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HomeMy WebLinkAbout11-23-10 (3)1505610143 REV-1500 ~"°'-'°' OFFICIAL USE ONLY PA Department of Revenue Pennsylvania county code veer File Number Bureau of Individual Taxes °E"""TaENT0FRfl1E""'E Po Box.zsoso~ INHERITANCE TAX RETURN 21 10 00794 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death. Date of Birth ', ~f n'7 n'] '7ww0 n7 11 7n1 n nA n1 1 D1 t? G V/ V J / Z ~i V V/ i i G V i V V 7 V i i 7 i V ' Decedent's Last Name Suffix Decedent's First Name MI SHEARER WILLIAM S (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's.First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE ITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW tZ; 3e m=o dZr 1. Original Return ~ 2. Supplemental Return ^ 3. p (date of death 1 8 o ^ 4. Limited Estate ^ 4a. Future Interest Co~omise ^ 5. Federal Estate T (date of death after 2-12-82) Return Required O g. Decedent Died Testate ~, t Maintt ned a Living Trust 1' S. Total Number Of (Attach Copy of wll) ^ (Attach Copy of~rust) afe De Slt Boxes ~ 9. Litigation Proceeds Received ~ 10. s~ou~P~~~a~t,~dat~~f death ~ ~ ~, Election to tax un er Sec. 9113(A) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE ANp CONFIDENTIAL TAX INFORMATION HOULD BE DIRECTED T0: Name Daytime Telephone Nurr~r EDMUND G MYERS (717 ~C a6 4~4 0 ~> ~ ~ r~ 7 REGISTER LS ~ 0T' ; t ~ W _;;,i 3 First line of address ~ r7 ~7 -p ~:' `' =~r r ~ ~~~ ~ 3 r:_~ ~ 301 MARKET STREET _ _ IV ~ ` ~O Second line of address (• p C,rl ' Cri PO BOX 109 ' City or Post Office State ZIP Code DATE FI ED LEMOYNE PA Correspondent's a-mail address: e9f1'1~Jd8W.COfT1 Under penalties of perjury, I deGare that I have examined this return, including accompanying schedules and statements, and to the best of knowledge and belief, it is true, correct and complete. DeGaratfon of preparer other than the personal representative Is based on all information of which preparer as any knowledge. SIGNAT E OF PERSON RESPONSIBLE FOR FILING RETURN DATE SAUNDRA L GOTWALT 9 d d ADDRESS 160 New Haven Street Mount Jo PA -17552 SIG E OF PREPARER OTHER THAN REPRESENTATIVE DATE EDMUND G. MYERS ~( •Y n ADDRESS 301 MARKET STREET, Lemoyne, PA ~, Side 1 ~ 1505610143 150561014 J 1505610243 REV-1500 EX Decedent's Social security Number oecedenrsName: SHEARER, WILLIAM S 207 03 71448 RECAPITULATION 1 5,000.00 1. Real Estate (Schedule A) ....................................................................................... 1. 180.61 2. Stocks and Bonds (Schedule B) ............................................................................. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)......... 3. 4. Mortgages 8 Notes Receivable (Schedule D) ........................................................ 4. 5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............... 5. 2 6,561.74 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6. j 7. Inter-Vivos Transfers & Miscellaneous Ikon; Probate Property Se arate Billin Re uested S h l d G p g ............ q ) u ( u e c e 7, 8. Total Gross Assets (total Lines 1-7) ..................................... ................................ g, 4 1 7 4 2. 3 5 ~ 9. 10. 11. 12. 13. 14. Funeral Expenses /£ Administrative Costs (Schedule H) ....................................... Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............................. Total Deductions (total Lines 9 & 10) ........................................... Net Value of Estate (Line 8 minus Line 11) .......................................................... Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ............................................... Net Vatue Subject to Tax (Line 12 minus Line 13) ............................................... 9. 10. 11. 12. 13. 14, 4 4 5,539.39 3 , 67 9 . 8 8 9 219.2 7 2 , 523.08 2 , 52 3. 0 8 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable i at the spousal tax rate, or t transfers under Sec. 9116 15 .0 00 (a)(1.2) X .00 . 16. Amount of Line 14 taxable 432 523.08 at lineal rate X .045 ~ 16. 9 , 4 63.54 17. Amount of Line 14 taxable 0 . 0 0 at sibling rate X .12 17. 0 . 0 0 18. Amount of Line 14 taxable 0 0 0 18 0 0 0 . at collateral rate X .15 . . 19. Tax Due .................................................................................................................. 19. 9 , 4 63.54 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. i ~ I ^ ide 2 i I I 150561tJ243 15056102.4 J .REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-10-00794 DECEDENT'S NAME SHEARER, WILLIAM S ', STREET ADDRESS 230 Haldeman Avenue ', CITY New Cumberland STATE PA ZI 17070 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) 2. Credits/Payments A. Prior Payments 15,000.00 B. Discount 789.47 Total Credits (A + B) (2) 3. Interest (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) Check box on Page 2 Line 20 to request a refund -_ .. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) Make Check Payable to: REGISTER OF WILLS, AGENT. 19,463.54 15,789.47 3,674.07 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: 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 I'rfe of either payments, benefits or care? ...........................:................................ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death withou 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 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 spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)J. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviv [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requiren 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 ~ adoptive parent, or a stepparent of the child is 0 percent [72 P.S. §9116 (a) (1.2)J. . 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, exG 72 P.S. §9116 1.2) [72 P:S. §91.16 (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 ( sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether t Yes No a a x x x ^ 0 a o 'ART OF THE RETURN. ie use of the surviving g spouse is 0 percent nts for disclosure of of a natural parent, an t as noted in (1.3)]. A blood or adoption. __. _ _ Rev-1502 EX+ (11-08) SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT '. ESTATE OF FILE NUM ER SHEARER, WILLIAM S 21-10-00 94 Atl real property owned solely or as a tenant In common must be roported at fair market value. Fair market value is defined as the price at which ny 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 Real property which Is jointly-owned with right of suMvorohip must be disclosed on schedule F. acts. Attach a copy of the settlement shoot if the property has been sold Include a copy of the decd showing decedent's interest M owned ss tenant in common. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Residence - 230 Haldeman Avenue, New Cumberland, Cumberland County, Pennsylvania. 185,000.00 Contracted Sales Price. Sale occurred on October 28, 2010. A copy of the Settlement Shee is attached t TOTAL (Also enter on Line 1, Recapitulation) 185,000.00 (If more space is needed, additional pages of the same size) Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 chedule A (Rev. 11-08) Rav-7503 FJ(+ (6-98) SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA ', INHERRANCE TA%RETURN RESIDENT DECEDENT ESTATE OF FILE NUM ER SHEARER, WILLIAM S 21-10-0 794 All property jointly-owned with right of survivorship must ba disclosed on Schedule F ITEM CUSIP VALUE AT DATE NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH 1 4 United States Savings Bonds Series E -valued using 180.61 savings bond calculator. A copy is attached TOTAL (Also enter on Line 2, Recapitulation) 180.61 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 6-98) Rev-7508 EX+ (B-88) SCHEDULE E CASH, BANK DEPOSITS, ~ MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN - RESIDENT DECEDENT - '. ESTATE OF FILE NUM ER SHEARER, WILLIAM S 21-10-00 94 Include the proceeds of IAipation end the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must pe disclosed on schedule F. it I ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 M8rT Bank Checking Account No. 7742fi959 42,015.18 2 Postmark Federal Credit Union 00 Regular Share Account 405.34 3 Postmark Federal Credit Union 13 Investor Choice Plus Account 107,914.61 4 Sovereign Bank Certificate of Deposit Account No. 0775146871 14,334.40 5 Sovereign Bank Certificate of Deposit Account No. 0775147465 2,751.48 6 Sovereign Bank Certificate of Deposit Account No. 0775147473 2,566.20 7 Sovereign Bank Certificate of Deposit Account No. 0775147671 12,164.02 8 Sovereign Bank Certificate of Deposit Account No. 0775147788 ~ 3,309.34 9 Sovereign Bank Certificate of Deposit Account No. 0775150618 2,206.20 10 Sovereign Bank Certificate of Deposit Account No. 0775150857 50,616.74 11 Sovereign Bank Certificate of Deposit Account No. 0775275324 13,729.80 12 Sovereign Bank Certificate of Deposit Account No. 0775290810 12,942.24 13 1998 Pontiac Bonneville SE Sedan 4D -Contracted Sales Price 3,000.00 14 Personal property distributed to Saundra Gotwalt -Appraised by Chuck Bricker. A copy of 280.00 the Appraisal is attached. 15 Sale of Personal Property by Chuck Bricker, Auctioneer -Auction held on October 2, 2010. 5,725.25 A copy of the Auction document is attached Total of Continuation Schedule See attached page TOTAL (Also enter on Line 5, Recapitulation) I 276,561.74 ---- (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) T SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PRO PERTY COMMONYVEALTH OFPENNSYLVANIA INHERRANCE TAX RETURN r cOntlin UP.CI ' RESIDENT DECEDENT ' ESTATE OF FILE NUM ER SHEARER, WILLIAM S 21-10-00 94 ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 16 Refunds Received - Verizon and Patriot News 170.63 17 Reimbursements to Estate at Settlement for Taxes -County Taxes: 161.57; School Taxes: 1,164.67 996.23 and Trash Services: 6.87. A copy of the Settlement Sheet is attached 18 Prudential Annuity Contract No. CS0000011441 -Beneficiary: Estate 1,265.64 TOTAL {Also enter on Line 5, Recapitulation) 276,561.74 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) REV-1151 EX+110-08) SCHEDULE H coM~~D~nNU~ FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE I SHEARER, WILLIAM S 21-1 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION A, FUNERAL EXPENSES: See continuation schedule(s) attached AMOUNT 1,059.74 B. 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zio Year(s) Commission raid 2. Attomev's Fees JOHNSON DUFFIE 7,500.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address Ciry State Zip Relationshio of Claimant to Decedent 4. Probate Fees 423.50 5. Accountant's Fees 6. Tax Return Preparer's Fees i 7. Other Administrative Costs I, 6,556.15 See continuation schedule(s) attached. TOTAL (Also enter on line 9, Recapitulation) 15,539.39 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 ~chedule H (Rev. 10-06) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUM ER SHEARER, WILLIAM S 21-10-0 794 ITEM DESCRIPTION AMOUNT NUMBER 1 Funeral Expenses Funeral Flowers 381.55 2 Funeral Luncheon 451.79 3 Minister Services 200.00 4 Miscellaneous Funeral Expenses 26.40 H-A 1,059.74 5 Other Administrative Costs Barbara Kelly -Home Monitoring 2,100.00 6 Cumberland County Register of Wills Office -Filing Fee for Inheritance Tax and Inventory 30.00 7 Edgar Cortequera -Home improvements to Prepare residence for Sale 1,490.00 8 Ronal Gotwalt -Home Improvement Supplies to Prepare residence for Sale 469.12 9 Sale of Personal Property by Chuck Bricker, Auctioneer -Expenses by Auctioneer in 2,030.00 Conducting of Auction 10 The Cumberland Law Journal -Notice of Estate Administration T5.00 11 The Patriot News -Notice of Estate Administration 162.03 12 Tracee Gotwalt -Cleaning of residence prior to Sale 200.00 H-67 6,556.15 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1512 EX+ (12-08) COMMONNIEALTH OF PENNSYLVANIA - INHERITANCE TAX RETURN RESIDENT DECEDENT T _.~ .-_.T , . SCHEDULE DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUM ER SHEARER, WILLIAM S 21-10-0 794 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbureed medical exp uses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 D&D Septic Service 90.30 2 East Pennsboro Ambulance 48.00 3 Goodyear _ Automobile Inspection 43.62 4 Griswald Special Care ~ 85.60 5 Leffler Energy -Home oil/Close out Account 847.00 6 Messiah Village _ Skilled Care 605.00 7 Messiah Village Home Health -Emergency Monitor 37.15 8 New Cumberland Boro ~ Sewer and Trash 97.55 9 PA American Water 68 27 10 PPBL -Home Electric 212 54 11 Robert Haring -Trash Removal 185.00 12 Settlement Costs for Sale of Residence on October 28, 2010 -This amount includes final 11,359.85 sewer payment. A copy of the Settlement Sheet is Attached TOTAL (Also enter on Line 10, Recapitulation) 13,679.88 (If more space is needed, additional pages of the same size) Copyright (c) 2009 form software only The Lackner Group, Ina Form PA-1500 chedule I (Rev. 12-08) .. _, , _ r _ REV-1573 EX+ (17.08) SCHEDULE J COMM~v ~f~o~~E~y~,v~iA BENEFICIARIES ESTATE OF FILE NU BER SHEARER, WILLIAM S 21-10-00 94 RELATIONSHIP TO NAME AND ADDRESS OF SHARE OF ESTATE MOUNT OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (Words) ($$$) I TAXABLE DISTRIBUTIONS [include outright spousal • distnbutions, and transfers under Sec. 9116 a 1.2 Saundra L. Gotwalt Daughter Entire Estate 160 New Haven Street Mount Joy, PA 17552 I ~ Total Enter dollar amounts for distributions shown above on lines 15 throw h 18 on Rev 1500 cover sheet as NON-TAXABLE DISTRIBUTIONS: II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEE Copyright (c) 2009 form software only The Lackner Group,. Inc. Form PA-1500 chedule J (Rev. 11-08) ESTATE OF WILLIAM S. SHEARER SCHEDULE OF EXHIBITS 'i EXHIBITA Last Will and Testament for William S. Shearer signed a d dated Apri123, 2008 EXHIBIT B Settlement Sheet for Decedent's Residence located at 230 Haldeman Avenue, -New Cumberland, Cumberland Co ty, PA sold on October 28, 201 D EXHIBIT C Savings Bond Calculator for 4 U. S. Series E Savings Bond EXHIBIT D M&T Bank Checking Date of Death Letter ~ EXHIBIT E Postmark Federal Credit Union.. Regular_ Share Acco nt and Investor Choice Plus Account Date of Death Letter EXHIBIT F Sovereign Bank Certificate of Deposit Accounts Date o Death Letter EXHIBIT G Appraisal of Personal Property by Chuck Bricker distributed to Saundra Gotwalt EXHIBIT H Sale of Personal Property by Chuck Bricker, Auctioneer ;422187. EXHIBIT A Last Will and Testament OF WILLIAM S. SHEARER I, WILLIAM S. SHEARER, of the Borough of New Cumberland, Cumberh Commonwealth of Pennsylvania, being of sound and disposing mind, m~ understanding, do hereby make, publish and declare this as and for my Last Will and hereby revoking and making void any and all Wills or Codicils at any time heretofo me. ARTICLE I DEBTS I direct the payment of all my legal debts and the expenses of my last illness a from my Estate as soon after my death as conveniently maybe done. ARTICLE II TANGIBLE PERSONAL PROPERTY County, Irv and ;made by funeral I give and bequeath my motor vehicle(s), household and personal effects z tangible personalty of like. nature (not including cash or securities), together with any insurance thereon, unto my daughter, SAUNDRA L. GOTWALT, if she survives m daughter, SAUNDRA L. GOTWALT, predeceases me, I give and bequeath the same u of my grandchildren who survive me, to be divided among them by my Personal Repre with due regard for their personal preferences in as nearly equal shares as practical. id other existing If my to those ARTICLE III REST, RESIDUE AND REMAINDER I give, devise and bequeath all of the rest, residue and remainder of my estate, of whatever nature and wherever situate, unto my daughter, SAUNDRA L. GOTW~LT, if she survives me. If my daughter, SAUNDRA L. GOTWALT, predeceases me, I give, devise and bequeath the rest, residue and remainder in equal shares unto my grandchildren, p ovided that should any grandchild also predecease me, I give, devise and bequeath suc deceased grandchild's share unto his or her then-living issue, 'per stirpes. ARTICLE IV UNIFORM TRANSFERS TO MINORS ACT In the event any beneficiary of my Will has not reached the age of twenty-fiv~ (25} years at the time for distribution of his or her share, distribution of said share may be discretion of my Personal Representative after considering the age and needs of the either directly to the beneficiary or to a Custodian for such beneficiary until age twer under the Pennsylvania Uniform Transfers to Minors Act, 20 Pa.. C.S.A. §5301, et applicable Uniform Gifts to Minors Act or Uniform Transfers to Minors Act in residence of such beneficiary as the case may be. My Personal Representative may ~ such Custodian any institution or person, including my Personal Representative, qua as a Custodian for such beneficiary under such Act iri effect at the time such distribut A receipt for. any payment or distribution so made shall be a full discharge them Personal Representative, who shall not be responsible to see to, or be liable for, the of such proceeds thereafter. ie in the ieficiary, five (25) I., or the state of ignate as ed to act is made. ~e to my ARTICLE V ', POWER OF PERSONAL REPRESENTATIVE My Personal Representative shall have the following powers in addition to th se vested in them- by law and by other provisions of my Will applicable to all property, whether principal or income, including property held for minors, exercisable without court approval and e ective until actual distribution of all property: A. To make distribution in cash or in kind, or partly in cash and partly in ~C such manner as they may determine. B. To retain an or all of the assets of m estate, real or ersonal, without e Y Y p investments authorized for Pennsylvania fiduciaries,. as they deem pro ~ regard to any principle of diversification or risk. ~, C. To invest in all forms of property without restriction to investments au Pennsylvania fiduciaries, as they deem proper, without regard to any diversification or risk. D. To sell at public or private sale, to exchange, or to lease for any period real or personal property and to give options for sales, exchanges or leas prices and upon such terms or conditions as they deem proper. E. To allocate receipts and expenses to principal or income or partly to e~ from time to time think proper. , F. To compromise any claim or controversy. G. To make such elections, decisions, concessions and settlemenis in cone all income, estate, inheritance, gift, generation skipping or other tax re payment of such taxes as my Personal Representative andJor Trustee .appropriate, without obligation to adjust the distributive share of any per affected. d, and in riction to ,without _~ prized for nciple of time any ,for such as they on with and the tl deem thereby . ARTICLE VI TAXES I direct that all estate, inheritance, transfer and other taxes of similar nature payable by reason of my death, together with any interest or penalties thereon, and imposed wi respect to any property, whether or not disposed by this Will, shall be paid out of the residue of m~ Estate. ARTICLE VII PERSONAL REPRESENTATIVE I name, constitute and appoint my daughter, SAUNDRA L. GOTWALT, E ecutrix of this my Last Will and Testament.. Should my daughter, SAUNDRA L: GOTW T, fail to qualify or cease to so act, I name, constitute and appoint my granddaughter, T CEE S. GOTWALT, Alternate Executrix to complete the administration of 'my Estate. I dir ct that no fiduciary appointed herein shall be required to post bond far the faithful administra 'on of the duties required in any jurisdiction. 'i IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, and Testament, this 23~{ day of ~~~ 2008. Last Will ~~ ~~~~ ~ SEAL} WILLIAM S. SHEARER Signed, sealed, published and declared by the above-named Testator, as and ~or his Last Will and Testament, in the presence of us, who at his request, in his presence and in the presence of each other, have hereunto subscribed our names as witnesses. ', AFFIDAVIT AND ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA . ss. COUNTY OF CUMBERLAND We, WILLIAM S. SHEARER, ~ b IZ ~ ~ . ~> A,6 5 k-'~J ~I and ~~ ri1 ct n. (~ ~ . (~ ~ C rS ,the Testator and the ~ witnesses, respectively, whose names are signed to the attached or foregoing instrument, bein first duly sworn, do hereby declare to the undersigned authority that the Testator signed and e ecuted the instrument as his Last Will and that he had signed willingly and that he executed it as 's free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the pr sence and hearing of the Testator, signed the Will as witness and that to the best of his/her kno ledge the Testator was at that time eighteen years of age or older, of sound mind and under no c nstraint or undue influence. [ S. S~HIEA ~/ V~ Subscribed, sworn to and aclrnowledged before me by WILLIAM S. $ Testator, and subscribed and sworn to before me by J b h, -L ~-, V v ~ M~' S and Fri yy~ u, ~ G. ~, u ~ ~ S ,witnesses, this ~ day of 2008. Public COMMONWEALTH GE PEIvNSY~vhi~~~ NOTARIAL SEAL ~~ GAIL J. MAHDNEY, Notary Publlc Lemoyne, Boro., Cumberland County My Commission Expires Feb. 19, 2010 , COMMONWEALTH GF PENNSYLVANI NOTARIAL SEAL GAIL J. MAHONEY, Notary Public Lemoyne Boro., Cumberland County My Commission Expires Feb.19, 201 :326479v3 EXHIBIT B ~. s Ctt1eTTleIlt StateTriellt U.S. Department of Housing and Urban Development snow nr,.,r~~~t IJn ~ ,n~_r»RS FINAL QFHA 2. CFmHA 3. OConv. Unins, 6: File Number 7. Loan Number 8. Mortgage Insurance Case Number VA 5. Conv.lns. CL10170 am o 9rve you a • • m es men ~ mw • p • s. + are TiHeFx ass Settlement S stem '~. NOIe: Ileme marked "Ip.o.e.r were paid ouudda tM dp~q• >nN' ors etxrNn hero tar IrdormeNon purporn eM w not Indudsd N the loble. (x y WARNING: tt i~ • crkne to kmalnpy make fats arolimams to Mu UNled SIGNS on lMS a nr/ oMar elmllaf lomr. Panoltb• upon Printed 1012712D10 at 11:01 JG convlc9on nn irwWtle • kne and kn fiwnrrleM. Fa tlerob eN: Tide 18 U. s. Code bsWon f 001 arW Sedbn r01n. ~~NAME OF BORROWER: Amy E. Holjes and Michael J. Holjes ADDRESS: NP,ME OF SELLER: Estate of William Shearerby his Executor Saundra L. Gotwalt - ADDRESS: . NAME OF LENDER: ADDRESS: ~. PROPERTY ADDRESS: 230 Haldeman Avenue, New Cumberland, PA 17070 New Cumberland Borou h . SETTLEMENT AGENT: Cornerstone Land Transfer, inc., Telephone: 717-730.9664 Fax: 717.730.9665 PLACE OF SETTLEMENT: 4705 E. Trindle Road McGhanlcsbur PA 17050 SETTLEMENT DATE: 1 012 8120 1 0 J. SUMMARY OF BORROWER'S RANSACTION: 00. GROSS AMOUNT DUE FROM BORROWER K. SUMMARYx?F SELLER'S T NSACTION: 400. GROSS AMOUNT DUE TO SELLER )1. Contrail sales 185000.00 401. Contrail sales rice 185 000.00 )2. Personal P 402. Personal Pro A )3. Settlement kre~1. ~~:~! 3200.75 40 . )4. ~';~ i •;: ~ . } ~;z e~ ., ~,: 404. ]5. ' 405. fitments for Hems aid b~ salter i yY ~~ n advance Ad ustmentc for items b b saler f n advance l6. Ci fta+m tax' . ij 17. n tax 10128/10to12l3tN0 lg, Sdrool taz ~1. ,. 11 19. TRASH ~ ..110 fig, ' "' trs ~'~!:~ ~. 3 7 `ftcaNn taxes - r -ns,. ea ,•'<<'~. Afti2 ~ a3cea ~?!'t`~ 0128h 0 to 06!'~ . ' 409. Tt~ ~' .MID 1012811010121311 ,...~ 161.57 996.23 6.87` 0 { ? a~1. - 410. '6 Y v l' ti }. ,_;'~; < 1. y:tf~ . `r` + 411. ~'`,4 ~ T> ~~: ~ •t+'* ~~ ~~~ ~_.~ 4 ~ ~ {~.~ rvi' F3' 412. y fi=r r*~, . ~ }: ?0. GROSS DUE FROM BORROWER l0. AMOUNTS Y OR ON BEHALF OF BOR 189 85j42 R(9 . Y~R i;"` b 420. GR ~.MOUN3~UE 70 SELLER ~, ,~Y,r ~ 186164.67 500. RED .....; ON5 Il~`A ~ . TRD.U . 11. Or 8 "` xtKZ ~ •. 0 501. 6c Slt See ft .. ~~> `'~r •`~~ s2. Princi amount of new bans 502. SeiUemerd ch es Yo seller line 1400 __ 11 342.55 13. Exi ' bans taken sub'ed to 503. Exis loans taken sti ed to µ, 504. Pa oft of First Mori a e Loan ~. 505. 8. ~• ,7 507. - 6. 508. 9. ~• Ad ustmer>ts for items un aid b seller Ad'ustmants for items un aid seller 0. 'flown taxes 510. Ci flown taxes 1. Coun axes 511. Coun taxes 2. School taxes ' .~ 512. School taxes 3. Sewer OMft) 101011101010128110 17.30 513. Sewer Oft4ID 10!01110 to 10128110 17.30 q. 514. 5. 515. 8. 516. 7. 517. 8 518, 9. 519. 0. TOTAL PAID BYIFOR BORROWER S 017.30 520. TOTAL REDUCTION AMOUNT DUE SELLER i 1 359.85 0. CASH AT SETTLEMENT FROM OR TO BORR OWER 600. CASH AT SETTLEMENT TO OR FROM SELLER f. Gross amourd due from borrower fine 120 189 365.42 601. Gross amount due to salter line 420 186164.67 2, Lass amoun aid /for borrovret ins 220 5 017.30 1102. Lass redudfon amount due seller Ifne 520 11 359.65 3. CASH FROM BORROWER _ _ - 184 348.12 603. CASH TO SELLER 174 604.82 BSTITU7E FORM 1091 SELLER STATEMENT: 1'he YYOnmtlan can4lned heroin U-NnpoAent lax Monna9on and b Mlrq Nmkhed m S're hlemN Rsvamw SaMoe. x you m roqulred b 9N ^ roNm, •OgOarw panepy or aMt are9on w~ Ea knpuead on you B Ws Nam I+ nquked to ba nPwled uW IM IR6 delemdnee Nat p hu nor bean sported. The ContrKt 6aNe Pow dawlEad on a_Oi above opuNYdee M Glop Progede of aeW~~eemM4arraWon. nbM, bat subJe4 to~dvl or u4rlksl penMOeitknposed by ~. Undo M 1n~:Ne dyorr correct ~peye~ IdsdlNntlm number. H you do not Provka your cored taxPper wsnlNWUcn per(Wy,1 ouWy tlla{ 1M number atwrm an Nis elabmsM h mY sorted pxpeyer MenliMatlon number. __ / --_- SELLER(S) SIGNATURE(S): / 1.ER(S) NtIN MAILING ADDRESS: ... lER(S) PHONE NUMBERS: MI ~ _ _ _ , ..~ r,_ ,.~., . -_--- _ _ 5t !! LtMtN I STATEMENT TitleEx ress Settlement S stem Printed 10!27!2010 at 11:01 JG L. SETTLEMENT CHARGES PAID FROM PAID FROM ro0. TOTAL S.4LcSJBROKER'S COMMISSION based on rlce $185 000.00 5.000 = 9 250.00 BORROWER'S SELLER'S Division ofcommission line 700 as tolbws: FUNDS AT FUNDS AT ..,. e D ern nn l..i InHn SmfYh Roalty SETTLEMENT SETTLEMENT '03. Commission aid at Settlement ' -" lTll I AAAI YV • 1 I ~.~llv I n ~ r~...rr ... v v.... r....... ....... ~... D1. Loan Ori ination Fee °~ .02: Loan Discount A3, sisal Fee 'q4. Cred'A Re rl A5. Lender's In lion fee D6. Mort A licaGon Fee 'A7. Assu lion Fee A8. A9. 10. _ tt HUD CERT1FiCAT10N OF BUYER ANO SELLER ~ a IsNwwe tlr NU - S~ wn~N SIM~ma11 end b Ow WAl w my wawhep~ rd MBd, M V ~ kw .ntl ACQYAI~ sl~l~mw+1 d ~A rwlpt~ F tl aseun.n IMA tl~ °n my ACOUlN y OY~ aau~ Yo, r Yy 1 hws noAivW ~ copy d tlis HUD-1 S~IINm~nl6blsmaM. .~ iNING: R 0: A CRpAE TO KNOW WOLV MAKE FAI-SE 6TATEMENTS TO THE TM HUD-1 S~N~m~M Sl~l~m~rt whkh 1 Mw Intl b ~ bw An0 ~ear~b ~ccounl of tlIb fED STATE6 ON THai OR ANY BMILAR FORM, PENALTES UPON CONVICTION Im~Mlm. 1 Mw aw~tl w MO °aln~ tla hAM~ b df~Mrad N icomdMluvAl110Y+ slabrtNM. 1 INCLUDE A FlNE AND IMPR160NMENT. FOR DETAILS SEE TITLE iB: CODE SECTION 7001 AND 6ECTpN 1010. ,,~//) 6ETTLEMENT AGENT: • '~ i6%~~a - ,~ .; 5 EXHIBIT C Calculated Value of Your Paper Savings Bond(s) Calculated Value of. Your Paper Savings Bond(s) Calculator Results for Redemption Date 07/2010 30.00 Bonds: 1-4 of 4 180..61 150.61 X18708516E E $10 05/1945 05/1985: $7.50 " $37.12 X6973121E E $10.08/1945' 08/1985 $7.50 .$37.83 X6963591E E $10 07/1945 07/1985 $7.50 $37.83 X4991295E ~ E $10 06J19 ~ . .~ 37.83 4 Bonds Totals for 30.00 50.61 .- NI Not Issued _. NE _htQt eligible for.pay~ent _ ... _.~ P5 Includes 3 month interest penalty MA Matured and not earnin interest Page 1 of 1 $44.62 MA $45.33 MA $45.33 MA $45.33 _ MA 180.61 http://www.treasurydirect.gov/BClSBCPrice 8/24/2010 _ _ EXHIBIT D _....,- 1VI8TBank 499 Mitchell Road, Millsboro, DE 19966 Adjustment Services Law Offices Johnson Duffie 301 Market Street P O Box 109 Lemoyne, PA 17043-0109 Re: Estate of William S Shearer Social Security: 207-03-7448 Date of Death: July 11, 2010 Phone 888-~02-4349 F ax (302)34-2955 September 2010 Dear Sir or Madam: Per your inquiry on August 24, 2010, please be advised that at the time of death, the above on deposit with this bank the following: l . Type of Account Checking Account Account Number 77426959 Ownership (Names o, fl William S Shearer Opening Date 0828/64 Balance on Date of Death $42,014.91 Accrued Interest $ .27 Total $42,015.18 ;d decedent had For further acrnunt information, dosures and/or reimbursement of funds please call the West Shore Plaza Office at 4{'7 We were unable to locate any safe deposit box for the above-mentioned decedent. This letter does not indade any accounts in which the deceased may have been listed as Power. oe Attorney, Ctiustodian ~ Repr~talive Payee, or TrusDee under a Written Agreement Sincerely, C~Yt Tammy R Spencer Adjustment Services 1730. 1~an.~ers, REC~EIVEC SEP 0 '7 2~~0 EXHIBIT E ~~_r _- .POSTMARK C R E D I T U N I O N August 25, 2010 Law Offices of Johnson, Duffie Attn: Dana L Wieseman PO Box 109 Lemoyne, Pa 17043-0109 Re: Estate of William S. Shearer SS 207-03-7448 for first class financial services Dear Ms. Wieseman: William Shearer has an account with Postmark Credit Union since 03/11/1954. The accoun is an individual account. The account balances including accrued interest as of the date of deaths as follows: Account 804 Account Account Type Balance Open Date 804-00 Savings $405.34 03/11/1954 593-13 Investor's Choice Plus $107,914.61 01/06/2006 Mr. Shearer did not maintain any life insurance or stocks with PostMark CU Statements for his account are only produced quarterly. I've included the last quarterly history printout of both accounts for July until August 25; 2010. The next quarterly sta produced until the beginning of October. If you should need further information, please call me at 717-671-5119, ext.615. Sincerely, y ~_~~ Miche e L.Treece Member Service Administrator AUS_z ~ ?~10 Went and the ~t will not be 2630 ~inglestou~n Roac1 • Harrisburg, PR 1 71 1 0-3666 717.671.5119 EXHIBIT F L T .~ ,_ Sovereign Bank ESTATE OF William Shearer SOCIAL SECURITY #: 207-03-7448 DATE OF DEATH: July 11, 2010 ~~ Account #: 0775146871 Type CD Open date: 9/23/1999 In the name of: William Shearer Date of Death Balance: $14,330.92 Int.(YTD) from 1 /1 /2010 to 6/30/2010 $10 .21 Accrued interest to date of death: $3.48 Other Info: Account #: 0775147465 Type: CD Open date 6/3/1985 In the name of: William Shearer Date of Death Balance: $2,751.48 Int.(YTD) from 1/1/2010 to 6/30/2010 $43 71 Accrued interest to date of death: $1.78 - Other Infer Account #: 0775147473 Type: CD Open date: 6/11/1985 In the name of: William Shearer Date of Death Balance $2,564.54 Int.(YTD) from 1/1/2010 to 6/30/2010 $37 52 Accrued interest to date of death: $1.66 Other Info: Account #: 0775147671 Type:- CD Open date: 10/2/1981 In the name of: William Shearer Date of Death Balance: $12,157.33 Int.(YTD) from 1/1/2010 to 6/30/2010 $10 .45 Accrued interest to date of death: $6.96 Other Info Account #: 0775147788 Type: CD Open date: 6/23/1983 In the name oft William Shearer Date of Death Balance: $3,305.98 Int.(YTD) from 1/1/2010 to 6/30/2010 $50. 7 Accrued interest to date of death: $3.36 Other Info: I Page 1 of 2 Sovereign Bank ESTATE OF William Shearer SOCIAL SECURITY #: 207-03-7448 DATE OF DEATH: July 11, 2010 ~ i Account #: 0775150618 Type: CD ~ Open date: 7/9/1990 In the name of: William Shearer Date of Death Balance: $2,205.91 Int.(YTD) from 1/1/2010 to 7/9/2010 $35 20 Accrued interest to date of death: $0.29 Otherlnfo: Account #: 0775150857 Type: CD Open date: 8/23/1993 In the name of: William Shearer Date of Death Balance: $50,070.37 - - Int.(YTD) from 1/1/2010 to 2/23/2010 - : - - -$.714 .19- - ~ , • - Accrued interest to date of death: . $546.37 Other Info: Account #: 0775275324 Type: CD Open date: 9/6/2000 In the name of: William Shearer Date of Death Balance: $13,725.11 Int.(YTD) from 1/1/2010 to 6/30/2010 $70. 0 Accrued interest to date of death: $4.69 - Other Info: Account #: 0775290810 Type: CD Open date: 8/9/2001 In the name of: William Shearer Date of Death Balance: $12,937.82 Int.(YTD) from 1/1/2010 to 6/30/2010 $66. 5 Accrued interest to date of death: $4.42 Other Info: Page 2 of 2 EXHIBIT G r APPRAISAL Personal Property of GU`M~ 5 ~ .~~ K ~„~. ~. ~ (L .~:,~0 ~{~~-~-G~ ~~~ti .~U~: , ;~ r ~ ~ ~~}~ Appraised by Chuck E. Bricker AU094-L Date ', -•_ ~~° ~ ~ ~ ~~-~ ITEM VALUE ~ ITEM VALUE Do V r t-t~ oo C ~ o~l~~ 57i op 1" ~ ~ S~ c: d, p C ~ .:~- PLOW hC C 1 ~ 2 S J ~ ~'~ ,~.b, tiv N /D~ ~~ S ~~ C61~~ti ck212 ~~ ~BG. Gc~ ~~ ~~¢ ~. ~ t~ ~4 ~- ' ~ C vc~ ~,.~ -~.- ' I -. __ .. - ~-.~~, EXHIBIT t •• ' ,r ~~~ .- ~ ~ ~ ~ ~~ - ~ Chuc~C Bricker, Auctioneer. . _ ~ .Bevy & sell on Commission -Complete Sale Service .. .. ~ ~.. 93 Texaco Rd., .Mechanicsburg, PA 1 TQ55 7f ~5T85 - ',, Psrsansi y ~ Gv ~l , SGf ~/f-~~/~ ' ' .r. Addrsr~s . ~ ~saa wt t~ilte srs . ~ c ~ ~ ~ L~ ~ I ~ . . . . ~, - .. ~utsiawdfa~ '~b~tai his ~ - .~ s~ 2-S ' 'ttbtN t~Oics . T~a#ai Crts~ .3 ~ 9s, azs' ~ E ,~ wee cost r ~ ~~, ~ Bats Sstup oir ~tP ~ ~ a d . . .