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Home My WebLink About05-12-08 (2) 15056041125 REV-1500 EX (06-05) PA Department of Revenue. Bureau of Individual Taxes . PO BOX 280601 HarrisburQ, PA 17128-0601 NTER DECEDENT INFORMATION BELOW ocial Security Number Date of Death OFFICIAL USE ONLY County Code Year INHERITANCE TAX RETURN 2 1 RESIDENT DECEDENT File Number o 8 o 2 5 7 Date of Birth 17201 275 9 o 2 172 008 05271917 ecedent's Last Name Suffix Decedent's First Name TROUTMAN A L ICE MI V ( Applicable) Enter Surviving Spouse's Information Below pouse's Last Name Suffix Spouse's First Name MI N / A pouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS LL IN APPROPRIATE OVALS BELOW 1. Original Return 4. Limited Estate o o o o 8. Total Number of Safe Deposit Boxes 2. Supplemental Return o o 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach Copy ofT rust) 10. Spousal Poverty Credit (date of death 0 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) ORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: ame Daytime Telephone Number 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received PET E R G HOWLAND E SQ. 717 234 4 182 inm Name (If Applicable) REGISTER OF WILLS USE ONLY W I X , WENGER & W E I D N E R ZIP Code (J .....;0 :7] -1'1 ;~~ ,.--~\ r") C) ;~Qi>.~ Fi~ED ~;) C:";) C;:) (;;."C5 irst line of address 5 0 8 NOR T H SECOND STREET =>~~ J,':.a. -< econd line of address N P 0 BOX 8 4 5 ity 01' Post Office State -u :::?: H ~~ R R I S BUR G P A -0 -~ 1 7 1 0 8 0 8 4P5 ~ N orrespondent's e-mail address:PHOWLAND@WWWPALAW.COM DATE S--"I-o\? 845 HARRISBURG PLEASE USE ORIGINAL FORM ONLY PA 17108 Side 1 15056041125 15056041125 --I cJ I 15056042126 REV-1500 EX Decedent's Social Security Number Decedent's Name: ALICE v. TROUTMAN 1 7 2 0 1 2 7 5 9 RECAPITULATION 1. Real estate (Schedule A) 1. 7 5 0 0 0 0 0 ....................................... . 2 Stocks and Bonds (Schedule B) 2. 1 5 2 9 9 7 ................................. . 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 (Scheduie E) 5. 3 2 1 3 . 4 3 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 6. 3 6 6 6. 2 3 7. inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) 0 Separate Billing Requested 7. 8. Total Gross Assets (total Lines 1-7) .......................... . 8. S 3 4 0 9 6 3 9. Funeral Expenses & Administrative Costs (Schedule H) 9. 1 0 4 9 1 2 5 . . . . . . . . . . . . . . . . 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . . . . . . . . . . . . 10. 5 1 9 3 7 11. Total Deductions (total Lines 9 & 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 1 1 0 1 0 6 2 12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . 12. 7 2 3 9 9 . 0 1 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. 7 2 3 9 9. 0 1 TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0 _ o . 0 0 15. o . 0 0 16. Amount of Line 14 taxable at lineal rate X .01L., 7 2 3 9 9 . 0 1 16. 3 2 5 7 . 9 6 17. Amount of Line 14 taxable at sibling rate X .12 o . 0 0 17. o . 0 0 18. Amount of Line 14 taxable o . at collateral rate X. 15 0 0 18. o . 0 0 19. Tax Due . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 3 2 5 7 . 9 6 O. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT o Side 2 I 15056042126 15056042126 ---' REV-150 EX F'age 3 Dece ent's Complete Address: DECED NT'S NAME ALlC V. TROUTMAN STREE ADDF1ESS 204 C NTER STREET File Number 21 08 0257 CITY ENOL STATE PA (1 ) 162.89 3. Inter stlPenalty if applicable D. In erest E. P natty Total Credits (A + 8 + C) (2) Total Interest/Penalty ( D + E) (3) 4. If Lin 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (4) 5. If Lin 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. En er thll interest on the tax due. (5A) (58) 8. E er thE! total of Line 5 + 5A. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT ZIP 17025 3,257.96 162.89 0.00 0.00 3,095.07 3,095.07 PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes a. retain the use or income of the property transferred; ...................................................................... 0 b. retain the right to designate who shall use the property transferred or its income; ............................... 0 c. retain a reversionary interest; or ................................................................................................ 0 d. receive the promise for life of either payments, benefits or care? ....................................................... 0 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .......... ........... ... ......... ... .............. ...... .., ............................ 0 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ......... 0 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which . b f" d' t' ? 0 contains a ene IClary eSlgna Ion. .................................................................................................. No [&J [&J [&J [&J [&J [&J [&J IF THE A SWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of eath 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) p rcent [72 P.S. 99116 (a) (1.1) (i)]. For dates of eath 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. 991 6 (a) (1.1) (ii)J. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax re rn are still applicable even if the surviving spouse is the only beneficiary. For dates of eath on or after July 1, 2000: The tax rate i posed 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 par t, or a stepparent of the child is zero (0) percent [72 P.S. 99116(a)(1.2)]. The tax rate i poslld 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. 9911 (1.2) [72 P.S. ~9116(a)(1)]. The tax rate i posed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P .S. 99116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-150 EX + (6-98) . SCHEDULE A REAL ESTATE CC MMONWEAL TH OF PENNSYLVANIA INHERITANCE TAX RETURN I1ESJDENT DECEDENT ESTATE OF FILE NUMBER ALICE II. TROUTMAN 21 08 0257 All rea property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real Drooertv which is jointlv-owned with riaht of survivorshiD must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION HOUSE AND LOT SITUATE AT 20 CENTER STREET, ENOLA, EAST PENNSBORO TWP, CUMBERLAND COUNTY, PA, BEING TAX PARCEL NO. 09-15-1290-083 (VALUED PER SETTLEMENT SHEET ATTACHED HERETO) TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) VALUE AT DATE OF DEATH 75,000.00 75 000.00 REV-150 EX + (6-98) '* SCHEDULE C CLOSEL V-HELD CORPORATION, PARTNERSHIP OR SOLE-PROPRIETORSHIP CO MONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE F ALICE .TROUTMAN ITEM NUMBE 1. FILE NUMBER 21 08 0257 Schedule C-1 or C-2 (including all supporting information) must be attached for each closely-held corporation/partnership interest of the decedent, other than a sole-proprietorship. See instructions for the supporting information to be submitted for sole-proprietorships. DESCRIPTION VALUE AT DATE OF DEATH TOTAL (Also enter on line 3, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) REV-1507 EX + (6-98) . CO MONWEAL TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE D MORTGAGES & NOTES RECEIVABLE ESTATE F ALICE .TROUTMAN ITEM NUMBER 1. FILE NUMBER 21 08 0257 All property jointly-owned with the right of survivorship must be disclosed on Schedule F. DESCRIPTION VALUE AT DATE OF DEATH TOTAL (Also enter on line 4, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) REV-150 EX + (6-98) '* SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY CO MONWEAL TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE :>F ALICE V. TROUTMAN ITEM NUMBER 1. 9. 2. 3. 4. 5. 6. 7. 8. 10. FILE NUMBER 21 08 0257 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. DESCRIPTION ORDINARY HOUSEHOLD GOODS AND FURNISHINGS 1991 CHEVROLET CHEVETTE (SALE PRICE - PENNDOT FORM MV-4T ATTACHED) 2007 FEDERAL INCOME TAX REFUND 2008 FEDERAL REBATE CHECK CAR INSURANCE PREMIUM REFUND STATE EMPLOYEES RETIREMENT SYSTEM CHECK PHONE REFUND CABLE REFUND NEWSPAPER SUBSCRIPTION REFUND PROPERTY TAX REFUNDS SET FORTH ON SETTLEMENT SHEET TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) VALUE AT DATE OF DEATH 1,000.00 400.00 300.00 600.00 33.50 295.28 4.09 3.74 82.75 494.07 3213.43 REV-150 EX + (6-98) '* SCHEDULE F JOINTL V-OWNED PROPERTY CO MONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE ( F ALICE V. TROUTMAN FILE NUMBER 21 08 0257 A. BET Y BRESSLER S~RVIVING JOINT TENANT(S) NAME If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. B c JOINTL Y- WNED PROPERTY: ETTEFI DATE ITEM F R JOINT MADE NUM8ER ENANT JOINT ADDRESS 1 006 STATE ROAD DUNCANNON, PA 17020 DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. 1. A. 10/1984 M&T BANK CHECKING ACCOUNT 61220965 (VALUATION LETTER ATTACHED) DATE OF DEATH VALUE OF ASSET 7,332.45 (If more space is needed, insert additional sheets of the same size) TOTAL (Also enter on line 6, Recapitulation) DAUGHTER RELATIONSHIP TO DECEDENT '?'oOF DECO'S INTEREST $ DATE OF DEATH VALUE OF DECEDENT'S INTEREST 50. 3,666.23 3 666.23 REV-151 EX -I (6-98) *' SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY CO MONWEAL TH OF PENNSYLVANIA INHERITANCE TAX RETURN FIESIDENT DECEDENT ESTATE F ALICE V. TROUTMAN FilE NUMBER 21 08 0257 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER 1. DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. ATTACH A copy OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECO'S EXCLUSION INTEREST (IF APPUCABUE) TAXABLE VALUE '\ TOTAL (Also enter on line 7 Recapitulation) $ (If more space is needed, insert additional sheets of the same size) REV-151 EX+(12-99) '* SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS CO MONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN FIESIDENT DECEDENT ESTATE OF ALICE V. TROUTMAN FILE NUMBER 21 08 0257 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. DESCRIPTION AMOUNT 1. FUNERAL EXPENSES: SULLIVAN FUNERAL HOME 7,828.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s)JEIN Number 01 Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees WIX, WENGER & WEIDNER (ESTIMATED) 800.00 3. Family Exemption: (II decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees CUMBERLAND COUNTY REGISTER OF WILLS 264.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. CUMBERLAND LAW JOURNAL (ADVERTISING) 75.00 8. SENTINEL (ADVERTISING) 1 90.54 9. VITAL RECORDS (DEATH CERTIFICATES) 18.00 10. PA AMERICAN WATER 36.42 11. DEBIE LUPOLD, TREASURER 318.24 12. PPL ELECTRIC 50.35 13. E.P. TWP SEWER & TRASH 105.70 14. CLOSING COSTS FOR REAL ESTATE EVIDENCED ON SETTLEMENT STATEME 755.00 15. WIX, WENGER & WEIDNER (ESTIMATED OUT-OF-POCKET COSTS) 50.00 TOTAL (Also enter on line 9, Recap~ulation) $ (II more space is needed, insert additional sheets 01 the same size) 10.491.25 REV-151 EX -/- (12-03) '* SCHEDULE. DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS CO MONWEAL TH OF PENNSYLVANIA INHERITANCE TAX RETURN FIESIDENT DECEDENT ESTATE OF ALICE V. TROUTMAN FILE NUMBER 21 08 0257 ~eport debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITE vi VALUE AT DATE NUM ER DESCRIPTION OF DEATH 1. DISCOVER CARD (CREDIT CARD) 74.72 2. KEYSTONE OIL 237.92 3. PPL ELECTRIC 46.74 4. PA AMERICAN WATER 24.99 5. DAILEY EYE 65.00 6. HOLY SPIRIT HOSPITAL 70.00 TOTAL (Also enter on line 10, Recapitulation) $ 519.37 (If more space is needed. insert additional sheets of the same size) '''~'''' X"'. CO"" MONWEAL TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ALICE V. TROUTMAN SCHEDULE J BENEFICIARIES NUMBP 1. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] BETTY L. BRESSLER -, 006 STATE ROAD DUNCANNON, PA 17020 WALLACE R. TROUTMAN -1216 GROSS DRIVE MECHANICSBURG, PA 17050 1. 2. FILE NUMBER 21 08 0257 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Lineal Lineal AMOUNT OR SHARE OF ESTATE 36,199.51 36,199.50 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHAR IT ABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) 1Ea!it Jlill aub ille!itameut I, ALICE V. TROUTMAN, of East Pennsboro Township, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking all other Wills and Codicils heretofore made by me. ARTICLE I. I direct the payment of my just debts and funeral expenses, the expenses of my last illness and funeral, and the expenses of administering my Estate as soon as my death as may be convenient to my Executors hereinafter named. ARTICLE II. I give, devise and bequeath unto my children, BETTY L. BRESSLER, Duncannon, Pennsylvania, and WALLACE R. TROUTMAN, Enola, Pennsylvania, my tangible personal property (not including cash or securities) to be divided between them as they shall agree, and if they cannot agree, then such item shall be sold and distributed as part of the residue of my Estate. ARTICLE III. I give, devise and bequeath all the rest, residue and remainder of my Estate, of whatever nature and wherever situate, in equal shares unto my daughter, BETTY L. BRESSLER, and to my son, WALLACE R. TROUTIvIAN. Should either of my children predecease me, I direct that such child's share shall pass to his or her issue per stirpes, by representation. ARTICLE IV. I name, constitute and appoint BETTY L. BRESSLER and WALLACE R. TROUTl'/IAN, executors of this my Last Will and Testament. If either Co-Executor ce~ases to so act or fails to qualify, I dir:ect that the vacancy not be filled and that the then-surviving Executor serve as the sole Executor of this my Last Will. IN WITNESS WHEREOF, I have hereunto set my hand and seal on this the 2 U!L day of tJ.fL.l"rJe-~ , 1985. \.( c~< L ~ -..-'" '/ j-,~c (. ",.', a -L ;~ Alice V. Troutman (SEAL) Signed, sealed, published and declared by the above-named Testatrix, as and for her Last Will and Testament, in the presence of us, who, at her request in her presence and in the presence of each other have hereunto subscribed our names as witnesses. ~O(~ --'" ..",.-;.... /F j~.,/ 4 l ,~...-- .., / ... ~,.. A cy f 1',\_ ."11:/(.// ./ 'Z<tU<t:' ;>ftl { Iv 7(, / -1/1].( ,!__,-, ~_ ~ i , ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA 55: COUNTY OF CUMBERLAND I, ALICE V. TROUTMAN, whose name is signed to the 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. Ii C ( , \=:~"t t~ L~7:;:)t.{2 Vc (SEAL) Alice V. Troutman Sworn or affirmed to and acknowledged before me, by ALICE V. TROUTh1AN, this ;/;{;f<' day of ,').' , 1985. ,/, . /, i /' '-:l ~7' ,-..--..i~z-."",:,> C":j.l (' /:> 'Jr.," /:",~,I,<?,,)(;')-' /-1.. 1/-< . ! Notary Public !;.\,CCUELlNE A. LENARD. Nol~ry ?ubi,!.:::. :,1< C(>mmis~i\ln Explr~> August L I. 193~, .:"'1[,,,,11$. FA {).:mt',rlar.1 GIl. AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA S8: COUNTY OF CUMBERLAND '... " ) - We . . n 1 < '{" ~ and '. ...:-:I/h" /...' d. .., / "'..-f " r., .,' the , it,.. --->. -.;~...;:;...' _ ' \ witnesses whose names are signed to the foregoing instrument, being duly qualified aecording to law, do depose and say that we were present and saw the Testatrix sign and execute the foregoing instrument as her Last Will and Testament; that she signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the Will as witnesses; and that to the best of our knowledge, the Testatrix was at that time eighteen (18) or more years of age, of sound mind and under no constraint or undue influence. ~~~d ~~ /) !,' /' ,~ 14 / . I. Ii I~!/I /: .~' .-"7" Lt-t.' ,-!"v:'r/-L./ -;1' X '--';-'1;...... {.JL. ;;--I,d' ~"'/'~ . / J'" / /" .' ..'.." r/'- ''''''..- r I Sworn or affirmed to and subscribed to before me by J':::.{'-...'~, and (:...) . ,\. f<.~.. , ( ",'" '. 'J'. --" ___. '~'" " .1, ". I,. -_or L:"~., witnesses, this ~) i:::,) day of -:'! ,'~: ,-n t_~c.: /.~:, 1985. /1 _,J'L./J /)1 U: /~ /" . (' / /7I .,.!,-'; / j~__ ., I Notary Public ,J~C;OUEUNE A. LE.NARD. N:lary Puh!~;. , _ " ". pI'.' ^ "".,at 2 I. I ~k ~ ~J1"1 r.;nrnirH$~j()n ~ X. 1,<..1 JiI'\';1W<oJ' ;.._~;~)(:'y1;e. FA C1J1Tl::;;i-tz."rd ell. OMB NO. 2502-0265 ~ A B. TYPE OF LOAN: U.S. DEPAF TMENT OF HOUSING & URBAN DEVELOPMENT 1.0FHA 2.QFmHA 3.00CONV. UNINS. 4. OVA 5.oCONV. INS. 6. FILE NUMBER: 17. LOAN NUMBER: SETTLEMENT STATEMENT 200804750.PFD 0826906451 8. MORTGAGE INS CASE NUMBER: C. NOTE: This form is furnished to give you a statement of actual settfement costs. Amounts paid to and by the settfement agent afll shown. Items marKed "[pOCr wefll paid outside the closing; they afll shown hefll for informational purposes and afll not included in the totals. 1.0 3198 (200804150.pfd/200804150.PFD/21) D. NAME 1- ND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER: Andrea M. ~ atter-Martin Estate of Alice V. Troutman Sovereign Bank 806 Belle Vi ta Drive 204 Center Street 1130 Berkshire Blvd Enola, PA 1 025 Enola, PA 17025 Wyomissing, PA 19610 G. PROPE TY LOCATION: H. SETTLEMENT AGENT: 20-1747090 I. SETTLEMENT DATE: 204 Center treet Lakeside Abstract & Settlements, LLC Enoia, PA 1 025 April 24, 2008 Cumberiand County, Pennsylvania PLACE OF SETTLEMENT Parcel # 09- 5-1290-083 Central Penn Real Estate Shermans Dale, PA J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION 100. GROS AMOUNT DUE FROM BORROWER: 400. GROSS AMOUNT DUE TO SELLER: 101. Contra Sale~' Price 75,000.00 401. Contract Sales Price 75,000.00 102. Person I ProoertV 402. Personal PropertY 103. Settlem nt Charaes to Borrower lLine 1400 4,021.55 403. 104. 404. 105. 405. Adiu ments For Items Paid Bv Seller in advance Ad'us/ments For Items Paid Bv Seller in advance 106. CitvfTo n T aXl:tS to 406. CitvfTown Taxes to 107. County axes 04/24/08 to 01/01/09 215.74 407. Countv Taxes 04/24/08 to 01/01/09 215.74 108. School axes 04/24/08 to 07/01/08 200.61 408. School Taxes 04/24/08 to 07101/08 200.61 109. Credit S werfTrash 2nd atr 77.72 409. Credit SewerfTrash 2nd qtr 77.72 110. 410. ",. 41,. 112. 412. 120. GROS AMOUNT DUE FROM BORROWER 79,515.62 420. GROSS AMOUNT DUE TO SELLER 75,494.07 200. AMOU TS PAID BY OR IN BEHALF OF BORROWER: SOO. REDUCTIONS IN AMOUNT DUE TO SELLER: 201. Deoesit or eamest monev 501. Excess Decosit (See Instructions) 202. Princio, Amollnt of New Loanls) 67,500.00 502. Settlement Charges to Seller Line 1406f 755.00 203. Existin 10arilSliaken subiect to 503. Existinaloan(s) taken subiect to 204. 504. Payoff of first Mort9age 205. 505. Pavoff of second Mortoaae 206. 506. 207. 507. . 208. 508. 209. 509. Ad ustments For Items Unoaid Bv Seller Adiustments For Items Unoaid Bv Seller 210. CitvfTo n TaxHs to 510. CitvfTown Taxes to 21,. Countv . axes to 5". CountvTaxes to 212. School axes to 512. School Taxes to 213. 513. 214. 514. 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. 220. TOTAL 'AID BY/FOR BORROWER 67,500.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 755.00 300. CASH A SETTLEMENT FROMfTO BORROWER: 600. CASH AT SETTLEMENT TO/FROM SELLER: 301. Gross A nount Due From Borrower (Line 120\ 79,515.62 601. Gross Amount Due To Seller (Line 420\ 75,494.07 302. Less Arr aunt Paid By/For Borrower lLine 220\ ( 67,500.00) 602. Less Reductions Due Seller Line 520) ( 755.00 303. CASH ( X FROM) ( TO) BORROWER 12,015.62 603. CASH ( X TO) ( FROM) SEUER 74,739.07 The undersi ned h.~reby acknowledge receipt of a completed copy of pages 1&2 of this statement & any attachments referred to herein. Bo ower _~L 'M .ti1J,l.1111:: Seller Esta~cem 0)..& Andrea M. Matter-Martin BY: ~ 'kb> ~ Wallace R. Troutman, Co-Executor By:,6~,t &~u &-f~c;;z., Betty L. ssler. Co-Executor -<-- $ L. SETTLEMENT CHARGES llll 700. TOTAL OMMISSION Based on Price Divisio of Commission ine 700 as Follows: 701. $ to 702. $ to 703. Commi ion Paid at Settlement 704. to aoo. ITEMS AYABLE IN CONNECTION WITH LOAN 801. Loan 0 ination Fee % to 802. Loan Di count % to 803. Apprais I Fee to 804. Cradit port to 805. Proces ng Fe,s to 806. Tax Se ice FE.e to 807. Flood C rt FeE' to 808. Commit ent Fee to 809. Mtg Bro er Fee Pd By Sovereign to 810. 811. 900. ITEMS 901. Interast 902. Morloa 903. Hazand I 904. 905. 1000. RESEI VES DEPOSITED WITH LENDER 1001. Hazand Insurance 3.000 1002. Mortoa e Insurance 1003. CitvfT Wl Taxes 1004. Counll Taxes 1005. School Taxes 1006. 1007. 1008. Aoore< te Adiustment 1100. TITLE HARGES 1101. Settlen ent or Closlno Fee 1102. Abstra or Title Search 1103. Title E mination 1104. Title In UranCtl Binder 1105. Electro ice Doc Retrieval 1106. Notarv ees 1107. Attome 's FeE'S inc des above item numbers: 1106. Title In uranCl. (inc des above item numbers: 11 09. Lende~ Coverage 111 O. Owne~ Coverage 1111. AL TA E dorsements 1112. Closin Protection Letter 1113. 1114. WireF 1115.0vemi htDelivery 1116. 1117. 1118. 1200. GOVEF NMENT RECORDING AND TRANSFER CHARGES 1201. Recondi g Fees: Deed $ 38.50; Mortgage $ 64.50; 1202. CitvlCo ntv Tax/Stamos: Deed 750.00' Morloaoe 1203. State T Stamos: Deed 750.00; MortQaoe 1204. 1205. 1300. ADDITI NAL SETTLEMENT CHARGES 1301. Survey 1302. Pest In 1303. Tax Ce 1304. 2008 C 1305. 1400. TOTAL ETTLEMENT CHARGES (Enter on Lines 103, Section J and 502 Section ~" I By signing pag.1 of this sb'_ th. signatories ackncwledga race", of a completed copy ofpag. 2 ..tho. two ~ll ~/~/ LaReside Abstract & SettlerrHnts, oL Settlement Agent ) Certified to b a truE! copy. % . Cody Financial Mortgage Services, Inc Cody Financial Mortgage Services, Inc Cody Financial Mortgage Services, Inc LSI FIS Sovereign Bank Cody Financial MortQage Services, Inc POC:L2025.00 EQUIRED BY LENDER TO BE PAID IN ADVANCE rom 04/24/08 to 05/01/08 @ $ 11.953125/day InsUlance Pramiumfor months to surance Pramium for 1.0 vears to Erie Insurance 7 days %) POC $258.00 . 4.000 4.000 11.000 months $ months $ months $ months $ months @ $ months (1il $ months (1il $ months (1il $ 21.50 per month 29.25 per month 8.01 oer month 18.11 per month 89.98 per month oer month oer month per month to to to to to Lakeside Abstract & Settlements LLC to Jeanette Pennincton to to Lakeside Abstract & Settlements LLC $ $ to Lakeside Abstract & Settlements, LLC to First American Title Insurance Company 67,500.00 666.75 100, 300, 8.1 to Lakeside Abstract & Settlements, LLC to Lakeside Abstract & Settlements, LLC Releases $ action Fee untv Tax to to to Lakeside Abstract & Settlements, LLC to Debbie Lupoid POC:S313.34 PAID FROM BORROWER'S FUNDS AT SETT1.EMENT 300.00 50.00 325.00 69.00 7.50 465.00 32.04 72.44 989.78 -216.63 666.75 ) 150.00 35.00 103.00 750.00 4,021.55 (200804750.PFD /200804750.PFD /22) Page 2 PAID FROM SELLER'S FUNDS AT SETTlEMENT 83.67 64.50 20.00 25.00 15.00 14.50 750.00 5.00 755.00 .... z W ~ Z CI ;; :! .... ~ A. o wW ~i %0 Wll: >::l .. dC-I (V\ R i "Ll II' '0 (y,\ tc' 'l qbcl II LAST NAME (OR FULL BUSINESS NAME) -rr 0 vt""""c~n (: D - t: CO-:~F!-LER. (\ --",,~,-< \_.c", ."'1. . ,,' (r- . .",' )1..J, ~.._ l"",. ST NAME (OR FULL BUSINESS NAME) LESS TRADE~N B.ll: W -' -' W U> c STREET 7 r+ rYl~'r r"\i'"-:Cl\ (' ",. bx n LAST NAME (OR FULL BUSINESS NAME) REFER TO COUNTY CODES LISTING ON REVERSE SIDE OF YELLOW COPY 3. LIEN FEE PA DLlPHOTO 10# DATE OF BIRTH OR BUS. 10# .... z W ~ Z CI ;; .U> c( o Z N O-PURCHASER LAST NAME 4. REGISTRATION OR PROCESSING FEE FIRST NAME MIDDLE NAME PA DLlPHOTO 10# DATE OF BIRTH STREET FEE EXEMPT NUMBER AS ASSIGNED BY THE DEPARTMENT 5. DUPLICATE REG. FEE NO.OF CARDS r+ CITY STATE ZIP CODE DATE ACQUIRED/ PURCHASED 6. TRANSFER FEE REFER TO COUNTY CODES LISTING ON REVERSE SIDE OF YELLOW COPY MAKE OF VEHICLE VEHICLE IDENTIFICATION NUMBER 7. INCREASE FEE Wo -'w ~o ffi i1i MOClEL YEAR >.... BODY TYPE (CP, TK. ETC.) CONDITION . REPLACEMENT FEE '''F~ ) .-/ d GOOD o TRANSFER OF PREVIOUSLY ISSUED PLATE o TRANSFER & RENEWAL OF PLATE o TRANSFER & REPLACEMENT OF PLATE o TRANSFER OF PLATE & REPLACEMENT OF STICKER SEND ONE CHECK IN THIS AMOUNT -t o FAIR o POOR OTAL PAID (ADD 1 THRU 8) 9. 10. TE TO BE ISSUED By lEPARTMENT (PROOF OF INSURANCE MUST BE ATTACHED.) o EXCHANGE PLATE TO BE ISSUED BY DEPARTMENT o TEMPORARY PLATE ISSUED BY FULL AGENT 11. GRAND TOTAL (ADD 9 & 10) REASON FOR REPLACMENT o LOST 0 DEFACED 0 STOLEN 0 NEVER RECEIVED (Lost in Mail) NOTE: If 'NEVER RECEIVED' block is checked, applicant must complete Form MV-44. EXPIRES Month Year TRANSFERRED FROM TITLE NO. VIN ll: Oz ILO z- Q~ ~.... o!!l ::i:B ~ll: c( SIGNATURE OF PERSON FROM WHOM ~ SIGN HERE PLATE IS BEING TRANSFERRED (IF OTHER THAN APPLICANT) GVWR UNLADEN WEIGHT REQ. REG. GROSS WT. RELATIONSHIP TO APPLICANT ISSUING AGENT INFORMATION POLICY EXPIRATION DATE., AGENT NO. ISSUING AGENT SIGNATURE TELEPHONE NO. '-G.: :;) I/WE CERTIFY THAT I/WE HAVE EXAMINED AND SIGNED THIS FORM AFTER ITS COMPLETION AND THAT THE INFORMATION GIVEN IS TRUE AND CORRECT IF ANY EXEMPTION IS CLAIMED, THE PURCHASER FURTHER CERTIFIES THAT HE/SHE IS AUTHORIZED TO CLAIM THIS EXEMPTION. I/WE ACKNOWLEDGE THAT I/WE MAY LOSE MY/OUR OPERATING PRIVILEGES(S) OR VEHICLE REGISTRATION(S) FOR FAILURE TO MAINTAIN FINANCIAL RESPONSIBILITY ON THE CURRENTLY REGISTERED VEHICLE FOR THE PERIOD OF REGISTRATION. I/WE ACKNOWLEDGE THAT I/WE MAY BE SUBJECT TO A FINE NOT EXCEEDING $5,000 AND IMPRISONMENT OF NOT MORE THAN TWO YEARS FOR ANY FALSE STATEMENT THAT I/WE MAKE ON THIS FORM. Telephone No. z o !i o ii: ~ W o 1ST ASSIGN- MENT (--' -)-, 1/ I f C) ()3(; ::3 2ND Signature of Second Purchaser or Authorized Signer ASSIGN- MENT tgnature 0 0- urchaser it e 0 ut oMz igner Telephone No. H.-' ~ o ;::: is o c( z NOTE: IF A CO.PURCHASER OTHER THAN YOUR SPOUSE IS' LISTED AND YOU WANT THE TITLE TO BE LISTED AS . JOINT TENANTS WITH RIGHT OF SURVIVORSHIP' (ON DEATH OF ONE OWNER, ~ TITLE GOES TO SURVIVING OWNER) CHECK HERE O. OTHERWISE, THE TITLE WILL BE ISSUED AS 'TENANTS IN COMMON' (ON DEATH OF ONE OWNER, INTEREST OF DECEASED OWNER ~ GOES TO HISIHER HEIRS OR ESTATE) lr NOTE: IF THE VEHICLE IS TO BE USEDASA DAILY RENTAL OR LEASED VEHICLE, CHECK THIS BLOCK D. IF BLOCK IS CHECKED, COMPLETE AND ATTACH FORM MV-1L ~ MESSENGER NUMBER: 2. DEALER I ISSUING AGENT rlJM&rBank 499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12 Phone (888) 502-4349 Fax (302) 934-2955 April 22, 2008 Wix Wenger & Weidner Attorneys At Law 508 North Second Street Post Office Box 845 Harrisburg, Pennsylvania 17108-0845 Re: Estate or Alice V Troutman Social Security: 172-01-2759 Date of Death: Februarv 17. 2008 Dear Sir or Madam: Per your inquiry dated April 15, 2008, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type of Account Checking Account Account Number 61220965 Ownership (Names of) Betty Bressler * Alice V Troutinan * Opening Date 10/28/84 Balance on Date of Death $7,332.45 Accrued Interest $ 0.00 Total $7,332.45 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 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, etc., please contact our Summerdale Plaza Office # 717-255-2261. Sincerely, /YM1,ic?,~i~/. . /1~;/'V7 () Nancy Clagett Records Management I~J ...... .. - -' - - .. ~ ~ ()o()~~ ~~~<O' ~ (\) ? -' ,.... _' t::r m \.I' ~()(\)--- (\)O~~~ ~ c- ... "'\l::k~g,o. )?'go.z~ ......c()::::;.:~ -J m(\) 0 u; 3 o c (\) ...... 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