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HomeMy WebLinkAbout04-13-11a 1505610140 REV-1500 EX (01-10) - PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes Coun Code Year ~' File Number PO BOX 280601 INHERITANCE TAX RETURN 2 1 1 1 0 3 0 9 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Deat h MMDDYYYY Date of Birth MMDDYYYY 1 6? 3 6 6 0 0 3 1 1 1 7 2 0 1 0 1 1 0 8 1 9 2 3 Decedent's Last Name Suffix Decedent's First Name MI S W E G E R S H I R L E Y A (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW Q 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 1 Z-12-82) 0 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 M A T T H E W A M c K N I G H T ? 1 7 2 4 9 2~3 5 3 First line of address 6 0 W E S T Second fine of address City or Post Office C A R L I S L E Correspondent's a-mail address: State P A ,~ B=yTM3rILLS US~rANLY --- ~. f ~ ,,:~ -~ ~---; _ ,__.. M~ ~ _ ~;C7 ~,~ , `l'.1 _~ ~ r _. ~_. ,"~-" i ; DATE FILED ~ ~` ZIP Code ~ 1 7 0 1 3 ~a-~ ;~ ...~ t 4~ ..u. y.•-1 -- _-- Under penalties of perjury, I 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 al{ information of which preparer has any knowledge. SIGNATUR;,fJF PERSON RF_,,,SP(~NSISLF~OR FILING RETURN DATE. ADDRESS 115 N• MARKET STREET MECHANICSBURG PA 17D55 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS 60 WEST POMFRET STREET CARLISLE PA 17D13 PLEASE USE ORIGINAL FORM ONLY L 1505610140 P O M F R E T S T R E E T Side 1 155610140 J 1505610240 REV-1500 EX Decedents Name: S H I R L E Y A• S W E G E R Decedent's Social Security Number 1 6 7 3 6 6 0 0 3 RECAPITULATION 1. Real Estate (Schedule A) ........................................... 1. 6 0 0 0 0. 0 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 Deposits and Miscellaneous Personal Property (Schedule E)....... 5. • 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 6. 2 7 9 8 . 6 5 7. Enter-Vivos Transfers 8~ Miscellaneous Nan-Probate Property (Schedule G) u Separate Billing Requested ....... 7. 8. Total Gross Assets (total Lines 1 through 7) ........................... 8. 6 2 7 9 8 . 6 5 9. Funeral Expenses and Administrative Costs (Schedule H) .................. 9. 1 4 6 1 4 . 6 6 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ............. 10. 5 8 9 1 . 6 0 11. Total Deductions (total Lines 9 and 10) ............................... 11. 2 0 5 0 6 . 2 6 12. Net Value of Estate (Line 8 minus Line 11) ............................ 12• 4 2 2 9 2 . 3 9 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. 4 2 ,~ 9 2 . 3 9 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 (] 15. 16. Amount of Line 14 taxable at lineal rate X .0 ~ ~ ~ 16. 17. Amount of Line 14 taxable at sibling rate X .12 4 2 2 9 2. 3 9 17. 18. Amount of Line 14 taxable at collateral rate X .15 ~ 0 0 18. 19. TAX DUE .................... ........................ ... ..... ..19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1,505610240 0. 0 0 0. 0 0 5 (] 7 5. 0 9 0. 0 0 5 0 7 5. 0 9 1505610240 ~~~a- ~ o~~ ~n rayr o Decedent's Complete Address: File Number 21 11 0309 DECEDENT'S NAME K SHIRLEY A. SWEGER STf?EET ADDRESS ---- 115 N. MARKET STREET CITY STATE ZIP MECHANICSBURG PA 17055 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, 075.09 0.00 (3) (4) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 5,075.09 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 : ...................................................................... ^ ^X 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? ....................................................... ^ X^ 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................... ^ 0 3. Did decedent own an "intrust for" or payable-upon-death 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? .................................................................................................. ^ 0 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 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, undE Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. Total Credits (A + B) (2) pennsylvania SCHEDULE A t DEPARTMENT OF REVENUE REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: SHIRLEY A. SWEGER 21 11 0309 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 self, 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 1. 1/2 INTEREST - 115 N. MARKET STREET, MECHANICSBURG, PA 17055 60,000.00 120, 000.00 TOTAL (Also enter on Line 1, Recapitulation.) I $ 60,000.00 If more space is needed, use additional sheets of paper of the same size. n~b-i~~a cnt ~vl-IU) pennsylvania SCHEDULE F DEPARTMENT OF REVENUE JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: SHIRLEY A. SWEGER 21 11 0309 If an asset was made jointly owned within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME(S) ADDRESS RELATIONSHIP TO DECEDENT A. DORIS SWEGER 115 N. MARKET STREET SISTER MECHANICSBURG, PA 17055 e c JOINTLY-OWNED PROPERTY: ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECEDENT'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1. A. PNC BANK -CHECKING ACCOUNT #51-4015-0097 5,597.29 50. 2,798.65 TOTAL (Also enter on Line 6, Recapitulation) I $ 2,798.65 If more space is needed, use additional sheets of paper of the same size. rctsv-i 5~ ~ tx+ (7 u-os> Pennsylvania ' DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF SHIRLEY A. SWEGER Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A, FUNERAL EXPENSES: 1, MALPEZZI FUNERAL HOME 8,726.62 B. 1. 2 3 4. 5. 6. 7. 8. 9. 10. 11. ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City State ZIP Year(s) Commission Paid: Attorney Fees: IRWIN & McKNIGHT, P.C. Family Exemption: (If decedents address is not the same as claimants, attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent Probate Fees: REGISTER OF WILLS 178.50 Accountant Fees: Tax Return Preparer Fees: PATRICIA A. ROSENDALE, CPA 350.00 REGISTER OF WILLS -FILING FEE 30.00 CUMBERLAND LAW JOURNAL -ESTATE NOTICE 75.00 THE SENTINEL -ESTATE NOTICE 187.54 REGISTER OF WILLS -SHORT CERTIFICATE 4.00 RECORDER OF DEEDS -FILING FEE 63.00 TOTAL (Also enter on Line 9, Recapitulation) ~ $ 14,614.66 FILE NUMBER 21 11 0309 5,000.00 If more space is needed, use additional sheets of paper of the same size. R1=V-1512 Ev+ (1c-08~ pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER SHIRLEY A. SWEGER 21 11 0309 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, PNC BANK -LINE OF CREDIT #40-03-048113419994 4,820.69 HELD JOINTLY WITH DORIS SWEGER BALANCE - $9,641.37 2. FIA CARD SERVICES -CREDIT CARD #5200017017056509 724.08 3. WEST SHORE EMS -AMBULANCE 346.83 TOTAL (Also enter on Line 10, Recapitulation} , $ 5,gg1.60 If more space is needed, insert additional sheets of the same size. KtV X1513 EX+ (01-10) . ' , Pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES . INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: SHIRLEY A. SWEGER 21 11 0309 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 outright spousal distributions and transfers under Sec. 9116 {a) {1.2).] 1. DORIS H. SWEGER Sibling 42,292.39 115 N. MARKET STREET REMAINDER MECHANICSBURG, PA 17055 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. ~, NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. I $ If more space is needed, use additional sheets of paper of the same size. LAST WILL AND TESTAMENT I, SHIRLEY A. SWEGER, of Mechanicsburg Borough, Cumberland County, Pennsylvania, being of sound mind, disposing memory and full legal age, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking al.l Wills and Codicils heretofore made by me. ONE. I direct my Executor or Executrix, as the case may be, to pay all of my debts, funeral and administrative expenses as soon as convenient 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 be paid by the Executor or Executrix of my estate. TWO. My Executor or Executrix may, at his or her discretion, compromise claims, borrow money, retain property for such length of time as he or she may deem proper; lease and sell property for such prices, on such terms, at public or private sales, as he or she may deem proper; and invest estate property and income without restriction to legal investments unless otherwise provided hereunder. I authorize and empower my Executor or Executrix to sell 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 I could do if living. My Executor or Executrix is authorized and empowered to 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 Executor or Executrix. THREE. I give, devise and bequeath my estate to DORIS H. SWEGER. In the event DORIS H. SWEGER predeceases me, then my estate I hereby give, devise and bequeath to Cheryl L. Cleland, Gerald L. Sweger and Donald R. Sweger, share and share alike, per stirpes, which provides that the child or children of any deceased beneficiary shall receive the share their parent would have received if living. FOUR. I nominate and appoint DORIS H. SWEGER, to be the Executrix of this my Last Will and Testament. If she has predeceased me, failed to qualify or is not able or does not serve for whatever reason, then I appoint Cheryl L. Cleland, to be the Executrix of my estate. In the event Cheryl L. Cleland is unable to serve for whatever reason, then I hereby appoint and nominate Gerald L. Sweger and Donald R. Sweger as co-executors. The substitute personal representatives having the same powers as the original Executor/rix hereunder. FIVE. No person(s) shall benefit hereunder unless such beneficiary shall survive me by thirty (30) days. SIX. No Executor acting hereunder shall be required to post bond or enter security in this or any other jurisdiction. SEVEN. No beneficiary may assign or anticipate his or her interest in any income or principal held or distributable hereunder; and no beneficiary's creditors may attach or otherwise reach any such interest. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 27th day of April, 1999. (SEAL) SHIRLEYA. SWEGER Signed, sealed, published and declared by the above-named person as and fox a Last Will and Testament, in our presence, who at said person's request, in said person's presence and in the presence of each other have hereunto set our names as subscribing witnesses. %~ ~ ~ I 1 ~ J ~ ACKNOWLEDGMENT AND AFFIDAVIT WE, SHIRLEY A. SWEGER, SHARON L. SCHWALM and BETZI A. MORRISON, the testatrix and witnesses respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testatrix signed and executed the instriument as her Last Will, and that she had signed willingly, and that she executed it as her free and voluntary act for the purpose herein expressed, and that each of the witnesses, in the presence and hearing of the testatrix, signed the Will as a witness and that to the best of their knowledge the testatrix was, at that time, eighteen years of age or older, of sound mind and under no constraint or undue influence. rr~ Q, SHIItL ~ . SWEGER ~~~~ ~a~,~ o~ SHARON L. SCHWALM ~ f U BETZI . MORRISOAT COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND Subscribed, sworn to and acknowledged before me by SHIRLEY A. SWEGER, the testatrix herein and subscribed and sworn to before me by SHARON L. SCHWALM and BETZI A. MORRISON, witnesses, this 27thday of April, 1999. Notarial Seal otary Public Martha L. Noel, Notary P u ~~ I : c Carlisle Boro, Cumberland County My Commission Expires Sept. 18, 199' ~ ~~her, Pennsylvania Association of Notaries` RC1M131( I vc 3/1/2011 To whom it may concern: Attached is the CMA that I have prepared for 115 N Market St, Mechanicsburg, PA, based on current market conditions. It is my professional opinion as a licensed real estate agent that the current market value is approximately $120,000. Sincerely Brad Cleland RE/lvJ[A,X 1st Advantage 6375 Mercury Drive Mechanicsburg, PA 17050 717-591-5555 office 717-591-7273 fax 717-591-7725 DID Each Office Independently Owned and Operated ~~~~ 1st Advantage ~. 6375 Mercury Drive, Suite 101 ML.S Mechanicsburg, Pennsylvania 17050 ® Office: (717) 591-5555 Fax: (717) 591-7272 ' t t r :` `~ :~ . 8~0~ A.U, Sna.,. Ldl~a. Ya . r .~ . ~ MADE THE 30 day of ~ ~ ~~ in the year of our Lard one thousand nine hwtdred sixty-eight, by and between FRANK STEPHENSON sad PAUL NOEL, ' Ezecut ors under the Last Will and Testament of ALVA S. MENEAR, . deceased,. late of the Borough of Mechanicsburg, County of Cumberland and State of Pennsylvania, ~ ., GRANTOR $ - AND DORIS H. SWEGER and SHIRLEY A. ~WEGER, of the Borough of Mechanicsburg, County of Cumberland and State of Pennsyl- vania, ~ ' - . ~ GRANTEES' WHEREAS, the said ALVA S . MENEAR ~ . was vested in her lifetime with title to premises hereuia/ter described, situate at lI5 North Market Street, Mechanicsburg, • County of Cumberland ,Commonwealth of Pennsylvania; and WHEREAS, the said ALVA S.~ MENEAR died. testate on .3uly 30, 1968 and her Last I~':Tl and Testament was duly. probated in theRegister o/ Wills ONcce in the County of Cumberland - and WHEREAS, Ehe said real estate hereina/ter described was not spectijccally devised, and the said FRANK STEPHENSON and PAUL NOEL qualified as exeeut ors of the Last Will and Testament; NOW THEREFORE, This Indenture Witnasseth that the said FRANK STEPHENSON and PAUL ~ ,Executers as aforesaid, • for and do consideration of the sum.oj Seventy-five Hundred and 00/100 (7500.00} Dollars, lawful money of the United States to them tin hand pout by the said Doris H. Sweger and Shirley A. Sweger at and before the ensealing and delivery herco/, ' the receipt whereof is hereby acknowledged, baps granted, bargained, sold, aliened, released and confirmed, and by these presents, by virtue of the power and authority in them vested by the Fi- duciaries Act of the Commonwealth of Pennsylvania; do grant, bargain, sell, alien, release and confirm unto the said .Doris H. Sweger and Shirley A. Sweger, theirheirs -and assiy~s; AI! mat certain. two-story house and lot of ground situate on the west side of North Market Street (Fourth Ward) in the Borough of Mechanicsburg, County of Cumberland and. State of Pennsylvania, bounded and described as follows, to wit: BEGINNING at the curb line in said Market Street next to Lot No. 133, now or formerly of Joseph G. Levy; thence along said curb ' line, north 19~t degrees west, thirty-eight (38) feet to Lot No. 131,. now or formerly of Emma 0. Myers; thence along said lot, south 70 3/4 degrees west, six (6) feet for pavement and one hundred seventy-four 1174) feet to an alley; thence along said, alley, south 18~C degrees east, thirty-eight~(38) feet to Lot No. I33; thence•along said lot, north 70 3/4 degrees east, one hundred seventy-five (175) feet and six(6) feet for pavement, to the place of BEGINNING. The said house bea.ng known as No. 115 North Market Street. BEING the same premises which Annie D. Stephenson, widow, by her deed dated September 23, 1925, and recorded in the Recorder's Office in and for Cumberland County in Deed Book •B•, Volume 10, ' Page 439, granted and conveyed unto Alva M. Stephenson, later Alva S. Menear. .t BOOKz 22PacE 592 ~ .=. , ~~~, 11/18/2010 10:52:14 AM CUMBERLAND COUNTY Inst.# 196800612 -Page 1 of 2 TO HAVE AND TO HOLD the said measr<aqe or tenement and tract of land, hereditaments and premises hereby granted and released, or ment:`oned and intended so to be, with the appurtenances, unto the said. grantee s their heirs and assigna,_to and for the only proper use and behooj of th.c grantee s, their heirs and assigns jorcver. itiYD flee said. grantorg , execcctors , as aforesaid, their heirs, execrators and administmtors do coianant, promise and agree to and :vith the said grantee s, their heirs and asaigics, by these prescnt.4, tTiat the grantor s haile not dune, committed any act, matter or thing whatsoever tulccrcby the pretnises hrrcby grnnted, or any part tlcercaj, is, are, shaft ar may be impeached, charged or cnctctnbered in title, or otherrviae ho:csoever. ' IN jY1T11'ESS TYHF.RF.OF, tlee said Ereautorg of the Estate of Alva S. Menear, • deceased, Grantor s. herein, have hereunto set their hand s and seals. the day and year first above written. nel, &,s~,a „nn tlinrrsD ~v ~~j'[t `G' C' /fit ~+'i'v ~~ pia Ihr•~lteetncPoF ..._ ..1..~°.f..~l ~........_.... __.»......_ stc.L •I~ /~ ~~ _ Executors ~oj the Estate of • . deo'd. •o~ough s O 1St. Cumb~ CO +', ~~~~! 1`~ F ~i1 {,~!~ ~~ fir...., : .. ;~r r tte? 1.7G R•.i Ed.t• tr.nla T•^ ,. C%(~'•"?~ ,~ .a w.~ ~>~ :~ ~i7-~~.~1+4» ' R••1 Ed•t• Tr~mi•r T~^ ~ , , / ~~jy ~;~ D. • :!.'~!~ Am !.~ r:~ .j •'i: ~ ~':: ~;~t+~'' l i ~3,tt .G~t~i~l~~'~'~". J 1• ~~ : I.:.ii A,nt U~l•~~a • t ~~~ Cwnb. Ce. Dl~t. GI. Aglls Cu^,b. Co. Dhk Cel. Ae1t-S ~' •-_ '^.._.• --.. ~ . ~~ •,~ '~ `.' ..' v ~r _, C011iMON3YEALTH OF PENNSYLV:4NIA r. • _' aa. ~~. "' CO[INTY OF CUMBERLAND /, On this, the ~ v ~ day o j ~ " ~'"~'~! , 19 6 8 , before me a Notary Public in and fo P8u1 tNotcnt and Stat ~ the undersigndpogieer, personafitl appeared Frank Stephenson i ,~'+r~A%n to me or aatiajactorif raven) to be the persons described in the foregoing instrtemeret, and acknotuledged that they ex= eerrtcd the satnc in the capacity therein stated and for the ptcrposes therein contained. IN xl'ITNESS Wf1EREOF: 1 hereunto set nay hand and o8ceial seal. ~ r ,. ~~ . 1~: , : s tit Mr Commission Fapi-es fe0ru~ry 16,196 Y Title of O,~ieer ~' ;t;~ ., • .. ~ ; . , ,K .t 6ta6srupbur~ PJ. Cumbeclufd Couch " CERTIFICATE OF RESIDENCE ~~'~~ I do hereby certify that the precise residence and exact post o,~ce addrP.sa of the within named grantee is lI5 North Market St. , cYtanicsburq, P nna. 17055 •, _ ~~ Attorne • or ...._. ..._ i! f t~eBS___...... --...... Y. BOOK 22PACE S93 . ~w.?.r.'a~^~' . .': 1:'I:cxil ' .~.ii A,. ~ f 11/18/2010 10:52:14 AM CUMBERLAND COUNTY Inst.# 196800612 -Page 2 of 2 Detailed Results for Parcel 19-23-0565-008. in the 2004 Tax Assessment Database DistrictNo 19 Parcel ID 19-23-0565-008. MapSuffix HouseNo 115 Direction N Street MARKET STREET Ownerl SWEGER, DORIS H ET AL C/O PropType R PropDesc LivArea 2202 CurLandVal 20000 CurImpVal 88930 CurTotVal 108930 CurPrefVal Acreage .16 CIGrnStat TaxEx 1 SaleAmt SaleMo SaleDa SaleCe SaleYr DeedBlcPage 00222-00592 YearBlt 1895 HF File Date 10/20/2004 HF Approval_Status A http://taxdb.ccpa.net/details.asp?id=19-23-0565-008.&dbselect=l 11/18/2010 ~~ v~--~" ~~-~^'^^ ~" -^^~~ ~ ^~- ~~-~'.'vvvvViaaV ii•. • bY1MV i~v Vif K4J.L VLKIIV 1 ^~ . Detailed Results for Parcel 19-23-0565-008. in the 2010 Reassessment Database Municipality: 19 -MECHANICSBURG 4TH WRD Property Type: R School District: 6 -MECHANICSBURG SD Owner: SWEGER, DORIS H ET AL Parcel ID: 19-23-0565-008. CG Status: House 115 Taxable Status: Taxable Property Number: Street: N MARKET STREET Old Assessed -Land: Zoooo New Assessed -Land: zs2oo Old Assessed -Buildings: ss93o New Assessed -Buildings: 114zoo Old Assessed -Total: 1os93o New Assessed -Total: 142400 Old CG Assessed -Land: NOT New CG Assessed -Land: NoT Old CG Assessed - New CG Assessed - Buildings: APPLICABLE AppLICABLE Buildings: Old CG Assessed -Total: New CG Assessed -Total: http://ccweb.ccpa.net/tax_lookup/Details.aspx?pid=19-23-0565-008. 11 /18/2010 ~'riox~ity 5o Plu~~- Account Statement PN ('. '~anlc period 71/05/2070 to 12/07 001221 DORIS SWEGER SHIRLEY SWEGER 115 N MARKET ST MECHANICSBURG PA 17055-3340 '~_:~ PNCBANK Primary account number: 51-4015-0097 Page 1 of 8 Number of enclosures: 0 For 24hour banking, and transaction or _ interest rate information, sign on to PNC BankOnline Banking at pnc.com. 'rj' For customer service call 1-888-PNC-BANK Monday - Friday: 7 AM - 10 PM ET Saturday & Sunday: 8 AM - 5 PM ET Para servicio en espafiol, 1-866-HOLA-PNC Moving Please contact us at 1-888-PNC-BANK ® Write to: Customer Service PO Box 609 Pittsburgh PA 15230-9738 Visit us at pnc.com ;~; TDD terminal: 1-800-531-1648 For hearing impaired clients only Important Information on Federal Deposit Insurance Coverage (FDIC) (3et acquainted with recent FDIC changes: '~ On July 10, 2010, the basic amount of FDiC deposit insurance coverage permanently increased from $100,000 to $250,000 per depositor, per institution. Beginning December 31, 2010, the FDIC will implement a new temporary insurance category to provide unlimited FDIC insurance coverage for funds held in noninterest-bearing transaction accounts (checking) at insured banks. This temporary category will remain in effect through December 31, 2012. F'or more information on FDIC or to learn more about how to maximize coverage, visit www.FDlC.gov or call toll-free at 1-877-ASK-FDIC (1-877-275-3342). Hearing impaired line 1-800-925-4618. ~'1a11'I~y ~0 PIuS Doris Sweger Shirley Sweger Int+e~~est Checking Account Sllummalry Account number: 51-4015-0097 Overdraft Protection Provided By: 9994 Balance Summary Beginning Deposits and Checks and other Ending balance other additions deductions balance 2,017.77 7,237.90 ~,lss.os s,og7.61 Average monthly Charges balance and fees 5,441.46 .00 Transaction Summary Checks paid/ Check Card POS Check Card/Bankcard withdrawals signed transactions P05 PIN transactions 32 0 0 Total ATM PNC Bank Other Bank transactions ATM transactions ATM transactions 0 0 0 .ti PN DM LT01-J O B07 212-140-N N N N N N-004003 50 2 `Priority 5o PiuS Account Statement ~. n For 24hour information, sign on to PNC Bank Online Banking ~~, on pnc.com. Account number: 51-4015-0097 -continued r. ~ ~ For th• period 11 /05/2010 to 12/07/2010 DORIS SWEGER Primary account number: 51-4015-0097 Page 2 of 8 Interest Summary Annual Percentage Yield Earned (APYE) 0.05% Number of days Average collected Interest Paid fn interest period balance for APYE this period 33 5,441.46 .23 As of 12/07, a total of $2~7 in interest was paid this year. Overdraft and Returned Item Fee Summary Total for this Period Total Overdraft Item Fees (OD) .00 Total Continuous Overdraft Fees (COD) .00 Total Overdraft Fees .00 Total NSF/OD Refunds .00 Total Year to Date 399.00 7.00 406.00 406.00 A~t~~~y Detail Deposits and Other Additions There were 4 Deposits and Other Additions Date Amount Description totaling $7,237.80. 11/10 5,000.00 Branch Deposit Te104000115010030 12/01 1,160.35 Direct Deposit -Civil Serv US Treasury 312 A 2589630 0 CSA 12/01 1,077.32 Direct Deposit -Civil Serv US Treasury 312 A 24349610 CSA 12/07 .23 Interest Payment Checks and Substitute Checks Check Date Reference Check Date Reference number Amount paid number number Amount paid number" 27.36 12/06 085930497 2595 * 71.19 11/15 085222266 2574 * 13.00 11/09 o8ss61x77 2596 16.Ot) 11/16 085788250 " 2576 * 14.00 11/09 Lo868s1378 2597 7A0 11/17 o8s448s54 2577 19.00 11/05 522o2824x 2598 50.00 11/17 086526953 2579 * 57.00 11/08 526255892 2599 5.00 11/22 o8x7o248x 2580 65.00 11/08 526255398 2600 10.0() 11/18 o8xo86o13 2581 58.33 11/08 526255893 2601 16.0() 11/16 085788242 2583 * 50.00 11/15 522818664 2602 105.0() 11/19 os3185xa2 2584 35.00 11/15 5228186x5 2603 14.97 11/26 085644261 2585 25.00 11/12 084156866 2604 200.OU 11/15 084971492 2586 55.00 11/16 086032284 2605 10.97 12/01 083978421 25$8 * 52.00 11/12 0774559x1 2606 58.00 12/01 522659446 25$9 9.00 11/16 os58912so 2607 57.74 12/01 522659445 2590 156.82 11 /12 5226x1992 2608 57.00 12/01 522659444 2592 * 57.76 11/15 E1215890775 2610 * 50.00 12/06 5263694Fi0 2593 28.83 11/16 08558962s 2611 74.00 12/03 075174406 * Gap in check sequence Online and ®e~tronic Banking Deductions Date Amount Description 11/05 34.27 Direct Payment -Ins Prem Bankers Life 357 1105 11/05 4.00 Direct Payment - XXXXXX2311 Priority 50 Plu 2722738 11/08 38.29 Direct Payment -Ins Prern Bankers Life 357 XX1106 11/08 32.50 Payrnent,E-Check Check Pymt Patriot News 2578 11/10 25.00 Payment,E-Check Check Pymt Fia Cardservices 2587 Online and Electronic Banking Deductions continued on next page There were ;32 checks listed totaling $1,525.97. There were 15 Online or Electronic Banking Deductions totaling $1.642.09. FORM166R . Priority 50 Plus Account Statement pNCBANK For the period 11 /05/2010 to 12/07/201 O for 24hour information, sign on to PNC Bank Online Banking DORIS SWEGER on pnc.com. Primary account number: 51-4015-0097 Account number: 51-4015-0097 -continued Page 3 of 8 Online and ~ectironic Banking Deductions -continued Date Amount Description 11/15 19.49 Direct Payment -Ins Prem Bankers Life 357 1113 11/16 211.00 Payment,E-check Util Pmt UGI Utilities 2591 11/18 48.82 Payment,E-Check Check Pymt Verizon ARC 2594 11/24 25.95 Direct Payment -Ins Prem Bankers Life 357 1124 12/02 9.99 Phone Order Pmt- Homeservic Home Service (us 228$087 12/03 56.22 Direct Payment - Elec Svc Ppl Eu x;XX~~XX0007W s 12/06 38.29 Direct Payment -Ins Prem B~±~kers 1..ifP 35'? ~..X.~XXX~:~XX1206 12/06 16.95 Direct Payment -Ins Prem Bankers Life 357 1205 12/06 4.00 Direct Payment - X~G~XX~~2311 Priority 50 Plu 6453536 12/07 1,077.32 Direct Payment -Reversal US Treasury 312 A 2434961 0 CSA Daily Balance Detail Date Balance Date Balance Date Balance Date Balance 11/05 1,960.50 11/15 5,990.12 11/22 5,428.47 12/03 7,301.30 11/08 1,709.38 5 6 11/24 5,402.52 12/06 7,164.70 11/09 1,682.38 .29 11/26 5,387.55 12/07 6,087.61 11/10 6,657.38 11/18 5,538. 12/01 7,441.51 11/12 6,423.56 11/19 5,433.47 12/02 7,431.52 PN DM LT01-J O 607 212-140-N N N N N N-004-003503 ~~~y ~ -_- . _ __ _~ - ~ PNCBANK .- Page 2 of 2 For the period ending 10/21/10 Account Number 40 03 048113419994 Important Information NEED TO FIX THE ROOF, INSTALL SOME NINDONS OR BUY A NEN FURNACE BEFORE MINTER SETS IN? USE YOUR LINE OF CREDIT TO COMPLETE THOSE HOME IMPROVEMENT PROJECTS TODAY. _ Activity Summary Previous Advances) Payments/ New Current Part Balance Charges Credits Balance Payment Due VARIABLE 9 , 675.72 24.4~~ 50.00 ~) , 65Q.21 51.22 un~ of -~®~'i~ Account "wary SHIRLEY A StiVEGER Account Number 40 0:~ 04811:419994 DURIS H S~VE(GER 'a For information call 888-7C2-22f5 Credit and Payment Information Statement Maximum Credit Still Payment Date Credit Available Due Date 10/21/ 14 100 , 000.00 90 , 374.28 11/ 15/ 14 Current Past Minimum Late Payment Due Payment Charge Due Amount Due 51.22 0.00 51.22 0.00 If a Late Charge has been assessed, the late charges and minimum payment are both due on the Payment Due Date. The amount of your late charges is itemized separately and is not included in the minimum p ayment shown above. Finance f'harg• and Credit Life .Insurance Information The ANNUAL PERCIJIITA6E RA?E for the Account is: 2, ~ 31 c~~, Corresponding AIfrWAL Daily Averaye Days in Credit Life PERCERirA6E P rt Periodic Daily Billing FINARCE CNARGE Insurance a RATE CAPRI Rate Balance Cycle Interest/Transfer Fee Premium VARIABLE 02.900 Jo 00.0081 t)1 lo(o) 9 , li41.:17 :~ 1 24.49 0.00 0.00 (c) (a) This rats may vary. !b) This rate will not vary. (c) Insurance premium for all o~rtstanding loan balances {variable & fixed). Fixed P&1 means a faced rate principal & interest part. Fixed 10 means a fixed rate interest only part. ' Important Information regarding your Faced Rate part: If you had transferred all or part of the principal balance in the Variable Rate part of the account to another part during the billing cycle, the following rates would have applied: Part Corresponding AlI~I11f1AL Daily Periodic Variable Rate Information: PERCERrA6E RATE (APIt) Rate Fixed P&f ri.3r,~,n~ 0.014668 Io This rats may vary, but once the rate is established for a new Fixed Rate Principal & Interest Part, it will not vary. Fixed 10 x.104Io 0.013983~7o This rate may vary, but once the rate is established for a new Fixed Rate Interest only Part. it will not vary. Please see Account Activity on the following page~s~ Please see reverse side for important information about your account. EOUAI H[IU SI N!'.1 FNIlFR b ~~ s ~~ ~~ ~~ m o I rA ~ o , Malpezzi Funeral Home 8 Market Plaza Way (717) 697-4696 Mechanicsburg, PA 17055 www.malpezzifuneralhome.com Jeremy J. Shartzer, FD Michael J. Malpezzi, Owner, FD Kyle C. Knipe, FD December 22, 2010 Doris Sweger 115 North Market Street Mechanicsburg, PA 17055 r~ t~~ F11T1Pral Corin~~ fnr ~l'irl~a~ :'~. Ca.~:nr.ar ~Ve sincerely appreciate the confidence you have placed in us a.nd will continue to assist you in every way we can. Please feel free to contact us if you have any questions in regard to this statement. THE FOLLOWING IS AN ITEMIZED STATEMENT OF THE SERVICES, FACILI"TIES, AUTOMOTIVE EQLIIPMENT, AND MERCHANDISE THAT YOU SELECTED WHEN MAKING "I'Ii>r FUNERAL ARRANGF,MENTS. 1. PROFESSIONAL SERVICES: Services of Funeral Director/Staff $4,fi25.00 FUNERAL HOME SERVICE CHARGES $4,625.40 SELEC" I~ED MERCH,4Ni!?ISE: So?ei Non-Ga.slteted Casket '~ ~ ,'780.00 1 ? Ga. Regular $ i ,~t8S.00 THE COS"I.OF O>iR SER~'IC.ES, EQtJ[Y!VIEN.ti~, AND ~Y1r,RC1=1,~tii~1Sr, TIiAT ~' OI' ~H.~e't; Sk;LEC:'t r::I~ $7,890.00 AT THE TIME FUNERAL ARRANC-I~MENTS WF2~: ~-lAnF ~~lE; Af?~%:4'~`CI:I:~ ~'ER`I'AIN PAYNIL;N?'S l'O O"THERS AS AN ACCUMMUDATION. "I'HE "rOLLO`VlNG IS AN ACCO(1N"!'INCA FOR "I'HO:~E CHARGES. CASH ADVANCES: Opening Grave $475.00 Cemetery Equipment $165.00 Certified Death Certificates $60.00 Newspaper Notices -Patriot $83.62 TOTAL CASH ADVANCES ,AND SPL;('EAL CHARGES $836.62 CONTRACT PRICE $8,726.62 TOTAL AMOt`NT D4':r. ,, ~ ~~~~~ r t - /© ~/ $5.,726.62 ~~ • www.FlACardServices.com ESTATE OF SHIRLEY A SWEGER 115 N MARKET ST MECHANICSBURG, PA 17055-3340 December 27, 2010 Account No.: 5200017017056509 Dear Estate of Shirley A Sweger: We have recently been informed of the passing of Shirley A Sweger and offer our condolences. Please be assured that this account has been closed. Shirley A Sweger was a valued FIA Card Services N.A. customer since. February 5, 1997 and we greatly appreciate the past business with us. While we certainly understand this is a difficult time for the family, we do require the necessary information regarding the financial affairs since there is a balance of $724.08 remaining on the above referenced FIA Card Services account. The information requested on the following page will enable us to take the appropriate action and contact the personal representative handling the financial affairs of the decedent. Please complete the enclosed Estate Status Form and return it to us using the postage paid return envelope provided in this package. If you have access to a fax machine please feel free to fax the form to 1.302.458.0679. You are not obligated to send us a death certificate unless the above referenced account was enrolled in one of the credit insurance, cardholder security or credit protection plus products. Should the family or legal counsel determine that opening an estate is not the best course of action, please have the Personal Representative of the decedent take a moment to call one of our senior associates at the number below to discuss the various options available to satisfy the remaining balance of $724.08. As a reminder, whether or not, you are the personal representative, executor or attorney handling the affairs of the decedent, you are not personally responsible for this debt. Subject to the above, if you are in a position to mail a payment in full, please mail it to FIA Card Services, PU Box 15409, Wilmington, DE 19850. For overnight mail, please use FIA Card Services, 1000 Samoset Drive, Newark, DE 19713. When sending a payment to our office, whether through the U.S. Postal Service or via overnight/express, please do not forget to write the account number listed above on the face of the check to ensure the payment is correctly credited to the account. Again please accept our condolences on the loss of Shirley A Sweger. If you should you have any questions with regard to the above referenced account, payment options, or how to answer the questions on the Estate Status Form attached, please don't hesitate to contact one of the senior associates in our Estate Department at 1.877.767.9383. Our hours of operation are Monday through Thursday, 8 a.m. to 8 p.m. and Friday, 8 a.m. to 5 p.m. Eastern. Sincerely, The Associates of FIA Card Services Estate Department Enclosures WEST SHORE EMS -BLS ® c~scovER ` 205 GRANDVIEW AVE SUITE 211 CAMP HILL, PA 17011 ON REVERSE SIDE Phone #: (800) 367-0512 Federal Tax ID: 23-2463002 EMERGENCY MEDICAL SERVICES PATIENT NAME: SHIRLEY SWEGER INSURANCE: MEDICARE B WCS . FEP / HIGHMARK NONE CALL NUMBER: 210384W DATE OF CALL: 11/06/2010 FROM: ACUTE REHAB HOSPITAL TO: 115 N MARKET ST ACCOUNT SUMMARY SHIRLEY SWEGER 115 N ~ T ST TOTAL CHARGES: 57.74 MECH ~ SBURG,_PA 17055 PAYMENTS/ADJUSTMENTS: 0.00 PLEASE PAY THIS AMOUNT: 57.74 nrrwnu w~ n~~n vcocn~aerinnr aNn RETURN STUB WITH PAYMENT _. DESCRIPTION OF CHARGE QUANTITY UNIT PRICE AMOUNT Wheelchair One Way -Member A0130 1.0 46.52 46.52 Transport Van Mileage S0209 3.0 3.74 11.22 .~..--_ o ~~~a~ - ~~~y~~ Total Char es DESCRIPTION OF PAYMENT RECEIPT PAYMENT DATE AMOUNT Total Credits 0.00 i : ~ ~ ~ WEST SHORE EMS -BLS 205 GRANDVIEW AVE SUITE 211 uiscovEe CAMP HILL PA .17011 ' ~~~ ON ~, ~® Phone #: (800) 367-0512 Federal Tax ID: 23-2463002 REVERSE SIDE EMERGENCY MEDICAL SERVICES PATIENT NAME: SHIRLEY SWEGER INSURANCE: MEDICARE B WCS FEP / HIGHMARK NONE CALL NUMBER: 209693W DATE OF CALL: 10/20/2010. FROM: 115 N MARKET ST TO: MOFFIT HEART VASCULAR ACCOUNT SUMMARY SHIRLEY SWEGER 115 N MARKET ST TOTAL CHARGES: 174.33 MECHANICSBURG, PA 17055 PAYMENTS/ADJUSTMENTS: 0.00 PLEASE PAY THIS AMOUNT: 174.33 DETACH ALONG PERFORATION AND RETURN STUB WITH PAYMENT DESCRIPTION OF CHARGE QUANTITY UNIT PRICE AMOUNT WHEELCHAIR MEMBER 2 WAY A0130 1.0 93.03 93.03 WAITING TIME - 1/2 HOUR A0999 1.0 28.94 28.94 Transport Van Mileage S0209 14.0 3.74 52.36 M r ~~~V l ~~ f~ ~~' ~o '~~ .c % ~~~~ ~~ ~~~ J Total Charges 174.33 DESCRIPTION OF PAYMENT RECEIPT PAYMENT DATE AMOUNT Total Credits 0.00 PLEASE PAY THIS AMOUNT -INVOICE DUE UPON RECEIPT ~ $174.33 RETURNED CHECK FEE - $31.00 WEST-SHORE EMS -BLS DISCOVER 205 GRANDVIEW AVE SUITE 211 CAMP HILL, PA 17011 ON REVERSE SIDE r~ ~ Phone #: (800) 367-0512 Federal Tax ID: 23-2463002 EMERGENCY MEDICAL SERVICES PATIENT NAME: SHIRLEY SWEGER CALL NUMBER: 209987W SHIRLEY SWEGER 115 N MARKET ST MECHANICSBURG, PA 17055 INSURANCE: MEDICARE B TIME FEP / HIGHMARK TIMP DATE OF CALL: 10/27/2010 FROM: HOLY SPIRIT HOSPITAL TO: ACUTE REHAB HOSPITAL ACCOUNT SUMMARY TOTAL CHARGES: 114.76 PAYMENTS/ADJUSTMENTS: 57.76 PLEASE PAY THIS AMOUNT: 57.00 DETACH ALONG PERFORATION AND RETURN STUB WITH PAYMENT DESCRIPTION OF CHARGE QUANTITY UNIT PRICE AMOUNT Stretcher One b'Vay Transport T2005 1.0 96.06 96.06 Transport Van Mileage S0209 5.0 3.74 18.70 ~a~~~ >> ~ 9 io s~ ~o Total Charges 114.76 DESCRIPTION OF PAYMENT RECEIPT 'PAYMENT DATE AMOUNT Private Payment /Check 2592 11/15/2010 57.76 Total Credits 57.76 i