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97-00029
1_ '2. \~) . \ J ,) PVITIION Hm I"HlBi\TE 1I11d <;!{ANT OF u:rl'l.;HS ,;) I... (1' 1..0 /:;l1 I:"s/all' (lj' t"HANCI'::: CIIANI>I.I':I': II. III CKI:\' also 1\1/(;1\'1/ (IS i"H^NCI':t; CII^NlJ{'EI': 1l1\~~~I':Y I "lk/ ill-'HANCI'::: c. tll CKI':\' I il/k/" F, c. JIl eKIl\.' !JC'['['''VI'r/ Sodal Security Nfl, 20B"2B-06~~ ') No. In: Regisll'Iol Wills \", Ilil' ("Olll,l" oj (~unll)erlilnd ('OIIlIl;ot\wl'altl1 01 Pl'lIl1\ylvllllia ill the lhe petitioll or till' IIlldl'r~igl1l'd I'l'~pel"lrtlll.\'rl'IHt'Sl'lll~ [hat: , Your pl'tiliollcr(sl, who is/Hl'l' 'IF; Yl'H!'S of age Of' older llllthl' C,\t'L'llt or:_8 il1th~ la,1 will olllil'ahovl' deced~l1l. llaled uA\'9v"t\i. <lIld eodicills) dilled N!A . __,._ nallled ... ...... 19_.~.Q,..._ (\Inll' Il'Il'I';lI\t <,:l1l'I\!l\\IHIl~'I.''', l.'.1l Il'IIlII1r1UliUIl, (kill II uf 1.'\I.'l'[I(OI, l'll.'.j De,'~ndl'l1l was dOllliciled allkalh in Clallllorland....u ... ..__... Counly, P~l1l1sylvllnia, with It.QJ;:.... ..._, last fa1llily or prilll'lpal rl'silklll'l' at _ .~O~}__~heA_~_~_~t R.~E.~~_tJ..,!~,~_!:"ou9~9_L_~.. .. Camp...IliJ.l .._......._____...~__ (lhl "(l'l'I.'I, Illllllhl'~ alld llHlll~'ipalilY) Dc('cndclll, thell n__ 87 ___ Yl'ars or agel died _____,}a_Du_i:!.!::.~" _~._ ;. ._....-..,,19..2..7.___., HI .J3J._~_~Q_.J~tc1g~ H~yefl W~~_t.( .,.,q~'l~P, ,!,IJ__lJ.f.._nf~.~l}IJYJY__r:!f.l.i.~l_ , .,_._____ _____---'-__.. Exe~pt a, I'ollows, d~l\'de1l1 did 1Inlllll\l'ry, was nol dlv"reed and did 1101 itaV\' a child born or adopled ul'ter ~.xcelllioll ol'llic will ol'l'ered 1m pr"balc: W1lS 1101 the viclim "I' a kil1i1lg alld was 1Icver adjudiealcd iIlL'ompelclll: .~9___qxq~p_tL()rts .._u.~_~____~__, DC(:Clldl'fll al death mVlwd property wilh estimated \'11111e~ as follows: (II' d"micile'd ill Pa.) ^II per'''lIal prop~rly (I r 1101 domidlcd ill }la,) Personal pl'Opt'rty in Pcnnsylvania (I r not dOll1ldled ill Pa,) Per~onH,1 properlY in County ValllL' or real e~lHl(, ill Pt.'!llllwlvHnia , siluated as 1',,11 "ws: _30.:13 Chc~tn.u.t:. Str(l(Jt,C'"iT11).!Ii_l2....__~_....__~__.__.. $~L~()~Il.Q..,.CJ.fJ....._._ $ ......._._..._---~-- $ .....--.--....---..- $ ..~..!().O I 000.00 WHEREFORE, pelilin1ler(s) r~speell'lIl1y requesl(s) th~ probHle 01 the IHSI will alld eodlcil(s) presented hcrl'wilh and the granl of' klters..._ te~ta!!!.~!"!.~.~!:"-y'__..-~__...___.~___._.,__.~._._~~_.~ (te~larlll'nl[ll'Y: adlllini\lnllillll l'.1.a.; .H/l1llnislrmioll d.h,Il,l',La.) Iltcro1l, 'J, " ~ 'O- '6 :c Oi:tJ c T.,IO ~:g _ 'J '".0.. 1j'<+-.. t5 0 1-1 " ", Vi I <".. /) // '//l , d ". c.-t~'-<. '<?"~"'U4' ~ m:.~c.~~E.enj~ g;:^SbUl;y...~--.-- 9l~,~h"!'1.i('.1~_p~'=-'..!_!tec _~~~~.rg I P^ 17055 .~t.....~1<,r ~..,.&il;::{1..cJZ~c:.d..~ .U.__ __.....P.9.E'l.L1.Yms.~b.".s.t '!'.'l.n._._~_ .:l.Q1LGb.9i;lJ;llvLiitr'lgj;,_.Cam2..J..!HL PI; 17011 ...-.-..--.-,------.. .--- .____.~._".____~..~_n. .____ ..... - _._ n'. ..___~.._____ ...... ..."...-.._~_._.._-+.__.-._. ...__.....~. ______n_..._' OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF J>ENNSYLV ANIA COlJNTY OF ...~UMlll,RLT\NIJ_... J l-lH Th~ petilionerls) ab"vc.nllllll'd slIemls) or affirm!,) thai Ihe 'Y')Cnlcnls Inlhe l'"rcg\ling petition lire lruc und correct 10 till' hCSlllJ' lhe ~Il(lwlcdge and l1l'li lif P mi-[mcrCI.,) Hilt! lhat as personal rcprcscn- lalll'l(.\) "lllic ahove dcel'delll pctlllonl'I!.\) II ill lIel 1111<1,. lily adm\lllst~l. Ull~ aceOldlng 10 IlIw. SWOIII 10 III allllllled .11,,1 ,"h"'III",d ~ "_ U.t!,7W..~ ~~~ :... Jwf,"c lIIe IhlS _ IOTII d,,\ III ' c}arcncl' ~. ^shulY :r/' .~. ~IJ/) ((,lll\1'j~ARY C!rv.Jt)fi -J..,_ I ,,.4 . --.. ~ .M c';--1.e.(.A.I(.~l(l'( tL'//(__ ~ _f"_~,'/t,L.""t:/((c?1{~(1f(~ ~ (f( MARY C LEWIS /(1'~IIIc'1, "".':1 Dorothy ;~lSt Ian 2 . ( (I ' .. '1 . I hi' I 10 \ , ,! 1:1\ I I', 11 I ~ . ' ~ 'I " I I II IILI( lilt' 11111>1111.1111 >II lii'l, \ III 1111)',111.11 l,'IIII,,111 ,', ill I, " , ,,II ii, '1',1 ,I 11"111 '" 'Ii : '" ,I 1,"1" lid ,I " III ii, \ " " I 'I.l., 11111,.11 1111" III1 "I d,,11 Ii ,Iiil 11,'lllllllilll I1I1 1,1,,\ lill Ii;, WARNING: It Is i1loqallo dupllGalf' tlli~; copy by pl"'ID~;lal or pllOlofllnpll, 0.111, /,"(~\11\ err;,,> .... ,i",~ '1.1)', I/i.'~' 'lI':. O;~'\.\. 'r.:.:.:l .. ..,'/ 1,\(.." . ..,il' " l"t '.\*..- ~~.... ,*~ ,'i% ::..~.y , '* 'i"" ......~!#INl ~,~\""" ~,,;:.,."f1,',".''.!'' /J. f)1~/l,(/i!'lrt(- (,(/,12/>2/ / ( ,( ;/ 11",iI'lll'j',I',li,!1 (J \"l' hll 1111\ '1'l!:lil,II(', IlIJ 4016841 . . JAN (J 3 1996 1).1((' COMMONWEALTH OF FENNSYLVANIA' DEPARTMENT DF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH 'IAt.lEC#oeCEDENTIFf.MdtII,L~ ." !l1""Em~",u"'UI\ $OCIALSECVFH!'Y'IUIolIl[/\ OAJ&~D(AJtt,MCfIf\ 0;;-;;;-- ,. .. F€lMle I, 208 -. 28 0621 DATE ~BIRTIt BlIlltlflACllCt/1t^d l>\.JoCt ~.~E.~" flI~.'!'!...:: ~:'.'!''''I:'''''~'.lil~_~NlI 1l,1,~dh O.y '-I .;",,~,.t'~~)(:lld~'Yl HOSf'lfAI., JTHI'" (Xt 12,09 M:>rdslown Ten 1nC",.....cD 1~lotnl[] oo;.['J ~'::'lnOfl , OfOEATH-liZll,A NAME ia""''''II<M<oo O'......NlVd,.,.".1 ~99.ECfD[tflOf~IIS NICOflIQIN? -- NIIW] ""'llJlty",I9t<if'r~. East Pennaboro Blue Ridge Haven West M..t.'.&"P_I<lRW.1Il0 lHUS/INOl,..$lflV "f'\DLf~~r~~~J:r DE~EOl!H 'IE >>AT <till -~~~';~~i:,~"~~ltd PaD:3partrrant of j r;'] ~[] MmInIaly~ ",al c'O::o. [JM)I&-.!ISI....ofyl l'Ilh 10.1'1 + j1~ud'l . Jd.;r'ldr j L--... ~~ DId u.JJ YN.'*f<WIIW9<l"'_ - ..... --, .. \lanua 1 19n.__ ~'ranceB AQfll.Ila....,.V1 , 87 COUNrrO('~H _u ='~II[J Cll'/. RACE .~iM-;;;,--~~Wl>-;;.ti(..- fSptri,J Cunber land " White ~fOt:Nl:JU.UA - I ,,,. ~""l U. wor~ lIONI ().oIoroa"'" oI1I'Qf1oonQ...d11I'Ol....'...edl l1J.~____ OC:CEotNTIr.lMIHOADOA&SI(SIr".~.!UlllpCOdlI SUflVI\lINO~UIIl! {~,,jI~"'~I\Io""1 3033 Chestnut Street " Canp Hill, Pa 17011 iAiiii'R'SN,Wf(f.lll,lo'"'' LUl - l! Willi"TI Hickey INI'OAll'NT" NAt.<<: (TypwPrrlj ... Clarence Asbury MrIHOOOI'OI!lPOSlflON ~Al'EOI'DlSroSlTlON 8urIaI;(J c/trNL&IIlfIO ~~OII'I"'O IM,.,In(Jdl_l .....rl "''"'_.._____[1 . 1nn" l!L- . m..Ja,~.-'L~ =-'- F\Al.&fFl I\ION...cTIHO AI SUCH llCl:N\l'EHUMIKR ,011654-1, ""'"U~l>II M t lIN Y ooW~,O"lhoc,ullItd.tT"'I'mt.~'I'lMpII"'''"I'''' p/lyK......_....~.I......"'\lMllIlD lS9........W\dIC>t1 <M1,ty"....."'~ 111.SI.I._....IJa In.C,,,,n f'+:I,lNC_nlwtd 17~ fXI ..~lIo/\"'twl~pMIOI__ MOTttEFnNA"'E(F~. M~XJt M""",.s.,'''J/''dl Martha Chandle" . Cairp..!lill . 1NI'0AWJ1T'I/MIl.INGAOOf\Ea9(SUMl (;~lffl..." ~18 lic<J(l'1l 914 Sheffield Avcnue Mcchanicsburg, Pa 17055 pt.AC1!Of OIS1'OS1TIOH . NtIlItolC_t''Y.Cl.mltOl~ LOCATION, CCyfTown, S1111,llpC04l" ._- . ::amte=_. N.Ulf AHOAOOAESSOF FACIl.ITV .1\Jllill:ill LlCEHSCNUMBEIl ___ u. __H'~""--~~MIl1 TlMl!C#OlIRH :r:AJE PFlcmouNCfOOCAtlIMonr, o.~""1 -"--"'~, 9....,.- ldd "... o ..A....oL l....--i ..LL- frol~llItlkMI_Inf..tt"or~6(_..l'oIcIlc_dl~ot~11l PotlOl'I\l'/I""mo<HOt<ty>p\Q' hU "'ilIII:or'III9Ir~Ol)'."ttl tIlor:lorlllWltlllul. l...Odt_u_onMal..... l=~~::"n 1~.,l(tdolllh ._Ac.-V'.~fI..:~ o! r ^},c) ('I JQ,l~:r"'" ___J,2!l~'! ~5 OlIIlro/OflA5~ObOO\lj(tufl I \ b~~~~~A~ctE~rri) ~j~ k_~1~j OLs.~o,\~ --,-!221~~~~, ,_~~~d1rd>'~._ ._+-__.. OOIro(OfJ'S~CON5(OUENCE Of\ 0 I , ., -- _.._---j.~-- I'l1'FlEA(lTOPlIYF1NOINOI l.lAHHIROIOf:AJH O'-'U Of INJURY tullE:]"'""' ii<J"'''..'''''''j''~."''.''''''-;;w;;;-&cUAA'' .....!LAlIll! I'NOJI fO ,MoPI' r\1I~. .....J gr~~;:>" 01 CAUN. NIb'll 'ti(' 11oo.W:KIt [] "" [I No ( J AWOIN LJ Ptn<J,,,, In~~I~lllO)n lJ Nap< .....rJ No'j() "*-it [] CoukIooltot,"tt,m.,toI (J~I~jUj..f.Ai;;m;:-tllm,../_iKlor'"oii\(i~-Nc!'-.['OCA'.oH~~~~,S.I.I--------~ b<itI<Ing.lMlll~1 * ~ ~ ~ ~ U"'''II''fO'tr1oONt'''''1 .-----.-~-._--~. [J 1IIONAIG'~'_'hllfl[0f'~--ii,iIiFt{'1) N() 'CIll'wYlHQ~nICIA"IPn"'-:_~~dllMf'l_INlII" rt11.....,,~tll.'..'-u..;..I,I..I".'"",..',jl,t<lIt.~J;lI l~ J ^"'^_~ 1........ItI""~I'lOl..Ifdtli,..Mh_Wl...,III..,.~II.M_IIt'..1..1t4..,.. ,. "'.._, ,,'._...... ,.,.....",.".,..." ~!-~.~~ ~ ',.,,'fYj""lO-"''':..''' ""'-l' ;;: .-. -J""'","'O."'{"l.'o. '~- ~1'_-_-.. _ "~~IjOCIllTII'YlHQ'HYIICI4HI'''l'I'C'''''''llIor""",o;lOQ''''~It'"'~I'''''II'''III''''.'''''ul'kl.'N l..U"'\V \) L 'I""MIlI~"', kINlritdt!fI, """'_..,,.. ........, ............ptec.. """du'IQtlll uu"(tl I"" mlnnl1 II ,t.tH .,......,... ,.. ..., ,...,. flAMl ANO ....OOf1~SS OF p.'A1',(lN WttO COIIlPlfTlfJ,CAA!Sl ()f f tt ....OICAlU"..INIA/COfLIONI" 111~",lll T~f'lOI.f'I':'1 fi ("1" O. KOl.'l f\'\ "" M t:J ll. ~:~ ~'~::..rmlll~t.l~~..~~ .~~~~I."~~~: ~ ~.'.~.~~: ~~~~~ ~~~".'~ ~I tn. tll1I', d'.~'~:~~ltl'~'~ ~~~,~~ ~~ ~~ ~~~~~I.~~ n !!......-c u_"_ ~__~_),~l~~ ~~_:-. ~st=ftf~~lL~JL --N:O,1TR"'dliiliN4f1l"E~ f nAJE"l(()'I.4,'.",',.....~.. , "~la_L~_.._ .~~ ~~.::'f'ljl-rJ___~;<1.' ~... /9'?:_._....______ I"lS CASE RlHRI1ED TO MEDICAl ticAMINfRIC R'.....lv'" vt,[J _~ '~"'n: OIh1ttqWllc'll'lI~_-v..mQIOcWn>bU noItllUlinglnll1tUlllltlt,l"ll_gMnlflPft.RTI .\2~, .l-cllt'lY'l ____.___ _Q.J~Jk0.~____.._ .~"-"< r~.L~~~1.u--__ I~ ~ Jf[ ~ c. _ ',~'-_' (t< _,'~' , ~ ~r iJ n' <=_1 fP t'\l CL-;- ... ~""'- g- O {] \ . ~ (- -u :Elf '-r} .",. =:('i) ;;gS .. Iii sa. ... \0 ~ U 1-1 ~ tI:I !~Id . tI:I ~ ..... ..:i tl ~ ~~~n u ~. ~ ~ ~ ~~ ~Iq tJ ~ .~ ., "'. . ' . . . ,':, COM~F~:';If'~hWr'!fI'~ftlJi '))'11 tAN 'A OI"I"T. ?ft01101 HARRISO (HlO, PA 11128~OOO 1 I I I INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE WITH REGISTER OF WILLS COlmlycutJf r f\l:V - ISOO [)( . (I '~91) FOR DATES or O[ATtt AI'TO\ l:i'I~1101 CtH:CI(IIEFlf II' A !lrOlJSAL 0 "OVE nTI( enr.Oll 15 CtAIMfO ... FILE NUMBER g ~ C ! B H \I L E Ii 0 C ~ C K K S E OE:CfDENT'S NAME (lA!\T. f:1H9T, AND MlDlll ~ INITIAL) Hickey Frllnc"" rH Cf lll.N r'~; COMI't rTr AOtHH ri!1 c. 'lOB CI"'stllllt Sll.""t e/lllll' 1111 J, I'^ DOll 50CIAL 5(CUHITVNUMOfA '~E OF mATH ?08.28.06?l ___19JJ.Q.!j1997 X 1. Ollqinal R(J!llrn 2. F~')~;-,~'- 10 1211-90<) CUlInty CUl1lberlnlld SllppIOffl(JIltl;iR.(JIUI;;--------~~D 3. lj4. Umllod [alalo 04.. FtJlllfO Inlmonl COlllprornl!lo 06. (lor dlltos 01 dootll oltor 12-12-02) [R] 8. Docodonl Dlod To~lale 07. Docodonl Malnlnlnod a Living Trust 1 B. (Allacll copy 01 Will) (Allocll . copy 01 TII,sl) C P ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFDRMATION SHOULD BE DIRECTED TO: o 0 R N n D E E S N T 717-691-7770 1. Raal Estato (Sdlodule Aj 2. Slacks and Bends (Schodulo B) 3. Clesely Held Slock/Por1nershlp Inloresl (Schedule C) 4. Mortgages and Nole. Receivable (Schedule D) 5. Cash, Bank Doposits & Miscollaneous Porsonol Proporly (Schedulo E) 6. .Jolnlly Owned Proporly (Schedule F) 7. Tran.lers (Schodule G) (Schedule L) 8. Tolal Gross Assols (Iolal linos 1-7) 9, Funorel Exponsos, Admlnlstratlvo Costs, Miscollanoous Expenses (Schodulo H) 10. Debts. Mortgage Llabllllles. Lions (Schodule I) 11. Telal Deducllons (totellinos 9 & 10) 12. Net Value 01 Estate (line 8 minus line 11) 13. Charitable and Governmenlal Bequest. (Schedule J) 14. Nel Value Subjoct to Tax (line 12 minus line 13) 15. Amount olllno 14 taxable aI6%,l rate (Include valllo.lrom Schodulo K or Schodule M.) HI. Amount 01 Uno 14 taxable a115% rala (Include valuos Irom Schodulo K or Sctlodulo M.) 17, Prlnclpal18x duo (Add lox Iromllno 15 Elnd Irom IIno 16.) 18. Crodlts/Sp Povorly Prior Paymanls Discount _.J!..:.29 + 60 , 000 . 00 + O. OQ 19. II line 10 Is greator Ihan line 17. enlor 1I1e dilloronca on line 19. This Is Ihe OVERPAYMENT. ~ ~ ICheek here If you ere requesting a rofund 01 your ovarpayment.1 20, If line 1719 groAter than line 10, onlor 1110 dlfforonce on Uno 20. This Is Iho TAX DUE, A, Enter the Inloreal on the bnlanco duo on Iino 20A, B. Entor Iho tolal elline 20 and 20A on line 20B, Tills I' the BALANCE DUE. Mako Chaek Pa abloto: Ro Ist.r 01 Wills, A ont ~ ~ BE SURE TO ANSWER ALL QUESTIONS ON PAGE 2 AND TO RECHECK MATH ... "'i Undnr penalliu ul plllr/ury, I decll\lQ thaI I have Q~<HI1I!llrlt Ihls ,el\lln, IncllH11llO IlQ{)ompllnyill\l8chodlilos alld stalenienls, and 10 thfl hllst or my knowlodllO IItHt hnhef, It is \rUIl, COlfflct <'Inti complete. i dfu,.lare that 1111 I\lal eslale hll5 bllen leported all".," trlM~et value. Oedl,allol\ of proparn! Ol1Hlt Ihlln the p6'~"!lal 11Iprnsel1lllllve 15 bouod on ",I Ill/ormatIOn 01 whlchplllparlll hll51\nykn(lwlnd\lll -- L/lW Offices - l~arl~n R. HeCale}, ?l9 East. Hain Street, P,O. Box 230 M"chanicsburp, , PA 17055 )18,000.00 20,155.62 None NonC1 370,820.00 NAME Marlin R. McCaleb, Esquire ___ TELrPHONE NUMOEfl COMPtE TE MAiliNG AOOf\[SS R E C A P I T U L A T I o N (1) (~) (3) (4) (6) (6) (7) None None (9) ,53,71.2.0"/ (10) 630.68 21 - 9/- 002'! YtAH NUMBER RomaJndor Rolllln (lor datos 01 dealh prlOl to 12-13-02) Fedoral Eslalo Tax Roturn Reqlllred Total Numbor of Safo Doposit BOKOS (8) 508, 97~;. 62 (11) (12)__ (13) (14) ( 0 . 00) x .06 = 54 , 3 n . 75 454 ,602.87 56,260.28 398,342.59 0.00 (16) T A X C o M r U T A T I o N (18) 398,31.2.58 X,15. 59 , 751. 39 Illtmost 0.00 (17) 59,751.39 (18) (19) 60,000.00 248.6] (20) (20A) ( 20B) 0.00 0.00 0.00 ADrHlr~S Cl~I"Cn(lU R. AS}lUI"Y, Co-J~xccutor ,2):1; }Ht(~E( :~Y~i~,!~ :::::::::::::: :::::::::: :::: 'M,'ch/ltd "!lhuljL P^ l'1055 AD(l!l[5s ..--...--- SI(] Turu. or PfU.PAAEA OTtlrR TtlAN f SEN1ATlVE / '. ) c://. if.t)i-~r( /t((}(;k,t (~ll;lyr~iii9ii7;;~;;-;7I';1;'';;n CJrlly CI'111", PI(lf.(I ~;{\'I""~IO, 1111 OAT[ 1f-1--'1 1 DATI: Law OfU"cs . MarlIn R. McCnlob 2i"9 .i\~.;;. i.i,ij [I. .S;;.;;,:;:. .};:O." 'Iie,;, .5j(j'......... ~l;:(;I..~;;l'~,i;l;,:.;;.. '1;;\. .i7(j,;~;'''... -...,...,........ . _.,,_._.1.J.._~~______.._"___ 'ff-I- y 7 rmlll 1500 (Rnv, 11 Ill) A, SETTLEMENT STATEMENT Ill: cOMt;~I~Ir;:;~T~(~~~ B 1.1POOl\.Oorl::::.,=-=::====---- 1. I J filA 2. [I fmllA 3 [I COrlY, Unlrls """,,,"',., 4 [I VA !i, [ J COrlV, [rlS. IJ~; IhqJ,HllllL'l)\ cd fIlHI~~lIlq illlll IJI\);111 f"lI!Vf>IOplllPllt OMB No. 2!,02,02G:J (Lxp. I l \\oln llillllll~t 8 ~M!\U,IU& In\u"nC8 CHI !iuml,~r 1I'(n;'I,-'lIIHI C. NOll) Hds fOl(l\ Is IUlnlshao to give you a statemont of actual liolllomunl costs. Atnounls paid 10 and llyll\6 so1l1omonl auonllHo shown. Hems markod "(p.Q,c_)" wore p,ll[J outside tho closll1g; Ih(lY (HO shown hOlO lor 111!ollllatlon1l1 purposos and are Ilolll\clurled In UIOIO[.lls. --, tJ IHm~ 'lid Moret I Of /111110>*11' [, Nime 'lId i.ddrtU 01 &~II.t f Ij,llll& dnd M~llll all elide! j'A'l'lcJ t:K ~1. KANI'; REI\1':CCA RANE ESTATE OF FHANCI':S r:IIANDLEI': III cn:y PNC ~1()W[,(;Ar:I': CORPORATION OF AI'lIm I CA ll, Proptrly llX~Uon '.10:1\ CIIESTNUT STREET CMII' 11 ILL , I'ENNSYLVANI A 111111 H. S.lIIell\llI! "UM1 LATSIIA & CAI'O/,r.!, P.C. f'hltlolSelllGflIenl j SGI1I8m8fll t1ale I, no OLII (;i':'1'TYSIlIIRC IHMII m:cIIANJ CSI\IIR(;, I'A IIO',S HA Y JO, 191J1 J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SEllER'S TRANSACTION 100, GROSS AMOUNT DUE FROM BORROWER: 406, GROSS AMOUNT DUE TO SELLER: 101. Contract sales price iIC!..J190 '.2-Q ._~~!:.,~~ntract ~~'p'r~~~____ II g, OO(). IIU lOi:'Personajpi"operty --.-,----.---".---' 402, Personal proporty f03, sei.tfeiiientChargestoborrower771ne'j 4(0)-- -'-8~7i"';r:t) 401..----------- l04~--.......---....-..-..._-.-n-.--.. ....- n~....._.._. -454.--."....-....-....-- .-..---. iOs:-'-'----.'.--.-.'-....----....".------ ----- -455.,--""'---...... Adjustments-for items paid by seller in advance: Adjustments for items paid by soller in-advanco: 106, City/town taxes ',/111/91 to 12(:11/91 238.18 406 City/town taxes 'itm/lJ7 to 12/J191 238.18 -."iOJ:-CouniYtaxes.--.~-fo.---- -~----- --m:-Coiinty taxes-.----n--..to-~- ~._--- --i58:-~~Sessmen[s-----.- 10--"-' ~-~--'~408.-ASsess,iiOnls-.---- to "lo9,"'Maintenance-'--"""-- io"---"-"~ 459."'Maintenance'---\o--' -TlilSChooI/Taxe's -",T1l'I71jT-\o--(jjuflJ7-- H 7 :L'I' 41 [Commitmenffoe----..~~--- -"i1~----..~-----tO---"- --- 4it. SCIIUO!./'IIiT"nll/')/ tOb 11~'-"--'------'fo-'-'-- ----~412:---.---.--- to 120, GROSS AMOUNT DUE FROM BORROWER: ] 26, 7H3. 2(, 420, GROSS AMOUNT DUE TO SEllER: 200, AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500, REDUCTIONS IN AMOUNT DUE TO SELlER: ~ 201. DepOSit or earnost money :, ',00, ()O 0 , xcm OpOSlt (see II1structlons) 3 .'i()() , ()II n202-;-piinCipiiJ amountoiiiew loan(s)'-. .. . ,-.. T:il)~)[i(i :nu 5oZ:SeHiefnCnicharges'toseiie!77TrJ8!400;-- -~nl.nll 203:-ExIsHngloan(s) taken subject to"'--"'d~n"-" 5011'xisiingloiilis}iake-risubjocHo"-' - 204:'-CoiiilliiimentFee---'"...,- . .,.-,,----.-- "-SoCPayoii of iiist nio;igageioan-.'--"-~ -------~. 205:-'----------'~-.. ..'_.. ,,-, .----.."'-.-- n 50S:'piyoH'0 Isccoiidnlortga geToiil--'-'-' --206--.--'---"'.'.'''''--'''-'---- ----.------ -.---- -506,--'.. . ".---- ,,___n --.... d n____'_....._"_ ~--,,---.., '.207,-"---- - ..., --'" ... .,.____'n_._.....d '-'-.'''- ..507.-."......~.--....--..-.-.-,.----~---'--. 208:------------ -----.,,-- _n_'''''__' 508 .2.69~----..-.~,---m--...-n.- ..---.--.'''''- -...--."-----..,, . 509,-' Adjustments for Items unpaid by seller: Adjustmonts for items unpaid by seller: 210, city/town taxes to --:>10, City/town taxes to .2[r-counlYiaxes'-"----~-'----.. ------- --'511-:-foiiiity TaXes----- to --2ICASsessmentS-' to . . .- ----SJ2'.-ASscssments.--,-'n-fO----.-- --....----- <_'n~....~_.,______._-...____.~._._~~____._____...~_ _'"'~__"."_' ----5i3-,--.Malnlfinan---CO--~---~.-.---.----"--to-'~... n_______ ._......,.._.._____.A' . m. School/Tms to ..--5i4:'S<:hooi/Taxes--.....--'-"..to __nO' ..,_.n ..,-. 2f~-------- to -. -515.-------.---.------[0---'-----'_.,,-'----- -m:- 10----- ------- -SIC'----------,d to"""'" --",-' 216, to---.----- -------- -m:--c-------.--.--\o- d'____ -.".--... =~m:::--=--=--==:~====l~-'~=~== ,:::=-='-== :=:ill:~:'-,:-=-:::'- ..,,__~:~__n' _.m_ -- . -~-2 i g~~---~--'----'-""-'-'- -- to'- m.._____"'-~____ 220 T T'L -"...,. WE 520. TOTAL REOUCTION AMOUNT DUE SElLER: .,_...:.....-!l.L-,~BY /FOR BORRO _ R: I 'l III I 1111 300, CASH AT SETTLEMENT FROM/TO BORROWER, GOO, CASH AT SETTlEMENT TO/fROM SElLER: ......,.,..., .....,._.,..,"'..... ~~~_~,..,..---.___...--'._-.-n.-~-~---~-- _~____......... 301. Gross amount duo from borrower (/illo 120,l 1;'(), 7H:l, :~(, 601. GlOSS amount duo to sollor (IIf'" ,1;'0) I ]g, .L~ '." 1,"1 ~.______.M'_'_,"~______'" . __........_...____~~~~___..__~___. . ________~.___"_______u.n...' ,.,__ _..~~__._,.., .".~_~n'__ ____~_...__a~.__~~~~ 302. Loss alll(Ji!n(\ paid by/lor horlOwer (tIIlO ??O) I I 1'\, /11111, II 1602, Loss loIn I f~ductit1n\ in o1I1\OUI1\ ilu~ \ell~r {Ii" \10' 11'\, 1,:'11,1111 301 CASII IIX1 !'HOM} I[ I TO! OOllROl'lfR 1\, 7.'n, :'(, 601 CASIII[ Xl TOI III fROM) SElLER 111/" 'II)'" il; _.~--_.__._--~-----,~.~------------------------ -~-~~~- --------_.~_.~ -----~--- --- ----_.__.....~.-_._--- 'or~1 lnU~ I~~'i ~I~(\\ -l / LJ .'1; 'leI,); 'f'-? IlIlll 1 l!1h .\ Ilf'l ,'.("n" ((11'\''-' (11,\.1)'(1") I\HI'A.HIIO()~? . " .-----.---.-...-..--.--.-..............-..---.....-.........---.......,_._.__.._...,_u._~___ PAio fRoM' I PAID rRUM L. SETTLEMENT CHARGES BORROWER'S SHun . ........__..__._m fUHOS fUHOS iolfTOlAl SALES/BROKER's C~MMissrOHB~i!d o~jr.i~;-'LI_m..1 iiiij~!iii.l:" ...L.?'.:.....!.'....::.~~~!I.~~~~~~'_.__Es~.l~[_M.[HL Division 01 commission (7ine mO) as. follow\: I II, :'1,1 I. I III 701."$ 1,;1';').1)11 to JAI'i: I;AjICilJ..:N I:I^J.TIII::; 702, $4;ni',.il(i to HI:^J.TY I-:XI,:UIJ'JI'I:S .. )()3.Conli1iliilori [laid at settlement 704, . 800 ITEMs' PAYABLE IN CONNECTION WITH LOAN. 801. Loan Origination lee . _ J''Yo "...I'Nt: ~~I)Hr(!~~:"....__....__u.___.._..._.. .. .LI!2).!}I) ....._. 802. loan oiscount .., ....... ~l.?;i o/.,.PW~~J()~I'0.\..c:J::..._____.__.___.___. _ I,,;g('-,WL..... . liOr-Appraisal Fce .,. ,. ,. to _.__.._...h._._.___._. . 804:- credi\~/ian:ArPLTC^'I'](IN..:=: to...__ _.._=::~:===-j.2.J.;_(i!2_..._..J'()~._____..._ 80S Lender's inspection ice ........ ....,._ ,__..._..__.___...___...___._.__.._._____ u .__.. ... 806: Morigage Insurance appllcation.fee to___.__.____.______...___.__..._.__._._.. .___ . 80("Ais'uniption fcc' .. ._._.......__..._... ._..._.. . 808 ~clilis/(i\tlitlh1hiK Exi'I~J.SS ~1^ U:-'::-I'NX' N()I(J'I;Al:i.; _ ._. _._"..__ ._.. _. _'l(J .ll!) . _ .. 809 XKtllX.tHI6H&.xiiip,H'iK_UIlC0~Ii-:NT f'Ri~I'AI{AtI()(._~_.I'Nc-fj()R'ii:^l:H._._ _. .__. ____ __. 25!'i.O() .. - 81O.uRI~tQ"WX -. T^Xf;EHYlgJ;~_"!~[\_~II~6NSMmLUcA__REAL..ESTATE..J'AX_SERY_._._.____70.00_ _..._.. -si l:i,UjOjj--(:I\i~.I'1i;.fc:^TI0N ... I'INN^CLE D^T^ SERVICES..- ry' ----1 900, ITEMS REQUIRED BY LENDER TO BE PAID IN AOVANCE. _____....._ 901.. Interest from 5/JIl/<J7 to 5/31/<J7 @ $ 2. 572f) !d~y ._.._..._..,..,...__.I,Z .15 - 902.-Mortgagelnsurance pienllu.nilo~~.-~__riiot.~~i;FiL:~0~EAITY==.::==.____.____ .____.LJJl!2.50. 903. Hazard Iniuianr.eprei1iiul11f.or__._Jr.s.:...~o___ ....___________._.__________.______. 9oCFiood Insurance--- --____yr::_to. ____.__ .__. __. _ ._ _._._______._____ ____ _ _ .._.. ___ . --905..--- .---... .--.. 1000. RESERVES DEPOSITED 'WITH LENDER n= 1001.. Hazard insurance 2 mo, @ $ 22. 'i9___E~r_I11.~.____.____..__._..~,~_.)ll__ ::;ilif';;::;:;;:'Wm::::iii: . f()02,-MortgagTinsurance7PHr-----.-.--.--j---iiio:@T---i;I;: 71 - per mo, Ij'Ll1 ;;;;;;;;,;;;;;;,;::;:;;:::;,::;::::;}:::::::: ..roo3-:CltY.Erop~!y.f~'~s==_=-=::_:::::'-:=--=:==. rii~-:-@ $-===Jl.~T~i:===- =-_ . - __:= V:::::;;;:@@:::;:;::+i: _J90<1~_Cou~~ .p~~Ee~!r. tax..es..._,__.__.____..J_._rTl~._~.L_3LQJ__.e~..rn~:........___ ._......lD2...1l.9-. ::::::}):;:::iNi++'W 1005, Annual assessments (Ma'!li:L.___..__rn~..(1Y.J___._._____.____P~~rno:..___ __ __ ::::i:i:i:i:i:iiii,:;:::::;:;;:;:~:;::,: [006,'Schooi' Properly faxes- 11 mo. @ $ f31 ':.KL__ per mo, ...9.1ill.....3Jl . :i;;:;:;:;:;;;;:;:;:;;;;:::::::;:;:;:;:;::::; :'}~~=~~~~~fJi~~:Jtr~ fax:,-:==__-==~~ ~ T-' --:".:-_.~:~*~:. --==-------=. ::I?:::::i;:;::;:,::<G::: 1669':--"-C:CR I~C:^'TE "SCHOI, ^Il, 1IIST~lFNT mo. @ $ per mo.------\'33B-:-(2)-. ;;:;;:;:;:::;:;:;;:;;:;:;:;:::::;:;:;:::::;::::: ..1100, TITLE CHARGES: 1101.. Settlement or closing fe~__ to ._.__. _._____ ___.___._. . .___ -no2'-'AiiStraCtOr-miesearch _. ---.~Tt~o-~.====--=--=---..-- ------ -- --- -..-----..--- .... . Ii 53:-fiiieexamlnation-- T15Cfiiiemsurancebinder to TJ6CooCumcnf prepaiaf[oii' to -Tj(jfi:"'Nolaijileiis to -niiCAiiorney'slees To io~l7in'TJnr;r;rm!.JiTI;1\sQUIRE -roc---.- __._____J.....__._..____,_._.~.__~.__ .,..--,.._..........--~_. . ---- - ".".mo'?r,r;t;':-o~.:.~,~,.,' ~,~.:,:i:.:.',.,.,_.;r.<:.;.:''7~:,. (r rlC Iud es a bo \'e I /e m S No,,' ::::::::::::;:;:;:;:;::::::::::::::,:::':::i:;::: ;::::::::::::::::::::::::'::::::::::::,:-'::": .Ii08.-Tltle--inslirarlce-----..-.----fo-LiITSll7\-nXI'OZZT;-TC~- --.-- -. ......'71;iO:.oci'.....'. ~.~.._._=..... !I ;~~;~d~~s~c~;~if=~b~~e!~msN:' -'$=--..JQ<J , SOO. 00 ~= ..=~ _____.' ~~ [!i;;!:!:i!!!!i;!!!'!~i;;i!i;~l; ~!!!i!i!!i;!;ii~\~;0.;:i:,.; 1110. Owner's coverage $ 118,000. 00 ::'::'::::::::::::::::i:'.'::::::::::::::::::::;:;: ::i:i:;::::::::::::::::;:;:;:i:i:;:i:i:i::::::: .. .l;U;"o;u",,",.~u;,,.u;,.'A~." .~_~u;o"&""A"~~ ,u... Ii ir:-tlCYaw:Kue"{---.i~iiOi~sEHEfftl00-.--.---.. _ ___________ _._25,1)0. ._____._.. "j 112.llas1ntlllOil~ - .m'JI5(iRSEf-mN'Y.:JOO-.------------ . ____________ ___2.:!,.QQ.. ...._______._ i 113~~Ks~Hg;,'i :tawi(X' ENlj[jR S i\~mNy8;T--------------.- 25 . 00 jj 14.------.----.-----------.-----....-----.--.-------------------...---- . 1200, GOVERNMENT RECORDING ANO TRANSFER CHARGES 1201.. Recording fees: Deed $ (i-:~~.ortgageJ..__.2.?...:.50 __..RBlease~__L_____.___._...______ __.____56,.QQ_. ___._.. 1202- Cily,lcountyia,!Stanips:. O~ed$. '. ......r.1~r!~a~.e..$__._.._____..__._._____..___ _....l,1.80,(J1L. ...-LJ80.UO... i20j'StaiiitaxiitampsDeed $ Mortgage $ ..._._..__........_._ .._____.___. _____.__.. j20(Tax CiiriiiiCates ....-- ... . .==-.==-=--=.:::~~=..::___..._.__.________.._.____..__ n.____.. 1205, . - 1300. ADDITIONAL SETTLEMENT CHARGES 1301.. Survey to ____. .._... ____ _ _ _ ._.__.. __ _' 1302, Pest inspection to - ]lousE H/Is'nm ---.--..---. -- - --- . . __._35.00_ j303MlERICAN IIllf-1i~ Slln~L!j-::'''iio~W IVARRAN'j'y------... - -.------.. ...---...."--.. ,,------.-- '1304SElVER--::-noRDUG1r'(jf'-TI"FIP'11IiXT-' ------.--.---- --------.-- ---.3.9.S..(](]__ . ._lQ...9JL ___-.-5.o..0CL -1305,-" -- ---..--"..------.-"-------.----.--.-----....-------.-------.....-.-...-- ~lDTAL SETTLEMENT CHARGES (ol1/ored ol1l1l1es 103, Sec/lon J and 502, Saclion K) rl30n (11" O/I1GJ rJt AI\.b.v-A. 6l,yt~ by .5tll~r qn~ f'6,QP ~~r{ 'h, C1)roC.~ cd.! . fe./ler J Estate of: Frances C. Hickey SS# 208-28-0621 01/01/1997 CONTINUATION SCHEDULE' Continuation of Schedule E ITEM # DESCRIPTION VALUE AT DATE OF DEATH 12 Ho~sehold goods, contents, 13,500.00 furniture and furnishings. 13 Harris Savings Bank, 10,000.00 Certificate #04-53-259018, balance at 0.0.0. 14 Harris Savings Bank, 10,000.00 Certificate #04-54-259022, balance at 0.0.0. 15 Harris Savings Bank, 10,000.00 Certificate #04-56-175553, balance at 0.0.0. 16 Harris Savings Bank, 10,000.00 Certificate #04-56-223916, balance at 0.0.0. 17 Harris Savings Bank, 10,000.00 Certificate #04-58-195113, balance at 0.0.0. 18 Jewelry. 900,00 19 Internal Revenue Service, 796.00 refund of 1996 federal inccme tax. 20 AARP, refund of unused 218.59 health insurance premium. 21 Hartford Insurance Co" 483.00 refund of unused auto insurance premium. 22 Patrick M. and Rebecca Kane, 238.18 refund of 1997 County & Bora Real Estate Taxes. 23 PatrIck M. and Rebecca Kane, 87.29 refund of 1996-97 School District Real Estate Tax. January 24, 1997 ~l;rlin F. M;;Caleb 219 E. Mlln Street" P.O. Bcx 230 ~nicsburg, PA 17055 The inror~lntion Hickey Estate Acoount Ilumber(~) Cll\5!l of /~ccount Dote Openae! f'rindpnl Ilnlnnce Accrued !n:crnnt Dalllnce n t Do te of Den th Account (Jwnerohi p !lame of Joint Owner, if any Dnte Ownnrshil' VI,lS tstnblir.hod Additional Infor- mation J(C'l)llot:tocl II} H;\E:~I!$- U S:\\ IN(JS h:\:\I\ Ilal11.- ,"'d\'ltll:' ()pl'l ;dHill' l'l'lltl'! !i:L~, \,>tt!J l:~th ;-;11\'l'l Lt'IIlII\'ll1', ]'l'll1h\-I\'<Ill1il I ':IJI:: 71; ;:n -11,11i i'17 '~:q .~I:Hl~~ Fa~ whi c 11 :'ou (!;odnl ~.ccount(o) of 208-28-0621 Frances ChMdlee reqlle~tad on tho SO~\lri tj' Humber is ns fo~lo\ln. 04-53-2590'18 04-54-259022 04- 56-17:;553 -- ----- 6 Mths. Ce.rt. 6 Mths. Cart. 1 Yr. Cart. .-- -- 1-19-95 8-19-94 5-25-90 -. $10,000.00 $10,000.00 $10,000.00 --- --- --- 10,000.00 10,000.00 10,000,00 Individual Wividual Wi vidual 1-19-95 8-19-94 5-25-90 Please have the Executor of this Estate sign the enclosE<l 1<-9 fom an::l retUlTl it to roo in the pravidE<l envelope. 'Il1ank you. ;'IH!(Jdl r- N n.J IJ'l - e, ;r I - .... - a' ~ ", .... ~~ .,' > 1::1 - " i,J LU r- :.~ '" .... :,;-; U - 0 o-l <t u - N C'l :I: a. ~ 9 " '" ~ II ~l~ t!; :5 ~ N C'l 0 - '" <Xl ... co ", '" LU... UJ!,lJ c>i , ~ '" (t. >- ... co co co c. .... 2 LUVl - " ..... \;1'" C1: ...J " ;"'1lJ u ..... Q... N "'''' z::> - n fij ~! ro <!> C'l '" '" '" 0 ~v; " ... ~ ..:Z ~NO co co co ... 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" ~ ~~ ~! ~>- ~~ t: 0 ~ w lJ ti ~:.'! ~~ 0 lJ U ,- !,;~ Q, iii: <l: ~ ::> :>~ ::> !,;gj '" g: g: g: 1<) /-;.3 BUREAU OF INDIVIDUAL TAXES INfllllllMH.f fAX IIIVI!llflN DIPI, ;'t10hOI IIMHlr~jllllf,'{;, I'll 1/1;'11 (l1l!)l " COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOtICl at INIIERIIMtf.r 'A>< APPRAISEMENT, ALlOWANtf O~ !ll:;ALlOWANC[ 01 OEDUCTlmlS ANIl A"ESSHEN1 III TAX DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN MARLIN R MCCALEB 219 E MAIN ST PO BOX 230 MECHANICS BURG ESQ 12-01-97 HICKEY 01-01~97 21 97-0029 CUMBERLAND 101 , > \~. "l .II'~ - , It!...,t ,_.tJ , i"I /" t t\1. ' A~9.,..':. W;w/.i. ...! ~\. r'~r.::. U'...i!lt~: tf~ .,'f' '1~J..'t~.,.-ti~k~ l" ""'- . ';i \,1 >. ". IH-',. FRANCES C C~~l ~____--l MAKE CHECK PAYABLE AND REMIT PAYMENT TOI REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ... RETAIN LOWER PORTION FOR YOUR RECORDS ..... rEV: g(,;" EY"A Fi'-- f 0';: 97rNoYicE --OF - i"NHEiii fA"N-CE" YA"X -IIPPRlii 5 Ej.;ENT ~""A i. i:6wA"N-C E - 'OR - - "_m_ -- - - - -""- DISAlLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF HICKEY FRANCES C FILE N(). 21 97-0029 ACN 101 DATE 12-01-97 APPROVED DEDUCTIONS AND EXEMPTIONS: q, Funeral Expensos/Adm, Costs/Misc. Expenses (Schedule HI 10, Debts/Mortgage LiabilitiB~/liBns (Schedule Il 11. Tohl Deductions 12, Net Valu. 01 1'8)( R.turn 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) 14, N.t ValUB of Esi.t. Subject to Tax PA 17055 TAX RETURN WAS, I X} ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTER~ST . SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIG1NAL RETURN 1. Real Estate [Schedule Al 2, Stacks and Bonds (Schedule Dl 3. Closely Held stock/Partnership Interest [Schedule Cl 4, Hortgages/Notfts Receivable (Schedule DJ 5. Cash/8ank Deposits/Hisc, Personal Property {Schedule El C. Jointly Owned Pro~erty [Schedule Fl 7. Transfers (Schedule G) 8. Total Assets NOTE: If an assessment was iS$ued previously, lines reflect figures that include the total of ALL ASSESSMENT OF TAX: 15. Amount of Line 14 16. Amount of line 14 17. Amoun't of line 14 18. Principal Tax Due at Spousal rat. taxable at lineal/Class A rat. taxable at Collateral/Class 8 rate TAX CREDITS: - P~YA;E~NT--r~-'-~~~EBI~T-"........... --0~3 -ZT=--9rt-----AAI852 99-'''''- ---,---~-----_. DISCOUNT If) INTEREST/PEN PAID I,} 2,987,57 · IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST, ~~_~,,~~_~_~_,,!i t,ted } CHANGED III 12 ) 131 14 ) 15 ) (0) 17 ) 118,000,00 20,155,62 ,00 ,.00 370,820,00 .00 ~ (8) (9) 110) 53,742,07 630,68 III ) 112 ) (13) 114) NOTE: To insure proper credit to your account, submit the upper pot'hon of this form wi ih your tax payment. 508,975,62 ~(,,37? 7~ 454,602.:..!!L 56,260,28 398,342,59 11" 15 and/or 16, 17 and 18 will returns assessed to date. 115 ) 110) 1171 ,00 X ,00... ,00X,06. 398,342,58 X ,15. 118 ) __~~~~~~c PAID '""1 60 ,00 O'~'OO-I I B'~~f~~_~T~; ~:~~~~~-~F~-=-- 6~: :,:~":~;:~ ~:NT~~~~~_:L A~~-EP~N'..I...:"~=~'.2,3,~~ ~ :cd IF TOTAL DUE IS LESS TItAN II, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REfUCTEU AS A "CREon" feR}. 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