Loading...
HomeMy WebLinkAbout02-18-10 (2)J 1505607120 REV- ~vOO EX (06-05) OFFICIAL USE ONLY PA Department of Revenue county code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO 60X.280601 2 1 0 9 1 0 0 7 Harrisburg, PA 17128-0601 RESIDENT DECEDENT tN I tK DtGEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 159 24 9663 10 10 2009 04 29 1932 Decedent's Last Name Suffix Decedent's First Name WRIGHTSTONE MARIE (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW 1. Original Return- ^ 2. Supplemental Return ^ 3, Remainder Return (date of death prior to 12-13-82) ~~ U 4. Limited Estate 4a Future Interest Compromise ^ d ^ 5. Federal Estate Tax Return Required ( ate of death after 12-12-82) X ~ J g. Decedent Died Testate (Attach Copy of Will) ^ ~ Decedent Maintained a Living Trust (Attach Copy of Trust) 8. Total Number of Safe De pOSlt BOXeS MI G MI ^ 9. Litigation Proceeds Received ^ 1 p. 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 BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number MICHAEL L. BANGS 717 730 7310 Firm Name (If Applicable) First line of address 429 SOUTH 18TH STREET Second line of address City or Post Office State ZIP Code CAMP HILL PA 17011 REGISTEI~F WILLS USE ONLY ,_,..I ~ C? tX3 ~,. '. G7 "t7 Di4T~ILED '~ '> -.-, ...y~l ., _"~~ '~~: i"'~ ~~:~..F Correspondent's a-mail address: ~naer penalties Or penury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it isstrUe, COrrgct and complete. Declaration Of preparer other than the oersonal reeresentative is hasPri ~-, all infnrm~4inn of ,.,1,;..1, ...e...,.... ti.... „_.. ~.__._.~_~__ Kathy J. Eppley DATE ADD SS ~ ~' ~ - 3615 Horsha rive, Mechanicsburg, PA 17050 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE Michael L. Bangs 429 South 18th Street, Camp Hill, PA 17011 Side 1 1505607120 1505607120 J 1505607220 REV-1500 EX Decedent's Social Security Number Decedent's Name: Marie G. W r i g h t s t o n e 15 9 2 4 9 6 6 3 RECAPITULATION 1. Real Estate (Schedule A) .......................................................................................... 1. 105,479.37 2. Stocks and Bonds (Schedule B) ............................................................................... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C).......... 3. 4. Mortgages 8 Notes Receivable (Schedule D) .......................................................... 4. 5,000.00 5• Cash, Bank De osits 8 Miscellaneous Personal Pro a P p rty (Schedule E) ................ 5. 5 9, 9 3 5 8 5 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested ............. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested ............. 7. 8. Total Gross Assets (total Lines 1-7) ....................................................................... g. 1 7 O , 4 15.2 2 9. - Funeral Expenses & Administrative Costs (Schedule H) ......................................... - 9. 21,648.83 10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I) ................................ 10. 2,927.16 11. Total Deductions (total Lines 9& 10) ...................................................................... 11. 2 4, 5 7 5. 9 9 12. Net Value of Estate (Line 8 minus Line 11) ............................................................. 12. 1 4 5 , 8 3 9 . 2 3 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• 1 4 5 , 8 3 9 . 2 3 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 14 5 8 3 9 2 3 at lineal rate X .045 ~ 16. 6 5 6 2 7 7 ~ • 17. Amount of Line 14 taxable at sibling rate X .12 0 0 0 17. 0 0 0 18. Amount of Line 14 taxable at collateral rate X .15 0 0 0 18. 0 0 0 19. Tax Due ..................................................................................................................... 19. 6, 5 6 2 7 7 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ^ Side 2 L 1505607220 1505607220 J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-09-1007 DECEDENT'S NAME Marie G. Wrightstone STREET ADDRESS 11 North High Street CITY Shiremanstown STATE PA ZIP 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. InteresUPenalty if applicable p. Interest E. Penalty 6,000.00 315.79 Total Credits (A + B + C) (1) 6,562.77 (2) 6 , 315.7 9 (3) Total InteresUPenalty (D + E) (4) (5) 246.98 (5A) (56) 2 4 6.9 8 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. 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 the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. 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 .................................................................................................................. ^ ^ d. receive the promise for life of either payments, benefits or care? .............................................................. ^ ^ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without ((~~11 receiving adequate consideration? ....................................................................................................................... ^ u 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... ^ ~^ 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. ' _~ ~ n 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 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 tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §9116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116 (a) (1.3)]. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. Rev-1502 EX+(~~-08) SCHEDULE A REAL ESTATE COAMAONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Wrightstone, Marie G. 21-09-1007 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. (Ir more space Is needed, additional pages of the same size) Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule A (Rev. 11-08) Rev-1b07 EX+ (6-98) SCHEDULE D MORTGAGES 8 NOTES RE FINABLE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Wrightstone, Marie G. 21-09-1007 All property jointly-owned with right of survivorship must be disclosed on Schedule F. (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 D (Rev. 6-98) Rev-1508 EX+ (6-88) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Wrightstone, Marie G. 21-09-1007 InGude 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 DESCRIPTION VALUE AT DATE OF DEATH 1 Interstate Waste Services Refund 34.55 2 Motorist Mutual Home Insurance Refund 185.13 3 Refund from Blue Cross/Blue Shield 510.00 4 Refund from Comcast 8.61 5 Refund from Neill Funeral Home 229.58 6 Refund from Verizon 34.42 7 Sale of Television -see Bill of Sale attached 800.00 8 VA Refund 98.00 9 Citizens Bank -Checking Account #6100714594 7,518.92 10 Citizens Bank -Savings Account #6140171547 50,516.64 TOTAL (Also enter on Line 5, Recapitulation) I 59,935.85 (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•1151 EX+ (10-06) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Wrightstone, Marie G. 21-09-1007 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER q. FUNERAL EXPENSES: See continuation schedule(s) attached B. 1 ADMINISTRATIVE COSTS: Personal Representative's Commissions Name(s) of Personal Representative(s) Kathy J. Eppley Street Address 3615 Horsham Drive city Mechanicsburg state PA Zip 17050 Year(s) Commission paid 6,736.96 5,000.00 2. Attorney's Fees Michael L. Bangs 5,000.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 306.00 5. Accountant's Fees 300.00 6. Tax Return Preparer's Fees 7. Other Administrative Costs 4,305.87 See continuation schedule(s) attached , TOTAL (Also enter on line 9, Recapitulation) 21,648.83 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 Wrightstone, Marie G. 21-09-1007 ITEM NUMBER DESCRIPTION AMOUNT Funeral Exae,nses 1 Blooms by Vicrey -funeral flowers 199.08 2 Giant -funeral luncheon expense 27.54 3 Gingrich Memorials 2,060.00 4 Hallmark -funeral cards 15.89 5 Michael's Crafts -funeral expenses 25.43 6 Neill Funeral Home 3,715.00 7 Raddison Penn Harris -funeral luncheon 483.43 8 Reverend Arthur -funeral honorarium 200.00 9 Staples -funeral cards 10.59 H-A Subtotal 6,736.96 Other Administrative Costs 10 Beverly Meglio -reimbursement for various painting supplies 25.41 11 Bob Grosko -electrical inspection at real estate 60.00 12 Cumberland Law Journal -estate advertising 75.00 13 Jeff Kelly -upgrade of electrical service at real estate 1,300.00 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 Wrightstone, Marie G. 21-09-1007 ITEM NUMBER DESCRIPTION AMOUNT 14 Kathy Eppley -reimbursement for various expenses in getting real estate ready for 804.89 sale 15 Kathy J. Eppley -reimbursement for various expenses for house 186.50 16 Mike Noll -deposit for painting at real estate 400.00 17 Mike Noll -second installment for painting at real estate 640.00 18 Mike Noll -final payment for painting at real estate 640.00 19 The Sentinel -estate advertising 174.07 H-67 subtotal 4,305.87 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1612 EX+ (12-08) scHEO v~E ~ DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Wrightstone, Marie G. 21-09-1007 Report debts Incurred by the decedent prior to death that remained unpaid at the date of death, Including unreimbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Hampden Township Ambulance 610.00 2 Holy Spirit Hospital 302.92 3 Hospice of Cantral PA 1,020.00 4 IWS of PA -waste bill 37.02 5 Leffler Energy 412.03 6 PAWC - 9/8/09 to 10/9/09 30.48 7 PAWC -10/9/09 to 11/6/09 26,87 8 PAWC -11/6/09 to 12/8/09 28.95 9 PAWC - 12/8/09 to 1 /11 /10 26.65 10 PP&L Electric - 9/24/09 to 10/23/09 38.53 11 PP&L Electric - 10/23/09 to 11/24/09 25,27 12 PP&L Electric -11/24/09 to 12/28/09 27.43 13 PP~L Electric -12/28/09 to 1/8/10 36.38 14 Quantum Imaging 4.61 15 Spirit Physician Services 95.76 16 Spirit Physician Services 10.00 Total of Continuation Schedule See attached page TOTAL (Also enter on Line 10, Recapitulation) 2,927.16 (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-1b12 EX+ (8.88) scHEOV~E ~ DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA continued INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER Wrightstone, Marie G. 21-09-1007 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98) REV-1613 EX+ (11-08) SCHEDULE J ANIA COMM BENEFICIARIES NHERITANCE TTAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Wrightstone, Marie G. 21-09-1007 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (Words) ($$$) Do Not List Trustee a I • TAXABLE DISTRIBUTIONS [include outright spousal and transfers distributions , under Sec. 9116(a)(1.2)] See attached schedule Total Enter dollar amounts for distributions shown above on lines 1 5 through 18 on Rev 150 0 cover sheet, as appro priate, II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I 0.00 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 11-08) SCHEDULE J BENEFICIARIES (Part I, Taxable Distributions) ESTATE OF: Marie G. Wrightstone 10/10/2009 159-24-9663 Item Name and Address of Person(s) Share of Estate Amount of Estate Number Receiving Property Relationship (Words) ($$$) 1 Elizabeth K. Eppley Grandchild 1,000.00 430 Brookview Court Mechanicsburg, PA 17050 2 Kathy J. Eppley Daughter one-third of residue 3615 Horsham Drive Mechanicsburg, PA 17050 3 Nathan D. Eppley Grandchild 1,000.00 422 Hillside Road New Cumberland, PA 17070 4 Beverly J. Meglio Daughter one-third of residue 2011 General Potter Hwy. Centre Hall, PA 16828 5 Jesse M. Meglio Grandchild 1,000.00 18 S. Harley Avenue Gloucester City, NJ 08030 6 Kristine M. Meglio Grandchild 1.000.00 449 Northstar Drive Harrisburg, PA 17112 7 Walter Bruce Wrightstone Son one-third of residue 430 Orchard Drive Steelton, PA 17113 Tote I 1 A. Settlement Statement R TVnP of I non form HUD-1 (3/86) ref Handbook 4305.2 U.S. Department of Housing and Urban Development nsec e.,..~,,...,t ni„ ocno nocc 1. ^FHA 2. ^FmHA 3. ^Conv. Unins. 4. ^VA 5. pConv.lns. 6. File Number 09367 7. Loan Number 8. Mortgage Insurance Case Number s orm is urnr e o give you a amen o amen co s. oun s pei o sn se amen agen ens own. C. Note: Items marked "(p.o.c.)" were pale outside the dosing; Grey are shown Here for information purposes and are not Irxiuded in th totals. WARNING: II is a crime to knowingly make false alatemenls to Cte UnNsd States on Ihls a any other slmller form. Penalties upon convection can include a fine ono im sonment. For details see: Title 1fl U. S. Code Sectlon 1i1o1 and section toto. TItIeEXpreSS Settlement System Printed 01107!2010 at 09:40 CH D. NAME OF BORROWER: Hong My Dinh ADDRESS: 405 E Main Street Shiremanstown PA 17011 E. NAME OF SELLER: Marie G. Wrightstone Estate ADDRESS: 11 N Hi h Street Shiremanstown PA 17011 F. NAME OF LENDER: ADDRESS: G. PROPERTY ADDRESS: 11 North High Street, Shiremanstown, PA 17011 Shiremanstown Borou h H. SETTLEMENT AGENT: 1st Advantage Settlement Services Inc., Telephone: 717-591-7755 Fax: 717-591-7756 PLACE OF SETTLEMENT: 6375 Mercu Drive Suite 102 Mechanicsbur PA 17050 I. SETTLEMENT DATE: 01108/2010 J. SUMM RY OF BORROWER'S TRANSACTION: K. SUMMARY OF SELLER'S TRANSACTION: 100. GR SS AMOUNT DUE FROM BORROWER 400. GROSS AMOUNT DUE TO SELLER 101. Contract sales rice 114 000.00 401. Contract sales rice 114 000.00 102. Personal Pro art 402. Personal Pro art 103. Settlement char es to borrower line 1400 2135.75 403. 104. 404. 105. 405. Ad'ustments for items aid b seller in advance Ad'ustments for items aid b seller in advance 106. Cit (town taxes 406. Ci flown taxes ' 107. Count taxes 407. Count taxes 108. School taxes 01!08110 to 06130/10 632.20 408. School taxes 01108110 to 06130110 632.20 109. Sewer 01108110 to 03131/10 40.57 409. Sewer 01108110 to 03131110 40.57 110. 410. 111. 411. 112. 412. 120. GROSS AMOUNT DUE FROM BORROWER 116 808.52 420. GROSS AMOUNT DUE TO SELLER 114 672.77 200. AMOUNTS PAID BY OR ON BEHALF OF BOR ROWER 500. REDUCTIONS IN AMOUNT DUE TO SELLER 201. De sit or earnesrt mone 1 000.00 501. Excess De sit see instructions 202. Princi al amount of new loans 502. Settlement char es to seller line 1400 9184.00 203. Existin loans taken sub'ect to _ 503. Existin loan s taken sub'ect to 2~• 504. Pa off of First Mort a e Loan 205. 505, 206. ~, 207. 507. Inheritance Tax Escrow 6 300.00 1st Advanta a Settlement Servi 208. 508. 209. 509. Ad'ustments for items un aid b seller Ad ustments for items un aid b seller 210. Cit (town taxes 510. Cit (town taxes 211. Count taxes 01101110 to 011081 y 0 9.40 511. Count taxes 01101110 to 01108110 9.40 212. School taxes 512. School taxes 213. 513. 214. 514. 215. 515. 216. 516. 217. 517. 218• 518. 219. 519. 220. TOTAL PAID BYIFOR BORROWER 1009.40 520. TOTAL REDUCTION AMOUNT DUE SELLER 15 493.40 300. CASH AT SETTLEMENT FROM OR T~ BORR OWER 600. CASH AT SETTLEMENT TO OR FROM SELLER 301. Gross amount due from borrower line 120' 116 808.52 601. Gross amount due to seller line 420 114 672.77 302. Less amounts aid b /for borrower line 220 1 009.40 602. Less reduction amount due seller line 520 15 493.40 303. CASH FROM BORROWER 115 799.12 603. CASH TO SELLER 99179.37 IJ.S. GEPARTMENT F HOUSING ANU t I'.T ~ T!-ear\IT nro tvumurn. ~....... T:11..C....«..... Q..Hl.~mnnl Cvefem Drinlul n~m~nnm at nQ•dn cN J_C ( I LGIYIGI\ 1 V 1 n 1 ~nl~l~ 1 • •^--•~ •--- ------------- - -- L. SETTLEMENT CHARGES PAID FROM PAID FROM 700. TOTAL SALESlBROKER'S COMMISSION based on rice x114 000.00 7.000 = 7 980.00 BORROWER'S SELLER'S Division of commission line 700 as follows: FUNDS AT FUNDS AT 701, 3 395.00 to RelMax 1st Advents a SETTLEMENT SETTLEMENT 702, 4 585.00 to Prudential Homesale Services Grou 703. Commission aid at Settlement 7 980.00 800. ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Ori ination Fee °k 802. Loan Discount °~ 803. A sisal Fee 804. Credit Re rt 805. Lender's Ins action Fee 806. Mort a e A lication Fee 807. Assam lion Fee BOB. 809. 810. 811. , 900. REMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest From to Ida 902. Mort a e Insurance Premium for to 903. Hazard Insurance Premium for to 904. 905. 1000. RESERVES DEPOSITED WITH LENDER FOR 1001. Hazard Insurance mo. Ire 1002. Mort a e Insurance mo, Imo 1003. Cit Pro art Tax mo. Imo 1004. Count Pro eri Tax mo. 40.88 Imo 1005. School taxes mo. 110.51 !mo 1009. A re ate Anal sis Ad'ustment 0.00 0.00 1100. TITLE CHARGES 1101. Settlement or closi fee 1102. Abstract or title search 1103. Title examination 1104. Title insurance binder 1105. Deed Pre - POC to Ban s Law Office 1106. Note Fees to Carol A. Hinman 5.00 10.00 1107. Attome 's fees includes above items No: 1108. Title Insurance to 1st Advanta a Settlement Services Inc. 928.75 includes above items No: 1109. Lenders Polic 1110. Cryvners Polic -107118626 114 000.00 - 928.75 1111. 1112. 1113. t 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recordin Fees Deed 62.00 ~ Mort a e ~ Release 62.00 1202. Cit /Count tax/slams Deed 1 140.00 • Mort a e 1 140.00 1203. State Taxlstam s Deed 1 140.00 ~ Mort a e 1 140.00 1204, 1205. 1300. ADDITIONAL SETTLEMENT CHARGES 1301. Sewer 1/1-3131 #5011520 to Lower Allen Townshi 44.00 1304. Tax Cerl Fee to 1st Advents a Settlement Services Inc. 10.00 1400. TOTAL SETTLEMENT CHARGES tenter on lines 103, Section J_and 502, Section K1 2135.7 5 9184.00 HUD CERTIFICATION OF eUYER AND SELLER I have carefully reviewed me HUD-1 Settlement Slateme , ~ n to the bee pf my knowledge and bsNaf, It Is a We and accurate statement of all receipts and tllsbursemenls made an my account or by me in this lrensaclio . I further ceNfy that I have re ve a copy HUD-1 Settement Statement ong y ~' ~ ,LCXEL a 9 S e WARNING: IT IS A IME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE The HUD-1 SelllemeM Statement which I have prepared is a True and accurate account of this UNITED STATES ON THIS OR ANY SIMILAR FORM. PENALTIES UPON CONVICTION banaacdon. 1 have caused or will cause the lands to ba disbursed in accordance with This elatement. CAN INCLUDE A FINE AND IMPRISONMENT. FOR DETAILS SEE TITLE 18: U. S. CODE SECTION 1001 AND SECTION 1070. _ SETTLEMENT AGENT: DATE: i~~ _! a~ Citizens Bank November 18, 2009 MICHAEL L BANGS 429 SOUTH 18TH STREET CAMP HILL PA 17011 Estate of MARIE G WRIGHTSTONE Date of Death: Oct 10, 2009 SSN: 159-24-9663 Dear Sir/Madam: 525 William Penn Place Suite 153-2618 Pittsburgh, PA 15219 In accordance with your request, the attached information sheet has been provided in the above decedent's name as of his/her date of death. For IL or LC accounts, contact our Loan Department at 1-800-708-6680. For all other inquiries, please call 1-888-999-6884 Sincerely, J Bush Operations Services ~~ Citizens Bank Account Number 6140171547 Account Title MARIE G WRIGHTSTONE Date O ened 10/24/1985 Account T e Savin4s Principal Balance as of DOD $50516.64 Interest from Last Postin to DOD $ .21 Account Balance as of DOD $50516.85 YTD Interest to DOD $47.91 Citizens Bank Account Number 6100714594 Account Title MARIE G WRIGHTSTONE Date O ened 8/ 19/ 1974 Account T e Checkin Principal Balance as of DOD $7518.92 Interest from Last Postin to DOD $ .00 Account Balance as of DOD $7518.92 YTD Interest to DOD $47.91 BILL OF SALE I, WALTER B. WRIGHTSTONE, have purchased a Samsung Television (IM40A650A) from the Estate of Marie G. Wrightstone for the sum of Eight Hundred and 00/100 ($800.00) Dollars. /'~•..~.. ~VTV ~L 1 Iil~\. ~. ~YV' ~'~3 ~i T~)'i vi~r~E .* LAST WILL AND TESTAMENT LAW OFFICES SNELBAKER, BRENNEMAN & SPARE I, MARIE G. WRIGHTSTONE, of the Borough of Shiremanstown, County of Cumberland, and Commonwealth of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, 1lereby revoking and making void all former wills and codicils by me at anytime heretofore made. FIRST. I order and direct that all my just debts and fiuleral expenses be paid by my Executrix or Executors, as the case maybe, hereinafter named, as soon as conveniently may be done after my decease. SECOND. I give and bequeath the sum of One Thousand ($1,000) Dollars to each of my grandchildren, namely, NATHAN EPPLEY, ELIZABETH EPPLEY, JESSE MEGLIO AND KRIST MEGLIO, who survive me. THIRD. I give, devise and bequeath al] the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever and wheresoever situated, in equal shares unto my three (3) children, namely, BEVERLY J. MEGLIO, KATHY J. EPPLEY and WALTER BRUCE WRIGHTSTONE, share and share alike. If any of my said children should predecease me, I order and direct that the foregoing shaze attributable to such deceased child shall lapse and my residuary estate shall be distributed equally between those children who survive me, without substitution of issue. LASTLY. I nominate, constitute and appoint my daughter, namely, KATHY J. EPPLEY, to be the Executrix of this, my Last Will and Testament, but if for any reason she should fail'to qualify as such Executrix or cease so to serve, then and in that event, I nominate, constitute and appoint my two (2) other children, namely, BEVERLY J. MEGLIO and WALTER BRUCE WRIGHTSTONE, to be the Executors hereof, each and all to serve without bond or other security as a condition of qualification hereunder. 1N WITNESS WHEREOF, I, MARIE G. WRIGHTSTONE, have hereunto set my hand and seal to this ray Last Will and Testament, which consists of two (2) typewritten pages to each ~+ of which I have affixed my signature this p~ Q !' day of November, A.D. Two Thousand Three (2003). ' - SEAL) MARIE G. WRIGHT ONE The preceding instrument, consisting of this and one other typewritten page, each identified by the signature of the Testatrix, was on the date thereof signed, sealed, published and declared by MARIE G. WRIGHTSTONE, the Testatrix therein named, as and for her Last Will and Testament, in the presence of us, who, at her requ in her presence and in the presence of each other, have subscribed our names as witnesse er to. LAW OFFICES SNEL9AKER. BRENNEMAN & SPARE COMMONWEALTH OF PENNSYLVANIA) COUNTY OF CUMBERLAND . SS. We, MARIE G. WRIGHTSTONE, RICHARD C. SNELBAKER and JANE J. GOONEY, the Testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and Testament and that she had signed willingly, and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as a witness and that to the best of his or her knowledge, the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. estatrtx fitness ~~~ ~ C (~e-~J (( W ness Subscribed, sworn to and acknowledged before me by MARIE G. WRIGHTSTONE, the Testatrix, and subscribed and sworn to before me by RICHARD C. SNELBAKER and .iANE J. GOONEY, tine witnesses, this ~.o~~ day of November, 2003. Stman L. Zych, MoRary Publb - ~"~ Boro,Gunbe~lar~dCour~r Notary Public ~ ,% Ally E~q~116s Nw. 24, 2000033 Winmt>~c. P~+linsvhranla A.sstx`f~tlcxt cA ~k1FA1(es -2- ~I~ '~ ,~ a~° ~ G~ a~ o ~ \~~Q~