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HomeMy WebLinkAbout05-30-08 ,-1 15056051047 REV-1500 EX (06-05) PA Department of Revenue Bureau of Individual Taxes PO BOX 280601 Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death OFFICIAL USE ONLY County Code Year File Number INHERITANCE TAX RETURN RESIDENT DECEDENT ~.'. " () 3" 0".11.0 1 Date of Birth 3 \ 0 '-to 'l~1 \.1 3 I 5 ~o () 1; Decedent's Last Name Suffix o~o ~'f~1 Decedent's First Name MI 1-. E '" *f'.-t. ~e ~ R~ .J,. (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI ""L I~.~ ~<2. \N[)fl L Spouse's Social Security Number ) '1\ '- .... 3lj 6 I.f ~7 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW _ 1. Original Return C> 2. Supplemental Return C> 3. Remainder Return (date of death prior to 12-13-82) 4a. Future Interest Compromise (date of C> 5. Federal Estate Tax Return Required death after 12-12-82) 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Trust) 10. Spousal Poverty Credit (date of death C> 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) C> 4. Limited Estate C> .. 6. Decedent Died Testate C> (Attach Copy of Will) C> 9. Litigation Proceeds Received C> CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number R bB E p..., E. Firm Name (If Applicable) fJ\)I /3. ((5 7 17 7"1 'f:3 I 6~ REGISTER OF WILLS USE ONLY ] () () o j,.. 0 l'<al\D t-.:I = c::::~ c.::.:> (..) o r-~ ~~;~ First line of address Second line of address o ,..- r'T""'l ::.u /' 3 ':1,';;;;.0 -< ~ -e w o '" t\~ ~f\.L {\ ~ 0 Pt\ /70JO ()O -0 DArf;.ffl2i!o 3'.': =~ City or Post Office State ZIP Code (.." C '::-.> - fl 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, cor c nd com pie . Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNAr p DATE ..,s-- Z. 7-CJ!:; OJ2.,WE- I CM1.f ,If t/...L\ Pic,' J1U~'- .__..~..- DATE B\1J -.Cu. t'-~f. '(t~_M Q_~LJL:::_J 1 0:1 0 ~--~-"-"--= PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056051047 15056051047 --.J \ ~ REV-150U eX Page 3 File Numb,,! Decedent's Complete Address: f'~--~~--~._----'."'---'-' i DECEDENT'S NAME : --Ye. R.~ V .- t.. . I STREET ADDRESS T 1- ff-D 6(?l~NeLL i ___~___W_'___'~._'_"_ff._~__,<_,___.,_,""_,."__,___._,~",_'_'_"~"_~"~~___'_,n'~._. ZENT1- \JR-LVG: I CITY C f\M P It I L-l- - : STATE fl i\ ZIP \ 1 0 "2 0 I_________^..._____.___.________._.._______~.__..__.__...__.__..___....._.__.... Tax Payments and Credits: I Tax Due (Page 2 Line 19) Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) ________ -----O.-.D.u--__ Total Credits ( A + B ;- C ) (2) .. __" .__tll.QLl__ ___ Interest/Penalty if applicable O. Interest E. Penalty Total Interest/Penalty ( 0 + [ ) .+. Ii Line 2 is greater than Line 1 + Line 3, enter the dilference. This is the OVERPAYMENT Fill in oval on Page 2, Line 20 to request a refund. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (3) ~-------_~.12.Q__.._ (4) _.._ ._______._____md.t>~_____ (~ .\ _____________n_~Q&'-"_ ___ _ B. Enter the wtal of Line 5 + 5A. This is the BALANCE DUE. (5A) ________________0 illQ___H (5B) O. VU A. Enter the interest on the tax due. Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BlOCr\:S 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred;........................................ .....H.......'...... ... [.1 [3" b. retain the right to designate who shall use tile property transferred or its income; .....H................ [J 1''1 c. retain a reversionary interest; or.......... ...... .. ......... .. ..... ...... ..........0. [] IZ d. receive the promise for life of either payments, benefits or care? ..... .. . H ... . H"H" [] l~ 2. If death occurred 811er Decembel' 12,1982, did decedent transfer property within one year of death without receiving adequate consideration? ... . ...... ..... ........ . [] Cta" 3. Did decedent own an "in trust for" or payable upon death bank 8ccount or security at his or her death? ..... .... D [&?' 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which conwins a beneticiary designation'l .............0. ...H....H........... ............... H ..... LJ ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN For oates 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. S9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural pare'll, elli adoptive parent, or a stepparent of the child is zero (0) percent [72 PS. ~9116(a)(1.2)]. The tax rElte 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 rloted il, 72 PS. S9116(1..2) [72 P.S. s9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 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. ..-J 150.56052048 REV-1500 EX Decedent's Name: RECAPITULATION Real estate (Schedule A). 2. Stocks and Bonds (Schedule B) 4. Mortgages & Notes Receivable (Schedule D) . 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) 3. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) c:::> Separate Billing Requested . 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) c:::> Separate Billing Requested. . . 8 Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H). . 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . . . 11 Total Deductions (total Lines 9 & 10). 12 Net Value of Estate (Line 8 minus Line 11) . 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) . . . 11. . . . 14 1. 2. 4. 5. 6. . 10. . 12. 13. Decedent's Social Security Number 3' D ~Ct"'11)7. .Lt 7. 8. 9. DO dO C> 0 o. 0 0 tJ D. ~ 0 0.6 i) ) ~ '1 T 7- 0 U '\>0 ~.41i7-0 0 D. DO ~ ltl.~ 3 D_~cJ TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(12) X .0_ - 15. Amount of Line 14 taxable at lineal rate X.O__ 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 . 19. TAX DUE. . . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPA"'fMENT Side 2 L 15056052048 15 16. 17. 18. - - . - O-D() c:::> 15056052048 --I RFV-1511 IEX+ (10-06) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF -JP~I\~ L. LeNTI. FILE NUMBER ~-Ob - Oc>LWl ITEM NUMBEf~ A. Debts of decedent must be reported on Schedule I. 1. FUJJERAL EXPENSES: r 1\1t\r\ e ~(tE. DESCRIPTION F......,J & ~l... t+ 0,.,... €. B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions 2. 3. 4. Name of Personal Representative(s) _ G t::;BALPj.:;.., S Mlf tt--~d ~- i< ~~~ G.L~j\J Ofl-l ~~~r,,;, 17 OJ I Street Address _il CAM " City Year(s) Commission Paid:_____ Attorney Fees Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant __ LllvD~__L~_ L.-~T1-- Street Address ~O G ~ ~cV t::.L-O/lJ.Ve City c. t\.\V\.~ ~ \ \.-L State L Zip lIll/l Relationship of Claimant to Decedent ~!O-l2LO 5. Accountant's Fees Probate Fees 6. Tax Return Preparer's Fees 7. -=t>. 0(- w\u.., - Fll-G- '-Ax,. Re-ru(J.,,J .. - ReS~a.utS 1D f~L-6 (A.MU-l.\ l~L.GA~Z; fl-bfl6~ Aft) I ~E'G\STE((. u I L TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) AMOUNT b ~ttO ,OD D.DD 3DDO' DO 3560,D[J Icl.uD \ ~jl>D ~, 'D D ~ 9;,. vlJ April 9, 2008 To Whom It May Concern: 4 Integrity BAN K The date of death balances (March 15,2008) for joint checking and savings account for Terry and Linda Zentz are as follows: Checking Account #203012122 Savings Account #403005647 $21,594.19 $3,819.08 Please contact me at 717-901-5500 with any additional questions. Sincerely, ~=~ Assistant Branch Manager New Cumberland Office 3345 Market Street, Camp Hill, PA 17011 . Phone: 717-920-4900.877- 1- HAVEIT . Fax: 717-920-4904 . www.integritybankon!ine.{()m Apr 08 08 11 :41 p Terry Zentz ING DIRECT 7175677433 p.12 Page 1 of 1 Put your refund into a 6-month .. and watdt it grow instead. '-.,>'" ~-"'/_""';'-'" ..,_-,'''' "c Details for TLSavings - 5339675 For informal1on on adding or {emoving a joint owner {or this account. Primary Account Holder Terry L Zentz Scrcorrdary .Account HO!der: Linda L'Zent?: Current AnouDI Percentage Yield: 3.00% Interest Earned This Month: $102.37 Interest Paid Year to Date: S 254.16 Inlerest Pa;r! in 2007 : $ 2.986.13 &' hCC,::'!'! '.'i,.m'ten.',' c.' Ei} ..:,,>: :'oac! Date Mar 19, 200S Mar 11. 201>8 Feb 29. 2008 Feb 15, ZOOS Fob 1. 2008 Jan 31, Z008 Jan 23, 200t Jan 14. 2008 Jan 2, 2008 Ot;-C J1. 2007 81 :.a:.S;?CC"" Posted Transactions Transaction Description 'nterE~5t RatE' Change to 2.~60% p.O!r.4 APY) Interest Rate Change to 3Jl57'1. p.10'/. APY) Monthly Interas! Paid Intcmel Withdrawal INTEGRiTY BANK checking account XXltXXX2122 t"terest Rate Change to 3,348% (3.4C% APY) Monthly lntercst Paid Intere-s-t Rat9'Cnange to 3.590% (3.65% APY) Internet Withdrawal INTEGRITY BANK checking account XXXXXX2122 IntemetWithdrawallUTEGRI1Y BAUK checking account XXXXXX2122 MOllthfy Inte-(e::.t P"",id iile Orange CD - Great Rate, Guaranleed Return Dnd No Market RiSK N..xtO Amounf Balance 108.63 40,09210 (2,000.00) 39,983.47 145.53 41,983.41 (5.000.00) 41.837.94 (2,1>1>0.1>1>> 46,837.94 '167.92 48,837.94 ~ '\.toal i' 'Secu<itVGuor_IOPriv...,. 1 Jo!itn"'T...... I CiM~ I 'lMShop I l(kb ~- CD . 1.o1;1i mte1&!Sf ~llld.s'1\U Sep1f9tlblt }OM $ 8,.4 ~ 1,69 3.,.>> 3 S https://secure.ingdirect.com/myaccountlING Direct.html ?command=display AccountDetails... 3/3 1/2008 Apr 08 08 11 :36p Terry Zentz 7175677433 p.2 . PMA account 868207697 . March 1,2008 - March 31, 2008 . Page 1 of 9 P M A'" Wells Fargo. PMA Package If you have questions about Ihis slatemenl or your sCC9unts: Phone: 1-800-742-4932, TTY: 1-8oo-600-48n Spanish: 1-8n-727-2932 , TTY: 1-888-355-6052 Chinese: 1.800-288-2288 Online: wellsfargo.com Write: Wells Fargo Bank, NA P.O. Bo)( 6995 Portland. OR 97228-6995 TERRY L ZENTZ OR LINDA L ZENTZ 20 GRINNEL DR CAMP HILLPA 17011-7715 March 31, 2008 Total assets: last month: Change in $: Change in. %: $42,177.70 $42,684.65 $(506.95) (1.19)% Total liabilities: last month: Change in $: Change in %: 50.00 $0.00 $0.00 0.00% PMA Qualifying. Balance: $42,177 .70 Contents Pago . . . . . . .2 . . . .3 Overview. . PMA Prime Olecking Account. Savings. . . . . . . . . . . . . . <I !1,tirement BlOkerage Account. .............5 {t14' ,. ;/ 11~524 Apr 08 08 11 :36p Terry Zentz 7175677433 p.4 . PMA account 868207697 . March 1,2008 - March 31, 2008 . Page 3 of 9 PMA Prime Checking Account ,Il,ctlvity summary Balance on 311 DepositslAdditions WithdrawalslSubtraclions Balance on 3131 638.55 0.03 .100.00 $538.58 Account number: 868207697 TERRYLZENTZ OR LINDA. L ZENTZ Wells Fargo Bank, !'IA. California (Member FDIC) Questions about your account: 1-800-742-4932 Works heel 10 balance your account and General Statement Policies can be (-ound towards the end of this statement Overdraft protection Your lIcoount is linked to the following for Overdraft Protection: . Savings .6868611013 Interest you've earned Interest eamed thiS month Average collected balance this month Annual percentage yield earned Interest and bonuses paid this year Total interest and bonuses paid in 2007 $0.03 $546.22 0.06% $0.10 $77.70 Transaction history Date Description BegInning balance on 3/1 314 Bill Pay Health Net RecurringxxlOO<644 7 On 03-04 3/31 Interest Payment Ending balance on 3131 Totals Depositsl Withdrawalsl Ending Daily Cheel< No. Additions SublTacliOns Balance 638.55 100.00 538.55 0.03 536.58 538.58 $0.03 $100.00 114526 Apr 07 08 06:45p Terry Zentz 7175677433 p.3 i rt-V~ E,CV)C QuoTE: C. V. ,~\. JI/4 45(,). / II ~1:5. Jj 950. Jl :;<75 I J1 qoo I f~~1t{ V i t-)I LL L zl2CT/2IC-- A-vro (2f:Ae Dwl2- L- fATH-te Sf-A'S 6terr~IC lt0-ru ,Si i)G L>GC'as tJ It J I{tAT' Cr.tJ 5,-/ S;I' c W'\ IJ /~, ?:?() ~ \ J So f ------ I/AL-uE (8LVr:;- g~j<:) tv" t 1- 8 'S> ~coro DOObf 6eAtJb CA{JiV!tlJ ~T - - r Apr 07 08 06:53p T eery Zentz TlIU'::Pl10 U~'l>~f;)\ 1\1. A. U.S. DE?ARiME~ T OF HOUSING and URBAN DE'IELOFMENT SEnU:.MENI SfAIEMENT PA PROPERTY SETTLEMENTS, LLC 4660 TrindteRoad- Suite 103 Camp Hill, PA 17011 7175677433 I I I 1 1.1 1 FHA. 4. ( J I/A I G. FilE NUI.tl6ER; I 30037 8. MORT. INS. CASE NO.: B TYPE: OF LOAN Phone: (717) 441-1671 FAX: (717) 763-7460 2. t'1 F!\,1)o-ljl. 5.! ] GONI/. iNS. 7. lOAN 'lUMBER. p.21 2.'( J CONV. i.Jt.J!\JS. I I II I C. N01E: This iorm is Jurnish~d to gve you & si.:ement 01 actual settlement costs "'mounts :>aid Ie a"::l by the settlement "bent are shown. i "(P.c.G.)' were paid oU1sic:e the closin.g; 1ney arQ shown here ~o~ infofr.1slio:1al purposes and are not included In the ,olals. I 0 NAME AND ADDRESS OF BORROWER: E. N~ME ANC: ADDflESS OF SEllER F NAME AM) AGDR,,55 OF \.l:NDER: I TERRY L. ZENTZ I PHYLLIS MARGARET KLAIN " LINDA L. ZEKTZ ESTATE G. 'flOPEATY lOGAnON. H. S:;:TTlEMENT AGENT: I~ 20 GRINNE;L DRIVE ~OWER ALLEN TOWNSEIP, CUMBEIU..AND COUNTY, PA ?A PROPERTY STL. SVS. PLACE 0" ~FTTLEMI'NT' I'c~t~y n-Walak, Camp HU1, PA i J. SUMMARY OF BORROWER"S TRANSACTION: IDe. GROSS AMOUNT CUE FROM SORROWER ro.. Centrael salS5 prrce 1 ~ 7 5000 . 00 , 102. PerwnalOrODeI1Y I \ 10; Seltlemenl Ci'1arges 10 Dorrower :i1ne 1400)! 3340.63 , 10'. I 110~ I Adi~Mments for .tems paia by 5.Iler In sdllance ; lOr.. CityfTovm lax to I 1.01 County ax 10/10/0710 12/ 31/071 134.21 ! 100.. A.ssEs5menls lo I i .09 Sc:MdTwc 10/10/0710 06/30/ 08~ 98{!..{!.2. \11[1. 10 111 112. 120. GROSS AMOUNT DUE FROM DORROWER 179459.26 "'" AMOUNTS PAID BY OR iN BEHA~F OF BORROWER \ I 203\_ Dep.ol).l Cf eames~ noney lll2. Principal amou "I of flew Joon( s) ,03. ExrslirrQ loan(s: taken subject to I'~ b----- ~ 1208 20' I I I 1 A"Justman!s lor items u~;>akl 'oV seiler l10. CltV(Town lax '0 211. Coun t'l tax 10 21.2, A$.SOS$Jl1QFll.$ to ["3. 10 ) 2'i". l15. 21~. I (211. i 2.. ! ZI; ! r .". TOTAL PAIl) BY/FOR 1l0RROWER JOJ CASH AT SETlLEMENT FROM QRTO BORROWER . 301. Gross anount due from borrower (line ;20) I 302 less 31>.",,,"1 paid l:y,r;or berrowllr (lina 220) 1 303. CASH 5JY.1 FR)*J (I ITOI BORROWER i .J >-7.#A-4 'Tg/I/-- J 12ft~'-:Z.;i? ~ ~__f euy(;' or Bo--rowefs $i.godture cV I,J 2000.00 179459.26 2000.00 177459.26 I~BrTS marked I. SE T1.EME.'lT DATE' H/10/07 I K. SUMMARY OF SELLER'S TRANSACTION; 4DO.GROSS AMOurn DUE TO SELLER 40 \.C<ln\l act "ates price T ~ 7 5 0 0 0 . 0'0 , 4G2.P3rsonal property 400. 40'4, .0:;. Adj"",:merls for ~ems paid by seller in adoanc3 40:;. Clr,fTown lax 10 T 401Counlylax 10/10/071012/311 07i "D!-A5sc~smonffi to J 4G9.5GhooITw< 10110/ 07Lo 06/3 0 IOS: 410. 411- 412_' 10 SOD. RECUCTIONS IN AMOUNT CUE TO SEllER 20 C 0 ~ 00 501 Exccss doposi~ (see ins.tructlons) I 5OlSefllemer>, chlJl'g&S 10 seller (lirle140Cl} I 503.Existlng loan(s) taken subjecllo T st>t.?ayollo" First Mortgage Loan I so...oayo11 0" Second Mortgage Loan 420.CROSS AMOUNT CUE TO SE.LLER . 506. S-J7. 5:8'. 509. Adjustments for items unpaid by se'le" ~lO,CiiyITown tax to S11,COlJnIY tax Ie ~\2..A~SC'$,e.mllrJ.s. t,:, St1 ~ S14. i 515. i 516. 517. !.18. 519. >>o.TOTAL REDUCTION AMOUNT DUE SEllER 600 CASH Al' SETiLEMENT TO OR FROM $EL~ER 001.Gr05S amounl cue tv sel',er (line 420) G"D2.Less reductiofl s.mount du~ se~ler {linG 520) _CASH l!lg T9f'fIJ FR~M~ SEI.LER / tJ It ~~ -- ,. Seller'!;. SigflalurQ 1 l \ 134.211 I 984. .4.2.. \ -, 1 176118 _ 63 14449. 7 ~ I i 14449.75 176118.63' 14449.75 161668.8-& : -e.J'~t.J'-i-o/... HUD.j .:;"0. 51e6 Apr 07 08 06:54p Terry Zentz 7175677433 p.22 U.S. DEPARTMENT OF HCUSING AND URBAN DEVElOFMENT SETTLEMENT STA YEMENT L. SETTLEMENT CHARGES 30037 700 TOT Ai. SALES/BROKER'S COMMISSION band on price $ l7 5 0 () 0 . 00 6 . 0 Divis'on "I Cnmmissjon Cine 700) as ~ollav."': Total: $10. 500 . 00 701 $ 5275.00 10 ERA-NRT. INC. 702 $ 5225.00 \0 CENTURY 21 - WALAK 700. Comcllssion paid al Salliemenl 70". TRANS. FEE WALAK l<1ALTZ ERJI.-NRT 800. ITEIIIS PAYABLE IN CONNECTION WITH LOAN 801. loan Originallo~ Fee % 802. Loan DISCOunt % 003. Appraisal Fee 10 1lOol. C1eclitReporl 10 BO!>. lenders Inspection Fee 806. Tax Svs. Fee 807. FoadCMf. aoe. 809. 810. 811. 900. tTEIIIS REQUI::lED BYLE/IIDER TO BE f>AIO 1/11 ADVANCE \lO\.lnlerestlrom 10 10/07 \010 31 07 @$ Jcay \lO2. Mortgage Insurance Premium 10' mo. 10 903. Hazard IrSUl61nCe PierrJurn lor yrs.10 ~. ~s,to 49.78 ;"mo. Ima. imo. imo. imo jmo, imo Imo. ilQS. 1000. RESERVES DEPOSITED WITH LENllEIl FOR :001. Hazard lnsuran:::a mQ, @ $ 1002. "'orlgage Insurance mo. @$ 1003. CiWrrowr, lax r:lO. @ $ 1004. Courly tax ",0. @ $ 1005. Assessments mo. Ii $ '006. MO@$ 1007. MO @$ 1008. MO. @$ 1100. TITLE CHARGES ! 101. S~tt1ement""elMing !eele 1102. Absllael or lilie sear=h Ie 1100. Tille eX.rlination Ie 1104. Titie insurance binder 10 1 \050. [)c,cume.'lt preparation 1c 110&. Notary laes Ie 1107. Attorney's leas fa (includ9S above items No.:) i 108. Tbte Jnsurance 10 (includes above ilems No.:) 1109. lender's c.over8;le $ 11fO. Owner's coverage $ ~13. 73 LOU MARTIN, CASH ESQ. PA PROPERTY SETTLEMENTS 175,000 i 1\ 1- tf2 , 13. 200 GOVERNMENT RECORDING P.ND TRANSFER CHARGES :201. Rgcordirig ft:.'€s Deed $ 38.50 Mortg~e $ Misc. $ 38.50 202 Cilylcoun:y la,}slamps: Deed $ 1750. DOMortgage $ 1750.00 203. Slale lax/stamps: Deed $ 1750.00Mortgaga1. 1750.00 204 20~ ! 300. ADDlTIONJll SI:TTtE"'ENTcIfJlFlGES 301. Survey 10 i 302. Pest Jns::l9Cticrl Ie P,,'NS INSPECT 45 .CD I 303. 07 SCHOOL BONNIE MILLER , 1364.75 30'. HOME WARR. AHS 485.00 305. 400 TOTAL SETTLEMENT CHARGES 'g~ler on lines 103 and 502. SecljonoJ aM K) 3340.63 14449.75 - PDrt,o.S ....g4" 'llal ho Iiawlify is assumed bV Settlsmenl A"anl iortlle 8GGUfacy nllnlnmaUo.. lUmllioh1l'd b\,t oU'erl';;~ 51\0'"," or t...a HOD.' S;:!lOemcnl Sla'emerd. SoUI~Il' lI,~lJ"t hereby C~[lrc:>5t'f 'O~"""':!S '.hefigt.t.ICl' de~ iMy ~~s co~d Ior'dts.b~;" all inlercst bearirlQ' ;r-;courrtin :r ~IJlyilT!tlr()cr-If1s11r1jliO' and Ie> Cf~rJlt ~l1y j,,~,..~!! 1;01)- 1!!.!f'I'!!d lao il!; ~..,[\ aC<,;O\).",l a~ :mdil~a! ~on'pV..1 or, lor its. ~Nic.s in \"i~ :flln~a.di90, HUO CERTIFICATION OF BUYEAS AND SELLERS 1 have cafefult; tev~WQd \t\e :-<<..10-1 Seltlerf'lCmt S\atamenl anC11a t,)Q b~&t o~ MY ilr:owledge and belief, it i$ & true and accurate statemQrll of all rc-ce'pt~ al1d d 5bursemert~ ~~ ;;;~-~".~..~~oiJt-T . '---L-oM :C.c---' , ,_ _ / ~ A Q;c e. '- v 'jt>t' u,,,,, Of "ouow."', &l9''''.'G s.ua,..s;go., '---' uycr':>> AlSOr'liISJi & PrTl)nc: Scllor's New Addrc50S &. PhCf'tr. t\C HU .1 SeW ,-.enl Statement w;,i;;~ [ na'". ~raP4:lrc.d is a true .and aC~lIr<'lll!!'account Of ImS trlmHelion I helVE' ceused Of will calJ~ It\e tund$.~<l!J,~ di~rS90 in aC(:t)fda,n:.e wilh 1his SlalomGl,..1. 10/.0/0'7 D-,.Iil:! . to kno-wingly make IlllSiC s1aterr,enls 10 the Unllect SUllies Oil '''''5 or any !i:nbar f(l;I11. Pen.afties. !JpOn GOrwicHon can melute a line Lftd Irnprison""ltn!, ~()I de1a.!\~ ~Cr . ~~ Sed-1M tOOl and 3~chQCI. \01il rlUll.l Rev. .5,186 ~ / // '\ n~ ~ LAST WILL AND TESTAMENT OF TERRY L. ZENTZ I, TERRY L. ZENTZ of 20 Grinnel Drive, Lower Allen Township, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking all other Wills and Codicils previously made by me. ITEM I: I direct that payment of all my just debts, expenses of my last illness, funeral expenses, and cremation expenses and the costs of administering my estate from my estate as soon after my death as conveniently may be done. ITEM II: It is my will that my body be cremated. ITEM III: I give, devise and bequeath all of the rest, residue and remainder of my estate, of every nature and wherever situate, together with all insurance policies thereon, unto my spouse, Linda L. Zentz, providing my said spouse shall survive me by ninety (90) calendar days. ITEM IV: Should my said spouse predecease me or die on or before the ninetieth (90th) day following my death, I gl ve, devise and bequeath all of the rest, residue and remainder of my estate of every nature and wherever situate, together with all 1 insurance policies thereon, to my three children, namely, Elizabeth A. Chilton, Gerald E. Smith, Jr., and Tamara L. Zentz absolutely, share and share alike; in the event any of my children predeceases me or dies within ninety (90) days of my death, then his or her share to go equally to his or her children then living, and if not survived by any child then his or her share to go equally to my surviving said children. ITEM V: I nominate, constitute and appoint Linda L. Zentz, my spouse, as the sole Executrix of this my Last Will and Testament, to serve without bond. In the event of the renunciation, death, resignation, refusal or inability to act for any reason whatsoever of the said Linda L. Zentz, I nominate, constitute and appoint Gerald E. Smith, Jr. my son to be sole Executor of this my Last Will and Testament, to serve without bond and if he refuses or is unable to act for any reason then Tamara L. Zentz, my daughter to sole Executrix. Will and Testament, set my hand this to this my Last 77. day of /,4.; - IN WITNESS WHEREOF, I, Terry L. Zentz, have, : ,;" h '-" "-- i ...... P''''"t ",if..., . " 2007. / 'f";""""":~'i:" ,,f. :' ,"/;';"'->~'l'?"."'"",;// "_e'vi "''-/ /7,,/'::<:: " (SEAL) :J'eiry/L. . Zentz Signed, sealed, published and declared by Terry L. Zentz, the above named Testator on the i).,_l Ii day of JI} .ivi<;,t" '3t::,:L , 2007, as for his Last Will -and Testament, In the presence of us, who, in his presence, and in the presence of each other, have, at his request, subscribed our names as witnesses hereto. 2 /- .., ~ _ .~ "j!, ' ';JL, (t" ~?;-~. \ Name '......,4 /"" lLtfL7/vCl L,t. Name i ) . 1'-2 ,/ ) .' , )1'~>""-"z(J' )": V '-:1 ~,v2~-- / / :/ residing at residing at '~~ (: . ~;jl.{:,; ;,;..' " ( <...t.. ',,1"'_/') ,^:/;::.d'/. / ~", ..-;r >e9t./')7' <~L'2. . /,..~-'1 '."" " r / I e..'/I j) (- COMMONWEALTH OF PENNSYLVANIA COUNTY OF YORK SS WE, the undersigned, the Testator and the witnesses, respectively, whose names are signed to the foregoing instrument, being first duly sworn and qualified according to law, do hereby declare to the undersigned authority that we were present and saw the Testator sign and execute the instrument as his Will, and that he had signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the Will as witnesses and that to the best of their knowledge, the Testator was at that time eighteen years of age or older, of sound mind and under no constrain or undue influence, and I, the said Testator, 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/" ,,< /..:.../ i ,,OJ'" i:. .:.::.:, ,~'..... ",,,-'.... .~ .' /,,/ .<testator. "<,r ... , t- 'I..l., )' 'j,' .:"( ?'~tl . (.' )~i tness y(...{~~,,-~.~- Wi tnessj ;f~) . :;?l;/J"c71" -'_/ /~' ~.j Sworn to and subscribed before me this pi,. Tday of NPlSii'AfR., 2007 . ~ 1'-.7;'7 t':> : Il,,;? i^~ .' .', ';>-. 'J}k,~/V9'''-' .' 1.1.-' ...,0, ; '>> ,,'---! Notary Public' '._ My Commission Expires: I" \ t\ i.1 sa!JBIOf~ j'J U01<"',0<;":'. "'<'Iqw~ . . "_'........_.,._ W 600l '6 ~ 'UBr Sa.lfdx:i l:l()jSSIUlU.lOO ^w ,{juno:J )jJo A "(W.,l MSINted ::l!lQnd NElON 'Sle^w '3 lJSClOl:i rees 1l:l!JBlON VINVA1ASNN3d ::10 H.L1V3MNOWVllOO COMMONWEALTH OF PENNSYLVANIA Notarial Robert E My Seal F" " ers, Notary Public I " ai/View Twp.. York Co ""ty 1 MYC.ommissJ(JI1~:Yr"'" u". ___..._.."".._.._._'"....:....,~J{.e,<;"an, 19 2009 i !,'kw !-.; .. . ......-. ..~'--:7~i;:;;;:i 3 .. fo:C ~<=>g. ~~~ 3~m g:n.3: _ "'- .. 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