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Home My WebLink About05-19-10~+ ~~ , J 15056071120 REV-1500 EX (06-05) PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number PO 60X.280601 INHERITANCE TAX RETURN Harnsburg, PA ~~~2s-oso~ ~ RESIDENT DECEDENT 21 09 0853 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death 168 26 2574 08 24 2009 Decedent's Last Name MYERS (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW Date of Birth O1 02 1928 Suffix Decedent's First Name MI MERLE H Suffix Spouse's First Name MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 1. Original Return ^ 2. Supplemental Return ^ 3. Remainder Return (date of death prior to 12-13-82) ^ 4. Limited Estate ^ qa, Future Interest Compromise (date of death after 12-12-82) ^ 5. Federal Estate Tax Return Required 8 Decedent Died Testate (Attach Copy of Will) ^ ~ Decedent Maintained a Living Trust (Attach Copy of Trust) 8. Total Number Of Safe Deposit Boxes ^ 9. Litigation Proceeds Received ^ 10. Spousal Poverty Credit (date of death between 12-3191 and 1,-1-95) ^ 11. Election to tax under Sec. 9113 A ( ) (Attach Sch. O) ~~rcrcear~nutly I - I MIS titF.:TION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number JERRY A. WEIGLE ESQUIRE 717 532 7388 ~ .~; Firm Name (If Applicable) WEIGLE & ASSOCIATES, P.C. First line of address 126 EAST KING STREET Second line of address City or Post Office State ZIP Code SHIPPENSBURG PA 17257 Correspondent's a-mail address: ~ ~, .. ; ! i ~, REGISTER Q!~ 1~L.LS USNLY'=_~ 1 ~ ~~' ~ Ian -" ~ : '` .. i _~? ,. ...~ v DATE FILED ~ '. .", ~I +- ~ _~ -ys--- ~ ~--; _.~.I under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNAT RE O PERSON RESPONSIBLE FOR FILING RETURN DATE -~ Linda M. Myers ~ -% ADDRES 161 u ar Bush Lane Cha be ur 17202 SIGNA RE F P PAR OTH AN REPRE A E DATE ~/ J rry A. Weigle Esquire ''" ~ 13 /® ADDRESS 126 East King Street, Shippensburg, 17257 Side 1 15056071120 15056071120 ~~ PA Inheritance Tax Return Signature of Additional Fiduciaries ESTATE OF FILE NUMBER Myers, Merle H. 21-09-0853 Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. Signature #2 Name Address1 Address2 City, State, Zip Date Penny E. Myers 58 Deadend Lane Shippensburg, PA 17257 ~ - l 3- /D J 15056072120 REV-1500 EX Decedent's -vame: Merle H. Myers Decedent's Social Security Number 168 26 2574 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. Mortgages 8 Notes Receivable (Schedule D) ........................................................ 4. 5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............... 5. 3 6 , 655.05 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6, 7. Inter-Vivos Transfers 8~ Miscellaneous -Probate Property (Schedule G) ~ S eparate Billing Requested............ 7. 8. Total Gross Assets (total Lines 1-7) ......................................... .... g. 3 6 , 655.05 9. Funeral Expenses & Administrative Costs (Schedule H) ....................................... 9. _ 17 , 2 3 6. 4 9 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............................. 10. 1 , 7 7 3 . 5 0 11. Total Deductions (total Lines 9 8~ 10) ................................................................... 11. 19 , 0 0 9 . 9 9 12. Net Value of Estate (Line 8 minus Line 11) .................................. . ....................... 12. 17 , 6 4 5. 0 6 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. 17 64 5 . 0 6 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 15. O . 0 0 16. Amount of Line 14 taxable at lineal rate X .045 17 , 645.0 6 16. 7 94 03 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. 7 9 4. 0 3 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ^ Side 2 15056072120 15056072120 J REV-1500 EX Page 3 Decedent's Complete Address: DECEDENT'S NAME Merle H. Myers STREET ADDRESS 154 Chamberlin Road CITY Shippensburg 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 D. Interest E. Penalty 700.00 36.84 File Number 21-09-0853 STATE ZI P PA 17257 Total Credits (A + B + C) Total Interest/Penalty (D + E) 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. (1) 794.03 f2) 736.84 (3) (4) (.5) 57.19 (5A) (5B) 57.19 Make Check Payable to: REGISTER OF WILLS, AGENT ~..~ _ _. - ~~ . ~ , m ' fi ~.;z~i9~'awa'~' D.i~.w~., 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 :.................................. ~ a c. retain a reversionary interest; or ............................ . 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? ................................................................... ................................................. a a 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. ~~ 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-1508 EX+ (8-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER 21-09-0853 Merle H. Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITENF NUMBER DESCRIPTION 1 Cash on hand in wallet 2 Highmark Insurance -refund of premium 3 Hopewell Township Landfill -refund 4 Monumental Life Insurance -refund of premium 5 Orrstown Bank Certificate of Deposit 40000 30388 Accrued interest on Item 5 through date of death 6 Orrstown Bank Checking Account 102000534 Accrued interest on Item 6 through date of death 7 Orrstown Bank Savings Account 702001133 Accrued interest on Item 7 through date of death 8 1980 Liberty Mobile Home - 46 x 24 9 1992 Buick Century Special Sedan -proceeds of sale 09-15-2009 10 2009 Husgvarna Yard Tractor and Dump Cart 11 Personal Property -per appraisal 12 Personal Property -proceeds of sale 5-11-10 of personal property not included on appraisal TOTAL (Also enter on Line 5, Recapitulation} VALUE AT DATE OF DEATH 60.00 363.92 173.12 3.29 5,107.76 6.95 3,729.66 0.03 2,660.72 0.60 19,700.00 700.00 1,620.00 2,449.00 80.00 36,655.05 (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) .., . COMMONEWREALTCCH OFqq~~PENEENSUUYLVANIA IN RESIIDENTEDECEDENTRN SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF rs, Merle H. FILE NUMBER 21-09-0853 ITEM NUMBER A. FUNERAL EXPENSES: Debts of decedent must be reported on Schedule I. DESCRIPTION See continuation schedule(s) attached B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zin Year(sl Commission raid 2. Attorney's Fees Weigle & Associates, P.C. 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Gary L. Myers Street Address 154 Chamberlin Road city Shippensburg state PA zip 17257 Relationship of Claimant to Decedent SOn See continuation schedule(s) attached 4. Probate Fees Register of Wills, Cumberland County 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) AMOUNT 10,607.99 2,449.00 3,500.00 132.00 547.50 17,236.49 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06) ~. r SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Myers, Merle H. 21 09 0853 ITEM NUMBER DESCRIPTION AMOUNT Funeral Ex enses 1 Fogelsanger-Bricker Funeral Home 2 Joseph Reese -grave opening Family Exem tion 3 Gary L. Myers -remainder of family exemption 4 Personal Property - to Gary L. Myers as part of family exemption 5 6 7 8 9 10 11 12 H-A H-B3 10,207.99 400.00 10,607.99 1, 051.00 2,449.00 3,500.00 Other Administrative Costs Charles H. Martin -appraisal of personal property Cumberland Law Journal -advertising Letters Testamentary Linda K. Klein -notary fees News Chronicle -advertising Letters Testamentary Register of Wills, Cumberland County -filing PA Inheritance Tax Return Register of Wills, Cumberland County -filing Family Settlement Agreement Sailhamer Real Estate -appraisal of mobile home Weigle 8~ Associates, P.C. -reimbursement for postage, xerox copies, and long distance telephone calls Copyright (c) 2002 form software only The Lackner Group, Inc. 75.00 75.00 23.00 129.50 15.00 100.00 100.00 30.00 Form PA-1500 Schedule H (Rev. 6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Myers, Merle H. 21 09 0853 ITEM NUMBER DESCRIPTION AMOUNT H-B7 547.50 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) .~ Rev-1512 EX+ (12-08) SCHEDULE 1 DEBTS OF DECEDENT, COMMONwEAITHOFPENNSYLVANIA MORTGAGE LIABILITIES, & LIENS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Merle H. FILE NUMBER 21-09-0853 Report debts incurred by the decedent prior to death that remained unpaid at the date of death. inc~urllnn ~~n.oi..,ti~~.~e.~ ..,e..:.._~ _..______ fir more space Is neeaea, aoaltlonai pages of the same size) Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 12-08) . RE,V-1513 EX+ (11-08) ,~ E COM IN~ ERITAN~E TAX RET~RN ANIA RESIDEN DECEDEN SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER M ers, Merle H. 21-09-0853 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (Words) ($$$) o Not ist rustee s I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 a 1.2 1 Christine A. Laughlin Daughter One-fifth 3,529.02 P. O. Box 72 Newburg, PA 17240 2 Gary L. Myers Son 154 Chamberlin Road Shippensburg, PA 17257 3 Linda M. Myers Daughter 1612 Sugar Bush Lane Chambersburg, PA 17202 4 Penny E. Myers Daughter 58 Deadend Lane Shippensburg, PA 17257 5 Ronald L. Myers Son 319 Airport Road Shippensburg, PA 17257 I One-fifth One-fifth One-fifth One-fifth I ~ Total Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 1500 cover sheet, as a ro i NON-TAXABLE DISTRIBUTIONS: II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 3,529.01 3,529.01 3,529.01 3,529.01 17,645.06 ate. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 11-08) LAST WILL AND TESTAN.~7'I' I, Merle fi. Myers, of North Newton Township, Ct~nberland County, Pennsyl- vania, declare this to be my Last Will and Testament and revoke any will or codicil previously made by me. ITEM I: I direct that all my just debts and funeral expenses, including my gravemarker and all expenses of my last illness, shall be paid frcan my residuary estate as soon as .practicable after my decease as a part of the adntinistratian of my estate . ITEM II: I give, devise and bequeath. all of r_-y estate of every nature and wheresoever situate to my wife, M. Jean .Myers, providing she shall survive me by thirty days. ITEM III: Should my wife, M. Jean Myers, predecease n~.or die on or before the thirtieth day following my death, I give, devise and bequeath all of my estate of every nature and wheresoever situate to my issue per stirpes living on the thirty-first day following my death. ITEM IV: I direct that all taxes that may be assessed ixi consequence of my death, of whatever nature and by whatever jurisdiction aznposed, shall be paid front my residuary estate as part of the expenses of the administration of my estate. ITEM V: I appoint my wife, M. Jean Myers, executrix of this my Last Will and Testament. Should she fail to qualify or cease to act as executrix, I appoint Linda May Myers and pay E. Myers, co-executors of this my Last Will and Testament. ITEM VI: I direct that my executrix or her successors shall not be required to give bond for the faithful perforniance of their duties in any jurisdiction. IN Y~IITNESS WHEREOF, I hereunto set my hand and seal to this my Last Will and Testament, written on two sheets of paper, dated this ~~ day of r ~~~TGtGi i' , 19 8 8 . ~ __ ~''L~~~_~-~~~ - -~"== --------- (SEAL Mer e H ~~~~ 1 .Myers The preceding instrument, consisting of this and one other typewritten page, each. identified by the signature of the testator, Merle H. Myers, was on the day and date thereof signed, published and declared by Merle H. Myers, the testator herein named, as and for his Last Will, in the presence of us, who, at his request, in his presence, and in the presence of each other, have sub- scribed our names as witnesses hereto. - ~ ---------------------------residing at--------------------------------- ~ residing at- °~~~ `` ~-- ~ ------------ CONIl~UN4dEALTH OF PENNSYLVANIA: COUNTY OF CLIMSERLAND SS We , Merle H . Myers , Jc~~ ./~~~= ~`~=~~- and ~~~~ J ~~ ~ the testator 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 testator signed and executed the instrument as his Last Will and Test~nent and that he signed willingly (or willingly directed another person to sign for him), and that he executed it as his free and voluntary act for the pui~oses therein expressed, and that each of the witnesses, in the presence and hearing of the testator, signed the will as witnesses and that to the best of our knowledge, the testator was at that time eighteen years or older, of sound mind and under no constraint. or undue influence. --~-J-~! ~~=-~~-A-~'' =~'~ ----------- le I-; . Myers ~ ~ _ --~.__ .-~ r, ~~ ---------------- Subscribed, sworn to and acknowledged, by Merle H. Myers, the testator and sworn to before me b % ~ ~,~ %' ~% s and ~'-~1 e Y ~i~ . ~ ~~ ~. f ~..~-.~-- . ~ ~:~-, ~ -.~ :~ ,witnesses , this. ~}'~• day e~~`.e~ ~1,'4.r~ /Z1, 19 8 8 . i ~~ Notary P~ lic ?Ky c ~ sion expires April 16, 1990 Ship•~nsburg Township Ctunberland County -2- 1 i~ O~ZRSTOWN FINANCIAL SERVICES, Il~C. ~ x''raditiv-t of ~xicllcrrce Weigle & Associates, PC 126 East King Street Shippensburg, PA 17257 Fax 532-5259 September 11, 2009 Re: Estate of Merle H. Myers Date of death August 24, 2009 ~7' IS HERERBY CE1~7"Ix'IED T,F~TAT TFIE ABOVE 11TA1t2ED DECEDENT, ON TIDE ABOVE DATE, FIAD TF~E ~`QLLOWING ACCOUNTS UClll''Fl` OI~RST~WN BAN.~.• C'~I~CKING ACCOUNT/Sl Account - Title of Account - Date opened - Joint Account (name/ date) - I3alance - Accrued Interest - . 5A. VI1V'GS ACCOUNT/S) Account - Title of Account - Date opened - Joint Account (name/date) - Balance - Aecrued Interest - 102000534 50+ Interest Cheek 10/27/00 M. Jean Myers 10/27/QO $3,729.66 $.03 702001 x.33 Statement Savings 10/27/00 1VI. Jean Myers 10/27/00 $2,660.72 $.60 77 East King Sveet, Shippcnsburg, Pennsy~v~ia 17287 r. uu~~ uu~ CERTIF1'CATE OF DEPOSIT(S) Account - Tit1e of Account - Date opened -- Joint Account (name/ date) - Balance - Accrued Interest - 4000030388 6-11 Month Growth 12/I2/08 None $5,107.76 $6.95 B st Regards, ,. ,, Vycki L. Gullixon Customer Service Specialist Orrstown Bank Post Office Bax 250 Shippensburg, PA x.7257 77 East 1{ing Street, Shippengbur~, Pennsylvania 17257 . ac.~~arn~,~~~( ~i~a.~ ~~~,~,~~, ~2~-. 4S)4 I!~. Kirr{; `if~ SlripTrerr~hrrr{;, I'~r, fi2ri O (' f i c~ (i 1 i) r:32- GO ~4)/(~~~~~t (i 17) ~3O- ~ 1 ~ i www.sailhamer.cotn / info(a~saill~amer.com E:;tate of Merle Myers 154 Chamberlin Road Shippensburg, Pa 17257 September 16,2009 This analysis has not been performed in accordance with the uniform standards of professional practice which requires valuers to act as unbiased disinterested third parties with impartiality,ogjectivity and independence and without accommodation or personal interest,it is not to be construed as an appraisal and may not be used as such for any purpose. In response to your request for a comparable market analysis of real estate for the estate of Merle Mmanufacturednhousing estimation of current market value/NADA book value, The property is located in the 154nChamberlinpRoadl Cumberland County,Pennsylvania. Located at on a private rented lot. No land value is included in this analysis. Tax parcel ID #11-10-0608-016-TR1O36f.'. The subject property is a 24x47,1980 Double tiaide by Liberty. Serial # O8L-2O337AB.Their is no deed for thPa•property, transfer is by a title thru Penn Dot in Harrisburg, 1 1/2 baths private well The property features 3 bedrooms, and septic system,FHA kerosene heat window A/C units living room, kitchen with all appliances (whic]1 have some age) dining room, alum sliding windows are the original not energy savings, 2x4 walls, with very limited insulation covered back porch 8x14,with ramp, front porch 6x10 with ramps also, storage shed. Ground rent is $3,0000 per year. Subject property is in fair condition.Selling property in "AS IS" condition.subject property is 29 years old like a car this home will depreciate in value in the future there is no deed but transfer by title. See attached copy of tax bills and tax assessment data base. My estimation of current market value is $18,900 to $20,500. Sailhamer Real Estate,Inc. ,~ Barry Negley-Associate Broker 494 East King Street Shippensburg, Pa 17257 , ~; Barry Negiey ~' Associate Broker 494 Easf King Streef • Shippensburg, PA 17257 Residence: 717-532-5704 Office: 717-532-6059 Fax: 717-530-5181 Cell: 717-262-3472 Pager #: 262-1658 ,„„~ MA18 Email: barry_negley@yahoo.com .®• ~ www.sailhamer.com -..n.,., I ~ r ` i ~, t i ts/ I ~; I I \; C L E c L r C I r I~~ ~ ~ ~~ f ~ t ~\: r[ ci ~ , ., . \ r ~tllrl I [ ' ~ i;i C I \ LCL L. ~ \ 1 LLL4 L'~CL.:" L..L. LOLL ~, I \\ /~. \L (t~. I ir, L ~ ~. ~jlt' ~' ice. ~ ~ - -' ' ___ __ _. aF _.. .. _ _ s 1 _ . __; -.~ _~_ _ _ VEHICLE IDENTIFICATION NUI>nBER ~ YEAR I~~ctcE OF ~rcHICLc ~ _ ---- _ - -- -._ __ _ - ._ f ~ .I _-__. _ f _ BODY TYPE DUP SEAT CAP PRIOR TITLE STATE I ODOIvi. PROCD. DATE ODOI•vt. MILES .__ _ _ _ ODOk4. STATUS ___,r~y~~_ ~ -. _ _ - -~z=- ----' _~~_~- ~~_____ - -- - _ _ __ _ DATEPA TITLED ~ I _ DATE OF ISSUE ~ UNLADEN WEIGHT ~ GVWR I GCWR ~ I TITLE BRANDS ~. I coi '` a ;.~ it$f ~ ;~':~ FfiF4 REGISTERED OWNER(S) io s• ~~ 1.':/ ~ t "m ~~~_L~ ~ fi~7~~5 ro =Sit ~~fRil~~~~ ~>~ ~~~'!~ / K_-- 4. aFfF rr .~.~ .ar ~ ; \ O ~~ ._ i{1_( FIRST LIEN FAVOR OF: _lF°"fr. ~~FiJ~"~1Fti J~~~S~ 7 ~~f~~ fff ~t / r ~o~ f ~° ~ ~o~ ss~ / % / -= FIRST UEN RELEASE r~F * DA~ / ~ i BY r, ~ c `~t~~ AUTHORIZED R RESENTATIVE '~~• MAILIN _. __.___ _ ._. _ „~,„_ G ADDRESS sr s: =' ~}1ST~~'H~~ D~Er~ClS1~' ~Q'h~~C ~:. . ~~; ~~o ~~~7 D~~RY S~ ~~r ;:;- r?F_=~ NA~;~t~S~U~G ~'A 3,~~,~,~ I certify as of the data of ;issue, the official records df the Rennsylvania Department of Transportation reflect that the person(s) or company named herein is the lawful owner of the said vehicle. SUBSCRIBED AND SWORN TO BEFQRE ME: ~ j MO.. DAY YEAR ~_ ~~ SIGNAI`UREOF PERSON ADMINISTERING OATH vg"?a°.J J /4 ~~~~ ~ \ c~~~l ' ~ ~ ' `L'SE °~ 3r ~ ' The un dersigned hereby rn8kes application for Certificate of Title to the vehicle described ~ ~ ~~`~ above, •:> subject to the enwmbrances and other legal claims set forth here. •;, ' ~t~r F, ~> ; ~ a~~ f i ~~ SIGNATURE OF APPLICANT OR AUTHORIZED SIGNER °-_, E:lt'~j. I r =%' SIGNATURE OF CO•APPLICANT/TITLE OF AUTHORIZED SIGNER SECOND LIEN FAVOR OF: ODOMETER STATUS 0 = ACTUAL MILEAGE ~ =MILEAGE EXCEEDS THE MECHANICAL - LIMITS -- . 2 = NOT THE ACTUAL MILEAGE 3 = NOT THE ACTUAL MILEAGE-ODOMETER. TAMPERING VERIFIED 4 = EXEMPT FROM ODOMETER DISCLOSURE TITLE BRANDS' A =ANTIQUE VEHICLE C =CLASSIC VEHICLE 0 =COLLECTIBLE VEHICLE F = OUT OF COUtJTAY G =ORIGINALLY MFGD. FOR NON-U.S. DISTRIBUTION H =AGRICULTURAL VEHICLE L =LOGGING VEHICLE P = IS/WAS A POLICE VEHICLE R =RECONSTRUCTED S =STREET ROD T =RECOVERED THEFT VEHICLE V =VEHICLE CONTAINS REISSUED VIN W =FLOOD VEHICLE X = IS/WAS A TAXI i If a second leinholder is listed up~n satisfaction of the first lien, the first lienholder must forward this Title to the Eureau of Motor Vehicles with the appropriate form and fee. SECOND LIEN RELEASED Dr TE BY AUTHORIZED REPRESENTATIVE ~~ S~~A~~~Y ~ ~A~L~~tY Secretary of Transportation When applying for title with a'.bu•ow er; other tharf your spouse, check one of these blocks. If no blocks checked, tlUe wilt be issued as 'Tenants in. Common". A ^ Joint Tenants with Rlght pi Survivorship (on death of one owner, tdle goes to the surviving owner). _ B ^ Tenants in Common (on death of one owner, interest of deceased owner goes to his or her heirs or estate). 1 ST LIEN DATE: -~ IF NO LIEN, CHECK ^ tST LIENHOLDER STREET CITY STATE ZIP FINANCIAL INSTITUTION NUMBER 2ND LIEN DATE: -~fv IF NO LIEN. CHECK ^ 2ND LIENHOLDER STREET CITY STATE ZIP FINANCIAL INSTITUTION NUfv16ER ._____1992 Buick Centur~r - Private Party Yncitng Kepert - Kelley iiiue t3~oK .; ~.~ °r. ~ Ke{ley Blue Book --- - - --- - -------------- ------ SEARCH THE TRUSTED RESOURCE - - Home Nevk Cars Used Cars Research & Explore News & Reviews Dealers & InYentary CEassi~ieds Laans & Insurance KBEs Gre~en• Used Car Prices ~ Search Used Car Ustings t Certified Pre-Owned t Compare Vehicles ~ Perted: Car Finder ~ Most Researched Vehides t CARFAX Vehice History Welcome Bade ~ Sign In ~ Create Account t My KBB ZIP Code: 17257 Latest Car News Home > Used Cars. > 199t @yLrk > Centuro Spacial Sedan aD 1992 Buick Century Special Sedan 4D Trade-In Value Private Party Value BLUE BOOKS PRIYkTE PARTI` VA~UE~' =aT Suggested Retail Value v Photo Gallery COflditlOn 4 Value Compare Vehicles ~u,r ;r Blue Book Review ExceNent $1,130 Consumer Ratings GOOd 590 Find Your Next Car Fair ;705 Specifications More Photos s n; Shopping Tools SEARCH LOCAL L ~ EXT ATE P ISTINGS Free CARFAX Record Check • Auto Loan from 5.49% APR Get Your Credit Scare Now Free CARFAX Record Check Powarae by ~X Get a Free Insurance Quote Payment Calculator VIN: Extended Warranty Quote No YIN? No Problem! Print For Sale Sign BUY A U5E0 CAR Average Consumer Rating (304 Reviews) Read Reviews On Blue Book Classifieds"' Buick ~,;,";'fi'r'? r 4.3 out of S Review this Vehicle Century 50 Miles Vehide Highlights ZIP Code 17257 Mileage: 142,000 To Vfew Ads, Cliek Engine: V6 3.3 titer Transmission: Automatic Driretrains FWD Ftt~O THE RIGFT CAR Compare used vs. New Selected Equipment Change Equipment Under (5,000 lgedard Both New and Used - Air Conditioning Power Steering AM/FM Stereo Sedan OpliJeeal Power Wkrdows TMt Whed Cassette To View List, Clidc Power Door Lode Cruise Control VIEW ~kOTNER VEHtC1E Select Year... • ` Blue Book Private Party Value "' ~ ' "' Private Party Value Is what a buyer can expect to pay when buying a used car from a private party. The Private Party Value assumes the vehlde is sold Or Search by Category "~ ~" and carries no warranrty (other than the continuing factory warranty). The final sale price may vary depending on the vehicle's edval condition and Or Change ZIP Code local market conditions. This value may also be used to derive Fair Market Value for Insurance and vehicle donation purposes. Vehide Condition Ratings Checl: Vehide Title History Excellent _ .__ ...... °' c 1,1,0 Save Vehicle Print ~ ~' Email ~ 89UQiRRK f El_ Eslimeted Payments F limo ~ 5.89% APR Get aPre-Owned Loan from 5.59% APR Get Your Credit Score Now Get a Free Insurance Quote rage i of ~ http://www.kbb.com~KBB/UsedCars/PricingReport.aspx?Yearld=1992&Mileage=142000&... 9/8/2009 ,. _ _ _ B. A. WALLICK ~ ~ 60-15033 _ 313 ~ - 1 cJ 4 2 613 CHARLES ST. ° 1030 - W SHIPPENSBURG, PA 17257 DALE ~ - - , W H - PAY TO THE ORDER OF "' ~ . ,... ,~:: ,..,,....,,,....~.~.,.,~ +~ ~ ~ r„u.,~ ." ..,~ .~,.. ,• ~ o f- - ~ - -{~' _ `.. _ ~ ,aq _LL ARS u 7 J _ - _ _ ° ... OxxsTOwrrB~rrx - _. AT _ ofEzu - _; ,. _ _... MEMO M, -, _ - ~ - _. - I I ~~~:03 i3 i5036~. 103 OOBS0311' 15~, 2 _:` , -~, t . ~ . ;. ., ; ~~. r w Nait's Pawner Equlp~ht X94 ~id~~e Iad ~hi~~e~~~sar~, PA. ~~Z57 '~~7-4x~~6~4~ ph~r~e ~~ ~-4x3-~x~ f~~ ma~~: g~~n~G~,o~p~-e~.ce~ ~a~ Cower sheet i _ _.___. __~ ~.,~l.e....... ~~.._.~ 3~~ j ~1 tt~r~ C~~~ ~~?'o~ ~ _. ~~te Sent ~ ~ ~ S -D ~i S Atno~tnt of pages ~,w/ cower page Md~9e ~ 'a S~aQG '~~~ ,1 T(1P17 U~~~na c i ~n~i iniNc~ : ~~ tinn7 'c '1 ~(1 F Io Appraisal of Personal Property of the Estate of Merle H. Myers, Deceased Appraisal Location - 154 Chamberlin Road, Shippensburg, Penna. 1725? Appraisal Date - April 29, 2010 Appraisal by - Charles H. Martin: Auctioneer Co-Executrixs - Penny E. Myers & Linda M. Myers Two small wall mounted cuckoo clocks @ $ 20.00 each Two small 2 shelf corner shelves @ $ 6.00 each Sessions pillar front mantle clock Mid-size oak rolltop desk Misc. small individual figurines of various types Small decorated wooden foot bench Small wooden child,s chair Living room recliner chair (needs repair) Two living room recliner chairs (common) @ ~ 10.00 each Small wooden dropleaf stand Swivel top floor light Walnut finish round glass front china closet Small owl figurine collection Small plastic dome clock (common) Small round white marble shelf stand Small round brass base dome clock Two matching dark finish step end stands ~ ~ 10.00 each Dark finish cedar lined blanket chest (needs refinished) Dark finish marble top lamp stand Set of 6 oak high back dining room chairs @ ~ 20.00 each Wooden frame platform rocker Set of 8 "Farm Scene" collectors plates @ ~ 5.00 each Wooden entertainment center (common) Paint decorated cross cut saw Castiron bull dog Misc. bird & animal figurines of various types Small wooden stool with decorated top Two gallon Crock Round paint decorated kerosene heater Decorated still handle milk can (dented) Misc. common dishware, tableware, ..cookware, etc 40.00 12.00 80.00 350.00 60.00 12.00 10.00 2.00 20.00 20.00 10.00 300.00 40.00 10.00 40.00 25.00 20.00 25.00 50.00 120.00 30.00 40 , 00 20.00 20.00 25.00 40.00 15.00 25.00 20.00 10.00 30.00 Continued a ' Pale 2 _er paint decorated iron skillet r'ew small electric kitchen appliances Three common round back bar stools @ ~ 6.00 each Small wooden three piece breakfast set Decorated wooden face wall clock ~looden round leg dropleaf table (needs refinished) Metal frame office swivel chair Small Frigidaire chest freezer Revolving floor fan Misc. common metal shelving Frigidaire upright freezer (approx. 14 cu. ft.) Seth Thomas elec. mantle clock (needs repair) Dark finish 5 drawer chest of drawers (needs refinished) Shower stool Set of 3 solid wood-side arm chairs C ~ 7.00 each Small oak dresser base only (needs refinished) Maple finish arm rocker Common metal frame hospital bed Misc. bedding, linens, etc Aluminum frame clothing hamper Small wall mount television (old model) RC,~ table model television (old model) Misc. common plastic & wooden arm lawn chairs Metal bed wheelbarrow Husqvarna rototiller (older model) Misc. garden tools (shovels, rakes, hoes, etc) Set of 4 wooden plank bottom chairs ~ ~ 25.00 each Two smaller size milk cans (rusty) ~ ~ 5.00 each Misc. garden hose, reels, etc Gasoline operated grass & weed trimmer Three common folding lawn chairs (plastic) G ~ 1.00 each Few misc. lawn figures of various types Scotts lawn seeder Electric hand saw Duracraft floor fan .Continued 20.00 35.00 18.00 20.00 25.00 40.00 20.00 50.00 20.00 5.00 85.00 15.00 30.00 8.00 21.00 40.00 30.00 20.00 20.00 10.00 10.00 25.00 10.00 25.00 30.00 20.00 100.00 10.00 16.00 25.00 3.00 10.00 12.00 15.00 10.00 ~ ' P ew baskets, crates, etc ~ 5.00 Galvanized tub 10.00 Small wooden step ladder 5.00 in'ooden porch swing 25.00 Misc. hand tools ( hammers, pliers, shears, screwdrivers etc ) 10.00 Two iron spoke equipment wheels ( antique) @ $ 10.00 each 20.00 Appraisal Total $ 2+49.00 Appraisal by , ; ~ Charles A. Martine ,auctioneer Pa. Lic. # AU001466L D PAGE 01 OF 01 ACCOUNT NUMBER 9043381800508879 Account Summary for MERLE H MYERS Previous Balance $1 , 601.55 Payments /Credits $201.55 Purchases & Other Charges $0.00 Finance Charges $0.00 Days in Cycle 30 New Balance $1 , 400.00 A minimum payment of $0.00 -- is due by 08/16/2009. ~' ------"~ ""~-""'- `""" "' "'""` "`""""" "' ""'~" °""• Send billing inquiries to: PO BOX 731 1-866-702-4074 Refer to the back side for more information and remittance instructions. MAHWAH NJ 07430 CREDIT CARD TRANSACTIONS TRANSACTION POST CREDIT DATE DATE PLAN DESCRIPTION OF TRANSACTION AMOUNT 06/29 06/29 12344-01 PAYMENT BY MAIL - THANK YOU 07/20 07/20 1234 $101.55CR 4-01 PAYMENT BY MAIL - THANK YOU $100.000R CREDIT PLAN DESCRIPTION DAILYEBALANCE DAIRATE(S~ODIC ~N E RATE CLOSING DATE 12344-01 12 MONTH SAC $1,517.02 0.06298% 22.9900 Y 07/21 our promotional balance of $1,400.00 must be received by 04/17/2010 in order to avoid accrued finance charges which currently equal $97.40 PREVIOUS (-)PAYM ENTS & (+)FINANCE (+)pURCHASES & (=)NEW CREDIT PLAN BALANCE MINIMUM CREDITS CHARGES OTHER DEBITS BALANCE PAYMENT 12344-01 $1,601.55 $201.55 $0.00 $0.00 $1,400.00 Finance charges ma b hi h $0.00 y e g er than the calculation above if your initial purchase was not paid in full b the d f y en o the grace period. Please include detached portion with payment Y Account No. 9043381800508879 Payment Due Date 08/ 16/09 Past Due Amount $0.00 New Balance $ 1 , 400.00 Minimum Payment Due $0.00 Enter Amount Enclosed in Boxes Below -- --: - Please make check or money order payable to ~~ • ~ ~~~~~ ~ ~ ~ """ """' "-"" "-~" DEPARTMENT OF ACCOUNTS 100 0009D43381,800508879 08162009 0014000D 00000000 01 0 3 #BWNJXVP 9 04 00 3 2 2 2 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~i~~~~~~~~~i~~~~~~~~~~~~~~~i~ MERLE H MYERS 154 CHAMBERLIN RD YARD CARD SHIPPENSBURG PA 17257-9713 P.O. BOX 609 MEMPHIS TN 38101-0609 sx Buz Ga ~~ '~d 90.00 1~ APD