HomeMy WebLinkAbout96-00865
PETITION FOR Pl{OnATE and (;\~ANT OF u:rnms
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I{eg,,'e. of Wil\l 10' the
COllllty 01 Cumberland.____. in the
('ull1l11oll\\l'al1h 01 PCIII1\ylvania
I hI.' pl'liliOll HI I Ill' lI111ll'l,igl\l'd Il'"pl'l.:'lflllly Il.pl'\.....l.lI1\ lhal:
)'0111 pl'tililllll'lt\), \\lIn i,,',m: lX ~l'al"lll a!!l' or nh.h:, anlhl'l'\CI.'III or__ .__~~__~_______ named
illlh,' I'll' II ill ollhl' allllll' de,'I'd"Ill, daled . Nay 28, ..__._______.___._, I\L91-
and ",dieillll daled None . ,. -. ---- --. --..-- ---
('t.I!C rdn.11l1 ~'lI"'111'LlIll'\.". ~'.~. ICI1IlI1~-i,lli"t1. d~'alh Oll'W,,'uItH, l'h:.l
l)e,endellt 1\:" domiciled'll dea,h in cumberland ....__._._ _u_. COli III I' , I'enn,ylvania, with
h .er. la" family ".prindpal.elidence al _ 109E._.QI:'ange Street ,....5hippensburg.._
___ __Cumber land. County., . Pennsylvania_
tli'l '1It'l'I. Ill1mh..', ;tlld 1lI1l11....ip"til~1
Decellllelll, then .._).02... _ ye'1I1 "I' age, died _October..l,---- .19 q" .
HI ____ShippensbuI:'g .Health.CareCenter, _Cumbecland.County ,
[:\(,:rpl a' f"lhm.., dc.:l.:l'lknl lIid IHlllllarry, wa... l1ul di\'lm:l:d and did Itnl have a child born or adopted
aftcr c\cl.:tllioll ollhl' will offc.:red for prohale; \\'a... not the vh.:lim of a killing and was ncver adjudicnted
ilh.:ompcll'lIt: ____ ..__. ~".._- .-- -..------.------
DCl.'cndc.:nl al lkalh o\\Il\.'d property with \.'\lilllalCd value... a... follow...:
(If domiciled in I'a.) :\11 pellollalp.opellY
(If lIot domidled in POI.) Per...onal property in Penn...y!\'ania
(If IltH domkilcd ill Pa.) Per...onal propeny in County
Value of r\.'alc.:~lalc ill PClInwh'ania
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WHEREFORI', pctiliollcr(,) .e'pcclflllly Il'<I"e'H') Ihe plOhate of Ihe la,1 will and eodicil(s)
p.e\Cllled he.ellilh alld Ihe g.allt of Ienell___ Testamentary
(tl:'till1l~rll.If~; il.!lIlilli'lrali!ll1 I:.l.a.; iu.lmini\lralinn d.h.fl.c.l.a,)
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OATH OF PEnSONAL nEPnESENTATIVE
COl\1l\1O i'>\\'E'\ LTII 0... I'E:'I:'IS \' I.\''\i'> 11\ I "
COlJ NT\' O.....J:u..MJ3_ER_~~~O.___________ J "''''
I he I'l'titiol\\.'Il"'1 aho\"c'II:ll11l,'d \\\\.':lr(-.) 11l alfirJ1l(\) Ihallhc.: \Ialell1l'l11~ in thc foregoing petition ure
IrllC and (otll'\.'llo Illl' 11...'\1 oltllc }..I1O\\ku~c :.Jlld bdil'f of pl.'liliollcr(~,) and thai a... pcr~nnal rcprcscn-
lali\c(") of the ahl)\l' dl.'(l'dclll pClilitllll'tl\) \\ill \\\.'11 and truly admilli!\ICr the c...latc iu:cording to law,
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'I" d MARY C, LEWIS /I"C/lIl'I' It. d -
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crnllrlCME or DEATH
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H, ANTHONY AOAMS
ATT.:lRNE....AT LAw
12B EAST KIH' STAEET.. SUITE A
SHIF'F'ENSBURG, PA 172117
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LAST WILL AND TESTAMENT
I, IIEI.EN ^. W I ~mEIHI, h..ln\ot II I' ,wnlul m lIlli, .u.mll!'Y a 11I1
llndel'slnndlng, dll make, !,ubllsh and d"clal'" Ihls my 1.,,,,1 Will and
Tl'gtaml~nt. lwro\Jy l'I~vokJng all prior wi lIll and e(Jdl(~llH ma(h~ ill any
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t im" Imf'll'" by me.
I' IHST:
dir'~ct thnt. all my fUllt~r'al eXpellHI!H ht! paId HB snOIl au
practical after my doath.
SECOND:
hOl'"hy Illve till! pow,'!' tll my Ex..elllor I.e..ter [;, FlIller
to dIstrlbut" my tanl:lble !,(,l'sonul property, In kind, to uny leKat,,(' at'
THIRD:
I Illve and IltJqu"ath to Karen 1.0n18e KI In" till! snm of Five
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person, IncludlOlot himself' at hlB ,,,,Ie dl,;r:I'etllln and fnl'ther direct
that any tangIble personal property not so distrIbuted he given to the
Solvation Army.
Thousand dollars,
FOURTII: The rest and residue or my estate I Ilive, devise and
beqeuath as follows:
a, One half to the Plnoy :.!uuntaln Unit.l'd BrethtH'n Nnr,lIng 1I0me.
b, One half to United [It'ethorn In Christ MIssIons Outreueh
FellowshIp of 302 l,ake Street, IInntinlldon, IN ,16750,
c. It Is my dnslro that all expenses of my nstate, Including but
not llmlted to taxes "OIl fens, he paid from the resldll" or my estate
prIor to the above stated distribution.
FIFTII: It is my IInsire that my hom" he sol,l for Blnll1<' famIly
residential purposes, If possIble, and to achieve such lI"slre I dIrect
that my r.xecutllr may sell my home publldy or prIvately.
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H. ANTHONY ADAMS _ ATTORNEV AT LAW _ 128 EAST KINO stREET. SUitE A _ SHIPr[NSltURO, f.CNNSVt....."NI" t7ZS1
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fOR DATES Of DEAf" AnER 12/31/91 CHECK HERE
\ '~I 0) INHERIT ANCE TAX RETURN ~OAV::~yug~DIT ISClAIMED 0
,.. 'J :.~ RESIDENT DECEDENT iiiiNUMOER---------
,,,,,,..,,,,,,,,,,,,,, '''''''.,v^,''^ (TO BE FILED IN DUPLICATE, 111.(
"""".'"'' '" ."""" W .. I
"..",::::',', ~~"i';:" u'''' ITH REGISTER OF Will,S) COUNTY CODE
- -- ..--~. hJelfift,' n'AMl fl4~'-'I~\1. Atjh-1.iliHiintjlf.^ti~---;-"":"'-':-- -~-~]OL(lOttjl ~ (oMrullAoDRls!.
ffi \~II1J:('rd Helen ,\. 109 E. Orange Street
~ \O(IAf111uRll, tHlMflill - - - ---jU^Tt 01 I)EAItI-- ---jilAIl 01 'UPIII- -.- Shi ppcnsburg, PA 17257
_.__~_4__' ___180-07-6862 _~_ __ __~O-1-96 _____ _ 6-26-1894 _ _ (ouMr-.Clullbecl:md
:ll 1. Oliginul Retur" 1..1 2. Supplomcnlol Relurn 03.
[J d. limiled [,Iulo I] 40. fuluro InhHlnt Comprom;\o [] 5.
(rol dulo, 01 df!nlh oliN 12.12.82)
C~ 6. Do(odent Died T olfolo I] 7. Oocodonl Muintuined n living T rUl'
(AUnch copy of Will) (Alluth ~~Py of T,usll
ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO.
NAM( ]tOiii-iiTi "'''w'G A.DDRf~~
ll.!. An!.l}Q.IJY_ Adams,_EsC]lIire_______ 128 E. Kini\ Street
H""O""'V"'''' . Shi ppensbllri\, I'A 17257
711J d,;32,- ,?7n.~~=~.o_.,_-,,_o-,~_~_--_ _ ..... .. ._H ___-,~~_==_
I. Real Ellole(5chodulo AI ( II 28,000.00 .._ _.___.___ ,-'
2. Slack. and Bond. (5chodule 81 I 21 .
3. Closely Hold Sloclt/Portnorship Interost (Schodule q (31 ~__
4. Mortgage. and Nolo. Recei,oble (Schedule OJ ( 41 . _ .
5. Co.h, Bonk Depo.its & Miscelloneou. Pe"onol Prope,'y( 51 __2,5JJ..I8
15chedule EI
6. Jointly Owned Properly (Schedule FI
7. Tron.fe" (Schedule GI(5chedule LI
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YEAR
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NUMBER
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Remaindor Relurn
(for dole. of deolh prio, 10 12,13.82)
Fedoral EUoto Tax
Return Required
T 0101 Number of Safe Deposit Boxes
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( 71 _m________.
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8. T 0101 Gran AnelS (Iatallin<<!\ 1.7)
9. Funerol Expensos, Administralivo Costs, Miscollaneous
Expen.e. (Schedule III
10. Debts. Morlgoge liobilitie., lien. 15chedule II
11. T 0101 Deduc'ions ('0101 line. 9 & 10)
12. Nel Valuo of Eslato (lino 8 minus lino 11)
13. Chariloble and Govornmenlal Boquests (Schedulo J)
lA, Not Value Subjeclla Toll. (Iino 12 minus linG IJI
IS, Amounl of line 14 laKablo at 6% ralo 115) ______._
(Indude values from Schedule K or Schedulo M.)
16, Amount of line 1d laKablo 01 15% ralo (16) _~,0OQ~q9
(Indude valuos ham Schedule K or Schedule M.I
17. Principal loll. duolAdd tall. from line 15 and from Ii no 16.)
18, Credils Spousal Poverty Crodit Prior Paymonl' DilCount
+--+
( 8)
30r 533. 78
( 9) J4,n].'.~9
(101____._
(111 14,133.80
(121 16,399.98
(131 16.399,98
(1AI -5.,000,00
x .06 =
x .15 =
750.00
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(17)
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(181
(19)
(201 750.00
(20A)
(20BI 750.00
19, If lino 18 is groaler than line 17, enler tho diHerenco an lino 19, TI.is is tile OVERPAYMENT.
ao 1l1l:m...r,u,.la'loJl..IC;lIl71.II(,nll,I:...I'ltlr.r.1r.1K'1'=1II.;].Trr1:!:1'JIII'lilll1
20, If Ii no 17 is grealer than line 18, entor the difforence on lino 20, This illho TAX DUE.
A. Enler Iho inlorosl on Iho balance duo on Ii no 20A.
B. En'e, Ihe 10'01 of line 20 and 20A on lino 20B. lhi. iSlhe BALANCE DUE,
Ma~o Chock Payable '0: Reglstor of Wills, Agont
.... BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH......
Under penolli.. 0' perjury, I declare thot I hove uomined lhis felurn, induding accompanying sehc'dules and ,Ialements, and 10 Ihe b..I of my knowledge and belief,
il is Irue, correcl and camplele. I declare Ihal all real eslale has bot'n repolted otttue "'al~el value, Declarolion of pre parer olher thon the personal represenlative is
bOIt'd on all information 01 which preparer has any ~nowlodg~.
$1 4ATURE Of PERSON RESPOr&SI!LE fOR filiNG R(TURt, ^DDR(SS DAtE
, .,) ![~l.h_ 91~il-~~,.}.\.\~:-7H I/LEQ,"-\..JJ..r.r..I~__5i, _~h~, '< /7/tJ7'
A R '1.), fJ AR R (JIlt lilTIMt RY'fil'~r-n'il:ftv[ AOIJRl55" I. ' orfy / 'I
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'-C~MMONWE^L'" or l'ElltlSYI.VNII^ \ lit:III:.lJULE """ \
\llll E 1111 N1CE 1 M( 1I111UlIll t:A:;1I ANlJ MISt:"1.I ANEllU:;
IIESIUENT UECEUEIH "EIISUNAL "IIUI'I:II IV
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ITEM
HUMUEII
IJI:5CllII'IIUlI
V^LUE AT
UATE Uf UEA111
1,043.11
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\, Orrstown Bank Checking Account
Acct. # 000-694932
502.15
2.
Refund of Resident Fund Account
Shippensburg Health Care Center
Personal Property Sold at Kenny's Auction House
Chambersburg, Pa
981. 52
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$
3.78
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SCIIEI.IlILE II
rUNEIlAl EXPENSES,
AIlMINISTIlAlIVF. COSTS AND
MISCEllANEOUS EXPEN5ES
Plonso P,lnl 0' Typo
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mAlE OF
Helen ^. \vini:erd
ITEM
NUMBER
DESCRIPIION
AMOUNT
A. Funeral Exponlo"
J,
Fogelsanger -Ikicker FlInern 1 Home
5,634,50
B, Admlnhlrullvo Call..
1, Porsonol Rcpfosonlolivo COlllmiuiol1S
Sadul SOtU,i1y I~u,"bo, 01 ro"onul Itop,olonlul;.o: 180 - 05 - 7462 1,400.00
Voor Commissions paid 1997
2, Allornoy FoOl H. ^nthony ^dams, Esquire 2,~00.OO
.'
3, Family Exomplion
Cluimunl Rolulionl!.;p
Add..1I 01 CI?imunl 01 docodonl'l doolh
SI,oel Add,oll
Cily Slolo Zip Cado
d, P,abole FoOl 102.00
C. MIIC..IIDn~oul. Expen.... .
I, Shippensbllrg Health Care Center 752.85
2, County Borough Tax 30.61
3, Borough of Shippensburg (\vater & Sewer) 155.45
d, Realty Transfer Tax 280.00
5, Interstate Pest Control 519.40
6, George L. Ebener & ^ssoc. 1,680.00
7, H. J. Tanner, Inc. (Fuel Oil) 164.64
. . :.
8, Borough of Shippensburg .: . . ~ 102.92
TOIAllAlso onlo, on lino 9. Rotapilulalion)
(II maIO 'poco h lIoodod, 1r1le.1 addUlonal ,100011 01 ,omo ,In.)
514 133.80
SCHEDULE "H" CONTINUED
9. GPU Energy 9.56
10. H.J. Tanner 149.20
11. Borough of Shippensburg 210.42
12. GPU Energy 27.33
13. H.J. Tanner 154.35
14. H.J. Tanner 257.00
15. GPU Energy 3.57
~,A'~;'q,;?!J;';;'.~~'.;o~t'~:~;;;1~'{~~~~iL:t;l;~c;,,:,:,~+-\,f~~":;'~"
LAST WILL AND TESTAMENT
I, IIELE~1 ^, WI~GERD, being of sound mind, memory and
understanding, do make, publish and declare this my Last Will and
Testament, hereby revoking nIl prior wills and codicils made at any
time before by me,
FIRST: I direct that all my funeral expenses be paid as soon as
practical after my death,
SECO~D: I hereby give the power to my Executor Lester C, Fuller
to distribute my tangible personal property, in kind. to any legatee or
person. including himself at his sole discretion and further direct
that any tangible personal property not so distrIbuted be given to the
Salvation Army,
TIIIRD: I give and bequeath to Karen Louise Kline the sum of Five
Thousand dollars,
FOURTII: The rest and residue of my estate I give. devise and
beqeuath as follows:
a, One half to the Piney Mountain Uaited Brethern Nursing 1I0me,
b, One half to United Brethern in Christ Missions Outreach
Fellowship of 302 Lake Street, lIuntingdon, I~ 46750,
c, It is my desire that all expenses of my estate. including but
not limited to taxes and fees, be paid from the residue of my estate
prior to the above stated distribution,
FIFTII: It is my desire that my home be sold for single family
residential purposes, if possible, and to achieve such desire I direct
that my Executor may sell my home publicly or privately.
H. ANTHONV ADAMS _ AHORkEY AT LAW _ US EAST KINO STAEET. SutTE A - SHIPPENSOURO, PENNSYLVANIA t nn
COMXO~W~:AI,TII 01' PEN~SYI,V,\lllA:
:SS
COUNTY 01' CUMBERLAND
We, \I, Anthony Adams and Sharon Coleman Adams, the wllneuses whose
names are signed to the foregoing Instrument. being duly qualified
according to law, do depose and say that we saw the Testntrlx sign nnd
execute the instrument as her Last Will and Testament; that she signed
willingly and that she executed it as her free and voluntnry act for
the purposes therein expressed; that each of us In the hearing and
sight of the Testatrix signed the Will as witnesses, and that to the
best of our knowledge and the Testatrix was at the time at least
eighteen (18) or more years of age and of sound mind and under no
constraint or undue influence,
Sworn to and subscribed before me by,
\I, Anthony Adams and Sharon Coleman Adams,
the witnesses, this, ;~1JI\ day of May, 1991,
-'f': .;/\" \
...1""" /
ii, -,' II }') i i'~-
Public
'j
Notary
,...
! N~i: "'~;';'- S::'!.'.
i l~.\ '.~~ r.I;~::: ~:'I~O? r.:,')~~r~' ~;.:~;!~
I ::":r:~t;nibur~ B:r:.'.:~'1. Cum::'(HI~r,;;: Ccunty
~'~i CCF'!mi:.si~:l ExpIres Feb. ~. 19~2
H. ANTHON V ADAMS _ ATTORNEV AT LAW _ un EAST tUNG STREET. SUITE'" - SHIPPENSDURO. PENNSYl.VANIA HZS1
~.-,--~-
:-.-
.:----:'~ --
,
SE'ITLEMENT STATEMENT
A. Sally J, Windcr SClllcmcnt Slalcmcnt B. LOAN TYPE:
Our Filc: LENDER
Loan /I
C, This form is furnishcd to give you II stlltcmcnt of IIctllnl sClllcmcnt custs. Amullnls paid tu and by the sClllement
agcntarc shown. Items markcd P.O.c. \Velc paid uutside c1nsing IInd ale nul included in lulals.
D, NAME OF nORROWER:
STEVEN I'. CALAI\1AN
STEVJ:N N. Sm:AI'.....:R
F, PROPERTY ADDRESS:
109 East Orange Streft
ShlPllensburg PA
E. NAME OF SELLER:
Estnlc of m:U:N A. WINGEIUJ
G. SE'ITLEMENT AGENT &
SETTLEMENT ADDRESS
Sally J. Winder, Esquirc
II. SETTLEMENT DATE:
112/28/97
I. SUMMARY OF BORRo\VER'iiYiiAN-SAc:J:,CJN----
100. GROSS AMOUNT DUE FROM BORROWER
101. Contract sales price $ 28,OUU.UU
102, Pcrsonal propcrty $
103, Settlcment charges to brwr (line 14(0) $ 653.50
104, Pay off first mlg loan $
105, Pay offinstalhnentloan $
Adjustmcnts for itcms paid by seller in advance
106, City/town taxes to 12131/96 $
107, County taxcs to $
108, $
109, Schooltaxcs to 06/30/97 $ 141.44
110,
III, Payoff installmcntloan
112,
120, Gross Amount Duc From Brwr. $ 28,794.94
200, AMOUNTS PAID BY OR IN BEHALF OF DRWR:
20 I. Dcposit or earncst moncy $ 5.00U.00
202, Principal amount of new loan $
203, EKisting loans(s) takcn subjcct to
204,
205,
206,
207,
208,
209,
Adjustmcnts for itcms unpaid by scllcr
210, City/town taxcs 01/01/97 to 02/28/97 $ 30.61 510. City/town taxes 01/01/97 to 02/28/97 $
211. County taxcs to 511. County taxcs $
212, Assessmcnts to 512. Assessments to
213, School taxcs to $ 513, School Taxes to 06/30/97
214, 514.
215, 515.
216, 516. Final Utility Bill
217, $ 517, Escrow for heating repairs
218. Closing Costs $ 518. Closing Costs
219, 519,
220, TOTAL PAID DY/FOR DRWR $ 5,030.61 520, TOTAL REDUCTION AMT DUE $ 2,965.46
300, CASH AT SEITLEMENT FROMfro DOIUWWER 600. CASII AT SEITLEMENT TO/FROM SELLER
301. Gross amount due from brwr. $ 28,794.94 601. Gross amount due to seller $ 28,141.44
302, Less amounts pd by/for brwr. $ 5.030.61 602. Less rcducliulls ill umuulll $ 2,965.46
303, CASH eX]ROM) (_TO) ORWR. $ 23,763.33 603. CASH eX_TO) (_ FROM) SLR $ 25,175.98
RECEIVED COMPLETED COI'Y OF SALLY J. WINDER SEtTLEMENT FORM for my/our records
Estntc of IIclcn A. WINGERD
$
$
$
$
STEVEN P. CALAMAN
STEVEN N. SHEAFFER
..-....... _'....0._'" .. h. _..... __'_.".__ .u..._...___~______
1. SUMMARY OF SELLER'S TRANSACTION
.lOll G!tOSS AMOUNT DUE TO SELLER:
-10 I. Cunlmet salcs price $ 28,000.00
402. Personal propcrty $
403.
4U4.
405.
$
$
406, City/town tax to 12/31/96
407. County taxcs to
408. Assessmcnts to
409. School taxes to 06/30/97
410.
411.
412.
420. Gross Amount Due To Scllcr $ 28,141.44
500. REDUCTIONS IN AMOUNT DUE TO SELLER:
50 I. Exccss deposit $
502. Selllemnt charges to sir $ 2,779.40
503. Existing loan(s) takcn subjcct to
504, Payoff 1st mort. loan
505, Payoff 2nd morl. loan
506.
507,
508,
509,
$
$
$
141.44
$
$
30.61
$
$
$
$
$
155.45
Oy:
LESTER C. FULLER
K, libTl'LbMENT CHARGES
700. TOTAL SALESIBROKER'S COMMISSION based on price$28.000. @6% IJAID FROM
OIVISION OF COMMISSION (LINE 700) AS FOLLOWS: BORROWER'S
701. $ 1,680,00 10 George L. Ebener & Assoc FUNDS AT
702, $ SETTLEMENT
703, Commission paid at Settlemcnt $
704,
800, ITEMS PAYABLE IN CONNECTION WITH LOAN
801. Loan Origination Fee ( %) to
802, Loan Discount % to
803, Appraisal Fee to
804. Credit Report to
80S, Under writing fee to
806. Application Fee to
807, Document Preparation Fcc tu
808, Tax Service Fee to
809. Flood Certification 10
810, Lien Release Fec 10
81 I. Application Fee to
900. ITEMS REQUIRED BY LENDER TO HE PAID IN AnV ANCE
90 I. Interest from to @ $ /day
902, Mortgage Insurance Premium for months to
903, Hazard Insurance Premium for years to
904,
90S.
1000, RESERVES DEPOSITED WITH LENDER
1001. Hazard insurance months @$ per month
1002, Mortgage insurance months @ $ per month
1003. City property taxes months @ $ per month
1004, County property taxes months@$ per month
1005, Annual assessments months @ $ per month
1006, Schoollaxes months@$ per month
1007, Flood Insurance months@ $ per month
1008, months@S per month
llOO, TITLE CHARGES
1101, Selllement or closing fee
1102, Abstract or title search
1103, Title examination
1104, Title insurance binder
IIOS, Document preparation to
1106, Notary fees
1107, Allorney's fees to Sally], Winder. Anthony Adams
(includes above items numbers;
1108, Title insurance to
(includes above item numbers; Endorsements)
1109, Lender's coverage
1110, Owner's coverage
lll1.
lll2,
1113,
1200, GOVERNMENT RECORDING AND TRANSFER CHARGES
1201. Recording fees Deed $ 23,SO;Mortgage S ;Release S
1202, City/county tax/stamps: Decd S 280,00 ;Mortgage $
1203, State tax/stamps: Deed S 280,00 ;Mortgage S
1204,
1205,
1300, ADDITIONAL SETTLEMENT CHARGES
130 I. Disbursement fee to
1302, Pest Inspection to Interstate Pest Control
1303, Septic Certification to
1304, Water test & Treatment to
130S, Overnight mail fee to
1400, TOTAL SETILEMENT CHARGES
to
to
to
to
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
S 350.00
$
$ 23,50
$ 280,00
$
S
S
S
S
S
S
$
653,50
PAID FROM
SELLER'S
FUNDS AT
SE'rI'LEMEN'1
$ 1,680,00
$
$
$
$
$
S (P,O,C,)
$
S 280,00
S
$ 519,40
$
$
S
$ 2,779,40
The HUD.I Selllement Statement which I have prepared is a true and accurate account of this transaction, I have
caused or will cause the funds to be disbursed in accordance with this statement.
.
t-fOCDHflf
I
I
I
I
I
I
I
I
I
D NO. AA
185256 COMMONWEALTH OF PENNSYLVANIA
DEPARtMENT OF REVENUE
OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
'*'
I.V.IWII"".I
RECEIVED FROM:
i
ACN
ASSESSMENT P:'
CONTROL ~
NUMBER
AMOUNT
ADAMS H ANTHONY
128 EKING s'T
101
.750.00
SHIPPENSaURG, PA 17257
ESTATE INFORMATION:
~ FilE NUMBER
Y 21-1996-0865
1:'1 NAME OF DECEDENT (lAST)
;I WINGERD HELEN A
I] DATE OF PAYMENT
EJ POSTMARK E
COUNTY
SSN 180-07-6862
(FIRST) (MI)
CUMBERLAND
DATE OF DEATH
REMARKS
m TOTAL AMOUNT PAID
.750.00
REGISTER OF WILLS
i!.V2 .
, .
RECEIVED BY '(, '/ . " ,{,{~ ,;..'/-c,
HAl R '.
: .r 1./ ,~ .7:;."-
MARY C. LEWIS /;-1')......" /.,/ . .
REGISTER OF WILLS '
LESTER C FULLER
C/OH ANTHONY ADAMS ESQUIRE
CHECKlI 111
SEAL
-.." --.-.- ., '-'.~l--- .__.-.- T-"'-
. .-
,
. .'
,.,.
,.
J
,
--, _.~
-:..i. -- -_.~ ."--:"..NII _~,. .,:.
J--135 -1'1
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU 0, !NDIVIDUAL TAXES
IHltfRIf""'C[ UK DIVISION
Ul.P'. :10.01
UARAISlUtlO. Pi l1us-a601
NDIICE or INltERIIANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
or DEDUCTIONS AND ASSESSHENl or lAX
H ANTHONY ADAMS
126 EKING ST
SHIPPENSBURG
Ese
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
PA 17257
06-30-97
WINGERD
10-01-96
21 96-0665
CUMBERLAND
101
""ount Rallltt.d
- ..
(: 1*
tlw.I\U II &I, IIl.HI
HELEN A
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ~
iiE'Y:is"TEx-AFP-itii-:9:fi-Niii'"icEnoFnitiHEiiiiAiicE-YAx-AppRAisEHENT-,--Ai.i.-OWANCE-oli-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
HELEN A FILE NO. 21 96-0B65 ACN 101 DATE
TAX RETURN WAS, I ) ACCEPTED AS FILED I Xl CHANGED SEE ATTACHED
If an assessment was issued previously. lines 14, IS and/or 16, 17 and 16
reflect figures that include the total of ahh returns assessed to date.
ASSESSMENT OF TAX:
15. AMount of line 14 at Spou..l rat. CIS)
16. AMount of Lin. 14 taxabla at Lin..I/CI... A rat. (16)
17. A.aunt of line 14 taxable at Collat.raI/CI... Brat. (171
18. Principal Tax Due
TAX CREDITS:
PAYHENT
DATE
03-07-97
ESTATE OF WINGERD
RESERVATION CONCERNING FUTURE INTEREST . SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1, R..1 E.I.I. ISch.dul. Al (1)
2. Stack. and Bonda (Schedule 8) (2)
3. Clo..ly Hald stock/Partnership Int.ralt (Schedul. C) (3)
4. Hartg.gal/Not.. Racaivable (Schedule OJ (4)
S. Cash/Sank Oeposits/Hisc. Personal Proparty (Schadule E) (5)
6. ~ointly Owned Proparty (Schedule F) (6)
7. Transfers (Schadule G) (7)
8. Total Alsats
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expens.s/Ada. Costs/Hisc. Expanses (Schadul. H) (9)
10, D.bt./Horlg.g. Ll.bl1lI1../Ll.n. (Sch.dul. II (101
11. Total Oaductions
12. Het Value of Tax Return
13. Charitable/Govarn.antal Baquasts (Schadule J)
14, N.t V.lu. of E.I.I. Subj.cl 10 T..
NOTE:
RECEIPT
NUHBER
AA165256
DISCOUNT l+)
INTEREST/PEN PAID (-)
,00
26.000,00
,00
,00
,00
2.533,76
,00
,00
(BI
14,133,60
,00
Ull
U21
US)
U41
,00 X ,DO:
,00 X ,06:
5.000,00 X ,15:
UB)
AHOUNT PAID
750,00
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
06-30-97
NOTICE
NOTE: To insure propar
cradit to your account,
subnit the upp.r portion
of this forn with your
tax pay..ant.
30,533,76
14,133 RD
16.399,9B
11.399,96
5.000,00
will
,00
,00
750,00
750,00
750,00
,00
,00
,00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST,
IF TOTAL DUE IS LESS TNAN II. NO PAYHENT IS REQUIRED,
IF TDTAL DUE IS REFLECTED AS A "CREDIT" (CR). YOU HAY BE DUE
A REFUND, SEE REVERSE SIDE OF TNIS FOR" FOR INSTRUCTIONS,)
11't,WOII,..P' ~ ~ ~"
Il.:k*;~
COMMO'llWEALTH Of PENNSYlVANIA
DEPARTMENT Of REVENUE
BUREAU 0' INDIVIDUAL TAXES
DEPT. 2B0601
HARRISBURO. PA 1712B.0601
. DECEDENT'S NAME. U_ ,J I J
LZ=. ".., ,.Ii. W0j'-"
INHERITANCE TAX
EXPLANATION
OF CHANGES
filE NUMBER
~/76 tJ P6S-
ACN /tJl
SCHEDULE
ITEM
NO,
EXPLANATION OF CHANGES
&~
.~
c.c
/14.,
/:1.
/~
~
~
, ;' ... . ~ .,
TAX EXAMINER:
/ --~ //'
.k-~
PAGE
/
(~/
S'I'I\'l'lJS HEI'OHT lJ.~I)!~llll!JI,t; u.6 ' l~
Name of Decedent: lIL'lclU\~\{illg~tL
Date of Death:~J~I.Y___nnu____
W ill No, 19<)(,-0086",
I\dmin, No,
Pursuant to Hule 6,12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the ahove-captioneu estate:
1. State whether administratiun of the estate is complete:
Yes x No
2, If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete:
3, If the answer' to No, I is Yes, state the following:
a, Did the personal representative file a final
account with the Court? Yes No___
b, The separ'ate OqJllilnS' ("urt No, (if any) for
the personal representative's account is:
c, Did the personal representative state an
account informally to the parties in interest? Yes X No
d, Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be attached to this report,
oate:-5-/) Jfj
I
-1 \ C~.\
'Signat..ure -
'-c~~
'-
'(y-.
(Please type r print)
L~ . ~\ I (jll\~~''l( I
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<,..) 7() II) n
I); ('-,
Aadress
Gn) <.:; .)
Tel, No,
Capacity: Personal Representative
~counsel for,personal
representatlve
(MAH:rmflAM3)
,