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Home My WebLink About04-01-08 (3)15056041147 -' REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes County Code Year File Number PO 80X.280601 INHERITANCE TAX RETURN Harrisburg, PA 1712&0601 RESIDENT DECEDENT 2 1 0 7 0 8 4 0 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 171 28 2621 Decedent's Last Name WILLIS 06 30 2007 (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Spouse's Soaal Security Number FILL IN APPROPRIATE OVALS BELOW a 1. Original Return 4. Limited Estate g. Decedent Died Testate ^ (Attach Copy of Will) 04 10 1920 Suffix Decedent's First Name MI HERMAN L Suffix Spouse's First Name MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) 4a. Future Interest Compromise ~ 5. Federal Estate Tax Return Required (date of death after 12-122) 7, Decedent Maintained a Living Trust Q B. Total Number of Safe De osit Boxes (Attach Copy of Trust) p 9. Litigation Proceeds Received ~ 10. Spousal PovertyY Credit (date of death 11. Election to tax under Sec. 911 A between 72-31-91 and 1-1-95) ~ (Attach Sch. O) ~ ) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number RICHARD L. WEBBER, JR. ESQUIRE 717 532 7388 Firm Name (If Applicable) WEIGLE & ASSOCIATES, P.C. First line of address 126 EAST RING STREET Second line of address City or Post Office State ZIP Code SHIPPENSBU'RG PA 17257 REGISTER OF WILLS US~ ONLY ca ra ~ - Q co , , = ~ ~' c 7~~ , rr~ ~ 'I CCC~~7U~ 'O C_4r . Z ' ~ : U jE FILED ~ -- .W ' Correspondent'se-mail address: rwebber@weigleassociates.com 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 preparer other than the personal representative Is based on all information of which preparer has any knowledge. SIG RE OF PERS RESPONSI E FOR F kING RETURN DATE ~ 7 Rita A. Mackey ..~ j ~ ~ /„ 59 Smithdale Road, Shippensburg, PA 17257 SIGN URE OF PREPARER OTIiER THAN REPRESENTATIV AD_~~ ~ Vii! ~ Richard L. Webber, Jr. Es uire DATE / . ~)(/ RESS q ~ ~ ~J G 126 East King Street, Shippensburg, PA 17257 Side 1 15056041147 15056041147 J . < PA Inheritance Tax Return Signature of Additional Fiduciaries I ESTATE OF I FILE NUMBER Willis, Herman L. 21-07-0840 I Under penalties of perjury, I deGare 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 preparer other than the personal representative is based on all information of which preparer has amy knowledge. Signature #2 Name Address1 Address2 City, State, Zip Date ~'`i~~. Thomas L. Willis 273 Briar Lane Chambersburg, PA 17202 Signature #3 ~..~,-~Q ~~~~~ Name Lloyd J. Willis Address1 59 Smithdale Road Address2 City, State, Zlp Shippensburg, PA 17257 Date ~'~ ~oZ ~7 O ~~ Signature #4 ~____~ ~ ~/~ _~ ~--P ~ ~ ZC/---rte" '-~-~ Name Address1 Address2 City, State, Zip Date Leonard P. Willis P.O. Box 457 Shippensburg, PA 17257 ti 15056042148 REV-1500 EX Decedent's Social Security Number oe~ede~rs name: Herman L. Willis 17 1 2 8 2 6 2 1 RECAPITULATION 1. Real Estate (Schedule A) .......................................................................................... 1. 2. Stocks and Bonds (Schedule B) ............................................................................... 2. 7 0 . 0 0 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) ................ 5. 7 0 , 3 8 9 . 7 2 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested ............. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested ............. 7, 8. Total Gross Assets (total Lines 1-7) ....................................................................... 8. 7 0, 4 5 9. 7 2 9. Funeral Expenses & Administrative Costs (Schedule H) ......................................... 9. 1 1 , 8 9 9 5 8 10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I) ................................ 10. 9 9 2 . 0 0 11. Total Deductions (total Lines 9 & 10) ...................................................................... 11. 12 , 8 9 1 . 5 8 12• Net Value of Estate (Line 8 minus Line 11) ............................................................. 12. 5 7 , 5 6 8.14 13. Charitable and Governmental Bequests/Sec 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. 5 7 , 5 6 8.14 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. 0 0 15. 0. 0 0 16. Amount of Line 14 taxable at lineal rate x .045 5 7, 5 6 8.14 16. 2, 5 9 0. 5 7 17. Amount of Line 14 taxable at sibling rate X .12 0. 0 0 17• 0. 0 0 18. Amount of Line 14 taxable at collateral rate ;K .15 0 . 0 0 18• 0 . 0 0 19. Tax Due ..................................................................................................................... 19. 2. 5 9 0. 5 7 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. a Side 2 15056042148 15056042148 J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21,07-0840 DECEDENT'S NAME Herman L. Willis STREET ADDRESS 67 Smithdale Road CITY Shippensburg STATE PA ZIP 17257 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit g. Prior Payments C. Discount 3. Interest/Penalty if applicable p. Interest E. Penalty 0.00 Total Credits (A + B + C) (1) 2,590.57 (2) 0.00 Total Interest/Penalty (D + 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. Make Check Payable to: REGISTER OF WILLS, AGENT (3) (4) (5) 2, 590.57 (5A) (5B) 2,590.57 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred :.................................................................................. ^ b. retain the right to designate who shall use the property transferred or its income :.................................... ^ O 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? ......... ~ x^ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a benefiaary designation? ...................................................................................................................... ^ ^x 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 netwalue of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after J,snuary 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. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child 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. §9116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116 (a) (1.3)]. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. Rev-15o3 EX+ (6-98) SCHEDULE B STOCKS 8s. BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Willis, Herman L. 21-07-0840 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER CUSIP NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OF DEATH 1 (4) Shares of Cumberland Valley Cooperative 70.00 Associates preferred stock certificate numbers 2763, 4917, 13049 and 2151 TOTAL (Also enter on Line 2, Recapitulation) 70.00 (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 B (Rev. 6-98) Rev-1 SOS EX+ (8-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDEWT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF (FILE NUMBER Willis, Herman L. 21-07-0840 Include the proceeds of litigation and the date the proceeds were received by the estate. All properly jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Adams Electric Cooperative, Inc. -.Patronage Capitol 100.52 2 Adams Electric Cooperative, Inc. -Patronage Capitol 1,055.60 3 AgChoice Farm Credit, ACA -Member Equity and accrued dividends 402.56 4 Cumberland County Tax Claim Bureau -Surplus from Tax Sale 55,854.16 5 Gross proceeds from consignment sale 2,760.25 6 M8lT Bank -Account #67386334 192.89 7 Orrstown Bank -Account #640697 211.69 8 Orrstown Bank -Account #647047 7,530.55 9 Personal property -Gross proceeds from sale 2,281.50 TOTAL (Also enter on Line 5, Recapitulation) I 70,389.72 (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-'1151 EX+ (12.99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES ~ ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Willis, (Herman L. 21-07-0840 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s) attached B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Sodal Security Number(s) / EIN Number of Personal Representative(s): Street Address City State Zip Year(s) Commission paid 2. ~ Attorney's Fees See continuation schedule(s) attached 3. Family Exemption: (If decedent's address is not the same as daimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. ~ Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 6,696.00 3,519.45 125.00 7. Other Administrative Costs 1,559.13 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 11,899.58 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 RENRN RESIDENT DECEDENT ESTATE OF (FILE NUMBER Willisn Human L. 21-07-0840 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-B2 ATTORNEY'S FEES continued COMMONWEALTH OF PENNSriVAN1A INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER Willis„ Herman L. 21-07-0840 ITEM NUMBER Weigle 8~ Associates, P.C. DESCRIPTION AMOUNT 3, 519.45 Subtotal 3,519.45 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-62 (Rev. 6-98) Rev-1502 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H-B7 OTHER ADMINISTRATIVE COSTS continued ESTATE OF (FILE NUMBER Willis, Herman L. _ 21-07-0840 ITEM NUMBER DESCRIPTION AMOUNT 1 Consignment Sale -Expenses 331.23 2 Consignment Sale - Labor to Walter S. Eutzy 429.02 3 Cumberland County Register of Wills -Filing fee for inheritance tax return 15.00 4 Cumberland County Register of Wills -Additional probate fee 45.00 5 Cumberland Law Journal -Legal Advertisement 75.00 6 Jones ~ Martin -Auctioneers commission on sale of personal property 570.38 7 News Chronicle -Legal Advertisement 93.50 Subtotal 1,559.13 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) f~ev-1,512 EX+ (6-98) SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER Willis, Herman L. 21-07-0840 Include unreimbursed medical expenses. (If more space is needed, additional pages of the same size) Copyright (c) 2002 farm software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98) REV-1513 EX+ (9-00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ~ FILE NUMBER Willis, Herman L. 21-07-08 40 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PE:RSON(S) RECEIVING PROPERTY DECEDENT (Words) ($$$) Do Not List Trus s I~ TAXABLE DI.S"TRIBUTIONS [indude outright spousal di rib d t f ti ons, an rans ers st u under Sec. 9116(a)(1.2)] 1 Rita A. Mackey Daughter One-Fourth 14,392.04 59 Smithdale Road Shippensburg, PA 17257 2 Leonard P. Willis Son One-Fourth 14,392.04 P.O. Box 457 Shippensburg, PA 17257 3 Lloyd J. Willis Son One-Fourth 14,392.03 59 Smithdale Road Shippensburg, PA 17257 4 Thomas L. Willis Son One-Fourth 14,392.03 273 Briar Lane Chambersburg, PA 17202 Total 57,568.14 Enter dollar amounts for distributions shown above on lines 1 5 through 18, as appropri ate, 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 NI -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) nC7 -{D a m ~ ~~ ~ ~•~o ~ ~ ro ~ m • m ~ ~• a ~ x~ r ~ ~ m ~ a ~ ~ RoH ~ O ` C'h ~' t'' 1-~ -__!~_ttt_1-i__.__ _Q_______ tD [A i/~ O _~ ~~ ~_ ;,__~ ~. T~ n c%hn t{I co v~ ~C y m ~ H ;~'~~r J W ~ C?i N G1 X C? D o O ~ O , orn N J D i m l F, a n N C/1 C.71 (n a N GJ cD ~ a,cnmp ° _ - ~ ~~~~ ° m~ fn .'.. w . ~ ~ p W 2 d ~ .~~ +-' ~mCA N a~Z: cn o ~ J T ~.n c O u m o '~. ~ o ~ ` _v~ , O Q d O r ~ f.;a 14 1F ~F 'F O a x~, ~ ~ ~ W ~ Fri ~, ~ ~ r m n ~ 00 O O ~ NN N N '~ \ \ '~ ._ ri7 00 C O ~P iP ~ ~ H D m dOOO ~n to v~ cn d z H H H H C~! 0000 Cn ~~c~~ n xxxx ro H rorororo ro CCCC H ~ ~ ~ ~ ~"~ n~c~n o ~' ~' ~' ~ x U] C!.! t11 U] GS! bRl bC! ~i 0000 C aaaa O aaaa C 0000 (2 ~~~~ x Oo a ~ to 1~1 'J'd 0000 O 0000 7C., 0000 H D m O N O a O d Cal N CJl 0098710925 ~ ' Adams Electric Cooperative, Inc. 1338 Biglerville Road PO Box 1055 /II~~ Gettysburg, PA 173 5-1055 _~~_ ® A Ta>rhstone F.aerg}~Coopeiative ~~~ 1-888-232-6732 www.adamseo,coop 3275 1 AV 0.312 4 3275 HERMAN L WILLIS EST C-8 P-8 67 SMITHDALE RD SHIPPENSBURG PA 17257-9525 ~n~~~~~n~u~~~~~~~i~n~~~~~u~~i~n~~~~~~i~n~~n~in~i~n~) e capital rtetlrement RETIREMENT SUMMARY YEAR AMOUNT THIS RETIREMENT ------100_52- 1990 65.28 CHECK AMOUNT 100.52 ------------- 100.52 CAPITAL CREDIT NVBR: 0096710925 Adams Electric Cooperative, Inc. CK#: 20736936 DATE: 12/17/07 Patronage Capital Retirement Adams Electric Cooperative, Inc. ® A Touchstone Energy"Cooperative _~ LEANARD P WILLIS 186 SHIPPENSBURG :MBL EST SHIPPENSBURG PA ].7257 Dear Mr. Willis: 1338 Biglerville Road, PO Box lOSS Gettysburg, PA 17325-1OS5 Telephone : 717/3 34-9211 Fax: 717/334-3980 Web Site: www.adamsec.coop November 21, 2007 Estate: Herman L Willis Patronage # 96710925 `Phis letter is just a reminder that in order to be able to pay out the balance of the patronage capital on this account the a completed Legal Statement will need to be completed and signed in the presence of a Notary Public. You may take the form to the Shippensl~urg District office of Adams Electric. They will help you complete the form and notarize it at no charge to you. As anon-profit utility, Adams Electric Cooperative annually allocates patronage capital to its member-consumers based on their electric: usage or patronage. Each member's annual patronage capital allocation is added to any prior year allocation and becomes subject to cash retirement as financial conditions permit. Patronage capital is required by cooperatives for working capital and equity purposes to secure long-term loans necessary to construct reliable electric facilities to serve mennber-consumers. For the past 28 years, the Cooperative has made special retirements of patronage capital to estates on a discounted lump sum basis. Both the general and special retirements are subject to annual authorization by the Cooperative's. Board of Directors. The special lump sump early retirement of an estate's patronage capital discounts the unretired patronage capital for each year that such arnounts are paid in advance. Applying the process to this estate's patronage capital yields an approximate lump sum amount of $1055.60. In order for the Cooperative to provide the special retirement, please: 1. Complete the enclosed Legal Statement. 2. Sign the Legal Statements in the presence of a Notary Public. ?. Retur!: the Legal State:~.ent ~53 1n tile, er.^viCSed pvStase-pa:d envelope au SUC:i aS pCSSlble. You may also direct t]he funds to a charity of your choice or the, Project Helping Hand program that assists members of the Cooperative. If you have any questnons, please let us know. Otherwise, we look forward to assisting you with settlement of the estate in December 20107. Sincerely, '' 7' me E. Smith filling Coordinator Enclosure -- N ~ ~ ~; m .-~ o N CO o y o W.. ' 14251 HERMAN L. WILLIS flEORDER 885 • U.S. PATENT NO. 5536280, 5576508, 564YY83, G1~35J, 5984364, 60 CHECK NUMBER 6 7 8 04 7 DATE 10 / 12 / 0'7 INVOICE NUMBER DATE DESCRIPTION GROSS AMT. DISCOUNT NET AMOUNT 32006TC 03/20/06 COURT ORDERED R 55854.16 0.00 55554.16 County of Cumberland ~ TOTALS 5 5 8 54.16 0. 0 0 5 5 8 54.16 PLEASE ADDRESS ANY CORRESPOiNDENCE REGARDING THIS VOUCHER ON TRANSACTION TO THE OFFICE OF THE CONTROLLER, CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PA. 17013. ~nriR~>~gaK_Piu~ n ~... ,, ~: -.: z ~ _,. :- -r_,x...'."' t-~ ~ -~ uT~, & ~4.uJ~ . ~ R t1 ,. ~.... .~...,,.- -->,xTa4 ~~ .., S Y ~ *d +S1t.ZjFI ( t ~ '~ ~71 ~ f ~~~ ~ ~ ~ ~ Sovereign Bank. so-7zssns~3 } C7.Y ~ ~~ ~~~ 4C~c~uNT` rtl~~l~NS~'LV:NIA DATE= '' ' CHECK NO. AMOUNT 'f,, a'~' ~ 10 12 07 678047 *****55854.16 j, ~ -l Y 1' X74 y(' ~..''~ ~ Y { ~ f ~ -~+',~'~Z~'~'X*FI~IE THOt7SAND EIGHT HUNDRED FIFTY-FOUR AND 16/100---------------- ~°,~a,.~.~ ~rq~~ t. ri ,.F. ~,` i"r~~ 1 f ~7'~a>`1~i X~: i ' `H~~2P~N T., . W I LL I S ~,~~~U~~ ,~r.. 67 SMITT-IDALE RD tif~ SHTPL~ENSBURG PA 17257 ~* '~ tl DOLLARS SIGNATURE.AREA.CON7AIPlS A KNIGHT & FINGERPRINT CHECi( WORDWG BRUCE BARCLAY CHAIRMAN GARY EICHELBERGER VICE CHAIRMAN RICHARD ROVE:GNO SECRETARY JOHN BYRNE CHIEF OPERATIONS OFFICER EDWARD SCHORPP SOLICITOR STEPHEN D. TILEY ASSISTANT SOLICITOR TAX CLAIM BUREAU OF CUMBERLAND COUNTY One Courthouse Square, Carlisle, PA 17013-3389 (717) 240-6366 I, Richard L. Webber, Jr., representing the co-administrators of the Estate of Herman L. Willis, have received a check in the amount of $55,854:16 from the Tax Claim Bureau which represents the proceeds entitled to Herman L. Willis due to a tax sale of his former property located at 65 7 67 Smithdale Road; Southampton Twp, Cumberland Count, PA, having a parcel number of 39-11-0308-005 Dated: "~-/ /~ ~~ Richard L. Webber, Jr. ., ,~, LOT #J~~ ~ •---'. f ECEIVED BY: y ~~~~~ ~~ DATE ~'~-~ CONSIGN( ADDRESS PHONE CONSIGNMENT CONTRACT AND SETTLF4QENT ~ ... ~ f~,tf~' ` ~~ , ;S fry ~ t,'r: _ f ._,r ;`!-" ~ r, ,~ ~ - ~ ~~ r f ° _~ ' r ~. ~ ; 1 4 L . ~ ~ ) r °~ '~ 1 ~ ~ F J4.. 1 - 5 _ -~•~- ~ i t ~{ ~~'1 i , ~J C a )r-~ f "t -- ' - . ~ '~ 't . t- ~\ `. .i IF"s.. ~ eT +J '~`e lL ~ is .i'~. 2~..- a .~ L ` i i 1 ~_~ SHEET # ~ OF~~ l"OTAL SHEETS I (consignor) hereby commission you to sell the items listed above & on the attached sheets to the highest bidder by public auction. I certify that I am the owner of the above listed items and have good title and the right to sell them. I certify that the items listed are free from all incumbrances. I agree to accept all responsibility for providing good title and for delivery of title to the purchaser. It is agreed that the consignee is not responsible for the loss of any item due to fire, theft, damage, etc. I understand that a % commission will be deducted from the gross sales of my items. "No Bid" items will be disposed of at the discretion of the Auctioneer/Auction House. Payment will be made to the consignor within days from date of s~ le. J~s~_ a~.`.r~'~~ ^•+: ~. ~ ~~.~~• Date 3 .~ } `,t ~ nsignor Sig s j t, ( ~(~` ._~ ~t ? . '_~ ~~~ ~ ~yi~s~~T' ' ~1,1t.r.`~Date _: .°} v- s (:, ~--kuct3n a Luc ion Sta1Y Signature r~~~NAR'3 SETTLEMENT COPY EXPENSES: SETTLEMENT - \\ TOTAL CON533IQNOR SALES COMMISSION ~ $ JJl ~ ~ ~ $ ~ '~ lav ~ ~~ TAXI-ALE u TI-~.k EXEN~t'T Please allow 3-4 weeks for ,. check to be mailed. ,,' ` ',' ` TOTAL EXPENSES cHect< No. NET PAYABLE TO CONSIGNOR 7 ., .• l ~ , ZIP CODE j f___"__®'~~_ p ~s~ 499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-] 2 Weigle & Associates PC Attorneys At Law Shippensburg, Pennsylvania 17257-1397 Re: Estate of Herman L Willis Social Security: 171-28-2621 Date of Death: June 30, 2007 Phone (888) 502-4349 Fax (302) 934-2955 September 27, 2007 Dear Sir or Madam: Per your inquiry dated September 21, 2007, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: Type off Account Checking Account Account Number 67386334 Ownership (Names o, f} Herman L Willis Opening Date 11/20/90 Balance on Date of Death $192.89 Accrued Interest $ 0.00 Total $192.89 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 King Street Office # 717-532-4132. Sincerely, ~ -: Nancy Clagett Records Management ORRST0~ITN B~~ A Tradition of Excellence Z7 Ea~King~~~x__.__ - - - P.O. Box 250 Shippensburg, PA 1725 7 October 1, 2007 To: Weigle & Associates 12fi East King Street Shippensburg Pa 17257 From: Traici Shaffer On•stown Bank Customer Service Center PO BOX 250 Shippensburg, Pa 17257 Re: Estate of Herman L Willis Date of death June 30, 2007 IT IS HER.ERBY CERTIFIED THAT THE ABOVE NAMED DECEDENT, ON THE ABOVE DATE, HAD THE FOLLOWING ACCOUNTS WITH ORRSTOWN BANK CHECKING ACCOUNT Account # Title of Account 640697 Herman L Willis SAVINGS .ACCOUNT Account # Title of Account Date opened Principle Accrued Interest 03/21/89 211.69 0.00 Date opened Principle Accrued Interest CERTIFICATE OF DEPOSIT Account # Title of Account Date Opened Principle Accrued Interest ORRSTOWNBANK A Tradition of Excellence Date 6/23/06 Page 1 Primary Account 647047 Enclosures _.._ i...!i!...i..i.!.i.i i iii ~;i...i.i.i.i..ii._i.~l,~,,~-~_ Robert C Willis Herman L Willis & Jane Peters 67 Smithdale Road Shippensburg PA 17257-9525 WE PUT THE LOW IN LOANS! ASK ABOUT OUR SPECIAL LOW RATE HOME EQUITY LINE TODAY! CP_LL 1-8$$-ORRSTOWN ABOTJT T!-?IS LIMITED T_TME OFFER! C H E C K I N G A C C O U N T S Account Title Robert C Willis Herman L Willis & Jane Peters Free Checking Check Safekeeping Account Numbei° 647047 Statement Dates 5/26/06 thru 6/25/06 Previous Balance 7,530.55 Days In The Statement Period 31 Deposit:>/Credits .00 Average Ledger 7,530.55 Checks/L)ebits .00 Average Collected 7,530.55 Service Fee .00 Interest Paid .00 Current Balanc;e 7,530.55 .~ ,,.~, . JoN~S &~ MARTIN, - A~TCTIONS & APPRAISALS Darryl Jones Neil Martine Newville, PA Shippensburg, PA ,~ SE7'ILEMENT STATEMENT SALE NAME: ~ ~ I i DATE OF SALE ADVERTISING EXPENSES: Lancaster Farmer The Guide Valley Times News Chronicle Other Other ' Sale Flyers Copies Type Setting Total Advertising Cost Total # of Bidder Numbers Total # Sale Sheets Cash Amount In Total $ of Checks Total # all Sale. Sheets ~ r ~'F3 /. ~~ + Advertising Cost _ Auctioneer's % • ~., ~ ~~ ~- ~~ ) , ~~ _ Misc. Charge _ Misc. Charge _ NPt Sale (after expenses) ,$~ / ~ . ~~ Thaak you for the oppomraity to work with you aad your fly.