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HomeMy WebLinkAbout08-24-11- 1505610140 EX (01-10) OFFICIAL USE ONLY REV-1500 ue PA Department o County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN 2 1 1 1 Q 2 2 1 PO BOX 280601 RESIDENT DECEDENT Harrisbur , PA 17128-0601 ENTER DECEDENT INFORMATION BELODW to of Death MMDDYYYY Date of Birth MMDDYYW Social Security Number 4 28 0364 0205201 1 0303 1 9 37 MI 2 ~ Decedent's First Name suffix E Decedent's Last Name R O Y SHERMAN (If Applicable) Enter Surviving Spouse's Information Below Suffix Spouse's First Name Spouse's Last Name Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPL`ISCATE WITH THE REGISTER OF WILL MI FILL IN APPROPRIATE OVALS BELOW n t R ~ 3. Remainder Return (date of death 1. Original Return ^ ur e 2 Supplemental f t d prior to 12-13-82) 5. Federal Estate Tax Return Required 4. Limited Estate e o a 4a. Future Interest Compromise ( death after 12-12-82) 0 l Number of Safe Deposit Boxes t T Q 6. Decedent Died Testate (Attach Copy of Will) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) f death t d ~ a o 8. 11. Election to tax under Sec. 9113(A) 9. Litigation Proceeds Received ~ e o a 10. Spousal Poverty Credit ( between 12-31-91 and 1-1-95) (Attach Sch. O) M ALL CORRESPONDENCE AND CONFID PLETED BE DIRECTED T0: ENTIALa AX IeFT U n DENT -THIS SECTION MUST CORRESPON . BE CO ber e Num elepho D y Name ZU J OEL R L L I NGER 7 1 7 2~ 4 6 0- 2 9 -~~. ,-- . _ ~~ p , r ~1 REGISTER 'LS USE O~l;LY -,:_~ ,~ r~ ~ ~ ,,;,~ "a "' , ~.~. ~ r-T'1 h;~ First line of address ~ _ ~ --- S T R E E T ~I ,_-, c~ .-~, ~ _,_. 1 4 NORTH M A I N ~~ ~ -_ - .~ --~ Second line of address ~. ~,-_ S U I DATE FILED C`' T E 2 0 0 ~' State ZIP Code -- City or Post Office C H A M B E R S B UR G P A 1 7 2 0 1 Correspondent's a-mail address: r enalties of perjury, I declare that I have examined this return, includinglaccoesentati a sbased on a ntfo m t on of wh ch preparer has any knowledge belief, Unde p it is true, correct and complete. Declaration of preparer other than the persona p ATE SIGNATU E OF PERSON RESPON IBLE FOR FILING RETURN ~C '`,~'~ ADDRESS ORRSTOWN PA 17244 11520 CUMBERLAND HIGH~~JAY D TE TU PAR OT HAN REPRESENTATIVE c AD Ess CHAMBERSBURG PA 1 201 1 NORTH STREET UITE 200 IGINAL FORM ONLY PLEASE USE OR Side 1 1505610140 1505610140 ~ J 1505610240 REV-1500 EX Decedent's Social Security Number 2 0 4 2 8 0 3 6 4 Decedents Name: ROY E. SHERMAN RECAPITULATION 5 5 0 4 9, 0 7 1. 1. Real Estate (Schedule A) ..••••••••••••••••"""""'••••••• 1 5 0 0, 0 0 2. 2. Stocks and Bonds (Schedule B) ..••••••••••••••••"""""'~•••~••• ... 3. 3 Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . ...... 4. Mortgages and Notes Receivable (Schedule D) .. • • • • • • • • • • • • • • .... 4. 1 1 6 4 4. 2 6 Schedule E) • • • 5. Cash, Bank Deposits and Miscellaneous Personal Property ( • • • • 5• 1 g 6 0 3. 1 9 r-1 Separate Billing Requested ... 6. Jointly Owned Property (Scheda rt P u .... 6. 5 2 1 5 6 2 6 7 y rope n-Probate neous N 7. Inter-Vivos Transfers 8~ Misce ~ Separate Billing Requested .. ..... 7. . (Schedule G) 2 4 3 0 6 4. 0 4 ....... 8. Total Gross Assets (total Lines 1 through 7 . • • • • • • • • • • • • • ..... 8. 1 9 Q 3 3 • 6 5 ........ 9. Funeral Expenses and Administrative Costs (Schedule H) .. • • • ..... 9. 4 4 9 ~ 5 7 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ... • • • 1 9 4 $ 3 • 2 2 11. Total Deductions (totalLines9and10) .••••••••••••••••••""" 11. ""'. 2 2 3 5 8 Q• $ 2 .......... Net Value of Estate (Line 8 minus Line 11) . • • • • • • 12 12. ...... . Charitable and Governmental Bequests/Sec 9113 Trusts for which 13 13. . ................ an election to tax has not been made (Schedule 2 2 3 5 $ 0 ~ 8 2 14. Net Value Subject to Tax (Line 12 minus Line 13) • • • • • • • • • • • • • • • • .14. • • ' TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 0 ~ 0 0 15. 0 ~ 0 p (a)(1.2) X •0 16. Amount of Line 14 taxable 2 2 3 5 8 0$ 2 16. 1 0 0 6 1 1 4 at lineal rate X .045 0 . 0 0 17. Amount of Line 14 taxable 0 Q 0 17. at sibling rate X .12 0 ~ 0 0 18. Amount of Line 14 taxable Q 0 0 18. at collateral rate X .15 1 0 0 6 1. 1 4 ... 19 ..... 19. TAX DUE ............................................ 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1505610240 1505610240 REV-1500 EX Page 3 Decedent's Complete Address: DECEDENT'S NAME ROY E. SHERMAN ____ _ _. __--- STREET ADDRESS 6 Ocker Lane - ___- --- cITY Shippensbu Tax Payments and Credits: 1. Tax Due (Page 2, Line 19} 2. CreditslPayments 8 550.00 A. Prior Payments 450.00 B. Discount 3, Interest (3) (4) 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMEN . Fill in oval on Page 2, Line 20 to request a refund. 1 061.14 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5} 5. If Line Make check payable to: REGISTER OF WILLS, AGENT WING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS PLEASE ANSWER THE FOLLO Yes No 1. Did decedent make a transfer and: ^ P Pe Y ..................... a. retain the use or income of the ro rt transferr b. retain the right to designate who shall use the property transferred or 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 December 12,1982, did decedent transfer property within one year of death ^ .................................. X without receiving adequate consideration? ..... • • • • 3. Did decedent own an "intrust 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 . . E UESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. IF THE ANSWER TO ANY OF THE ABOV Q 1994 and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spou For dates of death on or after July 1, , 3 percent [72 P.S. §9116 (a) (1.1) (i)]. 1 1995 the tax rate imposed on the net value of transfers to or for the use of oe ~e ui ements foridiscposuee of assets For dates of death on or after Jan. 2 P.S. 9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the sta u ry q fling 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: net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural paren , an • The tax rate imposed on the adoptive parent or a stepparent of the child is 0 percent [72 P.S. §9116(a)(1.2)]• nt's lineal beneficiaries is 4.5 percent, except as noted in • The tax rate imposed on the net value of transfers to or for the use of the decede 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. 1 3 A siblin is defined, ed on the net value of transfers to or for the use of the decedent's siblings is 12 b blood o~ adop§on16(a)(. )]. 9 • The tax rate impos Section 9102, as an individual who has at least one parent in common with the decedent, whet e y File Number 21 11 0221 STATE PA ZIP 17257 (1} 10 061.14 Total Credits (A + B) (2) 9 000.00 REV-1502 EX+ (01-10) Ivania SCHEDULE A pennsy DEPARTMENT OF REVENUE REAL ESTATE INHERITANCE TAX RETURN FILE NUMBER: RESIDENT DECEDENT ESTATE OF: 21 11 0221 N at fair market value. Fair market value is defined ble knowlledge of thepelevant facts. ROY E. SHERMA real roperty elled to buy or sell, both having reaso All p owned solely or as a tenant i e ca d a willing selblerr ne ther being comp i must be disclosed on Schedule F. would be exchanged betty Real prlolperty that is jointly-owned with right of survrvorsh p rt has been sold. VALUE AT DATE Attach a copy of the settlement sheet if the grope y OF DEATH Include a copy of the deed showing decedent's interest if owned as tenant in common. ITEM DESCRIPTION NUMBER situate 55,000.00 ether with improvements thereon erected, lying and being 1 Tract of real estate, tog Cumberland County, Pennsylvania, sold to0T00 copyof in Southampton Tow Sherman, his wife, for gross sale price of $55,00 Sherman and Lori A HUD attached 49.07 roration of real estate taxes at sale of above real estate 2 Received on p TOTAL (Also enter on Line 1, Recapitulation.} $ 55,0 If more space is needed, use additional sheets of paper of the same size. REV-1503 EX + (6-98) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ESTATE OF 21 11 0221 ROY E. SHERMAN All properly jointlyowned with right of survivorship must be disclosed on Schedule F. VALUE AT DATE ITEM DESCRIPTION OF DEATH NUMBER 1,500.00 ~, 30 shares of common stock College Towne @50.00 TOTAL (Also enter on line 2, Recapitulation) I $ 1,500. (If more space is needed, insert additional sheets of the same size) REV-1508 EX + (6-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT BER FILE NUM ESTATE OF 21 11 0221 ROY E. SHERMAN Include the proceeds of litigation and the date the proceeds were received by the estate. d with right of survivorship must be disclosed on Schedule F. tl i y-owne n All property jo VALUE AT DATE ITEM NUMBER DESCRIPTION OF DEATH 167.35 ~, Banker's Life, refund of premium 16.60 2. Century Link, refund 144.46 3. Banker's Life, refund of premium 4. raised b Dan Hershe Auctioneering Service, with copy Personal Property app y Y 3,644.00 attached 5. 1996 Dodge Dakota Pickup - 1/2 ton - V6, valuation attached 1,800.00 6, 1992 Chrysler Lebaron Convertible, 2-door, valuation attached 975.00 7. 1996 Nissan Maxima - V6 Sedan - 4 door SE, valuation attached 850.00 150.OC g. 2000 Tomos Sprint, valuation attached 1,000.0 g. 1978 Holiday Rambler, valuation attached 100.0 10. Homemade trailer, nominal value 11. Iled for rior to Required Minimum Distribution from Banker's Life Annuity, app ' p 2,046.0 death but received after death 397.0 12. Tax Refund for 2010 4.7 13_ C/C refund 250.0 14. Property tax rebate 99.1 15. Insurance refund TOTAL (Also enter on line 5, Recapitulation) $ 11,644.= If more space is needed, insert additional sheets of the same size) REV-1509 EX+ (01-10) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY FILE NUMBER: ESTATE OF: 21 11 0221 ROY E. SHERMAN If an asset was made jointly owned within one year of the decedent's date of death, it must be reported on Schedule G. ADDRESS RELATIONSHIP TO DECEDENT SURVIVING JOINT TENANT(S) NAME(S) 11520 Cumberland Highway son A. Thomas R. Sherman Orrstown, PA 17244 B. c JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. 1. A. 12/09 Checking Account #338931, Orrstown Bank, including interest accrued to date of death 2, A 12/09 Savings Account #703003855, Orrstown Bank, including interest accrued to date of death OF DATE OF DEATH DATE OF DEATH DECEDENT'S VALUE OF VALUE OF ASSET INTEREST DECEDENT'S INTERE 13,089.45 50. 6,544.7= 24,116.92 50 12,058.4 TOTAL (Also enter on Line 6, Recapitulation) If more space is needed, use additional sheets of paper of the same size. 18.603. REV-1510 EX+ (08-09) SCHEDULE G ennsylvania ~PARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND MISC. NON-PROBATE PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT MBER FILE NU ESTATE OF 21 11 0221 ROY E. SHERMAN This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. ITEM DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE NUMBER THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. 00 0 48 $04.73 1 IRA Account #7730099, Banker's Life and Casualty Company 48,804.73 . 10 ~ . named beneficiary, Thomas R. Sherman, son of decedent 2. Annuity Account #7789767, Banker's Life and Casualty 68,234.$3 100.00 68,234.83 Company, named beneficiary, Thomas R. Sherman, son 3. of decedent Annuity Account #7887487, Banker's Life and Casualty ~ 8,389.29 100.00 18,389.29 Company, named beneficiary, Thomas R. Sherman, son 4. of decedent Annuity Account #7929812, Banker's Life and Casualty 20,838.67 100.00 20,838.67 Company, named beneficiary, Thomas R. Sherman, son of decedent TOTAL (Also enter on Line 7, Recapitulation) $ 156,267. If more space is needed, use additional sheets of paper of the same size. REV-1511 EX+ (10-09) enns Ivania SCHEDULE H p Y DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT FILE NUMBER ESTATE OF 21 11 0221 ROY E. SHERMAN Decedent's debts must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A, FUNERAL EXPENSES: 9,901.00 ~, Fogelsanger-Bricker Funeral Home, funeral expenses 198 22 2. Fisher's Florist, flowers for funeral 792.00 3. Parklawns, cemetery g, ADMINISTRATIVE COSTS: ~ , Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City State _ i IP Year(s) Commission Paid: 5,500.Or 2 Attorney Fees: Joel R. Zullinger 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 Fees: Register of Wills -letters 210.00; will 15.00; JCS fee 23.50; automation 5.00; b t P 321.E 4. e a ro short certificates 48.00; filing return 20.00 5 Accountant Fees: g, Tax Return Preparer Fees: 185.E 7, Sollenberger's, vehicle title transfers 263.E g. Sollenberger's, vehicle title transfers 290 ~ g. Sharon Keefer, appraisal of real estate 67. 10. Adams Electric, utilities 73., 11. Helen Runshaw, preparation of income taxes 75 12. Cumberland Law Journal, advertise letters Dan Hershey Auctioneering Service, appraisal of personal property 125. 61 13. 14. CFJMA, sewer service to residence . 113. 15. News-Chronicle, advertise letters 550. 16. 1 % Realty Transfer Tax on sale of real estate 67 17. Adams Electric, utilities 90. 1 g. CFJMA, sewer service TOTAL (Also enter on Line 9, Recapitulation) $ 19,033. If more space is needed, use additional sheets of paper of the same size. Continuation of REV-1500 Inheritance Tax Return Resident Decedent 21 11 0221 ROY E. SHERMAN Page 1 File Number Decedent's Name Schedule H -Funeral Expenses & Administrative Costs - B7. ITEM DESCRIPTION NUMBER 1 g. State Farm, homeowner's insurance 20. Adams Electric, utilities 21. School real estate taxes prorated and paid from sale of real estate 22. CFJMA, final bill for sewer service SUBTOTAL SCHEDULE H-B7 AMOUNT 216.00 58.58 67.19 18.39 360 REV-1512 EX+ (12-08) SCHEDULE Pennsylvania DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES, & LIENS RESIDENT DECEDENT FILE NUMBER ESTATE OF 21 11 0221 ROY E. SHERMAN Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. VALUE AT DATE ITEM DESCRIPTION OF DEATH NUMBER 30.00 1, CFJMA, sewer service to residence 33.18 2. Century Link, telephone service 59.9^. 3, AT&T Mobility, cell phone service 155.0 i 4. Adams Electric, utilities to residence 37.1= 5. Lifeline, life alert service 9.Or g, Veterans Administration, balance due for prescriptions 7, Vivian Coy, Tax Collector, real estate taxes 125.2 TOTAL (Also enter on Line 10, Recapitulation} I $ 44~ If more space is needed, insert additional sheets of the same size. REV-1513 EX+ (01-10) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN ,,.~.~T n~rcnGIJT SCHEDULE J BENEFICIARIES RCJ~v~.,., .. ~..__-.. _ ESTATE OF: ROY E. SHERMAN NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY NUMBER TAXABLE DISTRIBUTIONS [IncluSec 91 ~6 (aj (12~1ldistributions and transfers under I. 1, Thomas R. Sherman, 11520 Cumberland Highway, Orrstown l PA 17244 156,267.52 Items 1-4, Schedule G 18,603.19 Items 1-2, Schedule F 40% of residue, consisting of cash 17,559.04 and personal property 1,925.00 2. Tammy J. Sherman, 10365 Upper Strasburg Road, Upper Strasburg, PA 17265 40% of residue, consisting of cash 18,769.04 and personal property 715.00 3. II Rhonda S. Sherman, 12470 Forge Hill Road, Orrstown, PA 17244 20% of residue, consisting of cash 8,738.03 and personal property 1,004.00 FILE NUMBER: 21 11 0221 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) .ineal Lineal I Lineal 194,354.75 19,484.04 9,742.0= S SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. ENTER DOLLAR AMOUNTS FOR DISTRIBUTION NON-TAXABLE DISTRIBUTIONS: POUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKE : A. S 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. rATAI nc oeRT TT -ENTER TOTAL NON-TAXABLE DISTRIBUTInNS ON LINE 13 OF REV-1500 COVER SHEET. AMOUNT OR SHARE OF ESTATE If more space is needed, use additional s ee s o s.. •, S =...... ~~, -T__~ ~`_ ~~~ ~_ ~ r'' 1 :- V V 1L JLOJi_O ANJi..I/ ~~O~~Aa~ E N~ ~+~..:Jj T~ •' - + - ~ i ll _ _.LJ - l.C:.~ 'f 1F~(~Y ~, ~lE-I~ I~~M~11~ I, ROY E. SHERMAN having my legal residence at 6 Ocl~ler Lane, Shippensburg, i'A 17257, Cumberland County, Connl~onv~~ealth of Pe~uzsylva~~ia, do hereby declare this to be mv_ j ' ast ~~~illand Testa~llent, revoking all other ~~~i11s and ~ odir.ils heretofore made by i~ze. i T a , ~ it T __ ~1~;L ~i-ug ~ l Si~ L ~ t~iljl 1l~? ~ ~Z~EL~~ ~Cd Q1~LE ~ f i+ T ~1u`, ~ li=~ fil~ ~ - 7.- ~~,~ _~ _C3~~.iI~~`~ cl~il~.~el, bn,, rr, ~l~e: Robvi~~ T . T ~ ~! 1!i~iji. ~ _^'c_.11~c;i~ ~'\. _i~1~.111iC..11. ! ~~1,5:.>j ,_,. ~'r1"' "~'i~ ~? 4 .a ~ 1 + f J~ -`L'~i.iScZl_, __ _1 L7 ~!:_L _ . li 11~r1 :.i~''..~ T ~"il~ ~ ,l~T`IZI~" ` _ Qi... a '* ~~ 1°`~ ~! 1 .~I~ i '.~?1~{~' 'fc~l ! ~ it ~l~t! ',! Il~ .i:.j ~i t_ ~ ~ - - 11 _ ~_. ~i1 ~. 1_l~ tib l ~ ' ~~._ ~~ E ~I L ~it.l i. IT'E~~I T~~r'C} e I gi~r'e all of nl~~ tangible person~.l property to n~v son. THOi~~IAS R. SHERIvIAN, my daughter, RHONDA S. SI-iER1ti1AN a.nd my daughter, T~~'I~~I~' T. S~IE~y IAA ~ . as follows: - -~ :`iii ' ~L gills Cf rail~~iili.e 1~e1"St3?la.l t~:"C?l~el`Cv Sslall Lie - ~ 1 ~ _ Inventol7ed and valued at a fair ilia:-ket value. ~. 1 mad- leave a Memorandulr listing some of the items of my tangible personal property which I wish curtain persons to have and. request that my wishes as set forth in the memorandum be observed by n1y Personal Representative. Any items of tangible personal property not so designated shall be divided and distributed among my children as follows: 381628-1 1 C. Each of zny above designated children may select one item, in rotation, in order determined by lot, until s~~ch time at which the items chosen by that child reach such child's proportionate share of the total value of rriy estate under Item Tl2ree, below, or until such time as the child wishes to make no further selections. D. Any items not selected shall be sold and the net proceeds added to the residue o_f any estate. E. To the extent that my children2 and stepchildren a.re unable to agree, the decision as to what may constitute "one item" for purposes of this selection shall be made by my Personal representative(s). f. ,~z2v disputes concel-z2izzg this zazethod of allocation shall be resolved by n2v Personal ,-. ; i ^~ raC',=•~r't •~t ~; ~i ~l'l t,' ~Q.-C'r"1lZ '7 I K c 7- ' C , ~ ~..~~.tl~ u~j v e i12 iii r s vi ~~~llt:l ~te~;l eJ~.iitaCit P ~ C CF_ ~ P (~1 CC'i'PtiCli2. _ _ L_r. ~.0 1~2e ~`~tel2t i21V Pei'SC>12ai rOpreSeT1$atl~-e ;S unab?e to i°eSO~ve a C~1S~l~iie ~1120~2~ t~vo ,1s ;22n~-e QT '2iV hezrS C,Cl11C~I~.21Ii~? il~e ~s?-?~~~?(i +~tsti"Ibtli-lo~2 O~ al~~' of ~?2~' ~~~~-Ln,-t2~! ~r01~e2`~1%., i ~~ _ .,v ~r1,..., 1T~?~:l ~ H~~I~~ T - r~ _ _ _ E ~~= ~; I?i~ =Ci(~~1~ ~l j ~ -;~til~P j ~ _I:ITt~ •.. 41 '~~it~1~-;~ ,-';• `,vhere~SOe~'ei' Si~Clo~ ' ' ~ ~' ~. iv ljl ~ CI2iICreticS loli,J vS. ~O Ii2~~% Soil, i ~IU00~i`~A+~~".,' ~ . JI~~ r;.l~i y ~~i ~ ~j- 1 ~' c FOi~ T Y (~-0°,;~) of tl~e z-esidue pez- stirpes, and to n2t% daug_h_ter, TAIvIl`/IY J. SHErld~~~N. ! ~l~ FORTY 440° o} of the residue per stirpes, and to my daughter. RHONDA S. SHErMAN. I wive TWENTY (20°%) PERCENT of the residue per stirpes. ~ ITE'~'I COI-I~-Q I haver?ot ;~ro~:Tided for z~z~~~ daughter, ROBBI~~ T . S~iE~I~N or znv son, TL~IO T I-Ii- ~. SHf,I~tiIAN, or tl2eir issue, as bone iciary(ies} under this my Last Will, for reasons that are good and sufficient tc me. It is n2y express desire that BOBBIN L. SHERMAN, TIlVIOTHY S. SHErMAN, or their issue, receive no portion of my estate whether passing under this my Last Will, or by intestacy or by any other means, unless and until I change this my Will to specifically include them. 381628-1 2 ITElV.~ ~'I~T~: Should an_y 'oeneficiary of mine be under the age of twenty-five (25 j years, my Personal Representative shall hold such bene_ficia~y's share of my estate, as Trustee, IN TRUST and shall invest, reinvest and distribute the principal and net income of su ch beneficiary's share as follows: 1~. Until StICl1 beneficiary attains the age of twenty-five (25) years, my Trustee, in my Tntstee's sole but reasonable discretion, nay pay or apply the income and any oi- all of the principal of such beneficiary's share for the health, maintenance, support and education of such beneficiary considering all other sources of i.ncorne available to suc1~ beneflClaly alld 1rj10 ~~Tl? to I?~~ rJ T~1zStee. UpCI2 SLiCh !ilei2eilClaly aeiaiillllg t11e age Of itivel~t'v-rive f 2`~i years. my T~ ~~stee shall distribute the balance of the pi-il~cipal a~,d i accu~~-~tll~ted income, i f anv. of each st~ch be~~etic?a7ti~'s share to such beneliciar°v. ~. °ilouia tale p~-inci ~al_ , ,'~1 ~'1~st ~ ~.>~~ ~ , ,_ ~ Ll c 1C 1"slctlC, 11i t!lt., 7G~G Gl~ ±iili I~? vi ii lV ~1 uuree, `~~ ',r i~CC~'~.1` ~~ ~~ ~ ~- _ ~~~ sdilal~ t~l ',~- ~.i?"~I~i Uic:.a~~~1~ ~,^li" vonrlll%?lll~~ i;t ~LI~i1 ~l" ~' 7 ~~~u =~~ ?_z t?sz ~~; ~ ~l~otilc ?_ts _e. ~ ~ `~ Lail _~15~7l±~t~~.~~~~1 jQT C~13\~ l,f~~~~~T C'.~ci~ i~ ^_ ~1 ~ li. ~I'J !. i~_iJtr{w, ;ice ~~~r~ - _ t.. ?. l'_-il I. J Si.~. _' ..~t.~.'t' ~ _..... ~. ;. i__...i_`." ~s rJ!_+ ! ._ - r _ _~!'~[ ~~-!.~_P'ikhj%3(\ ~~f" i!iCi`~, !~1`cf`:. iii it 1 i ~ ~:~ t~._. ~_ - ~~-- s 1 . ~~,, ?h ~~r. _:~.7leilC~c~1 ~,. S ?i:~ii11~ l~L t i ?_1tC10;~~- - - 1- _i:Zl %iCl.ii~~l~` ac~;_~r"~~1~1t)!! `~ il~ '~~:°~,eC~l`_' `~- ?~`~;- 1 !E-ie ~1,L~,~~El~v.1 ~7.v ciL i~i~Livl~LV. t sj t t_,.~ '"" --- ~ i'- _ II - - ! ~~I11 'vCia~Iii_!~ii:" ii~~~ !%ai.l!tL~ 5_ ~ ~~~s ~~;~~ ner ~t~~~otity, thus to l~in~ ,~r her direc.tl~ . C. All_ shares of principal and income l~erebv given shall be free from anticipation. assignment, pledge or obligation of my benefciaiy(s), and shall not be subject to anv _~~;~%1'f_tiC"^ .~-~_ it 1 r I r~ I ..~_ C1.6. P.<~~il~~~S~.~nL. i ITE?~''~ Sl-~: Iappoint my sozi. THOIti2A S R. SI=[EfZ!~~A 1_~T. Perso~_~al Representative of this m_y Will. 111 the event THOMAS R. SHERMAN is unable or unwilling t0 act OI" COI1t1I1Lle ~ to act as my Personal Representative, Iappoint my daughter, TAMNI Y J. SHE~ZIvIAN m y Personal Representative. 11~ the event TAMMY J. SHERMAN is unable or unwilling to act or continue to act as my Personal Representative, Iappoint my daughter, RHONI~A S. SHERMA N, 381628-1 3 my Persol~al Representative. I give to my said I'ersol7al IZepresentative(s jthe same powers as are hereinafter given to my Tllistee. Stich powers shall be in addition to those conferred bylaw. ITEM SEVEN: No bond shall be required of any flducialy hereunder in any jurisdiction. No fiduciary hereunder shall have any liability for ally mistake or error of judgment made in good faith. ITEM EIGHT: I authorize lny Personal Representative and Tllistee to exercise the following powers in additinl~ to those given by lativ, tc be exercised ire their sole disCretlo3l: -~- T o retain any or ail of the asseis of Iny estate, witl:~out regard to any pl-illciple of di~~ersitication, risk or productivitti-: 5. ' C II7veSC iIl alI tCl~11S 0~ property `~~''lthOtit i'estrli:tlOn l0 II1\~ estllleiiis alatlCji ~Le~i for : ii', i~ v~~e Cf f1dtlClaYV; '~- . ~ C CO121~?"C?21ISC a11~' C1~i711 CI" CCi]. s Cr©v c'i Sv; _ - ':_ ' ~,,, 1n~,1 I1nllev tC ;_,i' IITiV ~~rOt~C?iZ% ~-CI~1 Ill ~- 4S~:aiC: -. _ _; ~,._~~-C it_~CIZ_e~/ ~-C?l,l %~llti ~E'.I"sC11. 1:~_C~'Idir~g ali~~ ~~:t'(~II*Cr c~I" ~ iCiStec', ~'Ilt ~0 ~:t7tsl"t_'~1~,;~- ,~(~11`,L ?il= ~'_t9 n I' _}~11 Ci(~eTi it !)!'~) _.1't.~.'.. - -rL S~li aL ij~~Ul7~' LEI 'T"I`•~-°~t~ C~ r -`t ~ - ~ ~~ '~ .iCilall~,k' ,,~- In i~~:;c F. s(~i" ;111 , ,e(Z~ ~{~ ~~ l'~"l l ~ .~;- ~ _ _~.1' 1~ _; ~^~~~ti f rT r5i rCI`4~~ . ~316~ tE~ <<l!% i _ ~ ~~ ~~"~i i -_ _ 'J,~lICI;_S fCi ~~It'S ,.'~Cl?~ il~~., ~~~~ IC~~StiS ~~.a~ )CI Si _ _i t 1-3 Ilt;~~ alQf i ~l?J~DI7_ s?1Ct1 ~_r_i~lC _.~.~d r'~~tiCi1f1t1ii~ ti fi~^F~- r -e-• r.- '_ '"' a,lO~~a.l'~ I"e~'~'i}-'[S '~I4' { ' '`:i='~ ~~;v.S t~~ i_ i7IlC'i ~; ,' ~o - , - - ~l `' S~z ~ i ~_I IiI~,_rj_f` {_:i ~t 1~1 ~}' ~,° t; ,,i, i_7I ._.J ,.iii,.: it;e: ~~t_ i_; i .J ~i e l ~. i o repair.. alter or illlUrove anv real oI- personal prol:,ert~-: T. To distl-ibt~te in cash or in land or partly in each at ~%aluations tixed by them: . To keep reasonable amounts of cash in a bank 1IIZinvested if deemed advisable for the protection of the principal; K. To subscribe for or to exercise options for stocl~s, ~)Ol1dS Or Otller 1llVeStl~lelltS: t0 ~Oln lIl ally ~'iali vt lease, I1~0~-tgage, n2erger, COi1sC11datlOn~ reorganizatlOll~ fOreClOslil-e Cl' votlilg tlllst and to deposit sect?nties thel-ei_ulder, and to generally e.~_ercise all the eights of security hold_el-s or elllployees of ally colporatioll; T . To register secu~ Mies iI~ the nall~e of a Nominee ar isl such Inanller that title spa Il pass by delively; M. To add to the principal of any tnlst created by this instl~!iment any real or ersonal propel-ty received from any person by Deed, Will or 111 any other manner; p N. To exercise all power, authority and discretion given by this instrument after the termination of any tlist created herein until the same is fully distributed; O. To use their sole discretion in deciding whether stock dividends on stock they hold in trust should be apportioned to principal or income, except stock dividends of regulated investment companies which shall be added to pi-incipai; 381628-1 4 rte. To colniningle the assets of any tnlst estate created by this Will il~ any one or more common fiends for greater conveiuence and flexibility; ~. i o eii~ploy agelits, accotu~ltants, engineers and such ether persons, professional or otherwise, as maybe necessary for the proper administration of this estate or tnlst and to pay their compensation from such funds; and R. To disclaim all or any interest iii a property passing to ine or my estate. ITEll~I NINE: I realize that Personal Representatives are given discretion by law to make various elections wl~~ch affect the income and estate taxes payable by estates and beneficiaries, as well as the relative shares of beneficiaries, such as taking administration expenses as deductions for either Pstate or incol~~e tax ptiiYOSes, selecting options for the payment of employee death benefits, electing to take a qualified tel~llinable interest as part of file ~~ marital deduction. selecting altel-?late ;%ah_latioll dates_ j~osiponillg the pa-y-rhent of taxes. filing lOlilt ll1C41i1C ~ ~;~; QJr '?lip tax i'etU1~1S a1"~t:x reileCilllll~ CS?I'UClrcttc; StSJCii. i i1C dCCi`ivliS ~ ~~ -; TIl«~e b v zil_Y I1dtlClari~S 1]-1 ail_~ ~i %i1cSC iilal.terS Shall ~:;c billding ~jit~E, 'll~ 11Gt ~ ' ~ ; i_ ~~ _i_, ~i SL1G ~,~C4 ~~ Liue ~t_~iil ~}~~'. ~ lip.' 1t~LC' F"~ 11r~1"~~? c. j r-~~' ?_,j^`n,,~ 1i1V Ti~'~.iCl ~~ ~~`c' 't'; 7 ~ ~ ~ _ . - - ~ ~.3itE' ~71t C~~?'Ci!~elatlt`~'~i Iil~_' Rot 1 1~1C~_ ~ '-C~.1 s_ t ~~ ~~ ~lil is ivtcit~ - -- - -~~ --~~-_ __ ~`I_~tilr~~ 1 ~3~,t= jai ~r~ i --_ ___ 'ilcf'~,.~i~,il {_ ~:~lj~ ?turf ~~ ~~ ~':~(~ ~` " 3 l7 . ,._ .. '. (_! a~^i. ,%-: i=~. _~-~ ~7 ~ ql." F 15..,"1_. J ~~l ~:l-C'c.~~ ~~ Y _~t ~,_~I~l~l J ~i. iC'~T~.tI l.itell;r, ITE~T TE i ~T~ I direct filet all estate, illlleritallce ~.nd other taxes iii file ~lattll~e tllel-eof. together with any interest and penalties thereon, becoming payable because of my death wife _ 1 respect to the property C©11Stlttltlllg II2V grOSS estate f01' death. tax ptilpOSeS, Whether Or Ilot SUCIl ~ l~rO~el'~`J ?tiaSSeS 111idP1' tl~ic r12Y T .aSt V'~Ti11 ~=il.Cl i estai~11e11T^ Shale be veld ~. ~ • , glom the l~rll~cal,al of my reSldtlai~' estate, aliCl 110 ~?erSOil 1'eCel~~lllg O1" 11av1llg a 'CicllellClal li~.tereSl lit ails' vtaCll 'r0'eI-r ~ i' p 1, Tt~rhetl~er under this lll~~ T ast tiVill and Testa meet or otherwise, sl~.all at ai-iv time ~~P re~;uired to contribute to or refund any part thereof; PROVIDED, however, that this direction shall not apply to the taxes on any property included in my estate solely because of a power of appointment thereover which I possess but have not exercised or on any qualified terminable interest or to any generation- skipping transfer taxes. 381628-1 5 ~'I'EI~!~ I~,LEVEl~e If any beneficiary, person or entity in any marlrrer, directly or indirect)}~, C:011testS Or attacks this Will or any of its provisions, or objects to the accounts nr actions of my fiduciaries, without probable cause, such beneficiary, person or Entity shall pay all costs, including but not limited to attorneys fees, arising in comlection with such contest, attack or objection incrrn'ed by my estate, such tilrst or such fiduciary personally. In the event that such beneficiary, person or entity does not prevail in such action, any share or interest in my estate or such trust which worild otherwise pass to such beneficiary, person, entity or remaindennan under this Will shall be revoked and the property consisting of se.lch share shall be disposed of in the manner provided herein as if that contesting per-sore or entity lead predeceased be ti~~~ithout surviving issue. ~~E1,'~. & ~~'El~~'~~.~ J1lotT1~~ anti fJl tt~ l ~ ~ ~?'j' - i _ _ e ~~rw Si ~ii~S O I{1~' v'v i1{ ~rC 1~}i cziiv r~:,asvii `d _ _' t t ~ 1~1 E '.i~ ~~ 3.ltf I ! ~~.' `; ~ I i ~ l T -rp.^ 1 - - du~,iCl_ liit G.Il~_. ~! ~ ~ 1 C1 • 1 dt ~ ~l..f, t ai,` . ~ _ y _ 1• ~~ ~' ~~~. TI~G ~11~1~I i;i"~V1SI'lrls Ut `s_lli~s ~,`Vill end ail - -_ - '~_i:,i`l~i.~ ?1~ ~11t~1~)s`~til~~T S~'iC '.fi't'. ~ a c~ ~ t 4. _"d7~FL]s_r- ,;?~~ ~;iG ?S.Z.ti ,•G 11~~- ,{J! ~;-~~-,'~ __r ~l ~g ~' ~ t ti ~i~T ~~'1ii~~SS ~P~-ER>~0~, i ra:,;c at Slrippei~sb~rrg, ~ ei~i~s~%lv~nia. ~_~~~ ~~.~z~t.~st ~(~. ~(,~~~; _. ser_ my hand. and seal to this my i ast Will ai~.d Testament c;onsistir~g of sip ~~; pages plus the _ffidavit and C'er-tifrcation pages. ~---_ ~~~.~ ; ; .~ , ~~~ .-...~ .-~:-.~~ EAL ) RO . SITERMAN 381628-1 6 SIGNED, SEALED, PUBLISHED A.I~'D DECLARED By ROy F. SHERMAN, the above named Testator, as alid for his Last ~JUill and Testament, in t11e presence of us, vvho, at lus request and in his presence, and In the presence of each other, have hereunto subscribed our names as witnesses. o~ ~~ ~! .~ ~.~ ==-~'~f ~'- ..~'..-, Off//'~.fi~ ~~l! ~ / ~ .% ~/ ! .~~ f , /! Address 381628-I ~ / ~ ,.( ~~ ~ (( Address AFFIDAV:I'l~' COMMONWEALTH OF PENNSYLVANIA : SS: ' COUNTY OF DAUPHIN We, ROY E. SHERMAN, and - _, the Testator and the witnesses respectively, whose names are signed to the attached or foregoing instniment, being first duly swol~ll, do hereby declare to the undersigned authority that the Testator signed and e:~ecuted the instnullent as 1_~lis Last Will and Testament that he had signed tivillingly (or willingly directed another to sign for 111111-~, al?d that he e.~ecuted it as his free and vohlntaly pct for tl~e l~ul~~oses r1, Pre-il[l e_~~~ressed, alld that each of the ~tiitnesses. in the presence and hearing of the Testator. .~1 vlll.J ~l ` 'f Tfl 'f~ ~~ie },`7~1T as '~,'~'ltiiesS and ti~la! iv ~_ile ~l~st ~f fl,~=z1" 1-,2~j~jler1- Cre ~~ ~* T ct~]t-nr ;a ' V L jt..,-L1 1L! J ` ~t-lv 1 ~v~au.vi -'.gas aC t11i.Lt til~i? 1 ' ~l~T llcell Vl°u~I"S ~~~ ~~ ;2 0?- O~C~~'i. ~t s~liI1CI 1 ~ ~ - a ~' t - ~-. _12111 1 Cil!d Ll!iU.er iiLr ~i_'~jlst'la1 `~ ',~f~~ i- I1 ~ 0'i 1-li2dLie _.~., ~ 1.~~,e. _ ~,~; ,< ,,~,7I~-T~.~, ~~-.. WITN~;SS Subscribed, s~voln to and aci~12ow1edged before nee by RO,r E. SHERMAN. the Testator and the witnesses. on August :~~, 20{~ //. - 381628-1 8 CEI~'I'I~ICA'I'I®1~ COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF DAUPHIN . On August 20, 2007, before me the undersigned officer, personally appeared Robert P. Gz1~bb, Esquire (Pen.nsylvania Supreme Couz-t ID No. 76057), l~ZOwn to me or satisfactorily proven to be a member of the bar of the highest court of Pelvlsylvania and certified that: 1. He was personally present when the foregoing- acknowledgment and affidavit were si Zed by tl,e Testator. ROY E. SHERMAN and the witness(es); and ~.. pie was one of the witnesses whose names are si~~ed to the attached or foregoing _, jl~stz-un~ent. ,a,~.d that hei~,g dj_it« ~~ualified according t~o 1aw. did depose a~~d sa~~ that Le a%as present a11C'i sa:,~T ROY E. SI-IERI~~tAI~ . tl~Ie ~i'estator, sign and execute t1~e 1_?1st1~1ii~ent as 1115L~~St ~~~T?ll; tl~~t ~l~?~ Tc~St~tg.~" s1~~??d ~~v111tligh% -~11d ek;eCi.ttCd it ~S hIS ~~~ __iL c.~,il`.i vl~l-ILi~~j 1~,~ i `C ..~_~ ~l~i_(~~iu~~ !_jlt`iF~`li1 '~:11~1L~C`~°~1, j~z t ~~,~n~_i lpi~Cy~C lti +flr' ~lf?~i7"ij~{°~ -1I1(~ tiY~,l1! (l'!,^ ~.i!C .,~3toj" '_1jT~_~~ `: 1'I F` ~S I Ci `':~ ~ z;- 7~~~ ~` ~ i~ d~ . iiI_ ~ C > '1I1L'~ ~ 7~ ~;~i ~: t ~, Cl~ ii~c1C *liiil~ ! `~ _1 ~iC ~ _ ~`~~_j lfl 1Zl_11;r1 r+ll1~? ?11~'~~r,~?' i~(_4 r_('~~c;i.~;i!lji_ tTT''~~~~~~?C. ~I~lfj1_'Cii('ti. - ;~ ,,~ ,.,.~•' r ..il Rob ~ r ~,rt ~fi. Grubb, Esqujl-e ~3' ~_ `~ ~d WITNESS HEREOF, I hereunto set me hand a~ld official seal. `i' ;; Notary Public ~ j COMf~oN~f~A~~9°~ ~; 9:'~i~1C~~YL!lA9~9l~ E~QT~a9~9RL ~E~l. CF~RJL ~t. ~~'TE9:i, 9~o~t~r~y i='~;b9ic City of F;a~~risbur~, t~auphin County trty Co~nirission Expi~~s Esc. ~8, 20Q8 381628-1 9 1 ' ~Y ~v ~T-~~~I-~~~I~~~ This informal letter of instruction to my family and Personal 1~epresentative sezves to convey my personal wishes concenung distribution of selected personal effects. In any situation where the provisions of this letter maybe deemed to be inco~~sistent with or contrary to the terms of my Will, or other formal Estate Planning Documents, it is my desire and intent that the provisions of my Will and other formal Estate Plazuling instnunents sha11 govei~l and be controlling since I do not intend that this letter sha11 sel~Je in any respect as a Will nor shall the teens of ibis letter oven-ide the provisions of a Will or a T,_~zst executed by me whether it was siffned prior or st~Lsequent to tl~e date of this letter. D~s~t`l~~uti€~~~ of p~~°sot2al .1?~°o~~ea°t~; ~~~~I`I~t~~rn C~~ ~~~'Q~~~I°~`,' ~~4I~Ik~I~d'~,' --~ . J. II 6. o. 9. 10. 11. 12. i b. ~. 9. 10. 11. 12. 381628-1 1 Description of Property 13. 14. 15. 16. 17. ~~. ~~ .~'~~. _; -~. -. - ~~. Beneficiaj-y 13. 14. 15. 16. 17. ? ~. ,~ i ~~ . ~~_~. -, -, ~~ ~~. ~'~. Other Dig-ECtions To 1VI~T Family: 381628-1 2 A. Settlement Statement U.S. Department of Housing and Urban Development or /~~ -Ir 2502-0265(Paoe 11 n. type or i,oan 1. ^ FHA 2. ^ FmHA 3. ^Conv. Unins. I 6. File Number 7. Loan Number 8. Mortgage Insurance Case Number 4. ^ VA 5. ^Conv. Ins. I C. Note' 7hb form b furnished to give you a statement of actual aetaemmt coati. Amomb paid to and by the aedlement agent art shows Items marked "(p.o.a)" were paid oabrde the cloaiog; they arc shown here for informational purpan and arc oot ineluded in the tobb. D. Name and Address of Borrower E. Name, Address, and Taxpayer identification # of Seller F. Name and Address of Lender Thomas R. Sherman & Thomas R. Sherman, Executor of the Last N/A -CASH Lori A. Sherman Will & Testament of Roy E. Sherman 11520 Cumberland Highway Orrstown, PA 17244 G. Property Location 6 Ocker Lane, Shippensburg, PA 17257 Southampton Township, Cumberland County Tax Parcel No.: 39-37-2092-030C 100. Gross Amount Due From Borrower H. Settlement Agent Name, Address and Taxpayer Identification Number Joel R. Zullinger, Esquire 14 North Main Street, Suite 200 Chambersburg, PA 17201 Place of Settlement 1. Settlement Date 14 North Main Street, Suite 200, Chambersburg, PA 8/10/2011 K Summary of Seller's Transaction 4IN1_ tf r•ncc Smnnn+ ilnn T.. Celle Iul. contract sales price 55,000.00 401. Contract sales price 55 000 00 102. Personal Property 402. Personal Property , . 103. Settlement charges to borrower (line 1400) 713.00 403. 104. 404. 105. 405. Adjustments for items paid by seller in advance Adjustments for items paid by seller in advance 106. City/town taxes to 406. City/town taxes to 107. County taxes 08/10/11 to 12/31/11 49.07 407. County taxes 08/10/1 I to 12/31/1 l 49 07 108. Assessments to 408. Assessments to . 109. School Tax to 409. School Tax to 110. Garbage Fee 410. Garbage Fee 111' _ 411. 112. 412. 120. Gross Amount Due From Borrower 55,762.07 420. Gross Amount Due To Seller 55,049.07 200. Amounts Paid By Or in Behalf Of Borrower 500. Reductions in Amount Due To Seller 201. Deposits or earnest money 501. Excess deposit (see instructions) 202. Principal amount of new loan(s) 502. Settlement charges to seller (line 1400) 568 39 203. Existing loan(s) taken subject to 503. Existing loan(s) taken subject to . 204. 205 Partial Distributive Sh fr E f 504. Payoff of first mortgage loan . are om state o Seller 22,000.00 505. Payoff of second mortgage loan 206. 506. 207' 208 507. Partial Distributive Share from Estate of Seller 22,000.00 . 508. 209. 509. Adjustments for items unpaid by seller Adjustments for items unpaid by seller 210. City/town taxes to 510. City/town taxes to 211. County taxes to 511. County taxes to 212. Assessments to 512. Assessments to 213. School Tax 07/01/1 I to 08/10/11 67.19 513. School Tax 07/01/11 to 08/1 0/11 67 19 214. . 514. . 215. 515. - 216. 516. 217. 517. 218. 518. -- 219. 519. - 220. Total Paid By/For Borrower 22,067.19 520. Total Reduction Amount Due Seller 22,635.58 300. Cash At Settlement From/To Borrower 600. Cash At Settlement To/F,'om Seller 301. Gross Amount due from borrower (line 120) 302 Less amounts aid b /for b li 22 55,762.07 601. Gross Amount due to seller (line 420) 55,049.07 . p y orrower ( ne 0) ( 22,067.19 602. Less reductions in amt. due seller (line 520) ( 22,635.58) 303. Cash X^ From ^ To Borrower $ 33,694.88 603. Cash X^ To ^ From Seller $ 32,4] 3.49 - ~ - -- --- -° -•~-- ~ ~-•••-~~~~~~• ~.~.~.,.~,,, ,,,~ ,~ me ucsr m my tmowteage ana Dauer, n is a true and accurate statement of all receipts and disbursements made on my account or by me in tltis transaction. I further certify that I have received a completed copy of pages I and 2 of this HUD-1 Settlement Statement. Borrower Thomas R. Sherman Seller Thomas R. Sherman, Exec Estate of Ro}' E. Sherman Borrower Lori A. Sherman Seller SETTLEMENT AGENT CERTIFICATION Seller's Tazpayer Identification Number Solicitation sod Certification The HUD• I Settlement Stuement which I have prepared is a true and aaurate account of this transaction. I have You are required 6y law to provide the Settlement Agent named above with your correct taxpayer identification caused the funds to be disbursed in accordance with this statement. number. If yyou do not provde the Settlement Anent with your correct taxpayer identification number, you may be subject to civil or criminal penalties impo , by law. 1Jnderpmelties or perjury, I certify that the number shown on this statement is my wrrect taxpayer rdenfifiration number. Settlement Agent Date WARNING: It is a crime to Imowindy make false statements to the United States on this or any other similar form Penalties upon convwtion can include a fins and imprisonment For debits see: Title 18 U.S. Code secuon 1001 and Settion 1010. Seller's Si ature Date HUD - 1 3/91 RESPA, HB 4305.2 -_- -__ L. Settlement Charges Paee 2 _iVU. Total Sales/Broker's Commission based on $ @ %= 0.0 0 Paid-From Paid From llrvision of Commission (line 700) as follows: Borrower's F d Sel-er's 701. $ to un s at Settlement Funds at Settlement 702. $ _ to 703. Commission paid at Settlement 0.00 704. 800. Items Payable in Connection With Loan 801. Loan Origination Fee 802. Loan Discount % 803. Appraisal Fee to 804. Credit Report to 805. Lender's Inspection Fee to 806. Mortgage Insurance Application Fee to 807. Flood certification 808. 809. 810. 811. 900. Items Required By Lender To Be Paid In Advance 901. Interest from to @ $ /day 902. Mortgage Insurance Premium for months to 903. Hazard Insurance Premium for years to 904. 905. 1000. Reserves Deposited With Lender 1001. Hazard Insurance s per 1002. Mortgage Insurance s @ per 1003. City property taxes s @ per 1004. County property taxes s per 1005. Annual assessments s @ per 1006. School Taxes s @ per 1007. s per 1008. A re ate Adjustment 1100. Title Charges 1101. Settlement or closing fee to 1102. Abstract or title search to 1103. Title examination to 1104. Title insurance binder to 1105. Document preparation to Joel R. Zullinger, Esquire (settlement sheet) 100.00 1106. Notary's fees to 1107. Attorney's fees to (includes above items numbers: ) 1108. Title insurance to (includes above items numbers: ) 1109. Lender's coverage $ 1 110. Owner's coverage $ 1111. 1112. 1113. 1200. Government Recording and Transfer Charges 1201. Recording fees: Deed $ 63.00; Mortgage $ ;Releases $ 63.00 0.00 1202. City/county tax/stamps: Deed $ 550.00 ;Mortgage $ 550.00 0.00 1203. State tax/stamps: Deed $ 550.00 ;Mortgage $ 0.00 550 00 1204. . 1205. 130(1. Additional Settlement Char es 1301. Required services you can shop for _ 1302. 1303. Final Sewer to: CFJMA - 18.39 1304. 1305. 1306. 1307. - 1308. 1309. o..~ou,c^^^cu^ ~.nnryc~ teuaer on ones 1VJ~ AeCilOn J and SUl~ JCCtlon K) 713.00 568 39 Initial Escrow Account Statement Required by Section 10 (c) (1) of the Real Estate Settlement Procedures Act (RESPA) ]f checked, ~ the terms of your loan require you to have an escrow account to assure that the certain obligations relating to the mortgaged property, such as taxes, insurance premiums and other charges are paid. The amount specified below will be collected, along with your mortgage principal and interest payments, during the first 12 months after your account is opened to pay these anticipated expenses: FstrowAoootmt Begiuaing Date: Your escrow account payment will be $ per Payee Purpose Anticipated Due Date Estimated Amount HUD - 13/91 RESPA, HB 4305.2 3/28/2011 Dan Hershey Auctioneering Service 790 W. High St Carlisle PA 17013 717-532-4647 Estate Appraisal Report Ronda Carroll Marlin Model 25 22 $110.00 Remington Mode1788 22-250 $450.00 Arc welder $60.00 Makita rechargeable drill $40.00 2 Floor j acks $45.00 Welding helmet $10.00 Grill $5.00 Funnels $2.00 Creeper $12.00 White 42in Cut 13hp $225.00 25in TV $10.00 Harley Motorcycle Set $35.00 - ~~ Tom Sherman Winchester Mode137 20 ga. $150.00 North American arms 22 revolver $225.00 Hover Round $300.00 4 Wheel scooter $400.00 Air compressor $75.00 Car Ramps $15.00 Misc lot of hand tools $150.00 Dixion 3 Oin cut l Ohp $175.00 Lot of 4 Guitars $400.00 , _, Harley Motorcycle Set $35.00 Tammy Sherman Husgvarna snow blower $400.00 Craftmatic bed $175.00 Heater $3 5.00 Cutco Knife set $70.00 Harley Motorcycle Set $35.00 ~ \`~ ~~`~ Appraiser Steve Ege a .. B-22-2011 01:37P FROM: 1996 Dodge Prices, iiaiues & Specs - i~1ADAguides TO: 92641884 P.1 Page 1 of 1 • ~~°rl ~q: l on The Power of Vefllde Informuf I NOME AUTOS CLASSIC CARS MOTORCYCLES BOATS RVs MANUFACTURED 8UY A PRICE GUIDE j j HOMES ZemoaMQke > ChanOaYear ti Model > [Aenae Mileay~.Qpy iDi > value Report 1996 Dodpe Dalcot4 Piekup•i/=Ton-V6 snare ~ prln: ~. email We found 0 1996 f)odpe _ . _ ... b Cab Cl . _ Rough Averq{ie Claen Clean Ilstlnps of this model within u Prfcfn 0 Treda-1 Trode-ln Trade-in Rotell ; Zg mike o/your ZiP Coda i Glick to ON Thom lase Prlee f1,ID0 31,75D i 12,275 54,15D Milesgel 106,000 ;525 5525 ;525 ;525 SLT Pkg i 5175 1175 5175 5200 i i i I TOTAL PRICB 91,800 SIr450 ~Zr975 ~4r~7.5' • Tnlt aa.u pru.l. eal.e en, to[krenQtt . nowt auk.. a.,a7S misukA, j Gtl a EnrtrVitiShscktoa•y. DaA.acu~M Ayl>~a.ck.l.A.uttr_1Ran.tachx. ~; ! Vehlclo History Report j 5lmiler VahIGe9 '. Check Ior Accldentr Nowt :Prose 00 or Enter VIN; ~ :View another va111CFC i ~ View enoMer model ~ituroCi-.ck 4.~.:. :: ::. _. ____.. .. _ ..__.___._I find Your Cer i _ .. _ i :, - Dodpe _ . . i ZIP .172 57 ~ - - ..._ ..... A,~cdn~erelp ~ Soil You- Gr EtsllJSIf.QW. a ~~~~ '® `• Preo lnwronce Quote Qu~ceAlk.Iatn_nnA ~9yli i~Atlstate. _ _~® -:: -- Autn Drotedlon plan j Ece><lnstant_Ru~ia '~ i i ~ ~ hlolaA~kr ...... Pree Auto loan Quob ~~ fdedlt OKI ~~at {l.4' f ~~ ' 9<~1~13N~ ftroo Credit 9cora i `[Lee Online Credit Score !~ ~.~ <. Dlticlaintar Home ~ Medle Room ~ About Us ~ Help/FAQ ~ Contact Us ~ Advertise (link to Us ~ Buy a Price Gukie ~ Business Users ~ Chnnpa 2iP I Follow Us 0 OCeDYgphl ]Ott -MOAQuIq/.COm. AM RIpIHS Ruarv~O. CopYrIOM 1 -nVA[y rotltY O]OOW]OI1 G»ttu Syrtupt Cerpowtkn. httn://wwwe.naaaguiaes conv~;arsi 1 yyo~lio'dge/Dakota-Pickup- l -2-Ton-V6/Ciub-Cab/Values 2/22/2011 FEB-22-2011 01:37P FROM: 1992 Chrysler Prices, Values & Specs - NADAguides TO : X32641884 P . 2 Page 1 of 1 I ,. ~ADA~ " :lR~i(fidK~s Ths Povvsr of Vshlcb (rtlormatlan ~....: HOME AUTOS CLASSIC CARS MOTORCYCLES BOATS RVB MANUFACTURED BUY A PRICE GUIDE HOMES , CppDp4jgp~ ~ Chenae YeerAh.19G0! ~ ChnllBsLt331saoe tl Ootlone a Velue Repoli We found 0 1992 ChryslRr Labatron On. emasl t dsen 4',9 orln 1992 Qlryekr Convertible 2D aouph Avarepo _ aot+n _ Clean IlStinOs Of lhNi nl0del wlthln Prleinp Trodo-in Trads-fin Trado-In aolell ~ 23 miles of Your ZIP code CIIcN to 80o Thom : t-asa Prla N/A 5550 f850 ;1,825 I Milosges 96,000 5425 ;425 5425 ;425 Vehldo Hlatory Report Slmltar Vttftlele9 Check for Acddontr Now' : , ' Prese GO or Enter VItJi ° : Vlaw another vehN:te ' ` Vlew enothar modal /~0.~4 ' ` Pind Your Car - ------ . ; OhryakK I j '. _. __... _.... -- -._ ......... .. i ZIP .172- 97 ~`j ~ Anedl~+tdee~i ~ • I :Sall Your Car s.,:.al~.n~w '..... ~. Ai7rtd/~atlYcr~ Froe Inauronn Quob I QlLLQ1411IlStRtE..I1041..SAXL t~Ailstat~, Auto P-otectlon Plen . Fr_ra~.axiont_Qul+Ss i : 7~l±io~aAlab ~~ ~ i ~..... .... _.. _.._ Frao Auto loan Quota @a~C[tdit OKl ..~,; ~ siSiihi0h~ •® ,. :Free Godit Score I Free Online Credl Scare i I I I I .TOTAL PRICC N/A 5975 X1,275 t2,.25_Q' I • Thp Ntltll pr/Cta N D~fW On I t7fa•te vORIN~ nlsttln~Qpj . Oon'I mOLO • 12,250 ml~tsRa ca . ftwl..Yll1_~ttKN ~+Y~ FlMLQSe..ttlsr.NntipplacllJf ttatu.tb.tn fd:ddx. 1)IUtetntt:r Homc ~ Medle fioom 14hout Ue I Help/FAQ ([nosed Us I Advertise I Unk t0 lls l BuY a Prlee Guide I BI»Inese Users I Chenpa 2IP I Follow US OCuVYrtpht 7011 p110AQu{dtl cem. Aq RIQtM~ RONrvOd, CDOYnQRt I Vnv~ty iOllry O20DD•2D3 t C.hmmO 4ppm0 CtupO~~tbn. http://wwwenaua~uiu Smco i~~, 2 ? 1 y ~ 5 7~uysler/Lebaron/Convertible-2D/Values 2/22/2011 FEB-22-2011 01:37P FROM: T0:!~2641884 P.3 1996 Nissan Prices, Values & Specs - NADAguides - Page i of ..^I; ,: Ths Power of Vahlcta lntanrtallon .. r::: '• HOME AUTOS CLASSIC CARS MOTORCYCLES BOATS RVS MANUFACTURED BUY A PRICE GUIDE HOMHS ~,p~ek0 > ~QQe Year d MoGd > ~pOp>~.tl8lhpa a oo2mne s value RaPort ~ 1496 NI>tsan M~YlrnaA-V6 yea /piles 0 than ~ print ~ smell 1996 Nicean G IlstinOs of Ifils model within Clean j I Sedan 4D SE I Priei ng ouph Trade-I Avarepe Trade-In man Trsdo-In Rotall I 25 miles of your ZIP coda I i i ! d1cN 10 0w TAam i saes Price j ;856 ;1,525 ;2,075 13.925: MIIOnlpal 167,000 N/A N/A N/A N/A I i i I 'TOTAL PRICE ;850 ;1,825 ;2,075 4.3,6~5~. • Tah 0.Rd1 pAt~ q bOt00 on a dlco~ttIIEtl!!llu~Qnu . uon't makrl a i7,a23 mgt•k•. Ge[ a crltwrYfn.Gltit:k toew• fintlavt wrv..Avt000tt[k.ILWStOr_thin~lAliM. Vahtda Nistory Report Slmiler Vehicles Chsck for Acddonts how, ! • ~Prass GO or Gnla VINE ~ ; Vtew another vehicle i V1ew another model i ! /dufoChltk ~~ i "`"" i~ Rind Your Car ~I.-......._ i. i i NbOan _ ... _.._ . _ _ ~ ._. _ .. _.... . ZIP'17257 i I Au~c6l~iaere~ ~ ~ :Sall Your Car ~1.~.li0.k'l A M~.aerY®c °® Prea Ineuranq Quota Quat~Al4~toitt_anG_S.nye t~- Altst~Re. ~: Auto Proteetlon Dlan F.rae.lasisant_Quatn :. ~ ~~ ! ' _..- ---.._..... _ ... i Free Auto Losn Quote Boyyd C{Zdit OKl a~OtU~~h~ _ '~. i --- .. :- ----~---~ i Free Credit Scoro i i ; ~4.p QaIIl1~.Credit SCQrE . ~~ plstlalrrlor Homo I Meala Room (At»ut Vo I Help/FAQ I Contact Us I AGvertlse I Unk to Uo I Buy a Prlee Guide (Businesf Users I ChanOe ZIP ~ Follow Us OCovwgM 2011 NAOAaulda.mm, Act 0.gAU 0.,wrr~0. CaaY,k~t I /nncy Potlry 02000-2011 t7norn~fY~t~m, Corpontbn. http://wwweriaaaguiaesmcomii, 2si lyyo ~vissan/Maxima-V6/Sedan-4D-SE/Values 2/22/2011 FEB-22-2011 01:38P FROM: T0:~32E41884 P.4 2000 Tomos SPRINT - 49cc Standard Equipment, Prices 8c Specs - NADAguides Rage 1 of i ~- ::-. :~A " ' 1~~~' The Power a( Vehlds irtfcrmoflon i HOME AUTOS CLASSIC CARS MOTORCYCLES 60ATS RVs MANUFACTUR81> 8UY A PRICE GUID@ HOMES ~! > Chanaa Veer B Model > Cltenoa Ootlo~s > Standard lqulpmant 2000 Tomos rnaro ~prtnt OA._eman SPRINT ~ pricin Suppostod tow Avaraga 9 List Prlt:o Retai ' Ratoll 'Base 4rice 11,000 5150 3200 i j Optlonn (ad0.Cp114fIS) TOTAL PRICC ;100... _ _ , 1200 ... .. .. NADA Ides Gasel4eds ! pu ~ Spaclf7catlons Build f! Compare ! . SskfSh.tflLl3utgtsYSls6.And I ~.r~ ; 5tanaanl Equipment ! Bulid Another Vehicle Special Notes ;Compare Vehicles "'-trlar ~ See Other VehlGes ' • ~ ~ Select Another TrYn ~~ ® I Motorcycle History -- - - Report ~ _ I Standard lqulpmant ~tatalls -~ ~': Press 00 w EntarVlN ! Enpins 9peclficstlons (;~~L':, pisplacement (crl: 49 ! i Cyiindars: 1 .m ! Engine Stroke: 2 _ ... _ ... _ -- _ .. _ .. -....- ' _ _ Speeds : 2 Speed I Lnsure Your Vehicle ~ Transmlaslon SpaNflcatlone Frrw Qr-Ilne tns~rnn[n i Number Ot synods: 2 Spend ! ~ ~e I Dry Wolgbt pbs.): 110 A4001f~/Yf ! I Value t?xplanatlons ' :Know your Gadlt Prices shown sro retell consumer values and era to ba considered as selling Drices. Trade-In values Htetory I are to be Determined oy local dealers and ere generatry lower lean values shown. I ~jsq~jun.~ ~r ,QIS..~Cl?SZK.BtI ~09aatad Llat -The manufaehrrora (dicMtwto») hlgheat su90estod Ilst p*tcn In tho U.S.A. i ~~ I when the unit wao new. Unless indkated, the augyested Iist price dons not Include destlnatlott ! ; ! charges, dealer sat'up, state orloeal taxes, Ilcenae ceps or Insuronee. ~i ~, i ... _. . _.. .. .....! Low Retell Yalua - A low retell unit may have extenahro weer and tear. Body parts may have '•, Strap for ^ Motorcycle ~ dents and blemishes. The buyer can expeet to Invest In cosmetic sad/or mschenkal work. This I vehicle should ba In seta runntn0 order. Low rctall vehktes usvalry an: not found on dealer lots. i ~ Find v''o^^ur rnatorcvele Low Recall le not trade-In vdus. i v~'~-"' Average Recall Value - An average rttall unit should be clean wkhout obvious defects. All m ' rubber end cables should be in good condlllon. The paint should match and have D pond nnlsh. All . ... _ lights and awltches should work properly. Tltn mllea0e should he wkhln or ellytttly hlOhar than l.ha 'Sell Year Nocorcyel• ~ average range. This unit should also pans env emission Inspection. SCA.IL.,NO.w. GyRclct'11aclor ~® ' Shlp Your Notorcycle rTA~4.~11111pk19.~9ffi ;: irssio Home (Media Raom I Ahout Us 1 Help/FAQ 1 Contact Us 1 Advertise (Link to Us i Buy a Pr[ce Guide i Bvalness Users i ChanOa Z1p 1 Follow Us d OrnDYnQM 7D11 1UQAQaNu,toal. AR Rghlr R~rv~d. CoPYnOM 1 rrNrry rolrty 02000.7011 CArems 6YSUml torparrtbn, httn://www.naoa~uiaes cor vivioioicycieSi~v00/Tomos/SPRINT-49cc/Standard-Equipment 2/22/2011 FEB-22-2011 81:38P FROM: T0:926~188~ P-5 X978 Holida3~ Rambler T27=?27RBLL-FORD - 27'5" Standard Equipment, Prices & Spec.,. Yage 1 ot~ 1 .N~ •~ - - 3 ""'` Ths ~ovrsr of Vshlda Itdnrmatlon HOME AUTOS CLASSIC CARS MOTORCYCLES BOATS RV>o MANUFACTURED BUV A PRICE GUIDE HOMES f,AenDd.lieatttnuursc > ~I1D" Year r! Model > t~tartae Q~ns > ~rndard Equlpmant 1978 Holiday Rambler share Cqp print ~ ernes T27-127A6LL-FORD - 27'6" - 6upgestad Lo Avsrags Prlcin® List Price Re Rotalt i ! pas Priui 520,275 51,000 =1,100 ':, i Milssyet a7,00a N/A N/A i Optlonsr (odd onUonsl i i ;TOTAL PRICE #20,175 }1,000 E1,200 `:. Finance your RV ; Prlcinp A Specs Similar Vehldes Fend a loon ? Standard EQulpment ~ View another RV 5peclal Motes Know your Credit !History ' I j ': Fran OnIIIIe Credit Reoort 9~ Scorn I Standard Equipment Oatsila ~~ ~ .~ '~ i Length --.. _...- -----~-- - 2Tli" i Buy sn RV 6sp-Containsd R1C~_64s;a1lfs~II9_ti1S~tOL i ~ Yes s ` ~~ i ~ !iii 511dss i WA !• ~ Sell sn RV - - Floor PI\n Raer Bathroom ~q voLr new ar used RV ~ Coach Msign p~~r~~~~ ~ m MMH i Ltir a,iANO+ ~.rnr gAtk to too lYtended Wa-rsnty fsLGs99_SAtn..ExianQad ~ Vslus EYplsnetlons . ! Sllo1lce.ptutosti0.0 ~ Prices shown ore rated consumer values and ro be consldenrrl es selling prkes. Tretde•in values aro i A ~ to be determined by Nx:al Beaters end are genersUy lower than values shown. 9upputed Llst -The value listed nenetts the opproYlmato prloe of the unit when It Is brand now. -- -.... ;_..._.. ~ .. '.. .: --=~ - ~ , 71te prkos Ilst¢d aro furnished Dy the manufacturer end ara assumed to ba eomeet. e t p e i loin the Oood Ssm Club does not Indude fralOM charges, ' ~ Lowt- Rstall Value - A low retail unit may have ertanslva wear end tear. Body parts may have . ~iet_n]t?Aey~seving ~ i dents and blemishes. The buyer can expect to invest to eosmetk and/or mechanical work. This Q~~4YDSS vehkla shaukJ be M ooPlt runnlnp order, low retail vehkles usually ara not found on denier lots. ' ? ~ I Low retail is not ^ trade-In value. ~ n end without glaring detects. k! b d .... _ _ _ ... ea e ` Avsrsge Rstall Value - An average retell vehlda shoo Tints and grass should tx! In gooA conditlan. The paint shook! match and have a good fiMsh. The Interior shook! have wear In relatbn to the age of the vehkle. Cerptt and seat upholstery should bn dean, and oil power options shook! work. The mileego shook! be within the eccnptsbla range for the madei year, An Average Rstall vehlGe on a dealer lot rosy Include a nmlted warranty or puarentae, and possibly a current safety end/or amisslon tnspectbn (where aD011cabie~. Noul Vahictes with bw mileage that are M ezcopnonally good wrnlAion con be north o slgnlRcontly higher value then the Average Rstall prico shown. Horns (Medto Room I About US ~ Help/FAQ ~ Contact Us (Adv¢rtlso I Unk to U9 ~ Buy a Prtca Guido ~ Business Usors ~ Chango "LIP i Follow Us i6eovynsFt tot t Nswovlass.rers. su AqM. e.s.rv.s, cavrrlam 1 vnvay roan otaoo•tott Urams errnnu Cervo.M4^• http://~vwwenaaaguioesmconvnv si ly i~ ~rioiiday-Rambler/T27-127RBLL-FORD-276/Stand... 2/22/2011 ~FEB-28-2011(MON) 12:39 Joel R. Zullinger, Esq. Zullinger-Davis Law Of.Cices 14 North Main Street Suite 200 Charnbersburg, PA 17201. Fax 264-1884 February 28, 2011 Rc: Estate of Roy E. Sherman Social Security Number 204-28-0364 Date of Death February 5, 2011 1?' IS ~IE~12.SY CERTIFIED THAT TINE ABOVE NAMED ,D.EC,EDENT HAD THE FOLLOW.fNG ACCOUNTS WITH ORRS7'OWN BA11i'K: CF1'ECKING ACCOUNT Account No. - 338931 Account'T'ype - Relation Irit Check Date Opened - 3 / 1 / 81 Joint Account (name /date) - Thomas R. Sherman 12 / 18 / 09 Balance - ~ $13,089.17 Accrued Interest - x•28 ,SAVINGS ACCO UN~' Account No. - Aecount Type ~- Date Opened - Joint Account (name/ date) - Balance - Accrued Interest - (.~~~~STO~'1lN ~~~ A Trntlition cf Excellence 703003855 Statement Savings 10/31/OS Thomas R. Sherman 12 / 18 / 09 $24,115.34 $]..58 Best Regards, Vicki L. Gullixon Customer Service Specialist 77 East King Streei P.O. Box 25~ Shippensburg, PA 1725 i 1.888.ORRSTOW~ v~rv~ar.~~r~t~~+r~a.c®~ Received Time Feb. 28. 1;~7PM P. 001 /001