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HomeMy WebLinkAbout10-21-0815056041147 .J REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO 60X.280601 2 1 0 8 - 0 5 8 0 Harrisburg, PA 17128-0601 ~ RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 235401085 05142008 06121921 Decedent's Last Name Suffix Decedent's First Name MI GREENWOOD BERTHA M (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ® 1 Original Return ^ 2. Supplemental Return ^ 3. Remainder Return (date of death prior to 12-13-82) 4. t_imited Estate ^ qa, Future Interest Compromise ^ 5. Federal Estate Tax Return Required ^ (date of death after 12-12-82) 0 Decedent Died Testate ~ Decedent Maintained a Living Trust B. Total Number of Safe Deposit Boxes ® 6. ^ (Attach Copy of Trust) _ --- (Attach Copy of Wilp ^ 9. Liti anon Proceeds Received 1 p. Spousal Poverty Credit (date of death ^ 11. Election to tax under Sec. 9113(A) 9 ^ between 12-31-91 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 BRADLEY L GRIFFIE 7172435551 Firm Name (If Applicable) GRIFFIE & ASSOCIATES First line of address 200 NORTH HANOVER STREET Second line of address City or Post Office State ZIP Code CARLISLE PA 17013 Correspondent'se-mail address: bgriffie@griffielaw.COm REGISTER O~J~IILLS USE Y ~:~ ~ -.~ -- ~ ---I - --'T1 _ .T' fU ~; ---_ --' ~--- DATE FILED W W 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. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DAIF `'~~~ C ^wtl ~~ NORMAN C. MILLER ~p ~ ~p~(,~ nuDRESs 2190 NEWVILLE ROAD, CARLISLE, PA 17015 SIGNAT - RER OTHER THAN REPRESENTATIVE UATF Bradley L Griffie 200 North Hanover Street, Carlisle, PA 17013 Side 1 15056041147 15056041147 J REV-1500 EX 15056042148 uecodo~rsNamo. GREENWOOD, BERTHA M REC APITULATION 1. Reaf 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. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ............. 6. 7 Inter-Vivos Transfers & Miscellaneous Non-Probate Property . (Schedule G) ^ Separate Billing Requested ............. 7. 8. Total Gross Assets (total Lines 1-7) ....................................................................... 8. 9 Funeral Expenses & Administrative Costs (Schedule H) ......................................... 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10. 11. Total Deductions (total Lines 9 & 10) ...................................................................... 11. 12. Net Value of Estate (Line 8 minus Line 11) ............................................................ . 12. 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. TA X COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 15. (a)(1.2) X .00 16 . Amount of Line 14 taxable 16. at lineal rate X .045 17 . Amount of Line 14 taxable 17 at sibling rate X .12 18 . Amount of line 14 taxable 1 6 7, 9 9 8 5 6 18. at collateral rate X .15 19 . Tax Due ................................................................................................................... .. 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Decedent's Social Security Number 235401085 102,000.00 0.00 89,579.67 191,579.67 __ _ _ __ 6,908.30 16,640.11 23,548.41 168,031.26 168,031.26 25,199.78 25,199.78 Side 2 ~,,_,_ 15056042148 15056042148 REV-1500 EX Page 3 Decedent's Complete Address: GREENWOOD, BERTHA M ---. STREET ADDRESS 933 NORTH PITT STREET -- CITY CARLISLE Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. InterestlPenalty if applicable p, Interest E. Penalty File Number 21 - 08 - -0580 30,000.00 1,259.99 STATE PA Total Credits (A + g + C) - - - --------- ----- ZIP 17013 (1) 25,199.78 (2) 31,259.99 Total Interest/Penalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 2 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. g. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT (3) 0.00 __ (4) 6,060.21 (5). (5A) - _ _ -- 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 :................................................................................. I __~ [x b. retain the right to designate who shall use the property transferred or its income :.................................... ~ x j c. retain a reversionary interest; or .................................................................................................................. l -~ ~x-1 d. receive the promise for life of either payments, benefits or care? .............................................................. L_~ [ x ~~ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without 1 i 1 receiving adequate consideration? ....................................................................................................................... i- X- I 3. Did decedent own an "intrust 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)]. 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. SCHEDI~LE A ~.: '~ REAL ESTATE COMMUNWI /1LIIi OF PENNSVLVANIl1 '. '', INlilf21Il~NC(: T/V( RETUF2N ft1-.SIUF.N'1' D[CEDENT j FILE NUMBER ESTATE OF GREENWOOD, BERTHA M ~1 - 08 - -0580 All real property owned sole)y 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 wilting seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on schedule F. ITEM DESCRIPTION VALUE AT DATE OF NUMBER DEATH 933 NORTH PITT STREET 102,000.00 CARLISLE, PA 17013 (SEE ATTACHED HUD-1) TOTAL (Also enter on Line 1, Recapitulation) 102,000.00 SCHEDULE E ' ~ ' CASH, BANK DEPOSITS, & MISC. °°MM°NWEAET"°F RE"NSVLVANIA PERSONAL PROPERTY INI{fRITANCf TAX RETURN RESIDENT DECEDENT ' I ~ ___. .. _-_. _ - _...__-_ _ __.. ____z.-_ _ _... - - ___ __. __ __.-r:- _ _ __ __ _. _.. - IFILE NUMBER ESTATE OF GREENWOOD, BERTHA M ' 21 - 08 - -0580 - - ___ _ --- ___- _ - -- --- - _ 1-. Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM DESCRIPTION VALUE AT DATE OF NUMBER DEATH _ - -- -- 1 UNITED STATES TREASURY (STIMULUS CHECK) 300.00 2 PERSONAL PROPERTY (AUCTIONED) 387.50 (STATEMENT ATTACHED) 3 AARP (HEALTH INSURANCE REIMBURSEMENT) 38.00 4 TAX PRORATION CREDIT AT REAL ESTATE SETTLEMENT 808.95 5 M&T CHECKING ACCOUNT NUMBER 9838898105 88,024.22 (STATEMENT ATTACHED) 6 CASH 21.00 _- _ -- TOTAL (Also enter on Line 5, Recapitulation} 89,579.67 • ~ SCHEDULE H FUNERAL EXPENSES & COMMONWEALTH OF PF:NNSVLVANIA INHERITANCE. TAX RETURN ~ Ar111AINICTUATI~/C ^/1G~T~ RESIDENT DECEDENT /1LJIY~ h7 ~ fW ~ ~YC~ ~.IW ~ J i I - I~ FILE NUMBER ESTATE OF GREENWOOD, BERTHA M 21 - 08 - -0580 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION ~ AMOUNT NUMBER FUNERAL EXPENSES: - __ _ --- --- t- - ---- -- A. 1 IVA OBRIEN (PASTOR SERVICES) 25.00 B. i ADMINISTRATIVE COSTS: 1. ! Personal Representative's Commissions I ~ Social Security Number(s) / EIN Number of Personal Representative(s): Street Address City State Zip Year(s) Commission paid 2. Attorney's Fees GRIFFIE AND ASSOCIATES ~~ 3,000.00 3. ' Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip i Relationship of Claimant to Decedent 4. Probate Fees I, 493.00 5. Accountant's Fees 6. Tax Return Preparer's Fees II 7. Other Administrative Costs 1 ;CUMBERLAND LAW JOURNAL (ADVERTISING) 75.00 ~I TOTAL (Also enter on line 9, Recapitulation) 6 908.30 Schedule H ~ ' Funeral E~enses & COMMONWITI_TH OF PENNSYLVANIA I INI IE-.Ill IANCE TAX RETURN /QIdrT1~nIS1~ti1/e ~~ cOnbn '~~"'~ R L'.SIU[ NT UECEDEN i 1R11 .. _._- -- ESTATE OF GREENWOOD, BERTHA M FILE NUMBER 21 - 08 - -0580 - --- - - 2 ~ THE SENTINEL (ADVERTISING) - - - __ 3 ERIE INSURANCE GROUP (HOMEOWNER INSURANCE) 4 'PPL ELECTRIC UTILITIES 5 PPL ELECTRIC UTILITIES 6 NORMAN MILLER (TRASH REMOVAL) 7 REALTY TRANSFER TAX (SALE OF REAL ESTATE) 8 2008-2009 SCHOOL REAL ESTATE TAXES 9 !BOROUGH OF CARLISLE (WATER & SEWER) 10 PPL ELECTRIC UTILITY 11 .PPL ELECTRIC UTILITY 12 ~~ AUCTION COSTS 13 ...RESERVES 150.64 266.00 16.76 18.04 31.94 1,020.00 945.59 83.00 19.53 15.05 248.75 500.00 Page 2 of Schedule H SCHEDULEI ~ DEBTS OF DECEDENT, MORTGAGE COMMONWEALTH OF PENNSYLVANIA LIABILITIES & LIENS INHERITANCE TAX RETURN 1 RESIDENT DECEDENT ESTATE OF GREENWOOD, BERTHA M Include unreimbursed medical expenses. ITEM DESCRIPTION NUMBER 1 PPL ELECTRIC UTILITIES 2 KINETIC IMAGING (MEDICAL) 3 SPRING ROAD FAMILY PRACTICE (MEDICAL) 4 CV NEPROLOGY ASSOCIATES, INC. (MEDICAL) 5 MILLINIUM PHARMACY SYSTEMS (PRESCRIPTIONS) 6 BOROUGH OF CARLISLE (WATER & SEWER) 7 CARLISLE HMA PHYSICIANS (MEDICAL) 8 MASLAND ASSOCIATES (MEDICAL) 9 UNITED CHURCH OF CHRIST HOMES (NURSING HOME) 10 SPRING ROAD FAMILY PRACTICE (MEDICAL) 11 MILLINIUM PHARMACY SYSTEMS (PRESCRIPTIONS) 12 CARLISLE HMA PHYSICIANS (MEDICAL) 13 CARLISLE HMA PHYSICIANS (MEDICAL) 14 KINETIC IMAGING (MEDICAL) i -~ -- - FILE NUMBER 21 - 08 - -0580 TOTAL (Also enter on Line 10, Recapitulation) AMOUNT --.._ _. 13.87 33.33 94.56 116.80 18.00 62.25 107.06 3.34 15, 946.30 85.31 14.22 21.41 110.96 12.70 16,640.11 12EV-1513 EX+ (9-00) I ' ~~ SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN t2ESIDENT DECEDENT ESTATE OF GREENWOOD, BERTHA M NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I, ,TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1 NORMAN C. MILLER 2190 NEWVILLE ROAD CARLISLE, PA 17015 -- -- ~' FILE NUMBER ~' 21 - 08 - -0580 RELATIONSHIP TO ~ SHARE OF ESTATE AMOUNT OF ESTATE DECEDENT (Words) ($$$) Do Not List Trustee(s) FRIEND ONE HUNDRED 167,977.56 PERCENT Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 --- LAST WILL A ND TEST~?iMENT OF BERTHA M. GREENWOOD I, BERTHA M. GREENWOOD, of 933 North Pitt Street, Carlisle, Cumberland County, Pennsylvania, being of sound and disposing mind, .memory and understanding, do make, publish and declare this to be my Last Will and Testament, hereby revoking and making void all previous Wills and Codicils heretofore made by me. FIRST I order and direct my Executor hereinafter named to pay all of my just debts, funeral expenses and expenses involved or connected with the administration of my estate as soon after my death as is reasonably possible. I direct my Executor to pay all inheritance, estate, succession and legacy taxes, to which my estate or the transfer of any property hereunder may be subject, and to charge such taxes as part of the expenses of the administration of my estate, being deducted and paid from the residue of my estate and not to be deducted in any manner from any specific bequests made herein. However, my Executor need not accelerate and pay those unmatured obligations which, in his, her or its opinion, it might be proper and more advantageous to retain or renew and pay as they become due and payable.. If I do not own a burial plot or a grave marker at the. time of my death, I authorize my Executor/Executrix, in his, her or its sole discretion, to purchase a GRIFFIE & ASSOCIATES Attorneys At Law 200 N. Hanover Sheet 100 Lincoln Way East, Suite D Carlisle, PA 17013 Page 1 of 8 Chambersburg, PA 17201 burial plot and'to erect a suitable grave marker at my grave, and to expend sums from my estate for this purpose. SECOND I give, devise and bequeath my entire estate together with all insurance proceeds thereon of whatsoever nature and wheresoever situate to my dear and close friend, NORMAN C. NIILLER, of 2190 Newville Road, Carlisle, Cumberland County, Pennsylvania, provided he survives me by sixty (60) days per stirpes. I .direct my Executor/Executrix to divide among such beneficiaries all personal property of a sentimental or family nature (excluding cash, stocks, bonds and the like), including but not limited to jewelry, household goods, antiques, furniture and memorabilia, in accordance with a separate memorandum which I may place with my Will or deposit with my attorney. In the absence of such disposition by memorandum, I direct that the said tangible personal property be divided between my residual beneficiaries with due regard for their personal preferences in as nearly equal shares as practical, with the value of such dispositions being credited to the share of each respective recipient. If the said beneficiaries do not agree to the division of the personal property provided for hereunder, \I the decision of my Executor/Executrix, including the decision to sell the property at public or private sale and distribute the proceeds therefrom as provided hereinafter, shall be final and conclusive on all parties. THIRD Should my dear and close friend, NORMAN C. MII.LER, predecease me or die on or before the sixtieth (60) day following my death, then I give, devise and bequeath my entire estate together with all insurance proceeds thereon of whatsoever nature and GRIFFIE & ASSOCIATES Att~rn a ~L of 8 aw inn ~r u.,r.-„or .crroot g I00 Lincoln Way East, Suite D wheresoever situate to my dear and close friend, JASON NORMAN MILLER, of Mt. Holly Springs, Cumberland County, Pennsylvania, provided he survives me by sixty (60) days per stirpes. I duect my Executor/Executrix to divide among such beneficiaries all personal property of a sentimental or family nature (excluding cash, stocks, bonds and the like), including but not limited to jewelry, household goods, antiques, furniture and memorabilia, in accordance with a separate memorandum which I may place with my Will or deposit with my attorney. In the absence of such disposition by memorandum, I direct that the said tangible personal property be divided between my residual beneficiaries with due regard for their personal preferences in as nearly equal shares as practical, with the value of such dispositions being credited to the share of each respective recipient. If the said beneficiaries do not agree to the division of the personal property provided for hereunder, the decision of my Executor/Executrix, including the decision to sell the property at public or private sale and distribute the proceeds therefrom as provided hereinafter, shall be final and conclusive on all parties. FOURTH I specifically note that I have not provided for the distribution of any assets of any nature whatsoever from my estate to my step-children, ORRIS DAVID GREENWOOD, nor RONALD DARRELL GREENWOOD. I do so not out of want of affection, but because I have provided for-them as I desired during my lifetime. FIFTH I grant my Executor/Executrix the following powers in addition to and not in limitation of such powers as my Executor/Executrix shall hold by law: GRIFFIE & ASSOCIATES Att~neey~ Aft ~aw 2AA N_ Hnnwer Street ag ° 100 Lincoln Way East, Suite D (a) To retain all property received including the stock of any corporate fiduciary acting hereunder, provided such property remains productive. (b) To join in any corporation, partnership, recapitalization, merger, reorganization or voting trust plan; to delegate authority with respect thereto; to deposit investments under agreements and pay assessments; and generally to exercise all rights of investors, including but not limited to, the voting of shares. (c) To manage, operate, repair, improve, mortgage or lease on any terms any real estate held or owned by my estate. (d) To operate any business that I may own at my death. (e) To invest any funds of my estate in any stocks, bonds, notes or other securities or property, real or personal, without regard to the principle of diversification or any other statute or general rule of law in his, her or its absolute discretion, it being my intention to give my Executor/Executrix the broadest investment powers possible, providing such investments do not unnecessarily prevent the prompt settlement of my estate. (f) To sell or otherwise dispose of .any property, real or personal, tangible or intangible, at any time forming a part of my estate in any manner and on such terms and conditions as my Executor/Executrix shall see fit in his, her or its absolute discretion. (g) To borrow money for the payment of taxes or for any other proper purposes in the administration of my estate, and to mortgage or pledge estate assets as security. GRIFFIE & ASSOCIATES Att~ngeey~ o~ ~aw 100 Lincoln Way East, Suite D 2n/1 N. Nnnnver .4treet (h) To compromise claims without court approval including, but not limited to, any controversies with the United States of America or the Commonwealth of Pennsylvania concerning estate and inheritance taxes on any interests that may pass under this my Last Will and Testament. (i) To distribute in cash or in kind upon any division or distribution of my estate. (j) To undertake ,any and all acts deemed necessary and proper by my Executor/Executrix for the proper, advantageous and prompt management of the settlement of my estate. (k) In general, to exercise all powers in the management of my estate which any individual could exercise in the management of similar property owned in his own right, upon such terms and conditions as to him, her or it may seem best and to execute and deliver all instruments and to do all acts which he, she or it deems necessary or proper to carry out the purposes of this, my Last Will and Testament. SIXTH No interest of any beneficiary of my estate, either in income or in principal, shall be subject to anticipation or pledge, assignment, sale or transfer in any manner, nor shall any beneficiary have the power in any manner to charge or encumber his interest either in income or principal, nor shall-the interest of -any beneficiary be liable or subject in any manner while in the possession of my Executor/Executrix for the liability of such beneficiary. GRIFFIE & ASSOCIATES Att~gey~s o~ ~aw 200 N. Hanover Street 100 Lincoln Way East, Suite D SEVENTH I nominate, constitute and appoint my dear and close friend, NORMAN C. MILLER, as Executor of this my Last Will and Testament. In the event Norman C. Miller is deceased, unable or unwilling to serve ox shall cease to serve far any reason whatsoever, then I nominate, constitute and appoint my dear and close friend, JASON N. MILLER, as Executor of this my Last Will and Testament. I direct that my Executor shall not be required to give or post bond for the faithful performance of his duties in this or any other jurisdiction. EIGHTH I hereby declare it to be my expressed desire that my Executor/Executrix employ the law firm of Griffie & Associates, of Carlisle, Pennsylvania, for legal advice and assistance regarding this my last Will and Testament, they having considerable knowledge of my affairs, views and wishes respecting any matters that may arise at the probate of this instrument, the administration of my estate, and the execution of the powers herein mentioned. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, consisting of eight (8) typewritten pages, the first five (5) of which bear my signature on the side margin, for purpose of identification, this ~ ~ ~ day of ~ y Q ~ S ~ , 2006. ~~~ ~ ~ BERTHA M. GREENWOOD - 2~0 N. Hanover Street GRIFFIE & ASSOLCIATES Att~ngeyb~ o~ Saw 100 Lincoln Way East, Suite D ~ ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA: SS. nr,T nrr~~ nC ~''T TA~fRFRT .ANT) I, BERTHA M. GREENWOOD, the Testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly, and that I signed it as my free and voluntary act for the purposes therein expressed. ~. ~~~~ BERTHA M. GREENWOOD Sworn or affirmed and acknowledged before me by the Testatrix this day of 2006• NOTARIAL SEAL ROBIN ]. GOSHORN, NOTARY PUBLIC CARLISLE BORO., CUMBERLAND COUNTY MY COMMISSION EXPIRES APRIL 17 2001 2nA N. Hnnnver Street GRIFFIE & ASSOLCIATES Att~ngeyS~ o~ Saw 100 Lincoln Way East, Suite D ~ AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA: . SS. COUNTY OF CUMBERLAND WE ~ ~ a-d I t~ L • ~ v ~ ~~e and ~.1~~ 1. rJQiS~A i ~- the witnesses whose names are attached to the foregoing document, being duly qualified according to law, do depose and say that we were present and saw the Testatrix sign and execute the instrument as her Last Will and Testament; that she signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the Testatrix signed the Last Will and Testament as witnesses and that to the best of our knowledge the Testatrix was at the time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed and subscribed before me by~~ this ~ day of and 2006. -.~ a ,~ . rotary Publi NOTARIAL SEAL ROBIN !. GOSHORN, NOTARY PUBLIC CARLISLE BORO., CUMBERLAND (AUNTY MY CDMMISSION EXPIRES APRIL 17 2007 GRIFFIE & ASSOCIATES Att~age~y~ o~~aw 2M lV Hnnnvor .ctraat I00 Lincoln Way East, Suite D ~ ATTACHMENT TO SCHEDULE "A" A. Settlement Statement U.S. Department of Housing and Urban Development nsnc e........,.,t Ale ~cn~_n~ac rs....t.e~ ~~r~nnnnn~ 1. ^FHA 2. ^FmHA 3. ^Conv. Unins. 6. File Number 1 - 4 7. Loan Ntunber 1 6 8. Mortgage Insurance Case Number Th a torte is mashed tb give you a statement o adual set ement cos s. Amounts paid to and by the settlement agent are shown. C• Note: (tame marked "(p.o.c.)" were paid outside the dosing; they ere shown here for IMortnetlon purposes end are not Induded in the totals. WARNING: it la a crime to knowingly make false statements to the United States on thla or any other slmllar form. Peneltlea upon TIt18EXpresS Settlement System D. NAME of lioRROwER: Michael R. Mellott and Carolyn M. Mellott E. NAME OF SELLER: The Estate. of Bertha M. Greenwood F. NAME OF LENDER: AmTrust Bank 1111 Chester Avenue Cleveland OH 44 4 G. PROPERTY ADDRESS: 933 North Pitt Street, Carlisle, PA 17013 Carlisl Borou h x. SETTLEMENT AGENTi PA Real Estate Settlement Services, LLC 54 Alexander ad to ~ ariisle P 17 0 0 2 08 . SUMMARY OF BORROWER'S TRANSACTI N: K. UMMARY F ELLER' TRAN TION: 102 000.00 102 000.00 4 892.94 10 O1 08 12 31 08 101.71 30 01 08 12 31 OB 101.71 10 O1 08 06 30 09 707.24 10 O1 08 06 30 09 707.24 107 701.89 4 102 808.95 76 500.00 2 048.59 76 500.00 2 048.55 107 701.89 102 808.9'_ 76 500.00 2 048.55 R 31 201.89 100 760.3E SUBSTITUTE FORM 1098 SELLER STATEMENT: The Information contelned herein Is important tax information end is being famished to the tntemal Revenue Service. If you are required to file a return, e negligence penalty or other sendion will be Imposed on you if this Item Is required to t>e reported and the IRS determines that it has not been reported. The ConVad Sales Price desaibad on line 401 above constllutea the Gross Proceeds of this trensadlon. You are required bylaw to provide the pedlement agent (Fed. Tax ID No: ) with your corned taxpayer IdentiflcaUon number. K you do not provide your corned taxpayer idendflcatlon number, you may be subjed to dull w criminal penplUes imps ospd bylaw. n er penal es of p-erjury, I certHy that the number shown on thla statement Is my coned taxpayer Identlfleatlon number. TIN: ~ / r. I -`.~_ SELLER(S) SIGNATURE(S): ! SELLER(S) NEW MAILING ADDRESS: SELLER(S) PHONE NUMBERS: (H) (W) r \~ ' \ V ATTACHMENT TO SCHEDULE "E" •~ .~ OWNER Address - Date of Sale Auctioneer _ Sale Location Clerk Cashier Other PROCEEDS OF SALE: Cash .---------------------------------------------- $ ~__: 38~5~ ~ Checks ------------------------------------------ Other Miscellaneous (see attached list) TOTAL rROCEEDS OF SALE _________ LESS SELLER'S SALE EXPENSE: Auctioneer's Fee_-------------------------------------------------------------- $ ~ ~~ jai ~ 30, ~ f ~ O.o Miscellaneous (see attached list) Other Seller's Expenses Advanced by Auctioneer: DEDUCT TOTAL SELLER'S SALE EXPENSE TOTAL NET PROCEEDS TO SELLER I, (or we), the seller of goods; merchandise, andJor property sold at public auction on above date and location, acknowledge and accept this settlement of proceeds of sale. I (or we) agree to acxept all responsibility for providing merchantable title to all goods, merchandise, and/or property sold, an~dyfor delivery of title to the purchaser. Qs~ { (Dat (Seller's Signature) Auctioneer or Cashier's 'nature (Seller's Signature) FINAL SETTLEMENT Date ~ ~ ~~ Form No. FS Reorderfrom: MISSOURI AUCTION SCHOOL Phone 1-80D-835-1955 .~ - ©l~~l Bank 499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12 Phone (888) 502-4349 Fax (302)934-2955 October 15, 2008 Griffie & Associates Attorneys and Counselors at Law 200 North Hanover Street Carlisle, Pennsylvania 17013 Re: Estate of Bertha M Greenwood Social Security: 235-40-1085 Date of Death: May 14, 2008 Dear Sir or Madam: Per your inquiry dated October 8, 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 9838898105 Ownership (Names o~ Bertha MGreemvood* Opening Date 11/28/06 Closed 6/12/08 Balance on Date of Death $ 88, 024.22 Accrued Interest $ 1.93 Total $ 88, 026.1 S 2. Type of Account Savings Account Account Number 15004204211368 Ownership (Names o,~ Bertha MGreemvood* Opening Date 12/19/02 Closed 3/27/08** Please be advised, there was no safe deposit box found for the above decedent. ** Please contact the High Street Carlisle Branch for all additional information on accounts closed prior to the date of death. * 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 High Street Carlisle Office # 717-240-4536. Sincerely, Tracie Hare Records Management