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HomeMy WebLinkAbout11-29-101505610101 REV-1500 Ex ~O1_1°' ' PA Department of Revenue Pennsylvania OFFICIAL USE ONLY Bureau of Individual Taxes oEPARTMENTOFRE~EN~E County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN Harrisburg, PA 1'7128-o6oi RESIDENT DECEDENT ~+ ~ ~ 9 ~ ~ ~ S ENTER DECEDENT fNFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 1 ~ o j (0 00 6 ~0 09D(o oZ,o o `~ Dye ~2 1 `~ 2.Z Decedent's Last Name Suffix Decedent's First Name MI (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI ~ l /4' Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW III 1. Original Return O 2. Supplemental Return O 3. Remainder Return (date of death prior to 12-13-82) (~ 4. Limited Estate p 4a. Future Interest Compromise (date of O 5. Federal Estal:e Tax Return Required death after 12-12-82) I~ 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust Z 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O 11. Election to ta:>< under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number C~.~~.L~S ~ ~ y / EL,~S i ~ / 7 / '7 7~ ~ o-z.~ 9 REGISTER OF' WILLS USE ONLY First line of address Second line of address '~"' ~~ ~ ~~~ ~ ~~~ ~ -~ City or Post Office State ZIP Code `~_--~ m~C~~~~~58u~G Pry ~7DSS•g73~`~-' "' '~, ~~~ ~- ,,~ ~' `~_ ~~`> c~ ~ - Correspondent's a-mail address: Ge S-1 , ~Id S,3 ~ wrnr'" QSf'• ~f/~ `~-' ~i a .~- ~''' ~ -='7 ~";? Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the be~f my knowlednd behfef, -~ ; ; it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any kn@w~edge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE .~~i~r~i ~r~ r rccr cry v i rygr~ i nr~i~ cJCi c C~~,, UHI t . _._.._. `~_ __ ~~ z ~ / D ADDRESS ~~1~ ~' S~-I~~"Z~C .•, ~ _ C/Q~tsCr-~~ _, PLEASE USE ORIGINAL FORM ONLY Side 1 1505610101 1505610101 J J 1,50561,01,05 REV-1500 EX Decedent's Social Security Number Decedent's Name: ~C rG ~ ~ nc K. ~1 /Q s 5 P/ ~ / d ~ b a ~ ~° 6 RECAPITULATION 1. Real Estate (Schedule A) ........................................ ..... 1. ~ 9~ 4 p 0. ~ Q 2. Stocks and -Bonds (Schedule B) .................................. ..... 2. ~ ~ D S Q • ~] ,Z, 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. ._ Q Q 4. Mortgages and Notes Receivable (Schedule D) ...................... ..... 4. • Q D 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E).. ..... 5. ~ 3 ~ ~ ~ ~ s D 7 6. Jointly Owned Property (Schedule F) p Separate Billing Requested .. ..... 6. ~ 9 s' 7. Inter-Vivos Transfers ~ Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested... ..... 7. ~ ~ ~ Z ~' ~ . ~ 1 8. Total Gross Assets (total Lines 1 through 7) ........................ ..... 8. ~ ~ a, ~ a d 3 S Z 9. Funeral Expenses and Administrative Costs (Schedule H) .............. ..... 9. ~ ~ s" S s' O s' 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ......... ..... 10. 3 ~ 3 D • D ~ 11. Total Deductions (total Lines 9 and 10) ............................ ..... 11. 7 O ' ~ 5~' , a 7 12. Net Value of Estate (Line 8 minus Line 11) ......................... ..... 12. ~ ~ ' s fd Q ~ ~ , [{ s 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ................... ..... 13. . 0 D 14. Net Value Subject to Tax (Line 12 minus Line 13) ................... ..... 14. ~ ) s ~ Q / ~ ~ ~ ,~ 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 .00 , t~ d 16. Amount of Line 14 taxable at lineal rate X .0 ~ O O 17. Amount of Line 14 taxable at sibling rate X .12 ~ s ~ / ~ / '. /~ 2 18. Amount of Line 14 taxable at collateral rate X .15 ~ E? ~ ~ 7 7 • 3 1D 15. 16. 17. ~ (} 18. 19. TAX DUE ......................................................... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT .Q~ .Q Q ~ ~~q3 13S~S 1 -Co ~ ~ S~~ 8.s3 O Side 2 1,50561,01,05 1,505610]0.5 DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 2 8-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 012913 RUNDLE ELLEN B 62 S PIN OAK DRIVE BOILING SPRINGS, PA 17007 -------- fold ESTATE INFORMATION: SSN: 190-16-0066 FILE NUMBER: 2109-0859 DECEDENT NAME: MASSEY GERALDINE K DATE OF PAYMENT: 06/ 15/2010 POSTMARK DATE: 06/ 15/2010 COUNTY: CUMBERLAND DATE OF DEATH: 09/06/2009 REMARKS: CHECK#136 SEAL ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ ;> 70, 000.00 TOTAL AMOUNT PAID: INITIALS: CJ HtV-I IbZ tX(11-Jbl }~ 70, 000.00 RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS TAXPAYER CUMMU tHi_i n ur rtlvnlaYLVi~n~i,4 ARTMENT OF REVENUE BUREAU O'»= INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 DECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT 1'~CV- I I DL CA1, 1 1-7p1 ;~ :. ~ '- ,~~~;~~~ NO. CD 012041 SHIELDS CHARLES EDWARD III ESQ SIX CLOUSER ROAD MECHANICSBURG, PA 17055 ACN ASSESSMENT AMOUNT CONTROL NUMBER fold ESTATE INFORMATION: ssrv: ~ 90-~ s-oohs FILE NUMBER: 2109-0859 DECEDENT NAME: MASSEY GERALDINE K DATE OF PAYMENT: 1 1 /30/2009 POSTMARK DATE: 1 1 /30/2009 COUNTY: CUMBERLAND DATE OF DEATH: 09/06/2009 REMARKS: 101 ~ $19, 000.00 TOTAL AMOUNT PAID: $19,000.00 CHECK#107 INITIALS: SAP SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS TAXPAYER 0'0t~ 1 -- ~,i4-X C~~kL,~ %l0/~ ~o~ E.S T. ate' ~s. ~, .mil ~s ~'y 2 ! -d ~ - ~S~ __ :._%~_. _ '.r~~~ .__a~. __ ~SfQ 1e ~'ayls~SZ~`' o~_ ~v~t,rTs..'._ T~,osG_ i~tBas__ •. _ _:_:~-~/._~re~~y~_14_/~7~~._~ ._a~~u~~i,es oh S~~e~cr,~~:__~~ux~..y~'os~ . ,. __ r:__cr%~SfT~u.,~io~s _/~.??Q! __~o~_~~_ /t'sic~ic~ ©~' ~ est _..,.~r_s . s~o~ ..Bar._.... ,. 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Prior Payments /9 _~o• °° f 7D~ 0o0•_°O B. Discount / mOD.so 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. Total Credits (A+ B) (2) 9'Of ODD. 00 (3) ~, y6 7 v7 (4) 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 : ............................................ ^ X 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 requiremeints 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 1:he 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+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER ~/~ SSEy ~FDQ.I~-L DlJ1/ ~ K_ o /- D ~ - ~S`j 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 e• ,. ~/! oaf cam:.->, ~ndvn~~n: un~ u n ~ f r~ f~C ~ens.%a~fd~ S~.CCatrc "' CO/-donrinitc~ •~ssh, qtr I~ ~/i!/¢Qe o~' `vt~vGr ~4in pgl'~'1 ~ ~, Cum bpi-~articft"o ac,~, f cnrra, co hrr-,.anlY cct.llcAt t 3 ~t..ns~ nq ~ ~S'8 u. a~-^~. old a s ,p~.~ A,~.ru4r~.rct' J ~ S cof}- L. S tv ~nGY dred -D % a hG M - Srv e-c.rtG~, h us ~ am d ctrt cl Cc) ~~, ©~ Na v, S', .Z o!o ~r a ~°an s i c%.t-- a~' o ~ off' ~' / 9 ~ 9'0O . o ~ ~ 7~ ue ~.tca/ C'orrect` ~~y of f~ rx's deed and fie s~theryi~~' 5~iee~ a f~'cc~tecl hc~?e . TOTAL (Also enter on line 1, Recapitulation) I $ ~ ~~ 9q p ' °t~ i (If more space is needed, insert additional sheets of the same size) yo ~~ C~9 ~flAtl~ ~ tW e,~~ ut.Ie~d`' R T..nn n1 1 non A. Settlement Statement (HUD-1) 1.O FHA 2. Q RHS 3. QX Conv. Unins. 4. ~ VA 5.Q Conv. Ins. 6. Flle Number. 10-540 7. Loan Number: 10-08508 8. Mortgage Insurance Case Number: C. Note: This form is famished to gitre you astatement o/actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked (p.o.c.)' were paid outside the closing; they are shown here /for informational purposes and are not inGudad in the totals. D. Name and Address of Borrower. Scott L. Sweeney and Diane M. Sweeney 13 Kensington Square Mechanicsburg, PA 17050 E. Name and Address of Seller. Ellen B. Rundle, Executrix for the Estate of Geraldine Massey F. Name and Address of Lender. Sirva Mortgage, Inc. 6200 Oak Tree Blvd, Suite 300 Independence, OH 44131 G. Property location: 13 Kensington Square Mechanicsburg, PA 17050 Cumberland County, Pennsylvania H. Settlement Agent: 25-1857112 Midstate Abstract Company 2331 Market Street Camp Hill, PA 17011 Ptl. (717)763-1383 I. Settlement Date: November 5, 2010 Place of Settlement: 2331 Market Street Cam Hill, PA 17011 J. Summary of eorrowera transaction K. Summary of Sellers transaction 100. Gross Amount Due from Borrower: 400. Gross Amount Due to Seller. 101. Contract sales rice 194 900.00 401. Contract safes rice 194,900.1 102. Personal ro 402. Personal r e 103. Setlement Cha es to Borrower Line 1400 7354.92 403. 104. 404. 105. 405. Ad ustments for items id b Seller in advance Ad ustments for items ald b Seller In advance 106. C !Town Taxes to 406. Ci /Town Taxes to 107. Coun Taxes 11/05!10 to 01/01/11 97.93 407. Coun Taxes 11/05/10 to 01/01/11 97 108. Assessments 11/05/10 to 07/01/11 1 480.53 408. Assessments 11/05/10 to 07/01!11 1 480.: 109. Sewer Fee - 4th Qtr 11/05!10 to 01/01/11 65.52 409. Sewer Fee - 4th Qtr 11/05/10 to 01/01111 65.: 110. Nov. Condo Association Fee 11/05/10 to 12/01/10 201.11 410. Nov. Condo Association Fee 11/05/10 to 12ro1/10 201. 111. 411. 112. 412. 120. Gross Amount Due from Borrower 204,100.01 420. Gross Amount Due to Seller 196,745. 200. Amounts Paid or In Behalf of Borrower 500. Reductions In Amount Due Seller. 201. De sit or earnest more 5000.00 501. Excess de osit see instructions 202. Print al amount of new loans 155 900.00 502. Settlement cha es to Seller line 1400 12,918.1 203. Existi loan s taken su 'ect to 503. Existin bans taken sub'ed to 204. 504. Payoff First Mortgage 205. Direct Bill -T co Electronics 4,825.75 505. Pa off Second Mort a e 206. ~• 207. 507. De sit disb. as roceeds) 208. 508. 209. 509. Ad ustments for items un aid b Seller Ad ustments for items un aid b Seller 210_ C' /Town Taxes to 510. C' /Town Taxes to 211. Coun Taxes to 511. Coun Taxes to 212_ Assessments to 512. Assessments to 213. 513. 214. 514. 215. 515. 216. 516. 217. 517. 218. 518. Escrow for Inheritance Taxes to Midstate Abstract 5,000_i 219. 519. 220. Total Paid b/for Borrower 165,725.75 520. Total Reduction Amount Due Seller 17,918.E 300. Cash at Settlement from/to Borrower 600. Cash at settlement to/from Seller 301. Gross amount due from Borrower line 120 204 100.01 601. Gross amount due to Seller line 420 196 745. 302. Less amount paid by/for Borrower (line 220) ( 165,725.75 602. Less reductions due Seller (line 520) ( 17,918. 303. Cash X~ From ~ To Borrower 38,374.26 603. Cash a To C~ From Seller 178,827. The undersigned hereby acknowledge receipt of a completed copy of this statement & any attachments referred to herein Borrower Seller Estate of Geraldine K. Massey tt . Sweene ~-- ~ /~ ~ /; _ BY: ~~1/Yl'~iP ~ !!'~fo ~ /' Ellen B. Rundle, Executrix is M. Sweeney The Public Reporting Burdon for 1NS mrection of kirorrnation is estimated ~ 35 mknrtes per response tar totiecting, revlewkg, and reporting the data. Thb agency may not mllect fhb information. snd you era not regWred complete this form, urNess it displays a axrently vend OMB control rxmber. IJO oonfldantiaAty b assured: fhb disdostre b mandatory. This b designed to provide the parties to a RESPA covered transaction wish inlormatb during the settlernerN process. Page 1 of 3 HUD-1 (S W EENEY. SCOTT.DIANE. PFDi10-540/15 l { Cn4+lmm~n* f_h~rnaa 700. Total Real Estate Broker Fees $ 9,995.00 Pak From Paid From Division of commission (line 700) as fellows: eoria""'r' ' 701. 5 122.50 to RE/MAX 1st Advanta a Funds et Funds at 702. 4 872.50 to PRUDENTIAL THOMPSON WOOD sa"g"a`" satdamant 703. Commission aid at settlement 9 995•C 704. Referral Fee to Sirva Mort a e $1851.55 705. 800. Items Pa able in Connection with Loan 801.Our o ' ination cha a indudes Ori ination Point % or $775.00 $ 775.00 from GFE #1 802. Your credit or charge (points) for the specific interest rate chosen $ (from GFE #2) 803. Your ad'usted origination charges from GFE #A 775.00 804. raisal fee to Dwellworks from GFE #3 325.00 805. Credit Re N to CBC from GFE #3 18.00 806. Tax service to Sirva Mortgage (from GFE #3) 85.00 807. Flood cert~cation to FDSI (from GFE #3) 13.00 808 (from GFE #3) gOg. (from GFE #3) 810. (from GFE #3) 811. from GFE #3 900. Items Re uired Lender to Be Paid In Advance 901. Daily interest charges from 11/05/10 to 12/01/10 26 @ $18.150000/day (from GFE #10) 471.90 902. Mort a e insurance remium for months to from GFE #3 903. Homeowners insurance for 1.0 ears to State Farm Ins. from GFE #11 POC:6524.00 904. from GFE #11 905. (from GFE #11) 1000. Reserves De ited with Lender _, 1001. Initial deposit for your escrow account (from GFE #9) 1,157.77 omeovme s msurance mon s per mon 1003. Mort a e insurance months $ r month $ 1004. Property taxes $ County Taxes months @ $ per month Assessments months $ r month 1005. $ 1006. Countyll"wp Taxes 3.000 months @ $ 5122 per month $ 153.66 1007. School Taxes 5.000 months @ $ 185.43 per month $ 927.15 1008. $ 1009. Aggregate Adjustment $ -10.38 1100. Tftle Cha s 1101. Title services and lenders title insurance (from GFE #4) 1,498.75 _ 5.t 1102. Settlement or closin fee $ 1103. Owners title insurance to Midstate Abstrad Company Insurance Acct. from GFE #5 195.00 1104. Lenders title insurance to Midstate Abstrad Company Insurance Acct. $ 1,138.75 1105. Lenders title I' limft $ 155,900.00 1106. Owners title of limit $ 194,900.00 1107. A ent's ortion of the total title insurance remium to Midstate Abstrad Com an $ 1 173.70 1108. Underwriters rtion of the total title insurance remium to Midstate Abstrad Com an Insurance Ac $ 160.05 1109. 1110. 1111. 1112. 1113. 1200. Government Recording and Transfer Charges 1201. Government recordin cha es to Recorder of Deeds Office from GFE #7 162.00 1202. Deed $ 62.00 Mortgage $ 100.00 Releases $ Other $ 1203. Transfer taxes to Recorder of Deeds Office (from GFE #8) 1,949.00 1204. City/County tax/stamps $ 1;949.00 $ 1205. State tax/stam s $ $ 1,949. 1206. 1207. 1300. Additional SeWement Cha es 1301. R uired services that u can sho for from GFE #6 _ 1302. Tax Certification to Michael Lan an Tax Colledor 5. 1303. 1304. 1305. See addft'I disb. exhibit to 704.50 964. 1400. Total Settlement Cha es enter on Tines 103, Section J and 502, Section K 7 354.92 12 918. tlY ~n9 Page ~ a owe staremerw, ate signemnes ecwiwwieage receipt oT a compste° Dopy or page r m trww tvw page atatarnent / ~~~r (//~'\ /L//L/i///' Midstate Abstrad Company, Settlement Agent Certified to be a true copy. Page 2 of 3 HUD-1 (S'WEENEY.SCOTT.DIANE. PFD/10.540/15) Comparison of Good Faith Estimate (GFE) and HUD-1 Charges Good Faith Estimate liuu-i Charges That Cannot Increase HUD-1 Line Number _ Our origination charge # 801 _ 775.00 775.00 Your credit or charge (points) for the specific interest rate chosen # 802 Your adjusted origination charges # 803 775.00 775.00 Transfer taxes #1203 1,950.00 1,949.00 Char es That in Total Cannot Increase More than 10% Good Faith Estimate HUD-1 Government recording charges #1201 202.00 162.00 Appraisal fee # 804 325.00 325.00 Credit report # 805 20.00 ,18.00 Tax service # 806 85.00 85.00 Flood cert~cation # 807 13.00 13.00 # 810 200.00 Title services and lender's title insurance #1101 1,642.00 1,498.75 Owner's title insurance to Midstate Abstract Company Insurance ~ #1103 210.00 195.00 Total 2,697..00 2,296.75 Increase between GFE and HUD-1 Charges $ -400..25 or -14.84 Charges That Can Change Good Faith Estimate HUD-1 Initial deposit for your escrow account #1001 2,957.00 1,157.77 Daily interest charges # 901 $ 18.150000/day 471.90 471.90 Homeowner's insurance # 903 720.00 524.00 1 non Torma Your initial loan amount is $ 155,900.00 Your loan teen is 30 years Your initial interest rate is 4.2500 Your initial monthly amount owed for principal, Interest and $ 766.93 includes any mortgage insurance is 0 Principal 0 Interest ^ Mortgage Insurance Can your interest rate rise? ^X No ^ Yes, it can rise to a maximum of %. The first change will be on and can change again every _ months after . Every change date, your interest rate can increase or decrease by %. Over the life of tlhe loan, your interest rate is guaranteed to never be tower than % or higher than %. Even if you make payments on time, can your loan balance rise? ^X No ^ Yes, it can rise to a maximum of $ Even if you make payments on time, can your mouthy ^X No ^ Yes, the first increase can be on and the monthly amount owed for principal, interest, and mortgage Insurance rise? amount owed can rise to $ _ The maximum R can ever rise to is $ Does your loan have a prepayment penalty? ^X No ^ Yes, your maximunn prepayment penalty is $ Does your loan have a balloon payment? ^X No ^ Yes, you have a balloon payment of $ _ due in _ years on Total monthly amount owed including escrow account payments ^ You do not have a monthly a:scrow payment for items, such as property taxes and homeowners insurance. You must pay these items directly yourself. ^X You have an additional montttily escrow payment of $280.32 that results in a total initial monthly amount owed of $1,047.25. This includes principal, interest, any mortgage insurance and any items checked below. X^ Property taxes ^X Homeowner's insurance ^ Flood insurance ^ D O Note: if you have any questions about the Settlement Charges and Loan Terms listed on this form, please contact ycwr lender. Page 3 of 3 HUD-1 (SW EENEY. SCOTT. DIANE. PFD/10-540/15) HUD-1 Addendum Borrower(s): Scott L. Sweeney and Diane M. Sweeney Seller(s): Ellen B. Rundle, Executrix for the Estate of Geraldine Massey 13 Kensington Square Mechanicsburg, PA 17050 Lender: Sirva Mortgage, Inc. Settlement Agent: Midstate Abstract Company (717)763-1383 Place of Settlement: 2331 Market Street Camp Hill, PA 17011 Settlement Date: November 5, 2010 Property Location: 13 Kensington Square Mechanicsburg, PA 17050 Cumberland County, Pennsylvania Additional Adjustments For Items Paid By Seller In Advance (Borrower Debit) Description Amount From/Through Prorated Amount Sewer Fee - 4th Qtr 105.75 10/01!10 through 12/31/10 65.52 Total Line 109/409 65.52 Nov. Condo Association Fee 232.05 11/01/10 through 11/30/10 201.11 Total Ltne 110/410 201.11 Additional Disbursements Payee/Description Note/Ref No. Borrower Seller American Radon solutions 375.00 375.00 Radon Remediation American Home Shield 589.00 Home Warranty Kensington Square Condo Association 300.00 Initial Fee Hampton Township Authority 29.50 Trash -Nov. and Dec. Total Additional Disbursements shown on Line 1305 9Ei 704.50 $ 964.00 Additional Disbursements from Broker's Commissions Listing Selling Other Payee/Description Note/Ref No Broker Broker Broker Total RE/MAX 1st Advantage $ 5,122.50 PRUDENTIAL THOMPSON WOOD $ 4,872.50 The following persons, firms or corporations received a portion of the real estate commission amount shown above: Sirva Mortgage Total 1,851.55 0.00 $1,851.55 1,851.55 0.00 $1,851.55 WARNING: It is a crime to knowingly make false statements to the United States on this or any similar form. Penartfes upon convictlon can include a fine and imprisonment For details see: Title 18 U.S. Code Section 1001 and Section 1010. (SW EENEY.SCOTT.DIANE.PFD/10-540/15) HUD-1 Addendum - Continued Adjusted Origination Charge Details Origination Charge Origination Fee 775.00 to Sirva Mortgage, Inc. Total $ 775.00 Origination CreditlCharge (points) for the specific interest rate chosen Total $ Adjusted Origination Charges $ 775.00 Reserves Deposited with Lender Homeowner's Insurance 87.34 2.000 at 43.67 per month County/Twp Taxes 153.66 3.000 at 51.22 per month School Taxes 927.15 5.000 at185.43 per month Aggregate Adjustment -10.38 month Total 1,157.77 Title Services and Lender's Title Insurance Details BORROWER SELLER .Closing Service Letter 75.00 Midstate Abstract Company Electronic Doc. Preparation 50.00 Midstate Abstract Company Wire Fee 10.00 Midstate Abstract Company Notary Fee 10.00 5.00 Midstate Abstract Company Overnight Fees _ 15.00 Midstate Abstract Company Endorsements 100, 300, 8.1,810 200.00 Midstate Abstract Company Total $ 360.00 $ 5.00 Owner's Title Insurance BORROWER SELLER Owner's Policy Premium 1,333.75 to Midstate Abstract Company Insurance Acct. Total $ 195.00 $ Lender's Title Insurance BORROWER SELLER Lenders Policy Premium 1,138.75 to Midstate Abstract Company Insurance Acct. Total $ 1,138.75 $ WARNING: It is a crime to knowingly make false statements to the UMted States on this or any similar form. Penalties upon conviction can Include a fine and tmprfsonment. For details see: Title 18 U.S. Code Section 1001 and Sectfon 1010. (SWVEENEY. SCOTT. DIANE. PFD/10.540/15) REV-1503 EX+ (6-98) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Ali property jointiy-owned with right of survivorship must be disclosed on Schedule F. (If more space is needed, insert addtional sheets of the same size) Calculated Value of Your Paper Savings Bond(s) Calculator Results for Redemption Date 09/2009 •.,~•. ~4.:.~3~8 &~! ~i~r'3.;.~ R! iJt+Gi~ ~i~~.#Sw ~7eP~S~~ 7fr~i. Cpr~~t YT .L~F~~! ~~t $300.00 $430.12 $130.12 $19.26 Bonds: 1-5 of 5 y*+'sh~ y {i ~... t~ .. ~YV i~! ~ ~~~~~~ ~~~~~ ~ s .~3 ~ ~ t ~f ~ ~ ~ ~ ~ ~ i a .A'.~0..,,-' U ~w n~ ~~~~~ ~ ~ ~ R. i ~` ~ s R. ]fi~j~` [(E t }~p~ ,y{ {~ ! ~II ~Re H~~4 s [ , .. $~{ $ 1fW'a~~ pGw ~~yv /j rA ~Vi ~~it• ~ ,({ l { F is \~W ~{t ~~ v ~~~~ : ~ j] ~~i.~ . e. 0001815990I _ I $100 09/2000 :10/2009 k 09/2030 $ 100.00,~ $79.68: „ 0.,00% $179.68 L022864623I : I $50 ' 12/2006 10/2009 12/2036 , $50.00 $6.70: 0,.00% : $56.70. P5 L009050841I ~ I $50 06/2003 ~ 10/2009 . 06/203.3 ` $50.00 ; $14.58 , 0 .00% : $64.58 L009050840I I $50 06/2003 10/2009 ' 06/2033 $50.00 ` $14.58 _ 0,00% $64.58 L009009589I ,I r ~a _ , $50 X06/2003 ; 10/2009 06/2033 ~ ~ $50.00 _ $_14.58 ~ 0.00% $64.58 _ _ Totals for 5 Bonds `~ $300.00: $130.12 ` ~ $430.12 ~~~t~~ NI Not Issued ..._, ._. _,..:.Y_.. ..,_. ., .. .. _. NE; Not eligible for payment w._.,.. ... , _. __ PS Includes 3 month interest penalty_ MA :Matured and not earnin interest http://vvww.treasurydirect.gov/BC/SBCPrice Page 1 of DISCOVER BA~+IK February 1, 2010 Charles E Shields, III -Attorney at Law 6 Clouser Road Mechanicsburg, PA 17005 RE: Geraldine K Massey Dear Sir/Madam: Thank you for your recent inquiry. The following is the information you requested conceminca the above referenced estate: Account Number ending in: 8490 Account Type: Money Market Account Status: Closed Account Title: Geraldine KMassey -Sole Owner No Payable on Death Balance as of Date of Death: $14,986.14 Current Balance: $0.00 Safe Deposit Box: No 'Note: Interest is accrued daily and paid monthly. Due to interest being paid monthly, interest reporting for income tax purposes is based on interest paid. If you would like to obtain additional information or have questions concerning your account, you may contact us by calling 1-800-347-7000 (TDD 1-800-347-7454). Our automated voice response system is available 24 hours a day 7 days a week or you may visit our Web site at www.discoverbank.com. Account Managers are also available to personally assist you 24 hours a day, seven days a week. Sincerely, Deposit Products Customer Service Death Balance Letter PO Box 30416, Salt Lake City UT 84130-0416 .FDIC I~CV-IJUO G ~ ~ I-y/ J COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Indude 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 NUMBER DESCRIPTION VALUE AT DATE OF DEATH ~ ~ F~e ~•d on C~oseoli.t' /~D f ersbna.l inc. Twc %~e,~urn ,~r C.a.{cnd ~cr year ~o o q ~1 ~S.oD ~- ~roSS ~~°S /t1Y10~117~ ®~ /~'SScSrt'e-cr ~' ~ -~ S ~ ~6 weS y . ~uc~ o~ oServ. ce ~ C~~rr/• ~s/e, P~{ (o, ~ S 7. So 3. ~Sp err~laG~c ~o%~s /zof ~/a~ a~ ~acves ~u e~ oh ~~ S. Zo C~ee i¢~tc~ o~ee~ ~~~e~~it~` /;tea G/2e~1 ~, pSci~egL Se!%/'!ll ~~e/1?s c~ yl,[rn~l~iGrc ~o' ~h~q Gt/.c~i~~ ~,S'p. Do v' : C'/'c~f ~ corrccz~ ~os, f terror, C; 7~i~ns ~~C>~ o . /z ~, . cSC~C/Yl~ Lo• nS IZof lvD/'~i ~y ~ Lcuc~ on ~l ~ ~~ DD ~, //~~ ~/~Ie/'%G~tn W2~G/' ~-O . - r ~{i.ri, it~ 07` (~ee.rfjc~-f cs llG~`'~C~ nee`-Yt~ ~/ `~ . D a ~J ~u ~e ~ Screik/ . ~S o~ ~ic r/~. J~z[~ ~i ~~eh ~1'l~l/er ~~j~ig~oy ~~~4. 0O Cl. !~O SG L4~l~ ~DiN n1~t 7C /J~o S/~ `~~AW.S Y~ C~~n~~ G11S r"Q~2, I~ /~, ~f38.Og /o~ Su/e a~ Scr~Cra~ ~fC~S ~ ~k the 7~tt~ ~ ~~~n ra,l~ ~h~ eJd S '~ /~o, o0 ~~~ sG/Q ~ SGl~e/2?~ /i~P„l125 O~ ?L~Y/7i ~L(he ~ Ta n et Gcl ~e~et rG7 $ ~~D. DO /~~ c~fC~/;~~ ~I/eS~D/^5~ ~e>~ne~ Oh ~~-pu~n,~t of healff~ inse~~: ~3~! 00 ~ 3. /~ P.f Li ~t - ti~~~n ~ l~Yl ~P_n'~t?rS ~l5 U~': Tbr ~21 h (JI~~Ceq~ /~]Df : ~3~ 00 0 ~ ~. Cap/;s/~ ~Scn~i~e/ N~'>r~s~a.~oc~- _ /Qe~und oK p~-r p fir- sc<,bs. ~7I.07 /,s, /jI %sc. ~ltS/I ~kna~ ~~1 ~~ a~ 13e1`~a !ii!/ac~~ '~ ~7./D /G. ~~me~f ~o~ ~rud~n~a/ /vn -/~rrh Crate -~isur, ~/~~. ~ days ~~3, 700.00 r~ I7. ~ pur~tiaseo~ ~or~en~al Ioek:nJc~ by 'D~-bofal~ ~h:elds ~'~~~og ~~ S.oD 1 FS'. .rcwc.lry ~v~r~~ ~y .TanGf GV: c~a.,r,o+ tI~ ftt<(v9 See i~eMi 2eo~~ ,~. CjiCCI~'i ,~ Na, 6!D 073 /~L~ f„~o, (,75, .?3 .~rr~: aCcr-- ~' 4! o-c% vn z~ ~ hone 'B' see eon~ir,. shcGt~ TOTAL (Also enter on line 5, Recapitulation) $ ~ t f $7~, D7 (If more space is needed, insert additional sheets of the same size} ~, ~ s~~~-~ c, ~Nr~w. Esr o,~ ~I~sS~' GEnr~l,~~NE ,~ ~~c No ...~:_~~ ~S I `I _ ~ ~t~nn ~g C1'tti2E~yS ~A~t,~ LbN TjN• 7%»e 1ae~os; ~ No, 6~ ~ 7a8 753 ~, ~33,~oao, 1"?. .rirf Qtr. ~ d.o.d- mh ~~i C• __ - r v.~ _ Tine No. b 2 5 D ~3 6 SI t ~a6 9 s's•> __._ F In ~': QcCr. ~ cl, o. d D .Z~' ~. ~ ~~f. 0. ~ YQlua lion ~~i" 4~a~e ~ O. ~ J'T~ ~h14 ~b 2/, ~~~-ccnol t-~: ~u.d rn~aa Loy, ~~ ~.n~ su,r. ~3, !oD• a a a3 __ Zi+oh ~/yt.d~l~ ~s~a~P,i" S o% ~ ~~Q~"OfI .S,aL'~-~'P~ ~-bss ~'~lcs P~bcccds ~n ~Sa/c o~ ~ssor~fr,~/ ~~/r l20~ ~ C r ./~ ~g S6 ~ -'~- o ro- ~'vH Qind ~e,~~i~e s o~%~fa~ ~i.ix ,~al~ _ - es fatc to c~ cd a, / ~ ~' .l~~s~ ~'~ --- P/~ as s ~~h oh ~e se~fl ~e s e ' ' _ /~-. ~ ~ n e ~'v s '~ 97, 93 s r~ ,~~n e yob' ~4-sscs ~ 1s ~l~ol _ _ ~~_. _ '~/ ~ ~o, s ~ _ _. a~S, ~c~u,nd }~enn 11~~. ~-,sar. ~3o.ot Rowe's Auction Service 2505 Rimer Highway Carlisle, PA 17015 717-249-2677 249-1978 697-4794 To: Michael Rundle, Attorney l3 N. Hanover St. Carlisle, PA 17013 From: Rowe's Auction Service 2505 Ritner Highway Carlisle, PA 17015 Re: Estate of Geraldine Massey Auction Proceeds, Coins January 20, 2010 Total Sales $6457.50 Less 20% Commission -1291.50 5166.00 Spendable Coins not sold +25.20 Total Due $5191.20 ROWE'S AUCTION SERVICE ~;~6 3 5 6 ~ SPECIAL ACCOUNT 2505 RITNER HIGHWAY CARLISLE,. PA 17015 DATE ~(, d~Jl-- ~~ '2~ t ~ PAY TO TH~ S~'C y~ ~° l~1Lgt_-~ ~- tt 2 ~ ORDER OF ~'"~~ A.Ji~ 1M,aS~ i ~ L ~~..~,..~.~...~ Z~ ,p _ ~ c~ ~~~"''- DOLLARS L* 1 ~....~ ~_ ORRSTOWNBANK ° A Tfnditi^^on ofFxccAsncc MEMO ~S ~_i~t. s•~'Tt_en ~ ~ ~ ~ t.-~ ~ -~~ ~„ NP ~N:O 3 L 3 L 50 36~: L06 L i04 2011' 3 560- w ~~ W. David Rowe ~%iWe ~ a Ai_ic~t i an Derv ice ~5~c~5 !~ i t n e ~~ I~w y Carl i ale, F'F~ 171 www. rowesaE_tc.t ian~ervi.cF. ~-~an Set#: l ement Geraldine I~lassey C~tat a F'ar~e Geller,. 1~ Iterl7 DoSCI'xpt.lafi i-'r~.a'e' C?tv Total -_ Cali [ _. 1 ~. G ~ . tZt ~i .._ C a i n c~ ~. 1 G b ~~ - Cain ,~ i ~._?.~ . ~~ - C a I n ~- i ~. , ~--,..,~ . ~~ -- Cain ,.J ~. 7 ..~ ~ - k..i i~ I n [ lJ ~ ' j L.- f u ._ Cain €~ .t ~.~..., . ~~.~ -- Coin ~ 1 B~. ~ZtfZ~ -'- C a I T t ~ i~?- ~. J ~ . ~ ~ .- Coin ~. ~. 1 k~. ~~ -- Coin 1 ~ ~. 7 ~ . ~~ -- Gain l 3 ~. ~ ~ . ~RZs - Coin 1 ~E :t ~~ . ~~~ - Coin 1 ~ ~. ~Qi. ~~ __ Coin 1G l ?;, E~r~ - Cain 17 1 ~~. ~~ -- Cain 1 S ~. ~ ; , tZ~~ --- Coin 1 ~ ~. 7~„ ~~ - Coin ~~ 1 8~. ~~ - Coin ~~' 1 :L G~. ~~ - Cain ~~ 1 7~. ~~ -.. C a I n ~...'i .E. ,~ Q~ . ~~ -- Cain ~~f 1 iG~~. ~~ - Coin ~: ~ ~, ?~. Qty - Cain ~~ 1 7~. ~~ - Cain ~`7 ~. 5~Lt. ~~ - Cain ~'~ f 45. ~~ - Coin ~'~ 1 8~. ~~ - Coin G~ 1 ~ ;. ~~ - Coin i 1 EtZ~ . tZr~ - Coin 1 7~. ~JtZt - Cain ~.~ i ~i 1. ~~ -- Cain ~ 4 1 ~. ~ s . ~ 1 ~ C C7 1 n J .J { .L ' 7 ~ ~ 7 ~ ( 7~ E~ r KJ ~ - Cain .~ Ei i 8..., . r~ Q- - Cain .i7 ~. ,,,~^ ~~ --- Coin G8 ~. 7~. ~~ -- Coin ~ ~. E s. 0~ - Cain 4~ ~. Gtr ~~ _.__.~~..__.. _. ..__._ f ~. EL.~~ - Coin 4~' 1 7~, ~~ Date : ~ 1-~~--;~.'~~~ 16 ; 48 : ~~ Rowe' s A~_~ct i on S~~r~v ice ;~'~~~.~ F~ i t n e r~ Hwar C;~r~lisle, F'A 17~iS 717-x::49-677, ~4~--1 X78, 697-474 www. r~owesa-_lct i onsertvice. com Sett 1 ement Ger~~ld ine t1'iassey Estat e Seller~~ i4 F,~qe. r item Description F'r--ice G~ty Total -- Coin 4~ 1 8~. ~~ -- [ao i n 44 1 11 ~. ~~ - Coin 4~ 1 6~. ~~ -- Coin 46 ~- ~'. ~~ - Goin 47 1 ~~• ~~+ -- Coin 48 1 6.~~ -- Goin 49 1 7~. ~~ -- Coin ~~ 1 14.~~ -- Coin ~1 ~- 6~- ~~ -- Coin ~' 1 ~~. ~~ - Coin ~ 1 1 15. Q~~ -- Coin 54 1 65. ~~ - Coin ~~ 1 7Q~. ~t~ -- Coin ~6 1 ~?• ~~ - Coin S7 1 ~~- ~~ - l..a ~ n .38 1 7~w ~~ -- Coin 59 i ~. ~='~. ~1~ - Coin 671 1 6~. ~~ - Goin 61 1 6~. ~71~ -- Coin 6 '' 1 6~• ~~ - Coin 6 1 6~. ~~ - Coin 64 1 ~~. ~~ - Coin 6~ ~- 7~• ~~ -- Coin 66 1 6+Z1. ~~b - C o ~. n 68 ~ ~ ~ r K.`i~1 -- Coin 63 1 5~ . ~tZt - Coin 7~ 1 ~~- ~~ - Coin 7i 1 8~•~-~ -- Coin 7;~ 1 7 ~ - ~~ - Coin 7? 1 6J• ~~ - Coin 74 1 7~. ~F~ - Coin 7~ 1 8~. ~~ - Coin 76 1 4~t. ~~ - Coin 7? 1 ~~- ~~ - Coin 78 ~- 7~- ~~ _'- C o 1 n 79 ~. 45. ~~ - Coin 8~ 1 ~~. ~~ - Coin 81 1 ~='~. ~~ Items: 8~ AmoF4nt: 6,4~7.~~ )c~'~ e ~~ :~. _°~~~._i='E~`~~ 1 ~, o bbd : `~ Rc,w~~' ~, ~lr_lr_t i an Ger~v i ce ~~~t~ I~itner~ Hwy Carlisle, f='fa ~?~1 717--~~4~-~E7 f , ~4~--~ 1 `•37~, ~`~7--474 www. r~awesa~_~ct iartser~vice. cam settlement ~eller~c 14 Geraldine I'rla~sey Estate Cam~iis=ian at ~.~~. ~~~/, 1, X31. '~~ c'~ a .a Less ad.j~_~stmer~ts a ~-~., ;~~~.. ~ l~l e t d E_a e t a B e l l e rY w ~~, ~. E~ ~ ~~ Thank ya~_t fur- ya~_~r business F~awes f~~_~ctian! Jason Miller u ~` E ~~ 1) Recliner sofa $230.00 2) color TV w/ DVD-VHS 50.00 $280.00 c Date t ~ ~C gnature P~~,~ ~°i~ ,~`~. Rug Purchased from Geraldine Massey's Estate -Deborah Shields Oriental-looking rug $25.00 Total : $25.00 In-kind distribution from estate. No payment made at time of delivery. eborah Shields Date ~~ C 1 Jewelry Purchased from Geraldine Massey's Estate -Janet Wickard +~ 1) Heart flower pendant on gold chain ~ 2) Half-penny pendant ~/3) Aquamarine pendant on gold chain v4) Square diamond ring US} Green cameo with earrings 6) Diamond and pearl ring ,/`7) Carnage watch ~ 8) Diamond ring with wrap ~/ 9) Red stone with cross ring /10} ~ Amethyst pendant with clip earrings $10.00 $15.00 $75.00 $1,000.00 $15.00 $125.00 $5.00 $175.00 $20.00 $~l 50.00 Grand Total: ? 590.00 In-kind distribution from estate. No payment made at time of delivery. net Wickard l~-t~-v9 Date r ~_~ .. ~ ._._ _. _ _ ~.~ w Fnidenlial Financial Premium Accounting Division 3AS 101 welsh Road. Dresher. PA 13025 GERALDINE K. MASSEY C/0 ELLEN RUNDLE 62 SOUTH PIN .OAK DRIVE BOILING SPRINGS PA 17007 INSURED NAME: GERAL.DINE K. MASSEY POLICY NUMBER: REASON: CHECK DATE: CHECK NUMBER: CHECK AMOUNT: CLAIM NUMBER: 99999 GROUP LTC CLAIM PAYMENT SEP 14 2009 3420018187 $3,700.00 209252280003 CHECK STATEMENT This check represents a Long Term Care claim payment. PAYMENT AMOUNT $3,700 00 Should you have any questions, Customer Service Representatives are available to assist you, toll free at 1-800-732-0416. Detach before cashing or depositing check. Please retain this check statement for future reference. • s • -• ~ s Prudential Financial 3420181 87 Prudential Premium Accounting Division 3AS Wachovfa Bank of Delaware, N.A. 2101 Welsh Road Wilmington, DE 19603 62-22 Dresher, PA 19025 3~ ~ f*THREE THOUSAND SEVEN HUNDRED AND 00/100 DOLLARS Pay: f To the order of: I GERALD t NE K . MASSEY%3'c%*~ ~'c%%cz::Yi'c3c%cs'c%c~'c~'cs'cs~:c:; C/0 ELLEN RUNDLE%c%cs'cs+cs'c%c%s~%s'cst~'c%cs'c%cs'cs'cz'c:c%s'cs'cs'c%s'c i 62 SOUTH PIN OAK DRIVE BOILING SPRINGS PA 17007 ,} ~:, ~ ,p SEP 14 2009 $~%c%F%*3700.00 Void after 180 days Dollars Cents TREA URER CONTROLL~ ~~' 3 4 2D0 ~8 L8 ?~-• ~:0 3 L X00 2 2 5~: 20 ? 9 9 500 50 5 6 6-~' Lfl r r U R~ R~ r .~ t'LJ -'~~ ~ n ~ ~. ~ ~ ~ ~. < ~ d 3 d ~.- ~~ ~ ~ ' r: ~; c. i c: `, '~ T r; .. U=-- I (!~ :_ ~r- ~~_ ~ n. V i n :~ ~--~~ ~. r ._._.. -~ J ~ ~ it J r~s'~ T {: S ~ m~ __ ~ .c IT[ r ~' _ . `n fi ^~.-. m _ rn :: n ro~ amY; ' O ~A==: ' I ~mpT ~-{ ' :mD~x I";! Z n r rn mac==_ ' ~= ~= ~ ` i u t ~ _ - am . m3G ~~ p ~. = o ~; ~ _ = r, m r c: c., =r, rT ~: ~ - ~- c., T :. c; ;; :: _ G- e • r Currency and loose non-collector coins 100's $4,300.00 =43*100 50's $4,600.00 =92*50 20's $4,500.00 =225*20 10's $550.00 =55*10 5's $365.00 =73*5 2's $52.00 =26*2 singles $69.00 =69*1 loose coin $2.08 Total deposit from safe deposit box $14,438.08 11/16/2009 A~ Citizens Bank October 7, 2009 CHARLES E. SHIELDS, III 6 CLOUSER ROAD MECHANICSBURG PA 17055 Estate of GERALDINE MASSEY Date of Death: Sep 06, 2009 SSN: 190-16-0066 Dear Sir/Madam: 525 William Penn Place Suite 153-2618 Pitt:>burgh, PA 15219 In accordance with your request, the attached information sheet has been provided in the; above decedent's name as of his/her date of death. For IL or LC accounts, contact our Loan Department at 1-800-708-6680. For all other inquiries, please call 1-888-999-6884 Sincerely, Robert Roos Operations Services a~ Citizens Bank° Account Number . 6100731464 Account Title GER.ALDINE MASSEY Date O ened 6/6/ 1966 Account T e Checkin Principal Balance as of DOD $30675.23 Interest from Last Postin to-DOD $ .00 Account Balance as of DOD $30675.23 YTD Interest to DOD $19.08 T~ CitizensBank~ Account Number 6247287513 Account Title GER.ALDINE MASSEY Date O ened ~ 2/23/2006 Account T e Time De osits Principal Balance as of DOD $33020.49 Interest from Last Postin to DOD $20.12 Account Balance as of DOD $33040.61 YTD Interest to DOD $695.12 a~ Citizens Bank Account Number 6250436511 Account Title GERALDINE MAS SEY Date O ened 10/23/2007 Account T e Time De osits Principal Balance as of DOD $26955.02 Interest from Last Postin to DOD $49.05 Account Balance as of DOD $27004.07 YTD Interest to DOD $653.12 Monda Wickard 1) 2 black end tables 2) portable color TV "old" 3} old chair with ottoman ~~n . -~- -` Signatura~ Citizens Bank Customer Receipt $ 50.00 no value no value $ 50.00 Date ~ ~~ i ~ - ~ ~~ Please be sure to enter this transaction in your records. a Transaction Date Amount Description Account Number t~~,I~~V'.~~~-t,~c7~`:~t~~~'~s VV~~ ~L~~fr{1~~1~~4irr~} tc`.~~~ lrit t~t'E~fi ~ Alc~~slkLfftli F~.131~ Funds from your deposit may not be available for immediate withdrawal. All transactions are subject to 22089-BUNKER 8/06 1 M/PK verification as outlined in the rules and regulations of the Bank. Member FDIC Sharon Spencer 1) Iron umbrella holder ~~~- s,~a~e $ 60.00 $60.00 Date r~ '~ ~ ~~ ~~~r~'eri~ce Rug Purchased from Geraldine Massey's Estate -Deborah Shields Oriental-looking rug $25.00 Total: $25.00 In-kind distribution from estate. No payment made at time of delivery. eborah Shields Date Rowe's Auction Service 2505 R.itner Highway Carlisle, PA 17015 717-249-2677 249-19'78 697-4794 To: Michael Rundle, Attorney 13 N. Hanover St. Carlisle, PA 17013 From: Rowe's Auction Service 2505 Ritner Highway Carlisle, PA 1015 Re: Estate of Geraldine Massey Auction Proceeds, Jewelry 3anuary 20, 2010 Total Sales $9560.00 Less 15% Commission -1434.00 Total Due $8126.00 ROWE'S AUCTION SERVICE SPECIAL ACCOUNT ~;~6 3 5 2 3 2505. RITNER .HIGHWAY CARLISLE. PA t7015 pA~ 1 ~ p ..PAY TO T'f-~ ~ ~~ ~ ~~o-o~ . ORDER OF .,.~,,.....:,,Y a ~,/~ ~t b-~'~ m N_~ l.Cw-.~ n.r../~ Tc.~,~..~-~ S`~ ~..~ /.-~.--r~otiLAxs 8 ORRSTOWNBANg . ~ ~ ~~~ +~:03~3L5036~: L06 Li0 2 i~' 3.523 C~9 - -- ~~..,.~ W. David Rowe `~`! ?ate. ~i-17-1~E3~ t7-t~t:~~:`~-- Rowe' s A~_tct i on Service ~:~~~ ~2itner !-•!wy Car I i s l e 4 ~~A 174 1 www. r~owesa~_fr_t i onser~v ice. com ~ettlemet~t Geraldine I~lasseY Cstate Seller: 4 . ~' a c~ e Ott;m I~esc~rsiptiori ~'rszce C!ty Totaz -- J;. --- gold bangle bracelets 1 ~'~~. ~~ -- J ~:, - 1 ~+K b rs ac e ~. e t :~. 4~?~ . tZt~ - J:~ •- :~ 4 K -- b r ac e ~. e t ~- 41~3 . ~~ w/d Lam~~nds - J4 - 1~K br~ace~.et wldiatrtond ~. L~~. ~~ - J~ -- 1tZtl: brace ~. et w; d iamond :L 1 ~.~. r~~ --• J ~ -- 1 OFF'. bracelet •~. E~~ . ~-~- w/diamonds __ J? -- ~.4F'. go~.d t^ing 1 ~1i1.-. ~~ w/diamonds - JE3 - 14K gold ring a~/stone 1 ~~~. ~~ - J~ -- 18K gold ring 1 ~7~. rZtfd w/cli.amonds - J --1 E7! 141: gold ring :~ ~tZt~ . fZt~Z- w/diamonds -- J1 ~: - 14K White gold ring 1 17~. tZt~ - J1~` ••••• 14F~. gold ring w!Topa 1 17~. r1--Z~ - J1~ - iQF'. chain w/coin 1 7-~-0. i71~J --- J 14 -- 14 K g o ~. d c h ~~ i n ~. ~~tZ~ . ~~Zt wfd iamond - J1~ - 18K gold ring 1 ~.~ 75~. ~~ w/diamond - J1E - 1~K gold hear•Ir 1 1 f~1. t71~ w/diamond - J 17 -- 14F< gold earrings f 4Et~, tZt~Zt - J1$ - ~ 141{ gold bangles 1 ~S~.~t71 - J1~ •- ~ 1~FF: gold necklaces 1 wilt. Q-Qt --- Jam.' ~ - 14-K bracelet / L: rings 1 ~ ~~ . iZlt71 - J~' 1 -- 14K gold neck 1 ace 1 ~7rZE. ~~ w/dia - Jam';.:` - 14K gold opal/dia 1 ~1~. ~d~ ring -- J ~'~ - 1 ~ZtK gold ring 1 3QttZt~. ~~ w/diamonds - J~'4 -- 1i0F: gold ring w/chips 1 ~Q1. @~ - J~5 •- ~ 1 ~{~. gold r, i n y s 1 ~~. ~~ - J~~ - 14F'. Sapphire earrings 1 14f1t. ~t~D - J~`7 - ~ 1tZ~F: gold rings i 1 ~'~. ~~ - _ _. _. Wi G~ t e e S/ ~ ~ - 1 f - !. ~ C7 ~i..i ~ ~L.~ a ~..~ cJ i J ettlement e7.lerw 4 Rowe' s A~_tct i on ~er~v ice :;~~r~ Ritner~ Nwy Carlisle, ~'A 17~1~ 717--X49-;`~77, ~4~~--1 ~?'8, ~~7--4794 www. r~owesa~_~ct i onser~v ice. com Geraldine Massey ~atate -t 1. ~,,.., ,. ~. Page: ~: 1'tem Description F='rice C?ty Total - J ~ - Sterling rings/watch ~. 4~.~~ -~~ J31 - stick pin/tie ~. ~'~~. ~~ tack/ring ~- J ~ -- Sterling brace l et ~ 1 17. ~~ - J 33 - costume .j ewe 1 ry :~ ~~. ~~ -- J34 - costume/watches 1 8~.0+Z+ - J3~ - Cost!tme .jeweir~y ~- ~~. ~~ -- J 3~ -- Co st ~.~m a .j ewe 1 r- y 1 ~7. ~~ I t e m s ~~ A m o ~_in t; 9, 5E~7J. ~Z-0 Commission at 15. ~~tL+X 1, 4 f+. ~~~ less ad j~istments -1, 434. tZi~ h! e t d ~_i e t o s e l ~. a r~ ;. d, 1 ~~ . t~t~j Thank you for yo~_tr~ b~_~siness Rawes A!cction! Monda Wickard 1) 2 black end tables $ 50.00 2) portable color TV "old" no value 3} ald chair with attoman no value $ 50.00 ~". ~~~ _ crn~ ~ , Date ~ ~- ! ~, - ~ c~ -! ~` ~ S i gnatura~ ,~ .~ ~ ~I REV•1509 D(+ (1-9n SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF F{LE NUMBER /yI~SsEY, GF2~~D/n/F ~. ~l-D9--~S r ff an asset was made joint within one year of the decedents date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. CYj ~ ctiac ~ ~ /~'of ~ `f a3 /yJap/e ~C., /~?anh~iin, ~•~ ~7sSfS ~r%~.rd, Sh-an~~, 7~ ~ blood. B. c. JOINTLY-0WNED PROPERTY: ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY Include name of financial institution and bank account number or similar identifying number. Attach deed for jointly-held real estate. DATE OF DEATH VALUE OF ASSET ~ OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTERE; 1. A. oq~ (~ . S. S[tvin~s ~nct, , ~erie5 ~, IsS. [~jlZooo ¢ I ? cj. 6~ So~ ~ ~g~, ~~ ~' C Oo ~ 81 S qRv 1. `~IDD. °D Csee end ~~.~uah'on Shee# atf'ac!-t~c~~ TOTAL,(Also enter on line 6, Recapitulation) S ~~ ~ (If more space is needed, insert additional sheets of the same size) REY•1510 EX+ (1-9n COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE G INTER-ViVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER ~l~ ss Ey, ~E~e~~~~~~ ~ ~/- o9-~s9 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 VALU f 1. u. S. Sa,,'-ngs 3ond series 1 Tss, ofo zoo3 ~ ~ ~ ~ y S8 / o o ~o ~' o _' 1~ 65~. S8 ¢ ~ L Doq oSD 84 ~ Z . b'D.oo ~ p,v fv Gruc~e Sfa'rman ~ ~ra,ndni ect ~l Sr) ~. U. S. Sow,o~s Bond, Series ~, -iss. 06/2003 ~ L o09 ooq SBg ~ ~,S'o. oo ~ o. ~. -~ G-%nn;e Torun, niece C~sfo) ~ ~ ~F..s~ /oo~o -' o - ~ ~ ~..~5 ,3 U, S. SaVI h y S ~ohar, ~Gr'i t S T .ass. t~ ~2ooG 1 -• ~, o. D. ~ Sg nc f GV, ~o,~ rd CS i S~ f , l.~ 9e, ~s(o . 70 l 0 4 ~v -- G -- S(o. 70 ~sce f ot~Al va/ua1SOn ~Sh~ef a'~R~~iec/> `~. /1/ai~inu/ dvesf'tr~ L-~c ..Tnsur. C'v. f~nncc, fii~ ~ oI o fob /G7~ ¢ t~ayree- stia,rnn S~ncer~ niece ~-S',o~ SS, a3a.b? IOD~o --a -- ~ ~3~.b~ (see ra/G~f'ion l~tfer a~RClcd} S, ,lyi~d 1a~ Na,~'o~a1 ~'~C .rnswr. Ca. ~ l~n~~, ~ 1y -#~ /loo 018 ~ Soq [~, ~'~'/. ~: ~~yee --Michael Koh,, ~.;~d ~~ ~-ga) Csee ~a/ua~oh leiffzr Q~tr~l} ~- ~~ A~r;~~ ~~nahcia~ ~Csourres -[~ya~ >~ m~~r ~~~ ~r,s ur. ~ . ' X ~8~ 7~ ~. 9~} ~oo~o --o -- X78 s 7G 5 /4nn ~~~ ~ #~ ~ SOD y fi ~ S payees cm P~ua( `/7 sh4,res 8. Lisa S`~mum, niece C[~So) l' Moncl4 ~t1~GKard~n;~~ (I S~o~ Sharon ~encer, n ~ ~ ~ 1 S fo ) E. G~nint ~'ordu~r,, h~ect (, 1 Sso~ ~. ~.~.b~h sl, gel ds, s~ Sty ~- ~, 9d G. W'~ ll ~ a rv~ S ~x1;t~r, irk t~1,c.~ ~) S So) C b '~''~ h ~-.'~' ~~t TOTAL (Also enter on line 7, Recapitulation) $ g ~ ~ , a q / . ~ g (If more space is needed, insert additional sheets of the same size) 7 ~, 2 s~~1~ ~ ~ cad . b 9_ _~..____~.__..~~...~..~. __.r_____ . ~._.~__._._._~__._..____.___._...___.._______ __..____..___.___ --a ~" Lb a H'Merica~r L~~e .~i'ISUr. ev. --- --._~ _._._~_...._ y` -~- 5~sof1 ~o ~~ 73 ~! a 5s, sq' ~ 0 0 9n --- o - . /h ` hay/ ~ ~~,~f ~}- • ~isf e L a °~~-~ r~~ece _________r___._.________._.____ _ ~s _. ~. ~rd~t'~ rlje~ ~Sf 7J. Gt~~nc _ _.~._._..._._._.__..___ _.__._.__. ._.___.___-----_.._ .w. _ _ ____..___;_~____ ,E, /~,rl,~»da ~h~w /)j~c~sL ~I ~ --.~._._-----__ __._--.__.~_ __--. -r---- -- - _ _.._.r..~__ _._._._~r---'-- - !y/G~'4/~ ~ ~ ~~rl 4 ~ !7t GC jS/~ ,. G. ~I~a__ ~~__.~~'~c_e._r ne~.e~_ ~sfo 6crrstli C~ti~ (/a SrSfG~' ~IZ~o ~ am.1 7 uerc L~~ V `herein ~n deee~~lt~~~ce_ayf4~~e~ __._.~_. ___________ ___.___ ter, :NATIONAL WESTERN LIFE INSURANCE COMPANY October 23, 2009 Charles E. Shields, III Attorney at Law 6 Clouser Rd Mechanicsburg, PA 17055 Subject: Annuity 0101041674 Annuitant: Geraldine K._ Massey, dece-aced Dear Mr. Shields: In response to your letter of October 6, 2009, we are providing the value as of Mrs. Massey's date of death. As of September 6, 2009, the Accumulation Value was $55,232.67 and the Cash Surrender Value was $42,805.32. The cost basis maintained in the annuity for calculation of the taxable income was $32,959.83. The benefit has been paid Ito Sharon Spencer under the 5-year fixed period installment option Please contact the Policy Benefit Department at 800-531-5442 extension 585 iif you need additional information. We will be happy to assist you. Cordially, POLICY BENEFIT DEPARTMENT 850 EAST ANDERSON LANE AUSTIN, TEXAS 78752-1602 512-836-1010 AUTOMATED VOICE RESPONSE TOLL-FREE 888-695-5001 WATS 800-531-5442 CLIENT SERVICES DIRECT WATS LINE 800-922-9422 CLAIMS 800-531-5442 WWW.NATIONALWESTERNLIFE.COM FROM CAL-TECN_SERUICE, INC. - ~r FAX N0. 717-270-0495 Oct. 30 2009 03:20PM P1 .;V MI1D-fr.AeV~ 11dAT1~~1t~4C /~~ Life -nsura_nc® Company Aytytuiti~s at their Best 460 Wcstowr. P~rkwcy, Suite 300 Wes Ccs Moi7~4, i!l 50760 October 23, 2009 NIICHA~L KOTH 423 MAPLE AVE MANHEIM PA 17545 Re: Geraldine Massey, deceased Policy: 160018309 ...... ....: .. .. -- Dear Mr. Koth: ~ ~ - ~ .: ... . Enclosed please find our check in the amount of $10,972.47 which is payable to Mr. Michael Koth as a primary beneficiar)~ of this contract. The total mount of the death benefit was $12,$51.83 plus $48.41 death claim interest, less $1,927.77 for federal withholding. We are not able to determine the taxable amount of your death benefit because we were not supplied with complete cost basis information. Also enclosed is the certified death certificate that was submitted to us as a requirement for processing the claim. We have retained a copy of the original death certificate for our files, and axe returning the original to you. Ifyou have questions, please call us toll-free at 877-880-6367. We are available Monday through Thursday from 7:30 am to 5:00 pm (CST} and Friday from 7:30 am to 12:30 pm (CST). A service professional within the Claims and Benefit Department will be happy to take your important call. Sincerely, aka 1'lc~Q;c~, ::... .~.:::- .-- . Falon'Michalsla~ ~ .~ ..... ... ..-..... ~ . - ~ . Ciaims and Benefit Specialist Claims and }3enefit Department cc: file Annuity Dn-ision ~ P.0. Boz 799D7) Des Moines, Ik 50325.0907 Phone; 677-596-0240 ~ Fox: 8]7-SE6-0249) www.ntidloadonnuity.com '~-~~ GxE~,T.An~rERrcarr, September 18, 2009 Fllvaac~a~ A~souac~s Scott Moyer 33 T.4 Market St, Ste 302 Carnp IIi]I, PA T.7011 Company Name: Loyal American Life Insurance Company Policy•Number: 45004042 Deceased Name: Geraldine Massey Dear Mr. Moyer: Our records indicate that the bencFiciaries of the above policy are Michact Moth, David Spencer, Lisa Stayman, Miranda Shaw, Monda Wickard, Sharo» Spencer, Ginine Gordan, and Deborah Shields. In order to make a claim and distribution election, each beneficiary must campletc a separate Claimant Statement R:, Election. Request Form (CT,,2165) electing one of the options below: 1f n Lump Sum Etcction is desired (Top ofT.'A~c 1, Sectivos I, lI & TV of Page 2}: For Lwnp sum distributions, the Great American Benefct Choice Account Disclosurc/SignaturE .form must also be signed and returned. ~' sin Annuiti~,ation Election is desired (Top a[Page ~, PAges 3 & 4}:Payments cwnnot exceed your life expectancy and must start prioz~ to one year .front the date of death for non qualified policies and prior to 12!31 of the year following•the date of death for qualifed policies. Also, please be aware that a state premium tax may be withheld from the dcattt benefit prior to the calculation. We hlso request an original ccrtliled death certificate that reflects the cause anct manner of death. For lump sum distributions, the areal .l~.merican Benefit Choice Account Disclosure/Signature fotrn- must also be sighed and returned. If the bcnef..tciary elects to take a lump sum distribution, the Death •8enefit value will be equal to the Surrender Value as of the date of death. IFthe beneficiary elects a settlement option that is three yhars or greater, the Death Benefit value will be equal to the Account Value as of the date of. death. As of the reported date of death, the Account Value was $734,255.59 and the Surrender Value was $707,513.25. Due to the Serial Contract Rulo (ZRC Sec 72(e)(1 l)), the cost basis principle for both policies will be considered one contract to determine the correct non-taxable amounts. We arc unable to process any distributions until all paperwork is received from all bcnefciaries. If you have any questions about this letter or completing the form, please eantact me at 1 800-854-3G49. Sincerely, ~~ Life & Annuity Claims Department /Extension #il 853G cc: rFa 14ooG4 Enclosures: Claimant Statement & Election Request Form (CL2165} Fraud Warning Notice for applicable state Great American Benefit Choice Account Broclture Great Attxerican 8e~tefit Choice Account DiselosurelSignature Form (l3CAD) p.0. Box 5420, Cincinnati OH 452DT-5420 Overnight Mailing A~ddress: 525 Vinc Street, 7`b Flooc, Cincinnati Ohio 45242 smt REV-1511 EX+ (10-06) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Debts of decedent must be reported on Schedule L ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: ' . ~ hrIN6 3 205. FuN~l~C ~{vn-~' ~ C ~f-/lGI~S[~ ~~ = ~lOy d ~ S'.3.Sr B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions / Name of Personal Representative(s) ~J/e/~ ~. /Pu/Ici/e __ ~ /3, ~' y,~, Q D Street Address 6 ~ .S, f i/I ~!!~ ~/' City ~oi~!74 Vim/'//19S State ~~ Zip X700 ___ Years} Commission Paid: 2 • Attorney Fees Char/PS ~. cSLj/e ~G7S _~!!. ~ ~ / 3 8 ys' 00 ~• 3• Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant /~/p ~~ ~6~g .! /v Drl e Street Address City State _ Zip ____ Relationship of Claimant to Decedent 4• Probate Fees ClA4G~ O/"i q i ~-rtl i 5 SGT o~ S~ot~ ~'e/~f T~Ca7 e~„f' ~/ ~~. ~~ 5- Accountant's Fees ~v/tA +`i- K~~ ler! ~~ ~ ,23 fD $. ~~lOf/PJ'' cS~', ~-d,hi.l,'S~e/ J t ~ ~ ~ ~~~.s DO osc ou, r p~ c cd. P , /7D/3 /DAD Pfd- ~, J "~P r 6• Tax Return Preparer's Fees /D~f/~ p,¢ ~,!/~ e~, ~PS~/)'1~ ~- /3dvt~'ts%ny in ~'arl;3/e ~cr~f-~e~ IV~ts~~ex' ~13~f. y`/ $. ~4dver~'sin i~/ Ctcn, bcr~aec{ L.au~ ~ournn/ ~ 7S 0 0 . ~ 9. /tc~,S~r o~ !~/i//s, ~~li~g ~e ~r- 1nLi- T~ ~e~urh ~~S'.oo /O. /I K ~l'. tJ o~4~ !~/~o ~va/C ~G G To l~P~ /S ~r o~ Gvi //,s J~`~ B 0 0 7 . /~. fiGG ~/' ~i ~i%7 ~i/'S / 6GX~ ~•i74~ ~ L' C/p 6ll1 ~ /G ~P~. v~ Lvi ~~,5 ~ ~ SO . vD C ~ ce C o rtf~.~ cS`iPe ~/ TOTAL (Also enter on line 9, Recapitulation) $ 6 6~ SSS• DS" (If more space is needed, insert additional sheets of the same size) ~. z s~r~~ ~, ~on~~. ,~5~~ ________._____ /Z- ~vlrles ,~ucl~©iI_~i~~, ~e _o~~r-/sle,~_.~~ ,.~, !~uc~i o`teEy`,!'___..._ ___-____.__._ _~___~__ __ __~____.__Y______ ~3. ~, C~ ~~k_~ri ~Kcr,_ 0.cc~}i G,~f eU" ~(' ~(L~is~ D~~Yns ~uXL `_ - __._..._---_-.-- 1~ -- ~. 6D _ ____~__. ~~.. . ._ rG ~ L C h h a l t r rG a~ e5'~'af'~ a Q tSa ~ ._ .._.__...__.~_~_~. e __t .~~._~___ ___________pg~_ ____. ~ ___-___ ¢~ 0 4.© L ___ _ - _ /h~ - E'as /1'lOYerS ~ /YtOve ~rni lure f[aSS.~/3 ~r ~a~e-Xt -n f56 3.01 6. K st ~~ .-~ as~,~~ ...__~._ -_..___ __ ~? pp~ _~_________.--------_ - _----__._________-----__ __-__~._~~_ _______._ _r______._ _~___ __---_-.__ _ --_._._ ~~~.ab .___.____ ______v____ .. ___.__.-__ _ S. _._ _-___-~.- _._.- . ~__._ ~r~ _~____.___.~~o~~° __.____ ..____.._.__.. _ _____ ._ ._ _w __ _ _- _. _ _~.dl _--- ~a!n,~~~1 _ T ~_ -1_.~~R_.~~r%~ __..__.----~~._,-_ ..__--.___. r l 38, bS _ p p~, ~0?6, SfS __ ._._.._ - ._..__ ~ _... ' __.__~~ZS±.r~~-----_~~~~.~--_ ~,~.____.~~es______ _ __ _.___._... ____-___.__-__--.---- , ~.~ ~ OS ___._____.~ U ,/yJ ' Gl ~ ~i~i 5 C!lISC !~/ /' /1R~D o0 ____.~_._.__. _.. . _,,~_._ ~,~ ~ ~8- ~Q ~,Sr ~/JL f ~fi~.3i _ _________ ___._.-_..~~~ ~~s. ___-_______.__~_ ___ ~~__~~,~,~~_____~ ,,~_~.____M_.__________...__~______p~______.... 5~~ t~3a. a~ ._.__._.___ ~._ ~? _ .. /~iG~:~ ~ ~~r-ylS, /IIisc~_.._ Gy»ri~__yn_.._.1~~ ~..~_._~~_____.w.~_..__..__~.~______.___._~_._-__ ._....__._ ~~ o• 00 -~~• ______.______~_.---_-__-- __-. _ _ ___. _ e~.._.______.________.__ ~S~MQS ~S~-~~~t-~~ , ~~ - ___.___. ______ ~~- . __-~ _ bn ~ are ~n~~sf~ • _ _~c~~__----.----__..__ _--.- ~ 3 ?. D~ _ tt larn p s. 7S 33. P ~ ~ '`! y.~. 69 3~• _ _-___-_----___-- os~m4 r - __ .~' _____ ~e _~_~s.~ ~ ~ ~.~~~-__ _____~_________.___ __u______________________ ~lD,g4 __ ._ --_-__ ~. _ ~ ~ ~__I.~~L__ oGuts._ __ ____ __~____.~_. ___-__ _ _......_ ~d 3 a. v - ~ --~- ~ Co n ~ih S I-L~~" ti ~a c ~~ I ~s T. a ~' /n ~-ss ~ ~~ C~2~-~.y/NC= --!~' __ ~r ~~ .~/b. _ ~ a/- a9- 8S 3~ ~sf ~~S er ~- _._. ._._ - - -- - ! ~. d~/ _ 39. g C~Cer~ d14 9CS ~ _-_ _ ~. ~ S are ~ _ ~ .. ~ru ~ ___. ~~3 ~. oS _ yl. _._. ~ia~ _ _ ~Sd: S~ ~a _ '~3- /h~~taei~i'1 ~ /rr~rSuirr, ro rr-t ~~~±~ _~_.__ _ _~ L_ -~-.~--~ ~~dch l~yQa.~ It'turJ. ~er~:ces_ ~ /~f, sy 9~lOS-, 7S ___._ ~~~ ~iCl'I~r BIB - ~rtdo /~Sr1. ._____._ ~~.~z•05' ~6, nvSrmuSfer o~1 d ~. ~ ____- _ __ ~~- ~ ~1 mod; ~so~~/ she f c~.~r'F. ,~,~~b. t c,~ds F. sti; ~t~s ~ _ _ ¢~~. ~ _ ____ ~ ~. p `D`I ~vi Gc ~ /JIr5r5/D~'1 G ~~r ~ ,- y3 - sa ~{ q. .1. erns o~ Ctia c~ 5~ s ~ ~ 6v~' .,~ ~~ ~ ~ a~f~ l i ~ ~ ~r ~GJI'~%~YGnf ~Iee ~Q~___~_ ~ -- . . a~kP.~ic~ ~~~C 7D3 /~t~affvrs t,0i~ A~~ssion ~9 9qs-, . ~i11 e Il0/ j~T ~ ~/hl~iLes / /~l/'R r T ~• 6 , ~ ~i/1C 1ao~ ~4. f ~c% ~l @e~,l~ l S r ~ f,~_ 95~`~. o D . 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I[a~IIONa~ 1~r.TlriJk/~Oi13: ~`s o~ <i nt. ~a aeon talc ~i' ~ o ~ 375, oe p~~ *~s. ~ ~~ - • ~'1~1 I G1~a~~ ~ • ~Da,~iS, mi ~G• W ~w~ Bu L`a v~c~ o w~, Ott p . ~.-r 5 «-fe __ ~ .____ I ~° o ' °~ ___ ------------ - --~~G G1r1 ~ N k a~i ctrl ~ ~ ~ ----~~ ~ .____- _____ ~ ~ `~ S ~ hit. /-~.~ ~n ~ n. ___._.. _.~.__ ~~~ ~~~_~__.~ li,S, ~'~'I ~S~'. ~or"l~ ~r-t__ ~' ado _ ih.._.r,~~,,- ~,r Sa.le,._.___..__w.__ ______._.__..._.-W_ _ _.._-___ 3 zO •c __...__ ____ ~~ L~ ~ ~ Lands ~ r ~~ ~. ~~~~~~..~.,~~-~~~"-~~ mu~'l s /'L ._ ,ar ____ _ ~? ~~ ~~ s. _- .--_.______.___ s--~ ._______._.___~~._____._~__._ ~ __.~_______-__-_ __~._ __ 38.oa --' Dios. ~~ Go. ~~~ fir. /~~~ ss~-_~°_ _ __..__----_--- ~~ ~ ! - ________ _. ~~ ~~ _.____________-_-- --.____~.._~_____________._.~_~____________ __ ___.~3~.oS" ~~ ~ S rs _.___~_._ _._._____ __ ____._____------_ . --~.____. __~ ._ _ ~6 3,77 f~h5 fht ~S~G1- __ _ ~ $'. ~D -_ _. _ _..___ __ ___.___ ~ _' _ Ply./b ' ~~ (v9' G L ~ b' 3- ~__._~_.__ 1 ,~ ~~ 5~, Q;~~~vfioaa/ Lrior•C' ~-- ~orra~v ~~~~ ~ ~_s~ ~___ _______ _.._.__ -- - --- --~--- ~ --..__ ..~~__. mow' - __ os: ~~Z _ __.~_______ 1ST _-~~l2~i~ _ ~ __--____-____.. _..~_ _ ____ __-------.___-- _-~ 3 z.o , $ . ~ QL ~ o~~,'jF~ T9 _____.__.__ __..._ --.___ _r Re~+~wbur-semu~s ~ C~-~~es ~, Sh;e~lds ATE' ~r ~~. ' s~--ip _~.__._________ _.. ____.__ ..~z _._ _. _ _.. __--_ _... __-_ ___._ ~er~,~; e~! Inc,-1-'n _ i~es~~.~ _ _...-____ _ __ ________ -_ --__ __ __ ~~ ~..e~fiG~.__._~______... __ _ .._ _ __300, flc KC I f-111u I niJ r~.lR i i~..,+i~ rvl~ I ~.AIJI\ 1\L_t..Vl\IJJ~~ I / ~ ~`~rs so REMITTANCE ADDRESS BILL TO THE SENTINEL - LEGAL CHAF',LES SHIELDS P_O. BOX 130, CARLISLE, PA 17013 AD NUMBER CLASS SALESPERSON BILLING DATE LINES 375492 10 PUBLIC NOTICES shiek 10/16/09 24 * 2 AD DESCRIPTION START DATE STOP DATE EXECUTRIX'S NOTICE LETTERS TESTAME 10/02/09 10/16/09 PUBLICATION INSERTIONS RATE NET AMOUNT GROSS AMOUNT 3 THE SENTINEL - LEGAL 3 LGL 127.44 TOTAL AD CHARGE 127.44 3 PROOF OF PUBLICATION DAYS RUN O1PRF ~ 7.00 PURL"ASE ORDER PAY TH lS AMOUNT 13 4.44 Est Geraldine Massey 161.33* * AFTER 1 1 /15/09 MESSAGE: - - - Thy _ - ._ T _ ATTY CHARLES~?E. SHIELDS 11~~ oslo7- 1392 De~ ~_. -s~cLOUSER R~._ :___, ~: _- _ _. 3~76I5/360 ~~y at ~~ 5 ~~ =- -_ ~ MECHANICSBURG, PA 17055-9735 _ __ _ _ . _ ~ ~ 9 _ _ - ~ : ~292~ ~ - m~ Thl ~ - ;. ~: - lm - Date ~turday 1 S -:. `- ~Y to the f ~ ~~ ~ If order-o ~- _ _ _ . _ ~ G~~ ~ ~ / . g.~ ~„ L Clc G~ _ Do [lars ~ oa:,~: s~ - B~CM. Fa: - Citizens Bank- - _: Yoi _ ~ ~~ ~ - _ .. nberlink. com _ PlE Pennrylvania _ - `~n attachment -For ~ .~~, ~ ~_ ~: 0 3 6 0 7 6 15 0 ~: - 2 `L 5 5 5 L~~2:4~8 I~~ ~-3 9 2 ~~a~~~~ DETACH AND RETURN THfS PORTION WITH YOUR PAYMENT THE SENTINEL -LEGAL Est Geraldine Massey P (~ R(7X '13n C'ARI ISI F PA '17(7'13 AD NUMBER CLASSO START DATE STOP DATE 375492 PUBLIC NOTICES 10/02/09 10/16/09 AD DESCRIPTION BILLING DATE TELEPHONE NUMBER EXECUTRIX'S NOTICE LETTERS TESTAME 10/16/09 717-766-0209 CHARLES SHIELDS 6 CLOUSER ROAD MECHANICSBURG, PA 17055 1~~~!!l~~~l~l~~~~l~l~~l~~~~~l~!! GROSS AMOUNT OF 161..33 DUE AFTER 1 1 /15!09 TOTAL AMOUNT DUE 134.44 ENTER AMOUNT ENCLOSED r/3~,~~ 20200000003754920000000000000001613300000134448 ~,RdF .n~,,.r `. .w 4: i.~rrlll~ Lli VI.I.ICI~J .[' ullCl~dl 11V.[IICI 1111.. 630 South Hanover Street Carlisle, PA 17013- {717)243-2421 September 14, 2009 Ellen B. Rundle 62 S. Pin Oak Dr. Boiling Springs, PA 17007 The Funeral Service for Geraldine K. Massey We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way we can. Please feel free to contact us if you have any questions in regard to this statement. THE FOLLOWING IS AN ITEMIZED STATEMENT OF THE SERVICES, FACILITIES, AUTOMOTIVE EQUIPMENT, AND MERCHANDISE THAT YOU SELECTED WHEN MAI{ING THE FUNERAL ARRANGEMENTS. 1. PROFESSIONAL SERVICES Services of Funeral Director/Staff , $4795.00 FUNERAL HOME SERVICE CHARGES - $4795.00 SELECTED MERCHANDISE: 32 Oz Courtney Solid Copper $4490.00 THE COST OF OUR SERVICES, EQUIPMENT, AND MERCHANDISE THAT YOU HAVE SELECTED $9285.00 Cash Advances Clergy/Mass Offering, . Certified Copies of the Death Certificate , Flowers . The Sentinel with Photo , The Patriot (Shorter Version no photo) The Huntingdon Daily News Photo. Hairdresser, Corrected Memorial Folders, TOTAL CASH ADVANCES AND SPECIAL CHARGES . Total Total Cost . SUB-TOTAL INITIAL PAYMENT /DISCOUNT /CREDITS TOTAL AMOUNT DUE The unpaid balance over 30 days is subjected to a 1.50 % service charge per month - 18.0000 % per annum. $ l 50.00 $36.00 $185.50 $149.78 $104.07 $45.00 $40.00 $50.00 $760.35 $10045.35 $10045.3 5 ~ 100.00 ~~' _ Ir' 9945.35 ~ ~ ~ e'-j- I~-eN 2T $ _ ~ 6 ~e ~~~~~ Vc( ~ {LrrJ /~~^/ ~~; ~~ ~~ 3409 MADE IN U.S.A. -~- £aryr nloaa Relocation saviaa INVOICE Moving items for Ellen Rundle from Bethany Village, Maplewood Assisted Living Apt. # 204, 325 Wesley Dr., Mechanicsburg, Pa. to 13 Kensington Square, Mechanicsburg, Pa. on September 19, 2009. LABOR: Labor for September 19, 2009 - 78 X hrs. _ ruc Expense-__ _ _ . _ - . _ 65.00 Fuel Expense `-----._~- ... ...... ...... 30.00 Total Amount Due ~'~~ j,~_~~ $ 1~ .~ , t~ b Labor charges are calculated round trip from our facility in New Cumberland and back. Please make your check to: Mike Wyckoff ~ ~ -~- ~ ~ ~~ `-~~ G' REV-1512 EX+ (12-03) SCHEDULE 1 COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES, & LIENS RESIDENT DECEDENT ESTATE OF F{LE NUMBER /l1 ~ ss F y, G'ER~G,~/1vE" ~ ~~~- 0 9- ~ S~ ~ Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. VALUE AT DATE ITEM NUMBER DESCRIPTION OF DEATH ,. ~~n>na ~• ~~ G~o>v~,nu,e , Sul. duc on pP,rron~,! ~r-~- +~x, ~o`~ ~~ ~9. o0 ~P ' ~ ~'tcre i~,'C ~~3 9.8'S ~. Canf ~ncc-n~ ~ 3, ~efih ~n ~i !1 a y e, ~%nal ~~y m ~~ ~ f 3, o00 . ~ 7 Y 'F . ~3 on ~'re K. ~ i f le r, pP.~r' e~p,~a -fax '~/~ . o0 TC?TAL (Also enter on line 10, Recapitulation) $ ~ ,3, 6.30, D~ (!f mare space is needed, insert additional sheets of the same size} n~v-io~o t~+ la-uu) SCHEDULE J COMMONWEALTH t)F PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER ,/YI ~-s~s~; G'~a2,~¢~~/~E ~<- ~~--o ~- ASS RELATIONSH{P 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)J 1. $FF ~Nre-T 1~T~'~~NED ~n ~N~s -S ~-H-ai; D 1~ C ~ ~'. ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 TH ROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) SCfrt~.auG.t~' cT. _ _ ..___ :*_ _ _ .._._ ~ ~ .. _ ...Tana} J'. Cv ~ ckard Si ~X' I S ~ r~s- ..._.. rn__..~_....._.~....w.. d~° -_.._. _ w........ __ _ _. .._ - --L+-_. __... __.. _ .._ ___...~.____ _ _ _. _ , __ _ l.~ C~.rl~`slc~ __/~~ ...17a~3. __- _ _._ __. _ __ _ _ ~bort~ ~, Sh~~cfs~ S~Sf~tr _ . _ _ _._ __ _ __ __!_°..,~o_ks%dre,e..___ _~__._. _ _ _ _ _ _ _ ___._t~., ____ __ __. yr z~ 6 std G. __ . t.~t,__Gtn%o~,_P,~-___/7~~6,.._ _ _ yS T~tm7 Scl~cd.G. ~. harry _.. ;~. _Corer~'~__ ~_ra•_ _ ~. _ _ ~~ ~.~ r-~s;d.~~e _.. _._ I h roc „~'ri ~~S P~- )? zr~c j ._._ . _ 1.. _ ._... ..... _ .... ._ __._.. .., ..E-_..~_ _ _.. .... _ _ _... ,._W..._... _... _. .._ ._...... __.._ - _. k~,., __._._._.. ..__,.....~..~-,..... ..._~......... ,. .. 1 ~ __ ..~'Ylc~r~~lla G. 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M ~}SS Ley _ .___.~_ _ _ __ _ __..___ _ _.._ ~ I~~Q_ _. ~~~!~~a_..! _.,~._.n.~~_._.. _._ _ ........ __~__..._.~__.____ ~1--~-- ,: _.._____.______._ _.__._._~ ~._~r/;S~c~ .~A._..__../70!3.__----------_--___ _.~.-_--..__________.. _ ~~. ~r; qn GtJ~ ckar~ _________.._.._.____ .--..__...~__~r__ ,._.__ _ ~.__-.---_.~.._-______.. ____.____.v. _.____.___-~____ ----_.____~_____.._._.____. ~ - __. _ . -_._ _ ~.___w_ .__ _..._~. r...____ _...._ -- . - is ii ~ T~ __ _ _ __ ......._._ ._ ._. _ _ _____ _~. _ _. __ t_~ __~~_ r'Ol G _e _ _~~a.w.~iy~_~._. __....1~_~ r-~C ~~ U ~ .~_~D__~'-~____..~~..~'t_a_n__________._ ..._____.... 1 ~ ..~..~___.~.._._~_.___..._._~ ~.__.,~._._. ~....D _ ._ y~ .~~ 6. ~.~.~ S s ~cs.'~ __. ___. 4___ __-_ ...._.~ _. - _____.,d._.__._..~._ _._.___.. . Zf c~ _.l - _ ~~c~G~-_... _. Sao hrs;duc ~f ern S: ~ict~ -Gr ~g ~~ ~. S~d.~ ~~ -. sch~d. ~ LAST WILL AND TESTAMENT 4F GERALDINE K.1 MASSE Y I, Geraldine K. Massey, of Hampden Township, Cumberland County, :Pennsylvania, declare this to be my Last Will and Testament and revoke all Wills and Codicils previously made by me. ITEM I: I direct that all my legally enforceable debts and funeral. expenses, including all expenses of my last illness, shall be paid from my residuary estate as soon as practicable after my decease as a part of the expense of the administration of my estate: I direct that my funeral arrangements be handled by Ewing Brothers Funeral Home of Carlisle, Pennsylvania, that my burial service be conducted by a Roman Catholic priest„ and that my body be interred in the Cumberland Valley Memorial Gardens, Carlisle, Pennsylvania. Further, I authorize my personal representative(s) to expend funds from my estate, in such amount as my personal representative(s) shall consider necessary and desirable, for the purchase, erection and inscription of a suitable marker for my grave. ITEM II: I direct that all of my tangible personal property and all of my real property be sold at public or private sale by my personal representative(s), and I further direct that the net proceeds thereof shall be administered and distributed as a part of the residue of my estate. ITEM III: I devise and bequeath the residue of my estate of every nature and wherever situate, including any property over which I shall have any power of appointment, to the following named individuals in the percentages set forth herein: A. My sister, Janet J. Wickard, of Carlisle, Pennsylvania - i~ 5% B. My sister, Deborah S. Shields, of Mt. Union, Pennsylvar,~ia - 10% C. My brother, Barry R. Covert, of Orbisonia, Pennsylvania. - 10% D. My sister, Marcella B. Williams, of Chambersburg, Pennsylvania - 10°% E. My sister, Dorothy A. Bock, of Fannettsburg, Pennsylvania - 10% F. My niece, Sharon S. Spencer, of Marysville, Pennsylvaniia - l U% G. My niece, Ginine Jordon, of Gettysburg, Pennsylvania - 10% H. My niece, Monda Wickard, of Carlisle, Pennsylvania - 10% I_ My nephew, Brian Wickard, of Carlisle, Pennsylvania - 5% 1. My great-niece. Gracie Stayman, of Chambersburg, Pennsylvania - ~% ``'' r `~ f~/q, / K. My friend, Michael D. Koth, of Manheim, Pennsylvania - 5% With regard to the foregoing bequests and devises, should any of the above named persons, with the exception of Michael D. Koth, predecease me, I devise and bequeath his or her share of my estate to his or her issue, per stirpes, surviving me, and in default of any such issue, his or her share of my estate shall be added to the shares for the -other named persons, or theil- issue. In the event Michael D. Koth predeceases me, his share of my estate shall lapse and be distributed proportionately to the other named persons, or their issue. ITEM IV: I appoint Citizens Bank, of Carlisle, Pennsylvania, guardian of any property which passes, either under this Will or otherwise, to a minor and with respect to which I am authorized to appoint a guardian and have not otherwise. specifically done .so, provided that this appointment of a guardian shall not supersede the right of any fiduciary in its discretion to distribute a share where possible to the minor or to another for the minor's benefit. Such guardian shall have the power to use principal, as well as income, from time to time for the minor's support, health and medical care, and education (including college education, both undergraduate and graduate), or to make payment for these purposes, without further responsibility to the minor or to any person taking care of the minor. ITEM V: All federal, state and other death taxes payable because of my death, with respect to the property forming my gross estate for tax purposes, whether passing under this Will or otherwise, including any interest or penalty imposed in connection with such taxes, shall be considered a part of the expense of the administration of my estate and shall be: paid out of the principal of my residuary estate without apportionment or right of reimbursement. ITEM VI: I appoint Ellen B. Rundle of Boiling Springs, Pennsylvania Executrix of this my Last WiII. ITEM VII: I direct that all fiduciaries acting under this Will, whether or not named herein, shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal, this _ 2~~ day of ~.~ , 2006. ~~'/~~~~~,~~.~~~~C~ /7~t~+~r [SEAL] C The preceding instrument, consisting of this and two (2) other typewritten pages, each identified by the signature of the Testatrix, was on the date thereof, signed, published and declared by Geraldine K. Massey, the Testatrix therein named, as and for her last Will, in the presence of us, who at her request, in hei• presence and in the presence of each other, have subscribed our names as witnesses hereto. ~~: ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND We, Geraldine K. Massy, Michael R. Rundle and ~~~_~ ~ ~9 jnev~~a~ the Testatrix and the witnesses, respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and that she has signed willingly, and that she executed it as hei- free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as .witness and that to the best of his/her knowledge the Testatrix was at that time eighteen (18) years of age or older, of sound mind and under no constraint or undue influence. ~~~,~~~~ /~~ r~ Testatrix Witness i ness Subscribed, sworn to and acknowledged before me by Geraldine K. Massey, the Testatrix, and subscribed and sworn to before me by Michael R. Rundle and -E~ , ~-l ~e v~s~v~, the witnesses, this 2-~ day of _ t.z Ug~ , 2006. ~--~-- NOTARIAL S. Staei L. Snyder, No ]?ublic Carlisle Bora., Cumberland County My commission expires July I5, 2Q08