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HomeMy WebLinkAbout07-05-11J 1505610101 REV-1500 ex `°'_1°' ' enns lvania OFFICIAL USE ONLY a PA Department of Revenue PEPAA,ME Y a -`~~~ Bureau of Individual Taxes ~ County Code Year File Number Po Box z8o6oi ~ INHERITANCE TAX RETURN Harrisburg, PA 1'7128-0601 RESIDENT DECEDENT ,~- ! 1 C, ~! ~~` r,3 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY ~ Ca 6.~ o ~~~3 ~~ ~ 3 ~~'~ ~' I uv3 t 9 zs~ Decedent's Last Name Suffix Decedent's First Name MI my SRS ~~--~ Irv ~ (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW ® 1. Original Return THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 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 Q 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. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number REGIS WILLS ll .E ONL'V'_~ ' ~ -' ti _. ~I..n ` .:~ i- ..` First line of address r ~ rn ~" ~~ ° '~ c.r ~~ - _ ~~. ~ / c .~ ~e ~ c.. ~ ~ c- ~ -~, ~ ~.._ .. ~., _ -- Second line of address ;_ - ;. - ~~ r'~ w _ ' , ~ City or Post Office ~ w ~ L A Correspondent's a-mail address: ~~~L~J ~~ 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 ERSON RESPONSIBLE FOR FILING RETURN DATE ADDRESS SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS ~~~ .~ ~ ~-~_~~~a ~~~ ~~~ ~ PLEASE USE ORIGINAL FORM ONLY e ~ ~~~~ ~~ Side 1 1505610101 1505610101 J f ~_. State ZIP COde ,DATE FILED ;: 1505610105 REV-1500 EX Decedents Name: t, L L L' n,7 ~fl ~~ I ~- ~ ~ Decedents Soc~jial Security Number ~ ~ ~ ^ ~ 2' ~ ~ -~ RECAPITULATION 1. Real Estate (Schedule A) ........................................... .. 1. y C ~`') ~ G • Lj C~ 2. Stocks and Bonds (Schedule B) ..................................... .. 2. • 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ... .. 3. . 4. Mortgages and Notes Receivable (Schedule D) .. ..................... ... 4. • 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E).... ... 5. ~ ~ ~~ 9 • ~ ~.. 6. Jointly Owned Property (Schedule F) O Separate Billing Requested .... ... 6. 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested..... ... 7. 8. Tota! Gross Assets (total Lines 1 through 7) .......................... ... 8. • 9. Funerai Expenses and Administrative Costs (Schedule H) ................ ... 9. ~ ~ ,,Z "7 ,iqJ C'' 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ........... ... 10. 11. Total Deductions (total Lines 9 and 10) .............................. ... 11. 12. Net Value of Estate (Line 8 minus Line 11) .............................. 12. 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ........................ 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ............. .......... 14. ~ ~ 1 ~ ~ ~ ,~-. TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate. or transfers under Sec. 9116 16. Amount of Line 14 taxable at lineal rate X .0 ~ ~ ~ ~ 1 `l ~ 16. ~ ~ S^ ( ~! ^ j 17. Amount of Line 14 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable at collateral rate X .15 18. • 19. TAX DUE ......................................................... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT i ~~ I• y3 O Side 2 1505610105 1505610105 REV-1500 EX Pace 3 Decedent's Complete Address: File Number NAME -_ STREET ADDRESS CITY ~-L~U N ~n rn-~~~s 1 ~- ~ ~ /9 ~'~ v ~_ 2--~L~--- - - - _ ~1 \ ~~ jSTATE n~ ZIP /~~~, Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments _ A. Prior Payments _ / ~_ (~ J- V `'' - _ -- 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. !f Line 1 + L,ne 3 is greater than Line 2, enter the difference. This is the TAX DUE. Total Credits (A + B) (2) ~ ~ ~ ~ ~ ~ `~ (3) (4) Make check payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Ditl 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 er its income : ............................................ ^ c. retain a reversionary interest; or .......................................................................................................................... ^ 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? ........................................................................................................................ ^ ~(, IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse 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 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, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. Re'v-1508 EX - ~ . 57' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, SANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER ~~ Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION/ OF DEATN ~. !GCS S~TU2N ~~-'~' r(?" ~~~`~ ~2S'S'~Z 3s~ y ~} Ci U r 6 ..~ ~-r z .~2 ~~~ ~"~K 1 ~, ~ ~ t-G ~ ~~ ~ ~~~~1._zL S ~~. TOTAL (Also enter on line 5, Recapitulation) ~ $ ~~ d ~`~ ~ ~ (If more space is needed, insert additional sheets of the same size) REV4509 EX t (1-W) SCHEDULEF COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP T 0 CECEDENT B. S u s ~N ~'~ /~1 y~~ S C JOINTLY-OWNED PROPERTY: !TEM NUMBER LETTEF FOR JOINT T ENAN" DATE MADE JOINT DESCRIPTION OF PROPERTY Include name of financial institution and bank account number or similar identifying number Attach deed for jointly-held real estate. DATE OF DEAT'r+ VALUE OF ASSET °~o OF DECO S 'NTEREST _ DATE OF CEATF VALUE OF D'eCEDEN_ S INTEFES' 1. A. :?-3-1S:J ~~~~'~'Ty ~'J~ L>~,,$Ct~-Lft.~ t't!1.:~ ~+LZ~1Y~ 33`3 ~~`1~~r ~ TOTAL (Also enter on line 6, Recapitulaiion)' $ ~ ~ t~ J `'~ ~ cJ (If more space is needed, insert additional sheets of the same size) REV-1~1~ EX+(50-06j SCHEDULE H , FUNERAL EXPENSES & COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Debts of decedent must be reported on Schedule I. ITEM NUMBEF DESCRIPTION AMOUNT A FUNERAL EXPENSES: 1 S K l f 1 J J rJ ,~ ~ ~ v ~ ,y. ~?' (. I ~ t 1 ~ ~ ~ a7 ~" ~` ~ , (.d _J ~ iii C~ Ol t G ~'1 ~~ v rty .y' ,~~- t ~~ C- / ~{ .~~ ., C! ~ g. ADMINISTRATIVE COSTS: ~ , Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zip _ Year(s) Commission Paid: 2 Attorney Fees 3. Family Exemption I,If decedents address is not the same as claimants, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent - - _-- - -- I 4. I I Probate Fees 5. Accountants Fees 6. Tax Return Preparer's Fees 7. TOTAL (Also enter on line 9, Recapitulation) $ ~~-~ ~ 7, ~~ (If more space is needed, insert additional sheets of the same size) PAY ABLE TG DEBBIE LUPOLD, TREASURER 98 S. ENOLA DRIVE, ROOM 101 ENOLA PA 17025-0769 Assess Values Homest DESCRIPTION EAST PE ASSESS_NO - 09002990 Rates SCHOOL MAP NO: 09-14-0836-119 Homeste 101 CAROL LANE ACRES .550 DEED 00215 ! Oi025 PENN HE4GHTS LOTS 44&45PL2P88PG3 Residential Building RESIDENTIAL ?AX PAYER MYERS, ELLEN M & SUSAN 1C & JOHN W HARTMAN 101 CAROL LANE ENOLA PA 17025-1809 OFFICE HOURS M NDAY-THURSDAY 9:OOAM - 4:OOPM CLOSED FRIDAYS & FiOL1DAYS CLOSED SF_PT 20-24 & DEC 20-24 PHONE (717)901-9392 TAX PAYER COPY 2010 Staterr~er>t of Re®I Est Land Improvement Mineral 35,000 87,940 0 Exclusion 30R0 AREA S.D. 12.899001 12.89900 12.89900 BIII No: 4828 Control No: 009 - 002990 Bill Date: 7/15/2010 22,940 1,585.80 TAX AMOUNT DUE -> Sf Paid On or J-fter Zf Paid On or Before ~1,430.z8,: 51,459.45 ~ ;i,so5.ao RETURN ONE COPY WITH PAYMENT"fNF TAXES ARE ESCROWED FORWARD TO MORTGAGE CO.'*" 51.00 FEE FOR EACH ADD'L COPY OR RECEIPT +IF NOT PD BY 12/31/10 THIS BILL WILL BE RETURNED TO TAX CLM BUREAU FOR COLLECTION ~ FlLING OF A LIEN AGNST YOUR PROPERTY NOTICE OF PROPERTY TAX RELIEF Your enclosed tax bill includes a tax reduction for your homestead and/or farmstead property. As an eligible homestead and/or farmstead property owner, you have received tax relief through a homestead and/or farmstead exclusion which has been provided under the Pennsylvania Taxpayer Relief Act, a law passed by the Pennsylvania General Assembly designed to reduce your property taxes. r~ ~~ ~~-I ~~ 3 D a ~ ~~ 'lax Parcel No. oq-~~{, 0~'3~ ~-~l9 THIS DEED MADE the 3 day of ~ , in the year two thousand (2000), between ELLEN M. MYERS, a Widow, of the Township of East Pennsboro, County of Cumberland, State of Pennsylvania, GRANTOR AND ELLEN M. MYERS, a Widow, JOHN W. HARTMAN, a Single Man, and SUSAN K. MYERS, a Single Woman, of fhe Township of East Pennsboro, Cumberland County, State of Pennsylvania, as joint tenants with rights of survivorship and not as tenants m common, GRANTEES. WITNESSETH, that the grantor, for and in consideration of One Dollar ($1.00) lawful money of the United States of America, to the grantor in hand well and truly paid by the grantees, at or before the sealing and delivery of these presents, the receipt whereof is hereby acknowledged and the grantor being therewith fully satisfied, does by these presents grant, bargain, sell and convey unto the grantees forever, their heirs and assigns: ALL THAT CERTAIN lot or tract of land situate in the Township of East Pennsboro, County of Cumberland and State of Pennsylvania, more particularly bounded and described as follows, to wit: BEGINNING at a point on the north side of Sharon Road (50 feet wide) as shown on the hereinafter mentioned Plan of Lots, said point being the dividing line between Lots Nos. 45 and 46 on said Plan; thence northwardly along said Lot No. 46, a distance of 171.09 feet. to a point at the northerly line of Lot No. 44; thence North 85 degrees 21 minutes East along the northerly line of Lot No. 44, a distance of 145.67 feet to a point on the westerly line of Carol Lane (50 feet v~.ide~; thence w'ong *_he ~x,Psrerty line of Caro] Lane South 3 degrees 4 minutes East, a distance of 159.99 feet to a point on the westerly line of Carol Lane; thence southwestwardly along a curve to the right having a radius of 15 feet, an arc distance of 23.56 feet to a point on the North side of Sharon Road; thence South 86 degrees 56 minutes West along the north side of Sharon Road a distance of 124.15 feet to Lot No. 46, the place of BEGINNING. BEING Lots Nos. 44 and 45 in Plan No. 2, Penn Heights, as recorded in the Cumberland County Recorder's Office in Plan Book 8, Page 3. BEING the same premises which William B. Tenny and Shirley A. Tenny, his wife, by their Deed dated the 7th day of March, 1974, and recorded in the Cumberland County Recorder of Deeds Office in Deed book "N", Volume 25, Page 576, granted and conveyed unto Lloyd S. Myers and Ellen M. Myers, his wife. The said Lloyd S. Myers died on November 18, 1975, thereby vesting fee simple title in said premises to his wife, Ellen M. Myers, the grantor herein. 1 ~s n~ ~- ~' ~ rti ~. t~ P~ G t ~ HAVING thereon erected a dwelling house known as 101 Carol Lane, Enola, Pennsylvania. UNDER AND SUBJECT, NEVERTHELESS, to certain Protective Covenants, Restrictions, Resen~ations and Conditions of prior record. TOGETHER with all and singular the buildings, improvements, ways, woods, waters, watercourses, rights, liberties, privileges, hereditaments and appurtenances to the same belonging or in any way appertaining; and the reversion and reversions, remainder and remainders, rents, issues and profits thereof, and of every part and parcel thereof; AND ALSO all the estate, right, title, interest, use, possession, proper~~, clai~~. and demand whatsoever of the grantor both in law and in equity, of, in and to the premises herein described and every part and parcel thereof with the appurtenances. TO HAVE AND TO HOLD all and singular the premises herein described together with the hereditaments and appurtenances unto the grantees and to the grantees' proper use and benefit forever. AND THE SAID GRANTOR, does hereby warrant generally the property hereby conveyed. THIS CONVEYANCE IS BETWEEN MOTHER AND SON AND DAUGHTER AND THEREFORE EXEMPT FROM REAL ESTATE TRANSFER TAX. IN WITNESS WHEREOF, the grantor has hereunto set his hand and seal the day and year first above mentioned. ~/w"-~-~1 ~ art SEAL i ss ELLEN M. YERS .¢ ~ r-- cn ~ G >-- ~-"~ W W }- _ W ~ ~ ~' ~ , _, L._: o E ~~ O ~J ~ ~_ G, Q ~. ~~ ~ N . ~ _ O p ~ ti ~ ~ ~ O G tJ 2 its+~. t"',. ,~ „~~~c ,G~„~ PAGE :~ COMMONWEALTH OF PENNSYLVANIA ss COUNTY OF CUMBERLAND On this, the ~~ day of ~ I` 2000, before, me, a Notary Public, personally appeared ELLEN M. MYERS, known to me or satisfactorily proven to be the person whose name is subscribed to the within deed and acknowledged that she executed the same for the purposes therein contained. WITNESS, my hand and notarial seal the day and year aforesaid. ~,,,- . , <<iiTY is . ~,1`' !" P~ m `A~a~ s'-~':~r= NOTARY PUBLI IX' o~~f~3A .~~"' ~ r 1 ~Oi?9fic3 t: 1~ ., _. ,"x The undersigned certified that the precise residence and complete post office of the Grantees is: ~C~ A ORNEY FOR G TEES ~Nv Tit/e SeQ~~ ~e~~U~~Q) RECORDED on this l day of ~c R , 2000, in the Recorder's Office of the said County in Deed Book ~~, Paged `? . Given under my hand and the seai of the said office the day ar~d year a :;resaid.. ~.~'~xawrf z t-. e` ~ s-,.4 . fir. ~ fr~ a ~...w::. ., fay Recorder ~~u~ ~~.~ ~AG~~.~D27 ~ ~ ~~~~ ~~ ~9IIA~~~ Tax Parcel No. 09-14-0836-1 1 ~~ DEED THIS DEED, made this ~~~ day of September, in the year Two Thousand and Ten (2010) BETWEEN: JOHN W. HARTMAN, Executor of the Estate of Ellen M. Myers, deceased, JOHN W. HARTMAN AND SUSAN K. MYERS, of the County of Cumberland. Commonwealth of Pennsylvania, Grantors, Parties of the first part; - AND - JOHN W. HARTMAN, Single Man and SUSAN K. MYERS, Single Woman, both of the Township of East Pennsboro, County of Cumberland and Commonwealth of Pennsylvania, as joint tenants with right of survivorship, Grantees, parties of the second part WITNESSETH, that in consideration of the One and no/10'0 ($1.00) Dollars, in hand paid, the receipt hereof is hereby acknowledged, the Grantors do hereby grant and convey to the said Grantees: ALL THAT CERTAIN lot or tract of land situate in the Township of East Pennsboro, County of Cumberland and State of Pennsylvania, more particularly bounded and described as follows, to wit: BEGII`mTING at a point on the north side of Sharon Road (50 feet wide) as shown on the hereinafter mentioned Plan of Lots, said point being the dividing line between Lots Nos. 45 and 46 on said Plan; thence northwardly along said Lot No. 46, a distance of 171.09 feet to a point at the northerly line of Lot No. 44; thence North $5 degrees 21 minutes East along the northerly line of Lot No. 44, a distance of 145.67 feet to a point on the westerly line of Carol Lane (50 feet wide); thence along the westerly line of Carol Lane South 3 degrees 4 minutes East, a distance of 159.99 feet to a point on the westerly line of Carol Lane; thence southwestwardly along a curve to the right having a radius of 1 ~ feet, an arc distance of 23.56 feet to a point on the North side of Sharon Road; thence South 86 degrees 56 minutes West along the north side of Sharon Road a distance of 1.24.15 feet to Lot No. 46, the place of BEGINNING. BEING Lots Nos. 44 and 45 in Plan No. 2, Penn Heights, as recorded in the Cumberland County Recorder's Office in Plan Book 8, Page 3. BEING the same premises which Ellen M. Myers, by her deed dated February 3, 2000 and recorded in the Recorder of Deeds Office of Cumberland County in Record Book 215, Page 1025, granted and conveyed unto Ellen M. Myers, John W. Harman and Susan K. Myers, as joint tenants ~~~ith rights of survivorship. The said Ellen M. Myers is deceased, having died on June 13, 2010, and Letters of Testamentary having been issued to John W. Hartman and filed to '~10. 21-10-0637 in the Office of Register of Wills of Cumberland County, Pennsvlvania. TOGETHER will a1i and singular, the tenements, hereditaments, and appurtenances to the same belonging or in otherwise appertaining, and the reversion and reversions, remainder and remainders, rents, issues, and profits thereof, and also all of the estate, right, title and interest, property, claim, 01- demand whatsoever, both in law and equity, of the said parties of the first part, of, in, to, or out of the said premises and every part and parcel thereof. TO HAVE AND TO HOLD the said granted premises, to the said Estate of :Ellen M. Myers, her heirs; executors and assigns forever. Ai~1D that the said John Vv. Hartman, Executor on behalf of the Estate of Ellen M. Myers, her heirs, and administrators, do covenant, promise and agree to and with the said John W. Hartman, Executor that decedent died seized of the premises herein granted and that John W. Hartman, Executor, has ..not done, committed, or wittingly or willingly suffered to be done or committed any act, matter, or thing whatsoever whereby the premises aforesaid, or any part thereof, is, are, or shall or may be impeached or charged or encumbered in title, charge or estate or otherwise howsoever. IN WITNESS W~~IEREOF, the said John W. Hartman, Executor of the Estate of Ellen M. Myers, having died June I3, 20l 0, John W. Hartman and Susan K. Myers have hereunto set their hands and seals the day and year first abo~~e ~~rritten. Signed, sealed and delivered ESTATE OF ELLEN M. MYERS in the presence of: h J ~ ; /' Witness i .C /d.ffx 1.1~ L~!If, SJ~ ~ R.~,/~A.L' Witness i Jahn W. Hartman, Executor i s /~~` /~ ohn W. Hartman, Single Man Witness Susan K. Myers, Singh Woman ~ Le U r n 1y,~ Vr..~ri ~,.. ~.:.. . . ~,. ~~..ii 1..~ 2J~~'r C 4 COMMONWEALTH OF PENNSYLVANIA COL`NTY OF ~ t ~l~ On this, the _~ day of 5 ~ ~ , 2010, before me, a Notary Public, the undersigned officer personally appeared John W. Hartman, Executor of the Estate of Ellen M. Myers, John W. Hartman and Susan K. Myers, known to me (or satisfactorily proven) to ~e the person whose name is subscribed to the within instrument, and acknowledged that she executed the same for the purpose therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and off cial seal. Co~n,aer,~,-~a,r_~? o~ ~~~~rt~~sy>_~dr~r~En C-~-~ ~ - ~~ ~- ~- ,..., ~. "vry v_~.,;ra i:9si~r .~ .es f„s;c~ ~3. 2~i~ ~~~- ,~ Notary Public "I'he precise residence of the Grantees is 101 Carol Lane Enola, PA. 17025 5 ROBERT P. ZIEGLER RECORDER OF DEEDS CUMBERLAND COUNTY 1 COURTHOUSE SQUARE CARLISLE, PA 17013 717-240-6370 Instrument Number - 201026849 Recorded On 9/24/2010 At 12:15:41 PM * Instrument Type -DEED Invoice Number - 73361 User ID - MSW * Grantor - MYERS, ELLEN M * Grantee -HARTMAN, JOIiN W * Customer -JOHN HARTMAN * FEES - STATE WRIT TAX $0.50 STATE JCS/ACCESS TO $23.50 JUSTICE RECORDING FEES - $13.00 RECORDER OF DEEDS PARCEL CERTIFICATION $10.00 FEES AFFORDABLE HOUSING $11.50 COUNTY ARCHIVES FEE $2.00 ROD ARCHIVES FEE $3.00 EAST PENNSBORO SCHOOL $0.00 DISTRICT EAST PENNSBORO TOWNSHIP $0.00 TOTAL PAID $63.50 * Total Pages - 6 Certification Page DO NOT DETACH This page is now part of this legal document. I Certify this to be recorded in Cumberland County PA OF CU/y ~y ~"~ 8~9 Jr o () ~ z v~ ° RECORDER O D EDS ~~ 173 * -Information denoted by an asterisk may change during the verification process and may not be reflected on this page. Vi'll II IIIf IIIIJI Illfl ~' ' ~REy[P. 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