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Home My WebLink About03-1033Register of Wills of Cumberland County, Pennsylvania PETITION FOR GRANT OF LETTERS Estate of "~ M.~.rjle E. Hoffman Lack~ove also known as' M~j~le E. Lackhove;~Myrle H. Lackhove Myrle El-~z.,~m Hoffman Lackhove , Deceased Petitioner(s), who is/are 18 years of age or older, apply(les) for: - 0 3-103 3 Social Security No. 204-01-2727 (COMPLETE 'a' or 'B' BELOW:) A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the execut r ix the Decedent, dated 09/01/1989 and codicil(s) dated named in the last Will of State relevant circumstances, e.g., renunciation, death of executor, etc. Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incompetent: B. Grant of Letters of Administration (c.t.a.; d.b.n.c.ta; pendente lite; durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: I Name Relationship (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland Residence County, Pennsylvania with his/her last family or principal residence at 45 South 18th Street, Decedent, then 92 years of age, died 11/28/2003 Decedent 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 Borough of Camp Hill, Camp Hill, PA 17011 (list street, number, and municipality) at Holy Spirit Hospital, Camp Hill, PA (Location) $ 49,500.00 $ $ $ 70,000.00 situated as follows: 45 South 18th Street, Camp Hill, PA 17011 Wherefore, Petitioner(s) respecffully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: Si~lnature Typed or printed name and residence I Prepared by the Pennsylvania Dar Association Copyright (c) 1996 form software only CPSystems, Inc. Form RW-1 (1991) Oath of Personal Representative Commonwealth of Pennsylvania County of Cumberland 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 representative(s) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed before this { me ~ day of bL-c. BIo. Marjorie J. Ensminger, formerly Marjorie J. White Senft Estate of Myrle E. Hoffman Lackhove Deceased Social Security No: 204-01-2727 Date of Death: 11/28/2003 AND NOW, i ~ T'jJr b~Co ~ ,~, __, in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters ~ Testamentary r--J of Administration (c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; durante minoritate) are hereby granted to Marjorie J. Ensmin~er, formerly Marjorie J. White Senft in the above estate and that the instrument(s) dated 09/01/1989 Short Certificate(s) ..... $ Renunciation ........ $ Affidavits ( ) .... $ Extra Pages ( ) .... Codicil ........... JCP Fee .......... $ Inventory .......... $ described in the Petition be admitted to probate and filed of record as the last Will of Decedent. Letters Z/.~L. 0 0 400 I.D. No: 86556 Address: One West Main Street Shiremanstown, PA 17011 Telephone: 717/737-8761 tO Other ........... $ TOTA, ......... $ 7-q Z. 072 Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, Inc. Form RW-1 (1991) Register of Wills of Cumberland County, Pennsylvania OATH OF SUBSCRIBING WITNESS Estate of also known as Myrle E. Hoffman Lackhove Mryle E. Lackhove; Myrle H. Lackhove Myrle Elizabeth Hoffman Lackhove , Deceased No. ,,~l Marie A. Zei~ler Leon R. Zei~ler (each) a subscribing witness to the ['~ codicil(s) ~'] will(s) presented herewith, (each) being duly qualified according to law depose(s) and say(s) that she/he/they was/were present and saw the above Testator(rix) sign the same and that she/he/they signed as a witness at the request of Testator(rix) in his/her/their presence and ['~ in the presence of each other [] in the presence of the other subscribing witness(es). (Signature) Marie A. 2~gl~'r 41 South 18th Street Camp Hill, PA 17011 (Address) (Signature) Leon R. Zeigle~-~ 0 41 South 18th Street Camp Hill, PA 17011 (Address) Sworn to or affirmed and subscribed before me this il+/'~,-- day off'et'em JgJit2 Notary Public My Commission Expires: (signature and seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's commission.) J" NOTARIAL SEAL "~ BONm(L, WILLIAMS, NOTARY PUBLI~ / SHIREMANSTOWN BORO., CUMBERLAND CO.J MY COMMISSION EXP!RES APRIL ]8, 20051 NOTE: To be taken by officer authorized to administer oaths. Please have present the original or copy of instrument(s) at time of notarization. Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, Inc. Form #RW-2 (1991) his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Viral Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 P 9810821 No. " Loca Registrar Date ,)5.143 Rev. 2~87 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH NAME OF DECEDENT (First, Middle, Last) STATE FILE NUM~:R SEX SOC,A. SECUR,~ .OMBE. AGE(Laic~ay) UN RIY D R AY DAT~OFR'--- ' ~v~ze h. zu4 - O1 --2727 ~ . RESIDENCE dec~en~ ~ ~er s~e) 17b. Coum~l~ I~e ~ a FATHER'S N~E (Fkst. ~le, Last) ~8. John Hoffman ,0,. iorie Ensmin~er ----7DATE OF D,S,OS,T,ON Donatio~ [] Burial ~ Cremation g~ .... ' from Sh~te [] 2t,,. o,~ -E]12~.. 12-3-03 SIGNATURE OF 22a. ~.S SUCH 17d. [] NO, decedent lived ~ic ~ ,nd,s ~ Camp Hill MOTHER'S NAME (First, Middle, Maiden Surname) ...._ city/txxo Kathryn Rudloff ~2,.Myers-Harner FH, 1903 Mkt St. CH, PA 17011 ,e time, date and place s{aled. {Month, Day, Year) --~1 DATE OF INJURY ] T ME OF INJURY (Monlh, Oay. Year} I ~o.. 13Ob. M. [ PLACE OF INJURY - At home, farm skeet faclory, o~ca 13oo. ' ~ oE ~l~e~Y I ~NtGo r HmYv %'nCo wl~le~ uF~ Y s~.. ,n~. ~ _~_..i_ng_ ~ca~ .s~ ~ .d~?h whog._a~. ?th9t Physician has pr.on ..... d death and completed item 2a) E OF, 'PRONOUNCING AND CERTIFYING PHYSICIAN (Physician both p~'ono~ncing death a~d cerS¥~g lo cause of death) LICENSE NUMBER ~ -- v I(Momh, Day, Year) EXAMINER/CORONER? J26. Yes [] PART 8:Olher signi~cant conditions c~lbibuticg to death, but no( resul~ng in the underlyicg cause given in PART I. 30c. /30d' ___~f.LOCATION (Slreet, City/Town, State) (iN~leME._A.ND ADDR~[~SS OF PERSON WHO COMPLETED CAUSE OF DEATH m zt) Type or Pnnt -- ... - .. DATE FILED (Month, DaS. Year~j~ ._Sequen~lly list conditkms b. /f an)', leading to ~iale ~ DUE TO (OR AS A CONSE~ENCE OF): ~u~. E~ UNDERLYING [ CAUSE (D~ea~ ~ ~ ~ c. , J ~nt ~ P~ding Invesliga,~ ~~INE~CORONER 31am~r aa a~t~ ...................................................... :.. time, date. and place, and due to lhe cau~a(~} and ============================ ................................................... WhO Pr°~X)Unces death. ~as! ttlill a~ ~eslamen! ~l~ ~! lm~ l~r~by, That ....... L.6 .... ..L..L..z....qj.~..~...~ff. ................ ~..!.~.. ....... /:l..~:./LO......~c of the City or Town of.......~..]..?...O./. ................. ./....~.....L....r ................................................................................... in the County of f ' ~ " ~ State ............... p ................. ) ................ ...~.a.~..z~..~.!..¢...----...t~...t~.z~...,....c:~....~. ......... and of -.~.~-~-. being of sound and disposing mind and memory, do hereby voluntarily make, publish and declare this to be my LAST WILL AND TESTAMENT, hereby revoking any and all other WILLS heretofore made by me at any time. · nrc o , d IA/ ,~ .5~ I hereby nominate and aprmnt..~ ........ .4.....~....~ ..................................................................... [. ........................................ (Name) of.~[.O.~..~..~.~:.'~.t,.,...~.~..~.~.~:.~ g~- / $ ~ ~ 2 to be the Executor of this, my LAST WILL. (Address) It is my desire and order that the above-named Executor be allowed to act.~.E[~.q...~..~ .................... bond. (With or Without) After the payment of my just debts, funeral charges and expenses of administration, I dispose of my estate as follows: . ~ ~ . / / ~ .... '~ ~tt mit~ss tull~r~af, x hereunto subscribe my name and affix my seal this....~.-.-/ff ~ ~'' ' of -~ ~ ~'~ 7" ~-/~....~......l~......~.. ............ in the year one thousand nine hundred and--.-/--?,----~---?-- ........................... day ............................ '('ii';;;;ci; )", ,, c~..,~? /.~..c~..~ ........................... , .................................. .~:-: ........ ~--?---!-~ ............ ............................. . ¢ X The above-named !;..~.~.-tl: ............... : .............. Last Will and Testament, and has requested us to subscribe our names hereto as witnesses. We believe said Testator to be of sufficiently sound mind to make a Will. In our presence, on the date and at the place hereof, said Testator has signed, sealed, published and declared, and ~'e, in said Tcstator's presence, and in the presence of each other, subscribe our names as witnesses. Providence Publishing Company Keene. New Hampshire Copyright. 1950 "PROVIDENCE WILL FORM" (Trade Mark) CERTIFICATION OF NOTICE UNDER RULE 5.6 (a) Name of Decedent: Myrle E. Hoffman Lackhove Date of Death: November 28, 2003 Will No. 21-03-1033 Admin. No. To the Register: I certify that notice of 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 December 17, 2003: Name Address Marjorie J. Ensminger Paul Hoffman Dorothy Hoffman Wilda Bryne 3148 D Linda Lane Allentown, PA 18103 R.D.#1, Box 268 Liverpool, PA 17045 R.D.#1, Box 268 Liverpool, PA 17045 265 Malcolm Avenue Garfield, NJ 07026 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: Date: None Capacity: Jennifer B. ~i~p, Esquire One We~t Main Street Shiremanstown, PA 17011 (717) 737-8761 Personal Representative X Counsel for Personal Representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 003602 HIPP JENNIFER B. ESQ. ONE WEST MAIN STREET SHIREMANSTOWN, PA 17011 ........ fold ESTATE INFORMATION: SSN: 204-01-2727 FILE NUMBER: 2103- 1033 DECEDENT NAME: LACKHOVE MYRLE E HOFFMAI' DATE OF PAYMENT: 02/26/2004 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 1 1/28/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $16,622.73 ~: RiEMARKS: TOTAL AMOUNT PAID: MARJORIE J ENSMINGER $16,622.73 SEAL CHECK# 1011 INITIALS: AC RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS Register of Wills of CUMBERLAND INVENTORY County, Pennsylvania Estate of Myrle Elizabeth Lackhove also known as , Deceased No. 21-03-1033 Date of Death 11/28/2003 Social Security No. 204-01-2727 Marjorie J. Ensmin~er, Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this Inventory. I/We verify that the statements made in this Inventory are true and correct, lANe understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Name of Attorney: I.D. No.: Jennifer B. Hipp Esquire 86556 Address: One West Main Street Shiremanstown, PA 17011 Telephone: 717/737-8761 Personal Representative Signature: Signature: ~y J. ~n~ing~' Address: 3148 D Linda Lane Allentown, PA 18103 Telephone: 610/798- 9326 Dated: Description (See continuation page(s) attached) Value (Attach additional sheets if necessary) Total: 143,166.13 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventory. Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, ~nc. Form #RW-7 (199;)) Estate of: Date of Death: County: INVENTORY Myrle Elizabeth Lackhove 11/28/2003 Cumberland CASH: Contents of home and personal property ~ Sold at private sale Contents of home and personal property - Sold at public sale Donegal Insurance Companies Refund of homeowners insurance policy M&T Bank - Savings account number 015004206014702; date of death balance $10,474.97, accrued interest $0.20 Verizon - Refund of account Waypoint Bank - Checking Account No. 1005002315; date of death balance $21,535.89, accrued interest $5.19 Waypoint Bank - Checking Account No. 400002099; date of death balance $2,830.14, accrued interest $0.02 Waypoint Bank - Certificate of Deposit, beneficiary listed as Marjorie J. Ensminger; date of death balance $12,000.00, accrued interest $8.43 210.00 36,027.00 70.00 10,475.17 0.08 21,541.08 2,830.16 12,008.43 Waypoint Bank - Certificate of Deposit, beneficiary listed as Leon Zeigler and Marie Zeigler; date of death balance $5,000.00, accrued interest $4.21 REAL ESTATE/PA: Sale of real estate - Ail that certain piece or parcel of real estate having erected thereon a dewlling house being known and numbered as 45 South 18th Street, Camp Hill, Pennsylvania. The property was acquired by Robert N. Lackhove and Myrle E. Lackhove, husband and wife, by Deed dated April 30, 1956 and recorded April 30, 1956 in the Cumberland County Recorder of Deeds Office, a copy of said deed being attached hereto and incorporated herein. The said Robert N. Lackhove died April 10, 1985, whereupon full and complete title to the within described property became vested solely in Myrle E. Lackhove, the Decedent herein. The above-described real estate was sold pursuant to an Agreement of Sale for Real Estate dated February 11, 2004, a copy of which is attached hereto and incorporated herein. Final settlement took place on March 30, 2004. A copy of the deed conveying said real 5,004.21 55,O00.00 88,166.13 -2- estate, along with a copy of the Settlement Sheet, are attached hereto and incorporated herein. The sale price of the real estate was 55,000.00. 55,000.00 TOTAL RECEIPTS OF PRINCIPAL ............... 143,166.13 -3- REV-1500 EX +{6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. Z80601 HARRISBURG, PA 171Z8-0601 REV-1500 INHERITANCE TAX RETUR RESIDENT DECEDENT D E C E D E N T CAPB HpRL EpIO AC "'ES C O R R E S R E C A P I T U L A T I O N C O M T I 0 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Lackhove Myrle Elizabeth OFFICIAL USE ONLY FILE NUMBER 21-03 -1033 COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER 204-01-2727 DATE OF DEATH (MM-DD-YEAR) I DATE OF BI RTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPUCATE WITH THE 11/28/2003 J 09/24/1911 REGISTER OF WILLS (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER 1. Original Return ~ 247! Supplemental Return 4. Limited Estate . Future interest Compromise (date of death after 1Z- 1Z-8Z) 6. Decedent Died Testate Decedent Maintained a Living Trust (Attach copy of Will) (Attach copy of Trust) J J 9. Litigation Proceeds Received J J 10. Spousal Poverty Credit (date of death between 1Z-31-91 and 1-1-95) (date of death 3. Remainder Return priorto 12-13-8,') 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes Election to tax under Sec. 9113(A) (Attach Sch O) NAME Jennifer B. ~tipp Esquire FIRM NAME (if Applicable) TELEPHONE NUMBER 717/737- 876~, COMPLETEMNLINGAODRESS One West Main Street Shiremanstown, PA 17011 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or (3) Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) ~ Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 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) 12. Net Value of Estate (Line 8 minus Line 11) 13. 14. 55,00Q~0D l~one None None 83,161.92 None 5,004.21 31,362.21 None OFFICIAL USE ONLY (8) 143,166.13 (11) 31,362.21 (12) 111,803.92 Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13), made (Schedule J) Net Value Subject to Tax (Line 12 minus Line 13) (14) 111,803.92 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(aX1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate X .0 0 ilS) 0.00 0.00 x .0 45 (16) 0.00 X .12 (17) 0.00 111,803.92 X .15 (18) 16,770.59 19. Tax Due (19) 16,770.59 '~""*Copyright (c) Z000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. e-00) Decedent's Complete Address: STRP_P_, ADDRESS 45 South 18th Street CITY STATE ZiP Camp Hill PA 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 16,622.73 838.53 (1) Total Credits ( A + B * C ) (2) 16,770.59 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to recluest a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (SA) B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (SB) 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; ......................... ~ ~ b. retain the right to designate who shall use the property transferred or its income; ........... c. retain a reversionary interest; or .................................... 4. 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? ................................ r'~ ~'] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............................................. ~l [] 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. 17,461.26 0.00 690.67 0.00 0.00 0.00 Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all Information of which preparer has any knowledge. SIGNATUREOFPERSONRESPONSIBLEFORFILINGRETURN Marjorie J. Ensminger, f/k/a Marjorie J. Whi~ Senft ~ - .('--') ~ '- 3148 D Linda Lane - 7- i- i6Y ......................... G - - SIGN~[rUR~FPREpARE~OTHE{B-T~ANREPRESEN~IVE Jennifer B Hipp Esau' t F. ~ · -- -lre DATE ~f~ / One West Main Street ................................................................. = ............... * ....................... , ............... "::.=,:::: .............. ~=~"~:~!~!~m~m~{!~!!~!~i~h~ii~i~{~i~i~[~i!i~!~i~ii[~ii~i~[[~[[~iii~i~iii~iii[~iiii[i[{!ifiii[[iiiiiii~ii!iiiii~[[i[iiiiiiii{~J!! For dates~:~ ~e'at~ ~ ~r ~ff~'; ~J~iY"i' i'~ ~a~i' ~f~'r'~' ]~ai~"il i~'9~ 'ihs ia~'~te' i~n~o~d' ~ ~e' ~e~' va~Ue' ~ transfers 'to' o~ for the Use of th~ sullying spouse is 3% [72 P.S. 9116 (al (1.1) (i)]. For dates of death on or after Janua~ 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the su~iving spouse is 0% [72 P.S. 9116 (al (1.1) (ii)]. The ~tute does not exempt a transfer to a sullying spouse from tax, and the statutou requiremenm for disclosure of assets and filing a ~x return am ~ill applicable even ~ the surviving spouse is the only beneficiau. For dates of dea~ on or after Ju~ 1, 2000: ~e tax rote imposed on the net value of ~ansfem from a deceased child ~en~-one years of age or younger at death to 0r for ~e use of a natural parent, an adoptive parem, or a ~epparent of the child is 0% [72 P.S. 9116 (al (1.2)]. ~e ~x rote imposed on ~e net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 9116(1.2) [72 P.S. 9116(a~1)]. The tax ~te imposed on the net value of ~an~ers to or for the use of the decedent's siblings is 12% [72 P.S. 9116(a~1.3)]. A sibling is defined, under Se~on 9102, as an individual who has at lea~ one parent in common with the decedem, whether by blood or adoption. Co~dght (c) ZOOO form so.are onN The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-OO) REV- 150Z EX * (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT OECEDENT ESTATE OF Myrle Elizabeth Lackhove SCHEDULE A REAL ESTATE SS# 204-01-2727 11/28/2003 FILENUMBER 21-03-1033 All real property 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 property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Sale of real estate - Ail that certain piece or parcel of real 55,000.00 estate having erected thereon a dewlling house being known and numbered as 45 South 18th Street, Camp Hill, Pennsylvania. The property was acquired by Robert N. Lackhove and Myrle E. Lackhove, husband and wife, by Deed dated April 30, 1956 ~nd recorded April 30, 1956 in the Cumberland County Recorder of Deeds Office, a copy of said deed being attached hereto and incorporated herein. The said Robert N. Lackhove died April 10, 1985, whereupon full and complete title to the within described property became vested solely in Myrle E. Lackhove, the Decedent herein. The above-described real estate was sold pursuant to an Agreement of Sale for Real Estate dated February 11, 2004, a copy of which is attached hereto and incorporated herein. Final settlement took place on March 30, 2004. A copy of the deed conveying said real estate, along with a copy of the Settlement Sheet, are attached hereto and incorporated herein. The sale price of the real estate was 55,000.00. TOTAL (Also enter on line 1, Recapitulation) $ 55,000.00 (If more space is needed, insert additional sheets of the same size) Co[oyHght (c) 1996 form software only CPSystems, Inc. Form REV-I$02 EX (Rev. 1-97) PAGE RECORO[R OF DE~OS PEHHgYLVANIk ' ~g~II. I~TH J. ~HIT~, A~is~ra~r~ of ~he Es~a~e of CATI. ffiI~E J. HO[.'~, laLe of ~he Bo~ugh of C~p ~, C~berland Co~Ly, Pmmsylv~ia, deceased, G~NTOR, ~r~y of Lhe firs~ par~, ~B~T N. ~C~OVE ~d M~ E. ~CKHO~, him of ~he ~ugh of C~p ~, Co~y of ~berland, and S~aLe of Pennsylva~a, G~, ~v~ies of ~he second ~, WI~KEAS, the said CATI~RINE J. HOFFMAN was seized of the hereinafter described real estate during her l~fetime and at the time of her death died intestate on the twenty-seventh day of October, 1955; and Wi~KEAS, on tile sixth day of March, 1956, the Register of Wills of Cumber- land County, Pennsylvania, granted Letters of Administration in the Estate of said Catherine J. Hoffman, deceased, to Ruth J. White; and WI~REAS., the said Ruth J. White filed her bond in the Office of the Register of Wills, aforesaid, said bond being in the sum of Twenty-two Thousand Dol- lars, ($221000); and . WHEREAS, tJ?~Orphans' Court of Cumberland County, Pennsylvania, on the 30 day of OO~.~ , 1955, approved the sale of said property without the filing of an adc~itional security by the Administratrix aforesaid; Tills CONVEYANCE is made under the authority of Section 5kl of the Fiduciaries Act of 19&9, P. L. 512. CAIWp HILL 8CJIOOL DISTRICT REAL f'S1AIE T~ANSF['R ]'AX /~mf. ~.-~{.~.~t)~ ~. I~t~1~ ~o 1956 ~- At,th I '' fi. fi, ~II~i~ ~l,,Se,,h,r~ ~lit.e~s~t[[, That fbe~said Ruth J. White. Administratrix. fear and in consideration of the s~m, o/' Eleven Thousand and No/lO0 (~i~ll, O00.O0)- - - Dollars, law[~,l ~[oney of the t/hired Stgtes, to her in band paid by tlte said ROBOT N. ~CK[IOVE and MY~ E. ~CKHO~, his ~fe~ ,,t and be/ore the ensealin~ and delivery thereof, the receipt whereof is hereby ac- ~'nowled~ed, has granted, bargained, zold, released and confir,'ted and by th,'sa ;'resents does grant, ba~afn, sell, alien, release and conflr,~ zen. to the said ROBOT N. ~CKIIOVE and MY~E E. ~gKID~, ~a ~fo,~heir ]tefra and [[ those two lot~ or pieces of greed situate in the ~rough of'g~p Hi~, gounty of Cumberland, and S~ate of Pe~sylvanla, bo~d~ ~d desc~b~ as follows; to ~t: B~INNING at a ~in~ on the east aide of South 18th S~reet, as laid do~ on the plan of lots laid out by David M~a for Jacob L. Heyd, said ~int being at line of Lot No. 71, as sho~ on said pl~; thence no~hwa~, along Sou[h 18th Street, forty (hO) feet to a ~int at ~e of ~t No. 7~ on said plan; thence along the ~ne of ~t No. 7~, one hundred forty-two (~2) feet to a twenty (20) foot ~.ey; thence along said a~ey sout~a~ fo~y (hO) feet to a ~ line of ~t No. 71; thence westward, ~ong the ~ne of ~t No. 71, one hundr~ ~d forty-two (~2) feet to ~uth 18th SLree[, the p~ce of B~INNING. HI~G ~ts n~bers 72 and 73 on said pl~. The said lo~ being ~prov~ by a two ato~ frame dwe~ng house ~o~ as No. &5 South 18th Street, g~p Pennsylvania. ~NG the a~e pre, sea w~h Irene B, Wolf~-s~gls wo~,'.by deed dat~ Febma~ ~, 19~,, and reco~ in tbs g~bor~nd go~7 Reco~er's Of~es ~ Deed ~ok "T", Vol. 12, Page 320, grant~ ~d aonv~ ~o 3o~ H. Hoff~ and gather~e j. Hoff- m~, his ~fe. Jo~ H. Hoffm~ ha~ng predoeeas~ his ~fe, tiLle became vest~ in Cather~e J. Hoffm~, decease. ~Iogetller with all and sin._~lar the wags, waters, walercotLrses, rights, libertie,% privilei~es, hereditaments, and appurtenances whatsoever thereunto helen_ginS or i., an~w~e appertaining, and the reversion and remainders, rents, i~sues and profits thereof; and all the estate, r~ght, title, interest, use, trtzst, propertF, possession, claim and de.rt, nd wh~[tsoever in l~[tv, eq~itff or otl~rtvise howsoever, of, i~r, to or ot~t of the sa.re. ~a ~a~ ~.~ t. ~al~ the said hereditan~ents and premises hereby granted and rele~ed, or .~entioned, and intended so to be, wit]~ the appt~rtenances, tento the said ROBERT N. ~CKIIOVE and MY~ E. ~CKHOVE, his wife, their heirs trnd ~.~.~i~ns, to ~nd for the ertl!/proper z68e ~nd behoof of the said lleirs or ~ssi~m~ forever. Nad tile stt, fd RUTti d. WHXTE, Adn~nia~ratrix~ does couent~n~, p;'onrise.and a~ree to ~nd WiM$ the 8aid ROBERT N. ~CKIIOVE and MY~] g. LACK~VE, his wife, their h~rs · tt, id A~ninist re, rix h~ s not done, com;nitted, or knowingly or willin4!ly suff'ered to be done, com- .,gtted ~ny act, ~,~tter or thin~ what3oeve~5 whereby the premises hereb!/ ~'ranted, or ~nff p~rg tl~reof, is, are sh~ll or ~na~ be impeached, cha~ed or incumbered, in title, cha~e, estat~ or otherwise howsoever. ~. ~ih,ee$ ~ll~reo{, the said RUTII J. WHITE, A~nistra~r~, has heret6nfo se~ her /land and seal , the Sa. it altd uear above lt'rillen.. i. tll~ prezenee of Administratr of the Es%ate of ~ ~[eu.t~ .[ CUMBERLAND ~se' On th, is, the .3~'~' dali of April .4. D. 19 56 , before me a Notary Public, the undersigned officer, personally o,ppeared RUTH J. WHITE, Administratrix, known to me, (or satisfactoril~ proven) to be the persor$ wlu~se name is sr. bscribed to the within instrument, and ~cknow~dged that she executed the sanre for the p~rposes t~rein contained. ~. ~ihtezz ~llereoL I herez~nto set tory hand a~ official seal. ~IOH~ DAVID ~LMO~g, ~ola~ Pub ~ ..... ~et All.n Twp., Gumbedand ~oun~ --~m~--l~- ~(zes Fcbrua~ I, 1957 TIMe of O~eer nd Post .~ce el ,ilhin Gran!ca i~ ~o Recorded on thL~ ~ ~9 da~j o/ ~// A. D. 19 ~ , in the Recorder's 0~ o[ said County in Deed Book ~'"~"'~ /7 , ~ ~ Given under ~n~ ha~ and seal o/ the said O~ice, the da~ above w~tt~. 31 ~]-[er~[,g ~fift~, thc&t the precise residence of the C~rantee Attorney for ................................................................................. AGRE~NT OF SALE FOR ~ ESTAT~ THZS AGP~NT is enZered inzo this ll~Cday of ,~4~ , 2~04 by and ' ~ ' =~ . - ~ , De.we,. Maricrie u. Ensminger, also known as Marjorie j White Senft, = =~ · _x ...... x under ~he Last Will and =es~=m_~ cf u~v~= = Hoffman Lackhcve also know?_, as Myr!e E!izabe~h H. Lackhove, Myr!e E. Lackhcve, and Myrle H. Lackhove, laze of 5he Borough of Camp =~, Cu_~ber!and CounzQ', Pennsylvania, c/o Je_-,-.ifer B. Hip_c, Ese_-:~= and James D. Bogar, Escci~e_ _ , cf One Wes-~ ..=,..u-~ Suree:, Skiremans:cwm_, Cu_Tberiand called "PURCF_%SER" AGREED AS FOLLOWS: ~ PREM_!SES. ~ee Seller agr_e_ zs s .... grant and convey Purchaser, and the Purchaser agrees 5o purchase and accep~ zke co..¥~v=nc_---=_-- = of -~...e fo!!owinc, descr~. '=~ -=~ eszaZe situate in the Borough of Ca_-...p Hill, C'=~ber!and County, Per=-.sylvania, described as follows: Being all than certain piece or parcel of real estate having thereon erected a dwelling house being known and n'a~-ioered as 45 South !8nh S=reez, Cm~p Hill, C'=mberland Counny, Pem_nsy!vania 17011, zhe deed rom which is attached hereto marked E~tibi5 "A", and inco_-?orated herein. Tax Parcel No. 01-22-0536-057 2. PURC.=S. SE PRICE. The Purchaser agrees to pay the s'=m of to the Seller as u~-= ~u~t purclnase c~ce and considera:ion for the_uremises, payable as fo~=lows: s_,= .....g of ~ s Agreement, receipt of which ~s ~. .... : acknowledged; and $ u.~.~ss ochers_se herein crovided -: se:-!ement of ~his 3. SET~r.=~=NT. Final se:t!ement cf :his :ransacnion ska!! be ma~ ce ='-' nke Law 0_,~_ces=-'~ of Jer_-.if-r: _.~ "'.-.zpp and James D. Bogar cr any other m~ .... =~!y a~-==d upon !ocaUion, and shall be made cr begot= ~-'=s~ai- '~ = ~ ........... e cf setU!emenu ~ ,, =-R-~_~ _.,~- 2~04, -- ~ '~- ~== Seller shall ~ender no the Purchaser a ~rcper!y drawT. ~%d execun=~ deed cf ~-~ ~' -- spe__=~ warranty, conveying zo ~he-Purchaser a cccd and markena' i '~'~ ~ irc, lo, s = = ~ === s _ clea_ of ali ~ ~- ~d encu_P2~ra.~.ces, except eas= = ~ '~ ,: i ~:-~ _r..-r.-s or ~u, ..... = and use rescricuicr_s visible on =he ground c~ c= prior record, -~-:= to be such as ,._~_, be insured by a repuZab!e title insurance company in the con--:~. :=--.s',;lvania_ geographical =~=--_a without exception or Should Seller be unable to deliver such title, Purchaser shall have the option cf either cancelling this Agreement cf Sale for Real =sta:e and receiving back any monies.Da~__ as a depcsit or acce~ting_ such t~=____ as Se!~=~___ can w_~,~ou~ offset, adjustment, or abauememt of the purchase price. Estate. 4. Time is of the essence o~ :his Agreement of Sale for Real TR_~N'SFER T.~XES .~ND APPORT!OK~_,_~ENT CF REAL ESTATE TA_XES. RENTS ~N~ ~ ' =_ EXPENSES. A=! realty transzer :axes shall be paid e~ca!!y by the Seller and Purchaser, with Purchaser-paying one percent (1%) and Seller paying one percenn !%). Current rea! e~:a~=_ ~ :axes, utility charges and any munic.~al service f~e-= = or ~n~s___ be .~rora~ed =-~ and to ~h_~ = da~e c= settlement. 5 POSSESSION Seller =~ ~=~ .... pc - " ........... ,~=_ soession of ~ne said Dremises ~o Purchaser at :he time c~ =~-=~ ==--~emenn. 6. CO~iT!ON OF PROPERTY A3~ RiSK OF LOSS. The Seller agrees %!.=% the proper~y shall remain ~- sub='-~-~!y i~s presen~ condition un,i! dane of sort!emend, and ~= ~ ~s not, the Purchaser may rescind this conzrac:. Seller =~=~ bear the risk cf ~css -~om =~= cr o-~=- ~=s_==nv '=c:i! 5ime cf =,tt!emen:. 7. DEFAULT. Should Purchaser defaul- ~- performing this zc~==m=-~ any s'~ or s'~.s maid on account c= +h_ purchase price, mv way cz co%~.-~a~.ent or otherwise, ¢~=~ be ~=~, =~-=~ sv ¢=~=~ =~-~=- on account cf h_ ourchase money, -~= balance of '-~=~ skal! be recoverabT= ~- an action cf ass'~Dsin, cr as !iqcida~ed damages, as Seller shall elect, and in ~ke ~=~=~ case this ..g_~_me,., shall become null and void. Should Seller default in perform, ing this Agreement, Purchaser shall have the right of having nkis Agreement declared nui~ and void and -'~=- havinc any s'~m or sums paid on acco~-.t of the_~urckase .~:--c=~, by. way_ cf do~-pa~ent or otherwise, returned in full. 8 CONTiNGENCiES ~ ~ - · =---~ Agreemen~ of Sale for Re~! is no~ subject ~o nor con~ingen~ upon the occurrenc~ or ~ ...... _, bu~ ' ..c~=occ,__e,=ce cf any event inc!udinc noz necessarily bezng _o,_~w,_.g: ~= c~%aininc cf financinc '"=-- ~ .... the (co .... ..~_ona!, =='~, VA or c.~herwise); issuance cf a cer-~='e indicating ~ha~ ~he .... crc~er~v is ~r_e = and clea_- cf te~.i~es and/orwocc- '-~c_~--,..= ~--ec~s,= · the issuance cf a certificate indica:inc ..... ~k=_ 'l._,-= =~c~=~._. ~__~y is ~== =--c' clear radon c =, issuance cf a cernifi -~ = ~ ~ _a-' ~ = c=~ ~dica~in.c ~k-5 -~= .... .oro~ermv_ . is _~_~=_=_ and clear o= ~==~-based pain=,, and a ..om_o~,.._~ = '-=~'s inspecuion. -=. SUR~Y. '= ~= ~ .... ~as=~-- should de~e~.ine ~= -==~' fo-- ~ = m~ = s -k_ cos= and e:~ense thereof a curren= survey cf ~h_ .-emi-e , ~ = _ Do .... exc!usive!v by the Purckaser. !0. STATUS OF c= ~ . __~__. AJ~ WATER Tkis proper~y is served by pu~= c sewer and water. .......... = ...................... s no notice cf sidewalk and curbing. 12. ZONING OR DEED PSSTRiCTi9N. Seller warrar. Ss tha~ =he ures=-t use of zke =rouerzv vio!azes no exis:ing zoning crdinance or regulation or deed restrictions. Fur5he_~more, Seller has no notice of any proposed zoning change or change in use cr restrictions. 13. ~c~mr / ~-~.~v _. ' ......... ON ~._L~N,.. r- is understood that Purchaser has insoected :he above ,.,e .... to property and ~s* ncz relying upon any representations made by c:~:=~ or by Seller's agent(s). Seller agrees to s~!! and Purchaser agrees to purchase :he above- described ~rooertv "as is" -h-_- being no warranties _xc~_.ssec cr i~o!ied, as 5o :ne conc:::on of :he proper:y. Fur:he_-mcre, Purchaser ex?ress!y represents that Purchaser has had ~r~le o~crZunitv__ _ to ins~ec-. . :he abcv=-~===r_~d~ ~=~ to ~roper~y and :o invest!ga:=_ and have answered by ~].i_=- ~ ~a--ies any ~aestions Purchase_~ has recardinc_ _ z]._~= _~ro~ertv_ _ and ~-= .cresent condition cf s~me and ~;-~ ='-~ : -,~= .... ~_~=oer has not, in entering this~._~cTM~enz cf Sale _=~-~_ Rea!~ E-tare= =c~=- ~_pz_d any statements or re:resenu=:ions made to Purchaser by Se!!=~ Seller and Purchaser - '- -~=~= -;-~ the =cx_.cw___=~ ~__=, residential real estate transf_-=- ccn:emp!a:ed 'herein is excepted under the' Rea! Estate Seller Disclosure Law ~: ~: · . .~-. _ et. sec s~ch, Seller will nc: be cor~!e:ing a Seller's Property Disclosure Statement. This :rovision shall survive settlement. 14. PERSONALTY. The following specifically en~:merated items of personalty or personal property a-e included in the within sa!e: 15. EROKERS .~_N,-D AGLxTTS. Seller and Purchaser both re_~resen~ that they have dealt '~ ~'~ no real . w,~,, estate brokers or agents _,_~:- connecuion with this sale and that no brokers or rea! estate agen%'s com~,.issi0n is due any person on accoun~ cf this sale. Each 'par5y shall inde.?r, ify and hold harmless the c~:.-.er party from ~r.,e c,__:L~ cr demand of any b_vk,_ agent for any co~.,ission w.;=~_, any such broker cr =c may claim to De due ~m cr :-=~ -- a resul- ~= -~: ~_ ,,,_s sale. For .:b_e oerformance cf 5his Acreement and _____1 =c=: Iv_ bound hereby,_ ".',_~-= .~arties bLnd t'-=m=elves.._._ , ~:'.=L_ =-' ~=, ~persona! ~=~===.-.~=:ives,. successors and assi=r.-,~ = =_--~ wi She--== hands and seals -h_, = day. and y_a_~= ~ firs~ above wry__=_.. Wi~ESS: ~rchaser Bormze F. 7~cKee (SFAL) C~+~UCE11 ItUTtI J. WHITE, A~m!~is~ratrLx of the Estate of CATIi21iNE J. l{Oi"~u~, late of the Borough of Camp }[i3_!, Cumberland County, Pe:msylvania, deceased, G~TOR, party of the flrsb par~, AND ROBF. ET N. L&C~THOVE and Mi~Ri~E E. LACI~HO~, his w~._~e] of the Borough of Camp HiZ1, County of Cu:~berland, and State of Pennsylvan/a, GF~T~, parties of the second Wt~) ~?~'~, the said CATI{EF. iNE J. I{OFF~.[AN was seized of the hereina£her described real estate during her ~ ~ ~-- ~.e ..... and at the ~ime of her death died intestate On the "" m ~ 0~'. .~enty-oev~n.h da)' of October, !,~, and ~.';}~i~D~S, on ~i~e sixth day of Mar:h, 1956, the Register of Wills of Cum~oer- land County, Pennsylvania, granted Letters of Administration in ti:e Estate of sa!d Catherine j. Hoffman, deceased, to Ruth J. Whi~ej and .ILEa.~,o, the said Ru~h J. White fi!_~d her bond in the Office of the Register of ';~._~s ~ ~ , aforesaid~ said bond being in ~he suun of ~enty-bwo Thousand Do!- !ars~ ($22,000); and · ;'~ilEi~EAS~ the 0rph~ns' Court of C~ber!and Co~t7~ Pennsylvania, on the 3~ .... d~y o~ ~ , !955, approved the sale of said oroue~'~ ~houb the fi~ng of an adci~ionai security by the A~r&uis~ratr~ aforesaidl Tills CONVEi'^NCE is made under the authority of Section 5iJk of the Fiduciaries Act of 19&9, P. L. 512. Fuchib it "A" Ruth J. Wb_ite, Administratrix, /;,' an.d, in, von, side~'~r~ion, o/ tA~ s~m, o/' Eleven Thousand and No/lO0 (ji!,O00.O0)_ - - /)oZg~-s, ~a.w/~j n~oneV o~ ~Ae [~:te~ St~es, to her ~ hand pnfd b~ th~ said t[O~T N. L~CKHOVE and M~ E. ~C',{HOVE, ~ ~fe~ ..~ c~d beTo~'e tAe en.,s'et~lin.~ ~n.d de~iverU ther~o/~ lhe ~'eceQ~ wh.e~'eo~ is. h. er~hy ~mou:l~d~ed. ~ ?on,ed, ba~.ffained' sold,, rege~.ved and confir.med and by //~'sa 7'~'e.~enL, does fi,ant, barff~in, .*ell, ah;eh, release and confirn~ u,n. to the saz'd RO~T~ N. LXCKilOVE and MYP~E E. L~CKiD~, ~ ~-fe,their life,rs ~;nd .~xaiffnS, [i those two lots or pieces of gro~d situate in the Borough of C~p Hi~, Co~ty of Cumberland, and SLate of Pe~sy!vania, bo~d~ ~d desc:~bed as fo!lows; ~o ~_t: BEGiNNiNG a~ a point on the east side of South iSth Street, as !aid down on the plan of lots ~ ~ · ~a_d out by David Mumma for Jacob L. Heyd, said point being at line of Lot No. 7!, as sho~ on said p!~; thence no~hwa~!y, ~ong South iSth forty (~0) fee~ to a po~ a~ ~e of ~t No. 7~ on said plan; thence eastward, ~ong %he ~ne of ~ No. 7K, one hundred forty-&wo (~2) feet to a ~wenty (20)' foot ~.ey; thence along said a~ey sout~wa~!y fo~y (AO) feet to a ~t hne of ~ No. 7!; thence wes-w=~,, a!on~ ~he ~ne of ~t No. 7!, one hundr~ ~d for~7-~wo ~2) fee~ to South 18~h S~r~e~ the p~ce of ~iNNiNG. -~,O ~ts n~mbers 72 and 73 on said 9i=. The said lots being Lmpr~ved by a ;we s~c~, f?-ne dwe~ing house know~ as No. K5 South iSth Sgrget, Camo Pennsylvania ..... ?-%~l'!G the =~u~e .Drem~$e~ whi=h irene B. Wo~_, · . '" 's~n~_. wcman,.bv deed dated Feb~a~y ~, !9M~, and 5~o~ ~n.the C'~ber~nd Co~ty Recorder's O~nce in Deed ~ok "~,. Vol. 12, Page Dzu, granted ~d :onvey~ ~uto Jo~ H. Hoff~n and Ca~her~ue J Hoff] ~-. Jo~ H. Hoffm~ ha~_ng predeceased ~s ~_fe, t:~ became vest~ in Ca~her~ne J. Hof.~u~ decease. ' ~dl}cr wit/~ t~ZL t~td ~in. gtda. r ~he w~ys, w~ers, wafercot~rses, right& Liberties, privileges, h,eredit~e~t.% and ~pp~,~tenance~ wk~tsoever thereun, to belon ~i, ~ or in a~ywise ~ppert~,it~in~, ~d tl~ reversio~ ~*d remabtde~s, rents, isau. es a;~d ~irofl'ls t]$ereof ; ~cti ~gl tl~e est~ge, t'(~l~t, title, i~terest, ~se, trt~t, propert~, 7)ossessiu~z. c~tzim end de,[t~t~d tvh.t~tsoever b~ gt,w, eq~i~ or otl~rtaise l~otvsoever, off, i~, to ur ott. t o~ th.e $ttm. e. released, or n,entioned, a~d intended so to be, w~th, th.e ~pptbrtena~zt:es, t,~t~o the IO[IEICi' N. DICKItOVE ~d M~ E. ~CKiIOVE, his wife, their heirs RUTtt d. WHITE, l~istratrix, does cocem:~c~, p,'oncL~e ~n.d ~ree ~o a~g wL~:2 U~e I{ODE:[T N. ~CKHOVE and MY~.] E. LACKHOVE, ~s wife, their heirs I,.~* $ not done, committed, or/c~wwin~Ly or wiLiin~tg s~,ff~red to be done, cu.,- mit~ect ~ny ~ct, z~,~tter or t;~ tci~gsoever, zch.ereb~ Ute pr'emi,es h. er.eb~d ~'r~ed. or a~g par~ il~reofi, ~, ~re sl~g~ or m~ be in,penciled, ch.a~ed or incumbered, i~t title, c/~r~e, esgage or otJtertc~e Aowsoever. ~Jtt ,~-~iht,5~ *~IIl!=r:~£, t;~e said RUTH J. WttiTE, AdmLnistratr-'_x, h, erct~.to se¢ her h.a~zd, a~zd, seal , the du~./ tr.n.d l./e~' Catherine J [' ,~o£Zrz_n, deceased On i.h.~, the .~gq~L,. dug o/ Apri2 ~. D. 19 56 , be/ore a Nota~ Pubic, the u,~ders~n, ed o~ce% uppertre~ RUTH J. WHITE, A~stratr~, aclc:zotc~e~ed t/~a~ si~e e.~ecgted tAe sgn~e for ~Ae p~rposes tl~reig contai~zed. ~,, ~ih,e~s ~llere~5 f h.erez~nto set 'W hand and o~ci~g seal JO}IN DAVID T~MORE. Nota~ ?ubllo ~wer Allen Twp.. Camb~rland Coua~ Tl~e of Officer // A. D. 19 ~d , in tile R. ecorder's O.t~ce of said Count~ in Deed Book ~' (;ivm~ ~ndor thy h~md and scnl of the said O~ce, th.e day above whttem .~1 ~reh~ ~erfih:, thcd tthe precise residence of t.h.e C~ra.n.~,ee ~tmrney [ar Tax Parcel No. 01-22-0536-057 THIS DEED, )/lADE THE BETWEEN >" :' day of March in the year two thousand four (2004) MARJORIE J. ENSMINGER, also known as MARJORIE J. WHITE SENFT, Executrix of the Last Will and Testa- ment of MYRLE E. HOFFMAN LACKHOVE, also known as MYRLE ELIZABETH H. LACKHOVE, MYRLE E. LACKHOVE and MYRLE H. LAC~qOVE, late of the Borough of Camp Hill, Cumberland County, Pennsylvania, party of the first part, and ROBERT L. EGE and SUSAN A. EGE, husband and wife, of Carlisle, Cumberland County, Pennsylvania, as to a divided one-half (1/2) interest, and LEONARD R. MCKEE and BONNIE F. MCKEE, husband and wife, of Carlisle, Cumberland County, Pennsylvania, as to a divided one-half (1/2) interest, with the relationship of the two separate one-half (1/2) interests being that of tenants in common, parties of the second part: W~EREAS, the said Myrle E. Hoffman Lackhove, also known as Myrle Elizabeth H. Lackhove, Myrle E. Lackhove and Myrle H. Lackhove, by her Last Will and Testament, duly proved and recorded in the Cumberland County Register of Wills Office, Pennsylvania, in Docket Book 21-03-1033, Letters Testamentary being issued on December 16, 2003, provided, in pertinent part, as follows: I hereby nominate and appoint MARJORIE J. WHITE SENFT of 4065 4~ Street, Emmaus, PA 18049 to be the Executor of this my LAST WILL. ' NOW T~I$ INDEAFfUR~ WITNF~SSET~, that the said party of the first part, by virtue of the power and authority aforesaid, in said Will contained, and in consideration of the sum of Fifty Five Thousand Dollars ($55,000.00) to her paid by the said parties of the second part, at and before the ensealing and delivery of these presents, the receipt whereof is hereby acknowledged, has granted, bargained, sold and conveyed, and does hereby grant, bargain, sell and convey to the said parties of the second part, their heirs and assigns forever: ALL THOSE TWO CERTAIN pieces or parcels of land situate in the Borough of Camp Hill, Cumberland County, Pennsylvania, being more fully bounded, limited and described as follows, to wit: BEGINNING at a point on the east side of South 18~h Street, as laid down on the plan of lots laid out by David Mumma for Jacob L. Heyd, said point being at line of Lot No. 71, as shown on said plan; thence northwardly, along South 18=h Street, forty (40) feet to a point at line of Lot No. 74 on said plan; thence eastwardly, along the line of Lot No. 74, one hundred forty-two (142) feet to a twenty (20) foot alley; thence along said alley southwardly forty (40) feet to a point at line of Lot No. 71; thence westwardly, along the line of Lot No. 71, one hundred and forty-two (142) feet to South !8~n Street, the place of BEGIN- NING. BEING Lots numbers 72 and 73 on said plan. The said lots being improved by a two-story frame dwelling house known as No. 45 South 18=n Street, Camp Hill, Pennsylvania. BEING the same premises which Ruth J. White, Administratrix of the Estate of Catherine J. Hoffman, by deed dated April 30, 1956, and recorded April 30, 1956 in the Cumberland County Recorder's Office in Deed Book "D", Vol. 17, Page 38, granted and conveyed unto Robert N. Lackhove and Myrle E. Lackhove, husband and wife. The said Robert N. Lackhove died April 10, 1985, whereupon full and complete title to the within described prop- erty became vested solely in Myrle E. Lackhove, surviving spouse. The said Myrle E. Lackhove died November 28, 2003. TOGETHER with all and singular the rights, liberties, privileges, hereditaments and appurtenances whatsoever thereunto belonging or in anywise appertaining, and the reversions and remainders, rents, issues and profits thereof, and all the estate, right, title, interest, property, claim and demand whatsoever of the said Myrle E. Lackhove at and immediately before the time of her decease in law or equity or otherwise howsoever, of, in, to or out of the same: TO HAVE AND TO HOLD the said granted premised to the said parties of the second part, their heirs and assigns forever. AND the said party of the first part, does covenant, promise, grant and agree, to and with the said parties of the second part, their heirs and assigns, by these presents, that the said party of the first part, has not done, committed, or knowingly or willingly suffered to be done, any act, matter or thing whatso- ever, whereby the premises aforesaid, or any part thereof, is are, shall or may be charged or encumbered, in title, charge or estate, or otherwise howsoever. IN WITNESS WHEREOF, the said party of the first part has hereunto set his hand and seal the day and year above written. Signed, Sealed and Delivered ~ ! Cedi ~y this to be recorded "rix Cumberland County PA '"~"' Recorder of Deeds ~~:''d' -/~ *~' ( SEAL ) M~JORIE J. ENSMINGER, also kno~_ as ~&RJOR/E J. ~ITE SENFT, Executrix of the Estate of ~yr!e E. Lackhove ,-+..!1 CO~24-ONWEALTH OF PENNSYLVANIA : : COUNTY OF : ,'l!,k'~.~ ~<~', :~'! : SS On this, the ~<~'.- day of i~!,~.~ ~.i , 2004, before me, the undersigned officer, personally appeared MARJORIE J. ENSMINGER, also known as MARJORIE J. WHITE SENFT, Executrix of the Estate of Myrle E. Lackhove, known to me (or sakisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledge that she executed the same for the purposes therein contained. seal. IN WITNESS WHEREOF, I hereunto set my hand and Notary Public My Co~zsszon Expzres ~HIRE~AN~N BORO., CUMB~D L~ COMMISSION ~PIRES A~IL IS, 2005~ I do hereby certify that the precise residence and complete post office address of the within named grantees is / ~en~fez ~./~±~p, Es~ire Attorney for Grantees C0~2~-0NW~EA-LTH OF PENNSYLVANIA : COUNTY OF CUMBERLAND : SS. RECORDED on this day of , 2004, in the Recorder's Office of the said County, in Deed Book , page Given under my hand and the seal of the said office, the date above written. , Recorder. A. B. TYPE OF LOAN: U.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT 1.E]FHA 2.E]FmHA 3. E]coNv. UNINS. 4. E]VA 5. E]CONV. INS. 6. FILE NUMBER: I 7. LOAN NUMBER: SE'I-FLEMENT STATEMENT 3689-1 I 8. MORTGAGE INS CASE NUMBER: C. NOTE: Tlris form is furnished to give you a statement of actual settlement costa. Amounts paid to and by the settlement agent are shown. Items marked '[POC]' were paid outside the closing; they are shown here for informational purposes and are not included in the totals. i o 3/98 {EGE, R PFDF3689.1/14~ D. NAME AND ADDRESS OF BUYER: E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER: Robed L. Ege, Susan A Ege Leooard R. McKee, Bormie E McKee Eslale of Myrle E. Hoflman Lackhove 43 Harmony Hati Drive c/o Marjorie J. Ensminger, Executrix Carlisle, PA 17013 3148 D Linda Lane Allenlown, PA 18103 G. PROPERTY LOCATION: H. SETTLEMENT AGENT: 23-2048775 L SETTLEMENT DATE: 45 South 18Ih Sheel James D. Bogar Law Otfices PA2150 Camp Hill, PA t7011 March 30, 2004 PLACE OF SETTLEMENT One W~est Main St, Shiremanslown, PA 17011 J. SUMMARY OF BUYER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION 100. GROSS AMOUNT DUE FROM BUYER: 400. GROSS AMOUNT DUE TO SELLER: 101. Contracl Sales Price 55,000.00 401. Contract Sales Price ~ 55,000.00 ;102. Personal Properly 402. Personal Property 't03. Seltlemenl CharcJes Io Buyer (Line 1400) t,181.25 403. 104. 404. 105. 405. Ad/ustments For Items Paid By Seller in advance Adjustments For Items Paid By Seller in advance t06. County/Twp Taxes 03130/04 to 01/01/05 372.59 406. County/Twp Taxes 03/30/04 to 0t/01/05 372.59 107. School Taxes 03/30/04 lo 07/01/04 333.13 407. School Taxes 03/30~4 to 07/0t/04 333.1.' 108. Assessments to 408. Assessmenls to t09. Sewer 03/30/04 Io 07/01/04 30.66 409. Sewer 03/30/04 to 07/01/04 30.66 1 lO. 410. Ill. 411. 112. 412. 120. GROSS AMOUNT DUE FROM BUYER 56,917.63 ~ 420. GROSS AMOUNT DUE TO SELLER 55,736.38 200. AMOUNTS PAID BY OR IN BEHALF OF BUYER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER: 201. Deposil or earnest morley 5~500.00 501. Excess Deposit (See Instructions) 202. Principal Amount ol New Loan(s) 502. Settlement Charcjee to Seller (Line 1400) 3,247.30 203. Existio,q loan(s) laken subiect to 503. Existing loan(s) taken subject to 204. 504. Payoff of first Mortgage 205. 505. Payolf of second Mortgage 206. 506. Deposit or earnest money 5,500.00 207. 507. 208. 508. 209. 509. Adiustments For Items Unpaid By Seller Ad/ustments For Items Unpaid By Seller 210. County/Twp Taxes to 510. County/l'wp Taxes to 211. School Taxes 1o 511. School Taxes to 212. Assessments Io 512. Assessmenls to 213. 513. 214. 514. !215. 515. 216. 516. 217. 517. 218. 518. 219. 519. 220. TOTAL PAID BY/FOR BUYER 5,500.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 8,747.30 300. CASH AT SETTLEMENT FROMrro BUYER: 600. CASH AT SETTLEMENT TO/FROM SELLER: 301. Gross Amourlt Due From Buyer (Line 120) 56,917.63 601. Gross Amount Due To Seller (Line 420) 55,736.38 302. Less Amoun( Paid By/For Buyer (Line 220) 5,500.00) 602. Less Reductions Due Seller (Line 520) 8,747.30 303. CASH( X FROM)( TO)BUYER 51,417.63 603. CASH( X TO)( FROM)SELLER 46,989.08 The undersigned hereby acknowledge receipt of a~"ompleled copy ot pages 1&2 of this statement & any a0achmen s referred to herein. I HAVE CAREFULLY REVIEWED THE HUD-1 ~ETTLEMENT STATEMENT AND TO THE BEST OF MY KNOWLEDGE AND BELIEF IT IS A TRUE AND ACCURATE STATEMENT OF A. Lb-R~F. IPT...~ANJD~SBURSEMENTS MADE ON MY ACCOUNT OR aY ME IN THIS TRANSACTION. I FURTHER CERTIFY Tt IAT I HAVE RECEIVED A~OI~¥~F/TH~II.~D~, ~ETTLEMENT STATEMENT. Boye, ..,~.':"/:/.-/~'-~-'. o_ __ -~ ...... - _, ...... / '-.~ ~. _~-;~"- //, .... ' ._. '_.~.J / ~,,~.~_~.~_ /.:',- ,~ ~, 21, , . ~ ../ ,' ,~, Hooen J~. I=ge (~._ ~_~__~."' t~l~ie J. ~t'sr~in~e~, E~(e~c-~i"~-f~- X' y ..xt .__/b _~...,_/~/~""~-~;:~..~ ~ _ EsYale of Myrle E. HoUma~ackhove __ . Bonnie F. McKee FUNDS WHICH WERE REC,I~E~ A~I. HAVE BEEN OR WILL BE DISBURSED BY THE UNDERSIGNED AS PART OF THE S~LEMENT OF THIS ~.~.s~c~,o.. ~/~ ~emem~l Agenl WARNING: IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEME~S TO ~E UNITED STATES ON THIS OR ANY SIMI~R FORM. PENALTIES UPON CONVICTION CAN INCLUDE A FINE ~O IMPRISONMENT. FOR D~AILS SEE: TITLE 18 U.S. CODE SECTION 1~1 & SECTION 1010. L. SETTLEMENT CHARGES 700. TOTAL COMMISSION Based on Price $ @ % ' P^lo Feou PA~O ~=nou Division of Commission (line 700) as Follows: auY~a's sE~ ~ ~n's 701. $ IQ CUNOS 702. $ Io SETTLEMENT SET[LEMEN[ 703. Commission Paid at SeSlemenl 704. 1o 800. ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Origination Fee % to 802. Loan Discount % 1o 803. Appraisal Fee IQ 804. Credil Report Io 805. Lender's Inspection Fee Io 806. Mortgage App. Fee 807. Assumption Fee 808, Document Preparation 809. Tax Service Fee 810. Couder Fee 811. 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE ~)01. Interest From lo @ $ /day ( days %) . 902. MIP Totlns. for LifeOfLoan for months Io 903. Hazard Insurance Premium ior 1.0 years 1o 904. 905. 1000. RESERVES DEPOSITED WITH LENDER 100 . Hazard Insurance months @ $ per month 1002. Mortgage Insurance months @ $ per month 1003. Count¥/TwpTaxes months @ S per month 1004. School Taxes months @ $ per monlh 1005. Assessmenls months @ $ per monlh 1006. months @ $ per month 1007, months @ $ per month 1008, A,q,~.EscrowAdj. months @ $ per month 1100. TITLE CIIARGES 1101. Selllement or Closing Fee to 1102. Abstracl Or Title Search to t 103. Tille Examination to 104. Title Insurance Binder to 105, Document Preparation to I06. Nota~ Fees to B. Williams 107. Atlomey's Fees to James O. Bogar Law Offices (includes above item numbers.1101; 1105 108. Tille Insurance to James D. Bogar Law Offices 588.75 (includes above item numbers.1103; 1104 - End.-None 109, Lender's Coverage $ 110. Owner's Coverage $ 55,000,00 111. 112. 113. I14. TaxCertilication Io MichaelW. Harling, Tax Collector 5.00 1115. 2004 County/Twp/Borough Tax Io Jan Miller, Tax Collector 492.30 116. 117. 118. 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recording Fees: Deed $ 42.50; Mortgage $ ; Releases $ 42.50 1202. City/Counly Tax/Slamps: Deed 550.00; Mortgage 550,00 1203. Slale Tax/Stamps: Revenue Slamps 550,00; Modgage 550.00 1204. Assignmenl of Mortgage 1205. Slipulalion vs. Liens Prothonolary 1300. ADDITIONAL SETTLEMENT CHARGES 1301. Survey to 1302. Pest Inspection to 1303. Cou[ier 1304. Commission R/E Sale lo Rowe's Auction Service 2,200.00 1305. 1400. TOTAL SETTLEMENT CHARGES {Enter on Lines 103, Section J and 502, Section K) I 1,181,25 3,247,30 J~'~nffey' B. Hipp, Esquire, SelllerCent Agenl Certified to be a true copy / [368g-t/3689-t/14 ) REV- 1508 EX · (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Myrle Elizabeth Lackhove SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER SS~/ 204-01-2727 11/28/2003 21-03-1033 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1 2 3 4 5 DESCRIPTION Contents of home and personal property - Sold at private sale Contents of home and personal property - Sold at public sale Donegal Insurance Companies policy Refund of homeowners insurance Verizon Refund of account M&T Bank - Savings account number 015004206014702; date of death balance $10,474.97, accrued interest $0.20 Waypoint Bank - Checking Account No. 1005002315; date of death balance $21,535.89, accrued interest $5.19 Waypoint Bank - Checking Account No. 400002099; date of death balance $2,830.14, accrued interest $0.02 Waypoint Bank - Certificate of Deposit, beneficiary listed as Marjorie J. Ensminger; date of death balance $12,000.00, accrued interest $8.43 TOTAL (Also enter on line 5, Recapitulation) VALUE AT DATE OF DEATH 210.00 36,027.00 70.00 0.08 10,475.17 21,541.08 2,830.16 12,008.43 $ 83,161.92 (If more space is needed, insert additional sheets of the same size) Copyright (c} 1996 form software only CPSystems. inc. Form REV- 1508 EX (Rev. 1-97~ ROWE'S AUCTION SERVICE 2505 RITNER HIGHWAY CARILISLE, PA. 17013 717-249-2677 249-1978 697-4794 To: James D. Bogar, Attorney 1 West Main St. Shiremanstown, Pa. 17011 From: William G. Rowe 211 Old Stone House Rd. Carlisle, Pa. 17013 Meryl Lackhove Estate 45 South 18th St. Camp Hill, Pa. 17011 *Personal Property sold at Rowe's Auction Service less commission *Trash removal fi:om Karl Stine, Mechanicsburg*Check amount sent to Majorie Ensminger *Appraised items removed by family. Desk, Bed, Sewing bucket *Travel Trailer in rear of property to be removed February 4, 2004 $25,921.00 810.00 $25,111.00 210.00 no vflue Jim, thank you for your services. Marjorie is extremely pleased. / William G. Rowe ROWE'S AUCTION SERVICE Bill Rowe (AU 1538L) 2505 Ritner HighWay · Carlisle, PA. Ben Rowe (AU 1092L) 249-2677 697-4794 249-1978 Auction Is Action Call "ROwe'' For Satisfaction SELLERS NAME ADDRESS ; OTHER ~ (RH 79L) Bob Rowe (AU 2276L) Dave Rowe (AU 2295L) DATE PHO?E AUCTIONEER AUCTION DATE/LOCATION -'7.'i- ,_,o.~ -~ .A. ~% :% ~ ' ~ .%- 'q CLERK % DESCRIPTION OF MERCHANDISE .- I Commlssi~)~ the Auctioneers to sell the merch~,~dise to the highest bidder by Public Auction. Merchandise to be sold as is & grouped as necessary to obtain bids. I certify that I am the owner or authorized represen- tative of the merchandise, goods and or property and have good title and the right to sell and that they are free from all incumbrances. I agree to accept all responsibility for providi,~g merchantable title and for delivery of title to the purchaser. I agree to hold harmless the Auctioneers against any cl~mS of the nature referred to in this agreement. AUCTION SIGNATURE Total Sales (Clerking Tickets Attached) $ Less Sale Expense: % Commission Auctioneer $ % Commission Clerks $ OTHER: TOTAL SAT,F, EXPENSE DEDUCTED $ SELLERS NET $ M&TBank 499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12 James D.Bogar Attorney At Law One West Main Street Shiremanstown, PA 17011 Phone (302) 934-2774 F ax (302) 934-2955 January. 12, 2004 Re: Estate of AdvrleE. Hoffman £ackhove Social Security: 20d-01-2727 Date of Death: lVovember 28. 2003 Dear Ms. Jennifer B. Hipp: Per your inquiry received January 09, 2003, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type of Account Account Number Ownership (~ames Opening Date Balance on Date of Death Accrued Interest Total Savings Account 015004206014702 formerly 942 t 0217 Myrle Lackhove 03/78/84 $10,474.97 $ 0.20 For further account information, closures and/or reimbursement of funds please call the West Shore Plaza Office at # 717-255-2271. Sincerely, Nancy Clagett Records Management (302) 934-2774 LOOK FOP, US. WE'LL GET YOU THERE. 12/17/2003 JAMES D BOGAR ONE W MAIN ST SHIREMANSTOWN PA 17011 The information which you requested on the account(s) of MYRLE H LACKHOVE (Social Security Number 204-01-2727) is/are as follows: Account Number 1005002315 400002099 455300298 6000010150 Class of Account CHECKING CHECKING CERTIFICATE CERTIFICATE Date Opened 053085 012681 042597 121599 Principal Balance 21535.89 2830.14 12000.00 5000.00 Accrued Interest 5.19 .02 8.43 4.21 Balance at Date of 21541.08 2830.16 12008.43 5004.21 Death Account Ownership SOLE Name of Joint Owner, if any Date Ownership 053085 Was Established SOLE OWN/BNF TRUST MARJORIE LEON ENSMINGER ZEIGLER 012681 042597 121599 - '5 Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Account Ownership Name of Joint Owner, if any Date Ownership Was Established Additional Information Requested ERIN WATTS SENIOR SERVICES REP. P.O. Box 1'71 I. HARR~SaURG. P.~NNSYI.VANIA 1710~-1711 REV- 1510 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Myrle Elizabeth Lackhove SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERT7 FILE NUMBER SS~/ 204-01-2727 11/28/2003 21-03-1033 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes. DESCRIPTION OF PROPERTY % OF ITEM INCLUDE THE NAME OF THE TRANSFEREE, THEIR DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. NUMBER ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (;F APPLICABLE) 1 Waypoint Bank - Certificate 5,004.21 5,004.21 of Deposit, beneficiary listed as Leon Zeigler and Marie Zeigler; date of death balance $5,.000.00, accrued interest $4.21 TOTAL (Also enter on line 7, Recapitulation) $ 5,004.21 (If more space is needed, insert additional sheets of the same raze) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1510 EX (Rev. 1-97) LOOK FOR US. WE'LL GET YOU THERE. 12/17/2003 JAMES D BOGAR ONE W NLAIN ST SHIREMANSTOWN PA 17011 The information which you requested on the account(s) of MYRLE H LACICHOVE (Social Security Number 204-01-2727) is/are as follows: Account Number 1005002315 400002099 455300298 6000010150 Class of Account CHECKfNG CHECKING CERTIFICATE CERTIFICATE Date Opened 053085 012681 042597 121599 Principal Balance 21535.89 2830.14 12000.00 5000.00 Accrued Interest 5.19 .02 8.43 4.21 Balance at Date of 21541.08 2830.16 12008.43 5004.21 Death Account Ownership SOLE Name of Joint Owner, if any Date Ownership 053085 Was Established SOLE OWN/BNF TRUST MARJORIE LEON ENSMINGER ZEIGLER 012681 042597 121599 Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Account Ownership Name of Joint Owner, if any Date Ownership Was Established Additional Information Requested ERIN WATTS SENIOR SERVICES REP. P.O. Box I'~'! I. HARRISaURG. PENNSYLVANIA 1710S-1711 REV- 1511 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Myrle Elizabeth Lackhove SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS SS# 204-01-2727 11/28/2003 FILE NUMBER 21-03-1033 Debts of decedent must be reported on Schedule I. ITEM NUMBER 3 4 5 DESCRIPTION FUNERAL EXPENSES: Camp Hill Cemetary - grave opening Myers-Harner Funeral Home, Inc. - funeral expenses ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: Attorney's Fees Jennifer B. Hipp Esquire 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 Probate Fees Register of Wills Accountant's Fees Waggoner, Frutiger & Daub Tax Return Preparer's Fees Other Administrative Costs Borough of Camp Hill Final bill - sewer Jan Miller, Tax Collector - 2004 County and Borough taxes, prorated to date of real estate settlement John Barrett - Final bill - lawn maintenance and mowing Karl Stine Trash removal from home Michael W. Harling, Tax Collector - Tax certification fee - obtained for real estate settlement Total of Continuation Schedule(s) TOTAL (Also enter on line 9, Recapitulation) AMOUNT 400.00 7,337.75 6,475.00 272.00 125.00 60.00 492.30 44.00 810.00 5.00 15,341.16 31,362.21 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1511 EX (Rev. 1-97) Estate of: Myrle Elizabeth Lackhove Soc Sec #: 204-01-2727 Date of Death: 11/28/2003 Continuation of Schedule H-B7 (Other Administrative Costs) Item Description Amount 8 9 10 11 12 13 14 15 Pennsylvania American Water Company - Water bill final Penn Waste, Inc. Final bill trash and recycling PP&L - Electric bill final Recorder of Deeds Realty Transfer Tax RESERVES: Costs to conclude administration of Estate including filing fee for PA Inheritance Tax Return, Inventory and First & Final Account; preparation of Personal and Fiduciary Income Tax Returns Rowe's Auction Service - Commission for sale of personal property ($9,006.00) and labor to remove personal property from home ($1,100.00) Rowe's Auction Service - Commission - sale of real estate Sico Oil bill - final UGI - Gas bill final Verizon - Telephone bill - final 70.41 40.74 129.18 550.O0 750.00 10,106.00 2,200.00 1,350.77 60.01 84.05 15,341.16 REV-1513 EX + (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Myrle Elizabeth Lackhove NUMBER II. SCHEDULE J BENEFICIARIES SS# 204-01-2727 11/28/2003 NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [Include outright spousal distdb~Ions, and transfers under Sec. 9116~1.Z)] Wilda Byrne 265 Malcolm Avenue Garfield, NJ 07026 FILENUMBER 21-03-1033 Marjorie J. Ensminger 3148 D Linda Lane Allentown, PA 18103 Dorothy L. Hoffman R.D. # 1, Box 268 Liverpool, PA 17045 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Sister-in-Law Niece Cousin AMOUNT OR SHARE OF ESTATE Twenty (20%) percent of rest, residue and remainder Sixty (60%) percent of rest, residue and remainder Personal property per Will and twenty (20Z) percent of rest, residue and remainder jointly with ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: Ao SPOUSAL DISTRIBUTIONS UNDER SEC. 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 more space is needed, insert additional sheets of the same size) $ 0.00 Col3yri~3ht (c) ZOO0 form software only The Lackner Groul3. Inc. Form REV-1513 EX (Rev. 9-00~ Estate of: Myrle Elizabeth Lackhove Soc Sec #: 204-01-2727 Date of Death: 11/28/2003 Continuation of Schedule J, Part I (Taxable Bequests) Item Name and Address of Beneficiary Relationship Amount or Share of Estate 4 Paul A. Hoffman R.D. #1, Box 268 Liverpool, PA 17045 Cous in husband, Paul A. Hoffman Personal property per will and twenty (20%) of rest, residue and remainder, jointly with his wife, Dorothy L. Hoffman of the City or Town of ...... ~../?...{.V.....~... ...... ~.~....~....~....~. ................................................................................... in ~he County of .-.~.~:.~.~5..~.f~: ...... [:~..I.U..D..i....~Z{LT:~. .... and State bein~ of sound ~nd disposing mind and memory, do hereby voluntarily make, publish and declare this to be my LAST WILL AND TESTAmENt, hereby revokin~ any and all other WILLS heretofore grade by me at any time. I hereby nominate and appoint ~'J [~,; (: ~'. / ~ ~ ~ ~ ~ (Name) ~ --~ ............... ' ................. '+---:~ ..................... ~-. ............. : ............ ~.--~...~. ............. to be the Executor of this, my LAST WILL. (Address) Ig is my desire and order tha~ ~he above-named Executor be allowed to act.~iL~..l~.~..~..[ ........................ bond. (With or' ~ithout) After the pa~ent of my just debts, funeral charges and expenses of administration, I dispose of m~ estate as follows: , ~ ~ .__ ~n mitr~s~ m~r~nf. ~ hereunto subscribe my name and affix my seal this .............. ...t~.....~...~. .............. day of.....:,.~...,.~.~....'.~.....~......~.../.'..,~.....~.....~.~......~. ............ in the year one thousand nine hundred and....f~..~..:~..~ ........................... (Month) ~ "-':-,~? ,:-~LL~ ~t',, /~ I .................................... ~:.;.;.-~.:: ........................... , ............ ..~ ........................ ~;~- ...... .; ..... :~.- ...................... , . ..... :.:....,. .............................................. (Teat~to~.) (His o~ Her) Last WHI ~nd Testament, and has requested us to subscribe ou~ names hereto a~ witnesses. We believe said Testator to be of sufficiently sound mind to make a Will. In our presence, on the date and at the place hereof, said Testator has signed, scaled, published and declared, and we, in said Tcstator's presence, and in the presence of each other, subscribe our names as xvitnesses. l~rovldence Pl~l~li.hin~ Comlmny Keene. New ]lumlmhire C~Ollyri~rht, 1950 "PIt¢)VIDF, N¢"Iq 1VII,l, FOIIM" {'l'rnde Mnrk) STATUS REPORT UNDER RULE 6.12 Name of Decedent: Myrle E. Hoffman Lackhove Ne{~ji:2[: i '~::iii3 Date of Death: November 28, 2003 '04 AU6 18 ]q8 Will No. 21-03-1033 Admin. No. Pursuant to Rule 6 12 of the Supre~t~-~O{~h~s, Court Rules, I report the following with respect to completion of the administration'of the above-captioned estate: 1. State whether administration of the estate is complete: Yes xx Nc 2. If the answer is No, state when the personal representative reasonably believes that the ac[ministration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Oid the personal representative file a final account with the Court? Yes Nc XX 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 XX 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. Jennifer B. Hipp, Esquire Name (Please ,type or print) One West Main St. Shiremans~own, PA 17011 Address 1717 ) 737-876! Tel. No. Capacity: __Personal Representative (M~H:rmf/AM3) __Counsel for personal representative BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. ZR0601 HARRISBURG, PA 17128-0601 JENNIFER B HIPP ESQ 1W MAIN ST SHIREHANSTOWN PA 17011 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTZCE OF INHERITANCE TAX APPRAZSEMENT, ALLONANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE 07-19-Z00q ESTATE OF LACKHOVE DATE OF DEATH 11-28-2003 FILE NUMBER 21 03-1033 COUNTY CUMBERLAND ACM 101 Amoun~ Ree/~ted REV-1;q? EX AFP COl-OS) MYRLE E HAKE CHECK PAYABLE AND RENZT PAYHENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETA/N LOWER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTTONS AND ASSESSMENT OF TAX ESTATE OF LACKHOVE NYRLE E FILE NO. 21 03-1055 ACN 101 DATE 07-19-200q TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAZSED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks end Bonds (Schedule B) (2) 3. Closely Held Stock/Partnership Interest (Schedule C) (3) q. Mortgages/Notes Receivable (Schedule D) (q) 5. Cash/Bank Daposits/M/sc. Personal Property (Schedule E) (5) 6. Jo/ntly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets APPROVED DEDUCTZONS AND EXEMPTZONS: 9. Funeral Expansas/Adm. Costs/M/sc. Expanses (Schedule H) (9) 10. Debts/Mortgage L/ab/1/t/es/L/ens (SchaduZa Z) (10) 11. Total Deductions 12. Net Value of Tax Return 55/000.00 O0 O0 O0 85/161.92 O0 5/OOq.gl (8) $1,362.21 .00 NOTE: To /nsure proper cred/t to your account, subm/t the upper portion of th/s form w/th your tax payment. 15. lq. NOTE: ASSESSNENT OF TAX: 15. Amount of L/ne lq at Spousal rate 16. Amount of L/ne lq taxable at Lineal~Class A rate 17. Amount of L/ne lq at Sibl/ng rate 18. Amount of L/ne lq taxable et Collateral/Class B rate 19. Pr/nc/pal Tax Due TAX CREDZTS: PAYMENT RECEIPI DISCOUNT DATE NUMBER INTEREST/PEN PATD (- 02-26-200q CDOO$60Z 8:58.53 ltl3,166.1:5 (11) ~1 .362.21 (12) 111,80:5.92 Char/table/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (15) .00 Net Value of Estate Subject to Tax (lq) 111,80:5.92 Zf an assessment was issued previously, 11nee 14, 15 and/or 16, 17, 18 and 19 re~lect ~lgures that include the total o~ ALL returns assessed to date. IF PAID AFTER DATE ZNDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. (15) (16) (17) (18) will · O0 x O0 = . O0 9~D~ x~ ~5: ::~, .00'00 x : 111'80~-'~J:~ X 15 : ~:~.'L~6,770 59 ~- .: ~): &, ~ ,770 59 TOTAL TAX CREDZT I · RLANCE OF TAX OUE ~TEREST R~D TOTAL DUE 17,q61.26 690.67CR .00 690.67CR ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) RESERVATION: Estates of decedents dying on or before December 11, 1981 -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves tho right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. PURPOSE OF NOT[CE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section 11~0 of the inheritance and Estate Tax Act, Act 15 of ZOO0. (72 P.S. Section 91¢0). Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side. --Make check or money order payable to: REGISTER OF RILLS, AGENT A refund of a tax credit, which ams not requested on the Tax Return, Bay be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-I$1S). Applications are available at the Office of the Register of Hills, any of the 25 Revenue District Officasj ar by calling the special Il-hour answering service for fores ordering: 1-BO0-561-Z0501 services for taxpayers with special hearing and / or speaking needs: 1-800-~7-5020 (TT only). Any party in interest not satisfied aith the appraisement, alloaance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281011, Harrisburg, PA 17128-1011, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered an this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTH: Past Assessment Review Unit, Dept. 180601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. Sam page 5 of the booklet "Instructions far Inheritance Tax Return for e Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. If any tax due is paid within three (5) calendar months after the dacedent's death, a five percent (51) discount of the tax paid is alloaad. The 151 tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996j the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same tiaa period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 19BI bear interest at the rate of six (BX) percent per annum calculated at a daily rate of .OOO16q. All taxes which became delinquent on and after January 1, 1981 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for [981 through 2004 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1982 20Z .000548 ~J~'8-1991 11X .000301 ~ 9X .000247 1983 161 .000~58 1992 91 .0002~7 ZOO2 61 .00016~ 198fi 111 .000501 1995-199~ 7Z .000191 2005 5X .000157 1985 152 .000556 1995-1998 91 .0002~7 200~ ~Z .OOOllO 1986 iOZ .00027~ 1999 71 .000191 1987 lOX .00027~ 2000 7Z .OOO19Z --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date sheen on the Notice, additional interest must be calculated. BUREAU OF TNDZVZDUAL TAXES TNHER'rTANCE TAX nTVTSTON DEPT. 28060]. HARRI'SBUR[~, PA 17128-0601 JENNIFER B HIPP ESQ I W HAIN ST SHIREHANSTOWN PA 17011 COHHONNEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE INHERITANCE TAX STATEHENT OF ACCOUNT DATE 08-23-Z004 ESTATE OF LACKHOVE DATE OF DEATH 11-28-2003 FILE NUNBER 21 03-1033 COUNTY CUHBERLAHD ACN 101 Amoun~ Remi~ced REV-i$07 EX AFP C01-65) HYRLE E HAKE CHECK PAYABLE AND REHIT PAYHENT TO: REGISTER OF HILLS CUHilERLAND CO COURT HOUSE CARLISLE, PA NOTE: To insure proper credi* ~:o your account, submit: ~he upper por~:ion of ~: .h~s. ::form~h you~::~(ax payment. CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECOR~IS REV-1607 EX AFP (02-03) ~(¥;~"~' ..... "'-' .......... ESTATE OF LACKHOVE ##~ INHERITANCE TAX STATEHENT OF ACCOUNT HYRLE E FILE N0.21 03-1033 ACN 101 .-~DATE 08--23-2004 THIS STATEHENT ZS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN ZN THE NANED E~I~ATE. S~IO#N BELOW ZSA SUNNARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYNENTS, THE CURRENT BAL~ANCE, AN~,~ ZF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSHENT OR RECORD ADJUSTHENT: 07-12-2004 PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................... PAYHENTS (TAX CREDITS): 16,770.59 PAYHENT RECEIPT DISCOUNT (+) DATE NUHBER INTEREST/PEN PAID (-) AHOUNT PAID 838.53 02-26-2004 08-04-2004 CD00~602 REFUND .O0 16,622.73 690.67- ZF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYNENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT' (CR), TOTAL TAX CREDIT 16,770.59 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR TNSTRUCTZONS. )