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HomeMy WebLinkAbout04-29-09J 15056051058 REV-1500 EX (06-06) OFFICIAL USE ONLY PA Depanmenl of Revenue Y Bureau of Individual Tazes Ccunty Code year File Number Poeoxzaosal ~ ~ INHERITANCE TAX RETURN Harrisburg, PA 17128-osol RESIDENT DECEDENT 21 08 1239 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 204-01-3389 12/02/2008 07/15/1918 Decedent's Last Name Suffix Decedent's First Name MI Myers Sylvia A (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 t• 1. Original Return 2. Supplemental Return 3. Remainder Return Nate of death prior to 12-13$2) 4. Limited Estate 4a. Future Interest Compromise (date of 5. Federal Estate Taz Return Required death after 12-12-82) • 6. Decedent Died Testate 7. Decedent Maintained a Living Trust 0 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 - THIB SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECT Name ED TO: Daytime Telephone Nurtiber James D. Campbell, Jr. Firm Name (If Applicable) Caldwell & Kearns First line of address 3631 N. Front Street Second line of address City or Post Office Harrisburg Correspondent's e-mail address: State ZIP Code PA 17110 com (717)232-7661 C~ %~`, REGIS t[R US ~' E OIM_S , ~ ;i?,C? a n. [R rli cam= to C_,.. =~ s, - ?~_ ~ ..- _ y ~ onrEt-ueo W Under penalties of perjury, I declare that I have it is true, correct and complete. Declaration of u mis return, mcwamg accompanying schedules and statements, and to the best of my Imowletlge and belief, other than the personal representative is based on all information of which preparer has anv knnwlcdna aorv,vi cur rettJV~sPUNSIBLE FOR FILING RETURN DATE ADDRESS c~ aa / ~1 ~f~/yy~~`~y /'') - SIGNATURE PREPARER OTHER THAN REPRESENTATIVE DATI? - n 3~3r N ~~.+ sr ~-(,,,,r5u-s ~'~ ~~„~ PLEASE USE ORIGINAL FORM ONLY L 15056051058 Side 1 15056051058 15056052059 REV-1500 EX Sylvia A Myers Decedent's Name: 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, & 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 .0_ 15. 16. Amount of Line 14 taxable at lineal rate X .045 12,450.28 1g. 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 204-01-3389 2,148.42 83,659.14 215,140.97 300,948.53 23,150.10 1,125.54 24,275.64 276,672.89 276,672.89 12,450.28 12,450.28 15056052059 Side 2 15056052059 uogdope jo peo!q Aq jagjagm'luapaoap ay{gl!m uoww00 ut wajed auo iseal le se4 o4m jenpn!pui ue se'ZO16 uoQpGS jGpun'pauyap s!6ugq!s V((£-t)(e)9tt6§'S'd ZL)lua0JOd(Z1)argarq s,s6ugq!s s luape3ap aqj jo asn 941 jol jo of sjalsueA to anleA tau aqj uo posodujt alej xei aql u! a 011 se da0xa yua0jad (4)(¢)9116§'S'd ZLI(Z'09116§'S'd ZL p 1 1 (9 v)jle4-auo pue jnol s!saue!3yauaq !eaug spapaoap a41 jo asn a41 joj jo of sjajsuejl jo amen tau 941 uo pasodw!9lej xel aq 1(z 1)(¢)9116§'S'd ZLI luawad(0)ojaz s!pl!4o aqj jo luajeddals a jo quejed OAgdope ue'luajed lejnleu a jo asn aqj jol jo of yleap le jaWnoA jo 96e 10 SMA auo-14MA! 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Vd '6mgs01ueyoaVq an44 p00Mazaal8 ELL laloH .V uaeyg a laly6ne4 L LOLL Vd '111H dweo laaalS 4191 'S 60Z NOippil ){elAg .V 1N303030 01 dIHSNOIiV1321 SS3N00V 3WVN(S)1NVN311NI0f ONIAIANOS '0 911113043S uo pallodal aq mul li'gleap to alep s,luapaoap 041101eaA auo uiyllm lulof apew sum lasse us 11 6£ZL-90-LZ N38WfiN 3711d sJeAjN .V elAfAS 30 31V1S3 1N3o30301N301S3a A1213dOMd 43NM0 Al1NlOf Nan138 xV1.3DNV11a3HNl VINVA-MIAN3d 20 lUIV3MN0114W00 a 37nG3HOIS (as-sr txa eocii-n3a A. -- vmo rvv. LJUL-V LOO B. TYPE OF LOAN: U.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMEN 1.^FHA 2.^FmHA 3.^CONV. UNINS. 4.QVA 5. ^CONV. INS. 6. FILE NUMBER: 7. LOAN NUMBER: SETTLEMENT STATEMENT N H 1 8. MORTGAGE INS CASE NUMBER: C. NOTE: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "(POC)" were paid outside the closing; they are shown here for infor ti l ma ona purposes and are not included rn the totals. D. NAME AND ADDRESS OF BORROWER: L9 3198 (REGAN84BALIHAI(09).PFD/REGAN84BALIHAI(69y29) E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER: WI LLIAM A. BEGAN III SYRA K. LIDDICK SHARON A. HOFER SUNTRUST MORTGAGE, INC 5126 JENNIFER CIRCLE 209 S. 15TH STREET 2651 CARNEGIVE RD MECHANICSBURG, PA 17050 CAMP HILL, PA 17011 YORK, PA 17402 G. PROPERTY LOCATION: H. SETTLEMENT AGENT: 23-2386065 I SETTLEMENT DATE: 84 BALI HAI ROAD LEON P. HALLER ESC AGEN T FIRST AMERICAN TITLE INS . ME CHANICSBURG, PA 17050 A CU MBERLAND County, Pennsylvania PLACE OF SETTLEMENT pril 6, 2009 1719 N. FRONT ST. HARRISBURG, PA 17102 J. SUMMARY OF BORROWER'S TRAN SACTION K. SUMMARY OF SELLER'S TRA NSACTION 101. Contract Sales Price 168,000.00 401 . Contract Sales Price 168 000 00 102. Personal Pro a 402. , . Personal Pro erty 103. Settlement Char es to Borower Line 1400 4,458.30 403. 104. 404. 105. 405. r v 106 COUNTY/LOC m r r in n . AL TAXES to 406. COUNTY/LOCAL TAXES to 107. SCHOOL TAXES 04/06/09 to 07/01/09 267.44 407. SCHOOL TAXES 04/06/09 to 07101/09 267 44 108. REFUSE to 408. REFUSE to . 109. 409. 110. 410. 111. 411. 112. See addit'I disb. exhibit 89.90 412. 120. GROSS AMOUNT DUE FROM BORROWER 172,815.64 420. GROSS AMOUNT DUE TO SELLER 168 267 44 200. AMOUNTS PAID 6Y OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER: , .. 201. De osit or earnest mone 5,000.00 501. Excess De osit See Instructions 202. Princi al Amount of New Loans ~ 164,957.00 502. Settlement Char es to Seller Line 1400 16 178 08 203. Existin loans taken sub ect to 503. Ezistin loans taken sub~ect to , . 204. BROKER CREDIT 1,649.57 504. Payoff of first Mortgage 205. 505. Pa off of second Mort a e 206. 506. 207. 507. De osil disb. as roceeds 208. SELLER ASSIST TAX PROBATIONS 329.07 508. SELLER ASSIST TAX PROBATIONS 329 07 209. 509. . 210 ustments or terns n ar a er COUNTY/LO A ustments or terns n ar a er . CAL TAXES to 510 COUNTY/LOCAL TAX S 211. SCHOOL TAXES to . 511. E to SCHOOL TAXES to 212. REFUSE to 512. REFUSE to 213. 513. 214. 514. 215. 515. 216' 217 516. See addit'I disb. exhibit 615.11 . 517. 218. 518. 219. 519. 220. TOTAL PAID BY/FOR BORROWER 171,935.64 520. TOTAL REDUCTION AMOUNT DUE SELLER 17 12226 300. CASH AT SETTLEMENT FROM/T0 BORROWER: 600. CA5H AT SETTLEMENT TO/FROM SELLER: , 301. Gross Amount Due From Borrower Line 120 172,815.64 601. Gross Amount Due To Seller Line 420 168 267 44 302. Less Amount Paid ey/For Borrower (Line 220) ( 171,935.64) 602. Less Reductions Due Seller (Line 520) ( , . 17 303. CASH (X FROM) ( TO) BORROWER 880.00 603. CASH (X TOJ ( FROM) SELLER ,12226 151 145 18 The undersigned here I dge recei t a co ltd f , . p e e copy o ages 182 of this statement 8 any attachments referred to herein. Borrower c. ~ L ~ Seller SYRA K. LIDDICK SHARON A. HOFER ILLIAM A. BEGAN III HUU-1 (3-66) RESPA, Ha4305.2 Pa e2 L. SETTLEMENT CHARGES 700. TOTAL COMMISSION Based on Price 1 PAID FROMpgln ROM Division of Commission line 700 as Follows: eoRROwERS SELLER'S 701. $ 4,025.00 to FOR SALE BY OWNER PLUS REALTY 702. $ 3,975.00 to EXIT PLATINUM PLUS REALTY FuNOS Ar FuNOS aT SETTLEMENT SETTLEMENT 703. Commission Paid at Settlement 704. TRANSACTION FEES 8,000.00 to EXIT PLATINUM PLUS REALTY 195.00 600. ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Ori ination Fee 0.0000 % to CENTRAL PA MORTGAGE LLC , 1,621.20 802. Loan Discount % to 803. TAX SERVICE FEE to VALUTREE REAL ESTATE SERV 83.00 804. LOL FLOOD CERT to FIRST AMERICAN FLOOD SVGS 6.00 805. BROKER PAID COSTS to SUNTRUST MORTGAGE, INC POC:L7649 57 . 806. APPRAISAL FEE to CENTRAL PENN APPRAISALS 382.00 807. CREDIT REPORT to FIRST AMERICAN FLOOD SVGS 9 83 808. MORTGAGE BROKER FEE to SUNTRUST MORTGAGE, INC POC:L4874 48 . 809. COMMITMENT to CENTRAL PA MORTGAGE LLC , 600.00 810. FINAL INSPECTION to CENTRAL PENN APPRAISALS 100.00 811. JV PROCESSING FEE to SUNTRUST MORTGAGE, INC POC:L500.00 EM RE IRE BY L NDE T B PAID IN ADVANCE 901. Interest From 04/06/09 to 05/01/09 @ $ 22.600000/day ( 25 days %) 565.0 902. Mortga a Insurance Premium for months to DEPARTMENT OF HUD 2,637.10 903. Hazard Insurance Premium for 1.0 ears toERIE INSURANCE 479.00 904. 905. 1000. RESERVES DEPOSITED WITH LENDER 1001. Hazard Insurance 3.000 months $ 39.91 er month 119 73 1002. Mort a e Insurance months $ 73.81 er month 1003. COUNTY/LOCAL TAXES 3.000 months $ 10.60 er month 1004. SCHOOL TAXES 11.000 months $ 94.58 er month 31.80 1005. REFUSE months @ $ per month 1,040.38 1006. months $ er month 1007. COUNTY TAXES 3.000 months $ 24.61 er month 1008. AGGREGATE ADJUSTMENT months $ er month 73.83 1100. TITLE CHARGES -300.37 1101. Settlement or Closin Fee to 1102. Abstract or Title Search to 1103. Title Examination to 1104. Title Insurance Binder to 1105. Document Pre aration to 1106. Nota Fees to ' 1107. Attorney s Fees to includes above item numbers: 1108. Title Insurance to LEON HALLER ESC AGENT FIRST AMERICAN TITLE INS 1 078.88 includes above item numbers1101-1104 1109. Lentlefs Coverage $ 1110. Owner's Coverage $ 168,000.00 1 07888 , 1111. CLOSING PROTECTION LETTER to LEON P. HALLER ESC AGENT FIRST AMERICAN TITLE INS 35.00 1112. LOAN POL ENDS 100/300/8.1 to LEON P. HALLER ESC AGENT FIRST AMERICAN TIT LE INS 150.00 1113. ELECTRONIC IMAGING FEE to LEON P. HALLER ESC AGENT FIRST AMERICAN TIT LE INS 50.00 1200. GOVERNMENT RECORDING AND TRAN FER CHAR ES 1201. Recording Fees: Deed $ 38.50; Mortgage $ 80.50; Releases $ 119.00 1202. Ci /Count Tax/Stam s: Deed 1,680.00 Mort a e 1,680.00 1203. State Tax/Stam s: Revenue Stam s 1,680.00; Mort a e 1,680.00 1204. 1205 . 1300. ADDITIONAL SETTLEMENT CHARGES 1301. Surve to 1302. Pest Ins ection to 1303. 1304. 130 5. 1400. TOTAL SETTLEMENT CHARGES (Enter on Lines 103, Section J and 502, Section K) By signing page 1 of this statement. the sionatnriec n~k~..,.ne.~..e .e,-e:.,. ,.... ____,_._. ____ . 4,458.30 16.178.08 - ~ --~------ --°°--•°°y- ,~V,.~P. ~~ _ ~~n,y,o~ov wpy or p~ag~e%,~/o~r_t~nls t-wo page statement. Certified to be a true copy. LEON P. HALLER ESC AGENT FIRST AMERICAN TITLE Settlement Agent (REGANa4BALIHAI(09; I REGAN84BALIHAI(99) / 29 ) ADDITIONAL DISBURSEMENTS EXHIBIT Borrower: WILLIAM A. REGAN III Seller: SYRA K. LIDDICK SHARON A. HOFER Lender: SUNTRUST MORTGAGE, INC Settlement Agent: LEON P. HALLER ESC AGENT FIRST AMERICAN TITLE INS (717)234-4178 Place of Settlement: 1719 N. FRONT ST. HARRISBURG, PA 17102 Settlement Date: April 6, 2009 Property Location: 84 BALI HAI ROAD MECHANICSBURG, PA 17050 CUMBERLAND County, Pennsylvania PAYEE/DESCRIPTION NOTE/REF NO BORROWER SELLER PURCELL KRUG &HALLER UPS OVERNITE PURCELL, KRUG ~ HALLER TAX CERTIFICATION PECK'S SEPTIC SERVICE SEPTIC SERVICE PENN WASTE REFUSE 01/01-03/31 DEBRA BASEHORE, TAX COLLECTOR 2009 COUNTY TAXES DEBRA BASEHORE, TAX COLLECTOR 2009 LOCAL/LIBRARY TAXES Total Additional Disbursements shown on Line 112/516 44.80 45.10 25.00 90.90 54.35 295.38 149.48 $ 89.90 $ 615.11 (REGAN846ALIHAI(09).PFb/REGAN848ALIHAI(09)/29) Pt of DEED-IND. DGR T-t COPVgIGH'196E°RT ALL-STA TE LEGALSUPPIYCO. ONE COMMERCE DRIVE CRA NfGRD N. J. OJ016 ~~tS ~EE~1 Made the ~ da o y f May , in the year Nineteen hundred ¢nd ninety three (1993) ~FfiUPYll SYLVIA A. MYERS, Widow, Silver Spring Township, Cumberland County, Pennsylvania, GRANTOR - AND - SYLVIA A. MYERS, SYRA K. LIDDICK and SHARON A. HOFER, joint tenants with rights of Survivorship, GRANTEES ~t1'IIPS6P~, That in consideration of One ($1.00) Dollar9; tin hand paid, the receipt whereof is hereby acknowledged, the said grantor do es hereby grant and convey to the said grantees, their heirs and asstigns, AI:L *_h at certain piece or parcel o£ land situate in Silver S;r ing Township, Cwnberlard County, Penns-y lvar,ia, more particularly bou ndea and described as fol loco, to wit: HEGINNLNf: at a po i.ni in To•.~ashi.p Road No, Sag at the dividing line. between Lots Nos. 15 and 15 on the hereinafter mentioned plan of lots; thence along said dividing line, North GO degrees 41 minutes West, a distance c 200 faet co a point; thence South 89 degrees 19 minutes West, a distarc=_ of 1G0 feet to the dividing line between Lots Nos. 16 and 17 on the hereinafter mentioned Plan of Lots; thence by said dividing line, South 00 degrees 41 minutes East, a distance of 200 feet to a point in Township Road No. 599; thence North 89 degrees 19 minutes ^cast through Township Road Ne. 599, a distance of 100 feet to the dividing line between Lots Nos. 15 and 16 on the hereinafter mentioned Plan of Lots, at the point or place of BEGINNING. HE TIP@ ',ot Nn. 16 cn the Pi.an of Bali Hai as recorded in Plan Book 12, Page 43, Cumberland County records. NAVING thereon erected a brick dwelling known and numbered as 84 Bali tiai Road, Mechanicsburg, Pennsylvania. HEING the same premises which Robert P. Eichelberger, et al, by deed dated November 1, 1965, recorded in Deed Book "Y," Vol. 41, Page 284, Cumberland County records, granted and conveyed unto Millard 5. Myers and Sylvia A. Myers, his wile. The said Millard S. Myers died May 17, i 9'72, at ;which time title in fee simple vested by survivorship in Sylvia A. Myers, the within named Grantor. This is a conveyance from mother to herself and her daughters and, as ouch, is exemp+_ from all state and realty transfer taxes. r;eE~ ;iG ~"__ '7>f.5 ~n11 the said grantor des hereby SPECIALLY the property hereby conveyed. +~n witness ~l~erenf, said grantor has hereunto set and se¢l the day and year first above written. ~ignea. ~enleil snd igeliuere~ ~n the ~renenre of ;: , CU613=RL:i,"ru COGNTI"-PA '93 f~AV . 7 A[~ 8 '23 Cnnmarnttweulill of ~ennnglunniu h[nuntg of n CUMBERLAND n On this, the ~! day of May the undersigned officer, persanatly appe¢red ss. her ts93 ,before me, a notary public, SYLVIA A. MYERS, Widow, known to me (or satisfactorily proven) to be the parson whose nwne instrument, and ¢cknowledged that She executed the same far li M WITNESS WFIEREOF, Z have hereunto set rii~ (IInmmnnwenltlj of ~ennnglusnia ( C~nuntg of (nn' On this, the day of 1.9 ,before me UtuCCnnt hand i s subscribed to the with4n urpose therein cantaintd. n.d and notaiEialePkl rG ~' - ,1~ lfl Zi?~-~~ j, NO7AiiNl S!AL Came H'i~! C.;:aberl~etl Gaunty F,-0y Commissior, GepirFS Jury 3,1996 . a- the wnderstigned officer, Personally appe¢red "~~~ ~~~ ~" k,c~ { rte. ~: ~ " 'w known tome (or satisfaotortily proven) to be the Person whose name ~subsertBSd'SA°_ '~wtthatt instrument, and acknowledged lhat he executed the swne for the purpose therein wntained. IN WITNESS WHEREOF, f have hereunto set my hand and sent. ~'~n' ~ G a30 PAC'- ~it fY J hereh~ l'berlif~I that th.e precise address of the gyyrl1antee herein. is 84 Bali Hai Road "6 ~ ~.E,~,~ Mechanicsburg, PA 17055 / /~ !. GC.. C' ~:~,,~~v r~ rr~_t~~~, ~y1Via A, t1yeY~ ~^1~[Ye of CaunYg of ~ g$' On this, the day of 19 , 6q~are nae the undersigned officer, ymrsmtally ayyeared Mnoum tome (or satisfactorily proven) to be the yerson whose name rubscabed to the w%thin inxtramenf, and acknowledged that he eraneted the same for the p¢vpose therein, rmEt¢ined. IN WITNESS WHEREOF, 7 h¢ve hererento set my hand ¢rut seal. I ~ a '` a a H ,~ _ ~ w ~ ~ ~ ~c ~ z w L F H ~ . ~ ~ ~ ~ H \^ a o ~ ti m I (~ummnntuettltil of ~ennsgluttnitt ~IILtIif~ IIf ~'~~~~~t~, 4 ~.C~ ~SS. ~CCi1CDC~ 'in the Office for Recording of Deeds in and for ~iv ~~~Q ;- ~f~v (~ ~ 1 in Deed Book ~ No. ~ C~ page ~`.~ Etc. ~[1ttCS8 my hand and seal of Offoe this l- day of .1~~~ _ An~ru~Domini l9 ~'j ~~ ~~'~ PSEflF December 26, 2008 Account # 8501XXXXXX, 9801XXXXXX JAMES D. CAMPBELL JR. C/O CALDWELL & KEARNS 3631 NORTH FRONT ST HARRISBURG, PA 17110-1533 Dear MR. CAMPBELL: The following is the status of SYLVIA A. MYERS's primary account (8501) with PSECU as of the date of death. Joint Owner's Name SYRA K. LIDDICK, SHARON A. HOFER -ADDED 02.15.1978 AS JOINT TENANTS W/ROS Date of Death 12.02.2008 Date of Birth 07.15.1918 Share Description Open date S O1 Regular Shares Balance Accrued Dividend 02.15.1978 S 04 Checking 02 $57,174.80 $1.94 .15.1978 The dividend earned from January 1, 2008 through the date of d 42,655.22 0.29 eath was $736.77. The decedent had no loans with us. We do not have safe deposit boxes for our members. The following is the status of SYLVIA A. MYERS's prefix a ccount (9801) with PSECU as of th d death. e ate of Joint Owner's Name TENTATIVE TRUST ACCOUNT, I N TRUST FOR SYRA K LIDDICK AND SHARON A. HOFER . Date of Death 12.02.2008 Date of Birth 07.15.1918 Share Description Open date S O1 Regular Shares Balance Accrued Dividend 06.07.2004 C50 60 Month Certificate 06/08 2004 $26,632.36 $0.90 . C51 60 Month Certificate 06.08.2004 31,234.67 3.16 10 906.17 ] 48 C52 60 Month Certificate 06.08.2004 , . 20,037.41 2 71 C53 60 Month Certificate 06.08.2004 . 4,695.30 0 42 C54 36 Month Certificate 06.08.2004 . 20,000.00 2 38 C55 36 Month Certificate 06.08.2004 . 54 380 88 7 29 , The dividend earned from January I, 2008 through the date of death was $6,168.81. If you have any questions call 2 34-8484 in Harrisburg or our toll-free number (800) 237-7328. , At the menu prompt enter 6 and th i 2227. , en extens on Sincerely, j~'`/~J'~J~~J'/`-' ~ ~cf~e F ' f~ Member Service Representative Finance SupporC Unit Pennsylvania Stafe Employees Credit Union Main Address: 1 Credit Union Place, Harrisburg, PA 7 7110-2990 • 717.234.8484 • 800.237.732E Mailing Address: P.O. Box 67073, Harrisburg, PA 17106-7013 • 717.777.2100 (TCID) • 800.472.1967 (TDD( This credit union is federally insured by the Notional Credit Union Adminlsfmnon E I O pseCU.[Om quo pponunify Lender i ~~ ~,io I x.,, ,iy.. COh9 G9(N f ~~ "i101 F 'v~l!VANV'. IN h ( IltiG` inx ~GTURN i ~ r rvl .~rceL~rJr SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER Sylvia A. Myers 21-08-1239 This schedule must be completed and filed if the answer to any of questions i through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBE DESCRIPTION OF PROPERTY wrwoE rN~rvnms Or rnE rnnrvsr~nEE, rHEia acunorvswP -o>=cEOENrnrvo R rHS enrr or ranrvsrea. nrrncyncocr ormeoEEO roa asnt esrnre. DATE OF DEATH VALUE OF ASSET % OF DECD' INTEREST S EXCLUSION iravaucnsral TAXABLE VALUE The following tentative trust accounts, Sylvia A. Myers intrust for Syra K. Liddick and Sharon Hofer: ~ 1. PSECU 9801 S01 Regular shares 26,633.26 100 26.633.26 2. PSECU 9801 C50 CD 31,237.83 100 31237.83 3. PSECU 9801 C51 CD 10,907.65 100 10.907.65 4. PSECU 9801 C52 CD 2o,oaal2 10o zo.o4o.tz 5. PSECU 9801 C53 CD 4,695.72 100 n,695.72 6. PSECU 9801 C54 CD 20,002.38 100 26,002.38 7. PSECU 9801 C55 CD 54,388.17 100 54,368.17 8. Woodforest National Bank -Demand deposit Acct. 1333300075, Sylvia A. Myers payable on Death (POD) Sharon Hofer and Syra Liddick 87,235.84 100 nz235.8a p TOTAL (Also enter on line 7 Recapltulatlon) $ ~ 215,140.97 (If more space is needed, insert additional sheets of the same size) PSEfi~ December 26, 2008 Account # 8SOIXXXXXX, 9801XXXXXX JAMES D. CAMPBELL JR. C/O CALDWELL & KEARNS 3631 NORTH FRONT ST HARRISBURG, PA 17110-1533 Dear MR. CAMPBELL: The following is the status of SYLVIA A. MYERS's primary account (8501) with PSECU as of the date of death. Joint Owner's Name SYRA K. LIDDICK, SHARON A. HOFER -ADDED 02.15.1978 AS JOINT TENANTS W/ROS Date of Death 12.02.2008 Date of Birth 07.15.1918 Share Description Open date Balance Accrued Dividend S OI Regulaz Shares 02.15.1978 $57,174.80 $1.94 S 04 Checking 02.15.1978 42,655.22 0.29 The dividend earned from Ianuary 1, 2008 through the date of death was $736.77. The decedent had no loans with us. We do no[ have safe deposit boxes for our members. The following is the status of SYLVIA A. MYERS's prefix account (9801) with PSECU as of the date of death. Joint Owner's Name TENTATIVE TRUST ACCOUNT, IN TRUST FOR SYRA K. LIDDICK AND SHARON A. HOFER Date of Death 12.02.2008 Date of Birth 07.IS.1918 Share S O1 Description Regular Shares Open date Balance Accrued Dividend C60 60 Month Certificate 06.07.2004 06/08 2004 $26,632.36 $0.90 CS 1 60 Month Certificate . 06.08.2004 31,234.67 10 906.17 3.16 1 48 CS2 60 Month Certificate 06.08.2004 , 20 037.41 . 2 71 C53 60 Month Certificate 06.08.2004 , 4 695.30 . 0 42 CS4 36 Month Certificate 06.08.2004 , 20 000.00 . 2 38 CSS 36 Month Certificate 06.08.2004 , 54 380.88 . 7 29 The dividend earned from January 1 2 , , 2008 through the date of death was $6,168.81. , If you have any questions call 34-8484 in Harrisburg or our toll-free number (800) 237-7328. At the menu prom , pt enter 6 and th i 2227. , en extens on Sincerely, y ~ V Meade Fairf~ Member Service Representative Finance Support Unit Pennsylvania Slate Employees Credit Union Main Address: 7 Credit Union Ploce, Harrisburg, PA 17110-2990 • 717.234.8484 • 800.237.7328 Mailing Address: P.O. Box 67013, Harrisburg, PA 1 71 06-701 3 • 717.777.2700 (TDD) • 800.472.1967 (TDD) This credit onion is federally lnswed by the National Credit Union Administration. E al O pSeCU Lendm 9u PPo Y January 23, 2009 Caldwell & Kearns Attn: James D. Campbell, Jr. 3631 North Front Street Harrisburg, PA 1 71 1 0-1 533 Re: Estate of Sylvia A. Myers, Deceased Date of Death: December 2, 2008 To Whom It May Concern: Per your request dated December 22, 2008, Woodforest National Bank has researched our database for any information regarding the Decedent. The following has been located and documentation as requested is attached: 1. Accounts listed under Decedent: a. Demand Deposit Account i. Account number 1333300075 ii. Balance as of 12/2/2008: $47,235.84 iii. Signatory(s): Sylvia A. Myers iv. Payable on Death (POD) Beneficiazy(s): Shazon Hofer and Syra Liddick There will be no chazge for this reseazch. If you need further assistance, please feel free to contact me at 832-375-2045. Regards, ~ssa~Wo1J f~ ~ ~ " Legal Administrative Assistant Woodforest National Bank &Woodforest Bank 25231 Grogans Mill Road, Suite #440 The Woodlands, TX 77380 MWollf(u~Woodforest com Office: 832-375-2837 Fax:832-375-3837 P O. Box 7889 • The Woodlands, Texas 77387-7889 • 832-375-2000 www.woodforest.com Banking your way...EVERY DAY! EV-1511 EX+ (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TA% RETURN RESIDENT DECEDENT SCHEDULE N FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Sylvia A. Myers 21-08-1239 Debts of decedent must be reported on Schedule L ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: t Prepaid z. Family gathering after service 165.35 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Syra K. LiddlCk Social Security Number(s)/EIN Number of Personal Representative(s) 186-34-058a Street Address 209 South 15th Street Gty Camp Hill .state PA Z;p 17011 Year(s) Commission Paid. 2009 z. Aunmey Fees Caldwell & Kearns 3. Family Exemption. (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent a. Probate Fees & Short Certificates 5. Accountant's Fees 6. Tax Return Preparer's Fees z Cumberland Law Journal -Legal Advertising a. Carlisle Sentinel- legal advertising s. Septic replacement, tree removal, permits, probe tests and related costs (Required by township) to Photocopies TOTAL (Also enter on line 9, Recapitulation) ~ $ 4:000.00 a.ooo 00 360 00 150.00 75.00 166.50 14,223.75 9.50 23,150.10 (If more space is needed, insed additional sheets of the same size) Pennsylvania SCHEDULE I pevr,Rrn Ervr pr aEVe"uE DEBTS OF DECEDENT, '""ER`T""`ET""RET°R" MORTGAGE LIABILITIES 8e LIENS RESIDENT pECEDENT ESTATE OF FILE NUMBER Sylvia A. Myers 21-08-1239 Reuort debts incurred 6v the decedent nrin. re d.,t:, .~,.. ..:.,.:...a ::....:. ...:._ ._._ _..__.. :__:...:__ ..___._.____ _. .. u more space I5 neeeeo, Insert ad0ltlonal Sheets Of the Same Size. iee~~-u t 3 ex- tt r -os) ~~i Pennsylvania I SCHEDULE 7 DEPARTMENT OF gEVENpE wRERrraNCE Tax ReruRN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER Sylvia A. Myers o~_nn_~~zo NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT Do Not List Trustee(s) AMOUNT OR SHA0.E OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1. Syra K. Liddick, 209 S. 15th St., Camp Hill, PA 17011 Daughter 50% 2. Sharon A. Hofer, 713 Breezewood Dr., Mechanicsburg PA 17055 Daughter 50% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, A S APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FO0. WHICH AN ELECTION TO TAX IS NOT TAKEN 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. ~ If more space is needed, insert additional sheets of the same size. LAST WILL AND TESTAMENT OF SYLVIA A. MYERS I, SYLVIA A. MYERS of Silver Spring Township, Cumberland County, Pennsylvania, declare this to be my Last Will and Testa- ment, hereby revoking any will previously made by me. I - I direct the payment of all my just debts and funeral expenses out of my estate as soon as may be practical 'after my death. II - I bequeath certain items of my tangible personal SA[DIS, GUIDO & MAtiLAND 2109 Vlark ct Sveei L.Imp Hill. PA property, not including cash and securities, in accordance with a written list made by me during my lifetime. In the absence of such a list or designation on said list, I direct that my execu- trix hereinafter named distribute my household goods and personal effects between my daughters in as nearly equal shares as possi- ble, and that the remainder be sold and added to the residue of my estate. III - I devise and bequeath all the rest, residue and remainder of my estate of whatever nature and wherever situate unto my daughters, Syra K. Liddick and Sharon A. Hofer, in equal shares, the share of a deceased child to be paid to his or her issue per stirpes. ~ ''. \; \ Page 1 „I of this, IV - I appoint my daughter, Syra K. Liddick, Executrix my Last Will and Testament. Sl-iould my said daughter fail to qualify or cease to act as such, then I appoint my daughter, Sharon A. Hofer, to act in this capacity. Neither of my personal representatives shall be required to post bond in this or any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal on ~ _~ ~~~ a ~ this, the day of ~~~~-,~; ~ 1993. ~ Y, „~,~ ~ _ ,c~`~_,__' ( SEAL ) Sylvia A. Myers 9AIDIS, GUIDO ~ MASLAND 2109 Market Street Camp Hill. P4 Signed, sealed, published and declared by SYLVIA A. MYERS, Testatrix therein named, on, this and one (1) other sheet of paper as and fbr her Last Will and Testament, in our presence, who, in her presence, at her request, and in the presence of each other, have hereunto subscribed our names as attesting witnesses. /~ _ ~; ~ i77.•l,v ~ J~ h _I` ,` Address Address Page 2 .. R MIDIS, GUIDO i MASLANll 109 Merk ei Street Camp li ill, PA COMMONWEALTH OF PENNSYLVANIA) SS. COUNTY OF CUMBERLAND) WE, the undersigned, the testatrix and the witnesses, respectively, whose names are signed to the foregoing instru- ment, being first duly sworn, do hereby declare to the under- signed authority that the testatrix signed and executed the instrument as her Last Will and Testament and that she signed willingly (or willingly directed another to sign for her), and that she executed it as her free will and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the testatrix signed the will as witnesses and that to the best of their knowledge the testatrix was at that time eighteen years of age or older, of sound mind, land under no constraint or undue influence. Subscribed, sworn to and acknowledged before me by the testatrix, and subscribed and swo;rn~ to before me by both wit- nesses, this ~ day of -'/4«ey 1993. i o - Notary Public fdOL~ir 1,4 i. Sufis TrIEI MA ~ Mc, AUSLifJ ^7, ~ Camp N~~ Y °ubi,;; ~ L ~.i~ridl n ` JO,V MYCCm~, ~~`ruir iy~~ 196 l L \ ,. Testatrix ' ~ 4w JAMES R. CLIPPINGER CHARLES J. DEHART. III JAMES L. GOLDSMITH P. DANIEL ALT LAND JEFFREY T. MCGUIRE• STANLEY J. A. LASKOW SKI DOUGLAS K. MARSICO BRETT M. WOODBURN MICHAEL D. REED PAULA J. LEICHT ELIZABETH H. FEATHER KAREN W. MILLER DOUGLAS M OBERHOLSER •BOARO CERTIFIED CIVIL TRIPL ADVOCATE CALDWELL &KEARNS A PROFESSIONAL CORPORATION ATTORNEYS AT LAW 3631 NORTH FRONT STREET HARRISBURG, PENNSYLVANIA 1 7110-1 5 3 3 April 29, 2009 VIA HAND-DELIVERY OF COUNSEL CARL G. WAGS JAMES D. CAMPBELL. JR. THOMAS D.CALDWELL, JR. 1192H-20011 RICHARD L. KEARNS RETIRED JIJ-232~J661 FAX; JIJ-232-2J66 thefirm®caldwellkearns.com Glenda Farner Strasbaugh, Register of Wills r`,7 Cumberland County Courthouse ~o ~;~ One Courthouse Square ~~ ~~ ~a Carlisle, PA 17013-3387 !?~ m -.' iJJ 7) t~„ lG Re: Estate of Sylvia A. Myers ~~-, S? ~ : ,,:, Estate File No. 2008-01239 ~=~ -o PA File No. 21-08-1239 y-' w Dear Ms. Strasbaugh: Please find enclosed herewith an original and one copy of the Inheritance Tax Rehfm~ in the above-referenced matter. Sincerely, j~ (,. r ~~ . James D. Campbell, Jr. CALDWELL &KEARNS JDC:mm Enclosure cc: Syra K. Liddick osae~-ool; u~oso