HomeMy WebLinkAbout12-08-0815056041125
REV-1500 ~ (~-05)
PA Department of Revenue
Bureau of Individual Taxes County Code Year File Numt~er
Po sox 280601 INHERITANCE TAX RETURN 2 1 0 8 0 7 7 1
_ Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENl'ER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
0 6 3 0 2 0 0 8 0 3 2 6 1 9 2 7
Decedent's Last Name Suffix Decedent's First Name MI
H E N R Y A R L E N E B
(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
FILIL IN APPROPRIATE OVALS BELOW
^X 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death
prior to 12-13-82)
4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required
death after 12-12-82)
^X 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
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) (Rttach Sch. O)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Namme Daytime Telephone Number
S U S A N J H A R T M A N 7 1 7 2 4 9 7 7 8 0
Finn Name (If Applicable) - ~---
~~
REGISTER ~LS USE
Y
D U N C A N & H A R T M A N P C `~~ %~ ~
~..,_7 _
First line of address ~
-_ ~ ~
1 I R V I N E R O W - ~~ ~
_l
Second line of address ~~ ~ ~
~: -;
_..{
City or Post Office State ZIP Code DATE FILED ._,_ ~ --
__- __ _ _ -
..~. ~
C A R L I S L E P A 1 7 0 1 3
Correspondent's a-mail address: SUS811h81t1'Y1811@pa.llet
Under penalties of perjury, I dedare that I have examined this return, induding accompanying schedules and statements, and to the hest of my knowledge and belief,
ti is hue, correct and complete. Dedaration ofpn~parer other than the personal representative is based on all information ~ which preparer has any knowledge.
SIGNiyZ?Jd,RE OF ERSON RF.,SPON$IB FOR FILING RETURN DATE ,
289 SMITH RD i~ SHIPPENSBURG PA 17257
SIGNATU OF PREPARER OTHER T REPRESENTATNE DATE
S
_` ~ G~ / ~
PLEASE USE ORIGINAL FORM ONLY
Side 1
15056041125 15056041125
15056042126
REV-1500 EX Decedent's Social Security Number
Decedent's Name: ARLENE B. HENRY
RECAPITULATION
5 4 4 3 0 4 2
1. Real estate {Schedule A) ................................... ..... 1-
.
2. Stocks and Bonds (Schedule B) ............................. ..... 2•
3. Glossy Hek1 Corporation, Partnersh~ Or Sote-Proprietorsh~ (Schedule C) ..... 3.
4. Mortgages 8 Notes Receivable (Schedule D) ................... ..... 4.
2 2 5 0 • 0 0
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) .. ..... 5.
6. Jointly Owned Properly (Schedule F) ^ Separate Billing Requested .. ..... 6. 1 5 9 9 4 , 7 2
7. Inter-Vivos Transfers i3< Miscellaneous Non-Probate Property
(Schedule G) ^ Separate Billing Requested .. ..... 7.
8. Total Gross Assets (total Lines 1-~ ...................... ..... 8. 7 2 6 7 5. 1 4
9. Funeral Expenses & Administrative Costs (Schaiule H) ........... ..... 9. 4 8 9 8 • 4 1
1 0 4 0 4 8 9
10. Debts of Decedent, Mortgage LialHrrties, l~ Liens {Schedule q ....... ..... 10. ,
11. Total Deductions (total Lines 9 & 10) ...................... ..... 11. 1 5 3 0 3 • 3 0
1 e!. Net Value of Estaoa (Line 8 minus Line 11) .................... ..... 12. 5 7 3 7 1 , 8 4
1;I. Charitable and Governmental 8equestsJSec 9113 Trusts for which
an election to tax has not been made (Schedule J) ......... . ... ..... 13.
5 7 3 7 1 8 4
1~1. Net Value Subject W Tax (Line 12 minus Line 13) .................. 14. •
TAX COMPUTATION -SEE: INSTRUCTIONS FOR APPLICABLE RATES
1',i. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
ti6. Amount of Line 14 taxable
8 4
5 7 3 7 1
at lineal rate X .045 ,
16.
17. Amount of Line 14 taxab~ 0 0 0
at sibling rate X .12 17
113. Amount of Line 14 taxable
0
0 0
at collateral rate X .15 .
18
1!~.Tax Due ................................................19.
2!0. FILL IN THE OPAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
15056042126
Side 2
0. 0 0
2 5 8 1. 7 3
0. 0 0
0. 0 0
2 5 8 1. 7 3
15056042126
REV-1 b00 EX Page 3
Decedent's Complefie Address:
File Number
21 08 0771
DECEDENTS NAME
ARLENE B. HENRY _ _
--
STREETADDRESS
PO BOX 43
CITY ~ STATE ZIP
PLAINFIELD PA ' 17081
Tax Payments and Credits:
~. Tax Due QPage 2 Line 19) (1) 2,581.73
2. Credits/Pslyments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
Total Credits { A + g + C) (2) 0.00
3. Interest/Penalty if applic~le
D. Interes¢
E. Penalty
Total Interest/Penalty (D + E )
4. !f Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2, tine 20 to request a retund.
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.
(3) 0.00
(4)
0.00
(5) 2,581.73
{5A)
B. Enter the total of Line 5 +SA. This is the BALANCE DUE. {58) 2,581.73
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 : ..................................................................... . ^ 0
b. retain the right to designate who shall use the property transferred or its income; ^
::::::::::::::::::::::::::::::
c. retain a reversionary interest; or ............................................................ :
^ X^
d. receive the promise for I'rfe of either payments, benefits or care? ...................................................... . ^ 0
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ...................................................................................... . ^ 0
3. Did decedent own an "in trust for' or payable upon death bank account or security at his or her death? ........ . ^ X^
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designafion? ................................................................................................. . ^ ^X
IF THE AN.SVYER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE R AS PART OF THE RETURN.
For dates of death on or after Jury 1,1994 and before January 1,1995, the tax rate imposed on the net value of Vansfers to or for the use of the surviving spouse
is three (3) pen~nt [72 P.S. §9116 {a) (1.1) (i)j.
For dates of death on ~ after January 1,1995, the tax rate imposed on the net v~ue of transfers to or for the use of the surviving spouse is zero {0) percent
[72 P.S. §9116 (a) (1.1) (u)]. The stahlte does not eat a transfer to a surviving spouse from taoc, and the statutory requfremer-ts for discbsure of assets and
filing a tax retu~m 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 nei value of transfers from a deceased child iwerrty-one years ~ age or younger at death to or for the use of a natural parent, ~
adoptive parent, or a stepparent of the child is zero (0) percent ]72 P.S. §9116(x)(1.2)].
The tax rate imposed on the net value ~ transfers to or for the use of the deodents lir>e~ benefiaaries is fourandone-half (4.5) percent, exc as noted in
72 P.S. §91161:1.2) [72 P.S. §9116(a)(1)j.
The tax rate imposed on the net value of transfers to or for the use of the decedents siblings is twelve (12) percent [72 P.S. §9116(a)(1.3)]. Asibling is Mined, under
Section 9102, ,~s an individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-1502 EX + I;6-98)
SCHEDULE A
COMMONWEALTH OF PENNSYLVANIA REAL ESTATE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
ARLENE B. HENRY 21 08 0771
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 properly 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.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. 19 E. MAIN STREET 54,430.42
PLAINFIELD, PA 17081
[SEE ATTACHED HUD SHEET]
TOTAL (Also enter on line 1, Recapitulation) I S 54.430.42
(If more space is needed. insert addfional sheets of the same size)
REV-1508 EX + (8-98)
COMMOMWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, ~ MISC.
PERSONAL PROPERTY
ESTATE OF
FILE NUMBER
ARLENE B. HENRY 21 08 0771
Include thepp of Ndgation and the date tl~ proceeds were ieceNred by the estate.
AN p10pd>h k rrilh rift of wrvivorst~p must bs dtscbsed on SclaaluN F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. 1991 CADILLAC DE VILLE SEDAN 4 DOOR 1,300.00
[SEE ATTACHED KELLEY BLUE BOOK VALUATION]
2. DIAMOND RING
[SEE ATTACHED VALUATION]
950.00
TOTAL (Also enter on line 5, Recapitulation) I S 2,250.00
(If more apace is needed, insert additional sheets of the same size)
REV-7509 EX + (8-98)
COMMOMWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ARLENE B. HENRY 21 08 0771
ff art asset was made joint withir- one year of the decedent's dab of death, it must be reported on Schedule G.
289 SMITH RD.
SHIPPENSBURG, PA 17257
RELATIONSHIP TO DECEDENT
ADDRESS
SURVIVING JOINT TENANT(S) NAME
A. STEPHEN C. HENRY
s
c
JOINTLYAWN~FED PROPERTY:
SON
ITEM
NUMBER LETTER
FOR JOINT
TEN~4NT DATE
MADE
JOINT DESCRIPTION OF PROPERTY
INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR
IDENTIFYING NUMBER ATTACH DEED FOR JOINTLY-HELD REAL ESTATE.
DATE OF DEATH
VALUE OF ASSET % OF
DECD'S
INTEREST DATE OF DEATH
VALUE OF
DECEDENTS INTEREST
1. A. 09-04 PA CENTRAL FEDERAL CREDIT UNION 372.80 50. 186.40
SHARE ACCOUNT # 81907-010
[SEE ATTACHED DATE OF DEATH VALUATION]
y, A. 09-04 PA CENTRAL FEDERAL CREDIT UNION 28,744.97 50. 14,372.49
CERTIFICATE OF DEPOSIT ACCOUNT # 81907-080
[SEE ATTACHED DATE OF DEATH VALUATIONS]
3. A 09-04 PNC BANK CHECKING ACCOUNT # 5140185708 2,871.66 50. 1,435.83
[SEE ATTACHED DATE OF DEATH VALUATIONS]
TOTAL (Also enter on line 6, Recapitulation) I S 15,994.72
(if more saace is needed. insert additional sheets of the same size)
REV-1511 EX a~ (12-99)
SCHEDULE H
COMMOIJWEALTH OF PENNSYLVANIA FUNERAL EXPENSES ~
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
ARLENE [:I. HENRY 21 08 0771
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. EGGER FUNERAL HOME 2,545.22
2. BUTCHER SHOP FUNERAL EXPENSE 360.53
3. WEST PENNSBORO FIRE HALL FUNERAL EXPENSE 200.00
B.
2.
3.
4.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative (s)
Social Security Number(s)IEIN Number of Personal Representative(s) _
Street Address
City State _
Year(s) Commission Paid:
AttomeyFees DUNCAN & HARTMAN, PC
Family Exemption: (If decedents address is not the same as claimants, attach explanation)
Claimant
Street Address
City State _
Relationship of Claimant to Decedent
Probate Fees REGISTER OF WILLS
5 Accountants Fees
6. Tax Retum Prepa~er's Fees
7.
8.
9.
10
11
CUMBERLAND LAW JOURNAL -LEGAL AD
THE SENTINEL -LEGAL AD
SHORT CERTIFICATES
REGISTER OF WILLS FILING FEE
HELD IN RESERVE
1, 000.00
252.00
75.00
142.66
8.00
15.00
300.00
TOTAL (Also enter on line 9, Recapitulation) I S
Zip
Zip
1
(If more space is needed, insert addfional sheets of the same size)
REV-1512 EX + (12-03)
SCHEDULE I
COMMOMWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT,
INHERITANCE TAX RETURN ~ LIENS
MORTGAGE LIABILITIES
RESIDENT DECEDENT ,
ESTATE OF FILE NUMBER
ARLENE B~. HENRY 21 08 0771
Repart debts incurred by tie decedent prior to death which remained unpaid as of the date of death, brChrding unreirMwrsed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. CUMBERLAND GOODWILL FIRE CO. 165.00
2. PPL 43.97
3. EMBARQ 32.18
4. W. PENNSBORO 58.00
5. MCI 16.82
6. DEB PIPER, TAX COLLECTOR 859.87
7. RT CAREY DUMPSTER 235.00
8. HARRISBURG PHARMACY 21.15
9. PPL 81.85
10. CLEANING 200.00
11. RT CAREY DUMPSTER 368.00
12. INTERSTATE WASTE SERVICE 46.00
13. WEST PENNSBORO WATER & SEWER 58.00
14. MCI 14.05
15. TRAVELERS INSURANCE 354.00
TOTAL (Also enter on line 10, Recapitulation) I S 1
(If more space is needed, insert additional sheets of the same size)
Continuation of REV-15001nheritance Tax Return Resident Decedent
ARLENE B. HENRY 21 08 0771
Decedent's Name Page 1 File Number
Schedule I -Debts of Decedent, Mortgage Liabilities, ~ Liens
ITEM
NUMBER DESCRIPTION AMOUNT
16. PPL 32.95
17. WEST PENNSBORO WATER 8 SEWER 58.00
18. RT CAREY DUMPSTER
19. NEGLEY WELL
20. NEGLEY WELL
21. WEST PENNSBORO WATER & SEWER
22. PPL
164.84
5,110.00
2,314.69
116.00
54.52
SUBTOTAL SCHEDULE I 7,851.00
GRAND TOTAL SCHEDULE I S 10,404.89
REV-1513 EX + (g-00)
SCHEDULE J
COMMONNVEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
ARLENE EI. HENRY 21 08 0771
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [ndude outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1. CAROL D. WILLIAMS Lineal
1314 TAR COVE RD. DIAMOND RING
PASADENA, MD 21122
2. STEPHEN C. HENRY Lineal
289 SMITH RD. 1/3 SHARE
SHIPPENSBURG, PA 17257
3. MICHAEL P. HENRY Lineal
502 MIDDLE RD. 1/3 SHARE
NEWVILLE, PA 17241
4. ROBERT L. HENRY Lineal
107 W. MAIN ST. 1/3 SHARE
WALNUT BOTTOM, PA 17266
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
1. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET ;
(If more space is needed, insert additional sheets of the same size)
LAST WILL
TESTAMENT OF
I, ARLENE B. HENRY, of 19 E. Main Street, P.O. Box 43, Plainfield, PA, 17081,
Cumberland County, 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 any and
all other wills and codicils heretofore made by me.
FIRST. I direct that all my just debts and funeral expenses be paid from my estate as
soon after my death as practically and conveniently maybe done.
SECOND. I direct that my remains be cremated and my ashes disposed of in accord with
my expressed wishes.
THIRD. I authorize my personal representative to expend funds from my estate, in such
amounts as my personal representative shall consider necessary and desirable for the purchase,
erection and inscription of a suitable marker for my grave.
FOURTH. I give, devise and bequeath my 1.2 carat diamond ring unto my daughter,
CAROL D. WILLIAMS.
FIFTH. I give, devise and bequeath all the rest, residue and remainder of my estate unto
my sons, MICHAEL P. HENRY, ROBERT L. HENRY and STEPHEN C. HENRY, in equal
shares, per stirpes.
SIXTH. I direct that any and all Inheritance, Estate and Transfer taxes imposed upon my
estate passing under my will or otherwise, shall be paid out of the principal of my residuary
estate.
SEVENTH. I hereby nominate, constitute and appoint my son, STEPHEN C. HENRY
as Executor of this my Last Will and Testament. In the event of renunciation, death, resignation
or inability to act for any reason whatsoever of STEPHEN C. HENRY, I nominate, constitute and
appoint my son, MICHAEL P. HENRY as Executor of this my Last Will and Testament. I
hereby relieve my Executor from the necessity of posting security in connection with his duties,
as such, in any jurisdiction in which he may be called upon to act insofar as I am able by law to
do so. In addition to the powers conferred by law, I authorize my Executor, in his absolute
discretion, to retain in the form received, and to sell either at public or private sale any real or
personal property owned by me at the time of my death.
[~ ti'l`t ~I:SS ti~'HF_.I2FQF, I have hreunto set .n~• hand~utd sca4 ts, this. m~
i.:stit ~~'ill and lest<u~lent. ct~n~istil~~; ot~t~4c? t~}~e~srittcl~ t>ates this
,~RLENE B. HENRY --_ - ____ _--
Signed, sealed, published and declared by the above named Testatrix ARLI:NL B. 1Il:NRi' as
and for her bast t~'ill and Testament. in the presence of us, who, at her request, in her sight and
presence and in the- sight and presence of each other, ha~~e hereunto subscribed our names as
~vitncsses.
~ `J-
'~: ~ - --
~= ' ~.~
,'
C0~~1~Y10NWEALTI~ OF PEIVNSYL MANIA
COUs'~'TY OF CUMBERLAND
i '
,-f~ ~..~1 ;;~;r- ~! Jeri :rri~-ice-~ ~-`-
C/ --_ --
. SS.
I, .~~RLENE B. HENRY , "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; that I signed it willingly, and that I signed it as my
free and voluntary act for the purposes therein expressed.
" ~ "l~ L
ARLENE B. HENRt' ,~
Sworn or affirmed to and
acknowledged before me, by
~RLENE B. III~NRY this j~' ~'` day
of ~.,,~~ ~ , 2~0~.
~~..,,
~:.
~-
f ;
\o~ar~~ 1'ut~lic
f NOTAi2iAL SEAL
~ t~utfi~y L. Mummert, Notary Pub{ic
(~{.;rour~h of Carlisle, Cumberland Co„ PA.
~ My Commission Expires Aug. 71, 207 ,
1
C'C)1f;1ffl ~'ti< L'.~ f~ ~ ff Of~- f F -'~~= 4 ~'L i ;=#:~'I.~1
S.S.
`~ ~, J: , , ''~ .% ', -,,:._ ;,, and 4 `. , ,,.~.:__ : ; the it'1tnC;sties ~i`hUS2 naIilrs are
signed to the. attached or foregoing instrument, beitlg duly qualified tlrcordin~~ to la~i, do depose
anti sav that we ~~ere present and save ARLFNE I3. HENRY sign and execute thr instrument as
her Last Will; that she signed v<'illingly and that she executed as her free and voluntarti~ act for the
purposes therein expressed:. that ear-h of us in the hearing and sight of the "l~estatrix si~~ned the
will as witnesses; and that to the best ofour knowledge, the Testatrix ~~Vas at that tune ei~~hteen
{ i ~) or more years of age, of sound mind and under no constraint or undue int~ucncc.
f.
. ~ ~
/ ~•_/ ~
I.
y - ~ _
Sti~~orn or al~iirmed t~~ a-ld `~
subscribed before me by
_ .-:,~-,, _~ ~ -, _- and
... , ~ . t `t ' . - - ,witnesses,
thls ~~:', day of i:,.3-. _. .. G , ?Ot)~.
~~ •~. ~
i
..
Notary Public
j NOTARIAL SEAL
i 1,- `hv L. Mumrnert, Notary Public
~ daraugh of Carlisle, Cumberland Ca., PA
~~~r Commission Expires Aug. 11, 2007
OMB NO. 2502-0265
._ .. --
B. TYPE OF LOAN: _
--j
1.~FHA 2.~FmNA 3.aCONV. UNINS. ~~~ ~VA 5. X~CONV..^JS j
U.S. DEPARTMENT OF FfOUSlNG $ URBAN DEVELOPMENT ~.
6. FILE NUMBER: ~ 7 LOAN NUMBER. i
SETTLEMENT STATEMENT sIMON ~ 200$55$19 _.____________._j
$. tV90RTGAGE INS CASE NUMBER;
0270991749
`H 7' "r_ ~ fcrrr:~ rs furnishEd to <,rve yocr a stafornant of a~tua! se!tlement c~sfs. Amounts paid tc~ and by the sefflerner~f ;-~ger~t are shown
~~., ,~,-~rKer,:; "fPC:+ J" vvE'rg paJd outsxie fhe closing; they are shown here for rntormatior~a! purposes and are rrof ~ncluc+ed rn the totars ,
r, ^.Pn`~ r,;[,~ rJi~R~SS OF BORROyNER E. NAME AND ADDRESS OF SELLER, F. NAME AND ADDRESS OF LENDER.
~r . ,_. _, . , _. .. ~.
~~I?.E ~~ r,.; ~ f=_ ~ ^4'}C~N : n,1 HOWARD HANNA MORTGAGE SERV'CES
;Cis r: ^. !r~:T1_,ra<: i STEPHEN C. HENRY. EXECUTOR 119 GAMh4A DRIVE
II of the Estate of Arlene Henr,~ PfTTSBURGH, Pa. 1;1238-2982
H. SETTLEMEt`JT AGEM": 23-2x02316
PURITY ABSTRACT COr~,1PANY
PLACE OF SETTLEMEfJT
CENTURY 21 A BETTER4"S'AY'
39$ E HIGH ST, CARLISLE, PA
r' l)f~L ., v:,r'rTlfjN
•~,= a~ r ~~ ~ ~~
r .•,!rvFIELI~ ' t'ij,,,.
"~ ~ ''.,T PEf~R~;bvbR~", r,"JP, C;Ulv9BERLAND CO
I SETTLf~.P~IENT DATE I
i
•Jauember 1U. 2iJOt~; !
i,
i
J '7lJh1f,,1ARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION
106. GROSS AMOUNT DUE FROM BORROWER:
i ~ ontrtict ~I~.:, ~ ~cFa 112,500.00 404. GROSS AMOUNT DUE TO SELLER ____
401. Contract Sales Price ~~ COL ~, ;
+ r~,_~,o~r-, r~r,G~'
v 401. Personal Pro ert~ I
r~rn h~-yr _ tc b~rro~w~er4~me'400;1 ~ 5,+;02.01
1'~ tk~ 403.
_ 4014.
405.
~, ~ , ~ ~ r~;~~~rr f and fay Seller in advance Ad~ustments For Ifems Pard 8~ Seller;i~ advance _ __ _ __~
11.10'U8 to 01101iQ9 ~ 25.95
r, r, '7r a~r.~ w Taxes t1J10r'Cl$ ~o Cti01i09 ~
, S?~~ I
ou
___-
t' ~
~ ,
_____
Tax
407. C
__
T ~~ ~ ~~_--~t 1'tOr'1~~8 try 07101109 ~ 553.72
1 ,, r 40$. School Tax 11(t0,`08 Eo C71G1109 ~` ~ 7.'1
__ ---- -. 409.
_. ~__.-~.~-_ I
--- _. --- -.._..- ~
... __ 1
41 Q. ~T-__ __~`~. - ----;
_- ~__.____.._ _.-._
-- --
411.
__.. -
1
_ r i",,~~' ~ L4)d.il ~ ~' ~')UF f=ROrh1 E~C~Fi'ROWEF2 11$,6$1.6$ A20. GR05S AMOfXVT DUE TO SELC.~h~ t t ~,l)79,6~'~
AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER __ '
~
200._
_ +rl r1r 3rnk r nnnef~ 1,000.00 501. Excess Deposit See InskrucUonsi
__„~ __
'
r' ~u,.: ~ ~ur~t ` Ne.w Lua97+s)---~- 109,100.00 Line 14001 __~~ -.~-t 2 ~ __
502. Settlement Char es to Seller (
~ ~ sn,~c ~ r+',>1 ~ _ n suG ect to
__ -_.._ _._ --- - - 503. E~ostin loan ~s) taken sub~ect to __ ___, _
504. Pa off of first Mort a e to OCWEN LOAN SER Ji„IfdG, r ~ , 5'.
y 9 9 ~~ ~ __-1___-___~
505. Pa off of second Mort a e ______
506. _.._ _-___-_
507. {De osit dish. as roceeds __ __
~
~~-~Lf~i .~t ~ J'Cr ,,:.lt`.?NS -- 2,500.00 ~~ " `r ~ iiG~
508. SELLER CONCESSIONS ______~_~~._
_ _- _-__.__~r_-
~~ 509.
- -
~ _
_
PrTpc~rd 6y Seller
n t ~ 1tPms ~
~a ! Ad~ustments For Ifems Un aid ~ seller
~ _._
,
u r ~
+
-
L
,~ ~ to
~I r , to 51 U. Count !Tw Taxes ,n _..~._ ----_.-
511. Clt Tax ____
-- - „ I,. , + :; to
:
' 512. School Tax U~ ~ -- --- -
._.._~_...._-..__. __...-----------
-, .
_ .. -"- -._` 513..
514. -- - -- ---------- ~
515. ~ -.__
_ 516.
- ...._... ... ----- _. ..-_ ___ -
_. _
517. _._
v______
_
^-
518.. _ _._ _ _. _-_
~_._-.1
_. _ --.. __
}..
519.
1',:z , ~) ~U r ~+'7,h' !3'C1~2FZt'~ W'ER ~ 1'12,600.00 520 7"OTAL REDUCTION AMOUN7~ DUE S~=(LER ~,8 ~''J``s ``~ I
_ _ ER
~p ~ _ _ ITO BORROWER:
U GAS F{ AT SETTLEMENT FROM
?~,^ +, r~~ : +~r i,~,t ~, ~=turn braro~~~er (One 1207 11$.681.6$
.i; ,~ r ~r,r,,ar~,~-p a, ° }~~,rrFOr Borr~~wer (Line 220) 1' 112,000.00
) : !__ -,,__.- ,_ _:
600. CASH AT 5ETTLEMENT TO/FROM SELL
6x01. Gross Amount Due To Seiler (Line 4201 ~~ ___ ___ ~ { '~_E
602. Less Reductions Due Seller Line 520p -~ ~4~ 2`~1
,- ~=.rr,1^ ~ ~ ii=>) f3JFRCWER 6A81.68 603. CaSN(X 7U 1 { FF~?M 1 SELLER ~T 43U ~t~'~,
T ~, r ~~-t,w ~arkn^wa4EdgE: recel~t of a cor7ipleted copy c,f pants 1u2 of this statement & any attachrnent5 referred to h~re,r~.
_, .
5elier
I ,. ., ,, r-~~~ ,may --- STEPHEN t;. HENRY. EXECUTOR
__ _ _
,.~.TUtJ E. SIiLTC"J
~~ ~ (~ ~ ~ BY
+ (' C 1 ~ ~ ~ - ~--
.. ,• . - -.
TOTAL COMMISSION Based on Price
n fr tiro _r;~nr~rssron ~rire i D~~) ~s F
' ti G NOOKE HOOKE
~"_ ~ 3.;G ~~ . __._ ~~ CENTUR,Y 21 ,a, E
L. SETTLEMENT CHARGES j
11'~,5G0.00L 6.0000 °'~~ 8,750.00 -- ~-~,ni~ ~~:u~U r-~a.r, ~n;~re
,
- --- eG~Rt'z'-~V1GR S {'1 Lt R'~~
U ir~~s ., I ~'a~< eC .,etUPr'i7crn,
- 7AHNS ~_ flC,f~J FEE to CEhJTURY..1 A BETTER WAY 12'500
800. ITEMS PAYABLE IN CONNECTION WITH LOAN
~' ~~~ l.:ar ~, ~ F "~ ~ OOC+O ! to HO'sJARD NANNA Pv1ORTGAGE SERVVCE'S 1.091.00'
,` . r U. to _
„~~ .~~~ a to FIRST AMERICAN MORTGAGE, LLC POC 33?5.00 , ~--~ _-~
--
- ,~~~ F -t to FIRST Alv1ERICAN MORTGAGE. Ll_C r;,5 ; I
r ~- ' ~ r ~,: ~ r_, e to FfR,ST AMERICAN MORTGAGE. LLC
,~ ~ err ~ e ~ to FIRST ~AMERiGAN MORTGAGE LLC
s
u, =r r to HOWARD HANNA MORTGAGE SERVECES
F ~ F-rvr r h -_ __. ------ FIRST AMER9CAPJ MORTGAGE
_ __ ___.
~ ~ -~ ~ ~~
POC 31.09' 00'- 'DO 00
-''OCJ 00, ~ '
2„ 00
to OW RD HANfJA MOR GAGE aER U IC,_S ,00 00,
- -- _-t ----...- _-~
I
90U. ITEM5 REOL-IRED BY LENDER TO BE PAID IN ADVANCE
s ,t r ~ ' I t(. i7K a 1?~'1?Ot3 Via. $ "~8.68G~0001day f 21 days
-
"~' ~ ~ ~g~ u _ ~ r r rerniorrfio! months to
- -- -.._. '"!o}
---
- ~ --~ ~g,".28
_ ___.
-
1
,. ~~ ~ ~~ ;~ 'r. rr.iurn t~_r 1 1? y~ears_toERIE IP~SURANCE _ ~_
PQC$'~96QG~- - __~ ..__
'
i
9000. RESERVES DEPOSITED WITH LENDER
' F r ~ar~ , .-an S.OOC1 months 'cu '.3 i~,6, er month
_ 1L~? 35
it_a i r~i~ ~ , c 0.00 months r~ 3 t30 01 per rr~~onth _ _ - -
_ _
-- _- _ .- __ ---
r ,unt t i;~ 11.OU0 months l~ S 14 92 per month
__~ __. -._ _.__.__- _...
~t months r~ $ per month
7-U00 months r~ 81.9/ c,r month
pee month
-- - months ~ 3
- -
- -- -- - -
_ ~___
-~
~
__-,
,---r----- -
?64 1. ; jj~
-__ l
~ ~
,
~ 3 r r
~
.~_._
-
-
-__-_._ months ;cu
__ _ _..___ .-~__~ per month -------- -~-- -
- --
._---_--._._.----~ --- -.--
---r--- _ _
---- _
.__ -.
~~_:FL( _ ~UJ`1ih.1E_t~:T months ia~ 3 per month ,;75.06
1100. TITLE Cl-IARGE5
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ORCHARD SETTLEMENT SERVICES
DEED ~.--------+ _- . _ a
1uu ~J~!
to CASH 20.00
to DUNCAN & NARTMAN. PC ~ _- .----__-~ --.___~__ 1
~Ye,rr rit rnuNr i
fo P1.IRITY ABSTRACT COti1PAN~'' PLT.08-C}?o 0~92.8'1~
= stern nuirbers'I 101, 1103 - 25`id PHFA DISCOUNT i I
" ~~ J r o~ 3 109.100.00
LO$-0035591 , ±
,
i r er u, ~ $ 112,500.00 _ _ Ci 0-003333x3 _
-- ~ _ i
^, , f ~ i ~~ ~ Dili ~ to ~
PURITY ABSTRACT COMPANY t 50~30
~
'~
-
---- ---- ~ ~
~
' ^ r ~ F i-+
"f~" M1 P J' I`' PURITY ABSTRACT COMPANY N1A IF hJ0 FEES EhvTEREU a
~
' ' i ' Su'c ~~ ~ ~r 1 ~r,;er to LAWYERS TITLE INSURANCE CORPORATION 35.0 I
_
- -- ----.._
ee`r racf Fee pa ~H.age __._
to ---N__.__;_ -- ---
PURITY ABSTRACT COMPANY' l _
y -- __
~----
_12,(}C7 __ _',
rat F~-e oao`f ~^
verr.i to PURITY ABSTRACT COMPANY ~ -~,
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PURITY ABSTRACT COMPAPJY _----------
-------
_____ --
--------- +
__.3
51~C~,
,,I
_i_..
1200. GOVERNMENT RECORDING AND TRANSFER CHARGES
' ~ x r eu ~ae~1 $ 1ts.50: Cvlortgage $ 7$.50; Relaases ~ __-
~~ 1yi; oror n y ~ah_`~t3mps~ Dee~u _ t-125.00, MoR9a9e ._~_~-
1 _' d~- `_~r:~n r ~ Reven~~r Stamm- 1.125.00 hdort~a4e
,, RECORDER OF DEEDS
RECORDER OF DEEDS
1300. ADDITIOPIAL SETTLEMENT CHARGES
to ADVANCE LOOk:
~, , ,
---
I^JAt ,~"1cF __ _ fo WPTMA
j • ~^~;TF F~ , t:^ST I C._ ~ to NEGLEY"S WELL DRILL1PvG INC.^
140(1. TOTAL. SfcTTLEMENT CHARGES (Enter on Lines 103, Section J and 502, Section K)
- ,~ ~ nra r.~~r. , n ~w?;1~ , ry ;e p~r r.f a :omple."[ d «ny n~ ~, ~,~ i ur ihi~ t Ki Gai:~~.+51~fe'ra6~nt.
i' t•
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PURITY ABSTRACT
Settlement Agent
~ . , r ~ _.
---r-- ----- --1------- ---...__1
--{-
1 "' i UU _ l
_.__. *.. ..~ F ------i
_.._. ~ .._._ --1-1 ~ _0d ---- i
-_ I __~.-_----1- -------
---r----------}-___.___ -.__._..___i
H I; 375.00;
200.0('
`.602.01
ANY' ~';
i
i% ~ ,_..
u.2 ' ?d
~'~~ai~ti tiiA'ON . ,
neite~~- aloe tsoox rr~~ate raY~y ri•7c7rig xep*Jrt - ~:adll~ac, ~evltie - vlilc,ai rLeilcy t~iu... ~ u~,~ ._
~s
~~ 7ttE7RLt>;TED RESC]t)RCE
r~¢,~a~r
].991 Cadillac QeVitte Sedan 4t?
E,"t~E ~tJI~K ?~iVAIE ~~~Y ~~~.U~
. Condition
~ 1 1 ~ ~. i' .~-~~ r
i i P{~
Cob ~xY: ~ 3_. ~'. i ~ B .~
._ _ - -.,
~.
~' - ,~~_
~ Fair
;Selected )
Value
2 ~'~ ~ £
,,~,~-
$1x300
Average Consumer Rating (7 Reviews) ~ e„c Re~_r~ ars
_ - ~ -. 4.6 out of 5 1«vi:_,v: ~r;3 Ve h;~!e
Vehicle Highlights
Mileage: 22 S, 000
Engine: V8 4.9 Liter
Transmission: Automatic
Drivetrain: FWD
Selected Equipment
Standard
L~~~dtr^ni- ~or:e Do:;r ~ari< ~as_ett
P: _ `vic~r,ra~ C-ui>~, Cnntr_ Po~t~°r __nc
Blue Book Private Party Value
Pi~•.•ate Party Value i~ .ri-,at a buyer car: expel to pa'; ~.r~nen u•uyinu a •~~ed c .- *r'om a
~,~ ~vat° party. The Prwa~e Party Value assumes the ve~ E_±e a sr, ~~ .~_~ zs r;d Carrie=_
.: v:crrantb (other nar: the continuing factory n~arran*y). T..".e `final s=!e prlc° may
•,'a ienending nn the vehicle`s actual Condition and Iccai rnar~,e' onditio~<. This
rr;av also Ge r -: c' L~ derive fair h;arket >< ±~e i;^.r ncc_Q.°_p ,,-"- veh~_e
iu.;;.._,~,n Gu~rv,e
'>`h€._ie Cc~r:ditscr ~~tirrgs
>~ ~. ~~.
Special APR
and Lease Rates
available an
a!! models'
ht~:p:/i www.kbb.cam/KBB/UsedCars/Pricingl~epart.aspx?Yearld=1991 &Mileage= 2250Q0&... 9/4/2008
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A80UT LOANS PviARKED WITH AN ~ STATEMENT OF ACCOUNT
WRITE TO:
PENNSYLVANIA CENTRAL FCU
959 EAST PARK DRIVE
N HARRISBURG PA 17111-2810
3069 '_
RETURN SERVICE REQUESTED pA Cenfial
Toll Free 800-356-3875 FEDERAL CREDIT UNION
Fax 717-564-1503 www.pacecent~alicu.com
>11844 5387816 003 092119
ARLENE FIENRY
&/OR STEPHEN C HENRY
PO BOX 43
PLAINFIELD PA 17081-0043
u NtrUR 1 tRRORS OR MAKE INQUIRIES ABOUT
'ELECTRONIC FUNDS TRANSFERS" WRITE TO THE
ADDRESS AT LEFT OR CALL:
717/564-4661
125001RP ~l SF,
ACCOUNT NUMBER
81907-010
STATEM_EIVT
PERIOD
_
_____
FROM ~ TO
04-01-08106-30-08
SOCIAL SECURITY NO.
S.S.N. SECURED
REF LOC PAGE
1
lANNUAL FEES OR CHANGES
MIODAYIY TYPE OF ACCOUNT /TYPE OF TRANSACTION PERCENT- FINANCE ~-I'E Tp BALANCE
AGE RATE CHARGE CHARGES BALANCE
SKIP-A-PAY! SKIP-A-PAY! : SKIP-A-PAY!
YOU CAN SK[P YOUR JUNE, JULY : OR AUGUST LOAN
PAYMENT! PA CENTRAL WANTS 1'O HELP: YOU PLAN FOR
FUN IN THE SUN!
O10 SHARE ACCOUNT PREVIOUS BALANCE 243:59
040408 DEBIT 66260 vISA 15000- 93
59
04:3008 EFT DEP CNTRL PEN 193:00 ,
286:59
050108 MON PF CKS
05:050$ DEBIT 66260 vISA 15000- 13659
05:30.0$ EFT DEP CNTRL PEN 19300 32959
060208 MON PF CKS
06050$ DEBIT 66260 vISA 15000- 17959
063008 EFT DEP CNTRL PEN 19300 372:59
070108 MON PF CKS
06300$ DIVIDEND 21 37280
ANNUAL PERCENTAGE YIELD EARNED IS 00.52;Y
06300$ NEW BALANCE 37280
06300$ 090 SHARE ACCOUNT
NO TRANSACTIONS THIS PERIOD PREVIOUS
~ NEW BALANCE
BALANCE ];24
1:24
063008 OBU REG SH CERT 36 MO
DIVIDEND PREVIOUS BALANCE 2842607
06300$ 31890 2874497
RATE 4.5000% ISSUED 11/19/07 MATURE NEW
S 11/13/10 BALANCE 2874497
$634.82 REGULAR DIVIDENDS
P~~
t.~j~-~ ~~~ ~~~
~~cxober 9, ?t108
~ustlla J t-lart.nlan. E~~
T7lr~c~ln c~. Halvnan, t C
~~7i1G ~IL1IlC; 1'~0 4~'
s~.~lrlislc, PA 1`7()1 '.
T3Ci3: U6-spa-'?U0
i~~~r ~vls. flarr_ir~ali:
in respoust t~~ yatir requesi for Bate uf` L~e3th {DOD) balances for the customer rlotc:d abc~v~:, cur
r~:c3rus 5ht7~~ the 1t~ila~ring:
C'hec~:ng AGGOi~r~t
:account =~ ~ 14015`~7U8 Established: +J~-"9-?~~()
r~RT:ENE B FIEivRY
STFPI~EN ~ HENS
f~C?I~ balance: ~ ;',Y I1.~~ + C1.U8 a~;crued interest
.Please note r11a-t this ~#lce praz~ides date oY death balances for ~lepasit accounts (IIt~~, i;Ds, e-'iaeckillti ~:u~c
Savings j. V4'e do ixoz process any ~in~~rciai transactions or provide stafemer~ts. if you need assistance :~.-::_?
iv ~fthe7e items, please call 1-SSF-PNC-BANIti (1-$$$-762-265} o.r stap by your local IB`C' Bank bra:icl:
oitice.
~`vatiolla; d,ll3c111C•la1 ~erb~l+:c;s ~ellter
;>>de~tlher Pf~I(_'
Page '1 c0f 1