HomeMy WebLinkAbout03-25-08
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15056051047
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 Number Date of Death
OFFICIAL USE ONLY
County Code Year
File Number
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Date of Birth
I
7
Decedent's Last Name
Suffix
Decedent's First Name
MI
PL a
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
MI
IJ I-A-
Spouse's Social
Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
_ 1. Original Return
C=>
4. Limited Estate
C=>
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
C=>
2. Supplemental Return
C=>
C=>
C=> 4a. Future Interest Compromise (date of
death after 12-12-82)
C=> 7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
C=> 10. Spousal Poverty Credit (date of death C=> 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
6. Decedent Died Testate
(Attach Copy of Will)
9. Litigation Proceeds Received
-'-
8. Total Number of Safe Deposit Boxes
-
CHA-I<Lc.s
E
SH I F L PiS
I I (
7/7< 7'* (;, () ;"'oq
.- ,'""\
Firm Name (If Applicable)
REGISTER OF WILLS USE ONLY
IJ/ /r
r~ "
First line of address
,
(JLotlS€R
I< P.
Second line of address
City or Post Office
State
ZIP Code
DATE FILED
/Yl E (! It II- IV I C S fJ tI 116
pH
17 0 S. S 9 7 3 S'
Correspondent's e-mail address:CeSAle.td 53 @ t!D /fie I J to lie t
DATE
17090
DATE . /
.5 'z/jor
Side 1
L
15056051047
15056051047
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15056052048
REV-1500 EX
Decedent's Name F LE t4 ~ L E; III R 11/" II 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) . 5
6. Jointly Owned Property (Schedule F) c::> Separate Billing Requested 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) c::> Separate Billing Requested. . 7.
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) .. .. .. .. .. .. .. 12.
13. Charitable and Governmental Bequests/See 9113 Trusts for which
an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . 13.
14. Net Value Subject to Tax (Line 12 minus Line 13)
. 14.
TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2)X.0~ .,0 0 15.
16. Amount of Line 14 taxable
at lineal rate X .0 ~
17. Amount of Line 14 taxable
at sibling rate X .12
18. Amount of Line 14 taxable
at collateral rate X .15
I to 0 5" :z.... 1 2.
16.
.'" 0
17.
o 0
18.
19. TAX DUE. . . . . . . . .
. . .. .... 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
L
15056052048
Decedent's Social Security Number
/ 90 OlfD '14.Q 2
1.
32-0 &0
2.
4.
8.
I '1 e,,3 7 -'. {;, '1
I 7 fD~: to;;. I . 8
~o 1~7 ..3'9
.3. 7 "~; 1.3~. 5" 7
/b()5b;" :z
. " <EO 0
/'0 ~"~~J.;{
9
;{
0.0
OiO
7 "Z
c::>
15056052048
--.J
REV:1500 EX Page 3
Decedent's Complete Address:
DECEDENT'S NAME
File Number
J./- b 1- 783
STREET ADDRESS
NOt( /itA-Ai
fJ 5? S
E: FLEAt;LE
CA-lulsLE PIKE
CITY
thEClll1-NICS ~ I{JeG-
, STATE PA-
ZIP
/70$0
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
~
7. ;l. 2S. 30
o
o
o
Total Credits ( A + B + C ) (2)
o
3. Interest/Penalty if applicable
D Interest
E. Penalty
()
o
(3) 0
(4) ()
~
(5) 7; ~~S:30
(5A) t)
(5B) f)
Total Interest/Penalty ( D + E )
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in oval 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.
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred;.......................................................................................... 0 I8J
~: ~:::;~ :h~e~;~:i~~:~s:~~~::;:~. .~.~~.I~. ~~~. t~~. ~r~~~~.y. t~a.n.~~~.~r~d.. ~r. it~ .In~.o.~.e.;.:::::::::::::::::::::::::::::::::::::::::::: B !
d. receive the promise for life of either payments, benefits or care? ..................................................................... 0 181'
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. 0 ~
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. 0 l8J
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.
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. S9116 (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. S9116 (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
72 P.S. S9116(1.2) [72 P.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 PS. 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.
RfY-1502EX + (1-97,,)
SCHEDULE A
REAL ESTATE
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
F LGI!-GLE; /tI~R/I1I1-N /:~
2/-07-703
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
survivorshio must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
;<.
/HI iflaf ea'ftl//7 jJarc.~/ pi tOle! /1J1/l/Y)f/uY ..I;y /? cTa;e/bn7
!;pt/se 4f "~1f &r/'sle ~'J(e / /J!ee/;41JIc SbUIJ (SliFer
all'/11 $/(/1f510) I {!umbtr/all/ &tl1t5 j hlJl1tl. / t7$ /M;t:
jJ tl rJ; 'ut fa t r des en bed 1/1 Ina/ e e /' hi 111 deed fl-t)/U
#~/'1#1I1l k. mtl'1le ~u/ /jft?r/~l/l 5. F/etljk I tA.X / i
/Yc/'mR/1 ~. F/c~/e da;eq' lJer!..40/ 19'96 ~re~;decl
111 Ke tJfha:. 01 4 l?eetJrt!er ~,c .2>eea1- /Pr t!tt)JfJeJ'/~cI
~t?nf I/; !keel gCJal:: /5"1/ tf/'o/~ ;2/5 &4/'/jj #L>C
fJarcel/fb. 3{-/8- /33;2.- C)/:l,
cSa/cI jJrt/J1/ses /1/e/e solil -$ /3r~.I1?h/1 ;f8ae / J/nyle. 1J161J7/1
&11 ;!Ip;/' /~ zoo 7 J;r jJllrcAQ5l!'- j/rlc.e of 1/~OI ?Jot!. &>P
(Jet eel! cf atftfstl/c/ deevl ane! ::e#le/J1elff 5,1eet
alftickd)
/1/1 &.sc- ftup et:rllll/J /arce!s tJ/ itnttl Intfli'tJf/ed hi a.
e~"/11 / I/! ft/e.st graJtdt ?;pI/J,5;!;~ / A,lIer (};unf / It/Ut?lJ
itS /)1~re jlt1l'f/c.u/~riy descniJec/ ~ IIud Cerf,u'/1 deul
-ft-pm ~//I1ttl1 E: FletlJk ~ /J14'/'/aJ1 s, ~/e/c'j/~ t-(x-/
ti #tJrlJ1lll1 E F/e~7/e/ 4a1i~ Oee,. ~al 1716 aUP!
r'eb/'tlecl I'h 1ft tJfh?e t;f Ik ~rR/er ~f Deeds ~r
hl/er 6tt)t~ lit OeM' gCJ?'K c260 flare 81L/-, l3e~r/, ~
Parcel A/os. 300-1701-1)03 MU/ 300 -1701-00'1.
;J~lfer f!cun1y ~;;e/f1&1i PaIa <I
LtvnJ fl) 9~O (3ldj'l-//)/ Ifg-O 70Ial 1'1; Lice x ~, 8' -
(see SUf{Jothlz.j CkctrlJJelJ'IS an.ched)
VALUE AT DATE
OF DEATH
-/
/ () 0/ tDt.?t? ~ 0
;e-
1/0/ 3:2tJ. t) ()
TOT AL (Also enter on line 1, Recapitulation) $ / LfOI 320. Ii ()
(If more space is needed, insert additional sheets of the same size)
,.,
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30'/3 g
7/
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Tax Parcel No.38-18-1332-012
THIS DEED,
MADE THE
;!{.)F- day of Uef:'/1'1 b?'.J/ in the year one
thousand nine hundred ninety-six (1996)
BETWEEN
NORMAN E. FLEAGLE AND MIRIAM S. FLEAGLE, husband
and wife, of Mechanicsburg, Cumberland County,
Pennsylvania,
Grantors,
and
NORMAN E. FLEAGLE, of Mechanicsburg, Cumberland
County, Pennsylvania,
Grantee:
~ESS~ that in consideration of One and NO/lOa Dollars
($1.00), in hand paid, the receipt whereof is hereby
acknowledged, the said Grantors do hereby grant and convey to the
said Grantee, his heirs and assigns:
ALL THAT CERTAIN piece or parcel of land situate in silver Spring
Township, Cumberland County, pennsylvania, bounded and described
as follows, to wit:
BEGINNING bounded on the South by State Highway Route 11,
formerly known as the Harrisburg and Chambersburg Turnpike and
now know as the Carlisle Pike; on the West by Lot formerly of
George M. Messinger and now or formerly of Clyde Hessinger; on
the North by Rock Alley; and on the East by property formerly of
the Lamb Heirs, now or formerly of John Miller; having a frontage
along said Highway now known as the Carlisle Pike of fifty-two
(52) feet, more or less, and a depth from said Highway to said
Rock Alley of one hundred eighty-six (186) feet, the place of
BEGINNING.
BEING Lot No. 14 on the general Plan of said town as laid out by
Alexander Wells.
~ . / I
\~f- \ 5
Vc~y (~f\, l
HAVING ERECTED THEREON a frame dwelling house being known and
numbered as 6598 Carlisle Pike, Mechanicsburg, Pennsylvania.
BEING the same premises which Norman E. Fleagle and Miriam S.
Fleagle, husband and wife, by deed dated December 16, 1994 and
recorded December 20, 1994 in the Cumberland County Recorder of
Deeds Office in Deed Book 116, Page 520, granted and conveyed
unto Norman E. Fleagle and Miriam S. Fleagle, husband and wife,
the Grantors herein.
THIS IS A CONVEYANCE FROM HUSBAND AND WIFE TO HUSBAND AND,
THERFORE, IS EXEMPT FROM THE PAYMENT OF REALTY TRANSFER TAXES.
~the said Grantors hereby covenant and agree that they will
warrant specially the property hereby conveyed.
nv~ ~~O~ said Grantors have hereunto set their hands
and seals the day and year first above written.
Signed. Sealed and DeliY8nld
in the Preaence of
4lwJ (7 6t~~
~<</c!'~ (SEAL)
NORMAN E. FLEAGLE
~C~
i j / I.
/ [Ltc' (SEAL)
MIRIAM S.
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BOOK 151 PAGE 216
COMMONWEALTH OF PENNSYLVANIA
SSe
COUNTY OF CUMBERLAND
On this, the u.?O't1t day of U...(.t?-;l7'-{;.j'L , 1996, before me,
the undersigned officer, personally appeared NORMAN E. FLEAGLE,
known to me (or satisfactorily proven) to be the person whose
name is subscribed to the within instrument, and acknowledged
that he executed the same for the purposes therein contained.
-.. '~.,
.Tj,~;;;/"';P';'
IN WITNESS WHEREOF, I hereunto set my hand and offic~a.l""~~'!"'II;f',"
':0"\ . \ t~ l::. tJ. '1";', .~~
seal. 1';r~,"'. <;~:..-::.'.::~.,.~'(.-p '''-!>" " '';!.
~ 'J -<..... /' . .f.."H"~l;.1.~ "~" ..-:..:;. ~;.. ";",./)}-<,1:
I ,/ -)',1' /i/Jr;:? .~.. ,z':fS'EAL1,;::. " '-;:0 '; ..t,.
ary Public ,~ . ~ ~.e;.'f'~':'.,pv..rq0""] ';'"" ~ '
M Commission EXEires: .>. .e.d."1\ "4l-:~~:'~'
NOTARIA.L SE'AL II}';" .?\, ~iJ~ ':':'1 ,,Ii"';!
. ".. ',/~"1~'''''t.>.o ., ',f.:
CATHERINE J, SAlinA, NorMY PUBLIC ' ..~;:';~'~~~:f~'t?~....::<i:';"
I SHIREMMJSTOWN eOHG CllMmHLMlD DO. ~A, ;'>~~i~;Y,!,,;,..:>"\'
~~~ EXPIBES SE~1:9,1 999 .e.
COMMONWEALTH OF PENNSYLVANIA
SSe
COUNTY OF CUMBERLAND
On this, the J6d1 day of t!J:.~n'll.i.t'~ , 1996, before me,
the undersigned officer, personally appeared MIRIAM S. FLEAGLE,
known to me (or satisfactorily proven) to be the person whose
name is subscribed to the within instrument, and acknowledged
that she executed the same for the purposes therein contained~\''''';'Jt'''':Z:~.'
~\(~'1l~: ~4 E ~~~"1"~
IN WITNESS WHEREOF, I hereunto set my hand and offici",t'il \,,\:.....:J.t(/';~
1 ,,' )" .f.,- 1'01''',:.... -1'l"'~'"
sea . .~ /~f j,~,v('''cr " ..,.., ~ ~,
_.::- _. '\~, ._.". " <'l ",/ ~ ~
/I .~. ~ ~ ; ~;~..,.~';::, 9. 1=3 "5,
,{ ....7d~ 0C"'__ ~ ;:;;s i(sg~U' ," ~ 2.
,~.,.1,~~~/:. . ,~tj :~.
~':::. ......"1, o. .- ~'.~ r:'"
1';. V_',.J....,!,1(\'1'i\\~.'t ',~'" $ ..
{~t.~., ,:'I;.,:'~":>~~~.'~;;;?~ ,0\:~:f '.
. " '1"1,' ,:; i~ V '" U ~;.l \...~';~:
_"" ."'1 ,'" \ ,,>,''1; :"j.~
,~-:J" ,.It"IIlClI\"~ '
'" ";;~...~
(,4uz; :'," ~LeO.
Notary Publid/
My Coll\ll\is.sion :
r- NOT ARlf.\L SU.L
\' CAllIERlNf: J. Bf.\RRA, i~()T ARY i'UBLI.c p I'
S\1\REMf\t'JSTOWN Bl:~O; CU~~E!~,lAND c~~ I A'l
\ MV POMrAISSIOI', IYIRES :)E.l g,19...;:I J
l<~~,,""'''''~'''JI',~~,...-...."~.._~.n -~.!,~' ~"" .....'e.".....,"."......-........-...."".............
I do hereby certify that the precise residence and comp~~te
post office address of the within named grantee is ,,'1 (cr(,slc 11/r.e-.
.4t."".~,t4-" fJ,a 170.,f c;1 /I / )
Ou..-lc-t to ,1996 ,4d.w,J (I. ~
Attorney/Agent for
ouu~ 1.01 f'AGE 217
-- -
fOrm HUU-l \~/tlb) rer HandDOOK 4~OO.2
r I CIo'IUU:' CUllIUII::> c:l1 t::l UU~Ult:llC
A.' Settlement Statement
U.S. Department of Housing and Urban Development
S. Type of Loan OMS Approval No. 2502-0265 (exoires 11/30/2009)
1. DFHA 2. DFmHA 3- DConv. Unins. I 6. File Number I 7. Loan Number I 8. Mortgage Insurance Case Number
4. OVA 5. DConv. Ins. 07165 180834268
C. Note: I nlS form IS fumlsnea 0 give you a statement of actua settlement costs. AmO~n!S pala.lo ana oy me sememem agent are snown. I TitleExpress Settlement System
Items marKed "(p.o. c.)" were paid outside the closing; they are shown here for Information purposes and are not Included In the totals.
WARNING: It is a crime to Knowingly maKe false statements to the United States on this or any other Similar form. Penalties upon Printed 11/15/2007 at 09:39 KS
conviction can include a fine and imorisonment. For details see: Title 18 U. S. Code Section 1001 and Section 1010.
D. NAME OF BORROWER: Brandon Rowe
ADDRESS: P.O. Box 285. Landisbura. Pa 17040
E. NAME OF SELLER: Estate of Norman E. Fleagle
ADDRESS: C/O P.O. Box 447 Shermans Dale, Pa 17090
F. NAME OF LENDER: Countrywide Bank, F,S,B,
ADDRESS: 2512 Eastern Blvd York Pa 17402
G. PROPERTY ADDRESS: 6598 Carlisle Pike, Mechanicsburg, PA 170se
Silver Sorina Townshio
H. SETTLEMENT AGENT: 1st Advantage Settlement Services Inc., Telephone: 717-591-7755 Fax: 717-591-7756
PLACE OF SETTLEMENT: 6375 Mercurv Drive Suite 102 MechanicsburQ, PA 17050
I. SETTLEMENT DATE: 11/15/2007
J. SUMMARY OF BORROWER'S TRANSACTION: K. SUMMARY OF SELLER'S TRANSACTION:
100. GROSS AMOUNT DUE FROM BORROWER 400. GROSS AMOUNT DUE TO SELLER
101. Contract sales price 100 000.00 401. Contract sales nrice 100000.00
102. Personal Prooerty 402. Personal Prooerty
103- Settlement charaes to borrower lIine 140m 3 316.46 403-
104. 404.
105. 405.
Adiustments for items paid bv seller in advance Adiustments for items paid bv seller in advance
106. City/town taxes 406. City/town taxes
107. County taxes 11/15/07 to 12/31/07 29.31 407. County taxes 11/15/07 to 12/31107 29.31
108. School taxes 11/15107 to 06/30/08 446.29 408. School taxes 11/15107 to 06/30/08 446.29
109. 409.
110. 410.
111. 411.
112. 412.
120. GROSS AMOUNT DUE FROM BORROWER 103.792.06 420. GROSS AMOUNT DUE TO SELLER 100.475.60
200. AMOUNTS PAID BY OR ON BEHALF OF BORROWER 500. REDUCTIONS IN AMOUNT DUE TO SELLER
201. Deoosit or earnest money 501. Excess Denosit Isee instructions'
202. Princioal amount of new .loans 80,000.00 502. Settlement charaes to seller lline 140m 73.66
203. Existino loanls' taken subiect to 503. Existina loanls' taken subiect to
204. 504. Payoff of First Mortnane Loan 17.211.55
M & T Bank
205. 505.
206. 506.
207. 507. Overniaht Deliverv-Payoff 25.00
1 st AdvantaQe Settlement Servi
208. 508.
209. 509.
Adiustments for items unoaid bv seller Adiustments for items unoaid bv seller
210. City/town taxes 510. City/town taxes
211. County taxes 511. County taxes
212. School taxes 512. School taxes
213- 513-
214. 514.
215. Gift of Enuity 23.792.06 515. Gift of Eauitv 23.792.06
216. 516.
217. 517.
218. 518.
219. 519.
220. TOTAL PAID BY/FOR BORROWER 103.792.06 520. TOTAL REDUCTION AMOUNT DUE SELLER 41.102.27
300. CASH AT SETTLEMENT FROM OR TO BORROWER 600. CASH AT SETTLEMENT TO OR FROM SELLER
301. Gross amount due from borrower {line 12m 103.792.06 601. Gross amount due to seller lIine 420' 100.475.60
302. Less amounts paid by/for borrower IIine 22m 103.792.06 602. Less reduction amount due seller lIine 5201 41102.27
303. CASH FROM BORROWER 0.00 603. CASH TO SELLER 59 373.33
t'revlous eOltlons are oosolete
U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT
ENT STATEMENT
File Number: 07165
'fonn HUD-' (3/86) ref Handbook 4305.2
PAGE 2
SET:rLEM TitleExoress Settlement System Printed 11/ 5 7 at
L. SETTLEMENT CHARGES PAID FROM PAID FROM
700. TOTAL SALES/BROKER'S COMMISSION based on price $100.000.00 = BORROWER'S SELLER'S
Division of commission (line 7001 as follows: FUNDS AT FUNDS AT
701. $ to Re/Max 1 st Advantage SETTLEMENT SETTLEMENT
702. $ to
703. Commission oaid at Settlement
704. Transaction Fee to Re/Max 1 st Advantage
800. ITEMS PAYABLE IN CONNECTION WITH LOAN
801. Loan Oriaination Fee %
802. Loan Discount %
803. Aooraisal Fee to Landsafe Aooraisal Services. Inc. LR 340.00
804. Credit Reoort to Landsafe Credit Inc. LR 35.00
805. Lender Fee to Countrvwide Bank. F.S B LR 100.00
806. Tax Service Fee to Countrywide Tax Service LR 100.00
807. Flood Check Fee to Landsafe Flood Determination, Inc. LR 26.00
808. Aoolication Fee to CountrYWide Bank. F,S,B. LR 399.00
809.
810.
811.
900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE
901. Interest From 11/15/2007 to 12101/2007 fa)$ 14.5200 /dav 16 Davs LR 232.32
902. Mortaaae Insurance Premium for to
903. Hazard Insurance Premium for to Erie Insurance 480.00
904.
905.
1000. RESERVES DEPOSITED WITH LENDER FOR
1001. Hazard Insurance 3 mo. fa} $ 40.00 /mo LR 120.00
1002. Mortaaae Insurance mo.@$ /mo
1003. City Prooertv Tax mo. fa} $ /mo
1004. County Prooertv Tax 11 mo. fa} $ 18.60/mo LR 204.60
1005. School taxes 7 mo. @ $ 58.26 /mo LR 407.82
1009. Aaareaate Analvsis Adiustment LR -382.03 0.00
1100. TITLE CHARGES
1101. Settlement or c1osino fee
1102. Abstract or title search
1103. Title examination
1104. Title insurance binder
1105. Document Preoaration
1106. Notarv Fees to Kristen D. Shive 35.00 10.00
1107. Attornev's fees
(includes above items No: )
1108. Title Insurance to 1 st Advantage Settlement Services Inc. 858.75
(includes above items No: 1101-1104 )
1109. Lender's Policv-106225813 80.000.00 -
1110. Owner's Policv-105398149 100.000.00 - 858.75
1111. End 100 End 300 End 900 to 1 st Advantage Settlement Services Inc. 150.00
1112.
1113. ClosinaSvcLtr to 1st Advantaae Settlement Services Inc. 35.00
1200. GOVERNMENT RECORDING AND TRANSFER CHARGES
1201. Recordina Fees Deed $ 38.50 . Mortaaae $ 66.50 . Release $ 105.00
1202. CitY/County tax/stamns Deed $ . Mortaaae $
1203. State Tax/stamos Deed $ . Mortaaae $
1204.
1205.
1300. ADDITIONAL SETTLEMENT CHARGES
1301. Survey
1302. Pest Insoection
1303. Wire In Fee to 1st Advantaae Settlement Services Inc. 10.00
1304. Tax Cert Fee to 1 st Advantage Settlement Services Inc. 5.00
1305. Overniaht Deliverv Fee-Pka to 1st Advantaae Settlement Services Inc. 25.00
1306. Email Pkq/Doc Cony Fee to 1 st Advantage Settlement Services Inc. 35.00
1307. Sewer 10/1-11/15 to Silver Soring TownshiD Authoritv 58.66
1400. TOTAL SETTLEMENT CHARGES (enter on lines 103 Section J and 502 Section K) 3316.46 73.66
1 /200 09 39 KS
HUD CERTIFICATION OF BUYER AND SELLER
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
I have received a copy of the Hub-1 Settlement Statement.
:lJ:1
S et!1:n~ C(j- K ({t{ljt .' J/Ii~ C .
WARNING: IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE
UNITED STATES ON THIS OR ANY SIMILAR FORM. PENALTIES UPON CONVICTION
CAN INCLUDE A FINE ANO IMPRISONMENT. FOR DETAILS SEE TITLE 18:
U.S. CODE SECTION 1001 AND SECTION 1010.
The HUD-1 Settlement Statement which I have prepared is a true and accurate account of this
transaction. I have caused or will cause the funds to be disbursed in accordance with this statement.
SETTLEMENT AGENT:
~
DATE: 1/(I-r;/O'1-
{(/u:-,J
e
. VOL 261 rACE 814
THIS DEED,
Tax Parcel No. 300-01-003
300-01-004
;;(';.;>r'Clp"I.:" 1'\ : J J DEe 3 1 199/L
Li.-2J~\':'~~tJi!!A"~,t.; . ('T _
}j e /~/ . RECOltnKt
MADE THE
;2o.;A- day of nee /VIj;e..,.__ in the year one thousand
nine hundred ninety-six (1996)
BETWEEN
NORMAN E. FLEAGLE AND MIRIAM S. FLEAGLE, husband
and wife, of Mechanicsburg, Cumberland County,
Pennsylvania,
Grantors,
and
NORMAN E. FLEAGLE, of Mechanicsburg, Cumberland
County, Pennsylvania,
Grantee:
~~SET1t that in consideration of One and NO/100 Dollars
($1.00), in hand paid, the receipt whereof is hereby
acknowledged, the said Grantors do hereby grant and convey to the
said Grantee, his heirs and assigns:
ALL THAT CERTAIN piece or parcel of land situate in West Branch
Township, Potter County, Pennsylvania, bounded and described as
follows, to wit:
Parcel No. 1
BEGINNING at an iron pipe corner, the southwest corner of lands
of the Grantees (prior); thence by magnetic bearings of April
1967, South 79 degrees 25 minutes East along south line of said
Grantees (prior) land one hundred fifty (150) feet to a point in
the center line of Pennsylvania Route 144, the southeast corner
of the grantees (prior) lands; thence South 13 degrees 45 minutes
East along said Pennsylvania Route 144 center line twenty-five
(25) feet to a point, the southeast corner of the herein
described lot; thence North 79 degrees 25 minutes west one
hundred fifty (150) feet to an iron pipe corner; thence North 13
degrees 45 minutes West twenty-five (25) feet to, the place of
BEGINNING.
. VOL 261 !'IM 815
CONTAINING about 1/10 acre, being the same more or less but
subject to the right-of-way claim of Pennsylvania Route 144.
EXCEPTING AND RESERVING all of the oil, gas and minerals in, on
or under that parcel of land described above.
Parcel No. 2
BEGINNING at the southeast corner of a lot conveyed to Clarence
L. Wynn by deed recorded in Deed Book 163, Page 193 and in West
bounds of highway leading from Galeton to Germania (Route 144);
thence along South line of said Wynn lot West one hundred fifty
(150) feet to the southwest corner of said Wynn lot; thence South
6 degrees 45 minutes East parallel to said highway one hundred
(100) feet to a post corner; thence East one hundred fifty (150)
feet to a corner in West bounds of highway; thence North 6
degrees 45 minutes West along West bounds of highway one hundred
(100) feet to, place of BEGINNING.
CONTAINING 15,000 square feet more or less.
EXCEPTING AND RESERVING all the oil, gas and minerals in, on or
under said property together with the rights necessary and
covenient to recover the same.
GRANTING also to the grantee the right to take water from a
spring located north and east of the above described land.
BEING the same premises which. Peter Paul, Jr., II, also known as
Peter Paul III, by deed dated October 27, 1987 and recorded
October 30, 1987 in the Potter County Recorder of Deeds Office in
Deed Book 225, Page 791, granted and conveyed unto Norman E.
Fleagle and Miriam S. Fleagle, the Grantors herein.
THIS IS A CONVEYANCE FROM HUSBAND AND WIFE TO HUSBAND AND,
THEREFORE, IS EXEMPT FROM THE PAYMENT OF REALTY TRANSFER TAXES.
AUVDthe said Grantors hereby covenant and agree that they will
warrant generally the property hereby conveyed.
,VOL 261 PALE 816
IlV~~S ~~O~ said Grantors have hereunto set their hands
and seals the day and year first above written.
Signed, Sealed and Delivered
in the Presence of
~(?~
4~(]~
~c0d~ (SEAL)
NORMAN E. FLEAGLE
~, ct! :?'
jJ)J(/U a(;c_ 7k'/
MIRIAM S. FLEAGLE>' ,
( SEAL)
COMMONWEALTH OF PENNSYLVANIA
, J 1 . /7
6j?7ct[u..,j:a,1"~
SS.
COUNTY OF
On this, the c20ttt day of O-:-e?77'L?",'L , 1996, before me,
the undersigned officer, personally appeared NORMAN E. FLEAGLE,
known to me (or satisfactorily proven) to be the person whose
name is subscribed to the within instrument, and acknowledged
that he executed the same for the purposes therein containel;H\:;lj,:"II~;i;'""
;, ,";o,::'~~:j,;~~\:~:'"j?C'J' '.',,;
IN WITNESS WHEREOF, I hereunto set my hand and offJ,'c1.a.:l,,"'H~}i:-A -'0
seal. " { !;/(~f~'4,~.t:>,'.',\"
, - aJ./'/'a~~) LCSEAL) ;",,:!O'
[- NOTARiAL SEAL
I CATHERINE J. BARRA, NOTARY PUBLIC
I SHIBEMANSTOWN BOnO, CUMBERLAND CO. PA.
L_~,,~()_~1tvl~~.::!~N E:iP~~~!.~?,1999_
;:."~
"
;::;:,'
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,..:) ;,::. :~.:\, :::~~; ;;~.~
"FICE
JUAS
AYABlE
TO:
ESC:
TAX
\YEA
'FICE
JUAS:
AYABlE
TO:
MARY YONKIN, TAX COLLECTOR
239 GERMANIA ROAD
GALETON PA 16922
ESC:
MAP NO: 300-001 -004
GERMANIA RD
ACRES .350 DEED 0261 /0814
RT 144
SEASONAL DWELLING
TAX
~YEA
FLEAGLE NORMAN E
6598 CARLISLE PIKE
MECHANICSBURG PA 17055
SEPT 22 AND 29 9AM-5PM
SEPT 24,25,26,27 2PM-5PM
BOOKS CLOSE 12-31-07
PHONE 814-435-2475
MARY YONKIN, TAX COLLECTOR
239 GERMANIA ROAD
GALETON PA 16922
MAP NO: 300-001 -003
GERMANIA RD
ACRES .090 DEED 0261 /0814
RT 144
VACANT LAND
FLEAGLE NORMAN E
6598 CARLISLE PIKE
MECHANICSBURG PA 17055
SEPT 22 AND 29 9AM-5PM
SEPT 24,25,26,27 2PM-5PM
BOOKS CLOSE 12-31-07
PHONE 814-435-2475
Control No' 300.014567
2007 Statement of Real Estate Taxes
v . f. ......... ~ - !
Bill Date' 8/01/2007
Assessed Land I Improvement Mineral Total
Values 1,920 12,480 0 14,400
GALETON AREA S.D. Discount Face Penalty
Rates .03698810 I .03698810 2 % 5 %
SCHOOL R/E 71.02 461. 61 521.98 532.63 559.26
TAX AMOUNT DUE-> $521.98 $532.63 $559.26
If Paid On or After 8/01/2007 10/01/2007 12/01/2007
If Paid On or Before 9/30/2007 11/30/2007 12/31/2007
/ / $
Date Paid Amount Paid
Return Bill with Payment. Fora Receipt,
Enclose a self-addressed stamped envelo~
Tax Collector Signature
Control No: 300.014568
2007 Statement of Real Estate Taxes
Bill No:
251
8/01/2007
Bill Date'
Assessed Land I Improvement Mineral Total
Values 200 0 0 200
GALETON AREA S.D. Discount Face Penalty
Rates .03698810 I 2 % 5 %
SCHOOL R/E 7.40 7.25 7.40 7.77
TAX AMOUNT DUE-> $7.25 $7.40 $7.n
If Paid On or After 8/01/2007 10/01/2007 12/01/2007
If Paid On or Before 9/30/2007 11/30/2007 12/31/2007
/ / $
Date Paid Amount Paid
Return Bill with Payment. For a Receipt,
Enclose a self-addressed stamped envelop
Tax Collector Signature
REV-l508 EX "" (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF F
L EA-Gt~
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
/II tJ I( /IJ /J AI E.
FILE NUMBER
:LI- /) 7- 7~3
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
1,
VALUE AT DATE
OF DEATH
10.
II.
12.
/3.
/Y} I T I3AAlK.
II.) (Jkd:~ M: IVI? ';~7 loll ~~EK
13.) .54Y//11.5~. /lip. OJ$" ~o'l ~ODI ~R79 if
e,) A-UNU.r/ :tnt. 10 d./). 4-
b.) S4V/I1?" kU:, /ltJj;~4j' Aut.Aip. O;J.S t)olf 'j;{.tJ IDJ 9'13
E.) At!.d./'hul "htf. of, 4.0. d.
(.see YIl/tlf~hlJ'I felter tt lfacitLeI )
~R.tJ-A?/l77('}#J A1rIlJ /CEl/f1/BuRsE /J1E/II1S .fJA/ .s/H-E ~F
~/SLE Hk(f;"' ~Jf:.t)jlEJ2..,-ry
A-J {!.~['{/Jty T~es 11/IS/01- /;/,'/:31/07 (L,';ze LftJ'7j
~.) 5dzPo/ -r~eS /I/ts/n - 6/3%f' (L/M 'I~?)
(oee selllemel1t slJed allackcl $ sdedu/e .4-)
,tJfJL -' /4;"/;4-/ rehtnd
~q/e ,f L//I~/" tbl1f/ne/lttl/ VIN 1l{!" ~S 7' '193(p
;91'1 (fork. ;~suul ])e~.r2, /ff&.) ~,/J ~ !.4nfl;.s wit-te.l
Sa Ie 6/ tJ AIm f J~Io/ -
J(e.a1 ~.srate ;J1"fi{J€I"" T~ i<d?rJt t,...pm u,MlVlt:lttweaJ~ of ifJA-
-r;r~/ I(ece~~ h-6111 Auc.hOI1 by A1fW"'n ~hne..s J-o~k/
A ucJJOlJttr) Nl JiJ" 9, ~o!
Er; e :Inst.{ r. Groll..p. fa.rt;a-I Relu'fld
fY/f" T ;E4r/1< /JaIl/AI !?elunl Oil ~ rM"fJ~/11ent of /oQ.n hill/I.
Ef';C XnSII.f. 6rtJtA.f {larf,/(,/ Refund
Fr/e :rl/SUI', ~roup Part,'IlI Re./ulle/
JefAru1i ;Jri Ya-te ~/t of c;un Cvb;nei- fDS~ Ze-rAf\t~
~prate fJl'iyaie ~ pI Htt"d ;3o/k.r .ItS fY,sf"J -JOsh 'Zutmii
( &nh 1uAuI)
.:;,
J.
1.
$',
6.
1.
r.
9.
DESCRIPTION
Jf'
9, 75~, 7'1
:to
3, 2/ '1,77
I(
c). /3
~
27t). ;!:;
"os
~co?7: 31
7'1r..fk.,29
~
c-?7: I/!'
, b S'O. tJO
~ St;J,tJ/)
~ ~ S& ,~t)
r/
, J 9 J. 7tf.. S{)
J
~
f{, .00
1-t..07
?.5' 0, t)f)
l'
OJ. 00,00
~
S-oo..6)l)
J S7J.1Jt)
TOTAL (Also enter on line 5, Recapitulation) $ 'to; '-151. 3'1
(If more space is needed, insert additional sheets of the same size)
I
I
se).fED. E, (J.bntCl.
EJr. of FLEA6l.E; 4/t?J?/IIM E: FtL€ Nl'.
Iii &vndtrl 6Rd/ t&;t~.~ ~!I' ~nhl!-5e ;;J./CL
IS-! I TE'IJS .I)F jJefstJl///fLry 1-l-eJJ J3Aa ffe.IJ/J1 /J-u6Tf()/LJ-
i
I ::Ei/AMTESO/ft:f). IS A 7"rAC )It-;/) 116:71 t=To
/~. I ~I/ -;;'-rR/4 ,!;lLr (~) ItJhuJe,r(MA~Aw./t;/' ~",..fS 4ab- P71
1, ~ /
~/J:sk t1~ esh/n. J'lIIR~ ..aI- ~ ~~IJ, 1IfI) (2"-'03 ;.J~)
11. ~4&7hU~r - :51:)/,/ t; d-//~//'D t'uh..r. (/f7?,JSUL)
18'. I?Ufer JUf1lf kuI l&uJk Lf'/~. -M1 ~C/t(,Y
Ir. I (;-16cA: 7;cJ1 -2 /JUN.
{)/}~ : IIf$lfe~J QJt.. c)oSe~{)ui It/'ll)
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,
I
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E)<"I!IBI'T 70 SON!:/). F.
/Nf'EIV~;e'y ~,c /EIfSoAl/l-t-ry flaj)
A. ~/t/u/it1~hrM. Clza.ir ~ ~o/
8d i ()1t:I /Vprn ~ ru.(3) /luto/J C!.eJt( ch
(!'. J fwo oil ht6k/aHl/-U ..
c1lllr~< (.J),,/"; lWU'/s/o/ts , ,
e. I /J1/s~. /uI/ulMtL'c.p It/! tU'A?fchet1lLf11J/'tt~u.
f. : lh/st!'I'&Jts/ ~tt/1S". "..,..f/lzj1t~/1 tdensl/s.
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4 NIIJ!e U/1 /it }Allr""m
/t>/t/It/OOqU/ aAest ,f' t:lhl~e-r.s- Mtk'rfmq,fclres$d
~ 1-07- 7J'.3
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"i i ;..::,:,.' 'i
l!M&TBank
499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12
Phone (888) 502-4349
Fax (302) 934-2955
September 13,2007
Charles E Shields III
Attorney At Law
6 Clouser Road
Mechanicsburg, Pennsylvania 17055
Re: Estate of' Norman E Fleagle
Social Securitv: 190-26-4492
Date of Death: AUJ!ust 13, 2007
Dear Sir or Madam:
Per your inquiry dated September 12, 2007, please be advised that at the time of death, the above-named decedent had on
deposit with this bank the following:
l. Type of Account Checking Account
Account Number 2671046288
Ownership (Names oj) Norman E Fleagle *
Opening Date 12/09196
Balance on Date of Death $9,756.74
Accrued Interest $ 0.00
Total $9,756.74
2.
Type of Account
Savings Account
Account Number
015004200128799
Ownership (Names oj)
Norman E Fleagle *
Opening Date
12/07/96 Closed 08/21/07
Balance on Date of Death
$3,214.77
Accrued Interest
$
0.13
Total
- --- ..--....----- -- -- ------ ---- --- -~ ~ ---- -- ----~ - -----.. ---- -- ---- ---------.~ -------~ ---- ----
$3,214.90
3. Type of Account Savings Account / Holiday Club Account
Account Number 025004920101843
Ownership (Names of) Norman E Fleagle *
Opening Date 11/02/90 Closed 08/21/07
Balance on Date of Death $ 270.22
Accrued Interest $ 0.08
Total $ 270.30
4.
Type of Account
Home Equity Loan
Account Number
838504
changed to 12044439888234998
Ownership (Names of)
Norman E Fleagle *
Opening Date
09/24/01
Balance on Date of Death
$18,1 94.44 * * This amount is IIDt to be used for payojJ
purposes. For a payojJba/ance,p/ease ca//1-800-724-2440.
CUlTent Balance
$17,735.56 ** This amount is not a payojJba/ance.
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
Carlisle Pike Office # 717-795-1710.
Sincerely,
.~ay-
Records Management
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'r! EriE! Insurance
~ Group
100 Erie Ins. PI . Erie, PA 16530
ESTATE OF NORMAN FLEAGLE
C/O NORMA ROWE
PO BOX 447
SHERMANS DALE PA 17090
0e~o~'rt
Icr\1~/07
016.00
1.0.07
m ...\.-\ bOL\\\L
\OJ..O,
NOTICE OF PREMIUM REFUND
AA7894
. -- ----~-.-----._._---_._._--~--_.~._._---~...
" EriE! insurance
~ Group
100 Erie Ins. PI . Erie. PA 16530
PAY
TO
THE
ORDER
OF
ESTATE OF NORMAN FLEAGLE
C/O NORMA ROWE
PO BOX 447
SHERMANS DALE PA 17090
CODE
REASON it.. n
C~~~K ". LU
Premium Refund Due 10
Code 1 . Policy Cancelled
Code 2 ' Policy Expired
Code 3 . Premium Reduclion
Code 4 . Overpayment
POUCY NUMBER
Q49 2003613 H
DP164G 1/01
DATE
MO., DAY I YA.
11 19 07
REFUND AMOUNT $96.00
POUCY NUMBER Q49 2003613 H
AGENT NO. AA7894
AGENT'S NAME REISINGER INS AGY
REASON 1
REF. NO. X912535
CHECK NO. 24912535
NON-NEGOTIABLE
VOID 180 DAYS AFTER DATE
POSITIVE PAY PROTECTED
.--..---------------------------.--..-----..-.--.------------------------------------~.
AG.ENT
AA7894
REF. NO.
X912535
:J
Ci
Bank of America CustomerConnection 64-1278 "l
Bank of America. N.A. ~ ):
Atlanta, Dekalb County, Georgia ri
:z
DATE
MO'I DAY I YR.
11 19107
CHECK NO. 24912535
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$96. 00 I
F.ii1Sl!aJ'IIV tnturet;
L!Jhn::~~ on ba~.
EXACTLY *****96 DOLLARS AND 00 CENTS
f>~ CL.~~
AUTHORIZED SIGNATURE
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" Erie' Insurance
~ Exchange
ERIE INSURANCE EXCHANGE
P.O. BOX 1699 ERIE, PA 16530
NAMED INSURED COpy
Member . Erie Insurance Group
100 Erie Ins. PI . Erie. PA 16530
CANCELLA TION NOTICE
MAIL DATE
BAL:
11/20/07
$96.00 CR
CANCELLATION EFFECTIVE
11/15/07 12.01 AM
POLICY NUMBER Q49 2003613 H
POLICY EFFECTIVE DATE 01/20/07
HOMEPROTECTOR POLICY
STANDARD TIME
NAMED INSURED
ESTATE OF NORMAN FLEAGLE
C/O NORMA ROWE
PO BOX 447
SHERMANS DALE PA 17090
AA7894
WE ARE NOTIFYING YOU THAT THE ABOVE POLICY IS CANCElLED AS OF THE CANCELLATION
EFFECTIVE HOUR AND DATE SHOWN ABOVE. IF WE HAVE BEEN ASKED TO PROTECT OTHER
INTERESTS, WE ARE REQUIRED TO ADVISE THEM OF THIS CANCELLATION.
THE REASON FOR THIS ACTION :
REQUEST OF NAMED INSURED - SOLD
***FORMERLY - FLEAGLE, NORMAN
PREVIOUS BALANCE
UNUSED PREMIUM
PRESENT BALANCE
$.00
$96.00 CR
',_ 'h_$9_6_.Q..O_C!._~~lJNJ) ,CHEc:K ENCLQSE~,___
00369
AA7894
REIS REISINGER INS AGY INC
~MgBank
November 21, 2007
NORMAN E FLEAGLE
PO BOX 447
SHERMANS DALE PA 17090
RE:
Your Loan # 120-444-3988823-4998
Overpayment check # 488746 amount
$6.07
Dear Customer(s):
Congratulations! Our records indicate that the account listed above was paid in full on November 20, 2007.
Attached is a check which represents an overpayment on this account.
I would like to take this opportunity to thank you for banking with M&T. Please keep in mind that M&T offers a wide range of
financial products to meet your financial needs, including a variety of home equity and installment loan accounts. If you are
in need of financial services in the future, I hope you will turn to M& T.
If you have any questions regarding your account or any of M&T's products and services, please contact M&T's Telephone
Banking Center at (716) 626-1900 or (800) 724-6444 or stop at your nearest M&T Branch.
Sincerely,
<~~
Kathleen Evans
Operations Manager
L003
----- --~---.. --.--.. ---------------- --._._~-._._---_.._--
Manutacturel'$ and Tradel'$ Trust Company, 1 Fountain PlaZa, P.O. Box 767, Buffalo, New York 14240
L17Z (1V06)
--. '~--'-'---'~~----'-'---"---__"'_"___h______~____~~~__.___.___+. ___________.________________ _._~___________._________.___...___ ______________________________._.______
flM8ffBank
ManUfacturers andTraClors TrustCompsny
BUFFALO. N.Y. 14240
VOID AFTER 180 DAYS
C.C.R. No. 488746
10-4
.~
OVERPAYMENT ON ACCOUNT # 120-444- 3988823-4998
REF.
~y
Cs{X AND 07/100 DOLLARS
C\J
ex)
C\J
(Y)
L0
TO THE ORDER OF
NORMAN E FLEAGLE
POBOX 447
SHERMANS DALE PA
DATE
November 21, 2007
CHECK AMOUNT
17090
~~~h~~~~~~~~~$6-07
1!~~
AUTHORIZED SIGNATURE
COUNTERSIGNATURE REQUIRED IF MORE THAN $1.000.00
...- .-... "--'--~-',,--,-,._- .-...-....----..-- .-- ....-.-.-...-.-_.___._.___n.._~______,___._.__._~__.____..__._._.__~__
--~--.._--_._-_._--_..__._----_._----------~_.-._---_..--.-----.
" Erie' Insurance
~ Group
lOa E"e Ins PO . Erie, PA 16530
NORMAN FLEAGLE
6598 CARLISLE PIKE
MECHANICSBURG PA 17050-1767
b(~OC;\1
\0 \ \d \01
NOTICE OF PREMIUM REFUND
DP164G 1/01
DATE
MO,' DAV/VR
10 02 07
REFUND AMOUNT $50.00
POllCV NUMBER Q01 2002206 H
AGENT NO. AA7353
AGENT'S NAME REISINGER INS AGY
REASON 3
REF. NO. X809813
CHECK NO. 24809813
AA7353
NON-NEGOTIABLE
l~ri'Ei Insurance
~ Group
100 Erie Ins PI . Erie. PA 16530
NORMAN FLEAGLE ESTATE
6598 CARLISLE PIKE
MECHANICSBURG PA 17050
be~oC:;rl- IOII~/07
::I: n s .1> .e~u. t\ cI
Gu. n Co- 6 I Y\-C\
~U- Y\
. Erie" Insurance
~ Group
100 Erie Ins PI . Erie. PA 16530
PAY
TO
THE
ORDER
OF
NORMAN FLEAGLE ESTATE
6598 CARLISLE PIKE
MECHANICSBURG PA 17050
CODE
REASON ~ n
C~~~K r ~
Premium Refund Due to
Code 1 . Policy Cancelled
Code 2 . Policy Expired
Code 3 . Premium Reduction
Code 4 . Overpayment
POLlCY NUMBER
Q01 2002206 H
NOTICE OF PREMIUM REFUND
REFUND AMOUNT
POLlCY NUMBER
AGENT NO.
AGENT'S NAME
REASON
REF. NO.
CHECK NO.
AA7353
0-0000
500 .00
d-6 o. 00
q 50 00 +otoJ d-epo~ii
VOID 180 DAYS AFTER DATE
POSITIVE PAY PROTECTED
~
DP164G 1/01
DATE
MO'I DAY I YR.
10 05 07
$200.00
Q01 2002206 H
AA7353
REISINGER INS AGY
1
X817634
24817634
NON-NEGOTIABLE
-'
:i
1ii
Bank of America CustomerConnection 64-1278 ~
Bank of America. NA --s:i1 )>
Atlanta, Dekalb County, Georgia ~
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DATE
MO., DAYjYR.
10 05 07
CHECK NO. 24817634
$200.00 I
AGENT
AA7353
REF. NO.
X817634
EXACTLY ****200 DOLLARS AND 00 CENTS
r1lSe-cur;t" f~"IU'el;
i~l\lCted
t Dl'ta;h: on b:ll;c:k
-fJ~ a... -<J--e.-
AUTHORIZED SIGNATURE
. r!I Er;8' Insurance
~ Exchange
ERIE INSURANCE EXCHANGE
P.O. BOX 1699 ERIE, PA 16530
NAMED INSURED COpy
Member . Erie Insurance Group
100 Erie Ins PI. . Ene, PA 16530
CANCELLA TION NOTICE
MAIL DATE 10/09/07
BAL: $200.00 CR
CANCELLATION EFFECTIVE
10/04/07 12.01 AM
POLICY NUMBER QOl 2002206 H
POLICY EFFECTIVE DATE 01/20/07
PIONEER FAMILY AUTO POLICY
5T ANDARD TIME
NAMED INSURED
NORMAN FLEAGLE ESTATE
6598 CARLISLE PIKE
MECHANICSBURG PA 17050
AA7353
WE ARE NOTIFYING YOU THAT THE ABOVE POLICY IS CANCElLED AS OF THE CANCELLATION
EFFECTIVE HOUR AND DATE SHOWN ABOVE. IF WE HAVE BEEN ASKED TO PROTECT OTHER
INTERESTS, WE ARE REQUIREO TO ADVISE THEM OF THIS CANCElLATION.
THE REASON FOR THIS ACTION :
REQUEST OF NAMED INSURED - SOLD
~ddrFORMERL Y - FLEAGLE, NORMAN
PREVIOUS BALANCE
UNUSED PREMIUM
PRESENT BALANCE
$.00
$200.00 CR
$200.00 CR REFUND CHECK ENCLOSED
--------.-_.~----------_._-------._-_._._---
00008
AA7353
REIS REISINGER INS AGY INC
. REv.,SlO EX '1'.971
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON.PROBA TE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
~ LE A- 'l. E, Np/(/J1ntv' k.
FILE NUMBER
;ZJ~~7-7t3
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
ITEM
NUMBER
1,
DESCRIPTION OF PROPERTY
INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER
ATTACH A COPY OF THE DEED FOR REAL ESTATE.
/YJ ? -r I R./t A-ut. !/it'. A Z-E -:J. t.f B (. 97
'Be/ltf/t!/lIj: /IINIY1/J Jet/I} 1(t'ltJe J dau1hftr
fi-.Fe.c/e-ra,7tc{ l1/l1er/c.o.l'\ Le/tde-TS J CIa ss 15
:l,SLoJ3 sh. tV 'Iaa.'f{p = 1",-; J'eCf,oO
13. Fe.dem.ted C~;tQI Afpre<:..~a;HoVl Cia 50S B
12/."0 sh. @ ~2S.lq::= rf3jOSO,7b
C. Fc.de f'rJr:j &11 d Clo5 8
QQS-,o/1) ..sl.t.@ 1-8,70 .:: "f 8'){,$~..5'i
'! /7) 51~. 35
(See Va!uQ}ioYf Ie-Ifa fr6m m ~ T ::l"1Iives,~
&-tH!f)
%OF
DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE
VALUE OF ASSET INTEREST OF APPLICABLE)
f11, 5 'lb. 35 loo~ -6 - ?; 7591,.35
J
TOTAL (Also enter on line 7, Recapitulation) $ / 7; 5r~, 3 S-
(If more space is needed, insert additional sheets of the same size)
~ M&T Investment Group
M&T Securities, Inc.
285 Delaware Avenue, Suite 2000, Buffalo, NY 14202-1885
Date of death valuation
For the account of Norman Fleagle
Account # AZE248697
Date of death 8/13/07
Description of Security Quantity in Valuation Price per share
shares Date
8/13/07
Federated American 251.023 $23.46
Leaders Class B
Federated Capital 121.110 $25.19
Appreciation Class B
Federated Bond Class B 995.010 $8.70
We have received the information presented above from sources, which we
believe to be accurate. However, we do not guarantee their accuracy. The
price per share on valuation date is the closing price on that date.
Please contact Client Solutions with any further questions, or if we may be of
further assistance to you at 1-800-724-7788, Option #1. Thank you.
Sincerely,
/l~h
Robin Brown
Brokerage Investment Specialist
M& T Securities, Inc.
Investment and Insurance Products: . Are NOT Deposits. Are NOT FDIC-Insured. Are NOT Insured By Any Federal Government Agency
. Have NO Bank Guarantee. May Go Down In Value
M& T Investment Group",' is a service mark of M& T Bank Corporation and consists of M& T Securities, Inc., the investment-related areas of M& T Bank and
investment advisory firms MTB Investment Advisors. Inc., and Zirkin-Cutler Investments, Inc.
Brokerage services and insurance products are altered by M&T Securities, Inc. (member FINRAlSIPC), nol by M&T Bank.
M&"' Secunlles. Inc. IS licensed as an Insurance agent and acts as agent 10r Insurers. Insurance policies are obligations at the Insurers that Issue the policies.
Insurance products may not be available in all states.
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FL -
EAGLe-
,
AlPI</H/lA! E:
FILE NUMBER
;(1-1)7- 7~3
ITEM
NUMBER
A.
Debts of decedent must be reported on Schedule I.
DESCRIPTION
1.
FUNERAL EXPENSES:
t>1 V E7,?S FUAJ E IVH..
fJ1 Y Bl.$ Rf AI E7Vtt.
HOhlF of mE(!jfJ/-/Y/e s ;8u/(G-
HlPht€ - AdeIJ'h't;ruIJ t:/ealh c!u>f;-f-, cet,fes
2.
B. ADMINISTRATIVE COSTS:
f.
'I,
It/"
II.
1. Personal Representative's Commissions
Name of Personal Representative(s)A1t)II.Il1~_c1€lt-IV/&>--'Y'tf
Street Address_fl_ ~()X _ ~~ '-___~________
City $fle-RIJ/If/1/.5;PALE
State fJl1 Zip IZotti2_
Year(s) Commission Paid:_t1LJA------__..__
2.
Attorney Fees C!..nttrle.s E. SA,'elds bT
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
N Rfl/ c_
E"L/'/13L€
----- ---
Street Address
City
State _ Zip
Relationship of Claimant to Decedent
4.
Probate Fees w..t.rl ori ~ ; 1\ J '. Ss ~ of s'rw r-t cerf; .p.,' c.~~,S'
5.
Accountant's Fees 1 13 I-h' I ( J. H' f.) I? 1 - I, 1\1 ~ . l _ I I
J'Qne.t rtu.t-- I t, $- 1\ 'W(..0c.4<-, I/f.t',C.IIM14UI?~
Tax Return Preparer's Fees -ft,r c.leseout ID140 Pit ~O / Esf lolfll PIt4I,c,'/i:.
;/1 (!ulI1wla"tI LAw :JPl((',u~1
;,., Ca,../iS/t StlZhli~1
jlmbah fee -Iv A'f' cf j{J/!/S
a- ffr' cf 1v//1.5
l?e;I11~I"Se/J7tl1t -t" t/Ulrles ~ Sh/e/cl5 JZr p/, ;:J7~
~ JtrSCJIJ Sf;?lC;KnI'd::. (;r .ir//;4- ~t(/}f h'f-k It ;s~d . -/./..)
i/ (see (!M/7/! SNO.
6.
7.
A-d rtrt;5/"
A-t/ ferb '.5 /111
1ft" cI/ /; 1/ /J tl /
;; t >1LJ ret-
AMOUNT
yt
.3,l,K:Z./!)o
~ 3 b .eJD
I.VAtve-l:>
f'K'
Q I II ~ 7, ()/51
?oJ! g, 00
71 if1 0, ~o
~ 75. 00
, II 3, 7:(
~ J. 0 () t 00
~
IS; 00
~~ t)t)
TOTAL (Also enter on line g, Recapitulation) $ /7, ~ 2 ~. 18-
(If more space is needed, insert additional sheets of the same size)
p~ % Sr!JIEj), 11/ eoni'd-
Est: of R.EA-CtE /f~.R/II-1#' E
: /
M. t?e.//JtJt{rsc/)J~/Jf c- t:h.tr/t'5 E SA,elck 7lI ~r fJw/rJ~fJ/e51
jJ~>~CI rUt. (es/Jin.)
/3, EX f/E/YSE5 /2cL/l-TEt> 70 SAi-t;:" tJ,c= M~/SLE ;PIKE j>fltJpmry
.4.) ?Ir~rl1lj/;f /1;;/lery ,1 /J1~r&~e !by-tJlf /1.,& ~1)
/.3) ;1;1<</'y k5 t /(r/s/enj). c5%t've (L./ne //~tR)
0) ~ fNr, Fa (L/Ilc 13tpf/)
p,) <-)e;t/er; (;, .5//re/' ,5pPr/AJ /,[p~. ~~n1- (L'M /307)
(c>ee 5elJ7e/1/&/J1 r:5At!d n#2?c-lte?l' ~ Sdedtt/e ,,-I)
Ilf. , /{Jf,//Jr;urSUIlel/! C- Chdr/cS E. ~;','e-ltI.s 1$ h,t- Pt!.G ~ J; mi T
:IJanK h/fI "ff4H1 ~ ~k ~Jd~.x
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17. 7ri- &U/frt E/eelr/c.
II- t'fU'i~11
19. L f) we; - fl/U'c1t1J5e .~ rlJ()~l /J1a!&r/~ $ ~ ;>1)0/ Ih4 6(/-/,J'/~ f?,').e
;JrC(Jtrfy ,V IJ/(~j/e f!11c!,'I,'O'l and value tUttI Ii- ~ ,'/6,.. SIJ/Je.
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;ELLER NAME ,." ,
FINAL
SETTLEMENT
DATE OF SALE
PHONE
~DDRESS
ZIP
.---" ~\
,. _._ ..r
,of,
OCATION OF SALE
L,;.l~~ !' I
~UCTIONEER
; -.
.p..,~;.:",~}>.- .~. J.::::' -::~~::;'--
PHONE
( SELLER'S EXPENSES)
PROFESSIONAL FEES
AUCTIONEER
$
~ir ,.r', ..,->
t' " .;~- -,
,.;
~.
.~ :5.j"", (~,""'.':
CLERK
$
CASHIER
$
,-_.,~:""" ':~!?:A
OTHER EXPENSES
~--/
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l.,~.";
$
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$
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$
$
$
$
( TOTAL EXPENSES
~ L..# '1/ """,\1
$ . ' ;-N(" ,,,~ })
-:-,,-,
CASH
CHECKS
OTHER RECEIPTS
$
$
$
$
$
$
$
$
$
$
$
TOTAL RECEIPTS $ /? .- -.! ,--.
LESS TOTAL EXPENSES
NET PROCEEDS PAYABLE TO SELLER
$
.... <';':-:'"ro
. .' L
$
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
Date
(Seller's Signature)
SELLER'S COPY
(Seller's Signature)
Date
Date
Glenda Farner' Strasbaugh
Register of Wills
and
Clerk of Orphans' Court
Marjorie A. Wevodau
First Deputy
Kirk S Sohonage Esq
Solicitor
Register of Wills and Clerk of the Orphans' Court
County of Cumberland
One Courthouse Square
Carlisle, PA 17013
(717) 240-6345
FAX (717)240-7797
INVOICE
Bill To:
InvoiceNo:
Invoice Date:
Estate of:
Estate No:
1918
2n9/2008
N ORlvLA.N E FLEA GLE
21-07-0783
CI-L'\RLES E SHIELDS III
6 CLOUSER RD
JA
MECHANICSBURG, PA 17055
Qty
1
Fee Description
Short Certificates
Fee
Total
4,00
$4.00
Total:
$4,00
ATrYCHARLESESHIELDS III
6GLOUSER HD
MECHANICS BURG PA 17055
1105
Date
3 k /tJt
/ I
tffJ
I$f~
~
./ ~Dollars 6J
(
3- 7615/360
292
::~:;oihe ~~ jI ~
,aucf ~d ~
~:€ Citizens Bank / '
Pennsylvania " . ~./ /C ~
Foe ~ WI- s:c.~~6~c4y
I
I: 0 3 b 0 r b . 5 0 I: b 2 . 5 5 5 . 2 L. B II- . . 0 5
'.o'Onn".t'I'.>/(".',-nn
Cbt:ck~ c;bould be rnade payable to the Register of vCills. Term,s: Net 30.
Please return one copy of this l11YOlCt: with your payn1t:nt Thank 'iOU
REV-1512 EX+ (12-03)
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF ~L€A(;LE; AlIIt/J1A# E:
FILE NUMBER
rZ/~o 7 - 7cf.3
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. /Y} I r 1J.t#K - flM1E EIlU/Tlj LfJA-A/.:# I~ LfW :3~tff!;J,3 lf9fjJ
/P,
/1.
IJ .
~.
3.
f
.5.
6,
,4.) tY/2'f~7
6,) r /I~ /07
C,) IP/II/07
). 11/IS"/()7 (see, s~lIk/)Jut! 4/fac/au/ t, sdd."- L'N Sbtj)
fJt/L (;4S
1Jl1J,,! ~11~;") ~ (f,1/tcJt;r
/J1~7 ~/1~n~ TA,k (j,1Ie~r
-rr,'- ~1111t, E/eclr/c.
(/
fe/'iZ()n
~ II/Cqst &6/t.,
/Jd;rlt ;jllsch~re. tv,'~5t ~ 8//uhr
/
lin/1 hlA s Ie
cSlller Spr/if 7'A/J').5i../? re.' Se wer
f)/Ye~t Tf/
l);recl f~lfI(!,nt.s removed f,-[)fIII Ir1sT M. Itlferd.tJ.J.
WAd before e105/Are ,{ A~ct;
A. PPL Ga:,
~. P (J L E"lee.
a. Tri - County E/ec.
'D. "Direct -tt PttAfme-nt
(sa SfafttntlJf "lfl.chtt/ )
1'1:J. '1, 97
".
~Z,?, ?7
~
if 27. 97
~/7.. 2//.SS-
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.,
7. 2S"
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3'1.87
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/2 ,. 7/)
'i~.7;Z
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if 3. 74'
~
38.17
."
3 7,29
~ /71 'I?
7.
8:
q
TOTAL (Also enter on line 10, Recapitulation) $ :<0 J 181,39
(If more space is needed, insert additional sheets of the same size)
~ ~1&T Banl(
'-'
ACCOUNT NO.
ACCOUNT TYPE
STATEMENT PERIOD
PAGE
2671046288
CLASSIC CHECKING
AUG.14-SEP.13,2007
1 OF 1
00 1 04342M M 021
3986
NORMAN E FLEAGLE
6598 CARLISLE PIKE
MECHANICSBURG PA 17050-1767
CARLISLE PIKE
ACCOUNT SUMMARY
BEGINNING DEPOSITS & OTHER CURRENT ENDING
BALANCE OTHER ADDITIONS CHECKS PAID SUBTRACTIONS INTEREST PD BALANCE
NO. I AMOUNT NO. I AMOUNT NO. I AMOUNT
9,756.74 21 1,300.50 11 8,712.96 4 I 136.73 0.00 2,207.55
ACCOUNT ACTIVITY
POSTING DEPOSITS, INTEREST CHECKS & OTHER DAILY
DATE TRANSACTION DESCRIPTION & OTHER ADDITIONS SUBTRACTIONS BALANCE
08-14-07 BEGINNING BALANCE $9,756.74
08-14-07 PPL Gas Util Gas Bill 43.78 9,712.96
08-21-07 CHECK NUMBER 1530 8,712.96 1,000.00
08-22-07 US TREASURY 303 SOC SEC 644.50
08-22-07 PP ELEC BILL . 38.17 1,606.33
08-27-07 TRI-COUNTY REC ACH PAYMNT 37.29 1,569.04
08-28-07 DIRECTV Payment 17.49 1,551.55
09-11-07 PERSHING BROKERAGE 656.00 2,207.55
ENDING BALANCE $2,207.55
CHECKS PAID SUMMARY
1530 08-21-07
8,712.96
. REV-1513 EX+ (9-00)
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
NUMBER
I
F L l? A (; l. F/ /II t? /UJ14-1lI .e.
FILE NUMBER
.i< / -07 - 7;-3
AMOUNT OR SHARE
OF ESTATE
}'eo 70
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
1.
RELATIONSHIP TO DECEDENT
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not ListTrustee(s)
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
No fl..M A JEIM/ /?'oW€
1'0 130)( '-I if 1 VA-UGHTeR
~f1a<IJfI1If/.f f).4t.E I PI'! I 7 ~ '1 ()
1.
B CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
~_"""'-C:.="_.._:..
LAST WILL AND TESTAMENT OF NORMAN E. FLEAGLE
], NORMAN E. FLEAGLE, single man, currently of 6598 Carlisle Pike, Mechanicsburg, Silver Spring
Township, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding,
do make, publish and declare this my Last Will and Testament, hereby revoking and making void any and all
prior Wills by me at any time heretofore made.
I.
I direct the payment of all my just debts and funeral expenses as soon after my decease as the same can
conveniently be done.
2.
All the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever and
wheresoever situate, is to be distributed to my daughter, NORMA JEAN ROWE, currently of Shermans
Dale, Perry County, Pennsylvania. In the event that she predeceases me, then to her issue, per stir/Jes.
2 a.
For purposes of clarification: my son, NORMAN E. FLEAGLE, JR., has been omitted from my
will purposefully and by design. He is not, nor is his bloodline, to inherit through my will or from my estate
directly or indirectly by representation, partial intestacy, per stir/Jitallv, or in any other way or manner
whatsoever, nor is my said son to serve as an administrator of my estate under any circumstances.
3.
I nominate, constitute and appoint my daughter, NORMA JEAN ROWE, to be the Executrix of this
my Last Will and Testament. In the event that she is unable or unwilling to act as Executrix, I appoint my
granddaughter, JENILEE MIEDZWICKI, to be the Executrix in her place and stead. I fUt1her direct that
they shall not be req uired to fi Ie bond or other security in the Office of the Register of Wi lis for the purpose
of administering my Estate.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this ft)l,' day of
)t<tin.L(' , A.D. 2005.
, (Y ---r- // fL
/)1~'1/1J-'LA/)"'L' c.... C/1A~~ (SEAL)
NORMAN E. FLEAGLE
i Signed, sealed, published and declared by the above-named NORMAN E. FLEAGLE, as and for
I
hi4 Last Will and Testament, in the presence of us, who at him request and in his presence, and in the
pr~sel1ce of each other, have hereunto subscribed our names as witnesses.
t~td1- ~&)}Ia~
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