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HomeMy WebLinkAbout01-04-11J 1505610140 R~~ ~O t7( {01-10) C7FriCiAL USE rJN Y PA ~~ of Raverlrre Cour~r Code Yber Fie Number POBW(250601 T~ MII~RITANCE TAX RETURN ~_PA 17126-0601 DECEDENT 2 1 1, 0 0 9 2 9 ENTER DEC~tT MiFORM#TION BELOW '~ Social Security Number Date of Death MMDDYnrY Date of Birth MMODYYYY 1~6 24 9822 D902201D ],21219 32! Dscadsrlt's Last Name SuBbc DeoedsrlYs First Name '~ ~ BUT L E R J O A N C (N Applicable) EnRsr SunMMl8pouae's IMormaUon Below ~ Spouse's Last Name SufRx Spouse's First Name it MI Spouse's Social Security Number TENS RETURN MIDST BE FlLED tN_ c~uPLIf:A~E THE REGIS~R Of 1NILL5 ~ w AIrPROPRIATE OVAL8 BELOW ® 1.Oripinai Retum ^ 2. Supplemental Retum ^ 3. Remainder prior to 2- m (dabs of deaU~ ) ^ 4. Limited Estate ^ 4a. Future Interest Compromise (date of ^ 5. Federal Tax Retum Required depth after 12-12-82) ® 8. Dsosderlt Died Testate ^ T. DecOderlt Maintained d Living Trust 8. Total Nt~m of Safe Deposit Bozos (A~ Copy ~ y~ (Attach Copy of Tnrst) ^ 9, Litipstion Proceeds Receive d ^ 10. Spousal Poverty Credit (dabs of death ^ 11. Ebdio to urMsr Sec. 9113(A) between 12-31-91 and 1-1-95) (Atahch ) - TiN6 SECTION MUST BE CO~I.ETED. ALL CORRESPONDENCE AND COMFDENTNL TAX BE DKtECTED TO Nar rre Daytime Te o Number W IL L I AM A D UN CAN 717 '2 49 7780 r`> otlLY~y First line of address I'. ~ ~` ~ -w . ~ ;~. 1 w.7 1 I R V I N E R 0 W ~~~- LL ~ ,: Second ins of addre~ , ~ ~ - - ~ -_- I~ r _~ ,.~~ stet. 7~ [`srfw C A R L I S L E ConrspondarK's e~ addnas: B I L L D U N C A N a1 P A• P A 1 7 0 1 3 ~ ~. ET under penaitles a perj~ny, ~ dedare that I hwa exa~nN'ISd this rearm, incN+dNw socompanykp schedules and stalemerrss, and b my icnowMdpe and heliM, it a tue, cohere ~~a Room~plMR.~.~o.a~snlfor- a~pepFsNra~r oGtl~er uan ass persorW repn.en{ruw it e..ed on au infonnenon a which na any knarlsd0./. SKi~ ., IM .. IL ~F1~ ~1/.l /~=,CRERiRN I DATA' ~ / 1 13 DANDELION DRIVE BOILING SPGS• ' 17007 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE ,DATE ADDRESS 1505610140 P'LEA8E USE ORKitNAL FORM ONLY Side 1 150561~p 4~0 r s a J ~ J REV 150o Ex DeoedeM's Soci~l Security Number 1 8 6, ~ 4 9 8 2 2 RECAPITULATION 1. RBI Estate (Schedub A) ........................................... 1. 2. Stocks and Bonds(Schedub B) ...................................... 2. 3. Closely Held Corporation, Partnership or Sale-Propri~orship (Schedule C) ..... 3. 4. MoRgages and Notes Receivabb (Sc~edub D) .......................... 4. 5. Cash, Bank Deposits and Misoelbneous Personal Properly (Sdiedub E)....... 5. 6. Jointy Owned Property (Sc~edub F) ^ Separate BilNng Requested ....... 6. 7. inter-lrivos Transfers 8 Misoelbneous Property (Sd~edub G) Separate BilNng Requested ....... 7. 8. Total Gross Assets (total Lines 1 through 7) ........................... 8. 9. Funeral Expenses and Administrative Coats (Schedub H) .................. 9. 10. Debts of Dsoedent, Mortgage Liabilities, and Lfens (Schedule 1) ............. 10. 11. Total Deductions (total Lines 9 and 10) ............................... 11. 12. Nst Value of Edats (Line 8 minus Line 11) ............................ 12. 13. Charitable and Governmental Bequests/Sec 9113 Trusts Tor which an ebd'an to tax has not been made (Sdredub J) ...................... 13. 14. Nat Value Sub)sct to Tax (Line 12 minus Lino 13) ...................... 14. • ', ~ 1 3 8. 8 8 3 ? 0. 6 8 i 1 2! '1 0 6. 6 7 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATF~ ' 15. Amount of Line 14 taxabb at the spousal tax rate, or transfers under Sec. 9116 16. Amount of Line 14 taxable at lineal rate x .045 7 4 4 1 9. 8 0 1 s. . 17. Amount of Line 14 taxabb at sibM~g rate X .12 0 . 0 0 17. 18. Amount of Line 14 taxabb '' at collateral rate X .15 D . D 0 18. 19. TAX DUE .................... ........................... ....... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 1505610240 15D561[~2~ 1505610240 11597.11 i I I . 6 6 2. ? 0 0 2 4. 1 7 6 8 6. 8 7 ''4 1 9. 8 0 4 1 9. 8 0 0. D 0 '3 4 8. 8 9 0. 0 0 0. D 0 3 4 8. 8 9 I C] REY 1500 EX Pays 3 Faa Nianbar Decedent's Comoleha Addlress: 21 10 0 9 2 DEC;EDENrs NAME JOAN C• BUTLER STREET ADDRESS ~, 601 MILL RACE ROAD CIiY CARLISLE STATE PA Z~ 1?013 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2 ~~ 4,000.00 ~~~ 210.40 B. Discount 3. Interest 4. ff Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. FM M oval on Page 2, Ltns 20 to request a rotund. 5. H Line 1 + Line 3 is greater than Line 2, enter the d'rfference. This is the TAX DUE. (5) •89 •40 •51 .oa Make check payable to: REGISTER OF WILLS, AGENT 'I i ~1 PLEASE ANSMYER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE TE BLOCKS 1. Did decedent make a transfer and: Y ~ a retain the use or irroarre of the property ...................................................................... b. retain the right b designate who shall use the property trarrsierred or its irroonre; ............................. c. retain a rewersiorrary irderesx or ................................................................................................I, d. receive the promise for Nie of eitrrer peyrtteMs, trenefits or cane? ......................................................! 2. ff death ooamed after Decerrrber 12,1982, did deoederrt transfer property wiUdn one year of death wrthart tecerrtrg adequate c;onsideraafaon? ....................................................................................... 3. Did deoedert awn an'in tnrst for or payable~rpon+deafh txanlc account or seanity at his or her death? ......... ^ 4. Did decedent own an itr~vidual retirement account, annuity or other non-probate property, which contains a beneficiary designation? .................................................................................................. ^ IF THE ANSWER TO ANY OF THE A~VE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE ~ PART OF THE . For dales of death on or after July 1,1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to the use of tl~e surviving spouse 3 peroent p2 P.S. §9116 (a) (1.1) (~]. '~ For dales of death on or after Jan.1,1995, the fax rate imposed on the net value of transfers b ar for the use of the survi ' is 0 peroent [12 P.S. §9116 (a) (1.1) ('s)]. The staWle does not exempt a transfer b a surviving spouse from tax, and the statutory njqu is for disclosure of assets and tfiing a tax retain are st3 a~ppNcable even if the surviving spouse is the only benefiaary. ~ For dales of death on or sitar July 1, 2000: ~~ • The tax tale imposed on the net vaHie of translers from a deoe~ed ctuld 21 years of age or younger at dead b or for {he ~ ~ a natural parent, an adoptive parent a' a stepparent of the child is 0 percent (72 P.S. §9116(a)(1.2)]. I • The tax rate +mposed on the net value of transfers b a far the use of the decedents Feat beneficiaries is 4.5 percent, ale as noted in 72 P.S. §9116(1.2) [/2 P.S. §9116(ax1)]. • The taut tale imposed on the net value of traces to a for the use ~ the decedent's sibNngs is 12 percent [72 P.S. §9'~1 a)(1.3)]. A sibling ~ defxred, untie Section 9102, as an indrviduai who has at least one parent in common witl~ the decedent, wt-ether by blood or adoptia~,. (1) Total Credits (A + B) (2) ', (3) (4) '' REl/-1502 IX+ (01-10) Pennsylvania SCHEDULE A ~~ REAL ESTATE ~ Tex ~~ ars~oatr oc-(SKr ESTATE pF: FILE M1tM8E JOAN C• BUTLER 2 10 ~ 0929 AN real property owrrsd solely or as a taunt in common must be roported at fair rrrariret value. Fair market value is defined 'price at which property would be eou,hanged between a wlMing buyer and a wiwng seNer, rieitlrer being oornpelled b buy a seY, both having of the relevant fads. tisal properly tthat k joi+tlh~awnsd wiSr ~ of wrvlvorslrtp rrrwt btdNctossd on F A1bch a copy of the selfiemaM sheet if the property has been solo. REM hxkrde a copy d the deed showing deceder>Cs interest if awned as tenant in conrnon. VALUE AT DATE NICER OF DEATH DESCRIPTION 1- 601 MILL RACE ROAD ' 110,597.11 CARLISLE, PA 27013 [SEE HUD SHEET ATTACHED] I ', i I '~ ~I l ~, ~~ ~, I ', 'I TOT11L (ANo eater on line ~ , R~scapitula 6on~) ( i 110 , 5 9 7.11 'll REV 1506 IX + (~96) c~ortt~ot~twEALTrt of PENNSrLVANtA tNF1ER(TANCE TAX RETURN ESTATE OF JOAN C• BUTLER scN~v~ E CASH, BANK POSITS, ~ DISC. PERSONAL PROPERTY Include tl~e of wipaUon and the date tl~e poceeda wane received ey the estate. - - AN t~PMtf~ wllh dpM of survhronldp moat be dNdoad oa ScMduN F. ITEM ~ VALUE AT DATE PKHY~ER DESCRIPTION OF DEATH ~. REFUND CHECK THOMAS S• FILIP 1,352.00 2• PROCEEDS FROM SALE OF 2D01 FORD TAURUS ' 4,DD0.00 3- CENTURYLINK REFUND II 13.87 4• COMCAST REFUND II 34.01 5• '~ U•S• TREASURY PAYMENT ' II I 739.00 TOTAL (Also err an Ike 5, Recapidi~Uo~j '', ( ; 6 ,13 8 . REV-1508 EX+ (01-10) Pennsylvania SCMEDtlLE F °~~~ °F R JOINTLY-OWNED PROPERTY INHERITANCE TAX RETUfUI RESIDENT DECEDENT E8TATE OF: FLE NU ~ ~ JOAN C • BUTLER 21 1~] I D929 _ Nan asaat was node jointly owned wMhin one year ~ the decedenC'a dale of death. it nwst be rapol~ ol~ $cheduk G. SURVIVING JOINT TENANT(S~ NAIrE(S) ADDRESS RELATIONSNB~ TO DECEDENT ~ DEBORAH L- BRICKER 13 DANDELION DRIVE DAUGHTER BOILING SPRINGS, PA 17007 ', I ~. ~ II '~ c. I ner LETTER FOR JOM DATE MI1DE DESCR~TIDN aF PROPERTY arauDE NA1iE aF FN1diCIA1. eISiITUiION ND BANK ACCOIlf1T NUMBER aR SIMIAR ~ DATE OF DEATH ' %OF IpECEDBfTS DATE of DEATH VALUE of IMlw6ER TENANT JOBfr NUM~i. ATTACH GEED FORJOR(RY-HELD RFJ1L ESTATE. VALUE OF ASSET ~ NJTEREST DEtJ:DEOITS NQTpiESI ~. A. 4/05 MEMBERS FIRST SAVINGS ACCOUNT 10,525. 9 S0• 5,262.75 ~ 43106-DD ', [SEE DOD LETTERI 2• A• 4/05 MEMBERS FIRST CHECKING ACCOUNT 2,215•!6 50• 1,107.93 ~ 431D6-11 [SEE DOD LETTER] TOTAL {Also enbr on Lillie 6, Recapih~ionj~ ~ i 6, 3 7 D• 6 8 '' ..~.-~..,. ~..- ~,,.-..o, pe-nnsyhrania SCHEDULE H o~~xr of FUNERAL EXPENSES AND ^"~ T"'~ "~" l~s~oerr o~oFxr AD~NiSTRATiYE COSTS E8TATE taF FN.E NINE JOAN C• BUTLER 21 1~ 'x ;0929 DaCadNrts debts swat ba nporMd on SchadnN L ITEM NUMBER DESCRiPT10N I~ AMOUNT A. ~. 2• FtiP1ERAl. EXPEAISES: ITEMS FOR FUNERAL LUNCHEON - COMMISSARY ', ITEMS FOR FUNERAL LUNCHEON - DUNKIN' DONUTS ' S?•20 44.49 3• EYING BROTHERS FUNERAL HOME, INC• ' 2,347.93 B. I ADMINISTRATIVE COSTS: 1. Personal Represetrtadve Gorrrhs&arrs: Neme(s)dPeraonelRepmeeni~e(a) DEBORAH L- BRICKER 6,155.33 sreetAddra~a 13 DANDELION DRIVE ' qty BOILING SPGS• ;~ PA ~ 17007 Year(a) Cartrrbeion Palrk 2 011 ,~, ~, AgornayFeex DUNCAN >i HARTMAN, PC ' '~ ' 6,155.33 3. Partly Exemp~orr: tlf deoedenra addreea is not the name as deMr>erMb, alfech explane/on.) Claimant StroetAddieea Cth Stsb ZIP ~ ReleMaehip d Cleinsrt b Deoederrt li ' ~. ~ PmbateFeea: REGISTER OF WILLS ', '~ ' 335.50 5. Aoca"kantFeex 6. Tax ttehrm Preperer Fees: it z. 8• CUMBERLAND LAY JOURNAL -LEGAL NOTICE ', THE SENTINEL -LEGAL AD ~' 75.00 176.92 9• REGISTER OF WILLS -FILING FEE 15.00 10• HELD IN RESERVE 300.00 Tn7Al Also order an tine 9, ~ ) : 15 , 6 6 2 • ? 0 REV 1512 p(+ (12-OB) Pennsylvania SCHEDULE °~"'~"~ of DEBTS OF DECEDENT, naiEwr~cE ux MORTGAGE LIABILITIES, S LIENS r~ES~rr oECE~Hr i ESTATE OF ftLE JOAN C• BUTLER 21 1 0929 Report dla0b Nkurred ty Nis decedent prior y death that remaNied unpaid at the dab of death, includirq unreN~libu ntadk~l expanses. ITEM VALUE AT DATE ~~ DESCRIPTION OF DEATH t VNB MORTGAGE SERVICES, INC• ' 157.66 2• SOCIAL SECURITY PENSION REFUND TO US TREASURY 734.00 3• PPL - ELECTRIC BILL 175.21 4• CENTURYLINK ~ i 38.07 5• VNB MORTGAGE SERVICES, INC. I~~, 165.54 6• WILLOW CROSSING CONDO ASSOCIATION - HOMEOWNERrS FEE', ~I 130.00 7• ALLSTATE ~I 4.74 8- PPL - ELECTRIC BILL ~, 61.37 9. EXXON MOBIL I ' 124.3b 10- DISCOVER CARD '~ 1,2b9.32 11• WALMART CREDIT CARD ~, i 65.40 12• CITI CARDS - EXXON MOBIL BILL ~~ 1.91 13• DELUXE CHECK CHARGE i 21.75 14. CUMBERLAND GOODWILL EMS I 1,369.50 15• VALLEY NATIONAL BANK MORTGAGE PAYOFF 19,282.56 [SEE HUD SHEET ATTACHED] TOTAL (Also enter on Line 10, ~ ~' ~ 3 3 , 0 2 4.1? M moos space is needed. ir~t addftlonal sheela of the same alas. __ _._.. _ _.. _ - _ _ - _. _. _. _ ._.. _- _ r-_. i__~. _ _ Continuation of REV-15001nheritance Tax Return Resident Decedent JOAN C. BUTLER 21 10 0929 DeoedsM's Name Page 1 File Number Schedule I - Dsbts of Dscsd~nt, Morlpage Liabilitlss, b Liens REM NUR DESCRIPTION ' ~ AMOUNT 16• SETTLEMENT CHARGES ' 7,960.08 [SEE HUD SHEET ATTACHED] II l7• SETTLEMENT CHARGES FRBM ADDENDUM ~ 1,462.70 [SEE HUD SHEET ATTACHED] i ', ' I i ~ I ~ 9,422.78 ~~~ ~ I '', ', : 33,024.17 REV-1513 EX+ (07-10) Pennsylvania DEPARTMENT of REVENI~ Il~fRfUNCE TAX RETURN SCHEDULE J JOAN C• BUTLER 21 1 0929 RELATIONSHIP TO DEC AMOUNT OR SNARE NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Lbt Tros9sas) ~ OF ESTATE I TAXABLE DISTRIBUTIONS (Mdude ou spaeal di~u~ons and transieis under 12 9 6 ' 1 (a ( ).] Sec. i ji ~, 1. DEBORAH L• BRICKER Lineal 13 DANDELION DRIVE ~ 1 ~ 20%NON REAL EST BOILING SPRINGS, PA 17007 , I 12.5 REAL ESTAT 2- BENJAMIN C• HOLMES Lineal I '~ 1449 FINCASTLE LOOP ', ~~ 20%NON REAL EST COLLEGE STATION, TX 77845 ''~, 'i 12.5 REAL ESTAT 3. KATHY J- br1AGNER Lineal 570 GRAINS GAP ROAD '~ 20%NON REAL EST CARLISLE, PA 17013 ~ ~~ 12.5 REAL ESTAT 4• YVONNE M• GATES Lineal IC 20 BIG SPRING TERRACE I ' 20%NON REAL EST NEWVILLE, PA 17241 ! 12.5 REAL ESTAT 5. BILLIE JO BUTLER Lineal ~ 13646 CEDAR CREEK LANE !, '~, 20%NON REAL EST SILVER SPRING, MD 20904 ~i 50% REAL ESTATE ENTER DOLJJIR A#IOUMTS FOR DIST1~81If10NS SHOViM ABOVE ON LINES 15 TIiROIK~li 18 OF REV-1500 CO ~ AS APPROPRIATE. II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHK~t AN ELECTION TO TAX IS NOT TAKEN: ' 1. i I~ B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. I I TOTAL OF PAttT II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET ~ ' i ..,..... __...... ~...,.~,,., ..~ .,a,~:...,~ e~ .,~ ~~ .,~ x,e Q~ m~ LAST WILL TESTAMENT OF I, JOAN C. BUTLER, of 601 Mill Race Court, Box 1, Cazlisle, South 1d1i dleton Township, Cumberland County, Commonwealth of Pennsylvania, being of soon and disposing mind, memory and understanding, do hereby make, publish and declare this asl d'', for my Last Will and Testament, hereby revoking any and all other wills and codicils heretc~f red made by me. FIRST. I direct that all my just debts and funeral expenses be paid from r~ny estate as soon after my death as practically and conveniently may be done. SECOND. I direct that my remains be interred at Indiantown Gap Cerr~et ry beside my husband, WILLIAM R. BUTLER III, in accord with my expressed wishes. ', THIRD. I authorize my personal representative to expend funds from y estate, in such amounts as my personal representative shall consider necessary and desirable f~r t ~ purchase, erection and inscription of a suitable marker for my grave. FOURTH. I give, devise and bequeath any and all real estate owned b~ e' at the time of my death, unto my children as follows: to my daughter, BILLIE JO BUTLER'p I ive fifty percent (50%), per stirpes; unto my daughter, KATHY 3. WAGNER, my daughter DEBORAH L. BRICKER, my daughter, YVONNE M. GATE5, and my son, BENJAMIN CI OLMES, I give twelve and one-half percent (12 '/Z%), in equal shares, per stirpes. '~ FIFTH. I give, devise and bequeath all the rest, residue and remainder o 1' other property unto my children, BILLIE JO BUTLER, KATHY J. WAGNER, DEBO )I L. BRICKER, YVONNE M. GATES and BENJAMIN C. HOLMES, in equal shams f twenty percent (20%), per stirpes. ~~, SIXTH. I direct that any and all Inheritance, Estate and Transfer taxes ii'pz sed upon my estate passing under my will or otherwise, shall be paid out of the principal of my r siduary estate. ~~ SEVENTH. I hereby nominate, constitute and appoint my daughter, DE$O H L. BRICKER, as Executrix of this my Last Will and Testament. In the event of ren cialtion, death, resignation or inability to act for any reason whatsoever of DEBORAH L. BRIC , I nominate, constitute and appoint my daughter, KATHY J. WAGNER, as Executrix o~ this my Last Will and Testament. I hereby relieve my Executrix from the necessity of pos~i security in connection with her duties, as such, in any jurisdiction in which she may be calle~ u n to act insofar as I am able by law to do so. In addition to the powers conferred by law, I lau ~orize my Executrix, in her absolute discretion, to retain in the form received, and to sell either at public or private sale any real or personal property owned by me at the time of my death. ~, i, EIGHTH. I have made, or may from time to time make, a written memoran~lu~n,expressing my desire to give certain items of personal property to specific persons. I urge ~y Executor and beneficiaries to respect these wishes. Such a memorandum, if made, shall be star din conjunction with this Will. ~ IN WITNESS WHEREOF, I have hereunto set my hand and seal to this ~y Last Will and Testament, consisting of two typewritten pages this C C day of , T~0 2005. ~~ C. BUTLER Signed, sealed, published and declared by the above named Testatrix JOAN'. BUTLER as and for her Last Will and Testament, in the presence of us, who, at her request, ~n ~r sight and presence and in the sight and presence of each other, have hereun~to^s~u~bscrlibed ¢ names as witnesses. ~ ~ ~ /' /I V! ( ~ ~ D. COMMONWEALTH OF PENNSYL i~ANIA . SS. COUNTY OF CUMBERLAND . I, JOAN C. BUTLER, Testatrix whose name is signed to the attached or fore of g instrument, having been duly qualified according to law, do hereby acknowledge that I signed d executed the instrument as my Last Will; that I signed it willingly; and that I signed it as m~y to and voluntary act for the purposes therein expressed. _ ~ ~, Sworn or affirmed to and acknowledged before me, by JOAN C. BUTLER this ~~ of QC~ NOTARIAL SEAL Kathy L. Mummert, Notary Public Borough of Carlisle, Cumberland Co., PA Rrly Commission Expires Aug.11, 2Q0T ' TO,AN C. BUTLER day 2005. _, ,- :. COMMONWEALTH OFPENNSYLVANL4 . SS. COUNTY OF CUMBERLAND _ We, w iI~~QVh a n and ~~-~ ~ I~~ the witnesses whose names are signed to the attached or foregoing instrument, qualified according to law, do depose and say that we were present and saw JO sign and execute the instrument as her Last Will; that she signed willingly and as her free and voluntary act for the purposes therein expressed; that each of us sight of the Testatrix signed the will as witnesses; and that to the best of our kn Testatrix was at that time eighteen (18) or more yeazs of age, of sound mind an constraint or undue influence. Sworn or affirmed to and subscribed before me by 1,U- ~ liav~r~ ~ scan ~~ n D -~a wts this 1 I day of ~ b eat and witnesses, 2005. of b is NOTARIAL SEAL Kathy L Mummert, Notary Public Borough of Carlisle, Cumberland Co., PA Wly Commission Expires Aug. 11, 2007 duly .BUTLER ie executed hearing and age, the ~r no _~I~ MEMBERS i~ FEDERALCREDiT UNION SAVIN~i8 ~CiCCUNT: Account Number/Suilbc Da#e Account EstabNshed Prinapal Balance at Date of Death Accrued Interest to Dab of Death Total Principal and Accrued Interest Name of Joint Owner Date Joint Ownership Established 43106-00 06/19/1984 $10,525.40 $.09 $10,525.49 Deborah L. Bricker 04/15/2005 CHECKNNt3 ACCOUNT• • ' Acoount Number/Suffix 43106-11 Date Acxount Established O6h 9/1984 Principal Balance at Date of Death $2,215.86 Accrued Interest to Date of Death $0.00 Total Principal and Accrued Interest $2,215.86 Name of Joint Owner Deborah L. Bricker Date Joint Ownership Established 04/15/2005 MEMBERS 1~ FEDERAL ~ 'C~~~ Leig - ne StaNings Lending Insurance Support September 24, 2010 Esbb of: Joan C. Butler Dab ofi Death: 09J1?J2010 Social Security Number. 186-24-9822 UNION 51N111 Louise Drive P.O. I3ox ~I) Mechanicsburg, Pennsylvania 17055 (8(N)) 2233-23281, • Iwww.memberslst.urg A. MIIIM11N1t 1 l ~• .; _ ,. i r.rw l rr Nrwa 1.6wi IMiYr R w~ Y~rw i Cw. MiYr. qw iM6r 1 a. VA REi330 a ew. ra AOET/l016 a n~rrorawr~wrr..yw..rr~..r.ewr..rr..rwr. ~wwr.r.wr..ry*...r.wr.~ww.nw.~ ir..^rw~p..w.r.wMwwwrM w. .n~ww~w.rrrnwr .r r o. 11w.rAM...d~.....r. cM.~..wwr.wwsww: r.urMw~~rw+ws SLAM! C. MItTZ lsTATE Or JOAN C. M!lTLiR M1rC Of AYBtl~'.A, N.A. 72N f. W1dO'VER iTREET DEBORAH L. fit, EXECtJTItU( I~AOA ATMMA CA!lUBLl, M 17011 P.O. Bt'~lf 11!001 ' DALLM, TX 7q/t•Nfi ', N11BLL RAC! COURT. CMLNLE, PA t701i F i OR1cN BOUTHB~OLETONTOYYNBFI! rr..ra.ws gJ1~BI1LAlO ODUIRY f BOn11t Hprowrlln~t ~ i tM~10r.0d 1 4,i47.N I~ ~~ 261.00 q.62 M _ 647.26 i 047J 2M 7 60.420.00 ~~„ r... ~.r• `a wwr ,.. I artat aN www Pi~- ~ TMr-ri at~ltt ~ iil ~ r-~ - `. Nwn~.r, .ppoN,q in. ~.c ~ and utdaatoM tint Pw~M w" OaM an 4~ kr t#a yaar, ar aatnrwa for t#a awtaat fir, ntd Yt ~li'rwie a any olwga Iitr t aa~wtww neat a nrMa eataann salMr and saiowar de~at ~ apy Q~;tT ~ at~tttiw~aw~ au ~rnarNa +o Fray a Ttry ey tlal eha Ml~t Sattmwnt st~nMnt and to dw eat a my a~oa/adte Mt e.~, t M a ew ~i taasrt~M s at of naipa and dMeiaw~rada 1fNa tra~irya)~aa I AwNr °''~ ntoawad a tns FNA~1 s~tNntwnt ~tMlnwk noiaauy ~ nwliw~a rM ar by ma h rw ~nz - -- _ - -.~.~-~ To ria eat my ~ F~JD•1 alatamd rddeh I Iwo ~ pntpnod Y a Yw and aoarats aoaeud aMa 11nda vtdoh wan ntaMd aad ~ bnn a wf df demu.w atlwarana.wan. Oelobar4l.IflfOI ', F i TMh-. ~Itletttdttt A~ttt - r.a. ~ as pay ADDENDUM PROPERTY gi3PlCTION PEE TO A'NS gr3PECl NOVEMSS9t AStOCIATION DUES es MRS~wr ~S CPL PEE TO CLTIC Ef.ECTR01rC DELNERY I~ TO PREY a TLEY OvERNwMT oEUVder P0M To PREY a Ti1.EY pae. GARAGE DOOR RlPApt 130.00 OCTOelR A>1tOC1AT10N DUE TO VNLLOW CIN CONDO AEEOC. • nMLUDEt A LATt P!! TaAO IINlRRANCE TAX PAYMENT ElCROW X0.00 ~aoo OVERJNGMT PEE TO PREY a TILEY REiA4E CiRTMpCI-TION ~ TO WR.I.OMf ~ P.0.C. Ao~1 N NMi1011 Mq.TON'f WCK .. CMIi11lOR CNAIME TMIrt iy ATTY PEE= TO DUNCAN a MARTMAN, P.C. RIT Tiy ~ wlltiR R 1'O YYOIM M. GATM TObd eD N1N 145 ?S5 Tdal b Lint 1f06 1l~ORMATION REPORT1N~i ON REAL EsTATE TRANSACTIONS ' ~ TNEi IMJD EETTLSMENf STATEMENT CONTASM tE'ORTANT TAX INFORMATION (SOKEE E 0.N, 1, M AND UN! X0'1) AND IS EEEIt REINISIE~D 7O THE S1TEttlUU. RlVENISS IBtVICE M=YOU 111M:IIEDU111~ Ta IgLE A RETURN, A NtOUGL~l1L`E p$NALTY OIt OT-i®t SAlICTIDN wILL EE ON YOU If TNIt ITB1 a REOUOlED TO SE RlPOR~ ANO THE INTERNAL REVENUE SERVICEDlTERMIN~ TWIT R IIAB NOT E!E!1 REFOkTED. a C TAX PROalAT101/ ADD1 o~r.rrwwrr~r SCNDOL, REAL EETATE TAX ow.t+.sw r..,y/1.ana r.-r[11;7n1 aMd R[[1 AIM[ Tr FM[ aMwIR[/Eril[Tr-~Owr Af0Ea1~R: ![riu/Y 1. Ala r0[wir H, X10 ew a ud[. Rw Srr1[ Ts Fir CaaYrlaRdEwrTrt-sDM a[.awr..uw ~ Yw usa«a,+waaa, ar..Ir..-.oe..~an.a.+rsr.: [ ~a~rwawa, srwr[r-.oc.rar*+rM^wr 1/1>IM r[ G. alr[Ia -.O.C.f~r4Nf: [ a...r.enrAarrr.a G.aN[ia-.o.a.ar«rS.n.n -.o.~x~ alaaal- CballNllllk~id)IatblOnbM FMJD~ft:~elNrahir _- ___ OuraMr~l~~a ~~- <;, t1~ ~ ~! - ~ ~`' ~; ~ ult'~fl' d'~ 610.00 660.00 Your ~I~~,~i-~ (pY W filer klt 1ipeR~e 1Mieilt nM <iloM ~ ~ ~ ` ~ ~i ~ ~ 0.00 Y,~o~r.~z'!.'~.~~!!~ '~~' ~w _ Yt~,~~~ rye: 6G0.00 6f0.00~ 16.00 16.00 66.00 61.00 26.00 46.00 300.00 1010.00 M9 f/\ Wl 702.601 ~~. 101.34 10i.S~ ~. 1961.76 166.76 0•W 1fi. 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