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15056041125
REV-1500 EX (06-05)
PA Department of Revenue '*
~~~~:~~~:o~uaITaxes INHERITANCE TAX RETURN
Harrisburg, PA 17128-0001 ~- -- RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
OFFICIAL USE ONLY
County Code Year
2 1 0 7
File Number
o 4 6 7
Date of Birth
25166 594 2
05032007
08121941
Decedent's Last Name
Suffix
Decedent's First Name
C H A R L E S
LEROY
MI
J
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
Spouse's First Name
MI
Spouse's Social Security Number
o 2. Supplemental Return
o 4a. Future Interest Compromise (date of
death after 12-12-82)
o 7. Decedent Maintained a Living Trust
(Attach Copy ofTrust)
o 10. Spousal Poverty Credit (date of death 0 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. 0)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
FILL IN APPROPRIATE OVALS BELOW
00 1. Original Return
o 4. Limited Estate
00
o
THIS RETURN MUST BE FILED IN DUPUCATE WITH THE
REGISTER OF WILLS
6. Decedent Died Testate
(Attach Copy of Will)
9. Litigation Proceeds Received
o
o
1
I
3. Remainder Return (date of d~ath
prior to 12-13-82) i
5. Federal Estate Tax Return R~uired
8. Total Number of Safe Depos~ Boxes
W ILL I A M
A.
DUN CAN
71724 9 7 7 8 0
Firm Name (If Applicable)
DUN CAN &
HARTMAN,
P C
REGIST~~.O ~WILLS U~~NL~I ......../
'... -'1 ro..
't! 0 I:: i " '.
. I L...) 1- T'
-ry
First line of address
1 IRVINE
ROW
Second line of address
"i'
City or Post Office
State
ZIP Code
~?pe FILED W
. l,', I
~,
CAR LIS L E
P A
17013
Correspondenfs e-mail address:billduncan@planetcable.net
Under penalties . 'Y, I declare that I have examined this return, including acoompanying schedules and statements, and to the best of my knowledge and belief,
it is true, and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knoWledge. .
SPONSIBlE FOR FILING RlffURN 0 C
FCe.-'7?uC._ 3? / CJ K
DRIVE
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
NEWBURG
PA 17240 ,
DATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
Side 1
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15056041125
15056041125
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15056042126
REV-1500 EX
1. Real estate (Schedule A)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1.
Decedent's Social Security Num~er
25166 594 2
I
254000.00
Decedent's Name: LEROY J. CHARLES
RECAPITULATION
2. Stocks and Bonds (Schedule B)
....................... ........... 2.
3. Closely Held Corporation, Partnership Or Sole-Proprietorship (Schedule C) ..... 3.
4. Mortgages & Notes Receivable (Schedule D)
............. ........... 4.
14. Net Value Subject to Tax (Line 12 minus Line 13)
. . . . . . . - . . . . . . . . . . 14.
. i
4 8 9 1 2 2. ~ 7
2 1 6 1 . 0
1 7 6 9 9 2. 3
9 2 2 2 7 6. 0
6 1 4 0 1 . 1
4 1 6 7 6. j 5
1 0 3 0 7 7 . S 6
8 1 9 1 9 8. ~ 4
i
i
8 1 9 1 9 8. 91 4
i
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ....... 5.
6. JoinUy Owned Property (Schedule F) D Separate Billing Requested . . . . . " 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) D Separate Billing Requested . . . . . .. 7.
8. Total Gross Assets (total Lines 1-7)
................ -..........8.
9. Funeral Expenses & Administrative Costs (Schedule H) . . . . . _ . . . . . . . . .. 9.
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . _ . . . . . . . . . . 10.
11. Total Deductions (total Lines 9 & 10)
. ... . . . . . . . . . . . . . - . . . . . . . . . . 11.
12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . _ . . . . . . . . . . 12.
13. Charitable and Govemmental Bequests/See 9113 Trusts for which
an election to tax has not been made (Schedule J) . . . . . . . _ . . . . . . . . . . 13.
TAX COMPUTATION - SEE INSTRUCTIONS FOR APPUCABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) X.O _ o . 0 0 15.
16. Amount of Line 14 taxable 8 1 7 0 3
at lineal rate X .012- 7 . 9 4 16.
17. Amount of Line 14 taxable o . 0 0
at sibling rate X. 12 17.
18. Amount of Line 14 taxable 2 1 6 1 . 0 0
at collateral rate X .15 18.
19. Tax Due
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.
o. 0 0
3 6 7 6 6.7 1
O. 0 0
324.15
37090.86
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
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15056042126
15056042126
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REV-1500 EX Page 3
Decedent's Complete Address:
File Number
21 07 0467
DECEDENT'S NAME
LEROY J. CHARLES
STREET ADDRESS
425 CROSSROAD SCHOOL ROAD
.
CITY I STATE I ZIP I
CARLISLE PA 17013 I
Tax Payments and Credits:
1. Tax Due (Page 2 Une 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
37,090.86
15,000.00
789.47
3. InterestlPenalty if applicable
D. Interest
E. Penalty
Total Credits ( A + B + C) (2)
15,789.47
TotallnterestlPenalty (D + E) (3)
4. If Une 2 is greater than Une 1 + Une 3, enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2, Line 20 to request a refund. (4)
5. If Une 1 + Une 3 is greater than Une 2, enter the difference. This is the TAX DUE. (5)
0.00
0.00
21,301.39
A. Enter the interest on the tax due.
B. Enter the total of Une 5 + 5A. This is the BALANCE DUE.
(5A)
(5B)
21,301.39
Make Check Payable to: REGISTER OF WILLS, AGENT
I
PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BlOJKS
I
1. Did decedent make a transfer and: Yes No:
a. retain the use or income of the property transferred; ................. ..................................................... 0 00
b. retain the right to designate who shall use the property transferred or its income; ....... ........................ 0 00
c. retain a reversionary interest; or ................................................................................................ 0 00
d. receive the promise for life of either payments, benefits or care? ....................................................... 0 00
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .................................. ..................................................... 0 00
3. Did decedent own an "in trust for' or payable upon death bank account or security at his or her death? ......... 0 00
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? .................................................................................................. 00 0
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE FURN.
I
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spous.
is three (3) percent [72 P.S. 99116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent
[72 P.S. 99116 (a) (1.1) (ii)l. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and
filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an
adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. 99116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in
72 P.S. 99116(1.2) [72 P.S. 99116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. 99116(a)(1.3)]. A sibling is defined, u~der
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-1502 EX + (6-98)
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SCHEDULE A
REAL ESTATE
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
LEROY J. CHARLES 21 07 0467
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 ro e which is 'oin -owned with ri ht of survivorshi must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
425 CROSSROAD SCHOOL ROAD
CARLISLE, PA 17013
2.
SEE ATTACHED APPRAISAL
LOT 1 CROSSROAD SCHOOL ROAD - DEED BOOK 33Y PAGE 568
CARLISLE, PA 17013
SEE ATTACHED APPRAISAL
TOTAL (Also enter on line 1. Recapitulation) $
(If more space is needed. insert additional sheets of the same size)
VAL EATDATE
F DEATH
188,000.00
66,000.00
254000.00
REV-1508 EX + (6-98)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
LEROY J. CHARLES
p s a nan a a a ware recelV y a e.
AU property jointly-owned willi right of SUlYlvo ip must be disclosed on Schedule F.
ITEM VAL EAT DATE
NUMBER DESCRIPTION o DEATH
1. COMERICA BANK ACCOUNT #9409-03087-2 20,955.39
CLOSEOUT VALUE 7/23/07 ATTACHED STATEMENT SHOWS 12/31/06
VALUE OF $20,909.34 REQUESTS FOR 000 NOT HONORED
2. SOVEREIGN BANK ACCOUNT #1691016039 5,182.85
[SEE ATTACHMENT]
3. SOVEREIGN BANK ACCOUNT # 1691027456 120,367.47
[SEE ATTACHMENT]
4. F&M TRUST ACCOUNT # 08-10401 7,898.65
[SEE ATTACHMENT]
5. ABF DECEASED WAGES PROCEEDS 4,687.40
[SEE ATTACHED LETTER]
6. COMMONWEALTH OF PA 2006 TAX REFUND 251.00
7. M&T SAFE DEPOSIT BOX - CASH AS PER SAFE DEPOSIT BOX 27,970.00
INVENTORY ATTACHED - CERTIFICATES OF DEPOSIT FOUND IN BOX WERE
PREDECESSORS TO OTHER INVESTMENTS AND HAVE NO VALUE
8. 2003 VW BEETLE GLS HATCHBACK 20 - FAIR 11,370.00
SEE KELL Y BLUE BOOK V ALUA TION ATTACHED
9. 1999 CHEVROLET SILVERADO 1500 PICKUP EXTENDED CAB TRUCK _ FAIR 8,630.00
SEE KELLY BLUE BOOK VALUATION ATTACHED
10. 1997 BUICK RIVIERA COUPE 2 DOOR - FAIR 4,560.00
SEE KELLY BLUE BOOK VALUATION ATTACHED
11. 1985 TRUCK - CHEVROLET PICKUP - TOO OLD FOR VALUATION AND 250.00
NOT DRIVEABLE
12. UNITED STATES TREASURY 2006 TAX REFUND 2,513.00
13. CAPITAL TAX COLLECTION BUREAU 2006 TAX REFUND 170.86
14. COMCAST REFUND 442.16
15. WASTE MANAGMENT REFUND 97.77
16. ADT SECURITY SERVICES PREPAID INVOICE 56.65
TOTAL (Also enter on line 5, Recapitulation) $ 489 122.97
Include the roceed of liIlg tic d th d te lh~
FILE NUMBER
21 07 0467
. ad b lh estat
(If more space is needed, insert additional sheets of the same size)
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
LEROY J. CHARLES
Decedent's Name
Page 1
21 07 0467
File INumber
!
Schedule E - Cash, Bank Deposits, & Misc. Personal Property
ITEM VAL JEATDATE
NUMBER DESCRIPTION 0 DEATH
17. CONTENTS OF HOUSE AT 425 CROSSROAD SCHOOL ROAD, CARLISLE, PA 5,151.00
SEE ATTACHED IBIS ESTATE APPRAISAL
18. CENTRAL PA TEAMSTERS PENSION FUND 1,240.00
[SEE ATTACHED LETTER}
19. TEAMSTERS PENSION FUND 267,328.77
[12/31/06 ACCOUNT BALANCE - $ 259,220.57
08/31/07 ACCOUNT BALANCE - $ 273,409.92
VALUATION FOR PA INHERITANCE TAX FOR DOD CALCULATED USING
$259,220.57 + (14,189.35 DIFFERENTIAL + 4fi + $8,108.30) = $267,328.77}
SUBTOTAL SCHEDULE E 2 3,719.77
GRAND TOTAL SCHEDULE E $ 489,122.97
REV-1509 EX + (6-98)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF
LEROY J. CHARLES
FILE NUMBER
21 07 0467
If an asset was made joint within one year of the decedents date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSH P TO DECEDENT
A. MARY A. LESH 340 FOX HOLLOW ROAD FRIEND
LOT # 19 I
I
SHERMANSDALE,PA17090
B
c
JOINTL Y.OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DEC EDENfS INTEREST
1. A. 61 SHARES OF PEPSICO STOCK 4,148.00 50. 2,074.00
$68.00 PER SHARE
[SEE ATTACHMENT]
2. A. 6 SHARES OF MA TTEL STOCK 174.00 50. 87.00
$29.00 PER SHARE
[SEE ATTACHMENT]
,
TOTAL (Also enteron line 6, Recapitulation) $ 2 161.00
(If more space is needed, insert additional sheets of the same size)
REV-1510 EX + (6-98)
.
SCHEDULE G
INTER.VIVOS TRANSFERS &
MISC. NON.PROBA TE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
LEROY J. CHARLES
ITEM
NUMBER
1.
2.
3.
FILE NUMBER
21 07 0467
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
DESCRIPTION OF PROPERTY
INClUDE THE NAME OFTHE TRANSFEREE. THEIR R8.ATlONSHIP TO DECCOENT ANO
THE DATE OF TRANSFER ATTACH A COPY OF THE DEED FOR REAL ESTATE.
HARTFORD LIFE ANNUITY ACCOUNT # 712199898
[SEE ATTACHMENT]
MFS HERITAGE TRUST CO IRA ACCT# 0007-00060171758
[VALUE 3/31/07 - NO 000 RECEIVED DESPITE
SEVERAL REQUESTS - ACCT SPLIT AMONG
DESIGNATED BENEFICIARIES SO NO COMPLETE
STATEMENT AVAILABLE]
ABF FREIGHT SYSTEM, INC. 401 K FIDELITY ACCOUNT
[VALUE AS OF 05-09-07]
DATE OF DEATH % OF DECO'S
VALUE OF ASSET INTEREST
67,295.12 100.
61,979.37 100.
47,718.04 100.
TOTAL (Also enter on line 7 Recapitulation) $
lit more soace IS needed. Insert additional sheets of the same size)
EXCLUSION
~F APPliCABLE)
TAXABLE
VALUE
67,295.12
61,979.37
47,718.04
176992.53
REV-1511 EX + (12-99)
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SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
LEROY J. CHARLES
ITEM
NUMBER
A.
1.
2.
FILE NUMBER
21 07 0467
Debts of decedent must be reported on Schedule I.
DESCRIPTION
FUNERAL EXPENSES:
EWING BROTHERS FUNERAL HOME, INC.
CUMBERLAND VALLEY MEMORIAL GARDENS HEADSTONE
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
City
State
Zip
Year(s) Commission Paid:
Attorney Fees DUNCAN & HARTMAN, PC
Family Exemption: (If decedenfs address is not the same as c1aimanfs, attach explanation)
Claimant
Street Address
City
State
Zip
Relationship of Claimant to Decedent
Probate Fees REGISTER OF WILLS - FILING FEES
Accountanfs Fees
Tax Return Preparer's Fees COHICK & ASSOCIATES -2006 TAX PREP
CUMBERLAND LAW JOURNAL - LEGAL AD
SENTINEL - LEGAL AD
FEDERAL EXPRESS & POSTAGE
KELLER & ASSOCIATES - ACCOUNTING & TAX ADVICE FOR TAX TREATMENT
OF PENSION
DIVERSIFIED APPRAIS. SVCS. LOT 1 CROSSROAD SCH RD APPRAISAL FEE
DIVERSIFIED APPRAIS. SVCS. 425 CROSSRD SCH RD HOUSE APPRAISAL FEE
IBIS APPRAISAL SERVICES PERSONAL PROPERTY APPRAISAL FEE
KELLER & ASSOCIATES - 2007 TAX PREP *** ESTIMATED ***
RESERVED FOR FILING FEES & ADDITIONAL EXPENSES
TOTAL {Also enteron line 9, Recapitulation} $
(If more space is needed, insert additional sheets of the same size)
J MOUNT
7,456.65
2,339.00
46,113.00
500.00
500.00
75.00
142.66
900.00
575.00
250.00
250.00
300.00
1,000.00
1,000.00
61 401.31
REV-1512 EX + (12-03)
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SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
LEROY J. CHARLES
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medicat eJ penses.
FILE NUMBER
21 07 0467
ITEM
NUMBER DESCRIPTION
1. NORTH FORK BANK PAYOFF 2003 VW BEETLE
[SEE A IT ACHMENT]
2. SOVEREIGN BANK INSTALLMENT LOAN #6817195799 HOME EQUITY MORTGAGE
LOAN
[SEE A IT ACHMENTJ
3. NSF FEE AGAINST M&T BANK ACCOUNT #9838901651
VALU AT DATE
OF DEATH
3,804.34
31,480.77
18.00
4. SIPE MOWER & EQUIOMENT - TRACTOR REPAIRS
307.08
5. STATE FARM HOMEOWNERS INSURANCE - HAZARD INSURANCE PREMIUM
FOR DWELLING
189.48
6. PPL ELECTRIC BILL
290.73
7. DCM SERVICES, LLC - SEARS DISCOVER CARD # 5121071869015077 PAYOFF
2,025.34
8. WASTE MANAGEMENT TRASH BILL
97.77
9. DEBORAH W. PIPER - TAX COLLECTOR - HOUSE - SCHOOL TAXES
1,590.44
10. DEBORAH W. PIPER - TAX COLLECTOR - LOT - SCHOOL TAXES
483.45
11. EMBARQ BILL
625.27
12. PPL ELECTRIC BILL
88.62
13. DEBORAH W. PIPER - TAX COLLECTOR - HOUSE - REAL ESTATE TAXES
330.13
14. DEBORAH W. PIPER - TAX COLLECTOR - LOT - REAL ESTATE TAXES
100.35
15. DEBORAH W. PIPER - TAX COLLECTOR - PERSONAL TAXES
5.50
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
4!1 676.25
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
LEROY J. CHARLES
Decedent's Name
Page 2
21 07 0467
File I Number
Schedule I - Debts of Decedent, Mortgage liabilities, & Liens
ITEM
NUMBER DESCRIPTION MOUNT
16. STATE FARM - HOMEOWNERS INSURANCE 238.98
,
I
I
SUBTOTAL SCHEDULE I 238.98
GRAND TOTAL SCHEDULE I $ 41,,676.25
"""."" ex. '.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
LEROY J. CHARLES
NUMBER
I.
1.
2.
3.
4.
5.
6.
SCHEDULE J
BENEFICIARIES
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS pnclude outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)J
STEVE CHARLES AKA STEVEN CHARLES
109 MINNICK DRIVE
NEWBURG, PA 17240
LEON CHARLES
18 YANKEE PLACE
ELLENVILLE, NY 12428
CYNTHIA CHARLES
11 MELROSE AVE., APT. #A-1
NEW WINDSOR, NY 12553
LINDA CHARLES
115 FORBUS STREET
POUGHKEEPSIE, NY 12603
DARRYL CHARLES AKA DARYL CHARLES
4 AMY ROAD
MIDDLETOWN, NY 10940
KAREN CHARLES
425 CROSSROAD SCHOOL ROAD
CARLISLE, PA 17013
FILE NUMBER
21 07 0467
RELATIONSHIP TO DECEDENT AMOU IJT OR SHARE
Do Not ListTrustee(s) 0 ESTATE
Lineal
1/6 SHARE
Lineal
1/6 SHARE
Lineal
1/6 SHARE
Lineal
1/6 SHARE
Lineal
1/6 SHARE
Lineal
1/6 SHARE
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVEf; SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART n - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(If more space IS needed, Insert additional sheets of the same size)
LAST WILL
- & - - ---- .. ----
TESTAMENT OF
I, LEROY 1. CHARLES, of 425 Crossroad Road, Carlisle, Cumberland Cou ty,
Commonwealth of Pennsylvania, being of sound and disposing mind, memory and understandi g,
do hereby make, publish and declare this as and for my Last Will and Testament, hereby revok ng
any and all other wills and codicils heretofore made by me.
FIRST. I direct that all my just debts and funeral expenses be paid from my estate as so n
after my death as practically and conveniently may be done.
SECOND. I direct that my remains be in accord with my expressed wishes.
THIRD. I authorize my personal representative to expend funds from my estate, in su h
amounts as my personal representative shall consider necessary and desirable for the purchas,
erection and inscription of a suitable marker for my grave.
FOURTH. I give, devise and bequeath any and all tangible personal property owned by m
at the time of my death unto my children as follows:
(1) One-Sixth (1/6) share unto Leon ChaIles, per stirpes;
(2) One-Sixth (1/6) share unto Cynthia Charles, per stirpes;
(3) One-Sixth (1/6) share unto Linda Charles, per stirpes;
(4) One-Sixth (1/6) share unto Steven Charles, per stirpes;
(5) One-Sixth (1/6) share unto Daryl Charles, per stirpes; and
(6) One-Sixth (1/6) share unto Karen D. Charles, per stirpes.
FIFTH. I give, devise and bequeath any and all real estate owned by me at the time of my
death unto my children as follows:
(1) One-Sixth (1/6) share unto Leon Charles, per stirpes;
(2) One-Sixth (1/6) share unto Cynthia Charles, per stirpes;
(3) One-Sixth (1/6) share unto Linda Charles, per stirpes;
(4) One-Sixth (1/6) share unto Steven Charles, per stirpes;
(5) One-Sixth (1/6) share unto Daryl Charles, per stirpes; and
(6) One-Sixth (1/6) share unto Karen D. Charles, per stirpes.
It shall first be offered to my children at private auction and I urge them to respect my land as I did.
SIXTH. I give, devise and bequeath all the rest, residue and remainder of my estate unto my
death unto my children as follows:
(1) One-Sixth (116) share unto Leon Charles, per stirpes;
(2) One-Sixth (116) share unto Cynthia Charles, per stirpes;
(3) One-Sixth (1/6) share unto Linda Charles, per stirpes;
(4) One-Sixth (1/6) share unto-Steven Charles, per stirpes;
(5) One-Sixth (1/6) share unto Daryl Charles, per stirpes; and
(6) One-Sixth (1/6) share unto Karen D. Charles, per stirpes.
SEVENTH. I direct that any and all Inheritance, Estate and Transfer taxes imposed up n
my estate passing under my will or otherwise, shall be paid out of the principal of my residua y
estate.
EIGHTH. I hereby nominate, constitute and appoint my son, STEVEN CHARLES s
Executor of this my Last Will and Testament. In the event of renunciation, death, resignation r
inability to act for any reason whatsoever of STEVEN CHARLES, I nominate, constitute and appoi t
my son, DARYL CHARLES as Executrix of this my Last Will and Testament. I hereby relieve m
Executor from the necessity of posting security in connection with his duties, as such, in an
jurisdiction in which he may be called upon to act insofar as I am able by law to do so. In additio
to the powers conferred by law, I authorize my Exec utor, in his absolute discretion, to retain in th
form received, and to sell either at public or private s ale any real or personal property owned by m
at the time of my death.
TENTH. I have made, or may from time to time make, a written memorandum expressing
my desire to give certain items of personal property to specific persons. I urge my Executor and
beneficiaries to respect these wishes. Such a memorandum, if made, shall be stored in conjunction
with this Will.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and
Testament, consisting of two typewritten pages this 7,.(., day of
~\ 1\ ,\ t Vl(jLJ\ , 2007.
\} v '-Iv ' \......
L" /} / ~
e . ~ L.: t-Z-t::l ~ ~3.J,
LEROY J/CHARLES
Signed, sealed published and declared by the above named Testator LEROY J. CHARLES as and
for his Last Will and Testament, in the presence of us, who, at his request, in his sight and presence
and in the sight and presence of each other, have hereunto subscribed our names as witnesses.
\ ^ f"'f \, )
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SS.
I, LEROY 1. CHARLES, Testator whose name is signed to the attached or foregoing instrume t,
having been duly qualified according to law, do hereby acknowledge that I signed and executed t e
instrument as my Last Will; that I signed it willingly; and that I signed it as my free and volunta
act for the purposes therein expressed.
Sworn or affirmed to and
acknowledged before me, by
LEROY J. CHARLES this
of 11\("\ ('.'.U\ r \.,
\ _,J '.;.~. I\.
L ~.~/ ,re ~,(/'~9
LEROY J. ctHARLES
.', i
()< eLl
day
, 2007.
f NOTARIAL SEAL I
Kathy L. Mummert, Notary Public I
orough of Carlisle, Cumberland Co., P A,
My Com~~i.?~.~:pires A~Jl' 11, 20~.J
, /1 '
'I' ....t.
..-..d11.l\ t{ ;)
Nohll-Y_f~bllc
COMMONWEALTH OF PENNSYLVANIA
. *]
;/..
COUNTY OF CUMBERLAND
:ss.
We, \iLl'II/leU!\ f\'1>u{\(ctrl and.)C~J\n 't) l+cJ()((tS,
the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified
according to law, do depose and say that we were present and saw LEROY J. CHARLES sign and
execute the instrument as his Last Will; that he signed willingly and that he executed as his free and
voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the
Testator signed the will as witnesses; and that to the best of our knowledge, the Testator was at that
time eighteen (18) or more years of age, of sound l' d and under no constraint or undue influence.
. \ \ ^.,.,~ i} l\
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"'....... .
Sworn or affirmed to and
subscribed before meby
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this day of
and
, witnesses,
,2007.
\, .'1
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Notary Public
--.....-..............-----.-.-...,
......._-, Nor AmAL SEAL
, ~,athy L. Mummert, Notary Pub!ic i
J~orl()ugh of Ca!'!isle, Cumberland Co" P~,!
L~X.g.~~~Ls.Sk()f.XPir~~..~tl~:.!!:.3~O? ...I
APPRAISAL OF REAL PROPERTY
LOCATED AT:
425 Crossroad School Road
Deed Book 31G Page 942
Carlisle, PA 17015
FOR:
The Estate of Leroy Charles
t' ! g B/ 000/ IJ()
AS OF:
May 3, 2007
BY:
Susan B. Burkholder
State Certified Residential Appraiser
This indented use is for estate settlement
Summary Format
Form GA 1 - "TOTAL for Windows" appraisal software by a la mode, inc. - 1-800-ALAMODE
~ FannieMae
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Diversified Appraisal Services
A I A
I R
t
es op n erwrl er uan I a Ive nalysls ~ppralsa epor File No. 072407C
THIS SUMMARY APPRAISAL REPORT IS INTENDED FOR USE BY THE LENDER/CLIENT FOR A MORTGAGE FINANCE TRANSACTION ONLY.
Prooertv Address 425 Crossroad School Road City Carlisle State P A Zip Code 17015
Leoal Description Deed Book 31G Paae 942 County Cumberland
Assessor's Parcel No. 46-08-0585-035 Tax Year 2006-27 R.E. Taxes $ 1 797.67 SDecial Assessments ~ n. a.
.- Borrower n.a. Current Owner Estate of Leroy Charles Occupant r l Owner IX1 Tenant l Vacant
Neiahborhood or Proiect Name n.a. Proiect T vpe r I PUD r l Condominium HOA$ n.a. /Mo.
Sales Price $ n.a. Date of Sale n.a. Description I $ amount of loan charoes/concessions to be paid bv seller
Property riohts appraised IX1 Fee Simple I I Leasehold I Map Reference 8-585 Census Tract 0128.00
Note: Race and the racial eomnosition' d. .L'. moo I are RR+ ftRRrftlUI factors.
- Location DUrban 0 Suburban [gJ Rural Property values [gJ Increasing D Stable D Declining Single family housing Condoni niurn housing
-
- Built up DOver 75% [gJ 25-75% D Under 25% Demand/supply D Shortage [gJ In balance D Over supply PRICE AGE PRICE(i applic.) AGE
. $(000) (yrs) $(000) (yrs)
.. Growth rate n Rapid Ri Stable n Slow Marketina time n Under 3 mos. 1:><13-6 mos. n Over 6 mos. 80 Low New Low_
Neighborhood boundaries The subiect neiahborhood is bordered by Ritner Hiahway, Centerville Road Newville 400 Hioh 200 Hiah
Road and Kerrsville Road. I Predominant I !PrE ominant I
225 30
Dimensions 1 . 11 acre Site area Irregular Shape Irregular
Specific zoning classification and description Agricultural
Zoning compliance [gJ Legal D Legal nonconforming (Grandfathered use) o Illegal, attach description o No zoning
Highest and best use of subject property as improved (or as proposed per plans and specifications): [gJ Present use D Other use, attach description.
Utilities Public Other Public Other Off-site Improvements Type Public Private
Electricity ~ Water R Well Street Macadam ~ R
Gas n.a. Sanitary sewer On site Allev None
Are there anv apparent adverse site conditions (easements encroachments special assessments slide areas etc.)? IX1 Yes r l No If Yes attach descriDti n.
Source(s) used for physical characteristics of property: [gJ Interior and exterior inspection ~ Exterior inspection from street o Previous appraisal files
n MLS IX1 Assessment and tax records n Prior inspection n ProDertv awner Other (Describe): Dauahter
No. of Stories 2 Tvpe (Det/Att.) Dtchd Exterior Walls BrickIVinvl Roof Surface Shinales Manufactured Housina r l Yes IX1 No
Does the oroDertv aenerallv conform to the neiahborhood in terms of sMe condition and construction materials? IXI Yes I I No If No attach descrintion.
- Are there any apparent physical deficiencies or conditions that would affect the soundness or structural integrity of the improvements or the livability of the property?
. n Yes rxl No If Yes attach descriDtion.
.
Are there any apparent adverse environmental conditions (hazardous wastes, toxic substances, etc.) present in the improvements, on the site, or in the immediate vicinity 0
the subject property? DYes [gJ No If Yes, attach description.
I researched the SUbject market area for comparable listings and sales that are the most similar and proximate to the SUbject property.
My research revealed a total of 3 sales ranging in sales price from $ 187,000 to $ 221,000
My research revealed a total of 0 listings ranging in list price from $ 175,000 to $ 210,000
The analysis af the comparable sales below reflects market reaction to significant variations between the sales and the subiect property.
FEATURE I SUBJECT SALE 1 SALE 2 SALE 3
425 Crossroad School Road 55 McAllister Church Road 195 Lawrence Lane 404 Crossroad Schoo Road
Address Carlisle Carlisle Carlisle Carlisle
Proximity to Subject 3.28 miles 0.21 miles 0.15 miles
Sales Price n.a. 1$ 187 000 1$ 187,000 1$ 221 000
Price/Gross Livino Area r/J $ 125.84r/J I .. ... $ 125.17 r/J I. 1$ 123.33 r/J I
Data & Verification Sources Courthouse/MLS Courthouse Courthouse
VALUE ADJUSTMENTS DESCRIPTION DESCRIPTION I + (-)$ Adiust. DESCRIPTION I +( -)$ Adjust. DESCRIPTION I -)$ Adiust.
Sales or Financing None known , None known None known ,
,
, ,
Concessions Conventional Conventional , Conventional ,
Date of Sale/Time 5-31-07 : 12-1-06 : 11-1-06 :
Location Averaae Similar , Similar : Similar :
,
Site 1.11 acre 1.41 acre , -1 500 1.13 acre : 1.03 acre :
,
View Averaae Similar : Similar , Similar :
,
Desion (SMe) Colonial Contemporary : Colonial , Colonial :
,
. Actual Aoe (Yrs.) 27 vears 30 years , 16 years , 14 years :
, ,
II Condition AVQ/Brk/Vinyl Sim/Brick/Stucco , SuperiorNinyl , -5 000 SuperiorNinyl : -5 000
, ,
- Total : Bdrms: Baths Total: Bdrms: Baths I . ....... T etal : Bdrms: Baths I Total : Bdrms: Baths I .
Above Grade
6 : 3 : 1.5 5 : 3 , 2 , +1,000 7 , 3 : 2 : -3,000 7 : 3 : 2.5 -4,000
Room Count , ,
. ,
Gross Livina Area 1 470 Sa. Ft. 1,486 Sa. Ft. , 1 494 Sa. Ft. : 1 792 Sa. Ft. -16100
- ,
Basement & Finished Full bsmt Full bsmt , None , +5,000 Full bsmt
,
,
Rooms Below Grade None None None , fnshd familv rm -5,000
. ,
Garaae/Caroort Lra 2-car aaraae 2-car att gar : +2 000 None , +10 000 2-car garaae +2,000
,
Porch cvd deck Prh dck scrnd ph : -2,000 Porch, deck , Porch deck, fnce , -1,000
. ,
Flue for stove frolc CA : -3,500 Central Air , -2 500 Frplc Central air -3,500
,
- Net Ad i. (total) r l + 1X1-:$ 4,000 [XJ+ il - : $ 4500 il+ rxl-:s 32,600
- Adjusted Sales Price Net.2J .. ~j Net :2.4%1 Net 14.8 ~I
of Comparables Gross ..508%1 s 183 000 Gross 13.&% $ 191 500 Gross 16.6 % $ 188 400
Date of Prior Sale 5-29-85 8-11-77 5-17-06 $17,000 & on 11-15-05 11-1-03
Price of Prior Sale $ 1.00 $ 9,075 1$ 1.00 $ 1.00
Analysis of any current agreement of sale, option, or listing of the subject property and analysis of the prior sales of subject and comparables: No sale has taken ~ lace in
the past three years.
Summary of sales comparison and value conclusion: The Cost aooroach was not considered since this is not new construction or the Income a Joroach
due to the fact this is an owner occupied sin ale familv dwellina. The Sales Comparison approach is the best approach for this tvoe 0 ' orooerty.
This appraisal is made cg] "as-is", D subject to completion per plans and specifications on the basis of a hypothetical condition that the improvements have been c mpleted, or
o subject to the following repairs, alterations or conditions Appraised in current condition.
BASED ON AN D EXTERIOR INSPECTION FROM THE STREET OR AN [gJ INTERIOR AND EXTERIOR INSPECTION ,I ESTIMATE THE MARKET VALUE, AS DEFINED, Of THE REAL
PROPERTY THAT IS THE SUBJECT OF THIS REPORT TO BE $ 188,000 ,ASOF Mav 3 2007
PAGE 1 OF 3 Fannie Mae f rm 2055 9-96
Form 205 - HTOTAL for Windows" appraisal software by a la mode, inc. -1-800-ALAMODE
APPRAISAL OF REAL PROPERTY
LOCATED AT:
Lot 1 Crossroad School Road
Deed Book 33Y Page 568
Carlisle, PA 17015
FOR:
The Estate of Leroy J. Charles
; vk/ tJlltJ, ~O
AS OF:
May 3, 2007
BY:
Susan B. Burkholder, RL-000659-L
State Certified Residential Appraiser
This indented use is estate settlement
Summary Format
Form GA1- "TOTAL for Windows" appraisal software by a la mode, inc. -1-aOO-ALAMODE
LAND APPRAISAL REPORT
Borrower n.a.
Property Address Lot 1 Crossroad School Road
_ City Carlisle
Legal Description Deed Book 33Y Paae 568
Sale Price $ n.,a. Date of Sale n.a. Loan Term n.a. yrs.
Actual Real Estate Taxes $ 462.28 (yr) Loan charges to be paid by seller $ n.a.
- Lender/Client Estate of Leroy J. Charles Address
Occupant Vacant Appraiser Susan B. Burkholder Instructions to Appraiser Market Value
File No. 072407CLc11
Map Reference 46-08-0587 -14J
Census Tract 0128.00
County Cumberland
State P A
Zip Code 17015
Property Rights Appraised [gJ Fee 0 Leasehold 0 De Minimis PUD
Other sales concessions n.a.
U Urban 0 Suburban [gJ Rural
o Over 75% I:gj 25% to 75% 0 Under 25%
o Fully Dev. 0 Rapid I:gj Steady 0 Slow
o Increasing [gJ Stable 0 Declining
o Shortage [gJ In Balance 0 Oversupply
o Under 3 Mos. I:gj 4-6 Mos. 0 Over 6 Mos.
70% 1 Family _% 2-4 Family _% Apts. _% Condo _% Commercial
% Industrial 30% Vacant %
:. Change in Present Land Use 0 Not Likely -0 Likely (*) [gJ Taking Place (*)
. (*) From Vacant To Single Family
[gJ Owner 0 Tenant ~% Vacant
$ 80 to $ 400 Predominant Value $ 220,000
New yrs. to ~ yrs. Predominant Age 30 yrs.
Location
Built Up
Growth Rate
Property Values
Demand/Supply
Marketing Time
Present Land Use
Employment Stability
Convenien~ to Employment
Convenien~ to Shopping
Convenience to Schools
Adequacy of Public Transportation
Recreational Facilities
Adequacy of Utilities
Property Compatibility
Protection from Detrimental Conditions
Police and Are Protection
General Appearance of Properties
Appeal to Market
Good Avg. Fair Poor
o t?:~ 0 D
D~DO
o t?:~ 00
O~~DO
O~~OO
O~OO
D t?:~ D D
D~~OO
O~~OO
D~~OO
O~~OO
D~~OO
-
-
Predominant Occupancy
Single Family Price Range
Single Family Age
Comments including those factors, favorable or unfavorable, affecting marketability (e.g. public parks, schools, view, noise): Rural area with stable ownershio r:J atterns
within reasonable commuting distance to schools olaces of worshiD.
shoooina and transoortation.
The undersigned has recited three recent sales of properties most similar and prOximate to SUbject and has considered these in the market analysis. The description include a dollar
adjustment reflecting market reaction to those ttems of significant variation between the subject and comparable properties. If a significant ttem In the comparable property i superior
to or more favorable than the subject property, a minus (-) adjustment is made thus reducing the indicated value of subject; if a significant ttem In the comparable is inferior 0 or less
favorable than the subject property, a plus (+) adjustment is made thus increasing the indicated value of the subject.
ITEM I SUBJECT PROPERTY COMPARABLE NO.1 COMPARABLE NO.2
Address Lot 1 Crossroad School Road Lot 54 pennway Circle 169 Kerrs Road
Carlisle Carlisle Carlisle
Proximitv to Subject . 1.79 miles 0.72 miles
Sales Price $ n. a. .. ...... ...., $ 69900
Price $ ... . ....1$
Data Source Courthouse
- Date of Sale and DESCRIPTION DESCRIPTION I + H$ Adiust.
_ Time Adjustment n.a. 8-17-06
Location Averaae Similar
. SiteNiew 1.338 acre 2.02 acres
Dimensions IrreQular
Zoning classification Agricultural
Highest and best use [gJ Present use l Other (specify)
Public Other (Describe) OFF SITE IMPROVEMENTS Topo Slightly rOiling
[gJ Street Access [gJ Public 0 Private Size Typical for the area
o Surface Macadam Shape Irreaular
o to be well Maintenance [gJ Public 0 Private View Average
o to be on site 0 Storm Sewer 0 Curb/Gutter Drainage Aooears adeauate
o Underground Elect. & Tel. 0 Sidewalk 0 Street Lights Is the property located in a HUD Identified Special Flood Hazard Area?
Comments (favorable or unfavorable including any apparent adverse easements, encroachments, or other adverse condttions): No 800arent adverse easements
encroachments or other adverse conditions. Off-street Darking at or near site.
=
1.338 Sq. Ft. or Acres 0 Corner Lot
Present Improvements [gJ do 0 do not conform to zoning reg lations
Elec.
Gas
Water
San. Sewer
COMPARABLE N . 3
Lot 4 Kerrsville Road
Carlisle
0.96 miles
Is:
Is:
64 900
-3 400
Courthouse
DESCRIPTION
9-13-06
Similar
.99 acre
Courthouse
1+(- \$ Adiust. DESCRIPTION
: 6-12-07
: Similar
: +1 700 2.33 acres
: , :
,
, , :
, ,
: : :
, : :
,
Sales or Financing , , ,
n.a. ,
, , ,
Concessions ,
,
Net Adi. (Total) r l + rxI : $ 3400 rxI + r - : $
~fd~~~j~~tValue ... NeL4.9%1 $ 66 500 Net 2.6 %1 s;
Comments on Market Data:
AlthouQh one or more of the comparable sales are further than one mile for the subject propertv. the sales used are the nearest ava lable.
1,700
rl+ rxI- :$
Net 6.8% I s:
66 600
Comments and Conditions of Appraisal: This aooraisal was comoleted on the assumotion that the subiect is a buildable single familv lot.
t?: NoOVes
Is;
1$
73 500
I + -)$ Adiust.
-5 000
5,000
68,500
Final Reconciliation: With adiustments, all three comoarable sales are acceotable for for the direct sales comoarison analvsis and con Irm mv
- final ooinion of value.
I ESTIMATE THE MARKET VALUE, AS DEFINED, OF SUBJECT PROPERTY AS OF
May 3,
2007 to be $ 66 000
~.6.,/~
Susan B. Burkholder, RL-000659-L
Appraiser(s)
/r~
Larry E. Foote, GA-000014-L
Review Appraiser m aoolicable)
o Did [gJ Did Not Physically Inspect roperty
(Y2K]
Diversified Appraisal Services
Form LND - "TOTAL for Windows" appraisal software by a la mode, inc. -1-800-ALAMODE
--
----------
~
80072
,. ,.." '" """ ..1/ ",., ...,., "" ""'" "'" ,.",
LEROY J CHARLES
18426 FREELAND ST
DETROIT MI 48235-2538
STATEMENT OF {4.CCOUNT
---
Your Statement Savings
statement
October 1, 2006 to December 31, 2006
Account number 9409030872
Your account summary
Beginning balance
on October 1, 2006
Plus deposits
Interest
Ending balance
on December 31, 2006
To contact us
$26.33
Call
(313) 564-5717
Hearing impaired (TOO 800 822-6546)
$20,883.01
Visit Our web site
www.comerica.com
$20,909.34
Write to us
COMER/CA BANK
PO BOX 75000
DETROIT, MI 48275-8072
Interest rates on December 31, 2006
Interest rates we paid at the end of this statement period:
· on balances of $1 to $999: 0.50%
· on balances of $1,000 to $2,499: 0.50%
· on balances of $2,500 to $4,999: 0.50%
· on balances of $5,000 to $14,999: 0.50%
· on balances of $15,000 to $49,999: 0.50%
· on balances of $50,000 or more: 0.50%
-
Summary of interest you've earned
· Interest paid to you this statement period: $26.33
· Annual percentage yield earned this statement periOd: 0.50%
· Total interest paid to yoU this year: $93.40
The Come rica Gift Card ;s the perfect gift tor
everyone and every Occasion - birthdays,
holidays, graduations, weddings and more. Pi k
up your Gift Card today at any Comerica locati n
or purchase online at comerica.com. Some
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Daily limits are now increased for most
customers:
Former
A TM Umit:
$300
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New
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$1000
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Purchase:
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IJJ!mIm
Thank you for being a Comerica customer. We
value the trust and confidence that you continue
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Sovereign Bank
ESTATE OF
SOCIAL SECURITY #:
DATE OF DEATH:
Leroy J. Charles
251-66-5942
May 3, 2007
Account #: 1691016039 Type:
In the name of: Leroy J Charles
Date of Death Balance:
Int.(YTD) from 1/1/2007 to
Accrued interest to date of death:
Other Info:
Checking
Open date: 9/912002
$5,182.85
4/11/2007
$0.15
$1.39
Account #: 1691027456 Type: Checking
In the name of: Leroy J Charles ITF Linda Charles
Date of Death Balance: $120,367.47
Int.(YTD) from 1/1/2007 to 4/30/2007
Accrued interest to date of death: $19.58
Other Info: Linda Charles added as beneficiary 8/9/01
Open date: 8/8/1996
$760.53
Account #: 6817195799 Type: Installment Loan Open date: 4/6/2004
In the name of: Leroy J Charles
Balance Due at Death: $31,480.77
Int.(YTD) from to
Accrued interest to date of death:
Other Info: for more inforamtion please contact consumer finance at 877-768-2265
Page 1 of 1
COMMUNITY
OFFICES IN
FRANKLIN,
CUMBERLAND,
FULTON.AND
HUNTINGDON
COUNTIES
www.fmlruslonline.com
0022 0017 lj5486 Y
STATEMENT OF
08-10401
STATEMENT
FROM
5-01-07 5-3 -07 2
PAGE 1 OF 1
0 ENCLOS RES
5
Imlll.ullllllll.II..II.III1II1" .11.." 11.11111111111111111
*...***********AUTO**3-DIGIT 170
0.4330 AT 0.334 14 1 50
Y ::J CHARLES
. lX 4 .
CAR ISLE PA 17013-0004
XNVEST~RS SAV3:NGSMONTHLY STATEMENT
WITHDRAWALS/
o DEBITS 1
.00 7.902.87
ACCOUNT: 08-10401
INTEREST
PAID
4.22
NDING
ALANCE
.00
REFERENCE
DEPOSITS/
CREDITS
CHECKS/
DEBITS
ACCOUNT/INTEREST INFORMATION
13.79
00500802502 7.902.87
4.22 .~O
.00
YIELD EA~NED DISCLOSURE FROM
~RNED
BALANCE
5-01-07 THROUGH
.45"
7.898.65.
.97
5-3107 ***
DIRECT F&M TRUST - RITNER HIGHWAY OFFICE
INQUIRIES TO: 1901 RITNER HWY
CARLISLE, PA 17013
TELEPHONE: 717-960-1400
05/15/2007 14:00
717-7::(::-4447
HBG DI~;T OFFICE
PP,GE D3
---1
48500041046
R.EV-'Hi5 EX (05-04) (t~p
SAFE DEPOSIT ~
BOX INVENTORY
PA Dapl'l.rtmenl. of R9v~n~le PL.EASE USE ORIGINAL FORM ON
'S;;ial Se<)urlty or Death Certificate NumbfJr Date of D6alh County Code YSElJ File NI.Jrnbl.lr
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NAME AND AOD~eSg OF .P.>,RSON RI:QUESrlNG THEpPENJNq OF THE SA,FE DEPOSIT BOX
NAME: s..Ti\~l U,( ~J~LL~" __
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a NAME' . '^ if\l 1 I Y'.i..A-t I R.EOLA~ {J . ~ t' 1
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'[ INHt:RITANCS TAX DIVISION ~' '7 C 1
DEPT 21l0fl01 .,
Hp.RRJSBURG. PA 17-1:iIl-fJI301
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I NOTE~ Attach additional 8<j{' x 1'1" sh~et(s) It necessa,-y or usa duplicates of this page of form" ---------- --
i ThuD"p"rt,mr,t i~, ,,!utl,,)n,,,,,j t,y law, 42 J ,,'~_C. ~4(jfj (c)(2j(C)(i), t~ ISqUlrEI dis:lcqur<l of Soci-'li ,3ecuilty number>; in cOlllleclloll with ddrnini,;lBrlng r,t-;te I~) Jaw'; 'Ih;:, l)9part!n8nt W;~B h~ !
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1--"ith~:(,'-h~~?!2I]1j~~~~~t..ta::i~1fl.~~m!ti8LT~~" ,laj~Y!l'!Uh:bi':- lh. c:'2!~~rnOii'^',o,~[I:i2_[I_~~::r'!~~rom Gigclosin~_:~nlld8f1ttallw inf~l:~'1I ~XG'XlJ)~yfflc'~_I..E!~~)~:.',_ _ ____ _.I
Kelley Blue Book - Private Party Pricing Report - Volkswagen, New Beetle
_----0
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THE TRUSTED RESOUIlCE.
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2003 Volkswagen New Beetle GLS Turbo Hatchback 20
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"~1'1.'["~
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BLUE BOOK' PRIVATE PARTY VALUE
iff) Estimated Payments
$ 244jmo @ 6.0S"lo APR
~:'l': J j ,,'~.
Condition ,
Value
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6.35% APR
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~ ~ '" - ~,. ,
,~ if.'-. " p~
* -.~-- ~
'.
Excellent
$13,135
$12,405
$11,370
Good
Fair
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Review
et'1!:lrlJl
~~
, "..' Revi.ew.
. ..' .......~.. PriC!llil
Vehicle Highlights
Mileage: 19,923
Engine: 4-Cyl. 1.8L Turbo
Transmission: 5 Speed Manual
Drivetrain: FWD
Selected Equipment
Change Equipment
Standard
Air Conditioning
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http://www.kbb.comlKBB/UsedCars/PricingReport.aspx?ManufacturerId=50& Y earId=20...
Kelley Blue Book - Private Party Pricing Report - Chevrolet, Silverado 1500 Pickup
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BLUE BOOK' PRIVATE PARTY VALUE
@ Estimated Payments
$ 185 /mo @ 6.05% APR
_IJ!-;(;r T'~f.:' -:-
(':',:.\' ,'Co !~..~! <i! ';.
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Excellent
$10,225
$9,560
Good
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$8,630
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Vehicle Highlights
Mileage: 80,400
Engine: V8 5.3 Liter
Transmission: Automatic
Drivetrain: 4WO
Selected Equipment
Standard
Third Door
Air Conditioning
Power Steering
Change Equipment
Tilt Wheel
AM/FM Stereo
Dual Front Air Bags
ABS (4-Wheel)
Optional
Z71 Suspension
Power Windows
Power Door Locks
Cruise Control
Cassette
Single Compact Disc
Bed Liner
Custom Bumper
Alloy Wheels
Blue Book Private Party Value
Private Party Value Is what a buyer can expect to pay when buying a used
car from a private party. The Private Party Value assumes the vehicle Is sold
"As Is" and carries no warranty (other than the continuing factory warranty).
The final sale price may vary depending on the vehicle's actual condition and
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, Kelley Blue Book - Private Party Pricing Report - Buick, Riviera
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BLUE BOOK'" PRIVATE PARTY VALUE
[t;1 Estimated Payments
$ 106 /mo @ 6.05010 APR
Condition '
Value
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6.35% APR
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[;-\1""
Excellent
Good
Fair
$5,600
$5,115
$4,560
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Vehicle Highlights
Mileage: 72,740
Engine: V6 3.8L Supercharged
Transmission: Automatic
Drivetrain: FWD
Selected Equipment
Standard
Air Conditioning
Power Steering
Power Windows
Power Door Locks
Tilt Wheel
Optional
Change Equipment
Cruise Control
AM/FM Stereo
Cassette
Single Compact Disc
Dual Front Air Bags
ABS (4-Wheel)
Dual Power Seats
Alloy Wheels
Premium Sound
Front Side Air Bags
Leather
Moon Roof
Blue Book Private Party Value
Private Party Value is what a buyer can expect to pay when buying a used
car from a private party. The Private Party Value assumes the vehicle is sold
http://www.kbb.comlKBBIU sedCarslPricingReport.aspx?ManufacturerId=7 & Yearld= 199...
APPRAISAL SUMMARY
It is in my opinion, that as of d.o.d May 3,2007, the Fair Market Value of the personal
property of Leroy Charles, deceased, 425 Crossroads School Rd. Carlisle, PA 17013:
(Five Thousand One Hundred Fifty One Dollars and Zero Cents)
($5,151.00)
Ibis Appraisal
.
rV1CeS
The report must be read in its entirety. The Appraisal Summarv ONL Y is
not the appraisal report.
4
Central Pennsylvania Teamsters Pension Fund
Board of Trustees
WILLIAM M. SHAPPELL, Chairman and Trustee
TOM J. VENTURA, Secretary and Trustee
KEVIN M. CICAK, Trustee
TOMM FORREST, Trustee
PETER G HASSLER, Trustee
MIKE JONES, Trustee
KEITH L. NOLL, Trustee
HOWARD W RHINIER, Trustee
MICHAEL P. RYS, Trustee
DANIEL W. SCHMIDT, Trustee
MARTIN L. CULLEN, Assistant Admin strator
1055 Spring Street, Wyomissing, 19610
Mailing Address: P.O. B x 15223
Reading, PA 19 12-5223
Phone: 610-' 20-5505
TOLL FREE IN PA 1-800- 43-0136
TOLL FREE IN USA 1-800- 3 I -0420
FAX: 610- 20-9239
JOSEPH J. SAMOLEWICZ, Administrator
r:~)g
August 31, 2007
Mr. Steve Charles
Administrator to the Estate of
Leroy J. Charles
109 Minick Drive
Newburg, P A 17240
Re: Leroy J. Charles, Deceased
SSN XXX-XX-5942
Dear Mr. Charles:
We wish to acknowledge receipt of the death certificate for Daisy Frazier and the Short
Certificate for the Estate of Leroy J. Charles.
Please be advised, due to the fact that Daisy Frazier is deceased, the Estate is entitled to receive a
lump sum death benefit in the amount of $1,240.00, which represents the 9 years of Pension
Fund membership Mr. Charles accrued under the Defined Benefit Plan. Under the Federal
Income Tax Law, the Fund is required to withhold and pay to the IRS ten percent (10%) of the
amount of the lump sum death benefit, unless you complete and return the enclosed Defined
Benefit Plan IRS Code Section 402(f) Election Form requesting no Federal Income Tax
withholding. Once the Fund receives a completed Election Form indicating your distribution
preference, the Fund will process your benefit check.
Also, be advised that the Estate is entitled to receive a lump sum check representing
the Retirement Income Plan 1987. The balance at the last monthly valuation date, July 31, 2007,
was $273,409.92. This amount does not include net gains and losses after the last valuation date.
Under Federal Income Tax law, the Fund is required to withhold and pay to the IRS ten percent
(10%) of the amount of the lump sum distribution, unless you complete and return the enclosed
Retirement Income Plan 1987 IRS Code Section 402(f) Election Form requesting no Federal
Income Tax withholding or a different form of payment. Once the Fund receives a completed
Election Form indicating your distribution preference, the Fund will process your check with the
next monthly distribution.
We trust this information is satisfactory; however, if you should have any further questions i
this regard, please feel free to contact this office.
Very truly yours,
CENTRAL PENNSYLVANIA
TEAMSTERS PENSION FUND
,,~
Michell ouck
Pension Benefits Manager
MH/jag
Enclosure
Board of Trustees:
WILLIAM M. SHAPPELL, Ch8inwu1 and Trustee
TOM J. VEN'lURA, 8ecret8Iy and Trustee
KBVJN M. CIeAK, 'I\'u8Iee
TOMM FORREST, Trustee
PETER. G. HASSLER. Trustee
MIKE lONES, 'IIustee
KEl1H L. NOLL, 'IIustee
HOWARD W. RHINIER, Trustee
MICHAEL P. RYS, 'IIustee
DANIEL W. SCHMIDT, Trustee
January 8, 2008
Mr. William A. Duncan, Esquire
1 Irvine Row
Carlisle, P A 17013
Re: Leroy J. Charles, Deceased
SSN XXX-XX-5942
Dear Attorney Duncan:
We wish to acknowledge receipt of the Defined Benefit Plan Election Form indicating that the
Estate does not wish to have income taxes withheld.
Enclosed you will find our check no. 01855114 dated January 8, 2008 in the amount of
$1,240.00. This represents the gross amount due the Estate and is based upon the 9 years of
Pension Fund Membership Mr. Charles had accrued.
We trust this information is satisfactory.
Very truly yours,
CENTRA.L PENNSYLVANIA
TEAMSTERS PENSION FUND
\""~ '-- 1-___
Michelle L. Houck
Pension Benefits Manager
MLH/j ag
Enclosure
Central Pennsylvania Teamsters Pension Fund
2006 Statement of Benefits
Prepared for
"u~a<4
~.~
Lt:fJ\'J
~
LEROY J CHARLES
PO BOX 4
CARLISLE, PA 17013
We are pleased to present you with this 2006 Statement of Benefits, which provides you with informati n
regarding the amount of benefits you have earned under the following plans:
· The Central Pennsylvania Teamsters Retirement Income Plan 1987
· The Central Pennsylvania Teamsters Defined Benefit Plan
Much care has been taken in the development and preparation of this comprehensive statement that pr vides
valuable information on your accrued and projected benefits, as well as your vested status in the Fund.
Ultimately, we hope this statement will assist you and your family in making important decisions about your
future.
The Trustees have also provided you with this Statement so that you can help ensure the accuracy of th
Fund's records regarding your benefits. We urge you to compare the information contained in the State
to your personal and employment records. If you believe that this Statement contains incomplete andlo
inaccurate information regarding you, your spouse or your employment history, please contact the Fund Office
immediately.
You should be aware that the official Pension Fund documents set forth the specific rules regarding the ature
and payment of benefits. Nothing contained in this Statement in any way changes or affects the provisio s of
the official documents of the Fund (which may be changed from time to time). In the event of any
inconsistency between this Statement (including a miscalculation of your benefits) and the Fund docume ts in
effect at the time you are entitled to receive benefits, the terms of the official documents of the Fund the in
effect will control in all cases. Finally, because the Fund's records with respect to your hours worked in ny
year shall control in all cases, it is important for you to notify us if you believe that any of the informatio is
incorrect.
If you have any questions about any of the information contained on this
Statement, please contact the Fund Office toll free:
In the US at (800) 331 - 0420
In Pennsylvania at (800) 422 - 8~l30
Sincerely,
g'0Md 0{- 7~
Central Pennsylvania Teamsters Pension Fund 2006 Statement of Benefits
Personal and Employment Information
Social Security Number ......................XXX-XX-5942
Vesting Service as of December 31,2006..............29
Benefit Service as of December 31, 2006...........28.4
2006 Benefit Service Hours ..............................1,938
LEROY J HARLES
Date of Birth............................................... /12/1942
Vested Percent as of December 31, 2006.........100%
Current Hourly Contribution Rate ..............$ 5.945
2006 Employer Contributions .................$ 1,190.03
Spouse's Name............................................................. .. None on File
Spouse's Social Security Number ........ None on File Spouse's Birth Date...............................Non on File
Retirement Income Plan 1987
The Retirement Income Plan 1987 is a defined contribution
"money purchase plan," which means that the amount of
annual contributions made to the Plan have been credited to
individual bookkeeping Accounts that are established by the
Trustees for all Participants.
The Plan has been funded by Employer contributions made in
accordance with the terms of the applicable collective
bargaining agreements. Effective January 1, 2003, the
Retirement Income Plan 1987 stopped accepting employer
contributions.
All assets in the Plan are invested by the Trustees. The
Trustees have engaged the services of an independent
investment consultant to make recommendations with respect
to the investment of the Plan's assets, and to assist them with
monitoring the performance of the Plan's investment
managers.
RIP 1987 Asset Allocat on
on December 31, 200
Lookina Back - Your 2006 Account Activitv
1. December 31,2005 Account Balance (as shown on your 2005 statement) .............. $ 224,064.1
2. Adjustments to December 31,2005 Account Balance .................................... $
3. Employer Contributions................................................................................... $
4. Distributions...... .................................................. .............................................. $
5. Net Investment Return after Expenses G"15.70%) ...........................................
6. December 31, 2006 Account Balanci: (1 )+(2)+(3)+(4)+(5) .................. $ 259,220.5
Lookina Ahead - Your Proiected Account Balance
The amounts shown in the table on the following page are based on f'l combination of different ave age,
future investment returns and retirement ages. Your actual Accou* Balance at any time in the f ture
will be dependent on actual net investment returns through that date.
The value of your Account (and your Rollover Account, if any), will be available to be paid to you a of the
Valuation Date coincident with or next following:
· Your Early or Normal Retirement;
· Your death (paid to your beneficiary); or
Page 2
.. PEPSICO
STATEMENT OF ACCOUNT
The Bank of New York, Administrator
P.O. Box 1958
Newark, NJ 07101-9774 SEO#
0019027
1...111...111......11.1.1.1.1...1..1.1..11.1.,..1,1.1.1...11.1.
*************AUTO**3-DIGIT 170
MARY ANNE LESH &
LEROY J CHARLES JT TEN
RR 2
425 CROSSROAD SCHOOL ROAD
CARLISLE PA 17015-9449-25
Answers to many questions and requests are
available by visiting The Bank of New York's
webslte at: http://stockbny.com or
Emall at:Shareowners@bankofny.com
1-800-226-0083
Company Number
Account Number
Record Date
Payment Date
4348
0009454992
06/08/07
06/29/07
Next Antioipated Investment Date
T~ICE A MONTH
PLEASE RETAIN THIS STATEMENT FOR TAX PURPOSES: NO COPIES AVAILABLE
CURRENT DIVIDEND'PURCHASE INFORMATION
Plan Record Date Position
Held By You In CertifICate Form Held By Plan
Or Direct Registration Administrator
Rate
Gross Dollars
Paid
Service
Fees
Tax
Withheld
Net Dollars
Reinvested
Total
61.0000 5.6375
66.6375
.3750
24.99
.00
.00
24.99
YEAR- TO-DATE TRANSACTIONS
Transaction Date
Transaction Description
Transaction Dollars
Price per Share
Transaction Shares
Total Share Held By Administrator
01/01/07
0.1/02/07
03/30/07
06/29/07
BALANCE FORWARD
INCOME REINVESTMENT
INCOME REINVESTMENT
INCOME REINVESTMENT
19.80
19.90
24.99
63.0766
63.4464
65.2577
.3139
.3136
.3829
5.0100
5.3239
5.6375
6.0204
VISIT OUR WEBSITE AT WWW.STOCKBNY.COM TO OBTAI ACCOUNT BAL NCES,
TRANSACTI N HISTORY AND SUPRESS MAILINGS OF RE NVESTMENT ST TEMENTS.
GROSS DIVIDENDS
TAXES WITHHELD
ADDITIONAL INCOME
FAIR ARKEr VALUE
64.69
.00
.00
64.69
.10
4373,60 I
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72.07 Open: 72.46
Change: ,() ;1;; High: 72 46 !
% .cr, '1' 'FV L' 71'50
Change: 'jll. ."\. ow. .
Market Cap: 116,011,223,140
Outstanding 1 609 702 000 S$e full list
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!:.epsi StQ.ck $JNDU 13,754.10'Ht:tl~f"~9,n:t~~;,f/ulb
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Pepsico, Inc. (PEP) At 8:37PM: 66.q3 $ 0.1,8 (0.27 ... . PepsiCo Loses
Federal Court Decision on Customs Importation Fraud Case; ...
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10/26/20 7
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MAT Mattei, Inc
11/14/20073:49 PM
20.72
Change:
-0.47
Percent Change:
-2.22%
Open:
21.55
Yield:
3.14
High:
21.55
PIE Ratio:
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Low: Volume:
20.66 4,836,665
52 Week Range:
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Mattei, Inc
Toys
NYSE
366,845,000
7.6 Billion
9,570,048 (2.61 %)
1.42
29.71 on Monday, April 09,2007
19.62 on Thursday, November 08, 2p07
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1:"i-\LiL L
ur ,.~
Junc 13,2007
Hartford Li'e
William Duncan
I'ax: 717-249-7800
Contract Number:
Owner:
Decedent:
Owner's ,5'SN:
Date of Death:
Date of Death Value:
REFERENCE: Hartford Annuity Account # 712199898
Dear Mr. Duncan,
Thank you for your correspondence regarding the above anmtitycOJltra~t.
712199898
Leroy Charles
Leroy Charle~
XXX.XX-5942
May 3,2007
$67,295,12
Sincerely,
A. Taylor
I nvestme Ilt Product Selvices
Inforce Contract Services
Hartford Life Insurance Company
.'. ".. "HlIrtfQ61Lit~Ins\jm{;,.;eC()lnp tRies
~OO HopIlleadllwSit,eel...
, '. . ..' .Siffi.;,.)'ury,C"fO@S9.',"
Toll Free tSOO 862 t}668.
1 nveslme ~ tl'I:O(iuci. ;5~1:';'ic es
MailingAd(lr.,~s:. P.t). Ilox50S
Hal'lfOl'd,.('TU6.r02~~OSS<. .
1I,tl'lronJi{nie~I<i.';~iilli, '
INVESTMENT MANAGEMENT'"
YEAR-TO-DATE
Investment Summary
I
I
January 1,2007 through March 31, 2007
Page 1 of 4 .
Fund-Account Number: 0007-000~0171758
mll.'M
/11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
MFS HERITAGE TRUST CO TRUSTEE
IRA AIC LEROY J CHARLES
PO BOX 4
CARLISLE PA 17013-0004
004997
For help with your investment, contact
Your Representative: VT46
HARRY MEWES
Dealer:
PRIMEVEST FINANCIAL SERVICES INC
C/O W AUKESHA STATE BANK
100 BANK ST
WAUKESHA WI 53188-3700
1111111111111111'1111..11.111111111111'11.1..11111111111111111
Beginning value
Change in value
Ending value 3/31/2007
Year beginning 11//2001
S60,457.81
+1,521.56
=$61,979.37
Account at a Glance
Change in value reflects the reinvestment of dividend and capital gain distributions, os well os the appreciation or
depreciation of the investment.
Investment News
Traditional
so.OO
SO 00
OnUpe copies of your quarterly stateme ts
NoW irs even easier to gain access to your
quakterly MFS account information. Throu h MFS
ACCEtss, you can view and print "eStatemen s,"
whiCh are electronic copies of the quarterl
stat,ments you receive in the mail. Just 10
to MFS Access on mfs.com.
NeW, MFS Heritage Trust fee structure
Effe4tive May 15, 2007, plans that are servi ed by
MFSIHeritage Trust Company will change t a tiered
asse~-based fee structure. Clients with asse s up to
$50,000 will be charged $25 per year. No n es will
be a~sessed to investors with more than $5 ,000 in
their plans. See Commentary for more det ils.
IRA Contributions
Type aflRA
Contributions for
tax year 2006
Contributions for
tax year 2001
For balances, service information, and transactions, contact MFS directly
I!I www.mfs.com
Online account access, fund information, and
investor education
[m:! 24-hour-a-day automated information
Automated voice response service 1-800-MFS- TALK
(1-800-637-8255)
11 Service 8am - 8pm Easte n time
Personal Account Services 1-800- 25-2606
IRA Account Services 1-800-637- 255
529 Plan Services 1-866-529-163
CP5-0014358
534421
MFS. .-971 00., 0370086008. 29977. 29971.CNSMFS03.INV MF M.....,.. CPS.... ...00 I 064358
4.AR-GENPLUSTP
ENV #SKOS0993 96001 000084
Plan Vested Balance: $47,718 04*
Plan Name: Arkansas Best 401 k) Savings
Plan
LEROY J CHARLES
425 CROSSROAD SCHOOL RD
CARLISLE, PA 17013-9449
Dear Leroy J:
You've worked hard to save money for retirement in the Arkansas Best 401 (k) Savings Plan_ Since
you're no longer contributing to this plan, now is an important time to review your strategy to kee8
these savings on track.
In determining what your next steps should be, you may be looking for answers to several
key questions:
· Have my plan features changed?
· What are my options for my savings?
· Do I have the right mix of investments?
The enclosed Guide to Your Retirement Savings Strategy provides more information on the import~nt
points to consider and how Fidelity can help you with your next steps. Once you've had a chance t
review it, call for a free, one-on-one consultation with a Fidelity Retirement Specialistt who's familia
with the specifics of your former employer's plan. !
We're committed to helping you make the most of your retirement savings. Give us a call today aJ
1-866-956-3458 and speak with a Retirement Specialist about how Fidelity can help you now and i~
the future. i
I
Sincerely,
~
Jeffrey R. Carney
President, Retirement Services
Fidelity Employer Services Company
*Account balance is as of May 9, 2007.
tFidelity Representatives may use online planning tools.
Guidance is provided by Fidelity Representatives through the use of Fidelity's suite of guidance tools. These tools are
educational tools and not intended to serve as the primary or sole basis for your investment or tax-planning decisions.
Fidelity Investments Institutional Services Company, Inc., 82 Devonshire Street, Boston, MA 02109-3614
June 20, 2007
IH{K!\NS.I\) BEST
COnpOF{ATION
Duncan & Hartman, P. C.
Attn: William Duncan
One Irvine Row
Carlisle P A 17013
CC: Steve Charles (executor)
Dear Mr. Duncan:
We received the letter regarding the death of Leroy J. Charles.
The 401(k) Retirement account that Mr. Charles was enrolled in w~s a defined contribution plan.
There was no company match portion with this type of account. I have enclosed a copy of Mr.
Duncan's most current beneficiary form entered in on 03/30/2007.' The value of the account as of
06/1812007 was $47,872.35. I have enclosed a statement on that d~te for your records. Please
keep in mind that the balance of the account can change before the idistributions are completed
due to market fluctuations.
I have enclosed a 401(k) Final Distribution Form for Steve and eac~ ofms siblings to complete
and return to Arkansas Best Corporation Retirement Services so th~t we may release the funds
that are in Mr. Charles' 401(k) account. '
The following sections will need to be completed on all forms: Vetjfy Personal Information
(Employee's name and social security number), Beneficiary Infomiation with their name, social
security number, address, date of birth and phone number, and the Authorization section with
their signature.
The account will be distributed to the beneficiaries as desired as soon as administratively possible
after receipt of the completed Final Distribution Forms.
I have also enclosed a Special Tax Notice for you and for them to rrview before completing the
form. Please be aware the all non-spousal beneficiaries are not eli~ible to rollover their portion
into another qualified retirement account. I
Please have Steve return the Final Distribution Forms along with a Certified Death Certificate to
the address below:
ABF Freight System, Inc.
Attn: Danielle Scheurer
P.O. Box 10048
3801 Old Greenwood Road
Fort Smith AR 72917-0018
u
r;;.. ~(/\
If! can be of further assistance, please contact my direct line at (419) 494-8397.
I
!
tJalJd/t- ~(tf"
Danielle Simpkins Scheurer
Retirement Services Specialist
ARK/\i'JSA) BE ST
CORPOR.TIC I\j
Enclosures
Final Distribution Form-6
Special Tax Notice-l
Return Envelope-l
29, /.
E; ,:' .t!_ a-~/e:)--eoc)o
Page 1 of 4
i
Print This Page
""""""""'14~' wm' fj~'
.....~.:-: .....'.... . .'.
........- >....... . .
.................. . .'
""......' .
....... ......,. . - ,.
'.::: . ;..",~.,~,."'~,>,;..:~:.(~
ABF Freight System, Inc.
401 (k) Savings Plan
LEROY J CHARLES
425 CROSSROAD SCHOOL RD
CARLISLE, PA 17013-9449
Retiremet Savings Statement
i
it customtr Service: (800) 835-5098
Fidelity Inv stments Institutional
Services C .
82 Devonstlire Street
Boston, MAl 02109
Your Account Summary
I
Statement Period: 06/18/2007 to 06/18/2007
Beginning Balance
Change In Market Value
$47,750.93
$32.62
Ending Balance
$47,783.55
Additional Information
Vested Balance
$47,783.55
....................................................................................................................................................................1..........................................................
Your Personal Rate of Retum
This Period
0.1%
Your Personal Rate of Return is calculated with a time-weighted formula, *"idely used by financial
analysts to calculate investment earnings. It reflects the results of your int'estment selections as
well as any activity in the plan account(s) shown. There are other Person~1 Rate of Return
formulas used that may yield different results. Remember that past perfonmance is no guarantee
of future results.
Your Asset Allocation
Statement Period: ~6/18/2007 to 06/18/2007
https://plansponsorservices400.fidelity. com/plansponsor/sponsor/online~ statement_detail. do 6/20/200
FORM PAS23SlC-24 (Rev. 3/03) SIMPU: INTEREST
PENNSYlVANIA
MOTOR VEHICLE INSTALLMENT SALE CONTRACT,
28 NOV
Dated
tit3
ANNUAL
PERCENTAGE RATE
The cost of your credit as
a yearly rate.
Amount Financed
The amount of credit provided
to you or on your behalf.
Total of Paym~nts
The amount you rill have paid after you
have made all sC'I'eduled payments.
I
FINANCE
CHARGE
The dollar amount the
credit will cost you.
4. 9~ $
1834.86
14165.94
$
$
16 00.80
Your Payment Schedule will be:
No. of Payments Amount of Payments
$
$
Total Sale Price
The total cost of your p rchase on
credit, including your own payment
of $
$
Security: ~ou are giving a security interest in the motor vehicle being
purchased. I
jrepayment.11f un.. ~... .u
, 05917018b8
When Payments Are Due
Monthly, beginning
Filing Fees: $ 5. 00
Late Charge: If a payment is late, you will be charged 2% of the portion of the payment which is late for each monlt" u, fJal\ UI a montn greater than 10 days, that it remai s unpaid.
See below and any other Contract documents for any additional information about nonpayment, default, any requi ed repayment in full before the scheduled date and prepayment
refunds and penalties. '. . e eans estimate
In this Contract
we are
the SELLER.
P A I .D HAY 3
HARRISBURG PA 17R~o01
Add ress
Zip Code
AUTOHAUS ACOUISITION. INC.
4150 CHAMBERS HILL ROAD
Name
You are
the BUYER(S).
LEROY J CHARLES 425 CROSSROAD SCHOOL RD CARLISLE P~ 17013
Name(s) Address(es) Zip Code(sl
If there is more than one Buyer, each promises, separately and together, to pay all sums due us and to perform all agrefments in this Contract.
TRADE.IN:
You have traded in 95 CHEVROLE CAVALIER
the following vehicle:
Year and Make Description.
If a balance is still owing on the vehicle you have traded in, the Seller will payoff this amount on your behalf. You warrant nd. represent to us that
any trade-in is free from lien, claim, encumbrance or security interest, except as shown in the Itemization of Amount Finance as the "lien Payoff.'
PROPERTY INSURANCE: You may choose the person through whom insurance is obtained against loss or damage to he Vehicle and against
liability arising out of use or ownership of the Vehicle. In this Contract, you are promising to insure the Vehicle and keep it i sured.
CREDIT INSURANCE IS NOT REQUIRED: Credit Life Insurance and Credit Accident & Health (Disability) Insurance are not required to obtain
credit, and will not be provided unless you sign below and agree to pay the additional cost(s). Please read the NOTICEIOF PROPOSED CREDIT
INSURANCE on the reverse side. Your insurance certificate or poliCy wiil tell you the MAXIMUM amount of insurance ~vailable. All insurance
purchased will be for the term of the credit. We may receive financial benefit from your purchase of credit insurance.
nce
What is your
age? _ Years
62
What is your
age? ~ Years
Iflgle Credit Life Insurance
By signing, you both select Joint
Credit Life Insurance, which costs $
What are By signing. you both select Joint ~redit IWhat are Percentage
your ages? ACCident & Health Insurance, which costs $ - iyour ages? to be
N/A insured
1. ~_%
N/R
1.
2.
Signatures of both Buyers to be insured for Joint Credit Life Insurance
2.
Signatures of both Buyers to be insured for Joint
Credit Accident & Health Insurance
Insurer:
VEHICLE: You have agreed to purchase, under the terms of this Contract, the following motor vehicle and its extra equi ment, which is called
the "Vehicle" in this Contract.
N/U
No. 1M
Se ial NumQer
Year and Make
Series
fuli!y ~
Truck Ton Canacitv
Eq~~d ~=! A\fOLK~.~A6 ~lji1~gereo _ 5 Spd Other
with A.C. P.W. AM-FM Tape Vinyl Top
ASSIGNEE: We may assign this Contract and Security Agreement to a sales finance company which is the "Assignep.." I the Assi~nee assigns
the Contract to a subsequent assignee, the term also refers to such subsequent assignee. After the assignment, all rights and b~nefits of the
Seller in this Contract and in the Security Agreement shall belong to and be enforceable by the Assignee. The Assigne will notify you when
and if Seller makes an assignment.
NFB FUNDING, INC.
CO-SIGNER: Any person signing the Co-Signer's Agreement below promises separately and together with all Co-Signer(s) and Buyer(s), to pay
'All ~llmc:: rllIO ::l.nn t/'\ n~rfnrm ::l.1I ~arj:)Ampntc:: in thic:: r.nntr~rt r.n-~i"rfp.r will nnt hp. :an Ownp.r nf thE!! Vp.hir.lp..
IF YOU DO NOT MEET OUR CONTRACT
OBLIGATIONS, 'YOU MAY LOSE THE MOTOR
VEHICLE AND PROPERTY THAT YOU
BOUGHT WITH THIS CO TRACT, AND/OR
MONEY ON DEPOSIT WIT THE ASSIGNEE.
This Contract is between lIer and Buyer. All
disclosures have been ma e by Seller. Seller
intends to assign this Contr ct to the Assignee.
Itemization of Amo nt Financed
Cash Price
*
.....
ro
.c
C1>
co
*
'"0
C1>
~
'"
E
%
~
'"
o
>-
c:
o
~
C1>
.c
<5
.s
'"0
'iij
a..
~
c:
'"
o
E
'"
.....
o
c:
o
* :e
o
0.
'"
c:
* ~
~
>-.
'"
* E
~
$
To
$
*
$
Finance Charge
$
Total of Payments
$
EQti~d 03 A~~LK~.~AG ~l;\iTh~ereo _ 5 Spd. Other 3UWQOP1 r.lt1M440764
with A.C. P.W. AM-FM Tape Vinyl Top
ASSIGNEE: We may assign this Contract and Security Agreement to a sales finance ~ompany which is the "Assignee." If the Assignee assigns
the Contract to a subsequent assignee, the term also refers to such subsequent assignee. After the assignment, all. Ights and b~neflts of the
Seller in this Contract and in the Security Agreement shall belong to and be enforceable by the Assignee. The Asslg ee will notify you when
and if Seller makes an assignment. NFB FUNDING, INC.
CO-SIGNER: Any person signing the Co-Signer's Agreement below promises separately and together with all Co.Signar(s) and Buyer(s), to pay
all sums due and to perform all agreements in this Contract. Co-Signer will not be an Owner of the Vehicle.
CO-OWNER: Any person signing the Co-Owner's Security Agreement below gives us a security interest in the Vehicle a~d agrees separately and
together with all Co-Owner(s) and Buyer(s), to perform all agreements in the Security Agreement and all other parts ofi thiS Contract except the
"Promise to Pay" sectiOn.
TERMS: The terms shown in the boxes above are part of this Contract.
PROMISE TO PAY: You agree to pay us the Total Sale Price for the Vehi,cle by makin~ the Cash Downpayment and aSSign~g the Trade-In, if ~hown
above, on or before the date of this Contract, and paYing us the Amount Financed plus Interest. You promise to make payme ts In accordance With the
Payment Schedule. You promise to make payments on or before the same day of each month as the first payment due date., ou agree to pay all other
amounts which may become due under the terms of this Contract. You agree to pay the Seller or ASSignee costs of SUIt. You al 0 agree to ~ay reasonable
attorneys' fees if Seller or Assignee hires an attorney to collect amounts due under thiS Contract or to protect or get possessIo of the Vehicle. You agree
to make a ments at the place or to send a ments to the address which the Assi nee most recent! s ecifies in the written n tice to au.
SECURITY AGREEMENT: To secUre the payment of all sums due and the performance of all required obligations under this Contract, you give a security interest in the ehicle, in all part
(called "accessions") attached to the Vehicle at any later time, and in any proceeds of the Vehicle, including insuran e proceeds. The Assignee may. set.off any amounts due and unpai,
under this Contract against any of your money on deposit With ASSignee. ThiS Includes any money which IS now or m~y In the future be deposited With ASSignee by yo . ASSignee may d
this without any prior notice to you;
ADDITIONAL TERMS AND CONDITIONS: THIS CONTRACT CONTINUES ON THE REVERSE SIDE. YOU ARE OBlIGAT D TO ALL THE TERMS OF THE CONTRACT WHIC APPEAR ON TH
FRONT AND REVERSE SIDES.
By signing below, we agree to sell the Vehicle to you under the terms of this Contract and
Seller agrees to assign this Contract to the Assignee named above in accordance with the
first assignment printed in the reverse side, unless otherwise marked.
NOTICE TO BUYER'MDO NOT SIGN THIS CONTRACT IN BLANK. YOU ARE
ENTITLED TO AN E ACT COPY OF THE CONTRACT YOU SIG . KEEP IT TO
PROTECT YOUR LEGAL RIGHTS.
BUYER e.7 ~
~ignaturesOTboth Buyers to be insured for Joint Credit life Insurance
2.
Signatures of both Buyers to be insured for Joint
Credit Accident & Health Insurance .
Insurer:
VEHICLE: You have agreed to purchase. under the terms of this Contract, the following motor vehicle and its extra e9uipment, which is called
the "Vehicle" in this Contract.
N/U Year and Make Series Bodv Stvle No. ~ Truck Ton Caoacitv iSerial Number
%
~ $
o
.8 To
~ $
a...
To
*
N/A
* ~
c.
'"
c
* B
e
>.
'"
* E
QJ
~
$
To
$
Amount Financed
1416 .94
$
Finance Charge
$
Total of Payments
$
Payment Sch 0 ree to pay
to us the Amount Finan ed plus interest in
59
payments of $ 266. 68
each, and a final payment of
$ 266. 68 . The first
payment will be due on 28 DEe
03 , and then payment!
will be due on that sam day of each monll
following.
(SEAL)
l1J~h/0,
11/28/03 BUYER (SEAL)
D~ D~
CO.SIGNER: YOU SHOUl..O READ THE OnCE TO CO-SIGNER, WHICH HAS BEEN GIVSN TO YOU ON A SEPARATE DOCUM NT, BEFORE
SIGNING THE CO-SIGNER'S AGREEMENT.
CO-SIGNER'S AGREEMENT: You, the person (or persons) signing below as "Co-Signer," promise to pay to us all sums due on this Contract an to perform all
agreements in this Contract. You intend to be legally bound by all the terms of this Contract, separately ~nd together, with the Buyer. You are making this promise to
induce us to make this Contract with the Buyer, even though we will use the proceeds only for the Buyctr's benefit. You agree to pay even though w may not have
made any prior demand for payment on the Buyer or exercised our security interest. You also acknowledge receiving a completed copy of this Contrac .
(SEAL)
Co-Signer's Signature
Ad dress
(SEAL)
Co-Signer's Signature
Ad dress
ate
Date
CO-OWNER'S SECURITY AGREEMENT: You, the person signing below as "Co-Owner," together with Ithe Buyer or otherwise being all of the Owne s of the Vehicll
give us a Security Interest in the Vehicle identified above. You agree to be bound by the terms of the Secutity Agreement and all other parts of this Co tract except th
"Promise To Pay" section. You are giving us the security interest to induce us to make this Contract with theiBuyer, and to secure the payment by the Buye of all sums du
on this Contract. You will not be responsible for any deficiency which might be due after repossession and salb of the Vehicle.
BUYER, GO-SIGNER AND CO-OWNER, AS APPLICABLE, ACKNOWLEDGE RECEIPT OF A COMPLETED COPY OF THI
A~THETlME OF~IGNI~ I
. ~1 Ukt
BU YER
(SEAL)
Co-Owner's Signature
Add ress
BUYER
CO.SIGNER
NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORM TlON.
BANCONSUMER FORM PAS23SLC.24 (Rev. 3/031
ORIGINAL. White' DEALER COpy. Canary' BORROWER'S/CO.SIGNER'S COPY - Pink COpy. Goldenrod
Date
Co NTRAC.
CO.SIGNER OR CO-OWNER
" 2003 BANCON UMER SERVICE, INC
t Sovereign BanI{
November 30, 2007
Leroy J Charles
425 Crossroad School Rd.
Carlisle PAl 7013-9449
RE: 68171 5799
Dear Leroy J Charles:
Thank you for allowing Sovereign Bank to service your borrowing ne~ds. Enclosed is your cancelled
document to verify satisfaction of our lien.
Should you have questions about your account or would like informat~on about other products and se Ices
we offer, please visit your neighborhood community banking office or! contact us at
1-877-S0V -BANK(1-877-768-2265) between 7:00 a.m. to 11 :00 p.m.~ EST, 7 days a week. For
customers with hearing impairments, please call 1-800-428-9121 (TTt/TDD). One of our Customer
Service Representatives will be pleased to assist you.
Sincerely,
Stepfianie Pister
Consumer Loan Servicing Center
Mail Code: 10-421-LS2
PO Box 12646
Reading, P A 19612
Enclosure (1)
G RlSAT
If 35:3 I
l5C
Ur'b Y
c.
Prepared By:
Margaret Sirois,
SOVEREIGN BANK
450 PENN STREET
READING, PA 19062
1-800-935-0438
When Recorded Return To:
Deborah Previtera
Sovereign Bank
450 Penn Street
Reading, PA 19602
Satisfaction of Mortaaae
Sovereign Bank #:6017ILN6817195799 "CHARLES" Lender ID:AD3506/5551 0002160000000
Cumberland, Pennsylvania
Made this date November 14th, 2007
Name of Mortgagor: LEROY J CHARLES
Name of Original Mortgagee: WAYPOINT BANK
Current Owner: W A YPOINT BANK NKA SOVEREIGN BANK who by ~igning below certifies that: The
address of the Last Assignee is 450 PENN STREET, READING, PA 119601
Date of Mortgage: 04/06/2004
Original Mortgage Debt: $40,000.00
Mortgage recorded on 04/19/2004 in the Office of the Recorder of De~ds of Cumberland County, State
of Pennsylvania, in BooklReel/Liber: 1861 Page/Folio: 2071
Property Address: 425 CROSSROAD SCHOOL RD, CARLISLE, PA 17013 in the Township of WEST
PENNSBORO
The undersigned hereby certifies that the debt secured by the above-mentioned Mortgage has been fully
paid or otherwise discharged and that upon the recording hereof said Mortgage shall be and is hereby
fully and forever satisfied and discharged.
The undersigned hereby authorizes and empowers the recorder of sai~ county to enter this satisfaction
piece and to cause said mortgage to be satisfied of record. Witness th~ due execution hereof with the
intent to be legally bound.
*MMS*MMSSOVR*11/14/2007 10:27:01 AM* SOVR01 SOVROOOOOOOO 0000000028791 * PACUMBE*
60171LN6817195799 PASTA TE_MORT _REL **MMSSOVR*
Satisfaction of Mortgage Page 2 of 2
WAYPOINT BANK NKA SOVEREIGN BANK
On November 14th. 2007
BY~~
DEBOu H PREVIT.~ RA, Assistant
Secretary
STATE OF Pennsylvania
COUNTY OF Berks
ON November 14th, 2007, before me, DIANE A STENSON, a Notary Public in and for the County of
Berks County, State of Pennsylvania, personally appeared DEBORAH! PREVITERA, Assistant Secretary
of WAY POINT BANK NKA SOVEREIGN BANK, personally known to me (or proved to me on the basis
of satisfactory evidence) to be the person(s) whose name(s) is/are su~scribed to the within instrument
and acknowledged to me that he/she/they executed the same in his/h~r/their authorized and
that by his/her/their signature on the instrument the person(s), or the ehtity upon behalf of
person(s) acted, executed the instrument.
-\ " \~ ~
DIANE A STENSON
Notary Expires: 02/05/2011
COMMONWEALTH OF PENNSYLVANI~
NOTARIAL SEAL
Diane A Stenson, Notary Public
Reading., Berks Count)'
M Commission Expires Feb. 5. 20~ 1
WITNESS my hand and official seal,
(This area for notarial seal)
*MMS*MMSSOVR*11/14/2007 10:27:01 AM* SOVR01S0VROOOOOOOO 0000000028791* PACUMBE*
60171LN6817195799 PASTA TE_MORT _REL **MMSSOVR*
ROBERT P. ZIEGLER
RECORDER OF DEEDS
CUMBERLAND COUNTY
1 COURTHOUSE SQUARE
CARLISLE, PA 17013
717-240-6370
Instrument Number - 200743531
Recorded On 11/20/2007 At 10:56:02 AM
* Instrument Type - SATISFACTION PIECE
Invoice Number - 9186 User ID - KW
* Mortgagor - CHARLES, LEROY C
* Mortgagee - SOVEREIGN BANK
* Customer - SOVEREIGN BANK
* FEES
* Total Pages - 3
STATE WRIT TAX
STATE JCS/ACCESS TO
JUSTICE
RECORDING FEES -
RECORDER OF DEEDS
COUNTY ARCHIVES FEE
ROD ARCHIVES FEE
TOTAL PAID
$0.50
$10.00
~ertification Page
$11. 50
DO NOT DETACH
$2.00
$3.00
$27.00
Th~s page is now part
of t~is legal document.
I Certify this Ito be recorded
in Cumberland County P A
~to~
* - Information denoted by a asterisk may change during
the verification process a d may not be reflected on this page.
OOOAIM
111111111111111111111111111
~i
~
I
l.QYi"/IC1S'lQC1
\0 J j..,3 Ab 350(."
99555128100021655
;';'" :l::::'rJT n
1\ \. ....,.'L..I'. I I
ZIEGLER
/ I_~D ,- 01
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:; L c: C';, D :.: i~ 0 F DEE 0 S
! ';; (: F: l,,L\ N P CO U N j Y - ; /.
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i,j t"!~J i 1 \.
FH~ 10 59
Commonwealth of Pennsylvania
Space Above Irhis Line For Recording Data -
MORTGAGE
1. DATE AND PARTIES. The date of this Mortgage (Security Instrument) is ... .~RRP.... ..9.9.. ..Z9.Q4..... an
the parties, their addresses and tax identification numbers, if required, a~e as follows:
MORTGAGOR: LEROY C CHARLES
D If checked, refer to the attached Addendum incorporated herein, for *ditional Mortgagors, their signature
and acknowledgments. .
LENDER:
WAYPOINT BANK
449 EISENHOWER BLVD
HARRISBURG, PA 17111
2. CONVEYANCE. For good and valuable consideration, the receipt and $ufficiency of which is acknowledged
and to secure the Secured Debt (defined below) and Mortgagor's perfonnance under this Security Instrument
Mortgagor grants, bargains, conveys and mortgages to Lender the follo~ing described property:
SEE EXHIBIT A
The property is located in ..,..G:r.JN.\3.r::.RMNI;>,....................., at ..~~.~U~~m:;~RQN?..?.yijQq~.RR.........
(County)
......................'.........................., ....... .Y.A.RP,~.:r"r;...................., Pennsylvania . ))ql}~ ~~~X....
(Address) (City) (ZIP Code)
Together with all rights, easements, appurtenances, royalties, mineral ri$hts, oil and gas rights, all water an
riparian rights, ditches, and water stock and all existing and future improvements, structures, fixtures, an
replacements that may now, or at any time in the future, be part of the rf1al estate described above (all referre
to as "Property"),
3. MAXIMUM OBLIGATION LIMIT. The total principal amount secur~d by this Security Instrument at any
. h 11 d $ 40 000 00 ' Th' I' "f d
one hme s a not excee .. ......'......... I.. '.. .:.................... ,......':.l. IS lrmtatlOn 0 amount oes not
include interest and other fees and charges validly made pursuant to this ~ecurity Instrument.
4. SECURED DEBT. The term "Secured Debt" is defined as follows:
A. Debt incurred under the terms of all promissory note(s), contrac.(s), guaranty(s) or other evidence 0
debt described below and all their extensions, renewals, mqdifications or substitutions. (When
referencing the debts below it is suggested that you include it s such as borrowers' names, note
amounts, interest rates, maturity dates, etc.)
REAL ESTATE SECURED CLOSED END INSTALLMENT LOAN
MATURITY DATE: 04/06/19
PENNSYLVANIA - SHORT FORM MORTGAGE - CLOSED END (NOT FOR FNMA, FHLMC, FHA OR A USE)
(page 1 01 4)
~ @ 1995 Bankers Systems, Inc., St. Cloud, MN Form SFMC-MTG-PA 7/5/2000
Sf< I 8 6 r:'G ;~: 0 7 Ii
B. All obligations Mortgagor owes to Lender, which may later arise, ito the extent not prohibited by law,
including, but not limited to, liabilities for overdrafts relating! to any deposit account agreement
between Mortgagor and Lender.
C. All additional sums advanced and expenses incurred by Lender fOr insuring, preserving or otherwise
protecting the Property and its value and any other sums advanc~d and expenses incurred by Lender
under the terms of this Security Instrument.
This Security Instrument will not secure any other debt if Lender fails to $ive any required notice of the right
of rescission.
5. PAYMENTS. Mortgagor agrees that all payments under the Secured Debt will be paid when due and in
accordance with the terms of the Secured Debt and this Security Instrument.
6. WARRANTY OF TITLE. Mortgagor warrants that Mortgagor is or will be lawfully seized of the estate
conveyed by this Security Instrument and has the right to grant, bargatn, convey, sell, and mortgage the
Property. Mortgagor also warrants that the Property is unencumbered, except for encumbrances of record.
7. CLAIMS AGAINST TITLE. Mortgagor will pay all taxes, assessments, liens, encumbrances, lease
payments, ground rents, utilities, and other charges relating to the Proper~y when due, and provide to Lender
copies of all receipts on demand. Mortgagor agrees to make all payments when due and comply with all
covenants of any prior security interest on the Property.
8. DUE ON SALE OR ENCUMBRANCE. Lender may, at its option, decl~re the entire balance of the Secured
Debt to be immediately due and payable upon the creation of, or con~ract for the creation of, any lien,
encumbrance, transfer or sale of the Property. This right is subject to the restrictions imposed by federal law
(12 C.F.R. 591), as applicable.
9. PROPERTY CONDITION. Mortgagor will keep the Property in good condition and make all repairs that are
reasonably necessary.
10. AUTHORITY TO PERFORM. If Mortgagor fails to perform any duty or any of the covenants contained in
this Security Instrument, Lender may, without notice, perform or cause them to be performed.
11. ASSIGNMENT OF LEASES AND RENTS. Mortgagor irrevocably grants, bargains, conveys and
mortgages to Lender as additional security all the right, title and interest in and to any and all existing or
future leases, subleases, and any other written or verbal agreements for thf use and occupancy of any portion
of the Property, including any extensions, renewals, modifications or su~stitutions of such agreements and
rents, issues and profits. Mortgagor may collect, receive, enjoy and use th~ Rents so long as Mortgagor is not
in default under the terms of this Security Instrument.
12. DEF AUL T AND REMEDIES. Mortgagor will be in default if any party obligated on the Secured Debt fails
to make payment when due. Mortgagor will be in default if a breach occurs under the terms of this Security
Instrument or any other document executed for the purpose of creating, securing or guarantying the Secured
Debt. A good faith belief by Lender that Lender at any time is insecure ~ith respect to any person or entity
oblig,"oo on the Secmoo Debt m that the pro'pect of '"'y payment m th I v,une of the Prope"y i, impai"d
I
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,
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ilL. / ! .' ~
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(page 2 of 4)
~ @ 1995 Bankers Systems. Inc., SI. Cloud, MN Form SFMC.MTG-PA 7/5/2000
r
shall also constitute an event of default. Lender may accelerate the lsecured Debt subject to any notice
requirements of Lender to provide notice to Mortgagor as required by 1 w. Lender shall be entitled to all the
remedies provided by law, the terms of the Secured Debt, this Security I strument and any related documents.
All remedies are distinct, cumulative and not exclusive, and the Lender. s entitled to all remedies provided at
law or equity, whether or not expressly set forth.
13. EXPENSES; ADVANCES ON COVENANTS. Except when prohibite by law, Mortgagor agrees to pay all
of Lender's expenses if Mortgagor breaches any covenant in this Securit Instrument. Mortgagor will also pay
on demand any amount incurred by Lender for insuring, inspecting, p eserving or otherwise protecting the
Property and Lender's security interest. These expenses will bear intere t from the date of the payment until
paid in full at the highest interest rate in effect as provided in the terms 0 the Secured Debt. Mortgagor agrees
to pay all costs and expenses incurred by Lender in collecting, enforci g or protecting Lender's rights and
remedies under this Security Instrument. This Security Instrument shall r~main in effect until released.
,
14. INSURANCE. Mortgagor shall keep Property insured against loss by fi~e, flood, theft and other hazards and
risks reasonably associated with the Property due to its type and locatio . This insurance shall be maintained
in the amounts and for the periods that Lender requires and shall includ a standard mortgage clause in favor
of Lender. The insurance carrier providing the insurance shall be chos n by Mortgagor subject to Lender's
approval, which shall not be unreasonably withheld.
15. APPLICABLE LAW; SEVERABILITY; INTERPRETATION. This Security Instrument is governed by
the laws of the jurisdiction in which Lender is located, except to the ext nt otherwise required by the laws of
the jurisdiction where the Property is located. Any provision that appoint Lender as an agent is not subject to
the provisions of 20 Pa.C.S.A. Section 5601 et seq. (Chapter 56; Dece ents, Estates and Fiduciaries Code).
Lender, by exercising any of its rights under this Security Instrument, oes so for benefit of Lender. If any
section of this Security Instrument cannot be enforced according to its te s, that section will be severed and
will not affect the enforceability of the remainder of this Security Instr4ment. Whenever used, the singular
shall include the plural and the plural the singular.
16.JOINT AND INDIVIDUAL LIABILITY; CO-SIGNERS; SUCCES~RS AND ASSIGNS BOUND. All
duties under this Security Instrument are joint and individual. If Mortga or signs this Security Instrument but
does not sign an evidence of debt, Mortgagor does so only to mortgage ortgagor's interest in the Property to
secure payment of the Secured Debt and Mortgagor does not agree to ibe personally liable on the Secured
Debt. If this Security Instrument secures a guaranty between Lender ~d Mortgagor, Mortgagor agrees to
waive any rights that may prevent Lender from bringing any action or c aim against Mortgagor or any party
indebted under the obligation. Mortgagor agrees that Lender and any p rty to this Security Instrument may
extend, modify or make any change in the terms of this Security Instru ent or any evidence of debt without
Mortgagor's consent. The duties and benefits of this Security Instrument shall bind and benefit the successors
and assigns of Mortgagor and Lender.
17 . WAIVERS. Except to the extent prohibited by law, Mortgagor waives ~y right to appraisement relating to
the Property.
(page 3 of 4)
~ @ 1995 Bankers Systems, Inc., St. Cloud, MN Form SFMC-MTG-PA 7/5/2000
Oil
Dl\
86
l"~;t'... "'-=t -c~
jlb .t: U
i")
.,.
V
o NOTICE TO BORROWER: TillS DOCUMENT CONT INS PROVISIONS FOR A
VARIABLE INTEREST RATE.
!
SIGNATURES: By signing below, Mortgagor, intending to be legally bo~nd hereby, agrees to the terms and
covenants contained in this Security Instrument and in any attachments. M01gagor also acknowledges receipt of a
copy of this Security Instrument on the date stated on page 1.
" ..' /? ,;
~ 'd /7/ ./
tfI~ C p,-,~? (.:./tM.-r~>'6
(S;g~~m~~) 'iFioy" C' 'C~LE"S"""""""" '(D'at~)""
:ift-~-. ,J'._, 7J!??'i / -
n 17;"
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,/'" -,- 1__'/" f... ...-" .~-
i..' >;;;,.. 'ff.... j/ .......................................
ACKNOWLEDGMENT:
(Signature)
(Date)
(Witness)
COMMONWEALTH OF .... rA.........,......................., COUNTY OF . 9t}J1J'}r;~JANp...... .."........... } SS.
(Individual) On this, the ..~t;Q....... day of ...~.J;>R;I).~..,..~.9.Q4..........., be re me (!.~~,.1~f~:!:,.\...JJ;.:eMn'::'l-:t.:..,
the undersigned officer, personally appeared ~~.RQX..Y.. .C;~.J... .?.......................................,..
................................................................, known to e (or satisfactorily proven) to be the
person(s) whose name(s) is subscribed to the within inst ent, and acknowledged that he/she
, '.' executed the same for the purposes therein contained.
~.',.:~~.~w.itness whereof, I hereunto set my hand and officia{Zs 1. .... ~'j
p~~^" . I IQi //
, .. If .. . fi..JV Xl' . ~ .
, ~'AY comrmsslOn expires: ..... ............;..........;......;~'i......................
, NOTARIAles1!AL ~ '---
CONNIE S, OZEZINSKI, Notary Public '---" ~- ,'J I' .
Camp Hill Bora" Cumberland County /lJ--L!:C l' '-fui'--(L.L/'
My Co'nmission Expires J I 22 2006 . .: . . . . . . . . . . . . . . . . . . .. . . J/o . . . . v. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ,. .
_ ' u y , Title of Officer \
!
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I . h b 'f' d th h dd f th L d . h' d . ) 49 EISENHOWER BLVD
t IS ere y cerh Ie at tea ress 0 e en er WIt In name IS:. .. . .. .. . t... .. .. .. . .. ... ... .. . .. . .. . .. .. .. . .. .. .. .. , ..
... .~J~~~~,...fh..^?m......... ............ .... .....:::::~:.. .....,. ........ij...:. .... ..... ......... .
~ <91995 Bankers Systems, Inc" St, Cloud, MN Form SFMC.MTG.PA 7/5/2000
(page 4 of 4)
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