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HomeMy WebLinkAbout10-07-0815056041114 REV-1500 Ex (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN Q PO BOX 280601 ~ ! /\ r, f ~~ ~~ Harrisburg, PA 17128-0601 RESIDENT DECEDENT f (J `/ ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 02242008 08251936 Decedent's Last Name Suffix Decedent's First Name MI ADAMS LOIS H (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 INAPPROPRIATE OVALS BELOW Ox 1.Original Return 0 2. Supplemental Return Q 3. Remainder Return (date of death 0 4. Limited Estate 0 prior to 12-13-82) 4a. Future Interest Compromise (date of 0 5. Federal Estate Tax Return Required death after 12-12-82) Ox 6. Decedent Died Testate Q 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 0 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT -THIS SECTION MUST BE C OMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number ROBERT G. FREY 717-243-5838 ~., Firm Name (if Applicable) FREY & TILEY First line of address 5 SOUTH HANOVER STREET Second line of address City or Post Office CARLISLE State ZIP Code PA 17013 REGIST 4 ~ LLS US~NLY -s_~ Ga - ,' x {~ --~ _l,"Tl t - ---t >~ _ .. '~ - ~TE FILED Correspondent's a-mail address: RFREY@ FREYTILEY . COM Under penalties o perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best o my knowledge and belie , it is true, co~eryd complete. Declaration of preparer other than the personal representative is based on_alI information of which preparer has anv knowledge. i ~16AIM ~T~' ~ ~ ~ ~~ DATE ~~ /` ~~ SIGNATUR REPA ER HAI11f}2EP ~~ NTATNE DAT~ C / (ti ~ i~ ADDRESS s ~ S <~ ~~ St ~ ~' ~ ~ ~ ~ ~< ~ - v ~~- ~~ ~ t ~7~'i3 PLEASE USE ORIG NAL FORM ONLY Side 1 ~..~ 15056041114 15056041114 15056042115 REV-1500 EX Decedent's Social Security Number Decedent's Name: LO I S H ADAMS RECAPITULATION 1. Real estate (Schedule A) .......................................... . 1. 14 2 9 O 0 . 0 0 2. Stocks and Bonds (Schedule B) ..................................... . 2. NONE 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) .... . 3. NONE 4. Mortgages 8 Notes Receivable (Schedule D) ........................... . 4. NONE 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ....... . 5. 14 5 9 6 . 0 0 6. Jointly Owned Property (Schedule F) Separate Billing Requested ....... . 6. NONE 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) Separate Billing Requested ....... . 7 NONE 8. Total Gross Assets (total Lines 1-7) ................................. . 8. 15 7 4 9 6 . 0 0 9. Funeral Expenses & Administrative Costs (Schedule H) ................... . 9. 17 8 O 7 . 0 0 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............. . 10. 4 4 . 0 0 11. Total Deductions (total Lines 9 8~ 10) ................................ . 11. 17 8 51.0 O 12. Net Value of Estate (Line 8 minus Line 11) ............................ . 12. 13 9 6 4 5 . 0 O 13. Charitable and Governmental BequestslSec 9113 Trusts for which an election to tax has not been made (Schedule J) ....................... 13. 13 9 6 4 . 5 0 14. Net Value Subject to Tax (Line 12 minus Line 13) ....................... 14 12 5 6 8 0 . 5 0 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 0 15. O. O O 16. Amount of Line 14 taxable at linealratex.0 45 125680.50 1s. 5656.00 17. Amount of Line 14 taxable at sibling rate X • 12 17. Q , 0 O 18. Amount of Line 14 taxable at collateral rate X . 15 18. 0 . 0 0 19. TAX DUE ....................................................... 19. 5 6 5 6. O O 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAY MENT 0 Side 2 15056042115 15056042115 REV-1500 EX Page 3 186-28-4973 Decedent's Complete Address: File Number 21-08-253 DECEDENT'S NAME DECEDENT'S SOCIAL SECURITY NUMBER LOTS H ADAMS 186-28-4973 STREET ADDRESS 615 WOODLAND AVENUE CITY MT. HOLLY SPRINGS STATE PA ZIP 17065 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments 6500.00 C. Discount 325.00 3. Interest/Penalty if applicable D. Interest E. Penalty (1) 5656.00 Total Credits (A + B + C) (2) 6825.00 Total Interest/Penalty (D + E) (3) 0.00 4. If Line 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) 1169.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 0.00 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred : ....................................... ~ QX b. retain the right to designate who shall use the property transferred or its income : ................ ~ ^X c. retain a reversionary interest; or ...................................................... ~ ~X d. receive the promise for life of either payments, benefits or care? ............................. ~ ~X 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .......................... ~ ~X 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .. ~ ^X 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ...................................................... ~ ^X IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the 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)]. 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)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. 2n REV-1502 EX+ (6-98) SCHEDULE A COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT ESTATE OF FILE NUMBER 21-08-253 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 willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. (If more space is needed, insert additional sheets of the same size) z~7 REV-1508 EX+(6-98) SCHEDULE E ~+//++ COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, ~ M~SV. INHERITANCE TAX RETURN PERSONAL PROPERTY ESTATE OF FILE NUMBER LOIS H ADAMS 21-08-253 Include the proceeds of litigation and the date the proceeds were received by the estate. All orooertv jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE 1 Members 1st account no. 14668-11 137 2 2003 Buick Century, Kelley Blue Book valuation attached 6,500 3 Miscellaneous personal property and household goods 2,500 4 Real estate tax proration. See HUD-1 settlement statement attached. 922 5 Members 1st account no. 14668-00 5 6 Members 1st account no. 14668-05 3,447 7 Members 1st account no. 14668-40 1,085 TOTAL (Also enter on line 5, Recapitulation) $ I 14,596 (If more space is needed, insert additional sheets of the same size) REV-1511 EX + (10-06) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES ~ ADMINISTRATIVE COST; ESTATE OF FILE NUMBER LOIS H ADAMS 21-08-253 Debts of decedent must be re orted on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Hollinger Funeral Horne 8,895 B. 1 State Zip 2. Attorney Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant 4. 5. 6. 7. MINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Street Address City Year(s) Commission Paid: Street Address City State Relationship of Claimant to Decedent Probate Fees Accountant's Fees Tax Return Preparer's Fees senses of real estate sold Zip 5,000 313 Included w/ Atty. Fee Included w/ Atty. Fee 2,599 TOTAL (Also enter on line 9 Reca (If more space is needed, insert additional sheets of the same size) S 17 REV-1512 EX+ (12-03) SCHEDULEI COMMONWEALTH OF PENNSYLVANIA I DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES, ~ LIENS ESTATE OF FILE NUMBER ~OIS H ADAMS 21-08-253 Report debts Incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. (ir more space is needed, insert additional sheets of the same size) z1~ REV-1513 EX+ (9-00) SCHEDULE) COMMONWEALTH OF PENNSYLVANIA I BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER LOTS H ADAMS 21-08-253 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECENING PROPERTY Do Not L1st Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1 LOIS A. BARNER DAUGHTER 0.13 2 ROBYN A. PORTER DAUGHTER 0.13 3 PAMELA C. RUTTER DAUGHTER 0.13 4 MARGIE A. SHENK DAUGHTER 13% 5. ALBERT E. ADAMS, III SON 13% 6. RICHARD E. ADAMS SON 13% 7. PAULA. ADAMS STEP-SON 13% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THR OUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET I I. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1 Mt. Holly Springs United Methodist Church 10% TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0 (If more space is needed, insert additional sheets of the same size) Expenses of Real Estate Sold Settlement costs from HUD-1 settlement statement 1,035 Met Ed 66 Shipley Oil 211 Met Ed 76 S. Middleton Munic. Auth 66 County & Township Real Estate Taxes 241 Met Ed 41 Met Ed 33 Met Ed 35 Erie Insurance 84 Erie Insurance ~~ Replacement Refrigerator 491 Met Ed 42 Met Ed 79 Total expenses of real estate sold 2.599 X kr>`RA Settlement Statement - U. 5. De artment of Housin and Urban Develo ment Form US HUD - 1 Pa a No. 1 2. Fm HA 6. File Number 7. Loan Number 8. Mortgage Insurance 3. Conv. Unins. Case Number a. vA RE3065 0088481205 441-aaa6663 5. Conv. Ins. ABST#6478 C. This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "(p.0.c.)" were paid outs, the closing; they are shown here for informational purposes and are not included in [he totals. _ _ D. Name and Address of Borrower: RICHARD E. ADAMS 301 WEST PINE STREET MT. HOLLY SPRINGS, PA 17065 E. Name and Address of Seller: ESTATE OF LOIS H. ADAMS LOIS A. BARNER, EXECUTRIX PAULA. ADAMS, EXECUTOR F. Name and Address of Lender G. Property Location PNC MORTGAGE, LLC 615 WOODLAND AVENUE, MT. HOLLY SPRINGS, PA 17065 ISAOA ATIMA SOUTH MIDDLETON TOWNSHIP 2710 5TH AVENUES CUMBERLAND COUNTY MINNEAPOLIS, MN 55408 PART OF PARCEL NO. 40-30-2646-044 H. Buyer's Settlement Agent: Frey & Tilly Law OfflCe I. Settlement Date: Place of Settlement: 5 South Hanover St. ]uly 31, 2008 5 South Hanover Street TIN 25-1730538 Carlisle, PA 17013 @ 9:30 A.M. Carlisle PA 17013 ] SUMMARY OF BORROWER'S TRANSACTION K __ SUMMARY OF SELLER'S TRANSACTION 100 Gross Amount Due From Bortower a00 GrossAmount Due To Seller' " - lol Contract sales price 124,000.00 aol Contract Sales puce 124,000.00 102 Personal property a02 Personal property 103 Settlement charges from (line 1400) 4,591.08 ao3 loo aoa 105 405 Adjustments for items paid by seller in advance: Adjustments for items paid by seller in advance: 106 City/town taxes 7/31/08 to 12/31/08 101.07 a06 City/town taxes 7/31/08 to 12/31/08 101.07 107 County taxes a07 County taxes 108 Assessments 408 ASSe55ment5 109 409 110 School taxes 7/31/08 to 6/30/09 821.24 a1o School taxes 7/31/08 to 6/30/09 821.24 111 411 112 412 120 Gross Amount Due~From Borrower 129,513.39 ago Gross amount Due to Seller 124,922.31 ---------- 200 Amounts Paid By Or In Befialf Of Borrower 500 Reductions In Amount DuesTo Seller 201 Deposit or earnest money 0.00 501 Excess deposit (see instructions) 202 Principal amount of new loan(s)*** Wire $118,932.54 122,084.00 502 Settlement charges to seller (line 1400) 1,035.19 203 Existing loan(s) taken subject [0 503 Existing loan(s) taken subject to 2aa 5oa Payoff of first mortgage loan 2os 505 Payoff of second mortgage loan 206 506 207 507 208 508 209 509 Adjustments for items upaid by seller Adjustments for items upaid by seller 210 City/town taxes 1/1/08 to 7/31/08 61o City/town taxes 1/1/OS to 7/31/08 2u County taxes 511 County taxes 212 Assessments 512 As5e55menC9 213 513 21a School taxes 7/1/08 to 7/31/08 51a School taxes 7/1/08 to 7/31/08 215 515 216 516 zv ASSIGNMENT FEE POCL s17 zle CREDIT PAID BY LENDER 27.00 sle 219 519 22o Total Paid ey/For Borrower 122,111.00 520 Total Reductions to Amt Due Seller 1,03$.19 ---------- ---------- 300 Cash At Settlement FramfTO. Borrower. 600 CasfiAt Settfecnent To/From Seller: 301 Gross amount due from borrower (line 120) 129,513.39 601 Gross amount to seller from (line 420) 124,922.31 3oz Less amounts paid by/for borrower (from line 220) 122 111.00 602 Less reductions in amount due seller (from line 520): - 1 035.19 303 Cash (X) From ( ) To Borrower ~ 7,402.39 603 Cash ( )From (X) To Seller - 123,887.12 L. SETTLEMENT CHARGES Page No. 2 ,Sates/Broker's Comm. basedon price: 124,000.00 @ % = 0.00 Paid From Paid From 700 Sion of Commission (line 700) as follows: Borrower's Setter's to Funds at Funds at 701 to Settlement Settlement 702 J03 ommission paid at Settlement 0.00 7oa tams Payable In Connection With Loan: ~ 705 eoo Mortgage Amt: 122,084.00) Total charges, Lines 801 through 2,874.00 oan Origination Fee .000 % t0 oan Discount .000 °/a to ppraisal Fee to RELS VALUATION , redit Report to RELS REPORTING HA UPFRONT MIP PNC MORTGAGE, LLC 0.00 0.00 400.00 16.00 1,804.00 'INAL INSPECTION TO RELS VALUATION 135.00 'LOOD LIFE OF LOAN FEE TO WF INSURANCE 19.00 PROCESSING FEE TO PNC MTG 400.00 fNDERWRITING FEE TO PNC MTG 100.00 tams Required By Lender7o Be Paid In Advance: nterest From 31-)u1-08 to 1-Aug-O$ @ 21.740 per day = 21.74 lortgage Insurance Premium for months to PNC MORTGAGE, LLC .0.20 iazard Insurence Premium tar 1 years to ERIE INSURANCE P.O.C. years to PREMIUM OF $270 :eSerVES Dep05lted Wlth Lender:. Toot Rese rves, Lines1001 thorugh 1008: 255,52 7azard insurence 3 mos. @ $22.50 per month tortgage insurance mos. @ per month 'ity property taxes mos. @ per month .ounty property taxes 7 mos. @ $20.09 per month .nnual assessments mos. @ per month mos. @ per month 67.50 140.63 .chool taxes 2 mos. @ $85.17 Der month 170.34 '_ggregate Settlement Adjustment (122.95) it{e Charges:.. Settlement ar closing fee to .bstract or title search to 'itle examination to itle insurance binder to ocument preparation to FREY &TILEY Mary fees to torney's fees to FREY &TILEY dudes above items numbers: ) le Insurance to FREY &TILEY (COMMONWEALTH LAND TITLE INS. C0.) _ludes above items numbers: EXTENDED-NO REISSUE ) der's Coverage $ 122,084 Endorsements: 100, 300, 400 lets Coverage $ 124,000 OSING SERVICE LETTER TO COMMONWEALTH LAND TITLE INSURANCE CO. ERNIGHT DELIVERY FEES TO FRE Y &TILEY ernment Recording and Transfer Chargesc .Deed Rages: 0 Mtg'pages.: ^ding fees: Deed $40.50 Mortgage $50.50 Releases $ :ounty/stamp Deed EXEMPT Mortgage $ tax/stamps: Deed EXEMPT Mortgage $ 'JRDING FEE 70 RECORDER OF DEED5 1,076.62 150.00 35.00 10.00 91.00 'GNMENT OF MORTGAGE RECORDING FEE TO RECORDER OF DEEDS 27.00 ~ tionai Settlement Charges: to ~, ~pection to ~~ Taxes due from BorrowerlSelter to BOB C. CAIRNS, TAX COLLECTOR IRONIC DELIVERY FEE TO FREY &TILEY 50.00 l SEWER CHARGES TO SMTMA -ACCT NO. 500317/WELL WATER ~ P.O.C. RO.C.I sat aaa soy eaa soy I one 80~ 80f eos su av ?oc 901 90: 90: 90• 00! I lac I loo loo lion 1101 1102 1103 iloa uos 1106 1107 lloa 1109 1110 1111 luz 1113 L iZGO 1201 tzoz 1203 42.50 iz0a 1205 ~i3Qa 11301 897.46 130 130 95.23 13a Settlement Charges (enter onlines 103, Section ]and 502, Section K) 4,591.08 1,035.19 I CERTIFICATION I direct and authorize the Company to make distributions indicated far my account on the attached HUD-1 Settlement Statement, approving the tax prorations indicated therein, and understand that prorations were based on figures for the preceding year, or estimates for the current year, and in the event of any change far the current year, all necessary adjestments must be made between Seller and Borrower direct; likewise any DEFICIT in delinquent taxes will be reimbursed to Attorney/Title by Seller. I have carefully reviewed the HUD-1 Settlement Statement and to the best of my knowledge and belief, it is a true and accurate statement of all receipts and disbursements made on my account or by me in this transaction. I further certify that I have received a copy of the HUD-1 Settlement Statement. > > i.4:~ A RICHARD E. ADAMS ESTA,T~E OF LOIS H_,ADA(~F;S LOIS A. BARKER, EXECUTRIX To the best of my knowledge, the HUD-1 Settlement Statement which I have prepared is a true and accurate account of the funds which were received and have been or will be disbursed by the undersigned as part of the settlement of this transaction, ~~~~ ~/ v ! .. /J '/~~ Settl ' ent ent _ 4,~/F/ July 31. 2008 Date WARNING: It is a crime to knowingly make false statements to the United States on this or any other similar farm. Penalties upon conviction can include fine and imprisonment. For details see: Title 18 U.S. Code Section 1001 and Section 1010. INFORMATION REPORTING ON REAL ESTATE TRANSACTIONS THIS HUD SETTLEMENT STATEMENT CONTAINS IMPORTANT TAX INFORMATION (BOXES E, G, H, I, M AND LINE 401) AND SS BEING FURNISHED TO THE INTERNAL REVENUE SERVICE. IF YOU ARE REQUIRED TO FILE A RETURN, A NEGLIGENCE PENALTY OR OTHER SANCTION WTLL BE IMPOSED ON YOU IF THIS ITEM IS REQUIRED TO BE REPORTED AND THE INTERNAL REVENUE SERVICE DETERMINES THAT IT HAS NOT BEEN REPORTED. Solicitation of TIN Seller is required by law to provide the Attorney{Company with hisJher correct taxpayer identification number. If correct taxpayer identification number is not provided, hejshe may be subject to civil or criminal penalties imposed by taw. Certification of TIN Under penalties of perjury, I certify [hat [he taxpayer identification number shown in this statement is my correct taxpayer identification number. Seller Seller TAX PRO-RATION ADDENDUM Date Of Pro-Ration: BorrowerSeller SCHOOL REAL ESTATE TAX Owes: ]ulv 31, 2008 from July 1, 2008 to June 30, 2009 i School Real Estate Tax- Face $915.73 ~ ~ 897.a6 School Real Estate lax- Per Dav $2.50895 ~ ' {~ ASSESSMENT: , t ' COUNTY & MUNICIPAL TAX Owes (` Rom January 1, 2008 [o December 31, 2008 f Co. &Munic. Real Estate Tax- Face $246Aa I P.O.Q. Parcel No.: Co. +~ Munic. Real Estate Tax- Per Day $0.67403 See Settlement Sheet l i Lines tes 106 & 406, 110 & 410, School [axes P.O.C. or charged to Seller : 210 & 510, 214 & 514, a School [axes P.O.C. or chargetl to Borrower and 1303 for Co. &Munic. P.O.C. or charged to Seller : x Results of this Addendum. Co. & Munit. P.O.C. or charged to Borrower Kelley Blue Book -Trade-In Pricing Report -Buick, Century -Official Kelley Blue Book Site '' K~e~ Blue ~c THE TRUSTED RESOURCE ~.~m. _..,,>1~.car 2003 Buick Century Sedan 4D BllJf BOUK =' ~'RADE- ~ALI~ Condition ~ ~'~ Excellent ~'' Good (Selected) Fair Value $4,675 $4,205 $3,435 Search Local Listings: .' View Buick Century ~': Search all Classifieds in 17013 Average Consumer Rating (142 Reviews) Read Reviews ~r;'' ~' .~ ., v ; 4.4 out of 5 Review This Vehicle Vehicle Highlights Mileage: 80,000 Engine: V6 3.1 Liter Transmission: Automatic Drivetrain: FWD Selected Equipment Standard Air Conditioning Power Door Locks Dual Front Air Bags Power Steering Tilt Wheel Power Windows AM/FM Stereo 05/05/2008 11:32 AM i Send to Printer http://www.kbb.com/KBB/UsedCars/PricingReport.aspx?Yearld=2003&Mi...3&SelectionHistory=1863%7c25436%7c17013%7c0%7c0%7c&Printable=true Page 1 of 2 Close Window TaxDB Result Details Detailed Results for Parcel 40-30-2646-044. in the 2004 Tax Assessment Database DistrictNo 40 Parcel ID 40-30-2646-044. MapSuffix HouseNo 61 ~ Direction Street WOODLAND AVENUE Ownerl ADAMS, ALBERT E JR C/O PropType R PropDesc LivArea 1152 CurLandVal 24010 CurImpVal 67630 CurTotVal 91640 CurPrefVal Acreage .37 CIGrnStat TaxEx 1 SaleAmt SaleMo SaleDa SaleCe SaleYr DeedBkPage 0018N-0034 YearBlt 1954 HF File Date 11/02/2004 HF_Approval_Status A 05/05/2008 11:33 AM http://taxdb.ccpa.net/details.asp?id=40-30-2646-044.&dbselect=l Page 1 of 1 LAST WILL AND TESTAMENT OF LOIS H. ADAMS I> LOIS H. ADAMS widow, of South Middleton Township, Cumberland County, Pennsylvania, (mailing address; 615 Woodland Avenue, Mount Holly Springs, PA 17065), 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 and making void any and all Wills by me at any time heretofore made. 1. I direct my hereinafter named Executor or Executrices to pay all of my just debts and funeral expenses as soon after my death as may be found convenient to do so. I further direct that all inheritance, transfer, succession, estate and death taxes, including interest and penalties thereon, which may be payable on account of my death shall be payable from the residue of my estate regardless of whether the assets upon which such taxes are based are included in my probate estate. 2. I declare that I am the widow of Albert E. Adams, Jr., and that I have six children, LOIS A. BARNER, ROBYN A. PORTER, PAMELA C. RUTTER, MARGIE A. SHENK, ALBERT E. ADAMS, III, and RICHARD E. ADAMS. I further declare that I have one stepchild, PAUL A. ADAMS. It is my intent that my said stepchild shall be treated as if he were a child of mine. 3. If at the time of my death I still owe my daughter, LOIS A. BARNER, the sum of $3,000.00, the money is to be paid to her from the residue of my estate prior to any gifts os devises which I have made below. 4. All of the rest, residue and remainder of my estate, real, personal and mixed, and wheresoever the same may be situate, I give, devise and bequeath as follows: (a) I give devise and bequeath 10% of the remainder of my estate to the Mount Holly Springs United Methodist Church, 202 West Butler Street, Mount Holly Springs, Pennsylvania. (b) I give devise and bequeath 90% of the remainder of my estate in equal shares to such of my children and stepchild as shall survive me by a period of ninety (90) days, the share any deceased child would have received to pass to his or her issues, per stirpes, and if there be no such issue such share shall lapse and be added to the remaining share or shares. At the present time I have six (6) children, and one (1) stepchild as aforementioned. 5. Should any person less than 21 years of age be entitled to distribution from my estate, in such event the share that person would otherwise have received shall be paid to my hereinafter named Executor in trust. I authorize the herein named Trustee to receive and invest the same and to pay the income arising therefrom together with so much of the principal thereof as in his or her opinion is necessary or desirable to be expended for the proper maintenance, support and education of such person to or for the benefit of such person and upon such person attaining 21 years of age to pay to him or her the then remaining principal together with any undistributed income. 6. I hereby nominate, constitute and appoint my daughter, LOIS A. BARNER, and my stepson, PAUL A. ADAMS as Co-Executors of this my Last Will and Testament, but should either of them predecease me or fail to qualify as such, then the surviving person shall act alone as Executor, and I further direct that neither of them shall be required to post any bond to secure the faithful performance of his or her duties in the Commonwealth of Pennsylvania or in any otherjurisdiction. 7. In addition to the powers conferred by law, my hereinbefore named Trustees and Executors and their respective successors, are empowered: a. To invest any part of the trust corpus in such securities, investments, or other property as may be deemed advisable and proper, irrespective of Page 1 of 3 ~-JLLt.- whether the same are authorized for the investment of trust funds under the laws of any governing jurisdiction. b. With respect to any corporation, the stocks, bonds, or other securities of which may be held, to vote in person or by proxy on any shares of stock; to consent to the merger, consolidation or reorganization of such corporations; to consent to the leasing, mortgaging or sale of the property of any such corporations; to make any surrender, exchange or substitution of such stocks, bonds or other securities as an incident to the merger, consolidation or reorganization of such corporations; to pay all assessments, subscriptions and other sums of money which may be deemed wise and expedient for the protection and maintenance of the proportionate interest of the investment in such corporations; to exercise any option or privilege which may be conferred upon the holders of such stocks, bonds, or other securities of such corporations either for the conversion of the same into other securities or for the purchase of additional securities, and to make any and all necessary payments which may be required in connection therewith; and generally to have and exercise as to all such stocks, bonds and other securities, the powers of an individual owner who is not under trust obligation. c. To hold the trust corpus in one or more consolidated funds in which separate shares shall have undivided interests. d. To sell at public or private sale for cash or upon credit, or partly for cash and partly on credit, and upon such terms and conditions as shall be deemed proper, any part or parts of the estate, and no purchaser at any such sale shall be bound to inquire into the expediency or propriety of any such sale or to see to the application of the purchase moneys arising therefrom. e. To keep on hand and uninvested such money as may be deemed proper and for such period as may be found expedient. f. To compromise, settle or arbitrate any claim or demand in favor of or against the trust estate. g. And authorized in the discharge of fiduciary duties, to employ counsel and to determine and to pay such counsel reasonable compensation which shall 6e charged against the principal or income of the trust fund, and shall further be entitled to charge against the principal or income such other reasonable expenses and charges as may be necessary and proper to incur for the proper discharge of fiduciary duties and for the proper management and administration of the trust estate. h. In making any division of property into shares for the purpose of any distribution thereof directed by the provisions of the trust, to make such division or distribution, either in cash or in kind, or partly in cash and partly in kind, as shalt be deemed most expedient, and in making any division or distribution in kind may allot any specific security or property or any undivided interest therein to any one or more of such shares, and to that end may appraise any or all of the property so to be allotted and the judgment as to the propriety of such allotment and as to the relative value for purposes of distribution of the securities or property so allotted shall be final and conclusive upon all persons interested in the trust or in the division or distribution thereof. i. And authorized to register any shares of stock or other assets of any trust in their own names or in the name of a nominee. To retain and invest in shares of stock of my Trustee. k. To retain any investments including mutual funds which I may own at the time of my death and in addition to invest any part of the Trust corpus in such mutual fund or mutual funds as may be deemed advisable or proper, irrespective of whether the same are authorized for the investment of trust funds under the laws of any governing jurisdiction. I. To determine from time to time whether all or some portion of realized capital gains shall be treated as ordinary income for distribution to a beneficiary Page 2 of 3 or treated as principal to be retained as part of the corpus, and such designation need not be consistent from one year to another. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will and Testament written on three (3) pages, this ~~ 1~day of S'v ~ c., , 2007. ~~~ .C/ • liLGl~ir~'1/-I (SEAL) LOIS H. ADAMS Signed, sealed, published, and declared by LOIS H. ADAMS the Testatrix above named, as and for her Last Will and Testament, in our presence, who, in her presence, at her request, and in the presence of each other, have hereunto subscribed our names as attesting witnesses. j~+~5 ~a+ Page 3 of 3 Sew Inquires to: 5000 Loofas Drive PO Box 40 Mechanicsburg, PA 17055 www.membersl8LOrg Main Switchboard: (717) 697-1 i 61 or (800) 283-2328 f;2 Call: (717) 697-4372 or (800) 283-4372 TDD: (717) 697-5312 or (800) 283-2328 ext. 5312 TeleBranch: (717)795-6049 or (800)237-7288 Statement of Accounts Jan 25, 2008 thru Feb 24, 2008 Account Number: 14668 Account Balances at a Glance Checking : 137.36 Savings : 5.00 Certificates : 1,085.12 Loans: 0.00 Money Management : 3 ,447.32 2408 1 AV 0.312 4815-2408 * a~ I~r~lllr~~lll~~~~llr~~lrl~r~rlllrlrr~~ll~lrrrl~rrll~lrlrrl~lrl LOTS H ADAMS N 615 WOODLAND AVENUE ~ MT HOLLY SPGS PA 17065-1937 o~ ~~ ~- *, Page : 1 of 2 Your current Member Loyalty Reward level is Silver Are you interested in learning more about Identity Theft, Home Buying or ~Ffi1l~arrclai Atd?- Visit aurweisite-at-www.me~mberslst.-org or ask an associate for more details about these FREE seminars. CHECKING ACCOUNTS 11 -CHECKING Date Transaction DescriDlion Adc~ons Subtractions Balance .Aan 25 Baaixaa<3 ForfWamr 1, 075.41 Jan 28 Check 000130 Tracer 0001368069 50.00- 1,025.41 Jan 30 Withdrawal 37.00- 986.41 Feb 01 Deposit Transfer From Share 00 699.34 1,687.75 Feb 05 Withdrawal Members 1st Online Transfer 373.3x- 1,314.40 To Loan 4287590000146684 VISA PAYMENT TO 4287590000146684 Feb 05 Withdrawal ACH FIRSTENERGY OPCO 51.75- 1,262.65 TYPE: FE ECHECK lD: 1341968288 DATA: DIRECT DEBITING CO: FIRSTENERGY OPCO Feb 06 Check 000138 Tracer 0001025884 10.00- 1,252.65 Feb 07 Withdrawal ACH Kohl's 76.34- 1,176.31 TYPE: ACH Paymnt ID: 1133357362 CO: Kohl's Feb 08 Check 00013.9 Tracer 0001152843 23.00- 1.153:31 Feb 09 Withdrawal at ATM #Ki34604 200.00- 953.31 ATM RGNUMAC M&T 420 NORTH BALT MT HOLLY SPRG PA Feb 11 Withdrawal 11.00- 942.31 Feb 11 Withdrawal ACH JCPenney CC 13.54- 928.77 TYPE: JCP SPAY ID: 9069672103 CO'. JCPenney CC Feb 20 Check 000140 Tracer 0001205901 115.00- 813.77 Feb 22 Check 000143. Tracer 0001170944 16.00- 797.77 Feb 24 Withdrawal Members 1st Online Transfer 483.50- 314.27 To Loan 4287590000146684 VISA PAYMENT 70 4287590000146684 Feb 24 Withdrawal Members 1st Online Transfer To Share 05 214.27- 100.00 Feb 24 Deposit Members 1st Online Transfer From Share 05 31.36 131.36 Feb 24 Deposit Members 1st Online Transfer' From Share 05 6.00 137.36 Feb 24 Ending Balance 137.36 CHECK SUMMARY Check # Amount Date Check # Amount Date 000130 50.00 Jan 28 000140 115.00 Feb 20 000138' 10.00 Feb 06 000143` 16.00 Feb 22 000139 23.00 Feb 08 ' Astenisk next ;b number srdr~tes skip an number sequence --- Continued on following page --- Send Inquires to: li~in SwiEchltoard: (717} 697-1161 or (800) 283-2328 5t 5000 Louise Drive Ez ~: (717} 697-4372 or (e0o} 2s3-x372 .1~ 25 , 2008 tl~ru Feb 24. 2008 Po sox ao TDD: (717) 697-5312 or (800) 283-2328 ext. 5312 aa~sa+us Aooourit Number: 14668 Mechanicstwrg, PA 17055 TeleBrench: (717) 795-604s or (800) 237-7288 r i t b - Page: 2 of 2 ers s o g MEMBERS P www.mem 5 Chedrs G'l~ared fir 214. DO ~~ SAVINGS ACCOUNTS 00 -REGULAR SAVINGS - Date Transaction Description Adddiorts ~ ~~ - * ~ ~ Jan 25 Ba,~ance Forward 162.36 ~ Jan 31 Deposit Dividend 1.0009'0 0.25 162.61 ~ Annual Perrae~ntage Y"veld Famed 1.010% from 01/O1/2i0lAB Unougth 01/31/2gQ8 '~ Feb 01 Deposit ACH CIVIL SERV ~•~ 861.95 ID: 3121736156 CO: CIVIL SERV '~ Feb 01 Withdrawal Transfer To Share 11 699.34' 162.61 + ~ .Feb 24 Withdrawal Members 1st Online Transfer To Share 05 157.61- 5.00 Feb 24 Enditg BaAairce 5.00 02 -HOLIDAY CLUB Date Trarisactiort Description Additior~ ~ ~~ .Aan 25 Balance Fonvaml 0.00 Feb 24 Ending BaAan[ae 0.00 05 -MONEY MANAGEMENT Date Transaction Description Additions Subtractions Balance Jan 25 Ba/anrae Forward 3 ,107.79 Jan 31 Deposit Dividend Tiered Rate 5.01 3,112.80 Annual Percenbge YFeld Earned 2.0003b from Ol/01/2A08 through 01/31/2YX~tB Feb 24 Deposit Members 1st Online Transfer From Share 00 157.61 3,270.41 Feb 24 Deposit Members 1st Online Transfer From Share 11 214.27 3.484.68 Feb 24 Withdrawal Members 1st Online Transfer To Share 11 31.36- 3,453.32 Feb 24 Withdrawal Members 1st Online Transfer To Share 11 6.00- 3,447.32 Feb 24 End~g Balance 3,447.32 CERTIFICATE ACCOUNTS 40 -11 MONTH CERT Maturity Date -Mar 29, 2008 Date Transaction Descripton Additions Subtractions Balance Jan 25 Balance Forward 1~080•~ Jan 31 Deposit Dividend 4.890% 4.49 1,085.12 Annual Percentage Yield Famed 5. t~IAO% from 01/0111+A08 dhmt~h 09/31/2008 Feb 24 End~g Ba/anae 1,085.12 YTD SUMMARIES TOTAL DNIDENDS PAID 00 REGULAR SAVINGS 0.25 02 HOLIDAY CLUB 0.00 05 MONEY MANAGEMENT 5.01 11 CHECKING 0.00 40 11 MONTH CERT .4.49 Total Year To Date Dividends Paid NOTE: Total includes closed shares 9.75 Don't forget about our new Member Loyalty Rewards Program. The more products you have with us, the more benefits you'If receive. Ask an associate for details or visit our website at www.rnemberslst.org for details.