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09-20-10 (2)
15056051058 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN """_""" Po sox 2sosol 21 09 1185 Harrisburg, PA 17128-0601 RESIDENT DECEDENT i prior to 12-13-82;1 4. Limited Estate 4a. Future Interest Compromise (date of >~ 5. Federal Estate Tax Return Required death after 12-12-82) 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust _0..__. 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) ~ 9. Litigation Proceeds Received 10. Spousal Poverty Credit (date of death 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOUILD BE DIRECTED TO: Name Daytime Telephone Nuimber Michael Cherewka, Esq. (717) 232-4701 _. _ _ __ ___ _. Firm Name (If Applicable) _ _ _ REGISTER utLLS USE OI -{ The Law Offices of -~ _~ to _ _ __ _.. _ __ First line of address .. 1 ,,;, r-- , ,_ 624 North Front Street _.. y a'r`t ~ ~ ,' i i ~'li . ~,~; ~ o . ,,.. _ __ _ ............ .................................................................. . Second line of address , . - _ _. _.... .__...__ _ _. _..._. .._ __ ~,. ..._ ... ~m - :. _~- ; _ _. ... _ ....__ __ __ _ . . _ . . ~S? .: _ ... _ DA'~E FILED ~ ~ - City or Post Office State ZIP Code . ............................... ..............._...,,,............. ~ ._s 'Wormleysburg PA :17043 Correspondent's a-mail address: mcherewka@cherewkalaw.com Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of rriy knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. GN RE OF P ON RESPpbS LE FOR FILING RETURN DATE ADD ESS 624 North Front Street, Wormleysburg, PA 17043 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS 290 Pleasant Hill Road, Lewisberry, PA 17339 PLEASE USE ORIGINAL FORM ONLY Side 1 15056051058 15056051058 >n ,~` , ~~ 15056052059 REV-1500 EX Decedent's Name: Jean E Goodyear Number Decedent's Social Securit 201-18-6447 RECAPITULATION 1. Real estate (Schedule A) ............................................. 1. ' 196,725.36 __ _ _ _ _... _ .. _ .. _._ ................_......_.. _._ _..._.__._._W_........ 2. Stocks and Bonds (Schedule B) ....................................... 2. 118,672.82 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 0.00 4. Mort a es & Notes Receivable Schedule D 9 9 ( ) ............................. 4. 0.00 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ........ 5. 18,236.52 6. Jointly Owned Property (Schedule F) Separate Billing Requested ....... 6. 13,901.25 7. Inter-Vivos Transfers 8~ Miscellaneous Non-Probate Property ..H........:....._..._........ ._........~...,.....,::~.:....:..~ .................~...m....._......~ (Schedule G) Separate Billing Requested........ 7. 22,699.91 8. Total Gross Assets (total Lines 1-7) .................................... 8. 370,235.86 9. Funeral Expenses 8 Administrative Costs (Schedule H) ..................... 9. 26,297.82 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................ 10. 22,777.08 11. Total Deductions (total Lines 9 ~ 10) ................................... 11. ! 49,074.90 12. Net Value of Estate (Line 8 minus Line 11) .............................. 12. 321,160.96 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which .~..... m ~..,,~M ~.y.. an election to tax has not been made (Schedule J) ........................ 13. 0.00 14. Net Value Subject to Tax (Line 12 minus Line 13) ........................ 14. 321,160.96 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. ! 0.00 16. 17 18 19. TAX DUE ......................................................... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 15056052059 Side 2 15056052059 J REV-1500 EX Page 3 Decedent's Complete Address: 21 09 y 1185 DECEDENT'S NAME DECEDENTS SOCIAL SECURITY NUMBER Jean E Goodyear _ 201-18-6447 STREET ADDRESS 822 West Trindle Road CITY Mechanicsburg STATE PA ZIP 17050 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) 14,452.25 2. Credits/Payments 12 500.00 , A. Spousal Poverty Credit B. Prior Payments 0.00 C. Discount 657.87 Total Credits (A + B + C) (2) 13,157.87 3. InterestlPenalty if applicable D. Interest E. Penalty Total Interest/Penalty (D + E) (3) 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 1,294.38 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56) 1,294.38 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? .............................................................................................................. ^ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. ^ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before January 1, 1995, the~tax rate imposed on the net value of transfers to or for the use of the surviving spoused is three (3) percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for i:he use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. §9116(1.2) (72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116(a)(1.3)]. Asibling 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-15U2 EX~ (11-t38} ~ pennsylvania SCHEDULE A DEPARTMENT OF REVENUE INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT ESTATE OF FILE NUMBER Jean E. Goodyear 21-09-1185 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property that is jointly-owned with right of survivorship must be disclosed on Schedule F. Attach a copy of the settlement sheet if the property has been sold. ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE NUMBER OF DEATH DESCRIPTION 1' 822 West Trindle Road, Mechanicsburg, Cumberland County, PA; Sale Proceeds 121326.16 119,725.36 less repairs under sales agreement totally 1600.80c 2. Parcel of land, Tax Parcel #41-13-0108-018, Cumberland County, PA, Appraised Value 77,000.00 TOTAL (Also enter on Line 1, Recapitulation.) ~ 196,725.36 If more space is needed, insert additional sheets of the same size. ~,~ aitfiB ~4pprnvei iuc. z5nz~ta185 -- t~ A. Settlement S#atement (HUD-1) s. a of Loan 6. File Ntmbat: 7. I..DHn Nurttbar, e. Mo+tQage tnlursnce Cate rJumixr. ~.^ FiiA 2. [) RHS 3. (7~Carty. Uninu. tP.a9o 4. [~ VA 5. Q CvnY. t,+s. C, Fioba: 'rhta lbrrn 16 ftaytlshed fo pivs Ypu ^atetrme>tt n/aetuar aettlenrrntcasta. Arnowth pouf to and 6y the aat~an>rnf want ar^ shown. Ihma nteruse'~p.o.cj• trtfe pNd cublate Ms chimp 1My an ahr~wr; trsrr fbr rnfarnatlonal ptxpoaes aAd aro not k,efuBea' ~ the royals. , _....~. d. Warns rnd tsidrtN d Borrower. ~ E. Dame and Addreaf of StMer: F. Name and Addreeb of Candor: PttXrtela L. L^ubach FeteSi of Jan E. ~oalysar I NlGlta 1=Ar~o Bank, N.A. 5 VYtfkr Btrdh Laftr I hAeahaniartburp, PA t7(?50 t ! G. Praperylaoetlon: H. SaltlefnarttAyent: 26-ttl67tt2 t. $ettiamentU~te: BZ-' NJoet TMt~CI^ A.and' f~IfdaOOte Abstract Cotrtpar>ar Msc~haniotburq, PA 1'6.'10 2331 Market Strsat Auliutte 30, 2Gt 0 Gttrnbsyarrd County, Pennsylvani^ Camp Hill, PA 97611 Fh t"r1?t763-1383 Place of BettlarrtsrJ. ~ 2331 Ma-Ifst $U1Mt Cemo Httl. PA 1?tJt 7 Aue 8. 703. Cash ~ Gfwn ~~ To Bart+Ower I A2,690.4~ ....... 1716' undt:rSiatl areby a tmwtadge reCdlpt of a t~mpl^trc ropy of thb ateternent S erry att^ohmanb referrao t7 hsnin r~W'Irriver ~ S~Iher ~' / . P meta L La !` at Ja^n e. y~,~r _° ~%F_ ~,~ 7k vuUGt'>,~PQrh6 BK/en farlM- oaRrvfan d s,knftiYUf N fighMU0. K 35 mirnta pv rorpornr for eotlecirp, rrwWrvq, rnd rrParY~~g me lab. TFW rprnay~ rry rrt rareq wtia NarnlFvrt, tu14 you i» nal rrqurro k oomOirrN fhra tone, wJrhr k aupNyt ~ aungnoY vrid ONt7 tantd n~vrorr. Na a~dn,~wy Y 9tirwd. lr4s dirciwtrs a tnranOKery. 7hio ~ arripnrg to provWta the prriyr fa i RESPA oa+tr~0 A7rgxtm..irrt nrfn;mrwm Pegs 1 ot3 HU~1 (LAUBACM. PAMELA.PFPIt')-d30/d) ,brtl~nt Cl-a ss a.s rr;m ~.,...~.., s a.z~.ac ~r.JNr~ saK~s al tR.al Esiata Bratnr ~1 15noc r. fW,e~ ~I ~~N.°Or! p: ~lixnrsasc+rr Intro •~ .-- - rJ1-~,~.- to 't i A v ~~wa ,r,.....,^ , aG.00 r ~ fG" 4 D 11 `~ , r,Onim for; Ar fit 1 /~ I `"fit, +~~ )05. a4q. ; s to iM Co~ltMdiort Mritll l.Qan 49~rirom aFt ~i. Yt n otnt 95 or 4litS.00 . ~ .---- i c2 s n b0",, vrar a 1n11~Jan o1-~ o u ~ ott11s} for llie spoc~ tnter~e4t rate > t a h ) „ (from GFL V ~' FE ir1 495.00 6 , A 5t12. 'tour atodG cr o 3. four a oats or !n n .ar3a+ - , tram C fr0:n GF~ #3l- ROC:8380.0 81 14 B~. ~ raiscai ~ is F.ES ~~ from G'rE *"1 . 803. Cradit e rt to F.F A pct tom ~3} BO , ox ~ t i0 om # ' . Flso Carl n t~ (from ~or~ +til uvs. ~+ ~ _ gOg. (from ~ 81~;, ramaF 3 tram Rt tclrnd Q („eerwr fJO 6v Pald M Advanot 2 31i:6600C0 ' * 0) 23.32 ~G ~ CihO 9pt.~!nterrrtchor esfron, •08130/10 t0 09~ 3,x.. ~,t, ~! , !r~au.•ancc tommm tvr rnantfis :v _..~-----~- nCa for ra to Irtaurmrrce Co. r :B3__,. am ~k #i 1 e am Harts I Aram eFiie ~? i ~ 9014. _ - - from t3FE #1 i) s05. 1000. RMerva ftMi s>Srlttt lalndor 962.0E 1041. Initti~~ depaxii for your ~rscraw tacoount ~,~_._...~ -i-~-----~+ . .rnnsr+awner 4 . svrenca mon et man mdn E S - - . t~!vrttt~ ~ranu 1004. F>rnFa^h/ ta7oe. -.-------month n S uiriylax:ea mo ""'-'-"'-- montt., r month Nsoa+Jtrtnts $ A00.34 ip0~, ~~I-~~, r~ mpn * .75 r mOrth - IoolT!>:es . 0 morst-ta Ti. 3 {ieu month _ tooa_ "'- montlu__~i per month ; 1>JG7 monad ~ S per month $ 17x8. __ to 3 -193.59 1rZOb. ~a r ,Ad1usMWnl. ~~ ~ 10C. TMSe Clle ont ~ ;M4 j ? ,120.75 .5.i)( 11b1. Tithe a.rvir~t and lender's t~tia lrnuranco # ':101. 3ettletnanl a dod i~ Ovm e a Insurance ksdatate act Company nsurana Acct 1103 {kom 8 E #g 218.4 , 1 . mender's !e utanaE io .~atract Om a nfurnn~ Acct. ! a~~ . i 10ft. tandesis ilts ~ Ilm t ,~ ^ 1108. Ot~t7A1'A NIIQ DailO W'~~l 4 i8+t,0a4.40 p 30 $ 905 any t 10" onYs ~ailun of tits c>is+l titi• insuranca__orernium t0 MtdeteEe Pbstroi Com . 1'109. U,~detwritfw'Y o~rtiur~ of the total title iruurA4aeQrOmftml t0 MidEtilte Abstract Co"r~pat Iry n~urance 4c S~._ _ 123.43 1108 ,_,,, - - --- 1 i 10±' -- -- ---- 11 'l 1 -~- t 1 rt'd .,..------ ~ ._ 120A. Gorrt'Amtr>t Recardinp rand Trlrttaf~ef GhirpN ? 201. uav~emmest re0ardlnp Cha~~ 1c ~ecarder of Deeds OPhea 'irvrn GFE tt; (54.00 1202.Oaad S 52A0 aAor'.gage 3 Ga.00 Ralagsas $ Oihtir 5 t20?. Tr4ncfertapss T :a Rooord.r oflOwda Olflca (frRm OFE 1181 - 1,34D.00 . 7204 Gii 'ount. tsx/xt+~.M f $ 1,340.00 3 _ ~- 120b 51ata ta>ustampm $ _ -- ~~~ 1 340.OC ~.>~..~.- 17.bPt , _ 1207. _._.....,. 1300. Addit9ot->xl J~tWmMtt C M ' 13C1 ire sired wnrt~ac tha~ou can shop 4or + {front vFE ~b+ _ __ 119.00 _ 130^ ,•taad t'.EAfFfC4itnr to IhF~fi ~ t>q•~ ~._...r..~-.-.~ ,.... -------- 1303. i ox °+erViOe FM td L'VFR>= T5 S 100.00 __.~ 1304. _ 13Qb. Sae adafti dtsb. ~srhlsll to 8t?2.33 r,.._ 1400• TWali fiatUernfnt Chatoa (+fAtN' On IiRia fQ3, Sriatron J and aUtt tsactlon k1 3 865>9B 'I9.4y1,03 'IY ~W poyr t ,tt thk stt+um~M,1ly I~IOrW eewuwNayst r~oNpt a ~ ccr,~sst*a cry [t vo9r' z w rns: uw woo sr~umrms. r Midstate Atx+traC1 Gcmtae) ~ tltlamsr-t Anent ;;art"rfied `n to a true cry. Ptga 2 of 9 H~i'J-'I fU4U9AGrt.P4MElk.PFp/10-43G18) nparison et t3aacl Fll1h 6stimtttt (aFE~ end IiUD~1 Cherpat Gaod Faferr Eaflmiabtt FiU¢f .,_ra- at That Cannot 1nrraRSt fiUD~1 Lint Nrml»r i _ Our or~gindtbn sharps # t?tti _` 49s.0a a95.bG r Your crerlN or dta a (po-nte; for Uta ' irttar+ai refs allos4n # ISt?2 ~ Your ad wted a Ination charpea s 803 4S15,t)D 4D5.OJ lranahrtexee A1203 ~_--! _ 1.34C.00~~`5,340.00 Cho t Thet In Toni l;nnttoE htereae aAOre then 10'h 8aaal FstjtFl tEatltrtab H1113~•f -- Gcvemn»ntraeoRll cha etr rsi2Ci 1615.00 134.00 A ralsal fsl # 604 _ 380.00 380.00 Credit rt !r 806 14.84 14.84 _._. Total 5ti4.8A ~~ ~tB.t34 iruaeaes between OFE tlutd HUO-1 Charges i $ -8.00 or -1.p8 ...... CharyM Trial Cen Chenr~a QdGid Faith Estimate HUD••1 Initisldapaltforyouraac;cwacr_our,1 #i0D1 1,283,75 3t±2.D; Lally interest sh #901 i 1 t.8t'~OOOOrday 23.32 23.32 Horntawnar"s rneurance $ A03 373,4) _ 355.170 TINn>SetYiCtl And lender's Nik kleurattce #1101 ~' 1,Z78,tX1 1,tZ0.75 I Owner's title insurance to -AidstMt ApltraCi Company Infuranca ~ rlh 1 a9 - 2 id.UO - Food C.er88eatton iFt 302 -- 18.60 19.40 ,Tax9erviceFee Att31>+s ioo.Otn too.oo Loan Terms Your tniUal lean amount it - ~ 173 040 t1v r- Your loan Earn- it - 30 yeas Your inRlaf interest rata k 4.6250 96 Your urltlal mortUtly amount ovwrd for prEnwtE+al, intara,rt and 3 478,01 'nctudee any mortgage insuranet M ~ Rrhrrspal Q Interest t ^ Mor!9ape ineur•rnca Can your interest rats nle7 _ ® No ^ Y.a, ii can rise to a •naxbrrum of 9i. The firs! ohingt wiC ba ur and can chan9a agate every „" months after _ _ . Rtry ehanpt dolt, yk-ur Ineaest rats can Inert~ase or decxaast I py y:. Over 1hB Nte ~t the tale, your mtarstt raft is guararneaa sc ewer !~ lower !ttan 96 or higher then 9~. Even if you nttlke prymenta on tams, can your loan Getrtnov ties? ~ Ma ^ Yea, h ern rho to a maximum of ~ Even It gat: make plry~mtntt on tlme, can your monthly [] . Na Q Yes, the first innreeae cb.; be on nrxt the manfhiy amoune ewad for Wlncipat, interest, and matigape tnauranca thee? anwunt eubtd aqn tits ~ y__ The rrtaximtrn :t late tvm rise io M = ` r-" -- oaes yr~ur loan have a prepayment panahy7 ~ Y. No Yes, rout mnximunl ^ ^ Y prepayment pan~liy iy ~ toes your Ionn hsve r twtfoon payment? ^X hJo ^ Yae, yrx~ hove t t)allrron payment of ~` doe In"yenrs oc ' toil maRthiy amount awed including asarow aecaunt pdymt:rro ( ^ You do not hnv®e monthly escrow payment fcr!ierns, sucn as prcr~+nrty j taxes arld ttameownar's inaurarxt!.. You rhurt psr tbssa harts directly ~ ya:reeN l ® You h21vr an additiortal mo!tb~ly ssaovc payment pf;127.;18 that result ~ In n total Inwai marthty tr,etmt ;ru6+ad Qf StillQ,3'l. TAJs In~y;,,~~ prlnclDat. irterast, any rlai+gE~gr, ~nsurance~ and any Nome ehaduxi !~elcNr. [~, Prrpsrty trxee L^~ Homeowrrar'S insumnx ^ F!oaci irsurcnoe ^ - ~ O ^ Note; N }rou heva eny q~eatlone auout the Sdtilaman! Cheer and Leen Tsc'ns Utfad or thtd fUm~, piaese CDntac3 n,u lerrr slat Fay,' 9 of 3 HUC t (LA'JBACFI,PP.MELA.Prp/i a d30.+8j N0. ~ ~ ~ ~ ~ ~, _ Phone„ 432-9676 FAX: 432-3714 SHILLITO OIL, INC. 1014 York Road DILLSBURG, PA 17019 ~": ~ ~ ~3'~ -~~~,~ , ~j ., NAME ~ ~ ~~~v ~ DATE ~~ / ADDRESS ~ ~~ P '' ~~ TOWN ~ ~~ ~ PHONE `'~'~ TROUBLE REPORTED ORDER RECr'D. ~~~! BURNER MODEL TIME STARTED TIME FINISHED TOTAL TIME PARTS and MATERIALS: ~.. o ~ ~ r ~ - ~ ~t~ ~- ~ ~ ~' ~: THIS IS YOUR INVOICE AMOUNT -~ I'~ CUSTOMER'S SERVICE ~,~~~ SIGNATURE X MAN `t` The company assumes no responsibility for any damage to person or property cau plant after serviceman leaves premises except that resulting from its sole neglig Dillsburg Excavating & Septic, Inc. pAOAGHIC:16986 516• Range End Road Dillsburg, PA 17019 Phone: (717} 432-9704 Fax: (717) 432-3899 .: BILL TO ESTATE OF JEAN GOODYEAR C/O LOIS VALENCIA 290 PLEASANT HILL RD LEWISBERRY, PA. 17339 DATE INVOICE # 08/02/2010 68223 Customer Phone Customer Alt. Phone Customer Fax P.O. NO. TERMS 766-7480 C.O.D. DESCRIPTION DATE OF WORK AMOUNT Service by; Randy 822 W. Trindle Rd Mechanicsburg SEPTIC CLEANED 07/30/2010 263.00 SEPTIC INSPECTION 240.00 Thank you for your business. Total $so3.oo Clean, Install & Repair Complete Septic Systems -Equipment Rental- Water & Sewer Lines - Land Clearing -Trenching -Basement Excavating- Ponds -Grading -Storm Sewer Site Preparation If you choose to pay with a credit card there will be a 3% fee added for any amount totaling over $1000.00 per invoice/project. Township Pumper Inspection Reports will not completed or mailed until invoice paid in full. 822 West Trindle Road Re-wire dryer Remove old service Install new service base Replace breaker with proper size Per inspector Inspection i Hours 1 1 4 1 Parts $48.00 breakf;r, wire $120.00 wire meter ground rod $28.00 breake;rs $50.00 6hours Parts TOTAL: $150.00 $246.00 $396.00 REV-1503 EX+ (6-98) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE (NUMBER Jean E. Goodyear 21-C19-1185 All property jointly-owned with right of survivorship must be disclosed on Schedule F. (If more space is needed, insert additional sheets of the same size) Jean E. Goodyear Estate Schedule B 21-09-1185 ~ ~ l'~ !1._ __ ~ A.._ J. Series Denomination Serial Number Issue Date Date of DeathValue E 100 02029831097E Jan-77 552.16 E 50 L2046853366E Jan-77 276.08 E 100 02029831105E Jan-77 552.16 E 50 L2046853375E Jan-77 276.08 E 100 02029831131E Feb-77 552.16 E 100 02029831138E Feb-77 552.16 E 100 02029831164E Mar-77 552.16 E 100 02029831172E Mar-77 552.16 E 100 02029831179E Mar-77 552.16 E 100 02038892181E Apr-77 552.16 E 100 02038892188E Apr-77 552.16 E 100 C2038892196E0 Apr-77 552.16 E 100 02044579295E Jul-77 558.68 E 100 02050572813E Sep-77 558.68 E 100 02050572823 Oct-77 558.68 E 100 02050572831E Oct-77 558.68 E 100 02050572838E Oct-77 558.68 E 100 02050572839E Oct-77 558.68 E 100 02050572842E Oct-77 558.68 E 100 02050572894E Dec-77 513.80 E 100 02050572922E Jan-78 513.80 E 100 02050572932E Jan-78 513.80 E 100 02050572933E Jan-78 513.80 E 100 02050572954E Feb-78 513.80 E 100 02050572955E Feb-78 513.80 E 100 02050572986E Mar-78 434.16 E 100 02057689809E Apr-78 434.16 E 100 02057689833E May-78 426.68 E 100 02057689841E May-78 426.68 E 100 02057689850E May-78 426.68 E 100 02067730763E Jul-78 427.88 E 100 02067730769E Jut-78 427.88 E 100 2067730793E Aug-78 427.88 E 100 C2070502330E0 Sep-78 427.88 E 100 02076251855E Oct-78 427.88 E 100 02076251857E Oct-78 427.88 E 100 02076251862E Oct-78 427.88 E 100 02076251886E Oct-78 427.88 E 100 02076251907E Nov-78 431.92 E 100 02076251908E Nov-78 431.92 E 100 02076251927E Nov-78 431.92 E 100 02076251972E Dec-78 433.08 E 100 02076251993E Jan-79 433.12 1 Jean E. Goodyear Estate Schedule B Series Denomination Serial Number Issue Date Date of DeathValue E 100 02079985472E Jan-79 433.12 E 100 02079985489E Feb-79 433.12 E 100 02079985518E Feb-79 433.12 E 100 02083589037E Mar-79 433.12 E 75 K214295163E Apr-79 324.84 E 100 02083589051E Apr-79 433.12 E 100 02083589099E Apr-79 433.12 E 25 Q6339574429E Apr-79 108.28 E 100 02087151381E Apr-79 433.12 E 100 02093987957E Aug-79 438.36 E 100 02093987962E Aug-79 438.36 E 100 02093987978E Sep-79 438.36 E 100 02093987989E Sep-79 438.36 E 100 02093988027E Oct-79 438.36 E 100 02093988032E Oct-79 438.36 E 100 02096353552E Oct-79 438.36 EE 100 C687808EE Jan-80 325.00 EE 100 C687809EE Jan-80 325.00 EE 100 C687863EE Feb-80 325.00 EE 100 C687864EE Feb-80 325.00 EE 100 C687875EE Mar-80 325.00 EE 100 C687876EE Mar-80 325.00 EE 100 C80671052EE Feb-85 185.48 EE 100 C80671053EE Feb-85 185.48 EE 100 083991361 EE Mar-85 185.48 EE 100 C83991362EE Mar-85 185.48 EE 100 C83991372EE Mar-85 185.48 EE 100 C83991375EE Mar-85 185.48 EE 100 C142174906EE Jun-87 154.08 EE 100 C142174907EE Jun-87 154.08 EE 100 C142174908EE Jun-87 154.08 EE 100 C142174909EE Jun-87 154.08 EE 100 C142174910EE Jun-87 154.08 EE 100 0142174911 EE Jun-87 154.08 EE 100 C142175010EE Jun-87 154.08 EE 100 0142175011 EE Jun-87 154.08 EE 100 C1421750i 2EE Jun-87 154.08 EE 500 D19055796EE Apr-88 740.40 EE 500 D19055797EE Apr-88 740.40 EE 500 D19055798EE Apr-88 740.40 EE 500 D19055799EE Apr-88 740.40 EE 500 D19055800EE Apr-88 740.40 EE 500 D19055801 EE Apr-88 740.40 21-09-1185 2 Jean E. Goodyear Estate Schedule B Series Denomination Serial Number Issue Date Date of DeathValue EE 500 D19055802EE Apr-88 740.40 EE 500 Di 9055803EE Apr-88 740.40 EE 100 0189889121 EE May-89 142.36 EE 100 C189889122EE May-89 142.36 EE 100 C189889123EE May-89 142.36 EE 100 C189889125EE May-89 142.36 EE 100 C189889126EE May-89 142.36 EE 100 0202179281 EE Jul-89 139.56 EE 100 C202179282EE Jul-89 139.56 EE 100 C202179283EE Jul-89 139.56 EE 100 C202179284EE Jul-89 139.56 EE 100 C202179285EE Jul-89 139.56 EE 100 C202179336EE Jul-89 139.56 EE 500 D21737503EE Aug-89 697.80 EE 500 D21737504EE Aug-89 697.80 EE 500 D21737505EE Aug-89 697.80 EE 500 D21737506EE Aug-89 697.80 EE 200 R57789809EE Mar-90 273.60 EE 200 R57789810EE Mar-90 273.60 EE 200 857789811 EE Mar-90 273.60 EE 200 R57789812EE Mar-90 273.60 EE 200 R57789813EE Mar-90 273.60 EE 200 R57789814EE Mar-90 273.60 EE 500 D27133347EE Nov-90 670.60 EE 500 D27133348EE Nov-90 670.60 EE 500 D27133349EE Nov-90 670.60 EE 500 D27133350EE Nov-90 670.60 EE 500 D27133351 EE Nov-90 670.60 EE 500 D27133352EE Nov-90 670.60 EE 500 D27133353EE Nov-90 670.60 EE 500 D27133354EE Nov-90 670.60 EE 500 D27585864EE Mar-91 657.60 EE 500 D27585865EE Mar-91 657.60 EE 500 D27585866EE Mar-91 657.60 EE 500 D27585867EE Mar-91 657.60 EE 500 D27585868EE Mar-91 657.60 EE 500 D27585869EE Mar-91 657.60 EE 500 D27594964EE Apr-91 657.60 EE 500 D27594965EE Apr-91 657.60 EE 500 D27594966EE Apr-91 657.60 EE 500 D27594967EE Apr-91 657.60 EE 500 D27594968EE Apr-91 657.60 EE 500 D27594969EE Apr-91 657.60 21-09-1185 3 Jean E. Goodyear Estate Schedule B Series Denomination Serial Number Issue Date Date of DeathValue EE 500 D27594970EE Apr-91 657.60 EE 500 D27594971 EE Apr-91 657.60 EE 500 D27594972EE Apr-91 657.60 EE 500 D27594973EE Apr-91 657.60 EE 500 D27594974EE Apr-91 657.60 EE 500 D27594975EE Apr-91 657.60 EE 500 D27594976EE Apr-91 657.60 EE 500 D27594977EE Apr-91 657.60 EE 500 D27594978EE Apr-91 657.60 EE 500 D27594979EE Apr-91 657.60 EE 500 D27594980EE Apr-91 657.60 EE 500 D27594981 EE Apr-91 657.60 EE 500 D27594982EE Apr-91 657.60 EE 500 D27594983EE Apr-91 657.60 EE 500 D27594984EE Apr-91 657.60 EE 500 D27594985EE Apr-91 657.60 EE 500 D27594986EE Apr-91 657.60 EE 500 D27594987EE Apr-91 657.60 EE 500 D27594988EE Apr-91 657.60 EE 500 D27594989EE Apr-91 657.60 EE 500 D27594990EE Apr-91 657.60 EE 500 D27594991 EE Apr-91 657.60 EE 500 D27594992EE Apr-91 657.60 EE 500 D27594993EE Apr-91 657.60 EE 500 D27594994EE Apr-91 657.60 EE 500 D27594995EE Apr-91 657.60 EE 500 D27594996EE Apr-91 657.60 EE 500 D27594997EE Apr-91 657.60 EE 500 D27594998EE Apr-91 657.60 EE 500 D27594999EE Apr-91 657.60 EE 500 D27595000EE Apr-91 657.60 EE 500 D27595001 EE Apr-91 657.60 EE 500 D27595002EE Apr-91 657.60 EE 500 D27595003EE Apr-91 657.60 EE 200 R71597585EE May-91 263.04 EE 200 R71597586EE May-91 263.04 EE 200 R71597587EE May-91 263.04 EE 200 R71597588EE May-91 263.04 EE 200 R71597589EE May-91 263.04 EE 200 R71597590EE May-91 263.04 EE 200 871597591 EE May-91 263.04 EE 500 D40197831 EE Oct-93 485.40 EE 500 D40197832EE Oct-93 485.40 21-09-1185 4 Jean E. Goodyear Estate Schedule B 21-09-1185 Series Denomination Serial Number Issue Date Date of DeathValue EE 500 D40197833EE Oct-93 485.40 EE 500 D40197834EE Oct-93 485.40 EE 500 D40197835EE Oct-93 485.40 EE 500 D40197836EE Oct-93 485.40 EE 500 D40197837EE Oct-93 485.40 EE 500 D40197838EE Oct-93 485.40 EE 500 D40197839EE Oct-93 485.40 EE 500 D40197840EE Oct-93 485.40 EE 500 D40197841 EE Oct-93 485.40 EE 500 D40197842EE Oct-93 485.40 EE 500 D40197843EE Oct-93 485.40 EE 500 D40197844EE Oct-93 485.40 EE 500 D40197845EE Oct-93 485.40 EE 500 D40197846EE Oct-93 485.40 EE 500 D40197847EE Oct-93 485.40 EE 500 D40197848EE Oct-93 485.40 EE 500 D40197849EE Oct-93 485.40 E E 500 D40197850 E E Oct-93 485.40 EE 500 D40197851 EE Oct-93 485.40 EE 500 D40197852EE Oct-93 485.40 EE 500 D40197853EE Oct-93 485.40 EE 500 D40197854EE Oct-93 485.40 EE 500 D40197855EE Oct-93 485.40 EE 500 D40197856EE Oct-93 485.40 EE 500 D40197857EE Oct-93 485.40 E E 500 D40197313 E E Oct-93 485.40 EE 500 D40197314EE Oct-93 485.40 EE 500 D40197315EE Oct-93 485.40 EE 50 L515293437EE Oct-93 48.54 EE 100 C434101907EE Oct-93 97.08 EE 500 D40197809EE Oct-93 485.40 E E 500 D40197810 E E Oct-93 485.40 EE 500 D40197811 EE Oct-93 485.40 EE 500 D40197812EE Oct-93 485.40 EE 500 D40197813EE Oct-93 485.40 EE 500 D40197814EE Oct-93 485.40 EE 500 D40197815EE Oct-93 485.40 EE 500 D40197816EE Oct-93 485.40 EE 500 D40197817EE Oct-93 485.40 E E 500 D40197818 E E Oct-93 485.40 EE 500 D40197819EE Oct-93 485.40 EE 500 D40197820EE Oct-93 485.40 EE 500 D40197821 EE Oct-93 485.40 Jean E. Goodyear Estate Schedule B Series Denomination Serial Number Issue Date Date of DeathValue EE 500 D40197822EE Oct-93 485.40 EE 500 D40197823EE Oct-93 485.40 EE 500 D40197824EE Oct-93 485.40 EE 500 D40197825EE Oct-93 485.40 EE 500 D40197826EE Oct-93 485.40 EE 500 D40197827EE Oct-93 485.40 EE 500 D40197828EE Oct-93 485.40 EE 500 D40197829EE Oct-93 485.40 EE 500 D40197830EE Oct-93 485.40 EE 500 D40197858EE Oct-93 485.40 EE 500 D40197859EE Oct-93 485.40 EE 500 D40197860EE Oct-93 485.40 EE 500 D40197861 EE Oct-93 485.40 EE 500 D40197862EE Oct-93 485.40 EE 500 D40197863EE Oct-93 485.40 EE 500 D40197864EE Oct-93 485.40 EE 500 D40197865EE Oct-93 485.40 EE 500 D40197866EE Oct-93 485.40 EE 500 D40197867EE Oct-93 485.40 EE 500 D40197868EE Oct-93 485.40 EE 500 D64175923 Jul-98 387.20 EE 500 D64175924EE Jul-98 387.20 EE 500 D64175925EE Jul-98 387.20 EE 500 D64175926EE Jui-98 387.20 EE 500 D64175927EE Jul-98 387.20 EE 500 D64175928EE Jul-98 387.20 EE 500 D64175929EE Jul-98 387.20 EE 500 D64175930EE Jul-98 387.20 EE 500 D64175931 EE Dec-98 377.60 EE 500 D64175932EE Dec-98 377.60 EE 500 D64175933EE Dec-98 377.60 EE 500 D64175934EE Dec-98 377.60 EE 500 D64175935EE Dec-98 377.60 EE 500 D64175936EE Dec-98 377.60 EE 500 D64175937EE Dec-98 377.60 EE 500 D64175938EE Dec-98 377.60 EE 100 C829875249EE Jan-01 68.40 EE 100 C829875250EE Jan-01 68.40 EE 100 0829875251 EE Jan-01 68.40 EE 100 C829875252EE Jan-01 68.40 EE 100 C829875253EE Jan-01 68.40 EE 100 C829875254EE Jan-01 68.40 EE 100 C829875255EE Jan-01 68.40 21-09-1185 6 Jean E. Goodyear Estate Schedule B 21-09-1185 Series Denomination Serial Number Issue Date Date of DeathValue EE 100 C829875256EE Jan-01 68.40 EE 100 C829875257EE Jan-01 68.40 EE 100 C829875258EE Jan-01 68.40 $118,672.82 7 REV-1507 EX+ (6-98) SCFIEDIJLE D COMMONWEALTH OF PENNSYLVANIA MORTGAGES & NOTES INHERITANCE TAX RETURN RECEIVABLE RESIDENT DECEDENT ESTATE OF FILE NUMBER Jean E. Goodyear 21-09-1185 All property jointly-owned with right of survivorship must be disclosed on Schedule F. fir more space is needed, insert additional sheets of the same size) REV-1508 EX+ (6-98) SCHEDI~LE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Jean E. Goodyear 21-09-1185 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Miscellaneous furniture, furnishings, household items 1,500.00 2. PNC Bank, Money Market Account #50-3000-1488 10,020.22 3. PNC Bank, Checking Account #50-7008-1398 1 537.20 4. Yard Sale Proceeds 27.00 5. Refund -Penn Waste Trash & Homeowners Insurance 14.47 6. Refund State Farm Homeowners Insurance 137.63 TOTAL (Also enter on line 5, Recapitulation) 3 13,236.52 (If more space is needed, insert additional sheets of the same size) C7 2 m n 0 .p j w w 0 N O .1 0 L (D LU O O ~. (D N -, C7 cfl n O r+ n~ ~A Y v D m ~ z ~' m ~ O !~ o m j ~. _ _. ~. ~ J ~~. ~ T S ~~ O ~~ ~ ~o m J N :~ D O C Z O n O C Z o D o ~ o ~ Z m v -Is f O ~ Z D cr ~ t p N N 0 r~+ -~ ~ o ~ o ~rn N / ~ ~ ~~ ~ j ~ oZ Z C !'~ n v c~ ~, m -o ~O n ~ N O ~ N 4 ~ ~ ~ N ~ ~ ~ o C7 ~" ~~,. ,..G, p Q O ~ UN ~ .a 6 o CD .~G lL. N N n N O Q ~' m ~ n N G .-+ ~ ~ -+. CD N O ~'~' ~. ~ O o ~ .a _. ~ 3 .~ ~, r `~ ~. ~ C1 c`n ~ m ;~, ~ in ~ ~ c m ~9 ~. ~~ ~. y 6 C,~ N CAD L _, 0 c~ 0 s~ c~ c ~ • w f I mN o 1 ~ _o v ~g~ rn o ~ m ~~ ~ H~i9 n H~ N~ ~ fl+ ?a V'- ~'d rn 3 -~ z ~ ~ m o u~mv ., Z ~, om ~ qd o O c n a N ° ~ O G '~ ~ w -G ~ n ~ .C`~ O W ?r t7~ .9 0 ...1 w Z ~ ~ -n v -o o o m m n o Zn n2 < ~ , O c-o m ~ ~ ~ m 0 o ~ w .< ^~ ~ ~ Z~ rnm ©~ ~ ~ ~~ O ~ W O ~ ~ m 0 m 9 /~. r~ ~ r ~ art n ~~ r ~, ~ ~~ '+ '~ " n '1 f A ~ y -~ n ,n, r. ! % f q , r ~, ~' r, ~~' ~~t~~~ d ~~ !~~ ;- j Vic:] rG~~, ; ' 7; i . ~, ~~ ~, i t,, 1~ ~ ~~ f1~Y d'~, r ~~ ~~ t.EAtr~MG T~~ ~i4f/t~' A~ri12, ~O1.0 ~Uticba~l Chegewka, Esq. 6?~ North Franc St '4~Varmlcysbtug, PA 1744:3 RE: Jean Goc-dyea.M SSN: 201-18-b44'~ DOI1: 12-14-2C~9 I~.r Ivf r. Ck~et~~wka: Ir raspansc to your request fox Daie of Death (DOD) balances f'or the ctz5tomer noted a~aov~:, a~t~r records show the ~vllov~~ng: Checking ~ccoan~ ~ccGUnt #.5070081398 Established: 41 ••O1- 1979 JEAN GOODYEAR DaD balance: $ I,537.2t1 + 0.00 accrued interest ~rtarest paid 0I -O1-2C'09 thru 12-14-2Q09 $ C?.O1 YTD Satt~ings account Accoutat # 5031~Od 1488 Established: O1--C~ 1-19 i 9 JEAN' GOaDYE.4R DUD balance: $ I t~,Q20.2~ -~- C}.35 a~cxued interest Interest paid Ol -t~? -2Q09 #bxu 12-14-2009 ~ 25.59 YTD Please note that t~:is offica provides date cf death balances fc~r depc,sit accounts (1RAs, CDs, ~heel:irg end Sa~~ings). 'V~'e da not process any ~nanei~! transs~eti~n.R ar provide statements. if ycu need assist~ce with arty of t~}iesc items; ~plsase call 1-888-P1~C-$ANK (.l -888-76~-z26~) or atop by your local PNC Sark branch office. . Sincerely, ~l~tional Financial SerSrices Center P'~1C ~, ~l.A. IvScnbcr F:I3IC Page 1 of 1 REV-1509 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDI~ILE F JOINTLY OWNED PROPERTY ESTATE OF FILE NUMBER Jean E. Goodyear 21-09-1185 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 RELATIONSHIP TO DECEDENT A..Sharon G. Hanks 648 Lopax Road Daughter_ Harrisburg, PA 17112 B. Lois J. Valencia ' 290 Pleasant Hill Road Daughter Lewisberry, PA 17339 C. JOINTLY-OWNED PROPERTY: ITEM LETTER FOR JOINT DATE MADE DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH % OF DECD'S DATE OF DEATH VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. See List of Savings Bonds Attached. Joint Name with Lois Valenica 14,855.52 ' o S0 /0 7,427.76 2• A 03/14/07 Sovereign Bank, Account #0575137633 12,935.97 ' S0% 6,473.49 TOTAL (Also enter on lin e 6, Recapitulation) S 13,901.25 (If more space is needed, insert additional sheets of the same size) Jean E. Goodyear Estate Schedule F 21-09-1185 Jointly Owned Bonds Series Denomination Serial Number Issue Date Value EE 500 D64352648EE Au -89 697.80 EE 500 D64352649EE Au -89 697.80 EE 500 D64352650EE Au -89 697.80 EE 500 D64352651EE Au -89 697.80 EE 100 C832216681EE Ma -89 142.36 EE 100 C832216682EE Ma -89 142.36 EE 100 C832216683EE Ma -89 142.36 EE 100 C832216684EE Ma -89 142.36 EE 100 C832216685EE Ma -89 142.36 EE 100 C832216686EE Ma -89 142.36 EE 100 C832216687EE Jul-89 139.56 EE 100 C832216688EE Jul-89 139.56 EE 100 C832216689EE Jul-89 139.56 EE 100 C832216690EE Jul-89 139.56 EE 100 C832216691EE Jul-89 139.56 EE 100 C832216692EE Jul-89 139.56 EE 100 C832216660EE Jan-80 325.00 EE 100 C832216661EE Jan-80 325.00 EE 100 C832216662EE Feb-80 325.00 EE 100 C832216663EE Feb-80 325.00 EE 100 C832216664EE Mar-80 325.00 EE 100 C832216665EE Mar-80 325.00 EE 100 C832216666EE Feb-85 185.48 EE 100 C832216667EE Feb-85 185.48 EE 100 C832216668EE Mar-85 185.48 EE 100 C832216669EE Mar-85 185.48 EE 100 C832216670EE Mar-85 185.48 EE 100 C832216671EE Mar-85 185.48 EE 100 C832216672EE Jun-87 154.08 EE 100 C832216673EE Jun-87 154.08 EE 100 C832216674EE Jun-87 154.08 EE 100 C832216675EE Jun-87 154.08 EE 100 C832216676EE Jun-87 154.08 EE 100 C832216677EE Jun-87 154.08 EE 100 C832216678EE Jun-87 154.08 EE 100 C832216679EE Jun-87 154.08 EE 100 C832216680EE Jun-87 154.08 EE 500 D64352640EE A r-88 740.40 EE 500 D64352641EE A r-88 740.40 EE 500 D64352642EE A r-88 740.40 EE 500 D64352643EE A r-88 740.40 Jean E. Goodyear Estate Schedule F 21-09-1185 Jointly Owned Bonds Series Denomination Serial Number Issue Date Value EE S00 D64352644EE A r-88 740.40 EE 500 D64352645EE A r-88 740.40 EE 500 D64352646EE A r-88 740.40 EE 500 D64352647EE A r-88 740.40 14,855.52 Page: 1 Document Name: untitled DDHIST Time Deposit Display History 6017 02/18/10 Acct 0575137633 Alpha key GOODYJE.O1 Reques t ALLTRANS INT PYMT Trans date 09/30/09 Pymt date 09./30/09 Amt 21.91 CV 12,891.30 INT PYMT Trans date 10/30/09 Pymt date 10/31/09 Amt 22.68 CV 12,913.98 INT PYMT Trans ate 11/30/09 Pymt date 11/30/09 Amt ~- ~ a ~ ~ 21.99 ... a n ~ CV 12 , 9 3 5 .9 7 ~~-~- ~c~rc 5 -~- a -;.~ ..- ~ ~~ ~ . rte. ~ ,-.-H~~ INT PYMT Trans date 12 Z`/09 Pymt date 12/31/09 Amt 22.76 CV 12,958.73 INT PYMT Trans date 01/29/10 Pymt date 01/31/10 Amt 22.81 CV 12,981.54 TDDHISTREQ TDDINT _ TDDMAIN TDCMISC _ TDDHISTMONEY Last page of _ information. _ _ GN20000I02 COMMAND =__> F2=Retrieve F3=Exit F4=CRFwindow F6=Toggle F7=Backward ~r r Date: 2/19/2010 Time: 3:33:32 PM REV-1510 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCMEDIJLE 6 INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER Jean E. Goodyear 21-09-1185 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 NUMBS DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENTAND THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1 ~ Sovereign Bank IRA Retirement Account #0575137633 22,699.91 100 0.00 22,699.91 TOTAL (Also enter on line 7 Recapitulation) S I 22,699.91 (If more space is needed, insert additional sheets of the same size) Page: 1 Document Name: untitled DDHIST Time Deposit Display History 6017 02/18/10 Acct 0578113 193 Alpha key GOODYJE.O1 Request ALLTRANS INT PYMT TRANS DATE 12/31/08 PYMT DATE 12/31/08 AMT 30.98 CV 22,468.09 INT PYMT TRANS DA 06/30/09 P DATE 06/30/09 AMT 231.82 CV 22,699.91 CK ## HIST TRANS DATE 12/22/09 ORIG/RERUN ORIGINAL CK SEQ NBR 35500478 CK NBR 9918358 CK PYMT DT 12/27/09 CK AMT 2,915.85 FTW 0.00 DISB PYMT TRANS DATE 12/24/09 PYMT DATE 12/27/09 AMT 2,915.85 DISB METHOD 2 CV 19,784.06 INT PYMT TRANS DATE 12/31/09 PYMT DATE 12/31/09 AMT 237.45 CV 20,021.51 TDDHISTREQ TDDMAIN TDDINT TDCMISC TDDHISTMONEY _ Requested function ignored. (Not app _ _ ropriate for this situation). GN25010E02 COMMAND =__> F2=Retrieve F3=Exit F4=CRFwindow F6=Toggle F7=Backward Date: 2/19/2010 Time: 3:35:33 PM r REV-1511 EX+ (12-99) SCHEDULE H FUNERAL EXPENSES & COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Jean E. Goodyear 21-09-1185 Debts of decedent must be reported on Schedule L ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1 ~ Myers Funeral Home 9,199.00 2. Pastors as requested: Ray & Ruth Pace of Atlanta, GA 1, 302.40 s.' Funeral Luncheon 562.28 4. Funeral Clothing Items 26.48 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions 0.00 Name of Personal Representative(s) Social Security Number(s)IEIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees 14, 500.00 '' 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 0.00 Claimant Street Address City State _ Zip Relationship of Claimant to Decedent 4. Probate Fees 434.50 5. Accountant's Fees 0.00 6. Tax Return Preparer's Fees 0.00 ~. Legal Notices -Cumberland Law Journal 75.00 s. Legal Notices -The Sentinel 198.16 TOTAL (Also enter on line 9, Recapitulation) $ ' 26,297.82 (If more space is needed, insert additional sheets of the same size) 1 11 Q ~ ~ (n 1 air C3~ Y O ~+ r ~~G u '3 V +1 G AGK. M G Q. W y~r _ ~ • . A a 0~ M ~ m N G'~ "'~ ~ N C~ ~? g ~ ~ .. O ~ ~ ~ ^ ~ ~ a ~ ~ ~ ~ ~ ~~ ~ ' ~ ~ r tD 1.1 ~ m ~ ,r --.,. ~ ~ d N ~ ~ ^~... .D ~ p + ~ ~ rt. / .-„ o t , -c G r C -: ~ a ,r- ~ a ~ d ; ~ fl' -fl ~ „x ~ ~ A ~ 'a`' n ,p ` ~ .. ~~oo- ~ rn p o. 47 ~ a : ~ ~ ' ~,~ s ;, tv ~ ~t ~ t ~ ~- m m 0 .~, - r '' ~~ a r. • 'r xL~" iL! ~ ~ .~~' ~ • C~ • r~ ~r 12/15/2009 5:41:16 P~~1 Server: Christie Check 1 00 1 4 Tab 1 c 1 C9 Seat 1 1 Wi 11 ie 1,%~ 4.99 Unsweete~ ~~:; ~ Iced Tea l . 9t) GOH $ _ 4 tUr) 1 Filet hi~g~~ 18.9y ADD LOAD 1. 0.99 Pepsi 1.99 Seat 2 1 4~JilliP li3 ,},g~ (Jnsweeterieci Tce~i ~fea 1.yg GON $ ~ 4.93 ~ ~f1 i ~n~i i r i i c ~. nay . ~~. -~., Diet Pepsi 1,99 Seat 35 2 Decaf Coffee 3 ,15 Fishbowl Birthda - 5.00 GOH $ - 4.99 5ubTotal 449.54 Tax 26.97 Gratuity 55.77 Tata ~ 56~ r 2~ Cash 5b2.25 Tell Us Now We Did! You could Win $1,Q00 in cash! Visit our website at: www.hasss.cam far official rules ar7d to complete the survey. Enter the survey code be 1 i~w Survey Code:1610-1~347~-5101-1478 10 meals each under $10 limited time Buy $4U 'in gift cards and ge t a Free sandwich, fries, and drink! i oral uru rrui rrir~ rnri uru uri uu ~ Z ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~~ ~ ~y a ~. o ~ d ~ pw 7~ Q ~ h 9 ~ ~ ~ ~~ ~ a~ n ~ o ~ x~ d ~~_~, ~ ~ ~ O o a o a. 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O R1 % N ~ .,, co p A ? a ' ~; - .~ ~ t- s d 4. ~o t ^~ y n a. `~ a o ~.. ~ ~ ~ o o '~ N ~ ~" N ~ ~ *-, aQ ~ N ~ ~~ O (O ~ ~~ ~~,,, ~ ti ~- ar ~ _ _ S C~ O J -~= ~ ~ _ _----- ~_ ro "' ~ 1 o y r a ~,- cr (n O ti ~ f1 (V ~ y ~ o~ -~~ ~~ as t O ~ ~ s~ ~ o - hh < N ~i ~ s o O ac N ~ ~ ~ o ~ ~ ~.k n ~ ~ r ~ ~ .~ ~ ,: ~ ~ ~ ~- e N ~ t0 O ~ p d d a w 'o N 0 RECEIPT FOR PAYMENT ------------------- ------------------- GLENDA FARNER STRASBAUGH Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17613 GOODYEAR JEAN E Estate File No.: 2009-01185 Paid By Remarks: JOHN M EAKIN JN ------------------------ Receipt Distribution Receipt Date: 12/23/2009 Receipt Time: 10:32:14 Receipt No.: 1059407 Fee/Tax_ Description Payment Amount Payee Name PETITION LTRS TEST 360.00 CUMBERLAND COUN'T'Y GENERAL FUN WILL 15.00 CUMBERLAND COUN`T'Y GENERAL FUN SHORT CERTIFICATE 16.00 CUMBERLAND COUNTY GENERAL FUN CODICIL 15.00 CUMBERLAND COUN~PY GENERAL FUN JCS FEE 23.50 BUREAU OF RECEIPTS & CNTR M.D AUTOMATION FEE 5.00 CUMBERLAND COUN~PY GENERAL FUN ~~ C~~ ~.-~-- ~ r~_ ~~. ---------------- 4 3 4 . 5 0 Total Received......... 434.50 CUMBERLAND LAW JOURNAL 32 SOUTH BEDFORD STREET CARLISLE, PA 17013 Telephone - 717 249-3166 Faz - 717 249-2663 January 22, 2010 Cumberland Law Journal is published every Friday by the Cumberland County Bar Association and is designated by the Court of Common Pleas as the official legal publication for Cumberland County and the legal newspaper for publication of legal notices. TO: John M. Eakin, Esquire Jean E. Goodyear Estate RE: All legal advertising must be paid in advance. Make all checks payable to: Cumberland Law Journal. Advertisement publication date: January 8, January 15, and January 22, 2010 Advertising Cost $ 75.00 Proof of Publication $ 0.00 Second Proof Request $ 0.00 Payment received $ 75.00 Total Amount Due $ 0.00 RETAIN THIS PORTION FOR YOUR RECORDS REMITTANCE ADDRESS BILL TO HE SENTINEL - LEGAL JOHN M., ATTY. EAKIN P.O. BOX 130, CARLISLE, PA 17013 AD NUMBER CLASS SALESPERSON BILLING DATE LINES 378894 10 PUBLIC NOTICES wo1fC 01/13/10 36 * 2 AD DESCRIPTION START DATE STOP DATE EXECUTOR NOTICE LETTERS TESTAMENTA 12/30/09 01/13/10 PUBLICATION INSERTIONS RATE NET AMOUNT GROSS AMOUNT 3 THE SENTINEL - LEGAL 3 LGL 191.16 TOTAL AD CHARGE 191.16 3 PROOF OF PUBLICATION DAYS RUN PURCHASE ORDER Est.J.Goodyear O1PRF 1 7.00 PAY THIS AMOUNT I 198.16 237.79* AFTER 02/12/10 MESSAGE: Thank you for advertising with The Sentinel. Deadlines for in-column legal advertisements: Monday is Thursday at 5 p.m; Tuesday is Friday at 5 p.m.; Wednesday is Monday at 5 p.m; Thursday is Tuesday at 5 p.m; Friday is Wednesday at 5 p.m Saturday °~~~is Wednesday at 12 Noon; Sunday is Wednesday.. at 5 p . m. If you have any questions regarding your Legal bill please call Classified Manager at 717-240-7176 .Fax your legals to 717-243-3754 attention Classified Manager You can also EMAIL your legal to Classified ads: classifiedCcumberlink.com Please send a cover letter including your name and address as an attachment DETACH AND RETURN THIS PORTION WITH YOUR PAYMENT THE SENTINEL -LEGAL Est . J. Goodyear D n RnX 1 ~n rL~RI ICI F PD 17n'i AD NUMBER CLASSO START DATE STOP DATE 378894 PUBLIC NOTICES 12/30/09 .01/13/10 AD DESCRIPTION BILLING DATE TELEPHONE NUMBER EXECUTOR NOTICE LETTERS TESTAMENTA 01/13/10 717-766-3172 JOHN M., ATTY. EAKIN MARKET SQUARE BLDG. MECHANICSBURG, PA 17055 i~~~lll~~~lll~~~~l~l~~l~l~~~l~ll GROSS AMOUNT OF 237.79 DUE AFTER 02/12/10 TOTAL AMOUNT DUE 198.16 ENTER AMOUNT ENCLOSED 21540200000003788940000000000000002377900000198168 ~~v-isi~ irx~ ~~2-cs} ~ pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1~ Valencia Construction 9,711.19 2. Lowes -Miscellaneous Supplies 5246.62 4,659.82 3. West Shore EMS 894.93 4. United Water Company (Trindle Road) Monthly Water & Sewer/Septic Line Coverage 250.02 5. PP&L -Foreman Mill Road 164.17 6. PP&L - Trindle Road 838.70 7. Home Service USA -Water Line Repair 71.$8 8. Penn Waste Trash Removal-3 quarters 133.05 9. UGI-Monthly Service Fees 172.06 10. HARP Health Insurance-Final Bill 215.75 11. Verizon Telephone 71.73 12. UGI -Disconnection of Heat Line 94.60 13. Borough of Shippensburg -Water (Foreman Mill Road) 114.02 14. Central Penn Appraisals, Inc. (Foreman Mill Road) 275.00 15. State Farm Insurance -Car 383.47 16. State Farm Insurance -Homeowners 375.00 17. Walmart Credit Card-Final Payment 135.55 18. Miscellaneous Supplies 645.03 '- 19. Jerry'w Lawn Service 30.00 20. Ollie's Bargains -Basement Floor 940.91 21. Kerry's Lawn Equipment -Lawn Mover Repair 148.32 22. 1-800-Got Junk 528.00 23. Linda Moore, Tax Collector-Taxes on Foreman Mill road 643.41 24. Vicki Zortman -Cleaning 70.00 25. Electrical Repairs 180.00 ~j ~ b TOTAL (Also enter on Line 10, Recapitulation) $ 21,746.61 If more space is needed, insert additional sheets of the same size. ~" ~ ~~ ~~.~ .~. e. tv~.~ x-~ Estate of Jean E. Goodyear Schedule I Debts of Decedent, Mortgage Liabilities & Liens File No. 21-09-1185 Car over from Pa e 1 $21,746.61 26 Debra Basehore Weist, Taxes 320.97 27 John Eakin, Es uire 709.50 28 TOTAL ~ $22,777.08 Payment Membership Number COUpOn 023242530-1 Insured Member 1 JEAN E GOODYEAR Member 1 Coverages H Payment is due on or Due Date before the due date. 12-01-20D9 Insured Member 2 Member 2 Coverages 023242530127,575],201091207088.8 2 Thank you for participating PO BOX 8220 in the AARP Health Care PHILADELPHIA PA 1 91 01-8220 Options program. Call us I,,,III,I,,,,,IIII~,,,,,III„I,,,I,I„I,III,,,,,I,III,,,,I„li at 1-800-523-5800 with any questions. Amount Due $215.75 PLEASE DO NOT FOLD, STAPLE, OR TAPE COUPON AND CHECK WITH YOUR RETURN. PLEASE USE THE ENVELOPE PROVIDED TO RETURN COUPON AND PAYMENT. M ~' ~ O M_ ~ c~ ~ Q c- ~ J c~fl ~ p ~, 1 ~ -~, ~ ~ ~ iJ • ~ ,~. ~ ~ ~ ~ ~s ,- ~ :~ w o o ~ a~ Z 0 Z ~ a ~ ~ o ° ~~ o ~ o N .~ A O A ~ .. ~ ~ ~ t A °v -° v O N ~d L7 x ~ .aN _ ~- ~ ~ H ~ ° ° ~~ x N v ~ ~~ ~ : cHri ~ ~ p a v o ~ N w i U U W U Z z w z 0 0 z Q w U N J C"3 Q L!• W Q Q 0 ~- 0 0 0 N O Q ~: ,~ ~ ~, ~ 1- 7 ~ ~~G ~ ~ a. ~ ~u ~ ~ O ~ 4 Ci- w O ~~: u~ ~ Z ~ ~ Q. O p.. 0 4 °~'~'' ~ c~n M ~ ~ ~ J = v ~ ~ o~ W O v o ~ a N ~ o N ~ t ~ N .. O c'~cs ~ w ~ a o ~' Z °~,. LL1 r ~ t U U J ~` Z z~~ J~ O ~ N _ 4~ Q~ C °d '~ J Q~ 4~~ d LL r "i1 t!? Qom,. u~i., a v ~ ~ v ~ e- W7 W J OG p r J _ =Z _ ~ ~ ~ a ~ c ~ ~ ~ ~o ~ M ti N 7 c Q o °` Q~ d Q oav ~ w Q r z_ .. s ° ~ ~ r a o or ~ aNw Q o ° ~ °D ~ cn w 4 U Z Z 4 ~ N ? a O - v' SA Ser ice U Home ~~ . ~r 8' ~ ~ g ~~' Our Ref: 003795274 ~ d ~ , February 26 2010 Mrs Jean Goodyear ~ . 822 W Trindle Rd Mechanicsburg PA 17055 Re: Suspension of United Water Water Service Line Coverage service agreement #4386332 Dear Mrs Jean Goodyear This letter is to inform you that your United Water Water Service Line Coverage service agreement #4386332 is currently suspended, as we were unable to process your payment due to notification from your bank informing us that your account is 'closed'. We are sending this letter and will attempt to contact you, so that you can continue to have the peace of mind provided by your protection plan. In order to continue coverage, payment must be received within thirty (30) days of the date of this notice. Otherwise, your United Water Water Service Line Coverage Agreement(s) will b~ canceled and will require a 30 day waiting period upon reenrollment. Please be aware that.while your account is suspended, you will not be eligible to make a service call. Please contact our Customer Service Department, toll-free at 1-888-866-2128 (8AM to 8PM EST weekdays, and 10AM to 4PM weekends) at your earliest convenience to avoid cancellation of your protection plan. Any of our representatives will be happy to assist you. If you have recently contacted us to make payment arrangements or have already mailed your payment, kindly disregard this letter. We look forward to hearing from you. Sincerely, ~----~-~- ESTATE OF JEAN GOODYEAR LOTS VALENCIA EXC SHARON HANKS EXC 1020 ~'"""~ 290 PLEASANT HILL RD Lisette Martin LEiA/ISBER Y, PA 17~s so-1273/313 Customer Admi ~ ~'~'~a o+~ Pay to the ~ Date Home Service ~ Order of (~ ~_ 5•euniY o.~•~„ o~ ~~ ~ ANK Dollars ~ F••~°••• B•tk. Ce~.ntrBilapp NA_ 040 For- / ~ ~ ~~ ~ ~~ x:03 13 L 2?38~: 5 1 L 2 5 3 7 10 411 i0 2 ~~~ Home Service USA Corp. • 5301 Blue Lagoon Drive, Suite 400 • Miami, FL 33126 • Tel. 305-477-2764 • Fax 305-26~-iwu Email: info@hsusacorp.com • www.hsusacorp.com ~ ~" N ~ ~ ~ Q- tL ~ ~. O ~ C9 .,C O ~ ~ ~, fl. 0 O -Gp ~ ~ N ~ rn ~ c ~ ~ p ~ G n G 'A = ~ CD N `° n. CD `= ° ~ -o ~. m ~o• -* ~ -' m ~' cn cr C m' cu Z~; ~...~;G -vc ~ ~ zs cn co ~ ~ p -n -a `° m cv =., 'n ~ m o ~ ?. ~ ~ ~ cn "~~ ~ ~ w m ~' o s d, in ~ m ~ s t'A ~ ~ -- ~' ~°~a cCDi ~ '' O f~iti CD ~ ~ fi m ~ n. cn ~~ ,C y O ~ N G ~~. ~ Z ~ N ~ ~ . N O ~ U1 ?~ O y ~- ~ cn a o y v r o~ w~ G y 0 ~ y ~ W O ~ 6. N CNJ~ O ~ ~. ! ~ ,a ~~ com Ern j ° 3a~ =^~ ~ °c ~ ~ ~ A A ~ CD ~N { ~ N ~_ CDC O O ~ ~- o- ,4 It `, ,~ r ~ ' o z ~', C ~~ R'1 -< I! ~ pWp O ~~ N p i ~ O s 1 m ~ o Como tHl~ '~ Z m m `y Amy H 70 AN~~ .{ Z " ~ ~~~ ~ Z DH~'m r ~, N r ,~ wD • l4' ~ £ art ~ t~ rt ~ ~ '0 o ~ o ~, ~ °_; ~ .. 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"' ~ N N Q ~ N ~ ~ .Ni S~. ~~ --+ ~ ~ c~ ~ ~~ a ~ Q o Z N ~,4 z cn N ~'4 x n Z O' G' j N C C <S _.. _. _~ _` 1 ~~ ~® ®~' ~ _ qv +~ N ~ p ~' r"{ ~N° M M ~~ ~ m z£r"" ~~ ~ y ~ ~j ~ H ~ -G'tI p' ~ ~ Z c d c~"'n -~ m Q. o$ n Z I ~mZ o c C T~' d p ~ ~` t ~~, 1 ~ ~~ ~ m ~ ~' ~' ~ ~ ~ "O ~ ~s- J ~,, Z ~ o m w 'Tl STA ~ E FAR~~I I~ySURA~ICE COMPANIES ~ ~ State Farm Mutual Automobile Insurance Company ~~~~~ State Farm Dr Conoordvllle PA 19339 AT2 556R -6350 A o~oz~z GOODYEAR, JEAN E 822 W TRINDLE RD MECHANICSBURG PA 17055-4057 AUTO RENEWAL POLICY NUMBER 523 6202-F22-38K POLICY PERIOD *"* Your policy has the Guaranteed DEC 22 2009 to JUN 22 2010 Renewal Endorsement.'`*'' DATE DUE PLEASE PAY THIS AMOUNT DEC 22 2009 $383.47 Your premium has already been adjusted by the following: Premium Reductions(by vehicle) 1 Multiple Line 68.62 1 Antitheft 4.35 1 Vehicle Safety 14.38 1 Accident-Free 98.61 Your premium is based on the following ... /f not correct, contact your agent. 1 2006 SUBAf;U OJTeACK 4S481'62C767311094 otal Premium Vehicle 1 x::: Included .~ ~}: 18.1~/4q~ at'azw~x:4 ~x l~I.: 135.30 6.93 2.94 7 a..,..,~~.~ THIS POLICY PROVIDES FULL TORT OPT10N. The laws of the Commonwealth of Pennsylvania, as enacted by the General Assembly, only require that you purchase liability and first-party medical benefit coverages. Any additional coverages or coverages in excess of the limits required by law are provided only at your request as enhancements to basic coverages. The premium for basic liability coverage of $15,000/30,000/5,000 is $112.35 and medical payments coverage of $5,000 is $12.96. Based on your driving record, you have our Accident-Free Discount for preferred customers. /t~fi~~ ~u~,PS't'~ve~. ~ ~~~w~~e lx~r~ tel'~rGUs~i~rrp~ See reverse side for important information. Agent ROBERT C GARDNER INS AGCY INC ~i 49 7862 3534 Please keep this part for your record. Telephone (717)766-7180 __ ~ rb C u~ t=~ 0 H C~ x z 0 H 7d z w 0 a a 0 0 ~-3 N () z H N .'L rd K z H w N w N O O D ° D ~ o n °° G1 0 o ~ o ~ N D O ~ o ~ ~ ~ m z ~ °-' m ~ ~ D o c~ ~ coo ai ~ m ~ 0 o s~ ~ o m D O O ~ CC G Z _ O O ~G ~ ~ m C7 ~ D z _ n W c v D c°n °0 00 .A w o iw n z Q- o co ~ o ~ ~ ~ N ~- <_ r+ o, a o m O n ~- ~ o m ~ ~ ~" g" O m ~ O ~ ~ ~ v m O 0 v m CD (~ (D CD O ~ Q7 O- ~ ~ C •~ O p ~' c m A A W W C71 Ch D 0 c , : ; . < . - %r. fir;: r ~ ; ,.. ~ r.. -~r ' r~, ,, 's n ~ rn- ao:r:~o x I-~ o :, ~~ o tD ~ ~ ~ ~ ~ ~ , 'J ~ :` ~ ~ ~ ~ ~~ ~ J r7 fD O ~ rn_ ~`° ~ v ~ D D . G~ ~~ J ~ -- ~~ ~ ~~. ~ Z- rnco ~r .ern N -a -~ rn ~ n1 o py. 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D = D Z- W m o N m ~' _ D ~ ° O t j 0 N 0 ~ ~ ~ Z - -a ~ ~ 3'1 cn ~ C7 D ~ ~ ~ Z o ~ - - n = ~ W C ~ - G~ v D - w w 0 0 ~ m m m fD m O 7 p~ O, ~ N C ~ O_ p ~' C ~ ~ ~G ~ ° W W ~ ~ D 3 0 c ~ ~ w o i,w !fflf f `fr /l,.. r1f ~~~~ i f, f~~~ ~~ ~ '., l I ~%`-~ I a~~EOro ~ xoEnotD ~~ ,~~mxo ~ ~,~~ bx ,1 J `1 ~ _, N ~ w -~ w ~ o ~ ~~ -- N ~ rn N a~ rt .n rn rt -1 J (D O I al ~ N ~, ~ ~~ - N I O o~ ,n ~ .~ cn .p 7 u~ ~ rn ~ c ~ ~ ~ ~ ... w O O cA O ~ O ~ m ~ cQ c O c n p ~ Z r7 C 3 CD o ~ m ~ 3 z c ~ cD Z ~' ~ ~ p -! C ~ ~ ~'• CD ° ~ ~ ~ .. SD ~ .. N ° ° ~ ~ _a .a ° ° O O U1 W ~l O ° ~ ~ N N W ~ O ~ O ~ W O° O Account Number Statement Date Payment Due Date Days In Billing Period Credit Line Cash Advance Limit' Available Credit Available Caah" 6032 2075 0009 7126 11/23/2009 12/16/2009 31 =5,000 6200 =4,864 6200 Previous Balance - Payments +~- FINANCE CHARGE (net) + New Purchases + Cash Advances +/- Card Security, Insurance, Fees & Debit/Credit Adjustments (net) = New Balance Minimum Payment 656.07 656.07 60.00 6135.55 60.00 60.00 6135.55 610.00 ,, '; ~i`i Amount 661.99 656.07CR ' 673.56 ~ '~1 ~-.~ PAYMENT DUE BY 5:00 PM ON THE DUE DATE. We may convert your payment into an electronio debit. See reverse side for details. NOTICE; Sea reverse side for Billing Rights and other important information. 5404 OOla IDD 1 7 23 091123 Page 1 of 1 * 1 9112 75CG FSOU 7717 .:; ~' Manage Your Account Phone Number Account Number Billing Date I/erhlOrl My Account at verizon.com/billview 717-766-7480 717 766-7480 608 78Y 11/19/2009 I Verizon News VZ Wireless & FiOS Together! Call 1-877-299-7271 by 12/31109 to get $150 back, via prepaid card, when you sign i up for Verizon FiOS N, Internet, & home phone. Add Verizon Wireless & get all 4 svcs on ONE-BILL® starting ~ $134.99Imo. w/ term agmts., saving you $14.99/mo. Subj. to avail. terms & taxes. Limited time offer. TV, Internet, Phone - $99.99 Get stunning TV, blazing fast Internet & unlimited Natl. calling for $99.99 per mo. for 1 yr. Experience FiOS 100°Jo fiber optics straight to your home. Call 1-877-299-7269 today and get $150 back. Sign up by 1/16110. Install by 3/16/10, w/1 yr. agmt. Taxes, fees & terms apply. Get the Best of FiOS TV Call 1-877-299-7279 for a great value with the FiOS TV Essentials package. Only $47.99/mo w/1-yr. agrmt. Get Over 255 all-digital channels. Optional packages avail. with access to 115+ HD channels for addtn'I cost. It's the best value in entertainment. Subj. to availability & restrictions. Quick Biff Summary fcr MR WM J GOODYEAR Previous Balance $39.03 Payments Received Nov 9 -$39.03 i Balance Forward $.Jp New Charges Voice Services (see ~u ~) Taxes, Fees & Other Verizon Charges Total New Charges Due by Decembe~~ 15, `!~C'~ Total Amount Due by December ~5, ~DQ9 $27.1 i __ --- $11.30 $38A1 $3$.~ 7 Direct Payment Enrollment Online Billing & Payment Questions about your bill? -- verizon.com/billpay verizon.com/billview verizon.com or 1-800-VERI7.ON {1-800-8^7~-4966) Manage Your Account Phone Number Account Number Billing Date ' M Account at verizon.corn/bfllview 717-766.-7480 71~ 766-7480 608 78Y 1/21/2x10 °'ll'~1~~~11 y ~_-~ r _~.~._____: Uerizon News^ __.__~~ Verizon Makes Moving Easy With one call to 1-877-896-5526 Verizon can help set up your TV, Internet b phone at your new address. Call today and ask if Verizon FIGS is available in your home. Let Verizon take the worry out of setting up all your entertainment services. Service availability varies. We Want You to Stay With Us You are a valued customer b we want to deliver the very best service & value to you. Call us at 1-877-896-5531 to find out about the new ways Verizon can save you more rnoney. We appreciate being your provider, and we would like to keep you with us longer by improving your Verizon experience. Get More, Save More Call 1-877-896-5534 to make sure you're getting the best Verizon services at the best value -from phone and Internet, to TV and money- saving bundles. Together we'll evaluate your current services, and find ways to save you even more. Quick Blll Summary for MR J GOODYEAR Previous Balance $36.53 No Payment Received $.00 Balance Forward $36.53 New Charges Voice Services (See pg 3) -$2.60 Taxes, Fees b Other Verizon Charges -$.61 Total New Charges -$3.21 Total Amount Due -Please Pay Now $33.32 Revised Final Bill Pay your bill online at Verizon.com/payfinalbill To avoid referral to an outside collection agency, the lull amount is due upon receipt. Direct Payment Enrollment Online Billing & Payment Questions about your bill? __~_ _. _ _ __,__ w... __ _._. -- _-- _.____. _._ verizon com/billpay venzon.com/billview venzon com or 1 80U VERIZON (1-800.837 4966):..... e__....... ~K_....._.. INVOICE Bonnie Myers, ice anager Central Penn Appraisals, Inc 24 West Main Street Shiremanstown, PA 17011 Telephone Number: 717-737-4600 Fax Number: 717-737-9123 T0: PRIVATE LOTS VALENCIA 290 PLEASANT HILL ROAD LEWISBERRY, PA 17339 Telephone Number: Fax Number: Alternate Number: E-Mail: FOREMANMILLRD 1-6-2010 Internal Order #: Lender Case #: Client File #: Main File# on form: FOREMANMILLRD Other File # on form: Federal Tax ID: 25-1733269 Employer ID: LAND APPRAISAL REPORT ~~#Q .~L~ S '3=L ~~~.,y 5 „Y.~4~3 - 1. ~r.".E'f'sov ~ - .d. 7~~.~'•'.23+~•i-'~*'. ~ .. _ .7~~ } ~f. ~~4 ~ ~~ M:>id' ~SJ~j'j, ~, ~ i~~j's~ ' ` ~jf .>>„ r ~:Yf ~frr w. -w Lender: PRIVATE Client: PRIVATE Purchaser/Borrower: OWNER: ESTATE JEAN E. GOODYEAR _~ Property Address: FOREMAN MILL RQAD City: SHIPPENSBURCa County: CUMBERLAND State: PA Zip: 17257 Legal Description: QEED BOpK 0023X PAGE 00187 -; }w a1~~C~"„~'...s.~~x~ ~ ,.~itT"K~-~ ,3~Vi- ,~,~~~~yyr._ ~Fr, ~~ ` "V.~La.y yf~.~~„~F YS^- ~ v y. .~ F S { ~~.•.~-~ , , - F»~ . .. ~ .a- ~~4 's'~dY }~ i to-. ~ ~ '4 ,nom ~ u~ .~' 4 ~ nS x ~r k ris MLjO~ ~ ~S~ ?'~ ~~-~ haA~~,yfg1~ _~ 4.5.' r4, ..:-r~ .i.:~~~~~ E ~ ~ J. ,:- ~ "'~..~~ FOREMAN MILL ROAD, SHIPPENSBURG ~ 275.00 ~, SUBTOTAL ~; 275.00 -.. .. -, -. .'~.:._ _.. .._ . .- _.~._. fiv.;:~ ..:-tom: :.[t*1Gb'i'~:C•'t.:-.`..ar _ ac:Jt`•s .Z: -.S ..Iw ~ ~ _~t, .. .....i.. 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Wheel Horse Ask Any Pro!' , A a.wr *'° ~. ~,f '~'~i ~~~i~~ ~ ~ . ,,. 5220 EAST TRINDLE ROAD • MECHANICSBURG, PA 17050 SlmplvdreUea~r f v Trained Service Department • Sales • Servirae • Parts • Aa~essorres Ll'j"l"~ (717} 697-3366 wON©ER® • t~ , r15 ~°, a~ ~ ~j Husgvarna ~~~~~ y~ ~'`~v yGl~GI~L' ~ ® ~~~ Thar - °`~'~~ BiLLY GOAT - - - - LAV1/N-BDY ~,s • . •-,~ ~ ' . .r ~ 7 ~ ~' ~. ~.~~~~ www.ke rryslawnandgar~.~a~ tl. .~~~~~ ~~ ~ES~~~~C~ .. . VALE:1'JC ~ A CCIh~GT'RUCT ~: OIL UALEIUC T A CGiW aTRUCT x 01~ t} t~l~,l~l~ E'~~+~ ORCHARD RDAD w~~~ ORCHARD R~IAD CAI+'IF' i-I T LL, F'(~ 1 ?+~r 1. 1 CAMS' H ~: L.L, ~'A :~ 7~r i 1 TERM! I hdAL : ~. 4 t~lo r~et+_tr~n~ or° ser,t~ice war~r~antie~ ~~itho+_~t ~ r,eceipt t~Jor,k Or~derK #k: '7+~~1~ t~Q RETtJRC~aG t~N ~I~'EC T AL ORDER CJR ELECTRIC CAL tr'ARZ'S,s GH T F'~ED U :C A a CUGT'OiYIER !~' T rKUR A r~estoc•king fee of ~~~+°l. a.s char^ged on ~].~. r~et+_ir~n~. i~::~~, :~ WAGE: 4 OF ACCT. NO. DATE INVOICE NO. SALESMAN STORE P/O NUMBER SPECIAL INIFORMATION ~+ 1,3~1~~~ ail ~`~r` ~ ~ 3~t~ 1 F~ ~83/~~+='~ 1 ~k'+7~~ 1'~••-~+~ r ~t~ ORD. SHIP B/O LINE PART NUMBER DESCRIPTION LIST NET AMOUNT CHE~l~', ~~ ~ S~.~B T[JTAL _ -~~_ y 1. 1 ? GASH SALE : ~ ~ IYI ~ SC. _~- --._--? ~. ~~+ LABOR ...._ ...._.__~ ~ 1+~8. ~5 PLEASE PAY FROM THIS INVOICE T~IX E,~ ~~~ -•.---i ~. 4~ RECD B`~' -~' IIVUOICE T{~TAI_-? 148. ~^ a reed as rt o! the consideration for This sale that the IMPORTANT NOTICE ag pa price stawn hereon br the goods shall be paid on ar bebre the 1 Qth day of the rranth Idbwing the month of purchase. Ary portion of the sale price not paid within said Gme perbd shall thereaRer hear interest at the HIGHEST PREYAIUNG RATE. AU aims end returned goads MUST be accompanied by this irwo~ce. There will be no refund or exdtange on electrigl parts. The factory wananty constdutes a8 of the warrarnies wdh respect to the sale of this item(tems. The seller hereby expressy disclaims all wananties, either expressed or implied, inGuding arty >plied warranty of merchantahiliry or fitness for a particular purpose and the seller neither assumes nor authorizes any other person to assume for it any IiabiGty in connection with the sale of this itemfsems. 4 N ~ p~0 ~~~ ~~ o~ ~" ,a; Z O Z_©~o- ' ' O CD ~ U y ~' N ~ *' ch J O Q -~... 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Madison LLC PO Box 4705 Date: - " ~~ Lancaster, PA 17604 acv. - ~~/~ TeL•(717) 715-3102 Fax:(815) 572-5396 Team: LancasterC~31800gotjunk.com ROUte#: ~G ~ °~ ~ www.1800gotjunk.com/lncaster I `u'~! y~l~nc_iC~ StartTime: ~''~~ Name: End Time: ~ ~ ~ -; Company Name: Moving: ^ j ~, . ~~ Pickup Address: ~4~c~ ~-~ -~-~ ~~N'~ i~'~J" WHITE COPY OFFICE YELLOWCOPYCLIENT ,I City: ~ ` : ~ ~'~ State/Prov: ~ Zip/Postal: I~c~~ Home#: ~33,r U~c~C( Celf#: - Fax #: Office #: Email: _ 1 Bill Type Load Size Description Price Bill Type: V - Volume, B - Bedload, S HOW DID`YDU LEA f `/ ^Cash ^ Dis L`~C ^M/C ^ VISA ^A Name (as it appears on card: _ Signature: ^Invoice Contact#:_ Name: City: Job Completion``,, ~~... Signature: I trams: Au accounts are due upon rec maximum allowable interest rate as de satisfactorily completed and understanl pay a $35 returned check fee. G - - - _ _~~-._...._...~.__....-._..r_.~.~.__...... LAST WILL AND TESTAMENT Q1~' E. ~DODYEAR I, JEAN E. GOODYEAR and State of Pennsylvania,, being. do make, publish and declare this void any and all former Wills by ~ I direct the payment of all deeease as the- same can be conv~ of the Township of Silver Spring, County of Cumberland f sound and disposing mind,. memory and understanding,.. ny Last Will and Testament hereby revoking. and making ~e at -any time heretofore made. 1. just debts and funeral expenses as soon after my iently done. 2. I give, devise and bequeath personal and mixed, whatsoever n~ (2) daughters,. to wit,. SHARON alike, per stirpes. 11 the rest, residue and remainder of my estate, real, ure and wheresoever the same may be situate,. to my two HANKS and LOIS J. VALENCIA,. share and share 3-. Lastly, I nominate, constitu a and appoint my two (2) daughters, SHARON G. HANKS and LOIS J. VALENC , to be the Co-Executrices of this my Last Will and Testament and I direct that my sai personal representatives be excused from posting bond -1- or other security for the faithful of their duties, in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this March, A. D. 2007. ;~ day of ~~ ~ _~SLA~.) can E. Goodyear -2- GOMMONWEAI,TH QF PENN YLV?.NIA ) SS COUNTY OF C E1~.AND I;- A:l~- E~ ~4~D-~EAR foregoing. instrument, having beep t~ia~ I- si-ggect and: ex~cut-ed-fie say it willingly, and that I signed it as therein expressed. Sworn and subscribed to before me this G~~ "`` day of March, 2( Notary Public COMMOI~f WEAL1~- OF P COUNTY OF C the testatrix;: whose name is signed ~o the attac~ied or duly qualified according to law,- do hereby aclmo-wledge ~e instrument- as my Last Will and Testament; that I sighed my free and voluntary act and deed, for the purposes ~. - - (S-E~I.,1 E. Goodyear-- . MCSWWIALTH OF PENNiYIYANtA NOTARAAi. SEAL W+aldi M. Nelson, Notary Publlo _ Mwhen(csbur9 Borough, Cumberland CQUnty MVI Ccsmt~lssion Expires June 27, ZOQ7 ~~~~- ). SS ERLAND ) We, the undersigned; J: R $ERT STA~U~'F~R and-JO~Il~T M. EAK~t, the witnesses whose names are signe to the attached or foregoing. instrument, being duly qualified according to law, depos and say that we were present and saw the testatrix, ~~ E. GOODYEAR, sign and exec to the instrument as her Last Will and Testament;-that the said~testatrix executed it as her fr e and voluntary act for the purposes therein expressed; that each of us, in the hearing and sight of the testatrix,. signed the Will as witnesses;. and that, to the best of our knowledge .the tes , w , at the time,, eighteen (_18), or more years of age, of sound mind, and under o cans ~ , - ureyss ~r u~n~ influence. Sworn and subscn~bed to before me this ~~~~ day of March,. 200 . '~f ~ ~~~~ ~--~ ~ ~~.~~ Notary Public COMMONWEgLTH OP PEN Nat~vaN~ NOTARIAL SEgI Heidi M. Nelson, Notary Public Mechanicsburg Borough, Cumberland County MY Commission Expires June 27~ 2007 -3- I, JEAN E. GOODYEAR, o the Township of Silver Spring, County of Cumberland. and S-fate of Pennsyl aria, being of sound and disposing mind, memory and understanding, do m e, publish and declare this a Codicil to my Last Wi11 and Testament. 1. In the event that at the time of my decease, I still own United States Savings Bonds, I direct my said Executric s to pay from the proceeds of said Bonds, the sum of Ten Thousand ($10,000.0 )Dollars apiece to each of my following named grandchildren, to wit, JANA MOS , ELIJAH VALENCIA, CANDICE VALENCIA JOHN HANDS and JEREMY S. 2. I hereby ratify and confirm y Last Will and Testament in all other respects and to all intents and purposes not inconsistent herewith. IN WITNESS WHEREOF, I -ha e hereunto set my hand and seal this ~ `~ day of June, A.D., 2007. Jean E. (SEAL) 1 COMMONWEALTH OF COUNTY OF C I, JEAN E. GOODYEAR foregoing instrument, having beer that I signed and executed the sarr that I signed it willingly, and that purposes therein expressed. Sworn and subscribed to before me this j`~f ~~~ day of June, 2007. ~,~~ ~~. Notary Public COMMONWEALTH OF COUNTY OF We, the undersigned, J. R witnesses whose names are signet qualified according to law, deposE E. GOODYEAR, `sign and execs Testament; that the said testatrix E therein expressed; that each of us, as witnesses; and that, to the best (18) or more years of age, of soon influence. YLVANIA ) SS BERLAND ) the testatrix, whose name is signed to the attached or duly qualified according to law, do hereby acknowledge instrument as a Codicil to my Last Will and Testament; signed it as my free and voluntary act and deed, for the ~ c~ ~.. _ ~~./ (SEAL) Jean E. Goodyear COMMONWEALTH OF PENNSYLVANIA NOTARIAL SEAL Heidi M. Nelson, Notary Public Mechanicsburg Borough, Cumberland County My Commisslon Expires June 27, 2007 YLVANIA ) SS BERLAND ) )BERT STAUFFER and JOHN M. EAI~Il~T, the to the attached or foregoing instrument, being duly and say that we were present and saw the testatrix, JEAN ;e the instrument as a Codicil to her Last Will and ~ecuted it as her free and voluntary act for the purposes in the hearing and sight of the testatrix, signed the Codicil four knowledge, the testatrix, was, at the time, eighteen '. min , d der no constraint, duress or undue Sworn and subscribed to before me this ~~/~~ day of June, 2007. Notary Public COM~yjONWEALTH OF PENNSYLVANIA NOTARIAL SEAL - 2 - Heldi M. Nelson, Nota Mechanicsburg l3orou h ~' Public • MY Commisslon Exg ~ Cumberland County plres June 27, 2007 c~ ~t 0 ~ -~ 0 0~ c ~ ~ ~ C C V ~; o~ o ~ Z ~ ,~ d- Q N .N ~ ~ E 0 N O N ,.C U +.~ •r~ is 4-~ ~ ~ o O V ~ M ~ ~, cd O ~ +.~ ~ n 3 0 ~ U N C, o b ~ a ~ ~ ..~ ai ~~ +~~ ~ ~ ~ ~ •~,~ o~ a0 ~ V ~ v ~ ~ w V ~-+ V F- ~. 3f ~"` ~ ,~ ~~i: ,~,> ~ ~ t~ x ~ ~~ ` ` ~ y f y 'n P -i .'' M/.!/L ~~ UN/TED ST/~TES POST/~L SERV/CE ,~ Visit us at usps com Label 107R, January 2008 .~~ ~:3~~ ~ h ~~~` ~ r. ~4 ~~ » K fir './ ~ ~~ N., Or ~ ~~; r ~ ,>w~ tr ' Y ~ ~ ~, '$ f r ~, r i . ;'~; ; ~~ ~ ,' ~, :~ 1+9~,p+~'~~,~ T t ~V f t ~ ~ ~ 1 . ~ } ik , ~ ~ . F r ~-~ ,. _