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Home My WebLink About08-13-07 REV-150Q f..x + (6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT W I- ~ :!II) (.) 1Ii:~ w:5(.) J: iii: 9 (.) ltID -< to- Z W C W () W C DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Mattern Beatrice R DATE OF DEATH (MM-DD-Year) DATE OF BIRTH (MM-DD-Year) OFFICIAL USE ONLY FILE NUMBER 2 1 -0 6 1 1 4 6 '"CoUNTYCOOE ---VEAR- - - NuMBER- - SOCIAL SECURITY NUMBER 1 99- 0 5 - 8 3 8 0 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER o 3. Remainder Retum (date 01 death priorto 12-13-82) o 5. Federal Estate Tax Retum Required _ 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Attach Sch 0) THIS SECTION MUST BE COMPLET D. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS David H. Stone Es uire 414 Bridge Street FIRM NAME (If Applicable) Stone LaFaver & Shekletski TELEPHONE NUMBER 7177747435 New Cumberland PA 17070 z o i= <( ..J ;:) to- e: <( () w c::: z o i= ~ ;:) Q. ::E o () S 0.00 X _(15) 0.00 0.00 X _(16) 0.00 0.00 X .12 (17) 0.00 194,560.53 X .15 (18) 29,184.08 (19) 29,184.08 12/16/2006 11/1/1917 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) [R] 1. Original Retum o 4. Limited Estate [R] 6. Decedent Died Testate (Attach copy of Will) o 9. Litigation Proceeds Received o 2. Supplemental Retum o 4a. Future Interest Compromise (date of death after 12-12-82) o 7. Decedent Maintained a Living Trust (Attach copyofTrust) o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) I- Z W C Z o lL II) w iii: iii: o (.) 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Govemmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES (14) 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20. D CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < 150,000.00 OFFICIAL USE ONLY ) -~O 95,680.89;c ;g !;IO .. . _' -.;~:'o>o I I'-"".m ~'~20~ ,Jr--""'--) -) ~~ :.n ,.., (, :::~ C~;'::J --.l :r:- c: G) Co":> ---, '-- ~':J =--1 );...... c.. ,'-'") -.I 245,686.89 30,473.02 647.34 31,120.36 214,560.53 20,000.00 194,560.53 D d t' C I t Add ece en s omPI e e ress: STREET ADDRESS 14 S. 30th Street CITY I STATE I ZIP Camp Hill PA 17011- Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 29,184.08 26.000.00 1.368.42 Total Credits (A + B + C) (2) 27,368.42 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 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) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58) Make Check Payable to: REGISTER OF WILLS, AGENT 0.00 0.00 1,815.66 1,815.66 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 OVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of pe~ury, I declare that I hay min this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of pre n the person r res tative is based on all information of which preparer has any knowledge. SIGNATU L RILING RETURN DATE PA 17070 DATE ADDRESS 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 3% [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 0% [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 0% [72 P.S. ~9116(a)(1.2)]. The tax rate imposed on the net value of transfers to orfor the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~9116(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 12% [72 P.S. ~9116(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-15l32 EX + (6-98) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Mattern. Beatrice. R 21 06 1146 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 DroDertv which is jointlv-owned with riaht of survivorshiD must be disclosed on Schedule F. SCHEDULE A REAL ESTATE ITEM NUMBER 1 DESCRIPTION Property located at 14 South 30th St. Camp Hill Cumberland County, PA sold to Glenn L. Miller on May 4, 2007 VALUE AT DATE OF DEATH 150,000.00 TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 150 000.00 REV-Hi08 EX + (6-98) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Mattern Beatrice. R FILE NUMBER 21 06 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. 1146 VALUE AT DATE OF DEATH 1,875.00 296.64 449.32 41.63 233.49 409.03 30,000.00 54.29 300.00 7.04 40,005.78 30.00 184.86 15,201.39 0.51 6,218.46 ITEM NUMBER 1. 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 DESCRIPTION 1996 Oldsmobile PA Title #50338280601 MA sold to Richard S. File, Sr. on 1-25-07 Byerly Insurance-refund Cash on hand Comcast Cable-refund Farmers Insurance-refund Foremost Insurance-refund on home insurance Fulton Bank-Cert of Deposit #022-0245627 Princ. $30,000.00, Inl. $54.29 Fulton Bank-Cert of Deposit #022-0245627 - Accrued Interest Grandmothers clock at appraised value by Claude C. Wolfe & Assoc. Highmark-refund Integrity Bank-Time Deposit Accl. #0003002647 Internal Revenue Service-refund on 2006 1040 tax return Keystone Oil-refund M&T Bank-Checking Accl. #67028209 Princ. $15,201.39, Inl. $.51 M&T Bank-Checking Accl. #67028209 - Accrued Interest Net proceeds of sale of personal property sold at public auction by Claude C. Wolfe & Assoc. on April 21, 2007 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 95,680.89 Continuation of REV-1500 Inheritance Tax Return Resident Decedent Mattern, Beatrice, R Decedent's Name Page 1 21 06 1146 File Number Schedule E - Cash, Bank Deposits, & Misc. Personal Property ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 17 Retirement pension received 194.29 18 Uncashed check from Integrity Bank CD 179.04 19 Verizon-refund 0.12 SUBTOTAL SCHEDULE E 373.45 GRAND TOTAL SCHEDULE E $ 95,680.89 REV-1511 EX + (12-99) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Mattern Beatrice. R FILE NUMBER Debts of decedent must be reported on Schedule I. 21 06 1146 ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: Musselmans Funeral Home-funeral expenses 2,571.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) David H. Stone 9,213.00 Social Security Number(s)/EIN Number of Personal Representative(s) 175-48-4299 Street Address 414 BridQe Street City New Cumberland State P A Zip 17070 Year(s) Commission Paid: 2007 2. Attomey Fees Stone LaFaver & Shekletski 9,213.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees Register of Wills 314.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Bridge Street Realty-appraisal fee on property 425.00 2 Foremost Ins. Co-fire insurance on property 457.03 3 WN Tuscane Agency-liability ins on property 553.50 4 Checks written by decedent but not cleared 250.00 5 Comcast Central-services at property 47.85 6 Verizon-services rendered at property 46.69 7 PPL Electric-services rendered at property 70.58 8 Integrity Bank-return check fee 10.00 9 Settlement costs ($6,860.01) less reimb. ($872.26) 5,987.75 10 PAWC-water service at property 49.21 11 PPL Electric-services rendered at property 41.21 12 Penn Waste-services rendered at property 44.61 TOTAL (Also enter on line 9, Recapitulation) $ 30.473.02 (If more space is needed, insert additional sheets of the same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent Mattern, Beatrice, R Decedent's Name Page 3 21 06 1146 File Number Schedule H - Funeral Expenses & Administrative Costs - 87. ITEM NUMBER AMOUNT 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 DESCRIPTION AT&T-services rendered at property Verizon-services rendered at property PAWC-services rendered at property PPL Electric-services rendered at property Penn Waste-services rendered at property PPL Electric-services rendered at property Com cast Cable-services rendered at property Borough of Camp Hill-sewer services at property PAWC-water services at property PPL Electric-services at property PAWC-water service at property PPL Electric-services rendered at property PAWC-water services at property Cumberland Law Journal-advertising grant of letters The Patriot News-advertising grant of letters Register of Wills-filing Inheritance Tax Return and Inventory Reserve for closing expenses 37.67 23.97 17.53 53.79 44.61 18.97 49.64 85.00 17.53 30.12 18.12 21.65 20.53 75.00 134.46 30.00 500.00 SUBTOTAL SCHEDULE H.B7 1,178.59 REV-1512 EX + (6-98) . SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Mattern. Beatrice. R FILE NUMBER 21 06 1146 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION 1 AAA Financial Services-debt of decedent VALUE AT DATE OF DEATH 418.64 2 Retail Services-Boscovs credit card balance due 40.71 3 Mitch Smith, MSW< LCSW-debt of decedent 35.87 4 West Shore EMS-ambulance service 62.44 5 Camp Hill Emerg. Physicians-debt of last illness 40.28 6 Messiah Village-services rendered 49.40 TOTAL (Also enter on line 10, Recapitulation) $ 647.34 (If more space is needed, insert additional sheets of the same size) ",o'""".'w COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER Mattern 3eatrir.F! R 21 06 1146 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 Diane File Niece Collateral 49,853.51 52 Red Barberry Drive Etters PA 17319- 2 Maryann Mulhollan Friend Collateral 20,000.00 946 Hummel Ave. Lemoyne PA 17043- 3 Charles & Sue Smith Friend Collateral 5,000.00 2208 Logan Street Camp Hill PA 17011- 4 Donald Thompson Friend Collateral 10,000.00 11 Palmer Drive Camp Hill PA 17011- 5 Helen Thompson Friend Collateral 10,000.00 11 Palmer Drive Camp Hill PA 17011- 6 Karen L Murphy Niece Collateral 49,853.51 634 McCabe Road Landisburg PA 17040- 7 Suzanne J Quesenberry Niece Collateral 49,853.51 933 W. Trindle Road Mechanicsburg PA 17055- 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 TAXIS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1 Helen O. Krause Animal Foundation 10,000.00 PO Box 311 Mechanicsburg PA 17055- 2 The Salvation Army 10,000.00 440 West Nyack Road West Nyack NY 10994- TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 20,000.00 .. (If more space IS needed, Insert additional sheets of the same size) 1_ ,__, r"":~; t: , '::JL;; . . ;MC4'~~~( ....'~ ,", " ,<-( .".~ "j',':;" ;;; LAST WILL AND TESTAMENT OF BEATRICE R. MATTERN I, BEATRICE R. MATTERN, of the Borough of Camp Hill, Cumberlani County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. ITEfvl I: I direct that my Executor hereinafter named shall pay all my just debts and funeral expenses as soon as conveniently may be done after my decease from the residue of my estate. ITEM II: I bequeath my Grandmother's Clock that belonged to my mother to my niece, KAREN L. MURPHY. ITEM III: I make the following bequests: A) $20,000.00 to my niece, KAREN L. MURPHY, if she survives me. B) $20,000.00 to my niece, SUZANNE J. QUESENBERRY, if she survives me. C) $20,000.00 to my niece, DIANE FILE, if she survives me. DJ $10,000.00 to t:he HELEN O. KRAUSE ANI;1A~ FOUNOF.TION, INC., of Mechanicsburg, Pennsylvania. E) $20, oeo. 00 to my friend, rvlF..FYp"NN MCLH-:;LL?..N, of 1...ernoyr.e, Pennsylvania, ~f she survives me. FJ 55,000.00 to my neighbors, CHAR~ES and SUE S~ITH, o~ Fa?e 1 -~ :3 Ca~p Hill, Pe~r.sylvania, if either or both survive me. G) SI0,000.00 to the Salvation ArffiY of Harrisburg, Pennsylvania. H) S10,000.00 to my friend, DONALD THOMPSON, of Lower Allen Township, Pennsylvania, if he survives me. I) S10,000.00 to my friend, HELEN THOMPSON, of Lower Allen Township, Pennsylvania, if she survives me. In the event that the amount of my distributable net estate is insufficient to pay the above bequests to my named beneficiaries, then said beneficiaries shall receive their pro-rated share of the sum of my estate available for distribution. ITEM IV: I direct that my Executrix sell or convert into cash all the rest, residue and remainder of my estate, whether real, personal or mixed, and wheresoever situate, and I give and bequeath the net proceeds derived therefrom in equal shares to my niece, KAREN L. MURPHY, my niece, SUZANNE J. QUESENBERRY, and my niece, DIANE FILE, providing each survives me. If any of my said beneficiaries prede- cease me then that person's share shall be distributed in equal shares to those above named beneficiaries in this Item IV who do survive me. ITEM V: I appoint DAVIe H. STONE, of the law firm of Stone LaFaver & Shekletski, New Cumberland, Pennsylvania, Executor of this my last will. Page ~ of 3 ITEM VI: No fiduciary acting hereunder shall be required to post bond or enter security for the faithful performance of his or her duties in any jurisdiction. IN WITNESS WHEREOF, I, BEATRICE R. MATTERN, have hereunto set my hand and seal this (3 day of ~lJI\t" , 2006. J$~t. 01J~- BEATRICE R. MATTERN I I ! SIGNED, SEALED, PUBLISHED and DECLARED by BEATRICE R. MATTERN, the Testatrix above named, as and for her Last Will and Testament, and in the presence of us, who at her request, in her presence and in the her, have subscribed our names as witnesses. 414 Bridae St.. New Cumberland. PA Address 414 Bridae St.. New Cumberland. PA Address Page 3 of 3 '\' ,:,.,: I "\~'i,':lIl\lr~Jl'l',l!\'lAT/TR\;[STATErni!kM'\~\:ulun.k('d P\J{CEL #01210273357 DEED I JJ11 .)./'yJ tli{ THIS INDENTURE made the ^I' day of . / (A (\ , in the year 2007, between DA VID H. STONE, Executor of the Last Will and Testament of Beatrice R. Mattern, late of the Borough of Camp Hill, County of Cumberland, and Commonwealth of Pennsylvania, of the first part. hereinafter called the Grantor, -AND. GLENN L. MILLER, a married man, of the second part, hereinafter called the Grantee; WHEREAS, the said Beatrice R. Mattern became in her lifetime seised, as of fee, of and in to a certain tract of land, together with the improvements thereon erected, situate in the Borough of Camp Hill, County of Cumberland, and Commonwealth of Pennsylvania, and more particularly described hereinafter; and being so thereof seised, died on December 16,2006, having first made her Last Will and Testament in writing dated June 13,2006, duly probated and registered in the Office of the Register of Wills of Cumberland County on December 27,2006, wherein and whereby she appointed as Executor, the said David H. Stone, to whom Letters Testamentary were duly issued by said Register of Wills on December 27,2006, wherein and whereby said premises hereinafter described were not specifically devised, all as in and by said Will and the records of said Register of Wills more fully appears; :\ow THIS INDENTURE WITNESSETH, that the said Grantor, for and in consideration of the ~um of ONE HUNDRED FIFTY THOCSAND and Nn 100 ($150.000.00) Dollars. which ha~ been paid to him by the said Grantee at or before the sealing and delivery hereof, receipt whereof is hereb) -1- acknowledged, has granted, bargained, sold. aliened, released and confirmed, and by these presents does grant. bargain, sell, alien, release and confirm unto the said Grantee, ALL THAT CERTAIN lot or piece ofland situate in the Borough of Camp Hill, County of Cumber- land, and State of Pennsylvania, bounded and described according to a re-survey by D. P. Raffensberger, Registered Surveyor, made November 22, 1955, as follows, to wit: BEGINNING at an iron pin at the southwest corner of South 30th Street (formerly Princeton A venue) and the first alley South of Market Street; thence along the southern line of said alley in a westerly direction two hundred thirty-three and four tenths (233.4) feet to a IS-foot alley; thence in a southerly direction along the eastern line of said IS-foot alley, forty-two (42) feet to a post; thence in an easterly direction two hundred thirty-one and nineteen hundredths (231.19) feet to the western line of South 30th Street (formerly Princeton Avenue); thence in a northerly direction along the western line of South 30th Street (formerly Princeton Avenue) forty-five and one tenth (45.1) feet to the place of beginning. BEING improved with a single two-story dwelling house known and numbered as 14 South 30th Street, and a frame garage. BEING THE SAME PREMISES WHICH Harold C. Mattern and Beatrice R. Matter, his wife, by their deed dated June 4, 1996, and recorded June 7, 1996, in the Office of the Recorder of Deeds in and for Cumberland County, Pennsylvania, in Record Book 140, Page 600, granted and conveyed unto Beatrice R. Matter, deceased. TOGETHER with all and singular the buildings, improvements, ways, streets, alleys, passages, waters, water-courses, rights, liberties, privileges, hereditaments and appurtenances whatsoever, thereunto belonging or in any wise appertaining and the reversions and remainders, rents, issues and profits thereof, and all the estate, right, title, interest, property, claim and demand whatsoever of her, the said Beatrice R. Mattern, at and immediately before the time of her decease, in law, equity. or otherwise ho,,"soe\er. of in, to or out of the same. TO HAVE AND TO HOLD the said lot or piece of ground above described. with the buildings and improvements thereon erected, hereditaments and premises hereby granted or mentioned, and -2- intended so to be, with the appurtenances unto the said Grantee, to and for the only proper use and behoof of the said Grantee, forever. And the said Grantor, for himself and his respective heirs, executors and administrators, does covenant, promise and agree to and with the said Grantee, his heirs and assigns, that he, the said Grantor, has not heretofore done or committed any act, matter or thing whatsoever whereby the premises hereby granted, or any part thereof, is, are, shall or may be impeached, charged, or encumbered in title. charge, estate or otherwise howsoever. Ii\! WITNESS WHEREOF, the said Grantor has hereunto set his hand and seal the day and year first above written. \:,,-~\~ Witness COMMONWEAI.}fH OF PE~S'iL V ANIA~: COlJNTY OF ()t1}?2l.JtlZlla n : On this, the AjfI/l day of ~tlj4, ,2007, before me a Notary Public, the undersigned officer. personally appeared DAVID J~~ONE, Executor of the Last Will and Testament of Beatrice R. Mattern, known to me or satisfactorily proven to be the person whose name is subscribed to the within instrument, and acknowledged that he executed the same for the purposes therein contained. IN \VITNESS WHEREOF. I have hereto set .~i'~~'ALTHOfPENr'r'{'1 ,., " .....4A/AL s . .::.....;. ~'.... OAt"tc" - 'RTMA EA.. New CUII:U[.. ";. 'Joro N'c Notal) PUblic My Corr.mjs~~"I'E' ." umberiand Co. Xplres Jan. 21, 2009 -3- I hereby certify that the precise address of the Grantee is Attorney for -4- Fulton Bank LISTENING. January 18, 2007 Stone LaFaver & Shekletski 414 Bridge Street Post Office Box E New Cumberland, Pennsylvania 17070 Dear Mr. Stone: RE: Beatrice R. Mattern, deceased December 16, 2006 ill response to your recent inquiry concerning the accounts maintained in the name of the decedent, please be advised that the following accounts were open at the date of death: CD # 022-0245627, open 3/1/2006, matures 6/1/2007, balance $30,000.00 plus accrued interest $54.29; paying 4.40%, in her name only. If you should have any further questions, please do not hesitate to contact me at (717) 291-2437. Very truly yours, '?f~~~ Karen D. Hilleg~ 0 Credit illquiry Processor CONFIDENTIAL This information is furni5hed as a matter of bliSin8$S C,~U;t2S,! in answer to your inquiry, 2nd :$ hi Y0ur cor;fi;J;;'ltiai use only No responsibility is assurn?d by ti',s ba:1h or (::ny of J:; off:cers. Any opinion here~n expressed ~ SUJj::ct to chcl,;ge w1thcut Hoti::e. POBox 4887 Lancaster, PA 17604 fultonbank,com 1-800-FULTON-4 CLAUDE C. WOLFE & ASSOCIATES AUCTIONEERS & APPRAISERS FAMILY OWNED SINCE 1910 2009 LINCOLN STREET. CAMP HILL, PA 17011 717-737-0734 January 23, 2007 Appraisal for the Estate of Beatrice R. Mattern 14 South 30th Street, Camp Hill, PA 17011 CLOCK Grandmother's clock 300.00 This Fair Market Value appraisal is true and correct to the best of my ability as an auctioneer and appraiser with 35 years experience. Member: Certified Appraisers Guild of America CLAUDE C. WOLFE & ASSOCIATES \,,)v.{}.~& ~~4 ~ w. K. Dusty Chapman, CAGA I .....UL. {JL/ (J, January 19,2007 e InCC tegnry BAN K Attention: David H Stone STONE LaF A VER SHEKLETSKI 414 Bridge Street New Cumberland, P A 17070 Dear Mr. Stone: At the time oiher death, Beatrice Mattern had only one Time Deposit Account with Integrity Bank. This account balance at that time was $40,005.78, which we cashed out and put into the estate account. Please contact me at 717-901-5500 with any questions. Sincerely, ~~ Tiffany Martin Assistant Branch Manger New Cumberland Office :."" ~,,;'e: li, .: ,<"~. -',,..-: ~ 'I .' :;~ . h . j . F.;~ ~;!::J'J~ "'~1Il ,., IlL.... '. '.iI. w ;-;" '" '. '11I"'1 <, ~,.... :.' .i "". <";' lIl_." .:':., " .\ l"... .... .'. . ~ ~t ~ ~ Hill. PA lifJJ1 . PHM, 717-.920-4!JOO . 877-1-HAVE/T. Fttt: 717-!}2()-~ . """'" itItIt~com m M&fBank 499 Mitchell Street, Millsboro, DE 19966 January 18, 2007 Stone LaFaver & Shekletski Attorneys At Law 414 Bridge Street Post Office Box E New Cumberland, PA 17070 RE: Estate of Beatrice R. Mattern Date of Death: December 16. 2006 Social Security No.: 199"()5-8380 Dear Mr. Stone: In response to your request, please be advised that at the time of death, the above- named decedent had on deposit with this bank the following accounts. 1. Account 7Ype...........................Checking Account Account Number.... ............. ......67028209 Ownership (Names oj)...............Beatrice R. Mattern Opening Date........................... 10/21/96 (account closed 01/03/07) Balance on Date ojDeath..........$15,201.39 Accrued Interest $ 0.51 Total. . .. . ... ...... ... .. . ... ...... .. . .. . ... .$15,20 1.90 The above named decedent had a safe deposit box. For any additional information on the above accounts, including ownership, statements and closures please contact our West Shore Plaza branch at 717-255-2271. Sincerely, _ , Wr1i.J /Ja~G Charlene Warrington, ~~cords Management 1-888-502-4349 CLAUDE C. WOLFE & ASSOCIATES AUCTIONEERS .t APPRAISERS FAMILY OWNED SINCE 1910 2009 UNCOLN STREET . CAMP HILL, PA 17011 717.737.0734 Public Auction Date Address Auction for Estate of Beatrice R. Mattern Aoril 21. 2007 14 South 30th Street. Camo Hill. PA 17011 Gross.................................$ 9,479.00 EXPENSES Shoppers Guide Adv. , Sale Bills..............$ 371.40 Patriot News Mv. ............................. 371.00 Paxton Herald Adv. ............................ 166 .80 Other Adv. f\!lttqu~.~~e.k.......................... 195.44 Other Adv. .................................... Other Mv. .................................... Sign for Property............................. state Fumigation Tags......................... Registration Numbers......... . . . . . . . . . . . . . . . . . '1'ent/'1'arp . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Misc. Expenses )pprqts~l........................ ~Clerks at $ 70.00 each. . . . . . . . . . . . . . . ~ Runners at $ 70.00 each . . . . . . . . . . . . . . . ~r Sale preparation ~r ~r ~r 25.00 10.00 10.00 75.00 280.00 280.00 528.00 Personal Items Fee at~' .................. 947.90 Total Expenses for Auction..................... $3,260.54 Real Estate Gross.......... . . .. .. . . . . . .. .. . . .. $ 150.000.00 Real Estate Fee at --1-' (Due at Settlement) . 4.500.00 \ . C, r \.\) .Y... \j\.'~ 0~_~u-- clEjJ~r1e: -- roved : $ 9.479.00 Auction Gross - 3.260.54 6,218.46 - 7,413.00 1,194.54 Expenses Ne~ Checks OWed to~Auctioneer A. II.S. IJI'PAIUMENT OF IIOUS[NG AND IJRIIAN DEVELOPMENT SKI'TU;M~;NT STAn~l\'mNT lJ. l. [I FHA 4. [] VA (,. FILE NUMBER: 07-00131-ALT 8. MORTGA<iF INS. CASE NO.. 2. II 5. r] OF FI-IMA CONY. INS. 7. LOAN NUMBER 1> OMB No 2502-0265 LOAN 3. II CONV.IININS. TYPE C NOTE: rhis form is furnishcJ to give you a statement of actual settlement costs. Amounts paid to and by the sctllement agent arc shown. (tems marked "(p.n.c.)" were paid outside the closing; they arc shown here for infornmlional purposes and are not included in the lotals. I). NAME 8< ADDRESS OF BORROWER: E. NAME 8< ADDRESS OF SELLER: I' NAME 8< ADDRESS OF LENDER: G. PROPERTY LOCATION: 14 Soulh 10th Street, Camp Hill, PA 17011 II. SE1TLEMENT AGENT: Assured Land Transfers, Inc. PLACE OF SE'ITLEMENT: 101 Market S[reet, Lemoyne, PA 17041 (717) 76[-4720 SErrLEMENT DATE: 5/04/20()7 Glenn L. Miller 1040 Walnul Slreel, LenlOyne, I' A 17041 David H. Stone, Executor oflhe Estate of Bealriee R. Mattern Cash Sale , .I. Summa or Borrower's Transaction DISBURSEMENT DATE: 5/04/2007 K. Summa of Seller's Trausaction 400. Gross Amount Due To Seller: 100. (;ross Amouut Due From Ilorrower: 101. 102 103. 104. 10) (..'~ll!t~'_a_l:.~ __s~ ~~~ pr~c~_______~_ !J~_r~~I'~~,1 rl~(_~~~.~r~_ _~____ __~________.__. .S_?~llc]~~I]_~_~ha_l]~~~~J(_)__~(~I"~l~~cr: (Ifn.~_,! ~Q) ________ __ __ .!?_OLOOO.OQ _ __L.tJ.n 25 __~!~~l~~~~.t_~~~~P~~~.~__ _ ~.(~~~_erson_~I.p~~r~~~:Y _~_______ 403 404. 405. .ISO,OOOoQO 106 1117. lOX. 109. 110 AdjlJsllII~!I!.s_ForH~lIJs P~illlJ.Y~~tI.~r I!LM\,_a!!c~: (__\~~~~~~',1 _t~x~~. lo ____~_________ C'o""'l:_t~'('" _ _ 05/04107 to 12/3[/9?._______ Assessments to ____. ___ ___n__^dlustmcl!t~E!!!1tern..!l'aid_B}' S.!'!I~r In--^lIva!!c~: _~_06. S:~ty!~~~_.!.axcs to ____________ 5 7020 407-'--~1IlIy taxes ____~04IOL_t'~n.!..2/~1!0'7 408. Assessments to ___5](j.20 School Taxes V04/2007 10 6/)1112007 --. - -.......- "." ...._.._---~.._--_._------_._-,_.".._... .._------~_.~~-~-- Sewer Cllal]!-,,--,104i200]_ to 6110/2007_________ ________115.94 . _.______EO.2 409. School Taxes )/()412007 to (,/30/2007 ----_._-~_._.__._--_. .------.- .i.l..O~ewer C~~r!l"_510412()()7 ~o_6~3012007___ 41i 412. 4\J. 275.lJ4. 27.02 III 112. 113. 114. Ii). 11(, 120. Gross Alllount Due From Ilorrower: 150,872.2(, 201 _.~)~p~~~!~(_~~ e3!~~~~~_1_~L______~__~____ 202. 1'r1_I1(;_ip~l_ al~.lol!l~..t ()r.ne":..!t~a~l(sL 2031,;' x i~ li n ~_l oa II ( s)t ~:1_~_ ~~l_:~_~I_l?j ~~~ tJ ~_ 1 _ ~1_~Q9.0Q .2QI. Excess (Icpo~it (see instru~!!.~!...~~l________~__ __._ ..._.________ ___~____ _ ___~9~:__~_c_t!!?_t2~~~~t _~ l~~~g~~!~)__~~~!J~~~__! 400) __. . ___.. __ ._~_______ _~3. l~~!~t.~~g.~~~l!~k_~~.s~!)j~_~!~~___~__ )04. Payof!..!sIJI:1.t!l:..Ln. 505. !,:ryoff2l1d MIJL' .11-'--__ 506--=- Prope~~.!.?_x __ _________ _.~?~___~~_~i!..J~~.~_~ ________ )08 _._._~..__.- )09. _2.lJ()OJJO 204. 20.) 20Cl. 207 20X 20'! . . 8(,tJ,O I . _I~,()OOO() '5e-tLl1Z-'Y~t /i!{./<:.~~: /S(tJ D Q < (.1.J 210 Ci 211 212 As n.1 214. 21) 211> 217 21 X 21 'J. C(J ':.is f -UO~_/U (/4; (o8c"o. of e 72 ..d~ -- --=- 1/ 5187, 7S- , Adjustmcnts For Itcms lJnllaidlly Seller: _~O...:.. Cily/~~~~~_!~_~____ to ! 11_:5~5~~!~tYJ~~~s to ~ 12. Assessments to . _. --" --------- - 513. -------. )[4. _.,_.._..--~._._----- 51). - ------..-..-...--- 5[ (, )[ 7. --'-"--- _.,._-----~---_. 518. )19. IlclFrnT rrw' _}~L'_~'T~.~~ ~.~~~)l~.~lt.~I:_I_~(~~I~~r~wcr il.i~_c _!J(2)..___ ..__ }02. .I_~_~~~_f! 1?III"lt_.P.~J~i._ ~l'./!~~!'I)~).r~~~LQ.!!!c 2 20 )____~__ 103. Cash dXIFROM) ,[}ro) /lorrower: 520< Total Reductions 15,000.00 In Amount Due Seller: 6 h Jj}j:15.J! '!:O.1.:...Cir"ss at11lllJ11td_uet<,-,~lcrJI1I",_4~Ol _t5_,9,QQ.:QQ _ ~Y~~~~__~~!~~~!~n~!::_~~~~~I~t ~~~~~I!~E__Q~_:~_~_L___ 118,525.51 603. Cash lxfro) !ill' 21,860.01 1.'reVIUlIS ~. tlun 1 Ohsolete .) Il~~~1~~.15HI~ t~ X -- _. _..._150L87226 . _ ...._ ___1_L8_GOOI 129,012.25 Page I of 3 SB-4-3.\3X-OOO-1 HUll. I (3-8(,) RESPA, J/Il 4305.2 L. 7U1J. Total ~;ales!llroker's Commission: Based On Price $ SETTLEMENT CHARGES 0/0 ::. Escrow: 07-00131-ALT Paid From Borrower's Funds At Settlement Paid From Seller's Funds At Settlement 70L$_ ]02 $ 703. 704. _ _~ ____ tu..~ to _ 4,5l)(tVO $4 500.00 8.o!. I,oan (Jrigi@tivn(ee_..__ S02. Coall DiseoYnL SO).l\pprajsal fee to: _801. Cred.il r"pl1IUo; 805. Lellder~ 1JI~12e(;tion(ee _ sOG.. Mrntgml.einmmnceappJI(;atioll_CIT to __S07. A~SYIl1PtionfeJC___.. S()S SO~. SIO. 81!. .812.. W S14. .815 SI(,. 'Yo__ ------_%_~._._- I , . Interest 11:0111 to M.oLlg,ag(; _in~ma!1(;.e.Qr~mi ymfu.L..... ______ Ila~ar9 1I1~YraneeJ)(emi!!!1Lfo.r Floo;) i!]syran(;"premj~mJ:oL .. .{f!l$.-______.___fd_aL___.__CQg<!Y~) llliLl\L...______.. ._._______._....._.. _ _______~ .__ __xrs~lo___.___________.__.__ ___._.__.._ ________ . yrs" 10_.._.___.__ _______________ .___.______ 100L H.~a(d insyn.r.!l!;l;___ ______!l1o.n!h~$..__ __11r;r 1110n!IL_..__________.~ 1_ 1.002. M.Q,rtg,age_ in_"Ym!lCJ;_n_~_J!1Q!1!h~@..L..- P.eLmo_!]lh~_. ____ ____._~ _ ____._L ._ __..__ I I L 1003 _City properlYJai<eL___________)l1Qnlh...@L.L_ __ .___ PeI1llQD1h....~_. I 1 J 00_4.. COYnty m1lPJ;rty.1ai<<;L_______ !119.!!!b~_ @L__._ .- -~- ._12e.r.mQ!11iL.__.___~ ... -._-__-_-_-_...- -.--......-.------_'t=---.-. '_- '_'.-.._-. .- .-_- _-__...-..-_-.I~~=---~~ _..I 1_ UJ05.J\IJ1!yal as_scm!]C.!ltL_____~___mQJll~@..L-~- _Q<;r !llQ!1!h~_ _ I IloOG. I'lood i-"-'.YrJ!nce____.____..__._.lllQ.!!lh~@$_____ . peImoJ!llL____~ ______. ____~__ I I. !QQ7._______ _.!11.Qflths@_$.__ Q!'I1Donth ______ __..~_ L __I I IOo.s. ^gKregalc_^djll~me!1L________.___ ._______ _______ ____~______ IOO!). II 0 L Settlel11<;nLo[ cJo~inZ fe" 10____ UQ2. Al2:;tri.Klor tilkse!!(<.:.b 10__._ .___..__. lJOJ _ Tttle.cl\,lJnil!illiOJllo.. _______. I) 04.. Tltl, lilsYra.Q(;e._binder to_____ LI oS 1)0eWl1eilt Prep!!rillloILlJ,L____ _ II O(l NolaryJ);e~ t\.l. 1107. Attorney's fees to (includes above item Numbers: 1108. Title Insurance to Assured Land Transfers, Inc. (includes above item Numbers: 1101,1102,1103,1104 __ __ _____.______~__".._.._m_ ____ __ _n _ _._~_.__,_." ____I cl OS 75 L,.nd..er'~ c.Qyerag.e__L_____.__~____________ . ._______ ___..._ ____ QWn~r:s c.ovc.rage....Ji_J50,OQ(l.QQ_ J'remL4m;_ $. UQ.8~7 5_______ Notary Fe.c to.CaSU_ _______ ________ _. ____ m_______ . _ ____________._ ~ ~o.Q RG<;\lrding l);es: Pee9_$.._J.9,50___;Mmjgggc $. City!eQWltyJili<!stilmQs;l),,,dS . _ .__ _____ .S.!_!!.e taJ<!Stanms'-___ __P!;l;.Q l_____~n 3.,QQ.Q,Qo . ._~.~_____ _ __... :R~l,ases.$._ _ __.__. .....;MQr!gilZe_.$..____ .~_;MQ[tgagr;$ __ 3.2.50 ~____ ~J .5oo~OQ . . JSQQ..QQ 1301 . Survey to J 302. Pest UI~12"'Jj.oIUo______ 130J. _1}()4 1305. !J06. 13.07. 13.08. IJln 1310 UII 131~. 13 IJ" 1400_ FormN .SecJJ.w.LLaJ1I.L1ine_Jl12...Seclin.u..KJ~_____ _ Page 2 of3 __ _______2.653.2 GJ)UQ_OQ SU-4-35.18.000.1 x x x SI<:LLER'S AND/OR HORROWER'S STAn:M~:NT Escrow: 07-00131-ALT I have cardully reviewed Ihe IflJD-1 Seltlement Statement and to the besl of my knowledge and belief, il is a Irue and accurate statement of all receipts and d,sburSl'lllenls Illade on my account or by me in this transael1on. I furl her certify Ihatl have received a copy of the HUD-I Seulement Slatement. II00Towers/) ehasf~& Sellers The IIIJIJ-I Seulement Slatement which I have prepared is a troe and accurate account of this transaction. I have caused or will cause the funds to be ::~:,:::::::::~rn'"':z12~k Orno 4 ph. FATIC Support, Assured Land Transfers, Inc. WARNING: It is a crime to knowll1gly make false statements to the United Stales on this or any olher similar lorm. Penalties upon conviction can include a fine or IInprisonlllent. For details see: Tille 18 U.S. Code Section 1001 and Section 1010. Page J of J