HomeMy WebLinkAbout03-23-10 (2)15056041125
REV-1500 ~ (~) OFFI~. l,~ OIILY
PA Depslbllellt d Revenue
Blaaau d MtlMd~d Ta>oee INHERITANCE TAX RETURN Code YAar FYe Nwrlber
PO eox 280SD1 2 1 0 9 0 9 3 1
Heniebuta. PA 171211-0601 RESENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Soaal Security Number Date of Death Date of Birth
1 8 1 0 3 5 7 1 8 0 9 1 7 2 0 0 9 0 1 1 9 1 9 1 7
DeoedeM's Last Name
B L A C K
Sutibc DeoedeM's First Name
LAW R E N C E
(M Applicable) Enter Surviving Spouse's Infortnagon BNawlr
Spouse's Last Name Sufioc Spouse's First Name
Spouse's Soc9al Security Number
FILL IN APPROPRIATE OVALS BELOW
® 1. Original Retum
4. Limited Estate
® 6. Deoedsrlt Died Testate
(Attad- copy of Wdn
9. Litigation Proceeds Received
THIS RETURN MUST BE FILED IN DUPUCAtE WITH THE
REGISTER OF WILLS
MI
E
MI
2. Supplemental Retum
4a. Futuro Interest Compromise (date of
death aRer 12-12-82)
7. DscedeM Maintained a Living Trust
(Attach Copy of Trust)
10. Spousal Poverty Credit (data of death
between 12-31-91 and 1-1-95)
3. Remainder Retum (date of death
prior to 12-13-82)
5. Federal'Estate Tax Retum Required
8. Total Number of Safe Deposit Boxes
11. Eladion to tax under Sec. 9113(A)
(Attach 'Sch. O)
CORRESPONDENT -TINS SECTION MUST BE COMPLETED. ALL CORRE
Name
W I L L I AM A D U N C A N
Fim Name (K AppNcable)
D U N C A N & H A R T M A N,
First lice of addross
1 I R V I N E R O W
Second line of address
City or Post Oflloe
C A R L I S L E
Conespondent'a e-mail address: biildunCdn~De.n@t
v
~O~
a
DATE FILED
_~ z
_:;.
T:i
~:
i'ri
~~
..;.,
AND CONFIDENTIAL TAX NIFORMJ-TION SHOULD BE DIRECTED T0:
Daytime Telephone Number
7 1 7 2 4 9 ~,,7 8 0
P C
Stabs ZIP Code
P A 1 7 0 1 3
lJrxier perreNiee d penury, I dedne that I hwe examined this Islam. indudirg aooompairyirg sdledl~les and abslemerNa, and b the beet d my leawbdpe and beNei,
k is true, oomect and oanpkbe. d piepeie- other then the persond ropreserNalNe is based on al Monnelion d wfdCh preperelr has airy Imowledpe.
SIG RE OF PER FOR FILMIG RETURN DA
4~~
SS
14 KINGSBRIDGE CIRCLE CARLISLE PA 17013
OF PREPARER OTHER
DATE
1146 S. PITT STREET CARLISLE PA 17013
PLEASE USE ORIGINAL FORM ONLY
Sidi 1
L 15056041125 1.5056041125 J
~~
J
15056042126
REV-1500 EX
DecadeM'a Social Security Number
Deoedsnrs Nanb: LAWRENCE E. BLACK 1 8 1 0 3 5 7 1 8
RECAPITULATaN
1. Real estate (Sdbdub A) ....................................... . 1. 1 6 0 1 2 7, 9 4
2. Stocks and Bonds (Sdbdub B) ................................. . 2. •
3. Ckx;ely Fold Corporation, Partnership or Sole-Proprietorship (Sdbdub C) ..... 3. •
4. Mortgages ~ Notes Reoeivabb (Schedub D) ........................ 4. 0 . 0 0
5. Cash, Bank Deposits S MiaoeManeous Personal Property (Schedub E) ....... 5. 5 6 1, 7 8
6. Joi owned ~ eq
ntly Property (Schsdub F) ^ Separate Biili R nested .......
S. 0 , 0 0
7. Inner-Vivoa Transfers 8 Miscellaneous -Probate Property
Sd
d
~
4
5
7
1
2
7
2
(
re
ub G)
Separate Billing Requested ....... 7. ,
8. Total Gross Asset (total Lines 1-~ ........................... 8. 2 0 6 4 0 2, 4 4
9. Funeral Expenses ~ Administrative Costs (Sclbdub H) ................ 9. 1 2 1 1 6 , 8 9
10. Debts of Decedent, Mortgage Liabilities. 8 Liens (SGbdub i) ............ 10. 4 5 3 9 8 , 0 0
11. Total Deductions (total Luba 9 8~ 10) ........................... 11. 5 7 5 1 4 , 8 9
12. Net Valw of Estab (Line 8 minus Line 11) ......................... 12. 1 4 8 8 8 7 , 5 5
13. Charitabb and Governmental BequesWSec 9113 Tnrats for whidr
an election to tax has not been made (Schsdub J) .................. 13.
14. Net Vslw Subject to Tax (Line 12 minus Line 13) .................. 14. 1 4 8 8 8 7 , 5 5
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATE8
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(ax1.2> x.o _ 0. 0 0 15. 0. 0 0
16. Amount of Line 14 taxabb
1 4 8 8 8 7. 5 5
at lineal rate X .045 1s 6 6 9 9. 9 4
17. Amount of Lino 14 taxabb
at abling rate X .12 0. 0 0
1 ~.
0.
0
0
18. Amount of Line 14 taxabb
~ 0 ~
at oolbteral rate X .15 18. ~. ~ 0
19. Tax Dw ................................................ 19.
20. FlLL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
6 6 9 9. 9 4
Slide 2
15056042126 15056042126
REV 1500 EX Pepe 3
Decedent's Complete Addlress:
Fib NWnber
21 09 0931
oECEOENrsIVAhE
LAWRENCE E. BLACK
sTREEr ADORESs
24 CLIFTON TERRACE
CITY
CARLISLE STATE
PA ZIP
17015
Tax Payments and Credifia:
,. Tax Due (Page 2 Line 19)
2. CreditslPayments
A. Spousal Poverty Credit
B. Prior Payments 4,500.00
C. DLscount 236.84
3. InterestlPenally 'rf applicable
D. Interest
E. Penalty
4.
5.
ff Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
FNI M ovN on Pape 2, Line 20 b rogwat a rNund.
ff 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.
(1) ss99.94
Total Credits (A +B +C) (2) 4,736.84
Total InterestlPenalty (D + E) (3) 0.00
(4)
0.00
(5) 1,963.10
(5A)
B. Enter the total d line 5 +5A. This is the BALANCE WE. (5B) 1,9s3.10
Make Check Payable to: REGISTER OF NRii..L.S, AGENT
PLEASE ANSVYER THE FOLLOYYING QUESTIONS BY PLACING AN "X" iN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes tJo
a. retain the use or inoarre d the property transferred : ...................................................................... ® ^
b. retain the right b designate who shaA use the property transferred or its income; ............................... ^
r~ retain a reversionary or ................................................................................................ ^
d. receive the promise for Nk d either payments, benefits or care? ....................................................... ^
2. M death oaxrrred aAer December 12,1962, did decedent transfer property wiftrin one year d death
wNfrord reoeivirg adequate consideramon? ....................................................................................... ^
3. Did decedent awn an'~ bust for' or payable upon d~u, bank aocaxrt or seaxfty at his or her death? ......... ^ ^
4. Did decedent own an Individual Retirement Aooount, annuity, or other non~robate property which
contains a benefiaary designation? .................................................................................... ^
..............
IF THE ANSYYER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE R AS PART OF THE RETURN.
For dates d death on or after July 1,1994 and before January 1,1995, the tax rate imposed on the net value d transfers to ar for the use d the surviving spouse
is three (3) percent (12 P.S. §9116 (a) (1.1) (i)).
For dates d death on or after January 1.1995, the taut rate imposed on the net value d transfers to or for the use d the surviving spouse is zero (0) percent
[12 P.S. §9116 (a) (1.1) (r)J. The statute does rat exempt a transfer b a surviving spouse from tart, and the statutory requirements for disdosrxe d assets and
fisrg a tax return are sMl appNcable even A the surviving spouse is the only ber>efiriary.
Far dates d death on or after July 1,2000:
The tart rah imposed on the net value d transfers from a deceased childtwenty-one years d age a younger at death b or for the use of a natural parent, an
adoptlve parent, or a stepparent d the cfir7d is zero (0) percent (72 P.S. ~116(aK1.2)).
The tax rate irtposed on the net value d transfers to or for the use d the decedent's lineal benefiaaries is four and one-hall' (4.5} percent, except as nobd in
72 P.S. §9116(1.2) [72 P.S. §9116(aX1)).
The taa rate irrrposed an the net value d b'ansfers to or for the use d the deceder~'s sibNngs is twelve (12) percent (72 P.S. §9116(aX1.3)). A siekng is defined, urMer
Section 9102, as an individual who has at least ape parent in conrrnon wAh the decedent, whether by blood or adoption.
REV 1502 EX t (8-96)
aCHEDlJLE w
CoNNAONwF~uTN of FENNSnvANM REAL ESTATE
INMERRANCE TAX RETURN
RESDEN'T DECEDENT
ESTATE OF FILE IAIMBER
LAWRENCE E. BLACK 21 09 0931 _
N aM propeAr orwred solely or as ~ Mnnrt h coornan nwet be raporbd ~ fak narkat vaNre. Fair med~et value is defined as the price ~ wMch properly would be
exdtarrged between a w(NYrg buyer and a wiirrg seNer, neitiret being cortpeNed b buy or seN, both having reasonable knowledge of the rebvant fact.
liM nlrielr N rr~ d rawt M dMclsssd on Sclrsdrrls F.
ITEM VALUE AT DATE
NUII~ER DESCRIPTION OF DEATH
1. 24 CLIFTON TERRACE 159,000.00
CARLISLE, PA 17015
[RETAINED LIFE ESTATE -SEE ATTACHED HUD SHEET]
2. CITYiTOWN TAXES - PRORATA 69.51
[SEE ATTACHED HUD SHEET]
3. SCHOOL TAXES - PRORATA 1,013.33
[SEE ATTACHED HUD SHEET]
4. ASSOCIATION PRORATA FOR OCTOBER 45.10
[SEE ATTACHED HUD SHEET]
TOTAL (Also er-!er on line 1, Recapitulation) I i 160,127.94
REI/-1508 IX + (~
scwEOVCF E
~~,,,,,,,E„ ~,,, ~ ,,,~, CASH, BANK DEPOSITS, 8e MISC.
~'"~ Tt c ~~ PERSONAL PROPERTY
ESTATE OF FILE NUMBER
LAWRENCE E. BLACK 21 09 0931
include ~e proceeds of Ipipalbn and ttie dale Uie were renewed by the estate.
AN wMh of mint b~ dhdo:•d on ScinduM F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. THE SENTINEL -REFUND 10.91
2. BLUE CROSSBLUE SHIELD REFUND 23.95
3. STATE FARM INSURANCE REFUND 174.07
4. CHASE HOME FINANCING LLC REFUND 13.79
5. SOUTH MIDDLETON TOWNSHIP AUNTHORITY WATER 8 SEWER REFUND 101.00
6. READER'S DIGEST REFUND 7.50
7. MEMBER'S FIRST FEDERAL CREDIT UNION REFUND 89.85
8. PPL REFUND 140.71
TOTAL (Also enter an line 5, Recapih,l8~on) I s
REV 1510 EX + (8-08)
Col~ioNwF~TH of PENNSnvAN~-
CiF1ERRANCE TAX RETURN
RESIDENT DECEDENT
OF
scNEOV~ c
INTER-VNOS TRANSFERS 8
MISC. NON-PROBATE PROPERTY
LAWRENCE E. BLACK 21 09 0931
This sdiedule must be wmpleled and tied if Cie answer b any of questions 1 thnwgh ~ on the reverse side ~ 1he REV-1500 COVER SHEET b yes.
ITEM
NUMBER DESORPTION OF PROPERTY
.«xuoen+ew~a~n+e.nr~ena,~naaxrmoEC~e~ra+u
n+e an aF nwerse ~n~ ~cOw a nE o®wa ~x Esr~h.
DATE OFDFJITH
VALUE OF ASSET
%OFDECD'S
INTEREST
EXCLUSION
~ q
TAXABLE
YALUE
1. FIRST NATIONAL BANK OF CHESTER COUNTY 10,953.00 100. 3,000.00 7,953.00
CD ~ 290005943-092009-LAWRENCE BLACK EXCLUSION
[SEE ATTACHED DATE OF DEATH LETTER]
2. FIRST NATIONAL BANK OF CHESTER COUNTY 8,423.38 100. 3,000.00 5,423.38
CD ~ 290005945-09-2009-CAROL YENTZER EXCLUSION
[SEE ATTACHED DATE OF DEATH LETTER]
3. FIRST NATIONAL BANK OF CHESTER COUNTY 2,287.05 100. 2,287.05
CHECKING ACCT. ~ 112801 -09/2009
[SEE ATTACHED DATE OF DEATH LETTER]
4. MEMBERS FIRST FEDERAL CREDIT UNION 4,369.82 100. 4,369.82
SAVINGS ACCT. #3574-00 - 08J2009
[SEE ATTACHED DATE OF DEATH LETTER]
5. MEMBERS FIRST FEDERAL CREDIT UNION 4,000.00 100. 4,000.00
SAVINGS ACCT. ~ 3574-04 -08/2009
[SEE ATTACHED DATE OF DEATH LETTER]
6. MEMBERS FIRST FEDERAL CREDIT UNION 3,009.20 100. 3,009.20
HOLIDAY CLUB ACCT. ~ 3574-02 -082009
(SEE ATTACHED DATE OF DEATH LETTER]
7. MEMBERS FIRST FEDERAL CREDIT UNION 10,397.95 100. 10,397.95
CHECKING ACCT. #3574-11 -088009
[SEE ATTACHED DATE OF DEATH LETTER]
8. MEMBERS FIRST FEDERAL CREDIT UNION 575.56 100. 575.56
INVESTMENT SAVINGS ACCT. ~ 3574-05 -08/2009
[SEE ATTACHED DATE OF DEATH LETTER]
9. MEMBERS FIRST FEDERAL CREDIT UNION 7,696.76 100. 7,696.76
CERTIFICATE OF DEPOSIT ~ 3574-44 - 08/2009
[SEE ATTACHED DATE OF DEATH LETTER]
TOTAL (Also er~e- on prre 7 Recapitulatlor-j (= 45, 712.72
REV-1511 EX + (12-99)
scHEOV~ H
coe~oNwEA~TH of PENNSYWANIA FUNERAL EXPENSES Br
MHERRANCE TAX RETt~tN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBE
LAWRENCE E. BLACK 21 09 0931
Dabta of dacederrt mwt be reporbd on SolradrrN I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. HOFFMAN-ROTH FUNERAL HOME 8,732.89
B. ADMINISTRATIVE COSTS:
1. Personal RepresentetiMe's Commissions
Name d Persarel RepreserMstlre (s-
Sooid Seaaihr Nianber(syEtN Number d Personal Repaeenk~e(a)
Sheet llddieas
CiAr Stab Zip
tea(s) Carxniesion Paid:
2, AtbmdJtFeee DUNCAN 8 HARTMAN, PC 3,055.00
3, Farm E~aempron: (K decedent's adds is rxx the same as deimer~fs, attach explerrelbn)
Clairrerk
Strout Addre~
Cibr Sbb Zip
RebYarslrip d Claimant b Deoederrt
4. prpbab Feee REGISTER OF WILLS 114.00
5. Aooarnbn[s Fees
6. Tax Refum Propsers Fear
7. REGISTER OF WILLS -FILING FEE 15.00
8. HELD IN RESERVE 200.00
TOTAL (Also enter an fine 9, Recapitul8tion) ~ i
11
REV-1512 EX + (12-03)
scMEOV~E ~
~TM of PENNSrw~wa DEBTS 0~ DECEDENT,
'""~'~""~ T""'~" MORTGAGE LIABILITIES, 8 LIENS
RESIDENT DECEDENT
ESTATE OF FILE !NJ
LAWRENCE E. BLACK 21 09 0931
Report dabls hxumd br tll! daCadarlt prior b daalh which rwnaNlad unpaid as of flea dale of dsalh, irldudhp unnMubur'wad madicatl expanses.
REM VALUE AT DATE
FIBER DESCRIPTION OF DEATH
1. MEMBERS FIRST FEDERAL CREDIT UNION 43.28
VISA ACCT. dt 4672090000230391
[SEE ATTACHED DATE OF DEATH LETTER]
2. SOUTH MIDDLETON TOWNSHIP WATER & SEWER BILLING 101.00
3. CARLISLE PETROLEUM INC. 128.06
4. PRESCRIPTION PLUS iNC. 23.95
5. CLEANING SERVICES 60.00
6. CARPET CLEANING 8,4.75
7. TRASH REMOVAL 61.84
8. BATHROOM SHOWER ITEMS x,54
9. HERMAN PLUMBING 119.75
10. CARLISLE PETROLEUM INC. 95,00
11. SMITH'S APPLIANCE -REPAIRS 31.75
12. WASHINGTON MUTUAL PAYOFF OF MORTGAGE 40,992.66
[SEE PAYOFF STATEMENT ATTACHED]
13. DUNCAN 8 HARTMAN, PC -SETTLEMENT ATTORNEY'S FEE 275.00
[SEE ATTACHED HUD SHEET]
14. BANK CHECK FEES TO FREY 8 TILEY 20.00
[SEE ATTACHED HUD SHEET]
15. TRANSFER CHARGES 1,590.00
[SEE ATTACHED HUD SHEET]
TOTAL (Abo enter an line 10, Recapilul9tion) : 45 398.00
(If mole space is needed, :serf addltlonal sheela of the same sine)
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
LAWRENCE E. BLACK 21 09 0931
Decedern's Name Page 1 Fib Number
Schedule 1-Debt of Decedent, Mortgage Liabilities, b Lfens
ITEM
NUMBER DESCRIPTION AMOUNT
16. PAINTINGJREPAIRS/CLEANING FEES 990.00
[SEE ATTACHED HUD SHEET]
17. FINAL WATER 8 SEWER CHARGES 125.42
[SEE ATTACHED HUD SHEET
18. U.S. TREASURY - 2009 INCOME TAX DUE 633.00
s~lBTO'fAl 1 1,748.42
GRAfO TOTAL Sg1E0ULE I : 45, 398.00
REV-1513 EX + (9-00)
SCHEDULE)
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OF
FILE
LAWREN CE E. BLACK 11 uy u93~
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [ndude ht spousal distributans, and transfers under
t
9116
2
S
. )
(a (
ec.
1. LARRY B. BLACK Lineal
14 KINGSBRIDGE CIRCLE 50% SHARE
CARLISLE, PA 17013
2. CAROL YENTZER Lineal
1146 S. PITT STREET 50% SHARE
CARLISLE, PA 17013
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 T HROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
1. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET :
llf mrua cnara is naariarl incPA arirlitinnal chr~fc of tha cams ci~al
1. FNA 5 m m nt H n 0 m Form U N Ps N.
2. FmI4A 6. Flle Number 7. Lan Number 8. Mortgage Insurance
3. Conv. Unlns. Cass Numbly
4.-VA RE3233
5. cony. [ns. ABST#6557
C. This form is fUmished m qiw you a statement d actual settlement cab. Amounts paid m end by the settlement agent am shown. Items marked "(p.o.c.)' wen paid outs
the dosl • the an shown hen for infortnatbnal u and an not Indudad In the mtals.
0. Name and Address of Borrower: E. Name and Address d Seller:
ROGER L. CALAMAN LARRY B. BLACK
541 N. WEST STREET DARLENE M. BLACK
CARLISLE, PA 17013 CAROL M. YENTZER
RODNEY L. YENTZER
F. Name and Address of Lender
N/A
N. Buyer's Settlement Agent: Frey A Tile~f Law Offlee
S South Hanover St.
'[N 25-1730535 Carlisle, PA 17013
1. SUMMARY OF BORROWER'S TRANSACTION
loo
101 ContraG sales prig
302 Personatproperty
103 Settlement Charges from (Una 1400)
104
305
AQ(usbnents Ibr hems paid by sdMr In advance:
la gty/mwn taxes 10/22/09 m 12/31/09
log County taxes
loe Assessmerns
109
11o Schad taxes 10/22/09 m 6/30/10
313
132 ASSOCIATION DUE PRORATED FOR OCT.
120 erOw AmeuM DW Front eerrOret
200. . ,. %:~ ~
201 DepaeR or earnest molly
202 Pnntlpal amount o/ new loan(s)°t
zoo Existlnq Inn(s) taken wb~ct m
204
205
206
20~
2a
209
AdJusbnenb /Or Items upaid by seller
210 Clty/town taxes 1/1/09 m 10/22/09
211 County taxes
212 AsflfsmMb
211
z14 SCrOOltaxes 7/1/09 m 10/22/09
215
216
217
2/s
219
220 Trial -ald ey/POr eer.e.w
G. Property Lacatlon
24 CLIFTON TERRACE, CARLISLE, PA 17013
SOUTH MIDDLETON TOWNSHIP
CUMBERLAND COUNTY
t. settlement oats: Play a Settlement:
October 22, 2009 S South Hanover Street
Ia
~.
159,000.00 401 contract Sales prig
402 Personal property
2,939.00 403
.404
405
AdJustrnentr !br Items paid by sdkr /n advance:
69.51 Iob City/town taxes 10/22/09 m 12/31/09
407 County taxes
Ice Assesemente
409
1,013.33 41o school axes 10/22/09 m 6/30/10
411
45.10 412 ASSOCU-TION DUE PRORATED FOR OCT.
163,066.94
as:sasssss Izo craw Amount Dw to sdker
1,000.00 sot exact depalt (see Instnxxions)
sat Settlement charges m seller (urn 1400)
503 Exfstlnq len(s) taken subJeU m
so+ PayoR of first mortgage loan WM
sos PayoR o/ semnd mortgspe Ian
sob LOAN NO. 0604352911
soy GOOD THROUGH 10-30-09
sae
sag
~~
AdJusbnenb R7r Items upaid by seller
sla Clty/town taxes 1/1/09 m 10/22/09
511 County taxes
512 AeeespnNlb
SS]
514 Schad taxes 7/1/09 m 10/22/09
S15
Sib
S17
sle
S1a
1,000.00 b2a Total Reduetlom to Amt Dw Se1Nr
159,000.00
69.51
1,013.33
45.10
160,127.94
sasass=sea
1,000.00
3,000.42
40,992.66
44,993.05
son At ealtle~p~t.Etant
sal Gros amount due from twrrowr pine 120) .:
163,066.94 soo hall _.... _ Ti,~l~w~,~ri,,,,;;~ .. ~ - --;
sot Gras amount m seller from (Ime 420) 1610,127.94
sot Less amounts paid by/for borrower (from IUe 220) 1000.00 sot Ltle reductions in amount due seller (from an. 520): 993.05
sot Cash (X) -ran O To eerr.wer 162,066.94 sos CaeA ( )Fran (x) To seNar 1115,134.56
ass ss ss sos sssissssas
nuu-i ~. selT~essenT arw~es Page No. 2
2oR Totem SfNs/b~okn's Cgmns. Wed ms pa~~ isf.00o.00 O x ^ 0.00 Paw Fran h1d FnNn 700
Olvls/On oI Comm/SSion (!!ne 700) as /OIIOWS: EOrr'01MV~a SeUer•e
701 t0 FYnda at FYr1da at 701
702 t0 SettlerrNtlt SettleTartt 7D2
703 70]
704 commission paid at Settlement
704
705
i~ns
RnysWe Ia Connection WI`tff ~
'sou
aa
;
-~ `
~
"W
.
..
o
r _, ~
-
~~,.,,
;, s~,
.
(Mk~rtpage Amt: 0.00) total charges, Unes BOS thr9lph 011: 0.00
001 Loan Ortginatlon Fu .000 % t0 0.00 e01
t02 Loan DlfcOUM .000 ~ t0 0,00 a02
007 Apprelsal FN t0 a03
ao4 CredR deport to eo4
e05 Lender's Inspectlon FN to 005
a06 Mortgage tnwranp Appllpbon Fu to a0a
a07 AasumptlOn Foe t0 a07
aos eos
ao9 ~y
eiD eio
911 ui
,. 901 InOarest From 22-OCt-09 t0 O 0.000 pK day ~ 901
902 MOrtpige IneUranp Premium h1r morphs t0 902
903 Harerd Insurance PrMlium tOr 1 seers to 903
904 scarf to qp,~
905 905
1001 Hazard Infurenp mot. a per montll 1001
1002 Mtxtgage InfurMp mos. 0 per month 1002
1003 Cfty property texef mos. O per month 100]
1004 County property taxef mos. O per month 1004
1005 Annwl assasfinents mos. O per month 1005
1006 min. 0 per month 1006
ioo7 School texas mos. O Per month 1oD7
loco Aaastiaete Settlement Adiustnsent ......
1101 Settlement a dastrq faa to 170
1102 AbftrKt Or tlth search t0 110
1107 TkN exarnlnetlOn to 110:
IIo+ Title Insurarxa. hinder to 11a
3105 Document pnparatfon t0 IIo!
1106 NOtery hus t0 1101
11D7 Attorney's tw to FREY • TILEY/DUNCAN 8: HARTMAN, P.C. 880.00 275.00 11D;
(Indudef above Items numbers: )
11oa Title Inwranp tc FREY A TITLY (COMMONWEALTH LAND TITLE INf. CO.) 1101
pndudes above items numbers: ~
1109 Lenderf Coverage s Endorsements: uos
IIIO Owners cWerage s lI1C
1111 CLOSING SERVICE LETTER TO COMMONWEALTH LAND TITLE INSURANCE CO. 1111
1112
1112
1113 OVERNIQHT DELIVERY/BANK CHICK FEES TO FRET/ ~ TILEY
. ~~ 20,00 1117
~
-
v
1.201 necordba tees:
Deed :49.00 Mortgage:
wleaw ~ 49.00 1201
1202 City/county/stamp Dead ;1x590.00 ; Mortgage ~ 1,590.00 1202
1203 Stag tax/stemps: Dud ;1,590.00 Mortgage : 1,590.00 120]
1204
1204
uos
..
.. A.,~ ~-`~' ` ~ ~
.f, ..
4~
*~
17D3 PAINTINfi/REPAIRS/CLEANINQ FEE TO DARLENE M. BLACK AND RODNEY L YENT2ER 990.00 13oI,
lwz Pest irgpeUlOn to 1 702
170] Current Taxes due from Borrowr/SeNer to t 9o7
170+ FINAL WATER AND SEWER CHARGES TO SMTMA -ACCT NO. O1Si07 125.42 1 ]04
17os RESALE CERTIFICATE FE! TO THE STONlHlDfiE HOMlOWNERS ASSOCIATION 0.00 1 7os
17oe INITIATION FEE TO THE STONENlDQE HOMEOWNERS ASSOCIATION 280.00 1 7oa
1707 NOVEMBER ASSOCIATION DUES TO STONEHlD6E HOMEOWNERS ASSOCIATION
~. 140.00 1 707
iiot T
gnNee
t
1
~'-
"" ' 2,939.00 3,000.42 1 .00
w
~
1
,,yy~ ~* y,
4, 1 i.rYi :... Pf~J°i.t Y~ r .ni+Ttif ^~d-.:. .~ fT f~WI .~ a.'t'~.r~.~. .LP "k.:~". _ --. • ~^~s^~^~~s ~ ~~~~~~^. ~.
MUD-1
C E RTI FICATIO N
I direct and authorize the Company [o make distnbutbns indicated far my attount on the attached HUD-1 Settlement Statement, approving the tax proratlans
indicated MerNn, and understand that Droratlons were based on Rgures for the preceding year, ar estimates for the current year, and in the event of eny change
for the current year, all necessary adjustments must be made between Seller and Borrower direct; likewise any DEFICIT In delinquent taxes will be reimbursed
to Attomey/Title try Seller.
[ have nrelully reviewed the HUD-1 Settlement Statement and to the best of my knowledge and bNief, it +s a true and accurate statement of all renipts and
disbursements made on my account or by me in Mis transaction. I further certify that I have received a copy of the MUD-1 Settlement Statement.
--
ROGE MAN Y 8. B CK
/!I ~ _.
CAROL M. YENTI
To Uu best of my knowledge, the HUD-1 Settlement Statement which 1 haw prepared is a true and accurate attount of the funds which were received and have
bun Or will (1e disbursed by the undersigned as part Of the settlement Of Mis Cransaction.
October 22, 2009 _
Data
WARNING: It K a creme to knowingly make false statements to Me United States on this or any other similar form. Penalbas upon convlCtlon can include fine
and imprisonment. For details sae: Title 18 U. S. Code Section 1001 and Sectlan 1010.
INFORMATION REPORTING ON REAL ESTATE TRANSACTIONS
THIS HUD SETTLEMENT STATEMENT CONTAINS IMPORTANT TAX INFORMATION (BOXES E, G, H, I, M AND UNE 401) ANO [S BEING FURNISHED TO
THE INTERNAL REVENUE SERVICE. iF YOU ARE REQUIRED TO FILE A RETURN, A NEGLIGENCE PENALTY OR OTHER SANCTION WILL BE IMPOSED
ON YOU IF THIS ITEM [S REQUIRED 70 BE REPORTED AND THE INTERNAL REVENUE SERVICE DETERMINES THAT R HAS NOT BEEN REPORTED.
Solicitation of TIN
SNktr is required by law to provide the Attorney/Comparry wiM his/her cvnect taxpayer identlllntlan number. If correct taxpayer idendficatlon number is net
provided, he/she may be subJect to Uvil or criminal penalties imposed by law.
Certification of TIN
Under penaties of penury, I certfy that the taxpayer identification number shown in Mis statement 4 my coned taxpayer identification number.
Seller Seller
TAX PRO-RATION ADDENDUM
oats d noltatbn:
SCMOOil RlAL E ATE TAX Owees
Oetoiber 22, 200! from JuIY 1, 2009 to June 30, 2010
Schad Real Estatt Tax- Fan f1,503.64 P.O.C.
Schad Real Estate Tax- Der Day (4.11956
AS.fEldalENT:
COUNTY • MUNICIIAL TAX Oheu:
horn Jarwary c, 2009 co Daumap 11, 2009
Co. 6 Munit. Rue Estate Tax- Fop f369.82 P.O.C.
tiKr N0.: Co. 6 MumC. Real EstaM lax- Per DaY f1 01321
Su lettlernent Sheet
Unu y~
los • 40f, ilo a •lo, school to:as p.o c. er cn,r0ae ro Seiier ~
210 ~ 510, 214 ~ 514, ScMaW tut C.O.C. a marp~d ro 9orrowrr (
I
an/ 13i0>I for co. a M,nK. p.o.c. or cnargW ro SNNr x
Ruulb d tltb AddendWtt. LJ
co. a Mums p.oc. or cnarOW ro Borrower
Pi-~OFF.~TiaTEMEP~T .+ P~i.3 1
10 OR-09
'T1._a loan ~s no;n~ ~aei~riced by .;PMoryan Chase Bar[}•_, NA, successo t.c
Wastt~t.yt:oi: Mutua-~ Bank.
TO J;;ar_ :.dams FE : Loatt Nutnbe~ : 05U~s 33911
Client Number 156-0
Law Of _`ice Gur.Jc:i n find H ?,,awrence E Black
1 Irvine Rox~ Marian PI Blac}=
C'arl~a'_e PA 1"10.13
FROPERI"I ADDRESS:
4 C1 i f tort Tee race
Carlisle PF. 17013
'^O JOTuti ADAMS FAK NUMB EP : 717249'/$JO
Lean Type - Convent-ioral
t k~F***~k *r* k kYc ~k s*#*-r#x#*k****+*##~r •k :k*#~F ~k#+*###* #'k*##**##*###*###*~k*#*#•
PAYOFF' FIGURES irUST BE VERIFTEll WITHIN 24 HOURS BEFORE PAYOFF.
ADDITIODIAL AMOUNTS MAY" HAtiE BECOf9E DUE THF,T CHANGE THE PAYOFF AMOUNT
if payoff Funds are insufficient. t.o payoff the loan, we must recei•~e
funds t,; cover the deficient}> by 3:GG PM ET. If we do not recei+.>e the
funds to cover the deficiency by ~:CO PM ET, we will return *_he pa}>off
funds ir. the same manner as they were remitted. Interest will continue to
accrue, late charges may be incurred, and other acti<.>ity or t.ransactio~~s
ma;r tales place cn the lcan until sufficient funds are receieed to pad ~ha
i_an in fu'_1
**~*PLF.A.^,F CALL TDLL FREE 1-866-925-8937 TO ~TEF.Irs PAYOFF FI~~UR.ES****
i~.MUU1dTS D[[E
A. The next pa;m;ent due date is 1G-O1-09. Pa;mtent of the fol.Lowing
antcunt~ are required to pair the loan in full on 1J-~U-D9:
::urgent Total Unpaid Principal Balance $ -~O,i10.2G
Interest to 10-3C-C9 $ .17D..}0
Total amount to Pal Loan in Full on 10-30-09 ~ 40,jti".o(i
B. The following amounts are adci~t i~nal fees and co: t.s that. .tre du-~
1P.latlllg to this~oan:
Other :nttstarding Fees ~ ~ , _ 00
Payoff StateT:eut- E'ee $ OU**
Fecot: >e~-ante Fee $ , Op
^!YPAL FMC~[.Tt1T GUF. $ 40 , '~92 56
~P:eaae excluue the Recording cost i° ;t:e transactLOn in~>ol.~~es a
CcnJol~aatlon, Extension and Modificar.ion ccg_eement or the
sage cr refinance of a cooperati<~E writ.
*~'Pa;-off Ctatement Fee is due `_rom the requesting person o'' enci;~,~.
~f ~:ot .,;aid _n ful'~ by 10 3C G9, add a per -diem of y " i1.3.
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Tax Parcel No. 40-23-0602-168
THIS DEED
~ Made the ~ ~ day of ~ n.a , 2006;
BETWEEN Lawrence E. Black and Marian M. Blank, husband and wife,
of South Middleton Township, Cumberland County,
~a Pennsylvania,
~.~
r~
~~
GRANTORS,
AND Lany B. Black and Darlene M. Black, husband and wife, and
Carol M. Yentzer and Rodney L. Yentzer, wife and husband,
all of Carlisle, Cumberland County, Pennsylvania,
GRANTEES,
WITNESSETI~I, that the Grantors, for and in consideration of One and 00/100
($1.00) DOLLAR, lawful money of the United States of America, to the Grantors in hand
wie// and truly paid by the Grantees, at or belbre the sealing and delivery of these
presents, the receipt whereof is hereby acknow/edgred and the Grantors being therewith
fuuy sansli~ed, do by these presents grant, bargain, sell and convey unto the Grantees
forever
ALL THAT CERTAIN tract or parcel of land situate in South Middleton Township
in the County of Cumberland and Commonwealth of Pennsylvania, and more
spe~cally described in the Final Subdivision Plan for Stonehedge, Stage N, Clifton
Terrace, recorded in the Office of the Recorder of Deeds in and for Cumberland County
in Plan Book 60, Page 121, and more particularly described as follows, to wit:
BEGINNING at the southwest corner of Lot No. 24, said comer being located
North 32 degrees 45 minutes 50 seconds West, a distance of 210.25 feet from a
permanent concrete monument which marks the southwest property comer of land now
~ formerly of Stonehedge Developers, Inc. and land now or formerly of S & A Custom
Built Homes, Inc., and from the southwest comer of Lot No. 24, thence North 57
degrees 14 minutes 10 seconds East, a distance of 64.00 feet, thence North 32 degrees
45 minutes 50 seconds West, a distance of 9.00 feet, thence 'North 57 degrees 14
minutes 10 seconds East, a distance of 54.00 feet; thence South 32 degrees 45
minutes 50 seconds East, a distance of 46.00 feet, thence South 57 degrees 14
minutes 10 seconds West, a distance of 118.00 feet, thence North 32 degrees 45
minutes 50 seconds West, a distance of 37.00 feet, to the place of BEGINNING.
BEING Lot No. 24 on the aforesaid Final Subdivision Plan.
BEING the same premises which Frieda B. Weller by Janet W. Chevy, Agent,
and Janet W. Chevy individually, of Mechanicsburg, Cumberland County, Pennsylvania
by their Deed dated May 16, 2000 and recorded in the Office of the Recorder of Deeds
in and for Cumberland County in Deed Book 221, Page 356 granted and conveyed unto
Lawrence E. Black and Marian M. Black, husband and wife, Grantors herein.
THIS CONVEYANCE IS FROM PARENTS TO CHILDREN AND SPOUSES AND
IS, THEREFORE, EXCEPTED FROM PENNSYLVANIA REALTY TRANSFER TAX
PURSUANT TO 72 P.S. § 8102-C.3(6).
AND the Grantors hereby warrant specJally the property herein conveyed.
IN WITNESS WHEREOF, the Grantors have hereunto set their hands and seals
the day and year fast above written.
Witness:
-;
/ awrence E. Black
Marian M. Black
;-
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
ss.
ON THIS, the ~ "- day of ~-t , 2006, before me the
undersigned officer, personally appears Lawrence E. Black end Marian M. Black,
knovm to me {or satisfactorily proven) to be the persons whose names are subscribed
to the within deed and acknowledged that they executed the same for the purpose
therein contained.
WITNESS my hand and seal the day and year aforesaid.
,,.wr•~., t!ty ,.
"' •.
_„. .
tY. ~ V 14 M !! <y.. .1+ .
i' t%~ ,r No Public sMl
...• ~ ,,,~~. ,lanes M. Robir~eon, NodrY P~
~", ,- a`'` ;:`•. CsiNslsBoro,dlrnbeAendCau~ty
.~. ,
My Comn~iselon E~Nss .hu» 8, 2009
NNrnbar, Pennaylvanla Meoolatbn of NotariN
I hereby certify that the precise mailing address of the Grantees is:
24 Clifton Terrace
~ Carlisle, PA 17013
I
i
Att y for Gran s
_ . ~., . ~. ~ :2~.3
1 Certify tl~i~ ~ .: ;.. _ . .. .
In Cumberl a; ~ .: ',::: ~ : ~. ~ ~' '~
_ ~ ,
,..
.~'~,
1~. _ :. , of ~tc.~..
First National
,~
October 28, 2009
Duncan & Hartrnan, P.C.
Attorneys at Law
One Irvine Row
Carlisle, PA 17013
RE: Estate of Lawrence E Black
Date of Death: September 17, 2009
SSN: 181-03-5718
Dear Mr. Duncan:
9 N. High Street
P.O. Box 523
West Chester, PA 19381
~~ asa.8e1.4000
t nbank.com
Per your request, I submit information concerning the account held by the above
referenced decedent at the time of his death.
Account # Title Balance (a~ Accrued Total @ Date of
Date of Interest (a3 Death
Death Date of
Death
Checking # Lawrence E Black 52287.05 5.02 52287.07
112801 Carol M Yentzer
Opened Larry B Black
8/1/2007 made 'oint 9/9/2009
CD # Lawrence E Black 510,953.00 5536 510,958.36
290005943 Carol M Yentzer
Opened Lamy B Black
4/10/2009 made 'oint 9/9/2009
CD # Lawrence E Black 5842338 54.12 58427.50
290005945 Carol M Yentzer
Opened Larry B Blsck
4/10/2009 made 'oint 9/9/2009
Our records indicate there were no other open accounts held in the decedent's name at the
time of his death. If you have any questions or should you require any additional
information, please do not hesitate to call me at (484) 881-4264.
Sincerely,
M ,
/ ~ CC~~i. 7Z.,~.,c/l.t~
Michelle Greiner
Customer Service Operations
A Suhsdiary of
First Chester County Corporation
MEMBERS 1't
FEDERAL CREDIT UNION
SAVINGS ACCOUNT:
Account Number/Suffix
Date Acxount Established
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest
Name of Joint Owner
Date Joint Ownership Established
LIFE SAVINGS ACCOUNT:
Account Number/Suffer
Date Account Established
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest
Name of Joint Owner
Date Joint Ownership Established
3574-00
07/11 /1955
$4,369.82
$.97
$4,370.79
Larry Black 8 Carol Yentrer
08/31/2009
3574-04
02/01/2001
$4,000.00
$.88
$4,088.00
Larry Black 8 Carol Yentrer
08/31 /2009
`Opened by transfer of funds from 3574-00
HOLIDAY CLUB ACCOUNT:
Account Number/Suffix
Date Account Established
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest
Name of Joint Owner
Date Joint Ownership Established
CHECKING ACCOUNT:
Account Number/Suffix
Date Account Established
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest
Name of Joint Owner
Date Joint Ownership Established
INVESTMENT SAVINGS ACCOUNT:
3574-02
12/13/1991
$3,009.20
$.73
$3,009.93
Larry Black & Carol Yentrer
08/31/2009
3574-11
07/24/1986
$10,397.95
$.80
$10,398.75
Larry Black & Carol Yentrer
08/31 /2009
Account Number/Suffix 3574-05
Date Account Established 07/24/1986
Principal Balance at Date of Death $575.56
Accrued Interest to Date of Death $.2g
Total Principal and Accrued Interest $575.84
Name of Joint Owner Larry Black 8 Carol Yentrer
Date Joint Ownership Established 08/31/2009
CERTIFICATES OF DEPOSIT:
Account Number/Suffix 3574-44
Date Account Established 09/05/2008•
Principal Balance at Date of Death $7,696.76
Accrued Interest to Date of Death $13.43
Total Principal and Accrued Interest $7,710.19
Name of Joint Owner None
'Rollover from certificate 3574-43, originally established 02/20/2008.
5000 Louise Drive PO. Box 40 Mechanicsburg, Pennsylvania 17055 (800) 283-2328 wwwrnemberslst.ore
VISA ACCOUNT:
Account Number
Date Account Established
Balance on Date of Death
Joint Cardholder
LOAN ACCOUNT:
Account Number/Suffix
Date Loan Established
Principal Balance at Date of Death
Loan Type
Name of Co-Borrower
4672090000230391
07/22/1996
$43.28
Marian Black
3574-07
01 /05/1987
$.00
Personal Service Loan/Contractual Pledge of Shares
None
(N M S 1sT~gE{iAL C~IT
~~/Jl.k
Dania A. Kline
Insurance Services Specialist
November 4, 2009
Estate of: LAWRENCE E. BLACK
Date of Death: 09/17/2009
Social Security Number: 181-03-5718
LAST WILL
TESTAMENT OF
I, LAWRENCE E. BLACK, of 24 Clifton Terrace, Carlisle, South Middleton Township,
Commonwealth of Pennsylvania, being of sound and disposing mind, memory and understanding,
do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking
any and all other wills and codicils heretofore made by me.
FIRST. I direct that all my just debts and funeral expenses be paid from my estate as
soon after my death as practically and conveniently may be done.
SECOND. I direct that my remains be interred within my family's burial plot in
Westminister Memorial Gardens side by side with my wife, MARIAN M. BLACK, in accord
with my expressed wishes.
THIRD. I authorize my personal representative to expend funds from my estate, in such
amounts as my personal representative shall consider necessary and desirable for the purchase,
erection acid inscription of a suitable marker for my grave.
FOURTH. I give, devise and bequeath all of my estate of every nature and wherever
situate unto my wife, MARIAN M. BLACK ,provided she survives me by thirty (30) days. If
she fails to survive me by thirty (30) days, I give, devise and bequeath all of my estate unto my
children, CAROL MARIE YENTZER and LARRY B. BLACK in equal shares, per stirpes.
FIFTH. I direct that any and all Inheritance, Estate and Transfer taxes imposed upon my
estate Passing under my will or otherwise, shall be paid out of the principal of my residuary
estate.
SIXTH I hereby nominate, constitute and appoint my wife, MARIAN M. BLACK as
Executrix of this my Last Will and Testament. In the event of renunciation, death, resignation or
inability to act for any reason whatsoever of MARIAN M. BLACK, I nominate, constitute and
appoint both my children, CAROL MARIE YENTZER and LARRY B. BLACK, or the survivor
thereof, as Co-Executors of this my Last Will and Testament. I hereby relieve my Co-Executors
from the necessity of posting security in connection with their duties, as such, in any jurisdiction
in which they may be called upon to act insofar as I am able by law to do so. In addition to the
powers conferred by law, I authorize my Co-Executors, in their absolute discretion, to retain in
the form received, and to sell either at public or private sale any real or personal property owned
by me at the time of my death.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, , y Last Will and
Testament, consisting of one typewritten page this ' ~' ,day of ,''~J~t ~ r'. 2006.
J'
L WRENCE E. BLACK
Signed, sealed published and declazed by the above named Testator LAWRENCE E. BLACK as
and for his Last Will and Testament, in the presence of us, who, at his request, in his sight and
presence and in the sight and presence of each other, have hereunto subscribed our names as
witnesses.
~..
COMMONWEALTH OF PENNSYL i~ANIA
COUNTY OF CUMBERLAND SS.
I, LAWRENCE E. BLACK, Testator whose name is signed to the attached or foregoing
instrument, having been duly qualified according to law, do hereby acknowledge that I signed
and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my
free and voluntary act for the purposes therein expressed.
r
> ~
.~
Sworn or affirmed to and
acknowledged before me, by
LAWRENCE E. BLACK this ~ ~ day
of ~~1 G~Ch , 2006.
` ..R
Not ubl c
NOTARIAL SEAL
Kathy L. Mummert, Notary Public
Borough of Carlisle, Cumberland Co., PA
My Commission Expires Aug. 11, 2007
,_. ..~
A NC E. BLACK
COMMONWEALTH OF PENNSYL VANIA ,
COUNTY OF CUMBERLAND :SS.
We, ~ t I ~ I ~~ r~~~ ~ >UILC C.in and .~ ~`~'~ ~ RC~~.t~5
the witnesses whose names are signed to the attached or foregoing instrument, being duly
qualified according to law, do depose and say that we were present and saw LAWRENCE E.
BLACK sign and execute the instrument as his Last Will; that he signed willingly and that he
executed as his free and voluntary act for the purposes therein expressed; that each of us in the
hearing and sight of the Testator signed the will as witnesses; and that to the best of our
knowledge, the Testator was at that time eighteen (18) or more years of age, of sound mind and
under no constraint or undue influence
_ , 1 l'~~ •~ ~ ~
Cf ,- `~~
a,~,~~-
Sworn or affirmed to and
subscribed before ~{e b~
~ t (~ ((a'rY~ 1`i l~ l.) ~1~ C.lC1 and
:.~ cx~in ~~ Flc.~u ~n S
this 1 ~ witnesses,
day of ~(~Jt(.,h , 2006.
Notary ub 'c
NOTARIAL SEAS
Kathy L. Mummert, Notary Pubik
Borough of Car1lsle, Cumberland Co., PA
My Commission Expires Aug,11~ Z00T