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Home My WebLink About07-13-10' 1505610145 REV-1500 EX (01-10) pennsylvania ~I"Fl~.l~ ~~"~ PA Department of Revenue DEPARTMENT OF REVENUE County Code Year Fife Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOX 280601 Harrisburg, PA 17128-0601 RESIDENT DECEDENT 21-10-00414 __ ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 211-18-7693 03232010 08222022 Decedent's Last Name Suffix Decedent's First Name MI Dagen Verna M, (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number FILL IN APPROPRIATE BOXES BELOW 0 1. Original Return 0 4. Limited Estate 0 6. Decedent Died Testate (Attach Copy of Will) [~ 9. Litigation Proceeds Received THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS [_] 2. Supplemental Return 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) Q 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95} 3. Remainder Return (date of death prior to 12-13-82) ~] 5. Federal Estate T'ax Return Required 0 8. Total Number of Safe Deposit Boxes Q 11. Election to tax under Sec. 9113(A) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number Stephen D, Tiley, Esquire 717-243-5838 _.._.w_.....~,.w _ __ ~ _.____.~_~__.~~._._.~ I~~iTl~ ~.~i= WIIM ~ u~L~~ First line of address ~ ~ v,-~ 'j Frey and Ti1ey ~, ~,,~ +;.: ,_.a Second line of address ' -' ` r -, ,- •, 5 South Hanover Stree ~ ~ + --~~ ` ~- ~-~ City or Post Office State ZIP Code `~~~ ~~~ ~~~~~~~ ~~~ ~ _-.~~~~-+~~~~ ~ ~~~ ~~~~ ~ ~~~ . ~} __~ _~ ~ Carlsle PA 17013 '"' Correspondent's a-mail address: s t i 1 e y@ f r yt i l e y. c om Under penalties of perjury, {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 OF RSO,~ SPONSIBI~E FOr~FILING RETURN DATE ADDRESS +. J. Edward Dagen, 105 Fleetwood Dr., Carlisle, PA 17013 SIGNA _QTH THAN REPRESENTATIVE ,DATE j ADDRESS ~ Stephen D. Tiley, 5 South Hanover Street, Carlisle, PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 1,505610145 1505610145 J J REV-1500 EX 1505610245 Decedent's Social Security Number Decedent's Name: Verna M. Dagen 211-18-7693 RECAPITULATION 1. Real Estate (Schedule A) ........................................... 1. 4 8 3 4 () O . 0 0 2. Stocks and Bonds (Schedule B) ...................................... 2. NONE 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. NONE 4. Mortgages and Notes Receivable (Schedule D) .......................... 4. 4 3 9 7 _`i 3 . 9 7 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E) ...... 5. 3 2 6 Ei 8 . 3 4 6. Jointly Owned Property (Schedule F) OSeparate Billing Requested ........ 6. 12 8 9 O . 0 0 7. Inter-Vivos Transfers 8~ Miscellaneous Non-Probate Property (Schedule G) OSeparate Billing Requested ........ 7 4 5 5 2 6 9. 0 0 8. Total Gross Assets (total Lines 1 through 7) ........................... 8. 14 2 3 9 31.31 9. Funeral Expenses and Administrative Costs (Schedule H) .................. 9. 17 718.6 7 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ........... .. 10. .518 2 . 4 3 11. Total Deductions (total Lines 9 and 10) ............................. .. 11. 2 2 9 O 1.10 12. Net Value of Estate (Line 8 minus Line 11) ........................... .. 12. 14 O 10 3 0.21 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ..................... .. 13. 0 . 0 0 14. Net Value Subject to Tax (Line 12 minus Line 13) ..................... . 14 14 010 3 0.21 TAX CALCULATION -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 .0 0 15. 0. 0 0 16. Amount of Line 14 taxable at linealrateX.o 45 $l, 401, 030.21 16. 63046.36 17. Amount of Line 14 taxable at sibling rate X • 12 17. 0 . 0 0 18. Amount of Line 14 taxable at collateral rate X . 15 18. C) . 0 0 19. TAX DUE ..................................................... .. 19. 6304Ei.36 2p. F1LL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 0 Side 2 L 1505610245 1505610245 J REV-1500 EX Page 3 File Number 211-18-7693 Decedent's Complete Address: 21-1n-nnala DECEDENT'S NAME Verna M. Da en STREET ADDRESS 770 South Hanover Street CITY Carlisle STATE PA ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) 63046.36 2. CreditslPayments A. Prior Payments $60,000.00 B. Discount $3,152.32 Total Credits (A + B) (2) 63152.32 3. Interest (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in box on Page 2, Line 20 to request a refund. (4) 105.96 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00 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? .......................................................... CI ^ 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ................................................................................................. ~ ^ 3. Did decedent own an "in trust for" or payable-upon-death bank account or security at his or her death? .... ^X ^ 4. Did decedent own an individual retirement account, annuity or other non-probate property, which contains a beneficiary designation? ............................................................................................................ 0 ^ 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 Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 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 21 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 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 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 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+ (01-10) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: SCHEDULE A REAL ESTATE FILE NUMBER: Verna M. Dagen _ _ 21-10-00414 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 that is jointly-owned with right of survivorship must be disclosed on Schedule F. Attach a copy of the settlement sheet if the property has been sold. ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE NUMBER OF DEATH DESCRIPTION 1. Medical Office Building -Rental Property 9 Brookwood Avenue, Carlisle, Pennsylvania 1703 (South Midleton Township) See Exhibit "A," copy of Deed dated December 28, 1989 and recorded in Cumberland County Book "I," Volume 34, Page 765. See copy of year 2010 Notice of Change of Assessment Exhibit "B." Indicates value as of January 1, 2010 of $483,400.00. $483,400.00 TOTAL (Also enter on Line 1, Recapitulation.) ~ $ 483.400 If more space is needed, use additional sheets of paper of the same size. REV-1507 EX+ (6-98) SCHEDULE D COMMONWEALTH OF PENNSYLVANIA MORTGAGES & NOTES INHERITANCE TAX RETURN RECEIVABLE RESIDENT DECEDENT ESTATE OF FILE NUMBER Verna M. Dagen 21-10-00414 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Note & Mortgage from Benjamin Sukle and Heidi L.Sukle Secured by first mortgage on 20 Goodwin Street, East Greenwich, Rhode Island 02818 Original Balance $250,000.00 November 14, 2008 See copy of Amortization Schedule, attached as Exhibit "E." See copy of Note and Mortgage attached as Exhibit "F." Unpaid balance per Amortization Schedule $244,468.98 Accrued interest to date of death $616.20 2. Bond and Mortgage from Jonathan E. Dagen and Danielle A. Dagen Secured by first mortgage on 120 Westgate Drive, Mount Holly Springs, PA 17065 Original balance $200,000.00 August 25, 2008 See copy of Amortization Schedule attached as Exhibit "G." See copy of Bond and recordng certification page for Mortgage attached as Exhibit "H." Unpaid balance per Amortization Schedule $194,179.35 Accrued interest to date of death $489.44 TOTAL (Also enter on line 4, Recapitulation) $ I 439,754 (If more space is needed, insert additional sheets of the same size) REV-1508 EX+ (6-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. COMMNHER TANCE~TAx RET RNANIA PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Verna M. Dagen 21-10-00414 Include the proceeds of litigation and the date the proceeds were received by the estate. All roe 'ointl -owned with ri ht of survivorshi must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Refund -United States Treasury -Year 2009 Federal Income Tax Refund $5,616.00 2. United States Treasury -Social Security Benefits, paid to Sovereign joint bank account $1,408.00 3. Chapel Pointe at Carlisle: Refund of monthly nursing care fees $2,506.04 Refund upon resale of former Independant Living Unit $22,733.30 4. Refund -Commonwealth of Pennsy{vania -Year 2009 Pensylvania Income Tax Return $305.00 5. Personal property (furnishings) in nursing home room $100.00 TOTAL (Also enter on line 5, Recapitulation) $ I 32,668 (If more space is needed, insert additional sheets of the same size) REV-1509 EX+(01-10) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF: FILE NUMBER: Verna M. Dagen 21-10-00414 If an asset became jointly owned within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME(S) ADDRESS RELATIONSHIP TO DECEDENT A. J. Edward Dagen 1205 Fleetwood Drive San Carlisle, PA 17013 B C JOINTLY OWNED PROPERTY: ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOfNT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSET °io OF DECEDENT'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST Sovereign Bank Account No. 3381138847 1. A. 7112/04 0 Jointly held with J. Edward Dagen, see Exhibit "I." $25,679.97 50.00°l0 12,$40 0 Accrued interest to date of death $0.63 50.00% 0 0 0 0 0 0 0 0 0 0 0 0 0 TOTAL (Also enter on Line 6, Recapitulation} ` $ 12,840 .00 If more space is needed, use additional sheets of paper of the same size. REV-1510 EX+ (08-09) SCHEDULE G pennsylvania INTER-VIVOS TRANSFERS & DEPARTMENT OF REVENUE INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Verna M. Dagen 21-10-00414 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. ITEM NUMBER DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH % OF DECD'S VALUE OF ASSET INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1. 0 Cash gift May 21,2009 $180,000.00 100.00% $3,000.00 177,000 To: J. Edward Dagen ~ 1205 Fleetwod Drive 0 Carlisle, PA 17013 0 0 0 2. Vanguard Brokerage Services 0 Acct. No. 74869628 (See Exhibit "C"attached) $85,934.03 100.00% 85,934 0 3. Vanguard Mutual Funds 0 Acct. No. 09912738034 (See Exhibit "D" attached $192,334.67 100.00% 192,335 0 (Includes accrued dividends to date of death of $415.37,) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 TOTAL_LAlso enter on Line 7, Reca itulation $ 455,269 If more space is needed, use additional sheets of paper of the same size. REV-1511 EX + (10-09) pennsyfvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Verna M. Dagen 21-10-00414 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Gundel Funeral Home $240.88 2. Gundel Funeral Home $295.00 B ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address 1 Clty Year(s) Commission Paid: State ZIP 2. 3. 4 5 6 7 Attorney Fees: Frey and Tiley 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 Probate Fees: Accountant Fees: Fey and Tiley Tax Return Preparer Fees: Check printing for estate checking account 8. Sovereign Bank -fee for date of death balance letter 9. Advertising -Cumberland Law Journal ($75.00) and The Sentinel ($187.54) 10. Reserve for additional probate fee 11. Reserve to file Account -Est. 6/15/10 $730.00 12. Filing fee -Inheritance Tax Return $15,000.00 $757.50 $0.00 $276.00 $21.75 $20.00 $262.54 $100.00 $730.00 $15.00 TOTAL (Also enter on Line 9, Recapitulation) ~ $ 17,719 If more space is needed, use additional sheets of paper of the same size. REV-1512 EX+ (12-08) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Verna M. Da en 21-10-00414 Reoort debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS ~t more space is neeaea, mse~t auani~i iai s~ ~CG~s v. a is aai i is ai~c. Estate of Verna M. Dagen SCHEDULE I-1 File No.: 21-10-00414 Item No. Description Amount 1 Checks Cleared After Death: Sovereign Bank Account No.: 3381138847 Jointly Held With J. Edward Dagen Check No. 685 cleared March 24, 2010 to Millennium Pharmacy 74.03 2 In Your Home Care -Medical Expense 271.25 3 PP&L -Utilities -Medical Office Building 258.80 4 UGI -Utilities -Medical Office Building 229.46 5 Millennium Pharmacy 214.95 6 JC Ehrlich -Pest Control -Medical Office Building 167.48 7 JC Ehrlich -Pest Control -Medical Office Building 56.18 8 UGI -Utilities -Medical Office Building 87.75 9 S. Mid. Municipal Authority -Utilities -Medical Office Building 122.00 10 Carlisle Regional Medical Center 37.29 11 Robert C. Cairn, Tax Collector 1,101.15 Real Estate Taxes on Rented Medical Office Building 9 Brookwood Avenue, Carlisle, PA 17013 12 George Branscum, MD 39.75 13 Hartzell Eye, MDS 39.75 14 PP&L -Utilities -Medical Office Building 258.39 15 Tuckey Mechanical Services, Inc. - HVAC Service on Medical Office Building 258.75 16 Mutual Benefit Group -Insurance on Medical Office Building 494.00 17 Refund -United States Treasurey -Social Security 1,408.00 18 UGI -Utilities -Medical Office Building 63.45 TOTAL DISBURSEMENTS 5,182.43 1st & final Vern a Mae Dagen 7.6. l0.xls Page 1 7/6/ 10 at 2:55 PM REV-1513 EX+ (01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Verna M. Daaen 21-10-00414 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1 ~ J. Edward Dagen Son 100% residuary 1205 Fleetwood Drive Carlisle, PA 17013 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUG H 18 OF REV-1500 COVER SH EE-r, AS APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ 0 If more space is needed, use additional sheets of paper of the same size. LAST WILL AND TESTAMENT I, VEF.NA 1dJAE DAGEN, of the County of Cumberland and Commc-nwealth of Pennsylvania, being of sound mind, memory and understanding, do make, publish and declare this to be my Last Wiil and Testament, revoking any and all Wills and Codicils by me at any time heretofore made. FIRST: I order and direct my Executor hereinafter named to pay all of my just debts anal funeral expenses as soon as can conveniently be done after my decease. SECOND: I direct that all inheritance, estate, transfer, succession a.nd death taxes, of any kind whatsoever (including any interest and penalties thereon), which may be payable by reason of my death, whether or not with respect to property passing under this Will, shall be paid out of the principal of my residuary estate. Taxes on future interests nr.~ay be prepaid. THIRD: All the rest, residue and remainder of my estate, both real and personal, I give, devise and bequeath unto my son, J. EDWARD DAGEN, his heirs, personal representatives and assigns, in fee simple, absolutely. FOURTH: All legacies, shares or interests in my estate, whether principal or income, payable to any beneficiary under my Will shall to the fullest extent permitted by law be paid free and clear of, and the interest of such beneficiary shall not in any manner be subject or liable to, his or her debts, liabilities, contracts, engagements, anticipations and alienations or those of any other person, ox subject to attachment, execution, or sequestration., for the debts or liabilities of any person whatsoever; and the personal receipt by such beneficiary shall be the sufficient and only discharge of my Executor. FIFTH: I nominate, constitute and appoint my son, J. ED~VARIJ- DAGEN, to be the Executor of this my Last Will and Testament. I order and direct that my Executor shall serve without bond and that no indemnification, bonding or certification of any kind shall be required in the administration of this estate. IN WITNESS WHEREOF I have hereunto set my hand and seal this _ .=7~~ r'~~', day of :> ~~ ,~ : ; ~'~ , 2007. ,;; ;. r.,. ~ ~ ~` ~~ 4:`'. ~~~ ~'~;~,~ -~'1' ~~. ~'~~ (SEAL) VERNA MAE D~-GEN `` Signed, sealed, published and declared by the above named Testatrix, VERN~i l~E D~iGEN, as and for her Last Will and Testament, in the presence of us, who at her request and in her presence and in the presence of each other have subscribed our namf:s as witnesses hereto. !'~,r .1. ~ l ~ ` ~~ _ «. l 7... •'~..._~.. n. -2- COMMONWEALTH OF PENNSYLVANIA COUNTY OF LANCASTER SS: I, V~IZNA IVIAE DAG~N, Testatrix, whose name is signed to the ateached. instrument, having been duly qualified according to law, do hereby acknowledge that I sued and executed the instrument as my Last ~7Vi11; that I signed it willingly; and tl:iat I signed it as my free and voluntary act for the purposes therein expressed. Affirmed to and acknowledbed before me, by V~~IA NIA DAGEN, the Testatrix this .: ~!~~ ' `~~day of ~~-r:Y..~~~~~: , 2007. {/ : ! j ~~. ~ ~~ 4~~ 4 .e VE~tNA 1l~AE DA.GEN 11 ~ ~~ Notary Public CONlMOP11~/EaLTH ~~' ~ P~l~~ISYLVASli~ {Notarial meal Karen P,A. Tumer, t+~ry F'ubrc ~ Cariisle Soro, Cumt~and d".,~x~:~ty f1~4y Cammission .l~al~ 21, Z~l?~° ! Iviember, Pennsylvania Asso~l~ti;~~~ ~~¢ •~.r;..~r:~; -3- COMIvIONWEALTH OF PENNSYLVANIA SS: COUNTY OF LANCASTER } WE, ,~ f t ~ f ~,~~-~- ~. ~' -: and ~~, ~~ ~ w>- ,the witnesses -y .~ , whose names are signed to the attached instrument, being duly qualified according to law, do depose and say that we were present and saw the Testatr-~x sign and execute: the instrument as her Last Will; that VERNA 1V~AE DAGEl`~ signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and. sight of the Testatrix signed the Will as witnesses; and that to the best of our knowledge the Testatrix was at that time eighteen (1 °a~ or more years of age, of sound mind and under no constraint or undue influence. Affirmed and subscribed to before me by ;+~. "f~ 1W >~~ ~-~, . f r;-~.~,-~,~ and ~.~'r,; :-~ ~~ -~ ,witnesses, this . ~~{ ~-~ day of °~; ~,~~.: , 2007. } -- . r!; 1' ~ ~y ~~ , F~ ~~ /?~.~ ' f ~ ~ ~1C'--va---:s ~.~-- -- - Notary Public {w""=ti ivi~viCSh;1f4~Ef~..T~-i O~ P~P~lhl~YL~~ fil~tp[i2l ~~a~ '' }~3ie?f6 ~.'16Urllei. I`~kC~^rz ~:1D{~~ ' ~arEisle Coro, G~!r~.~nr~w~~ ~~a~~f icy ~mis~iar~ F~~~r~:..:a<<'~'~ ~~ _ _ y . P .rn~°;~!vania .~:, =~w~:; rr^n ~t '~lo2arles Aemi~er, Q -4- P-201-AT-11-V~larranty Geed, Short Form. Act of 19C9-Arranged for Photo-Recording ~' Henry Ha11, Inc., Indiana, PA _ ~ ~ ~'-t,tJ~~ ~ru/~,1/ y _~ ~:.. ~+3 's~ ~~d ~.'~: afl'a T,;=1'S~~"l.~y~ ~~- ~~ r"y~ L~/I .~~ X~f ~ r .i (/, C~ / ~s ~ ~_~,..,,, - cam.-- ~~ ..~....r..._,.........._...~.~.a .i <~ 1VIADE THE ~~ ~ day of December in the year o f our Lord one thousand nine hundred e i gh t y -nine (19 8 9 ) EETi~EEN CW ASS OCIAlES , A Partnership o f Carlisle , Cumberland County, Pennsylvania, hereinafter called Granter , and ROY K. DAGEN and VERNA M. DAGEN, his wife, of 20 West Penn Grant Road, Willow Street, Pennsylvania, hereinafter called G~°antees WITNESSETH, that in consideration. of One and no/100----------------------- in hand paid, the receipt whereo f is hereby acknowledged, the said yranto'r does he7•eby grant and convey to the said grantee s, their heirs and assigns as tenants by the entireties ALL that certain tract of land situated i.n South Middleton Township, Cumberland County, Pennsylvania, bounded and de:~cribed in accordance with Land Subdivision of Brookwood, dated April 1985 (revised through May 16, 1985) and recorded in Cumberland County Plan Book 47, Page _l~l, as follows : - BEGINNING at a_n iron pin on the western dedicated right-of-way line of Brookwood Drive C50 foot right-of-way} at the northeastern corner of Lot No. 5 as shown on the above described Plan; thence by said Lot i~o. 5, South 57 degrees 28 minutes 45 seconds West 200.00 feet to an iron pin in line of land no~nr or formerly of the Trustees of Carlisle Brethern in Christ Church ~ thence by said land, North 32 degrees 31 minutes l5 seconds~West 150.00 feet to an iron p~.n; thence by Lot No. 7 as shown on the above described :>ubdi.vision plan, i~torth 57 degrees 28 minutes 45 seconds East 200.00 feet to an iron pin on the western dedicated right-of-way line of Brookwood . ~,. ~-. Drive; thence by said western dedicated right-of-way of Brookwood Drive, South 32 degrees 31 minutes 15 seconds East 150.00 feet to an iron .pin. on said right-of-way line, the Place of BEGINNING. CONTAINING 0.6887 acres and being designated Lot No. 6 on the above mentioned subdivision plan . UNDER AND SUBJECT, NEVERTHELESS to a storm water drainage easement along the western boundary of the above described lot as more particularly shown on the above described subdivision :plan together with all maintenance and construction responsibilities as noted on said plan. BEING the same property which MDC Associates , A Partnership, granted and conveyed to CST Associates, A Partnership, Grantor herein, by deed dated October 31st, 1986 and recorded in th~~ Office of the Recorder of Deeds for Cumberland County in Deed Book "G", Volume 32, Page 968. --. .. - -.-> ~A Sl~f r ri~r~F'1+~~~\ y P ~. y, ;::.~J v~ e 4 tf .. ~' v ~ ~ ~ j ~' -- _~ ,; ; .= - • , .,. ~ ,.. , 1-. -ts f- ~: U ~ % « ~[r' ~F L6~~ ~lO ~. 4'P w ~~ ~' i"r ~~~ V~ ~i i~ ~ ~ C . ~V =~... ~ ^ CCC~ i ='~~ ;-~ t'\7 ~4.~--~ ~ e =~ ~"7 ~ ..5~ r-y - .. --~ ~~ J ~~ L~~ ~^'1 ~ ~ ~~ '~ e N ~`~e.1' V. ~„" AN.I~ the said grrxntor hereby covenants and agree s that it will warrant s p e c i a l ly the property hereby conveyed. IN GYITNE,SS WI~ERE®~', said grantor has hereunto set its hand and seal the day and year first above written. CW ASS 0 CIATES , A P artne rsh ip ,~ ... - ~~ ~'-~~--= ------ ------------------------------ ---------------------------.. s~aa. ~~~~~~, ~i~a~~~ a~~ ]@e~~~~r J ~ EDWARD DAGEN~ i~t ~P ~1<e~~~cr o~ --------- ---- spa r LINDA W . DAGEN ~--~ -------------------------------------------------------------------------- ----------------------~•-----------------------------------------------------------• SEAL State of PENNSYLVANIA ss. County of CUMBERLAND y On this, the ~-~ ~ day o f December , 19 ~3 9 ,before me, the undersigned officer, personally appeared J . Edward Dagen and Linda W. Dagen, his wife known to me (off satisfactorily proven) to be the persons whose names are subscribed to the within instrument, and acknowledged that they executed same for the purposes therein contained. .;_~~>:J;~~T.~. ~I~#'1VESS I~VHERE-OF, I hereunto set and andofficial seal .y_ ~.-v Z ~1 J _ ~ ~ ~ __ ~ ~ ----°-- -------°-------- ---------------------- -- y--- ~: ~: A _~ At3GE&.8~1~,- TAY ~8~~E------ --------------------------------------------- FN `~ ,~ ~ s~-:,,,L~~=` ~ - ARLISL~EO~tOUGN,~ilMBER~yDC4llNT Title of Officer. :' - : '. '; ~'~ , ' `'~, n ' 9NY CQM~tiSSION EX°iR~S GCT'. 3, 1892 l ~~ ~ ~ l..) _~,, r"" ~' S~ :i~'~' ~ - ~i6,"I~}P.C.'39!?ricf'i"~~l!c~,.'~~~G:~3?iGRG~t ~OfaP'ES I do hereby certify that the precise residence and complete post office address of the within named grantee s is ~ U~• i;~~i?.~/~a ..~,~~a,,.1- -'~`~z•~ Gv-r-~:'.~:.,~; sT~c.~~ ~ ~> ~ ~s-rJ~~ December Z~ L/ 19 89 ,., ,, ~----- - ~~ ~-Ls-= ---- ~=-- ~~`'~'---------------------- ------------------- G, antees Attorney for -----------.-~------------------------•---------------------- j.~ ,~.: Cnj ~~ ~ J' N 4-i •,~ /~ G~ .~ ~ ~ n ([j ~ ~ • ~ ~ H t11 ~ Q U ~ ~ O N (~ Q ~ ~ ~ ~ ~ ~ ~ ~ ~ cLi ~ ~ ~ ~ U ~ ~ ;~ ~'~/ Fj~~ h~ 3 E-+ H U ~ (/~ H ~ ~ ~ ~ O H ,!-~ ~~ H H COMMONYVE LTH OF PENNSYLVANIA / ss. County of ---- ---------------------- ~_lCty~!~-~ -------------------- RECORDED on this ------------------------------ day of ------------------------------------------------ =c A. D. 19_______1 in the Recorder's office of the said County, in Deed Rook ~~~ ~~~~ Vol- ------------------------- ~'a9'e ------------------------• Given under my ha the seal oft e skid he date above written. .~ ~. -------------------------------------------- ------------~ Recorder. `~l~~' Cumberland County Board of Assessment Appeals Old Courthouse, First Floor One Courthouse Square Carlisle, PA 17013 40003247-1A-16005 2606 DAGEN, ROY K & VERNA M T9 Pi 1205 FLEETWOOD DRIVE CARLISLE, PA 17013-3514 Deadline for Scheduling an Informal Review Appointment: April 12, 2010 NbTICE OF CHANGE OF ASSESSMENT The Cumberland County Board of Assessment Appeals is providing you with notice of the value on this property, determined as a result of the Cumberland County countywide reassessment completed this yE~ar. The countywide reassessment values each property at current Fair Market Value, as of January 1, 2010, equalizing and establishing a uniform tax base so that properties of like characteristics and the same actual Fair Market Value will be taxed the same. FORMAL APPEAL DEADLINE: April 12, :2010 MAILING DATE: March 1, 2010 Munic.: 40 - SOUTH MIDDLETON TWP School: S - SOUTH MIDDLETON SD Location: 9 BROORWOOD AVENUE BROOKWOOD LOT 6 PB 47 PG 141 Taxable Property Unit/Lot ID: L-0006 Land Size: .69 acres Property Type: CO Commercial - Office Parcel Identifier: 40-23-0604-017. 2010 Base Year Assessed Value Old Assessed Value Fair Market Value (2010 Market x 100%) (2004 Market) Land 180,300 180,300 14,730 Buildings 303,100 303,100 386, 710 TOTAL 483,400 483,400 401,440 2010 Clean and Green Values Land NOT NOT NOT Buildings APPLICABLE APPLICABLE APPLICABLE TOTAL Clean and Green values apply to qualified farm .and forest land and become effective only upon .application and approval. Clean and Green applications must be received - than 4:30 p.m. on Qckober 15, 2010_ Those by the Assessment ~ffice''no' later previously approved for Clean and Green do not need to re-apply. The ESTIMATED impact statement printed below is our best estimate of change, based on 2010 COUNTY tax figures. THIS ESTIMATE DOES NOT INCLUDE ANY BOROUGH, TOWNSHIP, OR SCHOOL DISTRICT IMPACT. Current 2010 County mills = 2.465 Adjusted 2010 County mills = 1.982 $ 990 2010 COUNTY Tax BEFORE Reassessment. $ 958 2010 COUNTY Tax AFTER Reassessment. (see reverse side) ~~ Vs"i11~11dI'~~ June 23, 2010 STEPHEN D TILEY FREY &TILEY ATTORNEYS AT LAW 5 S HANOVER ST CARLISLE PA 17013 Re: Estate of Verna M. Dagen Dear Mr. Tiley: P.O. Bo:~ 2600 Valley Forge, PA 19482-2600 www.vanguard.rom We are responding to the letter we received regarding the valuation provided for Verna M. Dagen's Vanguard account as of March 23, 2010. The account valuation report for Ms. Dagen's Individual Account lists the registration as it appears on the account. An individual account is a nonretirement account owned by one person. A transfer on death plan was established on the individual account to allow the assets to pass to a named beneficiary. The beneficiary designation is provided below. Verna M. Dagen -Individual Account Sole Beneficiary Percentage J. Edward Dagen 100% Our records indicate that the Verna M. Dagen Individual Account was established on January 7, 1998. The account valuation report provides the date in which the mutual funds were established. If you have any questions, please call Vanguard Voyager Select Servicesc~ at 800-284-7245. You can reach us on business days from 8 a.m. to 10 p.m. and on Saturdays from 9 a.m. to 4 p.m., Eastern time. Sincerely, Retail Investor Group Vanguard juv 51523388 \~ '~ V1i'i~ll~'Cl May 17, 2010 STEPHEN D TILEY FREY &TILEY 5 S HANOVER ST CARLISLE PA 17013 RE: ACCOUNT VALUATION Dear Mr. Tiley: P.O. Box 1170 Valley Forge, PA 19482-1170 www.vanquard.com Enclosed is the date of death valuation report you requested for Verna M. Dagen's brokerage account. You will receive a separate letter with information for any Vanguard fund accounts. If you have any questions, please call Vanguard Brokerage Services® at 800- 992-8327. You can reach us on business days from 8 a.m. to 10 p.m. or on Saturdays from 9 a.m. to 4 p.m., Eastern time. Sincerely, Vanguard Brokerage Services Retail Investor Group AXZ Enclosure(s): Account Valuation Report 10348183 i` ~~.. , Vanguard Brokerage Services® is a division of Vanguard Marketing Corporation, Member FINRA. Vanguard Brokerage Services® A Division of Vanguard Marketing Corporation Verna M. Dagan 1205 Fleetwood Dr Carlisle, PA 17013-3514 Individual Brokerage Account 74869628 Below is your date of death account valuation for the above referenced account 'Please note that the value of your Vanguard®mutual fund accounts will be provided separately Holdings Summary Values on: 3/23/2010 Stocks Total $0.00 FundAccess Total $65,925.10 Bonds Total $20,008.93 Total Account Value: $85,934.03 Holdings Stocks Symbol Quantity Price per Share Current Value No stock held in the account. Total stocks $0.00 FundAccess Symbol Quantity Price per Share Current Value Dodge & Cox Intl Stock Fund DODFX 635.8850 $32.8200 $20,869.7457 Fairholme Funds Inc FAIRX 1,200.5760 $33.7800 $40,555.4573 Gabelli Asset Fund GABAX 104.5030 $43.0600 $4,499.8992 Total FundAccess $65,925.10 Fixed Income Cusip Quantity Price per Share Principal Amount Accrued Interest DISCOVER BANK 254670XZ0 10,000.0000 $100.0000 $10,000.0000 $1.40 GREENWOOD DE CTF DEP FDIC ACT/365 INT@MAT CPN 0.150% DUE 08/17/10 DTD 02/17/10 FC 08/17/10 WESTERNBANK PUERTO 95989TLD1 10,000.0000 $100.0000 $10,000.0000 $7.53 RICO MAYAGUEZ PR CTF DEP FDIC ACT/365 MONTHLY CPN 1.100% DUE 02/25/11 DTD 02/26/10 FC 03/26/10 Total Fixed Income $20,008.93 Disclosure: The fair market value of the individual equity securities is calculated using the average between the highest and lowest quoted price of the securities on the valuation date. If the valuation date falls on a weekend or holiday, a weighted average of the highest and lowest prices on the nearest business days before and after the valuation date is used. Mutual Fund Securities are valued using the closing price of the funds on the valuation date. If the valuation dale falls on a weekend a weighted average of the closing prices on the nearest business days before and after the valuation date is used. Fixed Income Security (Bonds) valuations vary by type. Please consult the VBS® Bond Desk for specific inquiries. Page 1 of 1 Vanguarcl~ June 23, 2010 STEPHEN D TILEY FREY &TILEY ATTORNEYS AT LAW 5 S HANOVER ST CARLISLE PA 17013 Re: Estate of Verna M. Dagen Dear Mr. Tiley: P.O. Box 2600 Valley Forge, PA. 19482-2600 www.vanguard.com We are responding to the letter we received regarding the valuation provided for Verna M. Dagen's Vanguard account as of March 23, 2010. The account valuation report for Ms. Dagen's Individual Account lists the registration as it appears on the account. An individual account is a nonretirement account owned by one person. A transfer on death plan was established on the individual account to allow the assets to pass to a named beneficiary. The beneficiary designation is provided below. Verna M. Dagen -Individual Account Sole Beneficiary Percentage J. Edward Dagen 100% Our records indicate that the Verna M. Dagen Individual Account was established on January 7, 1998. The account valuation report provides the date in which the mutual funds were established. If you have any questions, please call Vanguard Voyager Select Services~~ at 800-284-7245. You can reach us on business days from 8 a.m. to 10 p.m. and on Saturdays from 9 a.m. to 4 p.m., Eastern time. Sincerely, Retail Investor Group Vanguard juv 51523388 {; 6 ~' .. r y t hi t d ~ ~r ta.F L1 -~ May 17, 2010 STEPHEN D TILEY FREY &TILEY ATTORNEYS AT LAW 5 S HANOVER ST CARLISLE PA 17013 Re: Estate of Verna M. Dagen Dear Mr. Tiley: P.O. Box :?600 Valley Forge, PA 19482-2600 www.vanguard.com We are responding to the letter we received requesting a valuation of Verna M. Dagen's Vanguard account as of March 23, 2010. The mutual fund information requested is included on the enclosed account value report. An account valuation report for the brokerage assets will be sent under separate cover. If you have any questions, please call Vanguard Voyager Select ServicesC) at 800-284-7245. You can reach us on business days from 8 a.m. to 10 p.m. and on Saturdays from 9 a.m. to 4 p.m., Eastern time. Sincerely, Retail Investor Group cep Enclosure(s): ** Verna M. Dagen Account Value Report ** 2010 Inherited Shares 51491902 r-"-~ ~ Page > 1 of 1 1l a.rd ~, Verna M. Dagen Report for 03/23/2010 1205 Fleetwood Dr Client Services: 800-662-2739 Carlisle, PA 17013-3514 Total report value: _ $192,334.67 (Total report value includes any accrued dividends.) ~ Verna M. Dagen -Individual Account Account value ummary Name Fund & Account - Date ~ Price Per Accrued Number Opened Shares Share Value* Dividends Inflation-Protect Sec Adm 5119-09912738034 06/01/2007 0.000 $24.83 $>0.00 - GNMA Fund Admiral Shares 0536-09912738034 05/16/2007 17,721.080 $10.83 $191,919.30 $415.36 Prime Money Mkt Fund 0030-09912738034 06/06/2007 0.000 $1.00 g~0.00 $0.01 Totals $191,919.30 $41.5.37 * Doesn't include accrued dividends. ----.._~__~.~-- -- --- - 0453637464 05/04/2010 13:26:24 ~~ `~+ /yam ~ V Page: 1 Schedule: 105 Verna Dagen, J Edward Dagen, POA Principal: $250,000.00 amortized over 30 years at 4.0000% (Ordinary Interest) Issued: 12-OS-2008 with first payment on 1-OS-2009 Payment: Equal Monthly (Principal + Interest} S~~C ~ ~ Payer: Heidi & Benjamin Sulam Home Mortgage APR 4.0000% # Of Payments 3S9 1 Pymt Payment No. Date "r :~ 12-OS-2008 . ~, 1 I -OS-2009 2 2-OS-2009 3 3-OS-2009 4 4-OS-2009 5 S-OS-2009 6 6-OS-2009 7 7-OS-2009 8 B-05-2009 ~1 9-OS-2009 10 I 0-05-2009 11 11-OS-2009 12 l2-OS-2009 2009 Totals dpi ~ 13 1-OS-2010 14 2-OS-2010 15 3-0OS-2Q 10 16 4-OS-2010 17 s-os-2o l o 18 6-OS-2010 19 7-OS-2010 20 8-OS-2010 21 9-OS-2010 22 10-OS-2010 Finance Charge $179,673.01 Amount Financed $250,000.00 Total Of Payments $429,673.01 Amount Of Payments Payments .Due $1,193.54 Equal Monthly Starting 1-OS-2009 $ 1, 192.15 12-OS-2038 Payment Principal Interest Principal Amount Payment Payment Balance 250,000.00 1, 193.54 360.21 833.33 249,639.79 1,193.54 361.41 ~ 832.13 249,.?78.38 1,193.54 362.61 830.93 248,! 15.77 1,193.54 363.82 829.72 248,:551.95 1,193.54 365.03 ~ 828.51 248,186.92 1,193.54 366.25 827.29 247,820.67 1,193.54 367.47 826.07 247,453.20 1,193.54 368.70 824.84 247,iJ84.50 1,193.54 369.92 823.62 246,'114.58 1,193.54 371.16 822.38 24b,343.42 1,193.54 372.40 821.14 245,!71.02 1,193.54 373.64 819.90 245,:>97.3 8 14,322.48 4,402.62 9,919.8 1,193.54 374.88 81 245,'?22.50 1, l 93.54 .13 817.41 244,846.37 1, I93.54 77._39 816 244,468.98 .S4 378. 814.0 244,090.34 1,193.54 379.91 813.63 243,'110.43 1,193.54 381.17 812.37 243,329.26 1,193.54 382.44 811.10 242,946.82 1,193.54 3 83.72 809.82 242,:163.10 1,193.54 3 85.00 808.54 242, ;l 78.10 l , l 93.54 386.28 807.26 241,'91.82 ~~~ ~~' "° PROMISSORY NOTE $250,000.00 November 14, 2008 East Greenwich, R.I. FOR VALUE RECEIVED, the undersigned Benjamin J. Sukle and Heidi L. Sukle (hereinafter collectively referred to as "Maker"), promises to pay to the order of Verna M. Dagen of Carlisle, Pennsylvania (hereinafter referred to as "Payee"), (Payee and any and all other holders of this :[Tote being hereinafter collectively referred to as "Holder"), at 770 South Hanover Street, Carlisle, PA 17013, or such other place as Holder hereof may designate in writing, the principal sum of Two Hundred Fifty Thousand dollars and 00/100 Dollars ($250,000.00) with interest as provided in this Note, as follows: I. Interest. From the date of this Promissory Note (until maturity or default as hereinafter_.provided), interest shall..' be payable at the rate of (four) 4% per annum. ~ "-~ II. Maturi The entire principal balance, together without any accrued interest due thereon shall be paid on or before November 17, 2038, III Payments. Monthly payments of not less than One Thousand 0-ne hundred Ninety-three and Fifty-four Hundredths ($1,193.54) Dollars monthly beginning January 5, 2009, and on the Fifth (5th) of Each month thereafter, until paid in full. Payee does hereby gift to Maker interest for the time period November 17, 2008 through December 5, 2008. The first payment due January 5, 2009 includes interest in arrears f;or the preceding month, and so on and so forth. Maker may make prepayments of principal, in whole or in part, at any time, and interest shall be calculated on the unpaid balance. All sums payable under this Note shall be paid not later than 3:00 p.m. (Providence time:) on the day when due in immediately available funds in lawful money of the United States of America. Whenever any payment to be made under this Note shall be stated to be due on a day other than a Business Day (as hereinafter defined), such payment shall be made on the next succeeding Business Day and such extension of time shall in such case be included in the computation of payment of interest. All payments under this Note shall be made to Holder without set-off or counterclaim and free and clear of and without deduction for any taxes, levies, imposts, duties, charges, fees, deductic-ns, withholdings, restrictions or conditions of any nature now or hereafter imposed or levied by any jurisdiction or any political subdivision thereof or any taxing or other authority therein unless Maker is compelled by law to make such deduction or withholding. If any such obligation to deduct or withhold is imposed upon Maker with respect to any amount payable by it hereunder, Maker will pay to Holder, on the date on w-hich such amount becomes due and payable hereunder, such additional amount as shall be necessary to enable Holder to receive the same amount which it would have received on such due date had no such obligation. been imposed upon Maker. Maker will deliver promptly to Holder certificates or other valid vouchers for all taxes or other charges deducted from or paid with respect to payments made by Maker under this Note. ~m.,::~~ "~" Within ninety (90) days after the end of each calendar year, Maker shall furnish to Holder an annual financial statement reflecting the f nancial condition of Maker and the results of Maker's operations, including, without limitation, balance sheets and profit and loss statements, federal and state income tax returns, all prepared in accordance with generally accepted principles of accounting consistently applied; all such financial statements shall set forth separately the property included in, the liabilities relating to and the results of the operations of, the Mortgage Property (as hereinafter defined); and ail such financial statements shall be certified as being accurate by Maker in writing. If any payment due under this Note is not paid when due, or if any other default or breach shall occur and continue beyond the expiration of any applicable grace or notice period under the terms or conditions of this Note, the Security Deed (as hereinafter defined} or any other document, instrument or _ . , - agreement now or hereafter evidencing, securing or relating to the Loan evidenced by this Note or affecting th~- property covered by the Security Deed, which terms and conditions are hereby incorporated herein with the same force and effect as if herein set forth at length, at the option of Holder, Holder may by notice to Maker declare the entire principal amount outstanding under this Note, together with all accrued interest thereon and all other sums due under this Note, to be immediately due and payable in full, whereupon same shall become immediately due and payable in full, without further notice or demand, Failure to exercise such option shall not constitute a waiver of the right to exercise such option if Maker is in default hereunder. In the event of any default in the payment of this Note, or a breach of any covenant, and if the same is referred to an attorney at law for collection oi• suit is brought hereon, Maker shall pay Holder, in either case, all expenses and costs of collection, including, but not limited to, court costs and reasonable attorneys' fees and disbursements. Time is of the essence of this Note. Subject to the fifteen (15) day period referred to in the next succeeding paragraph, any amount of principal of this Note which is not paid when due (whether at stated maturity, acceleration or otherwise) and, to the extent permitted by applicable law, any amount of interest under this Note which is not paid when due, shall bear interest, from the date on which such overdue amount shall have become due and payable by Maker until payment in full (whether before or after judgment), payable on demand, at a rate pear annum equal to five percent (5%) plus the rate of interest otherwise payable hereunder, or if such increased rate of interest may not 6e collected under applicable law, then at the maximum rate of interest, if any, which may be collected from Maker under applicable law (the "Default Rate"). In addition, and without derogating from the right of Holder to accelerate the maturity of this Note in the event of any default in the payment of this Note, if any payment under this Note is not received by Holder within fifteen (l 5) days of the date such payment is due, Maker shall pay to Holder on demand a late charge equal to five percent (5%) of the amount of such payment. The Maker may, on any Business Day, prepay the outstanding principal amount of this Note, in whole at any time, or ratable in part from time to time, provided, however, that: (a) Maker gives Holder at least 30 days' prior written notice of any prepayment specifying the date of prepayment and the principal amount to be prepaid; and (b} each prepayment shall be accompanied by payment of accrued interest to the date of such prepayment on the principal amount prepaid. No principal amount prepaid may be reborrowed. ~~f~ From time to time, without affecting the obligation of Maker or any sureties, guarantors, endorsers, accommodation parties or other persons liable or to become liable on this Note to pay the outstanding principal balance of this Note and observe the covenants of Maker contained herein, without giving noticf: to or obtaining the consent of Maker or any such sureties, guarantors, endorsers, accommodation parties or other persons, and without liability on the part of Holder, Holder may, at the option of Holder, grant extensions or postponements of the time for payment of said outstanding principal balance, interest or any part hereof, release any liable on any of said outstanding principal balance, accept a renewal of this Note, release or accept a substitution of all or any collateral given to secure this Note, join in any extension or subordination agreement, agree in writing with Maker to modify the rate of interest or terms and time of payment of said outstanding principal balance 9or period of amortization of this Note or change the amount of th.e monthly installments payable hereunder, or grant any other indulgence or forbearance whatsoever. no one or more of such actions shall constitute a novation. Presentment, notice of dishonor, protest and notice of protest and any and all lack of diligence or delays in collection or enforcement of this Note are hereby waived by Maker and all sureties, guarantors, endorsers and accommodation parties hereof and all otherpersons liable or to become liable on this Note.. This Note -~ ~ , shall be thing and several obligation of Maker and all sureties, guarantors, endorsers, accommodation parties `- and all other persons liable or to become liable on this Note, and shall be binding upon them anti their heirs, legal representatives, successors and assigns. Each notice, demand, election or request provided for or permitted to be given pursuant ~to this Note (hereinafter in this paragraph referred to as "Notice") must be in writing and shall be deemed to have been properly given or served by personal delivery or by sending same by overnight courier or by depositing same in the United States Mail, postpaid and registered or certified, return receipt requested, and addressed as follows: If to Holder: 770 mouth Hanover Street, Carlisle, PA 17013 If to Maker: 179 Tvy Street, Providence, RI 02906 Each notice shall be effective upon being personally delivered or upon being sent by overnight courier or upon being deposited in the United States Mail as aforesaid. The time period in which a response to such Notice must be given or any action taken with respect thereto (if any), however, shall commence to run from the date of receipt if' personally delivered or sent by overnight courier or, if so deposited in the United States Mail, the earlier of three (3) Business days following such deposit and the date of receipt as disclosed on the return receipt. Rejection or other refusal to accept or the inability to deliver because of changed address for which no Notice was given shall be deemed to be receipt of this Notice sent. By giving at least lthirty (30) days prior Notice thereof, Maker or Holder shall have the right from time to time and at any time during the term of this Note to change their respective addressed and each shall have the right to specify as its address any other address within the United States of America. The indebtedness evidenced by this Note is secured by, among other things, a certain Mortgage D-eed (the "Security Deed") dated of even date herewith, conveying a first mortgage Lien and security interest to the property as more particularly described therein, known as 20 Goodwin Street, Warwick, Rhode Island ("Mortgaged Property"). ~~ ~.~. This Note and the obligations of Maker hereunder shall be governed by and interpreted and determined in cordance with the laws of the State of Rhode Island (excluding the laws applicable to conflicts or choice of law). MAKER HEREBY IRREVOCABLE AND UNCONDITIONALLY (A) SUBMITS TO PERSONAL IRISDICTION IN TI-IE SATE OF RHODE ISLAND OVER ANY SUIT, ACTION OR PROCEEDING RISING OUT OF OR RELATING TO THIS NOTE, AND (B) WAIVES ANY AND ALL PERSONAL RIGHTS NDER THE LAWS OF ANY STATE (I) TO THE RIGHT, IF ANY TO TRIAL BY JURY, (II) TO OBJECT O JURISDICTION WITH THE STATE OF RHODE ISLAND OR VENUE IN ANY PARTICULAR FORUM IITHIN THE STATE OF RHODE ISLAND, AND (III) TO THE RIGHT, IF ANY, TO CLAIM OR RECOVER NY SPECIAL, EXEMPLARY, PUNITIVE OR CONSEQUENTIAL DAMAGES OR ANY DAMAGES OTHER HAN ACTUAL DAMAGES. MAKER AGREES THAT, IN ADDITION TO ANY METHODS OF SERVICE -F PROCESS PROVIDED FOR UNDER APPLICABLE LAW, ALL SERVICE OF PROCESS iN ANY SUCH UIT, ACTION OR PROCEEDING MAY BE MADE BY CERTIFIED OR REGISTERED MAIL, RETURN .ECEIPT REQUESTED, DIRECTED TO MAKER AT THE ADDRESS SET FORTH ABOVE, AND SERVICE .O MADE SHALL BE COMPLETE FIVE (5) DAYS AFTER THE SAME SHALL BE SO MAILED. NOTHING ;ONTAINED HEREIN, HOWEVER, SHALL PREVENT HOLDER FROM BRINGING ANY SUI'T', ACTION )R PROCEEDING OR EXERCISING ANY RIGHTS AGAINST ANY SECURITY AND AGAINST MAKER, ~h1D AGAINST ANY PROPERTY OF MAKER, IN ANY OTHER STATE. INITIATING-SUCH SUIT, ACTION -~ ,' )R PROCEEDING OlZ TAKING SUCH ACTION IN ANY STATE SHALL IN NO EVENT CONSTITUTE A - JVAIVER OFTHE AGREEMENT CONTAINED HEREIN THAT THE LAWS OF THE STATE OF RHODE :BLAND SHALL GOVERN THE RIGHTS AND OBLIGATIONS OF MAKER AND HOLDER HEREUNDER JR THE SUBMISSION HEREIN MADE BY MAKER TO PERSONAL JURISDICTION WITHIN THE STATE ~F RHODE ISLAND. This Note may not be amended, modified or change, nor shall any waiver of any provision hereof be effective, except only by an instrument in writing signed by the party against whom enforcement of any waiver, amendment, change, modification or discharge is south. Whenever used herein, the words "Maker", Payee" and "Holder" shall be deemed to include their respective heirs, legal representatives, successors and assigns. IN WITNESS WHEREOF, Maker has duly executed this Note on the 17~' day of November, 2008 and date first above written. Witness Benjamin J. Sukle Heidi L. Sukle r ~~~ MORTGAGE DEED Benjamin J. Sukle and Heidi L. Sukle of Providence, Rhode Island, for consideration paid, grant to Perna M. Dagen of Carlisle, Pennsylvania with MORTGAGE COVENANTS, to secure the payment of Cwo hundred Fifty thousand and 00/100 dollars ($250,000.00) Dollars, payable as provided in a certain promissory note of even date herewith. SEE EXHIBIT "A" ATTACHED HERETO THIS MOR'T'GAGE IS MADE UPON THE STATUTORY CONDITION AND WITH THE STATUTORY POWER OF SALE. WITNESS our hands this 1?`h day of November , 2005 In the Presence of: Benjamin J. Sukle Heidi L. Sukle STATE OF RODE ISLAND COUNTY OF KENT In East Greenwich on the 17~' day of November, 2008 before me personally appeared Benjamin J. Sukle and Heidi L. Sukle to be known by me to be the party executing the foregoing instrument and they acknowledged said instrument by them executed to be their free act and deed. Notary Public My Commission Expires ~$~BtT ` Page: 1 Schedule: 105 Mortgage Loan Principal: $200,000.00 amortized over 30 years at 4.0000% (Ordinary Interest) Issued: 8-25-2008 with first payment on 10-01-2008 Payment: Equal Monthly (Principal + Interest) Payer: Jonathan Dagen APR % Finance Charge 4.0000% $143,965.8 I # Of Payments Amount Of Payments 359 $955.47 1 $952.08 Pymt Payment Payment No. , D~ ate Amount 8-25-2008 1 10-01-2008 955.47 2 11-01-2008 955.47 3 12-01-2008 955.47 2008 Totals 2,866.41 ~ ~ ~ ~ 4 1-01-2009 - 955.47 5 2-01-2009 955.47 6 3-01-2009 955.47 7 4-01-2009 955.47 - ~ ~ ~ . - 5-01-2009 955.47 -. ~ 9 J 6-01-2009 ' ~ 955.47 10 ?-01-2009 955.47 11 8-01-2009 955.47 12 9-O1-2009 955.47 13 10-01-2009 955.47 14 11-01-2009 955.47 15 12-01-2009 955.47 2409 Totals 11,465.64 ~~ ~,U ~ 16 1Z= 1-01-2010 2 O 1-2010 - 955.47 5 47 18 _ _ 3-01-2010 19 4-O 1-2010 ~-~ - 20 , 5-al 201r 0 r~M.~r~ 95 4 21 6-01-2010 22 7-01-2010 23 8-01-2010 Amount Financed $200,000.00 Total OiF Payments $343,965.81 Payments Due Equal Monthly Starting I O-Ol -2008 9-O l -203 8 principal Payment Interest Payment Principal Balance 155.47 289.32 290.29 735.0 291.25 292.22 293.20 294.18 295.16 296.14 297.13 298.12 299.11 300.1.1 301.11 302.11 3,559.84 303.12 955.47 955.47 955.47 955.47 955.47 308.21 309.23 310.26 800.00 666.15 665.18 2,131,33 664.22 3.2 662.2 661. 9 58.34 ~ 657.35 656.36 65 . 654.3 653.36 .=- 652 646.24 645.21 2C-0,000.00 159,844.53 15-9,555.21 159,264.92 198,973.67 15-8,681.45 15-8,388.25 198,094.07 197,798.91 15>7,502.77 1 S>7,205.64 1 ~>6,907.52 196,608.41 196,308.30 196,007.19 195,705.08 195,401.96 195,097.83 194,792.69 194,486.53 154' 1~ 79.35 193,871.14 193,561.91 193,25 l .65 ,~ ,. '" MORTGAGE BOND WITNESSETH THAT Jonathan E. Dagen and Danielle A. Dagen, husband and wife, of 328 Juniper Street, Carlisle, Pennsylvania 17013, hereinafter referred to as OBLl'GOR, Is held and firmly bound unto Verna M. Dagen, by her POA J. Edward Dagen of 1205 Fleetwood Drive, Carlisle, Pennsylvania 17013„ hereinafter referred to as OBLIGEE, Is the sum of an amount consisting of two times the amount stipulated below to be paid to the Obligee in lawful money of the United State of America, to be paid to the said Obligee, its heirs, successors, or assigns, to which payment well and truly to be made, the said Obligor does bind his heirs, executors, administrators, and assigns and every one of them, jointly and severally, firmly by these presents. And so conditioned that anything herein provided to the contrary notwithstanding, it is expressly understood and agreed that the Obligation of this Bond shall cover, as well, any future advances that may be made by the Obligee to the Obligor, at any time or times hereafter, provided that at no time may the total balance due by Obligor to Obligee hereunder, whether the same represents in whole or in part, the initial advance or any future advance or advances, exceed the sum an amount consisting of two times the amount stipulated below to be paid to the Obligee. And the said Obligor does hereby empower the Prothonotary or amy attorney of any Court of record within the Commonwealth of Pennsylvania or elsewhere to appear for him and with or without a declaration filed, confess judgment him in favor of the Obligee, its heirs, successors, or assigns, as of any term, for the penal sum. above mentioned, which sum shall include and cover all payments required to be made by the Obligor in and by the terms and conditions of this bond as hereinafter set forth, including _ ___ .also an attorney's commission for collection of four (4%) percentage of the total of all such payments -~r $200.00, whichever is larger, together with costs of suit; and does + hereby waive stay of execution or other process on such judgment, and holding inquisition on any real estate levied on by virtue of any wit sued out on such jud,~gment is hereby dispensed with and waived and condemnation agreed to, which real estate maybe sold under a writ or writs of Execution or other lawful writ; and all exceptions of personal property from levy and sale on any execution under any law now in force or herc;after passed, is hereby waived, and further Obligor hereby waives all errors, defects, and imperfections in entering the said judgment or in any writ, or proceeding thereon or thereto or in anywise touching or concerning the same, and for the confession and entry of such judgment, this shall be sufficient warrant and authority. THE CONDITION OF THIS BOND is such that if the above bounden Obligor, his heirs, executors, administrators, or assigns shall well and truly pay or cause to be paid to the said Obligee, its successors or assigns, within 30 years from the date hereof, the sum of Two Hundred Thousand ($200,000.00) Dollars and all additional money advanced by the Obligee as herein or otherwise legally provided lawful moneys, aforesaid, with R. ,,~., interest at the rate of Four Percent (4%) per annum in monthly payments of not Less than Nine Hundred Fifty-four and Eighty-three hundredths ($954.83} Dollars monthly from the date hereof, or to be paid as follows. Obligor may make prepayments of principal, in whole or in part, at any time, and interest shall be calculated on the unpaid balance. LATE CHARGES: Four percent (4%) of the monthly payment fifteen (15) days or more late. SAID PAYMENTS to continue until the principal amount of the Obligation, additional advances anal other charges made to the Obligor or made for the protection of the mortgage security with interest is paid in full. THE PROVISION for the payment of principal and interest in monthly .installments shall not be construed as extending the maturity or due date for payment in full beyond 30 years from the date hereof. DUE ON Z'RAl'+TSFER: SHOULD THE LEGAL OR EQUITABLE TITLE TO THE REAL ESTATE WHICH IS THE SECURITY FOR THIS DEBT BE SOLD OR CONVEYED BY OBLIGORS, OR EITHER OF THEM, THEN THE UNPAID PRINCIPAL BALANCE OF SAID DEBT TOGETHER WITH ACCRUED INTEREST THEREON SHALL BE IIVIlVIEDIATELY DUE AND PAYABLE, ANYTHING HEREIN CONTAINED TO THE CONTRARY NOTWITHSTANDING. ANYTHING HEREIN provided to the contrary notwithstanding, it is expressly understood and agreedthat-the Obligor of this Bond shall cover, as well, any future advances that maybe made by the Obligee to Obligor, at any time or times hereafter, provided that at no time may the total balances due by Obligor to Obligee hereunder, whether the same represents, in whole or in part, the initial advance or any future advance or advances, exceed an amount consisting of two (2) times the amount stipulated " ~ _ - hereinbefore to be paid by the Obligee. PROVIDED FURTHER, and it is expressly understood and agreed, that the monthly payments made by Obligor shall be applied first to interest on the unpaid balance of"the principal sum and remainder thereof shall be credited on account of said sum. PROVIDED FURTHER, that the Obligor shall well and truly pay all taxes (which said term "taxes" shall wherever used in this Bond be taken and held to include all taxes;, water rents and all other municipal or other governmental assessments and charges) which now and also all those may hereafter be assessed, levied or charged against the premises granted in the Mortgage accompanying this bond as the same shall fall dui:, and shall on or before that first day of 3anuary of each and every year produce and deliver to the Obligee receipts for all such "taxes" for the current year assessed upon the mortgaged premises, and shall also keep and maintain at all times, in such company or compan%es as the Obligee shall approve, a policy or policies of insurance against loss or damage b~y fire, or other risk as required by the Obligee, in an amount not less than the amount due ~~~ on this bond upon the building and improvements upon the same premises, and all policies whatsoever covering the said improvements, whether in excess of the required amount or not, shall be duly assigned as collateral security to the Obligee, and to be by said Obligee retained, and shall also keep and maintain the buildings now on the mortgaged premises and any building erected thereon while this obligation shall be in force, in good and sufficient repair, and buildings erected thereon while this obligation shall be in force as above required (which although not so bound the Obligee may pay and maintain without impairing any other of the rights hereunder, and at the option of the Obligee all such payments or advances made by the Obligee maybe added to the unpaid balance of the loan). WITHOU'~ any fraud or further delay, then this Bond shall be void. PROVIDED, however, and it is hereby expressly agreed if at any time default be made in payment of said monthly installments, and total arrearages are equivalent to two (:2) contracted monthly installment payments; or default be made in the payment of "t:axes" when due, or the prompt and punctual maintenance of said insurance assigned as aforesaid when due, or the payment of the cost and premium thereof when due, whether purchased by the Obligor or Obligee, or of any sum of sums paid by the Obligee for or on account of any taxes or premiums or either (which payments have not a the option of the Obligee been added to the unpaid bala~ice of the loan), or maintenance of said buildings in good and sufficient repair after notice from the Obligee, or in the event the building or buildings shall be changed or altered, or if the title (both legal and equitable) to the mortgaged premises be transferred to anyone other than the survivor of the Obligor, or his heirs or devises, without the prior written consent of the Obligee, or in case of any default under the terms or the accompanying Mortgage, and such default in any one of these respects exist for a period of thirty (30) days; then and in such case the unpaid balance of the loan including additional advances and unpaid interest shall, at the option of the Obligee, become due and payable immediately, and payment of said unpaid balance of the loan, additional advances and all interest thereon and other payments herein agreed tosbe made by the Obligor may be enforced and recovered at once, " anything herein contained to the contrary notwithstanding; awrit or writs of Execution or other lawful writ maybe issued upon the judgment obtained upon this obligation Eby virtue of the warrant of attorney herein contained, or a complaint in an action of mortgage foreclosure may be filed upon the accompanying Mortgage and prosecuted to jud~~nent and execution and sale to recover the unpaid balance of the loan, all additional advances made by the Obligee as herein or otherwise legally provided, ail interest thereon remaining unpaid, together with all fees, cost, and expenses of collecting the samE:, including an attorney's commission of four percentage, or $200.00 whichever is larger, anything herein contained to the contrary notwithstanding; and as a concurrent and cumulative remedy or option for the benefit of the Obligee, its successors or assigns, the said Obligor does hereby authori2e and empower any attorney of any Court of Record to appear for him in any court of competent jurisdiction, to confess judgment against him in favor of the Obligee, its successors or assigns, in an amicable action of ejection for possession of property secured by the Mortgage accompanying this Bond, and described therein. ~T'~H" It is further expressly understood and agreed that, if any sum or sums of money shall become payable under any policies of insurance insuring the mortgage premises, or by virtue of any condemnation or taking of the mortgaged premises for public use, the Obligee shall have the option to receive and apply the same on account of this Obligation, or permit the Obligor to receive and use it, or any part thereof, for the purpose of repairing the mortgaged premises, or for any other purpose, without thereby waiving or imparing this Obligation, or the lien of the Mortgage securing it, the Obligor hereby expressly assigns and transfers unto the Obligee all sums of money payable under such insurance claims or condemnation proceedings, and does hereby irrevocably nonninate, constitute, and appoint the Obligee to act for the Obligor as a true and lawful attorney for the collection thereof. It is further expressly understood and agreed that the remedies of this Obligation and the accompanying Mortgage for the enforcement of the payment of the principal suns hereby secured, together with interest thereon, and for the performance of the covenants;, condition and agreements, matters and things herein contained are cumulative and concurrent and may be pursued singly, or successively, or together at the sole discretion of the Obligee, and may be exercised as often as occasion therefore shall occur. IF THIS INSTRUMENT is executed by more than one person as Obligor the authorizations, responsibilities, liabilities, and waivers of each shall be joint and several. Whenever used, the singular number shall include the plural, the plural the singular, the use of any gender shall include all genders, and the words "Obligor" and "Obligee" wherever use, shall include their heirs, executors, administrators, successors, vendees or assigns. WITNESS Obligor's hand and seal this ~ day of ~ ' , ~~ Signed, Sealedand Delivered In the Presence of ~~~ ~ (SEAL) ~ • U ~ SEAL) Nii l~ ~~~ t1 1 Yl Ff 3~f ! ~~~ ROBERT P. ZIEGLER RECORDER OF DEEDS CUMBERLAND COUNTY 1 COURTHOUSE SQUARE CARLISLE, PA 17013 717-240-6370 Instrument Number - 200829135 Recorded On 8/27/2008 At 10:39:56 AM * Instrument Type -MORTGAGE Invoice Number - 27835 User ID - KW * Mortgagor -DAGEN, JONATHAN E * Mortgagee -DAGEN, VERNA M * Customer -INFINITY ABSTRACT & SETTLEMENTS * FEES STATE WRIT TAX $0.50 STATE JCS/ACCESS TO $10.00 JUSTICE RECORDING FEES - $13.50 RECORDER OF DEEDS AFFORDABLE HOUSING $11.50 COUNTY ARCHIVES FEE $2.00 ROD ARCHIVES FEE $3.00 TOTAL PAID $40.50 * Total Pages - 6 Certification Page DO NOT DETACH This page is now part of this legal document. I Certify this to be recorded in Cumberland County PA ~~ of cvde~ ~ RECORDER CI D EDS * -Information denoted by an asterisk may change during the verification process and may not be reflected c-n this page. IIIIIIIIIAAIIIIIIIIIIII ~~ ~~yl1 Sovereign Court Ordered Processing \ Decedents - MA1-MB3-02-10 - P. O. Box 841005 -Boston, MA 02284 May 7, 2010 Stephen D. Tiley Frey & Tiley 5 South Hanover St Carlisle, PA 17013 RE: Estate of Verna M. Dagen Date of Death: 03/23/2010 Dear Stephen D. Tiley: Per your request, enclosed please find the account information as of the date of death for the above-named decedent. For your information, accrued interest is riot included in the date of death balance. Please feel free to contact me if 1 can be of any further assistance. Very truly yours, ~~ ~~~. Donna Penta Lead Specialist 617-533-1789 EXHIBIT "I" Sovereign Bank ESTATE OF Verna M Dagen SOCIAL SECURITY #: 211-18-7693 DATE OF DEATH: March 23, 2010 Account #: 3381138847 Type Premier Checking Open date: 7/12/2004 In the name of: J Edward Dagen Verna M Dagen Date of Death Balance: $25,679.97 Int.(YTD) from 1/1/2010 to 3/12/2010 ~ $3.39 Accrued interest to date of death: $0.63 Other Info: Page 1 of 1 EXHIBIT ,rIrr