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11-09-10 (2)
~ ~ 15056051058 -+ ~~~-1500 EX (06-05) PA Department of Revenue OFFICIAL USE O~IV Bureau of Irdhidual Taxes INHERITANCE TAX RETURN County Code Year PO BOX 280801 21 1 ilarrisbtrrg, PA t~128-osol RESIDENT DECEDENT ENTER DECEDENT INFORtW1TiON BELOW .. Soda) Security Number Date of Death Date of Birth ' 161-20-0345 ' 02/09/2010 01/14/1914 ~~ Decedent's Last Name Suffix Decedent's First Name MI HODGE TILLIE i _ _ R _ (N Applicable) Entw Surviving Spouse's Information Below ~, Spouse's Last Name Sutfix Spouse's First Name I ', MI Spouse's Sodai Security Number _ _ THIS RETURN MUST BE FlLED {N DUPLICATE SHE ' _ REGISTER OF (MILLS FILL IN APPROPRIATE OVALS BELOW ~ 1. Original Retum C:.J 2. Supplemental Retum ? 3. Remainder e~um (data f death priorto f2-1 2) C? 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Es e~, Tax Re Required death after 12-12-82) C.17 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust _.__~,_._ 8. Total Nurrt df Safe De it Boxes (Attach Copy of Will) (Attach Copy of Trust) O 9. Litlgation Proceeds Received O 10. Spousal Poverty Credit (date of death Gy? 11. Election fo nder 9113(A) between 12-31-91 and 1-1-95) (Attach Sjch. O CORRESPONDENT - TFMS 8ECTION MUST BE COMNLETED. ALL CORRESPONDENCE AND CONFIDENTULL TAX NIFORMA 8 LD f3E D CTED T0: Name Da Te _ _ _ _ ybme lephp umber ANDREW J. BENDER, ESQ. (717) 249-1'1 0 - Firm Name (If Applicable) _.__......_------,_ REGISTER -__: __ LS U -- _'c3~_.~ ~eY ALLIED ATTORNEYS ~ -c ..... First line of address _ ~ ~ l _' tp '. 61 WEST LOUTHER STREET ~ -o - ~ _ _ 3 ... Second line of address t~,7 r QA City or Post Office State ZIP Code ._____._... ___ ~ _ .._ E AILED ~.__ ...._._ d `_ _i CARLISLE PA ! 17013 _ ~ CorreaQondenrs e-mau address: ajbentier.lawta;~gmail.com I' Under penaldea of perjury. I declare that I have examined this return, including aocomperryirg schsdrrbs er-d statemerrta, and to the k and belief, it is true, correct and . Declaratbn of preperer other than the personal representatlve b based on all Infomratlon of whkfi has any 51C,~~YJrURE OF PE SON 318LE F FILING RETURN TE ~!J l!~ O U ADDRESS 419 BUTLER STREET, BROOKLYN, NY 11217 SIGNATU ER THAN REPRESENTATIVE D TE ~ a' d ADDRESS 61 WEST LOUTHER STREET, CARLISLE, PA 17013 PLEAlB U!E OWOINAL FORM ONLY Side 1 i 15056051058 1505605 158 I ;~~ i r~~ t~ a ~`n r ~-t a t'.:7 <~,: ' ._,..T r-} ::~ r~ 7 it. ~ J 15056052059 REV-1500 EX t>ers Name: TILLIE R HODGE Decedent's S I Secu ' Number 161-200 5r RECAPITULATION 1. Rwl estate (Schedule A) ............................................. L , 0.00 2. Stocks and Bonds (Schedule B) ....................................... 2. 3 8,568.14 3. Closely Held Corporation, Partnership or Sde-Proprietorship (Schedule C) ..... 3. _, 0.00 j ;, 4. Mortgages 8 Notes Receivatrle (Schedule D) ............................. 4. 0.00 5. Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedub E) ........ 5. 1 6,521.52 6. Jdntly Owned Property (Schedule F) C~ Separate Billing Requested ....... 6. 5,286.05 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property ' 783 16 8 8 (Schedule G) c~ Separate BilNng Requested........ 7. , . 8. Total Gross Asssb (total Lines 1-7) .................................... 8. 1, 9,158.87 9. Funeral Expenses 8 Administrative Costs (Schedule H) ..................... 9. 5,613.00 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule q ................ 10. 621.43 11. Total Deductions (total Lines 9 & 10) ................................... 11. 8 ,234.43 '. 12. Net Vatw of Estab (Line 8 minus Une 11) .............................. 12. 1,27 ,924.44 13. Charitable and Governmental BequestslSec 9113 Trusts for which 00 0 an election to tax has not been made (Schedule J) ........................ 13. . ,. ~_..~,.._ Q..~,~..... T__ ,~ s~o ,~ ..,,n„e ~ ;.~ , z~ - - - - . ,4. 1,27 s24.44 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfer's under Sac. 9116 (ax1.2) X .OQ .. _ ... 16. Amount of Line 14 taxable at lineal rate X .0 ~. .. ... _, 17. Amount of Line 14 taxable at sibling rate X .12 _,.. _ .. 18. Amount of Line 14 taxable 1, 272, 924.44 at r~liaterai rate X .15 15. 16. 17. 18. 19. TAX DUE ......................................................... 19. 20. FlLL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 15056052059 Side2 15056b~2p59 L J i i ii rw to REV-1500 EX Page 3 FiN Number ~...-21 _ 1.0~... ;0406 Decedent's Complete Address: ~ ~i i DECEDENTS NAIu~ DECEDENTS SOCIAL SgC11RITY N MBER TILLIE R HODGE 1 1-20-0345 STREETADDRESS 935 ROCKLEDGE DRIVE CITI' CARLISLE STATE PA ZIP 1 013 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. CreditslPayments 0.00 A Spousal Poverty Credit B. p~ payer 170,000.00 C. Discount 8,947.10 3. InteresUPenalty ff applicable D. Interest E. Penalty 0.00 0.00 (1) Total Credits (A+ B + C) (2) Total InteresUPenalty (D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enthr the difference. This is the OVERPAYfIIIENT. 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) A Enter the interest on the tax due. (5A) B. Enter tf>e total of Line 5 + 5A. This is the BALANCE DUE. (58) Make Check Payable fo: REGISTER OF YY-LLS, AGENT ~, PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPRbP~t~ATE B t 1. Did decedent make a transfer and: .................................. ~ II No a. retain the use or income of the property transferred :........................................................ b. retain the right to designate who shall use the property Vansferred or its income : ............................................ ~ c. retain a reversionary interest; or .......................................................................................................................... d. receive the promise for fife of either payments, benefits or care? ...................................................................... 2. If death occurred after December 12,1982, did decedent transfer property within one year of death wiltwut receiving adequate consideration? .............................................................................................................. 3. Did decedent own an "in trust for" or payable upon death bank account ~ security at his or her death? .............. 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which ©'I ........................................................................................................................ contains a beneficiary designation? ~, ^ IF THE ANSYVER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE ~ ~-S PART 0 ,: , 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 ~he use of ti ~ three (3) percent ]72 P.S. §9116 (a) (1.1} (ij]. 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 std ' ' ' spouse [/2 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requireilne ts,for discic filing a tax return are slid appkcable even if the surviving spouse is the only beneficiary. ~ I For dates of death on or after Juty 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-0rte years of age or younger at death th or ('or use of ; adoptive parent, or a stepparent of the child is zero (0) percent 172 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 benefiaaries is four and one-half',(4. )''percent, 72 P.S. §9116(1.2)172 P.S. §9116(x)(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,.3j]. A sibli Section 9102, as an individual who has at least one parent in comntort with the decedent, whether by blood or adoption. 190,938.67 178,947.10 0.00 11,991.57 0.00 11,991.57 THE RETURN. : surviving spouse zero (0) percent re of assets and natural parent, an as noted in is defined, under ii- REV~03 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DEGEDENT ESTATE OF TILLIE R. HODGE scN~ou~E s STOCKS & BONDS FILE I 21-1 ~..--- ~- All property jointly-owned with right of survhrorship must be discbsed on Schedule F. ITEM NUMBER DESCRIPTION ~ ~ AMERIPRISE MUTUAL FUND ACCOUNT #01011779286 0 002 2. M&T SECURITIES, INC. MUTUAL FUND ACCOUNT #AZD-149888 TOTAL (Also enter on line 2, Recapitulation) Iii ~ , (If more space is needed, insert additional sheets of the same size) I II i AT DATE 1EATH 255,543.58 83,024.56 14 REVd,lUB EX+ (6-98} SCMEpt1LE E COMMONWEALTH OF PENNSYLVANIA CASH BANK DEPOSITS, 8r IMISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER TILLIE R. HODGE 21-10-0406 Include the pnxaeds of Ntigation and the date the pnxeeda were received try the estate. All properly jointly~ownsd with right of wrvivorship nwst t» disclosed on SchsduN F. ~ ITEM LUE AT DATE NUMBER DESCRIPTION OF DEATH 1. MB~T BANK MARKET ADVANTAGE ACCOUNT #15004201143100 92,341.27 2. M&T BANK CHECKING ACCOUNT #9845713297 I 22,451.85 3. 1988 CHEVROLET NOVA (EXTREMELY POOR CONDITION; DOES NOT RUN) ', I 200.00 4. PSI DISTRIBUTION FUND PAYMENT 5. UNITED SECURITY ASSURANCE HEALTH INS. POLICY #56390 REFUND ' 6. UNITED SECURITY ASSURANCE HEALTH INS. POLICY X6634 REFUND 7. UNITED SECURITY ASSURANCE REFUND 8. CONTINENTAL LIFE HOSPITAL WITH NURSING HOME POLICY #05030668X REFUND 9. METLIFE DIVIDEND PAYMENT 10. REASSURE AMERICA CONTRACT #0001626024 PAYMENTS RECEIVED DURING LIFE NOT CASE 11. AMERIPRISE DIVIDEND PAYMENT 12. PSERS RETIREMENT ANNUITY PAYMENT RECEIVED FOR MONTH OF DEATH 13. FTC V. UNION CONSUMER BENEFITS LAWSUIT PROCEEDS 14. EWING BROTHERS FUNERAL HOME, INC. (FUNERAL PRE-PAYMENT PLAN) 357.15 674.$7 77.92 1,070.40 540.00 51.80 57.40 318.96 816.33 17.20 7,546.37 TOTAL (Also enter on line 5, Recapitulation) $ 1 X6,521.52 (If more space is needed, insert addlUonal sheets of the sart~e size) ~ I I ~ REV-~1~9 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT scN~ou~~ F JOINTLY OWNED PROPERTY ESTATE OF FI~.~ NUMBED TILDE R. HODGE 21-AO-0406 M sn asset was made jofM withM orte year of the decedent's data of death, it must be roportad on u G. SURVNING JOINT TENANTS} NAME ADDRESS ELATIONSH~P TO DECEDENT A. BRENDA LEiACOCK 419 BUTLER STREET N EICE BROOKLYN, NY 11217 ~', 8. i C. III -----_ ~ JOINTLY-ONMNED PROPERTY: ITEM NUMBER LETTER Fat JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTRUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYMIG NUMBER. ATTACH DEED FOR JOINTLKHELD REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF D CD'S REST DATE OF DEATH VALUE OF DECEDENTS INTEREST t. A• 02!09107 M&T BANK CD ACCOUNT #3100391XXXXXXX (TILDE R. HODGE & 25,3fi0.75 I'I 50 12,680.38 RRFNt1A .I I FAw :M:KI .2 • A, p~04p00 OPPENHEIMER ACCOUNT #A09-002XXXX (TILDE R. HODGE & 85,211.34 I Ii 50 42,605.67 RRFN~AIFACnGK.R WRnSI ® i ~ I I' i I ~~ !~ TOTAL (Also enter on line 6, Recapitulation) I ~ I, (If more space is needed, InssA add(tional sheets of the same size) 55,286.05 aM~ 1737+6~X + (6-06) r Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN NONRESIDENT DECEDENT ScfiEOU~E a INTlR-VIYi13 TRANSlsERi jt Use Schedule G, Part 2, ONLY for MISC. NON-PROBATE PROPERTY proportionate method of tax computation. ESTATE OF FILE NUMf~ERI TILLIE R. HODGE 21-10-0#0e~ Part 1 must include all transfers of real estate and tangible personal property located Complete Part 2 ONLY when the proportionate method of tax computation Innl, ~.~n in thn dnnrrin4inn of nrnnorfv ihw ftAt'A I'F1A 1TA1'1CfR~ WAC R1Ade aflff the name and relatton$hlo This schedule must be completed and filed if the answer to questions 1 throu gh 4 on the reverse s ide of the RE -1 3 cover s heet is yes. , ITEM DESCRIPTION OF PROPERTY Irwiude tote name of the tranataree, da relationship to Decedent and the date of htulater. DATE OF DEATH ~ QF DECD'S ~ U$ION NUMBER Attach a of the deed for real aerate. VALUE OF ASSET INTEREST IF FABLE TAXABLE VALUE 1 • PERSONAL PROPERTY (SEE ATTACHMENT) 9,740,00 100 ~' 9,740.00 2. SEE ATTACHED SCHEDULE OF ASSETS 829,043.16 100 I I I 829,043.16 flIART t TOTAL X 8 3 8, 7 8 3 .16 s ; 838,783.1E ., . DESCRIPTION OF PROPERTY ITEM Include the rams at the trerafsree, the relatlonstrip to Decedent and the date of transfer. DATE OF DEATH 96 QF DECD'S EX~L I NUMBER Attach a of the deed fa real estate. VALUE OF ASSET INTEREST IF LE TAXABLE VALUE L ~I I ~I i I MtT s TOTAL s S ~ o.a TOTAL (Also enter on Line 7, Recapiijula~ign.) I s 838,783.16 (ff more space is needed, use additional sheets of paper of the same size) ~EV-1737 IjX ~ (fi-08) REVERSE ~ Pennsylvania pEPARTMENT OF REVENUE INHERITANCE TAX RETURN NONRESIDENT DECEDd~Ii scNEOU~E N FuNElew~ ExptNSES ~ ADMINISTRATIVE COSTS ESTATE OF FILE NUME~ER TILLIE R. HODGE 21-10-04gS Debts of decedent must be reported on Schedule 1. ITEM NUMBER DESCRIPTION AMOUNT A• FUNERAL EXPENSES: 1' E1INING BROTHERS FUNERAL HOME, INC. 17,947.90 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commission(s) Iii Name(s) of Personal Representative(s) BRENDA LEACOCK ~'~I ', (Submit requested mforrnation for additional personal representative's on additional sheets) Social Security Number(s) or EIN Number(s) of Personal Represe~ative(s) 137-36-4381 I' Street Address(es) 419 BUTLER STREET II ~,hf1e5) BROOKLYN state(s) NY ZIP(S) 11217 ~I Year(s) Commission PaW 2010 ~ i i 2. AtWmey Fees i I 3. Probate Fees I~ 4• Accountant's Fees 5. Tax Retum Preparer's Fees 6. MistxN~eous Expenses SEE ATTACHED ITEMIZATION OF MISCELLANEOUS EXPENSES 25,748.11 48,193.27 493.50 150.00 3,080.22 85,613.00 'TOTAL (Also enter on Line 9, Recapitulation') ;' (If more space is needed, use additional sheets of paper of the same size) ~, !~ Use Schedulfl M ONLY for proportionate method of taxi computation. 1737-7 Ej(+ (li-08) >, Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN NONRESIDENT DECEDENT scNeou« ~ p~s~ ~~ pEC~OS~ Use Schedule I, Part 2, ONLY for i proportionate method of tax computation. Mo~ws~ ~~ws~~mes, ~ LieNS ESTATE OF FILE NUMBER TILLlE R. HODGE 21-10-040 Part 1 must include mortgage liabilities, liens and taxes against the Pennsylvania realty that~ere due and owed as of the date of decedent's death. Ce~annl~. Parf 7 ANt Y r-tmn tFh~ ereeerllenstw method of 1EsY comoutstion Isle) cted. •~ ITEM NUMBER DESCRIPTION AMOUNT L i~ I I I ~~ s 0.01 ., . ITEM NUMBER DESCRIPTION II AMOUNT 1 ~ CARLISLE REGIONAL MEDICAL CENTER ~'~ 50.00 2. PSERS (REFUND OF OVERPAYMENT TO DECEDENT) I ~~' I i~~ ', i 571.43 TOTAL MlT~ 3 'is 621.4:, TOTAL (Also enter on Line 10, Roca 'tulatio .) ~'s 621,4; (If more space is needed, use additional sheets of paper of the same size) .REV-1737-t E~(+ (s-0a) AVERSE ~ Pennsylvania SCMElfYLE J DEPARTMENT OF REVENUE B~NE~ICIARIES INHERITANCE TAX RETURN NONRESIDENTDECEDENi ESTATE OF FILE NUMBER TILLIE R. HODGE 21-10-0406, When flat rate method is elected, list the beneficiaries of the Pennsylvania When proportionate method is elected, list all beneficiaries. RELATIONSH P T ITEM DECEDE T AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON S) RECEIVING PROPERTY Do Not List T s OF ESTATE I. TAXABLE DISTRIBUTIONS [nndude outright spousal disidbutbna and transfers under Sec. 2116 (a)(1.2)I 1. Brenda Leacock, 419 Butler St., Brooklyn, NY 11217 Niece '/y Q~s:dke 2• James A. Roberts, 15934 Riverside Dr W, Apt 2C, New York, NY fao;2 Nephew ~ t 3- Jill Ann Roberts, 879 N Stillman St, Philadelphia PA 19130 Niece ~' , ~~;~k / y 4. Bruce Nunery, C!o Richard Plaza, 1835 Bumet Ave, Union, NJ o'lor3 Nephew '~y (Z,~,:dkc ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON REV1737 COVER SHEET OR THE PROPORTIONATE METHOq OF REV 1737 COVER SHEET, AS APPROPRIATE II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 2113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. I B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. KSHEET ON THE REVERSE SIDE TOTAL OiF ~ ~, I 50.00 (Enter total non-taxable distributions on Line 13 of REV 1737 cover ee .); (If more space is needed, use additional sheets of paper of the same size) I I -~. r ATTACHMENT TO SCHEDULE G - INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY 1. Personal Prouerty/Household Contents I The contents of the Decedent's home were gifted to Brenda Leacock (niece) in 2003I,by tie Decedent/Settlor & Trustee of the Tillie R. Hodge Trust dated May 24,1993. However, the Decedent retained the s~ of these items during life. 2. Schedule of Assets ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF EX~LU IpN (IF TAXABLE VALUE NUMBER Include the name of the transferee, the VALUE OF ASSET DECD'S AP~LI BLE) relationship to the Decedent and the date of INTEREST transfer. Attach a copy of the deed for real estate. i. 935 Rockledge Drive, Carlisle, PA $190,000.00 100% $190,000.00 [transfer to Tillie R. Hod a Trust 08/06/04] 2. Sovereign Bank Sovereign One Checking $7,200.50 100% I $7,200.50 Account #1671005627 [transfer to Tillie R. I Hod a Trust a rox. 08/03/07] I 3. Sovereign Bank Premier Checking Account $1,001.61 100% $1,001.61 #1671078896 [transfer to Tillie R. Hodge Trust 08/03/07] 4. Sovereign Bank Money Market Account $72,672.77 100% $72,672.77 #1674062540 [transfer to Tillie R. Hodge Trust I 08/03/07] ~ 5. Ameriprise Mutual Fund Account $141,306.07 100% $141,306.07 #01012981047 8 002 [transfer to Tillie R. Hodge I Trust 06/03/93) 6. Ameriprise Mutual Fund Account $86,911.26 100% $86,911.26 #07150648823 9 002 [transfer to Tillie R. Hodge Trust 06/03/93) 7. Merrill Lynch Account #500-43Y61 [transfer to $32,168.07 100% $32,168.07 Tillie R. Hod a Trust 10/29/04] 8. Ameriprise Annuity Account #93001781503 4 $88,079.23 100% $88,079.23 004 [transfer to Tillie R. Hodge Trust 06/03]93; named beneficiary James S. Roberts (brother) ~, predeceased Decedent & account will be I, distributed by estate] 9. Ameriprise Annuity Account #93001791746 7 $36,584.49 100% ' $36,584.49 004 ]transfer to Tillie R. Hodge Trust 06/03/93; named beneficiary Edythe R. Watson (sister) predeceased Decedent & account will be distributed by estate] ~ ~ 10. Ameriprise Annuity Account #930018402618 $66,707.69 100% $66,707.69 004 [transfer to Tillie R. Hodge Trust 06/03/93; no named beneficiary; account will be distributed by estate] 11. Ameriprise Annuity Account #930019486115 $21,527.10 100% ~ $21,527.10 004 [transfer to Tillie R. Hodge Trust 06/03/93; I account transferred to Jill Ann Roberts (niece) & James A. Roberts (nephew) per beneficiary designation u on Decedent's death] 12. Ameriprise Annuity Account #93002570667 0 $24,881.07 100% ' $24,881.07 004 [transfer to Tillie R. Hodge Trust 06/03/93; account transferred to Bruce Nunery (nephew) per beneficiary designation upon Decedent's death] 13. Ameriprise Annuity Account #930039558901 $46,564.96 1009'0 ' ~I $46,564.96 004 [ transfer to Tillie R. Hodge Trust 06/03/93; I Tillie R. Hodge Trust is listed beneficiary; I i proceeds of account will be distributed by trust ~ to beneficiaries of trust] 14. Midland National Annuity Account $13,438.34 100% $13,438.34 #8500121056 [account transferred to Brenda ' Leacock (niece) per beneficiary designation upon Decedent's death] TOTAL ASSETS IN ITEM N~11V~~ER 2 $829,043.16 # s ATTACHMENT TO SCHEDULE H ITEM NUMBER 6 -MISCELLANEOUS EXPENSES a. Cumberland County Law Journal -Advertise Grant of Letters $75.00 b. The Patriot News -Advertise Grant of Letters $194.73 c. Appraisal Fee (Personal Property) II ', $200.00 d. Account Valuation Fee (Valuation of Merrill Lynch Account} I ' $9.50 e. Account Valuation Fee (Valuation of Sovereign Accounts) $20,00 f. Locksmith Fee (open safe deposit box) $150.00 g. Donegal Insurance (homeowner's insurance pending transfer/distribution) $592.00 h. PP&L Electric (electric bills for Decedent's home pending transfer/distribution) $249.06 i. Lawncare for Decedent's home pending transfer/distribution (home unoccupied) $1,458.05 j. Water Bills for Decedent's home pending transfer/distribution '~ ', 131.88 TOTAL MISCELLANE~I~SIEXPENSES $3,080.22 ,r LAST WILL AND TESTAMENT OF TILLIE R. HODGE I, TILLIE R. HODGE, of 935 Rockledge Drive, Cazlisle, Cumberland C~aunty, Pennsylvania, being of sound and disposing mind, memory, and understanding, I so make, publish and declare this to be my Last Will and Testament, hereby revoking and makn~ void all I previous Wills and Codicils heretofore made by me. I First I order and direct my personal representative hereinafter named to pay fall of my just ~~ debts, funeral expenses, and expenses involved or connected with the administ~a~ion of my estate as soon after my death as is reasonably possible. However, my personal repre~en~thtive need not accelerate and pay those unmatured obligations which, in his, her, or its opinion, t,might be proper and more advantageous to retain or renew and pay as they become due a{n payable. If I do not own a burial plot or a grave marker at the time of my death, I authorize myl personal representative, in his, her, or its sole discretion, to purchase a burial plot and to grave marker at my grave, and to expend sums from my estate for this purpose. Second I order and direct my personal representative to consult with the Trustees of the Tillie R. Hodge Living Trust in order to determine from among the have possession of at the date of my death, which is owned by me, and which I onl Page 1 of 7 ct a suitable i see or roperty I have the use I ~~ . ~ ~' ~r and enjoyment of for my lifetime. Only property owned by me shall pass via tlhis, my Last Will and Testament. Property that is held in the Trust shall pass via the terms of thelTrust. Third I give, devise, and bequeath all the rest, residue and remainder of my $ai~3lestate, real, I personal, and mixed, whatsoever and wheresoever situated, absolutely and in fe~ Simple, in six I, (6) equal shares, per capita, as follows: ~ 1. A one-sixth (1 /6) shaze shall be distributed to my sister, EDYTIH~! R. WATSON; 2. A one-sixth (1/6) share shall be distributed to my niece, BRENfD~ LEACOCK; i 3. A one-sixth (1/6) share shall be distributed to my brother, JAIV~IE~ iS. ROBERTS; 4. A one-sixth (1 /6) share shall be distributed to my niece, JILL AlN~1! ROBERTS; 5. A one-sixth (1/6) shaze shall be distributed to my nephew, BRU'C 'NUNERY; 6. A one-sixth (116) share shall be distributed to my nephew, JAMIE lA. ROBERTS. Fourth I grant my personal representative the following powers in addition to acid limitation of such powers as my personal representative shall hold by law: a.) To retain all property received including the stock of any corporate acting hereunder, provided such property remains productive. b.) To join in any corporation, partnership, recapitalization, merger, ri voting trust plan; to delegate authority with respect thereto; to dep Page 2 of 7 in ~anization or linvestments r~~. i ~. under agreements and pay assessments; and generally to exercise all rights of investors, including but not limited to the voting of shares. c.) To manage, operate, repair, improve, mortgage or lease on any ~erms any real estate held or owned by my estate. d.) To operate any business that I may own at my death. !~ e.) To invest any funds of my estate in stocks, bonds, notes, or othe Securities or property, real or personal, without regard to the principle of dijve~safication or any other statute or general rule of law in his, her, or its absolute d~sc~retion, it being my intention to give my personal representative the broadest iriv~stment powers possible, providing such investments do not unnecessarily prev~en~t the prompt settlement of my estate. i f.) To sell or otherwise dispose of any property, real or personal, tan~ible or ~, intangible, at any time forming a part of my estate in any manner ~axd on such terms and conditions as my personal representative shall see fit ~n ~s, her, or its ~,I absolute discretion. g.) To borrow money for the payment of taxes or for any other proper ~~rposes in the administration of my estate, and to mortgage or pledge estate ass~t~ ~s security. ~~ h.) To compromise claims without court approval including, but not''1ir~ited to, any I controversies with the United States of America or the Commonvlve~lth of i Pennsylvania concerning estate and inheritance taxes on any intenes s that may pass under this my Last Will and Testament. i.) To distribute in cash or in kind upon any division or distribution of r~iy estate. Page 3 of 7 ~.--d~. , ~t , i j.) To undertake any and all acts deemed necessary and proper by ~y personal representative for the proper, advantageous, and prompt management of the settlement of my estate. In general, to exercise all powers in the management of my es~at~e'which any individual could exercise in the management of similar property o?wned in his or her own right, upon such terms and conditions as to him, her, br t'may seem best and to execute and deliver all instruments and to do all acts wl~ic fie, she, or it deems necessary or proper to carry out the purposes of this, my TJ,aSt Will and Testament. ~, k.) Fifth No interest of any beneficiary of my estate, either in income or in princsp~ subject to anticipation or pledge, assignment, sale, or transfer in any manner, n+,or beneficiary have the power in any manner to charge or encumber his interest eikh principal, nor shall the interest of any beneficiary be liable or subject in any mapm possession of my personal representative for the liability of such beneficiary. shall be ball any in income or ;~ while in the Sixth I nominate, constitute, and appoint my niece, BRENDA LEACOCK asp ~ representative of this, my Last Will and Testament. I direct that my personal repre not be required to give or post bond for the faithful performance of his, her, or its any other jurisdiction. ~,~,~, shall ies in this or Page 4 of 7 ,: M ~ Seventh I hereby declare it to be my express desire that my personal represent~tiw~ employ the law '~ firm of Stephanie E. Chertok, Esquire, of Cumberland County, Pennsylvanian f r',the legal advice and assistance regarding this, my Last Will and Testament, they having ~ dnsiderable knowledge of my affairs, views, and wishes respecting any matters that may ~ e~ at the probate of this instrument, the administration of my estate, and the execution of the pew >rs herein mentioned. IN WITNESS WHEREOF, I have set my hand to this my Last Will and ~. ~ ~' day of , ~ • - , 2004. ~~ ~~ i c TILLIE R. this Page 5 of 7 A(:K1V V W Ll~LIiMl~1~I 1 COMMONWEALTH OF PENNSYLVANIA SS ~ COUNTY OF CUMBERLAND '~, I, TiLLIE R. HODGE ,the Testatrix whose name is signed to the attach instrument, having been duly qualified according to law, do hereby acknowleklg ~i and executed the instrument as my Last Will and Testament, that I signed it v~ill signed it as my free and voluntary act for the purposes therein expressed. l or foregoing ghat I signed 1gly, and that I Sworn or affirmed and acknowledged before me by TILLIE R. HODG~, ~he Testatrix, 11 Ii this C~ ~ 1` day of ~' , - ~ , 2004. ' .~ ~~ F r NOTARY PUBLIC xaar;at s~ adc~w x. siww. rta.~r ~~ ~~, I ~~ ', Page 6 of 7 ~! ~I i r AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA SS I~ COUNTY OF CUMBERLAND ~~ ~ ,.-- ~, - ~z~- ~w ~y~~~ ~. • ~ ~. ~ ~ ~., and ~~_~. ~ ~ ~ ~-~~ r~~ 5 - --T~ } the witnesses whose names are attached to the foregoing document, being duly llalified according to law, do depose and say that we were present and saw the testatrixk s gn and execute the instrument as her Last Will and Testament; that she signed willingly and t~a the executed it as her free and voluntary act for the purposes therein expressed; that each sub~c b,'ing witness in the hearing and sight of the testatrix signed the Last Will and Testament as witn sites; and that to the best of our knowledge the testatrix was at the time 18 or more years of aged o~ sound mind, and under no constraint or undue influence. Sworn or affirmed and subscribed before me by iL~ ~ ,,,,4~. c+,~,~ ~:. ~ /„I ~ f,, and ~:~ ~ti ~, C. ~,~-:-t-~ ~'" this ,, y ~1,. day of ,,. G~ it / v ARY PUBLIC . 2004. Notarial Seal M~~' „~„~Pu~l~c i Y ion Expiroa t. 24,2006 Page 7 of 7 awT f~1~TA~ Di i~ w~TT T T'S! R • HOi~ , * * * . ~ /j, ~. ~ llY.. Date Signed :~~~` DECLI~RATION OF TRIIBT TILLIE R. HODC,~B ~~ ,~tTICI.B_ I ,~ettior - Trustee A. TIhLIE R. HODGE, of Cumberland County, State cif Pennsylvania, hereinafter called "Settlor," hereby t~ nsfers and delivers to TILLIE R. HODGE of Cumberland County, St#~ ~ of Pennsylvania, herein called "Trustee," all the right, title and interest in the property described in Exhibit "A° attached hereto, to constitute, together with any other prope~t !,that may become subject to this Revocable Declaration of Trust, the Trust Estate, to be held, administered, and distributed by t e Trustee as provided in this Revocable Declaration of Trust ar~d designated as the TILLIE R. HODGE TRUST. Successor Trustee B. 1. TILLIE R. HODGE is hereby designated as'~,T stee of all Trusts created by or to be created pursuant to thi,Revocable Declaration of Trust. a. Upon the death of Settlor, or should S~t for become unable, because of incompetency or other cause, ~t serve as Trustee before the natural termination of all trlu tts provided for in this Declaration, EDYTHE R. WATSp of Carlisle, Pennsylvania, shall become Successor T' s}tee of all Trusts provided for in this Revocable Declare ikon of Trust. Upon the death of EDYTHE R. WATSON, BREN~ ',LEA000K of Brooklyn, New York, shall become Successor Trustee of all Trusts provided for in this Revocable Declaration f Trust. b. Any Successor Trustee shall succeed to ~1 'title of the Trustee to the Trust Estate, and shall have ~1 'the powers, rights, discretions, and obligations oric~i filly conferred on such Trustee by this Revocable Decl~r Lion of Trust . 2. Settler agrees that no court proceeding shall, necessary to declare her competency, but instead she alg yes to an adjudication of incompetency by two certifying physicia ~, neither of whom are beneficiaries hereunder nor relatgd to any beneficiary under this Trust, as shall be selected by~the immediate Successor Trustee. ' 3. Any Successor Trustee shall not be personall~l liable for any act or omission of any Predecessor Trustee. Any', uccessor Trustee acting hereunder may accept the Trust assets) slivered to it by or on behalf of its Predecessor Trustee as cons tuting the entire Trust Estate, and such Successor shall not be'' gquired to take any action to recover further assets or to inve~ ilgate any acts done by any Predecessor Trustee, nor shall any ~u '~essor Trustee be required to bring any action to determine!,w lot constituted the Trust Estate or to obtain possession't lereof. Any Successor Trustee may continue to hold assets re~e'tred by it from the Predecessor Trustee in the same manner as tHo gh said assets had been originally deposited hereunder. ARTICLE II Additions to Trust A. Settlor shall have the right at any time, eiti her life or by Will at her death, to add other proper acceptable to the Trustee to the Trust created by thi Declaration and such property, when received and accel Trustee, shall become a part of the Trust Estate of tl during ~eKi by the 1 !Trust . PaNer to __C>hanc~e or R®voke Trust 8. While living and competent, the Settlor may, la 'any time and from time to time, by written notice signed by th$ ~ttlor and delivered to the Trustee: 1. Revoke or change the interest in any Truss created or to be created pursuant to this Declaration of~~a ~- beneficiary named in this Declaration or in any alum r~dment to this Declaration; 2 2. Amend any provision of this Declaration or any amendment to this Declaration to such extent as i~aay be acceptable to the Trustee; 3. Revoke in whole or in part any Trust or'Trusts created by or to be created pursuant to this Dec aration; 4. Withdraw all or any part of the TrustlE fate. ARTICLE .III i n=9'i'it HOTION OF INCOISE AND PRINCIPAL '' I~ Net Income to Settlor A. During the life of the Settlor, the Trusteed tYall pay to or apply for the benefit of the Settlor, in monthly ~ other convenient installments, all of the net income from ~hle Trust ~, Estate. vasion of Pr~~c B. If the payments from this Trust to which the be entitled, together with her other income, of whicY~ has actual knowledge, shall be insufficient in the dig the Trustee to provide for the reasonable care, suppc~. comfort of the Settlor, or of any person dependent up~~ Settlor for such support and maintenance, the Trusted him/her, or apply for his/her benefit, so much of thel up to and including the whole of the Trust Estate, asl may deem advisable. P,Hvment of Settlor•s E;pensas After Deatbl C. On the death of Settlor, the Trustee shall p• the Trust Estate (but not from any Trust Property that otherwise be exempt from Federal Estate Tax under the! of Internal Revenue Code Section 2039 or 2042 or succE provisions) the estate and other death taxes, includi~ and penalties, arising as a result of the Settlor's di than any additional tax imposed by Internal Revenue Cc ettlor may Trustee on of and the ~y pay to ~incipal, He Trustee out of pvisions interest (other Section 3 2032A(c)), without apportionment or charge against and beneficiary. Unless the Trustee shall determine tha~tother provisions have been made for the payment thereof, th~ Trustee, in the Trustee's discretion, may also pay out of the rust Estate the Settlor's last illness and funeral expenses, any xpenses and costs, including reasonable attorneys' fees, incurreid in the administration of the Settlor's probate estate, and t ~ legally enforceable debts of the Settlor. i ARTICLE IV '~ DIBTRIB ION AFTER SETTLOR'8 DEATH II Distribution to Settlor's Heirs A. On the death of Settlor, all the Trust Estalke the possession of the Trustee, after the payments re~e Paragraph C of ARTICLE III have been made or otherwise for, shall be held, conveyed, administered, and distil according to the following dispositive provisions: then in r~nced in provided 1. Soecific Bequests: a. The portrait of Settlor is to be given i 'kind to Brenda Leacock, and the oval marbletop table is t be returned to James S. Roberts. 2. Distribution of Residue of Trust Estate: a. Upon the death of Settlor, the undistrib fed portion of this Trust shall be distributed as fo]Lldws: (1) A one-sixth (1/6) share shall be disltributed to my sister, EDYTHE R. WATSON, outright a#id free of Trust; i (2) A one-sixth (1/6) share shall be ~i tributed to my niece, BRENDA LEACOCIC, outright and fake of Trust; I 4 i I (3) A one-sixth (1/6) share shall be ,distributed to my brother, J711[8B B. ROBERTB, outright alyd free of Trust; (4 ) A one-sixth (1/ 6 ) share shall b~ ~c~istributed to my niece, JILL ANT ROBERTB, outright aridl'free of Trust; (5) A one-sixth (1/6) share shall b~ istributed to my ne hew, BRIIC$ ~iIIlISRY, outri ht and i~r~i~ of Trust; P g ~ and (6) A one-sixth (1/6) share shall b~ istributed to my nephew, J1~lL86 ~i. ROBLRTB, outright aln free of Trust . ~I (7) If any of the above-named beneficiaries shall predecease the Settlor, leaving no issue alt ~tthe time of their death, the share of the deceased benle~ciary shall be divided equally among those beneflic~iaries who have survived the Settlor. 3.a. If any share of any Trust become dis~r'#~utable to a grandchild under the age of twenty-five (25),'',u tiler ~' ARTICLE IV, Paragraph A, Section 2, Subsection ~,~i(1) through (6), such share shall immediately vest ~n~~uch grandchild, but the Successor Trustee shall ret~,i ossession of each such randchild's share untill ~~ch P g grandchild reaches age twenty-five (25). The S'c ~ssor Trustee shall use and expend so much of the inc~om 'and principal of each such grandchild's share as it ~id~~ms necessary or desirable for his or her care, supp'p~. and education, and any income not so expended shall b 'added to the principal. The Trustee shall have, with rest at to each share so retained, all the powers and discretion 'ad with respect to this Trust generally. Upon attaining,a le twenty- five (25), such grandchild shall be given his or'h it share of the Trust Estate, outright and free of Trust. 'I 5 b. Settlor advises that she believes that, where practical, a complete education is of more imps 'ance than having funds available at a later date and, the fore, the Trustee is requested to exercise its discretio~h '1n a very liberal manner insofar as the education, incluc~i collegiate and professional education, of Sett~o '~'s grandchildren are concerned. The Trustee shal] eke into consideration all reasonable related living ex~e des in determining disbursements hereunder. B. As used in this Trust, the term "issue" shall 'refer to lineal descendants of all degrees, and the terms "chli c~," "children," "grandchildren," and "issue" shall inclu~le~'adopted persons. C. Settlor has intentionally omitted provisionli~' this i Trust for anyone not herein mentioned. D. Unless tenainated at an earlier date under tkh ' foregoing provisions, this Trust shall cease on the date whichli twenty- one (21) years after the death of the last survivor df the beneficiaries in being at the time of the death of the ffiettlor, or those living on the date prior thereto when this Tf $t becomes irrevocable, if that event shall occur. Upon such t~, nation, the Trust Estate remaining shall be distributed to thle persons then entitled to the income therefrom, in the same sh~,a~e~s and proportions as they were at the time entitled to rece~iv~e such income. I, ~IRTICLE Q F4IIERB OF TSE TRIIBTEE A. To carry out the purposes of this Trust and ~ any limitation stated elsewhere in this Trust, the Trt~ any Successor Trustee is, vested with the following pcb ect to e is, or s , in 5 r addition to those now or hereafter conferred by law, ;affecting the Trust and the real and personal property of therust Estate: 1. Authorized to retain in the Trust, for (such time as it may deem advisable, any property, including~js Ares of its own stock, received by it from the Settlor, wh$t ter or not such property is of the character permitted by'1 w for the investment of Trust funds, and to operate at t2}e~'~risk of the Trust Estate any business or property receivedlb~r it from the Settlor; ' ~~ 2. Authorized to buy, sell and trade in sle~IIUrities of any nature {including "short" sales) on margin, z~nd for such purpose many maintain and operate margin account 'with brokers, and may pledge any securities held or ~ z~chased by him with such brokers as security for loans and',adlvances i made to the Trustee; 3. Authorized to invest Trust Assets in s~c~urities of every kind, including debt and equity securities, commodities of every nature, including grecious''m contracts for the future delivery of commodities nature, to buy and sell securities, including bey margin options on recognized options exchanges, t covered and uncovered securities options listed~,o exchanges, to buy and sell listed securities opt~i individually and in combination, employing recogln investment techniques, such as to buy other than!, straddles, and strips; and to execute such agree$a may be required by securities brokerage firms ins, with the opening of accounts in which option and, transaction will be affected; ls, and f every na on 'buy back such ~..~ , zed preads, nts which margin 7 T _ ___~__ 4. Authorized to invest and reinvest the Trust Estate in every kind of property, real, personal or mi ed, and every kind of investment specifically including, but not by way of limitation, corporate obligations of eve kind, preferred or common stocks, shares of investment Trusts, investment companies, common Trust funds (incl~d'hg those established by the Trustee), mutual funds, andl,m ~-tgage participations; 5. Authorized to manage, control, sell, c#o Wey, exchange, partition, divide, subdivide, improve, repair; to grant options and to sell upon deferred paymentls to lease for terms within or extending beyond the durati~o of this Trust for any purpose including exploration for', rtd removal of gas, oil, or other minerals; to enter into cio .unity oil leases; 6. Authorized to borrow, mortgage, encumb~ or hypothecate, replace, renew or extend any encum~ ance upon any real property or any personal property, to ~ stitute, compromise, and defend actions and proceedings;' ?. Authorized to carry insurance of such ids and in such amounts at the expense of the Trust provid~d for in this Declaration as the Trustee may deem advisa~l ; 8. Authorized to invest and reinvest the ~ ~t funds in such property as the Trustee may deem advisaY~l ~ whether or not of the character permitted by law for th~ investment of Trust funds; 9. Authorized to borrow money from any pegs r~, firm or corporation, for any Trust purposes on such termis end conditions as the Trustee may deem proper and toi bligate 8 the Trust to repay such borrowed money. To borrow money and to encumber Trust property by mortgage, deed ofrust, pledge or otherwise, for the debts of the Trust br the joint debts of the Trust and a co-owner of the property in which the Trust has an interest, or for a Settlor's cue is and to guarantee a Settlor's debts; 10. Authorized upon any division or partila~'or final distribution of the Trust Estate, to partition,, llot, and distribute the Trust Estate in undivided inter~s~~ or in kind, or partly in money and partly in kind, a~ ~luations determined by the Trustee, and to sell such prdp~~ty as the Trustee may deem necessary to make division or ~,d~.$tribution; 11. Authorized to determine what is prindi ~1 or income of the Trust Estate, and apportion and a'il c~cate in its discretion receipts and expenses as between' 11ese accounts. Except insofar as the Trustee shall '~ ercise this discretion, and except as otherwise provided in his Trust, matters relating to the rights of beneficiaries', igong themselves as to principal and income shall be g vkerned by the provisions of the Principal and Income Law ~ d,m time to time existing; ', 12. Authorized to employ and consult with',s~,ch agents and counsel as may be reasonably necessary in c~n~lection with managing and protecting the Trust, and to ~ay'them reasonable compensation from the Trust Estate; 13. The enumeration of certain powers of $h~e'Trustee shall not limit its general powers. The Truste$, subject always to the discharge of its fiduciary obligati hs, is vested with and retains all the general rights, 'p veers and 9 privileges which an absolute owner of the same property would have. 11~tTICLE VI ~IIItIBTRATIVE PjtOVIBIONB A. The Individual Co-Trustee and/or any Succe~ shall receive reasonable compensation for their serv'r accordance with fee schedules in use from time to tit' administration of inter vivos Trusts normally in use Cumberland County for the period in which such serv'~ rendered. successor shall be appointed by a court of competent''jurisdiction upon petition of either the resigning Trustee or any~'~,person interested in the Trust. Upon the resignation of such Successor Trustee, show no successor be named by the Settlor in this Declaration, a r Trustee .s in 'for the banks in are B. The Individual Co-Trustee and/or any Succesls r Trustee shall have the right to resign this Trusteeship at a~ time. C. Any Successor Trustee appointed, as provide~in ARTICLE VI, Section B of this Declaration, because of the re~i nation or other act of any Trustee, shall, on such appointment~b ling made, immediately succeed to all title of the Trustee to the Trust Estate and to all powers, rights, discretions, oblig~t'bns, and immunities of the Trustee under this Declaration with $~e same effects as though such successor were originally nam~d ~s Trustee in this Declaration. ~~ D. If any provision of this instrument is unen o: the remaining provisions shall nevertheless be carri d effect. into le, 10 E. Except as otherwise expressly provided in this Declaration, no beneficiary of any Trust provided fc~r'in this Declaration shall have any right, power or authorit~r to alienate, encumber, or hypothecate his or her interest in the ',p~r~.ncipal or income of such Trust in any manner, nor shall such inn Brest of any beneficiary be subject to claims of his or her car ~itors or liable to attachment, execution, or other process o$ ~w. F. In any case where payment is made to an indo~~etent, the Trustee may make such payment to the guardian for th~~'~,person or the conservator of the person of such incompetent. I, G. All rights granted to any person by any prow'slions of this Trust may be exercised by such person at any tia ',during his or her lifetime and competency. H. Unless otherwise specifically provided in tai Declaration, all powers granted to any person by the',p pvisions of the Declaration may be exercised by such person aid by time during his or her life, except that if a guardian fob he person or property of any such person has been appointed byla court of competent jurisdiction, then neither such person nor a ~ such guardian or conservator shall have any power to exerc~i ~ any powers granted such person by any provision of this Declaration. I. The Trustee or any Successor Trustee shall hla ~ the right to dissolve any Trust hereunder at any time if It ~ value of the assets held becomeE less than TWENTY-FIVE THOU5AN~D DOLLARS ($25,000.00). If such Trust, in the absolute discret~,i ~ of the Trustee or any Successor Trustee, becomes sufficiently small in value that the administration thereof is no longer ec~r~dmically desirable, the costs thereof are disproportionate to 1tY~~ value of the assets, or the continuation thereof is no longer i ',the best interest of the beneficiary or beneficiaries, the Truk e!e or any Successor Trustee may terminate such Trust. On termination as herein provided, the Trustee or any Successor Trust~ee~ shall distribute the property of such Trust to the person, air persons then entitled to receive the income therefrom, in the proportion as specified in such Trust, otherwise in equal shar~s~.' J. In exercising its discretionary authority u~n~ller this Declaration to make payments to or for the benefit cpflthe "Income Beneficiary" from the net income or principal of the ~~ust Estate, the Trustee shall take into consideration amy~ncome or other means of care, maintenance or support available~ito such beneficiary from sources outside the Trust that maylb~ known to the Trustee. K. After providing thirty (30) days' written rio~ice, the Individual Successor Trustee shall have the right tq ~lnange the Individual or Corporate Successor Trustee to any coYtp~~ate institution which is authorized to conduct Trust busjir~~ss in the United States and has capital and surplus of not le~s~han TWENTY-FIVE MILLION DOLLARS ($25,000,000.00). L. This Trust has been accepted by the Trustee~~.r1 the State of Pennsylvania and, unless otherwise provided in thli~ instrument, its validity, construction, and all righ~t~ under it shall be governed by the laws of that State. I' ', I, the Settlor, certify that: 1. I have read the foregoing Revocable Declara~ijdn of Trust; 2. The foregoing Revocable Declaration of Trust I'Icorrectly states the terms and conditions under which the Truststate is to be held, managed, administered and disposed of by ',t~ Trustee; 12 ~, 3. I approve such Revocable Declaration of Trust in all particulars; and 4. As the Trustee named in such Revocable Declaration of i Trust, I approve and accept the Trust provided for injsuch Declaration. ~, EXECUTED ON THIS ~i~7""~<, day of f~-~:._ -- , 1993, at Carlisle, Pennsylvania. ~~~ Tillie R. Hod Approved: ~ ~ ~,/~ ~~ Stephen B. Lipson, Esquire Attorney for Settlor 13 STATE OF PENNSYLVANIA) SS. COUNTY OF CUMBERLAND ) On this, the ? /-I day of ; t C -- before me, the undersigned, a Notary Public, persona TILLIE R. AODGE, who proved to me, on the basis of s~ evidence, that she is the person whose name is subsc~ foregoing instrument and acknowledged to me that shei, same. '~ -~ Notary Public '- _, 1993 , appeared factory d to the cuted the NOR~3rk1~ J88~ Stephen 8. LlpsOr~, I~ tabu C3ttisle Bore. Cu~mbe MY Commission Expue~ J2i . 1 14 ~~, I 1. All bank accounts and stocks and bonds, for whir~2~ appropriate changes in ownership will be noted ~. the records of the financial institution or entity c~~ncerned. 2. All household goods, furnishings and appliances alnd all other tangible personal property presently ownedl~'and possessed by Tillie R. Hodge and for which there',is no title that is to be changed. ~i 15 -~~' Sovereign Court Ordered Processing 1 Decedents - MAl-MB3-02-10 - P. O. Box 841005 - Boston, MA 02284 October 4, 2010 Andrew J. Bender Allied Attorneys 61 West Louther Street Carlisle, PA 17013 RE: Estate of Tillie R. Hodge Date of Death: 161-20-0345 Dear Andrew J. Bender: Per your request, enclosed please find the account information as of'thl !date of death for the above-named decedent. For your information, accrued interest i~''not included in the date of death balance. Please feel free to contact me if I can be of any further assistance. Very~uly yours, 1 y~ ' i ~I--- ._.._ l ~~ Nicole ob .. Specialist 617-533-1789 ~~ ~,~ Sovereign Bank ESTATE OF Tillie R. Hodge SOCIAL SECURITY #: 161-20-0345 DATE OF DEATH: February 9, 2010 ~', Account #: 1671005627 Type: Checking Open d In the name of: Tillie R Hodge LIVING TRUST DTD 08!06/04 Tillie R Hod~~ Date of Death Balance: $7,200.15 Int.(YTD) from 1 / 1 /2010 to 1121 /2010 Accrued interest to date of death: $0.35 Other Info: Account #: 1671078896 Type: Checking Open In the name of: Tillie R Hodge LIVING TRUST Tillie R Hodge TTEE Date of Death Balance: Int.(YTD) from 1 /1 /2010 Accrued interest to date of death: Otherlnfo: $1,001.61 to 1 /22/2010 $0.00 Sri oi~ nn~ $0.52 8/3/2007 . ~I $0.01 Account #: 1674462540 Type: Money Market Open In the name of: Tillie R Hodge LIVING TRUST Tillie R Hodge TTEE Date of Death Balance: Int.(YTD) from 1 /1 /2010 Accrued interest to date of death: Other Info: $72,b53.67 to 1!22/2010 $19.10 1 Page 1 of 1 ~' III 813/200? p A i'• ~ O~ O M 1 H n ~~'p pop ~ p, "~ c~~ o e e og o e -'~t o01 w o i H uGi e o~ 'tl ar~~r n I•' o °a i 19zb sy. ~p1?q O Ap ~w a twit o I ~6 1,~~ 1••~ ~° o ~ o'd R7 W ~ ; d Me ry•h ~e o~ r 1 p'O p p M p a II 1 y al w~ P p ~R G ''. W W 1 ~\ ~O't ~ ~~~ to o i p 1y y ~ ~I -[y~ 'O M 'O ((p~~ ~ h1 ~ µ -3~1~~ H ~+ O ww p ~ e ~ p~ ~M~,! o, ~ c) j p7. N (1 O ft tr C p v I ~~ 1 d M~ ~C H K„ r• n ~ }Qy~~ 1 Val O e Y M ~ J r• II. !~~ ?~ 1 ~ Ll ~ r ; 4 ~- ~•~• ~C7Ho ~' ~ i x y o n"~o ~""rt ~ i o ym o ~.~ K ~; ~ ~ ~ ~y ww1p~ n Q'~ ~ ~ i ~~i ~ ~t~n ~K{a. ~~H ~ H =~ yH ~ 6 ~H~ i ~\ r9 yM F~ i O O (~ ;Y i~ 7~1 p yak ~~~ ~`, ~ ~ ~~ 0 0~ ~ n~ m 1 ~ v ~ p x/71 ~` e w ~ 1 (~~ ?. ~g e ~' w ~H ~ W ~~~~ OW1 1 @! ~H O ~1 a e~i !1 ~ o ~~. p ~ t7 ~f tf ~ O n~ 0 I~ 1 0 (t O ~ ~ ~ 1+ tp ~~~ A 1 ~ A ~wo ~ `~ ~ ~, a i ~ K O ID I C ~ O 1 ~ N ~ ~ 1 fA O' pwp11 N N 1 ~ N 1 4 ry M b' d J 1 A !i ~ N 1 [i' O W~ W W{ J I ~'. O~1 1~ yy b b ( VI W 1 ~i • ~ 1 ~ ', pro lU/l U 1 A 1~+ 1 O I 1 ~ 1 1 tl n 1 1 1 f I I I 1 n //aa~~ ~ a G' 1 tl7• ~ i oo ~ i PP~ENHEIME October 19, 2010 Andrew J. Bender, Esquire Allied Attorneys of Central Pennsylvania, LLC 61 West Louther Street Carlisle, PA 17013 RE: Acct #A09-0026152 Tillie Hodge (deed) & Brenda Leacack Jt Wros. Dear Andrew: William H. Roberts Senior Director -Investments Oppenheimer & Co. Inc. PA15 Mumma Road Wormleysburg, PA 17043 (Phone 717-763-8200 'Fhx 717-763-1765 Tpll Free 800-722-2244 Member of All Principal Exchanges In regazds to the valuation information requested by Brenda Leacock for the alpove- referenced account on February 9, 2010, please find the following: Account Opening Date: May 4, 2000 Joint Account Designation: May 4, 2000 CashlBank Deposit Value: $7,004.55 Money Mazket Fund Value: $38,267.31 Suburban Propane Partners Value: 350 shares @ $45.15 = $15,802.50 '~ Van Kampen PA Value Mun Income: 150 shares @ $13.28 = $1,992.00, Unit Investment Trust Values: Nuveen Tax Free Ut Tr: 102 Units @ $53.90 = $5,497.80 Pennsylvania Insd Muns Incm: 5 Units @ $24.34 = $121.70 Pennsylvania Insd Muns Incm: 3 Units @ $255.29 = $765.87 Pennsylvania Insd Muns Incm: 7 Units @ $247.19 = $1,730.33 ~' Pennsylvania Insd Muns Incm: 16 Units @ $876.83 = $14,029.2 Total Account Value on February 9, 2010: $85,211.34 Should you require any further information, please do not hesitate to call. ~I j~, Sincerely, '~ r c 7 TI)is !enor+ !c r , ~{r ;,~--,~.„ ~,r,rrm rc nnl1~ j+ is not and shouid not be co~r au-;~ ~ ~ r ..~ , ,~ ~: [i;me! & Co Inc. account M ... ti_ -•..._._...._ ~: ~~ statement ~: °~ a n I I I;y'•~ (t r(t y,i. 7~~1 )e r',Il~o upon for tax reporting 9 - av ~ a and Mich el G. Crows purposes. Market pr!ce~ eneciec ,ara a~ rn F~ are from sources believeu w oe re!!ab[e but r~ not warranted by us as Financial Advisor to accuracy or completeness nnr ,,o they rop es~nt guaranteed markets for the securities. Th!s +ntormai[on [s sublec t~change. Commissions, sales charges or deferred charges mulht uopl !the account were t0 be MGC/hk Immediately liquidated iii)penrrsur)cdr ~. ~(:¢ ,nc., nor any of its employees or affiliates d[>PS nnr arf-r ra+gal ar advice. V M/DL~/iMD NATIONAL' /~ Llfe /nsu~rance Company An~i~tities at their Best May 13, 2010 Estate of Tillie Hodge Andrew Bender 61 West Louther St. Cazlisle, PA 17013 Re: Tillie Halge, 8500121056 Beneficiary: Brenda Leacock Dear Mr. Bender: 4601 Westawn Parkway, Suite 300 West Des Moines, IA 5b266 This contract is an Annuity. Enclosed is the information that is needed to' complete the estate tax return. Decedent - Tillie Hodge SS# - XXX XX 0345 Date of Issue - 01!27/2003 Type of Contract -annuity Non-Qualified Date of Death Value (as of 02/09/2010) $13,438.34 If you have questions, please call us toll-free at 877-880-6367. We are availa~~e Monday through Thursday from 7:30 am to 5:00 pm (CST) and Friday from 7:30 ark o' 12:30 pm (CST). A service professional within the Claims and Benefit Department vWill~ be happy to take your important call. !, Sincerely, ~r (~c~ Cheri Bauer i Claims and Benefit Specialist Claims and Benefit Department '~ cc: file Annuity Division ~ P.O. Bax 79907 ~ Des Moines, !A 50325-0907 Phone: 877-586-0240 ~ Fax:817-586-0249 ~ www.midianrlannuity.ram 05/05!2010 16:41 7174414808 ANERIPRISE FINANCIAL PAGE 81 .l ... ~~ ~ ~ '- ~~ -"'"-~' ^--- Ri~nerSwucs Lifa Nueursnce Company Rive~oures Rands Me~tiM Gf'11Aoalf Cemp~ny Amaiprise ldrolcarspa 70100 AreNriprls+Rinsnaial linter Minneapolis, MN 66474 Miry 5.2()10 nAVrD RAYMOND LYOiv STE 106 49(14 LOiA31 DR MF.CFiANiCSBL1R.C3, PA I 7055fi900 Dcsr DAVID RAYMONTI' T.YUN: i Thank you for your ncemt inquiry regardin8 TILLIE R bi0I7GF's aoco~~nts. Tbeac arc the valuas of tl~e ~c~oants as of 02/U9/~(M ] 0. Account 3a~tvretiatian M~w~! Faa>da B-ix~t.~b.~ 01 01 1 77928b 0002 Individual - T~QD 01o1~9a1c14T a can Ttual ~~ 07150Ca48823 9002 Trnst ~nryfiias -Post 1985 t~.ccount.Nu~)~ Shilz I' 93001781503 4004 Trust ~I 93Q01791746 7004 Trust 930p18402b18 004 'Pn>,t 93001448b 11 5004 Trutd i 93Q0257Qf fi7 0004 'T`rust 93003955Ii901004 Trutt ~~ X.i#c i[>asnAraaic~ Ai:camtN 90902150202 S 004 Individual LTC Presaiana~ Aetgcn ~B~ Number QamerFbip 05!2010 16:41 7174414808 AhERIPRISE FIWihICIAL PAGE 02 910025701136 3004 Iudividuat Mutual Fonda ~aoonat Numb ~ v;~ ~ off' nit vitae rer o1a117792e60002 Sa555d3.5t3 G0265.49i3 4.230 U]O1Z981047 $002 5141306.07 37594.200 3.750 ffT130648823 9002 586911.26 20496.507 4.230 A~aaaitliea ~ Post 1985 ~'a .~ _ ' 9300]7131503 4 OlM S8S079.23 4300] 791746 7004 5365&4.49 930018403618 004 566707.69 9300194$6! 1 5004 521527.1 43t1425706fi7 0 OOd 524881.07 '~ 9300395513901004 54656d.9ti Life Itlanr>.nee E~.t ?~ _ 909021 50202 8 004 ,584925.94 LTC Premaium Ret4ur~a As~mt NutAb~r. 'Total Vaiug _ 9I00257083cS 3004 SA.OO 'lhe dart of death valttcs provided arc far a~ tax and aro naR a va]ue to be paid Aocowni nnarkct fluctuation as gavetned h1 eaeb product Ploese note tort the vabuea indicated for ffiY Life l~ wish the ittsttred dectasod reflect the goes loath bcaeHt at ciacc of darlh sad rwt tha cauh valua. Va1~ Tnsaranea Prodncte vrith only the c~avtlsr detx~aved tcflax the cash valua m of llte date ~' doath. Vah~r rnutnal fonds iacfade aoetuod dividends as applint~te. Vahtes pra-~idcd for ix~olaotages pnaduets acre n should be used a., extimatee only. The griaes used to pdavide vahiCS m astimatas obttdtacd lkom vuh lx rdia6le. Amexiprix Fin+poci~al pt+ovides thane valuaa as a eerviae m its clietLLs. Actual values u,~ec1 mums or t'or plaiming pucpoxs should lx veaifiod b7' your legal sad aocatmtittg advisors We eppnociatb the c+p~ar'euttitg #o be of serviwe b you. Plcaae «,ntsct na if you !rave any guestion.;- be s~ibjcct to ~o prvduci{s) iiuaad fad Life imy ptoprieUuy ty calcuiatcd, and ~urce~ bclicv~ to Rnaration of tax Sinceraip, Dime 13ick Death Settlcmeats Procesaieg Team ' 70100 Amcriptisa Financial Otter Minooapoiis, lv!>,T 55474 t -800-862-7919. ~tian 2a sale for F..state 5attkanca~ts ', Please do not reply to this email. This database does not support incoming mails P~elase tail the phone # within the letter If you require assistance. Thank you. Life Events Team ~ M&T Investment Group M&T Securities, Inc. 285 Delaware Avenue, Suite 2000, Buffalo, NY 14202-1865 October 13, 2010 Tillie R Hodge !, AZD 149888 Date of Death: 02/0912010 Description of Security Quantity in Shares Price per Bare on 02!0912101 MTB PRIME MNY MKT FUND INSTL 365.140 $1.00 '. (MPRn OPPENHEIlVIER STRATEGIC INCOME FD 20,926.435 High- $~. ~5'~, CL A (OPSIX) Low- $J.9~''', Close- $3.$~ We have received the information presented above from sources, which vice believe to be accurate. However, we do not guarantee their accuracy. The stock pride p~r shaze on valuation date is the closing price on that date. The mutual fund price pe share is the low/nav price on that date. Previous business day price is used if DOD falls nl a weekend or holiday. Please contact Client Solutions with any further questions, or if we may l~e', of further assistance to you at 1-800-724-7788, Option #1. Thank you. '1 I' Sincere! '~ Y~ III ~~~~fa v Francesco Musso Jr. I' Brokerage Operations Specialist 1~~, ' M&T Securities, Inc. Investment and Insurance Products: • Are NOT Deposits • Are NOT FDIC-Insured • Are NOT Insured By Any Federal'Go~e~nment Agency • Have NO Bank Guarantee • May Go Down In Vatue M8T frrveslment Group' is a service mark of M8T Bank Corporation and consists of M8T Securities, Inc., the investment-related areas o~ A?8T Bank and investment advisory firms MTB Investment Advisors, Inc., and Zirkin-Cutler Investments, Inc. Brokerage services and insurance products are offered by M8T Securities, Inc. {member F1NflA/SIPC), not by M8T Bank. M8T Securities, Inc. is licensed as an insurance agent and acts as agent for insurers. Insurance policies are obligations of the insurer th~t i~sue the policies. Insurance products may not be available in all stales. ~~ i I ~ M&T Bank 960 Walnut Bottom Road, Carlisle, PA 17013 717 240 4524 Fnx 717 241 7761 Allied Attorneys Of Central Pennsylvania, LLC b I West Loather Street Carlisle, PA 17013 Dear Mr. Bender, ,, i' Per your request, please tind below the date of death balance tor: ~~ Tillie Hodge, social security# 137-36-4381. '~ 1. Account # 31003910527084, Balance $25326.38 + accrued interest $34.37 = $~~3b0.75 Total 2. Account # 1 500420 1 1 43 ! 00, Balance $92338.04 + accrued interest $3.23 = $9 $41.27 Total 3. Account # 9845713297, Balance $22451.35 + accrued interest $O.SU = $224 1 }8~5 Total ~, In addition, you requested proof of title for the above referenced CD #310039105~'~084. Attached is a screen print showing the account title. Please let me know if I cart b~,e'~of any further assistance. 1 can be reached at 717-240-4524. Sincerely, Debra Flytc Stonehedge Office 9b0 Walnut Bottom Road Carlisle, PA 17015 rage: 1 Document Name: untitled P$TITLLO Customer Service Workstation EBRNDEF TITLE VERIFICATION Account #: 31003910527084 Product: CDA Title 1: TILLIE R HODGE 2: BRENDA J LEACOCK 3: 4: Address 1: 419 BUTLER ST 2: 3: 4: BROOKLYN NY 11217 Last Waiver Date: Employer 15:25:15 10/06/01 CIS Remarks: Y SubCode : 'CM M&T BANK SSN/TIN: 1;61200345 Package: Status A~TIVE Phones ~' DOB Sex ~ Maint 10~0~429 Mail Code: 00 Customer Code Restraint: N III Reference # Date Time Notes Description CSW7542757 10105125 14:22 BRANCH INQUIRY CSW6607315 10/04/13 12:36 BRANCH INQUIRY F2 Options F3 Main Menu ENTER Continue TSR EBRNDEF EBRNDEF ate: 61112010 Time: 3:25:42 PM 3R~~ .. ~~.:.~IER . _ ^.~ ~ : EEDS . , ' ~ ~ 1 NT Y - P A Tax Parcel # 04-1-0481-I98 -oy ~~c s ~r~ 2 ~~ MADE THE (o~"~ day of ftu ks~ in the year of oor LoM~d t~vo tbonsand four (2004) BETWEEN TILLIE R HODGE, Trustee of the TILLIE R HO ~ REVOCABLE LIVING TRUST, dated Febntary 14,..2 3, and TILLIE R HODGE, Trustee of the TILLIE R HOI~ E REVOCABLE LIVING TRUST, dated May 24, 199$, '~ amended, for the benefit of Tillie R. Hodge and her rc 'rues named therein, hereinafter called, '. G1~A~N1'EE. WITNESSETH, that in consideration of one (S 1.00) dollar, in hand paid, the ~ekeipt whereof is hereby acknowledged, the said Grantor does hereby grant and conv to the said Grantee, her heirs and assigns: ALL THAT CERTAIN tract of land situate in the Thud Ward of the Borough ~f Carlisle, Cumberland County, Pennsylvania, bounded and described as follo1ws: BEGINNING at a point on the southern side of Thorawood Lane on the divi ' 'line between Lats Nos. 9 and 10 on the hereinafter meationod Plan of Lots; thence png the Southern side of Thornwood Lane, South 79 degrexs 43 minutes 20 seconds W ~t 115 feet to a point at the intersection of Thornwood Lane and a continuation of the o~rner road to Mount Holly Springs; thence Westwardly and Southwardly by a curve t ''the left having a radius of 25 feet, and arc distance of 39.92 fcet; thence along said con ' ued road, South 11 degrees 45 minutes 40 seconds East 86.7 feet to a point; theme ~; the dividing line between Lots Nos. 1 and 10 on said Plan of Lots, North 79 degree $8 minutes East 137.75 feet to a point; thence by the dividing line between Lots IN . 9 and 10 on said Plan of Lots, North 10 degrees 16 minutes 40 seconds West 112.11 t to the place of Beginning. i, HAVING thereon erected a dwelling known as No. 935 Rockledge Drive. ~I UNDER AND SUBJECT to and together with the rights, privileges, agreemen ~ rights- of-way, easements, conditions, exceptions, restrictions and reservations as exist virtue of prior rocorded instruments, deeds or conveyances. 'I eoox 264 PAGE3OS9 ~~~~~~~~'~ "''"^'°^ "" ri i~~ocoi n~in rni lnn'v ~ Inct # 9(N143?d7R - Panu 1 of A . - ,. BEING the same premises that, Tillie R Hodge, by her deed dated . 2003 and recorded in the Vice of the Recorder of Deeds in and for Pennsylvania in Deed Book ,Volume granted and i R. Hodge, Trustee of The Tillie R Hodge Revocable Living Trust, c 2003, Grantor herein. quad County, unto Tillie wary 14, And the said Grantor hereby covenants and agrees that she will wan~ant gien~~ially the property hereby conveyed. IN WITNESS WHEREOF, the said Grantor has hereunto set her hand and s~ai the day and year first above writtcn. I, SIGNED, SEALED AND DELIVERED IN THE PRESENCE OF II _. TILLIE R HODGE B001f 2s~ P~tCE3Q~~ U15/201Q 12:23:39 PM CI IMRFRi nNn r~i wTV I ~~ y COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS. ~, On this, the le'f'~ day of 2004, before , ~ Notary Public for the Commonwealth of Pennsylvania, undersigned officer, y appeared TILLItE R HOIDGE, known to me (or satisfactorily proven) to 1pe a persons whose name is subscribed to the within instrument, and acknowledge that ' axecuted the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. ~.~ ~ ~ ~I t~y- llupMep (SEAL} Notary Public I do hereb c II y ertify that the precise residence a'nrd mplete post office address ~I'the within-named Grantees is: ~~S (~OLkf~~ ~ . ~~/~jlt,~'~ ~ a 3 Date: ~~-l " G'li~ Attorney for COMMONWEALTH OF PENNSYLVANIA SS. COUNTY OF ~ RECORDED on this day of A. D. 'Z0~#, in the Recorder's Office of the said County, in Deed Book ,Volume _ II ' ,Page . Given under my hand and the seal of the said Office, the date Isb ove ,~+ritten. 1 Certify this to be recorded In Cum'oerlattd County PA I! .~: ` , s ~~ ~: .. '~~~ ~ Reorder of Deeds ~~ 9001( 2~ PAGf~ ni~ann~n ~~•~z•zo o-,a n~ iunrrn a un r.r.~ wT.. ~'g~`~' REALTY TRANSFER TAX ~ e1w Tat[ vale ~1Ft OF PE~teriYLWWU ~~' ~ ~~ book I~NtreOor elllll/{A1 of /OIII~IIi1L TA~IEi PaOo Ii~reUir OiPf ~IOe03 ~~ ~~/~~~ ~ ~t~~Ot17s WiN RooorMotl Comgate each esctbn and 1Ne in dupNcaie wNh Recorder a baede w11en (1) the >t~ vsiudoor>tiderdion fa not'ee dead is wilFlout oorleideratiorl, a b+~ gHt, ar (3) a tax sxsmplion k clianled. A Stahrilerlt awllie is not required iF o tax tlaaed on: (1) ~Y raistfonellip ar {2) pubkc utlWty eseernerlt. K more epee i, needed, attsch adlfiiorlal alleet •_ .. Ali Innuiri~ ~wav ~ ditirdd M tlr lielletrrine ewrsen~ 11'1 the deed, (2)11111011 the Ifer ie wholy erlempt hOrrt Andn>nv H. Shaw (717) ~ X1177 3trsetMdrws Clly Sts1e Zfp Cod. 61 W. Loulhe- Street Catliso ~ PA 17013 orrworis~eMa{s) cc~-wM~teY~eeeeets) TtlNe R. a Revocable Trust dated F 14, TtBie R. Revocable L.l+ri ? dated 24, 1993 Saeel/lddreee 8trretAddrass 935 Rodded Drive Q35 R Drhre ~ Cey theta Zip Code City b'Ortes Zlp Cods Catible PA 17013 Cartoo ! PA 17013_____ tiMeetMdrsss Cory, Towneitip. »av~+a- 935 R Dries Carlisle Courtly 3dlool t)isirlet Tax Parosl h111rrtbier 1. AeMN! CMh Gar>.idenAion 2 OtlN- Condderatlon 3. Tad Gonsfdera~gor~ 1.00 + 0.00 = 1.00 4. Cottngr hewed VyNre ti. Cemnton leret Kalb Fsdar e. Fair Atrkat ~ 136.800.Q0 X 1.11 s_ 151,848.00 i 1 a l4ttaurtt d Exsrepeon CMNttsd 1 b. Feroerwape of Ntbrwtt Corrtryed 2. Cheek /Ippropda~a Box 8efow for Exemption Claimed ^ 1MiM or intestate suaoession ~ {Nsats of Dsaadsrrt l ^ Transfer to Indlaitriell Development /10sncy. ~ Trartshr to a trust. (Attad- compote Dopy of mist eQrsemerlt idertii[yirlg aY bsnsfichuies.) ~I ^ Transfer beMlesn prlndpal and agent. (Attach compote Dopy ~ aD~Y~'aw p~Y ~j ^ Transfers b ~ Comntorlwsaittt, tttel lJnNsd Btatee and Itistititttertgiliws by giR, deg eion~ of condelnnattort. (If conderrlnatbn or Nn feu of cordsrnriatiort. attad- copy of rseolutton.) ^ Transferirom mortgagor to a holder of a mortgage in dafau8. Mwtaape Book Number , i ^ Comecfive tx corlfinrtatay deed. (Attach complete vopy d the prbr deed beirp corrected or c1or1 ^ Statutory corporate oonsoNdation, merger or division. (Atlildt copy d arddss.) ^ Other (Please eacptein exemption c~ahrrted, it otMr than Nstsd above.) or b- lieu Under paaaMies d taws 1 deoi~ena tllat 1 haw amealtnid tt11e seebn~«~t, Inoltidlelo a>:oolrgwlghp MNbrlw~a~ and b tl1e beet of ran 11r1ereiedae and belie!. R M enw. aort+eot and FAII.WIlE TO COMPLlRE THif FORM PItOPlBlLY OR ATTACH Ataltl.ICABLE @OCtJMENTATION' M~111' !lEtWLt IN THE RECORDEI!'s IlEFtJBAt. TO RECORD THE DEED. II BOOK ;~~ PACE3Q~ '' ~,~ 7/15/2010 12:23:39 PM !`t u~R~at anin rn~ i~rrv ~ " '"" ' "" ~-- _ _ __ _ . tt,..,t, t\VJplt {/Vau11J pupa«axa~.ccpa.nevaerai Is.a~pYta=u4-lL-U42S t - ~ N2S.~CCdbselect= Detailed Results for Parce104-22-0481-198. in the 2004 Tax Assessment Database DistrictNo 04 Parcel ID 04-22-0481-198. MspSuffix HouseNo 935 Direction Street ROCKLEDGE DRIVE Ownerl HODGE, TII.LIE R C/O REVOCABLE LIVING TRUST PropType R PropDesc & THORNWOOD LANE LivArea 1826 CurLandVal 29750 CurlmpVal 113240 Cur'i'otVal 142990 CurPrefVal Acreage .34 CIGrnStat TaxEx 1 SaieAmt 1 SaleMo 08 SaleDa 09 5aleCe 20 SaleYr 04 DeedlBkPage 00264-03059 YearBlt 1976 HF i:51e_Date 11/16/2004 HF Approval Status R of 1 ~ 10/15/2010 9:56 AM Gary L. Foster, Realtor EXIT REALTY GROUP 57 East Main Street Mechanicsburg, PA 17055 (717) 591-1500 April 15, 2010 ', To Whom It May Concern: The 19th of February 2010, I completed a walk through inspection of the pro Rockledge Drive, Carlisle, Pa 17013. ' The purpose of the inspection was to determine the value of the property far Tillie R. Hodge. Through the Market Analysis process, I have determined the value of the pro~e $190,000. ', I do not have any interest in the property except to determine the market valu~. at 935 estate of to be Sincerely, C~~ d ~ ~' Gary L. Foster, Re Exit Realty Group ' THIS ANALYSIS HAS NOT BEEN PERFORMED IN ACCORDANCE WI' UNIFORM STANDARDS OF PROFESSIONAL APPRAISAL PRACTICE REQUIRES EVALUATORS TO ACT AS UNBIASED, DISINTERESTED'' PARTIES WITH IMPARTIALITY, OBJECTIVES AND INDEPENDENCE WITFIOUT ACCOMMODATION OF PERSONAL INTEREST. IT IS NOS' CONSTRUED AS AN APPRAISAL AND MAY NOT BE USED AS SUCH PURPOSE. THE CD BE F R ANY i ~', I~ ~~ i ~ l . 0 `~ ~ v ~ vt ~ ~ ~, ~~~ ~; ~ - ~~ ~~' ~ w W ~, ` . E ~ ~ C~ F-- i%. o ~ ~, w ~ ' ~ ~~ c~ j~ ~ ~ ~~,, o ~', w ~,' ~~ w Q ~p ~,r., ~ ~ ~~- I ~ ~ i~~ ~~~, o ~~ ~ ~ W ~ I~, ~ W ~- 'I C.~ CA 'q~' ! ~ I .~: C ICI m Q I o ~ ~ ~'1 ~ ~ 1 ~ U~ ~ ~'' mj `~ 1 d ~ O f- U Q ~ J p ' ~ W ~ a ' 'a '~ ~ ~, w o n~ z -- o O a } o ~ ~ ~ h d WOI] ~ ~ ti ~° J d ~ ~' I- W h ~~ W ~r U ~~ ~~ W ~ ~ ~ 1-- 0:. CJ ~ i]. „'~~ ~ d ~ h ~~ a o l+ry-. V ~ ~_ V il. ~ iy a: O~ ~~ ~w ~c o ~~ ~, W z ~~- w in .~ ' ~~ APPRAISAL Personal Property of ~/,~ L / E HD d~yE ~'S7`~Tx ~/ ~.5'~R U ck ~ Ed ,~~ DR, G.A-R.L-i S c.~ Appraised by Chuck E. Bricker AU094-L p~t~ ~ _ 2~ , „ p ` ~ ~° 13 ITEM VALUE ITEM ' VALUE NJ~.T L Oa2cH c / 5 'Oo C N ~ rA E-5K _ U~c~O U cL w F c-E 1 0 0 ~~ UE ~ MP i~ Di LU C E Uo S O/ ~ f~~ Nd / D ou Ov O~FK cN~s w 1 ,~ 2a NKE cstc~s r 1 v ao 1~ >J vTcll c. ti,c~.r s Oo ~ s 5 va -2v.1 R s r ~ ao.o~ ~c`~ ~...U,da Pos ~. ~ ~ Rid IOQ,c~ c ~v~ rz o clC ~ `~ a s r d E Gti / s v,oc vc,d ~ 00 C ~c/oPY FZ oPE ~ oa,ai / 1 U,OV !Ur s iu ~U, v~ ,DES W -c FT 1 U DU LE t~ ~ l~O,Uc Co~-0 3r?,dv .2- M r v2 v~ l T~ 5k L~ ~ /~, ~~jCZ, ~ t~' 1}, VU ~R L~ .Z~!/E S ~i '' S 3~ v~ P N~ v 120. vo $ ~- ,uK~ C`l~sT / vd ~ Oi' ~ F. T ec~ p, ao f/ c c Sv, Uo 5, G~ / s ~... ~ UVV C /!L U.w KS~ ~Oo L.W i R ~E 1 ~, 0 2~/~ cv~~ ~ ,~ ~~ oo ~ ~ a vo Oc 0 c.E D 40 !~c-~ i.E / U i /`f 1• 'i d L F K c , J Uv UV ~ EW ~ ~ U, 0 c i11KE O,OD L- ~ ~- 0.2 ~,U d9 c.~Y R. 5 U ~ 3d11, ca /! f3Eds 5 ~ G ~r cu E cv OD ov 1`1 pCE v (~~J,v , ~(/ R~LF 5 l~lvufi gu u ~ ' 3 00, 0. / ~t/fi~~E[,... t>U,(JD S POtl L / e ' UO,~ $ooK s~ by tc> /TE ~ sr N dv.v, Vl Gr v d , Uo ~ Pt-,~,~J GlG4 , s .2D, U IG ~ Std Gjl / V Ss7"~ W [.-NU F !-~tE ~O,fJ~ ~ VI~T, RM C 0200 os ssT"~ icw F .~o,o~ D EW %N N l SST, ,RC / G,aEN ~N Si s d 13U, L` C E d 55T, /N1F- l~ls -PU Y I'~s ~DU,G~ G N cE s k 0 vD ssT, /.`rJ~R W R-~ ~~L', o L~ Cr ~ LT !L! tR ~~. 3` UO dv~ ~ E ~ ~ N ~ a~~~,aa oT ~. s ~ ~ ~ ~, d ~ a / u.do ~-° /l! G l.r(J G ,.fit C ~ Cl~lar~ c~v~« ---- ____ l ~o,~}o /-1 vv~h~ ~. 3-~~ ~fC- ' ~,._ ^I~IP^~Gl~•'i~i~u,~~li~7IS7~.IP11.1-~~ 007852 858HMA 000064R `" 45 Sprint Drive M E REGIONAL DECAL CENTER Carlisle, PA 17013 ADDRESS SERVICE REQUESTED '' UPON .,.RECEIPT IF PAYING BY CREDIT CARD, FILL OUT BELOW AND SEE REVERSE SIDE CHECK CARD USING FOR PAYMENT .i ^ ^ i i ~ w.,~a;~w ^ MASTERCARD ®DISCOVER I~ VISA ``pass AMERICAN EXPRESS ACCOUNT NO. STAT'EMENIT DATE B L;4NCE DUE • 9457105 05/24/2010 $50.00 MAKE :CHECKS PAYABLE T©: Tillie R Hodge C/O Stephanie Chertok CARLISLE REGIONAL MEDICAL CENtER 61 W Lowther St P,O. BOX 281442 v Carlisle PA 17013 ATLANTA GA 30384-1442 I~~JI6~dIL~„~~11~~16~~1~11~{~~I~~LI~~~IId~~IJ~~~I~~l1 L~li~ll~~~.~ILI~d~~l~~{...ILI~J~I~~hJ~LL~L~i~l~ld~l 0000094571DSDO~OU0050(30TILLIE R'WODGE 3 ^ Please check if above adtlress is incorcect and indicate change on reverse side. TO INSURE PROPER CREDIT, DETACH AND RETURN TINS PORTION IN THE ENCLOSED ENVELOPE. PATIENT NAME PATIENT'A OUNT N0. DATE OF SERVIC PE OF ERViCE Tillie R Hodge _ 9457105,. 02/09/2010 II EMERGENCY ROOM 'DATE DESCRIPTION PAYMENT/ADJUSTMENTS 03!03/10 ADJUSTMENT 2,607.74- 03/03/10 INSURANCE P'AYMEN7 452:04- r PAYMENTS AND CHARGES RECEIVED AFTER THE STATEMENT DATE WILL BE REFLECTED ON THE NEXT STATEMENT. ~ ! r $50 .00 ME SAGE The amount shown on this statement is.outstanding at _: FOR BILLING ~UESTIUNS, LEASE CALL: this time. Yourprompt payment will be greatly (717) 960-1680 appreciated. ~; Bills can be paid online at our ha~spital Internet web site www.carltslertnc.com PON RECEIPT Ewing Brothers Funeral Home, inc. ' 630 South Hanover Street Carlisle, PA 17013- (717)243-2421 Apri124, 2014 Brenda Jackson Leacock 419 Butler St. '. Brooklyn, NY 11217 The Funeral Service for Tillie R. Hodge We sincerely appreciate the confidence you have placed in us and will continue to assist yc feel free to contact us if you have any questions in regard to this statement. THE FOLLOWING IS AN ITEMIZED STATEMENT OF THE SERVICES, FACILITIES, AUTOMOTIVE E AND MERCHANDISE THAT YOU SELECTED WHEN MAKING THE FUNERAL ARRANGEMENTS. I. PROFESSIONAL SERVICES Services of Funeral Director/Staff , $184C Embalming. $87~ Dressing, Casketing, Cosmo etc. $29( Z. FACILITIES AND SERVICES itt every way we can. Please Full Facility Usage $990001 ~ 3. AUTOMOTIVE EQUIPMENT ' Vehicle to transfer cemains to Funeral Home, $275:00 I Hearse (Casket Coach) $250.'00 Lead cazlClergy $125.00 Utility Vehicle for Death Certs etc., $125.b0 FUNERAL HOME SERVICE CHARGES $4770.Q0 SELECTED MERCHANDISE: Clarksburg (Aurora) Magnolia Poplar, $2800.00 Acknowledgement cazds, . $10.Q0 Register Book(s) $40.00 Memorial folders , $75.00 THE COST OF OUR SERVICES, EQUIPMENT, AND MERCHANDISE THAT YOU HAVE SELECTED $7695.OiD Cash Advances Certified Copies of the Death Certificate , $120.OQ1 The Sentinel Obituary with Photo , $132.94 TOTAL CASH ADVANCES AND SPECIAL CHARGES . $252.90 Total j Totat Cost $7947.90 ~~eKT Pa ,~ ~ ~Leaat~ ~ , ' SUB-TOTAL $7947.90 ~ ~ f n~~ ~~ INITIAL PAYMENT /DISCOUNT /CREDITS 7546.37 e/~ TOTAL AMOUNT DUE ~~ The unpaid balance over 30 days is sub}acted to a 1.50 % service charge per month -18.0000 % per annum. ~~ ;~~~ ~~~ s~ ~~ COMMONWEALTH OF PENNSYLVANIA STATE EMPLOYEES' RETIREMENT SYSTEM HARRISBURG REGIONAL COUNSELING CENTER 30 NORTH THIRD STREET, ROOM 319 HARRISBURG, PA 17101 TELEPHONE: (717} 783-9065 FAX: (717) 783-9599 TOLLFREE: 1-800-633-5461 www. sers.state.pa.us March 31, 2010 Estate of Tillie Hodge C/O Brenda Leacock 419 Butler Street Brooklyn NY 11217 Dear Ms. Leacock: Invoice # 22384 RE: Tillie Hodge SS#: ~ 161-20-0345 I We have recently been informed of the death of Tillie Hodge, a retired memberl df this System. We wish to extend our condolences to you at this time. Since Ms. Hodge died 2/9/10 and the February check was not returned to our'~,o ice, this account has been overpaid in the amount of $571.43 for the period from 2/10%'1 - 2/28/10. It will therefore be necessary for our office to be reimbursed for $57`1.3 to liquidate this overpayment. The reimbursement should be made payable to The State Employees' Retirei System, and mailed with the enclosed copy of this letter to the address shown' We will need a certified copy or an original death certificate for our file. Upon receipt of the reimbursement, this account will be closed. There are no benefits to be paid from this System. Should you have any questions concerning this matter, please do not hesitate tq me at the above address or by telephone at (717) 783-9065 or 1-8t)0-633-5461. Thank you for your cooperation. Enclosure Sincerely, ~. ~r~~ '~ Linda Dolan, Administrative Assis ~t , Harrisburg Regional Counseling C I j ~~G~ Insurance Group DS COPY MARIETTA, PENI~Y~VANIA 175t7-0C~02 RENEWAL OF POLICY HP 5054788 PREFERRED BL HOMEOWNERS POLICY RENEWAL DECLARATION * * * * EFFECTIVE 09/06/10 j 6P'fBC;`i`1 VA 1L C V1 A.M HP 5054788 09/06j10 09/06/11 DONEGAL MUTUAL INS. O ~ 000431 C HODGE TILLIE CARLISLE INSURA !SERVICES 09 935 ROCRLEDGE DRIVE 1 VALLEY ST SUIT 101 CARLISLE PA 17013 CARLISLE PA ~ 17013 HP-501 PREFERRED 100 HOMEOWNERS POLICY HP511 PROTECTIVE DEVICES SMORE -DETECTOR; DEAD-HOL~'~LDCRS ; FIRE EETiZQGLTISftGR t" ~ - -- H02353 PERSONAL PROPERTY REPLACBMBNT COST - PA HP-245 EBTENDED LIMITS COVERAGE - COW. A - DWELLING ~ HP-509 MULTI-PROTECTOR PLUS ~ 08/03/10 20:02:0953 ~ rt-21s~ea) ~~_ t Preeident ----- STATEMENT OF ACCOUNT ----- ------- PAYMENT PLAN ----~- '~HP 5054786 03 OF TOTAL PREMIUM $566.00 BALANCE PRIOR POLICY $26.00 TOTAL $592.00 TOTAL AMOUNT DUE 09/06/101...',... $592.00 TOTAL AMOUNT RECEIVED $0.00 ACCOUNT BALANCE $592.00 THANK YOU FOR LETTING US $E~ttJC YOU