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Home My WebLink About12-05-11J 1505610101 REV-1500 ex `°'-'°' PA Department of Revenue Pennsylvarda Bureau of Individual Taxes ~`~'w..`"T~~~INHERITANCE TAX RETURN PO BOX 280601 Harrisburg, PA i~i28-0601. RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY 300-22-7997 09/10/2010 Decedent's Last Name Suffix _.. __ ', Bender (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix I [none] Spouse's Social Security Number OFFICIAL USE ONLY County Code Year File Number a[ ,o oggi Date of Birth MMDDYYYY j 05/29/1925 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW OD 1. Original Return O 2. Supplemental Return O 3. Remainder Return (date of death pdorto 12-1&82) O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required death after 12-12-82) Cp 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number Darrel W. Bender, Esq. ! (717) 221-4537 First line of address 1652 Lowell Lane Second line of address Clty or Post Office New Cumberland Correspondent's a-mall address: BENDORIONCci4VERIZON.NET REGISTER OF WILLS USE OIiIL~' Q ~ G7 n ^ ` , T f~J ~i l -~ r~x ~ ~ DATE D [..? m "1-1 ~'1 -; yy,~ f~ '. S,1 ti`J17 . r,." ,;,,•~-. j _ ., "i: -,-~ ~ _J T1 ~r'..fJ C7 Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is tme, correct and complete. DeGaretion of preparer other than the personal representative is based on all information of which preparer has any knowledge. Si j RE OF PER SPONSIBLE FOR FILING RETURN DATE L ~ A~ ~M~i 1 f! L.s I { I 1652 Lowell Lane, New Cumberland, PA 17070 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 L 1505610101 1505610101 J ~~ ~J' ~~~a o'~P /~' REV-1500 EX oecedenc's Nems: Emily E. Bender Decedent's Social Security Number 300-22-7997 1. Real Estate (Schedule A) ............................................. 1. 2. Stocks and Bonds (Schedule B) ....................................... 2. '. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. ', 4. Mortgages and Notes Receivable (Schedule D) ........................... 4. 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)....... 5. 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ....... 6. ', 98,374.83 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested........ 7. 283,040.13 8. Total Groas Assets (total Lines 1 through 7) ............................. 8. ', 564,958.74 ', 9. Funeral Expenses and Administrative Costs (Schedule H) ............. ...... 9. ', 28,695.99 ', 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule Q ........ ...... 10. ' 1,156.90 11. Total Deductions (total Lines 9 and 10) ........................... ...... 11. 29,852.89 '. 12. Net Value of Estate (Line 8 minus Line 11) ........................ ...... 12. 535,105.85 '' 13. Charitable and Govemmentai Bequests/Sec 9113 Trusts for which .. ~... ,..W...~..... ... an election to tax has not been made (Schedule J) .................. ...... 13. ', 5,000.00 ', 14. Net Value SubJect to Tax (Line 12 minus Line 13) ................ . . ...... 14. ', 530,105.85 TAX CALCULATION • SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 "" 16. Amount of Line 14 taxable ~ ~~~~ ~~~~~~'~ ~~ ~~~~~"~~ at lineal rate X .0 45 ', 530,105.85 ~_.__ _ ~ ~ _...__. ....____.._._M_~ 17. Amount of Line 14 taxable at sibling rate X .12 e_.~__~ .... .,_„u _~__ _ _...; 18. Amount of Line 14 taxable 15.' 18. ! 23,854.76 17.1 at collateral rate X .15 18. __ 19. TAX DUE ......................................................... 19.' 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 15056101D5 1505610105 15D5610105 23,854.76 ', O REV-1500 EX Page 3 Flle Number Decedent's Complete Address: Emily E. Bender STREETADDRESS 624 Cedar Ridge Lane cITY Mechanicsburg ZIP 17055 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) 23,854.76 2. CredRs/PaymeMs A. Prior Payments - _ 22,464.84 B. Diswunt 847.34 Total Credits (A + B) (2) 23,412.18 3. Interest (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. FIII in oval on Page 2, Line 20 to request a refund. (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 442.58 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 Vansfer and: Yes No a. retain the use or income of the properly transfened :..................................................................................: ....... ^ ^X b. retain the right to designate who shall use the property transferred or its income : ..................................... ....... ^ ^X c. retain a reversionary interest; or ................................................................................................................... ....... ^ ^x d. receive the promise for life of either payments, benefds or care? ............................................................... ....... ^ ^fc 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................................... ....... ^ ^z 3. Did decedent own an "in trust for" orpayable-upon-death bank account or security at his or her death? ....... ....... ^ Q 4. Did decedent own an individual retirement account, annuity or other non-probate property, which contains a beneficiary designation? .................................................................................................................. ...... 0 ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. ~- . For dates of death on or after July 1, 1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: • The tax rate imposed on the net value of Vansfers 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. REV-1502 EX~+ (11-OB) ~ pennsylvania SCHEDULE A DEPARTMENT OF REVENUE INNERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT ESTATE OF FILE NUMBER Emily E. Bender 21-10-0991 All real property owned solely or as a tenant In common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being Compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property that is jointlyowned with right of survivorship must be disclosed on Schedule F. Attach a copy of the settlement sheet if the property has been sold. ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE NUMBER OF DEATH DESCRIPTION 1' Townhouse situate in Cumberland County at 624 Cedar Ridge Lane, Upper Allen Township, Mechanicsburg, Pennsylvania 17055. Sale price $129,900 less $5,000 seller's assistance {reported with sales expenses on Schedule H). 129,900.00 TOTAL (Also enter on Line 1, Recapitulation.) $ 129,900.00 If more space is needed, insert additional sheets of the same size. 1 REV-1508 EX+ (6-89) SCNEpULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS ~ MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Emily E. Bender 21-10-0991 Indude the proceeds of litigation and the dale the proceeds were received by the estate. AN prope-ty Jolntly~owned with right of aurvlvorshlp must bs dbdoaed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH Furniture, household goods, wearing apparel and jewelry 1,000.00 Cash found on premises 440.58 Federal Income Tax Refund 2,598.00 Insurance, utility and magazine subscription refunds due at date of death 1,061.69 Certificates of deposR 48,543.51 TOTAL (Also enter on line 5, Recapitulation) S 53,643.78 (If more space is needed, InseA additional sheets of the same size) REV-15og EX+ (ol-lo) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN ItESIDENi DECEDENT SCNEpYLE F ]OINTLY-OWNED PROPERTY ESTATE OF: FILE NUMBER: Emily E. Bender 21-10-0991 If an asset berme jointly owned within one year of the decedents dah of death, R must ba roported on Schedule G. , SURVIVING JO1NT TENANT(S) NAME(S) ADDRESS RELATIONSHIP TO DECEDENT A• Darrel W. Bender 1652 Lowell Lane son 'New Cumberland, PA 17070 B. C. JOINTLY OWNED PROPERTY: ITEM NUMBEA LETTER FDR.X)IHT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FlNANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIflING NUMBER. ATTACH DFED FOR ]DINKY NEID REAL ESTATE. DATE OF DEATH VALUE OF ASSET % of DECEDENT'S INTEREST DATE of DEATH VALUE OF DECEDENT'S INTERES! t. A. 09117108 PNC Bank, Cheokirg Account No. 000005004403176 5,022.38 50 2,511.19 2. A -09117108 PNC Bank, Savings Account No. 000005004057031 9,373.91 50 4,686.96 3. A '09115/08 PNC Bank, Savings Account No. 000005005168956 182,353.36 50' 91,176.68 TOTAL (Also enter on Line 6, Recapitulation) I; 98,374.83 If more space is needed, use additional sheets of paper of the same size. REV-1510 EX+ (OB-09) ~ Pennsylvania SCHEDULE G DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Emily E. Bender 21-10-0991 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. ITEM NUMBER DESCRIPTION OF PROPERTY INCWDE THE NAME OF THE TRANSFEREE, THE1R REtAIIDNSHIPTO DECEDENT AND THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET Wo OF DECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1~ Union Central Life Insurance Company, Deferred Annuiiy Contract No. ' A00001076F 27,810.58 100 0.00 27,810.5! 2 Union Central Life Insurance Company, Deferred Annuity Contract No. A00001083F(IRA) 74,121.47 100 0.00 74,121.4 3 Union Central Life Insurance Company, Defened Annuity Contract No. ` A64002191S 42,575.34 100 0.00 42,575.3 4 Lincoln Benefit Life Insurance Company, Deferred Annuity Contract No. LBF1114314 135,479.54 100 . 0.00 135,479.5 5 .Sovereign Bank Certificate of Deposit (IRA) IRA CD No. 1100030268 3,053.20 100 ' 0.00 3,053.2( TOTAL (Also enter on Line 7, Recapitulation) ~ I' 283,040.13 If more space is needed, use additional sheets of paper of the same size. REV-1511 EX+ (10-09) ~ pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Emily E. Bender 21-10-0991 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: t' Myers Funeral Home, cremation, funeral, internment, fee for minister and pianist 3,975.00 Silver Spring Presbyterian Church Women's Association, mercy meal 88.73 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: 0.00 Name(s) of Personal Representative(s) Darrel W. Bender & Dean K. Bender street address 1652 Lowell Lane / 322 Fortuna Drive city.. New Cumberland /Hatfield state PA up 17070 Year(s) Commission Paid: none paid 2. Attorney Fees: 45.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) 0.00 Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4• Probate Fees: 467.50 5. Accountant Fees: 0.00 6• Tax Return Preparer Fees: 0.00 ~• Utilities, HOA dues, snow removal, real estate taxes 8 insurance through date of sale of real estate 2,509.70 Costs of fixing up real estate for sale 6,204.92 Real estate commission, seller's assistance and closing costs 14,714.90 Publication of legal notices 385.83 Other administrative expenses 54.31 TOTAL (Also enter on Line 9, Recapitulation) $! 28,445.89 If more space is needed, use additional sheets of paper of the same size. Rev-ISIZ ex+ itz-oe~ pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Emily E. Bender 21-10-0991 Report debts Incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. If more space is needed, insert additional sheets of the same size. REV-1513 EX+ (OS-10) ~ pennsylvania DEPARTMENT OF REVENUE INHERRANCE TAX RETURN RESIDENT DECEDENT SCHEDULE BENEFICIARIES ESTATE OF: FILE NUMBER: Emily E. Bender 21-10-0991 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Llst Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (11).] 1• Darrel W. Bender, 1652 Lowell Lane, New Cumberland, PA 17070 son 50°~ 2. Dean K. Bender, 322 Fortuna Drive, Hatfield, PA 19440 son 50% 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: L B. CHARITABLE ANO GOVERNMENTAL DISTRIBUTIONS: 1. Silver Spring Presbyterian Church, 444 Silver Spring Road, Mechanicsburg, PA 17055 5,000.00 TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. ~;! 5,000.00 If more space is needed, use additional sheetr of paper of the same size. Estate of Emily E. Bender File Number: 21-10-0991 Sch E Miscellaneous Property Furniture, household goods (see attached explanation) PPL payment for old refrigerator & freezer $ 70.00 Alice O'Neill -sale of 4 pictures $ 60.00 Bed, 2 dressers, etc. given to grandchildren $ 270.00 Penelope Bemheisel -sale of furniture to buyer of real estate $ 600.00 Total household goods $ 1,000.00 Cash found in drawer $ 440.58 Certificates of Deposit $ 48,543.51 Genworth LT Care Insurance refund $ 501.66 Verizon refund $ 6.00 Readers Digest refund $ 7g.g4 Consumer Reports refund $ 12.00 Comcast refund $ 51.99 AARP refund $ 28.89 Boon Chapman refund $ 29.89 Time magazine refund $ 21.04 Professional insurance (dental) refund $ 308.97 Guideposts refund $ 21.31 Total Refunds $ 1,061.69 Federal Income Tax Refund $ 2,598.00 Total Schedule E $ 53,643.78 Estate of Emily E. Bender SSN: 300-22-7997 Schedule E: Valuation of furniture and household goods: $1,000.00 The decedent was 85 years of age at the time of her death. She was very frugal, and preferred the old familiar worn things she had to new things. She was short and slender, and in the last years of her life was not very active due to cardiac, vision and orthopaedic problems. For these reasons she put little wear and stress on her furniture. But in her later years she was not able to properly maintain her possessions. In preparation to show the townhouse for sale we donated the usable household goods, clothing and jewelry to the Salvation Army and Goodwill Industries. An old grill and some charcoal were given to a neighbor. The rest including food, supplies, electronics and small appliances were placed in the trash. The estate did not and could not have realized anything from sale of these items. Therefore no value is attributed to them. We arranged for PPL to pick up the old refrigerator and freezer for which the estate received a rebate of $70.00. The furniture and decorative items were used to stage the real estate for showing to potential buyers. The furniture was of 1950's and 1960's vintage contemporary style that had been acquired prior to 1972. It was not of exceptional quality and showed noticeable signs of wear. Other than the value of staging the townhouse for showing to potential buyers, the furniture represented a potential liability in that it would have been costly to remove without damaging the townhouse. We were concerned about how to dispose of the furniture quickly after the real estate sold. We contacted one auctioneer to obtain an appraisal of the remaining items and about removing them after the house sold. He promised to come out to see the furniture, but never called back or returned subsequent calls. We had anticipated that the net amount that would have been realized through an auction or otherwise would have been minimal. At best we hoped that the estate might have realized $1,000.00, net of expenses, from sale of the household goods and furniture at auction after adding in the $70.00 rebate received from PPL for a fifty (50) year old freezer and a thirty (30) year old refrigerator. The real estate sold with two weeks, with settlement initially set for four weeks after the contract was signed, but ultimately moved up four days earlier. After the contract was signed the buyer was approached through the realtors about purchasing the furniture. While we waited for weeks to see if she had any interest, we sold a table and several decorative items to the real estate agent for $60.00. A picnic table, some of the bedroom furniture, and an old plastic hanging light were given to sons and grandchildren. About a week prior to settlement the buyer indicated that she was interested and agreed to purchase everything that remained for $600.00, which saved the estate the cost of moving everything. This included the large dining room table, matching server and ten matching chairs, solid beech china cupboard, solid beech kitchen table, a couch, solid cherry desk, solid cherry coffee table, king size bed, mattress and box spring, matching dressers, many other chairs, a second picnic table and benches, and numerous other items of furniture, decorative items, garden equipment, tools, shelving, etc. r. d E a~ x y r.+ f0 'O N V C M r w 0 M N to ~ N M ~ O V3 fH ~ j ti ~ S te ~ O ~ aO0 ~ O ~ ~ }} ~ N ~ ~7 ~ f0 fA fi g ff) fR fA V - ER fR 8P pp SO O OSSMO ~O~~N OOSCOO p p O O ~ 0O0 0 000 C ~S pp ~dNS ~ rCO7~Nn ~p 050 W tOOSW W ~ p S~ S p 0 ~fONNN f0 ~ M M ~O rMMhC~ 10M ~ N = M r r r y fN to 4A fR f9 EA f9 fH ff! fH N b9 EA fA fH ff) fA b9 f9 EA ifl fA fR? fA fR b4 fR H V d L ~ d ~. w y ~ N d `O C C y N r ~ O O ~ O 7 O N V y U X X~~ ~ d t~ 00 oP~ c ~ ~ a~°~m ca _~ ~ ~' o U m ~ ~ y ~ o~ E ~ ~ ~ a~ C`0 ~ i ~ m~°v y a~ O) CA "" a~cd y C 41 N _ OZS a.. .. .. f0 m w niii> c c 3 y ~ o 0 0 ~ ~ ° a-c-c Z t ~° o a m o N ~ ~ 0 rnE E E E i a ~ c N N a1 m m ~N >> i0 °iav~ ~a c`od~icc~a Ec ° E~~~~ z ~ L O y O~ ~CA aUU m U dLLZ df0 0 (,> .-. 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Z C7UU7 '.3 IR W d (7 O M Ol a r~o:via I trs ur vvl~w CUMBERLAND COUNTY PENNSYLVANIA GRANT OF LETTERS No . 2010- 00991 PA No . 21- 10- 0991 Estate Of: EMILYEBENDER (First, Midd/e, Last/ Late Of: UPPER ALLEN TOWNSHIP CUMBERLAND COUNTY Deceased Social Securi ty No: 300-22-7997 WHEREAS, on the 28th day of September 2010 an instrument dated May 25th 1999 was admitted to probate as the last will of EMIL Y E BENDER /First, Middle, Lastl late of UPPER ALLEN TOWNSH/P, CUMBERLAND County, who died on the 10th day of September 2010 an WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, GLENDA EARNER STRASBAUGH Register of Wills in and for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to: DARREL W BENDER and DEAN K BENDER who have duly qualified as EXECUTOR(R/X) and have agreed to administer the estate according to law, all of which fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE, CARL/SLE, PENNSYL VANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my office on the 28th day of September 2010. eg/ster at w/1/s i i //~.,r "i°, r ~BpUI~ y ~ f **NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST) :~ ,:; ~; :x~. ;~ L~' N C7 LAST WILL AND TESTAMENT ~o -`~c~ ~~'Dm N OF '~ r ? .z7 Go '~3: EMILY E. BENDER ` ~~''~~ ?~' ~'_` ~~ ,:~ J~ w. I, EMILY E. BENDER, of 624 Cedar Ridge Lane, Meci~anics- burg, Cumberland County, Pennsylvania, make, publish and declare this as and for my Last Will and Testament, hereby revoking all other Wills and Codicils heretofore made by me. FIRST: I give and bequeath the sum of Five Thousand and No/100 ($5,000.00) Dollars to the Silver Spring Presbyterian Church, of Mechanicsburg, Pennsylvania, to be used for general church purposes as the governing body of the Silver Spring Presbyterian Church deems appropriate. SEC I devise and bequeath all the rest, residue and remainder of my estate of whatever nature and wherever situate, including any property over which I hold power of appointment and together with any insurance policies thereon, in equal shares, to my son, DARREL W. BENDER and to my son, DEAN K. BENDER, provided that should either DARREL W. BENDER or DEAN K. BENDER predecease me, I give and bequeath their share unto their issue per stirpes by representation. THIRD: No provision is made in this, my Last Will and Testament, for my son, DUANE G. BENDER, not necessarily because of any lack of affection for him, but because he is already well provided for. FOURTH: Should any of my grandchildren not have attained the age of twenty-one (21} years at the time for dis- tribution to him or her, I give, devise and bequeath the share of each such grandchild to my hereinafter named Trustee or Trustees, IN SEPARATE TRUSTS, to hold, manage, invest and reinvest the shares so received, and to use and apply from time to time such portion of income and principal for the said grandchild's education (including college, trade school or other similar r_ . `_i _. ', ,: -; .. •~ training or education), as my Trustee or Trustees, in their sole discretion, deem advisable. Any income or principal not so applied shall be dis- tributed to each grandchild when he or she attains the age of twenty-one (21) years. In the event any of my grandchildren die prior to the termination of this Trust, the interest of said grandchild in said Trust shall cease with any income and principal being divided evenly between or among my other grand- children that are living or the separate trusts established hereunder for their benefit. FIFTH: In addition to all powers granted to them by law and by other provisions of this Will, I give the fiduciaries acting hereunder the following powers, applicable to all proper- ty, exercisable without court approval and effective until actual distribution of all property: (A) To sell at public or private sale, or to lease, for any period of time, any real or personal property and to give options for sales, exchanges or leases, for such prices and upon such terms (including credit, with or without security) or conditions as are deemed proper. This includes the power to give legally sufficient instruments for transfer of the property and to receive the proceeds of any disposition of it. (B) To partition, subdivide, or improve real estate and to enter into agreements concerning the partition, subdivi- sion, improvement, zoning or management of real estate and to impose or extinguish restrictions on real estate. (C) To compromise any claim or controversy and to ~~ abandon any property which is of little or no value. ;_ • (D) To invest in all forms of property, including stocks, common trust funds and mortgage investment funds, without :: restriction to investments authorized for Pennsylvania fiduci- • cries, as are deemed proper, without regard to any principle of v4 ~-• diversification, risk or productivity. 2 (E) To exercise any option, right or privilege granted in insurance policies or in other investments. (F) To exercise any election or privilege given by the Federal and other tax laws, including, but not necessarily being limited to, personal income, gift and estate or inheritance tax laws. J •~ `;~:, ;. (G) To make distributions to my herein named benefici- aries in cash or in kind or partly in each. (H) To borrow money from themselves or others in order to pay debts, taxes, or estate or trust administration expenses, to protect o~ improve any property held under my will,. and for investment purposes. (I) To select a mode of payment under any qualified retirement plan (pension plan, profit sharing plan, employee stock ownership plan, or any other type of qualified plan) to the extent the plan or the law permits them to do so, and to exercise any other rights which they may have under the plan, in whatever manner they consider advisable. S XTH: I nominate and appoint DARREL W. BENDER, as Trustee of the hereinabove described trusts. In the event of the death, resignation or inability to serve for any reason whatsoever of the said DARREL W. BENDER, I nominate and appoint MARY ANN BENDER, wife of my son, DEAN K. BENDER, as Trustee of the hereinabove described trusts, who shall serve without bond and shall receive fair or reasonable compensation. SEVENTH: I direct that all inheritance, estate, transfer, succession and death taxes, of any kind whatsoever, which may be payable by reason of my death, whether or not with respect to property passing under this Will, shall be paid out of the principal of my residuary estate. IGHTH: All interests hereunder, whether principal or income, which are undistributed and in the possession of the fiduciaries acting hereunder, even though vested or distribut- 3 able, small not be subject to attac^.nent, execution or sequestra- tion for any debt, contract, obligation or liability of any beneficiary, and furthermore, shall not be subject to pledge, assignment, conveyance or anticipation. NI~1TH: I nominate and appoint DARREL W. BENDER and DEAN K. BENDER, Co-Executors of this, my Last Will and Testament. I direct that my Co-Executors, and their successors, shall not be required to post security or a bond for the performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, this .c"~'1- ~ day of ', .,<-_; . 1999 . ,:r.., ~l';..:.;~!; •~.-• (SEAL) EMILY E.; ENDER Signed, sealed, published and declared by the above- named Testatrix as and for her Last Will and Testament in our presence, who, at her request, in her presence and in the presence of each other, have hereunto subscribed our names as attesting witnesses. Address Address ._~ ,;ate' ..~ /_ 4 ..-~ .. ~Ep.27. 2010 2:41PM PNC BANK 412-705-2747 ~~~ t.~IN67't~tEwa'r September 27, 201 D Amanda Li PNC Bank Wvndsor Park Branch 1tE: Emily E Bender SSN: 300.22-7997 DOJ,]: 09-10-2010 Dear Ms. Li: Vo.0744 P. 2/3 In response to your request for Date of Death {DOD) balances for the customer noted above, our records show the following: Cert~icate of Deposit Account ~ 31400273619 Established: 09-08-2005 EMILY E BENDER DOD balance: $ 23,299.04 + 0.80 accrued interest Account ~ 31300322774 Established: 12-18-2007 EMILY E BENDER DOD balance: $ 4,133.69 + 0.72 accrued interest Account # 31100325640 EMILY E BENDER DOD balance: $ 21,081.92 + 0.72 accrued interest Checking Account Account ~ 5004403176 EMILY E BENDER DAI2REL W BENDER DOD balance: $ 5,022.3 8 + 0.04 accnied interest Sxvin~s Account Account ~ 5004057031 EMILY E BENDER DAI3RFT. W BENDER DOD balance: $ 9,373.91 + 0.69 accrued interest Established: 02-08-2008 Established: 09-17-2008 Established: 09-17-2DD8 Page 1 of 2 ,r. Sep. 27. 2010 2:41PM Account# SOOSi68956 PNC BANK 412-]05-2i47 EMILY E BENDER BARREL Rr BENDER DOD balance: $182,353.36 + 3.99 accrued itrterest Vo.0i44 P. 3i3 Established: 09-15-2008 Please mote that this office provides date of death balances for deposit aecaumts (DtAs, CDs, Checkimg and Savings}. We do not proceu nay iiaxneial trAaasectio.s or provide atateme~ab. If you raced assistance with any of these items, please call i-888-PNC-BANK (i-888-762-2265) or stop try your loom PNC Bank branch office. Sincerely, National Financial Servicas Center PNC Bank, NA. Member FDIC Page 2 of 2 Sovereign Court Ordered Processing \ Decedents - MA1-MB3-02-10 - P. O. Box 841005 -Boston, MA 02284 August 29, 2011 Darrel W. Bender 1652 Lowell Lane New Cumberland, PA 17070 RE: Estate of Emily E. Bender Date of Death: 09/10/10 Dear Mr. Bender: Per your request, enclosed please find the account information as of the date of death for the above-named decedent. For your information, accrued interest is not included in the date of death balance. Please feel free to contact me if I can be of any further assistance. Very truly yours, r~_~;~~,~ v~~, ~ l ~ ~ j Donna M. Long Lead Specialist , Phone:617-514-5189 ' Fax:617-533-1931 Sovereign Bank ESTATE OF Emily E. Bender SOCIAL SECURITY #: 300-22-7997 DATE OF DEATH: September 10, 2010 Account#: 1688137502 Open date: 10/8/1991 In the name of: Emily E. Bender Date of Death Balance: $2,817.54 Int.(YTD) from 1/1/2010 to 8/31/2010 $76.11 Accrued interest to date of death: 13 Other Info: Acct Closed 04/15/2011 Primary Benef: Darrel W Bender and Dean K Bender Type: IRA Page 1 of 1 The Union Ceahsl .1876 Waycross Road Life Inem~ance Cs~m~any Cincimtati Ohio 45240 (513) 595 2200 cvcvlv.wriamosnhaLoom Inr•n•re ~ r`aarWanb xut~cca, September 16, 2010 Re: A00001083F Emily E Bender The net proceeds are payable to Darrell W Bender and Dean K Bender, sons, per stirpes. The value of the policy as of the date of death was $74,121.47. The death benefit is the accumulation value as of the date of death. When an election is made, interest on claims will be calculated using the applicable death claim interest rate from the date of death to the date of settlement. This plan was funded by tax deferred contributions. Consequently, all death benefit distributions are fully taxable as ordinary income. Based on our understanding of the Federal Tax Regulations governing distribution of tax deferred annuity proceeds where the owner dies after the required beginning date, the following three options are available to each beneficiary. Each option lists the requirements necessary for the election. Receive the funds svstematically over a period not longer than the nonrecalculated single life expectancy of the beneficiary Claim Requirements: • Certified Death Certificate • Claimant's Statement Form UN 3963 completed and notarized • Personal Income Plan Election Form UN 5238 • Change of Beneficiary, Section 3, of the Tax Sheltered/Deferred Annuity Change and Service Request Form UC 2946 If this option is elected and a new beneficiary is not designated, upon the death of the beneficiary, the net death benefit will be payable to the estate of the beneficiary. The distribution must begin by December 31 ~` of the year following the year of death. Receiving the funds systematically based on the nonrecalculated single life expectancy of the beneficiary will spread out the tax liability. Securities offered through al8liate Americas Investmem Corp., Member FINRA/SIPC. The UaiotrG^.mtrat I3fe %mgrance C`ompsu~ .18.76 Waycro~ Rued t»nciaoeti Ohio 4524D (313) 595~2~00 www:unamaenhg7,ooon rne•netce fa~4Jm!Mlb.gota XUNRWm{ery~ September 16, 2010 Re: A64002191 S Emily E Bender The net proceeds are payable to Darrell W Bender and Dean K Bender, sons, per stirpes. The value of the annuity as of the date of death was $42,575.34. The death benefit is the accumulation value as of the date of death. When an election is made, interest on claims will be calculated using the applicable death claim interest rate from the date of death to the date of settlement. This deferred annuity policy was designed to provide annuity income benefits upon election; however, the annuitant died prior to this election, and as a result, the value of the contract is now payable. Under the current Internal Revenue Code, that portion of the value of the contract that exceeds the cost of the contract -the net premiums paid - is taxable to the recipient as ordinary income. Based on our understanding of the Internal Revenue Code governing distribution of annuity proceeds, the following three options are available to each beneficiary. Each option lists the requirements necessary for the election. Receive the funds systematically over a period not longer than the life expectanc off tt-e beneficiarv Claim Requirements: • Certified Death Certificate • Claimant's Statement Form UN 3963 completed and notarized • Personal Income Plan Election Form UN 5238 • Change of Beneficiary, Section 3, of the Tax Sheltered/Deferred Annuity Change and Service Request Form UC 2946 If this option is elected and a new beneficiary is not designated, upon the death of the beneficiary, the net death benefit will be payable to the estate of the beneficiary. The distribution must begin by one year from the date of death. Receiving the funds systematically based on the life expectancy of the beneficiary will spread out the tax liability. Generally, the gain will be distributed first. securities offered through affiliate Americas Investmem Corp.. Member FINRA/SIPC. T'he Union Central 1$'76 Waytro~ Road I1fe Imuramee Company Cincirmati Ohio 45240 (313)593-200 n~v.nrriancerriral.com Itiene~aie xarp September 16, 2010 Re: A00001076F Emily E Bender The net proceeds are payable to Darrel W Bender and Dean K Bender, sons, per stirpes. The value of the annuity as of the date of death was $27,810.58. The death benefit is the accumulation value as of the date of death. When an election is made, interest on claims will be calculated using the applicable death claim interest rate from the date of death to the date of settlement. This deferred annuity policy was designed to provide annuity income benefits upon election; however, the annuitant died prior to this election and, as a result, the value of the contract is now payable. Under the current Internal Revenue Code, that portion of the value of the contract that exceeds the cost of the contract -the net premiums paid - is taxable to the recipient as ordinary income. Based on our understanding of the Internal Revenue Code governing distribution of annuity proceeds, the following three options are available to each beneficiary. Each option lists the requirements necessary for the election. 1. Receive the funds systematically over a period not lonlter than the life expectancy of the beneficiary Claim Requirements: • Certified Death Certificate • Claimant's Statement Form UN 3963 completed and notarized • Personal Income Plan Election Form UN 5238 • Change of Beneficiary, Section 3, of the Tax Sheltered/Deferred Annuity Change and Service Request Form UC 2946 If this option is elected and a new beneficiary is not designated, upon the death of the beneficiary, the net death benefit will be payable to the estate of the beneficiary. The distribution must begin by one year from the date of death. Receiving the funds systematically based on the life expectancy of the beneficiary will spread out the tax liability. Generally, the gain will be distributed first. securftiea offered through atANaze amerirae Investment Corp., Member FINRNSIPC. U CORRECTED (if checked FILER'S name, street address, city, state, ZIP code, and telephone no. 1 Date of closing OMB No. 1545-0997 1st Advantage Settlement Services Inc. 6375 Mercury Drive 5/23111 ~Oo 11 Suite 102 2 Gross proceeds Mechanicsburg, PA 17050 Phone: 717-591-7755 g 129,900.00 Fonn 1099-S FILER'S federal Ident~cation numbs TRANSFEROR'S identification number 3 Address or legal description 204678721 TRANSFEROR'S name Estate of Emily E. Bender Street address (including apt. no.) City, state, and 21P code ~ het 4/F+AI9 Account or escrow number (see Instructions) 11113 P~ 624 Cedar Ridge Lane Mechanicsburg, PA 17055 Upper Allen Township 4 Transferor received or will receive property or services 7 8 ~ ~ as part of the consideration ('rf checked) . 5 Buyer's part of real estate tax $ 461.04 Proceeds From Real Estate Transactions Copy B For Transferor This is important tax Information and is being famished to the Intemal Revenue Service. If you are required to file a return, a negligence penalty or other sanction may be Imposed on you if this item is required to be reported and the IRS determines that it has not been reported. Fom, 1099-S (keep for your records) Department of the Treasury -Intemal Revenue Service Questions about this statement can be answered by calling 1st Advantage Settlement Services Inc. at 717591-7755. Instructions for Transferor For sales or exchanges of certain real estate, the person responsible for closing a real estate transaction must report the real estate proceeds to the Intemal Revenue Service and must famish this statement to you. To determine if you have to report the sale or exchange of your main home on your tax return, see the instructions for Schedule D (Form 1040). H the real estate was not your main home, report the transaction on Form 4797, Form 6252, and/or Schedule D (Form 1040). H box 4 is checked and you received or will receive like-kind property, you must file Form 8824. rroderal mortgage subsidy. You may have to recapture (pay back) all or part of a federal mortgage subsidy ff all the following apply. • You received a loan provided from the proceeds of a qualified mortgage bond or you received a mortgage credit certificate. • Your original mortgage loan was provided after 1990. • You sold or disposed of your home at a gain during the;first 9 years after you received the federal mortgage subsidy. • Your Income for the year you sold or disposed of your home was over a specified amount. This will increase your tax. See Form 8628 and Pub. 523. Account number. May show an account or other unique number the filer assigned to distinguish your account Box 1. Shows the date of closing. Box 2. Shows the gross proceeds from a real estate transaction, generally the sales price. Gross proceeds include cash and notes payable to you, notes assumed by the transferee (buyer), and any notes paid off at settlement. Box 2 does not include the value of other property or services you received or will receive. See Box 4. Box 3. Shows the address or legal description of the property transferred. Box 4. If marked, shows that you received or will receive services or property (other than cash or notes) as part of the consideration for the property transferred. The value of any services or property (other than cash or notes) is not included in box 2. Box 5. Shows certain real estate tax on a residence charged to the buyer at settlement. M you have already paid the real estate tax for the period that includes the sale date, subtract the amount in box 5 from the amount already paid to determine your deductible real estate tax. But 'rf you have already deducted the real estate tax in a prior year, generally report this amount as income on the "Other income" line of Form 1040. For more information, see Pub. 523, Pub. 525, and Pub. 530. IF THE TAX ID NUMBER SHOWN ABOVE AS "TRANSFEROR'S Identification Number" IS INCORRECT OR BLANK, PLEASE FILL IN THE CORRECT TAX ID NUMBER HERE: 2 7 ~~ $ 3 ~Z,3$ SOCIAL SECURITY NUMBERh'AX ID NUMBER Receipt of this statement is hereby acknowledged this 23 `~'9 d~ayy of /~'t 14Y , 20,x. ., '/~ ,Q....,ijh, nay .yc.t...,,T~.,,. ~l~ P---- C.a - rXe~-~, ..' Estate of Emily E. Bender ~ • OMB Approval No. 2502-0265 • ~~ A. Settlement Statement (HUD-1) 8. Flle Number. 7. Loan Number: B. Mortgage Insurance Case Number: Unins ^ Corn ^ RHS 3 ®FHA 2 1 . . . . . 11113 6800411926 448-07771338 70 4. ^ VA 5. ^ Com. Ins. - Q Nob: Thb form ie Tumbhad b give you a statement Of actual sMBsmsM wds. Amounts paW to grad by lM aedlemeM agsnte are shown Itarns madaed 'Ip.o.e)' wero Wb oadake Om doming they are shown here for Informstbnal purposes and are not Indtded In the totals. D. Name & Address of Borrower. E. Name 8 Address of Seller: F. Name 8 Address of Lender: Penelope A BenYaebel Estate of EmBy E. Bender Membem 1st Federal CredBlMbn 197 College F80 Road, Ends, PA 17025 1652 Lowell Late, New Cumbedand, PA 17070 5000 Loube Drive, Mechanicsburg, P a 17055 O. Properly Locatlorc H. SetOemeM Agent: I. SatllemeM Date: 05/2312011 824 Cedar Ridge Lane 1st Advantage Setllenterat Setvbes Inc. Disbursemerd Date: 05232011 b8edwraiaxburg PA 17055 8375 Mercuy Drive, SuOe 102, Madaartbsburg, PA 17050 Upper Allen Township Telephate: 717591-7755 Fax: 717591-7756 Pl~e of Settlement: Tdbss 6375 Mercury Ddve, Sulte 102, Mechancsburg, PA 17050 P 052312011 at 9:51 am by KS 100. Oran Aroslak grra kow 8onotwr a price 129,900.00 400. l3ron AaatedOwbaSaOan t. sabpdw t 102. Psmarlal 402. Personal 103. SetOaneMchsgeebbarawer(i1e1400) 7,24249 403. 104. 404. 105. 405. for Nsata sa0sr b advance ua6nsnb for bwra Idler N advance 108. COyAosn Wms b 408. CltyAown ~ b 107. County tease 0512312011 b 17fd12011 301.68 407. Counlytea~~ 011 b 12/3112011 301.68 100. Sdtool Tama 05232(111 b 0613(YLO11 139.04 408. Scholl Taxes 0523@011 b 081302011 139.04 109. HOA Dues Q5Ip2011 b 051312011 20.32 409. HOA Dues 05@312011 b 05/31/!011 20.32 110. Saver 05232011 b O8f~2011 48.00 410. Sewer 05232011 b 06/382011 48.00 111. 411. 112. 412 120. OrowAemrxdDuetromBonouiw 1s7,651.53 4m. OntaAmouMDusto9eMu 130,WB.W 200. Atnowtb Pant a bt:BelrMef Borrower .500. RedueOom h AmouN Dwto Sdkr aearrmstmamy 1, .. Eaooess xehwbttrlbne) 202. Pdradpd amount d new ban(s) 126,806.00 502 Settlement tiaatgee b seler (Ilan 1400) 15.038.84 203. a taken b 503. Eadatl s tdmra su b 204. 504: P offirst ban 205. CredlfaApprdadFeePOC(8) 400.00 505. Payo6dsecondmatgageloan 208. 508. 207. 507. 200. 508. 209. 509. tar ketm ee0ar Ad uabnsnb br Oarn un sa8w faares b 510. CltyAawn taxes b 211. CauMyt~xe~ b 511.- Countytaxes b 212 School Taxes b 512. School Taxes b 213. 513. 214. 514. 215. SdbrAeebt 5,000.00 515. SeBerAasist 5,000.00 218• 51& 217• 517. 218. 518. 219. 519. 3 ~ Tabu Paid Bsrrouar 300. CaMatBaltlemenikaolb'Borrouar 301. Gross amomd due fran barotver (Orm 120) 02 lees Arroietb paid byl(a bonossr Qlne 220) 133,008.00 137,851.53 133,006.00 520. TaW Raduaron Amwrd Due Bdlu 000.- CadrattteWeraerrttollromShcy 601. Gross amount due b seller (Ifne 420) 602. Less reduc0ora b amount due adler (Ikre 520) 20,030.04 130.409.04 20,038.84 3 03. Cah ®From ^ To Bomwwr 4,845.53 gp3, Cash ®To ^ From SdMr 110,x7020 Prev can editlons arc obsolete Page 1 4 HUo-1 ~ ,, 700. TMMReaIEshESBroterFw ,743.00 Raid From P81d From DNbbndaxanfesbn IIne700 astdwes: Borrower's .Seller's 701. gg6,gg to RelMaxlatAdvantage Funds at Funds at 702. 747.00 to Jack Gaughan Reatlor, ERA 'Settlement .Settlement 703. Pale ffi setllemerrt 8,743.00 704. ComNsalm to Relbtac 1st Advantage 350.00 1100. lam. N:Co «1tlr lwn aegYutim (Irrdudes OepYiatlm Pdnt 0.000%ar 50.00) 5505.00 (from GFE 01) 802. Yow ae~t a drags )for the epsdflc interest rate dawn tran GFE ft2) 803. Your adJuabd origlnalion dlargas (iron GFE A) 505.00 ~ to Members 1st Fedarai Credit Uniar Gran GFE 03) 400.00 806. Credit report to Members 1st Federal Credt lMbn ((mn GFE #+3) 20. 806. Tax aervke to Members 1st Federal CrerBt Unbn (iron GFE 03) ~7• Fbotl oartlflcatlotr fo Members 1st Federal Credf Unbn (from GFE N3) 12.50 808. ro .000. OMrre L.MkM.OO He Pr00 N Adverrce 1. Daily k4eresl charges frorrr 11 to 068112011 @ 515.8258fday (tram GFE ) 1 hq. far months a Members 1st Federal Credt Udai (from GFE 03) 1, b3 s irreurarrce to months ~ G 011) 422. 904. months to from GFE 811 1001. kritlel depos8 fa yaa esadr account (fran GFE 09) 1,30128 1002. Flomeowrrefa irreuraae 3 months $ 35.17hrnnth ;105.51 1003. Mortgage Insuaxxs months O.OOhranth ; 1004. CBy FmPMy Tax mardhs 5 O.OOMranth 5 1005.CasrtyPropertyTax 4 months ; 41.t5lmonth ;164.60 1006. ScfaolTarces 12 months 108.44hnonlh ;1,30128 1007. AggregaleAd)uMmerrt 5-270.11 1700: TBN 1101. Title services and krrdei's tllle klauraae from GFE t4 1,368.75 1102. Seltlerner4adosingfee to 5 1103. Ownefa tltle inaaanoe from GFE 2(1.00 1104. Lendefa title Yrelaarrar ;1,186.75 1105. Lsrrder'a tOb po0ry Ortit 5126,606.00 Center's PaBcy 11f)8. Osrrer'a t01e pdky Emit 5129,900.OD Oamels Pdlcy 1107. Agada patlon d the total tltle Insraalce prorrdum 51,027.44 1108. Underaribr's palbn dtlb rofal tltle insurance pradum 5181.31 1109. 1110. Notary to Kdsterr D. Shtve 10.00 1111. Tax Certl6callelorr Fee b 1st Alvan Settlement S 10.00 1112. t0 ; 17'00. ffovsrrlnnM m4Trarrshr 1201. Govemmer4 reoadng dlarpea ; (from GFE 07) 148.00 1202. Deed 58200 ;88.00 Release S 1203. Transfer taxes 5 lip GFE 08) 1,299.00 1204. COy/CcuMytarlatefnf~ Deed 1 .00 1205. Stale Tmr/starrps Deed it .lb 5 1,299.00 1206. Deed 1207. 5 1700:..A4dl8aref 8sltlsresrrt 130 , eervloea tlret you can dap fa (from GFE O6) 1302. Survey po 1303. to 1304. to 1305, to 1306. SarerMl$130 to AtlenT 112. 1307. Inhedtanoe Tax Payment to ' tar d W91s t 7,Z4Z.48 15,038.84 Rak1 oumlee d tloeYrg by (B)aroxer, (B)aler, (L~rrder, (IMvesla, &o(1(Jer. "Credit by larder shaven on page 1. "'Credl by seller stxxvn on page 1. Previous editlons are obso Page 2 of 4 HUD-1 .l HUD CERTIFICATION OF BUYER AND SELLER ' trove nrafuky reviewed the HU67 Seftkment Statement and to the brct of my knovAedge end belbf, k is a true and accurate elatemeM of all receipts end IMDunMrMrMS made on my accourd or hY me in tllis trernac0on I fuller certify that I have received a copy of the HUD-7 Settlement Statement 'arebpa A. / ~~~~~ d EmNy E. BerMer 7ua HUQi SstlNnNnt Sfa7rnerlt whidf 1 have proparsd N a true and ibbursed M acooNarrce vrNh this statement sETTLEMENr orwW pose the fads ro he .'S.Z~.II DATE NARNINCi: IT IS A CRIME TO KNOIMNOLY MAKE FALSE STATEMENTS TO THE UNITED STATES ON THIS OR ANY SIMILAR FORM PENALTIES UPON :ONVICT1pN CAN INCLUDE A FINE AND IMPRISONMENT. FOR DETAILS SEE TRLE 78: U.S. CODE SECTION 1001 AND SECTION 7010. 'rcvbus editlons arc obsolete Page 4 4 HUo-l s~lvE~ sp~~nc p~ESBytE~~an church Founded 1734 ^ Meeting House Erected 1783 444 Silver Spring Road ^ Mechanicsburg, Pennsylvania 17050 Phone (717) 766-0204 wrvw.silverspring.org Fax (717) 796-2189 June 16, 2011 Darrel W. Bender, Esq. 1652 Lowell Lane New Cumberland, PA 17070 Dear Mr. Bender, This will acknowledge, with our thanks, the generous gift to Silver Spring as directed by Emily Bender's will. The gift will likely be applied towazd the Waugh-Wilson Retreat Center which is currently being developed by the church on the recently acquired property next door. We are blessed to have had the opportunity to know Emily and to benefit from her generosity. This gift will be recognized at the next Legacy Giving Sunday along with others who have made planned gifts to Silver Spring throughout the year. Sincerely, John W. Greenleaf, Jr. for the CommitmentlLegacy Giving Committee 'COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OP INDIVIDUAL TAXES DEPT. 280801 HARRISBURG, PA 1 7128-0801 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT N0. CD 013777 BENDER DARREL W 1652 LOWELL LANE NEW CUMBERLAND, PA 17070 ACN ASSESSMENT AMOUNT CONTROL NUMBER lala ESTATE INFORMATION: sSN: 300-zz-7997 FILE NUMBER: 2110-0991 DECEDENT NAME: BENDER EMILY E DATE OF PAYMENT: 12/13/2010 POSTMARK DATE: 12/10/2010 COUNTY: CUMBERLAND DATE OF DEATH: 09/10/2010 REMARKS: RECEIPT TO ATTY SEAL CHECK# 216 101 ~ 518,000.00 TOTAL AMOUNT PAID: REV-1162 EX111.96) 518; 000.00 INITIALS: HMW RECEIVED BY: GLENDA EARNER STRAS6AUGH REGISTER OF WILLS TAXPAYER COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0801 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX(11-96) N0. CD 014584 1ST ADVANTAGE SETTLEMENT SERV. 6375 MERCURY DR SUITE 101 MECHANICSBURG, PA 17050 f.~a ESTATE INFORMATION: sSN: 300-2z-7997 FILE NUMBER: 2110-0991 DECEDENT NAME: BENDER EMILY E DATE OF PAYMENT: 06/16/2011 POSTMARK DATE: 06/06/201 1 COUNTY: CUMBERLAND DATE OF DEATH: 09/10/2010 REMARKS: RECEIPT TO ATTY CHECK#17887 SEAL ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ 54,864.84 TOTAL AMOUNT PAID: INITIALS: DB RECEIVED BY 54,864.84 GLENDA EARNER STRASBAUGH REGISTER OF WILLS TAXPAYER PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU of INDIVIDUAL TAXES AND FILE N0. 21 10-0991 PD Box zeosol TAXPAYER RESPONSE ACN 10159246 HARRISBURG PA 17128-0601 DATE 10-19-2010 REV-ITiT El AFI <ET-RT] DARREL W BENDER 1562 LOWELL LN NEW CUMBERLAND PA 17070-2239 EST. OF EMILY E BENDER SSN 300-22-7997 DATE OF DEATH 09-10-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT ® SAVINGS CHECKING TRUST CERTIF. PNC BANK NA provided the DaDartment with the information balowr which has boon used in calculating the Dotantial tsx due. Records intlicat• thst at the death of th• above-nsmed decedent. You ware a ioint owner/benafieiarv of this account. If you Taal the information is incorrect, plaas• obtain written correction from the financial institution, attach a copy to this form and return it to the above adtlress. This account is taxable in accordance with the Inheritance Tax laws of the Commonwealth of Pannsvlvenia. Please till {~1]) 797-9327 wlth g4a3tien3- COMPLETE PART 1 BELOW ^ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 000005005168956 Date 09-15-2008 7o ensure proper credit to the account. two Established copies of this notice oust accomparo payment to the Register of Wills. Make check ACCOUnt Balant e- $` 182.353.36 payable to "Ragistar of Wills. Agent". Portent Taxable X 50.000 NOTE: If tax payments era made within th roe Amount Subject to Tax y` 91, 176.68 months of the decedent's date of death, Tax Rat a X . 045 deduct a 5 portent discount on the tax due. Am Inheritance Tex due will become delinquent Potenti 1 0 2 . 9 5 al Tax Due ~` 4, nine months after the date of death. Peer TAXPAYER RESPONSE 0 A. ~ The above infonation and tax duo is correct. Remit payment to the Register of Wills with two copies of this notice to obtain CHECK s discount or avoid interest, or check box "A" and return this notice to the Ragistar of 0 NE Wills and an official assessment will be issued by the PA Department of Rsvenue. C BLOCK B. y1 The aDOVe asset has been or will bo raportotl and tax p aid with the Psnnsylvsnia Inheritance Tax return ON L Y J ~+ to be filed by the estate ravrasantative. C. ~ The above informs ion 15 incorr ct and/or debts and deductions were Daid. Complete PART 2~ and/or PART 3~ below. PART TAX If indicating a different tax rate, please state relationship to decadent: RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Date-Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Taz Rate 8. Tax Due PART DEBTS AND DEDUCTIONS CLAIMED :der penaltlesof perjury, I declare that the facts I have :m eta to th be of my knowledge and belief. 1 2 3 X 4 5 - 6 7 X 8 $ reported above are true, correct and HOME (~~ 7 ) 7 ~ Z.b WORK C ~r y ) 2,~'-~.5;~ TCI~ Al11MRCD ~ ne DATE PAID PAYEE DESCRIPTION AMOUNT PAID PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIYIDUAL TAXES AND FILE N0. 21 10-D991 Po cox zaosgl TAXPAYER RESPONSE ACN 10159245 WIRRISBURG PA 17126-0601 DATE 10-19-2010 REV•1e63 EY •FP <Re-Ee~ DARREL W BENDER 1652 LOWELL LN NEW CUMBERLAND PA 17070-2239 EST. OF EMILY E BENDER SSN 300-22-7997 DATE OF DEATH 09-1D-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT ® SAVINGS CHECKING TRUST CERTIF. PNC BANK NA provided the Department with the information below, which has bean used in calculating the potential tax due. Records indieat• that at 4he death of the above-named decadent, You warp a ioint owner/banaf iciary of this account. If yeu fool the infor.etion is incorrect. please obtain written correction frog the financial institution, attach a copy to this fora and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Commonwealth of Pennsylvania. Please call C717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 0 0 0 0 050 04057031 Data 09-17-2008 7o ensure proper credit to the account, two Established copies of this notice must aeeompa~q, payment to the Register of Wills. Make check Account Balance ~ 9,373.91 payable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE, If tax payments era made within th re• Amount Subject to Tax $ 4,686.96 months of the decedent's data of death, Tax Rata X . 045 deduct a 5 Dereent discount on the tax due. AM Inheritance Tax due will become delinquent Potential TaX DUO ~' 210.91 nine months after the data of death. A. ~ The above information and tax due is correct. Rewit payment to the Register of Wills with two copies of this notice to obtain CHECK a discount or avoid interest. or Cheek box "A" and return this notice to the Register of C ONE ~ Wills end an official assessment will be issued by the PA Department of Revenus. BLOCK B. Tha above asses has bean er will be reported and tax paid with the Pennaylvania Inharitanca Tax return ONLY ~ to be filed by the estate representative. C. ~ Tha above informs ion is incorrect and/or debts and deductions were Daid. Complete PART 2~ and/or PART 3~ below. PART If indicating a diffe rant tax rata, please state relationship to decadent: TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Date Established 1 2. Account Balance 2 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 5. Debts and Deductions 5 , 6. Amount Taxable 6 ~ 7. Tax Rata 7 X 8. Tax Duo 8 +~ PART DEBTS AND DEDUCTIONS CLAIMED 3^ DATE PAID PAYEE DESCRIPTION AMOUNT PAID WORK C7/'f ) Un er penalties of perjury, I declare that the facts I have reported above are truej, correct and - ' comp ate to the bast of my knowledge and belief. HOME C`~/ ~ ) ~7hM .i 2f0~~ . PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES AND FILE ND. 21 10-0991 Po Box zaosol TAXPAYER RESPONSE ACN 10159244 HARRISBURG PA 17126-0601 DATE 10-19-2010 DARREL W BENDER 1652 LOWELL LN NEW CUMBERLAND PA 17070-2239 EST. OF EMILY E BENDER SSN 300-22-7997 DATE OF DEATH 09-10-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS ® CHECKING TRUST CERTIF. PNC BANK NA provided the Department with the information below, which has boon used in calculating th• potential tax due. Records indicate that at the death of the above-named decedent. you ware a joint owner/beneficiary of this account. If you feel the information is incorrect. please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Commonwealth of Pennsylvania. Please call C717) 767-6327 with questions. - COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 000005004403176 Date 09-17-2008 To ensure proper credit to the account, two Established copies of this notice oust accompany payment to the Register of Wills. Make chock Account Balance ~` 5 a 022.38 payable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax payments era made within three Amount Subject to Tax ,S` 2,511.19 months of the decedent's data of death. Tax Rate X .045 deduct a 5 percent discount on the tax due. Any Inheritance Tax due will become delinquent Potential TaX Due $ 113.00 nine months attar the date of death. P T TAXPAYER ESPONSE ~ 1 A. ~ Tha above information end tax due is correct. Remit payment to She Register of Wills with two co pies of this notice to obtain a discount or avoid interest, or check box "A" and return this notice to the Register of CHECK Wills and an official assessment will be Sssuad by the PA Department of Revenue. ONE ~ C BLOC K B. ~ VH Th• above asset has boon or will be reported end tax D a1d with the Pennsylvania Inheritance Tax return ONLY ////~~~~--^^^^to be filed by the estate repro sentativa. C. ~ The above informs ion 15 incorr ct and/or debts and deductions ware Daid. Complete PART 2~ and/or PART ~ below. PART If indicating a different tax rata, plaasa state relationship to decedent: TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LTNE 1. Dat• Established 1 2. Account Balance 2 ~ 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 5. Debts and Deductions 5 - b. Amount Taxable 6 7. Tax Rate 7 X 8. Tax Dua 8 $ PART DEBTS AND DEDUCTIONS CLAIMED 0 DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury. I declare that the facts L have reported ~a lb io ve are^tlrue, co rr~re~ct and c mp~,a to t~h e9 bye st of my knowledge and beliefi. HOME C /1~ ~ /~ ~~^~~ ~ ' 1~--~3~ WORK ( "7 !7 1 ~Z/ - ~.r.~ ~ /Z ~.vn'B41 n n~.+u~,•n nr' TCI COIJA AIF AIIIMRCD Ile Payable To: DENNIS ZERBE, TAX COLLECTOR Township Of Upper Allen Tax Coll. MECHANICSBU TAXES G, PA 1705 TAX RATE ISCOUNT Until 0 COUNTY 1.902 ML 276.06 281.69 309.86 CNTY LIB .143 ML 20.76 21.18 23.30 TOWNSHIP 1.292 ML 187.49 191.32 210.45 ST LIGHT 1.000 ML .00 .00 .00 FIRE HYDRT .087 ML 9.47 9.66 10.63 TOTAL TAX DUE 493.78 503.85 554.24 Taxes are due and payable and payment is requested from: BENDER, EMILY E 624 CEDAR RIDGE LANE MECHANICS°!!RG PA 17155 0 Pay Tax Collector before 12/30/2011 On or after 01/01/2012, taxes are payable to Tax Claim Bureau, One Courthouse Square, Carlsisle, PA. 17013 Control #: 42-000759 Map #: 42-24-0792-038- TOWNSHIP OF UPPER ALLEN CEDAR RIDGE TOWNHOUSES LOT 4F PB 32 PG 73 Residential(Under 10 Acres) Acreage:.05 Deed Ref: 0028V/00499 ASSESSED LAND - 17400 ASSESSED IMPR - 130700 ASSESSED TOTAL - 148100 TAXPAYER OR MORTGAGE HOLDER COPY Return both copies with a self addressed stamped envelope for receipt Amount Paid Date Tax Collector »»»»»»»» TEAR ALONG THi$ LINE »»»»»««««« TF~1f2 ALONG THIS.LINE «««««««« s e ~- • Payable To: DENNIS ZERBE, TAX COLLECTOR Township Of Upper Allen Tax Coll. ~~e r•i ~11ACFQ1 eNn PARKWeY il325 MECHANICSBU TAXES G, PA 1705 TAX RATE ISCOUNTA Until COUNTY 1.902 ML 276.06 281.69 309.86 CNN LIB .143 ML 20.76 21.18 23.30 TOWNSHIP 1.292 ML 187.49 191.32 210.45 ST LIGHT 1.000 ML .00 .00 .00 FIRE HYDRT .087 ML 9.47 9.66 10.63 i TOTAL TAX DUE 493.78 503:85 1 .554.24 Taxes are due and payable and payment is requested from: BENDER, EMILY E 624 CEDAR RIDGE LANE MECHANICSBURG PA 17055 0 Control #: 42-000759 Map #: 42-24-0792-038- TOWNSHIP OF UPPER ALLEN CEDAR RIDGE TOWNHOUSES LOT 4F PB 32 PG 73 Reside~tial(L'ndar 10 Aas) Acreage:.05 Deed Ref: 0028V/00499 ASSESSED LAND - 17400 ASSESSED IMPR - 130700 ASSESSED TOTAL - 148100 Pay Tax Collector before 12/30/2011 On or after 01 101 /2 01 2, taxes are payable to Tax Claim Bureau, One Courthouse Square, Carlsisle, PA. 17013 TAX COLLECTOR COPY Retum both copies with a self addressed stamped envelope for receipt Amount Paid Date Tax Collector Office Hours: Cumberland County, PA WED, THURS 9AM-11AM 8 12-2 BILL # 413 EVENING HOURS CONSULT UPPERALLEN.ORG 4130111 Between OSID1111 Stating 07101111 Discount: County ~ 2%, Twp @ 2% OFFICE AT 100 GETTYSBURG PIKE *(200542000413* PENALTY AMOUNT MAILING DATE: 03101!2011 And 08130111 Penaky: County ~ 10%, Twp ~ 10% Office Hours: Cumberland County, PA WED, THURS 9AM-11AM 8 12-2 BILL # 413 EVENING HOURS CONSULT UPPERALLEN.ORG 04130111 Between 05101111 Starting 07101111 Discount: County ~ 2%, Twp ~ 2°h OFFICE AT 100 GETTYSBURG PIKE *(200542000413* M PENALTY AMOUNT MAILING DATE: 03/01/2011 And 06130111 Penalty: County ~ 10%, Twp ~ 10% COMMONWEALTH OF PENNSYLVANIA PUBLIC SCHOOL EMPLOYEES' RETIREMENT SYSTEM Mailing Address PO Box 125 Harrisburg PA 171UR-0125 Tol!-Free- 1-8RR-773-7748 (1-88R-PSERS4U) Loral - 717-7R7-8540 Web Address: wxtiv.psers..rtate.pa.us September 27, 2010 DARRELL W BENDER E5Q. 1652 LOWELL LN NEW CUMBERLAND, PA 17070 RE: Emily Bender SSN: XXX-XX-7997 Dear Mr. Bender Esq.: Building Locution 5 North 5th Street Harrisburg PA The Public School Employees' Retirement System is processing the benefit of Emily Bender. Please accept our condolences on your loss. PSERS issued the following monthly retirement benefit(s) prior to processing the death benefit: Check Date September, 2010 Check Amount $1, 776.68 Emily Bender was entitled to a prorated amount of $843.48 for the month of September. Therefore, please reimburse PSERS $933.20, which represents the total of the monthly benefit payments and debts (if applicable) listed above, minus the prorated amount. Please make your check or money order payable to Public School Employees Retirement System. Please retain this information for preparation of the member's lrnal tax return. If you have any questions, please contact the PSERS Member Service Center by calling toll-free 1-888-773-7748 (1-888-PSERS4U); Harrisburg local callers, please use (717) 787-8540. To contact PSERS by a-mail, use the following address: ra-ps-contact@state.pa.us. For your convenience, the Member Service Center is staffed each business day from 7:30 a.m. to 5:00 p.m. You may also find additional information on the PSERS website: www.psers.state.pa.us. Sincerely, ~ Y ~c'? ~~ ~u~lc Selraoe ~ yee~t ~ ,~etviedr~e~t S~ydte~s 1 ~~ ~ 1~0 ~ ~ G ~~~~~b~l~l I~IY~UIN~I~d~N~Y~1N~~~N~~~~a1N~I~ININ~a~I~ OL0008975710019010 Fuur Gerrer'utinns... Crlcbrnting Life, Honorhrg Tra<liliorxc RS BOYD L. MYERS, JR., Supervisor 37 E. MAIN STREET ,~^,~ MECHANICSBURG,PENNSYLVANIA 17055 `funeral ~'6me, ~%jZr^i. (717) 766-3421 STATEMENT OF FUNERAL GOODS AND SERVICES SELECTED Charges are only for those items that you selected or that are required. If we are required by law or by a cemetery or crematory to use any items, we will explain in writing below. if you selected a funeral that may require embalming, such as a funeral with viewing, you may have to pay for embalming. You do not have to p y for embalming you did not approve if you d arrangements such tree[ cr ti nor imme ate burial. If we chazged for embalming, we '{~ ex ain w below. For the Service o$~ F~ii ~'~_~' ,~ ~1~ ri~~~ Date of Death 1( v Charge to: L tit~a A. CHARGE FOR SERVICES SELECTED: 1. PROFESSIONAL SERVICES Services of Funeral Director/Staff .... $~~'' Embalming ...................... 5 •- Other preparation of body ............................... ~-~i- l.. SUB-TOTAL OF PROFESSIONAL SERVICES......... Al FACILITIES AND SERVICES Use of facilities and services for viewing (Visitation/Wake)....... .. f Use of facilities and services for funeral ceremony .......... .. 5 --~ Use of facilities and services for Memorial Service ............. .. 5~ Use of equipment and services for graveside service ........... .. 5 J Other use of facilities ..................... ...... SUB TOTAL OF EACILITIE l 5 - S E UIPMEN Q T .......... . A2 5 .i. AUTOMOTIVE EQUIPMENT Vehicle to transfer remains to Funeral Ho L` ~' Local ........................... v $ Hearse (Casket Coach) Local ........................... ~t7~~~ 5~-+._~. Limousine Local ........................... $~L.. Family car Local ........................... 5 .~- Flower car or floral disposition Local ..................... b~~ Lead car/cler car Local ....~~~. ~ ~.?{~.°.T f`., ~~ ``JJ E.~ Car for pallbearers r Local ........................... 5 Out of town transportation ......... f~ 5 '~" f SUB-TOTAL OF AUTOMOTIVE EQUIPMENT........ A3 f` NZ TOTAL OF PROFESSIONAL SERVICES, FACILITIES AND AUTOMOTIVE EQUIPMENT ....................... ............ A 5 B. CHARGE FOR MERCHANDISE SELECTED: Casket ..............:........... 5_ (Description) Other Receptacle ................. t (Description) Outer burial container ............. 5 lTlrcrrintinnl Other clothing f f Cremation urn .................. . f (Description) OTHER f f ~~ ~ ' TOTAL MERCHANDISE SELECTED ... ............... B 5 ` C. SPECIAL CHARGES: Forwarding of remains to $ (Funeral Home) Receiving of remains from 5 (Funeral Home) Immediate Burial ................. $ Direct Cremation ' f . . ..... ' A~ /LJf GrY S f ~ ~~L. UB- OTAL OF SPECIAL CHARGES .. .............. C 5 D. CASH ADVANCED Opening Grave .................. 5 Cemetery Equipment .............. 5 Lot and Deed ............. 5 Newspaper Notices-Local .. ~ 8~~ Newspaper Notices-Out-of-town .... 5 Telephone & Telegrams ........... 5 Airfare ......................... Clergy/Mass Offering .............. $ ~~,. f eJ.°j Pallbearers ...................... f Certified Copie~,~f the Death Certificat~Q.....~?,~7.f? ......... eN 5 Police Escort .................... f Flowers ........ .. . , i~~cl0 f Vault Service Charge .............. f D tits ~.t. f,1- g j h~'~ tr~ f f 5 5 SUB TOTAL OF ADVA f ~ k~ - NCES ......... .............. D We charge you for our services in obtaining: (specify cash advances that are marked-up) SUMMARY OF CHARGES A. Professional Services, Facilities and Equipment, and Automotive Equipment .................... j_ „p ~ .. ~~"' B . Merchandise ........ C S i l Ch ~ .. 5 - v 1 •'`r~ . pec a arges ..... . . . ......... . $ D. Cash Advances ..... 5 f ° Ya ~ 7 TOTAL OF ALL SECTIONS ....... ... ~ sc'"-""~ ~ 5 L ~' PAID AT TIME OF OR PRIOR TO ARRANGEMENTS ' n ~ ~ t `I7Sr Sk - ........~ ...,.. . - .. .. ~ ..... i ' SUB-TOTAL OF PROFESSIONAL SERVICES......... A1•~ 2. FACILITIES AND SERVICES Use of facilities and services for ^ viewing (Visita[ion/Wake)...... ~ ... 8 llse of facilities and services for funeral ceremony ......... ... 8 -~ Use of facilities and services for Memorial Service ............ ... 8 Use of equipment and services -~ ~ for graveside service .......... ... 8 ~J'~~ Other use of facilities ............................. .. 8 ~ SUB-TOTAL OF FACILITIES/EQUIPMENT .......... . A2 8 3. AUTOMOTIVE EQUIPMENT Vehicle to transfer remains to Funeral Hong-~ Local ......................... .. 8 J-t~+'i' Hearse (Casket Coach) ^17.- ~'~' Local ......................... .. 8 Limousine -• . L Local ......................... . .. S1L~- 'Family car Local ......................... .. 5 Flower car or noral disposition l t~._. S ~'' ......................... Loca Lead car/clergy car ~ Local .... ~C(,r. ~ ~ ~T... 1 _.., , .. 8 Car for pallbearers Local ......................... .. 8 --• Out of town transportation ....... .. 8~-J" 8 -~ 8 TOTAL OF AUTOMOTIVE E SUB U IPMENT A3 b ~ - Q ........ ,~t- TOTAL OF PROFESSIONAL SERVICES, FACILITIES AND AUTOMOTIVE EQUIPMENT .................... ............... A S B. CEIARGE FOR MERCHANDISE SELECTED: Casket .......................... 8_ (Description) Other Receptacle ................. 8 (Description) Outcr burial container ............. 8 (Description) Acknowledgement cards .......... 8 Regis[er book(s) .................. 8 Memory folders ................ 8 Prayer cards ..................... 8 Temporary grave marker ........... 8 Burial clothing ................... b ~~........Y-., OTHER 8 $ 8 ~ ~•' ~~ ~ TOTAL MERCHANDISE SELECTED .... .............. B 8 ' C. SPECIAL CHARGES: Forwarding of remains to 8 (Funeral Home) Receiving of remains from a (Funeral Home) Immediate Burial ................. 8 Direct Cremation ' ~+ 8 . . .....y S UB• OTAL OF SPECIAL CHARGES .. .............. C 8 ' D. CASH ADVANCED Opening Grave .................. 8 Cemetery Equipment .............. $ Lot and Deed ................. Newspaper Notices-Local ......... 8 ~ 8~~. Newspaper Notices-Out•of-town .... 8 Telephone & Telegrams ........... 8 Airfare ............. $ ~ ClergylMass Offering .............. 8 0• Pallbearers ...................... .8 Certified Copie~Qf the Death Certificatr~Q.....~35`? ......... cN 8 ~ ~- '~ Police Escort .................... 8 Flowers ........................ i~. ~~U 8 Vault Service Charge .............. 8 ~ °'`-`~ ~,,~ fem. s c> fY'' 8 8 b 8 SUBTOTAL OF D 8 ~~ A VANCES .......... ............. p We charge you for our services in obtaining: (specify cash advances that are marked-up) SUMMARY OF CHARGES A . Professional Services, Facilities and Equipment, and Automotive Equipment ... .... ............. ~ B. Merchandise ................. 8 f~ C. Special Charges .................. T c.~ ~~ D. Cash Advances ................... 8 Y ° TOTAL OF ALL SECTIONS .......... .......... ~a 5' 7 ~~ 8 ` w~ PAID AT T ' s e'"' _~ e IME OF OR PRIOR TO ARRANGEMENTS........ ..... ~ _^ BALANCE DUE ........ ,~!~- ~ ~ , - REASON FOR EMBALMING ~` N~'~ If any law, cemetery, or crematory requirements have required the purchase of any of the items listed above the law or requirement is explained below. I agree [ha[ 1 have examined the items of goods and services selected above and found [hem to be correct and according to the arrangements t have requested. I acknowledge receipt of a cop}' of this Statement of Funeral Goods and Scrv' ~cted. I represen(j at 1 have sufficient funds available for payment of the cash price for the goods and services selected. I also agree jo ttlakt~aymenrof$~~ I'~ within c~ days. [agree to be jointly and severally liable with amone else who signs below. A late charge of~ per month amounting to . per year will be applied to the unpaid balance beginning ~ days from the date of this agreement. 1 will also par' to the Funeral Director all reasonable costs paid by the Funeral Director to collect amounts 1 owe under this agreement. Those costs ma}' include attorneys' fees, court costs and other costs. Any additional services or merchandise ordered or requested aftyr the date of this agreement will be considered part of this agreement and the cost thereof will be reflected on the final bill or statement. ~ ~ (Seal) ~,( 1 aser) (Beall J (Purchaser) C7 WHITE-Funeral Dirccwr YEI.L'6W-Cusn,mer ~T-~--- ,~ ~• r1A1M B Y 1 ' t`1[ 1 s [ ~ --- ~, ~~~ ' ~, i~ I ~ 1 f ~~ M ~' ,n O A • _ O 00 U ~ m i i. M ~ ~ M ~~.. ~ ~ p U ~ ~ ~ O ~ O Cam.. L ~ ~+ ~ ~ ~ ~ ~,~ N .fl ~ .~~`p ~ OGU~ V' Darrel W. Bender, Esq. 1652 Lowell Lane New Cumberland, PA 17070 November 28, 2011 Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013-3387 re: Estate of Emily E. Bender File No. 2010-0991 State File No. 21 10-0991 Dear Sir or Madam: I enclose two (2) copies of the Pennsylvania Inheritance Tax Return (Form Rev-1500) along with a check in the amount of $442.58 for the balance of the Inheritance Tax due for the Estate Inventory for the Estate of Emily E. Bender. If anything additional is required or if you have any questions please feel free to contact me by telephone at (717) 774-2616, by email at BENDORION@VERIZON.NET or by mail at the address above. Very truly.~ y-~o\\urs, Darrel W. Bender, Esq. Attorney ID No. 58143 Enclosures ~~ ~ -''~ ~ ~ ~~+ ~=; ,J ~ ~ ;.~ x ~~ w Darrel W. Bender, Esq. 1652 Lowell Lane New Cumberland, PA 17070 November 21, 2011 Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013-3387 re: Estate of Emily E. Bender File No. 2010-0991 State File No. 21 10-0991 Dear Sir or Madam: I enclose the filing fee for the Inheritance Tax Return for the Estate of Emily E. Bender, which was sent previously. If anything additional is required or if you have any questions please feel free to contact me by telephone at (717) 774-2616, by email at BENDORION@VERIZON.NET or by mail at the address above. Very truly yours, Darrel W. Bender, Esq. Attorney ID No. 58143 Enclosures - ~~ := ~~ ~ m --n "~, `-, m c`7 ,`. , Q = ~ ~ ~ ~~ ~ JCSJ .~ ::~: ~~ ~ ~ ,7~ y s ~. ::~ *" f j ~;1 ~~ ~a 0 0 Q a ~~~ Via` ~ ~ .n ~ ° ~ sue. N U Q .~i N z y L ~, ~ ~ o ~ U y M i. M R7 rn ~ ~ ~M-i _^. V Cn ~ ~ .-i i.. ^4 ,~ C1. F. ~ ~ v7 .G,,,7 .N.. m~~~-