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Home My WebLink About01-0286IN RE: IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PETITION OF PENNSYLVANIA MARSHALL MARLIN MINICH ORPHAN'S COURT DIVISION (ISSUANCE OF BIRTH RECORD) NO. 2001 - •Z$6 REE OF BIRTH RECORD AND NOW, this day of March, 2001, upon consideration of the within Petition for Issuance of Birth Record, and hearing, it is ordered and decreed that: This Decree shall constitute a temporary birth record for Marshall Marlin Minich of North Middleton Township (231 North Middleton Road, Carlisle, PA 17013), Cumberland County, Pennsylvania, a male citizen of the United States of America, born September 22, 1946 at Carlisle Hospital, in Cumberland County, Pennsylvania to Nelson Leroy Minich and Kathleen May Arnold (maiden name), husband and wife, both residents at that time of Cumberland County, Pennsylvania. This temporary birth record shall be valid for six (6) months from the date hereof, with leave to Petitioner for further appeal for the issuance of a permanent birth record by the Bureau of Vital Statistics of the Commonwealth of Pennsylvania. By the Court: J. IN RE: PETITION OF MARSHALL MARLIN MINICH (ISSUANCE OF BIRTH RECORD) IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHAN'S COURT DIVISION NO. 2001 - PETITION FOR ISSUANCE OF BIRTH RECORD AND NOW, comes Marshall Marlin Minich, by this attorney, Stephen D. Tiley, Esquire, and files this Petition for Issuance of Birth Record of which the following is a statement: 1) Petitioner is Marshall Marlin Minich an adult individual of North Middleton Township (231 North Middleton Road, Carlisle, PA 17013), Cumberland County, Pennsylvania. 2) Petitioner was born on September 22, 1946 at Carlisle Hospital, in Cumberland County, Pennsylvania to Nelson Leroy Minich and Kathleen May Arnold (maiden name), husband and wife, both residents at that time of Cumberland County, Pennsylvania. 3) Petitioner is a male citizen of the United States of America. 4) Petitioner has lived all of his life in Cumberland County, Pennsylvania. 5) As of approximately 10 years ago Petitioner had a copy of a birth certificate issued by the Commonwealth of Pennsylvania but that copy has been lost or destroyed. 6) Petitioner recollects that the date of birth shown on the said birth certificate was wrong, but Petitioner does not know what wrong date it showed nor even whether the month, day, or year shown, or some combination of them, was wrong. Petition for Issuance of Birth Record for Marshall Marlin Minich Page 7 of 4 7) Petitioner does not have, has never had, and has never applied for a United State of America passport. 8) Petitioner has prepaid for a cruise to leave from Florida this Sunday, March 18, 2001. 9) In the absence of a passport, Petitioner is required to provide a certified copy of a birth certificate in order to be boarded on the cruise ship. 10) Petitioner made extensive searches for the missing birth certificate but has been unable to locate it. 11) Petitioner then attempted to obtain a copy of his birth certificate from the Division of Vital Statistics of the Pennsylvania Department of Health however it have found no record of Petitioner's birth as evidenced by the original sealed "Certificate of No Record" attached hereto as Exhibit "A" and incorporated herein by reference thereto. 12) The Division of Vital Statistics relayed to the wife of Petitioner that they can only search for birth records by birth date and that they cannot search for birth records by name of the individual or his or her parents names. The Division of Vital Statistics relayed to counsel for Petitioner that they can search by mother's maiden name and that they would have done so before issuing the "Certificate of No Record" and that therefore there is no record for this individual. 13) The Division of Vital Statistics relayed to counsel for Petitioner that they can search by mother's maiden name and that they would have done so before issuing the "Certificate of No Record" and that therefore there is no record for this individual. 14) A copy of the baptismal certificate for Marshall Marlin Minich is attached hereto as Exhibit "B" and incorporated herein by reference thereto. The said Petition for Issuance of Birth Record for Marshall Marlin Minich Page 2 of 4 baptismal certificate is signed by the pastor of Waggner's Brick Church (a/k/a Waggner's United Methodist Church) and shows that Marshall Marlin Minich was born September 22, 1946 in Cumberland County, Pennsylvania, to Nelson L. Minich and his wife Kathleen M. Minich. 15) Petitioner Marshall Marlin Minich and Constance Maureen Coyle were married on July 25, 1965. Their marriage license was issued by the Cumberland County, Pennsylvania Register of Wills Office and a copy of the application therefore is attached hereto as Exhibit "C" and incorporated herein by reference thereto. The application shows the date of birth for Marshall Marlin Minich to be September 22, 1946. Since the Petitioner was a minor at the time that the marriage license was obtained, parental consent to the marriage was required and was signed by Petitioner's mother, Kathleen M. Minich. 16) A copy of the Petitioner's original social security card and a social security record printout sheet is attached hereto as Exhibit "D" and incorporated herein by reference thereto. The said social security record shows that Marshall Marlin Minich was born September 22, 1946 in Carlisle, Cumberland County, Pennsylvania to Kathleen May Arnold and Nelson Leroy Minich. 17) A copy of Petitioner's original Pennsylvania Liquor Control Board photo ID showing his birth date of September 22, 1946 is attached hereto as Exhibit "E." 18) A copy of the obituary published in The Carlisle Sentinel (framed with a border) for the Petitioner's mother is attached hereto as Exhibit "F" and incorporated herein by reference thereto. The said obituary shows that Petitioner's mother died on April 22, 1990 survived by her son Marshall. 19) The Last Will and Testament of Petitioner's mother, Kathleen M. Minich was filed for probate in the Office of the Register of Wills in and for Cumberland County, Pennsylvania, to estate file number 21-90-606 and said Will provides that her residuary estate be distributed first to her surviving spouse and if he failed to survive her then divided between her two sons, one of which is named Marshall M. Minich. Petition for Issuance of Birth Record for Marshall Marlin Minich Page 3 of 4 20) An affidavit of Petitioner's father, Nelson Leroy Minich, is attached hereto as Exhibit "G" and is incorporated herein by reference thereto. 20) The Court of Common Pleas of Cumberland County, Pennsylvania, Orphan's Court Division, has jurisdiction to hear and determine this matter pursuant to 20 Pa.C.S.A. §711(9) which provides for such jurisdiction in regard to all proceedings which may be necessary with regard to issues concerning recordation of birth and birth records, appeals from the action of the Department of Health in connection with any matters concerning birth records, and for all other matters addressed to a court in connection with matters of birth records. WHEREFORE, Petitioner prays your Honorable Court for a Decree of Birth Record showing Marshall Marlin Minich to have been born in Carlisle, Pennsylvania on September 22, 1946, and such other and further relief as the Court may deem just and proper. Respectfully Submitted, Date: March 14, 2001 ~ r Stephen D. Tiley, Esquire 5 South Hanover Street Carlisle, PA 17013 717-243-5838 Supreme Court ID# 32318 VERIFICATION I, Marshall Marlin Minich, depose and say that I am the Petitioner in the above matter; and that the facts set forth in the foregoing Petition for Issuance of Birth Record are true and correct based partly upon personal knowledge and the remainder upon information and belief. I understand that this Verification is made subject to the penalties of 18 Pa.C.S.A. §4904, relating to unsworn falsification to authorities. Date: March 14, 2001 Marshall Marlin inich Petition for Issuance of Birth Record for Marshall Martin Minich Page 4 of 4 HBG D~ARTMENT4F HEALTH ... in pursuit of good health 210788 M~ ° pC~f~0~3~ 6g6~p01~II6W4-0~1 Name at Birth MARSHALL MARLIN MINICH First Middle Last NELSON LEROY MINICH Father's Name First Middle Last Mother's Maiden Name KATHLEEN M ARNOLD Place of Birth Date of Birth First CARLISLE City, Borough, Township 09-22-1946 Middle Last Pennsylvania CUMBERLAND County Robert S. Zi erma , Jr., MPH Secretary of Hea 03-08-2001 Date Issued Charles Hardester State Registrar If you had planned to use a birth record for official purposes, you should take this certificate to that agency and ask what evidence will be accepted as proof of age. WARNING: It is illegal to duplicate this copy by photostat or photograph. Division of Vital Recordsi •~ _ P.O. Box 1528 _ ~ • ~ New Castle, PA 16103-1528 HD 1056E REV. 09/00 a ~ ~•' ' ~ u y ~: r i! ~' ~ ~ `~ ,~~ ~ ~ ~ A ~'~ ~ ~ ~~ ~ .~; ~• \ ~ . v~ ~~ T~ ~ ~ ~ f~~' ~~ ~ ~ yr+ ~{ ~ ~ -~ ?~ .~, ~~ ~ ~ ~;~~~ .N ~~~ ~ ~' - ~ '~ ,~ ~ ~ ~ +..~ . ~, .~ ~ :~ GUUN'I'Y OF CUMIIIiitLA~OU Marriage Liee4tae APPlbation 1. COUNTY ISSUCIO LICPNSE +. OPFICIANT: __CUMH6RLAND ,t_N,t~ -JOhn R, Shafer CE OP MARRIAGE IClty. Horovak. 7owmhlp) ICountyl ---- ' R ~, _# 3, CarlislJPenna,____ Cu_tnb.__-.___ e._rtnE_ Minister s. DwrE or MARxucE (Month. Der. Ynq - - ---- --. 4G3 , - __ STATEMENT OF MALE ... .,a,.~,n,n..r.vn ------ STATEMENT OF FEMALE 6. ~~ ~ i~arshall Marlin Minich 2T. FULL NAME Constance Maureen Coyle e. MAILWO ADDRESS R, D. # 2, Carlisle Pa Yt. MAILING ADDRESS -__. _______-..__.___ _ _ _ -___ 21 North Hanover St, Carlisle 7. A. STATE H. COUNTY Rr, eOR(1G1• yOWNSNIP Pa, Cumb North Ml a On T 79. A. BTATE B. COUNTY C. C71'Y. HOROVCH. TOWNSHIP , B. OCCUPATION wp, pa, Cumb, Carlisle --~-- -_ Truck Driver a RACE White >0. OCCUPATION - ~ 1 71 RACE-~ ~- -- __ - -- -- Unemployed White 7q~ DATE OF BIRTH ltl Sept, 22 1946 It'C3='~`ig~e _ - 7-• DATE OF HDITx - - - _ YY. HIIfTHPL _.__ ACL _ 16 June 6 1949 1 Carlisle IY A. NUMBER ( OF PRIOR Q _ _ _ 128. HOW AND WHRI DISSOLVED ~ 71A. NUMBER - ~ ~ 7+B. HOW AND - - WHEN DISSOLVED -- _-___MARRIAGES - G I 17. CAVSEISI IF DVORCE _. _ D MARRIAGES - 75. CAUSEISI IF DIVORCED - .-. ._ I+. DOES APPLICANT HAVE ANY TRANSMISSIBLE IIISEA54i 1, YES....._.....__ NO..__.____ __.__ -'- '-- --'-'------------ ~ ~ _ - __ ..._ Ye. DOES APPLICANT HAVF. ANY TRANSNISSIBL~DISEASEf __ IS. FATHER'S TOLL NAME .... - - _ - _ Nelson L. Minich ' -- _ YER_......._.._ NO......____.. - ... .... .... .. _ T. TA EA'S FULL NAME Ra~ph H. Coyle • DF~reaCarlisle, Pa, - ~ __ u. r Ea•s RrsmENCa ~~ North Hano St n. rwrHVUS HmrxPUCE _ _ Carlisle, Pa, ver , Carlisle, Pa, - ---- ~---- ---._-.__.. _..-_ .- -- se. FATHER's amnmwcE -- ------- - - ' - .... .. _ - - Craighead 1D. FATHER E OCCUPATION Coal & EXE:CUV atlnCJ n 1V/jI1tE .B MCE - __ .. -_ ._ - ___.. +0. PATHEA'S OCCUPATION -._ _ _ +1 FATHCA'S RACE ----- ----- - -- ---- ' - - _ Middletown Air Depot I White Y0. MOTHER S TVLL NAME Kathleen Mae Minich - -. -. -. _.-- _--- _ +Y. MOTHER'S rDLL xAME _. _. _. _._ ----------------- -_ ' Genevieve A, Coyle YI. MOTHER S MAIDEN RAME Arn01(j - - - - - .. _ .__ _.__-._.___._______ .___. _._____ U. MOTHER'S MAIDEN NAME ---~ --- - _ _ Dosh - -- --- YY. MOTHER'S RESIDENCE ~ ~ R, D, # 2, Carlisle, Pa, N. MOTHlR'8 RCSIDENCE - - ~ -- - ss. Morxea•s amTxel,ACE -_ _ - 21 North Hanover St, Carlisle - _... __.. ._-. .. -.- _-- _ _ Carlisle . +s. MoT•xra•s am7TrnLACs ____-____. Carlisle Y+. MOTNER,S OCCUPATION I Housewife ?S. MoTxEi}•s RACC White _ u. MOTHERS OCCVPATAON ---- - +7. MOTNIX'S RACC Housewife White YS. DOES APPLICANT SATISFY AL(, PROVISIONS :R PENN~YLVANG'B MARRIAGE LAWf (Eee euestbna In front of doekeV YE6 _ _ _ __ Y. DOE8 APPLICANT SAT[STY ALL PAOV7810N8 D7 PENNXR,VANIA'8 MARRIAOIj ___.,.~ NO_.______ WW9 ISee eundonr N front o! docket) Ya8__..____ ND.._~._, We, the undersigned, each of w do solemnly ewesr the facts set forth make application to the Clerk of Oryltam' Court of Cumbe l d C t are true and correct to the bert of our knowledge and belief and do hereby r an oun y, P i . ~ ~ s ennsylvtn4, for Iteelw to m atty. Signature o[ Male Applicant ~~~~~~~~~~~~~~~~~~~~~-~~~~_ Signature of Female Applicant- Sworn and subscribed l0 6eforc me this ......... . PRE RITA~J R ILEA, ~ ..... . da of ~ , ~al~- D .....__. _. ...._ 4- C7v.-(~-'. _. _......._ ..... .. ...... Aulstant Cl k Clerk o rpha Court • er My Commixlon Expires 1st Mon, ...................................... Ja 1966 ....................................... Consent to the Marriage .............. of a Child or Ward f Kathleen M. Minich ........................................R......D. # 2 Residing at ................................................ ...................................................................................... .Carlisle, Pa, ... Do hereby certify that I am the ~'Yt~, Mother, IXZk7f~A(M7iC of Marshall Marlin Minich ............................................... ........................................................................................................ Residing at ..................._R. D. # 2 ..........................................Carlisle, Pa. Who ~ now ...~8..._..... Years cf age. I have been Informed o[ (his -!~ Intended marrtege le .Constance Maureen Coyle . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . And hereby consent to sold marrisg ~ e 7 Signature u..i... .'.....i....... .. z:.t:'-F. ~.~ YI ?Zf, ~.._. ...................... Witness ............. Witness Given before me this 19th day oE___~ulY Ia 65 .. _._ c .. ......... Clerk rp Covrt I Genevieve A, Coyle Residing ae 21 N, Hanover St, Carlisle, Pa, Do herc6y certify that I am the (IDit67F, Mother, >~fatxgaM7~M of .Constance .Maureen .Coyle Residing st .21 N. Hanover St, Carlisle, Pa, Who V now ._16_,._._ Yeah of age. 3 love been Informed o[ PIII-her) Intended marrLga to Marshall Marlin Minich And hereby coJ~ nt to said mrrriage. / Signature rG,L.Lru.~:.-ueR.:a~e.....~ . ~~-,r..~u WlNesa , Witness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Given before me this i........19th............_....~yof....._July...... Ig 65 .. i Cie O ni Court x°°.403.-.fi.l....-_ Marriage License COMMONWEALTH OF PENNSYLVANIA, COUNTY OF CUMBERL4ND, ~' To any Minister of the Gospel, ]ustlce o[ the Peace or other officers ar persons authorized by law b solemnize marrlsge: Ynu are hereby aulhoriud to join together in the holy state of matrimony according to the rites and ceremonies of your tfiurch, society or rcRgiouo de- nomination end the laws of the Commonwealth of Pennsylvania, ,_Marshal,l.,..,¢(Arlin.._M}ni,~h.._ .............. - .........................................A....tfinDr.............._.. Q(J/ and never heretofore married, _...ADStaItS.e....Mlu.xeen.._CoY..le........._......_.._.. ...... ..... A....Mina.r ..............._.......... ....................... ......... 9f]C>ll]Oat and never heretofore married, Given under my hand and seal of the O ~ ~~~~~~'~~~~~~~""""""'"~"""" rphans' Court of wid County of Cumberland, at'Carltsle, this Anno Dominl nne thousena nine hundred and Sixty-Five. ................22nd......_._........... ear of..........J.u.IY e ~ ATAt3~ COPY FROIIA RECORD .l.S:(....~~,.~... [~. _/11c.(?.l,~L( .,~.~~ , / ._. ..._._. ectyr+'}n;1y N rI ,. ~ ",} f ,) hand Cle k [the Orphu,d Court .... Cumberland C~a,<<~ `~~ • J NUMI DTE:03/08/01 SSN:206-36-4795 XC: UNIT: KC PG: 001 ACCOUNT SSN:206-36-4795 ETC:O RFN:65223700693 NAME NAA: MARSHALL MARLIN MINICH BIRTH DOB:09/22/1946 PLB: CARLISLE CUM* PA~,SEX:M ETB:0 PARENT MNA: KATHLEEN M ARNOLD FNA: NELSON L MINICH INTERNAL FMC:l CYD:03/XX/1963 ~C~R S~CTAL SEC~RI~' C~~,~ ~~ "~ ~ La ~~~~C`' ~~ "_ ~~RI~ICATION ~~ YOUR ~flC~~4. ~~~~ a~ ~_~ ~ ~fi~: ~u ,~y .M°, ~ ~' ~~ ~._~~:~:' d~ C~ ~~ ~Q~-~:. ~1i/'1lj~id~~~~~~.~8~0 ~tltl~aF / i~~Y~~ d ~r?+~5 ~ i.9'dJti..~ 6u':~ 1 ~,~~~:~~~~~ ~r~~R RI;:>' TOE ~a~~ ~"` ~ ~~~' 1~~~~~°~~~ ST~~~~;~~. ~~a~~~a A, ~: ~Xl~i~iT'd~'' fr S- "'"a' ~ ,'"""""'air", ~<~-~`,: ~' " ~`~ ~p ~~ ~~~~ ~7 Y. ~ ~ • .'t • ~ I. ~0 _ i I .1• _.r _ - ~ - i; t~,, ~ i,. . F <R ~.;7 ~; ~. • ,din ~ •., ~ u, _ .t y.. ..>~o .,_. -tip ~ .U E , Z T. y ,.L"» ~ z ~ n r ~ _ m+ m ~ C700 o~ j1_• ~ A~ ., !~, ~. ~ ~ r~ pT D }, ' ~ ,~- ~ ~, . :,,, o ~ •- .~ _ _.~., ~ ...x C (~ Entered Into Eternal Rest w APR 2 2 1990 KATHLEEN M. MINICH Kathleen M. Minich, 67, of 797 Waggoners Gap Road, Carlisle, died •r Sunday in Carlisle Hospital. She was born May 27, 1922, in ~ Carlisle, a daughter of the late Clair ~yBowers and Edna Keck Arnold. She (~~1" was a member of Waggoners United O Methodist Church, Carlisle. Surviving aze her husband, Nelson L. Minich; two sons, Charles N. and Marshall M., both of Carlisle; one brother, Mazlin Arnold of Carlisle; y, % two sisters, Shirley Calaman of Carlisle and Fay Lowery of Tuscon, Ariz.; seven grandchildren; and two M great-grandchildren. c~ Services will be held at 10 a.m.' Wednesday in Hoffman•Roth Fu•~ neral Home, 219 N. Hanover St., Carlisle, with the Rev. Tom Willard officiating. Burial will be in Wag- ggoners United Methodist Church iCemeterv. North Middleton Town• ~ Friends may call from 7 to 9 p.m. Tuesday at the funeral home. Memorial contributions may be made to American Cancer Society, Cumberland County Unit, 117 N. Hanover St., Carlisle 17013 . a~ -..,..~, IN RE: PETITION OF MARSHALL MARLIN MINICH (ISSUANCE OF BIRTH RECORD) Commonwealth of Pennsylvania ss: County of Cumberland I, Nelson Leroy Minich of 370 South Middlesex Road, Cumberland County, Pennsylvania, do hereby swear and affirm as follows: 1) I am the father of Marshall Marlin Minich of 231 North Middleton Road, Carlisle, Pennsylvania 17013. 2) My son, the said Marshall Marlin Minich, was born in Carlisle Hospital, Carlisle, Cumberland County, Pennsylvania, on September 22, 1946. 3) The mother of the said Marshall Marlin Minich was my wife, Kathleen M. Minich, whose maiden name was Kathleen May Arnold. We were married at the time of my son's birth. I verify that the statements made herein are true and correct to the best of my knowledge, information and belief, and understand that false statements herein are made subject to the penalties of 18 PA. C.S.A. §4904 relating to unsworn falsification to authorities. Dated: March 14, 2001. Sworn to and subscribed before me this 14th day of March, 2001 Steph D. Tiley, Notary Public son Leroy Minic ~~~~T~TI~/Y1TrWYY t.` ~ ~~ 6s~~. WiL1H.E8oRO.Ct.A1~001ifrY.PIA ~-~ ~!- YYCOMMI8810N~XP~.RM:1t~~04 _. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHAN'S COURT DIVISION NO. 2001 - AFFIDAVIT PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of Marshall M. Minich, Sr. File Number 21-~- o i -- Unto also known as ars a arm mac r. ecease Social Security 206-36-479 Petitioner(s) who is/are 18 years of age or older, apply(ies) for: [X] A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the Executor named in the last Will of the Decedent dated June 24, 2009 and codicil(s) dated Renunciation of Marshall M. Minich, Jr. is filed herewith. state re evenat circumstances, e.g. renunctatton, eat o executor, etc. Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the instrument(s) offered for probate, was not the victim of a killing and was never adjudicated an incapacitated person: No exceptions COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania with his/her last principal residence at 231 North Middleton Road Carlisle PA 17013 (North Middleton Townshi ) ist street a ress, town city, towns tp, county, state, zip co e Decedent then 62 years of age died on 7/22/09 at Carlsle Regional Medical Center Decedent at death owned property with estimated values as follows: (If domiciled in Pa.) (If not domiciled in Pa.) (If not domiciled in Pa.) 200,000.00 Value of real estate in Pennsylvania situated as follows: 231 North Middleton oa an ra ey rive, ar is e, N O G=7 -`:r~ _.. . --~- ~ C,n i, r L°G.'~ (. . , ~ ~ .. -. .~.: j~ ' : TJ O . ~ ~ ....r c 3 Page 1 of 2 [ ] B. Grant of letters of Administration (If applicable enter: c.t.a.; .n.c.t.a.; en ente ite; urante a sentta; urante manoratate Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: (If Administration, c.t.a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of Letters in the aparopriate form to the undersiened: OATH OF PERSONAL REPRESENTATIVE COMMONWEATLH OF PENNSYLVANIA courrTV OF CUMBERLAND The petitioner(s) above-named swear(s) or affirm(s) that the statement in the foregoing peition are true and corn to the best of the knowledge and belief of petitioner(s) and that as personal representative(s) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed hafnra ma thi e ~ ~'~. 't X~1 ~ ~~~ D~?P. X11 ~l~h For the Register File Number: ~ I - Q I - D ~ ~ Estate Of Marshall M. Minich, Sr. Social Security Number: 206-36-4795 Deceased Date of Death July 22, 2009 AND NOW c~~.umk~~ ~. I , 20~~in consideration of the Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters Testamentary are hereby granted to Michelle M. Bottoms in the above estate and that the instrument(s) dated June 24, 2009 described in thte Petition to be admitted to probate and filed of record as the las Will (and Codicil(s) of Decedent) FEES Letters ~-~-~.G , C;7" Short Certificates ~ vc~ Sup Renunciation ~ , Ct. I.D. No 46397 ~w ~ LL ~~ . ~`; Address: ~~-.~ icy ~~'v ~..~.-t- c,-~,, ,mot- , u-. ~ ~j . C~~L Telephone: TOTAL... +-} ~ ~ c~;~; Register of Wills ~~~,;,_~ r--- Signature ~. Attorney Name Robert G. Frey 5 South Hanover Street Carlisle, Pennsylvania 17013 (717) 243-5838 Page 2 of 2 OCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate. $6.00 Certification Number This is to certify that the information here given is an-rect~y copied from an original Certificate of Death duly fi;ied ~~~ilh me as Loco] Registrar. The original certificate will be forwarded to the State Vital Records Offire for pernu(nem filing. ~ar~r~I~t~..~C' JUt/ 3 1/2009 Local Re~l*istrar Date Issued C7 r•.~ °ca- t? ry- © ~ ~ ~ ~~ ~ C'7 'ra 'L1 c ; '-= ~ m (- N 11~,• 'VJY ~~ J.i .,.7 ( ~ ~ "_ ~ --- 3 •-Zr i alos-la3 REV llrzaas COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS TYPE I PRINT IN PERMANENT CERTIFICATE OF DEATH BLACK INK (See instructions and examples on reverse) STATE FILE NUMBER TI J 0 1. Name o1 Decetlenl (Rm, mitlde, ksL sumx) 2. Sax 3. Social Security Number 4. Date of Death (Monet, day, year) Marshall M. Minich Sr. Male 206 - 36 -4795 July 29, 2009 8. Age (Last BinlMay) Urlda 1 year Untler 1 day 6. Data of Birth (Monet, day, year) 7. BlMplace (Clry and stale a foreign country) Be. Place d Deam (Check Doty orre) 62 `~'°" °°" """ "`"A` Sept. 22, 1946 Carlisle, PA l"~L °"'~` Vrs. Inpadenl ^ ER /Oapedent ^ DOA ^ Nursing Home ^ Resitlence ^Ottrer-Slxciry: Bo. Coumy d DeaM &. City, Bore wp I Deem Btl. FaUKy Name (N not inslduWn, give street aM number) 9. Was Decetlenl a Hispanic Origin? ~ No ^ Yes - 111. Race: Arcencen Indian, Bkck, Whale, etc. Cumberland S. Middleton Carlisle R tonal Medical Center (If Yea,apeclfycuba°' ISp°°M White Mexican, Puerto Riwn, etc.) 11. DxatlenYS Uaual Kmtl d waM d one tlu' most d waki lik. Do rra sole ratl 12. Wes Decedent ever in Hxf 1 3. Decedenl'9 Etlucetlon (Specity only highest grade conp bted) 14. Marllal Status: Merrieq Never Married, 15. Sumving Spo use (II wife, give maiden name) Kind d WaN KIIM d Blgka99 / uslry f U.S. Armed Forcea7 Elemeaary! Secontlery (P12) College I7-4 or Sf) w~~' ~~ (~/~ ~xcavating ^Yes ®No 10 Widowed • 18. DecetlenYS Healing Address (Street cDy y rown, slate. n c ~ 231 North Middleton Rd Decetlent's Ditl DBCeOerA APNBIIiasitlarxe na,Slale pn ~aelna nor.^Yea.DecedentL;retlro N. Middleton Twp . Carlisle PA 17013 township? 17tl. ^ No, Decedent LMetl vnlhn 176. enemy Cumberland , Actual L;mils pl ciry/Lbre 18. Father's Name (First m'IDtlk, ktl, sulHx) 19. Mdher's Name (RnD, mitltlle, maitlen wmame) Nelson L. Minich Kathleen Arnold 20a. InlomlenYS Name Rme / PMxI 20b. Inlomanl's MallWg Address (Street city f rown, state, zip code) Marshall M. Minich, Jr. 26 Haven Way, Lugoff, SC 29078 21 a. Metlgd d Disp[eAion i ^ Dremahxl ^ Donetbn 21 b. Date o1 Dispoeilbn (Month, day, yearj 21 c. Platy d DisposAbn (Name d camel cry, aemerory er Deter Place) ltd. Locetion (Cory /sown, smte, zip code) ~a^ RemovalhomSate ~ b cram.Ban Awxw~ad Aug. 3, 2009 Waggoners United Methodist Church Carlisle, PA 17013 ^ ~ D ^Y~^~ ~ 22a. ~ a Furreral ~ licensee la I, rg as 22b. lkerxse Nunber 22c. Name antl Atltlress d FacXlty Hof fman-Ro h Funeral Home & Crematory, Inc - • ~ 1'sl P 1 013 CompMe Items 23a<anty wtlen cerayng 23a. k t t d knowbdge, deem aceurretl at die hoe, dale and place skletl. (Signature and title) 23b. Ucense Number 23c. Date S ro~D (Monet, Dav, yaeD physician is rid avaYade at time a awm la cBMy cmae d doom. Serra 21-26 meal 0e completed by person 24. Tme of DBaM 25. Dale ProMUnced Dead (Harm, day, year) 2fi. Wes Case Ref rred to Medal Examiner /Coroner for a Reason Other than Cremation a Donation? wnoaara~xtceadeem. a'~~M. ~ GLC Z ~ ~(7 ^vea CAUSE OF DEATH (See Instructbna erW examples) r Apgoximate imerval: tlan 27. Pan I: Eger the chain of events - dseases, Wiunes, a corr~pications -met drecly ceusetl me deem. DO NOT enter terminal events such as caNac alresl, Onset to Death Pan II: Enter other siaafirarA cond8ora cantnMAirm to tleam ha rid rewleng In me unkrtykg reuse given in Pan I. 28. qtl Tdacco Use Coariboe ro Deem? ^ Yes ^ Prahabty respiretay angst. a ventricular libdla wAhM stowing dre etiobgy. List oaY one cause an each line, I I ^ N k U f / I a1MEgATE CAUSE IFinal disease a ~ o nown n ) \ cpndtion resoling deem .~~ ! y (.L. Q.iI L 1/C~° ~ ~ ~ ~ C' 29. N Female: ~ a. r ~ ^ Due to a u seq /,a~~ Q ,y ~ ~ ~ ~ Na pregant within past year Sepeniky Wsl caldtiaa, M arty, b. I I ~ ,Lly !/t ~~ ! r~'~, !•Z j Lea3m W the cecee listed on Woe a ~ ^ Pregrum at fine d dam Due to (a as a canwquerlce oQ: r Emer the UNDERLYMG CAUSE ^ Na plagrenL bW preyleM wilhro 42 days (Disease a kNxy' mat'rlDkled me evenk rewlbtg n meml LAST c of deem Due to Or es 8 ( consequerxre o0: ^ Nd pregrenL Wt t 63 da ro , pregnan ys year d. r r helae tleath ^ Unknown W pregranl wglun the past year 30a. Wes an AoopsY Perrormedy 306, Were A uropay FMirlgs Aveeable Prgr ro Compl~tron 31. Manrrer of Deem 32a. Date d Injury (Monet, day, year) 32b. Describe How Injury Occuned 32c. Place d Injury: Horne, Fann, Street Faaay, d Cause d Deem? ,j~Natuml ^ Hamiddr Ofixe Builtlmq, eta (Speciry) ~~--r/ ^ Vas lyl No ^ Vea ^ No ^ t ^ PeMirg Imesdgeeon 320. Tma of Injury 32e. Injury al WoM? 32f. tl T2repwtation InN7 (~`PaclNl 32g. Locetan of Injury (9reeL cAy I loin, slate) O ^ Suicitle ^ Coultl Nrn be Detarm'metl ^ Yes ^ No ^ Ddver / Operator ^ Passenger PedesVian M ^Omer - Spedly^ ~' ~Y I~~ ~Y ~) • Carlllying phyakian (Physklarl ceralyirg cause of death when arrolher physician hoe pmrourx:ed deem and completetl Wem 23) 336. Nre and 7Ale Ce r - To drc b•aldmY knowkdga, deem oeeurt4d doe to tlro uuse(al antl mamler as epled_________________________________ ^ ~ ~~~ . • Pronourwing eM certHynrg physickn (Phy~ipen lxxh Prorlolxxir5 deem and cedFryg ro reuse of tleeMl 33c. License Nu 33tl. Date Signed (Month day, year) To tM beat a my lowwkdge, dam occurrdtl et IM IIrM, dab, and place, aM due to the cauee(e) and manner u sbWad_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ • Medkal Exarnlrer I Canner n~ `'~a /"'' ~ s 1 / s - , ~i l L ~ ~?,~ ` On the bask of examination end / or Investlgelbn, In my oplnlon, death aeurred et tM tFne, dale, and place, arM due to Iha cause(s) and manrer as skted_ ^ V ~ Name aM Atldreaa of Parson Who Canpleletl Cause Ot Deem (Ite m 27) Type / Pn Regkt afire erx e Filetl (Monet da ear) r ~ ~~,~pe.~ ~ i c i a i ~ i ~ i . y, Y -~ ~ ~ .~~~ti ~ ~~ ~~ Dispasitbn Permit No. ~ I;-y 1 ~ (p RENUNCIATION REGISTER OF WILLS CUMBERLAND COUNTY, PENNSYLVANIA Estate of Marshall M. Minich, Sr. I, Marshall M. Minich, Jr. Executor ,Deceased in my capacity/relationship as of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to Michelle M. Bottoms August /pZ , 2009 (Date) ~' //~ ~~ % (Sig ture ` (Street Address) Lugoff, South Carolina 29078 (City, State, Zip) Executed in Register's Office Sworn to or affirmed and subscribed before me this day of , 20 Deputy for Register of Wills ..,,, i~fl0~ S:~v~rldd0 dC) ~~31~ 8 i ~01 W~ t Z d3S 60~t Executed out of Register's Office Before the undersigned personally appeared the p •ty executing this renunciation and of / a _, 20~. ,~ ~~ ~ Notary Pu My Com is ion pirees: w~D~aoio (Signature and Seal of Notary or other offical qualified to administer oaths. Show date of expiration of Notary's Commission.) FOURTH Any and all payment or payments of any sum or sums, whether in cash or in kind and whether for principal or income, payable to any said child or children, shall be made upon the sole receipt of the respective individual to whom the payment is made, and free from anticipation, alienation, assignment, attachment and pledge, and free from control by the creditors of any such beneficiary. All shares of principal and income herein given shall be free from anticipation, assignment, pledge or obligations of any beneficiary, and shall nat be subject to any execution or attachments. FIFTH I hereby nominate, constitute and appoint my daughter, Michelle M. Bottoms, and my son, Marshall M. Minich, Jr., together as Co-Executors of this my Last Will and Testament, or the successor or survivor of them alone as Executor of this my Last Will and Testament. I further direct that no bond or other security shall be required of any Executor or Executrix appointed in this Will for the performance of his, her or its duties in any jurisdiction in which he, she or it may be called upon to act. SIXTH In addition to, and not in limitation of, the powers conferred by law or by other provisions of this Will, my Executrix shall have the following powers, each of which may be exercised from time to time by my Executrix in her sole discretion: (a) To retain in the form received, and to sell either at public or private sale, or to distribute in kind, any real or personal property. (b) To manage both real and personal property. (c) To invest and reinvest in all forms of property, notwithstanding the fact that any or all of the investments made are of a character or size which but for this expressed authority would not be considered proper for an Executrix (d) To exercise any option or rights arising from the ownership of investments. (e) To compromise claims without court approval and without the consent of any beneficiary. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will and Testament, written on three (3) pages (including notary page), this 24th day of June, 2009. ~~~~ ~ ~/.`~ <-~~- (SEAL) Marshall Marlin Minich, Sr. Signed, sealed, published, and declared by Marshall Marlin Minich, Sr., the Testator above named, as and for his Last Will and Testament, in our presence, who, in his presence, at his request, and in the presence of each other, have hereunto subscribed our names as attesting witnesses. :i ~~ (/ ,. 4 ' / . `' (. f" G Last Will and Testament of Marshall Marlin Minich, Sr. 2 COMMONWEALTH OF PENNSYLVANIA ) SS: COUNTY OF CUMBERLAND ) We, Marshall Marlin Minich, Sr., Stephen D. Tiley, and Sharon J. DeVos the Testator and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his Last Will and that he had signed willingly (or willingly directed another to sign for him), and that he executed it as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the Will as witness and that to the best of their knowledge the Testator was at that time eighteen (18) years of age or older, of sound mind and under no constraint or undue influence. Marshall Marlin Minich, Sr. ,i` "~ ~~~., ~ ~LI.Gt ~G~ Subscribed, sworn to and acknowledged before me by the Testator and the witnesses above-named, this 24th day of June, 2009. `l-s.- .J __._ ~_ ~,.. . __ r"' c_. _..__..._--~ . ~µ Notary Public ~~i s~ f'~d Cq~, M s ~' 20, 2010 Last Will and Testament of Marshall Marlin Minich, Sr. 3 CERTIFICATION OF NOTICE UNDER Pa. O.C. Rule 5.6(a) REGISTER OF WILLS CUMBERLAND COUNTY, PENNSYLVANIA Name of Decedent MARSHALL M. MINICH Date of Death: July 29, 2009 Estate Number: 21-01-0286 Date Letters Granted: September 21, 2009 To the Register: I certify that Notice of Estate Administration by Pa. O.C. Rule 5.6(a) of the Orphan's Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on September 28, 2009: Name: Address: Marshall M. Minich, Jr. 26 Haven Way, Lugoff, SC 29078 Michelle M. Bottoms 2822 Springflower Drive, Wilson, NC 27896 Notice has now been given to all persons entitled thereto under Pa. O.C. Rule 5.6(a) except: NO EXCEPTIONS - t( ~. Date: September Za, 2009 P ~'.~/J~ ~agnacure of rerson racing tnas corm Capacity: Personal Representative __ -Counsel Robert G. Frey, Esquire 5 South Hanover Street Carlisle, PA 17013 (717) 243-5838 Form RW-08 rev. 10.13.06 N -- : , . ~ ~ - ~- ` w 1 U cL f: . _ ~' cn ~, cc -:~ v ~_~ ._ a v n v~ Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone:(717) 240-6345 Date: 6/29/2011 FREY ROBERT G 5 S HANOVER STREET CARLISLE, PA 17013-3385 RE: Estate of MINICH MARSHALL M SR File Number: 2001-00286 ~~ ~~ _ =~ ~: ~ . . . ~ ;_` G ...f t4 ~ ..~- ~ ~.~ -- . .. ~, Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, N0. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 7/29/2011 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, .~ ? Glenda Farner Strasb Clerk of the Orphans' Court cc: File Personal Representative(s) Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone:(717) 240-6345 Date: 6/29/2011 BOTTOMS MICHELLE M 2822 SPRINGFLOWER DRIVE WILSON, NC 27896 RE: Estate of MINICH MARSHALL M SR File Number: 2001-00286 Dear Sir/Madam: ~~~ :n ~ ~"'~ Aj. f' I f ~ ~.~~i ~ ... .. -~.~ This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, N0. 103 SUPREME COURT RULES DOCKET N0. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 7/29/2011 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, .~~ ~~ ~ Glenda Farner Strasbau Clerk of the Orphans' Court cc: File Counsel Pa. O.C. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF ~ [ ~' ~~"`~~ ~~ ~'1~`"~ COUNTY, PENNS~'LVANIA Name of Decedent: t '~°~ ~ ' ~~ ~ ~ ~ ~~ ~ ~" ~ ~ ~' ~~~, ? .,... Date of Death: ~~ ~ ~- File Number:_ +° ~) ~ - ~ (,1 ~:.~t~~s~~ Pursuant to Pa. O.C. Rule 6.12, I report the following with respect to completion of thE; administration of the above-captioned estate: 1. State whether administration of the estate is complete :.................... ^ Yes ~No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is YES, state the following: a. Did the personal representative file a final account with the Court? ....... ^Yes ^ No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? ........................... ~ Yes ^ No .... d. Copies of receipts, releases, joinders and approvals of formal or informal accounts Inay be filed with the Clerk of the Orphans' Court and may be attached to this report:. --- ~ D t ~ ~~ V ' o e ~ . Signature of Person Filing this Form +.~_ _~ Q. C Capacity: ^Personal Representativ Q Colmsel ~ , ;- ~ -- ~; •- ~.- c'7 ~~ i~ Name of Person Filing this Form . , ... ~ ~ ° ~..n w ~, , , ~„ ~ r , _ ..__ t...: L.i~: "` ~. Telephone Form RW-/0 rev. 10.13.06 r~ - _ _ _ ~~ J 150561D145 REV-1500 ~"°'-'°' PA Depanment of Revenue Pennsylvania OFFICIAL USE ONLY o~a~w,.ewroracvuau Courriy Code Year File Number Bureau of IndHfdual Taxes INHERITANCE TAX RETURN PO BOX 28°801 Harrisburg. PA n12a-aeol RESIDENT DECEDENT ~ j ~~ ~ ~% ~~~- ENTER DECEDENT INFORMATION BELOW Sodas Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 206-30-4795 07292009 09221946 Decedent's Last Name Suffix Decedent's First Name MI Minich Marshall M (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name Mi Spouse's Sodas Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF ONILLS FILL IN APPROPRIATE BOXES BELOW ® i. Original Return ~ 2. Supplemental Return [~ 3. RerrgirWer Return (tlata of death pAOrto 12-13-82) Q 4. Limited Estate Q 4a. Future Interest Comprem{se (date o! [J 5. Federal Estate Tax Return Required death after 12-12-82) ® B. Decedent Died Testate ~ 7. Decedent Mairstained a Living Trust 1 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Utigauort Proceeds Received Q 1(). Spousal Poverty Credit (date of death [~ 11. Electfan to tax under Sec. 9113(A) between 12.37-91 and 7-1-951 (Attach Sch. O) CORRESPONDENT-THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX tNFORMATtON SHOULD BE DIRECTED T0: Name Daytime Telephone Number Robert G. Frey 7172435838 ' First tine of address 5 South Hanover Street Second line of address City or Post Office State ZIP Code Carlisle PA 17013 Correapondent'se-mailaddreas: rfreyr~freytiley.com REGISTER QF.yyIL'LS USE ONtY _: , ;~ ~...; - -, -` - _ { ~ - DATE FILED _, ..: _~ : -. Under penalties of perjury, I declare that I have examined this return, utduding accompanying schedules and statements, and to the best o kn my owledge and be4e1, it is true. ixltttxt and complete. OedaraBon Ot pteparer other than the Dersonal representative is based on aq Infortnalion °f which prenarer tins amt knowledge SIG ~E~F~ ~I~~ONSIRFILJiQ~~ ~ ,~ ~ ~ ' / ~ DATE ADDRESS -r. 1 ~ o ~~' Z.~ZZ n 5'~ti^~ ~OVJns' ~r- IN W, ~$Orl, ~C SIGNATURE pF R ARE THE F.fFF#TIVE hsTC ~ ~~/h ADDRESS ~ 5 South Hanover Street, C r isle, PA 17013 P SE USE OR1t31NAL FORM ONLY L 1505610145 Side 1 1505610145 l~ ~~ J REV-1500 EX 1505610245 Decedent's Social Security Number Decedent's Name: Marshall M Minich 206-30-4795 RECAPITULATION 1. Real Estate (Schedule A) ......................... . ................. 1. 4 4 4 7 9 0 . 0 0 2. Stocks and Bonds (Schedule B) ...................................... 2. NONE 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 6 3 2 15 . O O 4. Mortgages and Notes Receivable (Schedule D) .......................... 4. NONE 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E) ..... . 5. 1 O 151 . O 0 6. Jointly Owned Property (Schedule F) Separate Billing Requested ....... . 6. NONE 7. Inter-Vivos Transfers 8~ Miscellaneous Non-Probate Property (Schedule G) Separate Billing Requested ....... . NONE 7 8. Total Gross Assets (total Lines 1 through 7) .......................... . 8. 518 15 6 . 0 0 9. Funeral Expenses and Administrative Costs (Schedule H) ................. . 9. 3 5 4 15.0 O 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ............ . 10. 2 5 318 . O 0 11. Total Deductions (total Lines 9 and 10) .............................. . 11. 6 0 7 3 3 . 0 0 12. Net Value of Estate (Line 8 minus Line 11) ............................ . 12. 4 5 7 4 2 3 . 0 O 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ....................... 13 O . 0 0 14. Net Value Subject to Tax (Line 12 minus Line 13) 14 4 5 7 4 2 3 0 0 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0 O 15. O. O O 16. Amount of Line 14 taxable atiinealratex.o 45 457423.00 1s. 20584.04 17. Amount of Line 14 taxable at sibling rate X • 12 17. 0 0 0 18. Amount of Line 14 taxable . at collateral rate X , 15 18. 0 . 0 0 19. TAX DUE ....................................................... 19. 20584.04 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ~ Side 2 L 1505610245 1505610245 J REV-1500 EX Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME Marshall M Minich STREET ADDRESS CITY Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 3. Interest STATE PA ZIP 3 206-30-4795 (1) 20584.04 Total Credits (A + g) (2) 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in 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. (3) (4) 0 00 (5) 20584.04 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 : ............................................................................. 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 Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ................................................................................................. ^ 3. Did decedent own an "in trust for" or payable-upon-death bank account or security at his or her death? .... 4. Did decedent own an individual retirement account, annuity or other non-probate property, which contains a beneficiary designation? ..... 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 Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving ~~1~ spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an adoptive parent or a stepparent of the child is 0 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 decedent's lineal beneficiaries is 4.5 percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 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+(01-10) pennsylvania SCHEDULE A DEPARTMENT OF REVENUE INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT tSTATE OF: FILE NUMBER: Marshall M Minich All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property that is jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM Attach a copy of the settlement sheet if the property has been sold. NUMBER Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE DESCRIPTION OF DEATH 1. 730 North College Street, 1/2 interest. See HUD-1 settlement statement attached 2. 145 Longs Gap Road, 1/2 interest. See HUD-1 settlment statement attached 53,190 3. 231 North Middleton Road, See HUD-1 settlement statement attached 166,600 4. 1402 Bradley Drive, A-112, See HUD-1 settlement statement attached 150,000 75,000 TOTAL (Also enter on Line 1 Recapitulation) I $ 444 790 If more space Is needed, use addltlonal sheets of paper of the same size. REV-1504 EX+ (6-98) AT COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ESTATE OF SCHEDULE C CLOSELY-HELD CORPORATION, PARTNERSHIP OR SOLE-PROPRIETORSHIP FILE NUMBER Marshall M Minich Schedule C-1 or C-2 (including all supporting information) must be attached for each closely-held corporation/partnership interest of the decedent, other than asole-proprietorship. See instructions for the supporting information to be submitted for ~~IP_n~nnrier.,.~ti;..~ ITEM NUMBER DESCRIPTION 1. N.L. Minich and Sons, Inc., 4700 shares @ $13.45 per share. See letter from accountant and financial statements attached. VALUE AT DATE OF DEATH 63,215 _ TOTAL (Also enter on line 3 Recapitulation (If more space is needed, insert additional sheets of the same size) REV-1508 EX+ (6-98) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, ~ MSC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT t~tAiE OF FILE NUMBER Marshall M Minich Include the proceeds of litigation and the date the proceeds were received by the estate ~~~ „~,.~., .,~a~~ ~~ iiccuct~, ~~~~~~~ auuuwnal sneers or ine same slze> REV-1511 EX + (10-09) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Marshall M Minich Decedent's debts must be reported on Schedule I. ITEM SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS A. I FUNERAL EXPENSES: 1. Carlisle Memorial B 1 ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address 185 City Year(s) Commission Paid: State ZIP 2. Attorney Fees: 9,000 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4. Probate Fees: 5. Accountant Fees: 6. Tax Return Preparer Fees: 7. Expenses in connection to real estate sold 20,190 8. UHaul, removal of personal property 731 9. Auto repairs to Graham Pontiac 1,283 10. Executor's travel expenses, 11 ROUNDTRIPS OF 732 MILES @ $0.50 PER MILE 4,026 TOTAL (Also enter on Line 9, Recapitulation) ~ $ 35 415 If more space is needed, use additional sheets of paper of the same size. REV-1512 EX+ (12-08) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES 8~ LIENS ESTATE OF FILE NUMBER Marshall M Minich Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical exaenses. it more space is neeaea, insert aaamonai sneers of the same size. REV-1513 EX+(01-10) Pennsylvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: FILE NUMBED: Marshall M Minich RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] ~ Marshall M. Minich, Jr. 26 Haven Way, Lugoff, SC 29078 son 1/2 of residue 2 Michelle M. Bottoms 2822 Springflower Drive, Wilson, NC 27896 daughter 1/2 of residue 3. ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUG H 18 OF REV-1500 COVER SHE ET, AS APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. If more space is needed, use additional sheets of paper of the same size. Expenses in connection to real estate sold Closing costs for 730 North College Street, see HUD-1 542 Closing costs for 145 Longs Gap Road, see HUD-1 1,676 Closing costs for 231 North Middleton Road, see HUD-1 1,920 Closing costs for 1402 Bradley Dr, A-113, see HUD-1 5,927 PPL 168 North Middleton Authority g7 York Waste Disposal 45 PPL 168 Erie Insurance 220 Interstate Waste 321 Lowes 260 PPL 168 PPL 340 York Waste 44 Robin Sollenberger, tax collector 197 Erie Insurance 182 PPL 168 PPL 98 Pheasant Run Condo Association 550 North Middleotn Authority 116 Carlisle Electric 108 Quigley Mechanical Services 110 Lebo's Plumbing 3,578 North Middleton Authority 82 Robin Sollenberger, tax collector 840 North Middleton Authority 82 State Farm 93 R. Ferree, repairs 1,600 Basement repairs 500 Total costs in connection with real estate sold 20.190 Last Will and Testament of Marshall M. Minich, Sr. LAST WILL AND TESTAMENT OF MARSHALL MARLIN MINICH, SR. I, Marshall Marlin Minich, Sr., of North Middleton Township, (231 North Middleton Road, Carlisle, PA 17013), Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void any and all Wills and Codicils heretofore made. FIRST I direct the payment of my just debts and funeral expenses as soon after my death as may be convenient. SECOND I declare that I am now the widower of Constance M. Minich who died on January 14, 2009. We had two (2) children, to wit: a daughter Michelle M. Bottoms of 2822 Springflower Drive, Wilson, North Carolina 27896, and a son Marshall M. Minich, Jr. of 30 Haven Way, Lugoff, South Carolina 29078. I have no deceased children nor any other children living by my wife or otherwise. THIRD (A) I make the following specific bequests: (i) To each grandchild which I may have at the time of my death, I give and bequeath the sum of Two Thousand ... ($2,000.00) ... Dollars, (ii) To my daughter Michelle M. Bottoms I give and bequeath all of my wife's jewelry. (iii) To my son Marshall M. Minich, Jr., I give and bequeath all guns and my gun cabinet or cabinets which I may have at the time of my death. (B) All the rest, residue and remainder of my estate, real, personal and mixed, and wheresoever the same may be situate, I give, devise and bequeath in equal shares, ~~ per stirpes and not per capita, unto such of my children as shall survive me by ninety (90) days, Provided, However, that in the event there remains an unpaid balance on the loan secured by a $30,000.00 mortgage against the Pheasant Run Condominium unit known as A-113, 1402 Bradley Drive, Carlisle, Pennsylvania 17013, which loan was taken out in the fall of 2008 for the benefit of my son, Marshall M. Minich, Jr., then the share of my son Marshall M. Minich, Jr. shall be charged for the unpaid balance of said loan and his share shall be reduced by the unpaid balance of said loan, and by any ~~ interest or other payments made after the date of my death. At the present time I have ~ two children as aforementioned. Last Will and Testament of Marshall Marlin Minich, Sr. ~ FOURTH Any and all payment or payments of any sum or sums, whether in cash or in kind and whether for principal or income, payable to any said child or children, shall be made upon the sole receipt of the respective individual to whom the payment is made, and free from anticipation, alienation, assignment, attachment and pledge, and free from control by the creditors of any such beneficiary. All shares of principal and income herein given shall be free from anticipation, assignment, pledge or obligations of any beneficiary, and shall not be subject to any execution or attachments. FIFTH I hereby nominate, constitute and appoint my daughter, Michelle M. Bottoms, and my son, Marshall M. Minich, Jr., together as Co-Executors of this my Last Will and Testament, or the successor or survivor of them alone as Executor of this my Last Will and Testament. I further direct that no bond or other security shall be required of any Executor or Executrix appointed in this Will for the performance of his, her or its duties in any jurisdiction in which he, she or it may be called upon to act. SIXTH In addition to, and not in limitation of, the powers conferred by law or by other provisions of this Will, my Executrix shall have the following powers, each of which may be exercised from time to time by my Executrix in her sole discretion: (a) To retain in the form received, and to sell either at public or private sale, or to distribute in kind, any real or personal property. (b) To manage both real and personal property. (c) To invest and reinvest in all forms of property, notwithstanding the fact that any or all of the investments made are of a character or size which but for this expressed authority would not be considered proper for an Executrix (d) To exercise any option or rights arising from the ownership of investments. (e) To compromise claims without court approval and without the consent of any beneficiary. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will and Testament, written on three (3) pages (including notary page), this 24th day of June, 2009. ~~ ~f/~ r . (SEAL) Marshall Marlin Minich, Sr. Signed, sealed, published, and declared by Marshall Marlin Minich, Sr., the Testator above named, as and for his Last Will and Testament, in our presence, who, in his presence, at his request, and in the presence of each other, have hereunto subscribed our names as attesting witnesses. b ~ «., Last Wil! and Testament of Marshall Marlin Minich, Sr. COMMONWEALTH OF PENNSYLVANIA ) SS: COUNTY OF CUMBERLAND ) We, Marshall Marlin Minich, Sr., Stephen D. Tiley, and Sharon J. DeVos the Testator and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his Last Will and that he had signed willingly (or willingly directed another to sign for him), and that he executed it as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the Will as witness and that to the best of their knowledge the Testator was at that time eighteen (18) years of age or older, of sound mind and under no constraint or undue influence. i«~~ ~.~lOrL Marshall Marlin Minich, Sr. v ~~~~ ~~v , Subscribed, sworn to and acknowledged before me by the Testator and the witnesses above-named, this 24th day of June, 2009. ~!/•/ t ~-~ / N b!1 i ^ Notary Public Last Will and Testament of Marshall Marlin Minich, Sr. Settlement Statement: 145 Longs Gap Road U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT B. TYPE OF LOAN .. SETTLEMENT STATEMENT I. ^ FHA 2. ^ FHMA 3. ^ coNV. uNINS. 4. ^ VA S. ^ CONV.INS. 6. FILE NUMBER: 7. LOAN NUMBER 8. MORTGAGE INS. CASE NO.: C. NOTE: This form is famished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "(p.o.cJ" wem paid outride the closing they arc shown here for informazional purposes and are not included in the totals D. NAME & ADDRESS Scott A. Rhoades and Kimberly L. Rhoades OF BORROWER: 191 Union Hall Road Carlisle PA 17013 E. NAME & ADDRESS The Estate of Marshall M. Minich, Sr. OF SELLER: 5 South Hanover Street, Carlisle PA 17013 F. NAME & ADDRESS Orrstown Bank OF LENDER: 77 East Kin Stree P.O. Box 250, Shi ensbur , PA 17257 G. PROPERTY LOCATION: 145 Lon s G Road, Carlisle, PA 17013 H. SETTLEMENT AGENT: Assured Land Transfers, Inc. PLACE OF SETTLEMENT: 301 Market Street, Lemoyne PA 17043 (717) 761-4720 I. SETTLEMENT DATE. 11/19/2009 .I. Cn of Any .. T_..___-~. _-_-_ ____.-_.. _. _ _. _...,_,,.,,., 100. Gross Amount Due From Borrower: iti Summa of Seller's Transaction 400. Gross Amount Due To Seller: 101. Contract sales rice 102. Personal pro 166 600.0 0 401. Contract sales rice 402. Personal ro 166 600.00 103. Settlement charges to borrower: pine 1400) 6 246.3 8 403. 104. 404. I OS. 405. Adjustments For Items Paid B Seller In Adva 106. City/town taxes to nce: Adjustments For Items Paid B Seller In Advance: 406. Ci /town taxes to 107. County taxes to 407. Coun taxes to 108. Assessments to 408. Assessments to 109. 409. l IQ. 410. 111. 411. 112. 4t2. 113. 413. 114. 414. 1 I S. 415. 116. 416. 120. Gross Amount Due From Borrower: 172,846.38 420. Gross Amount Due To Seller: 166,600.00 . e t 201. De sit or earnest mon 202. Princi al amount of new loan(s) 203 Existin loan(s) t k b' 225 000.00 SO1. Excess de osit (see instructions) 502. Settlement charges to seller pine 1400) 16 670.00 . a en su ect to 503. Existin loan(s) taken sub'ect to 2~' 504. Payoff 1st M . Ln. 205. SOS. Payoff2nd M . Ln. 2~' 506. 207. 507. 208. SOB. 209. 509. Adjustments For Items Unpaid By Seller: 210. City/town taxes to 21 I. County taxes to Adjustments For Items Unpaid By Seller: 510. City/town taxes to SI 1. County taxes to 212. Assessments to 213. 512. Assessments to S13. 214. 514. 21 S. S 15. 216. S 16. 217. 517. 218. 518. 219. 519. 220. Total Paid By/For Borrower: 225,000.00 520. Total Reductions In Amount Due Seller: 16,670.00 301. Gross amount due from borrower pine 120) 302 Less amount aid b /f b li 172 846.38 601. Gross amount due to seller ine 420 166 600.00 . or orrower ( ne 220) 303. Cash (^FROM) iX~l'O) Borrower: Previous Edition Is Obsolete 225 000.00 52,153.62 602. Less reductions in amount due seller (line S20) 603. Cash (~O) (^FROM) Seller: 16 670.00 149,930.00 Form No. 1581 SBA-3538-000-1 3/86 HUD-1 (3-86) X - Page 1 of 3 X RESPA, HB 4305.2 L• SETTLEMENT CHARGES Escrow: 09-00257_AT T iuu. t otai JaleslBroker's Commission: Based On Price $ / = Paid From Borrower's Paid From S ll ' Funds e er s Funds At At 7p2. Settlement Settlement 7 o 'd t ett t 704. 8 1. ri ' ti ce ° o k I 0.0 0 802 Loan Discount % ~ I ' I f to: own ' 1 600.0 0 . r 8 r' t n fe 06. o in u a li ti o f to 807.A u n e 80 . o ntP e T o Ban 25 .00 80 . FI 'fi a ion F e wn Bank 30.00 810. 11 1. l 814. 81 1 l7. 88 0 821. 9 I. I r to /da O d 90 . M rt 'n c r o o to 9 r ' 4 I ce remi , t 905. 906. 10 1 in ur ce m nth r mon 1002 Morteaee insurance month n Q ner month ~ ~ 1003 Cuv orooertv taxes month (~ $ pe month ~ 1004 County nrooertv taxes month (a7 $ oer month i i 1005 Annual assessments mon he n t oer month ~ ~ ~ 1006 Flood insurance mon he rot 1; oer month 1007. mon h na S per month ~ ~ 100. t Ad u ent 1009. ] I01. I r c in a to 1 0. Abstra r i l arc to 1 ' I i ati 104. Tale i c r to D r ar i o ll N e 1107. Attorney's fees to (includes above item Numbers: ) 1108. Title insurance to Assured Land Transfers, Inc. (Reissue) (includes above item Numbers: 1101, 1102, 1103, 1104 ) 1 335.38 Il .Len v 0.0 P i~ l 8 1110. r' over 11 1. En or emen 1 00 t Assu d L T I c. ' 150.0 1 1 C n rvice ert it Americ 'tleI saran man 75.0 1114. No Fee to Cash 10. 10.00 1 0 . di fe ee 4 . a 56.50 :Re1e 105.00 12 i u :De •Mo ae 12 a 2.00 ~Mo a e 1 6.00 1 24 1205. 1 Ol. e t 1 130 v o ri /I-Ian sure d ransf In 2 .00 0 w r I Tax a In 4 4. 130 . 1 7. t r o line 1 Se tin - n - t'o n,...., wr,. , eon 6 24.8 .70.00 age t or 3 SBA-3538-000-1 SELLER'S AND/OR BORROWER'S STATEMENT Escrow: 09-00257-ALT I have carefully reviewed the HUD-1 Settlement Statement and to the best of my knowledge and belief, it is a true and accurate statement of all receipts and disbursements made on my account or by me in this transaction. I further certify that I have received a copy of the HUD-1 Settlement Statement. Borrowers/Purchasers 1~~ Scott A. Rhoades ~~~~ I L/ GL./ C~ C~ im rly L. ledes Sellers The E f Mars f ic~r. By: The HUD-1 Settlement Statement which I have prepared is a true and accurate account of this transaction. [have caused or will cause the funds to be disbursed in accordance with this statement q Settlement Agent: Date: ~q//dv °~~ J Title Officer, Assurcd Land Transfe c. WARNING: It is a crime to knowingly makc false sta ents to the United Stales on this or any other similar form. Penalties upon conviction can include a fine or imprisonment. For details see: Title 18 U.S. Code Section 1001 and Section 1010. Page 3 of 3 Settlement Statement: 730 North College Street A. U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT B. TYPE OF LOAN SETTLEMENT STATEMENT 1. ^ FHA 2. ^ FHIv1A 3. ^ CONV. UNINS. a. ^ vA s. ^ corrv.INS. 6. FILE NUMBER: 7. LOAN NUMBER 8. MORTGAGE INS. CASE NO.: C. NOTE: This form is famished to give you a statement of acNal settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "(p.o.c.)" wen paid outside the closing; they are shown here for informational purposes and are not included in the totals. D. NAME & ADDRESS Scott A. Rhoades and Kimberly L. Rhoades OF BORROWER: 191 Union Hall Road, Carlisle, PA 17013 E. NAME & ADDRESS The Estate of Marshall M. Minich, Sr. OF SELLER: 5 South Hanover Street, Carlisle, PA 17013 F. NAME & ADDRESS CASH _ G. PROPERTY LOCATION: 730 North College Street, Carlisle, PA 17013 H. SETTLEMENT AGENT: Assured Land Ttansfers, Inc. PLACE OF SETTLEMENT: 301 Market Street, Lemoyne, PA 17043 (717) 761-4720 I. SETTLEMENT DATE: 11/19/2009 7. Summary of Borrower's Transaction R Summary of Seller's Transaction 100. Gross Amount Due From Borrower: 400. Gross Amount Due To Seller: 101. Contract sales rice 53 190.00 401. Contract sales price 53 190.00 102. Personal ro 402. Personal roperty I03. Settlement char es to borower: (line 1400) 1 114.88 403. I04. 404. 105. 405. Adjustments For Items Paid B Seller In Advan ce: Ad~ustments For Items Paid B Seller In Adv ance: 106. Ci /town taxes to 406. City/town taxes to 107. Coun taxes to 407. County taxes to 108. Assessments ro 408. Assessments to 109. 409. I10. 410. lll. 4I1. 112. 412. 113. 413. 114. 414. Its. 415. 116. 416. 120. Gross Amount Due From Borrower: 54,304.88 420. Gross Amount Due To Seller: 53,190.00 w 201. IRposit or tamest moo 501. Excess de osit (see instructions) 202. Princi al amount of new loan(s) s02. Settlement char es to seller (line 1400) 5 328.90 203. Existin loan(s) taken sub'ect to 503. Exis[in loan(s) taken sub"ect to 204. 504. Payoff Ist Mtg. Ln. 205. 505. Payoff 2nd M . Ln. 206. 506. 207. 507. 208. 508. 209. 509. Adjustments For Items Unpaid By Setter: 210. Ci /town taxes to Adjustments For Items Unpaid By Seller: 510. Ci /town taxes to 21 L Coun taxes to - 511. Coun taxes to 212. Assessments to 512. Assessments to 213. Sta. 214. 514. 215. 515. 216. 516. 217. 517. 218. S l8. 219. 519. 220. Total Paid By/For Borrower: 520. Total Reductions In Amount Due Seller: 5,328.90 301. Gross amount due from borrower (line 120) 54 304.88 601. Gross amount due to seller (line 420 53 190.00 302. Loss amount aid by/for borrower ine 220) 602. Less reductions in amount due seller Qine 520) 5 328.90 303. Cash (®FROM) i~l'O) Borrower: 54,304.88 603. Cash (^X}1'O) (^FROM) Seller: 47,861.10 Previous Edition [s Obsolete SBA-3538-000-I Forn No. 1581 HUD-I (3-86) 3/86 X Page 1 of 3 }( RESPA, HB 4305.2 CFTTr FMFNT f`i-iARf_F.R Fccrnw~ 09-t1t12SR-AI.T 700. Total SalesBroker's Commission: Based On Price S %= Paid From Borrower's Paid From Seller's Funds Funds At At 7 t Settlement Settlement 7 ~ n a' ent 704. 1. L azt 'n e 802 Loan Discount t: 4. re 't t in e 0. a 'n ran a lica'o m i n 80 . 1 11. 1 ]. 8 4. 81 . 1 17. 818. 1 820. 821. 9 1.I / da s .Mort 'n uran i o. to 90 . H d'n re ium r . t 904. F din remiu r to 90 . 906. 100. in on er mo th 1002 Mortgage insurance months (il $ per month 1003. City~rooerty taxes months na, $ per month 1004. County.~rooerty taxes months (a) $ ner month 1005 Annual assessments months a S oer month 1006 Flood insurance months (a7 $ per month 1007 manih~ $ per month 1 0 . A ate A 'u n[ 1009. 1. lemen r 'n fee to 1 0 bstract or ' eazch 1 T't e e inati t 1104. it u c oc en ion t N t f t 1107. Attorney's fees to (includes above item Numbers: ) 1108. Title insurance to Assured Land Transfers, Inc. (includes above item Numbers: 1101, 1102, 1103, 1104 ) 524.48 1 1 v 0 r i .0 110. v 1 00 4.4 11 111 1114. No Fee to Cash 10.00 10.00 201 rd' 4 a eleases 48. 0. i •Mort 120. t De 3.8 ~Mrt a 31. 1.9 1 4. 1205. 3 1 urv i ec i w he ' c ax t r an T r 4 787 4 0 1 06 I 1 / dnn Tnfal CPr}tPmPO+ CFIA rOP (Enter on line 103. Section J-and -line 50.1,. Section K 1 114.8 8 2 .90 Form No. 1582 Page 2 of 3 SBA-3538-000-1 X X X SELLER'S AND/OR BORROWER'S STATEMENT Escrow: 09-00258-ALT I have carefully reviewed the HUD-l Settlement Statement and to the best of my knowledge and belief, it is a true and accurate statement of all receipts and disbursements made on my account or by me in this transaction. I further certify that I have received a copy of the HUD-1 Settlement Statement. Borrowers/Purchasers colt .Rhoades , ' / ~k~ ~~~~~~[l~ im erly L. oades Sellers The Es t of Mars 11 '~i~hJ Sr. By: ~ .11 The HUD-1 Settlement Statement which I have prepazed is a true and accurate account of this transaction. I have caused or will cause the funds to be disbursed in accordance with this state~m~ent~~j Settlement Agent: v~-~~' ~" Date: ~ ~w b p y Stephen M. Reeves, Assured Land T fers, Inc. WARNING: It is a crime to knowingly make false statements to the United States on this or any other similar form. Penalties upon conviction can include a fine or imprisonment. For details see: Title 18 U.S. Code Section 1001 and Section 1010. Page 3 of 3 Settlement Statement: 231 North Middleton Road A. Settlement Statement U.S. Department of Housing OMB Approval No. 2502-0265 ~ and Urban bevelopment B. Type of Loan 1. [ ]FHA 2. [ ] RHS 3. [ ]Conv. Unins. 6. FIIt? Number: 7. Loan Number: 8. Mortgage Insurance Case Number. 4. ( ] VA 5. ( ]Conv. Ins. 401000328-CB C. NOTE: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "(p.o.c.)" were paid outside of the closing: they are shown here for informational purposes and are not included in the totals. D. Name and Address of Borrower E. Name and Address of Seller F. Name and Address of Lender JOSEPH C. WILSON MICHELLE M. BOTTOMS, EXECUTRIX OF JACOB T. WILSON ESTATE OF MARSHALL M. MINICH A/K/A MARSHALL MARLIN MINICH, SR. PA PA G. Property Location 231 NORTH MIDDLETON ROAD. H. Settlement Agent iSFCl1RFl] I ANf) TRANSFFRR _ MFCHANI('RRI IR(; CARLISLE, PA 17013 Place of Settlement COUNTY: CUMBERLAND 5 S. HANOVER STREET PARCEL ID: 29-OS-0425-070 CARLISLE, PA 17013 TOWNSHIP: NORTH MIDDLETON TOWNSHIP I. Settlement Date 05!2012010 Disbursement Date 0 5/2012 01 0 J. SUMMARY OF BORROWER'S TRANSACTIONS K. SUMMARY OF SELLER'S TRANSACTIONS 100. Gross Amount Due From Borrower 400. Gross Amount Due To Seller 101. Contract Sales Price $150,000.00 401. Contract Sales Price $150,000.00 102. Personal Property 402. Personal Property 103. Settlement Charges to Borrower $2,773.25 403. Adjustments For Items Paid By Seller In Advance Adjustments For Items Paid By Seller in Advance 113. City/Town Taxes 413. Cityffown Taxes 114. County Taxes 404.93/yr 5!20/2010 to 1/1/2011 $250.72 414. County Taxes 404.93/yr 5!20!2010 to 1/1/2011 $250.72 115. School Taxes 1,541.70/yr 5/20/2010 to 7/1/2010 $177.40 415. School Taxes 1,541.70/yr 5/20/2010 to 7/1!2010 $177.40 118. Assessments 418. Assessments 119. 419. 120. Gross Amount Due From Borrower I $153,201.371420. Gross Amount Due To Seller I $150,428.12 200. Amounts Paid By Or In Behalf Of Borrower 500. Reductions In Amount Due To Seller 201. Deposit or Earnest Money 501. Excess Deposits 202. Principal 502. Settlement Charges to Seller $12,044.93 203. Existing Loan(s) Taken Subject to 503. Existing Loan(s) Taken Subject to Adjustments For Items Unpaid By Seller Adjustments For Items Unpaid By Seller 210. 510. 211. 511. 212. 512. 213. City/Town Taxes 513. City/Town Taxes 214. County Taxes 514. County Taxes 218. Assessments 518. Assessments 219. 519. 220. Buyer's Total Credits $0.00 520. Seller's Total Charges $12,044.93 300. Cash At Settlement FromlTo Borrower 600. Cash At Settlement To/From Seller 301. Gross Amount Due From Borrower (line 120) $153,201.37 601. Gross Amount Due To Seller (line 420) $150,428.12 302. Less Amounts Paid By/For Borrower (line 220) $0.00 602. Less Deductions In Amt. Due To Seller (line 520) $12,044.93 303. Cash [ X ]From ( ] To Borrower I $153,201.371603. Cash [ X ] To [ ]From Seller I $138,383.19 401000328 - CB L. Settlement Statement 700. Total Sale Commission Division of Commission (line 700) As Follows: 701. Commission Listing 702. Commission Selling 703. Commission paid at settlement 800. Items Payable In Connection With Loan 801 . Loan Origination Fee 802. Loan Discount 803. Appraisal Fee 804. Credit Report 805. Lender Inspection Fee 900. Items Required By Lender To Be Paid In Advance 901 . Interest 902 . Mortgage Insurance Premium 903 . Hazard Ins. Premium 1000. Reserves Deposited With Lender 1001. Hazard Ins. Reserve 1002. Mortgage Ins. Reserve 1003. City Property Taxes 1004. County Property Taxes 1010. Aggregate Accounting Adjustment 1100. Title Charges Page 2 Paid From Borrower's I Paid From Seller's Funds At Settlement Funds At Settlement 1101. Settlement/Closing Fee to Secured Land Transfers -Mechanicsburg $100.00 1102. Abstract or Title Search 1103. Title examination 1104. Title Insurance Binder 1105. Document preparation 1106. Notary fee to Colleen Blume, Notary Public $2.00 1107. Attomev Fee 1108. Title Ins. Total to Secured Land Transfers -Mechanicsburg $1,108.75 1109. Lender's Coverage $ ($) 1110. Owner's Coverage $150000.00 ($1108.75) ituu. uovernment Kecoramg Ana i ransTer cnarges 1201. Recording Fees for Deed 62.50; Recording Fees for Mortgage $62.50 1202. City/County Tax/Stamps 1500.00 $1,500.00 1203. State Deed Tax 1500.00 $1,500.00 1300. Additional Settlement Charges 1305. Tax Cert and Processing Fee to Secured Land Transfers -Mechanicsburg $15.00 1306. 2010 CountylTownship Real Estate Taxes to Robin K. Sollenberger, Tax Collector $404.93 1307. Inheritence Tax Escrow to Frey 8 Tiley $10,125.00 1400. Total Settlement Charges $2,773.25 $12,044.93 I IIeVC l.efClUlly ICVICWCU 1110 rlV V- ~ JClUC111Clil JldlC111Cl11 i91U lV 111C UCSI VI Ivry KIIUwICUyC anu ueuer it is true ana accurate statement of all receipts and disbursements made on my account or by me in this transaction. I further certify that I have received a copy of the HUD-1 Settlement Statement. B S SELLERS _ ii C..- VV~f~- Estate of Marshall M. Minich a/k/a Marshall Marlin Minich, Sr. r~ By- Ile A~ottoms, Executrix J ob T. Wilson The HUD-1 Settlement Statement which I have prepared is a true and accurate account of this transaction. I have caused or will cause the funds to be disbursed in accordance with this statement. Settlement Agent SECURED LAND TRANSFERS - MECHANICSBURG Date 05/20/2010 Settlement Statement: 1402 Bradley Drive, A-112 ~c~ 1 ~ w ~e A. Settlement Statement U.S. Deparbnent of Housing and Urban Development B. Tvoe of Loan nua e.,.,rr.,,~l u,. ~Fn~ noac 1. OFHA 2. ^FmHA 3. ^Conv. Unins. 6. File Number 7. Loan Number 8. Mortgage Insurance Case Number 4. VA 5. Conv.lns. 20101SWARTZ ~a mt is ay ~ C. Note: name marked "(p.o.c)" r~o P a «,tea me aoaap; m.y are anw , n«e rw mro,mation ~~aea a w are not incwaee a. u,e mtala. TitleEx ress Settlement S stem WARNING: tt u a aims W knowngy make false starementa to the UniOeo Stated on Nis a Ner smiler form. Panelliea upon p y mnVklion an Nclutle a fab erlE W71 aonman[ Far tletaila aee: Title 18 U. S. Code Section 1001 anC Section 1010. D. NAME OF BORROWER: Richard H. Swartz and Mary L. Swartz ADDRESS: 22 Rid ewe Drive Carlisle PA 17015 E. NAME OF SELLER: Estate of Constance M. Minich ADDRESS: clo Fre & Tile 5 South Hanover Street Carlisle Penns Ivania 17013 F. NAME OF LENDER: Orrstown Bank ADDRESS: 77 East Kin Str P.O. Box 250 Shi ensbur 'PA 17257 G. PROPERTY ADDRESS: 1402 Bradley Drive, Unit A 113, Carlisle, PA 17013 North Middleton Townshi H. SETTLEMENT AGENT: O'Brien, Baric & Scherer, Telephone: 717.249.6873 Fax: 717-249.5755 PLACE OF SETTLEMENT: 19 West South Str Carlisle PA 17013 I. SETTLEMENT DATE: 1011512010 J. SUMMARY OF BORROWER'S TRANSACTION: K. SUMMARY OF SELLER'S TRANSACTION: 100. GROSS AMOUNT DUE FROM BORROWER 400. GROSS AMOUNT DUE TO SELLER t 01. Contract sales 'ce 75 000.00 401. Contrail sales 75 000.00 102. Personal Pro 402. Personal Pro 103. Settlement cha es to borrower line 1400 1 732.50 403. 104. 404. 105. 405. Ad'ustments for ttems aid b seller in advance Ad'ustments for items aid b seller i n advance 1 O6. Ci ttown taxes 406. Cit ttovm taxes 107. Coun taxes 10115110 to 12/31110 41.99 407. Coun taxes 10/15110 to 12131/10 41.99 108. School Tax 10115/10 to 06130111 596.38 408. School Tax 10115110 to 06130111 596.38 109. 409. 110. 410. 111. Association Proration 56.64 411. Assoration Proration 56.64 112. 412. 120. GROSS AMOUNT DUE FROM BORROWER 77 427.51 420. GROSS AMOUNT DUE TO SELLER 75 695.01 200. AMOUNTS PAID BY OR ON BEHALF OF BOR ROWER 500. REDUCTIONS IN AMOUNT DUE TO SELLER 201. 't or earnest mone 2 000.00 501. Excess De sit see instructions 202. Pdnd al amount of new loans 35 000.00 502. Settlement cha es to seller line 1400 5 926.83 203. Existin loan s taken sub'eil to 503. ExisGn loan s taken su 'ail to 204. 504. Pa otf of First Mort a e Loan 205. 505. 206. 506. 207. Rent Proration 309.60 507. Rent Proration 309.60 208. 508. 209. 509. Ad'ustments for items un aid b seller Ad'ustmerrts for items un aid b seller 210. Ci flown taxes 510. Cit flown taxes 211. Count taxes 511. Coun taxes 212. School Tax 512. School Tax 213. 513. 214. 514. 215. 515. 216. 516. Securi D sit 600,00 217. 517. 218. 518. 219. 519. 220. TOTAL PAID BYIFOR BORROWER 37 309.60 520. TOTAL REDUCTION AMOUNT DUE SELLER 6 836.43 300. CASH AT SETTLEMENT FROM OR TO BORR OWER 600. CASH AT SETTLEMENT TO OR FROM SELLER 301. Gross amount due from borrower line 120 77 427.51 601. Gross amount due to seller line 420 75 695.01 302. Less artaunts aid b/for borrower line 220 37 309.60 602. Less reduction amount due seller line 520 6 836.43 303. CASH FROM BORROWER 40117.91 603. CASH TO SELLER 68 858.58 5. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENP SETTLEMENT STATEMENT File Number:201015WART2 ~N~~~~VU ~ ~~_~ PAGE2 TitleExoress Settlement Svstem SETTLEMENT CHARGES PAID FROM PAID FROM 10. TOTAL SALESBROKER'S COMMISSION based on rice $75 000.00 6.000 = 4500.00 BORROWER'S SELLER'S Division of commission line 700 as follows: FUNDS AT FUNDS AT 701. $ to Ebener & Associates SETTLEMENT SETTLEMENT 702. $ 4500.00 to 703. Canmission aid at Settlement 4500.00 800. ITEMS PAYABLE IN CONNECTION WRH LOAN BOt. Loan 0' ination Fee %Orrstown Bank 150.00 802. Loan Discount % 803. A sisal Fee 804. Credit Re rt 805. Document Pre oration Fee to Orrstown Bank 150.00 806. Flood Certification Fee to Orrstown Bank 14.50 807. 808. 809. B10. 811. 900. REMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest From to $ /da 902. Mort a Insurance Premium for to 903. Hazard Insurance Premium for to 904. 905. 1000. RESERVES DEPOSITED WITH LENDER FOR 1()01. Hazard Insurance mo. Imo 1002. Mort a Insurance mo. /mo 1003. Ci Pro Tax mo. Imo 1004. Coun Pro Tax mo. Imo 1005. School Tax mo. Imo 1009. A ate Ana sis Ad'ustment 0.00 0.00 1100. TRLE CHARGES 1101. Setttement or closin fee 1102. Abstract or title search to Robert L. O'Brien Es wire 150.00 1103. Title examination 1104. Title insurance binder 1105. Document Pr oration 1106. Nota Fees 1107. Attome 's fees to RobeR L. O'Brien 400.00 includes above items No: Attome 's Certificate of Title 1108. Title Insurance includes above items No: 1109. Lender's Cover a 35 000.00 1110. Owner's Cover a 75 000.00 - 1111. 1112. 1113. 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recordin Fees Deed $ 38.50 • Mort a 48.50 • Release $ 87.00 1202. C' ICoun taxlstam s Deed 750.00 • Mort a e $ 750.00 1203. State Taxlstam s Deed 750.00 ~ Mort a e 750,p0 1204. Assi nment of Rents Recordin to Cumberland Cou Recorder of Deeds 31.00 1205. 1300. ADDITIONAL SETTLEMENT CHARGES 1301. Resale Certificate to Pheasant Run Condo Association 50.00 1302. Assodation Dues thru 10110 to Pheasant Run Condo Association 550,00 1303. Fnal WaterlSewer #06000759 to North Middleton Authori 76.83 1400. TOTAL SETTLEMENT CHARGES enter on lines 103 Section J and 502 Section 1 732.50 5 926.83 MUD CERTIFICATION OF BUYER AND SELLER 1 ha Iry reviewed the HUD-1 Seth era Statem to Ne best of my krlPwledge and belief, a u a aue and aaurae statement M ell receipts and a' enh made my account m at This ansaGian. I furdter cart 1 a N the HUD-1 Seabment Statemen . ary w .--~+ s s ~ WARNING: R IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE The HUD-1 Staeement Statement which I have Prepared is a ws and accurate accent o(this UNITED STATES ON THIS OR ANV SIMILAR FORM. PENALTIES UPON CONVICTION transectbn. I have moused a will cause ale itnds tc t» disbursed h accordance wiN this statement. CAN INCLUDE A FINE AND IMPRISONMENT. FOR DETAILS SEE TITLE 18: U S. CODE SECTION 1001 AND SECTION 1010. ~~ SETTLEMENT AGENT: ~~ DATE'. (U I O Accountant's Valuation and Financial Reports: N.L. Minich & Sons, Inc. s_ s t/a C)possum Lake Accounting & Tax Service 99 Campground Road Carlisle, PA 17015-8918 Telepi:o,le: (717) 243-0366 Fax: (717)249-7663 E-mail: N. L. Minich & Son Inc. 730 N College Street Carlisle, PA 17013 October 15, 2009 To Whom It May Concern: Using the basis of assets plus the average of operations for five ~, vars, I have determined the fair market value of the corporate shares on July 29, 2009 as follows: Total Value $105,523.89 divided by 7,850 shares = $13.45 per share This is the same method used in previous calculations. Based on this determination, I have calculated the amount owed to the estate of Marshall Minich for his 4,700 shares at $13.45 per share to be $6;,215.00. Enclosed please find copies of the balance sheet, profit and loss ~ tatement. accounts receivable and accounts 1~ayable as of July 29, 2009. If I can be of any further assistance, please do not hesitate to call me. Sincerely, .--~ -~~ Axlene R. Graver Accountant & Tax Service cc: Michael Bangs, Attorney 3:40 PM N. L. Minich ~ Sons, Inc. ,o/,slo9 Balance Sheet Accrual Basis As of July 29, 2009 Jul 29, 09 ASSETS Current Assets Checking/Savings M 8 T Bank- Money Market Acct 10,220.63 M8T Bank 25,672.49 Petty Cash 543.14 Total Checking/Savings 36,436.26 Accounts Receivable Accounts Receivable _ ____ ___ _ 70,161.2a Total Accounts Receivable 70,161 24 Other Current Assets Inventory Asset -231.50 Total Other Current Asset<_ -231.50 Total Current Assets 106,366.00 Fixed Assets Concrete Trucks Concrete Trucks 91,804.00 __ -- _ Total Concrete Trucks --- 91,804.00 Construction Trucks/Trl 2005 Granite Mack 63,000.00 Dump Trucks 284,750.00 Excavating Equip 580 SL Case Backhoe Loader 4x4 28,000.00 D6fiS Komatsu with ripper 15,500.00 Excavating Equip -Other 312,636.00 Total Excavating Equip 356,136.00 Construction TruckslTrl - Othei 45,182.00 Total Construction Trucks/Tr 749,068.00 Furniture & Fixtures Office Furniture 3,044.48 Total Furniture & Fixtures 3,044.48 Less Depreciation Concrete Trucks -Accum Depi -145,587.00 Dump Trucks Accu Depr -87,339.00 Excavating Equip -Accum Depr -346,415.52 Office Furniturn Accum Depr -428.00 Pick-ups Accu Depr -42,038.00 Less Depreciation -Other -200,933.00 Total Less Depreciation -822,740.52 Pick-ups 1980 Ford Pick-up 1,375.00 1986 Chevrolet 2,250.00 1997 Ford F250 7,200.00 Pick-ups -Other 36,440.00 Total Pick-ups 47,265.00 Total Fixed Assets 68,440.96 Other Assets Prepaid Accounts IRS Corporate Est 5,000.00 Pa Corporate Est. - 5,200.00 - - _ _ __ Total Prepaid Accounts 10,200.00 Total Other Assets 10,200.00 TOTAL ASSETS 185,006.96 Page 1 3:40 PM 10!15109 Accrual Basis N. L. Minich $~ Sons, Inc. Balance Sheet As of July 29, 2009 LIABILITIES 8 EQUITY Liabilities Current Liabilities Accounts Payabfe Accounts Payable Total Accounts PayablE Other Current Liabilities Bank Loan- Line of Credit Payroll Liabilities Centax Federal Income Tax W/H Federal Unemp FUTA Local Tax Medicare Employee Medicare Employer Pa State Emp W/H Pa Unemployment Comp Fund Simple Investment Plan Social Security Emp FICA Social Security Employer FICA Payroll Liabilities -Other Total Payroll Liabilities Sales Tax Payable Total Other Current Liabilities Total Current Liabilities Long Term Liabilities Truck Loan-M 8 T BanM Total Long Term Liabilities Total Liabilities Equity Addt'i Paid In Capital Capital Stock Retained Earnings Net Income Total Equity TOTAL LIABILITIES 8 EQUITY Jul 29, 09 28,493.71 - __---- 28,493.71 40,000.00 72.50 -7.00 67.05 224.93 -3.19 -3.19 131.99 512.96 1, 376.35 -13.64 -13.64 1.239.56 931.98 2,293.69 43.225.67 71 .719.38 29,667.81 29,667.81 101,387.19 56,410.90 55,397.00 2,423.47 -30,611.60 83,619.77 185,006.96 Page 2 1:oa PM N. L. Minich 8c Sons, Inc. o9rosros P ~Of it & LOSS Accrual Basis January 1 through July 29, 2009 Jan 1 -Jul 29, 09 Ordinary Income/Expense Income Concrete Calcium 246.50 Truck Tlme 2.852.50 Concrete -Other 129,898.73 Total Concrete 132,997.73 Excavation Equipment Labor 11,555.83 Sand ?_,821.25 Slate 4 1,240.00 Snow Removal ' ,268.35 Stone 38,259.90 Topsoil 2,410.00 Excavation -Other 2,350.00 Total Excavation 201,905.33 Sales 2,588.30 Total Income 337,491.36 Cost of Goods Sold Cost of Goods Sold Job Materials 3 ",474.29 Parts 8~ Repairs ~ 3,894.77 Raw Materials 5";,527.83 Vechicles-Fuel $ Oil 24,?47.67 Vechicles-Licenses 9,879.00 Vechicles-Tires 4,721.30 Cost of Goods Sold -Other ? ,505.28 Total Cost of Goods Sold 145,150.14 Payroll Employees 75,662.65 Payroll Taxes Federal Unemployment 460.86 Pa Unemployment Comp 4,400.14 Payroll Taxes -Other 9,102.84 Total Payroll Taxes 13,963.84 X-Less Cash Discounts -31.94 Total COGS 234,744.69 Gross Profit 102,746.67 Expense Advertising 5,830.25 Automobile Expense Emission Testing 40.81 Gas 8 Oil 1,778.31 License 81.00 Parts 8 Repairs 131.21 Tires 42.93 __ _ -- --- Total Automobile Expense 2,074.26 Bank-Merchant Acct. 685.94 Bank Service Charges 40.00 Cable Television 24.95 Commissions 620.00 D.O.T. Physicals-Drug-Alcohol 455.00 Depreciation Expense 5,270.52 Driver Record Services 30.00 Dues and Subscriptions 510.00 Freight 8 Delivery 356.64 Fuel Surcharge 18.66 Page 1 ~;04 pM N. L. Minich 8~ Sons, Inc. c-~o~o9 Profit & Loss Accrual Basis January 1 through July 29, 2009 Jan 1 -Jul 29, 09 Insurance Auto Insurance 14,087.38 Disability Insurance 759.80 Keystone Health Plan Central 15,584.47 Liability Insurance 822.00 Package Insurance 3,908.96 Umbrella Insurance 2,590.67 Work Comp 7,155.06 Total Insurance 44,908.34 Interest Expense Loan Interest 1,320.07 Interest Expense -Other _ 419.00 Total Interest Expense 1,739.07 Late Fiie Penalty 21.00 License-Mining 300.00 Miscellaneous 913.52 Office Supplies Computer supplies 770.17 Office Supplies -Other 970.61 Total Office Supplies 1,740.78 Postage and Delivery 250.91 Printing and Reproduction 502.14 Professional Fees Accounting 2,050.00 Legal Fees 300.00 Notary 74.00 Total Professional Fees 2,424.00 PUC-Safety Reg. Books 8 Supplie 405.56 Rent 17,500.00 Repairs Building Repairs 65.52 Equipment Repairs _ 23.81 Total Repairs 89.33 Salaries Payroll 401K Emp Retirement 366.34 Salaries Payroll -Other 43,328.50 Total Salaries Payroll 43,694.84 Shop Supplies Cleaning-Janitorial 37.67 Shop Supplies -Other ~ ,188.52 Total Shop Supplies 1,226.18 Slatebank 336.00 Taxes Federal Vehicle Axel Tax 604.33 Pa Safes Use Tax 169.10 Real Estate Tax 2,483.33 SalesTax 164.52 Taxes - O[her 30.04 Total Taxes 3,451.32 Telephone Cell Phone 2,212.12 Internet Monthly Service 279.84 Telephone -Other 1,420.76 --- ~ ~ - Total Telephone 3,912.72 Page 2 1;oa PM N. L. Minich $c Sons, Inc. 09/03/09 Profit & Loss Accrual Basis January 1 through July 29, 2009 Jan 1 -Jul 29, 09 Travel 8 Ent Meals 11526 Total Travel & Ent 115.26 Uniforms 1,245.73 Utilities Electric 2.909.39 Heating 253.04 Trash 279.65 Water 8 Sewer 141.09 Total Utilities --_--- ---_ 3,583.17 Water 131.60 Water Testing From Ponds 180.00 Total Expense __ ___ 144,587.70 Net Ordinary Income -41,841.03 Other Income/Expense Other Income Cash Discount 236 86 Dividends . 2 18 Finance Charge Customers Finance Charges 578.91 Finance Charge Customers -Other -15.69 - Total Finance Charge Customers -- _ __ -- 563.22 Other Income Interest Income 87 81 Pa Sales Tax Discount 119 36 Other Income -Other 20.00 Total Other Income 227 17 Sale of Assets _ _ 10,200.00 Total Other Income _ 11,229.43 ` Net Other Income 11,229.43 Net Income -30,611.60 Page 3 m n. ' OOtn 0000 h0~00(OM Otn to aONO~tn ON00000~ ~p JI Otn ~f~000QNC00~MM~~N~t00(ON M)t0000f~O~i N Q,, Oh ~00t000 h hNOMh(00~ to Q00 GOONOO~~N r . H~ ON00 O)aD NCO to 00hOO~tc')NONN000 CO (D ONCOh t0 i O~ O K CO V' CO ~ M h 00 h h V N f~ N N .- ~ N O ~ M ~~ c0 ~ ~ r F. ~ .-- V h h q N N .- '- ~ O) ~ O ' 0 0 0 0 0 0 0 0 0 0 0~ 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0~ to I~ I O O O O O O O O O O O M O 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 M ~ I 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0 0 0 1, ~ A i h ~ O , ~, O O O O O O O h 0 0 0~ 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0~ N' G ~ O O O O O O O O O O O N O O O O O O O O O O O O O O O O O O ~ M j Cf i 0000000 MO OOO ~ 000000000000000000,.E ~ j r ~ ' ~ I a0 •- I ~ I O O M 0 0 0 0 0 0~ 0~ 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 O f O1 OO LL7 I~OOO SON ONOO X000000000000000'' ~ ~p ~ O O h~ O O O~ O~ O~ O O O 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 ~ A '. ~ c0 ~ M ~ 'I A ~ M ~ N ~ O O i N '~ OON 000.-~OOOtnOOCO~00N00000000000 O .~ ~ O O O f O 0 0 f O N 0 C 0 ONO O f O M 0 0 f 0 0 0 0 0 0 0 0 0 0 0 0 1 N' N M I O O MO O O O O N O h O~ 0 0~~ O O O 0 0 0 0 0 0 0 0 0 0 0 ~, ~ ~ ~ Q Oc0 Mtq N ' r ~ r'. r N ~ N Of 7 Q ~ I OOOOOOOOOOOOCOMO~0a000~ tp ON 00000' aD ' ~ ~+ 000000~ONOO)OMMO NOOO NOCOOOOh~R CD ' a dl qh 0000000 OhOOMN Os{Otn 'ct OOO O~NOO V V Ni 1~ `~ ~ CO 1n O h~i9 t0 GOON NN000 CDO NfO h O 7 (p O O h h h d1 (O h N .-- ~ N Of ~ M ~ CO 7' O U ~ N h ~ ~ ~ 1~ Cn Of i V Q N .~ V ._ C J Z V C O ~ d c ~ ~ v '~ m U :+ C V J ~ CL V >~ Of m QCJ y C 7 +~ C J m pl . C e 0- ~ O' Ol ~ io eo >. ~ c~ is O N p ~ c y Y C O m~ U W~ F' V ego e v m U ~ 'a d LL C D d F Y C Z ~ °tf L O A y m to O ~ =_ :' 'o Oi ~- p O - 'O dl 8 Y ~ ~ ~ ~ d ~ >. '> y ~'m o 3L A ~~a ~ ~=OQ ~ mW rn~gt ~~~~m ma!'.3j m Y H A N N 8 y Q m~ m~~ >. ~ to C= C O~~~ d e0 J c Y c ova os a~,~v cL c c °_'« >>ag°, m~vrs °fm Z`u°, ~ ma:v= o ~ mad m A d ~ o o m'm °e m'm m 3Q1-; ~'? o as m- A QmfflmLDUU~u.U' U' S~~YYY~2ZOSSSSd'HF-3Y H- O H ~ °' a °- M O O r ~ r O COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1712g_0601 RECEIVED FROM: REV-1162 EX111-96) PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT N0. CD 015363 BOTTOMS MICHELLE M 2822 SPRINGFLOWER DRIVE WILSON, NC 27896 ------- fo~~ ESTATE INFORMATION: FILE NUMBER: DECEDENT NAME: DATE OF PAYMENT: POSTMARK DATE: COUNTY: DATE OF DEATH: SSN: 206-36-4795 2101-0286 MINICH MARSHALL M SR 12/20/2011 12/19/201 1 CUMBERLAND 07/29/2009 REMARKS: RECEIPT TO ATTY ACN ASSESSMENT AMOUNT CONTROL NUMBER TOTAL AMOUNT PAID: CHECK#156 INITIALS: CJ SEAL RECEIVED BY: S 10,459.04 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: REV-1162 EX111-96) PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 015364 FREY ROBERT G 5 S HANOVER STREET CARLISLE, PA 17013-3385 ------- ford ACN ASSESSMENT AMOUNT CONTROL NUMBER TOTAL AMOUNT PAID: S 10,125.00 REMARKS: RECEIPT TO ATTY CHECK#11235 INITIALS: CJ SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS 2011-Ju'~-19 "0:52 AM RBC CENTURA 12524543418 2/2 Pa. O.C. Rule 6.12 STATUUS REPORT REGISTER OF WILLS OF ~C~ C,1 COUNTY, PENNSYLVANIA Name of Decedent: ~~ ~~ ~`~ (~. ~ ~ ~~ ~ t~ [ t1 ~ (' ~~1 ,--- Date ofDeath: ~..~ V 2-~ ~ Z ~ C~ File Number; ~~ ~ - ~ ~ - ~} ~~ ~~ Pursuant to Pa. O.C. Rule 6.12, X report the fol]owing with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete :........... . . . ...... Yes ^ No 2. if the answer ie No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is 'YES, state the following: a. Did the personal representative file a final account with the Court? ....... ^Yes (~,~Vo b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Aid the personal representative state an account ~ ~+ informally to the parties in interest? ,,, ............................... ICJ Ycs ^ No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts maybe filed with the Clerk of the Orphans' Court and may be attached to this report. ~ Dnfe ~ v ~'~ l ~ Z ~ r ^ Slgnnlure of Person FIlI~ cAb Porrn Q v~ ~a7 -~' ~ c peciry: ^Pereonal Representative Counsel i ~ ~ '`Y-'-'=_ d.. _~ la Farm rh g `me ajPerson Filin N~n ~/~l ~.~- ~ / ~ ~ ,-. _, t z Addrers ~. f ~ . ~. C..] C, C. ~ ~ ~-~ ~ ~ ~ ~ ~ L "l CV ! 1 V Telephone FormRW-lD rov. !0./3.Od i~ ~;~ ~~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: FREY ROBERT G 5 S HANOVER STREET CARLISLE, PA 17013-3385 fold PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX111-961 NO. CQ 016100 ACN ASSESSMENT AMOUNT CONTROL NUMBER ESTATE INFORMATION: ssly: 2os-36-4~ss FILE NUMBER: 2101-0286 DECEDENT NAME: MINICH MARSHALL M SR DATE OF PAYMENT: 06/12/2012 POSTMARK DATE: 06/ 1 2/201 2 COUNTY: CUMBERLAND DATE OF DEATH: 07/29/2009 REMARKS: CHECK#11274 SEAL 101 ~ 51,152.83 TOTAL AMOUNT PAID: INITIALS: DMB RECEIVED BY: 51,152.83 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS nr1C1![ ~~~(~~- ~HERITANCE TAx ~~nC~S'~f ~~t'~~'t~c3 '~i `ui 3UREAU OF INDIVFpUAL TAXES APP~T'._ LL ANCE DR DISALLOWANCE pEpAFTMENTOFREVENUE FNNERiTANCE TAX DFVfSfON ~Y'~CfT•_Ij}~1~,~~D ASSESSMENT DF TAX REY°i'~41 Ex AFP C12-11: PO E:OX 28DGei NAP,RISSURG PA A%228-O6CS !!,,u p ry ~~~~ `jvn f ~ P~! JI ~ 4 DATE D6-05-2012 ESTATE OF MINICH SR MARSHALL H p i,_IJ` DATE DF DEATH 07-29-2D09 ORPhAP~~+ UU~F FILE NUMBER 21 01-0286 CUMBERLAND CO., ~PA CouNTY CUMBERLAND ROBERT G FREY ACN 101 5 S HANDYER ST APPEAL DATE: D$-04.-2012 CARLISLE PA 17013-3307 (SeererersesideunderObjecteons) Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER DF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE ~--Y RETAIN LOWER PORTION FDR YOUR RECORDS ~' REY-1547 EX AFP CI2-1I) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF: MINICH SR MARSHALL MFILE NO.:21 01-0286 ACN: l0I Y)ATE: 06-D5-2012 ---- TAX RETURN WAS: C X) ACCEPTED AS FILED L ) CHANGED APPRAISED VALUE 4F RETURN YiASED ON: DRI6INAL RETURN 1. Real Estate CSchedule A) tl) 444,79D.00 NOTE: To ensuro proper .0 D credit to your account, 2. Stocks and Bonds CSchedulo B) C27 3. Closely Hold Stock/Partnership Intarost CSchedule C) {3) 6 3,215.00 submit the upper portion of this form xlth your 4, Mortgagor/Notes Reeolvable CSchedule D) C4) •0Q tax paymont. 5. Cash/Sank DepositslMisc. Porsonal Proporty CSchedulo E) {5) 10,151.00 6. Jointly Owned Proporty CSchedule F) {6) .00 7. Transfors CSchedule G) {~) .QO e. Total Ascots {8) 51$,156.00 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expensos/Adm. Costs/Misc. Exponses CSchedule N} {9) 35.415.00 lO. Debts/Mortgage Liabilities/Liens CSchodule I) C10} 25,318.00 11. Total Doductlons C11} _ 60,733.00 12. Net Value of Tax Return C12) _ 4 57,4 23.00 13. Criaritatrlo/Governmental Bequests; Non-electeC 9113 Trusts (Scttodula J) (23) .00 14. Net Value of Estate Subject to Tax (14) 4 57x4 23.00 NOTE: If an assessment uas issued previously, lines 14, 15 and/or 16, I7, 18 and 14 Mill reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Lino I4 at Spousal rato i15} .00 X 0 0 .00 16. Amount of Line '.4 taxable at Lineal/Class A rate C16) 4~i7. 4?3.06 X 045 = 20,584.04 1T. Amount of Line 14 at Sibling rata C17) -f}f) X 22 : Di3 18. Amount of Lino I4 taxable at Collatoral/Class B rate (i83 .00 X 15 - .00 19. Principal Tax Rue (19)° 20 , 584.04 TAX CREDITS: ~ PAYMENT ~ DATE RECEIPT NUHBER DISCOUNT C+) INTERESTlPEN PAID (-) AyOUNT PAIR 12-19-2011 ~ CD015364 .QO 10,125.00 I2-19-2011 CDOI5363 .QO 1D,454.04 BALANCE OF UNPAID INTEREST/PENALTY AS OF 22-20-2011 TOTAL TAX PAYMENT 20,584.04 BALANCE DF TAX DUE .Op INTEREST AND PEN. T,152.83 TOTAL DUE 1,152.83 iF PAID AFTER DATE IHDiCATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR}, YOU MAY SE DUE FCR CALCULATION OF ADDiTIOHAL INTEREST. A REFUND. SEE REVERSE SIDE aF THIS FORM FOP. INSTRUCTIONS. BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 ROBERT G FREY 5 S HANOVER ST CARLISLE APPR'A~~~,~~AL~~CE TOR DISALLOWANCE OF l9~~b1~'~,~,~,~.~ ASSESSMENT OF TAX CUT ALONG THIS LINE ---- ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~-'~ -------------------- ---------------------------------------------------------------- REV-1547 EX AFP C12-11~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF: MINICH SR MARSHALL MFILE N0.:21 01-0286 ACN: 101 DATE: 06-05-2012 TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) Pennsylvania ~ DEPARTMENT OF REVENUE REV-1547 IX AFP (12-1ll NOTE: To ensure proper credit to your account, submit the upper portion of this form with your tax payment. c8) 518, 156.00 c9) .47 .00 clo)_ 25.318.00 11. Total Deductions cll) 60,733.00 12. Net Value of Tax Return C12) 457,423.00 13. Charitable/Governmental Bequests; Non-elected 9113 Tr usts (Schedule J) C13) .OD 14. Net Value of Estate Subject to Tax C14) 457,423.00 NOTE: If an assessment was issued previously, li nes 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to d ate. ASSESSMENT OF TAX: 15. Amount of Lirie 14 at Spousal rate C15) .00 X 00 - .00 16. Amount of Line 14 taxable at Lineal/Class A rate C16) 47.4?3.00 X 045 = 20,584.04 17. Amount of Line 14 at Sibling rate c17) .00 X 12 = .00 18. Amount of Line 14 taxable at Collateral/Class B rate (18) .00 X 15 - .00 19. Principal Tax: Due C14)= 20,584.04 TAX CREDITS: PAYMENT RECEIPT DISCOUNT C+) DATE NUMBER INTEREST/PEN PAID c-) AMOUNT PAID 12-19-2011 (0015364 .00 10,125 00 12-19-2011 (0015363 .00 . 10,459.04 BALANCE OF UNPAID INTEREST/PENALTY AS OF 12-20-2011 TOTAL TAX PAYMENT 20,584.04 BALANCE OF TAX DUE .00 INTEREST AND PEN. 1,152.83 TOTAL DUE 1,152.83 * IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. cl) 444,790.00 c2) .00 c3) 63,215.00 c4) .00 c5) 10, 151 .00 c6) .00 v) .00 L~lL.jU~ ~~ li~~~~ J~DATE 06-05-2012 ESTATE OF MINICH SR MARSHALL M »s,~~?~f;;; DATE OF DEATH 07-29-2009 ~tP~'~ GUJr1~ FILE NUMBER 21 01-0286 ~~ ~,PA COUNTY CUMBERLAND ACN 101 APPEAL DATE: 08-04-2012 P A 17 013 - 3 3 0 7 (See reverse side under Objections ) Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 Pennsylvania ~~ `~~` BUREAU OF INDIVIDUAL TAXES I~Lhl~GI`tiV r~TANCE TAX DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION REV-1607 EX AFP (12-11> Po Box 2BO6o1 ~~4~~~~;T;74iT~4VT OF ACCOUNT HARRISBURG PA 17128-0601 EDi2 JUL 13 PM 12~ 42 DATE 07-09-2012 ESTATE OF MINICH SR MARSHALL M DATE OF DEATH 07-29-2009 L:1..'•_-'1~'. _~. FILE NUMBER 21 01-0286 Q~~ J v01%~r COUNTY CUMBERLAND ROBERT G FREY ~~~~~~ ~;Q„ PA ACN 101 5 S HANOVER ST Amount Remitted CARLISLE PA 17013-3307 - MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 NOTE: To ensure proper credit to your account, submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE - - - - ~_ RE_TAIN LOWER PORTION FOR YOUR RECORDS _ ~ _ REV-1607 EX AFP C12-11) *** INHERITANCE TAX STATEMENT OF ACCOUNT **~ ESTATE OF:MINICH SR MARSHALL M FILE NO.: 21 01-0286 ACN: 101 DATE: 07-09-2012 THIS STATEMENT PROVIDES CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 05-29-2012 PRINCIPAL TAX DUE: ~~ moo. ,,. PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT C+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 12-19-2011 CD015364 .00 10,125.00 12-19-2011 CD015363 .00 10,459.04 06-12-2012 CD016100 1,152.83- 1,152.83 TOTAL TAX PAYMENT 20,584.04 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.