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HomeMy WebLinkAbout01-03-08 ---I l.5D5bD...l.l....7 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 INHERITANCE TAX RETURN RESIDENT DECEDENT 2 1 0 6 *' Date of Birth 210401837 10072006 10071949 Decedenfs Last Name Suffix Decedenfs First Name GROGAN KAY (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS File Number 0939 MI M MI FILL IN APPROPRIATE OVALS BELOW [!] 1. Original Return D 2. Supplemental Return D 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate D 4a. Future Interest Compromise D 5. Federal Estate Tax Return Required (date of death after 12-12-82) iXI 6. Oecedent Died Testate D 7. Oecedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes I__..J (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received D 10 Spousal Povert~ Credit (date of death D 11. Election to tax under Sec. 9113(A) . between 12-31-91 and 1-1-95) (Attach Sch. 0) ~ORRESPONDENT . THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: ame Daytime Telephone Number ROBERT C. SAlOIS 7172436222 Firm Name (If Applicable) SAlOIS, FLOWER & LINDSAY REGISTER OF WILLS U~NL Y o '~~O '-j ~g -,-- C) . '; (::: :i:i 7:::: First line of address 26 WEST HIGH STREET Second line of address ~"-, .).~ City or Post Office CARLISLE -J:"R DATlii=ILED State PA ZIP Code 17013 i-I J'- Correspondent's e-mail address:rsaidis@sfl-Iaw.com = c.:=') = C-. :to.. L I (..) :P'> U1 .+:'"" Under penalties of pe~ury, I declare that I have examined this return, including accompanying schedules and statements. and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE (Jx) "- 'j{ 1^(~~-1::J:D ~) ArIa K. Mitlerling / -,,2 - ,,2M'i ADDRESS '. 115 Sk 17050 26 West High Street, Carlisle, PA 17013 Side 1 L l.5D5bD4l.l....7 l.5D5bDIfl.l....7 ---I --I lSDSbD...21...1I REV-1500 EX Decedenl'sName: Kay M Grogan 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) D Separate Billing Requested............. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) D Separate Billing Requested............. 7. 8. Total Gross Assets (total Lines 1-7)....................................................................... 8. 9. Funeral Expenses & Administrative Costs (Schedule H)......................................... 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)................................ 10. 11. Total Deductions (total Lines 9 & 1 0)...................................................................... 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 INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, of transfers under Sec. 9116 (a)(1.2) X ~ 16. Amount of Line 14 taxable at lineal rate X .045 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 0.00 15. 87,925.32 16. o . 0 0 17. 0.00 18. 19. Tax Due... ..................................... ............................ ............... ........ ............ .............. 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. L Side 2 1505bO...2l....1I Decedent's Social Security Number 210401837 158,000.00 41,016.29 0.00 199,016.29 35,296.33 75,794.64 111,090.97 87,925.32 87,925.32 0.00 3,956.64 0.00 o . 0 0 3,956.64 o 15D5bO...21...1I --I REV-1500 EX Page 3 Decedent's Complete Address: DECEDENT'S NAME Kay M Grogan STREET ADDRESS 29 Court lane File Number 21-06-0939 - ~ITY IZIP 17013 I STATE PA Carlisle Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1 ) 10,000.00 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total Credits (A + 8 + C) (2) Total Interest/Penalty (0 + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 2 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. (3) (4) (5) (5A) (58) 8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT 3,956.64 10,000.00 6,043.36 PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: a. retain the use or income of the property transferred;.................................................................................. b. retain the right to designate who shall use the property transferred or its income;.................................... c. retain a reversionary interest; or.................................................................................................................. d. receive the promise for life of either payments, benefits or care?.............................................................. 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?.......... ................... .......... ....... ................. ...... ............. .................. ......... ......... Yes D D D D 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. No ~ ~ ~ ~ ~ ~ For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. ~9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. ~9116 (a) (1.1) (ii)]. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. ~9116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedenfs lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. ~9116 1.2) [72 P.S. ~9116 (a) (1 )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. ~9116 (a) (1.3)]. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. Rev.1502 EX+ (6-9S) . SCHEDULE A REAL ESTATE COWolONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Grogan, Kay M FILE NUMBER 21-06-0939 All real property owned solely or as a tenant In common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller. neither being compelled to buy or sell, both having reasonable knowiedge of the relevant facts. Real property which Is jolntly-owned with right of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION 1 Residence--29 Court Lane, Carlisle, PA - Tax Parcel #06-18-1371-002-U66 VALUE AT DATE OF DEATH 158,000.00 TOTAL (Also enter on Line 1, Recapitulation) 158,000.00 (If more space is needed. additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule A (Rev. 6-98) Rev-1508 EX+ (6-98) *' SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Grogan, Kay M FILE NUMBER 21-06-0939 Include the proceeds of litigation and the date the proceeds were received by the estate. All property Jolntly-owned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION 1 Federal Income Tax Refund (2006) VALUE AT DATE OF DEATH 2,853.00 2 Refund from Mortgage Services Center - Refund of tax and insurance escrow 1.524.74 3 Refund from UGI Utilities 35.20 4 Member's 1st Federal Credit Union - Checking Account #102363-00 33.431.27 5 Member's 1st Federal Credit Union - Certificate of Deposit #102363-46 2.045.71 6 Member's 1st Federal Credit Union - Checking Account # 102363-11 121.45 7 Automobile - 1996 Mercury Sedan 800.00 8 Household Items 101.18 9 Large Appliances 103.74 TOTAL (Also enter on Line 5, Recapitulation) 41.016.29 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) Rev-1510 EX+ (6-98) . SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMON~THOFPENNSYLVAN~ INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Grogan, Kay M FILE NUMBER 21-06-0939 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. ITEM ....., .IUNOF .v ...., ,,-y DATE OF DEATH % OF DECO'S EXCLUSION TAXABLE NUMBER INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. 1 Fidelity Investments--Holy Spirit Hospital - 159.926.58 100.000 159,926.5 0.00 Retirement Savings Statement (401K) Beneficiary: Keith A. Grogan, son TOTAL (Also enter on Line 7, Recapitulation) 0.00 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA.1500 Schedule G (Rev. 6-98) REV.1151 EX+ (12.99) . SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Grogan, Kay M Debts of decedent must be reported on Schedule I. FILE NUMBER 21-06-0939 ITEM NUMBER A. FUNERAL EXPENSES: DESCRIPTION AMOUNT See continuation schedule{s) attached 11,802.00 B. 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Social Security Number(s) I ErN Number of Personal Representative(s): Street Address City Year(s) Commission paid State Zip 2. Attomey's Fees Said is, Flower & Lindsay 5,000.00 3. Family Exemption: (If decedenfs address is not the same as claimant's, attach explanation) Claimant Street Address City Relationship of Claimant to Decedent State Zip 4. Probate Fees 424.00 5. Accountanfs Fees 222.00 6. Tax Retum Preparer's Fees 7. Other Administrative Costs See continuation schedule{s) attached 17,848.33 TOTAL (Also enter on line 9, Recapitulation) 35,296.33 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA.1500 Schedule H (Rev. 6-98) Rev-1502 EX+ (6-98) *' SCHEDULE H.A FUNERAL EXPENSES continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Grogan, Kay M FILE NUMBER 21-06-0939 ITEM NUMBER DESCRIPTION AMOUNT 1 Enola Cemetary--Partial payment burial plot 300.00 2 Gingerich Memorials - Deposit for Memorial Stone 1,350.00 3 Gingerich Memorials - Final payment for memorial stone. 1,350.00 4 Sullivan Funeral Home 8,052.00 5 Zion Lutheran Church Cemetary 750.00 Subtotal 11,802.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H.A (Rev. 6-98) Rev-1502 EX+ (6-98) . SCHEDULE H.B7 OTHER ADMINISTRATIVE COSTS continued COMl.lONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIOENT DECEDENT ESTATE OF Grogan, Kay M FILE NUMBER 21-06-0939 ITEM AMOUNT NUMBER DESCRIPTION 1 1-800 Got Junk - Fee to sell household items. 204.00 2 Carlisle Borough (Water/Sewer) 16.18 3 Carlisle Borough (Water/Sewer) 19.00 4 Carlisle Borough (Water/Sewer) 37.58 5 Carlisle Borough (Water/Sewer) 56.44 6 Carlisle Borough (Water/Sewer) 19.00 7 COCUOA-Condo Association 180.35 8 COCUOA-Condo Association 143.35 9 COCUOA-Condo Association 271.70 10 COCUOA-Condo Association 258.70 11 COCUOA-Condo Association 128.35 12 Embarq-Phone DSL 78.00 13 Embarq-Phone DSL - Final Bill 32.06 14 John O'Neill, Tax Collector - Real Estate Taxes 2.047.33 15 PPL Electric 26.35 16 PPL Electric 27.63 17 PPL Electric 52.75 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) Rev-1502 EX+ (6-96) *' SCHEDULE H.87 OTHER ADMINISTRATIVE COSTS continued COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIOENT DECEDENT ESTATE OF FILE NUMBER 21-06-0939 Grogan, Kay M ITEM NUMBER AMOUNT DESCRIPTION 18 PPL Electric 27.96 19 PPL Electric 24.65 20 PPL Electric 24.65 21 PPL Electric 22.02 22 PPL Electric 40.27 23 PPL Electric 14.28 24 Residence--29 Court Lane, Carlisle, PA - Closing Costs for Sale of Condo Brokers Commission--$11,060.00; Settlement Preparation $165.00; Notary Fee $10.00; Realty Transfer Taxes $1,580.00; Home Warranty $385.00; Wiring Fees $20.00; Resale Certificate $50.00; COD UOA $38.35; Final Water/Sewer $18.86 13.327.21 25 Said is, Flower & Lindsay - Reimbursement for expenses to advertise the Executor's Notice in the Cumberland Law Journal and The Sentinel 273.52 26 UGI Utilities-Gas 58.00 27 UGI Utilities-Gas 175.05 28 UGI Utilities-Gas 210.67 29 UGI Utilities-Gas 51.28 Subtotal 17.848.33 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) Rev-1512 EX+ (6-98) . SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Grogan, Kay M FILE NUMBER 21-06-0939 Include unrelmbursed medical expenses. ITEM NUMBER DESCRIPTION 1 AAA Visa Credit Card VALUE AT DATE OF DEATH 22.59 2 ATT Mastercard 20.00 3 Caremark-Health Insurance Copayment 25.00 4 Carlisle Borough (Water/Sewer) 32.45 5 Carlisle Borough (Water/Sewer) 19.47 6 Citibank Credit Card - Payoff credit card. 579.91 7 Comcast (Cable) - Final Bill 25.08 8 Craftways - Book club 36.91 9 Embarq-Phone DSL 69.69 10 ERA Mortgage - Payoff Mortgage Loan 74,040.26 11 House of White Birches - Book Club Payment 32.91 12 John O'Neill, Tax Collector - ColTwp Taxes 422.01 13 Pennsylvania Department of Revenue - State taxes owed from final individual tax return. 21.00 14 Pier 1 Credit Card 5.86 15 PPL Electric 88.68 16 State Farm-Condo Renewallnsuarnce 297.00 Total of Continuation Schedule See attached page TOTAL (Also enter on Line 10, Recapitulation) 75,794.64 (If more space is needed. additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98) Rev-1512 EX+ (6-98) . SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Grogan, Kay M FILE NUMBER 21-06-0939 ESTATE OF ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 17 UGI Utilities-Gas 55.82 TOTAL (Also enter on Line 10, Recapitulation) 75.794.64 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98) REV 1513 EX+ (9-110) . SCHEDULE .. BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF NUMBER Grogan, Kay M NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal CJistributions, and transfers under Sec. 9116(a)(1.2)] RELATIONSHIP TO DECEDENT Do Not List Trustee/sl FILE NUMBER 21-06-0939 SHARE OF ESTATE AMOUNT OF ESTATE (Words) ($$$) I. 1 Keith A. Grogan 8825 Hepner Court Bristow, VA 20136 Son One hundred percent (100%) of the residue. 88,406.17 Total 88,406.17 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 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98) ~"> , : ,} ~,U"~ OF KAY M. GI~OGAN I, ~\y ~1. GROGAN, of 39 Faith Cir.cle, Car.lisle, Cumberland County, Pennsylvdnia, 17013, do hereby ~akQ, pUblish and declare this t.o be my Last Will;md Te~'da:rncnt, hereby l.evokiny all wills and codicils previously made by me. FIRs'r I direct that all my just debts and funeral expenses be paid and satisfied by my Executor hereinafter named as SOon as con- venientl may be after my death. SECOND I give. devise dnd bequeath all of my estate whether real, personal or mix(~d, dnd wlH~resoever situate, unto my son, Keith .1'\. Grogan, who is seven y\?!ars old and wa:; born on November 24, 1972, in Trust nevertheless as h(~n~inafter provided_ i 'fHT:D TRUST PROVISIONS If my son shall not have reached the age of twenty-one (21) on the d te of my death, his interest in this estate shall be paid to cy p~Gnts, Russel and ArIa Mitterling of 325 Shady Lane, Enold, Cumberland County, Pennsylvania, or the survivor of them, in Trust until he has reached ~he ~9c of twenty-one (21) years. In the event that both of my pdlenb, shall predecease me, I direct that my sister, _. ..... Donna Mitterling of Mechanicsbur~, Pennsylvania, be my Trustee_ I _______._.___ ~_._.__ . Puq2 1 cf 4 Pilqes { d wtJtc : ~n LI2II2I 121 r . ! nr a'~~Tl6LL~I2IL 1:: 'ON xtJ.::J J tJ IG3W I (jd: WO~L::l '1'" ::i, .1 ,i~'",",~," 1: .1;j..~/'! \, In oeder t.O ca~ry uuL the purposes of the trust established ~n this will the 'j'rusL:~(', in addition to all other powers granted by this will or by 1 dW shaLl. have the following powers over the trust estate ::.;ubject to any 1 i Hi tations elsewhere in th':".J W ':'11: (1) To ctccept in kind Clnd ret.uin any ifropt:;l ty which 1 may Own at my death, w.i thout regard ! any principal of diversification, and to invest in r purchase any form Or property, without restriction o leqal illVl!t.;tml'nt.s for fiduciaries. (2) To ~ell at public or private sale. exchange r l(~dse for: any period of time and real or pe!:'sonal property, and to 91ve options for sales Or leases. (3) '1'0 barr-ow money and to mortgage or pledge <my real 01 pt'.r~.ior,dl property_ ('1) '1'0 '"(.(;,ister ~,)roi)('rty J.1l ::'h.-.:' rj<-Ui~.' of a .lOlTlU1L'e en to hold property unu~gistt~rc'cJ. (5) To con1prOIill.Se claiI>ls. (6) 1~ distribute prope~ty in kind. Bond r 0 bond she1l1 be required of the Trustee appointed hereunder. Compensation y Trustee shall receive reasonable compensation for services rendere, to my estate during administration as determined by the Cuurt in which t,his Will i8 admitted to probate. .. F'OURTH _. .. EXECUTon . I I I dl?~oip..t my pa.n'llt~, RUS:':il.'l dIld ArIa rhth.:cling, u!: the:' surv~vo of tllC'n1, as Execulorf; of this lviII. In the event theJt my p:, rent:, ::;11' 11 ')[I'l:nl.:'-;'l~;e me or bc' un,lhlc C'1' unwillintJ to serve, [ Hd Wl:J!2 : ~n L00- 0t . 1 nr H:L86LL~0L 1: .ON XtJ.:l tJIQ3WIC:ld: WOC:l.:l ~~~ , .. 'I { No Bond Requi red ! No bond or other security shall be required of dny Executor appointe~ in this Will. Powers My Executor Bha.ll have, in extension and not in limitat:ion of t.he powen, given by law or by other prOVisions of this Will, the following powers wi th respect to the S(~ttlemenl and administration of my estate: I I i Sdme Powers As Trust.ee (rl ) To pxercise with regar~ to the probate est_ate ,oil 1 of the power.s and author.ity conferred by thi!; Will on the Trustee over the trust estate. Krnpl',)ym(~nt of l\ttocneY9, AdvisnT."s, and 0t,her Agents (bl 1'0 employ dny a't1:orney, i nVt:st:neIlt advisor, accountdnl, broker, tax specialist, or any other agent del~mF~d necessary by my Executor; and to pay from :ny (".-st.ate reasonable compensation for all services perform'O'd by any of them. Conduct Bus.iness (c) To conduct alone or with others any business i.n which I am engage or in which I have an interest at my death, with all the powers of owner with respect thereto, including the power to deh~g;lte d.i!:lcretionary duti(~s to others, to invest other prop'c'r ty held hereunder in such bu~ineS5 <loti t.o or.ganize a partnership or corporation to carry out such bU3iness. Distribution of Estate _. .-' (el) When paying legacic.~s or dividing or d.i.stribut.lnq my est:ate, to mab~ such payments, division or distl.-ibul'.lon wholly or partly in kind by allotting fJd LJ 01 Oln[ (1' Yf'1(-)/L~0/_ T: .ON Xtl..::l tlla3WICJd: WOCJ..::l Wtl8c:0T '."~';'\'.~il .~ ,~_l' \ ,;~ ',' '.:'1~~ . . it,. ~ I 'I. _u_ V~~'.~-~~'''''''''''J Ol'''".........L.I...... z:>et..:UI:.L1:1es or ol::ncr personal or real properties or undivided interests wherein as a paLl of the whole of anyone or more payments or share at cllrrent va IlleS l.n the manner deemed adviseable by r:JY Executot" . FIFTll GUARDIAN I appoint my parents, Russel and ArIa Mitterling, or the surviv r of t.he;.'>m, R':; Glurdian of the person of any child of mine who has no n!dched thp lige of twenty-one (21) years on ~he date of r.ty death. In th(~ event th:lt my parent!> shall predecease me, I appoint my sister, Danni.l M5t.to.rling, as Guardian. It is my specific and explici t. desire that neither my husband, Brild D. Grogan r nor my in-laws, ,John and Grelch~n Grogan, nonE' of whom have shown any inter- est in my ::;on, Kl~ith, up t.o the present time, he ap!Jointed GUiu:dian. IN W l'l'NESS WHEHEm>, I, KAY fil. GHOGAN, have hereby set my 1\ , hand to t.his my Last will and Testi;iment On this -,./ day of '(<{oi,)" i ' 1980, at Harrisburg, Penn~..ylv~illi<l. Signed, sealed. publ i~;hed and declare by KAY M. CHOGAN the above-n med Te9tat~ix, as and for her' Last Will and Tetita- ment, ill the presence of U6, who, at her request, in her presence, and in the presence of each other, have subscribed I) ~~r nam",,, a~ w; In)Su''r''' .!\ \ .'.j , . i --'lJ[~ <..... '!.ll.UI.L'>\ I " ! J' / {" . I -(.1 ,,~ :;..,L-----.:~.,<___.~_-__ADDRESS -.:.._~'?(':.:_ --r---.... --~ ____ p __ I I I , \ ../ '-, , J' :LjIq_~LL.j~ L~Kj1.:~ , KAY I1...: GROGAN ADDRESS '{J j- \ ) -- A \ . L....) . l :: (\ ~_, l.:J (,. - -, I , ) .-;. lUt \'J :)v~(: f LJ(~ . I ~1 & s- I (~-.: /[.'c 'I" /" , /1 . ' <'. . ..,J >,1 /; I '. ( ,/ ( l . I', /.; '.' ') ~_-L4a.._............ J..J:.....l... . 1~~---------"""" 01d WtlBc: 01 L00 01 . I Tlf IJD~B6LLf:0L T: "Qt.j Xtl~ tlIQ3WICJd: WDl'J-l COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INOIVIDUAl TAXES DEPT. 280601 HARRISBURG. PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT MITTERLlNG ARLA K 115 SKYLINE DRIVE MECHANICSBURG, PA 17050 -------- fold - - ESTATE INFORMATION: SSN: 210-40-1837 FILE NUMBER: 2106-0939 DECEDENT NAME: GROGAN KAY DATE OF PAYMENT: 08/27/2007 POSTMARK DATE: 08/24/2007 '" COUNTY: CUMBERLAND DA TE OF DEATH: 10/07/2006 NO. CD 008591 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $10,000.00 I I I I I " I I ., ... -, - ...... ........-..' i :.:' TOTAL AMOUNT PAID: ., -$10,000:00'-- : 'REMARKS: ARLA MITTERLlNG CHECK# 1033 ' . ,. : .... SEAL INITIALS: OM. RECEIVED BY: TAXPAYER GLENDA FARNER STRASBAUGH REGISTER OF WILLS CVlOUS ealilons ~re OOSOleLe Torm NUU.l \JIOo) reJ NBnoooOK 4"U::l.~ A Settlement Statement U.S. Department of Housing and Urban Development B Tvoe of Loan OMS Annroval No. 2502-0265 lexnlres 11/30/2009) 1. DFHA 2. DFmHA 3. DConv. Unins. I 6. File Number I 7. Loan Number I 8. Mortgage Insurence Case Number _4 OVA 5. DConv. Ins. PYFN07-127RCS 0044765451 c. Note: I, "IS arm IS lumlsnea..~a give you a s a emefll ~ ae ua 5elllemen cas s~_~~aun 5 pal I LO ano oy me sememen agen are sown. I, TitieExpress Settlement Syslem Items marked ~{p.o,c.)" were paid outside the closing; Ihey are shown here for fnlorma~lon purposes and ~re nollncluded In the lolals. WARN,ING: n j~ a crime 10 knOWIngly ':f1Bke false statements to the United Slales on Ihls or any olher similar form. Penallles upon Printed 07/19/2007 at 13:29 RLM conviclion can Include a fine and Imnrisonmenl. For details see: Tille 16 U. S. CodG Seellon 1001 and Seclion 1010. o NAME OF BORROWER: Judy Gwen Kochert ADDRESS: E NAME OF SELLER' Estate of Kay M. Grogan ADDRESS: F. NAME OF LENDER: ERA Home Loans ADDRESS: 3000 Leadenhall Road Mount Laurel NJ 08054 G. PROPERTY ADDRESS: 29 Court Lane, Carlisle, PA 17013 Carlisle Borouoh H. SETTLEMENT AGENT: Pyramid Land Transfer LLC, Telephone: 717-960-1122 Fax: 717-960-1123 - PLACE OF SETTLEMENT: 55 W. Church AVe. Carlisle PA 17013 I. SETTLEMENT DATE 07/20/2007 J. SUMMARY OF BORROWER'S TRANSACTION: K. SUMMARY OF SELLER'S TRANSACTION: 100. GROSS AMOUNT DUE FROM BORROWER 400. GROSS AMOUNT DUE TO SELLER 101. Contract sales nrica 158 000.00 401. Conlracl sales orice 158000.00 102. Personal Prooertv 402. Personal Pronertv 103. Selllement ehames to borrower (line 1400\ 5 929.71 403. 104. 404. 105. 405. Adiustments far lIems aaid bv seller in advance Adiustments for Items oaid bv seller in advance 107 Count v taxes 07/20/071012/31/07 364.72 407. Counlv taxes 07/20/071012131/07 364.72 109. 409. 110 410. - 111. 411. - 112. 412. 120. GROSS AMOUNT DUE FROM BORROWER 164 294.43 420. GROSS AMOUNT DUE TO SELLER 158364.72 200. AMOUNTS PAID BY OR ON BEHALF OF BORROWER 500. REDUCTIONS IN AMOUNT DUE TO SELLER - 201. Deoosit Dr earnesl monev 2000.00 501. Excess Denosit Isee instruclionsl 202. Prineieal amount 01 new loans 150 100.00 502. Selllement charnes 10 seller lIine 1400\ 13327.21 203. Exislino loan/sl laken sub'ecl to 503. Existinn loanlsl taken subiecllo 204. 504. Pavofl 01 First Mortqane Loan 74 040.26 ERA Mortnane __205. 505. 206. 506. 207. 507. 208. 508. 209. 509. Adjustments for items unoaid bv seller Adiustments for items unllaid bv seller 212. School Taxes 07/01/07 to 07/20/07 96.62 512. School Taxes 07/01/071007/20/07 96.62 213. 513. 214. 514. 215. 515. 216. 516. 217. 517. 1218. 518. 219. 519. 220. TOTAL PAID BY/FOR BORROWER 152 196.62 520. TOTAL REDUCTION AMOUNT DUE SELLER 87 464.09 300. CASH AT SETTLEMENT FROM OR TO BORROWER 600. CASH AT SETTLEMENT TO OR FROM SELLER 301. Gross amount due lrom borrower IIine 120\ 164 294.43 601. Gross amount due 10 seller (line 420\ 158364.72 302. Less amounls naid bvllor borrower lline 220\ 152 196.62 602. Less reduction amount due selier lIine 520\ 87 464.09 . 303. CASH FROM BORROWER 12097.81 603. CASH TO SELLER 70 900.63 SUBSTITUTE FORM 1099 SELLER STATEMENT: The In'ormallon cool~lned herein Is Impor1ant tax Inlon:nallon and is being furnished 10 Ihe Internal ReVt!!nue Service. If you are requtred to flle a return. ~n~'~rar:;;v~=~i~I~:I~e ~~~~~~"b:d~mJ:~~dl:'~~IiI~~~IS lIem IS required to be reported and Ihe ,J/1S determines lhall! has nol been reported. The Contract Sales Price desoobed on ~;~~~ I~~~~~~~~?~:~rl~ _~/~~ :~~:~ ;':~~~~f~~J:' ~~I:~,~6n:~;~ o~11~' Sale or EXchange,;~f Principal Residence, for any gain. wllh your Income lax return; for olher transactions, ~~~~;. ~~dy b~el~~~~~~ovl~~II~ :~~'::t~~~~~~ V=me:,:eadK ~~I~~~ Under penaltIes of p~~:~~ j~~;II~~~~II~::~b~~~~~~I~~th~~~~~~l~sd~~td:r~~:i:a;~;I~~~~ri~=~~~cauon TIN: SELLER(S) SIGNATUREIS): SElLER(S) NEW MAILING ADDRESS: "VlQUS eOlllons are oOSOlele - , lis DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT T File Number: PYFN07-127 form MUU~' 1;Jf"ti) ref N8nODDU", "t,JUlJ.":: PAGE 2 SETTLEMENT STATEMEN TilleExnress SeUlemenl Svslem Printed 07119/2007 at 13:29 RLM L. SETTLEMENT CHARGES PAID FROM PAID FROM 700 TOTAL SALES/BROKER'S COMMISSION based on orice $158 000.00 @ 7.000 = 11060.00 BORROWER'S SELLER'S Divisicn 01 commission nine 700\ as lollows: FUNDS AT fUNDS AT 701. $ 11 060.00 to ERA-NRT Inc. SETTLEMENT SETTLEMENT - 702. $ 10 703. Commission oaid al Seltlement 11 060.00 704. Transaction Fee to ERA-NRT Inc. 165,00 165.00 BOO. ITEMS PAYABLE IN CONNECTION WITH LOAN 601. Loan Onainalian Fee % 802. Loan Discount % 803. Annraisal Fee to STARS (P.O.C.\ 275.00 Buver LR 804. Credll RenDrt to FNMA CBC IP.0.C.119.95 Buver LR 805. Aoolication Fee \0 ERA Home Loans tP.O.C.! 500.00 Buver 806. Flood Cert 10 STARS (P.O.C.\ 19.50 Buver 807 Doc Preo \0 ERA Home Loans (P.0.C.185.00 Buver 808 809. 810. 811. 900.ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interesl From 07/20/2007 to 08/01/2007 @$ 30.9800 /dav 12 Davs LR 371.76 902. Mortnane Insurance Premium for tD 903. Hazard Insurance Premium fDr to 904. 905. 1000. RESERVES DEPOSITED WITH LENDER FOR 1001. Hazard Insurance mo. @$ /mo 1002 Mortnane Insurance mo. @ $ /mo 1003. Cilv Prooertv Tax mD. @$ /mo 1004. Counlv Pronertv Tax 7 mo. @ $ 73.96 /mo 517.72 1005. School Taxes 13 mo. @ $ 155.10/mo 2.016.30 I: 1009. Anorenate Anatvsis Muslment tD ERA Home Loans -443.75 1100, TITLE CHARGES 1--1101. Setllement Dr c10sinn fee 1102. Abslract or tille search 1103. Title examinallon 1104. Title insurance binder 1105. Document PrenaratiDnlDeed ID Said Is, Flower & Lindsav POC 1106. Nolarv Fees 10 pvramid Land Transfer LLC 22.00 10.00 1107. Allornev's fees 10 Saidis Flower & Lindsav POC /inciudes abDve ilems ND: \ 1108. Title Insurance to Pvramid Land Transfer. LLC 1 033.88 /includes above items No: \ 1109. Lender's Polic" 150100.00 - 1110. Owner's Policv 158 000.00 - 1 033.88 1111 End 100 End 300 End 810 OwnlD Pvramid Land Transfer LLC 200.00 - 1112. Documenl Relrieval Fee 10 Pvramid Land Transfer LLC 50.00 1113. ClosinoSvcLlr \0 pvramid Land Transfer LLC 35.00 1200, GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recordino Fees Deed $ 38.50 . Mortoaae $ 76.50 . Release $ 115.00 1202. Cilv/Counlv lax/slamos Deed $1 580,00 . Mortoaoe $ 1 580.00 1203. Slale T ax/slamns Deed $1 580.00 . Mortnane $ 1 580.00 1204. 1205. 1300. ADDITIONAL SETTLEMENT CHARGES 1301. Survev 1302. Warranlv to AHS 385.00 1303. Wire Transfer Fee to Pvramid Land Transfer LLC 10.00 1304. Overninht Pkn/Pavoll to pvramid Land Transfer LLC 20.00 20.00 1305. Resale Cert 10 COC UOA 50.00 1306. Initiation Fee \0 COC UOA 236.80 1307. Julv Dues to COC UOA 38.35 1308. Final Waler/Sewer #3774 10 Carlisle Borouah 18.86 1400. TOTAL SETTLEMENT CHARGES lenter on lines 103 Section J and 502 Section K\ 5 929.71 13327.21 Hun CERTifiCATION OF BUYER AND SELLER inh~~: ~:~~~~B~~vil~~~~~~~e~~~~a~f~~II~~~~;I~~r:c~:yn~r tl~~hl~~O~\ ~~re=ls1:I~~~~~el1ef, 1119 B true and accurate slatement or all recelpls and disbursements made on my account or by me ,,~.~'7<ocMd: ~C.~ I~~ c".,eO"ay~ ~ ~ "" - G~ WARNING: IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE UNITED STATES ON THIS OR ANY SIMILAR FORM. PENALTIES UPON CONVICTION CAN INCLUOE A FINE AND IMPRISONMENT. FOR DETAILS SEE TITLE 18: U.S, CODE SECTION 1001 AND SECTION 1010. The HUD-1 SetUemenl Statement wtllch I have prepared Is a true and accurate act:ount of this transBcUon. o~';;;;I~e~~.~.~(~'?:n~ ~1~ MEMBERS 1st FEDERAL CREDIT UNION 'AUG 1 6 2007 PRIMARY OWNER:Keith A. Grogan REGULAR SAVINGS ACCOUNT: Account Number/Suffix 102363-00 Date Account Established 06/09/1988 Principal Balance at Date of Death $33,426.04 Accrued Interest to Date or Death $5.23 Total Principal and Accrued Interest to Date of Death $33,431.27 Name of Joint Owner None Date Joint Ownership Established 103978-00 08/18/1988 $961.45 $.24 $961.69 Kay M. Grogan 08/18/1988 CHECKING ACCOUNT: Account Number/Suffix 102363-11 Date Account Established 06/09/1988 Principal Balance at Date of Death $121.45 Accrued Interest to Date of Death $.00 Total Principal and Accrued Interest to Date of Death $121.45 Name of Joint Owner None CERTIFICATES OF DEPOSIT: Account Number/Suffix 102363-46 Date Account Established 04/21/2006* Principal Balance at Date of Death $2,044.07 Accrued Interest to Date of Death $1.64 Total Principal and Accrued Interest to Date of Death $2,045.71 Name of Joint Owner None *Purchased by transfer of funds from 102363-00. CERTIFICATES OF DEPOSIT: Account Number/Suffix 102363-47 Date Account Established 06/29/2006* Principal Balance at Date of Death $9,026.45 Accrued Interest to Date of Death $4.82 Total Principal and Accrued Interest to Date of Death $9,031.27 Name of Joint Owner Keith A. Grogan Date Joint Ownership Established 06/29/2006 *Purchased by transfer of funds from 102363-00. M~RA:~\Uh~ Danielle A. Kline Insurance Services Specialist August 14, 2007 Estate of: KAY M. GROGAN Date of Death: October 7,2006 Social Security Number: 210-40-1837 5000 Louise Drive. P.o. Box 40 · Mechanicsburg, Pennsylvania 17055 . (717) 697-1161 · www.members1st.org !r~~ ~,~i p[ ~l[ n~ 'U...'fi<" h ~.~ <<ll !i !i ~~~:~:F:;gmj !.~ ~" My~Mg~~t;ill"P~" ;:~ I ..~I-...~.I~B~~,~ lr- ~i q~:S-m~;U"','~;~H-~:Hfijn);' i.~ ~. ~ f~g~U'g~~f~rUjli ~ II ~I I ~ I .,; i it}! ~ · ~ ~,. i,i. i """ 'I}M~~~~^,7~wr,_-:~:7'7$'i~"Ti<~_:~>J!1I1P,!{:;_'~~~~~'JiA"'r",;;,;.'f1!1In~1"'~~~:~':~~~"-.;.~I:1Htt"",':::mY:~.t::;trom'(,_-).'k'f, ~? :~ It ~l . ~ !J i ;;] ~ ~ H ., ~:. l' \i1 ~- !l ; ~ ~f, , f ~i I " g '[2 5 l'~ c ~ ~2 ~ '. ~ m '! ~F. [~ I R ~ ,i/ g Ii ~ ;l ~ ~ g m ~ ~ ~Ii, ~ G m rn ~ " < r, ~ aa;;1 i~',~ ~11f. ~ ~,,, g:~~ ~. ~lt: r~ L i"::"=i i!~ 8 ~'... ~a ij" .....1 1: ifl H ~~ ~~ f,ji I I I I tJ tti ,,,, ,J> ,0' r- m. I"li I'~'-^- ':~<'.'i~ I) ::r:LlJ-iC .Jl>lI":lD.Jl> ;JCIClC:;C:: :iIIl-.lVl'\1 ~ -i::r: lIlQ ;..t OlmMZ C:::iIIlC :iIIl:illl 0 (1')< m ~ o lJl ....C1 -i/J't 4:: \';llLlJ Jl>0> z.... ;lI: ;n " ID ~ ;: n\: ~ ,..-'m'm ~ !Tl'VJ btJ r~ l.niO 1:IZ'''' ;aoo)>:)> ;z ..... VI; ....""i D .... IoU l:-'l' ~ ~ v -~ ~:- m ,-y Iii ...a:, tr'~ .... VI "c:l Q ~ ,~ z r: S:3 ~ :a ~i tl tr ..... ;c rt1 ~ 3: "I LM D in Q- LM ""i )> IT' tr' nd m ~ m ()I Q m '0 Q VI H ""i ~ ". Z .I'l ---IiI ~ . ~1 t:J~ 1:1 VI Jl>""i .... -.l .... .... .... "" ~ ~ Ii ~ ~ ~ ~ < ~ ...a x D""' " ~ "' i5 ?i 3: III g 1:" > ~ ~ 0 ~ c:: "U ....... 0 :0 @f3~< ~ :a ~ u' "" ~. ~ ~ ~ 11 n . ~ ~ (,", C> 0 ---- O:J ~l' g c:i 5j -:-Q CI Ul E l::l t:l ~! .... Cl t:;I -, u:o " ~ "" " I'IJ ~.~ ili " g ~ I.tI ~ ~ ~ Ir' M if. jj .. rl, 0.. f ~ I 2.i I::J c::l :7, ..... VI ::li' ",,~Ii~ ,;"[iR':;' :4fllt'!~JL~:"';.-.~k-;~~,'-:.E!i.!1m. ;;; I~ 1= ! .i=:?:..L......___~__L , ;, I''" , ,,- ",:,.,,~ ,i ~!: ~~ ; I;~ ;\,', <::. C" C>;1 I~~ i ,',. ~q. 0./ C) il) I t/:. :0 ';;....~.. ,'," I, : fi',J :~ :i~ ~ n I~ >.~.",.:i. ~~I' It. ,~, . I ' ,;0 .l\ll ~ If " ~ ~ ",) hI 'I if" ~? (: 1\ \ :"?I' iG'1 " ~('. J:: 'I \'.I;'! .1 ..1 r '. I .1' ".. '. "'i' ..1 I i-:r. I; I~ \U, ..: i ~..'.I!..i....i...... \.I'..ffi.I...,......I... ..1. !...t-.." i~.il.j.,ur ~ ...a IT' ru I.tI I.tI CI c:l lJ'1 tr' CI t:J .... UJ J::: W tb Cl ..... n 111 ::0 ::j 'TI 00 '" ~~ 111:! o~ 'TIZ -i -10 _"TI -f-i r" fTI~ 'TI!G 00 " ::OJ;! )>:2 o <z 111 :r - n r fTI Kelley Blue Book - Trade-In Pricing Report - Mercury, Sable Page 1 of3 .. Kelley 1111 Book .... .. 'H' Dumo 10iQJV&CE. It . . . "ia. advertisement Search Used Car listings Lis1 Quick Dealer Price Quote USED CARS 1:iQme > ~ > 1296 > Merum' > Sable > ~D_~Q > Equipment COMPARE CARS REV!EV'.'S &. RIi,T!t>JGS CLASSIFIEDS FINANe! 1996 Mercury Sable G Sedan 40 Trade-In Value Private Party Value Suggested Retail Value Photo Gallery Compare Vehicles NltW! Blue Book Review Consumer Ratings Find Your Next Car Specifications a Shopping Tools Free CAR FAX Record Check Auto Loan from 6.19% APR Compare Insurance Rates Payment Calculator SEll YOUR USE D CAR on Blue Book Classlfleds~ Reach millions of shoppers on kbb.com, Cars.com, and other popular sites. Find out more, Click BUY It USED CAR on Blue Book Classifleds~ 1t:1_~r.c:u.ry__._____!.II I~~_~------_. I~.~...~!I.:.~..?~.!:~~....._. ZIP Code 11?01}) To View Ads, Click FIND THE RIGHi CAR Compare Used vs. New I.~~.d._:~..~.~!~~~......___._.... BLUE BOOKS TRADE-IN VAlUE (WHAT'S THIS? Condition (WHAT'S THIS? Value Excellent Good $1,000 $800 $510 Fair NEXT STEPS: Get PriCing on New Vehicles Sell Your Sedan Average Consumer Rating (30 Reviews) Read Reviews .*..t? 4.4 out of 5 Review This Vehicle Similar New Vehicles 2008 Mercury Sable 2008 DOdge Avenger Photos ~ Priclne E!J.QtQJ; Eril:ln.il T" ......... 0 ~T T1 11"\ n /1 n ,,..,f\rV7 Kelley Blue Book - Trade-In Pricing Report - Mercury, Sable I~..o_~.,~=-~:.?J. I~:.~.a.~_"__. To View List, Click rlEW ANOTHER VEHICLE I.~~..::~.'::::JII I~~JII I.~_:!ect Model.::JII Or Search by Category Or Change ZIP Code More Results >> . 2008 Toyota Camry 2007 Honda Civic 2007 Nlssan Altlma 2007 Toyota Yarls 2008 Volkswagen letta 2007 Honda Accord 2008 Toyota Corolla 2008 Mazda MAZDA3 2008 Acura TL 2008 Toyota Avalon Vehicle Highlights Mileage: Engine: Transmission: Drivetrain: 115,500 V6 3.0 Liter Automatic FWD Selected Equipment Change Equipment Standard Air Conditioning Power Steering Power Windows Tilt Wheel AM/FM Stereo Dual Front Air Bags Blue Book Trade-In Value Trade-in Value is what consumers can expect to receive from a dealer for a trade-in vehicle assuming an accurate appraisal of condition. This value will likely be less than the Private Party Value. because the reselling dealer incurs the cost of safety Inspections, reconditioning and other costs of doing business. Vehicle Condition Ratings Check Vehicle Title History Excellent aar:JaD $1,000 "Excellent" condition means that the vehicle looks new, is in excellent mechanical condition and needs no reconditioning. This vehicle has never had any paint or body work and Is free of rust. The vehicle has a clean title history and will pass a smog and safety inspection. The engine compartment Is clean, with no fluid leaks and is free of any wear or visible defects. The vehicle also has complete and verifiable service records. Less than 5% of all used vehicles fall into this category. Good arXDLl $800 "Good" condition means that the vehicle is free of any major defects. This vehicle has a clean title history, the paint, body and interior have only minor (If any) blemishes, and there are no Page 2 of3 iI Finane Get a New ( Get a Pre-O APR Your Credit Get a Free I n /1" ,^^",..., Kelley Blue Book - Trade-In Pricing Report - Mercury, Sable major mechanical problems. There should be little or no rust on this vehicle. The tires match and have substantial tread wear left. A "good" vehicle will need some reconditioning to be sold at retail. Most consumer owned vehicles fall into this category. Fair DtD':."I::~ $510 Page 3 of3 N/A RSS l1li About Us "Fair" condition means that the vehicle has some mechanical or cosmetic defects and needs servicing but Is still in reasonable running condition. This vehicle has a clean title history, the paint, body and/or interior need work performed by a professional. The tires may need to be replaced. There may be some repairable rust damage. Poor m;y.w~w.l "Poor" condition means that the vehicle has severe mechanical and/or cosmetic defects and is in poor running condition. The vehicle may have problems that cannot be readily fixed such as a damaged frame or a rusted-through body. A vehicle with a branded title (salvage, ~ood, etc.) or unsubstantiated mileage Is considered "poor." A vehicle In poor condition may require an Independent appraisal to determine its value. Kelley Blue Book does not attempt to report a value on a "poor" vehicle because the value of cars in this category varies greatly. * Pennsylvania 8/10/2007 Accurate Condition Appraisal Change Condition Accurately appraising the condition of a vehicle Is an Important aspect In determining Its Blue Book value. Taking our 16 question condition quiz will ensure you know the correct condition rating. NEXT STEPS: Get Pricing on New Vehicles Sell Your Sedan @ 2007 Kelley Blue Book Co., Inc. All rights reserved. May-Aug 2007 Edition. The speCific information required to determine the value for this particular vehicle was supplied by the person generating this report. Vehicle valuations are opinions and may vary from vehicle to vehicle. Actual valuations will vary based upon market conditions, spedfications, vehicle condition or other particular circumstances pertinent to this particular vehicle or the transaction or the parties to the transaction. This report is intended for the individual use of the person generating this report oniy and shall not be sold or transmitted to another party. Kelley Blue Book assumes no responsibility for errors or omissions. (v.0707B) I=fiI' Emall This Page Careers FAQ Advertising Buy the Book Contact Us 51te Map Media Center Privacy Policy Copyright & Trademarks @ 1995-2007 Kelley Blue Book Co., Inc. n 11 ^ ,"'^^,.., f'PitllJliW Holy Spirit Hospital Retirement Savings Statement October 1, 2006 - December 31, 2006 ENVtf:40011533 405894073116 D KAY M. GROGAN 1793 CESSNA STREET CARLISLE, PA 17013-1188 ~ For online access, log on at: http://www.fidelity.com/atwork For information, call: (800) 343-0860 Your Account Summaiy Beginning Balance Transfer Out Change in Account Value Ending Balance $153,979.78 -159,926.58 5,946.80 $0.00 Your Personal Rate of Return This Period 3.9% Year to Date 8.7% Your Personal Rate of Return is calculated with a time-weighted formula, widely used by financial analysts to calculate investment earnings. It reflects the results of your investment selections as well as any activity in the plan account(s) shown. There are other Personal Rate of Return formulas used that may yield different results. Remember that past performance is no guarantee of future results. Account Value This section displays the value of your account for the period, in both shares and.dollars. Investment Shares on 09/30/2006 Shares on Price on Price on 12/31/2006 09/30/200612/31/2006 Market Value on 09/30/2006 Market Value on 12/31/2006 Blended Investments. Fid Freedom 2010 10,619.295 0.000 $14.50 $14.62 $153,979.78 153,979.78 $0.00 0.00 Remember that a dividend payment to fund shareholders reduces the share price of the fund, so a decrease in the share price for the statement period does not necessarily reflect lower fund performance. . Some of your investments are classified as a Blended Investment. Blended Investments may include a mixture of stocks, bonds, and/or short term assets. Please refer to the "Additional Investment Information" section to determine the allocation of your blended investments' underlying assets. The asset breakdown of your portfolio is reflected in the pie chart in the "Asset Allocation" section. Please read this statement carefully. Any error must be reported to Fidelity Investments within 90 days. 11533 40011533 0001 20070109 403B Fidelity Investments, P.O. Box 770002, Cincinnati, OH 45277-0090 Page 1 of 7