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HomeMy WebLinkAbout12-30-10 (2)1505610140 REV-1500 EX (01-10) PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number PO Box 2sosol INHERITANCE TAX RETURN 2 1 1 0 0 2 3 1 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 0 6 9 1 4 4 8 1 8 0 2 2 7 2 0 1 0 0 6 0 5 1 9 2 2 Decedent's Last Name Suffix Decedent's First Name MI McLaughli n Dorothy F (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Non e Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required death after 12-12-82) 0 Q 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax 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 Scot t W. Mor r i son, Esq 717 582 2300 ~...~ REGISTER ~~S USE O~ r n ~ ~ nr~ ' ` ~.. d L...,.y First line of address I ~ , ~w~/ ~~~ O :.~, 6 West Main Street Second line of address ~ ~~ ~ ~~ E rV P O. Box 2 3 2 ,~ Cit or Post Office State ZIP Code D~ FILED a Y New Bloomfi eld PA 17068 Correspondent's a-mail address: Under penalties of pery'ury, t declare that I have examined this return, including acxompanying schedules and statements, and to the best of my knowledge and belief, it is tru rrect and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIG RE OF PERSO X61 OR FI ETk1 ~ DATE C/ 20/ A RESS 3 Conn' Drive Mechanicsbur ~ 124 Point 'd a Drive York PA SIGNAT R E THAN REPRE IVE ~ D TE 1 2. ~~ o A P ox 232 New Bloomfield PA 17068 PLEASE USE ORIGINAL FORM ONLY Side 1 1505610140 1505610140 J 1505610240 REV-1500 EX Decedent's Social Security Number Dorothy F. McLaughlin Decedent's Name: 0 6 9 1 4 4 8 1 8 RECAPITULATION 1. Real Estate (Schedule A) ........................................... 1. 9 0 0 0 0. 0 0 2. Stocks and Bonds (Schedule B) ...................................... 2. 0 • 0 0 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. • 4. Mortgages and Notes Receivable (Schedule D) .......................... 4. • 5. Cash, Bank De osits and Miscellaneous Personal Pro e p p rty (Schedule E)....... 5. 5 2 9 2 0 . 9 9 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 6. • 7. Inter-Vivos Transfers 8 Miscellaneous N n-Probate Property (Schedule G ~] S Billi R ) eparate ng equested ....... 7. 8. Total Gross Assets (total Lines 1 through 7) ........................... 8. 1 4 2 9 2 0 . 9 9 9. Funeral Expenses and Administrative Costs (Schedule H) .................. 9• 1 5 5 1 9. 2 4 10. Debts of Decedent, Mort a e Liabilities, and Liens Schedule I 9 9 ( ) ...... ....... 10. 1 6 1 2 9. 5 2 11. Total Deductions (total Lines 9 and 10) ........................ ....... 11. 3 1 6 4 8. 7 6 12. Net Value of Estate (Line 8 minus Line 11) ..................... ....... 12. 1 1 1 2 7 2. 2 3 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ............... ....... 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ............... ....... 14. 1 1 1 2 7 2. 2 3 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a>(1.2> x .0 0. 0 0 15. 0. 0 0 16. Amount of Line 14 taxable at lineal rate X .045 1 1 1 2 7 2. 2 3 16, 5 0 0 7. 2 5 17. Amount of Line 14 taxable at sibling rate X .12 0. 0 0 17. 0. 0 0 18. Amount of Line 14 taxable at collateral rate X .15 0 0 0 18. 0. 0 0 19. TAX DUE ............................................... ....... 19. 5 0 0 7. 2 5 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ^ Side 2 1505610240 1505610240 J REV-150 EX Page 3 Decedent's Complete Address: File Number 21 10 0231 DECEDENT'S NAME Doroth F. McLau hlin STREETADDRESS 2100 Bent Creek Boulevard CITY Mechanicsbur STATE PA ZIP 17050 Tax Payments and Credits: ~ ~ Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 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. (1) 5,007.25 Total Credits (A + B) (2) 0.00 (3) 21.95 (4) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 5,029.20 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; ............................... ^ Q c. retain a reversionary interest; or ................................................................................................ ^ d. receive the promise for life of either payments, benefits or care? ....................................................... ^ 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................... ^ Q 3. Did decedent own an "intrust for" or payable-upon~ieath bank account or security at his or her death? ......... ^ Q 4. Did decedent own an individual retirement account, annuity or other non-probate property, which contains a beneficiary designation? .................................................................................................. ^ ^X IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN For dates of death on or after July 1, 1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an adoptive parent or a stepparent of the child is 0 percent [72 P.S. §9116(a)(1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. • The tax rate, imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1502 EX+ (01-10) Pennsylvania SCHEDULE A DEPARTMENT OF REVENUE REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Dorothy F. McLaughlin 21 10 0231 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 that is jointly-owned with right of survivorship must be disclosed on Schedule F. Attach a copy of the settlement sheet if the property has been sold. ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE NUMBER OF DEATH DESCRIPTION Tract of land with improvements located at 55 South 19th Street, Camp HIII, PA 17011; 90,000.00 See Cumberland County Deed Book "S", Volume 20, Page 37 attached hereto; Sold to Dean L. Foote and Elizabeth P. Knouse on November 19, 2010 -See settlement statement TOTAL (Also enter on Line 1, Recapitulation.) I S 90,000. If more space is.needed, use additional sheets of paper of the same size. REV-1 ~i08 EX + (6-98) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. IN REST ENT DECEDENTRN PERSONAL PROPERTY ESTATE OF FILE NUMBER Dorothy F. McLaughlin 21 10 0231 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. PSECU Account #0175 S01 92.55 2. PSECU Account #0175 04 16,431.84 3. PSECU Account #0175 07 23,842.71 4. PNC Bank checking account #5140040605 7,357.95 5. Sale of personal property -see attached Fahnestock Auction Service statement 3,111.00 6. Real estate taxes and sewer refund -see attached settlement statement 1,236.14 7. Scott Bendensky -sale of personal .property 50.00 8. Keystone Oil -refund 775.80 9. Allstate Insurance -refund 23.00 TOTAL (Also enter on line 5, Recapitulation) ~ S 52, 920.99 (If more space is needed, insert additional sheets of the same size) REV-4511 EX+ (10-09) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Dorothy F. McLaughlin 21 10 0231 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Myers-Harner Funeral Home 6,729.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City State ZIP Year(s) Commission Paid: 2, Attorney Fees: SCOtt W. Morrison, Esquire 8,340.00 3. Family Exemption: (If decedents address is not the same as claimants, attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4. Probate Fees: Glenda F. Strasbaugh, Register of Wills 81.50 5 Accountant Fees: 6. Tax Return Preparer Fees: 7. Cumberland Law Journal -estate advertising 75.00 8. Sentinel -estate advertising 293.74 TOTAL (Also enter on Line 9, Recapitulation) I $ 15,519 24 If more space is needed, use additional sheets of paper of the same size. REV-1512 EX+ (12-08) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE R DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER _Dorothy F. McLaughlin 21 10 0231 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Fahnestock Auction Service -commission 1,088.97 2. Costs to sell real estate -see attached settlement statement 1,567.50 3. ROBC Limited -nursing home costs 4,153.06 4. Alert Pharmacy -medical account 302.42 5. PA American Water -water bills 337.32 6. PP&L -electric bills 438.65 7. AT&T -phone bills 38.16 8. Health South -account 9.00 9. Susquehanna Internal Medicine -account 10.00 10. Crumay Parnes Associates -account 66.72 11. UGI -gas account 146.44 12. Martson Law Office -guardianship 645.00 13. R. William Associates PC -tax preparation 840.00 14. State Employees Retirement System 668.72 15. Family Ford -car inspection 8~ detailing 107.60 TOTAL (Also enter on Line 10, Recapitulation) I ~ 16,129.52 If more space is needed, insert additional sheets of the same size. Continuation of REV-1500 Inheritance Tax Return Resident Decedent Dorothy F. McLaughlin 21 10 0231 Decedent's Name Page 1 File Number Schedule I -Debts of Decedent, Mortgage Liabilities, ~ Liens ITEM NUMBER DESCRIPTION AMOUNT 16. Safeguard -estate check printing 90.68 17. Borough of Camp Hill -sewer bills 217.50 18, Penn Waste -garbage 97.50 19. Comcast -account 151.21 20. Janet L. Miller, Tax Collector -2010 taxes 2,618.98 21. Scott Bendinsky -cleaning out house contents 1,130.64 22. Cordier Antiques & Auctions -commission 1,103.45 23. Procopio Landscaping Services -mowing 300.00 SUBTOTAL SCHEDULE I 5,709.96 GRAND TOTAL SCHEDULE I ~ 16,129.52 REV-1513 EX+ (01-10) Pennsylvania ~ SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Dorothy F. McLauahlin 21 10 0231 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outs' ht spousal distributions and transfers under Sec. 91 T6 (a) (1.2).] 1. Melissa McLaughlin, n/b/m, Melissa Humer Lineal 3 Connie Drive one-half Mechanicsburg, PA 17050 2. Dennis A. McLaughlin Lineal 124 Pointe Ridge Drive one-half York, PA 17402 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER S HEET, AS APPROPRIATE. II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. S Ir more space is needed, use additional sheets of paper of the same size. LAST WILL AND TESTAMENT OF DOROTHY F. McLAUGHLIN I, DOROTHY F. McLAUGHLIN, of Camp Hill, Cumberland County, Pennsylvania, being of sound mind, memory and understanding, do hereby make, publish and declare this to be my Last Wilms and Testament, revoking hereby all wills and codicils at an~t~,:; - me ~ '~'-i ~- ~t~ <. heretofore by me made . r".;:~,~.~ _ ~ ~_._ I. =-~ .. _ ~-.. ~~ I direct that all of my just debts, together with the expenses of my funeral and the cost of a gravemarker, be paid as soon as practicable after my~death. II. I give, devise and bequeath all the rest, residue and remainder of my estate, both real and personal, of whatever kind and wrieresoever situate, of which I shall die possessed or of which I shall be entitled to dispose at the time of my death, to my beloved husband GROVER H. McLAUGHLIN. DOROTHY F. McLAUGHLIN PAGE ONE OF THREE PAGES III. In the event my husband GROVER H. McLAUGHLIN shall predecease me, dies simultaneously with me or dies within thirty (30) days after my death, my aforesaid devise and bequest to him shall lapse and, in that event, I give, devise and bequeath all the rest, residue and remainder of my estate to my beloved son DENNIS A. McLAUGHLIN and my beloved daughter MELISSA A. HUMER, per stirpes. IV. I hereby nominate, constitute and appoint my husband GROVER H. McLAUGHLIN as Executor of this my Last Will and Testament. In the event he shall for any reason fail to qualify, or having qualified shall cease to act as Executor hereof, then I nominate, constitute and appoint my son DENNIS A. McLAUGHLIN and daughter-in-law MELISSA McLAUGHLIN as Alternate Co-Executors of this my Last will and Testament or, in the event one of them predeceases me though I nominate, constitute and appoint the survivor as my Alternate Executor or Executrix, as the case may be. V. I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of the administration thereof, without apportionment. DOROTH F. McLAUGHLIN PAGE TWO OF THREE PAGES VI. I direct that no person serving as Executors of this Will be required to enter security in any jurisdiction in which they might act. /()~~/~ IN WTTrdESS WHEREOF, I have this ~ v day of 2006 hereunto set my hand and seal. Signed, sealed, published and declared by the above-named Testator, DOROTHY F. McLAUGHLIN, as and for her Last Will and Testament in the presence of us, who, at her request, in her presence and in the presence of each other, all being present at the same time, have subscribed our names as witnesses. WITNESS: ~:~~ ~~/ ~ `~~ \ of ~~ ~ >'`~~- DOROTHY F:~ McLAUGHLIN PAGE THREE OF THREE PAGES COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN We, DOROTHY F. McLAUGHLIN, Thomas P. Lyon SS Herschel Lock and the Testatrix and the Witnesses respectively, whose names are signed to the attached or 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 had signed willingly, and that she executed it as her 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 witnesses and that to the best of their knowledge the Testatrix was at the time Eighteen (18) years old or older, of sound mind and under no constraint or undue influence.. c-'_"_. ~ DOROTHY F. McLAUGHLIN ' !!''~~ 7 I Subscribed, sworn to and acknowledged before me by DOROTHY F. McLAUGHLIN, the Testatrix, and subscribed and sworn before me by Herschel Lock WITNESS /~ WITI~T SS and Thomas P. Lyon witnessed, t is.~' day of , .~,2.~. 2006. ~~ ~`. 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(i~ Aa~i ~ ta. rterisl w~~ k Arnii- ~e2eae4dN/, tw ritd eriiali~- • ie IN~r /~ I . eat toawnr a !Ar'+~att e~INR, ~ • • { . ALL THJIT dtfl'l'11iN 'tl11Ct Ot parcel o! land situate in th0 iOrOOgh Ot caeip Hlli. County oi~ Cumberlan0~ Bta~e of pennfyivania, • ire ~• pattiCularly bOUOdAd a~ doweribeA aeQe~Nin~ t0 a ou~rwy prepssai by D. P. Aa##eneperger, 5egiatered• Svrwyos. •dtted ootobsr 3. 1956; • ee A=GINNING at a point on tbe.eaatezly line of South 19th sweet, vhich' ,. i+ot~t io one 'hund~taa (1001 • Beet nostb 'ot tt-e •interneetson or tt-e ,easel , . line of South 19th 6treet with the nostherly line of~?hsi'd oereset ') { thence Horeb 3Z° 30' wsat'along the easel easterly line of South 19tl+' ' Street 'fifty (501 fAwt +e a pcfnt; lheneo roxth S7o 70' ooo! a dselenes `~ of one hundred and ewf~nty tiZ01' test to a •ataxe to the 'wieetecly lice o! a tventy t201 '1Eoot aileyt aout]i 3=° •30' eset along We~ laid sins o! t~ a11eY tiftY t50) feet eo s~ stakes en thw line• dfvillnq' Lego Moe, sop sae•• • •. , 200 oh the hereinafter me~tionad plan of iota; Wuxh'S7° 30' west alolnq its asst ~ntioaed tics one Ao~>tf0 ano twnEj- (l20) feet to a point .OM1 ' .the' easterly line o£ •Sovtb 19th Btreet~ cJis plies 'of tliori~atc. • •1 1 as:~ Loto Nos. zoa er+d Z01, en0 ~ sOUCkes'n teCl (301 teat O! Lot eto: ~ 202 On the ylaa o~E J. L. liey~d, which pis» ie •secosded in the otlice !Pr• I • the recording of Oesaa in and #or Cusab~riand County. P.enneylvania- ie~ plwn Ao°1t 1. Da•~o t5. ~ ~ ~ { • .1 flAVi11G tber~on ereeeed 's one • end one=Lest etoly oricic and tract aroilF I tl1~i lloeee known and nuwberad ii ~e_ S~5 iooel-' 19.sb Street.. { ~' ~ ' ' ' sszao• t~s samQ pso~~see wnicb aslpt- RairDeekeir- ••dr., i~d Bslirr K. Bar:-I' ~ backer. hl.f riffs. bY, tlwis deed d~Ced the 3t>th day of Oelobes 19Sti' =eQO~ed00 in the recos~lar'e office atoressLd 5r1'Oeed• Yoo1c tl~ Vbi. ld- ~ ~ legs 466 9riwted and conveyed unto 711~1irw D. C1ayC01t~ Jl. - anl~.•Rub1r, Clayton, hie wi#e. ~ ~. ': '. ' '• m.=Ocl~~2~~ 2010 3~24PM •Franklin Real E~lale Caili~le •. .. Nu~1049 P~ 4 .. . 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Items marked '~POCJ" wen: paid outside the closing; they are shown here for informational purposes and are not included in the btals. 1.0 3AB (FOOIE.KNOUSESSSI9THST.PFD+08.5~2006A) D• NAME AND ADDRESS OF BORROWER: Dean L. Foote and Elizabeth P. Knouse 55 South 19th Street Camp Hill, PA 17011 E. NAME AND ADDRESS OF SELLER: Estate of Dorothy F. McLaughlin F. NAME AND ADDRESS OF LENDER: INTEGRITY BANK G. PROPERTY LOCATION: 55 South 19th Street Camp Hill, PA 17011 H. SETTLEMENT AGENT: 68-0510988 Community Land Transfer, LLC I. SETTLEMENT DATE: November.l9 2010 Cumberland Courity, Pennsylvania PLACE OF SETTLEMENT 2331 Market Stroet Camp Hill, PA 17011 , J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRA NSACTION 100. GROSS AMOUNT DUE FROM BORROWER: 400. GROSS AMOUNT DUE TO SELLER: 101. Contract Sales Price 90 000.00 401. Contract Sabs Price 90 000.00 102. Peradnal Pro a 402. Personal Pro 103. Settlement Cha es to Borrower Line 1400 3 032.25 403. 104. 404. 105. 405. ' Ad ustments For Items Paid 8 Seller In advance A ustmants For !tams Pefd B Ssllerln advanee 106.. G /Town Takes to 406. C !Town Taxes 10 107. Court Taxes 11/19/10 to 01/01/11 91.93 407. Court Tsxes 11/19/10 to 01/01/11 91.93 108. School Taxes 11/19/10 to 07/01/11 1 110.32 408. School Taxes 11/19h0 to 07/01/11 1 110.32 109. ~ 409. 110: 4th Qtr. Sewer 11/19H0 to 01/01/11 33.89 410. 4th tr. Sewer 11/19/10 to 01/01/11 33.89 111. 411. ' 112. 412. ?20. GROSS AMOUNT DUE FROM BORROWER 94,268.39 420. GROSS AMOUNT DUE TO SELLER 91,236.14 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER: • 201. De osit or earnest mon 2 OOO.DO 501. Excess De osit See Instructions 202. Princi al Amount of New Loans 108 500.00 502. Settlement Cha es to Salter Line 1400 1 567.50 203. Existin loan s taken sub act io 503. Exiatin loans taken sub act to 2~• 504. Pe ff of first Mortge a 205• 505. o second Mo a e 2~• 50B. D osit retained b sailer 2 000.00 207. 507. 208. 508. 209. 509. Ad'ustments For Items Un aid B Seller A ustments Far Items Un ald 8 Setter 210. C . !Town Taxes to 510. Ci /Town Taxes to 211. Court Taxes to 511. Court Taxes to 212. School Taxes to 512. Schoot Taxes to 213. 513. 214. 514. 215• 515. 216. 516. 217• 517. Escrow for inheritance Taxes to Commun Land Tra 8 075.00 218. 518. 219. 519. 220. TOTAL PAID BY/FOR BORROWER 300. CASH AT SETTLEMENT FROMITO BORROWER: 301. Gross Amount Dus From Borrower Line 120 302. Less Amount Pak! B 1For Borrower Line 220 110,500.00 84 268.39 ( 110,500.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 800. CASH AT SETTLEMENT TO/FROM SELLER: 801. t3rosa Amount Due To Salier Line 420 802. Lass Reductions Due Seller Line 520 ( 9,642.50 91 236.14 :' 9,642.50 '303. CASH ( FROM) (X TO) BORROWER 16,231.81 603. CASH (X TO) ( FROM) SELLER 81,593.64 i rte undersigned hereby acknowledge receipt of a aomplatad copy of pages 1 iL2 of this statement & any attachments referred to herein. Borro~r ~~~~~~' De .Foote ~F1 ab th P. Knouse Seller Estate Dorothy F. McLa~gh •n _ ~ennls A. McLaughl' , cutor BY: t ~~ivr ~.w . ~a~ -~.lrLL~d/~~ Mali sa Humer, Co-Executor ~ L. SETTLEMENT CHARGES 700: TOTAL COMMISSION Based on Price ~ % PAID FROM PAID FROM DiVisron o mmission Iin@ 700 8S FO/IOWS: 6oRROWER'S SELLER'S 701. ~ t0 FUNOS AT FUN0.S AT 702.5 t0 SETTLEMENT SETTLEMENT 703. Commission Paid at Settlement 704. to 800. ITEMS PAYABLE IN CONNECTION WITH LOAN 900. ITEMS REQUIRED BY LENDER TO BE PAID iN ADVANCE 901. Interest From 11!19/10 to 12/01!10 ~ S /da ( 12 da s % 902. Mo a e Insurance Premium or months to 903. Hazard Insurance Premium for 1.0 ars to 904. 905. ' 1000. RESERVES DEPOSITED WITH LENDER 1001. Hazard Insurance months $ er month 1002. Mo a e Insurance months S er month 1003. C' /Town Taxes . months S r month 1004. Coun Taxes months S r month 1005. School Taxes months S per month 1~• mont a S r month 1007• months l~ S per month 1608• months S er month 1100. TITLE CHARGES 1101. Settlement or Closin Fee to 1102. Abstract or Title Search to 1103. Td min tion to 1104. Title Insurance Binder to 1105. Electronic Document Pre to 1108. Closi Service Letter to Commun Land Transfer LLC 75.00 1107. Attome s Fees to includes above item numbers: 1108. le In urance to COMMUNITY ND TRAN FER 903.75 ncludes above item numbers1102 1103 & 1104 1109. Lender's overa e S 108,500.0 903.75 1110. er's overa e 5 0, 0.00 111. ndorsaments 100, 300, 8.1 to ommun Land Trans er, LLC 150.00 1112. Note ee to Commun' Land Transfer 5.00 1113. otary Fae to Community Lan cans er 5.00 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recordi Fees: Deed S 83.00; Mortgage ~ 78.00; Releases S 141.00 1202. C' !Coun TaxlStam s: Deed 800.00 • Mort a e 900.00 1203. Stets Tax/Stam s: Deed 900.00; Mort a e 900.00 1204. 1205. 1300. ADDITIONAL SETTLEMENT CHARGES 1301. Surve to 1302. Pest Ins coon to 1303. Termite Treatment to Bowers-Pest Control 882 50 1304. . 1305. 1400. TOTAL SETTLEMENT CHARGES Enter on Lines 103 Section J and 502 Section K 3,032.25 1,587.50 ay ~ontw a•w ~ a nw° slNema,l, m.,~°eon...~,ow~.ao. maipt cr ° wmpNt°d copy a p~ 2 or W° -wo ~. °u Com un sfer, Settlement e t Certified to be a true copy. . ( 06.641.006 / 06-542.006 / 6 ~ 801. Loan O ination Fee % to 802. Losn Discount °~ to 803. Appraisal Fee to 8 4. Credit Report to 805. Lender's Inspection Fee to 808. Mort a e'Ins. .Fee to 807. Assumption Fee to 808. Commitment ee to INTEGRITY BANK 542.50 809. Document Prep. ee to _I G ITY BANK 300.00 810. lood Cert. Fee to NTEGRI BANK 15.00 811. PSEC~k March 18, 2010 Account # 0175x;J~~~X SCOTT W MORRISON CENTER SQUARE PO BOX 232 NEW BLOOMFIELD, PA 17068 Dear MR MORRISON: The following is the status of GROVER H. MCLAUGHLIN's account with PSECU as of the date of death. Joint Owner's Name DOROTHY F. MCLAUGHLIN, ADDED 01.15.1979 AS JOINT TENANT W/ROS Date of Death 02.21.2010 Date of Birth 11.30.1920 Share Description Open date Balance Accrued Dividend S O1 Regular Shares 01.15.1979 $ 92.53 $0.02 S 04 Checking 01.15.1979 16,430.94 0.90 S 07 Money Market 07.10.2006 23,834.93 7.78 Loan Description Open Date Balance Accrued Interest L O1 PSL Loan 03.03.1982 $ 0.00 $0.00 L 09 VISA 06.15.1987 0.00 0.00 The dividend earned from January 1, 2010 through the date of death was $21.45. We do not have safe deposit boxes for our members. If you have any questions, please call 234-8484 in Harrisburg or our toll-free number, (800) 237-7328. At the menu prompt, enter 6 and then extension 2227. Si-~cerely, Meacie airf Member Service Representative Finance Support Unit Pennsylvania State Employees Credit Union Main Address: 1 Credit Union Place, Harrisburg, PA 17110-2990 • 717.234.8484 • 800.237.7328 Mailing Address: P.O. Box 67013, Harrisburg, PA 1 71 06-701 3 • 717.777.2100 (TDD) • 800.472.1967 (TDD) psecu.com This credit union is federally insured by the National Credit Union Administration. Equal Opportunity Lender ~~ ~~ April ~, 7114 ~co~tt'4V Mv~sa~n Egqu#xe Gent~cr Square ~ . PG Boy 232 Neer Blooxx~feld, PA 1?068 RE: Grover H IVIcL~g~ita- ~SIV: 175-1~4-7~?9 . 1D: 02!'211241 Dear Mr. Moaison: In resp~z to your request for Daate crf Ith D~ bakes. for the eustomeer noted above, Qur records show t ~ollvv~g: ~b Account Account # 504G~443$7b ~sta]a~shed: I4I4812009 ~irRC~~R H 1~C~AUC1HLIlv I~1~ ba~xce: ~ 12,718.54 + t1.40 non interest laearmg Accocmt# 5I4(1t~44645 Established: 09t'~1f1962 GrRO~TER II ~1riCi.AUCi?~3LIl'~t ~. Rt~'1"IIY F I~iGLAUGHGIN DOS balance: S ?,357,79 f O.1G ao~rr~ed xnteres >~ ~ 41141/201Q - 42~~12414 ~ ~4.~~ ~~ Account Account # St}05191Q21 Established: fl']12t~3?' GRi~-~TE.R ~I IViCLAU~.HI.i13 . IUD bal$nce. $148x456.58 + 74.81. ~~ t~te~est Interest paid (~1/4112tI1t~ -- Q2~I1~414 - $88.45 Page t of 2 i 0 osta3ti o c~bxslc~ xor~ : ~ 16 xA~ ESTATE-DROVER F] MCLAUGHLIN 3 CONWIE OR S~CgANICSBtJttG, PX v7050 (71i) 766-5488 PROD ZTl1 I11V CODS NC>. ------ I'ISr! DESC&IPTION ------- DXI. 4S F~OOBTBR t700tCIE JARS 47 1tASE iCBIP'QBD) 4e Bax L,OT cxlcxetas 49 LG VASS 50 CIiICdSSN TEA POT BC3X LOT 51 CANDLE STICxs 52 RRD STATUE 53 HOiK LOT 8AS£$ 54 $OX LOT CATS ~ DQGS 55 88ER ST$LN 56 GIRL STATUB 57 STATUE 58 R8D 5TATtIL BUDA 59 4 STORAGE TbTBS b0 BOX ZOT ORIEATAL STATQB3 b1 BLACK STATUE 62 4 bRIEIiTAL FIGURES 63 Holt LOT 11 4BISl~AL FIC~[JRE5 b9 BTSAM CL.HA1~ b5 TRAY LOT 3 FIG088S 66 BUX LOT ORIEt1TAG fPEGURE3 67 MEA3URi3~1G C(1P5 fib HO]C IAT FZRtTBES 2 b9 WATER FIGURE 7o Box ~.or a~I®rrAL vAS~s 7i ORIEIQTAL BOBBLE 81;ADS 72 l1Ar1GER RACK 73 BOX LpT OQIEt9TAL !'STUFF° 74 FOX 75 Rr•~~trr PLAp'T STAND 76 PICNIC SASHET 77 2 COQI~~S ?S YIS~ 4zZPS ?9 2 CLOt~tS p2lHNE$TOCZC AUCTI~i SERVICE 32$ BRADX RbpAD NEW Bid)014FiELD PAt PHONE 717 582 8565 - - COl15IGNOR STAT134~tEt1T - - PAGE 1 AUCTIOtd NQ~ER 100618 UNIT TOTAL CbMMIS3ION ' s~xr.r.~u' S RESERVE QTY PRICE PRICE Il140i3IiT NET A690IIi4T AMbUNT 1 11.44 11.00 358 3_85 7.i5 .00 7 1.40 1.00 35$ .35 .65 .00 1 12.00 12,40 358 4;20 7_SO _04 1 2.40 2,00 35i .70 1.30 .04 1 3_50 3.50 35~ 1.23 2.27 _00 1 7_00 7.40 35$ Z_45 4:55 .00 t 9_40 9_00 351} 3.15 5.85 _DO 1 1_00 3.00 35$ _35 .55 .00 1 5.40 5.Oa 359c 1.?s 3.25 _oo 1 5.00 5.04 35~ 1.75 3.25 .DO 1 10_00 10.00 354 3.50 6.50 _D0 1 5_00 5.00 354 t.75 3. Z5 _DO t 13.00 13.Od 35'4 9.55 8.45 .00 1 77.00 17.Q0 35'1 5.95 11_05 .44 1 47.50 47.50 354 76.63 30.87 .00 1 7_oa 7.00 354 z.45 4.55 .DD 1 5.00 5..00 354 1_75 3.25 .40 1 25-04 25.OD 354 8.75 16_25 _40 1 6.00 6.00 358 2.10 3.98 .QO 1 13-00 13.00 354 4.55 $_45 _40 1 7.00 7..00 358 2.45 d.55 .00 1 4.00 4,OD 354 1,44 2.60 .00 1 2.00 2.OD 354 ,70 1_30 .00 1 4.50 4.50 35'k 1.58 Z.92 _Op 1 1.00 1,OD 354 .35 _65 .D4 1 10.00 10.00 358 3.50 6.SD ,04 1 1.04 1.00 35~ .35 .65 .04 1 17.00 17.D0 35$ 5.95 11.05 .00 1 Z_00 2.00 35~ _70 1_30 _00 1 1.00 1.00 358 .35 .65 _00 1 5.00 5.40 354 1.75 3.Z5 _00 1 4.00 9..00 354 1.40 Z.64 .00 7 6.00 6.00 358 2.10 _ 3.90 _t10 1 1.00 1.00 358 .35 .65 _00 C4NT L1yUED 1 0 Obl23/1D ca>1ts>Lc xoro#>~ . i 16 NAME ESTATE-C~M1FER H MCLAUGHLIN 3 UO~i872E AR b~QiAlQSC88URG, PA 17050 1717) 766-5488 FAf1Y+TE$TOt:K AUCTION 3$RVICE 328 SRADY RDOAD NEW BLrCJOiMFIELD PA P'BONE: 717 5B2 8555 - - fl01ldSIGNOR S'Pi1TFF~'NT - - PAGff 2 AUCP]'C~7 NiR+1BSR 7 00518 PROD ITM IRY SIT TOTAL t:01~lI5SION SSLi+Sf~' 6 RESERVE C30DE 210. ------ ITffi+! fl$SC,RIPTION ______.. NO. 1~ PRIM: PRICE AMOUNT NET Ai-IOUNT AMOUNT 80 ~,~y ~~,g~g 1 b.00 6-04 354 2.10 3.90 .00 81 CLOTHES BASKET t 9.00 9.00 354 3_15 S_85 .00 $2 Hpg LOT q~pyg 1 Z.SD 2.50 354 .$8 1.62 .00 83 CLRC'Ur'~ SA-~ i 93.00 13.00 354 4_55 8_45 _00 84 {KLq~gg BOg gTC i 4.00 4.00 354 i.40 2.50 ,00 85 PALM SAND$R 7 11_00 11.00 359 3.85 7.15 _00 8b i00' TAPS 1 8_00 8.00 354 Z.BO 5.20 .00 87 DIRT T3L'i7LL 1 7.00 '7.00 354 2.45 9.'55 .00 s~ aox LoT TOOLB i 5.00 5.00 354 1.75 3.,zs .a0 69 BDX LOT L1RIT,I, ATC 1 5..00 5.00 354 i .75 3.25 _00 gp CpyR COyEg i 5.00 5.40 354 1_75 3.25 .00 91 BOX LOT KNIVES 1 1.00 1.00 354 _35 .65 -QO 92 CAT 1 9.00 1.00 354 .35 _65 _00 93 flUTCf3 COOKER 1 8.00 8_00 354 2.$0 5.20 .00 94 RUA5TEi2 & LR019 1 t .00 1 .00 35$ .35 .65 .00 95 2 fiH8LV8S 1 2.00 2.00 354 .70 1.30 _00 2 96 LG STSLN 1 22.54 22.50 354 7.88 14.62 -00 97 5 PiCTiIRE6 1 10.00 10.00 354 3.50 b_50 .00 98 Titi•.Y LOT 1KISG GI.A53 1 2.00 2 _ 00 35$ . 70 1 , 30 .00 ~ MI9C 1 7.00 7 _t10 359 2.45 4.55 _00 1 DD CA18']'I DISH 1 1 .00 1 .04 359 _35 . b5 .00 l Ot BC]% LOT CiI.ASSEFT2IRE 1 16.00 16 _ 00 3 S ~ 5 . b0 10.4 0 .0 0 i02 ASH TRAYS 1 1.00 1.00 354 .35 .65 .DO tai TIME LIFE OI,D WEST BOOKS 9 '17.00 17.00 354 5.95 11.05 .00 109 FISH PC?STERS 1 1t .DD 11.00 35$ 3.85 7.15 .00 105 PAY PHONE 1 155._00 155.00 354 59.25 100.75 .04 iDG OIL LAlYP 1 7_00 7.04 354 2.45 4.55 .00 107 AYR FORCE BOC}ICS i 27.50 27.54 354 9.b3 17.83 .00 t 08 F'I.ICs!<IT BOOK 1 i 5.U0 15.04 354 5.25 9.75 .OD 109 <f7WII DVD`S 9 30.00 30.00 354 70.50 19.50 _DO 1i0 L3IATHER JACKET 1 30.00 30.x0 35$ 10.50 19.50 .00 11 1 NSSTIPTG BGFiLS 1 15.00 15.00 354 5. a5 9.75 .00 112 HLACS LSATHBR JACKET 1 27.50 27.50 359 9.63 97..87 .00 1 13 HSip QN IitBST 1 5.00 5.00 354 t .75 3.25 .40 C a N T I N l3 E D I.I€' ist1F,~C1~~/ T 1. I~tInt=f 1S1T Ibc~3.LIT T,JFT Cis ~ All ! tl-Trif -f1Tll~r 1 4 CODS IG1+y0R N~$R 116 4ilhl+l£ E3T?sTB-GROVBR H MCLAUGHLIN 3 CdNNiE DR HECI33NIC68UItC3~ PA 17054 06123/10 - - t~ONBIfHi4R S~ATElSSNT' - - PAGE 3 (? 171 7fifi- 5486 FAL{~!1E8'!.'OeK R[K'TIdlt $ERSFLCE 328 BRADY RDOAL7 N$W H1,p(xtFl$Lp PA Pt;t)N8: 777 582 8565 ASACYION iltli~i$II2 100b1$ PROD ITM I11tV IJNI4' TOTAL CO!`~SISSIGirI SELLLit`S [tE$ERV$ COD£ flO_ ------ ITEM DESCRIPTION ------- i5t0. Q'fY PRICE PRICE A1wI0ITlPP 1+1>yT ANO[I!~'i' 1STlOUNT > it# MILZ4748Y UNIFO~WiB 1 500_O(t 5x0.00 35~ 175.00 325.QQ .00 i t 5 9TICII LIt3fiT 1 19.00 19.00 358 6..65 7 2.35 .OQ 116 t~18R8LL11 STAND 1 17.00 17.00 35b 5_95 11.05 .00 117 4 PiCTURE5 1 10.00 10.00 35$ 3.50 C_50 .04 1t8 FLORP-L PICTURE 1 9_00 9_00 35t 3.15 5.85 .00 1 i 9 LG 5TA't'DES 2 25.00 50.00 351E 17.50 :; 32.50 .00 120 2 CyCyg OII. 1 7.00 7.00 358 , Z.95 4.55 .00 127 CROC>OB'£ 5ST 1 b.00 b.00 35~ 2.10 3.90 .00 4 22 I>ItloP,t~xE i 3.OQ 3.00 35~ 1.05 1 .95 .00 '123 ggiiZNG LKACgINE 1 2.50 2.50 358 _88 t _ 62 .00 124 SEtfI1PG KITS 1 8 _ QO 8 - 00 35~ 2..00 5.20 .00 125 ~IpG Tpg~,E 1 2.00 2.00 35g .70 1 .3Q .00 12b YELLCyFT POT 1 10.00 10..00 3.58 3.50 6.50 •00 18'1 3 SSUVL~'LS 7 b. 40 b.00 35~ Z . i 0 3.90 .00 182 VACUMB 1 15.00 15.00 35$ 5.25 9.75 .DO 183 ~iT HQE 1 11.00 11.00 35$ 3.85 7.15 .OQ 184 DIGGING IRO14 1 14.00 1.00 351 4_90 9.10 .00 185 B,AKLS ETC 1 2.00 2.00 35~ .70 1.30 .00 1$fi 3 PZCHS 1 70.00 7.0.00 35~ 3.50 6.50 .DO i $7 ~iI$31'PAL 5Tal1QD 1 6.40 6.00 35$ 2.10 3.90 .00 188 AX, RAKE >3TC 1 7.00 7.00 358 2.45 4._55 .UO 189 {,1OLF GL.08S 7 20.00 20.00 356 7.Ofl 13_00 .00 19Q t,1DLF CLUBS 1 10.00 10.00 351E 3.50 b.50 .00 191 SILVER SET 1 8.00 8.00 356 Z.80 5.Z0 .00 S92 SNDF- BLOWER 1 50.04 50.00 35# 17.50 32.50 .00 193 ~g 1 11.00 ,1_00 35ik 3.85 ?_i5 .00 i44 Tom ~ 1~.da ,z.aa 3s$ a.zQ ?_8Q .oo 195 TO"I'E & ~37-TERIlkI, 1 5.Ot} 5.00 358 1 .75 3-25 -00 196 MIC~WAYE 1 2.00 2.00 35~ .70 1.3D .40 ig7 C.~iAIR 1 10.00 10.00 35$ 3.50 5.50 .00 198 STEP STOOL 1 11.00 11_00 356 3.85 7_15 .00 1gg urrxrxG CHAIR 1 9_00 9.00 35~& 3.15 5_85 .00 ZQO I,Iyg }~I~ 1`flAP 1 15.00 15.0.0 35$ 5 _ 25 9.7 5 . QO 21 Z 21 r~CBiCAN 1 ZZ . 50 2Z _ 50 35$ 7.88 i 4.53 .00 213 C1QPiPASS i 55.D0 55_00 35S 19.25 35.75 .00 C O H T I K U E D LIB firt}F~irf7?.ail. t /. Nu1~~{ ~i~.T..zba~ciT WH ~i: ~ (~(3 !.f)-Tit'-(~T~r? 1 FAHI3LST1)CK RtiC?IUN SERV ICE 328 $W~DY RDOAD NEW BI~t301vlFIEi,D PA PRONE: 717 5$Z $555 0 061231 1 fl - - CDI4sI~ 5'1'~TEi4ffiiT _ _ PACE 4 AIIC'1' IO9~T NDllABR '~ 0661$ CIXiSiGNOR iTQ03ER 715 KATE 88TATL-GRdVF..R R MCL?IUGHLIN 3 G~6NNIE Ddb iyECHANICgBURi~, PA 17854 {717 ?66-548$ PRQD ITN IeiV i7lTIZ TOTAL iX~HaISSIDN S~.LE~t' S RE.SIItVE t;ODB 130. __---- ITEM DBSCRIPTIQN ------ - 100. QTY PRICE PRICE AtiSIDAFT i~PET A[~UNT AMt3DNT 214 ASS 1 fi.OD fi_00 35# 2.10 3.90 .00 Z15 BSA~CELSTS 1 16_DD 16.00 35# 5.60 10.40 .00 216 7R?,Y LOT $RACS>;>;TS 1 25 . DO 25.00 35# 8.75 16.25 _0 0 217 'PRAY LOT BO2ACELBTS 1 1b.OD ifi_00 35# 5.60 10.40 .00 218 TRAY LOT PI4t8 1 27.Sfl 27.50 35a 9.63 17.87 .04 219 BARRING$ 1 11.00 11_04 353 3_$5 ., 7.15 .44 220 1 OZ $ILVSR & COA&T£RS 1 15.00 15_00 356 5.25 3.75 .40 221 TRAY LC?T 138C1Q~8 1 11 .Ofl i 1 _ 00 35i 3 . $5 7.15 _00 ZZ2 PEARLS 1 10.00 tD_OD 353 3..50 6.50 .00 2Z3 Z POCICET1t14IVE3 t 3.00 3.00 35# 1.05 1.95 .00 2Z~! JENLERY CABINET 1 55.DD 55_00 35# 19_25 35.75 .00 225 FIRE CO PIN 1 6_DD 6.D0 35# 2,10 3.90 .00 226 ruSC JSfiIIiERY 1 27.50 27.50 35# 9.53 17.87 _00 227 l2II9GS ETC 1 35.00 35_00 35# 12.25 22.75 .OD 2Z8 tiATC73$S 1 17_fl0 17.00 35$ 5.95 11.05 .40 229 MI9C JBNLERY 1 5.00 5.00 35$ i.75 3.2'5 .00 230 HLACR JSNLERY BOX 1 10.D0 10.00 35# 3.50 6.50 .00 Z31 ROCFCIi4G CHAIR 7 10 . DO 1 D _ 00 35$ 3.50 6.50 .00 232 IdAFLE CHEST 1 30.D0 30,00 35~b 10.50 19.50 .00 Z33 C0~8 CHAIR 1 32.50 32.50 35# 11_38 21.12 .DD 234 2 DQtESSffi35 1 110.00 l i 0.00 358 38.50 ?1 .5.0 .00 Z35 CHAIR & 1+II~TE RACK 1 Z.DO 2.00 35# .70 1.30 .OD 23b Z iX~NER STANDS 1 1_5D 1_50 35# .53 .97 .06 237 HAR STOOL 1 5.00 5.00 35# 1.75 3.25 .OD 238 2 Ei+3? STANDS 1 6.00 6.00 35# Z.10 3.94 .OD 239 2 END 3'CP-NDS 1 1 b - OQ i 5.00 35# 5.64 14.40 . DO zoo st~vlNG t ,7.00 ,~.Da ss# s-gs ,,.~s .vo 291 $8EL1TIlOG 2 5. DO 1 D . OD 35$ .3.50 6.50 .00 24.2 SHELVING t 3.5D 3_50 356 1.23 2.27 .OD 243 D4tOP LEAF TABLE 1 3.00 1_00 356 .35 .fi5 .00 244 tBtEFiri WII~fG BACK 1 17.00 17.00 356 5.95 1 t . 05 .00 245 Fit>i3ERSD CHAIR 1 3 7 . DO 11.00 3 5# 3 _ 85 7.7 5 .00 246 RBCf.INBR 1 24._64 20.00 35# 7.pd 13.Dd .DD 247 2 GARBli&$ CAIOS i 10.00 10.00 356 3-50 6.50 .00 248 DRESSER 1 25_00 25.00 356 8.75 16.25 _Ofl coNT rrlv~n J./~' ir(li,isf37F,1 T I I+T[IDS.7 1f~.T..i~c31tIT iwiN ~C~i:t3fti /f'--TT11"-f1T(1'J' 1 4 p6l23/i0 C701Q8IC~,1iCHt N[ 116 Nl-ME _ ESTBTE-GR01t$R H IdCLAUGI~LIt9 3 CONNxS DR 3~S~ICt3BS7~Cis ISi 17050 i?1?~ 766-5488 1rAIDA£S'80C1C AQCRIODt SEitYICE 328 BRADY -DOAD N$it BLOOMFIELD PA PHL~2dE: 7'17 5$2 $565 - - CONSiGi~~t STATEMENT - - PP~GE 5 AUCTI{~1 NDI~BER : 188618 FRfOD I'PDt I2iY [1N.I`P T~FIL CG~SiSSLDaI SELLE>&' S RE51~2VB CODE ND. ------- T'PSt4 ~E5CRIpTIOi~ ------- IfO. QTY PRI~CS PRIGH AMOUNT IiBT AAIO[714'P #d+~O~TNT 2d9 6I,ZDA.1t RcY!1rx72 3 32_SD 32.Sfl 358 i3.3$ 21.12 _80 asp DRBSSEH 1 55.D0 55.DO 35$ 19.25 35.75 .00 251 og>rtcs IZ1t~ ~ 1_ov 1 _ofl 35e _3s _65 .ao 252 C~-BINB'1' 1 Z.DD 2.OD 358 .70 1.30 .00 253 CX7FFSS T141~LE 1 5.00 5.00 358 1 .?5 3.Z5 .Ofl 268 BAt~00 50FA 3 42.50 42.50 35$ 14.x38 .,, 27.62 .00 269 43l8LE 7 4 CHAIRS 1 22.50 2Z.T~0 358 '3..88 14.62 .00 270 80QKCASES 1 12.D0 12.00 35$ d.2D 7_BD _OD 274 BC)dRC?~SE 2 7.Ofl 14_DO 358 d.9D 9.10 .DO x72 PLATS CABIliBR 2 30.00 60-00 359 27.00 39_00 .OD 273 3BCRSTAftY 1 1'1.00 11_00 35$ 3.85 7_15 .00 274 Pl~-IHITBQ CABINET 1 12,00 12.D0 358 9.29 7,80 .00 275 ZQ!<PLE 1iOTCFi 1 32.50 32_50 3571 71 .3B Z1.12 -DO 2?6 tiiTALL STdNp 1 17.50 17.50 358 6.13 17.37 .DO 277 Hf3TC1i SIDSBf}ARD T1iBL19 .CHAIRS 1 860.00 260. DO 35i~ 9i ,DO 169.00 .OD 278 rLOC>ffZ L>!liPS 2 1Q:80 20.00 35$ 7_40 13.OD _OD 279 P'IAOR Z8!!P 1 i0.00 1fl.Oa 354s 3.50 6.50 _DO 280 CIATI:iES TREE 1 3 3.04 i 3.00 358 4_ 55 8.45 .OD 293 ALT3M LA[3D8R i 2.50 Z. SO 35~ _ 88 1 .62 . DO 2gg l1AC STANLD 1 3.5D 3.50 35$ 1.23 2.23 .OD 295 CCINES 1 4.D0 4.08 35$ 1.40 2.60 .DO 296 3 LA.ti1N CH7IIRS ] 5.flfl 5.00 35+6 1.75 3.25 -DO 2g8 NgEggp 1 3.DU 3,00 35$ 1.05 4.95 .OD 299 RDCICIPG CHATA i '1.00 1.00 35$ .35 .65 .DD 300 G~iS WEED Els3'E3~ i 1 .OQ 1 .0D 35~ .35 .55 . DD 304 BLEC WEED EATER 1 i.80 1_t10 35$ .35 ,55 .DD 302 EL1~C LiEF.D ENTER t 1 _ QQ 1. a4 35~ .35 .65 . DD 303 BOX LOT 1 3-54 3-58 35~ 1.23 2.27 .QO 3Q4 BOX LOT 4 2,Q{t 8.44 359 2.80 5.20 ,00 34S >30~c iqT 3 2.80 6.00 358 Z.40 3.90 .ti0 30b B+~ I~4T 7 4.00 4_q0 358 1.40 x.60 .a0 307 SOiX LOfi 1 4_50 1.5D 358 .53 .47 .80 348 H~ LOT 7 1_ep 7.OD 358 Z.45 4.55 .80 349 ~ LOT 1 1_QO 1_q0 358 .35 _fi5 _00 310 HOX LQT 1 9.qq 9.qq 358 3.15 5.85 .DD C ©N T I N U E A i.19 ist'fr~~rn~~J.T ~. x>iilD~7 1~~,T~ibaluT w~f ~~ ~ At'1 / n-7nr-n-rnf 0 46!23!10 OCdY5ItR40R i 16 N%~ ES21-TE-GROM1-ER H MCLAUG~LIN 3 C~NIiiB DR MECi~lNTCSB[TRCi, Pt! 77050 1777} 766-5488 F?.BliES3'flCK AOCTI~T S~lVbCE 328 BRADY RDdAD NEFi BIAQMFIEE.D P11 gxoriL: 717 58Z 8565 - - COi27BI 3TATEf~Ii'T - - PROD ITM I27V i]1,iTIT TOTAL COUB 1~C3- ------ IT1~d DSSCRIPTiC3R ------- 1+T0. 4~ P'RICE PRICE 3i1 SO% LO2 7 7.00 7.08 35i 31Z BOX LO2 7 7.00 7.08 359 313 73~% LCT 1 6.00 6.08 358 314 SO% LOT 1 2_00 2.00 35$ 3i5 BOX LOR i0 1.00 10.00 35$ 376 SOX LOT t 1.00 1.00 359 319 HDX LOT Z 1.00 Z.80 359 3Z0 SOX LOT 1 1.00 1.00 359 321 eaX LO? 1 6.00 6.00 35~b 322 8030 L(Yr 2 5 _ OD 1 D. DO 35# 323 SO% LO? 3 2_00 6.00 359 324 HOX LoT 3 3.00 9.00 35$ 325 BO% 1134 t ~ i .00 11 .00 359 325 BOX LOT 1 8.0.0 8.00 359 3Z7 H07f LOT 7 2.50 2.50 358, 328 80X iA4 1 1.OA 1.00 359 TOTAL C~tOSS SALE i4HOtId~T ACTfifAL SALES T{3TAL r~ss +c~~ss~~au CaMp~arsn . ~s rro 1rarA~ t~ ~zo~vs To'rA~ IT~s: 1 e9 TOTAI. F7i3E TU? SELLIIt AVERAGE ITEfiII QC>N~4ISSYOfi( Ai•10~[ll1T HOTS THA~VK3 FOR GOIQSIG14F1iG Y(ITti US. > _ $IDDER OF THIS ITffi+I IS CRl ACCOQN'£_ PAGE 6 AIJCTIOAi HtA~SEtt 100618 CD~dIS3I0Ii Sffi.LER' S RSS"F~tYE }~DONT 7~TST R![dU1+T1' AMOi3N'p 2.45 4.55 .00 2_95 9.55 .00 2.10 3.90 .00 .70 1_30 _00 3.50 6_50 .00 .35 .65 .40 ,Ta 7.30 .00 .35 .fi5 .DO 2.10 3.90 .00 3_50 6.50 _00 2.10 3.90 _00 3.15 5.@5 .00 3_S3 1_i5 _00 2.80 5.20 _00 .@8 1.52 .00 .35 .65 .00 3:.111.00 3,711.00 1,08$.97 2,022.03 2,022.03 5-76 LIL ~(36iTO~6LTl. ~T~Df-f ~~~'-~b~~uT W~l 9~~A~5 I, t7-T1'~f -~T~~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE BUREAU OF PROGRAM INTEGRITY DIVISION OF THIRD PARTY LIABILITY ESTATE RECOVERY PROGRAM PO BOX 8486 HARRISBURG, PA 171Q5-8486 April 6, 2010 SCOTT W MORRISON ESQUIRE P 0 BOX 232 6 W MAIN ST NEW BLOOMFIELD PA 17068 Re: Dorothy Mclaughlin SSN: ###-##-4818 Dear Attorney Morrison: Pursuant to your letter dated March 11, 2010, the Department of Public Welfare (DPW), Estate Recovery Program, has reviewed the information you provided regarding the above-referenced individual. It has been determined that this individual did not receive any type of assistance during the questioned period. Therefore, according to the information you provided, the Department's Estate Recovery Program will not seek any recovery from this estate. If your client applied for Medical Assistance and had an application and/or hearing pending at the time of death, please advise us and provide any additional information that may affect a recovery by our Department. If you have any questions, please feel free to contact me. Sincerely, Vince A. Porter Recovery Section Manager (717)772-6604