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:~
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P)
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Correspondent's e-mail address: bea..MerCS Ej) efJ")C. r1it
Side 1
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15056051047
15056051047
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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
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15056052048
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15.
16.
17.
18.
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15056052048
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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.
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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:)~
$
@
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~ElLER'S
~ r:UNP~ AT I ~Jr~::::$:"-:
I S~TTLE~:;;~ :.ETTlCt.1E'H
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- -
35000
75.00
275QO
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months ,fl'! $
mor.th$ ~ $
months @ $
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months @ $
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NEGOTIABLE
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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
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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.
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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.
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, A.D. 2007.
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FREDERICK D. BAKER ;c;--J
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IN WITNESS WHEREOF, I have hereunto set my hand and seal this Jertt:
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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.
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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
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