The URL can be used to link to this page

Home My WebLink About09-09-101505610143 REV-1500 EX (01-10)1 ~ j W OFFICIAL USE ONLY PA Department of Revenue pennsylvania County Code Year File Number Bureau of Individual Taxes DEPARTMENT OF REVENUE PO 60X.280601 INHERITANCE TAX RETURN 21 10 0420 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 210 16 5624 04 O1 2010 05 09 1927 Decedent's Last Name Suffix Decedent's First Name MI OBERDORF gAggAg,A E (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW X^ 1. Original Return ^ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate ^ 4a. Future Interest Compromise (date of death after 12-12-82) ~ 5. Federal Estate Tax Return Required 6 Decedent Died Testate (Attach Copy of Will) ^ ~ Decedent Maintained a Living Trust (Attach Copy of Trust) ~ 8. Total Number of Safe De osit Boxes P 9. Litigation Proceeds Received ~ 10. Spousal Povert Credit (date of death between 12-31 ~1 and T-1-95) ~ 11. Election to tax under Sec. 9113(A) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SI-fOULD BE DIRECTED TO: Name Daytime Telephone Number EDMUND G MYERS (717) 761 4540 First line of address 301 MARKET STREET Second line of address PO BOX 109 City or Post Office State ZIP Code LEMOYNE pA Correspondent's a-mail address: egm@jdsw.com REGISTER C~1~..1_S USE~6NLY 3: _~ (~ t ("f"# { "~ ! t , ~.~c= " ~ ~ a ,` ~ '~ ..._ __ DATE FILEED ~ _1 ~' . __~~~ ~.' ,~~ Under alties of perjury, I d tare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is tr e, orr t and comple . D r tion of prep rer other than the personal representative Is based on all information of which preparer has any knowledge. SI A RE F PERSON RE 0 IB FOR FILIN RETU DATE ~ Ambrose N. Oberdort Ct I ~ ~ ~Q~ (~ ADDRESS 513 Bowman Avenue, Lewisberry, PA 17339 SIGNA E OF PREPARER OTHER THAN REPRESENTATIVE DATE EDMUND G. MYERS C~ ' ~~~ ADDRESS 301 MARKET STREET, LEMOYNE, PA Side 1 1505610143 150561D143 J J 1505610243 REV-1500 EX Decedent's Social Security Number Decedent's Name: OBERDORF, BARBARA E 210 16 5~ 62 4 RECAPITULATION 1. Real Estate (Schedule A) ....................................................................................... 1. 30,000.00 2. Stocks and Bonds (Schedule B) ............................................................................. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)......... 3. 4. Mortgages & Notes Receivable (Schedule D) ........................................................ 4. 5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............... 5. 1:18 , 381.85 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6, 1 , 0 4 5 . 6 4 7. Inter-Vivos Transfers & Miscellaneous f~q Probate Property (Schedule G) ^ Separate Billing Requested............ 7, '2 6 13 6. 2 0 ~ ~ 8. Total Gross Assets (total Lines 1-7) ..................................................................... 8 1'7 5 , 5 63.6 9 9. Funeral Expenses & Administrative Costs (Schedule H) ...................... ................. 9. :14 , 911.42 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............. ................. 10. 4,787.47 11. Total Deductions (total Lines 9 & 10) .................................................. ................. 11 ~~. 9 , 6 9 8 . 8 9 12. Net Value of Estate (Line 8 minus Line 11) ......................................... ................. 12. 155,864.80 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. 15 5 , 8 64.8 0 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .00 15. 16. Amount of Line 14 taxable at lineal rate X .045 155 8 64.80 ~ 16. 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 18. 19. Tax Due ........................................... _ _ 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 1505610243 1505610241 0.00 7,013.92 0.00 0.00 7,013.92 J REV-1500 EX Page 3 .. ^ _ _ ~ JJ~_~~. File Number 21-10-0420 VCGCI~ICIII ~ vV1~~~~c« rwvivvv. DECEDENT'S NAME OBERDORF, BARBARA E -- STREETADDRESS 418 Second Street `___ -------- ~- CITY ~~ Enola STATE PA ZIP 17025 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) 2. Credits/Payments A. Prior Payments 5,500.00 t3. Discount 350.70 Total Credits (A + B) (2) 3. Interest (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) Check box on Page 2 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 7,013.92 5,850.70 1.163.22 Make Check Payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred :............................................................................... b. retain the right to designate who shall use the property transferred or its income :.................................. c. retain a reversionary interest; or ............................................................................................................... d. receive the promise for life of either payments, benefits or care? ............................................................ ^ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without ^ receiving adequate consideration? .................................................................................................................... ^ x 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? .................................................................................................................. i~ ^ 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 tl~e use of the surviving spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 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 u:;e 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+ (11-08) SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER OBERDORF, BARBARA E 21-10-0420 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on schedule F. (If more space is needed, additional pages of the same size) Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule A (Rev. 11-08) Rev-1508 EX+ (6-98) SCHEDULE E _ CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER OBERDORF, BARBARA E 21-10-0420 All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Deposit to Account 500.00 2 Deposit to Account 500.00 3 BELCO Federal Credit Union Certificate of Deposit Account 12,494.65 4 BELCO Federal Credit Union S1 Savings Account 5,013.61 5 BELCO Federal Credit Union S4 Checking Account 11,908.55 6 BELCO Federal Credit Union S6 Money Market Account 10,931.75 7 Pennsylvania State Employees Credit Union Checking Account 04 5,277.26 8 Pennsylvania State Employees Credit Union ID 51 ~ 12 Month Certificate of Deposit Account 23,789.69 9 Pennsylvania State Employees Credit Union ID 52 ~ 12 Month Certificate of Deposit Account 4,691.0$ -4 10 Pennsylvania State Employees Credit Union ID 54 ~ 12 Month Certificate of Deposit Account 12,177.18 -6 11 Pennsylvania State Employees Credit Union Money Market Account 07 18,206.16 12 Pennsylvania State Employees Credit Union Regular Shares 01 11.72 13 Pennsylvania State Employees Credit Union Regular Shares 03 0.06 14 2005 Honda Civic 4 Door LX Sedan -Contracted Sales Price 10,400.00 15 Personal Property 1,500.00 Total of Continuation Schedule See attached page TOTAL (Also enter on Line 5, Recapitulation) 118,381.85 ___ (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) Rev-1508 EX+ (6-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN continued RESIDENT DECEDENT ESTATE OF FILE NUMBER OBERDORF, BARBARA E 21-10-0420 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) Rev-1509 EX+ (6-98) SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER OBERDORF, BARBARA E 21-10-0420 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIOIVSHIP TO DECEDENT A. Traci A. Oberdorf B. C. 418 Second Street Daughter West Fairview, PA 17025 JOINTLY OWNED PROPERTY: ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT 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 ASSE % Of= DECD'S INTERE=ST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1 A 7/12/1973 BELCO Federal Credit Union Checking 1,085.83 50.OC10% 542.92 Account No. 069860 2 A 7/12/1973 BELCO Federal Credit Union Savings 1,005.43 50.000% 502.72 Account No. 069860 TOTAL (Also enter on Line 6, Recapitulation) I 1,045.64 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev. 6-98) Rev-1510 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER OBERDORF, BARBARA E 21-10-0420 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER DESCRIPTION OF PROPERTY THE DATE OF TRANSFER SATTACFi A COPYEOF TIE DEIED ~OR REAL ESTATDE DATE OF DEATH VALUE OF ASSET °r° OF DECD'S INTEREST EXCLUSION (IF APPLICAE~LE) TAXABLE VALUE 1 BELCO Federal Credit Union IRA -Beneficiaries: 26,136.20 26,136.20 Ambrose N. Oberdorf, Son Karen Oberdorf, Daughter Traci A. Oberdorf, Daughter Wayne G. Oberdorf, Sr. Son Dawn E. Spoonhour, Daughter TOTAL (Also enter on Line 7, Recapitulation) I 26,136.20 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule G (Rev. 6-98) REV-1151 EX+ (10-06) SCHEDULE H COMMONWR~EALT~EOFqq~~PENN YLVANIA FUNERAL EXPENSES & IN RESIDENT DECEDEN~RN ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER OBERDORF, BARBARA E 21-10-042(1 ..............,................. r......,,., .., r..........., ....., ..., r....., .. ITEM DESCRIPTION AMOUNT N MBER q. FUNERAL EXPENSES: See continuation schedule(s) attached 5,206.03 B. 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zia Year(sl Commission paid 2. Attorney's Fees JOHNSON DUFFIE 5,500.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 3,500.00 Claimant Traci A. Oberdorf Street Address 418 Second Street City Enola State PA zip 17025 Relationship of Claimant to Decedent Daughter 4. Probate Fees 424.50 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 280.89 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 14,911.42 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER OBERDORF, BARBARA E 21-10-0420 ITEM NUMBER DESCRIPTION AMOUNT Funeral Ex enses 1 Funeral Expenses 5,206.03 H-A 5,206.03 Other Administrative Costs 2 Cumberland County Register of Wills Office -Filing fees for Inheritance Tax Return and 30.00 Inventory 3 Cumberland Law Journal -Notice of Estate Administration 75.00 4 The Patriot News Co. -Notice of Estate Administration 175.89 H-B7 280.89 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1512 EX+ (12-08) SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER OBERDORF, BARBARA E 21-10-0420 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. -TEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Blue Cross 5.67 2 Checks Clearing After Date of Death 361.27 3 Comcast Cable -Final Bill 59.55 4 Comcast Cable 177.31 5 Cumberland County Per Capita Taxes 5.00 6 Debbie Lupold, Treasurer 247.05 7 Dirty Dog Hauling -Emptying of Residence 800.00 8 East Pennsboro Township -Ambulance Services 115.00 9 East Pennsboro Trash 180.00 10 Penn National Insurance -Homeowners Insurance 115.00 11 PennDot -Automobile Registration 36.00 12 Pennsylvania American Water -Final Invoice 9,82 13 Pennsylvania American Water 119.95 14 PPL Electric Utilities -Final Invoice 125.10 15 PPL Electric Utilities 187.18 16 Reimbursement - to Traci for payment of additional Comcast Bill, Verizon Bill and Penn 371.86 National Homeowners Insurance I Total of Continuation Schedule See attached page TOTAL (Also enter on Line 10, Recapitulation) 4,787.47 (If more space is needed, additional pages of the same size) Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule t (Rev. 12-08) Rev-1512 EX+ (6-98) SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN continued RESIDENT DECEDENT ESTATE OF FILE NUMBER OBERDORF, BARBARA E 21-10-0420 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-150() Schedule I (Rev. 6-98) REV-1513 EX+111-08) SCHEDULE J COMMN RES D NTEDECED N$,RNANIA BENEFICIARIES ESTATE OF FILE NUMBER OBERDORF, BARBARA E ~ 21-10-0 420 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (Words) ($$$) I TAXABLE DISTRIBUTIONS [include outright spousal • distributions, and transfers under Sec. 9116 a 1.2 1 Ambrose N. Oberdorf Son 1/5th of Residue 513 Bowman Avenue Lewisberry, PA 17339 2 Karen Oberdorf Daughter 1/5th of Residue 1780 Alpine Road Dover, PA 17315 3 Traci A. Oberdorf Daughter 1/5th of Residue 418 Second Street & Choice of West Fairview, PA 17025 Personal Property 4 Wayne G. Oberdorf Sr. Son 1/5th of Residue 242 Colt Drive Palmyra, PA 17078 5 Dawn E Spoonhour Daughter 1/5th of Residue 93 Scotlands Court Hampstead, NC 28443 Total Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 150 0 cover sheet, as a r o ~riate. NON-TAXABLE DISTRIBUTIONS: II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 11-08) ESTATE OF BARBARA E. OBERDORF SCHEDULE OF EXHIBITS EXHIBIT A Last Will and Testament for Barbara E. Oberdorf signed ar~d dated September 29, 1997. EXHIBIT B Settlement Sheet (HUD-1) for sale of Decedent's property located at 218 Second Street, West Fairview, East Pennsboro Township, Cumberland County, PA EXHIBIT C Date of Death Value Correspondence from BELCO for Decedent's Accounts EXHIBIT D Date of Death Value Correspondence from PSECU for Decedent's Accounts 413432 EXHIBIT A 010897-0001/September 25, 1997/EGM/NLB/100916 ~ttst mill ttnD ~estttment of BARBARA E. OBERDORF I, BARBARA E. OBERDORF, of the Borough of West Fairview, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and i declare this as and for my Last Will and Testament, hereby revoking and making void any and all Wills or it Codicils at any time heretofore made by me. ARTICLE I I direct the payment of my legally enforceable debts and the expenses of my last illnes;> and funeral from my Estate as soon after my death as conveniently may be done. ARTICLE II I give and bequeath my automobile, those items of my household and personal effects and other tangible personalty of like nature (not including cash or securities), together with any existing insurance thereon, which my daughter, TRACI A. OBERDORF, shall choose, and any items described in this Article she does not choose, I give and bequeath unto such of my children as are living at the tune of death, to be divided among them by my Executors or Successor with due regard for their personal preferences in as nearly equal shares as practicable. 010897-00001/September 24, 1997/EGM/NLB/100916 ARTICLE III I give, devise and bequeath all the rest, residue, and remainder of my Estate, of whatsoever nature and wheresoever situate, unto my then-living issue, per stirpes by representation. ARTICLE IV In the event that any beneficiary of my Will shall not have reached the age of twenty-one X21) years at the time for distribution of his or her share, distribution of said share maybe made in the discretion of my Personal Representative after considering the age and needs of the beneficiary, either directly to the beneficiary or to a Custodian under the Pennsylvania Uniform Transfers to Minors Act, 20 Pa. C.S.A. § 5301 et seq., or the applicable Uniform Gifts to Minors Act or Uniform Transfers to Minors A.ct in the state of residence of such beneficiary as the case may be. My Personal Representative may designate as such Custodian any institution or person, including my Personal Representative, qualified to act as a Custodian for such beneficiary under such Act in effect at the time such distribution is made. A receipt for any payment or distribution so made shall be a full discharge therefor to my Personal Representative, who shall not be responsible to see to, or be liable for, the application of such proceeds thereafter. ARTICLE V I name, constitute and appoint my sons, AMBROSE N. OBERDORF and ~JVAYNE G. OBERDORF, Co-Executors of this my Lasi ~'i11 and Testament. If either fails to qualify or ceases to so act, I direct that the other shall complete the administration of my Estate without the appointnnent of a Co- Executor, and I further suggest that neither Executor claim a commission for the discharge of his responsibilities hereunder. No fiduciary appointed herein shall be required to post bond for the faithful administration of the duties required in any jurisdiction. 010897-OOQ01/September 24, 1997/EGM/NLB/100916 IN WITN;~ESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, thisZ)' day of ~~~~~'`~1, , 1997 ARBARA E. OB O12F // ~~ Signed, sealed, published and declared by the above-named Testatrix, as and for her bast Will and Testament, in the presence of us, who at her request, in her presence and in the presence of each other, have hereunto subscribed our names as witnesses. ~~u~~ ~ .._-- .~ 01-0897-00001/September 24, 1997/EGM/NLB/100916 ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA . SS. COUNTY OF CUMBERLAND _, We, BARBARA E. OBERDORF, ~~~ nd ~ ~ . ~~,~.,~the Testatrix and the witnesses, respectively, whose names are signe o the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instniinent as her Last Will and that she had signed willingly and that she executed it a:> her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witness and that to the best of his/her knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. ~. BARBARA E. OBE ~~~~ Witness . , ~ ,q,,~G~--~ r Witness Subscribed, sworn to and acknowledged before me by BARBARA E. OBERDORF, 'Testatrix, and ~ . -~~ and '~ -~~..,~, . , witnesses, this ~ U~ ~ day of .~~ , 1997. ,- Notary Public My Commission Expires: NOTARIAL SEAL DiANNE LENIG, Notary Public Lemoyne Borough Cumberland Co. My Commission Expires Dec. 21,1997 EXHIBIT B Previous editions are obsolete form HUD-1 (3166} ref Handbook 43Q5.: Anchor Abstracting, Inc. A. Settlement Statement U.S. Department of Housing and Urban Development OMB No. 2502-0265 27 E Philadelphia St. B. TYPE OF LOAN York, PA 17441 Phone: 717-699-4800 699 0687 71 1. ^FHA 2. pFmHA 3. ^Conv. Unins. 4. ^VA 5. ^Conv.lns. - Fax: 7- 6. FILE NUMBER 10-6179DLM 7, LOAN NUMBER Y- is orm is umis e o give you a s a emen o ac ua se emen cos oun s pai o an C. NOte: Items marked "(p.o.c.)" were paid outside the closing; they are shown here for information purp WARNING: It is a crime to knowingly make false statements to the United States on this or any o conviction can include a fine and im risonment. For details see: Title 16 U. S. Code Section 100 8. MORTGAGE INSURANCE CASE NUMBER y e se emen agen are s own. oses and are not included in the totals. TItIeEXpreSS Settlement System ther similar form. Penalties upon 1 and Section 1010. D, NAME OF BORROWER: Nail! Equities, LLC ADDRESS: E. NAME OF SELLER: Estate of Barbara E. Oberdorf ADDRESS: 418 2nd St. Enola PA 17025 F. NAME OF LENDER: CASH ADDRESS: G. PROPERTY ADDRESS: 418 2nd St., Enola, PA 17025 East Pennsboro Townshi H. SETTLEMENT AGENT: Anchor Abstracting Company, Inc., Telephone: 717-699-4800 Fax: 717.699-0687 PLACE OF SETTLEMENT: 27 East Philadel hie Street York PA 17401 I. SETTLEMENT DATE: 07!26!2010 J. SUMMARY OF BORROWER'S TRANSACTION: K. SUMMARY OF SELLER'S TRANSACTION: 100. GROSS AMOUNT DUE FROM BORROWER 400. GROSS AMOUNT DUE TO SELLER 101. Contract sales rice 30 000.00 401. Contract sales rice 30 000.00 102. Personal Pro e 402. Personal Pro art 103. Settlement char es to borrower line 1400 387.00 403. 104. 404. 105. 405. Ad ustments far items aid b seller in advance Ad'ustments for items aid b seller in advance 106. Cit /town taxes 406. Cit (town taxes 107. Count taxes 07126!10 to 12131110 107.61 407. Count taxes 07126110 to 12131110 107.61 108. School taxes 07126110 to 06/30111 656.52 408. School taxes 07126!10 to 06130111 656.52 109. 3rd Qtr. Sewer &Refus®7126110 to 09130110 83.75 409. 3rd Qtr. Sewer &Refus®7126110 to 09130!10 83.75 110. 410. 111. 411. 112. 412. 120. GROSS AMOUNT DUE FROM BORROWER 31 234.88 420. GROSS AMOUNT DUE TO SELLER 30 847.88 200. AMOUNTS PAID BY OR ON BEHALF OF BOR ROWER 500. REDUCTIONS 1N AMOUNT DUE TO SELLER 201. De osit or earnest mone 500.00 501. Excess De osit see instructions 500.00 202. Princi al amount of new loans 502. Settlement char es to seller line 1400 1 168.80 203. Existin loans taken subject to 503. Existin loan s taken subject to 204. 504. Pa off of First Mort a e Loan 205. 505. 206. 506. 207. 507. 2pg. 508. 209. 509. Ad'ustments for items un aid b seller Ad'ustments for items un aid b seller 210. Cit /town taxes 510. Cit (town taxes 211. Count taxes 511. Count taxes 212. School taxes 512. School taxes 213. 513, 214. 514. 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. 220. TOTAL PAID BYIFOR BORROWER 500.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 1 668.80 300. CASH AT SETTLEMENT FROM OR TO BORROWER 600. CASH AT SETTLEMENT TO OR FROM SELLER 301. Gross amount due from borrower line 120 31 234.88 601. Gross amount due to seller line 420 30 847.88 302. Less amounts aid b /for borrower line 220 500.00 602. Less reduction amount due seller line 520 1,668.80 303. CASH FROM BORROWER 30 734.88 603. CASH TO SELLER 29179.08 SUSSTfTUTE FORM 1099 SELLER STATEMENT: The information contained herein is important tax information and is being furnished to the Internal Revenue Service. If you are required to file a return a negligence penalty or other sanction will be imposed on you if this item is required to be reported and the IRS determines that it has not been reported. The Contract Sales Price described on line 401 above constitutes the Gross Proceeds of this transaction. You are required by law to provide the settlement agent (Fed. Tax ID No: 23.2980646) with your correct taxpa r i ntifi anon nu e . If y do not vide our correct taxpayer identification number, you may be subject to civil or criminal penalties imposed by law. Under penalties of perjury, I c the mbar show on th' stateme t is correct taxpayer identification number. TIN: - - / - SELLER(S) SIGNATURE(S): SELLERS} NEW MAILWG ADDRESS: SELLER(S) PHONE NUMBERS: (H) (W) U•S. DEPARTt~4ENT CF HOUSING '~.NC URBr1N ;EVELOPPAENT pile Number: 10-6179 PAGE 2 SFT71 FMFNT STATEMENT" TitiaFYnracc Sattlamant Cvatam __ _ _ _ __ L. SETTLEMENT CHARGES PAID FROM PAID FROM _ _ 700. TOTAL SALES/BROKER'S COMMISSION b_as_ed on rice $30 000.00 = BORROWER'S SELLER'S Division of commission line 700) as follows: __ ---- FUNDS AT FUNDS AT 701. $ __to _, SETTLEMENT SETTLEMENT to _ 702. $ _ __ 703. Commission aid at Settlement _ -500.00 704. 500.00 POC Earnest Money retained as art of commission b 500.00 800. ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Ori ination Fee °f° _ 802. Loan Discount % _ 803. A raisal Fee 804. Credit Re ort _ 805. Lender's Ins ection Fee 806. Mort a e A lication Fee 807. Assum tion Fee _ 808. _ 809. 810. 811. 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest From to $ /da 902. Mort a e Insurance Premium for to 903. Hazard Insurance Premium for to 904. 905. 1000. RESERVES DEPOSITED WITH LENDER FOR 1001. Hazard Insurance mo. $ !mo 1002. Mort a e Insurance mo. $ !mo 1003. Cit Pro ert Tax mo. Imo 1004. Count Pro ert Tax mo. Imo 1005. School taxes mo. $ /mo 1009. A re ate Anal sis Ad ustment 0.00 0.00 1100. TITLE CHARGES 1101. Settlement or closin fee 1102. Abstract or title sQ~rsh 1103. Title examination 1104. Title insurance binder 1105. Document Pre aration 1106. Notar Fees to Darren Miller 35.00 14.00 1107. Attorne 's fees includes above items No: 1108. Title insurance to Chica o Title Insurance Com an includes above items No: 1109. Lender's Polic NONE 1110. Owner's Polic 30 000.00 - 1111. 1112. 1113. Tax Cert fee to East Pennsboro clo Debbie Lu old 10.00 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recordin Fees Deed $ 52.00 • Mort a e $ • Release $ 52.00 1202. Cit !Count tax/stam s Deed $300.00 • Mort a e $ 300.00 1203. State Tax/stam s Deed $300.00 • Mort a e $ 300.00 1204. 1205. 1300. ADDITIONAL SETTLEMENT CHARGES 1301. Surve 1302. Pest Ins ection 1303. 2010-2011 School Taxes to East Pennsboro clo Debbie Lu old 704.80 1304. 3rd Qtr. Sewer & Refuse to East Pennsboro Townshi 140.00 1400. TOTAL SETTLEMENT CHARGES enter on lines 103 Section J and 502 Section K 387.00 1 168.80 Huu CtHfIhIGATION OF BUYER AND SELLER l h carefully reviewed the HUD-7 Settlem nt and to the best of my knowledge and belief, it is a true and accurate statement of all receipts and disbursements made on my account by me in this transaction. I furthef~ that I have re ived a cop o - ttlement Statement, a~ ~ ie Estate of rbara E. Oberdo G'LC _ y: m rose er o xecu or WARNING: IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEME TS TO THE The HUD-1 Settlement atement which I have prepare is a true ccurate account of this UNITED STATES ON THIS OR ANY SIMILAR FORM. PENALTIES UPON CONVICTION Vansaction. I have cau d or will cause the funtls to rsed i accordance with this statement. CAN INCLUDE A FINE AND IMPRISONMENT. FOR DETAILS SEE TITLE 18: U.S. CODE SECTION 7007 AND SECTION 1010. SETTLEMENT AGENT: DATE: EXHIBIT C DECEDENT ESTATE INFORMATION 1. Name(s) in which the account was held: BARBARA E OBERDORF 2. Account number: 63830 3. Balance as of date of death: $40,290.28 Balance Accrued Dividends YTD Dividends Opened Regular Savings: S1 $5,012.02 $1.59 $6.10 8/10/1988 Christmas Club: S2 Whatver Club: S3 Checking: S4 $11,906.04 $2.51 $2.51 8/11/1988 Money Market: S6 $10,906.89 $24.86 $24.86 3/12/2009 Certificates: Balance Accrued Dividends Certficate Number YTD dividends $12,465.33 $29.32 36927 $119.86 $ $ 4. Date the account was initiated: CERTIFICATE OPENED 11/2004 5. Name(s) in which Safe Deposit Box was held: NONE 6. Date the box was initially rented: 7. Branch address at which the box is located: 8. Loan Information: Balance Accrued Interest Per Diem Int A. Unsecured Loans: _ L14 Classic Visa Card B. Secured Loans: C. Mortgage Loans: $ $ $ $ $ $ $ $ $ 9. Miscellaneous: .~ ~,Q ~ ~~ ~ ~. ~ ~-~ 134. ~ o ~ ~ (-~ c c 2~.( ~'~ h 1 ~ ~ ~ ice. ~~~`~ ~T~ ~ l D 7 ~- ~ -ter L~~~ -- l7 ~ l7 ~! ~~ 1 -~ L t_c..c ~ C' ~ t S 2 ! +J . 1 -~ f~ t-.~~~- m U,~- ~~ ~ /-~ S D ~ 1~ A-~ ~_ EXHIBIT D PSEC April 30, 2010 Account # 0210XXXXXX DANA L. WIESEMAN C/O JOHNSON DUFFIE LAW OFFICES PO BOX LEMOYNE, PA 17043-0109 Dear MS. WIESEMAN: The following is the status of BARBARA E. OBERDORF's account with PSECU as of the date of death.. Joint Owner's Name NONE Date of Death 04.01.2010 Date of Birth 05.09.1927 Share Description Open date Balance Accrued Dividend S O1 Regular Shares 12.30.1988 $ 11.72 $0.00 S 03 Christmas Shares 11.09.1989 0.06 0.00 S 04 Checking 12.30.1988 5,277.26 0.00 S 07 Money Market 10.28.2009 18,206.16 0.00 C51 12 Month Certificate 07.30.1998 23,789.69 0.00 C52 12 Month Certificate 07.30.1998 4,691.08 0.00 C54 12 Month Certificate 02.04.1999 12,177.18 0.00 The dividend earned from January 1, 2010 through the date of death was $202.15. The decedent had no loans with us. We do not have safe deposit boxes for our members. We need the executrix to sign, date and return the enclosed Authorization to Close Account form. If you have any questions, please call 234-8484 in Harrisburg or our toll-free number, (800) 237-7328. At the menu prompt, enter 6 and then extension 2227. Sincerely, ~ , . ~ ~ ~'~ Meacie Fairfax Member Service Representative Finance Support Unit Pennsylvania State Employees Credit Union Main Address: 1 Credit Union Place, Harrisburg, PA 1 71 1 0-2990 • 717.234.8484 • 800.237.7328 Mailing Address: P.O. Box 67013, Harrisburg, PA 1 71 06-701 3 • 717.777.2100 (TDD) • 800.472.1967 (TDD) psecu.com This credit union is federally insured by the National Credit Union Administration. Equal Opportunity Lender JERRY K, DUI~FIF. R[CHAKD W. STF1~'.aRT C R(IY' WFI~NFR. IR. EDl1IUNll G. 1YIYFRS DAVID W. DF.LUCE: )otl~ A. STATLER JEFFIJRSON ]. SHIPMAN JEFF'REl' B. RET`I'1G KF.Y'IN E. OSBOR'~;E RALPH H. WRIUHT, IR. MARK C_ DUFFIE JoHti R. NL~'()ShY MICHAEL J. CASSIDI JOHNSON DUFFIE September 8, 2010 Register of Wills Office Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 RE: Estate of Barbara E. Oberdorf Date of Death: April 1, 2010 Your File No. 21-10-0420 Our File No. 10897-1 Dear Register: Enclosed for filing please find the following documents for the above referenced decedent: MEILISSA FEEL C7REEVY WADF. D. MANLEY ELIZABETH D. SHOVER /'~^1DREW P. DOL,LMAN ~~ARAFi E. HOFFMAN ANDREI~' J. PETSU, )R. OF COUNSEL HORACE A. JOHNSON I'. LEE SHIPILIAN (196-2006} 1. 2 Original PA Inheritance Tax Returns showing remaining tax due in the amount of $1,163.22. Estate Check No. 124 is attached. 2. Inventory 3. One copy of Page 1 of the Pa Inheritance tax return, which we ask that you time-stamp and return to us in the enclosed envelope. 4. 1 copy of the Inventory ,which we ask that you time-stamp and return to us. 5. Check attached to this correspondence, Estate Check No. 123 in the amount of $30.00 representing the $15.00 filing fee for the Inheritance Tax Return and the $10.00 filing fee for the Inventory. Should you have any questions, please do not hesitate to contact our office. Thank you for you assistance in this matter. Very truly yours, ~ -- _ ON D FFI ,STEWART & WEIDNER ~ ~ ~~'=`. ' ~~ ~~ G i 6 . - , Dana Wies man ~-{-~ ~ .~. ~... t r_ ~. , ,.. _~ Estate Administration Paralegal ~, ~ w Enc. ~~ Qp -~a ~'~:.- :~ r_~ c.... c: Ambrose Oberdorf, Executor ~~ ~ c;? ~,~~~, :413461 ,~''"~ M,,,,, ~' 301 MARKET STREET P.O. BOX 109 LEMOYNE, PENNSYLVANIA 17043-0109 WWW.JDSW.COM 717.761.4540 FAX: 717,761.3015 MAIL~jDSW.COM JOHNSON, DUFFIE, STEWART &WEIDNER, P.C.