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HomeMy WebLinkAbout12-29-09~~ ,~,, ,.~~ , 1505607121 ""+ REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau oflndivldual Taxes INHERITANCE TAX RETURN PO BOX 280601 2 1 0 9 0 4 7 0 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 1 7 2 2 4 9 0 1 7 0 5 0 8 2 0 0 9 0 6 0 6 1 9 2 7 Decedent's Last Name Suffix Decedent's First Name MI G U R L E Y B EV E R L Y S (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS MI 1. Original Retum ~ 2. Supplemental Return ~ 3. Remainder Retum (date of death prior to 12-13-82) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required death after 12-12-82) 0 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust ~. 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST 8E COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SMVU~u rst u-rctc: r to ~ u: Name Daytime Telephone Number H U B E R T X G I L R O Y 7 1 7 2 4 3 3 3 4 1 Firm Name (If Applicable) - - - -~-- ----- REGISTER OF WILLS USE ONLY M A R T S O N L A W O F F I C E S ~ h,, ~~~ First line of address ! e-~,y; c,~ ~ ~.,, ~=~? ~ (: n ~ "r) ~ j ~...~ ~ ~ r~.~ 1 0 E A S T H I G H S T R E E T ~ ~~' _ N Second line of address ~ ~ ~'~ r-- ' ~ '~ City or Post Office _ . r'~ bA'~TB~ILED~ ;' -tai State ZIP Code ~.~; , .... C A R L I S L E P A ], 7 0 1 3 _~ ~ {;.~ ~~ ~ ~~ Correspondent's a-mail address: H G I L R O Y a M A R T S O N L A W• C O M Under pena~fes 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 representathre is based on all information of which preparer has any knowledge. TURF OF PERSON R SPO IBLE F FILING RETURN DATE 75RESS LE LA v ETTERS PA 1,7319 SIGNAT P R O R THAN REPRESENTATIVE DAT~,., ADDRESS 10 EAST HIGH ST EET CARLISLE PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 1505607121 1505607121 J J 1505607221 REV-1500 EX Decedent's Social Security Number oecedent'slVame: BEVERLY S- GURLEY 1 7 2 2 4 9 0 1 7 RECAPITULATION 1. Real estate (Schedule A) ........................................ 1. 1 1 2 0 0 0. 0 0 2. Stocks and Bonds (Schedule B) .................................. 2• • 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. • 4. Mortgages & Notes Receivable (Schedule D} ........................ 4. • 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ....... 5. 6 8 3 6 . 0 6 6. Jointly Owned Property (Schedule F} ^ Separate Billing Requested ....... 6. • 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested ....... 7. • 8. Total Gross Assets (total Lines 1-7) ........................... s. 1 1 8 8 3 6. 0 6 9. Funeral Ex enses & Administrative Costs Schedule H P ( ) ................ 9. 2 3 4 4 0 . 2 8 10. Debts of Decedent, Mort a e Liabilities, & Liens Schedule I 9 9 ( ) ..... ....... 10. 3 9 6 . 7 6 11. Total Deductions (total Lines 9 & 10) .................... ....... 11. 2 3 8 3 7 . 0 4 12. Net Value of Estate (Line 8 minus Line 11) .................. ....... 12. 9 4 9 9 9 . 0 2 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. 9 4 9 9 9 . 0 2 TAX COMPUTATION - 9EE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) x .0 0. 0 0 15. 0. 0 0 16. Amount of Line 14 taxable 9 4 9 9 9 0 2 4 2 7 4 9 6 at lineal rate X .045 16. • 17. Amount of Line 14 taxable 0 0 0 0 0 0 at sibling rate X .12 17, . 18. Amount of Line 14 taxable 0 0 0 0 0 0 at collateral rate X .15 1 g. . 19. Tax Due ......................................... ....... 19. 4 2 7 4. 9 6 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1505607221 1505607221 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 09 0470 DECEDENT'S NAME BEVERLY S. GURLEY STREET ADDRESS 1710 WALNUT STREET __ _ CITY ', STATE .ZIP CAMP HILL PA 17011 Tax Payments and Credits: i. Tax Due (Page 2 Line 19) (1) 4,274.96 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Total Credits (A + B + C) (2) 0.00 3. Interest/Penalfy ifapplicable D. Interest E, Penalty Total InteresbPenalty (D + E) (3) 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is fhe OVERPAYMENT. Fill In oval on Page 2, Line 20 to request a refund. (4) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 4,274.96 A. Enter fhe interest on fhe tax due. (5A) B. Enter fhe total of Line 5 + 5A. This is the BALANCE DUE. (5B) 4,274.96 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 : ...................................................................... ^ Q b. retain the right to designate who shall use fhe property transferred or ifs income; ............................... ^ Q c. retain a reversionary interest; or ................................................................................................ ^ 0 d. receive the promise for life of either payments, benefits or care? ....................................................... ^ Q 2. If death occurred after December 12, 1982, did decedent Transfer property within one year of death without receiving adequate consideration? ....................................................................................... ^ Q 3. Did decedent own an "in (rust for" or payable upon death bank account or security of his or her death? ......... ^ Q 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. 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 fhe use of the surviving spouse is Three (3) percent (72 P.S. §9116 (a) (1.1) (i)J. 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)J. The statute does not exempt a Transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The fax rate imposed on the net value of Transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (O) percent (72 P.S. §9116(a)(1.2)J. The tax rate imposed on the net value of transfers fo or for the use of fhe decedent's lineal benetfciaries is four and one-half (4.5) percent, except as noted in 72 P.S. §9116(1.2) (72 P.S. §9116(a)(1)J. The fax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent X72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with fhe decedent, whether by blood or adoption. REV-1502 EX + (6-98) SCHEDULE A COMMONWEALTH OF PENNSYLVANIA REAL ESTATE INHERITANCE TAX RETURN occincnrr ncr~GnGNT ESTATE OF FILE NUMBER BEVERLY S. GURLEY _ 21 09 0470 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 behNeen a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real ro which Is In -owned with rl ht of survivorshl must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Residence located at 1710 Walnut Street, Camp Hill Borough, Cumberland Co., PA, known as 112,000.00 Tax Parcel No. O 1-21-0269-193, being described in Deed dated 12/ 11 /2001 and recorded in Cumberland Co. Deed Book 249, Page 4122, being conveyed to Beverly S. Gurley, Decedent herein. Value is actual sale value. See attached Settlement Statement TOTAL (Also enter online 1, Recapitulation) ~ a 1 12.00c).UO (If more space is needed, insert additional sheets of the same size) REV-1508 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER BEVERLY S. GURLEY 21 09 0470 Indude the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. VALUE AT DATE ITEM OF DEATH NUMBER DESCRIPTION 1. M&T Bank checking 391177394 1,3=49.61 See attached 2. Personal property and household goods, actual sale value 1,771.09 3. Personal property and household goods, estimated value 2,000.00 4. Sewer proration 9/ 19/09-10/ 1/09 8.15 5 . County Tax proration 9/ 19/09-01 /01 / 10 2 4 6.68 6. School Tax proration 9/ 19/09-01 /01 / 10 1, 4 60.5 3 TOTAL (Also enter on line 5, Recapitulation) ~ S 6.8 3 6.06 (If more space is needed, insert additional sheets of the same size) REV-1511 EX + (10-06) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER BEVERLY S. GURLEY 21 09 0470 Debts of decedent must be reported on Schedule I. 1 TEM NUMBER A. 1. 2. 3. DESCRIPTION FUNERAL EXPENSES: Mussleman Funeral Home, Lemoyne, PA Mt. Calvary Episcopal Chruch, donation for funeral luncheon Blooms By Vickery, funeral flowers AMOUNT x,97 3.32 ~O.OU 13 3.56 Q, ADMINISTRATIVE COSTS: 1, Personal Representative's Commissions Name of Personal Representative (s) Street Address Cry State _ Zip Year(s) Commission Paid: 2 Attorney Fees MARTSON LAW OFFICES (estimated) 6, 5 00.00 3, Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address Cry State _ Zip Relationship of Claimant to Decedent 4. Probate Fees Oberland County Register of Wills 248.00 5 Accountant's Fees 6, Tax Return Preparer's Fees 7 Cumberland County Register of Wills, filing fee, Inheritance Tax return ~ ~ .00 . g The Patriot News, advertising Letters Testamentary l 67.31 . 9 Cumberland Law Journal, advertising Letters Testamentary 7 ~ .00 , 10. M&T Bank, estate checks ~ ~~ 7 ~ ~0 00 11 Cumberland County Register of Wills, additional probate fee . 12 Cumberland County Register of Wills, Short Certificates x.00 . 13 Cumberland County Register of Wills, fee to appoint Administratrix due to death of Executor '20.00 . 14. UGI, service pending disposition of real estate 396.67 75 =13 15 Penn Waste, service pending disposition of real estate . . 16 service pending disposition of real estate Verizon 62.98 . 17. , PPL, service pending disposition of real estate 7 g .42 720 OU 1 g, Antiques Marketplace, Inc., Lemoyne, PA, rental for sale of personl property . TOTAL (Also enter on line 9, Recapitulation) S 2 ; 44U ~ 8 SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS (If more space is needed, insert additional sheets of the same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent 21 09 0470 BEVERLY S. GURLEY Page 1 File Number Decedent's Name Schedule H -Funeral Expenses & Administrative Costs - B7. ITEM AMOUNT NUMBER DESCRIPTION 62.50 19. Borough of Camp Hill, sewer service pending disposition of real estate 3 , 5 8 5.00 20, Homestead Group, real estate commission 3 , 5 8 ~ .00 21. Heritage Group, real estate commission 10.00 22. Kerwin & Kerwin, notary fee 1,120.00 23 , 1 % Realty Transfer Tax > > ~}, 7 2 24, PA American Water, service pending disposition of real estate ; ~ , 00 25. Patriot News, tag sale advertisment 125.30 26. Miscellaneous expenses for sale of personal property SUBTOTAL SCHEDULE H-67 I 4,673.52 REV-1512 EX + (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER BEVERLY S. GURLEY 21 09 0470 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Camp Hill Borough, account payable 62.50 3. PA American Water, account payable 4. UGI, account payable 5. Penn Waste, account payable 6. Verizon, account payable 7. PPL, account payable 8. UGI HVAC Service, account payable TOTAL (Also enfer on line 10, Recapitulation) I $ (If more space is needed, insert additional sheets of the same size) 44.46 164.00 48.75 31.42 35.63 10.00 396.76 REV-1513 EX + (9-00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER tip v ~tCL Y J. l7UiCL1G Y G 1 v7 v'+ i v RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DI STRI BUTT ONS (include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. Melissa G. Hoy Lineal 47,499.51 75 Eagle Lane Etters, PA 17319 2. Estate of Stephen C. Gurley Lineal 47,499.51 c/o 10 East High Street Carlisle, PA 17013 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ONLINE 13 OF REV 1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) ,~~ . to ~~x: LAS T W ILL AND TESTAMENT C~ . r~ - . _~_ O F ~ i.~, - --• - ~ : BEVERLY S. GURLEY ,, ; N ~ ,; . 1..:.1 ~ ~~-~ . ~ ~ ~-.. ~ v ~..? EVERLY S. GURLEY, of umberland ounty, Pennsy vania L ..') I, Last Will and Testament, hereby revoking and are this decl to be my id all Wills, Codicils, or writings in the nature thereof o making v by me at any time heretofore made. I TEM I: I direct that the expenses ~ of my last illness _ and funeral shall be paid from my e state as an administrative expense. ITEM II: I give, devise, and bequeath all my rings 'ewelr unto my daughter, Melissa S. Gurley Hoy, of and other ~ Y Lemoyne, Cumberland County, Pennsylvania. ITEM III: I give, devise, and bequeath all the rest, residue and remainder of my estate unto my beloved husband, Robert G. Gurley, provided that if he digs before the thirtieth (30) day following the day of my death, this gift shall lapse or be divested and I give such property to my issue in equal shares, per stirpes. ITEM IV: No interest of any beneficiary under this 'll or any Codicil hereto shall be subject to anticipation or W~ voluntary or involuntary alienation. ITEM V: In addition to powers given him by law. mY Executor and his successor shall have the following powers, appli- cable to all property held by them, effective without Court Order T/ .--~ `~ (SEAL) .,~ +r~~-t., ~.'~ : lia;. ..G ~. RF.~IF.RT.Y _ C;i1RI, Y r and until actual distribution: (p,) To retain any property received by him; (g) To sell real estate for any purpose, publicly or rivately, for such prices and on such terms as he deems proper, P out liability on the purchasers to see to application of the with purchase moneys; (C) To compromise Controversies; (D) To distribute in cash or kind or both at such valuations as he may fix. ITEM VI: All taxes, interest, and penalties thereon le b reason of my death with respect to property comprising payab Y toss taxable estate, whether or not passing under this Will, my g shall be paid from the principal of my residuary estate. ITEM VII• I appoint my husband, Robert G. Gurley, Executor of this Will. If he does not act or continue to act, I oint m son, Stephen C. Gurley, Executor in his place with the app Y same powers and duties. No fiduciary acting hereunder shall be required to post bond or enter security in any jurisdiction. IN WITNESS WHEREOF, I have set my hand and seal to this m Last Will and Testament, consisting of this and one other page Y seal at the end of which I have also set my hand and affixed my~ fora reater security and better identification, this T day of 9 ;, °%f* /~ ~~ ~ SEAL) BE ERLY S, GURLEY We, the undersigned, hereby declaredtbyttheeabovegnamed Will was signed, sealed, published and resence Testatrix as and for her Last Willhe~d resencentandninhthe presence of us, who, at her request and in P of each other, have hereunto set our hands and seals the day and ear above written, and we certify that adishosingemindeandumemory. Y thereof, said Testatrix was of sound an P .~ Page typo of two typewritten pages ;;% ~~ / ~ - ,i. ,. ~~ ; no i -vim L A A• ~ 1. FHA 2. FmHA 3. X CONY. UNINS. 4. QVA 5. CONY. INS. U.S. DEPARTMENT OF HOUSING 8 URBAN DEVELOPMENT 6 FILE NUMBER: 7. LOAN NUMBER: SETTLEMENT STATEMENT 8. MORTGAGE INS CASE NUMBER: C. NOTE: This form is fumpOC "rwere a d outs/d ~e clos,nquthey a're shown heref ~ Ir nfivnrPat onal pu~oses and are notenCluded iri the totals. Items marked ( I P 1.0 3f98 (LEMOYNE-1710-WALNUT.PFDILEMOYNE-1710-WALNUTrZ2) D. NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER: Inc. Estate of Beverly S. Gurley, Centric Bank Lemoyne Land Corp., 4320 Linglestown Road 319 South Third Street, P.O. Box 31 by Melissa S. Gurley Hoy Lemoyne, PA 17043 as Administratrix d.b.n.c.t.a. Harrisburg, PA 17112 G. PROPERTY LOCATION: H. SETTLEMENT AGENT: 23-2083639 I. SETTLEMENT DATE: 1710 Walnut Street Kervvin 8 Kerwin September 18, 2009 Camp Hill, PA 17011 Cumberland County, Pennsylvania PLACE OF SETTLEMENT Tax Parcel No. 01-21-0269-193 4320 Linglestown Road Harrisburg, PA 17112 101. Contract Sales Price 112,000.00 401. Contract Sales Price 102. Personal Pro 402 Personal Pro ~n~ Settlement Chames to Borrower Line 1400 2 507.25 ;ill 09/19/05 to 10/01!0 Taxes 09M 9/09 to 01 /01 h T~vaa 09/19/09 to 07/01/1 Or Barnes[ mvnvy I Amount of New Loan(a losn(s~ taken subject to to Taxes 301 Gross Amount Due From Borrowler (Line 1 302 Less Amount Paid By/For Borrower (Line 303. CASH X FROM TO BORROWER The undersigned hereby ack receipt Borrower emovne La ., nc 1,460.53 10,000.00 89. 0006 0 99,600.00 116,222.61 99,600.0 16 622.61 112,000.00 403. 404. 405. 406. Sewer Bill 09/19/09 to 10/01/09 407. Coun Taxes 09h 9/09 to 01 /01 h 0 8.15 246.68 408. School Taxes 09/19109 to 07/01/10 1 460.53 409. 410. 411. 412. 420. GROSS AMOUNT DUE TO SELLER 500. REDUCT ONS IN AM UNT DUET SELLER: 113,715.36 501. Excess De osit See Instructions 502. Settlement Cha ea to Seller Line 1400 9 920.50 503. Existin loans taken sub ect to 504. Payoff of first Mort a e 505. Pa off of second Mort a e 506. 507. 508. 509. us ens r ms n a, a er 510. Sewer Bill to 511. Coun Taxes to 512. School Taxes to 513. 514. 515. 516. 517. 518. 519. 520. TOTAL REDUCTION AMOUNT DUE SELLER 9,920.50 6 CA M T I R• 601. Gross Amount Due To Seller Line 420 ) 602. Less Reductions Due Seller (Line 520 603. CASH X TO FROM SELLER 113,715.36 ( 9,920.50 0 103,794.86 a completed copy of pages 182 of this statement 8 any attachments referred to herein. 7 Seller Es ate of Beverly S. Gurley BY• ` ~ elissa S. Gurley y ~ gsident HUO-1 (3-86) RESPA. HB4305.2 ~~ (10 TOTAL C 1 Division of 302. Loan Discount Ins. App. Fee m Fee aS „, .. s.t•• ~Te~Q RF 111RED BY LENDER TQBE.. 901. Interest From 09/18/09 to 10/01109 902 Mort a e Insurance Premium for rn 903. Hazard Insurance Premium for 1.0 904. 905. 1001. Hazard Insurance 1002. Mort a e Insurance 1003. Sewer Bill 1004. Coun Taxes 1005. School Taxes 1006. 1007. 1008. 1101. Settlement or Closin Fee 1102. Abstract or Title Search 1103. Title Examination 1104. Attome s Fees 1105. Document Pre aration Deed 1106. Nota Fees 1107. Attorney's Fees t0 to to to to to 13 to months (~ S per month months C$ a per month months ~ a per month to to to to to to to PAID FROM PAID FROM BORROWER'S SELLER'S FUNDS AT FUNDS AT SETTLEMENT SETTLEMENT 20.00 1112. 1113. Closin Service Letter to Stewart Title Guaran Com an 75.00 Releases $ Recording Fees: Deed $ 40.00; Mortga e $ 56.00; 1201 96.00 1,120.00 . 1202. Ci /Coun Tax/ tam s: Deed 1 120.00 • Mort a e 00; Mort a e 1 120 1203. State Tax/Stam s: Deed . to Re rder of Deeds 20.00 00 25 1204. UPI Certittcations to Recorder of Deeds . 1205. Asai nment of Rents 1301. Surve to to 1302. Pest Ins action 1303. Sewer Bill Jul IAu Se t 1304 to Cam Hill Borou h POC:S62.50 . 1305. 2009/2010 School Taxes to Janet L. Miller, Tax Collector 0 i E 2,507.2! 1400. TOTAL SETTLEMENT CHARGES th t edge receipt of a comp eted copy of page 2 of this two page statement. cknowl natories a si e , ey signing page 1 of this statemen g Kervvin ~ Certified to be a true copy. Settleme nt 10.00 ~ 120. 1, 870.50 ~ (LEMOYNE-1710-WALNUT / LEMOYNE-1710-WALNUT 122 ) 499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12 Phone (888) 502-4349 Fax (302) 934-2955 September 29, 2009 Manson Law OffiEes Attorneys at Law 10 East High Street Carlisle, Pennsylvania 17013 Re: Estate of Beverly S. Gurley Social Security • 172-24-9017 Date of Death • May 08. 2009 Deaz Sir or Madam: Per our inquiry dated September 24, 2009, please be advised that at the time of death, the above-named decedent had on Y deposit with this bank the following: l , Type of Account Checking Account Account Number 39177394 Ownership (Names o,~ Opening Date Balance on Dote of Death Accrued Interest Total Beverly S Gurley* 8/28/64 Closed 5/21/09 $1,349.61 $ 0.00 - ---- -- ------------------------- -- $1,349.61 Please be advised, there was no safe deposit box found for the above decedent. ou believe there are additional accounts not referenced, please provide * If upon reviewing the information above, y For any additional information on the us with an account number and/or name of any possible joint account holder. lease contact above accounts, including ownership and any changes, closures and/or reimbursement of funds, etc., p our West Shore Plaza Of~lce # 717-731-1730. S' ly, JI.O~,uQ.,: ~ Tracie Hale Adjustment Services Sn ,~~io,~ ~~>> 5~ , a~~