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11-23-10
1505610149 REV-1500 Ex(o1-1oj OFFICIAL USE ONLY pennsytvania ce.anrnw, ornMeu+c County Code Year File Number PA Department of Revenue Bureau of Individual Taxes INHERITANCE TAX RETURN Po sox zeoeol RESIDENT DECEDENT 21 10 0 2 2 9 Harrisburg, PA 17128-0801 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 187 16 4397 02 26 2010 10 18 1925 Decedent's Last Name Cogley, Sr• (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW ~ 1. Original Return Suffix Decedent's Frst Name MI Mr• John W Suffix Spouse's Frst Name MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS Q 2. Supplemental Return O 3. Remainder Return (date of death prior to 12-13-82) Q 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required death after 12-12-82) ~ 6. Decedent Died Testate ~ Z~ Attach CoM~of Trust) a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) ( py Q 9. Litigation Proceeds Received O 10• betweenl2 31y91 anitd(d ~e95)death O 11' Attach Sch. O) nder Sec. 9113(A) CORRESPONDENT -This section must be completed. All Correspondence and Confidential Tax Information Should be Directed to: Name Daytime Telephone Number Elyse E• Rogers, Esquire 717 612 5801 rv First line of address Keefer Wood Allen & Rahal, LLP Second line of address 635 N• 12th Street, Suite 400 City or Post Office State ZIP Code Lemoyne PA 17043 Xt'R.p,F WILLS U~NLY _,,.7 rr ` ~. I.~ ~..~... ~/~ ~ ti ~ .., ~~ -rt ~.~, - '~ «_: ICJ r `.._ -3'bATE FILED ~ Correspondent's a-mail address: erogerS keeferwood corn Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of the preparer other than perso al r resentative is based on all informationof which preparer has any knowledge. SIGNATt,IREO ERSON RE/BPOI~SIBLE FOR FILING ~ ~ A ~ DATE ~-'1 - le 35 N. 12th ~ eet, uite 400 PA 17043 PLEASE USE ORIGINAL FORM ONLY ~! ~~f - Side 1 1505610149 1505610149 J Estate of: John W. Cogley, Sr. Mr. Executor Lynn F. Sheffer John W. Cogley, Jr. 655 Hunters Lane 2136 Worthington Avenue Lewisberry, PA 17339 Bethlehem, PA 18017 187-16-4397 J 1505610249 Rev-1500 IX Decedent's Social Security Number 187 16 4397 Decedent's Name: John W. Cogley, Sr. Mr. RECAPITULATION 1 150,000.00 1. Real estate (Schedule A) • • • • • • • • • ............................... . 2. 0.00 2. Stocks and Bonds (Schedule B)••••••••••••••••••••••••••••••'• " " 3. 4. 5. 6. 7. 8. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) • • • • • • Mortgages and Notes Receivable (Schedule D) • • • • • • • • • • • • • • • Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E) • Jointly Owned Property (Schedule F) O Separate Billing Requested • • • • • • Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested • • • • • • Total Gross Assets (total Lines 1 through 7). • • • • • • 3• 4. 5 6. 7. a 0.00 0 •0 0 11,336.06 45,496.11 5 9 ,14 9.0 8 265,981.25 42,309.80 9. •••••••••.• Funeral Expenses and Administrative Costs (Schedule H) • 9. 1,234.21 10. Debts of Decedent, Mortgage Uabilities, and Liens (Schedule I) • • • • • • • • • • • • • 10. 43,544.01 11. ....................... Total Deductions (total Lines 9 and 10) 11. 222,437.2.4 12. Net Value of Estate(Une8minusLinell)••••••••••••••••••••••••••••• 12. 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which 0 • 0 0 an election to tax has not been made (Schedule J) • • • • • • • • • • • • • • • • • • • • • • • 13. 222, 437.24 14. Net Value Subject to Tax (Line l2 minus Line l3) ••••••••••••••••••••••• 14. TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9118 Q• Q Q 15 0. 0 0 (a)(1.2) X .00 18. Amount of Line 14 taxable 2 2 2, 4 3 7 • 2 4 1 e 10 , O D 9.6 8 at lineal rate X .045 . 17. Amount of Line 14 taxable 0 • 0 0 17 Q • Q Q at sibling rate X .12 . 18. Amount of Line 14 taxable Q • Q Q 18 Q . Q Q at collateral rate X .15 . 10,009.68 19. TAX DUE .................................................... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ~ Side 2 1505610249 1505610249 J Rev-1500 EX Page 3 Decedent's Complete Address: DECEDENTS NAME John W. Cogiey, Sr. Mr. 114 aTv Camp Hill e Drive Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) Fle Number 21 10 0229 PA 2. Credits/Payments 10,500.00 A. Prior Payments B. Discount 500.48 Total Credits (A + B) 3. Interest 4. If Line 2 is great FI~~ jn oval on Page 2, Line 20 toffequest a relfundhe OVERPAYMENT. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. ZIP 17011 (1> 10.009.68 (2) 11,000.48 (3) (a) (5) 0.00 990.80 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. retainareversionaryinterest;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" orpayable-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 containsabeneficiarydesignation? ••••••••••••••••••••••~••••~•"'•"""""•' IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent [72 P.S. Sect. 9116(a)(1.1)(i)]. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S. Sect. 9116(a)(1.1)(ii)]. The statue does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0 percent [72 P.S. Sect. 9116(a)(1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in 72 P.S. Sect. 9116(1.2) [72 P.S. Sect. 9116(a)(1)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. Sect. 9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1502 EX+(01-to) ~ Pennsylvania pEPART!`tEN7 OP REVENVE INHERITANCETAX RETURN RESIDENTDECEDENT SCHEDULE A REAL ESTATE FILE NUMBER: ESTATE OF: 21 1 ~ 0229 John W. Cogley, Sr. Mr. All real property owned solely or as a tenant in common must be reported atfair market value. Fair marketvalue is defined as the price at which property would be .. _ __ _ ._.:,~:__ ~..,,....,..a ~ ,.,arm„ _ewuar. neither being compelled to buy or sell, both having reasonable knowledge of the relevantfacts. If more space is needed, insert additional sheets of the same size. REV-1508 EX+(B-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCETAX RETURN RESIDENT DECEDENT SCHEDULE E CASH BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER ESTATE OF 21 10 0229 John W . Cogley, Sr. Mr. 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. VALUE AT DATE ITEM _ DESCRIPTION OF DEATH 1 Misc Household Items 2,440.00 Per appraisal 2 Traveler's Insurance, refund 34.00 3 Highmark, Health Insurance Premium Refund 370.14 4 PA Property Tax Rent Rebate for 2009 property tax year 300.00 5 2004 Chevrolet Trailblazer 8,050.00 Per kbb.com 6 Kemper Annuity Payment 135.73 7 Worldcom Settlement Fund -Class Action Settlement Check 6.19 TOTAL (Also enter on line 5, Recapitulation) I 11,336.06 (If more space is needed, insert additional sheets of the same size) REV-1508 EX+101-10) i "~ Pennsylvania DEPARTMENT Of REVENUE INHERITANCETAX RETURN RESIDENTDECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY FILE NUMBER: ESTATE OF: 21 10 0229 John W. Cogley, Sr. Mr. If an asset became jointly owned within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME(S) ADDRESS RELATIONSHIP TO DECEDENT A. See schedule attached e. c. JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY. INCLUDE NAME OF FINANCIAL ITEM FOR JOINT MADE INSTITUTION AND BANKACCTNUMBERORSIMILARIDENTIFYING TENANT JOINT NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. %OF DATE OF DEATH DATE OF DEATH DECD'S VALUE OF VALUE OF ASSET INTEREST DECEDENTS INTEREST NUM. 1 B 042707 Sovereign Bank Checking Account 10,030.63 50.000 5,015.32 0571204260 Jt with Lynn Sheffer Total value $10,030.82 B 042707 Interest on above item accrued as of 0.19 50.000 0.10 decedent's death 2 C 032508 Sovereign Bank Money Market Acct 40,216.87 50.000 20,108.44 0574177159 Jt with Scott Cogley Total value of account $40,216.87 3 D 040908 Sovereign Bank CD 0575498324 Jt with Lori 10,201.17 50.000 5,100.59 Doyle Total value $10,201.17 n Bank CD 0575498332 Jt with Lynn rei S 10,221.17 50.000 5,110.59 4 B g ove 040908 Sheffer Total value $10,221.17 5 A 042708 Sovereign Bank CD 0575504972 Jt with John 10,168.48 50.000 5,084.24 W. Cogley, Jr. Total value $10,168.48 6 E 050908 Sovereign Bank CD 0575509013 Jt with Allison 10,153.65 50.000 5,076.83 O'Brien Total value $10,153.65 TOTAL (Also enter on Line 6, Recapitulation) 45,496.11 If more space is needed, use additional sheets of paper of the same size. Page 2 Estate of: John W .Cogley, Sr. Mr. Schedule F -Jointly-Owned Property The surviving cotenants are as follows: A. John W. Cogley, Jr. Son 2136 Worthington Avenue Bethlehem, PA 18017 B. Lynn F. Sheffer Daughter 655 Hunters Lane Lewisberry, PA 17339 C. Scott R. Cogley Son 5047 Ravenwood Drive Mechanicsburg, PA 17055 D. Lori C. Doyle Daughter 4516 Crooked Hill Road Harrisburg, PA 17110 E. Allison O'Brien Daughter 600 Gladstone Avenue Baltimore, MD 21210 21 10 0229 REV-tsto EX+(oa-oe) i SCHEDULE G a Pennsylvan OEPAATMENT~ OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCETAXRETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT FILE NUMBER ESTATE OF 21 10 0229 John W. Cogley, Sr. Mr. This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-t50o is yes. DESCRIPTION OF PROPERTY & H IN VALUEOOF ASSET /INTERESD'S (IIXPPL`ICAB E) TVALUEE NUM FOR REAL ESTATE DATEOFTRANSFER. ATTACH COPYOF DEED 1 LPL Financial 46,786.38 100 46,786.38 Beneficiaries: Decedent's children, John W. Cogley, Jr., Lynn F. Sheffer, Scott R. Cogley, Lori C. Doyle, Allison O'Brien 2 Kemper Annuity KI11015376 12,362.70 100 12,362.70 Beneficiaries: Decedent's children, Lynn Sheffer, Allison O'Brien, John Cogley, Scott Cogley, Lori Doyle Per 04/05/10 fax TOTAL (Also enter on Line 7, Recapitulation) I 59,149.08 If more space is needed, use additional sheets of paper of the same size. REV-1511 EX+(10-09) ',~ ~~;` Pennsylvania DEVARTMEN7 Of REYENVE INHERITANCETAX RETURN RESIDENTDECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF 21 10 0229 John W. Cogley, Sr. Mr. Decedent's debts must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A, FUNERAL EXPENSES: 1 Neill Funeral Home 2 Mt. Olivet Methodist Church g, ADMINISTRATIVE COSTS: ~. Personal Representative Commissions: Name(s) of Personal Representative(s4.ynn Sheffer/John W. Cogley, Jr. street Address 655 Hunter Lane / 2136 Worthington Avenue aty Lewisberry /Bethlehem State FA zip 17339 / 18 Year(s) Commissioh Paid: 2010 2, Attorney Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4, Probate Fees: 5. Accountant Fees: 6. Tax Return Preparer Fees: See schedule attached 7 TOTAL {Also enter on Line 9, Recapitulation) 8,294.57 147.70 10,000.00 5,000.00 315.50 17,893.10 42,309.80 If more space is needed, use additional sheets of paper of the same size. Estate of: John W. Cogley, Sr. Mr. Schedule H, Part B -Administrative Costs Miscellaneous Expenses Page 2 21 10 0229 Item Descri tion Amount Number 7 Keefer Wood Allen & Rahal, LLP, out of pocket expenses 52.87 8 The Sentinel, legal advertising 176.92 9 Cumberland Law Journal, legal advertising 75.00 10 Chuck Bricker, appraisal of household items 100.00 70.69 11 PPL 238.50 12 Orkin, carpenter ants 13 Mark Hilbert, house appraisal 375.00 177.59 14 Verizon 21.90 15 UGI Utilities 97.95 16 Lower Allen Township, sewer 26.56 17 PA American Water 67.09 18 PPL 108.85 19 Verizon 20 Traveler's Insurance, homeowner insurance 46.00 18.90 21 UGI 22 Sovereign Bank, service fees 30.00 87.50 23 Drew Cogley, lawn care 53.14 24 PPL 25.77 25 PA American Water 16.28 26 UGI 130.00 27 Drew Cogley, lawn care 28 Lynn Sheffer, reimbursement for goods & supplies for home 404.63 repairs/improvements TOTAL. (Carry forward to main schedule) ...... 2,401.14 Page 3 21 10 0229 Estate of: John W. Cogley, Sr. Mr. Schedule H, Part B -Administrative Costs Miscellaneous Expenses Item Descri tion Amount Number 29 Scott Cogley, reimbursement for supplies for home repair/improvements 282.61 23.38 30 PA American Water 192'97 31 S. Drew Cogley, lawn care 32 S. Drew Cogley, reimbursement for supplies for home repair/improvement 157.50 111.33 33 PPL 97'95 34 Lower Allen Township, sewer 16.09 35 UGI 36 J.S. Norford Heating, Plumbing, basement water intake valve 113.25 60.00 37 Drew Cogley, lawn care 38 NPRA, Archival Programs, obtain Decedent's service records 60.00 144.97 39 PPL 22'69 40 PA American Water 16.09 41 .UGI 21.09 42 PA American Water 97'50 43 Drew Cogley, lawn care 95.07 44 PPL 16.09 45 UGI 46 Traveler's Insurance, homeowner insurance 10/1/10-10/31/10 24.50 71.02 47 PPL 48 PA American Water 21.09 49 Lower Allen Township, sewer 10/1-2010-12/31/2010 97.95 50 Know Swett, powder post beetle treatment 100.70 51 Deluxe Checks, estate checks 11.45 TOTAL. (Carry forward to main schedule) ...... 1,855.29 Page 4 21 10 0229 Estate of: John W. Cogley, Sr. Mr. Schedule H, Part B -Administrative Costs Miscellaneous Expenses Item Descri tion Amount Number 16.08 52 UGI 53 Central Penn Radon, Inc., radon mitigation system 745.00 22.03 54 PA American Water 55 Lynn Sheffer, reimbursement for misc out of pocket expenses including 214.41 house supplies, postage, photocopies 56 Scott Cogley, uhaul rental 32.65 57 Lien T. Pham, credit/roof repair 125.00 58 Settlement charges re: sale of 114 Limestone Drive, Camp Hill, PA 17011 10,990.61 Settlement charges: $12,005.01 minus items paid in advance by seller $119.57 county taxes $825.62 assessments $ 31.09 sewer $ 38.12 trash 16.08 59 UGI 79.44 60 PPL 23.04 61 PA American Water 33.35 62 Allison O'Brien, uhaul rental 1,007.00 63 John W. Cogley, Jr., gas for 2,014 miles 297.50 64 Lynn Sheffer, gas for 595 miles 34.48 65 Lynn Sheffer, reimbursement for home repair supplies TOTAL. (Carry forward to main schedule) ...... 13,636.67 REV-1512 EX+(12-08) '~ Y' ~~, ~ Pennsylvania ,_ pEPARTMENT OF REVENUE INHERITANCETAX RETURN RESIDENTDECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS FILE NUMBER ESTATE OF 21 10 0229 John W. Cogley, Sr. Mr. Report debts Incurred by decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. VALUE AT DATE ITEM DESCRIPTION OF DEATH NUMBER 1 Dept of Vet, prescriptions 26.06 2 PA American Water 31.24 3 PPL 93.09 4 Sears, payment of credit card 80.61 5 HSBC Card, credit card 636.77 61.20 6 UGI 7 Dept of Veterans Affairs, medical office visit 50.00 8 PA American Water 30.45 199.35 9 Verizon 10 Capital City Jewelers, watch repair (watch taken prior to Decedent's date of 25.44 death) TOTAL (Also enter on Line 10, Recapitulation) I 1,234.21 If more space is needed, insert additional sheets of the same size. REV-1513 EX+101-10) `*; Pennsylvania OEPARTMENt OF REV£NV£ SCHEDULE J INHERITANCETAX RETURN BENEFICIARIES RESIDENTDECEDENT ESTATE OF: FILE NUMBER: John W. Cogley, Sr. Mr. 21 10 0229 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBE NAME AND ADDRESS OF PERSONS RECEIVING PROPERTY Do Not Llst Tru s OF ESTATE z TAXABLE DISTRIBUTIONS [Include outright spousal distributions, and transfers under Sec. 9~ ~ 6(a)(1.2).] John W. Cogley, Jr. 2136 Worthington Avenue Bethlehem, PA 18017 Lynn F. Sheffer 655 Hunters Lane Lewisberry, PA 17339 Scott R. Cogley 5047 Ravenwood Drive Mechanicsburg, PA 17055 Lori C. Doyle 4516 Crooked Hill Road Harrisburg, PA 17110 Allison O'Brien 600 Gladstone Avenue Baltimore, MD 21210 zz Daughter 44,487.44 44,487.45 44,487.45 44,487.45 44,487.45 ENTER DOLLAR AMOUNTS FOR D ISTRIBUTIONS SHOWN ABOVE ON LINES 15 TH ROUGH 18 OF REV-1500 COVE R SH EET, AS APPROPRIATE. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 913 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. If more space is needed, use additional sheets of paper of the same size. ~~1.~~ U'U' Illlll ~1LIlIlQll ~Q~S~~~IICIl~C(:7YIll~ () }+ JOHIvT ~'. CO(~LE~ , SR. I, JOHN ~'1'. COGLEY, SR.; of Lower Allen Townshil_>> Cumberland Couni.y, Penns~~lv~:Lnia, dr, make, t:~uhlish and declal°e this to be my Last ~~'ill and Testamem, hereb~~ r~evohing all Fills a.nd Codicils by me heretofoi°e made. ITEI\~ I: Famil~l'ormation. I am a widower, having been married to F1tEDA 11~I. COGLEY. I have five children: JOHN ~~. COGLEZ', JR., LZ'1~TN F. SHEFF:CIti, SCOTT R. COCxLE1', LORI DOZrLE, and ALLISON OBRIEN. These are descr.•ibecl in this \~'ill as "my chilclz•en," oi• as "a child. of mine." any person born to or adopted by issue of mine is to l:~e included as issue of mine. Provided; hov~~ever•; no adopted person shall 1~enefit under this ~'ili unless the oi•de~~ or decree of adoption is entered before the adopted person attains tl~e age of twent,y- one (21) yeas°s. IT:CM II: Death. Taxes. I direct: that. all inheritance and estate taxes bec;oining due ley i°eason of my death, whether payable by my est.at.e or by any recipient, of any property, shall. be paid bjT the Executor out of'tlie residue of my estate, as an expense and cost. of aclniinistration of my estate, except. that. no taxes shall }:~e charged against, any gift qualifying foi° the mar•it.al or charitable deduction in my estate. The Execut.oi~ shall have no duty o1° obligation to obtain reimbu~°sement for any such tax so paid, even though on proceeds of insu~•ance o1° other 1~~~°ope~°ty not passing under this ~fiill. ITI~M III: Debi,s and Finn] Ex~~enses. I direct. the Execut.ur t,o pay the expenses of my last ilhless and fune~•al expenses fi•on~ the residue of my estate as an expc;nse and cost. of aclministrat,ion of my estate. ITEl\~1 IV: Tani}:ale Personal .Properti~. I may leave a wrii.t.~n list in m}- safe deposit box cu° elsewhere disposing of certain items of my tangible personal l~n~•ol-~erty. The Executor shall dispose of items of•n~y personal Page 1 ~, C property as s1.,ecilied in i.he written list. If' no written list. is found in my safe dc:p~sit box or elsewhere and propc~°ly identified b~~ the Executor within thirty (30j da~•s after i.he 1_,robat;c of• my Fill, it. shall be pr°esumed that there i.s no other st~.ii.iment. or• list. Any subsequently discovered list shall be ignored. I give any 1_~r°operty of the type described in this :It.enr and not set forth in a written list to my chilclr•en; to be divided among them as they shall agree. Should i,here be no agreement; the Executor shall divide this property among them in as nearly equal portions as the Executor, in the discretion of t;he Executor, deems al_~propriate, having due regard to the personal prefi~rences of my children. ITEZ\~I V: Residue. I give t;he residue of• my esi;ate, not disposed of in t:he preceding portions of'this ~~rill, t,o my children, in those proportions which wi11 be necessary for' each of my children to receive an equal amount of'pr•ol:>e~°ty passing as a re;>ult; of'rny death, tal;.ing into account not only probate propert.~- which passes as Dart of't.he residue, but also jointly held 1_,roperty and p~•operty which passes ley beneficiary designation. If any of n1y children do not. su3°viee me, but. ar•e survived by then living issue, the share of my deceased child shall I_,e paid to liis or her• then living issue, per stirpes. ITEN1 ~%'I: ~4dminist.r•ative Powers. In addition to the powel•s granted at law, the I~xecutor shall possess the following powers, each of which shall be construed broadly and Waxy be exec°cised without court approval; but in a fiduciary capacity only: (a) Detain Invest.men.t;s. To retain any investments I have at my do at.l~, including specifically those consisting of" stock of any bank even i_{' I have. named that. bank as t;he Executor. ~(:>) 1'ary Invest;ment;s. ~('o vary investments and t•o invest in l,onds, stocks, notes, r°eal estate ruortgages or• ot;her securities or in other prol~,er•ty, re-al o~° per°sonal_, without Ueing rest,rict,ed to so-called "lega] investrneni:s", anal u~:it,l:lout being limited by any staiut;e o~° rule of law regarding investments by fiduciaries. (c) Division of ~ssc.t,s. In or•der• to divide the p~°incipal of m~; estate or° make disi~,ril~utions, the Executoo3° is aut;horire.d to disi~,r•ibut.e Ya~,f. `.~ ~ C ',~ persona] hr-operi,~= and real proper•t}'partly or wholly in kind, and t.o alluc;at.e specific assets among beneficiaries so long as the #;oLstl mar°l~ei ~~al ue of each share is not. affected by the dig=ision; distribution or• allocation in kind. The Execui;or° is authorized to make; join in and consummai.e partitions of lands, voluntarily or• involuntar•il~=, including giving o:f mutual deeds, or o#;her c,l,ligations, with as wide power's as an indi>>idua] c;wner in fie simple. (d) Sell Assets. To sell either at public or• private sale any or. all rc:a] or• personal property tieverall~= or in conjunction with other persons, and to consummate sa.le(sj by deed(s) or' other i.nstr•unient(sj to the Purchaser•(,sj, convey=ing a fee simple title- No purchaser shall be obligated to see to the applicai,ion of the purchase money or• to make inquiry into t:he validit3= of any sale. The Eaecui;or• is authorized to make; execute, acknowledge and deliver deeds, assignments, options or othe~° writings as necessary or' convenient: to r_arry oui. the powers conferred upon the Executor. Lej Encumber Real Estate. To mortgage real estate, and t.o make leases of real estai;e. (f) Bor•rou= Money. To borrow money= from any person, including the Executor, to pad= indebtedness of mine or° of my estate, expenses of administration or° inheritance, legacy, estate and other° taxes, and to assign and pledge assets of ~n•y estate. (g) Pay= Costs. To pay all costs, taxes, expenses and ch<~i•gcs in connection with the administ~°atio~~ of m}~ estate. (hj Distributions Without Court: Order. To make di.stributio~is of income and of'princil~al to the proper beneficiaries, during the adrn.inistrat.ion of my estate, with or without- court order. in such manner° and in such amouni:s as my Executor deems prudent and ~cl~p~°opriat;e. Page ~ ~/ C (.i j ~'ot,e Stock. To exercise voting rights v~'ith respect. to securities which form a pars oi' niy estate, and. to exercise. alJ the I;owers incident. to the ov~~nershil~ of securities. (jj Reoi°~anize. 'I'o uni.te with other owners of property similal° to property in m}r estate to carry out and' plans for the z°eor•ganization of any company' whose securities form a pay°t of my estate. (l;j Disclaim. To disclaim any intel•est in propertti' v~rhich ti~~ould devolve to me or niy estate by v~Thatevel° means; including but not limited t,o the following means: as beneficiary under a will, as an appointee under the exercise, of a power of appoini;ment,; as a person entitled t.o take by intestacy, as a donee of an inter .=ivos tra~zsfei:°, and as a donee under a third-party benefici.a~°~' contract. Q j Tax Returns. 'Tc~ prepare, execute and fiJ.e tax returns of an)' tSTpe required by applicable law, and to snake all tax elections author°ized by law. (mj Allocate Ext~enses. To allocate administrative expenses to income or to principal, as the Executor deems appropriate. However, no allocation to income shall be made if the effect of the allocation is to cause a ~°cduction in ~i,he amount of any' est.ai.e tax marital deduction or estate tax chai°itabJ.c deduction. (n} J;InpJo~Advisors. To employ custodians of property', investment or l~usincss advisors, accountants and attorney's as the Execui,ol• deems apps°opr•i.ate, and to compensate these persons from assets of my estate, without affecting the compensation to v~'17ich the Execut.oi° is entitled. (oj Ad~iust Basis. '1'o make any adjustment t,o basis author°i~ed by law, including, l~~ut not limited to increasing the basis of anti pro~,erty included in my estate; ti~°hether or not. passing under this ~'~'ill, ~bti- allocating any amount, l;y which the bases of asset,~~ in at' be 4 ~ r ~ ~__~- incx•eased. The Executor shall l,e under no duty- and shall not. be ~•equired t.o allucai.e basis increase exclusively; px•imax•il}~, or at all to assets ~~hich pass as part of my probai.e estate. as opposed to other property for which a basis adjustment, is allowable. The Executor shall allucat.e basis increase equitable among those beneficiaries receiving pr•oper•i-y as a result of• m~T death, but shall not. be liable to any person, nor subject t.u removal or surcharge, for any reasonable allocation of• basis increase. (h) Cozn~_>>°omise Claims. To compromise claims. (q) ni.her Aci.s. To do all other acts in tl~e Execui,oz•'s judgment deemed necessary o~° desirable fur t;hc proper and advantageous management, investment and distribution of the estate. ITEM ~'II: Beneficiaries Under Aye 25. If a beneficiary under the age of twenly-five (`?~) years is entitled to receive assets under this Will, the oldest. person who served as Executor of my estate shall x•etain those assets as Custodian fox• the beneficiary under the Pennsylvania Uniform Transfers to I\Zinors Act. The Custodian may receive and administer all assets authorised by l.au7, and shall have full tauthor•ity as provided in the Pennsylvania Uniform Transfers to Minors Act: t.o use assets in the manner the Cusf.uclian deems advisable for the best interests of the bencficiar•y. I also designate the oldest person who served. as Executu~° of mkt est:at.e as successor Custodian of any property for which I am cusi,odi.an under any tlnifuz°m Gifts to Minors Act. or Uniform Transfers to Minors Aci . ITE1~•7 x'171: Sw°vival. Any person who has died within i.hii•iy (30j days of my deai.h, or under such circumstances that. the order of our deaths ca~rnot be established by proof, shall be deemed to have predeceased me ITEM I~: «~ith r~esl>ect t.o Executuz•s: I~~~Y~ .~ Executors. I make the following p3-ovisiun.s (a) Initial Executors. I appoint my children; L~-NIA? F. ~~ SHEFFER and JOI~r~T ~~'. COGLE~', JR. io lie i;he Executors, herein collecti~~ely referred to as the "Executor." i (bj Siucesso~° Executors. In the event. that: either L~ NN F. I SHEFFER o~• JOHN ~~'. COGLE~', JI:. ar•e unable or refuse to serve as i Cu-Execut,ur, my son; SCOTT R. COGLEI', shall serve as CU-Execut,o.r' I ~Tit1~ the other of t.liem. (c) Compensation The ExeCUt•Or shall have the i°ight t,o receive 1°easonal~le compensation for services rendered and ~°eiml~u~°5ement foi° reasonal_;le c:xpensc.s. (dj Standard oI' Care. No Executor shall 17e liable oi• accountable for any loss that. may result. Ii°om the good faith exercise of the authorit~~ gl•anted in this ~~Till. (e) Security. The Executor is specifically relieved from the duty of filing bond or entering security. IN «'ITNESS WHEPLEOIi~, I have sot my hand and seal to this, my Last ~~'ill and Testament, consisting of'this and the preceding five (5) pages; at. the end of each page of which I hav also set ~riy= initials for greater security and bct.ter identification this J 2 day of , 2U C~ ~ (SEAL) )HN VP. COG Y, S V1'e, the under°signed; hereby certify that. the f'oz•egoing V~'ill was signed, sealed, l~ ublished and declared u}~ the abo~Te-named Tesi•ator as and 1'or his Last. ~~1'ill and Testament, in the presence of us, who, at his request. and in his presence and in the pr•esencc• of• each other; h<<~~e hereunto set our hands and seals the day and year first abo>>e v~~i•iti;en, and we certify that. ai. the time of the e~ectition thci°eof, the Tesi.at.o~~• was of sound and disposing mincl and memor>>. i - ,tJ`~~v (SEAI_,j F~esidi.ng at: ~~~ ~%~'/~'~~-r'--/ W ~~, ~ ~ ~ ~ SEAL ( } P.esiding at ~~ ~ ~ , ~C~-c-v~ ~ ~-9'~-~ ~ S Pik ~ ~~ ~ .~ ACIiNOt~'LEDGMENT COMMONV~'EALTH OI' PENNSY~L~~'ANI_A j COUNT' OF I, JOHN t~T. COGLEZ', CI'~., Testator, whose Warne is signed to the attached ox• foi°egoing in5tx•uxnent, having been cluly qualified according t.o law, do hereby acknowledge that 1 signed and executed the instrument as my Last tA'ill and Testament; that I signed it v~~illi.ngly; and that I signed it as my free and voluntar~T act, fox the purposes therein expx•essed. w /h. (SEAL ~HN tit'. COG ~', R. Sworn to axed subscrib before me this ~a}C,~ day of 2U 01~ . NotarST Publi My Commission Expi~°es: (SEAL) COMMOtJV~LALrH OF f'ENNSYLVAPifA NOTARIAL SEAL CYNTHIA J. RULE, IJotary Public Camp Hill Boro., Cumberland County My Commission Expires February 3, 2008 AFFIDA~TIT COMMONV~'EALTH OF PENNS~'L~'ANI:~ SS: COUNTY OF ~~ ~ ) ti~'e, L~/ ~ GUS ~; ~ and ~~ ~ ~ ~ P ~S , i-he ~fiil;nesses whose names ai•e signed t,o the attached oi• for°e~oing instrument; being duly qualified according to law, do depose and say that; we ~=ere present and saw Testator°, JOHN V~'. COGLEY, SR. sign and execute the instrument. as his Last ~~'ill and Testament; that. Testator signed willingly and that he executed the «'ill as his free and voluntary act. for the purposes therein expressed; that. each of us in the hearing and sight of'the Testator signed the ~7i11 as ~~'itnesses; and that. to the best. of• our• knowledge the Testatoi° alas at. that time eighteen (1.8) or more years of age, of sc,pnd mind and under no constraint or undue influence. Fitness Witness Sworn to and subsc~•i d before me this ~ ~ day of 20 ~ 4. Notary Pub is My Commission Expires: (SIa;AL) COMMONWEALTH OE PENNSYLVANIA NOTARIAL SEAL CYNTHIA J RULE, Notary Public Camp Hill Boro., Cumberland County IJ!y Commission Expires February 3, 2008 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: SHEFFER LYNN F 655 HUNTERS LANE LEWISBERRY, PA 17339 fold PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ESTATE INFORMATION: SSN: ~ s~-16-4397 FILE NUMBER: 2110-0229 DECEDENT NAME: COGLEY JOHN W SR DATE OF PAYMENT: 05/25/2010 POSTMARK DATE: 05/25/2010 COUNTY: CUMBERLAND DATE OF DEATH: 02/ 26/ 2010 REV-1162 EX111-96) NO. CD 012795 ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ 510, 500.00 TOTAL AMOUNT PAID: 510,500.00 REMARKS: RECEIPT TO ATTY CHECK# 1515 SEAL INITIALS: CJ RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS TAXPAYER ~'-'~ OMB Approval No. 2502-0265 ((~~~~~'~~ A. Settlement Statement (HUD-1) FINAL ~~-.~ o ._ 1. Q FHA 2. Q RHS 3. Q Conv. Unins. 4, Q VA 5. Q Conv. Ins. 6. File Number: H510030 7. Loan Number. 228429540 8. Mortgage Insurance Case Number: C. Note: This form is furnished to give you a statement of adual settlement costs. Amounts.paid to end by the settlement agents are shown Items marked "(p.o.c)" were paid outside the closing; they are shown here for informational purposes and are not included in the totals. D. Name & Address of Borrower. Truc T. Tran, Lien T. Pham 411 B East Main St, Mechanicsburg, PA 17055 E. Name 8 Address of Seller. Estate of John W. Copley, Sr. 114 Limestone Drive, Camp Hill, PA 17011 F. Name & Address of Lender: Bank of America 9000 Southside Blvd., Bldg. 70, P.O. Box 45140, Jacksonville, FL 32256 G. Property Location: 114 Limestone Drive Camp Hill PA 17011 Lower All T hi H. Settlement Agent: Heritage Se0lement Services, LLC Phone: 717-975-2117 Fax: 717-730-9665 I. Settlement Date: 10/28/2010 Disbursement Date: 10/282010 en owns p Place of Settlement: 4705 E. Trindle Road, Mechanicsburg, PA 17050 Tttle6cpress Printed 10282010 at 2:01 pm by KL 100. GrossrAmounEDue from;Borrower 400.:Gross Amount Due td Seller 101. Contract sales price 150,OOD.00 401. Contract sales price 150,000.00 102. Personal 402 Personal ro 103. Settlement charges to borrower (line 1400) 5,353.36 403. t(04. 404. 105. 405. ~Ad'ustments for kerns aid b seller in advance Ad'ustmerrts for items aid b seller in advance 1 O6. Cityftown texas to 4f16. Cityltown taxes to 107. County taxes 10/28201 D to 121312010 119.57 407. County taxes 1 02 812 01 0 to 121312010 119.57 108. Assessments 1 028201 0 10 OIi130Y1011 825.62 408. Assessments 10128201D to 06!302011 625.62 109. SEWER (OINID) 10282010 to 12(312010 31.09 409. SEWER (OM/D) 10282010 to 12(3112010 31.09 110. TRASH (O/NID) 10282010 to 121312010 38.12 410. TRASH (O/NID) 10282010 to 121312010 38.12 111. 411. 112. 412 120• Gross Amount Due from Borrower 156,367.76 420. Gross Amount Due to Seller 151,D14.40 200. Amounts:Pafd b :or iri: Behslf:ot.Borrower $00: Reductions in Amount Due to Seller. 201. Deposft or earnest money 1,000.00 501. Excess deposit (see instruc0ons) 202. Prinapal amount of new loan(s) 80,000.00 502. Settlement charges to seller (line 1400) 12,005.01 203. Exisfin b s taken su'o'ect to 503. Existin loo s taken sub'ect to ~ 504. Pa oft of first mort a e loan .205. 505. Payoff of second mortgage loan 206. 506. 207. ... 507. 208. 508. 209. ~ 509. Ad'ustments for items un aid b seller Ad uslmeMs for items un aid b seller 210. Cityflown taxes to 510. City/town taxes to 211. County fazes to 511. County taxes to 212. Assessments to 512. Assessments to 213. 513. 214. 514. 215. 515. 216. 516. 217. 517. 218. 518. 219, 519. 220• Total Paid bylfor Borrower 61,OD0.00 520. Total Reduction Amount Due Seller 12,005.01 300. Cash afSettlemenYfrotNto Borrower - ., __< ,;; .60D: Cash af:Settlementtolfrom,,Seller 301. Gross amount due from borrower (line 120) 156,367.76 601. Gloss amount due to seller (line 420) 151,014.40 302, Less amounts paid byflor borower (line 220) 81,000.00 602. Lass reductions in amount due seller (line 520) 12,D05.01 303. Cash QX From ~ To Borrower e ¢ co N n . m, w 75,367.76 ,asponw w 603. Cash QX To ~ From Seller 139,009.39 ... ..... .... ... . .... _._, -~ _...- ~.-._......w. ~....,~~....~.~.m, u o.u,.¢ uxs ouowun a nwq.~ory. ~ma 4OaRpn.a b pmYpv Uw pWea lo. RlSPw mvenE Innodbn wpb fnromuYm YuMp Ne s.uimne,u gvmss. Previous editions are obsolete Page 1 of 3 HUD-1 700. Total Real Estiite Broker#ees $ 9;250:00 Paid From Paid From Division of cpmmission- line 700 as.follows: Borrower's Seller's 701. $4,750.00 - to RelMaxlstAdvantage Funds at Funds at 702. $4,5D0.~ to Keystone Realty Group, Inc. Settlement Settlement 703. Commission paid at settlement 9,250.00 704. Broker Fee io Keystone Realty Group, Inc. 175.00 800. items~P.a Iein.ConnectiorcwitliLoan 801. Our origination charge (Includes Origina8on Point % or $0.00) $590.00 (from GFE #1) 802. Your credit or charge (points) for the specific interest rate chosen $ (from GFE #2) 803. Your adjusted originalion charges (from GFE A) 590.00 804. Appraisal fee to LandSafe A raisai $390.00 P.O.C. B (from GFE #3) 805. Credit report to LandSafe Credft, Inc. $35.00 P.O.C. B (from GFE #3) 80fi. Tax service to Bank of America (from GFE #3) 89.00 807. Flood certification to LandSafe Flood (from GFE #3) 26.00 808. to 900. Items.R aired b Lendertoibe Paid id:Advance 901. Daily interest charges from fnxn 10!28/2010 to 11/01/2010 @ $9.0400lday (from GFE #10) 36.16 902. Mortgage Ins. Premium for months to (from GFE #3) 903. Homeowner's insurance for 12 months to Cumberland Insurance Com an (from GFE#11) 422.00 904. months to from GFE #11 1000. Reserves'De osltetlwitli;.Lerrder %~ <. 1001, InitialdeposRforyourescrowaccqunt (fromGFE#9) 579.45 4002. Homeowner's insurance 5 months $ 102.091month $510.45 '1003. Mongage Insurance months $ O.OOlmonfh $0.00 1004, City Property ax months $ O.OOimonih $D.00 1005. County Property Tax 9 months $ 55.96/month $503.64 1006. Assessments 3 months $ 35.17/month $105.5 1007. Aggregate Adjustment $-540.15 1100. Title.Cha es 1101. Title services and lender's title insurance (from GFE #4) 1,033.75 1102. Settlement or closing fee to $ 1103. Owner's the insurance (from GFE #5) 370.00 1104. Lenders title insurance $963.75 1105. Lender's 8tle policy limit $80,000.00 Lender's Policy 1106. Owner's title poky limft $150,000.00 Owners Policy 1107. Agent's portlon of the total Bite insurance premium $1,069.94 1108. Underwriter's portlon of the total title insurance premium $263.81 1109. Notary Fee ao Nota Public $25.00 20.00 1110. Courierfee ~ to Herita a Settlement Services, LLC $20.00 1111. ElecWnioDocumentFee ;toComerstoneLandTransferA entf $25.00 1112. Tax Cert Reimbursement Fee to Heri a Settlement Services, LLC $ 1 D.00 1200. GovemmerrfRecordin and'Transfer;Cha es'"" 1201. Government recording charges (from GFE #7) 152.00 12D2. Deed $62.~ Mort a e $90.00 Release $0.00 1203. Transfer taxes (from GFE #8) 1,500.00 1204. CitylCounty taxlstamps Deed $1,500.00 Mort a $0.00 1205. State Tax/slamps peed $1,500.00 Mo a $0.00 1,500.00 12~• Deed $0.00 Mori a e $0.00 Release $0.00 1207. 1300. AdditidnaLSettlement:Cha es.: 1301. Required services that you can shop for (from GFE #6) 1302. Survey to $ 1303. Inspec8on Fee to Central Penn Home Ins coons 20D.00 -1304. Radon Inspection Fee to TCS Industries, Inc. 125.00 1305. Termite Cert - ~ to Home Paramount 55.00 1306. 2010-11 School Tax • to Bonnie Miller r r r ~ ~ r 5,353.36 1,225.01 12,005.01 mu uuuwiue yr aosmg oy tnlonower, ts)eiler, (L)ender, (gnvestor, Bro(Iner. Previous editions are obsolete Page 2 of 3 HUD-1 ,Com arjsofl#oftGoo~F=adh~Gs_4_ma`_te`; _ aiid;Iill1~D-,si~ha °'";°~-nc"' ,~~r `" ~. , ~~I Cha, es~TihaftGan'n`'oreas_e'rx~:9:"f'`.~f~itis~~"`,M~`~UE11Wae~l~lumbeG.~', x"~ " Our dri idatfo r .,1c =.`r,-P~'~.s, r:>`r ~ ' °f1 rk~ : ~ _ ,x801 x~..,, . Your.aeditnrrcftaae~Pemis.Hof,;~!esPedrBGiFlteresl~te;ehoserr}, ' ~1,~,,,'802 ;~„ , . - - Youradjusted~brpgin9tionichar-gz~ ~: '.,:,,~;' ~tY': ^~t .:y >~,e863,~'' T:ransfertartgs,, =" f~ ` -~:~-rr,,.~ ~.'r `:`ns.~x ~'-~3.~d Char es'Tfiatlm~'gtial~C~att~tllti"__a_~1~9~ ,..'~ ~'t~~-~€~ ~~If_ GOYBrFIr112'!`3~~fT9A~a.~~Gj~~3~r.. jF~r~ % `~. '* .. 5~~~.. #5>~14~ s~'~.'~~, :..,_-~2 *_..c Appraisalifed3fo~~ r.tt:>~:~rbrc~~ `~• _~~~x.: ~-'~>~-"„~~~r'J~i' < .'~'~i~ ~LSiaa. Cretlit•ieporttfo ~, F.~il~~ ~+t-';yak ~~~~s;~~-' ~s~,.:3~` r, s Ott,. _.L, ~ ~ _ :, Taxserv{i~ito ,r F .•~+ ~+- -~ =~~ Ns ~~r~ Flood CeitfiEaBon + ~ ..I -~?'r '3rT~~~'?!y. ~~~~"5 ..~ .; :: r„,';: •- ny K m1'~c . ,;z n'k`~v .a`~~~,,~ ~„#Yt Wts i Char 'esTh517Gan~Chan e,_ ,'? - r,6 :; ~' ~;~t ~`~'ir~ rs.rs'14 ~`~a°-. '-.t ,; r-: , Initial depbslt§orryourescrow;aceount s ..f' ":,,,?:~I ~ :~' Y~ 10Q1 '._, Daily intefesfr,eharge; .~ r. ~? . ~~, n` ;'"rgF901 '. $9?Q400lda Homeowiiergslnspcr~tee wti T ; 3 t S r F ~~r ., r., , ,:i ,+~ fe + . +^ , ~ >k1903 ++ '-;' ka TitleserviixsaarWrlender+sstl6e`uisu~ce.. - ~ '~~.n-~r~, k;~_ ~ ;', ~;1a01; :` r , . OwneGs!titlt~sfrwice, ,~.„:~ .,v;~s`~'_ „~ ~a ~~{iu»', ::,:~f a1,O.3~,~,` Loan Terms ~' 't GooilfFaith,EsUmate'- , ` ~; HUD-1 590.00 59D.00 0.00 0.00 590.00 590.00 1,500.00 1,500.00 Yi°Good':xaifh.Esbmate;: ,g (: '~` '' HUD-1 152.00 152.00 390.00 390.00 35.00 35.00 89.00 69.00 26.00 26.00 692.00 692.00 $ 0•~ or 0.0000% `~:.Goo~F.a'rth,Fsfimate ' HU0.1 1,119.24 579.45 36.16 36.16 422.OD 422.00 1,108.75 1,033.75 0.00 370.00 Your iniGal!loarvamoun('~s ' ' ~;,. , "?`'~~~. i r. r ~,. $80,000.00 Your loarijter~rrrrs { ~`: ~ I h~ "yam ~i "~ n° }~~1°.rp~,~t,~ t~R,%>~-, 30. years q~a~y s. Your IniBafyq[eresttatetis ~ ~ i° '~n y 4_-`~' ~ r`f' k: 4 1250% t ~ M ~ , h ~ f . '~ S ~'- 11?;", f X34 vs~ ».. Your mrhalimonth~ambunh~wed for{~nna al , nterest~and,ar mort a e; $387 72 ind d p , t 1y. g g ~ ansuranrre is ~ ~ ~ ~ '' , •' ~~ , - : . u es QX Pdnd al ' _ r p i ~` ~?'~ rr ,: 0 Interest ~ , r ~ r ~ '' ^ Mod a e Insurance . _°,i~ ~ ,~y ~ ~, r 4 g g Can your~lrrteiesfrate~~n~~~~~ '~ "`~~`" `t' ,° ~~~4'~~~~~~, ~ ~~ sA;dsty~-~ai ^X No. ^ Yes, it ran rise to a maximum of %. The first change 1 ~ ~, i ,~ ~" ,`sw ~s, ~~ rid,~~ ~~~ 4 -4 ~'~ ~ ° ~ will be on 1 / and can change again every years after I I Every change ~ ,~ },~~ik" ~~n x ~; date, Your interest rate can inaease or decrease by °~. Over the I'rfe of the loan, your r ->. w t~.~ r r 'af't ,~,i;,. ~ ' ' mterest rate is guaranteed to never be lower than °~ or higher than % . -: ,~ ~ -~ ;;~ ,~ ~} "sue Even if or1 make ~""" tom' ~'` .ib,. " '?r ~ ra.,~, y paymen~s ontGrrre; can yourloan balance:rise~ ° ^ ^ X No. Yes, it pn rise to a maximum of $ Evenlf you make,~ayr~enis`on~me,--ca~ypur~rjionthlyamount owed for ' QX No. ^ Yes, the first increase ran be on ! ! and the monthly pdnapal;,ihterest=and'mortgage;ipsprance~rise2 ~x ' ~-c , R; ~ amount owed can rise to $ , ~ -_ ~ ~ , r, '~ -i ~ The maximum It can ever rise to is $ ss ~rti~ ray ~. s, ~,~ Does youi?J,oat„~haveia}prepayment,'peraaltyT, f r: ~ ~ ,i I ~ y~~; Q No. ^ Yes, your maximum prepayment penalty is $ Does yourloan~ have.aballoonpaymenh ,~ ', ~ k, ;; ^X No. ^ Yes, you have a balloon payment of $ due in -- ~ Fes,," ~; a^ years on ! Total moninlytamounf.aved~nduduig escrow account~ayminis r ~~ Q You do not have a monthly esaow payment for items, such as property faxes ~ ~p } ti I { ~ ~~ y?; t' r .ri' , a. a ~ ~ k ~;i c'} and homeowners insurance. You must pay these items directly yourself. { , '~~ ~ f~ -~ ~l ,~ it t ~ QX You have an additional monthly esaow payment of $193.22 ' ~~ z ; ~*,~ a .~~r~ ~a ~ ',~c , ~''` t!! that resuRs in a total initial monthly amount owed of $590.64. This indudes prindpal, interest, any } ,, r '', ~ ~•~~ c ~ } ~ ~ ~ ~ kr~,z~ r ya I `` } ~ ~ ? ~ mortgage insurance and any hems checked below: QX P o t t QX ' ,~+V r f ,, ~,~~„~ , ~ ~ per r y axes Homeowner s insurance ~' ~~~-+nj a ~~.t1 + ~'" ''~'~ti 5~ ~~ ~ ~~+ Q Flood insurance QX School Tax j t 1 ~ ' tit , ^ note: It you nave any ques0ons about the Settlement Charges and Loan Terms listed on this form, please contact your lender. Previous editions are obsolete Page 3 of 3 HUD-1 .s~t~ ~_~--'~ Truc T. Tran Lien T. Pham :i W ~x~_ E tat of John W. Cogley, Sr. v~t~~ The HU0.1 Settlement Statement which I have prepared Is a We and accurate account of this transaction. I have caused orwill puse the funds to be disbursed In accordance with this statement SETTLEMENT AGENT '+f DATE WARNING: IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE UNITED STATES ON THIS OR ANY SIMILAR FORM PENALTIES UPON CONVICTION CAN INCLUDE A FINE AND IMPRISONMENT. FOR DETAILS SEE TITLE 18: U.S. CODE SECTION 1001 AND SECTION 1010. Previous editions are obsolete Page 4 of 4 HUD-1 HUD CERTIFICATION OF BUYER AND SELLER 1 have prefully reviewed the HU0.1 Settlement Statement and to the best of my knowledge and belief, R is a true and accurate statement of all receipts and disbursements made on myaccount or by me in this trensaction. I further certify that I have received a copy of the HUD-1 Settlement Statement APPRAISAL Persorroperty of 3 C k 1 tJ ~ , C ~ ~ L ~ `l ~= s T~ ~1< i! ~'' 1 ~~1E s~~NF `u~ CAM 1' t/iL ~ pal , ~7of/ w....ra:~sd a.. ~'1,~ir_k F_ Bricker AU094-L Da#e,~ -,9Z ~}~- /~ r.rr......,,.. _, _..__ ITEM VALUE ITEM VALUE ~ ' ~ c T. ie/ e .~ s Occ s,~ ~~ Via, b o /U,dO ~ c-~ w ~ ski"~ - ~ 2 p, ~v~~~i .2 ~, on ~ Q / ~ ~ ~ ~ i ~ ~ ~w 2~o,va F~ ~R ~ ~- T BL ~ ! ..9 .*~ ~' ~_.~, oo s ~ s ,~-! P SJU o w ~ 'L ~ c.~ 2 ~u, taa '~ /3c /~: tir" ~~9 ~~ t 5 ~ T `~~, oo ~ , P, M r, w E ~. ..SUS a G ~ ~~ F ~ ~ ~ R Nd r.~ TH~,~ c ~- ~~ c < ~ ,~- ~ ~'I s /,~o, oa ,~D, ,C>v .~ .~ 7 E ~ ~. a d E ~ , I~GGv ~R Gt.~ fL ~ ~-- v 0 , LQ SST, S ~-L TLn L S D. 00 3l~c YRaV~ ~' 1~l, ~t 3D, Do S.ST~ t~ ~d~N des ~O,G~ S e~± ~ ~ L F ° U, U~ f L~ ~ ~1 evF T Ud ~7 ~J~/~ ~ /' / 1- a~ ~~Ur, /~ 3 pc ILL ~>Nd ,~ EcG R.,M; s f , :,va ' ~ ~ _ ~ ~ ~~ ~~--- ECU/ L oc F ~ .- - ---- - 7 Ff ,~ ~,,, ~.. F T ~ C~ , av - - - -- --_ -- ..~ L MPs S. OD ~c. V ~ ^ tt C ~~ ~7 ~Pc, ~~ a b ~; D~11 F2 a ~~~ _-- -_ - L r4 M ~ S T.g D CAD -- - - _ C o~ ~R / yv, ov -- - E ~~ E2 u F SE Q 0~ - - _ -.kt~~ :~f yo.~~ -- - _- ~/ c'~ N E>rL 7,00 - , C U~ ar2 7y a, do _ _ - --- ,~CZ i~~f~2 ~O,~D -- - - r r- ( _ -- ~.~ F- ~arJ. C :~, '~ ~~`` 2004 Chevrolet TrailBlazer -Trade In Value, blue book value -Kelley Blue Book THE TIRtiSTirt7 iti?~Q~Ue advertisement Page 1 of 2 i~ Send to Printer 2004 Chevrolet TrailBlazer Extended Sport Utility 4D advertisement ~~~E ~~~~~ ~~~~~-~~ ~1~~~~ Condition Value -~ ~= U ~~ nt Good $8,050 C~ ~- ' (Selected) a:r ~~ ,~,...„ ~ Vehicle Highlights 'Mileage; 66,000 .Engine: 6-Cyl. 4.2 liter ;Transmission: Automatic ~~ , ` (1 Drivetrain: 4WD_._, 1 ` l.~ ~. _ ~ 111 !Selected Equipment :Standard ~ Tilt Wheel ABS (4-Wheel) !Air Conditioning Cruise Control Roof Rack Power Steering AM/FM Stereo Privacy Glass :Power Windows Single Compact Disc Alloy Wheels `Power Door Locks Duai Front Air Bags ':Optional F&R Side Air Sags Running Boards :Power Seat Towing Pkg..... _ Blue Book Trade-In Value Kelley Blue Book Trade-In Value is the amount consumers can expect to receive from a dealer for atrade-in vehicle, assuming an accurate appraisal of the vehicle's condition, mileage and features. This value will likely be less than the Private Party value because the reselling dealer incurs the cost of safety inspections, reconditioning and other costs of doing business __,_ _r...._.. __...._ __.~.._.. __....._. Vehicle Condition Ratings Close window Excellent $8,550 • Looks new, is in excellent mechanical condition and needs no reconditioning. • Never had any paint or body work and is free of rust. _ __,_,_L __.-..n.~.,.rrT~oar-~r~wr;~;naRPnnrt_asnx?Yearld=2004&Milea~e=66000&VehicleClass=Us... 318/20 CERTIFICATE OF TITLE FOR A VEHICLE i95~ t3 3~9~~?~~L3C7D9~9 ],-Citl1 --, ~VA~Il19~:J/~~~~G~L..37~~:~ L~~'7 1 i~~~i?i ~.~~.7 ~ ~ 1.7~~~i1 ~'~7 ~'lJ~ ~~ 4 ~ VEHICLE IDENTIFICATION IJUM$ER YEAR MAKE OF VEHICLE TITLE NUMBER-. ~ 1~J21l173) L~~~~]24 I ~3 511 I I ~ I ' BODY TY P E DUP SEAT CAP PRIOR TITLE STATE ODOM, PROCD. DATE , ODOM. MILES ODOM. STATUS a~ ~ 7 y''~ ~ ~i.l~~~l iJ~ -I J +~ ~~! ~L~~~ I I ~I _I - DATE PA TITLED DATE OF ISSUE UNLADEN WEIGHT 6VWR GCWR TITLE BRANDS - .ODOMETER STATUS _ - 0 =ACTUAL MILEAGE - I ='MILEAGE EXCEEDS THE.MECHANICAL - LIMITS - 2 =NOT THE ACTUAL MI4FAGE ' 3 -NOT THE.ACTUAL MILEAGE-ODGMETEF3 - r - "''~' TAMPERING VERIFIED:' - a =EXEMPT FROM ODOMETER DISCLOSURE ` ~ ::?iTLE 6RANDS ~. REGISTE RELY OVJfJERIS) A =ANTIQUE VEHIGIE ~ ~~ °' C -CLASSIC VEHICLE ^- 'µ'' ff~~ ^' l~~~ ~^,t ~y ~:Ll Hitl 7a C ~'t7~>L~'1 ~I~ ~ .. :.r.. ., ,.. ;::. D =COLLECTIaLc VE F -OUT OF COUNTR O ~~~. I_1J'It ~~~~~ ~~~~~ - - G=ORIGINALLKMFC O '~ DISTRtBtrnoN O H ~~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~. H AGRICULTURAL ~ ~ V F--1 L LOGGING VEHICI ~ N O H P = ISANAS A POLICE O r"r R = RECON5TRUCTE ~ 1--r C s 5 =.STFlEETR00 T =RECOVERED THE °~ • - :V =-VEHICLE.CONTAt ~ ' w aFLpOD VEHICLE ~ O O ' X > ISNJAS A,TAXI O N FIRST LIEPJFAVOR OE k `SECOND LIEN EAVOR OF. O O ; T ~ GMAC t ~" - N o N .P ~> ~ ~ n ~ If. a second lienholder is. listed upon satisfaclian ;of the fiat: li ~ b J ~ 7 J '~ ' Itenholtler must.forward .this TItIe to Ihe..Bureau. of 'MOtOf Vetlic ~ N ~ ~. rm antl fee t f : .. ( C `~ E SED . e o apprOPna .. ~ x ~ ~ A FIRST LIENAEL TE D ~ 1--1 ~ A ~ !~ ~ BY ~ 1 ~ v ~ N SECOND LIEN RELEASED ~ t"~ ~ UTHO (ZED REPRESENTATIVE DATE ~ o '~MAIt:ING.AC)DRESS. By ~ "Z O O O AUTHORIZED REPRESENTATI~ ~ - _ ~ ~ ~~~~ _ ~ ~ ~ ~~~ 8~ _ ~ 1~ ~ iJ ~ r 7~ 7 {~7 {-~ -y- / ~~~~ ~ ~ ~ ~ ~ - r ~ 13 .3 iJ La L. Y iJi. 1'1 7 N .. 6~ tJI tJ'I . ~ t l certify as of the date o1 Issue; the otliaal recortls of the Pennsylv named herein i5 an or com onis t th f h ania Department ALL~~ ~ ~~~~~~~ _ the (awful owner y p e pers ) lect t a of Transportation re ~ • of the said vehicle. Secretary Of Traluportalion > ` ~ 1 1 1 ' ~ ~ ' ~ , rte - , It a co-purchaser other than your spouse is listed and you went the title io ~SUBSCR18ED AND SWORN , be listed as "Joint Tenants With Right of Survivorship" (On death pf one .~ - TO~~BEFORE.ME: MO- oar YEAR l owner,.title goes to surviving owner.) CHECK.HERE ~. Otherwise, the title ~ ~ will be issued as "Tenants in Common" (On death of one owner, interest of ~ I deceased owner goes to his/her heirs or estate). tC ~~ yy~ SIC+NATURE OF PERSON ADMINISTERING OATH IF NO LIEN, CHECYC. ^ " ~ tST LIEN DATE: y~~ ~ ' 1ST LIENHOLDER ¢- ~'i STREET ' ~ CITY STATE ZIP 1 ~ ~ ~! FINANCIAL INSTITUTION NUMBER ' CHECK --~ IF NO LIEN . 2NU LIEN DATE: ,,.p T,c untlersgnee n rebY m anObcallor 0., amecau- o, i,llp L. Vw .e. n_,_ 0.~..nbec aooae. subieci m me encumora~ces a~a omel lane: cia~m, eel lom~ r,elc . 2ND LIENHOLDEF ^#- . ~ STREET N SIGNA.iVtic ;~f AvFli":AI+' n~F P:Ji H~,~.e c; v. iiEF P qTy STATE ZI ~ /1 ., ' FIIVANGIA'_ INSTIT IJTION NJMBEF ~"il~i%1~121~ :yC;GC)Llill ~L11T11T1i1T~ ^i ~a ?> Close Window ~ » Print Window Checking Account Summary Current Date: 03/05/2010 Account Number: 0571204260 S~rnrnary Tnforrnation Available Balance 511,846.04 Ledger Balance 511,846.64 ' $0.00 Ledger Balance as of 03/04/2010 s Deposits Today Today's Withdrawals $0.00 Last Deposit $1,551.00 Interest Accrued This Statement $U.31 last Deposit on 03/03/2010 Interest Paid YTD $1.82 Balance Last Statement $10,030.63 Interest Paid Last Year $14.18 Last Statement Date 02/19/2010 Next Statement Date 03/21/2010 PQSted Activity Date Activity Description Deposits Withdrawals Balance US TREASURY 303 03/03/2010 SOC SEC 030310 $1,551.00 $11,846.04 187164397A SSA 03/02/2010 KEMPER ANNTZ PMT $135.73 510,295.04 AXA EQUITABLE 03/01/2010 ANNTY.PAYM 100227 $52.23 $10,159.31 000901982EV0 THE HARTFORD 03/01/2010 RPS 00 LTF $76.45 GA20360-1022 ~~ -- _ $10,030.63 0 - -"' ATM CASH W/D 007165 00- $200 $10,029.74 02/18/2010 SOVEREIGN 3556OLDGET . CAMP HILL PA VERIZON ARC 02/17/2010 CHECK PYMT 100216 $185,61- $10,229.74 093 7 PPL EU ELEC SVC $101.98- X10,415.35 02/16/2010 5257077003WS UGI UTILITIES $57.73- $10,517.33 02/12/2010 UTIL PMT 021110 0936 VETERANS AFFAIRS $g.00- $10,575.06 02/09/2010 PAYMENT 100206 0935 f~d~~e i 07 ~ JOHN W COGLEY SR SCOTT R COGLEY Account # 574177159 Balances Beginning Balance $40;196.83 Current Balance $40,216.87 Deposits/Credits + $20.04 Average Daily Balance $40,196.83 WithdrawalslDebits - $0.00 Interest Paid this Period " $ 20.04 Annual Percentage Yield Earned 0.59% ~____~ .~.:.. o.,.:,,,~ $ 20.04 Paid Last Year _ $308.25 Paid Year-To-Date $ 42.19 *The interest earned and the interest paid may differ depending on when interest is credited to your account. Account Activity Date Description Additions Subtractions Balance 01-22 Beginning Balance $40,196.83 ,$20.04 $4.~. 0 - ~ _ F Balance IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR ELECTRONIC TRANSFERS CALL YOUR CUSTOMER SI'RVICE CENTER AT TFIE NUMBER SFIOWN ON THF.. "T'OP OF YOt1R STATEMENT OR WRITE TO THE RANK FOR DEBIT CARD ISSUES: Sovereign Bank .Attn: Debit Card Services M A i iv16 301-06 P.O. BOX 841003 Boston, MA 02284-1003 FOR ALL. OTHER ISSUES: Sovereiggn Bank Attn: Ctient Relations 10-421-Cltl P.Q. BOX 12646 READING, PA 19612-2646 Please contact us if you think your statement or receipt is wrong or if you need additional information about a transfer on the statement or receipt. We must hear from you no later than 60 days after we sent you the FIRST statement on which the error appeared. • Tell us your name and account number. • Describe the error or the transfer that you are unsure about and explain as clearly as you can why • "1 ell us the dollar amount of the suspected error. you believe (here is an error or why you need further information. If you tell us orally, we may require you to send your complain) or question in writing within 10 business days. We will promptly investigate the matter and call or write to you with an answer within 10 business days (10 calendar days in Massachusetts). If we need more time, we may take up to 45 days to investigate your complaint or question. If we do, we will credit your account within this 10 day period for the amount you think is in error, so you wdl have the use of the money during the time rt takes us to complete our investigation. If we ask you to put your complaint or question m writing and we do not receive it within 10 business days, we may choose not to credit your account. For errors involving ne~+ accounts, pain) of sale purchases or foreign transactions.. we may take up to 90 days to investigate your complaint nr question. For new accounts we may take up to 0 business days to credit your account for the amount you think is in error. We will sell you the results of our investiggation within 3 business days after completing our investigation. If we decide there was no error, we will send you a written explanation. You may ask for copies of the documents we used in our investigaUOn. Important information about your Sovereign Debit Card the networks through which some of your Sovereign Debit Card purchases are processed have hegun allowing merchants to process your purchases without either a signature or a PIN. If you are nut required to enter your PIN when you make a purchase, your ppurchase may be processed either through the Visa network or through the STAR or NYC'I: nehvorks. If your purchase is processed through S'I'AR or NYCC-, different terms apply and you will not be eligible for the rights and protections available Through visa. Plcasc sec your Personal Deposit Account Agreement liir more information. -1/'?/ 59 /~c{s;c~ ~ r~/ ~ Drivins Directions from 4516 Crooked Hill BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG PA 17128-0601 REV-1543 EX pFP (eB-09) ~~:~~~al~i~ i~l~i~el~ INFORMATION NOTICE AND TAXPAYER RESPONSE ral Service i... Pose 1 of 2 ~e FILE N0. 21 10-0229 ACN 10125412 DATE 05-05-2010 EST. OF JOHN W COGLEY SSN 187-16-4397 DATE OF DEATH 02-26-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: LORI C DOYLE REGISTER OF WILLS 4516 CROOKED HILL RD 1 CDURTHOUSE SQUARE HBG PA 17110-3404 CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKLNG TRUST ® CERTIF. SOVEREIGN BANK provided the Department with the information below, which has been used in calculating the Iftvou3feelatheuinformation isdincor ect{ please obtain writtenbcorre tiondfromethe financial institutianr,/ attachcaa opv to thiscform . ___ and return it_ to the abovz_address. This_accoun# is tax able .in accordance with kbe Inheritance Tax laws of the Commonwealth of _. Pennsylvania. Please call 0717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 0575498324 Date 07-09-2004 To ensure proper credit to the account, two Established covies of this notice must accompany payment to the Register of Wills. Make check Account Balance $ 10 ~ 2O 1 • 17 payable to "Register of Wills, Agent". Percent Taxable ~( ~ ~ 50.000 NOTE: If tax payments era made within three Amount Subject to Tax $ 5 ~ 1 OO • 59 months of the decedent's date of death, X 1 5 deduct a 5 percent discount on the tax due. T aX Rata ' Anv Inheritance Tax due will become delinquent potential Tax Due $ 765.09 nine months after the date of death. PART TAXPAYER RESPONSE A. ~ The above information and tax due is correct. Remit payment to the Resister of Wills with two covies of this notice to obtain a discount or avoid interest, or check box "A" and return this notice to the Register of CHECK - wills and an official assessment wiil be issued by the PA Department of Revenue. BLOCK ~ B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return C ONE 0 N L Y to be filed by the estate representative. C. ~ The above informa ion is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART ~ below. PART If indicating a different tax rate, please state relationship to decedent: TAX RETURN - COMPUTATION OF TAX ON JOINTiTRUST ACCOUNTS LINE 1. Date Established 1 2. Account Balance 2 3. Percent Taxable 3 X 4. Amount Subject to 7az 4 $ 5. Debts and Deductions 5 $ 6. Amount Taxable 6 7. Tax Rate ~ X 8. Tax Due B PART DATE PAID PAYEE DEBTS AND DEDUCTIONS CLAIMED DESCRIPTION AMOUNT PAID TOTAL CEnter on Line 5 of Tax Computations ~ Under penalties of periury, I declare that the facts I have reported above jre true, correct and complete to the best of my kr)owledge and belief. HOME ~ WORK C ~ rr, rn„r,~,r •1/1-ADCO T1ATF PENNSYLVANIA INHERITANCE TAX INf ORMATION NOTICE BUREAU OF INDIVIDUAL TAXES AND F I L E PO BOX 280601 TAXPAYER RESPONSE ACN HARRISBURG PA 17128-0601 DATE eEV-1543 E% I1FP (BB-BB) N0. 21 10-0229 _10125410 05-05-2010 EST. OF JOHN W COGLEY SSN 187-16-4397 DATE OF DEATH 02-26-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: LHNN F SHEFFER REGISTER OF WILLS 655 HUNTERS LN 1 COURTHOUSE SQUARE LEWISBERRY PA 17339-8700 CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. SOVEREIGN BANK provided the Department with the information below, which has been used in calculating the potential tax due. Records indicate that at the death of the above-named decedent, you were a Soint owner/beneficiary of this account. If you feel the information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Commonwealth of Pennsylvania. Please call C717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 0575498332 Date 07-09-2004 To ensure proper credit to the account, two Established copies of this notice must accompany payment to the Register of Wills. Make check Account Balance $ 10 ~ 221 • 17 payable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax payments are made within three Amount Subject to Tax $ 5, 110.59 months of the decedent's date of death, Tax Rate ~( , 1 Gj deduct a 5 percent discount on the tax due. Any Inheritance Tax due will become delinquent Potential Tax Due $ 766.59 nine months after the date of death. PART TAXPAYER RESPONSE A. ~ The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain CHECK a discount ar avoid interest, or check box "A" and return this notice to the Register of C 0 N E ~ Wills and an official assessment will be issued by the PA Department of Revenue. B L 0 C K B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return 0 N L Y to be filed by the estate representative. C. ~ The above informs ion is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART ~ below. PART If indicating a different tax rate, please state relationship to decedent: TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Date Established 1 'i'"' 2. Account Balance 2 +fi 3. Percent Taxable 3 X ~` 4. Amount Subject to Tax 4 5. Debts and Deductions 5 - `~ 6. Amount Taxable 6 7. Tax Rate 7 X 8. Tax Due 8 $ PART DEBTS AND DEDUCTIONS CLAIMED 3^ DATE PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL CEnter on Line 5 of Tax Computation) 8 Under penalties of perjury, I declare that the facts I have reported above are true, correct and complete to the best of my knowledge and belief. HOME C ) WORK C ) PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES AN D PO BOX 280601 TAXPAYER RESPONSE HARRISBURG PA 17128-0601 REV-1543 EX RFP (OB-OB) FILE N0. 21 10-0229 ACN 10125409 DATE 05-05-2010 EST. OF JOHN W COGLEY SSN 187-16-4397 DATE OF DEATH o2-26-201D COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: JOHN W COSLEY REGISTER OF WILLS 2136 WORTHINGTON AVE 1 COURTHOUSE SQUARE BETHLEHEM PA 18017-4957 CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. SOVEREIGN BANK provided the Department with the information below, which has bean used in calculating the potential tax due. Records indicate that at the death of the above-named decedent, you were a joint owner/beneficiary of this account. If you feel the information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tzr- laws of the Commonwoalth of Pennsylvania. Please call C717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 0575504972 Date 07-09-1914 Ta ensure proper credit to the account, two Established copies of this notice must accompany payment to the Register of~Wills. Make check Account Balance ~` 1 D ~ 168.48 payable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax payments are made within three Amount Subjeet to Tax ~` 5 ~ 084.24 months of the decedent's date of death, Tax Rate X , 15 deduct a 5 percent discount on the tax due. Any Inheritance Tax due will become delinquent Potential TaX DUe $ 762.64 nine months after the date of death. PART TAXPAYER RESPONSE 0 A. ~ The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or check box "A" and return this notice to the Register of CHECK Wills and an official assessment will be issued by the PA Department of Revenue. C ONE• B L 0 C K B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return 0 N L Y to be filed by the estate representative. C. ~ The above informs ion is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART ~ below. TOTAL CEnter on a ne s or iax l:O mpULaLlOnJ € Under penalties of perjury, I declare that the facts I have reported above are true, correct and complete to the best of my knowledge and belief. HOME C ) WORK c ) PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES AND F I L E PO BOX 280601 TAXPAYER RESPONSE ACN HARRISBURG PA 17128-0601 DATE REV-1543 E% AFP [OB-087 N0. 21 10-0229 10125715 05-07-2010 ALLISON C OBRIEN 600 GLADSTONE AVE BALTIMORE MD 21210-2203 EST. OF JOHN W COGLEY SSN 187-16-4397 DATE OF DEATH 02-26-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. SOVEREIGN BANK provided the Department with the information below, which has been used in calculating the potential tax due. Records indicate that at the death of the above-named decedent, you were a Joint owner/beneficiary of this account. If you feel the information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Commonwealth of Pennsylvania. Please call (717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 0575509013 Date 07-27-2004 To ensure proper credit to the account, two Established copies of this notice must accompany 1 5 3. 6 5 payment to the Register of Wills. Make check Account Balance $ 1 0 ~ payable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax payments are made within three Amount Subject to T2X y~ 5 ~ 076.83 months of the decedent's date of death, Tax Rate ~( • 1 5 deduct a 5 percent discount on the tax due. Anv Inheritance Tax due will become delinquent Potential Tax DUe $ 761 • 52 nine months after the date of death. PART TAXPAYER RESPONSE ~ ~ LT IN :AN° ~FFICIALTA~C A~ESSMENT A. ~ The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain CHECK a discount ar avoid interest, or check box "A" and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. C ONE ~/ B L D C K B. 1111 above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return 0 N L Y to be filed by the estate representative. C. ~ The above information is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART ~ below. PART If indicating a different tax rate, please state relationship to decedent: TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS iPAD LINE 1. Date Established 1 2. Account Balance 2 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 5. Debts and Deductions 5 6. Amount Taxable 6 7. Tax Rate 7 X 8. Tax Due 8 OFFICIAL U5E ONLY ~ AAF PA DEPARTMENT OF REVENUE 1 2 4 5 6 7 PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL CEnter on Line 5 of Tax Computation) 8 Under penalties of perjury, I declare that the facts I have reported above are true, corrpe/cCt/and complete to the best of ;may,knowledge and belief. HOME C L() (.~ ) ~( Z ~ J `b ~ ,.~ .~ ~ ~ ~'! ~ l C __---= W 0 R K C t-f 1 ~.) ~ Lf 3 ~ -- ~ 3 c1 -~-' Account Balances Page 1 of 1 # ~ MY Proflie °Eirnalf~Re .esenratlve, o •" E • 6ALANCES ' • ~ : • • ~Yrnt7al ' Quick Quote Account: Summary: All LPL Financial View: All Security Types ,. r„h,, n Prim j Export I t3aian~C~ r+~ yr ~,~~,..,. ,., Assets % of Assets T e 66.41 0.14°/ ash Balance 0'0 N~ Mar in Balance 363.2 3 7 19°/ Mone Market Funds Totai Cash and E uivaients , 3,429.6 7.33% 31,960.7 68.31 E uities and U tions 11,395.97 24.36% Mutual Funds Securities Total 43 6.72 92.67% Total LPL Financial Portfolio Holdin s 46,786.3 100.00°~ Funds Available 0.0 Bu in Power Value of your Total Portfolio 46,786.37 __ _ _ _ 66.31 % Equities and Options 24.36% Mlutual Funds ® 7.33% Cash and Equivalents r iv200--[C1C LPL Einanciat iJ~embe~ Fnvacv idiahe'. date ;~rvviaed .~~~ ICY Sys!err~a ~ humscn Frnanc~a!. facts=,~, Re,.arch S.,~stenis Inc. and Lgirer z Reuters cornf~n;• ~uoiee GltdRf,%SIP~~ rohc are delayer ~ .eas; 2~ mir~u!es. Kemper ~ Investors LIFE INSURANCE COMPANY A member of the ®lurich Group Apri128, 2010 Keefer, Wood, Allen & Rahal, LLP Attorneys at Law -Attn: Elyse E. Rogers 635 North 12~' Street, Ste 400 LeMoyne PA 17043 RE: John Cogley, Deceased Contract No: KI11015376 Dear Ms. Rogers: Kemper Investors Life Insurance Company Service Center PO BOX 19097 GREENVILLE, SC 29602-9097 OVERNIGHT ADDRESS: 2000 WADE HAMPTON BLVD GREENVILLE SC 29615-1064 TOLL-FREE 1.800.449.0523 Thank you for providing a copy of the Letters Testamentary for John Cogley's estate and authorizations signed by the Executors. As requested, we are please to provide the following information: • Value of Contract on 2/26/2010 was $12,362.70 • Designated Beneficiaries -Lynn F. Sheffer, Lori C. Doyle, Scott R. Cogley, John W. Cogley, and Allison R. O'Brien, children. If you have any questions or need further information, please contact our Customer Service Center at 1-800-449-0523 for assistance. Sincerely, Claims Service Center CC: Michael S. Midvedt Sr. Linsco Private Ledger 1330 Old Ivy Way Mount Pleasant SC 29466