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HomeMy WebLinkAbout10-19-091505607120 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO 60X.280601 y~(~ /~ Harrisburg, PA 17128-0601 RESIDENT DECEDENT 2 1 v_/ t-'r ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 187 58 2713 O1 28 2009 07 30 1962 Decedent's Last Name Suffix Decedent's First Name MI RUDY SYLVAN L (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETUR N MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW X~ 1. Original Return ~ 2. Supplemental Retum ^ 3. Remainder Return (date of death prior to 12-13-82) r 4. Limited Estate J ^ 4a. Future Interest Compromise ^ 5. Federal Estate Tax Return Required (dale of death after 12-12-82) X 6. Decedent Died Testate I~ I~~ ~ Decedent Maintained a Living T (Attach Copy of Trust) rust F,~ 8. Total Number of Safe Deposit Boxes -- (Attach Copy of Will) ~,~ 9. Litigation Proceeds Received 10. Spousal Poverty Credit ((date of death 11, Election to tax under Sec. 9113(A) ___ ^ between 12-31-91 and i-1-95) (Attach SCh. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number ROBERT C. SAIDIS ESQ. 717 243 6222 r..s .._, Firm Name (If Applicable) SAIDIS, FLOWER & LINDSAY First line of address 26 WEST HIGH STREET Second line of address City or Post Office CARLISLE State ZIP Code PA 17013 REGISTER OF V1l1LS USE,.~LY ; ', j'; ,...~ - -F-t - --- ~~ _.-, ,-, ;; - -5 •, - DAT~FILED `'~ Correspondent'se-mail address: rsaidis@sfl-law.com Under penalties of perjury, 1 declare that 1 have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative Is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE . Jonathan E. Rudy 601 16th Street, New Cumberland, PA 17070 Robert C. Saidis Esq. `d /~/ /ADD ADDRESS / / ' 26 West High Street, Carlisle, PA 17013 Side 1 1505607120 1505607120 REV-1500 EX 15D5607220 Decedent's Name: $~/ I V a n Lee R U d~/ RECAPITULATION 1. Real Estate (Schedule A) ...................................................................................... 1. 2. Stocks and Bonds (Schedule B) ..............................._........................................... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C).......... 3. 4. Mortgages & Notes Receivable (Schedule D) ............................._....................... 4. 5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ................ 5. 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested ............. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested ............. 7, 8. Total Gross Assets (total Lines 1-7) .............................__.................................. g. 9. Funeral Expenses & Administrative Costs (Schedule H) ...................................... 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10. 11. Total Deductions (total Lines 9 & 10) ............................._............................._..... 11. 12. Net Value of Estate (Line 8 minus Line 11) .............................._.......................... 12. 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) .............................................. 13. 14. Net Value Subject to Taz (Line 12 minus Line 13) .............................................. 14. TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .00 0 0 0 15. 16. Amount of Line 14 taxable at lineal rate X .045 2 0 0 16. 17. Amount of Line 14 taxable at sibling rate X .12 0 0 0 17. 18. Amount of Line 14 taxable at collateral rate X .15 5, 4 7 3. 6 1 18. 19. Tax Due ............................................................................................................... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Decedent's Social Security Number 187 58 2713 21,363.30 21,363.30 5,558.82 10,328.87 15,887.69 5,475.61 5,475.61 0.00 0.09 0.00 821.04 821.13 Side 2 1505607220 1505607220 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 -- Sylvan Lee Rudy STREET ADDRESS 454 High Street ._._. _ CITY Enola STATE I ZIP PA 'I 17025 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) 821.13 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 0.00 Total Credits (A + B + C) (2) 0.0 0 3. InteresUPenalty if applicable _ __ __ p. Interest E. Penalty Total InteresUPenalty (D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is theDVERPAYMENT. (4) Check box on Page 2 Line 20 to request arefund - 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE (5) 8 21.13 A. Enter the interest on the tax due. (5A) -_ _- - B. Enter the total of Line 5 + 5A. This is theBALANCE DUE (5B) $ 21.13 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 transfer and: Yes No a. retain the use or income of the property transferred :...................................................................... ....... ~.J ~i xf'. b. retain the right to designate who shall use the property transferred or its income :.......................... ...... ~ __ c. retain a reversionary interest; or ..............................._..........................................................__......... ....... ^ d. receive the promise for life of either payments, benefits or care? .................................................... ....... [~ ~x 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .......................................................................................................... ....... U ~- 3. Did decedent own an "in trust for' or payable upon death bank account or security at his or her death?. ........ ~ x 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ..............................__............................__........................................... ....... [J CX IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. §9116 (a) (1.1) (ii)]. The statutedoes not exemota transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §9116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116 (a) (1.3)]. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. Rev-1509 EX+ (8.98) SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Rudy, Sylvan Lee 21 __ tf an asset was made joint wtthln one year of the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Margaret A. McKee 454 High Street Friend Enola, PA 17025 B C JOINTLY OWNED PROPERTY: ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH ALUE OF ASSE % OF DEGD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1 A 11/3/2004 454 High Street, Enola, PA -Parcel ID 42,726.60 50.000% 21,363.30 #45-16-1049-034A All that certain tract of land situate in East Pennsboro Township, Cumberland County, Pennsylvania, containing approximately .18 acres of land and know and numbered as 454 High Street. TOTAL (Also enter on Line 6, Recapitulation) I 21,363.30 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev. 6-98) REV•1151 EX+ (12.99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF I FILE NUMBER Rudy, Sylvan Lee 21 __ Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s) attached B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s): Street Address City State Zip Year(s) Commission paid 2. Attorney's Fees Saidis, Flower & Lindsay 3, Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4,543.82 1,000.00 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 15.00 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 5,558.82 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Rudy, Sylvan Lee 21 __ ITEM NUMBER DESCRIPTION AMOUNT Funeral Expenses 1 Blooms by Vickery -Flowers for funeral 439.27 2 Musselman Funeral Home -Prof services $1,800; Oak casket $825.00; Marblelon 3,261.00 urn/valt $325.00; Death certificates $36.00; Newspaper death notice $150.00; Authorization $25.00; Minister $100.00 3 Susan Rudy -Reimbursement for cemetary lot 800.00 4 Telefloral -Funeral flowers 43.55 H-A Subtotal 4,543.82 Other Administrative Costs 5 Register of Wills -Filing fee for the Inheritance Tax Return 15.00 H-B7 Subtotal 15.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1512 EX+ (6-98) ,. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF (FILE NUMBER Rudy, Sylvan Lee 21 __ Include unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 454 High Street, Enola, PA -Mortgage 7,997,gg One-half of mortgage due at date of death because the property was jointly owned with a friend. 2 Andrews ~ Patel 5.00 3 Behany Oil 693.53 4 Debbie Lupold, Treasurer - 2009 County Township 255.57 5 East Pennsboro Township - RUDY SL0001 500.25 6 F. M. Oppel -Heating oil 650.34 7 Insurance 103.00 8 Susan Rudy - Reimbusement for filing income tax return; Legacy Writer re Will and 82.30 POA 9 Vital Statistics -Birth certificates 36.00 10 West Shore Anesthesia -Medical bill 5.00 TOTAL (Also enter on Line 10, Recapitulation) I 10,328.87 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98) REV-1513 EX+(9.00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF I FILE NUMBER Rudy, Sylvan Lee 21-- NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY D E LED~NY (Words) ($$$) Do ~ a 5) I. TAXABLE DISTRIBUTIONS [include outright spousal distributions and transfers , under Sec. 9116(a)(1.2)i Margaret A. McKee Friend 5,473.61 454 High Street Enola, PA 17025 Diane Miller Mother 1.00 PA Jonathan E. Rudy Father 1.00 601 16th Street New Cumberland, PA 17070 Total 5,475.61 Enter dollar amounts for distributions shown above on lines 15 through 18, as approp riate, on Rev 1500 cov er sheet II. 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 SHEETI 0.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule) (Rev. 6-98) LAST WILL AND TESTAMENT OF SYLVAN L. RUDY 1, Sylvan L. Rudy, a resident of Enola, Pennsylvania declare this to be my Last WiI1 and revoke aII former Wills and Codicils. ARTICLE I Identification of Family At the present time I am unmarried and have no children. in making this Will, 1 do not have in mind to provide for any children hereafter born to or adopted by me. ARTICLE U Appointment of Fiduciaries A. Appointment of Personal Representative. I appoint my father, Jonathan E. Rudy, as Executor of my estate. If Jonathan E. Rudy is or becomes unable or unwilling to serve, I appoint my stepmother, Susan K. Rudy as alternate Executor. B. Bond; Court Supervision. My Executor shall have the right to serve without bond and to administer and settle my estate without the intervention or supervision of any court, except to the extent required by law. Nothing herein shall prevent my Executor from seeking the assistance of the court in any situation where my Executor deems it appropriate. ARTICLE III Specific Gifts A. Gifts of Specified Items of Property. I give all my interest in certain items of tangible personal property to the beneficiaries designated in this section as follows: 1. Specific Gift One. 1 give I give my share of the property and mobile home located at 454 High Street, Enola, Pa 17025 and my Truck. and my Automobile and all contents with such and all of my worldly possessions to my life- partner, Margaret McKee if Margaret McKee survives me. If Margaret McKee does not survive me no property shall pass under this Article. B. Insurance. I give to each recipient of an item of tangible personal property my interest in any insurance covering the item. My purpose in making this gift is to give each recipient the benefit of insurance coverage for which I have already paid. Wiii of Sylvan L. Rudy Page t ofb lnitials:~~~' " 'U~ Date: _ J It is not my intention to give any recipient the proceeds of an insurance claim that exists but is unpaid at my death. C. Specific Gifts of Cash. I give to each of the following beneficiaries the amount set forth opposite the beneficiary's name; provided, that if an individual named below does not survive me, his or her gift shall lapse: Name of Beneficiarv Amount of Cash my mother, Diane Miller $1 my father, Jonathan E. Rudy $1 ARTICLE IV Disposition of Residue I give all of the rest and residue of my estate, wherever located (hereafter referred to in this Article as "residue"), to Margaret McKee. If Margaret McKee does not survive me then I give all of the residue to my father, Jonathan E. Rudy. If I am not survived by any party named in this provision, I give the entire residue to my heirs. ARTICLE V Alternative Methods of Distribution A. Purpose of Article. Recognizing that under certain circumstances the terms of this Will may direct that property be distributed outright to a person who is under age twenty-one (21) or under a legal disability; I make the following provisions to facilitate the distribution of property to such persons. B. Alternative Methods. Whenever the terms of this Will direct my personal representative (referred to in this Article as the "fiduciary") to distribute property outright to a person who is then under age twenty-one (21) or under a legal disability, the fiduciary may retain pursuant to Paragraph C. of this Article or distribute all or any portion of that property in any one or more of the following ways: 1. 2. 3. 4. 5. Will of Sylvan L. Rudy Delivery directly to the beneficiary; Delivery to the parent or stepparent of the beneficiary; Delivery to the guardian of the beneficiary's person or property; Delivery to any Custodian for the beneficiary under the Uniform Gifts to Minors Act; Delivery to any then existing trust created for the beneficiary; Page 2 of 6 Initials: ~,~Date: ~ - ~ ~~ VV ~~R 6. Deposit in a financial institution in an account established in the name of the beneficiary alone pursuant to the laws of the State of Pennsylvania; 7. Storage of any tangible personal property in safekeeping with the costs of storage to be borne by the beneficiary; or S. Sale of any tangible personal property and delivery of the proceeds in any manner permitted by this Article. Provided the fiduciary acts in good faith, upon delivery of any property in accordance with the provisions of this Article, the fiduciary shall be discharged from all responsibilities in connection with the property. C. Discretionary Trust. Any property not distributed as provided in Paragraph B. of this Article shall be retained by the fiduciary in trust for the beneficiary on the following terms and conditions: During any period in which the beneficiary is under a legal disability or under twenty-one (21) years of age, the fiduciary shall pay to or apply for the benefit of the beneficiary so much of the income and principal of the trust as the fiduciary, in its sole and absolute discretion, determines is advisable for the beneficiary's health, support, education and general welfare. At such time as the beneficiary is neither under a legal disability nor under age twenty-one (21), the fiduciary shall distribute any remaining trust assets to the beneficiary. If the beneficiary dies before all of the trust assets have been distributed, the fiduciary shall distribute any remaining trust assets to the beneficiary's estate. AR~'ICLE VI Administrative Provisions A. Powers and Duties of Personal Representative. My personal representative shall have all of the powers and duties granted to or imposed upon personal representatives serving with non-intervention powers pursuant to the laws of the State of Pennsylvania. B. Debts and Expenses. All expenses of administration chargeable to principal, the expenses of the disposition of my remains, and all my legitimate debts, if and when paid, shall be paid from the principal of my residuary estate. No debt need be paid prior to its maturity in due course and except as otherwise provided in this Will no interest in any property passing under this Will need be exonerated. C. Taxes. All estate, inheritance or other similar death taxes, together with any interest. or penalties thereon, arising by reason of my death with respect to any property includable in my taxable estate, and any adjusted taxable gifts, whether passing under or outside of this Will, shall be paid from the principal of my residuary estate without reimbursement from the recipients or beneficiaries of such property, provided, Will of Sylvan L. Rudy Page 3 of 6 Initials: ~ ate: ~= g` however, that in the event any proceeds of insurance upon my life or any property over which I held a power of appointment are included in my estate for purposes of determining the federal estate tax liability of my estate, then the residue of my estate shall be entitled to receive from the recipients of any such proceeds or property the portion of such federal estate tax liability attributable to such proceeds or property determined in accordance with IRC ~§ 2206 and 2207. AR~'ICLE VII Miscellaneous A. Number and Gender. Unless the context indicates a contrary intent, the plural and singular forms of words shall each include the other, and every noun and pronoun shall have a meaning that includes the masculine, feminine and neuter genders. B. Survival. To "survive" me, as that term is used in this Will, a person must continue to live for thirty (30) days after my death. C. Descendants. The "descendants" of an individual include only the following: 1. All such individual's biological descendants, except any person not born in lawful wedlock and his descendants, unless the biological parent who would otherwise cause him or her to be a descendant has acknowledged paternity or maternity in legitimation proceedings, or in an unambiguous signed writing identifying such person by name, or by raising such person in the same household; and 2. Persons adopted by such individual or one of his or her descendants, and their descendants. If the parent, who would cause a person to be a descendant as defined above, is replaced in an adoption proceeding, such person shall remain a descendant unless such parent voluntarily consents to the relinquishment of his or her status as parent in connection with such adoption proceedings. D. Heirs. The term "heirs" shall mean those persons entitled to inherit under the then-applicable laws of the State of Pennsylvania governing the descent of an intestate's separate estate. They shall inherit in their statutory proportions. E. Exclusion of I'retermitted Heirs. Other than as set forth in this Will, I make no provision for any child of mine or descendant of a deceased child of mine. I specifically make no provision for any person (whether now living or hereafter born), other than a child named or referred to in Article I or a descendant of mine as defined in this Will, who may be entitled to claim an interest in my estate under the laws of the State Will oi'Sylvan L. Rudy Page 4 of 6 Initials: ~~~~~te: ~ ~~ 0 ~t of Pennsylvania. F. Legal Disability. A person is under a legal disability if my persona] representative determines, in good faith, that the person is incapable of managing his property or of caring for himself, or both, or is in need of protection or assistance by reason of physical injury or illness, mental illness, developmental disability, senility, alcoholism, excessive use of drugs, or other physical or mental incapacity. G. Title to Real Property. Upon my death, title to any real property passing under this Will shall vest in my personal representative in his fiduciary capacity and shall remain so vested until my personal representative distributes or sells that property, at which time title shall vest in the distributee or purchaser. H. Disclaimer. Except as may be otherwise specifically provided in this Will, in the event that any beneficiary disclaims an interest arising out of this Will or any trust created herein it is my intention that the interest disclaimed shall be distributed in the same manner and at the same time as if the disclaiming beneficiary had died immediately preceding the event pursuant to the laws of the State of Pennsylvania. I. Governing Law. The provisions of this Will shall be interpreted in accordance with and in light of the laws of the State of Pennsylvania. J. Corporate Successors. Whenever a corporation or other business entity is referred to herein, the reference shall include any successor organization. K. References to Statutes. In this Will, the abbreviation "IRC" shall refer to the Internal Revenue Code of 1986 as amended. ~i ('? n~ Will of Sylvan L. Rudy Page 5 of 6 Initials: ~~° Date: G~ -~ I have initialed and dated for identification purposes all pages of this my Last Will, and have executed the entire instrument by signing this page on the ~ day of~ ,/~..i , 200, at ~.h/~ Win- ,Pennsylvania. Sylvan L. Rudy Attestation and Statement of Witnesses Each of us declares under penalty of perjury under the laws of Pennsylvania that Sylvan L. Rudy, the Testator, signed this instrument as his Last Will in our presence, all of us being present at the same time, and we now, at the Testator's request, in the Testator's presence, and in the presence of each other, sign below as the witnesses, declaring that the Testator appears to be of sound mind and under no duress, fraud, or undue influence. [Witness Signature] ~~~~ G~/~ ~ ~v~s~S [Print Name] Residing at .J~ 7 ~(p~ ~~I~ i'/o~,~ 1 ,~~~~~/2 ~ , i ~~T~ [Witness Signature] [Print Name] Residing at ,_ ~, Will of Sylvan L. Rudy Page 6 of 6 lnitials:~ Date: __~ ' ~ __ SELF-PROVING AFFLDAVIT STATE OF PENNSYLVANIA COUNTY OF } } ss. 1 I, the undersigned, an officer authorized to administer oaths, certify that Sylvan L. Rudy, the Testator, and ,and the witnesses, whose names are signed to the attached or foregoing instrument and whose signatures appear below, having appeared together before me and having been first duly sworn, each then declared to me that: l) the attached or foregoing instrument is the last will of the Testator; 2) the Testator willingly and voluntarily declared, signed and executed the will in the presence of the witnesses; 3) the witnesses signed the will upon request by the Testator, in the presence and hearing of the Testator, and in the presence of each other; 4) to the best knowledge of each witness the Testator was, at that time of the signing, of the age of majority (or otherwise legally competent to make a will), of sound mind and memory, and under no constraint or undue influence; and 5) each witness was and is competent and of the proper age to witness a will. J ,~~ ~ ~%y ~~~ ~~ ~~~ [Witness Signature] /Y~7i~~~ G ~Fr/r~~ [Print Name] ~~ Sylvan L. Rudy 'G~~ ~ ~-,----~ ~ [Wifiess Signature , [Print Name] Residing at ~~~ " /~ ~~~ ~ Residing t ~cJO ~~'~~tio~ /-~ ~G' ~~si~ ~'.~/~1~1a~~~'T,c~,%~ , ~ l~E~/ Cam., 6 ~ ~ c ~ 17J ;.~ 0 17G ~C% Section for Notary Public: Subscribed, sworn and acknowledged before me by the said Sylvan L. Rudy, Testator, and by the said ,and wifiesses, this -day of , 200_. [Signature of Notary] [Print or stamp name of Notary] • ti~r~7/ DEED WARRANTY "~ . ~ ,...~, IND. OR CORP.#6975 ~,'" ~ ,:;',,, i:~ ZJ~~ fJU 3 ~'(~ P~4F~L NO.: 45-16-1049-034A This .Deed , made the ~-~ ~ l day of /~vvi~r3 G~'t-2004 Between Michael J. Frey, sinctle person, herein designated as the Grantors, And Sylvan L. Rudy and Margaret A. McKee herein designated as the Grantees, Witnessetl:, that the Grantors, for and in consideration of Twenty Nine Thousand Nine Hundred Ninety Nine and No/100 ($29,999.00} lativful money of the United States of America, to the Grantors in hand well and truly paid by the Grantees, at or before the sealing and delivery of these presents, the receipt whereof is hereby acknowledged and the Grantors being therewith fully satisfred, do by these presents grant, bargain, sell and convey unto the Grantees forever, joint tenants with a right of survivorship. ALL TH T ERT IN tra t or Parcel of land and premises, situate, lying and being in the -~~~~~~ev ~~Cn~z~e County of Cumberland and Commonwealth of Pennsylvania, more particularly described as follows: BEGINNING at a point on the South side of High Street (formerly called Hill Street) at corner of la,zds now or late of Harry May; thence along High Street South thirty~ve de rees~tlwenty-five minutes East one hundred and thirty-two hundredths feet (S. 35 a 25 `E~~~o a ~oint; thence along line of lands of Harry Musser South fifty-eight degrees nine minutes West seventy- seven and six tenths feet (S. S8~ 09' W. 77.6) to a point; thence along lands now or late of Casimi,•o DiPaolo, North thirty-five degrees sixteen minutes West one hundred feet more or less (N. 35 ~l fi' W. 100.00) to line of la,:ds now or late of Harry May; thence along same North fifty- four degrees forty four minutes East seventy-seven and five tenths feet (N. S4~ 44' E. 77.5) t~ the point and place of BEGINNING. BRING the same premises which Michael J. Frey and Denise M. Frey, by deed dated December 31, 1984 and recorded in Cumberland County on May 14, 1985 in Deed Book G 31 Page 210, granted and conveyed unto Michael J. Frey, Grantor herein. Together with all and singular the buildings, improvements, ways, woods, waters, watercourses, rights, liberties, hereditaments and appurtenances to the same belonging or in anywise appertaining; and the reversion and reversions, remainder and remainders, rents, issues and profits thereof, and of every part and parcel thereof,• And Also all the estate, right, title, interest, use, possession, property, claim and demand whatsoever of the Grantors both in law and in equity, or, in and to the premises herein described and every part and parcel thereof with the appurtenances. To Have And To Hold all and singular the premises herein described together with the hereditaments and appurtenances unto the Grantees and the Grantees proper use and benefit forever. And the Grantors covenant that, except as may be herein set forth, they do and will Specially Warrant and Defend the lands and premises, hereditaments and appurtenances hereby conveyed, against the Grantors and all other persons lawfully claiming the same or to claim the same. In all references herein to any parties, persons, entities or corporations, the use of any particular gender or the plural or singular number is intended to include the appropriate gender or number as the text of the within instrument may require. ' Wherever in this instrument any party shall be designated or referred to by name or general reference, such designation is intended to and shall have the same e, fJect as if the words "heirs, executors, administrators, personal or legal representatives, successors and assigns" has been inserted after each and every such designation. i.,r` ',: - rdi r_ti : :.rt :!',~ !rl fri eT'I ~ fD ~~-. r m ro r-J c,; r•n rn cJ'J rn rri ,r, ~ r,: ~n t ~`r i; i - ~ ._.y % r*i x•~ si: cc~ cry - 1-~ i . C.J! '1'1 ,. ~. I_ l_1'i - w [:U - 7.i ~~ C~J 4J LJ ~. ^r. 1; " U ' 1~ Q ~~ ._ ;: ~,;'~, BQ~K ~ PACE ~"~ _ ` • + X ~ t~ 41 a:-' til ~1 1J G~ f ::_rl ,J-•~ ~ fl 1.11 t.~,• :,f'1 ~l ... ,1 S~ '-LJ l`_' ~O G ._ r. .C' •n In Witness Whereof, the Grantors have hereunto set their hands and seals, or if a corporation, it has caused these presents to be signed by its proper corporate officers and its corporate seal to be affixed hereto, the day and year first above written. Signed, Sealed and Delivered in the presence of or Attesfed by ~ r--- Michael 3. Frey Commonwealth of Pennsylvania, County of Llii~lf~e~/rva~--. }ss: Be It Remembered, that on /~py~~,e / ~p~ before me the subscriber personally appeared Michael J. Frey known to me (ar satisfactorily proven) to be the person whose name is subscribed to the within deed and acknowledged that he executed the same for the purposes therein contained. Witness my hand and seal the day and year ~Q Camp Hill BorogCtimber~land Cfounry My Commission Expires Oct. f 7, 2005 Member, Pennsylvania Association of Notaries BOOK ~66 PAGt ~']'~ ~__ Michael J. Frey TO Sylvan L. Rudy Margaret A. McKee Dated ~ ~~ ~ "~' ~ ______ The Undersigned certifies that the precise residence and complete post office address of the Grantee is: 454 High Street West Fa' 'ew, A 17025 ~~ C!i"~~'y f?~~s fo tie recorded ~~, ~'_i,~;v~~~l~',ld County PA ~. ,q ~ A. sox ass Fa~~ ~7~ TaxDB Result Details Page 1 of 1 Detailed Results for Parce145-16-1049-034A in the 2004 Tax Assessment Database DistrictNo 45 Parcel ID 45-16-1049-034A MapSuftix HouseNo 454 Direction Street HIGH STREET Ownerl RUDY, SYLVAN C/O & MARGARET A MCKEE PropType RT PropDesc LivArea 720 CurLandVal 29620 CurImpVal 4290 CurTotVal 33910 CurPrefVal Acreage .18 C1GrnStat TaxEx 1 SaleAmt 29999 SaleMo 11 SaleDa 03 SaleCe 20 SaleYr 04 DeedBlcPage 00266-00369 YearBlt 1974 HF File Date 02/24/2005 HF_Approval_Status A httn~//taxdh.ccna.net/details.asn?id=45-16-1049-034A&dbselect=l 10/2/2009 ~~ ~~ n~ {L,,F. ~~~~ ~`t i ';. ~~ ~~ ,TMl~ ~ j ~ ~t5s~ .o ~ i ~ 4 '~~ ._ .. ^, _ W O ti- p O ~ ~ P u C ~ a ~~ ~~ O w U ~ ~ ~ ~} ~ cn ~ T .~ ~ C'~ G ~ 3~ ~x ° ~ ~~ v ~ ~. ©Y o ~ -p TS ~Q a4 ~~ w c c-Cd ~ o ~, ~ ~ of 9 v N A ss ~~U ~, ~ VVO 0 -- ~.--= .~y ~~ :-r ~.~ ~;,,. ~.. r•+°' z 0 z w r Q