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HomeMy WebLinkAbout06-14-11 (3)a 1505610140 REV-1500 EX (01-10) PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes Coun Code Year tY File Number Po Box 28oso1 INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 RESIDENT DECEDENT 2 1 1 1 0 1 1 4 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYW Date of Birth MMDDYYW 0 5 5 2 0 7 4 6 7 0 1 1 0 2 0 1 1 0 5 1 9 1 9 2 8 Decedent's Last Name Suffix Decedent's First Name MI N I C H O L S O N B E T T Y ~1 (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 12-12-82) © 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 TO: Name Daytime Telephone Number s•,, M A R C U S A- M c K N I G H T I I I 7 1 7 2- 2 ~5 3 ~r ~-- ~~ ~~ REGISTE USE !<;1~LY -' ~--~ ~'~~ ~ `_ ~C First line of address ~~Q ~ ~ ,, ~::~~ 6 0 W E S T P O M F R E T S T R E E T ~~ ~ ~~- + ~ ~.. - ; Second line of address C~ C~ City or Post Office State ZIP Code DATE FILED C A R L I S L E P A 1 7 0 ], 3 Correspondent's a-mail address: 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 all information of which preparer has any knowledge. SIGNATURE OF_PERSON RESPONSI E FOR FILING RETURN DATE 2033 HARVEST~bRIVE MECHANICSBURG PA 17055 SIGNAT ~EP ER THAN REPRESENTATIVE DATE I ADDR S 60 WEST OM RET STREET CARLISLE PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 L 1505610140 1505610140 J ~~ Oh20'C9505'C Oh2U'[95054 Z aP!S 1N3WAdd213n0 NV ~O ONf1~321 d JNIlS3flb3213214 f1OJl ~I ~VAO 3Hl NI ~'ll~ 'OZ 9 2 'z 2 2 0 2 ,61 ....... ............................................... 3f1a Xdl '61 O D' 0 81 0 0' 0 n a ~ owy ~gl algexe} aul~;o }u l 0 0' 0 ~L ~ 0 0' 0 Z ~' X a}e~ 6uligls ;e algexe} ~ ~ aul~ ~o ;unowy 'L ~ 9 2' Z 2 2 0 2 .g ~ Z 9' h 6 h 6 h h 5bo' x a;e~ leaull ;e algexe; til aul~ ~o;unowy 'gl 0 0' 0 .5 ~ 0 0' 0 0' x (Z' 1)(e) 9616 .oaS aapun spa}sues} ~o `a}ea xe} lesnods ay;;e algexe;;,~ aul~;o;unowy 'S1 S31H2! 318V~1'lddd 2iO~ SNOIl~f1211SN1 33S - NOIlVlf1~~V~ Xbl Z 9 ' t~ 6 h 6 h ~t 'til ...................... (£ 1 aul~ snulw Z ~ aul~) xel o~ ~oafgng anleA ~aN 'b 1 • ~£ ~ • • • • • • ~ • • • • ~ ~ • ~ ~ ~ ~ ~ ~ ~ ~ (~ alnpayoS) apew uaaq }ou sey xe; o} uol;oala ue yolynn ~o~ s;sn~l £ 116 oaS/s;sanba8 le;uawwanoO pue alge3l~ey~ ~£ ~ Z 9 ' fi 6 h 6 h t1 'Z1 ....... ..................... (1~ aul~ snulw g aul~) a3~s3I<o anleA~aN 'Z1 O Z' h S 2 Q E ' l l ....... ........................ (01 Pue g saul~ le~o}) suol~onpaa le3ol ' l l D 2 • 2 I Z 2 •0 ~ ~ ~ • ~ • ~ ~ ~ ~ ' ' ' ~ (I alnpayoS) sual~ pue 'sal;lllgei~ a6e6~ow '}uapaoaa }o s;qaa '0 ~ 0 S ' 2 h S 9 E .6 • • ~ ~ ~ ~ • ~ • ~ ~ ~ ~ ~ ' ' ' ' (H alnpayoS) s;sod and}e~;slulwpy pue sasuadx3 le~aun~ 'g Z E • 6 h Z Z Q h .g ..... ...................... (L y6nay} 1 sau!l le}o}) s3assd sso~O le3ol '8 S 0 • 6 6 E t1 E ~L ~ ~ ' ' ' ~ ~ pa;sanba~ 6u!II!8 a;e~edaS (O alnpayoS) ~(}~adad a}egoad- N snoauellaoslW'8 spa;sued sonln-aa}ul ~L 0 0 • O ~9 ' ' ' ' ' ' ' pa}sanba~ 6ullll8 a;eaedaS ~ (~ alnpayoS) ~f~adad paunnp ~l}ulo f 'g 2 E • 0 S Z 0 6 2 .5 ~ ~ ~ ' ~ ' ' (3 alnpayoS) ~(}~adad leuos~ad snoauellaos!W pue s}lsodaa ~lue8 `yse~ 'g • .~ ..... ..................... (4 alnpayoS) algenlaoa21 sa;oN pue sa6e6~olN ~~ • '£ ' ' ' ' ' (~ alnpayoS) dlys~o;al~dad-aloS ~o dlys~au}~ed `uol;e~od~o~ plaH ~tlasol0 '£ • .Z ..... ................................. (8 alnpayoS) spuo8 pue s~loo;S 'Z 0 0'0 0 9 2. 9 '[ , ~ ..... ...................................... (b alnpayoS) a}els3 lea2i ' 1 ,NOlldlf111dd~32! Z 9 +1 Z 0 2 S S O NOS 10 H ~ I N ' W Jl .L .L 3 8 :aweN s,~uapaoao ~agwnN ~(}l~noaS Ielo oS s,}uapaoaa X3 0051-n32i Ofi20'C95052 r ~ _ - __ Continuation of REV-1500 Inheritance Tax Return Resident Decedent BETTY M. NICHOLSON 21 11 0114 Decedent's Name Page 1 File Number Correspondents Name Daytime 'Telephone Number M A R C U S A M c K N I G H T I I I 7 1 'T 2 4 9 2 3 5 3 First line of address 6 0 W E S T P O M F R E T S T R E E T Second line of address City or Post Office C A R L I S L E State ZIP Code P A 1 7 0 1 3 Correspondent's a-mail address: unaer penames oT pequry, I aeaare that I have examined this return, including accompanying schedules and statements, and to the beat of my knowledge and belief, it is true, conect and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATU E OF PERSON RESPONSIBLE FOR FILING RETURN AT l~ ADDRESS 2247 CANTERBURY DRIVE MECHANICSBURG PA 17055 REV-1500 EX Page 3 Decedent's Complete Address: Ffle Number 21 11 ()114 DECEDENT'S NAME BETTY M. NICHOLSON STREET ADDRESS 5327 COBBLESTONE DRIVE CITY MECHANICSBURG STATE PA ZIP 17055 Tax Payments and Credits: 7 • Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments 16, 000.00 B. Discount 909.42 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) 20,227.26 Total Credits (A + B) (2) 16, 909.42 (3) (4) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 3,317.84 Make check payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred : ...................................................................... ^ b. retain the right to designate who shall use the property transferred or its income; ............................... ^ Q c. retain a reversionary interest; or ................................................................................................ ^ X^ d. receive the promise for life of either payments, benefits or care? ....................................................... ^ Q 2. If death occurred after December 12, 1982, did decedent transfer property within one year of deatl~ without receiving adequate consideration? ....................................................................................... ^ X^ 3. Did decedent own an "intrust for" orpayable-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 C 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. • REV-1502 EX+ (01-10) a pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF: FILE NUMBER: BETTY M. NICHOLSON 2'I 11 0114 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property that is jointly-owned with right of survivorship must be disclosed on Schedule F. Attach a copy of the settlement sheet if the property has been sold. ITEM Include a copy of the deed showing decedent's interest if owned as tenant in com~~non. VALUE AT DATE NUMBER OF DEATH DESCRIPTION 1. 5327 COBBLESTONE DRIVE, MECHANICSBURG, PENNSYLVANIA 162,600.00 SOLD -SETTLEMENT SHEET ATTACHED TOTAL (Also enter on Line: 1, Recapitulation.) I $ 162,600.00 If more space is needed, use additional sheets of paper of the same size. REV-1508 EX + (6-98) SCHEDULE E CASH BANK DEPOSITS & MISC. COMMONWEALTH OF PENNSY , , LVANIA IN RN PERSONAL PROPERTY S ~ RE DENT D DENT ESTATE OF FILE NUMBER BETTY M. NICHOLSON 21 11 0114 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointty-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. PNC BANK, N.A. 9,249.67 CERTIFICATE OF DEPOSIT #31800329793 2. PNC BANK, N.A. 1,354.93 CHECKING ACCOUNT #5005710215 3. MEMBERS 1ST FEDERAL CREDIT UNION 3,358.62 SAVINGS ACCOUNT #275621-00 4. MEMBERS 1ST FEDERAL CREDIT UNION 7,337.15 CHECKING ACCOUNT #275621-11 5. MEMBERS 1ST FEDERAL CREDIT UNION 4,275.44 MONEY MANAGEMENT ACCOUNT #275621-05 6. MEMBERS 1ST FEDERAL CREDIT UNION 12,163.47 CERTIFICATE OF DEPOSIT #275621-40 7. MEMBERS 1ST FEDERAL CREDIT UNION 54,336.48 CERTIFICATE OF DEPOSIT #275621-43 8. MEMBERS 1ST FEDERAL CREDIT UNION 103,403.01 CERTIFICATE OF DEPOSIT #275621-44 9. MEMBERS 1ST FEDERAL CREDIT UNION 5.04 SAVINGS ACCOUNT #230899-00 10. PSECU -SHARES 01 205.40 11. PSECU - SHARE C 50 43,873.64 12. PSECU - SHARE C 53 22,969.67 13. PSECU - SHARE C 54 12,228.13 14. JOHN HANCOCK 15,989.67 ANNUITY #BK3918846 BENEFICIARY: THE ESTATE OF BETTY M. NICHOLSON TOTAL (Also enter on line 5, Recapitulation) I $ 290,750.32 (If more space is needed, insert additional sheets of the same size) REV-1510 EX+ (08-09) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS AND MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER BETTY M. NICHOLSON 21 11 0114 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page thrf:e of the REV-1500 is yes. ITEM NUMBER DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1. MEMBERS 1ST FEDERAL CREDIT UNION 5,196.44 100.00 5,196.44 IRA CERTIFICATE OF DEPOSIT #275621-15 BENEFICIARIES: RUTH E. MORRIS/JUDITH A. BEICHLER 2. MEMBERS 1ST FEDERAL CREDIT UNION 23,228.41 100.00 23,228.41 IRA CERTIFICATE #275621-16 BENEFICIARIES: RUTH E. MORRIS/JUDITH A. BEICHLER 3. METLIFE 5,974.20 100.00 5,974.20 ANNUITY -CONTRACT #8562544 TOTAL (Also enter on Line 7, Recapitulation) I $ 34, 399.05 If more space is needed, use additional sheets of paper of the same size. REV-1 S11 EX+ (10-09) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER BETTY M. NICHOLSON 2'1 11 0114 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. MALPEZZI FUNERAL HOME 8,265.07 2. GINGRICH MEMORIALS 165.00 B. 1 ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City Year(s) Commission Paid: State ZIP 2, Attorney Fees: IRWIN & McKNIGHT, P.C. 18,000.00 3. Family Exemption: (If decedents address is not the same as claimants, attach explanation.) Claimant Street Address City State ZIP _ Relationship of Claimant to Decedent 4. Probate Fees: REGISTER OF WILLS 365.50 5 Accountant Fees: 6. Tax Return Preparer Fees: PATRICIA A. ROSENDALE, CPA 625.00 INCOME TAX RETURN AND FIDUCIARY TAX RETURN 7. REGISTER OF WILLS -SHORT CERTIFICATE 12.00 8. CARPET INSTALLATION 869.70 9. WESLEY MEWS CONDOMINIUM ASSOCIATION -ASSOCIATION MONTHLY FEES 966.00 10. SHERWIN WILLIAMS -PAINT 80.00 11. PATRIOT NEWS -ADVERTISING FOR OPEN HOUSE 53.52 12. OFFICE MAX -FLYERS MADE TO SELL REAL ESTATE 23.00 13. CUMBERLAND LAW JOURNAL -ESTATE NOTICE 75.00 14. THE SENTINEL -ESTATE NOTICE 198.16 15. CLOSING COSTS ON SALE OF REAL ESTATE 1,801.00 16. BILL SOWERS -AUCTIONEER -COMMISSION & COSTS 4,983.60 17. FAW HEATING AND A/C -SERVICE 59.95 TOTAL (Also enter on Lirie 9, Recapitulation) $ 36.542.50 If more space is needed, use additional sheets of paper of the same size. REV-1512 EX+ (12-08) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FNLE NUMBER BETTY M. NICHOLSON 21 11 0114 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. MEMBERS 1ST FEDERAL CREDIT UNION -VISA #4672090000364158 43.25 2. BONNIE K. MILLER, TREASURER -REAL ESTATE TAXES 650.92 3. BONNIE K. MILLER, TREASURER -PERSONAL INCOME TAX g.gp 4. UGI -UTILITY 237.21 5. WATER/SEWER 97.39 6. PP&L -ELECTRIC 90.93 7. LOWER ALLEN TOWNSHIP 228.70 8. PA DEPARTMENT OF REVENUE -INCOME TAXES 354.00 TOTAL (Also enter on Lina 10, Recapitulation) I $ 1, 712.20 If more space is needed, insert additional sheets of the same size. • REV-1513 FJ(+ (01-10) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF: FILE NUMBER: BETTY M . NICHOLSON 2'1 11 0114 RELATIONSHIP 1'0 DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List'Trustee(s) OF ESTATE I, TAXABLE DISTRIBUTIONS [Indude outtsn'ghts usal distributions and transfers under Sec. 91'6 (a~1.2).] 1. JOHN A. NICHOLSON Lineal 12,000.00 28A N. MARKET STREET MECHANICSBURG, PA 17055 2. JUDITH A. BEICHLER Lineal 2033 HARVEST DRIVE 25% REMAINDER MECHANICSBURG, PA 17055 3. MARK J. NICHOLSON Lineal 47839 8TH STREET 25% REMAINDER LANCASTER, CA 93536 4. RUTH E. MORRIS Lineal 2247 CANTERBURY DRIVE 25% REMAINDER MECHANICSBURG, PA 17055 5. STEPHANIE L. NICHOLSON Lineal C/O RUTH E. MORRIS, GUARDIAN 25% REMAINDER 2247 CANTERBURY DRIVE MECHANICSBURG, PA 17055 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER S HEET, AS APPROPRIATE. II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 DOVER SHEET. $ It more space is neeaea, use aoaitionai sneers or paper of the same size. . _ _ - _ - S~ a • ~~~ y ~fl. ~ I, BETTY M. NICHOLSON, of Lower Allen Township, Cumberland County, Pennsylvania, declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils heretofore made by me. ONE. I direct my Co-Executors to pay all of my debts, funeral and administrative expenses as soon as convenient after my decease. Furthermore, I direct 1,hat 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 Co-Executors of my estate. TWO. My Co-Executors may, at their discretion, compromise claims, borrow money, retain property for such length of time as they may deem proper; lease and sell property for such prices, on such terms, at public or private sales, as they may deem proper; and invest estate property and income without restriction to legal investments unless otherwise provided hereunder. I authorize and empower my Co-Executors to 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 Co-Executors are authorized and empowered to engage iin any business in which I may be engaged at my death, for such period of time after my death as seems expedient to said Co-Executors. `~`f3/ Y THREE. I specifically give, devise and bequeath the sum of Twelve Thousand and no/100 ($12,000.00) Dollars to my son, JOHN A. NICHOLSON, pro`rided that the following conditions of this specific bequest are met: A. That JOHN A. NICHOLSON does not contest the provisions of this Will for any reason and releases my estate and my Co-Executors upon receipt of the sum of Twelve Thousand and no/100 ($12,000.00) Dollars;. B. That at the time of my death JOHN A. NICHO:LSON is not seeking a hearing before a Cumberland County Judge regarding the custody of STEPHANIE L. NICHOLSON. If at my death a custody hearing is already scheduled before a Cumberland County Judge, this condition will be met if he cancels it within thirty (30) days of my death. I do not wish my granddaughter to undergo custody litigation which is funded by this specific bequest. If these conditions are not met this bequest will lapse ar.~d be used for estate administration expenses, legal fees, or payment of any inheritance tax due the Commonwealth of Pennsylvania. FOUR. I give all the rest, residue, and remainder of my estate of every nature and wherever situate as follows: A. JUDITH A. BEICHLER .....................................25% B. MARK J. NICHOLSON .....................................25% C. RUTH E. MORRIS ..............................................25% D. STEPHANIE L. NICHOLSON ..........................25% ** **In Trust to Marcus A. McKnight III and Ruth E. Morris as Co-Trustees as set forth in Paragraph Five less the sum of $12,000.00 bequeathed to my son, JOHN A. NICHOLSON, the father of STEPHANIE L. r1ICHOLSON, whether the bequest to him is in effect or used by my estate if he fails to meet the conditions of this bequest. 2 r FIVE. If my granddaughter, STEPHANIE L. NICHOLSON, has not yet attained the age of Twenty-Three (23) years of age at the time of my death, then I; give, devise, and bequeath 25% of my estate less the sum of Twelve Thousand and no/100 ($12,000.00) Dollars in TRUST to RUTH E. MORRIS and MARCUS A. McKNIGHT, III as CO-TRUSTEES for the benefit of my granddaughter, STEPHANIE L. NICHOLSON, who has not yet attained the age of Twenty-Three (23) years subject to the following provisions. A. This TRUST will be for the sole benefit of my granddaughter, STEPHANIE L. NICHOLSON as provided herein. B. The net income of the Trust shall be applied a1: the sole and absolute discretion of the Co-Trustees to the support, maintenance, education and general welfare of my granddaughter, STEPHANIE L. NICHOLSON, in such manner as the Co- Trustees deem proper, without regard to any other funds which may be available for the Trust purposes, or may be accumulated in Trust. C. I further authorize the Co-Trustees, to apply not only the income, but also so much of the principal as the Co-Trustees deem necessary, in, for, or toward the maintenance, support, education and general welfare of my granddaughter, STEPHANIE L. NICHOLSON, in such manner as they shall deem proper. V~'hen my granddaughter, STEPHANIE L. NICHOLSON, attains the age of Twenty-'Three (23) years, the Co- Trustees will distribute to said child the balance of principal acid accumulated income contained in said Trust. 3 __ - - D. The Co-Trustees shall have the following powers, in addition to those vested in them by law, for my property held for the benefit of my granddaughter, STEPHANIE L. NICHOLSON, whether income or principal, exercisable without court approval and effective until the distribution of all property under the terms of this Trust; the Co-Trustees, at their discretion, may compromise claims, borrow money, or retain property for such length of time as they may deem proper, sell, .lease, pledge, mortgage, transfer, exchange, convert or otherwise dispose of or grant opti~~ns of all or any portion of Trust property for such prices, on such terms in public or private transactions as they may deem proper; and invest Trust property and income without restriction to legal investments. SI_X. I nominate and appoint JUDITH A. BEICHLER and RIJTH E. MORRIS to be the Co-Executors of this my Last Will and Testament. If they are unable to serve, I nominate and appoint MARCUS A. McK1~TIGHT, III to serve as Executor in their place. SEVEN. No person(s) shall benefit hereunder unless such beneficiary shall survive me by thirty (30) days. EIGHT. No Co-Executor or Co-Trustee acting hereunder shall be required to post bond or enter security in this or any other jurisdiction. NIlVE. 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. 4 IN WITNESS WHEREOF, I have hereunto set my hand and seal this 22nd day of December 2010. r OZ-~S~) BETT M.IVICHOL30N Signed, sealed, published and declared by the above-named person as and for 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. ~~;~ 5 ACKNOWLEDGMENT AND AFFIDAVIT WE, BETTY M. NICHOLSON, SHARON L. SCHWALM, and TRACI D. SMITH, 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 instrument 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 o:P age or older, of sound mind and under no constraint or undue influence. BETTY . NICHOLSON SHARON L. SCHWALM ,-, l1 TRACI D. SMITH COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND Subscribed, sworn to and acknowledged before me by BETTY M. NICHOLSON, the testator herein, and subscribed and sworn to before me by SHARON L. SCHWALM and TRACI D. SMITH, witnesses, this 22nd day of December 2010. r '~~ .~ COMMONWEALTH OF PENNSYLVANIA a . PII liC Notarial Seal Martha L Noel, Notary Public Carlisle t$oro, Cumberland County My Comm~sion Expfr+es Sept, 18, 2x11 Member, Pennsylvania Association of Notaries LAVU OFFICES A. Settlement Statement U.S. Department of Housing and Urban Development ~~ ~~/~~ ~ ~Ci~J~~~~ OMB No. 2502-0265 _ B. TYPE OF LOAN _ WEST POMFRET PROFESSIONAL BiJILDJNG 1. (]FHA 2. ^FmHA 3. OConv. Unins. 60 WEST POMFRET S 7REET 4. VA 5. Conv. Ins. CARLISLE, PENNSYLVANIA 97093-3222 6. FILE NUMBER 7. LOAN NUMBER (797) 249-2353 OLLEYR&11 8. MORTGAGE INSURANCE CASE NUMBER C. Note: roans mekea -~poe.r wen ~ w o'wa. u,. alosMg~ nwy an shown hsr. for iMonnMio„ pwpoM.,,,d.r.,wt b~q~ M m. roe,,:. TiUeExpress SetGement System croai ~ ana ~m~im. r~ a.r,se s.. ~ t ucoa s~`.~ao ~~°~`a~a s~.oa~"o~~ o 'o e~"°` ~°`~ Printed 06106@011 at 14:19 JMR D. NAME OF BORROWER: ROBERT M. OLLEY, SR. and LINDA E. OLLEY ADDRESS: 104 PARK VIEW ROAD NEW CUMBERLAND PA 17070 _ E. NAME OF SELLER: BETTY M NICHOLSON ADDRESS: 5327 COBBLESTONE DRIVE MECHANICSBURG PA 17055 F. NAME OF LENDER: ADDRESS: _ _ G. PROPERTY ADDRESS: 5327 COBBLESTONE DRIVE, Mechanicsburg, PA 17055 Lower Alien Townshi _ H. SETTLEMENT AGENT: 18M REAL ESTATE SERVICES, LLC, Telephone: 717.249-2353 Fax: 717.249.6354 PLACE OF SETTLEMENT: West Pomfret Professional Bld 60 West Pomfret Carlisle PA 17013 I. SETTLEMENT DATE: 0610812011 J. SUMMA OF 0 R' RANSACTION: _ MMARY OF SELLER'S TRANSACTI N: 100. GROSS AMOUNT DUE FROM BORROWER 400. GROSS AMOUNT DUE TO SELLER 101. Contract sales 162600.00 401. Contract sales rice _ 162600.00 102. Personal P 402. Personal P _ 103. Settlement to borrower line 1400 1948.00 403. _ 104. 404. _ 105. 405. _ Ad'ustments for items aW b seller in advance Ad'ustments for items aid b seller i _ n advance 107. Coun taxes 06106111 to 12131111 372.71 407. Coun taxes 06106N 1 to 12131111 372.71 108. Scholl Tax 06106111 to06130111 104.06 408. School Tax 06106111 to06130111 _ 104.06 109. 409. _ 110. CREDIT SWRITRASH balance 10.40 410. CREDIT SWRITRASH balance _ 10.40 111. ASSOCIATION FEE 06106111 to06130111 110.83 411. ASSOCIATION FEE 06106111 to06130111 _ 110.83 112. 412. _ 120. GROSS AMOUNT DUE FROM BORROWER 165146.00 420. GROSS AMOUNT DUE TO SELLER _ 163198.00 Z00. AMOUNTS PAID BY OR ON BEHALF OF BOR ROWER _ 500. REDUCTIONS IN AMOUNT DUE TO SELLER 201. ' or earnest mone 16 260.00 501. Excess 't see instructions _ 16 260.00 202. Princi amount of new loans 502. Settlement ch to seller line 1400 _ 1801.00 203. Existi loan s taken su 'ect to 503. Existin loan s taken su 'ect to _ 204. 504. Pa off of First Mort a Loan _ 205. 505. _ 206. 506. _ 207. 507. _ 208. 508. _ 209. 509. _ Ad ustmerrts for items un aid b seller _ Ad ustments for items un id seller 213. 513. 214. TRASH Q-A M J= 53.984102111 to06106111 38.11 514. TRASH Q A M J= .9A4102111 to06106111 _ 38.11 215. SEWER Q-A M J- 50.004102111 to06106111 35.32 515. SEWER Q-A M J- .004102111 to06106111 _ 35.32 216. 516. _ 217. 517. _ 218. 518. _ 219. 519. _ 220. TOTAL PAID BYIFOR BORROWER 16 333.43 520. TOTAL REDUCTION AMOUNT DUE SELLER _ 18134.43 300. CASH AT SETTLEMENT FROM OR TO BORR OWER _ 600. CASH AT SETTLEMENT TO OR FROM SELLER 301. Gross amount due from borrower line 120 165146.00 601. Gross amount due to seller line 420 _ 163198.00 302. Less amounts 'd b Ifor borrower line 220 16 333.43 602. Less reduction amount due seller line 520 _ 18134.43 303. CASH FROM BORROWER 148 812.57 603. CASH TO SELLER 145 063.57 U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT File Number. OLLEYR6.11 PAGE 2 SETTLEMENT STATEMENT TiflnGvnrnee Cnfflmm~n4 C,.efe.., Drinfnrl rumRMn11 ~~f 1d•1D I\AD L. SETTLEMENT CHARGES PAID FROM PAID FROM 700. TOTAL SALESBROKER'S COMMISSION based on rice $162 600.00 = BORROWER'S SELLER'S Division of commission line 700 as fellows: FUNDS AT FUNDS AT 701. to SETTLEMENT SETTLEMENT 702. to 703. Commission 'd at Settlement 800. REMS PAYABLE IN CONNECTION WRH LOAN 801. Loan 0 ' ination Fee % 802. Loan Discount 803. A sisal Fee 804. Credit R 805. Lenders In Fee 806. Mort A icatlon Fee 807. Assum lion Fee 808. 809. 810. 811. 900. REMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest From to Ida 902. M Insurance Premium for to 903. Hazard Insurance Premium for to 904. 905. 1000. RESERVES DEPOSRED WRH LENDER FOR 1001. Hazard Insurance mo. Imo 1002. Insurance mo. Imo 1003. C' Tax mo. !mo 1004. Coon Tax mo. 54.24 Imo 1005. Shcool Tax mo. 126.61 Imo 1009. A ~e An 's A 'ustment 0.00 0.00 1100. TRLE CHARGES 1101. Settlement a dosin fee 1102. Abstract a title search 1103. Title examination 1104. Title insurance tinder 1105. Document ration 1106. No Fees 10.00 1107. Attome 's fees to IRWIN & MCKNIGHT P.C. 250.00 indudes above items No: 1108. Title Insurance indudes above items No: 1109. Lenders Cov NONE 1110. Owners Co 162 600.00 - 1111. 1112. 1113. 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recordi Fees Deed 62.00 • Mort • Release 62.00 1202. C' /Coon tax/starl Deed 1626.00 • Mat a 1626.00 1203. State Taxlstam s Deed 1626.00 1626.00 1204. 1205. 1300. ADDRIONAL SETTLEMENT CHARGES 1301. Surve 1302. Pest to 'on 1303. Resale Certificate to STERLING PROPERTY MANAGEMENT INC. 175.00 1304. Audyaneer Fee to William Sowers P.O.C. 4 878.00 Seller 1305. 1306. 1307. 1308. 1400. TOTAL SETTLEMENT CHARGES enter on lines 103 Section J and 502 Section K 1948.00 1801.00 HUD CERTRCATION OF BUYER AND SELLER I haw rsviaarsd tln NUD-1•Saltlamsnt Statement and to tha hest of my knosAsdpe and hsl true and accurate statamsrd of all nealph and dhbursemants nuWa on my account or by r in tlMs .1 turtlter pAify that I haw rseehrod a copy of the HUD-1 8aMhmeM Statement. BETTY M NICHOLSON WARNMIG: IT IS A CRWE TO KNOWMiOLY MAKE FALSE STATEMENTS TO THE The NUD-1 8tatema h a trw and aeeixate account of thh transaction. UNITED STATES ON THIS OR ANY SIMILAR FORM. PENALTI~ UPON CONVICTION I have pw usMllPfiaW dls6uriad M accordance wHh tl~h stahmsnt. CAN INCLUDE A FINE AND IMPRISONMENT. FOR DETAIL8 SEE TITLE 10: U.S. CODE SECTION 1001 AND SECTION 1010. By: ~ / / ~ ~ u, ca. cu i i i u ~ JUnivi i lV~ U111V~ ~t I L- I U~-L 141 ~: ~PNC February 23, 2011 Marcus A McKnight III Esq. Irwin & Mclnight P.C. 60 ~V Pomfret St Carlisle, PA 17013-3222 'RE: Betty M Nicholson SSN: 055-20-7467 DOD: O 1-10-2011 Dear Mr. McKnight: In response to your request for Date of Death (DOD) balances for the customer noted above, our records show the following: Certificate of Deposit Account # 31800329793 Established: 07-21-2008 BETTY M NICHOLSON DOD balance: $ 9,243.37 + 6.30 accrued interest Interest pasd 01-01-2011 thru 01-10-2011 $ 0.00 YTD Checking Account Account # 5005710215 Established: 01-08-2008 BETTY M NICHOLSON DOD balance: $1,354.93 non interest bearing Please note that this ot1'ice provides date of death balances for deposit accounts (IR.As, CDs, Checking and Savings). We do not process any ~oancial traasoctiona or provide statements. If you need assistance with any of these items, please call 1-888-PNC-BANK (1-588-762-2265) or stop by your local PNC Bank branch ot~ice. Sincerely, National Financial Services Center PNC Bask, N.A. - MemberFDIC Ivo, VUIL r, ILL ~ I I i Pa,ee 1 of 2 reb. 1j. Dui ~ ~u;~UHivi riu~ ~Hiu~ 411-IUD-Z 141 iuo. UU11 r. l~L This message is intended for the use of the individual or entity to which it it addressed and may contain information that is privileged, confidential and exempt from disclosure under applicable ~ 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 notifred 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 ADO-762-177 and irrlmediately destroy this faxed document. Pa.~e 2 of 2 st MEMBERS 1st FBDBRAL CRBDTT UNION ,<< ~v~. : ..~ ~~t~~, JOINT OWNER JOSEPH NICHOLSON REMOVED AS JOINT OWNER ON 03/04/2o~e REGULAR SAVINGS ACCOUNT: Account Number/Suffix Date Account Established 275621-00 Principal Balance at Date of Death 11/28/2005 Accrued Interest to Date of Death $3,358.41 Total Principal and Accrued Interest $.21 . Name of Joint Owner $3,358.62 None./ CHECKING ACCOUNT: Account Number/Suffix Date Account Established 275621-11 Principal Balance at Date of Death 03/04/2010 Accrued Interest to Date of Death $7,336.98 Total Principal and Accrued Interest $•17 Name of Joint Owner $7,337.15 None MONEY MANAGEMENT ACCOUNT: Account Number/Suffix Date Account Established 275621-05 Principal Balance at Date of Death 05/04/2010 Accrued Interest to Date of Death $4,275.07 Total Principal and Accrued Interest $•37 Name of Joint Owner $4,275.44 / None IRA CERTIFICATES OF DEPOSIT: Account Number/Suffix Date Account Established 275621-15 Principal Balance at Date of Death 09/24/2010* Accrued Interest to Date of Death $5,194.72 Total Principal and Accrued Interest $1.72 Name of Beneficiary $5,196.44 Ruth E. Morris 50% Judith A. Beichler 50% *Rollover from IRA certificate 275621-17, origina Opened by transfer of shar f lly established 03/18/2010. es rom 275621-10. ~ERTIFiCATES Or DEPOSIT: Account Number/Suffix Date Account Established 275621-40 Principal Balance at Date of Death 03/19/2010 Accrued Interest to Date of Death $12,158.25 Total Principal and Accrued Interest $5'22 Name of Joint Owner $12,163.47 None CERTIFICATES OF DEPOSIT: Account Number/Suffix Date Account Established 275621-44 Principal Balance at Date of Death 09/30/2010* Accrued Interest to Date of Death $103,368.86 Total Principal and Accrued Interest $34.15 Name of Joint Owner $103,403.01 None ./ *Rollover from certificate 275621-45, originally established 03/19/2010. 275621-16 01 /27/2006** $23,218. i'3 $9.68 $23,228.4.1 Ruth E. Morris 50% Judith A. Beichler 50% 275621-43~ 07/22/201() $54,315.1 ~) $21.29 None .~ SUUU Louise Drive P.O. Box 40 Mechanicsburg, Pennsylvania 17055 800 28~- ( ) 2.328 wwwmemberslst.org VISA CREDIT CARP gCCOUNT: Account Number Date Account Established Balance at Date of Death Name of Joint Cardholder *Contractual Pledge of Shares. Estate of: BETTY M. NICHOLSON Date of Death: 01/10/2011 Social Security Number: 055-20-7467 4672090000364158* 03/04/2010 $43.25 None BERGS 1 sT FEDERAL CREDIT UNION anielle A ,~ ~ ' ~~~--- .Kline Lending Insurance Support Specialist February 3, 2011 • S~ MEMBERS 1st PEDBRAL CREDIT UMON PRIMARY OWNER: REGULAR 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 CHECKING 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 W~ e~~ Jose h Nic p holson 230899-00 06/04/2003 $5.04 $.00 $5.04 Betty Nicholson 06/04/2003 230899-11 06/04/2003 $.00 $.00 $.00 Betty Nicholson 06/04/2003 BERS 1sT FEDERAL C:RE1DIT UNION Danielle A. Kline Lending Insurance Support Specialist February 3, 2011 Estate of: BETTY M. NICHOLSON Date of Death: 01/10/2011 Social Security Number: 055-20-7467 5000 Louise Drive P.O. Box 40 Mechanicsburg, Pennsylvania 17055 (800) :283-2328 wwwmemberslst.org PSEC~k March 4, 2011 Account # 8386XX~S;XXX MARCUS A MCKNIGHT III WEST POMFRET PROF BLDG 60 WEST POMFRET ST CARLISLE, PA 17013-3222 Dear MR. MCKNIGHT: ,_., ,r ~~~ =~i~~x ~ ,.~ ' .,3 , (~~ ; The following is the status of BETTY N NICHOLSON's account with PSECU as of the date of death. Joint Owner's Name JUDITH BEICHLER, RUTH MORRIS ADDED 03.23 W/ROS •2010 ASS JOINT TENANT Date of Death 01.20.2011 Date of Birth 05.19.1928 Share S O 1 Description Regular Shares Upen date 03 23 2010 Balance ~~ccrued Dividend C 50 24 Month Certificate* . . 04 16 2010 $ 205.40 g~ 0.02 C 53 24 Month Certificate* . . 04 16 2010 43,873.64 16.12 C 54 * 24 Month Certificate* . . 22,969.67 13.99 Funds were transferred from the account of Joseph Nicholso n w 12'228.13 ho died 02.18.2010 5.25 The dividend earned from January 1, 2011 through the date of death was $35.38. Th We do not have safe deposit boxes for our members. a dececlent had no loans with us. If you have any questions, please ca11234-8484 in Harrisburg or our toll-free number prompt, enter 6 and then extension 2227. , (800) 237-7328. At the menu Sincerely, ~: .~ `• r~ ;` , ~~-'~ Meaci Fairfax ~~ Member Service Representative Finance Support Unit Main Address: 1 Credit Union Place, Harrisbur PA 171~0.2990State Employees Credit Union Mailing Address: P.O. Box 67013, Harrisburg, PA 17106 7013 • 717.234.8484 • 800.237.7328 717.777.2100 (TDD) • 800.472.1967 (TDD) This credit union is federally insured by the National Credit Union Administration. E ual p pS@CU.COm 9 pportunity Lender MetLife P.O. Box 14592 Des Moines IA 50306 ~> Sara Nicholson "~ ,~1 5327 Cobblestone Drive ' Mechanicsburg PA 17055 / ;, _f~„' MetLife January 24, 2011 RE: METLIFE INSURANCE COMPANY OF CONNECTICUT CONTRACT 8562544 OWNER Betty M Nicholson Dear Ms. Nicholson: Thank you for notifying us of the death of Betty M Nicholson. Please accept our condolences. According to our records for the above referenced annuity, 58 monthly payments are payable, with the right to commute to JOSEPH A NICHOLSON, s~ beneficiary. If a lump sum is preferred the Commuted ~Jalue at death is $5,974.20. -- In order for us to settle the contract(s), the following is required: • Certified Death Certificate for Betty M Nicholson • Completed & signed beneficiary claim form for each beneficiary If you have any questions, please contact our Customer Service Center at 1-800-515-1075, Monday through Friday between 8:30 a.m. and 6:30 p.m., ET. ' cerely, T L. Johnson Annuity Representative -Post Issue Processing MetLife Annuity Operations and Services __ _ _ - _ _ - ~ _ _ _ - I L U• V• L V I I L• I V Y ••• V V 1 1 1• 1 11 11 \ V V V I\ 11 I o John Flaneoclc Lifs In6lRanoo Company ((,I,g ,A,' `_~ 'John NRllooCk AMUlks 9eIVICe CMOer ;~ f~fpt~sb D~ ~ NH 0l001~815 ~ ~ ~• Pata+rolah, NH 09602 9505 the future is yours www J~nntStia,tblD Pe6rnary 8, 201 I K~ Noel Fax#717 249-6354 Rear Ms. Noel: ~~ AND CONTRACT NO.: BK3918846 OWNER/ANNTJI'fANT: Beay MNchol9on Bi:NfiFYCXARY(lES): Joseph A Nichohmn We arore recx6uly notified of 1~1e death of Betty M NiehoLon. Enolosed vYh'h tbii letter, you wiU find the forma required to settle the death claim for the con~aoR reEezanced above. All oriSinal . including a ooortified n~hl' aII c meat be submitted by the primary beneficiary. Pleas be advi6ed that we wiq suspepd Payments below >i~ ~ ~ ~~ If a ~°ary 6one5eiary is dt~a5ed, please confect w at the phoine numbest mfarmarioa Btstty M Nudrolsoolr was receiving montlily Payments fromtheabove-reftrenced ooatract ender the l0 'Year Fixed Period °Pdoo. These psymm~ began oa 11/1%Z003. Aa the payout period bah not aocpired, payments will now continue to the desigpsted benefidary mad710/1/2013. TLe bey should dead his or her beme8ciary by eor>apleth~g and retarraIDg the encloaod C~nge of RagisOration >iorm alo>ag wlth the Beneficiary Clahn 3taarement We will ps+ovmptIy settle the claim upon receipt of aU required forma from all beaefiaiariea. The death berwfit wrll not be paid nrrtil this thee. Please note that ihr variable co~acts, ~ invest sub~ocom>m tNill relmia in their currant allocaatons u>stil the claim is settled. A return envelope is enclosed for your convenience. _ Ifyau have any quamans or c~nceros about ffiis letter, please cell us at 877-543-2363. Olnr Claims Service / Wives are available on wedcdaya gram 9;00 stn. to 5:00 p.m. EST'. l - sibcerely, ~ 7 John Haacock Aanumes \\ F11 _ lo~ ~ J CASE ALL YOUR CONTRACT NUMBER BK3918846 FOR CHANGE OF ADDRESS -USE THIS SECTION AND MAIL TO: JOHN HANCOCI( ANNWTIEB 8ERVICE CENTER 186 ~RPORATE DRIVE, PORTBYOUTH, NN O~B01~B16 PO BOX a606, PORT8MOllTH, NH 03802•N606 PLEASE PRINT CHANGE OF ADDRESS BELOW MAIL FUTURE CHECKS TO: NO. AND STREET ----- pTY STATE 7JF CODIE LEGAL ADDRESS FOR STATE INCOME TAX PURPOSES COMPLETE ONLY IF DIFFERENT FROM MAILING ADDRESS NO. AND STREET -'-~ CITY -- STATE CODE SIGNATURE DATE MUST BE SIGNED BY PAYEE TO EFFECT ANY CHANGE. EST OF BETTY M NICHOLSON C/0 JUDITH A BEICHLER RUTH E MORRIS 60 WEST POMFRET ST CARLISLE PA 17013 JUDITH A BEICHLER 8r RUTH E MORRIS EXECUTORS THIS STUB IS YOUR PERMANENT RECORD OF PAYMENT CASE ALL Np, 880-300935538 DUE GATE MO. DAY YEAR 02 23 11 880-300935538 AMOUNT OF CHECK 15989.67 DEDUCTIONS EXCESS INTEREST ANDJ PECIAL PAYMENTS FILE OR CONTRA NUMBER AMOUNT OF PAYMENT BK391884 15989.67 IMPORTANT NOTICE TO RECIPIENTS OF PENSION OR ANNUITY PAYMENTS ONLY. If Federal Income Texas have been withheld from the payments you are recelWnp and if you do rxtt wish to have taxes withheld. please let us lalow, However, ff You sled rx>< to have wlthholdinp appppl~yy to your payments, or E you do not have en h Federal Income Tax twifltheld from r paaayyyment you may be rasporwi~ ~ ~ N I~ wfCthttld~inp and mesh penakies under tthnee tats payments are rld sUfflCkrlL VlNthholdlnp is meetly a method of taxes which you owe and therefore dose ndchartpe your total liabildy~~ If Federal Income Taxes are riot beinopldwlthheid fyrom our payment because that election and have Faderol ncome Tam withheldifrcYou ~h to revolve please let ua Imttw. Y Payments, • 8 Market Plaza Way iur~hanicsbur~. PA 17055 February 2, 2011 Judi Beichler 2033 Harvest Drive Mechanicsburg, PA 17055 (717) 697-4696 The Funeral Service for Betty M. Nicholson _ . reciate the confidence you have placed in us and will continues this mentevery We sincerely a p ou have any questions in regard way we can. Please feel free to contact us if y MOTIVE EQUIPMENT, THE FOLLOWING IS AN I'I'ENIIZED STA'I'I:NIENT OF THE SERVE F,~ ARRANGEMENTS. AND MERCHANDISE THAT YOU SELECTED WI~'N MAKIN 1. PROFESSIONAL SERVICES: $4,625.00 Services of ~aeral Director/Staff $4,625.00 p-IJ~RAy HOME SERVICE CHARGES SELECTED ~RCHANDISE: $1,200.00 Steel Casket $845.00 Grave Liner $75.00 Maroon Register Package THE COST OF OUR SERVICES, EQUIPMENT, AND MERCHANDISE $(,745.00 THAT YOU HAVE SELECTED _ T THE TIIVIE FUNERAL ARRANGEMENTS ~~ MADE, WE ADV ~~G ~O THOS CHARGES. A O~gS AS AN ACCOMMODATION. THE FOLLOWING IS AN AC CASH ADVANCES: $1,050.00 Opening Grave $210.00 Cemetery Equipment $90.00 Certified Death Certificates $170.07 ._ _ . Newspaper Notices -Patriot - ..._ $1,520.07 " ~ TOTAL CASH ADVANCES AND SPECIAL CHARGES $8,265.07 CONTRACT PRICE TOTAL AMOUNT DUE $8,65.07 /~ ~D ~ ~~~~/~~ ., r Gingrich Memorials 5x43 simoson FOny Road Methan~csburg, PA 17050 C717~ 766-5622 -- iZ0 fei for r~etunisd ck 353 383 stop Pent Balance Due: s~6so0 Ck~# tti~E 2~,, 00 ..ap ~ ~~~~ ~ ~~ ~ ~'", ~On- Judi Beichler Stet 2033 Ht~~ a~ enlent Mechauicoburg, PA 1705lf 3/3/2091 Coatract FamilrNsme Rir:tlVamq Coa~roct3 PAid Ltere:t g~~ 12-20677 Nb;hoison 8ettty 1600 ;0.00 60.00 stss.oo Payment Dah Pay~eat A~nosn! Interact Cb~grRe Cb H~~ ~.~ :0.00 2/7/2091 =140.00 10.00 3/2/2011 (:116.00) :0.00 AJi~ranct chwr~a of I I1Z~ pcr w,awtl6 (X4a6 awwralty~ will be a~lilQd afier ~0 al~rys s r' From: "Home Depot Sa{es" <hon~edepotflocxing@homedepotmeasures,corr~ Subject: Thank you for your order. Date: February 22, 2011 2:31:40 PM EST To: judi.beichier@gmail.com Reply-To: homedepot~ooring@homedepotmeasures.com ~ ~ ~~~ A Home Depot Authorized Service Provl thank you for your order. or any order change requests please contact your The Home Depot store, 4120-MECHANICSBURG. Please remember it will ike approximately 24 hours for your initial order to be processed before we can make any updates. Matenal for Line Item 1 Carpet 'E~2'0 - ~Afcae.~BEi3~1(RIGHTj/CLOS1, BED2(LEFT~GLOS2, CLO$3 QTY Descriptron_ " `, - Urnf Unit Ext. Pni~e Price 9.67 28-529 -Touchdown Caramel (In.Stock) (12'0 x 3T3) ~ Q '. $8.01 397.8 olor. Carmel D .67 raffic Master 6# 7/16 inch Pad Q $4.41 219.0 ote: U raded ad for this line would on! cost an additional $89.40 $0.20/s p X7.0 ip up and haul away carpet and pad ~ .. Q $0.40 150. 00 ote: !f the adjoining rooms that have ceramic will be significantly higher than the CH $0.00 $0. rpeted rooms, the installers may discuss ramping the carpet towards the ceramic to inimize this height difference. If that is something that the customer desires, the nstallers will be able to do this at an additional cost. arning(s): This line item is missing the following rooms: LR, DR. Please $0.00 $0. onfirm with customer. per mrs no Ir or dr being done Labor Total 150.8 Line Ite 767.7 1 Qrder ~S~mma, . ry .Measure ~#6.560340,_.Quote #1fi05249 - _ lJne # ~1re~s ~ Maferie~ ~ Cost Labor-Cost Line' .. _ .. _. . 'Total 1 ED1 RIGHT CLOS1 BED2 LEFT CLOS2 CLOS3 $616.9 $150.8 $767.7 ~._ I~ ~~• ~~ r~Q~[~it pitd ~ >70¢ . J~ ~ °~'~~~, lea. > joss /~ 26.20» Irwin & McKnight Attorneys At Law Attn: Karen Noble Re: Betty Nicholson Estate Down Payment Check Dear Karen: Enclosed is the balance of the down payment check Auction Service in the amount of $11,382.00 for recollected on May 14~' by Bill Sowers Cobblestone Dr. in Mechanicsburg, pa sale of Real Estate located at 5327 As you will note, my commission of $4,878.00 has be check amount of $16,220.00. en deducted from the original Should you have any questions, please feel free to cal 1. Thank ou G ~ William C. Sowers AU005328