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Home My WebLink About09-08-08 (3)~~ / 15056041147 REV- ! SOO EX {06-05) OFFICIAL USE ONLY PA Department of Revenue county cede Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN Po Box.2soso~ 2 1 0 8 0 4 4 4 Harrisburg, PA 17128-0601 `~ RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social :iecurity Number Date of Death Date of Birth 168 26 7393 03 18 2008 02 26 1930 Decedent's Last Name Suffix Decedent's First Name MI WISER GLADYS I, (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouset's Social Security Number THIS RETURN MUST BE FILED 1N DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW 1. Original Return u' 2. Supplemental Return C 3, Remainder Return (date of death prior to 12-13-82) ~t. Limited Estate ~ 4a. Euture Interest Compromise ~ 5. Federal Estate Tax Return Required (dale of death after 12-12-82) g, Decedent Died Testate f-l ~ Decedent Maintained a Living Trust 8. Total Number of Safe De o (Attach Copy of Will) L~ (Attach Copy of Trust) p sit Boxes 9. Litigation Proceeds Received ~ 1 p, Spousal Poverty Credit (date of death 11. Election to tax under Sec. 911 A between 12-31- 1 and 1-1-95) ~ ~ ) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number ADAM R.~SCHELLHASE ESQ. 717 263 2121 Firm Name (If Applicable) SA:LZMANN HUGHES PC First line of address 79 ST. PAUL DRIVE ' Second line of address City or Post Office CH.AMBERSBURG State ZIP Code PA 17201 REGISTER O~U111LLS USE~ILY r~ j -r? ~rT ~ r t..r.1 cr ~~ ~ ~ ; , r r ~ +, '~ ~ ~ - -~ DA~$ FCLED N 7 CJl .~ C~~ !' ~) '- -n ~::~a C1 r-i1 .r~ Correspondent's a-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. Linda K. Ruth 5201 Gibson Hill Road, Edinboro, PA 16412 SIG J U$jE jQy PAP .ROT THAN REPRESENTATIVE Adam R. Schellhase Esq. Ob' 455 Phoenix Drive, Suite A, Chambersburg, PA 17201 Side 1 15056041147 15056041147 J 15056042148 REV-1500 EX Decedent's Social Security Number ~eceoern•s Name. G 1 a d y S L. W i s e t' 1. 6 8 2 6 7 3 9 3 RECAPITULATION 78,000.00 1. Real Estate (Schedule A) .......................................................................................... 1. 2. Stocks and Bonds (Schedule B) ............................................................................... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C).......... 3. 4. Mortgages & Notes Receivable (Schedule D) .......................................................... 4. 1 5 , 3 1 0 . 1 5 5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ................ 5. 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested ............. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested ............. 7, g. Total Gross Assets (total Lines 1-7) ....................................................................... g. 9 3, 3 1 0. 1 5 3 7 , 9 7 1 . 0 9 9. Funeral Expenses & Administrative Costs (Schedule H) ......................................... 9. 2 ' 7 8 6 ' 2 8 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10. 11. Total Deductions (total Lines 9 & 10) ...................................................................... 11. ~ 4 0 ; 7 5 7 3 7 12• Net Value of Estate (Line 8 minus Line 11) ............................................................. 12. 5 2 , 5 5 2 . 7 8 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) .................................:............... 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ................................................. 14. 5 2 , 5 5 2 7 8 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, of transfers under Sec. 9116 (a}(1.2) X .00 0 0 0 15. 0. 0 0 16. Amount of Line 14 taxable at lineal rate x .045 ' 5 2, 5 5 2. 7 8 16. 2, 3 6 4. 8 8 17. Amount of Line 14 taxable 0 0 0 17. 0. 0 0 . at sibling rate X .12 18. Amount of Line 14 taxable 0 0 0 18. 0. 0 0 . at collateral rate X .15 19. Tax Due ..................................................................................................................... 19. 2, 3 6 4 8 8 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. L 15056042148 Side 2 15056042148 J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-08-0444 i DECr EDENT';i NAib1E I Gladys L. Wiser STREET ADC)RESS 100 Cieversburg Road CITY I STATE ZIP Shippensburg I PA ! 17257 Tax PaymE:nts and Credits: 1. Tax Due (Page 1 line 19) 2. Credits/Payments A. Spousal Poverty Credit g, F'rior Payments C. Discount 3. InteresUP~enalty if applicable p, Interest E. Penalty 0.00 (1) Total Credits (A + B + C) (2) Total lnteresUPenalty (D + E) 4. If Line 2 i:s 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. g, Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check Payable to: REGISTER OF VYILLS, AGENT (3) (4) (5) (5A) (56) 2,364.88 0.00 2,364.88 2,364.88 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" 1N THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred :.................................................................................. ~ I z ' ' 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? .............................................................. ~ ~x 2. If death occurred after December i2, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................................................... n 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? ...................................................................................................................... ^ C IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE iT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. §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) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §9116 (a) (1.2}]. The tax rate: imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)J. The tax rate: imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116 (a) (1.3)]. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. Rev-1502 EX+ (6-98) SCHEDt~LE A REAL ESTATE COMMONWEALTH Of PENNS'/! VANIA INHERITANCE TAX RETURN RESIDENT DECEDENT cSTATE OF IFiLE NUMBER Wiser, Gladys L. 29-08-0444 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is def ned as the pric:: at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on schedule F. (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule A (Rev. 6-98) Rev1508 EX+ (6-98) SCNEDtJLE E CASH, BANK DEPOSITS, 8~ MISC. PERSONAL PROPERTY COUMONWEALTH OF ?ENNSV'..`~/ANIA iNHER!TANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Wiser, Giadys L. 21-08-0444 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. (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) REV-1151 EX+(12-99) gCHEDULE H FUNERAL EXPENSES & CCMbICNWEALTH OF PENNSYLVANIA IN E T E E TRN ADMINISTRATI`~/E COSTS R SIDEN D CE C N ESTATE 01= FILE NUMBER Wiser, Gladys L. 29-08-0444 Debts of decedent must be reported on Schedule 1. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s) attached B. 1 ADMINISTRATIVE COSTS: Personal Representative's Commissions Social Security Number{s) / EIN Number of Personal Representative(s): Street Address City State Zip Year(s) Commission paid 2. Attorney's Fees SALZMANN HUGHES PC 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) ' Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. I Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 5,960.00 5,400.00 490.25 7. Other Administrative Costs 26,120.84 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 37,971.09 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-t5U2 EX+ (6-98) SChEDULE h-A FUNERAL EXPENSES cont9nued C:OMMONWE4LTH OF PENNSYLVANIA INHERITANCE TAX RETURN ~I RESIOEN? OECEOENT ESTATE OF FILE NUMBER Wiser, Gladys L. 21-08-0444____ Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-A (Rev. 6-98) Rev-1502 EX+ (6-98) SChEDULE H-B7 OTHER ADMINISTRATIVE COSTS COMMONWEALTH CF PENNS~L!/ANIA continued INHERITANCE TAX ~ETURN RESIDENT DECEDENT ESTATE OF ~FfLE NUMBER Wiser, Gladys L. 21-08-0444 Copyright (c)1002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) Rev-1512 EX+ ~(6-98) ,. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECECENT sc~E~u~E ~ DEBTS OF DECEDENT, MORTGAGE LfABiLJT1ES, & LIENS ESTATE OF FILE NIiMSER Wiser, Gladys L. 21-08-0444 Include unreimbursed medical expenses. ITEM VRLUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Adams Electric - ~ 202.62 2 Borough of Shippensburg 37.06 3 CFJMA 85.40 4 Chambersburg Hospital 84.00 5 Encompass Insurance 120.30 6 MS Hershey Medical Center 575.33 7 ~ Orrstown Bank -mortgage payments ~ 403.42 8 PCH Collectibles ~ 83.44 9 Shippensburg Area EMS 710.00 10 Timmons Oil - 321.00 11 WSEMS 163.71 TOTAL (Also enter on Line 10, Recapitulation) ~ 2,786.28 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule f (Rev. 6-98) REV-1513 EX+ (9-0D) SCHEDULE J COMMGN4~/EALTH OF PENNSYLVANIA U g E~ E F 1 C lAR! ES INHERITANCE TAX RET RN RESIDENT CECECENT FILE NUMBER ESTATE OF Wiser, Gladys L. 21-08-04 44 NANIE AND ,ADDRESS OF REL A T lONSHiP TO DECEDENT SHARE OF ESTATE AN10L'NT GF ESTATE NUMSER PERSONS} RECcIVING PROPERTY Do Not List Trustee(s) {Words) ($$$) I TAXABLE DISTRIBUTIONS (include outright spousal - distributions, and transfers under Sec. 911o(a)(1.2)i 1 Linda K. Ruth Daughter 5201 Gibson Nill Road Edinboro, PA 16412 2 Clay A. Wiser Son 3617 Butter Bridge Road Pletcher, NC 28732 3 Roy E. Wiser Son 53 Water Street Walnut Bottom, PA 17266 4 Samuel E. Wiser Son 470 E. King Street ~Shippensburg, PA 17257 5 Tommy R. Wiser Son 211 Senior Drive Shippensburg, PA 17257 See continuation schedule attached Continuation Total Enter dollar amounts for distributions shown above on lines 1 5 through 18, as appropr iate, on Rev 1500 cove r sheet II- NON-TAXABLE DISTRIBUTIONS: - A. SF~OUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 1 U.UU Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98} sc~~ou~~ ~ BENEF1CfARlES (Past 1, Taxable Distributions) ESTATE OF: Gladys L. Wiser 03/1812008 168-26-7393 Item Name and Address of Person(s) Share of l=state Amount of Estate Number., Receiving Property Relationship (Words) {$$$) 6 Nancy L. Wright Daughter 1466 Woods Drive, Lot 22 Shippensburg, PA 17257 Total LAST WILL AND TESTAMENT of Gladys L. Wiser I, Gladys L. Wiser, currently residing at 100 Cleversburg Road, Shippensburg, 17257, Cumberland County, Pennsylvania, being of sound mind and memory, declare this to be my last will and testament, hereby revoking any and all prior wills and codicils. Disposition of Remains FIRST: I direct that my body shall be buried in accordance with directions provided by my executor herein named at apre-arranged burial lot next to my husband, Ward Wiser. Distribution of Personal Property SECOND: I give and bequeath all personal and real property in accordance with the Distribution of Residue clause below. Distribution of Residue TI~IIRD: The rest of my estate, both personal and real, I bequeath. to my seven children, Nancy L. Wright, William E. Wiser, Tommy R. Wiser, Samuel E. Wiser, Clay A. Wiser, Roy E. Wiser, Linda K. Ruth, to share and share alike. Anti-Lapse Provisions FOURTH:. If any gift herein fails to vest with the designated beneficiary for any reason, then if the predeceased beneficiary has living biological children at the time of my demise, then the gift shall pass to said living biological children in equal shares; if the predeceased beneficiary has no living biological children at the time of my demise, then the gift shall be shared equally among all my beneficiaries of the residual clause to whom gifts have vested. ,y .,'~ ~ Page 1 of 5 INITIALS ~~'~~ ; ~,,, Minors and Incapacitated Beneficiaries FIFTH: Unless otherwise specifically stated within a bequest herein, if any income or principal shall be payable to any person who shall be a minor or who shall be incapacitated for any reason, my executor as trustee shall hold such income and principal and distribute to the beneficiaries in accordance with the Uniform Transfers to Minors Act. 1~he trustee shall be entitled to apply such income and principal to the health, maintenance, support and education of such person during minority or prior to the time of distribution noted above without the appointment of any guardian or committee or any authority of court. My executor as trustee shall be entitled to make direct payment of income and principal to the parent or other person in charge of such minor or incapacitated person, or to his or her guardian or to a custodian under the Uniform Transfers to Minors Act. My executor shall have the power to establish a trust with a recognized bank or trust company to carry out the foregoing functions in part or in whole. The selection of such bank or trust company shall be at the sole discretion of my executor. My executor shall have the authority and power herein to appoint someone else as trustee of any trusts established herein, and said appointed tn~stee shall have all the rights herein stated. Payment of Burial Expenses and Death Taxes SIXTI-I: All expenses of my last illness, my funeral and burial,. and administration of my estate are to be paid from assets of my estate: I expressly state that I d.o not prefer an overly expensive casket as I view that expense as a waste of money. All estate, inheritance and other death taxes, together with iruterest and penalties on them, payable with respect to property or interests subject to taxation by reason of my death a.*~d whether passing under my will or any codicil thereto, or otherwise, including jointly held and other non-testamentary property shall be paid out of the principal of my residuary estate without apportionment. Powers of Executor SEVENTH: I confer on my executor the right to sell or otherwise convert any real or personal property at public or private sale, at such time or times, in such manner, and for such price or prices, and on such terms and conditions as my executor shall determine, and to execute and deliver good and sufficient conveyances, assignments, and transfers of the property, without liability of any purchaser for the application of any consideration; to borrow money and to secure its payment by mortgage of real or personal property, pledge of investments, or otherwise, without liability on the part of the lenders to see to the application thereof; to retain any investments at discretion; to invest and reinvest at discretion, without restriction to so-called "legal investments"; to make distribution in cash or in kind; to allocate anal distribute different kinds or disproportionate shares Page 2 of 5 INITIALS ~'~ ~{ ~~ of property or undivided interests in property among beneficiaries, in cash or in kind, or partly in each; and to do all other acts and things necessary or appropriate in the manal.>ement, administration and distribution of my estate. Appointment of Executor EIGI-ITH: I appoint my daughter, Linda K. Ruth, of Edinboro, Pennsylvania, as personal representative, executrix, of my last will and testament. If for any reason she is unable or unwilling to quality as executrix or having qualified is unable or unwilling to act, then I appoint my son, Tommy R. Wiser, as my executor. Waiver of Bond NlN"TH: I direct that no fiduciary hereunder shall be required to furnish bond in any jurisdiction, and if any bond is necessary; no surety shall be required. Interchangeability of Language TENTH: Words used in the singular may be read to include the plural or the plural may be read as the singular. Similarly, the masculine form may be read to include the feminine and neuter; the feminine may be read to include the masculine and neuter; and the neuter may be read to include. the masculine and feminine. Executor and executrix shall be interchangeable and read as is consistent with the use within the context contained. Headings ELEVENTH: The headings used on the various paragraphs of this will are included for convenience only and shall have no legal significance. I have signed this Last Will and Testament this )'~ day of ~` ~~ __.. r'` ' , 2005. ~`-~ ~. - d ~ .. ~" ` _ _. c' ~ 'i`~~ ~ ~ f , a_ Gladys L. f'W iser Page 3 of 5 INITIALS ~7 ~, ~~;,~ f` 't d ~ _ --r -`f - ~. t. :' ------- witness: C i,. _, ~ ,~..,- ~~-w- '~.~ Address: ~ .~=`~- ~ ~; ~~ ~ {{ f i Witness:~?~~~~~,~ %u '~I~~~~••~,~: ~:.. Address: w;t=~=` ~ ~~ 4 Y°~ ., ~~ . Acknowledgment and Aftida~rit Commonwealth of Pennsylvania, Countv of Cumberland We, the testator in and the undersigned witnesses to the Last Will and Testament, the attached or foregoing instrument, who have signed the instrument, having been qualified according to law do depose and say: (a) that I, the testator, do hereby acknowledge that I signed the instrument as my Last Will and Testament, that .I signed it willingly and as niy free and. voluntary act for the purposes therein expressed; and (b) that we, the witnesses, were present and saw the testator sign and execute the instrument as the testator's will, that the te-stator signed it willingly and executed it as the testator's free and voluntary act for the purposes therein expressed. that each of us in the hearing and sight of the testator°signed the will as a witness and t:hatto the best of our knowledge the testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Gladys L. V~iser ~ Witness ~-' +~, Witness ~~ ~'` Page 4 of 5 INITIALS 3`~. ~ -~~,' i,; , 3 Aclcnozvle~lganent Commonwealth of Pennsylvania County of Cumberland SS ., .. Un this. the ,~ ~, ., day of ~ ~~ ' ' ` - ° , 2006, before me ; ~-' the undersigned officer, personally appeared Gladys L. Wiser, known to me or satisfactorily proven to be the person whose name is ascribed to the foregoing document and that she executed the same for the reasons therein contained. I have signed my name and affixed my seal. 1 ~~ ~~ ,, ! ~ , r ~ _ 1.. Not~uy Public, l~'[y Commission Expires 3 _____..___... Notarial ;ieal ~~~- ;v?eiiss^? Ft. k~L'flson. Notary ~'u~lic ~~ ~~i~P~~?'sburg Roro, Cumb,~rland Gpi:r?ty __ 5,,7~`, _~''?missicr? Expires ~~b. 15. ~a?i}c~ +j , >-1' tt Page 5 of 5 INITIALS ,,! ~~ ~ G ,, Previous editions are obsolete form HUD-1 (x;86) ref Handbook 405.2 CAPITAL ABSTRACT A. Settlement Statement U.S. Department of Housing and Urban Development M N. 2 -o x ;r f v / o _ __ B. TYP F L AN CORPORATION t. ^FHA 2. ^FmHA 3. ^Conv. Unins. 4. ^ V ^ nnv. ns. b. FILE NUMBER 08-844 7. LOAN NUMBER S. MORTGAGE INSURANCE CASE NUMBER This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. C. Note= Items marked "(p.o.c.}" were pard outside the closing; they are shown here for information purposes and are not includetl in the totals. WAR NiNG: Il is a crime to knowingly make false statements to the United States on this or any other similar form. Penalties upon Title Express Settlement System D. NAME GF BORROWER: Nathan Oberholtzer and Benito Oberholtzer 77 A"r t Ro d en bury A 17257 E. NAME: OF SELLER: Estate of Gladys L. Wiser 100 leversbur Rod Shi n'bur~ PA 1725 F. NAME OF LENDER: A R~SS~ G. PROPL-RTY ADDRESS: 100 Cleversburg Road, Shippensburg, PA 17257 oath m t n T w h' H. SETTLEMENT AGENT: Capital Abstract Corporation, Telephone: 717-261-9143 Fax: 717-261-9783 P A E ETT E N 9 in of W a t ham ersbur PA 17201 ). - 7/2 0 J. MMARY F B RR WER' T N A TI SUMMARY F ELLER' TRANSA TI N: } R AM NT DUE FR RR W -R 4 0. R SS AMOUNT D T E LER 7s ooo.o0 78 000.00 1 482.58 o f ri i ri n v n A m o f ri i I ri v 07 25 08 12 31 08 140.85 07 25 OS 12 31 08 140.85 07 25 08 06 30 09 1 228.76 07 25 08 06 30 09 1 228.76 ~ , 80 852.19 4 T 79 369.61 t 7 800.00 7 800.00 4 383.27 7 274.73 Orrstown Bank 1 315.25 Vivian Co Tax Collector • 52.00 CUMBERLAND FRANKLIN JOINT MU I 82.35 Borou h of Shi ensbur r' i I r i un i flown to re< 22 T L> PAID BY/FOR RR W R 7 800.00 0,_ T TAL RED TION AM NT D E E L R 20 907.60 3 li AT SETTLEMENT FROM OR 70 BOR A T TT T T FR 80 852.19 79 369.61 7 800.00 20 907.60 L303 CAS~~ FR M R W 73 052.19 H T 58 462.01 SUBSTITUTE I°ORM 1099 SELLER STATEMENT: The information contained herein is Important tax inform alion and is being furnished !o the Internal Revenue Service. If you are rec~~ired to rile a return, a negll ante penalty or other sanction will be imposed on you it Ihis item is required to be reported and the IRS determines that ft has not been reported. The Contract Sales Price described on line dot above constitutes the Gross Proceeds of this transaction. you are required by law to provide the settlement agent (Fed. Tax ID No: )with your correct taxpayer identification number. It you do not provide your correct taxpayer Identification number, you rt~ay be sub(ect to civil or criminal penalties imposed by law. n er pens i es o par)ury, 1 certify that the number shown on this statement ~s my correct taxpayer identification number. TIN: _- / -_ SELLER(S)SIGNATURE(S): -/ SELLER(S) NEW MAILING ADDRESS: SELLER(S) PHONE NUMBERS: tH) -(W) Previous editi~.ons are obsolete U.S. DEPARTMENT OF HOUSING AND URBAN DEVY:LOPMENT - r-I.II-AIT [~TATCr. ,I GAIT form HUD-t (x/86) ref Handbook 4706.2 File Number: OK-28d4 PAGE 2 'TL M NT HARG PAID FROM PAID FROM ~ 700. TOTAL SALE lBROK R'S COMMI SION ba d n rice 78 000 . 00 = 3 603.27 BORROWER'S SELLER'S r omm' i n (tin 70O)a follow FUNDS AT FUNDS AT 3 603.27 Carl E. Ocker Auctioneer SETTLEMENT SETTLEMENT S tn 0~ 7 __ -_. .~ _ ~ - i - n 3 603.27 8 0. IT M PAVA L N NN CTI N WITH L AN i n 9 IT PA RE UIRED BY END R T BE PAID IN ADVANCE 1 .R ° EP ITED WITH L NDER' 0.00 0.00 1 7 . T E CHARGES Cash 10.00 Ca ital Abstract Cor oration 654.08 78 000.00 - 654.08 1 2 V T A TRA R •dingfees Deed S 38 . S0 -Mortaan 38.50 780.00 780.00 780.00 780.00 Y 1 482.58 4 383.27 HUD CERTIFICATION OF BUYER AND SELLER 1 have carefully r i 74ed the H D-t ¢ettlement Statement and to the best of my knowledge and belief, it is a true antl accurate staterent of all receipt ~ '- s and disbursements made on my account or by me ~ in this trans eh ) furl r c tify al t- ve received a copy of the HUD-1 Settlement Statement. ,/ ~j f~ 1 %' -. i_,,,,..~~ ! ' Nalha Obenc~l~er ~ ~,.'! ~ - BeJita_ holi zer / 1 Estate of Gladys L. Wiser WARNING: IT I:I A CR ME TO KNOWINGLY MAKE FALSE STAT ME NT O THE The HUD-t Settlement Statement which I have prepared is a true and accurate account o/ this transaction. UNITED STATES ON THIS OR ANY SIMILAR FORM. PENALTIES UPON CONVICTION 1 have caused or will cue the /un disbursed in accordance with Ihls statement. CAN INCLUDE A FINE AND IMPRISONMENT. FOR DETAILS SEE TITLE fe: (( °a U.S. CODE SECTION 7001 AND SECTION 7010. ey: ~ --7 ~~-~fv~ ~.s~r~~ ~~ A Tradition of Excellence July 24, 2008 To: Salzmann Hughes, P.C. 354 Alexander Spring Road Suite 1 Carlisle Pa 17015 I~'rom: Traci Yohe Orrstowr~ Bank Customer Service Center PO BOX 250 Shippensburg, Pa 17257 Re: Estate of Gladys L Wiser Date of death March 18, 2008 IT IS HERERBY CERTIFIED THAT THE ABO G'E NAMED. DECEDENT, ON THE ABOVE DATE. HAD THE FOLLDI~ING ACCOUNTS WITH ORRSTOT~N BANK: CHECKING ACCOUNT Account # Title of Account Date opened Principal 604151 Gladys L Wiser 05/12/83 2111.19 Salzmann Hughes Cg G'IIVGS ACCOCINT Account # Title of Account CERTIFICATE OF DEPOSIT Account # Title of Account Accrued Interest 0.00 Date opened Principal Accrued Interest Date Opened Principal Accrued Interest P.O. Box 250 •Shippensburg, PA 17257 • 717.530.3530 • 717.532.4143 fax f~~ ~ Franklin County Teachers' -~~. Credit Union YYrrrkitY; To,rther to Y~atks tls~ ~Gr~z~n v 1156 Kennebec Drive Phone: 717-264-6506 P.O. Box 505 Toll Free: 888-968-7828 Chambersburg, PA 17201 Fax: 717-264-1441 www.fctcu.org Salzmann Hughes, P.C. Attorneys at Law Attn: Adam R, Schellhase, Esq. 354 Alexander Spring Road, Suite 1 Carlisle, PA 17015 Re: Estate of Gladys L. Wiser Dear Mr. Schellhase: Iri response to your letter, dated April 29, 2008, is the following information concerning Gladys L. Wiser ar_count. Name in which the account was held Account Number: Balance as of March 31, 2008: Accrued dividend to May 5, 2008 Account Type: IRA: Loans: Gladys L. Wiser 26961-01 $11.71 NJA (dividends paid at quarter end, if account is open) Single Ownership N/A N/A (paid off 05-2007) If you have any further questions, please feel fee to contact me. Sincerely, C~ Cyndy Stancliff Assistant Manager cstancliff@fctcu.org 1505642148 REV-1500 EX Decedent's Social Security Number ~Jecede~es Name: G I a d y S L. Wiser 15 8 2 6 7 3 9 3 RECAPITULATION 7$, 0 0 0 0 0 1. ...................................................................... Real Estate (Schedule A) .................... 1. 2. Stocks and Bonds (Schedule B) ............................................................................... 2. 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. 1 5 , 310.15 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested ............. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested ............. 7. g. Total Gross Assets (total Lines 1-7) ....................................................................... g. 9 3 , 310.15 9. ..................... Funeral Expenses & Administrative Costs (Schedule H) .................... 9. 3 7 , 9 7 1 . 0 9 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10. 2 ' 7 8 6 ' 2 8 11. Total Deductions (total Lines 9 & 10) ...................................................................... 11, 4 0 ; 7 5 7 . 3 7 12• Net Value of Estate (Line 8 minus Line 11) ...................................................:......... 12. 5 2 , 5 5 2 . 7 8 13. Charitable and Governmental BequestslSec 9113 Trusts for which , an election to tax has not been made (Schedule J) .................................:............... 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ................................................. 14. 5 2 , 5 5 2 . 7 8 TA:K COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, of transfers under Sec. 9116 (a)(1.2) X .00 0. 0 0 15. 0. 0 0 16. Amount of Line 14 taxable 5 5 2. 7 8 ' 5 2 1 g, 2, 3 6 4 8 8 , at lineal rate X .045. 17. Amount of Line 14 taxable 0 0 0 17. 0 0 0 at sibling rate X .12 18. Amount of Line 14 taxable 0 0 0 18. 0. 0 0 . at collateral rate X .15 19. Tax Due ..................................................................................................................... 19. 2, 3 6 4. 8 8 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ~. L 15056042148 Side 2 15Q56042148