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Home My WebLink About02-0449 Estate of DONALD E. PIPER. SR. PETITION FOR GRANT OF LETTERS No. ~ I- 0..2 . 4'-1g also known as , Deceased Social Security No. 184264307 DONALD E. PIPER. JR. Petitioner(s). who islare 1 B years of age or older. apply)ies) for : (COMPLETE "A" OR "B" BELOW:) GJ A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut OR Decedent. dated 1/26/02 and codicil(s) dated named in the Last Will of the State relevant circumstances. e.g.. renunciation. death of executor. etc Except as follows, Decedent did not marry, was not divorced and did not have a child bom or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incapacitated: o B. Grant of Letters of Administration (c.la.. d.b.n.c.la.: pendente lite. durante absentia: durante minoritate) Petitioner(s) after a proper search haslhave ascertained the Decedent left no Will and was survived by the following spouse (if any) and heirs: I Name Relationship Residence I (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in CUMBERLAND County, Pennsylvania, with hislher last family or principal residence at 117 WILLOW DRIVE. SHIPPENSBURG. PA (list street number and municipality) Decedent, then 66 years of age, died APRIL 30 . 2002 . at SHIPPENSBURG, PA (Location) Decedent at death owned property with estimated values as follows: (if domiciled in PA All personal property ......................................... $ (if not domiciled in PA Personal property in Pennsylvania .................... $ (if not domiciled in PA Personal property in County .............................. $ Value of real estate in Pennsylvania ........................................................................................ $ Total............... ............. ............. ....... ... .............. .... ..................... ... .... ... .... ............. $ 20,000.00 90.000.00 110.000.00 Real Estate situated as follows: 117 WILLOW DRIVE, SHIPPENSBURG. PA Wherefore, Petitioner(s) respectfully request(s) the probate of the Last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: Typed or printed name and residence DONALD E. PIPER JR. 432 PRINCESS ANNE RD. VIRGINIA BEACH VA 23457 1.'1-101 - ,.., Oath of Personal Representative Commonwealth of Pennsylvania County of CUMBERLAND The Petitioner(s) above-named swear(s) and affirm(s) that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of P 'tioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly administer th . estate ~g to law. Sworn to and affirmed and subscribed ~ _ o ALD E. PIPER, JR. 7th day of ~~. {t!JtJJ47j _ . 'r fs l10 . 1m.. . Y LEWI I before me this DECREE OF REGISTER Estate of DONALD E. PIPER SR. also known as Deceased NO.RlJ - 0:1 . &../ 4 'j Date of Death: 4/30/02 Social Security No: 184264307 AND NOW MAY 7, , reverse side hereon, satisfactory proof having been presented before me, 2002 , in consideration of the Petition on the .......r ~ ~ 't, _ .- . :n c.' d f',' IT IS DECREED that Letters \XI Testamentary 0 of Administration are hereby granted to DONALD E. PIPER, JR. ((c.la.. d.b.n.c.l; pendente lite; durante abl;entia; dUl;ln~ minoriate) ~ I -.,J \.C.I in the above estate and that the instrument(s), if any, dated 01-26-2002 described in the Petition be admitted to probate and filed of record as the Last Will of Decedent. FEES (:) -.) $ 6.00 $ $ 1 2 . 00 $ $ $ 5.00 $ $ Letters .................................... $ 235.00 Short Certificates(s) ............... Renunciation .......................... Extra Pages ( ) ............... I.T.R....................................... JCP Fee ................................. Inventory............................... . Other..................................... . Signature Attorney: SALLY J. WINDER 1.0. No: 24705 Address: 701 EAST KING STREET SHIPPENSBURG PA 17257 TOTAL .............................$ 258.100 mailed to atty 507-02 Telephone: 717 532 9476 DATE FILED: 5-7-200? Last Will and Testament ;21- 0;) - t.Jl-Jq I, Dona~d E. Piper, Sr., a resident of Pennsylvania, Cumberland County, declare that this is my will. REVOCATION OF PREVIOUS WILLS FIRST: I revoke all wills and codicils that I have previously made. CHILDREN SECOND: I have the following child(ren) now living: Donald E. Piper, Jr. and Christine A. Rotz and Jamie S. Forster. FAILURE TO LEAVE PROPERTY THIRD: If I do not leave property in this will to one or more of the children or grandchildren whom I have identified above, my failure to do so is intentional. DEFINITIONS FOURTH: As used in this will, the term "specific bequest" refers to a gift of specifically identified property that I leave in this will. The term "residuary estate" refers to all property subject to this will that is not passed by specific bequest or that is specifically left to or becomes a part of my residuary estate when a beneficiary of a specific bequest fails to survive me. The term "residuary bequest" refers to a gift of all or a portion of my residuary estate. SPECIFIC BEQUESTS OF PROPERTY FIFTH: I give Secretary Bookcase, Piper Kitchen Clock, Piano Light, All power and hand Tools, Radio Light, 2 Trunks, Brass Bed frame, Kitchen Light (above shack bar), Glass front night stand, Kitchen Table and chairs, Rose pattern dishes, Pinball machine, Brass canner, Mom's bible, Low Boy Oak Dresser, 12 quart slow cooker, Antique wall phone, Bowl and pitcher w/stand, Picture of mom as a teen, 2 Kerosene wall lights, Piper rocking chair, Popcorn afghan, mom's books to Donald E. Piper, Jr. However, if Donald E. Piper, Jr does not survive me, the property shall go to Sharon K. Piper. SIXTH: I give 1 kitchen clock, Grandfather clock, pool table, "Gone with the wind" light and stand, Radio light, Jugs with coins, Clock (in living room on garage wall), Movies, 2 trunks, Van, Coffee table, Living room furniture, Roll-top desk, Desk in dining room, Dining room hanging light, All stereo equipment and TV, Lincoln rocking chair to Christine A. Rotz. However, if Christine A. Rotz does not survive me, the property shall go to Steve R. Rotz. Page ~ Initials: ~, ~ 5f1E..., Date: //2G,f~ SEVENTH: I give Family kitchen clock, Hoosier cabinet, jewelry box (one dad made mom), Bedroom set (front bedroom), Brass stricking alarm clock, Radio light, High standing chair, Glass tool box, Tool bench in shed, 2 trunks, Plant stand, Kitchen dishes. to Jamie S. Forster. However, if Jamie S. Forster does not survive me, the property shall go to John Forster. EIGHTH: I give Mother's jewelry (equally divided) to Christine A. Rotz and Jamie S. Forster. However, if one of these beneficiaries does not survive me, the surviving beneficiaries shall take his or her share equally. If there are no surviving beneficiaries, the property shall go to my residuary estate. NINTH: I give Proceeds from the sale of the house to Donald E. Piper, Jr. and Christine A. Rotz and Jamie S. Forster. However, if one of these beneficiaries does not survive me, the surviving beneficiaries shall take his or her share equally. If there are no surviving beneficiaries, the property shall go to my residuary estate. TENTH: I give The remalnlng clocks, the material in the secretary, pictures and kerosene lamps (all divided evenly) to Donald E. Piper, Jr. and Christine A. Rotz, and Jamie S. Forster. However, if one of these beneficiaries does not survive me, the surviving beneficiaries shall take his or her share equally. If there are no surviving beneficiaries, the property shall go to my residuary estate. RESIDUARY ESTATE ELEVENTH: I give my residuary estate to Donald E. Piper, Jr and Christine A. Rotz and Jamie S. Forster. However, if anyone of these beneficiaries does not survive me, the surviving beneficiaries shall take his or her share. ENCUMBRANCES AND LIENS TWELFTH: All personal and real property I give in a specific or residuary bequest shall pass subject to any encumbrances or liens on the property. SURVIVORSHIP PERIOD THIRTEENTH: When this will states that a beneficiary must survive me for the purpose of recelvlng a specific bequest or residuary bequest, he or she must survive me by 45 days. DIVISION OF BEQUESTS FOURTEENTH: Any specific bequest or residuary bequest made in this will to two or more beneficiaries shall be shared equally among them, unless unequal shares are specifically indicated. Page L Initials:Uc./J, ~ -51fE., Date: / 17--G~ Ie ~ PERSONAL REPRESENTATIVE FIFTEENTH: I name Donald E. Piper, Jr. as my personal representative. If Donald E. Piper, Jr. for any reason does not qualify or ceases to act as personal representative, I name Christine A. Rotz as my personal representative. No personal representative shall be required to post bond. PERSONAL REPRESENTATIVE'S POWERS SIXTEENTH: I direct my personal representative to take all actions legally permissible to have the probate of my will done as simply and as free of court supervision as possible under the laws of the state having jurisdiction over this will, including filing a petition in the appropriate court for the independent administration of my estate. SEVENTEENTH: I grant to my personal representative the following powers, to be exercised as he or she deems to be in the best interests of my estate: 1) To retain property without liability for loss or depreciation. 2) To dispose of property by public or private sale, or exchange, or otherwise, and receive and administer the proceeds as a part of my estate. 3) To vote stock, to exercise any option or privilege to convert bonds, notes, stocks or other securities belonging to my estate into other bonds, notes, stocks or other securities, and to exercise all other rights and privileges of a person owning similar property. 4) To lease any real property in my estate. 5) To abandon, adjust, arbitrate, compromise, sue on or defend and otherwise deal with and settle claims in favor of or against my estate. 6) To continue or participate in any business which is a part of my estate, and to incorporate, dissolve or otherwise change the form of organization of the business. The powers, authority and discretion I grant to my personal representative are intended to be in addition to the powers, authority and discretion vested in him or her by operation of law by virtue of his or her office, and may be exercised as often as is deemed necessary or advisable, without application to or approval by any court. PAYMENT OF DEBTS EIGHTEENTH: Except for liens and encumbrances placed on property as security for the repayment of a loan or debt, I instruct my personal representative to pay all debts and expenses, as provided for by the laws of Pennsylvania. . 1.Q I~ Page l Initials: DEI I ~ * I Date: 1/7-G/C 7- PAYMENT OF TAXES NINETEENTH: I instruct my personal representative to pay all estate and inheritance taxes assessed against property in my estate or against my beneficiaries out of all the property in my taxable estate, on a pro-rata basis. NO CONTEST PROVISION TWENTIETH: If any beneficiary under this will contests this will or any of its provisions, any share or interest in my estate given to the contesting beneficiary under this will is revoked and shall be disposed of in the same manner as if that contesting beneficiary had failed to survive me and left no living children. SIGNATURE I, Donald E. Piper, Sr., the testator, sign my name to this ins~rumenk' this .:J(() day of J(\()u0J1 i ' ~dOOd, at ..)'n\cf\ I teL . I declare that I sign and exe ute thlS instrument as my last will, that I sign it willingly, and that I execute it as my free and voluntary act. I declare that I am of the age of majority or otherwise legally empowered to make a will, and under no constraint or undue influence. tb~.J (' ~S (Signed) WITNESSES We, the witnesses, sign our names to this instrument, and declare that the testator willingly signed and executed this instrument as the testator's last will. Each of us, in the presence of the testator, and in the presence of each other, sign this will as witness to the testator's signing. To the best of our knowledge, the testator is of the age of majority or otherwise legally empowered to make a will, is mentally competent and under no constraint or undue influence. We declare under penalty of perjury tha~the foregoing is true and correct, this :.~LP day of .JMua..rLj , ~dO()d.' . at Witness #1: _~t.u~~ 0 ci- R~Siding at: ~J.lZef :i!;i)h/JloiYQ Bmsl Wltness #2: ________~_____ (ct1 D 0 \lY' '5f1z.. Page :i..- Initials: ll-..L-, ~ ' Date: (/.7- C/C7- I ACKNOWLEDGMENT Commonwealth of pennsylvania 1 6 County of: LUIY'~2Z rlC\.n I, Dbv00J d 2. PI P<2-r.5\L , the testator 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 that I signed it willingly and as my free and voluntary act for the purposes therein expressed. Officer: I l ~ AFFIDAVIT NOTARIAL SEAL PAMELA A:::\NiTALSKI Notary Public ShippensbUi~; l.Iumberland CO~,nty M'j Commission Explr~~~_eb. 9, ,,004 Commonwealth of Pennsylvania County of:~(y\~rIGnd We, ':.kp~n A &10 and J6;'CIO~ IJ Ceh the witnesses whose names are signed to the attached or foregoing instrument, having been duly qualified according to law, do depose and say that we were present and saw the testator sign and execute the instrument as his/her Last Will; that the testator signed willingly and executed it as his/her free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the testator signed the will as a witness; and that to the best of our knowledge the testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. sw~rn to or affirmed and sUbscribecr~t~ before me by -.::rtepre() B Y'f b and ,~ :-tTI (',\ 0.- U f~b wi tnesses, this ~Io day of -:}o.n\..)(t."1 ' ~ dO:Jd.-. . Witness:i\ ~ U NOTARIAL SEAL PAMELA A SWITAlSKL Notary Public Shippensburg Cumberland County M'j Commi~si~~.~:pires F.~!:E004 ,- r(fltJ, Page.~ Initials: l;;"C,. J/2(P /6 ~ Date: p- CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: DONALD E. PIPER. SR. Date of Death: 4130/02_____ ___ Estate No. 21-02-00449 SSN: 184264307 File No. Date Letters Granted: 517/02 Will or Administration No. To the Register: I certify that Notice of Estate Administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on 6/6/02______ - --- ----- DONALD E. PIPER, JR. Address 609 S MOUNTAIN EST RD __________ SHIPPENSBURG_ _________ _ PA__17257 3671 EDENBERRY CT _ nn _____ ______ VIRGINIA BEACH ___ _ ______ _____ __ _ _ -'LfL23457_ 432 PRINCESS ANNE ROAD n VIRGINIA BEACH _____ ______________-"!.A_2.3457 Name CHRISTINE A. ROTZ JAMIE FORSTER Notice has now been given to all persons entitled thereto under Rule 5.6(a) except ------------_._--_._-~_.__."._.~._-_._._---,..._,._--~--_.~-_._- Date__~/01()-:>-. -- ~Jw~_ SALLY J. WINDER Name (Please type or print) Capacity: __ Personal Representative n. X_ Counsel for Personal Representative Address 9974 MOLLY PITCHER HIGHWA't'_________ __ SHIPPENSBURG____ _____ ~A17257 Telephone No_ 717 532 9476 - , . "".1 r- I .=) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX( 11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT SALLY J WINDER ESQUIRE 9974 MOLLY PITCHER HIGHWAY SHIPPENSBURG, PA 17257 u______ fold ESTATE INFORMATION: SSN: 184-26-4307 FILE NUMBER: 2102-0449 DECEDENT NAME: PIPER DONALD E SR DA TE OF PAYMENT: 11/06/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 04/30/2002 NO. CD 001813 ACN ASSESSM ENT CONTROL NUMBER AMOUNT 101 I $3,828.66 I I I I I I I I TOTAL AMOUNT PAID: $3,828.66 REMARKS: DONALD E PIPER JR C/O SALLY J WINDER ESQUIRE CHECK# 122 SEAL INITIALS: DO RECEIVED BY: REGISTER OF WILLS MARY C. LEWIS REGISTER OF WILLS FlE..}.,s.:it.J{~~) '* COMMONWEALTH OF PENNSYLVANIA . DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0001 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT / 7- 'Zju~i i FILE NUMBER 2 1 -0 2 0 4 4 9 "'COiiiTY"'COCr -~ -- HUiftR-- c I- Z W o W (.) W o DECEDENTS NAME (LAST. RRST. AND MIDOlE INITIAL) PIPER DONALD E. SR DATE OF DEATH (MMoDD-Yea) DATE OF BIRTH {w.<<lD-y...) SOOAL SECURITY NUMBER 1 8 4-2 6-4 3 0 7 THIS RElVIlN IIUST BE F1lBJ 111 DUPlICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER l!! :.::Stn ,,"''' w"" ",00 <Jg:~ .. '" 04130/2002 08116/1935 (IF APPLICABLE) SURVMNG SPOUSE'S NAME (LAST. FIRST. AND"DOlE IN1T1AL) 00 1. Original Retum o 4. Limited Estate 06. DecedentDieOTeslale l""""a''''''''''1 o 9. Litigation Procoeds Received o 2. Supplemenlal Retum o 48. Future Interest Compromise rdaltrideattl * 12-12.s2) o 7. Decedent Maintained a Living Trust(AtlllchCOJlyafTrust) o 10. Spousal Poverty Credit (<i*ofc\ealll bettween 12-31-91 nll-1-95) o 3. Remainder Retum (_af~priortl12.t3-821 o 5. Fedefal Estale Tax Retum Required _ 8. T olal Number of Sale Depos~ Boxes o 11. Eleclion 10 lax under Sec. 9113(A) 1"""",,"01 THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFlDENTlAL TAX 1NF0RIIAllON SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS SALLY J. WINDER 9974 MOLLY PITCHER HWY FIRM NAME I" Applicable) z o g ;:) l- ii: <( (.) w a:: z o 1= <( I- ;:) l1. ::Ii o (.) ~ I- 0- Z w Q Z o .. .. w '" [!j " TELEPHDNE NUMBER 717532 9476 SHIPPENSBURG 92,000.00 PA 17257 OFFicIAL .USE ONLY (1) (2) (3) (4) (5) 1. Real Eslale (Schedule A) 2. Stocks and Bonds (Schedule B) 3. CkJse~ Held ColJlOration, Partnership or SoIe-Proprietorsllip 4. Mortgages & N_ Receivable (Schedule D) 5. Cash, Bank Deposils & Miscellaneous Pe""",,1 Property (Schedule E) 6. Join1ly Owned Property (Schedule F) (6) o Separate BUling Requested 23,739,50 7.lnler.VNOS Transfefs & MOcellaneous Non-Probate Property (7) (Schedule G or L) 8. TOIaI Gros. Assets (lOlal Lines 1.7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts 01 Deceden~ ~age Liabilities, & ~iens (Schedule I) (10) 1 t Tolal Deductions (IOtal Lines 9 & 10) 12. NelValu. of Estate (Line 8 minus Line 11) 13. Charitable and Govemmental BequestslSec9113 Trusts forwhidl an eIeclion 10 tax has nol been made (Schedule J) 14. Net Valu. Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR API'lICABlf RATES 15. Amount ot Line 14 iaxable at the spousal lax rale, ()ftransle.. under Sec. 91 16 (aXU) 19. Tax Due X _(15) 85,081,30 X ,045 (16) X ,12 (17) X .15 (18) (19) (8) 115,739,50 16. Amount of line 14 taxable at lineal rate 26,761,58 3,896,62 (11) (12) (13) 30,658,20 85,081,30 17. Amount of line 14 taxable at sibling rate (14) 85,081,30 18. Amounlof Line 14 taxable alcollateral rate 3,828.66 3,828,66 20 0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < Decedenfs Com lete Address: STReET AllOAESS 117 WILLOW DRIVE . . CITY SHIPPENSBURG Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. CnldiISt1'aymenIs A. Spousal Poverty Credit B. Prior Paymenls C. Disalunt STATE PA ZIP 17257 (1) 3,828.66 TOlaICredils(A+B+C) (2) 3. InleresllPenaty ij applicable D. Inlerest E. Penalty TOlaIlnleresllPenaty ( 0 + E) (3) 4. ~ Une 2 is greater lIIan Une 1 + Line 3, enter Ihe difference. This is Ihe OVERPAYIIENT. Chick box on PIge 1 line 20 III request. refund (4) 5. ~ Une 1 + Une 3 is greater than Une 2, enter Ihe diffelence. This is Ihe TAX DUE. (5) 3.828.66 A. Enter Ihe inteleSl on Ihe laX due. (SA) B. Enterlhe IOlaI ofUne 5 + SA. This is Ihe BALANCE DUE. (58) 3.828.66 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN ox" IN THE APPROPRIAtE BLOCKS 1. Did dec:edenl make a I1ansfer and: Yes No a. retain Ihe use or income of Ihe property l/wIsferred: ........................................................................... 000 b. retain Ihe righllo designalewho shall uselhe property transferred or its income; ........................................ 0 00 c. retain a IllVel&ionay interest; or ............................................................................................::........ 0 00 d. receive Ihe promise lor life of eilherpaymenls, benefils or care? ............................................................. 0 00 2. ~ death 0CCUITlld alter December 12, 1982, did decedent transfer property willlin one 'feat of death withoIII receiving adequaIe <:on&ideraIion?............ ......................... .......................................... ................ 0 00 3. Did dec:edent own an 'in trust for' or payallle upon death bank account or security at his or her dealll? ................. 0 00 4. Did dec:edent own an Individual Retirement Account, annuity, or other non-probate property which contains a benelicialy designalion? ....................................................................................................... 0 00 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPlETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. =~" I__..._.~~_""_."""lhebesl"..,~""_.lio_amc:t""..... ~ ~. io_"'..~"__hls""~. SIGNA TlJRE FOR FlUNG RETURN DA. /~ VA SENTAnVE LL Y PITCHER HIGHWAY NSBURG < PA 17257 For dates of death on or after July I, 1994 and before January I, 1995, Ihe laX rate imposed on Ihe net value of transfers 10 or lor Ihe use of Ihe surviving spouse is 3% [72 P.S. 59116 (a) (1.1) (ill. For dales of dealll on or after January i, 1995, Ihe laX rate imposed on Ihe net value of transfels 10 or for Ihe use of Ihe surviving spouse is O'l\ [72 P.S. S9116 (a) (1.1) (ii)]. The statute does no! eJ<8IllOI a lranSfer to a surviving spouse from laX, and Ihe statutory requirements for disclosure of asseIs and filing a laX retum are still applicable even n lIIe surviving spouse is Ihe only benelicialy. For dales of death on or after July 1, 2000: The laX rate imposed on Ihe net value of transfels from a deceased child ~ty-ooe yeatS of age or younger at death 10 or lor Ihe use of a natural parent, an adoptive parent, or a stepparent of Ihe child is O'l\ [72 P.S. 59116(aX1.2)). The laX rate imposed on Ihe net value of transfers 10 or for Ihe use of Ihe decedent's lineal beneliciaies is 4.5%, excepC as noted in 72 P.S. 5911q!1.2) [72 P.S. 59116(aXl)). The laX rate imposed on Ihe net value of transfeIs to or for Ihe use of Ihe dec:edent's siblings is 12% [72 P.S. ~9116(aXl.3)). A sibling is defined, under SecIion 9102, as an individuai who has at least one parent in oommon willi Ihe decedent, whether by blood or adoplion. ..... REV.l502EX+ (!.971 . COMMONWEALTH Of PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER PIPER DONALD E SR 21 02 0449 A11,..1 property.- solely or IS 11llnlnt In common must be raportld II fair martll VlIUI. Fair market value is defined as "'" price at which proper1)' would be exchanged between a willing buyer and a willing seller, _ being compelled to buy Of sen, bo1h ha~ng reasonable knowledge 01"'" relevant fads. ROll property which Is jointly.o_ with right of lurvtvorshin must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION IMPROVED PARCEL OF GROUND KNOWN AS 117 WILLOW DRIVE, SHIPPENSBURG, PA SOLD AND TRANSFERRED 8/30/02 PER ATTACHED DEED COPY AND AGMT OF SALE VALUE AT DATE OF DEATH 92,000.00 TOTAL (Alsoetller Dflline 1, Recap;tulation) $ (If more space is needed, insert additional sheets of the same size) 92 000.00 .---- ~---.. . ,- "'Q. ~<fttli. , .," . '. '"....'~.'r.,"I. THIS DEED "-nil.. M1llE the .:;f".- day of eighty-three (1983). /JUy in the year nineteen hundred and ~ Dean M. Sm.u:o and Cathy J. Smuro, his wife, of 219 Holland laid, Fayetteville, Franklin Cbunty, Pennsylvania, GRl\NIO~, AND D:nald Piper and Marjorie A. Piper, his wife, of 200 East Garfield Street, Shippensburg, pennsylvania, GRllNl'EES , Wl'lNESSETH, that in consideration of the sun of Fifty-'lhree Tb:>usand ($53,000.00) Dollars, in hand paid, the receipt whereof is hereby ackrlowledged, the said Grantors do grant and convey in fee sinple to said GranteeS, . ALL the folloWing described parcel of ground lying and being situate in ,Shippen8bur~P, OJntlerland Cbunty, Pennsylvania, rounded and described as follows : ~G at an ira1 pin at the Western edge of Willow Drive; thence along the 'WesteJ:n edge of said Drive, South 11 degrees West, 110.2 feet to an iron pin; thence along lot No. 16, secticn E, North 72 degrees 15 minutes West, 100.~ fee~ to an 1rori pm; thence along lot No. 17, Section E, along a curve to the left, a distance of 106 feet to an iron pin; thence along lot No. 20, Section E, South 75 degrees 15 minutes East, 116.4 feet to the iron pin at the place of BEX>INNING. . It being lDt No. 18, Section E in the revised M?untain View J\ddition, surve~ by John Howa.tt1 !t:Cle11an, c.S., dated May, 1963, the sarre being filed of record in Plan Book 18, Page 22. . BEING THE SAME REAL ESTATE which iXluglas E. Helm and Evelyn Kay Helm, his wife, by deed dated AUgust 16, 1980 and recorded anong the deed records m CUnberland OJunty, Pennsylvania, m Deed Book "a", VolUJle 29, Page 217, conveyed to Dean M. SIlUro, ~ with his wife, Cathy J. SIluro, are the Grantors herein. SUBm:T to restrictions as set forth in the above recited deed. AND the said Grantors will warrant generally the property hereby conveyed. . "" c:<.> '" -, .' '^' 'T1 ,." i'l , ,., C'> '" " ::x .., 0 .. . ~ '" "" .... I.n t:, 0 ':J '" r, ". u,: ;or- .... ;~J 0 ". 1''' - <:, . - .. , ...., 0 . .~.. ... " "..,. 0 :!! .,- :..z: 00' ')> '" C'> c:. co "' <.., co V> 0 r_ ... ~,.' .... w ::c -1. m 8U"" t::nO '."'" uo r u ,,',:..t 72 . " H:J;ii..~ti!~'I;.t\ . ."..Wl~l.?:f1'~,'~.'. "daY' " ," " ':i~~;'li.lii<i%jj~-i~4~~,"j;';"" ~ . :, .~.; ..'. . , . .,' . ,.,~. .~::,l .'~ .;. ". ,,:;~,;,;>'r'.'~'!;~ . .' .". ," ~ "" , ,.1 '....~...~...;.";, .. ", . .':' ."~'; J. . .:,.~~:';:... l IN w.I'1NESS ~ said Grantors have hereunto set their h8nls'weeal ;, and ,year first above written. ...........-.- / / 4Q.~ (l( '};1tU-etO.' ' .~an M. Smuro ~ C:ft2:0. . : " "" ....... y, (. (.......) , l: :",;" ........." 't, '"",' w.I'1NESS : , 'dj~' '0.' . JkZ~t.-:;.:- ' (SEAL) ............,..,............, . ~ STATE OF PENNSYLVANIA : <XXJN1Y OF FR1lNKLlN en this' '~1" , day of' '~I1Y , , " ., , 1983, before rre, a Notary Public, the undersigned officer, personal Y appeara:l. Dean M. Smuro and Cathy J. Snm'o, his wife, moWn to rre (or satisfactorily proven), to be the persons whose !lanes are subscribed to the within instrurrent, and acknowledged that they executed the same ,for.the pw:poses therein contained. ' ",; Witness ~ hand and official seal, the day and year aforesaid. ,: '" , " I .. ",. ~ ,; I ' , ~ /hA' , ",......."",1'.1. . " \~ I, ." . .. p ~""" "~'" ')\1'I1f) "" ~J,. #lC (J1 'AI (" . ~, .'''f''1';j~ 00l'ARl{ ....m. T'e'" · . 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(,~f~.<( . t~~ .,r ..' , "BOO~ 30 fACE 73 . 'ii ~ .~ ~C-:..NDARD AGREEMENT FOR THE SALE OF REAL ESTATE -, r-......~l<<.bl.-IIOl~IO_b)',lIlcltlelllbo:noftllePenlUylvani....osocw;..orRF.AJ..TO~(PAll.) '8 BUSINESS IT PA LICENSED BROKER~ ~ PHONE .:....:Z...- FAX S'~Q-'5 BROKER (c...... ) ADDRIlSS BROKER IS THB "GENT foa DR Breker iI NOT lbt' Apat far Seller and . aI..: 0 AGENT FUR BUYEa DaiIRlllted "pal(l) lor Seller. I appUCllbat: o TRANSACTION LICENSEE R:~~NS~~ITH PALlCENSl\D BROKER ~ BROKER (~) .. ....5, PHONE t) m AOOR1!S8 FAX Z'f- BJlOKEll18 THE AGENT FOR BUYER. Daipated Apal(s, lor Bu,er. if IIpplicabk: DR Braker II NOT tile A... r... Buyer..... .. alan: 0 AGENT FOR Sfo:LLER 0 SUBAGENT FOR SELLER 0 TRANSACTION LICENSEE 1 , , . . . , I I " 11 " " " ,. 11 11 11 " .. " 12 " " .. " 27 " .. " " " " " " .. " " " ... 41 " " .. .. .. " .. .. .. " 12 12 N " .. 11 II H WIIaa &be.... Broker II"..' for SeDer aacI Aaent for Buyer, Broker fl. Dual "'amt. All 01 Broler'.lbmea an-aile DualAp... UNLESS tIIIft Me ...... DeIIIp.aed A.-a for Bayer ... SeJIer. II the __ LkenIet ill de:sipaIH for Stoller and Buyer, the I..kmIee II . Dual AIeDL I. [bis 1I11J'(cmcnl,..... ~~? ~ t<<. SElLEII(8), ,c~ ot " m 2a> "2- ,Is Mtween . ailed ~Iler," and BUYERIS): ,QlJtd"Buyer." (Bl .... wW be paid to Seller by Buyer .'oIloWI:, I .. J ,..1~ I. CaIIl ordted: IIC lilflin, Chi. Aj<<ement: 1.u1T'-\.IN ~ _it- $ II 2. Caah or cbeck within _ dI)'1 of the execution of this Agreement: S za 3. I ~w;. 4. Cuh.""""',,,<atifi"_'".''''.fK.''''''' TOTAl. : ~=~~ DepoIita paid QD 1CCOUI11 of purchase pncc: 10 be heJd by Broker for Seller, umns OlIlerwl5e slaced here. 14 .. " " " " " " " " " " II 31 " " " Ju..\y ?rY"\2.. (e) (D) (El Seller', wnftal appronl Seulc:mcnl to be on Conveyance from Seller will be ,orbefOfe if811yerand Seller agree. (F) Payment of tratu;fer wes will be divided eqLlally belween Buyer and Seller unless olheJwise SLaled here: (0) At lime of ~t, the followina will be IIdjwiled pro-llIla 001 daily basis between Buyer and Seller, reimbuning where applicable: lues (1ClC InfOOllllion Reprdini Tu Prol1lliOfl); miU; inlere5f 0/1 marg. auumption.~; ~mj>>jum fees and homeowner anocUition fees, if any; Willet andI(X" ICWCt fees. if any. together with any olber lienable lllunki~1 service. The charges are 10 be pI'O-l"lted for the period(sl ~vcn:d: SeUet....iII pay lip to and including the dale of seuleIDerlt; Buyer will pay for all days followinB sectlemc:nt, uDle" otherwise $f.ated ...., .4. FIXTllIlES.. PEJlSONALPROPEaTY (1..QO) (A) INCLUDBD in 1m' sale and pw1:hase price an: all uisting ileJm permanently inslllled in the Property. free of lien&, including plwRbing; heating. lillltinl tif:lUml> (including cbluKkJicl5 and ceilinf fans); wah'r !lemmenl .'i}'~lellls; pool and spa equipment; pnJc door openen IDd lransmiltcQ; television antennas: shrubbery. plantings and unpoUed lrees; allY relllaininM helling and c'lOkillg fuels slored on IRe Propcr1y at the time of settlemenl; wall 10 wall carpelil1g: winolow cove. h ware, shl sand hli . buill-in .ir t;:onditioners; built-in appIi~t::t~j.~_UPles50lhmvisestaled.AI!lOinc]lIdetJ: ~8r ( ~ I' f )\A' . (B) J...B4aED itaDa (not owned by ScUer): (C) SXCLUDED fj~wmt and ircnu: 5. DA'I'E8fI1M.EISOrmEHSSENCE(1-<l2} (. (A) 1bc laid dale fur lICulernenl and all other dales lUll.! lil1lell referred 10 for lhe perhmllal\l.;e of any Ilf the ubfigmillns of Ittis Alreemem IIf"I: aareed 10 be of the esaencc of this A,gm::menl and are binding. (8) For1he pwpoICl aflbis Agreement. number of days will be CWlnled from the diUe ofex.ecuIUm. by eJdudin, tile day /his ABreemenl WIIS executed &lid iacluding the lasl day oflhe time period. (C) The eWe oIlCl11emenl it not e:t1ended by any other provision of lhis Agreemenl and may only be euended by mUluaI wriuea llJreCmeld of ........... (0) c.n.mll"" p,'"'''' '" ",-p"'." '" ~"A.",,,,,,,... '0'''''''"''' '0 tho B,y".... So"" A,y "'-POol" U~~'ol"bl' aod may be &Cd by Itrikinl withe pre-pnnted leU and msenmg a dlfTerenll1me penod acceptable to all puhes ~ AlS-ZK Pqe J 01' SellerJ.UJ_: ", '" COPYRIGHT PF.NNSYI.YAN'A ASSf:X:lATION or aEAl.TOIse.zeu ".. Ii 1"..,,-.1 REAU RS' ..-..---"- A1S.2K 1 , , . . . 1 I . " 11 " 1l '"",,- " " " .. " .. " .. .. .. " " 53 .. IS II " II .. . ~ .. " 11 " II .. " " 11 " " .. 11 12 U .. 15 Ii II II .. .. " " u .. . . II . .. ,.. '" '12 ." ,.. ,. ,. '07 lO. lO. .11 111 '" 1ll '" '" ". 111 111 '19 ". '21 '" '" '" ,,, ". m '" ,.. '31 '" '" '13 '31 135 '" m '"~ ,. .., '" '" '" '" '''' --/$J!J (8) MJou::;i=: Bu~cr~n:n, !l~Of1J~: f~Og as (0"'1.( (jO Mmimurn Term YeaR Typo 01 lnIcraI ~ 'l>; however, BuU[!JllC' 10 accept lite In~rnt rate all may be commUted by the ~ aender, IlOIlo excceda muimum inIerat rate of' t- -/~ %. S. DiIcounI pointa, w.n origilllltton, Joan placement and OIlier fee;.; churged oy the lender a~ I percentage of the mortgage loan (cJI;cluding any tnOttpac ifl5tll'lnCe premiums or VA funtling fee) IJOl 10 uceed - 0- % (0% if not specified) ollhe moI18ll8c Joan. 1bc inletell. "* and fc:cs provisiooll requiml by Buyer an: sluisfJed if II mortgage lender makc~ available 10 BLlyer the right 10 glWllfllce an inlerest nue at or below the MuJrnwn InIere.,t Rate specified herein with the percentage fees a' or below the llI'IWnt spe<:ifaed beRlin. Buyer liva Seller the riahl. at: SeIJer', IIJk option and as pamitced by the mortgase lendu and applicable IaWI, to coolribute financially, without promiJe of teimbunanc:at. to the Bu)'cc and/or the nlOItJaIe lender to make the above terms available 10 Buyer. Wllhin _ DAYS (IOdlY5 if noc specified) of the CJI;eaItion ollhis Agreemenl. Buyer will make a compkted. wrilten rnortatge application for the tDDItpp tamlapeciflcd above to alapOflsible IOOl1pge lender. The Broker ror Buyrr, If' any, otbenrise the 8rokrr for Seller, is _&boriIed1o ~lewllll~orthe r'pD8eIorasslsllnglnthemortpp......proctSL I, MoI1pae ~ date 0 fa wrilten L'OInmitment i~ not received by Stller by the above date, Buyrr ..... SeDer.. to estmd the rummibnmt dale uaW Seller IermiMles this Aareemeal in wrttbll by DlItke to Buyrr. 2. Upon m:eipt of. mllCtpIe commitment. Buyer will promptly deliver a copy of the commilment to Seller. 3. Seller bu the opCioB to IenI1inIIe this Agrec:meIlt in wriling. after the mortgq:e commitmenl date if the mortgaSC conunitmeht: a. bftOlvaliduaci.llhedateofaeIlJement, OR b. I. oonditioncd lIpJIl the IaIe IIDd IdIJement or..., GIber prupert" OR c, Containa any other condition IlOI &peCified in Ihi. Agrument thai is not sati~lied and/or removed in writinl by the mortPlle lender within. --1- DAYS after the IJKII'tpae 4."OIMl1tment ale hi pangnph 6 IC) (I). 4. If chis Apement is tenninatcd aupecifled in~6(C)(l)or(3).orthelDDC'lgage Ioao is noI obtaiDCd foraetUement. aU depo5it mooies plidonaa:ountofplll'CbMepricc will beretumed to Buyer. BuyerwiJl be responsibJe foc an)' premWrm for mechanics' lien insuranceand/or title IWCb, Q" fee rw canceJJahon of same, if any; AND/OR an)' premiums for flood il\SW1\DCe, mine subIidence iDSUranCe an4Ior rill: insur- ance with atcadcd coverap. or cancellatioo fee. if any: ANOOR any appraisal rees and charJa pUt in Idvance 10 the rnor1pIe lender. If the IDlll1pge Imder requira repaiR to the Property, Buyer will. upon receipt, deliVt"l a copy of the rnortp&e lender', requiremerns to Seller. SdIa' will, within ~ DAYS of nx:eipt of the morlgq:e lender's requirements. notify Buyer whelhef' Seller will make the required repaiR at SeUer'. eycnsc. I. If SdlerdXJOlClll to make Ihe required repaiR, Buyer will accept the Property andagre.e to the REI..BASE let forthin~ H althis "- 2. If Seller dXlOICIDOI to make the required repaiR, or If SeIer r.u.1o rapond within IJle time 1PftD. Buyer wiU, within ~ DAYS, DOIify Seller in wrilina of BU)'Cl"lI choice tlltcnninute lhis ^grcclllCtlt OR llIake the requiral rc('llllirs al Buyer's u,pcnNI and with Selkr'K pennilSion, whk:h will not be ooraMMlllbly wilhheld. If Seller dc-nieli Buyer penn.i~~ion 10 make the required rep&in, Buy" may, within ~ DAYS 0( Se.lb'. dellial.letmina&e thill Agreement, in which ca&e III depl'lsil monies paid on account 0( pcwchue price will be returned prompIIy 10 Buyer and this Agreement wiU be VOID. .......... o ;Nor APPUCABLB Ill' ~~J"w"[poO' oY"S ..~'(X). C::U; ,muimum.lowIAlBuyer'.C05tSupennittedby the mortpae lender. Cl (e) (0) (8) FHAlVA,IF APPLICABLE (f) II ia eaprcsal.y apecd that notwilbslanding any other provisions 0( this COOlnlcl, Buyer will not be obligated to complete of the PIq)c:rty deacribed ne.an IX" to incw- any penalty by forfei~ of earnest money deposits or otherwise W1Iess livcn, in accor- dance with HUDIfHA IX" VA requirements, I written statement by the Federal Housinl Commi Adminiltmioo, or a Direc1 ~LeaderlettinafonlttheappraisedvalueofthePropertyofnotless (lhedoUaramounttobe inserted illbe sab price 81 stated in this Agreement). Buyer will have . ge and option of proceedinS with consummation of the coo- InICt witbout regard to Ihe IIlJIOUt\t of the appraised valuati appraised valuation is arrived III to determine the maximum moolage tile Oepanment of Housina: aod Urban Development . HUD does not warrant the value nor the condition oflhe Property. Buyer &bouJd IIIlisfy him&elflbcrse.lf thal the price tiall of the Proper1y are acceptable. WaraIrtI=. Sectioo 1010 18, U.S.C., Department of Housing and Urban Development and FedenII Housina AdministriWoo ~. provo vet for the flUl'POI'iC of. .. infllX'ncing in any w.y the action of such Dcpanmenl, maker;, passes, uUers or pub- liIhes knowinl the Arne to be false.. . &hall be fined under this tilk or imprisoned not more thlUl two years, or botJt." 101 Houalna.... Urban ~elopmeDI (HUD) NOTICE TO PURCHASERS: Buyrr's AdOlowled&emenl o BlIyer has ra:eived the HUD Notice "For Your Proteclion: Gel: a Home Inspeclioo" (lICe Notk'ell and InfORllltton 00 Proper1)' Condition loIpections). Buyer undecstands the importance of aeuill~ an independent hllme in~pccliun and twl~ thouahl aboul this befon: Kigning thi~ A...."'''''l. hl~~~ ~k (H) CIrIMkadoa We the: undenianed, Selkr(s) and BuYer1:s) JNU1.y to thi~ Ir.amactillll each cenily that me lenns of lhis contrw;t for purchase are InIe to the beaI of our knowledle and belief, and thad any other agreement en1ered into by any of thew panie1l in connection with lhil tOlDSlC- lion i.lUlchcd 10 this AgreemenL 7. 1NSPECJ10NS (HI') (A) SdIa' IIRCI to permit .inripectioos by authorized appraisers, rc:putabk cer1ifiers, insurer's representatives. ~urveyon, municiplll olneials and/or Buyer.. IDlY be required by the mortaage knder, if any, or in.~urillg IICncies. Seller funher agrees 10 permil any other inspectioM required by or proridcd ror in the: lcrmI of lhi, Agreement Buyer hbS the right 10 IltcnLI all ills~ions. (8) Buyer n:aeI'WI the riJhI to make a pre-actIIement walt-throuah ilMpcclioo of the Propmy. Buyer', riahllo make thi, inapection ia not waived b1 an)' oIhct provisioo of lhis Apemenl (C) SeLler will have beatinl and all utilities (including fuel(s)) on for the in~pcct.ions. (D) All inspcclOB, includ.ing borne inspectors, are authorized b)' Buyer to provide a copy of any repon~ 10 Broker lor Buyer. .. PROPIaTY INSPECI10N CONTINGENCY (1-02) <- Other poviijoaI ollhia Agreemenl may provide b inspections and/or certificatioo.~ thai are not waived or altered by Buyer's elcctioo here. o WAJVED. Buyer undeBtaods thai Buyer ha.~ the option to reque.~t in.~pectioll~ of the Prorcr1y (see Proper1y lnspectioo Notices and /&rirotuncnIaI Notices). BUYER WAlVES THIS OPTION and agrees tllthe RELEASE set forth in paragrQph 25 of this Agreement iii' EUCrn~ . (A) Wtthio ____ DAYS (15 days if not specified) of the e~eculion ()( this Aareement. Buyer, ill Buyer's <<pense, may choose to!.ave in~- tiona andIOI" cenifications completed by licensed or otherwi.'ie qualified pm'es~ionills (see Pn'flCny lospeclion NotiCCi and EuvirorutlClltal ~). This oontinaency does 001 apply to the followi"l exi!lling oolklitions lntdfur ileh\~: (0) (B) Should Buyere1ect 10 have I home inspectioo ollhe Property. a<l dellned in the Pertllsylv~niil Home h\.~pecliQ/\ Law, (see Information Regarding the Iiomc lnapeclion Law) such holl1e ilUplXlton shilll he perfornM.-od hy a fullmcmhcr illltlllld standing of a nati(lflul hume inspection .....'Wll,:i- .ion, or by a penon R1perviaed by a full member of a national ")fllC inspection Ulisociatiun. in accordance willi lhe ethical Ita?"" """ oIi/-:J-;ofmot.-;,"oo t1t 141 """1IlitWa: AlS-1:K Pate 1: ~ II SdIer IwUllls: ill II " " " .. .. .. " .. It 10 " " " 14 " " " " " 80 " " " .. as .. " II It .. " " " II .. .. " II .. ". '" ,,, '~ ,ot ,.. '05 '''' '" ", '" 111 "' 112 '" '14 '" ". '" ". n. l~O '" '" l~~ ". '10 116 '" '" 1~' no 131 '" '" '" '" '" 131 '" l~t '''' '" ,,, ". '" '15 '" , ~ . , .02) are ,.n or tbiI A......- il' dIecked: Seltkme:nl of OCher Property . p:ncy AcIdeDdum (pAR Form SSP) Sale a. Scukmcnl of Other Property Contingency with RiJht to Continue Marketing Addendum (PAR Form SSP.cM) o Seulement ofOlher Property Conlinpncy Addendum (PAR Form SOP) o Tenant-Occupicd Property Addendum (PAR form TOP) o o 0- ..,....... SeDer 1ICIuIlndedp.ncdviD&. copy olllUl Ap'eaoalt al the time of upln&- '" _)?{"l~_'. ", ~ L.. ~ ...,..).. 1- t' I 1 'JU -, III BVYEIl'S MAD.JNG ADDRESS; 7S &.1... J IIJ,<." ::: .UYIlIl"O~~U!F. . tp" , 4 ~ ~ - - 7 -, ~7:;: 621 ~~ ""'-VoJ> ~~ } BUYER (2 ~ ............;...:..v. DATE' ~ ""'t-' / t21 IU SSI r.-/ 1 . ~~ -'Oil. " '" IQ In U4 Wll'NESS BUYER DATE . 124 ... SSI '" UI RI 127 WITNESS BUYER DAn i27 m ~ p' m 129 ~ .-~_._~"(-) ~ .. -" ~. 131 [J)MUIr......... tbe CaaIumer NoIke ulldopted b1 the Staae ... &Ute COIIIIIliMIon at 49 PL Code '35.3J6. m IUI D" ...sea-... naiftd ........ of SeDer" estiJMled du8ina.... belo(e.... thiI AJl"t'tIDft1L 636 U1 Q' SIller..,......... ....t. tile ~ aad ~~ ~for1b In thIlIAJIftIMIIL 631 : SILLU.'SMAlUNGADDR.ESS: tj.J,2 (l. ".J(r; 11 ,-tr,11( ,'-fi.l) ::: .. ~ I/'l (. ',.1 '~,J ,.: ~,"'(U [/1..:' _, II;} lI4D 14' SELLEII"OCONTACTNUMBER(Sh . " -/ ),- 1'/- j );'J '1.'(. " -;'i )-' 7 ,,7 ( i, >1.., ~ :: WITNESS ~ j,'/i1l/<"11 --/--!"A r \ SELLER DATE 7/; I If;...' ::~ 144 . / SSI" / '- . 1 I 'fiH ... 545 ... WITNESS SELLER DATE &41 141 SSI &41 ... 14. "I WITNESS SELLER DATE 64t iii SSI IfIt ~ I~l IN B~'CeI1iIIca"'(cbedlalltbal.-eappUcabkJ: > , 112 III [J""""" ......... ......a-I ~~ --,ulred If PnpertJ ... bWk bd'ore In': Tho UDdenIpod I...iccoieeI involved in &53 114 "'. "" 1 "'~OD~oC thcir,brOken.cerlIydwtlhl;ir~ls':lJuelOthebestottheirknowlodp:andbelid. ~ 1M:" 'IW.ll"'.... "'_" .'~' vcdinthil~.veinfofmedSe"ofSeller"'obJiplionlunderTbcRcWemialI.ad-Baed' B~ .. PainI Huard RcductioaAct. 42 U.S.C.I48S2(d), and .:_are ofthcir responsibility 10 ensure compliance. B54 151 &51 IliI 0 Ileprdia& FIlA Mortpga: The undenigned Ucensees involved in ili! l1'aIlSaCtion, on behalr or themselves and their broken. j:Cftiry lhat 6S1 1St &hctamloflhilcontt8Ct rocpurchasc are Inle to tbc bcst of their knowledge and belid, and tbatal1y Olhcr ~nlentcrcd u\loby any of 6~ ... &hcsc putica ill cannec:tioo with this transaction illn.:hed 10 this Agccmcnl. &60 :: ~~ MecUalioa: The undersigned 0 Broker rOf Seller ~:r rOf Buyer agree to submit to mediation in accordance with :~ au ~21ofthisAI;'=tneIlt. 663 ~ ~ HI UOI'ER FOR SELLER (CompuJ N_J 665 1M ACCEPTED BY 6M Ml Hl .. III UODll FOR B 511 ... ACCBP'I'ED BY 61t ~ 610 111 AJS..1KPaaclor8 611 BUYER'S COPY -", . -r.JI~ Statement u.s. 0._01_ ,"-..;,.,..,,;"'-" ,- and Urbon Oo>oIopme.' T ..j OMS No. 2502-0215 B. T_ of Loan 1. 0 FHA 2. 0 FmHA 3. 1&1 Conv. Unins File Number Loan Number Mortgage Insurance Cese Number OVA 0 ~U9-821/1CunJr.l 0000007864 4. 5. Conv. Ins. C. NOTE: this form Is furnished to give you a statement of actual seWement costs. Amounts paid to and by the settlement agent are shown. Items marked "p.o.c" were paid outside of closing; they are shown here for informational purposes and are not included in the totals. ~~DFU;S$;O"'BO,RRqwelWolt.A.KlInk" .. '.. '.' "":,;::.:.;:~~;::.n_~':":J}")'::.:i':';~;~~~:~:::"0n~~":;:: ;,.. ,'. ';'.:".' :" .. '".:" . ;.; '. ":t:': :,:: "1I1Ma Lan., BoUJng $pI1ng$, PA 17007 E. NAME AND ADDRESS OF SELLER: Don-'d E. PIp"" Jr~ Executor ,p. F.i!!e'f!\N~ADDRESS OF LENDE 811 Home Bank, N.A. . . . - - ~;-~:~,,d.r~~::~:~'!:::- :f!;<~'::.. ' ': :'~,~:r:; ': :i'- :,::.-::':,:i:: ::~:i~(; rt .".. &teIJe DIIve, Ste 101, P.O. Box.44M, Lancaster, PA 1780f '4$4 G. PROPERTY 117 WI/low Drlve LOCATION: Shlpp".$butg, PA 17241 t1,,8ElJ1.EMENT AGENT: ~~B.dc&s.:heIw - . ,Ie:',".,'!'-'.'--" -'--I " -- _ -_-_- _ .- ";1PWf~OF~ETTLEMENT 7 WNtSclIlfh sc.-. Can/ale, PA 17013 ""''I1N:' 'u. " ~... .. ..... .., <Z$o17D1$1':'" ..... . . .'. I. SETTLEMENT DATE; 0813012002 RESCISSION DATE: J. SUMMARY OF "ORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION :101L GROSS.AMOUNT.DUE FROM BORROWER: . <400. GROSS AMOUNT DUE TO SELLER: . . . .~~ AAft u. M .w.i~'l"~""Price';~i:"'i_ ,:.; ";i"):,~::!:b:,;;;.!~;:i~~~,!;;)":;-,~,,.i --:;,:;':, ,.;': &92 000.00 102.__ 402.__ ~"J~~l\I,~lI"lO,"",-,.. :..~ - . . ..' 403: ; . .' , '.. - !~t;;.;'~,~"'C':'" '~......... . . ._, ...::'.......... . $2,92g.95 . .. 104. 404. I 10'1."',:: ~Ct~,,~;,,:;)':: ~ . . . 405. ADJUSTMENTS FOR ITEMS PAID BY SELLER IN ADVANCE: ADJUSTMENTS FOR ITEMS PAID BY SELLER IN ADVANCE: '. toi. ~..... . " . '10'" . 401. CIIy/Iown T_ .10 107.CounIYT_ 08/30/2002 10 01/01/2003 $96.25 407. County T_ 08/30/2002 10 01/01/2003 $96.25 ':l.,.IoI11.Ttflttntl' 08/30/2002. 10' 07/01/2003 $740.52 400._." 08/30/2002 10'; 07/01/2003 $740.52 lot. 4OlI. '110. .'.... .' . 410. . 111. 411. : 1.12;..:" ....:,.. . . ;;";"" . " . . 412. . .. . $95,766.72 $92,836.77 120. GROSS AMOUNT DUE FROM BORROWER: 420. GROSS AMOUNT DUE TO SELLER: 200,AMOUNTS PAID. BY.ORlN BEHALF.OF BORROWER: . 500. REDUCTIONS IN AMOUNT DUe.TO SELLER: 20'. Dopool\<<_....... $2,000.00 501. EJCCUI depoait (He inltructionl) 202.'~""""0I_IoIo(.r~,"':. '. ..:...<.;...,.,.. .' '.. I $73,600.00 502. _"choIvOalo_-'400 .: . $7,890.18 203.ExlotIngIolo(.)........bjoctlo 503. Existing ktan(l} taken subject to 204:'"", ;:,~,.';~'!"::~". ~ :',i; ,........... .. ,. . .. 504:P~oItIrot Ioon~:.' .. . 205. 50S. Payoff of aecond rnortgag. ~n _..<S4i.l.Z-:....".c. ;.>:c:;:< ;~::~.;~':::~f~;i\ :; , .::: ..'. I . $3,900.00 SOB. Sell.... 'u..uC' .'. ,'. ....'.. .. . . $3,900.00 201. 507. 2R::::::_~:::j:~':;-1't::;??]!: i;";.,". -';!'J',[,,"" '.:".~ ,-' . . :. 508:' .. .... .. ... . . 201. 509. ADJUSTMENTS FOR ITEMS UNPAID BY SELLER: ADJUSTMENTS FOR ITEMS UNPAID BY SELLER: 210.Clty__ 10 510. Cityltown wn 10 .'21M:o."lW._ .......,.. . ., '.' ~ . . . . . 511. County ..... ..' 10. . ~ 10 512. Auuamentl 10 :".:21 ..... ,.;.. " .. . . .. 513;, . . . ..... '.. 214. . 514. ~ ~';,~21..~"~" ,"':i':;, l:f!'~\--"! " .::1""1 ' : ,_:;".,~f:'" .. ..... 'i ... ..." .. H....... ., . . 515.. . .'- .".. 211. 518. :;-~:i:a~,!i~f~:'\t,-r.:A" '\' ',,}' :~.",: ~ '.' , '. . ~ . . '517.' 211. 511. ,.... l' ,',-,",., .-.-,,~,". "',"." .,';11.. . . .' "220. 1'OTAL' PAID 1lY1FOR'" " . 520. TOTAL REDUCTIONS .. .. 'BORROWER: .'. . '79,'00.00 IN AMOUNT DUE TO SELLER: $11,790.18 3(lll:)(l,qtI~~'t~Q.BORROWER:" '. .-,,, ........ 600. CASH AT SETTLEMENT.TOIFROMSELLER .. . 301. Groa amount due from borrower (line 120) $95,766.72 601. Gross amount due to seller (line 420) $92,836.77 i :.. _ij(~by/for bcirroWer (llile'220) .- $79,500.00 602. Leas feductions In alllL d. ..U.r (line 520):' . . " ... '11,790.18 303. CASH ( 00 FROM ) ( 0 TO) BORROWER: $16,266.72 603. CASH ( 0 FROM) ( 00 TO) SELLER: $81,046.59 .' HUD-1 (3-86) RESPA, HB 4305.2 - ....,,- , PAGE 1 '3/8Il1 OMS No. 2 SETTLEMENT CHARGES . TOTAL SALES/BROKER'S COMMISSION BASED ON PRICE $92,000.00 o 6 ". $5,520.00 PAID FROM BORROWER'S FUNDS AT SETTLEMENT PAID FROM SELLER'S FUNDS AT SETTLEMENT DIVISION OF COMMISSION (LINE 700) AS FOLLOWS: 7.,.U,735.00 10 BIt ~y 702. $2,785.00 kI S.il.bamer Re.1 .Esute .703..CornmIukln _. MtIIImInI 704. $5,520.00 800. ITEM PAYABLE IN ONNECTI N WI H LOAN: 101.~origInolloo_ ::0;250 ,,:oo:_!c....Il...._, !l.A. 802, l.OM ~ ,. ~._..."" . SI:&a.l st~ 804. Crd raport to: Crlldco ----... 808. Mortoege INuw1ce application ,.. 10 107.__ 808. A.dIlin T.. to AlII Hc:wae Ban.t lOt. 1'lIlolC. LolUl l'r tor'_toAII H.... _ ($21. 00 I'OC) 810. Flood Cert ,... to Fir.t ....r1can ($29.00 POC) 811. fI.... live ..... to I'1r.tAlaaz'tcat1 900. ITEMS RE UIRED B N ROBE PAl IN ADVANCE: 10':__ 0'130/2002 10' 08/JU2002 802. MotIpge InelnncI ptIII'l'Ikn for rnoa. 10 803.Hazool""""""'..........iW: . ,..... 904. FIocId inII.nnce premUn for yra. ta .... 1000. RESERVES DE $184.00 $275.00 P.D.C.) $20.00 P.D.C.) ($25.00) ($0.92) $290.00 $0.20 ($0.50) $96.00 o $13.29,.., $26.58 1001. -HuM:S InM.rwlct '002. _......... '003. _ 1004. County praper1)' taxa 100$;~~",1_1II 1001. Flood ~ lOO1.ScbooJ.. tan_ SITED WITH LENDER: 3.00_0 -0 _0 7.00_0 "- -- 3;00""""'" $15.33......... ......... ........... $23.29......... ........... ........... $73.67........... . ........... $45.99 $1 3.03 .- $221.01 ,008. __ 1D08. re at:e:,Accountin Escrow .Ad' ustment 11 00. ITLE HARGE : ($93.19) 1101. SattIImInICN' '-10 1102.AtIIIrIc:IOftilllMMbIQ' . 1103.TItIe~to 1.1ot _ iRM'tnce-bindlr-ICt. 1105.00r:unenI~1o 1108. ~ro.oo C...ll 1107.AIiclrM(...to SaJ.J.y J. Winder, E.squire incIudH abcM N&.mDers: 11011.TitII~1O O.Br1en, Baric' Scherer __Ilomo_ 1101-1105 1107-1111 1109.Under'.~ 11.0. o.rw. .' $810. 75 1111. J:ncItI 1100-$50 1300-$50 1900-$50 .112. .fJuI..-dCl.,. lou; 1113. O'Brien, Baric , Sa1Mr~ (overnight ~..) 1200. G RNMEN R ROING AND TRANSFER CHARGES: '201. _ ..... . '128.50 : $54.50 , 1202.C__, .... $920.00:_ ,__~.' lloOd $920.00,_ ,.... .~ 1300. 01 I NAL S 114.00 $73,600.00 $92,000.00 ---- -.rmm _ $35.00 $10.00 ,- 113.00 $920.00 $920.00 MENT HARGES: 1301.. . .0:,.",:,,:,: 1:'.2.__10 II (8.... I -$250/I'..t-$35) ,.....CI'_: (1l'-J._.4tlDl234) ''''. oil SlU (~u..l "ater actl29002800) '300.'('02 aC/loOlb...U &t di.ac) 1300. Ed Jlart!.n (alIad r-.ovlll) '3117.. X6t:1lylt&UU(J.......eri'i.c.} $285.00 PO.C. $107.10 $104.04 $884.04 $100.00 $255.00 '1400. roT AL SE'ITLeMEHT CHARGES ,- 0aIIMf ClIlIIIY~'" --",921.15 $7,890.18 C/. ?.I'IA"lSoloror D.,.:~ llaIo: 8V4dJ. - Date: SeIer or Agenl: llaIo: The HU001 5etIIIment SWIemInt which I hlv. pNpantd I. . true and accurate account of tN. tranllclion. _1IlII_l ...., - 'llaIo'~~ David A. Baric WARNING: It II. crimi to knowingly mak.,.... Itlltemenlllo the United Swta on thit. or any other ,imilar form. PenaItiu upon conviction eM lnducMa fine and irnprtIon. ment Fordelaill...: Tille 1. U.S. Code Section 1001 and Section 1010. .,~.". . COMMONWEALTH Of PENNSYl VANJA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER PIPER DONALD E SR 21 02 0449 I"dude the proceeds 01 liliga1ion and the date the proceeds..... received by the _Ie. AU pntpelly joinIly_ wiIh the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. NET PROCEEDS OF SALE OF PERSONAL PROPERTY SOLD 8/17/02 5.840.25 2. PERSONAL PROPERTY SPECIFICALLY BEQUEATHED. VALUED PER ATTACHED APPRAISAL AND TAKEN IN KIND BY BENEFICIARIES 9,541.00 3. MELLON BANK (NOW CITIZENS BANK), CHECKING ACCOUNT 414-000-5150 DATE OF SEATH BALANCE PER ATTACHED BANK STATEMENT 8,358.25 TOTAL (Also enler 00 line 5, Recapilulation) $ (ff more space is needed, insert additional sheets of the same sizel 23739.50 8 Mellon Bank PERSONAL BANKING STATEMENT DONALD E PIPER SR DR MARJORIE A PIPER 00'41 414-000-5150 PAGE 2 OF 4 BASIC CHECKING ACCOUNT 414-000-5150 (continued) . DATE POSTED bESl:ATPTltIN _17.10Z CHEat, 3Ml _laIOZ lI'W'1I IELLlIN A11I NITHO_L 1007Z96 511IPPENSlIUllIl lEST 511IPPENSIIUIlCl PA ClEat , _ . lI4I'1'/OZ IIISC AUT'lIIlATEO CREO IllIL TREAS :S0:S HUOJ6ZlINISC PAY ZS006..:stl61500 CHEat, _ CItECIt , 3147 . ClEat , 3M:S . ClEat , 35'i4 . _Zz/oZ _23/0Z _ZIiIOZ _Z9IOZ lI'tI30/0Z 05l01/0Z 05l02l0Z O5/07.l0Z O!il'0&f02 OSIOIIOZ DEPOSITS ANI OTllER ADDYnONS CHECKS ANI cmtER NITIIftD.....LS Z'.32 ZOO.OO 51.:S0 34. 911 1'.08 _.40 59.00 ZOO.OO 100.00 I , 29.00 35.39 111.14 140.00 ZOO. 00 ....64 .00. OAlLV BAl&NE:E 7.754.78 7.5O:s.... '.Z24.18 8.88D.78 8.680.78 8.580.78 8.551.78 8.516.39 8.358.25 8.158.25 8.10'.61 8.109.61 8.10'.61 II1B'iI 3.53't HH 3536 3537 1.774.76 _Z2 IELLlIN ATH NITHO_L 1007747 SHIPPENSIIUIlCl lEST SHIPP_ PA _Z4 IELLlIN Ant NITH_L 8007t30 SHIPPEIISlIlIIll lEST 5IIIPP_ PA _27 IlASTERIDEY POS PURCIfA5E __I TEl'JICOINC.100ZZZ364D VIRllINIA 8CH VA _29 IIASTE_V POS PUIlCII'ISE '907325 AIIlICO OIL 0771.1911 ItARSHALL VA . _29 IlASTERIDEY POS PURCIfA5E 84600Z0 CITllllI7355AY-A-_ VI_A BEACYA CHECK.' 354Z . OSIOl IELLlIN Ant NITHD_L 1008551 SHIPP_ lEST 5IIIPP_ PA 05/06 IIASTE_V POS PUIlCIIUE '759374 lEIS ~ '115 SIlO 5IIIPP_ PA SERVICE CH.IRCE ~ CLOSINIl 8ALANCE . V_ ~L V SERVICE CIIAIlllE FOR YlIIIR PJCKAQE ACCOlIolT lIAS BEEN IlAIYEO BECAUSE VIII lET THE DEPOSIT RELAnmeHIP ""'ICE REliIUIREIENT. 20.07 OOOOOZS00761631 13:s.6' 001lllD2Z0066780. 50.18 OOOOOZZOO025544 Z6.OO 00000_67718 11.'5 00000ZZOO"7&57 3544 "63.39 00000Z2_'6643 3M5 Z'.32 oooOOZZ006'6546 _ 140.00 00000.900288D74 3147 5'.00 001lllD2HDSZ87.2 5l.:so _2200247808 34.911 1llID00.9OQ101808 1'.08 000002Z00787'" PLEASE USE THE ACCOlIolT RECONCILEIENT FIIRIt LOCATED ON THE LAST PAIlE OF THIS STATElENT TO BALANCE YlIIIR ACCOlIolT. t\PPRAISAL OF PERSONAL PROPERTY OF THE ESTATE OF DONALD E. PJPER SR.. DF..cEASED. 117 WILLOW DRIVE. SHIPPENSBURG. PA ON MAY 8. ~ Beq.....ed items in Will: Oak secretary desk Oak stand with claw feet 3-Piece contempol'lllY living room suit Modern oak drop leaf coffee table Hand-made oak grandfather's clock ,Ansonia key-wind clock (not complete) Piper? cane seat & back rocker Modern wash stand with old wash set Copper wash boiler Modern oak roll top desk Oak wall telephone Plant stand Round oak table 4 Oak Windsor-style chairs @$20.00 Oak Hoosier-style kitchen cabinet Nesco electric roaster Wooden writing table with drawer J-ligh stllncji"g Chair j Brass double bed Oak dresser with mirror . 2 Modern night stands @$ 30.00 Hand-crafted wooden jewelry box Assorted kitchen dishes in cabinets Miscellaneous costume jewelry Hand-made wooden work bench 3-Piece oak bedroom suit including double bed, dresser, & chest of drawers........................................................................ Glass-front tool box 2 Camel-back trunks @$ 80.00 Flat"top trunk Lincoln-type rocker . 35-in~ RCA portable color television 2 VCR's @$ 35.00 8. Track player Cassette PIaF Turntable ....i'CP disc player , . A~Iii1er/receiver Assorted VHS tapes (movies) r~l table .ipiD'baI1 machine , '-'," '1' ~. .- . t / I J I / / < $ 140.00 $ 45.00 $ 175.00 $ 40.00 $ 90.00 $ 15.00 $ 35.00 $ ,55.00 $ 30.00 $ 70.00 $ 110.00 $ 25.00 $ 170.00 $ 80.00 $ 190.00 $ 20.00 $ 70.00 $ 30.00 . .$ 70.00 $ 140.00 $ 60.00 $ 25.00 $ 30.00 $ 30.00 $ 15.00 $ 650.00 $ 20.00 $ 160.00 $ 60.00 $ 55.00 $ 140.00 $ 70.00 $ 5.00 $ 10.00 $ 5.00 $ 20.00 $ 15.00 $ 25.00 $ 90.00 $ 140.00 i- t-' ' . .' '. . ~ -2- Assorted tools (lot) Modem set of rose pattern dishes Bible Common picture frame of mother (sentimental) Common popcom afghan Modem books (novels, etc.) Jugs with coins Other ite....: Memorex portable color television Sharp VCR Entertainment center Common sectional sofa Orange recliner (shows wear) Oak stand 9 Mantel/shelf clocks @$45.oo 3 Common wind-up alarm clocks @$ 5.00 Oak mission-style wall clock Jerome weight-driven shelf clock Modem Centurion steeple clock Bracket kerosene lamp Oak pressed-back youth chair Common upholstered chair TreAAmHl . H&R M622 .22 cal. handgun Serial #AC 12862 Miscellaneous table lamps (lot) Maytag automatic washer (older model) Maytag dIyer (older model) Common coffee table Modern Regulator wall clock (Korea) . Bracket kerosene light with green shade 3-candy dispenser on pedestal Miscellaneous lawn & garden tools Craftsman push power mower Kerosene lamp with milk glass shade 2 Common solid bottom dining room chairs @$ 8.00 Washboard Smoking stand Bracket kerosene lamp (electrified) '. Common barn lantem Common baskets Common floor light 2 Common crocks @$ 3.00 Castor set (not complete) 3 Padded oak bar stools @$ 10.00 $ 40.00 $ 20.00 $ 5.00 $ no value $ 5.00 $ 15.00 $ 25.00 $ 40.00 $ 35.00 $ 30.00 $ 40.00 $ 20.00 $ 30.00 $ 405.00 $ 15.00 $ 45.00 $ l20.00 $ 35.00 $ 30.00 $ 35.00 '.$ 5.00 $ 55.00 $ 60.00 $ 30.00 $ 45.00 $ 20.00 $ 5.00 $ 25.00 $ 65.00 $ 20.00 $ 20.00 $ 35.00 $ 30.00 $ 16.00 $ 15.00 $ 15.00 $ 25.00 $ 8.00 $ 15.00 $ 5.00 $ 6.00 $ 20.00 $ 30.00 , '1" < .~ " - 3- Kerosene lamp with cast base Small counter scales with tray Pillar-type shelf clock Craft Shop banjo-type clock Wall coffee grinder Bracket light with milk glass base & shade 18 Assorted miniature kerosene lamps@$ 8.00 2 Brass hand bells @$ 20.00 Quasar microwave (older model) Microwave stand 4 Cast iron skillets @$ 8.00 Glass butter churn 2 CabinetjlllS@$ 5.00 Miscellaneous pressed glass Assorted tinware 2 Granite bowls @$ 10.00 Small kitchen appliances (lot) Hanging kerosene lamp Welch weight-driven shelf clock Modern 31-day wall clock Walnut-finish shelf clock 2 Common crocks @$ 5.00 Common jug . Cast iron pot with 3-foot Wooden block plane Agate coffee pot Sad & flat irons (lot) 2 Common brass/copper spittoons @$ 15.00 45 cal. muzzleloading handgun (Spain) Small glass-front entertainment center Common 5-drawer chest of drawers Oak 4-drawer cabinet with feet Stellar wall clock Brass-color double bed 4 Modern 2-drawer oak file cabinets @$ 25.00 Modern McCoy wash bowl & pitcher Wooden 5-drawer chest of drawers 6 Common kerosene lamps @$ 30.00 < New Home console sewing machine Wooden blanket chest (needs refinished) Oval bow-glass picture frame (Statue of Liberty) Common wall mirror Cuckoo clock Modern quilt rack $ 25.00 $ 30.00 $ 40.00 $ 90.00 $ 40.00 $ 55.00 $ 144.00 $ 40.00 $ 30.00 $ 20.00 $ 32.00 $ 40.00 $ 10.00 $ 15.00 $ 15.00 $ 20.00 $ 35.00 $ .45.00 $ 120.00 $ 20.00 $ 65.00 .$ 10.00 $ 15.00 $ 25.00 $ 20.00 $ 35.00 $ 40.00 $ 30.00 $ 35.00 $ 15.00 $ 20.00 $ 55.00 $ 40.00 $ 90.00 $ 100.00 $ 45.00 $ 40.00 $ 180.00 $ 65.00 $ 40.00 $ 60.00 $ 20.00 $ 30.00 $ 25.00 ;;. .. \ ~~ . ~ - 4- 2.Drawer stand with turned legs $ 120.00 Modem ceramic wash bowl & pitcher $ 15.00 Modem clothes tree $ 15.00 Rayo kerosene lamp $ 35.00 2 PedestaI-type kerosene lamps @$ 35.00 $ 70.00 Wooden jewelry box $ 20.00 Cedarjewelrybox $ 15.00 1989 Dodge Grand Caravan LE with V -6 engine, cruise, air, power windows & locks, & 39,000 miles.................................. $ 1,800.00 1975 Winnebago Brave camper $ 700.00 TOTAL: $ 9,541.00 APPRAI~ -. ./~ Dennis L. Gotshall, AuctioneerlProp. Dan Hershey Auctioneering Service P A Lie. #AU.oo2306-L 3 Brown Road Shippensburg, P A 17257 < I ,..~. ""''''''''I''l'n~ COMMONWEALfH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF PIPER DONALD E SR FILE NUMBER 21 02 0449 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1- FOGELSANGER-BRICKER FUNERAL HOME, FUNERAL ACCOUNT 7,054,00 B. ADMINISTRATIVE COSTS: 1- Personal Representative's Commissions Name of Personal Represenfatiye (s) DONALD E. PIPER, JR. 2,161.78 Sodal SeaIrity Number(s) I EIN Number of Personal Representa1ive(s) Street Address City Slate Zip Yea~s) Commission Pa~: 2 Attomey Fees SALLY J, WINDER 5,332,22 3. Family Exemption: IIf decedents address is nollhe same as daimanfs, attach explanation) Claimant Street Address City Stale Zip Relationship of Claimant II> Deoedent 4. ProbateFees REGISTER OF WILLS, LETTERS, FILING, SHORT CERTIFICATES 279.00 5. Acx:ountanfs Fees 6. Tax Retum Prepare~s Fees 7. SAILHAMER REAL ESTATE, COMMISSION ON SALE OF PROPERTY 5,520,00 8. RECORDER OF DEEDS, TRANSFER TAX 920,00 9. CFJMA, FINAL SEWER BILL 107.10 10. BOROUGH OF SHIPPENSBURG, FINAL WATER BILL 104,04 11. BARRY NEGLEY, TAX COLLECTOR, 2002 SCHOOL TAXES 884.04 12, ED MARTIN, MOVE ENCROACHING SHED 100,00 13. KATHY KELLER, LAWN MAINTENANCE 255.00 14, SELLER'S PORTION OF REPAIRS TO HOUSE PER CONTRACT 3,900,00 15. BOROUGH OF SHIPPENSBURG, ADDITIONAL WATER BILL 54.40 16, DAN HERSHEY AUCTIONEERING SVC., APPRAISAL FEE 90,00 TOTAL (Also enter on line 9, Recapitulation) $ 26761,58 (tt more space is needed, insert additional sheets of the same size) " ".~. REV."'''''i'."~ COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS ESTATE OF PIPER DONALD E SR FILE NUMBER 21 02 0449 Include unreimbursed medical expen.... ITEM NUMBER DESCRIPTION AMOUNT 2,346.61 1. LOWE'S HOME IMPROVEMENT, ACCT 816-0227-618249-6 BALANCE DUE ON ACCOUNT 2. SPRINT, TELEPHONE ACCOUNT 249.36 3. PENELEC, ELECTRIC BILL 141.53 4. CHAMBERSBURG HOSPITAL, BALANCE ON ACCOUNT 99.04 5. PULMONARY ASSOCIATES, OUTSTANDING BALANCE 57.40 6. CUMBERLAND VALLEY EMS, AMBULANCE SERVICE 768.00 7. CHAMBERSBURG IMAGING ASSOCIATES, PC, BALANCE ON ACCOUNT 152.78 8. CFJMA, SEWER ACCOUNT 81.90 TOTAL (Also ,,(",<Xl line 10, Recapitulati<Xl) S (~mote space is needed, insert adOrtional sheets of the same size) 3 896.62 , .ev;.15"ex..-I,* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER .....c: !::R 21 0' n..uo RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Wit Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS Pndude ou1ri;jht spousal distributions, and transfefs under See. 9116 (a) (1.2)1 1. DONALD E. PIPER, JR SON SPECIFIC BEQUESTS 432 PRINCESS ANNE ROAD ONE THIRD NET VIRGINIA BEACH, VA 23457 2. CHRISTINE A. ROTZ DAUGHTER SPECIFIC BEQUESTS 609 SOUTH MOUNTAIN ESTATES RD ONE THIRD NET SHIPPENSBURG, PA 17257 3. JAMIE FORSTER DAUGHTER SPECIFIC BEQUESTS 3671 EDENBERRY COURT ONE THIRD NET VIRGINIA BEACH, VA 23457 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-l500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-I500 COVER SHEET $ (ff more space is needed, insert additional sheets of \he same size) STATUS REPORT UNDER RULE 6.12 Name of Decedent: ~~ [' f ~ J S;r: /v v/ lie Date of Death: Will No.: ;)/) () :2 -- 0 J 111 Admin. No.: Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes Rr No 0 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No ~ b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the person~~sentative state an account informally to the parties ininterest?Yes~ No 0 - c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk ofthe. Orphans' Court and may be attached to this report. Date:~/6+ . J:;J,( ( JIi1~ Slgnatur~ Name 54//1 J W'~ qqN (fId//1 ~~ ~ Address J ~Mn~it.. ~ flJ- Teleph~ :'" r:: \1'1 0- - \ ~ 'Z , ~ :x: s ! - - ~.), ..~ .)"~ Capacity: 0 Personal Representative ~ Counsel for personal representative /?-6/- /j/ \. BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX SALLY J WINDER 701 EKING ST SHIPPENSBURG DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNty ACN 12-02-2002 PIPER SR 04-30-2002 21 02-0449 CUMBERLAND 101 - REV-1541 EX AFP <01-02) DONALD E PA 17257 Allount Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REY=iS'4-j-E3f-AFP--loY:02Y-NoYicE--OF-YNHEifiTANCE-YA'irjrpPRAisEi.fiNT~--ALl-oWAiiCE-(iR------------ ----- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF PIPER SR DONALD E FILE NO. 21 02-0449 ACN 101 DATE 12-02-2002 TAX RETURN WAS: [X) ACCEPTED AS FILED ) CHANGED NOTE: I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will re~lect ~igures that include the total o~ ALL returns assessed to date. ASSESSMENT OF TAX: 15. Allount of Line 14 at Spousal rate (15) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. Allount of Line 14 at Sibling rate (17) 18. Allount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS: .00 X 00 = .00 85,081. 30 X 045 = 3,828.66 .00 X 12 = .00 .00 X 15 = .00 (19)= 3,828.66 RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate [Schedule A) 2. Stocks and Bonds [Schedule B) 3. Closely Held Stock/Partnership Interest [Schedule C) 4. Mortgages/Notes Receivable [Schedule D) S. Cash/Bank Deposits/Misc. Personal Property [Schedule E) 6. Jointly Owned Property [Schedule F) 7. Transfers [Schedule G) 8. Total Assets (1) (2) (3) (4) (5) (6) (7) 92,000.00 .00 .00 .00 23.739.50 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Misc. Expenses [Schedule H) 10. Debts/Mortgage Liabilities/Liens [Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequests; Non-elected 9113 Trusts [Schedule J) 14. Net Value of Estate Subject to Tax (9) (10) 26,761.58 3.896.62 (11) (12) (13) (14) NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 115,739.50 30.658 20 85,081. 30 .00 85,081.30 n...~... l+J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID [-) 11-06-2002 CDOO1813 .00 3,828.66 TOTAL TAX CREDIT 3,828.66 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 . IF PAID AFTER DATE INDICATED. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. [ IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" [CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)