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Home My WebLink About03-09-09-~ REV-1 SOO 1505607120 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue courriy coda rear File Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO 60X.280601 Harrisburg, PA 17128-0601 RESIDENT DECEDENT 21 0 8 0 0 7 3 8 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 207303132 06302008 12021939 Decedent's Last Name Suffix Decedent's First Name MI RICRERT KATHRYN M (ff 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 INAPPROPRIATE OVALS BELOW ® 1. Original Return ^ 2. Supplemental Retum ^ 3. Remainder Retum (date of death prior to 12-13-82) ^ 4. Limited Estate ^ qa, Future Interest Compromise ^ 5. Federal Estate Tax Retum Required (date of death after 12-12-82) ® g Decedent Died Testate ^ ~ Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes (Attach Copy of waq (Attach Copy of Trust) ^ 9. Litigation Proceeds Received ^ 10. Spousal Poverty Credn (date of death 11. Election to tax under Sec. 9113(A) between 12-31 ~J1 and i-1-95) ^ (Attach SCh. O) ,C,ORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Nname Daytime Telephone Number THOMAS P . GACRI 71723700 ~ _-;~ Firm Name (ff Applicable) ECRERT SEAMANS CHERIN & MELLOTT, LLC First line of address 213 MARKET STREET Second line of address 8TH FLOOR City or Post Office HARRISBURG State 21P Code PA 17101 - w = I,. 7 r -~ _. ~ REGISTER OFFS USE~ILY ~` j , t -- ~7 ~D - ':: „ , .. - _i f~ - ':>= W DATE FILED ,~ ~~~ _~_) t_i t..~~ i_7 c`-7 -=7 ..'I..1 c.' rs-t ~ r _, Correspondent'se~-mail address: tgacki@eckertseamans.com Under penalties of perjury, I dedare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, R is true, correct and complete. DeGaretion of preparer other than the personal representative Is based on all information of which preparer has any knowledge. ~,~r Spcott L. Rickeyrt ~ y ADDRESS f~ ~ _. 01`L~ % ~ r (. r~C/t..J~ ~ /~7 4 Cromwell curt Mechanicsburg~A X7050 SIGNA~OF P~tEPARE@~07fiE REPRESENTATIVE ,..rte Thomas P. Gacki ~ lj ~ Z ~ (} 213 Market Street, Harrisburg, PA 17101 Side 1 1505607120 1505607120 J REV-1500 EX 1505607220 oeoeaenrsName: RICKERT, KATHRYN M RECAPITULATION 1. Real Estate (Schedule A) .......................................................................................... 1. 2. Stocks and Bonds (Schedule B) ............................................................................... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C).......... 3. 4. Mortgages & Notes Receivable (Schedule D) .......................................................... 4. 5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ................ 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ............. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ^ Separate Billing Requested ............. 7. 8. Total Gross Assets (total Lines 1-7) ....................................................................... 8. 9. Funeral Expenses & Administrative Costs (Schedule H) ......................................... 9. 10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I) ................................ 10. 11. Total Deductions (total Lines 9 & 10) ...................................................................... 11. 12. Net Value of Estate (Line 8 minus Line 11) ............................................................. 12. 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ................................................. 13, 14. Net Value Subject to Tax (Line 12 minus Line 13) ............................................... .. 14. TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .00 15. 16. Amount of Line 14 taxable at lineal rate X .045 6 3 4, 2 2 2. 4 3 16. 17. Amount of Line 14 taxable at sibling rate X ,12 17. 18. Amount of Line 14 taxable at collateral rate X .15 18. 19. Tax Due ..................................................................................................................... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Decedent's Social Security Number 207303132 143,000.00 63,186.99 104,934.89 82,210.65 285,408.62 678,741.15 44,017.92 500.80 44,518.72 634,222.43 634,222.43 28,540.01 28,540.01 Side 2 1505607220 1505607220 REV-1500 EX Page 3 File Number 21 - 08 - 00738 Decedent's Complete Address: Rickert, Kathryn M STREET ADDRESS 1295 Strafford Road ------ - - ----- .--- --- __ - ---- ...--------------- CITY - - - -_ __... _ - -- - - ;STATE _ ,ZIP Camp Hill PA 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) 28,540.01 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments 28,200.00 C. Discount 1 427.00 Total Credits (A + E~ + C) (2) 29,627.00 3. Interest/Penalty if applicable - -- --- p. Interest E. Penalty Total Interest/Penaky (D + E) (3) 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) 1 , 0 86.9 9 Check box on Page 2 Line 20 to request arefund -- --- -- - 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) - -- -- - - A. Enter the interest on the tax due. (5A) - B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) ~ . Make Check Payable to: REGISTER OF W1LLS, 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 :.................................... '~~ J ~ x c. retain a reversionary interest; or .................................................................................................................. J I x I 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? ....................................................................................................................... ~I I x' 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... '-I ~, z~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ...................................................................................................................... U' 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 exemot 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 Juy 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 (O) percent [72 P.S. §9116 (a) (1.:t)]. 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 (?I2) percent [72 P.S. §9116 (a) (1.3)]. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. SCHEDULE A REAL ESTATE caanoNwEUTH ov aENNSVI.vnNw INHERRANCE TFU( RETURN '. RESIDENT DECEDENT j ' FILE NUMBER ESTATE OF Rickert, Kathryn M 21 - 08 - 0038 All real property owned solely or as a tenant in common must be re orted at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a wilting seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on schedule F. ITEM DESCRIPTION VALUE AT DATE OF NUMBER DEATH 1 1295 Strafford Road, Lower Allen Township, Cumberland County (Sale Price) 143,000.00 I TOTAL (Also enter on Line 1, Recapitulation) ~ 143,000.00 ' SCHEDULE B STOCKS 8~ BONDS ~ ~ COAMgNNIFALTN OF PENNSYLVANIA ' INNERRANCE TA%RETURN ~ I ~, RESIDENT DECEDENT ~, _-__- _-___-_ -_- _- __.__. _ -.____. ~.-______... _ _. __- - _- - __ ____ _ - _.-_. _.__- _ . - _. - _ -___.-1-_-- __.. _ _ __ _. -_ i _--_-_ FILE NUMBER ESTATE OF Rickert, Kathryn M ~i 21 - 08 - 00738 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM DESCRIPTION NUMBER ' UNIT VALUE VALUE AT DATE OF DEATH 1 264 Shares Snap On (SNA) _---- --- 13,730.64 2 ' S6 Shares Tenneco Automotive (TEN) 757.68 3 '' 280 Shares Pactiv (PTV) ' 5,829.60 4 52 Shares EI Paso Corp. (EPG) ', 216.84 5 207 Shares Alcatel Lucent (ALU) 1,250.28 6 60 Shares LSI Corp (LSI) 368.40 7 98.303 Shares Merck (MRK) 3,705.04 8:59.707 Shares Eli Lllly (LLY) ', 2,756.08 9 303.174 Shares American Century Growth Fund (TWCGX) 7,297.40 10 333.652 Shares American Century Ultra Fund (TWCUX) ' 7,223.57 11 614.501 Shares American Heritage Fund (TWHIX) 12,486.66 12 ', 219.971 Shares Wells Fargo Adv Opportunity Inv 7,564.80 TOTAL (Also enter on line 2, Recapitulation) ', 63,186.99 SCHEDULE E CASH, BANK DEPOSITS, 8~ MISC. COMfYpNWEALTN DF PE"NSVLVANIA ~ PERSONAL PROPERTY INNERRANCE TAX RETURN '. RESIDENT DECEDENT ESTATE OF Rickert Kathryn M FILE NUMBER , 21 - 08 - 00738 InGude the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. - - -- ITEM NUMBER _ .. _ - DESCRIPTION _ __.- _- VALUE AT DATE OF DEATH 1 PSECU Regular Share Account 5.18 2 PSECU Checking 9,198.50 3 PSECU Money Market 11,640.70 4 PSECU CD ID 51 10,400.87 5 PSECU CD ID 54 19,077.89 6 PSECU ID 56 38,845.90 7 Miscellaneous Personal Property 1,000.00 8 2005 Honda CR-V 14,000.00 9 Reimbursement of County Taxes at Settlement 66.43 10 Reimbursement of School Taxes at Settlement 653.77 11 Reimbursement of Sewer/Refuse at Settlement 45.65 TOTAL (Also enter on Line 5, Recapitulation) ~ 104,934.89 SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT - -- - - - - ESTATE OF Rickert, Kathryn M FILE NUMBER 21 - 08 - 00738 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT Scott Rickert 4 Cromwell Court Son A Mechanicsburg, PA 17050 Bret Rickert 5 Linden Court Son g Carlisle, PA 17013 JOINTLY OWNED PROPERTY: ITEM LETTER ~ - --- ---- DATE -- _-_ ___ ~~ I TPRC I~.O~C~F PRO~ERTkY T---- _ _ -- Ilnclude name o manaal Ins I u wn an ban account number ~ DATE OF DEATH - ------- % OF - -- DATE OF DEATH NUMBER -- - - 'FOR JOINT ~ TENANT -}- --- - MADE JOINT --- ---- for similar identi in number. Attach deed for'olntl -held real ~ 9 I Y testate. - _ _ - - ----- -- __ - ~ VALUE! OF ASSET . DECD'S INTEREST' __ __ ---- --- - - -- -- - - VALUE OF DECEDENT's INTEREST -- 1 A,B ' > 1 ear y PSECU Re ular Shares Acct 9 , 'I 5.18 33.3% ' --- 1.73 2 A,B i > 1 year ;PSECU CD 50 ', ', 16,915.92 ', I 33.3% 5,638.08 3 A,B ~ > 1 year ~, PSECU CD 53 I 25,269.28 '. 33.3% 8,422.25 4 A,B > 1 year PSECU CD 55 ~i2,560.08 ! 33.3% 17,518.27 5 B !~ > 1 year PSECU Regular Share Acct 5.18 50% 2.59 6 A > 1 year PSECU Regular Share Acct 5.18 ~~ 50% 2.59 7 B ! > 1 year PSECU CD 51 ', 4,842.60 50% 2,421.30 8 ', A i > 1 year 'PSECU CD 51 ' 4,842.60 ' S0% 2,421.30 9 B I I > 1 year ',~ PSECU CD 52 '~ 10,228.04 50% 5,114.02 10 A ! > 1 year PSECU CD 52 ~ 10,228.04 ' S0% ' 5,114.02 11 ' B ', > 1 year 'PSECU CD 53 ~ 21,959.53 50% 10,979.77 12 A > 1 year PSECU CD 53 2:1,959.53 50% 10,979.77 I TOTAL (Also enter on lin e 6, Recapitulation) 82,210.65 SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN COt7tI h U@CI RESIDENT DECEDENT ESTATE OF Rickert, Kathryn M FILE NUMBER 21 - 08 - 00738 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. JOINTLY OWNED PROPERTY DESCRIPTION OF PROPERTY ITEM FORTJOINT' MADE Include name of finanaal institution and bank account number r'~ ilar identif in number Attach deed for jointl -held real N MBER DATE OF DEATH I DE~CDFS DAVAOU O TH y g . y U a e TENANT ~ JOINT e -- --T- -~- ____ ...-- _ -- - - - - __ _ VALUE: OF ASSET iINTEREST'DECEDENTS INTEREST _ -------- _-- _--------- -- 13 B > 1 year PSECU CD 54 13,594.95 50% ! 6,797.48 14 ' A '~, > 1 year I PSECU CD 54 13,594.95 50% ' 6,797.48 i I I i I I , i i i i '; ~, Page 2 of Schedule F COMMONWEALTH OF PENNSYLVANIA SCHEDULE G INHERITANCE TAX RETURN INTER-VIVOS TRANSFERS ~ RESIDENT DECEDENT MISC. NON-PROBATE PROPERTY ESTATE OF Rickert, Kathryn M :FILE NUMBER 21 - 08 - 00738 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes. ITEM DESCRIPTION OF PROPERTY DATE OF DEATH % OF EXCLUSION NUMBER Indude the name of the transferee, their relationship to decedent VALUE OF ASSET DECD'S (IF APPLICABLE) TAXABLE VALUE and the date of transfer. Attach a copy of the deed for real estate. INTEREST 1 State Pension Distribution to Scott Rickert 145,704.31 10000% ~ 3,000.00 142,704.31 2 State Pension Distribution to Bret Rickert 145,704.31 ~ 10000% 3,000.00 142,704.31 i ~~ I ', I I ~I '~ i ~ ~ I ---- - - TOTAL (Also enter on line 7, Recapitulation) 285,408.62 SCF'EDU.F H CONMONWFALTH OF PENNSYLVANIA ~ r~~ INHERRANCE TAX RETURN e~A~T{~e~/~ RESIDENT DECEDENT rv~-w~ w ~ ~ r~ ~ ~ ~ r. FILE NUMBER ESTATE OF Rickert, Kathryn M 21 - 08 - 00738 Debts of decedent must be reported on Schedule I. NUM ER ;FUNERAL EXPENSES: DESCRIPTION AMOUNT _ _ _ __ - -- -_ _- --- -----L----- -- . - A. 1 'Funeral Service 5,595.00 i 2 'Cedar casket 3,195.00 3 'Steel vault ii 1,345.00 4 ~' Grave opening II 725.00 5 ;Miscellaneous including hairdresser, cemetery equipment, clergy honorarium, casket ' 5,125.34 flowers, stationary set, family meal ($625.34) and gravestone ($3,800) B. ADMINISTRATIVE COSTS: L Personal Representative's Commissions ~'I Social Security Number(s) / EIN Number of Personal Representative(s): ~'i I Street Address ' City State Zip Year(s) Commission paid '~ 2. Attorney's Fees Eckert Seamans ~i, 10,000.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant i Street Address City State Zip Relationship of Claimant to Decedent ~I a. ! Probate Fees Register of Wills of Cumberland County ~I 450.00 5. ~ Accountant's Fees ~ 6. ' Tax Retum Preparer's Fees 7. Other Administrative Costs 1 ~ Seller Assist paid at closing ~ 5,500.00 '~ TOTAL (Also enter on line 9, Recapitulatian) 44,017.92 Schedule H ~~ ~ """' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ~'~~~~"~~ ~'~ RESIDENT DECEDENT -- ESTATE OF Rickert, Kathryn M -- __- -- _-- 'FILE NUMBER 21 - 08 - 00738 2 Real Estate Commission paid at closing 7,150.00 3 Notary Fee at closing 5.00 4 Deed preparation for closing 115.00 5 Transaction fee for closing 195.00 6 Transfer tax at closing 1,430.00 7 'School tax paid at closing ! 1,146.24 8 Tax certification at closing ! 5.00 9 Sewer/Water paid at closing 96.25 10 Death notice 326.12 11 35 death certificates 210.00 12 PPL 117.61 13 PPL I 112.53 14 PPL 70.40 15 PPL 119.64 I 16 ', PPL 124.33 17 Pennsylvania American Water 13.50 18 Pennsylvania American Water 12.82 19 Pennsylvania American Water 12.99 20 '~ Pennsylvania American Water ' ~' 13.69 i I Page 2 of Schedule H Schedule H ~~ ~ """' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ~'~' ~~S'a"~ ~'~ RESIDENT DECEDENT __ ESTATE OF Rickert, Kathryn M _- - - -- FILE NUMBER 21 - 08 - 00738 21 Pennsylvania American Water 4.51 22 UGI 13.64 23 UGI 25.86 24 UGI 11.99 25 UGI 11.99 26 UGI 38.94 27 Sewer/Trash ~ 87.50 28 Sewer/Trash 87.50 29 '~ AT & T 2.53 30 ~ Scott Bendinsky--House Clean out fee ' 300.00 31 'Charles Weller-grass cutting 222.00 SCHEDULEI DEBTS OF DECEDENT, MORTGAGE CDI~.MONWEALTN DF PENNSYLVANIA '. LIABILITIES & LIENS INHERRANCE TA% RETURN ~ RESIDENT DECEDENT ESTATE OF Rickert, Kathryn M Include unreimbursed medical expenses. ITEM -- ---- NUMBER 1 PPL June 2008 Bill 2 Verizon 3 PA American Water June 2008 bill 4 East Penn Ambulance 5 Susquehanna Twp. EMS 6 Health Network Labs 7 MCHS Camp Hill 8 MCHS Camp Hill DESCRIPTION FILE NUMBER 21 - 08 - 00738 AMOUNT 127.84 168.56 12.02 58.00 40.00 28.38 27.00 39.00 TOTAL (Also enter on Line 10, Recapitulation) ~ 500.80 ~ttsk t11 tt~r ~~e~t~rKent OF KATHRYN M. RICKERT BE IT REMEMBERED, that I, KATHRYN M. RICKERT, of 1295 Strafford Road, Camp Hill, Lower Allen Township, Cumberland County, Pennsylvania, being of sound mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making null and void any and all Wills and Testaments and writings in the nature thereof made by me at any time heretofore. ITEM 1: I direct that all my just debts and fimeral expenses be paid as soon after my demise as may be convenient. ITEM 2: I give the sum of Ten Thousand Dollars ($10,000.00) to my grandson, SPENCER L. RICKERT, and I appoint my son, Scott L. Rickert, as Financial Guazdian thereof. TI EM 3; I give the sum of Ten Thousand Dollazs ($10,000.00) to my granddaughter, LEXI E. RICKERT, and I appoint my son, Bret M. Rickert, as Financial LC~'lA Guazdian thereof. S~~e6 ITEM 4; I give the sum of Ten Thousand Dollazs ($10,000.00) to each of my natural grandchildren hereafter bom, and appoint their parent to be the Financial Guazdian of this bequest. ITEM 5: All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate, whether it be real, personal or mixed, including property over which I have a power of appointment, I give, devise anti bequeath unto my two sons, SCOTT L. RICKERT and BRET M. RICKERT, in equal shazes per stirpes. In the WITNESS: KATH M. RICKERT event either of my sons do not survive me, then their share shall be given to their children, less the Ten Thousand Dollazs ($10,000.00) bequest as set forth above, with their mother designated as financial guazdian if my grandchildren aze under age eighteen (18). ITEM 6: In the event that I am not survived by my sons, or any grandchildren, I then give, devise and bequeath my entire residuary estate unto BROTHERS and SISTERS, who are living at the time of my demise. ITEM 7: I direct my hereinafter named Co-Executors to pay all inheritance, estate, succession and legacy taxes of whatsoever nature and kind, to which my estate or the transfer of any property passing hereunder or otherwise passing by reason of my demise, may be subject and to chazge such taxes against my residuary estate, it being my intention that none of the aforesaid taxes, either federal or state, on any property required to be included in my gross estate, under the provisions of any state or federal law now in force or hereafter enacted, shall be prorated among the persons interested in my estate to whom such property is or may be transferred or to whom any benefit accrues. ITEM g; I appoint my two sons, SCOTT L. RICKERT and BRET M. RICKERT, as Co-Executors of this my Last Will and Testament. ITEM 9; I direct that my Co-Executors, Guardians, or their successor shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set m;y hand and seal thisday of February, 2004. WITNESS: ~, KATHRYN M. RICKERT COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF YORK We, KATHRYN M. RICKERT, JAN M. WILEY, ESQUIRE and LINDSAY M. STRATHMEYER, the Testatrix and the witnesses respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and Testament and that she had signed willingly (or willingly directed another to sign for her), and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the; presence and hearing of the Testatrix, signed this Last Will and Testament as witness and that to the best of their knowledge the Testatrix was at the time eighteen (18) years of age or older, of sound mind and under no constraint or undue influence. ~~71-,ti;~,~. --a- THRYN M. RI•CK'ERT w~ _ C..~J ~JL-, SS SS Sworn to and subscribed before me this,~~ay of February, 2004. NOTARY PUBLIC MY COMMISSION EXPIRES: $ t~l ,~~Mofary Pic dIHRMee on 6q~lres May 1y, 2005 n..iWef, P6MByh/a111gA9~dedOnofNOterles Notarial Seal S. Dawn GladfeRer, Notary Public Oillstwrg Boro, York Cour~rttyy My Commission Expires May t], 2005 Member, PermsylvanaASSOCiaUOnafNotaries OIIB NO. 2502-0265 A. B. TYPE OF LOAN: DEPARTMENT OF HOUSING & URBAN DEVELOPMENT U S 1.QFHA 2.QFmHA 3. QX CONV. UNINS. 4.~VA S.QCONV. INS. . . SETTLEMENT STATEMENT 6. FILE NUMBER: °~97 7. LOAN NUMBER: ~~ 8. M O~~~GwE INS CASE NUMBER: $~ MORTGAGE INS CASE NUMBER: C. NOTE: This favor la fumished fo plus you a statement ofactual setdsrnart costs. Amounts paid !o end by qre as(tlemsnt agent aro dawn. llama marked '[POCr were paid oufalds the doslrrg; dray ero shown here kx hrfomradonal purposes end are not induded kr dre totals, 1.0 ~ (BE000w,lONN.PFtJa6darQ D. NAME AND ADDRESS OF BORROWER: Joan Beddow 1295 Strafford Road Camp Hlll, PA 17011 E. NAME AND ADDRESS OF S LLER: Fatale of Kathryn M. Rlckart F. NAME AND ADDRESS OF LENDFJt: Susquehanna Bank 4185 W. Market Street York, PA 17408 G. PROPERTY LOCATION: 1295 StroHord Road Camp HiM, PA 17011 H. SETTLEMENT AGENT: 25-1857112 Mklstate Abstract Company 1. SETTLEMENT DATE: November 14 2008 Cumberland County, PenrrayNania PLACE OF SETTLEMENT 2331 Merkel Street Camp HIII, PA 17011 , J. SUMMARY OF R'8 CTION K SUMMARY OF 8ELLER'S TRANSACTION 100. GR098 AMOUNT DUE FROM BORROWER: .GROSS AMOUNT' DUE TO SELLER: 101. ConbaG Sales PAae 143 000.00 401, Contact Saba Ptke 143 000.00 102. Personal P 402. Personal P 103. Settlement Char to Borrower ne 1400 4 518.38 403. 104. 404. 105. 405. A 'uatrnents For Ibms Paid 8 Sepsln advenr~ uatrneMs For l6sma Paid Ssdsrln advance 106, C /Town Texoa b 408. C /f own Taxes to 107. Coun Taxes 11/14/08 b 01/01!09 66.43 407. Coun Taxes 11/14/08 to 01/01/09 88.43 108. School Taxes 11/14/08 to 07!01/09 653.77 408. School Taxes 11/14108 to 07N1I08 853.77 109. 4th Qtr. 3ewerlRehne 11/14108 to 01 1/09 45.66 409. 4th Qtr. SewslRefuse 11/14!'08 l0 01/01/08 45.85 110. 410. 111. 411. 112. 412. 120. GROSS AMOUNT DUE FROM BORROWER 148282.23 420. GROSS AMOUNT DUE lU SELLER 143,785.85 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 8110. REDUCTIONS IN AMOUNT DUE TO SELLER: 201. Do 8 or eameat 5000.00 801. Exoesa t See Iralrudbns 202. Pain ' I Amount of New Loa a 93 000.00 602. Settlement Cha es to 8er Line 1400 10147.49 203. Exist) loan s taken su act to 503. ban a taken au act to 204. 504. Pa of ikat Mo a 205. . P o sewn a 208. 608. 207. 507. diab. es rooaeda 208. 505. 209. Seller Aasbt 5500.00 509. SeNar Aaslst 5500.00 A abnenfa For Items U S Seder For I(ems U 8 Seger 210. C /Town Taxes to 510. C /Town Taxes to 211, Cou Taxes to 511. Coun Taxes to 212. SchoolTaxea to 512. School Taxes to 213. 513. 214. 514. 215. 518, 218. 518. 217. 517. 218. b18. 219. 519. 220. TOTAL PAfD 8Y/FOR BORROWER 103,500.00 520. TOTAL RE'DUC710N AMOUNT DUE SELLER 15,647.48 300. CASH AT SETTLEMENT FROMRO BORROWER; 800. CASH AT SETTLEMENT TOIFROM BEt.LER: 301. Gross Amount Due From Borrower Line 120 148 282.23 801. Gross Amount Due To Ibr Llna 420 143 785.85 302. Lass Amount Pakl B /For Borrows ins 220 ( 103 500.00 802. Lest Redudbna Due Soler ne 520 ( 15 647.4 303. CASH (X FROM) ( TO) t30RROWER 44,782.23 803. CASH(X TO) ( FROM) SELLER 128,118.38 The undersigned hereby ~knowbdge receipt of a compbted copy of pages itk2 of this statement & any aEtachmenta roferred to herein. eorcowa ~ Soler - V o Bs ow eta thryn . Ridcerl PaW 4 , ,i'' L. BETTLEMEM' CHAROE8 .TOTAL COMMISSION Baasd On Prks 143 DDD DD 5.0000 X i' 160.00 PAp FROM PAR) FROM Dhd as a: eoRROwEas sa~ER•s Ot. 9,600.00 10 sell ilJfa)6 AT FUnDa AT ,66D.00 10 Rea 80 ales SErnEMFM 6E1'TLEAIENr mm n al nt ,150.00 0 000.11'EA118 PAYABLE IN CONNECTION SlYtilt LOAN 801. Loan Inalbn Fee X to 802. loan Dbcount X to hat Fes to bal Se ces P C: B 5350.00 -25.00 K to adopt Data : B 25.00 _ - 4. 7 805. !-ender'a I n ee to 808, a Ina. .Fee to 807. ee to 808. 809, Tax Service Fee to Tax Service Provider see 89.00 810. 811. 812. 813. Flood Fee to Flral Amedcan Ss 18.00 8i4. Commttrnent Fee to BPA (nc. LMC LP F C tees 595.00 815, ee to 018. 817. 81 . 819. 820. t i00. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest From 11/14108 to 12101A08 0 15.924700/d 17 d %) 270.72 80 . o nsuranae rom mon 8113. Hazard Insurance Promium for 1.0 an to Erb Insurance POC:B384.00 904. 905. 1 000. RESERVE8 DEPOSITED WITH LENDER 1001. Hazard irrourance 3.000 month 32.00 month ~~ 98.00 1002. Mo Inwronce ~ months ; r month 1003. C /Town Texas months r month 1D04. Coon Taxes 10.000 months 41.41 r month 414.10 1005. School Taxes 8.000 months ; 86.84 r moth 521.04 1008. mon r 1008, b Ad usfinent months r month -453,84 1100. TIRE CHAROI"s8 1 101. Settlement or Cbakl Fee to 1 102. Abstractor Tills Search to 1103. TIIb Exam to 1104. Tito Inwronce likrder to 1105. Ebdronk Dorxanent P to Mklatate Abstract Coma 8p.00 1108. Clod Service Letter to Midstab Abatrod Coma 35.00 1107. Attom s Fees to Hs m nom ra: _ 1 b 1 u CT Rshsu Includes above Nam numbera.1102 1103 61104 1 1 . Le a Cove ; ,000.00 1 110. r'e overage ; 43,1100.00 986.38 1 11. En emerds 1 ,300, 8.1 to to 150, 1 1 .Note ~ to to Com 10.00 1 113. Note Fee to tract 5,00 14. em ht Few 6 Hand to Idslale attest Com - 18,00 1 15. Wks Transfer Fee to Mldatate Abetted Com n 10,Dp 1 18. Deed ro to A tad LLC 115.OD 1 117. Transa on Fee to R a S,OD 1 118. Tranaedlon ee to RFIMAX A-1 Rarhy 195.00 1 200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1 1 201. Recordl Fees: Deed i 50.60; Mo ; 78.50; Rebores ; 202. CI ou Tax/Stam • Deed 1 0. ~ Mort a 129.00 1 1 203. Stale Tex/Stam Deed 1430.00; Mort 1430.00 1 204. 1 205. 1 500. ADDMONAL SETTLEMENT CHAROE8 1 301. Surve to 1 302. Pest Ina on to 1 303. Tax CeNilirotition fp Bonnb K. Mlller Tax Colbdor 13.23.Oti46-349 1D.00 1 304. 2008 School Texw to Bonnb IC. MBbr Tax Colbdor 1 •23-0545349 1 148.24 1 305. 4th Olr. SewerlRetuae to LowerAlbn Township Author8y 98.25 1 400. TOTAL SETTLEMENT CHARGES Enter on I.bres 103 Secflon J arx1002 Section 4,618.38 10147:49 ~r dPte WYe ~ q sq ~n,~,,. ~ npr,~v~~ ~~~ ~~ A ~ WnpRa rAYr W ~~ L q vA O,o y~a0 Nw,IN,N. Mfdetab Al>atrad Comperly Settbment Agent Certified to be a true copy. t oe.sw raeauTr~> ~G~ N O ~ MN~ rim o ZO'J9 MAR _9 pM ~~. 37 ono ~ U `~ N CLEF{{ U~ ~ ,1~ ~ ~ o~~~~~ s,{ca~~T~p ~ ~o Q~ ~ ~ J O ~SO~1Mf1 O o ~ 7 W ~~ jJ o LL ~0~~ m ~ o = M ~ M W~W+M-~ W W O Q O o ac~°z~a wM ~~g~c a .eN Q~~=J '~ Wo ~UCWCOJ ~ ~ ~~ J L~L ~ W ~ ~5s ~,a c~o~o~ ^ v a ~ C -y ux1. a ~ !,~ M W U N ~' ~u uan SEAMANS Eckert Seamans Cherin & Mellott, LLC TEL 717 237 6000 213 Market Street - 8th Floor EAx 717 237 6019 Harrisburg, PA 17101 www.eckertseamans.com Thomas P. Gacki 7 t 7.237.6093 tgacki@eckertseamans.com March 6, 2009 Glenda Farner Strasbaugh, Register of Wills & Clerk of the Orphans' Court Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013-3387 Re: Estate of Kathryn M. Rickert No. 2108-0738 Dear Ms. Strasbaugh: Enclosed for filing please find the original and (2) copies of the Inheritance Tax Return for the above-referenced estate. Also enclosed is a check in the amount of Fifteen and 00/100 Dollars ($15.00) to cover the cost of filing same. Please date-stamp the extra. copy of the Return and return it to my office in the enclosed self-addressed, stamped envelope. Thank you for your courtesy and cooperation in this matter. Please do not hesitate to contact us if you have any questions. Yours truly, / ~ i Thomas P. Gacki n TPG:kmo Enclosures cc: Scott L. Rickert (w/enc.) Bret M. Rickert (w/enc.) ~o ': -:, ~ C7 :~_.~~m rJ~ `_?0~ t_:.~ ~_ .~ Cfl -v N w ~+ -~. ~; r-r- ' S.a j ~. { - ~ .~., ._.~. ~, ~_'7 c ~. ~- .; ~ -, :~, HARRISBURG, PA PITTSBURGH, PA PHILADELPHIA, PA BOSTON, MA WASHINGTON, DC WILMINGTON, DE {L,0373306.1} MORGANTOWN, WV SOUTHPOINTE, PA WHITE PLAINS, NY