The URL can be used to link to this page

Home My WebLink About02-09-07 .-J 15056051058 REV-1500 EX (06-05) PADepallmentofRewnue '* Bureau of lndMdual Taxes PO BOX 280601 Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social SecurIty Number Date of Death OFFICIAL USE ONLY Coun~ty Code Year INHERITANCE TAX RETURN RESIDENT DECEDENT 21 06 File Number 0625 Date of Birth 209-28-9593 06/17/2006 12/08/1929 Decedent's Last Name Suffix Decedent's First Name MI WARNER FLORENCE E (If Applicable) Enter Surviving Spouse's Infonnatlon Below Spouse's Last Name Suffix N/A 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=;, 4. Umited Estate c:> 3. Remainder Return (date of death prior to 12-1:Hl2) 5. Federal Estate Tax Return Required c=J __ 48. Future Interest Compromise (date of dealh after 12-12-82) C) 7. Decedent Maintained a living Trust (AItach Copy of Trust) c:=J 10. Spousal Poverty Credit (date of death ,=) 11. Section to tax under See. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT - THIS SECnoN MUST BE COIIPlETED. ALl CORRESPONDENCE AND CONFIDENTIAL TAX INFORJIAllON SHOULD BE OIREC1BI TO: Name Daytime Telephone Number 6. Decedent Died Testate (AItach Copy of WIll) 9. Litigation Proceeds Received o 8. Total Number of Safe Deposit Boxes C-i Robert R. Black (717) 243-3727 Firm Name (If Applicable) Landis & Black .--.,-'"'--"._..-~--.- -- -.....---. -~......-._- REGISTER ~)W1LLS USE ~ First line of address 36 South Hanover Street I \';::J Second line of address City or Post Office Carlisle State ZIP Code ~ .I?J~:~!:,~I:[l.. I I t PA 17013 o 17050/ 7073 Carlisle Pike, Lot 86, Carlisle, PA 17013 "TIVE PA 17013 PLEASE USE ORIGINAL FORM ONLY L 15056051058 Side 1 15056051058 .-J c) --1 15056052059 REV-1500 EX Decedent's Social Security Number Decedent's Name; FLORENCE E WARNER 209-28-9593 '~_._'---"-~---"'~-----"--~-"-"----~'-~'--'-'~-"------....~.-- ---~-----.--~-~--,~~--~ - .~-- --"-~~-"~'-"---'^-~'--'.~~-_..~-^_.'~--._- ",-,--~,"~,_--,-,,~~,_'"'.._--.-_._._--- RECAPITULATION 1. Real estate (Schedule A). ..... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1. 137,140.38 0.00 0.00 0.00 9,188.11 0.00 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . .. .. 2. 3. Closely Held Corporation, Partnership 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.:l Separate Billing Requested . . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) <=;) Separate Billing Requested.. . . . . .. 7. 0.00 146,328.49 8. Total Gross Assets (total lines 1-7)... . . . . . . .. . . .. ...... '" . . . .. '" .... 8. 9. Funeral Expenses & Administrative Costs (Schedule H). '" . . . . .. . .. '" .. . .. 9. 29,470.81 10. Debts of Decedent, Mortgage liabilities, & liens (Schedule I)..... ........... 10. 305.30 11. Total Deductions (total Lines 9 & 10)................................... 11. 29,776.11 12. Net Value of Estate (line 8 minus line 11) .... . .. . . . .... ....... .. " . . .. . 12. 116,552.38 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . . . . . . . 13. 0.00 ---.-.--------~-.-.-.----~----.-->----.--....----..---..~-~---..P..--,------.---..~-.-.-.-....-~ . "."~'.--.~."-"-~----'_.-.~'_"."~'__'~"'_"~..___.._..w'. .,._ 14. Net Value Subject to Tax (Line 12 minus line 13) ............... . . . . . . . . . 14. 116,552.38 TAX COMPUTAnON - SEE INSTRUCnONS 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 45 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 15. 16. 5,244.86 17. 18. 19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 5,244.86 20. FIll IN THE OVAL IF YOU ARE REQUESnNG A REFUND OF AN OVERPAYMENT L 15056052059 Side 2 15056052059 -I RE\i-1500 EX Page 3 Decedent's Complete Address: DECEDENT'S NAME DECEDENrS SOCiAl SECURITY NUMBER FLORENCE E WARNER 209-28-9593 S1REET ADDRESS 1390 Waggoner's Gap Road CITY I STATE I ZIP Carlisle PA 17013 Tax Payments and Credits: 1. Tax Due (Page 2 Une 19) (1) 2. CreditsIPaymenlS A. Spousal poverty Credit 6. Prior Payments C. Discount 5,244.86 Total Credits (A + B + C ) (2) 0.00 3. InterestJPenalty if appficable D.lnteresl E. Penalty TotallnterestJPenalty ( 0 + E ) (3) 4. If Une 2 is greater than Une 1 + Une 3, enter the differ&nce. This is the OVERPAYMENT. FlU In oval on Page 2, Une 20 to request a refund. (4) B. Enter the total of Une 5 + 5A. This is the BALANCE DUE. (5) (SA) (5B) 5,244.86 5. If Une 1 + Une 3 is greater than Une 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. 5,244.86 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN 'T IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property lransfened;.......................................................................................... 0 Ii] b. retain the right to designate who shall use the property transferred 01' its income; ............................................ 0 Ii] c. re1ain a reversionary interest; 01'.......................................................................................................................... LJ Ii] d. receive the promise for life of either payments, benefits 01' care? ...................................................................... 0 [iJ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. 0 00 3. Did decedent own an "m trust for" 01' p.ayabIe upon death bank account or sewrity at his 01' her death? .............. 0 IiJ 4. Did decedent own an Individual Retirement Account, amuity, 01' other non-probate property which contains a beneficiary designation? ........................................................................................................................ 0 Ii] 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 transfElfS 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 i72 P.S. ~116 (a) (1.1) (ii)l. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for <fJSClosure of assets and JiUng 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 paren~ or a stepparent of the child is zero (0) percent [72 P.S. ~9116{a)(1.2)1. The tax rate imposed on the net value of fransfElfS to or for the use of the decedenrs 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 lax rate imposed on the net value of transtElfS to or for the use of the decedenfs siblings is twelve (12) percent [72 P.S. S9116(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 FLORENCE E. WARNER FILE NUMBER 21-06-0625 ESTATE OF AU ..al property owned solely or as a tenant In common must be .-ported at fair martet value. Fair market value is defined as the price at which property would be exdlanged between a wiling buyer and a wiDing seier, 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 Sclledule F. ITEM NUMBER 1. DESCRIPTION All that certain tract of land with the buildings and improvements erected thereon situate in VALUE AT DATE OF DEATH North Middleton Township as recorded in Cumberland County Deed Book a, Volume 32, Page 147. Parcel No. 29-07-0471-014. Sold at public sale 1012112006. See attached HUD net sale price - $137,140.38 137.140.3':: TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 137. '140 .~~~.., REV-1508 EX+ (6-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FLORENCE E. WARNER Include the proceeds of litigation and the date the proceeds were received by the estate. All property Joln1ly-owned with right of survivorship must be disclosed on Schedule F. FILE NUMBER 21-06-0625 ITEM NUMBER DESCRIPTION 1. Citizens Bank - Close Checking Account #6100736059. See attached letter. 2. Highmark - Insurance Refund 3. Cash 4. Public Sale - Personal Property - Bricker's Auction. See attached. 5. Two (2) Burial Spaces at Westminster Cemetery@ $2.142.00. See attached letter 6. Proceed - American Income Life Insurance Co. Policy No.l882676 - $5.833.00. Beneficiary patty S. Weber. Non-taxable. See attached VALUE AT DATE OF DEATH 2.827.96 151.00 266.15 1.663.0C 4.280.0C 0.00 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 9.188.11 REV-1511 EX+ (12-99) *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAl EXPENSES & ADMINISTRATIVE COSTS FLORENCE E. WARNER FILE NUMBER 21-06-0625 ESTATE OF Debts of decedent must be reported on Schedule L ITEM NUMBER A. DESCRIPTION AMOUNT FUNERAL EXPENSES: Hoffman-Roth Funeral Home - Services 2. Carlisle Memorial - Headstone 1. 8.803.47 2,110.00 3. N.L. Minich - Grave Excavation 4. N.L. Minich - Set Monument 120.95 325.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representalive(s) Patty Sue Weber I Robert L. Warner Social Security Number(s)IEIN Number of Personal Representalive{s) Street Address 1 South Locust Lane I 7073 Carlisle Pike, Lot 86 City Mechanicsburg, 17050 I Carlisle .Slate PA Zip 17013 Year(s) Commission Paid: 2007 6.853.00 2. Attorney Fees 6.853.00 3. Family Exemption: (If decedenrs address is not the same as daimanrs, atlach explanation) Claimant None Street Address City Slate . Zip Relationship of Claimant to Decedent 4. Probate Fees 5. Accountanrs Fees 6. Tax Retum Preparar's Fees 7_ Embarq -Invoice 8. PPl- Invoice 9. Comcast - Invoice 10. The Sentinel - Invoice 11. Embarq - Invoice 12. PPL - Invoice 537.03 36.97 69.44 50.52 41.99 35.88 128.60 TOTAL (Also enter on line 9. Recapitulation) $ (If more space is needed. insert additional sheets of the same size) 25,965.85 ~t;arrlea l'orward) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS (Continued) ESTATE OF FILE NUMBER Florence E. Wamer 21-06-0625 Sub-Total (Page 1) $25.965.85 13. Lowe's - Invoice 122.3 3 14. Comcast - Invoice 50.52 15. PPL - Invoice 62.31 16. Embarq - Invoice 37.29 17. Penn Fuel - Propane 87.65 18. York Waste Disposal - Invoice 41.67 19. Comcast - Invoice 50.52 20. Patty Weber - Reimbursement for trash container - Public Sale preparation 450.00 21. Lowe's - Invoice 34.69 22. Asso. Products - Toilet - Public Sale 99.22 23. PPL - Invoice 1.23 24. Embarq - Invoice 36.11 25. PPL - Invoice 9.02 Sub-Total (Carried Forward) $ 27,048.41 SCHEDULE H FUNERAL EXPENSES & ADMINISTRA TNE COSTS (Continued) ESTATE OF FILE NUMBER Florence E. Warner 21-06-0625 Sub-Total (page 2) $27,048.41 26. PPL - Invoice 35.57 27. Robert Sollenberger, T.C. - Real Estate Taxes 1,373.11 28. Embarq - Invoice 36.50 29. Comcast - Invoice 11.40 30. PPL - Invoice 26.17 31. Embarq - Invoice 35.95 32. Robert Warner - Reimbursement for payment of real estate appraisal 550.00 33. PPL - Invoice 119.10 34. Penn Fuel - Propane 152.19 35. PPL - Final Invoice 36.28 36. Embarq - Final Invoice 46.13 TOTAL $ 29,470.81 REV.1S12 EX+ (12..03) . COMMONWEALTH Of PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDUU I DEBTS Of DECEDENT, MORTGAGE UABIUTIES, & UENS FLORENCE E. WARNER FilE NUMBER 21-06-0625 ESTATE OF Report debts incurred by the cIecedent prior to death which remained unpaid as of the data of death, lncIudIng unreImbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Three Spring Family Practice - Invoice 20.84 2. Cumberland-Goodwill Rescue -Invoice 9.46 3. Patty Weber - Reimbursement for legal services advanced 275.00 TOTAL (Also enter on line 10. Recapitulation) $ (If more space is needed, insert adlfrtional sheets ofllle same size) 305.30 REV-1513EX+(9-00) .. COMMDNWEALlH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FLORENCE E. WARNER FILE NUMBER 21-06-0625 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECBVlNG PROPERTY Do Not list Trustee(s) OF ESTATE I TAXABlE DISTRIBUTIONS pnclude outright spousal disl1ibulions, and lransfers under See. 9116 (a) (1.2)) 1. Robert L Warner, 7073 Carlisle Pike, Lot 86, Carlisle, PA 17013 Son 20% S.S. No. 194-42-8010 2. Lester C. Warner, 12 Mountain View Terrace, Newville, PA 17241 Son 20% S.S. No. 202-42-7380 3. Unda L Durf, 22 Evandale Court, Carlisle, PA 17013 Daughter 20% S.S. No. 190-58-8072 4. Patty 8. Weber, 1 South Locust lane, Mechanicsburg, PA 17050 Daughter 20%, 8.8. No. 164-60-1429 5. James E. Warner, 721 Bloserville Road, Newville, PA 17241 Son 20%, S.S. No. 204-62-5773 ENTER DOLLAR AMOUNTS FOR DISTRIBlfTlONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE. ON REV-1500 COVER SHEET II NON- TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBlfTlONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BBNG MADE O.OC B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 0.00 TOTAL OF PART 11- ENTER TOTAL NON-TAXABlE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0.00 Of more space is needed, insert additional sheets of the same size} LAST WILL AND TESTAMENf OF FLORENCE E. WARNER I, FLORENCE E. WARNER, of the Township of North Middleton, Cumberland County, Pennsylvania, make this Will, revoking all my fonner wills and codicils I'I'IM I: I direct that all my just debts, ftmeral expenses and administration expenses, including my grave marker, - shall be paid from the assets of my estate as soon as practicable after my decease. l'I'IM II: 1 devise and bequeath all of the residue of my estate, of every nature and wherever situate, to my husband, Lester M. Wamer, pro- viding he shall survive me by thirty (30) days. ITIM III: Should my husband, Lester M~ Warner, predecease me or die on or before the thirtieth day following my death, 1 devise and bequeath the resi- due of my estate, of every nature and wherever situate, in equal shares, to my five (5) children, namely, Robert L. Wamer, Lester C. Warner, Linda M. Duff, Patty Sue Wamer, and James E. Warner, or their issue, living on the thirty- first day following my death, per stirpes. 111M IV: 1 direct that all taxes that may be assessed in conse- quence of my death, of whatever nature and by whatever jurisdiction i.mposed, shall be paid from my residuary estate as a part of the expense of the admini- stration of my estate. ITBM V: 1 appoint my husband, Lester M. Warner, Executor of this, my Last Will. Should my husband, Lester H. Warner, fail to qualify or cease to act as Executor, I appoint my children, Robert L. Warner and Patty Sue Warner, or the survivors thereof, Executors of this, my Last Will. I'I'IM VI: I direct that neither my Exerntor nor his successors shall be required to give bond for the faithful perfonnance of their duties in any jurisdiction. ~ ..TN, WITNESS WIlERIDF, I have hereunto set my hand this 30 ~daY of 1StLf(11- , 1987. M~ G Wa/~_/),~,<.-- Florence E. Warner (SEAL) lAW OFFICES LANDIS, BLACK, INSON &. SCHORPP 5lE.I'ENNSYLVANIA nOll The preceding instrwnent, consisting of this typewritten page, identi- fied by the signature of the Testatrix, Florence E. Warner, was, on the day and date thereof, signed, published and declared by Florence E. Warner, the Testatrix therein named, as and for her Last Will, in the presence of us, who, at her request, in her presence and in the presence of each other, have sub- scribed our names as witnesses thereto. ~ rVJ;~ ~~~~ A. SETILEMENT STATEMENT U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT HUD-1 OMB No. 2502-0265 B. T of Loan 1 OFHA 2.0FmHA 3. ~Conv. Unins. 4. OVA 5. OConv. Ins. 6. File Number: re06-236 7. Loan Number: 11961810 8. Mortgage Insurance Case Number: C. NOTE: This form is fumished to give you a statement of actual settlelll6nt costs. Amounts paid to and by the settlement agent are shown. Items marked "(p.o.c.)" were paid outside the closing; they are shown here for informational purposes and are not included in the totals. D. Name and Address of Borrower(s): Lester C. Walll6r E. Nalll6 and Address of Seller(s): Estate of Florence E. Warner F. Name and Address of Lender: M&T Mortgage Corporation G. Property Locatioll: 1390 Waggoners Gap Road. Carlisle, Pennsylvania 17013 North Middleton Township, Cumberland County 29-07-0471-014 & 29-07-0471-015A 1 Fountain Plaza, Buffalo, NY 14203 Place of Settlement: 1 Irvine Row, Carlisle, PA 17013 H. Name of Sett/elll6nt Agent: Duncan & Hartman, P.C. I. Settlement Date: 12-20-2006 ~:~i;J,~t~~~j:~~Ji::~?~{:'~,~;,;;;'~ 6 6IT-i6 403. 404. 405. to 12-20-2006 to 12-31-2006 10.53 137800.00 to 12-20-2006 to 12-31-2006 10.53 109. School taxes 12-20-2006 to 6-30-2007 110. 707.85 12-20-2006 to 6-30-2007 707.85 124020.00 1 378.00 205. 505. Payoff of second mortgage loan 206. 506. 208. 508. 209. 509. to to to to to to 210. C' /town taxes 211. Coun taxes 212. Assessments f~'~:~>rl~_",J:~,~; </:-_:-'~!.J 214. 215. To Borrower From Seller 127,140.38 700. TntoIl Isslori' " ;,.,',y+:<;.c'.\," ,. cY >""i'.,.'."..,'.i '", .,' Paid From Paid From based on Jllice $ fll) %= aor-s SelIel's , . Funds at Funds at SeIIlemenI Settlement 701. S to 702.$ to 7M 704, 800. Items Pavabl& In com1adtori..ilthtt\liol'l ", ,', " "','< 'j' :' "\ " ',",<,,;,,',,"': ,', ,.': ."," '" 801. Loan Orioination Fee % 10 Rn? "" 'n ""'R"" 803. """"'issl Fee POC S301;.00 M&T Ilon -35.00 804. Credit R- cae ~. 806. 807, 808. TlIX Service Fee F ' A. ,.... n RETS n.oo ann ~- Ron 810. Fee M&T __ Comotation 195.00 811. Document Fee M&T <4Oll.00 1I1? 1l1D on 813. 814. <>.", ' '""". "'.', '.' , :'" '" ."J"---', " ,: "','h,'" ., 901, Interest from 12-20-2006 to 1- 1-2007 181 S 20.3868 Idav 244.64 902. Motlaaoe insuJanI:e Ill8Rlium for months to 903. Hazan:! insuranoe IJl8lIlium for ....arts! to !llW 905. 10M. ./;,-' :',;- ," 'Ue, ,,"", ::C:;'}",:"",","'C':(,",/ ;fJ::-,l":,~rPL,;t:~-:.~. "', '. """ ~ .....~...... 31; 4,7 ..... mnnIh lOR ?fl 1002. Morloaae insurance monthS@ S ...... month 1003. taxes months fll) S oer month 1004. Coo taxes 11 months fll) S 19.17 oer month 210.87 ,nn<; ~, ..... .-.. """"" 1 006. School orooertv taxes 7 months ft S 75.33 Der monIh 527.31 1007. oer month ""'" - ."VlIl M 1100. TItle eha....... ,",', "" <, '. """",,',"':, :''-'''':;':", ,L'"," :"e,,'," ", '" '., ,. 1101. SetIIement or- fee 10 1102. Abstract or \iUe search 10 11n~ 1104. Tille insurance binder 10 1105. Document _ration to 11M CMh 1!;00 1107, Attorney's fees 10 rlllcludes above item numbers: I 1108. Tdle insurance to William A. Duncan, Agent for United General Tille 1,048.75 . 11nt.11114 1109. lender's mver.me $ 124020.00 Premium $ ~)'j:<,'~.~{;~:;~t::o~';r., ;.. ',',;', ,,',, 1110, Clwnefs""""""'" S 137 800.00 PJemIum S 1 048.75 _s'" "j',' ," , 1111 ,100 -oM 8,1 1 fiO on 1112. Ck\!linn Prolection letter Uniled General TiUe 35.00 1113, OvemiohllW"lA!IEmaiI Fee Ounca . Dr- 80.00 .""n Y";:",',"(F ',,",'; '. "","" '...., ",C, ';;,,",; , " 1201. Recorcfllllllees: Deed 38.50 --64.50 Release 0.00 103.00 1202. Citvl : 1 378.00 1203. SI~1e t"""""'"'"': 1 378.00 1204 1205. 1300 A.'...... ChArOilS: "i ' : u' ....,.:',', ,:,": , ..."",,' ,,/' ,..y,'-,:. '" 13n1 1302, 1303, 1304 1305. 1400. Total Settlement Charass 'enter on _,03 SectIon J and 5OZ. Sec:tlon KI 66n.16 1 378.00 CERTIFICATION: I have carefully reviewed the HUO-l Settlement SlaIement and 10 the best 01 my knowledge and belief,lI is 8 true and accurale stalement 01 an receipls and clisl>IJ.-nents made on my account or by this transacllon. I further cerliry that I receIwld 8 copy oIlhe HUD-l Setl\emenl Slatemenl. SlIJnatUre of BorroMor J-nali." L> '7t~ Signature 01 Borrower The HUD-l Settlement Statement which I have pn>pared is a true and acculllle account of the funds dlsbursed or 10 be disbutsed by the undersig~ partofthese~ll!f11enl . this ~. ~~Jl; . J /-7/..?o;:; ~ / Signature I Agenl ~ Date WARNING: II is a crime to knowingly make raise statements to the United Stales on this or any other similar Iotm. Penalties upon conviction --- '__.....0 0 fi~ oM iml\li!i;ionmenl. Fordetallssee: Title 18 U.S. Code SecIIon 1001 and Section 1010. ~~.. Citi>zens Bank" '-<< . Acc::ount Number 6100736059 Account TItle LESTER WARNER OR FLORENCE WARNER Date Opened 6/6/1966 Account Tvoe . . Principal Balance as ofDOD $2827.96 Interest from Last P . to ooD $.00 Account Balance as ofDOD $2827.96 YTD Interest to DOD $.00 BRICKERS AUCTION Buy & Sell on Commission - Complete Sale Service 93 Texaco Rd., Mechanicsburg, PA 17055 766-5785 Personal Property of /-.c6Jl~ ~ Address e:; OJ./~ S Sold At Public Sale tJ € T.. Outstanding Total Sale Total Checks Total Cash Cash After Payout Expenses Property Fee Sale Setup or Help Auctioneer & Clerks Adv. Cost Total Expenses Jf/ 33r /; /; J-Lf)1J - VI / t h3 ~ rJU c li1R IJ-Fn~E-X:PcN~ES ~ ;Ju~~~ ~~ Thank You For Se/ectina Chuck Bricker. Auctioneer & Staff ~e5tmin5ter (([emeterl!? ~nc. 1159 Newville Road Carlisle, Pennsylvania 17013-1777 Phone (717) 249-2029 FAX (717) 249-9365 December 5, 2006 To Whom It May Concern: Th1s 15 to verify that Lester M. and Florence M. Warner purchased two (2) bur1al rights with Westminster Cemetery on March 2, 1961 in the amount of $145.00 The current value of these spaces is $2142.00 each. If &r.j further information is needed please feel free to contact the office. Regards, ~d',J ~~ Fonda Ta~:: 0'''' - Administrator _ _ _ ,iIU Am.erleaulneome Life -- :aL..J.I..I...:f Insurance Company EXECUTIVE OFFICE P.O. BOX 2608 WACO. TEXAS 76797 DATE CLAIM NUMBER CHECK NUMBER 07/27/06 L882676 857521 C1./DLF CLAIK ON - WARNER,FLORENCE E INSURED - WARHER~FLORENCE E STATE GENERAL AGENT - OLDHAK DURRON R E3320 PAYEE - PATTY S WEBER ******~****** BENEFITS PAID ************* DEATH BENE TOTAL PAY KENT * AKOUNT PAID * 5,833.00 5,833.00 * POLICY * 3827229 ". ;~. . -T::~. i~'_ ._~:.. ~ .~; ;:;:-:.~.:..:: ~~.:::!':'~'_.' DETACH BEFORE DEPOSmNG - - ,,-. -, _ ' THE FACE OFTHIS DOCur.1ENT HAS A COLORED BACKGROUND O:-.L \'JHIT~ PAPE:R ,- '0'- _- 10 CENTRAL NATIONAl BANK WPCO. TEXAS 1010 NINETY DAY!'> \FTER 07/27/0'6 , . JIR" .~rlealilueo_etHe ~DV fusurance Company , EXECunyE OFFfCE P.O. BOX 2608 WACO. TI;XA$ 767'R ' 48-719 1119 CHECK NO. 85752l" $5,833.00 lUU ARE DIRECTEDTOpAY " , *~* 'FIVE THOUSAlfO EIGHT HUNDRED THIRTY THREE &00/].00 DOLLA TO THE ORDER OF PATTY S WEBER 1. S LOCUST LANE MECHANICSBURG PA 17050 CLAIHON~ L882676 , WARlIJ?R,~FLORENCE E oar 1390.WAGGONERS GAP RD> , CAR~IS~i.PA 17013~83" . 'R~ C. Smith CEOlPresident