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HomeMy WebLinkAbout12-05-11 (3) 1505610140 REV-1500 EX `°'-'°' OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN Po Box 28oso1 2 1 1 1 0 3 3 8 Harrisburg PA 17128-0601 RESIDENT_DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYW Date of Birth MMDDYYYY 1 8 6 3 0 6 6 9 3 0 3 0 5 2 0 1 1 D 4 2 8 1 9 2 5 Decedent's Last Name Suffix Decedent's First Name MI M E N T Z E R S R W I L L I A M F (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name: Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS MI 1. Original Return ^ 2. Supplemental Return ^ 3. Remainder Return (date of death prior to 12-13-82) ^ 4. Limited Estate ^ 4a. Future Interest Compromise (date of ^ :5. Federal Estate Tax Return Required death after 12-12-82) ~ O 6. Decedent Died Testate ^ 7. Decedent Maintained a Living Trust B. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) ^ 9. Litigation Proceeds Received ^ 10. Spousal Poverty Credit (date of death ^ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number D O N N A L G O D F R E Y E S Q 7 1 7 4 2 2 7 8 6 5 First line of address 1 1 2 2 F L E E T W O O D Second line of address City or Post Office C A R L I S L E D R I V E State ZIP Code P A 1 7 0 1 3 Correspondent's a-mail address: GODFREYESQUIREI~.AOL.COM "~C;J ;., _,~ x Y`~ ~ `: ,, ..,. r-T°s L __. ~..7 t Under pe Ri of perjury, 1 deGare that I h xamined return, including acx:ompanying schedules and statements, and to the best of my knowledge and belief, it is tru co and complete. Dedaratio f pa oth than the personal representative is based on all information of which preparer has any knowledge. SIG U OF PERSON RESPONSIB OR ILIN E RN DATE of ~ .~ ~- 12/5/2011 3 ARBOR DRIVE BOILING SPRINGS PA 17007 S U OF PREPARER O HER HAN REP ESENTATI DATE ~,. „ ~ '~ ~ e .~t.~ o ._, 12 / 5 / 2 011 1122 FLEETWOOD DRIVE CARLISLE PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 1505610140 1505610140 REGISTER OF WILLS USE ONLY C7 ' . .~- U _,_. ~~:.-~~ F.... ~ `TS r 'Yi -r-r~C7 t'~ F i-rz I %~c%~ ~~ r~' 3 C~ ~' ~ ~. ,a~ .. J 1505610240 REV-1500 EX Dec:edent's Social Security Number 1 8 6 3 0 6 6 9 3 DecedenrsName: WILLIAM F- MENTZER ~ SR RECAPITULATION 0. 0 0 1. ......................................... Real Estate (Schedule A) .. 1' 8 9 6 8. 8 0 2. Stocks and Bonds (Schedule B) .................................... .. 2• 0. 0 0 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ... .. 3. 0. 0 0 4. Mortgages and Notes Receivable (Schedule D) ........................ .. 4. 6 8 1 9 2. 5 9 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E).... ... 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested .... ... 6. 0. 0 0 7. Inter-Vivos Transfers & Miscellaneous N n-Probate Property uested Re Billin t ~ S 7 0 • ~ ~ .... g q epara e (Schedule G) . ... 8 7 7 1 6 1 . 3 9 8. Total Gross Assets (total Lines 1 through 7) ........................ ... . 9 1 7 8 4 5. 9 3 9. Funeral Expenses and Administrative Costs (Schedule H) . 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) .... ....... .. 10. 6 8 2 2 . 9 1 11. Total Deductions (total Lines 9 and 10) ...................... ....... .. 11. 2 4 6 6 8 . 8 4 12. Net Value of Estate (Line 8 minus Line 11) ................... ....... .. 12. 5 2 4 9 2 . 5 5 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ............. ....... .. 13. 14. ... ......... Net Value Subject to Tax (Line 12 minus Line 13) ....... ..14. 5 2 4 9 2 . 5 5 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 0 (a)(1.2) x.o _ 16. Amount of Line 14 taxable 1 0 0 0 0 16 2 3 6 2. 1 7 at lineal rate X .045 . 17. Amount of Line 14 taxable ~ 0 ~ 17 0 • ~ ~ at sibling rate X .12 18. Amount of Line 14 taxable ~ 0 ~ 18 0 • 0 ~ at collateral rate X .15 . 19 2 3 6 2. 1 7 19. .......................................... TAX DUE ........ . .. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ^ Side 2 1505610240 /505610240 Tax Payments and Credits: ~. Tax Due (Page 2, Line 19) 2. CreditslPayments 2,060.00 A. Prior Payments B. Discount 103.00 3. Interest 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (1) 2,362.17 Total Credits (A + E3) (2) 2,163.00 (4) (3) 0.00 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 199.17 Make check payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred : ................................................................. ..... ~ O X 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 ^ without receiving adequate consideration? ................................................................................. h? ...... ^ ... 3. Did decedent own an "in trust for" or payable-upon~Jeath bank account or security at his or her deat ...... Did decedent own an individual retirement account, annuity or other non-probate property, which 4 . contains a beneficiary designation? ............................................................................................ ...... ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1,1994, and before Jan. 1,1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after Jan. 1,1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the si:atutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an adoptive parent or a stepparent of the child is 0 percent [72 P.S. §9116(a)(1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. File Number REV-1.500 EX Page 3 21 11 0338 Decedent's Complete Address: _ Mar .1 09:08a JACK RDRMS 258-5670 p.1 LAST WILL AND TESTAMENT OF WILLIAM F. MENTZER, SR. I, WILLIAM F. MENTZER, SR., Cumberland County, mind, memory and Pennsylvania, being of sound and disposing derstanding, do hereby make, publish and declare this as and for un my Last Will and Testament, hereby revoking all other wills and `•.=y"----s --=-Div-i_... ..<~v '_ -_^ FIRSL I direct the payment of my debts and the expenses of my last illness and funeral from my estate as soon after my death as '1 conveniently may be done. Further, in this connection, I authoY-ize my personal re resenta~i~e t~ ~xpenti fiii•1ds froffi my est~t~, ih such ameunt as my ~. P .and desirable for personal representative shall consider necessary ~,! the urohase- ereet~.on and inscription of a suitable marker~~or my A grave. SECOND I give, devise and bes~ueath g~' e*`tire estate :~f "=~a`e-==- '~' _:-._.-` da s. Should my wife. prede:.ease =~'_ ~- surv ive me by thirty ( 3 0 ) Y ail to survive me by thirty (30) days, then I give, devise and f bequeath all of my estate of whatever nature or wherever situate unto my children, WILLIAM F. MENTZER, JR., JEREMIAH L. MENTZER, DOROTHEA ADAMS and CRISTINE gCtiROEDER, per stirpes: i ~: ~, Mar it 09:OSa JRCK RDRMS 258-5670 MENTZER, as Executrix of this my Last k=ill and iest.anert. Shcuid my wife fail to qualify or cease to act as Executrix, I appoint my children, WILLIAM F. MENTZER, JR., and JEREMf~$ L. MENTZER, DOROTHEA ADAMS and CRISTINE SCHROEDER, Co-Executors of this my Last Will and Testament. It is my understanding that my children will not receive compensation for their services as they are all sharing equally in my Will . T relieve my personal represert.a _v~ =--r~ _~ _ necessity of posting securi4y r~ conr.e;:ti ;.. ~~'-: ____ .:.:_:,__ .s =_.-. in any jurisdiction in which he may be called upon to act insofar :~ as I am able by Iaw to dv so. FOURTH zn addit©n to the powers Ct~tlfe~`~'ec~ by law, I authorize my Executrix in her absolute discretion: A. To retain in the form received and to sell either at ;~ public or private sale any real or personal property. ~' B. To manage real estate. C. To invest and reinvest in all forms of property without being confined to legal investments, and without regard to -~ ~...... _,"..,.~.t.....~ ..a .___~.~....__~,.,.~,._...... N II. Ta exercise any cNtion or _-~:.~s aY___-_ ___-. ~. ~ ownership Of iri~te~trnetits . E. To compromise claims without court approval, and ~,~ without the consent of any beneficiary. ;': ~; 1~' p.2 - - - - 258-5670 Mar 11 09:OEa JRCK RDRMS tc ~_~-~, Lss - _- - typewritten pages, the first t°~a (2} which bear ,.~;~ sgr.~atura in =rz margin for the purpose of identification, this the day of p.3 1994. _ i?i J . ~ ~,~,~~/,fir ,rte' ~ f• (SEAL) WILLIAM F. ENTZER,. SR. ~~`'. r -~~.~ Signed, sealed, pual;.sh et] dilfl ~~~ ~ C:rCa '•~.•_ ~••••• testator WILLIAM F. MEDTTZER, SR., as and for his bast Will and Testament, in the presence of us, who, at his request, in his sight and presence, and in the sight and presence of each other, have hereunto subscribed our names as witnesses. ~'~ `' ~ ~~~ ~ N,.~---~ ADDRESS ~ ~ ~ ~~ 3~ ~ -~ ~~ •~'''~~r ~ ~-'L ADDRESS ~ - REV-?503 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF FILE NUMBER WILLIAM F. MENTZER SR 21 11 0338 All property jointly-owned with right of survivorship must be discbsed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1, OPPENHEIMER EQUITY INCOME FUND 4,625.64 441.378 SHARES @ $10.48 PER SHARE AS OF 3/4/2011 2. PRUDENTIAL FINANCIAL, INC 68 SHARES @ $63.87 PER SHARE AS OF 3/4/2011 TOTAL (Also enter on line: 2, Recapitulation) I S (If more space is needed, insert additional sheets of the same size) 4,343.16 October 28, 2011 ~m~~~n~~~~nun~~n~~n~~~ii~~~nn~~n~i~n~i~n~i~u~~i~ Donna L. Godfrey 1122 Fleetwood Dr. Carlisle, PA 17013-3512 Dear Ms. Godfrey: ~~PPenh~ime~~u~d~ OppenheimerFunds Services ~- Division of OppenheimerFurxls, Inc. P~.O. Box 5270 C)enver, CO 80217-5270 www.oppenheimerfunds.com Thank you for informing us that William F. Mentzer, Sr. passed away. Please extend our condolences to their family. Mr. Mentzer's only open account was a joint tenancy with right of survivorship, not tenants in common (JT TEN WROS NOT TC) account, which is currently registered as follows: 008354000591965 Oppenheimer Equity Income Fund, Inc. - Class A Shares WILLIAM F MENTZER SR & LENA M MENTZER JT TEN WROS NOT TC The account was opened on October 1, 1968. Note than effective August 18, 2011, the account number changed from ~~~to as a result of a Fund reorganization, approved by the shareholders of Oppenheimer Balanced Funrl. Please contact us if you would like any additional information about the Fund merger. The date-of--death account value was requested in your correspondence. Although Mr. Mentzer passed away on a Saturday, and no market trading occurred on that date, we are pleased to provide you with the account value as of the preceding business day. As of March 4, 2011, the total dollar value of account number 002404000591965 was $4,625.64, based on 441.378 shares and a share price of $10.48 per share at Net Asset Value (NAV). To transfer the account assets to the estate of William F. Mentzer Sr., we ;,eed the fallovdirsg items submitted to us: A Letter of Instruction from Dorothea S. Adams as the appointed executor for the estate of Mr. Iventzer, stating speciricaliy what should be done and signed in her of~ciai legal capacity. A photocopy of the death certificate for Lena Mentzer. And one of the following: ®A completed and signed Account Application for the estate of Mr. Mentrer, providing the estate's account information and Ms. Adams' information as executor if the assets are going to remain invested in OppenheimerFunds mutual funds. We are unable to rep°egister the account using the deceased shareholder's Social Security Number. Please contact'the IRS at www.irs. _ ov or 1-866-816-2065 to apply for the estate's Taxpayer Identifiication Number. We have enclosed an Account Application for your use. Or A Form W-9, completed and signed with the estate's Taxpayer Identification Number, if the assets are to be redeemed immediately. We have enclosed a Form W-9 for your use. Once completed, please mail the required paperwork to us referencing ID(JC# 205494422, our internal tracking number for the original documentation, in the enclosed postage-paid reply envelope. Alternately, the paperwork may be faxed to us at 303-768-1500. After we receive the required documentation, we will be pleased to honor your request. If you have any questions or need additional assistance, please email us via the "Contact Us" section of our website, www.oppenheimerfunds.coin, or call us at 1-800-CALL-OPP (225-5677). We are available Monday through Friday from 8:00 a.m. to 8:00 p.m. Eastern Time. We will be glad to assist you. Sincerely, D. Gingrich OppenheimerFunds, Inc. The Right YYay to Incest Encl: Forzr. W-•9 Account Application Postage-Paid Reply Envelope IDOC# 205494422 Prudential IMPORTANT TAX RETURN DOCUMENT ENCLOSED 000ooo/oaalne 8 417 7 8 Recipient WILLIAM F MENTZER SR 531 E SPRINGVILLE RD BOILING SPRGS PA 17007-9715 mputershare Computershare PO Box 43033 Providence, RI 02940-3033 Within USA, US territories 8 Canada 800 305 9404 Outside USA, US territories tr Canada 732 512 3782 vrww.computershare.com~nvestor ~ HolderAcc:ount Number 0001 X3922616 I N D iiii~ Recorc! Oatra Nov 23 2010 Cfieck Number 0010874550 t3SNfTIN 6`ertified _ . yam- ._, q0I 050107 DOAtLNf3FQS_POI PRt7.019R52 10~'g4177&PA 177R7i .~: ~s~....xs x - a.~~-vw.rva:~~u~.+~rsc wavsmm .. v~+raruzmr.~u~:arnaaa~e:~~rmurxa~r~wrwew<,«ws a4a ..ew:.rw~., n~ -, Prudential Financial, Inc. -Combined Dividend Payment 1.2010 Tax Form 1099-DIV „.~ ~ . , . ~ corrected c~ cf>eclted) Form 1099 -DIV -Dividends and Distributions 2010 Copy B -For Recipient This K importard taK Information and ~ burg ftenislred to the Internal Revenue Service. H you are required to BIe a rehxn, a negligence penaky or otlrer sarrctlorr may be hrposed on you iF this Inrwrne k iaxabte acrd the IRS detennirres tlrat it has not been reported. Recipient WILLIAM F MENTZER SR 531 E SPRINGVILLE RD BOILING SPRGS PA 17007-9715 Account Number 00013922816 Recipient's ID No. ending in "'='•6893 Payer's Federal ID No. 22.3703799 OMB No. 1545-0110 Deparhnant of the Treasury - IMemal Rovenue Service i'a Total Ordinary to QualiSed a ~ Nondividend 4 FEDERAL INCOME s ''Foreign Tax ~f Foreign Courttry ~J Cash t.iq~lbn Dividends ($) Dividends {$} Distributions ($} TAX WITHHELD (S) Paid ($) I oru.S. Possession I Disni. ($) Payer's Details 78.20 78.20 0.00 0.00 0.00 PRUDENTIAL FINANCIAL INC 010 COMPUTERSHARE P.O. BOX 43010 i PROVIDENCE RI 02940-3010 Form 1099-DIV (Keep for your records) Dividend Confirmation Payment Date I Class Description Partici atin ShareslUnits ( Dividend Rate I Gross Dividend ($) I Deduction Amount ($) I Deduction Type I Net Dividend ~$) 17 Dec 2010 ~' COMMON 68 Year-To•Date Pald $1.15000 78.20 78.20 0.00 0.00 N1A 78.20 78.20 46UTX P R U "'~" OORX6A-PP-(F2) ` Dow i~0.01 % Nasdaq ~ 0.03 Prudential Financial, Inc. (PRU) On Dec 2: 50.40 4o.aato.asil PRU HIStOrICaI Pnc@S Get Historical Prices for. GO ___ _____ Set Date Range r~ Daily Start Date: Mar 4 2001 Eg. Jan 1,2010 ;`~ Weekly End Date: Mar s 5 2011 ;.' Monthly ~,~ Dividends Only Get Prices Firsi ~ ?reviaus ~ Next ~ Last Prices Date Open High Low Close Volume Adj Close" Mar 4, 2011 64.42 64.63 63.10 63.87 3,803,700 62.0a~ http://finance.yahoo.com/q/hp?s=PRU&a=02&b=4&c=2001 &d=02&e=5&f-=2011 &g=d 12/4/2011 REV~1508 EX + (6-98) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER WILLIAM F. MENTZER SR 21 11 0338 Indude the proceeds of Ifigation and the date the proceeds were received by the estate. All propeAy jointly-owned with right of survivorship must be discbsed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. M8~T SAVINGS ACCOUNT 9,459.59 2. M&T CHECKING ACCOUNT 1,674.83 3. CERTIFICATE OF DEPOSIT M&T BANK 33,696.50 4. PERSONAL ITEMS 3,045.25 AUCTION 7/9/2011 SEE ATTACHED AUCTION LOG 5. FARM EQUIPMENT ITEMS 19,287.00 AUCTION 5/7/2011 SEE ATTACHED LOG 6. MED AMERICA LONG TERM CARE FUND 1,029.42 TOTAL (Also enter on line 5, Recapitulation) I E 68,192.59 (If more space is needed, insert additional sheets of the same size) 11/itpC1 ~~~1Qii,ii 499 Mitchell Road, Millsboro, DE 19966 Adjustment Services Phone 888-502-4349 F ax (302) 934-2955 November 14, 20] 1 Donna Y, Godfrey 11222 Fleetwood I)ri~e Carlisle9 P~ 17013 Re: Estate of William F Mentzer Social Security: 186-30-6693 Date of Death: March 5, 2011 Dear Sir or Madam: Per your inquiry on October 23, 2011, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: i . Type of Account Account Number Ownership (Names ofj Opening Date Balance on Date of Death Accrued Interest Total 2. Type of Accaunt Account Number Ownership (Names qfl Opening Date 3alance on Date of Deaiiz Accrued Interest Total Savings Account William F Mentzer Sr Dorothea S Adams (POA) 02/04/05 $9.459.59 $ .04 __ __ __. ___._ __ $9,459.63 Checking Account William F Mentzer Sr Lena M Mentzer Dorothea S Adams (POA) 08/08/88 $1,674.83 $ .00 $1,674.83 3. Type of Account. Account Number Ownership (Names ofl Opening Date Balance on Date of Death Accrued Interest Total Certificate of Deposit William F Mentzer Sr 09/17/10 $33,696.50 $ 314.01 $34;010.51 For any additional information on the above accounts, including ownership and any changes, closures and/or reimbursement of funds, please cs11 the Spring Garden lice at #717-240.4525. We were unable to locate any safe deport box for the above-mentioned decedent. This letter does not include any accounts in whid- the deceased may have been listed as Power of Attorney, Custodian of iJniform Transfers, Representative Payee, or Trustee under a ~Nritten Agreement Sincerely, ~1 ~~ ~! Tammy Spencer Adjustment Services Rick Foreman Auctioneer Au1163I~ 386 Springfield Rdo Shippensburg Pa 17257 (717~776~4602 ~ ~~, •t.,~,, ._.~.. r ~,~~_~` } 66f ~+ ;- ~? ~~ , J ~/~// ~~~~~74~~G•.~a^ E~~d.~C~-~.' J 6^'~'T.`1Sa.,,' ~ / ~' Ff ti ..a ,¢ '. ~~ hick Foreman Auctioneer Au1163L 386 Springfield lZd. Shippensburg Pa 17257 ~717~776m4602 ~~ 'y~~~ ~~~rrr -qp e(~ ; ~~; R, rr p ~pji ~ ~ ~' 4; t~ ,retie °' ,t"' ~` E !' c.. y jf !'~' ~> f f 'f ...~,.~ f ...de'/ r r ~ ~, ~ ~ .. s~ ~ ~ ~ ~~! ~~ ~ ~" _.__...____.._...r~.._._~_~.~_.____._._ „ ~p ~ ~~¢ ~ ~f BUYER ITEM LOT # BUYER ITEM LOT # 12 BUYER _ ITE M LOT # BU1~ER ' ITEM - - BUYER ~- s ~~... 9 ( ' f 1' ) ITEM :'I LOT # LOT # { e g t 10 BUYER BUYER _. ITEM LOT # ~ _ ~ ®_. ~ 11 BUYER 1E ITEM ~ :' LOT # C~? _ $ k a i y s f r ITEM LOT # ~~ _~ _ ~ 2 BUYER ~ _ $ ® . ITEM LOT # BUYER ``~-°~ I ;? (BUYER r ITEM ~~~ ~ +~" LOT # ITEM E ; _ ~F` r ______________-___________ -___~_________________________________ ___.__._r. BUYER ITEM LOT # /1 BUYER ITEM LOT # ~ - 3 BUYER ITEM LOT # ® _ $. ,. • 15 BUYER ITEM LOT # } f -__-y - i i s i r r _ ~ i BUYER ,~:_' . g~ }~e~ ITEM BUYER.- f tt E ITEIV~ : ' ~ _ ~ ~~ ,, i, .I a LOT # ~ LOT # s -3-- -- 4 BUYER BUYER 6 ITEM ~~ ~' - ITEM LOT # LOT # ~; :,,. ® - ~ ~ _ $ `® _ ~ 6 5 BUYER _ '`'' ~ BUYER ....:. ;" ~~.... ~;. ~ ITEM ITEM s LOT # LOT # BUYER 8 ~ ;, BUYER - ITEM LOT # _~ ~ G 13 BUYER ITEM LOT # ® - ~ i 14 BUYER ITEM LOT # --® _ $ L BUYER ITEM LOT # BUYER ITEM LOT # ~_-_J 3 BUYER ITEM LOT # C~ _ $ . . 'i I L 4 '.,~_: s BUYER t ITEM LOT # i "s ® _ ~ o 6 4 1 r P 9 3 11 BUYER ITEM LOT # ~ - - ---- 3 BUYER ITEM LOT # 1 ~' _ $ ~` _. 15 ..' BUYER i ..... i ITEM ~ LOT # i .: •`'._. 9 t ! G f k 11 12 BUYER BUYER ITEM LOT # C~3 = ~ 13 BUYER ITEM LOT # ® _ $ ITEM LOT # ._ 1 BUYER ,- .~..-. --. -- -- F ITEM ' LOT # ® _ $ ~~ r c BUYER 8 ' BUYER ITEM - LOT # , _.. E ® _ $ o -. ~ 1 BUYER .= 1 BUYER .. ._ ~ < _, ITEM `~ '• ITEM 9 LOT # - ~ LOT # - 3 ~ 4 '` BUYER BUYER ~. ` ~~ ' f ITEM ~ ~ ~ ITEM LOT # LOT # -' _.- _-_. _ . __._..-... _ ._._ _-_ __... __ -.._ .._ -__ _..__ __ - a- _ _ -_ __ __...- .- -_. _..._ ._ -._ _~ _ -._ ___ _. ~_..___. -__ __ BUYER ITEM LOT # BUYER ! ' ~ BUYER ~_"' ITEM • , E •• t LOT # i LOT # E E i S ITEM - - - LOT # _ ~• __:. _~_~ _ $ _ F, - ITEM ..` s ';_ '~.._ LOT # ~~l _~ _ $ o .-_ 6 BUYER ITEM '• !._ ~:: ~. : , . LOT # _~ _ ~ ~ , BUYER ITEM LOT # R s E ITEM I_OT # ~_ ® ~ ®. ;: G ITEM E ` ' LOT # _~ _ $ • 14 BUYER ITEM LOT # ~~ BUYER a i d ITEM LOT # ®_ - $ ©~ ;~ k 3 S Rick Foreman Auctioneer Au1163L 386 Springfield Rd. Shippensburg Pa 17257 (717)776-4602 ,~~ ~.ey 9 ~~ ~~ ~~ rd~ ~~~ ._ L,~~c4. ~~rn~ ~- ~ ~~ J 3 _ ~ V ~ -- ~~ ~~ ~ /,,p a M ~c,~ jts-~ /~ `f ~' ' --- ~~f BU~'ER ~~ ~ BUYER ~ r ,.. ~ ~-- ._. -°~,, ITEM ~'` i ~ ` sly .. ' ~ 4` ITEM - ~ ~ ~- ~ ~ ~ ~g~'~ ~~...~1-~r l LOT # ~ i LOT # ``~~ ~ 4 ,_ ., 3 ` ,~ , BUYER - i BUYER ~~' (~ } ~ ITEM ~ ~ ~;; ~. :,...~...~. i,_: ~ ITEM ? t ~---t ..~1 `~~ ' V ~~_ LOT # ~ LOT # ~~ 1 ~.~ t..., i y J 5 BUYER `<~ i 6 BUYER ~ ITEM '`-_ ~ 1 ~- ~--~',~ , ~~ ~ ~ ITEM ~~ ~r,.... `~~ ~ - I LOT # , LOT # j e 1 BUYER ~-~ ~~ i ~ BUYER ITEM ~~~ ~ ~~'' --~ ~ ITEM ~ ~~~`' ~~` J~ ~ r,.._„~ LOT # i LOT # i SHEEI_# _ -- _- SHEET TC]TAL $ ~) ~~ - - - - - - R~ ininnnir_ TnTei $ BUYER - , _ _ - .i ~ 4 BUYER IT~II _ ` - ~ ~ ` I ITEM ~~ .T '~ 1 l.. ~ `~.._ ~ ~~' t +..7 s LOT # ; LOT # I ------ ------ ------------------- ---- -I--------------- ------------- -- ------------__ I ~ 6 BUYER '~ I I ITEM ~ ~-~~~ - I I I LOT # I ~ '; t I - $` ~ I I 7 BUYER I 8 BUYER ~ ~' ~ 1 ~ 4~. I ITEM ~ t ~....~. ~~ ITEM t ~ ~--- ~-• I LOT # i LOT # ( 1 ~` 'f ,._ -- - - ---- ----------------------t----------------------- --------- 11 ~ _i BUYER `~ ,r. ITEM ~ ~ 1 ~• ~', 1 ~, P~~_~ LOT # ~ .~~:-% _$ 13 ~ ~~~ BUYER ITEM t ~ < , ~. LOT # ® _ $ . ~-~ I I 1 BUYER ITEM ~ =~. .f ~ ~.v. LOT # 14 BUYER t` ~. ITEM ..~~ ~ .) ~~ ~. I f ', +,~~ ~ `~f._c.=- '~ ~ LOT # ---------- ---- ---- -- --- -- ------- -_-- ---t- BUYER ~ ~ ~~ ~ I i ,- - ITEM ~~ ~ ~~1, ~i ~ I I LOT # - ~r`L ® $ ~ I SHEET 6 .I BUYER `~ ITEM t ` LOT # . `-- ~ ~; _® _ ~ I SNEF'f T[~TAI ~ - ~L~ E __-- _ -- _ -__ Ri in~nutic TnTei $ _ F BUYER `-`~ `~' ~ BUYER ~'~ ~- , ~-t- '~~ '~ t t I ;.r r !..- ITEM ` ~ ~. l;~.t i t r LOT # i LOT # _ ~~ 1 BUYER ITEM i ~, I t ---~-- 1 _ I "7 ~ i BUYER ITEM ~~', ~- . ~., r-°.., ~,.. ITEM ~- ;F,. s`,, ~-% LOT # s t ~~~~~~ $ • `..% --------------- --------------r-----------------.___----. _ BUYER 1 '1 I I ITEM 1 ` ~,.~ ~...,~li..~~~-s~.~ .t 1 LOT # ~ ~ ~ $ 1 I I BUYER ~'' ITEM ~~~~ ~ ~~~'~`~:-- ~~ .BUYER }} y, ITEM 1~„-,~ ~~ h---..:Z} `r~-~,- ~_. ~.'~.. ~-- 1 ^f BUYER ITEM ~„ `~ ~ ,vs ,s^` '' 1' I 1 1 I t I I I t 1 f I I 13 ~~.,_~ BUYER ~~~ u ITEM ~`~--~ ~~~ ~ 4 LOT # '~`~ 1 BUYER ITEM ' LOT # SHEET #_ 14 BUYER ITEM ~.~~~ ,; .,4: ~J LOT # $ ~ ~-} ~~ i SHEET_TOTAL ! ! - ~ > _t_ __RI INNIN(: Tf1T~l $__ __ _,. ., - a F i LOT # t t E"'t ~- - --- - - ITEM _1~ . ~ ~ ~ ~ ! ~ ~ ~.~~ ~-_.. LOT # ~ 4 BUYER _~ ~ ~ ~ ITEM LOT # i t i - --- ~ 5 ,'F i BUYER -, ~~~ ITEM ~ ~ i t LOT # ~ i $ ~ ``~ ~ BUYER ~ s' `? ~~ ~ ~ ~ f k 1 S t "' ITEM ~ ' i ~' ~ t It LOT # --------'-------------------- --- --~- -------- ----------------------------~3 7 ~~; BUYER , BUYER ~ i 8 " ~ y.. ITEM ~ ~_.. ~-~ i ITEM ~ ~:_._..~ ~... ~ ... 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I/ ITEM ~ ~` 1 I` t ~~ ~. _ LOT # ___ ~ _ I 1 t I I 1 i $ ~ • `''~~ CuGFT ~ SHEET TnTAL $ ~i.C7 . ~ ~ i __ Rl INNINr T(7TAI '$ ___ IM ~~..€ $ `, 3 BUYER ~~ {J ITEM +f ~ ..1...i~-,~F LOT # {'~~C~' ® _ , ~~ $ ~~ BUYER `~-~ _ ,- ~. 4 _ _ ITEM rr s~ ~ ~ ~ LOT # pi BUYER ~ ITEM ~`~ `~ ~.. ! ~ . }_ LOT # 5 ~ 6 ;- BUYER - BUYER ~_ l ~~ ~. - .- r n j, `: _ ITEM ~ ~ . ~.: ~ # ~ ~ ~ ~,/ ~_ ~ ~ ~. ~ ~~~ L'!;°~ i ITEM ~~ ~ ~ _i ~ y ~ --~1 ~..~ J LOT # LOT # __ ,_. ,. ~/ 5 `~~ ~~ Y BUYER ;~Z t 1 ITEM: ~ ,~ ~ '~ .S ,I 1 ~.~e~~-=~- `~-° LOT # ~, (~,' ® _ $ i e I N 6 F I 6 E t F I // r 11 '~ 'f~ ° BUYER I ITEM =~/~.:' E LOT # I ,., ~ ® _ $ ..~ J I 12 e ! BUYER ~._.> i ., f _ ITEM } .~- r`."~~ f ~ ~ ._:? .~ '-' LOT # r`- `._.. ® _ $ ~ _ 3 BUYER ~ ~.1-' ITEM ~_, LOT # ~.. ~~~ -_ ~ _ $ . ~..~ 1 BUYER ITEM • ~ ~ ~ LOT # SHFFT # ~~~' ~. f ~ ~ ~ ~r' I SHFFT TllT01 $ ~~ . ~~'l 14 j BUYER `"~ ITEM ~_ .~ ~ ~ ':, ~~~ - LOT # `- _® _ $ ~ ...f ....~ BUYER ~~ ITEM _ a~,~ ~. LOT # ~. ~~~, _® _ ~ BUY~E _ `'_.~ ~a BUYER y~,~, ILA-M ~ ~ ' ~ ITEM ~ `~. ' T LOT # t i LOT # a t a i v i } 9 I g I E 1 C i e a 7 f`^1. x 8 ~- BUYER ~ ~- -~' ~ BUYER ~°" ~.._ _ ITEM ~~ t i `~~~ ~ i~~~ t : ~ ~ ITEM 5~ ,~;\ t ~ ~~, 'i ', ~ l t ~ ~a~_.s~.~ 1~ f~ ~ ~ ~ i, LOT # a LOT # • 9 f~i e 10 G=~ ~== :, ~. BUYER „_.~`y ~ BUYER ~ '--' ~-. k - f _, ~.- ~ \ i i --~-~- t / ~. ~- ~~ a ITfM_ ~ ~.~ 4~ ~~~L.~ ~ ITEM ~~~ t ~.' 1~-'l +Y~ ~_ i ~ ~ ~ ~ ~ t.~~~t LOT # r LOT # J _.~, r g - F -- --, --16--- --- --------------~ i i BUYER -.~-~ i ti « ( t i ITEM ~ ~ ~ ~ ~ ~ ~ ~ ~~~ ~ ~`~~`J~~~ e .. t - LOT # ~ _~_ _® _ $ ~~ SHEET # SHEET TOTAL $ ~ iJG7~ r>''ti i RI IAIAl1A1!_ Tl1TA1 $ BUYERS '/ 1' BUYER t M ~~..~ .,,.,~.% ~ ITEM .,~'' . ~l, t t ~ , ~'~~~ ~ ~.._~ LOT # ; LOT # ~ • - -- - - - - --- - -- - - -- - -- ---- -- --- -- - --- -- - --- ~ - ~ - - ~ 4 6~> BUYER ~-~, ~ BUYER ~~ t ...~ 5yl / 4 ITEM ~----- , ~ ~ `'~~,~ t- -'~ ~ ITEM + ~, ` ~ ~ '...' - ~ ~..~ _~' ~._.f LOT # ,,~^ ~ LOT # ~_ 1 BUYER ~ 1 BUYER ~ ,._._ ITEM ~~. ~. ':. ~.. ~ ~. _ ~ -~ i ITEM ~~ /~~~ r, f / ~. ~~ <: ~~ LOT # i LOT # 1 1 1 ' - i i "~ ~ 8 BUYER ~d 1 ~ ITEM ,.....~.`~-j~' r ~.~ LOT # F'~ ' ~ ~~~ 1 ® J 1 - $ s - ------------------------- 9 - -- -- - - -- ~ R;-.~.- i 10 f' BUYER 1 BUYER _ =~~ ITEM ~ ~ ~ ~-- '! ~- ITEM i•,..-: t- . ~ , - ~.' ~-- LOT # °~ i LOT # ..,,, , ( i_ .~ E 1 -----_-__ -----------_ ..- - -- ----- -- -----------____J_----------------------------------_. i _ 1 BUYER ~ ~' ~ 1 BUYER ~ ~~~ ITEM ~' 8i, ~ ~ ~~`'>~' J ~ ~' ~, ,~ ~ ~i, ~' .~ ~ ;~ jr~~l _.._,~+.-„ ~r i ITEM ~_ ~ ~ ~ ~ ~~ 1 ~.-~ °~ t I;{~ i LOT # ~ LOT # 1 ~- 1 13 ~ 2z BUYER ~-~' ITEM ~,+F ~..: ~. / i~~ , .._. ~ ! t",~ i _ - LOT # -~, ® _ $ P ~ t-~ / ..~-. ~ ~ BUYER f ~ 1 r,~ 1 ITEM ~~ ' `` ~ _ fir{ ~~ .-',; ~ LOT # ~ Ca3 = $ . (' ~ % o t 1 r i CHFFT # CHFFT Tf1T01 $ ~ ~ .~ ~~ 4 ,; -~ BUYER ~ ~__! ! t,:' , ~ '> ~,1 ~: r~~ p ~ "-~ >> ITEM ~ ~ r r u~ ~ ft ~~`'... LOT # ` ~ BUYER ITEM e' ~° r LOT # B11I~IAl1A1!_ TC]TAL_~ `~M ~~ `~ `' ~ BUYER ~ %~ ~'~ i' ,~ ~ ~ i. c a "'~ 'i _~~ ~ ; ~ `~ r t ~ ~::.. ~ ~'.. ~_ ~ ITEM ~ -...~" }~- ~'"• ' ~ LOT # ,...'f ...~ t ~ ,~ ~, BUYER `~-4'~~-' ...~,. _. ~~11 I _.. ITEM 1 } ~ ~. ~_ 9 4t i• ~ f LOT # ~ 4 i BUYER f i ITEM ~ LOT # i i 0 i BUYER ~ ~ y ITEM ~. ~~~ ~ 4_~~~_ LOT # l ? ~ ; A _-~- ~ --~-.. ® - $ . ~~°, 6 ~~ BUYER . '~---` ~ .. ^ `, ITEM ~_... ~; { ~ _ rr~ , ~ ~ 1 ~1,. LOT # `! ~~~-~. ~ _ $ .' -----------------"-- ------------------i ~-7 ~ ~ 7 BUYER ~ 8 BUYER ~/"'" ` ITEM ~ ~ " ~ ITEM S ~ F' ~_` ~ , ~~ LOT # -- i LOT # ` P ----Z------------------------------- 1 p ';`~° BUYER _~_ `~-~ i ,~ ~ ITEM ~ ~..~~ ~ _"" `..~ \ (~%~ LOT # '~ I ,...• 11 ~'~-~ BUYER' f " `' ~ ~~ ITEM ~ ' ~!- LOT # _ ® _ $ ~~ 1 ~ 12 (,_; ~ BUYER { 1 ~- ITEM ~ -~~~.-\ _~~' ~ '~~ 1~~~ ~~,~- ~. ~ LOT # i 1 f - ---- ------------- ------------a--------- --------------------= 13 ~~ BUYER ,~, ITEM I ~~y I' ~~ ~ ~ ~ ~1 ~~~,~ ~~~~ LOT # ~- 4 ~, ' BUYER , ~~ ITEM ~.~1 ~' ~ t .._~ ~ ~ I~..~J~ F~ ~~..; ~ " 1 BUYER ~ ~ -~ ~ - ~ {{~ ~ ITEM k„i, 'r i ~' 1. _ ~ ~ LOT # ` ~ ® _ $ ~` ! ~1 .. 16 1~~ BUYER l ! f° .~, k .1 ~.,, r ITEM ~ Y tom} ~~'_.~ .. ~ ~ . v ~ ~p ~ ~_ LOT # _~ _ $~~ ~ ~k...s} Y ~ ~ ~ BUYER ®-°'~ i ~ , BU~EE y{ }1-- / i {j ~ ~ ITEM ` K . +_. ,.~ LOT # +' i LOT # .. ~ , ,` 1 F; ,~ I i -- - ---- - - -----------------------------r-----_.-.----------- -------- ------ -- I 4 ~'~ / 3 BUYER ~~ ~ BUYER ITEM {~~ rt ~~ _....~' i ITEM 1. v } ! ~~ ~.. LOT # i LOT # I I 7 ~`~ ~ I 8 ~°+ BUYER ~ i BUYER s7 / + _ ~ j ITEM ~ `a~ .y^~ ~ `..~.St'~~k l~._.._ i ITEM ~_~ ~~ ~ -5,. ~ ~. ~ ~,~ ~''~J~ :~~ t ~.•'~ k I LOT # ~ LOT # ri I ._..._-~-----------------------------I-----------------------_._-:.__ BUYER ~ ~ ~ i BUYER ~, I I ~'"'I--t ITEM ~+ i . ~` i ITEM Y,;1 ~ ~ t ~'`*.-..~ t LOT # ~ LOT # ® _ $ I _® $ 11 ~°; - i 12 f~. ~ BUYER ~?= I BUYER `~--" -~^'' I ~ _.. r~ ' ~ ....-,, ~ i , i ~ + ITEM i ~ ~ ~: ~ ~ ~ I '~--~ ~` ~'~---~ ITEM j i ~ LOT #~ i LOT # ~~: I `~ r I I 15 ~~ i 16 ,~ BUYER I BUYER ,---,~ , ~r ~ ~ ~ ~, ITEM ~f 1 i , I ITG~A ~ - ....,.....~ LOT # .-~ i .. ~- --: . ~~~ SHFFT # QHFET T(ITAI $ 1 G' BfJYER f ~ ~~ .. 1i i ITEM ' ~ t` 1~ s ~` ru _~ ~~ LOT # t _~ _ 4 BUYER °~~'` ~~r ~ BUYER t_~,..~_„.. ~..,~ 7' ~ ~ ~ yy ITEM ~I ~ 1. ~ .~j ITEM i ~ ~t ~.,3 LOT # LOT # ~--- ~ - - - -_~ - 6 ~ F _ ~ ~ _- I BUYER ~• ~~~ ~ ~~~~ ITEM ~- ~' ~ 6 `.. ff ~-'~'/~ ` J __ LOT # ' I 1 I ® ~, ,~, t / ---r------------------_------ _------------ ~~, BUYER ~~,,. ~ ~---~ .~' ~ BUYER -. ITEM t 'E~ -~ ~3 ~ b' t:,~ ~ ITEM. ~` ;~`,_~ ; ~, * I, f ~ ~'~~~ ` ~f ~ {t i - ;, r . i j BUYER y _ ~ ~°`' ~-~ ITEM `.. ~ ~ ,! ` ~ d c ~ ' ~ ~/~~ i _ r~3 4 LOT # 11 BUYER I ~~ ~^ t i ~ , _, ` o fTEM ~ ~ ~~`,. ~ t~ ~ . .% LOT # _ ,~~,.. LOT # _c~ BUYER --~' ~ I r e~ r ITEM ~'s. r ~ ~ ~ ~ ~ ' ~~ w ' I' ~~~ LOT # ~= ; ~„~ _ ~2 _ ~-- , BUYER ,_..~ . ~_:`. ITEM ~i )~ ~ ~~'~~ `~ U~~ ~'' ~'~{~~1~; ~... LOT # -------------- -- - -- - --___- --- - -a- 13 '` ~ ~ BUYER ~~ ~ ~ ~ i ITEM ~- ~ ~ ~_ `~~-~'~ ~~ ~~ ~~~.. ~ W ~. t LOT # 1 i~ 15 - ---- --- ~` BUYER ~' r' ITEM ~ 1. ~ ~_ j ~ ~~ ~ ~. f' ~ ~~ xj; r LOT # 4 BUYER ITEM / -'~-°'"'_ LOT # .® l - ~~ fe ....frt • -.~ J I \ ,~ ,~/}[ ~FFT # _ ~, CI.ICCT Tf]TA-L_~. ''~~' !._ BUYER ~~` ITEM ~ ~;,~,(~~ ~' ~.~ i LOT # F~ ~ r ~1 r--~ ,-~.,, _ @ __ ~ ~ BUYER ~ ~ '°'= ~ N. LOT # i _k %~ • i ~ 4 .~ ~ _ j BUYER `--~ '`- ~ ~ -., t 's, C ~ ; ~ ,~ 'f ? Y ITEM i ~ ~`~~ ~. ~ LOT # -`TT ~, , _ ~~1 ~.-, _® - $ ~ I _ -i -- -- - - -- - - - - -- 6 -- -- - - -- ~_.-. 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ITEM ` ~ ~``,°ti,. ~~ ~ }1 L ~ S i - ~ i ITEM ~ I LOT # t LOT # BUYER ITE.,~A LOT # t t t I t t t a t s t t t i ~~` BUYER ~--' '~ `t -~ °~--- ITEM _.. \' ~i -'fit ` LOT # --- ---------------__-__------ =~------------t--------~-~------------------- _ 11 Er-. ~°'r BUYER \ ~'~ ~ , ' '' ITEM 4 ~; i `~ `,~'ti ~ ~._,._ LOT # a:~~ BUYER , --- `--~' `~' ITEM ~`~ ~ .~I LOT # ( £• ~ ~, BUYER t ,~} k ~ ~' ITEM ll~ ~`~ g' t~ } ~'r~l t ~~' 1. 1~ Vl~ LOT # -~ ~~:~ ® - $ ___ • cuGGT ~ suG~r Tnrei $ ~~ S2 BUYER 1 Ott / ~'~ ' ITEM 9 ~ ` , i ~~ t i ~ ~' ~~~ _~ '~. t BUYER , t. t `~ , ~ , _ ! ITEM ~~ )~ ~ ~ ~~~ LOT # _® _ ~, $ ~ C..~~~ ~i w~nni~ rnrei ~ UY F ~ I ~ ~ BUYER i C i M ' ~ ' ~~ ITEM ~ sd' LOT # ; LOT # ~ ~ i ___-- --___ __ ----------- - ------- ------ 3 ~ BUYER ~t `Y~ ITEM `~;~ j~~r `, I ~~.., ° ~ ~ LOT # i I BUYER ITEM $ l ~~~'~..,' 5 i6 -----------~~ --__ -- ------------------_-----1--------------- BUYER ~-'~ ~ BUYER ~; ~ ` ~ (~ ITEM ~ ~~ ~~,~~ ~' i~ A ~- i ITEM - L ~ .J LOT # ~ LOT # _ ~-~; - a I 1 ---- --------------------------------r------------------- - ,,,~ i 7 BUYER `"~~"~ ~ ! (" t ~: ITEM ' ~ i LOT # ~ . ~` , ~ ~ _ _- s _~ , ~ _ $ ~'~~-~~ 8 ',~.~` BUYER ITEM ~ d., ,~ ! i `, ,~ `; LOT # ,~ `,.__ 9 ~.. :~.; ...~ ~ 10 BUYER - i BUYER ~~~~-` ,I _ ITEM- e~;, f ITEM d 1 l l ~. ~ ll ~ ~ ~~ ` ~,~. ~ T----~~ LOT # ~ i LOT # 11 ~~ ( ; 12 BUYER ~'°-"~ ~ BUYER --~ '~ '~ ~ .<~'~ t t` _ ~` ~.;~,. ' ~ i ITEM ; ~l l 1 ~: ,~ _ ~., `:~ ITEM . ~~,,.~ - `_ i ~ _, f,,.._. LOT # ~-' ~ LOT # _ 13 -~ ~ ~~ - 14 BUYER v ~~`~ ~ BUYER ITEM I ~ t ~ ~ -~' '. s ITEM `a 1 t a~ t LOT # ~ LOT # _ i .~ __ - 16 1 BUYER ! BUYER T ~ ~-'~ i ~ !`` ~ ~ -i ,_~ L_ ~ l `l ITEM _ ~ ~ ~~ , ~( ~`t ;L=-- ~,,~ ;l :'l~l I ITEM LOT # - . ~ LOT # -~ , _ r-°a ,.-~-, f . ` ~- t 21-JGGT dE C--IG~T_S!_ITAI ~ fl1 ~L~.~+_~~C.1 ~_ ~ DI_I_AIAIIAI/2 Tl1TAI `P L `.... --~-- ' BUYER •--~ t i 1 ~ ~ I ~ fl ~ -r._ E I r "1 ~~' ~..•,~._ ~" c„_ < --~-_ ITEM •~., '~i.,~. ; ` ~" ..~~~ BUYER ~ ~ ~~ ITEM -~.~•~_ . ~' ~~ C.~-~ ~ ~- LOT # BUYER ~ ~-•~•- ~ ~~ i ITEM ~ "~~ `~ ~;. ~ = f ' ,, ~ ~_ i LOT # _® ' 6 ~ BUYER ~` ~ _ I ITEM _ t, ~ LOT # i ~ _~, r'- j- _ ..,,~ \ ~ ~ / ~ $ BUYER LOT # BUYER / -~- , , i ~ ~ ~~~.. ~ .. 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'e. ~ ITEM 1. ~. err ~ !~~,~~~ ~ f ~ - i~ ~.~.il ~i ~ ~~ ~ ~a~ LOT # f~ ~ ~i LOT # - _ ,~ ~ $ ~ L -- - - . _. - __ __-_-- ___ __ BUYER _ '7 " / ~ ,BUYER ~ j ITEM ~t~l,^_4 ti ~;~ ~~~~ +°~ i ~ r~~.1~,~~ ~~ ~. ~r~ ;,.~. ---"~ ITEM 1 ~ ' LOT # I /~ ~ `LOT # ~ , ~., , ,~ ~ 7 --------------- - a ---- BUYER -, ITEM ~ \ ~~ ~ ~ ~ ~..____ LOT # BUYER ITEM ~.~ ~.1~~~..-.1 LOT # - - ~k J~- ~'~' BUYER ~.~ , , .-, , _, ITENF I ,~ ~ ~ ' _ t BUYER ITEM ~_; I-~.._. ~ , '~,__,5.,_~1 ``..1~ LOT # LOT # ~.- -- ------ - -------------- ---- - --- -_- . ! ~.J~-- - _- 3 - --_ .-_ ,- . _ _-_ .._, .. _ 11 ~~ ~~ ; , i 12 r ~, BUYER '-~ ~ BUYER s ~ ~ ITEM ~~ .1...`;` ~ ~ 1 ail ~~,'` .. 1._I~ 'Y t'~, -i' i ITEM ~'A ~ ; / ~ `~_t~, LOT # i LOT # ~' r- i 13 ~~ _ _..--- __ - BUYER ~ 14 ~ f ~ ' t BUYER (~,, s i ~--~, ITEM - ~ 1 ~'~~)',M1 ~( l i 1 ~~,t~ ~~~ ' ~„ ~ I ITEM ~ ~ ~ ~f~ LOT # i ~ - ~i i LOT # --- - -- - - - _.i __ __ BUYER - _. ---~--~-- i 16 - ---- -------- -------------- q ~ _ ~ BUYER ~. ,. ~f ~~ ` , ", ~ '~ ~'y' _ ~ j ~~.. l ~~~~ ~ ITEM ~ {~- ~- s ~ ~ l ~ ~. ~ ~ ~--r . ITEM _ ~ ~ ~,~ ~, ~ ~ ~_ .~ ; .,,. LOT # ~--~ ,--- ~ LOT # ® - IEET # SHFFT Tf1T~l $ ~ ~ ~. C'~ ~ REV-1510 EX+ (08-09) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VNOS TRANSFERS AND MISC. NON-PROBATE PROPERTY ESTATE OF FILE WILLIAM F. MENTZER SR 21 11 0338 This schedule must be completed and filed 'If fhe answer to any of questions 1 through 4 on page three of fhe REV-1500 is yes. ITEM NUMBER DESCRIPTION OF PROPERTY INCLUDE THE NARE OF THE TFUWSFEREE, THEIR RELATIONSHP TO DECEDENT AND THE DATE OF TRANSFER ATTACH A COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST EXCLUSION PF APPUG1alE) TAXABLE VALUE 1. Family farm transferred to The McNaughton Company on 0.00 100.00 100.00 0 9/9/2003 for $814,500.00. Decedent had 1/3rd interest. transfer was to an unreSlted third party. Exempt 72 P.S. 9107(c) since it was doen with adequate consideration TOTAL (Also enter on Line 7, F~ecapitulation~ E 0.00 M more space is needed, use additional sheets of paper of the same size. ~5t TaxParcel# 7~ ~U~~~D3~~D3~ THIS DEED, made this ~. -- .. _., ~-~~iS :J ~;~ Vnf OEEGI C' day of September, 200 3~ S~ ~ 1 ~ P!~ 12 9 BETWEEN: WILLIAM F. MENTZER, widower, of South Middletown Township, Cumberland County, Pennsylvania, and RICHARD H. BALDWIN, widower, and MARY E. SHUGHART, widow, of Monroe Township, Cumberland County, Pennsylvania, (hereinafter called the "Grantors"), parties of the first part; AND THE McNAUGHTON COMPANY, a Pennsylvania Corporation with a business address of 4400 Deer Path Road, Suite 201, Harrisburg, Dauphin County, Pennsylvania, (hereinafter called the "Grantee"), party of the second part. WITNESSETH, that the Grantors for and in consideration of One ($ I.00} Dollar lawful money of the United States of America, to the Grantors in hand well and truly paid by the Grantee, at or before the sealing and delivery of these presents, the receipt whereof is hereby acknowledged and the Grantors being therewith fully satisfied, do by these presents grant, bargain, sell and convey unto the Grantee forever, the described properly: ALL THAT CERTAIN tract of land with the improvements thereon erected situate in South Middletown Township, Cumberland County, Pennsylvania, containing 104.3004 acres, bounded and described as more fully set forth in Schedule A attached hereto. BEING the same premises which the Orphans' Court of Cumberland County in the Estate of Harry S. Mentzer, Estate No. 21-82-621, by Decree Awarding Real Estate dated June 19, 1984, granted and conveyed to William F. Mentzer, Mary E. Shughart and Anna J. Baldwin, their heirs and assigns, as equal tenants in common. Said Decree Awarding Real Estate is recorded in the Office of the Recorder of Deeds of Cumberland County in Deed Book 5-30, Page 1192. ALSO BEING the same premises which Richard H. Baldwin and Anna J. Baldwin, husband and wife, by deed dated February 16, 2000 and recorded on March 9, 2000 in Cumberland County Deed Book 217, Page 401, granted and conveyed to Richard H. Baldwin and Anna 3. Baldwin, husband and wife. The said Anna J. Baldwin died on Macch 16, 2000 and by operation of law title vested in her surviving spouse, Richard H. Baldwin, one'of the Grantor's herein. 12/05/2011 8:10:28 AM CUMBERLAND COUNTY Inst.# 200350220 -Page 1 of 11 EXCEPTING A-ND RESERVING unto the Grantor, William F. Mentzer, anon- assignable life estate in and to the following portion of the above described premises which shall include the existing house, barn and yard with the following boundaries: from the front door of the house in a southerly direction the distance of l0U feet, which shall include the driveway; from the center point of the house a distance of 125 yards to Springville Road; from the back of the hour to dis ~ of the house distance of 25 direction toward Lindsey Road; from the cen Po yards in an easterly direction, which shall include the barn. The life estate interest of William F. Mentzer is restricted to that portion of the premises as is described above. The above described area shall be solely and excl lesselwritten consent is obtained from d shall not be used or trespassed upon by anyone un William F. Mentzer. The ingress, egress and regress (i.e. driveway to home and barn) for the Property shall remain the same. Northwithstanenter and exit from thte eastsideave the right to use the lower portion of the barn and entrance. The Grantee shall be responsible for clearing out and disposing of any materials, items and/or debris in the lower portion of the barn. Such life-estate shall automatically expire upon the death of said William F. Mentzer. Grantee shall be responsible for the payment of all real estate taxes assessed against the above described real estate. UNDER AND SUB3ECT nevertheless to the exceptions, reservations, restrictions and conditions as contained in prior deeds of conveyance. Together with all and singular the buildings, improvements, ways, woods, waters, watercourses, rights, liberties, privileges, hereditaments and appurtenances to the same belonging or in anywise appertaining; and the reversion and reversions, remainder and remainders, rents, issues and profits thereof, and of every part and parcel thereof; And also all the estate, rights, title, interest, use, possession, property, claim and demand whatsoever of the Grantors both in law and in equity, of, in and to the premises herein described and every part and parcel thereof with the appurtenances. To have and to hold all and singular the premises herein described together with the hereditaments and appurtenances unto the Grantee and to Grantee's proper use and benefit forever excepting and reserving as aforesaid. And the Grantors covenant that, except as maybe herein set forth, they do and will specially warrant and defend, the lands and premises, hereditaments and appurtenances hereby conveyed, against the Grantors and all other persons lawfully claiming the same or to claim the same, by, from or under them. In all references herein to any parties, persons, entities or corporations, the use of any particular gender or the plural or singular number is intended to include the appropriate gender or number as the text of the within instrument may require. 2 boos 259 ~Aur~i66 12/05/2011 8:10:28 AM CUMBERLAND COUNTY Inst.# 200350220 -Page 2 of 11 Wherever in this instrument any party shall be designated or referred to byname or general reference, such designation is intended to and shall have the same effect as if the words "heirs, executors, administrators, personal or legal representatives, successors an assigns" had been inserted after each and every such designation. IN WITNESS WHEREOF, the Grantors have hereunto set their hands and seals, or if a corporation, it has caused these presents to be signed by its proper corporate officers and its corporate seal to be affixed hereto, the day and year first above written. SIGNED, SEALED AND DELIVERED IN THE PRESENCE OF OR ATTESTED BY i i~~~%~''~h7 ~ William .Mentzer v Mary E. ughart ~OMMONWE TH OF ENNSYLV NIA, COUNTY O~ ~ ' Be it Riemembered, that on -~ ti~~ °~ , 2003, before me the subscriber, a Notary Public, personally apps ear d WILLIAM F. M.ENTZER, known to me (or satisfactorily proven } to be the person whose name is subscribed to the within deed and acknowledged that he executed the same for the purposes therein contained. WITNESS my hand and seal the day and year aforesaid. 12/05/2011 8:10:28 AM Richard H. Bal win CUMBERLAND COUN Notary Public Noland SMI ct; t~ v++~w,gton, ~udr~ 3 ~M P~ ~~„~ ~ 2r~2nos 6CQI! ~ ,, `~~~tionorMotaiies My Commissio x Tres: Ty Inst.# 200350220 -Page 3 of 11 COMMONWE TH OF PENNSY VANIA, COUNTY OF ~--c~'1~ S.: 2003, before me the Be it Remembered, that on subscriber, a Notary Public, personally appe ed RICHARD H. BALDWIN, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within deed and acknowledged that he executed the same for the purposes therein contained. WITNESS my hand and seal the day and year aforesaid. Notary Public My Commission Expires: Nokarial Seed t~lencla M. Waif>inp6on• Notary Pubic G~~r np HIR BCIOr AiilbeAend Co~xdY Jlv ~.,omrca~elon E7~Yis D9c. 27, 2006 COMMONW~ TH OF PENNS COUNTY OF VANIA, .. Be it Remembered, that on ~ , 2003, before me the subscriber, a Notary Public, personally a eared MARY E. SHUGHART, known to (or satisfactorily proven } to be the person whose name is subscribed to the within d,y and acknowledged that she executed the same for the purposes therein contained. ~ WITNESS my hand and seal the day and year aforesaid. Notary Public My Commission Expires: Notadel seal Glenda M, Wpn, Notary PUbic Camp Fiii Boro, C~snberland Cour>ey The Undersigned certifies My Cron Expires ~~ 27.2006 that the precise residence Member, F~ennsywarMa Asso~auon or Nota~es and complete post office address of the Gran a is: ~;~ ZDt o - I-ka.~ ~U~~ t ~A t? i t G I'+ Attorney for 4 12/05/2011 8:10:28 AM CUMBERLAND COUNTY Inst.# 200350220 -Page 4 of 11 Sep 04 03 O1:Ola Lyons Surveyin8 L, AL D ' TI •71 ~ 432 1 105 P • 2 ALL TART CERTCOUN'TY, PENNSYL~~ BOUNDED AND DDESCRIBED AS PER SURVEY CLTMBERLAI~ID DONE 9Y LYONS 5L~VE1rING, AS FOLLOWS, TO WIT: B$GII~1NII-IG AT A MAC} NAIL AT THE CENPERLiNE ~TERSECTION OF EAST SPRIl~IGVILLE XtOAD (T•686) ~+OgMERI,Y L.R 21020} (40' LEGAL WID"I'~ AND LINDSEY ROAD (T-SI7) (20` LEGAL WIDTH} AT THS NORTHWEST CORNER OL]FI~, E 3QIDPAGE 875} (PLAN gORNiE,RLY OWNED BY RAYMOND E. DIEHL {D~C"ORNSR OF LAND NOW OR FORMERLY BOOK 4S, PAGE ~, S R NAND }ANN E. BEN (DEED HOOK 207, PAGE 959) (PLAN BOOK 79, OWNED ~ ~~ 3T CORNER OF LAND NOW OR FORMERLY PAGE 116, LOT NO.2 & 11) AND' SOLE OWNED BY ANN G. FI.,ATLEY AND KAT'HERYN HIIS.EARY ~~ BOOK 152, PAGE 212) (PLAN 900K 35, PAGE 132, LOT NO. lr A.) THENCE ALONG SAID LINDSEY ROAD CENIEItLINE AND FLATLEY AND HII,L6ARY LAND BY A BEARING OF NORTH 84°54'06" EAST F03t A DISTANCE OF 1,630.58' TO A MAG NAIL, SAID MAG NAIL BEING AIANG SAID LIIVDSEY ROAD CENT, ALONG SAID pLA~ANYDRA~YMO YE AND GENEVIEYE AIDIEHL (DEp~ H~KL~ NOW CIR FORMERLY 0 VOLUME 27, PAGE 83); B,) TIIENCB LEAVING SAID LINDSEY ROAD ~RL1NE AND ALONG SAID DIEHL LAND By A BEARL'~TG OF SOUTH 02°14'23" EAST PASSING OVER A REBAR AT A DISTANCE OF 10.01' FOlt A TOTAL DISTANCE OF 2,882.70' TO A REBAR. SAID REHAA BEII~iG THE SOU'I'IIWEST CORNER OF SAID DIEHL LAND SAND~N~ ,~~, O~~ EED OWNED BY GEORGE F. D]XON, JR., QTIP BOOK 130, PAGE ~, TRACT NO. 1); C J THENCE ALONG SAID DIXON LAND AND EyENI'UALLY LA, ~'NOWGE 1044) FORMERY OWNED BY MISTY MEADOWS PARTNERSi~ (DE® BOOK S 4, 3 AND 2 RESPECTIVEI-3~ (PEE 2 (PLAN BOOK 8?, PAGE 65, LOT N0. 11, l0, 9, 8, ?, 6, , OF MISTY MEADOWS BY A BEARING OF SOUTH $S°18'04" WEST FOR wS P RTIVBRSHIP 1,428.41' TO A REBAR, SAID REAR BEING ALONG SAID MISTY MEADO LAND (SPEi O I~ BY~LBERT E. ANDO'i1~A ADAMS (DEED BOOK Q, VOLUME FORMERLY 35, PAGE 4619) {PLAN BOOK 64, PAGE 38, LOT NO. 3); D.) THENCE ALONG SAID ADAMS LAND FOR THE FOLLOWING 'TWO COURSES AND DISTANCES: 1.) BY A g$ARING OF NORTH 00°27'36" WEST FOR A DISTANCE OF I8I.28' TO A REBAR, SAID REBAR $IING THE NORTI~AST CORNER OF SAID ADAMS LAND: 2.) BY A BEARING OF SOUTH 85°19'50" WEST PASSING OVER A RBBAR AT A DISTANCE OF 184.59' FOR A TOTAL DISTANCB OF 206.62' TO A POINT, SAID POINT BE1NG AT THE NORTHWEST OF SAID ADAMS LAND ANDR 1020} (40' CE1~!'i'EgLINE OF 'LAST SPRINGVII.i'E ROAD (T~86) (FORMERi- LEOAL WIDTI-I); ~ ~~ l1~~~ J ~~ 800K 2~9 PA~t~,Y.~ 12/05/2011 8:10:28 AM CUMBERLAND COUNTY Inst.# 200350220 -Page 5 of 11 717 432 1105 p'3 Sep 04 03 01:O1a Lyons Surveyin8 NG SAID CENTERLINE OF EAST' SPRINGVII~,LE ROAD FOR THE E,) THENCE ALO FOLLOWING EIIGHT COURSES AND DISTANCES: _ 1 J BY A CURVE TO CORD FTC ~ OF NORTH 058 30'' EAST FOR A IENGTH OF 165.92' AND A CFIORL1i DISTANCE OF 155.34' TO A P()i1dT: 2) BY A BEARII~IG OF NORTH 00°I9' 26" WEST FOR A DISTANCE OF 191.78' TO A POINT 3.) BY A BEAR~G OF NORTH Ol°47'03" WEST FOR A DISTANCE OF 66.70' TO A POINT; 4) gy A,BgARIN'G OF NORTH 01°40'35" WEST FOR A DISTANCE OF 249.30' TO A POINT; 5.) BY A BEARING ~ NORTTH 02°01'29" WEST FOR A DISTANCE ~ 579.87' TO A POINT; 6.) BY A BEARING OF NORTH 02° 17'33" WEST FOR ~- DISTANCE ~ 100.53' TO A POINT; 7) SY A BEARING OF NORTH 04'03' 24" WF~T FOR A DISTANCE OF 74.37' TO A POINT; 8.) BY A BEARING OF N()RTEI 03°20'01" WEST 0 EAS ~RINGVII.LE ROAD TO A ~~T. SAID POINT BEING IN THE CEN' ~ LNG LAND NOW OR {T.6$6) (FORMERLY L.R. 21020) (40' LEGAL ~~)MFStCI3ESE (DEED BOOK N, FOR~RLY OWNED BY ROBERT~J. K 44 PAGE 4s. lAT NO.2); VOLUME 36. PAGE 747) (PLAN F.) 'WHENCE LEAVING 5AID CENTERLINE OF FAT SpR~GVIl 1.E ROAD AND ALONG SAID MER4I~SE ~~ ~ A BEARING OF NORTH 86°13'37" FEAST PA551NG OYE,R A CONCRETE MONUMENT AT A DISTAN~~ 28E1NG TIC 50L>7~AST CANNER OFSSAID TO A REBAR AND AXLE. SAID REBAR AND MERCHE513 LAND: G.) THENCE ALONC3 SAID MERC~~ LAND FOR'rl~ FOLLOWING TWO COURSES AND DISTANCES: t .) BY A BEAR~EGBOEF~ TAEONORTHEAST CORNER OP SAm MER 1CHESE TO AN AXI E, SAID LAND; 2.) BY A BEARING OF SOU[N ~° 12' 19" WEST PASSING OVER A CONCRETE MI~NU~T AT A BEING IN'I~SCfi iNTLRT.TNE OF EAST SPAIl`1G OVII.LE ROAD tTA POINT, SAID POINT 686) (FORMERLY L.R 21020) {40' LEGAL VyIDTI~; H,) THENCE ALONG SAID CSNTERLI~ ~ EST Sp~GVILI.E ROAD FOR THE FOLLOWING TW0 COURSES AND DISTANCES: 1.) BY A CURVE TO THE LF~ HAVING A RADIUS OF 786.89', AN ARC LENGTH OF 21.13' AND A CI;OIID BEARING OF NORTH 10°00'24" WEST FOR A CHORD DISTANCE OP 21.15' TO A POINT; 80fl!( 259 prc~~.'70 12/05/2011 8:10:28 AM CUMBERLAND COUNTY Inst.# 200350220 -Page 6 of 11 Sep 04 03 D1:O2a Lyons 5ur~eyin8 717 43~' 1205 p.4 2.) BY A BEARING OF NORTH 10`40' 10" WEST FOR A DISTANCE OF 221.24' TO A MAG NAIi., SAID MAG NAII. BEING THS POINT AND PLACE OF BEGINNING. C'ANTATNiING 4,543,323.72 SQUARE FEET OR 104.3004 ACRES. BEING THE SI1ME PREMISES WHICH RICHARD H. BALDWIN AND ANNA J. BALD WIIV, HIS WIFE, BY DE~D DATED FEBRUARY lb, 2000 AND RECORDED IN DEED BOOK 217, PAGE 401, IN THE RECORDER OF DEEDS IN AND FOR Ct1114HERLAND COUNTY, PENNSYLVANIA, GRANTED AND CONVEYED UNTO RICHARD H. BALDWIN AND ANNA J. HALDWIN, HIS WIFE. ALSO BBiriG TI1E SAME PREMISES WHICH THE ORPHAN'S COURT OF Ci,'MBERLAND COUNTY IIJ T~ ESTATE OF HARRY S. MEN'IT.ER, ESTATE NO. 21.82.621, BY DECREE AWARDINGRBAL ESTATE DATED NNE !9, 1984, GRANTED AND CONVEYED TO WII,LIAM F. MENZ7BR, MiARY B. SHUGHART AND ANNA J. BALDWII3, TII!?iR HEIRS AND ASSIGArS, AS EQUAL TENANTS II3 COMMON. SAID DECREE AWARDING REAL ESTATE IS RECORDED IN TfIE OFFICE OF THE RECORDER OF DEEDS OF CIJMBE'RLAND COUNTY TN DEID BOOK S, VOLUIv~ 30, PAGE 1192. LESS A1~iD FJCCEPTING THE FOLLOWING AREAS OF' LAND THAT LIE WITHW THERIGHT- OF-WAY OF 1~AST SPRL+iGVII.I.E ROAD (T-b86) (FORMERLY L.R 21020) (40' LEGAL WIDTH) AND LIl~IDSEY ROAD (T-S 1'n (20' LEGAL WIDTTH). BEGIINriYNG AT A MA(1 NAIL AT THE CENTERLINE II~Tl'ERSECTION OF EAST SPRINGViI.LIr ROAD (T.b86) {FORMERLY L.R 21020) {40' LEGAL WIDTH) .AND LIIQDSEY RDAD (T-Sl7) (20' LEGAL WIDTI~ AT TIC NORTHWEST CORNER OF LAND NOW OR FORMERLY OWNED BY RAYMOND E. DIEHL (DEED HOOK P, YOLi7MG 30, PAGE 87S) (PLAN HOOK 43, PAGE 36, LOT NO.2), THE SOUTHEAST CORNER OF LAND NOW OR FORMERLY OWNED BY 'C'HOMAS R. AND ANN B. HENJEY (DEED HOOK 207, PAGE 959) (FLAN BOOK 79, PAGE i i6, LOT NO.2 8t 11) AND THE SOUTHWEST CORNER OF LAND NOW OR FORMERLY OWNED SY ANN G. FLATLEY AND KATHFRYN HILIEARY (DEED BOOK 1i2, PAGE 212) (PLAN BOOK SS, PAGE 132, LOT NO. 1}; A) THENCE ALONG SAID LIIQASEY ROAD CENTERI.Il~ AND FLATLEY AND HILLEARY LAND BY A BEARING OF NORTH X14°i4'06" EAST FOR A DLSTANCE OF 1,630.58' TO A MAG NAII., SAID MAG NAIL BEING ALONG SAID LIIVDSEY ROAD CENTERLINE, ALONG SAID FLATLEY AND HILLEARY LAND AT THE NORTHWEST CORNER OF LAND NOW OR FORMERLY OWNED BY RAYMOND E. AND GENEVIEVE A DIF.HL (DEED BOOK 1, VOLUME 27, PAGE 83); B.) THENCE LEAVING SAID LINDSEYROAD CENTERLINE AND ALONG 5AID DIEt3L LAND BY A SEARING OF SOUTH 02°14'23" EAST FOR A DISTANCE OF 10.01' 'PO A REBAR, SAID REHAB ON THE SOUTHERN LEGAL RIGHT-0F-WAY LINE OF SAID LII~iDSEY ROAD AND ALONG SAID D1EHI. LAND; GJ T~IETTCE ALONG SAID SOUIT~RN LEGAL RIGHT-0F-WAY L1NE OF LINDSEY ROAD BY A BEARING OF SOUTH 84°S4'06" WEST FOR A DISTANCE OF 1,629.OI' TO A POINT, SAID PORVT BEING AT THE ,SECTION OF SAID SOVTIIERN LEGAL RIGHT-0F WAY LINE OF LIN'DSEY ROAD WITH THE EASTERN LEC#AI.RIGHT-OF-WAY LIIVE OF EAST SPRTNGViLI.;E ROAD; B~oK 259 PA~t~.~.7i 12/05/2011 8:10:28 AM CUMBERLAND COUNTY Inst.# 200350220 -Page 7 of 11 . $t+p Q4 03 Q1:03a Lyons Surveyins 717 43`c'. 1105 P.5 D.) THENCE ALONG SAID EASTERN LEGAL R1(`,ITI'.pF-WAY LINE OF EAST SPRINGV[LLE ROAD B7' A BEARING OF 50UTH 10°40'10" EAST FOR A DISTANCE OF 210.73' TO A POINT; E.) THENCE BY SNu~ ALONG SAID EASTERN LEGAL RIGHT-0F-WAY LINE OF EAST SPRL~TGVII.LE ROAD BY A CURVE TO THE RIGHT HAVING A RADIUS OF 506.89', AN ARC LENGTH OF x2.07' AND A CHORD BEARR~TG OF SOUTH 09°53'09" EAST FOR A CHORD DLSTANCE OE 22.07' TO A POINT, SAID POINT HEINC ALONG LAND NOW OR FORMERLY OWNED BY ROBERT J. AND DIDRA A. INERCF~SE (DEED ROOK N, VOLUME 36, PAGE 747) (PLAN HOQK 44, PAGE 45, LOT N0.2); F.) 'TFIENCE ALONG SAID ME1tCHESE LAND BY A BEARING OF SOU'T'H 86° 12' 19" yir'EST FOR A DISTANCE OF 20.09' TO A POINT, SAID POINT HE1NG IN THE CENTERLINE OF EAST SPRINQVII.J.E ROAD (T~86) (FORMERLY L,R 21020) (40' LEGAL WIDTH); G.) THENCE ALONG SAID CENTERLINE OF EAST SPRINGVII.LE ROAD'FOR THE FOLLOWING TWO COURSES AND DISTANCES: 1.) BY A CURVE TO THE LEFT HAVING A RADIUS OF 786.89', AN ARC LENGTH OF 21.15' AND A CHORD BEARING OF NORTH 10°00'24" WEST FUR A CHORD DISTANCE OF 21.15' 'PU A POINT; 2.) BY A BEARING OF NORTH 10°40' 10" WEST FOR A DLSTANCE OF 221.24' TO A MAG NAIL, SAID MAG NAIL BEING THE POINT AND PLACE OF BEGINNING. CONTAINING 21,149.94 SQUARE FEET OR 0.4853 ACRES. BEGIINNING AT A POINT ALONG THE LAND NOW ORFORMERLY OWNED BY ROBERT J. AND DEBRA A MERCHESB (DEED BOOK N, VOLUIv1E 36, PAGE 747) (FLAN BOOK 44, PAGE 45, LOT N0.2) ON THE EASTERN LEGALRIGHT-0F-WAY LINE OF EAST SP'RINGVLLLE ROAD (T-686) (FORMERLY L.R 21020) (40' LEGAL WIDTH;I: A.) THENCE ALONG SAID EASTERN LEGAL RIGHT-OF-WAY LINE OF EAST SPRINGVII.LE ROAD FORTHE FOLLOWING EIGHT COURSES AND DISTANCES: I .) BY A BEARING OF SOUTH 03°2U'Ol" EAST FOR A DISTANCE OF 894.74' TO A POINT; 2.) BY A BEARING OF SOUTH 04°05'24" EAST FOR A DISTANCE OF 74.55' TO A POINT; 3.) BY A BEARING OF SOUTH 02° 17' 33" EAST FOR A DISTANCE OF 100.89' TO A POINT; 4.) BY A BEARING OF SOUTft 02°01'29" EAST FOR A DISTANCE OF 579.98' TO A POINT; 5.) BY A BEARING OF SOUTH O1°40'35" WEST FOR A DISTANG'1~ OF 249.34' TO A POIIVT; 6.) BY A HEARING Of SOUTH O1°47'03" WEST FOR A DISTANCE O'F 6b.94' TO A POINT; 4 3uuK 259 Pact~.72 12/05!2011 8:10:28 AM CUMBERLAND COUNTY Inst.# 200350220 -Page 8 of 11 Sap Q4 03 O1:Q4a Lyons Surveyin8 717 431? 1105 p•6 7.) BY ABEARING OF SOUTH 00°19'26" WEST FOR ADIST.ANCE OF 192.03' TO A POINT; 8.) BY A CURVE TO THE RIGHT HAVING A RADIUS OF 592.76', AN ARC LEI~GITH OF 1G4.08' AND A CEIORD BEARING OF 30UTIi 07°36'22" EAST FOR A CHORDD DISTANCE OF 163.36' TO A POINT, SAID POWI' BEING ON SAID EASTERN LEGAti,, RIGHT-0F-WAY LINE OF EAST SPRII3aVILI.E ROAD AND .ALONG THE LAND NOW OR FORMERLY OWNED BY ALBERT E. III AND DQROTHEA S. ADAMS (DEED BOOK Q, VOi.UME 33, PAGE 469) (PLAN BOOK 64, PAGE 38, LOT NO. 3); B.) TI$ENCE BY 5AID ADAMS LAND BY A $EARirIG OF SOUTH 83~°19'50" WEST FOR A DISTANCE OF 21.36' TO A POINT, SAID POINT BEING AT THE NORTHWEST CORNER OF SAID ADAMS LAND AND iN Tl]E CENTERLINE OF BAST SPRINGVILLE ROAD (T-6g6) (FORr+lLRI,Y L.R 21020) (40' LEGAL WIDTH); C.) TkIENCE ALONG SAID CENTERLII~ OF EAST SPRINGVII.LE ROAD FOR ~ FOLLOWING EIGHT COURSES AND DISTANCES: 1.) BY A CURVE TO THE LEFT HAVIl3G A RADIUS OF 572, 76', AN ARC LENGTH OF 165.92' AND A CHORD BEARING OF NORTH 07°58'30" EAST FOR A CHORD DISTANCE OF 165.34' TO A POINT; 2.) BY A BEARING OF NORTH 00°19'26" WEST FOR A DISTANCE OF 191.78' TO A POINT; 3.) BY A BEARING OF NORTH 01°47'03" WEST FOR A DISTANCE OF 66.70' TO A P(]Ir6i't; 4.) BY A BEARING OF NORTH Ol°40'35" WEST FOR A DISTANCE OF 249.30' TO A POINT; 5.) BY A BEARING OF NORTH 02°01'29" WEST FOR A DISTANCE OF 579.87' TO A POINT; 6.) BY A BEARING OF NORTH 02°17'33" WEST FOIL A DISTANCE OF lOD.53' TO A POINT; 7.) BY A BEARING OF NORTH 04°05'24" WEST FOR A DISTANCE OF 74.3'1' TO A POINT ; 8.) BY A BEARING OF NORTH 03°20'0 i" WfiST FOR A DISTANCE OF 894.72' TO A POINT, SAID POINT BEINGt IN THE CENTERLINE OF EAST SPRINGVII.LE ROAD FO~TtMERLY OWNED Y ROBEEtT 7' AND DEBRA A MFRCHE3E (DEED BOOK N,R VOi.UME 36, PAGE 74?) (PLAN BOOK 44, PAGE 43, LOT N0.2); D.) THENCE LF,AYING SAID CENTERLINE OF EAST SPRINGVII.IE ROAD AND ALONG SAID MER~HESE LAND BY A BEARING OF NORTH 86° 13'37" EAST FOR A DISTANCE OF 20.00' TO A' POINT, SAID POINT BB1NG THE POINT AND PLACE OF BEGINNING. CONTAIIJING 46,457.49 SQUARE FEET OR 1.0665 ACRES. +~,._~ B~SUL'I'II~11G IN A NET AREA CONTATNT-dG 4,475,716.29 SQUAR~ ~ ~`.t'0~~~34~(;[~breCOrded tll C::utzlbt:;rlalld County PA 3 AOp!~ ~~~ °,~GE:~,1~3 12/05/2011 8:10:28 AM CUMBERLAND COUNTY ~° Recorder of Deeds Inst.# 200350220 -Page 9 of 11 ' n ~ ` aer .-. ~ ~ ae aE ae ae % ~ ac c .-+ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~~ qq !7 V N N N ~2- CC R73Y~ . .~70 pp C ~~ ~ ~~ ~ . ~ d ~, ~ ~ ~ 1Q1 ~- ~ j~ ~ 7D 7 ILi y ~S7 yti i p . ,. C7 ~ ~3 Ti r+- ..YY7Zi la ..n i f ~; V ~ t"4' 1'1 12/05/2011 8:10:28 AM F{~`7~ %~I r i+ Lori w"' ~i ( .' f I~ ~~„ Y7 i '^ v:7 f~ M W '~ G+ .1 00 ~' fO ~~' fJl I.:L 111 r•- 4 - i~~.'~~ I:N I~.~ i7 •r N f+3 LIt ~ 9 M •.ri F+.f m O C ^S7 a.? C} ~ [} C7 G Ct •r' ~' !` Q O Ti ~, CUMBERLAND COUNTY Inst.# 200350220 -Page 10 of 11 `, ~,.,, RECORDER'S 115E ONLY '.ev.les ex 0~•0~l Slal• ox a' REALTY TRANSFER TAX ~ r ~ COMMONWEALTH OF PENNSYLVANIA STATEMENT OF VALUE cg• Num r DEPARTMENT OF REYENIUE BUREAU OP INDIVIDUAL TAXES R•oor , 11,~ DEPT. 280603 HARRISBURG, PA 17128-0603 See Reverse for Intfrucflonf Complete each section and file in duplicate with Recorder of Deeds when {1) the full value/consideration is net set forth in the deed, {2) when the deed is without consideration, or by gift, or {3) a tax exemption is claimed. A Statement of Yalw is not required if the transfer is wholly exempt from tax based on: (1) family relationahip',or (2) public utility eassmelN. If man space is needed, attach additional sheet{s). ~3~- ~~a S o (v.~ d -c~.~o 2, Check Appropriate Box Below for Exemption Claimed 1 • ^ Will or intestate succession INaM• ~ ~~ •m) Erta• R • Numb•r) ,~.. ' ^ Transfer to Industrial Development Agency. ^ Transfer to a trust. {Attach complete copy of trust agreement identifying all benefidaries.) ^ Transfer between principal and agent. {Attach Complete copy of agencylstraw party agreement-) ^ Transfers to the Commonwealth, the United States and Instrumentalities by gift, dedication, condemnation or in lieu of condemnation. (If condemnation or in lieu of condemnation, attach copy of resolution.) ^ Transfer from mortgagor to a holder of a mortgage in default. Mortgage Book Number ,Page Number ^ Corrective or confirmatory dead. {Attach complete copy of the prior deed being corrected or <:onfirmsd.) ^ Statutory corporate consolidation, merger or division. {Attach copy of articles.) ^ Other (Please explain exemption claimed, if other than listed above.) •Nwslet penalties of law, I detlan tisat 1 have examined this StaternerM, indudhst; ocoompanyhq Infarmotion, and to the bast of my knowledge e>tsltt Belief, it is true, eorn~t and complete. t~s. ~sreetwe or morn ~ w! ~.rr..,..... ~ -- ~o{,K 259 ~~{,t:~~.~5 a ~3 FAILURE TO C ETE THrS FORM PROPERLY OR ATTACH APPLICABLE DOCUMENTATION MAY RESULT IN THE RECORDER'S REFUSAL TO RECORD THE DEED. 12/05/2011 8:10:28 AM CUMBERLAND COUNTY Inst.# 200350220 -Page 11 of 11 RE~f-1511 EX+.(10-09) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER WILLIAM F. MENTZER SR 21 11 0338 Decedents detrts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSE: 1. RONAN FUNERAAL HOME 2. ESTATE ADVERTISEMENT 3. WESTMINISTER CEMETERY B. 2. 3. 4 5. 6. 7. City State ZIP ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City State Year(s) Commission Paid: Attorney Fees: Donna L. Godfrey, Esquire Family Exemption: (If decedents address is not the same as claiman4s, attach explanation.) Claimant Street Address Relationship of Claimantto Decedent Probate Fees: CUMBERLAND COUNTY REGISTER OF WILLS Accountant Fees: Tax Return Preparer Fees: TOTAL (Also enter on Line 9, Recapitulation) I S If more space is needed, use additional sheets of paper of the same size. ZIP 10,494.75 232.68 1,795.00 4,600.00 223.50 500.00 17.845.93 Ronan Funeral Home 255 York Road 717-258-9863 Email: ronanfh~pa.net Lynn A. Ronan, F.D. Carlisle, Pa 17013 Fax 717-241-404'1 Monday, March 14, 2011 Mrs. Dorothea Adams 3 Arbor Dri~~e Boiling Springs, PA 17007 Our Family Serving Your Family Dear Dor, Thank you for selecting ot~r funeral home to provide ser`-ices for your family daring }lour time of bereavement. 1 hope that you found our services, so far, to be of the highest standards that we always try to achieve. The fallowing is a summary of the sen•ice charges as previously explained and provided in written form on the services for: WILLIAM F MENTZER. S PROFESSIONAL SERVICES R Basic service of funeral director and staff $ 4,630.00 Embalmlingg $ Incl. Dressin , Casketing, and Cosmetology aration of Bod Other Pre $ Incl. $ Incl. y p Total Funeral Service Selected TOTAL PROFESSIONAL SERVICES $4,630.00 Use of Facilities & Staff for Visitation $ Incl. Use of Facilities & Staff for Ceremony at Funeral Home $ Incl. Use of Staff & Equipment for Graveside Service $ Incl. Transfer of Remains to Funeral Home $ Incl. Hearse ! Funeral Coach $ Incl. Flower Vehicle $ Incl. Flower !'.Lead Car $ Incl. OTHER 11VIERCHANDISE SELECTED Casket: KENSINGTON $3,470.00 Outer Burial Container MCCALMONT SUPREME $1, ] 70.00 Memorial Package $ 125.00 TOTAL OTHER l1iERCH_ANDISE SELECTED 54,765.00 CASH ADVANCES of Death Certificate Copies Certifiegi $ 90.00 , _ Clergy onorartum Newspaper Notice Sentinel $ 100.00 $ 225.80 Newspaper Notice Patriot-News $ 415.77 Flowers $ 268.18 CASH ADVANCE TOTAL $1,099.75 'TOTAL OF SERVICES $10,494.75 BALANCE DUE $10,494.75 ?f there are any questions or concerns that remain unanst~ eyed; please call int. Sincerely, l.~~tui A. Ronan Funeral Director a -~-. C n A .~' v ~ v ~ ~ r -' ~' a • ny a < F ~ °.:y (~ 5 ~ ~ ~ ~ ~ p "c y n I ca. o~~.~~ ~'~ a ~S :;G~'-°+ b ~ ro ~ Cr_.r „~ ~ do .. n ."~ rl n r ~• ~ ~ Ci' : :1 u ` '' ~: _ ~ y ~ ~ ~~ L ti ^~ t ~, w :. ~ ~ G r7 G. [D ~ .C J ~ ry ~TJ A N ry M r ~ "9 ~ ~ ~ . ~. ~ ~ N K ' W . 7 - ~ ~ .. r ~ ' I ~ ~ ~ ~ ~~~ Il l il a :::: :~ I ~ :: :~: ~ _ l R- w ~. ~.' .. . .. .. ... ... L f j ~ ~~ ~~e <y° ~ o ~~'~~" c `'=°• ~~ 2=`~ ~~y ~ ~ A ~ O m Q° ~ y a ;r, ~-~, p 'b M n A „~ ~ ~: i r r A . r!~~7 A ~ x ~ r• 3, ~ ~ ce ti~ ~ "~A ,ti ~ C ~ A ~ ~ .'~' ; r+ ~ ~~ ~ m . wyn ~ ~. S 4, f G y n ~. /'\ r ~ ~. rt ~ < .."" u n s n ~ ~ C a #- j 3. ' c ' T t z ~_ 'J C J c_` F rI ~~ ---v _ .r _ ~. _~ ~ - x ~ ~ Y •~ ~ S r G ~ ~ ~ ?i ~ ~ ~ S ... o n f ~ ~' C.• r F ~ G r ~ ~ ~ ~ TJ _ ~~ r G cam.- su~ r `" r .~ w ' < II r' .~ C £ ~ 'JC -~r r~ _~^^=_ _- ~. ~ r f ~ ~ rJ" "J r`j Cj ~ r ~ ! 1. 1. _ ~. V ` ^ ~r rte-' (' ~ .~_. < ... ~ n 3 ~ ~ " y ~ ~ _ _ ~, ~ _ n` rG `` _ _.. C. ~ ~ ~G _ _ `~"6 :n ? f9 R vv.+ O _ ~.' r .. ? G ~ i S S C a w n .? T v r ^c u ~.. e~-t Z W s~ G ~"~ F1y v 1~++ f y 4_, n [rJ .~ ~V '~t' ~~~ ~g~A ~a'b'~ by~w~.v Q ~/j•,~ A w~° :~ ~ 0 ~C~ ti ~ O ~ i IcRriS Hn,t~inrx of >Ps,...+~ 1.-,,,,:., #",~„ Retail Installment Contract and Security Agreement _ -___ _____ ^ Tri-County Memorial Gardens LLC ("LLC") C3 Westminster Cemetery LLC ("LLC") Contract # zany") StoneMor Pennsylvania Subsidiary LLC (`'Company") StoneMor Pennsylvania Subsidiary LLC ("Company") :ry") Tri-County Memorial Gardens. ("Cemetery") Westminster Cemetery ("Cemetery") 740 Wyndamere Road. Lewisberry. PA 17339 I t59 NPewilh Rnarl r~~rTicli~ p,~ !Tn! ~ err-yea-,a~~ 717-349-?029 vely in this Agreement as "Seller'} are owners and operators of the Cemetery. THIS AGREEMENT is made by and between Seller and - tlnminnr~oP .•~!!~a rl-,. ••n,....t•. ;.Li artu ~ompatty agtttes to yeti to Purchaser, or his designated benet7ciary in accordance with the terms hereof, the following items. to be provided or used at the above checked la:ation. Burial Rights covered by the Agreement are shown by the map of such gardenl6uilding on file in the office of the CEMETERY, and are more particularly described below. ! +Mausoletw: ^ Chapel ^ Garden ^ Tandem ^ Side-by 'fide ^ Single ^ Developed ^ Preconsttvction 7 Double Depth ^ Side-by-Side Niche: ^ Chapel ^ Garden ^ Single ^ Companion ^ Developed ^ Preconstruction 1 Single ^ Developed ^ Preconstruction ~. ~,:. ~ - 2nd Choice 1st Choice 2nd Choice Garden __---_------ -- -_-_ Building --.-.------_---- _-__ Building -_.-- Section ______- __. Section __-___________-. Section - ________. Lot ------- - ------ No.(s) -------- ---- No.(s) -- --______------ ---- c,...:,i.-. _t...-~~°~ --------- . -_ l.2vC1 Level 3. TTEMIZATION OF CHARGES LLC* Company* (A) BuClal Rights (as described in Pnta. l above) --_ $ __ _ _ ed for use at another cemetery. (B) Perpetual Care __-____. $ _- ___ . ~.-., r ~.., ~.~53 ~.ciiw~diG .JiJI:UWIi a __- (D)Second Right of Interment $ _!-________- - (E) Vault(s) --_-..~ $ -__---- - --------'---- ----------------- (~ Urn(s) _.--- _... $ -- (G) Mausoleum I,etterine/Crv_ nt Plate c -- - --- --- -- ----- ------- H) Memorial/Monument _ - __ _ (I) Granite Base(s) (1) [nstallation Charge -__--- $ -_----------___-- $ --__-- ---_ _- (K) Caskets $ _ _ ___ _-- Vase: Y / N (L) intnat ree for interment __t___ $ __ __:i~ (M)Final Interment/Entombment/Inurnment Fee $ . _ Granite Size - X (N) Permanent Records & Processing Fee S ______195.0_ __ _____ __ . $ __ - rP1 Ca#,~c Taw - W -.- __...-- --- .. - '~ --_ -- 4. 'COTAL CASH PURCHASE PRICE (A THRU P) Color: - ITEMiZATION OF THE AbIOUNT FINANCED x P (I) Total Cash Price v P /77 ~ Tln~.•.t t~~.....~,+• 1 (`.,~1, A ( i ...1, ^ r.- r. -«. ~ .= .. - _ .. _. . _.... _.,__.. ~ -~...... ~..u, ~. y _.. - x P B. -Grade In: _ OId Agreement No. - _ C. Total Down Payment (2A+ 2Bj ...........:........ $ __...' _..- -u..--- (3) Unpaid Balance of Cash Price (1 - 2C) ................ $ - __ _-__ Gauge: _ ___ _ Gauge: ~ t~+l rtnunce trharge ......................... ,~ (5) Total Unpaid Balance (3 + 4j ........................ S •condarily liable to the other for the sales of items and services provided by one another pursuant to this Agreement: however, Purchaser shall not be required to exhaust ;ore proceeding against the other. yn_vAL wEFiCENTA4E ili1TE FIHANC~~RGE ' AMOUNT FINANCED R cost of your credit as a yearly rate. The dollar amount the credit will cost you. The amount of credit provided to you TOTAL OF PAYMENTS The amount you will havta paid after you TOTAL SALE PRICE The total cost of purchase a! Credit. includ- on your own behalf. have made all,payitre)tts as scheduled. ing down payment of 5 ~' =` ter of Payments Amount of Payments First Payment Due Date Thereafter, Payments Are Due ---- $ _ - _ O Monthly on _ -- $ - - ~; Uti ~ ~~ x#. nr of n.lPrtq h. n. .,,....I,o .=rf ... ;. _. ..e.4 C - ~. '.,';~ .. .'.o:,:. ..,v..... ,. i.i~,..uain~i.., ilu.u 1-lino. ` V - to pay a penalty and you may be entitled to a refund of part of the Wnance Charge. l to General Provisions un the !averse side hereoT) for additional information about nonpayment. defaalt. delinquency charge, security interests, any required payment in full before the k nalt ira. CONSUMER CREDIT SALE AND IS SUBJECT TO THE ADDITIONAL GENERAL PROVISIONS CONTAINED ON THE REVERSE SIDE .-...~ afa •YaaJ .~V a~LLilll:i vL. irs, executors, administrators,soccessors and assigns of the parties hereto. 'PRfITFrTTnnrrrRTri4fl`.1Tr. 7CSnnrrr~nrc l+~1Arm.r~r... ..,...........-,_,._,~...._._.~-._---._...-- _ The Sentinel www.cumberlink.com .~A,,y~r~tdl~i ATTY.-AT-LAW DONNA L. GODFREY 1122 FLEETWOOD DRNE CARLISLE, PA 17013 717-422-7865 AD NUMBER PAGE NO. 397109 1 of 1 BILL DATE SALESPERSON 05/26/11 wolfc START DATE STOP DATE 05/12111 05/26/11 AD NUMBER nu ~w~.n~r ~ wi. --- -- 397109 NOTICE LETTERS TESTAMENTARY HAVE B 10 PUBLIC NOTICES 28_ " 2 cols Publication Insertions Rate N®t Amount Gross Amount 3 THE SENTINEL -LEGAL 3 LGL $148.68 TOTAL AD CHARGE $148'68 3 PROOF OF PUBLICATION 01 PRF $7.00 3 MOBILE SITE MOB2 $2.00 PREVIOUSLY PAID ($157.68) Purchase Order Est.W.F.Mentzer $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 df insertion. For questions, call (717) 240-7130. THE SENTINEL c/o LEE NEWSPAPERS PO BOX 540 WATERLOO IA 50704-0540 Retum tnrs poroon xnm your payment ^ Check # ^ Credit Card ^®o®^®^~ Acct #: ^ Ems. Date: ^ ^ Name on credit card Signature THE SENTINEL c/o LEE NEWSPAPERS PO BOX 540 WATERLOO IA 50704-0540 Leaal Ad Number 397109 Billing Date 05/26/11 Amount Due $ .00 AInOUr1t Enclosed $ lease make checks payable to: Th1E SENTINEL ooozss ATTY.-AT-LAW DONNA L. GODFREY 1122 FLEETWOOQ DRIVE CARLISLE, PA 170!13 THE SENTINEL clo LEE NEWSPAPERS PO BOX 742548 CINCINNATI OH 45274-2548 ~~~n~~~t~nr~t~~nt~r~n~u~r~~~r~n~n~~tt~n~u~~n~~~n~~~ 2154020D00000397109000000000000000DOOOOOOOOOOD0008 CUMBERLAND LAW JOURNAL 32 SOUTH BEDFORD STREET CARLISLE, PA 17013 Tele: (717) 249-3186 Fax: (71 T) 249-2663 June 3, 2011 Cumberland Law Journal is published every Friday by the Cumberland County Bar Association and is designated by the Court of Common Pleas as the official legal publication for Cumberland County and the legal newspaper for publication. of legal notices. TO: Donna L. Godfrey, Esquire William F. Mentzer Estate RE: Legal advertisements must be received by Friday Noon. All legal advertising must be paid in advance. Make all checks payable to: Cumberland Law Journal. Advertisement inserted on following dates: May 20, May 27, and June 3, 2011 Advertising Cost $ 75.00 Proof of Publication $ 0.00 Second Proof Request: $ 0.00 Payment received $ 75.00 Total Amount Due $ 0.00 Becky H. Morgenthal, Executive Director REV-9512 EX+''~12-08) Pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES, 8c LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER WILLIAM F. MENTZER SR 21 11 0338 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Auctioneer Expense (See Auctioneer Invoice) 3,202.00 2. Met Ed -Electric 206.44 3. West Shore EMS 997.66 4. Gary Shugart -auction cleaning 1,045.00 5. Carlisle Hospital Medical Bill 1,132.00 6. Kinetic Imaging 92.07 7. Yellow Breeches EMS 80.74 8. Klinger & Associates (2010 Tax Returns) 40.00 9 PA Department of Revenue 2010 Tax Liability 13.00 10. M&T BANK ACCOUNT CHARGE 14.00 TOTAL (Also enter on Line 10, Recapitulation) I S 6,822.91 If more space is needed, insert additional sheets of the same size. REV-1513 EXt (OL10) Pennsylvania DEPARTMENT OF REVENUE SCHEDULE J BENEFICIARIES ESTATE OF: FILE NUMBER: WILLIAM F. MENTZER SR 21 11 0338 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON{S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE 1 TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1. DOROTHEA S. ADAMS Lineal 25.00 3 ARBOR DRIVE BOILING SPRINGS PA 17007 2. CRISTINE SCHROEDER Lineal 25.00 67 LAKEVIEW TIMBERS DRIVE GOULDSBORO PA 18424 3. WILLIAM F. MENTZER, JR Lineal 25.00 1139 CEDAR CREST DRIVE LEBANON PA 17046 4. JEREMIAH L. MENTZER Lineal 25.00 1142 DUNLIN COURT MECHANICSBURG PA 17050 II. 1 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. S If more space is needed, use additional sheets of paper of the same: size.