HomeMy WebLinkAbout12-29-06
REV.l500 EX + (8-00)
COMMONWEALTHOF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
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DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Q'Nem Patricia Ann
DATE OF DEATH (MM-DD-Year)
DATE OF BIRTH (MM-DD-Year)
OFRCIAL USE ONLY
FilE NUMBER
2 1 -0 6 0 6 9 4
""ColiNTYCOOE ---VEAR- - - NUMBER- -
SOCIAL SECURITY NUMBER
1 95- 3 2 - 4 6 6 0
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
o 3. Remainder Return (dateofdeathprior1D12-13-82j
o 5. Federal Estate Tax Rerum Required
_ 8. Total Number of Safe Deposit Boxes
o 11. Eleclion to tax under See. 9113(A) (AllaCh Sch 0)
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TELEPHONE NUMBER
717 766-3172
Mechanicsburg, PA 17055
THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
John M. Eakin Market Square Building
FIRM NAME (If Applicable)
152,000 -fl9
73,671.27
(8)
21 ,063.55
91,733.35
(11)
(12)
(13)
(14)
OFROIAL USE ONLY
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X _(15)
X _(16)
112,874.37 X .12 (17) 13,544.92
X .15 (18)
(19) 13,544.92
07/28/2006 04/27/1940
(IF APPUCABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
00 1. Original Return
D 4. Limited Estate
00 6. Decedent Died Testate (AllaChcopyofWHI)
o 9. Litigation Proceeds Received
o 2. Supplemental Retum
o 4a. Future Interest Compromise (dale of death aller 12-12-82)
o 7. Decedent Maintained a Living Trust (AllaCh copy of Trust)
o 10. Spousal Poverty Credit (date ofdealh belween 12-31-91 and H-95)
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1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
D Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
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)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Govemmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
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225,671.27
112,796.90
112,874.37
112,874.37
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20. [Kl
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under See. 9116 (a)(1.2)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
Decedent's Complete ress:
STREET ADDRESS
312 E. Portland Street
CITY I STATE I ZIP
Mechanicsburg PA 17055
Add
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1 )
13,544.92
15.000.00
677.25
3.
Total Credits (A + 8 +C)
(2)
15,677.25
Interest/Penalty if applicable
D. Interest
E. Penalty
4.
Total Interest/Penalty (D + E)
If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (5A)
8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58)
Make Check Payable to: REGISTER OF WILLS, AGENT
(3)
2,132.33
0.00
5.
0.00
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 IZl
b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 IZl
c. retain a reversionary interest; or ...................................................................................................... 0 IZl
d. receive the promise for life of either payments, benefits or care? ............................................................. 0 IZl
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration?. ... ... ..... ......... ................ ...... ........... ........... ...... ...... ................. 0 IZl
3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? ................. 0 IZl
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ....................................................................................................... 0 IZl
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
ADDRESS
Market S are Building
Mechanicsburg, PA 17055
DATE
>>t ~ Ob
ADDRESS
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. ~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 0% [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 0% [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 4.5%, 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 12% [72 P.S. ~9116(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
ESTATE OF FILE NUMBER
O'Neill Patricia. Ann 21 06 0694
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 DrOllArtv which is iointlv-owned with riaht of survivorshin must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
312 E. Portland Street, Mechanicsburg, PA 17055, selling price
VALUE AT DATE
OF DEATH
152,000.00
TOT At (Also enter on line 1, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
152000.00
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...JIIUI'IM"L" W.LL-......J.I'-t....;.J
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A. Settlement Statemen Post-It'" Fax Note 7671 0018 12 {7:1 I~~..;;..
To ~hn- from I
CoJOep1, Co. 'i?
Phone, Phone <<
]j J-9~ - I!4lSJ,L oMB No. 2502-0265
B.TvoeofLollD Fax<< (sJCli - ~ 7 t;< J Fax .
1.0 FHA. 2.0 FmHA 3. 1m Conv_ unins) .- - ~ :urance Cue Number
4.0 VA 5.0 Conv. Ins. 71086LEE I I
C. NOTE: This form is furnished to give you a statem<mt of actual settlement costs. Amounts paid to and by the settlement a~ent ere sho\\1Tl.
Items marked "(p.o.c.)" were p.e.id outside the closing; they are shown here for informational purpOses and are not inelu ed in the totals.
D. NAME OF BORROWER: Sonia M. Lee
ADDRESS OF BOroloWER: 765 Bpplet Road Unit C, Mechaoicsburg. FA J 7055
E. NAME OF SELLER: The Estate of Patricia A. O'Neill {e~j'd HLvl::>.
ADDRESS OF SELLER:
F. NAME OF LENDER: Members 1st Federal Credit Union
ADDRESS OF L.ENDER: 5000 Louise Drive, Mechanicsburg, P A 17055
G. PROPERTY 312 'East Portland Street
LOCATION: Mechanicsburg, P A 17Q55
H. SETfLEMENT AGENT; SIMPLE SECURE LAND TRANSFERS, LLC
3425 SIMPSON FERRY ROAD, CAMP HILL, PA 17011
PLACE OF SETTLIj:J\fENT: 3425 SIMPSON FERRY ROAD, CAMP BILL, PA 17011
1. SETl'UMENT DATE:
J. SUMMARY OF BORROWER'S TRANSAcnoN K. SUMMARY OF SELLER'S TRANSAC ON
I OO,QROSS AMOTJNT DUE OWER S AMOUNT D
J 0 I.Contracua1p_" ntic.. '5') ,n ^^ f"'nn_'" sales price
,
.402.~!l1 pm~ .. .-
.li13..Settlernent cba~ to borrower (lin.. 140m 4_(i~O.52 403.
104. _. 1404.. '-
J_O.~, . 40" H_
~strQents for items p~d by seller in e,d"....,... ~mt1l:1US..fur items pai,d by seller i1'-8dvanc. .. ..~
,l06.Cityltown ~CJl 1212712.QOli to ,\,nn 4n6C:;tv/~own taxes ] 212712nJ)~ to 12/~ Il20Jlti
WJ~ountv taxes to !I07.CounlY ta)ses 10 .-
~~sments to 14,98,Assessmtm,ts tn ~-:-
I09.Schnnl '1:axcs 1)12711006 to 6/'01'2007 644.5'; 409.School TaM.s 12ml2006 to 61301200~ .,~
IIO,Se=rIItlIsh 12L2'Za006 to 121ll1200~ 4.68 410_S.~rrrrasb ----1ZltU2006toI2f;U12006 468 -
UJ... to 411. _to "-
12. to 412. to
.120.GROSS AMOUNT DUE FROM OORROWER ~ 157,234.75 420.CiROSS AMOUNT DUE TO SELLER .. 152,654.23
200.AMOUNTS PAID BY OR IN BEHALF OF BORROWER. 5oo.REDUeTIONS IN AMOUNT DUE TO SELLER
201.neoosit or eanlllSt -""..... 1nl n,,^ at J:",,,,,ss deposit ~ instructinns\
202.Principal amount of ement chaJVS to sellcr(line 1400) 10 '1M 00.
1Ql.El\istjn~ 101U1(lI) tjlken subjecJJo'. 503.El'.istine 10Iln(l>) 'cet to
lOL-. '~M])~""~ 50A27.00
wasninEtpn Mutual .
.w......... . .. 505_PaYJl~d~Jl)all .~..
PNC..Bank..
206.Princ.maJ amount of s.l:Jler financinl!: 506.Princ.ip~..o.~.allCing
207. sO't. -
208, 508. .- '-
299. 0 509. .---
2.09a S09a -
209b 509b
Adjustments for items unpaid by seller Adj..!!.stments for items unpaid by seller '-
2J..Q.Citv/lown ~es to 51O.Citv/town taxes to
~ll.ty taxes to 5)1_~;S 10
t2.U.Assessments to 'Ii? '...-cnts to
.213, tQ... 513, 19
tl4.... to 514. to '.-
215. - lP 515. to ..-
216. to 516. to '-
~(, '1'1 517. --..!ll-._ '--
1218.. to Sill to
219. to 519. to
220. TOT At AMOT.JNTS PAID .. 106,000.00 520. TOTAL REDUCTIONS IN ~ 91,449.69
BY OR IN BEHALF 01' BORROWER AMOUNT DUE SELLER
30e.CASH AT SETI'LEMENT FROMfl'O BOR.llOWF.R 600.CASIi AT SETTLEMENT TOIFR.OM SELI.IlR
30 I ,Gro" Amonnt due from bOU'Qwer (line 120) f'i72R4.7S 60J.(lross atnoul1tdue to s..I\... (line 420) 152 6~4.2'
1302.L / r hol'Mwcr /li!lC.220\ 106 000.00 1602.Less reductions in cUe! (line 52m 91 449.69
303.CASH Ii) From 0 To BORROWER ~ 51,%84.75 603.CASH IXJ To o From SEL.LER ~ 61,204.54
PAGEt
Q200c 01,.1", SJR-I, '.eo. <M31 7IlO-em .. LaMt Gel........
liUD-l (3.S6) RESPA, H.8 4305.1
OEC-27-2006 WED 11:13AM 10:
PAGE: 1
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U.S. iJEPAR.TMENT OF HOUSING AND URBAN DEVELOPMENT
SETTLEMENT STATEMENT
PAGE 2
L. ~lement Cllarl!es @ !2..l1MlL Paid From Paid From
700. TOTAL !lALESlBROKER'S COM. based on J)1'ict IS2..~.~ %-
~jxision ofColl)l1Jission (1in~,700)!aS foU~: "- Borrower's Sl:ller's
to ..Bwax R~lty Associate.s Funds At Funds At
791. 4.s.sS. 00 to B&QKERS..&E..u.IY..QOM Settlc:mmt ~lemont
~2~ 453W, 9,12Q./\I\
7Q3, Commis~on.~IrttI!""",1
704. to
, 800. Items Pavab e In Connertlon WttIl LOaD
f-B,Ol. {..oen ~ation Fcc % 10
I 802,~an Discnunt. . % to
803. ApD~iMI Fee to ....- -.-
8.94, (:redit Re.R2!1..-. tn - -- -_. -..-
1 .Ll&Jllli:l:'.tln~e to "-
-..Mortgalle InsuTance Application Eee to .....-
8 . . pplication J:f!!' tQ Membe(SJ..~~.J;edit UniQll:iSOl'oj; 30,0.00
--6:._J,J~ to Metnb~~i.t_lJnilln.- 2~;:: -'-
....a: LOP.kum~~eJ! ~exnber5 1st Federal ~~ '-
~lJL to
~1l to -- -'--
#2, to
. 111' to "-
11l14. to -,,-
815 to
[)(J,....llem. Reaulred Bv Lender 1'0 B~ Paid In AdvaDee 87.67
l).. Interest fr.p.J!L.12lll{2.\106 to 1/]/2007 L-J7~a4LldaY
02. Mortl!~~qntbslo ...
Q3__Jiv.ard Insurance PrcmiUIJl for vears tQ. "-
...904. _~_. to ".- -'-
905. years 10
1000. Reserves DeDo.lle\l With Len4er . .JlU.i.
~t.ar~c_ 3 rnonth!@ 5Q.75 per month '-".-
~OJ:I:S!a\!e insurance months@ peT mnnth "-
1003. ChI( W'opertv taxcs months@ per mOlltQ ---
.1.1)04. County properly tQX~ 11 monthS@ 38 O~ Pllr mnn.h ~8..~5
lD.a5.. Annual llSRAA!!ffi'lnts monthg@ _--2-4JJ!L --
\006. School_Taxes --2..m01lJh.dil \05.97 --
J.llQ1...^nre~~e 6.<ljustment - months@ -.~ (5-'.1...Ul -....-
1..008. months(a1 --l!..llr month -,- /---.-..
1009.
1100. Title Chams
D..O 1. Settle.~t or closing ke to '''-
1102, Abstract or title search tP.
.um.J:~~tion tQ ---
J I 04.. Title insurance binder to - .--
JlQS, DOCUl'\'\enl OTo:varati on to '-
1106.N~fees to Si~~.~~C. .-W_O .~
.lllllJ."tlomev" fc~ to ~!~I~:~'.\C;?I!.~~,.: .ril!W:Rtim:\~~ ~~t{~.
(in~llIrl,,!, above items Ijumber!l- to .si1mllltSe;!;.lID: I .IUd Transfm. U::C'
J.lQR...IillJ!~
~: tl 02.11 03.11 04
Jl.09. Lender's..Qove1'l\llc' INS AMT: 101 000..\1.2--
l1..llil,-<~:ll!D.!lo...COyf:l'ase: .. ~j_~L-
J.11.2Jl...,gI1.!l~. 100, 3@. 8 1 ~~~ ~._.-
Jlll...Cl.os.ins Se.rvicr Letter ~lLEirs1.A~t!Uniw:anF~.n" J>" 1----
1112 to 1-----
1113. tn
1200.. Government Recordilllr and TraJUlfer ChaNes
~~. ~l:j;QTtlil1g Cees' Q=d $~8,50i I ~e(s) 564 50: g.Mortia&e(s) i~S lMon
.llQLCi~stamng' Deed 51 .520.00' I....MoTtwagefs) . S-Mort6lalJ~s) --1,.520.00
l2!l.~~ps' Deed $1,520.00; L-MoTtaageW 'S..Mortl1~~(s) I.,mon..
~- -
20S.
13QO~ Addltlon.1 Settlement ClJal'2el
D.DI. Surv~v to "-
302. P~Slln~ to
1l03.RoofJn.s~ to
n04. to SinnllJt s.~s.fm..LLr l~M ,OM
~,,~SlID'iee. I:.~ toB~ --..J9.5..QQ. r----
~Q6. to ", . . --~
~lax~~~t to &j!l11t~ Realty --.-.- "---
1308.Cmnc~.. to Tri-Countv -- --~
1309. to
\400. Total Settlement Charges (enter on Ilnes 103, SectIon J and 502, SectionK) ., 4,630.52 10,704.00
CU,1lFI.CA nON DA'TEq 2n7/2006
I have careful/\, reviewed the JflJD.. t Settlement Statement and to the best ofmy knowledge and belief. it is a truc and accurate sWemet1\oraJfficclpts and
disbursements made on my account or by me in this transactjOn. r flll'ther certify that , have received a copy of the HW ' I Sen/ement Statement.
The ES1ate of Patricia ^. O'Neill
Sonia M. Ue
Borrower
.a~
Thomas L. O'Neill, ExeculOr
Seller
Borrower Seller
The Hl,ID-J .S~lcment Statement which I have prepared is a true and lICQII'8le account of this transac:tion. I have caused the fIlnds 10 be disbursed in accord.
anee WIth th,s statement. SlMJ>LE SECURE LAND TRANSFERS, LLC
Settlement ~scnt .l2I.21..!2Ollli.... Date
WARNING: It is a crime to knowingly make false statements to rile United ~ on this or any other similar form. Penalties upon oonviction can incl~de a
"nesnd impri.onmcnt. Fordetail59~: Title 18 U.S_ CodeSeclion 1001 and Section 1010. 71 0lJ6LEF.
DEC-27-2006 WED 11:14AM 10:
PAGE: 2
REV-1508 EX + (6-98)
.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
O'Neill Patricia. Ann
FILE NUMBER
21 06
Indude .the p!'OCElEl<ts of litigation and the date the proceeds were received by the estate.
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
0694
ITEM
NUMBER
1.
DESCRIPTION
PNC Bank Account # 7993, see attached
VALUE AT DATE
OF DEATH
35,352.96
2.
PNC Bank Account # 2408, see attached
3,882.89
3.
PP&L Refund
101.22
4.
Patriot News - Refund
34.49
5.
IBM - Dividend
31.20
6.
Verizon - refund
12.80
7.
IBM Savings Plan, see attached
34,185.36
8.
Haar's Auction- miscellaneous furniture
70.35
TOTAL (Also enter on line 5, Recapitulation) $
(If more llPiiCEl is needed, insert additional sheets of the same size)
73 671.27
Total Banking Statement
~ PNCBAN'
8 For 24-hour information, sign on to PNC Bank Online Banking
on pnc.com.
Account nwnber: 50.7007-2408 - continued
For the period 07/18/2006 to 08/15/2006
PATRICIA A O'NEIll DECO
Primary account number: 50-7007-2408
Page 3 of 4
PNC has a new address on the Web. Visit pnc.com forall your banking needs. .
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Performance Money Market Account Summary
Account number: 50-0369-7993
Patricia A Oneill Deed
Beginning
balance
35,352.96
Deposits and
other additions
.00
Checks and other
deductions
35,352.96
Ending
balance
.00
. Please seethe Activity Detail section for
additional information.
Balance Summary
Average monthly
balance
..- ,'--- '20,724.14-
Charges
and fees
.00---- ." .
Annual Percentage
Yield Earned (APYE)
0.00r.
Number of days
. In Interest periOd
Average collected
balance for APYE
Interest f>ald
this period
As. of OS/15,.atotal of $718.92 in interest
was paid this year.
Interest Summary
17
35,352.96
.00
Activity Detail
Other Deductions
Date
08/04
08/04
Amount Description
.00 Outstanding Item Close
35,352.96 Debit Memo Reference No 026557891
There were 2 Other Deductions totaling
$35.352.96.
Daily Balance Detail
Date Balance
07/18 35,352.96
Date
08/04
Balance
.00
.
FORM953R.l00
Total Banking Statement
PNC Bank
o PNCBAl\
For the period 07/18/2006 to 08/15/2008
Primary account number: 50-7007-2408
Page' of 4
Number of enclosures: 0
A
B
PATRICIA A O'NEILL DECD
312 E PORTLAND ST
MECHANICSBURG PA 17055-3354
Q For 24-hour banking, and transaction or
interest rate information, sign on to
'tt PNC Bank Online Banking at pnc.com.
For customer service call 1-888-PNC-BANK
between the hours of 6 AM and Midnight ET
Para servlcio en espatlol, 1-866-HOLA-PNC
Moving? Please contact us at 1-888-PNC-BANK
t8:I Write to: Customer Service
PO Box 609
Pittsburgh PA 15230-9738
"--'- --'_ ..!5i Visitys_~~pnc.:..C?-~____.__..__
'iii TDDterminal: '-800,531,1648
For hearing impaired clients only
R.8..'.I:.aijJ.,OF:....;n...~.'~lp.. .....-_!! -S"W
". .' ~ "...,'~..-~,._....'""~.....'..'''....._i''''H.,''>.''"._.,_,~..,'',.,..:,..-,_.,";...""",,_..~"..."",..'.,,.>,; .,....,.,,,.,'.,~i,...,._.,,..-,',..__,,:.<.,..,'
lJ"ink:Vepoiif'.ccouiits ---,,~ .
Description ...,.~~ ....
Interest Checking - .~O-7007-2408 -, ~.~..~..,. .,.~
Performance Money Market 50-0369-7993
Total Deposits
Deposit Balance
.~i8~.89
.00
3,882.89
~
-
Important Account Information
Amendment to the Account Agreement for Personal Checking and Savings Accounts
The infOlmation stated below amends certain information in olltAccount AgreementfoYPersonal Checkln.g and SaVingsXccoUfi~
(Agreement). Please take the time to review the folloWing and keep it with yourrecords. All otheiilifon:natioll iuthe Agreement
continues to apply to your account. If you have any questions, please stop by your branch or call us at the numberfisted on the top
of your statement. Weare happy to answer any questions you may have. Thank you.
Effective July 1, 2006.
A "remotely created check" is a check that you are authorized to create and present for payment by an authorized sign;,
oJiffieaccount on which the' check Isdra\Vn,and whicnQOefnlut1lave:lhe'SignatureofaiiEi:tilliorized'signel"'o-u,that .,.c.
account and includes checks that are defined in applicable law as "remotely created checks" .
If you deposit a "remotely created check" with us, you represent and warrant to us that the check is authorized to be
paid in the amount stated on the check and to the payee named on the check.
In addition to the above, we may honor "remotely created checks" authorized in the amount stated on the check and to
the payee named on the check, by you or a joint owner of your account.
You agree to indemnify us for any loss that we may incur directly or indirectly from YOllr deposit of a "remotely
created check" in violation of the terms set forth above. You further agree that all of the terms in this Agreement and
under applicable law that apply to a "check" and/or "item" apply to "remotely created checks", including without
limitation, substitute checks created from and check images of "remotely created checks", except that "remotely
created checks" will not be sign~d by an authorized signer onthe account on which the check is drawn.
The following example Is not part of the amendment to the agreement but Is provided to enhance understandIng of this
topic:
Your individual account statements begin on the following page
FORM953R-l005
~ STATE STREET.
liliiii For Everything You Invest In-
Retiree Services
P.O. Box 550868
Jacksonville, FL 32255-0868
THOMAS O'NEI ESTATE OF PATRICIA 0
112 STONER DRIVE
MECHANICSBURG PA 17055
ACCOUNT ID IBM
- -IB001
PLAN NAME THE IBM SAVINGS PLAN
Oct 06,2006
005159802
876-27-****
THOMAS O'NEI ESTATE OF PATRICIA 0
TAX YEAR
EMPLOYER ID NO.
DISTRIBUTION AMOUNT
FEDERAL TAXABLE AMOUNT
STATE TAXABLE AMOUNT
TAXES WITHHELD .
AFTERTAX EE CONTRI~UTIONS
CAPITAL GAINS
ORDINARY INCOME
NET APPRECIATION
IRS DISTRIBUTION CODE
TYPE OF DISTRIBUTION
THIS STUB IS THE TAX REPORT PERTAINING TO THE ATTACHED DISTRIBUTION. RETAIN THIS PORTION FOR.YOUR.ij;icOME.........................
TAX RECORDS. THIS INFORMATION IS BEING REPORTED TO THE INTERNAL REVENUE SERVICE.
GROSS PAYMENT AMOUNT
FEDERAL TAX WITHHELD
STATE TAX WITHHELD-
NRA TAX WITHHELD-
OTHER DEDUCTIONS
NET PAYMENT AMOUNT
34,185.36
2006
04-3581074
34,185.36
34,185.36
34,185.36
34,185.36
34,185,36
4
11.00 5 ~ 5~BO 211. 1:0 ~ ~OOOO 2BI: ~~Ob ~~~bll.
~..' '.- ,,"""....> ",-,. "'~"',,,;.-.,,.,..,, ....~"",.;'..,'........~W.0:1.;:}.;. .;.,:~
REV-1511 EX + (12-99)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
O'Neill Patricia. Ann
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
Debts of decedent must be reported on Schedule I.
FILE NUMBER
21
06
0694
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Myers Funeral Home Inc. 4,692.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s)
Social Security Numbe~s)lEIN Number of Personal Representative(s)
Street Address
City State Zip
Yea~s) Commission Paid:
2. Attomey Fees John M. Eakin 4,500.00
3. Family Exemption: (If decedents address is not the same as claimants, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees Letters Testamentary 381.00
5. Accountants Fees
6. Tax Retum Prepare~s Fees
7. The Cumberland Law Journal, estate notice 75.00
8. The Sentinel, estate notice 151.55
9. Central Penn Appraisals, real estate appraisal 350.00
10. Mary Haring- trash removal 195.00
11. Cost of Selling Real Estate 10,704.00
12. Filing Fee 15.00
TOTAL (Also enter on line 9, Recapitulation) $ 21 063.55
(If more space is needed. insert additional sheets of the same size)
REV.1512 EX 1" (6-96)
*
SCHEDULE.
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
O'Neill. Patricia. Ann
FILE NUMBER
21 06
0694
Include unreimbursed medical expenses.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
See Attachment Page(s)
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
8 349.47
Continuation-of REV-1500 Inheritance Tax Return Resident Decedent
O'Neill, Patricia, Ann
Decedent's Name
Page 1
21 06 0694
File Number
Schedule I - Debts of Decedent, Mortgage Liabilities, & Liens
ITEM
NUMBER DESCRIPTION AMOUNT
1. Sears Credit Card 82.79
2. PP&L Electric 101.22
3 United Water 24.60
4 Boscov's Credit Card 1,750.31
5 Capital One Credit Card 430.69
6 Oakwood Center Radiation - medical 9.98
7 Discover Credit Card 2,507.27
8 Sewer/Refuse Mechanicsburg 117.50
9 Washington Mutual - home loan 3,119.12
10 West Shore Surgery Center - medical 189.86
11 Andrew & Patel Association, medical 4.59
12. Holy Spirit Hospital - medical 101.38
13. Quantum P. E.T. LP - medical 436.88
14. Riverside Anesthesia - medical 17.93
15. Shipley -oil 280.00
SUBTOTAL SCHEDULE I
9,174.12
O'Neill, Patricia, Ann
Decedent's Name
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
21 06 0694
File Number
Page 2
Schedule I - Debts of Decedent, Mortgage Liabilities, & Liens
ITEM
NUMBER DESCRIPTION AMOUNT
16. PNC Bank (loan) 737.51
17. Bowser Boutique - book account 34.98
18. Lawn Unlimited Inc. - book account 508.00
19. Verizon - telephone 96.50
20. Heritage Medical Group, LLP - medical 85.05
21. Kilmore Eye Association - medical 106.55
22. West Shore EMS - ambulance 64.70
23. Neurology Center P.C. - medical 37.92
24. Susquehanna Surgeons - medical 17.42
25. Washington Mutual Mortgage, see attached 50,427.00
26. PNC Bank Mortgage, see attached 30,318.69
27. Assoc. Otolaryngologists of Pa 31.92
28 Pulmonary and Critical Care Med Assoc. 80.56
29. Camp Hill Emergency Physician 12.43
SUBTOTAL SCHEDULE I 82,559.23
GRAND TOTAL SCHEDULE I $ 91,733.35
""-"" ",. ".
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
()'NAiIl
NUMBER
1.
SCHEDULE J
BENEFICIARIES
.. Ann
NAME AND ADDRESS OF PERSON{S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS pnclude outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1.
Thomas L. O'Neill
112 Stoner Drive
Mechanicsburg, PA 17055
FILE NUMBER
21 06
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Brother
nf\Q.d.
AMOUNT OR SHARE
OF ESTATE
entire estate
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 n - 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)
. ,;..,,-~? t j" ,>...~. "" .' ,,' ~ I ,~ ~ , "',' ." ...: ~ , . ~
~ ...\' ,
, <
. '
'l'j . .
,
If{a.rtt 2l11Iill (ttt~ 'Qft~tatntnt
OF
PATRICIA A. O'NEILL
I,
PATRICIA
A.
O'NEILL,
of
the
Borough
of
Mechanicsburg, Cumberland County, Pennsylvania, being of
sound and disposing mind, memory and understanding, do
hereby make, publish and declare this my Last will and
Testament.
1.
I direct the payment of all my just debts and funeral
expenses as soon after my decease as the same can
conveniently be done.
2.
All the rest, residue and remainder of my estate, of
\'lhatsoever nature and wheresoever situate, I give, devise
and bequeath to my brother, THOMAS L. O'NEILL, absolutely
and in fee simple.
3.
In the event THOMAS L. O'NEILL predeceases me, the gift
shall not lapse but go instead to his heirs at law.
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4.
Lastly, I nominate, constitute and appoint my brother,
THOMAS L. O'NEILL, to be the Executor of this my Last Will
and Testament.
I further direct that no bond or other
security be required of my personal representative to
guarantee faithful performance of his duties.
III WITNESS WHEREOF, I have hereunto set my hand and
seal this It) 1 ~ day of June, 1994.
~Rtf~~EAL)
Patricia A. O'Neill
Signed, sealed, published and declared by the above-named
PATRICIA A. O'NEILL as and for her Last will and Testament, in
the presence of us who have subscribed our names hereto as
witnesses, at her request, in her presence and in the presence of
each other.
z:
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