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HomeMy WebLinkAbout06-01-07 (2) --.J 15056041125 REV -1500 EX (06-05) PA Department of Revenue. Bureau of Individual Taxes . INHERITANCE TAX RETURN PO BOX 280601 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death OFFICIAL USE ONLY County Code Year File Number 2 1 0 7 018 5 Date of Birth 090 - 0 7 - 0 3 o 2 122 0 0 7 o 4 0 1 1 9 1 6 Decedent's Last Name Suffix Decedent's First Name G RAY LILLIAN MI E (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW [ZJ 1. Original Return D 4. Limited Estate [ZJ D 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) 10. Spousal Poverty Credit (date of death D 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received D D D D 8. Total Number of Safe Deposit Boxes 2. Supplemental Return D D 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required W ILL I A M A ADD A M S E S QUI R E 717 243 763 8 Firm Name (If Applicable) REGISTER OF WILLS USE ONLY First line of address 4 3 W SOU T H S T Second line of address .... .'1 i i + I ") City or Post Office State ZIP Code DATE FJI2ED CAR LIS L E P A 17013 "j "f -, Correspondent's e-mail address:waddams@earthlink.net... Under penalties of pe~ury, I declare that I have examined this retum, including accompanying schedules and statements, and to the bestbfmy knowledge-ElflEl belief, it is true, correct and compl te eclaJlltion of preparer other than the personal representative is based on all information of which preparer has any knowlOOge. SIGN}\TURE,. ONSI F RETURN . / .DATE V ' V v-~O ADDRESS 110 Briarwood Lane, SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE Carlisle PA 17015 DATE ADDRESS 57 W. Pomfret St., Carlisle PLEASE USE ORIGINAL FORM ONLY PA 17013 Side 1 L 15056041125 15056041125 -.J ~ -.J 15056042126 REV-1500 EX Decedent's Social Security Number Decedent's Name: L ill i a n RECAPITULATION E. Gray 090 - 0 7 - 0 3 1. Real estate (Schedule A) . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1. 16490000 2. Stocks and Bonds (Schedule B) .................................. ~ o 0 0 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 4. Mortgages & Notes Receivable (Schedule D) ........................ 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ....... 5. 6. Jointly Owned Property (Schedule F) 0 Separate Billing Requested. . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) 0 Separate Billing Requested. . . . . .. 7. 37080064 8. Total Gross Assets (total Lines 1-7) 8. 5 3 5 7 0 0 6 4 .......................... . 9. Funeral Expenses & Administrative Costs (Schedule H) 9. 3 8 5 8 3 5 9 . . . . . . . . . . . . . . . . 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . . . . . . . . . . . . 10. 11. Total Deductions (total Lines 9 & 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 3 8 5 8 3 5 9 12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . 12. 4 9 7 1 1 7 0 5 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . 14. 4 9 7 1 1 7 0 5 TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X.O _ 0 0 0 15. 0 0 0 16. Amount of Line 14 taxable 4 9 7 1 1 7 0 5 3 at lineal rate X .O~ 16. 2 2 7 0 2 7 17. Amount of Line 14 taxable 0 0 0 0 0 0 at sibling rate X .12 17. 18. Amount of Line 14 taxable 0 0 0 0 0 0 at collateral rate X .15 18. 19. Tax Due . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 2 2 3 7 0 2 7 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT o Side 2 L 15056042126 15056042126 ---I REV-1500 EX Page 3 Decedent's Complete Address: DECEDENT'S NAME Lillian E. ~ STREET ADDRESS 13 Strawberry Dr. File Number 0185 ~ ~~--~~~ -~-~~- I STATE I PA CITY Carlisle ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 22,370.27 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total Credits (A + B + C) (2) 0.00 Total Interest/Penalty ( D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00 0.00 22,370.27 A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5A) (5B) 22,370.27 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ...................................................................... 0 00 b. retain the right to designate who shall use the property transferred or its income; ............................... 0 00 c. retain a reversionary interest; or ................................................................................................ 0 00 d. receive the promise for life of either payments, benefits or care? ....................................................... 0 00 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................... 0 00 3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? ......... 0 00 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? .................................................................................................. 0 00 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. 99116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. 99116 (a) (1.1) (ii)]. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. 99116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. 99116(1.2) [72 P.S. 99116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. 99116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1502 EX + (6-98) '* SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Lillian E. Gray 0185 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is iointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION 13 Strawberry Dr., Carlisle, PA 17013, selling price VALUE AT DATE OF DEATH 164,900.00 TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 164900.00 REV-1508 EX + (6-98) '*' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Lillian E. Gray SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 0185 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. M& T Bank checking 43,451.15 2. Sovereign Bank checking 28,463.65 3. Gibb Financial 274,845.72 4. U.S. Savings Bonds, Series E 14,528.48 5. Internal Revenue Svc, tax refund, 2006 1040 8,930.00 6. Tax proration received on 13 Strawberry Dr., Carlisle 381.64 7. Personal property 200.00 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 370 800.64 REV-1511 EX + (12-99) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Lillian E. Gray SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 0185 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Hoffman Roth Funeral Home 2,783.48 2. Allenberry, funeral reception 2,302.08 3. Car Service - Transportation for care giver to her home 300.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Social Security Numbe~s)/EIN Number of Personal Representative(s) Street Address City State Zip Yea~s) Commission Paid: 2. Attorney Fees William A. Addams 18,100.00 3. Family Exemption: (If decedenfs address is not the same as c1aimanfs, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 330.00 5. Accountanfs Fees preparation of 1041 fiduciary return - Klingler & Assoc. 600.00 6. Tax Return Preparer's Fees 7. Sentinel, advertising estate ad - approximate 130.00 8. Cumberland Law Journal 75.00 9. Klingler & Assoc. prepare 2006 1040 225.00 10. PA. Dept. of Revenue, 2006 PA 40, tax due 112.00 11. Realty Transfer tax 1,649.00 12. Ebener & Associates, real estate commission 9,894.00 13. Register of Wills, filing fees 100.00 14. Sovereign Bank, return of last retirement pay 1,239.77 15. IRS, 1st quarter estimated tax for 2007 125.00 16. PP&L 250.10 17. Embarq 62.78 18. Waste Management 44.88 TOTAL (Also enter on line 9, Recapitulation) $ 38,583.59 (If more space is needed, insert additional sheets of the same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent Lillian E. Gray Decedent's Name Page 1 21 07 0185 File Number Schedule H - Funeral Expenses & Administrative Costs - 87. ITEM NUMBER DESCRIPTION AMOUNT 19. 20. 21. PMT Condo Assoc. Final Water Final Sewer bill 125.00 60.50 75.00 SUBTOTAL SCHEDULE H-B7 260.50 R~""".i'* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FilE NUMBER lillian E. Grav 0185 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not list Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS [include outright spousal distributions. and transfers under Sec. 9116 (a) (1.2)] 1/2 of residue 1. Samuel Gray Lineal 110 Briarwood Lane Carlisle, PA 17015 1/2 of residue 2. Eileen F. Weeks Lineal 232 Heather View Dr. #d Jonesboro, TN 37659 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART n - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) ::,>-".- E _.. r;} : i :." ,~'l !'t. !.() '~'-' ,'" -:;R- +.~ i.-.,:; j....;i co ;:C;; ~ .~ * (i~: c::.~ c: c...J i:.N c~, l:t-. i',)", U1 cr, ~~~: :;;;:: ~; ~. S<;;. .~ .'. ;;; .:::;. :-,..,j :~:: r::,:;, ~: rJ! ;','1 ('J:; f!' 1;::;: (,.,J ft' ',r.; .' CO r,:::: '.::;-" f ,"! n c en d 3: /TI ;l3 ;l3 /TI n /TI ;; -t .... fj Co ....., ;:-.I (/) 0 :c: n""l lXl 0 l> Z =CD A -" -....; A.o (J) c;o D"cn "-' CD: "-' . (J) 9 2) 0 ... 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DESCRIPTION OF BONDS I am the owner or perron entitle~ to payment of the securities described below, which bear the name(s) of L-t l \ d. (\ E G; R.~ dl S- ~ ue-( 0 (<-?LL( ISSUE DATE SERIAL NUMBER ISSUE DATE SERIAL NUMBER ISSUE DATE SERIAL NUMBER t-L.> A -+-J- /') ~ j) / I ......,.- / 2. REQUEST FOR PAYMENT (If you need more space, use the continuation sheet on page 3.) { ~ check. I request that the descriped bonds be redeemed and payment be made in the form of 0 Direct Deposit. o To the extent of: (Complete this line only if ~arlial redemption and reissue of the remainder is desired or if the signer is only entitled to a portion of the bonds listed. See Item 2 in the Instructions.) (Social SeCurity Number of Payee) OR 3.5"' ~ '71 ~ (,p 17 (Employer Identification Number of Payee) 3. DELIVERY INSTRUCTIPNS (Read Item 3 in the Instructions before completing this section and complete only Item 3A or 3 B.) A. MAIL REDEMPTION CHECK To: S.tlVA.u e...-\ C, fZtt \...f [. Y-E'CuTOf \ (Name) I l 0 13 ~(Ct (' VD-0--Z5--Vt LtJL.v--<- (Number and Street or Rural Route) ~Il)[ ~_ (City) I-Ir- (State) - ..-- ICO l ~ (ZIP Code) B. DIRECT DEPOSIT FUNDS As AUTHORIZED BELOW: (Depositor's Account No.) (Name/Names on the Account) Type of Account: 0 Checking 0 Savings Bank Routing No. (Financial Institution's Name) (Phone No.) 4. SIGNATURE You must wait until you are in the presence of a certifying officer to sign this form. Sign Here: ./' 'S; & /J. U <2.-1 G M Lf (Signature) (Print Name) -t-- Home Address ilo ?3^-ICv'tlu~ ~ (Number and Street or Rural Route) CO-r{l) le- tY4 ~City) (State) (E-Mail Address) . ~ liDto (ZIP Code) -- "7 I 7 - 2.lf 1- '1 7 ~ :3 (Daytime Telephone Number) Certifying Officer- The injdividual must sign in your presence. Complete the certification and affix your stamp or seal. Stt RAV*L I Cc,K~~ , whose identity is known or was I CERTIFY that proven to me, personally appeared before me this at ~l~~le- P A- (City) (State) day of ~tL>\ ~ (Month) 200 "7 (Year) , and signed this form. (Signature of Certifying Officer) (OFFICIAL $T AMP OR SEAiL) (Title of Certifying Officer) (Number and Street or Rural Route) o o i I i i RESERVED FOR IDENTIFICATION NOTATIONS Customer Account Number I and Date Established: I 0 Document(s} _ Description: I Identified by (Signature andIAddress): (City) (State) (ZIP Code) INSTRUCTIONS TO CERTIFYING OFFICER Each person appearing before y u must establish identification by positive and reliable evidence before this form is signed, unless he or she is personally known to yo . Place an adequate notation above or on a separate record, showing exactly how identification was established. A notation is adeq ate if it is sufficiently detailed to permit, at a later date, a determination of the exact identification actually used. You and the orga ization will be held fully responsible for the adequacy of the identification. The signatures to the request m st be executed in your presence. Fully complete and sign the certification form provided for your use for each signature you witness. If you are an employee (rather t an an officer) authorized to certify signatures, insert the words "Authorized Signature" in the space provided for the title. Insert the p ace and date, as required on the form, and impress the seal of your organization. . PRIVACY ACT AND PAPERWORK REDUCTION ACT NOTICE We're asking for the information on th s form to assist us in processing your securities transaction requests. Our authority comes from 31 U.S.C. Ch. 31 which authorizes the Treasury Depa ent to borrow money to pay the public debt of the United States. Also, 26 U.S.C. 6109 requires us to use your SSN on certain forms when we report axable income to IRS. It's voluntary that you provide the requested information, but without it, we may not be able to process your transaction request. Information concerning your securities holdings and transactions is considered confidential under Treasury regulations (31 CFR Part 323) and t e Privacy Act. However, the following routine uses of this information may include disclosure to the following persons or entities: agents and con ractors who help us manage the public debt; others entitled to the securities or payment; agencies (including disclosure through approved computer matches) determining eligibility for benefits, finding persons we've lost contact with, or helping us collect debts; agencies for investigations or prosec tions; courts, counsel, and others for litigation and other proceedings; a Congressional office asking on your behalf; and as otherwise authorized b law. We estimate it will take you about 15 minutes to complete this form. 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GRC 88J05-07 ~~:o,:::;~)!O~r::= ::=::;-:hs::~~s:e~~~~~ =~ea~~~~~~~~~~:~nshth~lals. WARNING: " i~ a aime to knowingfy make false statemen to.~'::,~~ ~~ates on this ~ any other simila~ form. Penalties upon U.S. Department of Housing and Urban Development nOAR . nnrnv~' 'n "~M_ I J. Loan NUll1ber I 8. Mortgage Insurance Case Number I TiUeExpress Settlement Systerr D. NAME OF BORROWER: Judith L. Gross Arm.,,,... E. NAME OF SELLER: The Estate of Lillian E Gray mn.,,,... F. NAME OF LENDER: Nt A Anmu:",,,,. G. PROPERTY ADDRESS: I3 Strawberry Drive, (arlisle, PA 17015 H.SElTLEMENT AGENT: Salzmarm Hughes, P.C., Telephone: 717-249-6333 Fax: 717-249-7334 m 95 Alexander 8orin!!: Rbad Carlisle P A 170 I3 I <~~ 05n5n007 J SUMMARY OF BORROWER'S Tf; ANSACTION: 100 "'I>r",,, A..rIlIMT 1n1 1n? 1n' ''''' 1n" 164 900.00 K. SUMMARY OF SELLER'S TRANSAr.TION: 400 "'I>n"" AOAnllMT 401 4n? 4n' 404 4"" 164 900.00 14nm 2 871. 25 ""11'" i' ".lv"n~" 106 408 1n7 OS/25/07 'n12/31/07 210.86 407 OS/25/07 In 12/31/07 210.86 in. OS/25/07'n 06/30/07 146.60 4n. OS/25/07 to 06/30/07 146.60 .nl> 4nl>. lln 24.18 . 4,n 24.18 111 4" 112 412 1?n 168 152.89 d?n T nl II: TO Si=LLi=R 165 281.64 ?nn AMnIINT~ "nn '''1> ?n, 5 000.00 "n, 207 50' 11 678.50 ?n, 503 ?04 ""4 Payoff of I n.n 7n5 5n" ?n. 506 ?n7 "n7 7n. "no 20Q SOQ A.lill.tm"n bv...11 r ?In ",n ?II "" ?l7 517 213 . 513 ?l4 "14 ?I" "" ?I. . "8 2'7 517 ?1. ",. ?II> "'I> "n TnTA 5 000.00 520 Tr'lT"' N AM()l lNT DIIF SFI I FR 11 678.50 300 CASH AT M nl> Tr'I 600. CAC'u AT ""TTI lOR - 301 Gross amoo n 168 152.89 601 165 281.64 30' f 5 000.00 607 11 678.50 303 CASH FI>n.. Rr'lRRn,^",I> 163 152.89 603. CASH Tn S"I I "I> 153 603.14 SUBSTITUTE FORM 1099 SELLER STATEMENT: The information contaIn herein Is Important tax information an,d is being furnished to the Internal Revenue SVrvice. If you are requ!",d to file a return, :,;:.rc:~:~C::~:t:~:~ G~~;:'':~cr~~dt:'~~i::iS Item is fl! uired to be reported and the IRS determines that 11 has not ~en reported. The Contract Sales Price deSa1~ on You are required by law to provide the selOement agent (Fed. Tax 10 No: 1 with your rorrect taxpayer identification number. If you do not provide your correct taxpayer identification number, you may be subject to civil or criminal penalties imposed by law. Urn: er penalties of perjury, I certify that the number shown on this statement is my correct taxpayer identification number. TIN:_-_-_'_-_---+ SELlER(S)SIGNATURE(S): SELLER(S) NEW MAILING ADDRESS: I SELLER(S) PHONE NUMBERS: ~(H) (W) U.S. DEPARTMENT OF HO SING AND URBAN DEVELOPMENT SETILEMENT STAT MENT File Number: GROSSJ05-07 , I __","h"'_ P' PAGE 2 1 .. VO~ 'no . 'M . ,n, 'n 9 894.00 In Geor""e Ebener , Associates PAID FROM BORROWER'S FUNDS AT SETTLEMENT PAID FROM SELLER'S FUNDS AT SETTLEMENT 7"" T"n. ~A1 "~IBR"K"R'~ r.OMMIOO'ON boo"" no "rice <164 900.00'. 6.000 _ 9 894.00 9 894.00 IN on. oM .M on. on. on. on, .n. ono ..n 0" onn M. an, on, an. on. '''''nR -... .-, <.. .- .. u 'M. 'M' Y' c, D"R TO> DC 0'1" 'N '''v'''''c , <-- 'n ~, .-. - f 'n R -. -. ,-- -- -, ,~ _n ~, ... -. ,_. ".-.. -- -. /-- 0.00 0.00 'M' 'Mn "no ..n, ..M ..~ ..n. ..no". . <__. "n, .... . ..na ~o" ,.,,____ Stewart Title Guarantv-IPA RE S5 1 183.75 "no ...n ~ .,.a_,~. "" "" "" pnn """CO""CNT 0"""0"1 ~"1\1 38.5 "M "M "n. "n< ,,"" .nnl"~ O"TT' "M"...f "HAR=o In South Middleton Authori tu Prnnertv- Manarrement Inc. , 164 900.00 - 1 183.75 R "uAR"cO . "nriMn_ , n. "1 649.00 .u. .. n.~'l 649.00 'Un_.n.' .. 38.50 1 649.00 1 649.00 60.50 75.00 . 2 871.25 11 678.50 "M 14 --TT' cM Hun CERTIFICATION OF BUYER AND SELLER I have ear.fully ~ 1M HUO-' Sel~_el IInl S.ta1erntnt and to lhtt beat of my knowledge and belief. it is a true and ac:r::urlle ,telement ollall receipts and disbursements m.dII on my account or-by me ~~su.,~~rJI;V~ved~IIM:p~S.lu~n~ta~e) . ...'" LGroH 7 ~.&~ ~./ (' ~ '--/{I TheESlateollillianE7/ ~~~hN~+~~loc;r:;:~ ~ ~N~~GaR ~iJ~~M~~J:~~~Sc1~~~~ON ~ ~'h~J'~~trfJ~E,~P ':~~I~g~~~~ ~~R DETAILS SEE TITLE 18; ~lilttlementStalemenlwhichlhlilve~dililillnJeandacl:Ul'llleaccounIClflhi5transaClion I .__e;sedjwlleaUHIhe IUndS/~sburs/t:UJrdal"lC:ewith ~sIalBmenL . / - ('")"" '/l" / 5 - 2r - () 7> '-4- f"E / I I I i KI~ngler & Associates, P.c. , 236 S Hanover St 1arlisle, P A 17013-3906 717-243-7743 5GRA YLEO March 9, 2007 CONFIDENTIAL Lillian E. Gray 13 Strawberry Drive Carlisle, P A 170] 3-4438 Dear Mr. Gray: We have prepared the enclosed retrrns from information provided by you without verification or audit. We suggest that you exami~e these returns carefully to fully acquaint yourself with all items contained therein to ensure that there are no omissions or misstatements. I Federal Filing Instructions I i Your 2006 Form 1040 shows a tot41 overpayment of$8,930, which is to be refunded to you in its entirety. ! I I Sign and date the return on Page 2.1 Initial and date the copy, and retain it for your records. ! Mail the Form 1040 return by April 17,2007 to: I Internal Revenue ~ervice Philadelphia, PAl p255-0002 Pennsylvania Filing Instructions I , , Your 2006 Form P A-40 shows an a~ount due of $112. A check in the amount of $112 should be made payable to the Pennsylvania !f>epartment of Revenue. Write "S.S.N. 090-07-0343, 2006 Form PA-40" on the check. I Sign and date the return on Page 2 *nd mail it by April 17,2007 to: I I PA Dept ofReven~e/Payment Enclosed I Revenue Place I Harrisburg, PA 17~29-0001 ! Pennsylvania Estimate Filing Ins.ructions I Your required estimated tax payme~ts are shown below. Each payment is to be accompanied by a completed preprinted coupon. ~ake each check payable to Pennsylvania Department of Revenue, and write your social sefurity number and "2007 Form PA-40ES" on the check. Reminders for estimated tax installments will not be sent to you. You should establish your own reminder system for making timely deposits. Due Dates: 4/] 7/07 6/1 5/07 9/17/07 1/15/08 Remittances: $125 $0 $0 $0 I P A Department of Revenue Dept 280403 . Harrisburg, PAl V] 28-0403 Also enclosed is any material you ~urnished for use in preparing the returns. If the returns are examined, requests may be made fur supporting documentation. Therefore, we recommend that you retain all pertinent records fori at least seven years. I Mail To: In order that we may properly advlse you of tax considerations, please keep us informed of any significant changes in your financi~l affairs or of any correspondence received from taxing authorities. . If you have any questions, or if we! can be of assistance in any way, please do not hesitate to call. Sincerely, : i~ }- A~ ~_c:... Klingler & Associates, P.c. . THE LAST WILL AND TESTAMENT OF LILLIAN E. GF:AY Being of lawful !age and sound and disposing mind and memory and not acting under any duress, f~aud, undue influence or inducement of any person, I, LILLIAN E. GRAY, a ~omiciliary of Mount Holly Springs, Pennsylvania: ITEM 1 Hereby make, pu~lish, and declare this my last Will and Testament, revoking and rendering null ~nd void other Wills and codicils heretofore made by me. ITEM 2 I direct my Exedutor to pay the following as soon after my death as may be practicable: a. All of my just debts and the expenses of my last illness, funeral and of the administr~tion of my estate; but my Executor need not accelerate and pay those unmatured pbligations which, in his opinion, it might be proper and more advantageous to retain or renew and pay as they become due and payable. b. All inheritance, transfer, estate and similar taxes (including interest and penalties) assessed or payable by reason of my death, on any property or interest in my estate for purpose of computing ta:{es. My e:<ecutor shall not require any beneficiary under this ~."ill to reimburse m\1 estate .for'. ta:{es pai d on property passi ng under the terms of thi s vii 11. . _-~ ~ ~ ITEM 3 ) TESTATOR - The term !'Testator" Will, whether male o~ female. as used in this Will refers to the mak~~pf t~is -/ ~ --I EXECUTOF: - The term 1'E:-:ecutor" as used in this t,.Jill refers to the person I appoint to execute t~is Will, whether male or female. ~_ SURVIVAL - Whenever ~ provision of this Will conditions a beneficiary's taking by that beneficiary .urviving the Testator, such condition of survival shall be construed as a condi~ion precedent to the validity of the gift, devise or bequeath; and such c$ndition shall be satisfied only upon survival by the beneficiary for a pe1iod of thirty days after the date of death of the Testator or until this Will i* probated, whichever shall be the first to o~~tir, unl~s E:;pressly statedothttnlise in a provision of this Will. ::-~~3 ~ !-T') ! .~,~ C~: -'.-...i- ;-~.!~ ! '-"'-' PAGE ONE OF SIX PAGES 1'.) --J , ~ ? ,.1/ · r6~ ~ -tf.; A /U-U it _' ~ \~.~2' ~~: --;) 9!f .~ ~h - . .Jl1d3-1 ~ -co- CHILDF:EN - The term "children" as used in this ~'Jill shall include any children hereafter born to on adopted by me, and any minor stepchildren living with me at the time of my d~ath, as well as the children I now have, EILEEN WEEKS and SAI'1UEL GF:AY, IV, unlless e:.:pressl y stated otherwi se in some provi si on of thi s ~lJill. t1INOR - The tet-m "Mihot-II as used In this ~Jill means a person under years of age. DESCENDANTS - The tehn "Descendants" as used in this L1Jill means the immediate and remote lawful li~eal descendants or offspring by blood or adoption of the person referred to who are in being at the time they must be ascertained in ot-der to gi ve effect: to the rEference to them. F'EF: STIFWES - The te~m "Per Stirpes" as used in this Will means that i-Jhene\ter distribution is to b~ made per stirpes, the estate or portion of the estate, to be so distributed, srall be divided into as many shares as there are surVivIng heirs in the nearest! degree of kinship to the decedent and deceased persons in the same degree of k~nship who left issue who survive the decedent. This degree of kinship sh~ll be termed the root generation. Each surviving heir in the root generation ~hall take one full share. Those remaining heirs, i.e. the surviving issue of the deceased persons in the root generation, shall take the share of their decea~ed ancestor in the root generation, such share being divided in the follo~ing manner: each surviving issue shall take the fractional share that his or her immediate ancestor would have taken had he or she survived; and wh~n there are two or more such surviving issue in the same degree of kinship th~y shall divide such fractional share equally among them. F'ER CAPITA - The ter~ "Per Capita" as used in this ('Jill means that whenever distribution is to b$ made per capita, the estate or portion of the estate, to be so distributed, s~all be divided into as many equal shares as there are surviving iSSUE, sta~ding in the same degree of kinship to the decedent. Distribution shall b$ made without reference to right of representation of the surviving issue. ISSUE - The term "Is~ue" as used in this Will means all persons i'lho are descended from the p$rson referred to, either by legitimate birth to or adoption by that per$on or any of that descendant's legitimately born or legally adopted desc$ndants. INTENTIONAL OMISSION or other person, not Testament, whether provided for in this - I haVE intentionally omitted to provide for any relative named as a beneficiary, under this my Last Will and aiming to be an heir of mine or not, unless otherwise my Last Will and Testament. PAGE TWO OF SIX PAGES ,;;eff~ ~4(f ~ .g7J-v13 - ~ ITE!'l 4 I hereby give, d~vise and bequeath all the rest, residue and remainder of my said estate and property of which I may die seized and possessed, and to which I may be entitled at the time of my death, of whatsoever kind and nature, and wheresoever it m~y be situated, be it real, personal or mixed includinq any i _ . power of appointment, that I may have, absolutely and in fee simple forever to my children, who shall survive me, in equal shares, and to the issue, living at my death, of such children who shall predecease me, per stirpes and not per capita. ITEM 5 In the event that the above beneficiaries shall not survive me, I hereby give, devise and beq~eath all the rest, residue and remainder of my said estate and property, of whi~h I may die seized, and possessed, and to which I may be entitled at the time!of my death, of whatsoever kind and nature, and wheresoever it may b$ situated, be it real personal, or mixed, including any power of appointment!that I may have, absolutely and in fee simple forever to: SAINT PATRICKS CATHO~IC CHURCH in CarliSle, Pennsylvania. ITEM 6 I hereby appoint my son, SAMUEL GRAY IV as Executor of my Will. If my Executor fails to sertve, or for any reason fails to continue to serve, I then appoint my daughter, EILEEN WEEKS to serve as Executor. ITEM 7 I designate my Executor to be an Independent Executor to the fullest extent permissible under the laws of the State of Pennsylvania. I direct that no bond or other security be ,required. I further direct that no action be had in any court relative to the administration of my estate other than to prove and record thi s vJi 11 and to return an inventory, 2.pprai sal and 1 i st of cl ai ms of my estate. ITEM 8 My E:-:ecutor shall have the foil owi ng pOv-lers, v-lhi ch are to be construed in the broadest manner consistent with the validity of this Will and with their duties as fiduciarieS. The powers stated herein are not intended to be exclusive, but shall be in addition to those granted by law and shall also pertain to any admini!strators or trustees who Succeed the fiduciaries I have appointed. These powers are: a. to take possession of property, to keep it safely, and to segregate it from oth,er property ol^med or hel d by the fi duci ary; PAGE THREE OF SIX PAGES -) I..t-- 7') ~. 1J >;::-:Z '. : i ,;JJ::! ;f,(~,- .. -'7 flf!4, f ~~IiJ- ~ ~ b. to ret~in and to invest in property, or an undivided interest in property, including residential real estate, for any per-iod, ~'Jhether- or not the property be of the character permissible for investment by fiduciaries; c. to sell, transfer, exchange, lease, rent, mortgage, pledge, give options upon, partition and otherwise dispose of real Or personal property, at private or public s~le, for cash or upon whatever terms the fiduciary deems advisable, without notice or order of court; d. to render liquid my estate, in whole or in part, and to hold cash or readily marketable securities of little or no yield for such period as my fiduciary deems advisable; e. to borrow in the name of my estate or of the trust, upon whatever terms and conditions and for whatever periods my fiduciary deems advisable for the purpose of preserving, protecting or imprOVing property held by him; f. to pay, compromise, adjust, settle, compound, renew or abandon claims held by my fiduciary and claims asserted against my fiduciary, on whatever terms he de~ms advisable, without prior court authority; g. to distribute in cash or in kind, or partly in cash and partly in kind, in divided or undivided interests, notwithstanding the fact that distributive shares may as a result be composed differently; h. to insure the property he holds as fiduciary against the risks, and in the amounts he, in his discretion, deems expedient, and to obtain and pay for life, health, liability and other forms of insurance for the beneficiaries of the trust, in his discretion; i. to employ attorneys, accountants, investment advisors and other professional assistants including depositaries, proxies, agents, and appraisers; j. to enter into transactions with other fiduciaries including e>:ecutors or trustee$ of estates and trusts in which my beneficiaries have an interest, and including him as fiduciary for other estates and trusts; k. of corporate pOvJer: to engage in the powers necessary to the effective administration securities, including, without limiting the generality of this 1. po~er to vote in person or by proxy upon all securities held by the fiduciary; 2. power to engage in a voting trust or voting agreement with respect to securities; PAGE FOUR OF SIX PAGES cY~ 11 {/~l{~ !Y~ - 1/ ~ ..62'A{) --= - QE: ~. power to consent or become a party to, or participate in; mergers, consolidation, sales of assets, recapitalization, reorganizations, dissolutions or othe'r alterations of corporate structure, including adjustments in capital structure affecting securities held by the fiduciary, whether or not these adjustments involve payments by or to the fiduciary; and of a nominee; 4. power to hold securities in unregistered form or in the name 1. to pay himself reasonable compensation for his services. ITEM 8 If any part of this Will, or any trust hereby created, shall be invalid, illegal, or inoperative, for any reason, it is my intention that the remaining parts, so far as possible and reasonable, shall be effective and fully operative. My Executor may seek and obtain court instructions for the purpose of carrying out as nearly as may be possible the intention of this Will shown by the terms hereof, including the term held invalid, illegal or inoperative. ITEM 9 Either I or my spouse have served in the Armed Forces of the United States. Therefore, I direct my Executor to consult the Legal Assistance Officer at the nearest military installation to ascertain if there are any benefits to which my estate or my descendants are entitled by virtue of such service. Regardless of my military status at the time of my death, I direct my Executor to consult with the nearest Veteran's Administration Office to ascertain if there are any benefits to which my survivors may be entitled. ITEM 10 I have made, or may from time to time make, a written memorandum expressing my desire to give certain items of personal property to specific persons. I urge my Executor and beneficiaries to respect these wishes. Such a memorandum, if made, shall be stored in conjunction with this Will. PAGE FIVE OF SIX PAGES ;i A r! J!., h-<-- e-,~ ~ ~tl7)..l) .----, 8-E- IN WITNESS WHEREOF I have hereunto set my hand and seal in the presence of the witnesses whose names appear hereafter, published this ~7 day of "--'[;1 h.U.AUJJ.h/ 19 q D . ~i , -' . .~ I.&.c (SEAL) ATTESTATION On thisc(f1~ day of ;;~~~~< 19~, LILLIAN E. GRAY, the Testator, personally Published and Declared the foregoing Last Will and Testament, in the presence of each of us and all of us together, who, at the Testator's request, personally witnessed the Testator Sign and Seal the same. We then, at the Testator's request, and in the presence of the Testator and of each other, also signed each page of the said document as witnesses. We further state that each of us believes that at the time the Testator executed the foregoing instrument said Testator was of sound mind and memory, of lawful age, and did so execute it as a free act and deed and not under the unlawful influence of any person. NAME: ~/~! NAME: ,&JJ.-i.:LU' )7v ' 0~t..IJ--, .3 82 tf Can-ict.jl~ Jh:e..,5e- JJi-. ADDRESS: CacuP /Iill, II}- /7011 I ADDRESS: Jg-:J.r/~/.:L1'''''-/.&.., ~fj,jku..r(jJ;f J NAME: :A~~):~L. ADDRESS: (0 2.. cr A J. do"""- ~ R ,g C""- --r (~.s 'e PAGE SIX OF SIX PAGES Commonwealth of Pennsylvania Self-Proving Clause STATE OF PENNSYLVANIA COUNTY OF CUMBERLAND I, LILLIAN' E. GRAY, Testator, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. ~i ~ ~ A5!1.(! LILLIAN E. GF:AY Sworn or affirmed to and E. GRAY, the Testator, this Notary Notarial SA...aI Wanda K Hurt.er, Notary Public Carrltile Boro, Cumberlari:I Countv My Commission Expires Oct. 18, 1993 Affidavit Membef, P$nn"Ylvania Associa:ion of N~"r:es STATE OF PENNSYLVANIA COUNTY OF CUMBERLAND l1Je, EUC;ENF ~ Z:!EdTEL ,.f)t:JU12.ES /Y). Be(}TEt..- , and ..Th.c ""o...~ Gr, \<.a V\~ , the wi tnesses whose names are si gned to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the Testator sign and execute this Will as her Last Will; that LILLIAN E. GRAY signed willingly and that LILLIAN E. GRAY executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator signed the Will as witnesses; and that to best of our knowledge the Testator was at that time eighteen (18) or more years of age, of sound mind and under no constraint or undue influence. ~&~ lffr N ;:) .- ~--'U--u ';0____ - ~~ vJ I TNESS :;:~ r.. D P- K O--.-l WITNESS by and Sworn or affirmed to and subscribed to before me EU6E/V~ vv: BEU/EL- , DOLO/f.E5 IV/ _ /..~EtJTeL.- ~,. . -r""c",^~ ('r'~~~, \.'Jit-nes,S ~es /' _:~~~~. ~d- NctariafSea/ ~~__ ____ Wanda K Hunter, Notary Public Not a r y Carlisle Bora, Cumbeifanj County My CommissioO Exjlres 0::1.18,1993 /P? y;' c:7 . Member, PennSylvania A~ of Nota;ies