 01 SeIer: KEANE D. STARNER KENNETH A. STARNER 4063 CARLISLE ROAD KEVIN N. STARNER GARDNERS, PA 17324 KIM L. CASSATT F. Nome and Address 01 Lender M & T MORTGAGE CORP. ISAOA AnMA &560 CARLISLE PIKE MECHANICSBURG PA 17050 H. Buyer's Settlement Agent: Frey & nley Law OffIce 5 South Hanover Sf. Carlisle PA 17013 TIN G. Properly Location 4063 CARLISLE ROAD, GARDNERS, PA 17324 DICKINSON TOWNSHIP CUMBERLAND COUNTY PARCEL NO. 08-43-2754-020 Selllement Date: September 29. 2005 02:00 P.M. Place 01 Settlement: 5 South Hanover Streel Carlisle PA 17013 TIN 25-1730538 J SUMMARY OF BORROWER'S TRANSAcnON K. SUMMARY OF SELLER'S TRANSAcnON 100 Groll Amount Du. from loriOw.r .00 Groll Amount Du. To S.1ler 101 Contracl sales price. less gilt 01 equity $ 36.385.00 110,615.00 40t Contract SOles price 110.615.00 102 Personal properly .02 Personal property 103 Selllement charges Irom (line 1.00) 2,818.02 403 lo.c 4o.c IOS .os Acfustments for Items paid by seBer in advance: AdjllJfments for Items paid by seifer In advance: 106 Clty/lown taxes 9/7.'1105 to 12131105 68.54 406 Clty/lawn taxes 9n9105 to 12/31105 68.54 107 County 10000S ~7 County taxes 108 Assessments .08 Assessmenls 109 409 110 Schoollaxes 9/7.'1105 to 6/'!IJ106 1,094.24 410 School laxes 9/7.'1/05 10 6130106 1,094.24 111 411 112 412 120 Groll Amounl Due From 10000wer 114,595.80 420 Groll Amount Du. to S.ler 111,777.78 ------------ ------------ ------------- ------------- 200 Amounts raid Iy 0; In ..haI Of lorrowet 500 IlIdvcllonsln Amount Du. To Seier 201 Deposil or eanesl money 501 Excess depositlsee inslNctlonsl 202 Principal ornounl 01 new Ioan(s)... Wire $113,328.73 115,000.00 502 Seltlement chorges 10 seier (lne 1.00) 0.00 203 Ellistlng loanls)laken subjecl to 503 existing Ioan!s) taleen subject to 2o.c 504 Payo" olllrst mortgage loan 205 505 Payo" 01 second mortgage loon 206 506 207 507 208 508 209 509 A~frnents for Ilems upaid by seller Adjuslments lor Items upoid by seller 210 Clty/lown taxes 1/1/OS 109/29105 510 CIlY/lawn taxes 11110S 109n9105 211 County laxes 511 County laxes 212 Assessments 512 Assessments 213 513 21. School taxes 7/1/05 to 9n9105 514 School taxes 7/1/05 to 9/29/OS 215 515 216 516 217 517 218 518 219 519 220 TolaI raid Iy/For lorrower 1 t 5,000.00 520 Totol leduclollllo Amt Due SeI.r 0.00 ----------- ------------- ----------- ------------ 300 Cash AI Sellement From/To:1orrower: I 600 Cash At S.ttlement To/From s...r: ,. 301 Gross amounl due lrom borrower line 120) 114,595.80 601 Gross amount to seier from (Ine 420) I 111,777.78 302 Less amounts pald by/lor borrower Ilrom Ine 220) ellS 000.001 602 Less reductions i1 amounl due seHer Ilrom line 520): (0.00) 303 Cash ( ) Fram (X) To a_ (404.20) 603 Cash ( ) From (X) To S.'.r 111,777.78 ----------- ------------- -------- ------------ HUD-l L. SETTLEMENT CHARGES Page No. 2 700. Total'Sciles/irOker'i Ccimm.bcisect on PrIce: ' 110.615.00 ." . 0.00 Paid from Paid from 700 DMsIon of Commission (Nne 7oo) as folows: lorrow.r's S...r's 701 10 Funds at Funds at 701 702 10 Selllemen' Selll.men' 702 703 703 704 Commission paid 01 Selllemenl 704 70S 705 800 Items Payable In Connection With Loan: " 800 (Mortgall. AmI: 115.000.00) Total charges. Liles 8011hrough 81 1.099.00 801 loan Origination Fee .000 % to 0.00 801 B02 loan Dlscounl .000 % to 0.00 B02 803 AppraIsat Fee ta M&T MORTGAGE CORP. 320.00 803 804 Creell Report 10 804 805 lender's Inspection Fee to , 80S 806 Applcallon Fee 10 M&T MORTGAGE CORP. 100.00 B06 807 Assumpllon Fee 10 807 808 TAX SERVICE FEE TO M&T MORTGAGE CORP. 76.00 808 809 FLOOD CERnFlCAnON FEE TO M&T MORTGAGE CORP. 8.00 809 810 PROCESSING FEE TO M&T MORTGAGE CORP. 195.00 810 811 DOC/PREP FEE TO M&T MORTGAGE CORP. 400.00 811 900 Items Requlredly'L:enCler'To Ie Paid In Advance: " :~. ; 900 901 Inleresl from 29-Sep-05 to 1-0ct-05 @ 19.69178 per day = 39.38 901 902 Mortgage Insurance Premium lor monlhs 10 902 903 Hazard Insurance Premium lor 1 yeors 10 ERIE INSURANCE EXCHANGE P.O.C. 903 904 YEARLY PREMIUM $405.00 904 90S 905 1000 Reserves Deposited WIth Lender: ToaI .eserv.s. Uil..l00l'lhoiugh 1001: 532.89 1000 1001 Haza'd insIxance 3 mos. . $33.75 per month 101.25 1001 1002 Mortgage Insurance mos.. per monlh 1002 1003 City properly laxes mos. . per month 1003 1004 Counly properly laxes 8 mos. . $22.42 per month 179.36 100.4 1005 Annual assessments mos. . per monlh 1005 1006 mos. . per month 1006 1007 Schoollaxes 4 mos. . $121.47 permonlh 485.88 1007 1008 Aggregate Settlement Adjustment (233.60) 1008 1100 TIlle Charges: 1100 1101 Settlement or ciosWlg lee 10 1101 1102 Abstracl or tille search 10 1102 1103 nile examinalion 10 1103 1104 nile insurance binder 10 1104 1105 Documenl preporallon to 1105 1106 Notary lees to 1106 1107 Allorney's lees 10 FREY & nLEY P.O.C. 1107 (includes above items numbers: I 1108 ntle Insurance 10 FREY & nLEY 1,033.75 1108 (Includes above Hems rombers: J 1109 lender's Coveroge $ 115,000 Endorsements: 1109 1110 OwnenCoverage $ 110,615 1110 1111 CLOSING SERVICE LETTER TO FREY & nLEY 1111 1112 1112 1113 OVERNIGHT DELIVERY FEES TO FREY & nLEY 10.00 0.00 1113 1200 Government Recording and TranSfer Charge D..d POlles:' 0 MIg palles.: 1200 1201 Recorclng lees: Deed $38.50 ; Mortgage: $64.50 ; Releases $ 103.00 1201 1202 City/counly/slCll'l1jJ! Deed EXEMPT ; Morlgage: $ 1202 1203 State lax/slamps: Deed EXEMPT : Morlgage: $ 1203 1204 1204 1205 1205 1300 Additional Settlemenf'Charges: ' 1300 1301 Survey 10 1301 1302 Pesllnspecllon 10 1302 1303 Currenl Taxes due from BorrowerlSeler 10 Carolyn R. McQullen. TCIX CoUector 1303 1304 1304 1305 1305 1306 1306 1307 1307 1400 Total Settlement Charges (enteronllnes 103, Secllon J and 502, Section K) 2,818.02 0.00 1400 ------- ...---.-.- HUD-I CERTIFICATION I cfnet and authorize the Company to malte distnbullons indicated ror my account on the attached HUo-l Settlement Statement. approving the tox prorations indicated therein. and undentand thot prorations were based on ligures for the preceding yeor. or estimates for the current year. and In the event of any change for Ihe current year. 01 necessary odjestments must be mode between Seller and Borrower direct; likewise any DEFICIT In delnquenttoxes wiI be relmblned to Attomeyllltle by Sellel'. I hove corefuly reviewed the HUo-l Sefllement Statement and to the best of my knowledge and be dlsblnements made on my accaunt or by me In this transaction. I further certify that I have recJtv ~ {}<~ KEANE D. STARNER KIM . CASSATI I~r(\~;) ~ li~~r.:> KENNETH A. STARNEIf. IrtA I ~ jf c.,.J V'-.JL.J KEVIN N. STARNER To the beSt of my knowledge. the HUD-I Settlement Slatement which 1 hove prepared Is a true and accurate account of the ruods which were received and hove been or wi be disblned by the undersigned os port 01 the settlement of ttis tronsacllon. SeDtember 2'.2005 WARNING: Ills a crme la knowingly make false slatements 10 Ihe United States on this or any olher similar lann. Penalties upon convlction can Incklde fine and Imprisonment. For detals see: nile IB U.s. Code Secllon 100\ and Secllon 1010. INFORMATION REPORTING ON REAL ESTATE TRANSACTIONS THIS HUD SETTlEMENT STATEMENT CONTAINS IMPORTANT TAX INFORMATION (BOXES E. G. H.I. M AND UNE .cot I AND IS BBNG FURNISHED TO THE INTERNAL REVENUE SERVICE. IF YOU ARE REQUIRED TO FILE A RETURN. A NEGUGENCE PENAlTY OR OTHER SANCTION WILL BE IMPOSED ON YOU IF THIS ITEM IS REQUIRED TO BE REPORTED AND THE INTERNAL REVENUE SERVICE DETERMINES THAT IT HAS NOT BEEN REPORTED. Solicitation of TIN Se" Is requi'ed by low to provide the A"omey/Company wllh hIs/her correcltQlCPoyer lcIentllicatlon number. "cOlTecllaxpoyer tdenlllication number Is not provided. he/she may be subject fa cM or c:rIn*1oI penalties impoSed by law. Certification of TIN Under penalties 01 perjury. I certify thol the laxpayer Idenflftcolion number shown in this statemenl Is my cOlTecllaxpoyer identlllcatlon number. Date Seller Seller TAX PRO.RATlON ADDENDUM Date 01 Pro-Ilallon: lonower September 2t. 2005 SCHOOL REAL ESTATE TAX from July 1. 2005 to June 30. 2006 School Real Estale Tox- Foee School Real Estat.lox- Per Coy Owes: 12.0 mIs $1.487.-40 $".07507 ASSWMENT: $123.950.00 COUNTY a. MUNICIPAL TAX 110m Jonuay 1. 2005 10 December 31. 200S Co. & Munlc. Real Eslale Tax- Foce Co. & Munlc. Real Eslate lox- Per Day Owes: 2.21"57 mils ,. $27.....' $0.75203 Porcel No.; S.. Selllemenl Sheef lines 106 .. 406,110" 410, 210.. 510. 214.. 514. and 1303 lor Ilesulls of lhb Addendum. Yes Schoollaxes P.O.C. or CIlarAed 10 Seier: Q Schoollaxes P .O.C. or charged 10 aooower Co. & Munlc. P.O.C. 01' choll:led 10 Seier: x Co. & Munic. P.O.C. or charged 10801T0WBr SeUer P.O.C. P.O.C. .1J(ALI lVU.l BEGINNING at a point in the center of Pennsylvania State Highway Route No. 34, which was formerly known as Gettysburg Road, and is now known as Carlisle Road, at the northwestern corner of Tract No.2 hereinafter described; thence from said point at the place of beginning along said Highway, North 9 degrees 25 minutes East 120 feet to a point in said Highway at land now or formerly of Dale and Opal McBeth; thence along line of said land now or formerly of Dale and Opal McBeth, South 80 degrees 45 minutes East (in prior deed erroneously recited to be North 80 degrees 45 minutes East), 132.45 feet to a pin at corner of lands formerly of Ira Davis and now Tract No.3 hereinafter described; thence along line of said Tract No.3 hereinafter described, South 9 degrees 25 minutes West 120 feet to a stake at the northeastern corner of Tract No.2 hereinafter described; ,thence along line of Tract No.2 hereinafter described which was formally of Ira Davis, North 80 degrees 45 minutes West (in prior deed erroneously recited to be South 80 degrees 45 minutes West), 132.45 feet to a point at the Place of BEGINNING. TRACT NO.2 BEGINNING at a point in Pennsylvania State Highway Route No. 34 formerly known as Gettysburg Road and now known as Carlisle Road, at the southwestern corner of Tract No.1 above described; South 80 degrees 45 minutes East 132.45 feet to a stake in line of Tract No.3 hereinafter described which was formerly of Ira Davis; thence along a portion of the western line of Tract No.3 hereinafter described, southwardly a distance of 30 feet to a stake; thence North 80 degrees 45 minutes West a distance of 132.45 feet along said Dav is lands to said State Highway; thence along said State Highway North 9 degrees 25 minutes East 30 feet to a point at the Place of BEGINNING. TRACT NO. 3 BEGINNING at an iron pin at the northeast corner of Tract No.1 hereinabove described, which iron pin is at corner of land formerly of Dale McBeth and land formerly of Ira Davis; thence from said iron pin at the place of beginning along land now or formerly of Ira Davis, South 80 degrees 43 minutes East 54.2 feet to a stake; thence still by land now or formerly of said Ira Davis, South JO degrees 28 minutes West 150 feet to a stake in line of land now or formerly of Dorsey Hewitt; thence along line of said land now or formerly of Dorsey Hewitt, North 80 degrees 45 minutes West a distance of 52 feet to an iron pin at the southeastern corner of Lot No.2 hereinabove described; thence along the eastern line of said Lot No.2 hereinabove described, North 10 degrees 28 minutes East 30 feet to a point at the southeastern corner of Lot No.1 hereinabove described; thence along the eastern line of said Lot No.1 hereinabove described, North 9 degrees 25 minutes ast 120 feet to an iron pin at the Place of BEGINNING. THE ABOVE described three Tracts of land have thereon erected a dwelling house which has the mailing address of 4063 Carlisle, Road, Gardners, PA 17324. THE ABOVE described three Tracts of land are all of the land which Charles A. Losch and Eva M. Losch, husband and wife, by deed dated July 31, 1965 and recorded August 14,1965 in the Office of the Recorder of Deeds, in and for Cumberland County, at Carlisle, Pennsylvania, in Deed Book "R," Volume 21, Page 908, granted and conveyed to Allen N. Starner and Ruth P. Starner, husband and wife. TIlE SAID Ruth P. Starner having died on September 3, 2003, title to the same remained vested by operation of law solely in her surviving spouse, Allen N. Starner, whose Executors are the Grantors herein. BEING the same premises which Charles A. Losch and Eva M. Losch, husband and wife, by deed dated July 31, 1965 and recorded August 14, 1965 in the Office of the Recorder of Deeds, in and for Cumberland County, at Carlisle, Pennsylvania, in Deed Book "R," Volume 21, Page 908, granted and conveyed to Allen N. Starner and Ruth P. Starner, husband and w The said Ruth P. Starner having died on September 3, 2003, title to the same remains vested operation of law solely in her surviving spouse, Allen N. Starner, whose Executors are the Grantors herein. 217 REV-1508 EX+ (6-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Allen N Stamer Include the proceeds of litigation and the date the proceeds were received by the estate. All Drooertv iointlv-owned with riaht of survivorshlD must be disclosed on Schedule F. FILE NUMBER 128 ITEM NUMBER DESCRIPTION 1 Household Contents 2 PNC Bank, C/O #21001052659 3 PNC Bank, Checking Account #5140192254 4 PNC, C/O#31oo02411143 5 Automobile, 2004 Ford Explorer 6 Central PA Teamsters Pension Fund 7 Refund, Little's Gas 8 Refund, Automobile Insurance Premium VALUE AT DATE OF DEATH 500 1,000 5,653 1,103 9,311 659 70 263 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed. insert additional sheets of the same size) 18,559 JUN-15-2005 19:01 PNCBANK 412 768 3458 P.01 ~.::;.-::--::-:=.....:......-~ QPNCBAN< Jmle 16, 200S Robert M Frey Anomey at Law S S Hanover St. Carlislc, PA 17013 scp RE: Estate of Allen N Stamer (Deceased) SSN; 180-26-5454 DOD: 05-16-2005 Dear Mr. Frey: In responsc to your request for Date of Death balances for the customer DOted above, our records show thc following: Certificate of Depolit Account #2100 1 052659 Established 05-12-1995 ALLBN N STARNER DOD balance: S 1,000.00 + SO.41 accrued interest Account #31000241143 Established 07-13-2004 ALLEN N STARNER. DOD balllDce: S 1,067.94 + $34.81 accrued interest Cbecldaa AUoaDt Account #5140192254 Established 04-01-1963 ALLEN N STARNER DOD balance: S5,652:3 1 + SO.55 accrued interest The decedent mamtaiDcd InvcsbDcnt Account #79997051, for further infonnation please call1-800-762-61l1. Page 1 oe2 . Central Pennsylvania Teamsters Pension Fund JOSEPH J. SAMOLEWICZ, Administrator Board of Trustees WILLIAM M. SHAPPELL, Chairman and Trustee TOM J. VEN11JRA, Secretary and Trustee KEVIN M. CICAK, Trustee THOMAS K. WarRING, Trustee KEITH L. NOLL, Trustee PETER G. HASSLER, Trustee MICHAEL P. RYS, Trustee HOWARD W. RHINIER, Trustee MIKE JONES, Trustee TOMM FORREST, Trustee ~l}!lO~~ MARTIN L. CULLEN, Assistant Administrator ~ ~~ . 1055 Spring Street. Wyomissing, PA 19610 t$ I $) Mailing Address: P.O. Box 15223 ~ m Reading, PA 19612-5223 Phone: 610-32~5505 e:i) e::J TOLL FREE IN PA 1-800-343-0136 o ~ ~ 0 TOLL FREE IN USA 1-800-331-0420 ~~~~ FAX: 61O-32~9239 .~9 July 14, 2005 Robert M. Frey, Esquire Frey & Tiley, Attorneys -At -Law 5 South Hanover Street Carlisle, P A 17013 RE: Allen N. Starner SSN 180-26-5454 Dear Attorney Frey: Weare in receipt of the death certificate and short certificate for our member, Allen N. Starner, and the death'certificate for his deceased wife, Ruth Starner. The enclosed check represents the final payment on behalf of Mr. Starner. The check is not pro-rated based upon the date of death, but it is a full month's payment. There are no further benefits payable from this Pension Fund on behalf of the deceased. If we can be of any further service to you, please do not hesitate to contact us. Sincerely yours, CENTRAL PENNSYLVANIA TEAMSTERS PENSION FUND MLH 1lh/M-TL#429 Enclosure ~ \- \\"-... Michelle L. Houck Pension Benefits Manager PF08 217 REV-1510 EX+ (6-98) COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF Allen N Stamer FILE NUMBER 21-05-0471 DESCRIPTION OF PROPERTY ITEM INCLUDE THE NAME OF THE TRANSFEREE. THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF DATE OF DEATH % OF DECO'S EXCLUSION TAXABLE NUMBER TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (1F o\PP\.ICABlE) VALUE 1. PNC Investments, Annuity, Contract GA0595775 31,144 100.00% 31,144 TOTAL (Also enter on line 7 RecaDitulation) $ 31 144 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. (If more space is needed, insert additional sheets of the same size) Life and Annuity Claims P.O. Box 94212 Palatine,IL 60094-4212 ~ Allstate. You're in good hands. July 7, 2005 Frey & Tiley Attorneys at Law Attn: Carol Wert 5 S. Hanover Street Carlisle, PAl 7013 Re: Administrator for: Contract No: Allen N. Stamer Allstate Life Insurance Company GA0595775 Dear Ms. Wert: We have been requested to complete Internal Revenue Service (lRS) Form 712 with regard to the referenced contract. The purpose of Form 712 is to provide an estate or donor with the value of a life insurance contract or with its proceeds as of certain date (usually the owner's date of death or date of transfer of the contract). The contract referenced was an annuity contract, which is not reportable on IRS form 712. The following information is provided regarding the value of the annuity and other data as of the date specified: . Date of Death: 5/16/2005 Annuity Value. as of Date of Death: $ 31,143.91 Cost Basis: $ 30,488.47 Named Beneficiary: Kim L. Cassatt *The actual amount paid may differ due to Market Value Adjustments andlor any applicable Surrender Charges. If you have any questions, or need further assistance, please contact the Customer Care Unit at 1-877-499- 6418. Sincerely, ~~ Lin Breckler Life and Annuity Claims Overnight Address: 544 Lakeview Parkway, Vernon Hills, IL 60061 ToU Free Fax: 1-866-635-4523 217 REV-1511 EX + (12-99) COMMONWEALTH OF PENNSYLVANIA ~HERrrANCETAXRETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Allen N Stamer FILE NUMBER 21-05-0471 ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Hoffman-Roth Funeral Home, Funeral Services 7,257 2. Gingrich Memorial, Inscription 100 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s) I EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees 15,778 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 348 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Cumberland Law Journal, Advertising 75 8. The Sentinel, Advertising 173 9. Register of Wills, (1) Short Certificates 4 10. Pa Inheritance Tax Return, Filing Fee 15 11. Checks cleared after the date of death 141 TOTAL (Also enter on line 9. Recapitulation) $ 23 891 Debts of decedent must be reported on Schedule I. (If more space is needed, insert additional sheets of the same size) REV-1512 EX+ (12.ro) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN T NT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER Allen N Stamer 21-05-0471 Report debts Incurred by the decedent prior to death which remained unpaid as of the date of death, Including unrelmbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Check cleared after Date of Death 141 2. Sprint, Utilities:T elephone 131 3. Shipley Energy, Fuel Oil 181 4. MetEd, Utilities:Electricity 113 5. Waste Management, Utilities:Trash Removal 65 6. Belmont & Crystal Springs, Water Service 8 7. Recorder of Deeds 44 8. Carolyn R. McQuillen, Tax Collector 295 9. Elzin Weidner, Farm Taxes 45 TOTAL (Also enter on line 10, Recapitulation) $ (If more space Is needed. insert additional sheets of the same size) 1,023 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1 Kenneth A. Stamer Son 25% of residue of estate 356 Waters Road, Patten ME 04765 2 Kevin N. Starner Son 25% of residue of estate 411 Plainview Road, Gettysburg PA 17325 3. Keane D. Starner Son 25% of residue of estate 4063 Carlisle Road 4. Kim l. Cassatt Daughter 25% of residue of estate 41 Wolfs Bridge Road, Carlisle PA 17013 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 $ 217 REV-1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Allen N Stamer SCHEDULE J BENEFICIARIES FILE NUMBER 21-05-0471 (If more space is needed, insert additional sheets of the same size) . ~ ~ LAST WILL AND TESTAMENT OF ALLEN N. STARNER /"' I. ALLEN N. STARNER, of Dickinson Township (R. D. #2. Box 111. Gardners) Pennsylvania. being of sound and disposing mind. memory and understanding. do hereby make, publish and declare this as and for my Last Will and Testament hereby revoking and making .void any and all wills by me at any time heretofore made. 1. I direct my.,: hereinafter named Executrix to pay all of my just debts and funeral expenses as soon after my death as may be found convenient to do so. 2. All the rest. residue and remainder of my estate, renl, personal and mixed and wheresoever the same may be situate, 1 give, devise and bequeath to my wife, Ruth P. Starner. her heirs and ass igns to the exclusion of my children born and unborn, provided my said wife, Ruth P. Starner. shall survive me by a period of ninety (90) days. 3. Should my said wire, Ruth P. Starner, predecease me or fail to survive me by the aforesaid perIOd of ninety (90) days, then in such event all the rest, residue and remainder of my estate, real, personal and mixed. and whe,resoever the same may be situate, I give" devise and bequeath as follows: A. All guns and hunting equipment and fishing equipment which I may own at the time of my death I give and bequeath in equal shares to my three sons. Kenneth A. Starner and Kevin N. Starner and Keane D. Starner, provided each of them shall survi.ve me by a period oC ninety (90) days but should any of them fail to so survive me then the share such deceased son would have received shall lapse and said items shall be distributed to my son or sons so surviving me. B. Should my daughter Kim L. Starner survive me hy a period of ninety (90) days a~d should she be I1nnHlI't'ied, in such event I d ireet Page I or 3 Pages .-:-~- __ .~~.i1'II .",~ IN WITNESS WHEREOF. I have hereunto set my hand nnd seal to this my Last Will and Testament written on three pages this 9th day of March, 1982. {}~YJ. JJ-~ Allen N. Starner Signed, sealed, published, and declared by ALLEN N. STARNER, the Testator above named. as and for his Last Will and Testament, in our presence, who, in his presence, at his request, and in the presence of each other, have hereunto subscribed our name~ as attesting witnesses. ~L " " ONi l' f!wJ I Page 3 of 3 Pages i (SEA L) I ! 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 FREY ROBERT M 5 S HANOVER STREET CARLISLE, PA 17013 n______ fold ESTATE INFORMATION: SSN: 180-26-5454 FILE NUMBER: 2105-0471 DECEDENT NAME: ST ARNER ALLEN N DA TE OF PAYMENT: 12/19/2006 POSTMARK DATE: 12/19/2006 COUNTY: CUMBERLAND DA TE OF DEATH: 05/16/2005 NO. CD 007585 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $1,092.00 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: CHECK#1007 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS $1,092.00 GLENDA FARNER STRASBAUGH REGISTER OF WILLS