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Home My WebLink About01-26-0915056D712D REV-1500 EX (06-05) OFFIt:IAL USE ONLY PA Department of Revenue ounty a ear i e um er Bureau of Individual Taxes INHERITANCE TAX RETURN Po Box.2aosol >~ RESIDENT DECEDENT 2 1 0 8 0 1 0 3 6 Harrisburg, PA 17128-0601 Social Security Number Date of Death Date of Birth 09 19 2008 O1 15 1916 Decedent's Last Name Suffix Decedent's First Narcle MI SIPE CHARLOTTE E (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ® 1. Original Return ^ 2. Supplemental Return ^ 3, Remainder Return (date of death prior to 12-13-82) 4. Limited Estate 4a. Future Interest Compromise ~ i. Federal Estate Tax Return Required ^ ^ (date of death after 12-12-82) (~ 6 Decedent Died Testate y, Decedent Maintained a Living Trust B. Total Number of Safe Deposit Boxes L_J (Attach Copy of Will) ^ (Attach Copy of Trust) ^ 9. Litigation Proceeds Received 1 p. Spousal Poverty Credit (date of death ~ 11, Election to tax under Sec. 9113(A) ^ between 12-31-91 and 1-1-95) (Attach Sch. O) Name Daytime Telephone Number NICHOLAS T. GARD ESQ. 717 656 6717 r~ Firm Name (If Applicable) SMOKER GARD ASSOCIATES LLP First line of address 912 WEST MAIN STREET, SUITE 402 Second line of address City or Post Office NEW HOLLAND State ZIP Code PA 17557 REGISTER,OF{VI~ILLS USE ONLY-- =,~ t ... t - - a;:r1 _, _r ; '.~ _.. ,_it _ . ^~ ~.~ _~ Di'~'E FILED N ` ---, i ::_' 1 ._ . ~i Correspondent's a-mail address: Under penalties of perjury, I declare that I have ine is return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, corcect and complete. Declaration r r her than the personal representative Is based on all information of which preparer has any knowledge. ~ / Wilson L. Sipe Jr. ~~~ ~6,0~ 920 Sprin Garden Street, Elizabethtown, PA 17022 SIGNATURE EP THER T N REPRESENTATIVE DA/TE /~~~ Nicholas T. Gard Esq. /~'' f 6 " a~ 912 West Main Street, Suite 402, New Holland, PA 17557 Side 20 150560712D ~_ ~) 1505607220 REV-1500 EX Decedent's Social Security Number Decedent's Name: C h 8 C I O t t e E. Sipe RECAPITULATION 1 115,500.00 1. Real Estate (Schedule A) ........................................................................................ .. . 2. Stocks and Bonds (Schedule B) ............................................................................. .. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)........ .. 3. 4. Mortgages & Notes Receivable (Schedule D) ........................................................ .. 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) .............. .. 5. 4 1 8 2 2 8 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested ........... .. 6. 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested ........... .. 7. g. Total Gross Assets (total Lines 1-7) ..................................................................... --- .. g. 1 1 9 6 8 2 2 8 9. Funeral Expenses & Administrative Costs (Schedule H) ...................................... ... 9. 2 0 6 4 1 5 1 10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I) ............................. ... 10. 3 7 1 2 7 11. Total Deductions (total Lines 9& 10) ................................................................... ... 11. 2 1 0 1 2 7 8 12. Net Value of Estate (Line 8 minus Line 11) .......................................................... ... 12. 9 8 6 6 9 5 0 13 Charitable and Governmental Bequests/Sec 9113 Trusts for which . an election to tax has not been made (Schedule J) .............................................. ... 13. 2 0 0 0 0 0 14. Net Value Subject to Tax (Line 12 minus Line 13) ..........................:................... ... 14. 9 6 6 6 9 5 0 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 15 (a)(1.2) X .00 0 0 0 . 16. Amount of Line 14 taxable 16 at lineal rate X .045 9 6, 6 6 9. 5 0 . 17. Amount of Line 14 taxable 17 at sibling rate X .12 0 0 0 ' 18. Amount of Line 14 taxable 18 at collateral rate X .15 0 0 0 . 19. Tax Due .................................................... ............................................................... .. 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 0.00 4,350.13 0.00 0.00 4,350.13 Side 2 1505607220 1505607220 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-08-011036 ~- Charlotte E. Sipe _ STREET ADDRESS 51 South Point Drive CITY STArE 1ZIP - - - _ Mechanicsburg PA ~ 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) 4,350.13 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments 4,132.62 C. Discount 217.51 Total Credits (A +g+C) (2) 4,350.13 3. InteresUPenalty if applicable p, Interest E. Penalty Total InteresUPenalty (D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) Check box on Page 2 Line 20 to request a refund 5, If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.0 0 A, Enter the interest on the tax due. (5A} g. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56) ~ , I) ~ Make Check Payable to: REGISTER OF WILLS, AGENT ,,~t '~ ~:~ tt = ~ - ~ i : .. ;~~a~.~y'~ s Ls~~.~"'to.`,l~'~wi ~ ,.~~ ~ - ,r : ;f.. ~-` .: ~ _. ~Y~„',I 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 :.................................................................................. ~ ~x b. retain the right to designate who shall use the property transferred or its income :.................................... Iu~~ c. retain a reversionary interest; or .................................................................................................................. ~J d. receive the promise for life of either payments, benefits or care? .............................................................. ~ ^x 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................................................... ^ ^x 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ...................................................................................................................... IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. §9116 {a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 'I , 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §9116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) I~ercent [72 P.S. §9116 (a) (1.3)]. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. Rev-1502 EX+ (6-98) SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAx RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER Sipe ,Charlotte E. 21-08-01036 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined a:> the price at which property would be exchanged behveen a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable kno~Hledge of the relevant facts. Real property which is jointlyowned with right of survivorship must be disclosed on schedule F. (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule A (Rev. 6-98) , Rev-1508 EX* (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, 81: MISC. PERSONAL PROPERTY ESTATE OF (FILE NUMBER Sipe ,Charlotte E. 21-08-01036 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. """' DESCRIPTION NUMBER 1 Citizens Bank -Checking Account No. 6100701271 2 Proceeds from the sale of the decedent's personal property 3 Refund/Reimbursement -Homeowner's Insurance 4 RefundlReimbursement -Medical Insurance 5 RefundlReimbursement -Upper Allen Township -Sewer Bill 6 Reimbursement of 4th Quarter Sewer -paid at real estate settlement of 51 Southpoint Drive, Mechanicsburg, PA 7 Reimbursement of County real estate taxes -paid at real estate settlement of 51 Southpoint Drive, Mechanicsburg, PA 8 Reimbursement of School real estate taxes -paid at real estate settlement of 51 Southpoint Drive, Mechanicsburg, PA LUE AT DATE OF DEATH 2,242.48 810.00 75.54 160.17 112.00 69.39 49.28 663.42 TOTAL (Also enter on Line 5, Recapitulation) I 4,182.28 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) REV-1151 EX+ (12-99) SCHEDULE H COMMONWEALTH OFPENNSYLVA.NIA FUNERAL EXPENSES ~ INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NuM13tF( Sipe ,Charlotte E. 21-08-01036 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A- FUNERAL EXPENSES: See continuation schedule(s) attached I 9,070.00 B. 1 ADMINISTRATIVE COSTS: Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s): Street Address City State Zip Year(s) Commission paid 2, Attorney's Fees Smoker Gard Associates LLP 2,500.00 3, Family Exemption: (If decedent's address is not the same as Gaimant's, attach explanation; Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees Register of Wills 302.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 8,769.51 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 20,641.51 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Sipe ,Charlotte E. 21-08-01036 ITEM DESCRIPTION AMOUNT NUMBER Funeral Expenses 1 Funeral Meal 300.00 2 Memorial Plaque 290.00 3 Myers Funeral Home, Inc. -Funeral Home Bill 8,480.00 H-A Subtotal 9,070.00 Other Administrative Costs 4 3rd Quarter Sewer -paid at real estate settlement of 51 Southpoint Drive, 117.66 Mechanicsburg, PA 5 4th Quarter Sewer -paid at real estate settlement of 51 Southpoint Drive, 112.00 Mechanicsburg, PA 6 Central Penn Real Estate -Realtor's Commission -paid at real estate settlement of 4,067.50 51 Southpoint Drive, Mechanicsburg, PA 7 Cumberland Law Journal -Estate Notice 75.00 8 George H. Eager, Esquire -Preparation of Deed -paid at real estate settlement of 51 50.00 Southpoint Drive, Mechanicsburg, PA 9 November HOA Dues -paid at real estate settlement of 51 Southpoint Drive, 12.00 Mechanicsburg, PA 10 One-Half (112) of Realty Transfer Tax -paid at real estate settlement of 51 1,155.00 Southpoint Drive, Mechanicsburg, PA 11 Postage 15.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Sipe ,Charlotte E. 21-08-01036 ITEM DESCRIPTION AMOUNT NUMBER 12 PPL Electric -Utility Bill 59.83 13 Remax 1st Advantage -Realtor's Commission -paid at real estate settlement of 51 2,862.50 Southpoint Drive, Mechanicsburg, PA 14 Resale Certification -Southpoint Condo -paid at real estate settlement of 51 50.00 Southpoint Drive, Mechanicsburg, PA 15 Tax Certification -Marlin Yohn -paid at real estate settlement of 51 Southpoint 5.00 Drive, Mechanicsburg, PA 16 The Sentinel -Estate Notice 150.64 17 United Water -Water Bill 22.88 18 York Disposal •• Trash Bill 14.50 H-67 Subtotal 8,769.51 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1512 EX+ (6-98) SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN o~c~ncuT nFrcnFNr ESTATE OF (FILE NUM6EK Sipe ,Charlotte E. 21-08-01036 Include unreimbursed medical expenses. (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98) GN_15~7 FYa f4-fl(Il SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURIV RESIDENT DECEDENT ESTATE OF FILE NUMBER Sipe ,Charlotte E. 21-08-01036 NAME AND ADDRESS OF I IP DECEDENT SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) (Words) ($$$) Inc u e outrig t spousa • distributions, and transfers under Sec. 9116(a)(1.2)] 1 Wilson L. Sipe Jr. Son 100% of 920 Spring Garden Street Residuary Elizabethtown, PA 17022 Estate Tatal Enter dollar amounts for distributions shown above on lines 5 through 18, as approp nate, on Rev 1500 cove r sheet II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1 [Please enter a charity into the Beneficiary field in Transact] 2,000.00 TOTAL OF PART II -ENTER TOTAL NON-tAXAt3Lt UI51 KltiU I IUNJ ulv ulvt ~s ur r<tv-15uu t,vvtl< anct I ~ c,vvv.vv Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98) (( ~lov 05 08 03:23p EAGERSPINELLOQUINNSTENGEL 717 2907978 p.2 ` uU~, UU cuUU xCU VC •4y rN t'Llr LLL FAX Pic. Ili 960 11~?3 P~~@2 ' nMMK BDCan3 are oa901BN - eom!m1V-~la'~1Tlu uwr ,>` S ettlerne~it St: r .T1eriI U.S. Departrnene afHousing and urban Development nun e.........~1 w, f5117mf.57nrnlrnc f1/7nrJMat v. . ~ a,. •. ~FNA 2. OFmHA, 3. nJCorw. tkdns 8. FDs Number 7. Loan Number ~8 NatBage Insurance Casetlumber 4. vA 5. Conv. fns. PYFNQ8,57RCS A A a ! I+ o~w.. ele p,e.n, here la inlamBl:an rnaPn+e eld en na{bdvaeO In Nllave, TdI0EIQ1I65S Selflement J}'Slam ea tlWMv11~~7 l ' sd ^ r ' i wcm Oea Wl (p.o.e) 6 Y C, 'r01a: .Icon rtro/ted 'NARIWYe: A h a come b YnolnftY mane bdaa BteLitlan4 b Bra W lea 91Nq OrHdl a Y. aNN Blnieer )a.m. Dtllilllla upon ~ Dle acypnlDSa- mav[bon ry,l aaddesfine ane .neN.Fa OeN'kiae file taU_SC ban t D rVRME OF 130AROWER: Bradley A. Jones and Robin W. Jones 91td Patricia M. Wagner AODPESS: E. NAMEOFSEL~~1: EstateoiCharlatte f.. SipO A]DPESS' F. NAIdEOF LENDER: Commerce BenklHarritsburg, N.A ADDRE~S• 3601 Paxton Street, Harrisburg PA 1711 T _ G PRDPERTYADDRE55: 51 SaAhpoiritOrlve, Nechanlcshrag, PA 17055 U erAlfenTownshi H. SErrLEh~N7 RGENT: Pyramid Land Transfer LLC, Telephone: 717-960-1122 Fax: 717-960-1123 PLACE OF SETTLEMENT 55 W Cbu-eh Are. t;,atllsle PA 17013 I. SETTLEMENT OATS: 1110512008 J. SUMMAR F ORR WER'S TRANSACTIONS ~~ K SUM ARY OF SFt..LE S TR ACTION__~ GROSS A[v10UNT OUE FROM BORROWER 100 40D. GROSS ANOUNTDU TO SELLER . tot ConlractsalesoAce 115500.00 4D1. Co sctsales :ice 115500.D0 . 102 Personal property 4 Pananal Fro [ 103. Sett) meal charoes to txmower ne 1400 6 35521 40 , tOd. 4~' 105. ~' Adlusbnenb nor fEemS Laid b saner in advance Ac ueVnar'15 toritems Id b seller i~ advance f07 Camlvtaxes 111051081a12f31108 49.28 4D7. Covnl 11JDS1DBtD) 1168 49.28 108. 5 hoolTaxes 11/05/081o06l3Df09 663,12 448. SrhodTaxes 11/65/08 to 09 B63.42 tD4. 110 4ihQlrSevrar 11l05J081a12131f08 69.39 408. 41 4th gtrSew r 11105JOBto12l31l08 69.39 1St. dl , 112. GROSS AMOUNT DUE FROM BORROWER IZO 1 667.90 412 420 GROSS A NT DUE TO S~LER 116.282.09 . ~~ 200. AMOUNTS PAID BY OR ON SEHALF Of BOR ROWER 500. REDUCTIONS IN AMOUNT DUE TO SELLER 201 poro3~teameatmonev 1000.00 501. It seeinsin)ction 202 Prindnalamoun'ofnawktarts 9 400.00 502. Sellktmentdt l0 8Re• ne140 ' 8419.66 4 Z03 Eaisfna IoeMs1 taken srJDiect to act to 03. E>dsll n s tali({ X04. 04. P A Frslldo a an 205. 206 Novsn•tar;lOADues 1110110Bto11lOS108 12.00 505. Nevemt~H Dues 11Poi108tof1N5W8 12.00 7AT. 507. tea, 508 I ~ Ad'ustrremtts far iterne aid IM 509. Ad u9tments for Ibms un aid b seller ~ 513. lid. 514. 215. ~ 515. 216. 516. 217. 517. ~$ 518. . 239. 220. TOTAL PAiD BYIFOR BORROWER 83 A12.00 519. 620. TOTAL REDUCTION AMOUNT pUE SELLER 8.d31.66 r 30 , CASN AT SETTLENFNT FROM QR TO BORR OWER 600. C H AT SETR.EM ENT TO O•R FROM 5 ELLE R 301 Gross amount due `rort borrower Dine 1201 12 637.30 601. Gros mcum due to sever ire 11628209 302 Less amounrspald bv/for borQuvLer~line 2201_ I 4 412.00 2. Lee reduction mo salter Gre 8 431.66 I srta CASH FROM BORROWER _ 29 225.30 600. CASH TO SELLER 10T 850.43 $~'65TrTL/Te POMi ro9p 5EV1.E1c l~ATFNEMf~ ThllnlsmaGwaaants'1W Midn i11nD0Raul a. MorRYJWn eM Ic baby AvwflBOb Yes Nkrnl RBVana6 Sav~re. My011fn raq Md beY! B nNUln, B` r rx DMlMy or ohd 3stiYBn vN be:nPaaeE al poo it aif ilMl^.eWi.dbae llKRB08M the IRS eBGTIn{c FatETIB nOr eeBn arporlea. TM Canlnct SSln Pnm a,waBd Dn 1 dO~rEBNCONMMei !_GOK Pn)o[LEBd IW Ya~W~[u.. SELLF1T INS7AUC1tON5. naverKlall>rr vee )oaaMndoa In!lrrnce Narv+m7/1!,$Tea, 6zBMQB arvTCyor P~fQBno,ax inpGBin,MT pv NCnmalBa n3roan; brOMY:MlBLaa~c, iwnpran ax eBCBOU. wan a ram ngr. remt6TS7 ar[M eaeara b (ram nodot. v erereWnd lp i«vb p.ova!!,l WlkvMlcyaMd:d.TeR ID iJa twth g~aaur' tarlecilU,DBl.ridlrNlBGlbnnVm:d ryau do not povidlyD'J(WIgO',a aBnUOrun Iv,.mtrv.poJ nlrrd etwjad to OrA Oa mw<sIpM911KLn2mMOy Wa. spareelN BB7al.f¢.YymBl be avarner Bnarn ere MB nsllnxnl Kl~p mr..rJ bl~eyor lawrt~! ~nurr.aa. pl,_ 1 9f1LF~=IGHATURE(Sk ~ - SELLe M1(5) MEM' MAR1Na J4ppRE5S Nov 05 08 03:23p EAGERSPINELLOQUINNSTENGEL 717 2'307978 p.3 Nvv-uu-coup Yltu ~JC 4y rr~ °t... i.tc FA}: No. fl; y6iJ 1'~3 P. 003 ...,.aub e,.~., ue,o,ciwe ' U:S. L'fPART1dENT OFr""lSING ARO URBAN DEVELOPMENT ''~ Fla Number. PYFN0837 PAGE; 2 AGIIL.GIYIGI~1 JI .mc.nl ..... ~._._-__.__..__._ --- L SETTLEMENTGHARGES PAiD FRDM PAID FROM 70D. TOTAL SALc5rBR01CER'$ COrnrAtSS10N Dosed on Drirt 5115 50000 ®6.000 = 6,830,00 BORROWER'S SELLERS Divlslan of commission Blne 7lb as rd r. FUNDS AT FUNDS AT 7D1. S 86250 to R 15i Advanta a SETTLEMEtvT SETTLEtvtEN7T 4 D67.50 ID Central Penn Real !;state 702 . 6 930.00 io3. Commi6l:on aid et Senleme~t 70a. Trarsac~ionFee W RernaxlstAdvania a 250.00 800. ITEMS PAYABLE IN CANNECTION WITH LOAN 80'.- LDan Od on Fee 5G 802 LDan Discount xConunerre BankJHarrlsbur N,A LR 924.00 803, isatfee b 9A A raiser P.O.C. 325.00 f3 er LR 25.00 Boa. CredR RaoDR b uitaz alort Services 2.54P C LDR 805..4drrotisasrior Fee ro Commerce BenklHartisbut .IL LR 575.00 806. tYtdVryritin ReulewFea ro Commerce Bank 397.OOPOC BY LDR 807 Oveni t tAat b UNshl ere 576.00 POC BY LDR Boa. Glood a Fea ro Wolters t0lnlrer Flnanetal SvcslPCIS6POCLDR 809. HERS A i n Fee to MERS .95 POC BY LDR 850. 811. I 900, TTEh15 REOUTAED BY LE2lDER TO BE PAID 1N ADVANCE 90t. ;merest fmm 1110512008 b 12101M008 6 15.4D00 Ida 26 Da s LR 400.40 902. A1ort a e Insuranc Premium (Dr ID --~ 903. N8 d trlrurence Premium bor tD 904. 905. 100D, RESERVES DEPOSITED WITH LENDER FOR toot.: t>staane ~. ® mO 1002 Mo a o Iruurence rno, ® Imo tOD3. i1 Pm e T Imo R Imo co Plo Ta>t 11 mo. ~ 26.37 hno LR 1004 290.07 , Scn tTezes fi me. 84.79 lrrm LR itx>6 508.74 . to09 ,seq. 's pd"ustmrrlt to CommetCeBanklHarrisbur N.A. LR -171.68 1100• TITLE CHARGES 1101. Itkmenl ad n !aa t t D2 !.DS ct Dr hTlo h t5D3. Title ez~llaiDn . t1W. Title Itsuranca tinder SD 00 t t05. Coament aratwro0eed A1Mfne E er 22 . 1108- N to Faes b rarn(d Land Transfer LL . i1Ci7. Fllorn Itaas ndudee aoara Clem 5 raB. TDe Insole b amid land Transfer LLC 844.88 Includes Idbtllra tams N _ 1109. Lenders Pd 92 40D.00 - t t10. 0 f6 P 11 0.00 •844.88 ~ 200 00 t nt. End tD0 End 9 0 lnarb ramid Land Transfee U.C . 50 00 t1t2 GogrnerllRallieuetFee b Land Transfer LLC . n13. Cbsi SvcLtr b id Land Transfer LLC 35.00 GOVERNttENT RECOADN4GANDTRA FER CHARGES 200 . Ram CoadS38.50 • MD 68:50 • Release 1 t 107.00 , C 'Coon Deed it 155.00 Mon s 1 155.00 . 1203. StateTax/~em s e di) 1 500 •Mon e e 1155.00 1 Od. T Parcel Ce fI b Recorder at Deeds 20.00 t2C5.2008Cn. .d5PD3r2 D8.095d1oo1 017,44PD8lt3f08 1300. ADDITIONAL SETTLEMENT HARGES - t , T Can tc ADarlin Y S.OD OD SD 1302. Resate Cars 1 Sotdh lot Dodo 00 20 . 1303. Ovemi ht P - w P nnlid Land Transfer LL . lYereTrnnslerFee ro P mid LandTrensler LLC t3C4 10.00 . t rd OIr Sewer to U er Allen Townshi 117.66 ath t)tr Sewer to U A11en Tawnshi 13Cg 112. 0 . rvot,ymber s10A e t Sotdh Din! Condo t3C7 9D.00 . S3CB. Initiation Fee ro South Dint ndo 960.00 ,em total cr:rrlC-JIF1dTCHa,PfES renter an lineslOD.SeClionJand502,S 9i K 6355.21 8419.66 Nu0 CERrICICwTION Or 9urERANO elt~~ea h ,I,e.9d 1 NU0+1 S eNanwd 6p1s,eM ena n dN Dee! 1~l mY troMecDe rtd ~ i ~ a Inge end ars~Ma la~etwtid al RcNprs an urcem.nn m+,e un rm ccnurc a sy ma xt ~ ' son on. I Mh MY afar I MYe racaeas a ceOY ~` Y. °M 9'eta~n L/,/ Y o ~ IBiC^ r~ r ~... ~ ~s~S< / - ISA CN.Y,E NNOWx6W M4NE FlY-eE 6TA~E11Da1S i0 THE 7Ta Nl10~t SsaJt tsbtemax llwecreyr•aN alnw aMaw~t••cmurc of lf; 4amatlbn. Eb ON AIW 61UI(AaroRN.PEWllT1F3 U70N (ANVI('fI7N I rww wua '1 one to v, t'veuree0 elee¢npnce ,.iet d,i/,Ieler,te,Y. ~wFINE u,NC IaBli. FOa DtTML66EE~YlE 16: / .,. !L7'pN t[p1 AND 9ECTON 1010. l/~. ar LAST WILL AND TESTAMENT OF CHARLOTTE E. SIPE I, CHARLOTTE E. SIPE, of Upper Allen Township, Cumberland County, Pennsylvania, do make, publish and declare this to be my Last Will and Testament, hereby revoking all Wills and- Codicils by me at any time made. ITEM I: I direct that all inheritance and estate taxes becoming due by reason of my death, whether such taxes may be payable by my Estate or by any recipient of any property, shall be paid by my Executor out ~~f the property passing under this Will which is not specifically bequeathed or devised, as an expense and cost of administration of my Estate. My Executor shall have no duty or obligation to obtain reimbursement for any such tax paid by my Executor, even though on proceeds of insurance or other property not passing under this Will. In the absolute discretion of my Executor, my Executor may pay such taxes immediately or may postpone the payment of taxes on future or remainder interests until the time possession thereof accrues to the beneficiaries. ' ITEM II: I give, devise and bequeath all of my property, real, personal and mixed, to my husband, WILSON L. SIPE, if he survives me. ITEM LII: Lf my said husband, WILSON L. SIPE, predeceases me, I. give, devise and bequeath as follows: (a) The sum of Two Thousand Dollaxs ($2,000) to SHEPHERDSTOWN UNITED METHODIST CHURCH, 1934 South York Street, Mechanicsburg, Pennsylvania; and (b) A11 of rest, residue and remainder of my Estate. to my son, WILSON L. SIPE, JR., if he survives me or, if he does not, to his issue, per stirpes. Page 1 of 4 pages. ITEM IV: In the settlement; of my Estate, my Executor shall possess, among others, the following powers, to be exercised for the best interests of the beneficiaries. (a) To retain any investments I may have at my death so long as my Executor may deem it advisable to my Estate so to do. '~-~Y ~~.f .~ tR ^~ $ (b) To vary investments, when deemed- desirable by my'-~,~~~ ~`=~ ~ *~~ ,,~ Executor, and to invest in such bonds, stocks, notes, real estate mortgages, or other securities or in such other real or personal property as my Executor shall deera wise, without being bound by any statutes or rules of law ref;ulating invest- ments by executors. (c) In order to effect a division of the principal of my Estate or for any other purpose, including any final distri- bution, my Executor is authorized to make said divisions or distributions of the personalty and realty partly or wholly in kind. If such divisions or distributions are made in kind, said assets are required to be divided or distributed at their respective values on the date or dates of thE~ir division or distribution. (d) To sell either at public or private sale and upon ' such terms and conditions as my Executor may deem advantageous to my Estate, any or all real or personal estate or interest i therein owned by my Estate severally or in conjunction with other persons or acquixed after my death,. by; my..;:Executor,~ •and ,~,,. ~;~.._. to consummnate said sale or sales by sufficient deeds or ~. ~ ~ ~ ~ :' ' ; ~: ; , .i ~,. ,> ~f ~ other instruments to the urchaser or urchasers ' conve in. ~~;:~ p P ~ y g F ~j~~: r , , ~:~, - ee si e i le free nd e f mpl t t a cl ar of all trust and without obligation or liability of the purchaser or purchasers to see to the application of the. purchase money or to make inquiry ~~~ 'into the validity of said sale or sales; also, to make, it Page 2 of 4 pages. ~~-rT ~~ __ _ f ~, , ,, i t .... 1 :~J, i i. ''u[ a3~ yf elf AI , F, execute, acknowledge and deliver any and all deeds, assign- ments., options. or other writings which may be necessary or desirable in carryin g out any of the powers conferred upon my Executor in this paragraph or elsewhere iri my Will. (e) To mortgage-real estate, and to make leases of real estate. , _ (:f) To borrow money from any party, to pay indebtedness' ~"~~F' of mine or of my Estate., expenses of administration or in- Y heritance, legacy, estate or other taxes. (g) To pay all costs, taxes, expenses and charges in connection with administration of my Estate. My Executor shall pay expenses of my last illness and funeral. (h) To vote any shares of stock which form a part of my Estate, and to otherwise exercise all the powers incident to the ownership of such stock. () In the discretion of my Executor, to unite with other owners. of similar property in carrying out any plans for the reorganization of any corporation or company whose securities form a part of my Estate, ITEM V: Any person who shall have died at the same time as Testatrix, or in a common disaster with her, or ~ under such circumstances that it is difficult; or impossible to determine who died first, shall be deemed to have predeceased her. ' ITEM VI: I nominate., constitute and appoint my husband, WILSON L. SLPE, to be zny "Executor." In the event of the death or resignation of WILSON L.' SIPS as Executor, or ;`~ ~.~~"~' his refusal or inability to act as such, WILSON L. SLPE, JR. shall be substituted therefor. My Executor is specifically relieved from the duty or obligation of filing any bond or bonds . Page 3 of 4 pages. :~ IN WITNESS WHEREOF, I have set my hand and sea.1 to this my Last Will and Testament, consisting of this and the pre- „ ~ ~. ceding 3 pages , this ~',C3 day of ~~~ '~•~j,', __ 19 ~ ~~ . C~~~!~--`f'=mot ~~---- Page 4 of 4 pages. WI'~NES SES ~~ ~~ _ i ,(SEAL) Residing at ~-~ r ,~ ~,_ ~~~- '~-~ (SEAL) Residing at ,~~~ G~2f~r~ -7!.~ a.f% ~~/ (~c2.0~ Z v a s ~- (.SEAL) Residing at ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA /, s S S COUNTY OF ref-r°-/.?,~.~~~~` I, CHARLOTTE E. SIPE, Testatrix whose name is signed to the foregoing instrument, having been duly qualified according to law, hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it as my free and voluntary act for the purposes therein expressed. Sworn to and acknowledged before me , /by CHARLOTTE E. SIPE, Textatrix, this =~'~'`~_ day of_ _~1~~C~j,~*/'~___ 19;~"='__ `l Notay y Pu is ~ (_S EAL ) t;.~~~a~i~~t:. tn•rfn^. n'Srf~R'' rUni_ft; C,..,.., _ ., '~~! ~ l~, 1'_18; ii,. _. I Crr~F.~~i~, ,d County AFFTDAVTT COMMONWEALTH OF ~P~E/JNP?SY VANIA Q' ~~.f.~ SS COUNTY OF C,~-~/n'` the witnesses whose names are signed to the foregoing instrument, being duly qualified according to law, depose and say that we were present and saw Testatrix sign and execute the instrument as her Last Will and Testament; that she signed it willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the Last Will and Testament as witnesses; and that to the best of our knowledge the Testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. /, Sworn to and subscribed before me by (~~,/,~.y~' /~, ~,~~,L~r~J this day of 19-~--t- ' '" ~C~t~' ,~ ~ No ry Pu lic ttootttr n. MYERS, P10T!(RY PUBLfU (.SEAL) ray rnc,;~ ;, ~-,, L;;;,,,,,; ecr~r;e~ 12, 1sa5 T;; p., Cu'nL9r','.ad CnurtY ~~ ., r ~ 1~ ~ ~~ ~~d. ~ N 1 Smoker Gard Associates LLP Attorneys at Law www.smokergard.com NEW HOLLAND MICHAEL D. SMOKER NICHOLAS T. GARD LEOLA LANCASTER CORY J. MILLER MOUNT CARMEL CHRISTINA M. BRAY January 23, 2009 LITITZ STEPHEN W. GROSH SHILLINGTON Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013 RE: Estate of Charlotte E. Sipe Our File No. 8978 Dear Sir or Madam: Please find enclosed one (1) original and two (2) copies of the Inheritance Tax Return to be filed in your office concerning the estate. I have also enclosed estate check no. 1004 in the amount of $15.00 representing your filing fee. Kindly time-stamp the copies and return same, along with the appropriate receipt to my office in the self-addressed envelope that has been provided. If you should have any questions, please do not hesitate to contact my office Sin erely, .s w ~`~ e they Reybok Paralegal har Enclosures ^ LANCASTER 220 North Duke Street P.O. Box 1522 Lancaster, PA 17608 Telephone: 717.291.1413 Facsimile: 717.390.4861 `4~ NEW HOLLAND 912 West Main Street Suite 402 New Holland, PA 17557 Telephone: 717.656.6717 Facsimile: 717.656.8174 ^ LEOLA 49 East Main Street P.O. Box 218 Leola, PA 17540 Telephone: 717.656.6717 Facsimile: 717.656.4704 Thank you. r--a c-:~ c~ .,.~ P r,3 ~~ ~_ C -T --T _ <~? ' ,, i~ .... .-. ;; '`- .~ ---, -~ r:3 rn i _ =, ^ MOUNT CARMEL 105 South Oak Street Mount Carmel, PA 17851 Telephone: 570.339.2558 Facsimile: 570.339.2666 ii ~~' ~ I ~ r ~~ ~ Ede ~ t '1.~ i 1 (I i~E~,I ; ~ I ~~~ 1 ~ _ <- ~'1~.. , Y t i t , E.~ .d' 1 1 . i VS- 4' t. i i i) ..~ 1 s e~da t~ : .., ry1: Z~Q~ ~!~~3 26 PM '~ ~.~~ -., "' ~ C~ t f E f j7r. }V (~,ji~` ` ~1S ,yc ~~ Q ~ r~~ k cn :~ ~ ~ ~•~ ~ 1 c4 ^1 `, ~ y ~ ~ r ~ ~' ~ "C'3 C4j ~. 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