Loading...
HomeMy WebLinkAbout02-0231 PETITION ~lso ktlowtt as The pelition of the undersigned respectfully represents that: Yom petitioner(s), who is/are 18 years of age or older an the exeeu~v'5 in the last wilt of the above decedent, dated 0--0[~" fl> ' and codicil(s) dated FOR PROBATE and GRANT OF LETTERS No. To: Register of Wills for the County of ~691~'-6~1'[/g7i4c[ in the Commonwealth of Pennsylvania namcd ,197 (stale relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at~-~- death in h~---(' last family__or principal residence at . ~/~'~ (list street, number and muncipality) Decendent, then, , 1-9'"- , Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania . situated as follows: I~t('.'l~'04~O]~,~ WHEREFORE, petitioner(s) respectfully presented herewith and the grant of letters theron. requestS) the~obate of the last will and codicil(s) (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PEnNSyLVANIA ~ ss COUNTY OF d-~'/"tcL~ e- f t/o° ',¢d~ The petitioner(s) above named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed before me this 4th day of /'~2~,~ARC H /-'2 0 0 2 ~-/ xx~Fxx hgat~x~'x: ffla~v~ I ~ --/ - Register 1 -46-1 No. Estate Of GLORIA J PHILLIPS , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW MARCH 4, 2002 x~l~x'~ . in consideration of the petition on the reverse side hereof, satisfactory proof having been presented~before me, 57 IT IS DECREED that the instrument(s) dated ,~J/~ / /~ described therein be admitted to probate and filed of record as the last will of ~r-/m f-/.~ ~/~/'/~ and Letters are hereby granted to FEES Probate, Letters, Etc .......... $. 2 0 0.0 0 Short Certificates( ) .......... $. 3 0.0 0 xx~mm:i~io~ ~x~r.a..pa~s $ 6.00 jcp $ 5, O0 TOTAL__ S 241.00 Filed ...M.A.R..C.H...4.,..2. .0.Q .2 ............... mailed to execs-on 3-4-02 MARY'C "~l,~egiste~°f ills /- ATTORNEY (Sup. Ct. I.D. No.) ADDRESS PHONE his is to certify that the information here given is correctly copied from an original certificate of death d~ly filed with me as Local. Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 P 806;[3554 No. mos ;,3/~.v 2/aT COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH * VITAL RECORDS ~v,~P.,., CERTIFICATE OF DEATH · ~ .... : LAST WILL AI~D TESTAI~]NT OF GLORIA J. PHILLIPS I, GLORIA J. PHILLIPS, of the Township of East Pennsboro, County of Cumberland and State of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this my Last Will and Testament, hereby revoking and making void any and all prior Wills by me at any time heretofore made. l, I direct the payment of all my just debts and funeral expenses as soon aftem my decease as the same can be conveniently done. I give, devise and bequeath all the rest, residue and remainder of my estate, real, personal and mixed, whatsoever and wheresoever the same may be situate, to my two (2) sons, to wit, W!LL!~-~ J. ERNEY and TROY D~ ~~. sha~e and share alike, per stirpes. LASTLY, I nominate, constitute and appoint my two (2) sons, the aforementioned, WILLIAM J. ERNEY and TROY D. ER~Y, Co-Executors of this my Last Will and Testament, and direct that they be excused from posting bond or other security for the faithful performance of their duties in any Jurisdiction. -1- IN WITNESS WHEREOF, I have hereunto set my hand and seal this _~... day of July, A. D., 1996. SEAL) Signed, sealed, published and declared by the above named, GLORIA J. PHILLIPS, as and for her Last Will and Testament, in the presence of us, who have subscribed our names hereto as witnesses, at the request of said testatrix, in her presence and in the presence of eaGh other. -2- COMMONWEALTH OF PENNSYLVANIA ) : COUNTY OF CUMBERLAND ) SS. I, GLORIA J. PHILLIPS , the testatrJ_~ whose name is signed to the attached or foregoin~ instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and volun- tary act and deed, for the purposes therein contained. Sworn and affirmed to and acknowledged before mTb~ , the testat rix , this GLORIA J. PtIILLIPS day of July , A. D. , 1996. COMMONWEALTH OF PENNSYLVANIA ) : SS. COUNTY OF CUMBERLAND ) We, the undersigned, J. ROBERT STAUFFER and SUSAn'! A. I~IcCOY , the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, depose and say that we were present and saw the testatrix , GLORIA J. PHILLIPS , sign and exe- cute the instrument as ill. her Last Will and T~stame~.t; that the said testat.Vix , GLORIA J. PHILLIPS , executed it as ~her free and Voluntary act for the purposes therein expressed; that each of us, in the hearing and sight of the testatri~ , signed the Will as witnesses; and that to the best of our knowledge, the testatrix was, at the time, eighteen (18) or more years of age, of sound mind, and under no constraint, duress or undue influence. Sworn and subMcribed to before/Z/_~~' ~. me this / J~' day of July , 19 96 · Name of Decedent: CERTIFICATION OF NOTICE UNDER RULE 5.6(a} Date of Death: ~ - / ~ - 0~'- Will No. Admin. No. 0,'~-_~,,31 To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on - Name Address Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: Si~ture Name Address Telephone~ ~"~ ~-~ ~ 5- Capacity:__X~Personal Representative __Counsel for personal representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF iNDIVIDUAL TAXES DEPT. 28O601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 001820 ERNEY TROY D P.O. BOX 67 THOMPSONTOWN, PA 17094 fold ESTATE INFORMATION: SSN: 176-34-8956 FILE NUMBER: 21 02-0231 DECEDENT NAME: PHILLIPS GLORIA J DATE OF PAYMENT: 11/07/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 02/18/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $11,799.23 1 I I TOTAL AMOUNT PAID: $11,799.23 REMARKS' TROYD ERNEY SEAL CHECK//117 INITIALS: JA RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 I INHERITANCE TAX RETURN RESIDENT DECEDENT I - O I co~ ~ ~ Z LU C~ UJ 0 I11 C~ I-- Z Iii Z o uJ n, 0 o DECEDENT'S NANE (LAST, FIRST, AND MIDDLE INITIN.) PHILLIPS~ GLORIA J. DA~D~(MM-D~YEAR) IDA~OFBIR~(~I*O~'~) 02/18/2002 10/19/1944 (FAPPL~ABLE)SURVIVINGSPOU~SNAME(~FIR~DMIDD~) N/A SOCIAL SECURITY NUMBER 176-34-8956 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURrrY NUMBER N/A [] 1. OdginalRatum [] 4. Limited Estate [] 6. Decedent Died Testate (Ntach copy of Will) [] 4a. Future Interest Compromise (da. of ~ a~ter u-12-s2) [] 7. DecedentMaintainedaLivingTmst(Auachc~wofTmst) [] 10. Spous~JPOve~Credit(dataofd~12-31-91 md1-1-95) [] 3. Rema~lerRelum(dateofd~a~pdo~tol2-13-s2) [] 5. Federal Estate Tax Relum Required 1 8. Total Number d Sde Deposit Boxes [] 11. Election to tax under Sec. 9113(A)(~t=~scho) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME TROY D. ERNEY FRM NAME N/A TELEPHONE NUMBER 717-535-4551 COMPLETE MNUNG ADDRESS P.O. BOX 67 THOMPSONTOWN, 'PA 170~.~ 1. Real Eslate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sde-FYopde~orship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Persorel Properly (Schedule E) 6. Joinlty Owneq Propaty (~ F) [] separate a,ing Requested 7. Inter-Vivos Tratsfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (tolal Unes 1 - 7) 9. Funeral ~ & Adminislmtive Costs (Schedule H) 10. Bebls o( Decedent, Malgage Liabilit~s, & Liens (Schedule I) 11. Total Oeductions (tolal Unes 9 & 10) 12. Net Value of Estate (Une 8 minus Une 11) 13. 14. (1) (2) (3) (4) (5) (6) (7) (9) (10) Charitable axl ~ Boquests/Sec 9113 Trusts for which an electlen to tax has mt been made (Schedule J) Net Value Subject to Tax (Line 12 minus Une 13) 210,000.00 5,168 · 52 30,249.56 43,795.42 (6) 27,008.45 (11) (12) (13). (14) OFFICIAL USE ONLY 289,213.50 27,008.45 262,205.05 262,205.05 SEE INSTRUCTIONS FOR APPUCABLE RATES 15. Ama~ of Une 14 taxable at the spousal tax rate, er transfers under Sec. 9116 (a)(1.2) 16. Nmc~ of Line 14 taxable at lineal rate 17. Amount of Une 14 taxable at sibling rate 18. ,Nnm~t d Line 14 ~e at cdlebrat rate 19. Tax Due 20. 0 X .0 0 (15) 262,205.05 x.0 45 (16) 0 X .12 (17) 0 X .15 (18) ¢9) [] [CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 0.00 11~799.23 0.00 0.00 11~799.23 > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < STF PA42021F.1 Decedent's Complete Address: 1115 JERUSALEM ROAD C~ MECHANICSBURG Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 0 0 0 0 o Interest/Penalty if applicable D. Interest E. Penalty ISTATE PA (1) Total Credits (A + B + C) (2) Total Interest/Penalty (D + E) (3) If Line 2 is greater than Une 1 + Une 3, enter the difference. This is the OVERPAYMENT. Check box on Page I Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the ditference. This is the TAX DUE. JZIP 17050 11~799.23 A. Enter theintemst on thetaxdue. 0.00 0.00 0.00 11,799.23 (4) (5) (SA) B. Enter the total of Line 5 + 5A. This is the BN.ANCE DUE. (5B) Make Check Payable to: REGISTER OF I/FILLS, AGENT 11,799.23 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 dght to designate who shall use the pmpe~'y transferred or its income; ................... [] [] c. re{ain a mvemionary 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 property 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. Llader penallJes d p~, I declare lhaH have examined Ibis relurn, induding_ _~ schedules axl statemeats, and to the ~ ~ ~ ~ge ~ ~i~, ~ ~ ~ ~ ~ ~P~e. Dedaralion d prepare' o~er ~han the pemonal representalive is based on all information d which preparer has any knowledge. SIGNATUREOFPERSONRESPONSIBLEFORFILINGRETURN TROY D. ERNEY, CO-EXECUTOR DATE ADDRESS ?.O. BOX 67~ THOM?SON?OWN, ?A 17094 ADDRESS BOX 257, NEW BLOOMFIELD, PA 17068 WILLIAM J. ERNEY, CO-EXECUTOR DATE 11 / 6 / o 2 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 3% F2 P.S. ,{9116 (a) (1.1) (i)]. Fa' dates of death on or a~er January 1, 1995, the tax rate imposed on the ne{ value of transfas to or for the use of the surviving spouse is 0% [72 P.S..~9116 .(a) !1.1) (ii)]. The statute does not e~empt a transfer to a sun~ing spouse from tax, end the statutory requirements for disclosure of assets and fling a tax retum are still app,caae even ffthe sumiving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax ~e imposed on the ne{ 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 steppamnt of the child is (P/~ [72 RS. §9116(a)(1.2)]. The tax rate imposed on the nc~ value of transfers to or for the use of the decadent's lineal beneficiaries is 4.5%, 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 transfem to or for the use of the decedent's siblings is 12% [/2 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. STF PA42021F.2 REV-1502 EX + (1-97) (I) COMMONWF_ALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF PHILLIPS, GLORIA J. SCHEDULE A REAL ESTATE FILE NUMBi~R 21-02-00231 All mai pmporty owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which prope~y would be e,~changed between a willing bu~ and a willing seller, neither being compelled to buy or sell, bolh having reasonable knowledge d~e r~eva~ facts. Real property which Is jointly-owned with dght of survivorship must be disclosed on Schedule R ITEM NUMBER 1. VALUE AT DATE DESCRIPTION OF DEATH 210,000 6.26 ACRES WHEREON IS ERECTED A ONE STORY FRAME DWELLING, KNOWN AS 1115 JERUSALEM ROAD, MECHANICSBURG, HAMPDEN TWP. CUMBERLAND COUNTY, PA (SEE ATTACHED COPY OF REAL ESTATE SALES AGREEMENT) TOTAL (Also entee on line 1, Recapitulation) 210,000.00 (If mom space is needed, insert additional sheets of the same size) S't~ PA42021F.3 · REV-1503 EX + (1-97) (I) COMMONV~=ALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF PHILLIPS, GLORIA J. SCHEDULE B STOCKS & BONDS FILE NUMBER 21-02-00231 All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM DESCRIPTION NUMBER 1. VARIOUS EE U.S. SAVINGS BONDS (TOTAL OF 61) TOTAL (Also enter on line 2, Recapitulation) (If more space is needed, insert additional sheets of the same size) VALUE AT DATE OF DEATH 5,168.52 $ 5,168.52 STFPA42021F.4 REV-1508 EX + (1-97) (I) COMMON',,~cALTfl OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF PHILLIPS~ GLORIA J. SCHEDULE E CASH, BANKDEPOSITS,&MISC. PERSONALPROPERTY FILENUMBER 21-02-00231 Include lhe proceeds d litigation and the date ~e proceeds were received by,he estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule R ITEM NUMBER 2. 3. 4. DESCRIPTION o 6. 7. 8. 9. 10. 11. 1995 OLDSMOBILE CUTLASS MISCELLANEOUS HOUSEHOLD ITEMS SOLD BY AUCTIONEER ALLFIRST CHECKING ACCOUNT %00686-4580-5 REFUND OF UNUSED CANCER INS. PREMIUM FROM MUTUAL OF OMAHA REFUND OF UNUSED AUTO INSURANCE PREMIUM FROM NATIONWIDE REFUND FROM HIGH[VL%RK BLUE CROSS/BLUE SHIELD BENEFIT FROM MUTUAL OF OMAHA (CANCER INSURANCE) REFUND FROM IRS (2001 INCOME TAX) PRUDENTIAL MONEY MARKET ACCT.%02808248401 REFUND FROM MONUMENTAL LIFE INS. CO. (INSTALLMENT LOAN INS REFUND FROM PENN STATE MILTON S. HERSHEY MEDICAL CENTER TOTAL (Also enter on line 5, Recapitulation) VALUE AT DATE OF DEATH 6,000.00 2,030.50 3,372.12 14.12 385.70 24.36 3,469.50 1,019.00 12,501.02 1,416.24 17.00 $ 30,249.56 (If more space is needed, insert additional sheets of the same size) S'rF PA42021F.9 'REV-1510 EX + (1-97) (I) COMMONV~r-ALTH OF PENNSYLVANIA INHERiTANCE TAX RETURN RESIDENT DECEDENT ESTATE OF PHILLIPS, GLORIA J. SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER 21-02-00231 This schedule must be completed and filed if the answer to any d questions 1 through 4 on the reverse side d the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERT'f % OF ITEM iNCLUDE ~ NAME OF THE TRANSFEREE, Tt-EIR RELATIONSFIP TO DECEDENT N~ THE DATE DATE OF DEATH DECD'S -D(CLUSION TAXABLE VALUE NUMBER OF TRANSFER. ATrACH A COPY OF TFE DEED FOR RF-AL ESTATE- VALUE OF ASSET INTEREST (~F APPUCABLE) 1. PRUDENTIAL FINANCIAL IRA ANNUITY CONTRACt 43,795.42 100.00 0 43,795.42 #E0018514 TOTAL (Also enter on line 7, Recapitulation) $ 4 3,7 9 5.4 '. S't'F PA42021F,I 1 (If more space is needed, insert additional sheets of the same s~ze) REV-1511 EX + (1-97) (I) COM~TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF PHILLIPS, GLORIA J. SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS [ FILE NUMBER 21-02-00231 Debts of dec___~de_.nt must be reported on Schedule I. ITEM NUMBER 5. 6. 7. DESCRIPTION FUNERAL EXPENSES: NEIL' S FUNERAL HOME ADMINISTRATIVE COSTS: Personal Repmsenlalive's C(xnmissions Name d Pe~enai Relxesaf, alb~s) Sodal Security Number(s) I EIN Number d Personal Representative(s) Stme{ Address City State Year(s) Commission Paid: AttomeyFees- PREPARATION OF DEED Family Exempt: (If decedent's address is noHhe same as daimant's, altad~ explana~) Claimant Sa'eel Address City State Zip Relationship d Claimant to Decedent ProbaeF~ - CUMBERLAND CO. REGISTER OF WILLS Acc~s Fees Tax Re~ Pret~s Fees FAHRESTOCK AUCTION (35% COMMISSION ON SALE OF PERSONAL PRe PPL (THROUGH DATE OF SALE) CINGULAR WIRELESS (FINAL BILL) HAMPDEN TOWNSHIP (TRASH REMOVAL) COMCAST (CABLE) 2002 COUNTY/TWP. REAL ESTATE TAXES 2002 PER CAPITA TAXES 2002/2003 SCHOOL REAL ESTATE TAXES HOMESTEAD GROUP, INC. (7% COMMISSION ON SALE OF REAL ESTAT 1% TRANSFER TAX ON SALE OF REAL ESTATE SEE ATTACHED SCHEDULE H (See Schedule H - Page 2 of 2) TOTAL (Nso enter on line 9, Recapitulation) ~ERTY) AMOUNT 5,197.00 0.00 125. O0 (e1 0.00 200.00~) 0.00 0.00 710.68 600.00 27.54 30.62 4.89 331.32 10.00 596.70 14,700.00 2,100.00 _~[374-70 27~008.,45 (If more _space. is needed, insert addition.al s_heets of the same size) STFPA42021FA2 Schedule H (Page i o= Z) REV-1511 EX + (1-97) (I) COMMONWEAJ.TH OF PENNSYI.VANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF PHILLIPS, GLORIA J. SCHEDULE H FUNERAL EXPENSES 8, ADMINISTRATIVE COSTS I FILE NUMBER 21-02-00231 Debts of decedent must be repoffed on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. 5. 6. 7. ADMINISTRATIVE COSTS: Perse~,~l Represe~'s Commissions Name o~Person~ ~s) Social Security Number(s) I EIN Number d Personal Representative(s) Street Address City Stale Year(s) Commission Paid: Attomey Fees Family ~: (If decadent's address is not the sane as daimenfs, altach expla~o~) Claimant S~'ee~ Address Relationship d Claimant to Decedent Probate Fees Accountant's Fees Tax Rel~ Preparer's Feas PENN NATIONAL (HOMEOWNERS INS.) MECHANICSBURG INS. (HOMEOWNERS INS.) REMOVAL OF REFUSE VERIZON (PHONE BILL) THE PATRIOT NEWS (ADVERTISEMENT OF REAL ESTATE) ED CLAPPER (MOWING) UV SYSTEM FOR WATER TREATMENT REQUIRED FOR SALE OF PROPERTY TOTAL (Also enter on line 9, Recapitulation) (If mom space is needed, insert additional sheets of the same size) STFPA42021F, 12 Schedule H (Page 2 of 2) 0.00 0.00 0.00 0.00 77.00 497.13 350.00 95.47 140.10 590.00 625.00 2,374.70 REV-1513 EX + (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF PHILLIPS GLORIA J. SCHEDULE J BENEFICIARIES FILE NUMBER 21-02-00231 RELATIONSHIP TO DECEDENT NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) I. 2 o II. 1. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] TROY D. ERNEY P.O. BOX 67 THOMPSONTOWN, PA 17094 WILLIAM J. ERNEY BOX 257 NEW BLOOMFIELD, PA 17068 SON SON AMOUNT OR SHARE OF ESTATE 50% 50% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If mom space is needed, insert additional sheets of the same size) STFPA42021F. 14 LAST WILL AI~ TESTA~.fl;:NT OF GLORIA J. PHILLIPS I, GLORIA J. PHILLIPS, of the Township of East Pennsboro, County of Cumberland and State of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this my Last Will and Testament, hereby revoking and making void any and all prior Wills by me at any time heretofore made, I direct the payment of all my just debts and funeral expenses as soon after my decease as the same can be conveniently done. I give, devise and bequeath all the rest, residue and remainder of my estate, real, personal and mixed, whatsoever and wheresoever the same may be situate, to my two (2) sons, to wit, WILLIAM J. ERNEY and TROY D. ERNEY, share and share alike, per stirpes. LASTLY, I nominate, constitute and appoint my two (2) sons, the aforementioned, WILLIAM J. ER~Y and TROY D. ER~Y, Co-Executors of this my Last Will and Testament, and direct that they be excused from posting bond or other security for the faithful performance of their duties in any Jurisdiction. IN WITI~ESS WHEREOF, I have hereunto set my hand and seal this .~_ day of July, A. D., 1996. (SEAL) Signed, sealed, published and declar, ed by the above named, GLORIA J. PHILLIPS, as and for her Last Will and Testament, in the presence of us, who have subscribed our names hereto as witnesses, at the request of said testatrix, in her presence and in the presence of each other. ~ -2- COMMONWEALTH OF PENNSYLVANIA ) : COUNTY OF CUMBERLAND ) SS. I, GLORIA J. PHILLIPS , the testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and volun- tary act and deed, for the purposes therein contained. Sworn and affirmed to and acknowledged before meby~ GLORIA J. PIIILLIPS , the testatrix , this day of July , A. D. , 1996. COMMONWEALTH OF PENNSYLVANIA ) : SS. COUNTY OF CUMBERLAND ) We, tile undersigned, J, ROBERT STAUFFER and SUSAN A. H¢OOY , the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, depose and say that we were present and saw the testatrix , GLORIA J. PItILLIPS , sign and exe- cute the instrument as J~her Last Will and T~stament; that the said testatrix , GLORIA J. PtlILLIt'3 , executed it as ~Yher free and voluntary act for the purposes therein expressed; that each of us, in the hearing and sight of the testatrix , signed the Will as witnesses; and that to tile best of our knowledge, tile testatI'iX was, at the time, eighteen (18) or more years of age, of sound mind, and under no constraint, duress or undue influence. Sworn and sub~.cribed to before ~'" ~.~_~.~ ~..~. me this / ~'z- day of July , 1996. STANDARD AGREEMENT FOR THE SALE OF VACANT LAND A/S-VL This form recommended and approved for, but not restricted to use by, the members of the Pennsylvania Association of REALTORS® (PAR). S LER'S BUSINESS; RE A IONSHIP W~H PA LICENSED BROKER BROKER (Company) D~`.s~~f~ ~~ --~"'~~~ PHONE 7G ~- 71 Z~ ADDRESS ~ /lLN~ FAX 7/ ~ ~~ _7_~r-,~) BROKER IS THE AGENT FOR SELLER Designated Agent(s) for Seller, if applicable: r- OR Broker is NOT the Agent for Seller and is a/an: ^ AGENT FOR BUYER ^ TRANSACTION LICENSEE ~~~~/~~ ~, UYER'S BUSINESS RELATIONSHIP WITH PA LICENSED BROKER BROKER (Co~any li~ ~ s ~ .~~~ ~ fG 2--- PHONE A nnuFCC ~7~ l_ l ~/y- ___ FAX BROKER IS THE AGENT FOR BUYER Designated Agent(s) for Buyer, if applicable: OR Broker is NOT the Agent for Buyer and is a/an: ^ AGENT FOR SELLER ^ SUBAGENT FOR SELLER ^ TRANSACTION LICENSEE 1 2 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 36 39 40 41 42 a3 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 When the same Broker is Agent for Seller and Agent for Buyer, Broker is a llual Agent. Atl of Broker's licensees arc atso liuat Agents utvt.>,~~ there are separate Designated Agent(s) for Buyec and Seller. If the same Licensee is designated for Seller and Buyer, the Licensee is a Dual Agent. 1. phis agreement, dated ~G T~ F , is between SELLER(S) G -~ ~ ~ ~'~'~ called "Seller,".and BUYER(S) ~ ~ /~ E~/>7f S/~~~/s~ ~7/~ G.] ~..r/~ 4?~- ' ~/ 6 ~~~Gi ~F".~.+//l . called "Buyer." 2. PROPERTY (1-98) Seller hereby agrees to sell and convey to Buyer, who hereby agrees to purchase: ALL TIIAT CERTAIN lot or piece of ground wit buildings and improvements thereon erected, if any, known as: ,~ . ~s vv _ ~., 2~.<~/~r„~ in the ~/~ui/.s!S/~! ~~ f - ~ , County of ~ j~xa2.~,,F 2. L /I ill /~ in the Commonwealth of Pennsylvania, Zip Code / 7 V Ste'- ~ Identification (e.g., Tax ID #; Parcel #; Lot, Block, Deed Book, Page, Recording Date) 3. TERMS (7-01) / (A) Purchase Price ~,,rilL~l~/fi/~J/I_ ~ ~ Ti~ ~~ yl!l ~i!~ ' U.S. Dollars ' which will be paid to Seller by Buyer as follows: ,r 1. Cash or check at signing this Agreement: $ ! ~i OOO ~" 2. Cash or check within days of the execution of this Agreement: $ 3. $ 4. Cash, cashier's or certified check at time of settlement: $ ? ~~~ ~v U TOTAL • $ 2/O, Ooy ~' (B) Deposits paid on account of purchase price to be held by Broker for Seller, unless otherwise stated here: (C) Seller's written approval to be on or before: fj O ?~-~ (D) Settlement to be on ~ , or before if Buyer and Seller agree. (E) Conveyance from Seller will be by fee simple deed of special warranty unless otherwise stated here: (F) Payment of transfer taxes will be divided equally between Buyer and Seller unless otherwise stated here: (G) At time of settlement, the following will be adjusted pro-rata on a daily basis between Buyer and Seller, reimbursing where applicable: taxes (see Notices and Information Regarding Tax Proration); rents; interest on mortgage assumptions; condominium fees and home- owner association fees, if any; water and/or sewer fees, if any, together with any other lienable municipal services. The charges aze to be pro-rated for [he period(s) covered: Seller wilt pay up to and including the date of settlement; Buyer will pay for all days following settlement, unless otherwise stated here: 4. .FIXTURES AND PERSONAL PROPERTY (1-00) `~ . (A) INCLUDED in this sale and purchase price aze all existing items permanently installed in the Property, free of liens. Also included: 5. Buyer Initials: A/S-VL Page 1 of 6 Seller Initials: •,f Pennsylvania Association of COPYRIGIiT PENNSYLVANIA ASSOCIATION OF REALTORS~'2998 REAL'TORS® 8rot a~troas ~ m. w» rr n.r ~.e.• ti w~•i*~+ (B) LEASED items (items not owned by Seller): (C) EXCLUDED; SPECIAL CLAUSES (7-01) (A) B~efo~ signing this Agreement: LW`Buyer and Seller have received the Consumer Notice as adopted by [he State Real Estate Commission at 49 Pa. Code §35.336: ~uyer and Seller have received a statement of their respective estimated closing costs. C1VB~er has received the Deposit Money Notice (for cooperative sales when Broker for Sellea is holding deposit money). (B) The following are a part of this Agreement if checked: ^ Tenant-Occupied Property Addendum (PAR Form TOP) ^ ^ __ ^ 1 2 3 4 5 6 7 B 9 10 11 12 13 14 15 16 17 18 s0 6. DATES/TIME IS OF THE ESSENCE (5-01) 61 (A) The said date for settlement and all other dates and times referred to for the performance of any of the obligations of this Agreement are 62 hereby agreed to be of the essence of this~Agreement and must be adhered to. 63 (B) For the purposes of this Agreement, number of days will be counted from the date of execution, by excluding the day this Agreement was 64 executed and including the last day of the time period. 75 (C) The date of settlement is not extended by any other provision of this Agreement and may only be extended by mutual written agreement of 66 " the~Parties. s7 7. F~ ICING CONTINGENCY (7-01) _ 68 [~~ WANED: 'This sale is NOT contingent on financing. ^~~_ 69 ^ ELECTED ._' • C.. ~J~ ~ ~`L ~7 ^ /s ~ C.,rJD 70 (A) This sale is contingent upon Buyer obtaining financing as follows: ~-( • 71 1. Amount of loan $ . 7z ~ 2. Minimum Term years 73 3. Type: ^ Land Acquisition Only 74 ^ Land Acquisition and Conswction 75 '• ^ Other 76 4. Interest rate %; however, Buyer agrees to accept the interest rate as may be committed by the lender, not to exceed 77 . a maximum interest rate of %. 78 5. Discount points, loan origination, to placement and other fees charged by the lender as a percentage of the loan (excluding any insur- 79 ance premiums and VA funding fe,~~not to exceed % of the loan. 8D The interest rate and fees provisi~ns~'quired by Buyer are satisfied if a lender makes available to Buyer the right to guarantee an interest rate 81 at or below the Maximum Interest ate specified herein with the percentage fees at or below the amount specified herein. Buyer gives Seller 82 the right, at Seller's sole option d as permitted by the lending institution and applicable laws, to contribute financially, without promise of 83 reimbursement, to the Buyer and/or lender to make the above terms available to Buyer. 84 (B) Within 10 days of the execution of this Agreement, Buyer will make a completed, written financing application to a responsible lender accord- 85 ing to the terms above. The Broker for Buyer, if any, otherwise the Broker for Seller is authorized to communicate with the lender for 8G the purposes of assisting in the loan process. 87 I;C) 1. Upon receipt of a financing commitment, Buyer will promptly deliver a copy of the commitment to Seller. 88 2. Financing commitment date . If a written commitment is not received by Seller by the above date, 89 Buyer and Seller agree to:extend the commitment date until Seller terminates this Agreement in writing. 90 3. Seller has the option to terminate this Agreement in writing, on or after the financing commitment date, if the financing commitment: 91 a. Is not valid until the date of settlement, OR ` 92 •- b. Is conditioned upon the sale and'settlement of any other property, OR 93 c. Contains any other. condition not specified in [his Agreement 94 4. In the event Seller does not terminate this Agreement as provided above, Buyer has the option to terminate this Agreement in writing if 95 the financing commitment: 96 a. Is not obtained by or valid until the date of settlement, OR 97 b. Is conditioned upon the sale and settlement of any other property which do not occur by the date of settlement, OR 98 c. Contains any other condition not specified in this Agreement which Buyer is unable to satisfy by the date of settlement. 99 5. If this Agreement is terminated as specified in paragraphs 7 (C) (2), (3) or (4), all deposit monies paid on account of purchase price will 1DD be returned to Buyer. Buyer will be responsible for any premiums for mechanics lien insurance and/or title search, or fee for cancellation 101 of same, if any; AND/OR any premiums for flood insurance, mine subsidence insurance, and/or fue insurance with extended coverage, 102 insurance binder charges or cancellation fee, if any; AND/OR any appraisal fees and charges paid in advance to lender. 103 (D) S~llf~'~~tst 104 L.1'" NOT APPLICABLE 105 ^ APPLICABLE. Seller will pay: 106 ^ $ ,maximum, toward Buyer's closing costs as permitted by the lender. 107 ^ 106 8. INSPECTIONS (1-98) • 109 (A) Seller hereby agrees to perthit inspections by authorized appraisers, reptitable certifiers, insurer's representatives, surveyors, municipal officials 11tl and/or Buyer as may be required by the lending institutions, if any, or insuring agencies. Seller further agrees to pemut any other inspections 111 required by or provided for in the terms of this Agreement. 112 (:B) Buyer agrees that Buyer, or anyone on the Property at Buyer's direction or on Buyer's behalf, will leave the Property in its same condition. In 113 the case of damage, Buyer will bear the risk of restoring the Property or of reimbursing Seller for any loss of value. 114 (C) Buyer reserves the right to make apre-settlement inspection of the Property. Buyer's right to make this inspection is not waived by any other 115 provision of this Agreement. 116 9. STATUS OF WATER (7-01) 117 (A) An Property source of water 118 is not available for the Property. 119 ^ is available for the Property through (Name of Service Pcovider) 120 CO1,~F1't(ECTION TO OFF-PROPERTY WATER SOURCE CONTIIVGENCY 121 [~/ WANED. Buyer acknowledges that Buyer has the option to make this Agreement contingent on determining that the terms of connecting t22 the Property to anoff-Property water source are acceptable to Buyer. Buyer WAIVES THIS OPTION and agrees to the RE1.;EASE set forth in 123 paragraph 24 of this Agreement 124 ^ ELECTED. Buyer will, within days of the execution of this Agreement and at Buyer's expense, determine the terms of connecting 125 the Property to the water source. If the terms of connection are not acceptable to Buyer, Buyer will: 12G 1. Accept the Property as is and agree to the RELEASE set forth in paragraph 24 of this Agreement, OR 127 2. Terminate, this Agreement in writing, in which case all deposit monies paid on account of ~urehase price will be returned promptly i26 to Buyer and this Agreement of Sale will be VOID. ` 129 (B) ^ Seller represents that the Property is served by an on-site water source. 130 ON-STTE WATER SERVICE INSPECTION CONTINGENCY 131 ^ WANED. Buyer acknowledges that Buyer has the option to request an on-site water service inspection of the Property. BUYER WANES 132 ,~~IS OPTION and agrees to the RELEASE set forth in paragraph 24 of this Agreement. 133 u" BLEGTED 13A 1. Buyer has the option, within days of the execution of this Agreement and at Buyer's expense, to deliver to Seller a written inspec- 135 lion report by a qualified, professional water testing company of the quality and/or quantity of the on-site water service. 136 2. Seller agrees to locate and provide access to the on-site (or individual) water system, if applicable, at Seller's expense, if required by the 137 inspection company. 138 3. ff the report reveals that the water service does not meet the minimum standards of any applicable governmental~uthority and/or fails to 139 satisfy the requirementsfor quality and/or quantity as set by the lender, if any, then Seller will, within ~~ days of receipt of the 14D report, notify Buyer in writing of Seller's choice to: 141 a. Upgrade the water service to the minimum acceptable levels, before settlement, in which case Buyer accepts the Property and 142 agrees to the RELEASE set forth in paragraph 24 of this Agreement, OR 143 b. Not upgrade the water service. 144 4. If Seller chooses not to upgrade the service to minimum acceptable levels, or fails to respond within the time given, Buyer will, within 145 3" days, either. ~ ' 146 a. Accept the Property and the water service and, if required by the lender, if any, and/or any governmental authority, .upgrade the water 147 service before settlement or within the time required by the lender, if any, and/or any governmental authority,•at Buyer's expense 148 and with Seller's permission, which will not be unreasonably withheld, and agree to the RELEASE set forth in paragraph ?A of this 149 Agreement. If Seller denies Buyer permission to upgrade the water service, Buyer may, within 5 days of Seller's denial, terminate 150 this Agreement. If Buyer terminates this Agreement, all deposit monies paid on account of purchase price will be returned promptly 151 to Buyer and this Agreement will be VOID, OR - . 152 b. Terminate this Agreement, in which case ali deposit monies paid on account of purchase price will be returned promptly to Buyer 153 and this Agreement will be VOID. 154 (C) uyer is aware that there is no developed water source forthe Property. • 155 156 j~~, j~ 157 / Gj J J (~ (~~ 158 Buyer Initials: A/S-VL Page 2 of 6 Seller Initials: 159 16D 1G1 162 163 .1.64 165 166 167 168 169 17D 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 18G 187 188 189 19D 191 192 193 194 195 196 197 198 199 200 201 202 203 204 gas 206 2D7 208 209 Z10 211 212 213 214 215 216 217 z1a 219 22D 221 222 223 224 225 226 2z7 228 229 230 231 z3z 233 234 235 236 237 238 239 240 241 242 243 244 245 246 z47 248 249 250 251 252 253 254 255 256 257 O. N,S~i'E WATER SERVICE APPROVAL CONTINGENCY [~ WAIVED. Buyer acknowledges that Buyer has the option to make this Agreement contingent on receiving municipal approval for the instal- lation of a well. BUYER WANES THIS OPTION and agrees to the RELEASE set forth in paragraph 24 of this Agreement. ^ ELECTED. Within 10 days of the execution of this Agreement, Buyer will make a completed, written application for the municipal approval for the installation of a well. This sale is contingent upon Buyer obtaining, within days of the execution of this Agreement, munici• pal approval for the installation of a well. Buyer will pay all costs associated with the application for approval, including but no[ limited to any municipal fees and test expenses. In the event Buyer is unable to secure approval for well installation, Buyer will either: 1. Accept the Property as is and agree to the RELEASE set forth in paragraph 24 of this Agreement, OR 2. Termina~:: this Agreement, in which case all deposit monies paid on account of purchase price will be returned promptly to Buyei and this Agreement will be VOID. 10. STATUS OF SEWER (7-01) (A) Seller represents that Property is served by: ^ Off-P,~operty Sewage Disposal System ^ Individual On-Lot Sewage Disposal System (Sec Sewage Notice 1) Individual On-Lot Sewage Disposal System in Proximity to Well (Sec Sewage Notice 1; see Sewage Notice 4, if applicable) ^ Ten-acre Permit Exemption (See Sewage Notice 2) , ^ Holding Tank (See Sewage Notice 3) _, ^ None (See Sewage Notice 1) ' ^ None Available (See Sewage Notice 5 or Sewage Notice 6, as applicable) (B) Connection to an off-Property sewage disposal system ' ~ not available for the Property. /~~ ~ P~F~ ~®.~ ~/S /~! Lq' is available for the Property through (Name of Service Provider) PUBLIC SYSTEM CONTINGENCY ^ WAIVED. Buyer acknowledges that Buyer has the option to make this Agreement contingent on receiving municipal approval for the con nection of the Property to a sewage disposal system. BUYER WANES THIS OPTION and agrees to the RELEASE set forth in paragraph 2~ ~f this Agreement. [~' ELECTED. Within l0 days of tltc execution of this Agreement, Buyer will make a completed, written application for tjte„~ttunicipal approva for the connection of the Properly to a sewage disposal system. This sale is contingent upon Buyer obtaining, within / U days of the exe cation of this Agreement, municipal approval for the connection of the Property to a sewage disposal system. Buyer will pay all costs associ ated with the application for approval, including but not limited to, any municipal fees and test expenses. In the event Buyer is unable to se:cun approval for sewer connection, Buyer will either: ~ ~ 1. Accept the.Property as is acid agree to the RELEASE set forth in paragraph 24 of this Agreement, OR 2. Terminate this Agreement, in which case all deposit monies paid on account of purchase price will be returned promptly to Buyer and thi Agreement will be VOID. (C) INDIVIDUAL ON-LOT SEWAGE DISPOSAL INSTALLATION CONTINGENCY ^ WANED. Buyer acknowledges that Buyer has the option to make this Agreement contingent on receiving atl applicable governmen approval for the installation of an individual sewage system. BUYER WANES THIS OPTION and agrees to the RELEASE set forth in pars graph 24 of this Agreement. ^ ELECTED. Within days of the execution of this Agreement, ^ Buyer ^ Seller will make a completed, written application to all appropriate authorities for the installation of an on-lot sewage disposal system, and will pa all costs associated with the application for approval, including but not limited to, any fees and percolation test expenses. This sale is contin gent upon the receipt of all applicable government approval for the installation of an individual sewage system within days of the exe cation of this Agreement. In the event test results are unacceptable to Buyer or approval for an individual sewage system is unable.to be secures Buyer will either. 1. Accept [he Property as is and agree to the RELEASE set forth in paragraph 24 of this Agreement, OR 2. Terminate this Agreement, in which case all deposit monies paid on account of purchase price will be returned promptly to Buyer and thi Agreement will be VOID. Buyer will promptly deliver all informlation and test results acquired through the approval process to Seller. (D) INDIVIDUAL ON-LOT SEWAGE DISPOSAL INSPECTION CONTINGENCY ^ WANED. Buyer acknowledges that Buyer has the option to request an individual on-lot sewage disposal inspection of the Property. BUYS: _,_ ~ANES THIS OPTION and agrees [o the RELEASE set forth in paragraph 24 of this Agreement. L!~' ELECTED 1. Buyer has the option, within ~ ~ days of the execution of this Agreement and at Buyer's expense, to deliver to Seller a written inspec lion report by a qualified, professional inspector of the individual on-lot sewage disposal system. 2. Seller, at Seller's expense, agrees, if and as required by the inspection company, [o locate, provide access to and empty the individual o: lot sewage disposal system. Seller also agrees to restore the Property, at Seller's expense, prior to settlement. 3. If tt~t~eport reveals defects that do not require expansion or replacement of the existing sewage disposal system, Seller will, withi s days of receipt of the report, notify Buyer in writing of Seller's choice to: a. Correct the defects before settlement, including retests, at Seller's expense, in which case Buyer accepts the Property and agrees I the RELEASE set forth in paragraph 24 of this Agreement, OR b. Not correct the defects,,or if Seller fails to respond within the time given, Buyer will, within ~ days, either: 1) Accept the Propcrcy and the system and, if required by the lender, if any, and/or any governmental authority, correct the defcc before settlement or within the time required by the lender, if any, and/or any governmental authority, at Buyer's sole expen: and with Seller's permission, which will not be unreasonably withheld, and agree to the RELEASE set forth in paragraph 'e of this Agreement. If Seller denies Buyer permission to correct the defects, Buyer may, within 5 drys of Seller's denial, teen rate this Agreement. if $uyer terminates this Agreement, all deposit monies paid on account of purchase price will be returne promptly to Buyer and this Agreement will be VOID, OR 2) Terminate this Agreement in writing, in which case all deposit monies paid on account of purchase price will be returne promptly to Buyer and this Agreement will be VOID. 4. If the report reveals the need to expand or replace the existing individual on-lot sewage disposal system, Seller may, within ~~ day of receipt of the report, submit a corrective proposal to Broker for Buyer, if any, otherwise to Buyer. The corrective proposal will includ but not be limited to, the name of the remediaflon company; provisions for payment, including retests; and completion date for correcti~ measures. Within 5 days of receiving Seller's corrective proposal, or if no corrective proposal is received within the time given, Buy. will: a. Agree to the terms of the corective proposal, if any, in writing, in which case Buyer accepts the Property and agrees to tl RELEASE set forth in pazagraph 24 of this Agreement, OR b. Accept the Property and [he system and, if required by the lender, if any, and/or any governmental authority, correct the defer before settlement or within the time required by the lender, if any, andlor any governmental authority, at Buyer's sole expense ar, with Seller's permission, which will not be unreasonably withheld, and agree to the RELEASE set forth in paragraph 24 of th Agreement. If Seller denies Buyer permission to correct the defects, Buyer may, within 5 days of Seller's denial, terminate th Agreement. If Buyer terminates this Agreement, all deposit monies paid on account of purchase price will be returned promptly 1 Buyer and this Agreement will be VOID, OR c._, Terminate this Agreement in writing, in which case all deposit monies paid on account of purchase price will be returned prompt] to Buyer and this Agreement will be VOID. -~ - 11. ENVIRONMENTAL AUDIT & PROPERTY INSPECTIONS (1-98) (A) Seller represents and warrants that Seller has no knowledge, except as listed below, of whether: 1. The Property has been contaminated by any substance in any manner which requires remediation; 2. The Property contains any wetlands, flood plains, or any other environmentally sensitive areas, development of which is limited or pn _ eluded by law; 3. The Property contains any substance, the removal or disposal of which is subject to any law or regulation; 4. Any law has been violated in the handling or disposing of any material waste or the discharge of any material into the soil, air, stufac water, oc ground water, $. The Property contains underground fuel or liquid storage tanks. EXCEPTIONS: ~~ Buyer Initials: '1 A/S-VL Page 3 of 6 c~a /7~ .;~ ~ ~ 256 Seller Initials: [l/ ~`~ ~ 257 258 (B) Seller and Buyer acknowledge that Broker. 258 259 1. Is a licensed real estate broker, 259 260 2. Is not an expert in construction, engineering, or environmental matters; and 260 261 3. Has not made and will not make any representations or warranties nor conduct investigations of the environmental condition or suits- 261 262 bility of the Property, or any adjacent property. Y 262 263' 263. C NVIRONMENTALAUDIT/INSPECTION CONTINGENC . 264 WANED. Buyer understands that Buyer has the option to request audits and inspections of the Property. BUYER WAIVES THIS OPTION 264 265 and agrees [o the RELEASE set forth in paragraph 24 of this Agreement. Buyer reserves the right to make apre-settlement inspection of the ~ 265 266 Property. 266 287 ~ ^ ELECTED. Within days of the execution of this Agreement, Buyer has the option, at Buyer's expense, to have the following audits 267 268 or inspections completed by a licensed or otherwise qualified professional (check the inspections that Buyer will order): 268 269 ^ Environmental Hazards 269 270 ^ Underground Storage Tanks 270 271 ^ Property Boundary/Square Footage Verification/Delineation 271 272 ^ Flood Plain Verification/Delineation 272 273 ^ Wetlands VerificationlDelineation ~ 273 274 ^ Specific Property Inspection limited to 274 275 276 ^ If Buyer is not satisfied with any condition as stated in any written report Buyer receives pursuant to the audits or inspections obtained under 275 276 277 this provision, Buyer will, within the time allotted for obtaining such audits or inspections: 277 278 1. Accept the Property with the information stated in the report(s) and agree to-the RELEASE set forth in paragraph 24 of this Agreement, 278 279 280 OR 2. Terminate this Agreement in writing, in which case all deposit monies paid on account of purchase price will be returned promptly to 279 280 281 Buyer and this Agreement will be VOID. 281 282 12. NOTICES & ASSESSMENTS (1-98) 282 283 (A) Seller represents as of Seller's execution of this Agreement, that no public improvement and/or homeowner association assessments have been 283 284 made against the Property which remain unpaid and that no notice by any government or public authority has been served upon Seller orany- 284 -285 one on Seller's behalf, including notices relating to violations of zoning, housing, building, safety or fire ordinances which remain uncorrected, 285 286 .. .~. and that Seller knows of no condition that would constitute.violation of any such ordinances which remain uncorrected„unless otherwise spec- 286 287 ified here: 287 288 (B) Seller knows of no other potential notices (including violations) and assesshents except as follows: ~!f ~.- 288 289 _. • , violations) and assessments are received after execution of this Agreement and before settlement, Seller will tices (includin n t th C I 289 _. , 290 .290,.. 291 g e even any o ( ) n notify Buyer in writing,. within 5 days of receiving the notice or assessment, that Seller will: 291 292. 1. Comply with notices and assessments at Seller's expense, in which case Buyer accepts the Property and agrees to the RELEASE set forth 292 293 ~ Paragraph 24 of this Agreement, OR 293 294 2. NOT comply with notices and assesstnents at Seller's expense, in which case Buyer will notify Seller within 5 days in writing that Buyer will: 294 . 295 a. Comply with the notices and assessments at Buyer's expense and agree to the RELEASE set forth in paragraph 2F1 of this Agreement, 295 296 OR 296 . 297. b. Terminate this Agreement, in which case all deposit monies paid on account of purchase price will be returned promptly to Buyer. 297 egg and this Agreement will be VOID. 298 egg .. If Buyer fails to notify Seller within the time given, Buyer accepts the Property and agrees to the RELEASE set forth in 299 3oD Paragraph ?A of this Agreement. 300 301 (D) Buyer is advised that access to a public road may require issuance of a highway occupancy permit from the Pennsylvania Department of 301 302 Transportation or appropriate authority. -_ 302 303 13. TITLE, SURVEYS, & COSTS (7-01) ~ 303 30A (A) The Property is to be conveyed free and clear of all liens, encumbrances, and. easements, EXCEPTING HOWEVER the following: existing 304 3D5 deed restrictions, historic preservation restrictions or ordinances, building restrictions, ordinances, easements of roads, easements visible upon 305 ..306 the grolmd, easements of rZcord, privileges or rights of public service companies, if any; otherwise the title to the above described real estate 306 307 will be good and marketable and such as will be insured by a reputable Tide Insurance Company at the regular rates. 307 308 (B) In the event Seller is unable to give a good and mazketable tide and such as will be insured by a reputable Title Company at the regulaz rates, 308 309 as specified in paragraph 13(A), Buyer will have the option of taking such title as Seller can give without changing the price, or being repaid 309 310 all monies paid by Buyer to Seller on account of the purchase price and Seller will reimburse Buyer for any costs incurred by Buyer for those 310 311 items specified in paragraph 13(C) and in paragraph 13(D) items (1), (2}, (3); and in the latter event there will be no further liability or obli- 311 312 potion on either of the parties hereto and this Agreement will become VOID. 312 313 (C) Any survey or surveys which may be required by the Title Insurance Company or the abstracting attorney, for the preparation of an adequate 313 314 legal description of the Property (or the correction thereof), will be secured and paid for by Seller. However, any survey or surveys desired by 314 315 Buyer or required by lender will be secured and paid for by Buyer. 315 316 (D) Buyer will pay for the following: (1) Title search, tide insurance and/or'mechanics lien insurance or fee for cancellation of same, if any; (2) 316 317 .Flood insurance, fire insurance with extended coverage, mine subsidence insurance, and cancellation fees, if any; (3) Appraisal fees and 317 318 charges paid in advance to lender, if any;- (4) Buyer's customary settlement costs and accruals. 318 31s 14. ZONING CLASSIFICATION (1-98) ~ S 319 320 (A) Zoning ClassrFication 320 321 Failure of this Agreement to contain the zoning classification (except in cases where the property {and each parcel thereof, if subdividable} is 321 322 zoned solely or primarily to permit single-family dwellings) shall render this Agreement voidable at the option of the Buyer, and, if voided, 322 323 any deposits tendered by Buyer shall be returned to the Buycr without any requirement for court action. 323 324 (B) ZONING APPROVAL CONTINGENCY ~ , ~ _ 1< , 324. 325 ^ ~IQOTAPPLICABL$ _ .: 325 326 (9' WANED. Buyer acknowledges that Buyer has the option to make this Agreement contingent on receiving municipal approval for the 326 327 intended'use of the Property. BUYER WAIVES THIS OPTION and agrees to the RELEASE set forth in paragraph 24 of this Agreement. 327 328 ^ ELECTED 328 329 1. .This sale is contingent on Buyer receiving zoning approval, or variance, or special exception from 329 330 (municipality) to use the Property as a (proposed use). 330 331 2. .Application for the apprmval (or variance/special exception) will be made within days of the execution of this Agreement. Buyer 331 332 will pay for applications, legal representation, and any other costs associated with obtaining approval. 332 333 3. If the municipality requires the application to be signed by the current owner, Seller agrees to do so. 333 334 4. If futial, unappealabie approval is not obtained by ,this Agreement will be VOID, in 334 335 which case all deposit. monies paid on account of purchase price will be returned promptly to Buyer. 335 336 15. LAND Jh,~ RESTRICTIONS OTHER THAN ZONING (7-01 } 336 337 338 (A) ®" None Known (B) ^ .The Property, or a portion of it, is preferentially assessed for tax purposes under the following Acts (See Land Use Restrictions Notices): 337 338 339 ^ Farmland and Forest Land Assessment Act (Clean and Green Program) 334 340 ^ Open Space Act (an Act enabling certain counties of the Commonwealth to covenant with land owners for preservation of land in 340 341 farm, forest, water supply, or open space uses) s 341 ' 342 ^' Agricultural Area Security Law, Act 43 of 1981, 3 P.S. §901. et seq. (Development Rights) 342 343 844 ^ Other ^ Buyer and•Seller have determined the consequences that may result from the sale or a change.in the use of the Property, or any portion 343 344 345 346 of it. (C) ^ Seller has no knowledge of any covenants, subdivision restrictions or other restrictions affecting the Property unless,oiherwise stated here: 345 346 347 347 348 (D)` ^ Seller has no knowledge of any rights to timber, crops or minerals, except coal, that do not transfer with the Property unless otherwise 348 349 3511 ;: stated~here: ~~ ',(E) ^ ~ Buyer acknowledges that any land use restrictions associated with the Property's enrollment in the Clean and Green Program orundet the h d li f P 349 350 351 at e very o roperly. Buyer agrees t ~y Open Spicy Act or any other program identified in this paragraph 15, are encumbrances upon the 351 352 title subject to.these encumbrances will not violate Seller's duty under paragraph 13(A) of this Agreement. 352 353 f' , ~ 353 354 354 , .t /~ ~ ,~ ~,. ~c/ h -r ~'' ' ' ~ I iti l ll S ~ 355 356 356 -- n a e er s: A/S-VL Page 4 of 6 Buyer Initials: _ 957 16. CO NOTICE 357 358 35 NOT APPLICABLE ^ 358 9 APPLICABLE 359 360 THIS DOCUMENT MAY NOT SELL, CONVL'Y, TRANSFER, INCLUDE OR INSURE THE TITLIi TO THG COAL AND RIGHTS OF SUPPORT UNDERNFr1T1l THE SURFACE LAND 360 361 DESCRIBED OR REFERRED TO HEREW, AND THE OWNER OR OWNERS OF SUCH COAL MAY HAVE THE COMPLETE LEGAL RIGHT TO REMOVE ALL SUCH COAL AND 361 362 IN THAT CONNECTION, DAMAGE MAY RESULT TO THE SURFACE OF THE LAND AND ANY HOUSE, BUII.DIIIG OR OTHER STRUCTURE ON OR W SUCH LAND. (Th1S 362 363 notice is set forth in the manner provided in Section 1 of the Act of July 17, 1957, P.L. 984.) "Buyer acknowledges that he may not be obtaining the 363 364 right of protection against subsidence resulting from coal mining operations, and that the property described herein may be protected from damage 364 365 due' [o mine subsidence by a private contract with the owners of the economic interests in the coal. This acknowledgment is made for the purpose • 365 366 of complying with the provisions of Section 14 of the Bituminous Mine Subsidence and the Land Conservation Act of Apri127, 1966." Buyer agrees 366 367 to sign the deed from Seller which deed will contain the aforesaid provision. 367 368 17. POSSESSION (7=0'I) . 368 369 (A) Possession is to be delivered by deed, keys (if any) and: 369 370 1. Physical possession to vacant Property free of debris, with all structures broom-clean, at day and time of settlement, AND/OR 370 371 2. Assignment of existing lease(s), together with any security deposits and interest, a[ time of settlement, if Property is leased at the execu- 371 372 tiotr of this Agreement or unless otherwise specified herein. Buyer will acknowledge existing lease(s) by initialing said lease(s) a[ time of 372 373 execution of this Agreement 373 374 (B;1 . Seller will not enter into any new leases, written extension of existing leases, if any, or additional leases for the Property without the written 374 375 consent of Buyer. 375 376 18. RECORDING (3-85) This Agreement will not be recorded in the Office for the Recording of Deeds or in any other office or place of public 376 377 record, and if B'pyer causes or permits this Agreement to be recorded, Seller may elect to treat such act as a breach of this Agreement. 377 378 19. ASSIGNME (3-85) This Agreement will be binding upon the parties, their respective heirs, personal representatives, guazdians and succes- 378 379 sots, and to [he extent assignable, on the assigns of the parties hereto, it being expressly understood, however, that Buyer will not transfer or assign 379 380 this Agreement without the written consent of Seller. 380 381 20. DEPOSTT & RECOVERY FUND (1-98) 381 382 (A) Deposits paid by Buyer within 30 days of settlement will be by cash, cashier's or certified check. Deposits,. regazdless of the form of payment 382 383 and the person designated as payee will be paid in U.S. Dollars, and will be paid to Broker or party identified in paragraph 3(B), who will retain 383 384 them in an escrow account until consummation or termination of this Agreement in conformity with all applicable laws and regulations. Any. 384 385 uncashed check tendered as deposit may be held pending the acceptance of this offer. 385 386 (B) In the event of a dispute over entitlement to deposit monies, a broker holding the deposit is required by the Rules and Regulations of the State 386 387 Real Estate Commission (49 Pa. Code §35.327) [o retain the monies in escrow until the dispute is resolved. In the event of litigation foi• the 387 388 return. of deposit monies, a broker will distribute the monies as directed bya final order of court or the written Agreement of the parties. Buyer 388 389 and Selleragree that; in°tFYe'evenNany broker or affiliated licensee is joinet~ in litigation'for the return ot` deposit:monies, the attorneys' fees and 389 390 costs of the broker(s) and licensee(s) will be paid by the party joining them. 390 391 (C) A Reai Estate Recovery Fund exists to reimburse any persons who have obtained a final civil judgment against a Pennsylvania real estate 391 392 licensee owing to'fraud, misrepresentation, or deceit in a real estate transaction and who have been unable to collect the judgment after exhaust- 392 393 ing all legal and equitable remedies. For complete details about the Fund, call (717) 783-3658, or 1-800-882-2113 (within Pennsylvania) and 393 394 ( 7) 783-4854 (outside Pennsylvania). 394 395 21. PNED COMMUNITY (HOMEOWNER ASSOCIATION) NOTICE FOR PURPOSES OF RESALE ONLY (7-01) 395. 396 ~ NOT APPLICABLE 396 397 ^ APPLICABLE 397 398 (A) Buyer acknowledges that the Property is part of a planned community as defined by the Uniform Planned Community Act. (See Definition of 398 399 . Planned Community Notice for the definition contained in the Act.) •~, 399 400 (B) §5407(a) of the Act requires Seller to furnish Buyer with a copy of the Declazation (other than plats and plans), the bylaws, the rvles.and reg- 400 401 ulations of the association, and a Certificate containing the provisions set forth in §5407(a) of the Act qDl 4D2 (C) Within days of the execution of this Agreement, Seller will submit a request to the association for a Certificate and the documents 402 403 necessary [o enable Seller to comply with the Act. The Act provides that the association is required to provide these documents within 10 days 403 404 of Seller's request. 404 405 (D) Under the Act, Seller is not liable to Buyer for the failure or delay of the association to provide the Certificate in a timely manner, nor is Seller 405 406 liable [b Buyer for any erroneous information provided by the Assceiat5on and included in the Certificate. 406 407 (E) Buyer may declare the Agreement VOID at any time before Buyer's receipt of the association documents and for 5 days thereafter, OR until 407 408 settlement, whichever occurs first. Buyer's notice declaring the Agreement void must be in writing; thereafter all deposit monies will be 408 409 returned to Buyer. 409 410 (F) In the event the association has the right to buy the Property (right of first. refusal), and the association exercises that right, Seller will reim- 410 411 burse Buyer for all monies paid by Buyer on account of purchase price and for any costs incurred by Buyer for: (1) Title search, title insur- 411 412 ance and/or mechanics lien insurance or fee for cancellation of same, if any; (2) Flood insurance, fire insurance with extended coverage, mine ' 412 413 subsidence insurance, and cancellation fees, if any; (3) Appraisal fees and charges paid in advance to mortgage lender, if any; (4) Buyer's 413 414 customary settlement costs and accruals. 414 415 22. MAINTENANCE & RLSK OF LOSS (1-98) 415 416 (A) Seller will maintain the Property, grounds, fixtures, and any personal property specifically scheduled herein in its present condition, normal 416 417 weaz and tear excepted. 417 418 (B) In the event any system or appliance included in the sale of the Property fails and Seller does not repair or replace the item, Seller will promptly 418 419 notify Buyer in writing of Seller's choice to: 419 420 1. Repair or replace the failed system or appliance before settlement, or credit Buyer at settlement for the fair mazket value of the failed sys- 420 421 tem or appliance (this option must be acceptable to the lender, if any). In each case, Buyer accepts the Property and agrees to the 421 422 RELEASE set forth in paragraph 24 of this Agreement, OR 4P2 423 2. Make no repairs or replacements and not credit Buyer at settlement for the fair market value of the failed system or appliance, in which 423 424 case Buyer will notify Seller in writing within 5 days or before.~settieri}eAt, whichever is sooner, [hat Buyer will: ~ 424 425 a. Accept the Property and agree to the RELEASE set forth in paragraph 24 of this Agreement, OR 425 426 b. Terminate this Agreement, in which case all deposit monies paid on account of purchase price will be returned promptly to Buyer 426 427 and this Agreement will be VOID. 427 428 (C) Seller will beaz risk of loss from fire or other casualties until time of settlement. In the event of damage by fire or other casualties to any prop- 428 429 erty included in this sale that is not repaired or replaced prior to settlement, Buyer will have the option of rescinding this Agreement and 429 430 promptly receiving all monies paid on account of purchase price or of accepting the Property in its then condition together with the proceeds 430 431 of any insurance recovery obtainable by Seller. Buyer is hereby notified that Buyer may insure Buyer's equitable interest in this Property as of '431 432 the time of execution of this Agreement. 432 433 23. WAIVER OF CONTINGENCIES (1-00) 433 434 In the event this Agreement is contingent on Buyer's right to inspect and/or repair the Property, Buyer's failure to exercise any of Buyer's options 434 435 within the time limits specified in the contingency provision(s) will constitute a WAIVER of that contingency and Buyer accepts the 435 436 Property and agrees to the RELEASE set forth in paragraph 24 of this Agreement. 436 437 24. RELEASE (1-00) Buyer hereby releases, quit claims and forever discharges SELLER, ALL BROKERS, their LICENSEES, EMPLOY 437 438 EES, and any OFFICER or PARTNER of any one of them and any other PERSON, FIRM, or CORPORATION who may be liable by or 438 439 through them, from any and all claims, losses or demands, including, but not limited to, personal injuries and property damage and all of 439 440 the consequences thereof, whether now known or not, which may arise from the presence of environmental hazards, any deficiencies in the 440 441 on-site water service system, or any defects or conditions on the Property. This release will survive settlement. 441 442 25. REPRESEI'QTATIONS (1-00) 442 443 (A) Buyer understands that any representations, claims, advertising, promotional activities, brochures or plans of any kind made by Seller, Brokers, 443 444 their licensees, employees, officers, or partners are not a part of this Agreement, unless expressly incorporated or stated'iri this Agreement. 444 445 (B) It is understood that Buyer has inspected the Property before signing this Agreement (including fixtures and any personal property 445 446 specifically scheduled herein), or has waived the right to do so, and has agreed to purchase it in its present condition unless otherwise 446 447 stated in this Agreement. Buyer ackirowledges that Brokers, their licensees, employees, officers, or partners have not made an 447 448 independent examination or determination of the structural soundness of the Property, the age or condition of the' components, envi- 448 449 ronmental conditions, the permitted uses, or of conditions existing in the locale where the Property is situated; nor have they made a 449 450 mechanical inspection of any of the systems contained therein.. 450 451 (C) It is further understood that this Agreement contains the whole agreement between Seller and Buyer and there are no other terms, obligations, 451 452 covenants, representations, statements or conditions, oral or otherwise of any kind whatsoever concerning this sale. Furthermore, this Agree- 452 453 ment will not be altered, amended, changed, or modified except in writing executed by the parties. 453 454 (D) The headi s, captions, and line numbers in this Agreement are meant only to make it easier to find the paragraphs. . n (' 454 455 ~ Buyer Initials: A/S-VL Page 5 of 6 Seller Initials: •`~ ~ 455 457 458 459 460 461 462 463 464 ''465 466 467 ass 469 470 471 472 473 474 475 476 477 478 479 480 481 482 483 484 485 488' 487 488 489 490 491 492 493 494 495 496 497 496 499 500 501 502 503 504 505 506 507 508 509 510 511 512 513 514 515 516 517 .518 519 5211 -521 522 523 524 525 526 527 526 529 53D 531 532 533 534 535. 53G 537 538 539 540 541 542 543 544 545 546 547 548 549 550 551 552 ..... ~-......... ~. ~./ Should Buyer: Yeu 457 (A) Fail to make any additional payments as specified in paragraph 3; OR 456 (B) Furnish false or incomplete information to Seller, Broker(s), or the lender, if any, concerning Buyer's legal or financial status, or fail to coop- 459 erase in the processing of the financing application, which acts would result in the failure to obtain the approval of a financing commitment; 460 OR 461 (C) Violate or fail to fulfill and perform any other terms or conditions of this Agreement; 462 [hen in such case, Seller has the option of retaining all sums paid by Buyer, including the deposit monies, 1) on account of purchase price, 463 or 2~ds monies to be applied to Seller's damages, or 3). as liquidated damages for such breach, as Seller may elect, unless checked below. 464 LQ/ Seller is limited to retaining sums paid by Buyer, including depq~sit monies, as liquidated damages. 465 If Seller elects to retain all §ums paid by Buyer, including deposit monies, as liquidated damages, Buyer and Seller will be released from 466 further liability or obligation and this Agreement will be VOID, q67 27. MEDIATION (7-~~) 4se ^ NOT AVAII:ABLE 469 ^ WAIVED. Buyer and Seller understand that they may choose to mediate at a ]nt~~r dote, should a dispute arise, but that there will be no ob- 470 tgation on the part of any party to do so. 471 ELECTED a72 (A) Buyer and Seller will try to resolve any dispute or claim that may arise from this Agreement through mediation, in accordance with the 473 Rules and Procedures of the Home Sellers/Home Buyers Dispute Resolution System. Any agreement reached through a mediation conference 474 and signed by the parties will be binding. 475 ; (B) Buyer and Seller acknowledge that they have received, read, and understand the Rules and Procedures of the Home Sellers/Home Buyers 476 Dispute Resolution System. (See Mediation Notice.) 477 (C) This agreement to mediate disputes arising from this Agreement will survive settlement. 478 479 Buyer and Seller acknowledge that they have read and understand the notices and explanatory information set forth in this Agreement. 480 Buyer acknowledges receiving a copy of this Agreement at the time of signing. NOTICE TO PARTIES: WHEN SIG)rIT'iD, THIS AGREEMENT IS A BWDIN Agreement, and all addenda, bearing thC:srgnatures of all parties, constitutes acce ce to consult an attorney before signing if they desire legal advice. , Buyer Name (pri Mailing Address Home] E-Mail WITNESS Buyer Name (print) Mailing Address _ Home Phone Work Phone E-Mail 497 498 FAX # 499 • 500 501 WITNESS BUYER ~ DATE 502 Buyer Name (print) SS # ~ 503 Mailing Address 504 Home1 E-Mail 461 482 463 ACS ~teturn by facsimile transmission (FAX) of this 484 tis Agreement. Parties to this transaction are advised. 485 .486 487 ~llL.~ i 9 ~, / DATE ~U ~~ U 88 SS # 489 r 490 _ -_ 491 Work Phone ~(s ~ - / S U D FAX # 492 i 493 494 Work Phone 505 FAX # 506 507 508 Seller hereby approves the above contract this (date) 509 And in consideration of the services rendered in procuring the Buyer, Seller agrees to pay the named Broker for Seller a fee of 510 of/from the herein specified sale price. In the event Buyer defaults hereunder, any monies paid on account will be divided 511 Seller, , Broker for Seller, but in no event will the sum paid to the Broker for Seller be in excess of the above specified Broker's fee. 512 513 WTrNF.SS SELLER - - DATE+ OGT /~. 6 a, 514 Seller Name (print) '~2 rn ~ 'D , rR~ ~ SS # ~ - 515 Mailing Address po 2 C~~c 6 7 /lfnn„ `oSo.v Td v~U ~~ ~ O ~ ~/ 516 517 Home Phone ~'~ I ~~ ~-t S . ~~ ~ S / W_ ork Phone FAX # 518 E-Mail 519 ,. 520 WITNESS SELLER DATE o 521 _ Seller Name (print) ` ~''• SS # 522 Mailing Address U 523 ~• 524 Home Phone 7 r 7 - ~~~ - ~/O.~ 2 Work Phone 7/`7 - 4 ~~ ~ ~Z~/ 7 FAX # 525 E-Mail ~A-f~~'~f, r o yu 1Y/. Amt 526 527 WITNESS SELLER DATE '~ 528 Seller Name (print) SS # 529 Mailing Address 530 Home Phone Work Phone E-Mail 531 FAX # 532 533 534 The undersigned ^ Broker for Seller ^ Broker for Buyer agree to submit to/m,,ed~i~ation in accorndance with paragraph 27 of this Agreement. 535 BROKER FOR SELLER (Company Name) ~_ ""''`~''~~ `''~' 537 ACCEPTED BY BROKER FOR BUYER (Company Name) ACCEPTED BY A/S-VI: Page 6 of C BUYER DATE 495 ___ _ SS # 496 DATE ~?~ ~ o Z 538 ' 539 540 _ DATE 541 542 543 544 545 546 547 548 549 550 551 552 BROKER'S COPY SELLER'S ESTIMATED CLOSING COSTS Y This form rcconuncndcd and approved Cor, but nq~,(csviclcd w use by, th``e members oC the Pcnnsylvanir Assa:irtion of/RL'ALTORS~ (PAR). 1 PROPERTY ~~ ~E'/~~,5 a (P fir?/! G~ ~G~G~/l C~ f~/C S F~i~' . 2 SETTLEMENT DATE ~i 3 r a 5 6 1. Broker's Fee z • 'l. Preparation of Deed a 3. Transfer Tax ~ 4. Seller's Assist to Buyer 1 o S. Home Warranty 11 b. Municipal Certification 12 '7. Settlement Fee 13 8. Notary Fees 1a L Survey 15 10. Tax Certifications 1G 11. Overnight/Express Mail Charges 17 12. Domestic Lien Search is 13. Other 1 s 14. Other 2U z1 ~ Estimated Costs z2 _ 23 Adjustments (+/-) (e.g., real estate taxes, refund of escrow)_ za $ ~ r coo. ~-o $ 2 oa $ / o . n-r~ z5 TOTAL ESTIMATED COSTS/ADJUSTMENTS $ 2s z~ Purchase Price 2a !~ 2e % Total~Costs/Adjustments 30 31 Estimated Proceeds . 32 33 Seller's Estimate of Mortgages, Equity, and Other Loan balances, liens, assessments, etc. $ 3a I ~~ , f r S, v-v 35 ESTIMATED NET PROCEEDS TO SELLER $ 3G 37 The estimated proceeds do not take into account any other mortgages, liens, assessments or other obligations which may be 3a against the Property or the Seller. 39 ao .The above figures are approximated closing costs and will be adjusted as of date of final settlement, if necessary. a1 a2 I/We understand and have received a copy of these estimated closing costs before signing the agreement of sale. a3 a4 45 46 al a8 as 50 51 52 53 SELLER 5a SELLER s5 SELLER 56 s~ BROKER (Company Name) 5a ACCEPTED BY ® Pennsylvania Association of ~ REALTORS® i*nua+w n. wk. a nw E.w• h v«w~..+. v PURCHASE PRICE $ SEC / 7n-s 3 Charges DATE ' DATE ~O ~' Oa DATE L _ COPYRIGHT PENNSYLVANIA 1 OF REALTORS® 1996 9/01 BUREAU OF ZNDTVIDUAL TAXES INHERTTANCE TAX DIVTSTON DEPT. 2:80601 HARRTSBURG, PA 17128-0601 TROY D ERNEY P 0 BOX 67 THOHPSONTOWN COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF /NHERZTANCE TAX APPRAISEMENT, ALLO#ANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX RE¥-I;~i7 EX &FP (01-OS) PA 1709q DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 01-20-2005 PHILLIPS 02-18-Z002 21 02-025! CUMBERLAND 101 Amount Remitted GLORIA J MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA I70I$ CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF PHILLIPS GLORIA J FILE NO. 21 OZ-OZ$1 ACN 101 DATE 01-20-2005 TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Reel Estate (Schedule A) (1) 2. Stocks end Bonds (Schedule B) (2) $. Closely Held Stock/Partnarsh/p Interest (Schedule C) ($) q. Mortgages/Notes Rece/vable (Schedule D) (q) $. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expansas/Adm. Costs/M/sc. Expanses (Schedule H) (9) 10. Debts/Mortgage L/ab/1/t/as/Liens (Schedule Z) (10) 11. Total Deduct/ohs 12. Net Value of Tax Return 15. lq. ZlOzO00.O0 5~168.52 .00 .0O 30;2q9.56 .00 q$~795.qZ (B} 27,008.q5 Char/table/Governmental Bequests; Non-almcted 9115 Trusts (Schedulm J) Net Velum of Estate Sub,act to Tax NOTE: To insure proper credit to your account, submit thm upper port/on of th/s form with your tax payment. 289,215.50 .00 (11) 27.008-45 (~2) 262,205.05 (15) . O0 (1~) 262,205.05 NOTE: ASSESSMENT OF TAX: 15. Amount of L/ne lq et Spousal rate 16. Amount of Line lq taxable et Lineal/Class A rata 17. Amount of Line lq et S/bl/ng rata 18. Amount of L/nm lq taxable et Collateral/Class B rata 19. Pr/ncipal Tax Due TAX CR;PITS: PAYMENT RECEIP1 DISCOUNT (+J DATE NUMBER INTEREST/PEN PAID (-) CD001820 .00 11-07-2002 Zf an assessment was issued previously, lines 14, 15 and/er 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. (15) .00 x O0 = .00 (16) 262,205.05 x Oq5= 11,799.25 (17) .00 X 12 : .00 (18) .00 x 15 = .00 (19)= 11,799.2:5 ANOUNT PAID ZF PAID AFTER DATE ZNDZCATED~ SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 11,799 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 11,799.25 .00 .00 .00 ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT ZS REQUIRED. XF TOTAL DUE ZS REFLECTED AS A 'CREDIT' (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) STATUS REPORT UNDER RULE 6.12 Name of Decedent Date of Death: wil i No. Admin. No. Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: State/whether administration of the estate is complete: Yes ~' No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to this report. Date: (MAH:rmf/AM3) S ign/a bu're ~ame (Please type or print) Address ' Tel. No. Capacity: / Personal Representative __Counsel for personal representative BUREAU OF /NDZV/DUAL TAXES ~IH~RZT&HCE TAX u~P¥. ?80601 HARRISBURG; PA 17118-0601 TROY D ERNEV P 0 BOX 67 THONPSONT0#N CUT ALONG THZS LZNE ~ PA 17094 COHMON#EALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRA/SEHENT, ALLOMANCE OR D/SALLOWANCE OF DEDUCTZONSAI~ASSESSHENTOF TAX DATE 01-20-2005 ESTATE OF PHILLIPS DATE OF DEATH 02-18-2002 FILE NUMBER 11 02-0251 COUNTY CUMBERLAND ACN 101 IEEV-1S47 EX lIFP (81-03) GLORZA J HAKE CHECK PAYABLE AND REHIT PAYHENT TO: REGISTER OF #ILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 RETAZN LONER PORTION FOR YOUR RECORDS 4 REV-lS&7.EXAFR (OI-03)*NOT~EOF ZNH~-RZTAHCE-TAX-APPRA$SEMENT,-AL-LOMAHCE-OR ................... DZSALLO#ANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF PHILLIPS GLORIA J FZLE NO. 21 02-0231 ACN 101 DATE 01-20-2003 TAX RETURN NAS: ( X ) ACCEPTED AS FILED ( ) CHANGED RE$~kVATZON CONCERNZNS FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN l. Rool Estate (Schodulo A) (1). 2. Stocks u~d Bo~ds (Schedule B) (2) 3. Clo~ly ~ld S~o~/Pmr~r~p Zn~o~s~ (~1o C) (3) 4. Hor~s/~os Ro~/v~lo (~le D) (4) S. ~~ bsi~s~i~. Peril P~ty (~lo E) 6. ~n~ly ~ P~rty (~1o F) (6) 7. T~sfors (~10 G) -- (7). 8. To~I AsM~s APPROVED DE~CTZONS AND EXEMPTIONS= 9. F~I E~M~s/A~. Cos~s/Hisc. E~sos (~o~10 H) (9) 10. ~s~r~ Ll~]l~ios/Lims~ (~1o [) (10) 12. b~ qal~ of T~ Ro~u~ 210~000.00 5~168.52 .00 .00 30;Z49.56 .00 43. r795.42 (8) 27,008.45 Churitablo/Oovorflmefltal Boquosts; Non-olectod 911~ Trusts (Schodulo J) I~t Value of Estate Subject to Tax NOTE: To Lnsur~ proper cradLt to your ~ount, suimLt th uplmr portLm of thLs fora wJ, th your 289,213.50 1S. Amount of Lino 14 at Spousal rate 16. Amoun~ of Uno 14 tnxublo at Linoal/Class A rato 17. ABount of L/no 14 at Sibling rata 18. Amount of Ltno lq texable at Collateral/Class B rate 19. Prln~tpml Trix Duo rAX CREDITS: DATE NUHBER -11-07-2002 CD001820 Ug~, ,...mfl' (+j ZNTEREST/P~N PAID (-) .00 (~).. .00 x O0 = .00 (16) 262,Z05.05 x 0~5= 11,799.23 (17), .00 x 12 = .00 (18). .00 x 15 = .00 (19)= 11,799.23 AH~---..mT' 11,799.23 TOTAL TA----------~ CRED:I:-------~ T---L 11,799.23 1 Pe~IB~ ~iguPe$ that include tbs total o~ ALL pe~uPn$ assessed to date. ASSESSMENT OF TAX= .00 (11) ._ ~7 . 008 . iq (12) 262,205.05 (13) . O0 (~4) 262,205.05 ZF PAZD AFTER DATE ZI~ZCATED~ SEE REVERSE FOR CALCULATZON OF ADDZTZONAL 7.NTEREST. BALANCE OF TAX DUE .00 XNi=KEST AND PEN. .00 TOTAL DUE .00 ( ZF TOTAL DUE XS LESS THAN $1, NO PAYHENT ZS REI1UZRED. ZF TOTAL DUE Z$ REFLECTED AS A "'CREDI'T" (CR), YOU HAY BE DUE A REFUI~. SEE REVERSE SI'DE OF TflZS FORtl FOR ZNSTRUCTZONS.)