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Home My WebLink About05-02-111505610105 REV-1500 EX (oz-si) (Fp `j!t OFFICIAL USE ONLY PA Department of Revenue Pennsylvania County Code Year File Number ~E»..ME~. o, ~~~E„~~ Bureau of Individual Taxes INHERITANCE TAX RETURN ~~ (~~ UO ~~ PO Box z8osoi RESIDENT DECEDENT l/ 0 V Harrisbur , PA 1'7128-D6oi ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY ,Date of `Birth _ MMDDYYYY _-- - 247-72-0967 .08/03/2010 03/26/1926 Decedent's Last Name Suffix Decedent's First Name MI Gollick _ __ _ Katherine __._ __ __ .................. ..... __ __ (If Applicable) Enter Surviving Spouse's Information Below MI Spouse's Last Name _ Suffix Spouse's First Name _ .__ Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE _ _. REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ~ 1. Original Return O 2. Supplemental Return O 3. Remainder Return (Date of Death Prior to 12-13-82) O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required death after 12-12-82) O 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (Date of Death O 11 • Attach Schedulen0}r Sec. 9113(A) Between 12-31-91 and 1-1-95) ( CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name .Daytime Telephone Number ~___ , - _ ._~ John H Klingler CPA (717) 243 7743 REGISTER Qi~IVILLS USE ONt9( =~,-~ O T ~ r~ A ~ ~ n ~ C ^' ~i First Line of Address -- - .1156 Walnut Bottom Road ~. ' -_, Second Line of Address ~ _- _ _ __ _..._.__ .. _ __ . _ -_. C~ ~~rt ~ ~'-` }'~` - -n `~~ ~ ~~ Suite 2 ' ___~__ ___ ~ __~ ~ -- D ~ED ~ ~ ,.~_~ .._ __ ._~._-_.-.-__ City or Post Office _. State ZIP a iV ./~ Q '-Tl PA ;17015 Carlisle _. __ ...... -.-........... Correspondent's a-mail address: jhk kacpa CC 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. D claration of prepay other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF P AF1SI (LING RETUR~ F r /' DATE / 525 Limestone Road, Carlisle, PA 17015 SI ATU E OF~EPAREf2 OTHER THAN REPRESENTATIVE DATE ADDRE 1156 Walnut Bottom Road, Suite 2, Carlisle, PA 17015 PLEASE USE ORIGINAL FORM ONLY 1505610105 Side 1 1505610105 REV-1500 EX (FI} 15D56102D5 Decedents Social Security Number nacadeM•s Name: Katherine GOIIiCk !. 247-72-0967 RECAPITULATION 1. Real Estate (Schedule A) ........................................... .. 1. 2. Stocks and Bonds (Schedule B) ..................................... .. 2. ! 4,572.88 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ... .. 3. ' __ 4. 9 9 ( ) ......................... Mort a es and Notes Receivable Schedule D .. 4• ~~ ~ ~.__ 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)..... .. 5. ! 99,074.91 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ..... .. 6. '` _~_ __~_! 7. Inter-Vivos Transfers 8~ Miscellaneous Non-Probate Property 7 269 358.91 (Schedule G) O Separate Billing Requested...... . .. , 8. ( 9 ) ................. Total Gross Assets total Lines 1 throu h 7 .......... .. 8. ' 373,006.70 9. Funeral Expenses and Administrative Costs (Schedule H) ............. ...... 9. ' 19,195.35 10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) ........ ....... 10. ! 540.71 11. Total Deductions (total Lines 9 and 10) .......................... ....... 11. 19,736.06 12. Net Value of Estate (Line 8 minus Line 11) ....................... ....... 12. '. 353,270.64 13. Charitable and Governmental BequestslSec 9113 Trusts for which ' an election to tax has not been made (Schedule J) ................. ....... 13. i 14. J ( ) ................. Net Value Sub'ect to Tax Line 12 minus Line 13 14. ( ....... 353,270.64 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_ 15. 16. Amount of Line 14 taxable at lineal rate X .0 45 353,270.64: 16. ~ 15,897.18 17. Amount of Line 14 taxable 17 ~ at sibling rate X .12 . _-_.___~_-_ 18. Amount of Line 14 taxable at collateral rate X .15 __: 18. __ 19 , 15,897 18 19. TAX DUE ............. ............. ............ ...... ... ... . I ...--- --- _._ 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 15D5610205 15D561D2D5 REV-1500 EX (FI) Page 3 Decedent's Complete Address: Katherine Gollick STREET ADDRESS 525 Limestone Road cITY Carlisle Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. CreditslPayments 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. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (4} (5) 15.722.86 174.32 (3) Make check payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred .......................................................................................... b. retain the right to designate who shall use the property transferred or its income ........................................:::: c. retain a reversionary interest .......................................................................................................................... d. receive the promise for life of either payments, benefits or care? .......................:.............................................. ^ 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. ~ ^ 3. Did decedent own an "in trust for" or payable-upon-death bank account or security at his or her death? .............. ^ 4. Did decedent own an individual retirement account, annuity or other non-probate property, which contains a beneficiary designation? ........................................................................................................................ ~ ^ COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. _. _ ,.. IF THE ANSWER TO ANY OF THE ABODE QUESTIONS IS YES, YOU MU For dates of death on or after July 1,1994, and before Jan. 1,1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an adoptive parent or a stepparent of the child is 0 percent [72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal benefidaries is 4.5 percent, except as noted in [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. 14,936.74 786.12 File Number STATE ZiP PA 17015 (1j 15,897.18 Total Credits (A + B) (2} REV-1503 EX+ (6-98) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Katherine Gollick 21-10-0808 All property jointly-owned with right of survivorship must be disclosed on Schedule F. (If more space is needed, insert additional sheets of the same size) REV-1508 EX+ (6-98) SCHEDULE Ep COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF Katherine Gollick Indude the proceeds of litigation and the date the proceeds were received by the estate. All 'ointly-owned with right of survivorship must be disclosed on Schedule F. FILE NUMBER 21-10-0808 proPe Y t VALUE AT DATE ITEM DESCRIPTION OF DEATH JMBER 1 PNC Bank -Checking Account - #5003961858 4,174.31 2 Members First FCU -Checking Account -182646-19 21,836.16 3 Members First FCU -Savings Account -182646-00 20,148.18 4 Members First FCU -15 mo Certificate -182646-45 12,708.86 5 Members First FCU - 36 mo Certificate -182646-43 17,056.71 547.19 6 Cash-on-Hand 7 Coins -Auction gross proceeds 18,372.50 8 Jewelery -Auction gross proceeds 1,277.50 9 Household Goods -Auction gross proceeds 2,803.50 150.00 10. Insurance refund rt TOTAL (Also enter online 5, Recapitulation} $ 99,074.91 (If more space is needed, insert additional sheets of the same size) REV-1510 EX+ (08-09) ~ pennsylvania SCHEDULE G DEPARTMENT Of REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Katherine Gollick 21-10-0808 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes, ITEM NUMBER DESCRIPTION OF PROPERTY wauoE THE N44ff of THE 7AANSFEaff, THEIR RHATIDNSHIP To DECEDENT AHD THE DATE OFTRANSFElIATfACI1ACOPioFTHEDEEDFORREALE51'ATE DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST EXCLUSION (IfAPPLICABLE> TAXABLE VALUE i• Bankers Life 8~ Casualty Annuities (3). Karol A Chaney, daughter, 82,598.91 100 82,598.91 beneficiary. 2 Personal Residence, 525 Limestone Rd, Carlisle, PA 17015. Assessed 186,760.00 100 186 760.0( Value: Land $24,600, Imp. $162,160, Total $186,760 , Memo: The personal residence was gifted to Karol A. Chaney, daughter, and Amanda D. Chaney, grand-daughter on March 16,2010. Deed attached. TOTAL (Also enter on Line 7, Recapitulation) $ I 269,358.91 If more space is needed, use additional sheets of paper of the same size. REV-1511 EX+ (10-09) ~ Pennsylvania DEPARTMENT Of REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Katherine Gollick 21-10-0808 Decedent's debts must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: 1' Hollinger Funeral Home 8~ Cremaory -per attached statement 8,060.00 B. 1 ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City Year(s) Commission Paid: 2. 3. Attorney Fees: Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) claimant Karol Chaney 3, 500.00 street address 525 Limestone Road city Carlisle state PA zIP 17015 Relationship of Claimant to Decedent daughter 4. Probate Fees: 5. Accountant Fees: 6. Tax Return Preparer Fees: ~• Sentinel -advertising 145.06 8. Patriot News -advertising 284.33 s. Met-Ed -final home electric bill 306.62 ~ o. Register ofWills -Filing fee 153.50 ~ ~. Rowe's Auction service -comm. on sale of coins 3,215.18 ~ 2. Rowe's Auction service - comm. on sale of jewelry 447.12 TOTAL (Also enter on Line 9, Recapitulation) $ 16,111.81 State ZIP If more space is needed, use additional sheets of paper of the same size. SCHEDULE H (continued) Estate of 21-10-0808 Katherine Gollick Item Number Description Amount 13. Interstate Waste Services - trash removal 307.89 14. Martson Law Office - law referral 25.00 15. U-Haul - hauling $18.97, $33.71 and $54.11 106.79 2.64 16. Postage 17. Rowe's Auction Service - hshld goods comm. 981.22 18. Klingler & Associates - final 1040/PA40 260.00 19. Klingler & Associates - Form 1500 750.00 20. Klingler & Associates - Fiduciary returns 350.00 21. Estimated remaining closing costs 300.00 Page Total 3,083.54 REV-1512 EX+ (12-08) ~ Pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT Katherine Goffick FILE NUMBER Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unre mba sed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE 1. _ _ _ OF DEATH Manor Care - unreimbursed medical expenses 90.67 2. Manor Care - unreimbursed medical expenses 450.04 TOTAL (Also enter on Line 10, Recapitulation) $ 540.71 If more space is needed, insert additional sheets of the same size. REV-1513 EX+ (01-10) ~~ Pennsylvania DEPARTMENT DF REVENUE INHERrrANCE TAX RETURN RESIDENT DECEDENT SCHEDULE BENEFICIARIES C.11AIC U Kather NUMBER I 1. 2 3 4 5 6 7 r: ne Gollick NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] Karol Chaney, 525 Limestone Rd, Carlisle, PA 17241 Bryan Eder, 104 Hillcrest Drive, Abbeville, SC 29260 Christine Finkenbinder, 1109 Pheasant Dr. N, Carlisle, PA 17013 Waylon Trimmer, 210 Hill St, Apt 2, Mt Holly Springs, PA 17065 Brandi Boone, 2645 Sandhill Point Circle, Davenport, FL 33837 Amber Clair,12Country View Estates, Newville, PA 17241 Amanda Chaney, 525 Limestone Rd, Carlisle, PA 17241 FILE NUMBER: 21-10-0808 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not List Trustee(s) n~ ccreTc Daughter Grandchild Grandchild Grandchild Grandchild Grandchild Grandchild 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: 1. 40.00% $300.00 12.00% 12.00% 12.00% 12.00% 12.00% 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 OF KATHERINE GOLLICK I, KATHERINE GOLLICK, a resident of the Commonwealth of Pennsylvania, make, publish and declare this to be my Last Will and Testament, revoking all wills and codicils at any time heretofore made by me. FIRST: I direct that the expenses of my last illness and funeral, the expenses of the administration of my estate, and all estate, inheritance and similar taxes payable with respect to property included in my estate, whether or not passing under this will, and any interest or penalties thereon, shall be paid out of my residuary estate, without apportionment and with no right of reimbursement from any recipient of any such property. - ,~ SECOND: It is my desire that, upon my death, I be buried at Arlington National Cemetery beside my husband. THIRD: I give the sum of Four Thousand Dollars ($4,000.00) to the Marist Brothers of the Schools, in Laredo, Texas, for the care, maintenance, and needs of MARVIlV GOLLICK, if MARVIN GOLLICK survives me. ' FOURTH: I give the sum of Three Hundred Dollars ($300.00) to BRIAN EDER, if he survives me. FIFTH: I give all the rest, residue and remainder of my property and estate, both real and personal, of whatever kind and wherever located, that I own or to which I shall be in any manner entitled at the time of my death (collectively referred to as my "residuary estate"), as follows: A. I give 40 percent of my residuary estate (the FIRST SHARE) as follows: (a) If KAROL CHANEY survives me, to KAROL CHANEY. (b) If KAROL CHANEY does not survive me, I give the aforesaid 40 percent of my residuary estate to the other beneficiaries of my residuary estate, in proportion to their interests under this Article FIFTH and subject to the provisions of this will. B. I give 12 percent of my residuary estate (the SECOND SHARE) as follows: (a) If CHRISTINA LITTLE survives me, to CHRISTINA LITTLE. (b) If CHRISTINA LITTLE does not survive me, I give the aforesaid 12 percent of my residuary estate to the other beneficiaries of my residuary estate, in proportion to their interests under this Article FIFTH and subject to the provisions of this will. C. I give 12 percent of my residuary estate (the THII2D SHARE) as follows: (a) If WAYLON TRIlVIlI~R survives me, to WATLVIV rK11viN1ER: `~~-~~''"~' (b) If WAYLON TRIlVIMER does not survive me, I give the aforesaid 12 percent of my residuary estate to the other beneficiaries of my residuary estate, in proportion to their interests under this Article FIFTH and subject to the provisions of this will. D. I give 12 percent of my residuary estate (the FOURTH SHARE) as follows: (a) If BRANDI WOLAVER survives me, to BRANDI WOLAVER. (b) If BRANDI WOLAVER does not survive me, I give the aforesaid 12 percent of my residuary estate to the other beneficiaries of my residuary estate, in proportion to their interests under this Article FIFTH and subject to the provisions of this will. E. I give 12 percent of my residuary estate (the FIFTH SHARE) as follows: (a) If AMANDA CHAIVEY survives me, to AMANDA CHANEY. (b) If AMANDA CHANEY does not survive me, I give the aforesaid 12 percent of my residuary estate to the other beneficiaries of my residuary estate, in proportion to their interests under this Article FIFTH and subject to the provisions of this will. F. I give 12 percent of my residuary estate (the SIXTH SHARE) as follows: (a) If AMBER CHANEY survives me, to AMBER CHANEY. (b) If AMBER CHANEY does not survive me, I give the aforesaid 12 percent of my residuary estate to the other beneficiaries of my residuary estate, in proportion to their interests under this Article FIFTH and subject to the provisions of this will. SIXTH: If none of the beneficiaries listed in paragraph FIFTH survive me, I give all the rest, residue and remainder of my property and estate, both real and personal, of whatever kind .and wherever located, that I own or to which I shall be in any manner entitled at the time of my death to the Marist Brothers of the Schools in Laredo, Texas. SEVENTH: If any property of rriy estate vests in absolute ownership in a minor or incompetent, my Executor, at any time and without court authorization, may: distribute the whole or any part of such property to the beneficiary; or use the whole or any part for the health, education, maintenance and support of the beneficiary; or distribute the whole or any part to a guazdian, committee or other legal representative of the beneficiary, or to a custodian for the beneficiary under any gifts to minors or transfers to nninors act, or to the person or persons with whom the beneficiary resides.. Evidence of any such distribution or the receipt therefor executed by the person to whom the distribution is made shall be a full discharge of my Executor from any liability with respect thereto, even though my Executor may be such person. ff such beneficiary is a minor, my Executor may defer the distribution of the whole or any part of such property until the beneficiary attains the age of twenty-one (21) yeazs, and may hold the same as a separate fund for the beneficiary with all of the powers described in Article EIGHTH hereof. If the beneficiary dies before attaining said age, any balance shall be paid and distributed to the estate of the beneficiary. EIGHTH: I appoint.KAROL CHANEY to be my Executor. If KAROL CHANEY shall fail to qualify for any reason as my Executor, or having qualified shall die, resign or cease to act for any 2 ~ s ~ l~ I ~~ ..-- reason as my Executor, I appoint CHRIST L as my xecutor ' -I-iire~t' at no:Execu or=sha be required to file or furnish any bond, surety or other security in any jurisdiction. NINTH: I grant to my Executor all powers conferred on executors under the Pennsylvania Probate, Estates and Fiduciaries Code, as amended, or any successor thereto, and all powers conferred upon executors wherever my Executor may act. I also grant to my Executor power to retain, sell at public or private sale, exchange, grant options on, invest and reinvest, and otherwise deal with any kind of property, real or personal, for cash or on credit; to borrow money and encumber or pledge any property to secure loans; to exercise all powers of an absolute owner of property; to compromise and release claims with or without consideration; and to employ attorneys, accountants and other persons for services or advice. The term "Executor" wherever used herein shall mean the executors, executor, executrix or administrator in office from time to time. TENTH: I direct that for purposes of this will a beneficiary shall be deemed to predecease me unless such beneficiary survives me by more than thirty days. This document was prepared under the authority of 10 U.S.C. § 1044 and implementing military regulations and instructions, by Captain Joseph Krill, United States Army, who is licensed to practice law in the State of Pennsylvania. IN WITNESS WHEREOF, I, KATHERIl~ GOLLICK, si my name and publish and declare this instrument as my last will and testament this ,~ day of , 2006. KATHERINE GOLLICK The foregoing instrument was signed, published and declazed by KATHERINE GOLLICK, the above-named Testatrix, to be her last will and testament in our presence, all being present at the same time, and we, at her request and in her presence and in the presence of each other, have subscribed our names as witnesses on the date above written. .~ :'~ J /, ~~-/ ~ ~ ~~ 'V ~2C~:~v having an address at having an address at !'mil /' 7~ _S^J - 3 _ - ACKNOWLEDGMENT AND AFFIDAVIT '' '' .K; ~`_ ~~ ~Y COMMONWEALTH OF PENNSYLVANIA, COUNTY OF CUMBERLAND, ss. {~ We, the Testatrix and the witnesses, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declaze to the undersigned authority that the Testatrix, KATHERINE GOLLICK, signed and executed said instrument as her last will and testament in the presence and hearing of the witnesses, and that she had signed willingly, and that she executed it as her free and voluntary act and deed for the purposes therein expressed, and that each of the witnesses at the request of the Testatrix, in the presence and hearing of the Testatrix and each other, signed the will as witness, and that to the best of his or her knowledge the Testatrix was at the time at least eighteen years of age or emancipated, of sound mind and under no constraint, duress, fraud or undue influence. %~, KATHERINE GOLLICK Testatrix ` - -- rit: ~y~ /~2.c~~~ Witness ~ ~. print: /~Uf~4- /q - ~r2 ? Witness Subscribed, sworn to and acknowledged before me by the said KATHERINE G(~.,LICK, Testatrix, and subscribed and sworn to before me by the above-named witnesses, this ~ day of 2006. No Public ~' My commission expires on ``~ ~~ ,ZOe f s COMMONWEALi H OF PENNSYLVANIA Notarla! Seal Betsy S. lGstler, Notary Publk Carlisle Boro, Cumberland County My Commission Expires May 14, 2009 Member, Pennsylvania Association of Notaries Calculated Value of Your Paper Savings Bond(s) Calculated Value of Your Paper Savings Bond(s) Calculator Results for Redemption Date 08/2010 50 $4,572.88 $3,785.38 Bonds: 1-21 of 21 Page 1 of 1 NA E $50 .06/1979 06/2009 $37.50 : $181.68 $219.18 ; MA NA E $50 05/1979 05/2009 $37.50 $181.16. $218.66 MA NA E $50 05/1979 05/2009 $37.50 $181.16 $218.66: MA NA E $50 04/1979 :04/2009 $37.50 . $179.06. $216.56 MA NA E $50 09/1979 09/2009 $37.50 $181.68 $219.18: MA NA E $50 09/1979 09/2009 $37.50 $181.68 $219.18 MA NA E $50 08/1979 08/2009 $37.50 $181.68 $219.18: MA NA E $50 08/1979. 08/2009: $37.50 $181.68: $219.18 MA NA E $50 07/1979 07/2009 ` $37.50 $181.68 $219.18 MA NA' E $50 07/1979 07/2009 $37.50 $181.68 $219.18 MA NA E $50 06/1979 06/2009 $37.50: $181.68 $219.18 ~ MA NA E $50 12/1978 12/2008 $37.50 $179.04 $216.54 MA NA E $50 01/1979 01/2009 ~ $37.50: $179.06. $216.56 MA NA E $50. 01/1979 01/2009 $37.50 $179.06. $216.56 MA NA E $50 02/1979 02/2009 $37.50 $179.06 $216.56 MA NA E $50. 02/1979 02/2009 $37.50 $179.06 $216.56 MA NA E $50 03/1979 03/2009 $37.50 $179.06 $216.56 MA NA E $50 03/1979 03/2009 $37.50 $179.06 $216.56' MA NA E $50 03/1979 03/2009 $37.50. $179.06 $216.56: MA NA E $50 04/1979: 04/2009. $37.50 $179.06 $216.56 MA NA E $50 12/1978. 12/2008 $37.50 $179.04 $216.54 MA Totals for 21 Bonds $787.50 $3,785.38 $4,572.88 NI -Not Issued • NE Not eligible for payment P5 Includes 3 month interest penalty MA Matured and not earnin interest http://www.treasurydirect.gov/BC/SBCPrice 8/13/2010 PNCBANK, NATIONAL ASSOCIATION PO BOX 535230 00001 PITTSBURGH, PA 15253-5230 00911060 For Inquiries Please Call 1-888-762-1099 E.I.N. 22-1146430 031060 KATHERINE GOLLICK 525 LIMESTONE RD CARLISLE PA 17015 40 2010 . . . . . . : . : . . . . . . . . . . . . . ... - '' ~ - XXX-XX-4360 THIS STATEMENT IS A FORM 1098 OMB NO. 1545-0901, OR A FORM 1098-E OMB NO. 1545-1576, OR 1099-A OMB NO. 1545-0877 OR 1099-B OMB N0.1545-0715 OR 1099-C OMB NO. 1545-1424, OR 1099-DIV OMB NO. 1545-0110 OR 1099-INT OMB N0.1545-0112 OR 1099-MISC OMB NO. 1545-0115 OR 1099-OID OMB NO. 1545-0117 U.S. INFORMATION RETURN 2010 - 1099-INT, INTEREST INCOME ACCOUNT NUMBER US SVG BOND 0040 0017610 0260813 BOX 3 INTEREST ON U.S. SAVINGS BONDS AND TREAS. OBLIGATIONS 3,785.38 TOTAL BOX 3 INTEREST 3,785.38 THIS INFORMATION IS IMPORTANT TAX INFORMATION AND IS BEING FURNISHED TO THE INTERNAL REVENUE SERVK:EIF YOU ARE REQUIRED TO FILE A RETURN, A NEGLIGENCE PENALTY OR OTHER SANCf10N MAY BE IMPOSED ON YOU IF THE IRS DETERMINES THAT AN UNDERPAYMENT OF TAX RESULTS BECAUSE YOU OVERSTATED A DEDUCTKN~1 OR DID NOT REPORT CORRECT AMOUNTS. ` FORM 7088 CAUTION: THE AMOUNT SIIONIN MAY NOT BE FULLY DEDUCTIBLE BY YOU. UMn'S BASED ON THE LOAN AMOUNT AND THE COST AND VALUE OF THE SECURED PROPERTY MAY APPLY. ALSO, YOU MAY ONLY DEDUCT INTEREST TO THE EXTENT n' WAS INCURRED BY YOU, ACTUALLY PAID BY YOU, AND NOf REIMBURSED BY ANOTHER PERSON. ' FORM 1099.OID: THIS MAY NOi BE THE CORRECT FKa`l1RE TO REPORT ON YOUR INCOME TAX RETURN. PLEASE REFER TO THE INSTRUCTKNi4 ON THE BACK ~ THI3 STATEMENT. COPY B FOR PAYER, RECIPIENT, BORROWER,OR DEBTOR ~1"'ti X RB•(O11R9FMF 10981099 A/B/C!D/1!M/O REV (11.091 MEMBERS is~ FEDERALCREDIT [7NION PRIMARY OWNER: Katherine Gollick SAVINGS ACCOUNT: Account Number/Suffix 18264&00 Date Account Established 03/17/1999 Principal Balance at Date of Death $20,147.86 Accrued Interest to Date of Death $.32 Total Principal and Accrued Interest $20,148.18 Name of Joint Owner None CHECKING ACCOUNT: Account Number/Suffix 182646-11 Date Account Established 03/17/1999 Principal Balance at Date of Death $21,836.03 Accrued Interest to Date of Death $.13 Total Principal and Accrued Interest $21,836.16 Name of Joint Owner None CERTIFICATES OF DEPOSIT: Account Number/Suffix 182646-43 Date Account Established 07/14/2008* Principal Balance at Date of Death $17,052.99 Accrued Interest to Date of Death $3.72 Total Principal and Accrued Interest $17,056.71 Name of Joint Owner None *Rollover From Certificate of Deposit 182646-40, Originally Established 08/15/2007 CERTIFICATES OF DEPOSIT: Account Number/Suffix 182646-45 Date Account Established 03/08/2010* Principal Balance at Date of Death $12,707.68 Accrued Interest to Date of Death $1.18 Total Principal and Accrued Interest $12,708.86 Name of Joint Owner None *Rollover From Certificate of Deposit 182646-44, Originally Established 04/07/2009 VISA ACCOUNT: Account Number/Suffix 4672090000252189 Date Account Established 07/19/1999 Principal Balance at Date of Death $0.00 Joint Cardholder None 5000 Louise Drive P.O. Box 40 Mechanicsburg, Pennsylvania 17055 (800) 283-2328 wwwmemberslst.org PRIMARY OWNER: Amber Chaney SAVINGS ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner Date Joint Ownership Established Estate of: Katherine Gollick Date of Death: 08/03/2010 Social Security Number: 247-72-0967 203222-00 03/22/2001 $25.99 $0.00 $25.99 Katherine Gollick 03/22/2001 MEMBERS 1ST FEDERAL CREDIT UNION Leigh-Anne Stallings Lending Insurance Support Specialist April 25, 2011 Nov,lU. ZUIU 1Z:15f'M NNC BANK 412-705-2747 LEADING TitE MrkY November 10, 2010 Sheri Gutshall FNC Bank Carlisle $ranch RE: Katherine Go]lick SSN: 247-42-0967 DOD: 08-03-2010 Dear Ms. GutshaU: No, 3269 P. 2/2 In response to your request for hate of Death (DOD) balances for the customer noted above, our records show the following: Checking Account Account # 5003961838 Established: 09-27-2002 KATI~RINE GOLLZCK DOD balance: $ 4,174.31 no» interest bearing Please note that this office provides date o~ death balances for deposit accounts (IKAs,.CDs, Checking and Savings). We do not process any fnancinl transactions or provide statements. if you need assistance with any of these items, please call 1-888-PNC-HANK (1-888-762-2265) or stop by yow local PNC Bamtc branch office. Sincerely, National Financial Services Center PNC Bank, N.A. Member k'DIC This message is intended for the use of the individuad or entity to which it is addressed and may contain information that is privileged, conf dential and exempt, from disclosure under appdicable law. If the reader of this message is not the intended recipient or the~employee or. agent responsible for delivering this message to the intended recipient, you are hereby notified that arty dissemination, distribution or copying of this communications is strictly prohibited If you have received this communication in error, please notify me immediately by reply or by telephone at 500-762-1775 and immediately destroy this faxed document. Fage 1 of 1 ~J G~ ~ L: c ~. Y~I -L~L'•..•.L ~l7! .L ~! ~G n J.J n .°,C :v;nleR a ~1~_tci: i OTi 5er~~~ i ce ~:SIZ+~ ~ i'l; ii e i-~ 1-~lni~x ii C~rY 1 :~. ~7 ]. e ; I~~°~t r1~7l~'li::k 5 r~ 1 i _..C.'t~"'•GE~ f! ~ G`F 7-' i J7t~g Gr~~'a. ,~'!?LI. btiit!{,°J., r'i!4?E ~ct~_[Ct 7. :1 T•1C~C'r'~: ?.^ES,. 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' , !t~ RO'VE' Bill Rowe (AU 1538L) S AUCTION SERVICE (Rx 79L) 2505 Ritner Highway Carlisle, PA 17015 249-1978 697-4794 249-267? Dave Rowe (AU 2295L) Auction Is Action Call "Rowe" For Satisfactio ~~ gg SELLERS NAME ~' ~ '~ °°~' ~,~'~~"1.~~." ~° x DATE 1 +~ ~ i ~ ~-~ ~ ~ ADDRESS ~.~ .~.. ~.; ~._ : r+n. ~ ~, ~ cy ~ ~, ,~. ~-~ ~.~"~ o ~• ~ ~ ~ e ; i ~ ~ PHONE ~' e'~ s"~ °,~ ~ ,~ ~~ ~ ~. OTHER AUCTIONEER % .~ ~M AUCTION DATE/LOCATION '~~~~ ~~ CLERK %.- r DESCRIPTION OF MERCHANDISE y~~3=%~'~ ~1~~~'",~! R /~`,- "~" tJ~{ 1. ~.T ~a..a t ~. .~s@. A +~ ~~ 3'~ .t.a i ~ t~ tr`~ t ~..... ~~ ~ t' ~ ....~,~ + ~ v~ ~+} ,rte ~ t a ~~ ~ i ~' ~ ~J'v:. i... ...„31°~~Y y_`.l7a prta_ !'. r".~ T'~ i...~P5.1'der'"~ "~"s ~ C~ '-r'~"'a.... f,.._~~ ~i t ; f ~'J ~ ~i L i'. e!'~:.~'"~ ~y3 (~ ~ ., ~... r~a3 ~ ~,.R,T ~ ~. l $~ _'~(/ ~ .~ ~ 1 `~~ ~ t'~e,.AY-+."•+:'l.n... ~"a~ G..f r `JG'^s `~ ~ ~k v....f' *-'~~.,~.~i ,~+ct .~ th ~ "y. ~C?P t r "b ~~P~...,,., /~~J ~ r I x~.,+~ ~rt1 f :lrw.fl.J~-~'~ c=~~ ~i i~n ~~ T`--~ ~' ,~ ~.-r^ ~ ".'^ ~ '~y~ ' s P.1 :.( ~J'~~ ~.~ ~1, {/~f~ y 4{rr p~ ~ ~ j F JJq/ J~ }, (''`4~y',, q~ ~ ~ ~ e~ rye ! 5 ] ~~ (/ 7f i ~ ~ ~~ lY~l +'*....1~'Jr ' `~ ~) w..~ ~ ~.i !I ~"~.._ ~ ~ ~' ~) ~ 8 ""- ~ S ' ~/{a/~ C ~' «, V'tiai I-L~:g ..:...._ ~s..fW-.f.~ I~ ti/ i ~' 3 1~ ~ Cam- [ 3~d` 1~L, J~a _ l.r-•~^~ry"°'..°.r'i~!/ 'C.. ~ X~ ~~ i ~"ati' ~'S B~'P 7 "tt'~ _/ 1 ~„ ~.~+~,.vtigvr ~ ,e: J ~ ±~~' a`f r #' c ~~ n ~F'~.L I [ t;, ~.r1'~. N Gu~'~t- rte'-- ~1~~~'s ~ Jai -'~°`° ~a~ 1 j~'~ i ~. "7 "'° +5 ~'°s .~=1 "" /'r Y 1~'E i~'t ~') a....i~ ~,...a 3- cT F ~---~-~c C"~s I Commission the Auctioneers to sell the merchandise to the highest bidder by Public Auction. Merchandise to be sold as is & grouped as necessary to obtain bids. I certify that I am the owner or authorized- represen- tative of the merchandise, goods and or property and have good title and the right to sell and that they are free from all incumbrances. I agree to accept all responsibility for providing merchantable title and for delivery of title to the puchaser. I agree to hold hazmless the Auctioneers against any claims of the nature referred to in this agreement > ,,r' !.~ ,;;' . ,r' , ~, ~.,r. ~- ; - t .i `~': ~..w '!j s'~"'°"'"'s"M.erw.rva r.,,.:a~` r ..-.,, ,, ~ i w` „'`f ~~t° AUCTION SIGNATURE SELLERS SIGNATURE _ ~ Total Sales (Clerking Tickets Attached) $ °"` -^--~-- Less Sale Expense: "~ c'~% Commission Auctioneer % Commission Clerks OTHER: ~~xr~ TOTAL SALE EXPENSE DEDUCTED $ SELLERS NET $ ~ ROWE'S AUCTION SERVICE (R~ 79L) 2505 Ritner Highway Carlisle, PA 17015 Bill Rowe (AU 1538L) 249-1978 697-4794 249-2677 Dave Rowe (AU 2295L) SELLERS N ADDRESS OTHER Auction Is Action Call "Rowe" For Satisfaction ~.~'i'~ f3~ ~.~,~§, ~.~ ii ~ f4'~' ~-- ,ta. 6' a wt. ~_ TE a 4.? ~ ~ _ v ,~ : r. ~ ~'~ ~ PHONE . {, ~` "'~~ ~ t~ ~~ ~ 4.~ °~ AUCTIONEER % :l ~ .r~~'£ "~.~•- AUCTION DATE/LOCATION ~i~ CLERK % ~~ DESCRIPTION OF MERCHANDISE I' ~/ lG;. ~'~f+^iO4 !"Y .I~i~' x 4 ~(f/~~ iJ~TM ~..'il' Cif. ~s'/yY ~' e.~ ~'- mss"°rSr~': 6 A' . ~3 I Commission the Auctioneers to sell the merchandise to the. highest bidder by Public Auction. Merchandise to be sold as is & grouped as necessary to obtain~bids. I certify that I am the owner or authorized represen- tative of the merchandise, goods and or property and have good title and the right to sell and that they are free;" from all incumbrances. I agree to accept all responsibility for providing merchantable title and for delivery;of: '. ; ; > `- title to the purcla~ser. I agree to hold harmless the Auctioneers against any claims of..the nature referred to in this agreement. ~ '' '' --%~ AUCTION SIGNATURE SELLERS SIGNAT E Total Sales (Clerking Tickets Attached) $ ~ ~ ~ `"' '1._ 5 " Less Sale Expense: % Commission Auctioneer $ `~ ~- t ~ ~ ti~ % Commission Clerks $ OTHER: TOTAL SALE EXPENSE DEDUCTED $ ..~ SELLERS NET $ ~. `r ~ ~ ~ ~ `~' .~.~it {: a ~. t~',1"-•K'sJ"J: +=~,t:~~1~.'~ +f 1.i u ~J~'o ~Y.+~': ~ ~ ~ ~ - ~.CiV•aE'g 5 ~1_t[.:i: i q't•i ~Cr~v ZC~' Cr,ii.~1.~~ ~t~ i"t~}~.~, '~'a.'7-i«:4~-~:L--" T; q ~r;•~--Y r??'8~ E'.~7--•~,}•79r+ v~wa•~. r-giv~~•~a.tcv i q~:;rr~~li~e. ~qm =i E! ~ 'C ~. E' iil E i"1 '~: ~ L7 q ~ + 7 i` ! _ . r~-1 ~ ~ ~ ~, , ` . . F~ r = i. ~ E 1 't ~ ~ L~ c: s c'r~ :i ~ ~~ •~. r.] ri :, G! i, y •'l u •t: 7 7. ~, ..... ~ i.1 v ~ r-• r..' q i 't'i q ~ ~:!• F ~ i ~•i :!. 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'~ `,:i ~ , 111 I~J i_t~ P" ~' t: r" Ca ,~ `~ .., ~ ., l~1~1 -- ~~,~,~ ..._ ~>~.i ~. IL"kYS C'! i_ic~r'ir E' i^ ~ ~, 'J~Fk~.l. ~IGI - if3~ - ~•t-'ik~o +~4~+ ~;~_l~~r•ter'_y 1. `~''~~~: )l+k~ _' ~~~FQ1 '"~+c~. k.~fG ~ !_:r11"ii E? 1'" 5 ~. ~~ s~~. I~I1MI ~~41 - ~~k'~.~?14't q~_i`~rwtar'~ !. `a~•~+.1'I~ct •- #i~~-1•i~ - ~>~;!"L~. l~+i~ ~i_I~ir ~ era :t '~tF~. ~Zn~+ -- ~ii~ 4• °: -- ~ , ~ZI , 1;~1?s c~ ~_i ~ r~'t p r~ s - --- ... - - --- - - - - - - - - - ~ :l -- ':1E:,'~i .. -7.117~ ~,'tsI ,t~ `~' .',~. ~~ll~ I' I rl 1 V ~! . ~ u JI, IY: lrl~i .- - i;awe' -, f-1,_tt~~ '' ail f~~ryv ir[i C: ~J+~ `: ~~ i. 't tl G'r" i-~ tad }i wvr4~o r~a~v~.s~fit,_lcticrr,~er~vic:~:„cam 7~~rr! 7:}scr~i ~tian ~'r- i c r E~z ~ v i7; JY 7 -' '7 7c ~ w K.t ,. +}I l:L+ 7 1 i cl J. V E' = ~..i ~.., ~! a S~ lyi i _ F7 l ~. r ~ ~ ti ~', - j~lr'i ," ~~'`f~ - ~1 ~i.~.lti=i„ f1-'{+C.! i_ {'lct.~. ~ ~ •~ ~.: r. i 7 ~~-1~r_+~~ l~lN:~ "t el i; ~•C f a ,_t j ` a r` 1,, a i_i i', ~3 ~_i t~ :i. El F? 5 ~ f~ a b! E t: (-) ~ t C i :!. a'!? ! ;. .- "O N co m ,;~,: ~ ~~--Z i__.. .,e. S- [~~~ " ~ ' ~ f "b ~~ ~~~ ~ ~ .5 C O O 0 0 0 ~ 00 00 00 00 ~ O 0 000 ~ C w W W w ~ ~ N N N N ~ ~ O O O O N N ~ ~ ~ ~ ~ ~ O O O O }1 ~ ~~~ o p 0 00o p 00 ° °° ° 1" o -~ o ~ r' n 0 000 ~ ~ ~~~ ~ 0 000 w www o ~ N N N N O O O O ~ _ ,,, ~ m 0 000 ~ D 0 ~ ~O -I Z ~ ~~ ~ ~ Sw~ s~ ~ .~ O ~ n. (A ~ ~ ~ ~ ~ .fin.. 7 y w~v a ~ d ~:o~~~ o::. 0 o ;~ N W ~ W W ~ 7 V n V V~ N N~ N N~a D ~ O n O O °V W N N ~ ~ __ ~ V V V -~ ~ N N N .P C7 O O O O ~ 0 oov co 3 0 000 ~ 0 000 0 000 O O O O 'Tl O O O O ~ O O O O V l Z fD O W _ ~ ~ U1 C~ OD W ~ 0 W ~ (O O 0 a1 _ 7 O 0 0 W N fA ~'t -1 p ~ ° ~ ~ uni n 3 ~~ ~ ~ o ~ ?. n vac -~. o -- o , .. 0 0 0 O V 0 fD ~ O wow < N A V-O-~O ~ tC N OoAO pj N ~ ~ ~ ~ ~ O 000 (p ~ O Payable To: ROBERT C CAIRNS, TAX COLLECTOR PO BOX 40 BOILING SPRINGS, PA 17007-0040 Phone: (717) 258-6484 EXT 2010 MAP NO: 40-24-0758-087 Desc: 525 LIMESTONE ROAD Acxes .340 Deed; 0025M-00065 FORGE ROAD ACRES LOT 15 SEC B PB 21 PG 4 ® Residential Building I N~~~®®~ $1.00 FEE FOR ADDITIONAL RECEIPTS Tax Payer: Office Hours: MON-TOES-WED 9:OOAM - 3:OOPM 4 FORGE ROAD; SCHOOL ADMIN BLDG CLOSED HOLIDAYS PHONE (717) 258-6884 EXT 2010 Bill No: 2164 BIII Date: 3/1/10 Control No: 40003824 Assessed Value: Land: 24,600 Improvement: 162,160 Tota1:186,780 Discount Face Per~lty COUNTY R/E 2.39900 $439.08 $448.04 $482 84 COUNTY LIB ,180 ~.~ ~.~ . ~.~ MUN FIRE PROTC ,2200p S41 ~ ~ ~ TAX AMOUNT DUE If Date $512.30. $522.75 $575.02 Is On 3/1/ 5/1/10 thru 6/30/10 7/1/10 or Later .i GOLLICK, -~- i ntrcirvt ~ ~~ ~ 525 LIMESTONE RD CARLISLE, PA 17015-4348 ,~ Q~ ,\ ~` cJ . _, a~ TAXPAYER'S COPY -KEEP THIS PORTI`~N FOR YOUR RECORDS e ~. ~c~i SCt ~z~rG~ RECORDATION REQUESTED BY: Salzmann Hughes, PC 354 Alexander Spring Road, Suite 1 Carlisle, PA 17015 (717) 249-6333 WHEN RECORDED MAIL TO: Salzmann Hughes, PC 354 Alexander Spring Road, Suite 1 Carlisle, PA 17015 (717) 249-6333 TAX PARCEL N0.40-24-0758-087 SPACE ABOVE THIS LINE IS FOR RECORDER'S USE ONLY THIS DEED, MADE THE 16th day of March in the year two thousand ten (2010), IIIpIUNlllll~ oo,~s BETWEEN KATHERINE GOLLICK, adult individual, of the Commonwealth of Pennsylvania, hereinafter called Grantor, AND KAROL A. CHANEY AND AMANDA D. CHANEY, mother and daughter, of the Commonwealth of Pennsylvania, hereinafter called Grantees, WITNESSETH, that in consideration of the sum of One and 00/ 100 ($1.00) Dollars, the receipt whereof is hereby acknowledged, the said Grantor does hereby grant and convey unto the said Grantees, their heirs and assigns, tenants with the right of survivorship, ALL THAT CERTAIN tract of land situate in South Middleton Township, Cumberland County, Pennsylvania, bounded and described, as follows: BEGINNING at a point on the Eastern side of Limestone Road, on the dividing line between Lots Nos. 15 and 16 on the hereinafter mentioned Plan of Lots; thence by said dividing line, North 58 degrees 54 minutes 30 seconds East, One Hundred Forty-nine and Ninety-three Hundredths (149.93) feet to a point; thence South 31 degrees 11 minutes 50 seconds East, One Hundred (100) feet to a point; 58 degrees 54 minutes 30 seconds West, One Hundred Fifty and Twelve Hundredths (150.12) feet to a point on the Eastern side of Limestone Road; thence by the Eastern side of Limestone Road, North 31 degrees 05 minutes 30 seconds West, One Hundred (100) feet to the place of BEGINNING. BEING Lot No. 15 of Section "B" of the Plan of Lots known as Forge Road Acres as recorded in the Office of the Recorder of Deeds for Cumberland County in Plan Book 21, Page 4, and having thereon erected a brick dwelling house and attached garage. BEING the same premises conveyed by Kenne{:1^: L. Klimek and Mary Nell Klimek, by Deed dated January 21, 1974, and recorded on January 21, 1974 in the Office of the Recorder of Deeds in and for Cumberland County in Record Book M, Volume 25, Page 85, to Katherine Gollick, Grantor herein. THIS IS A NONTAXABLE TRANSFER FROM MOTHER TO DAUGHTER AND GRANDDAUGHTER. UNDER AND SUBJECT to any existing covenants, easements, encroachments, conditions, restrictions, notations and agreements affecting the property, visible or of record. SUBJECT, HOWEVER, to the restrictions and conditions recorded in the Office aforesaid in Misc. Book 166, Page 512, except as follows: 1. Any dwelling house constructed on this lot shall have not less than 1100 square feet of living area. 2. The exterior dimensions of any ranch type dwelling house constructed on this lot shall be not less than 26 feet by 44 feet, excluding garage or carport. 3. A garage or carport at least 14 feet wide shall be erected with each dwelling house. .AND the said Grantor hereby covenants and agrees that she will warrant specially the property hereby conveyed. IN WITNESS WHEREOF, said Grantor has hereunto set her hand and seal the day and year first above written. Signed, Sealed and Delivered in the presence of ~/~-- u~ ' `~~7T~1~ Wiz.-'~L KATHERINE GOLLICK COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss. QN On this, the ~~' day of March, 2010, before me, the undersigned officer, personally appeared Katherine Gollick, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that she executed same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. QEORQE F DOU(~AS, ~, NO~TIIRY C~uStE~CUMeE~AND~0~lldn Not Publi MY COMMI3310N E~IRES 20. 2011 ~' I do hereby certify that the precise residence and complete post office address of the within named Grantees is: ~ 2S Lr r~.~5 v a N ~ Q~d /'1C ~~',~ R ~,s ~~ ,~ ,1 a tS __ ;--- Date: 3f 1 L (/ U F , -._ Attorney or Grantees SALZMANN HUGHES, P.C. 354 Alexander Spring Road, Suite 1 Carlisle, PA 17015 ROBERT P. ZIEGLER RECORDER OF DEEDS CUMBERLAND COUNTY 1 COURTHOUSE SQUARE CARLISLE, PA 17013 717-240-6370 Instrument Number - 201009601 Recorded On 4/16/2010 At 11:18:26 AM * Instrument Type -DEED Invoice Number - 64010 User ID - KW * Grantor - GOLLICK, KATHERINE * Grantee - CHANEY, KAROL A * Customer - SALZMANN * FEES STATE WRIT TAX $0.50 STATE JCS/ACCESS TO $23.50 JUSTICE RECORDING FEES - $11.50 RECORDER OF DEEDS PARCEL CERTIFICATION $10.00 FEES AFFORDABLE HOUSING $11.50 COUNTY ARCHIVES FEE $2.00 ROD ARCHIVES FEE $3.00 SOUTH MIDDLETON SCHOOL $0.00 DISTRICT SOUTH MIDDLETON TOWNSHIP $0.00 TOTAL PAID $62.00 * Total Pages - 5 Certification Page DO NOT DETACH This page is now part of this legal document. I Certify this to be recorded in Cumberland County PA ~y c~ cu~eP ,O c 4~s ~~'T/ ° ° RECORDER O nso * -Information denoted by an asterisk may change during the verification process and may not be reflected on this page. uuuifliiiaiiiumi Payment Receipt -The Sentinel Date: __ ~1 / i3 j2.f! 1 D lassified Display Subscriber Single Copy Carrier Other: Customer/Account Name: lt~.~ ~ ~ C,~i ~i .i'~ E Account/Ad Number: ~J~ ~''~ $- Amount Paid` ~ ~ ~- (~ Paid BY: Cash Charge ~ Check ( l n i~ Check No.) Received By: 1' f1 e patriot-1~ew~~ CLASSIFlED ADV. RECEIPT $12 MARKET ST. P.O. BOX 2265 , HARRISBURG, PA 17105 PHONE 255-8121 JAN. FEB. MAR. APR. MAY JUN. JUL AUG. SEPT. OCT. NOV. DEC. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15' 16 17 18 19 20 21 2 23 24 25 26 27 28 29 30 31 TF Mon. Tues. Wed. Thurs. Fri. Sat. Sun. KEYWORD White -Office Copy Pink -Counter Copy Yelkwv -Customer Copy $„~ AMVUIV 1 ~ ~ /y `~ '~') RECEIPT FOR PAYMENT ------------------- ------------------- GLENDA FARNER STRASBAUGH Receipt Date: 8 /10/2010 Cumberland County - Register Of Wills Receipt Time: 12:03:55 One Courthouse Square Receipt No.: 1062201 Carlisle, PA 17613 GOLLICK KATHERINE Estate File No.: 2010-00808 Paid By Remarks: KAROL A CHANEY WZ ------------------------ Receipt Distribution ------ ------- ------- ---- Fee/Tax Description Payment Amount Payee Name PETITION LTRS TEST 90.00 CUMBERLAND COUNTY GENERAL FUN WILL 15.00 CUMBERLAND COUNTY GENERAL FUN SHORT CERTIFICATE 20.00 CUMBERLAND COUNTY GENERAL FUN JCS FEE 23.50 BUREAU OF RECEIPTS & CNTR M.D AUTOMATION FEE - 5.00 --------------- CUMBERLAND COUNTY GENERAL FUN Cash $153.50 Total Received......... $153.50 a~ ~,,a r z` RITER A E w~srE somea Import~n~ Messages PO BOX 553916 DETROIT MI 48255-3916 Submit payments and remit coupon to the Detroit PO (717) 423-5383 Box address listed on the coupon below. Address Service Requested All other correspondence must be mailed to• Western Md Waste Systems, LLC Customers: PO Box 2421, Cumberland, MD 21503 2090000069 <B> Id~IhIIII~I~IhII~Iq~pyull~nl~IILII~LI~yIIIIIIPyllly KAROLA_CNANEY 525 LIMESTONE RD CARLISLE PA 17015-4348 IWS of PA Customers: 354 Alexander Spring Rd Ste #3, Carlisle, PA 17015 IWS Western PA Collection Customers: 7095 Glades Pike, Somerset, PA 15501 IWS of Lehigh Valley Customers: PO Box 59, Walnut Port, PA 18088 Service Address: Account Number: 060486 Previous Balance: (195 00) 0001 - 525 Limestone Rd Invoice Date: 10/31/2010 Current Balance: . 307 89 Carlisle, PA 1 70 1 5-4348 Invoice Number: 0002283348 Please Pay: . $112 89 Blanket PO: Due Date: Due Upon Receipt INVOICE DETAIL Date Reference Description PO # Quantity Amount Totals Site 0001 - 525 Limestone Rd Carlisle, PA 17015-4348 10/01/2010 30 YD Rolloff Service-Trash 10/25/2010 0000207301 30 YD Open Pull & N/R-Trash 10/25/2010 0000207301 Dump/Trash 10/25/2010 Fuel Surcharge ~yi- d P/ 1.00 0.00 0.00 _ 1.00 180.00 180.00 = 2.44 45.00 109.80 1.00 0.00 ,Og Current Charges: 307.89 Taxes: 0.00 Invoice Totals: $307.89 ~~ c bl To expedite processing, please detach and return below portion with your pay nt ~OTES:. n. '~~E~CEt~PT DATE ?' { ~ NO. RECENED FROM dl- ~~ ADDRESS ' ~tt? ~~ o . ; `~ ~" r FOR ~' ;:~ -r, ~ ~. ;O x. a ~, ~ LSS ` ... ~ ~: o V. A CCOUNT H OW PAID AMT. OF ACCOUNT CASH AMT. PAID CHECK BALANCE MONEY DUE ORDER X4695.2 ~-' g $ o2S~ od BY f.~I~ ~ . ~~ ®20 5 ~~+ ®SLSTO': WebBEST Receipt ' Page 1 of 1 U-Haul Sales Item Invoice Sales Items Contract No.: 00318610 U-Haul Moving & Storage of 1111 Harrisburg Pike (717)249-8818 Thursday 9/9/2010 11:37 AM Carlisle CARLISLE, PA. 17013 (811067) Part Code Description DS KIT,DISH SAVER,(8 SETTINGS)w/D SST TAPE,SLF STK PPR,1-3/4inXSSYD, Customer Signature P P`~Jt ~~ ~s Item Cost uanti Line Cost $10.20 1.00 ea. $10.20 $3.85 2.00 ea. $7.70 Subtotal: $17.90 Taxes: $1.07 Total Charges Including Tax: $18.97 Cash Payment: $18.97 Tendered: $20.00 Change: $1.03 Net Paid Today: $18.97 DARRYL ARBEIT https://webbest.uhauldealer.com/ContractPrinting/receipt.aspx?source=printing_obj acts&gu... 9/9/2010 WebBEST Receipt IrU-Haul Sales Item Invoice Contract No.: 00318553 Monday 9/6/2010 11:41 AM Part Code GP DS CK DP U-Haul Moving & Storage of 1111 Harrisburg Pike Carlisle CARLISLE, PA. 17013 (811067) Description KIT,GLASS PACK,(18 POUCHES)w/D KIT,DISH SAVER,(8 SETTINGS)w/D KIT,DISH PAK,CELL DIVIDERS BOX,DISHPAK,5.2CF 18X18X28in Customer Signature cw'~. Q~ Sales Items Page 1 of 1 (717)249-8818 Item Cost uan ' Line Cost $10.20 1.00 ea. $10.20 $10.20 1.00 ea. $10.20 $5.95 1.00 ea. $5.95 $5.45 1.00 ea. $5.45 Subtotal: $31.80 Taxes: $1.91 Total Charges Including Tax: $33.71 Cash Payment: $33.71 Tendered: $40.71 Change: $7.00 Net Paid Today: $33.71 DARRYL ARBEIT https://webbest.uhauldealer.com/ContractPrinting/receipt.aspx?source=printing_obj ects&gu... 9/6/2010 WebBEST Receipt U-Haul Sales Item Invoice Contract No.: 00318543 Sunday 9/5/2010 2:33 PM Customer Name: sales Part Code LG SST WP Customer Signature - (sales) G 9 ~`'~~~ Page 1 of 1 U-Haul Moving & Storage of 1111 Harrisburg Pike Carlisle CARLISLE, PA. 17013 (811067) Cust Ph -Email: Sales Items (717)249-8818 i-!n ~~ uanti Line Cost $2.56 15.00 ea. $38.40 $3.85 1.00 ea. $3.85 $8.80 1.00 ea. $8.80 Subtotal: $51.05 Taxes; $3.06 Total Charges including Tax: $54.11 Cash Payment: $54.11 Tendered; $60.11 Change: $6.00 Net Paid Today: $54.11 MICHAEL ALEXANDER Description BOX;LARGE,4.SCF 18X18X24" TAPE,SLF STK PPR,1-3/4"XSSYD,R PAPER,WRAPPING,lOLB https://webbest. uhauldealer.com/ContractPrinting/receipt.aspx?source=printing_obj ects&gu... 9/5/2010 CARLISLE BARRACKS PO CARLISLE, Pennsylvania 170139997 413{870015 -0098 08/20%2010 (717i~~o-1930 10:10:51 AM ~E .~ Sales t:e:;ei pt I .Product Sa i e J:-i i t F i na 1 Description Qty Price Price 44c Negro 6 $0.44 $2.64 Leagues l3aseball PSA Total: ~ $2.64 I' Paid by: ~~~~ Cash ~~ $3.00 ~--:Change Due : -$0.36 is Order stamps at USPS.com/shop or call tr~BfltY-Stamp24~= Go to~USP~~eom/clicknship '. to print shipping labels witri postage. 1;- For other information call 1-800-ASK-LISPS. Get your mail when and where you want it with a secure Post Office Box. Siyn up for a box online at usps.com/poboxes. ~~~x~~~~~~~~r~x~~~~~x~~~*~x~~~*~~x~~~~~~~ Bill#: 1000201603379 Clerk: 05 All sales final on stamps and postage Refunds for guaranteed services only Thank you for your business: 7t 9f * k yCYt1C Yf Yt 7t 7t Yf Yf ~f 7C Yf 1fYfYC "XY! 1C 7C Yt Yf YC 7C YL 7C Y! J' 1C Yt YC W ,' x 7C •r. x Yf Y(SC Yc t'X Yl Yt Yl YC 7Y 7C Ac ft YIYt iCY( Yl X Yf Yt Yl7C ICYC7Y~CY(1t'X It Y[ n ;~~' K x ~ R k HELP US SERVE YOU BETTE;` _ Go to: https://postalexperienr>`.com/Pas TELL US ABOUT YOUR :?~t,~ NT POSTAL EKPERIENCE VOUR OPINION COUNTS Y(Yf YCX 7CYl7C 7C YCYf ~Yf Y[7C 1K 1C YC Yf 7K 7k YC7t X7C YC Jt 7C yt **7K %7kx YtX is /t YC 7C 7k Yl Y(~ iC7t yf 7K ll iC 7C 1! Yf 7r 7t YCYf Yl YCYCYCIC 7CYl Yl Yf 7C 7k Yf Y! X 1YYC X Yl X 1t YC *~Yl Customer Copy Hollinger Funeral Home & Crematory, Inc. Eric L. Hollinger, Supervisor 501 North Baltimore Avenue Mount Holly Springs, Pennsylvania 1.7065 STATEMENT OF FUNERAL GOODS AND SERVICES SELECTED Charges are only for thcee items thaz y[m selected or that are required. If we are regtired by law or by a cemetery or crematory to uce any items. wr will explain the reason in writing below. ff you selected a ftmeral that may require embahtring, such as a ftmetal viewing, you may have to pay for embalming. You do not have [o pay For ett[halm- ing yot, did no[ approve if seTlec~te~d such as or burial. ff we charged for embalming, weplain by For the Service of ~-l-~T E'~~ ~7/C Date of Desth l7'U~' ~ ~~~~ ~ ~ ~ ~rY/c vc. ~. Name Address A. GHABGE FOB SEevtCFS Sffi.E(.1ED: 1. PROFESSIONAL SERVICES services of FSuterat DirecrodStaff ...... S ~•~°` Embalming .....................5~ tiur pre aratimt of ed ......................... s sU8_TOTAL OF FJ(fAFE3SIONAL SERPiCES ..........ai S 2. FAC[Lff1F5 AND SERVICES ' Use of facilities and sevics ~~,g viewing (VisraGon/Wake)~:'"CJR.. S Use of Fidlities and services~~ ~/ .~~~~ for tunaal areatony .G~., . Use of facilities and services for Memorial Service ............... S Use of equipmnn[ and For gnveside servia~//~. r~5 / ~7~7ryt~~Q~ Ocher use oy'F - ~~ 0.~ o ~[l / ° ,~(J/~ ..............................5 SUB-'rO~rAL OF FA((~I17FS/EQUII71ffiVT .......... a2 S~ 3. AUTOM07IVE EQUIPMENT Vehicle to [[ansfer remains m Funeral Home loot ..................... ....5 G~ Hearse (Casket Coach) Local ..................... .... S limousine Loral ..................... .... S Family car Loral ..................... .... s Flower cu or floral disposition Local ..................... ....5 I.esd tar/dergy car t.orl ..................... .... S Car for pallbeaze:s IAIaI .........................5 of nor wtati .......... S _ S SU&TOTAL F Ai]TOMOTIVE EQUt]P!l~ri' .... . TOTAL OF FROFESSIONAT. SERVICFS, ~tY State other dothirtg f~f~ X70/s' cremation um ................... S (Description) OTEIER ~ S ~~~ s ~~ TOTAL ersE sErEC.-rm .................E G sFEC~Ar. caAxGFS: Forwarding of remains [o a (Funeral Home) Receiving of remains from s (Funeral Home) ImmerL Burial ............ ..... f Direct Cremation ............ ..... E S SUB-TOTAL OF SFF.CiAL CHARGES ................C S D. CASH ADYANC® %~®/ ,. -- /r/~A+_/J,, ~ ~ /' Opening Gave ~.'~76~V~'~'IC.L~~~,/P7 Cemetery Equipment ...../........ S J Lot ar[d Deed ... ..~.`w~ S Newspaper N . , f/!+/(~i . S~ Tekp~hr~ & Tek ~~ S~ ............ .... a .cagy offering ............... S~ .....................5 Certified Cop' of the ~~ ..... S te1`,~x...........:~ vault service charge ............... S s ~',/ a S a s ~p SUB-TOTAL OF ADVANCES .......................D S ~~~ ~ %/ C//1, _'~ We cha[ge yrm fa our xrvices in obtainir[g: ' P O (/ (,may aasb mat me mmr~duP FA(~IrfFS AttID AFrOMOTiVE ~ ~ ~ S ~rtif.~J' ~.Q ~f,C..lfB,,lr EQUIPAffiq'r .................................. A S B. CHAIit<sF ~~~~L4E 'F.LECfffiF caskg. Ri ~ (~r!l.G........ , so739S~q(%'A ~~r (DesrnPUOS 2E ~' ~~ 6+G/'/ ~~K Other Receprade ................. S (Description) Outer burial mruainer ............. S (Description) Admowkdgement ands -........... S ~.~"~'.,l',~i,~ ) .................. s-~' .. ~ .~620.vS... s % ~~ SU11HlARY OF CHABGES A Ptofessiooal Services. Iracilities and Equipment, and Automotive ~ /Qjt~ B. Merchandise ............. ...... . S~yZ! O C. Speaal Charges ................ D Cash Advances S s . ................. . TOTAL OF ALL SECTIONS ...... ................. S PAID AT TAlB OF OR FSBJH TO AHSAIVC,~ffiVTS ............. ................. S _, Be-tANCE DUE ............... .. _ . . .:............... S : .. ~ FOR G ~ ~/ tf any law, . or aammry requirements have required the p of oFthe ,the w ~~ I agree that I have eximined the items ~ goods and services selected above and found them m be mmcr and according m the arrangements t have requested. I acknowledge receipt of a mpy of this Statement of Funeral Goads and Services Selected. I represent have suffuiem fords available for payment of tbe rash price for the goods and services sdecred. I also agree paymeru ~ S within days. I agree m be joiody and severally Irable with else who signs below. A lue druge of ~o~ . [>a month amouoettB m per Year will be applied m the unpaid balwm beginning ,~ ~Ys firm [he dale of this agreement. I wifl also pay m the flrrteral Director unable cases paid by the FWneral Diecror m crogecr amoums I owe order this agreemem. Those costs may include atmm~r3' fees, court costs~!~a r coos. Arry additional services or merchandise ordered or requested abet the date of this agreement will be considered parrTwf this a tan 'die m. ~PAI be teAected on the final bill or statement. (Sean X--~', ~ ~ ~~(~ (Purchased (Iicertsed Fungal ) O Feo,ny1ww Funeal nirtaars A.sadi4an ~ FuKnl Dhemor YP[[.OW Fuoml D4eaor Pala Cusromer farm -600 Revised 1/04 ~~6-i l 450 Oy I i K ~~ ~- - , DATE $ CHECKS $ CASH ~-I CHECK RECD RECEIVED FROM AMOUNT RECEIVED NO• BY RECEIVED FOR RECEIPT NUMBER 24497 HC~• 1~7an o~ RETAIN THIS RECEIPT FOR YOUR RECORDS - - - -- _ . --1:o c~ _. _. _ . _..__.._____ .- ..- _ ~ 1 - _ - $CHECKS $ CASH DATE - CHECK RECD RECEIVED FROM . RECEIVED FOR RECEIPT AMOUNT RECEIVED NO. BY NUMBER 24693 ~~~'.~~ ~n~r RETAIN THIS RECEIPT FOR YOUR RECORDS