HomeMy WebLinkAbout02-11-08
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15056041147
REV-1500
PA Department of Revenue
Bureau of Individual Taxes
PO BOX.280601
Harrisburg, PA 17128-0601
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
EX (06-05)
OFFICIAL USE ONLY
..
County Code Year
F lie Number
INHERITANCE TAX RETURN
RESIDENT DECEDENT 2 1 0 7
0637
Date of Birth
168 24 1011
06 04 2007
03 31 1926
Decedent's Last Name
Suffix
Decedent's First Name
MI
GLADFELTER
JEAN
D
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name
Suffix
Spouse's First Name
MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
~ Original Return D 2 Supplemental Return D 3. Remainder Return (date of death
prior to 12-13~2)
D 4. Limited Estate D 4a. Future Interest Compromise D 5. Federal Estate Tax Return Required
(date of death after 12-12-82)
[RJ 6 Decedent DIed Testate [Xl 7. Decedent Maintained a Living Trust 1 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
D 9. Litigation Proceeds Received D 10. Spousal Poverty Credit (date of death D 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
JOHN D. FLINCHBAUGH
717 848 4900
Firm Name (If Applicable)
()
CGA LAW FIRM
REGISTER OF WILLS~SE ONLY
First line of address
135 NORTH GEORGE STREET
Second line of address
C-.)
City or Post Office
State
to..-,
DATE FILE[)lJ
ZIP Code
YORK
PA
17401
Correspondent's e-mail address:
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief,
it is true, correct and complete. Declaration of prepare other than the personal representative is based on all information of which preparer has any knowledge.
c;~ F PERSON RESPONSIBLE FO NG T N DA~
Jennifer A. Leib, V.P. - M & T Bank e>(..
ADDF<ESS
13 Baltimore St 31
DATE
John D. Flinchbaugh
z..-
7/03"
ADDF<E SS,
{-/
135 North George Street, York, PA 17401
Side 1
L
15056041147
15056041147
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15056042148
REV-1500 EX
Decedent's Name J e anD. G I a d felt e r
Decedent's Social Security Number
168 24 1011
175,994.04
RECAPITULATION
1. Real Estate (Schedule A)...............................................................................
1.
2. Stocks and Bonds (Schedule B)............................................................................... 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C).......... 3.
4. Mortgages & Notes Receivable (Schedule D).......................................................... 4.
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E)................
6. Jointly Owned Property (Schedule F) 0 Separate Billing Requested.............
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) 0 Separate Billing Requested.............
8. Total Gross Assets (total Lines 1-7).......................................................................
9. Funeral Expenses & Administrative Costs (Schedule H).............
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 ).............................................................
13. Charitable and Governmental Bequests/See 9113 Trusts for which
an election to tax has not been made (Schedule J).................................................
12.
13.
14.
14. Net Value Subject to Tax (Line 12 minus Line 13).................................................
TAX COMPUTATION. SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, of
transfers under Sec. 9116
(a)(1.2) X .00 0 . 00 15.
16. Amount of Line 14 taxable
at lineal rate X .045
17. Amount of Line 14 taxable
at sibling rate X .12
18. Amount of Line 14 taxable
at collateral rate X .15
673,473.47
16.
o . 0 0
17.
o . 0 0
18.
19. Tax Due...
19.
20. Fill IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
Side 2
L
15056042148
5.
43, 598 . 5 6
6.
7.
532,853.17
8.
752,445.77
34,939.30
9.
44,033.00
78,972.30
673,473.47
673,473.47
o . 0 0
30, 306 .31
o .00
o . 0 0
30, 306.31
0
15056042148
~
REV-1500 EX Page 3
Decedent's Complete Address:
DECEDENT'S NAME
.Jean D. Gladfelter
STREET ADDRESS
:l1 Westfields Drive
File Number 21-07 -0637
-----~_.-
'--
CITY
I STATE
!ZIP
-~--
Mechanicsburg
PA
17050
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A Spousal Poverty Credit
B. Prior Payments
C. Discount
(1) 30,306.31
30,000.00
1,515.32
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Credits (A + B + C)
(2)
31,515.32
Total Interest/Penalty (0 + E)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 2 Line 20 to request a refund
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A Enter the interest on the tax due.
(3)
(4)
1,209.01
B. Enter the total of Line 5 + SA. This is the BALANCE DUE.
(5)
(SA)
(5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and:
a. retain the use or income of the property transferred;.____....__.__.______.________.__. ..__.__________..__.....__.__.__.....____.__.__
b. retain the right to designate who shall use the property transferred or its income:__..__.______...____ ______.______..
c. retain a reversionary interest; or .__....__. .____. .... .........__.____.......__.__.......__.... __... "" ____.__.. ...______ .... ..______..... __.......
d. receive the promise for life of either payments, benefits or care?__..____.______....______.__.__.__.......____.______..__
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration? ..________.. ____.... ..____ __ ____......... __.. __... ..... __. __..__..... ________.. ..________.. ....____. ..__... __. ..______.
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation?... .......... ----. --. --.. ..--.. --.. ----.......... --.............. . --.... --...... ..------.. __.. __.......... ____.. __.. L!J
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Yes No
D 0
D 0
D 0
[J [~J
D 0
il [Xl
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the
surviving spouse is three (3) percent [72 P.S. 99116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero
(0) percent [72 P .S. 99116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements
for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a
natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. 99116 (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent.
except as noted in 72 P.S. 99116 1.2) [72 P.S. 99116 (a) (1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. 99116 (a) (1.3)]. A
sibling is defined under Section 9102. as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
Rev-1502 Ell + (6-98)
.
SCHEDULE A
REAL ESTATE
COMMONWEAL TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Gladfelter, Jean D.
FILE NUMBER
21-07 -0637
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be
exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts
Real property which Is jointly-owned with right of survivorship must be disclosed on schedule F.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
1
Real estate located at 31 Westfields Drive, Mechanicsburg, Cumberland County,
Pennsylvania, 17050 - Actual net sale proceeds per attached HUD-1 settlement
sheet
175.994.04
TOTAL (Also enter on Line 1, Recapitulation)
175.994.04
(If more space is needed. additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule A (Rev. 6-98)
Rev-1508 E:<+ (6-98)
*'
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Gladfelter, Jean D.
FILE NUMBER
21-07 -0637
Include the proceeds of litigation and the date the proceeds were received by the estate
All property jolntly-owned with the right of survivorship must be disclosed on schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 AARP - Long term care policy refund 94.12
2 Encompass Insurance - Refund of auto insurance 495.00
3 Highmark Freedom Blues - Health insurance refund 81.46
4 Sovereign Bank - Certificate of Deposit - 1685539866 - Balance as of date of death 5.330.52
5 Sovereign Bank - Certificate of Deposit - 1685539866 - Accrued interest as of date of 3.23
death
6 Sovereign Bank - checking account - #2731703008 - Balance as of date of death 3.517.38
7 Rowe's Auction Service - Appraisal of decedent's personal property, including 33.720.00
automobile - see attached
8 Rowe's Auction Service - Actual net proceeds of sale of tangible personal property 356.85
of decedent (not included on appraisal)
TOTAL (Also enter on Line 5, Recapitulation)
43.598.56
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule E (Rev. 6-98)
Rev-1510 EX+ (6-98)
.
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Gladfelter, Jean D.
FILE NUMBER
21-07 -0637
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes
ITEM DESCRIPTION OF PROPERTY DATE OF DEATH % OF DECO'S TAXABLE
EXCLUSION
NUMBER INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
THE DATE OF TRANSFER ATTACH A COPY OF THE DEED FOR REAL ESTATE,
1 Sovereign Bank - Certificate of Deposit/IRA - 3,107.77 3.107.77
2768018091 - Balance as of date of death - two
grandchildren are beneficiaries
2 Sovereign Bank - Certificate of Deposit/IRA - 1.47 1.47
2768018091 - Accrued interest as of date of
death - two grandchildren are beneficiaries
3 M & T Bank - Account 1101912002 - Balance as 529.743.93 529,743.93
of date of death - See attached valuation report
FUNDS HELD IN A REVOCABLE TRUST OF
DECEDENT - attached hereto
TOTAL (Also enter on Line 7, Recapitulation) 532.853.17
(If more space is needed, additional pages of the same size)
Copyright (e) 2002 form software only The Lackner Group, Inc,
Form PA-1500 Schedule G (Rev, 6-98)
REV-1151 EX+ (12-99)
.
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Gladfelter, Jean D.
FILE NUMBER
21-07 -0637
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A. FUNERAL EXPENSES:
DESCRIPTION
AMOUNT
See continuation schedule(s) attached
4,220.84
B.
ADMINISTRATIVE COSTS:
1.
Personal Representative's Commissions
Jennifer A. Leib, V.P. M & T Bank
Social Security Number(s) / EIN Number of Personal Representative(s):
Street Address
13 Baltimore Street
City
Hanover
State P A
Zip 17331
Year(s) Commission paid
2007/2008
9,775.38
2.
Attorney's Fees
CGA Law Firm
9,775.38
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City
Relationship of Claimant to Decedent
State
Zip
4.
Probate Fees
310.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
Other Administrative Costs
See continuation schedule(s) attached
10,857.70
TOTAL (Also enter on line 9, Recapitulation)
34,939.30
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H (Rev. 6-98)
Rev-1502 EX+ (6-98)
.
SCHEDULE H-A
FUNERAL EXPENSES
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Gladfelter, Jean D.
\FILE NUMBER
21-07 -0637
ESTATE OF
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
Cocklin Funeral Home, Inc.
4.220.84
Subtotal
4.220.84
Copyright (c) 2002 form software only The Lackner Group. Inc.
Form PA.1500 Schedule H-A (Rev. 6-98)
Rev-1502 EX+ (6-98)
.
SCHEDULE H-B7
OTHER
ADMINISTRATIVE COSTS
continued
COMMONWEAL TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Gladfelter, Jean D.
FILE NUMBER
21-07 -0637
ITEM
NUMBER
AMOUNT
DESCRIPTION
1
CGA Law Firm - Estimated final closing costs of administration
2.000.00
2
Credit Card Services
825.03
3
Cumberland Law Journal - Advertise Grant of Letters
75.00
4
Debra Basehore Wiest - Real estate tax certification fee
5.00
5
Debra Basehore Wiest - Real estate tax
1.556.21
6
HomeService Main - Automatic deduction - in-home water system service contract
9.16
7
House Doctors - Repair down spout at decedent's property
105.00
8
John R. Davis - Services rendered
50.00
9
Lawnscape, Inc. - Lawn care (four invoices)
836.55
10
M & T Bank, Trustee - Trustee fee for administration of Revocable Trust
2.289.32
11
Mark Heckman Real Estate - Appraisal fee
350.00
12
Marsh Advantage America - Insurance premium (liability/property)
619.00
13
P P & L Electric Utilities - Seven invoices
285.06
14
Penn Waste Inc. - Maintenance and repairs - and utility payment - three invoices
72.33
15
Register of Wills - Swearing in of Executor in York County
10.00
16
Rowe's Auction Service - Appraisal Fee
165.00
17
Silver Spring Township - Utility payment - sewer - two invoices
171.40
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B7 (Rev. 6-98)
Rev-1502 EX+ (6-98)
*'
SCHEDULE H-B7
OTHER
ADMINISTRATIVE COSTS
continued
COMMONWEALTH Of PEHNSYlVAN\A.
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Gladfelter, Jean D.
IFILE NUMBER
21-07 -0637
ESTATE OF
ITEM
NUMBER
DESCRIPTION
AMOUNT
18
Sovereign Bank - Administative Expense - Home Equity Line of Credit
27.00
19
T -Mobile - Phone invoice
57.25
20
Teresa Strickler - Notary fees
10.00
21
The Sentinel - Advertise Grant of Letters
150.64
22
United Water Pennsylvania - Utility payment (three invoices)
91.67
23
Verizon - Phone bill
67.61
24
Virgin Noss - Excess liability claim loss for water damages to Mrs. Noss's property
1.029.47
Subtotal
10.857.70
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B7 (Rev. 6-98)
Rev-1512 EX+ (6-98)
.
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Gladfelter, Jean D.
FILE NUMBER
21-07 -0637
Include unreimbursed medical Qxpenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Blondie's on Main - Haircut 18.00
2 Lisa M. Stankovic, MD - Medical expense 15.00
3 Loan from John and Jean Gerschefski on January 14,2005 - This loan was to 22.000.00
replace decedent's home equity loan with Sovereign Bank, a commercial banking
institution.
4 Loan from Wayne Gladfelter on or about January 14,2005 - This loan was to replace 22.000.00
decedent's home equity loan with Sovereign Bank, a commercial banking
institution.
TOTAL (Also enter on Line 10, Recapitulation)
44,033.00
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule I (Rev. 6-98)
REV-1513 I'X+ (9'{)Q)
.
SCHEDULE ..
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
NUMBER
Gladfelter, Jean D.
NAME AND ADDRESS OF
PERSON(S} RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal
distributions, and transfers
under Sec. 9116(a)(1.2}]
Jean Davis Gerschefski
9556 Fern Hollow Way
Montgomery Village, MD 20886
FILE NUMBER
21-07 -0637
ESTATE OF
RELATIONSHIP TO
DECEDENT
Do Not list Trustee(s)
SHARE OF ESTATE AMOUNT OF ESTATE
(Words) ($$$)
I.
Daughter
1/3 residue
Elizabeth R. Gladfelter
250 Valley Park South
Bethlehem, PA 18018
Daughter
1/3 residue
Wayne L. Gladfelter
1180 Josephine Road
RoseviJIe, MN 55113
Son
1/3 residue
Total
Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT
BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
0.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule J (Rev. 6-98)
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JECt51 31IlIill ClUO QIcslcrmcnt
OF
JEAN D. GLADFELTER
I, Jean D. Gladf el tar, of Mechani csburg, Cumber land County,
Pennsylvania, being of sound and disposing mind, memory and
understanding. do make, publish and declare the following as and
for my Last will and Testament, hereby revoking and making void any
and all wills and Testaments, or writings in the nature thereof by
me at any time heretofore made.
1.
I dlrect that all expenses of my last illness, including
hospital expenses, expenses for medical care, funeral expenses and
the cost of a gravemarker, as well as all debts or obligations owed
by me at the time of my death, which in the opinion of my Executors
are not subject to either a legal or equitable defense, shall be
paid from my residuary estate, unless otherwise provided herein, as
soon as practicable after my decease, as a part of the expense of
the administration of my estate.
II.
I give and bequeath all items of tangible personal property
which I may own at the time of my death, including any automobiles
which I may own, together with any insurance policies thereon in
equnl shares to my surviving children, to be divided among them in
kind as they may agree. In tho event that none of my said children
survive me, said tangible personal property shall be divided among
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their surviving issue equally and distributed to such Issue in kind
per capita.
III.
I give, devise and bequeath all the rest, residue and
remainder of my estate, real, personal and mixed, of whatever kind
or character and wherever situated, which I may own or have the
right to dispose of at the time of my death in equal shares to my
children, Wayne L. Gladfelter, Jean D. Gerschefski and Elizabeth R.
Gladfelter.
In the event that any of my children predecease me,
the share of my deceased child shall not lapse but shall instead be
distributed among said deceased child's issue, per stirpes.
IV.
In the event that any beneficiaries under this will should be
twenty (20) years of age or younger, then I direct that their share
shall be held in trust for them by Dauphin Deposit Bank & Trust
Company, or its successor, subject to the following terms and
conditions:
(1) Each respective beneficiary shall have the right to
receive the net income from his or her separate
share in peri ad ic installments unt i 1 final
distribution of the principal as hereinafter
provided.
(2) The Trustee is expressly authorized to expend, for
the use and benefit of each of the beneficiaries
hereunder so much of his or her respective share of
income or principal as may be necessary for his or
her proper maintenance, support, health or medical
needs, and education, including a college,
graduate, professional or technical education.
(3) Each of said benefiCiaries shall have the right to
receive, when he or she shall have attained the age
of twenty-five (25) years, one-third (1/3) of the
balance of his or her respective share of the
principal, together with any undistributed income
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thereon.
(4) Each of said beneficiaries shall have the right to
receive, when he or she shall have attained the age
of thirty (30) years, one-half (1/2) of the balance
of his or her respecti ve share of the principa 1,
together with any undistributed income thereon.
(5) Each of said beneficiaries shall have the right to
receive, when he or she shall have attained the age
of thirty-f i ve (35) years, the ba lance of hi s or
her respect i ve share of the pr i ncipa I, together
with any undistributed income thereon.
(6) Notwithstanding any of the above provisions, the
Trustee, in its sole and absolute discretion, is
expressly authorized to exceed the above limits of
distribution to or for the use and benefit of any
of the beneficiaries hereunrler for the pl~rchase of
a home, for allY benef i c i ary' s advanced educat ion,
or taking advantage of ~ sound business
opportuni ty, which the Trustee feels to be a
prudent investment, or to make such other
distribution as the Trustee feels justifiable.
(7) Should any of the beneficiaries hereunder die
without having received his or her full share of
the principal of said trust estate, the same, or
any undistr ibuted . portion thereof, together with
any undistributed income, shall be paid by the
Trustee to his or her issue per stirpes when and as
they severally and respectiv~ly attain the age of
twenty-one (21) years.
(8) Should any of the beneficiaries hereunder die
without having received his or her full share of
the principal of the trust estate, leaving no issue
surv i ving, the share Ir/hich he or she wou 1 d have
taken, if living, or any undistributed portion
thereof together with any undi str ibuted income,
shall be added per stirpes to the other shares of
surviving beneficiaries or the issue of any
deceased beneficiary as provided herein, and be
distributed in accordance with the above
provisions.
(9) Should the issue of any deceased beneficiary be
twenty-one (21) years of age, then his or her share
shall be pa id forthw i th i ot.herw ise, the Trustee
shall hold and retain the shares of such issue or
any distr i butees who may be under twenty-one ( 21)
years of age at the time their shares become vested
in them absolutely, and pay, expend, use and apply
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the income and principal therefrom, for their
maintenance, support, health or medical needs and
education, and pay over and deliver unto them the
balance of their respective shares of income and
principal when and as they severally and
respect i vel y attain the age of twenty-one (21)
years.
v.
My personal representatives and the Trustees of any trust
created hereunder shall have the following powers and authority in
addition to, and not in limitation of, any other rights and powers
granted by law:
A. To retain any propert.y transferred, devised or bequeathed
to them by me, or any undivided interest therein,
regardless of the character of said property, or whether
it is such as may be authorized by law as u legal
investment by a fiduciary;
B. To sell any estate or trust property, for cash or on
credit, at public or private sale; to exchange any of
said property for other property; to grant options to
purchase or acquire any estate or trust property; and to
determine the prices and terms of sales, exchanges and
options;
C. To execute leases and sub-leases for terms extending
beyond the termination of any Trust established herein;
t.o subdivide or improve real esta t.a and tear down or
alter improvementsj to grant easements, give consents and
make contracts relating to real estate or its use; and to
release or dedicate any interest in real estate;
D. To borrow money and to mortgage or pledge any estate or
trust property in connection with the administration of
the Trusts created hereunder; to execute promissory notes
or other obl igat ions for amounts so borrowed; und to
secure the payment of any amounts so borrowed by mortgage
or pledge of any real or personal property; provided,
however, that said authority may be exercised only to the
extent that it is necessary or required in connection
with the proper administration of my estate or any of the
trusts created hereunder, and shall not be used for the
purpose of making speculative investments or for the
purchase of securities on margin;
E. To take any action with respect to conserving or
realizing upon the value of any estate or trust property,
4
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and with respect to foreclosures, reorganizations or
other changes affecting the estate or trust property; to
collect, pay, consent, compromise or abandon demands of
or against the estate or trust property, wherever
situated; and to execute contracts, notes, conveyances
and other instruments, including instruments containing
covenants and warranties binding upon and creating a
charge against the estate or trust property, and
containing provisions excluding personal liability;
F. To keep any property in the name of a nominee, with or
without disclosure of any fiduciary relationship;
G. To employ agents, attorneys, auditors, depositaries and
proxies, with or without discretionary powers;
H. To give proxies, to deposit securities with and transfer
title to committees representing security holders and to
participate in voti~g trust, reorganizations, and other
transactions involving the common interest of security
holders;
I. To exercise any option to subscribe for or purchase any
stocks, bonds, certificates, or other securities which
may be given to it as the holder of other stocks, bonds,
certificates, or other securities constituting a part of
the estate or trust property;
J. To . purchase stocks. bonds or other property, real or
personal, from the executor or legal representative of my
spouse's estate, or any trust established by ny spouse,
even though such:executor or legal representative is also
a fiduciary hereunder;
K. In the event that my spouse survives me, to join with my
spouse or his personal representative in the filing of
any income or gift ~ax return for any period prior to my
death and wi thout requir ing indemnification from my
spouse or his personal representative for any liability
which may arise from joining in such return;
L. To elect to take administration expensp.s on either the
estate's federal income tax return or the estate's
federal estate tax return in s~ch manner as to provide
the greatest overall tax savings. My Executors are
authorized but not required to adjust the interest of any
beneficiary detrimentally affected by such election in
order to compensate said beneficiary for any loss due to
the making of such election;
M. To exercise any election provided in the Internal Revenue
Code or under Pennsylvania Inheritance or Estate Tax Laws
with respect to the valua~ion of property for purpose of
5
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such taxes, and the time and manner of payment of tax,
and no adjustment in any beneficiary' 5 interest in my
estate shall be made by reason of the making of such
election;
N. To deduct, retain, expend and payout of any money
belonging to the estate or any trust established herein
any and all necessary and proper expenses in connection
wlth the operation and conduct of the same, and to pay
all taxes, insurance premiums on any policy constituting
part of the trust property, and any other legal
assessments, debts, claims or charges which at any time
may be due and owing by, or which may exist against my
estate or any trust established herein;
o. To charge commissions or compensation for their services
hereunder, which commissions or compensation in the case
of a corporate fiduciary may be charged aga lnst OT
payable from both principal and income received on an
annual basis at such rates as may be provided in its
published fee schedule in effect at the time said
services are performed;
P. To pay over and deliver the principal and/or income
payable to any minor beneficiary hereunder to a guardian
or custodian under the Pennsylvania Uniform Transfers to
Minors Act or similar state law in effect in the state 1n
which either I die a resident or which the minor resides,
including a custodian selected by my personal
representatives (who may select age 21 for the
terroinationof the custodianship if the same is permitted
under applicable state law) or to deliver the same to a
parent of the minor or to a person with whom the minor
resides during minority.
Q. To make any distributions or division of estate or trust
property in cash or in kind, or both.
VI.
I direct that all state and federal estate, succeSSIon,
legacy, inheritance or other transfer taxes, however designated,
together with any interest thereon, that shall become payable by
reason of my death with respect to any property which is included
in my estate for pUTposes of computing such taxes and subject to
administration by my personal representatives, shall be paid from
my residuary estate, as an expense of administration and without
6
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apportionment.
My Executors shall have no duty or obligation to obtu.ln
reilllbursement for any such tax paid by them even though on proceeds
of insurance or other property not passlng under this Will.
VII.
1 appoint Dauphin Deposit Bank & Trust Company, or its
successor, Executor of this my Last Will and Testament.
I n the
event it cannot or does not desire to act as such Executor, then I
appoint my son, Wayne L. Gladfelter, Executor 1n its place and
stead. All shall serve wi tho lIt bond.
Any fiduciary who is an individual shall be entitled to
receive reasonable compensation for his or her services hereunder
and shall be reimbursed for all expenses incurred in connection
with the administration of my estate or any trusts establ ished
herein. Compensation for any corporate fiduciary for its services
hereunder shall be in accordance with its published fee schedule in
effect at the time said services are performed.
IN WITNESS WHEREOF,
this my Will this U(t'I/J
I have hereunto set my hand and seal to
day of
?
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Utn_ t(;~~~
-~n D. lad alter
1997.
( SEAL)
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Signed, sea led, pub1 ishp.d and declared by thp above-named
Testatrix, as and for her Last Will and Testament, In the presence
of us, who, at her request, In her presence and in the presence of
each other, a 11 be i ng present at the same tIme, have her- eunto
subscribed our names as witnesses.
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COMMONWEALTH OF PENNSYLVANIA )
( SS.
COUNTY OF YORK )
I, Jean D. Gladfelter, the Testatrix, whose name is signed to
the attached or foregoing instrument, having been duly qualified
according to law, do hereby acknowledge that I signed and executed
said instrument as my Last Will; that I signed it willlngly; and
that I signed it as my free and voluntary act for the purposes
therein contained.
~o ~Mk!/h< -~<--
J n D. G dfe er, Testatrlx
to and
me this
1997.
/
No1~11:u Soal
MaurlWn K. P.:Jtt.er. Notary Puhllc
Vor'1\. y~ County
My Comrnl96i:>n EJpir8S Marc/116, 1999
COMMONWEALTH OF PENNSYLVANIA )
( SS.
COUNTY OF YORX )
We, the undersigned 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 the Testatrix,
Jean D. Gladfelter, sign and execute the instrument as her Last
Will; that the said Jean O. Gladfelter signed willingly and that
she executed it as her free and vol unt ary act for the purposes
therein expressed; that each of us in the hearing and sight of the
Testatrix, Jean D. Gladfelter, signed the Will as witnesses; and
that to the best of our knowledge, the Testatrix, Jean D.
Gladfelter, was at the time 18 or more years of age, of sound mind
and under no constrnint or und~<~,<i.D~enC!)~:<<<) f:< A _
~ _~ -- / ~~ I H
I witness
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k.
Sworn or subscribed to and
ac~ryo~ledged ?f'.ore me this
u(; III day of . t;..L1 , 1997.
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Notary Public'
N<lTarlJISoal
Maure6T1 K p.vas!. Notary Public
Vorl\.. YOlk Covr1ty
My Commi9sion EJrpirgs ~rch 15, 1~
01-09-/08 16:22 FROM-m & t bank
7176304533
T-854 P002/010 F-164
AMENDMENT OF REVOCABLE TRUST AGREEMENT
/ THIS AGREEMENT, executed ln
I
I' ,
T(~~' 1997, between JEAN D.
Cumbex:land County,
I _/
duplicate,
this
'l /.,/ //,
;~' day
of
GLADFELTER
of
Mechanicsburg,
Pennsylvania, hereinafter called "Settlor"; and
DAUPHIN DEPOSIT BANK AND TRUST COMPANY,
York,
Pennsylvania,
hereinafter called "Trustee."
WHEREAS, the parties now desire to amend "SECOND" provision
said Trust Agreement dated May 25, 1990, because of a change in
family circumstances.
NOW, THEREFORE, the parties hereby agree that effective as of
the day and year first above written provision "SECOND" of said
Revocable Trust Agreement dated May 25, 1990, is hereby Qmended to
read as follows:
WITNESSETH:
"SECOND: Dispositive Provisions After Mv Death:
A. Upon the death of Settlor, the principal and any
undistributed lncome of this Trust, together with any other
property reee i ved by the Trustee as a pour-over from any other
trust, or otherwise, shall be divided into oS many equal shares as
there shall be children of Settlor then living, plus children of
Settlor who shall have previously died leaving issue then living,
and such shares shall be distributed to such surviving children and
survl v1ng lssue per stirpes of any deceased chi ldren 1n the
following manner:
( 1) Each respect i ve benef ic i ary sha 11 have the right to
recei ve the net income from his or her separate
01-09- 08 16:22 FROM-m & t bank
7l'iti:5[,14~~:5
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share in periodic
distribution of the
provided.
installments
principal as
until final
here ina fter
(2) The Trustee is expressly authorized to expend, for
the use and benefit of each of the beneficiaries
hereunder so much of his or her respective share of
income or principal as may be necessary for his or
her proper maintenance, support, health or medical
needs, and education, including a college,
graduate, professional or technical education.
(3) Each of said beneficiarles shall have the right to
receive, when he or she shall have attained the age
of tvJenty-five (25) years, one-third (1/3) of the
ba lance of hi s or her respect i ve share of the
principal, together with any undistributed lncome
thereon.
(4) Each of said beneficiaries shall have the right to
receive, when he or she shall have attained the age
of thirty (30) years, one-half (1/2) of the balance
of his or her respective share of the principal,
together with any undistributed income thereon.
(5) Each of said beneficiaries shall have the right to
receive, when he or she shall have attained the age
of thirty-five (35) years, the balance of his or
her respective share of the principal, together
with any undistributed income thereon.
(6) Notwithstanding any of the above provisions, the
Trustee, in its sole and absolute discretion, is
expressly authorized to exceed the above limits of
distribution to or for the use and benefit of any
of the beneficiaries hereunder tor the purchase of
a home, for any benef i c i ary' s advanced education,
or taking advantage of a sound business
opportunity, which the Trustee feels to be a
prudent investment, or to make such other
distribution as the Trustee feels justifiable.
(7) Should any of the beneficiaries hereunder die
without having received his or her full share of
the principal of said trust estate, the same, or
any undi str i buted porti on thereof, together with
any undistributed income, shall be paid by the
Trustee to his or her issue per stirpes when and as
they severally and respectively attain the age of
twenty-one (21) years.
2
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ll(b~I1Lj:JG~
'J'-~~4 P~~4!010 F-164
(8) Should any of the beneficiaries hereunder die
without having received his or her full share of
the principal of the trust estate, leaving no issue
surviving, the share \-Jhich he or she would have
taken, if living, or any undistributed portion
thereof together with any undistributed income,
shall be added per stirpes to the other shares of
surviving beneficiaries or the issue of any
deceased beneficiary as provided herein, and be
distributed in accordance with the above
provisions.
(9) Should the issue of any deceased benef ic i ary be
twenty-one (21) years of age, then his or her share
shall be paid forthwith; otherwise, the Trustee
shall hold and retain the shares of such issue or
any distributees who may be under twenty-one (21)
years of age at the time their shares become vested
in them absolutely, and pay, expend, use and apply
the income and principal therefrom, for their
maintenance, support, health or medical needs and
education, and pay over and deliver unto them the
balance of their respective shares of income and
principal when and as they severally and
respectively attain the age of twenty-one (21)
years.
IN WITNESS WHEREOF and intending to be legally bound, the
undersigned have caused this Agreement to be executed the day and
year first above written.
witness:
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Uean D. ladf Iter, Settlor
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4~a.uNL C(). tY:u-&--
;:7J ALliNG Sf,(J(frflRY
DAUPHIN DEPOSIT BANK AND
TRUST COMPANY
BY:_~~~
VICE PRESIDENT 8.
REGIONAL lRUS1 MANlIGER
Attest:
3
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T-8~4 P005/010 F-164
COMMONWEALTH OF PENNSYLVANIA )
( SS.
COUNTY OF YORK )
On th~s, the. day of {:.cl''-i. 1997, before me,
the underslgned offlcer, personall}' qppeared JEAN D. GLADFELTER,
known to me (or satisfactorily proven) to be the person whose name
is subscribed to the within Agreement of Trust, and acknowledged
that she executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I have hereunto set my hand and seal the
day and year first above written.
"
'< ;/11/,
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u .llCNol<Jrl~dSoill
Mauroen I(. Rutter. Nolary Public
Yorl(, York County
My Commission Expires rl.<lrch 15. 1999
COMNONWEALTH OF PENNSYLVjI,NIA )
( SS.
COUNTY OF YORK )
On this, the ,.- day of (~....~,~j.~c,< , 1997 f before me f the
u n d e r s i 9 n .e d ; officer, personally,.,. appeared,
}/>Jl:j' D.>!' /i;'./ , who acknowledged h-imsEdf to be the
'? .{:( President of Dauphin Deposit Bank and Trust Company f a
banking institution, and thatshe as such ),~;: President being
authorized to do so f executed the foregoing instrument for the
purposes therein contained by signing the name of the institution
by hi-mself as '7.1 '~ ' President.
-./u.' .'v
IN WITNESS WHEREOF, I have hereunto set my hand and seal the
day and year first above written.
./ /
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Notary. Public
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J NOTARIAL:... "
MA'lGARF.T J. WOLSI'.., .t,..ldIY Publ;c I
York Tv".'.. Y~r~ r~.,,~y, PA
My Commi,..e>n Expi,,,,, Juno 1 1998
- ~.- . I
4
01-09-'08 16:23 FROM-m & t banK
7176304583
T-854 P006/010 F-164
REVOCABT-lE TRUST AGREEMENT
by and between
Jean D. Gladfelter
Seltlor
and
Dauphin Deposit Bank and Trust C0111pany,
Trustee
7/8<,]
01-09-'08 16:23 FROM-m & t bank
7176304583
T-854 P007/010 f-1b4
I, Jean D. Gladfelter (Settlor) of 330 Wellsville RO<ld, Vvellsville, Pennsylvani<l
17365, hereby transfer to Dauphin Deposit Bank and Trust Company (hereinafter
called the Trustee), a Pennsylvania bank and trust comp;:my, such property as may
be delivered cllntemporaneollsly here\,vith, or [It such time or times hereafter, to be
held in Trust as follows:
FIRST: Dispositive Provisions For My Benefit - During my lifetime:
A. All of the net income shall be paid to me at least q,-wrterly or shall be paid or
accumulated and added to principal, as I may direct in writing;
B. As much of the principal <IS I may from time to time request in 'writing shall
be paid to me, or as 1 may otherwise direct;
C. If, in the Trustee's opinion, I am at any time unable to act or to apply the
payments to 111Y own best interest and advantage, the Trustee may apply
directly for my benefit as much of the income and/or principal as the Trustee
In<1Y, from tinw to time, deem appropriate for my welfare, comfort, support or
E'lllergency needs, directly and without the intervention of a guardian, and mClY
Cldd to principal as much of the income as the Trustee deems advisable.
D. Trustee shall keep true and correct books of account, which bOL)ks of account
shall <It all reasonable times be open to the inspection of Settlur lH his duly
i"lppointed representative. Trustee shall also quarterly render Settlor a detailed
statement showing all receipts and disbursements on account of the trust estate
and the manner and form in which the trust estate is invested at the time of the
rendition of such statement.
SECOND: Dispositive Provisions After My Death - Upon my death while the
trust continues, the Trustee shall pay the then-remaining principal and income to
my Executor or Administrator for dispositio.ll as part of my Estate.
THIRD: Right to Revoke and Amend: I reserve the right to revoke or amend this
trust, in whole or in part, at any time and from time to time by <1n instrument in
vVliling, ddivcled tu tlw Trustee and ill tended to take effect during my lifetime;
C'xcept that the duties, powers ,u1.d liabilities of the Trustee shall not be chcm~ed
without its vvritten consent. The Trustee reserves the right, at an}' time upon thirty
(30) <.iclys advance written notice to m.e, to resign the trust and deliver the trust
E'sti1te to me, after deducting therefrom its fees and any expenses then due and
pnyable.
FOURTH: Additions to Trust: Subject to the approval of the Trustee, either I or
Clny nllwr entity may add property, real Clnd personal, tu the principal of this trust.
01-09-'~8 lb:~J fHUM-m ~ t bank
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FIFTH: Trustee's Powers: In addition to the powers granted by law, my Trustee
s11<111 have the following discretionary powers, applica[)le to principal and income,
whkh s11<lll be exercisable without leave of court <lad shall continue until
distribution is actually made:
A. To accept and retain any or all property at any time hereRfter delivered or in
any other manner hereafter acquired, ll1cluding stock or other securities of the
Trustee, or of a holding company controlling the Trustee;
B. To invest in all forms of property (including, but not by way of limitalion,
real estate, all types of stocks, bonds, options, and participations in common
trust funds and money market funds); without being confmed to investments
prescribed by statute and ,vithout being required to diversify;
C. To buy investments at a premium or discount;
D. To hold property unregistered or in the name of a nominE'e;
E. To give proxies, both ministorial and discretionary;
F. To compromise claims;
G. To join in any merger, consolidation, reorganization, voting trust plan, or
other concerted action of security holders, and to delegate discretionary duties
with respect thereto;
H. To borrow from Dauphin Deposit Bank and Trust Company or from others,
and to pledge real or personal property as security therefor; to loan cash or
securities upon such terms and conditions as trustees deem appropriate.
l. To sell <\t public or private sale for cash or credit or partly for each 10
exchange, to im.prove or to lease for any period of tune, any real or personal
property; and to give options for sales, exchanges, or leases.
J. Tl1 allucale <lny property r('ceived or charge incurred to principal or income
or partly to each, without being obliged to apply the usual rules of trust
;)(counting;
K. To distribu Ie in cash Of in kind or partly in each;
L. To retain any part or all of Iny business interests held in this Trust as long as
the Trustee considers it advisable to do so; and to conduct, alone or with others,
3ny such business in which I am engaged, with all the powers of an owner or
with respect thereto, including the power to deJeg<1te discretionary duties to
others em? to pay "?equl1te compensation tt? ony such person; to invest other
property H\ sud, busmess, and to m.corporate It or chilnge Its form.
01-09-'03 16:23 FROM-m & t bank
7176304533
T-354 P009/010 F-164
SIXTH: Compensation: The trustee shall be compensated in accordance ,'vith its
st<1ndard schedule of charges in effect from tim.e to time during the period of its
services, and this compensation shall be paid from rrincipal or income or partly
(rom each in the sole discn:>tion of the Trustee. Settlor hereby Clcknowledges
receipt of Trustee's current fee schedule, .which is subject to revision from time to
tim.e.
SEVENTH: Non~Assignment: No part of the income or principal of the property
held under this Trust shall be subject to C\ttachment, levy or seizure by any
creditor, spouse, assignee or trustee or receiver in bankruptcy prior to actual
receipt theret?f Th~ Trustee shall I?"Y over the net income an~ the principal to the
persons herem deSIgnated, as thell" ll1terests may appear, Without regard to any
attempted <1nticipation (except as specifically provided in this a~reement),
pledgIng or assignment under the Trust, and withou t regClrd tn any clzllm thereto
or attempted levy, attachment, seizure or other process against nlC.
EIGHTH: Guardianship: If at any time hereafter, a proceeding is initialerl in Cll1Y
jurisdiction to have a Guardian appointed for my estClte, it is my express in tention
that the Cuurt making such a determination, appoint Dauphin Deposit Bank and
Trust Company, or its successor, as the Guardian of my estate.
NINTH: Law Governing Trust: This trust is creatE'd and accepted in the
C,ommnnwealth of Pennsylvania and shzdl in all respects be governed by its IClws
and shall have its situs at York County, Pennsylvania.
Executed on
o/~
2..)
,1990
NOTE:
Before executing this document you may
want to consult with your Attorney to
aSsure that your wishes are being set forth
accurately and in pwper legal form
WJTN,~SS: \ ,. ~, / . / /,
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. .
. ,
TheJoregoing trust is. hereby 6.ccepted.
Executed on ?/la;,:l~ , 1990
Dauphin Deposit Bank and Trust Company
// ~~)
By _t.~_~__~__Q.:c5:::L'~__.
IImnS1 OiT"C0r:
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'j'-l5:Jtj Pl11~/~1~ f-164
COMMONVVEALTH OF PENNS1'L VANIA )
COUNTY OF ?-:.i rn}L--- )
On this, the pf.s--.tj.. day of ff~ ' 1990 , before me, f1 notary public in and for
the said Commonwealth and County, personally appeared~"I'. .tI~known
to me (or satisfactorily proven) to be fll.e person whose name is subscribed to the
foregoing Revocable Trust Agreement and acknowledged that he/she executed the
S<1111e for the purposes therein contained.
VVITNESS my hand and notarial seal.
~ff;V)~' t C~~
~lary Public ~.
My Commission Expires: .
(SEA L)
NOT ARIAl. SEAL
OONNIE L HESS. NOT ARY PUBliC
YORK, YORK COUNTY
MY COMMISSlor. ~XPIRES JAN. 10, 1'-'93
Mcmber, Penn~y1v8"ia ~tiDlion 01 Notaries
- ,r
A. B. TYPE OF LOAN:
U.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT 1.DFHA 2.DFmHA 3.DcONV UNINS. 4.DVA 5. DCONv. INS.
6. FILE NUMBER: 17. LOAN NUMBER:
SETTLEMENT STATEMENT 10941-2
8. MORTGAGE INS CASE NUMBER:
C. NOTE: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown.
Items marked "[POC)" were paid outside the closing; they are shown here for informational purposes and are not included in the totals.
1.0 3/98 (10941-2 PFD/l0941-216)
D. NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER:
John Edwin Ger~schefski and Estate of Jean D. Gladfelter
Jean Davis Gerschefski
9556 Fern Hollow Way
Montgomery Village, MD 20886
G. PROPERTY LOCATION H. SETTLEMENT AGENT: 23-2628089 I. SETTLEMENT DATE:
31 Westfields Drive CGA Law Firm
Mechanicsburg, PA 17050 November 14, 2007
Cumberland County, Pennsylvania PLACE OF SETTLEMENT
135 North George Street
York, PA 17401
J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION
100. GROSS AMOUNT DUE FROM BORROWER: 400. GROSS AMOUNT DUE TO SELLER:
101. Contract Sales Price 176,000.00 401. Contract Sales Price I 176,000.00
102. Personal Property 402. Personal Prooertv
103. Settlement CharQes to Borrower (Line 1400) 539.50 403.
104. 404.
105. 405.
Adjustments For Items Paid Bv Seller in advance Adiustments For Items Paid Bv Seller in advance
106. Cityrrown Taxes 11/14/07 to 01/01/08 16.36 406. Citvrrown Taxes 11/14/07 to 01/01/08 16.36
107. County Taxes 11/14/07 to 01/01/08 48.95 407. County Taxes 11/14/07 to 01/01/08 48.95
108. School Taxes 11/14/07 to 07/01/08 977.95 408. School Taxes 11/14/07 to 07/01/08 977.95
109. 409.
110. 410.
111. I 411.
112. 412.
120. GROSS AMOUNT DUE FROM BORROWER 177,582.76 420. GROSS AMOUNT DUE TO SELLER 177,043.26
200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER:
201. Deposit or earnest money 1,000.00 501. Excess Deposit (See Instructions)
202. Principal Amount of New Loan(s) 502. Settlement Charaes to Seller (Line 1400\ 49.22
203. ExistinQ loan(s) taken subiect to 503. Existina loanls) taken subiect to
204. 504. Payoff of first Mortgage
205. 505. Payoff of second MortQaQe
206. 506. Deposit retained bv seller 1,000.00
207. 507.
208. 508.
209. 509.
Adiustments For Items Uno aid Bv Seller Adiustments For Items Unoaid Bv Seller
210. Cityrrown Taxes to 510. Citvrrown Taxes to
211. County Taxes to 511. County Taxes to
212. School Taxes to 512. School Taxes to
213. , 513.
214. 514.
215. 515.
216. 516.
217. 517. I
218. 518.
219. 519. I
220. TOTAL PAlO BY/FOR BORROWER 1,000.00 520. TOTAL REDUCTION AMOUNT DUE SELLER I 1,049.22
300. CASH AT SETTLEMENT FROMrro BORROWER: 600. CASH AT SETTLEMENT TO/FROM SELLER:
301. Gross Amount Due From Borrower (Line 120) i 177,582.76 601. Gross Amount Due To Seller (Line 420\ 177,043.26
302. Less Amount Paid By/For Borrower (Line 220) ( 1,000.00) 602. Less Reductions Due Seller (Line 520) ( 1,049.22
303. CASH ( X FROM) ( TO) BORROWER 176,582.76 603. CASH ( X TO) ( FROM) SELLER 175,994.04
OMS NO 2502 0265 ~
The undersigned hereby acknowledge receipt of a completed copy of pages 1 &2 of this statement & any attachments referred to herein.
I HAVE CAREFULLY REVIEWED THE HUD-1 SETTLEMENT STATEMENT AND TO THE BEST OF MY KNOWLEDGE AND BELIEF, IT IS A TRUE AND
ACCURATE STATEMENT OF ALL RECEIPTS AND DISBURSEMENTS MADE ON MY ACCOUNT OR E IN THIS TRANSACTION. I FURTHER CERTIFY
THAT I HAVE REC ED OPY T UD-1 SE LEM N TEMENT. \ \
/ \;\; \j;;f:}. :z\ Seller lJ Ii P
Edw' \l
l:UHJ C
ean avis Gerschefski
TO THE BEST OF Y KNOWLEDGE, THE HUD-1 SETTLEME T STATEMENT WHICH I HAVE PREPARED IS A TRUE AND ACCURATE ACCOUNT OF THE
FUNDS WHICH ERE RECEIVED ANQ HAV BEEN OR WILL BE DISBURSED BY THE UNDERSIGNED AS PART OF THE SETTLEMENT OF THIS
TRANSACTION. - ~ ...J I)
CGA Law Firm
Settlement Agent
WARNING: IT IS A CRIME TO KNOWINGLY M KE FALSE STATEMENTS TO THE UNITED STATES ON THIS OR ANY SIMILAR FORM. PENALTIES UPON
CONVICTION CAN INCLUDE A FINE AND IMP ISONMENT. FOR DETAILS SEE: TITLE 18 U.S. CODE SECTION 1001 & SECTION 1010.
age
L. SETTLEMENT CHARGES
700. TOTAL COMMISSION Based on Price $ @ % PAID FROM PAID FROM
Division of Commission 7iine 706) as Follows: BORROWER'S SELLER'S
701. $ to FUNDS AT FUNDS AT
702. $ to SETTLEMENT SETTLEMENT
703. Commission Paid at Settlement
704. to
BOO. ITEMS PAYABLE IN CONNECTION WITH LOAN
801. Loan Origination Fee % to
802. Loan Discount % to
803. Appraisal Fee to
804. Credit Report to
805. Lender's Inspection Fee to
806, Mortoaoe Ins. App. Fee to
807. Assumption Fee to
808. Flood Certification Fee
809.
810.
811.
900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE
901. Interest From to @ $ Iday ( days %)
902. Mortoaoe Insurance Premium for months to
903. Hazard Insurance Premium for 1.0 years to
904.
905.
1000. RESERVES DEPOSITED WITH LENDER
1001. Hazard Insurance $ oer
1002. Mortgage Insurance $ per
1003. Citv/Town Taxes I $ oer
1004. County Taxes ( $ per
1005. School Taxes @ $ per
1006. @ $ oer
1007. @ $ per
1008. Aooreoate Accountino Adiustmen @ $ oer
1100. TITLE CHARGES
1101. Closino Fee to CGA Law Firm 500.00
1102. Abstract or Title Search to
1103. Title Examination to
1104. Title Insurance Binder to
1105. Document Preparation to
1106. Notarv Fees to CGA Law Firm 10.00
1107. Attorney's Fees to CGA Law Firm
(includes above item numbers: T
1108. Title Insurance to
(includes above item numbers: )
1109. Lender's Coverage $
1110. Owner's Coverage $
1111. Security Title/CGA Law Firm
1112.
1113.
1200. GOVERNMENT RECORDING AND TRANSFER CHARGES
1201. Recording Fees: Deed $ 39.50; Mortgage $ Releases $ 39.50
1202. City/County Tax/Stamos: Local Transfer Tax . Mortaaae 1,760.00 POC:B1760.00
1203. State Tax/Stamos: State Transfer Tax 1,760.00; Mortaaae POC:S1760.00
1204.
1205.
1300. ADDITIONAL SETTLEMENT CHARGES
1301. Survev to
1302. Pest Inspection to
1303. Final Sewer rental fee due to Silver Sorino Townshio Authoritv 39.22
1304.
1305.
1400. TOTAL SETTLEMENT CHARGES /Enter on Lines 103, Section J and 502, Section K) 539.50 49.22
P
By signing page 1 of this statement, tl1e signatories acknowledge receipt of a completed copy of page 2 of this two page statement
Certified to be la true copy.
S"ubstltute 1"orm 109~~-S:
SELLER'S TAX 10 SOLICITATION: THE INFORMATION IN BLOCKS E. G. H. I AND ON LINES 401,406.407 and 408 IS IMPORTANT TAX INFORMATION AND IS BEING FURNISHED TO THE INTERNAL REVENUE
SERVICE. IF YOU loRE REQUIRED TO FILE A RETURN. A NEGLIGENCE PENALTY OR OTHER SANCTION MAY BE IMPOSED ON YOU IF THIS ITEM IS REQUIRED TO BE REPORTED AND THE IRS DETERMINES
THAT IT HAS NOT ElEEN REPORTED. YOU ARE REQUIRED BY LAW TO PROVIDE THE SETTLEMENT AGENT WITH YOUR CORRECT TAXPAYER IDENTIFICATION NUMBER. IF YOU DO NOT PROVIDE THE
SETTLEMENT AGENT WITH YOUR CORRECT TAXPAYER IDENTIFICATION NUMBER. YOU MAY BE SUBJECT TO CIVIL OR CRIMINAL PENAL TIES IMPOSED BY LAW
For sates or exchan9Bs 01 certain real 8state, the person responsible for closing a real estate transaction must report the real estate proceeds to the Intemal Revenue Service and must fumish this statement to you. To
determine if you have to report the sale or exchange of your main home on your tax return, see the 2007 Schedule 0 (Form 1040) instructions. If the real estate was not your main home, report the transaction on Form
4797, Sales of Business Property. Form 6252, Installment Sale Income, and/or SChedule 0 (Form 1040), Capital Gains and Losses. You may have to recapture (pay back) all or part of a Federel mortgage subsidy If all the
following apply: e) You received a loan provided from the proceeds of a qualified mortgage bond or you received a mortgage credit certificate; b) Your original mortgage loan was provided after 1990, and; c) You sold or
disposed of your home at a gain during the first 9 years after you received the Federal mortgage subsidy. This will increase your tax. See Form 8828, Recapture of Federal Mortgage Subsidy, and Pub. 523, Selling Your
Home.
If you have already paid the real estate tax for the period that includes the sale date. subtract the amounts on Lines 406, 407 & 408 from the amount already paid to determine your deductible real estate tax But If you have
already deducted the real estate tax in a prior year, generally report this amount as income on the "Other income" line of Form 1040. For more information, see Pub. 523
For Paperwork RedClction Act Notice. see the 2007 Instructions for Forms 1099. 1098. 5498, and W-G2.
Department of the Treasury. Internal Revenue Service
UNDER PENALTIES OF PERJURY. I CERTIFY THAT THE NUMBER SHOWN BELOW ON THIS STATEMENT IS MY CORRECT TAXPAYER IDENTIFICATION NUMBER
Seller's Signature
TaxID/SSN:
Seller's Signature
TaxID/SSN:
Seller's Signature
TaxID/SSN
Seller's Signature
TaxID/SSN:
(10941-2/10941-2/8 )
DISBURSEMENTS SUMMARY I BALANCE SHEET
Borrower: John Edwin Gerschefski and Jean Davis Gerschefski
Seller: Estate of Jean D. Gladfelter
Settlement Agent: CGA Law Firm
(717)848-4900
Place of Settlement: 135 North George Street
York, PA 17401
Settlement Date: November 14, 2007
Property Location: 31 Westfields Drive
Mechanicsburg, PA 17050
Cumberland County, Pennsylvania
INCOMING FUNDS
John Edwin Gerschefski and Jean Davis Gerschefski
Total Incoming Funds
176,582.76
176,582.76
DISBURSEMENTS
Silver Spring Township Authority
Estate of Jean D. Gladfelter
CGA Law Firm
Closing Fee
Notary Fees
Recorder of Deeds
Recording Fees
Final Sewer rental fee due
Closing Proceeds
Settlement Agents Fees
500.00
10.00
39.22
175,994.04
510.00
Government Charges
39.50
39.50
Number of checks - 4
Total Disbursements
176,582.76
-~ (j~ I 'If'
Estate of Jean D. Gladfelter
1\,l.1~
(10941-2.PFD/10941-2/8)
CC(Q)~V
REV-485 EX + {J.()4} *'
COMMONWEALTJ-; OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION
DEPT 280601
HARRISBURG. PA 17128.0601
SAFE DEPOSIT BOX
INVENTORY
Please Print or Type
COUNTY CODE
~\
FILE NUMBER
MUST BE COMPLETED BY REPRESENTATIVE OF FINANCIAL INSTITUTION WHERE SAFE DEPOSIT BOX IS LOCATED AND RETURNED TO ABOVE ADDRESS
~ ('1 Uc
NAME AND ADDRESS OF PERSON REQUESTING THE OPENI'1G OF THE SAFE DEPO IT BOX
(NAME) J') l. / BtJ n I< b Je r) () I Fe r J-e. " b
t( it, f'Y) 0 r c: --5+-r eC.
(CITY)
I-Ja... n 0 ve...-r
N,l\ME. ADDRESS AND RELATIONS IP (IF NY) TO DECEDENT, OF PERSON(S) PRESENT AT THE BOX OPENING
a. (t:olAME) .., JT-If 11 ' i _' I I (RELATIONSHIP) .
J f n nl , V'- ~ .J::, E^e~h-Ix
(STREET NAME) (CITY) ,
D.
(STREET NAME) f:3
b. (NAME)
(STREET NAME)
c. (NAME)
(STREET NAME)
SOCiAl SECURITY (Rewiredl OR DEATH CERTIFICATE NUMBER (onlv if SSN is unknown)
~ - 2t.-
(ZIP CODE)
f 705'0
(STATE)
(ZIP CODE)
J 7331
(STATE)
(ZIP CODE)
(RELATIONSHIP)
(CITY)
(STATE)
(ZIP CODE)
(RELATIONSHIP)
NAME AND ADDRESS OF FINANCIAL INSTITUTION WHERE THE SAFE DEPOSIT BOX IS LOCATED
(CITY)
(STATE)
(ZIP CODE)
(NAME) fY) C T J I.
(Y DO. fJ ,.:...
NUMBER r~':f
NAME AND ADDRESS OF PERSON(S) HAVING ACCESS TO BOX
a. (NAME) I . \ r
T'!" fA. n, 1) h w.cLr e- \ -l,a (
(STREET ADDRESS) \ I "" .
3\ \J'l'-';.:\:-Y:te.l0. J.)('I\!-t
(CI ._J.~J'AJt) (ZIP CODE)
\' f-\ ll()~
E TAKING THE INVENTORY
CF-:P
WAS A WILL IN THE BOX? 0 YES ~'NO If yes, a. Date of will:
b. Name and address of personal representative. if named in the will
(NAME)
(STREET NAME)
c. Name and address of attorney. if any
(NAME)
(STREET NAME)
L--
Rrl
~r
(STATE)
1-11
(ZIP CODE)
170'5
/<9: .;:.:;:-
b. (NAME)
(STREET ADDRESS)
(CITY)
(STATE)
(ZIP CODE)
--:J
r:; ilA- {
c 1", e \ l e-l'"
~
15 (~(h n1 1--.
(CITY)
(STATE)
(ZIP CODE)
(CITY)
(STATE)
(ZIP CODE)
SAFE DEPOSIT BOX INVENTORY
INSTRUCTIONS
Page
c/..
of
Q,
(1 )
(2)
(3)
(4)
15)
(6)
(7)
(8)
ITEM
NO.
=J
The Department is authorized under federal law . 42 U.S.C. S 405(c), to use the decedent's Social Security number in
administering this state tax law. The Department uses Social Security numbers to establish a decedent's identity and
ensure proper credit for tax payments.
Cash: Report total only.
Stocks: List in detail every common or preferred certificate, warrant or other rights found in box. Stocks are to be
designated by name of company, certificate number, date of certificate, name in which stock is registered. and
number of shares and class of stock.
Obligations of U.S. Government: Number of items, date of issue, face value, names in which registered and
type of ownership, i.e., jointly held, payable on death, etc.
Bonds: Designate by name, amount, serial number, or other designation. (Bearer Bonds)
Bank and Savings and Loan Passbooks: State name of depositor, number of book, last date appeanng In book,
name of bank and branch, and balance.
Jewelry, Coins, Stamps, Manuscripts, etc: List and describe as fully as possible.
Deeds, Mortgages, Current Insurance Policies or other evidences of indebtedness: List and describe as fully
as possible.
All other contents.
ITEM DESCRIPTION
~
I~
YTI13E 30K1:3U7~?17
PRt
("
~
5""'e~\ \ e-r
B r .(ft', L ~
. P.
DATE
M
r.
7-~3-07
~ Executor(trix) 0 Administrator(trix)
o Estale Representative ....Joint owner of sate deposll box
NOTE: Attach additional 8', x 11n sheet(s) if necessary or use duplicates of this page of form.
Sovereign Bank
ESTATE OF
SOCIAL SECURITY #:
DATE OF DEATH:
Jean D Gladfelter
168-24-1011
June 4, 2007
Account #: 2731703008 Type:
In the name of: Jean D Gladfelter
Date of Death Balance:
Int.(YTD) from 1/1/2007 to
Accrued interest to date of death:
Other Info:
Checking
Open date:
1/5/1981
$3,517.38
6/3/2007
$0.00
$1.39
Account #: 1685539866 Type:
In the name of: Jean D Gladfelter
Date of Death Balance:
Int.(YTD) from 1/1/2007 to
Accrued interest to date of death:
Other Info:
CD
Open date: 2/15/2005
$5,330.52
5/31/2007
$3.23
$88.07
Account #: 2768018091 Type: CD/IRA Open date: 8/12/1988
In the name of: Jean D Gladfelter
Date of Death Balance: $3,107.77
Int.(YTD) from 1/1/2007 to 5/31/2007 $44.30
Accrued interest to date of death: $1.47
Other Info: Beneficiary: Katherine Gladfelter & Christopher Gladfelter, grandchildren
Account #: 6819024657 Type:
In the name of: Jean D Gladfelter
Date of Death Balance:
Line of Credit
Open date: 6/3/2002
$0.00
Page 1 of 1
To:
Jennifer A. Leib, CFP
Vice President
M & T Investment Group
13 Baltimore Street
Hanover, PA 17331
From:
William G. Rowe, Appraiser
Rowe's Auction Service
2505 Ritner Highway
Carlisle, PA 17015
Re:
Personal Property Appraisal
Estate of Jean D. Gladfelter
20 Westfield Drive
Mechanicsburg, PA
Date:
July 31,2007
:FOYER
Large green wine bottle
Wreath
,KITCHEN
Drop-leaf table
Set 4 plank-seat chairs
High chair
Metal shelf
Bottles
Bread maker
Microwave
Pear print
Vincent - copy print - table setting
Framed needlework
DINING ROOM
Cupboard, pine - 2 pc.
Drop-leaf table, walnut
Set dishes - Bavaria - "Margarite"
Rug, room size, Oriental style
Painting, signed Roberts
Print - Meade's headquarters
Set chairs (8) - Duncan Phyfe style
Dishes - Henriot Quimper
DEN
Recliner / ottoman
Bookshelf
Painting, signed Barteal
Television
Television cabinet
Set of books - Dickens
Gladfelter Appraisal
~(Q)~W '
I
ROWE'S AUCTION SERVICE
2505 RITNER HIGHWAY
CARLISLE, PA 17015
717 -249-1978
$30.00
$5.00
$250.00
$180.00
$85.00
$30.00
$10.00
$10.00
$10.00
$10.00
$10.00
$10,00
$1,250.00
$350.00
$85.00
$250.00
$75.00
$45.00
$800.00
$200.00
$120.00
$30.00
$30.00
$35.00
$25.00
$25.00
07/3112007
Indenture - 18th Century - framed
Stand, rectangular - small
Pair tables, Duncan Phyfe @ $75 each
Lamp stand, round
Wood plaque, eagle
Painting, stairway - modem
$75.00
$25.00
$150.00
$25.00
$5.00
$30.00
LIVING ROOM
Chippendale arm chair
Chest of drawers, 2 over 3 - bracket foot
Print - wine glass & fruit
Lamp stands - Queen Anne style - pair
Floral painting
Painting - Stanley L Gladfelter
Bottle - Bohemian glass
Vase - Bohemian glass
Flask bottle, red
Bottle vase, red
Stand, round - mahogany
Candle stand, small
Watercolor "Homestead" - signed E. Williams
Desk, slant lid - Chippendale
Display case - small - tall
Collection wines & tumblers - Bohemian glass
China - 5 pc - Staffordshire "Hunting Scene"
Light green wine bottles (2) @ $15 each
L.arge green wine bottle
Wicker Demijons (2) @ $10 each
Hedware cask (rope frame)
Wicker baskets (2) @ $5 each
Coffee table - Queen Anne style
$1,050.00
$900.00
$20.00
$85.00
$50.00
$250.00
$65.00
$55.00
$20.00
$10.00
$30.00
$20.00
$85.00
$1,200.00
$85.00
$125.00
$80.00
$30.00
$30.00
$20.00
$20.00
$10.00
$120.00
BEDROOM
Stand, cherry - 1 drawer
Computer
Computer desk
Cheval mirror
L.amp
Glass case / ceramic butterflies
Watercolor - lake scene
Sampler, large - child with lamb - floral- signed Anna Weihle?? circa 1820-1840
Bookcase
Chairs (2) - Duncan Phyfe
$120.00
$85.00
$20.00
$100.00
$30.00
$30.00
$30.00
$7,500.00
$30.00
$90.00
BEDROOM
Chest of drawers - Chippendale - fluted quarter columns, OG feet
Oval mirror
Print - "Dutch Country"
Night stand - 3 drawer
$2,500.00
$15.00
$10.00
$30.00
~. .
William G. Rowe
IJ )4/ 500
$3\1,72000 --!P 3 '~ 7;) ()
~--- \2 j
H~W
(I UL ~.f JC (ilL
2003 Toyota Camry LE - 17 ,628 miles
$1~,50Q 00
TOTAL
Gladfelter Appraisal
2
07/31/2007
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