HomeMy WebLinkAbout11-21-11~ _ __ _ _ _ T
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150561D143
REV-1500 ~`(°'-'°'
OFFICIAL USE ONLY
PA Department of Revenue pennsylvanla coumy coos veer Fiw Number
Bureau of Individual Taxes 0A'RA1B1TO"-°'E
Po Box.26o601 INHERITANCE TAX RETURN 21 10 0 613
Harrisburg, PA 1712&0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
172 46 2720 05 28 2010 10 16 1953
Decedent's Last Name Suffix Decedent's First Name MI
LEEDY CONNIE J
(ff Applicable) Enter Surviving Spouse's Information Bslow
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
x^ 1. Original Retum ^ 2. Supplemental Retum ^ 3. Remainder Retum (date of death
prior to 12-13-82)
^ 4. Limited Estate ^ 4a. Fuexe Interest Canpromiee 5. Federal Estate Tax Retum Required
(date or dselh~~attftaper 72-122)
® 8' DNtaeh C~ d W II ^ ~• nn~ (:pPyB1OT T qj Living Trust ~ B. Total Number Of Safe Deposit Boxes
^ 9. Litigation Proceeds Received ^ 10. bs~°Utvreense1lL~-31 91 erond~7_~1-95~death ^ 11.Elecbon t0 tax under Sec. 9113(A)
(Attach Sch. O)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
BRADLEY L GRIFFIE (717) 243 5551
First Iine of address
200 NORTH HANOVER 3T
Second Iine of address
City or Poat Office State ZIP Code
CARLISLE PA 17013
REGISTER OPS USE Q~VLY ,. ,.
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correspondents a-mail address: bgriffie~griffielaW.com
Uis~true~cort~ect a°frxi imp deGaD reecla~rettion~pre~panrer ~rstlta~n ~e nGuding aooompanying schedules and statements, antl to the best of my krrovrled®e and belief,
personal repreaeMadve is based on all information of which Dreparer has am knowledge.
Alexandra C.
1505610143
Side 1
155610143
~~
1
~~
~ Qt
~ ~ ~ ~a
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tr .'
1505610243
REV-1500 EX
Decedent's Social Security Number
oec•a•nrsN.m•: Leedy, Connie J. 172 46 2720
RECAPITULATION
1. Real Estate (Schedule A) ....................................................:.................................. 1. 90 , 000.00
2. Stocks and Bonds (Schedub B) ............................................................................. 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)......... 3.
4. Mortgages & Notes Receivable (Schedule D) ........................................................ 4.
5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............... 5. 4 , 314.34
6. Jointty Owned Property (Schedule F) ^ Separate Billing Requested............ 6.
7. Inter-Vivos Transfers 8 Miscellaneous I~nq Probate Property
Se
arate Billin
Re
uested
S
h
d
l
G
p
g
q
............
) U
(
c
e
u
e 7,
8. Total Gross Assets (total Lines 1-7) ..................................................................... 8. 94 , 314.34
9. Funeral Expenses & Administrative Costs (Sctiedule H) ....................................... 9. 94 , 386.41
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............................. 10. 2 , 2 97.22
11. Total Deductions (total Lines 9 & 10) ................................................................... 11. 96 , 683.63
12. Nat Value of Estate (Line 8 minus Line 11) .......................................................... 12. -2 , 3 6 9 . 2 9
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. -2 , 3 69.2 9
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116 15 0
00
(a)(1.2) X .00 . .
16. Amount of Line 14 taxable 0
00 16 0
00
.
at lineal rate X .045 . .
17. Amount of Line 14 taxable 0
0 0 17 0
0 0
,
of sibling rate X .12 . .
18. Amount of Line 14 taxable
0
00
18
0
00
•
at wllateral rate X .15 . .
19. Tax Due .................................................................................................................. 19. 0.00
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ^
150561.0243
Side 2
1505610243 „~
1' l•
REV-1500 EX Page 3
Decedent's Complete Address:
File Number 21-10
DECEDENT'S NAME
Leedy, Connie J.
STREET ADDRESS
1141 Pheasant Drive North
CITY
Carlisle STATE
PA ZIP
17013
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19) (1) 0.00
2. Credits/Payments
A. Prior Payments
B. Discount 0.00
Total Credits (A + B) (2) 0.00
3. Interest (3)
q. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4)
Check box on Page 2 Line 20 to request a refund
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) Q,QQ
Make Check Pa able 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 :............................................................................... ^ ^x
b. retain the right to designate who shall use the property transferred or fts income :.................................. x
c. retain a reversionary interest; or ...............................................................................................................
d. receive the promise for life of either payments, benefits or care? ............................................................ x
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration? .................................................................................................................... ^ 0
3. Did decedent own an "in trust for' or payable upon death bank account or security at his or her death?....... ^
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? .................................................................................................................. ^ ^x
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 January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disGosure 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 p2 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)]. A
sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
Rw-7502 EXr (11~)
SCHEDULE A
REAL ESTATE
COMMONWEALTH OF PENNSVLVANU
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF (FILE NUMBER
Lt3edy, Connie J. 21__
All real property owned soNlY or as a tsnaM In common must ba ropwtW at fair market Wane. Fair market value is deFlnad as the price et whleh property would be
exchMped between a vnlllnp buyer end a willing seller, nehher being compelled to txry or sell, both h~~lnp reasonable knovAedpe of Ole rolwam facts.
Real property whleh is landl''ce'ned whh right of wrvhrorohip must bs disclosed on schedule F.
Copyright (c) 2009 forth software only The Lackner Group, Inc. Form PA-7500 Schedule A (Rev. 11-OS)
(If more space is needatl, additional pages of the same size)
Rw-108 EX+ (6-~)
SCHEDULE E
CASH, BANK DEPOSITS, 8t MISC.
PERSONAL PROPERTY
COMMONN~EALTM OF PENNBVLVANIA
INNERRANCE TA%RtZURN
RE8IDENT DECEDENT
ESTATE OF (FILE NUMBER
Leedv. Connie J. 21-10
InUude the proeeeda of Ikigedon and the date the proceeds were received by the aerate.
All preparty jWntlyotNrted with tl» dlJm of wrvWOrship must W dlaelosad on scMduh F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Members 1st Federal Crodit Union -Checking Account No. 278460-00 (See attached 72.53
statement)
2 Members 1st Federal Crodit Union -Savings Account No. 279460-11 (See attached 18.04
statement)
3 Members 1st Federal Credit Union -Holiday Club Account No. 279460-02 (See attached 0.06
statement)
4 Members 1st Federal Credit Union -Supplemental Savings Account No. 279460-01 (See 1.66
attached statement)
5 M&T Bank -Checking Account No. 2679054821 (See attached statement) 58.11
6 M&T Bank -Savings Account No. 15004219432313 1,443.06
7 Real Estate Tax Proretions from settlement - (See attached HUD-1) 1,044.03
8 AAA Life Insurance Company -Health Insurance reimbureement 250.00
9 AARP Membership Refund 16.00
10 Richard H. Jeffries, O.D. -Refund of overpayment 110.85
11 1996 Honda Civic LX Sedan -Title No. 49605772401 (See attached Kelley Blue Book value) 725.00
12 1996 Jeep Grand Cherokee -Tice No. 49443330106 (See attached Kelley Blue Book value) 575.00
TOTAL (Also enter on Line 5, Recapitulation) I 4,314.34
pf more space is needed, additional pages of the same size)
Copyright (c) 2002 fonn software only The Lackner Group, Inc. Fonn PA•7500 Schedule E (Rev. 6-98)
REV-1157 Exr (10-08)
SCHEDULE H
co ,,,N~, FUNERAL EXPENSES 8r
~~~~~~ ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Leedy, Connie J. 21-10
Debts of decedent must be reported on Schedule 1.
ITEM DESCRIPTION AMOUNT
A, FUNERAL EXPENSES:
See continuation schedule(s) attached
B. I ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
2,840.15
Street Address
City State Zio
Yearfsl Commission paid
2. Attomev's Fees Griffis 8~ Associates 6,000.00
3, Family Exemption: (If deoadent's address is not the same as Gaimant's, attach explanation) 3,500.00
Claimant Alexandra C. Leedy
Street Address 51 East Penn Street
Ciry Carlisle State PA Zio 17013
Relationshio of Claimant to Decedent Daughter
4. Probate Fees 258.50
5. Accountant's Fees
6. Tax Retum Preparers Fees
7. Other Administrative Costs 81,787.76
See continuation schedule(s) attached
TOTAL (Also enter on Ilse 9, Recapitulation) 94,386.41
Copyright (c) 2009 form software only The Lackner Group, Inc. Fonn PA-1500 Schedule H (Rev. 10-06)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF (FILE NUMBER
Leedy, Connie J. 21-10
ITEM
NUMBER DESCRIPTION AMOUNT
Funeral Expenses
1 Fogelsanger-Bricker Funeral Home 2.840.15
H-A
Other Administrative Costs
2 PPL Electric UUIlties
3 York Waste Disposal
4 The Sentinel - (Advertising)
5 Cumberland Law Journal - (Advertising)
6 Orrstown Bank - (bank fees)
7 Vital Records - (Death Certlflcates)
8 Real Estate Settlementfees: - CitiMortgage (mortgage payoff) 75,093.93
Realtor's Commission A,500.00
Final Water 8 Sewer Reading 286.10
(North Middleton Township)
Waste Disposal 145.62
Courier/Overnight fees 20.00
Notary fees 10.00
Real Estate Transfer Tax 900.00
Tax Certification Fee 5.00
Broker fee 250.00
(See attached HUD-1)
2,840.15
H-B7
242.14
44.93
187.54
75.00
9.50
18.00
81,210.65
81,787.76
Copyright (c) 2002 form software only Tha Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98)
Rw-1612 EJ(a (12-0a)
SCHEDULE 1
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, ~ LIENS
GONIMONN/EALTH OF PENNSYLVANIA
INHERRANCE TAX RETURN
RE8IDENT OECEDENi
ESTATE OF FILE NUMBER
Leedy, Connie J. 21-10
Report debts Incuvreid try ale decedent prior to death drat remslnsd unpMd at tha date of deatll, Including unrelmbwrW medial expsnra.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Comcast 473.00
2 Amerigas 52.59
3 CitiMortgage - (Mortgage payment) 522.82
4 Guardian Long-Tenn Care Pharmacy 733.45
5 Carlisle Digestive Disease Associates 32.16
8 Blue Mountain Anesthesia Associates 80.98
7 Forest Park Health Center 180.00
8 Spring Road Family Practice 71.25
9 Kinetic Imaging 119.36
10 Ben Souders Landscaping - (mowing) 31.80
TOTAL (Also enter on Line 10, Recapitulation) I 2,297.22
(If more space is needed, additional pages or the same size)
Copyright (c) 2009 form software only The Lackner Group, Inc. Farm PA-1500 Schedule I (Rev. 12-08)
REV-1513 EX~ (11.06)
SCHEDULE J
°O""71~°>F~~~"""'" BENEFICIARIES
ESTATE OF I FILE NUMBER
Leedv. Connie J. 21-10
NAME AND ADDRESS OF RELATIONSHIP TO
SHARE OF ESTATE
AMOUNT OF ESTATE
NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (Words) ($$$)
I TAXABLE DISTRIBUTIONS [include outright spousal
• distnbuhons, and transfers
under Sec. 9116 a 1.2
Alexandra C. Leedy Daughter All of net estate 100.00
51 East Penn Street ($0..00 )
Carlisle, PA 17013 *Insolverit
Estate
Total 100.00
Enter dollar amounts for distributions shown above on lines 15 throw h 18 on Rev 150 0 cover sheet as a r o riate.
NON-TAXABLE DISTRIBUTIONS:
u• 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 SHEETI
Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1800 Schedule J (Rev. 11-08)
LAST t~1I LL AND TESTAMENT
OF
I order and direct my Executor hereinafter named to pay all of my just debts,
I, CONNIE J. LEEDY, of 1141 Pheasant Drive North, Carlisle, Cumberland
County, Pennsylvania, being of sound and disposing mind, memory and understanding,
do make, publish and declare this to be my Last Will and Testament, hereby revoking and
making void all previous Wills and Codicils'heretofore made by me.
FIRST
_~
funeral expenses and expenses involved or connected with the administration of my estate
as soon after my death as is reasonably possible. I direct my Executor to pay all
inheritance, estate, succession and legacy taxes, to which my estate or the transfer of any
property hereunder maybe subject, and to charge such taxes as part of the expenses of the
CONNIE J. LEEDY
administration of my estate, being deducted and paid from the residue of my estate and
not to be deducted in any manner from any specifiic bequests made herein. However, my
Executor need not accelerate and pay those unmatured obligations which, in his, her or its
opinion, It might be proper and more advantageous to retain or renew and pay as they
200 N. Hanover Street
t'.arlisle. PA 17/173
GRIFFIE & ASSOCIATES
Attorneys At Law
Page 1 of 8
100 Lincoln Way East, Suite D
Cleambersbur~, PA 17201
become due and payable. If I do not own a burial plot or a grave marker at the time of my
death, I authorize my Executor/Executrix, in his, her or its sole discretion, to purchase a
burial plot and to erect a suitable grave marker at my grave, and to expend sums from my
estate for this purpose.
SECOND
I give, devise and bequeath my entire estate together with all insurance proceeds
thereon of whatsoever nature and wheresoever situate to my daughter, ALEXANDRA C.
LEEDY, providing she survives me by sixty (60) days, per stirpes. I duect my
Executor/Executrix to divide among such beneficiaries all personal property of a
sentimental or family nature (excluding cash, stocks, bonds and the like), including but .
,, not limited to jewelry, household goods, antiques, furniture and memorabilia, in
accordance with a separate memorandum which I may place with my Will or deposit with
my attorney. In the absence of such disposition by memorandum, I direct that the said
tangible personal property be divided between my residual beneficiaries with due regard
for their personal preferences in as nearly equal shares as practical, with the value of such
~ dispositions being credited to the share of each respective recipient. If the said
0
beneficiaries do not agree to the division of the personal property provided for hereunder,
the decision of my Executor/Executrix, including the decision to sell the property at
public or private sale and distribute the proceeds therefrom as provided hereinafter, shall
be final and conclusive on all parties.
FOURTH
Any devise or distribution under this Last Will and Testament which is payable to
any beneficiary who may be under eighteen.(18) years of age or, in the judgment of my
GRIFFIE & ASSOCIATES
Attorneys At Law
200 N. Hanover Street page 2 of 8 100 Lincoln Way East, Suite D
Carlisle, PA I70I3 Chambersburg, PA 17201
L
Executor/Executrix, mentally disabled, shall be held in a separate trust by my
Executor/Executrix as trustee until such beneficiary reaches eighteen (18) years of age or
during such period of disability. During the term of any trust created pursuant to this
Paragraph, the Trustee is authorized to expend and apply so much of the net income and
principal of each such trust as the Trustee shall consider advisable for the health,
maintenance, support, and education (including college education, undergraduate and
graduate) of each such beneficiary until he or she attains eighteen (18) years of age, or
until all such amounts are paid out of trust. I direct that no Trustee shall be required to
give or post bond for the faithful performance of the Trustee's duties in this or any other
jurisdiction.
FIFTH
I grant my Executor/Executrix the following powers in addition to and not in
limitation of such powers as my F..xecutor/Executrix shall hold by law:
(a) To retain all property received including the stock of any corporate fiduciary
' acting hereunder, provided such property remains productive.
(b) To join in any corporation, partnership, recapitalization, merger,
reorganization or voting trust plan; to delegate authority with respect thereto;
to deposit investments under agreements and pay assessments; and generally
to exercise all rights of investors, including but not limited to, the voting of
shares.
(c) To manage, operate, repair, improve, mortgage or lease on any terms any real
estate held or owned by my estate.
GRIFFIE & ASSOCIATES
Attorneys At Law
DO N. Hanover Street pa e 3 of 8 100 Lincoln N'ay East, Suite D
Carlisle, PA 17013 g Chmnbersburg, PA 17201
(d) To operate any business that I may own at my death.
(e) To invest any funds of my estate in any stocks, bonds, notes or other securities
or property, real or personal, without regard to the principle of diversification
or any other statute or general rule of law in his, her or its absolute discretion,
it being my intention to give my Executor/Executrix the broadest investment
powers possible, providing such investments do not unnecessarily prevent the
prompt settlement of my estate.
(f) To sell or otherwise dispose of any property, real or personal, tangible or
?I
ti
intangible, at any time forming a part of my estate in any manner and on such
terms and conditions as my Executor/Executrix shall see fit in his, her catr its
absolute discretion.
(g) To borrow money for the payment of taxes or for any other proper purposes in
r
the administration of my estate, and to mortgage or pledge estate assets as
security.
(h) To compromise claims without court approval including, but not limited to,
any controversies with the United States of America or the Commonwealth of
Pennsylvania concerning estate and inheritance taxes on any interests that may
pass under this my Last Will and Testament.
(i) To distribute in cash or in kind upon any division or distribution of my estate.
(j) To undertake any and all acts deemed necessary and proper by my
Executor/Executrix for the proper, advantageous and prompt management of
the settlement of my estate.
GRIFFIE & ASSOCIATES
Attorneys At Law
200 N. Hanover Street
Carlisle, PA 17013
Page 4 of 8
100 Lincoln Way East, Suite D
Cfiambersburg, PA 17201
a e . . . .
(k) In general, to exercise all powers in the management of my estate which any
individual could exercise in the management of similar property owned in his
own right, upon such terms and conditions as to him, her or it may seem best
and to execute and deliver all instruments and to do all acts which he, she or it
deems necessary or proper to carry out the purposes of this, my Last Will and
Testament.
SIXTH
No interest of any beneficiary of my estate, either in income or in principal, shall
be subject to anticipation or pledge, assignment, sale or transfer in any manner, nor shall
any beneficiary have the power in any manner to charge or encumber his interest eithi~r in
income or principal, nor shall the interest of any beneficiary be liable or subject in any
manner while in the possession of my Executor/Executrix for the liability of such
beneficiary.
SEVENTH
I nominate, constitute and appoint my daughter, ALEXANDRA C. LEEDY, as
Executrix of this my Last Will and Testament. In the event my daughter is deceased,
unable or unwilling to serve or shall cease to serve for any reason whatsoever, then I
nominate, constitute and appoint my sister, SUSAN Y. BRICKER, as Executrix of this
my Last Will and Testament. I direct that my Executrix shall not be required to give or
post bond for the faithful performance of his, her or its duties in this or any other
jurisdiction.
GRIFFIE & ASSOCIATES
AttorneysAtLaw
200 N. Hanover Street 100 Lincoln Way East, Suite D
Carlisle, PA 17013 Page 5 of 8 Chambersburg, PA 17201
W WITNESS WI~REOF, I have hereunto set my hand and seal to this, my Last
Will and Testament, consisting of eight (8) typewritten pages, the first five (5) of which
bear my signature on the side margin, for purpose of identification, this ,~
l
day of ~ ,2008.
WITNESS:
CONNIE J. Y
GRIFFIE & ASSOCIATES
Attorneys At Law
200 N. Hanover Street 100 Lincoln Way East, Suite D
Carlisle, PA I70I3 Page 6 of 8 Cliambersburg, PA 17201
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA:
SS.
COUNTY OF CUMBERLAND
I, CONNIE J. LEEDY, the Testatrix whose name is signed to the attached or
foregoing instrument, having been duly qualified according to law, do hereby
acknowledge that I signed and executed the instrument as my Last Will and Testament;
that I signed it willingly, and that I signed it as my free and voluntary act for the purposes
therein expressed.
...
_ - NNIE J. LE Y
Sworn or affirmed and acknowledged before me by the Testatrix this
day of ,2008.
. MCTAR1At NK
Notan b~iewo .
/C~OIIOM. CiN~AI~ ......
JilNjr~:C~Miibilonanpk«,~ t7, X3011
GRIFFIE & ASSOCIATES
Attorneys At Law
200 N. Hanover Street pa 7 of 8 100 Lincoln Way East, Suite D
Carlisle, PA 17013 ~ Chambersburg, PA 17201
AFP~DAVIT
COMMONWEALTH OF PENNSYLVANIA:
. SS.
COUNTY OF CUMBERLAND
WE, ~"~ ~... F'P,r'ZZ. and 6ro-d le, L . G~ ~~r`~. ,
the witnesses whose names are attached to the foregoing document, being duly qualified
according to law, do depose and say that we were present and saw the Testatrix sign and
execute the instrument as her Last Will and Testament; that she signed willingly and that
she executed it as her free and voluntary act for the purposes therein expressed; that each
subscribing witness in the hearing and sight of the Testatrix signed the Last Will .and
Testament as witnesses and that to the best of our knowledge the Testatrix was at the time
18 or more years of age, of sound mind and under no constraint or undue influence.
Sworn or affirmed and subscribed before me by 11 L
and ~,. C~ f < _ this ~ day of , 2008.
~'~-
Notary Publi
RGd~M ,~ -.A.:i:r:.~l
1 ~'~; .
`, ~ .•~~•~ Notary Rublic
• ._ .
;. tyr~it,~pOtt ~., ..:.~Yl~,1~1~ .
~.,.,.~
GRIFFIE & ASSOCIATES
Attorneys At Law
200 N. Hanover Street 100 Lincoln Way East, Suite D
Carlisle, PA 17013 Page 8 of 8 Chmnbersburg, PA 17201
Attachment
to
Schedules A, E, and H
B. E F LOAN:
A.
USING & URBAN DEVELOPMENT 1. FHA 2. FmHA 3. X CONY. UNINS. 4. ~VA S. QCONV. INS.
U.S. DEPARTMENT OF HO 6. FILE NUMBER: 7. LOAN NUMBER:
SETTLEMENT STATEMENT 8. MORTGAGE INS CASE NUMBER:
C. NOTE: This form is lumished to give you a statement of actual settlement orosts. Amounts paid to and by the settlement agent are shown.
!tams marked "(POCJ" were Pa/d outside the dosing; they are shown here for informational purposes and em not mduded m the totals.
t.o area (cnottzoe.rFac~otrzasr~
D. NAME AND ADDRESS OF BORROWER:
MITTEN FADNESS REALTY, LLC E. NAME AND ADDRESS OF SELLER:
ESTATE OF CONNIE J. LEEDY F. NAME AND ADDRESS OF LENDER:
CORNERSTONE FEDERAL CREDIT
UNION
G. PROPERTY LOCATION:
1141 PHEASANT DRIVE NORTH
PA 17013
CARLISLE H. SETTLEMENT AGENT: 25-1838737
CRAIG A. DIEHL, ESQUIRE I. SETTLEMENT DATE:
September 30
2011
,
CUMBERLAND County, Pennsylvania
, PLACE OF SETTLEMENT
3464 TRINDLE ROAD
CAMP HILL, PA 17011
, ,
101. Contract Sales Prloa 90 000.00 401. Contract Sobs Price I 90,000.00
102. Personal 402. Personal
103. Settlement to Borrower Line 1400 2,976.88 403.
104. Pa 1st ' 404•
105, 405.
106. (Town Taxes b 406. Ci awn Tatms to
107. Coon Taxes 09/30H 1 b 12/31H1 84.29 407. Coon Taxes 09/30/11 to 12!31/11 84.29
108. School Taxes 09/30H 1 to 06f30M 2 959.74 408. Sdtool Taxes 09/30h 1 to 06/30/12 959.74
109. 409.
110. 410.
111. 411.
112. 412.
120. GROSS AMOUNT DUE FROM BORROWER 94,020.91
200. AD BY M OWER:
201, it a' eamast mate 1000.00 420. GROSS AMOUNT DUE TO SELLER 91,044.03
500. U IN AMOUNT DUE TO SELLER:
501. Exoess De See InaWdions
202. Pried Amount of New Loans 72,000.00 502. SetOement Cha to Seller Line 1400 6,116.72
203. Exfatin loans taken su act to 503. Existln loans taken su to
204. 504. Payoff of first Mor~age to CTTIMORTGAGE, INC1#11 75,093.93
205. 505. Pa of second
206. 506.
207. 507. t disb. as rotxieds
208. ~.
209. Closin Cosh Pak! B Seller 509. Clan CoaLa Pak! Seller
ms ~ r u r ms n ar er
210. CI /Town Taxes m 510. /Town Taxes to
211. Coon Taxes to 511. Coon Taxes to
212. School Taxes to 512. School Taxes to
213. 513.
214. 514. i
215. 515.
216. 51B. ~
217. 517,
218. 518.
219. 519.
220. TOTAL PAID BY/FOR BORROWER 73,000.00
3 T R•
301. Gross Amount Due Fran Borrower Line 120 94 020.91 520. TOTAL REDUC710N AMOUNT DUE SELLER , 81,210.65
R:
601. Gross Amount Due To Seller Line 420 91,044.03
302. Leas Amount Pak! B or Borrower Line 220 ( 73,000.00 602. Leas Redudlons Due Soler Line 520 ( 81,210.6
303. CASH X FROM TO BORROWER 21 020.91 B03. CASH X 7O) FROM SELLER 9,833.38
The undersignetl hereby ay! etlge rctul a~teo copy of pages 7 tsa a tnfs statement a an cements reterrec to he fn.
Borrower l~J/ Seller
AZIITTEN~FA NES~Sj~EAL~TY, LLC ST T O CO IE J. EDY
HU61 (388) RESPA HB0.705.2
.T N
PAID FROM
PAID FROM
Division ofCommisabn ine-700 es Follows: aorsrsDwF.rrs sELLExs
701. $ 2,250.00 f0 RFJMAX REALTY ASSOCIATES FUNDS AT FUNDS AT
702. $ 2,250.00 t0 WEICHERT REALTORS FIRST CHOICE SETTLEMENT SETTLEMENT
703. Commission Paid at Settlement 4,500.00
704. Broker Fee to RFJMAX REALTY ASSOCIATES 300.00
801. Dan ins on ee to
802. Loan Discount % to
803. Appraisal Fee to CORNERSTONE FEDERAL CREDIT UNION 350.00
804. Review Fee b CORNERSTONE FEDERAL CREDIT UNION 350.00
805. Flood Cart ~ to CORNERSTONE FEDERAL CR DIT UNION 12.00
806. Ins. A .Fee to
807. Assumpfion Fee tD
808.
809.
B10.
811.
901. Interest From OB/30H 1 tD 10!01/11 $ !day ( 1 da %)
902. M Insurence Premiumfor months b
903. Hazard Insurance Prerr~um for 1.0 ars tD
904.
905.
1001. Hazard Insurance montlis $ r month
1002. M Insurance months $ r month
1003. CI !Town Taxes months $ r month
1004. Coun Taxes montlrs S r month
1005. School Taxes months $ per month '
1006. months $ r month
1007. months ~ $ per month
i0pg, months r month
1101. Attom Fees for Seller POC ~ GRIFFIE & ASSOCIATES
1102. Final Water & Sewer (b 9/30 to NORTH MIDDLETON TOWNSHIP 286.10
1103. Refuse fo 9130 m YORK WASTE DISPOSAL 145.62
1104. Courier Fee to CRAIG A. DIEHL ESQUIRE 20.00 20.00
1105. Dowment Pre aretlon to
1106. Note Fees fo CASH 15.00 10.00
1107. Electronic Document Prep to
includes above item numbers:
1108. Title Insurance tD CRAIG A. DIEHL ES UIRE Reissue 718.88
includes above item numbers:
1 tog. Lender's Coverage $ 72,000.00
1110. Ownel's Coverage $ 90,000.00
1111. Endorsements 100, 300, 8.1 to CRAIG A. DIEHL, ESQUIRE 150.00
1112.
1113.
1201. Reoording Fees: Deed S 62.00; Mortgage $ 86.00; Releases $ 128.00
1202. CI /Coun Tax/Stam :Deed a
1203. State TaxlSte s: Revenue Stems 1,800.00; M 900.00 900.00
1204. RecoM Assn of Rents Leases to RECORDER OF DEEDS 33.00
1205.
1301. Surve to
1302. Pestlns ctlon to
1303. Tax CertlBcatlon Fee to CRAIG A. DIEHL ESOUIRE 5.00
1304. Broker Fee to WEICHERT REALTORS FIRST CHOICE 250.00
1305.
1400. TOTAL SETTLEMENT CHARGES Enter on Lirlec 103 Section J and fi02, Section K 2,976.88 6,116.72
By signing page 1 of this statement, the signatories acknowledge receipt of a completed Dopy of page 2 of this two page statement
Certlfied to be a true copy. CRAIG A. EHL, ES UI E
Settlemen ent
(CAD112BB /CAD71298/3)
Attachments
to
Schedule E
MEMBERS 1n
PBDBRAL CRBDIT ANION
SAVINGS ACCOUNT:
Account Numf»r/Suffix
Date Account Eshblished
Principal Belanoe at Date of Death
Accrued Interest to Date of Death
Total Principal and Acarled Interest
Name of Joint Owner
CHECKING ACCOUNT:
Account Number/SufNx
Date Account Established
Princpal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest
Name of Joint Owner
HOLIDAY CLUB ACCOUNT:
Account Number/Suffix
Dete Account Establistuxl
Princpal Balance at Date of Death
Accrued Interest to Date of Death
Total Princ~al and Accrued Interest
Name of Joint Owner
279460-00
02/04/2006
$71.63
$.09
$72.53
None
279480-11
02/04/2006
$18.04
$o.oo
$18.04
None
279460-02
02/04/2006
So.oo
$0.06
io.06
None
SUPPL.EAAENTAL SAVINGS ACCOUNT
Account Number/Su(fbr 279460.01
Date Account Established 06/08/2009
Princpal Balance at Date of Death 51.59
Accrued Interest to Date of Death 50.07
Total Principal and Accrued Interest 51.66
Name of Joint Owner None
LOAN ACCOUNT: Alexandra Lesdy is Primary Owner
Account Number/Suffuc
Data Loan Established
Princpal Balance at Date of Death
Loan Type
Collateral Held
Interest Rate
Name of Co-Borrower
Name of Co-Borrower
Estate of: Connie J. Lesdy
Date of Death: 05/28/2010
Social Security Number: 172-46-2720
VIN#1YVHP800045N48954
MEMBERS 1mifF~JE^,D'E,'R~~AL CREDIT UNION
LeigL~h-Anne Stallings ~A~~
Lending Insurance Support Specialist
July 14, 2010
303482-01
03/29/2007
$5837.39
Indirect Used Vehicle
2004 Mazde Mezda6,
5.9996
Vlfilliam Leedy
Connie Leedy
5000 Louise Drive P.O. Box 40 Mechanicsburg, Pennsylvalila 17055 (800) 283-2328 wwwmemberslst.org
p zs~
499 Mitchell Road, Millsboro, DE 19966 Adjustment Services
Phone 888-502-4349
Fax (302) 934-2955
June 30, 2010
Griffie & Associates
Attorneys At Law
200 North Iianover Street
Carlisle, PA 17013
Re: Estate of Connie J Leedv
Social Security: 172-46-2720
Date of Death: May 28.2010
R '
, y
Dear Sir or Madam:
Per your inquiry on June 21, 2010, please be advised that at the time of death, the above-named decedent had on
deposit with this bank the following:
1. Type of Account Checking Account
Account Number 2679054821
Ownership (Names o~ Connie J Leedy
Opening Date 03/D2i90
Balance on Date of Death $58.10
Accrued Interest $ .01
Total $5811 _._--.---....__._..
2. Type of Account Savings Account
Account Number 15004219432313
Ownership (Names ofl Connie J Ieedy
Opening Date 09/Z4~8
Balance on Date of Death $1,443.02
Accrued Interest $ .04
Total $1,443.06
For further account information, closures and/or reimbursement o[ foods please call the North Middleton Office at #717.240-4521.
We were nnsbk to locate any safe deposit box for the above-mentioned decedent
$II1C0 ,
//I
uzilnne M Kimble '
Adjustment Services
6/~1~201+9 ,
9 ,"
t.
THE TRiUiTED ~iOt1f~E
• w~
BLUE BttOK~ TRADE-iN YALUE
Vehicle Highlights
Mileage: 200,000
Engine: 4-Cyl, 1.6 Liter
'Transmission: Automatic
Drivetrain: FW D
:Selected Equipment
Standard
iAir Conditioning Power Door Locks AM/FM Stereo
..Power Steering Tilt Wheel Dual Air Bags
!Power Windows Cruise .Control Steel Wheels
- ---._...------..~~.......---- advertisement ----
1996 Honda Civic -Trade In Value, blu...
Condition Value
Excellent $1,275
Gaad ,, $1,075
~ Fair $725
(Selected)
advertisement
Honda Civic
Learn More
Inventory
Special Offers
Presented by:
Dealer Locator
Extended
Warranty
Irl .,.
Blue Book Trade-In Value
Kelley Blue Book Trade-In Value is the amount consumers catl expect to
receive from a dealer for atrade-in vehicle, assuming an accurate appraisal of
the vehicle's condition, mileage and features. This value will likely be less
than the Private Party Value because the reselling dealer incurs the cost of
safety, mspections,,reconditioning and other costs of doing_business.
Vehicle Condition Ratings ~_~--
Send to Printer
advertisement
Close Window
1996 Honda Civic LX Sedan 4D
6/,~~/20iA 1996 Honda Civic -Trade In Value, blu...
Excellent
$1,275
^ Looks new, is in excellent mechanical condition and needs no
reconditioning,
^ Never had any paint or body work and is free of dust.
^ Clean title history and will pass a smog and safety inspection.
^ Engine compartment is clean, with no fluid leaks and Is free of
any wear or visible defects.
^ Complete and verifiable service records.
Less than 5% of all used vehicles fall into this category.
Good
~~ $1,075
^ Free of any major defects.
Clean title history, the paints, body, and interior have only minor
(if any) blemishes, and there are no major mechanical problems.
^ Little or no rust on this vehicle.
^ Tires match and have substantial tread wear left:
^ A "good" vehicle will need some reconditioning to be sold at
retail.
Most consumer owned vehicles fall into this category..
Fair (Selected)
~'.,~": rr: $725
^ Some mechanical or cosmetic defects and needs servicing but is
still In reasonable running condition.
Clean title history, the paint, body and/or interior need work
pertormed by a professional.
^ Tires may need to be replaced.
^ There may be some repairable rust damage.
Poor
~' :~::~ °~ N/A
^ Severe mechanical and/or cosmetic defects and is in poor running
condition.
^ May have problems that cannot be readily fixed such as a
damaged frame or a rusted-through body.
^ Branded title (salvage, flood, etc.) or unsubstantiated mileage.
Kelley Blue Book does not attempt to report a value on a "poor" vehicle
because the value of these vehides varies greatly. A vehide in poor
condition may require an independent appraisal to determine Its value.
* Pennsylvania 6/21/2010.
6/21/Z'd10 .
rHE ntusraEa ~soutlcl:
: W,~
1996 Jeep Grand Cherokee -Trade In ...
advertisement
BLUE BQQK& TRADE-!N VALUE
Condition Value
Excellent $1,175
Good $950
~ Fair $575
(Selected)
Vehicle Highlights
Mileage: 200,000
;Engine: 6-Cyl, 4.0 Liter
Transmission: Automatic
Drivetrain: 2 W D
„t,:";: ..y<<e .:.**s' . ?~'3.? ., st~s;~!:i~N~a'k:~.~` ,~.*.",r a's.~#5't3.d'i',4~`'+d~~~.&"C: o :. .. ~.
Selected Equipment
:Standard
'Air Conditioning Tilt Wheel ABS (4-Wheel)
Power Steering Cruise Control Roof Rack
Power Windows AM/FM Stereo Alloy Wheels
Power Door Locks Cassette
_ _ .. __
adv. ... ._~..
_. _..... _....__. ertisement - ~~
w... .;;;'w ,Y .;«'zm'"x^ .1s#=~ti{ni~p"a'+t:n~.~`,~i52,"$i'#.i. i~t'~S'ft~,3'a?~a!kC3;,F~"~~r:"w:... 'Fi~Z!.
Jeep Grand Cherokee
.. yil~_.,_.
I ,...I:,,,: Y ~~.
Internet Price Build & Price
Incentives V1ewInventory
Get a Brochure Find a Dealer
Presented by:
Blue Book Trade-In Value
Kelley Blue Book Trade-In Value is the amount consumers can expect to
receive from a dealerfor a trade=in vehicle, assuming an accurate appraisal of
the vehicle's condition, mileage and features. This value will likely be less
than the Private Party Value because the reselling dealer incurs the cost of
safety inspections, reconditioning and. other costs of doing business.
_ _ _ _. _ __
Vehicle Condition Ratings
~€ Send to Printer
1996 deep Grand Cherokee Laredo Sport Utility 4D
Close Window
6/21,/010 , 1996 Jeep Grand Cherokee -Trade In ...
Excellent
~ $1,175
^ Looks new, is in' excellent mechanical condition ;and needs no
reconditioning.
^ Never had any paint or body work and is free of rust.
^ Clean title history and will pass a smog and safety'inspectlon.
^ Engine compartment is clean, with no fluid leaks'and is free of
any wear orvisible-defects.
^ Complete and verifiable service records.
Less than 5% of all used vehicles fall into this category.
Good
C7~ `F $950
Free of any major defects,
^ Clean title history, the paints, body, and interior have only minor
(if any) blemishes, and there are no major mechanical problems.
^ Little or no rust on this vehicle.
^ Tires match and have substantial tread wear left.
^ A "good" vehicle will need some reconditioning to be sold at
retail
Most consumer owned vehicles fall into this category.. ..
Falr (Selected)
'; ~" ~ $575
^ Some mechanical or cosmetic defects and needs servicing but is
still in reasonable run~5ing condition.
^ Clean title history, the paint, body and/or interior need work
performed by a professional.
^ Tires may need to be replaced.
^ There may be some repairable rust damage.
Poor
^ Severe mechanical and/or cosmetic defects and is in poor running
condition.
^ May have problems that cannot be readily fixed such as a
damaged frame or a rusted-through body.
^ Branded title (salvage, flood, etc.) or unsubstantiated mileage.
Kelley Blue Book does rioCattempt to report a value orr.a,"poor" vehicle
because the value of these vehicles varies greatly. A vehicle in poor
condition may require an independent appraisal to determine its value.
* Pennsylvania 6/21/2010