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09-17-10 (2)
15D5610143 REV-150 ~ f~-~~ ~ OFFfCtAI. USE ONLY PA Department of Revenue Pennsylvania co~niy Code veer Ft~e Nrmber Bureau of Individual.Taxes °®"""~10F1~'°" Po eoxa_sosol INHERITANCE TAX RETURN 21 10 0031 Harrisburg, PA 17128~0B01 RESIDENT DECEDENT ENTER DECEDENT INFORMATION t3ELOW Soda) Security Number Date of Death [rate of Birth 201 18 6826 12 17 2009 03 07 1927 DeoedeM's Last Name Su~ac Decedent s First Name MI HJt-CF~1AN ~~ L {If Appl'~cable) Enter Surviving Spouse's IMbrmatlon tiefow Spouse's Last Name Suffix Spouse's Frst Name MI Spouse's Sodas StcutTly Number T'HI3 RETURN MU5T BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ^ 3, Rer<tainder Return (date d death 1. lXrgiriei ReUrrn 2- SuPP~i R~4rrn ^ prior 1012-13-82) ^ 4. Lirnfted l~tsb9 ^ '~• ~~ d deep alfCer z-t2~2} ^ 5. Federal Estate Tax Return Recyuked ® e U ~ TWMI~ ^ 7 i ory) ~ trust ~ 8. Tohal Numt~r d Sale ~ePoelt t3oooes ^ 9. u8gatiort Proceeds ReaeNed ^ 10. l t~w+~sn1~ m~5) ~' ^ 11.E Sch O) rtder Sea 9113(A) cAp~PONpB(i -1'HS SEC710N MIDST ~ (~11PL.ETED. ALL AND WNFIDENTIAL TAX MlFORMATION SHOULD t3E DIRECfEfl TO: ~~ Daytume Telephone Number JENNIFER H HIPP 717 737 8761 REGISTER OF W1t4S tJSE OtyL.' First tine of address 1 NEST MAIN STREET Second Ilne of addras~ Cfty or Past OfNae SHIREMANSTdNN State ZIP Code PA 17011 Correspondent's a-mafl address: np ~e ~~~enq my d is ~t aand~aord D~De~ciar~atlonp~n~uer o~ tt~thereonat r~r~ v~ isAbaaed orai~ htortrtaaorr'or~vidt ~prep~es'erat~t knowde~e.• s ~c ow Che i L Framer " RESS P.O. Box 285 Clsvsrdalt: NY 1 Slt?NA OF OTHER 71#1411 IiEPR[SENTATTiIE DATE Jennifer B. Hipp ~{ l~ 4 O 1 West PA 17011 Side 1 15D563~0143 15D561D143 DATE =~, --;rr - ~-': _ `- s_~ > •_ ., -; . , [, L_~~~ '~~ ~_. ?' r~ ,"~ i \,' l -~ J REV-1500 EX 1505610243 Decedent's Name: BaCj'lfilln, Betty L. RECAPITULATION 1. Real Estate (Schedule A) ....................................................................................... 1. 2. Stocks and Bonds (Schedule B) ............................................................................. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)......... 3. 4. Mortgages & Notes Receivable (Schedule D) ........................................................ 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............... 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6. 7. Inter-Vivos Transfers & Miscellaneous N~q Probate Property (Schedule G) u Separate Billing Requested............ 7. ......................... s. g. Total Gross Assets (total Lines 1-7) ............................................ 9. Funeral Expenses & Administrative Costs (Schedule H) ....................................... 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............................. 10. 11. Total Deductions (total Lines 9 & 10) ................................................................... 11. 12. Net Value of Estate (Line 8 minus Line 11) .......................................................... 12. 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. TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 15. (a)(1.2) X .00 16. Amount of Line 14 taxable 1 0 6 3 . 0 2 7 31 16. ~ , at lineal rate X .045 17. Amount of Line 14 taxable 0 , 0 0 17. at sibling rate X .12 18. Amount of Line 14 taxable 0 . 0 0 18. at collateral rate X .15 19. 19. Tax Due .................................................................................................................. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Decedent's Social Security Number 201 18 6826 503,629.50 103,550.74 1,199,345.30 1,806,525.54 75,462.52 75,462.52 1,731,063.02 1,731,063.02 0.00 77,897.84 0.00 0.00 77,897.84 Side 2 1505610243 1505610243 .~ REV-1500 EX Page 3 rlnrnrlnn+°c (_mm~lc4!P ~flflrP_CS' File Number 21-10-0031 DECEDENT'S NAME Bachman, Betty L. STREET ADDRESS 17 Hillcrest Drive CITY STATE ZIP Mechanicsburg PA 17055 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments 35,000.00 B. Discount 1,842.11 3. Interest 4, If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 2 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (3) (4) (5) 41,055.73 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 ............................................................................................................... ^ x d. receive the promise for life of either payments, benefits or care? ............................................................ ^ 0 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? .................................................................................................................. ^ ^x 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 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 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. (1) 77,897.84 Total Credits (A + B) (2) 36,842.11 Rev-1502 EX+(11-08) SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ESTATE OF 21-10-0031 Bachman, Bett L. 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 wlRlenagP operty wh clh is jointly-owned with right oflsurvivorshipemusttbe disclosed on scheduleeF9e of the relevant facts. Attach a copy of the settlement sheet if the property has been sold Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE ITEM DESCRIPTION OF DEATH NUMBER 223,707.90 1 Pocono Pines Real Estate -All those two certain lots or tracts of land situate in Naomi Pines, Tobyhanna Township, Monroe County, Pennsylvania, being Lot Nos. 2 and 3, Section B of a map entitled "Lake Front Cottages Sites at Pocono Pines, Pa., for sale by F. C. Miller, Easton, Pa., Plotting No. 5, J. L. Westbrook, Stroudsburg, Pa., September 1917, Scale 1" = 50', recorded at Stroudsburg, in Plat Book No. 1, Page 200, resurveyed July 1930 by Edward C. Hess, C. E. Stroudsburg, Pa." recorded in the Monroe County Recorder of Deeds Office in Plot Book No. 4, Page 49. The property was acquired by Betty L. Bachman by Deed dated June 28, 2006, and recorded July 6, 2006 in the Monroe County Recorder of Deeds Office in Record Book 2273, Page 4053, a copy of said Deed is attached hereto and incorporated herein. Said property is being transferred to the Decedent's four (4) children in equal shares, as tenants in common, concurrently with the filing of this return. A copy of the Deed, as well as the letter transmitting same to the Monroe County Recorder of Deeds for filing, is attached s astfollows:cCounrty Assessed Value~$30,190 00 x CommontLevel Rat oe 7 4bed properly Total Assessed Value - $223,707.90. 254,721.60 being 2 Upper Allen Township Real Estate -All that certain piece or parcel of real estate, Parcel No. 1 on the attached Deed, having erected thereon a dwelling house known and numbered as 17 Hillcrest Drive, Mechanicsburg, Pennsylvania. The said property was acquired by Betty L. Bachman by Deed dated March 20, 1972, and recorded November 14, 1972, in the Cumberland County Recorder of Deeds Office in Deed Book "X", Vol. 24, Page 166. A copy of said Deed is attached hereto and incorporated herein. The spai pp~ erty has b Ilows:t County Assessed Va~ue a $202,160h00 x Common Level Rat of 11'26 =Total Is as fo Assessed Value - $254,721.60. 25,200.00 3 Upper Allen Township Vacant Lot -All that certain piece or parcel of land located in Upper Allen Township, Cumberland County, Pennsylvania, being tax parwas acquired2by Betty~L. also being Parcel No. 2 on the attached Deed. The said property Bachman by Deed dated March 20, 1972, and recorded November 14, 1972, in the Cumberland County Recorder of Deeds Office in Deed Book "X", Vol. 24, Page 166, a copy of said Deed being attached hereto and incorporated herein. The above-described property has been listed for sale, but has not yet sold. The Total Assessed Value is as follows: County Assessed Value - $20,000.00 x Common Level Ratio -1.26 =Total Assessed Value - $25,200.00. 503,629.50 TOTAL (Also enter on Line 1, Recapitulation) (If more space is needed, additional pages of the same size) Form PA-1500 Schedule A (Rev. 11-08) Copyright (c) 2009 form software only The Lackner Group, Inc. ,~ 3~ IX c~/(~ %~ /S D E E D THIS INDENTURE, made the ~' ~ day of ~ u' ~s~ ~ in the year Two Thousand Six (2006). BETWEEN THE ESTATE OF ALICE V. BITTER by Betty L. Bachman, Executrix of The Estate of Alice V. Ritter, hereinafter referred to as "Grantor" AND BETTY L. BACHMAN, adult individual, having a mailing address of P.O. Box 77, Bowmansdale, Pennsylvania 17008, hereinafter referred to as "Grantee" WHEREAS, Russell. F. Ritter and Alice V. Ritter, husband and wife, became in their lifetime seized in fee of certain tracts of land situate in Naomi Pines, Tobyhanna Township, Monroe County, Pennsylvania, more particularly described hereinafter; and WHEREAS, Russell E. Ritter, died July 5, 1979, thereby vesting title in Alice V. Ritter, who survived him; and WHEREAS, Alice V. Ritter died October 5, 2005, leaving a Last Will and Testament dated November 10, 1999, and recorded in the Office of the Register of Wills of Cumberland County, Pennsylvania in No. 2005-00963 naming Betty L. Bachman Executrix to whom Letters Testamentary were duly issued by said Register on November 1, 2005; and WHEREAS, 2. Bequests of the Last Will and Testament of Alice V. Ritter provides in pertinent part as follows: " 2. BEQUESTS. (a) If my daughter, Betty L. Bachman, survives me, I give and devise to her all of my right, title and interest in my real } roperty situate in Naomi Pines, Tobyhanna Township, Monroe County, ~G ecrnG~ ~.,~-=u~ p Pennsylvania, as more fully described in Deed dated November 26, 1945, recorded in Deed Book 152, pages 59, et se ." WHEREAS, the said Betty L. Bachman survived Alice V. Ritter. WITNESSETH, That the Grantor, for and in consideration of the sum of ONE and NO/100 DOLLAR ($1.00), lawful money of the United States of America, well and truly paid by the Grantee to the Grantor, at and before the sealing and delivery of these presents, the receipt whereof is hereby acknowledged, has granted, bargained, sold, aliened, enfeoffed, released, F[EG Bool: ~'~?3 Pnse ir~L.~=3 sas9a~.~ conveyed and confirmed, and by these presents does grant, bargain, sell, alien, enfeoff, release, convey and confirm unto the Grantee, her heirs and assigns, ALL THOSE CERTAIN two lots or tracts of land situate in Naomi Pines, ~ ~` ~2 (~ ~~vczx Tobyhanna Township, County of Monroe and Commonwealth of Pennsylvania, bounded and described as follows, to wit: TRACT NO. 1 BEGINNING at an iron pipe on the Northerly side of Miller Drive and being the Southwesterly corner of Lot No. 4, Section B, as shown on Map entitled "Lake Front Cottage Sites at Pocono Pines, Pa., for sale by F. C. Miller, Easton, Pa., Plotting No. 5, J. L. Westbrook, Stroudsburg, Pa., September 1917, Scale 1" = 50', recorded at Stroudsburg, in Plat Book No. 1, Page 200, resurveyed July 1930 by Edward C. Hess, C. E., Stroudsburg, Pa." recorded in the Office for Recording of Deeds, etc., at Stroudsburg, Pa., in and for the said County of Monroe in Plot Book No. 4, Page 49; thence along the Northerly side of Miller Drive (bearings from Magnetic Meridian of 1917) North eighty nine degrees fifty minutes West five and seven-tenths feet to the point of curvature; thence by the same on a curve to the left having a radius of one hundred fifty feet a distance of ninety four and three-tenths feet to an iron pipe a comer of Lot No. 2; thence through said Lot No. 2 and by other lands of Russell F. Miller, of which this piece was formerly a part, North eighteen degrees thirty two minutes West one hundred seventy feet, more or less, to a corner distant one hundred feet from the edge of the water of Lake Naomi; thence in an Easterly direction parallel to and distance one hundred feet from the edge of the water of said Lake a distance of one hundred seven and five-tenths feet to an iron pipe, the Northwesterly corner of the aforesaid Lot No. 4; thence by said Lot No. 4 South fifteen degrees ten minutes East one hundred sixty nine feet to the place of BEGINNIl~TG. BEING all of Lot No. 3 and part of Lot No. 2 as shown on the aforesaid Map. BEING THE SAME premises which Russell F. Miller and Dorlie S. Miller, his wife, by their deed dated November 26, 1945 and recorded November 26, 1945 in the Monroe County Office of the Recorder of Deeds in Deed Book 152, Page 59 granted and conveyed unto Russell E. Ritter and Alice V. Ritter, husband and wife. Tract No. 2 BEGINNING at a pipe on the Northerly side of Miller Drive, a comer of Lot No. 2 and No. 3, Section B, as shown on map entitled "Lake Front Cottage Sites at Pocono Pines, Pa. for sale by F. C. Miller, Easton, Pa., Plotting NO. 5", surveyed September 1917, by J. L. Westbrook, Stroudsburg, Pa. and recorded in the Office for the Recording of Deeds, etc., at Stroudsburg, Pennsylvania, in and for County of Monroe, in Plat Book No. 1, page 200 and resurveyed July 1930 by Edward C. Hess, C.E., Stroudsburg, Pa. and recorded in the aforesaid office in Plat Book No. 4, page 49; thence, along the Northerly side of Miller Drive in a Southwesterly direction and along a curve to the left having a radius of 1225 feet, an arc length of one hundred feet to a pipe, a corner of Lot No. 1 and Lot No. 2, Section B; thence, by Lot No. 1, Section B (Bearings from Magnetic Meridian of 1917) North twenty six degrees twenty minutes West one hundred fifty five feet, more or less, to a corner distant one hundred feet from the edge of water of Lake Naomi; thence, in a Northeasterly direction parallel to and distant one hundred feet from the edge of water of Lake Naomi, one hundred twenty five feet, more or less, to a corner; thence through Lot No. 2 Section B and by lands conveyed by Russell F. Miller and wife to Russell E. Ritter and wife by deed dated November 26, 1945, and recorded in the aforesaid office in Deed Book, Vol. 152, page 59, South eighteen degrees thirty two minutes East one hundred seventy feet, more or less, to the place of BEGINNING. BEING part of Lot No. 2, Section B as shown on the aforesaid map. BEING THE SAME premises which Russell F. Miller and Marjorie L. Miller, his wife, by their deed dated May 22, 1947 and recorded July 24, 1947 in the Monroe County Office of the Recorder of Deeds in Deed Book 162, Page 39 granted and conveyed unto Russell E. Ritter and Alice V. Ritter, his wife. The said Alice V. Ritter was erroneously referred to as Olive V. Ritter on the deed conveyance. UNDER AND SUBJECT to the following restrictions 1. That the said Grantor, the principal or principals, their heirs or assigns, shall and may at all times enter in and upon the land aforesaid for the purpose of laying down and constructing sewers, drains, water pipes, electric light wires, and to keep and maintain the same upon the said land. 2. That all buildings, or any part thereof, erected upon the lot or land aforesaid, shall be built at a distance of not less than fifty feet from the public road, or highway, fronting upon said lot or land. 3. That no building or any part thereof, erected upon said lot or land, shall be used as a barn, outbuildings, store or place for selling merchandise, warehouse, slaughter house, carpenter, paint or blacksmith shop, or any purpose other than as a residence. 4. That no beer, wine or intoxicating liquor of any kind or character, shall be sold upon the said lot or land, or in any building erected upon the same. 5. That no fences shall be erected or built upon said lot or land higher than three feet, and the said fences, if erected, shall be open work and of artistic design. The above restrictions and reservations are hereby placed upon said lots in pursuance of a general plan of the owners to enhance the value by beautifying and making more healthful the occupancy of said lands, and said restrictions and reservations are so created as a part consideration for the purchase of said lots; and each and every purchaser shall abide by such covenant, and be entitled to enforce the rigid observance of the same, against any person or persons violating the same. And also it is expressly covenanted and agreed between the parties hereto, that the above restrictions shall attach and run with the land, they being assumed by the purchaser in part consideration of the purchase thereof, and shall be binding upon their heirs and assigns, whether included in subsequent conveyances or otherwise; and it shall be lawful for the said Grantor, or any of its principals, their heirs or assigns, and for the owner of any lot or lots, to institute and prosecute any proceedings in law or equity, for damages or for injunctions, against the person or persons having violated, or threatening to violate, any of the covenants and restrictions herein. TOGETHER with all and singular the buildings, improvements, ways, streets, alleys, passages, waters, watercourses, rights, liberties, privileges, hereditarnents and appurtenances whatsoever thereunto belonging, or in anywise appertaining, and the reversions and remainders, rents, issues and profits thereof; AND ALSO all the estate, right, title, interest, property, claim and demand whatsoever, of the said Alice V. Ritter, at or immediately before her demise, in law, equity, or otherwise howsoever, of, in, to or out of the same. TO HAVE AND TO HOLD the said lots or tracts of land, with the buildings and improvements thereon erected, together with the hereditaments and prerises hereby granted or mentioned and intended so to be, with the appurtenances, unto the said Grantee, her heirs and assigns, to and for the only proper use and behoof of said Grantee, her heirs and assigns forever. AND the said Grantor does covenant, promise and agree, to and with the said Grantee, her heirs and assigns, that the said Estate, has not done, committed, or knowingly or willingly suffered to be done or committed any act, matter or thing whatsoever whereby the premises hereby granted, or any part thereof, is, are, shall or may be impeached, charged or encumbered, in title, charge, estate or otherwise howsoever. IN WITNESS WHEREOF, the Estate of Alice V. Ritter by Betty L. Baclunan, Executrix, has caused this Deed to be executed the day and year first above written. WITNESS: GRANTOR: Estate of Alice V. Ritter Betty L. Bachman, Executrix COMMONWEALTH OF PENNSYLVAT]IA : SS COUNTY OF ~~ • ~ ~^ ~ ~-- On this, the ~ day of~~~ , 2006, before rne, the undersigned officer, personally appeared Betty L. Bac n, Executrix of the Estate of Alice V. Ritter, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that she as such Executrix executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. ~~ ~~2 otary Public My Commission Expires: (SEAL) :Ui~~,Niv~:`.H""~AF..TT-~ OF ~'ENNSYLVAMA Notarial Seal Cindy L. Leitzel, Notary Public ` .ity of Harrisburg, Dauphin County ;viy Commissian ~xpiresDec. 2, 20x6 Sne-~r,~,~ o_;;,..,;t,;~;-;~- a,c~^is:~on of Notaries CERTIFICATE OF RESIDENCE I hereby certify that the precise residence of the Grantee herein is as follows: Ms. Betty L. B; P.O. Box Bowmansdale, I COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF MONROE RECORDED in the Office of the Recorder of Deeds, in and for said County, in Record Book ,Page WITNESS my hand and official seal this day of , 2006 . Recorder of Deeds Y --- ~~ State Tax Paid REALTY TRANSFER TAX Book Number COMMONWEALTH OF PENNSYLVANIA DEPA0.7MENT Oi 0.EVENUE 6U0.UV OF INDIVIDUAL TAX6 STATEMENT OF VALUE page Number DErt. 28060] MARRISEURG, PA 1712!-060] Date RBCDrtleG }y, U / r~ See Reverse for Instructions - Y V v Complete each section and file in duplicate with Recorder of Deeds when (1) the full value/consideration is not set forth in the deed, (2) when t deed is without consideration, or by gift, or (3) a tax exemption is claimed. A Statement of Value is not required if the transfer is wholly exempt from tax based on: (1) family relationshi or (2) public utili easement. If more space is needed, attach additional sheet(s). A. CORRESPONDENT -All inquiries may be directed to the following person: TELEPHONE NUMBER NAME (717) 233-5731 Stanley A. Smith; Rhoads &Sinon LLP STREET ADDRESS -CITY/STATE/ZIP CODE P. O. Box 1146, Harrisburg, PA 17108 DATE OF ACCEPTANCE OF DOCUMENT B. TRANSFER DATA GRANTEE(S)/LESSEE(S) GRANTOR(S)/LESSOR(S) Betty I... Bi7CIlII7Si1 'The Estate of Alice V. Ritter STREET ADDRESS STREET ADDRESS c/o Rhoads &Sinon LLP, P. O. Box 1146 CITYSTATEZIP CODE CITY STATEZIP CODE Harrisburg. PA 1.71.08-1146 C. PROPERTY LOCATION CITY, TOWNSHIP, BO STREET ADDRESS Lot #2 and Lot #3 Naomi Pines SCHOOL DISTRICT couNTY PnE•nnn Mountain Monroe D. VALUATION DATA 1. ACTUAL CASH CONSIDERATION 0 4. COUNTY ASSESSED VALUE 30,190.00 E. EXEMPTION DATA tA. AMOUNT OF EXEMPTION CLAIMED 100% 2. OTHER CONSIDERATION 5. COMMON LEVEL RATIO FACTOR 7.09 18. PERCENTAGE OF INTEREST CONVEYED 100 P. O. Box 77 Bowlnansdale, PA 17008 Tobyhanna Township TAX PARCEL NUMBER 19/6/1 /5 3. TOTAL CONSIDERATION 0 6. FAIR MARKET VALUE 214,047.10 2. Check Appropriate Box Below for Exemption Claimed Alice V. Ritter 2005-00963 Will or intestate surcessi~n (NAME OFDECEDENTJ (ESTATE FILE NUMBER). ^ Transfer to Industrial Development Agency. ^ Transfer to a trust. (Attach copy of trust agreement identifying all beneficiaries). 72 PS Section 8102-C.3.(7) ^ Transfer between principal and agent. (Attach complete copy of agency/straw party agreement). ^ Transfers to the Commonwealth, the United States, and Instrumentalities by gift, dedication, condemnation or in lieu of condemnation. (If condemnation or in lieu of condemnation, attach copy of resolution). ^ Transfer from mortgagor to a holder of a mortgages in default. Mortgage Book No._ Page and Mortgage Book No. _ Page - ^ Corrective or confirmatory deed. (Attach complete copy of the prior deed being corrected or confirmed). ^ Statutory corporate consolidation, merger or division. (Attach copy of Articles). ^Other (Please explain exemption claimed, if other than listed above.) i i/~ / 614333.1 COUNTY OF MONROE RECORDER OF DEEDS 7th & MONROE STREETS STROUDSBURG, PA 18360 Area Code (570) 517-3969 Helen Diecidue -Recorder Mary Ann Lesh -Chief Deputy Jamie Butz -Deputy Instrument Number - 200628771 Recorded On 7/6/2006 At 12:36:43 PM * Instrument Type -DEED -TAX EXEMPT Invoice Number - 440637 * Grantor -BITTER, ALICE V EST * Grantee - BACHMAN, BETTY L User - EFS * Customer -BROADS & SINON LLP * FEES STATE WRIT TAX $0.50 JCS/ACCESS TO JUSTICE $10.00 RECORDING FEES $19.50 AFFORDABLE HOUSING $13.00 COUNTY ARCHIVES FEE $2.00 ROD ARCHIVES FEE $3.00 TOTAL $48.00 Book - 2273 Starting Page - 4053 * Total Pages - 8 RETURN DOCUMENT TO: BROADS & SINON LLP PO BOX 1146 HARRISBURG, PA 17108 TAX ID # 19/6/1/5 Total Tax IDs: 1 o~oEEOS oF,k~p I Herebv t;ERTIFY that this document is rocoraed in the mQ o~ Recorder's Ut(tee of Mon-ne County, Qennavlvaaia c° /~~~~iC~ll/ A~n+snva°rP THIS IS A CERTIFICATION PAGE Do Not Detach Book: 2273 Page: 4060 THIS PAGE IS NOW THE LAST PAGE OF THIS LEGAL DOCUMENT - n ormat~on enote y an asteris may change during the verification process and may not be reflected on this page. 013718 II I I II I II IIII I II II III III NAMES D. BOGAR ATTORNEY AT LAW ONE WEST MAIN STREET SHIREMANSTOWN, PENNSYLVANIA 17011 e-mail mail@bogarlaw.com JAMES D. BOGAR JENNIFER B. HIPP' 'Also admitted to New Jersey Bar September 15, 2010 Helen Diecidue, Recorder of Deeds Monroe County Courthouse 7th and Monroe Streets Stroudsburg, PA 18360 TELEPHONE (717) 737-8761 FACSIMILE (717j 737-2086 Direct a-mail jhippQbogazlaw.com RE: Estate of Betty L. Bachman to Stephen D. Bachman, Cheryl L. Fraser, Gregory R. Bachman and Michael R. Bachman Tax Parcel No: 19/6/1/5 Dear Ms. Diecidue: We are forwarding a Deed for the above-captioned property, as well as a check in the amount of $62.00, same representing the filing fee for same. Please record this Deed and return the recorded Deed to our office in the enclosed self-addressed and stamped envelope. Your time and assistance in this matter are greatly appreciated. Very truly yours, JENN ER~~ HIPP JBH/bbl Enclosures cc: Cheryl. L. Fraser, Executrix Tax Parcel No. 19/6/1/5 THIS INDENTURE, -fh MADE THE ~5 day of September, two thousand ten (2010) BETWEEN CHERYL L. FRASER, Executrix of the Last Will and Testament of Betty L. Bachman, late of Mechanicsburg, Upper Allen Township, Pennsylvania, party of the first part, and STEPHEN D. BACHMAN, married person, of Panama City, Bay County, Florida, as to a twenty-five percent (25%) interest; CHERYL L. FRASER, married person, of Queensbury, Warren County, New York, as to a twenty-five percent (25%) interest; GREGORY R. BACHMAN, married person, of Etters, York County, Pennsylvania, as to a twenty-five percent (25%) interest; and MICHAEL R. BACHMAN, married person, of Mechanicsburg, Cumberland County, Penn- sylvania, as to a twenty-five percent (25%) inter- est, and the interests as between STEPHEN D. BACHMAN, CHERYL L. FRASER, GREGORY R. BACHMAN and MICHAEL R. BACHMAN shall be that of tenants in common without the right of survivorship, parties of the second part: WHEREAS, the said Betty L. Bachman by her Last Will and Testa- ment, duly proved and recorded in the Cumberland County Register of Wills Office, Pennsylvania, in Docket Book 21-10-0031, Letters Testamentary being issued on January 12, 2010, provided, in pertinent part, as follows: THIRD: I devise and bequeath all the rest, residue and remainder of my estate of whatever nature and wherever situate, including any property over which I hold power of appointment and together with any insurance policies thereon, in equal shares, to my children, STEPHEN D. BACHMAN, CHERYL L. FRASER, GREGORY R. BACHMAN, and MICHAEL R. BACHMAN ... FIFTH: In addition to all powers granted to them by law and by other provisions of this Will, I give the fiduciaries acting hereunder the following powers, applicable to all property, exercisable without court approval and effective until actual distribution of all property: (A) To sell at public or private sale, or to lease, for any period of time, any real or personal property and to give options for sales, exchanges or leases, for such prices and upon such terms (including credit, with or without security) or conditions as are deemed proper. This includes the power to give legally suffi- cient instruments for transfer of the property and to receive the proceeds of any disposition of it. ... (G) To make distributions to my herein named benefici- aries in cash or in kind or partly in each. ... NINTH: I nominate and appoint CHERYL L. FRASER, Execu- trix of this, my Last Will and Testament. ... I direct that my Executrix ... shall not be required to post security or bond for the performance of [her] duties in any jurisdiction. NOW THIS INDENTURE WITNESSETH, that the said party of the first part, by virtue of the power and authority aforesaid, in said Will contained, and in consideration of the sum of One Dollars ($1.00) to her paid by the said parties of the second part, at and before the ensealing and delivery of these presents, the receipt whereof is hereby acknowledged, has granted, bargained, sold and conveyed, and does hereby grant, bargain, sell and convey to the said parties of the second part, their heirs and assigns forever: ALL THOSE CERTAIN two lots or tracts of land situate in Naomi Pines, Tobyhanna Township, Monroe County, Pennsylvania, bounded and described as follows, to wit: TRACT N0.1 BEGINNING at an iron pipe on the Northerly side of Miller Drive and being the Southwesterly corner or Lot No. 4, Section B, as shown on Map entitled "Lake Front Cottage Sites at Pocono Pines, Pa., for sale by F. C. Miller, Easton, Pa., Plotting No. 5, J. L. Westbrook, Stroudsburg, Pa., September 1917, Scale 1" = 50', recorded at Stroudsburg, in Plat Book No. 1, Page 200, resurveyed July 1930 by Edward C. Hess, C. E. Stroudbsburg, Pa." recorded in the Office for Recording of Deeds, etc., at Stroudbburg, Pa., in and for the said County of Monroe in Plot Book No. 4, Page 49; thence along the Northerly side of Miller Drive (bearings from Magnetic Meridian of 1917) North eighty nine degrees fifty minutes West five and seven-tenths feet to the point of curva- ture; thence by the same on a curve to the left having a radius of one hundred fifty feet a distance of ninety four and three- tenths feet to an iron pipe at corner of Lot No. 2; thence through said Lot No. 2 and by other lands now or late of Russell F. Miller, of which this piece was formerly a part, North eigh- teen degrees thirty two minutes West one hundred seventy feet, more or less, to a corner distant one hundred feet from the edge of the water of Lake Naomi; thence in an Easterly direction parallel to and distance one hundred feet from the edge of the water of said Lake a distance of one hundred seven and five- tenths feet to an iron pipe, the Northwesterly corner of the aforesaid Lot No. 4; thence by Lot No. 4 South fifteen degrees ten minutes East one hundred sixty nine feet to the place of BEGINNING. BEING all of Lot No. 3 and part of Lot No. 2 as shown on the aforesaid Map. TRACT N0. 2 BEGINNING at a pipe on the Northerly side of Miller Drive, a corner of Lot no. 2 and No. 3, Section B, as show on map entitled "Lake Front Cottage Sites at Pocono Pines, Pa. for sale by F. C. Miller, Easton, Pa., Plotting No. 5", surveyed September 1917, by J. L. Westbrook, Stroudsburg, Pa. and recorded in the Office for the Recording of Deeds, etc., at Stroudsburg, Pennsylvania, in and for County of Monroe, in Plat Book No. 1, Page 200 and resurveyed July 1930 by Edward C. Hess, C.E., Stroudsburg, Pa. and recorded in the aforesaid office in Plat Book No. 4, Page 49; thence, along the Northerly side of Miller Drive in a Southwest- erly direction and along a curve to the left having a radius of 1225 feet, an arc length of one hundred feet to a pipe, a corner of Lot No. 1 and Lot No. 2, Section B; thence by Lot No. 1, Section B (Bearings from Magnetic Meridian of 1917) North twenty six degrees twenty minutes West one hundred fifty five feet, more or less, to a corner distant one hundred feet from the edge of water of Lake Naomi; thence, in a Northweasterly direction parallel to and distant one hundred feet from the edge of water of Lake Naomi, one hundred twenty five feet, more or less, to a corner; thence through Lot No. 2 Section B and by lands conveyed by Russell F. Miller and wife to Russell E. Ritter and wife by deed dated November 26, 1945, and recorded in the aforesaid office in Deed Book, Vol. 152, Page 59, South eighteen degrees thirty two minutes East one hundred seventy feet, more or less, to the place of BEGINNING. BEING part of Lot No. 2, Section B as shown on the aforesaid map. BEING the same premises which The Estate of Alice V. Ritter, by Betty L. Bachman, Executrix of the Estate of Alice V. Ritter, by deed dated June 28, 2006 and recorded July 6, 2006 in the Monroe County Recorder of Deeds Office in Deed Book 2273, Page 4053, granted and conveyed unto Betty L. Bachman. The said Betty L. Bachman died December 17, 2009. UNDER AND SUBJECT to the following restrictions: 1. That said Grantor, the principal or principals, their heirs or assigns, shall and may at all times enter in and upon the land aforesaid for the purpose of laying down and construct- ing sewer, drains, water pipes, electric light wire, and to keep and maintain same upon the said land. 2. That all buildings, or any part thereof, erected upon the lot or land aforesaid, shall be built at a distance of not less than fifty feet from the public road, or highway, fronting upon said land. 3. That no building or any part thereof, erected upon said lot or land, shall be used as a barn, outbuildings, store or place for selling merchandise, warehouse, slaughter house, carpenter, paint or blacksmith shop, or any purpose other than as as a residence. 4. That no beer, wine or intoxicating liquor or any kind or character, shall be sold upon the said lot or land, or in any building erected upon the same. 5. That no fences shall be erected or built upon said lot or land higher than three feet, and the said fences, if erected, shall be open work and of artistic design. The above restrictions are hereby placed upon said lots in pursuance of a general plan of the owners to enhance the value by beautifying and making more healthful the occupancy of said lands, and said restrictions and reservations are so created as a part consideration for the purchase of said lots; and each and every purchaser shall abide by such covenant, and be entitled to enforce the rigid observance of the same, against any person or persons violating the same. And also it is expressly covenanted and agreed between the parties hereto, that the above restrictions shall attach and run with the land, they being assumed by the purchaser in part consideration of the purchase thereof, and shall be binding upon their heirs and assigns, whether included in subsequent convey- ances or otherwise; and it shall be lawful for the said Grantor, or any of its principals, their heirs or assigns, and for the owner of any lot or lots, to institute and prosecute any proceed- ings in law or equity, for damages or injunctions, against the person or persons having violated, or threatening to violate, any of the covenants and restrictions herein. TOGETHER with all and singular the rights, liberties, privileges, hereditaments and appurtenances whatsoever thereunto belonging, or in anywise appertaining, and the reversions and remainders, rents, issues and profits thereof, and also all the estate, right, title, interest, property, claim and demand whatsoever of the said Betty L. Bachman at and immediately before the time of her demise, in law or equity or otherwise howsoever, of, in, to or out of the same. TO HAVE AND TO HOLD the said granted premises to the said parties of the second part, their heirs and assigns forever. AND the said party of the first part, does covenant, promise, grant and agree, to and with the said parties of the second part, their heirs and assigns, by these presents, that the said party of the first part, has not done, committed, or knowingly or willingly suffered to be done, any act, matter or thing what- soever, whereby the premises aforesaid, or any part thereof, is, are, shall or may be charged or encumbered, in title, charge or estate, or otherwise howsoever. IN WITNESS WHEREOF, the said party of the first part has here- unto set her hand and seal the day and year above written. Signed, Sealed and Delivered 'n the Presence of ~ r (SEAL) CHERYL FRASER COMMONWEALTH OF PENNSYLVANIA SS. COUNTY OF On this, the /ay of ~~'~^~-- ~ 2010, before me, the undersigned officer, personally appeared CHERYL L. FRASER, known to me (or satisfactorily proven) to be the person described in the foregoing instrument, and acknowledged that she executed the same in the capacity therein stated and for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. `t (SEAL) Notary Publi NOTARtAI SEAL CAROL a BOGAR, NOTARY PUBLIC My Commission Expires SHiREMANSTOWN BORO, CUMBERLAND COUNTY MY COMMISSION EXPIRES NOVEMBER 13, 2011 CERTIFICATE OF RESIDENCE I do hereby certify that the complete post office address of the within named grantee is: P.O. Box 285, Cleverdale, NY 12820. °~ ~ ~ ~ 2 010 JE I R B. HIPP Attor ey/Agent for Grantor, NTS REV-i83 EX (7-08) (I) r . pennsylvania _ DEPARTMENT OF REVENUE Bureau of Individual Taxes PO BOX z8o6o3 Harrisburg PA i7u8-o6o3 REALTY TRANSFER TAX STATEMENT OF VALUE State Tax Book Nu USE ONLY Page Number See Reverse for Instructions Date Recorded Complete each section and file in duplicate with Recorder of Deeds when (1) the full value/consideration is not set forth in the deed, (2) the deed is without consideration or by gift, or (3) a tax exemption is claimed. A Statement of Value is not required if the transfer is wholly exempt from tax based on family relationship or public utility easement. If more space is needed, attach additional sheets. A CORRESPONDENT All inquiries may be directed to the following person: Name Telephone Number. Jennifer B. Hipp, Esquire (717) 737-8761 Street Address City State ZIP Code One West Main Street Shi r~nan5toiwn PA 17011 B. TRANSFER DATA Grantor(s)/Lessor(s) The Estate of Betty L. Bachman Date of Acceptance of Document Grantee(s)/Lessee(s) Stephen D. Bachman, Cheryl L. Fraser, Gregory R_ Bachman & Michael R. Bachman Street Address C/o Jennifer B. Hipp, Esquire Street Address c/o Cheryl L. Fraser One West Main Street P.O. Box 285 City State ZIP Code City State ZIP Code Slir~nstown PA 17011 Cloverdale NY 12820 C. REAL ESTATE LOCATION Street Address City, Township, Borough Lot No. 2 and Lot No. 3 Naomi Pines T hanna TOWnSnl County School District Tax Parcel Number Monroe Pocono Mountain 19/6/1/5 D. VALUATION DATA 1. Actual Cash Consideration 2. Other Consideration 3. Total Consideration $0.00 + _ $0.00 4. County Assessed Value 5. Common Level Ratio Factor 6. Fair Market Value $30,190.00 X 7.41 = 223 707.90 E. EXEMPTION DATA 1a. Amount of Exemption Claimed ib. Percentage of Grantor`s Interest in Real Estate lc. Percentage of Grantor's Interest Conveyed 1008 100 1008 2.Cheek l~rpr~prEa±e 3~x Rolnw fnr F,~rem~tin~ [rl~ie~Arl ® Will or intestate succession. Betty L. Bachman 21-10-0031 {Name of Decedent) (Estate File Number) ^ Transfer to Industrial Development Agency. ^ Transfer to a trust. (Attach complete copy of trust agreement identifying all beneficiaries.) ^ Transfer between principal and agent/straw party. (Attach complete copy of agency/straw party agreement.) ^ Transfers to the Commonwealth, the United States and Instrumentalities by gift, dedication, condemnation or in lieu of condemnation. (If condemnation or in lieu of condemnation, attach copy of resolution.) ^ Transfer from mortgagor to a holder of a mortgage in default. (Attach copy of Mortgage and note/Assignment.) ^ Corrective or confirmatory deed. (Attach complete copy of the deed to be corrected or confirmed.) ^ Statutory corporate consolidation, merger or division. (Attach copy of articles.) ^ Other (Please explain exemption claimed, if other than listed above.) Under penalties of law, I declare that I have examined this statement, including accompanying lnrormation, ana t~ the best of my knowledge and belief, it is true, correct and complete. Signature of Correspondent or Responsible Party Date FAIL E OMPLE THIS FORM PROPERLY OR ATTACH REQUESTED DOCUMENTATION MAY RESULT IN THE RECOR ER'S REFUSAL TO RECORD THE DEED. - ~~ 901-A7-Wxr.nb Ds.. abort Fbrs+. Ad of 1909. .~ Hmn Fl.ll, Ina., ln.!++e+.. Yi. - - ~ ~ _. - ,- y+ _ ~O?~ day of ~"~~~ in the year MADE THE ~ of our Lord one tha~usand nine hundred seventy-two (1972) . _ _ BETIVEEN GERALD R. BACP-MAN and BETTY L. BACHMAN, 1 his wife, parties of the first part, hereinafter called the ' ,.. _ ' Grantor s. and BETTY L. BACHA4AN, individually, Party of ' the second part, hereinafter called the . Gra+ltee iVITNESSETH, that inconsideration of the sum of One' and No/100 ---_ - - - - -------($1.00) ---' ---- -- - -Doilalx, . in hand paid, the receipt whereof is herebyaelcnowledged, the said grantors do hereby grattt and convey to the said grantee her heirs and assigns, - ALL those two (2) certain pieces or parcels of land., together with the improvements thereon, situated in the Township 'of Upper A11en, Cou.^ty cf Cumberland and Commor_wealth of Pennsylvania, more parti- y ~ cularly bounded and described as follows to wit:- PARCEL NO. 1: BEGINNING at a point on the northern line. of Hillcrest. Drive on the hereinafter mentioned Plan of Lots at corner of Lot No. 3; thence by the dividing line between Lots No. 3 and 4.on said plan, iri a northwesterly direction, one hundred fifty-seven (157) feet to lands now or formerly of Sheaffer Williams; thence by said lands now or' formerly of Sheaffer Williams, North 69 degrees 15 minutes East, two hundred seventy-five (275) feet to Lot No. 5 on said plan; thence by ~ the dividing line between Lots No. 4 and 5 on said plan, in a south- t easterly direction, one hundred sixty-three (163} feet to a point on the northern line of Hillcrest Drive; thence by the northern line of Hillcrest Drive in a southwesterly direction, two hundred seventy- s five (275) feet to a point, the Place of BEGINNING. BEING Lot No. 4 on the Plan of Lots. of "Orchard Terrace", which plan is of record in the Cumberland County Recorder's Office in Plan Book 8, - at Page 25_ i HAVING thereon erecter a one-story ranch type dwelling. i EEING the same premises which Robert D. Nailor and Marjorie 2d. Nailor,- his wife, by their deed dated September 19, 1961, and recorded in the Office of the Recorder of Deeds in and for Cumberland County, Penn- i Sylvania, in Deed Book "H", Volumes 20, Page 1024, granted and conveyed unto Gerald R. Bachman and Betty ~_ Bachman, his wife; the parties herein. .PARCEL N0..2: BEGINNING at a point. on the southern line of Hillcrest Drives on the hereinafter mentioned Plan of Lots at the eastern end of ' Lot No. 17; thence by the southerr. line of Hillcrest Drive, North 69 4 ~~ ° f er~r~ 2'~e~r,_ i66 __ __ _ ..- - _ _ . . __-- . _ .. _ _ - degrees 45 minutes East One Hundred (100) feet to a point at th~ `' western corner of Lot No. 19 on said Plan; thence by the dividing line between -Lots 18 andflEt ~a.ayointanthencesbytthelnorthernion P One Hundred Sixty (160) P line of Lot No. 10 on said Point at cornerdofrLot No~:ml7ttthencet Ong Ilundred (100) feet to a p by the dividing line between Lots 17 and. the1PlaceoofhBEGINNINGetion -^ One Hundred Sixty (160) feet to a point, BEING ~oLotB is of record in the Cumberla drCounty Recorder's1Office Plan o~ ~ at Page ,. in Plan Book j BEING the same premises which 3oseph C. Ludesanddrecorded indthe his their deed dated February 20r 1963, wife, by Volume 20,'Page 869, Recorder's Office aforesaid in Deed Book "T". granted and conveyed unto Gerald R. Bachman and Betty L. Bachman, his wife,, the Parties herein. This dead is a .trans`er from husbandose oflvestingrabsoluteotitle individually as Grantee for the purp and ownership in wife-grantee. AND the said grantors hereby covenant and agree that they will warrant - - generally the property hereby conveyed. - IN iVITNESS iVHEREOF, said prantoas have hereunto act their lea~ad s and seals ° the day rul year first abode written. ~ , /~ ~G1Ts.~ ~ 1:F__.__.-.._.. sEAL ~ipntd, healed dad ~rlintni yL Y~ ;a-Ciimai~ ,: _ra~ l in the ~imean et •~J~ ~~ ~ y~k ~'~L ., _~ ., ~/ . ': '"""ge y .~ac~unan ~~ .roc i~_CG_ ._._._~__._.__.- ss - . ._ • ___ - - ~. ^. c . - - - tioa . ~~ ''oo °O . ~ _ -_ • ~. ~ ._ - . -. '. r~1 , - _ _ _ State of Pennsylvania sa. iourtly of Dauphin j . On this, the ~'~ dal! of m.cu-l.-~ 19 72 ,before v;+.e, a Notary Public in and .for said state and county, the wadersigncd of/icer, personally appeared - I_,' GERALD R. BACH,NAN knoicn to n:e (or satisfactorily proven) to be the person whose name is subscribed to tlee acithin i:~strumettt, and aeb-nowledDed thnt he executed the same for fhe purt7ps~;fhr,~cin contained. r`•~'~~v:.....,~•'; •. - IN TVIT'NE3S WHEP.~OF, I hereunto set my )eand a~ official seal./~ _=~ p • O 1 =t • ~ '' ~~n ~ .1" -Notary_Pub~c-°-_. _~_~ ..1-c-I•- i BCCf~ ~•~~~cE iS7 ...., i~ State of Pennsylvania ss. _ - County of Cumberland 4 On this, the. .?OJT.. day of . m~"`~ , 19 '7 2 , before. me, a Notary Public in and for. said state and county; the uuderariyned ojJiter, personally appeared . BETTY L. BACHMAN • b-noxc'n to me (or satisfactorily proven) to be the persmL whose frame _is subscribed to the xvithin instnament, and ach7rowledyed that she executed the same for the pur~peeN'tF'er~in._, co+eeained. ~ ~ ~~u ~~'~ a ~ - IN IVITNF.SS ZYHEP.COF, I hereranta set »ey hand and o~cial seal. ,~ ~~. ~ 1? ~ •. `t y `: - ~7 n . ~ ~ s, /~.'Lr~. .1~_~t`Cs/ ~ FLORENCE 8. LOSCNER. NOTARY PUBLIC ". r - _ MECN.lNICSBCRC 60flDUGH ~ ~ Ul ~ .- ,O ' Notar Public-: •` • CU:.iBFP.L;.NO COUNTY ~ ~a^' '~' i•<~-~~- - MY COhthtISS10N EXPIRES APRIL 6, 1914 ~ ~ - - - Ttt~K'~"al '~1~~r' _ n - ' I do hereby certify that the precise residence and emnplete post office address ! of the within named grantee is H~llerest Road, BowmsTl~ e, Pennsylvania. ' :' 19 r / 1 ~' ~<« .- _ ~~ . Attorney for ....~._.~.~sdnt~e.~~N~Sl.__~. - - . ~- S ~\ N ~~ b ~ p FC ~ L"1 ~ ~-+ W a a a a ~ F W _ W F W ~ r•r ~ w 3 COldh10NW ' ~H OF PENNSYLL~ANIA, ' !/ ~ as. RECORDED on this _L_~-_.._!. daY of ,--/-/--~r-=r"-`'~- ~~- _ A. D. 12J~, in the RecordeY'a OtJaee of said County, in Deed Eook ~ _ Voi. ~~ __, Pape ~ - Given u>ider Tray hand and tch~e seal of the said oJ~ „f he date above uy-itten. -r---~------- - --- --- -_ a~~~~i~ ~'?P;c i68 I ~~, ~. Rev-1508 EX+ (6-98j i COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, ~ MISC. PERSONAL PROPERTY ESTATE OF (FILE NUMBER Bachman, Betty L. 21-10-0031 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. VALUE AT DATE ITEM DESCRIPTION OF DEATH NUMBER 1 Citizen's Bank -Checking Account No. 6100700801, date of death balance $48,047.06; 48,047.06 accrued interest $0.00. 2 2009 Cadillac -Sold at private sale to Kelly Cadillac 32,000.00 3 Jewelery -per appraisal 1,375.00 4 Personal Property -per appraisal 8,842.00 5 Comcast -Refund of overpayment 63.62 6 Internal Revenue Service - 2008 Personal Income Tax Refund 12,227.00 7 Nationwide Insurance -Premium Refund 77.96 8 OnStar -Refund 348.74 9 PA Turnpike Commission - E-Z Pass Refund 40.68 10 PPL -Refund 32.60 11 PPL -Refund 21.26 12 Prescription Solutions -Refund 7.00 13 United American Insurance Company -Premium Refund 467.82 TOTAL (Also enter on Line 5, Recapitulation) I 103,550.74 (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) a~ ~i~r~~n~ ~~r~k. January 20, 2010 JAMES D BOGAR, ESQUIRE ONE WEST MAIN STREET SHIREMANSTOWN PA 17011 Estate of BETTY L BACHMAN Date of Death: Dec 17, 2009 SSN: 201-18-6826 Dear Sir/Madam: 525 William Penn Place Suite 153-2618 Pittsburgh, PA 15219 In accordance with your request, the attached information sheet has been provided in the above decedent's name as of his/her date of death. For IL or LC accounts, contact our Loan Department at 1-800-708-6680. For all other inquiries, please call 1-888-999-6884 Sincerely, Ann Rhodes Operations Services ~~ Citizens B~r~dc Account Number 6100700801 Account Title BETTY L BACHMAN Date O ened 1/7/1983 Account Type Checking Principal Balance as of DOD $48047.06 Interest from Last Posting to DOD $ .00 Account Balance as of DOD $48047.06 YTD Interest to DOD $ .00 M'u r~ M~ s 34 WEST MAIN STREET MECHANICSBURG, PA 17055 APPRAISAL Phone: 717-766-9422 APPRAISAL Appraisal for: Estate of Betty Bachman 01/13/2010 1. Pair of lady's diamond earrings. The earrings are 14 karat white gold in a leaf design. Each earring has a round diamond of approximately .05 points set in the center. The earrings are designed for non-pierced ears. Value: $125.00 2. Lady's 14 karat white gold diamond pendant. The pendant consists of seven round diamonds set in a leaf design on a 14 karat white gold chain. The pendant is set with six diamonds of .03 points each and a center diamond of .OS points. Value: $250.00 3. Ruby 14 karat white gold lady's Hamilton watch. The watch consists of a watch with i 0 .02 point diamonds around the case. The watch includes a 14 karat white gold bracelet. The watch bracelet is set with 18 dia- monds of .03 points each. Value: $500.00 ~- ~ 1-..a ~ : ~ s ~ ~° ~. ~ ~~ ~ ~5 ~- ~ ~ y l~ W ~.°~~ Ce i ~ . r has ~ l~~uh.cj fin: r1,4~ .~-T ~ of ~ ~ o ~ ~ ~--c ~' 1 ~~ ~ rt%~ is c~-~ ~ G s << ` ~ ~, o- S~' APP ~S~°titj ~u~ ~ '~ ~ ~c'cw~-. ~ ~~r ~ ~n ~~~ k (~ (f ~4 ~ .'..~ ~ .5- S ~, ail 1 ~:~ ~©f~, -~ e~ r,, -~;~, s Ss~ n ~- c~ s~ ~.~ i~ ~1.~ ~~~,a o ~'~s it ~~~~~,~ ~ j~,~,~ Ja ~~ ~u D. c ;.~ This appraisal constitutes our carefully studied opinion of ^ the retail replacement cost through our facilities 29 the distress sales nature value of the article(s) described above insofar as the mounting(s) have permitted observation. We assume no Gabirity with respect to any action that may be taken on the basis of this appraisal. 1' L.l ' ~.. NV~ 'III L ~ - Appraiser E/mew Muter Auctions, /nc, License No. AU-649-L 717-790-2240 www richardmurryauctioneercom 14 North Walnut St. Second Floor Mechanicsburg, Pa. 17055 IN RE: Personal Property Appraisal OWNER Estate of Betty Bachman 17 Hill Crest Dr. Mechanicsburg, Pa. 17055 DOD 12/17/2009 Attn: Cheryl Fraser Box 285 Cloverdale, NY 12820 This appraisal is completed as per request to determine a fair market for the following list of personal property. Dry Sink $200 Contents of Sink 10 Four Bar Stools and Bar 32 Childs Roll Top Desk 90 Oak Side Board 200 China Hutch 750 Clear Glassware 45 Egg Cups 10 Lenox Ware 70 Bowls and Plates 60 Symphony China Set for Eight 125 Pressed Glass 10 Flatware 15 3 Samsung TV Sets @ 200 each 600 Dinning Room Table and Chairs 300 Pressed Back Chair 20 Stand N~ Bachelors chest 300 Victorian Lamp 125 Bird Collection In Curio 90 Table Lamps 30 Jard and Pedestal 20 Coal Bucket 20 E/ine~ Murry Auctions, /nc. License No. AU-649-L 14 North Walnut St. 717-790-2240 Second Floor www richardmurryauctioneercom Mechanicsburg, Pa. 17055 Bust Birds & Decorative Urns 30 Pottery Jar 40 Lamp and Stand 40 Gate Leg Table 65 Stand 3 0 Flower Picture 30 Bird Picture 30 4 Arm Chairs 120 Marble Top Stand 125 Studio Piano by Marshall & Wendell 450 White Marble Top Stand 175 Walnut Desk 150 Lamp 100 Wrought Iron Patio Furniture 80 Mantle Clock 60 Floor Lamps 15 Glass Basket 20 Figurines 25 Books N/V Oak Curio Cabinet 150 Krick Knacks 30 Larger Display of Bird Figurines 100 Upholstered Furniture 100 Coffee Table 20 Credenza 20 Stand and Umbrella 15 Vacuum Cleaner 10 Sewing Machine 10 Old Projector N/V Mirror and Sconces 30 Empire Chest of Drawers 200 Gossip Bench 40 Bedroom Furniture 100 Picture 20 Fishing Pole 10 Animal Figurines 125 E/mew Mummy Auctions, /nc. License No. AU-649-L 14 North Walnut St. 717-790-2240 Second Floor www richardmurryauctioneer.com Mechanicsburg, Pa. 17055 Dolls 40 Oval Picture 10 Wall Hanging 20 Oval Picture 10 Bedroom Furniture 50 Lamp 10 French Phone 10 1920's Picture 10 Household Linens 20 Jewelry Cabinet 300 Contents of Cabinet 50 Penny Bank 45 Bedroom Furniture 700 Cat Figurines 10 Floor Lamp 10 Heater 5 Sewing Machine 5 Dresser 10 1 Drawer Stand 10 Settee 50 De-humidifier 20 What-nots 10 Baskets and House wares 10 Milk Glass Decanter 15 Tins and Cutlery 20 China Closet ~5 Table and Chairs 15 Director Chairs 20 Exercise Bike N/V Drift Lamp 10 Upholstered Furniture 10 Tier Stand 20 Table and Chairs 15 Pool Table 250 Stand 5 Cabinet 5 E/mer Mummy Auctions, /nc. License No. AU-649-L 14 North Walnut St. 717-790-2240 Second Floor wwyv.richardmurryauctioneer.com Mechanicsburg, Pa. 17055 Golf Clubs 25 Contents of Utility Room 50 Few Tools 10 Baseball Bat 10 Old TV N/V Milk Can 10 Kitchen Primitives 100 Hutch 20 Contents of Hutch 10 Horn 10 Dog Figurine ~ 10 Wicker Furniture 40 High Chair 5 Long.Handled Tools 5 Ladder 10 Lawn Mower 80 John Deere LA 125 Lawn Mower Tractor 900 Chain Saw 30 Hedge Cutter 5 Upon observation of the aforementioned items it is to the best of my knowledge and belief that eight thousand eight hundred forty-two ($8842) Dollars would represent a fair market value. Sub b , 'chard Murry Rev-1510 EX+ (6-98) SCHEDULE G INTER-VIVOS TRANSFERS 8~ MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Rachman. Bettv L. _ 21-10-0031 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 DESCRIPTION OF PROPERTY DATE OF DEATH % OF DECD'S EXCLUSION I TAXABLE INCLUDE NAME OF TRANSFEREE THEIR RELATIONSHIP TO DECEDENT AND INTEREST (IF APPLICABLE) VALUE NUMBER THE DATE OF TRANSFER. ATTACK A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET 1 Wells Fargo Investment Account -Date of death value 1,163,345.30 1,163,345.30 $1,163,345.30. This "TOD" account was transferred to the Decedent's four (4) children. 2 Brandon Bachman -Gift made prior to date of death. 3,000.00 3,000.00 0.00 (AN EXEMPTION IN THE AMOUNT OF $3,000.00 IS CLAIMED IN ACCORDANCE WITH THE PROVISIONS OF THE INHERITANCE AND ESTATE TAX ACT, BEING 72 P.S. SECTION 9108 (c) AND 72 P.S. SECTION 9107 (c)(3)). 3 Cheryl L. Fraser -Gift made prior to date of death. 12,000.00 3,000.00 9,000.00 (AN EXEMPTION IN THE AMOUNT OF $3,000.00 IS CLAIMED IN ACCORDANCE WITH THE PROVISIONS OF THE INHERITANCE AND ESTATE TAX ACT, BEING 72 P.S. SECTION 9108 (c) AND 72 P.S. SECTION 9107 (c)(3)). 4 Genna Bachman -Gift made prior to date of death. 3,000.00 3,000.00 0.00 (AN EXEMPTION IN THE AMOUNT OF $3,000.00 IS CLAIMED IN ACCORDANCE WITH THE PROVISIONS OF THE INHERITANCE AND ESTATE TAX ACT, BEING 72 P.S. SECTION 9108 (c) AND 72 P.S. SECTION 9107 (c)(3)). 5 Gregory R. Bachman -Gift made prior to date of 12,000.00 3,000.00 9,000.00 death. *(AN EXEMPTION IN THE AMOUNT OF $3,000.00 IS CLAIMED IN ACCORDANCE WITH THE PROVISIONS OF THE INHERITANCE AND ESTATE TAX ACT, BEING 72 P.S. SECTION 9108 (c) AND 72 P. S. SECTION 9107(c)(3)). I Total of Continuation Schedules I I I See attached a es TOTAL (Also enter on Line 7, Recapitulation) 1,199,345.30 (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-1510 EX+ (6-98) ` COMMON WEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Bachman. Betty L. ITEM DESCRIPTION OF PROPERTY INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND NUMBER THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. 6 Heath Fraser -Gift made prior to date of death. *(AN EXEMPTION IN THE AMOUNT OF $3,000.00 IS CLAIMED IN ACCORDANCE WITH THE PROVISIONS OF THE INHERITANCE AND ESTATE TAX ACT, BEING 72 P.S. SECTION 9108 (c) AND 72 P.S. SECTION 9107 (c)(3)). DATE OF DEATH o~INTERE8DTS EXCLUSION VALUE OF ASSET (IF APPLICABLE 3,000.00 3,000.00 7 Hunter Bachman -Gift made prior to date of death. * 3,000.00 (AN EXEMPTION IN THE AMOUNT OF $3,000.00 IS CLAIMED IN ACCORDANCE WITH THE PROVISIONS OF THE INHERITANCE AND ESTATE TAX ACT, BEING 72 P.S. SECTION 9108 (c) AND 72 P.S. SECTION 9107 (c)(3)). 8 Mackenzie Fraser -Gift made prior to date of death. * 3,000.00 (AN EXEMPTION IN THE AMOUNT OF $3,000.00 IS CLAIMED IN ACCORDANCE WITH THE PROVISIONS OF THE INHERITANCE AND ESTATE TAX ACT, BEING 72 P.S. SECTION 9108 (c) AND 72 P.S. SECTION 9107 (c)(3)). 9 Madelana Bachman -Gift made prior to date of death. 3,000.00 *(AN EXEMPTION IN THE AMOUNT OF $3,000.00 IS CLAIMED IN ACCORDANCE WITH THE PROVISIONS OF THE INHERITANCE AND ESTATE TAX ACT, BEING 72 P.S. SECTION 9108 (c) AND 72 P.S. SECTION 9107 (c)(3)). 10 Michael R. Bachman -Gift made prior to date of death. 12,000.00 *(AN EXEMPTION IN THE AMOUNT OF $3,000.00 IS CLAIMED IN ACCORDANCE WITH THE PROVISIONS OF THE INHERITANCE AND ESTATE TAX ACT, BEING 72 P.S. SECTION 9108 (c) AND 72 P.S. SECTION 9107 (c)(3)). 3,000.00 3,000.00 TAXABLE VALUE 0.00 3,000.00 3,000.00 0.00 0.00 0.00 9,000.00 SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY continued FILE NUMBER 21-10-0031 Form PA-1500 Schedule G (Rev. 6-98) Copyright (c) 2002 form software only The Lackner Group, Inc. Rev-1510 E7(+ (6-98) COMMONWEALTH OF PENNSYLVANIA ~uucaiTAN[:F TAX RETURN SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY continued ESTATE OF Bachman, Betty L, FILE NUMBER 21-10-0031 ITEM DESCRIPTION OF PROPERTY INCLUDE NAME OF TRANSFEREE THEIR RELATIONSHIP TO DECEDENT AND NUMBER THE DATE OF TRANSFER. ATTACK A COPY OF THE DEED FOR REAL ESTATE. 11 Ridge Bachman -Gift made prior to date of death. '" (AN EXEMPTION IN THE AMOUNT OF $3,000.00 IS CLAIMED IN ACCORDANCE WITH THE PROVISIONS OF THE INHERITANCE AND ESTATE TAX ACT, BEING 72 P.S. SECTION 9108 (c) AND 72 P.S. SECTION 9107 (c)(3)). DATE OF DEATH % OF DECD'S EXCLUSION VALUE OF ASSET INTEREST (IF APPLICABLE) 3,000.00 3,000.00 12 Stephen D. Bachman -Gift made prior to date of 12,000.00 death. *(AN EXEMPTION IN THE AMOUNT OF $3,000.00 IS CLAIMED IN ACCORDANCE WITH THE PROVISIONS OF THE INHERITANCE AND ESTATE TAX ACT, BEING 72 P.S. SECTION 9108 (c) AND 72 P. S. SECTION 9107(c)(3)). TOTAL (Also enter on Line 7, Recapitulation) 3,000.00 TAXABLE VALUE 0.00 9,000.00 1,199,345.30 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule G (Rev. 6-98) Page 1 of 2 Jennifer B. Hipp ___ ___ From: Tylavsky, Stacy [stacy.tylavsky@wellsfargoadvisors.com] Sent: Wednesday, February 03, 2010 10:45 AM To: Jennifer B. Hipp Subject: FW: Bachman, Betty Estate Valuation Jen, Here is the Estate Valuation. This is the figure I will be using on the PA Request for Waiver that I am required to send to PA Dept of Rev. I moved the assets to the 4 kids yesterday, so that is complete. Please let me know if you need anything else from this end :) Stacy staCy A. Ty~avsky Senior Registered Client Associate Westfall, Tylavsky & Lombardo Investment Group of Wells Fargo Advisors 1 151 Office Foods Drive Suite C Pensacola, FL 32504 850 432-1411 fax 8~0 432-1944 From: Hein, AmyL. [mailto:amy.hein@wellsfargoadvisors.com] Sent; Wednesday, February 03, 2010 9:18 AM To: stacy.tylavsky@wfadvisors.com Subject: Bachman, Betty Estate Valuation Attached is the estate valuation you requested. Please review the report for accuracy and completeness before sending to the client. Thank you, Amy Hein Estate Valuations Key Client Solutions Group 314-955-6002 ATTENTION: THIS E-MAIL MAY BE AN ADVERTISEMENT OR SOLICITATION FOR PRODUCTS AND SERVICES. If you are a current Wells Fargo Advisor client and wish to unsubscribe from marketing e-mails from your financial advisor, reply to one of his/her e-mails and type "unsubscribe" in the subject line. This action will not affect Page 2 of 2 delivery of important service messages regarding your accounts that we may need to send you or preferences you may have previously set for other e-mail services. If you are not a client, please go to https://www.wachovia.com/email/unsubscribe For additional information regarding our electronic communication policies please go to http://wellsfargoadvisors.com/disclosures/email-disclosure.html Investments in securities and insurance products are: NOT FDIC-INSURED/NOT BANK-GUARANTEED/MAY LOSE VALUE Wells Fargo Advisors, LLC is a nonbank affiliate of Wells Fargo & Company, Member FINRA/SIPC 1 North Jefferson, St. Louis, MO 63103. Estate Valuation Date of Death: 12/17/2009 Valuation Date: 12/17/2009 Processing Date: 02/03/2010 Shares Security Identifier or Par Description High/Ask Low/Bid 1) 026547109 4651.995 AMERICAN HIGH INCOME TR (AHITX) SH BEN INT M tual Fund (as quoted by NASDAQ) Estate of: Betty L. Bachman Report Type: Date of Death Number of Securities: 9 File ID: Bachman,Setty0002436 Mean and/or Security Div and Int Adjustments Value Accruals u 12/17/2009 10.55000 Mkt 10.550000 49,072.74 2) 190193103 3129.513 CAPITAL INCOME BLDR FD (CAIBX) SH BEN INT Mutual Fund (as quoted by NASDAQ) 12/17/2009 47.92000 Mkt 47.920000 149,966.26 3) 27B26L280 23223.223 EATON VANCE MUNS TR (ETPAX) PA MUN INCM A Mutual Fund (as quoted by NASDAQ) 12/17/2009 8,11000 Mkt 9.110000 211,563.56 9) 353996805 18235.294 FRANKLIN CUSTODIAN FDS INC (FCISX) INCOME FD CL C Mutual Fund (as quoted by NASDAQ) 12/17/2009 2,07000 Mkt 2.070000 37,747.06 5) 353496300 27322.404 FRANKLIN CUSTODIAN FDS INC (FKINX) INCOME FD CL A Mutual Fund (as quoted by NASDAQ) 05000 Mkt 2 12/17/2009 , 2.050000 56,010.93 6) 354723801 38887.004 FRANKLIN TAX FREE TR (FRPAX) PA T/F INCM A Mutual Fund (as quoted by NASDAQ) 12/17/2009 10.25000 Mkt 10.250000 398,591.79 7) 453320103 9419.147 INCOME FD AMER INC (AMECX) COM Mutual Fund (as quoted by NASDAQ) 12/17/2009 15.49000 Mkt 15.490000 145,902.59 B) 544004104 10922.33 LORD ABSETT SD DEB F'D INC (LBNDX) CL A Mutual Fund (as quoted by NASDAQ) 12/17/2009 7.32000 Mkt 7.320000 79,951.46 39,538.91 9) MMKT 34538.91 BANK DEPOSIT SWEEP Total Value: Total Accrual: Total: $1,163,395.30 $1,163,345.30 $0.00 Page 1 + Please see the final page for IMPORTANT INFORMATION ABOUT THE ESTATE VALUATION REPORT. Wells Fargo Advisors does not render tax or legal advice. If you have any questions please consult with your tax and legal advisors. Wells Fargo Advisors is the trade name used by three separate registered broker-dealers: Wells Fargo Advisors, LLC, Wells Fargo Advisors Financial Network, LLC and Wells Fargo Investments, LLC, Members SIPC, non-bank affiliates of Wells Fargo b Company. Date of Death: 12/17/2009 Valuation Date: 12/17/2009 Processing Date: 02/03/2010 Portfolio Endnotes IMPORTANT INFORMATION ABOUT THE ESTATE VALUATION REPORT Estate of: Betty L. Bachman Report Type: Date of Death Number of Securities: 9 File ID: Bachman,Betty0002436 The information in this Estate Valuation Report (referenced below as the Report) is based on the Estate Valuation Worksheet provided to us by the Financial Advisor requesting the Report. We have not used client statements, internal accounting data, or any other resources to independently verify the identity or quantity of securities held, the date of death, or the alternate valuation date, if applicable. In most cases, we use Estate Val, a valuation and pricing program, to provide information on the value of securities on the requested date. Estate Val software is provided by Estate Valuations b Pricing Systems, Inc., (EVP), a third-party vendor unrelated to Wells Fargo Advisors. The pricing and valuations generated by EVP are derived from sources it believes to be reliable, but the accuracy and completeness of this information is not guaranteed. Depending on how the Report will be used, the pricing generated by EVP for some securities may warrant additional consideration. Users may want to supplement or adjust the values provided for certain types of securities. For example: - Brokered Certificates of Deposit, and certain bonds, may possess a death put feature. EVP provides a value which does not account for the possibility that a successor owner may be able to put the security back to the issuer at par, upon the death of the original owner. - Treasury Inflation Protection Securities (TIPS) are often not identified as such in the Report, so the inflation factor say not be reflected in the value and accrued interest shown. - Variable rate auction securities may be reported by EVP at par, without reflecting accrued interest or market conditions. Other types of variable rate securities may not reflect accrued interest. The databases used by EVP do not encompass all markets or types of investments. For example, Estate Val does not provide valuation data on investments such as annuities, equity options, limited partnerships, or managed futures funds, among others. If the Financial Advisor is able to obtain pricing or valuation data from other sources with respect to such investments, we may include that data in the Report for informational and convenience purposes. We will identify such investments in the Report. We do not audit or independently verify the data provided to us, and make no representations as to the accuracy or completeness of information provided to ws by others. This Report does not in any way supersede the information contained in client statements and trade confirmations, which are the official record of account positions and activity. We make no representations that the information contained in this Report is suitable for any particular purpose. It is the responsibility of the client, together with his or her tax and legal advisors, to determine the appropriate information to include on any tax return, inventory, or other accounting. Page 2 * Please see the final page for IMPORTANT INFORMATION ABOUT THE ESTATE VALUATION REPORT. Wells Fargo Advisors does not render tax or legal advice. If you have any questions please consult with your tax and legal advisors. Wells Fargo Advisors is the trade name used by three separate registered broker-dealers: Wells Fargo Advisors, LLC, Wells Fargo Advisors Financial Network, LLC and We11s Fargo Investments, LLC, Members SIPC, non-bank affiliates of Wells Fargo & Company. REV-1151 EX+(10-06) i ~ , COMMNHERITANCE TAX RETURNANIA RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES ~ ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Bachman, Betty L. 21-10-0031 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A, FUNERAL EXPENSES: See continuation schedule(s) attached B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Cheryl L. Fraser Street Address P.O. Box 285 city Cleverdale state NY zip 12820 Year(sl Commission paid 2, Attorney's Fees Bogar and Hipp Law Offices 3. 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 12,568.65 15,000.00 16, 800.00 4. Probate Fees 523.50 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 30,570.37 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 75,462.52 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 Bachman, Betty L. 21-10-0031 ITEM AMOUNT NUMBER DESCRIPTION 1 Funeral Exggnses Neill Funeral Home -funeral bill H-A 2 3 4 5 6 7 8 9 10 11 12 13 14 Other Administrative Costs Cheryl L. Fraser -bills of Decedent paid by Cheryl Fraser prior to date of death Citizen's Bank -outstanding checks as of date of death Comcast -cable -Bowmansdale properly Comcast -cable -Bowmansdale Property Comcast -cable -Bowmansdale Property Dennis Zerbe, Treasurer -taxes for Bowmandale property (lot and house) Discover -credit card payment H8~R Block -tax preparation fee H. B. McClure -heating oil for Bowmansdale property H. B. McClure -heating oil for Pocono Pines property H. B. McClure -heating oil for Bowmansdale property H. B. McClure -heating oil for Bowmansdale property H. B. McClure -heating oil -Bowmansdale property 12, 568.65 12,568.65 650.98 3, 500.00 127.22 61.89 124.64 3,076.82 2,436.20 400.00 199.35 62.54 406.27 276.75 285.18 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Bachman, Betty L. 21-10-0031 ITEM NUMBER DESCRIPTION AMOUNT 15 H. John Davis -heating oil -Pocono Pines property 373.77 16 H. John Davis -heating oil -Pocono Pines property 541.11 17 Home Paramount -termite treatment -Bowmansdale property 477.00 18 Linda Woehrle -tax payment -Pocono Pines property 959.77 19 Linda Woehrle -taxes for Pocono Pines property 4,123.72 20 M. V. Keiper -repairs to broken pipe -Pocono Pines property 181.50 21 Monroe County Recorder of Deeds - fee to record deed 62.00 22 Mumma's Jewelery Store - jewelery appraisal fee 75.00 23 Murray Appraisal -personal property appraisal fee 174.90 24 Nationwide Insurance -Homeowner's insurance payment for Bowmansdale and Pocono 390.25 Pines properties 25 Nationwide Insurance -homeowner's insurance payment 1,077.12 26 Nationwide Insurance -Homeowners Insurance 149.12 27 Nationwide Insurance -Homeowners insurance 386.88 28 PA Department of Revenue -estimated tax payment 500.00 29 PA Department of Revenue -State Income Tax payment 505.00 30 PA Turnpike Commission 5.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Bachman, Betty L. 21-10-0031 ITEM NUMBER DESCRIPTION AMOUNT 31 PPL -electric bill -Pocono Pines Property 69.98 32 PPL -electric bill -Bowmansdale and Pocono Pines properties 195.10 33 PPL -electric bill 89.49 34 PPL -electric bill -Pocono Pines property 1.95 35 PPL -electric bill -Bowmansdale property 88.32 36 PPL -electric bill -Pocono Pines and Bowmansdale properties 128.24 37 PPL -electric bill -Bowmansdale 53.86 38 PPL -electric bill -Bowmansdale and Pocono Pines properties 73.06 39 PPL -electric bill -Pocono Pines and Bowmansdale properties 54.11 40 PPL -electric bill -Pocono Pines and Bowmansdale properties 91.38 41 PPL -electric bill -Bowmansdale and Pocono Pines properties 66.02 42 Register of Wills -Short Certificate 4.00 43 RESERVES: -Costs to conclude administration of Estate, including filing fees for PA 5,000.00 Inheritance Tax Return and Inventory, preparation fees for Income Tax Returns and Fiduciary Tax Returns and payment of taxes and maintenance costs for Bowmansdale real property until sale 44 Rick Hart -11 Hours -lawn care and maintenance for Bowmansdale property 165.00 45 Rick Hart - 36.5 hours + $15 gas -lawn care and maintenance for Bowmansdale property 362.50 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Bachman, Betty L. 21-10-0031 ITEM DESCRIPTION AMOUNT NUMBER 46 Rick Hart -lawn care and maintenance for Bowmansdale property 200.00 47 Rick Hart - 23 hours -lawn care and maintenance for Bowmansdale property 345.00 48 Rick Hart - 25 hours + $29.00 gas -lawn care and maintenance for Bowmansdale property 404.00 49 U. S. Treasury - 2009 Federal Income Tax payment 241.00 50 Upper Allen Township -sewer -Bowmansdale property 112.00 51 Upper Allen Township -sewer bill -Bowmansdale property 112.00 52 Upper Allen Township -sewer bill -Bowmansdale property 117.60 53 Upper Allen Township Tax Collector -Tax payment for vacant lot in Upper Allen Township 80.58 54 Upper Allen Township Tax Collector -tax payment for Bowmandale property 831.70 55 Wells Fargo -fee to provide date of death valuation 50.00 56 York Waste Disposal -trash - Bownmansdale properly 43.50 H-B7 30,570.37 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) SCHEDULE J COMMN DENTED EDENT NANIA BENEFICIARIES R S ESTATE OF FILE NUMBER Bachman, Betty L. 21-10-0031 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT Do N t List T stee s (Words) ($$$) I TAXABLE DISTRIBUTIONS [include outright spousal ~ distributions, and transfers under Sec. 9116 a 1.2 Gregory R. Bachman Son 114 of rest, 1245 Old Trail Road residue and Etters, PA 17319 remainder Michael R. Bachman Son 114 of rest, 6355 Creekview Road residue and Mechanicsburg, PA 17050 remainder Stephen D. Bachman Son 114 of rest, 7037 Benton Drive residue and Panama City, FL 32404 remainder Cheryl L. Fraser Daughter 1/4 of rest, P.O. Box 285 residue and Cleverdale, NY 12820 remainder Total Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 15 00 cover sheet, as a ro 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 Rtv-1500 cwtrc srltt t I Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 11-08) LAST WILL AND TESTAMENT OF BETTY L. BACHMAN s~ `~ L ~~~.. v ,~, ~` ., ~.,~ _w :~ e~ `~. I, BETTY L. BACHMAN, of Bowmansdale, Cumberland County, Pennsylvania, make, publish and declare this as and for my Last Will and Testament, hereby revoking all other Wills and Codicils heretofore made by me. FIRST: I give and bequeath all of my jewelry to my daughter, CHERYL L. FRASER. It is my desire that she distribute some of the family jewelry to my sons, STEPHEN D. BACHMAN, GREGORY R. BACHMAN, and MICHAEL R. BACHMAN. The distribution shall be in CHERYL L. FRASER'S absolute discretion, and shall not be binding on her in any manner. Should CHERYI, L. FRASER prede- cease me, I direct that this bequest be and become a part of my residuary estate to be distributed as set forth hereinbelow. SECOND: I give and bequeath to my children, STEPHEN D. BACHMAN, CHERYL L. FRASER, GREGORY R. BACHMAN, and MICHAEL R. BACHMAN, their choice of .any of my tangible personal property. I direct that the order in which STEPHEN D. BACHI~IAN, CHERYL L. FRASER, GREGORY R. BACHMAN and MICHAEL R. BACHMAN select items of my personal property shall be estzblished a,s follows: each child.... in order of descending age shall select one piece, without regard to that item`s value, as follows: the eldest child shall choose the first and eighth piece; the second eldest child shall choose the second and seventh piece; the third eldest child shall choose the third and sixth piece; and the youngest child shall choose the fourth and fifth piece, and thereafter continuing. Any items not selected by my children, shall be and become a part of my residuary estate to be disposed of as set forth hereinbelow. THIRD: I devise and bequeath all the rest, residue and remainder of my estate of whatever nature and wherever situate, ,~ -~ -' `..,.' including any property over which I hold power of appointment and together with any insurance policies thereon, in equal shares, to my children, STEPHEN D. BACHMAN, CHERYL L. FRASER, GREGORY R. BACHMAN, and MICHAEL R. BACHMAN, provided that should any of my children predecease me, I give and bequeath such child's share unto his or her issue per stirpes by representation, and if there be a failure of same, then I give and bequeath such deceased child's share to my surviving children as provided herein. F~URT~? s Shou l d ar_y o f my grandchi 1 dzen no t have attained the age of twenty-two (22) years at the time for dis- tribution to him or her, I give, devise and bequeath the share of each such grandchild to my hereinafter named Trustee or Trustees, IN SEPARATE TRUSTS, to hold, manage, invest and reinvest the shares so received, and to use and apply from time to time such portion of income and principal for the said grandchild's education (including college, trade school or other similar training or education), as my Trustee or Trustees, in their sole discretion, deem advisable. The Trustee or Trustees, in exercising their discretionary authority with respect to the payment of income or principal of the within Trust to my grand- children, shall take into consideration any income or other resources available to my grandchildren from sources outside this Trust. Any income or principal not so applied shall be dis- tributed to each grandchild when he or she attains the age of twenty-two (22) years. In the event any of my grandchildren die prior to the termination of this Trust established herein for their benefit, the interest of said grandchild in said Trust shall cease with any income and principal being divided evenly between or among that deceased grandchild's brothers or sisters or the separate Trusts established hereunder for their benefit and, in the absence of any brothers or sisters, or any Trusts 2 .,~ ,.,3 t~ V ~%"~~~ !~ ,~ established hereunder for their benefit, to my other grandchil- dren, or the Trusts established hereunder for their benefit, in equal shares. FIFTH: In addition to all powers granted to them by law and by other provisions of this Will, I give the fiduciaries acting hereunder the following powers, applicable to all proper- ty, exercisable without court approval and effective until actual distribution of all property: (A) To sell at public or private sale, or to lease, for any period of time, any real or personal property and to give options for sales, exchanges or leases,-for such prices and upon such terms (including credit, with or without security) or conditions as are deemed proper. This includes the power to give legally sufficient instruments for transfer of the property and to receive the proceeds of any disposition of st. (B) To partition, subdivide, or improve real estate and to enter into agreements concerning the partition, subdivi- sion, improvement, zoning or management of real estate and to impose or extinguish restrictions on real estate. (C) To compromise any claim or controversy and to abandon any property which is of little or no value. (D) To invest in all forms of property, including stocks, common trust funds and mortgage investment funds, without restriction to investments authorized for Pennsylvania fiduci- aries, as are deemed proper, without regard to any principle of diversification, risk or productivity. (E) To exercise any option, right or privilege granted in insurance policies or in other investments. (F) To exercise any election or privilege given by the Federal and other tax laws, including, but not necessarily being limited to, personal income, gift and estate or inheritance tax laws. 3 a 4j~]{ ,/ (G) To make distributions to my herein named benefici- aries in cash or in kind or partly in each. (H) To borrow money from themselves or others in order to pay debts, taxes, or estate or trust administration expenses, to protect or improve any property held under my will, and for investment purposes. (I) To select a mode of payment under any qualified retirement plan (pension plan, profit sharing plan, employee stock ownership plan, or any other type cf qualified plan) to the extent the plan or the law permits them to do so, and to exercise any other rights which they may have under the plan, in whatever manner they consider advisable. SIXTH: I nominate and appoint STEPHEN D. BACHMAN, as Trustee of the hereinabove described trust. In the event of the death, resignation or inability to serve for any reason whatso- ever of the said STEPHEN D. BACF~'lAN, I nominate and appoint CHERYL L. FRASER, as Trustee of the hereinabove described trust. I direct that my Trustee or Trustees shall serve without bond and shall receive fair and reasonable compensation. SEVENTH: I direct that all inheritance, estate, transfer, succession and death taxes, of any kind whatsoever, 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. EIGHTH: All interests hereunder, whether principal or income, which are undistributed and in the possession of the fiduciaries acting hereunder, even though vested or distribut- able, shall not be subject to attachment, execution or sequestra- tion for any debt, contract, obligation or liability of any beneficiary, and furthermore, shall not be subject to pledge, assignment, conveyance or anticipation. 4 NINTH: I nominate and appoint CHERYL L. FRASER, Execurix of this, my Last Wi11 and Testament. In the event of the death, resignation or inability to serve for any reason whatsoever of the said CHERYL L. FRASER, I nominate and appoint STEPHEN D. BACHMAN, Executor of this, my Last Will and Testament. I direct that my Executrix or Executor, Trustee or Trustees, as the case may be, and their successors, shall not be required to post security or a bond for the performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, this /~~~' day of June. 2004. BETTY BACHMAN Signed, sealed, published and declared by the above- named Testatrix as and for her Last Will and Testament in our presence, who, at her request, in her presence and in the presence of each other, have hereunto subscribed our names as attesting witnesses. Address Address 5