HomeMy WebLinkAbout12-09-09 (2)
1505607120
-~ REV-1500 EX (06-05) OFFICIAL USE ONLY
PA Department of Revenue county coda Year File Number
Bureau of Individual Taxes INHERITANCE TAX RETURN 2 1 0 9 0 5 6 9
PO BOX.280601
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
172 24 7890 06 14 2009 10 10 1930
Decedent's Last Name
FREHN
(If Applicable) Enter Surviving Spouse's Information Below
Suffix Decedent's First Name
VIOLET
MI
E
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
R EGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
" I 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death
I prior to 12-13-82)
4. Limited Estate ~ 4a. Future Interest Compromise
1 ~ 5. Federal EState Tax Return Required
(date of death after 12-12-t32)
I~ g Decedent Died Testate ~ ~~ (AHadBCopy Hof T ~)a Living Trust 8. Total Nurclber of Safe Deposit Boxes
(Attach Copy of Will)
9. Litigation Proceeds Received 10. Spousal Poverty Credit ((date of death
~ between 12-31-91 and 1-1-95) y 1, Election to tax under Sec. 9113(A)
_ (Attach Soh. O)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
JERRY A. WEIGLE ESQUIRE 717 532 7388
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Firm Name (If Applicable) .n a ~`~-•
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WEIGLE & ASSOCIATES, P . C . REGISTER
LS US~NLY
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First line of address ~~ ~
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126 EAST KING STREET ~-
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Second line of address
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FILED
City or Post Office State ZIP Code
SHIPPENSBURG PA 17257
Correspondent's a-mail address:
Under penal " of perjury, I deGare t I have ami this return, including accompanying schedules and statements, and to th$ best of my knowledge and belief,
it is true, and comple lion er than the personal representative Is based on all information of which preparer has any knowledge.
SIGN PE N R ONSI E FO ~ RE N DAT ~ ~ ~'
Robert L. Frehn Jr.
ADDRESS
49 Water Street, Walnut Bottom, PA 17
S TU OF PREPAR OTHER THAN P ES ATN DATE
~~ ~~ ~~ Jerry A. Weigle Esquire ~ 2
126 East King Street, Sh
17257
V Side 1
1505607120
1505607120
J~
REV-1500 EX
Decedent's Name: V i 0 i e t E. F r e h n
Decedent's Social Security Number
172 24 7890
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.
5•
6.
7.
8. Mortgages & Notes Receivable (Schedule D) .............................._........................
Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ................
Jointly Owned Property (Schedule F) ~ Separate Billing Requested .............
Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) ~ Separate Billing Requested .............
Total Gross Assets (total Lines 1-7) .............................___. . ,.,,
........................... . 4.
5.
6.
7.
g.
83,632.52
3 , 6 3 2 . 5 2
7,393.63
9. Funeral Expenses & Administrative Costs (Schedule H) ...................................... 9.
2,074.75
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............................... . 10.
11. Total Deductions (total Lines 9 & 10) ..............................._..........................._ .
• •••
11. 9 , 4 6 8 3 8
12• Net Value of Estate (Line 8 minus Line 11) ............................._............................. 12.
74,164.14
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 Tax (Line 12 minus Line 13) ..............................
................
14. 7 4 , 16 4.14
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. 0 0 0
16. Amount of Line 14 taxable 7 4 , 16 4.14
045 16. 3 , 3 3 7 3 9
at lineal rate X .
17. Amount of Line 14 taxable 0 0 0 17 0 0 0
at sibling rate X .12 .
18. Amount of Line 14 taxable
0 0 0
18
0 0 0
at collateral rate X .15 .
19. Tax Due ............................................................................................................... 19. 3. 3 3 7. 3 9
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
1505607220
Side 2
L 1505607220 150560?220
REV-1500 EX Page 3
Decedent's Complete Address:
File Number 21-09-0569
DECEDENT'S NAME
Violet E. Frehn
STREET ADDRESS
35 Maple Avenue
CITY
Walnut Bottom STATE
PA ZIP
17266
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
3. Interest/Penalty if applicable
p. Interest
E. Penalty
3,000.00
157.89
Total Credits (A + B + C)
(1) 3,337.39
(2) 3,157.89
Total InterestlPenalty (D + E)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is theOVERPAYMENT.
Check box on Page 2 Line 20 to request a refund
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is theBALANCE DUE
(3)
(4)
(5) 179.50
(5A)
(5B) 17 9.5 0
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPIROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred :............................................................................. ~ x^
b. retain the right to designate who shall use the property transferred or its income;..... .......................__..
c. retain a reversionary interest; or .............................._............................._............................................... ^ ^x
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? .................................................................................................................
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? ................................................................................................................ ^ ^x
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 exem~ta 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 do 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-1506 EX+(6-68(
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Frehn, Violet E. 21-09-0569
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointlyowned with the right of survivorship must be disclosed on schedule F.
ITEM
NUMBER
DESCRIPTION VALUE AT DATE
OF DEATH
1 Embarq -refund 17.83
2 Fogelsanger-Bricker Funeral Home -refund 100.00
3 Kuhn Communications -refund 18.50
4 Blue Cross/Blue Shield -benefit check 959.25
5 M 8t T Bank Certificate of Deposit #124264 28,301.26
Accrued interest on Item 5 through date of death 13.96
6 M & T Bank Certificate of Deposit #499855 17,279.18
Accrued interest on Item 6 through date of death 635.91
7 M $ T Bank Certificate of Deposit #499863 9,000.00
Accrued interest on Item 7 through date of death 331.22
8 M 8r T Bank Checking Account #97242063 13,559.90
Accrued interest on Item 8 through date of death 0.43
9 MetLife Total Control Account #4048244656 9,100.78
10 Penn National Insurance -refund of auto premium 108.00
11 PPL Electric Utilities -refund 10.30
Total of Continuation Schedule See attached page
TOTAL (Also enter on Line 5, Recapitulation) 83,632.52
(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 E (Rev. 6-98)
Rev-1508 EX+ (6-98)
SCHEDULE E
CASH, BANK DEPOSITS, ~ MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSVlVAN1A
INHERITANCE TAX RETURN continue
RESIDENT DECEDENT
ESTATE OF (FILE NUMBER
Frehn, Violet E. 21-Q9-0569
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PEA-1500 Schedule E (Rev. 6-98)
REV-1141 EX+ 00.08)
SCHEDULE H
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES ~
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Frehn, Violet E. 21-09-0569
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
Name(s) of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission paid
2. Attorney's Fees Weigle 8 Associates, P.C.
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
365.37
4,931.00
4. Probate Fees Register of Wills, Cumberland County 79.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 2,018.26
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation) 7,393.63
Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Frehn, Violet E. 21-09-0569
ITEM
NUMBER DESCRIPTION AMOUNT
Funeral Expenses
1 Fogelsanger-Bricker Funeral Home 157.37
2 Funeral Reception 208.00
H-A subtotal 365.37
Other Administrative Costs
3 Coons Garage -repairs to vehicle prior to sale 161.36
4 Cumberland Law Journal -advertising Letters Testamentary 75.00
5 Expenses of public sale 1,478.40
6 Linda K. Klein -notary fee 20.00
7 News Chronicle -advertising Letters Testamentary 129.50
8 Register of Wills, Cumberland County -filing PA Inheritance Tax Return 15.00
9 Register of Wills, Cumberland County -filing Family Settlement Agreement 75.00
10 Register of Wills, Cumberland County -one Short Certificate 4.00
11 Robert L. Frehn, Jr. -reimbursement for repairs to vehicle) prior to sale 40.00
12 Weigle 8 Associates, P.C. -reimbursement for postage, xerox copies, and long 20.00
distance telephone calls
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
Frehn, Violet E. 21-09-0569
ITEM
NUMBER DESCRIPTION AMOUNT
H-B7 Subtotal 2,018.26
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98)
Rev-1571 EX+ (12-08)
SCHEDULE 1
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE (NUMBER
Frehn, Violet E. 21-09-0569
Repoli debts incurred by the decedent prior to death that remained unpaid at the date of death, Including unreimbureed medical expanses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 M 8t T Bank Checking Account #97242063 -checks clearing after date of death 72.50
2 PPL Electric Utilities 113.00
3 Robert L. Frehn, Jr. -reimbursement for lawn mowing and trimming shrubbery; and 930.00
packing personal property for auction
4 West Shore EMS 959.25
TOTAL (Also enter on Line 10, Recapitulation) I 2,074.75
(If more space is needed, additional pages of the same size)
Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 12-08)
REV-154 EX+ (11-05)
SCHEDULE J
COM NH"E~R~iTnidCETnzRETURN'4N~ BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
rrenn, violet t. 21-09-05 69
NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (Words) ($$$)
Do Not List Trustse s
I. TAXABLE DISTRIBUTIONS [include outright spousal
distributions, and transfers
under Sec. 9116(a)(1.2)]
1 Robert L. Frehn Jr. Son 100% 74,164.14
49 Water Street
Walnut Bottom, PA 17266
Total 74,164.14
Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 15 00 cover sheet, a ' app ropriate,
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOl' TAKEN
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVEF~ SHEET 0.00
Copyright (c) 2009 form software only The Lackner Group, Inc. Form P -1500 Schedule J (Rev. 11-08)
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LAST WILL AND TESTAMENT ~`n "' "'~~"'~
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_ ''hn n ~rr~
c:5~ ~ :;,~::7
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I, VIOLET E, FREHN, of Walnut Bottom, Cumberland Coiin~~~?Pettsisyl~£ana?, '.
~ ':7
(..: ~ C~: r..
being of sound mind, memory and disposition, do hereby make gdblish!~nd;• 'r'+
.c- . ,
declare this my Last Will and Testament, hereby revoking and making void ,
all wills by me at any time heretofore made,
FIRS I'. I order and direct the payment of all my just debts and funeral
expenses as soon as may be convenient after my decease.
SECOND. I give, devise and bequeath all my estate, real, personal and mixed,
whatsoever and wheresoever situate, to my beloved husband, :ROBERT L. FREHN, SR.,'
I absolutely.
THIRD. In the event my said husband predeceases me or is not living on the
60th day following my death, Z then give, devise and bequeath my sand estate
to my son, ROBERT L. FREHN, JR., on a per stirpes distribution basis.
FOURTH. I nominate, constitute and appoint my husband, ROBERT L. FREHN, SR.,
to be the Executor of this my Last Will and Testament; if he be unable to
fulfill the duties of Executor, I then nominate, constitute and appoint my
son, ROBERT L. FREHN, JR., to be the Executor of this my Last Will and
Testament.
FIFTH. I direct that my personal representative shall not tie required to
give bond for the faithful performance of his duties in any jurisdiction.
IN WITNESS WHEREOF, I, VIOLET E. FREHN, have hereunto set my hand
and seal to this my Last Will and Testament, this 11th day of January,
1980.
' c> .- I
~ ; ~'...,,~%. t.-- `~Z.,:. ~-c._,_.~~• ~ SEAL )
NARK AND WEIGLE _l_
Attorneys at Law
sn~ovensoun. Pa. '
This instrument was by the Testatrix, VIOLET E. FRE]:IN, on the date
hereof, signed, published and declared by her to be her Last Will and ~'estament,
in our presence, who at her request and in her presence and in the presence of
each other= we believing her to be of sound and disposing mind and memory,
have. hereunto subscribed our names as wityre ess s~ ~
C.L. ir.
,•' /
.-,
.. ~.
COMMONWEALTH OF•PENNSYLVANIA '
SS
j CQUNTY OF CUMBERLAND ,
I, VIOLET E, F$EHN, the Testatrix whose name is signed to the fore-
tiie purposes therein expressed..
a
~, going instrument, having been duly qualified according to law, do hereby acknow=
ledge that I signed and executed the instrument as my Last Wily that I
signed it willingly; and that T signed it as my free and voluntary act for
Swoxn or affirmed to and acknowledged
before me; by Violet E, Frehnt the
Testatrxt this llthday of January,
1980,
hoary E. ,YEZ:rers, F:atory Pohiit
S`Japen:burp, PA Cumberland County
My Cantniuion Expires July 2T, t9fSt
COMMONWEALTH OF PENNSYLVANIA
SS
CQUNTY OF CUMBERLAND ,
/ .~
~ ,~ ~ ~ `
We, Jerry A. Weigle and Nancy J. Monn
the.witnesses whose names are signed to the foregoing instruments being duly
i
qualified according to law, do depose and say that we were present and saw
Testatrix sign and execute the instrument as her Last Will; that she signed
-2~.
MARK AND WEIGLE
Attorneys at Law
Sbippensburp, Pa.
willingly and that. she executed it as her free and voluntary act for the
purposes. therein expressed; that each of us in the hearing and sight o~ the
Testatrix signed the will as witnesses; and that to the best of our knowledge
" the Testatrix was at that time eighteen (18~ or more years o1` age and of sound
'- mind and under no constraint or undue 'influence.
! Sworn or affirmed to and subscribed
before me by Jerrv A. Weigle and
Nancv J. Moran , witnesses,
this 11th day, lof, January, 1980.
P~4ary Searess, n:ctary pi:=+K
5; i,pen:6i::;, pA Cum6erard CaR:rY
Mr Commis::vrt ~zC~~ 1v;y iT, lS82
;i
MARK ANO WEIGLE
Attor~ys at Law
Shippensbury, Pa.
-3-
0 M&TBank
499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12
Weigle & Associates, P.C.
Attorneys at Law
126 East King Street
Shippensburg, Pennsylvania .17257-1397
JUN 2 9 2009
Phone (888) 502-4349
Fax (302)934-2955
June 25, 2009
Re: Estate of Violet E. Frehn
Social Security: 172-24-7890
Date ofDeath: June 14 2009
Dear Sir or Madam:
Per your inquny dated June 19, 2009, please be advised that at the time of death, the above-named decedent had on deposit
with this bank the following:
1. Type ofAccount Checking Account
Account Number 97242063
Ownership (Names o,~ Violet E Frehn
Opening Date 01/28/80
Balance on Date ofDeath $13,559.90
Accrued Interest $ 0.43
Total ~__----------------------------------------- ---------------
$13,560.33 -------
2. Type ofAccount Certificate of Deposit
Account Number 31003916124264
Ownership (Names o~ Violet E Frehn*
Opening Date 4/28/06
Balance on Date ofDeath $ 28,301.26
Accrued Interest ~ $ 13.96
Total ~-•-------------------------------------------------=---------- -
$ 28,315.22 -
3. Type ofAccount Certificate of Deposit
Account Number 31003918499855
Ownership (Names o,~ Violet E Frehn
Opening Date 06/02/08
Balance on Date of Death $17,279.18
Accrued Interest $ 635.91
Total $17,915.09 ~-------~~ ~--
4. Type ofAccount Cert~cate of Deposit
Account Number 31003918499863
Ownership (Names o,~ Violet E Frehn*
Opening Date 06/02/08
Balance on Date of Death $ 9, 000.00
Accrued Interest $ 331.22.
Total $ 9,331.22 -----~-----~
Please be advised, there was no safe deposit box found for the above decedeniw
* If upon reviewing the information above, you believe there are additional accounts not refere~hced, please provide
us with an account number and/or name of any possible joint account holder. For any additional information on the
above accounts, including ownership and any changes, closures and/or reimbursement of funds, etc., please contact
our Walnut Bottom Office # 717-532-2414.
Sincerely,
%1~L~i
Tracie Haze
Adjustment Services
.:;al Control Account®
Account No. 4048244656
SN-07i641•TCAIPAO!
VIOLET FREHN
PO BOX 45
WALNUT BOTTOM PA 17266-0045
May 2009
Statement Period From 5/01/09 To 5/31/09
Page 1 of 1
Customer Service: (800) 638-7283
If you need to send mail to the Total Control Account department, please write to us at: ftiAetLife and
Affiliates, Total Control Account, 485 E US Highway 1 FL 4, P.O. Box 4121, Iselin, NJ 0883b-4121. If you are
enclosing forms or your own letter, please remember to include your account number artd write out your
complete name, street address, city, state and ZIP Code. Please also remember to sign''your forms or
letters.
TCA MONEY MARKET OPTION (MMO)
EFFECTIVE ANNUAL YIELD 1.50% AS OF 05/31/09
Account Summary
Interest
$9,089.31
$11.47
$9,100.78
$55.87
$0.00
Transaction Details
5/31 Interest
Il~p~~~rp~l@I
$11.47
•
LORI J RADNOR ~-e2za~2~,3 12 9 8
WILLIAM M STONER 2161
PH. 717-352x7021 //~~
2630-C SHIPPENSBURG RD. DATE ~,~'" "~O~
BIGLERVILLE, PA 17307-9742
PAY TO
THE ORDER OF '~ ~
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790 West High Street
' Carlisle, PA 17013
(717) 532-4647
Steve Ege 717-385-5438 Cell Chris Bream 717-226-1920 Cell
.~
SELLERS NAME F- ~.~ ; '- ~T ! ~ " t" , .. ~ ~'" ~. t E t x DATE - . ''-~~
ADDRESS '~~1`~ ~~ ~ .~ ~~ ~~.~•~C~`~C PHONE ..~.`,, ~ .2f, ~~
-~ ,
OTHER ~ 4~ ~ ~ ~ • . ;~~ ~ -~- , ~ ~ - ~~ ~ `i ' r. c,,,~.~~.' ~ AUCTIONEER % ~ ~
AUCTION DATE/LOCATION.q- J-0 `I CLERK
DESCRIPTION OF MERCHANDISE
~~~~ ~~ ~~ ~ ~ e ~~
~~~.~~
~>
I Commission the Auctioneers to sell the merchandise 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 representa-
tive of the .merchandise g ~ds and/orP rope pand hav goo P title ang the right to sell and that they are free
from all incumbrances. ~I a ee to acce tall res onsibilit for rovidin merchantable title and for delivery of
title to the purchaser. I agree to hold harmless the Auctioneers against an ims of the n~~ re ed in
this agreement. Trash fee applied if applicable. ~ ;,-
.'
fi'
AUCTION SI ATURE SELLE~ZS SIGN.t~ RE
Total Sales (Clerking Tickets Attached) $ _~ t~' ~ _ =~ •
Less Sale Expense: ~ ,.
~-~ % Commission Auctioneer $ ~ ~ • ~ `~
% Commission Clerks $
OTHER:
TOTAL SALE EXPENSE DEDUCTED $
,c:
SELLERS NET $ ~ .= ~ ~ ~' ~'
. , , t~fi ~~t,
AUCTION SIGNATURE
___
_ - - ;~-r f ~ ~ ~, _ __ -
RUNNING TOTAL
.. r
..