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Home My WebLink About02-29-08 ~. ---1 15056041147 REV-1500 EX (06-05) PA Department of Revenue Bureau of Individual Taxes PO BOX.280601 Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death OFFICIAL USE ONLY Count~' Code Year Fiif; Number INHERITANCE TAX RETURN RESIDENT DECEDENT 2 1 0 7 -0714 Date of Birth 203103055 04052007 05311904 Decedent's Last Name Suffix Decedent's First Name ANNA MI E MENTZER (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 ~ 1. Onginal Return ~ 6 Decedent DIed T estaie . {Attach Copy of Will) o 2. Supplemental Return 0 3. Remainder Return (datE of death prior to 12-13-821 4a. Future Interest Compromise 0 5. Federal EstatE Tax Return Required (datE: of oeaU"'! after 12-1L-82) 7. Decedent Maintained a liVing Trust 0 8. Total Number 0: Safe Deposit Boxes IAttach Copy of Trusl) 10 Spousal Povertv CredH (date of death 0 11. Election to tax under Sec. 9113(A) Delween 12-3~i--91 and 1-1-95) (.I\ttach Sch. 0) o o 4 Limited Estate o o 9 Litigation Proceeds Received o CORRESPONDENT _ THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number BRADLEY L GRIFFIE 7172435551 Firm Name (If Applicable) GRIFFIE & ASSOCIATES REGISTER OF WILLS USE ONlY ,'" _J Co::.o:) First line of address ~;-ri 200 NORTH HANOVER STREET 1'-'-\ t~TJ f',J \.D Second line of address ::-~ DATE FII;,ED City or Post Office CARLISLE State FA ZIP Code 17013 1,.J C d t' '1 dd b g r iff i e @ g r iff i e 1 a w . COIn orrespon en s e-mal a ress: Under penalties of perjury, I declare that I have examined this return, including accompanying scheduies and statements, and to the best of my Imowiedoe and belief il is true, correct and complele. Declaration of preparer other than tne personal representative is based on allrnformatlon of which preparer has any knOWledge. ' SIGNATURE OF PERSON RESPONSIBLE FOR FILI"G RETURI'.... DATE ADDRES!! ~~ a, 6/ HcX?!'-./ Dorothy A. O'Hara -2/15) 6 g. 225 Walnut Street , Carlisle, PA 17013 DATE Bradley L Griffie 0' Sl ~ o North Hanover Street, Carlisle, PA 17013 Side 1 L 15056041147 15056041147 -1 co .. ADDITIONAL Personal Representatives MENTZER, ANNA E SS# 203-10-3055 4/5/2007 Under penalties of perjury, the undersigned declare that they have examined this return, including accompanying schedules and statements, and to the best of their knowledge and belief, it is true, correct and complete. 2 Signature Name Address City, State, Zip Date 3 Signature Name Address City, State, Zip Date 4 Signature Name Address: City, State, Zip Date 5 Signature Name Address: City, State, Zip Date 6 Signature Name Address: City, State, Zip Date ~~fJ!/d~;r~} Russell E. Mentzer 37 Kenwood AVenue Carlisle ~ PA 17013 .-.J 15056042148 REV-1500 EX Decedent's Name: MENTZER, ANNA E RECAPITULATION 1. Real Estate (Schedule A)......................................... 2. Stocks and Bonds (Schedule B)...................................................... 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C).......... 3. 4. Mortgages & Notes Receivable (Schedule D)................. 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). Decedent's Social Security Number 203103055 1. 2. 4. 5. 6. 7. 8. 9. 9. Funeral Expenses & Administrative Costs (Schedule H)..... 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)........ 11 Total Deductions (total Lines 9 & 10).. 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).. ................. 14. Net Value Subject to Tax (Line 12 minus Line 13)........ 10. 11. 12. 13. 14. o . 00 o . 00 o . 0 0 o . 00 5,37278 58, 000 0 0 63,37 2 .78 11,260.99 316 00 11,57699 51,795.79 51,795.79 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 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 51,795.79 19 Tax Due.... 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 L 15056042148 15. 16. 17. 18. 19. 15056042148 2,330.81 2 , 330 . 8 1 D .-.J REV-1500 EX Page 3 Decedent's Complete Address: DECEDENT'S NAME MENTZER, ANNA E STREET ADDRESS 262 ARCH STREET File Number 21 - 07 - -0714 CARLISLE -I STATE ZIP CITY PA 17013 Tax Payments and Credits: 1 Tax Due (Page 1 Line 19) 2. Credits/Payments A Spousal Poverty Credit 8. Prior Payments C. Discount (1) 2,330.81 Total Credits (A + 8 + C) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty 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. B Enter the total of Line 5 + 5A This is the BALANCE DUE. (3) 0.00 -~~- (4) (5) 2,330.81 (5A) (58) 2,330.81 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?.... ................. ... ............... 0 ~ 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 n 0 r", 0 LJ n ~ L-J 0 ~ II [!J ~ 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. S9116 (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 72P.SS9116 1.2) [72P.S S9116 (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 F' .S. S9116 (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. *' ~ - tl ..... lIli ,. :y~, SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY : ~~--~-------- I FILE NUMBER -.---- 121-07--0714 I COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF MENTZER, ANNA E Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 2,065.78 M&T BANK CHECKING ACCT. NO. 617334 2 PERSONAL PROPERTY AUCTION 3.307.00 -- --------..-- 5,372.78 TOTAL (Also enter on Line 5, Recapitulation) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDEN' ESTATE OF MENTZER, ANNA E SCHEDULE F JOINTLY-OWNED PROPERTY I FILE NUMBER I 21-07--0714 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME Dorothy A. O'Hara A JOINTLY OWNED PROPERTY: ITEM I LETTER i DATE NUMBER I FOR JOINT I MADE TENANT i JOINT ADDRESS 225 WALNUT STREET CARLISLE, PA 17013 RELATIONSHIP TO DECEDENT DAUGHTER Include name 3'fi~~n~\~!i~~Vt5?Forf~r?!bEa~nccount number DATE OF DEATH or similar identifying number. Attach deed for jointly-held real VALUE OF ASSET estate, % OF DECD'S INTEREST I 50% A 02/12/1965 REAL ESTATE 262 ARCH STREET CARLISLE, PA 17013 (DEED ATTACHED) (SETTLEMENT SHEET ATTACHED) 116,000.00 TOTAL (Also enter on line 6, Recapitulation) DATE OF DEATH VALUE OF DECEDENT'S INTEREST 58,000.00 58,000.00 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TM RETURN RESIDENT DECEDENT ESTATE OF MENTZER, ANNA E SCHEDULE H FUNERAL EXPENSES & ADIVIINISTRATlVE COSlS Debts of decedent must be reported on Schedule I. ITEM NUMBER. FUNERAL EXPENSES: A. 1 HOFFMAN-ROTH FUNERAL HOME, INC. DESCRIPTION i B. i ADMINISTRATIVE COSTS: 1. I Personal Representative's Commissions I I Social Security Number(s) / EIN Number of Personal Representative(s): Street Address City Year(s) Commission paid State Zip 2. Attorney's Fees GRIFFIE AND ASSOCIATES 4. Street Address City Relationship of Claimant to Decedent Probate Fees 3. Family Exemption: (If decedent's address IS not the same as claimant's, attach explanation) Claimant 7. 5. Accountant's Fees 6 Tax Return Preparer's Fees Other Administrative Costs State Zip CUMBERLAND LAW JOURNAL ESTATE ADVERTISING TOTAL (Also enter on line 9, Recapitulation) FILE NUMBER 21 - 07 - -0714 AMOUNT 8,152.10 2,000.00 207.00 75.00 11,260.99 ,*' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Schedule H Funeral Expenses & Administrative Costs continued - 0-'.__- ____~________~__ i FILE NUMBER i 21 - 07 - -07'14 i ESTATE OF MENTZER, ANNA E 2 I THE SENTINEL ESTATE ADVERTISING I i COSTS OF AUCTIONING PERSONAL PROPERTY I 158.62 3 632.50 4 BOROUGH OF CARLISLE 18.86 5 PPL ELECTRIC UTILITIES 16.91 Page 2 of Schedule H SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF MENTZER, ANNA E _________J__ __~______________________ ~,---,-.---. ! FILE NUMBER~-~-~-~---'_._~--~-_._. 121-07--0714 Include unreimbursed medical expenses. -- ITEM DESCRIPTION NUMBER AMOUNT 1 BOROUGH OF CARLISLE (WATER AND SEWER) 18.86 2 UGI (GAS SERVICE) 148_33 3 PHAR AMERICA (PRESCRIPTION) 148_81 -----------~- -- --- TOTAL (Also enter on Line 10, Recapitulation) 316.00 ~V-1513 EX+ (9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT I. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] RELATIONSHIP TO DECEDENT Do Not List Trustee(s) I FILE NUMBER I 21-07--0714 SHARE OF ESTATE AMOUNT OF ESTATE (Words) ($$$) ESTATE OF MENTZER, ANNA E NUMBER DOROTHY O'HARA DAUGHTER Fifty Percent 0.00 2 RUSSELL E. MENTZER SON Fifty Percent 0.00 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 I I ! I i I ___~______TOTAL~F PAR~II- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEEj 0.00 Attachment to Schedule "E" m!M&TBank 499 Mitchell Road, MilIsboro, DE ]9966 Mail Code DE-MB-]2 Phone (888) 502-4349 Fax (302) 934-2955 September 20, 2007 Griffie & Associates Attorneys and Counselors at Law 200 North Hanover Street Carlisle, Pennsylvania 17013 Re:Estate of: Anna E Mentzer . Social Security: 203-10-3055 Date of Death: Avril 05.2007 Dear Sir or Madam: Per your inquiry dated September 14, 2007, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type of Account Checking Account Account Number 617334 Ownership (Names of) AnnaEMentzer * Opening Date 01111/83 Closed 04/09/07 Balance on Date of Death $2,065.78 Accrued Interest $ 0.00 Total - --- ---------- -- -- --- --- ------ ------ ---- -- ------ ---- ---- - --- ---- - ----- -- - -- --- -- -- --_._-- $2,065.78 >------------------- --------------- -- -- -- ------------ -- -- __________ ____ ______ __ - _____ _n__ Please be advised, there was no safe deposit box found for the above decedent. * If upon reviewing the information above, you believe there are additional accounts not referenced, please provide us with an account number and/or the name of any possible joint account holder. For any additional information on the above accounts, including ownership and any changes, closures and/or reimbursement of funds, please call the Stonehedge Office # 717-240-4524. Sincerely, 1fJZ$~~ Nancy ckg~~ t Records Management FINAL SETTLEMENT SEllERNAMEf;'-r~ ~ ()~ frI~ ADDRESS~' b~ 0 I /f-aft,,- DATE OF SAlE~ ;ZO, ,;zOO 7 PHONE ZIP LOCATION OF SALE ;2 to} ~ J;&, ra~, - f?tt , I AUCTIONEER PHONE 19(0.00 ( ,'SE(U:RiS EXP~f!;ISe$~~v PROFESSIONAL FEES AUCTIONEER (TOTAL EXPENSES $ & 3~.50) CASH $ 45i. ;2,5 CHECKS $ ~.855. /5 / OTHER RECEIPTS $ $ $ $ $ $ $ $ $ TOTAL RECEIPTS $ ~.~O7.00 LESS TOTAL EXPENSES $ G:,3J.5o CLERK $ CASHIER OTHER EXPENSES \ , r:;:~ ~ $ 10 r 50 $ cd r. OCJ $ $ $ $ $ $ $ $ I (or we), the seller, accept this settlement and acknowledge receipt of the above specified net proceeds from the auction of my goods and property sold on the above date. I accept all responsibility for providing merchantable title to all goods, and property sold, and for delivery of title to the purchaser. (~-~-~ Auctioneer or Cashier's Signature -2.~a - 0 7 Date pd :LN !vII t'ltwt: }/C'v. ;jJ (rid"" a. (7 C J.; tP'_~ Date (~lIe;'aignature) , 7/:2e/o"7 / ( (Seller's Signature) Date "'~I i ~n'~ ,....n~v Attachment to Schedule "F" .-:~; .. . 20l~AT-Wananty Deed, Shan Form. Aet of 1909. Hen!'Y Hall, Inc.. lndia.na, Pa. ~bi~ tJgeeb, MADE THE 12th day of Februarv of our Lord one thousand nine hundred and six ty - fi ve (1965). in the year BETWEEN MINNIE E. THOMPSON, Widow, of the Borough of Carlisle, Cumberland County, Pennsylvania, hereinafter called Grantor ANNA E. MENTZER and DOROTHY A. O'HARA, as joint tenants with the right of survivorship, of Carlisle, Cumberland County, and Pennsylvania, hereinafter called Grantee S : WITNESSETH, that in consideration of Eight Thousand ($8,000.00) Dollars, do e s hereby grant in hand paid, the receipt whereof is hereby acknawledged, the said grantor and convey to the said grantee s, their heirs and assigns, ALL that certain lot of ground situated in the Third Ward of the Borough of Carlisle, Cumberland County, Pennsylvania, more particularly bounded and described as follows, to wit: Bounded on the North by property of Lee Wilson; on the East by Arch Street; on the South by lot of Lot Walker and lots of others and on the West by a public alley. Said lot having a front on said Arch Street of 22 feet, more or less, and extending in depth a dis- tance of 129 feet, more or less, to said public alley. IT BEING part of Lot No. 20 on that certain Plan of Additional Building Lots laid out by Jacob Livingston which Plan is recorded in the Office of the Recorder of Deeds in and for Cumberland County, Pennsylvania, in Miscellaneous Book 8, Page 439, as reference thereto will more fully appear. IT BEING the same premises which Meily T. Sheaffer died vested of by deed recorded in the Office of the Recorder of Deeds in Deed Book "2", Volume 8, Page 172. And the said Meily T. Sheaffer died on the 6th day of May, 1946 leaving a Last Will and Testament which Will is duly probated in the Office of the Register of Wills in Will Book 44. Page 274, wherein among other things he devised all of the above described property to his daughter, Minnie E. Sheaffer Thompson, also known as Minnie E. Thompson, Grantor herein. tf.1DK)i 21 PAGE 635 I BtJDnn 21 PACr 6~3Q AND, the said grantor ,do e s hereby covenant and agree to and with the said grantees, that she , the grantor, her heirs, executors and administrators, shall and will Wa1-rant generally and forever defend the herein above described premises, with the hereditaments and appurtenances, unto the said grantees, the i r heirs and assigns, against the said grantor ,and against every other person lawfully claiming or who shall hereafter claim the same or any part thereof. . ( . '. GL. l"JLLc $ChLDJ [: is!. C~f';b. CO. Pa. 1% R..! E.lft, T"051" r.", .. . .Of ,'~ 7L,'I/ O( ...t. Pi. y"-,,,,'v AliI, c'.' . ('l/li{'\4.') \krt'\T'~ r",...~, ,llh"' (',,\ .,~ -.l,k mrough 01 CC:L,,--Lwl...L. Cumbo eg. Pa. 1% Real. Esta~ Tra051erT. ax ~'i:' ,', .,. K $;Q oc 1', d'll'~~~Illt. _~ ....--4, UllM' i 1.;~, ::5T~1 , ,(, ri' . I . ,<' f '. , c ' ~ UllI ',Ce. '......~"',.,,, ,. CLQ ., r. ..~t5 IN WITNESS WHEREOF, said grantor ha s hereunto set her the day and year first above written. hand and seal !;ignrll, !;ralrll aw llIrliarrl'D in t1r1' l)Jrrlll'nrl' of .._....n._.....__.n.n.~.-n--__.C'n.:~:.......-..m... e ____._.____.._....._..........__nn..___.....____...._nn.e ___........__.__mnn.._n.....n_nm....mn.................n...... e .") .:/ '/ -- ..0.:tu,.~.1:.:'k"f.=..L.:.:~f1.7...2.~~...~ :2:E._....__ A " n:l .(/z-":ZM?>L..n:i...;:e<..,.-n--n-n- State of PENNSYLVANIA County of CUMBERLAND On this, the / -< rf; }ss. day of February , 1965 ,before me, the undersigned officer, personally apIJeared MINNIE E. THOMPSON, Widow, known to me (or satisfactorily proven) to be the person within instrument, and acknowledged that 5 he contained. IN WITNESS WHEREOF, I here'unto set my han~7and official se~l 7 ( / ~ . ~ . ~{2/.A:/-.--L' / ~fp;;;~' .........-..-~:~:~~~/~~i~:~~::::::2L.~.~:~~:............~~:,;-~,;, MY 'COMMISSIUN EXP!IRES jAt., 25, 19'6itlril'fj1 Offi;;er. i,::--:'~ . ~ . whose name is subscribed to the executed the same for the purposes therein r//;.~':~')~:~tl' ,~~. '.:: I ~ ..: < . '':' ('II, ' . State of 1 > ss, J County of On this, the day of , 19 , before me, the undersigned officer, pe1'snnally appeared known to me (or satisfactorily proven) to be the person within instrument, and acknowledged that he contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal, whose name subscribed to the executed the same fo:r the pU17JOSeS therein ..............................................-........................................ ~ Title of OfficC1', J do hereby certify that the precise residence and complete posiNJffice address of the within named grantee is oZ c: c2 a..e~..d~ ~~~~ iff{ ~/ o2C 196C f~(~Lzr~~._.---........- Attorney for .. ~~.::2..............__......_ o~..., 0.. .,-1 ~ >-< 1Il III >-< X +> 1-0 u.l ::: f- i=: 0 Z 0 0 "" > c:r:. '0 c:r:. ~ .,-1 ;>-t 0 .,-1 0 Cl1 > f- :s: Cl .... 1-0 ~ f- :::::--- /:I ::f -< '""0 .... III Z '--3 W Z ~ ~ " 0 ro .,-! 4-! <t:;' b f- --.; ~ tt) 0 0 c c:::: "----- c:>.. c::: ...... r-:' <( ::E u.l .... e:::: L-.; ::::> ~ 0 0 N rJ) ..<: e:::: E- x E- f- ro tlO G tf) f- Z .,-1 <: 8 ~ 1-0 '"'" < ~ -. co u.l lY. Cl1 < ..<: u.l u.l u.l ::c .... t;J H - C c:r:. z < 0 ..<: c-::- 0 Z Z .... <"';-. u.l H Z ..... t;J :2:: < -< ::: ~; ~~::~;=e:::~.~L:::(~~.~~:...__.. }ss. .~ _, ' {ii ---- h ,: RECORDED on this ..._..__;:;~iL....L. day of ........"/.!.i.Lki.-'.."a:::.?~!..~ / ~ / A. D, 19..k.~., in the Recorder's Office of said County, in Deed Book 7?J Vol, ..----...;;:2../....., Page .....1P...~~j-::..... Given under my hand qn: !Le seal,J2i!:!Le s~ce, the date above written. 17.-r>------,~. ( ~-- ...-------__-1______..................___...._______________....__, Recorder. BDDK )J}21 f,\CE 6:37 , OMS NO. 2502-0265 ,r A. . - . B. TYPE OF LOAN ... 1DFHA 2DFmHA 3. DCONV UNINS. 4. [JVA 5 DCONV INS. U.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT 6 FILE NUMBER I 7. LOAN NUMI3ER SETTLEMENT STATEMENT 1274R 1 ALDRlrH 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. 10 3/98 (12746 1 ALORtCH/127'~6 1 .\LDRJCH/32) D. NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER. F. NAME AND ADDRESS OF LENDER Mark C Aldrich and Dorothy A. O'Hara Asuncion Arnedo-Aldnch 225 Walnut Street 219 Walnut Street Carlisle, PA 17013 Carlisle, PA 17013 G. PROPERTY LOCATION H. SETTLEMENT AGENT I. SETTLEMENT DATE 262 Arch Street Martson Deardorff Williams Otto Gilroy & Faller Carlisle, PA 17013 August 31, 2007 Cumberland County, Pennsylvania PLACE OF SETTLEMENT 10 East High Street Carlisle, PA 17013 J. SUMMARY OF BORRO\JVi=R'S TR/\NSA.CTION I K. SUMMARY OF SELLER'S TRANSACTION 100 GROSS nll<=FROM 400. "Ct"'\'" '" nllF T( "'rl I <::C. 101. Contract Sales Price I 11600000 401. Contract Sales Pnce I 116,00000 i 102. Personal Property i 402. Personal Prooerty 103. Settlement Charqes to Borrower (Line 1400) I 1.849.00 403. i 104. I 404. i 105. I 405. I Arlil/<tmpnt< For Itpm< Pair! Bv .c:;pllpr In adv"'n"p Ariil/stmAnt.< For Item.< P"'iri Bv SAIIAr in arlvancA 106. County/Twp. Taxes 09/01107 to 01/01/08 I 15423 406. CountvlTwp. Taxes 09/01107 to 01/01/08 , 154.23 I 107. School Taxes 09/01/07 to 07/01/08 951.80 407. School Taxes 09/01107 to 07/01/08 ! 95180 108. Assessments to ! 408. Assessments to 109. ! 409. I 110. I 410. , 111. ! 411 112. I 412. I 120. GROSS AMOUNT DUE FROM BORROWER 118,95503 420. GROSS AMOUNT DUE TO SELLER 117.106.03 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER: 201. Deposit or earnest monev I 1,000.00 501. Excess Deposit (See InstructIOnS) I 202. PrinCipal Amount of New Loan(SI 502. Settlement Charqes to Seller (Line 1400) 1,224 72 203. Existinq loan(s) taken sublect to I 503. Existinq loan(s) taken subject to j 204. I 504. Payoff of first Mortgage to Redevelopment Authorit ! 3,50000 205. , 505. Payoff of second Mortqaqe I 206. I 506. I 207 507. (Deoosit disb. as proceeds) I 208. 508. 209. I 509. Adiustments For Items Unoald Bv Seller Adlustments For Items Unoaid BvSeller 210. County/Twp Taxes to 510. County/Twp. Taxes to 211. School Taxes to i 511 School Taxes to : 212. Assessments to 512. Assessments to 213 513. I 214. I 514. , 215. 515. 216. 516. 217 517 :18. 518 :19. 519 '20 TCTAL PA/D BY/FOR BORRCWER 100000 520. TOT4L REDUCTiON AMOUNT DUE SELLE,", 4724 72 100. CASH AT SETTLEMENT FROMITO BORROWER: 600. CASH AT SETTLEMENT TOIFROM SELLER: ,01 Cross .';mount Due From Borrower rLiIle 120) 113.955.03 1301 '3ross Amount Due To Seller, Line 420) 11710603 ;02. Less .';mount Paid By/For Borrower (Line 220) ( 100000) i302 Less Reductions Due Seller ,.Llne 520) '. 472472, 'C3 CASH ( X Ff~OM) , TO ! BORROWER ......, 117955.03 603. CASH r X TO) r .c=,",CM I SELLER 112381 31 ~.'"' Tile underSigned IlerebY"aC~!iOZ.Ie<'J,.ge r ceipt 'Y(l' co Borrower . /."14/-, , " i/ v~ I . ,? Mark C AttJr2 ~--- ,""sunclon fyr,ledo-.';Idrlch !/-/ v ~copy of pages 1.3.2 of thiS statement ,3. allY attachments referred to Ilerelll Seller It' !- L r~/ C{ (~. ,e.; ~~ Dorothy A. O'I-Iarad f-'UI::'-i r3-B6} RESF;" rl84:JC:: 2 - ~ - . Paae 2 L. SETTLEMENT CHARGES ., 700. TOTAL COMMISSION Based on Price q; -(ci) 0.0000 % PAID FROM PAID FROM Division of Commission (line 700) as Follows: BORROWER'S SELLER'S 701 $ to FUNDS AT FUNDS AT 702. $ to SETTLEMENT SETTLEMENT 703 Commission Paid at Settlement 704 to 800. ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Oriqination Fee 0.0000 % to 802. Loan Discount % to 803. Appraisal Fee to 804. Credit Report to 805. Lender's Inspection Fee to 806. Mortqaqe Ins. App. Fee to 807. Assumption Fee to 808 809. 810 811. 1900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest From to @ $ /day ( days %) 902. MortgaQe Insurance Premium for months to 903. Hazard Insurance Premium for 1.0 years to 904. 905. 1000. RESERVES DEPOSITED WITH LENDER 1001. Hazard Insurance $ per 1002. Mortqaqe Insurance $ per 1003. County/Twp. Taxes $ per 1004. School Taxes $ per 1005. Assessments @ $ per 1006. -(Ci) $ per 1007. @ $ per 1008. ca>- $ per 1100. TITLE CHARGES 1101. Settlement or Closinq Fee to 1102. Abstract or Title Search to 1103 Title Examination to 1104. Title Insurance Binder to 1105. Document Preoaration to 1106. Notarv Fees to 1107 Attorney's Fees to (includes above item numbers: ) 1108 Title Insurance to Lawvers Title Insurance Comoanv (includes above item numbers: ) 1109. Lender's Coverage $ 1110. Owner's Coverage $ 1111 1112 Attorney's Certificate to Martson Deardorff Williams Otto Gilroy & Faller 650.00 1113. 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recording Fees: Deed $ 39.00, Mortgage $ Releases $ 39.00 1202. City/County Tax/Stamos: Deed . Mortqaqe 1 % Transfer Tax 1,16000 1203. State Tax/Stamps: Revenue Stamps 1,16000; Mortqaqe 1 % Transfer Tax 1,160.00 1204 Mortqaqe Satisfaction to Cumberland County Recorder of Deeds Recordinq Fee 27.00 1205. 1300, ADDITIONAL SETTLEMENT CHARGES 1301. Survey to 1302. Pest Inspection to 1303. Final Sewer & \!Vater Bill to Borouqh of Carlisle Acct 04687 37.72 1304 1305 1400. TOTAL SETTLEMENT CHARGES (Enter on Lines 103, Section J and 502, Section K) 1,84900 1.22472 By signing page 1 of this statement, the signatories acknuwledge receipt of a completed copy of page 2 of thiS two page statement Certified to be a true copy. Marts Deardorff Williams Otto Gilroy & Faller Settlement Agent ('127461 ALDRICH / 12746 1 ALDRICH / 32 ) - J . " LAST WILL AND TESTAMENT QE ANNA E. MENTZER I, ANNA E. MENTZER, of Carlisle, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make and declare this as my Last Will and Testament and revoke all wills and codicils heretofore made by me. FIRST I direct the payment of my debts and expenses of my last illness and funeral from my estate as soon after my death as conveniently may be done. SECOND I give, devise and bequeath all of my personal property, exclusive of cash, stocks, bonds, choses in action and all other :\ " evidence of intangible personal property, wherever located, '- <:' equally and jointly to my beloved children, DOROTHY A. O'HARA, of ~ Carlisle, Pennsylvania, and RUSSELL E. MENTZER, of Carlisle, "-~, Pennsylvania. My said children are to make such selection among themselves as they desire. Any items not so selected or any items which cannot be agreed upon for distribution shall be sold at public or private sale and the proceeds thereof added to my residuary estate. THIRD ---- --......04-_ In the event that DOROTHY A. O'HARA, shall predecease me I direct that my real estate be sold and the proceeds thereof added to my . l... FOURTH RUSSELL E. MENTZER, per stirpes. my estate in equal shares to my children DOROTHY A. O'HARA and I devise and bequeath all the rest, residue and remainder of FIFTH succession taxes out of that portion of my estate which would I direct my co-executors to pay any inheritance, transfer or MENTZER as CO-Executors of this my Last Will and Testament. I of administration. I appoint DOROTHY A. O'HARA and RUSSELL E. otherwise pass under Paragraph Fourth, Supra hereof as an expense hereby relieve my CO-Executors from the necessity of posting security in connection with their duties as such in any juriSdiction in which they may be called upon to act insofar as I am able by law to do so. this, my Last Will and Testament, consisting of tWO(2) IN WITNESS WHEREOF, I have hereunto set my hand and seal to typewritten pages, the first page (1) of which bears my signature in the margin for the purpose of identification, this ,27;;;< ~ /- I-~b /~ I' c<~_. L-/ / ./ , 1996. day of / [/70_ ..0'.. (L Z -/ ;'V-) '--7'1 L---L- ~ Anna E. Mentzer (SEAL) . signed, sealed, published and declared by the above-named Testatrix, ANNA E. 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