Loading...
HomeMy WebLinkAbout07-16-07 . "..J 15056051058 ... REV-1500 EX (06-O5) PA Department of Revenue *' Bureau of Individual Taxes PO BOX 280601 Harrisburg. PA 17128-0601 ENTER DECEDENT INFORMATION BELOW r~~~~!.~~~~!'!~~Et~"'''-''''''-''''''''''''-''''''''''''''j Date of Death INHERITANCE TAX RETURN RESIDENT DECEDENT 00947 Date of Birth ; 1 84-38-2284 1 0/16/2006 1 0/09/1954 Rush Decedent's First Name Decedent's Last Name Virginia MI j.-..'.....-i 1_~J (If Applicable) Enter Surviving Spouse's Information Below ~~~~Et:!~_s.t..~~':r!~......_____.._.__.._._____...__.._.._......_.__.. : ! Suffix Spouse's First Name r--"-~-"-'-'--~'~"'_.~"~~-'~"""'-''''''''--'''~''''~'''---'''''-'''~-....- MI r.......-' L".J 1......_.._...._."...._.....___._.__.........._......_.._.........._.,._...._~....H.. . . . . . . . . . . , . , . ,.....-...........-.---.--...-...........,....,..........,...,..-.-....--~....__._._..,--,.-,-"_.__.._-...,,.._._._.< ,~p()l!~El.~...~()~!lJl.~El<::.l!~ty!'!l!I11~l:lr. THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ~ 1. Original Retum c::> 2. Supplemental Retum c::> 3. Remainder Retum (date of death prior to 12-13-82) 5. Federal Estate Tax Retum Required c::> 4. Limited Estate c::> 4a. Future Interast Compromise (date of death after 12-12-82) c::> 7. Decedent Maintained a LMng Trust (Attach Copy ofTrust) c::> 10. Spousal Poverty Credit (date of death c::> 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.~Y!i.~!!I~p.~.~~.!.~~'!!~r.."___...._._.........""_ c::> ca;J 6. Decedent Died Testate (Attach Copy of Will) c::> 9. Litigation Proceeds Received 8. Total Number of Safe Deposit Boxes ZIP Code ! (717) 249-1177 I'.) I ..............--.....-........................."......................---..........c:::::J......................" . ,.. REGISTERe.. ~LSUSE~ i?,J CS -'3-0 c: IG; '>'? !I :i: ("') r- ! G ~ ".! )> 'F;; i rT'1 l-n -. :z:; ::j:) I :D CJ < (j) 7'- 0"\ ! (' _', <") .JOO -0 i "..c, "=n ,")011 :x' 11 ,'-)C I (~) -::0 N I r"T'1 . -u-1" i ! OA~FILED 1 .---..-..---....-.--.-.----------0--. Stephanie Chertok. Esq. Rrm Name (If Applicable) r__....~_._...~.,.'...HH_._...__...H__........_..._._.....m..__..._...._ I I l.__.........._.........__.........................._........._..M..............._ .,.........._.._..._...~..,.............._..._....__..~.,..........~._..._......._......H'_'-,........_..__...._..~..~_.....,___..~.._,..._.._...~..._. ; First line of address 61 West Louther Street or Post Office 17013 Correspondent's e-mail address: Under penaltfes of perjury. I declare that I have examined this retum, Including accompanying schedules end statements. and to the best of my knowledge end belief. it is true, correct and complete. Declaratfon of preparer other than the personal representative Is based on ell intonnetlon of which preperer has any knowledge. SIGNA! OF IlI'mp~R FILING RETURN pATE ~ '7//&' c A RES .1 /7^- ^ 01 vvEs;r fnh1/ef2 Sr: UIfZ USLE ,-->.4 /)ots SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY L 15056051058 Side 1 15056051058 --.J dtll ~ " -I 15056052059 REV-1500 EX p.f3C8l:I.':!:l!:!_~~~~~_~':~~-"-~_~~.I11!>llE_,_..., 184-38-2284 Decedent's Neme: Virginia L Rush RECAPITULATION 1. Real estate (Schedule A). ............................................ 1. 149,900.00 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . ., 2. -------......----.<! 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . ., 3.! 4. Mortgages & Notes Receivable (Schedule D). . . . . . . . . . . . . . . . . . . . . . . . . . . ., 4. I J" 131,193.19 \ 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . ., 5. ~--------"'""'._-~. + \ 6. Jointly Owned Property (Schedule F) c:::> Separate Billing Requested . . . . . ., 6. I 7. Inter..Vivos Transfers & Miscellaneous Non-Probate Property ~ (Schedule G) c::> Separate Billing Requested... . . . ., 7.! 8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ., 8. I "i 281,093.19 i 31,419.451 9. Funeral Expenses & Administrative Costs (Schedule H). . . . . . . . . . . . . . . . . . . ., 9.! --""-'1 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I). . . . . . .. . . . . . . . . 10. i-w-___"....- 61,289.93 ! 92,709.38 I 11. Total Deductions {total Lines 9 & 10)...................................11.1 --{ ;.....- 12. Net Value of Estate (Line 8 minus Line 11) .. . .. . . .. .. . ... .. . ..... .. . . . .. 12. I 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) .. . . . . .. . . . . . . .. . . . . . . . . 13. ~= 188,383.81 ; .~ 14. Net Value Subject to Tax (Line 12 minus Line 13) .. . . . . . . . . . . . . .. . . . . . . . . 14. TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (e)(1.2) X .0_ 16. Amount of Line 14 taxable at lineal rate X.O 45 20,000.00 17. Amount of Line 14 taxable at sibling rate X .12 168,383.81 18. Amount of Line 14 taxable at collateral rate X .15 188,383.81 ! 15. 16. 900.00 20,206.06 17. 18. 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . ., . ., . ., ... . . .,. . . . . . . . . . .... . . .. . . . 19. 21,106.06 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT c:::> 15056052059 Side 2 15056052059 --1 L REV-\100 EX Page 3 , Decedent's Complete Address: DECEDENTS NAME Virginia L Rush STREET ADDRESS 20 Hillside Circle L~2J~!~I~:~!r M DECEDENl'S SOCIAL SECURITY NUMBER 184-38-2284 CITY Camp Hill Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. I nterestlPenalty if applicable D. Interest E. Penalty TotallnterestlPenalty ( 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) B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (5) (SA) (58) 3,099.32 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. 3,099.32 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; .......................................................................................... D Ii] b. retain the right to designate who shall use the property transferred or its income; ............................................ D Ii] c. retain a reversionary interest; or.......................................................................................................................... D iii d. receive the promise for life of either payments, benefits or care? ...................................................................... D Iil 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. D Ii] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. D Ii] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ Ii] 0 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. ~9116 (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. ~9116 (a) (1.1) (Ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. ~9116(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. ~9116(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+ (6-9. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Virginia L. Rush SCHEDULE A REAL ESTATE FILE NUMBER 00947 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 knowladge of the relevant facts. Real property which Is Jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION Hillside Circle, Wormleysburg, Pennsylvania VAlUE AT DATE OF DEATH 149,900.00 TOTAL (Also enter on line 1, Recapitulation) (If more space is needed, insert additional sheets of the same size) 149.900.00 ~ ~ U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT A. HUD.1 UNIFORM SETTLEMENT STATEMENT B. Type of Loan 1.[ J FHA 2.[ J FmHA 3.[] Conv. Unins. 6. File Number: 7. Loan Number: 4.[ J VA 5.[] Conv. Ins. 105.926 N/A C. NOTE: This form furnishes a statement of settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "(p.o.c.)" were paid outside the closing; they Bre shown for informational purposes and Bre not included in the totals. D. Name & Address of Borrower: E. Name, Address & TIN of Seller: F. Name & Address of Lender. Charles F. Schubert, Sr. & Mary E. Schubert Estate of Virginia L. Rush N/A 841 Hillside Drive 20 Hillside Circle Camp Hill, PA. Wormleysburg G. Property Location: TIN of Seller: 20 Hillside Circle Place of Settlement Wormleysburg. PA 139 W. High Street Carlisle, Pennsylvania 17013 I. Settlement Date: K. Summary of Seller's Transaction 400. Gross Amount Due to Seller' (OMB # 2502.0265) 8. Mortgage Insurance Case Number: , PA H. Settlement Agent: Anthony L. DeLuca, Esquire J. Summary of Borrower's Transaction 100. Gross Amount Due from Borrower: November 30, 2006 101. Contract sales price $149~00.00 401. Contract sales price $149,900.00 102. Personal Property 402. Personal Property 103. Borrower's settlement charges (line 1400) 2,648.25 403. 104. 404. 105. 405. Adjustments for Items paid by seller In advance Adjustments for Items paid by seller In advance 106. Cityltown taxes 11/30/2006 to 12/31/2006 42.26 406. Cityltown taxes 11/3012006 to 1213112006 42.26 107. County taxes 11/30/2006 to 12131/2006 45.86 407. County taxes 1113012006 to 1213112006 45.86 108. Assessments to 408. Assessments to 109. School taxes 11130/2006 to 06/30/2007 959.32 409. School taxes 11/30/2006 to 0613012007 959.32 110. 410. 111. 411. 112. 412. 113. 413. 120. Gross Amount Due from Borrower $153,595.69 420. Gross Amount Due to Seller $150,947.44 200. Amounts Paid by or In Behalf of Borrower: 500. Reductions In Amount Due to Seller: 201. Deposits or earnest money $5.000.00 501. Excess deposit (see instructions) 202. Principal amount of new loan(s) 502. Settlement charges to seller (line 1400) $11,546.07 203. Existing loan{s) taken subject to ~03. Existing loan(s) taken subject to 204. 504. Payoff of first mortgage To: FNCB 41.144.98 205. 505. Payoff of second mortgage 206. 506. 207. 507. 208. 508. 209. 509. Adjustments for Items unpaid by seller Adjustments for Items unpaid by seller 210. Cityltown taxes to 510. Cityltown taxes to 211. County taxes to 511. County taxes to 212. Assessments to 512. Assessments to 213. to 513. to 214. 514. 215. 515. 216. 516. 217. 517. 218. 518. 219 519. 220. Total Paid Byltor Borrower $5,000.00 520. Total Reduction Amount Due Seller $52,691.05 300. Cash at Settlement Fromfto Borrower 600. Cash at Settlement Tolfrom Seller 301. Gross amount due from borrower (line 120) $153,595.69 601. Gross amount due to seller (line 420) $150,947.44 302. Less amounts paid bylfor borrower (line 220) 5,000.00 602. Less reductions in amount due seller (line 520) 52,691.05 303. Cash Irxll from II" 11 to Borrower $148,595.69 603. Cash rxl to II" 11 from Seller $98,256.39 Substitute Form 1099 Seller Statement The information in Blocks E, G, H. I & line 401 (or, if line 401 is aslerisked, line 403 and 404) is important tax information and is being furnished to the Internal Revenue Service. If you are required to file a relurn, a sanction will be imposed on you if this item is required to be reported and the IRS determines that it has not been reported. If this reai estate is your principal residence, file Form 2119, Sale or Exchange of Principal Residence, for any gain, with your income tax return; for other transactions, complete the applicable parts of Form 4797, Form 6252 andlor Schedule D (Form 1040). You are required to provide the Settlement Agent (named above) with your correct taxpayer Identification number. If you do not provide the Settlement Agent with your taxpayer Identification number, you may be subject 10 civil or criminal penalties imposed by law. Under penalties of perjury, I certify that the number shown on this statement is my correct taxpayer identification number. (Seller) (Seller) Estate of Virginia I. Rush Estale of Virginia L. Rush ~ ., L. Settlement Charaes 700. Total Sales/Broker's Commission: (based on price) $149.900.00 @ 6 % Paid from Paid from Division of Commission Cline 7001 as follows: Borrower's Seller's 701. $4,522.00 To; Georoe L. Ebener & Associates Funds at Funds at 702. $4,472.00 To: M.C. Walker Realty Settlement Settlement 703. Commission paid at Settlement $B,994.00 704. 800. Items Payable In Connection with Loan B01. Loan Oriainatian Fee B02. Loan Discount B03. Aooraisal Fee B04. Credit Reoart B05. Lender's Insoection Fee B06. Mortoaae Insurance AODlicatian Fee B07. BOB. 809. 810. Bl1. B12. 813. 814. 900. Items Required bv lender to Be Paid in Advance 901. Interest from I I to I I (/j) $ I I per day 902. Mortoaae Insurance Premium for 903. Hazard Insurance Premium for 904. 905. 1000. Reserves Deooslted wIth lender 1001. Hazard insurance months $ oer month 1002. Mortaaoe insurance months $ per month 1003. Citv orooertv taxes months $ per month 1004. County orooertv taxes months $ per month 1005. Annual assessments months $ per month 1006. months $ per month 1007. 1008. 1009. Aoareoate Accountina Adiustment 1100. TItle Charaes 1101. SelllemenVclosina fee 1102. AbstracVtitle search 1103. Tille examination 1104. Title insurance binder 1105. Document preparation 1106. Notarv fees To: Notary Public 2.00 1107. Allomev's fees (includes above item numbers 1108. Tille insurance To; A.L. DeLuca. Esa. Agent for Security Title Guarantee Coro. of Baltimore 1,108.75 (includes above item numbers 1101,1102,1103,1104 1109. Lender's coveraae 1110. Owner's coveraoe. $149,900.00 1111. 1112. 1113. 1200. Government Recording and Transfer Charaes 1201. Reeordina fees: Deed 3B.50 Mortoaoe Release 38.50 1202. Citv/countv tax/stamos: Deed 1,499.00 Mortoaoe 1,499.00 1203. State tax/stamos; Deed 1,499.00 Mortoaoe 1,499.00 1204. 1205. 1206. 1300. Additional Settlement Charaes 1301. Survev 1302. Pest Insaeetion 1303. Ovemioht Mailino To; Anthony L. DeLuca. Esquire 25.00 1304. County, Library and Borouoh Taxes To: William A. O'Donnell, Tax Collector 925.03 1305. Water bill To: Pennsvlvania American Water 103.04 1306. 1307. 130B. 1400. Total Settlement Charaes (This Number Transfers to Lines 103 & 502 Above) $2.648.25 $11,546.07 OE~'_ I have s;te;ully reviewed the HUD.' Settlement Statement and to the best or my n dge a . beli If,J is a UE ~ceurate statement or all receipts and 7.?/ mn"/". account or by me in this transaction. I rurther certify he . HUD.' Settlement Statement. . .... .,.- --- Seller V ., ,...., Borrower r::?"'jV- r I '!!S[ate u. .~.' s <:::;f), a.,,-Chaa Sr. ~ !l3; rt, Sri 7. Seller ~ . Borrower - , .. !l, Ma.r:y'E. Schubert To the best or my knowledge the HUD-' Settlement Statement which I have prepared is true nd accurate account of the funds which were received and settlement or this transaction. Settlement Agent November 29, 2006 Date . DeLuca, Esquire ake ,... sllleme~llo lhe Unlled S1118. on InlS Dr any Olner Slfnll", lorm Penallltts upon c:onYicllOn can Include I fine Ind impnsonment For delails see: Tille 18 U 5 .. DISBURSEMENT REPORT ~ Name and Address of Borrower: Charles F. Schubert, Sr. and Mary E. Schubert File Number: 105-926 Contract Sales Price: .Name and Address of Seller: . Estate of Virginia L. Rush 20 Hillside Circle Wormleysburg $149,900.00 PA Settlement Date: November 30, 2006 PROCEEDS 201. 202. Item Proceeds from Bu r(s) Deposits or earnest money Principal amount of new loan(s) Entity Charles F. Schubert, Sr. and Mary E. Schubert Amount $148,595.69 5,000.00 $ 000 TOTAL: $153,595.69 DISBURSEMENTS Item Entity Amount Disbursements to Seller(s) to Estate of Virginia Rush $98,256.39 Payoff of first mortgage to FNCB 41,144.98 Commission paid at Settlement to George L. Ebener & Associates 4,522.00 Commission paid at Settlement to M.C. Walker Realty 4,472.00 Notary fees to Notary Public 2.00 Tille insurance to A.l. DeLuca, Esq. Agent for Security Title 1,108.75 Guarantee Corp. of Baltimore Deed to Recorder of Deeds 38.50 City/county tax/stamps: to Recorder of Deeds 1,499.00 State tax/stamps: to Recorder of Deeds 1,499.00 Ovemight Mailing to Anthony L. DeLuca, Esquire 25.00 County, Library and Borough Taxes to William A. O'Donnell, Tax Collector 925.03 Water bill to Pennsylvania American Water 103.04 to TOTAL: $153,595.69 to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to l' REV-1508 EX+ (6-98) *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Virginia L. Rush 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 NUMBER DESCRIPTION 1. PSECU Regular Share Account # 0450116553 ;PSECU Checking Account # 0450116553 Bank Savings Account # 0626796627 ; Harrisburg Radio Lab Store Credit TOTAL (Also enter on line 5, Recapitulation) (If more space is needed, insert additional sheets of the same size) FILE NUMBER 00947 VALUE AT DATE OF DEATH 513.35 4,162.77 103,531.01 3,686.06 18,500.00 800.00 Commerce "Bank Commerce Bank/Harrisburg N.A. 3801 Paxton Street . Harrisburg, PA "111 888-937-0004 STATEMENT DATE VIRGINIA L RUSH 20 HILLSIDE CIRCLE CAMP HILL PA 17011 09/30/06 0626796627 ACCOUNT NO. *** SAVINGS *** PREMIER SAVINGS ACCOUNT NUMBER 0626796627 PREVIOUS STATEMENT BALANCE AS OF 06/30/06 ........ ................ PLUS 1 DEPOSITS AND OTHER CREDITS ...... ............. LESS 0 WITHDRAWALS AND OTHER DEBITS ................ CURRENT STATEMENT BALANCE AS OF 09/30/06 .......... ........... .... NUMBER OF DAYS IN THIS STATEMENT PERIOD 92 BEGINNING RATE CYCLE-051 2.47200 102,887.96 643.05 .00 103,531.01 *** SAVINGS ACCOUNT TRANSACTIONS *** DATE DESCRIPTION 09/30 INTEREST PAYMENT DEBITS CREDITS 643.05 ----------------------------------------------------------------------------------- *** BALANCE BY DATE *** 06/30 102,887.96 09/30 103,531. 01 PAYER FEDERAL ID NUMBER INTEREST PAID YEAR TO DATE 23-2324730 1,427.42 *** INTEREST EARNED THIS STATEMENT PERIOD DAYS IN PERIOD . ..~..................... INTEREST EARNED ........................ ANNUAL PERCENTAGE YIELD EARNED (APY).... *** 92 643.05 2.50% "'n.-rr-. ___ __....____ ___ .. C C:Ii../j Fou 1-10 I/J HoUSE- tOtALLED # /..f73. 31 .__..IO.Jd&l...j?"i"iEO..'. ',~-;)()....~....EO/?_._r.tff: .ZgQ4_STQ.'Y~____..._.. ... '_"" ."._.. .... . ._____.__ . -. .J!RR~l...._.TMK_.I.H.~_..h/ATERJ3ED,_EJJIfgr:kIhJ~1_.",~"i~EI1.)_.,.._C.~CI.t.... . "" .....LoVE5EAT.r.__.C_HAI/?'1_" T~) _.D.vD.. _P~~fJ<,..__~._LAM P~_.)......_ .tKQC.f~rfJ. ~ L:S .. ... . , .' ...,.-------.-.. -- _._SJ1JzRbL\'u~,~ .-Sb.,(;.)J,t)____.___. ____.___._._________._.._____._.__. _._____..._._.._..___-'--~.1!tRJ.r~le..tt_ ()!; - . -- f!_~. rO..DK.__IYJJ.J &[. _~I.{J_..__ '. -.,i11f~~~AlTDDJ<.6R.1~4..DJb.,..g_~JJb-~4D.____ .. ... . -- -------......--.. _.__mJ~.R.. ._....,,/.0.__ ..______.. .____ ..._.____. _.. .____. '_m__.. .. ...... _.__._....__._____.,_ ...._____.__.... .____...". _ _______.""..... '.'__ ..______mm.'__ , .,--... .. ..---~-._.-,._--- ..AJJltYJ"PS... ._L.~ .-~......,--_..---...~IlfU-.J\dL6Ql< _.P,.I!Q"S&._!__.S .~_W 33 E;3__:::_____.____._~_____ , -.., - ..----.~..--.. ". --.--. ,P-'-~ru..R1;____.__ I.t?...___....".. ., ..dO.___.... _..__.._ . __ __....____ __ ... ._.._".... ..._____,,_.__________..._.____......__ ....__......____,_....,,___.___ _"d_." ---- ... ---..' . .8fLif~~-Lf> ..._hJ~mP .. . .~-- - __ ...~'(>_J~~_______ . ..--....---.--...--. .-.-- .--. --.-. -- .. Ull<6 ~Q~ .. . .' ........"........ -..--..--.---..--.1].... ...c.... -.. ....-.. ...... .... .....' .-..-........... """ '''-----''.'' ......... '__ .... ....". _...._._ ._.__.. ........ .._ .".... .....__....... ........ ._.._ ........... ...."...-...__. r~jk5 tD &/lt/J....r (~ ~f::lilUDm\~ I~b. r'aFru~P.Jlrot Db A P(e,~. /5" ~bL/"r ~'6. (V $J) rnlC{l.6LQ~V6 Ir ....AQJ.b.......__...__l~.____..._ \I~9~..._ _"" .. .9:0_. ...." ,__".' .fbpQK~ .. _............ .__~. ._.. _._:.p.~ rlb....~HJ3IRsLV. .16.... . 6 FOJ...!i/ul:r ..~~-'-~~J!lt~._...li.__..__._.....~t~tQl_~.. '.__ -.----.t.,..___L~.~__$.<c._[_._....____"... 9_.. ....___..~s H..~~L~..~E:J]}_J'.. . __f~Y~Jd~. _.....J. ~_..._.._._.f!.: H L4>.l~. ...___._ A~._....____..~k..fL....._....... _ __~ _b....... ..J1?!!).t~.....~l.Ql_. ....Jt>.... .~-Q~....~.~~.._._L~.. -~_--.~B_:~~;L-__._LD____._~~j_~~~_._.___...."..f... .... __.__~.~.3_~._C~)__.._.._ .1Q._. . I~~()J~$..._.. .........__~_ '.. _. .__....r~~....:! ~L._.__.__ j_... ..____..~~.I I.Q- ~...~ ~_.._.. ____. {, "'_" ...b.Jlm.@.S ...La.}. . '_' J.P.... rpb~tf:>Y:__..~~ . .__..[l~_.g~L._.__.ID.....___[~t'J..~_t.L_. ... ..,.cr .d. _.J.,OI,~Hr~T(lIJ.1 b RrRbQfl1 I l'eA UJILT.l5... ..tM>rN~... I; n~ ~ ~ } () TR flt.:l.d .. (..BfJ.J'JM I<2:I rJ. ..s r~Mb I D .t\1/ R.)<J)Q.. ..J 0 3 (J Iu J.JCrSrb/ tJI TIJ.ff;h!; I... . }Yl&Ynb.fJ.A~lJJ{J 40 .. .h..A rnP. ~f) l.V>~~k~()) ID . ',- ~bl.t Of' k. IVI ng .s@'YJ;.}~! .__..._.__....___L.. ._.___P..B-' .1.)[1 U.k. ... __.!iJ>_._ ..._ ___.bJLil1e__.......___..... ..~_...... . .-,.,,~&!!.6JUrrl_bl;&--.m.....JQ " .rfJ.RS~t!!J..Y. ..._ L ....._bAYhP_ ....._ ", ..__.,.L.1J~,.. ._.~'Y~I~lJ5).._. )~~.... __._~.o.OJ(--.....__-.:u"......j~ ...4.:~fLA.... ...-......_J.-._...,_....~~~&tm.~. ....-..-~.---....-b-~~ -Nb~E.....__.___.~___.._.._l:u1_.rA~fJs._... ..~.._Q.J)_.__ ~~r...... '._-(..._W~I(. .....~. I.~." _.....e..HJ9:..r. .. .tb ..~.m~k%:..._'.U> .. - fYl..~... -...--.......:~..._.._._..Prr.~U.C,i{,... ...._..._.__..~_._. ._.. J1ILt,,-lL~.rYL.....,. .__....J.t> __.n.~......."..._ ...., ..."....._..1 J._~... 7& nt~..._.._... _.~,..._f_.___ __....Ur..t!1tf,L i-J... .___._._...._'?..... ....._.____._~~ol<~.{~p>.. .. __...J?? "_ ....., .._........_._.._~ """ ..... ..............._. _.' __...___ [qQ bS.._.__,.. _.__...~.__..._ __.c,.,~ ~s!S_ ._....._..M.._,._.._..__,_.~jj.14Dv._Yb._._... ""__ ...(...____ ._______.._.._...___... .Ll.9-(X.,~I$.'".. (!, 1!-~.t__3.~I_...q ""'., .... ...~.~~.4(J1l}~ .._._.. ..J 7._ ___...J~J~J;,~.Sl:~{j)..._,_Q,>_.... . 'm .... _...._:_-_........L<{_Q_l.L_].~. PJc,rlA,R.!_.__^~.....r=L~I;,.,P...'Yl__ "". JQ....--__..~QE~IDrro.M~LJ.~~~b .___AEr9;~.~R~.. PIe..nl,a..__.~~_.....EI0;,~/. k.o.t...jlJ......___b.bt..pU!j._... ..!~.. .. A.J?HJjln.l).b~ ; 10 [) r~'8~ _'_. .~_,_. _fLC:r.IJ.&d _~E? .. _~6_ _......~.cU:c.+t_... JS; Potb .~.P~ t 10 ~~8r.:r"O .fIrobl<,.f::, $"' P I c'rlA~ ~ .J.. WAlVlOS ... ib r1:.Jlg <c -r ..C.O_.J..rJ mpgo .fQ;~~g, (f)D?"d1.Q !jrU:~~'?:R.._.... ..___d.b '. - n.~"~z:T'r-"G'6_ ..__.LD.t..~ ._.....~.l)..... ._.~~..u:t_..... ~.._. ''''.'_. ,J~f-" r---. - 9..~~ c-ft 1'\ _'" .,. ____._.._.__Gb66.Wl.tL.._._.....__.. ._-.... _ .._.. (! t...6 TU &s ./6 go ~ 2:S g J'l1 f(lU IQ {J p t-..ua um ~ gO ~.~ . ~ Yoi;g .~ eD0.t~ ."' ,'~.."-.,.....,,_............__....-....'_~,'W.......__",......_,,.<_...:.,_.......~.....~.._-":'_.,.-........"_<;"......,......"...,,..,'''''.,.~.,..__,........_.._.__..,....,''"''''''_'''"'_'_'_ .,,~06...>-_""""'...;,__,_.__.._ ,.....--'......~,._......__..,..._ "., ,~._.,~..._...,..,,_....,_._~..~.~...'" ....~., _~_'_'__,'".. _'--"._,"""._...-.____..__.,._....;...,-......._'".._.... Pennsylvania Slole Employees Credit Union II I P.O. Box 67013 (717) 234-8484 (Harrisburg) Harrisburg, PA 17106-7013 (800) 237-7328 (Nationwide) website - http://www.psecu.com TALK TO US FOR ALL YOUR LOAN NEEDS! AUTOS & TRUCKS, MORTGAGES, PERSONAL & MORE! WWW.PSECU.COM OR CALL 800.LOAN.555 EQUAL OPPORTUNITY LENDER II J 11111111111111111111111111111111111111111111I1111I111111111 VIRGINIA L RUSH 20 HILLSIDE CIR CAMP HILL PA 17011-1818 JOINT ONNER PAGE 1 " " "'" P.O. Box 67013 (717) 234-8484 (Harrisburg) Hmrisburg, PA 17106-7013 (800) 237-7328 (Nationwide) WebS[fe - http://www.psecu.com CONSOLIDATE HOLIDAY DEBT & PAY JUST 4.9% ANNUAL PERCENTAGE RATE! USE THE VISA~ BALANCE TRANSFER OPTION IN PSECU_HOHE~ TO HOVE BALANCES TO YOUR CAPITOL CARD~. VIRGINIA L RUSH JOINT ONNER PAGE :2 0202 300 054 4 10 2002678 .. The HarrisbLr-g .. . RADIO LAB. . DISTRIBUTORS OF CS'S .T.V:S. STEREO .VIDEO 19TH 1& PAXTON STS. MAILING ADDRESS 909 SOUTH 19TH ST HARRISBURG, PA 17104 PHONE (717) 236-9048 -ro ~ E S~~-rt 0 ~ V fU!rv~ ~uJ ft U fQ.,G.,\,tJlJ\- {LUJ rt I+A-S AJJ rr 800.00 Cg &91t LD l-tit L~ Ur WJro L~ · CA~ ~lC{JfD ~JL j;N <;to(LLcfl€~rf- () N l~ · -r l+~j ~~ . \~\d--7\60 YOU'LL ALWAY S DO BETTER AT THE RADIO LAB Ewing Brothers Funeral Home, Inc. 630 South Hanover St.; Carlisle, PA 17013 Since 1853 Phone: ~717)243-2421 Fax: (717)243-7553 E-Mail: EwingBrothers@aol.com STATEMENT OF FUNERAL GOODS AND SERVICES SELECTED Char3es are only tor those items that you selected or that are required. If we are required by law or by a cemetery or a crematory to lIse any items we will explain the reasons in writing below. If you selected a funeral that may require embalming, such as a funeral with viewing, you may have to pay for ' embalmi.ng. YOll,do not ~ave to pay for embalming YOll did not approve if you selected arrangements such as cremation or immediate burial. If we charged for embalmmg we will explom why below. For the Service of: Virginia L. "Gini" Rush Date of Death October 16, 2006 Charge to: Charles Anthony Washington 245 E. Louther Sl. Carlisle Name Address Steven A. Ewing, Supervisor Seymour A. Ewing, F.D. William M. Ewing, F.D. City PA State $ -0- $ -0- $ -0- TOTAL MERCHANDISE SELECTED........... B $ C. SPECIAL CHARGES Forwarding of remains to (Funeral Home) Immediate Burial. . . . . . . . . . . . . . . . . . . $ -0- Direct Cremation. . . . . . . . . . . . . . . . . . $ -o- S -0- C$ A. CHARGE FOR SERVICES SELECTE . Traditional Package Itemized Services 1. PROFESSIONAL SERVICES Services of Funeral Director/Staff. . . . . . . . . .$ 3,695.00 Embalming . , . . . . . . . . . . . . . . . . . . . . . . . . .$. -0- Other preparation of body Other Clothino $ $ Cremation Urn. . . . . . . . . . . . . . . . . . . . .$ (Description) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$ -0- SUB-TOTAL OF PROFESSIONAL SERViCES..... ..... A1 $ 3,695.00 2. FACILITIES AND SERVICES Use of facilities and services for Viewing (VisitationlWake). . . . . . . . . . . . . . . ., -0- Use of facilities and services for Funeral Ceremony. . . . . . . . . . . . . . . . . . . . . $ . -0- Use of facilities and services for Memorial Service . . . . . . . . . . . . . . . . . . . . . . $ . . -0- Use of equipment and services for Graveside Service. . . . . . . . . . . . . . . . . . . . . ., . . -0- Other use of facilities (Funeral Home) ReceiVing of remains from SUB-TOTAL OF SPECIAL CHARGES. . . . . . . . . . D. CASH ADVANCED: Opening Grave (EstimateJ. . . . . . . . . . . .$ Cemetery Equipment. . . . . . . . . . . . . . .$ Lot and Deed. . . . . . . . . . . . . . . . . . . . . . $ Newspaper Notices - Out-of-town . . . . . . $ Telephone & Telegrams.... ..... .. ..$ Airfare. . . . . . . . . . . . . . . . . . . . . . . . . . . $ Clergy/Mass Offering. . .. . ....... ....$ Pallbearers. . . . . . . . . . . . . . . . . . . . . . . $ Certified Copies of the Death Certificate. $ Police :~...................$ t:J Flower~. . . , . . . . . . . . . . . . . . .$ Vault Serv ce Charge, . . . . . . '. . . . . . '. . .$ Sentinel obituary with photo (Estimate). . $ Patriot Obituarv withPhoto (Est.) $ Rock charge if any???? $ $ $ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$. -0- SUB-TOTAL OF FACILITIES/EQUIPMENT. . . . . . . . . . . . A2 $ 0.00 3. AUTOMOTIVE EQUIPMENT Vehicle to transfer remains to Funeral Local . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ -0- Hearse (Casket Coach) Local. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ -0- Limousine Local. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ -0- .Family Car Local. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ -0- Flower car or floral disposition Local. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ -0- Lead car/Clergy Local. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ -0- Car for pallbearers . 'I: _0_ -0- -0- -0- 3,990.00 $ -0- $ -0- -0- 750.00 -0- -0-, -0- -0- -0- 100.00 -0- 90.00 -0- -0- -0- F5.00 275.00 -0- -0- -0- ~ " A Brenner Family Dealership" BRENNER 717 -697-8400 717-697-9133 FAX BRENNERFAMILY.COM 61 MAILING ADDRESS: P.O. Box 1019 Camp Hill, PA 17001-1019 STREET ADDRESS: 6271 Carlisle Pike Mechanicsburg, PA 17050 plG-A/;;(.-t/l ./Z/F$~ 7.s /3~:r.A-'to /T 2003, A/f~S<Y-W ~a?AA-() F~/'Y7 177'E'" t:--S7m2: Or ;s;. ()IC / J: $V{) oc:J. Y'n~ }2(;.R.l"J7' iCv Tr7F /-r.hTu{/lT 7?7~'?L- F~ /q ~47~C C/~ ILl. 5/0. S'"{ ?/AJ rl-1'~ ~ ,.r- ,& ?C(2CJ, /) '-.17 f... ~&- 5,-':'/1- r TO p,z::;.vc-G./U1-'L- CJ rc ..:>,# I, f/i-'T' 1/ ~H FfA..c,,~ Tf7&' -Tnl5 ES7/'! r~ tvH,-':: "t,.1 ,g/7,;/f./A,-i.!Z- ~5~ ;?b-.:Fi,v&-:. 71-7/; ;rrilG plt.".,.-, C~& ./lCA/O r~/I"-('-('.&-, }2-C;,.r~ ~t!/1 CJIZ*'4{7 U'5~v.J ore p1tye . (7~ REV-1510 EX+ (6-98. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER Virginia L. Rush 00947 This schedule must be completed and filed if tha answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE TRANSFEREE. THEIR RELAllONSHIP TO DECEDENT ANO THE DATE OF 1RANSI'ER. ATTACH A COPY OF THE DEED FOR REAl ESTATE. EXCLUSION TAXABLE VALUE 'SERS Retirement Account, March 2007, Carol L. Floyd, Sister 'SERS Retirement Account, March 2007, Anna M.lrwin, Sister 'SERS Retirement Account, March 2007, Beverly A. Murtoff, Mother 'SERS Retirement Account, March 2007, Lisa G. Puscian, Sister !SERS Retirement Account, March 2007, James A. Rush, Brother ,SERS Retirement Account, March 2007, Jerome A. Rush, Brother 'SERS Retirement Account, March 2007, John W. Rush, Brother SERS Retirement Account, March 2007, Mary I. Rush, Sister 'SERS Retirement Account, March 2007, Charles Anthony Washington, , NepheYi 'SERS Retirement Account, March 2007, Fred Belardi, Friend TOTAL (Also enter on line 7 Recapitulation) $ (If more space is needed, insert additional shaets of the same size) .. COMMONWEALTH Of PENNSYLVANIA STATE EMPLOYEES' RETIREMENT SYSTEM 30 NORTH THIRD STREET - SUITE 150 HARRISBURG. PENNSYLVANIA 17101-1716 TOLLfREE: 1-800-633-5461 www.sers.state.pa.us Stephanie E. Chertok Attorney at Law 61 West Louther Street Carlisle, Pa. 17013-2936 Dear Ms. Chertok: July 2, 2007 I am writing in response to your attached letter regarding the SERS retirement accoun~ ot virgi~~.a .L. Rush, 184-38-2284.. In your correspondence you request a list of the beneficiaries and amounts distributed as death benefits from Ms. Rush's account. After consulting with the SERS Legal Department I have been advised that I can provide that information. All money has been paid as follows: Fred Belardi Carol L. Floyd Daniel Z. Floyd Anna M. Irwin Beverly A. Murtoff Lisa G. Puscian Ashley N. Rush James A. Rush Jerome A. Rush John W. Rush Mary J. Rush Valerie J. Steinman Charles Washington Total $234,661. 59 $51,013.39 $30,608.03 $51,013.39 $51,013.39 $5-1,013.39 $30,608.03 $51,013.39 $61,216.07 $51,013.39 $275,472.30 $51,013.39 $30,608.03 (23%) (5%) (3%) (5%) (5%) (5%) (3%) (5%) ( 6%) (5%) (27%) (5%) (3%) $1,020,267.78 Please also be informed that SERS funds are not subject to Pennsylvania state taxes of any kind, including inheritance taxes. If you have any questions I can be reached at (717) 237-0277. Sincerely, ~ ~ ;?5:rector Benefit Determination Division REVo1511 EX+ (12099) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Virginia L. Rush FILE NUMBER 00947 Debts of decedent must be reporlBd on Schedule I. ITEM NUMBER A. DESCRIPTION AMOUNT 1. FUNERAL EXPENSES: Ewing Brothers Funeral Home Services of Funeral Director Casket Outer Receptacle Opening Grave Mass/Clergy Obituary and Death Certificate ADMINISTRATIVE COSTS: 0.00 B. 1. Personal Representative's Commissions Name of Personal Representative(s) : Charles Anthony Washington Social Security Number(s)/EIN Number of Personal Representative(s) Street Address 245 East Louther Street City Carlisle Year(s) Commission Paid: . N/A State PA Zip 17013 2. Attorney Fees 3. Family Exemption: (If decedent's address is not the same as claimanfs, attach explanation) Claimant Street Address City Relationship of Claimant to Decedent 4. Probata Fees 360.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 90.00 7. Settlement Fees 8. Advertisement for Tag Sale at Decedent's Residence 9. Estate Notice TOTAL (Also enter on line 9, Recapitulation) $ (If more space Is needed, Insert additional sheets of the same size) 31,419.45 RECEIPT FOR PAYMENT ------------------- ------------------- GLENDA FARNER STRASBAUGH Cumberland County - Register Of Wills One Courthouse Square Carlislet PA 17U13 RUSH VIRGINIA L Estate File No. : Paid By Remarks: 2006-00947 CHERTOK STEPHANIE CMM Fee/Tax Description PETITION LTRS TEST WILL SHORT CERTIFICATE JCP FEE AUTOMATION FEE Check# 2332 Total Received......... Receipt Date: Receipt Time: Receipt No. : 10/27/2006 14:16:41 1046148 Receipt Distribution ------------------------ PaYment Amount Payee Name 310.00 15.00 20.00 10.00 5.00 ---------------- $360.00 $360.00 CUMBERLAND COUNTY GENERAL FUN CUMBERLAND COUNTY GENERAL FUN CUMBERLAND COUNTY GENERAL FUN BUREAU OF RECEIPTS & CNTR M.D CUMBERLAND COUNTY GENERAL FUN / U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT A. HUD-1 UNIFORM SETTLEMENT STATEMENT B. Type of L.oan 1.[] FHA 2.[) FmHA 3.[) Conv. Unins. 6. File Number: 7. loan Number: 4.[) VA 5.[) Conv. Ins. 105-926 N/A C. NOTE: This form furnishes a statement of settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "(p.o.c.)" were paid outside the closing; they are shown for informational purposes and are not included in the totals. D. Name & Address of Borrower: E. Name, Address & TIN of Seller: F. Name & Address of lender: Charles F. Schubert, Sr. & Mary E. Schubert Estate of Virginia L. Rush N/A 841 Hillside Drive 20 Hillside Circle Camp Hili, PA. Wormleysburg G. Property location: TIN of Seller: 20 Hillside Circle Place of Settlement Wormleysburg, PA 139 W. High Street Carlisle, Pennsylvenla 17013 I. Settlement Date: K. Summary of Seller's Transaction 400. Gross Amount Due to Seller: (OMB # 2502.0265) 8. Mortgage Insurance Case Number: , PA H. Settlement Agent: Anthony L. Deluca, Esquire November 30. 2006 J. Summary of Borrower's Transaction 100. Gross Amount Due from Borrower: 101. Contract sales price $149;900.00 401. Contract sales price $149,900.00 102. Personal Property 402. Personal Property 103. Borrower's settlement charges (line 1400) 2,648.25 403. 104. 404. 105. 405. Adjustments for Items paid by seller In advance Adjustments for Items paid by seller In advance 106. CI1y/town taxes 11130/2006 to 12/31/2006 42.26 406. City/town taxes 11/30/2006 to 12/31/2006 42.26 107. County taxes 11/30/2006 to 12/31/2006 45.86 407. County taxes 11/30/2006 to 12/31/2006 45.86 108. Assessments to 408. Assessments to 109. School taxes 11/3012006 to 06/30/2007 959.32 409. School taxes 11/30/2006 to 06/30/2007 959.32 110. 410. 111. 411. 112. 412. 113. 413. 120. Gross Amount Due from Borrower $153.595.69 420. Gross Amount Due to Seller $150.947.44 200. Amounts Paid by or In Behalf of Borrower: 500. Reductions In Amount Due to Seller: 201. Deposits or earnest money $5,000.00 501. Excess deposit (see instructions) 202. Principal amount of new loan(s) 502. Settlement charges to seller (line 1400) 511,546.07 203. Existing loan(s) taken subject to ~03. Existing loan(s) taken subject to 204. 504. Payoff of first mortgage To: FNCB 41,144.9B 205. 505. Payoff of second mortgage 206. 506. 207. 507. 208. 50B. 209. 509. Adjustments for Items unpaid by seller Adjustments for Items unpaid by seller 210. City/town taxes to 510. Cityilown taxes to 211. County taxes to 511. County taxes to 212. Assessments to 512. Assessments to 213. to 513. to 214. 514. 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. 220, Total Paid Bylfor Borrower $5,000.00 520. Total Reduction Amount Due Seller $52.691.05 300. Cash at Settlement Fromlto Borrower 600. Cssh at Settlement Tolfrom Seller 301. Gross amount due from borrower (line 120) $153,595.69 601. Gross amount due to seller (line 420) $150.947.44 302. less amounts paid by/for borrower (line 220) 5.000.00 602. less reductions in amount due saller (line 520) 52,691.05 303. Cash fxl from f1 to Borrower $148,595.69 603. Cssh IIXlI to I I from Seller $98,25639 Substitute Form 1099 Seller Statement The information in Blocks E, G, H, I & line 401 (or, If line 401 is asterisked, line 403 and 404) is important tax informalion and is being furnished 10 the Internal Revenue Service. If you are required to file a return, a sanction will be imposed on you if this item is required to be reported and the IRS determines that it has not been reported. If this real estate is your principal residence, file Form 2119. Sale or Exchange of Principal Residence, for any gain, with your income tax retum; for other transactions, complete the applicable parts of Form 4797, Form 6252 and/or Schedule 0 (Form 1040). You are required to provide the Settlement Agent (named above) with your correct taxpayer identification number. If you do not provide the Settlement Agent with your taxpayer identification number, you may be subject to civil or criminal penalties Imposed by law. Under penalties of perjury, I certify that the number shown on this statement is my correct taxpayer identification number. (Seller) (Seller) Estate of Virginia I. Rush Estale of Virginia L. Rush L Sett ement Charaes 700. Total Sales/Broker's Commission: (based on pricef Division of Commission (line 700) as follows: 701. $4,522.00 To: Georae L. Ebener & Associates 702. 54,472.00 To: M.C. Walker Realtv 703. Commission oaid at Settlement 704. 800. Items Pavable In Connection with Loan 801. Loan Orioination Fee 802. Loan Discount 803. ADoraisal Fee 804. Credit Reoort 805. Lender's InsI'>Action Fee 806. Mortoaoe Insurance Application Fee 807. 808. 809. 810. 811. 812. 813. 814. 900. Items Reaulred bv Lender to Be Paid In Advance 901. Interest from I I to I 902. Mortoaoe Insurance Premium for 903. Hazard Insurance Premium for 904. 905. 1000. Reserves Deooslted with Lender 1001. Hazard insurance 1002. Mortoaoe insurance 1003. Citv orooertv taxes 1004.CountvDroDartvtaxes 1005. Annual assessments 1006. 1007. 1008. l009.AMr6<]ate Accountino Adiustment 1100. Title Char"es 1101. Settlement/closino fee 1102. Abstract/title search 1103. Title examination 1104. Title insurance binder 1105. Documentoreoaration 1106. Notarv fees To: Notarv Public 1107. Altome-v's fees -(includes above item numbers 1108. Tille insurance To: A.L. Deluca, Eso.-ACent for SecurilVTille Guarantee Corp. of Baltimore (includes above item numbers 1101,1102.1103,1104 1109. lender's coveraoe 1110. Owner's coveraoe - 5149,900.00 1111. 1112. 1113. 1200. Government Recording and Transfer Charges 1201. Recordino fees: Deed 38.50 Mortoaoe 1202. City/county tax/stamps: Deed 1,499.00 1203. State tax/stamos: Deed 1,499.00 1204. 1205. 1206. 1300. Additional Settlement Charaes 1301. Survey 1302. Pest InsOBction 1303. OvamTciht Mailing To: Anthony L. Deluca, Esouire 1304. County, Librarv and Borouoh Taxes To: William A. O'Donnell, Tax Collector 1305. Water bill To: Pennsvlvania American Water 1306. 1307. 1308. 1400. Total Settlement Charaes (This Number Transfers to Lines 103 & 502 Abovel CERTIFICt~~N I have ~ully reviewed the HUD.1 Settlement Statement and to the best of my n \.t~gJ apl"ber.~ is a disWMSernellf5 ma~ mv account or by me in this transaction. I further certify ha // ", I/ :-~rr I O'P'>A'" Seller IA I'IJlV. V 1l3- L...... ~71 '!'S'rate ~, s -"" ". Cha~ sl . Sj ~ rt, StJ 7 ...-- ./ Seller '-nil ~ D. . Borrower , " 1/ MaWE. Schubert . To the best of m knowled e the HUD-1 SeUlement Statement which I have prepared is true ~nd accurate account of the funds which were received and seUlemenl of this transaction. SelUemenl Agent November 29, 2006 . Deluca, Esquire' e '.IAII.emlnlslothe Unlled Sllles on Ihls 01 8")"DI"" Ilm..ar form p,nillhls upon cartYiChon tlfllnclude. line.rd imprl5Ol1menl For dellAls see Tille 111 U S $149,900.00 @ 6 % Paid from Borrower's Funds at Settlemenl Paid from Seller's Funds al Settlement $8,994.00 T@5 I lperdav months months months months months months 9i $ $ $ $ $ oar month oar month oar month oer month oar month oar month 2.00 1,108.75 Release 38.50 1,499.00 Mortl'laoe Mortl'laQe 1,499.00 25.00 925.03 103.04 $2,648.25 $11.546.07 ccurate statement of all receipts and HUD-1 Settlement Statement. Borrower Date DISBURSEMENT REPORT Name and Addrell of Borrower: Charles F. Schubert, Sr. and Mary E. Schubart File Number: 105-926 Contract Sales Price: .Name and Address of Saller: . Estate of Vir9inia L. Rush .20 Hillside Circle Wormleysburg $149,900.00 PA Settlement Date: November 30, 2006 PROCEEDS 201. 202. Item Proceeds from Bu er(s) Deposits or earnest mone Principal amount of new loan(s) Entity Charles F. Schubert, Sr. and Ma E. Schubert Amount $148,595.69 5,000.00 $ 0.00 TOTAL: $153,595.69 DISBURSEMENTS Disbursements to Seller(s) to Estate of Virginia Rush $98,256.39 Payoff of first mortgage to FNCB 41,144.98 Commission paid at Settlement to George L. Ebener & Associates 4,522.00 Commission paid at Settlement to M.C. Walker Realty 4,4 72.00 Notary fees to Notary Public 2.00 Title insurance to A.L. DeLuca, Esq. Agent for Security Title 1,108.75 Guarantae Corp, of Baltimore Deed to Recorder of Deeds 38.50 City/county tax/stamps: to Recorder of Deeds 1,499.00 State tax/stamps: to Recorder of Deeds 1,499.00 Ovemlght Malling to Anthonv L. DeLuca, Esquire 25.00 County, Library and Borough Taxes to William A. O'Donnell, Tax Collector 925.03 Water bill to Pennsylvania American Water 103.04 to TOTAL: $153,595.69 to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to to Item Entity Amount .~be patriot-News Now you know Order Confirmation Ad Order Number Customer Pavor Customer 0001603597 RUSH RUSH Sales Rep. Customer Account Pavor Account djones 130705 130705 Order Taker Customer Address Pavor Address djones 245 E. Louther St. 245 E. Louther St. Order Source Carlisle PA 17013 USA Carlisle PA 17013 USA Phone Customer Phone Pavor Phone 717-243-7101 717-243-7101 PO Number Special Priclna Ordered Bv None mary V\ Customer Fax ~~ \ \ \ t> pb Customer EMall Tear Sheets Proofs Affidavits Blind Box Promo Tvpe 0 0 0 Class Level 2 Invoice Text Materials Net Amount $53.00 Tax Amount $0.00 Total Amount $53.00 Pavment Method redit Card - VISA:619 Payment Amount $53.00 Amount Due $0.00 Ad Number Ad Tvpe 0001603597-0' CPPL Ad Size : 1.0X 15 Li Color <NONE> Production Method Production Notes Ad Booker External Ad Number Ad Attributes Ad Released No Pick Up 11/14/2oo68:50:42AM 1 CUMBERLAND LAW JOURNAL 32 SOUTH BEDFORD STREET CARLISLE, P A 17013 November 24, 2006 Cumberland Law Journal is published every Friday by the Cumberland County Bar Association and is designated by the Court of Common Pleas as the official legal publication for Cumberland County and the legal newspaper for publication of legal notices. TO: StephanieE. Chertok, ESQUIRE Virginia L. Rush, ESTATE RE: Legal advertisements must be received by Friday Noon. All legal advertising must be paid in advance. Make all checks payable to: Cumberland Law Journal. Advertisement inserted on the following dates: November 10, 17,24, 2006 Advertising Cost Second Proof Request 75.00 $ 0.00 $ 0.00 $ 0.00 ------------- $ 75.00 Proof of Publication Payment received Total Amount Due Payment received by REV-1512 EX+ (12~3) '* SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILmES, & UENS COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Virginia L. Rush 00947 Report debts Incumd by the decedent prior to death which remained unpaid II of the date of death, Including unrelmbul'led medica' expenses. ITEM VAlUE AT DATE NUMBER DESCRIPTION OF DEATH 1. \First National Community Bank Mortgage 41,144.98 2,400.00 114.99 441.93 2. 3. Nerizon 5., i$ervice Oil Company 612.11 6.. :Tiger Trash 7. y _ _...._~n~__~,..._'<<,,' 'h.M~""W ".........."",.,,..."',,. ,--.-,_" -__,'., ., ."""~w.,,."_~n','.,~ ,,, "'-_'N','..__~"'_.. . ,.., 8. 9. 11. 101.25 12. 14,510.83 TOTAL (Also enter on line 10, Recapitulation) (If more space is needed, insert additional sheets of the same size) l U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT A. HUD.1 UNIFORM SETTL.EMENT STATEMENT B. Type of L.oan 1.[) FHA 2.[) FmHA 3.[) Conv. Unins. 6. File Number: 7. Loan Number: 4.[] VA 5.[) Conv. Ins. 105-926 N/A C. NOTE: This form fumishes a statement of settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "(p.o.c.)" were paid outside the closing; they are shown for informational purposes and are not included in the totals. D. Name & Address of Borrower: E. Name. Address & TIN of Saller: F. Name & Address of Lender: Charles F. Schubert, Sr. & Mary E. Schubert Estate of Virginia L. Rush N/A 841 Hillside Drive 20 Hillside Circle Camp Hill, PA. Wormleysburg G. Property Location: TIN of Seller: 20 Hillside Circle Place of Settlement Wormleysburg, PA 139 W. High Street Carlisle. Pennsylvania 17013 I. Settlement Date: K. Summary of Seller's Transactlon 400 Gross Amount Due to Seller' (OMe # 2502-0265) 8. Mortgage Insurance Case Number: , PA H. Settlement Agent: Anthony L. DeLuca. Esquire J. Summary of Borrower's Transaction 100. Gross Amount Due from Borrower: November 30, 2006 101. Contract sales price $149;'900.00 401. Contract sales price $149,900.00 102. Personal Property 402. Parsonal Property 103. Borrower's settlement charges (line 1400) 2,648.25 403. 104. 404. 105. 405. Adjustments for Items paid by seller In advance Adjustments for Items paid by seller In advance 106. City/town taxes 11/30/2006 to 12/31/2006 42.26 406. City,town taxes 11/30/2006 to 12'31'2006 42.26 107. County taxes 11130'2006 to 12/31/2006 45.86 407. County taxes 11130'2006 to 12131'2006 45.86 108. Assessments to 408. Assessments to 109. School taxes 11'30/2006 to 06130/2007 959.32 409. Schoollaxes 11 '30'2006 to 06/30'2007 959.32 110. 410. 111. 411. 112. 412. 113. 413. 120. Gross Amount Due from Borrower $153,595.69 420. GrollS Amount Due to Seller $150,947.44 200. Amounts Paid by or In .Behalf of Borrower: 500. Reductions In Amount Due to Seller: 201. Deposits or eamest money $5,000.00 501. Excess deposit (see instructions) 202. Principal amount of new loan(s} 502. Settlement charges to selier (line 1400) $11.546.07 203. Existing loan(s) taken subject to ~03. Existing loan(s) taken subject to 204. 504. Payoff of first mortgage To: FNCB 41,144.98 205. 505. Payoff of second mortgage 206. 506. 207. 507. 208. 508. 209. 509. Adjustments for Items unpaid by seller Adjustments for Items unpaid by seller 210. City/town taxes to 510. Cityftown taxes to 211. County taxes to 511. County taxes to 212. Assessments to 512. Assessments to 213. to 513. to 214. 514. 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. 220. Total Paid Byltor Borrower $5,000.00 520. Total Reduction Amount Due Selier $52,691.05 300. Cash at Settlement Fromlto Borrower 600. Cash at Settlement Tolfrom Seller 301. Gross amount due from borrower (line 120) $153,595.69 601. Gross amount due to seller (line 420) $150,947.44 302. Less amounts paid byffor borrower (line 220) 5,000.00 602. Less reductions in amount due seller (line 520) 52.691.05 303. Cash rxl from r 1 to Borrower $148,595.69 603. Cash 00 to rl from Seller $98,256.39 Substitute Form 1099 Seller Statement The information in Blocks E, G, H. I & line 401 (or, if line 401 is eslerisked, line 403 and 404) is important tax information and Is bein9 furnished to the Internal Revenue Service. If you are required to file a return, a sanction will be imposed on you if this item is required 10 be reported and the IRS determines that it has not been reported. If this real estate is your principal residence, file Form 2119, Sale or Exchange of Principal Residence, for any gain, with your income tax return; for other transactions, complete the applicable parts of Form 4797, Form 6252 and'or Schedule 0 (Form 1040). You are required to provide the Settlement Agent (named above) with your c,orrecl taxpayer Identification number. If you do not proVide the Settlement Agent with your taxpayer identification number, you may be subject to civil or criminal penalties imposed by law. Under penalties of perjury, I certify that the number shown on this statement Is my correct taxpayer identification number. (Seller) (Seller) Estate of Virginia I. Rush Estate of Virginia L. Rush L. Settlement Char~es 700. Total Sales/Broker's Commlsslon:-Cbased on Drlcel Division of Commission !line 700) as follows: 701. $4,522.00 To: Georoe L. Ebener & Associates 702. $4,472.00 To: M.C. Walker Reallv 703. Commission gaid at Settlement 704. 800. Items Pavable In Connection with Loan 801. Loan Orloination Fee 602. Loan Discount 603. Aooraisal Fee 604. Credit Reoort 805. Lender's InsDection Fee 606. Mortoaoe Insurance Aoolication Fee 607. 60B. 609. 810. 611. 612. 613. 614. 900. Items Rellulred till Lender to Be Paid in Advance 901. Interest from I I to I 902. Mortoaee Insurance Premium for 903. Hazard Insurance Premium for 904. 905. 1000. Reserves DeDoslted with Lender 1001. Hazard insurance 1002. Mortoage insurance 1003. Citv orooarty taxes 1004. Countv oroDertv taxes 1005. Annual assessments 1006. 1007. 1008. 1009. Aooreoate Accounti"" Adiustment 1100. Title Charges 1101. Settlement/closino fee 1102. AbstracVlitle search 1103. Title examination 1104. Title insurance binder 1105. Document DreDaration 1106. Notarv fees To: Notarv Public 1107. Attornev's fees (includes above item numbers 1108. Tille insurance To: A.L. DeLuca, Eso. ADent for Securitv Title Guarantee COrD. of Baltimore /includes above item numbers 1101,1102,1103,1104 1109. Lender's coverace 1110. Owner's coverace - $149,900.00 1111. 1112. 1113. 1200. Government Recordlno and Transfer Charlles 1201. Recording fees: Deed 38.50 Mortoaoe 1202. Citv/countv tax/stamos: Deed 1,499.00 1203. State tax/stamos: Deed 1,499.00 1204. 1205. 1206. 1300. Additional Settlement Chaflles 1301. Survey 1302. Pest InsDection 1303. Overnioht Mailino To: Anthony L. DeLuca, Esouire 1304. Countv, Library and Borouoh Taxes To; William A. O'Donnell, Tax Collector 1305. Water bill To: Pennsvlvania American Water 1306. 1307. 1306. 1400. Total Settlement Charaes (This Number Transfers to Lines 103 & 502 Above! CERTIFICA~ I have ca ully reviewed the HUD.1 Settlement Statement and 10 the best of my I dge a belilf, is anru ccurate statement or all receipts and dls . _':.~m~a ~. account or by me in this transaction. I further certify, ha . T ...- HUO.1 Selllement Stalemenl ~~ ~ _" ~y/O.C~ Seller _ V .W....... Borrower ~ al~'''1I1Mio1 RUsh .--... ". Cha~ s . ~J.lllJrt, StJ TJ / Seller ~), 4.A~ fj . Borrower -yTT /I Ma.eYE. Schubert To the best or m knowle e the HUD.1 Selllemenl Statement which I have prepared is Irue ~nd accurate account 01 the funds which were received and setllement of this transaction. Setllement Agent November 29,2006 . DeLuca, Esquire. I... SlatemenlJ 10 tM. United, Sta.s on UUS Of an"J' 0I.hel' S,","1r (oem P.naktes \.fPOr\ eon~hoI\ t:an Include: a line and impnsonmal'\t For det1lils ...- Title 18 U S $149,900.00 Iiil 6 % Paid from Borrower's Funds at Settlement Paid from Seller's Funds at Settlement $8,994.00 I /Ill $ r I Der day months months months months months months $ $ $ $ $ $ Der month Der month Der month Der month Der month oer month 2.00 1,106.75 Release 36.50 1,499.00 Mortoaoe MOHcace 1,499.00 25.00 925.03 103.04 $2,648.25 $11,546.07 Date DISBURSEMENT REPORT File Number: 105-926 Contract Sales Price: .Name and Address of Seller: . Estate of Virginia L. Rush 20 Hmside Circle VVormleysburg $149,900.00 PA Settlement Date: November 30, 2006 Name and Address of Borrower: Charles F. Schubert, Sr. and Mary E. Schubert PROCEEDS Proceeds from Buyer(s) Charlas F. Schubert, Sr. and Mary E. Schubert $148,595.69 201, Deposits or earnest money 5,000.00 202. Principal amount of new loan(s) $ 0.00 TOTAL: $153,595.69 Item Entity Amount DISBURSEMENTS Disbursements to Seller(s) to Estate or ViraTnia Rush $98,256.39 Payoff of first mortgage to FNCB 41,144.98 Commission paid at Settlament to George L. Ebener & Associates 4,522.00 Commission paid at Settlement to M.C, Walker Realty 4,472.00 Notary fees to Notary Public 2.00 TItle insurance to A.L. DeLuca, Esq. Agent for Security Title 1,108.75 Guarantee Corp. of Baltimore Deed to Recorder of Deeds 38.50 City/county tax/stamps: to Recorder 01 Deeds 1,499.00 State tax/stamps: to Recorder 01 Deeds 1,499.00 Overnight Mailing to Anthony L. DeLuca, Esquire 25.00 County, Library and Borough Taxes 10 William A. O'Donnell, Tax Collector 925.03 Water bill to Pennsylvania American Waler 103.04 10 TOTAL: $153,595.69 to 10 to 10 10 10 to to to to to to to to to to to to to to to to to to to to to to to to to to to to to 10 to to 10 to to to to to to to to to Item Entity Amount ~'~..Fi1.):.!i';;;l.;ro? ,,'.'t' J:" ~~~~]!'t ~\,~".. . ~w , ~ \. ;oj ~I ;.;..."s;~ 1. {:,,:, Qi,J;';',.rJ. ';1 f:lf~2} "'.1~- "":'P. .~;;,,~, ,~~~'C:::;;.'>f Ai': ~ ~':;i:,",1~. ~~l, :::\~,~":.tc, ");t.','''}~.i-:~~~~I-.~:~4.o:l''W~..1.,}1\:''''f.~.~/i~;~ JrJ'~ .>t:~;-li;}j!i~f~)l};: .I:;-}'~.~~~~ ~,?i; ,'~.{5'r.r{;::'f.~1~$f( .!:. ;-"'.... ~V~'}"-- ~ ;<~:c.(~ ~ ~. * .V- ;:tf1-t": fii, K '<Jt:. ;,~+:~~ I',z;; ';'i':; %",.r,'tf r l!i"""~~:t . ~;'; ~,t. ,:, ~bS.-,-~Jft~ ; .~>tiIF~~~- !~;j~:i'~"~~'>i.\:f(~~~.ty-~~ r,;~,~~-~,tj ~'l }~~I';:; {J,il?~~ ,~.\ ~ ~Jt;l r~:~~:I{~ ~ "''1 FIRST NATIONAL COMMUNITY BANK 192 EAST DRINKER STREET DUNMORE PA 18512 (570) 346-7667 I'lnl NIIlIoaal 0xm0Iaity BIII1: ANNUAL BORROWER STATEMENT FOR TAX YEAR ENDING: 12-31-05 l.-.:IFNCB" CD1lIUIJY Is Olllltll!lIAII fJIcb.-. 1I-I77-'nY.PNCB -- FORM 109B-MORTGAGE INTEREST STATEMENT OMB1f 1545-0901 0255056 01 MB 0.326 -AUTO T1 0 2020 17011-181820 RM 2050 111I11111I11111111I111111111111111111111111111111111111I1111I1 VIRGINIA RUSH 20 HILLSIDE CIR CAMP HILL PA 17011-1818 184-38-ZZ84 Z4-0566588 lZ-100168-4 08/06/91 001 BOX 1 - MORTGAGE IITEREST RECEIVEO FROM PAYER/BORROWER FOR TAX REPORTING BOX 2 - POINTS PAID ON PURCHASE OF PRINCIPAL RESIDENCE FOR TAX REPORTING BOX 3 - REFUND OF OYERPAID INTEREST FOR TAX REPORTING OTHER - 2,251.99 .00 .00 ::":";'l''';~m'Yf0'i''~:c;];m;!;fJ'1~;,,!:F,i;i'~:f,'ii;!~~B~~:~}:?';);,.~,~~~~i~iSi~i~.1i!:ill~8!SSGif:"if2ii1i1i\ft~tit~j;;;~tJi~~~~~~iZ:L~~~f,;if';;j;;:~if!'.b'&;~~:;~~;E:~:;;!"J~~7~;';;"!7.-'T~.t1,'~:'~;""-;~S;';:-;::+.Cf:L'S!r';:;.g:;.t95;t~,!~.;;;~";! .;..- ; .. ...;".<i <,...,......",1 ... '''1 ." I .. I I I .J E~: ;f.ii~~;;i ;~ii:M!~;~:::~!;~1~<,;t:~:;~~:~:~~~ffi; ~?:;~L,1'E;:.~; . '"-'.' -. ;.... . ..~ -"",\ .. ., -:>0,", . . .: ~~.' ~.:,::,~~.": .... .. - ..: .. :~r} ~~J.~:ti!::ff':!!~::~t~;.~~~:~:.:W b:~'0~: : ."..1' . . . .' .,. ..1 .....'../ - . '~: ..: ; :'<i Invoice Invoice Number: 166; I I Hospice of Central Pennsylvania 9B South Enola Drive P.O. Box 266 Enola, PA 17025 Invoice Date: 10/1B/0t: Page: 1 Voice: Fax: 717-732-1000 717-732-5348 Resident: Virqinia Rush c/o Mary Irene Rush 245 E. Louther Street Carlisle, PA 17013 Customer ID: RushV -l---.--------, Due Date 11/2/06 " Payment Tenns Net 15 Days ,', I Description Amount Residential Care 10109/06-10/16/06 2,400.0-01 !"'~ . . Iii _.- WllE1t.... iJ ~-- ; 'lJR13INIA RUSH ESTATE f.~:ASHINGTON EXECUTOR 102 CARI.ISI.E, PI>; 17013 . . HIM (Db 1H1111ZS13 PAYTOTIlI W . DAn I i f OlIIlIIIOF rPf 1I.z' '<6 (I btiilfil.. A.- I $ i., <fOr;, /1)j6() ~ Ir-.t00 IJAlj'a'" rry,;.~ 0",.. 0{61l DrllAM ~ IF- I PSECU: . I HAIUV$Ill.IAG, At. 1711lJ.Gl1l ..... .~Cl~. 101 .: 2-313&H U:.':O~qc . -OIoSblo 7B 2BBa' ! !Ii -' . t Total Invoice Amount. 2,400.00 " ':1 Check/Credit Memo No: Payment/Credit Applied . TOTAL 2,400.0C Thank you for choosing Hospice of Central Pennsylvania. ~:.. ..:;;)i.:1i:i!~.:. ::~-~ ::':,.:'~~":::-:~:..;~.7:"" ...:-.. .. .. SEWER .;.. t * TR~ .Btff6D u.s. POSTAGE P B 3 5 7 '1 9 i' ., ,2.4'4'2,fJ09~u~ MtH ~rMMtJ ~ ~--", - .". '"",''' ~f.' ~ Cf~::~ -' '~.," '-. - '.~"$-,_ 40130-0 SERVtCELOCATlON '\2lIri':f1ILLSIDE DRIVE "TOTAL.DUE: . 114.99 IFPAlOAFTE 1.0/31/06 .. A:t RUSH, VIRGINIA MAIL TO: 2.0 -HILLSIDE DRIVE .. _CAMP..HILL PA , 7n,. ' _.~---_. 1701~2007 ~A06 22 1~/13/Q~ i.ENDER OF NEW ADDRESS ' GINIA . . PAE1~8~!~S~2~T~ i mtn U lIu!lull. 111.1.1. Iwl.1l uj..J 111.1.1 JI ,I,ll ~ Accounting Associates 1849 W Lisburn Rd Carlisle, P A 17013-9734 717-258-6671 March 22, 2007 CONFIDENTIAL VIRGINIA L RUSH 245 E LOUTHER STREET CARLISLE, PA 17013 We have prepared your 2006 tax returns for the Federal, State and local wage tax. Professional services rendered in connection with the preparation are as follows:. Form 1040 (Individual Income Tax Return)....................................................$ Schedule B (Interest and Dividend Income) .................................................... P A Form P A -40 (Income Tax Return)............................................................. PA Sch A&B (Interest and Dividend Income)................................................. P A Form P A- V (payment Voucher) ................................................................ 55.00 5.00 10.00 10.00 10.00 Amount due $ 90.00 If you have questions or would like to discuss this invoice, please do not hesitate to contact me. :&1 Floyd Fahnestock ~ Ii 1,_' .,. Pb~C~J' 1,) ,: ~ ,;;", j ,~ ~<< ~r'~ .~ '-.?' ~ _;1(",- ~"' .tJ.r"'.";?'l~;~' _ ...,~:o.W'~;l', -:;~Ol. 't~_~'-j ~~ .'ir-r'fr,,"Ji..t-., \I , .' l~t~~~<1 'J '~ra;~-f:li' ... ~F' I 122 VIRGINIA RUSH ESTATE CHARLES A. WASHINGTON EXECUTOR 245 E. LOUTHER ST. CARUSLE, PA 17013 LJ 60-8111/2313 DATE q ~ $ 6. (cQ ::> DOLLARS (D '.curlt~ ....Iur.. t i:~f~l! Cf. a~ a ~; PAY TO THE ~ ORDER OF . ~ -::x,,~~ ; ~ 4~ ioo- i I PSECU HARRISBURG, PA 17110-2990 c&-Q~ II' 0 It 5 b It '18 2 8 8 III M' ---........ ""::~-:CJ.,:"\'(~-v!....~ ~': -'~~ i~c.!_" :~.~;..,.~~l<" "; .r''-:~~>.... .~~,1('~;f~.~j'"",~ \~l ~T"":e-..':',: llf;.N-;"~/c:',>~-,-~.~ ~>-) :1 ".~. ~I" !.t~, . !l FOR I: 2 ~ . :18 . . . bl:O .22 ~ - t I I I I I I I I , I I I I I I I I I I I I I I I , I t I , I I I , I , I t I , I , I I I 1 1 I \ .. I \i 1 Cl \' 19" I - 1 (\) Ie I - 1::1 1-0 \~ 13 \ (\) I:? I!!!. 1 -6' \ ~. \9' 1-<: \% I ,g. \ ~ P' 1-0 \~ ,Ill 1<:1" \ro Ie; '..::. I (\) 1- \~ ~9 e;~ "c (\) ~ ~o 0'" ::I 9:. \! <:1"~ ::c. ~Qo I)l ., o.~ S!;~ ~ l/l 9. <& (\) ~ ~ t.V ~~ ~ ~, o 0 ~~ 0" - 0 ~s. 9,,"" ::To ~ ~ ..::.'Cf (\) ..' ~.~ g~ g!;: ;?~ ~~ ii 3 ' ~~ -' ~ ~ UI .............---.-.- ---.---'--:-'--~- ~ ., l 'tl ~ -'6 o ':I ... ., (') t, 'tl ... I)l ~. ~ ;t."J1 ::Il/l,% ~ 1\ 3l' . ::I l"" ~~ ~.~ :::::l"" 3' ~ , ~ (l) ~ ~ ~ ~ ~ i a- ~ o ~ ~ \ t;!'. g ~ """ "" "" i -0 % -0 l "" ~ 0 ... ~ o 9.- 9l. 9l. ~ ~ i C'l (j) ; Q) Fi' Fi' i -- g g g i ~ ~ ~ 0% % ~ ". ~ I 0 ".... 9l !t 0 %. 1 lO g ~ g ~ ~ ~ co CD ~ 9l (J) ~ i III 9l S ::c I)l ".... <.3 10 ~ 10 S !!!. "0 -" " lO III fA z Ii) 0 fA ~ 10 co .2. ~ 0- -+ ~ ()I i' i CD W. CD !. '0 a ::s i ...... 4It I ttft .fit ~~~~ is'&~'~ -v d ~ 1k' - d <r' ." ~ .. .I> t3 ~ ~"g~ ({ fr~ <w,<<tT\)::aO ~.~ ~ ~.,%. g g '0:"'0-'0'< ~~ ? -=::1 s- ':I ':I o~- Ill(\) "'ii' oa.goo-O':l 3 a.O(ll ':In iil3 m g::s =!.. (\l 0 '::I (II ':I _wl/l-::!\~> i '< ~ % 'in 0 ~ "< (j;'o'=2.. ~ ~ o.=(\)~3 en (1)t::Y" tll goo( o~ft\$~ %,0 ~0.15 tll.<o _,1:: a.t::~_.IQ"" _. ~ ~ tll.a a ~ l/l _::I '< .... ij) is a.. 0 ~. ~ "Cc:. 0 ~.... ':I ~ \ ... , \ ~ ~ ~ F- ~ Cl o f . -- .. 01410 88MCE Oil il5ueOI. ~ liThe Company That Cares" 3798 Paxton Street, P.O. Box 1677 Harrisburg, Pa. 17105 www.servlceollco.com 564.1657 *** STATEMENT *** EST. OF VIRGINIA RUSH C\O CHARLES WASHINGTON 245 E LOWTHER STREET CARLISLE, PA 17013 ACCT# t.!.E.18/ 11/::::;0/06 . 'rlATE> '.2RE:P ....~!'.'.'< 2tll~SQ~1)=;1.t$!\I" .. . .,~.....; "1'_"'.; ." . "'_:-'<:.,n".,,,.._:::~.:..-_".."".".':.: ~;':",,:,,'" .:.:".....'.<;::.,.;.:.:1.. ..d...... ... ... .'ACCT.~"4~~.~~Vio~s:~~(~6E.i;" 11/10/06 8()23E, '#2'FUEL OIL '0' ....}OO c!) 11 /30/0€. .429.:315Q'((( . FINAI\!CECHARGE >}} ".' ....... . .'(.BALANCtt:DlJE ) . '. .. . . ..' DELIVERED TO:20HILL8IDE CIRCLEiCAMPHILl., ....... .... ".' .....'. 7~?~~$a~~ ~?~.~~~e?p ~UF:RENT OVER :-':::0 OVEFi: 60 OVER 90 OVER 1 E' ......1C':C" ......c. c:. ,_,._1 If C:...1 Cl.OO 0.00 () . (j() ::::;!:;E,.Sf.:, ~o~ 10-\ \ \>1<\ D '\ ~b 0f Y-4J~. ~' . " A Brenner Family Dealership" BRENNER 717 -697 -8400 717-697-9133 FAX BRENNERFAMILY.COM ,e- MAILING ADDRESS: P.O. Box 1019 Camp Hill, PA 17001-1019 STREET ADDRESS: 6271 Carlisle Pike Mechanicsburg, PA 17050 f}7~A/:-t,VZ ./Z/TS~ 7.s J'3?f7~Co /T zoo3. /I/;::S<f'?N /??~ ~ 7?1G" c-"31/t'/2-=- Or ~ OVC I J: g;O uo. Yn~ J2,-,J",J7' ~ ;l77F ,/?'/7Tc-t./"r "''1 Ti7'6-?t::- .;c~ ~ ~47~ C/~ ;4; 5/0. " ?J,-I,j r-r7 ~ i& c~ 1/ .,- TO ~&'U1.-t.~ CJjC :67#'. vcfiU- ~li" 5L':'/I.. 1/~H;::~: 7"f-?'~ --rnl5' 5S7~ TI;;' [,vHt;; V ,g/?C;:/VNi./l.- ~5~ i?b"CF"t-t..-o:. 7/-7/; fT/GG plt.-i'-' C~& ACAIO r.;c:A.,~~-:-. J2-q",~ - -r--n 711 CtIZ1.HY {/ ~""r-l;' t./se0 ore p1b~ . c~7~ Pennsylvania State Employees Credit Union III1II111 P.O. Box 67013 (717) 234-8484 (Harrisburg) Harrisburg, PA 17106-7013 (800) 237-7328 (Nationwide) website - h"p:/ /www.psecu.com VISA- PAGE 1 0184XXXXXX 01/25/07 TOTAl . NEW BALANCI; 724.14 AMOUNT.PASTOUI; MEMBER NUMBER PAYMENT DUE DATE 68.50 + .CURf\ENTAMQUNTDUE I. ! 20.00 _ MINIMUM PAYMENT I 88.50 405 1 AV 0.293 1...1111111111111111111.11.11111..1.11.11111111.1.111...1111.1 VIRGINIA L RUSH 20 HILLSIDE eIR CAMP HILL PA 17011-1818 AMOUNT OF PAYMENT ENCLOSED \(l ~'- \ 0" \\~ $ p'> 1000901843002082284 TO REPORT A lOST OR STOLEN CARD' CAll OUR BUSINESS NUMBERS USTED AT THE TOP OF EACH STATEMENT PAGE FROM 7 AM - 5 PM MONDAY TO FRIDAY AND B AM TO 12 PM SATURDAY, OTHERWISE CAll 800-556.5678 ,---.- .. - ....._-_._~--_... '--.--. O' --.----.--..- -- I MEMBER NUMBER . BTATE.MENT DATE PAYMENT DUE DATE CR!'DlT UMlT BA~ CBEASf.BEFORE i DETACHING HERE T 0184382284 L 12/31/06! 01/25/07 ID 09 SUSPENDED VISA POST TRAN REFERENCE 1201 1220 - 0.00 724.14 0.00 AVAILABLE 0.00 1130 1220 DESCRIPTION ADJUSTMENT REMOVE lATE FEE DCF - CORRECT lATE CHARGE PAYMENT ADJUSTMENT ACCOUNT ADJUSTMENT: DCI - VISA INTEREST ADJUSTMENT AMOUNT 40.00- 11. 50- YTD FINANCE CHARGE: YEAR TO DATE 1.72 f ". PREVIOUS BALANCE - P"YMENTS - CREDITS + ptj~~CAsH'-'.+" 'OeBrTADJUsNENTS + Ta;ALFIHAH~'C";;GE- -~ NEW BAlANCE i PURCHASES . i . I' o. 00 I 0 . 00 I ... 5.91' I' 724. 14 i ADVANCES 0 . 00 I 0.00 I 0 . 00 0.00 i o. 00 ! 0.00 0 . 00 f~~;:~~~s----11~~[~}~?t TI~~~,A~~(?t-;~?~~~~I~:~fit..-~~ 0301 000 600 0 10 2060737 -- o o o (/'r :a Q) t:: ~ ? o.\.l eDQ) ,~o ~ eD eD.\.l' ~o~ t::eD (/'r ~ ~ ....-l(/'r W-- ? .. OQ)W O? Wt::O onl t::~\l) I1lnlO ~~ ~ lO.\.lr-l t::nl ~~~ ..-l p.~ ;...-l nl ~ g..\.l ~fSl? ~ .\~ ~ wg ~ ~N Q'\ ~..... ~ ~~ !--:'~\ ~il ~ ~~~p i:l~ 0 " s ..u" Q* .,~ Q\oo<"'1-' <.9.9Q ~i.g ~dQ,* :::~ ..~ -=~ ... 00 -S~ -=~ - ... .. -= .. -= ... ~ *.a ~ c;e -S \,('l ~ -= C";' t- -= ~ t"':':s t};o ~:eOl-<~ ., 0 ::: 'a ,0) , 0 : 'so.e. <( 'J~ j ~ ~~~ .. ~~ ::: ." ~ 0) -4 ~ : ""ta '7a ;.~ :s ~ ~ ~ 0 -:: .5 ~ ,.~ ",::%%: .= ~ C"l '-' 2261'(00** \ \ \ ~ ~ .a .S \ \ \ \ I I \ I I I I I , I , , I \ I I , I \ I I I I \ I I , , , , I , , I I I I . \ ! \1 \~ \-e 1'S: \ 0 -a'P 0)'" ~8 ~Cll ~a- .fi~ 'i';l e'~ t.g ~@ ~.E . , ~.s:;.. '0 ~'l 'c "G) : ~(:l I I , ~\ '0' C:l \ ~~ ~ e p.. \n 9 ~ ~ o ! ~ e tl '"0 ~ ~ Q ~ ~ .g '~ :g ~ 6 ;.-. "0 ~ ~ ~ .~ .~ :j ... Eo ~cO .g Po ~ ~ e ~~.~ ~ 8'~ ~ ~ ~~ ~ . .... II) .~ '" :a ~ ~ 9 ~ .... tl ~:a ,... ~.... 8 II) ~ 8 c:l '.;1 tl ~ .~ \ g ~ s C:l '0 :a II) '+3 :a.e..... ~ g ....~ ~ .~ ~g .~~ p. .;;: "" ........ .... .... '"0 S e ~ s ~ eo .~-d e p. \oo<~ .... ~ e a ! ~ ~~ OeO tile "'.~ ~::; '" II) ~~ "" 0 ~~.,~ ~'2 ~;.-. "0-0 (I:l... '0 ~ Q ~ ~.~ Q e t"l~ '"" tIlP. t"l'o , 0 '0.... .S C:l ~ ~ ~ ~ ~ .~ II) .~ ~ ~ 5 ~ E. .lOi cO ~ ~ '+3 tIl ::;..-,s '+3 OIl .~ C:l ~ ~ 'p '0 'Ob ~ ~::; .c ~ SQ'; .S 0 ole '8"0 ~e ',a.~ le ~ 0 '"0 ....~ 0 a .'" ~ ~ ~ ,~cO :e II) '.;:1 "0 j::! C:l ....-t; S II) ........ """tl ... '" ~~ II) cO ::; 21 '.;:I p- 6-"t:l ~.... 0 0 Q d ." d C:l "" "" c<l ." 0 ::; 0 ::I II) ~'-e 0$ oS C:l 0 :>-Oil) ~i::l ;:> Po ~"tl ..... C:l ~ ~ p.. ~ 'J3 til e:l .S i:S ~ * a * ~ * ~ .a ~~ ~. ~ ~ ~o~.:r. ~ ~~ ~ ~ .go 0 ~ ~% ~ ~ ~1 * .$? d * sa lea o,!? .~ .sg e"" Po ecO .~ II) "tl~ ~~ _0 ~~ ~ ,P'S ~~ ..d~ ge %g c<le ~ 0::1 ~~ II) ~ II) g ~ tl 6 ;.-. % ~ "t:l Q ~ '3 .S .g ~ ~ II) .~ t~ Po 0 ~ ~ ~ ~ 1 ~ e ~ .a cO ~ ~ Q. a ~ 0 ~ :. .a a Po .2 o ~ <;;; o ~ .... "tl . ~ ~ ~"" ai .... '" :e 0 e ~ ~ ~ -%Po II) II)~ % ~e \00< a", Po .... 0 ...... .P..... o II) '0 Q) '0 II) ~ cO ~ \;f,) Q Q Q) 'ta,P ,P ~ ~~ * * * * * -- TIGER T-R-A-S-H . . "~~.R..... ,~, !U,........r. ij.1~~f'e9~~~~~~.p,.Y~~n~T#r:,,:..~.. :, .... . . .. .~~-':~: :':>"-.:"::'~::'_;';:,:':' "~::":'" ,'liger trash .,;~'~' '.~: ,:~' .... . -> ' O/Box';'2444 : "'1":., . "- ,;'r,':i;":'~A"::5,/j'2":'4~"4':'>4>F, ,. .'i.;';' A . a.1.~O ...... :... ,"". ""........ ':;::~:, :</: ;~? f~:~i,: .;:_:;-)/.;;~:;<h/;;;:::,,;,;\_:'::.i'.:l'-,:.; - :r:.h'~g~~;:.::.::~~~::')'::,: 23851 Charles Washington 245 E Louther St Carlisle, PA 17013 11/28/06 72911 1 0.00 TIGER TRASH P.O. Box 2444 0 York, PA 17405-2444 (717) 699-11110 FAX (717) 699-0309 Purchase O~JIpj1rash.com ... 1. 00 PC 3 . 00 TYC 1. 00 ; . . {_: Deli very Charge Pull Charge Disposal Fee per Ton PRE-PAYMENT ..,/' 3:0. 00 .;p.~;j:.~~ "~I 4 51i(0 0 Jr""'" 30.00 225.00 195.00 -450.00 :;!;.~.,..,.. y~;. '. '" :;' ........- * .'. \rvC6 p!J ~'" Service Address: Same 20 Hillside Circle 3006-08 Camp Hill, PA 0000 Sales Tax 12/28/06 . ' i/A OJ'> ~ i'c";,' "r::v.,/" ..... , _,~ 7 " ' ~>~~~t<t;. l{,/i 'J (~A 'I.~ B; :.J: It:. -llA.." E (:) :'~:;;J,f,;JJ,.~J 6J'.~' \ -- ~ a. ,.;l t'$ \0 c:> 'E ~ c:> 'Co ~ r.:. ",,_<It .... r- ~ .....o~ '3 'IE o '" '-5 ~ ~ ~ ~ s .~ "'w~ ~:l"" ~ 0 0 u >' ~ _ t'$ "O~S i ~.~ ~.c;~ ij:~ e ~ ~ i~t'$ ",:;$ bDO"a .S ~ ::s .... Yo 0 -:= :! (,,) ~i:~ .... 0 i Q .~ "'0-:$ u.....l+-' ~~ 0 .,::;. .....-;;j u(:l.f;. '2e\) 7. ~ t.t ..; i:O "" ~ Q ~ ~ ~':' g.,::;.-; .... Q ~ Q)~"" -0-0-0 ~~-; -en tIl 0 g"'a~ .t: 6 Q ~gi .~ eS '" "a .~ '.E. :::l .e ... o ~ $ (,,)0-0 ~ '" e ~-ig. oti~ 'f'" u "" ..;..ao 'a"<il"a -= t'$ ~ ,.: io.t::o ~ u .....- _-s~~ tIl~....-o t= 0'- r/I ':::::lee ~ 0 e ~ -= ~ 0 Q !)IlS..... .'Do .S e ~ .'Do .~ ; ~ ~ ~.- 50 ~a1$~ :?;lo u'" .s l;> :::l~ 0'- ...~ 1~ u 0 ~~ ~ u oJ? t)~ ~ .,::;.3 :::l "i~ '~J5 o .... ~"i .... ~ .~ f/'J Qoi rJ) .to :?;l:::l ~~ e.S i~ ~ ~ ~.... 'i~ '" ... u t) .- - g eS U g f'i S ~ .- Q "t)~ u'" ~g ~~ u S -:So ~ 0 VA ~ gl Q.:; . c:ie. 0.... .a .... Q) :::l "t)-o~ ~~! -00... t) "d ~ u ... .... ~ ~.~ ~e~ o eS ~ ~.~ ~ o.~'e; ",- "';; <a-o g .::; '" '" ',g 'i u '0 :; ~ u ~.,::;. :s ~::s'" .... 0 u .~'" ;';...... \) 0.... ... ..... . u ... \) ... ~i~ - '" ~ "'._ 0 .~ -:S ~ .........0 ~ 0.... o u "i ~ -0 E- o ...... '-' .€, '" 0 o~~ 0. \).... e...1 oe'" ~u~ ;%$~ 0. !Se ... ~ 0 ,J:; 0 (,,) ~.~ ~ ~~~ G) C"Q. ill ~ . tIl ~...r 2'- .P 0.-0 ~ ...retf.l ~........ u 6--:S eu~ ;:0:-.",,0 !.! g "'"' ~.... 6~;: ~~ g. . ..... 0. \) oeeS~ c:oo~ o(,,)_.~ .~ ..,.....-: "'" tIl 'I1l eS.~ t) to .... ~ G) '" c: 0.- o.U 0.0. U tIl -d ",-:S \) tae ~ o.t)....~ e%~~ 0.-0 .... ... eeu-o a ~% i ~ ~ :::l \) o"'~~ I:-' 0.'-- ~ ~ ~ ~ o -= .~~ .... -; .' e .... o"9Q ~-~ ~ ~ ,.;l eS .... ~ 'Co .~ ..... .ta u o '" "9 ~ .... ~ ~ g "<il % g ~ ~ .P . i~ :::l .~ g"i o"a to u '" '" .... e -:So. u u .::':. g,& e'O S u ::s c: o 0 ~~ ,.!:;~ ~~ ~~ .:e~ o~ ~-o Si bD .S~ :::: 0\' .... 0\ ~..b ::::=.0\ .... t.rl "<il' ug taor u- ~ta t- o ~ ~ 9 t .. '\ \ A :; ; \ 'i. Q -; ~ i- % ~ .... r.f). - ~ ~ o .,;. .~ ... '$ :?;- & -- YEAR/Mio A 06 , Transfer = T Direct De osll = DO Debi! Card = DC Teller Machine = ArM Automalic Pa men! = AP CODE .; PAYMEt/TUo....WAl CODIGO T ~DELPAllO loanPa enl=LP E nse=E +) DEPOSIT CANT1DAD DEL POS Tax Deduclibie = TO BALANCE 4l - ~ , PPLElectric UtiUties Electric -- Service For: VIRGINIA RUSH 10 HILLSIDE CIR CAMP HILL PA i7011 - - .. ~..... .-.._., ...~- '.--"-~."'-_.__...-...._._. --.,.-- Final DupUeateBill QuestioDs about . tJiis bill? Please _' contact us by Jan 4 at 1-800-342-5775 (l-SOo-DIAL-PPL) or write to: Customn Servi~ .' 827 Hausman Rd. Allentown, PA 18104-9392 www.pplelectric.com . I / \ l' I I \ " ..," " '..:.....~.:"'" ppl J~~: ", .. Page 1 ,\10 ~h ~ Summary Page Balance as of Dec 1, 2006 Char.Les: TotarPPL ELECIRIC UTILmES Charges Total Charges C~07~9300~__ _ j $158.35 $1.~ $ 159.60 r~~!I~I?_~);~t~t~~~~~~[~J-i~~~~tr~jll-L:~\-:~ -~ ~~~ -::___:-_ _:_o______:~__-n__:~::_._r-~:I~:~-_:;: Account Balance $ 159.60 Electric Use This graph shows your electric use over the last 13 months. Types of Meter Readings: Actual _ Estimated lIII Customer D 24 KWH - Average Per Day Meter Reading Information 1 20 Actual 24606 Actual 24604 KWH BIlled -----.,- 16 Average - Dee 2005 2006 12 Temmrature 31F 50F KW Per Day 19 1 8 Yearly Use: Total A vera~c 4 Use Month { Jan 2005 - Dec 2005 6839 57 0 . Jan 2006 - Dec 2006 607S SOl I DJFMAMJJASOND 2005 Months 2006 Other imDortant information on back ...