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03-22-11 (2)
1,50561,01,40 ~ REV-1500 EX ~°'-'°' OFFICIAL USE ONLY _ _ PA Department of Revenue Ye + F-iIP, dumber Bureau of Individual Taxes County Code ar P® BOx 280601 INHERIT,A,NCE TAX RETl1RN 2 I D 9 D 1 1 3 2 Harrisburg. PA 17128-0601 RESIIDENT ®ECE®ENT Y___,~„ ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Biith MMDDYYYY 2 5 2 3 6 4 7 6 6 1 2 0 3 2 0 0 9 L 0 7~ 9 1 9 3 0 Decedent's Last Name Suffix Decedent's First Name M1 J O N E S W I L I~ I A P'I E (If Appticabie) Enter Surviving Spouse's Information Below Spouse"s Lasi Dame Suffix Spouse`s Firs': Name ~I THIS RETURN MUST BE FNLED IN DUPLICATE WITH 'THF_ REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW a 1, Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-821 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax: Return Required death after 12-12-82? 6. Decedent Died restate ~ 7. Decedent Maintained a Living Trust e- 8. Total Number of Safe Deposit Boxes (Attach Copy of 1l1lill} (Attach Copy of Trusty 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 j Attach Sch ~~;; Spouse"s Sociai Securaty Number I~VKRCJr'VIYUCIV ~ - ~ fl9J JCV ~ IVI\ IYIVJI DG Nv~nrLl i vv. n~~ vvnn~.v~ v~.u~~.v~ r.~.a+ v.........~~. ~ .,.~ .,.,. ~... ............... _...- _-- '-- -.-,-- - -- - - Name Daytime Telephone P~urnber [1 A R C U S A f1 c K N I G H T~ I I :I 7 1? 2 4 `~ ~? 3 5 B ~ REGISTER OF VVILL:i USE ONLY ~i ~ First line of address 6 Q W E S ~' Second line of address City or Post Office C A R L I S L E Correspondent's a-mail address: State ZIP Code ~ DATE Flt_E:D P A 1 7 0 lu B l)nder penalties of perjury.. E declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief it is true correct and complete Declaration of preparer other than the personal representative is based on all in#ormation of which preparer has any knowledge. SIG RE OF P SON R,E.SP SIBLE F R FI G RETUR f~F~? E ;~ , , -- ~~~ ADDRESS 31,1,0 EARLE ST EET HARRISBURG PA 1~_~~1,09 _ SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE ~'~ ~ DATE. ADDRESS 6D WEST POMFRET STREET .CARLISLE PA _]~ ~~O:L3 PLEASE USE ORIGINAL FORM ONLY 1505610140 P O f1 F R E T S T R E E ~" Side 1 1,SD561,01,4i .~,1 ~~; ,._. +~ 1505610240 REV-1500 EX Decedent's Social ;iE~c:urity Num ber Decedents Name: W I L L I A f1 E• JONES ~' S 2 5 6 4 7 6 6 RECAPITULATION 1 Real Estate (Schedule A) ........... .............. .. 1. I E ~ ~" D D • © 0 2. Stocks and Bonds (Schedule B) ................................... 2. 3 Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) .. 3. 4. Mortgages and Notes Receivable (Schedule D) ....................... 4. 5 Cash. Bank Depos!ts and Miscellaneous Personal Property (Schedule E) .. .. 5. 3 7 ~' r'~ ~ 8 . 5 6 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ..... .. 6. • 7 Inter-Vivos Transfers & Miscellaneous N -Pro pate Propert y ~ g (Schedule G) Se orate Billin Requested .. 7 • 0 0 D. 8 Total Gross Assets (total Lines 1 through 7) ......................... .. g. 4 9 5 ? .3 8 . 5 6 9. Funeral Expenses .end Administrative Costs (Schedule H) ... ..... 9. 6 8 ~ 6 9 . 0 8 10 Debts of Decedent. Mortgage Liabilities, and Liens (Schedule I) ....... . 10. 4 ~ .5 1, 1, 5 11 Total Deductions (total Lines 9 and 10) ......................... ...... 11. 7 0 5 i~ 0 . 2 3 12. Net Value of Estate (Line 8 minus Line 11) ...................... ...... 12. 4 i? 2 i' _L 8 . 0 0 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ................ ...... 13. 5 1, 6 4 3 . 6 ~ 14. Net Value Subject. to Tax (Line 12 minus Line 13) ................ ...... 14. 0 7 0 5 ~~ 4 . 6 6 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under SE~~:. 9116 (a)(1.2) X .0 __ 0 0 0 15. 16. Amount of Line 14 taxable at lineal rate X 0 __ 0. 0 0 16, 17. Amount of Line 14 taxable at sibling rate X 12 0 0 ® 17. 18. Amount of Line 14 taxable at collateral rate )< 15 3 7 0 5 7 4 6 6 18. 19. TAX DUE ........... ......................... . .. ..... .. 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT I L 1505610240 Side 2 0. D 0 0. 0 0 ~0 . 0 0 5 5 5 ~3 16. 2 0 5 5 5 ~~ I~ • 2 0 1,50561,024D J ICE-V-15Cu EX Page 3 File Number C~ecedent's Complete Address: 21 09 01132 DECEDENT'S NAME WILLIAM E. JONES STREET ADDRESS 2650 SPRING ROAD c i _~. CARLISLE S ~ ATE ;_IP PA '1701;3 Tax Payments and Credits: i 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. If Line 1 + Line 3 is greater than pine 2, enter the difference. This is the TAX DUE. ;1 i `i5, 586.20 Total Credits (A + B) (2) 0.00 r3) (4) 0.00 (5) 55, 586.20 Make check payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS t . Did decedent m~~ke a transfer and: `Fes iVo a retain the u~~E or income of the property transferred : ............................................................... ..... ~ ~~ b. retain the right to designate who shall use the property transferred or its income; . ,...... ................ ~' .... s_.~ c. retain a reversionary interest; or ......................................................................................... ... ~ d. receive the p~omise for life of either payments, benefits or care? .................................................. ..... ~ ,X~ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ............................................. ............... .................. .... C ~~ 3. Did decedent Quin an "in trust for" or payable-upon-death bank account or security at his or her death? ... .... C ~~ 4 Did decedent own an individual retirement account, annuity or other non-probate property, which contains a beneficiary designation? ............................................................................................. ..... C ~0 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE C AND FI LE IT AS PA RT OF THE RETURN. For dates of death on or after July '', 1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for °he use of the surviving spouse 3 percent [72 P.S. §9116 (a) (1.1ti (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 (r2 P.S. X9116 (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 fil ng a tax return are still applicabiE 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)]. o The tax rate imposed an the nef value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except a;. naked in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. • The tax rate imposed on the ne+ value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116(a)(1.3)J. y~ sibling is defined. undE Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. .~ REV-150 E:X+ (01-10) pennsylvania DEPARTMENT OF REVE:M1tUE INHERITANCE TAX RET'~JFN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF: FILE NUMBER: WILLIAM E. JONES 21 09 01132 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 acopy 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 1. 2650 SPRING ROAD, CARLISLE, PENNSYLVANIA 124,000.00 TOTAL (Also enter on Line 1, Recapitulation.) $_ 124,000.00 If more space is needed, use additional sheets of paper of the same size. REV-153 EX + (6-98) ti COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, ~ MISCa PERSONAL PROPERTY ESTATE OF FILE NUMBER WILLIAM E. JONES 21 09 01132 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION 1. M&T BANK -CHECKING ACCOUNT #49821598 2. M&T BANk: -SAVINGS ACCOUNT #15004214149666 3. METLIFE -ANNUITY #070259778 AB ANNUITANT: DELORES E. JONES (DIED 06/2009) BENEFICIARY: WILLIAM E. JONES ** 4. METLIFE -ANNUITY #071900697 AB ANNUITANT: DELORES E. JONES (DIED 06/2009) BENEFICNARY: WILLIAM E. JONES ** ** PROCEEDS NEVER PAID OUT TO WILLIAM E. JONES DUE TO LITIGATION. COURT ORDER APPROVING SETTLEMENT OF ESTATE WA:i REACHED ON 06/28/10. PROCEEDS ON BOTH ANNUITIES WERE PAID TO THE ESTATE OF WILLIAM E=. JONES ON 10/05/10. 5. PERSONAL PROPERTY -SETTLEMENT STATEMENT ATTACHED TOTAL (Also enter on line 5, Recapitulation)~_$ (If more space is needed, insert additional sheets of the same size) VALUE AT DATE: OF DEATH 16,933.17 177,658.64 84, 532.00 83, 834.00 8,780.75 371,738.56 r~ REV-15'rl EX+ (10-09) pennsylvania ' DEPARTMENT OF REVENUE INHERITANCE TAX RETl11~N RESIDENT DECEDENT ESTATE OF FILE NUMBED WILLIAM E. JONES 21 09 01132___^ Decedent's debts must be reported on Schedule 11e ITEM NUMBER DESCRIPTION ~ AMOUNT A. FUNERAL EXPENSES: 1. MAJOR H. WINFiELD FUNERAL HOME, INC. 12,893.00 B 1 2 3 4 t;ihy HARRISBURG State PA __ zIP 17109 ADMINISTRAI IVE COSTS: Personal Representative Commissions: tJame(s) of Personal Representative(s) BARBARA SPRAGLIN Street Address 3110 EARLE STREET Years} Commission Paid: Attorney Fees IRWIN & McKNIGHT, P.C. Famify Exemption: (If decedents address is not the same as claimant's, attach explanation.) Cla~irnant Stne~~t Address {;it,~ State ReNationship of Claimant to Decedent Probate Fees 5 Accountant Fees: 6. Tax Return F1reparer Fees: PATRICIA A. ROSENDALE, TAX PREPARATION -- 2009 320.00 7. CLOSINU COSTS FROM SALE OF REAL ESTATE 9.153.06 8. REGISTER OF WILLS -FILING FEE 30.00 9. NOTARY' FEES 60.00 10. CUMBERLAND LAW JOURNAL -ESTATE NOTICE 75.00 11. THE SENTINEL -ESTATE NOTICE 187.54 12. ADVANCE AUTO PARTS -REPAIRS TO VEHICLE 119.89 13. L&M HEATING AND AIR CONDITIONING -REPAIRS TO REP,L ESTATE 147.91 14. HILTON'S LOCK SERVICE -CHANGE LOCKS ON REAL ESTATE: 122.31 15. JONES •& MARTIN AUCTIONS, LLC -PUBLIC SALE COMM{SSION 4,39CI.37 16. MARK HFCKMAN, APRAISER -APPRAISAL ON REAL ESTA"fE 400.00 17. NATIONWIDE INSURANCE -HOMEOWNERS INSURANCE 1,058.00 18. REGISTER OF WILLS -SHORT CERTIFICATES _~ 52.00 TOTAL (Also enter on Line 9, Recapitulation) $ 68,769.08 SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS 17,800.00 18, 500.00 ZIP If more space is needed, use additional sheets of paper of the same size. _ _ __ I~ __ _ _ ' Continuation of REV-1500 inheritance Tax Return Resident Deced~er~t; 'WILLIAM E. JONES ;?'1 09 01132 ®ecedent's Name Page 1 ___^ File Number Schedule H -Funeral Expenses & Administrative Costs - B6. Tax Return Preparer Fees ITEM NUMBER DESCRIPTION _~~ AMOUNT COHICK & ASSOCIATES INCOME TAX PREPARATION FOR TAX YEARS 2007 & 2008 544.00 SUBTOTAL SCHEDULE H-B6 ~ 544.00 ' Continuation of REV-1500 Inheritance Tax Return Resident Decederii: WILLIAM E. JONES 21 09 01132 Decedent's Name Page 2 ~____ File Number _ Schedule H -Funeral Expenses & Administrative Costs - B7. ITEM NUMBER DESCRIPTION _i AMOUNT 19. IRWIN & McKNIGHT, P.C. -LITIGATION ATTORNEY FEES 2,916.00 SUBTOTAL SCHEDULE H-B7 ~ 2,916.00 REV-1512 EX+ (12-08) pennsylvania DEPARTMENT OF REVEPJUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER WILLIAM E. JONES 21 09 01132 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimburse~d medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. ICUMBERL,AND COUNTY TAX CLAIM BUREAU -REAL ESTATE TAXES-PRORATED I 1,556.68 2. DANIEL KAMBIC -MEDICAL 359.84 3. NORTH MIDDLETON AUTHORITY -WATER/SEWER 420.92 !I 2 413.71 4. PP&L ELI~CTRIC , TOTAL (Also enter on Line 10, Recapitulation) ~ $ 4,751.15 If more space is needed, insert additional sheets of the same size. REV-1513,E:X+ (01-10) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN SCHEDULE J EENEFICIARIES ESTATE OF: FILE NUMBER: WILLIAM E. JONES 21 09 01132 _ _ RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSONS} RECEIVING PROPERTY Do Not List Trustee(s) __ OF ESTATE TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under I Sec. 9116 (a) (1.2),] 1, JOHN PAUL LEWIS Collateral 500.00 4450 MIXEDWOOD DRIVE LADSON, SC 29456 2. MATTIE HUNTER Collateral 500.00 209 WEST THIRD ST PLYMOUTH, NC 27962 3. BARBARA J SANOR Collateral 1,000.00 102 CLARINDON PLACE CARLISLE, PA 17013 4. VIVIAN COLEMAN CoNateral 1,000.00 521 B SOUTH WEST STREET CARLISLE, PA 17013 5. LUCY CONK Collateral 500.00 514 N. COLLEGE STREET CARLISLE, PA 17013 6. CASSANDRA L_YLE Collateral 500.00 5128-B WYNNEWOOD ROAD HARRISBURG PA 17109 7. REV. OLiVER GALBREATH Collateral 1,000.00 2545 YATES AVENUE BRONX., NY 10469 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER. SHEET, AS APPROPRIATE. jj. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TA.X IS PJOT TAKEN: 1. 6. CHARITABLE AIVD GOVERNMENTAL DISTRIBUTIONS: 1. RADIO BIBLE CLASS 1,000.00 PO BOX 266 GRAND RAPIDS, MI 49501-0266 2. WORLD CHALLENGE 1,000.00 PO BOX 260 LINDALE, TX ;75771 3. BOWIE LIFE ASSEMBLY 1,000.00 B 17214 QUEEN ANNE ROAD " UPPER MARBORO, MD 20774 TOTAL OF PART l I -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF F;EV~-1500 COVER SHEET. •$ 87,643.67 If more space is needed, use additional sheets of paper of the same size. Continuation of REV-1500 Inheritance Tax Return Resident Deceder~t: WiL.LIAM E. JONES 21 09 01'132 Decedent's Name Page 3 File Number Schedule J -Beneficiaries - 1 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT Do Not 1_ist Trustee(s) AMOUNT OR SHARE OF ESTATE ! TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under ___ Sec. 9116 (a) (1.2).] 8. MRS. CHARLES OLIVER GALBREATH Collateral 1,000.00 2545 YATES AVENUE BRONX, NY 1046) 9. NANCY HAMPTON Collateral 5,000.00 1337 RIDGEWA.Y STREET MEMPHIS, TN 38106 10. REJOICE DUPREE Collater<~I ~ 1,000.00 413 HOLLY LANE: MAULDIN, SC 29662 11. MARTHA J. CHEBBET Collateral 1.000.00 PO BOX 2477 NAKURU, KENYA. EAST AFRICA ~ i 12. ANDREW DAMS p Gollaterai 1 ~'00.~00 1102 SEATON ROAD DURHAM, NC 2'713 13. ARTHUR DAMS Collateral 1,000.00 1102 SEATON ROAD DURHAM, NC 2;T713 14. CURTIS SMITH Collateral 1.000.00 265 LINCOLN STREET CARLISLE, PA 17013 15. RICHARD AND BARBARA SPRAGLIN Coliatera! 19.321.84 3110 EARLS STREET 1 CI% RE.MAINDER HARRISBURG, IF',A 17109 16. VERNE E. HERF;ON Collateral 19,321.83 1536 N. 5TH STREET '10`% REMAINDER HARRISBURG. PA 17102 17. TOWANDA L. ACEY Collates! 19.321.83 2403 11TH STREET ')0`%~ REMAINDER ALTOONA, PA 16601 18. DENISE TURNER Collateral 79,32.1 83 Po BOX 5468' o ~~ O°~h REMAINDER ATLANTA, GA 30308 19. CAMERON ACEY TURNER Collateral 19,321.83 PO BOX 54682 11J%> REMAINDER ATLANTA, GA 30308 20. REV. GALBREATH AND OLLIE GALBREATH Collateral 19,321.83 1412 POST LANE= 10°/~ REMAINDER BOWIE, MD 20716 21 FRED D. AND RUTH M. JOHNSON Collateral 38,643.67 87 B STREET 20°io REMAINDER CARLISLE, PA '17013 ` Continuation of REV-1500 Inheritance Tax Return Resident Decedent WILLIAM E. JONES 21 Ci9 01132 Decedent's Name Page 4 File NumbE:r Schedule J -Beneficiaries - 1 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT po Not List Trustee(s) ~ AMOUNT OR SHARE ____ OF ESTATE _ I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 22. CHRISTINE YOUNG -PER COURT ORDER DATED Collateral 200,000.00 06/28/2010 c ~ i . ~~ Continuation of REV-1500 Inheritance Tax Return Resident Decedent 'WILLIAM E. JONES 21 C)9 01132 Dac.edent's Name Page 5 File Number Schedule J -Beneficiaries - 213 11. B. CHARITABLE AND GO`~/ERNMENTAL DISTRIBUTIONS: 4. HAITI HOUSE OF HOPE TUBERCULOSIS HOSPITAL FOR CHILDRERJ S,000.Op UNIT 2109 UEBH 3170 AIRMAN DRIVE FORT PIERCE, FL. 34946 5. THE NEW CHURCH OUTREACH AT LAKEVIEW 5,000.00 NAPURU, KENYA EAST AFRICA 6. SHILOH MISSIONARY BAPTIST CHURCH (20% REMAINDER) 3$,643.07 409 WEST STR.EE~T I CARLISLE. PA 17~~13 ~' SUBTOTAL SCHEDULE J-2B ~ 48,643.67 ~Ot °Y~`~ll ~d c~~.t I, WILLIAM E. JONES, of the North Middleton "Township, Cumberl,~ld County, Pennsylvania, declare this instrument to be my Last Will and 'Testament, hereby expressly revoking all Fills and Codicils heretofore made by me. ONE: I direct my Co-Executors to pay all of my debts, funeral and adrn.inistrative expenses as soon as may be done conveniently after my decease. Furthermore, I direct that all state, inheritance, succession and other death taxes imposed or payable by reason of :my death and interest and penalties thereon with respect to all property composing of my gross estate for death tax purposes, whether or not such property passes under this will, shall bey paid by the Co-Executors of my estate. TWO. My Co-Executors may, at their discretion, compromise claims, borrow money, retain property for such length of time as they may deem proper; lease and sell property for such prices, on such terms, at public or private sales, as they may deem proper; and. invest estate property and income without restriction to legal investments unless otherwise provided hereunder. I authorize and empower my Co-Executors to seal any realty and/or personalty owned by me at my death and not specifically devised or bequeathed herein, at public or private sale or sales and to give good and sufficient deeds and/or bills of sale therefor, in fee; simple, as l: could do if living. My Co-Executors are authorized and empowerec[ tea engage in any business in which I may be engaged at my death, for such period of time after my death as seems expedient to said Co-Executors. THREE: I give, devise, and. bequeath all of my estate of every nature ~a1d wherever situate to rmy wife, DECOKES E. JONES, provided she sw-~Tives me by thirty i;~0) days ar more. q ~~ 1 t FOUR: If my wife, DECOKES E. JONES, has predeceased or failed to siuvive me by thirty (30) days o r more, I specifically give, devise, and bequeath all of my remainiing estate of every nature and wherever situate to the following: A. JOHN PAUL LEWIS ..................................................$500.00 B. MATTIE HUNTER .....................................................$500.00 L. BARBARA J. SANOR ..............................................$1,000.001 D. RADIO BIBLE CLASS ..............................................$1,000.0(1 E. VIVIAN COLEMAN ..............................,...................$1,000.00 F. WORLD CHALLENGE ...........................................$1,000.00 G. LUCY CONN ...............................................................$500.OID H. BOWIE LIFE ASSEMBLY .....................................$1,000.00 I. CASSANDRA LYLE ...................................................$500.00 J. HAITI HOUSE OF HOPE ........................................$5,000,00 K. REV. OLIVER GALBREATH ................,................$1,000.00 MRS.CHARLES OLIVER GALBREATH............$1,000.00 L. NANCY HAMPTON ............................................ ....$5,000.0-0- M. REJOICE DUPREE .........................................., ... .... $1,000.00 N. MARTHA. J. CHEBBET ............................,.......... ....$1,000.tit1 O. ANDREW DAMS ....................................,............. ....$1,000.00 P. ARTHUR DAVIS .................................................. ....$1,000.IDO Q. CURTIS SMITH ................................................... ....$1,000.00 R. THE NEW CHURCH OUTREACH AT LAKEVIEW ..................................................... ....$5,000.00 2 FIVE,: If any of my above-named individuals in Paragraph Four have predeceased me or any of the above-named organizations cease to exist, thhen their share willl be equally distributed to those remaining organizations or individuals namc~d above. SIX.: I give, devise and bequeath all the rest, residue and remainder of r~ry estate of whatever nature and wherever situate to the following: A. RICHARD AND BARBARA SPRAGLIN .................................10%~ B. VERNON E. HERRON ...............................................................10%~ C. TOWANDA ACEY........ ................................................................10%- D. DENISE TURNER ........................................................................10%~ E. CAMERON ACEY TURNER .........................., ...., ......................10 °/~ F. REVEREND GALBREATH AND OLLIE GALBREATH .................................................................10°/~ G. FRED D. JOHNSON AND RUTH M. JOHNSON ...................20°/0 H. SHILOH MISSIONARY BAPTIST CHURCH ........................20°/0 SEVEN: If any of my above-named individuals in Paragraph Six have preci~eceased me or any of the above-named organizations cease to exist, then their share will be equally distributed to those remaining organizations or individuals narried. above. EIGHT: I appoint my RICHARD SPRAGLIN and BARBARA SPRAGL~Ia`~i to serve as Co-Executors of this my Last Will and Testament. NINE: No Co-Executors acting hereunder shall bye required to post bond c-r enter security in this or any jurisdiction. 3 ~~~ IN WITNESS WHEREOF, I have hereunto set my hand and seal this 5'. __ ~d.ay of May 2009. WILLIAM E. JO ES Signed, sealed, published and declared by WILLIAM E. JONES, the above named. Testator, as and for his Last Will and Testament, in the presence of us, who, at his request and ire his presence; and in the presence of each other have subscribed our names as witnessf;s heY•eto. ~~ 1 ~ ~/ 4 a ' ~ a 4 ACKNOWLEDGMENT AND AFFIDAVIT .- WE, 'WILLIAM E. JONES, KAREN S. NOEL and SHARON L. SCHW.A.LM, the testator and witnesses respectively, whose names are signed tc- the foregoing instrc~rn.ent, being first duly sworn, do hereby declare to the undersigned authc-rity that the testator si~Tned and executed the instrument as his last will and that he had signed willingly, and that he Executed it as his free and voluntary act for the purpose herein expressed, and. that each of the v~ri.tnesses, in the presence anal hearing of the testator, signed the will as a witness and that- to the best of their knowledge the testator was, at that time, eighteen years of age or older, of sound mind and under no constrains: or undue influence. 1~ ~: SHARON L. SCHWALM COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND . Subscribed, sworn to and acknowledged before me by WILLIAM E. JONES the testator herein, and subscribed and sworn to before me by KAREN S. NOEL and SEIARON I,. SCHWALM, witnesses, this ~ day of May 2009 *~~~~~~~~~ A. Settlement Statement HUD-1 ~~ ~Ilall~.,;, ~ ) t~MB Approval No. ~:Fd:-;?-(:)?.65~ 1. ^ FHA 2. Q RH 5 3. Q Conv. Unins. 6. File Number: 7. Loan Number: 8. Mortgage Insurance Case N urnlaer: 10419 1011003632 4. ^ VA 5. QX Conv. Ins. C. Note: This form is famished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agents are shown. Items rnarke:d "(p.o.c)" were paid outside the closing; they are shown here for informational purposes and are not included in the totals. D. Name & Address of Borrower: E. Name & Address of Seller: F. Name & Address of Lender: - Robert A. Mixell, 8rionna R Mixell Estate of William E. Jones Vision Mtg Capital, a Div of Cont BM. 1887 Esther Drive, Carlisle, PA 17013 620 West Germantown Pike, Suite 3fi0, Plymouth Meeting, Pa 19462 G. Property Location: H. Settlement Agent: I. Settlement Date: 01/14/2011- 2650 Spring Road 1st Advantage Settlement Services Inc. Disbursement Date: 01/14/2011 Carlisle, PA 17013 North Middleton Town hi Telephone: 717-591-7755 Fax: 717-591-7756 s p Place of Settlement: ------ TitleExpress 6375 Mercury Drive, Suite 102, Mechanicsburg, PA 17050 Printed 01/14/2011 at 9:10 am by KS 100. Gross Amount Due from Borrower 101. Contract sales price 124,000.00 102. Personal ro e 103. Settlement charges to borrower (line 1400) 4,733.96 104. _ - 105. Ad ustments for items aid b seller in advance 106. Cityltown taxes to - 107. County taxes to 108. School Taxes 01114/2011 to 06/3012011 811.05 109. 110. 111. - 112. 120. Gross Amount Due from Borrower 129,545.01 200. Amounts Paid b or in Behalf of Borrower 201. Deposit or earnest money 1,000.00 202. Principal amount of new Eoan(s} 120,000.00 203. Existin loa s taken subject to 204. 205. Appraisal Fee Credit 32.11 206. 207. - Z08. __ 209. Ad'ustments for items un aid b seller 210. Cityltown faxes to 211. County taxes 01/01/2011 to 0111412011 - 14.68 212. School Taxes to 213. _ 214. ~- 215. ~-- 216. ~+- 217. ~- 218. ~- 219. 220• Total Paid b /for Borrower 121,046.79 300. Cash at Settlementfromlto Borrower 301. Gross amount due from borrower (line 120) 129,545.01 302. Less amounts paid bylfor borrower (line 220) 121,046.79 303. Cash ~X From ~ To Borrower 8,498.22 400.. Gross Amount Due to Seller 401. Contract sales price _ _ t;?4,000.00 402. Personal roe ` 403. _ _ ___ ~ - 404. -- - 405. _ _ ~ - Ad'ustments for items aid b~ seller in advance __ __ _ - 406. Cityltown taxes to _ _ - - 407. _ County taxes to - 408. School Taxes 01/1412011 to 06/30/2011 - 811.0°i 409. -~ __ _ - 410. -_ ~~ - - 411. .____-- 412. ---_.-- 420. Gross Amount Due to Seller ~ 1124,811.05 500. Reductions In Amount.Due to Seller ~ ~ 501. Excess deposit (see instructions) __ _ _ ~ - - 502. Settlement charges to seller (line 1400) ~- 9,153.06 503. Existin loa s taken subject to - -' 504. Pa off of first mort a e loan ___ ! -- 505. Payoff of second mortgage loan ___ _ - - 506. _ -' -` 507. Inheritance Tax Escrow ;!3,128.66 508. `- _ ~- - 509. ----_._-- Ad'ustments for items un aid by seller ~~ - -- 510. Cityltown taxes to _ --' -- 511, County taxes 01/0112011 to 01114/2011 - 14.Ei8 512. School Taxes __ to _ ~ - - 513, _ - 514. ~ - 515. _ _ ~ -- 516. __ -_--i 517. __ ---- 518. -`_ _----- 519. .__----... 520. Total Reduction Amount Due Seller 32,296.40 fi00. Cash at Settlement tolfrom Seller _ a 601. Gross amount due to seller (line 420) _ 124,811.05 602. Less reductions in amount due seller {line 520) ~ 3:?,296,40 603. repo rng Cash XD To ~ From Seller e a is agency may no co a ~ m orma o __ _ _ - 9;1,514.65 --- - ------- rt a you are no regwre o c uus romt amass n dlspays a wrtenoy va1W oM8 control number. No conlldenllallly Is assured; Ihls dlsGosure Ls mandatory.-This Is deslpnad to pmvWe the panles to a FtESF'A covered Uansaegon wllh Inlonnallon during the selgemenl process Previous editions are obsolete Page 1 of 4 - HUD-i 700. Total Rea tEl teas Broker Fees $7,790.00 - ~ Division of commission (line 700) as follows: Paid From Borrower's hair! f=r'c~m S ~~ I l e ~' ~:> 701. $4,340.00 _ to RelMaxlstAdvantage 'I J Funds at Fund= ,:~t to Help-U-Sell 702. $3,450.00 Settlement 5et: tl E~ ment _ 703. Commission paid at settlement _ _ _ _ ~,"90.00 800. Items Pa able in Connection with Loan ~ ~ ~ ~ 801. Our origination charge (Includes Origination Point % or $0.00) $596.20 (from GFE'. #1) _ _ _ _ _ ~_ _~ 802. Your credit or charge {points) for the specific interest rate chosen $ (from GFE: #2) _ _ 803. Your adjusted origination charges (from GFE A) ~ _ 596.20 ""'"_~_._ 804. Appraisal fee to R Scott Archibald $400.00 P.O.C. B" (from GFE: #3) ~ ~ 805. Credit report _,_^ to Kroll Factual Data $17.89 P.O.C.(B') (from GFE #3) _ _ 806. Tax service _ to (from GFE #31_ _ ._.____._ _ ___~ 807. Flood certification to Kroll Factual Data (from GFf= #3) 8.0 808. Ellie Mae Closing Fee to Vision Mt Ca ital, a Div of Cont Bk (from GFE= #3) 100.00 _ w r ~ 809. Compliance Inspectin to (from GFEE #3) _ _ _ _ 900. Items Re uired b Lender to be.Paid in Advance 901. Daily interest charges from from 01114!2011 to 0210112011 @ $12.50001day (from GFE #10) 225.00 __ _ ~~ ~ 902. Mortgage Ins. Premium for months to (from GFI= #3) _ __~ ~ 903. Homeowner's insurance for months to Unitrin Auto & Home Insuran~ $430.00 P.O.C.(B")(from GF!E #11) _ _ 904. months to (from GFE #11 _ 1000. Reserves De osited with Lender 1001. Initial deposit for your escrow account (from GFE #9) 1,277.20 - r i - 1002. Homeowner's insurance 3 months @ $ 35.841month $107.52 _ _ _ _ 1003. Mortgage Insurance months $ 70.OOlmonth $0.00 ~~ ~_. 1004. City Property Tax months @ $ O.OOlmonth $0.00 ~ _ 1005. County Property T~ix 13 months @ $ 33.661month $437.58 ~ ~ _ 1006. School Taxes 8 months @ $ 143.91/month $1,151.28 ~ r 1007. Aggregate Adjustment $-419.18 ~ ~~ y 1100. Title Charges ~ ~ ~- 1101. Titie services and lender's title insurance (from GI=E #4) 1,074.06 1102. Settlement or closing fee to $ R 1103. Owner's title insurance {from GFE #5) 15.00 Y ._ 1104. Lender's title insurance $869.06 1105. Lender's title policy limit $120,000.00 Lender's Policy _ ~ ~'~ 1106. Owner's title policy limit $124,000.00 Owner's Policy 1107. Agent's portion of the total title insrrance premium $751.45 1108. Underwriters portion of the total title insurance premium $132.61 - ~~ 1109. ~~ 1200. Government Recordin and Transfer Cha es ~~ 1201. Govemment recording charges (from GFE #7) _ 198.50 1202• Deed $64.00 Mortgage $84.00 Release $0.00 _ V~ ~ 1203. Transfer taxes {from GFE #8) 1,240.00 _ ~ ~~ 1204. CitylCounty tax/stamps Deed $1,240.00 Mort a e $0.00 ~ ~ ^ ~ __ 1205. State Tax/stamps Deed $1,240.00 Mortgage $0.00 ~ _ _ _ Y ~! 1,240.00 1206. Deed $0.00 Mort a e $0.00 Y ~ -~--4 __ _ 1207. Record Assignment of Mortgage $ 50.50 _ ~Y , ._ 1300. Additional Settlement Cha es '- 1301. Required services that you can shop for (from GFE #6) ~' _ 1302. Survey _ to $ ~~ 1303. Pest Inspection to $ ~^ _ 1304. Home Inspection to $ ~ ~ ~~~~ _ _ 1305. Realtor Transaction Fee to $ ~ -' __ 1306. Tax Certifications to Help-USell ^ 5.00 _ 1307. Final waterlsewer 10114-1114 to North Middleton Munici al Authori __ __ ~ 118.06 ' ~ ~ • ' ~ ~ 4,733.96 __9,153.06 *Paid outside of closinci by (B)orrower, (S}eller, (L)ender, (I)nvestor, Bro(K)er. Previous editions aye obsolete Page 2 of 4 ~ HUD-1 Com orison of Good Faith Estimate GF and HUD-1 Char es Char ei;fihat Cannot Increase HUD•1 Line Number Qur origination charge # 801 Your credit or charge (points) for the specific interest rate chosen # 802 Your adjusted origination charges # 803 Transfer taxes # 1203 Char es That in Total Cannot Increase More Than 10% Government recording charges # 1201 Appraisal fee # 804 _ Credit report r # 805 _ Flood cert~cation ~ # 807 Ellie Mae Closing Fee ~ # 808 Compliance Inspectin ~ # 809 .. ~• ~ rr ~- Char es That Can Chan e Initial deposit for your escrow account # 1001 Daily interest charges from # 901 $12.50001day Homeowner's insurance # 903 Title services and lenders Utle insurance # 1101 Owner's title insurance # 1103 Pest Inspection # 1303 Home Inspection ~ # 1304 Realtor Transaction FeE> # 1305 Good Faith Estimate HUD-1 Y_~ ~ _ 596.20 - - `i9G.20 _ ~ _ _ 0.00 _0.00 -.~~ -- 596.20 'i9~6.20 1,240.00 ~ 1,240.00 Good faith Estimate ----, HUD-1 +__ r 175.00 198.50 ~~ 450.00 _400.00 _ 40.00 17.89 ~--~ ~~ -- e.oo a.oo _ 100.00 100.00 100.00 0 0.00 ~~~- 873.00 724.39 $ __ -148.61 or _17.0229% Good Faith Estimate HUD-1 ~ 2,220.00 1,2;'720 ~ 225.00 __ 2;?5.00 M __ 420.00 430.00 ~Y 1,388.38 1,074.06 ~~ 0.00 15.00 75.00 0.00 Y 350.00 ___ 0.00 .~ 200.00 0.00 Your initial loan amount is $120,000.00 Your loan term is 30. years Your initial interest rate is 3.7500% Your initial monthly amount owed for principal, interest, and any mortgage $555.74 includes insurance is ^X Principal X^ Interest Mortgage Insurance Can your interest rate risE: ~ X^ No. ^ Yes, it can rise to a maximum of °/o. The first change will be on 1 ! and can change again every years after ! I .Every change date, your interest rate can increase or decrease by %. Over the life of the loan, your interest rate is guaranteed to never be lower than % or higher than %. Even if you make payments on Ume, can your loan balance rise? ^X No. ^ Yes, it can rise to a maximum of $ -~M!__ Even if you make payments on time, can your monthly amount owed for ^X No. ^ Yes, the first increase can be on i 1 and the monthly principal, interest, and mcxtgage insurance rise? amount owed can rise to $ The maximum it can ever rise to is $ Does your loan have a prepayment penalty? ^X No. ^ Yes, your maximum prepayment penalty is $ ____` Does your loan have a balloon payment? ^X No. ^ Yes, you have a balloon payment of $ due in years on ! i Total monthly amount owed including escrow account payments ^ You do not have a monthly escrow payment for items, such as property taxes and homeowner's insurance. You must pay these items directly yourself. ^X You have an additional monthly escrouu payment of $283.41 that results in a total initial monthly amount owed of $839.15. This includes principai, interest, any mortgage insurance and any items checked below: ^X Property taxes 0 Homeowner's insurance ^ Flood insurance ^ ^ ^ Note: If you have any questions about the Settlement Charges and Loan Terms listed on this form, please contact your lender. Previous editions are obsolete Page 3 of 4 HUD-1 - - - + ~. ~ .~ _ HUD CERTIFICATION OF BUYER AND SELLER I have carefully reviewed the HUD-1 Settlement Statement and to the best of my knowledge and belief, it is a true: and accurate: statement of ali rer.,~:ripts ~3nd ' diobursements made on my account or by me in this transaction. I further certify that I have received a copy of the HUD-1 Settlement Statement ~_ Robert A. Mixell Brionna R Mixell .~. The HUD-1 Settlement Statement which 1 have prepared is a true and accurate account of this transaction. I have caused or will cause the funds to loe disbursed in accordance with this statement SETTLEMENT A DATE WARNING: IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE UNITED STATES ON THIS OR ANY SIMILAR FORM. PENALTIES UPON CONVICTION CAN INCLUDE A FINE AND IMPRISONMENT. FOR DETAILS SEE TITLE 18: U.S. CODE SECTION 1001 AND SECTION 101(). Previous editions are obsolete Page 4 of 4 HUDD-1 • • 1 1 • 1~ iyame of Borrower: Name of Seller: File Number Robert A. Mixell Estate of VUlliam E. Jones 10419 Brionna R Mixell TitleExpress i Prepared 01/14/2011 a¢ ~J:OE~ am tvote: This page is furnished to give you an itemization of the amounts shown on Lines 1101, 1103 and 1104 of the Settlement Statement (HUD-1 ). This page accompanies but is not a part of the settlement statement. If a discrepancy _ exists, the information shown on the Settlement Statement (HUD-1) applies. Paid From Borrower's Funds at Settlement PaiCl F=r'om Seller''s Funds at Settlerrte~nt 1100. Title Charges Amounts Included in Line 1101 _ ___ __ _ 1101. Title services and lender's title insurance _- a. Overnight Delivery Fee-Package $ 25.00 __ b. EmaillDoc Ca_p_y Fee 35.00__ c. Wire In Fee 10.00__ d. Notary Fee 60.00__ e. Closing Service Letter 75.00_ $ 205.00-- 1,074.06 _ _- _ - _- - _ - __ ______-_ - _ _______-_ - _ _ __-_-_ _ _ ___ - _____._-_ - _ ____ _-_ ----------- 1102. Settlement or closing fee -_ _ -________._- 1103. Owner's title insurance (policy) $ 15.00 -- _- 15.00 _ ______- 1104. Lenders title insurance (policy) 719.06 $ 869.06-_ - _ _ ______-_ a. Endorsement 900 EPL-Residential 50.00 __ _ _ _ ___ 50.00 -_ b. Endorsement 100 (No Violation) _- _ _______ _-_ _ 300 Survey 50.00 -_ c. Endorsemen t _- _ _ _______- _ _ (Total 1103 + 1104) $ 884.06 1105. Lenders title policy limit $120,000.00 103674956 PASLE _ _ ____ _-_ 1106. Owners title policy limit $124,000.00 5011442-1508[1 - _- _ _ __ _-_ 1107. Agent's portion of the total title insurance premium $ 751.45 -_ -_ _ __ _ _ _ _-_ 1108. Underwriter's portion of the total title insurance prem. 132.61 -__ _- .__ ____ _-_ (Total 1107 + 1108) $ 884.06 -_ - __ ______-_ __._ _ 1109. - --- 1110. -- 1111. --.- --- 1112. ---- - -- --- -- - - _.--- - - - -------- -._--------- ~-..---------~ Additional Information for Line 1101 Items 1100. Title Char es with Pa ee Total Charge Borrower POC or Credit Borrower _ Line 1101 Seller -l _ _ _ F'aid -_ 1101. Title services and lender's title insurance $ __ _ _ ___ a. Overnight Delivery Fee-Package to 1 st Advantage Settlement Services Inc. 25.00 -_ _- 25.00 _ _ ______-- b. EmaillDoc Copy Fee to 1st Advantage Settlement Services Inc. 35.00 --- _- 35.00 _ _ _ __ -_ _ c. Wire In Fee to 1st Advantage Settlement Services Inc. 10.00 -_ _ 10.00 - -_ - d. Notary Fee to Kristen D. Shive 60.00 -- _ 60.00 _ _ _ --- e. Closing Service Letter to First American Title Insurance Company 75.00 -_ _ 75.00 ' --- 1104. Lender's title insurance to 1 st Advantage Settlement Services Inc. 869.06 __ -- _- 869.06 - -- - -- - -- ~_ $ - -- - - 1,074.06 -- - --- --1,074.06 ~ - -~_------~ -- L_...----------- Date 1/14/11 - ~~ . _ Date 1x14/11 -- Robert A. Mixell - `~ _~/_~ Datc: __1/1_4_,x1.1____ Brionna R Mixell M&T 499 Mitchell Road, Mil.l~~boro, DE 19966 Mail Code DE-MB-12 Irwin & McKnight, PC West Pomfret Professional Building 60 West Pomfret Street Carlisle, PA 1.7013-3222 Re: Estate of: William E Jones Social Security: 252-36-4766 Date of Death: December 3.2009 Dear Sir or Madam: Phone (888) 502-4:349 Fax (302) 934-2'955 December 15, 2009 .Y: . '~: ,. .. ~' .~~ r.~.'. ~: t' fU ,; : - , Per your inquiry, pease be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type o~'Account Checking Account Account Number Ownership (Names o,~ Openir~~, Date Balance on Date of Death Accrued Interest Total 49821598 William E Jones 0228/75 closed 12/07/09 $ 16933.04 $ 0.13 ---------------------------------- - $ 16933.17 2. Type c f :Account Savings Account Accocart Number 15004214149666 Ownership (Names ofd William E Jones Openir~~ Date 12/Z8/06 closed 12/07/09 Balarcc e on Date of Death $ 177651.34 Accn~.ed Interest $ 7.30 Total $ 177658.64 Please be advised, there was no safe deposit box found for the above decedent. * If upon reviewing the information above, you believe there are additional accounts not referenced, please provide us with an account number and/or name of any possible joint account holder. For any additional information on the above accounts, including ownership and any changes, closures and/or reimbursement of funds, etc:., p).ease contact our Spring Garden branch, 100 south Spring Garden Street, Carlisle, PA 1701.3. Office # 717-240-4!25. Sin rely, u.c.2LLF~t~~~ .. Orissa Sears Adjustment Se~r•~ices i 101 Erf~ord Rd, Suite 200 . Camp Hill, Pa.. 17011 ' PH 717.72,d~d358 ®~- Tb: Karen Noll Fax: Phone: 71 ~1-724-358 RC: Delor~es/William Jones Estate KQthleen Fronk 2 including cover) 12/10I0!~ ^ IJr+gent D For Review D Ples~e Comment O Please Reply ^ Please Recycle • Comments: Attached please find the DOD values for Delores' two qualified accounts. F3ecause both accounts are invested in the fixed interest investment options, intterest will continue to accrue until the proceeds are paid out. Metlife will need an authorization, signed by the judge, to settle the clairY~ ar~d pay proceeds to the estate of William ;Jones. Once that is done, 1 can connpfE;te the paperwork with the executor of the estate. Of course, I will need an origir~aU death certificate and short certificate. Let me know if there is anything additional that you need from me. -- ~ •[~ia~',G 1 ve. ~. w Summary Report for Delores E Jones Creaked by: Kathleen Fronk, Financial Services F~epresentative Printed on: 1211 QI2.009 Detorgs E Jones AN(~UiTY PI20DUCT SUMMARY MetLife 8~ Affiliated Companies ~,Z~ ~ ~~ Plan QualifiedlNon•- Account Number Product Type Qualified tndicato~r '~ Of Date AccowM Value ~ ~,~ ~~~ ~ 070268778 AB ~ Prefiecent:e Ptus Account TDA u lified 12!0912009 $8rt !ii?'4.i~9 Q a , ~` "" --~ _~. ,_ -~ Owner DECOKES JONES ~ Issue Date 06/11 /1991 Participant DECOKES JONES Group Neme HARRISBURG SCHOOL DIST '8482: Group Number 0070450 Rider and Benefit information is not available for this policy? of Total Investment Choices Account Vatule Credited Balance Balance MetLife Fixed lnteresl 100,0°~ i~/A NIA :i8~4,574.•79 Servicing AgenUAgency KATHLEEN H FRONK ~ Address CENTRAL PENN FI GP ~ 101 ERFORD ROAD SUITI= 200 CAMP HILL, PA 17011 Delores E Jones Account Number Product ~-~- 071900697 AB reference Ptus Account Qwner DECOKES JONES Issue Date Q~6/09/1993 Annuitant DECOKES JONES ' Rider and Benefit inform ation is not avellabie for this policy. of Total Investment Choices Account Value Credited Balance Balance MetLife Fixeci Interest 100.0°1a NJA N/A $83,879.34 Servicing AgenUAgency KATHLEEN H FRONK ~ gddress 101 ERFORD RQAD SUITE 2t)0~ CENTRAL PENN FI DP CAMP HILL, PA 17011 ANNUITY PRODUCT SUMMARY MetLife ~ Affiliated C:ompalnies Plan Qualified/Non- ~ Ot Date Acc:au~nt Value I ~l ~ ~~ `Type Qualified Indicator ,~~.,~ IRA Qualified 12/09/2009 ~83,879.3a ~~`~ ~.~~. -, ~~~, rnp~rkanfi lrtfara~2-t;on ~ _ Metropolitan Life insurance Company P.O. Box 10356 Des Moines, IA 50306-0356 MetLife _ E~~~~~ i7C? :RWfN ~:, iAW` ~) WTLLIAb? E JONES ESTATE BARBARA. SPRAGLIN, EXECUTOR 60 WEST POMFRET ST CARLISLE, PA 17013 Date: 10-05-2010 Customer Service 1-800-560-5001 Check No: 50023984 Metropolitan Life Insurance Company P.O. Box 14594 Des Moines, IA 50306-3594 ESTATE C1F REV WM E JONES BARBARA, SPRAGLIN EXECUTOR 60 W POMFRET ST CARLISLE, PA 17013 Date: 10-06-2010 Customer Service 1-800-638-7732 Claim Proceeds Gross Payment 86,097.86 MetLife Check No: 500241573 Contract No: 071900697 ~ 4 IN RE: IN THE COURT OF COMMON PLEAS {JF' WILLLAM E. JONES :CUMBERLAND COUNTY, PENNSYLVA ~;,~ ~-.~ _. ~-~ --~-~ o ,;.~ ~- ORPHANS COURT G ~~ ~~ ` 21 -- 09 - 1132 ' ~ ~ c~~ :.k "~t:~ ~ = _ `~-; :,~ ORDER OF COURT `,~.~r=~~ ? , _~` 1. r~J y ~ ', z ~ AND NOW, this 28th day of June 2010, after hearing and consideration ol` the Petition for Approval of a Settlement Regarding the Probate of the Will of William E. Jones, it is hereby Ordered anal L)ecreed as follows: 1. The .Appeal of Probate filed by Gwendolyn Mosley to the: Will of William E. Jones which was dated Ma`s 5, 2009, is hereby withdrawn and deemed to be dismissed with prejudice. 2. Within thirty (30) days of the date of this Order of Court., the Estate will pay to C;lu•istine Young, the sum of One Hundred Seventy-Five Thousand and no/100 ($1.75,000.00) f)ol.l,ars. Upon the sale and settlement of the real estate situate in North Middleton Township by the Estate of William E.. Jones or within six (6} months of the date of this Order of Court, the f nal payment of Twenty-Fi~~~e Thousand and no/100 ($25,000.00) Dollars will be paid to Christine Young on behalf of herself and others. 3. Christine Young will be solely responsible for the distribution of the sums paid by the Estate of William E. Jones to other relatives of the deceased. Said Christine Young will hold harmless the Estate of William E. Jones and indemnify the Estate if any claims are made against the Estate of William E. Jones, its Executrix, Barbara Spraglin„ or its legal counsel, 'Irwin & McKnight, P.C. regarding the distribution of these funds. ~~ . ~~~ ;. S 4. The Estate of William E. Jones will pay any inheritance taxes due to the Commonurea th of Pennsylvania. It is understood that all benef ciaries of the payments made by the Estate: of William E. Jones, his nieces, nephews, or friends of William E. Jones are subject to the inheritance tax rate of fifteen percent (15%) which will be paid by the Estate of William ~;. Jones. 'The settlement reached by the parties is hereby approved this 28t" day of June 2010 and the previous C)rder of Court of December 17, 2009 is hereby vacated. By the Court, ~. `~ _ -~ ~. M. L. Ebert, Jr. Judge ~~ 1 Marcus A. McKnight, III, Esq. L. Rex Bickl~~y, Esq. _ - - c - _ ORPHANS' COURT' DIVISION COURT OF COMMON PLEAS OF In Re: WILLIAM E JONES CUMBERLAND COUNTY PENNSYLVANIA NO. 21-09-1132 CERTIFICATE OF SERVICE OF ORDER ORDER DATE: 6!28/10 -_ - ____________ JUDGE'S INITIALS: MLE -_ ____________ TIME STAMP DATE,: 6/28/10 __ _! _____________ IN RE: ORDER OF COURT __ _____________ SERVICE TO: L 1~EX BICKLEY -_ __...________ MARCUS A MCKNIGHT METHOD OF IVI~~ILING: ENVELOPES P:E~OVIDED BY: ® USPS ®PETITIONE:E~ ® RRR ^ JUDGE ^ HAND DELIVERED ^ CLERK OF ORPHANS COURT ^ OTHER MAILED: 6/28/10 SERVICE TO: METHOD OF MAILING: ^ USPS ^ R.RR ^ HAND DELIVERED ^ OTHER -____ MAILED: ENVELOPES PRC-VIDED BY: ^ PETITIONER ^ JUDGE ^ CLERK OF ORPHANS COURT ~., _. i ~ ~ ~' t ' ~~~ ~ ~~ Deputy -- -------- Clerk of Orphans' Court ~ JONES & MAKIINAUG710N5, LLC 544 Mohawk Road Newville, PA 17241 Darryl Jones Neil Markin Newville, I'A Shippen5bur~g, ('A SETTLEMENT STATEMENT - ~~ SALE NAME: L~~ ~ I 1 i ~;~ _ ~ ~ Q S ~ j ---~ ~T --~. ----- DATE OF SALE ~ ~ ` r-~CC)1~ _______._. 'T - ADVERTISING EXPENSES: Lancaster Farmer __ _~___ The Guide Valley Times ~_ _-_-____ News Chronicle Other __ __-___ Other `_ ____ Sale Flyers Copies __ _-_-__. Type Setting __ ~___ Total Advertising Cos~t__ _-_____ Total # of Bidder Numbers 'Total # Sale Sheets Cash Amount In_ Total $ of Checks "Total # all Sale Sheets_ ~ ~ ~ ~:~ - -~ ~ ,_ _+- Advertising Cost _ ~ _- .Auctioneer's %~° ~ ~ ~-- ~~ ~~,~ ~~~ `~_ - 'Vlisc. Charge __ _- Misc. Charge ~_ _- .~ Net Sale (after expenses) $ ~ .J ~ ~~ ~~ ~ ;~~ Thank- you for the opportunity to work with y-ou and your fam~~1 y M~..fl1.~ ~'. ~t?'1',1VV~'I.tL~FtlN~'1R~~ HD114'~, ~IN'C. 1Vliir:i~ctr~ of ~'o~tiftvrt" Ur.~emher'l, ZU09 "i'he E.~inte Q~ ltc~v. 19r, W i Il ium T. Jones, J r, ?(la Noah rrunt:,Sl:reel; ~~~Ubr a~;cE .Tsax 7,5,1 ~o Scerleon, I~ertnsylYan,it;~ .~ 71 ~1;~ 7~17~~~~-~34Z .h't~x ?'t 7-93)-7737 Jilt'tarr. !i. Wi'~e1d-`Page, Su~e~J,v~~• The Funeral Servi~~a I'or~ l~cv, nr. Willi~l~ $. Jonra Jr, We tn~er~ty appprdein~e t•~ c~~nlitiCnCc you, i'>tuve i7CLtl If1 us and will Crn~lint~e to nssis( yu~l In CVCry Wcly W8 CF1.t1. f' i ~ F' • ~ F~louae ' c,C e to ConUICC ~~s ~ you t ruvu ony qucsuuns 1 rcg;trd ti~ lhls >,c;tternent, TIiB>aQtl"OwrNO is AI~1 t~'iaMtZt31~ S'rn~'>l;Mt:N't"01~'fl~~ tifLR,V.lt~S, FACii.11'tES, AU"rlJMra•rIV1313QutC'MGN9', ' ANta M81tC.'FIAi1Cl~tSQ"t f1AT ~rQ'lI St;t..[;t~"1'l:1~ Vlfi•fRhl MAKlNQ'1'i~'I~IJNI~ItAL ARRANClRM•t1N'1'5, 1. I'rnh~lnnal t~rvteety Puncl'ttl Utroer~r 6~ Sc~fC" a'~149t1,OD $lndafming .~tia~.ao t:lttter I~ropnrarion ol'f~ucly ~~~,(~ •!Nl z. ~aallhiea & frryuipt~ttrl~ flee oFQquir 1ldr, 3tr~t~P Ci~r'~iawii~u ~T$.17Q U4e aCl?.r,u1F~ 8~ Suinfa~ t'4wrvh uldwirt~ll'rq~rnd ~~75•DO 3. Amm~~utfve:l:ryulpmu:~a iannc,vl Copch ,~`,~~•~~ T~:u~ct'aroe ltrmi~inu ca 1=~mwr,~1 Hurnc ~1~45,a0 t.imnuaii-c 5~75.t1u A~idfrivnnl Trn~9(~or~giurt ~,iyrr t.>t~ FttN{~qAl: }tUM1:5rR1'ICI~ LnnHt;l~:~ s~~'.s.rm .y~t+rC'rt~u MfirRCt~IANDIC+fx, tithe pruehcd '~6~n~p.04 Cuet+~m Mc,r>lurlal f'aclrnpa s'1a3.ut1 Adcli ticmtll I'ro~rnms t~ t 261q Ot7 'f Hh CUb'T ~@' OUK SI~RVIC ~' , EQi 11PMtf;1VT~ ANU MCRCI•t~tNU1Sr TtiAT YUt - I~IA'Vt~ Sff~1.iCQ9'iwD , ~.t.=I~~,({p A'r'i'hll; 'I'tMr ~t1NARAl.. A.RRANGl~ML~N9`'3 WfltU3 Mat~rt, wR AgvnNC93D Cf:lt'rAIN I'nYMilf~1'~ 1'o c'rI~1•r~RS ns ant wCrJUMMf11~A'r1UN• '171t;1a'pLLGWiNCl1S AN ACCCII lN'!"TNQ hUtl'19.145~ Ch1A1'tf~r13:~. CASH ADVANCES Newepapo~• 1`tu~lCO ~7.5t~,alti CoAifiotl Gantos t; I tt.gA TC1TA1. CASfif ADYAtVf'~ti ANt) t,i'f,Cr1At. CHAUCtt.9 7C~1! ill St-I3~~Tu't'~t, ;61ZN9S t~(1 tNP{'IAt_ t~AYMHNT ~ Dtst,n~J~lrlr~c:rul3tat•fr~1c 1tl/~q t ~~ t ~'t~A tr ~I~~f'04l' ` t' I~Ut~ • ~ - - - ~ ..~~ i11 Val. ttiJf t •- 14/07/10 1 0.13 0 00 O.OD 0511 ti10 1 21.01 0.00 0.00 06/17/10 1 ;'A2 0.00 0,00 07/21/10 1 Finance Charge 7.02 O.OD 0.00 ~ 08/23/10 1 Finance Charge 6.22 0.00 0.00 09122/10 1 Finance Charge 6.22 0.00 0.00 I 10!27!10 ~ =' ~ 1 Finance Charge 7.22. _0.0.0. 0.00 t 07/24/09 William ' .07l28/09 .99204 1 New Patient Extended 290.12 155~OD" 128.01 0.00 1; 08/21/09 William 08/24/09 99214 1 Est Patient Extended 453.8 105:00 79.53 0.00 1:'. 09!21109 William 09/23/09 99214 1 Est Patient Extended 222.2 105.00 79.53 OAO t;. 09/21/09 William 09/23/09 90471 1 Administration of#1 V05.8 25.00 O.OU 0.00 Immuni t 09/21/09 William 09!23109 90736 ostavax Im V05.8 230.00 O.OD 0.00 C 10/06/09 William 10/15/09 99214 Patient Extended 782.3 105.00 79.53 0.00 I F 10/19/09 1~Nilliam 10/21/09 99213 1 Est Patient Intermediate 428.0 65.00 49.37 0.00 E 0.00 I D.00 I 305.00 I 359.84 ~ 0.00 f Make Checks Pa able To: Daniel Kambic, DO = • ~ PO Box 7649 t71 ~~ Steelton, PA 17113 '" Balance is overdue. Contact us or be referred to a collection agency. ""` -_ _-_ V Reorder: ~~' Software Corporation 443-321-5600 TS-04-LTD ~ 54.84 ~ 0.00 ~ i • ~~ ~~~ ~~~~~~~ ~ ~~~ ~~a~~~~~~~~ ~.~~~ ~~~L'-~1+~~~2 ~fl~t~ E f` E t ~. ~a_: I.: I I i '~ CUSTOMER'6 ORDER NO. PHONE DATE NAME . .. _ ADDRES& SOLD BY CASH ~ C 0 D , CHARGE - ON ACCT MDSE: RE?D F~IID,OIJi' ' L~'r QTY. E7ESCRIPTION PRICE= AMC3UNT ~- .. ~~,_. ~~ ~~ ~ ~ _. .. i ............. _. w ._~:. .. ... ~~ :., • ,.._ ~ ~ ~ 1. /~'`~J `~ ~ ~"~r ~ 1 . /~ ~ .. -..., ~ ' 1 I J ,... .. 1 .._. ._ .....- .~ r ~ ~ ~ ~ _ t , ~ ~,., _:...... •, ~+ • _. ('~~ _.. .. .......~_~~...i~.~r... .~L_.. ~....1_...7'-.r...,.rt'i"'~ti ~~... ~::.. ~,~J' ~,/~^ 1.~_. e,. J~'ti!~.r~~G .-. r 1 1 ~ ~/ v~ .r i i i 1 i i i ~,~ t...(Z/' . ,C../ a .r i i i i ri ,•,,> ~ f ! L ~ ~~ TAX `,`- L RECEiVEO BY TOTAL ~ ~"'~ ; tt ~~f~~L ~ ~~ f I i 1 I f "~. '1 I ` ~~ ~ II claims and returned goods MUST be accompanied by this bill F ~ °"~ ~ ~ To RBnzler '"'~ ~d ~[ta-22:i-n:3e0 or r7Q~5.c~m ~ ~~1 ~ A'~'!S/D'~l11,0r37r'~as'r't~t '''° ~ } Dover, DE. ~_ , ~ ~a~,l~~ - : ~ { 302-69H-1414 ~~ sue- ~ ~ ~ I. ~M41N( ~~`NV~#C ~ WAl ER SYSTEM ° HAR~DWA(!E ' l G~, ~ ~ ~ Middletown, DE 3o2-37F.~-7860 `~ ~3 i~3 Pulaski Nichway ~ C:~alt~morF~l, ~l[ ~' 410-574.0(11 f ~ Fain: ~ 10-`.a'4 -~' 3 `.~ www nartheast~+rn.com ' 1-6; 2- ~ .rtn) 'A F~pUR: (8771- NE 24HOUR (1-81 ~!~ r r.:i ,~ ," :.1 ~~~1 ii-' 1 ~~~~-. t-,:~,,~~.- _ Owings Mills, MD Carlish;, pq 'i10-363-7900 '17-2tii-1'89 i ._.._ -- _ Prince Fredrick, MD X10-535-4375 Hanover, PA - ._ ~~ { ._ ~ .~~ :~ - - . ' Salishury, MU 717-67 2!36 .~ .. .~~~~ s5 '~t~ , -;s; x10-219-1188 ... Timonium, MD Lancaster, PA +~-~----_.,,, 410-252.9610 717-560-41199 C 410-848 7044MD Yark, PA .1 R L E S D fl H I 470-876-5355 717-854-5534 -------~ __- _..r_ c. ~ s ~ . NORTHERSfERN SUPP~r 1~~1 F Alexandria VA '~, Martinsburg, WV 700.922.565 304-754-801a Christiansburgg, VA 540-382-855~U Dulles VA 703-6(i1-0304 Roanoke, VA 540-342-4060 Winchester, VA 540-662-4158 265 EAST POMFREI STREW 1 CARLISLE, PR 1703 , 1-, , ~., .1 f ::~ ,. ~. !., ~ i.! ~ ; i. i; (117) 243-1789 ,:, , , -,..y. ' +.~ ,; ~ ~ (: ;' i''I(: ~ ;:' l? :.l ~. i i:, 4301352353810233 i ~~ o ~ ~-- °; ~ ~'~ ~.s ~ w ~ ~_~ Y ~ ~ a L1. N N FYt~ ~ ee..i ~ C~ ~ r .... p ~.3 7 ~ ~ j \O ~ ~ .~. op d Oil .... p ~ ;~ _ r~ ..-7J ~r S'ri V9 d R ~7 .'~ f~1 ~ 7 4r Q @7 K per ~~. Y..~ t Q C7~ CTS ~•r • T~ CJ~ 6 om m ~ Q .t' ~.. ~... .~. d .. p ~+'~ +T t""1 C^J l+ d O O O G? ~ M [ 6 ~"'~- V~ C7 O ~. l~ E^ p W Sit ~'9 ~"+ r'1 O eV 6 fs3' .."'C " CV' .-r cV ~.. 4 C.~ ~"~. oo c'V G7 N ,.... p v ~ ~.. ~ V .. J ~ ~ ~.p ~ ~L? O ~ ~ ~ ~ ~~ G? [ 6 . .~. , .-. d L:a W E-~ E" d C C C ~'f W N d t'i Q ~ ~ d e'„f CT Yf O OG ~ m oG ~'^' Z` C~ . ~' F ~. N 0o C ~ G~ e+. cVt O c~ b O v ~. e'~a w O ~ U O cV s~ eV Ca ems. ~., ~ ca. era• ~ a -• ti ._ ea d --- -~- ~ ~ ~ O a ' _. ~ oc E,.. w a c 1 E-• .. as cma tr ~ x ~.. cr3 m ts3 ..~ Cs.. -~ x C. [sl Rs. H o d ~- ac ..~ oC va ..3 ~C E- 4 6 ~•• a a rt tz ~ H F L% C.3 E~ E-r ~ cx My..7 i~ E-+ E-~ ea E~+ ce C/~ ~ Qc 1 cn ~ !` ~ ~] . I Y r I Y W o, ~. c~ ~~ ~ r ~!Z ~ ~ 7 w us ',f J n . 13 ~ ~ ~ ~ ~ O u'~ ~ ~ ~ ~° i i L o ~ ~ O O 0 c!~ V ° ~ ~ =~ -~, r C~ ~ ca ~ ~ ?r ° a ~ ~~ ~ , ~ ~ a d ~ ~ ~ - o ~ ~ y a ~ ~~ ~ ~y ~ o ~ . ~ ~ ~ a ~:a ~- .1 oe ova v •~a Zt7 ~'~1 V~ R~7 ~ ~ n ~ N ~ ° ~ ~ ~ ° a _ w ~ - c - ° E- '~ o ~ ~~ ~ au o I ti ° a °: ~ A ..,.. .a .-.-_ ea a r w --- cri c+ .... ~ y. tss •--~ 'l ~ c- ~... d orb oc a ~ O ti a ~C .~ L77 E--' ~C ...tom VJ O. C 4G c-~- ~ i r.a y ~ .-.~ H OG "~~ a.. ..r ~ ~.... CC S .r+ .~.. S r ~ CV E'er ".s GG] t!1 C7 C~ e+t C++ ~ W CC ~++. C7 U .~.. m Q7 OC S .....r .-. ,~ ~ OC T. C/~ C 7 •-, ~t7 OC b -,~ ~ V CAi C ~ CrJ cc ~ a A w a .3 .~ ~ ;rs ao r~ ~ v r as za6 t ..t d ..3 tr1 a ..a ~ ~]i uZ ~; d ~- Crw ctis r cr •-a w c.~ ..a --• ra o ~ ac ~-• oa r-- a~ w ?~ o ..~ U ...~ crs ~-- Ssa o~ ~. w a -emu C.~ rti ca xx ..~ ~ x s oc o x ^,- ya .= ..a x wG a E E~-+ ari U O.. E~+ ti h Ct7 ~ i ~~ COHICK & ASSOCIATES 390 ALEXANDER SPRING ROAD CARLISLE, PA 17015 717-249-5321 TO: WILLIAM & DELORES JONES 1536 N 5TH STREET' I~ARRTSBURG, PA 17102-1609 sTATE~nEn~T of AccouNT DATE PAGE 10/08/10 a of ~. CUSTOMER ID; JONES,. WNI AMOUNT PAID AMOUNY DUB 5Q~.00 FOWFo501L osroih9 ~4 n IR Y'VIN f~ McIQVI GHT WEST POMFRET PROFESSIONAL BUILDING 60 WEST POMFRET STREET CARLISLE, PENNSYLVANIA 17013-3222 WILLIAM E. JONES L)c;cE;mber 8, 2009 7341-1 Matter No. 7341-1. Miscellaneous Fees: Hours/Rate 10/06/09 MAM Draft/Finalize Petition and Order of Court 2.50 $600.00 $240.00/lrllr 10/06/09 MAM Telephone call with John Chronister 0.2U $48.,00 $240.00/lh~r 10/06/09 MAM File Petition 0.3O $72.,00 $240.00/lx~ 10/15/09 MAM Letter to clients 0,2O $48.00 $240.00/]x- 11/06/09 MAM Preparation for hearing 1.50 $360.00 $240.00/1x- 11 /09/09 MAM Telephone calls with Cathy Smith (Met-Ed) O. Sl) $120.00 $240.00/1x• 11 / 12/09 MAIM Preparation/Attendance at Court Hearing 4.00 $960.00 $240.0()/]x• 11 / 12/09 MA.M Preparation for hearing 1.0() $240.00 $240.00/lli• 11 / 16/09 MAM Telephone call with Vern 0.2 ~ $60.00 Telephone call with attorney $240.0(:)/1u~ 11 / 17/09 MAM Telephone call with Attorney Bickley 0.1(:1 $24..00 $240.00/lu~ 1 r ~A / ~.,. Matter No.` 7341-1 Miscellaneous 11/18/09 MAIM Telephone call with Attorney Bickley 12/04/09 MAIM Telephone call with Fred Johnson 12/04/09 MAIM Conference with Fred Johnson 12/04/09 MAM Letter to Judge Ebert Hours: Total fees: Expenses: 10/06/09 MAIM Register of Wills 10/06/09 MAM John Chronister -Personal Service 11/09/09 MAIM Orphan's Court -Three (3) subpoenas 11 /09/09 MAIM Fee for personal service of two (2) subpoenas 11 / 12/09 MAIM Masland Associates, Inc. /Medical Records (William E. Jones) 11/20/09 MAM Carlisle Regional Medical Center Records (`ilVilliam E. Jones) Total expenses: Retainer: 10/06/09 Deposit to account 12/08/09 Retainer applied December 8, 2009 PagE- 2 0.10 $24.00 $240.00/Y~r 0.25 $60.00 $240.00/l~r 1.00 $240.00/l~r 0.25 $240.00/lu~ 12.15 $240.00 $60.00 $2,916.00 $30.00 $110.00 $15.00 $150.00 $83..46 $115..38 $503.84 $500 $500.00 CR f •, + ` y O° Matter No.` 7341-1 December 8, 2009 Miscellaneous page 3 Billing Summary Previous balance $0.00 Payments & adjustments 0.00 Current fees & expenses 3,419.84 Retainer applied 500.00 C:R Total now due $2,919.84 Due date 01/07/10 Retainer Summary - A matter-level retainer Previous retainer balance $0.00 Retainers received 500.00 Retainer available 500.00 Retainer applied 500.00 C R New retainer balance $0.00 ACCOUNTS DUE BEYOND 90 DAYS ARE CHARGED INTEREST AT THE RATE OF 18% PER ANNUM FOR YOUR CONVENIENCE WE ACCEPT VISA, MASTERCARD AND DEBIT CARD PAYMENTS.