Loading...
HomeMy WebLinkAbout11-23-101505610101 EX (oi-lo) ~ REV- ~ ~ OO OFFICIAL USE ONLY PA De artment of Revenue Pennsylvania P DEPARTMENT OF REVENUE County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN Po Box Zso6o1 ~, / D ~ O o ~ / 9` Harrisburg, PA 1']128-o6oi RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY Decedent's Last Name Suffix Decedent's First Name MI E N ti E s s y C ~ ~-~ Wit- ~' (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI ol.~/ ~ Spouse's Social Security Number N MUST BE FILED IN DUPLICATE WITH THE FILL IN APPROPRIATE OVALS BELOW ~ 1. Original Return O 4. Limited Estate 6. Decedent Died Testate (Attach Copy of Will) Q 9. Litigation Proceeds Received THIS RETUR REGISTER OF WILLS O 2. Supplemental Return O 4a. Future Interest Compromise (date of death after 12-12-82) O 7. Decedent Maintained a Living Trust (Attach Copy of Trust) Q 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) Q 3. Remainder Return (date of death prior to 12-13-82) ~ 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes C] 11. Election to tax under Sec. 9113(A) (Attach Sch. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number C ,~/ ~4-~ ~ E s ~- s H~ F~ ;~ s ~~ L -~ / 7 7 6 6 a z o q ~~ First line of address b C,~D u S~~ ~~ Second line of address /~~ / ~ City or Post Office State ~~ c y Div ~ ~ s Q u ,~ ~ ,~'~- ZIP Code _~ ~.v~ REGISTER OF ~LS USE .`f _ 1 ( f~ ~ `~ t -- ~'~ . L..~ -~ _~ _: ---~- . ATE FILED ~ ______ 1 7 o S s~ ~ 3 S` Correspondent's a-mail address: e ~$ ~/ °(~(,~$ 3 ©~,Q~/n(~S]~1~~/ --, ._l .7 :i C.:'+ k Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statemen s, and to the best of my knowledge and belief, it is true, correct d complete. Declaration of preparer other than the personal representative is based on all infor tion of which preparer has any knowledge. SIGNATURE O ERSO E P IBLE FOR FILING RETURN f~ DATE ~ 7 rtlo./ /~ ~....._._.__ / Z> ADD ~c,¢N EA'rYESSy /eis EiYiYE~sy ~oe~o Gv. rnxc~o~ r a~ ~ C~~~ ~/it~ ~ ! 70// ~ ~ ,~r~ EftGC~ ti ~c CLu~ P~ SIGNATUR O PREP RER ER T RE ENTATIV DATE ADDRESS y~L~'J ~. s~~t~~' /~ PLEASE USE ORIGINAL FORM ONLY Side 1 1505610101 1505610101 J ~~ J 1505610105 REV-1500 EX Decedent's Social Security Number Decedent's Name: CL/~'1~ .T_ !TE'/VNE~Sy l S ~ l 7 RECAPITULATION 1. Real Estate (Schedule A) ............................................. 1. ~! O O a d. d ~ 2. Stocks and Bonds (Schedule B) ................................... .... 2. . Q U 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . .... 3. . (~ Q 4. Mortgages and Notes Receivable (Schedule D) ....................... .... 4. . © D 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)... .... 5. 7 ~ , j ~ 3 • 7 3 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ... .... 6. . Ea Q 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested.... .... 7. --~ s p~ q S ~ 7 , 8 8. Total Gross Assets (total Lines 1 through 7) ......................... .... 8. ~ ~ L.~ ~' ~ ~ . ~' 9. Funeral Expenses and Administrative Costs (Schedule H) ............... .... 9. 3 p ~ ~ ~ „ s O 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) .......... .... 10. jr'~ ~ ~ 7 11. Total Deductions (total Lines 9 and 10) ............................. .... 11. 3 / O ~ 3 T 7 12. Net Value of Estate (Line 8 minus Line 11) .......................... .... 12. ~ ) 3 ~ p (~ O 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) .................... .... 13. ~ Q O 14. Net Value Subject to Tax (Line 12 minus Line 13) .................... .... 14. ~ ~ 3 ~ Q (p , ~ TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0~ . (~Q 15. ~ ~ ~ 16. Amount of Line 14 taxable at lineal rate X .0 ~ 3 ~ 3 ~' ~ (p Q ~ 16. ~ ~ ~ Z ~ ~ Z 7 17. Amount of Line 14 taxable at sibling rate X .12 • ~ p 17. ~ ~ (~ 18. Amount of Line 14 taxable at collateral rate X .15 • Q Q 1 g. '; ~ ~ 19. TAX DUE ..................................................... ....19. ~ / ~ Z ~ •Z~' 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 L 1505610105 1505610105 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF IPtDIVIDUAL TAXES DEFT. 280801 HARRISBURG, PA 1 7 1 28-0601 ECEIVED FROM: HENNESSY SEAN J 1006 W FOXCROFT DRIVE CAMP HILL, PA 17011 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EXt11-96) NO. CD 01 1778 ACN ASSESSMENT AMOUNT CONTROL NUMBER fold ESTATE INFORMATION: SSN: 1 53-7 4591 1 FILE NUMBER: 2109-0619 DECEDENT NAME: HENNESSY CLARA J DATE OF PAYMENT: 09/22/2009 POSTMARK DATE: 09/21 /2009 couNTY: CUMBERLAND DATE OF DEATH : 06/ 22/ 2009 TOTAL AMOUNT PAID: REMARKS: $7,695.00 CHECK# 1010 INITIALS: SAP SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REG{STER t)F Wti 1 S COMMONV`JEALTH OF °ENNSYL`.'A'V'A DEPARTMENT OF REVENU. BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: HENNESSY SEAN J 1006 W FOXCROFT DRIVE CAMP HILL, PA 1701 1 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ACN ASSESSMENT CONTROL NUMBER -------- fold ESTATE INFORMATION: SSN: 153-14-5911 FILE NUMBER: 2109-0619 DECEDENT NAME: HENNESSY CLARA J DATE OF PAYMENT: 03/ 26/ 2010 POSTMARK DATE: 03126/2010 couNTY: CUMBERLAND DATE OF DEATH: 06/ 22 j 2009 AMOUNT 101 ~ $135.00 TOTAL AMOUNT PAID: REMARKS: RECEIPT TO ATTY SEAL CHECK# 2936 $135.00 INITIALS: WZ RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REV-1162 EX(11-96) NO. CD 012521 TAXPAYER CQMMONWEALT;-I OF PENNS~L`dAN'~A DEPARTDJIENT OF REVENU- BUREAU OF INDI~,'IDUAL T 4XES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: HENNESSY SEAN J 1006 W FOXCROFT DRIVE CAMP HILL, PA 1701 1 -------- fold PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ACN ASSESSMENT CONTROL NUMBER ESTATE INFORMATION: SSN: 153-14-5911 FILE NUMBER: 2109-0619 DECEDENT NAME: HENNESSY CLARA J DATE OF PAYMENT: 03/26/2010 POSTMARK DATE: 03%26/2010 COUNTY: CUMBERLAND DATE OF DEATH: 06/ 22/ 2009 AMOUNT 101 ~ $ 5, 801.44 TOTAL AMOUNT PAID: REMARKS: RECEIPT TO ATTY SEAL CHECK# 1019 INITIALS: WZ RECEIVED BY: $5,801.44 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REV-1162 EX(11-96) NO. CD 012520 TAXPAYER COMMONb^JEA'_TH 'JF P~'~'XISY'_V~~NIA DEPARTMENT OF REVENU_ BUREAU OF INDIVIDUAL --'~X.,. DEPT. 280601 HARRISBURG, F'A 171 28-~~601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT 1"j ~{NI,C~iL3~/ L'I~( REV-1162 EX111-96) N0. CD 013636 SHIELDS CHARLES EDWARD 111 ESQ SIX CLOUSER ROAD MECHANICSBURG, PA 17055 ACN ASSESSMENT AMOUNT CONTROL NUMBER -------- fold ESTATE INFORMATION: SSN: 153-14-5911 FILE NUMBER: 2109-0619 DECEDENT NAME: HENNESSY CLARA ~ DATE OF PAYMENT: 1 1 / 1 2/201 0 POSTMARK DATE: 1 1 / 10/2010 COUNTY: CUMBERLAND DATE OF DEATH: 06/ 22/ 2009 101 ~ X87.07 1 TOTAL AMOUNT PAID: REMARKS: RECEIPT TO ATTY SEAL CHECK# 1026 $87.07 INITIALS: WZ RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS TAXPAYER REV-1500 EX Page 3 Decedent's Complete Address: File Number .~ `'Qg-' ~~ f Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments J. ~~• Y~ A. Prior Payments _ / 3S• ~ B. Discount ? b 4 S. Do __- - - --- 3. Interest 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. f1) /~)ZI.Z`7 Total Credits (A + B) (2) ~T, D 3(• • ~~ ~,zy (3) !~ (4) (5) ~7, 0 7 Make check payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred :.......................................................................................... ^ b. retain the right to designate who shall use the property transferred or its income : ............................................ ^ c. retain a reversionary interest; or .......................................................................................................................... ^ d. receive the promise for life of either payments, benefits or care? ...................................................................... ^ 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. ^ 3. Did decedent own an "in trust for" or payable-upon-death bank account or security at his or her death? .............. ^ 4. Did decedent own an individual retirement account, annuity or other non-probate property, which contains a beneficiary designation? ........................................................................................................................ ~ ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent [72 P.S. §9116 (a) (1.1 } (i)]. For dates of death on or after 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. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an adoptive parent or a stepparent of the child is 0 percent [72 P.S. §9116(a)(1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1}]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1502 EX+ (6-98j SCHEDULE A COMMONWEALTH OF PENNSYLVANIA REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ~~ C'/I//j/~SS ~ FILE NUMBER y G~~e,9 ~: a/-oq-~/9 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. ,~// ~f Cc~fa,'~ fray- ~~ 1 a,n d ctn d ~ ~ m ~ ~ vern~ n.~s ~1re0 n ~ ~CC~e.~ lM ~ ]~v ~o u y ~ o~ /v2.u.~ c wrn ~tc~~ ~'o u,nt o ~ C ~.~rn be,r--I an d , (~ w~,m oln w ea.) f~f.,, mf ~ n a _ c~;c~ ~ra,~f " Qirtd irn~ro~~-rn~>tifs were sold +o ,~a.l~h ~ Shires amd s~~rsa>h k. ~h ~ res , G~ ~ s w ~ .~e., c~n~( -~~~'le -~r~~ ~~ d e l.'ve,rec~ b ~.a.~ Ce~fa. ~ n ~eeo~ d~ Y ~ ~~M ~>r aDD q, ~' ~-~ d deer, ~l ~ o~ o 0 0, a D ~ 2~ ~ ~ e a~n~ Cm r ~e~ of ~ e ~1 P y 61 Gc.. G he ~ ~I.e 1 ~'r0 , /f ~ s ~ , S e ~ Cap 7 0 ~ Se ~lerl ~Iz[ s.he~t ar~acle~1 ~i~re~ ~S ~e/% TOTAL (Also enter on line 1, Recapitulation) ($ j 5 © ~Q~ 00 (If more space is needed, insert additional sheets of the same size) Tax Parcel Number: 25-25-0008-072 THIS INDENTURE MADE THE "M't day of I'~ ~ , in the year of our Lord two thousand and nine (2009). BETWEEN SEAN J. HENNESSY and CHRIS J. HENNESSY, as Co-Executors of the Estate of CLARA J. HENNESSY, deceased, late of the Borough of New Cumberland, Cumberland County, Pennsylvania, and the said SEAN J. HENNESSY, in his individual capacity as beneficiary, Grantors, and RALPH E. SHIRES and SUSAN K. SHIRES, husband and wife, of New Cumberland, Cumberland County, Pennsylvania, as tenants by the entireties, Grantees. WHEREAS, the said Clara J. Hennessy, was vested in her lifetime with title to the premises hereinafter described, in the Borough of New Cumberland, County of Cumberland and Commonwealth of Pennsylvania; and WHEREAS, the said Clara J. Hennessy, departed this earthly life, testate, on the 22nd day of June, 2009, and Letters Testamentary were duly issued to the said Sean J. Hennessy and Chris J. Hennessy, by the Register of Wills of said Cumberland County, docketed to No. 21-09- 0619; and WHEREAS, the lands herein-mentioned were the subject of an option to purchase in favor of SEAN J. HENNESSY, as per Item II in said Will, which reads in pertinent part as follows, to wit: "I hereby give my son, SEAN J. HENNESSY, the option to purchase my home at 200 Poplar Avenue, New Cumberland, Cumberland County, Pennsylvania, for the lesser of the appraised value of such property at the time of my death ...Such option must be exercised within six (6) months following my death." NOW, THEREFORE, THIS INDENTURE WITNESSETH, that the said Sean J. Hennessy and Chris J. Hennessy, Co-Executors, as aforesaid, for and in consideration of the sum of ONE HUNDRED NINETY THOUSAND and No/100ths ($190,000.00) DOLLARS, and other good and valuable considerations, to them in hand paid by the said Grantees, at and before the ensealing and delivery hereof, the receipt whereof is hereby acknowledged, has granted, bargained, sold, aliened, released, and confirmed, and by these presents, by virtue of the power and authority in them vested by the Fiduciaries Act of the Commonwealth of Pennsylvania, do grant, bargain, sell, alien, release, and confirm unto the said Grantees, as tenants by the entireties, their heirs and assigns: ALL that certain lot or piece of land situate in the Borough of New Cumberland, County of Cumberland and State of Pennsylvania, known as the south half of Lot No. 26, Plan No. 2 of Rosemont, recorded in the Recorder's Office at Carlisle, Pa., in Plan Book No. 1, page 96, and bounded and described as follows: BEGINNING at a point on the Western side of Poplar Avenue eleven hundred fifty-one and seventy-five hundredths (1151.75) feet South of the southwestern intersection of Poplar Avenue and Fourth Street; thence at right angles with Poplar Avenue in a westerly direction parallel with the line of Lot No. 25, two hundred sixty-two (262) feet to the eastern line o f Hillside Road; thence along the eastern line of Hillside Road in a southerly direction, eighty- three and fifteen hundredths (83.15) feet to a line of Lot No. 27; thence along the line of Lot No. 27 at right angles with Hillside Road, in an easterly direction two hundred sixty-two (262) feet to the western line of Poplar Avenue; thence in a northerly direction along the western line of Poplar Avenue, eighty-three and fifteen hundredths (83.15) feet to the place of BEGINNING. BEING part of the same premises, which Charles C. Stoner and Helen R. Stoner, his wife, by deed dated the 20~' day of October, 1950, and to be recorded herewith, granted and conveyed unto John C. Hennessy and Clara J. Hennessy, his wife. The said John C. Hennessy departed this earthly life on August 23, 1972, whereupon full and absolute title to the said premises vested in the said Clara J. Hennessy by the laws of the Commonwealth of Pennsylvania incident to tenancies by the entireties. Her said Estate is the Grantor herein. TO HAVE AND TO HOLD the said messuage or tenement and tract of land, hereditaments and premises hereby granted and released, or mentioned and intended so to be, with the appurtenances, unto the said Grantees, their heirs and assigns, to and for the only proper use and behoof of the said Grantees, their heirs and assigns, forever. AND THE SAID GRANTORS, Co-Executors, as aforesaid, their successors and assigns do covenant, promise and agree to and with the said Grantees, their heirs and assigns, by these presents, that the Grantors have not done, committed any act, matter or thing whatsoever whereby the premises hereby granted, or any part thereof, is, are, shall or may be impeached, charged or encumbered in title, or otherwise howsoever. IN WITNESS WHEREOF, the said Co-Executors of the Estate of Clara J. Hennessy, deceased, and the said Sean J. Hennessy, as an individual beneficiary, Grantors herein, have hereunto set their hands and seals the day and year first above written. The said Sean J. Hennessy, in his individual capacity joins herein solely to release any arguable right of purchase he may have in or to the premises under the terms of his late mother's Will. He does not, in his individual capacity make any representations as to the property or its title nor does he join in the warranty of title. Signed, Sealed and Delivered in the Presence of: Witness S~ ~~Y! -~ ~e11~s~ y (SEAL) SEAN J. HENNESSY, Co-Executor of the Estate of CLARA J. HENNESSY, Deceased Witness s~ o~ ~ N~neSs y (SEAL) SEAN J. HENNESSY, in his individual capacity as beneficiary S~UI/'~S ~- ~!~/~4eS5y (SEAL) Witness C RIS J. HENNESSY, Co-Executor of the Estate of CLARA J. HENNESSY, Deceased COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS: On this, the 4' ~ day of ~ec • , A.D. 2009, before me a notary public, in and for the Commonwealth of Pennsylvania, personally appeared SEAN J. HENNESSY and CHRIS J. HENNESSY, known to me (or satisfactorily proven) to be the persons whose names are subscribed as Co-Executors of the Last Will and Testament of Clara J. Hennessy, and in the case of Sean J. Hennessy, as an individual beneficiary, and acknowledged that they executed the same in such capacity. IN WITNESS WHEREOF, I hereunto set my hand an official seal. Notary Public My commission expires: (SEAL) CERTIFICATE OF RESIDENCE I do hereby certify that the precise and exact post office address of the within Grantee is: S~ ~iGl .~LacG, Fit . Attorney for Grantee A. U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SETTLEMENT STATEMENT OMB No. 2502-0265 B. TYPE OF LOAN 1. ^ FHA 2. ^ FHMA 3. ~~ CONV. UNINS. 4. ^ VA 5. ^ CONV.INS. 6. FILE NUMBER: 7. LOAN NUMBER 09-00041-RLT 217683159 8. MORTGAGE [NS. CASE NO.: C. NOTE: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "(p.o.c.)" were aid outside the closin ;the are shown here for informational purposes and are not included in the totals. D. NAME & ADDRESS Ralph E. Shires and Susan K. Shires OF BORROWER: 1103 Oak Lane, New Cumberland, PA 17070 E. NAME & ADDRESS The Estate of Clara Hennessy OF SELLER: 200 Po lar Avenue, New Cumberland, PA 17070 F. NAME & ADDRESS Bank of America OF LENDER: 2733 Pa er Mill Road, Suite 7, W omissin , PA 19610 G. PROPERTY LOCATION: 200 Po lar Avenue, New Cumberland, PA 17070 H. SETTLEMENT AGENT: Riverside Land Transfers, LLC PLACE OF SETTLEMENT 301 Market Street Suite 100 Lemoyne PA 17043 (717) 441-1555 _ I. SETTLEMENT DATE: 12/04/2009 J Summary of Borrower's Transaction K Summary of Seller's Transaction 100. Gross Amount Due From Borrower: 400. Gross Amount Due To Seller: 101. Contract sales price 190 000.00 401. Contract sales price 190,000.0 102. Personal property 402. Personal property 103. Settlement charges to borrower: (line 1400) 7 313.87 403. 104. 404. ]O5. 405. Adjustments For Items Paid B Seller [n Advance: Adjustments For Items Paid B Seller In Advance: 106. City/town taxes to 406. City/town taxes to 107. County taxes 12/04/09 to 12/31/09 67.56 407. County taxes 12/04!09 to 12/31/09 67.5 108. Assessments to 408. Assessments to 109. School Taxes 12/04/2009 to 6/30/2010 985.98 409. School Taxes 12/04!2009 to 6/30/2010 985.9: 110. Sewer l0/l1/12 12(04(2009 to 12(31/2009 18.09 410. Sewer 10!11/12 12104!2009 to 12/31/2009 18.0: 111. 411. 112. 412. 1 13. 413. 114. 414. _ 115. 415. 116. 416. _ 120. Gross Amount Due From Borrower: 198,385.50 420. Gross Amount Due To Seller: 191,071.6: ZO . Amounts P id B In B h If f B rr wer: . R ti n m un u I er: 201. Deposit or earnest mone 4 000.00 501. Excess deposit (see instructions) 202. Principal amount of new loan(s) l 52 000.00 502. Settlement charges to seller (line 1400) 17 680.8: 203. Existing loan(s) taken subject to 503. Existing loan(s) taken subject to 204. 504. Payoff 1st Mtg. Ln. 205. 505. Payoff 2nd Mtg. Ln. 206. 506. 207. 507. 208. 508. 209. 509. Adjustments For Items Unpaid By Seller: 210. City/town taxes to Adjustments For Items Unpaid By Seller: 510. City/town taxes to 211. County taxes to 51 I. 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 By/For Borrower: 156,000.00 520. Total Reductions In Amount Due Seller: 17,680.8`_ 30 ash At Se tlement Fro To B rrowe : 600. a h At Se lement Fr m o eller: 301. Gross amount due from borrower (line 120) 198 385.50 601. Gross amount due to seller (line 420) 191 071.6= 302. Less amount paid by/for borrower (line 220) 156 000.00 602. Less reductions in amount due seller (tine 520) 17,680.8`_ 303. Cash (FROM) ^TO) Borrower: 42,385.50 603. Cash (~~fO) (CiFROM) Seller: 173,390.7E Previous Edition Is Obsolete SB-4-3538-000-1 Fotm No. 1581 HUD-1 (3-86) 3/86 RI;SPA, HB 4305.2 X Page 1 of 3 X _ ter. wrr !`[7AD!'1CC Fcrrnw• tl9_Mfldl-RI.T L. - -- ------ 700. Total Sales/Broker's Commission: Based On Price $ °ro = Paid From Borrower's Paid From Seller's Divi i f m i Funds Funds At At t l S Settlement 702. 5 675.00 to Homestead (~rou emen ett 703. Commission aid at settlement 11 650.0 704. Additional Broker Commission to Homestead Grou 295.00 801. an Ori ination fee % ` 802 Loan Discount 803. A raisal fee to: LandSafe A raisa( Services Inc. POC 385.00 b B 804 Credit report to LandSafe Credit Inc POC $35 00 by B 805 Lender's insaection fee 806 Mortgage insurance application fee to 807 Assumption fee 808 Tax Service Fee To• BAC Tax Service CorRoration ~ 89.00 809. Flood Certification Fee To: LandSafe Flood Determination Inc. ~ 26.00 810. Lender Fee To: Bank of America ~ 590.00 811. 812. 813 814. 81 S. 816. 817. 818. 819. 820. 821. 9 1 Interest from 12/04/2009 to 1/01/2010 20.8200/da 28 da s 582.96 902. Mort a e insurance remium for mo. to 1 903 Hazard insurance premium for vrs to 904 Flood insurance Qremium for rs. to ~ 905 _ 906. 1001 H and insurance 3 months 46.00 er month 138.00 f 1002 Mortgage insurance months~a $ per month 1003 Cityproperty taxes months @ $ per month 1004 Countv orooertv taxes 11 months.~a $ 73 39 per month ~ 807.29 L 1005 Annual assessments months~a $ per month 1006 Flood insurance months Cad $ per month 1007. School Tax Reserves 7 months n S 148 79per month ~ 1,041.53 1008. A e ate Ad~ust~nent 661.66 1009. 1101. Settlement or closin fee to _ 1102. Abstract or title search to 1103. Title examination to L1104. Title insurance binder to L1105. Documen~re~aration to _ 1106. Notary fees to __ 1107. Attorney's fees to (includes above item Numbers: ) 1108. Title insurance to Riverside Land Transfers, LLC (Basic Rate) (includes above item Numbers: _) 1 308.75 1109. Lender's covera e 152 000.00 remium: $0.00 - _ ~ 1110. Owner's covera e 190 000.00 Premium: 1 308.75 1111. Endorsements 100 300 900 to Riverside Land Tran fer LLC 150.00 1112. Closin Service Letter to First American Title Insurance Com an ~ 75.00 1113. Overni ht CourierlHandlin to Riverside Land Transfers LLC 25.00 1114. Nota Fee to Cash 10.00 10.0( 1201. Recordin fees: Deed 62.00 •Mort a e 90.00 :Releases 152.00 1202.' City/county taxlstamps: Deed $ :Mortg_a~ ~ { 1203. State tax/Stamps: Deed $ 3.800.00 ~Mort~age $ ~ 1.900.00 1.900.0( 1204. 1205. 1301. Surve to 1 02. Pest ins ection to 1303. Wire Fee to Riverside Land Transfers. LLC ~ 20.00 1304. Electronic Document Fee to Riverside Land Transfers. LLC ~ 25.00 1305. Radon Mitigation to American Radon Solutions ~ 740.00 1306. Sewer 10/11/l2 Escrow to Riverside Land Transfers. LLC _ ~ 58.9 L 1307. Sewer'7/8/9 to New Cumberland Boroueh ~ ~ 6190 1308. Inheritance Tax Escrow to Riverside Land Transfers LLC ~ 4,OOO.OC 1400_ Total Settlement C'.harue (Enter on line 103. Section J-and -line 502. Section K) ~ 7,313.87 17,680.85 Form No. 1582 Page 2 of3 SB-4-3538-000-1 X X SELLER'S AND/OR BORROWER'S STA'CEMENT Escrow: 09-00041-RLT I have carefully reviewed the HUD-1 Settlement Statement and to the best of my knowledge and belief, it is a true and accurate statement of all receipts and disbursements made on my account or by me in this transaction. I further certify that I have received a copy of the HUD-1 Settlement Statement. Borrowers/Purchasers Ralph E Shires ~ ~'"` F- Su n K. Shires Sellers The Estate Clara Hen ssy By: The HUD-1 Settlemen tateme t which I e p ared s a true d ccurate account of this transaction. I have caused or ill cau the funds to be disbursed in accord a with h st teme Settlement Ag t: Date: ~v v Title ~cer, Rive ide Land ransfers, L'C WARNING: It is a crime to knowingly make false statements to the United States on this or any other similar form. Penalties upon conviction can include a fine or imprisonment. For details see: Title 18 U.S. Code Section 1001 and Section 1010. Page 3 of 3 REV-1508 EX ~.(1-97) - SCHEDULE E + COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, ~ MASC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF ~CN~,~~ S`// n~~~~ J. FILE NUMBER ~ ~_ ~ g_ d Iq Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. / rE~95 S,l,/DW N o/V ~F T~/7ZE',hlT Si ~T~~1EalT E?/Il ~5.4~~' f?~ ,~P4L ~Si-4TC /~s ~~' ~SC~lED, ~I. ~ ,~--~a~or~ ~ak~ y %xeS -L,'ne '~a~ B- ~~ '' SCE on/ ~~ - ~, ~f 0 9 e. a? 7nvenfo~ of ~~t ~eSr~' 6sx ~, ~k/y /o, zoo9 re.su,rf'eA~ wt /hp a b Jc i / ~/nS 0~--- J~~,a,~y cll~a~ ~n ~ I'Cd~ eJ~it fc ]~t4,;< c~,~earS erv S c~ ~. P/2S0/7Q / Hof J~rtrJ:S~ o~` n.o T~tn • Zn v~7br y ~ ~ ~u a/(ear a.- o ~, YiL~Ke RS ~a!'GCl~~d Ok/ ~inr0 TGf~ /2°Sitluctny ~YI~~iG~ar/e5: C~lri 5 yC/tA~s~y ~S°~ 1 - ,Q. cS~a,~ ,~/eti~essy ~Sb.~ ~~ee ~yoe~ in{~~/j ~~y ~cef ~tffa~~~ 'f ~ s T ~~n~ (fie va/aaho~ ~c~e~' a l~a cl ec~~ ~ _ ~~i~~: /~~. Ne - ~a ~. 7l 027 ~ ,Q die t'. 4 GCS". 7~ o~•D • ~ v n 1 ~/3? ~. C'~^l','~. ~ ,s:f No. 3ioo 3913 ~I/~a ~~ ~ . ~f. a ccr `fa d ~ D- d - ph 1 ~tn~ C L~ f, ~-ccr. ~ ~. D, a(_ ©h rim ,/~. lQ, eau/ ~it~~r/~-x~/ ~/ei^a / C~~~ ~~,'L~.on ~~ ~°• D o 26 S Z o 7. ~i~ /~-tcr. ~v cf. o, A/ e~ .L~e~ ~ C~ d%~( ~rof,~ecc~'ve Q ya /K a ~'vh /e~e.~. %I'~cs+~ h`9u~s ~ ~ 1 ~5.ed o~ c%sc-6uf c1u-cis iss~ ~f2m~'~y !'~-r~r a~•v~.~~~~~ fb7, s~ f CI85,g8 ~~~•~~ ~~ 3 , SU r 7 4. 7 S" ~~a ~, o0 ~ o•o~ ~~ Spa ~9 ~a s~. 8s ~ae3. s~ 'e o3 ~/ ~ X56.63 ~~.~ ~Z TOTAL (Also enter on fine 5, Recapitulation) ` $ 7c~ Jt'~3 7~ ~_ (If more space is needed, insert additional sheets of the same size) . z ~~~ F, ~~t~ ~' ~c~un~/ ~'or ~/cps ~ ~; c es ~~b .~. 7S 9. 7~ni~s ref /~ai~ ~y a-uy ~~,•`y ~+~~~r~,~' : - ~a ~~,; q ~ -s~aru~'e ol~l ~Qt rs ~ ~ of ~ sma.l,~ -}~,, les , J al d' ~~~ ~~! ~ T v !~) ~~ ~ v~ cS/,Yl.ll.G! ~-t~ u~ ~~%y~,G~2 S, 2- a ~ c~ c1 iS~J~Lrd ~~ C~Cc i rs , an of ~ 1~; cis ~ y ~heS f ~~ ~ a-x.e /; : ~s ~.~'1. Cc;~ r OvY1.~ a 5S o ~-f'e~0 ~.(-F l~n i c.~~ k'n..~.~ ~s , ~P>, ~G~~ T , l~. $ . /~~ - ~° C52~ hr~c.~e. Q ¢,~"p. o0 ~~~~~- ~5'~~F ~f ~' Mara ~- ~~t2nes~y Zl-a9'-~ / Y CLAR.A J. HENNESSY ESTATE -- SCHEDULE E CHRIS Miscellaneous Kitchenware $ 6.00 Old Microwave - no carousel $ 1.00 Stainless steel kitchen utensils $ 1.00 Miscellaneous pots & pans $ 3.00 Very small chest of drawers $ 12.50 Engraved wedding band 30.00 TOTAL $ 53.50 SEAN Pie plates $ 1.50 10 canning jars with loose lids $ 3.25 Homemade sewing cabinet (no machine) $ 4.25 Two oil based lamps (one cracked -not antiques) $ 7.50 Old blanket chest (homemade -lock broken) $ 6.00 Small vanity with mirror and stool $ 50.00 Old white enamel top table $ 4.25 Miscellaneous plates & cups $ 1.50 Cutlass Siera (1993) mileage 40,000+ Assorted knickknacks 1.50 TOTAL $ 79.75 JACQUELINE Miscellaneous Corelle dishes $ 3.25 Home finished oak table and chairs $ 75.00 Sofa and chairs $ 60.00 2 end tables & lamps $ 6.00 Small table & lamp $ 3.25 Blanket Chest (cedar lining) $ 25.00 Old wooden bed (spring and mattress shot) $ 17.25 Standing white metal lamp $ 2.00 Old sewing machine -needs repaired $ 5.00 Miscellaneous sewing items $ 2.00 Stand alone stool $ 2.25 Small wooden bed (passable springs) $ 10.00 Small table 15.00 TOTAL $ 226.00 ~c,e,~ ~ o J~, f u7 Q M&TBank 499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12 Phone (888)502-4349 Fax (302)934-2955 August 4, 2009 Charles E. Shields, III Attorneys At Law 6 Clouser Road Corner of Trindle and Clouser Roads Mechanicsburg, PA 17055 Re: Estate of Clara J. HennessX Social Security: 153-14-5911 Date of Death: June 22 2009 Dear Sir or Madam: Per your inquiry dated July 29, 2009, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type ofAccount C'heckingAccount Account Number 42271274 Ownership (Names o, f) C'1 ara J Hennessy Opening Date 10/28/74 Balance on Date of Death $ 1, 588.16 Accrued Interest $ 0.08 Total __ _.._ $1,588.24 2. Type ofAccount Account Number Ownership (Names o~ Opening Date Balance on Date of Death Accrued Interest Total Certificate of Deposit 31003913918256 Clara JHennessy* 8/25/99 $ 58, 572.49 $ 124.85 $ 58, 697.34 Type ofAccount Box Number/Location Ownership (Names of} Opening Date Safe Deposit Box 0000401/ Highland Park Clara Hennessy* Sean JHennessy, POA, Co-Owner* 8/01/50 * If upon reviewing the information above, you believe there are additional accounts not referenced, please provide us with an account number and/or name of any possible joint account holder. For any additional information on the above accounts, including ownership and any changes, closures and/or reimbursement of funds, etc., please contact our Highland Park Office # 717-737-3322. Sincerely, ~ `. ~~ ~- Trade Hare Adjustment Services ~to~Bank August 14, 2009 Charles E. Shields, III 6 Clouser Road Corner of Trindle and Clouser Roads Mechanicsburg, Pennsylvania 17055 Dear Mr. Shields, III: RE: Clara J. Hennessy, deceased June 22, 2009 In response to your recent inquiry concerning the accounts maintained in the name of the decedent, please be advised that the following accounts were open at the date of death: Savings # 1371-09092, open 1/8/2003, date of death balance $263.54 plus accrued interest $ .03, in her name only. If you should have any further questions, please do not hesitate to contact me at (717) 291-2437. Very truly yours, Karen D. Hillegas Credit Inquiry Processor t• -xis- ~ w` ~ '~r - _ o. .a u P O Box 4887 ~ Lancaster, PA 17604 ,,~ fultonbank.com ~ 1-800-FULTON-4 1.~~ ~, g. ~~rn~~ o . ~~ ~ , ~ X~l1 ~' ~'-. 2 ~ 4 ~ ~ a -~ ~-• ~s o~~s,~,,obr ~~ ~t ~,~ ~u~~~aS `'ter ' ~ ~-~~~ ~ ~, ~~~ 7$ SN~~~ t G3A~~ ~ Edmunds used Oldsmobile Cutlass Ciera car appraisal. Used Oldsmobile car pricing. ~saont.iro JG~N ~ . gin; .!t; - ~ k~ • Qidsmobile • Cutlass Ciera • 1993 • A ura • Aston Martin • qi i • Bentley • BMW • Bugatti • Buick • Cadillac • Chevrolet • h sler • Dodae • Ferrari • Fiat • Ford • GMC • Honda • HUMMER • Hyundai • Infiniti • ur • Jee • Kia • Lamborghini • Land Rover • Lexus • Lincoln • Lotus • Mahindra • Maserati • M~ybach • Mazda • McLaren • Mercedes-Benz • Mercury • MINI • Mitsubishi • Nissan • Porsche • Rolls-Royce • Saab • Scion • smart • S~,yker • S aru • zuki • Tesia • Toyota • Volkswaaen • VpIVO 3/25/10 1:51 PM http:/ivrww.edmunds.com/used/1993/oldsmobile/cutlassciera/1747/options.html?tmvaction=vdpresult Page 1 of 4 Edmunds used Oldsmobile Cutlass Ciera car appraisal. Used Oldsmobile car pricing. 1~" ` - 4 . _ . -' 1993 Oldsmobile Cutlass Ciera Appraise Your Car Style: S 4dr Sedan ~ Show All Styles TMV Pricing: A~raise Your Car Photos I41A Editors' Rating Not Yet Rated ~ Read the Model Review 8.1 i Consumer Rating 21 Reviews ~ Write a Review Fuel Economy 23 mpg 3!25/10 1:51 PM PARTNER SPOTLIGHT PARTNER SPOTLIGHT F. a aF:rr ~r+t~.~+,T YEHICLESPOTLIGHT >_.+ .• c.~ ~.-+++'{'~' 'TRUE MARKET VALUE _.._. _. Shopoinq_tor a Used Car? Auto7r,ader,camt Find Your Car Now ` Show Me the CARFAX! Flnd Out What Others Are Pav(na Search millions .M.a::,~.o• Find out how many :For The Car You Want ~, .. Check the GARFAX of vehicle (istin s - Ra ort for ever and find the ca9 ~°' - *' t records Exist on Wdh Edmunds TMV® you get a customized ~j~ P y ~ ~ ~ s ~ a used cars j price estimate based on your Zip Code, your 'it j/. ~ehide you're you want NOW. considering. A~~.,,~r•~`---°•~ {car, and your desired options. __..,,.., y .Tf~ ~.... w.,.«.•,.... Buying & Selling • View Ail Styles • Appraise Your Car • Prices in Your Are • Resale Values • True Cost to Own Vehicle Details • Available Features • Standard Warranty • Safety • lr • ~ Multimedia • Search Used Oldsmobile Listings • Sell Your Car Online Used Car Appraiser Back • Auto Loans as low as 4.24% APR SCE' 5 Review ~dmunds.com Pricing Report ,, 1993 Oldsmobile Cutlass Ciera S 4dr Sedan National Base Price O~tionaf Equipment Cruise Control AM/FM/Cassette Audio System 3.3L V6 OHV 12V FI Enaine True Market Value"" Pricing Trade-In Prparty Dealer Retail $86 $292 $636 $9 $29 $73 $1 $3 $7 $1 $3 $8 43 310 325 .._.,. 11~ha~ ~an~l A~ff~rd? ~~ Find out ~uvithEdmunds Afford~k~ifi~y Cai+cuiator ~. -Tell us your"dexired monthly payment, and we'll give you a price range for your next car. ;~~^ _ ~ . r ~. i ~._J ~.c?~ cutators http://www.edmunds.com/used/1993/oldsmobile/cutlassciera/1747/options.html?tmvaction=vdpresult Page 2 of 4 Edmunds ifsed Oldsmobile Cutlass Capra =ar appraisal. Used Oldsmobile car pricing. • Photos Tilt Steering V1~heel ~ $1 $2 • Photo Archive Power windows $i $4 Ratings & Reviews Driver Front Airbag $2 $7 Color Adjustment $0 $0 • Model Review Light Brown • Road Test Regional Adjustment $_5 $-17 R to Ings for Zip Code 17055 • Road Test Mileage Adiustmeri# $318 $318 Reviews 40,000 miles • Consumer Reviews Condition Adjustment $-31 $-104 Awards History • Reliability Av Total 537 Ss~B • Consumer Discussions Certified Used Vehicle Payment Price Another Vehicle Calculators Print Window Stickers: Tra -In l Private Party) Dealer Retail BUying a NeW Car? Get new car pricing in your area. • Auto Loan Calculator ~ __.~ '` ` ZIP: i 17055 Select a Make T ; ' Select a Mod---_-el ~; Helpful Tools • Maintenance Schedule Buying This Car Used? • Recall Notices • Technical Search 1993 Oldsmobile Cutlass Ciera Listings Near You ervice Bulletins Zip Code: 17055 Research a New Car SI~V den Truck Minivan /Van ,~, ~"`' ~° yor.. ...oJ Convertible CoutJe Luxu Hybrid Browse by Make: _.._.._______._..___.__.__________ New Car Buying Guides: ` Select a Make :~ A Smart Look at What's New for 2009 Ready to Seil Your Car? Create an ad that will reach the most buyers anywhere and sell your car fast! ~`~ ,~,. Enter your zip code to get started: v k ~; ,- ~ ~ ZIP: 17055 (Continue ~! powereC by~1~z1~Yf~~S' $6 $9 $18 $0 $-36 $318 $-223 $~ss NJA Buying a used car? Get a CARFAX Vehicle History Report to help you buy your next used car with confidence. Get a CARFAX Report now. • Search Used Oldsmobile Listings Auto Loans as fow as 4.24% APR • Sell Your Car Online 3/25/10 1:51 PN ~' 2010 Buying Guides Your ultimate guide to what's hot in 2090 for cars, trucks, SUVs, ~ more. TIPS & ADVICE Latest News for Car Shoppers: Edmunds Daily 10 Steps to Buying a New Car New Car Buying Guides Best Cars Insider Secrets How Much Car Can You Afford http://www.edmunds.coin/usedJ1993/oldsmobile/cutlassciera/1747/options.html?tmvaction=vdpresult Page 3 of 4 Edmunds used Oldsmobile Cutlass Ciera car appraisal. Used Oldsmobile car pricing. 3/25/10 1:51 PM . ~,.~.~ _ ~: r .y1'--,- !.~..~£':"~ c tl'S '. i."i( r~£`,'IC,':r<. ~!? fC ;~,t~,I~:P t.,:3} ~t' '.i~.. ~t3~i.'iuLit,C: = C., ,~t~~5 LIe~:4Gf .... r ;i~. rt!.j ...' t,:, f,i7t t,. .`,<l^1S .. , !; "i) _~ ~.f... x^31.: ~-Cl~~, Si .Jf,. ~i (''L3.11 _ _. .3~ i ~ _ _ ;:f.~3 ~~~J)` _ E~. 7~ _7'~' ~ . c <,~?~tr3c.r s csi~ i(x ~o-n~z~a~r[aer~t o~~c~rtt~s~~~i~~ . ~ .,,iii t'4"s CS it'..., http://www.edmunds.com/used/1993/oldsmobile/cutlassciera/1747/options.html?tmvaction=vdpresult Page 4 of 1993 Oldsmobile Ciera -Private Party Pricing Report -Kelley Blue Book ~~~ THE TRUSTft3 RESf~URCf _w..~,.~.~ .~.. {~.tstrt i ~~I fIlK,~t."T EVE ~ d ~~ t~ E'a S~/ ~fl c+~mpare rates and sane. advertisement 1993 Oldsmobile Ciera S Sedan 4D ~~V~ ~~~~~~ ~~~~~~~ ~~~~ ~~~~~ Condition Va ue Excellent $1,605 !"~~~~, ~ .!1!111 ir~~ , ~r~i~~~~ __ Good $1,405 ~~ Fair $1,105 (Selected) ._ Vehicle Highlights Mi{eager 40,000 ::Engine: V6 3.3 Liter Transmission: Automatic 'Drivetrain: FWD '.Selected Equi pment ::Standard Air Conditioning Power Steering AM/FM Stereo 'Optional Power Windows Tilt Wheel Cassette Power Door Locks Cruise Control Blue Book Private Party Value Kelley Blue Book Private Party Value is the amount a buyer can expect to pay when buying a used car from a private party. The Private Party Value assumes the vehicle is sold "As Is" and carries no warranty (other than any remaining factory warranty). The final sale price may vary depending on the vehicle's actual condition and local market conditions. This value may also be used to derive Fair Market Value for insurance and vehicle donation purposes. Vehicle Condition Ratings Excellent ,~ $1, 60 5 Looks new, is in excellent mechanical condition and needs no 3/25/10 1:47 PM Send to Printer i:ntet~ Z{P ~vd~: ~1~~4 1 H~-v It?C]~C~ Close Window http://www.kbb.com/kbb/UsedCars/PricingReport.aspx?Yearld=1993&Mi...897%7ctrue%7c392900%7ctrue%7c392906%7ctrue&Action=&Printable=true Page 1 of __...... ~r{~earficamanf .».._......._...._.... 1993 Oldsmobile Ciera -Private Party Pricing Report -Kelley Blue Book reconditioning. Never had any paint or body work and is free of rust. Clean title history and will pass a smog and safety inspection. Engine compartment is clean, with no fluid leaks and is free of any wear or visible defects. Complete and verifiable service records. Less than 5% of all used vehicles fall into this category. Good $1,405 Free of any major defects. Clean title history, the paints, body, and interior have only minor (if any) blemishes, and there are no major mechanical problems. Little or no rust on this vehicle. Tires match and have substantial tread wear left. A "good" vehicle will need some reconditioning to be sold at retail. Most consumer owned vehicles fall into this category. Fair (Selected) ~~~ $1,105 Some mechanical or cosmetic defects and needs servicing but is still in reasonable running condition. Clean title history, the paint, body and/or interior need work performed by a professional. Tires may need to be replaced. There may be some repairable rust damage. Poor N/A Severe mechanical and/or cosmetic defects and is in poor running condition. May have problems that cannot be readily fixed such as a damaged frame or arusted-through body. Branded title (salvage, flood, etc.) or unsubstantiated mileage. Kelley Blue Book does not attempt to report a value on a "poor" vehicle because the value of these vehicles varies greatly. A vehicle in poor condition may require an independent appraisal to determine its value. * Pennsylvania 3/25/2010 3/25/10 1:47 PM http://www.kbb.com/kbb/UsedCars/Pricing Report.aspx?Yearld=1993&Mi...897%7ctrue%7c392900%7ctrue%7c392906%7ctrue&Action=&Printable=true Page 2 of REV-1510 EX + (7.97) COMMONWEALTH OF PENNSYLVANIA INHERfTANCE TAX RETURN SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF k ~~ N~SSy C LA-~ /~. J'. FfLE NUMBER ~ j _ D 9 ~ ~ ~ 9 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER ATTACH A COPY OF THE DEED FOR REAL ESTATE . DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST EXCLUSION IF APPLICABLE TAXABLE VALUE 5a~t o~ d ecec~ult' ,made w~ ~ ~ n one r ear- rr Dt' cp, o. d. ~~p , Oc~O . o a ~ ~j 000. oo ,~/!~- ~ 3, f~OO. ~ 3j pGYJ .a ~ . ~ ~ ~ ~N~ sFCuarrr~~ : ~/I~oS7~~ ,/~h h u ; f '~'en fi~t~' #>~ (0 9 ~ 8 ~f 9 ST S Y ~7 a, ~ 95. ~8 / 0 010 --o -- 7~, ~ 93'. ~8 ~~a/aa~ow a s off' ~. o. a! ~s o6fx i~ 6 y ~i r~~ ~~l ~o /~~ ~ l3axx .~eeurifi+~s /~'/~i'IK/~ 6G{Q.S ~J4.fIQ~,~G ih @~ ka/ ~3 ~p C~l/'iS /~Cnn~~t y, Son ~~ ~~~ssy, row fa t~ . C'ohtn, c~a.c' ~i~'`tr TOTAL (Also enter on line 7, Recapitulation) ' ~ '7~~ ~ Q S', 7g (If more space is needed, insert additional sheets of the same size) f~ffa~1 mea~ ~ ~-~~ ~l, ~~7~ o~ ~~ir~1/~3sy, ~~~ 7: ~ - :fir : ~~rj s ~T: /~/~r1/l~ssy ~~~ /~a/~ ~a~I~ La~~ BILE' ~O. - Z~-o y- ~ / ~ ~C C/urc~ ~~ /7~~~ ~'!~ is .~. /y~/l/l~ssf/ ~~S ~i~/ewi~ Gam'/,~'P~ ~1 ~ ~5 ~./k/1I ~SSi o~'! . REV-111 EX+ (12-99) ~'~;~~~ SCHEDULE H ~~. COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. n^ n ~4 -''~'~ n'4bKS ~~tMf.~ 1~ OPY1G ~ ~ ~ ~ IA,riV~` ~ /"~t . C/"~,- ~t,1d) -'~ ~- ~un era ( IYl enl , S~-. Qa.uls L u, ~wra.v>< Ch ~ Neu C° wYwb. ~ ~ SD • ot~ B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) pP.A')'1 f Nei nes s y C~1,,~/ ~~~ Social Security Number(s)/EIN Number of Personal Representative(s) Street A dd ress /00~ ~ti' . /tox C rra ~f ~i". n - City C4M.C1 rl / ~~, State ~•t Zip ~ 70l ~ Year(s) Commission Paid: ~~ YC~ (~Sce ~~luq~ ~,e : CA- ~'xr' C'hr.'S ~': ~eh~essy ~ 2. Q-l~S rte, Attorney Fees C~jq r/~ ~, sh, oD ~~0, ODID. 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant /YQ D,/iF~' ~LlG//j LLB ,/I~j~/(/~' Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees ~ py i q, n q,1 i S5~ Ot $x'10 ~ ~ C 2rf7 ,~~Cct.~"cS ~j/~ v DD 5. Accountant's Fees $~~ C~D.~ ¢~¢ ~~ ,nan~~jy~oq~.ryjq,,rf ~ ~'a,~ o/r ~ ~ ~vo~n~/GGyy ~~~u , P 930, yS 6. Tax Return Preparer's Fees ~o~ c`D~ak~ ~~1D ~~~~ ~~~ ~, 7. C~//3R6F~dae~~ /TG`Y,~7S of A9nl/N ~/'~.IYSE~' /OED S~TiZE/yi~T ~ % ~~'/11 ~'~UT oN ~ A~.E' o~ R.~~t E~ TA~T~ ,~: /~ cct,l~ rb sa IGS Cora M ~ ss i o -1 --- L; ~ ~ 703 t` / ~~ ~vs~i DO r3. No~~.y Fe ~'4s~ - L;ire !/~~ ~ C . Leo / 7ra~S~r l~ - ~,ne /,~0,3 /O. o0 ~ ~ , ~OD. e0 ~. Se ~e~ ~s crr~ ~ ~ ,R,'vers~ Ac L~ ~4~s,~s, LAC - L,:,~ /30! ¢~'~r.y~S' See o ~i~. ~icef TOTAL (Also enter on line 9, Recapitulation) $ 3p~ ~/q SD (If more space is needed, insert additional sheets of the same size) ~='~ d'G Scher. 1~, ~rs~d. ,SST D~ tYc~iy~-~~ Y~ ~~~ ~' ~/~ ~/~. ~~~o ~ ~~ / `~ ~f C,II1 $. T Ce-f~1T A~ ~e~v~r ,~~-~,~ fo /l/eu1 Cum6. /~~ou ~ ~f8j9- I,'ne /~07 ~~ ~ f~ I.9p 1`S. ~cc.~jcss ~isur, Co ., a~ Lo~~a; Dry! t~/oincoli/nGrs ~- a°~'~na/ ~~~ /~~~K e ~~~wal ~ ~3~~. `~ p. /~o6•n G~s~oe~er`t. f ~~ Co/~~~ (~ ~,;~'Q ~ !~i eaf/~ gyp. ?.~~~ f l 6 ~ 7_ z7 ~o • ~~'e ~/ate o~ /l~o~ ~'u rn. b. ~ re~a-"r o ~ C'.~o y°e~aliY,l~~, e~ . ~~ s~e ~ l ~D, 00 9 /~, /~etv ~umd . ~o ray o~~ve~" ~~, gs ~~. ~~irrburs~~nf ~ ~T eke ~~ien .{ r ~ !/ow;n ; ems = ~ r ~• ~or1 ~/effs G'/eani~-ty ~enl~tr~ /J7~l~t„/"»-~s ~r ~~ean~ U ~ c ,`30~l~G ~D/~ ~5'al~ ~ 8`1• ~O ,Q. S/Yll}1 ~~S1~i~wl'ars~ 1.L,~ 1~~ Gc~a~y1 ~/io~' ~r~ ~K /~~~5~ j ,~~e Cleanc~- ~und/c ~ ~/us sh, j~p~; ~ .~/ /57, ~NN(~/~9S ~ju.~~ ~~~~ G1ed ni /~2~'ial~ ~/o . 57 1~. ,/~~7s ~ilhole~/e G'/ub a~aos~~~~`~~" ~~~ 3s" /~. %r' TQs~, of y©~k, ~i~, ~r ct sc ~1 ~ ~i~m~~l~~, ~~v~ ~t~ ~It~''a/ ~SLj .~,~- rya S• o~ f ~{, ~a. ~. lriafrr- '~ ~ 7.85 5', ~~r iS ,,~ri n /cY, e~ /Vein (~u~c 6 . , ~a x nt o ~vin9 ~ rQss, a~-c/ U a~ ~a~ /1?a~n ~id~ytce- ~~~ ~/~d. 00 /fir, ~i iit c, r~ ~ S f ~u m ~. h ~~~nq , ~ ~, .E7r~.~ ~S Ss nf~~ , f~~il'~ F d ~ U La ,~r i rt Pl~e~v. {v'r o5u /c ~ .5'a T, `f 9 l1. ~~;r/e C. Craw Ford ~ ~ssor+ed I ~,or ~1 serv ~ccs assoc. w~ ~. y C~ 2an ~ -~.~ , 1~e~ u,~ r i n~ , ¢~o . d f ~ o k.SL 1.~, ~ ~eP. Sj-o ~ S o~G ~ 750 . o0 18 . ~Gti rrbv..~etY~tXt~ ~o ~6u.k ~~ ~~~n ~r G fCcc~~ ems. ~ I ~.(o~l ~ R. ~P~ ~/oo. z~ C S P~ Cd ~`l.t'r h . 5 ~ eC~) ~. P~ L ~~~,.s~ a/. /~~ . ~i~• Gt/a~cr ~ ~- 93 a~. I~eerlesS 1,nsur. Co b~ vPila~n~ 0/Y G.c.rrrrtt u~ ~a-!. ~-ue - ~ ~ , ~.~ 5~.~. S~ ~, dYl~(/rC.~ (~f~l 4 ~e ~2t ~~~~ ~~ ~ f ` ~lli~'lK ~/~ Ov . , P a~ /~d ve~~~rn %~t ,~ ~Gcm ~c~'~~ L~ ~er~r/t~~ (~ ~' 7S- o0 ~8_ ail ~g ~ ~ G~c~ s~cr avC .Grr~lls Pr /S dt~ 02 ~ r/ , , / ~ , ~ali ~ O/9a~ fQ/tp pit-fB 1'C L /6 ~ ~Gr~ a,7~ ~~ j~,s ~~ / s~. a 30. ~eiin d!t!'~/,~~YI !b ~!'l~t ~'rGS ~ _ ~i~P~~s _,~ tD r ~pt~"l ~ ~e~~~~ jY'a~lit~7S~ ~hv~vCoPics, ?~_ L es~nin ~ ~ls. °D 3!. ~'X~ra a~caf~ C~rfr~~rt~s ~r pre-olec~sed spousa~ needed ~" V ~' r` ~ ~i c a h~ o i'k5 la C1l.r r y o* t1~' G's RU C ~G 1y1Q~~ D b~G~ r~t.G~ REV•1512 EX+ (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE t DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF /~{~NNC- s s y, ~~~ ~ FILE NUMBER a!-©9- 61 ~ Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medica{ expenses. (If more space is needed, insert additional sheets of the same size) REV-1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] ,. ~y~~~ ~: ~E~~~Sy Soh y3 ~l ~ ~Q4/~ ~Ea~/~ bane /hcC~u.re ~ ,/~~ /78y/ a? ~~CQrtE~/~ ~~~/ Gt a u,~,f-~- y3 Soy /~ar~yi!10~ ~r-• OXo/1 /~i11 ~1j o~7 `~S 3 ~SE,gN cT. ~~~y~3s ~ SOH f 3 /oo ~c C~J ~~rol~ c~/': ~~ /yi!/ ~i¢ /70l/ ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTR16UT10NS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE i. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. T07AL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET ~ $ (tf more space is needed, insert additional sheets of the same size) III eo\wi_1s\iiENNESSYclara LAST WILL AND TESTAMENT OF CLARA J. HENNESSY I, CLARA J. HENNESSY, of the Borough of New Cumberland, Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. ITEM I: I bequeath my automobiles, household and personal effects and other tangible personalty of like nature (not including cash or securities) together with any existing insurance thereon to such of my children, JACQUELINE COHEN, CHRIS J. HENNESSY, and SEAN J. HENNESSY, as are then living, to be divided among them by my Co-Executors with due regard for their personal preferences in as nearly equal shares as practical. ITEM II: I hereby give my son, SEAN J. HENNESSY, the option to purchase my home at 200 Poplar Avenue, New Cumberland, Cumberland County, Penr~sylvar~ia, fcr the lesser of the appraised value of such property at the time of my death or One Hundred Twenty Five Thousand and NO/100 0125,000.00) Dollars. Such option must be exercised within six (6) months following my death. Any share which my son, SEAN J. HENNESSY, may be entitled to receive under Item III below may be used by him as a credit to reduce the aforesaid purchase price, if Page 1 of 4 he so desires. Should my son, SEAN J. HENNESSY, predecease me or fail to exercise such option, I devise such residence as part of my residu- ary estate. ITEM III: I devise and bequeath all the rest, residue and remainder of my estate, of every nature and wherever situate, in equal shares to my children, JACQUELINE COHEN, CHRIS J. HENNESSY, and SEAN J. HENNESSY, or to the survivor of them. ITEM IV: I appoint my children, CHRIS J. HENNESSY and SEAN J. HENNESSY, Co-Executors of this my last will. ITEM V: No fiduciary acting hereunder shall be required to post bond or enter security for the faithful performance of his duties in any jurisdiction. IN WITNESS WHEREOF, I, CLARA J. HENNESSY, have hereunto set my hand and seal this ~' f day of ~~`~---~~'~ 2006. /' ~ 7 ^'.rcr ~ C /OZ/ CL`'~ARA J. HENNESSY SIGNED, SEALED, PUBLISHED and DECLARED by CLARA J. HENNESSY, the Testatrix above named, as and for her Last Will and Testament, and in the presence of us, who at her request, in her presence and in the presence of each other, have subscribed our names as witnesses. ,•~',.-~ C~~C~~~ n Address ~ , ~. ~~ _ ~, ~~~. ~ ~ ~~ Witness Address Page 2 of 4 i i. COMMONWEALTH OF PENNSYLVANIA: ~'~ ~' S S . COUNTY OF CUMBERLAND 'i I, CLARA J. HENNESSY, the Testatrix whose name is signed to the ~, attached or foregoing instrument, having been duly qualified according to law do hereby acknowledge that I signed and executed this instru- ~' '~ i; ment as my last will; that I signed it willingly and that I signed it ~i as my free and voluntary act for the purposes therein contained. ~ ~ ~ 7`~_ y CLARA ~ HENNESSY Q`` Sworn to or affirmed to and ~~a,~~c``knowledged before me by CLARA J. HENNESSY, the Testatrix, this ~ `~v` da of . , '~ y ~ 2006. i COMMONWEALTH OF PENNSYLVANIA NOTARIAL SEAL Notary u lic KATHLEEN KEIM, Notary Public New Cumberland Boro. Cumberland Co. My Commission Expires Dec. 5, 2006 Page 3 of 4 COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND h ~r , W e , ~~~-~~~ ~ ~.~~~C~/.~ ~``--' and ~ - , the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according ~o law, depose and say that we were present and saw Testatrix sign and execute the instrument as her last will; that Testatrix signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the will as witnesses; that to the best of our knowledge, the Testatrix was at that time eighteen or more years of age, of sound mind and under no constraint or undue influence. r ~ . ~~ " - tne ~) Witness Sworn to or affirmed to and ackno dged before me by GEC ~ ~~ ~~~~G~G~i i.~/~ and ~~'(~- witnesses, this ~ ~ day of ~ 1'~ ~ 2006 . f- ~~ONV1iE~tttLTH OF PENNSIR.V ~ ~ AN1A Notary Putbl c NOTi~iAL SEAL KATHLEEN KE1M, Notary L'rubiic New Cumberland Boro. Cumberland Co. fNy Commission Expires Dec. 5, 2006 Page 4 of 4