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Home My WebLink About04-30-09 (2)J 15056051047 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue Coun Code Year File Number Bureau of Individual Taxes ty PO BOX 280601 INHERITANCE TAX RETURN I Harrisburg, PA 17128-0601 RESIDENT DECEDENT 2-. ~ U ~ d ~ ~;.~ ffi ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth ~ 07 3~.~5 i 3 0 >~ 3 1 Zoo g ~~~ >r i,9 `3;~: Decedent's Last Name Suffx Decedent's First Name MI 6 E ~ R }~/~ ~R Y ,.. E. (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name Mt ,.:•.. ~ , Spouse's Social Security Number FILL IN APPROPRIATE QVALS BELOW THIS RETURN MUST BE FILED IN DUPLICATE WITH THE !~ ~S~l~ ~(' REGISTER OF WILLS g ~ 1. Original Return O 2. Supplemental Return O 3. Remainder Return (date of death prior to 12-13-82) O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required death after 12-12-82) ~ 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O 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 CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number Firm Name (If Applicable) .~ . REGISTIr LLS U NLY -z' rte-. - ., ~ ° r First line of address 33 y S h e~ 2~ Second line of address City or Post Office State ZIP Code L it/ e w v~ l 1 e P f~ 1 ~ z y l ~ ~ ~~ J ~ W ~' , -T E.f3 ~ O _:: l ~_ :7 - { ~ ~-~ ~ ~ ~° - ,~ ' ~lp-"-I 3's .. r, 1 ~ DATE FILED W Correspondent's e-mail address: 2 0.f . le ~ A I C K ~ /1 SO n ~ ~ a l.L, 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, it is true, correct and complete, Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056051047 15056051047 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE J 15056052048 REV-1500 EX Decedent's Social Security Number Z'a 7 .3 y. ~ .S ~ l :3 . 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) O Separate Billing Requested ....... 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) O 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 8~ 10) ................................... 11. 12. Net Value of Estate (Line 8 minus Line 11) .............................. 12. 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which 29 w5, U' o o -- A'~ .. T _2... •,.,~ - .~ - ~ . , ~~< Z2,2.3~2~`0 i i ; l 3 ; y: 01~ ~: T y3Ot~3`~'9 • w ,~.•..~, . 23~'~b~3~~~ ~= l ~ 2~ 8 9 ~ ~ ~=o ~'~`~`sw9`b an election to tax has not been made (Schedule J) ...................... .. 13. • 13 Li 12 i i 14 q ~~ "7 Q Je U ~ ~ ~~ I 14. ) ...................... ne m nus ne Net Value Subject to Tax (L .. . t TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(L2) X .0_ 15. e 16. Amount of Line 14 taxable // // at lineal rate X .0 ~ ~ o ~~ LO ~ 5. ~ (0 16. ' u ~ ~~ ~ ~ -~ s ~ ~i 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-0F AN OVERPAYMENT O Side 2 15056052048 15056052048 REV-1502 EX+ (6-98) SCHEDULE A COMMONWEALTH OF PENNSYLVANIA REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER ott' ~ ~~ar 2/QS~'D/83 All real property owned sol ly or as s 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. Reel property which is jointly-owned with right of survivorship must be disclosed on Schedule F, ITEM NUMBER DESCRIPTION ~. ~ ~ ~~ ~ s--Q, ,.,r VALUE AT DAI t ~V ~f Ire L' ~ r ,-!I TOTAL (Also enter on line 1, Recapitulation) I $ L~ %J~,- v av~ °~ (If more space is needed, insert additional sheets of the same size) OMB NO. 2502-0265 ~• 6. T.. _; OF LOAN: J.S. DEPARTMENT OF HOUSING 8 URBAN DEVE LOPMENT 1.QFHA 2.QFmHA 3. QCONV. UNINS. 4. QVA 5. QCONV. INS. SETTLEMENT STATEMENT 6. FILE NUMBER: 2s3z 7. LOAN NUMBER: 8. MORTGAGE INS CASE NUMBER: , ~. 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 [POCJ' were paid outside the dosing; they are shown here for inforrrrationa! purposes and are not included in the totals. 1.0 3NB (2532.PF~2532nt) ). NAME AND ADDRESS OF BORROWER: =rends L. Bear 'hoebe S. Bear E. NAME AND ADDRESS OF SELLER: Estate of Mary Diehl Bear F. NAME AND ADDRESS OF LENDER: 3. PROPERTY LOCATION: 199 Barnstable Road H. SETTLEMENTAGENT: 23-3003499 Search 8 Settlement Solutions, Inc. I. SETTLEMENT DATE: June 13 2008 ~umberlandCounty,Pennsylvania pLACEOFSETTLEMENT 111 North 6th Street, PO Box 1659 Readlnp, PA 19803-1659 , J. SUMMARY OF BORROWER'S TRAN SACTION K SUMMARY OF SELLER'S TRANSACTION D0. GROSS AMOUNT DUE FROM BORROWER: 01. Contract Sales Price 190,000.00 400. GROSS AMOUNT DUE TO SELLER: 401. Contract Sales Price 190,000.00 02. Personal Pro 402 Personal Pro e 03. Settlement Char es to Borrower Une 7400 2,419.50 403. 04, 404. O5. 405. Ad ustments Forltems Paid B Sellerln advance Ad'ustments For Items Pald Seflerin advance O8. C' /Town Taxes 08/14/08 to 07/01/09 170.80 408. Ci fl'ownTaxes O6H4l08 to 01/01/09 170.80 D7. Coun Taxes to 407. Coun Taxes to OB. School Taxes 06/74/08 to 07/01/08 76.55 408. School Taxes 06/14/08 to 07/01/08 76.55 09• 409. 10. 410. 11 • 411. 12. 412. 20. GROSS AMOUNT DUE FROM 80RROWER 192,666.85 420. GROSS AMOUNT DUE TO SELLER 190,247.35 00. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER: 01. D ositoreamestmone 19,000.00 501. Excess De osit Seelnstructions 02. Prind al Amount of New Loans 502. Settlement Char es to Seller Line 1400 1,900.00 03. Existin loans takensub'ectto 503. Exisdn loans taken subectto ~• 504. Payoff of first Mortgage O5. 505. Pa off of second Mort a e O6. 506. De os(tretafnedb seller 19,000.00 07. 507. O8. 508. 09. 509. Rd ustments For Items Un and B Seller Ad ustments For Items Un ald B Seller 10. Ci !Town Taxes to 510. CI /Town Taxes to 11. Coun Taxes to 511. Coun Taxes to 12. School Taxes to 512. School Taxes to 13. 513. 14. 514. 15. 515. 18. 516. 17. 517. 18. 518. 19• 519. 20. TOTAL PA/D BY/FOR 80RROWER 19,000.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 20,900.00 00. CASH AT SETTLEMENT FROMITO BORROWER: ]1. Gross Amount Due From Borrower Line 120 )2. Less Amount Paid B/For Borrower (Une 220) 192,666.85 ( 19,000.00) 600. CASH AT SETTLEMENT TOIFROM SELLER: 601. Gross Amount Due To Seller Line 420 190,247.35 802. Less Reductlons Due Seller(Line 520) ( 20,900.00 73. CASH (X FROM) ( TO) BORROWER 173,666.85 603. CASH (X TO) ( FROM) SELLER I 169,347.35 The undersigned hereby acknowledge receipt of a completed copy of pages 1&2 of this statement 8 any attachments referred to herein. Borrower ~~~~~ G rinds .Bear Phoebe S. Bear Sell r ^,` ~ ~2~ G~7~.~-u~ Estate of Mary Diehl Bear Paps 2 L SETTLEMENT CHARGES 700. TOTAL COMMISSION Based on Price $ % PA~AtOM PAID FROM Division Of Ccmmfssion lln8 700 aS FOIIO W5 BORROWERS SELLERS 701, $ t0 FUNDS AT FUNDS AT 702, $ t0 SETnEMEM SETiLEMEM 703. Commission Paid at Settlement 704, to 800. ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Or' ination Fee % to 802. Loan Discount °k to 803. DocumentPreparaCan to 804. Credit Report to 805. Appraisal Fee to 806. licafion Fee to 807. Tax Service Fee to 808. Flood Certlfication 809. Underwri0n Fee 810. 811. 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest From to ~ $ Iday ( days %) 902. Mort a e Insurance Premium for months to 903. Hazard Insurance Premium for ears to 904. 905. 1000. RESERVES DEPOSITED W17H LENDER 1001. Hazard Insurance $ r 1002. Mort a e Insurance $ er 1003. C /Town Taxes $ er 1004. Coun Taxes $ r 1005. School Taxes (al $ per 1006. $ 1007. @ $ per 1008. re ate Ad'ustment $ er 1100. TITLE CHARGES 1101. Settlement orClosin Fee to SearchBSettiementSolutions Inc. 125.00 1102.AbstradorTitleSearch to Search&SettlementSofutions,lnc. 350.00 1103. TIUe F~camination to 1104. Tllle Insurance Binder to 1105. Document Pre aration to 1106. Note Fees to 1107. Attorney's Fees to includes above item numbers: 1108. Title Insuance to indudes above item numbers: 1109. Lenders Coverage $ 1110.Cmvner'sCoverage $ 190,000.00 1111. 1112. 1113. Commonwealth Land Title Insurance Company 1114. Federal Express Fees Search & Settlement Solutions 1115. Certifcation Fees Search & SettlementSolutions 1116. 1117. 1118. 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recording Fees: Deed $ 44.50; Mortgage $ Releases $ 44.50 1202. Cit /Coun Tax/Stam s: Deed 1,900.00• Mort a e 950.00 950.00 1203. State Tax/Slam s: Deed 1,900.00; Mort a e 950.00 950.00 1204. 1205. 1300. ADDITIONAL SETTLEMENT CHARGES 1301. Surve to 1302. Pest Ins action to 1303. 1304. 1305. 1400. TOTAL SETTLEMENT CHARGES (Enter on Lines 103, Section J and 502, Seetion K 2,419.50 1,900.00 By signing page 1 d ttis slalement, Nesignatores ackravAeage recept °f a campetee copy ar page 2 of aas tvro page atatament,~,~ ~ (~ e ' Search 8 Settlement Solutions, c Settlement Agent t zs3z izssz re I Tax Parcel No.: THIS INDENT URE MADE THE ~3 yday of June in the year of our Lord two thousand eight (2008) BETWEEN JACOB LEHMAN BEAR. JR., Executor of Estate of MARY E. BEAR, a/kla MARY DEIHL BEAR, deceased, late of West Pennsboro Township, Cumberland County, Pennsylvania, the said Executor being of 334 Shed Road, Newville, PA 17241, party of the first part, ' GRANTOR, AND FRANCIS L. BEAR, and PHOEBE S. BEAR, husband and wife, of 197 Barnstable Road, West Pennsboro Township (Carlisle), Cumberland County, Pennsylvania 17013, parties of the second part, GRANTEES, WHEREAS, Mary E. Bear, a/k/a Mary Deihl Bear, died on January 31, 2008, seized in fee of the hereinafter described real estate, and by her Last Will and Testament dated May 26, 1999, since her death duly proved and remaining of record in the Register of Wills, in and for Cumberland County, at Carlisle, Pennsylvania, and filed to estate File No. 21-2008-0183, provided, inter alia as follows: FOUR: I app©int JACOB L. BEAR, JR., JOHN H. BEAR, DEBORAH K. CAMPBELL, AND, STEPHANIE E. BEAR, to serve as Co-Executors of this my Last Will. FIVE: My Executors may, at their discretion, compromise claims, borrow money, retain property for such length of time as they may deem proper; lease and sell property for such prices, on such terms, at public or private sales, as they may deem proper; and invest estate property and income without restriction to legal investments. SIX: No Executor or Trustee acting hereunder shall be required to post bond or enter security in this or any jurisdiction. WHEREAS, the said John H. Bear, Deborah K. Campbell, and Stephanie E. Bear renounced their right to serve as Co-Executors, resulting in Letters Testamentary in the Estate of Mary E. Bear, Deceased, being issued by the Cumberland County Register of Wills to Jacob Leaman Bear, Jr:, on February 20, 2008, without the requirement that any bond be posted by him, which Letters Testamentary remain in full. force and effect, and, WHEREAS, the said Mary E. Bear, a/k/a Mary Deihl Bear, died an unremarried widow of J. Lehman Bear, who died on December 27, 1994, and, WHEREAS, Section 3351 of the Probate Estate and Fiduciaries Code (20 Pa. C.S.A. 3351) gives personal representatives the power to sell at public or private sale any real property not specifically devised, and, WHEREAS, the hereinafter described real property was not specifically devised. ~'. ,; ~ , Page I of 3 NOW THIS INDENTURE WITNESSETH, that the s~dld' i~ttlHtars for and in consideration of the sum of ----ONE HUNDRED NINETY 7`F1'OU.~AND-__ ($190,000.00)-- Dodlars lawful money of the United States, to them in hand paid by the said Grantee, her heirs and assigns, at and before the sealing and deliver hereof, the receipt whereof is hereby acknowledged have granted, bargained, sold, aliened, released and confirmed, and by these presents, da grant, bargain sell, alien, release and confirm unto the said Grantee, her heirs and assigns, ALL THAT CERTAIN tract of land situate in West Pennsboro Township, Cumberland County and State of Pennsylvania, bounded and described as follows: BEGINNING at a point in the center of the township public road leading from State Highway_Route No. 641 to the Ritner Highway, said point being a corner of other land now or formerly of Francis L Bear and Phoebe Shaffer Bear, his wife, the following courses and distances: (1) North 7-1/4 degrees East 193.4 feet to a point; (2) North 43 degrees West 53.1 feet to a' point; (3) North 11 degrees 10 minutes West 142 feet to a stake; (4) South 75 degrees 50 minutes East 217.5 feet to a point; (5) South 4 degrees West 328.7 feet to a point in the center of the said township road; thence along the center of said township road; North 88 degrees West 149 feet to a point, the Place of BEGINNING. BEING the same premises which Jacob S. Bear and Jessie L. Bear, husband and wife, by deed dated April 23, 1959 and recorded April 23, 1959, in the Office of the Recorder of deeds, in and for Cumberland County, at Carlisle, Pennsylvania, in Deed Book "B," Volume 19, Page 393, granted and conveyed to J. Lehman Bear and Mary Deihl Bear husband and wife. THE SAID J. Lehman Bear died on December 27, 1994, thereby vesting the entire fee simple title in Mary Deihl Bear, whose estate is the Grantor herein. TRACT No. 2 ALL THAT CERTAIN tract of land situate in West Pennsboro Township, Cumberland County, Pennsylvania, bounded and described as follows: BEGINNING at a point in the center of the Township Road leading from State Highway Rottte No. 641 to the Ritner Highway; thence by other land now or formerly of J. Lehman Bear and Mary Deihl Bear, North 4 degrees East 233 feet, more or less to a point; thence along a fence line, by land now or formerly of Francis L. Bear and Phoebe Shaffer Bear, his wife, North 84 degrees 45 minutes East 270 feet more or less, to a point; thence along a fence line by land now or formerly of Jacob S. Bear and Jessie L. Bear, his wife, South 17 degrees East 295 feet, more or less, to a point on the eastern side of the public road aforesaid; thence by the center of said Road, North 86 degrees West 369 feet to the Place of BEGINNING. CONTAINING 1.89 Acres, more or less. BEING the same premises which Jacob S. Bear and Jessie L. Bear„husband and wife, by deed dated April 22, 1966 and recorded April 22, 1966, in the Office of the Recorder of Deeds, in and for Cumberland County, at Carlisle, Pennsylvania, in Deed Book "Y," Volume 21, Page 289, granted and conveyed to J. Lehman Bear and Mary Deihl Bear. n J(dt~ i(.J}'v Page 2 of 3 THE SAID J. Lehman Bear died on December 27, 1~J4, thereby vesting the entire fee simple~title in Mary Deihl Bear, whose estate is the Grantor herein. 4;~~ THE SAID TRACTS having erected thereon a dwelling house la-own as and numbered 199 Barnstable Road, Carlisle, Pennsylvania 17015. TOGETHER with all and singular ways, waters, water-courses, rights, liberties, privileges, hereditaments and appurtenances whatsoever thereunto belonging, or in anywise appertaining, and the reversions and remainders, rents, issues and profits thereof,• and also all the estate, right, title, interest, use, trust, property, possession, claim and demand whatsoever of the said Mary E. Bear. a/k/a Mary Deihl Bear at and immediately before the time of her death, in law, equity or otherwise howsoever, of, in, to or out of the same: TO HAVE AND TO HOLD, the said buildings, hereditaments and premises hereby granted and released, or mentioned and intended so to be, with the appurtenances, unto the said, Grantees, their heirs and assigns, to and for the only proper use and behoof of the said Grantees, their heirs and assigns, forever. AND the said Grantor does covenant, promise and agree, to and with the said Grantees their heirs and assigns, by these presents, that he the said Grantor, has not done, committed, or knowingly or willingly suffered to be done or committed, any act, matter or thing whatsoever whereby the premises hereby granted, or any part thereof, is, are, shall or may be impeached, charged or encumbered, in title, charge, estate, or otherwise howsoever WITNESS the due execution hereof the day month and year first above written. WITNESS: `~ ,t/~j . ;t /J~t (SEAL) / Jacob Lehman Bear, Jr., Executor f the Estate of Mary E. Bear, a/k/a Mary Deihl Bear, Deceased Commonwealth of Pennsylvania } ss. County of C{.,L~(/{--1.~U,~~-1dt On this, the I ~ day of ~u~ , 2008, before me, the undersigned officer, personally appeared JACOB LEHMAN BEAR, JR., Executor of the ESTATE of MARY E. BEAR, a/k/a MARY DEIHL BEAR late of West Pennsboro Township, Cumberland County, Pennsylvania, Deceased, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that he execa~ted the same in the capacities therein stated and for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. ~u~::,u,svre,~rps or•• r~rrn+sn„wwxa ~nI^ PIOTARIAL SEAL ~,~,~ ~'~~ ~~C{!~/ (SEAL) MELISSA M. 2EIDERS, FiHo~ /, ~urg, Dauphin Peb 24, 99 I do hereby certify tlutt the precise residence and complete post office address of the within named Grantees is fl, / ~•-~ , . q7 !3/hM S~+lr~. ~ . Ca~-'(I s (ct P~ I ? o t S - Charles M. 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Lehman Bear died on December 27, 1994, thereby vesting the entire fee simple title in Mary Deihl Bear, whose estate is the Grantor herein. TOGETHER with a certain easement and right-of-way described in Deed of Right-Of-Way dated November 23, 1982 and recorded December 29, 1982 in the aforementioned Recorder's Office in Miscellaneous Record Book 282, Page 428, the same being a 50-foot right-of--way situate along the southernmost portion of property then owned by Ronald E. Shughart, et ux. and extending from the above- described property, to the legal right-of-way of Longs Gap Road. TOGETHER with, and under and subject, nevertheless, to, the certain Right-Of-Way Agreement dated October 15, 1982 and recorded December 29, 1982, in the aforementioned Recorder's Office in Miscellaneous Record Book 282, Page 931. TOGETHER with all and singular ways, ,waters, water-courses, rights, liberties, privileges, hereditaments and appurtenances whatsoever thereunto belonging, or in anywise appertaining, and the reversions and remainders, rents, issues and profits thereof,• and also all the estate, right, title, interest, use, trust, property, possession, claim and demand whatsoever of the said Mary E. Bear a/kla Mary Deih[ Bear at and immediately before the time of her death, in law, equity or otherwise howsoever, of, in, to or out of the same: TO HAVE AND TO HOLD, the said buildings, hereditaments and premises hereby granted and released, or mentioned and intended so to be, with the appurtenances, unto the said, Grantees, their heirs and assigns, to and for the only proper use and behoof of the said Grantees, their heirs and assigns, forever. AND the said Grantor does covenant, promise and agree, to and with the said Grantees their heirs and assigns, by these presents, that he the said Grantor, has not done, committed, or knowingly or willingly suffered to be done or committed, any act, matter or thing whatsoever whereby the premises hereby granted, ar any part thereof, is, are, shall or may be impeached, charged or encumbered, in title, charge, estate, or otherwise howsoever WITNESS the due execution hereof the day month and year first above written. WITNESS: yy ^ ~" 7 ~`L ~~.._ /' ~.,,. ~ ~ .~.5 (SEAL) acob Lehman Bear, Jr., Executor of a Estate of Mary E. Bear, a/k/a Mary Deihl Bear, Deceased Page 3 of 4 b fo y a8ad / / Saajun.r~ 10~~a1r10j1~' ~~ ~~ ~/y ~L / ~p~ yal~ ~r~/~~G/ ~~' d'°~^YS ~~' ~' st saajuv.r~ paurnu uiyn.M ay; ,~o ssarppn ao~•o ;sod a1a1 uroa puv aouapisal asioa.rd ay; lnyj Ajil.taa ~Cga.ray op I oioz •oz ~aa ,~ w ~ (7~SS) I ;( SYv (~ •Inas Imo o puff puny Cur jas ojuna.ray I `,dO~X~HM SSQt~.LIM AlI •paugnjuoo uta.rayj sasodrnd ayj lo~'pun pajnls utalayl sau;otidno ayi ut auras ay1 pajnaaxa ay jvyj pa8pajntouaton pun '~uaurn.usu: uzyjin+ ai11 01 paquosgns st aurnu asoyna uosrad ayj aq of (uanord ~Clt.~o1an,,(azjns lo) our of unaoux `pasnaaaQ `vtunnt~isuuad `~fjuno~ punt.raqutn~ `dzysunto,L o.rogsuuad Isar ,~o ajnt gyQg 7HI.~Q d?I6'W nCXln `21b',~S '.~~I2IdLlr.~o ,~Ld.LS3 ayj•~o 1ojn~axg '•?If `~~S NE~WH~7 SO,~df palnaddn ~Cttvuosrad `lao~o pau8tsrapun ayj 'aur a.ro~aq `6002 ` tramc~'~~ .~° `gyp ~,•s'~° ayj `s?yj up ~caro /~az~r W'~t'~ •~o ~Ctuno,~ ss~ I t niuna1rGruuad,~o yl1vanauoututo~ ROBERT P. ZIEGLER RECORDER OF DEEDS CUMBERLAND COUNTY 1 COURTHOUSE SQUARE CARLISLE, PA 17013 717-240-6370 Instrument Number - 200905723 Recorded On 3/2/2009 At 12:18:14 PM * Instrument Type -DEED Invoice Number - 38179 User ID - RAK * Grantor -BEAR, MARY E * Grantee -BEAR, JACOB LEHMAN JR * Customer - FREY * FEES STATE WRIT TAX $0.50 STATE JCS/ACCESS TO $10.00 JUSTICE RECORDING FEES - $23.00 RECORDER OF DEEDS PARCEL CERTIFICATION $10.00 FEES AFFORDABLE HOUSING $11.50 COUNTY ARCHIVES FEE $2.00 ROD ARCHIVES FEE $3.00 CARLISLE AREA SCHOOL $0.00 DISTRICT NORTH MIDDLETON TOWNSHIP $0.00 TOTAL PAID $60.00 * Total Pages - 6 Certification Page DO NOT DETACH This page is now part of this Legal document. I Certify this to be recorded in Cumberland County PA ~~4 of cuye~ . RECORDER O D DS taan * -Information denoted by an asterisk may change during the verification process and may not be reflected on this page. iiiiiiuii~i~~uu S• W. Barrett Real Estate & Appraisal Services - File No. 08-0122 -------,_....-------j 04/08!2008 Jacob Bear 334 Shed Road Newville, PA 17241 File Number: 08-0122 In accordance with your request, I have appraised the real property at: Longs Gap Road Carlisle, PA 17013-8604 The purpose of this appraisal is to develop an opinion of the market value of the subject property, as vacant. The property rights appraised are the fee simple interest in the site. In my opinion, the market value of the property as of April 3, 2008 is; $105,000 One Hundred Five Thousand Dollars The attached report contains the description, analysis and supportive data for the conclusions, final opinion of value, descriptive photographs, limiting conditions and appropriate certifications. Respectfully submitted, Stan A. Skowronek Certified Residential Appraiser REV-1508 EX • (1A)) 4 ~ SCHEDULE E CAMMONWEALTHOFPENNSYLVANIA CASH, BANK DEPOSITS-, ~ MISC. INHR SIDENTDECEDENTRN PERSONAL PROPERTY ESTATE OF FILE NUMBER ~c~ru ~13gar- Z>D 8'-418`3 Indude the proceeds of litigation and the date the proceeds were received by the estate. Ali property jointly~owned with the right of survivorship must be discbsad on Schedule f. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH ~ Q,~r~- -.,Q~a-~- ~ d,ct,~,e.P~i,~ ,,e=~-~x-, ~' ~ x-13 ~ ~"5' ~~ b TOTAL (Also enter on line 5, Recapitulation) ~ s ~~ (If more space is needed, insert additional sheets of the same size) Z ~~ Z ~ Z 2000,Buiak Century -Private Party Pricing Report -Official Kelley Blue Book Site ~~v~ ~~ ~~ ~~~~~ Page 1 of Nome New Cars Used Cars Research & Explore News & Reviews Ready To Buy Classifieds Loans & Insuran Used Car Prices ~ Search Used Car Listings ~ Certified Pre-Owned ~ Compare Vehicles ~ Perfect Car Finder ~ Most Researched Vehicles Welcome Back ~ Sign In ~ Create Account ~ My KBB ZIP Code: 170].3 Recently Viewed You Might Also LiN Home > SJ ed Cars > 20Q0 > Buick > Century > Custom Sedan 4D 2000 Buick Century Custom Sedan 4D Trade-In Value Private Party Value _ ~~~ ~~~~~ ~~~~~~~, ;~~~~' ~~~~ . ~,.,~:, __ _ _ _ __ _ _ Suggested Rctafl Value _ ., ., _ Estimated Payment: ~x n if'' #~ s - ' $ 53 /mo CAD 5.49% APR Photo Gallery ~~~ ~~ "~~~ Condition ;: ,.- Value .~, _, ,._,u Compare Vehicles r~EU.~! ~" Review " "` '" ~ ~XCe~~ent ' ~-3r54~ C~et a Pre-Owned t..oan from `~ .~ Consumer Ratings ~~~~~ '~ "~" ~Sood $3x165 6.29°lo APR Find Your Next Car ~`~''"`~ ~~ ~'~-~~~~~" Fair _ <•. $2 715 r Get Your Credit Score Now SpeCifiCatiOnS More Photos ' Get a Free Insurance Quote Shopping Tools • ---•---~- e~dvertisernent --- ~~ ~ ~ ~ ~ * Sr ARCN LQCAL LIS"FiNGS Free CARFAX Record Check Auto Loan from 5.39% APR Get Your Credit Score Now Free CARFAX Record Check Powered by ,~~?' :.~,, e.,~.. __.._. Get a Free Insurance Quote _ _ _ _ _ _ Payment Calculator ',' VIN: Extended Warranty Quote No VIN? No Problem! Print For Sale Sign _. _ _ _ _ __. _ _ _ ~~~ ~ ~~~(} ~~~. Average Consumer Rating (226 Reviews} Read Reviews on Blue Book ClassifiedsT" powered By ~~'~' ~,: , Buick_ _ __ _ Century _ _. 25 Miles or less ZIP Code 17013 I To View Ads, Click http://www.kbb.com/KBB/LTsedCars/PricingReport.aspx?Yearld=2000&Mileage=85000&VehicleClass=U... 3/30/200 I 2000 Bujck Century -Private Party Pricing Report -Official Kelley Blue Book Site Special Package Offer! .'";z~:; t~~. ° 4.4 out of 5 Review this Vehicle For one low price you _ _. ~~~'~ can reach millions of ~°°°~° ~~~~~~~~~~ used car shoppers. Vehicle Highlights Page 2 of Learn more now Mileage: 85,000 - Engine: V6 3.1 Liter - Transmission: Automatic ~~~~ ~~~ ~~~ f~~ Drivetrain: FWD Compare Used vs. New ___ Under $5,000. _. Selected Equipment Change Equipment Both New and Used Standard ' Sedan , Air Conditioning Power Door Locks Dual Front Air Bags Power Steering Tilt Wheel ABS (4-Wheel) To View List, Ciick power Windows AM/FM Stereo ~~~~ ~~.~~~~ ~~~~~~~ Optional Select Year... Cruise Control Blue Book Private Party Value Or Search by Category Private Party Value is what a buyer can expect to pay when buying a used Or Change ZIP Code car from a private party. The Private Party Value assumes the vehicle is sold "As Is" and carries no warranty (other than the continuing factory warranty). T'he final sale price may vary depending on the vehicle's actual condition and local market conditions. This value may also be used to derive Fair Market Value for insurance and vehicle donation purposes. Vehicle Condition Ratings Check Vehicle '1"itie Flistory Excellent _.~~ _. ~3,54C? + t..aaks new, is in excellent mechanical condition and needs no reconditioning. + Never had any paint or body work and is free of rust, • Clean title history and will pass a smog and safety inspectian, s Engine compartment is clean, with na fluid leaks and is fret, of any wear or visible defects. • Camplete and verifiable service retards. http://www.kbb.com/KBB/UsedCars/PricingReport.aspx?Yearld=2000&Mileage=85000&VehicleClass=U... 3/30/200 Agreement for Sgle of Persana~ and C~nat~e~ Property by Aucf~~orc :- Agreem~ent made this -- ---~~_-- _-- day-o+' ~_~ /~-. - --- ---- -,~1~- '_ between _ 1 _ ` /'f- ' - -µ' --- 1 - -- ,- - --------- --- __________ ______ ___-- ----____-- --____-, hereafter called Seiler, / ^` G~ , . - - ,•% _ and __ i ~ ,r .:_. _,t-f ti :,,~,-~ ~'~1~ ~~,~~j;1 y;,,~,!°~- -- -~-~~i ;~ -!t~•reaixer called Auctioneers. r--- - The auctidfiieer hereby agreds to use Psis professional skill. knowledge, and experience to the best ad- vantage of both parties in• prepe°xing for and donducting the stile. The seller hereby agrees to turn over and delirer to the auctioneers, to be sold at pu3~lic auction the items listed below and on the reverse side and attained sheets_ No item shall be sold or withdrawn from the sale prior to the auction except by mutual. agreement bet~seen seller and auctioneer. Tf item is said or withdTB.Wn auctioneer shall receive full commission on 7ne item. / : y. l,F. ______....___ __________________-______-__ /,/ ~ The auction is to be held at _ _,~./"f~ .~ -.~.~=_ ` ~~ •r- ~ or_ the __...._____"`~ _ day of 1 ~1'~~1.~_______._.,~c1~Q.,~,, . And in case of postponement because a ..~ -- inclement weather, said auction will take lace on later date agreeable to both parties. Tt is mutually agreed that all said goods be sold to the highest bid der, tirith the exception of items specified by seller in writing to be protected. Auctioneer shall receive full cerazrission on any item witlsdrawz) from sale or transferred or sold within 6Q days after the auction. Tt is further mutually agreed that the auctioneers may deduct their fee at set rate below from the gross sales receipts, resulting from. said auction sale. The auctioneers agree to turn net proceeds frocxx sale o': er to seller imnxediately following auction, along with sale records and receipts. The seller agrees that all expenses incurred for the advertisement, prornotion, and of conducting said auction shall be first, paid from ti'fe proceeds realized from said auction before the payment and satisfaction of any loins or encumbrar cos. The seller covenants and agrees that he has good title and the. right to sell, and said goods fi1•e free from all inaumhranees except a5 follows: {if none ~'ItYT~ ATQ7RTlE3 ____-.---------------- Ttem Mortgage or Lein Holder Address Apgraximate Unpaid Balance ~An _-_-_--/-~~ ..- r...!' -_•.------ Seller agrees to provide merchantable title to all items sold and deliver title to purchasers. Seller agrees to hold harmless, the auctioneers agaix:st asxy ~;la.ims •;;f the hat::: ~ refer;..:.;, to in this contract. Seller agrees to pay all sale expenses izxciudirig: .~ ~' ~ ,~7 J ~`~ - Jw uctituieer'~; P'ee--c.~.~-b~. ~•-------------•------- ~_..///,~.~.rl,/.,~~~e' ""r '",~' Clerk's Fee----------------------------------- Laahier's Fec -------- ---------- ------ • '~ ,~ ,,,per /' J/ / ~ ~ - `- --~K~--------''`""=-`"`=~'"-,,,.~,= i~ y~~ ~%'iJ1 ;%.,r~ ~ ~/ / .rr.. ,....~=' /•'/•.~ T"-"~~5 ,r'~Si~aturel Telephone ,- C. Cher Pers n __________.---____-- -- ~;~~.~ Advertising_.._~ ' f°~'`~~~!~~%_ r a , y /~ ~)ther_ _ ~ _ ~~-~ der li,~i~~~~ .,, t '' ~ -------- -T ~ ; (Auctioneer's Addressl {'rPlephone} •{Sel1cr's Signaturz.l ;Telephone) (SeIler's Address) --- - {.tye.ll€:r's Social Security No. or ,s E13 ID No. ) .A ~ ,r~ ~ .:,;. ; ~_s a :max:, ~~ ~~ , ... . . .~' ;;~^ ~ ~~, ~f7~ _~,~~ .~ } , -,.. ,_.. _.. _ _•~ v ~ ~ 1,~~, ass _. --.. -- j,~ L ~~ J ~ ~ ! i ~~.., ~- } ~ ,, ~ ~~j ~' _.... y/9~ . _ _ .._ _ .. ~~ //.%% .__ .,lone_r --- ----- .., ~: ~., --', 'lYiSC°Ilc~!"t°CliS lSe? 'r'~CI'icL'i ;, _ _ _. ._ L ,. ,. _ Q r ~ ~ _ E ~~:^x g ..._ _.._......__. .. _.. ... .v - ~ t^, r e per s ~x~,~er?ses +..'y. `.(c+[i C'`~Cf J'1 ~-i i.:{'; Ct r.r'r~' ~ ~ ~7 '~ ~r~7,a~ Exr~~r~s.~ .~~, ` ~ _i./ a ~^' -- ~ ~- ---" ,z.: ;-~ tt" >7T) i. ~~. r15 OII:TV 'YUf' arc\t~i!"C° ~'P(C.l'38 71 c'~'? .~ ,ST:r t. ._. C.t S..rC1 .~CC~ ._. «.iS alit= Ji _ __ .. ~$rll 3 .E'• in,~11Rr ___`.if+3 S,~Yf .`..) at m '. -,oi N s 1.~~ t„~,~q I~1 M&T Bank . TAX`.~L1 tiUKl~TER R~TIREl1AENT !D !lCl. 207-34-6813 L207346813 INDIVIDUAL RETIREMENT ACCOUNT MST BANK AS TRUSTEE FOR 4319 52,468 MARY E BEAR 334 SHED RD NEWVILLE PA 17241 ~~~:-~ .............. ..:.._.............:..~ >:; 16-0538020 ::~~:~.. STA7EMENT'PERfOt)` PAGE 01-01-08 to 12-31-08 1 M&T TELEPHONE BANKING CTR PO BOX 767 BUFFALO, NY 14240 800-829-1924 ~~ 07-31-32 WKTii TRANSACTION QE$CRIPTIOti AMOUNT ''BALANCE'::"" ACCOUNT NO 35-004201359583 ACCOUNT TYPE 10 FOR 10 RATE 9.650 MATURING 12-27-09 REGULAR IRA 01-01-08 BEGINNING BALANCE 61,114.29 0 3-20-08 INTEREST 1,357.24 62,471.53 . 6~-20-08 TRANSFER OUT TO BENEFICIARY 62,471.53= .00 ACCOUNT NO 35-004201572482 ACCOUNT TYPE PREM INT RATE 6.820 MATURING 12-27-09 REGULAR IRA 01-01-08 BEGINNING BALANCE 35,111.77 01-02-08 INTEREST 163.99 35,275.76 01-02-08 TAX WITHHELD-NORMAL W/D 50.00- 35,225.76 01-02-08 TAX WITHHELD-NORMAL W/D 1,000.00- 34,225.76 01-02-08 PAYOUT DISTRIBUTION 10,000.00- 24,225.76 01-02-OS PAYOUT DISTRIBUTION 450.00- 23,775.76 02-O1-OS INTEREST 133.27: 23,909.03 02-01-08 TAX WITHHELD-NORMAL W/D 50.00- 23,859.03 02-01-08 PAYOUT DISTRIBUTION --53 450.00- 23,409.03 03-03-08 TAX WITHHELD-NORMAL W/D 50.00- 23,359.03 03-03-08 PAYOUT DISTRIBUTION ---X450.00- 22,909.03 ~-20-08 INTEREST " 208.36 23,117.39 03-20-08 _ TRANSFER OUT T ~ ~E'NEF'I~C"I'~ARY 23, 117.39- . 00 *** CONTINUED NEXT FORM **~ L007 (11A78) .~: zoa7 Form 8879 oepartrnent a the Treasury Internal Revenue Service ~, IRS a file Signature Authorization - Do not send to the IRS. This is not a tax return. - Keep this form for your records. See instructions. OMB No. 1545-0074 Zoo? Declaration Control Number (DCN)' 0 0 2 3 5 4 9 410.0 6 3 8 Taxpayer's name Social security number MARY E BEAR 207-34-6813 Spouse's name Spouse's social security number Tax Return Information-Tax Year Endin December 31, 2007 (Whole Dollars Only 1 Adjusted gross income (Form 1040, line 38; Form 1040A, line 22; Form 1040EZ, line 4) ......................... 1 19 , 5 5 5 . 2 Total tax (Form 1040, line 63; Form 1040A, line 37; Form 1040EZ, line 10) ...................................... 2 1 , 0 3 8 . 3 Federal income tax withheld (Form 1040, line 64; Form 1040A, line 38; Form 1040EZ, Tine 7) .................... 3 1, 7 5 5 . 4 Refund (Form 1040, line 74a; Form 1040A, line 44a; Form 1040EZ, line 11a; Form 1040-SS, Part I, line 12a) .... 4 7 17 . 5 Amount you owe (Form 1040, line 76; Form 1040A, line 46; Form 1040EZ, line 12) .............................. 5 • Tax a er Declaration and Si nature Authorization Be sure ou et and kee a co of our return Under penalties of perjury, I declare that I have examined a copy of my electronic individual income tax return and accompanying schedules and statements for the tax year ending December 31, 2007, and to the best of my knowledge and belief, it Is true, correct, and complete. I further declare that the amounts in Part I above are the amounts from my electronic income tax return. I consent to allow my intermediate service provider, trans- mitter, or electronic return originator (ERO) to send my return to the IRS and to receive from the IR~a) an acknowledgement of receipt or reason for rejection of the transmission,(b) an indication of any refund offset,(c}the reason for any delay in processing the return or refund, anc~d) the date of any refund. If applicable, I authorize the U.S. Treasury and its designated Financial Agent to initiate an ACH electronic funds withdrawal (direct debit) entry to the financial institution account indicated in the tax preparation software for payment of my Federal taxes owed on this return and/or a pay- ment of estimated tax, and the financial institution to debit the entry to this account. I further understand that this authorization may apply to future Federal tax payments that I direct to be debited through the Electronic Federal Tax Payment System (EFTPS). In order for me to initiate future pay- ments, (request that the IRS send me a personal identification number (PIN) to access EFTPS. This authorization is to remain in full force and effect until I notify the U.S. Treasury Financial Agent to terminate the authorization. To revoke a payment, I must contact the U.S. Treasury Financial Agent at 1-888-353-4537 no later than 2 business days prior to the payment (settlement) date. I also authorize the financial institutions involved in the processing of the electronic payment of taxes to receive confidential information necessary to answer inquiries and resolve issues related to the pay- ment. (further acknowledge that the personal identification number (PIN) below is my signature for my electronic income tax return and, if applicable, my Electronic Funds Withdrawal Consent. Taxpayer's PIN: check one box only lauthorize BIG SPRING SENIOE CENTER to enter or generate myPlN 7r 9845 ERO firm name do not enter all zeros as my signature on my tax year 2007 electronically filed income tax return. I will enter my PIN as my signature on my tax year 2007 electronically filed income tax return. Check this bobnly if you are entering your own PIN and your return is filed using the Practitioner PIN method. The ERO must complete Part III below. Your signature - Date - 0 3 / 14 / 2 0 0 8 Spouse's PIN: check one box only I authorize ERO firm name to enter or generate my PIN do not enter all zeros as my signature on my tax year 2007 electronically filed income tax return. I will enter my PIN as my signature on my tax year 2007 electronically filed income tax return. Check this bobnly if you are entering your own PIN and your return is filed using the Practitioner PIN method. The ERO must complete Part III below. Spouse's signature - Date - Practitioner PIN Method Returns Only-continue below Certification and Authentication-Practitioner PIN Method Only ERO's EFIN/PIN. Enter your six-digit EFIN followed by your five-digit self-selected PIN. 2 3 5 4 9 4 9 8 7 6 5 do not enter all zeros I certify that the above numeric entry is my PIN, which is my signature for the tax year 2007 electronically filed income tax return for the taxpayer(s) indicated above. I confirm that I am submitting this return in accordance with the requirements of the Practitioner PIN method and Publication 1345, Handbook for Authorized IRS a-file Providers of Individual Income Tax Returns. ERO's signature - Date - 0 3 / 14 / 2 0 0 8 ERO Must Retain This Form -See Instructions Do Not Submit This Form to the IRS Unless Requested To Do So For Privacy Act and Paperwork Reduction Act Notice, see the instructions. Form 8879 (2007) BCA Copyright form software only, 2007 Universal Tax Systems, Inc. All rights reserved. US8878S1 Rev. i € Department of the Treasury - Internal Revenue Service ~ 1040 u.s. Individual Income Tax Return 207 99 IRS Use Onl -Do not write or sta le in this s ace. La be i L For the year Jan. 1-Dec. 31, 2007, or other tax year beglnning ,2007, ending ,2o OMB No. 1545-0074 (see In- Name Spouse's Name (if Joint Return) Home Address City, State, and ZIP Code Your social security number stnxaions) E MAR Y E BEAR 2 0 7- 3 4- 6 813 Use the L Spouse's social security no. IRS label. Olharwlse, E pleeseprint 199 BARSTABLE RD You must enter or type. E CAR ISLE A 17 015 - 7 4 2 0 • our SSN s above. • Checking a box below will not Presidential change your tax or refund. Election Campai n - Check here if you, or your spouse if fiiln 'ointly, want $3 to o to this fund see instructions - You Spouse 1 Single 4 Head of household (with qualifying person). (See instructions.) Filing Status 2 Married filing jointly (even if only one had income) If the qualifying person is a child but not your dependent, enter Check only 3 Married filing separately. Enter spouse's SSN above this child's name here. - one box. and full name here.- 5 Quali 'n widow(er) with dependent child (see instructions) Exemptions fia Yourself. If someone can claim you as a dependent,do not check box 6a .................. Boxes checked on b S use .................................................................................. fia and 8b 1 c Dependents: (2) Dependents (3) Dependent's ~~ if qual- No. Of children on fic who: relationship to d ~ for x x If more 1 First name Last name social security no. u credit see rust • lived with you 0 than • did not live with f you due to divorce our or separation depen- 0 (see mstr.) dents, Dependents on 6c O not entered above Se@ i tr Add numbers ns . d Total number of exemptions claimed ................................................................................ on lines above - 1 7 Wages, salaries, tips, etc. Attach Form(s) W-2 Income 7 Attach 8a Taxable interest. Attach Schedule B if required ........................................... . Ba 5 2 . Form(s) W-2 here. b Tax-exempt interest. Do not include on line 8a ............ 8b . Also attach Forms 9a Ordinary dividends Attach Schedule B if required 9a W-2G and . .............................. ........... . 1099-R if tax b Qualified dividends (see instructions) ........................ 9b was withheld. 10 Taxable refunds, credits, or offsets of state and local income taxes (see instructions) ........ 10 11 Alimony received .......................................................................... 11 f 12 Business income or (loss). Attach Schedule C or C-EZ .................................... 12 I you did not get a W-2 13 Capital gain or (loss). Attach Schedule D if required. If not required, check here - ~ 13 , see instructions. 14 Other gains or (losses). Attach Form 4797 ..............:................................... 14 15a IRA distributions .......... 15 b Taxable amount (see inst.) .. 15b 17 , 0 8 7 . 1fia Pensions and annuities .... 18 12 , 4 71 . b Taxable amount (see inst.) .. .1fib 1, 8 5 4 . 17 Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E ...... 17 18 Farm income or (loss). Attach Schedule F .................................................. 18 Enclose, but do not attach any 19 Unemployment compensation .............................................................. 19 , payment. Also, 20a Social security benefits ..... I2pa~ 14 , 2 62 . ~ b Taxable amount (see inst.) .. 20b 5 6 2 . please use 21 Other income. List type and amount (see instr.) 21 Form 1040-V. 2Y Add the amounts in the far right column for lines 7 through 21. This is youtotai income - 22 19 , 5 5 5 . Adjusted Gross Income For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see instructions. BCA Copyright form software only, 2007 Universal Tax Systems, Inc. All rights reserved. US7040;1 23 Educator expenses (see instructions) ....................... 23 24 Certain business expenses of reservists, performing artists, and fee-basis gov. officials. Attach Form 2106 or 2106-EZ ... 24 25 Health savings account deduction. Attach Form 8889........ 25 2fi Moving expenses. Attach Form 3903 ...................... 26 27 One-half of self-employment tax. Attach Schedule SE ...... 27 28 Self-employed SEP, SIMPLE, and qualified plans .......... 28 29 Self-employed health insurance deduction (see instr.) ...... 29 30 Penalty on early withdrawal of savings .................... 30 31a Alimony paid b Recipients ssN - 31a 32 IRA deduction (see instructions) .......................... 32 33 Student loan interest deduction (see instructions) .......... 33 34 Tuition and fees deduction. Attach Form 8917 ............... 34 35 Domestic production activities deduction. Attach Form 8903.. 35 36 Add lines 23 through 31a and 32 through 35 ................. ............................. . 37 Subtract line 36 from line 22. This is youradjusted gross income ....................... - Rev. 1 36 19,555. Form 1040 (2007) MARY E BEAR 207-34- 38 Amount from line 37 (adjusted gross income) .............................................. Tax and 39a Check r 8 You were born before Jan. 2, 1943, 8 Blind. ~ Total boxes Credos if: L Spouse was bom before Jan. 2, 1943, Blind. checked - 39a C Standard b If your spouse itemizes on a separate return or you were adual-status alien, Deduction see instructions and check here ...................... ........ - 39b for- ............... • People who 40 Itemized deductions (from Schedule A) or your standard deduction (see left margin) ...... . checked any 41 Subtract line 40 from line 38 ............................................................... box on line 42 If line 38 is $117,300 or less, multiply $3,400 by the total number of exemptions claimed on 39a or 39b or line 6d. If line 38 is over $117,300, see the worksheet in the instructions ................... . who can be claimed as a 43 Taxable income. Subtract line 42 from line 41. If line 42 is more than line 41, enter -0- . dependent, 44 Tax (see instr.). Check if any tax is from: a ~ Form(sy s61a b ~ Form 4972 c ~ Form(s) 8889 see instr. 45 Alternative minimum tax (see instructions). Attach Form 6251........... . • All others: 46 Add fines 44 and 45 Single or Married filing 47 Credit for child and dependent care exp. Attach Form 2441.. 47 separately, 48 Credit for the elderly or the disabled. Attach Schedule R .. 48 $5'350 49 Education credits. Attach Form 8863 ...................... 49 Married filing 50 Residential energy credits. Attach Form 5695 .............. 50 jointly or Qualifying 51 Foreign tax credit. Attach Form 1116. if required .............. 51 widow(er), 52 Child tax credit (see inst.). Attach Form 8901 if required .... 52 $10,700 Head of 53 Retirement savings contributions credit. Attach Form 8880 ... 53 household, 54 Credits from: a Form 8396 b Form 8859 C Forth 8839 54 $7,850 55 Other credits: a Form 3600 b 8 Forth 8801 c 8 Form 55 56 Add lines 47 through 55. These are yourtotal credits ..................................... . 57 Subtract line 56 from line 46. If line 56 is more than line 46, enter -0- .... , _ . • , , . • • . • , , • • , - 58 Self-employment tax. Attach Schedule SE ................................................ Other 59 Unreported social security and Medicare tax from: a ~ Form 4137 b ~ Form 8919 ... . TaXeS 60 Additional tax on IRAs, other qualified retirement plans, etc. Attach Form 5329 if required ... . 61 Advance earned income credit payments from Form(s) W-2, box 9 ......................... . 62 Household employment taxes. Attach Schedule H .......................................... 63 Add lines 57 through 62. This is yourtotal tax .......................................... - Payments ifi4 Federal income tax withheld from Forms W-2 and 1099...... 64 1 , 7 5 5 . 65 2007 estimated tax pymts and amt applied from 2006 return 65 If you have a 66 a Earned income credit (EIC) .............................. 66a qualifying child, Nontaxable combat attach Schedule b payelecbon • • • • • • • • - 66b EIC. 67 Excess social security and tier 1 RRTA tax withheld (see inst) 67 68 Additional child tax credit. Attach Form 8812 .............. 68 69 Amount paid with request for extension to file (see inst) ...... 69 70 Payments from: a ~ Forth 2439 b~ Form 4136 C~ Form 8885 70 71 Refundable credit for prior year minimum tax from Form 6801, line 27 71 72 Add lines 64, 65, 66a, and 67 throw h 71. These are ourtotal a ants ................ - Refund 73 If line 72 is more than line 63, subtract line 63 from line 72. This is the amount yowverpaid Direct deposit? 74 a Amount of line 73 you wantrefunded to you. If Form 8888 is attached, check here - See instructions - b numtie XXXXXXXXXXXXXXXXXXX - c T e: ~ Checking ~ Savings and fill in 74b, Account 74C, and 74d, - d number XXXXXXXXXXXXXXXXXXXXXXXX or Form 8888. 7g Amount of line 73 you want a lied to our 2008 estimated tax - 75 Amount 76 Amount you owe. Subtract line 72 from line 63. For details on how to pay, see instructions - YOU OWe 77 Estimated tax penalty (see instructions) .................... 77 D 19 40 6, 650. 41 12, 905. 42 3, 400. 43 9, 505. 44 1, 038. 45 46 1, 038. 56 57 1, 038. 58 59 60 61 62 s3 1, 038 . FORM 1099 72 1, 755. 73 717 . 74a 717 . 76 Thtrd Party o you want to allow another person to discuss this return with the IRS (see Instructions)? Yes. Complete the fdlowing. NO Designee Designee's Phone Personal identification name - no - number (PIN) - .,Sign Under penaftres of per)ury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief, they are true, correct, and complete. DeGaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge. Here Your signature Date Your occupation Daytime phone number Joint return? E T I RE D See instr. Keep a copy Spouse's signature. ff a }Dint return, bah must sign. Date Spouse's occupation for vour records. Preparers ' Date Check if Preparer's SSN or PTIN Pa Id signature self-employed 5 2 5 0 5 0 817 Preparer's Firm's name (or BIG SPRING SENIOR CENTER EIN Use Only m"p~)"~ ZIPc~pdeend ' NEWVILLE PA 17241- Phone no. BCA CopyrtgMtortn software only, ZOOS umlversal Tax systems, Inc. All dents reserved. usloaos2 Rev. 1 Form 1040 (2007) M H SD I M I r 0 N r O O N H a O a w a H ~i H W Q a I 0 -V to H o ro U W O U N z O In r O1 I H ~O 00 N l0 I C' O1 M r+ ~r I 61 M r-I M I 00 H I H N I ~ ~ I H ~ I ~-i '-i I O U I a >C I W I N a ~ rn ,p rn ro O k ~ ro H o u-> r rn I ~ l0 O~ N l0 I d' 61 M r-i C' I dl M H M I r~ H I H rn rn 0 S-I C~ OJ ~ 1 +~ .~ I ro ~ I J! •rl I ~ ~ I . ,~ b ~ N -rl Gu $ x o r H t!] I I I I 2 I H I w I I i sa a~ ro a o in r to I m to rn N r I ir> rn M '-I o I u~ M H M '-i I 61 H H i N ~n M r I ~ Ql r-i 'O~ I t.f) M M i r H I H r r r r H F H H O M N a' N ~r ~r O o r ~o c CO V' cr N M v+ ~ M ~n o ~n r O M N r-I l0 M l0 H H H M M ~a ~ ~ a H ~ ~ 2 z z W H H a W ~nwwx a w w H W H H ~ a a a o ~ ~ H x w U a H z ~co~ca w ~ H w a cn E~ z ~ 3 US 1040 PRINTED 03/14/2008 MARY E Main Information Sheet 199 BARSTABLE RD CARLISLE PA 17015-7420 Email Taxpayer Occupation Filing Status Taxpayer SSN 207-34-6813 Birth 07/31/1932 Death Day Phone Evening Cell or Fax PIN 79845 2007 Spouse RETIRED SINGLE Preparer ID: Preparers Preparer's Use: 1 MES 2 YES 3 Preparation Fee: Spouse Occupation 525050817 4 5 6 Date: Time in return 15 min. Recap of 2007 Income Tax Return Eamed Income .......... Federal Tax .............. 1 , 0 3 8 . Federal AGI .............. 19 , 5 5 5 . Withholding .............. 1 , 7 5 5 . Taxable Income ......... 9 , 5 0 5 . Refund/(Due) .............. 7 17 . EIC ...................... Tax Bracket .........._... 1 5 . 0 State .................. PA _ Tax .................... - - Wrthholding .......... Refund/Due........... . State .................. _ _ Tax .................... - - - Withholding .......... Refund/Due........... . Instant RAL Maximum RAL Partial RAL 2 week check 2 week deposit Qualifying refund... . Fees ................ Net refund ......... . Instant check....... . Fast check .......... ' 2 week check ... . State check......... . Check one ......... . Copyright form software only, 2007 Universal Tax Systems, Inc. All rights reserved. US104001 US 1040, 1040A, 1040EZ, 1040NR Income Worksheet 2007 Name: MARY E BEAR SSN: 2 0 7- 3 4- 6 813 Interest. List all interest on Schedule B, regardless of the amount. Unem to merit andlor state tax refund. Fill out 1099G worksheet Additional Earned Income Taxpayer Spouse Total Scholarship income - no W2 ...................................................... Household em to a income - no W2 ........................................... . Social Security/Railroad Tier 1 Benefits Taxpayer Spouse Total Social Security received this year ................................................ 1 4 , 2 6 2 . Railroad Uer 1 received this year ............................. . .................. Total .......................................................................... 14, 262. 14, 262 . Medicare to Schedule A .......................................................... 1 1 2 2. Federal tax withheld ............................................................ Married Filing Separately If the filing status is married filing separately and the taxpayer and spouse lived together at any Ume during the year, up to 85% of social security and railroad benefits received are taxable. See Main Information Sheet, filing status 3 .............................................................................................. All others Modified adjusted gross income for this computation consists of AGI (without social security or railroad benefits) + Form 8815, line 14, + Form 8839, line 30 + Form 2555 (EZ) exclusions + student loan interest adjustment 18 , 9 9 3 . +tax-exempt interest: and excluded income from American Samoa (Form 4563) or Puerto Rico: + 50% of the benefits received: 7 , 131 . ................................ 2 6 , ~ 2 4 . ; If the mod~ed AGI is less than $25,001 ($32,001 married filing jointly), none of the Social Security and RR Benefits are taxable .. If the modified AGI is between $25,000 and $34,000 ($32,000 and $44,000 married filing joinUy), 50% of the benefits received is taxable ............................................................................................................ 5 6 2 . If the modified AGI is greater than $34,000 ($44,000 married filing jointly): 85% of the social security and railroad benefits received is taxable ..........................A Modified AGI .................... $34,000 ($44,000)................ ; Subtract .......................... X 85%= Minimum 50% of the benefits received or $4,500 ($6,000 married filing jointly) ................................................................. I Add ........................................................................................ B Taxable social securi and railroad retirement tier 1. Minimum of A or B ............................................... . Lump Sum Payment of Social Security and Railroad Tier 1 Benefits Amount received for 2007 ........................................................ Using the above modified AGI, this is the taxable amount of the 2007 benefit ................................................ . Amounts taxable from previous years ......................................................................................... Taxable benefits using the lump-sum election method Copyright form software only, 2007 Universal Tax Systems, Inc. All rights reserved. USW10401 Department of the Treasury Internal Revenue Service Andover, MA 05501-0025 Mary E Bear %Jacob L Bear Jr 334 Shed Rd Newville, PA 17241-8758 ~,~"L° Notice Date: May 19, 2008 Notice Number: C P 1378 Taxpayer Ident'rfication Number: Primary: XXX-XX-6813 For assistance, you may call: 1-866-234-2942 Understanding Your Economic Stimulus Payment Please keep a copy of this notice for your records. Dear Taxpayer: Your Economic Stimulus Payment You are entitled to an economic stimulus payment of $600.00 as provided by the Economic Stimulus Act of 2008. You can expect your payment by 5/23/08. If you do not receive it within six weeks of this notice, please contact us at the number shown above. You will not be required to report the amount of your stimulus payment as taxable income on your 2008 federal income tax return. If you receive any federal benefits or federally financed benefits, those benefits generally will not be affected by any stimulus payment you receive. What You Need To Do You do not need to do anything. If you received a refund on your 2007 federal income tax return and had it directly deposited into a bank account, we will directly deposit your stimulus payment into the same bank account. If not, your stimulus payment check will be mailed to you. If your tax refund was directly deposited into a refund anticipation loan account, your stimulus payment check will be mailed to you. How We Calculated Your Payment Your payment is based on information you submitted on your 2007 federal income tax return such as your filing status, the number of qualifying children, and your net income tax liability. The next page shows a detailed explanation of how we calculated your stimulus payment. Note: You will not be required to report the amount of your stimulus payment as taxable income on your 2008 federal income tax return. For general information, tax forms, and publications or to view "Where is My Stimulus Payment'; visit www.irs.gov vrww.ire.gov Catalog Number 51256M Notice x.378 (5-2006) Page 1 of 2 ~~~ i LISA BROUGHTON - Re: prod -Date of Death Request From: DATE OF DEATH REQUESTS To: BROUGHTON, LISA Date: 3/23/2009 8:00 AM Subject: Re: prod -Date of Death Request To: Lisa 3/23/09 Please print a copy for your files. Please find below the date of death balance for: Mary E. Bear, social security # 416-57-4518. 1. Account # 35004201359583, Balance $61,114.29 + accrued interest $581.68 = $61,695.97 total 2. Account # 335004201572482, Balance $23,775.76 + accrued interest $133.27 = $23,909.03 total 3. Account # 9843932667, Balance $5,753.31 + accrued interest $0.29 = $5,753.60 total Records Management /DOD Unit M&T Bank- "Understanding what's important." ...._ w.. EaS~ Cati.;r~ l~.C- r.,~,. ~_,,. ~~ ~iU~ Slu..l'i~:ti. ~~' . ~ I i,llsa~( 'i;:' c-Cilci~t. »> <LBROUGHTON~mtb.com> 3/19/2UU9 2:56 .PM »> Account Information Date of death: 0l /31 /2008 Account Number: 35004201359583 Product Type: Deposit Account Account Number: 35004201572482 Product Type: Deposit Account Account Number: 9843932667 Product Type: Deposit Account ~- Pennsylvania State Bank Additional Information SOCIAL SECURITY NUMB Request Details Deliver to: Requestor Delivery Options: E-mail file://C:\Documents and SettinfTs\F13R1vTLB1\L~cal Settings\Temt~~.XPgrpwise\49C7419ER... 3/23/2009 ~ J A ~ w u~u hc.~..nn,.nt ~..t,~ ,•.A~__r;.-_L..o...a! °eve..ue S°^^ce + ~- ~ ~U~ ~ U a OnI -Do nol Wrtta or.tanie In this ap•o•. .S. Individual Income Tax Return For the year Jan, 1-Dec. 31, 2008, or other tar: year beginning , 2008, ending , 20 OMB No. 154,5.0074 Label Your first Hams and initial Last name Your social security number (See 1. ~ ~ ~~ ~ ~~ 7 ; 3y. ~ S /3 instructions on pegs 14.) 9 If a joint return, pouae's first Hams and inlliai Last name Spouse's soclel security number E Use the IRS t. label. Oth i ,H Home address: (number and street). It you have a P.Q. box, see page 14. Apt. no. You mUat enter ` ~ erw se, please print E C ~ ~, ~ ~ your SSN(s) above. J q or type, E City, town or post office, stat e, and ZIP code. ii you have a foreign address, see pegs 14. Checking a box below will not Presidential un ~~ W t r' ~ /"t 7 7 / change your tar, or refund. Election Campaign ~- Check here If you, or your spouse If filing jointly, want $3 to go to this fund (see page 14) - ^ You ^ Spouse i ®Single 4 ^ Head of household (with qualfying person). (See papa i5,) If Filing Status 2 ^ Mprried filing jointly (even If only one had income) the qualifying person is a child but Hat your dependent, enter Check only 3 ^ Married filing separately. Enter spouse's S5N above this child's name here - one box. and full name here. - 5 ^ Qualifyln~ widow(er~wfth dependent child (see pape_ 16) Exemptions If more than four dependents, see page 17. 6a Yourself. If someone can claim you as a dependent, do not check box 6a b Spouse c Dependents: (1) First name Last Hama (2y Dependent's social security number (~) Dependant's relationship to ou O d qualityinq child fm child tax credit see a 17 d Total number of exemptions claimed on ee and 8b No. of ohlldren on 8c who: • lived with you • ditl not live with you due to divorce or s•patatlon (see pape 18) Depsntlertts on Bc not entered above. Add numbers lines above - 7 Wages salaries tips etc. Attach Form(s) W-2 ~ Income 8a , , , Taxable interest. Attach Schedule B if required ~ '- Attach Form(s) W-2 here. Also b 9a lax-exempt interest. Do not include on line 8a Ordinary dividends. Attach Schedule B if requfred eb • 9a attach Forms W-2G and 1099-R if tax b i0 9b Qualified dividends (see page 21} Taxable refunds, credits, or offsets of state and local income taxes.(see page 22) , 10 was withheld. 11 Alimony received 11 12 Business income or (loss). Attach Schedule C or C-EZ 12 13 Capital gain or (loss). Attach Schedule D if required. if not required check here - ^ 13 If you did not 14 Other gains or (losses). Attach Form 4797. , 14 yet a W-2, 15a IRA distributions 15a _ b Taxable amount (see page 23) 15b Z Sd !~ _ '"~ see page 21. 18a Pensions and annuities 16a b Taxable amount (see page 24) 16b Enclose but do 17 Rental real estate, royalties, partnerships, S corporations, trusts etc. Attach Schedule E 17 , not attach, any 18 Farm income or (loss), Attach Schedule F , i8 payment. Also, 19 Unemployment compensation 19 please use Form 1040-V. 20a Social security benefits I ZOa 1 ~ ~ /s ~ ~ b Taxable amount (see page 26} 20b ~ 21 Other income.-List type and amount (see page 28) ______ ______________________________ 21 22 Add the amouhts in the far right column for lines 7 through 21. This is yourtotal income - ~ ~~ S 23 Educator expenses (see page 28) ~ Adjusted GrOSS 24 Certain business expenses of reservists, performing artists, and .fee-basis;goverrtment officials. Attach Form 2106 or 2106-EZ 24 InCOme 2,5 Health savings account deduction. Attach form 8889. 25 28 Moving expenses. Attach Form 3903 ~ 27 One-half of self-employment tax. Attach Schedule SE 27 28 . Self-employedSEP, SIMPLE, and qualified; plans 28 29 .. Self-employed health insurance deduction (see page 29) 29 30 Penalty an early withdrawal of savings 30 31a Alimony paid b Recipient's SSN - 31a 32 IRA deduction (see page 30) 32 33 Student loan interest deduction (see page 33) . 33 34 Tuition and fees deduction. Attach Form 8917 , ~ I '35 `Domestic productionactiviti~s deduction. Attach Form 8903 35 36 Add lines 28 through 31 a and 32 through 35 36 37 Subtract line 36 ftom line 22. This is your adjusted gross in come - 37 / Lrl For Disclosure;'Privacy Act, and Paperwork Reductiran Act Notice, see page 88. Gat. tJo. tt320B Form 1~ (2008). SCH~ui.ii.t5 Ass Schedule A-Itemized aeducti®ns "'"" "" ''"'~~"'" (Form 1040) '%~ ~~~~ (Schedule B is on backs l ! nN~ulflmHnl of Ilirs Tn,nsury inrorn,li Hnvenun SorVU.e - Attach to Form 1040. - See instructions for Schedules A&B (Form 1040). A11aChmenl Seyuenc;e No. 07 Name(s) st7own nn Form )DAp ~ Your social security numbor ec.eaSe~ E /3 ~e.a 20~ ; ~~/_3 Medical Caution. Do not include expenses reimbursed or paid by others. ((~~ and 1 Medical and dental expenses (see page A-1}. 1 1~~._l._3~ __.~_ ~ Dental 2 Enter amount from Form 1040, line 38 ~ ? j ~ ~. SY F ..) ". (~ _ (~~ ` Expenses 3 Multiply line 2 by 7.5 %7 (.075) 3 4 Subtract Ilne 3 from line 1. It hne 3 s more. than Irne 1, enter -U-. ~ 4 ~ ~ ~ -I Taxes You 5 State and local (check only one box-: i I i Paid a C._l Income taxes, or l 5 (See b (-1 General sales taxes ~ page A-2•i 6 Real estate taxes (see page A-5) . _ 6.__ ~_ __...__._.__ ~ __._ . 7 Personal property taxes . 7 8 Other taxes. List type and amount - 8 9 Add lines 5 through 8 9 O Interest 10 Home molfigacde interest and points reported to you on Form 1098 1a You Paid 11 Home mortgage interest not reported to you on Form 1098. If paid (See to the person from whom you bought the home, see page A-6 page A-5.) and show that person's name, identifying no., and address - _ Note. I 111 Personal f2 points not reported to you on Form 1098. See page A-6 ~ interest is for special rules 12 . not deductible. 13 Qualified mortgage insurance premiums (see page A-6) 13 14 Investment interest. Attach Form 4952 if required. (See page A-6.) 14 15 Add lines 10 through 14 15 ~ ~~ Gifts to 16 Gifts by cash or check. If you made any gift of $250 or Charity more see page A-7 16 _ , Ii you made a 17 Other than by cash or check. If any gift: of $250 or more, gift and got a see a e A-8. You must attach Form &283 if over $500 p g 17 -- - -----_- - - -- benefit for it, 18 Carryover from prior year 18 ~ see page A-7. 19 Add lines 16 through 18 . . . . . . . . . . . . . . . . . . . . 19 ~~ Casualty and Theft Losses 20 Casualty or theft loss(es). Attach Fom~ 4684. (See page A-8.) 2p (~ Job Expenses 21 Unreimbursed employee expenses-job travel, union dues, job and Certain education, etc. Attach Form 2106 or 2106-EZ if required. (See page . . Miscellaneous A-9.j -... ... 21 . . ...... DedUCtI0n5 22 Tax preparation fees 22 __ (See 23 Other expenses-investment, safe deposit box, etc. List type and page A-9.) amount - . _ 23 _ 24 Add lines 21 through 23 24 25 Enter amount from Form 1040, line 38 25 -$-~/ '- 26 Multiply line 25 by 2% (.02) 26 2S~ 27 Subtract line 26 from line 24. If line 26 is more than line 24 , ente r -0- 27 ~ Other' 28 Other-from list on page A-10. List type and amount - . - . _ . _ _ _ . _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ __ _ _ Miscellaneous Deductions 28 Total 29 Is Form 1040, line 38, over $159,950 (over $79,975 if married filing separately)? Itemized ~ No. Your deduction is not limited. Add the amounts in the far right column for ~~ qg Deductions lines 4 through 28. Also, enter this amount on Form 1040, tine 40. ~ - 29 ^ Yes. Your deduction may be limited. See page A-10 for the amount to enter. 30 If you elect to itemize deductions even though they are less than your standard deduction, check here - ^ For Paperwork Reduction Act Notice, see Form 1040 instructions. Cat. No. t'133oX Schedule A (Form 1040) 2008 3-21-2008 MAIL TO PAYEE CHECK #OC 05810023 HAS BEEN ISSUED FOR $2,453.34 THE CLAIM ON THE ANNUITY LISTED ABOVE HAS BEEN APPROVED AND A CHECK FOR ~ YOUR SETTLEMENT AMOUNT IS ATTACHED BELOW. WESTERN-SOUTHERN LIFE WILL ~ NOTIFY THE IRS THAT THE TAXABLE AMOUNT OF THIS PAYMENT IS $43.83 FOR THE 2008 TAX YEAR. _ IF YOU HAVE ANY ¢UESTIONS, CALL A WESTERN-SOUTHERN LIFE REPRESENTATIVE AT (800) 926-1702 -~ ~ _~ AMOUNT OF CONTRACT $9,857.15 _ . WESTERN-SOUTHERN LIFE ASSURANCE COMPANY CINCINNATI OHIO STATEMENT OF DEATH CLAIM SETTLEMENT INFORCE DEPT BEAR MARY E 980 5159 BEAR MARY E W0020627787 TOTAL PAYABLE THIS CONTRACT OTHER CHECKS ISSUED FOR FEDERAL INCOME TAX WITHHELD AMOUNT OF THIS CHECK Detach the check below. $7,392.86 $10.95 $9,857.15 $2,453.34 "7CBN007Y" 56 REV-1510 E%+11An COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ESTATE OF SCHEDULE G INTER-VIVOS TRANSFERS 8~ MISC. NON-PROBATE PROPERTY FILE NUMBER /~ This schedule must be completed and filed 'If 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 NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER ATTACHACOPY OF THE DE ED F R REAL ESTATE. O DATE OF DEATH VA L UE OF A ET S S °k OF DECD'S INTEREST EXCLUSION FAFPI.ICASLE TAXABLE VALUE //' ~/,~~} ~ j m \ J ~ /~J / ~ ~. ~ M1 ~lJ i. ~ l~ .~ ~3;~D~'~ loG~% .~ ~3,l4~ I n (' ~ ~~ ~a~ a //}~ GG'1G!'LL~ ~•.~t~~GV~ ~~}u~C.11ft1.r. ~~~ C~ ~ S ~ 7, / oc~ ~-~ 9, U S /i TOTAL (Also enter on line 7, Recapitulation) I S l 13, ~,ia~ ~. '-~- (Ifmore space is needed, insert additional sheets of the same size} Page 1 of 2 LISA BROUGHTON - Re: prod -Date of Death Request From: DATE OF DEATH REQUESTS To: BROUGHTON, LISA Date: 3/23/2009 8:00 AM Subject: Re: prod -Date of Death Request To: Lisa 3/23/09 Please print a copy for your files. Please find below the date of death balance for: Mary E. Bear, social security # 416-57-4518. ~'~ 1. Account # 35004201359583, Balance $61,114.29 + accrued interest $581.68 = $61,695.97 total ~a 2. Account # 335004201572482, Balance $23,775.76 + accrued interest $133.27 = $23,909.03 total 3. Account # 9843932667, Balance $5,753.31 + accrued interest $0.29 = $5,753.60 total Records Management /DOD Unit M&T Bank- "Understanding what's important." P.as~ u~. 1:~{Cic 1 '.;= ~ ~ _, i` .~i~,i .ill .j+..~ Ti~;~, u .;+,:< i-i IJ(;t;' tIG ..`C7~1?i:. »> <LBROUGHTON@mtb.com> 3/19/2009 2:56 PM »> Account Information Date of death: O l / ~ 1 !2008 Account Number: 35004201359583 Product Type: Deposit Account Account Number: 3.5004201572482 Product Type: Deposit Account Account Number: 9843932667 ~` Product Type: Deposit Account Pennsylvania State Bank Additional information SOCIAL SECURITY NUMB Request Details Deliver to: Requestor Delivery Options: E-mail file://C:\Documents and Settin£rs'~,F,BRNLBl1L,~ca1 Settings\Temt~\XP~pwise\49C7419ER... 3/23/2009 Allstate Life Insurance Company P.O. Box 94212 Palatine, IL 60094-4212 Telephone: (877) 499-6418 Facsimile: (866) 635-4523 March 18, 2008 Estate of Mary E. Bear 199 Barnstable Road Carlisle PA 17015 Re: Mary E. Bear Contract PJo: GA.16174339 Type of Contract: IRA Dear Executor or Administrator: ~~ A I I state You're in good hands. We are required to furnish the IRS with the date of death value of a contractholder's Individual Retirement Arrangement on a Form 5498. The value of the account on January 31, 2008 was $17,944.53.. Please note that this value maybe used to complete Form 8606. Form 8606 is required when contributions were made to this IR.A during the calendar year. Annuity proceeds are not reportable to the IRS on Form 712. Form 712 should only be used. for life insurance contracts. If you have any questions, please contact us at 1-877-499-6418. Sincerely, Bobbi Jo Seveska Sr. Claim Examiner ~J ,. ~ WESTERN-SOUTHERN LIFE ASSURANCE COMPANY CINCINNATI OHZO STATEMENT OF DEATH CLAZM SETTLEMENT ZNFORCE DEPT BEAR MARY E 3-21-2008 MAIL TO 98 G 515 9 BEAR MARY E PAYEE W0020627787 CHECK #OC D581DD23 HAS BEEN ISSUED FOR $2,953.34 THE CLAIM ON THE ANNUITY LISTED ABOVE HAS BEEN APPROVED AND A CHECK FOR YOUR SETTLEMENT AMOUNT IS ATTACHED BELOW. WESTERN-SOUTHERN LIFE WILL NOTIFY THE IRS THAT THE TAXABLE AMOUNT OF THIS PAYMENT IS $43.83 FOR THE 2008 TAX YEAR. ZF YOU HAVE ANY QUESTIONS, CALL A WESTERN-SOUTHERN LIFE REPRESENTATIVE AT (800) 926-1702. AMOUNT OF CONTRACT .,, $9,857.15 REV-1511 EX+ (10-06) scNEOU~E N COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE CC-STS RESIDENT DECEDENT ESTATE OF FILE NUMBER Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: ~' ~ ~- ~~~ee~~ ~ e~u~ B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City _ State Zip Year(s) Commission Paid: 2. Attorney Fees 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 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. gis^7. S~ f 2 `7C~, --- C~~r ~~Z9~~v ~-r 7~ .-~ TOTAL (Also enter on line 9, Recapitulation) I ~ ~3; 7©~'~ ~s {If more space is needed, insert additional sheets of the same size) ~ ~ ~ ~~ ~ ! / ~, ~ d ~~ ~- ~- ,,d.ec,~ ~erc,ec...~~ ~0C7 -- ~~ ~. a. ~- rte.- 2a 1 ~ 7 a ~a~o~2- ~~ ~ ~ ~ ~~ CAD .~.-°~e.,.- ~-n- .,.ate ,~ .~-~e. 7 REV-1512 EX+ (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCFIEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER ~rn ~ ,~ ~ ~ 13 ~~ ~. r _ 21o S _ a r ~S _3 Re~„rt dpt,r~ tnr_urr .d by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. (If more space is needed, insert additional sheets of the same size) ~: Page 1 FAMILY HOME MEDICAL ~ Time: 10:37:10 Order#: 00030941 1 SPRINT DRIVE Date: 01/19/2008 CURRENT Customer ~ CARLISLE PR 17015 Phone: 866 486-5201 Name : MARY BERR Delivery Date: 01/19/2008 Address: 0 Address: City CARLISLE State PA Zip: 17013 Phone: 000 243-2802 INVOICE QTY 4TY TRAM DELIVER RETURN PRODUCT DESCRIPTION TYPE AMOUNT 1 D5070 BED PAN DELUXE SALE 29.95 (~ 29.95 per EACH TX .00 1 R7174-50PK UNDERPAD TENDERSORB 23x3 SALE 18.95 DISPOSABLE SOLD IN QTY 50 KENDALL (~ 18.95 per BOX OF 50 TX .00 ------------------------------------------------------------------------------- f '~ i. f ~ ,~'" 1 if C ~~ 1 ,~ CASH SALES TAX: .00 P.O.#: TOTAL: 48.90 Primary Insurance: CASH ~ Coinsurance: CASH ~ Invoice# CASH SALE ~ CASH SALE ~ 00037002 Salesman ~ Del. By ~ Ship ~ Received or Returned By ~ Customer Number p~~ I Ip I ~ 000000000012463 } Page 1 FAMILY HOME MEDICAL Time: 11:48:48 Order#: 00031225 1 SPRINT DRIVE Date: 01/26/2008 CURRENT Customer CARLISLE PA 17015 Phone: 866 486-5201 ------------------------------------------------------------------------------- Name SALE CASH Delivery Date: 01/26/2008 Address: X Address: X City X State PA Zip: X Phone: 000 - ------------------------------------------------------------------------------- INVOICE QTY QTY TRAN DELIVER RETURN PRODUCT DESCRIPTION TYPE AMOUNT 1 GS6370 GLOVES EXAM VINYL MEDIUM SALE 8.95 POWDER FREE GULF SOUTH ~ 8.95 per SOX OF 100 TX .00 ------------------------------------------------------------------------------- ,~~ ~a ~, CASH SALES TAX: .00 P.O.#: TOTAL: 8.95 Primary Insurance: CASH ~ Coinsurance: CASH ~ Invoice# CASH SALE ~ CASH SALE ~ 00037362 Salesman ~ Del. By ~ Ship ~ Received or Returned Ey ~ Customer NumHer HJF ~ ~P ~ ~ 000000000000001 ------------------------------------------------------------------------------- (LIFT, HOYER PATIENT MANUAL SUNRISE 01/03/2008 00036437 101.89 ~-, v g P~~3~~Y ~ ~ ~D ~.8q 101.89 APPLIED TO DEDUCTIBLE MEDICARE AND CAPITAL BLUE CROSS APPLIED THIS AMOUNT TO YOUR ANNUAL DEDUCTIBLE. PLEASE PAY FROM THIS INVOICE. THANK YOU. BALANCE DUE - BEAR, MARY E -------> 101.89 LIFT, HOYER PATIENT MANUAL SUNRISE 01/03/2008 00036437 101.89 101.89 0.00 3784 02/11/2008 -------------------------------------------------------------------------------- ALTERNATING PRESSURE PAD 01/03/2008 00036645 -5.61 5.61 APPLIED TO DEDUCTIBLE ~~ s a s oy ~ ~ 3 ~~~ s~~~ PLEASE PAY FROM INVOICE. THANK YOU! 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L ~~ ~. n ;, a N 7 m 2 0 g N ~, Al N n s ~' C O n ~ ~ ~ n m Q fl O ~ . = A O O ~ ~ $ ~ ~ _ C -G O ~ ~ (7i (n ~ N O W O ~ C ~ W OD N -1 p O -~ D r C~ 2 W t:] Page 1 FAMILY HOME MEDICAL Time: 16:34:04 v /~ Order#: OOCy'0442 * 1 SPRINT DRIVE Date: 01/08/2008 /i /~ v CURRENT Customer ~ ~ UX CARLISLE PA 17015 Phone: 866 486-5201 ------------------------------------------------------------------------------- Name MARY BEAR Delivery Date: 01/08/2008 Address: 0 Address: City CARLISLE State PA Zip: 17013 Phone: 000 243-2802 INVOICE QTY QTY DELIVER RETURN PRODUCT DESCRIPTION IRAN TYPE AMOUNT 1 G16130P250 TOOTHETTE 250 PLAIN ORAL SALE 29.95 DISPOSABLE SWABS STERILE GULF SOUTH (INDIV. WRAPPED) @ 29.95 per PACK OF 250 TX .00 J . [T--CARD:MC SALES TAX .00 -Number :***+****.*** Date :**** TOTAL 29.95 Primary Insurance: CARD ~ Coinsurance: CARD ~ Znvoice# CREDIT CARD SALES ~ CREDIT CARD SALES ~ 00036369 Salesman ~ Del. By ~ Ship ~ Received or Returned By ~ Customer Number JII ( (P ~ ~ 000000000012463 ------------------------------------------------------------------------------- z Mail Payments to: VISA PO BOX 4517 CAROL STREAM IL 60197-4517 ' Important f~ws - ER , ~ g TO REPORT A LOST OR STOLEN CARD PLEASE CALL MEMBERS 1ST FGU AT 717.78b-603b OR 888-6 ~ d HOURS. TO OBTAIN ACCOUNT 1NFORMA^eon24 HE CARD THA GNES YOU CA HBACK ACGour>-t Activity $t1Ce YoUT 13si au~w~i.~a~a AmOUnt Description Trans Date Post Date Plan Name Reference Number 24164077338091007656976 TARGET 00020990 CARLISLE PA S 27.66 62 ~=-"" 38 12/04 12/05 PPLN01 PPLN01 24498137338561660383921 LIFELINE SYSTEMS INC. FRAMINGHAM MA . ~ ~ ,.,....,,,,~ 12/03 12105 12110 PPLN01 24692167344000987399172 LOWES #01710' CARLISLE PA 66.01 1y0g 1y0g 12110 PPLN01 24692167344000987399180 LOWES X01710' CARLISLE PA SEAMANS MARKET SHERMANS DALE PA ~ ~ 1y0g 12110 PPLN01 24427337343040005495877 74692167347000495536077 CREDIT VOUCHER 21 17 12113 12114 LOWES X01710' CARLISLE PA 32 91 12116 PPLN01 24164077348105144737283 STAPLES 00108704 CARLISLE PA ~ ~ ~ ~ 1?J13 12116 PPLN01 24323037349122090011937 RILLO'S CARLISLE PA 3 ~~ 6.84 12114 12117 PPLN01 24427337350040004269430 SAYLORS NEWVIULLE PA 134.01 12116 12!18 PPLN01 24226387351360810472557 WM SUPERCENTER CARLISLE PA ~ ~ 12/17 12117 12118 PPLN01 24164077351498968177361 SHEETZ 00002634 CARLISLE PA KNISELYS PET & FARM CENTE CARLISLE PA 1483 12117 12/18 PPlN01 24158137351101912390193 24226387352360864069514 WM SUPERCENTER CARLISLE PA 9017 00 56 12118 12119 PPLN01 PPLN01 24323007353253353010070 CARLISLE SMALL ANIMAL CARLISLE PA . 5 27 12119 12120 PPLNOt 24692167353000301819192 LOWES #01710' CARLISLE PA 17J19 12120 PLEASE DETACH COUPON AND RETURN PAYMENT USING THE ENCLOSED ENVELOPE • ALLOW 5 DAYS FOR MAIL DELIVERY 5726 ~~ Page 1 FAMILY HOME MEDICAL ~ ~ ~ Time: 14:50:30 Order#: 00030129 1 SPRINT DRIVE Date: 12/29/2007 CURRENT Customer CARLISLE PA 17015 Phone: 866 486-5201 Name MARY BEAR Delivery Date: 12/29/2007 Address: 0 Address: City CARLISLE State PA Zip: 17013 Phone: 000 243-2802 INVOICE QTY QTY TRAM DELIVER RETURN PRODUCT DESCRIPTION TYPE AMOUNT 1 B162310 LEG STRAP WIDE LARGE 20" SALE 9.95 W 9.95 per EACH TX .00 ------------------------------------------------------------------------------- CASH 'SALES TAR: .00 P.O.#: TOTAL: 9.95 Primary Insurance: CASH ~ Coinsurance: CASH ~ Iavoice# CASH SALE ~ CASH SALB ~ 00035.925 Salesman ~ Del. Hy ~ Ship ~ Received or Returned By ~ Cu,etomer Number AIQ4 I ~ p ~ 000000000012463 Page 1 FAMILY HOME MEDICAL Order#: 00029857 1 SPRINT DRIVE CURRENT Customer CARLISLE PA 17015 Phone: 866 486-5201 ------------------------------------------------------------------------------- Name MARY BEAR Delivery Date: 12/22/2007 Address: 0 Address: City CARLISLE State PA Zip: 17013 Phone: 000 243-2802 INVOICE QTY 4TY a nruv DELIVER RETURN PRODUCT DESCRIPTION TYPE AMOUNT 1 ESC2006 UNDERPAD REUSABLE 36"x54 SALE 29.95 QUICKSORB COTTON BED PAD ® 29.95 per EACH TX .00 CASH SALES TAX: .00 P.O.#: TOTAL: 29.95 Primary Insurance: CASH ~ Coinauraace: CASH ~ Invoice# CASH SALE ~ CASH SALE ~ 00035564 Salesman ~ Del. By ~ Ship ~ Received or Returned 8y ~ Customer Number JZI ~ P ~ ~ 000000000012463 ------------------------------------------------------------------------------- ,~ :- .r~ Time: 15:16:14 ~~ Date: 12/22/2007 a ~/ tw 61 ... y d~ ~ ,;~P, ~ ~ ~. ~~ r ~ , ~~Y`~ ~''` ~'l DUAL IT'l 9~~r< PFiPRMAGY , I P1C 1 SN°iIJI GhiIVE CAF~LISLE:, PP. 17113 717-149-5691 ~~~ saved lht; b~s~ nor Cnri~tmasi *All G1fts '31~ UrF ~(~;<~1~~cle~ Y~tl'~kt~e C'aclclle: ~ Wehkir'~z ~ Li1ok...Look,..Lrrk...Look...Loam GNP ~+IT C ~ ' ~~ ,y ~iilTA~ CIUE ~~!~'`I`I CASN 12.0(1 CNANGr: ,ut 1211~,I U7 15 :24 Si~Es Gi)1 r;5~11 U G:: O~ ~r THANK You FOR SHUPPING WEI':~ MAP,KLTS tt95 CARI_:tSLE, PA. CL.UH CIJ ~ iUMr R I PHARMACY FlRMACY TAX 90990092709 Price 20.00 5.OU 00 BAL 25.00 :REDIT PURCHASE 01/U9iU8 12:22 ;ARU>< SXXXXXXXXXXXX94~3 .,1 AFPr~ved w~1 Inst L~ylrb02:321 1UTFI: 602321 tE(id: 511 :E~~tt : 0015380 OCATIUN IU: OOUOOu511 'AYMFNT AhIOUNT 25 00 'F Cradlt 25.00 CHANGE .00 1/09/08 12:27. PM 0095511 0039 480 *~~c* a y ~~ ~'~~.* J~1RT ~~tv1r' rrrt~r~iey. live better. S U P k R C E N T E R WE SELL F'l7R L.E55 MANAGcR ANtiELA 5IERER ( '~ i "r ) 258 -~ 1250 CARLISLE", PFNNSYLVANIA ~;1 i! e!~i'r'9 UP1t 00003492 TEit 27 TR1t 08592 DHAl. irtR.1GAT 0085x5210066 29.84 K SUBTOTAL 29.84 lAX 1 b.000 X 1.79 / TOTAI. 31,.63 VISA TEND 31.63 ALCt1UN! 114423 APPRDVAI ltf,~748ti:3 TNF"+N s ID -02li80U7b47888919 VALIDRIION --3tiWLl PAYMENT SERVICE - E ~_f CHANGE DUE 0.00 ~Jt~~'` 8 / ~ 8 Zr # ITEMS SOLD 1 ........................ Tcx 5495 to18 125'7 7946 4538 MASLAND ASSOCIATES INC ~III~IIIIIIII ~ ~~ ~ I I (I I I ~ III 220 WILSON ST i I I ~I I ~I I (` II~II ~III~ III ~II~ ~illl II.~ ~~I~~ (II~) I~I~~III III IHIIII (I CARLISLE, PA 17013 Buy any electronics today? 49 1929 _ .. . Rete trse+n at Wala+art.cn++/ratings. 01 !07/08 12 ; 59:49 C (~ P Y ,,= ti.._ .. ***CUSTOMER COPY*** 01~8200f3 1Q :08:54 Sa1~= Transaction 1i S Card Type: UISA ,, (~ Acc: *~~~*~*~~~**4423 S ,' ~~' ~ t `~~~ Entry : Swiped ~~=~'~ c~ ~ Invoice # 915 `' ~~ * Total : 2~ _ QC] L. MART Reference No .: 0005 Save money. Live better." Auth.Code: 665920 Response: AP SUPERCENTER MANAGEREANGELA SIERER CARLISLE PENNSYLVANIA CUSTOMER COPY ST1t 2574 gPir 00000415 TEJt 31 TR>i 07106 ENSURE 6PK 007007440705 F 6.97 N SUBTOTAL 5,97 TOTAL 6.97 CASH TEND 10.00 CHANGE DUE 3.03 # ITEMS SOLD 1 i TC>t 1279 7718 4342 3339 8610 ~ 7 ~~I~I~~~~~N~~ah~~III~~~U~~I~~IH~~~~IN~~~~IH~NN~~~~Irh~~III~II~~liNll~~ ~a0. RateBthe~nateWain+ar}icon+%ratinss. 12/30/07 10:33:10 THANK Y01.1 hOR SHOPPING 1J1::1`i MARKETS tt95 f_:ARI_I>LE, PA. n ~~~~ ,~ ~'" ~. ~~~ owurr.c.l.amn. ~.•!rv w.r e•ri Visit us on the Internet www.GiantFoodStores.con My goal is to ensure your satisfGcticT every ttme you sho with us. I# the:•e t s anyth i its mare ~ can do to i rap,. ave ,your e~hadeHoeh,p5tore Manager write: Gi arrt ,=ooe :Store #112 25'5 S. Spring Garden Street CarlisJs, PA 170x3 6e Store Telephone: {717) P 249-2323 FHfIRHACY 20 OO Pharmacy Telephone: (717t 249-£3836 «*~ TAx .oo BAL 20.00 12/30/07 10: 09AM Cl_+J FS I;USFOMFR 9b990092709 T HMUf YOU x8005604325 f, R E D I F F' U R C H A S F O 1! Q 7; O 8 12:1 6 CARDtt: SXXXX;?XXXXX?(X9923 6 ® 1.79 COTTONEL WIPES 10.74 PJ ~~ ApNroved {< C1 CTTN BLL3000 .8.. N Hos ( t_c,<~tt69- a58 TAx PAID .00 RUTH: 692858 ~**xTOTAL ~ A ~1•`~3 1 RE Gtt ~~t t A,S H C .00 SEW#: 001665q CASH CHANGE. 10.00 .37 t_OCA1 ION 7D: Ooi)uOg5t t TC~iAL NUMBER OF ITEMS SOi_p = 7 . } '12/30it?7 10:1.0 AM ^112 86 0036 872261 f AMOUNT PAYMk:N 2O 00 l ~~~~:~* BONUSCARD SAVINGS SU r~~MARY **~K~ VF Credit 20.00 2007 tiGNUSCARD SANIivGS 08.71) CHANGE .00 ~~~~x~~K REWARDS °GIIV~~z: SU?iM`'~•_ . ^,~*"^~. tiU7~08 1"L:16 PM 0095511 OQ27 48G Earn Redeem Btu ",;line ~7 t2 0 p T .. ~ ; X.Yl7t Yl Y(}!!!X y(1C %ir~k'Y('K Y: YC XY!` ~ . ... SAYLOR' S MARKET 37 CARLISLE ROAD PHONE 776-]551 ADA 0001 02 02559861 17./29/01 11:36arn 041 PUFFS NO LOTION $5.39 T KLNX POPUP WIPES $1.99 T WF ISU ALCOHOL $2.79 T~ $ EN AA BATTRY -~ti T $ EN AA BATTRY -- ~~ $ SF GARBAGE BAGS $1.59 (TPR SAVINGS $0.20) SUBTOTAL $16.76 SALES TAX $1.01 TOTAL $17.77 CASH $50.00 CHANGE $32.23 ~'L A/ s"7, 72 --~~ ! ~/ 9, 3~ qs,~? ,~~.,~. '7 9, ~ o G„ „~ 9'. 3 L ~O~`.+.-P 3 9~ ° ~ • EMBARQ Page 1 of 6 Monthly Statement Account Number January 25, 2008 717-243-2802-676 Payment Options & Contact Info Current Charges At-A-Glance Retail Store in Your Area a CARLISLE 346 York Road In the Embarq Building Pay Online E MBARQ. com/myaccou nt Pay by Phone 1-877-813-7604 Customer Service 1-800-829-8009 Repair Service 1-800-788-3600 Internet Address E M BARQ.com/residential EMBARQ Services Total Pd ~,s~~ ~~ 3 ~~.~s Previous Balance Payments & Adjustments Balance Total Current Charges Total Amount Due 35.32 I -35.32 I .00 I 63.65 ( $63.65 Current Charges Due By: 02/19/08 ff received after February 25: 564.45 3 6 ®Please Recycle ~~e=-r'_ ~EMBARQ Page 1 of 6 Monthly Statement Account Number December 25, 2007 717-243-2802-67s M Payment Options & Contact Info Current Charges At-A-Glance Retail Store in Your Area ~ CARLISLE EMBARa Services Total 346 York Road ~,,( In the Embarq Building _®1 Local and Optional Services -Page 3 27,82 Previous Balance Payments & Adjustments 32.15 I -32.15 Total Current Charges Current Charges Due By: 01/17/08 If received after January 25: 535.76 ® Please Recycle DELIVERY ADDRESS r 7 L Z Q U r r o ~ ~ a i ~ ~ ~ N _ L ~~ ti w ° ~ r ~ - J n `~ O z w J Y ~ Q O J w ¢_ a: -RIVER PAID: ^ YES s z LL p BILLING ADDRESS ~ w ~ ~~ ^ z\ \` 0 a `O INSTRUCTIONS V o , z 4 Q RECEIVED BY ON ACCOUNT: ^ ACCOUNT PHONE CI ZO TERMS PREVIOUS BALANCE ,, +~11~~ DATE LAST GALLONS DEGREE DAYS JULIAN DRIVER CARLISLE PROPANE COMPANY = P.O. BOX 577 GALLONS PRICE CARLISLE, PA 17013 (717) 249-3112 AMOUNT PA SALES TAX TICKET PREVIOUS BALANCE NO. _ DEL. DATE SUB TOTAL ; ;:~ ~'"` PAYMENT PAY THIS AMOUNT PAST DUE: ^ SNIFF TEST: ,.^ ~I ,~ i CO m CCU St® NUMBER DUE AMOUNT DUE ~ @~ [d' ^ ^ Visit Us on the web at 09547385639-01-4 ON RECPT $9.36 / Indicates the Comcast www Comcast com services you subscribe to MARY BEAR How to reach us... For service at: 199 BARNSTABLE RD CARLISLE PA 17015-7420 News from Comcast We regret losing you as one of our cable subscribers. Our records indicate that the final balance shown above is now due. Your prompt payment is appreciated. Any outstanding equipment must be returned to our office within 7 days. Please Summary of Charges statement Prepared 02/21/08 BiNed from 03/02/08 Previous Balance 54.36 Comcast Cable Television 44.94 cr call us at any time should you wish to reconnect your service. Taxes, Surcharges & Fees 0.06 cr Hearing /Speech Impaired Call 711 ~ ~ / Total Due X9.36 C/yam Detail of Charges on back I ~g.3~ ~~ 3'~D ,f 7~ D~ L C1 Of O ~ v p 3QW £z 3'° e ".. . ~p t ~ ,~ y y p p G y Z ~~ 4 3 p p d ~~ H pr•a 4 d ,'_.. p p~ Rt p 0 ~ C1 p $ w ,~ ,~ V '~ ~ C p ~ O O ~ ~ ~ ~ O p a '.p".. O~ Gs ~ V i N. N +r tp E~ p p= s p y .~ p~~ p p ~ p wp p p ~ ~ ~ _ (~ ~- C ~ ._.. C1 p d ~~ ~ ` ~ d = V v~ d ~ ~ w ~a=Ww ~ 4~ ~ O `~ .~ ~. a:. ~ r ~ ~-~ 0~ m = .~ = - a ~ ~ N a ~ ~ ~ ~ F Q ~ o C ~ ~ NfL ~ JO Wr'I . mr a a s ~^ ~}l -d ~ = QCC ¢ J ~< ~ ~ m ~ ~a O ~ 1' J m Q fL D ~ ~U or' i m° °ooc`n~o°•~°.~ N ~ ~ M~I~ ~ ~ `* o ~ a a~ D N ~ ~ ~ ~ .. ZQZ~y~ ~ ~ y ~ t0 p V ~ ~ Z ~ =C ~ > >~ ~ o Q c c a p~ M 'i f a , d ,,, . . --.. _ ~ ~ _~~' r ~~i O ~ ~ ~oN9 6N4 00 yNg cq ~` vo 4 `,,, ~~ ~ ~. ~, ~. H ~~` a ~:: ~ ~ ~ N ~ i~. ~~~ ~ ~ U ~~~: a ~ ~ ~ ~ °~ a, v sl. ~, ` H '`~` U ~ ~ W ~ti: ~ ~ p Gil ~ ii^:..: ~ ~ w UH H ~~ .~~- ~ ~ • ~ ~ qq LY. }!~„ V .~ ~ N ~a° ~ } ~~ ~~V ~~a ~ ~ ~ ~ d - ~ ~ ~ ~ ~ O a Ca U o y~vria ~~~ ~ Q ~b ~a,.cvM~ ~ ~ ~p"~ 33 y w v ffi;a~oQ°o '~S~ c$ ~y~~~ d~ v a~ `oUoNOa°.° r N Q1 ~~ M M O O ~. Q a ~~ ~~~ ~ U U ~QQ~ M ti r _~ ~~~ ~, '~~~Ai ~~o ~o~ O~~ p > N ~ ~ + Q F + ~ ~ ~ OMO ~ pr 7~0 O O w ~ 00 00 N V 't N ~ o g N N -. a ~ a a QQ ~~Q ~ ~'a ~ ~ ~~ ~ ~~ ~~~ ~ ~~ ~ ~~ Q a U d r x d~ N w Q zy o~ ~~ Q Q 8 N ~ O N 00 ~ ~O O ~~~ ~ m • ~ ti ~ ~r ~ W~ ~~~a ~r>°,o~ a,u F~ .,~ Q W U n L~ '~ .L~ C O b O i~ w c d 0 .~ .~ c f ' PPL Electric . Utilities Electric Service For: J LEHMAN BEAR 199 BpRNSTABLE RD CARLISLE PA 17015 Questions about thts bill? Please contact us by Apr 8 at 1-800-342-5775 (1-800-DIAL-PPL) APL Electric . Utilities Electric Service For: J LEHMAN BEAR 199 BARNSTABLE RD CARLISLE PA 17015 Qaestions about this bill? Please contact us by Mar 7 at1-800-342-5775 (1-800-DIAL-PPL) O ~ 4a~Y~ pp ~ M 62740-73000 Summary Page Balance as of Mar 18, 2008 $0.00 Char es: Tota~PL ELECTRIC UTILITIES Charges $51.04 Total Charges ~51.u4 ~:: ~` <. '` Account Balance ~ 8 $51.04 3 ~7~ ~~ ~f ~~ ri ~~ ~ ~ 9 ~~ `,~~•®~o•~~,~"~, Page I ®~-_ . `- ~a- pM pp «~p giR ry Summary Page Your Bill Accniint;N~iintier 62740-73000 8C . ~ ~ R[l bBt~~Q ~ ~0!C W.61t1.. . Balance as of Feb 15, 2008 $0.00 Char es: Tota~PL ELECTRIC UTILITIES Charges $69.74 Total Charges $69.74 Pa This Amount ~Io Later;thao::l~Lar 7 2008 $6~7 . Account Balance $69.74 ,a~.~~ ~~ ~~ 37~q or write to: ~~ Customer Service / ~ '7~ 827 Hausman Rd. (p • Allentown, PA 18104-9392 www.pplelectric.com Electric Use This graph shows your electric use over the last l3 months. Types of Meter Readings: Actual - F,stimated Customer [~ 36 30 24 18 12 6 0 KWH -Average Per Day FMAMJJASONDJF 2007 Months 2008 Meter Reading Information Meter #73137289 Feb l5 Actual 38496 Jan l8 Actual 37875 28 Da s KWH Billed 621 Average -Feb 2007 2008 Temperature 25F 31 F ItwH Per Day 20 22 Yearly Use: Mar 2006 -Feb 2007 Mar 2007 -Feb 2008 Total Avera e Use Moatb 8498 70 8677 723 43427191088$ YALE ELECTkIC SUPPLY COMPAIZ'! 6490 CARLISLE PIKE I'~CHANICSBURGI PA 17650 (717) 766-0258 Merchant ID: 5600000130$9 Tern ID: 002 Ref N: 006 ~ COUNTER SALES TRIC SUPPLY CO. REMIT TO: YALE ELECTRIC SUPPLY P.O. BOX 647 LEBANON, PA, 17042-0647 :e ~ IA 17055 ~~~~~ 4240589-0002-04 04/08/08 ick Up VISA 2037 B 1 L usturner C v o~ >s>'E~E~tifF1E~~t3l;S I.c)al.. THRNK YOU, ......................................... .... ................ _ * WES 81575 E 11.3600 11.36 4 RI'T FRQSTED _7--1f 2 DIA *** TENDERS *** VISA 16.04 P~ ~~~` .~ ~f '~ ~~ ~ r~-a~ ODDE E%PLANATIDN .~• * * THIS I S YOUR INVOICE * * sue TOTAL 11.3 6 - BTAIE TA%APPLICA9LE C - CONSIDER COMPLETE ...... MSC, CHAfIGE, Y - FED./OTFIBi TAK APPLICAEIE D - DNiECT 9NIPMENT y~ •yyuu ... v::::: L.iµ...}~.It}...... {4i: vv. - BTA1E d FEDERAL TA% F .FACTORY MINIMUM ii%;FiFZ~:N7+~i ii:;:;::' :iii:::~~~1•T:t+::YM1M:i•:?!f::i: 8 -BALANCE BPLK ORDERED « - REruRNED cn.. '-"' TELE. CHARGE ~AEIGHT 7QTAL MATERIAL CANNOT BE RETURNED WITHOUT NET TERMS : INV 0 DUE : 04 AUTHORIZATION AND WILL BE SUBJECT TO A /OS/O8 FED.iOTHER TAX RESTOCKING CHARGE. *** ORDER COMPLETED *** srarE rAx ff .,6$ PAST DUE INVOICES SUBJECT TO 1.6% PAYMENT RECD. - 12.04 SERVICE CHARGE. TOTAL-AMT DUE 0.00 XLOPTB 8188 DUPLICATe r ~~ n _ , THANK YOU F[iR ;NI)Pf'ING WE1S MARKETS #95 CAR(.1SLE, PR. Item Price i]Tf; 6.09 +c*** TAX .00 BAL 6.09 Ci._U13 CUSTOMER 40990092707' CREDIT PIJk(,HA~,E. O1 /1~'/0$ 13 :39 CARD#: ~;{XXxXXXXr,XXX49?.3 ;r .x Approved *~ Hirst L.oy#67101 AUIH: 671017 REG#: ~~11 SEO#: 001898? LOCA I l ON Ti) ~ OUO(i0051 I PRYMF:~N( AMOUNT r' ~1 t SAYLOR' S MA 31 CARLISLE PHONE 1~6• RKET ROAD ]~~1 VALERIE 0001 O1 1)1717046 01/11/08 6:44pm 030 $ WYLR 13= BLLN $1.79 F (TPR SAVINGS $0.70) TF 70Ci ENVELOPE $2.19 T SUBTOTAL $3.98 SALES TAH $0.14 TOTAL $4.12 CASH $4.12 CHANuE $O.OO ~~ ~ a~~~ L ,r"~ L UEIS MRRKEI" #95 CARI_I~I_E, PA S ifIRE PHONE# 71 l -r'4 ~ -$r~sri l;l_l!R i.;IISTOMER 40990092709 item Price PFIAf7MACY 2Ci.00 #**+- 1"AX .00 BAL 20.00' _. -- - - CREDIT PURCHHSE 01/2L~/Q8 12:26 CAR11~: Si;X~':{:KN,XXX?(XX4423 * t ANpresve+_1 Host Lo<a#F;41905 AllfH: 691905 REG#: 511 SE[1# . 00243`34 LOCR T IOrJ I I:i 0C!Or)nn=. t ~ ~, ~-Us--~-~ , g,p 8 / ~- 2 1NAL.* MART Save money, Live better, SUPERCENTER WE SELL FOR LE55 MANAGER ANGELA SIERER t 717) 258 - 1250 CARLISLE, PENNSYLVANIA ST8 2574 OP8 -00000239 TE8 28 TR8 09"i,: SC WATER 007874209633 F 3,qg SC WATER 007874209633 F 3,gg N SPARKLE 8RL 003040000137 5.18 X CHEERALIQUID 00300044048 18.37 X GVWWHT VNGR 007874235255 F 9,g8 N SUBTOTAL 45.90 TAX 1 6.000 X 2,16 VISA TTEND 48.06 ACCOUNT 84423 APPROVAL 8610506 TRANS ID -0288014648654281 VALIDATION -682F PAYMENT SERVICE - E CHANGE DUE 0.00 # ITEMS SOLD 7 TC8 4775 1334 1057 2641 2528 I I~NI IIIN IIIN TIN III IN Niel BN IIIIII Till iIIB ~I I~IIII INIII II IIII III IIII Bua any electronics todey9 Rate thse at WalAart.co~/rattnss. 01/14/08 13:01:1.5 ***CUSTOMER COPY~r** t ,~~ N ~~ ~~ D g D' 2~v :.~ . .. ,±:,•,-sel+~~ Yd.See, S~:h^rin~s, Evr:v ~r !?•~y'; . ... ?,s ur tt:~ Irsief nt~f 4 1 n M,1 ± .., to ,_ ,~; . ~,~..,,. ,t l_+'~• ' ,., ast.,;li, .., ,.u, ~ _.oa. ;: ii i., .prprDVY? ~c;u: . ;r~i~r :.yc::r; ,. i;ie:.;. .-t ; c.- ur t12. t.h+r~c; IiJC!7, $tDC•e tlarsaser ri!~Yrt i'fYOC2 StDrC: Ail G, _..i :r ~,. `yP!'tdly (~rrt is fl :)},"C,Pa ! -,rr. i s,l~'r``1U[2e. t 71'x) `a `+fi,-'~>-r x ~, ?:y. =s ~Nt.Ef'I1Of1;:! ~ (11 ~) y~,..<r..~~.,f.~ '3Niti ~,') r,. e t 9i ~i6 ~i;:'11 r1il ~..,.;Q:~ ia~ iJP 'J.fi~S f :, ; ftG~al.iS!'si.tY SFlU:,N{it; .20-~ Pr i cd~ y,~u gay 2.19 ii '. `. t ":i 3 ~'~ it it I ril F;F I Ui'l SFiV) iJi_~.` i ~j ~ tti_ Hr f kh ':;HU 1 N1~5 t i ii?' f'~`i I I] ,s a;,:, lr,~w; ~ . 'r; :: It ,. tY~ t:F!gMC;E ?) 7M ~~~ L . Tom' ~ 8 ~ WAL*IIAART , Save money. Live better. SUPERCENTEk WE SELL FUR LES5 MANAGER ANGELA SIERER ( 717) 258 - 1250 CARLISLE, PENNSYLVANIA ST1t 2574 OP8 00003494 TEtt 31 TR1< 08907 15 LEASH 089033800110 7.27 X SUBTOTAL 7.27 TAX 1 6.000 % 4.44 TOTAL 7.71 CRSH TEND 20.00 CHANGE DUE 12.29 # ITEMS SOLD 1 TCtt 8123 2224 2635 6088 0189 11111111 ~I~ IINa ll lll~I lNl llllllu illll it 1111' ~! !~I ~IIIII IINII II IIIIIi 1111111 li lll( Bua any electrons daa9 Rate thew at Wal~nart ~ttnss. 01/02/08 1~,. ~~4. !bs ~g n ~ .. (1 WALE MART Save money. Live better. ~r ~ SUPERCENTER WE SELL POR LESS MANAGER ANGELA SIERER ( T17) 258 - 1250 CARLISLE, PENNSYLVANIA - ST1t 2574 OP>t 00003420 TE>< 03 TRit 09113 TAPE DISPENS 00753530'290 3.97 X SUBTOTAL 3,97 TAX 1 6.000 % 0 4 ~'- TOTAL 4 , 2 - ~ CASH TEND 20. 0 CHANGE DUE 15.79 __ # ITEMS SOLD 1 - ---- - - -- TC# 5204 0171 0209 4163 5397 `- ~ ~~ ~ ~ ~ 11111111111 11111181111111 ~lll 111 llllill l1lil it l ll 11111 illi Illl 111 l l 11111 111 llll'iiI Buy any electronics todaa? Rate ~art,com/rattn-=~; 02/28/08 16:50:19 ~.,X ~~~ ~ HOME UEF~OT 414 1013 S. HANUVER ST, CARLISLE PA 17013 STORE MANAGER MAkK ULRICH 249-1771 4149 00002 20970 i)5~15!0~3 71 FLF7T3 ~U'F~PM . LE ~ i~~~~~, A ~ 1 ~1,. ~.-:1 err ~~~~ ' 019442148218 3/4 GAL CPLG <A> 1.19 019442148003 3/4X1/4GLBSH KA> 1.46 10 Nobel Blvd. ' ~/n~ SUBTOTAL 2.65 Carl isle, PR 17013 n ~ SALES TAX (717) 245-2334 ~/" TOTAL .$2.81; CASH 264 269000199 3 1'744456 ~ CHANGE DUE 7.19 06/03/2008 04:54Pm ', 9403072 GW SPRAYER 1 1 /2GRL I~ IIIIIilllllllllllllllll Ill~llllilil~llllllllliillll 9.9 9.93 4149 02 20970 05/25/2008 0427 Subtotal 9.93 6.001 Tax 0.60 Total 1 Check 0:53 ~'f'1•ic 1023 Change 0.00 A Cash Back ~ ~ ~ / ~~ ~ n~ z~~~v~ _ ~~ ~ , ~ ', y ~~M1i ~ r ~ ~ ~l"' ~i ~~ ',i . 4 ~ .^'` + !~I. I.~ f / 6, ~'d ~N~~'r7~ I w ~ ~.~ Locnliy Owned & Operoi ~, .~ SUPERIRAR~C Sto;riehecl~e ~hcr~g~g C'erttis~' {~~;~ ~~,iili'Ii.i~ }~r;:)1i11•~1i31 ~,(3a9.~ Carlisle, P~ 17013 717-249-2345 iI5/2008 TERM 5 4:07:42 PM HELLD, MY NAME IS 547 Isaiah Welcome GOLD SAVINGS iD: 41100032184 , SPR WTR 2 ~~ 5.79 11.58 00001540020246 old Savings 2 ~ ].80 -3.60 JBTOTAL 2 7.98 ~~ 0,00 ITAL 7 `' DUE==> ~~"''~ - ~~ . ~~ ~- . . ~~~~0 ~ ~' With us, it's personal. Store #11018 429 S. HANOVER ST. CARLISLE, PA 17013 (717> 258-4800 Register #2 Transaction #35187 Cashier #110187522 1/17/08 7:28PM 1 CHARMIN GIRNT 8PK 4.99 ON SALE. Reg 1/7.99 1 Items Subtotal 4.99 Tax .00 Total 4^: 99 *CASH PAYMENT* 5.00 Tendered 5 00 Cash Change ^~~, ~~ ,i a `~' (HANK YOU FOR SHOPPING A~ WEIS MARKETS # 95 CARLISLE, PR WEIS MARKETS #95 CRRLISLE, PR STORE PHDNE# 717-243-8535 IteA Pria Item Price COMET SPRAY 1.89' COTTONELLE 3.79 COMET SPRAY 189 (, UNISOM 8.69 LISTERINE c ~`~ CLUB CUSTDMER 40990092709 CLUB CUSTOMER 40990i)9~7c? e*a* TAX .Od BAL 12.48 as** TAX .23 BAL ~.9'0' --------------------------- --..---_____ Cash 10.Odfi CRED:[1' PURCHRSE 01/27/08 15:13 CHANGE 3.10 CARD#; SXXXXXXXXXXXX4423 12!29/07 12:11 PM 0095107 0038 109 , *~ Reproved ** ! Host Log#611995 +.~++~,+,.+++.,.++++,+++~+.,,.~++++-~ „ " '" AUTH: 611995 WEIS/MR.Z'S:KING'S MARKERS ' REG#: 104 Where Freshness Matters! : SEQ#: 0025348 LOL'ATION IO: 000000104 3 Easy ways to order Party Platt2rsI PAYMENT AMOUNT 12,8 At our Service [1eli, Online at Weismarkeis.cum pr ' --.-- __..._____.....__..__ __._.__...__._.___. 7011 Free 1-866-999-WEIS 1F Credlt 12.48 <-~*,r~~~~~~**~*~,~~~~~~*~~+~~~~;~~~..~r, CHANGE .UO °,~~ o~ ~. ~~ SCOT 0001 11 11137416 01/27/08 10:52am 111 HRS HRS PU ~ KTTL CK BBO KC SR CRM/ON ~ ULTRA $2.99 F $2,99 F /T DELI SUB $4.29 TF HRS HRS KTTL CK BBO KC SR CRM/ON $2.99- V F $2.99- V F SUBTOTAL TOTAL i VISA j ACCT# Sr4423 i EXP: 03/10 '~ BEAR STEPHANIE E 01/27!08 10:43 ~ AUTH # 631256 -SEQ # 00009335 LID # 05226611 CHANGE .01 # OF ITEMS: 3 $8.49 $0.33 $8.82 $0.00 SCOT 0001 11 11136386 12/28/07 4:49pm 111 CRST PH MOUTHWSH $4.99 T SUBTOTAL $4.99 $0.30 , TOTAL ~ -$ CASH $20.30 CHANGE $15.01 # OF ITEMS: 1 g4.63 REV-1513 EX+ (9-00) SCNEDI~LE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER `YY1 A ,r i c ~ '~ -~ ~ ~- Z r a 8' ~- ~ ~ ~ 3 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT Do Not LlstTrustee(s} AMOUNT OR SHARE OF ESTATE I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 3 -T ~ ~ zC~ ~,~ ~~~v,~~r~ ~~ l~z~; Z ~ 3 ~~tl~ ~v llv~ IQc~ ~ ~ ~ `~~, ~.11er'~c~n5' ~a~~e rP~ 17t~9C~ ~~ p~ b ~ Ott ~, t~ ~ eQ ~. p b-~ t f ~©~sv~ tl ~ ~A 17~~1 7 > 1~ G'..C~ Ea S~r ~F ~ ~ P ^ r ~`j ~ vim. ~i~~ 2 -~~ ~V~~v~}~C~ ~~ 17~~r° ~ ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 TH ROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET S (If more space is needed, insert additional sheets of the same size) ~ } COPY L.~LS~I~VILL .~~.T/D ~~S~.~VI~.?V'IJ I, MARY E. BEAR, of West Pennsboro Township, Cumberland County, Pennsylvania, declare this instrument to be my Last Will and Testament, hereby expressly revoking all Wills and Codicils heretofore made by me. ONE: I direct my Executors to pay all of my debts, funeral and administrative expenses as soon as may be done conveniently after my decease. TWO: I give, devise, and bequeath all of my estate of every nature and wherever situate in equal shares to my children, JACOB L. BEAR, JR, JOHN H. BEAR, DEBORAH K. CAMPBELL, and STEPHANIE E. BEAR, per stirpes. If one of my children named herein should predecease me, the share of said deceased child will be distributed equally to the issue of said deceased child, provided that such issue have attained the age of twenty-one (21) years. If one of my children have predeceased me without living issue the share of said child will be distributed equally to my children who survive me. THREE: If one of my children have predeceased me leaving issue under the age of twenty-one (21) years, I then give, devise, and bequeath said shares in TRUST to FINANCIAL TRUST COMPANY, as TRUSTEE for the benefit of said issue of my predeceased children subject to the following provisions. a. This Trust will be for the sole benefit of the issue of my deceased children who are under the age of Twenty-One (21) years as provided herein. b. The net income of the TRUST shall be applied at the sole and absolute discretion of the Trustee to the support, maintenance, education and general welfare of my children's issue, in such manner as the Trustee deems proper, without regard to any other funds which may be available for the Trust purposes, or may be accumulated in Trust. c. I further authorize the Trustee, to apply not only the income, but also so much of the principal as the Trustee deems necessary, in, for, or toward the maintenance, support, education and general welfare of my said beneficiaries, in such manner as it shall deem proper. d. When each issue of my deceased child attains the age of Twenty-One (21) years of age, the Trustee will distribute the balance of the Trust principal and accumulated income to said issue. e. The Trustee shall have the following powers, in addition to those vested in it by law, for my property held for the benefit of my beneficiaries, whether income or principal, exercisable without court approval and effective until the distribution of all property under the 2 ~ . Y terms of this Trust; the Trustee, at its discretion, may compromise claims, borrow money, or retain property for such length of time as it may deem proper, sell, lease, pledge, mortgage, transfer, exchange, convert or otherwise dispose of or grant options of all or any portion of TRUST property for such prices, on such terms in public or private transactions as it may deem proper; and invest Trust property and income without restriction to legal investments. FOUR: I appoint JACOB L. BEAR, JR., JOHN H. BEAR, DEBORAH K. CAMPBELL, and STEPHANIE E. BEAR, to serve as Co-Executors of this my Last Will. FIVE: My Executors may, at their discretion, compromise claims, borrow money, retain property for such length of time as they may deem proper; lease and sell property for such prices, on such terms, at public or private sales, as they may deem proper; and invest estate property and income without restriction to legal investments. SIX: No Executor or Trustee acting hereunder shall be required to post bond or enter security in this or any jurisdiction. 3 r ~ ~+ IN WITNESS WI3EREOF, I have hereunto set my hand and seal this p~~9 day of May, 1999. S Rr t ,~ • ~~Q `7 (SEAL) MARY E. BEAR Signed, sealed, published and declared by MARY E. BEAR, the above named Testatrix, as and for her Last Will and Testament, in the presence of us, who, at her request and in her presence and in the presence of each other have subscribed our names as witnesses hereto. ~/ Ch ~, y ~- ~ . C del a~ ~ ~~ 4 ACKNOWLEDGMENT AND AFFIDAVIT WE, MARY E. BEAR, CHERYL L. CLELAND, and SHARON L. SCHWALM, the testatrix and witnesses respectively, whose names are signed to the 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 that she had signed willingly, and that she executed it as his free and voluntary act for the purpose herein expressed, and that each of the witnesses, in the presence and hearing of the testatrix, signed the will as a witness and that to the best of their knowledge the testatrix was, at that time, eighteen years of age or older, of sound mind and under no constraint or undue influence. MAR E. AR CF~~ ~. ~ . C? I~lG~~ CH RYL L. CLELAND G~.~ !n-~ ~. ~ s~ ~ a. ~ l'''am-_ SH RON L. SCHWALM COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND . Subscribed, sworn to and acknowledged before me by MARY E. BEAR, the testatrix herein, and subscribed and swornt't~ before me by CHERYL L. CLELAND and SHARON L. SCHWALM, witnesses, this~~3'ay of May, 1999. Notary Pub c Notarial Seal Martha L. Noel, Notary Public Carlisle eoro, Cumberland County My Commission Expires Sept. 18, 1999 ..n~„~ r«ivan~~~. ~`ssor,;ane, ;f Notari?s REV-154'0 EX Page 3 Decedent's Complete Address: ipg~o X83 File Number DECEDENT'S NAME ____`Ct~r _______~ . 3 ~ a r ~ STREET ADDRESS e / ~ __. ~a s n S 7'a.,~ ~~ -~ d CITY ~) ~ -_- ~-- r STATE ~ T ZIP ~ ~~ /~ Tax Payments and Credits: 1. Tax Due (Page 2 Line 19} 2. Credits/Payments A. Spousal Poverty Credit _ _ _ B. Prior Payments ~ ~ ~' 9 C. Discount 3. Interest/Penalty if applicable D. Interest E. Penalty ,~ ~• 2 9 Total Credits (A + B + C) (2) ~ I , 9 9 zj~ -' -----_- ---- 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. c3) '7. ~ q (4) (5A) (5B) 2 CoC,o, ~ 9 Make Check Payable to: REGISTER OF WILLS, AGENT . ~~~.~ .mom ' ~>, ~: '~'~A;~ ~ ; ; ~ ~ - s f; - 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 :.......................................................................................... ^ b. retain the right to designate who shall use the property transferred or its income : ............................................ ^ c. retain a reversionary interest; or .......................................................................................................................... ^ 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? .............................................................................................................. ^ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. ^ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate properly which contains a beneficiary designation? ........................................................................................................................ ~ ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. ~a 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}}. 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. pc~ ~~p ~GY A ~~~