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Home My WebLink About08-17-11• 1505610105 J ~ IX (o2-u) (iZ) OFFICIAL USE ONLY REV 1500 ~ ~a PA Department of Revenue P~~ ~~E County Code Year File N Bureau of Individual Taxes INHERITANCE TAX RETURN ~~ ' Po Box 28o6oi RESIDENT DECEDENT Harrisbu PA 1 i28-o6oi ENTER DECEDENT INFORMATION BELOW MMDDYYYY Social Security Number Date of Death MMDDYYYY Date of Birth 201-1 &3738 06/07/2010 08/19/1924 Decedent's Last Name Suffix Decedent's First Name MI Taylor Martha P (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 ~ 1. Original Retum O 2. Supplemental Retum O ''<3. Remainder Retum (Date of Death Prior to 12-13-82) O 4. Limited Estate O 4a. Future Interest Compromise (date of O ;i. Federal Estate Tax Retum Required death after 12-12-82) i~ 6. Decedent Died Testate O ines a Living Trust 8. Total Number of Safe Deposit Boxes ta 7. Deceden~PY o (Attach Copy of III) f T A ( ) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (Date of Death O 1 t. EAlection tSct~duu Oer Sec. 9113(A) 95 ( ) ) Between 12-31 ~ 1 and 1-1- CORRESPONDENT - THI8 SECTION MUST BE COwIPLETED. ALL CORRE8PONDENCE AND CONFIDENTIAL TAX INFORMATION BHOULD BE DIRECTED TO Daytime Telephone ~lajnber Name (717) 648-4925 ~ ~~ r Daniel J Ta for ~ RE613TER OF,. ~ l3~E ONL r j ~ .~ ~' ...__ _~ First Line of Address ~ ~? ~~ ". 121 Coventry Dr ~~ ~ ~,~~~ ~."~ ~ Second Line of Address ~ ~~ ~ State ZIP Code L DATE FILED City or Post Office Carlisle pa 17015 Correspondent's e-mail address: Under penalties of perjury, i declare that I have examined this return, including accompanying sd~edules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Dedaretbn of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIG OF PER S~M~BLE,j:Et~I~~CfroG R RN ~/ 6 „ SIGNATURE OF PREPARER OTHER THA REPRESENTATIVE DATE ADDRESS PLEASE USE ORI~i1NAL FORM ONLY L 15U5610105 Side 1 1505610105 J ~~ J 1505610205 REV-1500 EX (FI) Decedent's Name: Martha P. Taylor Decedent's Social Security Number 201-16-3738 RECAPITULATION 1. Real Estate (Schedule A) ........................................... .. 1. 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. 108,359.82 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ..... .. 6. 17,225.81. 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested...... .. 7. 3,675.22 8. Total Gross Assets (total Lines 1 through 7) ........................... .. 8. 129,260.85 9. Funeral Expenses and Administrative Costs (Schedule H) ................ ... 9. 15,905.40 10. Debts of Decedent, Mortgage liabilities and Liens (Schedule I) ............ ... 10. 12,218.92 11. Total Deductions (total Lines 9 and 10) .............................. ... 11. 28,124.32 12. Net Value of Estate (Line 8 minus Line 11) ........................... ... 12. 101,136.53 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ..................... ... 13. 76,560.28 14. Net Value Subject to Tax (Line 12 minus Line 13) ..................... ... 14. 24,576.25 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 _ 4.50 16. 1,105.93 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. 1,105.93 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 L 1505610205 :L505610205 J 'f2EV-1500 EX (FI) Page 3 File Number Decedent's Complete Address: DECEDENTS NAME Martha P Taylor --- STREETADDRESS - -- --._ __-- __--_.-_-- - 121 Coventry Dr CITY I STATE: _ _ - I ZIP Carlisle pa 17015 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. (1) 1,105.93 Total Credits (A + B) (2) (3) (4) (5) 1,105.93 Make check payable to: REGISTER OF WILLS,,4GENT. 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 fora or payable-upon-death bank account or security at his or hE:r death? ....... ....... ^ 4. Did decedent own an individual retirement account, annuity or other non-probate property, which contains a benefiaary designation? ................................................................................................................. ....... ~ ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE R 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 benefiaaries 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. C:WP\WILLS\TAYLOR.WILL 05/06/97 f LAST WILL AND TESTAMENT OF 1~~ARTHA P. TAYLOR I, MARTHA P. TAYLOR, of 29 Pheasant Street, Mechanicsburg, Cumberland County, Pennsylvania 17111, being of sound and disposing mind and memory, do hereby make, publish and declare this for and as my Last Will and Testament, hereby revokin g any and all wills by me at any time heretofore made. ITEM I - I direct my Executor, hereinafter named, to pay all my just and lawful debts and funeral expenses out of my personal estate as soon. after my decease as is convenient. ITEM II - All the rest, residue and remainder of my Estate, real, personal, and mixed I give, devise and bequeath, to my son, DANIEL J. TAYLOR. RUPP AND MEIKLE, 355 NORTH 21ST STREET, CAMP HILL, PA 17011 ITEM III - If my son, Daniel J. Taylor, should predecease me, then I give, devise and bequeath all the rest, residue and remainder of my Estate, real, personal and mixed, to his children (my grandchildren) share and share alike. ITEM IV - In the event my son, Daniel J. Taylor predeceases me and leaves no children surviving him, I give, devise and bequeath all the rest, residue and remainder of my Estate, real, personal and mixed, to my brother and sister, Parker Peterman of Bronxville, New York, and Emily Hutchison of Enola, Pennsylvania, share and share alike or the survivor of them. ITEM V - In the event my son, Daniel J. Taylor, predeceases me and leaves no children surviving him and my brother and sister, Parker Peterm.an and Emily Hutchison, predecease me, I give, devise and bequeath all the rest, residue and remainder of my Estate, real, personal and mixed, to Trinity Lutheran Church, Camp Hill, Pennsylvania. ITEM VI - I nominate and appoint my son, Daniel J'. Taylor, as the Executor of this my Last Will and Testament. If my son, Daniel J. Taylor; predeceases me or if he is unable to serve as my Executor, I nominate and appoint my brother, Parker Peterman as my successor Executor, of this my Last Will and Testament. 2 ITEM VII this Will. - No bond shall be required of any person appointed as Executor in ITEM VIII - Until distributed, no gift or beneficial interest shall be subject to anticipation or to voluntary or involuntary alienation. ITEM IX - My Executor shall have the following powers in addition to those conferred by law until all property is distributed: A. To retain any real or personal property in the form received and to sell it a public or private sale. B. To manage real estate. C . To purchase all forms of property without being confused to so-called legal investments and without regard for the principle of diversification. D . To exercise any option or rights arising from awnership of investments. E. To compromise claims without order of Court or consent of any legatee. F. To distribute in cash or in kind. 3 G. To employ attorneys, accountants, agents, investment advisors, tax specialists or others deemed necessary by my Executor; and to pay from my Estate reasonable compensation for all services performed by them. IN WITIIF.SS WHEREON, I,IVIARTHA P. TAYLOR,; have hereunto set my hand and seal to this, my Last Will and Testament, on this ~~ day of May, 1997. MARTHA P. TAYLOR WITNESSES: " - ..__ residing at: residing at: ~.~ y~ ~~~~ . /~A- ,l 4 COMMONWEALTH OF PENNSYLVANIA COUNTY OF WE, MARTHA P. TAYLOR, . SS: ~_ ~, and i' ~ u. c~e,~ L . 1 ~-~ ~ s ,the Testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing will, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and Testament and that she had signed willingly (or willingly directed another to sign for her), and that she executed it as her free -and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witness and to the best of his or her knowledge the Testatrix was at the time eighteen (18) years of age or older, of sound mind, and under no constraint or undue influence. ~^ - MARTHA P. TAYLOR, Te ix ~--- Witness ~-b~y Witness Subscribed, sworn to, and acknowledged before me by MART P., TAYLOR, the Testatrix, and subscribed and sworn to before by ~ '-) . , and ~2t,~_j ,witnesses, this ' day o , 199. Z~c~~? ~ o Public (SE_AL) No~r~t aeiu u~-Ttt~c~ w, n~tt~, Noroy, ~ Camp Hid 00% Cumbi~~land Ca,'A ~~M ~~ ~, REV-1512 EX+ (12-08) pennsylvama SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES Slt LIENS RESIDENT DECEDENT ___ ESTATE OF FILE NUMBER Martha P. Taylor 2011-00171 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. If more space is needed, insert additional sheets of the same size. CONTINUING CARE RX 28 S SECOND ST NEWPORT PA i 7C}74 ~# S T A T E M E N T#~ Statement Date: iQ/31/iQ Page: 1. Account #: 100055582 hIARTHA TAYLOR DANTEL TAYLOR 121 COVENTRY DR CARLISLE, PA i7Qi5 Date Description Qty Amount Previous Balance 54.73 n ~~ ~~ ~ ~,~p° ~~~~ Ending balance - Pay this amount ----------------_:~ 254.73 Past Due Past Due Past Due Current 31~bQ days bi--9Q days 9Q+ days • QQ • OQ . QQ 254. 73 aVESTTONS PLEASE GALL i--BaQ--b75--2279 EXT: 13Q4 _____.~___________.~__~__~___~.________________w_____.~.~~.~.__.~ Please cut here and remit this portion with payment Remit ta: CONTINUING CARE RX 5775 ALLENTOWN BLVD SUITE iQi HARRISBURG, PA 17ii2 Name: MARTHA TAYLOR DANIEL TAYLOR 121 COVENTRY DR CARLISLE, PA i7Qi5 Statement date: iQl31/iQ Account #: it?t~Q55582 CC Ending balance: 254.73 Amount enclosed: .. r' Cumberland Goodwill EMS PO BOX 12910, PHILADELPHIA, PA 19176-0910 (800) 369-7544 Patient name: TAYLOR, MARTHA P. MARTHA P. TAYLOR 121 COVENTRY DR CARLISLE, PA 17015 Run number: 10-26944 Date of call: 4/13/2010 Time of call: 13:25 Caller: From: <Doctor's O~ce> To: Cumberland Crossings Retirement Community Primary payor: Patient Pay Secondary payor: Description Stretcher Van 1 Way Mileage Check # Quantity Unit price Payment date Amount 1 $80.00 $80.00 3 $1.75 $5.25 S aS pd ~ ~ as, ~ ~ Cumberland Goodwill EMS .- PO BOX 12910, PHILAC~~LpHIA, PA 19176-0910 (800) 369-7544 Patient name: TAYLOR, MARTHA P. Run number: 10-22918 Date of call: 4/1/2010 Time of call: 15:27 Caller: From: Carlisle Regional Medical Center MARTHA P. TAYLOR To: Cumberland I~rossings Retirement Community 121 COVENTRY DR CARLISLE, PA 17015 Primary payor: Patient Pay Secondary payor: Description Check # Quantity Unit price Payment date Amount Stretcher Van 1 Way 1 $80.00 $80.00 Mileage 2 $1.7~~ $3.50 g3 sv ,~-.~- sere ces 4150 OLSON MEMORIAL HIGNWAY~ SUITE 200 MINNEAPOLIS, MINNESOTA 55422-4811 TELEPHONE 763-852-8620 Hours (CT): 7:00 am - 9:00 pm M - TH Fnx 877-326-8784 7:00 am - 5:00 pm F TOLL-FREE 877-326-6766 8:00 am - 12:00 pm 5 December 30, 2010 RE: Estate of: MARTHA TAYLOR Our Client: Chase Account No Unpaid Balance Reference No ************1328 $7748.78 6547171 Dear Sir or Madam: We are trying to resolve the unpaid balance owed by the estate of the deceased. We will accept $5036.71 as a resolution of the full amount owed, provided payment is received in our office by 01/29/2011. Please call one of our account representatives toll free at 1-877-326-6766 to confirm this arrangement or to make payment by telephone. ~~' j Cordial) ~~' DCM Services, LLC ~ "'~ ~: This company is a debt collector. We are attempting to collect a debt and any information obtained will be used for that purpose. Calls may be monitored or recorded for quality assurance purposes. NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION -Side i of 2- ~~ *'"Detach Lower Portion and Retum with Payment""" I _ -- DCM Services, LLC 4150 OLSON MEMORIAL HWY STE 200 Reference #: 6547171 Client ID: JPMC11 ~i MINNEAPOLIS MN 55422-4811 Unpaid Balance: $7748.78 ADDRESS SERVICE REQUESTED Checks Payable to: DCM Services LLC IIAI~INnI~~~NIh~IN~a~Nq~~~I~il~~~~~~ Amount Enclosed: $ December 30, 2010 ~1~11~1111~111"~I'~~~I~I~~~~III111~11~~~1~1~~1~1~1~1~~1~11'I~'~' ass»-~ss2 DCM Services/Chase § #~i~Ni~i oss4as2~ P O Box 14 7 3 ~ The Estate of MARTHA TAYLOR Minneapolis MN 55440-1473 MARTHA TAYLOR 121 COVENTRY DR ~~~~~~~~~~~~~~~~~~~~~~~~i~~~~~~~~~~~~i~~~~~~~~~~~~~i~~~~~ii~~~ CARLISLE PA 17015-4507 6 5 4 7171 13 2 8 ~~~~"70~'~~ RESIDENT STATEMENT FROM CUMBERLAND CROSSINGS 1 LONGSDORF WAY CARLISLE, PA 17015 717-245-9941 Statem~ht Date Due Date 01 /31 /2011 2/23/2011 $6,838.23 ACCOUNT NUMBER 20630279 AMOUNT PAID $ Please make check payable to CUMBERLAND CROSSINGS MRS. MARTHA P TAYLOR Remit To: c/o MARTHA TAYLOR Diakon Lutheran Social Ministries 121 COVENTRY DRIVE P.O. Box 8500-1131 CARLISLE, PA 17015 Philadelphia, PA 19178-1131 FACILITY NAME RESIDENT NAME ACCOUNT NUMBER CUMBERLAND CROSSINGS MRS: MARTHAP TAYLOR 20630279 1 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 Martha P Taylor 2011-00171 Decedent's debts must be reported on Schedule i. NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1' Hoffman-Roth Funeral Home Crematory,lnc. 9,494.10 Carlisle Memorial Service,lnc The Quarter Food Catering The SentineUExecutors notice letters testament B. 1 2. 3. 4. 5. 6. 7. ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City ___.~___w Year(s) Commission Paid: 1,839.00 244.49 145.06 185.25 Attorney Fees: 3,500.00 Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) Claimant Martha P. Taylor Street Address 121 Coventry Dr ____ _ - City Carlisle _ State PA ZIP 1'T015 __ Relationship of Claimant to Decedent Son -same address as Martha P Taylor __ Probate Fees: 202.50 Accountant Fees: 250.00 Tax Return Preparer Fees: 45.00 State _ ZIP TOTAL (Also enter on Line 9, Recapitulation) I $ 15,905.40 If more space is needed, use additional sheets of paper of the same size. RECEIPT FOR PAYMENT ------------------- ------------------- GLENDA FARNER STRASBAUGH Receipt Date: 2/09/2011 Cumberland County - Register Of Wills Receipt Time: 12:12:06 One Courthouse Square Receipt No.: 1064356 Carlisle, PA 17613 TAYLOR MARTHA Estate File No.: 2011-00171 Paid By Remarks: DANIEL J TAYLOR HMW ------------------- ----- Receipt Distrib ution ----- -------- -------- --- Fee/Tax Description Payment Amount .Payee Name PETITION LTRS TEST 135.00 CUMBERLAND COUNTY GENERAL FUN WILL 15.00 CUMBERLAND COUNTY GENERAL FUN SHORT CERTIFICATE 24.00 CUMBERLAND COUNTY GENERAL FUN JCS FEE 23.50 BUREAU OF RECEIPTS & CNTR M.D AUTOMATION FEE 5.00 CUMBERLAND COUNTY GENERAL FUN Check# 109 ---------------- $202.50 , Total Received..... .... $202.50 r~ ~J ~ ,~ .FUNERAL HOME ~ CREMATORS', INC. 219 North Hanover Street Carlisle, Pennsylvania 17013 717.243.4511 toll free 1.866.451.4511 fax 717.243.3723 www.hoffmanroth.com info@hoffmanroth.com July 21, 2010 Daniel Taylor 121 Coventry Drive Carlisle, PA 17013 Statement of Funeral Expenses for: Martha Taylor Date of Death: June 7, 2010 Account Id: 15962-136 PACKAGE: Traditional Funeral Service TRADITIONAL FUNERAL SERVICE PACKAGE MERCHANDISE: Casket: Coleman Outer Container: Cave Proof Box $ 4, 550.00 Sub Total: $ 4,550.00 $ 1, 990.00 $ 975.00 Sub Total: $ 2,965.00 TOTAL FUNERAL HOME CHARGES: $ 7,515.00 CASH ADVANCES: Mt. Olivet Cemetery $ 1,500.00. 10 Certified Death Certificates at $ 6.00 each $ 60.00 Newspaper Notice -Patriot $ 3'71.62 Flowers $ 8.48 Hairdresser $ 40.00 Sub Total: $ 1,980.10 Total Funeral Expense: $ 9,495.10 Balance: S 9495.10 Please return this portion with your Remittance. Amount Enclosed Martha Taylor Service ID#: 15962-136 SERVING OUR COMMUNITY SINCE 1__907 fi#ie Sentinel 'w wrw~.tumbsrlink.com ,- ~/~ Pi CAREIStE 5-iPPENSBURG PE£RY COUNTY DANIEL TAYLOR 121 COVENTRY DRNE CARLISLE, PA 17015 717-6484925 AD NUMBER PAGE NO. 395378 1 of 1 BILL DATE SALESPERSON 04/07/11 wolfs START DATE STOP DATE 03/24/11 04107/11 AD NUN~ER AD DESCRIPTION CLASS LINES 395378 EXECUTOR'S NOTICE LETTERS TESTAMEN 10 PUBLIC NOTICES 26 * 2 cols Publication Insertions Rata Net Amount Gross Amount 3 THE SENTINEL -LEGAL 3 LGL, $138.06 TOTAL AD CHARGE $138.06 3 PROOF OF PUBLICATION 01 PRF $7.00 PREVIOUSLY PAID ($145.06) Purchase Order Est.M.P.Taylor $0.00 $0.00 Thank you for advertising with The Sentinel! Deadline for in-column legal ads is 4:00 p.m. two business days prior to date of insertion. For questions, call (717) 240-7130. THE SENTINEL c/o LEE NEWSPAPERS PO BOX 540 WATERLOO IA 50704-0540 rcerum m~a portron t~ your paynnnt ^ Check # ^ Credit Card ^~^®^®^~ Acct #: Ems. Date: m m Name on credit card Signature THE SENTINEL c/o LEE NEWSPAPERS PO BOX 540 WATERLOO IA 50704-0540 Legal pease make checks payable to: THE SENTINEL ~~ THE SENTINEL DANIEL TAYLOR c/o LEE NEWSPAPERS 121 COVENTRY DRIVE PO BOX 742548 CARLISLE, PA 17015 CINCINNATI OH 45274-2548 21540200000003953780000000000000000000000000000001 PROOF OF PUBLICATION State of Pennsylvania, County of Cumberland Jackie Cox, Retail Sales Manager, of The Sentinel, of the County and State aforesaid, being duly sworn, deposes and says that THE SENTINEL, a newspaper of general circulation in the Borough of Carlisle, County and State aforesaid, was established December 13,1881, since which date THE SENTINEL has been regularly issued in said County, and that the printed notice or publication attached hereto is exactly the same as was printed and published in the regular editions and issues of THE SENTINEL on the following day(s): March 24, March 31 and April 7, 2011 COPY OF NOTICE OF PUBLICATION '.~ csK~ ~ ~ , Tawnsfil~ f South ,. t ~ dec~e~ts+~,~~r'a~e'1~~~"" tfi~ ~~~-It~tsAfi'r ,~~ rw~:.. ~ ~, ~~ a _; 7sr : I 1 .~ ~{36ES0 i >v ,.~ ~ r ~ ~ ri i ~y„ ~ &F~~t ('''i~' C^--, r~ .'~. a rte` h ., ,_ o '~ g ~~ ~.~.,~ 1.~ ,. K Affiant further deposes that he /she is not interested in the subject matter of the aforesaid notice or advertisement, and that all allegations in the foregoing statement as to time, place and character of publication are true. Sworn to and subscribed before me this ~~ I :Notary Public My commission expires: NOTARIAL SEAL BAMBI ANN HECKENOORN Notary Public CARLISLE BOROUGH, CUMBERLAND CNTY i~Ay Commission Expires Jan 27, 2014 e %~~,-~~ FUNERAL HOME 6Y CREMATORS', INC. 219 North Hanover Street Carlisle, Pennsylvania 17013 717.243.4511 toll free 1.866.451.4511 fax 717.243.3723 www.hoffmanroth.com info@hoffmanroth.com July 21, 2010 Daniel Taylor 121 Coventry Drive Carlisle, PA 17013 Statement of Funeral Expenses-for: Martha Taylor Date of Death: June 7, 2010 ~ Account Id: 15962-136 PACKAGE: Traditional Funeral Service TRADITIONAL FUNERAL SERVICE PACKAGE $ 4,550.00 Sub Total: $ 4,550.00 MERCHANDISE: Casket: Coleman $ 1,990.00 Outer Container: Cave Proof Box $ 975.00 Sub Total: $ 2,965.00 TOTAL FUNERAL HOME CHARGES: $ 7,515.00 CASH ADVANCES: Mt. Olivet Cemetery $ 1,510.00 10 Certified Death Certificates at $ 6.00 each $ 60.00 Newspaper Notice -Patriot $ 3'71.62 Flowers $ 8.48 Hairdresser ~ $ 40:00 Sub Total: $ 1,980.10 Total Funeral Expense: $ 9,495.10 Balance: $ 9.495.10 Please return this portion with your Remittance. $ Amount Enclosed Martha Taylor Service ID#: 15962-136 SERVING OUR COMMUNITY SINCE 1 90__7 .,. ' Cacrlisle 111'emoridl. Service, Inc. Price • r~--~o . ~ DESIGNERS AND BUILDERS OF ~,,.. Cemet Memorials ~ v~ ~ `~ ~ ~ ~ et ~ v 41 South Bedford Stre ~ ~ ~ ~~ d Carlls(e, PA 17013 oL Telephone ,1717) 243-5480 ~.-Q~ m~ Total Price 4 "'~ Please design and build the fallowing memorial - ~ , Date / / . - For Add Des Mai Die Base ~ -~ x / -- ,~. ~ 0 '` ~° Markers Posts 9 Vases Price ~r ~~,; .~~~' Tax Deposit Balance Due Style of Letters S Foundation to be furnished by Material to be best selected monumental grade and to be free from imperfections and first class in every way. Work to be finished in a workmanlike manner. This memorial to be erected in . - ~ Cemetery in or near during the month of /•~T -~ l`+' unless unavo~aaniy aeiayeo oy 1aWr troubles and other contingencies beyond our control and then as soon as possible. Additiona ettering and other work on thi§ memorial in the future is not included in the Contract Price. Title and right of possession and removal of said stone, monument or appurtenances shall remain for all purposes in Carlisle Memorial Service, Inc. until work and materials ordered are fully paid by purchaser or purchasers. In consideration of the acceptance by Carlisle Memorial Service, Inc. of this order, the undersigned (hereinafter known as the purchaser) agrees to pay Carlisle Memorial Service, Inc. ' Dollars on or before the 15th day following the billing of the work or job upon completion thereof by Carlisle Memorial Service, Inc. Thirty (30) days from date of invoice a 1-1/2% finance charge will be added to the unpaid balance. Said billing to be notice of completion thereof, this order shall become a contract between the purchaser and Carlisle Memorial Service, Inc. upon acceptance thereof irrthe space below by a duly authorized representative of said Carlisle Memorial Service, Inc. It .being understood that this instrument upon such acceptance covers all of the agreement between the purr;baser and Carlisle Memorial Service, Inc. and • that no agent or representative of Carlisle Memorial Service, Inc. has made any statements or agreements, verbal or written, modified or adding to the terms and conditions herein set forth. It is further understood that upon the acceptance of this order the contract so made cannot be cancelled, altered, or modfied by the purchaser or by any:agerit of Carlisle Memorial Service, Inc. in any manner except by agreement in writing between the purchaser and Carlisle Memorial Service, Inc. and it is 1lereby understood and agreed by all parties involved that in case of default by purchaser or purchasers,twenty-five per cent of the total original cost of the work or work and materials ordered, as the case may be, shall be a specified correct sum as liquidated damages which purchaser shall owe Carlisle Memorial Service, Inc. less any payment on account made prior to such default, t ' specification of damages to be due regardles of removal and taking possession of stone, monument or materials from purchaser or purchase y C isle Mem I Service, Inc. up~utbwi uch default. - ~ ° (SEAL) to 20~ ~ (SEAL). pn~ ~q /9a~ / ~-/ ~O ~V ~u /V'im' . >: ~r. . Carlisle Memorial Service, Inc. Approval By ~ 7 i ~~ ~ ~' ~ ~~~~ White: Office Copy; C ary: Customer opy; Pi alesman Copy; Gold: Deposit Copy LAW FIRM OF LINDA A. CLOTFELTER 5021 E. TRINDLE ROAD, SUITE 100 MECHANICSBURG, PA 17050 -(717) 796-1930 telephone Dan Taylor July 31, 2011 Fees: Hours 07/28/10 Telephone conference with client re: support and 0.25 $48.75 divorce issues. 07/29/10 Do a shared custody support calculation and 0.25 $48.75 Telephone conference with client. 07/14/11 Office conference with client re: estate issues and 1.20 $234.00 divorce related issues. Billing Summary Previous balance Payments & adjustments Current fees & expenses Total now due Hours: 1.70 Total fees: $331.50 - $0.00 0.00 331.50 $331.50 This invoice includes work through the billing date. For your convenience we accept Mastercard and Visa for payments. Payment is due within fifteen (15) days and fee disputes must be raised within that time. You will be charged interest at a rate 1.5% for any overdue sums. We reserve the right to terminate service until the account is paid or payment arrangements are made. ' REV-i5o8 EX+ (ii-io) .~ ~ Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEp1~ILE E CASH, BANK DEPOSITS 8~ MISC. PERSONAL PROPERTY ESTATE OF: FILE NUMBER: Martha P Taylor 2011-00171 Include the proceeds of litigafion and the date the proceeds were received by the estate. su nreeertv lointlv owned with right of survivorship must ibe disclosed on Schedule F. If more space is needed, use additional sheets of paper of the same siza_. METRO BANK RE: Martha P Taylor 3801 Paxton Street 888.937.0004 Harrisburg, PA 17111 mymetrobank.c~om July 21, 2011 To Whom It May Concern, This letter is to verify the account balance of Martha P Taylor at the time of her death. Her available balance on June 07 2010 was $4,850.04. Please feel free to contact me with any additional questions or concerns;. Thank you, Maria T. Theodoratos Assistant Store Manager f -Carlisle- Metro Bank - - ------, --- ...... ~ ~,.,u.,~ ~„<u~ ~wux rage i or l Kelley Bice Book ~~ ~ ~,.~- . __ Car Trade-In Values _ _ ;~. ~o I Trade-in Values Vef>lide High MPG: Clt~i 17/Hwy 25 Doors: 4 Drivetrain: FWD EPA pass: Lar~pe Can Country of Origin: Unibsd Stabea Max Seating: 6 Ergine: Y6, 2.7 Lltsr Excellent $2,475 / Good $2,200 Fair $1,750 Transmisdon: Aubomatlc Body Style: Sedan Country of Assembly: Canada Your Cor~Agured ppt~ons Our are-selectaa optlors, based on trP~l e~N~c for n:is car. .~ oadars that you added wMb oonflpurirq this car. E"k"e Coapbrt and Comerriarroa V6, 2.y t.itar nir condMorrkp Power Wlrrdows Ttatran-issipn Power Door Locks Automndc odse caved Drtvrstrain SbeerMrg FWD Power Steerkrg TNt YVlred EnEartainrrwit and =natrrrrnsNatlon AM/FtN Stereo Cbwette Glossary of Tenns ... ..................... Kelley Blue sook®Ttade-In Values This is the amount you can eft to reoeMe when you trade in your car m a dew. ~ ~ ~ ~ based on the style, oorrditlon, mileage and apdons indkxted. Excellent Corrdltton: 396 of aN rxrs we value meet this ollteria. This car looks new and is h e:roellent medrarrical corrdltlorr. The car has never had arty paint or k' does ~ need m00^kp and ~ fnee of trot. The ~ con~psrtrrrerrt is dean and free of fluid leeks, and the body and krterlor are free of wear a visible defects. It has a dean tide history and wiN pass a safety and smog fnpection. It also has complete and verMiable service records. Good Oorrditiort: 8296 of a8 cars we value meet this ortteria. This cbr Is free of any major defects and major medranical problerr~c. The p~ ~, and Interior have any mirror (if any) blemishes and there is Node or no rust on the car. The tU+es match and have srtbstarWel tread IeR Though It may need some reoondtloninp, >t has a clean title history. Fair Corrditbn: 1596 of aU cars we value meet this crlterb. TMs car has some mechanical or cosnretlc defects and needs servickrg, but is stK h safe rurrrtkrg conditlon and has a din tide history. The paint, body arrcl/or interior may mead prol~essbrbl ~. The tires may need replacing and there may be sane repairable rust http://www.kbb.com/dodge/intrepid/2001-dodge-intrepid/se-sedan-4d/?vehicleid=4023 &in... 7/31 /2011 - - - --- - - - - --- ~- . Ewa asvo~ 1\V • 1V W A -1,cuCy rsiue t3oox Page l of l damage. ®1995-ZOl l KeNe~r Bkie Book Co.'. Lx. M rlpFilt rearv~d, ~ ~ ~ I Tlrrtii of Servloe I Rh~scY P~o1Cr ~ 2rd~ ~K w Book Co.. Inc. Aq rlDhOr roierved. 7/29/2011-Q/~/2011 FdlMio+i. 7M spec~llk bNbimaLlon to deeen-Nne fhe veAx Jior tl~ts suPPMed by the Peen 9ene-stkJQ this report VihlcN vakxtkHa aro opkNbne and mar vary bom vehlak to vehkie. Acew/ tlie~ r ~ +ed upon market condK/oru, sPeaKo~elonr, veAldie oor-dk/on or adpr perEre~rlar dmum~sfanas pertlneM eo Mlr partlauAsr vehkk or sold or trsnsmktsd to the bsnsactbn. 71-It report b kKendsd Ibr the kMlvldual use ofthe person peneratktp thlr repot prh' aM sAa9 not be Park : Kelley slue Book assumes rro rrspona~ltty 16r errors or omlaslwu. (r.11OBO) http://www.kbb.com/dodge/intrepid/2001-dodge-intrepid/se-sedan-4d/?vehicleid=4023&in... 7/31 /2011 ~~ Northwestern Mutual® Variable Annuity Confirmation Statement Contract No: 14928476 ~- 30040S20950000067 Martha P Taylor Annuitant: Martha P Taylor 121 Coventry Dr Contract Date: 03/08/1999 Carlisle PA 17015 Account: B - QQ Series back end design Market: Personal Annuity Income Plan: Period Certain -Guaranteed Rate Period Certain: 10 Years Page 1 of 1 Effective Date: April 8, 2010 Income Payment $484.70 Amount deposited to checking account XXXXX5190 at METRO BANK. This payment is only valid if all Annuitants are alive on the due date of 04/08/2010. Last payment date for this income plan is 02/08/2019. Fixed Period Certain -Guaranteed Rate Interest Rate 4.95% Transaction Value $484.70 Fixed Period Certain -Guaranteed Rate Account Balance $41,737.14 Thank you for choosing a Northwestern Mutual Annuity. If we can be of service, please contact your Financial Representative: Donald E Failor, CLU PO Box 1751 Harrisburg PA 17105-1751 Phone No. (717) 238-5715 Network Office: NM Harrisburg Inc PO Box 62030 Harrisburg PA 17106-2030 or call Income Benefits at 1-866-269-2950, or visit us at www.nmfn.com to view your contract details or change your allocations. Please note, not all contracts may be accessible via the website. A steady, reliable source of income can give you freedom from some worries so that you have time to enjoy yourself. You can be confident about the future because your fixed rate income plan is backed by the financial strength of Northwestern Mutual. Includes all transactions processed through 04/05/10. The Northwestern Mutual Life Insurance Company • 720 East Wisconsin Avenue, Milwaukee, WI 53202-4797.414 271 1444 • www.nmfn.com DWS Quarterly Attount Statement INVESTMENTS January 1, 2011 through March 31, 2071 Deutsche Bank Group AT 02.035254 98017`8177 A"'3DGT ~ Irwestment`Professional: DAVID HAMILTON ~Irlrllr~rllll~~l"I'"111'II~~~~1~1{~~I~I~Irrlrll'lunr~l~r~l~ 176 tUMB~~RLAND PKWY STE 101 MARTHA P TAYLOR MECHANI~SBURG PA: 17055-8031 121 COVENTRY DR (717) 591-1700 CARLISLE PA 17015-4507' Shareholder Servtas: {800} 621 ~ 1048 7 a.m. to 7 .m. (C77 Monday through Friday Autnrrrat+eaf Assistance 24 hours a day International: Call collect {8i6) 435-7177 7 a.m. to 7 p.m. (C7~ .Monday through Friday Web Site.. www.dws=investments.com r~ Your Primary Account Wumber: 91244736. A 2 percentage point reduction in payroll~taxes in 2011 means more in each paycheck. Why not take the o,pportunity to a~~yy yyourself first by investing that amount? Visit dws=investments.corn for details about the full range o~DWS funds. Period Year to Date Your Portfolio Value o~ro~ ~ o~>fao~T oT~o~ - o~~~o~~ Beginning Portfolio Value $58,219.42 X58,219.42 Purchases/Reinvested Distributions $142.85 $142.85 Redemptions -$300.00 -$300.00 Change in Value $1,310.37 $1,310.37 Transfers $0.00 $0.00 I Ending Portfolio Value on 03/31/2011 $59,372.64 $59,372.64 I Your Portfolio by Asset Type ~ Percent of Asset T y~ Yalue on Change Yalue on , Portfrilio Fund Name 01/01/2011 + This Period = 03/31/2011 y 32.65% Income Funds ' 32.65% DWS High Income Fund-A $19,144.06 $238.30 $19,382.36 Total Income-Funds ___ ___. _ __ __ $1.9,144.06 _ _ 5238.30 $19,382.36 ^ 67.35% Multicategory/Asset Allocation Fund 67.35% DWS Balanced Fund-A $39,07!5.36 $914.92 $39,990.28 Total. Multicategory/Asset All"ovation Fund $39,07!5.36 $974.92 $39,990.28 Total Portfolio Value 558,219.42 $1,153.22 $59,372.64 Page 1 of 4 035254 1 /3 1 REV-1513 EX+ (01-10) ~ Pennsylvania SCHEDULE ~ DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: Martha P Taylor NUMBER NAME AND ADDRES5 OF PER50N(S) RECEMNG PROPERTY I TAXABLE DISTRIBUTIONS [Indude outright spousal distributions and transfers under Sec. 9116 (a) (1.2).) 1. Daniel J. Taybr 121 Coventry Drive Carlisle, PA 17015 FILE NUMBER: 2011-00171 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE i0o Not List Trustee(s) OF ESTATE Son 4.59/0 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COWER SHEET, AS APPROPRIATE. I<7 NON TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. 76560.28 TOTAL OF PART II -ENTER TOTAL NON TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. l$ 76560.28 If more space is needed, use additional sheets of paper of the same size. REV-i5o9 EX+ (oi-io) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCNEL1t1LE F JOINTLY-OWNED PROPERTY ESTATE OF: FILE NUMBER: 2011-00171 Martha P. Taylor If sn asset became jdM~y owned within one year of the decedent's date of death, it must be reported on Schedule G. SURVMNG JOINT TENANT(S) NAME(S) ADDRESS RELATIONSHIP TO DECEDENT A• Daniel J Taylor 121 Coventry Dr Son Carlisle, PA 17015 B' Lori Ann Taylor 648 N Hanover St Carlise, PA 17013 Daughter-in-law C~ Martha P.Taylor ^nr~t v nurwen pQn~QTYe 121 Coventry Dr Carlisle, PA 17015 Mother of son If more space is needed, use aGdmonal sneers of paper or me same s<ie. I 1 Of 2 vw~~nvs MIIICI 11ii1 ~~ Customer Service ~~~ PO Box 6170 $imi Valley, CA 93092.5170 Hom® Loans 0 0 8 8 4 6 3 of AB o.365 `"AUTO TO 0 076717015-4507 MSR CC Ati 0000----0--2- M228461N 1 P88839 DANIEL J TAYLOR 121 Coventry Dr Carlisle PA 17015-4507 Il~iil~ll~llllliill~~lii~l~lllli~li~l~il~llll~~~~llllll~ilililill Statement date 07/14/Z011 ,Account Number 189129320 Property address 121 Coventry Dr. . ,FOR CUSTOMER SERVICE: 1.866.653.6183 Make your Mortgage Payment online. Add up the benefits! Tired of writing checks, licking envelopes, and mailing payments every month? Use Mortgage Pay on the Web through Bank of America, N.A. and enjoy the: • No fee when using a Bank of America account • Speed and Convenience of paying online • Flexibility to schedule a payment up to 30 days in advance Get Started Today! 1. Go to www.bankofamerica.com and login (or Enroll if needed- 2. Select your account by clicking on the'Mortgage' link 3. Click'Pay Now in the Payment Summary section on the left 4. Use Mortgage Pay on the Web to schedule your mortgage payment H 0 M E l 0 A N Homs loan overview as of 07/14/2011 Amount due on 08/018011 as of 07/14/2011 SUMMARY Principal Balance 5318,322.57 Home loan payment due 08/01/2011 $1,775.34 Escrow balance $1,767.86 (see next page for account details) Late Charge if payment received after 08/16/2011 564.10 DID YOU KNOW? In accordance with the terms and conditions of your Adjustable Want more flexibility? Bank of America, N.A. online payment Rate Mortgage, the principal and interest portion of your service, MortgagePay on the Web, allows you to make your payment has been adjusted. Your new payment amount is payments around the clock. Visit www.bankofamerica.com and shown in the Home Loan Details section. check out the demo to see just how easy it is. Calls maybe monitored or recorded to ensure quality service. We may charge you a fee (of up to 340.00) for any payment returned or rejected by your financial institution, subjectto applicable law. _ .. . - - _ __ _..- - .._ l ..__.._.._. __ - - -----._ _ ---~--- ----- -- -- - ----. _.._ __ Accountnumber 189129320 ~9) Daniel J Taylor PAYMENT INSTRUCTIONS 121 Coventry Dr. 1. Please Carlisle, PA 17015 • don'tsend cash • don't staple the check to the payment coupon • don't include correspondence • include coupon with payment 2. Write the account number on the check or money order. 3. Make the check payable to Bank of America, NA. Attn: Remittance Processing PO Box 15222 Wilmington, DE 19888-5222 tEE OTHER NDE FOR IAIR'OIITANi INFOIIMATION ors Bank of America, NA. PO HOX 15222 ' WILMINGTON, DE 19886-5222 Payment due Aug 1, 2011 X1,775.34 After Aug 16, 2011 late payment $1,839.44 Pleeu et~ts e-eail ielermeliae sa IMe reverse si/e d a~ ceeeae. Additional Principal Additional Escrow Check total ' IIIIIIIII'I'I'lllllll~ll'llllllr~IIIIIIII1111i1111~111r11~~llllll 189129.320900000177534000183944 ~:586990058: L89 L 293 20i1' ...~ .. „a. ,, -. q~s 1 ~' •:.. - parcel # T a "~ v ~0~~ Jgti 1? R~1 ~ 22 T~ ~~ -na day of January , 2007, MADE ,this ~ ~ OMES, INCA formerly known as 5&A CUSTOM BUIL'T~~ BETWEEN 5& ~S .INC., a Pennsylvania Corporation, of State College, HO County, Pennsylvania, "GRAN'TaR" TAYLOR, husband and wife, AND DANIEL J. TAYLOR and LORI ~ lisle, Cumberland County, and ~RTHA P. TAYLOR, all of lvania, Sin le individuals, point Tenants With the Right of Pennsy Su v ivorship. ~~ S„ GPt~~NTEE Four Nine TH that in consideration of the sum of Three Hundred Fi ~e receipt WITNES5E ~ 988.00) Dollars, in hand pall Hundred Eighty-Eight and 00/100 ($354, t and convey in fee ereof is hereby acknowledged, the said Grantor. does hereby gran wh simple to said Grantees, their heirs and assigns, TAIN tract of land situated in the South Middleton Townshi~ed ALL THAT CER Lot No.144; as shown on a Plan Cumberland County, Pennsylvania being • ntial Development, Final Subdivision Plan, Section 5, dated Forgedale Cross>~ng, Reside Inc., State College, Pennsylvana, July 23, 2004, prepared by PennTerra Eng ae~ g~d ~ follows: Plan Book 91, Page 39, being bounded and t of way line of Coventry Drive (50 BEGINNING at an iron pin, lying in a southerly righ a northerly corner of Lot No. 143; thence along said lot and foot right of way) and being 87 South 54 degrees 51 minutes 22 seconds West, 253Fo feed~e an uon along Lot No. 2 • bein a northerly corner of Lot No. 287 and a southerly ~ der ° es 03 minutes OS pin, 8 Crossin ,Section 6; thence along the Sectton G lands N~1 line c>'f sa>td lands and being a g l ' in an eas y seconds West, 26.31 feet to an iron pin, yin8 s 1 g minutes Lot No 145 North 27 degree southerly corner of Lot No. 145; thence along 8 feet to an iron pin, being an easterly corner of said 1 ~toan~ying 243.6 t of wa ,thence slang said ngh y 28 seconds East, . in a southerly line of the Coventry Dave righ y' • t Navin a chord bearing of South 48 degrees 5 5 minutes 05 along a curve to the ngh , g ~oo~ $ X84 ..... CUMBERLAND COUNTY Inst.# 200701915 -Page 1 0 }_' .~ n7n~i~rn~ 1~•~4.1Fi AM CONTAINING 0.483 acres BEING known and numbered as 121 Coventry Drive, Carlisle, Pennsylvania 17013. Lot No. 144 is subject to a 10-foot utility easement along its street frontage. SUBJECT to Declaration of Restrictions and Protective Covenants for Forgedale Crossing as set forth in Misc. Book 424, Page 252. BEING part of the same premises which John E. Anderson and Pauline E. Anderson, husband and wife AND Robert A. Thomas and Deborah J. Thomas, husband and wife, by Deed dated April 1, 2003 and recorded April 2, 2003 in the Oi~ice ofthe Recorder of Deeds in and for Cumberland County in Deed Book 256, Page 1728, conveyed unto S&A Custom Built Homes, Inc., grantor herein. This Deed is executed by Calvin Trimble, Attomey-in-Fact for S&A Custom Built Homes, Inc., pursuant to authority as granted in Power of Attorney as set forth in Misc. Book 724, Page 391. AND the said GRANTOR hereby warrants specially the property herein conveyed. IN WITNESS WHEREUP, the said S&A Homes, Inc. formerly known as S&A Custom Built Homes, Inc. has caused this Deed to be signed in its corporate :name by it Attorney- in-Fact, Calvin Trimble, the day and year first above written. Witness: Sd~A Homcs, Inc. formerly known as S&A Custom Built Homes, Inc. ~ ~ • ~ ~- By: Calvin Trimble, Attorney-in-Fact -. ~ 5 ~` ~~ ~ ~ ;: ,~ c ~„ .... ~- ~ ~ ~ .~- ~ M ,~„+ 1 µ ~ ~: ~ ~ a ~° ~ ~ . i c~+t w ,.,,, .,.,. c~ e~- ~~~~~.,~a a~~~~ ~ w • w ^ • • • ^Q • w~Q w~Q w • • 4f C.~ W ~ ~ C~ C.7 v 4 .ii+ ~^ ~ ~. Q fa1MRFRl ANI~ CnUNTY °o~r ,~ 4085 Inst.# 200701915 - Paae 2 of 3 .+ ...a..... ,~ ,. 1. COMMONWEALTH OF PENNSYLVANIA :ss. COUNTY OF CUMBERLAND On this the I f'~day of January , 2007, before me, the undersigned officer, personally appeared Calvin Trimble, Attorney-in-Fact for SBtA Homes, Inc. formerly known as S&A Custom Built Homes, Inc., known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that he~e cuted same for the purposes therein contained as and for the act of lus prmc>tpal and capacity therein stated. WITNESS my hand and official seal the day and year first above written. _~ ~~ Notary Public Commonwealth Ot Penns vanta Nola~tal Ser GbNem F. Thanpeor~ NOfry Pr~ic t~ Mdt~eion'TINp., Ctmbe~lsrsf Oasity M~tC+arrtlbebn E.luns 18,2007 (IAMfMbK, P~err~ayhRania Assod~tlon~ Of Nolerbs I hereby certify that the precise residence and complete post office address of the within named Grantees is ~ ~ .n Date: '' ~o r~ ~ I Certify this to be recorded In Cumberland County PA O OY o a ~~~• Recorder of Deeds ~6 _ Aiteeney for Grantees ~e~r ~,~c~ ;bA~;; .~. .~...-rt--- 07/22/2011 10:39:15 AM CUMBERLAND COUNTY Inst.# 200701915 -Page 3 of 3 REV-1510 EX+ (08-09) ' pennsylvan~a DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS AND MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER Martha P Taylor 2011-00171 ~~_ __~_,..~_ _..~ ~_ _,..,,...~e«aa ,..a aie~ ~f++,o anawar tr, anv of questions i through 4 on page three of the REV-1500 is yes. If more space is needed, use additional sneers or paper or the same size. Date:12~08~10 Page 1 of 1 ' 002649 ESTATE OF MARTHA P TAYLOR 121 COVENTRY DR CARLISLE PA 17015 4507 IF YOU HAVE ANY QUESTIONS, PLEASE CONTACT THE COMPANY AT: CUSTOMER SERVICE REP AT 1-800.523-5800, PAYEE: ESTATE OF MARTHA P TAYLOR Check No. 0029870394 Healtf~ ~e REG POLICY SYM POLICY NUM PROD CODE INSURED ACCOUNT NUM CHECK AMOUNT g ~ OBB TAY LOR 0613275971 $*'``783.00 iii CHECK DESCRIPTION ~ YOUR ACCOUNT IS CANCELLED. THE REFUND CHECK BELOW REPRESENTS MONTHLY PAYMENTS PAID BEYOND THE CANCELLATION DATE. ;~ No. 181762_~~ Form T-258-8 Printed in U.S.A. AARP LIFE INSURANCE ,PROGRAM FROM NEW YORK LIFE 5505 W. CYPRDAg33607Ib70700 TAMPA, FLORI I~~~III~~~III~~~~~~11~1~1~~1~~1~1~1~11~~~1~~~1~~1~1~~~111~~~11 DANIEL J TAYLOR X21 COVENTRY DR CARLISLE PA 17015-4507 Flnanclal Life Insurance Program rTUm 0790 CHECK NO: 0031757163 MARCH 17, 2011 TOLL FREE SERVICE NUMBER 1-888-7746711 CONTRACT NUMBER: A19M=s16Martha P Taylor INSURED'S NAME: Og~17~11 CHECK DATE: TYPE OF TRANSACTION: Death Claim Paid to Beneficiary Daniel J Taylor 121 Coventry Dr Carlisle PA 17015 . CONTRACT AMOUNT 5 2,848.00 AMT PAYABLE TO YOU S 2,848.00 'y S 2,848.00 TOTAL S 2,848.00 TOTAL AMOUNT PAYABLE TO YOU ~ 2'844.22 MISCELLANEOUS INTEREST DUE YOU . _ AMOUNT WITHHELD OU (4 2,892.22 TOTAL AMOUNT PAYABLE TO Y Enclosed is a check for the total ~o~hepdatelthis check was issuedst includeteiscff2zm the date of death to t at a ra