HomeMy WebLinkAbout06-21-06 (2)
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REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
REV -1_ EX .. (e-GO)
COMMONWEALTH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
DEPT. 28OllO1
HARRISBURG, PA 1712~1
. ~DECEDENT'S NAME (LAST. FIRST. AND MIDDLE INITIAL)
Weaver, Mary L.
...
ffi DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
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~ ! 02/08/2006 04/25/1922
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21 06
COUNTY CODE YEAR
SOCIAL SECURllY NUMBER
00158
NUMBER
196-14-4336
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
. ::~ .'.:'PUCABlE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE I~"-'" ' :
S"CI.'\l :EC"~~:;Y NUMBER
I
o 3. Remainder Retum (date of death priorto'12:i 3:a2)
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o 2. Supplemental Return
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- -T ~- 1. Original Return
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4a. Future Interest Compromise (date of death after
12-12-82)
7. Decedent Maintained a Living Trust (Attach
copy of Trust)
10. Spousal Poverty Credit (date of death between
12-31-91 1-1-95
5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
6. Decedent Died Testate (Attach copy
ofWlII)
9. Litigation Proceeds Received
o 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
!'lAME
. Thomas S. Beckley
fiRM NAME (W appNcable)
. Beckley & Madden
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irElEPHONE NUMBER
(717)/233-7691
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
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212 North Third Street
Post Office Box 11998
Harrisburg, PA 17108
.-......;
(1) 119,500.00 ,-) ~~'.::::l
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(2) None
(3) None f',)
(4) None C~)
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(5) 156,887.49 - .'f"l
C)
----j c., fTl
(6) None
en
(7) None 0
(8) 276,387.49
(9) 20,482.50
(10) 4,555.07
(11) 25,037.57
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
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11. Total Deductions (total Lines 9 & 10)
(12) 251,349.92
------
(13) 1,900.00
(14) 249,449.92
(15)
(16) 11,225.25
---~.._.
(17)
(18)
(19) 11,225.25
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
x .00
15. Amount of Line 14 taxable at the spousal tax rate,
or transfers under Sec. 9116(a)(1.2)
249,449.92 x .045
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16. Amount of Line 14 taxable at lineal rate
x .12
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
x .15
19. Tax Due
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
20. ~
ii&i1i~t11!!fl.~ &.~
Form REV-1500 EX (Rev. 6-(0)
Copyright 2000 form software 1>nly The Lackner Group, Inc.
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Decedent's Complete Address:
STREET ADDRESS
521 North Enola Drive
CITY
Enola
I STATE PA
I ZIP 17025
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
L. CfeoitsfPayments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1 )
11,225.25
11,250.00
561.26
Total Credits (A + 8 + C)
(2) 11 ,8 11. 2 6
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty (D + E) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4)
Check box on Page 1 Line 20 to request a refund
5. 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. (SA)
8. Enter the total of Line 5 + SA. This is the BALANCE DUE. (58)
Make Check Payable to: REGISTER OF WILLS, AGENT
0.00
586.01
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;.................................................................................. B ~
b. retain the right to designate who shall use the property transferred or its income;.................................... ~
c. retain a reversionary interest; or.................................................................................................................. D ~
d. receive the promise for life of either payments, benefits or care?.............................................................. D ~
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death 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 ~
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 penalties of perjury, I declare tIIat I have examined this retum, Including accompanying schedules and statements, and to the best of my knowledge and belief, n Is true, correct and complete. Declarallon
of preparer other than the personal representallve is based on aU informallon of which preparer has any knowledge.
SIGNATURE OF PERSON RES SIBLE FOR FILING RETURN ADDRESS DATE
Linwood Marsh
DATE
ADDRESS
505 North Enola Drive
Enola, P A 17025
541 Furnace Hills Pike
Lot 32
Lititz, PA 17543
212 North Third Street
Post Office Box 11998
Harrisburg, PA 17108
b -/7-tJ6
ADDRESS
DATE
J 'dO/f)1,
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. 99116 (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. 99116 (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 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. 99116 (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. 99116
1.2) [72 P.S. 99116 (a) (1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P .S. 99116 (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.
*'
SCHEDULE A
REAL ESTATE
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RET\JRN
RESlOENT OECEDENT
I FILE NUMBER
I 21 - 06 - 00158
ESTATE OF
Weaver, Mary L.
All real property owned solely or as a tenant in commo~ must be reported at f..ir ;narke~ .....;..8. Fair market value is defined as the price
at which property would be exchanged between a willing buyer and a wimng seller, neither being compelled to buy or sell, both having
reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on
schedule F.
ITEM
NUMBER
1
DESCRIPTION
VALUE AT DATE OF
DEATH
---..------- --
119,500.00
531 North Enola Drive
Enola, PA 17025 (see settlement sheet attached)
-----
TOTAL (Also enter on Line 1, Recapitulation)
119,500.00
.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
I FILE NUMBER
21 - 06 - 00158
ESTATE OF W M L
eaver, ary .
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly~wned with the right of
survivorship must be disclosed on schedule F.
ITEM
NUMBER
1 M&T Bank checking account #17066174
DESCRIPTION
VALUE AT DATE OF
DEATH
17,614.02
2
M&T Bank savings account #21000001140516
60,032.34
3
M&T Bank Certificate of Deposit #31003913938866
50,088.75
4
Sovereign Bank Savings Account $ 0924026263
26,686.16
5
Refund - Verizon
5.22
6
Refund - Comcast
62.76
7
Refund - West Shore Oil
65.05
8
Refund - County Taxes
212.77
9
Refund - School Taxes
161.02
10
Refund - Sewerrrrash
59.40
II
Miscellaneous personal property (donated to charity)
1,900.00
TOTAL (Also enter on Line 5, Recapitulation)
156,887.49
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADNINISTRAllVE COSlS
ESTATE OF
Weaver, Mary L.
I FILE NUMBER -~-----
21 - 06 - 00158
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
AMOUNf
FUNERAL EXPENSES:
Sullivan Funeral Home
2
Rolling Green Cemetery
B.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
1.
Social Security Number(s) I EIN Number of Personal Representative(s):
2.
Street Address
City
Year(s) Commission paid
Attorney's Fees Beckley & Madden
State
Zip
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City
Relationship of Claimant to Decedent
Probate Fees Cumberland County Register of Wills
4.
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs
1 Leon O. Gerlach
2 PP&L Electric Utilites
State
Zip
6,397.00
1,626.00
10,000.00
364.00
300.00
14.49
1,781.01
20,482.50
i
Total of Continuation Schedule(s) I
~-,-------- -
TOTAL (Also enter on line 9, Recapitulation) I
*'
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Schedule H
FunercII Expenses &
Ach1inislratNe Costs continued
ESTATE OF
Weaver, Mary L.
I FILE NUMBER
21 - 06 - 00158
I
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3 ! Pennsylvania-American Water
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4 UGI Gas Service
5 PP&L Electric Utilities
6 Notary Fee
7 i Realty transfer tax
8 Power of attorney recordation fee
9 Tax Certification fee
10 Postage
11 Photocopies
13 The Patriot-News (advertising fee)
12 Cumberland County Law Journal (advertising fee)
Page 2 of Schedule H
36.23
53.80
18.95
5.00
1,195.00
17.00
2.50
35.00
65.00
75.00
277.53
.
SCHEDULE I
DEBTS OF DECEDENT, MORTGAGE
LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF W M L
eaver, ary .
I FILE NUMBER
21 - 06 - 00158
Include unreimbursed medical expenses.
ITEM
NUMBER
1 Pennsylvania-American Water
DESCRIPTION
AMOUNT
11.87
2
Comcast Cable
45.25
3
Messiah Village
21.70
4
Verizon
23.68
5
PP&L Electric Utilities
17.22
6
UGI Gas Service
22.05
7
State Auto Insurance co.
287.00
8
Pinnacle Health Hospitals
3,437.11
9
Debbie Leopold, Treasurer (real estate taxes)
329.47
10
P A Muncipal Retirement System (refund of overpayment)
244.72
11
East Pennsboro Township (sewer/trash)
115.00
TOTAL (Also enter on Line 10, Recapitulation)
4,555.07
REV-1513 EX+ 19-00)
.
SCHEDULE J
BENEFICIARIES
ESTATE OF
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
NUMBER
NAME AND ADDRESS OF PERSON{S) RECEIVING PROPERTY
L
I FILE NUMBER
21 - 06 - 00158
RELATIONSHIP TO
DECEDENT
..Dn1llo.t.Usu.rw_!p)
I AMOUN~ OR SHAR~"-
i OF ESTATE
1-
120%
120%
I
120%
Weaver, Mary L.
I
I
I TAXABLE DISTRIBUTIONS (include outright spousal distributions)
I Linwood Marsh
! 505 North Enola Drive, Enola, P A 17025
i
I.
Son
2 i Rey Ann White
1541 Furnace Hills Pike, Lot 32, Lititz, PA 17543
3 I Roger Marsh
505 North Enola Drive, Enola, PA 17025
Daughter
Grandson
4 Traci C. Lumadue
i 148 Millers Gap Road, Enola, P A 17025
!
5 I Vicki Henninger
I
i 2 Michele Drive, Enola, PA 17025
Grandson
20%
Grandson
120%
II.
I
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i Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet I
I NON-TAXABLE DISTRIBUTIONS: .
I
I A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT
BEING MADE
I
I
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,
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I B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
i American Cancer Society (miscellaneous property - see attached)
385.00
2
i The Salvation Army (miscellaneous property - see attached)
600.00
3
Champions for Children (miscellaneous personal property - see attached)
915.00
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET:
1,900.00
..
LAST WILL AND TESTAMEN!'
OF
MARY L. WEAVER
I, MARY L. WEAVER, a resident of Cumberland County, Penn-
sylvania, being of sound and disposing mind and merrory, do make,
publish and declare this to be my Last Will and Testament, hereby
revoking all Wills and Codicils by me at any time made.
ITEM I: TAXES. I direct that all inheritance and estate
taxes beccming due by reason of my death, whether such taxes may be
payable by my Esta:te or by any recipient of any property, shall be
paid by my EKecutor out of the property passing under this Will, which
is not specifically bequeathed or devised, as an expense and cost of
administration of my Estate. My Executor shall have no duty or
obligation to obtain reimbursement for any such tax paid by my EKecu-
tor, even though on proceeds of insurance or other property. not
passing under this Will.
ITEM II: PCMERS OF APPOIN'lMENT. I hereby exercise all
p:Mers of appoint:rrent which I may have at the time of my death in
favor of my Executor., and all property subject to all such po.Ners of
appointment shall be included in my Estate.
ITEM III: PERSONAL POSSESSIONS. I hereby give and bequeath
all of my household fund ture and furnishings,
books, pictures, /
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Page 1 of 5 Pages
..
29695
jewelry, china, linen, silverware, wearing a~l and all other
articles of household or personal use and adornment, per stirpes, to
such of my issue as survive me with said articles to be divided among
such persons as they shall agree. Should there be no agreement as to
sane or all of said articles, such articles shall be distributed, if
at all, as my Executor, in my Executor's sole discretion, may decide.
Any articles which my Executor detennines to distribute to a minor may
be delivered by my Executor to the adult person with whan the Ini.oor
resides or who has the care or control of the minor without bond and
the receipt of such person shall be a ccrrplete release of my Executor.
Any i terns not disposed of in the foregoing manner shall be donated by
my Executor to char.i ty .
ITEM IV. I direct my Executor to sell my real property and
autarobiles and add the proceeds to my residual estate.
ITEM V: RESIDUAL ESTATE. I give, devise and bequeath all
of the rest, residue and remainder of my property, real, personal and
mixed, in equal shares to such of the foilowing naned persons as
survive me:
LIMmD MARSH
(my son)
of Cumberland County,
Pennsylvania;
REY ANN WHITE (my daughter) of Manheim, Pennsylvania;
Page 2 of 5 Pages
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[11!)L;
29695
VICKY MARIE MARSH (~ grandchild) of ClmIberland County,
Pennsylvania;
TRACIE LYNN MARSH (my grandchild) of Cumberland County,
Pennsylvania; and
ROGER MARSH (my grandchild) of Cumberland County,
Pennsylvania.
ITEM VI: EXOCU'IOR' S PCMERS. In the settlement of ~
Estate, my Executor shall possess, arrong others, the following powers:
. (a) To sell either at public or private sale and upon such
tenns and conditions as my Executor may deem advanta-
geous to my Estate, any or all real or personal estate
or interest therein, whether owned by Ire severally or
in conjunction with other persons or acquired after my
death by my Executor and to consUll1l1ate said sale or
sales by sufficient deeds or other instruments to the
purchaser or purchasers, conveying a fee simple title,
free and clear of all trust and without liability of
the purchaser or purchasers to see to the application
of the purchase money or to make inquiry into the
validi ty of said sale or sales; also, to make, execute,
acknCMledge and deliver any and all deeds, assignI'llants,
options or other writings which may be
necessary or
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Page 3 of 5 Pages
29695
desirable in carrying out any of the powers conferred
upon my EXecutor in this paragrafi1 or elsewhere in my
Will.
(b) To pay all costs, taxes, expenses and charges in
connection with the administration of my Estate,
including, specifically, my burial/funeral expenses and
grave marker.
(c) To distribute II'!Y Estate in kind or in money. In the
event assets are distributed in kind,such assets shall
be distributed at their value (s) on the respective
date (s) of their distribution.
(d) To do all other acts in the judgment of my Executor
necessary or desirable for the proper and advantageous
management, investment and distribution of my Estate.
ITEM VII: GUA.'RDI..l\NSHIP. If at any time any minor child
shall be entitled to receive any assets hereunder, DAUPHIN- DEPa)IT
BANK AND TRUST CCMPANY, having offices in and around HarriSburg,
Pennsylvania, shall act as Guardian of the assets payable to such
child. Said Guardian may receive and administer all assets authorized
by law and shall have full authority to use such assets, both princi-
pal and incane, in any manner said Guardian shall deem advisable for
the best interests
of such child, including college, universit~ 2//
'-J(/f:/~
Page 4 of 5 Pages
post-graduate or other education, without securing court order. Said
Guardian shall have all the rights and privileges as to the Guardian-
ship (s) and the assets thereof as are herein granted to my Executor as
to my Estate and the assets therein.
I'lEM VIII: SIMULTANEOUS DEATH. Any person who shall have
died at the same time as me or, in a coornc>n'disaster with me or under
such circumstances that it is difficult or impossible to detennine who
died first, shall be deemed to have predeceased me.
ITEM IX: EXEOJ'roR. I hereby naninate, constitute and
aPFOint my son, LINVO:>D MARSH, and my daughter, REY ANN MARSH, to be
my Executors. In the event of the death, disqualification, refusal or
inability of either of my children to serve, the other alone may serve
as my Executor. My Executors and Guardian specifically are relieved
fran the duty or obligation of filing any bond or other security.
IN WI'INESS WHEROO.F, I have hereunto set my hand and seal to
this, my Last Will and Testarnent,consisting of this and the preceding
four (4) pages, at the end of each page of which I have also set: my
initials for, greater security an~ ~tter identification thiS, /I/~j;
~., tq9J;,7JI;{~ '
day of /-d:a:1/J,I:.::1 ' 199=5".
Page 5 of 5 Pages
~b/~~SFAL)
MAR~. WEAVER
We, the undersigned, hereby certify that the foregoing Will
was signed, sealed, published and declared by the alx>ve-named Testa-
trix, as and for her Last Will and Testament, in the presence of us
who, at her request and in her presence and in the presence of each
other, have hereunto set our hands and seals the day and year above
wri tten, and we certify that at the time of the execution thereof, the
said Testatrix was of sound and disposing mind and menory.
~ kM~SEAL)
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Residing at 1-;5 1./~ 21#7k..J
~~11) 4(1/ / /2 ~1
Residing a~f}13~ (~" ~uc?t/( )/
f? II/~ ..
~9!J")/ P;r
Res~ding at 1;>>0 E L~jkw .sf 1tf
fJ/(qit A~M'1) 1/1 ))(J~J..
AFFIDAVIT
Carm:>nweal th of Pepnsylvania
County of ~?
We, the undersigned Testatrix and Witnesses , respectively,
whose names are signed to the attached or foregoing instrument, being
duly qualified according to law, do depose and declare to the under-
signed authority that:
1. The Testatrix signed and executed the instrument as the
Testatrix's Last Will and Testament.
2. The Testatrix signed and executed the Will willingly as
the Testatrix's free and voluntary act for the purposes therein
expressed.
3. Each of the Witnesses, in the presence and hearing of
the Testatrix, si~ed the Will as a witness.
4. 'lb the best of the knowledge of each of the undersigned,
the Testatrix was at the time 18 years of age or older, of sound mind
and under no constraint or undue influence.
-Y~~~~L
( "Testatt . )
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( ''Wi tness") , j
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Sworn or affinned and subscribed to before me by the
abov.e-narned Te?;a )a~tr' and Witnesses, this Iltli day of /1eU.rnJ...-v .
.{~ ~ /$
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r:: ~(;'Wi~'s;, -:;:!?-
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jIUU[ L/, IL~r--L<./
No~ Public
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( SEAL)
NOTARIAl. SEloJ.
. MARY V. DAVIS. kn;;f1 ).::ic
CIty of Harrisb;;m ;"":~::".' . 'unty
M COmmjssi~U~:!:':: ";~J -:;.1998
OMS NO. 2502~.4! ...
A. B. TYPE OF LOAN:
U.s. DEPARlMENT OF HOU!ING" tJRIIAN DEVELOPMENT 1.I!IFHA 2.[]FmHA 3.0CONV. UNM. 4.QvA I.OCON.INS.
6. FILE NUMBER: 17. LOAN~
ScnLEMENTSTATEMENT 08-253 00CI4e47234
I. MORTGAGE INS CASE NUMBER: ~ MORTGAGE INS CASE NUI&R:
62M'15.375%
C. NOTE: T/Ii$ fllnn ;, fumi6hed 10 give you I a/allJment of I1due1I8IlIement COIt:s. Amoc.rIII paid III end by lire .",.".",.,., _ ~
IItms IIIIJIItad TPOCr MIln paid outside /he cming: /hey _ --. ,.,. tor /nlonnaIIoneI1/lII1IfMe1 end _ not /ncNded In lire IlIWI.
t.o_ -
D. NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER:
Oevld L MonlIan EsI8le of MeIy L W_ ......... cay Sri of ......
521 N. EnollI Drive 323Z NewIMlk DrM
EnollI, PA 17025 MIemiIbuIg, OH 45342
G. PROPERlY LOCATION: H. SETll..EMENT AGENT: 25-1857112 I. SETIlEMENT~~
521 N. EnolI Drive Midslel8 AbalnIct Campeny
Enolll. PA 17025 .15, aooe
Cumberlllnd County, PennsyMlnlll PLACE OF SETTLEMENT
2331 Merkel SlIwl
Camp HIlI, PA 17011
J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION
100. GROSS AMOUNT DUE FROM BORROWER: 400. GROSS AMOUNT DUE TO SELLER:
101. Contrad Salel Price 119500.00 401. ConlrIC\ S... PrIce 119 500.00
102. Personal P_ 402. Personal PmIIiIiiV
103. Settlement Chartles to Borrower line 14001 5814.46 403.
104. 404.
105. 405.
Adiustments For Items Plid Bv Seller In advance Adiu_ For...... PaId Av Sa/larln ~
106. CltvfTown T_ to 406. CiiVlTown T_ ID
107. CountvTIllll$ 05115106 to 01101107 212.n 407. r...."""T_ 05I151Oe ID 01101107 212.n
108. School TIllll$ 05115106 10 07101106 161.02 408. SchoolT_ 05115106 ID 07101106 111.02
109. SewerlRefuse Proralion 0511510610 07101106 59.40 409. SewerlReIuse Proration 05I151Oe ID 07101106 51.40
110. 410.
,1,. 411.
112. 412.
120. GROSS AMOUNT DUE FROM BORROWER 125,747.85 420. GROSS AMOUNT DUE TO SELLER 119,933.19
200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 1i00. REDUCTIONS III AMOUNT DUE TO SEUER:
201. DoonosRoreamest- 5 975.00 501. EJccess 0..-. See Inatruc:IIonI
202. PrlnciDal Amount 01 New Loanls 111850.00 502. Setltemenl r.to-ID Sa/Iar 1<1l1111 1.218.50
203. Existina loan s taken s- 10 503. Exis . '" _11l8ker\_ID
204. 504. po; oftnl~
205. 505. Pa of aec:ond
206. 506. -oe.> R reIIllneejl;;;-.... 5 975.00
207. 507.
208. 508.
209. 509.
Adiustments For Items UflDaid Bv Seller For /lema SeIer
210. CilvfTown T_ to 510. CliYfTown T_ ID
211. CountvTIllll$ to 511. C"'.....T_ to
212. School T.... to 512. SchooIT_ ID
213. 513.
214. 514.
215. 515.
216. 516.
217. 517.
218. 518.
219. ~ 519.
220. TOTAL PAlO BYIFOR BORROWER '-- 117,625~~ 520. TOTAL REDUCTION AMOUNT DUE SEUER 7,194.50
300. CASH AT SETTLEMENT FROMfTO BORROWER: 600. CASH AT SETTLEMENT TOIFROM SEUER:
301. Gross Amounl Due From Borrower Une 120 125747.65 601. Gross Amount Due To SeIer l.kIe 420 119933.19
302. Les. Amount Plid BvlFor Borrower (Une 220\ ( 117,625.00 602. Less ReducIiona Due SetIei-IiJ.... 5201 ( 7 ,1V4.50
303. CASH ( X FROAI) ( TO} BORROWER 8,122.65 603. CASH ( X TO)( FROM} SELLER 112,738.69
The underslgned hefeby ack~ receipt 01 a compleled copy 01 P8geIl&2 01 Ihis ltatement & any __ nalerrecUo.beleln.
/ ~:/ "
I I ; #A /"= /j~ /}
Boml'Mlr ~ /V'~ Seller ': .,.,." .''/ . b..",
01 l. Morrison \. Ie 01 MaIy L We_r I
'---
L. SETTLEMENT CHARGD
'"
. TOTAL COMMISSION hMd 011 Prlce
DMIian CommiuiCln 00 ..
7111. $ Ia
Ia
isoion Paid ..
Ia
'00. ITEMS PAYABLE IN CONNECTION WITH LOAN
801. L08I1 .... % 10
802.lD8I1 DisoounI % to
803. AppralNf .. to oI>e~
804. ClOd. to CBC_
805. Lende(11nIpec:IIon .. to
806. Flood CerttlIc8IIon .... 10 Firll_ FIoocl 0..._
7. Adminll_ 10 Na_ Bank 1-
808.
809.
'10.
'11.
'00. ITEMS REQUIRED BY LENDER TO BE PAlO IN ADVANCE
901.1_1 From O5I1MJl1 10 O6IDli06 $ Ie.
902. M . lnsur.nce PremUn for months to Nationel
903. H_rd Insurance Pramium for 1.0 a.. to AIII181a _
904.
905.
1000. RESERVES DEPOSITED WITH LENDER
1001. Hazard Insurance 3.000 montIlI
1002. Me Insurance monIIlI
1003. C own T_ montIlI
1004. Cou T_ 4.000 monIIlI
1005. School T_ 10.000 monlIlI
1006. monlIlI
I
1008. ale'_
1100. TITLE CHARGES
1101. s._nt", F..
1102. _orTllt_
1103. Ti
1104. Tille Insurance _
1105. EIedronic llocumenI
1106. _~
1107. 1 F_
. allow _numbers:
$
$
$
$
-
to Mid.- Abstract
to
to
10
to
10
to
M__
r
to
10
10 Calh
~ to be alrue copy.
17
..
MI
incIude.__numbers.ll021103&1104
1109. Lenclefl $ "1, 50.
"1 . fl $ 11 ,500.
1111. _100, ,1 10 Midllale_
1112. Nota .. 10 MidI_Abltrad
"13. Nolary .. to Midllate
1200. GOVERNMENT RECORDING AND TRANSFER CHARGES
1201. R"""'" Fees: Deed $ 38.50; M $ 52.50;
1202.' un TaxlSla : Deed 1 195.00'
1203. Slale Tal<lS Deed 1195.00;
1204. POWIl< 01 10 mbeMnd R
1205.
1300. ADDITIONAL SETTLEMENT CHARGES
1301. S
1302. PeI1I
1303. TaxCe_
1304.
1305.
1400. TOTAL SETTLEMENT CHARGES Enter on Unesl03, SoclIon J and 502 -
.,.....pege, dllil ~ ..........~NClIipIfII............"crI,. 2e1...,..........
POC
38.83
45.55
-
-
-
-
-
27.4
102.12
. monIII
ny
-.
-'
I'0Il....
-
_AT
-
........
......
MaAT
~
mAl
1.
110.
109.
1,021
-3<48.41
15.
38
1
1
91.
11 .
1185.00 i
17.00
2.50
5,814.4
1.218.50
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QIAMPI(Ni
- FOIl -
CHILDREN
CHAMPIONS FOR CHILDREN
of the
Capital Area Intermediate Unit
55 Miller Street, P.O. Box 489 " Summerdale, PA i 7093-0489
(717)732-8400" FAX (717)732-8414 " E-mail: C4C@caiu.org
March 27, 2006
Lynn Marsh
505 N. Enola Drive
Enola, PA. 17025
Dear Mrs. marsh:
The Champions for Children Committee would like to take this opportunity
to thank you for your very generous donation of the walker, 2 canes, bath seat,
and hearing aide you donated. I am sure they will be put to good use by staff
and students. Our staff estimated the value of these items at $915.00.
Again, thank you for your contribution.
Sp~cX~~
Pamela laudermilch
Secretary
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Apt. ~ Floor
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(Y)o..0(~ LU 37060
Tb SALVATION AB1VIY
ADULT REHABiliTATION CENTER
3650 Vartan Way. Harrisburg, PA 17110
Phone: (717) 541-0203
1Ii1"tWeat)Qr~6s-4f.t!"o. '3... 7 20 0 Co
N8ne-YVlo...V- s \/-C .
AdchaI' 52 \ (). Eno' a. Oy;~
CIty F no J a. et.te,o A- Z1P-' 70") c;
Tel No. 7'3 ~ -CJ C)~ L
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THANK YOU
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ALL DONATIONS SUBJEC.T TO DRIVER'S INSPECTIONJ 1/./\ tP
Toll Free Pho!'8 (800) 95 . TRUCK " (f) ()./ ,
OFFICE COpy .
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GIFT RECEIPT
NAME
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ADDRESS 5'"2).
CITY e #(1;d
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ITEM(S) RECEIVED J(,08fi,PSI6
fJy
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DATE REC'O c3 - 2 0 -Or..;
REC'D BY K. {);..V i~
For Cancer Information call 1-800-227-2345 or visit www.cancer.org
Your American Cancer Society thanks you for joining the fight against cancer.
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