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02-12-09
~. 1505607121 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN 2 1 0 8 0 6 8 5 Hamsburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 2 0 1 1 8 9 2 6 7 0 6 0 4 2 0 0 8 0 7 2 7 1 9 2 4 Decedent's Last Name Suffix Decedent's First Name MI G O O D H A R T G E O R G E C (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 (date of ~ 5. Federal Estate Tax Return Required death after 12-12-82) ^X 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust ~ 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTU\L TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number J O E L R Z U L L I N G E R 7 1 7 204 6 ~ 2 9 ;_, Firm Name (If Applicable) ~ ' ~ ~ ~~> REGISTER OK t-S USE Y > Z U L L I N G E R D A V I S P C ~i-n ~ ~ ~~ First line of address `~~' ='~ '`--~ 1 4 N O R T H M A I N S T R E E _ ~,.~ C _) T _~ `~"' '~ , r__ ~.~^± Second line of address ~ ~ ~~ ' - W - S U I T E 2 0 0 u+ City or POSt Office State ZIP Code DATE FILED C H A M B E R S B U R G P A 1 7 2 0 1 298 Hiah M ]f4 NORTH MAIN-STREET, SUITE 200 CHAMBERSBURG PA 17201 PLEASE USE ORIGINAL FORM ONLY Side 1 1505607121 1505607121 Correspondent's a-mail address: Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, i4 ie 4n in mrror} nnrl mmnlo4e rlnrhrofinn of nroneror nlhnr khan 4he nn.enn~l mnmen..f~ti..e le h~~e.l .... ~n i..1......~a......f ...ti:..ti ............. ~..... ...... ~..,...a..a..,. 1505607221 REV-1500 EX Decedent's Social Security Number Decedent's Name: GEORGE C• GOODHART 2 0 1 1 8 9 2 6 7 RECAPITULATION 1 3 0 5 1 4. 7 1 1. Real estate (Schedule A) ........................................ 1 2. Stocks and Bonds (Schedule B) 1 7 9 7. 0 0 .................................. 2. 3. Closely Held Corporation, Partnership orSole-Proprietorship (Schedule C) ..... 3. 4. Mortgages & Notes Receivable (Schedule D) ................. ...... . 4. 1 4 8 3 4 3 . 4 3 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ...... . 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ...... . 6. 1 4 8 3 . D 5 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property 4 8 8 7 8 0 8 (Schedule G) ~ Separate Billing Requested ...... . 7. . 8. Total Gross Assets (total Lines 1-7) .................... ...... . 8. 3 3 1 0 1 6. 2 7 9. Funeral Ex enses & Administrative Costs Schedule H P ( ) ......... ...... 9. . 2 5 5 6 7. 6 1 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ..... ...... . 10. 4 3 4 3. 8 3 11. Total Deductions (total Lines 9 & 10) .................... ...... . 11. 2 9 9 1 1 . 4 4 12. Net Value of Estate (Line 8 minus Line 11) .................. ...... . 12. 3 0 1 1 0 4 . 8 3 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which 0 0 0 an election to tax has not been made (Schedule J) ........... ...... . 13. • 14. Net Value Subject to Tax (Line 12 minus Line 13) ........... ...... . 14. 3 0 1 1 0 4 . 8 3 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.z) x.o _ D 0 0 15. 0. 0 D 16. Amount of Line 14 taxable 3 0 1 1 0 4 8 3 1 3 5 4 9 7 2 at lineal rate X .045 16. . 17. Amount of Line 14 taxable 0 0 0 0 0 0 . at sibling rate X .12 17. . 18. Amount of Line 14 taxable 0 0 0 0 0 0 . at collateral rate X .15 1 g. . 19. Tax Due ......................................... ...... .19. 1 3 5 4 9. 7 2 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAY MENT Side 2 1505607221 15056D7221 REV-1500 EX page 3 Decedent's Complete Address: File Number 21 08 0685 DECEDENTS NAME GEORGE C._GOODHART ----- STREET ADDRESS 401 WALNUT BOTTOM ROAD _ - -__ - _ __ CITY STATE ZIP SHIPPENSBURG PA 17257 Tax Payments and Credits: 1 • Tax Due (Page 2 Line 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments 11, 542.50 C. Discount 607.50 3. Interest/Penalty if applicable D. Interest E. Penalty (1) 13,549.72 Total Credits (A + B + C) (2) Total InterestlPenalty (D + E ) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. 12,150.00 (3) 0.00 (4) 0.00 (5) 1, 399.72 (5A) (5B) 1,399.72 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred : ...................................................................... ^ X^ b. retain the right to designate who shall use the property transferred or its income; ............................... ^ ^X c. retain a reversionary interest; or ................................................................................................ ^ 0 d. receive the promise for life of either payments, benefits or care? ....................................................... ^ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................... ^ Q 3. Did decedent own an "intrust for" or payable upon death bank account or security at his or her death? ......... ^ 0 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? .................................................................................................. X^ ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3} percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January, 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. §9116 (a} (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent (72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1502 EX ~ (6-98) ' SCHEDULE A COMMONWEALTH OF PENNSYLVANIA REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT' ESTATE OF FILE NUMBER GEORGE C. GOODHART 21 08 0685 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real ro which is ointl •owned with ri ht of survivorshi must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Tract of real estate, together with improvements thereon, 130,000.00 sold to Alan L. Goodhart & Lorelei H. Goodhart, for gross purchase price of $130,000.00 2. Received on proration of real estate taxes 514.71 TOTAL (Also enter on line 1, Recapitulation) ~ ~ 130,514.71 (If more space is needed, insert additional sheets of the same size) REV-1503 EX : (6-96) SCHEDULE B COMMONWEALTH OF PENNS`fLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT' ESTATE OF FILE NUMBER GEORGE C. GOODHART 21 08 0685 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 13 shares of common stock, C.V. Cooperative 130.00 @10.00 per share 2. 7 shares common stock, Daimler Chrystler 511.70 @73.10 3. 30 shares common stock, Hershey Co. 1,155.30 @38.51 TOTAL (Also enter on line 2, Recapitulation) I $ 1 (If more space is needed, insert additional sheets of the same size) REV-1508 EX,+ (6-98) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. IN RESI DENTEDE EDENTRN PERSONAL PROPERTY ESTATE OF FILE NUMBER GEORGE C. GOODHART 21 08 0685 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Account#6100800253, Citizens Bank 25,176.46 2. Account #6140715520, Citizens Bank, 20,049.58 including interest accrued to date of death 3. Account #6140716268, Citizens Bank, 21,073.80 including interest accrued to date of death 4. Account #6140754445, Citizens Bank, 12,333.23 including interest accrued to date of death 5. Account #6140774853, Citizens Bank, 17,953.81 including interest accrued to date of death 6. Account #6140852579, Citizens Bank, 6,002.57 including interest accrued to date of death 7. Account #6140852587, Citizens Bank, 6,026.19 including interest accrued to date of death 8. Account #6140878160, Citizens Bank, 14,529.04 including interest accrued to date of death 9. Account #6252090310, Citizens Bank, 6,184.61 including interest accrued to date of death 10. Gross proceeds from sale of personal property 10,912.00 by Gateway Gallery Auction on 9/20/08, copy of settlement statement attached 11. Gross proceeds from sale of personal property 5,598.30 by Gateway Gallery Auction on 11/24/08, copy of settlement statement attached 12. 1986 GMC truck in poor condition 250.00 13. Refunds Blue Cross/Blue Shield 872.27 14. Funds received from claim for recovery of 533.85 unclaimed property held by Pennsylvania Treasury Department 15. Tax Stimulus payment 600.00 16. Refund, Waste Management 67.08 TOTAL (Also enter on line 5, Recapitulation) 13 148,343.43 (If more space is needed, insert additional sheets of the same size) • Continuation of REV-1500 Inheritance Tax Return Resident Decedent GEORGE C. GOODHART 21 08 0685 Decedent's Name Page 1 File Number Schedule E -Cash, Bank Deposits, ~ Misc. Personal Property ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 17. Refund, Adams Electric Cooperative 80.64 SUBTOTAL SCHEDULE E 80.64 GRAND TOTAL SCHEDULE E S 148,093.43 REV-1510 EX,+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT' SCHEDULE G INTER-VIVOS TRANSFERS 8~ MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER GEORGE C. GOODHART 21 08 0685 This schedule must be completed and filedrf the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER DESCRIPTION OF PROPERTY INCLUDE THE NAMEOFTHETRANSFEREE,THEIRRELATIONSHIPTODECEDENTAND THE DATEOF'rRANSFER. ATTACHACOPYOFTHEDEEDFORREALESTATE. DATE OF DEATH VALUE OF ASSET %OFDECD~S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1. Transamerica Annuity Account #26235776, named 48,878.08 100. 48,878.08 beneficiaries, Carla M. Miller and Carol A. Walk, children of decedent TOTAL (Also enter on line 7 Recapitulation) I $ 48 878 08 (If more space is needed, insert addfional sheets of the same size) REV-1509 EX + (6-98) SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN ESTATE OF FILE NUMBER GEORGE C. GOODHART 21 08 0685 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. ADDRESS SURVIVING JOINT TENANT(S) NAME A. Carol A. Walk 298 High Mountain Road Shippensburg, PA 17257 B C JOINTLY-OWNED PROPERTY: TIONSHIP TO DECEDENT daughter ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSET ~ OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1. A. U.S. Series EE Bonds as shown on attached listing 2,966.10 50. 1,483.05 TOTAL (Also enter on line 6, Recapitulation) I $ 1,483.05 (If more space is needed, insert additional sheets of the same size) REV-1511 EX.+ (10-06) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES ~ INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER GEORGE C. GOODHART 21 08 0685 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Fogelsanger Bricker Funeral Home, funeral services 9,375.51 B. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Street Address City Yearts) Commission Paid: State Zip 2, Attorney Fees Joel R. Zullinger 3, Family Exemption: (If decedent's addn;ss is not the same as claimants, attach explanation} Claimant 4. 5. 6. Tax Return Preparers Fees 0.00 9,500.00 0.00 402.00 7. Adams Electric, utilities 46.25 8. Ausherman Bros., appraisal of real estate 300.00 9. Cumberland Law Journal, advertise grant of letters 75.00 10. Southampton Township, refuse collection 42.21 11. Kuhn Communication, cable service 34.71 12. News-Chronicle, advertise letters 121.25 13. Barrett Appraisals, appraisal of real estate 325.00 14. Embarq, telephone service 46.07 15. Adams Electric, utilities 38.91 16. Kuhn Communication, cable service 34.71 17. Embarq, telephone service 46.99 18. Adams Electric, utilities 38.99 TOTAL (Also enter on line 9, Recapitulation) 3 25.567.61 Street Address City State Zip Relationship of Claimant to Decedent Probate Fees Letters 310.00; will 15.00; short certificates 32.00; JCP fee 10.00; automation 5.00; filing return 15.00; filing inventory 15.00 Accountants Fees (If more space is needed, insert additional sheets of the same size} • Continuation of REV-1500 Inheritance Tax Return Resident Decedent GEORGE C. GOODHART 21 08 0685 Decedent's Name Page 2 File Number Schedule H -Funeral Expenses 8~ Administrative Costs - B7. ITEM NUMBER DESCRIPTION AMOUNT 19. Kuhn Communication, cable service 16.66 20. Embarq, telephone service 37.07 21. Southampton Township, refuse collection 42.21 22. State Farm Insurance, truck insurance 88.01 23. Timmons, fuel oil for residence prior to sale 396.14 24. Gateway Gallery Auction, commission on 9/20/08 public sale 2,182.40 25. Gateway Gallery Auction, commission on 11/24/08 public sale 2,377.52 SUBTOTAL SCHEDULE H-B7 ~ 5,140.01 REV-1512 EX + (12-03) SCHEDULE 1 COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES, ~ LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER GEORGE C. GOODHART 21 08 0685 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Kuhn Communication, cable service 34.71 2. Carla Miller, reimbursement for expenses paid on behalf of decedent prior to death 3. Adams Electric, utilities 4. ~Embarq, telephone service 5. Vivian Coy, Tax Collector, real estate taxes due at Beth 6. IWSEMS, ambulance service 2, 028.13 36.42 50.44 1,221.86 972.27 TOTAL (Also enter on line 10, Recapitulation) I $ (If more space is needed, insert additional sheets of the same size) REV-15A 3 EX + (g-0o) COMMONWEALTH OF PENNSYLWANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER GEORGE C. GOODHART 21 08 0685 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. Carla M. Miller Lineal 7813 McClays Mill Road 1/2 of residue Newburg, PA 17240 2. Carol A. Walk Lineal 298 High Mountain Road 1/2 of residue Shippensburg, PA 17257 3. Georgianna Rosenberry Lineal 780 Cumberland Avenue specific bequest of Chambersburg, PA 17201 $1,000.00 NOTATION: The specific bequests in paragraph FOURTH of the decedent's will were made prior to the decedent's death. II. 1 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 0.00 0.00 TOTAL OF PART 1T -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I $ 0.00 (If more space is needed, insert additional sheets of the same size) n r .~ ._ ._t'"i'. a r. .., . _.. .___ _ _ _ - i _ " ' . . _ _ J ._ ~ _ _ ~___ __ _. _~-- - .:. _~ _ ~. _ __ _- _- - ~ ~- __ _ , . W~ - - -;ter-'-ew ~ _.~_~.. ;~-- ~? _--__.- - _ ._ - ~ _ J _ ..._ v_ _. _ L _ .. ~.. ... ... ... _~ w_..v_ ~- .~ . 1 ' '.B~r..~ l ...L _.. .~: ~. rll ~' IT ' ... Ll'•G''7 _ ~ D~~ ~`~'~.. ~..~ .. .~: ~E~ ~ -;..~ ,~i L l ..,... _~" ._.~ :_ ". ~:J.1 ~~ is r~. _' i'~. ~ .~~ _:1G ~` ~~~'~. ,~~~i /~; r - n r~,,E ~~ Y ~ _ :. ~ i--.v FiJ j'w~ ~ y ~ ~1 ~/ r---.fie: ~- ` L ~.. - ~,. "\ 1 .-. ~ y ~""1 i e L: w ~r~ :J~ ~ (_ \1 l r` ~. ~y. ~ _... ~ ~ te ~.. .. ..-.... .. __ _ _ - 4 i r^' 1-~ -rC' ~,.` `~~~ __ n,^. - - -~ tySirJ' , i.--.. ... . , q~,~ .,-: •,' ~~ ~~~`~ G~~~~" ri. ~..o.e,... ,., ....:..... _t_n ~ _ ~~'u'r ~ _ . . A. Settlement Statement U.S.DepartmentofHousing ,r and Urban Development oMB No. 2soz-0265 B T e of Loan 1. ^ FHA 2. ^ FmkL4 3. ^Conv. Unitas. 6. Flle Number 7. Loan Number ~ Mortgage Insurance Case Number 4. ^ VA 5. ^Conv. Ins. ~ _637 C. Note: rni. rarm v mml.bed to a~ a yn.. meeomt ar.ermu e.mm.nt m.ta Amoa.t• p,ia m a•d ly uK waemmt .gmt.m ebew•. tteme m.rlred'yp.e.r.)^..ere r•ia aaulae me elmma; trwy •te show. hem m. i•f•rto•tia••1 IwrVaau •ed •n ant odwed b au bt•la D. Name and Address of Borrower E. Namy Address, and Taxpayer identification # of Seller F. Name and Address of Lender Alan L. Goodhart Estate of George C. Goodhart N/A -CASH Lorelei H. Goodhart Carla M. Miller & Carol A. Walk, 399 Walnut Bottom Road k.xecutors Shippensburg, PA 17257 G. Property Location 401 Walnut Bottom Road, Shippensburg, PA 1'7257 H. Settlement Agenl Name, Address and Taxpayer Identi£cation Number Jce1 R. Zullinger 20 East Burd Street, Suite 6 Shippensbtug,PA 17257 251530888 Place of Settlement I. Settlement Date 20 East Burd Street, Shippensburg, PA 17257 1/26/2009 1G Summary of Seller's Transaction of Borrower's Transactions 100. Gross Amount Due From Borrower 400. Gross Amount Due To Seller 101. Contract sales price 130,000.00 401. Contract sales price 130,000.00 102. Personal Property 402. Personal Property __ 103. Settlement charges to borrower (line 1400) 2,166.00 403. _ _ . _ _ 104. 404. _ __ _ 105. 405. Adjustments for items paid by seller in advance Adjustments for items paid by seller in advance _ _ _ 106. City/town taxes to 406. City/town taxes to 107. County taxes to 407. County taxes to 108. Assessments to 408. Assessments [o 109. School Tax 01/26/09 to 06/30!09 514.71 409. School Tax 01/26/09 to 06/30/09 514.71 110. Garbage Fee 410. Garbage Fee ___. __ _. 111. 411. 112. 412. 120. Gross Amount Due From Borrower 132,680.71 420. Gross Amount Due To Seller 130,514.71 200. Amounts Paid By Or in Behalf Of Borrower 500. Reductions in Amount Due To Seller 201. Deposits or earnest money 501. Excess deposit (see instnlctions) 202. Principal amount of new loan(s) 502. Settlement charges to seller (line 1400) _ __ _ 1,300.00 203. Existing loan(s) taken subject [0 503. Existing loan(s) taken subject to 204. 504. Payoff of first mortgage loan 205. 505. Payoffofsecond mortgageloan 206. 506. _ __ 207. 507. 208. 508. - _. - - - 209. 509. Adjustments for items unpaid by seller Adjustments for items unpaid by seller 210. City/town taxes to 510. City/town taxes to 2ll. --- __ County taxes 01/01/09 to 01/26/09 17.69 511. - County taxes 01/01/09 to 01/26/09 17.69 212. Assessments to 512. Assessments to 213. School Tax to 513. School Tax to 214. 514. 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. 220. Total Paid By/For Borrower 17.69 520. Total Reduction Amount Due Seller 1,317.69 300. Cash At Settlement From/To Borrower 600. Cash At Settlement To/From Seller 301. Gross Amount due from borrower (line 120) 132,680.71 601. Gross Amount due to seller (tine 420) 130,514.71 302. Less amounts paid by/for borrower (line 220) ( 17.69 602. Less reductions in amt. due seller (line 520) ( 1,317.69) 303. Cash hl From ^ To Borrower $ 132,663.02 6Q3. Cash X^ To ^ From Seller $ 129,197.02 i have carefidly reviewed the fit1D-1 Settlement Stntemeat aad to the twat of my lmowledge and belief n is a tme aaa accurate smtemeat of au receipts m~ msoursements made oo my accom[ or try me is ~ transaction. l fi certify th t I have received a completed copy of pages 1 and 2 o s I-IUD-1 ettleroe to Qry / _ Borrower L. Goodhart eller la M. M'lley Exe or o eorge C. Goodhart Estate Borrows L relei H. Goodhatt Seller arol A. Walk, Executor of George C. Goodhart Estate SETTLEMENT AGENT CERTIFICATION Seller's Taxpayer Identification Number Solicitation and Certification The HUD-1 SeHlemmt autmmant which 1 have ~ar~d a taw end •rcumb emounl of this Uanaschon. I have You ere required M law to provide the Settlement Agent named above wish yttm norrtc[ taxpayer identification '~m~ad(~the,funds tab die ed' mor m wtpthr`tltis sutement mba. If you do nM provide the Settlanerrt A ant moth taxp dentifintion number, you may CI( ' , ^ ' .~~ O ~ ^ ~ ~ hownb aan this anwment ib mY wrt~°actlti~ mpoe~ Mficeti ~ num~~°ea o~' p~ury. I mortify that the number l.~(fl.l,( (~1 a p•Yxi Settlement A e [ Dale WARNQJG It u • crime to knowin I :make w sutemenu t Ne United ~SUtes on this or any oths similar form szoo~ io~o° CO°viwon tun inalu~e fitw.pd impri,onmani ror dnuih.se: riu.Ia u.s. cos. aamion tool .nd Seller's Signature Date II[ID - 1 3/91 RESPA, HB 4305.2 Page 2 700. Total SalesBroker's Commission based on $ @ % = 1 - ~ Paid From Borrower's Paid From Seller's - Division of Commission (line 700) as follows: __ - Funds at Puuds at _ 701, $ ~ [0 _ _ Settlement Settlement 702. $ --- to 703. Commission paid at Settlement _ _ 704. 800. Items Payable in Connection With Loan _ _ 80 L Loan Origination Fee % - 802. Loan Diswunt _ -- -_-_ _ 803. Appraisal Fee to -- - -- 804. Credit Report to 805. Lender's Inspection Fee to _ _ 806. Mortgage Insurance Application Fee to __ 807. Assumption Fee _ 808. Flood Certification Fee to: 809. 810. - _ _ 811. 900. Items Required By Lender To Be Paid In Advsnce __ 901. Interest from to @ $ /day 902. Mortgage Insurance Premium for months to __. --- - 903. Hazard Insurance Premium for yeazs to 904. 905. r nnn u.~...,.. n.....a:mn w:rr. r....n.r 1001. Hazard Insurance s (rb per 1002. Mortgage Insurance s (~ ~ per 1003. City property taxes s ~ per 1004. County property taxes s Per 1005. Annual assessments s ~. Per 1006. School Taxes s per 1007. s per 1008. A ate Reserve Adjustment ttnn Ttn. rt.ar..a 110 L Settlement or closing fee to - 1102. Abstract or title search [o 1103. Title examination to Action Real Estate Services, LLC 167.00 1104. Title insurance binder to _ 1105. Document preparation [o _ 1106. Notary's fees to 1107. Attorney's fees [o Joel R. Zullinger, Esquire (POC to Seller) 650.00 (includes aboveitems numbers: __ ) 1108. Title insurance [o (includes above items numbers: ) _ --- 1109. Lender's coverage $ 1110. Owner's coverage $ _ -___ _ _ - 1111. - 1112. 1113. 1400. Total Settlement Charges (enter on lines 103, Section J snd 502, Section K) 2,166.00 1,300.00 Initial Escrow Acrnuot Shtemeot Required by Sectioa 10 (t) (1) of the Resl Estate Settleroeot Procedures Act (RESPA) If checked, ~ the terms of your loan requve you to have an escrow account to assure that the certain obligations relating to the mortgaged property, such es taxes, insurance premiums and other charges are paid. The amount specified below will be collected, along with your mortgage principal and interest payments, during the £vst 12 months after your account is opened to pay these anticipated expenses: ~Aepq~, Begioaiog Date: Your escrow account payment will be $ per ___ Payee Purpose Aodcipated Due Dete Estimated Amount 1200. Government Recording and Transfer Charees 1201. Recording fees: Deed $ 39.00; Mortgage $ ;Releases $ 39.00 1202. City/county tax/stamps: Deed $ 1,300.00 ;Mortgage $ 1,300.00 0.00 1203. Slate tax/stamps: Deed $ 1,300.00 Mortgage $ 0.00 1,300.00 1204. UPI Tax Certification Fee to: Recorder of Deeds 10.00 1205. 1300. Additional Settlement Char es 1301. Survey to: 1302. Pest Inspection [o: 1303. - - - -------- I304. 1305. 1306. 1307. _--- 1308. - - -- - - 1309. HUD - 1 3/91 RESPA, IiB 4305.2 Historical Quotes: Charting Tools for Looking Up a Security's Exact Closing Price - BigC... Page 1 of 2 More [ ~~ ~~1i~~` A at firfott~ YOII'U PVEVER DtiIYE A GAR WITHUIJT t3RAKES. Hems ~ Duottss ~ Nsrrs ~ Mdustrias ; Marlcats ~ Hlsiorlcal tluotss BtDRoPorts, f ®AdvsnesdTools Prsmlum Products This Historical Quotes tool allows you to look up a security's exact closing price. Simply type in the symbol and a historical date to view a quote and mini chart for that security. ~~ Enter Symbol: HSY Enter Date: 6/4/2008 Hershey Co Wednesday, June 04, 2008 Closing Price: 38.60 open: 38.39 High: 38.80 I_ow: 38.22 volume: 1,138,100 Go To Charting ~~ ~ ~) No Splits 2-Month Daily Chart of Hershey Co Sponsored Links AARP Auto -Official Site Over 50? Save $363 On Auto Insurance. Start Saving! Free Quotes Now! aarp.thehartford.com DIRECTV -Official Site DIRECTV's Lowest Price Online: 150 channel Package for $29.99/mo (1yr) www.directv.com Buy Stocks for $4 No Account or Investment Minimums. No Inactivity Fees. Start Today! www.ShareBuilder.com Practice Forex Trading Start Trading With A Free $50,000 Demo Account. Play Before Pay! www.fxcm.com Learn more~bQUt_th~ next:.step.4eyond mutual funds http://bigcharts.marketwatch.com/historical/default.asp?detect=l &symbol=HSY&close_da... 1/22/2009 Historical Quotes: Charting Tools for Looking Up a Security's Exact Closing Price - BigC... Page 1 of 2 More f ~~ a ch• A service oCMriu~tl+ r~~W~n Hama 18uotas (Naxrs ~ Mduedrias ~ Maricarts ~ Historiral Quotes ~Roports ~ ®Adrareea~d3ools PreeeriomPrpduFts This Historical Quotes tool allows you to look up a security's exact closing price. Simply type in the symbol and a historical date to view a quote and mini chart for that security. ~-~ Enter Symbol: DAI Enter Date: 6/4/2008 Daimler Ag Wednesday, June 04, 2008 Closing Price: 73.02 Open: 72.68 H'gh: 73.61 how: 72.58 volume: 723,600 Go To Charting No Splits 2-Month Daily Chart of Daimler Ag Sponsored Links AARP Auto -Official Site Over 50? Save $363 On Auto Insurance. Start Saving! Free Quotes Now! aarp.thehartford.com Home Equity Loans Info Get Info on Home Equity Loans from 14 search engines in 1. www.info.com Government Grants (Free) Are you Eligible for Free Grants? Find out Now and Apply online! USGrantGuide.org Apply For Personal Loans Up To $15,000. Bad Credit OK. Apply Now. loans. www.CreditLoan.com Learn more about the neat step bey_on~ m..ut5~al funds 73,0 ~~ _ ; 11.70 http://bigcharts.marketwatch.com/historical/default.asp?detect=l &symbol=DAI&close_da... 1 /22/2009 Calculated Value of Your Paper Savings Bond(s) Calculated Value of Your Paper Savings Bond(s) Calculator Results for Redemption Date 06/2008 Page 1 of 1 Total Price Total Value Total Interest YTD Interest $1,012.50 $2,966.10 $1,953.60 $58.20 Bonds: 1-27 of 27 Serial # Series Denom Issue Next Final Issue Interest Interest Value Date Accrual Maturity Price Rate K55877520 EE $75 08/1987 08/2008 08/2017 $37.50 $69.27 ; 4.00% $106.77 K54366425 EE $75 06/1986 .12/2008 06/2016. $37.50 __ $88.50 . 4.00% $126.00 K75211966 EE $75 03/1988 09/2008' 03/2018. $37.50 $67.17 4.00% $104.67 K55876679 EE $75. 06/1987 12/2008'..06/2017 $37.50 $71.40 4.00% $108.90 K55864293 EE $75 04/1987 1.0/2008 04/2017 $37.50 $71.40 .4.00% $108.90 K75212683 EE $75 06/1988 12/2008 06/2018 $37.50. $67.17 4.00% $104.67 K70999052 EE $75 01/1988 07/2008! 01/2018 $37.50 $67.17 4.00% $104.67 K70999051 EE $75 01/1988 07/2008. 01/2018'. $37.50: $67.17 ' 4.00% $104.67 K55863408 EE $75 01/1987 07/2008 01/2017. $37.50 $71.40 4.00% $108.90 K55861313 EE $75 09/1986 '..09/2008'. 09/2016. $37.50 $86.04 '.. 4.00% $123.54 K70998243 EE $75 10/1987 .10/2008 10/2017 $37.50: $69.27 . 4.00% $106.77 K55863407 EE $75 01/1987 07/2008 01/2017 $37.50 $71.40 4.00% $108.90 K55877521 EE $75 08/1987 08/2008 08/2017. $37.50 $69.27 '. 4.00% $106.77 K55862208 EE $75 11/1986 11/2008 11/2016 $37.50 $73.56 4.00%_ $111.06 K75212682 EE $75 06/1988 .12/2008 06/2018 $37.50 $67.17 4.00% $.104.67 K55864294 EE $75 04/1987 ' 10/2008 04/2017. $37.50. $71.40 4.00% $108.90 K82085788 EE $75 10/1988 :10/2008 10/2018 $37.50' $65.10 4.00% $102.60 K70998244 EE $75 10/1987 10/2008 10/2017 $37.50 $69.27 4.00% $106.77 K82085099 EE $75 .08/1988 08/2008 08/2018 $37.50 $65.10 4.00% $102.60 K82085787 EE $75 10/1988 10/2008 10/2018 $37.50. $65.10 ', 4.00% $102.60 K53330981 EE $75 02/1986 08/2008 02/2016 $37.50 $88.50 4.00% $126.00 K55861314 EE $75 09/1986 09/2008 09/2016' $37.50: $86.04 .4.00% $123.54 K55862207 EE $75 11/1986 '.11/2008 11/2016 $37.50 $73.56 4.00% $111.06 K82085098 EE $75 08/1988 08/2008 08/2018 $37.50 $65.10 4.00% $102.60 K75211965 EE $75 03/1988 09/2008 03/2018 $37.50 $67.17 4.00% $104.67 K55876680 EE $75. 06/1987 ;12/2008 06/2017 $37.50 $71.40 , 4.00% $108.90 K53330982 EE $75 02/1986: 08/2008 02/2016 $37.50 $88.50 '... 4.00% $126.00 Totals for 27 Bonds, $1,012.50 $1,953.60 $2,966.10 Notes NI Not Issued NE Not eligible for payment P5 Includes. 3 month interest penal ty MA 'Matured and not earnin interest http://www.treasurydirect.gov/BC/SBCPrice 6/25/2008 _ _ ~.//'~` /~~ `1 ~-A~T THE MATURITY HEREOF WILL PAY ~r ~~ To ;a:ut<_t.7c. C vC~'i'3i-~:~~T ?')i-1~-~2~? ~~_ r. l<< f_ ~~~~ ~~RUMPN SERI~,S EE Ta [~~~ ~`~\JMPN ~ . s~Ri~s EE ~~~ ISSUE DATE WHICH IS THE FIRST DAY OF Fr ~ 1~_~' (MONTHI---_ --(YEAR)-- u ~"~ ~AVIr~;~ ;~~T X73-127 ,~ T" ~"°~s=°uE°TT°T"°~ ~~ E ~" qE° K 5 3 3 3 0 9 8 2 E E wns",xmorv &meq a{pe7 r~ rya ~~ ~ ~~~~~ AT THE MATURITY HEREOF WILL PAV ~~ G~Oii2~~ C t,OCIDNAKT 201-18-92b7 P O ~3GX 44 R R 2 SHIPPEhS?~Ut~t~ PA 17257 (3 CAR(]L A G~3C~OHAftT z04-52-4G 11 ISSUE DATE WHICH IS THE FIRST DAY OF U - S I~Ao1I~AA~6 5~~, ~i~Nt~S-LSSU~ AU:T ~~`~~3e=`~PL7' 17 'J.UL i 9.87 r X70 680 EE ~o~y~ w.s"~"coo" & lar~ a) tl. ?.~Lwy LA!~SY ~El' ~,~,_~~'~~~'~~~ '~.~~~:.~'~~~~~~~~, SERIES E a,~"EaE°Fw«Pa~ __ _____ _ ~" v~€~~~~ G t~uut)HA~T 2~1-13-~~e~7 MAl~~~ ~I~~sd ~' U DUX ~~ R ;~ ~ SNIPP~~JS3UK~ PA 17257 t~ ~~U~G~~"~~t(y'S r~CDtd~*5~~~~U:~ I ~~t :;,A~'~' 273-I;e 7 %~R~L A ~U~~iART 2;~If.-S~-~~~,~# :~~~`~tAY_,1:9~~ ,T-s~ ~ _ ___ ~` ,., , ~ ~ ~.:.~~~~ :. ~ ,. , .,,.v S2 5 E 119 6 E _ x:00009000 7:00 ,~-a 00 7 5 2 L X96 511' .. ~ ,~ ~ . ~~~!~~~~ ~:~~~~~,~ ~~~~'~~~~~a SERIES E E 2:~ 1 18 9~b7 =Ju 198 ~I ,~ ..._ , P ~ ~3i~X 4~ ~ ~ 2 SHI~PcNSBtlf~v P~ 1 7257 ~1'S S A VI~iii 5 , ; ~G ~ ~~{y~IJ ^~N~~1~ SGT - 2 T 3 12;7 I o@~ ~RQ '~ .~p [j ~ 2 JTC I~ r""T 988 Ala ~' \' CAi~L3L A G~~;3HA ~Y ~-- -- 2.Ci~t 52 4Q1i /y///~'~ ~ ~ ~~ / / K82085098EE ~ ~:000090007~:00 ~ ~' 00820 8509811' / ! ~:~ 9 AT THE MATURITY HEREOF WILL PAV ~j \y~,-/'"~ ~~ 1T~rT~i~ sl~~~~ C1 ISSUE DATE ~Y~:i''JV i~~~~J WHICH IS THE FIRST DAY OF Tii Ear:"L~ C L-~~~uN=;F I _ i' . i~ _: ~, u.4~' LL ~ ~.~ UJHia~' T C I DAl!IN~GTAM~ L Fri-'4-~~-4~1i ;.~ i.-C 14~r<, "~~u M AjM Aj.~ s~RlES EE .~ `~~~.wvE`.ro.~E. `""~ K 5 5 8 G 2 2 0 7 E E oE..a ~a. T ~,.~ s,~~..~ www~NCror+ &ne'n a/MT .7 ~„Ra ~ PI ....., v~ ~ -.. ~~i-/` ~~, ~ AT THE MATURITY HEREOF WILL PAY !/ _ 1 ., U L ,. UL A,. _. [~~r °~\UMAN s~:RiES EE .'_ ~ :'.~3.i ISSUE DATE WHICH IS THE FIRST DAY OF O L I--- ' Y R IM T H ( Ea 1 I ~ t_ I C , \ l . 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U S SAVINt~,S ~/A1k~T 2?3-~2;? ~~ ,` ___ , ., ~~ . ~~ ~~ ~`'`K82085099EE ~~ ~:000090007~:00 - ~ 008 ~0;85099~i' i .~~~ ~~~~=_~~~~<<~~~ SERIES EE EREOF w,ll RAY 2::1 1~ X207 33 1938. icJ~Zr'~ C i~C3JC3HARF gi~x~~~:r ~~~~~~,~~~~t~~~ ~c~~~~+~~:~°rc~~~,~~ SERIES EE Y HE0.EOF wl ~~ vqv n+in).4M.'~rb9Jin'^.t~ali~l.W R~1Mi.W1+#;IAdc.Lh T~ _---- v=~t+rCt ~:: ~uutil-ta§< t zU i-1rs-`iLt~ T G~'T i"t37 ~~ ~ R' ~ !} ~ ~ ~ 158UING AGENT'S SNIYr'Lt~a~i~t~ PR i7~.~7 1i ~ SdYdN6S _ ti,U Y3T~~g~`~ S ~'E ~K ~A~~ 273-1~7 i;Ai~UL t~ lilJ..,UhJiK~ c~i4-~~-4tt31 1C3 ~~-"~~fts~ . . ~,~- ` ° K~0998244EE x:00009000 7:00 ~ 00 70998 244ii' ~! ~G'~~~ ~~~~ ~~~.~~' a SERIES E E ~~'~~'~ .5~~~`Y~f~b~Y~Yt~ 7~r~~,~,~5; i 2~1 i~ 92b7 1C3 i~88 T.~ ~~~R~~ C i~~Clt3Nr~~ZT ---- ~' ~ tsl~ X 44 K ~t 2 SNIPPEtiScSt3t~~ PA i7Z57 ,~B~fD(~`~~~5U}~ ~~MV 6n ~P ~C~ _ fl i ~~~ i 9,~ 8 ~ ~t I CAR[lL A i~~J~i-iAiZF ' 234 52 4Q 11 `---- ~I ~~-- ~ , K82085988EE .~ ~ ~ ' ~.u0009000 7.00 ~ ~ 008 208 5 788n' ~~. ~ ,~~./`\/~-~,~ ~ AT THE MATURITY HEREOF WILL PAV ! f- '~J'+ ~~ ~~r~s)~~i~S~~CV `~ / wHCSSUEFDA of of = To !~' Ct~RGc G GC~%HART - _ - P ~ Bt7X 44 R R 2 ~' StIPPENSSURG PA 17257 C, fi C A RUL +~ GU C %~iAR T 2;)1-1¢-92F7 ?~4-52-411 IMONTHI-_-----l Y£4R APR,-'~ 1987 U ~ S 16~"n°~tit`I~ S ~~ B~' ~ ~.~~~,~~PU E ; ,A ~~T 2 7 3-12 ~ %7 `N'rL~Y 14$7 "'~\UMAN si:RIES EE ~~ .~o~==~~E~.TO.~E. 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J 1111n9~i l~l ~/,, I~ I AT THE MATURITY HEREOF WILL PAV - ~ /i ~,i ~15~.~TT~~iYa~A 1 ~ i~ ISSUE D A T E J ~1' S~~J~`~ WHICH IS THE FIRST DAY OF =_ _ TO ~/ SERIES EE IMDNTHI _ (YEAR) 1 165UINO AOENT~6 f i 7 i ~~'.. S ~ I ~ - ~ ;~-' S ~ U ' P r, 17 ~? 5 7 ~ I~, S a°:Sl~t ~T~d ~ S' ~~:iu5-I SS~3E Ca'C:t_ ~ ~Ui:?~>>i~fT ?'"'~-~~-+ 11 ?c, ~-~~ 1<:~7 TP .PO~=~NE~T,oTPE ,E~~ESof ~ K 5 5 8 v 3 4 0 7 E E oEP.P W~P~P~TOP ~.. s.,.'.,au~g ~~...~~I~'.~~~~~~~~~~~~~~~«~ SE~~ES EE ~~yy ~~~a((~~yy T gEPEOF W LL YnV __ ` f ._+ T. ----- +,3,;~{L~uc ~. ~uu~i,A~tt. Lui-1$-ytEs7 tI~1" l~i#37 i.+ i7 U X ~ ~ i1 71 ~ tSSVIHG AGENTS S#i1t'iJt~~'~r3uttto i?~ i?G'S7. I~j! S ~~~~I`*~yIPtlii~si1~ . ~ LF~J, ~IJT~~51 STS i/~~ ~~~I ~~ A~7 Z73-127 ~.Ai~t11. w isVuutillt~T tu4-.~~-4G11 143 U~C-~I~87 S _ ~~- , K~0998~43EE x:00009000 7:00 00 70998 24 311' ~~ /~i AT THE MATU RITV HEREOF WTI L,~L~PAV 'I E ~ I '~ `s' ' ~~.1~J~~ti~~s~~ ~~~~~~3 ISSUE D A T E WHICH IS THE FIRST DAY OF ~, ~ = TO _ __ 1. _ ~ ~I --3:'-, (-'. 7 '_ !_~ i i _. - `-' ^ 1= ; r; '__ L - ,~ - ~r ~I~NTI-II - _ }'~~n~1- ~, . ,.~.. I_ -~-, 17`7 S>.12/[~1"~v~ DATING STAMP `~9\ U M AN SL'RIES EE o.oA PM0i55U~"=Tq.P`. ~ y .`~`5 ~ ~; 5 5 8 61 313 E E W.SP~P~T~P s....I., ~,,, s ,, ,~¢ .~ . ,; :a AT THE MATURITY HEREOF WILL PAV ~~,~~~=1~~F~~~ I ~ji ~ ' ~ ~ ~ ISSUE D A T E ~~ ~i WHICH IS THE FIRST DAY OF ._.. Ta ~~ ~~~ ~AUMAN sLRi~s EE IMONTHI (YEARI ISSUING AQENT~S ~.~T ~27?=127 {'4'C;L a ~UL~u1A~T %''`<~-;?-4'` 11 ?c: FFt~' 1'37 oEr.A .~o~,wvERTpy~.. ~ .rE~-~F} ~ K ~~~ 6 3 4 0~ E E F~ ~~ ~~ ~i~~~~~ ~~~~~~~~~:~~, SERIES EE ~~. ~ EAEOF w i'~~-' rr~ '~j"~~'~,,,,'~~}~~~~.~~~~~t~.d ~, I~n(,(~~y~~ic1~,Z~1 ~ _ ,a :! E C` ,:, T E +0i ~ ~I _ s,,9 ~. r. i TSe.' . r.>a~ ot- 1 .ps -. ~ ;i 1 ~'~•; ~~- Tip E~iEG~ttiE C t~;I7~HARI' GOl-ls-5+267 JAN-_~~--'19f3t~ P G IiDX 44 It it 1. Sti IPPENSBiJ~G PA 2 7257 t1 Ste(©("j~~~f'$!~b'$ Q~ _ A~3' 273-1~.? CAFCCIL A v~t2VHAftT 1G4-5L-4t31~. 2ti~.F€#~; i988 -- -- •, >, w. ;; n s ,. ', ~; ~~-- K~0999051EE x:00009000 7:00 00 709990 5 L11' u "s ~~~,...~~~~~§~~~~~~~~~~~~~~~~r:cE~~, SERIES l~~ T.' CiEG#{ut G l~Lil`iGHAR~ ZQi-i6-9Zb7 JAAI-~" -198$ ~ G 8uX 4~ K K 2 SNIPP~I~Sd+~ii+~ PA 17257 U S=s`~9Y`tf'1i~t:~~ BU N~l.,~~ ~~SU>~ i1R A~7 273-1~? CARi~L A GOI7UNAR~ 2t74-5L-4011 ; 25'~E~t3; 1~3~~ ~~=~,- K10999052EE x:00009000 7:00 00 7099905 211' ~ ~~~~~~<., ~~~~I ~~~~~4~~~~ ~~3t~~~~~:1~~~~~~, SERIES EE ~~.~ ,~: aT~ .wIL _ _ _ I T• ~;cU~~~ C ~111~17UHART 2~1-18-9267 .lUtti" ----'188 P }7 I31JX 44 R R 2 SNIPPcN~~UR~ PA 1?2~7 ;U-(~ry;°'"S"A~Iy+N~S '1 L/V~STA~W ~~^~ 0~2 I~~T .273--27 ~~A}Zt'~}. ~ i~13~31If-iafS,T L'i:,tit'SZ"'~t{1~~ ~. ~'4-.,.~~~,."~~~~ ~, , ,. ~, ~s ~ ~ ;~ ~~ K~~ 5 212 b 8 3 E E ~~ . ,~ _ _ ~„ ,w,,.,.~.~.M x:0000 9000 7:00 ~ 00 7 5 2 L 268 311' ~, . , _ ~ ~ AT THE MATURITY HEREOF WILL PAV ~_ '~ To .~ >.` ~~ l"~~~SRvE C GGCii-TART Zed}-}Q-~2~7 F u aGX 44 R F 2 SrIPPEItiS3UFi~ PA 17257 CA~:L A GCiCi~t-APT ?«4-52-421 ~UMAN SL'RIES EE ISSUE DATE WHICH IS THE FIRST DAY OF (MONTMI ~ _ IYEARI-- APH-'~ 19~?,7 U^^ ~~' S IB~I~O~gE(yTfp S ~~, L' W ~ I~MINO61f~MP`~ *~- ~ AG'T 273-127 ~7 NtAY__LG~7 oE...~o~„~~ER~a.~E. TE~FS ~ ~ 5 ~~ ~ ~ j" 2 9 3 E E wnsxirtcraH &~ew~ e/tAe 7 w1 ~ f~~ ~~J AT THE MATURITY HEREOF WILL PAV T~ _= ~- v~ORO~ C ~U;JG~riART 201-18-`3Zti7 P 0 DUX 44 #~ P Z ~NiPPEPiSt3Ul~u PA 17257 r` +~J P, CARt3L A 1;U~7i.3i~AizT 204-~2-4011 ISSUE DATE WHICH IS THE FIRST DAY OF Jr~I TFI I _ - - 1 f~ V ~' U ~ S 16CbMOM4~N1f~Q S ~ B~JNDS-ISSUE 17 \'1111_ 19~? o- TA JM~AT SERIES EE .~ .~o~s,~vE~.,oTwE.E , , Eo~~.~Ea.~.~EREO, ~ 5 ~ 8 ? 6 6 7 ~ E E oE..A „A ~ ~...~.~ 5 ,P o,., ,..~ wnsNixcior~ Smeea~ o(eAr'7 .ry ~E~~r~~Y~~~liq~r~~ ~`~~~~i#~~~:~. ~~~~, SERIES EE _ __ _ __ __ _ Ti ~t_U~{~r~ ~ L~.~iJEi~N~T Lt~1-I:~-t72o7 k'~F~~ -__\1~t3d ' fSSUING AGENT 5 ~ SHIt'~~f~SidUS~+:~ ~A 1727 ~ S SAVItv~$ Ll~ A%T, Z73-1,27 C,AZil~ A GD~f~~iAkT 2134-52-4I;?li ` J~~'MAY_-~"986 ~: ~-= ~C~521196bEE x:00009000 7:00 -~ 00 7 5 2 L L966ii' ~~,A Tii ~- SERIES EE Tii .o. TA J_IPN sLRIES EE ,~ ~: ArrT~~THE MATURITY HEREOF WTI L~LVP~AV-~ + ~{ ~?ESN +(Ipr~y{,{~ ~~3~r_ ^~C`~P~r° ~~'~.l41'~~~t7 ~ wHICSSUHEFDAtDE of t{ ~ I MONTH I _ _ _ _ I vEAR l - - t ~SUWG .dEd t.~U '~ Ot~ ~GGT 2ry7?-127 C " F: C L ^, C C C G i- A ~ ? ., ~i; ~ : _ 4,.~ I i '~1 DV U LsT~R7 `J;C'. wnsxlxcTOH S anent' o/dc 7 ~ ~~ ~~ ~', AT THE MATURITY HEREOF WILL PAV 5~ ~~~ 425EE ISSUE DATE WHICH IS THE FIRST DAY OF (MONTHI---_ -_I YEARI Cit~:i'Cl~+= i, i~l.U%F-t~;}t~ l~l-lci-y~~7 AU,V 1567', IB9UIN0 AOENT'6 ~ is +'. LJ X st 4 n K ,L ~t~iYrchJtsLii~ i'A i7ta7 U 11~ a~y~.it~aaS, d~14p5-ISSU~~ K ftv~l ~~-.~-iL7 CA#+iiL ~ L,L1ui~Fir1K7 2u4-~2-jtsil 1u ~cP 19b7 r~ A~o=,~uE~T.oT~E,E F ~~~E.o ~ ~ " ~ ~ ~' ~' S ~ Ci E E ,>~ `()1 ocrnn wnsxirvclox wnv ~~ of t4e~i7 ~ ~~ ~a a~ Citizens Bank Account Number 6100800253 Account Title GEORGE C GOODHART Date O ened 4/1/1980 Account Type Checking Principal Balance as of DOD Interest from Last Posting to DOD $25176.46 $ .00 Account Balance as of DOD $25176.46 ~7TI, T~.,,,.o~~ *„ T1nTl $21.44 __ I I L I11LG1 GJl Lv iwi a~ CMtiaens Ban~C Account Number Account Title _ Date Opened _ Account Type Principal Balance as of DOD Interest from Last Posting to DOD Account Balance as of DOD YTD Interest to DOD 6140715520 GEORGE C GOODHART 6/13/1997 Time Deposits $20000.00 $49.58 $20049.58 $289.99 ~ ~~~ ~~ Account Number Account Title _ Date Opened Account Type Principal Balance as of DOD Interest from Last Posting to DOD Account Balance as of DOD YTD Interest to DOD 6140716268 GEORGE C GOODHART 7/ 11 / 1997 Time Deposits $21052.34 $21.46 $21073.80 $364.91 ~~ Citizens Bank.... Account Number Account Title Date Opened Account Type Principal Balance as of DOD Interest from bast Posting to DOD Account Balance as of DOD YTD Interest to DOD 6140754445 GEORGE C GOODHART 1 /7/2000 Time Deposits $12332.05 $1.18 $12333.23 $213.11 ~~ Citizens Bank Account Number 6140774853 Account Title GEORGE C GOODHART Date Opened Account Tye 9/12/2000 Time Deposits Principal Balance as of DOD $17937.97 Interest from Last Posting to DOD $15.84 Account Balance as of DOD $17953.81 YTD Interest to DOD $310.90 ~~ Citizens dank Account Number 6140852579 Account Title GEORGE C GOODHART ened Date O 1/11/2002 p pe Account T Time De osits y Principal Balance as of DOD $5989.76 Interest from Last Posting to DOD $12.81 Account Balance as of DOD $6002.57 YTD Interest to DOD $74.34 ~~ citizens Bank Account Number 6140852587 Account Title GEORGE C GOODHART Date Opened 1/11/2002 Account Type Time Deposits Principal Balance as of DOD $6011.29 Interest from Last Posting to DOD $14.90 Account Balance as of DOD $6026.19 YTD Interest to DOD $86.41 ~~~~ ~~~. Account Number 6140878160 Account Title GEORGE C GOODHART Date O ened 1 / 17/ 1991 Account Tye Time Deposits Principal Balance as of DOD $14500.00 Interest from Last Posting to DOD $29.04 Account Balance as of DOD $14529.04 YTD Interest to DOD $210.22 J Account Number 6252090310 Account Title GEORGE C GOODHART Date Opened 9/18/2007 Account Type Time Deposits Principal Balance as of DOD $6179.82 Interest from Last Posting to DOD $4.79 Account Balance as of DOD $6184.61 YTD Interest to DOD $107.18 ~.~ John F. Kohler, Jr. -Auctioneer II ((~~)) ~ ff ~ Final Settlement ~ z~ ~ ~ 3 ~~ ~~~- irs ~ Date .~ ~ % , Z Z-" Z~ ~~' ~f S~ Owner CSC' O~c.,~ ~: G ~ C~ 71~~+2. j C~S ?"/47c" ~2~~ ~1~2..~ L ~.t, A-"~,.~ Address ~~F,f rl?rl~ ~ ~.-~ ~~ ^ S. ~ ,~ ~~,_ ~ f~ ` ~ ~ 2..~ 7 r ~ Date of Sale ~ `_`ZC~' ~~ Sale Location G 1~"~~ l~i`~ ~ ~~~~°7~, L.. Auctioneer ~~ ~-~~ Clerk ~- Cashier Other --.__ PROCEEDS OF SALE : Cash ................... ~ I ~~ ~ ~ Z ~ -~ Checks ................. Other .............................................. Miscellaneous (see attached list) ............... Q Total Proceeds of Sale ................................................. a ~ LESS SELLER'S SALE EXPENSE Auctioneer s F'ee ......... . Other Seller's expenses advanced by auctioneer: Miscellaneous (see attached list) ............... ~ ~ Deduct Total Seller's Sale Expense .................................... ;_ ~ ~ ~ ~ 2 ~ .- Total Net Proceeds to Seller ........................................... S ~U I, (or we), the seller of goods, merchandise, and/or property sold at public auction on above date and location, acknowledge and accept this settlement of proceeds of sale. I (or we" agree to accept all responsibility for providing merchantable title to all goods, merchandise, and/or property sold, and for delivery of title to the purchaser. T (Date) (Au i near or Cashier's Signature) (Seller's Signature) (Seller's Signature) "~~ John F. Kohler, Jr. -Auctioneer Final Settlement Date ~ ~~ ~~ Z- ~ . (~ ~ Owner ~'~.~'~2-G ~' ~~ Cl(~'a ~In _~ ~"i ~,; i~.~ --, ~~ la-l.K ~~ ~i.A ~'Y (C~~ /L Address Z ~:~ Hr 1 ~ FI M 7"N C l~-~ ~~ ~-- S F~ 1 ~~ ~; fU S ~~ +~-(`, I~i4 I `~ ~. ~'~ ~ Date of Sale ~ f ' ~ ~ ~ 1 ~' Sale Location ~ i4-TZ~ s ~ ~ ~ ~~~~~, C irC Auctioneer ~ t~`'~- I,i~~. Clerk ~~w ~ Cashier-~ ~--i~~ Other PROCEEDS OF SALE: Cash ................... ~ _ , `J q~-- ''~ Checks ................ . Other .............................................. Miscellaneous (see attached list) ............... ~~ Total Proceeds of Sale ................................................. S ~ ~ ~° _ LESS SELLER'S SALE EXPENSE :~~ ~ ~ Auctioneer's Fee .........~.~,,,,,,,,,,,,,,,,,~ ~ (~ -- Other Seller's expenses advanced by auctioneer: C1< Miscellaneous (see attached list) ............... Deduct Total Seller''s Sale Expense .................................... ; Z, 3~'` , Total Net Proceeds to Seller ........................................... a 2 ----- I, (or we), the seller of goods, merchandise, and/or property sold at public auction on above date and location, acknowledge and accept this settlement of proceeds of sale. I for wel agree to accept all responsibility for providing merchantable title to all goods, merchandise, and/or property sold, and for delivery of title to the purchaser. t Seller's Signature ) (Seller's Signature) rd Time ~w L AL\Al~lS eC1LY1G1tLCA July 11, 2008 Joel R Zullinger Via Facsimile 1-717-264-1884 RE: Annuity Number 26235776 Dear Joel R Zullinger: Transamerica Life Insnraace Company 4333 F.dgewood Road 1VE 1?O Box 3183 Cedar Rapids, Io~ra 52406-3183 Thank you for the recent inquiry on the above listed non-qualified annuity for Frances L Goodhart (Deceased} and George C Goodhart (Deceased). This policy was opened on March 31, 2000 and was the only policy with Transamerica Life Insurance Company held by either Frances L Goodhart or George C Goodhart. Our records indicate the following beneficiary information for this annuity: Primary Beneficiaries: Carla M Miller Carol A ln7alk Contingent Beneficiary: None Listed As of June 4, 2008, the date of death for George C Goodhart, the fu11- accumulated value was $48,878.08. The following is the Pre-Tefra and Post Tefra information for this annuity: Pre-Tefra Principal: $ 0.00 Post Tefra Principal: $35,000.00 Tax Deferred Interest Earned as of: June 4, 2008 $13,878.°08: Full Accumulated Value as of: June 4, 2008 ~$48,878.Q8~ Transamerica Life Insurance Company is a member of the Insurance Marketplace Standards Association (IMSA), an organization committed to high ethical marketplace standards in the sale and service of individual life insurance and annuities. M`mb" °fReceived Time Jul, ll. 3:02PM . •