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Home My WebLink About09-06-07 -.J 15056041125 REV-1500 EX (06-05) PA Department of Revenue '* ~~~~~~~g~~~uaITaxes INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 ~- -~ RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death OFFICIAL USE ONLY County Code Year 2 1 0 6 File Number 1 1 3 9 Date of Birth 208426204 1216200 6 o 1 1 0 1 9 5 1 Decedent's Last Name Suffix Decedent's First Name PAC E CAROL MI R (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number o 2. Supplemental Return o 4a. Future Interest Compromise (date of death after 12-12-82) o 7. Decedent Maintained a Living Trust (Attach Copy of Trust) o 10. Spousal Poverty Credit (date of death 0 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number FILL IN APPROPRIATE OVALS BELOW [XI 1. Original Return o 4. Limited Estate [XI o THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS o o 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received 8. Total Number of Safe Deposit Boxes J A C QUE L I N E Firm Name (If Applicable) A KELLY 71754 1 555 0 r---.~, REGISTE~wiLLS 'USE~i.y "~cO . . :'0 C/) -'-J "'/'1 .-to ~ '-,.1- 0..:::,:", r-n , ~;.;:::-:? 01 .....-,... /'.... Second line of address -0 J A N L BROWN & ASS 0 C I ATE S First line of address 8 4 5 SIR THO MAS COURT SUI T E 1 2 =" City or Post Office State ZIP Code I ~,._- ~u ,..--j ~E FILED N W H A R R I S BUR G P A 17109 Correspondent's e-mail address:JACKIEJLB@VERIZON.NET Under penalties of pe~ury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATU OF PERSON RESPON~LE FOR, FlUNG RETURN DATE 7 c; r~ _ 0 MECHANICSBURG , SUITE 12 HARRISBURG PLEASE USE ORIGINAL FORM ONLY PA 17109 Side 1 L 15056041125 15056041125 --.J ~ - -.J 15056042126 REV-1500 EX Decedent's Name: CAROL R . PACE RECAPITULATION Decedent's Social Security Number 208426204 1. Real estate (Schedule A) 2. Stocks and Bonds (Schedule B) .................................. 2. 14490 0.00 5499.77 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . " 1. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 4. Mortgages & Notes Receivable (Schedule D) ........................ 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ....... 5. 6. Jointly Owned Property (Schedule F) 0 Separate Billing Requested . . . . . " 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) 0 Separate Billing Requested. . . . . .. 7. 17105.81 14. Net Value SUbject to Tax (Line 12 minus Line 13) ...... ..... .. '" " 14. 1 6 0 0 4 4. 5 6 3 2 7 5 5 O. 1 4 5 4 5 8 2. 9 8 4 2 3 9 8. 5 7 9 6 9 8 1. 5 5 2 3 0 5 6 8. 5 9 1 5 0 0 O. 0 0 2 1 5 5 6 8. 5 9 8. Total Gross Assets (total Lines 1-7) ........................... 8. 9. Funeral Expenses & Administrative Costs (Schedule H) . . . . . . . . . . . . . . " 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . . . . . . . . . . . . 10. 11. Total Deductions (total Lines 9 & 10) ...........................11. 12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . 12. 13. Charitable and Govemmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . 13. TAX COM PUT A TION . SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X.O _ o . 0 0 15. 16. Amount of Line 14 taxable o . 0 0 at lineal rate X.O_ 16. 17. Amount of Line 14 taxable 1 8 0 0 5 5 . 0 0 at sibling rate X .12 17. 18. Amount of Line 14 taxable 3 5 5 1 3 . 5 9 at collateral rate X .15 18. 19. Tax Due . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. o. 0 0 O. 0 0 2 1 6 0 6.6 0 5327.04 2 6 9 3 3.6 4 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT o L Side 2 15056042126 15056042126 -' REV -1500 EX Page 3 Decedent's Complete Address: DECEDENTS NAME CAROL R. PACE -- , ---.---- - -----.----------- STREET ADDRESS 4 SHOEMAKER LANE File Number 21 06 1139 CITY MECHANICSBURG I STATE PA -----,----~--_.-.-..__...._--- I ZIP I 17050 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 26,933.64 Total Credits (A + B + C) (2) 3. InteresVPenalty if applicable D. Interest E. Penalty 0.00 TotallnteresVPenalty ( 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) A. Enter the interest on the tax due. 0.00 0.00 26,933.64 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5A) (58) 26,933.64 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ...................................................................... 0 [&] b. retain the right to designate who shall use the property transferred or its income; ............................... 0 [&] c. retain a reversionary interest; or ................................................................................................ 0 [&] d. receive the promise for life of either payments, benefits or care? ....................................................... 0 [&] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................... 0 3. Did decedent own an 'in trust for" or payable upon death bank account or security at his or her death? ......... [&] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which . b fi' d' t'? '3(1 contains a ene clary eSlgna Ion. .................................................................................................. ~ [&] o o 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. S9116 (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. S9116 (a) (1.1) (ii)]. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. s9116(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. s9116(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. s9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1502 EX + (6-98) . - COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE I ESTATE OF FILE NUMBER CAROL R. PACE 21 06 1139 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell. both having reasonable knowledge of the relevant facts. Real property which is Jointlv-owned with rlaht of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION Real estate located at 4 Shoemaker Lane, Mechanicsburg, Pennsylvania see attached settlement sheet VALUE AT DATE OF DEATH 144,900.00 TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 144,900.00 REV-1503 EX + (6-98) '* - COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF CAROL R. PACE ITEM NUMBER 1. All property Jointly-owned with right of survivorship must be disclosed on Schedule F. FILE NUMBER 21 06 1139 IBM Corporation 55.484 shares of common stock @ $95.37 DESCRIPTION VALUE AT DATE OF DEATH 5,291.51 2. The Walt Disney Company 6 shares of common stock @ $34.40 206.40 3. The Walt Disney Company dividend record date 12/15/06 1.86 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 5499.77 REV-1508 EX + (6-98) . - COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF CAROL R. PACE SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1, Members 1st FCU 25.00 Savings Account #67384-00 2. Members 1 st FCU 206.62 Checking Account #67384-11 3. Cash on hand 132.88 4. Members 1 st FCU; credit for bounced checks 120.00 5. 2004 Chrysler PT Cruiser; sold to private party 10,000.00 6. Household goods sold at Brickers Auction 1,705.00 7. Household goods and jewelry sold on ebay 1,937.45 8. Erie Insurance; refunds 388.00 9. Verizon; refund 1.58 10. Penn Waste; refund 32.19 11. credit for county taxes already paid 197.09 12. US Treasury 575.00 refund of Federal income taxes for 2004 13. US Treasury 1,785.00 refund of Federal income taxes for 2005 FILE NUMBER 21 06 1139 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly.owned with right of sUlVivorship must be disclosed on Schedule F. TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 17105.81 REV-1510 EX + (6-98) . - COMMONWEAL TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF CAROL R. PACE SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. FILE NUMBER 21 06 1139 DESCRIPTION OF PROPERTY ITEM INCLUDE THE NAME OF THE TRANSFEREE. THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH % OF DECO'S EXCLUSION TAXABLE NUMBER THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPliCABLE) VALUE 1. AXA Equitable 62,885.33 100. 62,885.33 IRA Account #63U-076054 Sandra Pace (sister), beneficiary 2. AXA Equitable 68,402.20 100. 68,402.20 Annuity #305613332 Sandra Pace (sister), beneficiary 3. Fidelity Investments 28,536.71 100. 28,536.71 401(k} account #W504148-21JAN07 Sanda Pace (sister), beneficiary 4. U.S. Savings Bonds, Series EE, three $100 bonds 220.32 100. 220.32 POD to Sandra Pace (sister) see attached Inventory Report TOTAL (Also enter on line 7 Recapitulation) $ 160,044.56 (If more space is needed, insert additional sheets of the same size) REV-1511 EX + (12-99) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF CAROL R. PACE SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21 06 1139 ITEM NUMBER A. B. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. Debts of decedent must be reported on Schedule I. 1. 2. FUNERAL EXPENSES: Myers Funeral Home Gingrich Memorials; gravemarker DESCRIPTION AMOUNT 4,152.50 550.00 ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Sandra E. Pace Social Security Number(s)/EIN Number of Personal Representative(s) 208-42 -6205 Street Address 1443 Newtown Circle City MechanicsburQ State PA Zip 17050 Year(s) Commission Paid: 2007 Attomey Fees Jan L. Brown & Associates Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation) Claimant 7,078.00 15,000.00 Street Address City Relationship of Claimant to Decedent State Zip Probate Fees Register of Wills 427.00 Accountanfs Fees Parks & Company; preparation of income tax returns (2002-2006) and fiduciary returns Tax Retum Preparer's Fees 1,000.00 Cumberland Law Journal; legal advertising The Sentinel; legal advertising ACH Deluxe Checks; estate checks USPS; registered mail fee for stock settlement charges for real property at 4 Shoemaker Lane, Mechanicsburg, PA school tax; real property at 4 Shoemaker Lane Patriot News; advertisement to sell 2004 Chrysler PT Cruiser The Sentinel; advertisement to sell 2004 Chrysler PT Cruiser Silver Spring township tax collector Black's Detachable Truck Systems; dumpster for real property at 4 Shoemaker Lane PPL Electric Utilities; real property at 4 Shoemaker Lane Penn Waste; trash, recycling for real property at 4 Shoemaker Lane 75.00 137.03 8.25 10.93 16,218.50 70.92 35.80 33.99 10.00 694.70 1,083.03 283.08 TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 54 582.98 Continuation of REV-1500 Inheritance Tax Return Resident Decedent CAROL R. PACE Decedent's Name Page 1 21 06 1139 File Number Schedule H - Funeral Expenses & Administrative Costs _ 87. ITEM NUMBER 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. DESCRIPTION AMOUNT Bio Med; clean up for real property at 4 Shoemaker Lane Gordon's Jewelers; diamond appraisals R.E. Fink; septic pump out Commonwealth Corporation; cleaning, odor removal of real property 4 Shoemaker Ln Veterinary bills for care of cats inspection, recon, body work, registration of 2004 Chrysler PT Cruiser dry cleaning of personal property (quilt) Brian Pace; services performed for real property at 4 Shoemaker Lane Gloria Kautz; services performed for real property at 4 Shoemaker Lane John Kautz; services performed for real property at 4 Shoemaker Lane Jacob Kautz; services performed for real property at 4 Shoemaker Lane Nicole Murray; services performed for real property at 4 Shoemaker Lane Matthew Kautz; services performed for real property at 4 Shoemaker Lane Jessica Eckenrode; services performed for real property at 4 Shoemaker Lane B.J. Taylor; services performed for real property at 4 Shoemaker Lane Gloria Kautz; hours spent caring for cats Executor out-of-pocket expenses including but not limited to cleaning supplies, electrical supplies, lawn care, cat food, cat liter, cat materials, stamps, gas, etc. Register of Wills; family settlement agreement filing fee Register of Wills; Inventory and Inheritance Tax Return filing fee USPS; certified mail fee for income tax returns 100.00 159.00 175.00 2,250.00 254.86 672.01 20.03 885.00 907.50 375.00 217.50 15.00 150.00 127.50 60.00 510.00 732.39 20.00 30.00 53.46 SUBTOTAL SCHEDULE H.B7 7,714.25 REV-1512 EX + (12-03) . , '* SCHEDULE. DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF CAROL R. PACE Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, Including unreimbursed medical expenses. FILE NUMBER 21 06 1139 ITEM NUMBER DESCRIPTION 1. Washington Mutual Home Loans; mortgage on property at 4 Shoemaker Lane, Mechanicsburg, PA Loan #8419667368 2. Chrylser Financial; loan on 2004 Chrysler PT Cruiser Loan #1000140665 VALUE AT DATE OF DEATH 32,895.09 6,750.00 3. VISA; outstanding debt account #4121449998673847 25.90 4. National Recovery Agency; outstanding bills for Pinnacle Health and Quantum Imaging Account Nos. 260070242,260091432,260106307,200407484 661.30 5. National Recovery Agency; outstanding bill for Dental Health of Silver Spring Account #364800 307.92 6. Accounts Recovery Bureau, Inc.; outstanding bills for Pinnacle Health Account #270040357 536.76 7. Pinnacle Health; outstanding bill Account #200712766 14.60 8. Pennsylvania Department of Revenue State income taxes for 2002 18.00 9. Pennsylvania Department of Revenue State income taxes for 2003 17.00 10. Pennsylvania Department of Revenue State income taxes for 2004 19.00 11. Pennsylvania Department of Revenue State income taxes for 2005 14.00 12. Pennsylvania Department of Revenue State income taxes for 2006 622.00 13. US Treasury Federal income taxes for 2006 517.00 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed. insert additional sheets of the same size) 42.398.57 ",,,,m:. - COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF CAROL R. PACE SCHEDULE J BENEFICIARIES RELA TlONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON{S) RECEIVING PROPERTY Do Not List Trusteees) OF ESTATE 1. TAXABLE DISTRIBUTIONS pnclude outright s~usal distributions. and transfers under Sec. 9116 (a)(1. )] 1. Sandra E. Pace Sibling 170,049.78 1143 Newtown Circle Mechanicsburg, PA 17050 2. Gloria J. Kautz Sibling 10,005.22 138 N. Middlesex Road Carlisle, PA 17013 3. Matthew P. Kautz Collateral 11,769.06 19 Greenspring Drive Mechanicsburg, PA 17050 4. Gloria J. Kautz, Trustee f/b/o Jacob A. Kautz Collateral 11,975.47 138 N. Middlesex Road Carlisle, PA 17013 5. Brian P. Pace Collateral 11,769.06 1443 Newtown Circle Mechanicsburg, PA 17050 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. Cumberland Valley Eagle Foundation 10,000.00 6746 Carlisle Pike Mechanicsburg, PA 17050 2. Helen O. Krause Animal Foundation, Inc. 5,000.00 P.O. Box 311 Mechanicsburg, PA 17055 TOTAL OF PART n - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 15.000.00 t FILE NUMBER 21 06 1139 (If more space is needed. insert additional sheets of the same size) J::-/l~ LAST WILL AND TESTAMENT OF CAROL R. PACE I, CAROL R. PACE, now domiciled in Cumberland County, Pennsylvania, declare this to be my Last Will and Testament. I revoke all other wills and codicils that I may have previously made. Article I My just debts and expenses of my last illness, funeral, and administration of my estate shall be paid by my Executor from the principal of my residuary estate as soon as practicable after my death. Article II All inheritance, estate, and succession taxes (including interest and penalties thereon, but not including any generation skipping tax) payable by reason of my death shall be paid out of and be charged generally against the principal of my residuary estate without reimbursement from any person. This provision is not a waiver of any right which my Executor has to claim reimbursement for any such taxes which become payable as the result of any property over which I have the power of appointment. uJ Article III I give, devise and bequeath in accordance with any memorandum which I have eitber handwritten or signed, located with my will or with my valuable papers and found within 30 days of the probate of my will. Gifts may only be to persons who survive me or to organizations which exist at my death, and if there is a conflict, the memorandum having the latest date shall govern. Article IV I give and bequeath all of the mM stock that I own at the time of my death in equal shares, to my nephews, MATTHEW P, KAUTZ, of Cumberland County, BRIAN P. PACE, of Cumberland County, and JACOB A. KAUTZ, of Cumberland County, per stirpes. Article V I give and bequeath all oftbe Disney stock that I own at the time of my death to my nephew, JACOB A. KAUTZ, per stirpes. Article VI I give and bequeath to the CUMBERLAND V ALLEY EAGLE FOUNDA nON, EIN #25-1780658, located at 6746 Carlisle Pike, Mechanicsburg, PA 17055, the sum of Ten Thousand and 00/100 ($10,000.00) Dollars, to be used at their discretion. Article VII I give all of the cats that I own at the time of my death to the HELEN 0, KRAUS ANIMAL FOUNDA nON, INC., EIN # 23-2214917, located at P.O. Box 311, Mechanicsburg, Pennsylvania, 17055-0311, as the foundation has a "no kill" policy. In the event that the HELEN O. KRAUS ANIMAL FOUNDATION, INC. accepts all of my cats and provides care for all of my cats, I give 2 cP and bequeath to the HELEN O. KRAUS ANIMAL FOUNDATION, INC., the sum of Five Thousand and 00/100 ($5,000.00) Dollars. Article VIII All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate, I give, devise and bequeath in equal shares to the following: SANDRA E. PACE, of Cumberland County, Pennsylvania, GLORIA J. KAUTZ, of Cumberland County, Pennsylvania, MATTHEW P. KAUTZ, of Cumberland County, Pennsylvania, BRIAN P. PACE, of Cumberland County, Pennsylvania and JACOB A. KAUTZ, of Cumberland County, Pennsylvania. If any of the named beneficiaries predecease me or fail to survive me by thirty (30) days, I give, devise and bequeath his or her share to his or her issue who survive me, per stirpes, or if he or she have no issue, the share(s) are to be added equally to the other shares. Article IX Except as otherwise provided in this Will, I have intentionally failed to provide for any other persons or relatives, whether claiming to be an heir and/or relative of mine or not. Insofar as I have failed to provide in this Will for any of my relatives, and/or issue now living or later born or adopted, such failure is intentional and not occasioned by accident or mistake. Specifically, I have failed to provide for DEANNA MURRAY, STEVE WOLAVER, JR, ANGELA WOLAVER, NICOLE MURRAY and ARRAY A FICKES. Article X If a beneficiary under this Will has not attained the age of twenty-five (25) years, the share of the beneficiary shall be placed in a separate trust, for the benefit of that beneficiary according to 3 the terms in Article XI. Article XI In the event that a Trust is created hy or as a result of any part of this Will, the terms and conditions ofthe Trust shall be as follows: A To expend and apply so much of the net income and so much of the principal ofthe Trust as the Trustee shall consider advisahle for the support, care and education of the child until the child attains the age of twenty-five (25) years. B. Upon attaining the age of twenty-twO (22), one-half (1/2) of the child's share shall be distributed outright to the child. C. Upon attaining the age of twenty-five (25), the remaining principal and accumulated income of the child's share shall be distributed outright to the child. E. No beneficiary or remainderman of this Trust shall have any right to alienate, encumber, or hypotbecate his or her interest in the principal or income oftbe Trust in any manner, nor sball any interest be subject to claims of bis or ber creditors or liable to attachment, execution, or other processes oflaw. Article XU In order to carry out the purposes of tbe Trust establisbed by this Will, tbe Trustee, in addition to all otber powers granted by tbis will or by law, sball have the following powers over the Trust estate, subject to any limitations specified elsewhere in this Will. (a) to retain in the form received and to sell either at public or private sale, any real estate or personal property except that whicb I specifically bequeath berein, 4 ~ (b) to manage real estate, (c) to invest and reinvest in all forms of property without being confined to legal investments, and without regard to the principal of diversification, (d) to exercise any option or right arising from the ownership of investments, (e) to compromise claims without court approval and without consent of any beneficiary, (f) to file any federal income tax return for any year for which I have not filed such return prior to my death, (g) to make distributions in cash or in kind, or in both, and to determine the value of any such property, (h) to employ any attorney, investment advisor, or other agent deemed necessary by my Executor; and to pay from my estate reasonable compensation for all their services, and (I) to conduct along with or with others, any business in which I am engaged in or have an interest in at the time of my death. Article XIII I hereby appoint SANDRA E. PACE as Trustee of Trusts created in this Will for BRIAN P. PACE. In the event of the renunciation, death, resignation, or inability to act for any reason whatsoever of SANDRA E. PACE, I nominate and appoint GLORIA J. KAUTZ as the trustee of any Trust(s) created in this will for BRIAN P. PACE. I hereby appoint GLORIA J. KAUTZ as Trustee of Trusts created in this Will for MATTHEW D. KAUTZ and JACOB A. KAUTZ. In the event of the renunciation, death, resignation, or inability to act for any reason whatsoever of GLORIA J. KAUTZ, I nominate and appoint SANDRA E. PACE as the trustee of any Trust(s) 5 J created in this will for MATTHEW D. KAUTZ and JACOB A. KAUTZ. Article XIV I nominate, constitute, and appoint SANDRA E. PACE, of Cumberland County, Pennsylvania, and GLORIA J. KAUTZ, of Cumberland County, or the survivor of them, as Co- Executrix's of my Last Will and Testament. I direct that my Executrix's or successor Executrix be pennitted to serve without bond and in addition to those powers granted by law, I grant them power to sell both real and personal property, at private or public sale, to invest cash without being limited to statutory investments, to distribute in cash or in kind in like or in unlike shares and to file any qualified disclaimer I could have filed if living. My Executrix shall receive reasonable compensation for services rendered to my estate. Article XV In addition to the powers conferred by law, I authorize my Executrix, in her/their absolute discretion: (a) to retain in the form received and to sell either at public or private sale, any real estate or personal property except that which I specifically bequeath helshe herein, (b) to manage real estate, (c) to invest and reinvest in all forms of property without being confined to legal investments, and without regard to the principal of diversification, (d) to exercise any option or right arising from the ownership of investments, 6 cJ (e) to compromise claims without court approval and without consent of any beneficiary, (f) to file any federal income tax return for any year for which I have not filed such return prior to my death, (g) to make distributions in cash or in kind, or in both, and to determine the value of any such property, (h) to employ any attorney, investment advisor, or other agent deemed necessary by my Executor; and to pay from my estate reasonable compensation for all their services, and (i) to conduct alone or with others, any business in which I am engaged in, or have an interest in at time of my death. IN WITNESS WHEREOF, I, CAROL R. PACE, hereby set my hand to this my Last Will and Testament on this ~ day of October, 1997, at Harrisburg, Pennsylvania. ~ If jJ CZ-ce -- CAROL R. PACE In our presence, the above-named CAROL R. PACE signed this and declared this to be her Last Will and now at her request, in her presence, and in the presence of each other, we sign as witnesses. Name Address ~b,l Ot.rn~lIer ~~ ;rfJ~ g45 :Sl(--rhoma.s c".J. ~, ~/lll1j J'tJs-. L~dWA,d/7/t)J 7 cJi 1, CAROL R. PACE, Testatrix, who signed the foregoiog instrument, having beeo duly qualified according to law, acknowledge that I signed and executed this instrument as my Will, and that I signed it willingly as my free and voluntary act for the purposes therein expressed. Sworn to or affirmed and acknowledged before me by CAROL R. PACE, the Testatrix, this ~ day of October, 1997. ~ ~.~~~ N t ry Public ~ f AA..J.. ~ r ~ CAROL R. PACE MOfAIIIAL seAL JAM L IRC)'Ntol. No~ry Pubic ... PaxtOC' T"'Po, Dauphin Co~ PA 11ft c;ommlltloft bp"- McRh 20. 2000 We, the undersigned witnesses who signed the foregoing instrument, being duly qualified according to law, depose and say that we were present and saw the Testatrix sign and execute this instrument as her Will; that she signed and executed it willingly as her free and voluntary act for the purposes therein expressed; that each of us in her sight and hearing signed the Will as witnesses, and that to the best of our knowledge, that she was at that time eighteen (18) years or more of age, of sound mind, and under no constraint or undue influence. Sworn to or affirmed and subscribed to before ll}:. r- by~O.m'llt:-f and /€;J I1k/e ~, wit~- -his ~ day f October, 1997. Witne s 1?:'-:1- At J-U JAM NOI'AIW. SIAl .... ~ MOWN. No.., ItublIc I af; CalI.W. ~ Dauphin Co., PA . -.-- March 20, ., 8 cJ ~ o ~ 0.0 Q)..... a:: a5 ~~ o Q) - > ~ .- Q)U >< ~ ""'co CI) 00 _ 00 0 ~~ z ~~~ M .i:: 02.aCl) roIV- Q>O:EIV - _0 ~g~ - .0 i.L C.C &a.Uj Q) CI) iLl.!.! I C IV ,=0 1>< 'CI) Iz .. .. .. ,................ NNN 000 ~~~ "<:t(O(O 000 .................. 000 000 ~~~ "<:t..-..- 000 N C":? o N N CI)~ ..= IV > ...... .... o Q) Ol eo a.. r i i r I ! '#.*-'#. 'O"<:t..-..- Q;<<!C"!C\! >M"'<:t"<:t '#.*-*- SCOO>O> IVCO~C":? D::M"'<:t"<:t N C":? o -...... II)~ ! CI) - .5 "0"0 Q)- ::J 0 en en ..!/2"'C:Q) c: m.Q iii :R ;>, iii "0 .oIt)U"O -en.gQ) Q) .- Q) Ol ;>, "0 c: -c:~CO OOCO~ Z.o"O~ enQ)C:Q) CO~O... ..c-OO "O~51"O Ce.Q) o::Jiii~ .o;>,oen '"OI-o.rn C:_Cii...u 15Zffi.E~ J:.Q."O- J: -51.8 c-~:JL. CO ffi ... ~ ,Q oE"*a.Q. - ;>", E 2 a:l ~= Q) CO c:X"O ~ooQ)co co-Exc: "fi~M.l!!O ><:9 CO Q)"O w~en.o~ en W Q) iU";:: co-"OEQ. ~ Q) .:! 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N N Cl)0>00 Cl)LOCO(O ouo Eggg O~T-"- C~ CI) o II) ,~ www Cl)WWW CI) (/) "0 C o CD C"-NM Z . A- U.8. DEPARTMENT OF HOU81NG & UR8AN DI!VI!LOPMENT l.QFHA 2-OFmHA 8. FILE NUMBER: 07324 8. MORTGAGE INS CASE NUM8ER: B. TYPE OF LOAN: 3.0CONV. UNINS. 4.0VA 17. LOAN NUM8ER: 0001821204 SETTlEMENT STATEMENT OM8 NO. 2502.0265 =;'1 5.[&JCONV. INS. C. NOTE: 7hl.1bnn I. fuml_to pM l'OU 0 .,.lamanl O/ICIu.' "/fIamenl cost.. Amount. paid to .nd by tho .._nt .nt.,. shown. llam. _d "(POCr...... paid out_ th8 cIosInp; "'.Y'" shown h8T8 "" 1n1bnn.1Ion., purpo... .nd.re nOllncludad In Ih8tolal.. 1.0 ~ I013204A:11>>4IB D. NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER: CI~ R. Mel._, Jr. .nd MoII188 M. Me_. 1404 SklM_ Drtva, Apt H H.rrtlburg, P.. 17110 Eltate ot Clrol R. Pace .. Shoemaker Line _nlcaburg, PA 17050 Amorican Brok... Canduli 520 8ro.dhollow ROId MoIvlUo, NY 11747 G. PROPERTY LOCATION: .. Shoemaker lana Mach.nlcaburg, PA 17050 Cumbertand County, Pannl)4vanll H. SETTLEMENT AGENT: Koylllono L.nd Trono'or, Lid. 25.1878915 PLACE OF SETTLEMENT 3421 Mlrtcet Stree. Clmp Hili, PA 1701 1 J. SUMMARY OF BORROWER'S TRANSACTION 100. GROS8 AMOUNT DUI! FROM 80RROWER: 101. Canlroel Sal... P~ca 144900.00 102. Poroonal Prooartv 103. SalUornonl en.ro..to Ilonowor L1n.1400\ 8338.45 104. 105. K. SUMMARY OF SELLER'S TRANSACTION -, GR088 AMOUNT DUI! TO SI!LLI!R: 401. Canlroct Sa'... P~C8 402. Poroonal Prooortv 403. 404. 405. AdluSlmant. For n.m. P.1d Bv Sailor In advonco lOll. Cllvlfawn T..... to 107. COUnIvT..... 07120107 10 01101108 108. School Tax to 109. 110. 111. 112. 120. GROSS AMOUNT DUE FROM BORROWER 200, AMOUNTS PAID 8Y OR IN 81!HAlF OF 80RROWER: 201. 0000111 or oom"'l mon.. 202. Princiolll Amounl of N_ Lo.n .1 203. Ex/oUno lOIn. token aubl~ 10 204. 205. 20ll. 207. 208. 209. Soll.r AoIi.1 AdluSlmant. For llam. Un..'d Bv S.1Ior 210. CllvlTown T.... 10 211. COUnIvT..... 10 212. School T.. 07101107 10 07120107 213. 214. 215. 218. 217. 218. 219. AdluSlmant. For llam. Pold Bv S.11or In .dvanco 40ll. C1lv1filwn T.... 10 197.09 407. Counlv T..... 07120107 10 01101108 408. School Tax 10 409. 4 flI. 411. 412. 153,435.54 420. GROSS AMOUNT DUE TO SELLER 500, RI!DUCTlONS IN AMOUNT DUE TO 8ELLI!R: 3000.00 501. E..... DoaaoIt Sooln.trucUon. 144 900.00 502. SoIUomonl en.;a...to SoIlor ILln. 14001 503. EJdltfnn lOin I' taken lU""ecllo 504. P...tlo'"rat Mortg8ll.1o W.shlnglon Mutu.1I//841 505. P.lIOtI of 88COnd Morta.o. 5Oll. 507. (0_111 dl.b. II oroClOd. 508. 5798.00 509. SoIlor .....'.1 AdluSlmant. For n.mo Unoald Bv S./I.r 510. CllvlTown T.... 10 5'1. CounIvT..... 10 70.92 512. School T.x 07101107 10 07120107 513. 514. 515. 518. ,511. elC10W for Inheritance rax 10 KeVltonallnd Trenl' 518. 519. I. SETTLEMENT DATE: July 20, 2007 144900.00 197.09 I 148,097.091 10422.80 29,530.37 5 796.00 70.92 10000.00 55,819.79 I 148097.09 II 55,819.79, 89.277.30 220. TOTAL PAID BYIFOR BORROWER 183,788.92 520. TOTAL REDUCTION AMOUNT DUE SELLER 300, CASH AT 8ETTlEMI!NT FROMITO 80RROWER: 600. CASH AT SETTLEME II 8I!LLI!R: 301. Gron Amounl Duo From Ilonowor IL n.120\ 153435.54 801. Grou Amount Duo To e 420 302. L.... Amounl Peld 8YiFor Borrower (L1n. 220 I( 153788.92 802. L.... Reductlono Du. S LIn.520 303. CASH ( FROM) ( X TO) BORROWER I 331.38 803. CASH ( X TO) ( FROM) SELLER Th'".=~(i'~_._'''..'.:'~~_.'-''- ( aft j Li E.m:6be of rol R. Pice ~ri R. Melllvonda, Jr. 1 "".t? _. (;__' .. h. 't' BY... ?f....-r..... c, I eo.... , VJ(~u. .. L. SETTLEMENT CHARGES . 700. TOTAL COMMISSION B..ad on PrIco S 144900.00 IlIl 5.5000 % 7969.50 PAl) FROM PAlO FROM Division 0 Commission lne 700 as Follows: BORROWER'S SELLER'S 701. $ 7,969.50 to RelMex R..11v Asaocletes. Inc. FUNDSAT FUNDS AT 702. S to SETTlEMENT 8ETItEMENl 703. Commission Paid at Setuement 7,909.50 704. Transaction Fee to RelMex Really Associet... Inc. 250.00 295.00 800. ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan l"lrinlnatlon Fee 0.??oo % to Letort Mortaa e Grouo. Inc. 1.449.00 802. Loan Discount % to 803. Appraisal Fee to Mark Heckman 350.00 804. credit Report to Letort Marta,ae Greu ,Inc. 28.34 805. processln e. to Leton Mottaaoe up,lnc. 500.00 806. Mortnane Broker Premium to Letort Mortaeae GrQua. Inc. aeld by Lender $382.25 POC 807. AsaumpUon Fee to 808. 809. 810. 811. 812. Commitment Fee to American Brokers Conduit 595.00 813. Tax SeMce Fee to American Brokers ConduIt 92.00 814. Flood Hazard Fee to American Brokers Conduit 19.00 815. 816. 817. 818. 819. 620. 900. ITEMS REQUIRED BY LENDER TO BE PAlO IN ADVANCE 901. Interest From 07120107 to 08101107 <lIJ $ Idey ( 12 deys % 344.14 902. M a e Insurance Premium for months to 903. Hazard Insurance Premium for 1.0 wars to 904. 905. 1000. RESERVES DEPOSITED WITH LENDER 1001. Hazard Insurance 3.000 months S 34.38 Def month 103.14 1002. Mortolo. Insurance months . Der month 1003. Cltvffown Taxes months . Der month 1004. Countv Taxes 7.000 months $ 36.33 oar month 254.31 1005. School Tax 2.000 months S 113.85 par month 227.70 1006. months S er month 1007. mn~ . m 1008. re ate IV:J ustment months -. ner month -216.07 1100. TITlE CHARGES 1101. SeWement or Ctoslna Fee to 1 102. Absb8ct Of nUe Sesrch to 1103. nUel".mlneijnn to 1104. Title Insurance Binder to 1105. Document PrenJIfaUon to 1106. NotaN Fees to CASH 25.00 15.00 1107. AttorneYs Fe.. to includes above item numbers: "nR Tille In'''~nrA In K "dTr n r 1 nR'" Includes above item numbers: 1109. lender's Covereoe 5 144,900.00 AL#106211200 1110. Owner's Coverage $ 144,900.00 PAUlO106259054 1111. Endorsements 100,300,8.1 to Ke tone land rani er. Ltd. 150.00 1112. Closing protection Letter to Ke tone Lend Transfer, Ltd. 35.00 1113. ax CertHlcations to Ke tone Land ransfer, ltd. 5.00 1114. Overnloht to Ke tone Land Transfer, Ltd. 20.00 14.00 1115. Retrieve E Mall Documents to Ke tone land Transfer, ltd. 25.00 1116. Wire Fee to K tone Land Transfer, td. 15.00 1117. 1116. 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recordlno Fees: Dead $ 38.50: Mortoeo. $ 64.50; Releases $ 103.00 1202. CIIv/Coun Te"'Stam s: S 1449.00' Mort e . 1 449.00 1203. State Tax/Stamns: Revenue Stamns 1 449.00; Morlaeae 1 449.00 1204. 1205. 1300. ADDITIONAl SETTLEMENT CHARGES 1301. SurveY to 1302. Pesllnsnection to B& T Insneetione Inc. Inv. #30990 50.00 1303. 2007 School Taxes to Debra Welsl Tax Collector 1366.1' 1304. Seolle Service to R. E. FInk & Sons Inv. #11266 675.00 1305. Reimbursement 10 Re/Max Realty Associates, Inc. 20.00 1400. TOTAl SETTLEMENT CHARGES Entlr on Lln..103 Sletlon J and 502 Slctlon K\ 8.338.45 10.422.50 .,_",,,'~..'''_'''''''''_''''_'_I~',,,",,''''''''~'''''oI'''''''7m / / / If ~~ Po , Keystone land Transfer. Ltd. Settlement Agent Certified 10 be a true copy. (01324107324/251