HomeMy WebLinkAbout07-31-0915056041114
REV-1500 EX (DB-D5,
PA Department of Revenue
Bureau of Intlivitlual Taxes INHERITANCE TAX RETURN
PO BOX 290801
Hameburg PA 17129.0901 RESIDE
ENTER DECEDENT INFORMATION BELOW
Soelal Security Number Date of Death
Suffix
BURGNER
(If Appllubla) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
Spouse's Social Security Number
OFFICIAL USE ONLY
County Code Year flle Number
~1 ~ JJ9/
Date of Birth
10111911
Decedent's First Nama MI
ALETHA Y
Spouse's Fint Name MI
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
0 1.OngMSI Retum Q 2. Supplemental Retum ~ 3. Remaintler Retum (tlate of death
poor to 12.13-92)
4. Limited Estate ~ 4a. Future IMerast Compromise (date of ~ 5. Fetlerel Estate Tax Retum Required
tleam after 12-12-02)
(~ 9. Decetlent Dietl Testate ~ 7. DetetleM Maintalnetl a Living Trust ~ B. Totai Number of Sete Deposit Boxes
(Attach Copy of Wilq (Attach Copy of Tmaq
0 B. Lidga9an Prooeetls Received Q 10. Spousal Poverty Credit (data of death (] 11. Election to tax under Sec. 9113(A)
betvreen 1231-91 and 74-99) (Attach Sch. O)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO
Name Daytime Telephone Number
ROBERT G. FREY 717-243-5838
N
Finn Name (If Applicable) REGISTER tb.F7WILL3 USE Y
FREY & TILEY f
r~ = j C
'
First line of address --<> c-
-.,~ ~ ~ tv
r;
5 SOUTH HANOVER STREET .
U%
~
Sewnd line of address ~
t 7 v
city or Post Office
CARLISLE
Correspondent's o-mail address:
State
PA
LEY.COM
(": 77 W
ZIP Code DA F LI ED
17013
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SIGNATURE OF PE~~pN RESP~jNSIBLE FOR FLING RETURN DATE
ADDRESS
P. O. BOX 109 , CARLISLE, PA 17013
SIGNA E PREPA ROT R HAN PRES TIVE ~ DATE
r Z pa
ADDRESS
5 SOUTH HANOVER STREET, CA LE, PA 17013
PLE7ISE USE ORIGINAL FORM ONLY
Side 1
L 15D56041114 15056041114
J
REV•7500 EX
Decedent's Social Security Number
Decetlent'e Neme: ALETHA Y BURGNER
RECAPITULATION
1. Real estate (Schedule A) ........................................... 1
2. Stocks end Bonde (Schedule B) ................. . .................... 2. NONE
3. Closely Hald Corporegon, Partnership or Sole-Propnatorship (Schedule C) ..... 3. NONE
4. Mortgagee & Notes Receivable (Schedule D) ............................ 4. NONE
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ........ 5.
B. Jointly Owned Property (Schedub F) OSeparate Billing Requested ........ 6.
7. Inter-~vos Trensfers & Miscellaneous Non-Probate Properly
(Schedule G) ~Separete Billing Requested . , ...... 7. NONE
8. Total Gross Assets (total Llnas t-7) .................................. S.
9. Funeral Expenses & Administrative Costs (Schedule H) .............. ..... 9.
10. Debts of Decedent, Mortgage Liabilhies, 8 Liens (Schedule I) .......... ..... 10. NONE
11. Total Deductlor» (total Lines 9 & 10) ............ . ............... ..... 71.
12. Net Value of Palate (Line B minus Line i t) ....................... ...... 12.
73. Charitable and Governmental Bequests/Sec 9713 Trusts for which
an election to tax has not been made (Schedule J) .................. ..... 7 g.
136000.00
10000.00
137606.00
283606.00
14597.00
14597.00
269009.00
0.00
14 NNValuaSub}scttoTax(Linel2minuaLine73) ........... 14. 269009.00
TAX COMPUTATION • SEE INSTRUCTIONS FOR APPLICABLE RATES
i8, Amount of Line 14 taxable at
the spousal tax rate, or
transfers under Sec. 9118
(a)(7.2)x.a 0 15. 0.00
16. Amount of Line 14 taxable
at linealretax.045 269009.00 15. 12105.00
77. Amount of Line 14
taxable at sibling rate X • 12
17. 0.00
58. Amourd of L1ne 14 taxable
at collaterel rate x , 15 18. 0 . 0 0
19. TAX DUE ....................................................... 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Slde 2
15056042115
12105.00
0
L 15056042115 15056042115
REV-1500 EX Pege3 174-D5-1914
Decedent's Complete Address:
Flla Number
21-0&1191
DECEDENTS NAME
LETHA Y BURGNER DECEDENTS SOCIAL SECURITY NUMBER
174-05-1914
STREET ADDRESS
10 WEST NORTH STREET
CITY
CARLISLE STATE
PA ZIP
17013
Tax Payments and Credits:
1. Tax Due (Pepe 2 Line 19)
2. Credita/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
3. InteresUPenalty 'rf applicable
(1) 12105.00
Total Credits (A + B + C) (2) 0.00
D. Interest
E. Penalty
Total InteresUPenalty (D + E )
4. If Line 2 is greater than Line 1 + Line 3, enter the dltTerence. This is the OVERPAYMENT.
FIII In oval on Page 2, Line 20 to requsat a rofund.
5. If Lina t + Line 3 is greeter 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.
(3) 0.00
(4)
(5) 12105.00
(5A)
(58) 12105.00
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a Uanafer and:
f
r
f th
t
d
i
t Yes
^ No
: ......................................
e proper
rans
e
re
ncome o
y
a. retain the use or .
b. retain the right to deaignata who shall use the property transferred or its income : ................ ^ Q
c. retain a reversionary interest; ar ..................................................... . ^
d. receive the promise for life of either payments, henefits or care? ............................ . ^ 0
2, If death occurred after December 12, 1982, did decedent transfer property within one year of death
^
Q
without receiving adequate consideration? ................................................ .
3. Did decedent own an "in trust for" or payable upon death bank account or secudty at his or her death9 . . ^ ^X
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate properly which
contains a beneficiary designation4 ..................................................... . ^ ^
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 p2 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. §9118 (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 fax 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. §9118(1.2) [72 P.S. §9118(a)(1)].
The tax rate imposed on the net value of Vansfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116(a)(1.3)]. Asibling
is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
pennsylvania ~ SCHEDULE A
DEPARTMENT OP REVENUE
INHERITANCE TAX RETURN REAL ESTATE
ESTATE OF FILE NUMBER
Aletha Y Burpner 21 A8-1191
All real property owned why or as a tensrd in common mwt be reporbtl et fair market value. Fair market value is tleanetl as the pots at whidr property
would be exchanged between a willing buyer antl a willing seller, neither befog eompe8etl to buy ar rill, twM having reasonable knowledge of the relevant facts.
If more space is needed, insert additional sheets of the same slza.
217
REV-1808EXt (8-98) SCHEDULE E
CASH, BANK DEPOSITS, 8r MISC.
oo~iromERITANCETAXRETURN~IA PERSONAL PROPERTY
llf more space is needed, insert additional sheets of the same size)
2n
"~-'~E"'`E~~' SCHEDULE F
COMMONWEALTH OF PENNSriVANIA JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
ESTATE OF FILE NUMBER
Aletha Y Burgner 21-08-1191
If an asset wu made Joint within one year of the decedenYS date o1 death, k must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME I ADDRESS I RELATIONSHIP TO DECEDENT
A. Donna B. Frederick
B.
C.
JOINTLY AWNED PROPER TY:
LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH
REM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION ANO S.WNACCWNT NUMBER OR SIMILAR DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT 10~^~NON~~R'"rT^CX °EEO FOR.wiNnv~NELO REAL ESTATE. VALUE OF AS ET INTEREST DECEDENTSINTEREST
1. A. 5/4ro7 Wachovia Certificate of Deposit no. 247412042975363 8,307 50.06% 4,154
2. A 7/24/00 Wachovia Certificateof Deposit no. 247412051273398 71,732 50.00% 35,888
3. A Wachovia Account no. 1010072342891 33,017 50.00°k 18,509
4. A Wachovia Account no. 1000324142494 15,830 50.00% 7,915
5. A Smith Bamey Money Market Account 8,884 50.00% 3,432
5. A Legg Mason Value Trust, 73.812 shares ~ $27.20 per share 2,003 50.00% 1,002
7. A Certificates of Deposk held in Smith Bamey account 137,455 50.00% 68,728
0
0
D
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
TOTAL (Also enter on line B, Recapitulationl~ S 137.806
(If more space is needed, insert additional sheets of the same size)
Box 1098
lisle. PA 17013
B.
1.
SCHEDULE H
FUNERAL EXPENSES &
Aletha Y Buraner 21-08-1191
OF PENNSYLVANIA
NINISTRATIVE COSTS:
Personal Representative's Commlasiona
Name of Personal Representative(s)
Street Adtlreea
City
Year(e) Commlealon Paid: _
State Zip
2. I Adomey Fees
3. Famly Fxempdan: (tt decetlent's address is not the same ae cl6imanl's, attach explanatlon)
Claimant
A.
1
EXPENSES:
4.
5.
6.
7.
Street Adtlreas
city State
Relationahlp of Claimant to Decetlant
Probate Fees
Aewuntent's Feea
Tax Retum Preperor's Fees
penses in connection with real estate sold
(If more space is needed, Insert additional sheets of the same size)
Zip
5,000
9,597
REV-1519 EX+ (1 t-OB)
Pennsylvania
DEPARTMENT Of REVENUE
INHERITANCE TAX RETURN
ESTATE OF
SCHEDULE)
BENEFICIARIES
FILE NUMBER
RELATIONSHIP TO DECEDENT I AMOUNT OR SNARE
w nio~e ueeee Gun eOOGCRS AF PFRSON(Rt RFCFIVINO PROPERTY DO N01 Llai TNateNa) OF ESTATE
TAXABLE DISTRIBUTONS [InGude outrlOht spousal tliaMbWOna and trenatera under
See. 2118 (a) (1.2).]
Frederick
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV•ib00 COVER
11. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 2113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
100%
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV•1500 COVER SHEET.
II more apace Is needed, insert addldonal sheets of the same elm.
Expenses in Connection with Real Estate Sold
Expenses from HUD-1 settlement statement g~5g7
Seller Assistance from HUD-1 settlement statement 4,080
PPL 36
PPL 55
Donegal Insurance 222
PPL 43
PPL 46
Aaro Energy 345
Robin Sallenbarger, Tax Collector 350
Donegal Insurance 222
NoRh Middleton Authority 84
Total Expenses of Real Estate Sold 50.337.000
Total g 897
LAST WILL AND TESTAMENT OF
ALETHA Y. BURGNER
I, ALETHA Y. BURGNER, of North Middleton Township, (910 West North
Street, Carlisle), Cumberland County, Pennsylvania, being of sound and
disposing mind, memory and understanding, do hereby make, publish and
declare this ae and for my last Will and Testament, hereby revoking and
making void any and all Wllls by me at any time heretofore made.
1. I direct my hereinafter named Executrix to pay all of my just debts and
funeral expenses as soon after my death as may be found convenient to do so.
2. All the rest, residue and remainder of my estate, real, personal and
mixed, and wheresoever the same may be situate, I give, devise and bequeatl
to my daughter, Donna B. Frederick, her heirs and assigns, of 835 West
North Street, Carlisle, Pennsylvania, but should she pre-decease me then to
her issue per atirpes.
3. Shovld aqy person less than 21 years of age be entitled to distribution
from my estate, I nominate, constitute and appoint Farmers Trust Company
and its successors, 1 West High Street, Carlisle, Pennsylvania, as Guardian
of the estate of each such person, and authorize and direct it to receive and
invest the same and pay the income arising therefrom together with so much
of the principal thereof as in its opinion is necessary or desirable to be
expended for the proper maintenance, support and education of such person,
to the person having custody of such person, and upon such person attaining
21 yearn of age to pay to him or her the then remaining principal together _
with any undistributed income.
4. I have made no provtsion herein for my husband, Eugene Et. Bergner,
for the reason that I am confident he will have adequate resources independen
of property passing under this Will.
5. I hereby nominate, constitute and appoint my said daughter, Donna B.
Frederick, as Executrix of this my last Will and Testament, but shouldshe
pre-decease me tir=fail to qualify, then I nominate, constitute and appoint my
~~ ---~,
son-in-law, Robert I. Frederick, Jr. as Executor ofthie my last Will and
Testament and I further direct that neither my said daughter nor my son-in-
-:j law, shall be required to post any bond to escort: the faithful performance of
her or his duties in the Commonwealth of Pennsylvania or in any other
jurisdiction.
IN WITNESS WBEREOF, I have hereunto set my hand and seal to this my
~:f, last Will andTestament written on two (2). pages this /3~day of ~*^-~
1978.
(SEA:
Alet Y. Burgn
Signed, sealed, published and declared by Aletha Y. Burgner, the
j
i Testatrix above named, as and for her last Will and Testament, in our
presence, who, in her presence, at her request, and in the presence of each
other, have hereunto subscribed our names as attesting witnesses.
~ ~. ~..
~~
OMB NO. 2502A265 /.~
A. B. TYPE Of LOAN:
U.S. DEPARTMENT OF HOUSINGd URBAN DEVELOPMENT 1'X^FHA 2.~FmMA 3.QOONV. UNINS. 4.~VA 5.^CONV. INS.
SETTLEMENT STATEMENT 8. FILE NUMBER: 7. LOAN NUMBER:
WEAGLE 2o996Ta67
8. MORTGAGE INS CA5E NUMBER:
441-9113935-703
C. NOTE: This krrrl is fumishetl to ghre you a statement of acNal SeMemenl costs. Amounts peitl b and by the settlement agent are shown.
Items marked `(POCJ' were psid outside Hx cbsinp; grey are shown here PorinlomraNone/ purposes entl are not inclutlatl in the totals.
10 SgB (WEAGLE VfGMEPGLEMI
D. NAME AND ADDRESS OF BORROWER:
KEVIN B. WEAGLE and
TAMMY K. JOHNSON E. iJAME AND ADDRESS OF SELLER:
DONNA B. FREDERICK, EXECUTR% F. NAME AND ADDRESS OF LENDER'
HOWARD MANNA MORTGAGE SERVICES
MORTGAGE SERVICES
119 GAMMA DRIVE
PITTSBURGH, PA 15238
G. PROPERTY LOCATION'.
910 W. NORTH STREET
CARLISLE, PA 17013 H. SETTLEMEM AGENT: 23-240231fi
PURITY ABSTRACT COMPANY I. SETTLEMENT DATE'
June 10, 2009
NO. MIDDLETON TNP, CUMBERLAND CO. PLACE OF SETTLEMENT
Century 21 Piscioned Realty
3315 Market St, Camp HIII, PA
J. SUMMARY OF BORROWER'S TRANSACTION K. BUMMARV OF SELLER'S TRANSACTION
100. GR038 AMOUNT DUE FROM BORROWER: 100. GROSS AMOUNT DUE TO SELLER:
101. ContnG Sales Price 136,000,00 401. Do0treG Saka Pricy 136.000.00
102. PersonalPro 402. Personal Pro a
103. Se0lemenl Cha es to Bortower Line 1400 9,154,42 403.
104. 404.
105. q05.
Ad'ushnenh For Items Paitl B Seller in advance A 'usfnronts For Items Paid B Sellerin advance
106. Coun R Taxes 0&10109 to 01101710 200.33 406. Coun /f Taze6 O6H0/09 l0 01/01/10 200.33
107. C' Tax to 107. C' Taz to
108. School Tax 06/10/09 t0 07/01/09 73.91 008. School Tax Ofi110109 to 07lOtl09 73.91
109. 409.
110. 410.
111. 411.
112. 412.
120. GROSS AMOUNT DUE FROM BORROWER 145,426.68 420. GROSS AMOUNT DUE TO SELLER 136,274.24
200. AMOUNTS PAID BV OR IN BEHALF OF BORROWER; 500. REDUCTN)N91N AMOUNT DUE TO SELLER:
201. De sk or earnest moos 4800.00 501. Excess De oe4 See Instructions
202. Prlnci al Amount o1 Naw Loan a 133 500.00 502. Se0kment Cha es to Seller Line 1400 9,596.75
203. Ezislln loans taken sub' ct to 503. Exlatin loans taken sub eq to
204. 504. P tt of first Mon age
205. 05. Pa o0 o7 sawnd Mona e
208. 508.
207. 507. De asH diaE. as roceeda
208. 508.
209.3%SELLER ASSIST 4,080.00 509.3%SELLER ASSIST 4,080.00
Ad usfinents For lkma U aid S Se11er Ad'usbnenb For Items Un !d B Seller
210. Coun R Taxes to 510. Coun ? Taxes to
211. C' Tax to 511. C' Tez to
212. SCpn0l Tax [0 512. School Taz lG
213. 513.
214. 514.
215. 515.
216. 518.
1217. 517. INHERITANCE TAX EBCROW to PURITY ABSTRACT 9,520.00
218. 518.
219. 519.
220. TOTAL PAID BY/FOR BORROWER 142,380.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 23,196.75
300. CASH AT SETTLEMENT FROMRO BORROWER: 800. CASH AT SETTLEMENT TOIFROM SELLER:
301. Grans Amount Dua From Borrower Line 120 145,428.66 607. Grose Amount Due To Seller Line 420 136,274.24
302. Less Amount Paid B /For Borrower Line 220 ( 142,380.00) 602. Less Retluctions Dua Salkr (Line 520 ( 23,196.75
,303. CASH(X FROMj( 70)BORROWER 3,048.68 603. CASH(X TO)( FROM)SELLER 113,077.49
Tha undarsignatl hereby acknowledge recelpl of a completed copy of pages 182 of this statemenl8 any a0achmenla refertetl to herein.
Borrower `~ - ~ Seller
KEVI B. WEAGLE
~<1~ DONNA 8. FR ICKRX~
~A~h MV K. J NSO
L. SETTLEMENT CHARGES
700. TOTAL COMMISSION Barad on Prka $ 13fi,000.00 6.0000% 8,1fi0.00 aaiornon anio vaou
Division o/Commission iine 700 as FOlbws: soaaowEa's ssusas
701.E 4,105.00 to Hooka, Hooke 8 Eckman runos al vuaws aT
702. $ 4,055.00 1o CENTURY 2t PISCIONE I REALTY, INC. ssmENaan ssntsNSwr
703. Commission Paid at Se0lement 8,160.00
704. TRANSACTION EE to CENTURY 21 PI CION RI RF>.LTY,1 225.tl0
800. REMS PAYABLE IN CONNECTION WITH LOAN
801. Loan Od ination fee 1.0000 % fo FIRST AMERICAN MORTGAGE. LLC
802. Loan Oiscounl °/ to
1,312.40
803. Appraisal Fee to CENTRAL PENN APPRAISAL $425 P C
804. Credit Report to CREDIT PLU 28.09
805. Lenders lnspedion Fae to
BO6. Flood Cen Fee to
80]. Yield Spreatl Premium ptl to to FIRST R AN MORT E. LLC pd lender $t835.fi3 POC
806. Document Prep Fee to H WARD HANNA MORTCah E SERVICES 175.00
809. Admin Fee to HOWA D MANNA MORTGA E SERVICE 475.00
810. Courier Fee to FIRST AMERI AN MORTGA E. LLC 25.00
811.
900. ITEMS REQUIRED BY LENDER TO BE PAIDIN ADVANCE
901. Interest From O6/10/09 fo 07/01/09 8 19.200000/day ( 21 days %) 403.20
902. Mon a e Insurance Premium for months to D PT OF HUD UPFRONT MIP 2 296.70
903. Hazartl Insurance Premium for 1.0 ors to ERIE INSURANCE 8362 POC
904.
905.
1000. RESERVES DEPOSRED WITH LENDER
1001. Hazard Insurance 4.000 months $ 30.17 er month 720.68
1002. Mon a e Insurance 0.000 moMOS $ 59.78 r month
1003. Coun /( Taxes 6.000 months E 29.13 er month 174.78
1006. Li Taz montOS E er month
1005. School Tax 14.000 months $ 104.91 per month 1,468.74
1006. months $ er month
1007. months r month
7008. AGGREGATE ADJUSTMENT months E er month -347.02
H 00. TITLE CHARGES
1101. Settlement Or Cbsi Fae to
1102.E-Mail Document Retrieval to PURITY ABSTRACT COMPANY 50.00
1103. TRIe Examination to
1104. Title Insurance Binder to
1105. Document Pre oration to FREY 8 TILLV DEED/POC
1106. Note Fees to NOTARY CLERK
7707. Adomeya Feea to
20.00
10.00
includes above item numbers:
1108. Title Ins rents to PURL ABBTRACT OMPANV P.0 -176 1 038.75
inGUtles above item numbers.1101, 1003 -BASIC RATE
1109. Lenders Coverage 133,500. 70 864231PAL
1110. Owners Coverage / 6,000.0 106873884PAO
1111. A END:166, 300, 900 to PURL AB T A T C MPANV 150.00
1172. Domestic Relations Search to PURL AB T CT COMPANY 20.00
1773. Insured Closing Letter to FirstAmedgn 61e Insurance Company 35.00
1114. vernight Fea package to PURITY ABS ACT OMPANV
1115. az nFee to PU I T TCOMPANY
1116. 12.00
00
7112
1178.
7200. GOVERNMENT RECORDING AND TRANSFER CHARGES
1201. Rewrtling Fees: Deatl E 48.50', Mart age E 56.60', Releases E
1202. Gi /Coun Ta Stam s: Deed 1,36 .00' Mon e e
1203. State Tax/Stam s: Revenue Stam s 7360.00: Mon a e 705.70
1,360.00
1,360.00
1204. RECORDER OF DEE S
1205. RECORDER OF DEEDS
1J00. ADDITIONAL SETTLEMENT CHARGES
1301. Surve to
1302. Pest Ins ion fc B8T INSPECTIONS POC
1303. FINAL WATER(SEWER to NORTH MIODLETON TWP AUTHORITY 61.75
1304.
1305.
7400. TOTAL SETTLEMENT CHARGE8 EMar on Linp 707, Seetlon J and 601, Seetlon K
9,154.42
9,596.75
av moons woes mvw n.mmem. me uaeewwaun°.neao.~pa.m.,pwiee r~rae.a.s mmu ew e.a.mmmem~,.~ , I
PURITY AUBSTRACTC M~^P'~A(N/~lV"Jj!)/'jCw
Se0lement Agent
Canifetl to ba a true copy.
I WFM~E(WEiG~E t1a)
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Fax Transmittal 1/2/2009 i2:21:OB PM PAGE 2/003 Fax Server
~~y rH~~ Refemae ID: 2632453
I~LIIIW/ ec6ovia Bank N.A.
Balance Confirmation Services
P O Box 40028
Roanoke, VA 240227313
January 2, 2009
FREY 8c TII.EY
S SO[JTH I-IANOVER STREET
CARLISE, PA 17013
SI)BJECT: Verification / Confirmation of Aooount and Balance Information provided for:
Customer: ALETBA Y BIIRGNER (SSN~ X7C7C-XX-1914)
Date of Death: Noveloaber S, 2008
st Account lnformatJ
Aoroud Aooou~ Date ofl)mth Avenge .Dote Idatvnly IntaeR Aee,ued r1D Date
Type Nuaober Halanoe Hal+noe• Opened Da4 Rate Iote~eet ImuW Paid Cloaat
CEA7'D+ICA7'E OF }QOCOOOODOOC5363 58,307.20 3/4n007 596.00 5221.86 12/Sn008
DEPOSIT
LEGAL7717~: ALE'IfIA BURGHER
DONNA H FR®ERICK
CI.OBING HAIANCE: 58421.93
ACCOUNT AS 771'L.ED BINCE OPEND7G
CERTD~iCA77? OF X70000A700QD398
DEPOSIT
]EOAL7TTLE; ALE'1'HA BURGHER
DONNAH FRI+IDHRICK
C[.OSII4G BAIANCE: 57204398
571,73217
7nanooo
5126.03 S2~24.39 12/Sn008
ACCOlRST AS TIIS.ZID SINCE OPENING
Fax Transmittal 1/2/2009 12:21:08 PM i~AdE 3/003.. Fax Server
w~lCHdVFA ner~ m: isszas3
No 9a& Deposb Box !bond fbr out.
• Date o~Pdeath bahuwe does not include accrued interest.
• If date of death ocmcra on a weekend a a holiday, date of death balanx does not include any tranaectiona that were
~malde duriJng that time period.
f~
Diana Mdduire
Servicenter Associate
Phone~(540)563-?323
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