HomeMy WebLinkAbout05-09-08
~
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
.
County Code Year
File Number
INHERITANCE TAX RETURN 21 08
RESIDENT DECEDENT
-0072
Date of Birth
164186642
12282007
11071920
Decedent's Last Name
Suffix
Decedent's First Name
FREDITH
MI
E
SHAW
(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
181 1. Original Return 0 2. Supplemental Return
o
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
0 4. Limited Estate 0 4a. Future Interest Compromise
(dale of death after 12-12-82)
181 6. Decedent Died Testate 0 7. Decedent Maintained a Living Trust
(Attach Copy of Will) (Attach Copy of Trust)
0 9. Litigation Proceeds Received 0 10 Spousal Poverty Credit (date of death
. between 12-31-91 and 1-1-95)
o
o
8. Total Number of Safe Deposit Boxes
o
11. Election to tax under Sec. 91131A)
(Attach Sch. 0)
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
City or Post Office
CARLISLE
State
PA
ZIP Code
17013
REGISTER OF WILLS USF..i>NL Y
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First line of address
200 NORTH HANOVER STREET
Second line of address
N
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. bgriffie@griffielaw com
Correspondent's e-mail address: .
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements and to the best of my knowledge and belief
it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information' of which preparer has any knowledge. '
SI A TURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE
S,~
ADDRESS
Nancy S. Tritt
s:
17007
DATE
Bradley L Griffie
s-
17013
L
Side 1
15056041147
15056041147
~
D1J
-.J
15056042148
REV-1500 EX
Decedent's Name:
SHAW, FREDITH 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).......................................................... 4.
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E)................ 5.
6. Jointly Owned Property (Schedule F) 0 Separate Billing Requested............. 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) 0 Separate Billing Requested............. 7.
8. Total Gross Assets (total Lines 1-7)....................................................................... 8.
9. Funeral Expenses & Administrative Costs (Schedule H)......................................... 9.
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)................................ 10.
11. Total Deductions (total Lines 9 & 10)..............................................
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, of
transfers under Sec. 9116
(a)(1.2) X ~
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
15.
1,142,497.92
16.
17.
18.
19. Tax Due........................................................
............................................................
19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
L
Side 2
15056042148
Decedent's Social Security Number
164186642
1.
166,900.00
66,456.52
o . 00
2.
252,332.22
o . 0 0
684,595.58
1,170,284.32
25,114.21
2,672.19
11.
27,786.40
1,142,497.92
1,142,497.92
51,412.41
51,412.41
o
15056042148
-.J
REV-1500 EX Page 3
Decedent's Complete Address:
DECEDENT' NAM
Shaw, Fredith E
STREET ADDRESS
31 Mount Rock Road
File Number 21 - 08 - -0072
CITY
STATE
ZIP
Newville
PA
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
17241
(1) 51,412.41
54,000.00
2,570.62
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Credits (A + 8 + C)
(2)
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.
8. Enter the total of Line 5 + 5A. This is the 8ALANCE DUE.
(3)
(4)
(5)
(5A)
(58)
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
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?.......... ......................................................... ................................... ................ ~J D
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
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?.... ................................. ......................................................................
56,570.62
0.00
5,158.21
0.00
Yes
[J
[J
[J
[J
No
[!J
[!J
[!J
[!J
[x]
[]
D
[!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. ~9116 (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. ~9116 (a) (1.1) (ji)]. 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.
'.
SCHEDULE A
REAL ESTATE
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF Shaw, Fredith E
-~-
I --~-~~..-._-
FILE NUMBER
21 - 08 - -0072 ________
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 wilnng seller, neither being compelled to buy or sell, both having
reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on
schedule F.
ITEM DESCRIPTION VALUE AT DATE OF
NUMBER DEATH
--
31 Mount Rock Road 166,900.00
Newville, PA 17241
(Settlement Sheet attached)
TOTAL (Also enter on Line 1, Recapitulation) 166,900.00
.
SCHEDULE B
STOCKS & BONDS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
I FILE NUMBER
21 - 08 - -0072
ESTATE OF Shaw, Fredith E
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
I DESCRIPTION
II Prudential Financial, Inc.
Account No. C0028593911
I 262 Shares at $92.86 per share (Statement attached)
UNITVAL~VALUE AT DATE OF
_-+ DEATH
24,329.32
Thrivent Financial for Lutherans
Thrivent Investment Management
1,587.908 shares at $26.53 per share (Statement attached)
42,127.20
TOTAL (Also enter on line 2, Recapitulation)
1--_______
I 66,456.52
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF Shaw, Fredith E
I FILE NUMBER
21 - 08 --0072
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 DESCRIPTION
NUMBER
Orrstown Bank
Checking Account No. 146000952
(Statement attached)
2 Orrstown Bank
Certificate of Deposit No. 4000020110
(Statement attached)
3 Orrstown Bank
Certificate of Deposit No. 4000020112
(Statement attached)
4 Adams County National Bank
Checking Account No. 129461
(Statement attached)
5 Adams County National Bank
Certificate of Deposit No. 165183
(Statement attached)
6 Adams County National Bank
Certificate of Deposit No. 165182
(Statement attached)
7 Adams County National Bank
Certificate of Deposit No. 165220
(Statement attached)
8 Personal property
(Statement attached)
9 Comcast Refund
VALUE AT DATE OF
DEATH
""- ~---"---
36,635.09
72,155.77
30,312.44
6,319.04
22,194.53
22,261.42
44,794.91
16,875.50
17.74
TOTAL (Also enter on Line 5, Recapitulation)
252,332.22
.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF Shaw, Fredith E
FILE NUMBER
21 - 08 - -0072
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
I
I
10 I Continental General Insurance Premium Refund
I
11 I Thrivent Financial for Lutherans Annuity disbursed
12 I Embarq Refund
I
13 I Erie Insurance Homeowner's Refund
j
14 I Tax proration at real estate settlement
-l\iALUE A-T DATEOF
t-- DEATH
35.60
DESCRIPTION
170.38
7.07
71.00
481.73
Page 2 of Schedule E
*'
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ITEM
NUMBER
I
Shaw, Fredith E I FILE NUMBER
21 - 08 - -0072
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes.
I DESCRIPTION OF PROPERTY DATE OF DEATH I % OFj I EXCLUSION I TAXABLE VALUE
I ~~~I~hdee ~:~e no~~r:~;f~~e :~t~~~r::o~:::~~:ti~~:=iio:or:C:s~:~~ VALUE OF ASSET I~T~~~~T I (IF APPLICABLE) .
I Jackson National Life Ins. Co. 49,739.17 II 100% . I 49,739.17
Annuity Policy No. 0059281420
(Statement attached) I
I
70,216.45 100%
ESTATE OF
2 New York Life
Annuity Policy No. 52126269
(Statement attached)
3 AI.G. Life Companies (U.S.)
Annuity Policy No. TOO01515960
(Statement attached)
4 Allstate Life Insurance Company
Annuity Contract No. GA 0838572
(Statement attached)
5 Prudential Financial
Annuity Contract No. A2013149
I (Statement attached)
6 Thrivent Financial for Lutherans
Annuity Contract No. 3834608
(Statement attached)
7 Thrivent Financial for Lutherans
Annuity Contract No. 9146774
(Statemennt attached)
8 Cash transferred to daughter,
Linda L. Jacoby on December 21,2007
9 Cash transferred to daughter,
Nancy S. Tritt on December 17, 2007
70,216.45
59,308.26 100%
59,308.26
101,155.52 100%
101,155.52
38,653.93 100%
38,653.93
19,045.28 100%
19,045.28
13,434.59 100%
13,434.59
12,000.00 100%
12,000.00
12,000.00 100%
12,000.00
TOTAL (Also enter on line 7, Recapitulation)
684,595.58
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
I FILE NUMBER
21 - 08 - -0072
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes.
ITEM I
NUMBER I
101
Shaw, Fredith E
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,
DATE OF DEATH I
VALUE OF ASSET
I
154,528.89 I
I
100%
I' EXCLUSION I TAXABLE VALUE
(IF APPLICABLE) I .
I ----L
I 154,528.89
I
I
I
Pruco Securities Account - Account No, 5822-1610
Made joint with daughter Nancy S. Tritt on
March 14,2007 (Statement and letter attached)
%OF
DECD'S
INTEREST
11 Pruco Securities Account - Account No. 5347-0467
Made joint with daughter Linda L. Jacoby on
March 14, 2007 (Statement and letter attached)
154,513.49
100%
154,513.49
Page 2 of Schedule G
.
_L__
SCHEDULE H
FUNERAL EXPENSEs &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
21-08--0072
~-~.~_._-_.-
ESTATE OF Shaw, Fredith E
Debts of decedent must be reported on Schedule I.
ITEM I
NUMBER I FUNERAL EXPENSES:
A. 1 I Egger Funeral Home, Inc.
I
I
I
I
DESCRIPTION
AMOUNT
773.78
B.
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Social Security Number(s) / EIN Number of Personal Representative(s):
Street Address
City
Year(s) Commission paid
Attorney's Fees Griffie & Associates
State
Zip
2.
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
4,000.00
Street Address
City
Relationship of Claimant to Decedent
State
Zip
4.
Probate Fees
Register of Wills
700.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs
TOTAL (Also enter on line 9, Recapitulation)
25,114.21
.
Schedule H
Funeral Expenses &
Administrative Costs continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF Shaw, Fredith E
2
I The Sentinel (Ad)
I
I Cumberland Law Journal (Ad)
I PPL Electric Utilities
Bank fees on estate account
3
4
5
6
PPL Electric Utilities
7
Realtor's Commission
8
Notary fees
9
Realty Transfer Tax
10
Newville Water & Sewer Authority (Final)
11
I Realtor Transaction Fee
I Seller contribution to buyer closing costs
I
i Real estate tax proration
I Auction costs
I
I Reserves
I
I
I
12
13
14
15
Page 2 of Schedule H
150.614
75.00
I
18.1~
10.0$
27.32
10,014.00
10.od
1,669.0q
67.001
125.00
1,000.00
51.72
5,922.65
500.00
~
i
!
'.
SCHEDULE I
DEBTS OF DECEDENT, MORTGAGE
LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF Shaw, Fredith E
I FILE NUMBER
21 - 08 - -0072
Include unreimbursed medical expenses.
ITEM DESCRIPTION AMOU~T
NUMBER
-~ f-- I
1 PPL Electric Utilities 44.25
i
2 Newville Water & Sewer Authority 99.35
i
I
3 Masland Associates (Medical) ~5.00
I
4 Erie Insurance Group (Homeowners) 411.00
!
5 Greenridge Village (Room & Board) 1,02b.14
6 United States Treasury 1 ,26~.OO
(2007 Personal Income Taxes)
7 Pennsylvania Department of Revenue 17l 3.45
(2007 Persona/Income Taxes)
TOTAL (Also enter on Line 10, Recapitulation) 2,672 .19
m=V-1513 EX';: (9-00)
.
SCHEDULE J
BENEFICIARIES
ESTATE OF
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
I FILE NUMBER
21 - 08 - -0072
SHARE OF ESTATE I AMOUNT O~ ESTATE
(Words) ($$$~
---:
Shaw, Fredith E
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)
NUMBER
Linda L. Jacoby
25 Strawberry Drive
Carlisle, PA 17013
Daughter
I Fifty Percent
21
I
i
I
I
I
I
I
Nancy S. Tritt
33 Silver Maple Drive
Boiling Springs, PA 17007
Daughter
Fifty Percent
I
i Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet
II.
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS
NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET!
I
I
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'\
LAST WILL AND TESTAMENT
OF
FREDITH E. SHAW
I, FREDITH E. SHAW, of 31 Mt. Rock Road, Newville, Cumberland County,
Pennsylvania, being of sound and disposing mind, memory and understanding, do make,
publish and declare this to be my Last Will and Testament, hereby revoking and making
void all previous Wills and Codicils heretofore made by me.
FIRST
I order and direct my Executor hereinafter named to pay all of my just debts,
funeral expenses and expenses involved or connected with the administration of my
estate, including all taxes that may be assessed in consequence of my death, as soon after
my death as is reasonably possible from the proceeds and assets of my estate prior to any
other distributions. However, my Executor need not accelerate and pay those unmatured
obligations which, in his, her or its opinion, it might be proper and more advantageous to
retain or renew and pay as they become due and payable. I have already secured a burial
plot and grave marker at the Newville Cemetery, Newville, Pennsylvania, and direct that
my remains be interred there.
GRIFFIE & ASSOCIATES
Attorneys At Law
200 N. Hanover Street
Carlisle, PA 17013
Page 1 of7
100 Lincoln Way East, Suite D
Chambersburg, PA 17201
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,
SECOND
I give, devise and bequeath my entire estate of whatsoever nature and wheresoever
situate, together with all insurance proceeds thereon, in equal shares to my children,
NANCY S. TRITT, of 33 Silver Maple Drive, Boiling Springs, Pennsylvania, and
LINDA L. JACOBY, of 102 Woodcrest Drive, Carlisle, Pennsylvania, who survive me
by sixty (60) days, per stirpes. It is further my desire that my Executor/Executrix, after
consultation with any heir or heirs of mine who survive me, and in his, her or its own
discretion, choose such articles from my tangible personal property (exclusive of cash,
stock certificates, bonds, and all other tangible evidences of intangible personal property)
as he, she or it believes will be useful to such heir or heirs or desirable for him or her or
them to have, either from a sentimental point of view or otherwise, and to deliver such
articles to such heir or heirs or among such heirs in equal or unequal shares as determined
by the further exercise of his, her or its discretion, provided no other heir objects to the
distribution. All tangible personal property not so distributed is to be sold, either publicly
or privately, by my Executor/Executrix, adding the proceeds of such sale or sales to my
residuary estate and to be disposed of in equal shares among my surviving heirs after
payment of my estate debts, taking into account the tangible personal property otherwise
provided to them.
THIRD
I grant my Executor/Executrix the following powers in addition to and not in
limitation of such powers as my ExecutorlExecutrix shall hold by law:
(a) To retain all property received including the stock of any corporate fiduciary
acting hereunder, provided such property remains productive.
GRIFFIE & ASSOCIATES
Attorneys At Law
200 N. Hanover Street
Carlisle, PA 17013
Page 2 of7
100 Lincoln Way East, Suite D
Chambersburg, PA 17201
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(b) To Jom m any corporation, partnership, recapitalization, merger,
reorganization or voting trust plan; to delegate authority with respect thereto;
to deposit investments under agreements and pay assessments; and generally
to exercise all rights of investors, including but not limited to, the voting of
shares.
(c) To manage, operate, repair, improve, mortgage or lease on any terms any real
estate held or owned by my estate.
(d) To operate any business that I may own at my death.
(e) To invest any funds of my estate in any stocks, bonds, notes or other securities
or property, real or personal, without regard to the principle of diversification
or any other statute or general rule of law in his, her or its absolute discretion,
it being my intention to give my Executor/Executrix the broadest investment
powers possible, providing such investments do not unnecessarily prevent the
prompt settlement of my estate.
(t) To sell or otherwise dispose of any property, real or personal, tangible or
intangible, at any time forming a part of my estate in any manner and on such
terms and conditions as my Executor/Executrix shall see fit in his, her or its
absolute discretion.
(g) To borrow money for the payment of taxes or for any other proper purposes in
the administration of my estate, and to mortgage or pledge estate assets as
security.
(h) To compromise claims without court approval including, but not limited to,
200 N. Hanover Street
Carlisle, PA 17013
any controversies with the United States of America or the Commonwealth of
GRIFFIE & ASSOCIATES
Attorneys At Law
Page 3 of7
100 Lincoln Way East, Suite D
Chambersburg, PA 17201
Pennsylvania concerning estate and inheritance taxes on any interests that may
pass under this my Last Will and Testament.
(i) To distribute in cash or in kind upon any division or distribution of my estate.
G) To undertake any and all acts deemed necessary and proper by my
ExecutorlExecutrix for the proper, advantageous and prompt management of
the settlement of my estate.
(k) In general, to exercise all powers in the management of my estate which any
individual could exercise in the management of similar property owned in his
own right, upon such terms and conditions as to him, her or it may seem best
and to execute and deliver all instruments and to do all acts which he, she or it
deems necessary or proper to carry out the purposes of this, my Last Will and
Testament.
FOURTH
No interest of any beneficiary of my estate, either in income or in principal, shall
be subject to anticipation or pledge, assignment, sale or transfer in any manner, nor shall
any beneficiary have the power in any manner to charge or encumber his interest either in
income or principal, nor shall the interest of any beneficiary be liable or subject in any
manner while in the possession of my Executor/Executrix for the liability of such
beneficiary .
FIFTH
I nominate, constitute and appoint my daughter, NANCY S. TRITT, as Executrix
of this my Last Will and Testament. In the event my daughter is deceased, unable or
unwilling to serve or shall cease to serve for any reason whatsoever, then I nominate,
GRIFFIE & ASSOCIATES
Attorneys At Law
Page 4 of7
200 N. Hanover Street
Carlisle, PA 17013
100 Lincoln Way East, Suite D
Chambersburg, PA 17201
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constitute and appoint my daughter, LINDA L. JACOBY, as Executrix of this my Last
Will and Testament. I direct that my Executor/Executrix shall not be required to give or
post bond for the faithful performance of his, her or its duties in this or any other
jurisdiction.
SIXTH
I hereby declare it to be my expressed desire that my Executor/Executrix employ
the law firm of Griffie & Associates, of Carlisle, Pennsylvania, for legal advice and
assistance regarding this my last Will and Testament, they having considerable
knowledge of my affairs, views and wishes respecting any matters that may arise at the
probate of this instrument, the administration of my estate, and the execution of the
powers herein mentioned.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last
Will and Testament, consisting of seven (7) typewritten pages, the first four (4) of which
bear my signature on the side margin, for purpose of identification, this
.ff
/
.
day of J1lll1_cL
.
, 2005.
WITNESS: ...
/!er-C(7 ~
~
y--. if, r
o -h_LeL . c.... ___b 'L(L/U-'
FREDITH E. SHAW
200 N. Hanover Street
Carlisle, PA 17013
GRIFFIE & ASSOCIATES
Attorneys At Law
Page 5 of7
100 Lincoln Way East, Suite D
Chambersburg, PA 17201
~
~
c~
\
-
c0
~
., ..)
.....)
r.o
~
( ---..
\'7)
.....
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA:
: SS.
COUNTY OF CUMBERLAND
I, FREDITH E. SHAW, the Testatrix whose name is signed to the attached or
foregoing instrument, having been duly qualified according to law, do hereby
acknowledge that I signed and executed the instrument as my Last Will and Testament;
that I signed it willingly, and that I signed it as my free and voluntary act for the purposes
therein expressed.
~.... i ,1 () cor
.j ..f'u...cl.CC1t.- L/,..-<CYJ;t c::L(/r.-r-
FREDITH E. SHAW
Sworn or affirmed and acknowledged before me by the Testatrix this
j;:t:
day of
/lLMd
.
, 2005.
~/
OTARIAL SEAL
ROBI" J. GOSHORN. NOTARY PUBLIC .
CARLISLE BORG., CUMBERLAND COUNTl
MY COMMISSION EXPIRES APRIL 17 2001
200 N. Hanover Street
Carlisle, PA 17013
GRIFFIE & ASSOCIATES
Attorneys At Law
Page 6 of7
100 Lincoln Way East, Suite D
Chambersburg, PA 17201
AFFIDA VIT
COMMONWEALTH OF PENNSYLVANIA:
: SS.
COUNTY OF CUMBERLAND
WE, (Y'\Dr'\~ ~,r~ and fSro...dk7 L, G\.-~fC;
the witnesses whose names are attached to the foregoing document, being duly qualified
according to law, do depose and say that we were present and saw the Testatrix sign and
execute the instrument as her Last Will and Testament; that she signed willingly and that
she executed it as her free and voluntary act for the purposes therein expressed; that each
subscribing witness in the hearing and sight of the Testatrix signed the Last Will and
Testament as witnesses and that to the best of our knowledge the Testatrix was at the time
18 or more years of age, of sound mind and under no constraint or undue influence.
"
and
Sworn or affirmed and subscribed before me by
nl ~~ S t!,;},;t this f~. day of
I
/Y2a.-itL
, 2005.
//t?~a.Ll4~
Notary Public (j
NOTARIAL SEAL
ROB1N J. GOSHORN, NOTARY PUBUC
CARLISLE BOOO., CUMBERlAND COUNTY
MY COMMISSION EXPIRES APRil 17 2007
200 N. Hanover Street
Carlisle, PA 17013
GRIFFIE & ASSOCIATES
Attorneys At Law
Page 7 of7
100 Lincoln Way East, Suite D
Chambersburg, PA 17201
ATTACHMENT TO SCHEDULE "A"
Prevloua edltlona are obaolete
41 A. Settlement Statement
f ".~ u.s. Department of Housing and Urban Development
". OMS No. 2502-0265 (expires 11/30/2009)
FRANKLIN REAL ESTATE SERVICES AND ABSTRACTING COMPANY, INC. S. TYPE OF LOAN
1035 WAYNE AVENUE. CHAMBERSBURG, PA 17201 1. OFHA 2. OFmHA 3. OConv. Unins.
TEL. 717-264-3290
FAX: 717-264-1985 4. OVA 5. K1Conv. Ins.
6. FILE NUMBER /7. LOAN NUMBER
CT A0945 51415420
8. MORTGAGE INSURANCE CASE NUMBER
C. Note: I ma onn Ta firrnlalied,to give you a atatement Of actullaeRlement coata. Amounta paid, to and y tne aeRlement agent are anown. I TitleExpress Settlement System
Itema marked "(p.o.c.)" were paid outalde the cloalng; they are ahown here for Infonnatlon purpoaea and are not Included In the lotala.
WARNING: It la a crime to knowingly make falae atatementa to Ihe United Statea on thla or any other almllar fonn. PenallJea upon
conviction can Include a line and ImDrlaonment. For detalla aee: TItle 18 U. S. Code Section 1001 and Section 1010. Printed 03/06/2008 at 12:03 JLF
D. NAME OF BORROWER: Joseph P. Miller and Vanessa J. Stenger
ADDRESS: 14 East Burd Street Shippensburg, PA 17257
E. NAME OF SELLER: Estate of Fredith Shaw
ADDRESS: 33 Silver MaDle Drive Boilina SDrinas PA
F. NAME OF LENDER: Patriot Federal Credit Union
ADDRESS: 800 Wavne Avenue. Chambersbura. PA 17201
G. PROPERTY ADDRESS: 31 Mount Rock Road, Newville, PA 17241
West Pennsboro Township
H. SETTLEMENT AGENT: Franklin RE Services and Abstracting Co., Telephone: 717-264-3290 Fax: 717-264-1985
PLACE OF SETTLEMENT: 1035 Wavne Avenue. Chambersbura. PA 17201
I. SETTLEMENT DATE: 03/07/2008
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 orice 166900.00 401. Contract sales Drice 166900.00
102. Personal Prooertv 402. Personal Prooertv
103. Settlement charaes to borrower (line 1400) 6 269.37 403.
104. 404.
105. 405.
Adjustments for items oaid bv seller in advance Adiustments for items oaid bv seller in advance
108. School Taxes 03/07/08 to 06/30/08 481.73 408. School Taxes 03/07/08 to 06/30/08 481.73
109. 409.
110. 410.
111. 411.
112. 412.
120. GROSS AMOUNT DUE FROM BORROWER 173.651.10 420. GROSS AMOUNT DUE TO SELLER 167.381.73
200. AMOUNTS PAID BY OR ON BEHALF OF BORROWER 500. REDUCTIONS IN AMOUNT DUE TO SELLER
201. DeDosit or eamest money 1.000.00 501. Excess Deoosit (see instructions)
202. Princioal amount of new loans 136 900.00 502. Settlement charoes to seller (ljne 1400) 11 885.00
203. Existina loan(s) taken subiect to 503. Existina loan(s) taken subiect to
204. 504. Payoff of First Mortaaae Loan
205. 505.
206. 506.
207. 507.
208. 508.
209. 509.
Adjustments for items unDaid bv seller Adiustments for items unDaid bv seller
211. County taxes 01/01/08 to 03/07/08 51.72 511. County taxes 01101/08 to 03/07/08 51.72
213. 513.
214. 514.
215. Seller Paid Closina Costs 1 000.00 515. Seller Paid Closino Costs 1 000.00
216. 516.
217. 517.
218. 518.
219. 519.
220. TOTAL PAID BYIFOR BORROWER 138.951.72 520. TOTAL REDUCTION AMOUNT DUE SELLER 12.936.72
300. CASH AT SETTLEMENT FROM OR TO BORROWER 600. CASH AT SETTLEMENT TO OR FROM SELLER
301. Gross amount due from borrower (line 120) 173.651.10 601. Gross amount due to seller (ljne 420) 167 381.73
302. Less amounts oaid bvlfor borrower (ljne 220) 138951.72 602. Less reduction amount due seller (line 520) 12936.72
303. CASH FROM BORROWER 34 699.38 603. CASH TO SELLER 154445.01
fonn HUO.1 (3/86) ref Handbook 4305.2
TIN:_"_" 1_"_"
SELLER(S) NEW MAILING ADDRESS:
SELLER(S) PHONE NUMBERS:
You are required by law to provide the aeRlement egent (Fed. Tex 10 No: I with your correct taxpayer Identlflcallon number. If you do not provide your correct taxpayer Identlncatlon
number, you may be aubJect to civil or criminal penalllea Impoaed by law. Under penaltlea of perjury, I certify that the number ahown on thla atatementla my correct taxpayer Identlncallon number.
SUBSTITUTE FORM 1099 SELLER STATEMENT: The Infonnatlon contained herein la Important tax Informallon and la being furnlahed to the Internal Revenue Service. If you are required to nle a return
a negligence penalty or other aanctlon will be Impoaed on you Ifthla Item la required to be reported and the IRS determlnea that It has not been reported. The Contract Salea Price deacrlbed on '
line 401 above conatltutea the Groaa Proceeda of thla tranaactlon.
SELLER(S) SIGNATURE(S):
(HI
(W)
Previous editions are obsolete
U.S'. D~PARTMENT OF HOUSING AND URBAN DEVELOPMENT
SETTLEMENT STATEMENT
File Number: CT A0945
TIlE Sttl tS
form HUD-1 (3/86) ref Handbook 4305.2
PAGE 2
I e xoress e emen )ys em nn e at
L. SETTLEMENT CHARGES PAID FROM PAID FROM
700. TOTAL SALES/BROKER'S COMMISSION based on price $166.900.00 = 10 014.00 BORROWER'S SELLER'S
Diyision of commission (line 700\ as follows: FUNDS AT FUNDS AT
701. $ 5.032.00 to B-H Aaencv SETTLEMENT SETTLEMENT
702. $ 4,982.00 to Exit Platinum Plus
703. Commission oaid at Settlement 10014.00
704. Transaction Fee to Exit Platinum Plus 195.00
800. ITEMS PAYABLE IN CONNECTION WITH LOAN
801. Loan Oriaination Fee %
802. Loan Discount %
803. Aooraisal Fee to Barrett Aoorisals (P.O.C.) 300.00 Buyer 25.00
804. Credit Reoort to TransUnion 30.56
805. Lender's Insoection Fee
806. Mortaaae Aoolication Fee
807. Tax Service Fee to PHH Mortaaae Services 85.00
808. Processina Fee to Patriot Federal Credit Union LR 200.00
809. Underwritina Fee to PHH Mortaaae Services 350.00
810. Flood Certification Fee to PHH Mortaaae Services 19.50
811.
900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE
901. Interest From 03/07/2008 to 04/0112008 {(i)$ 23.9106 /dav 25 Davs LR 597.77
902. Mortaaae Insurance Premium for to
903. Hazard Insurance Premium for to State Farm (P.O.C.) 362.00 Buver
904.
905.
1000. RESERVES DEPOSITED WITH LENDER FOR
1001. Hazard Insurance 3 mo. ((i)$ 30.17 /mo LR 90.51
1002. Mortaaae Insurance mo. <1'i! $ /mo
1003. City Prooertv Tax mo.<1'i!$ /mo
1004. County Prooerty Tax 3 mo. {(i) $ 37.61 /mo LR 112.83
1005. School Taxes 11 mo. <1'i! $ 129.25 /mo LR 1 421.75
1009. Aaareaate Analysis Adiustment to Patriot Federal Credit Union LR .271.14 0.00
1100. TITLE CHARGES
1101. Settlement or closina fee
1102. Abstract or title search
1103. Title examination
1104. Title insurance binder
1105. Document Preoaration
1106. Notarv Fees to Bonita M. Crawford 10.00 10.00
1107. Attornev's fees
(includes above items No: )
1108. Title Insurance to Franklin Real Estate Services 1,193.75
(includes above items No: Regular Rate )
1109. Lender's Policv 136 900.00 .
1110. Owner's Policy 166 900.00 . 1.193.75
1111. End 100 End 300 End 900 to Franklin Real Estate Services 150.00
1112.
1113.
1200. GOVERNMENT RECORDING AND TRANSFER CHARGES
1201. Recordina Fees Deed $ 38.50 . Mortaaae $ 64.50 . Release $ 103.00
1202. CitY/County tax/stamos Deed $1669.00 . Mortaaae $ 1 669.00
1203. State Tax/stamos Deed $1 669.00 . Mortaaae $ 1 669.00
1204.
1205.
1300. ADDITIONAL SETTLEMENT CHARGES
1301. Survey
1302. Pest Insoection
1303. 08 Ctv Txs Par-46-20-1758-052 to Deborah W. Pioer 286.84
1304. Final Water & Sewer Bill to Borouah of Newville 67.00
1305. Transaction Fee to B-H Aaencv 125.00
1306.
1307.
1308.
1400. TOTAL SETTLEMENT CHARGES (enter on lines 103 Section J and 502 Section Kl 6 269.37 11 885.00
p' t d 03/06/2008 1203 JLF
HUD CERTIFICATION OF BUYER AND SELLER
I have carefully ravlewed the HUD.1 Settlement Stetement and to the beat of my knowledge and brllef. it la a true and accurate atatement fall racelpta and dlabursementa made on my account or by m
in thla tranaactlon. I further certify that I ~"e racelved a copy of the HUD.1 Settlement Statem,t
~A It' YJrn.tJfl'j ^' 1 I ,
Jot? .
~_~'5'. l~, l:Ste~,",,"~
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 AND IMPRISONMENT. FOR DETAILS SEE TITLE 18:
U.S. CODE SECTION 1001 AND SECTION 1010.
By:
.
a A. Settlement Statement
...~ ,'.
. 1'., u.s. Department of Housing and Urban Development
OMS No. 2502-0265 (exoires 1113012009)
FRANKLIN REAL ESTATE SERVICES AND ABSTRACTING COMPANY, INC. S. TYPE OF LOAN
1035 WAYNE AVENUE. CHAMBER5BURG, PA 17201 1. DFHA 2. DFmHA 3. DConv. Unins.
TEl. 717-264-3290
FAX, 717-264-1985 4. nVA 5. K1Conv. Ins.
6. FILE NUMBER /7. LOAN NUMBER
CT A0945 51415420
8. MORTGAGE INSURANCE CASE NUMBER
C. Note: It:~. ~":rtc~d~p~:~)"(~::- ~~~ :~~~m~~ cjO:I~;.tt:.e;~==~.:"r:'Fo~~:Sor:~~~~ ~~.:'.~-::'=~~: :,oC~~~:~I~~o:'r~gl.. I TilleExpress Settlement System
~~~:~o~: ~~~ 1~1~':e' ~~~~~~~"f:D~::~:~~~ ~::'c:~: :::~~~~I~;dU~;.t~~~~ ~~r:n'~Xo~t:~~ .~~~~~~o1~.t.n.ItJ.. upon Printed 03/06/2008 at 12:03 JLF
D. NAME OF BORROWER: Joseph P. Miller and Vanessa J, Stenger
ADDRESS: 14 East Burd Street Shiooensbura. PA 17257
E. NAME OF SELLER: Estate of Fredith Shaw
ADDRESS: 33 Sliver Maole Drive. BoHina Sonnas. PA
F. NAME OF LENDER: Patriot Federal Credit Union
ADDRESS: 800 Wavne Avenue Chambersbura. PA 17201
G. PROPERTY ADDRESS: 31 Mount Rock Road, Newville, PA 17241
West Pennsboro Townshic
H. SETTLEMENT AGENT: Franklin RE Services and Abstracting Co" Telephone: 717.264-3290 Fax: 717.264-1985
PLACE OF SETTLEMENT: 1035 Wavne Avenue Chambersburo. PA 17201
I. SETTLEMENT DATE: 03/07/2008
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 orice 166 900.00 401. Contract sales orice 166 900.00
102. Personal Pronertv 402. Personal Pronertv
103. Settlement charaes to borrower {line 1400\ 6 269.37 403.
104. 404.
105. 405.
Ad'ustments for items oaid bv seller in advance Ad'ustments for items oaid bv seller in advance
108. School Taxes 03/07/08 to 06/30/08 481.73 408. School Taxes 03/07/08 to 06/30/08 481.73
109. 409.
110. 410.
111. 411.
112. 412.
120. GROSS AMOUNT DUE FROM BORROWER 173 651.10 420. GROSS AMOUNT DUE TO SELLER 167381.73
200. AMOUNTS PAID BY OR ON BEHALF OF BORROWER 500. REDUCTIONS IN AMOUNT DUE TO SELLER
201. Deoosit or earnest monev 1 000.00 501. Excess Denosit {see instructions}
202. Princioal amount of new loans 136 900.00 502. Settlement charaes to seller lIine 14001 11.885.00
203. Existinn loan/s\ taken subiect to 503. Existino loan{s) taken subiect to
204. 504. Pavoff of First Mortnaae Loan
205. 505.
206. 506.
207. 507.
208. 508.
209. 509.
Adiustments for items unoaid bv seller Adiustments for items uncaid bv seller
211. Countv taxes 01/01/08 to 03/07/08 51.72 511. Countv taxes 01/01/08 to 03/07/08 51.72
213. 513.
214. 514.
215. Seller Paid Closinn Costs 1 000.00 515. Seller Paid Closinn Costs 1 000.00
216. 516.
217. 517.
218. 518.
219. 519.
220. TOTAL PAID BY/FOR BORROWER 138951.72 520. TOTAL REDUCTION AMOUNT DUE SELLER 12.936.72
300. CASH AT SETTLEMENT FROM OR TO BORROWER 600. CASH AT SETTLEMENT TO OR FROM SELLER
301. Gross amount due from borrower lIine 120\ 173651.10 601. Gross amount due 10 seller (line 420\ 167.381.73
302. Less amounts naid bvlfor borrower I/ine 2201 138951.72 602. Less reduction amount due seller (line 5201 12,936.72
303. CASH FROM BORROWER 34 699.38 603. CASH TO SELLER 154.445.01
form HUD.1 (3186) ref Handbook 4306.2
SUBSTITUTE FORM 1098 SELLER STATEMENT: The Information contained herein Is Important tax Information and Is being furnished to the Intemal Re....enue Service. It you are required to file I return,
e negligence penalty or other ..nctlon will be Imposed on you II this Item Is required to be reported and theiRS determines that ft has not been reported. The Contract Sale. Price deSCribed on
line 401 above constitute. the Gross Proceeds of this transaction,
You are required by law to provtde the uttlement agent (Fed. Tax 10 No: . ) with your correct taxpayer IdentJflcatlon number. If you do not provide your correct taxpayer Identification
number, you may be subject to cMI or crlmln.1 penalties Imposed by I.w. Under penalties of perjury, I certify th.t the number shown on this statement Is my correct taxp.yer Identification number.
TIN:_._"_,_._w_ SELLERIS)SIGNATURE(S):
SELLER(S) NEW MAJUNG ADDRESS:
SELLER(S} PHONE NUMBERS:
(H)
(W)
r,........,. .....UUU. .,.. Uuaul"'.
U.S: DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT
SETTLEMENT STATEMENT
File Number: CT A0945
form HUD~1 (3(86) ref Handbook 4305.2
PAGE 2
TitleExoress Settlement System Printed 0310612008 at 12:03 JLF
L. SmLEMENT CHARGES PAID FROM PAID FROM
700. TOTAL SALES/BROKER'S COMMISSION based on price $166 900.00 = 10 014.00 BORROWER'S SELLER'S
Division of commission (line 7001 as follows: FUNDS AT FUNDS AT
701. $ 5 032.00 to B-H Agency SETTLEMENT SETTLEMENT
702. $ 4 982.00 to Exit Platinum Plus
703. Commission oaid at Settlement 10014.00
704. Transaction Fee to Exit Platinum Plus 195.00
800. ITEMS PAYABLE IN CONNECTION WITH LOAN
801. Loan OriQlnafion Fee %
802. Loan Discount %
803. Aooraisal Fee to Barrett Aoorisals (P.O.C.) 300.00 Buver 25.00
804. Credit Report to TransUnion 30.56
805. Lender's Insoection Fee
806. Mortnaoe Aoolication Fee
807. Tax Service Fee to PHH Mortaage Services 85.00
808. ProcessinQ Fee to Patriot Federal Credit Union LR 200.00
809. Underwritino Fee to PHH Mortgage Services 350.00
810. Flood Certification Fee to PHH Mortgage Services 19.50
811.
900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE
901. Interest From 03/0712008 to 04101/2008 @$ 23.9106 Iday 25 Davs LR 597.77
902. Mortoaoe Insurance Premium for to
903. Hazard Insurance Premium for to State Farm (P.O.C.l 362.00 Buver
904.
905.
1000. RESERVES DEPOSITED WITH LENDER FOR
1001. Hazard Insurance 3 mo. @ $ 30.17 Imo LR 90.51
1002. Mortnane Insurance mO.@$ Imo
1003. City Prooeriv Tax mo.@$ Imo
1004. County Prooeriv Tax 3 mo. @ $ 37.61 Imo LR 112.83
1005. School Taxes 11 mO.@$ 129.25 Imo LR 1 421.75
1009. AQQreQate Analysis Adiustment to Patriot Federal Credit Union LR -271.14 0.00
1100. TITLE CHARGES
1101. Settlement or closinn fee
1102. Abstract or title search
1103. Title examination
1104. Title insurance binder
1105. Document Preparation
1106. Notarv Fees to Bonita M. Crawford 10.00 10.00
1107. Attornev's fees
{includes above nems No: 1
1108. Title Insurance to Franklin Real Estate Services 1193.75
{includes above items No: Regular Rate 1
1109. Lender's Policy 136 900.00 -
1110. Owner's Policy 166 900.00 - 1 193.75
1111. End 100 End 300 End 900 to Franklin Real Estate Services 150.00
1112.
1113.
1200. GOVERNMENT RECORDING AND TRANSFER CHARGES
1201. RecordinQ Fees Deed $ 38.50 . Mortoaoe $ 64.50 . Release $ 103.00
1202. CitvlCountv tax/stamps Deed $1,669.00 . Mortnane $ 1 669.00
1203. State Tax/stamps Deed $1.669.00 . MortQaQe $ 1 669.00
1204.
1205.
1300. ADDITIONAL SETTLEMENT CHARGES
1301. Survey
1302. Pest Insoection
1303. 08 Ctv Txs Par-46-20-1758-052 to Deborah W. Piper 286.84
1304. Final Water & Sewer Bill to Borough of Newville 67.00
1305. Transaction Fee to B-H Agencv 125.00
1306.
1307.
1308.
1400. TOTAL SETTLEMENT CHARGES (enter on lines 103 Section J and 502 Section K\ 6 269.37 11 885.00
Hue CERTlFICAnON OF BUYER AND SELLER
1 have carefully reviewed the HUD-1 Settlement Statement and to the be.t of my knowledge and b,U.f, tt I. a true and accurate statoment of all...ceiptl5 and disbursements made on my account or by m
In thlo '..noootion. I 'urthor eortlfy tho. I ~ 0 roeol.od 0 copy of tho HUP.1 Sottlomont Ste.ome!"1 JiJ.
( ~ / , l.cbti.iJJiJ I. rrnr
Ov . 0 . ftgi J' '"
..}?,~~0.~. ~e.<::JA.-4,.~
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 AND IMPRISONMENT. FOR DETAILS SEE TITLE 18:
U.S. CODE SECnON 1001 AND SECTION 1010.
By:
ATTACHMENT TO SCHEDULE "B"
\f Thrivent Investment Management'
P.O. Box 219348, Kansas City, MO 64121-9348
Phone: 800-THRIVENT (800-847-4836)
E-mail: mail@thrivent.com. www.thrivent.com
Member FINRA. Member SIPe.
A subsidiary of Thrivent Financial for Lutherans@
Appleton, WI . Minneapolis, MN
January 30,2008
Nancy S Tritt
33 Silver Maple Dr
Boiling Sprgs PA 17007-9598
RE: 00465462
THRIVENT LARGE CAP STOCK FUND - A
ACCOUNT NUMBER 990033900
FREDITH E SHAW
Dear Ms. Tritt:
We have received your request for information. In the table below we have listed the December 28,2007
account value for the above referenced account.
Any shares and balances of the mutual funds listed reflect values as of the date quoted. A mutual fund
account balance is based on the net asset value share prices as of specific dates; values may fluctuate on a
daily basis.
Please note we are only providing the requested information. We do not evaluate the credit worthiness
of our shareholders.
As of December 28, 2007
Fund Name
Account
Number
990033900
Number of
Shares
1,587.908
Price Per
Share
$26.53
Balance
$42,127.20
If you have any questions, please call us at 800-847-4836. Business hours are Monday through Friday
from 7 a.m. to 9 p.m. and Saturday from 9 a.m. to 1 p.m. Central time.
Sincerely,
j:J/~
Dale Robinett
Lead Mutual Fund Representative
ATTACHMENT TO SCHEDULE "E"
~
ORRSTOWN
BANK
A Tradition of Excellence
January 31, 2008
To: Griffie & Associates
200 North Hanover Street
Carlisle Pa 17013
From: Traci Shaffer
Orrstown Bank
Customer Service Center
PO BOX 250
Shippensburg, Pa 17257
Re: Estate of Fredith Shaw
Date of death December 28, 2007
IT IS HERERBY CERTIFIED THAT THE ABOVE NAMED DECEDENT, ON THE
ABOVE DATE, HAD THE FOLLOWING ACCOUNTS WITH ORRSTOWN BANK
CHECKING ACCOUNT
Account # Title of Account
146000952 Fredtih E Shaw
Date opened
04/18/07
Principle
36538.95
Accrued Interest
96.14
SA VINGS ACCOUNT
Account # Title of Account
Date opened Principle
Accrued Interest
CERTIFICATE OF DEPOSIT
Account # Title of Account
4000020110 Fredith E Shaw
Date Opened Principle
10/05/07 71951.29
Accrued Interest
204.48
4000020112 Fredith E Shaw
10/05/07
30226.54
85.90
P.O. Box 250 · Shippensburg, PA 17257 . 717.530.3530 . 717.532.4143 fax
~ ADAMS COUNlY
NATIONAL BANK
January 29, 2008
Griffie & Associates
Attorneys and Counselors at Law
200 North Hanover St
Carlisle, PA 17013
Re: Estate of Fredith E Shaw
Dear Mr. Griffie:
The following information is being provided as per your request:
Acct. Type Account No.
Account
Principal on
D.O.D.
$6,317.86
$21,702.89
$21,851.76
$44,365.28
Checking
C.D.
C.D.
C.D.
129461
165183
165182
165220
Accrued
Interest to
D.O.D.
$1.18
$491.64
$409.66
$429.63
Ownership
Date Opened
Individual
Individual
Individual
Individual
2-14-85
2-18-05
2-18-05
4-15-05
Inquiries concerning ACNB Corporation stock information should be directed to the Registrar and Transfer
Company at 1-800-368-5948. If you need any additional information, please contact me at (717)339-5116.
Sincerely,
'A oV:J Q. h ~
Lois A Kime
Deposit Services
nNAL SETTLEMENT
. / Dol. 7~~'?
OWNER ~':}j 1/ ~;/~/::; .~~--- (~h/~4' '--u /'
Address . ..:1/ '.;~ 4/te--:? ~ '/t?~/,,?~:/ ,/
Del. of Sel. (!~~(.?#~d ,0Sel. lO"t;on~~~~~4;;:V
Auctioneer....-.:;;///,:1' ,;<7?;~>;u-~// ~~ ~ _4 _ _.. _ _~L
Other
{ ,
Ii
PROCEEDS OF SALE:
Cash...m ..........m....m................. ... $
/~/ ?75, qJ
Checks...m.Um....h..........m..Um .m
Oth er....h...... ...........mum..... m .... ......m.m ... ..........m...... m. m.m m....
-
/ "
;r
()
Miscellaneous (see attached list)........mm..................m.
:>0
TOTAL PROCEEDS OF SALE................m...........$ / ~ g 7.:5' ,
LESS SELLER'S SALE EXPENSE: ~
::~:~~;'iuu~;4:.;$~6;7,
Advanced by Auctioneer:
6.'51/ 5/~~~~~ fl;md ~ff )
~~A2~
_~kz.
f4f,///~/ ~
"~
-
~>
/c/(J ,
(JO
/o~,
c,~O'
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oCJ
3~'
eo &7
Mi:.<.dlaneous- (see attached list) m.......m.m.......
~~9;?O? c,~
/ (J C;?~:;, :is
DEDUCT TOTAL SELLER'S SALE EXPENSE.....m$
TOTAL NET PROCEEDS TO SELLER.m....$
,5'1;2':<, &S-
~ r:; /.-
./ ("/ tJ ;;- df ~ ,f:.J
I, (or we), the seller of goods, merchandise, and/or property sold at public auction on above date and
location, acknowledge and accept this settlement of proceeds of sale. I (or we) agree to accept ell re-
sponsibility for providing merchantable title to all goods, merchandise, and/or property sold, and for
delivery of title to the purchaser.
\,~--"-" '-'''f~~-;+ \:-.}!~(..\\-r-\)(
) ,
( eller's Signature)
, /?;:?f? L..
(Seller's Signature)
ATTACHMENT TO SCHEDULE "G"
Form 712
(Rev. May 2000)
Department of the Treasury
Internal Revenue Service
Decedent -Insured (To be filed by the executor with Form 706, United States Estate (and Generation-Skipping Transfer) Tax Return. or
Form 706 - NA, United States Estate (and Generation-Skipping Transfer) Tax Return, Estate of nonresident not a citizen of the United States.)
Life Insurance Statement
OMB No. 1545-0022
1 Decedent's first name and middle initial
2 Decedent's last name
SHAW
3 Decedent's social security number 4 Date of death
(if known) 164-18-6642 12/28/200
FREDITH E
5 Name and address of insurance company
JACKSON NATIONAL UFE INSURANCE COMPANY ONE CORPORATE WAY LANSING, MI 48951
6 Type of policy
SPDA
7 Policy number
0059281420
8 Owner's name. If decendent is not owner, attach copy of
application.
9 Date issued
10 Assignor's name. Attach copy of
assignment.
SHAW, FREDITH E 1/12/2000
12 Value of the policy at the 13 Amount of premium (see instructions 14 Name of beneficiaries
time of assignment $35,000.00 ANNUAL NANCY S TRIIT, LINDA L JACOBY
15 Face amount of policy.
16 Indemnity benefit
17 Additional insurance
18 Other benefits
19 Principle of any indebtedness to the company that is deductible in determining net proceeds Loan Principal
20 Interest on indebtedness (line 19) accrued to date of death. LO<ln I"tere:st
21 Amount of accumulated dividends
22 Amount of post-mortem dividends
23 Amount of returned premium
24 Amount of proceeds if payable in one sum . No.
25 Value of proceeds as of date of death (if not payable in one sum)
26 Policy provisions concerning deferred payments or installments.
Note: If other than lump-sum settlement is authorized for a sutviving spouse, please attach a copy of the
insurance policy.
15 $
16 $
17 $
18 $
19 $
20 $
21 $
22 $
23 $
24 $
25 $
- - - - - - ~ - - - - - - . - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - + - - - - - + - - - - - - - - - - - - - -
---+----------------- -------------------------+---- ------._--- -----,----.---- -._--------
27 Amount of installment
28 Date of birth, sex, and name of any person the duration of whose life may measure the number of payments.
- - - - - - - - - - - - ~ - - - - - - - - - - - - - - - - - _ _ _ _ _ _ _ _ _ _ _ 4 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ + _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ . _ _ _ _ _ _ _ _ _ _ _ _ _ _. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
~ - - - - - ~ -- - - - - ~- - - - ~~ - - - -- -- - -- - ~- - -- --- - -. - -- - ---- -- --- - -- - ~- - - -- ~- -- -~~ -- -- -- - -- -- - -- -~- - - - ~ -- -- ----- --~- - -- ~ -- - --~ - - -~ - - -- -- -- -- -. - - -- - -~ ---
29 Amount applied by the insurance company as a single premium representing the purchase of
installment benefits
30 Basis (mortality table and rate of interest) used by insurer in valuing installment benefits.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ~ - - - - - - - - - ~ - - - - - - - - - - - - - - - - - - - -
11 Date assigned
49 739.17
0.00
0.00
0.00
0.00
49,739.17
31 Were there any transfers of the policy within the three years prior to the death of the decedent?
DYes
- - - - - - - - - - - - - - - - - - - - ~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - ~ - - - - - - - - - - - ~ - - - .
~ No
32 Date of assignment or transfer:
/
/
Month Day Year
33 Was the insured the annuitant or beneficiary of any annuity contract issued by the company?
34 Did the decedent have any incidents of <;lwnership on any policies on his/her life, but not owned by
him/her at the date of death?
DYes
DYes
35 Names of companies with which decendent carried other policies and amount of such policies if this information is disclosed by your records.
- -- -- -- - - -- -- - - - ~ - - - - -~ -- - - - - ~ - --~ - ~---- - - -- ---- -- - -- - - - - - - - --- --- - - - ~- - - -- -- - - - -- -- - - - - - - - - - - - -- - -- -- - - -- -- -- -~. -- - - -- - - -- -- ~- - - - ~ - - - - - -- - -- - -- - -~- - - - -- - - - - -- - ,.
-- - -- -- - -- - - - - --~-- - - -. -- -- -- ~- - - -- --- - - -- -- -- -- --- -- - -~- - - - --- - -- ~ -- -- --- -- - - -- - -- - - - - --- -- - - - - -- - - - - -- - - - - - -- -- - --- -- ~- --- -- - - -- --- - -- -- - -- -- --.- ---.
[iJ No
[iJ No
The undersigned officer of the above-named insurance company (or appropriate Federal agency or retirement system official) hereby certifies that this statement sets forth true
and correct information.
4~ fj~~
Signature ~
Assistant Vice President
Title ~
February 28, 2008
Date of Certification ~
Cat. No. 10170V
Form 712 (Rev. 5-2000)
OPTIMAX ANNUITY
Statement Date: January 12, 2005
Provided by Jackson National Life
For the period January 12, 2004 to January 12, 2005
Jackson National Life Insurance Company@ II'~ .
Insuring your financial future~
www.inl.com
Prepared for:
Lynn R & Fredith E Shaw
31 Mt Roel< Rd
Newville PA 17241
Your Representative:
JENNIFER R COOKERL Y
C/O FIRST CAPITAL INS SRV
101 S GEORGE ST
YORK PA 17401-0000
Representative Phone: (717) 845-3788
Activity Summary
Account Information
Beginning Period Policy Value
+ Interest Earned for Period
- Withdrawals for Period
$43,838.05
$1,410.35
$0.00
Policy Number:
Annuity Type:
Issue Date:
Owner(s):
Annuitant(s):
0059281420
Ending Period Policy Value
$45,248.40
Nonqualified
January 12, 2000
Lynn R & Fredith E Shaw
Lynn R & Fredith E Shaw
Early withdrawals may be subject to surrender charges as stated in your policy. If your policy had been surrendered as of the
statement date, a surrender charge of $1,131.21 would have been assessed to your ending policy value.
Your Transaction Detail
-.
Date
Transaction Type
Transaction Amount
1/12/2005
Interest Earned for Period
$1,410.35
Your annuity earned an annual effective rate of 3.22% during this statement period. The annual effective rate represents
the average credited rate on your policy in the last year.
Congratulations!
You're putting the power of tax deferral to work for you.
You're saving the smart way,
you don't pay taxes until money is withdrawn!
Tax penalties may be levied by the Internal Revenue Service for surrender prior to age 59 1/2.
~
Questions? Please, contact your JNL representative, or call us at 800-777-7779
Monday-Friday, 8:00 a.m. to 8:00 p.m. (ET).
Write us at IMG Service Center, P.O. Box 30386, Lansing, MI 48909-7886.
Email usatCustomerCare@jnli.com.
ULOFL
.
The Company You Keep'
WiDnm of t:he
Dalbll1' Service AWlIIl'Il
hom 2000-2006
1"'''''''/-.
>,Y O"ltl"'l
,~I ,
.f A""UIT'L
....\ SEW, C [,AwJ\.rw ,
'~:.UG'
February 25,2008
Nancy Tritt
33 Silver Maple Drive
Boilng Springs, PA 17007
Re: Fredith E Shaw
Policy Number: 52 126 269
Policy Date: 06/9/2006
As of the date of death December 28,2007, the value in Policy 5212629 was
$70,216.45
If you have any questions, please contact me or our Customer Service
Representatives at 1(800) 762-6212 between 8:30 am and 5:30 pm, Monday
through Friday. Thank you for your continued interest in New York Life, and we look
forward to serving you for years to come.
r7t~
Carline Dessources
Service Associate
(800) 762-6212 ext. 5684
NYL Annuity Service Center. Lockbox 2400.5635 S. Archer Ave. . Chicago, IL 60638.1800-762-6212
Issued by New York Life Insurance and Annuity Corporation (A Delaware Corporation)
Variable annuities are distributed by: NYLlFE Distributors, LLC, Member NASD/SIPC
51 Madison Ave, New York, NY 10010
Annuitant - Fredith E Shaw
Policy Number -- 52 126 269
Policy Date - JUNE 9 2006
New York Life Insurance and Annuity Corporation
(A Delaware Corporation)
Home Office
200 Continental Drive, Suite 306
Newark, Delaware 19713
Executive Office
51 Madison Avenue
New York, NY 10010
THE CORPORATION New York Life Insurance and
Annuity Corporation (NYLlAC), a stock company
incorporated /n Delaware, will pay the benefits of this
Single Premium Deferred Fixed Annuity (the "Policy")
In accordance with its provisions. The following pages
are also a part of this Policy.
REPORT TO OWNER At least once each Policy Year,
New York Life Insurance and Annuity Corporation will
provide a report in connection with this Policy. The
report will tell the Owner how much Accumulation
Value there is as of the end of the reporting period. It
will also give the Owner any other facts required by
state law or regulations.
ANNUITY BENEFIT On the Annuity Commencement
Date, the Accumulation Value will be applied to
provide a monthly Income Payment, as stated in
the Annuity Benefit section.
The Issue Date is shown on the Policy Data Page.
","-
IF YOU HAVE QUESTIONS OR CONCERNS ABOUT YOUR
POLICY, PLEASE CALL US AT 1-800-762-6212.
DEATH BENEFIT If you die before the Annuity
. Commencement date, we will pay proceeds to the
Beneficiary upon our receipt of Proof of Death and all
claim Information.
~J.kat
RIGHT To RETURN POLICY Please examine your
Policy. Within 10 days (or longer if required by
state law) after delivery, you can return it to the
Corporation or to the agent through whom it was
purchased, with a written request for a full refund
of the premium. Upon receipt of this request, the
Policy will be void from the start, and a full
premium refund will be made.
President
~~
Secretary
MainStay Preferred Fixed Anuity
Single Premium Deferred Fixed Annuity
Monthly Income Payments Begin on the Annuity Commencement Date.
Single Premium Payment Payable as Shown on the Policy Data Page.
Interest Credited on the Accumulation Value at a Rate Set by the Corporation.
This Policy Is Non-Participating.
In Pennsylvania, there Is currently no premium tax on annuities. If a premium tax applies in the future, we will advise
you of the amount of such tax and its effect upon any payments made to you.
205-190PA
New York Life Insurance and Annuity Corporation
Home Office
Newark, Delaware
Executive Office
51 Madison Avenue
New York, NY 10010
POLICY DATA PAGE
Annuitant
Policy Number --
Policy Date
Owner
Fredlth E Shaw
52126269
JUNE 9, 2006
Ms Fredlth E Shaw, Same
AGE:83
FEMALE
Plan
NON-QUALIFIED
Purchase Premium:
Minimum Purchase Premium for this Polley:
Initial Interest Rate Guarantee Period Ending On:
$65,000.00
$5,000.00
JUNE 8, 2009 (3 YEARS)
ANNUITY COMMENCEMENT DATE:
JUNE 9, 2016
SURRENDER CHARGE SCHEDULE:
POLICY YEAR PERCENTAGE
1 7%
2 7%
3 7%
4 6%
5 5%
POLICY YEAR
6
7
8
PERCENTAGE
4%
3%
0%
Initial Interest Rate:
5.10%
Minimum Guaranteed Interest Rate:
2.85%
(Effective annual yield)
Minimum Partial Withdrawal Amount:
$100.00
Minimum Accumulation Value that must be maintained In the Policy after a Partial Withdrawal: $2,000.00
ISSUE DATE: JUNE 9, 2006
205-190PA
'to" '.
AIG Life Companies (U.S.)
AIG LIFE INSURANCE COMPANY
AMERICAN INTERNATIONAL LIFE
ASSURANCE COMPANY OF NEW YORK
A Member of American International Group, Inc.
February 12,2008
Nancy Tritt
33 Silver Maple Dr
Boiling Springs P A 17007
Re: Contract #: T0001515960
Deceased: Fredith Shaw
Dear Ms. Tritt:
Thank you for your recent inquiry regarding the referenced annuity contract. It is our pleasure to
be of service to you.
The value of the contract on December 28,2007 was $59,308.26.
Should you have any questions or require further assistance, please contact our Client Care
Center by using our toll free number of 1-800-424-4990.
Sincerely,
----I:>~----;-)
. Umj txJ:Q)u
Peggy Baker
Claims Dept.
Annuity Administration
P.O. Box 15403 . Amarillo, TX 79105-5403 . 800.233.2947
Allstate Life Insurance Company
P.O. Box 94212
Palatine, IL 60094-4212
Telephone: (877) 499-6418
Facsimile: (866) 635-4523
~ Allstate,
You're in good hands.
January 14, 2008
Nancy Tritt
33 Silver Maple Dr.
Boiling Springs, PAl 7007
Re:
Contract No:
Fredith Shaw
GA0838572
Dear Ms. Tritt:
We have been requested to complete IRS Form 712 with regard to the above referenced contract. The
purpose of Form 712 is to provide an estate or donor with the value of a life insurance contract or its
proceeds as of a certain date (usually the owner's date of death or date of transfer of the contract).
This contract is an annuity contract, which is not reportable on IRS Form 712. The following infonnation is
provided for estate purposes only as of the date specified:
Date of Death:
Annuity Value* as of Date of Death:
Cost Basis:
December 28, 2007
$ 101,155.52
$ 75,843.66
*The actual amount paid may differ due to Market Value Adjustments and/or any applicable Surrender
Charges.
If you have any questions, please contact me at 1-877-499-6418 Ext. 86497.
Sincerely,
Jennifer Evans
Sr. Claim Examiner
Copy to: Linda Jacoby
Fax tjerver
l/L.;;j/~UU~ L,:V::>:'L.o kJl'1 kJAUt.
'L./UV'L.
tax berve..r
Prudential ~ Financial
Prudential Investments
Annuity Services
PO Box 7960
Philadelphia, PA 19101
(888) 778-2888
WNW.prudential.com
January 23, 2008
Bob Y ockin
717-697-1451
Contract#:A2013149
Dear Mr. Y ockin:
As requested, the date of death value of the above contract in the name of Fredith E. Shaw was
$38,653.93.
If you have any questions, please call the Prudential Annuity Service Center at (888) 778-2888. You
can obtain contract values, request fotms and duplicate statements, and conduct certain fInancial
transactions 24 hours a day 7 days a week with our automated phone system. The Service Center is open
Monday through Friday between 8:00 a.m. and 8:00 p.m. Eastern time. If you are using a
telecommunications device for the hearing impaired, you may call (800) 654-7637, Monday through
Friday between 8:00 a.m. and 8:00 p.m. Eastern time.
Sincerely,
Jonathan Scott
Mutual Funds & Annuities Associate
A Prudenllel Buslness
COIpOrD Oflic.
761 Broad Sh.
Nawaril NJ 07102-37n
3~~:a> _NJ(
we ..
ct\-\-Y' ~ r 'W\c . f~
\tr Thrivent Financial for Lutherans'
4321 N. Ballard Road, Appleton, WI 54919-0001
Phone: 800-THRIVENT (800-847-4836)
E-mail: mail@thrivent.com . www.thrivent.com
Securities offered through
Thrivent Investment Management Inc.,
625 Fourth Ave. S., Minneapolis, MN 55415-1665,
a wholly owned subsidiary of Thrivent Financial for lutherans.
Member NASD. Member SIPC.
January 29,2008
Nancy Tritt
33 Silver Maple Dr
Boiling Springs PA 1 7007
Subject: Fredith Shaw Death Claim
Dear Ms. Tritt:
This letter is in response to your letter dated January 14, 2008 concerning contracts 3834608 and
9146774 held on the life of your mother, Fredith Shaw.
Contract 3834608 is a fixed annuity contract. The date of death value is $19,045.28. The cost basis is
$10,000.00 and the tax gain is $9,045.28.
Contract 9146774 is a settlement agreement. The date of death value is $13,434.59. The cost basis is
$7,417.39 and the tax gain is $6,017.20.
Due to privacy laws, if any further information is needed, we will need a copy of the court document
appointing you the executor of your mother's estate.
Please let us know if you have any questions or if we may assist you in any way. You may reach death
claims at 800-847-4836.
Sincerely,
..
Dtir uJ ~~
Deb Wenninger, ALHC, ACS
Claims Examiner, Centralized Service Team
Death Claims and Service
Life and Health Product Service Operations Department, FSO
dkw
SHAW: Fredith, deceased, 3834608 & 9146774
502658514
~ Prudential
~
Pruco Securities, LLC
COMMAND Service Center
PO Box 15070
New Brunswick, NJ 08906-5070
(800) 235-7637
www.prudential.com
January 23, 2008
Mr. Robert P. Y ockin
The Prudential Insurance Company of America
150 Corporate Center Drive, Suite 105
CampHiII,PA 17011-1759
Re: 5822-1610
Fredith E. Shaw & Nancy S. Tritt JT TEN
Dear Mr. Y ockin:
Per your request, we are confirming the balance on the above-referenced Pruco Securities Account. Our
records indicate that as of 12/28/2007, the value of this account was:
Investment Shares Price Value
EVHMX 3,658.278 $11.09 $40,570.30
MKHCX 11,781.221 $6.14 $72,336.69
OPABX 3,394.005 $12.15 $41,237.16
Money Market 384.740 $1.00 $384.74
Total Portfolio Value
$154,528.89
If you have any questions or need additional information, please contact the COMMAND Service Center at
(800) 235-7637. Customer Service Representatives are available to assist you between 8:00 a.m. and 8:00
p.m. ET, Monday through Friday.
Sin~?-.J~
JOhX~
Registered Principal
Pruco Command Operations
Pruco Securities, LLC
EJH
Securities products and services are offered through Pruco Securities, LLC, 751 Broad Street, Newark, New Jersey 07102-
3777, member SIPC, a Prudential Financial company. Prudential, Prudential Financial and the Rock logo are registered
service marks of The Prudential Insurance Company of America, Newark, NJ and its affiliates.
A registered principal of Pruco Securities, LLC.
~
\.~
~ Prudential
~
Pruco Securities, LLC
COMMAND Service Center
PO Box 15070
New Brunswick, NJ 08906-5070
(800) 235-7637
www.prudentia1.com
January 23, 2008
Mr. Robert P. Y ockin
The Prudential Insurance Company of America.
150 Corporate Center Drive, Suite 105
CampHiIl,PA 17011-1759
Re: 5347-0467
Fredith E. Shaw & Linda L. Jacoby JT TEN
Dear Mr. Yockin:
Per your request, we are confirming the balance on the above-referenced Pruco Securities Account. Our
records indicate that as of 12/28/2007, the value of this account was:
Investment Shares Price Value
EVHMX 3,657.367 $11.09 $40,560.20
MKHCX 11,781.221 $6.14 $72,336.67
OPABX 3,393.571 $12.15 $41,231.88
Money Market 384.740 $1.00 $384.74
Total Portfolio Value
$154,513.49
If you have any questions or need additional information, please contact the COMMAND Service Center at
(800) 235-7637. Customer Service Representatives are available to assist you between 8:00 a.m. and 8:00
p.m. ET, Monday through Friday.
Si?7~J~
JOh';;4;::y
Registered Principal
Pruco Command Operations
Pruco Securities, LLC
EJH
Securities products and services are offered through Pruco Securities, LLC, 751 Broad Street, Newark, New Jersey 07102-
3777, member SIPC, a Prudential Financial company. Prudential, Prudential Financial and the Rock logo are registered
service marks of The Prudential Insurance Company of America, Newark, NJ and its affiliates.
A registered principal of Pruco Securities, LLC.
4~
~
Prudential ~ Financial
-
Pruco Securities,LLC
po. Box 15090, New Brunswick NJ 08906-5090
April 11, 2008
Bradley L. Griffie, Esquire
Griffie & Associates
200 North Hanover Street
Carlisle, PA 17013
Dear Mr. Griffie,
Per your request, please find the information regarding the requested dates of joint
account ownership relative to the Estate of Fredith E. Shaw:
Account Number: 5822-1610
N/O Fredith E. Shaw & Nancy S. Tritt JT TEN
Opening Date: 03/14/2007
Account Number: 5347-0467
N/O Fredith E. Shaw & Linda L. Jacoby JT TEN
Opening Date: 03/15/2007
Both of these account have been held in joint ownership since inception. Pruco does
not "retitle" accounts during their lifetime. A change in ownership would require a new
account. I trust this is the information you desired.
If you have any questions concerning this account, please feel free to contact the Pruco
Command Service Line at 800-235-7637.
Sincerely,
.. .--J IJ
~~ ,.
Eric Harney U
Pruco Command Operations
Securities products and services, including the COMMAND and Investor Accounts, are offered through Pruco Securities
LLC, 751 Broad Street, Newark, NJ 07102, member SIPC and a Prudential Financial Company. Prudential Financial is a
service mark of the Prudential Insurance Company of America, Newark, NJ and its affiliates.
EJH