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HomeMy WebLinkAbout10-24-07 ~ 15056051047 REV-1500 EX (06-05) PA Department of Revenue Bureau of Individual Taxes PO BOX 280601 Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death OFFICIAL USE ONLY County Code Year File Number INHERITANCE TAX RETURN RESIDENT DECEDENT Date of Birth Decedent's Last Name Suffix Decedent's First Name MI (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW .. 1. Original Return -<::) 2. Supplemental Return C) ~ 4. Limited Estate C) 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required - C) 4a. Future Interest Compromise (date of death after 12-12-82) ~ 7. Decedent Maintained a Living Trust (Allach Copy of Trust) ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Allach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number 6. Decedent Died Testate (Allach Copy of Will) 9. Litigation Proceeds Received o 8. Total Number of Safe Deposit Boxes ~ REGIS,i.E~F WILLS'~ ONLY 'T! ~c:~ . .-.\ P) ~ -r) Correspondent's e-mail address: bea..MerCS Ej) efJ")C. r1it Side 1 L 15056051047 15056051047 --.J ~ ....J 15056052048 REV-1500 EX Decedent's Name: FtfEJJ~IC!(!'K 1). SAX€/'( RECAPITULATION 1. Real estate (Schedule A). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1. 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. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . .. 5. 6. Jointly Owned Property (Schedule F) c::::> Separate Billing Requested . . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) c::::> Separate Billing Requested. . . . . . .. 7. 8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 8. Decedent's Social Security Number 1.77 lib 0$2.1 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 Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) .. . .. . .. . . . . . .. . . .. .. . .. 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . . . . . . . 14. TAX COMPUTATION - SEE 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .O~ 16. Amount of Line 14 taxable at lineal rate X.O ~ 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .......... ',' . . . . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 t;,L 6- -:Z 15056052048 () 7 I 15. 16. 17. 18. L/ 3.7 - 15056052048 ....J REV-1500 EX Page 3 File Number '-1- 07- ";ZS Decedent's Complete Address: DECEDENT'S NAME ________E4!fP~l(lel( _]). 8_.f-~____. STREET ADDRESS 1;)3'S tv. 7~llf/tJLG" /UJ. CITY MeCNIJAJ/es /i",!?Gr -----r STA:rE-;;' ZIP 17tJss Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) ?l ~ ')'7S./I, ----+---Q- - "" 7Sr;.~D _ _______-.! :l $"""0. ,,________ 3. Interest/Penalty if applicable D. Interest E. Penalty I' .s; eJOO. D" Total Credits (A + B + C ) (2) f) _______________ ._....___...__ . - __n"____________________ o - - --- --- - - Total Interest/Penalty ( D + E ) 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. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (3) 0 (4) .,. 7,;; 'I. ;'1 (5) 0 (5A) 0 (5B) 0 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. 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 ~ b. retain the right to designate who shall use the property transferred or its income; ............................................ D ~ c. retain a reversionary interest; or.......................................................................................................................... D IZl d. receive the promise for life of either payments, benefits or care? ...................................................................... D ~ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. D ~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. D ~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ ~ D IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. 99116 (a) (1.1) (i)). For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. 99116 (a) (1.1) (ii)]. The statute does not 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. 99116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. 99116(1.2) [72 P.S. 99116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. 99116(a)(1.3)). A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. ES7: pF ;:=;t!!.ED~/eK j). ~/fKE7'< Nt:'. 2 1-07 -~2S __imXCALLl1k!t?lPA!utf'~___/f.f!/,,!/~]Z~A//Jf€!YT oFj/'/j-/L}'Z.1L~ /?4-;Z-S- =_:=-~=::~==r~=~~~~~Z~~~~=~-:;~_.. _____________________~--~~/---elMl(E---~~.d.L~~L----~-._...L?tKL__... _=_..~~.6...-_J).~Z.Z/.._ _nnm .(t.4-~;z6I..vz:.L'ffi'.PgZ2'1:"'6I"n~~~En ~nnj n.nn_ 'I _. . _.____j__l.If/Alc::tJ.__~xl:?el.~__&L~~--lJdU~tL-~ ._. __ =_h_~Z~'~_'t_=c,J.,f! .. _.______ ... ______ L_.&)_.tft_~_~_..M:.ME_________h .___u___.___________. .___._ I /PET dEs/lJtlE:::: ~ I'/{) 9l.fZ.IZ --.- .---..--, . ----..---.-.-----..-- .-.--------.------.--- -----.-.. . _______________.___h__. ________._________1___ -...--------- .----... i IIET ~//)l{~ 77J ~F .J)/Y/1JsiJ //lIJP - -t "'- _n___.__________ -.- --..---~---.-_.--..-.~-.-~-.-~.~ - . . _u_._.._. ...----.--.-.-..-~.... ------...'.---- -.-..- .1~~bL€:t(At. 2/i~tl.q{mg;lt-f. /~ _ _.....__._._IPi._z j~)~_ J)~J/df.L_e)___u . ~ J _~..~_ _tJlfftLs$.A . _:z. ~/tL~_/ A!Il>.()!td~IJ'Z't, 01/ G2C2Zu_ , i .:::- -0-- Y.3f; .. ._l!JJ(!,If,fg _l!,. ...____~/fI~7fz_._ ..-?!!~__.._ ~!&/f(? 0 9_@_. ~$k .. ~ =-..-.,z_L~~,-_~:J._ . Y3 Ii _ __ _/[7(/# AI. _.. /s~__(JI!/{€lf1Fi .,gc4l~f/~/)~fiJ _7". $"2~ ~ =-u.2~/~~" ~3 I ~€cltfJ : .1 -.._- -I.- - OcIAlfj/:_&tf~. I ,1-...... /f1 (CIf1lff_l?I.?;/!/!€J(" Y3 _/tESj~t{t=:~f!/ eft It (}tl 1 ~'ls:,-()O~, 61 -:TL . PH- f!!!lf7J..71( ~ l $7~.~ ~_~'6.!t2 Y3 /Ce1J)tl€ If 'IhIll'1-tJl/ =~:z/~~,fpl #.J /, f, S 3 --- ......~... . ........ ::;- ..~ILR..-~.._~_J__ ~..'i_;;7~../' REV-1502 EX+ (6-98) SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER ~II-K~ RE/)~/el( ':JJ. ,2,1- C> 7 - "2.s- All real property owned solely or as a tenant in common must be reported al fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant lacts. Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER i. DESCRIPTION VALUE AT DATE OF DEATH Res i den r; a-l Real E~to.Te a) J2{?S w. TriYltJ/e Rd., Jl\echltnic$bu~" (r\1lmrDt! I~.) CtuY\\o!.rlaNld Co" Pt.., na.. T ~ paV'c.eJ ND. 'Z- Z. - :1.l.# - () '1 7 3 - () q z. prope.r~ hft-s heen upprlJ.,'se.d per new IDt.l.Yl 1-{r-t>Ll.tJ}" h1etw;eN" Jst- F. c!.. Lt.. a1 ~031 oot). DD. Meti~$tJ Z. IOtLJ<v, btHulk..t out 1fk h--tU:.J,IDtt41 .:>l1are.s Dt 1Y1; c.httel 1). I3liKer fJJt1t'1 Er;n N. 8rJ(U' Sc> !LS 10 ~vo"rJ a ~rc.uI c5'a.le D!- ~ prell1;Se~. ~e Cf#Rt:-h~t:I Ii~~;: Q True app &rr~d ~.I1-17>I'JIIL." &P.Y q /4e & - Exe(!ufr/c~.f d~t!.d MUlIt ~r ~f A'ea/'f Transfer ~ cSM~nteJ1t t9/ I/a/ue a/l&t.Iu4' IJ~~. AlSb, .5t!!e se/lleAlt'1I1 SAt!ef 0'1 ~h'na.Hu! ~a.l"/ a #lJ.ciJ~tI fo sehed. r. TOTAL (Also enter on line 1, Recapitulation) $ c20:3 / 1!)()t:J, t!)O (It more space is needed, insert additional sheets of the same size) REV.18J EX 111.921 I': I, ,tt~ RECORDER'S USE ONL Y I S'o'e 101. Paid REALTY TRANSFER TAX Book Numb.r COMMONWEALTH OF PENNSYlVANiA STATEMENT OF VALUE DEPARTMENT OF REVENUE Page Numbe( BUREAU OF INDIVIDUAL TAXES DEPT. 280603 Date Recorded HARRISBURG, PA 17128.0603 See Reverse for Instructions Complete each section and file in duplicate with Recorder of Deeds .when (1) the full value/consideration is not set forth in the deed, (2) when the deed is wilhoul consideration, or by gift, or (3) 0 tax eltemption is claimed. A Statement of Value is nol required if the transfer is wholly exempt from tax based on; (1) family relationship or (2) public utility easement. If more space is needed, attach additional sheetls). . -. .. . l-.lam" CI/II-IUES E: SfllS-j).5 -1lL- 51reel Address ro C LbUSEJe ,e/). T elepilo"e Number: Areo Code ( 7/7 If1E(!::J/V'/(!,SJ3ttll6- S'ih Dote of Acceptance of Document ) 7hb, -e;zotj Zip Code / 7 t:>~.s- ii," :::TRANSFER.DATA '.,' ". ',' ,:':....~.../:.~' Granlor(s)~ hle:USSl! :r.131}Kt:~ ~ L9t1AJ.4I. 8.H~ (!trflxlts tl 5/. ()F - 'lJ/! ]), 8~/:1iR 5treel Address C/o CI-/ If I!.Ll:5 E: SI; / e:z.LJ.S .2JE'" CL OtiS City. }1JE'(!!f A //I/O 58 tlJf6 rontee(.tiLauIl'll't11 111 FL./sSR ,6/1~ ~ Slale //I Stale J1/1 Zip Code (70S$" L /;285 TR./AlIJIE City $ErJfI ,1-.41/('5$1( RG Streel Address Tax Parcel Number ~ 2 - P-'I- P773 -o'-l:l = 4. County Assessed V olue ,+f'fDlUlse/J Yilt4/;" fJe( 5, Common Level Ralio Faclor A-A"'1fYJ-15 AL 6. Fair Market Value = ~3/ Oal 00 E" ','EXEMPTION"D"''PA. ..... " "'. ,'. .... ,'. "".: . ". '''''' . 0', .'----- ;-. ..- '.~',-'.-~'-'- ~ ,'- ,.' . . -'. ~. I .- J .....-M ". '.......,., ~. ',0' 10 t..,. ..... ". .~.. "":,,,... .~. .--".. - ..-. ...-...... . ~- .-..... , .. . k" '-. ....,. .,., ,." '. ".... '. - -.. .." . ~. '-. ., . '.. . ..... . '. '. ". 10. Amount of Exemplion Cloimed 33 Y3 tJ 1 b, Percenlage of Inlerest Conveyed /t>O "0 2. Check Appropriate Box Below for Exemption Claimed HeED5f!lC!R.]), t3#Ka( {Nome of D1tc.edtlln'~ ~ Will or intestt;lte succession o o o o ;2./- 07- tJfD<< S- (Estal. Fil. Number) Transfer 10 Industrial Development Agency. Transfer to 0 trust. IAttach complete copy of trusl agreement identifying all beneficiaries.) Transfer belween principal and ogenl. (Allach complete copy of agency/straw party agreemenl.) Transfers to the Commonwealth, Ihe United Sloles and Instrumentalities by gift, dedication, condemnation or in lieu of condemnation, (If condemnation or in lieu of condemnation, attach copy of resolution.) o Transfer from mortgagor to a holder of 0 mortgage in default. Mortgage Book Number o o ~ , Page Number Corrective or confirmatory deed, (Allach complete copy of the prior deed being corrected or confirmed.) Statutory corporate consolidation, merger or division, (Atlach copy of articles.) Other (please eltplain exemption claimed, if other than listed above.) j6 ;18{ /1ty /CEaalr tJ~ 77/t: /&ft.ty 7MA8rS( "::>EE" /J-I}/}/71plflllt.. .sN~ T A TT,,!f(!.#G.7J (Z;/I/rE"fs~ 7//)# fi//7lf 1<11/?€ N. JOIf/VS/:?N ""/~x ))/ J// 5/1) ~ /J~p r~;= /CS-J/$7//UE Uncler penalties of law, I declare that I have examined this Statement, including accompanying information, and to the best of my knowledge and belief, it is true, correct and complete. Signature of 7r anden! or Re.panlible Part E Oat. iJ 1-/3-07- FAILURE TO COMPLETE THIS FORM PROPERLY ORATIACH APPLICABLE DOCUMENTATION MAY RESULT IN THE RECORDER'S REFUSAL TO IlI=C"Olln n.u: n1:a:n ~flI/-,z tfeally hYU1S/r ~ 05~-kment D/ f/alue. ~______________'__~_(!~I: __e:f ___~~r~~" _~'__~kc_S ____I!1~ps~~_~_;T. ____Balcer_. .. --~".'-'-~'--_._._-- ----_.._-----------..I.-----------~--- ------..-----------~----.-----~---- _______~_________I-&'_~ _1lJ-)!-_d;:s~S~__w~ln..__~Ud. J&b.II.s~B7___ I ~ ~r~_ Ize -------~~/IPlAh'nJ_ n/tv~J1t ~&/J: ______~ 7k _ ft;~fr/IL{llL~.5ill/Jt~ ~iC 1i:e~~LCI~ :0. &kr- _______1 &lJfrJ/ne"_~~Jf-?4C~ /eJ//$e Lft4-l_ec5fai? ffu,1i'e~ ~ aJ/// ~hhi~nd II rts/CI'a4;fr' cL4HSI? pmJ'lI/,"I_~r 2ifL:U1zJ~,.L___ _c5-A4~.5 fp Je d~ft"6~1ic/ t1hUJ..~~'Lr24!.:v/j//t1J-. w/~w,,__~ ____ retssQ :r. /5ee/:er,l. ~ i.,'J _fv.aoLzL_e.iLlq'..reH _~j,~_hrrf________~__ 11U;kI_/lhtJ~C.~L~~_~_~./ /Jt,Choe./ --p. 4.~~q MVI ~yi1 ___ -----.-- _Lf!-~r -L-7k J:.4./c1 ~ u.j.LJlu1/~;j ~--{ll~-~/et2-,. du'Ld r~L 't__nm______________ /)1 e j, '.5 Sq.z & hzr. ._______________________n____~____________________.____._. ------;z--"#Ok'k4~-L-Afe--,I?~~!tj~.~.3;.~fl c,,~__.__ _ A ePet-~/_& ~A,sa(-_-/o.-----~~~~----~-~/~!..ii!!1-& ~-n-------------- -----------~~~-~ -~~- ~~ ~________n____n__nn_nn____________ ---------_____ _____~_juL--..1il/ue___ ~_H&____~dt:rfo kl&tt:kIrt~~_._e..sta.te_i.s__~I____ me.______.. ____________________ _St.t.f~L'e.1J l~lIml1..~ ~__k._meg_ q'/Jrr/) u h ~ J1 e_Pf~._ ~____~!Jt'!:~_____~____ _~___n_____________. __t1~r/J..dJ1._.rL_I&.__re~._~t2la ~_~__ ht81.'?~L_L__ ./d;. ~__Ct ~___Iz~___P.!1~g;N.__~_ {J2)__~;'(/~_!J.t___&___e.sl~L1i..---d::t_!~___lJece.~t:t';)---;;' .!:__~~r (p_. .._ '___ ..___ -__._________________ ..I-tf,L___fHpJ1~--Jllds-j't1ti---i(g-..LSm!e---nk-.--~!1/4 '!.c~__~____Si1_~!______ ......_~________ ...-------__~___. _d;~kL'k.!_iIJp.I1__ /i...-z?k__ --~_lil--2~-:elu!q!:.~IJ-'---7J'd.s _~__t&__h __________ ..---....---- --- ...... ...---;2t?t:fJ-~J1...--I:!f__dt----r:.44r~ -_ d..___&jlft/J:l/'.!e.>.. ./J_~t /,,1-;_~k(llJ~ft..~ ..... ...._ .__ .~_li6J.c__'l. ..&.--ii, ':t4. .. L~__I!!:d<2$~"'_:""...l:j3S~3,;'3. ~3L ... ___ /( ~1~h~_/!tL.~~___~___;Z,_z~(, _, ~~__..{?_?!!l....I_'.s__Mu_J..__..~J~--. -#l!'e( 11$ flll.!'t _d_rL ~'.?. fr:a/l.5)!!f:h~~~ Tax Parcel No. ;J..:J. - :14- t) 773 -I)l{z.. THIS INDENTURE Made the /'1 jI, day of Sept.. (2007). in the year two thousand and seven BETWEEN MELISSA I. BAKER and ERIN N. BAKER, as Co-Executrices of the Estate of FREDERICK D. BAKER, deceased, late of Monroe Township, Cumberland County, Pennsylvania, Grantors, and the same said MELISSA I. BAKER, surviving widow of the said FREDERICK D. BAKER, of the same Township, County and Commonwealth, Grantee. WHEREAS, the said FREDERICK D. BAKER, was vested in his lifetime with title to the premises hereinafter described, in the Township of Monroe, County of Cumberland and Commonwealth of Pennsylvania; and WHEREAS, the said FREDERICK D. BAKER, departed this earthly life, testate, on the lath day of June, 2007, and Letters Testamentary were duly issued to the said MELISSA I. BAKER and ERIN N. BAKER, by the Register of Wills of said Cumberland County, docketed to No. 21-07- 0625; and WHEREAS, this property was not specifically devised. NOW, THEREFORE, THIS INDENTURE WITNESSETH, that the said MELISSA I. BAKER and ERIN N. BAKER, as Co-Executrices of the Estate of the said FREDERICK D. BAKER, deceased; as aforesaid, for and in consideration of the sum of ONE and No/IOO ($1.00) DOLLAR and other good and valuable considerations, to them in hand paid by the said Grantee, at and before the en sealing and delivery hereof, the receipt whereof is hereby acknowledged, have granted, bargained, sold, aliened, released, and confirmed, and by these presents, by virtue of the power and authority in them vested by the Fiduciaries Act of the Commonwealth of Pennsylvania, and by virtue of their own inherent powers and authorities vested in them by the laws of this Commonwealth, do grant, bargain, sell, alien, release, and confirm unto the said Grantee, her heirs and assigns: ALL THAT CERTAIN tract ofland situate in the Township of Monroe, County of Cumberland, Commonwealth of Pennsylvania, more particularly bounded and described as follows, to wit: BEGINNING at a point in the center line of Trind1e Road (L.R. 305), at corner oflands now or formerly of Josiah J. Zeigler; thence extending along the center line of the Trindle Road (L.R. 305) aforementioned, South 84 degrees 45 minutes East, a distance of200.00 feet to a point; thence along lands now or formerly of Joseph V. Garvey, South 06 degrees 50 minutes 30 second East, a distance of 334.11 feet to a concrete monument; thence along other lands of Joseph V. Garvey, North 84 degrees 45 minutes West, a distance of 200.00 feet to a point on line of lands now or formerly of Josiah J. Zeigler; thence along said line of lands of Josiah J. Zeigler, North 06 degrees 50 minutes 30 seconds West, a distance of334.11 feet to a point in the center line of the Trindle Road (L.R. 305) aforementioned, the point and place of BEGINNING. CONTAINING 1.638 acres. BEING Lot No.2 on the Final Subdivision Plan for Joe V. Garvey, which said plan is recorded in the Cumberland County Recorder's Office in Plan Book 33, Page 145. UNDER AND SUBJECT, NEVERTHELESS, to rights of way and easements of record and as more particularly shown on the recorded Subdivision Plan of Joe V. Garvey as recited above. UNDER AND SUBJECT, FURTHERMORE, to a twenty (20) foot wide private right of way for the purpose of ingress, egress and regress, into, over and upon said twenty (20) foot right of way, as well as the responsibility of maintenance for said right of way as more particularly set forth in a Right of Way and Maintenance Agreement on record in the Cumberland County Recorder of Deeds Office at Miscellaneous Book 529, Page 301. BEING THE SAME PREMISES which Mary Beach Carson, f.k.a. Mary Beach Garvey and Kimber D. Carson, her husband, by deed dated August 28, 1996, and recorded September 4, 1996, in the Cumberland County Recorder of Deeds Office in Deed Book 145, Page 544, granted and conveyed unto Frederick D. Baker and Susan M. Baker, his then wife. Susan M. Baker subsequently predeceased Frederick D. Baker whereupon he became the sole and absolute owner of the said premises by virtue of the laws of this Commonwealth incident to the doctrine of tenancies by the entireties. The said Frederick D. Baker has since departed this earthly life and his Estate is the Grantor herein. THIS TRANSACTION IS PARTIALLY REAL ESTATE TRANSFER TAX EXEMPT AS IS MORE FULLY EXPLAINED ON THE AFFIDAVIT OF VALUE ATTACHED HERETO. TO HAVE AND TO HOLD the said message or tenement and tract of land, hereditaments and premises hereby granted and released, or mentioned and intended so to be, with the appurtenances, unto the said Grantee, her heirs and assigns, to and for the only proper use and behoof of the said Grantee, her heirs and assigns, forever. AND THE SAID GRANTORS, Co-Executrices, their heirs, successors, and assigns do covenant, promise and agree to and with the said Grantee, her heirs and assigns, by these presents, that the Grantors have not done, 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, or otherwise howsoever. IN WITNESS WHEREOF, the said Co-Executrices of the Estate of FREDERICK D. BAKER, deceased, Grantors herein, have hereunto set their hands and seals the day and year first above written. Signed, sealed and delivered in the presence of: sl t!AIJ.5 E 5111 ~ Ifi zg: I s//J!e/;Js/i L. /JaKer (SEAL) MELISSA I. BAKER, Co-Executrix of the Estate of FREDERICK D. BAKER :1 OHR.J P. SA/t-k/.t' 71L >/ P'rl/t N. SaKer- (SEAL) ERIN N. BAKER, Co-Executrix of the Estate of FREDERICK D. BAKER COMMONWEAL TH OF PENNSYLVANIA : : SS. COUNTY OF CUMBERLAND On this, the /'1 f4 day of $ell/. , A.D. 2007, before me the undersigned officer, personally appeared MELISSA I. BAKER and ERIN N. BAKER, known to me (or satisfactorily proven) to be the persons whose names are subscribed to the within instrument, and acknowledged that they executed the same in the capacities therein set forth and for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. ?/ t?M/'k~ E. S/" eltU tiT Notary Public CERTIFICATE OF RESIDENCE I HEREBY CERTIFY that the precise residence of the Grantee is: I d35 W. -;;'//I~k lIaI., lH(tltlln/~.sJur" fJA /7~SS" (J fj tA4s f Slue//> 10 Attorney for Grantee REV-I508 EX + (1-97) ~ ~ SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INH~~~;~~~i DT:2E~~~~RN PERSONAL PROPERTY ESTATE OF B II /L8R.) FI2IE.D&.lek )). FILE NUMBER ,21-(;7- b:lS" Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. ll'1€m13PJeS J!at FEDGTUtl- CREDIT L(NIDN ,f..) ~(.!uJ4r .sew//lf.f ~etl: # /13 331-1/0 /).) ,II- {!~r, .In f: fz, d,~; Ii 1>>1 Z fr:.,." R e.J t!.ltec.K/"j ;f.tt/; ~ It! 3 33/- /I ( S~ Y/lIHllhIJA Ie It~r ~lIlJc6eq') d. ]);SttJi//fy .B~/eUIc.~ ,.t7~ me'AI./ /#6 / ,ee,,-ho- ~ Hl5. (};. .3. J<t~i FOrd -r;.u..c.-k VIN I FT1>'X 08"SVKt3 ;;"97.52 (~J/aleu~h#" {r"hf ;P~na/t:/ de/It/J?er hn/c.us .IhiJ; Jaks) ., I~ /7'3. 69 ~ 00. Z9 · " 7.3. '-12 ~ /'~_il/ l' :J.. 7 tU).. bD I TOTAL (Also enter on line 5, Recapitulation) $ L/J 7 / :2. tJ 0 (If more space is needed, insert additional sheets of the same size) REGULAR SAVINGS ACCOUNT: Account Number/ Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner Date Joint Ownership Established CHECKING ACCOUNT: Account Number/Suffix Date Account Established rincipal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner Date Joint Ownership Established SUPPLEMENTAL SAVINGS ACCOUNT: Account Number/Suffix Date Account Established rincipal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner Date Joint Ownership Established VISA: Account Number/Suffix Date Account Established Balance at Date of Death Name of Joint Cardholder Estate of: FREDERICK D. BAKER Date of Death: June 10, 2007 Social Security Number: 177-46-0521 ~1~ MEMBERS 1st FEDERAL CREDIT UNION 183331-00 04/12/1999 $1,173.69 $.29 $1,173.98 None 183331-11 04/12/1999 $673.42 $.00 $673.42 None ~t~t .. INSURANCE DEPARTMENT 5000 Louise Drive P. O. Box 40 Mechanicsburg, PA 17055 1-800-283-2328 or (717) 697-1161 191733-00 03/10/2000 $148.29 $.05 $148.34 Melissa Baker 03/10/2000 191733-11 03/10/2000 $1,463.04 $.00 $1,463.04 Melissa Baker 03/10/2000 191733-01 08/18/2001 $1,000.98 $.27 $1,001.25 Melissa Baker 08/18/2001 4155372221833310 04/15/2003 $.00 None Mf\MBERS 1ST FEDERAL CREDIT UNION ~~ 1\ :i1A\LL- Danielle A. Kline Insurance Services Specialist July 20, 2007 5000 Louise Drive . Po. Box 4U . M echanicsburg, Pennsylvania 17055 . (717) 697-] 161 . www.l11el11bers1st.org L.."-I ~I""\.I"I""\. I 1 ""'I" ""'I UL.I '....1 I I tJ THE PAYMENT INDICATED BELOW IS FROM THE BENEFITS PROVIDED UNDER AN INSURANCE CONTRACT WITH - [N G Jia) ReiiaStar Life Insurance Company 00 GH -S CHECK NUMBER 04240536 JULY 12, 2007 PA TIENT I CLAIM NO. I GROUP POLICY NO. I L07F07036-01 I 612782 ALL FREDERICK D BAKER IF YOU HAVE ANY QUESTIONS ABOUT THIS PAYMENT PLEASE CONTACT 1285 W TRINDLE RD DISABILITY INCOME CLAIMS 877-895-4616 '1ECHANICSBURG PA 17055-4514 P.o. BOX 1552 MINNEAPOLIS MN 55440-1552 TYPE OF TOTAL TOTAL COD SERVICE DATE OF SERVICE CHARGES BENEFIT See See back ALLOWED DEDUCTIBLE % BENEF I T bacl ~EEKLY BENEF IT 060607-061007 164.84 ',(, ,";~::, ,<_,.C. OF F,:S!ET S BI,~;EF I T ADJUSTMENT ,~:~ PRE TAX ;;,irfEDUCT IONS PAYMENT ADJUSTMENT *TOT'AL PAYMENT AMOUNT 0.00 0.00 164.84 0.00 0.00 164.84 IXI6S PAYMENT FOR 6/6/07-6/10/07. See other side for Rights and Review Procedures FR EDIR! CK DB AK ER 128SW TRINDLE RD MECHANlCSBURG PA '-~::'_:. _.:>,:-_~_:-..,..,,- ,:~/':' ~ ,,\",i-:: ::. -' - :, ReliaStarLife InsuranceCoinpany by ~~~-~....~ Treasurer · If- 0 ~ 2 ~ 0 5 :l b II- I: 0 :l . .00 2 2 51: 20 7 9 9 500 9 2 ~ . ~ II- 1)()NALI) ])ELLIN(;EI~ A1\fIC1'S AIT'1'() SALFJS PA SAL]~Sl\1AN -1\1\" 08] 2HHL 1100 South YorkSt Mechanicsburg, Pa 17055 717-796-1056 reddellinger@comcaSlnet 9/26/2007 Melissa Baker 1285 W Trindle Rd Mechanicsburg Pa 17055 Melissa" Reference - 1997 Ford F 150 4x4 serial # 1FTDX0868VKB29752 Color Black --170,000 miles. Current value reference NADA and taking into consideration the need of New tires (4)-a rear bumper and cosmetics. Current Low retail-------$ 5, 750-----minus-$1200 for the above repairs.--==$3,550 Wholesale----Value---in its present condition--- $2,700 Thanks for the opportunity to serve you -- Donald Dellinger REV.1509 EX + (1.97) SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEALTH OF PENNS\ "VANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF 161P,KE7t.l F,;eE.l>6f'/~K 2>. FILE NUMBER ;l/-a7- '2~ If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. ~(J.IN AI. ~"KBl :3 ~ tv. A-/'4ba /l-ve, Husho/,.~/I 17l>~a e/, tt.....,nre... B. c. JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY '10 OF DATE OF DEATH ITEM FOR JOINT MADE Include name of financial institution and bank account number or similar identifying number. Attach DATE OF DEATH DECO'S VAlUE OF UMBER TENANT JOINT deed for jointiy-held reai estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. II ')'7 ~e.~1A,.1a.t" Sa.v;Y11S A-~et: ~ / bL/ qr" 2. -DO aJ MtnI,~ Js.e f:. t. Lt. -I ~ p"'" rU."I'a./1- ~I ?J"~. 3~ $ SD~ "X-vt. r. . '0 :1.,. 3,,9. 9S- I., Ht/. qg :/, ,4. f/8/91 C.ke~;~ A-ut.. 1(,4 If" 2 -1/ 4f~- ~ en J~ -,:: c. 1.(. 3 ~/. 2/ S'l)~ ., I 'to. ~/ (Set. /l1I//,{1l h,~ /elftr g#~c.h~~) TOTAL (Also enter on line 6, Recapitulation) $ J I ""375 .S~ .. fl+......._"'-._____.____-'_-' ____--'-_..J.J_~._ _I. . #'. PRIMARY OWNER: ERIN BAKER REGULAR SAVINGS ACCOUNT: Account Number/ Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner Date Joint Ownership Established CHECKING ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner Date Joint Ownership Established Estate of: FREDERICK D. BAKER Date of Death: June 10, 2007 Social Security Number: 177-46-0521 fvl~ MEMBERS 1st FEDERALCREDlT UNION INSURANCE DEPARTMENT 5000 Louise Drive P. O. Box 40 Mechanicsburg, PA 17055 1-800-283-2328 or (717) 697-1161 164462-00 01/08/1997 $2,369.35 $.60 $2,369.95 Fred Baker & Susan Baker (deceased 3-31-99) 01/08/1997 164462-11 01/08/1997 $381.21 $.00 $381.21 Fred Baker & Susan Baker (deceased 3-31-99) 01/08/1997 ~MBERS 1ST FEDERAL CREDIT UNION ~CLnuUs. ~. tQJ\U.- Danielle A. Kline Insurance Services Specialist Ju!y 20, 2007 SOOO LOUIse Dnve . PO. Box 40 . Mechanicsburg, Pennsylvania 17055 . (717) 697-1161 . www.members1st.org ,-1510 EX '(1-97) SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT iTATEOF ~IfK~ F/tE"~FIf!./t!R ?:>. FILE NUMBER ;L I - 07- ~ zS- 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, :M BER DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER ATTACH A COPY OF THE DEED FOR REAL ESTATE, DATE OF DEATH VALUE OF ASSET %OF DECO'S INTEREST EXCLUSION IF APPLICABLE) TAXABLE VALUE 'De.e-edt-nt ct;eDl at ~ SI. H )'.s retirement (31a.n Wlt5 flof SUldJlCJ /b w;Htdrllwal f,U:+ew~ pUII:dty. ThLr't. a..re fC,e.re;fo,-.. no ~ a.~~es.s41oIe ;tt.rn!. 'i-D repor-t hereat. TOTAL (Also enter on line 7, Recapitulation) $ 0 (If more soace is np.p.np.n im:p.rt ",rlrlilinn"J "h""lc "f Ih., c"~n ~,~^\ REV.1511 EX+ (12-99) . r .9...;; \1~!Ji';~ '~~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF ;)...1-07-'2~ " If I<EJt< , 1=,eF/J Ffl. ICK '1>. FILE NUMBER Debts of decedent must be reported on Schedule 1. ITEM NUMBER A. DESCRIPTION 1. FUNERAL EXPENSES: n1 (.Llpezz.~ Fi.tY1~raJ H'jh- PlAJ< Tent Meal Home "t /Y1eehQ.,nicsbl.(.~ Re.ubJ.s (of" Tet1t t:or wllk~ W ~I ~. B. ADMINISTRATIVE COSTS: 2. 3. 4. 5. 6. 7. ~. '1. II. 1. Personal Representative's Commissions Name of Personal Representative(s) lYle.liSStL :I. 8a.Kt.r ~ Er-;t\ N. &keY" Social Security Number(s)/EIN Number of Personal Represenlative(s) Street Address AMOUNT ,r S; 7/7# 35" fC 303. HZ WAIl/ED ~ ~ SOO. of) ~ ~... SaJ,.t:)e; "'9 s. 00 111~. tJO -37S.bO ".19. ()f) ,., :2().r;~ t' ~ Sl:),co 'is: Of) City State _ Zip Year(s) Commission Paid: Attorney Fees C ht.Mes E. $h;~Jd.s 11I Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant !J1el,'sSfI:r. &~er Street Address / ~ f $' U/. n./~t/Ie. R tI. City Muhttnics bur, State ~/I Zip /7~~ Relationship of Claimant to Decedent tv,/6.IV . ' I 'SS I ~t SJ,t),[ CeJ'flhCfJ.r~ Probate Fees .,. tPr'f'ba I 14,- Accountant's Fees lJ"4~ BruK.b;l\, 1-1<; ~ ~JtJeK ~ Mec.hat1icsbu.~ , '" S p~. dE>sw.J: rD~O I PA qo, loca.J,dt;. cuvJ "p loClI.} Tax Return Preparers Fees PII- Ifl, p(.u.~,-n.rtl..."h /<-Is ,e:tz.. {}'1ern; ,ItE (jpurJt,r fie 10 (Jay ,ff h'"a/ bill 14J(C~ -11 I'lfl.DrlrJa,e ($te 3elf!tllltllt ~hu.f tl/6u_ltIp $ S'eitt.H. .z." l,ne IUJ s) A,I,t;I'''1141 Slt"rr ee"f"h'ca.fe~ 1I-""/'/"()1I4/ tJr"b"f~ ~.. ;::',';/"1 ft.e fp I?~snr of Iv/lk (Se.e f!Dnl,/JtcdJ'nt e/lukdU .., TOTAL (Also enter on line 9, Recapitulation) $ 1(;1 2 jb. 37 (If more space is needed, insert addilional sheets of the same size) self €/J N., r!.h1I'r/. est: ()~ ~tff(Sl" HE 1JEl2/(!.K 11. It;~et'i/r/rujd .C'IJ/:l/s ~... ....S'Ylf; 11~{____ I~. TIHI!'erti.$;'f__L~ .... ..... e..I{IHJJu~tI.. ..4v .HI.( "A.I I? GIUltlll_t{)t/~iru__= e {,(~((Af ~/VIIL[T, 'fk Af:;.Jfn.d It. &IAtAI![!~~Jt~'lt .ti_CJL~de$~.SI1/?/rk Ji[-kr(J~/r;~/t:&/ i ~.p.sk~/_uef!l'b:l'<<llnl!(f,,,!/$,, ~ ~.... e~;". No. 2/- tJ7- ~2-'S" -';;u... 70 "- 7S:~ c SlJ d)~ f~~ so CHARLES E. SHIELDS, III ATTORNEY-AT-LAW 6 CWUSER ROAD Corner ofTrindle and Clouser Roads MECHANICSBURG, PA 17055 GEORGE M. HOUCK (1912-1991) July 25, 2007 TELEPHONE (717) 766-0209 FAX (717) 795-7473 Malpezzi Funeral Home 8 Market Plaza Way Mechanicsburg, P A 17055 Re: Frederick D. Baker, deceased Dear Sir / Madam: Please find enclosed Check No. 101 in the amount of $5,717.35 in payment of your recent invoice. I have enclosed a copy of this invoice for your ready reference and convenience. Thank you for you kind attention to this matter. Very truly yours, ~/?~2? Charles E. Shields, III Attorney-At-Law CES/mjj Enclosure cc: Melissa 1. Baker 60-8224/2313 2183094339 101 DATE? -~if- () ~1 fv1st MEMBERS 1" FEDERAL CREDIT UNION Medwliabuf&, PA 17055 lfWW.membmllt.oq MEMO I: 2 3 . 3 B 2 2 ~ . I: 2. B 3 0 9 ~ 3 3 9 III O. 0 . ----_.....-......-.........,.;_........_.,_.=-<='.~"..,>=~....-......",~-_.-....__._-~ Malpezzi FUNERAL HOME Michael J. Malpezzi, Owner · Jeremy J. Shartzer, Funeral Director 8 Market Plaza Way · Mechanicsburg, PA 17055 . Phone: (717) 697-4696 July 10, 2007 Mrs. Melissa 1. Baker 1285 West Trindle Road Mechanicsburg, P A 17055 The Funeral Service for Frederick D. Baker We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way we can. Please feel free to contact us if you have any questions in regard to this statement. THE FOLLOWING IS AN ITEMIZED STATEMENT OF THE SERVICES, FACILITIES, AUTOMOTIVE EQUIPMENT, AND MERCHANDISE THAT YOU SELECTED WHEN MAKING THE FUNERAL ARRANGEMENTS. SELECTED MERCHANDISE: Cremation Container Solid Mahogany Urn Register Memorial Cards, Aclm. Celestial Cherry Keepsake Urn Ceramic Keepsake Urn Thumbies THE COST OF OUR SERVICES, EQUIPMENT, AND MERCHANDISE THAT YOU HAVE SELECTED C. SPECIAL CHARGES Direct Cremation with Memorial Service $365.00 $475.00 $68.00 $65.00 $95.00 $140.00 $1208.00 $3125.00 AT THE TIME FUNERAL ARRANGEMENTS WERE MADE, WE ADVANCED CERTAIN PAYMENTS TO OTHERS AS AN ACCOMMODATION. THE FOLLOWING IS AN ACCOUNTING FOR THOSE CHARGES. CASH ADVANCES Opening Grave Certified Death Certificates Newspaper Notices - Patriot Newspaper Notices - Out of Town Clergy/Mass Offering Flowers TOTAL CASH ADVANCES AND SPECIAL CHARGES $570.00 $84.00 $306.75 $108.60 $200.00 $115.00 $4509.35 SUB- TOTAL INITIAL PAYMENT / DISCOUNT / CREDITS TOTAL AMOUNT DUE $5717.35 $5717.35 1111.~ 11..1 l"U"" 11, n,.,,"'t;I-~ J~... i" ,4/.11......,.~." '" ""'0,'1 REV-1512 EX+ (12-03) SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF BJ1.I(~.1 FIlE ])FJlreK ]). FILE NUMBER 2/ - () 7- 6 j S Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Pe.eult."t wa,S sole Oblijor- on morl:?l.lIje +r, lMt.tIIt~ Isf F="e.ciero-l c.re~:+ ltni Or! Qo.tt.J f1t>v. 22., tJ.oo:z W re..~nJed "Dee. S, '2.002. 1M +le. () f,f;c.t. 01 -ML Ret:!.Drdu- of. Dee.tI.s:,., O.rtd +Or C~bt.rIQ.llJ CoL(n~ ' Pbtn". aM ~rt~~e 8bo/( 17 is:, PtUje. 432(", 1M th ku.e. ct.mDW\t e+ fD2,SDo#ooJ Stlwbs~- ue..n tI y a. s.s I ~ eol b11\ S Cl.Wl~ ol4te -lD PH H I'\1.l) ,.t1 a., t fie r /I ,. tC So F=Or Q$S.~nMt.nt se.e. rn~se~lla.neoLlS &ok b~ 2, tfJ4r "'19. (Se.t!. &pf tJ. l'eleYJttZt tfl:ltJtS Df S4U/ M.rJI'fljtUJt! 4/fILdu.d) F: W\ a..I ~- D ff ho.l4Alc.e. \.Uo,' C,See. seNllment shed Ill/Ae.heel.l L,,,e fo,! ~nby) I"fv.j hi f'A(JfVlenTs wc:.re. h\tt.tJe. nt; Jl.u:e 3D) .1"u 1y 291 a.NLJ ~4"wj1" sf a I 7.bO 1- ;" fk flnUu,nt 01 ! j f" :> 'I ad,.1 f,ret./ - (see. eofJia o! ehu;k r~;skr enfria A/hu;lu:.t:I) t;u.e.st f),'tiJJ1bSt/c.S r III C. J LtA-bo riA. Ivry serv/c~ Ctnf,.4 ;;/1 IItmqft)/t)9Y ~ul OIlCP/E>'!J 1-1 t>/y S fJ i r/I- 1I00p:';" I ~ liE', ~OS.31 '.2, "17" 77 , '3 It. 13 ~Lff) . Of) I J5: 10 2.. 3. il (If more space is needed, Insert additional sheets of the same size) TOTAL (Also enter on line 10, Recapitulation) $ Sf) J 989, S I NOTE November 22. 2002 [Date] MECHANICSBURG [City] Pennsylvania [State] 1285 W TRINDLE ROAD,MECHANICSBURG,PA 17055 [Property Address] 1. BORROWER'S PROMISE TO PAY In return for a loan that 1 have received, I promise to pay u.s. $ 62,500.00 (this amount is called "Principal"), plus interest, to the order of the Lender. The Lender is MEMBERS 1ST FEDERAL CREDIT UNION, Federal Credit Union I will make all payments under this Note in the form of cash, check or money order. I understand that the Lender may transfer this Note. The Lender or anyone who takes this Note by transfer and who is entitled to receive payments under this Note is called the "Note Holder." 2, INTEREST Interest will be charged on unpaid principal until the full amount of Principal has been paid. 1 will pay interest at a yearly rate of 5.3750 %. The interest rate required by this Section 2 is the rate I will pay both before and after any default described in Section 6(B) of this Note. 3, PAYMENTS (A) Time and Place of Payments I will pay principal and interest by making a payment every month. I will make my monthly payment on the 1 s t day of each month beginning on J a n u a r y 1, 2003 . I will make these payments every month until I have paid all of the principal and interest and any other charges described below that I may owe under this Note. Each monthly payment will be applied as of its scheduled due date and will be applied to interest before Principal. If, on December 1, 2017 , I still owe amounts under this Note, I will pay those amounts in full on that date, which is called the "Maturity Date. " I will make my monthly payments at ,P.O. BOX 40 MECHANICSBURG, PA 17055 or at a different place if required by the Note Holder. (B) Amount of Monthly Payments My monthly payment will be in the amount of U.S. $ 506.55 4, BORROWER'S RIGHT TO PREPAY I have the right to make payments of Principal at any time before they are due. A payment of Principal only is known as a "Prepayment." When I make a Prepayment, I will tell the Note Holder in writing that I am doing so. I may not designate a payment as a Prepayment if I have not made all the monthly payments due under the Note. I may make a full Prepayment or partial Prepayments without paying a Prepayment charge. The Note Holder will use my Prepayments to reduce the amount of Principal that I owe under this Note. However, the Note Holder may apply my Prepayment to the accrued and unpaid interest on the Prepayment amount, before applying my Prepayment to reduce the Principal amount of the Note. If I make a partial Prepayment, there will be no changes in the due date or in the amount of my monthly payment unless the Note Holder agrees in writing to those changes. BAKER 183331 0020472684 o MUL T1ST ATE FIXED RATE NOTE-Single Family-Fannie Mae/Freddie Mac UNIFORM INSTRUMENT o -5N 100051 MW 05/00 Form 3200 1/01 \!l VMP MORTGAGE FORMS. 18001521.7291 '2.. Page 1 of 3 Initials: VI:>' / I "III" 11111 111111111111111111111 5. LOAN CHARGES If a law, which applies to this loan and which sets maximum loan charges, is finally interpreted so that the interest or other loan charges collected or to be collected in connection with this loan exceed the permitted limits, then: (a) any such loan charge shall be reduced by the amount necessary to reduce the charge to the permitted limit; and (b) any sums already collected from me which exceeded permitted limits will be refunded to me. The Note Holder may choose to make this refund by reducing the Principal I owe under this Note or by making a direct payment to me. If a refund reduces Principal, the reduction will be treated as a partial Prepayment. 6. BORROWER'S FAILURE TO PAY AS REQUIRED (A) Late Charge for Overdue Payments If the Note Holder has not received the full amount of any monthly payment by the end of 15 calendar days after the date it is due, I will pay a late charge to the Note Holder. The amount of the charge will be 5. 0000 % of my overdue payment of principal and interest. I will pay this late charge promptly but only once on each late payment. (B) Default If I do not pay the full amount of each monthly payment on the date it is due, I will be in default. (C) Notice of Default If I am in default, the Note Holder may send me a written notice telling me that if I do not pay the overdue amount by a certain date, the Note Holder may require me to pay immediately the full amount of Principal which has not been paid and all the interest that I owe on that amount. That date must be at least 30 days after the date on which the notice is mailed to me or delivered by other means. (D) No Waiver By Note Holder Even if, at a time when I am in default, the Note Holder does not require me to pay immediately in full as described above, the Note Holder will stilI have the right (0 do so if I am in default at a later time. (E) Payment of Note Holder's Costs and Expenses If the Note Holder has required me to pay immediately in full as described above, the Note Holder will have the right to be paid back by me for all of its costs and expenses in enforcing this Note to the extent not prohibited by applicable law. Those expenses include, for example, reasonable attorneys' fees. 7. GIVING OF NOTICES Unless applicable law requires a different method, any notice that must be given to me under this Note will be given by delivering it or by mailing it by first class mail to me at the Property Address above or at a different address if I give the Note Holder a notice of my different address. Any notice that must be given to the Note Holder under this Note will be given by delivering it or by mailing it by first class mail to the Note Holder at the address stated in Section 3(A) above or at a different address if I am given a notice of that different address. 8. OBLIGATIONS OF PERSONS UNDER TillS NOTE If more than one person signs this Note, each person is fully and personally obligated to keep all of the promises made in this Note, including the promise to pay the full amount owed. Any person who is a guarantor, surety or endorser of this Note is also obligated to do these things. Any person who takes over these obligations, induding the obligations of a guarantor, surety or endorser of this Note, is also obligated to keep all of the promises made in this Note. The Note Holder may enforce its rights under this Note against each person individually or against all of us together. This means that anyone of us may be required to pay all of the amounts owed under this Note. 9. WAIVERS ] and any other person who has obligations under this Note waive the rights of Presentment and Notice of Dishonor. "Presentment" means the right to require the Note Holder to demand payment of amounts due. "Notice of Dishonor" means the right to require the Note Holder to give notice to other persons that amounts due have not been paid. BAKER 183331 0020472684 o 4& -5N (0005) ~ Page 2 of 3 Form 3200 1101 Initials: ft>7) 10. UNIFORM SECURED NOTE This Note is a uniform instrument with limited variations in some jurisdictions. In addition to the protections given to the Note Holder under this Note, a Mortgage, Deed of Trust, or Security Deed (the "Security Instrument"), dated the same date as this Note, protects the Note Holder from possible losses which might result if I do not keep the promises which I make in this Note. That Security Instrument describes how and under what conditions I may be required to make immediate payment in full of all amounts I owe under this Note. Some of those conditions are described as follows: If all or any part of the Property or any Interest in the Property is sold or transferred (or if Borrower is not a natural person and a beneficial interest in Borrower is sold or transferred) without Lender's prior written consent, Lender may require immediate payment in full of all sums secured by this Security Instrument. However, this option shall not be exercised by Lender if such exercise is prohibited by Applicable Law. If Lender exercises this option, Lender shall give Borrower notice of acceleration. The notice shall provide a period of not less than 30 days from the date the notice is given in accordance with Section 15 within which Borrower must pay all sums secured by this Security Instrument. If Borrower fails to pay these sums prior to the expiration of this period, Lender may invoke any remedies permitted by this Security Instrument without further notice or demand on Borrower. WITNESS THE HAND(S) AND SEAL(S) OF THE UNDERSIGNED. a;[}~/j( ?/7~~ FREDERICK D BAKER (Seal) (Seal) -Borrower -Borrower (Seal) -Borrower (Seal) -Borrower (Seal) -Borrower (Seal) -BOrrower (Seal) -Borrower (Seal) -Borrower {Sign Original Only] BAKER 183331 0020472684 o Q -5N 100051 C!> Page 3 of 3 Form 3200 1/01 (9A t..t ~l~\ ~\.\ A \te0 ~. " ~ L' liT r'. Z; = G L L~ ,'.: -,~ 0 ~-.: ~) L~ :.~ 0 I:: L: ~ E ~~ :.~ , ":' ;.: , "0 eel f ~ " '- ..: \ ...,.., Ii' llJ! i I ; .- '"1 f) C~" - / ' '. l.. i _ () 5 q fil 0 (r: 0-' III I ,-' Prepared By: Gwen R. Stoner Return To: MEMBERS 1ST F. c. U. 5000 LOUISE DRIVE MECHANICSBURG. PA 17055 Parcel Number: 22-24-0773-042 [Space Above 1bis Line For Recording Data] MORTGAGE DEFINITIONS Words used in multiple sections of this document are defined below and other words are defined in Sections 3. 11, 13. 18, 20 and 21. Certain rules regarding the usage of words used in this document are also provided in Section 16. (A) "Security Instrument" means this document, which is dated together with all Riders to this document. (B) "Borrower" is FREDERICK 0 BAKER November 22. 2002 Borrower is the mortgagor under this Security Instrument. (C) "Lender" is MEMBERS 1ST FEDERAL CREDIT UNION Lender is a Federa 1 Credi t Uni on BAKER 183331 0020472684 PENNSYLVANIA - Single Family - Fannie MaefFreddie Mac UNIFORM INSTRUMENT G -6IPA) 100081 ~ Page 1 of 16 MW 0&100 o Form 3039 1/01 Initials: rb') 11111111111111111111111111111111111 VMP MORTGAGE FORMS- (800)521-7291 BK I / 8 5 FG 4 3 2 6 organized and existing under the laws of THE UN IT ED STATES OF AMER I CA Lender's address is P.O. BOX 40. MEeHAN I CSBURG. PA 17055 Lender is the mortgagee under this Security Instrument. (D) "Note" means the promissory note signed by Borrower and dated The Note states that Borrower owes Lender Si xty Two Thousand November 22. 2002 Five Hundred and no/lOa Dollars (U.S. $62.500.00 ) plus interest. Borrower has promised to pay this debt in regular Periodic Payments and to pay the debt in full not later than December 1. 2017 (E) "Property" means the property that is described below under the heading "Transfer of Rights in the Property. " (F) "Loan" means the debt evidenced by the Note, plus interest, any prepayment charges and late charges due under the Note, and all sums due under this Security Instrument, plus interest. (G) "Riders" means all Riders to this Security Instrument that are executed by Borrower. The following Riders are to be executed by Borrower [check box as applicable): D Adjustable Rate Rider D Balloon Rider D VA Rider D Condominium Rider D Second Home Rider D Planned Unit Development Rider D 1-4 Family Rider D Biweekly Payment Rider D Other(s) [specify) (H) "Applicable Law" means all controlling applicable federal, state and local statutes, regulations, ordinances and administrative rules and orders (that have the effect of law) as well as all applicable final, non-appealable judicial opinions. (I) "Community Association Dues, Fees, and Assessments" means all dues, fees, assessments and other charges that are imposed on Borrower or the Property by a condominium association, homeowners association or similar organization. (J) "Electronic Funds Transfer" means any transfer of funds, other than a transaction originated by check, draft, or similar paper instrument, which is initiated through an electronic terminal, telephonic instrument, computer, or magnetic tape so as to order, instruct, or authorize a financial institution to debit or credit an account. Such term includes, but is not limited to, point-of-sale transfers, automated teller machine transactions, transfers initiated by telephone, wire transfers, and automated clearinghouse transfers. (K) "Escrow Items" means those items that are described in Section 3. (L) "Miscellaneous Proceeds" means any compensation, settlement, award of damages, or proceeds paid by any third party (other than insurance proceeds paid under the coverages described in Section 5) for: (i) damage to, or destruction of, the Property; (ii) condemnation or other taking of all or any part of the Property; (iii) conveyance in lieu of condemnation; or (iv) misrepresentations of, or omissions as to, the value and/or condition of the Property. (M) "Mortgage Insurance" means insurance protecting Lender against the nonpayment of, or default on, the Loan. (N) "Periodic Payment" means the regularly scheduled amount due for (i) principal and interest under the Note, plus (ii) any amounts under Section 3 of this Security Instrument. BAKER 183331 0020472684 . .6(PAI (00081 ~ Initials: FI) ~ a Page2of1a Form 3039 1/01 BK \ 7 8 5 FG 4 3 2 7 (0) "RESPA" means the Real Estate Settlement Procedures Act (12 V.S.C. Section 2601 et seq.) and its implementing regulation, Regulation X (24 C.F.R. Part 3500), as they might be amended from time to time, or any additional or successor legislation or regulation that governs the same subject marter. As used in this Security Instrument, "RESP A" refers to all requirements and restrictions that are imposed in regard to a "federally related mortgage loan" even if the Loan does not qualify as a "federally related mortgage loan" under RESPA. (P) "Successor in Interest of Borrower" means any party that has taken title to the Property, whether or not that party has assumed Borrower's obligations under the Note and/or this Security Instrument. TRANSFER OF RIGHTS IN THE PROPERTY This Security Instrument secures to Lender: (i) the repayment of the Loan, and all renewals, extensions and modifications of the Note; and (ii) the performance of Borrower's covenants and agreements under this Security Instrument and the Note. For this purpose, Borrower does hereby mortgage, grant and convey to Lender the following described property located in the COUNTY [Type of Recording Jurisdiction] of CUMBERLAND [Name of Recording Jurisdiction]: SCHEDULE "A" ATTACHED which currently has the address of 1285 W TRINDLE ROAD MECHANICSBURG ("Property Address"): [City], Pennsylvania 17055 [Street] [Zip Code] TOGETHER WITH all the improvements now or hereafter erected on the property, and all easements, appurtenances, and fixtures now or hereafter a part of the property. All replacements and additions shall also be covered by this Security Instrument. All of the foregoing is referred to in this Security Instrument as the "Property. " BAKER 183331 0020472684 Initials: ~ B o G -6IPAIIOOOS) ~ Page 3 of 16 Form 3039 1/01 BK I 7 8 5 FG 4 3 2 8 491~ WAtf t..o ~ SS :~'3ERT r. ZIEGLEP. ~,:~CORDER OF DEEDS 'I(BERLANfl eOUNTY-r:. , 02 DEe 5 Af'l 9 20 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ASSIGNMENT OF MORTGAGE (5) THIS ASSIGNMENT OF MORTGAGE (5), executed this 22ND day of NOVEMBER 2002 ,by and between Members 1st Federal Credit Union, a corporation organized under the laws of the U.S. Government (12USC17S1), called ASSIGNOR. and PHH MORTGAGE SERVICES called ASSIGNEE, 6000 Atrium Way. Mt. Laurel, NJ 08054 FOR VALUE RECEIVED. the within mortgagees). together with the Note(s) secured thereby for each and every obligation described therein, 1s (are) hereby transferred and assigned to the ASSIGNEE, its successors and assigns,.. said mortgagees) being recorded in the public records of MONROE TOWNSHIP/CUMBERLAND County, Pennsylvania, and duly identified as follows: Original Mortgagor FREDERICK D. BAKER 1285 W. TRINDLE ROAD $62,500.00 MECHANICSBURG, FA 17055 Date of Mortl'lage 11/22/02 Book No. r 7<6:;- Page' No. ~fc; Clerk's File No. This Assignment is made without representation, warranty or recourse on ASSIGNOR herein. IN WITNESS WHEREOF the undersigned Members 1st Federal Credit Union has caused these present to be signed in ita name by its undersigned officers. and its seal affixed this 22ND day of NOVEMBER 2002 MEMBERS 1ST FEDERAL CREDIT UNION By: Fred ::tt: Assistant V.P. of III Real Estate Lending in the presence of: ~~:~ COMMONWEALTH OF PERNS SS COUNTY OF CUMBERLAND On this the 22ND day of NOVEMBER 2002 ,before ms. a notary public, the undersigned officer. personally appeared Fred H. Ryerse, III. known to me (or satisfactorily proved) to be the person whose name ia subscribed hereto. and acknowledged that he is Assistant V.P. of Real Estate Lending for MEMBERS 1ST FEDERAL CREDIT UNION and that he executed the same as Assistant V.P. of Real Estate Lending for the purpose herein contained. In Witness Whereof, I hereunto set my hand and official seal. ~~\\~.~~ Notary Pub I c Prepared By: Cumberland County. Pennsylvania Name: MEMBERS 1ST FEDERAL CREDIT UNION Address: 5000 Louise Drive Mechanicsburg. PA 17055 My Commission Expires: NOCItial Seal DIaleIIo ... ~. NOlIty Public I\4ln>, C1tmbcr\ucL eo"lIl}' ..., 8apirIa My 3. 2Ol>> ......~AMclClllliQnolN<*1Iea 800K 692 PACE1649 SEP-i8-2007 04:14PM FROM-TRiCOUNTY ABSTRACT 171776 i 3830 T-3D3 P 002/003 F-275 ~ ... ~....a.....- B TYPE OF LO~N , 1---. ~~CONV UN!NS 4,DvA 5, DeoN ~ 1 OFHA 2,OFmHA u.s. DEPARTMENT OF HOUSING & URBAN oEVELOPMENT ~ 17 LOAN ~JUr','1BER: 6 FiLE NUj'A8ER: SETTLEMENT5TATEMENT BAK20707 0206593998 8, rvl0RTGJi..G~ INS CASE r~UM:;lt::R . . e, NOTE: r . ~ J f .. d t- gi' 'e you a sr-te'n$nl of aC'uOli selllemfJlll costs Amounts poliO to and by t/lEl SfJWc:menf agent are shown, hIS o(m.s Urnl5ne u " " , ,.' '. " _ r. ,. -I'd .' ~ _ _I I 'k-d "'i;;JO-r er~ p'id ou(slde [he cfosing' mOlY are showl) here for ,nfoi'm.,I,O(;df purposes add ara no, In" u ea In i,,<;: ro/" s, (BInS nla, r;; it v W ;:t . r l.a ~.'9d (S~K20T-OT PFu:p~.K;'07-.;7;~ij NAME AND.A.DDRESS OF SELLER: .......- 'I ~ NAME AND ADDRi;SS OF LEI~DER, 0, t,J,Il,rV1E AND.o.u('JKESS OF BORROWER: -"1 ~. MEMeEi"S 1ST FEDERAL CREDIT IvlELl5SA I, B,A.KER UNION 12a5 IJIJEST TR1(\JDlE ROAD 5000 LOUISE DRIVE: MECHA(\jICSBURG. PA 17055 ME:CHANICSI3URG, PIi. 17050 G. PROPERW lOCATION: r H, SETTi-i::lvlI;NT ,:l,GEr~T 25-1619811 -I I SETtLE MEN 1285 WEST TRINDLE ROAP CHARLES E. SHIELDS Iii MECH,:"NICSaURG, PA 17055 I - 1 SGp18n,D8r 20, CUMBERLAND County, Pennsylvdnia I PLA,CE OF SETTLEMENT DIsDurse'0912Si 3414 CHESTNUT STREET .' I C,A.MP Hill, PA 17011 -'~~ J. SUMM'ARY OF' BORROWER'S ~NSA~TION ~- K SUMMARY OF SELLER'S T~Af~S,;C I iON .. - 100. GROSS AMOUNT DUE FROM BORROWER.:. .100. GROSS AMOUNT OUt: TO SELLER: , 101, Contract Sales Price ! 401. Con\r<lct Sales Frlca 102 p",($onal Pro~ert~ I 402. Personal Property - 103. S€nlement Charges to 80rrol/J$r (Una 1400) _ ~. 2.84915 403. 48..105,31 404 I 104, PAYOFF 1ST tvlORTGAGE to MORTG.A.GE SERViCE C ----.~~ 105. PAYOFF TO ESTATE OF :=REDi2RICK to ESTATE O~ Fi 100.14494 405. Adjllstments For II~rn$ Paid~ 81:' Sellar in advance r---- Adi~J$lmeil(S For Items Paid Bv Seller in advance 106. Cltylim',n Taxes to 406, Cit\Ifown I s""es 10 , - I 407 County T2.~es to 107. Cour,;/ Ta~e;> to 108 SCHOOL TAX to ! 408. SCHOOL TAX to 103. ! 409 I - 110. -- 410. - 111- I 411- I 112, t 412. 120. GROSS AMOUNT DUE FROM SORKOWeR ; 152,000.00 420, GROSS AMOUNT DU~ YO SELLER --.. - \. lJII;::'I""-:"I""""I .-.. 200. AMOUNTS PAID aY OR IN BEHALF O~ BORROWER; 500. REDUCT10NS!N AMOUNT DUE TO SELLER: 201 Deposit or earnest money I 501, Excess Deposit (Se~ Instructlons) 202. Principal .A,mount of Naw LOCJn(s) r 152,QOO.00 502. Settlement Chan:J6S to Seller fLine 1400) 203 E:.isllna jOCJn(s) 1aken subiect to 1 503. Exlsllr.:Q !canls) taken subject 10 i , -- 504. Payoff oi first Mortgage 204. I , 505, Payoff of second MortCj~ - 2Q5. , 206 t 506 207. I 507, - 208. ; 508 209 , 509. -- -.-.",,", Ad;~$rrneflfs t:or lter:Js Unoaid By Sellar ACfiuslm~flts ,t:or Items Unpaid BV Seller --,----- ~ 210. Citv/Town Taxes ~o I 510. CiryfTown Taxes to I - 211- Couniv Taxes to 511. County I axes to 212. SCHOOL TAX to 512 SCHOOL TAX 10 i i -- , 213 513. I I - 214. I ~. i 21ti I 515 I I - '.--.-..... 216, ~. 217 I 517. i -- , 218. 518. 219, I 519, ! 220 TOTAL P.41D BY/FOR BORROWER I 152,000,00 620 TOTAL REDUCTION AMOUNT DUE SELLER I I ~. 'OIF'ROM -SELLfR: -. - 300, CASH AT SETTLEMENT FROMrrC BORROWER: ~9. CASH AT SETILEMEN I 301. Gross Amount Due From BorroWer (Line 120\ t 152,000.00 1301 Gross Amount Dus To Seller rLine 420) i 302. Less A,mount Paid By/For Borrower (!-.ine 220) I( 152,000.00) 602. Less Reductions Due Seller (Line 5~O) ,. i\ I , JOJ CASJ./ ( ~ROM ) ( TO j SOFmOWER 0,00 $03 CASH ( m)( FROM) SELLER ; -............ '/ Ir'<S T DATE 2Q07 07 o TI18 Undersigned tlQr€:by acknowledge receipt of a completed copy of pages 1&2 of this statement S any altachments r",ferr8d to herem. I HAVE C-"lREFUU. Y REVIEWED THE HUD-1 SETTLEMENT STATEMENT AND TO THE BEST OF MY KNOWLEDGE Nm ~::LlEF, IT IS A TRUE AND ACCURATi: STAT~MENT OF ALL RECEIPTS A~JD DISBURSEMENTS r,..;ADE ON MY ACCOUNT OR BY ME IN THIS TRANS,~CTION. I FURIf-1ER C;RTI THAT I HAVE RECEIVED;" COF-Y OF THE HUD.l SETILEi\.1ENT STATEMENT, BOrrower Seiler MELISSA I, BAKER TO THE BEST OF MY KNOWLEDGE. THE HUD,1 SETTLEMENT STATEMENT WHiCH I HAVE PREPARED IS A TRUE AND fl.,CCURIl.TE ACCOUNT OFl Fut~D3 WHICH INE;RE; RECE;IVI::P Ar-lD HAVE: e!:e:t~ Of';: WIL,- J'lf': DI$J3UR$~D 8'0' T~IE UhID"''''GIGt,ED AG PART or Tile OC::TTL.Cr,lD-n or TI1I0 IRp,NSACnON. SETTLEMENT OFFICER SsLUemenl ....gent WARNING: IT IS A CRIME TO KNOlNlNCl Y MAKE FALSE STATEMENTS TO THE UNITED STATES ON THIS OR ANY SIMILi>.R FORM. PEN?L TIES UF CONVICYION C,.lN INCLUDE A Flr~E AND IMPRISONMENT. FOR DETAilS SEE: wru: 18 U.S. COD~ SECTION 1001 3. SECTION 1010. SEP-18-2007 04:15PM FROM-iRICOUNTY ABSTRACT \7177613830 T-303 P 003/003 F-ZT5 L. .:lC I I I...C 1V1I::: Ii I vn;.>.Kl..lIC;:' - . 'j----;;:;p FRCf.l I QORRCt.'i;.".::. PAID ?RC.~"1 1700 TOTAL COMMISSION BasEliJ on PriC~ Division of Commission J!jne 700) as Follows' 701 $ 10 702 $ to 703, Commission Paid at SettleI118f)( 704 TRfl.NSAC liON FEE to . _ BCO.ITEMS PA,Y;"SLE lr~ CON~!ECTION WITJiJ:9AN 801 Loan Oriqination Fee 02500 % to MEMBERS 1ST FEDERAL CR~T Ut!19N 802. Loan Di$col,Jnl - % to 803 Appraisal Fee to M~M13ERS 1ST FEDER.A,L CREDIT UNION 804. Credit Report to 805. Lender's Inspection Fee ~ \0 806. Mortgage Ins. Aop. Fe.. 10 _ 807 Assumplion Fea to 808. UNDERWRITING FEE to MEMBERs 1ST FEDERAL CR!::DIT UNION 809. DOCUrv1ENT P'REPFEE .- to t\..1f;~,,1eERS 1ST FEDE~L CREDIT UNION 810. Bil 900. ITEMS R~OUIRED SY I...ENOER TO BE PAID IN ADVANCe -- -"- 901 IntGrast From 0'0/,5107 to 10101107 @ $ 33.250000/day ( 6 days 902. Mortgag~ Insurance Premium for months to 903, Hazard Insurance Premium for~. 10 years \0 904. 905, 1000. RESERVES DEPOSITED WITH LENDER 1001. Hazard Insurance 1002, MOligaqe Insurance 1003. City/Town Taxes 1004. CountvTaxes 1005, SCHOOL TAX 1006, 1007. 10Ca. AGGREG.ATE ESCROW ADJUSn'1E 110(t 11TI-I: CHARGES 1101. Settlement or Closing Fee 1102 CLOSING PROTECTION LEITER 1103. TITLE SEARCH & HUD PREP 1104. Title Insurance Bindsr ~,Document Pre~ti9n 1106. ~~otai)' Fees 1107. .A.ttOinGY's Fees (includes above item numbers' 110S, Title Insurance (includes above item oiJmbats; 1109, Lender's Coverage 111 O. Owner's Coverage 1111. ENDORSEMENTS 10030081 1112. 1113 1Z0Q. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201, Recording Fees: Deed $ : Mongaga $ 6650; 1202. City/County TOl)4/$tamps: Dee<l : M(':(\gage 1203, State TaxJStamps: Rev0nue Stamos ; Mortgage 1204. 12Q5. OVERNIGHT/COURIER FEES 13QO. t-DDlTIONAL SETTLEMENT CH~RGI::S 1301 Survey 1302. Pest Insp$ctlon 1303. TAX CERTIFICATION FEE 1304 1305. 1400. TOTAL SETTLEM~NT CHARGES {Enter on Lines 103. Suct,i~n J i1li'ld 502, Section I<r~'-" 6~ b!ani;~o ~t1~t1 1 of lhl:. l;Itl:flt;m~n{, tr.t' ~i~n~t;Jn:l!" tlcKnowledge: r~ce!Ft of i:I ;:omplolod COpy Qr pa06 2 or m\~ ('NO oaaa slal=-me:)~ $ @ % ~ElLER'S ~ r:UNP~ AT I ~Jr~::::$:"-: I S~TTLE~:;;~ :.ETTlCt.1E'H --t--~ ~ - I - ~ 380001 - - 35000 75.00 275QO I ~] i I %) -I ~-_--- +-=r-- . ,~~ - [ -~-' I l===~-~~ *:~ ~.-- monUi5 @ $ mOi1ths @ $ months ,fl'! $ mor.th$ ~ $ months @ $ montfls@l $ months @ $ mOlith~",.@ _ ~ tJcr per per Der per PO( per month month monih month month month month r,lornh oer 10 to FIRST AMERICAN TITLE iNSURANCE COMP,A,NY to TRI-COUI~ I Y ABSTRACT SERVICE ~ to to to to -- I ~ i 35.CO[ 150001 I CASH CHARLES E SHIELDS III 1500 623,25 I I I -l..... ___ _ t _____ ______ ~--- 495501 L ___ u____ =t==~- 150':-001 r= - I to TRI-COUNTY AB$TR~,CT SERVICE, AGENT S $ to iRI-COUNTY ABSTRACT Sl::RVICE 152,000.00 495 50 ) 1061S125! 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(~c~Ott1r / =. ;.i.:J;..'.~~~;.~{i':~II,., CJOI"'" v F~;';,\"( J "...-.-1' j I ).., kl .) n..L- .~ /"1 .,.r.. \ J ~ f 1"1 11 ;i" t" (J K ." j /' (() C- . ~._i~~~~NT' \0'./ (p. i "'j...:; .-1t1t ( 1.i....ti+ld '~l{)(;p"._iLl-~~<~/ji'~- . ) I ./ ~:)THEJ\ .,<~'.Ho\llt; . Cvri ~~ j"Nfll{lj 'Ctl~;-ffo.t:+t)'~);.p,;MlA4:l . t..Oj. dQtttl'1;. tm I'T'~:-, ikll:c ~ ~lQin oupli~t~ lr. (~i~Il(;Z Ch~:k tl6); M",mo ~: 2 ; ~ 3 B 2 2!. 1,~ "~E!.. ;'.OB , I r I i' Ii ' --to ~C!5S11i to~ 2 NEGOTIABLE I I i 1 .a REV-1513 EX+ (9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF 8 /i K~ FR.€j)E:t< leI( :D. NUMBER I 3. FILE NUMBER 1. RELATIONSHIP TO DECEDENT NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)J rn E LJ ss A :r:. t31fJ<c'"t! I ;;t8S" UJ. -Jriodle Rd. widoW mec.ho-t1;c.sbu71J Pit /70 sS- MI CH A-cL J>. t:> fJ-f(J:::J'( So "1 Lf~()(g Gre.en ParI< .:Dr. /llt. JO\l, PA /75 S 72- ~R"J /'I. /$HKi:7f dlll.tjh~r 3 if w. /I,.i.ba /h'e. Hershey" PA /7t) 33 :2-1- 07- "ZS AMOUNT OR SHARE OF ESTATE Y3 Y3 Y3 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.. 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. I TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) LAST WILL AND TESTAMENT OF FREDERICK D. BAKER I, FREDERICK D. BAKER, currently of 1285 West Trindle Road, Mechanicsburg, Monroe Township, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this my Last Will and Testament, hereby revoking and making void any and all prior Wills by me at any time heretofore made. 1. I direct the payment of all my just debts and funeral expenses as soon after my decease as the same can conveniently be done. 2. All the rest, residue and remainder of mY' Estate, real, personal and mixed, whatsoever and wheresoever situate, I give, devise, and bequeath to be equally divided and distributed in three (3) shares, as follows, to wit: A) One share to my beloved wife, MELISSA I. BAKER. In the event she predeceases me, then to her children, NICOLE M. GRIMES and RYAN P. GIUMES in equal shares. In the event either of them predeceases me, then to the survivor of them, veT capita. In the event none of them survive me, then to my two children as set forth more fully hereinbelow. B) One share to my son, MICHAEL D. BAKER. In the event he predeceases me, then to his sister, ERIN N. BAKER. C) One share to my daughter, ERlN N. BAKER. In the event she predeceases me, then to her brother, MICHAEL D. BAKER 3. I nominate, constitute and appoint my beloved wife, MELISSA I. BAKER, my son, MICHAEL D. BAKER, and my daughter, ERIN N. BAKER, to be Co- Executors of this my Last Will and Testament. I further direct that they shall not be required to tIle bond or other security in the Office of the Register of Wills for the purpose of administering my Estate. ~~ . (~h t fl~r-- $u,cU~~(" , A.D. 2007. C) d~9f "!~=f') - ' ~~ / -'p'7") y)-., ':;;;.;' k _ 'YS ~2, -TJ ~}/~d/. 'p/QV ~ cE~~AL) .s. FREDERICK D. BAKER ;c;--J r'-;) '-:-:1_ (::~) --.J IN WITNESS WHEREOF, I have hereunto set my hand and seal this Jertt: C._ c- .:;.~-= r'J \.I::> .....-- ", ~n (]l Signed, sealed, published and declared by the above-named FREDERICK D. BAKER, as and for his Last Will and Testament, in the presence of us, who at his request and in his presence, and in the presence of each other, have hereunto subscribed our names as witnesses. ~t~? ~~ 2 CHARLES E. SHIELDS, III ATTORNEY-AT-LAW 6 CWUSER ROAD Corner ofTriruile and Clouser Roads MECHANICSBURG, PA 17055 GEORGE M. HOUCK (1912-1991) TELEPHONE (717) 766-0209 FAX (717) 795-7473 October 23, 2007 Register of Wills Cumberland County Court House 1 Court Square Carlisle, P A 17013 Re: Estate of Frederick D. Baker No. 21-07-0625 Dear Register of Wills: Please find enclosed for filing 2 copies of the Inheritance Tax Return for the Frederick D. Baker Estate as well as Check No. 105, in the amount of $250.00 for additional Probate and Check No.1 06, in the amount of $15.00 for the filing fee. Thank you for your kind attention to this matter. Very truly yours, ~f,~p Charles E. Shields, III Attorney - At-Law CES/mjj Enclosures gr:1 !!.J f-'" ...... f ,.1) 1/' ;r~('J' , -' _",h.