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Home My WebLink About81-00057 No. 21-81 PETITION FOR PROBATE OF WILL AND LETTERS TESTAMENTARY r-.-' ..> ( '--'-. In the Estate of Samuel D. Herzog ,deceased. '-mri!ll:1\lst~ Ji\w~tk'th~1tt-rity ~f Cumberland, In the Commonwealth of Pennsylvania. Petllioner(s) Is (are) the execut or named in the Last Will and Testament of Samuel D. Herzog dated June 20. 1979 Decedent was a citizen of the United States and a resident of Lower Allen Township (Borough), Cumberland County, Commonwealth of Pennsylvania. Decedent died on Monday the J2..!;.Lday of January A.D.19~, In the County of Dauphin ,State of Pennsyl van:i.lllhe age of 1..2...- years. Decedentlf1ID! (has not) been married and{f(;H; (has not) had children born to him ~ since the ex- ecution of the above described Will. Decedent was possessed of personal property to the value of $15 000.00 and of real estate to the value of -S3~, 000 00 as near as can be ascertained; said real estate situated as follows 2930 MorninEsi de Drive, Low"r All pn Townsnip, r.Rmp Hi 11 ,-E'.enl1syl vRni R (Cumn",.] Rnd COl1nty) Therefore, your petltioner(s) respectfully apply(ies) for the probate of the said Last Will and Testa- ment and for Letters Testamentary theron. Dated January 19. 1981 ~ c-, b,,~ Craig C. Dunn, Trust Officer Name and address of Petltloner(s) CCNB Bank, N.A. 21st and Market Streets Camp Hill, Pennsylvania 17011 COMMONWEALTH OF PENNSYLVANIA l COUNTY OF CUMBERLAND j Craig C. Dunn ss named in above application, being duly sworn statements set forth in this petition are true to the best of ~ccording to law say(s) that the h~s Imowledge and belief. Sworn and subscribed before j -(;7 i''j · me~Ja_uarY. 19,____ 19~ .e,~ 'J - - - fddq-- ,~_ tt eglster A {:) u...bl..-1A-- 0".u:f C!. -- ~ - -- ---- -------~----~-~--- Filed: January 27, 1981 Attorney J~J JI, AIfI1~(.,/)~ If'J if. i (-IS . :~ ..-::? /-/1;- 5,/ 1/ -;J'4-,l... . . . " CO""o."""" 0< 'E""""'''''''\ OF C~~B~R~~P) SS. nal1le i.s si.gned. the testator .whOS~en d.ul~ qual i.- 1 ,,,,OE" 0, ....00, . ",.""",,0" .,.'0' · 'oed ,od to "',' ,..",..d 0' fO'.~~""" '0'''''.'.''. th,,;~ o~~'" .,n- f,ed ,ooo,dio, ";,~~, " "" ",.' .i'" ~~~,~..~ ,0' fO' tn. e~ecuted. the ~ns 'gned. i.t as m~ free an . 1.. and. that 1 s~ ~ng ~, therei.n e~yressed.. yuryoses ff'rfC\ed to and. Sworn or a ~ J1'~;' ~~:19.12-' of CO~~T'i ac~nowleaged. 'pefor~~~' ~l~ da~ the testat or ;;;.-- N\' ,~\l;'\"';1l':;,\,'J Cul\\\" ~ co"""''''''' 0< ,,,",,,"'''''''\ 55, 0" c~~~ro..l>.~P) CO\J~T'i " ' . d J.t..~.Jbe'-'J "-,,. C. 1>"". ,., c....o, fo,.,oio' .., ". und."too.d, ". ,I',o.d to ... ,,- "" ...... ..d ",. .i"..... ~.o,~ ~...~""ifi.d ,ooo,dio' to '':''0 ..d ...00" . .,_0" '.'''' 0' d ,,,, ",. ...",00 , ':." "",,, ..'. .,;.,,';.,;.~ "ll' """ ,,,,OE" 0, ....O...outed " ",. ,0>,_0' 0> " , "..""',, 0, ....00 ."iO ..."".d' ."oed .,llio'" ~d 'e.~, "" fO' "'. pUcP"','';,,';' ,,,..,0' .i""" " .i' f'" ,od .~ "" . ...,in' "d "", 0 oU' '0"""'" '.l" th., "0' of ~, ,0 ~ ,od "", ,0 tn. .." o~ "eo of .ouod ",cd tn. .", .. .,'o""~',,," " 0' mo,. ".".0 ..,ta"" ..," th'. ,0' ""du' ioflueo"" and under nO constx:a~n C-.'b' " ~ saJIt&. .,.V1$Y A1'f\"'"':'''is''''f u.," "" ...... ...... uo"............- ,10" \' (. I \:\", ~ \ 1 ,',1'\ i l.I\,:;"" ,," ' COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND 5S: crJligC._ D_\lnl1.M.sJst.ant Vlc~J'r"sident & Trll~t OfJlc~.l'-,.C.C~B_.BA~!<,_N-d~L.-' being duly _._.swo.rn.--. _._ ___ according to law, deposes and says that hl1 .on-behalLoL_CCNll.Jlalllc... ::.A. .!~ _~~".=-'c'!~_____________ __ _ ,,' of the Estate of Samuel D. Herzog --- late of Lower Allen Township , Cumberland County, Po., decoased and thot the 'th" . t d b Craig C Du th 'd~" w, In IS an ,nven ory ma e y._ _' ..._,' __ '.' . lUL___ ...- - ------.--, e .a' _......ecutoJ:---- of the entire e.tate of .aid decedent, consisting of all the personal proporty and real estate. except real e.tate outside the Commonwealth of Pennsylvania, and that the figures oppo.ite each item of the Inventory repre.ent it'. fair value a. of the date of decedent's death. CCNB Bank. N.A. By: ~::.j. c:: ,b"..r'-Assistant Vice President ---- -E~"utor x"'iImilIMl'iI~ 1< Ti'iISlOOfficer a ,bA ; C -/ I ~f' tJ /] .41/&','" ,./ ..d ..b."'b, d b,I." m', \ 19 _.ti....- ~:~ -~-----------"-------'_. 2101 Market Street '-- <)'c, ,..-o.-"..A"'\. .,. ,.c;,amp.Jl.ill. PA 17011 AddulI ,I' ~.- ""i., l~.i.t: ;. ,')':f,' Date of Death ~~_________._------ Jan~ary Day Month 1981 Year n ~r.; INSTRUCTIONS ~~ OJ I. An inventory must be filed within three months after appointment of personal representati'!];p ._..0 2. A supplement inventory mu.t be filed within thirty days of discovery of addition.1 assets. '" ~i .... 3. Additional .heet. may be attached as to personalty or realty ;::;:~ .-~ (.,'! 4. See Article IV, Fiduciaries Act of 1949. -' '2 .,.... r ~. i 03 ,,,,'" ~ i,,1""1 ".,g "'" ;;;::0 ;g ~a .t'.r~ Vol ';:9 0 ,';J "'1 :<> .:'") "" .-~ ~ -.: \ OJ ... \ 'M ~ P- er \ lJ) 'M I" >- .c ,; 1 lJ) m . ~ UJ " ~ '" ~ I- :> ~ ..; w 0( 0 m 0 Q, l- E-< u " 0 0 Vl m m UJ C g'~ >- I'- '" UJ " m '" I- :I: Q, OJ Q, c I Z I- -' u.. ..; ~ ~ .-< -' 0( 0 0 :;!I Q, :.: 0 <Xl I w u.. 0( w '" :l: I > 0 '" ~ .;. 0( .-< ,\ Z - lJ) N Z 0 ... c OJ II C OJ ~ @ 0 I' Vl z :> 0 '" 9 .3 u ..., z 1\ UJ <{ .... Q, -0 aJ c - ~ \ " 0 m @ -" -" ~ E -0 Ul - ~ 0 I ~ ~ 0 -' U u: '" COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND l J 55: _Cr.aig_C~Dunl1-,__Assiatant.-VlcQ-l'rce8ldent. &. '['rlls t Of+lcefL,-CCNB.JlANK..,Jl.A._-_.-.- --......-- being duly ~'.'o~n----- according 10 I.w, doposes and says that he _..-U1L.b.chalL.o.L.CCNB-.Bank.,Jl.A. is Executor .__..,_ _""_ of the Eslate of Samuel D. Herzog lale of ___.Low"lcAllen .Township .._ _.____, Cumberland Counly, Pa., deceased .nd Ih.t Ihe within is an inventory mado by ___Craig_C._.Ounn_--~. ._-- -.--" the said 'Rv('>("IIt-nr of the entire estata of s.id decedenl, consisting of alllhe personal prop.rly and re.1 eslate. except real est.te outside the Commonwealth of Pennsylvania, and Ihat the figures opposite each item of the Inventory represent it's fair value as of the date of decedenl's death. CCNB BANK, N. A. ~~MY1~ and subscribed before me, By: Cw.:.q c!.. b~ Assistant Vice President T Exmto. . ~m\t;l.(4tR'l< & (rus t Of flcer (0 A'x:;:-..L 't. q 19 ';{ ( '(J j~ (J....II? <' .-' .' YHYlllS J. Rts:, No"'Y 'ublic Camp Hill, Cumberlilnd County, Pa. My Commission Expires Julr S. 1985 JLO. Box JOR Camp Hill, PA 17011 Address Day January Month 1981 Date of Death 12 Year INSTRUCTIONS I. An inventory must be filed within three months after appointment of persan.1 representative. 2. A supplement inventory must be filed wilhin thirly days of discovery of additional a..ets. 3. Additional sheets may be attached as to personalty or realty 4. See Article IV, Fiduciaries Act of 1949. <> ,.- C"")r" ~S~. -n' ':uS:~ ,-::?:. '(~ "....L': cO "':x> ~ ...,~ c::> ~:?o t./'!?J ..:'? jl'.:' --< ,,-..... I :71::,1 '-C "; -0 ;,. , r::. '" .~ .c Ul .,; >- ~ ~ I- W ~ ~ '" < ~ w fo< " 0.. I- u 0 0 " " 0 Vl C '" >- W '" W ~ .. .. ..... I- J: 0.. .-< 0.. c '" I- ..J L1. .-< ~ ~ I Z <( 0 <: 0.. 0 L1. ..J :l: .... w 0 <( W .;.. <( 00 > '" ; ... .!. z ~ ~ Z 0 ~ C C " N. Vl Z 0 0 '" ~ '" U Z w <( ... 0.. ." c ~ - ~ -.: 0 " <1\ ..0 "'" "\ .e E ." ~ 0 I .. " 0 , ..J U Ii: '" COMMONWEALTH OF PENNSYLVANIA OEPARTMENT OF REVENUE BUREAU OF EXAMINATION OFFICIAL NOTICE OF INHERITANCE TAX ASSESSMENT *' DATE .;' (,I ,~,.' /:'/ ESTATE "", ., FILE NO. I. ,I. / ';' I i)'7i-- / /j .' '. COUNTY n , / , ' ; ,.-. ( , 1.'1 .-/),11....'''' ..(.,- DATE OF DEATH ./ ,;,/ / Appraised Value of Estate: Real ESlate Personal Property G '" . ".-' '.--r , , .; I + ., , + ,,) '/,. s; /, ~. I / , i, Jointly Held PropertylTransfers Total Gross Estate Total Approved Deductions Claar Value of Estate $ I i, ~/ il/';:' L' >~ Less: Approved Charitable Exemptions "-.--'---'- Clear Value of Estate Subject to Tax $ ,( ''/ ('j i/ j.,. ,.: _ Amount Taxable @ 6% Rate s tax due s Amount Taxable @ 15% Rate /f/ ,/./~;. , ,. tax due ;! . /,./ 'i'/' . )(! / . TOTAL PENNSYLVANIA INHERITANCE TAX DUE $ ~/Il , ,/,/.1 ;Ie! , * * * .. .. .. A five percent discount totaling $; will be granted if the Inheritance Tax is paid by Less Credits: DATE OF PAYMENT AMOUNT PAID OISCOUNT INTEREST TAX CREDIT iL'i.r) I,) .. il.. 71 , s !:<'/,'.:/.: + $//, , $ = $ ,'.' /;~.' (c 1'/ ",' 1\ + = ,II: I I 1....1.../. + = Interest accrues al the rate of six (6) percent per annum on the unpaid balance of Inheritance Tax from to data of payment. Interest due if paid by is BALANCE OF PENNSYLVANIA INHERITANCE TAX DUE G .f.'; r J "~ ./;//1. ~ Assessed by: // /, . . ( I f (/ See Information on Reverse Side Agent for thl Com ~'Ith , i/':- , , ''j 'c. \.>. '.",i " I :l:I.: ':.\ HEV.jI1!l r>< I (J.flOI COMMONW~ALTH OF PENNSVLVANIA DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "F" STATEMENT OF DEBTS AND DEDUCTIONS -.----~ .-..-._'~:.::;..~..",,--,_,_:_,.~.-.;....o."-.=_, Estate or__Sllmuw......u..-llc.J:zo~ Date of Demh........l/:..l4DU_Fi1e No,_ll::..8.l..::.l7 WHEN CLAIMING THE FAMILY EXEMPTION, COMPLETE THE FOLLOWING: Cleimant CCNB BANK. N. A. Relationship to Decedent Executor Claimant's Address POBox lOR ('nm" Hill P^ 17011 ITEM NO. DATE NAME OF PA VH BEMARKS AMOUNT .Br.>11ofPA -Xr'l5lt:Qn'c fe e <;lR<; .~tflt"P. J.lnm"', Tn" Ji'l"",..t"r;f> Ol">r17'C'(> !-I"\ l_?()_Al J.W.Mumer r p Richard McGee Richard McGee p W-8l--- Gim Tax Planni?c Se~VimAL THIS PAGE I hereby certify that to the best of my knowledge and belief the foregoing is ~ofu~gga true statement of debts, funeral expenses and expenses of administration submitted to the estate as deductions for Inheritance Tax purposes. SIGNATURF OF ATTORNEV/FIDUCIARY DATE OFFICIAL USE ONLY DEBTS AND DEDUCTIONS ARE ALLOWED IN THE SUM OF S /0, /r~7 '7, t 5- AT , 1'7- PERCENT. //-;0-;'/ DATE GENERAL INHERITANCE TAX INFORMATION ., Unsatislied liabilities incurred bV the decedent prior to his/her death are deductible against his/her taxable estate. In addition to debts incurred by the decedent or estate, otller items are claimable including the cost of administration, attorney lees, fiduciarv fees, luneral and burial expenses including the cost of a burial lot. tomhstone or grave marker. All debts being claimed against on estate ore subject to the approval 01 the Register of Wills with whom the Inheritance Tax Return is filed, Evidence to support the decedent's or tile estate's liability for the debts being claimed should be attached to this schedule. A family exemption of 82,000 Olav be claimed by a spouse of a decedent who died domiciled in Pennsylvania. If there is no spouse, or if the spouse has forfeited his/her rights, then anv child of the decedent who is a member of the same household can claim the exemption. In the event there is no such spouse or child, the exemption cen be claimed by a parent or parents who are members 01 the same household as the decedent. Tile lamilv exemption is allowable only against assets which pass by a will or by the Pennsylvania Intestate Laws. C "C " n > m ~ ~ > 0 0 " Vl Z C'l n c:: " -I Z 3: z t"" '" m ;<: z > 9 9 t"" :;:l -I ~ Z Z '" -I tT1 9 P -I -< Vl m Vl 0 Vl Z 0 .., 0 ." ." :>:I ~ ~ 0 - ." 0 ." - Z n - >- t"" c:: Vl tT1 0 Z -< .< ~ tT1 tT1 ~ > > :>:I :;:l INSTRUCTIONS FOR COMPLETING SCHEDULE "F" 1. If the family exemption is being claimed, indicate the claimant's name. address and his/her relationship to the decedent. Enter "family exemption" in the remarks column and the amount claimed in the amount column. 2. Assign consecutive numbers to each item listed. 3. Enter the date on which each debt was incurred and/or paid. 4. Enter the names of each payee. 5. Provide a briel explanation in the remarks column for each debt claimed. 6. Enter the amount of each debt being claimed. 7. The form must be signed by the person who has assumed the responsibility for paying the debts. - -. - - .-- -.. _.:==..,-.,,'"'-'=:.:---~~~~......-"-" ~ . , , ~'" \ 'IH!V.4~~ fXt (:J.!I0) COMMONWEALTtI OF PENNSYLVANIA OEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "F" STATEMENT OF DEBTS AND DEDUCTIONS Estate of Samuel D. Herzog Date 01 Deatll-1L!1JJH____File No, 21-81-57 WHEN CLAIMING THE FAMILY EXEMPTION. COMPLETE THE FOLLOWING: Claimant CCNB Bank, N. A. Relationship to Decedent Executor Claimant's,l\ddress P.O. Box 308, Camp Hill, Pa. t7011 ITEM DATE NAME OF PA VEE NO. 22. 5-22-8t PA. Power & Li ht Co. 23. 5-28-81 Richard HcGee 24. 6-2-81 James K. Arnold Es uire REMARKS AMOUNT Electric service to 5-18-81 L>lwn maJnt.e E' te'g n 25. 6-2-81 James K. Arnold lis uire 26. 6-4-81 Wildeman & Obrock CPA's 27. 6-8-81 PA. Power & Light Co. 28. 6-15-81 Riverton Consolidated Water Co. 29. 7-3-81 Loucas C. Tzanis H.D. 30. Re ister of Wills & Tw . taxes due R E ur haser Settlement costs on sa e of real est Fee for relaration of 1980 Federal & State Personal & Fiduciar returns Final bill for e e ri Fi a ~ Pr f Fees for fll ino RCC Debts & Deductions 31. 32. 33. Arnold Slike & Ba Ie CCNB Bank. N .A. Wildeman & Obrock CPA's Attar e i Reserve for re aration of Federal & State Fiduciar income tax returns Filin fees registered mail costs, notar fees, etc. TOTAL 200.00 $10,577.05 TOTAL THIS PAGE I- I hereby certify that to the best of my knowledge and belief the foregoing is a just and true statement of debts, funeral expenses and expenses of administration submittedJnihe..est"te as nedu ions for Inherittrnce.Tax IlJJrBoses. " t t CCNB tianK, N.A., xecutor ot 18 :::iamuel . tierzog c.S a e B . C/ . c.. . 1i"'M'l.-- Trust Officer 10/5/81 Y SIGN URE OF ATTormr::VjFIDUC1ARY DATE OFFICIAL USE ONLY DEBTS AND DEDUCTIONS ARE ALLOWED IN THE SUM OF S / b !> f) 1.0 r; AT Ii) PE RCENT, ," /I-Jo-SI DATE LS GENERAL INHERITANCE TAX INFORMATION Unsatisfied liabilities incurred IJV the decedent prior to his/her death arc deductible against his/her taxable estate. In addition to debts incurred by tile decedent or estate, other items arc ciaimable including the cost of administration, attorney fees, fiduciarv fees, funeral and burial exp~nses including the cost of a bl.lriallot, tomhstone or grave marker. All debts bein[) claimed against an estate are subject to the approval of the Re[)ister of Wills with whom the Inheritance Tax Return is filed, Evidence to support the decedent's or the estate's liability for the debts being claimed should be attached to this schedule, A familv exemption of 82,000 may be claimed by a spouse of a decedent who died domiciled in Pennsylvania, If there is no spouse, or if the spouse has forfeited his/her rights. then any child of the decedent who is a member of the same household can claim the exemption. In the event there is no such spouse or child, the exemption can be claimed bV a parent or parents who are members of the same household as tile decedent. The family exemption is aliowable onlv against assets which pass bV a will or by the Pennsvlvania Intestate Laws. r ." " n > tn > ~ Z > 0 0 " ~ 1:1 C'l n c: " z :::: z t'" '" > ~ ~ t'" tn ~ Z '" - Z % tn ..., tn ..., Z ~ ..., -< tn - ~ rJl '" Z 0 '" :2 ..., ~ '"I1 ., '" ~ ~ 0 - ." ,. 0 ." .. ~ Z n ~ . > '" r' c: G. '" c.: I tn l...:~.' 0 l.:~' - c..: Z cr.\.": c:: ;:~~: o- r' (.J~ LU"" .... ~.J -< -< -< 0::0:: 1i:i ~c::) tn tn ~ <.; > > '" '" INSTRUCTIONS FOR COMPLETING SCHEDULE "F" 1. If the familv exemption is being claimed. indicate the claimant's name, address and his/her relationship to the decedent. Enter "family exemption" in the remarks column and the amount claimed in the amount column. 2. Assign consecutive numbers to each item listed. 3. Enter the date on which each debt was incurred and/or paid. 4. Enter the names of each payee. 5. Provide a brief explanation in the remarks column for each debt claimed. 6. Enter the amount of each debt being claimed. 7. The form must be signed by the person who has assumed the responsibility for paving the debts. .". '"'. REV....ll EX+ (ll-flO) COMMONWEAL TH OF PENNSVLVANI~ OEP~RTMENT OF REVENUE TRANSFER INHERITANCE TAX RESlaENT aECEaENT or. ~,,~ 'It. i1E'J i[I1;" !,(~ .'. - ' ~1~@ STATEMENT OF FIDUCIARY (Instruction. on Ro.o..o Sid.) Estate 01 Snmue1 D. Herzog Do te 01 Dea th Jnnunrv 12. 1981 Lost Address 2930 Norningside Drive Social Security No. 172-09-1929 Cnmp Hill. PA 17011 State Fi I e No. 21-81-57 IClTYI (5TA TEl (liP) County File No. ?1-~1-57 I. Decedent died: ( ) Intestate (without 0 will) ( X) Testate (leaving 0 lost will--capy attached) 2. Is the liling 01 0 Federal Estate Tax Return required lor this estate? Yes_ No x 3. ( X) Executor ) Administrator Nome CCNB BANK, N .A. Social Security No. 23-1280778 Address P.O. Box 308 r..mp HiT' Ph (CITY) (STATE) '7OTf lZIPI 4. All correspondence should be moiled to ( ) Attorney (X ) Fiduci ary. S. 1/ on attorney is representing the estate, indicate: Nome James K. Arnold. Esoui re Telephone No. 737-3405 Address 2109 Market Street r!:lm~ lH" p^ (CITY . (STATE) P?~~I List 011 sole deposit boxes registered in the decedent's individual namehar jointly with, or os on agent or deputy 01 another, or in decedent's individual nome with right 01 access by anat er os agent or deputy. Include the nome and address 01 the bonk or other institution where the safe deposit box is located, the nome (s) in which the box is registered and the relationship 01 the joint holders to the decedent. NAME AND ADDRESS OF BANK OR OTHER INSTITUTION IN WHICH DECEDENT MAINTAINED A SAFE DEPOSIT BOX NAME OR NAMES IN WHICH SAFE DEPOSIT BOX 15 REGISTERED RELATIONSHIP OF JOINT HOLaERs TO DECEaENT CCNB BANK, N.A. Samue1D, Herza Camp Hill Shopping Center Cam Hill, PA 17011 Under pen"alties 01 perjury, I declare that I hove examined this retum, including accompanying schedules and statements, and to the best of my knowledge and beliel it is true, correct and complete. CCNB Bank, N.A., Executor of the Saml1~ D.. Herzo,," Estate Bv: {~-<'-<-1 C. .1..)~Trl1.~t Officer 10/5/81 sIGNAT"RE Of FIDUCIARY aATE HUD.' UNIFORM SETTLEMENT 5T ATEMENT IOHM AI'I'IIOV-O Hue., R"....5176 OMO. NO. 6J'A.1!iOl " , .----.----.--- ---- " A. B. TyrE OF LOAN U.S. DEPARTMENT OF HOUSING AND UrmAN DEVELOPMENT ____________ __________n____________ --.---- 1. Ol'lj" 2_ OrmHf( 3_ D CONV UNINS ,SETTLEMENT 5T ATEMENT 4_ OVA 5_ ~CONV H<S __.___ - ___o__-_----_---.--j_----___.. --- ------------- 6. File Numbel: 7. I.oiln Numbcr: -~..- --_.._...._--.~._---_._-- -~- --- 1401-Paglt 1 ALL.STA.l[ L(,GAl SUPPLY CO" ;>69 Slll'H'l'ld ~;t '''ounu'll,ulr, N J 0109? e. MOrlgagc InSUfilnCl.' Case Nurnbcr: --~---'~" - -_..------ ,--- .'--- _..__.._.__ _________------n--------. C. NOTE: This (orm is furnished 10 give you a sr:Jt/..'flwllt of ;JeW;ll suttlaflwnr costs. Amounts paid to and by tIll! settlement agent arc shown. Items mcukcd "(p.o.c.)" weft! {laid outsid(.' tilt! closing; they aft.' shownlwre for inf(}(IIlJtionaf purposes and c1ra not includL'd in the to tals. -- ...-----.---.-----.. .-._..- - 0_ no -- - - . -- -.- ---_.._~ -..-.- ....~..--_...-..~._.-- ...--- O. NAME OF BORROWER: E. NAME OF srLLER: r. NAME or lENDER: ..)E/?..ey r. /1Ct:oputt'u.. oJ. ccv(J (J,(IV,f. ,u.4. ;),ftl?/lI,v Ptf"j>~JI/ ,SVJ /I.l.l C. j?€TcI(JoA) E),'eC/hl.J/( OP W? .&~I " 71?VdI cp,HNPY E,!,1#% or MHt/Ct.. ./). l/~f206'. Pee. ._-~---_._----~..- ..___.. ___.__._n ...~_____._ ..---'- --- ---- ---.-' ._~_.~..._-- .._- G. PROPERTY LOCATION: Ii. $[ li!.EMENT AGENT: L SETTLEMENT DATE: .2?JO HMU/LJ6ctItl!; IAf;Vt;" J~II1,:;J ~ ~,e.vtfc.~ 5.J(1.. Wu/.1f'I? ,f~'v /4 _......_ ._ .__u__.'" --- --_._----~.---_._-_._.._._._-_.._--- JtlP'~ ~ /9,?/ PLACE OF SElTLEMENT: ~N/ ;fILLI ~ c;l-It//? /I/L-c., ~ J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION 100. GROSS AMOUNT DUE FROM BORROWER: 400. GROSS AMOUNT OUE TO SELLER: 101. Contract sales price _~Cbo. - 401. Contract sales price 7t' 000. - -----_.._~ 102. Personal propertY 402. Personal property 0 103. Settlement charges to borrower (line 1400) 1~~'1'1.' 7.. 403. - 104. 404. 105. -- 405_ Adjustments (or items paid by seller in advance Adjustments for items paid by seller in advance 106. City/town taxes ----- 1---- _ to 406. C'ly/lOwn ta~~ to - 107. County taxes to ~. Coun!v taxes to - 108. Assessments to 408. Assessments to 109. . "r':#4I7L- 77' r.7;ii)tU -- JL25_ 409. Jc;tPp~X&,f, -r~ bJ.Jo/fJl 31.7k 110. .Jr:ult:/! rb . -- /7.9r ~. ~IL.5II.~J.{IJ/~ /0 ~. /7.9,)" 111. 411. 112. 412. 120. GROSS AMOUNT DUE '1117 'Ii. 'It. 420. GROSS AMOUNT DUE f~ 0'19.73 -- FROM BORROWER TO SELLER 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER: 201. Deposit or earnest money 4. (70<1. - 501. Excess deposit (see instructions) 'I "'Ol!>. - 202. Principal amount of new loan(s) _ ,,2~E~ 502. Settlement char~es 10 seller (/in. 1400) I.;',>/.,ro 203. Existing loan(s) taken subject to 503. Existing loan(sl taken ~ubjcct to . - 204. 504. Payoff of first mortgage loan 205. - 505. Payoff of second.mortgage loan 206. 506. - ------- ----.--- 207. ._--~.- 507. 208. 508. - 209. ._m______ 509. Adjustments for irems unpaid by seller Adjustments for items unpaid by seller I 210. City/town taxes to ..-. ~. Cilyltawn taxes to 211. County taxes to _ __n_'__ 511. Countv taxes to 212. Assessments to -------- 512. Assessments to 213. /98/ CJ1. ~ rlJ/fi .z2I/~.s -_.---- 513.17151 CP. "/,w./: ~~J 214. Tl? (,;IJl):~ . _nJ6,...!.If_ 514.____L&!.-#j)l; 1- 3C../'I 215. - ------- 515. 216. 516. 217. . -------- 517. - 218. 518. ---- 219. 519. - -- 220. TOTAL PAID BYIFOR '-/(1, OJ 6.1 Y 520. TOTAL REDUCTION AMOUNT s: 2.8 7. G'I BORROWER DUE SELLER 300. CASH AT SETTLEMENT FROM{TO BORROWER 600. CASH AT SETTLEMENT TO/FROM SELLER - . - - ---.,.--- --- --- 301. Gross amount due from borrower (line 120J 'II, 7'1'1.1J t 601. GfOSS amount due to seller (line 420) '1"1 0'19.73 . -"'--"-'. -- ---------=-- - 302. less amounts paid by/for borrower (line 270; ''!PI {J 36.141 602_ Less reductions in amount due seller (line 520) l.s;].n~'i I 1------ 303 CASH C;8i:(ROMIIOTOI BORROWER /170~.3'1. 603_ CASH (,j:::j:TOI (0 FROM) SELLER 30//7f:,2.I?7 .--~ -' - I L. SETTLEMENT CHARGES TOTAL SALES{BROKER'S COMMISSION b.scd on price $ I/tJ,ClOd @ 2. " ' . " %=' ~C;O._ PAID FROM DOIIRDWER'S FUNDS AT SETTLEMENT PAID FROM SELLER'S FUNDS AT SETTLEMENT ___~O. - - .---.-----.-.-.-...----------.---.-.-- Division of Commission (line 700) ;J5 (ollows: 701. $------ -...---------t~ ~---------..-.-.--+- .--.--.----..--.-.-. ----. -70i$-~oii.---, -===:-tor:id~~~c:,;Ji7jji.k 703. Con!rni!.sion_[~_i.q __~1.~ttlcmcnJ____.,___ _____.__.~____~.___.. 704, 800. ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Origination Fcc __'jo___!l?J!PtII.'!_~lffJJyLL .._ 802. Loan Discount % 803, Appraisal Fee:=.==:=:~-<<>..__tiPi!pliiiJl)21)jjJlr.---n-- . 804. Credit Report ..____._ __.-'0_____, ,. - ,.. .. - 805._Lender's Inspection Fee .._____________ _____ _______ 806, Mortgage Insurance Application Fee to 807, Assumption_ Fe~::-_-:-:"-'::"--=::::--'=::'=: ,. 808. 809, 810. 811. gOO, ITEMS REOUI RED BY LENDER TO BE PAID IN ADVANCE gal. Interest from to _..i'~_n_,----_{daY_---n .-----.....----- --.-- 902. Mortgage Insurance Premium for months to _______.____.____ ------.-- 903. Hazard Insurance Premium for .y'ears !.Q.__.,~_+________~_._______ --.- 904. --years to 905. 1000. 1001. 1002. 1003. 1004. 1005. 1006. 1007. 1008. 1100. TITLE CHARGES 1101. Settlement or closing fee to 1102. Abstract or title search to 1103. Title examination to 1104. Title insurance binder to 1105. Document preparation to 1106. Notary fees to 1107. Allomey's fees to (includes above items numbers: , l00.-=ritle insurance to . (includes above items numbers: 1109. Lender's coverage $ 1110. Owner's coverage $ 1111. .!X;5D PRt;f'Ii~lfnop 7'<7 /U'pt1~a cS'-IA!~"' ~q 1112.' 1113. 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recording fees: Deed $ 16. - ; Mortgage $ 9. - ; Releases $ 1202. Cit Icountv tax{stamps: Deed $ "ItJ17. - ; M2!!!l!!ge $ 1203. State tax{stamps: Deed $J?"- - ; Martqi!B~ ------ 1204. -------- ---- 1205. 1300. ADDITIONAL SETTLEMENT CHARGES 1301. Survey to 1302. Pest inspection to 1303. Ii!! CP. ~ r~t:.__ mA'/!'~______.__._____.._______ I ::::. TOTAL SETTLEMENT CHARGES (ellIe, all lilies 103, Secrion J alld 502. seCli~~-::-'---- -.----------- -- - _______Y'Cl'-=__ ------- __, . '705:...-:,.__. ... .. j (j.o..-:-c . ._-------------~-'_. -- -------- RESERVES DEPOSITED WITH LENDER Hazard insurance ______, months @..Ji ___P_~! m.9_nth Mortgage insurance _____1 months @ $ per month City property taxes ... CD. '-/ months @ $ 'per month Goo<Hy propertv taxes r6C/f(IO(... II months @ $ ____,_PEr month Annual assessments months @ $ . per month months @ $ per month months@ $ per month months @ $ r month /J.f.</r;t./) JLJKtZ.. &1Y.fLo/: .soRt> ;<PI?T.. ~ . 't!'E/.) n/.b. ,jLIICE v MX.t..6V . 11"1 " /ltJ2 IJ&/,M:-r M,ut) #~oCl..m;~. 133.S0 _. so.. 1/0<7.- . I/Ot;'. 8~.7 On . 19 . the undersigned acknowledge receipt of a copy 01 this Statement. approve the same and authorize the disbursement of the funds to the payees named therein. 1jr c.c. . .....__..__..__......,. .,~.&"__.......,,................., Seller . V.4~~ 2e....;., I~ ...lvAL1Ll-...C.....fJ~... Borrower ........................... .................. ,...""""".."."""",. Seller r (70;~:5:9kL,,,,,.--,,,,, Borrower ~}..'k. ...._..;.....'...c_'"-i.;.~...~.~.-'-t~-,._ .........-.....-., ...-~) -....... , . ,. I ". ' f 'II "or CCI'JEJ. MAIN OFFICE JJl BRIDGE STREET NlW CUMHEH LAND, PeNNSYLVANIA 17070 {71/} 774:"1d06 CCNBBANK,N.A. ., . 1 2 3 ,. Checkinq Accoun ts: Number 390-256-6 Date Opened 02/08/63 Balance at Date of Death -.S233.82 Name of Joint Owner, if any None Savinqs Accounts: 1 2 3 Number. 'None Date Opened I , Balance at Date of Death Name of, Joint Owner, if any Certificates of DeRos it: 1 2 3 Number None Date Value at Date of .Death Name of Joint Owner, if any Maturity Date Interest Rate interest Paid Quarterly, Semi-linnua 1, etc. Debts: None - Others: ct:.:': ~ '.::K ::. A.. C:..~.~fI Hl1...L. PAt 'Estate of Samuel D. Herzoq .Date of Death: 01/12/81 Name of Ban Association ,{~ ' , . ~, Signat :e'of Bank of Savings Association Official QUESTIONS CONCERNING PROPERTY TRANSFERS 1. Did decedent, within two years of death, make any transfer of any material part of his eslate without reccivlnp, valuable and adequate consideration? (Answer "Yes" or "No",) No 2. Did decedent, within two years of death, transfer property from himself' herse.1f to himself/herself and 01;1011'"-1 party or parties (including a spouse) in joint ownership? (Answel "Ves" or "No".) .~ 3. If the answer to one or two above is "Yes" and the transfers me claimed to be nontaxable, provide the following information: a. Age of decedent at time of transfer. b. Copy of death certificate. c. Affidavit by the attendinR physician indicating the state of decedent's health at lime of transfer. d. All other information supporting nontaxability of transfer. 4. Did decedent, in his/her lifetime, make any transfer of property without receiving a valuable or adequate consideration therefor which was to take effect in possession or enjoyment at or afler his/her death? (Answer "Yes" or "No".) No a. Was there any possibility that the properly transferred might return to transferor or his/llOr estate or be suhject to his/her power of disposition? (Answer "Yes" or "No".) b. What was the transferee's age at time of decedent's death? 5. Did decedent in his/her lifetime make any transfer without receiving a valuable and adequate consideralion therefor under which transferor expressly or impliedly reserves for his/her life or any period which does in fact end before his/her death: a. The possession or enjoyment of or the right to income from the property transferred? (Answer "Yes" or "No".) -B2- b. The right to designate the persons who shall possess or enjoy the property transferred or income therefrom? (Answer "Yes" or "No".) No 6. If the answer to five b. above is "Yes," state whether the right was reserved in decedent alone or others. 7. Did decedent in his/her lifetime make a transfer, the consideration fOf which was transferee's promise to pay income to or for the benefit or care of transferor? (Answer "Yes" or "No".) No S. Did decedent, at any time, transfer property, the b61cficial enjoyment of which was subject to change, because of a reserved power to alter, amend, or revoke, or which could revert to decedent under terms of transfer or by operation of . law? (Answer "Yes" or "No".) No 9. If the answer to eight above is "Yes," was the powef to aller, amend or revoke the interest of the beneficimy reserved in the decedent alone or the decedent and others? (Answer "Yes" or "No".) '" > ~ J>: .... ...; ... ...; ...: I'l 0 \<.l \<.l ..... ~ :>- :>- '" ...; ::; 'tl C") .... r' 00 en ~rl' ~ ",'" Z i ..: s;'" Pl~ 0 00 '" ro~ ~O \<.l " p~ ! ~ U);.TJ ..... ....0:) ":4:1 .~t:J '" " ...; ~;~J;' :-'11'1 :;J ... ...; I ;".J 0 ..... '0 ) ....l :<: :I: t-~ ", ...: "j - Z :> 0 G(/~ "0 U = M <1 - 0 1 '" '" ~~~ ~ - N U "' ~ !;: ,-::;, 0 ~ J>: ~ LI- 0 ... 0 '" 0 z d '" '" :>- ... d - \<.l Z Z ... I<l ... I<l Z ....l d - d ...: ~ z ~ I<l ::;; 0 :;J U I<l ....l Z Z ... \.:1 Z - Q '" 0 0 0 ...: ::: ...: I<l ...: u CI '" ::J 'lSaJalU! s,wapaoap a4l !O anle^ la~Jp.w a4l aleo!pUI '\7 'lSaJaIU! s,luapaoap a4l!0 aDelUaoJad a4l aleolPul 'e: 'AlJadoJd paUMO AIIU!O! a4l !O anle^ la)jJBW IBIOI a41 aleo!pUI 'l 'pa4s1lqBlSa SBM d!4SJaUMO lU!O! a4l alBp a4l PlJe (S) JaUMO-OO a4l!0 luapaoap a4l Ol d!4SUO!lBlaJ pUB SsaJppe 'aWBU a4l apnloul '"S" alnpa40s JO! SUO!lOnJlSIJ! a41 U! paleO!pUl se Auadoid leUOsJad liB aqIJOsaa '"\;/,, alnpa40s JO! SUO!lOnJlSU! a4l U! pale01PU! se AlJadoJd IBaJ liB aqIJOsaa 'l 'lSJ!! alBlsa leaJ lsn 'papnlou! aq Ol aJB AlJadoJd alqlDuelU! pue alq!DUBl 4loS 'd!4SJO^!^JnS!0 l4DIJ 4l!M slueUallu!of SB Sa!lJed JO AIJBd Ja4l0UB 41!M AllU!of luapaoap a4l Aq pauMo 'IBUOSJad pue IBaJ 'AuadoJd lie apnlou! lsnw "3,, alnpa40s "3,, 31nC3HOS ElNI131dWOO 1:10:1 SNOI10nl:llSNI '. " ." '" ,- Signed, sealed, published and declared by SAMUEL D. HERZOG, Testator therein named, on this and one (1) other sheet of paper as and for his Last Will and Testament in our presence, who, in his presence, at his request and in the presence of each other, have hereunto subscribed our names as attesting witnesses. ('4 Q. i\~ Name c ^ '1 /) fl/~ , (-'C/-. 'Address ~~h~~'''~>:>'~' Name '<\--- \ ~'A_\.:S_'-L'--";.. r Cc.'-. A~dress 'I I I I I \ \ I I ; I ! , I "OLD, Sua A aATLI!1' ATn*HIYI At LA. ___n_n c.... .I\&.r-"~"""'- Page 2 REV.4&4 EX+ 1500eol INHERITANCE TAX SUMMARY SHEET (BUREAU USE ONLY) m Original o Supplemental o Remainder File Number 21-81-0057 Estate Nome !iamue1 D. HerzQi:________ Dote of Death January 12, 1981 Social Security Number 172-09-1929 REPORT OF INHERITANCE TAX APPRAISER I, the undersigned duly appainted Inheritance Tax Appraiser in and lor the County 01 Cumberland Pennsylvania, do respectfully report that I nave appraised the real and porsonol property os reported In the loregolng retum at the values set forth opposite each Item In the last column to th rlght,in Sche~s "A", "8", "e", and "E" Dated: November 9, 1981 _- ~~0 &- v.-()-' INHERI T.:ANCE TAX APP RAI R coaE ADJUSTMENTS REMAINDER APPRAISEMENT CODE INVENTORY VALUE AS APPRAISED (HARRISBURG USE ONLY) Real Property (Schedule A) $ 00+ 92+ Perianal Property (Schedule B) 10+ Jolnt.Held Properly (Schedule E) 2lH Tranlfeu (Schedule C) non 30+ TOT AL GROSS ASSETS 173 525 07 Len Debts and Deductlonl 40- 93- (SCHEDULE F) CLEAR VALUE OF ESTATE o Life Estate RATE FACTOR PRINCI PLE VALUE CODE o Annuity FOR USE OF REGISTER ONLY CODE COMPUTATION OF TAX $ $ $ $ $ Tax on $ 6% Tax on $ 15% Tax on $ Tax on $ Tax on $ Exemptions Totol Estate TOTAL TAX INTEREST FROM BALANCE $ $ $ TO Leu Credits DATE OF PAYMENT INTEREST FROM BALANCE DUE DISCOUNT INTEREST + $ 5 = + = BALANCE $ TO S 5 $ AMOUNT PAID TAX CREDIT 5 REV.4t17 EX" 17-fiO! ..",~. 'n':>: ~t::tZ;tF~t r~;:~~~~ ....: "~"~J( .",~:,,,,, COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF I<EVENUE TRANSFER INHERITANCE TAX RESIDENT DECEDENT INHERITANCE TAX APPRAI SEMENT GJORIGINAL o SUPPLEMENTAL Estate of Samuel D. Herzog File No. __~_-81-~.257__ Caun ty Cumberland Dote of Death January 12, 1981 In the event that any future Interest In this estate Is transferred In possession or enjoyment to collateral heirs of the decedont after tho expiration of any estate for life or for years. tho Commonwealth hereby oxpressly resorves the right to appraise and assess transfer Inheritance taxes at the lawful collateral rate on any such futuro Intorest. PROPERTY NOT INCLUDED IN RETURN BUT APPRAISED BY THE COMMONWEALTH - ,." ASSET SUMMARY DEPARTMENT'S APPRAISED VALUE 'I. Totol Reol Property - SCH. "A". . . . " $ 2. Totol Personol Property - SCH. "B". . . . $ 3. Total Jointly Own.d Property _ SCH. "E" $ 4. Total Transfers - SCH. "C". . .'. . . .. $ , 40 .000. 00 122.504.71 11,020.36 $ $ $ $ $ 173,525.07 40,000.00 122,504.71 11,020.36 Unreported $ Unreported $ Unreported $ Unreported $ none o LIFE ESTATE TOT AL GROSS ASSETS DREMAINDER DANNUITY TOTAL VALUE $ I do hereby certify that the above appraisement is mode in canfarmit~ with Pennsylvania low and has been filed this day with the Register of Wills. ~_ ' ; k// ___~,-~-v/.tV.A~Av,_r November 9, 1981 ~ AP~ DATE 0' none OJ :> 'M '" ... o-i 'M Q o-i .c: 0 rJl 00 OJ " ~. ~ ~ ~ 0 '" o-i ~ " '" 0 ... rJl ~ E-< Z ~ >= OJ 00 :>< ;tl .:: .:: 0 'M . OJ'" ..:I . .:: o-i o-i .:: N Q ... o-i ~.:'1 '" '" 0 'M o-i ;:l M ;:;: ::D ... "" OJ ... OJ ~ 0 '" OJ.o <: .., ~ n '" - '" '" o-i CO U Z en '" U HU o-i ~I '" - 0 r:.. - r:.. !2 0 ~ ~ r:.. 0 I'-< ... 0 '" 0 z d '" '" :>< ... d - ~ z z ... ~ ... ~ z "" d - 0 ~ ~ z :><: ~ ~ "" z ::;: z CI ;:l u " Z - ~ '" ~ 8 0 ~ :l :;:: ~ CI " 03 " _,?J ""1 -' Fl'ri '."1 , ' (,")("1 ':J "I;tl ,-..".'., ..- .1:1 ':!.:;:, .. 1'1 r r..~ ? '.,.) , '1 " .~ -: 00 ~ '- ~ ~ ~ .. ~:: :1 ,- <C 0 P:: c .. " .. >< ~ N 0 ,.. .. .... -.. ....1<C P:: fo< " W I'<Z ~l ::> .. H 0 Z Z ~ u ~ ~ >< Z~ 0 ~ Sz .., .... < ~ OI'<H " l!I iil ,.. ~ ~ .~ 0 r-'l 00 ~ "" . - . Z ~ H }~> r:(:l .... " ~ 0><::> ....1 ~E-< '- f-' ,.. ~ UE-<H ~ UCO J W "" . ,.. Z 0 ~ <C tI:lCQ .~ .--. ,.. m ," ~ '" ~::> H " >- . Z 00 !;;l Z 0 p:: .f-: , ... '" . Z - (: H Z " . U 00 ~E-< ..' (/) < 0. E-< CO..... 0000 ~ " '" " ~ .. ~ P::O 0,,", ~ ~ OH c' .. .- A . ::>~UI 00 1'<0 - . Iii " S H " o H ~ ~~ , "" ,- 0 . U - co ~ 00 CQ - " 001 fo< <C 1'<0 ,.. ;'.J Z z < ~~ ZH <C ~ CQ " - .. .. ~ u ~CQ ;aN E-< U Z .. (h -< E-<S 00 ~ U ~" " :'g ,..J ~ ~ 0 U ," ZU 0 " c :;, H .. .., 0;; ... .J :J ~ ;) (f) .. :g .~ ':; " .~ 'I; ~ .. - / . .. COMPOSITION OF NET BALANCES PRINCIPAL Cash Truot for Short-Term U. S. Government Securities TOTAL PRINCIPAL $11,712.31 $11,712.31 INCONE ~ Trust for Short-Term U. S. Government Securities TOTAL INCOME $ 1.726.56 $ 1,726.56 TOTAL PRINCIPAL AND INCONE $13,438.87 2 lIiu( .LuG fAG[ 224 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND I J 55: _GXJrig~J_~Tl!l,_J)SS is tan, Vi_G~J:.resideIl.LLIr.!ls LPf f ice~CNB BAN~-1i..A, being duly -5warn according to law, deposes and says that h~ _OD hphpl f nf r.CNlLllank, N A. is Executor __ of the Estate of Samuel D. Herzog late of Lower Allen Township , Cumberland County, Pa., deceased and that the within is an inventory made by ___~raJLG._lll1TUL__ ____ -----, the said-EYpc"to" - of the entire estate of said decedent, consisting of all the personal prop.r1y and real cst_ate, except real eitate ~ulside the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value as of the date of decedent's death. c.:- ~'-j"""",-",,~ and subscribed before me, l -7 7 19 y/ 'r.:? I - ~..-;rL./\--t:..-(/")_. CCNB Bank, N,A. c.. Z)u,."J;SSistant Vice Executor .xX~fSr rus By: C\...-J.;)~ ~ 1.-- . . --~ ~ I 2101 Market Street Camp Hill, PA 17011 Addren l\lU't/\\f{ ~)tJULK n' f" "0"1";' i ,II ; {,Jirll~ P"J~ ../. 18L'i .IY" ,,",,,.,,, . GLl'll:J~LLrl_: ,;,iU:l:Y t\~l\I,:iyl.'i.'f\'l~ Date of Death 12 1981 Yur January Month D.y INSTRUCTIONS I. An inventory must be filed within three months after appointment of personal representative. 2. A supplement inventory must be filed within thirty days of discovery of additional assets. 3. Additional sheets may be attached as to personalty or realty 4. See Article IV, Fiduciaries Act of 1949. Q) ~ 1-r-! " 0. 0- Ul .... Iil .c .,; >- Ul " ~ . .... W " ~ '" ~ '" .... :< '" rl W ~ 0 " 0 Q. E-< " 0 III .. . " .... 0 W W 0 '" ~ ... '" J: '" " ~ -<: " I- Q. Q) " I .... ...J LL .-< .,; ~ .-< Z ...J <( 0 0 .-< c.. ~ 0 co I W 1.L <( W j -<: :l: I I 0 '" >- < .-< Ii > z ~ - Ul N Z 0 " Q) 0 Q) " !ij ci Ii III z I :< 0 '" ~ 0 U .., Z w <( ,., <It Q. .", " ~ '" I " 0 -.: ~ .. ..c -0 ... .. E Ul - ~ 0 I I '" " 0 , ...J U u: CD 2-3-81 2-6-81 2-11-81 2-13-81 2-13-81 2-13-81 2-13-81 2-17-81 2-19-81 2-24-81 3-25-81 4-9-81 4-9-81 4-16-81 4-27-81 4-27-81 5-7-81 5-12-81 5-18-81 5-19-81 5-21-81 5-22-81 5-28-81 6-2-81 6-2-81 6-4-81 6-8-81 6-15-81 7-3-81 PRINCIPAL-DISBURSEMENTS Bell of Pennsylvania, Telephone service to 1-25-81 Professional Pharmacy, Prescriptions Lower Allen Township, Trash & Sewer service to 3-31-81 Riverton Consolidated Water Co., Service to 2-29-81 Jack Gaughen, Realtor, Appraisal Fee Newmyer Funeral Home, Inc., Funeral Services Lester G. Connor, Real Estate appraisal fee PA. Power & Light Co., Service to 1-20-81 Arnold, Slike & Bayley, Reimbursement for costs advanced PA. Power & Light Co., Service to 2-18-81 PA. Power & Light Co., Service to 3-19-81 Harrisburg Hospital, balance due Register of Wills, Agent Pa. Inheritance Tax - Gross Less Discount J. W. Mumper, Jr., Repairs & maintenance 2930 Morningside Drive, Camp Hill, Pa. PA. Power & Light Co., Service to 4-20-81 Register of Wills, Fee for filing Inventory Lower Allen Township, Trash & sewer service to 6-30-81 Richard McGee, Lawn Maintenance on 5-7-81 Richard McGee, Lawn Maintenance on 5-17-81 Riverton Consolidated Water Co., Service to 4-30-81 CCNB Bank, N.A., Reimbursement for personal & fiduciary tax planning services PA. Power & Light Co., Service to 5-18-81 Richard McGee, Lawn Maintenance - to 5-27-81 James K. Arnold, Esquire, Estate's pro-rata share of unpaid County & Township taxes due R/E purchaser James K. Arnold, Esquire, Settlement costs on sale of real estate Wildeman & Obrock, CPA's, Fee for preparation of 1980 Federal & State Personal & fiduciary returns PA. Power & Light Co., Final bill Riverton Consolidated Water Co., Final bill Loucas C. Tzanis, M.D., Professional services Register of Wills, Fees for filing RCC and Statement of Debts & Register of Wills, Agent, Balance of Pa. Inheritance Tax Arnold, Slike & Bayley, Attorney's Compensation CCNB Bank, N.A., Executor"s Compensation Wildeman & Obrock, CPA's, Reserve for preparation of 1981 Federal & State Fiduciary Income Tax Returns Reserve for filing costs, Filing fees, registered mail costs, notary fees, etc. $23,250.00 (1.162.50) on Decedent 1 s house, TOTAL PRINCIPAL DISBURSEMENTS 4 lIbL~ J.UtJ i ~G[ :22,7 $ 1.40 111.33 53.85 9.40 150.00 3,031. 70 150.00 50.47 83.63 21. 22 22.22 17.38 22,087.50 225.00 3.83 3.00 53.85 13.00 10.00 9.40 50.00 3.78 10.00 36.14 1,251. 50 120.00 1. 78 3.45 86.30 Deductions 10.00 1,192.20 2,266.04 2,266.04 100.00 200.00 $)3_,608.U PRINCIPAL INVESTMENTS ~-20-81 2,500 Units Trust for Short-Term U. S. Government Securities $2,500.00 4-9-81 4,000 Units Trust for Short-Term U. S. Government Securities 4,000.00 6-3-81 34,500 Units Trust for Short-Term U. S. Government Securities 34,500.00 8-7 - 81 1,000 Units Trust for Short-Term U. S. Government Securities 1,000.00 INCOME RECEIPTS Trust for Short-Term U. S. Government Securities 4-7-81 4-16-81 7-7-81 8-5-81 9-8-81 10-6-81 Interest Interest Interest Interest Interest Interest $ 11. 30 10.11 412.89 465.27 475.92 441. 94 $1,817 .43 TOTAL INCOME RECEIPTS ~1,817 .43 INCOME DISBURSEMENTS CCNB Bank, N.A., Income Commissions $ 90.87 $ 90.87 TOTAL INCOME DISBURSEMENTS 5 L"L~ iLJtJ I'm ~~8 A_WOLD, SLI.t &: DA'rLr.y Antlll\;n'lATU.. -............ C...It.Il,....."......,;.... ~ " In the event settlor becomes ill, incompetent or requests, trustee, at its discretion, shall use so much of the income and principal of the trust estate as it believ8s necessary and proper for the support and maintenance of settlor, and may disburse such amounts in anyone of the fOllowing ways: A. To that person or corporation who is taking care of or has custody of the settlor; B. Directly to the settlor; C. To any creditor of settlor for his benefit. II Upon settlor's death, the then remaining principal of the trust estate and all assets which may be added thereto from settlor's Last Will and Testament shall be distributed as follows: A. niece, Susan added to and subparagraph 10% thereof shall be distributed to settlor's Geib Dillahey, if living, and if not it shall be become a part of the distribution set forth in B below. B. The remaining 90% shall continue to be held IN TRUST for the benefit of Michele Geib, settlor's grandniece and the daughter of Susan Geib Dillahey. Trustee may, at its sole and absolute discretion, distribute from income and principal from time to time for the health, maintenance, support and education of the beneficiary. The trustee shall exercise its discretion with due regard to other funds available to her for any such pur- poses. When she reaches the age of 21 years, trustee shall distribute one-third of the then remaining principal; when the said Michele Geib reaches the age of 25 years, trustee shall dis- tribute one-half of the then remaining principal; and when she reaches the age of 30 years, the trust shall terminate and the trustee shall distribute the entire remaining trust to the said beneficiary. Should settlor's said grandniece predecease him or die before attaining the age of 30, then the remaining portion of her trust shall be distributed to settlor's niece, Susan Geib Dillahey, if living, and if not, to settlor's intestate heirs at law determined in accordance with the laws of intestacy of the tate of Pennsylvania in effect at that time and determined as of he date of settlor's death or the death of the said Michele Geib, hichever occurs last. - 2 - III The principal and income of this trust shall be free from anticipation, assignment, pledge or obligation of any beneficiary and shall not be subject to any execution or attachment or to voluntary or involuntary ali.enation. IV Trustee shall have the power but not the duty to make such expenditures out of this trust as, in its discretion, it may consider desirable in order to faci.litate the settlement of the estate of settlor. In exercising such power, trustee may pay in whole or in part any of the following items: the expenses of last illness and burial, including cost of grave marker, debts, income taxes, death taxes on any and all property included in the gross estate for tax purposes; and all other items in connection with the settlement of the estate. Any such items may be paid directly by trustee or the funds for their payment may be transferred by trustee to the executor or the administrator of the said estate, and neither such executor or administrator nor any beneficiary of such estate shall be required to reimburse trustee for any funds so paid or transferred. All such death taxes on present or future interests shall be paid at such time or times as trustee may think proper, regardless of whether such taxes are then due, provided that any postponed taxes on future interests shall be charged against the particular share with respect to which the taxes are imposed. V Settlor hereby reserves, exercisable whenever and as often ARNOLD,SUU; & n...vu:y AnOl"TY' At LA" _.........." c....'hu r................., as he may wish while he is living, the power to withdraw all or - 3 - . .~ part of the principal, to add to the trust upon approval and acceptance by the trustee, and to revoKe or alter this trust in whole or in part by writings other than a Will delivered to the trustee, but not to increase the responsibilities of the trustee without its written consent. VI Any corporation resulting from any merger, conversion or consolidation to which CCNB BanK, N.A. may be a party or any corporation otherwise succeeding generally to all or the greater part of the assets and business of CCNB BanK, N.A. shall be the successor to it as trustee hereunder without the execution or filing of any paper or any further action on the part of any party hereto or beneficiary thereunder. VII This instrument shall be construed and administered in accordance with the laws of the Commonwealth of Pennsylvania. The validity of the trust hereby created shall be determined in ac~ordance with the laws of the Commonwealth of Pennsylvania. VIII The trustee shall have the following powers and duties in addition to those already vested in it by law and by other provisions of this trust: A. To retain any or all of the assets of this trust, real or personal, including its own stocK, without regard to any principle of diversification or risK. ."'OLb,.'3UU: Be BAYlr.:Y AnnUltnATLA.. ...........t.... t...lllLl.r.........Ia.."', B. To invest in all forms of property, including stocK, common trust funds and mortgage investment funds whether - 4 - <.: ZZ ZO en~H <.:P-<en ~ H ..:l "~ P-<><H ....Q ZZ O~"" ::<:0 i:>: ::<:U~"'" o 0,,", UQ U I ~~ - ~ O..:len I i:>:Z,"" ....~ <':<'1 P::pq ;I: S~ ~O UU 0 Z . " o N i:>: ~ ;I: tI U . ~J I ~ " ~ t:. 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