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HomeMy WebLinkAbout08-26-10 1505610140 REV-1500 EX (°'_'°' PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number Po Box 2sosol INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 RESIDENT DECEDENT 2 1 1 0 0 1 9 1 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 1 8 4 1 2 2 3 6 3 0 2 2 0 2 0 1 0 1 1 1 0 1 9 2 2 Decedent's Last Name Suffix Decedent's First Name MI B A R R I C K K E N N E T H E (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 OVALS BELOW 1. Original Return 4. Limited Estate QX 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) 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 Tax Return Required 8. Total Number of Safe Deposit Boxes 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 T0: Name Daytime Telephone Number W I L L I A M A D U N C A N 7 1 7 2 4 9 7 7 8 0 First tine of address 1 I R V I N E Second line of address City or Post Office C A R L I S L E State ZIP Code P A 1 7 0 ], 3 Correspondent's e-mail address: B I L L D U N C A N a1 P A• N E T REGISTER'OF WILLS USE ONLY '-~ ~:a _~~~ ~ j ._~.~ ~ - , ~~ :_.~ __ (J _QAT~ FILED ~` .~' -....1 .~ '~ .~ r .) _~. ,~:. ° ', . Under penalties of perjury, I declare that 1 have examined this return, including accompanying schedules and statements, and to the hest of my knowledge and belief, it is true, correct complete. Declaration of rer other than the personal representative is based on all information of which preparer has any knowledge. SIGNA F NSIB F FILING RETU ,,.~,° 12 IRENE COUNT CARLISLE PA ],7015 SIGNATURE OF REPARER OTHER N REPRESENTATIVE ADDRESS 340 DORWOOD DRIVE __ CARLISLE PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 1505610140 1505610140 J R 0 W .~ ~ , ~~ J REV-1500 EX ~ecedenrsWame: KENNETH E • BARRICK Decedent's Social Security Number 1 8 4 1 2 2 3 6 3 RECAPITULATION 1. Real Estate (Sd~edule A) ........................................... 1. 1 3 9 4 9 5. 3 0 2. Stocks and Bonds (Schedule B) 2. 6 0 4 1 • 5 6 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. • 4. Mortgages and Notes Receivable (Schedule D) .......................... 4. • 5. Cash, Bank ~ Deposits and Miscellaneous Personal Property (Schedule E)....... 5. 7 5 5 9 0. 5 3 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 6. 4 8 9 9 . 2 1 7. Inter-Vivos Transfers & Miscellaneous Nan-Probate Property (Schedule G) a S r Billi t R t d 7 epa a e ng ....... eques e . 8. Total Gross Assets (total Lines 1 through 7) ........................... 8. 2 2 6 0 2 6 . 6 0 9. Funeral Expenses and Administrative Costs (Schedule H) .................. 9. 1 7 2 2 5 . 2 3 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule 1) ............. 10. 2 ? 7 9 • 1 ? 11. Total Deductions (total Lines 9 and 10) ............................... 11. 2 0 0 0 4 . 4 0 12. Net Value of Estate {Line 8 minus Line 11) ............................ 12. 2 0 6 0 2 2. 2 0 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. 2 0 6 0 2 2 . 2 0 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 . 0 0 15. 16. Amount of Line 14 taxable at lineal rate x .045 2 0 6 0 2 2. 2 0 1 s. 17. Amount of Line 14 taxable at sibling rate X .12 0 . 0 0 17. 18. Amount of Line 14 taxable at collateral rate X .15 0 0 0 1 g, 19. TAX DUE ......................................................19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 1505610240 0. 0 0 9 2 ? 1. 0 0 D. 0 0 0. 0 0 9 2 7 1. 0 0 D Side 2 1505610240 1505610240 REV-1500 EX Page 3 Decedent's Complete Address: DECEDENTS NAME KENNETH E - BARRIC_K__ __ STREET ADDRESS - --- - ---- 837 W- NORTH STREET - CITY - CARLISLE STATE - ---- PA ZIP ]7013 File Number 21 10 0191 Tax Payments and Credits: ~ • Tax Due (Page 2, Line 19) 2. CreditslPayments A. Prior Payments B. Discount 6,500.00 (1) 9, 271.00 3. Interest 341.90 Total Credits (A + B) (2) 6 , 8 41 - 9 0 (3) (4) 0.0 0 (5) 2, 429.10 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval 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. Make check payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred : ...................................................................... ^ Q b. retain the right to designate who shall use the property transferred or its income; ............................... ^ Q c. retain a reversionary interest; or ................................................................................................ ^ d. receive the promise for I'rfe of either payments, benefits or care? .................••------.............................. ^ Q 2. ff death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate oonsideration? ....................................................................................... ^ X^ 3. Did decedent own an "in trust for" ~ payable-upon-death bank account or security at his or her death? ......... ^ Q 4. Did decedent own an individual retirement account, annuity or other non-probate property, which contains a beneficiary designation? .................................................................................................. ~ ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994, and before Jan. 1,1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse 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)]. Asibling is defined, undE Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1502 E:X+ (01-10) Pennsylvania ~ SCHEDULE A DEPARTMENT OF REVENUE REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: KENNETH E• BARRICK 2L 10 0191 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 befiNcen 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 Indude a copy of the deed showing decedent's interest 'rf owned as tenant in common. VALUE AT DATE NUMBER OF DEATH DESCRIPTION 1- 837 WEST NORTH STREET CARLISLE, PA 17013 [SEE ATTACHED HUD SHEET] 139, 495.30 TOTAL (Also enter on Line 1, Recapitulation.) ~ S 13 9 , 4 9 5.3 0 REV-1503 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER KENNETH E• BARRICK _ 21 10 0191 AN properly jointly-owned with right of swvivorship must be disclosed on Sdbdule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Q6327232715E - $25.00 ISSUED 5/1979 109.33 [SEE ATTACHED] 2- Q6306821409E - $25.00 ISSUED 02/1979 108.28 [SEE ATTACHED] 3- Q39165417E - $25.00 ISSUED 12/1979 110-62 [SEE ATTACHED] 4- Q6338075156E - $25.00 ISSUED 08/1979 105.59 [SEE ATTACHED] 5- Q6366636326E - $25.00 ISSUED D9/1979 109.59 [SEE ATTACHED] 6- Q6185418203E - $25.00 ISSUED 06/1977 139.70 [SEE ATTACHED] 7• Q6212712028E - $25.00 ISSUED 10/1977 139.67 [SEE ATTACHED] 8- Q6198814144E - $25.00 ISSUED 08/1977 139-6? [SEE ATTACHED] 9• Q6163516261E - $25.00 ISSUED 03/1977 138.04 [SEE ATTACHED] 10• Q6281086674E - $25.00 ISSUED 08/1978 106.9? [SEE ATTACHED] 11- Q6293343454E - $25.OD ISSUED 10/1978 106-97 [SEE ATTACHED] 12- Q6226285495E - $25-00 ISSUED 12/1977 128.45 [SEE ATTACHED] 13• Q63048550752E - $25.00 ISSUED 12/1978 108.27 [SEE ATTACHED] 14- Q6240332229E - $25-DO ISSUED 03/1978 108.54 [SEE ATTACHED] 15- Q6256468446E - $25.00 ISSUED 05/1978 106-6? [SEE ATTACHED] 16- Q6395998966 - X25.00 I SSUED 0 2/1980 110.62 [SEE ATTACHED] SCHEDl~ILE B STOCKS & BONDS TOTAL (Also enter on line 2, Recapitulation) I : 6 , 0 41 - 5 6 Continuation of REV-1500 Inheritance Tax Re#urn Resident Decedent KENNETH E. BARRICK 21 10 0191 Decedent's Name Page 1 Eile Number Schedule B -Stocks & Bonds ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 17• 436035 EE - $50.00 ISSUED 07/199? 41.12 [SEE ATTACHED] 18• 478112337 EE - $50.00 ISSUED 10/1991 64.46 [SEE ATTACHED] 19- METLIFE STOCK 99 SHARES X 41.00 4,059.00 SUBTOTAL SCHEDULE B 4 ,16 4.5 8 GRAND TOTAL. SCHEDULE B 5 6,041.56 REV-1508 EX + (8-98) SCHEDULE E ~j ~~++ CONMAONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, ~ M~~7C. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER KENNETH E• BARRICK 21 10 0191 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointhr-ovmed with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH ~. PROCEEDS OF PNC CHECKING ACCT- # 5140429338 1,195-?4 [SEE ATTACHED DOD LETTER] 2- COMMONWEALTH OF PA STATE TREASURY DEPT- REFUND 89.55 3- CENTURYLINK REFUND 5.36 4- US TREASURY TAX REFUND 94.00 5- MIDLAND NATIONAL LIFE ANN UITY POLICY # 8500126468 26,622.61 [SEE DATE OF DEATH LETTER ATTACHED] 6- WESTERN NATIONAL ANNUITY POLICY # VV220225 24,275.30 [SEE DATE OF DEATH LETTER ATTACHED] 7- MEMBERS FIRST AIG POLICY 23,3D?-97 [SEE DATE OF DEATH LETTER ATTACHED] TOTAL {Also enter on line 5, Recapitulation} ~ S 7 5, 5 9 0. 5 3 REV-1509 EX+ (01-10) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF: FILE NUMBER: KENNETH E• BARRICK 21 10 0191 ff an asset was made jointly owned within one year of the decedent's date of death, fit must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME(S) ADDRESS RELATIONSHIP TO DECEDENT a. KENNETH J• BARRICK s. FRANK L• BARRICK c JOINTLY-0WNED PROPERTY: 12 IRENE COURT ISON CARLISLE, PA 17015 340 DORWOOD DRIVE ISON CARLISLE, PA 17013 ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANGAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECEDENTS INTEREST DATE OF DEATH VALUE OF DECEDENTS INTEREST 1. A.B~B. 10/0? MEMBERS FIRST CHECKING ACCOUNT 10, 699.11 33.33 3, 566.01 # 102404-DO 2• A•8B- 10/07 MEMBERS FIRST SAVINGS ACCOUNT 4,000.00 33.33 1,333.20 # 102404-04 TOTAL (Also enter on Line 6, Recapitulation) I S 4 , 8 9 9 • 21 REV-1511 EX+ (10-09) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER KENNETH E• BARRICK 21 10 D191 Decedents debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. CARLISLE MEMORIAL SERVICES - MEMORIAL PLAQUE 50.00 2- CARLISLE MEMORIAL SERVICES - VA MARKER ON GRANITE 480.00 3- WESTMINISTER CEMETERY 144.80 4• SWING BROTHERS FUNERAL HOME, INC• 9,220.34 5- FUNERAL RECEPTION 320.00 6• OPEN AND CLOSE GRAVE 1,595.00 B. 1 2. 3. 4. 5. 6. 7. 8- 9- 10- 11• CITY Stake ZIP ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Repn~errtative(s) Street Address Year(s) Commission Paid: AttomeyFees: DUNCAN & HARTMAN, PC Family Exemption: (ff deceder>Ys address is not the same as claimants, attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent Probate Fees: REGISTER OF WILLS Accountant Fees: Tax Reium Preparer Fees: CUMBERLAND LAW JOURNAL - LEGAL NOTICE REGISTER OF WILLS - SHORT CERTIFICATES THE SENTINEL - LEGAL AD REGISTER OF WILLS - FILING FEE HELD IN RESERVE 32?-50 75.00 32.00 145.06 15.00 300.00 4, 520.53 TOTAL (Also enter on Line 9, Recapitulation) I S 17 , 2 2 5 • 2 3 REV-1512 EX+ (12-08) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES, ~ LIENS ESTATE OF FILE NUMBER KENNETH E• BARRICK 21 10 0191 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. N- MIDDLETON AUTHORITY - WATER & SEWER BILL 82.30 2- ROBIN K• SOLLENBERGER - PERSONAL TAXES 9.80 3• PPL - ELECTRIC BILL 53.39 4- ROBIN K- SOLLENBERGER - REAL ESTATE TAXES 328.31 5- DIVERSIFIED APPRAISAL SERVICES - PROPERTY APPRAISAL 350.00 6- PPL -ELECTRIC BILL 30.84 7• N• MIDDLETON AUTHORITY - WATER & SEWER BILLING 82.30 8• PPL - ELECTRIC BILL 47.4D 9• WILLIAM A• DUNCAN, ESQ- - DED PREP 8 ETC- 325.00 [SEE ATTACHED HUD SHEET] 10- TRANSFER TAXES - PROPERTY 1,393.00 [SEE ATTACHED HUD SHEET] 11- N• MIDDLETON - FINAL WATER/SEWER BILL 76.83 [SEE ATTACHED HUD SHEET] TOTAL (Also enter on Line 10, Recapitulation) I ~ 2 7 7 9 - 17 If more space is needed, insert additional sheets of the same size. REV-1513 EX+ (01-10) Pennsylvania ~ SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: KENNETH E - BARRICK a~, i.n ni.gi. RELATIONSHIP TO DECEDENT .AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS pndude outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1. KENNETH J- BARRICK Lineal 12 IRENE COURT 50~ SHARE CARLISLE, PA 17015 2- FRANK L- BARRICK Lineal 340 DORWOOD DRIVE 50~ SHARE CARLISLE, PA 17013 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 T HROUGH 18 OF REV-1500 COVER S HEET, AS APPROPRIATE. II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. ; ~t mnra cnar~ is naariari i icP a~irfitinnal ch~tc of nanPr of the camp ci~a ~~- I, KE~ii~'FTH E. BAI~iCK, of 837 W. North Street, Carlisle, North 1/sddletcr_ i ownship, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as artd for my Last Will and Testament, hereby revoking any and all other wiles and codicils heretofore made by me. ••~_ FiHST. I direct that alt tray just dCJL.s a'::~ furtera.i C:~i~icil"sc~ v~ ~alU a e,~Til IT1y CSCaie a~ Soon after my death as practically and conveniently may be done. SECOND. I direct that my remains be interred within my family's burial plot in ar..cord with my expressed wishes. THIRD. I authorize my personal representative to expend funds from my estate, in such amounts as my personal representative shall consider necessary and desirable for the purchase, erection and inscription of a suitable marker for my grave. FOURTH. I give, devise and bequeath any and all tangible personal property owned by me at the time of my death unto my sons, Kenneth J. Barrick and Frank L. Barrick, in equal shares, per stirpes. FIFTH. I give, devise and bequeath any and all real estate owned by me at the time of my death, unto my sons, Kenneth J. Barrick and Frank L. Barrick, in equal shares, per stirpes. SLXTH. I give, devise and bequeath all the rest, residue and remainder of my estate unto my suns, Kenneth J. Barrick and Frank L. Barrick, in equal shares, per stirpes. SEi~`ENTH. I direct that any and all Inheritance, Estate ar~d Transfer taxes imposed upon my estate passing under my will or otherwise, shall be paid out of the principal of my residuary estate. EIGH~'H. I hereby nominate, constitute and appoint my sons, Kenneth J. Barrick and, Frank L. Barrick, as Co-Executors of this my Last Will and Testament. I hereby relieve my Executors from the necessity of posting security in connection with their duties, as such, in any jurisd?ction ire which they may be called upon to act insofar as I am able by law to do so. In addition to the powers conferred by law, I authorize my Executors, in their absolute discretion, to retain in the form received, and to sell either at public or private sale any real or personal property owned by me at the time of my death. i ~L~,TT'~ . I have made, or may from time to time make, a written memorandum expressing my desire ro ~~•~ e certain items of personal property to specific persons. I urge my Executors and bcr~ef ci~?ri~.s t~:; respect these wishes. Such a memorandum, if made, shall be stored in conjunction II'~ WITi~tESS ~'VHE~ZEOF, I have hereunto set my hand and seal to this, my Last Will and Testament, consisting of two typewritten pages this ~,~'~ day of ~ ~, ,~~<< : ~'';- , 2004. .~ / '~ ZZ _ KErtNETH E. BARRICK Signed, sealed published and declared by the above named Testator Kenneth E. Barrick as and for his Last Will and Testament, in the presence of us, who, at his request, in his sight and presence and in the sight and presence of each other, have hereunto subscribed our names as witnesses. C, ~,C~'1J~.s.2 , -~ . it ` ~ ~ ! •r`'~ l' ~•. s~ ~ f ~- - CO~~:~~ ~~~~v"~1%~:~lLTH OF PENNSYLVANIA J~. CCr ~~'_~~~ :a~~ '~ ~ ~:'U13L~.~PLAND T, Ker~n~±}~ E. Warrick, Testator' whose name is signed to the attached or foregoing instrument, having been duly tlualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. - NNETH E. BARRICK Sworn or affirmed to and acknowledged before me, by Kenneth E. Warrick this ;" ~ day r ~~ of 2004. ~-~~ ~ ,~. l ., J ~ J/ A I'/I ~ Y 1 ~.~ ~totary ublic _...- NOTARtAt SEAL - Kathy L. Mummert, Notary P~biic Borough of Carlisle, Cumberland Co., PA - My Commiuion Expires Aug. a 1, 2007 COMMONWEALTH OF PENNSYLVANIA CO UNTY OF CUMBEI~'LAND :ss. ,~ We, .~ t C- ~`ti'' ; ~'`~- ~ and ' ~11~:' ~, ` ~-. t ~`t c.; =~ ~ ~" ~~ " the witnesses ~' ~ ~ ~ whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Kenneth E. Warrick sign and execute the instrument as his Last Will; that he signed willingly and that he executed as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator signed the will as witnesses; and that to the best of our knowledge, the Testator was at that time eighteen. j 18) or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed before me by "~w-~ ~~~ 1-- , !~} - - ~~ ~ . ~'~ ~ and ,, r ~ ~~ ~-a ~ I'' ~,`,,4 .; , witnesses, ~, this ' day of ;<i ~~ } , 2004. ,'~~ ~' ~ /~ t~ ~~Tota.ry ub1~ ` ~~ ~~ `~ f'7 ~ , ~~ ~1~ ! r f i 1 J r ~~ ~~'J J }i 1 L1,, ~, ~ . ~ r NOTARIAt SEAL Kathy L. Mummert, Notary PUbiic Borough of Carlisle, Cumberland Co., PA My Commission Expires Aug. 11, 2007 ~AY~Y~[ME~M~~AjTURIYR HEREOF wFIL PAY 184 12 2363 ~ ~ ~~ S~RI~S ~~ ~ , ~ + _ _ ...: ~' ~ 1',~~ ? ' ~~:~~~~ ~~uTtRk3T c~c~~~s~ scs v~x~ r ~~` _ 184 12 2363, ;p ~ j- 3 47~ ~ I~$ ., ~ l~~i!E d7ryiT~J ~ ;t ~" KENNETH BARRICK :~~RB _MPl~~~ t .e i ',~ ~ ~179u1M~TAiil~}tT~I~ ~'. ~,7 W . NORTH ST . ~ ~ ~p~tIISLE PA ~ 1?Q;I~w,1:7`~4 . M , DATtt6 (i 67A6t1a .. ~ .~ I 9 PDA ~P LINE M I:~K, ~ ~, a. - °:, Pik. ~'~>~` t~~' ~ 9 0~ 7 7 7~~;~~ M~~ ~ ~ ~~ ~ Nf ~~; `~g55$~>'~?'~a t 1 ~ _ _ ~ ....., °~ ' ~~~~~.i t '}_ r:D000190DO ?~.Q ~ 3C? 5, 58©493 ? 7~'' ~~~~ AT THE ORIGINAL MATURITY HEREOF WILL PAY - y~" _ _ ~yl~i~iA~Yu.Rn~~i~;~1~9~a71~s~,, ~Il~'n~1~'`~t~ ~e1~"11iG'i1 ~~ -$ ;i~ ~ ~ ~~, ,~ ~,, ~; ~; • ;~~ _ :~:. - --- .. ... __ ._ __ ..__ "'~~- ~ uuauaaaxaaaaaauaanaua..uuuu. a a . au _ uu a u.aua..atu ae .(_ • =' ~ro~' `Aiirs •,."~ _. ;~.L'~j~__" " , i ~, ~, ~! ~~~~ ~. 1o KEtrNET w E BARR i CIE 184 12 2363 83T N NORTH ST M R CAii1.ISt~ PA lTt~l3 9i 1 40184 1223b3 1 oR IRS PAULINE h BARRi GK [wy.eNe rs ~SLMO UIID[A avTNDINTY 01 TI[ {tOND A[T. AS AY[NO[D. AND 4 ftlh 4.x'1 ~ ~~~~°.~~=.~ ~r~ -`l~ ~~G:~.~ ~`~.~~..3 ~DkENNETH E BARR ICK 184 12 2363 837 ~i NORTH ST N R CARtI StE PA 1?Q13 ~~~ ooie~ ~2z3b3 ~ flR ~~~ ~:':..'':`.`:.. l~t5 PAULINE M BARRIC~C 'i i TNIy WND IS ivyU[D UMD[R AUMOP,TT Of J[Ct TO THE ilRYS AND [OND,T,ONS yTAT[D ` INbBP£NDEyLC! HALL stxnae A«o o.r[D. AND o[Erv[N[oyTAN .~ . ~F R ~ F S E TMuwAS ~na oN [nT ISSUE DATE WHICH 15 7HE f-1RST DAY OF _ MA_Y_ ~1'~T_ ~ _ _ (MONTH! _- (YEAgi -~ ' ., ,- NAYY ; ~R6$lNJ~3~AN~~ ClpT1~A MA9M ~- ~ ~ °~ ~-~' ISSUE DATE ~~! WHICH IS THE FIRST DAY Of ~I _ ., M A.RC l~T~ _ _ M a. (MONTH -, _ . ! YEARI ~ i~ ~~ M -, ~, ~. N A V T~ E ~A, ~~/'y~MC'~ 4 CEMAR~ ~T~O6T ~T ~ `il ,~,,N ~ i Q7 ~ n„ ,, ,, :,~ '~ ~ ~ l ry yOMD ACT. AS AY[ND[O. AND b yVh .of. n w~u ec vAUO oN~v it ou~v iN- OICOwiNO NcunT o[ MYMCNT rN[REfON. ~v.~. ~;-~-~.~~. Q 6 240 332 229 E I° KE I~fE TN E 8 ARRt EK 18~r • 1 ~~ 2363 e3T w NORTH ST M R CAR ,i~ SlE PA , 1~~~3 . 9 ~ 1 0418~- 1223 b3 1 -~ ~ ~~ MRS PAULINE M BARRiSK - ..rr.. ISSUE DATE WHICH IS THE FIRST DAY OF ~E~ ~E~:~_ .~~?_8 (MONT~ _, (YEAR) ,r `~ NA ~Y,~ R~~i~A~CE ', CENT'fR MAi H ~ ;C Mss wwe n ~ysu[D u«aN AuTNeiNTV or xoxo Att. As AY[ND[e, Awe s w~- - INOEPENDEi CE HALE J[Ci TO M[ T(t1Yy AND CONMTN)My yTAI[D of. rc vnu ~[ vAUO o«n n DuEV ,N- yClll~[D AMO DAT[D. AMD D[lWM[DWAN IIOWINp AIt [ivT Of MvM[NT i«C«[EO/II. //~~ (}'{~ l^( 7 ~F RT ~ ~ F TII[ASU 5 D[6PARTM[NT f I ~ u. ~~fv~ f/~{~ ~ ~ ~ ~ T l l ~ ' 1 1 .5 2 E ~s~ut uA ~ ~ WHICH IS THE FIRST DAr 01 ~~cENNETN E BARR ICK 18~- 1Z 2.3rb3 83 T M NORTH ST M R CARL I S~ E PA 1?013 911 40184 122.3b3 1 0R . ~4R5 P#Ul I NE M BARB ICK o~~.~~~~R_.~~~?~ (MONTH __-. _._ (YEAR) NARY a ~~~~ CENTER 1iASN D G ~ OAT( 6TAMP oECEMS\~R ~t ~~~-~ KafW1O~ACT, Aa Au[NO[o.,ND lg gu! pI. n rMA ~[ vuD ority Ir our IN- OllOmiM rKt(IR7Of MYY[M TN[R[fO~. ~ K~,~~~ Q 6 226 285 495 • INDEPENQENCE HAIL 4 SERIES E ~. ~. I.W ,~[,si t,sY~[I.@.1~9flfat.~BT~Cm:meMLiG@pflPaJio®nnu~w IssuE DATe WHICH IS THE FIR41 DAr !1F ~I ~: TO KENNETH E BARR I CK 1B4 12 2363 . l1CTORf ~ .1_~-TI!~~; f MONTFII _ - (Yk"4Y i ., 1 R3T W NORTH ST M R ~~~~' ,~ , . ~:: CARLISLE pA iT413 \~ `'`''r 911 04164 122363 1 NAVY RE~N~f~AN'CE i~! ~ ~ OR MRS PAUL I'VE M BARR ICK mi[ wNO Is Ismce uNecw AuraoiNTr of INOE~EN~ENCE MALL y[aTOTN[nRrsANOCOiiDrtloirgbTAno SCRIa(O AND DAT[D, ANO D[lN(R[O DT AM SERIES E tRCAWUASNONQTONLMT ~ a n"^ • c- ~ DATINc,> giTpMP OC1CI~~ER tar i~78 ;IY> , ~I ~~ ._ , RY DONO AGT, Ag AYFMOFO. ARD IY bUP 1Of. IT Wlll e( Y,I~C OM\Y If OVIY IN- OILOW~NO RrcuRr or ••weNr ~+c,CroR ~, ~~ ~. K ~.~~.~~ Q 6 2~ 3 3 4 3 4 5 4 E- _ 'Q; C mny M rmi~ y l vco cv v:4:+...~.,.a..st~vm m "C,t".;C1r ~2G:9i.¢mccvx•..~7CC2sY.a _L 2: .'.L,,,:: l .5::; . 5.~ MfMNYYWHMtYWYYMYf\YNY ~ ;~ '~ x .:~$sTi ~~'! ~~~. ~" ., ~~T~ ~ ~ ' , -" ~,~ - AT THE ORIGINAL MATURITY H[R[OF WILL PAY ,~`.~`-`, C~~Jr :T..~_'~J7C~~...1I'~~ I~~C~~~l~c'~`~'~~~;~' ISSUE DATE . t~- WHICH IS THE FIRST Dar OF , -, 7o IEEMiCtTti E -BARRIG-IE ld4 12 ~~+63 ~._. 88T M N9RTN ST M R ,~ , CAIR,I~t.~ PA 1TVI3 '1 , ,.' 9~ 1401 t4 1 ~2 3b3 1 MAYYQlEE"f~ °~'TIiA~C ~' GEN~'81~AT~~ ~` ] ~ [~i MRS PAUL I~ !~ BARN I CfI _ _ _ _ ~`=aI TMig aONO Ig IgbU[O UND[R •VTNORITY 01 T FR*Y DOND ,Cr, AS ANFND(O. •NO I[ gV a- INDEPENDENC HALL +aTro rM[ nlrrb •NDto.Drnorg ST•T[O cor I, w~u ma Y•uo oN\Y ~r Du\Y iN- S^_Nlm[D •M~ O•T[O. •NO O[LIV[R[D „'•N IOI.OW~N~R(CTIVI Of 9•VYlNI rNFRifOR. ~~ - SERIES E TR`•w SNIDNGTON (NT ~ N ;~~~.~~ Q 6 2 81 8 6 6 7 4 E `' ,.:.., ~~.« ;m. Y 3]-: cc ~ ~=:IF.~L »c~vAnAn vm^.-n ,. ,.c v r ,-.^-em¢°'m^ ]mc mvmrY.cmomvm¢m o .~ -- -_.-- __ _ ____. __ .~.13F14 \ii3Ullnifl1 O.J4ub.rWit.AlA.+iuY:It:i[Yr~.A~ulbiutilYLi 0.v ¢'A~ C...Q r A.1~ . Q~. ..i, W...c +` . ,~.. ~. wnmFmu-aunrwYaaawawmw.nwYaYwraaYYw[YU~~e~waww~wsYn _~. _ _. ~ -'-'-,~ - f - _ -__ _~. _. _ Yam[rwwYaYaaYaaYasYaYtYWYYYaYa,aYaYSUSYx C ~ ~` ,~~'~~m~~~`~~ .,.:_~S+ -d ~? . 1 ''~- ~~ ~ ... __ ~an~Tsaeiserr~r. - - „'-~ alraxe~+~ae~sRa°~m~f~o~me*ne~ml+i!easave~sasrrror,*~*~a~rs+nc~~rr ...mlmm~5ue>Knaew't~ , ~~ 1 1,~~ r ~- AT THE ORIGINAL MATURITY HEREOF' WILL PAY ~~~,.1~~~1.~~ ~~~'~~., ~ ~~~~.~ '~ `~~! _~ s)'~c~ ~ ~~19 ~ 15 S U E D A T E WHICH IS THE FIRST DAY Of To KENNETH E BARB iCK 184 12 2.3b3 -,M~,,~-GM--~-~~~- 837 W hGRTH ST M R ,. GARI,I SlE RA 17G13 ;' ~` 911 U (? 18 4 i 22 3 b 3 1 N A 1l Y, R ~""~l9~tN~} E C EN ~ ~R ~~,M,A ~ pR MAF~~H 26 14~? MRS PAUL I NE M BARB IGK ____ i TMIf /pwD 1315/D[D Ywp[w AUTNOwITT O[ TN wTY /ONO ACT, A] AY[ND[D. AND IS W/- INDEPENDENCE HALL ~~ 0 uaiwio w«o oATio i«o OnneemTw~rDi OllLri'ING m[•[ Iiw f OArM[MTI TNEmEIO/. ,I TREA/URY OEPAIRY[wT ~ ~~- _..~. Q 616 3 5 ~. 6 2 81 E ~ ~ ~~~ ~ ` • ~ ~~ WASNINOTON r-0 a '/+/7 ~` S Mf 6[/ //14JYIy _ ~A~LS!-t9ifl9aur/~m "QCL!ilCie/Vm~l2! p~om._ om~epApjpmo~oeamomo o emo {~yAp.; amomamomomamom(~ImomD omomamnmomamomamemomemomom9 omamomomnecmomQ~p/~ pwesym ~Y I ~ ~ .. I c4 ~ ~ ` n.- .. . i r~~.,~ ., ... WHICH IS THE FIRST DAY OF 1o KENNETH E BARRiCK 184 12 23b3 831 W NORTH ST M R GARIISIE PA 11013 931 00184 1223b3 1 A~G1~.ST_ _ 1 ~~Z -.(MONTH) _ __ _ (YEAPIi ~I r% f ' '~ ~.. ~ NAVY. R'~°I~-NCE~~I ~,j 1 CE NT's R OA STAMV 0 ~~ ~~ I AUGI`iST 13 19.~~` ~h - - w ~~~ ~," OR MRS PAUtI NE M BARRi CK INDEPENDENCE HALL C~R'TF~ F tNls /owe is lssutD uwou AUiTlownv or T JECT TO TN[ T[wY] AMD CONDITION] 3TAT[ /C/I/LD ANO DAT[D. AND D[Lrv[w[Dr T"`WASION6OM[NT II7V /OND ACT, AE AYlMD[D. ANO IS/UM •~' !O[. iT Wlll •[ VwIID ONIV 1[ OY IV IN- IOILOWiNOmtC[IIiO[ MYY[NT TNEM [Ow. ff,' I' NN .~~.~ ~. Q 6 1~ 8 81414 4 E_ __~~ W• /I •..~ - r ~i To KENNETH E BARRICK 184 iZ 23i3 83 T M NORTH ST M R GARl.ISLi~ PA 1T0.13 911 OalB~r .12363 1 ~~~ t" OR ~,: MRS PAUI.tHE M BARRIGK 111q /Ow01/ 1S/D[D VN/[R ADTNOw11V Or T INDE ENDENCE HALL 'uE~s'°co NDD raD. AND DELrvIw[DT/v Aw ;~ F ~' T F ~ F pl[A/uwY OcaAwTYCNT t WASNINOTOM wnlcn Is Ina rlrtol urLT ur (MONTt-1 YEARt •~ ~~ IVA Y~/ : t~E~ ~Yi~A!~ GEN~;Ea WASH d;~ OCT~B~ 22 ~fi~? --- /ONO ACT. Af [Y[ND/O. AND I/ SOw~ IT ImILL /[ vµlp ONIV II pyly INS OWIN/ R[G[I/T W wwYawi TNEM/OI~ ~.~. ,~-~-~~~. Q 6 212 712 0 2 8 E - r~~ --~: T'~4 E NNE T H E 8 ARR I CK 18 4 837 ~! NQRTti ST M R CARI.I SLE PA Tt~13 91 i 80184 1223 b3 1 t3R MR 5= PAUL I NE p~.~~. rYts woND Is taw[D uNO[w AuTNOwm or ~~~ ucT ro c«[ c[wY: AND coNmT+oNS srAr[u aGwtw[D AND DAT[D. ANO D[lIV[w[D aY A« TR[ASVwv D[PAATMCNT WASHINGTON J J V L V A I G WHICH IS THE FIRST DAY OF JS1NE_ _ 1.~ 1~ _ _ ~(MONTHI __ (YEAR) i~ - ~, ~, hA~iY . ~ E6g~~~NG~ CEAITE~t MASH C; ~ pATINC! ST ~ua~., O4~ ~ ~,; ----- I wowo AcT, As •Y[YD[o, ANO to suw- i IT Wt[,L al VALID ONIV If DU IY IN- ~LOWI«4 RCC[iai.0f IMVNCNT TNEPCfOR. ~~~-" ``N.,,;~~ ry Q ~ 18 5 ~ 18 -2_Q.3 .E INDEPENDENCE HALL. --. SERIES E f TT~l.:-. KENNETH E 8ARRICK ~ 1.84 837 ;M N©RTN ST M R CARII S1.E AA 17t~L3 9~ 1 OfJI84 12236.3 1 OR 151 PAU i. I NE M B ARR I CK IaaVL ur [ c WHICH IS 7HE FIRST pAY OF _ _ .; NA V1f ; R Et~N~'~~UI i~GE CENT I~R [•~IJ^'C-T~AT.,IP 0 ?C SE PT~~MBER 22 Y9~7'~ al TNta wo«D is Isw[D uwo J[CT IO TYL T[wYf AYD CI INDEPENDENCE HALL a[w1wW AMD DAT[D. AN - SERI E S ~ TT1EA~ 9 D QroY [NT ~~ 'Ai1Sff • - ~c 9wD ewo f~4w [w.wo ew +we owuwowoaeao~ua: oN o aao rwa a naowa aweaew' -; - - - r:~ [wn ooilo AcT, Aa AYaD[D. AYD Is auw- .,.. aor IT wui a[ vnuD oNl.r Ir DuLr IY- rOLIOWINOY(C[IrT Or MVY[Nt TN[II[rOw. ~i ~I Cd,CII ~y AT TMt ORIGINAL MATURITY HEREOi WILL PAY '~~~ ~~~ ` ~O KENNETH E BARR i CK 164 12 2363 83T W NORTH ST M R CART.I SlE PA 17013 911 .00184 122363 1 -- ---- ---- - --- ------ -_~w~ a, p~ ~;:~ ~a ^sx~at v ~• f~ -:_ - ~issuE aA~e ,.,s WHICH ly THE FJRS CAY CF y ~: ~~ ~/ a! _ ~l t1ll._E ._ ~~T'~_ _ _ t ~~ IMnNT'N1 _ __ _, fvE ARJ .. ~~I ~, ~ Es' NA v~ R~~~ ~~i~iANC~'` GENDER MASH D,'C pR J U~ Y AT14~ i 9 Z'4 ~' ~~ . MRS PAUL I NE M 8 ARR I CK _ ~ ?~~~~ ~--- ~~~ T«IS aoND h IaW ro uYDaw ADTNOwTT[ or t TY so«D ACT. •[ •Y[NO[D. A«D tL ww- ~[cr co T«[ nwra •YD CO«onw«L s*A*[o or. IT wIL[ w[ wLtD o«[v ,r Du[+ I«- i INDEPE !DENCE HALL 3GYIwLOANDDAT[D.AMODI[n[w[DwYAY L~OWIY4A[:CIr10rrAVY[YStM[R([O2 y;~l _ SERIES ~ T11[AiU[[M O[PARTMENi ~' WASHINOTON ~. K. ~..~~..~.~ ~. Q 6 3 3 8 0 7 5 15 6 E, ~' ~F n,rf rj a'Ufi rNry ~' ' ~ SL2Ci';7 ,a c ....:^, ~a 3 3'%';aC7[.Y uiEYCS41M.i11"7G80CI[.4..:YCa1i@RllfirYlCY4[ _ ii1 __ '~'__ _' ~.f[CO Wf1[Pa:.iiti4iiCt~,~i:ilCiPYA.t i:'yCaYCi 3 +u aCi ~~ )1 _ _ ...__ _.__.______. I )fir ___.. __.. ____ _ ~r\ L~"T Ytw[rMirrWrrrM[[rNN[[/YYIWrMMNM[rNMM[M1•wMlMlrr[1[N[[IA[[[[Y[MiM1[[[[r[fT .. L~~ r'4 ~~q~T. ~' _. ,y. ., I- ~ I{ ,; , ~. -- _ .~ - >r , rr C-'3~a ~'r~_.: ~: .... ..._.'d:.~-~ _ -. ~~'~ / YEYN[HME[•Y111[W[[OY[L[[•Wr[W/M[[WIYY[MYLLrll CtlrlMY[YBBW[WWr1lNWf ~ .... .ter .-. i~{3:~~ _. . ._... - i -- . ~. .,~,t .._ __; _...__.' ^ . - - - ._.~,.,•._.ea~..,~.5 ~a _ ~ __ _ - _-•~-~-~c.~--ate _ `~ '~-'y~+°~ ~ ~~ r~~ 9~~~-','` ``r`E "~' if ~0 N rl 1 ~..~.bY_e~~1d ~ _ '~:_ 0, ~~' _ ~ a . ~~, y ; . ~ `''~, _ ~ . .ate. ~~! y3 aX ..,<+k.`~.."tti.`~4;.:+~' N3. Y<~ ~ ~ ~~"s~~'T~ - ~ ~~~. ., , ..i.` l ~ *~1'f±R 4*t,~rsTa;['-~"; ~.«.~:r x .: wti~Y rt M. ~~T .,~.A,., t . r r q•• w +..~. - T.. r n . r .~ .-{ SAT ~ ~Y~~~3"c' ' ~~ i~~~~-d1>tl`+ ^'~ AT TN ~e ORI ~INAI MATURITY HtRFC~F WILL fAY - ~ ~ - '~ i ( t r n '"` ISSUE DATE ;„ ~~ KEN"VET3 ~ 34R~IGK 194 12 23b3 !?E.CTE,MB..ER.IYL~'7~,,~~ ~~~ 937 ~ VORTN ST M 2 `~~~' `,i~~' ~ CAR L I SL E ~ 4 17 013 , ~~+ . ~- ,~ ~~~`~ 911 3 013 4 12 2 3.63 1 NA YY ; R E~rlrj~~11M'A ~#C E r ~` ~1 ~~ C~ l~T~R AS~~t t3 uw Ir+V . ~T.u.L~w ~ L,1 r .,I i i X79 '~I~, _ ~ oR nECEM~eER of 1 ~, _~~ o ~~~.''7~~ MRS ~AJ~I~E M 3A2~1CK _ [~~4,' u 1 TNIa BOND IS ~aSU[D UND[R AUTHORITY O/ T TY 90X0 ACT, Aa Ar[r0[D. ANO +a SD9- r, _ lNDEPENCIERC HALL $CR e[D AND DAfl L'M ANONDCLNFRED 9v AN Oar'. J+wiNGtAttB[ni~~r out N+f DEPE. P +~~' TREASURY DFOAATMENT \ r~ WAS/IINGTON SERIES E ~~-=- ~-- Q 6 3 916 5 417 0 E, ~~~ .... ~ ....-. a ~. . :~.~ ~'a:~LG+.+t~3II~':w+~ti L. "d- tiliiiwGr A...~t4 iC3.a t a r-a;::a r.:.a~+'a.,[f+raata ,~.a.;,t,.a.a .r '[~~Y+I [ A~i~G!an[ r as r c~.a:a4» A.T,".4:r73 3.a.e' +~~: ~'.~.. a a>e':. a ~a~.._a .T,a a~~:"~. a~_~I . __ _.___ _ ._ _.. __ p C--#~q--~ -- ~~- - arwurunnrrrmuun[m[ uunsusu E[EU[NUarrrauauu urrnnuruuru nanam[n r,~}„c: ~"!~"- ~ [iT j ik7 1 nms a~ -,• ~• rr,• ~,~ .wit. -. ~'.r ;C ~ ~ ~ S T :`a • R ~ ,. -_ ~ • '~ t. 6 ~ 4+ ' _.~.r. ~^'a• ~~ :'~ zY' t , ~ x° ''~'~- ~' ~ u[u[auuaaaa[u[uua[uuuaEa[utu.uauuunrrunuuurruuruua.rutrurutiunuuuau[ ~ ', ~-,. ~ .~ ~ +'a~--.'s:--•..~. _.. ~-~"~^_-"'^-'^"~(. ~' WHICH IS THE FIRST DAY O~ .- '~ HA~Ir q'E ~g~T~iwC ~ C ENTER 1iA~-H ,~ C FEdRUA~Y ,247191 ,- T~EKNETM E aA~tR i ~K 18~r 1Z Zlb~- 837 M NQaTH ST M` R CAt1i.I Sl.E P/r .. .._ ...~~t013 9~ ~ .0©1~~ 1223b3 l MR S ~ PA tJt. I ~ !! BAitRI C K Ern bre n nw[D tlNe[9 AUTMOrRY or J[CT TO TN[ TCRMf AXO [OROIIN)Nf fTAT[D .. 9ero Arr. Af Ar[Ne[O. are n w9- rt wAE •e YAa10 ONLY II eUtY iN- .OWINOPCC[tPrOI N[(1ECNt rN[PCIO~. ~.~. `~.~..~A<~~ Q 6 3 0 6 8 21 4 0 9 E SrYMNe/[}t/rn/ILIP ~ ~I {N~EpENOENCE HALL scRteto Awo oanD. Aro aan[R[9wAN ~FRT~~ E T1![ASUnYO[warr[rt y(ASNINGTON 1 ~~. r ~', t,... :.:$.:s..~_._.~ _. _ ._ ~OKENNETN E BARRICK 184 1Z 2363 83 T w NORTH ST M R CARL~SIE PA 17013 93.2 00184 122363 1 oR MRS PAUL INE M BARB f CK TNn 9oro Is iswm uXe[P AuTNORtTr o• [ ~~ ~tcTro TX[r[wra uDCOnarroNa arArte "'WI ~ENDEI CE t1Ali. T a[M9lD ANO OA1[D. Ar0 Otlrv[R[09TAr ~~~~ ~ ~ ~ Tr[AlUrV DEPro ,tl[NT ~- ~ _ ..,C3.3" v 6 il [': a aCi9ruLY ~~a4+~ii.~-fYY ~G~pGl4~7iP.eSlel".i9rGDi"sGCew wnRC c,eae7pP~Ni3Ce9.k+a?aC~iG_i[ii@fl~Gi2iylll .i f swtttt[tata[a[ata[a •~`~~ /sa~ ~i~r1. 11 ~~[uut6Wao[[YAr[a[rtWYUWUa[a0[ufaa. WHICH IS THE FIRST DAY OF _I ~A ~_ :19 719 Aq, _ _ ,~ NAVY ;~tE~-~~~A+NCE CENTER MASH 0 ~ OATINCf STi1[rM MAY 0S 1979/ r •orD AcT, As Ar[raD,Arensu9- OI. ~T .YILL 9t YA4D Oral II OYIY rr~ ellerlNb R[<[1-r O[ MYNLMT TXIA[Ie~. tv. r~._,~~-~ ~~~' 0 6 3 2 7 2 3 2 71 ~ E r.``~'~~~ `-.,, OMB Approval No 2502-0265 ;` - ~ 11~! • ~ A. Settlement Statement (HUD-1 } .a '~~ ,~- . . 6 File Number 7 Loan Number B Mortgage Insurance Case Number ' FHA RHS 3 Cunv Unins. d VA 5 Conv Ins C Note. This loan is furnished to groe you ~ statemenE or actual settlement costs Amounts paid to and by the settlement agent are shown items marked "(p.o c t" were pa~tl outside the closing, they are shown here for informational purposes and are not included in the totals. p Name 8 Address of Borrower. E Name 8 Address o1 Seller F Name 8 Address of Lender Rebecca A. Stor Kenneth E Garrick Estate F8M Trust 18 Derry Drive 214A Westminster Drive Landisburg PA 17040 G Property Location 837 West North Street, Carlisle, North Middleton Township, Cumberland County, Pennsylvania H Settlement Agenc Scott W Morrison, Esq. 6 West Main Street New Bloomfield PA 17068 Place of Settlement 6 West Main Street New Bloomfield PA 17068 Carlisle PA 17013 t Settlement Date 6/23/10 100. Gross Amount Due from Borrower 400.Oross Amount Dus to Se1Nr tOt. Convect sales price 139,300.00 _ 401. Contract sales price - 139,300.00 102. Personal property _ X402. Personal property 103. Settlement charges to borrower (Ifne 1400) 4,190.91 ' 403. 104. 404. _ 105. a. 405. a. Adjustments for Items paid by seller In advance Adjustments for Items psld by seller In sdvanes 106 Cityltown taxes to 408. Clrynown taxes to to7. County taxes 6/23/10 b12/31/10 171.80 _ 407. County taxes 6(23!10 io12/31l10 171.80 108. Assessments 6/23!10 to6/30/10 23.50 .408. Assessments 6/23/10 to6/30/10 23.50 109. 409. 110. 1410. _ - __ 111. 411 _ 1t2.a. 412. a. 120. Gross Amount Due from Borrower 143,686.21 420. Oross Amount Dw to Sslhr 139,495.30 200. Amounts Paid by or In Behalf of Borr_owar Raductlons In Amount Dw to Ssllar 500. tot. Deposit or earnest money 3,500 00 _ '501 Excels deposit (see instructions) __ 202. Principal amount of new loan(s) F8M 111,440.00 502. Settlement chsrpes to setter (Nne 1400) 1,804.83 203. Existing loan(s) taken subject to 503. Existl ban(s) taken subject b 204. 504. Payoff of first ntortpal)e ban 205. .505. PayoM of second mortpape loan 206 508. 207 507. ;'08 508. 209. a 509. a. Adjustments for items unpaid by seller Adjustments for items unpaid by seller 210. Cityltown taxes to 510 Cltynown taxes to 211 County taxes to 511. County taxes to 272. Assessments to 512 Assessments to 713 513. 214 514. 215 515 71f 516, :t7 517. 218 518 719 a 519 a 220- 'rota) Paid byltor Borrower 114,940.00 520. Total Rsductlon Amount Dw Seller 1 ,804 83 )00. Cash at 3sttlement horn/to Borrower B00. Cash at SettNment loJfrom getter 301 Gross amount due from borrower (line 120) 143.686 21 601 Gross amount due to seller {Ifne s20) 139.495.30 Jut Less amounts paW byifor borrower pine 220} ! 1 14.940 001 602. Less reductkxts in amount due salter pine 520) ~ 1 .804 831 J09 (:ash X From To Borrower 28 746 21 60~ Cash X To From Seller 137,690 47 rn~~ Pub/ c Rtporonq Burden for tn~s ; unecuon of ~nrormauon .s estimated at 35 minutes per response for collecLny, rev~ewuiy and ~~~portiny the data This ayenc, may not collect tnis inlormation, and you are nut regwred to complete this form unless a d~sptays a urrenYly va1~d OMB iontrpl number Ne contidentiaht, ~s assured, this disclosure is manciatory 7h,s s :fe<~yned to provide Eke parties to .i RESPA'?.)v! rc~(1 tf :1n~~~Ir:tir~n µ,ith ir~,t~)rm3tic~n durrny the Settlement ()rOCE,'tiS °'~r"Jir~u~ -_ t~t~,_)r,5 .iri• ~~IiSt~I~Ee t~.3r~P ? ,Jf 3 HUD-t ..~ 700. Total Real Estate Broker Fees C)~:~sien ~~f %o`nr,~ss~on (Irne 7C0) as follows: 7UI $ to '02 $ to 7U3 Curnnuss~on paW dt settlement "U4 Paid From Paid From Borrowers Seller's Funds at Funds at Settlement Setttemenl 800. Items Payable in Connection with Loan 801 Our oriq;nat,vn charge Farmers & Merchants S 650.00 (from GFE #1) 802. Your credit or charge (points) for the specific interest rate chosen S 139.30 /from GFE #2) N03 Your ad;usfed or~gmation charges Farmers & Merchants (from GFE A) 789.30 eo4 Appraisal ree to Nationwide Property ~ Appraisals - $650.00 - POC (from GFE #3> -375.00 ao5 credit repot ro Credit tenders Service Agency (tram GFE #3) 14.05 H06 Tax service to (from GFE #3) d07 Hood cerhlirat~on First American (from GFE #3) 14 00 508 a 900. Items Required by Lender to 9e Paid in Advance ExGude last day in talcs -line 901 901. Daily interest charges trap 6/23/10 to6/30/10 (~ S 16.03 /day (from GFE #t0i 128.23 902. f~fortgage ,nsurance premium fa months to (from GFE #3) ,)(13 i-t-~mecwner's insurance fa i years to USAA (from GFE #11 ` 595 58 )04 a 1000. Reserves OspositW with Lsnd~r 1001 Initial deposit for your escro w account (from GFE #9) tU02 Homeowner's .nsurance months ®S per month S ~ 003 hlorgaye insurance months Q S per month S 0.00 1004. Property razes months ®S per month $ 0.00 1005 months ®S per month _ S 0.00 1uU6 a months ~ S per month S 0.00 1~iU7 Aggregate Adiustment -S 0.00 1100. Title Charges 1 t O 1 7rtle services and lendei s tilts insurance _ (from GFE #4) 1,483.75 t t U2 Settlement or closing fee S 1103 Owner's Llle insurance (from GFE #5) 1104. Lender's title insurance S 1 105 Lender's title policy tin,il $ t 1015 Owner's title policy limit $ t 107 Agent's portion of the total lifts insurance premium 5 t tOA, Underwriter's portion of the total title insurance premium S 1 toga. William Duncan, Esquire -deed preparation, etc. 325.00 1200. Government Recording and Transfer Clurgas 1201. Government recording charges (from GFE #7) 1202 Deed S 62.00 Mortgage S 86.00 Rete_ases S 148.00 1203 Transfer lazes (from GFE #8) 1204 CrtyrCounty taxrstamps Deed S 1,393.00 Mortgage S 1,393.00 1205 State tax stamps Deed S 1,393.00 Mortgage $ 1,393.00 t208.a. 1300. Additional Settlement Charges 1301. Requaed services that you can shop for (from GFE #6) 1302. S 1'403. S 1.304 t 305 a North Middleton Authority -final water and sewer bill 76.83 rr . r 4,190.91 1,804.83 CERTIFICATION e e.uet, ,reviewed the F!liD t Setuement Statement and to the best of my knowledge and belief, d ~s a u and accurate statement of al receipts and tihu~ser nfr r~ ,air r r n,y account or me :n this transaction. I further certify that have``rece~ved 3 ~ f tf~e Hll!)-1 SettleAment $ta , ~i,r,..wNr '~-~.M~~((~ ~ ~ ~' \ ~~ ~ ~' Date ~i/'~~')I~ ~ S1t~t~ ~~1! ,~~~( L V~ Rebecca A si~r~ ` r~fE~~~: ~tr'r! Estate ~, ~~ ~.~wer Date. Seller ~ ~ Date r^ me best ~t mq F,ne .ledge the HUD-1 Settlement Statement which I have prepared .s a true and actor ccaunt of the funds which were recewed r~ ~! ~ ,:e ..,.ei~ ~- ~.~I! ! e d~sb~. reed !,v the ,ndarsrgned as part of the settlement of tnis Iransactron / Settlement -t /~,/5,,..--- ~t!' 7~/~'' Date Agent t~ `- Date Cott 1a1 t~lrJrnso .Esq. :.r~kr,iNt3 R n :+ rnr~e ro bnnwingiy r^aF.e false statements to the Un!ted States on tn~s or any other s~mdar (or~n PenatUes upon conwct,on can mdude a tine ~r~praOn~nNar F.;, .;erods sere T~te_ 1q iJ S code Sec'.~on 1001 and Section v)1C r'•~•.~~_u,ti ~ddmnti .irv` )Lsoi-ale Page 2 cf 3 H uo-1 i~ ~~~ lii~W1AV 1 i~G ~~Y April ~, ~~ l 0 I)~can & Ilartn~~a Attorney s at I.,aw (v)ne ltvi ~o K~~w C~.rlisle, Y q l'C111 ESE: kennei.h E Rarriclti ;~~iCv: I~4-1:'. ~~fi3 1`7ear ~ir~1~~~aclasn: In rc~ponse tc~ vouz request for Date of Dean (I)(~D) balances fo-r the ct~tomer noted ai~ave, ~»lr records show tho follav~ring: Checking Account Account ~ 514U~2~338 Establisher: (1~- b-197 KENNETH E 1~r'~RRICK I~)(~D balance: 'l; i ,1 ~`~.14 non interest b~arin~, PEease note that ~f~is aI'('ice prt~v~des late Uf deall7 balances for dep~~sit Rc:cuants tiR A;, CDs, Checks_n~ and Savings}, We da not process any financial traus~ctions or provide statements. If yc~ta razed assista[~c:e with at~y of'tbese itc;R15, piea>e calf (-S$$-PNC-BAIL-IC t ; -8$$-76y-2?6~.) or strip by your local P~iC Bank brand: t ~t~Fce. Sinccreiv- ~latiatial i~'inai~cial Services Center PNC. 13a~, lti.t~. titeinbc;t FDIC Pa~;z 1 of 1 St MEMBERS 1St FEDERAL CREDIT UNION REGULAR SAVINGS ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner Name of Joint Owner Date Joint Ownership Established LIFE SAVINGS ACCOUNT: Account NumberlSuffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner Name of Joint Owner Date Joint Ownership Established Estate of: Kenneth E. Barrick Date of Death: 02/20/2010 Social Security Number: 184-12-2363 102404-00 06!1111988 $10,699.11 $1.68 $10,700.79 Kenneth J. Barrick Frank L. Barrick 10/23/2007 102404-04 02101 /2001 $4, 000.00 $.62 $4, 000.62 Kenneth J. Barrick Frank L. Barrick 10!23/2007 MEMBERS 1ST FEDERAL CREDIT UNION • ~~~~ ~ ~~~~~ Leigh-Anne Stallings Lending Insurance Support Specialist March 31, 2010 7O1)1) Louise I~ri~~e f'.C). I3o~ -~O Me~haliirsbur~;. Pennsyl~~allia 17t1~S • (St)Cl} ?~3-?3?~ • ~~~~~~~~'.ulrlnberslst.or~ Explanation of Your Benefits Midland National Life Prepared By: Lori Brecht Ttcesday, Jzcne 08, 2010 __ _ __ Mailed to: Estate of Kenneth Garrick Claim Number: 2125737 12 Irene Ct. Policy: 8500126468 Carlisle PA 17015 Date Paid: 6/9/2010 Insured: Pauline Barrick Total Settlement: $30,931.09 Annuity :mount $26,622.61 Claim Interest 2.75% $4,308.48 Cash .Settlement of $30, 931.09 Paid to: Estate of Kenneth Garrick 121rene Ct. Carlisle PA 1701 S Annuity Sen~ice Center * P.C).F3ox 79907* Des Moines, IA 50325-0907 Phone: 877-880-6367* E~a 877-586-02-19 I/ M/DLr4ND NAT/ONAL' /I~ Life Insurance Com an P Y Annuities at their Best July 20, 2010 WILLIAM DUNCAN DUNCAN & HARTMAN PC ONE IRVINE ROW CARLISLE PA 17013 Re: Pauline Barrick #8500126468 Beneficiaries: Estate of Kenneth Barrick Dear Mr. Duncan: 4b01 Westown Parkway, Suite 300 West Des Moines, IA 502bb This contract is an Annuity. Enclosed is the information that is needed to complete the estate tax return. Decedent - Pauline Barrick SS# - XXX XX 0455 Date of Issue - 3-24-2003 Type of Contract -Non-Qualified Annuity Date of Death Value (as of 7-22-2004)- $26,622.61 If you have questions, please call us toll-free at 877-880-6367. We are available Monday through Thursday from 7:30 am to 5:00 pm (CST) and Friday from 7:30 am to 12:30 pm (CST). A service professional within the Claims and Benefit Department will be happy to take your important call. Sincerely, C~~ 1~~~-0•~. Lori Brecht Claims and Benefit Specialist Claims and Benefit Department cc: file Annuity Division ~ P0. Box 19901 ~ Des Moines, IA 50325-0901 Phone: 8)7 58b-0240 1 Fax: 877 886 0249 ! ~nrww.rnidlandannuity.com WESTERN J NATIONAL Life Insurance C o m p a n y P.O. Box 871 Amarillo, Texas 79105-0871 1.800.424.4990 July 30, 2010 DUNCAN & HARTMAN PC ONE IRVINE ROW CARLISLE PA 17013 RE: Policy Number: VV220225 Deceased: Kenneth E. Barrick Dear Mr. Duncan: ~: Thank you for your recent inquiry regarding the referenced annuity contract. It is our pleasure to be of service to you. We would like to take this opportunity to respond to your letter dated July 14, 2010. Cash Value as of Date of Death on 2/20/2010: $24,275.30 If you have any questions please contact our customer service representatives, at 1-800-424-4990. We appreciate this opportunity to serve you. Sincerely, ~'~ ~~~~~ Sandra Castillo Claims Examiner ~-r_,r, ;wllr..~: :_ - ~- __.._ ~i~.*' ~ ~c~ie,wy urr,"~'Ir3r(s;: 8arrick, Kennei_h ~'. C.~Rl.lt~w.+;:i flsisal'r'r<<lt:r+~al'~ ~`ra:il:ii~+.:t: rl!drz~~l:k: Status, Po~c;~ vr~rirr~a;°r namr~~s'j: ~I~:~trr~_k~f"'~~r~r~;~rrtar~lt r1,~nT..(s7. il~d'7)"C)M" dl ^~V Clflf'R y j ,. ,~e3Y. (~,L1~1ifiCciY::la]!r'k: Is.'StLff' cia~:e° IFtetp ~ v+~e~ rTi art t: Ce:rst taasi~ ~'~r-~ ter'rre pofcie5, this equals the total pren-i~lrrls pacl.~ ass rof OZ/~~j2C114D: t~~rst-TIFRA cast basis: ~ ! ~.. L u.... r ~ it +~I~:~l~:~i:. Pr;~f~r I ~~t F~e.r ~e~ lri~:nk~+. $~rrr::k, Es;L^'1rI~ ~i .. t`irlCr t:h;., kt""tlY'7c`~f~l ~. Ni~;l S~i1r}fiflE~Ci fV' +~I :~] Il . C1J as sal {72,(:t6/~!~1f9: '23,30?,97 ii,~ l)l.4l.w,.` I~:;:, +c;i! (; l1 il:Y f~~~ "~^r.i~,1#;:CJl.i.t'C+ i(urTl L~ ~: E"~.d5~.1 eCd(UE4. ~i'Ilia EI:}E.~LiCUt ~I r~~~.aC3!~ clliY d~.i~? 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