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HomeMy WebLinkAbout01-12-12 (2)-~ REV-1 ~~~ °`t0t-10) 1505610143 PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes ~ ~~ ' ~a vas Fie N'r'wer Po Box.2sofiol INHERITANCE TAX RETURN 21 11 0 0 4 8 6 Harrisburg, PA 17128-0601 RE3IDPNT 1'ft=Ct=WENT Social Security Number 072 12 6383 Deosdent's Last Name ~PEBB Date of Death 04 09 2011 (If Applicable) Enter SurvNing Spouse's Information Below Spouse's Last Name Date of Birth 09 14 1923 Suffer Decedent's First Name MI FLORENCE Suffer Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ® 1. Original Retum ^ 2. Supplemental Retum ^ 3. Remainder Retum (date of death prior to 12-13-82) ^ 4. Limited Estate ^ 4a. ~~ I death artxCO~) ^ 5. Federal Estate Tax Retum Required ® g. Dscsdau Died Testate ^ 7. Decedent AAehfaYied a Living Tnrst (Attadl Copy of VVa) (Attach Copy or Tn,et) (( 8. Total Number of Safe Deposit Boxes ^ 9. L)Ugadon Proceeds Received ^ 10. DSetMr~aen 1231 timid 1-~~a ~' ^ 11. Electlon to tax under Sec. 9113(A) (Attadt Sch. 0) CORREBPONDENT -THIS 8ECTION MUBT BE COMPLETED. ALL CORREBPONDENCE AND CONFIDENTUIL TAX INFORMATION SHOULD BE ERECTED TO: Name Daytime Telephone Number DEBRA R PALLET 717 737 1300 First line of address 24 NORTH 32ND STREET Second line Of address City or Post OMice State ZIP Code CAH{P HILL PA 17011 r~ REGISTER LS USEbIYLY - ~,.~ C..., r ~°" ,. ~,,; ~ rte- , :~ ~~~ tV ~ ~ ~ ~~~ ~ h ~~ `v D/~l`E FILED tJJ - ' r~-~'~ t ;: 4 .~' '1 i T3 r~ cornsponrMnt'se-malladdress: walletdeb~aol.com under p~q of I dsdare that I have examined this return, indudirg acxompanying schedules and statements. and to the beat of my IcnaMsdge and belief, h fa bY~, cdrrieCt snd~pbte. Dedaratlon of pn~parer other than the perswtal represer>taHve is based on atl infortnatlon of which preparer has any knowledge. Jean Hoin ADDRESS ~^ ~~ 106 Ar+r~ley Avenue, Whiting, NJ 08759 /a ~«~. 9~ ~ ~ Z SIQNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ~„Q,r,~ ~ , ~~a-- Debra K Wallet fa,,t (, , 20 ~ z, AoDRESs 24 North 32nd Street, Camp Hi11, PA 17011 1505610143 Side 1 1505610143 1505610243 REV-1500 EX o.oedenr. runs: W E B B, FLORENCE Decedents Social Security Number 0 7 2 12 6 3 8 3 RECAPITULATION 1. Real Estate Schedule A .................................................... 1, 12 4 , 6 8 6 . 6 7 2. Stocks and Bonds (Schedule B) ............................................................................... 2. 3. Ck~sey Held Corporation, Partnership orSole-Proprietorship (Schedule C).......... 3. 4. Mor~ages 8 Notes Receivable (Schedule D) .......................................................... 4. 5. Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) ................ 5. 15 2 , 10 3 . 7 0 8. Jointy Owned Property (Schedule F) ^ Separate Billing Requested ............. 8. 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property (Schedule G) Q Separate Billing Requested ............. 7. 8. Total Gross Assets (total Lines 1-7) ....................................................................... 8. 2 7 6, 7 9 0. 3 7 9. Funeral Expenses & Administrative Costs (Schedule H) ......................................... 9. 2 6 , 811.41 10. Debi of Decedent, Mor~age Liabilities, & Liens (Schedule I) ................................ 10. 7 0 2 . 5 6 11. Total Deductions (total Lines 9 810) ...................................................................... 11 • 2 7 , 513.9 7 12. N~ Value of Estab (Line 8 minus Line 11) ............................................................. 12. 2 4 9 , 2 7 6 . 4 0 13. Ctuu~able and Governmental Bequests/Sec 9113 Trusts for which an ebcHonto tax has not been made (Schedule J) ................................................. 13. 9 2 , 6 91.15 14. NstValtte 8ubJsct to Tax (Line 12 minus Line 13) ................................................. 14. 15 6 , 5 8 5 . 2 5 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9118 (a)(1.2) X .00 15. 18. Amount of Line 14 taxable at Ilneal rate X .045 18. 17. Amount of Line 14 taxable at sibling rate x .12 61 , 7 9 4.10 1 ~• 18. Amount of Line 14 taxable at collateral rate x .15 9 4 , 7 91.15 18. 19. Tax Due ..................................................................................................................... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 7,415.29 14,218.67 21,633.96 Side 2 1505610243 1505610243 J REV 1500 EX Page 3 Dscedelrt's Complete Address: File Number 21 - 11 - 00486 Wsbb, Florence STREET ADDRESS 5237 Windsor Boulevard CITY Mechanicsburg STATE PA ZIP 17055 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 12,000.00 631.58 3. Interest 4. H Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 2 Line 20 to request a refund 5. N Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. Total Credits (A + B) (1) 21,633.96 (2) 12,631.58 (3) 0.00 (4) (5> 9,002.38 Make Check Payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ................................................................................. b. retain the right to designate who shall use the properly transferred or its income :.................................... x c. retain a reversionary interest; or .................................................................................................................. ^ ^ d. recehro the promise for life of either payments, benefits or care? .............................................................. ^ x 2. If death oocuned alter 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?......... ^ ^x 4. Did decedent own an Individual Retirement Acx:ount, annuity, or other non-probate property which contains a beneficiary designation? ...................................................................................................................... ^ 0 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS 18 YES, YOU MUST COMPLETE SCHEDULE a AND FILE R AS PART OF THE RETURN. For dales of death on or attar Jukk 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 pecent p2 P.S. §91'f6 (a) (1.1) (~]. For dales of death on or attar January 1,1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 pecent j72 P.SS §9116 (a} (1.1) (fi)]. Ths statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for d~cbsure of assets and filing a tax return are still applicable even if the survNing spouse is the ony beneficiary. For dates of death on or after Jug 1, 2000: • Ths tax rats ~po~d on the net value of Vansfers from a deceased child 21 ars of age or younger at death to or for the use of a natural parent, an adoptive patent, 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) . A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, ther y b or adoption. oow~oNwaxtH of re~nv~wU lR~i1rM10ETAX WEnJRN RMDOiTOBC@DBfi SCHEDULE A REAL ESTATE FILE NUMBER Et3TATE of .Webb, Florence 21 -11 - 00486 All nal property owned solelyy or as a tenant in common must bs~teiaorted at fair market value. Fair market value is defined as the price at would be exchanged between a willing buyer and a adding seller, neither being compelled to buy or seH, both having reasonabNp~~O ledge of the n3levant facts. Real property which is jointly-owned with right of survivorship must bs disclosed on schedule F. Attach a spy of the settlement sheet if the property has been sold. Include a copy of the deed showing deoedenYa interest if owned as tenant in common. ITEM DESCRIPTION VALUE AT DATE OF NUMBER DEATH 1 5237 Windsor Boulevard, Mechanicsburg, PA (based on proceeds from actual sale -see attached HUD-1; note $8,000 tax escrow) 124,686.67 I TOTAL (Also enter on Line 1, Recapitulation) I 12+4,886.67 SCHEDULE E CASH, BANK DEPOSITS, & MISC. ~TM°'`"121~''~` PERSONAL PROPERTY NNEWTANOE TAX RE7UIW IIEIDBIT DBC®BIT FILE NUMBER ESTATE OF Webb, Florence 21 -11 - 00486 Includ~e the pproceeds of litigation and the date the proceeds were received by the estate. All property Jointly-owned with the right of survivorship muit tae dlsclossd on schedule F. ITEM DESCRIPTION VALUE AT DATE OF NUMBER DEATH 1 Members First Savings Account #13162-00 25.74 2 Members First Money Management Account #13162-05 99,290.89 3 PNC Savings Account #5130174845 19,419.17 4 PNC Checking Acxount #5140067322 19,070.33 5 Cash in possession of Decedent 117.47 6 Personal possessions and 2001 Toyota (based on proceeds from auction -see attached 8,615.05 statement) 7 AAA refund 8 Readers Digest refund 9 Patriot-News refund 10 Union Car Insurance refund 11 PA State rebate 12 Nationwide Insurance refund 13 2 paintings of flowers and framed picture of dog on bed (based on auctioneer's estimate) 14 Allianz Life Insurance policy #20605753 (made payable to the Estate) 68.75 24.95 149.55 6.22 250.00 49.83 100.00 4,915.75 I TOTAL (Also enter on Ltne 5, Recapftulatlon) I 152,103.70 ~ 9G'®U.EH oowoNwen.~n, of re~snwwa 8t .rw~rNC~n,ro~ AiDNNSTRATNE©06'I'S ®~ FILE NUMBER ESTATE OF Webb, Florence 21 - 11 - 00486 Debts of decedent must be reported on Schedule I. ITEM NUMBER FUNERAL EXPENSES: DESCRIPTION AMOUNT A. 1 Myers Funeral Home 4,594.00 2 Cemetery marker 85.44 3 Funeral luncheon 314.21 B. ADMINISTRATIVE COSTS: 1. Personal Reprossntative's Commissions Name of Personal Representative(s) Jean Hoin 5,000.00 street Address 10B Ardsley Avenue city Whiting state NJ zip 08759 Year(s) Commission paid 2012 2. Attorneys Fees Debra K. Wallet, Esq. 5,000.00 3, Family F~oemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address Cily State Zip Relationship of Claimant to l~cedent 4. Probate Fees 367.50 5. Axountant's Fees 6. Tax Return Proparer's Fees ~, Other Administrative Costs 1 Attorney's postage, photocopies, mileage, etc. 50.00 TOTAL (Also enter on line 8, Recapitulation) 26,811.41 col~ol~un+oF PEr~svwiwin INF~FMTANCE TAX RETURN RE810ENT OEGEDENT Sd>led~~e H F~1E1'AI 6g78t189B & ESTATE OF Webb, Florence FILE NUMBER 21 -11 - 00486 2 Harland Clarke (estate checks) 30.57 3 Nationwide Insurance 160.53 4 Pennsylvania American Water 197.21 5 Tom Langan (locksmith) 80.00 6 PPBL 420.36 7 D 8~ S (car inspection) 71.01 8 Michael E. Sopp, III (lawn mowing; spring cleanup and mulching at 5237 Windsor 1,965.00 Blvd.) 9 Larry's Auto Detail (to prepare car for sale) 211.95 10 PennDot (transfer of car title) 58.50 11 Tru Green (grub control at 5237 Windsor Blvd.) 362.76 12 Executrix expenses (5 round trips from NJ to PA - 320.4 miles/trip x $0.50 x 5 = $801; 901.00 $20 tolls per round trip x 5 = $100) 13 Darlene Watson (cleaning and prep of house for sale) 390.00 14 Lower Allen Township (trash/sewer) 207.90 15 Stanley Steamer -carpet cleaning 104.94 16 Tom's Home Services (painting and repairs) 2,406.08 17 Bonnie Miller, Tax Collector (school taxes) 1,362.97 18 Walker Realty (express mail) 13.25 19 Terminex (termite treatment) 1,551.84 Page 2 of Schedule H COwAMONWEALTFI OF PENNSYI.vANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Schecit~ie H F~rter~l FSq~ert~& ~Y~1'ti~hl@ ~06t6 GOf t~11I0d ESTATE OF Webb, Florence FlLE NUMBER 21 -11 - 00486 20 ~ Enviroquest (radon mitigation) 860.00 21 ~ Overnight mail and postage charges incurred by Executrix ( 44.39 Page 3 of Schedule H SCHEDULEI DEBTS OF DECEDENT, MORTGAGE ~""°"~TM°F`ti"M'~` LIABILITIES, & LIENS MN61RANfX: TAX RETUFW R~DBIT DBC®BiT FlLE NUMBER ESTATE OF Webb, Florence 21 -11 - 00486 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, inGuding unreimbursed medical expenses. ITEM DESCRIPTION AMOUNT NUMBER 1 Darlene Watson -cleaning 182.85 2 I Comcast Cable I 121.57 3 I Buchanan & Erb I 354.98 4 I Verizon I 43.16 ~ TOTAL (Also enter on Line 70, Recapitulation) ~ 702.56 REV-7673 p(i (N-0!) _ ~ SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES I NHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Webb, Florence FlLE NUMBER 21 -11 - 00486 NUMBER NAME AND ADDRESS OF PERSON(S) RELATIONSHIP TO DECEDENT SHARE OF ESTATE (Words) AMOUNT OF ESTATE ($$$) RECEIVING PROPERTY oo Not Lbt 7natN(s) I~ TAXABLE DISTRIBUTIONS [indude outright spousal di ib i d f str ons an ut trans ers under Sec. X116 (a) (1.2)] 1 Jean Hoin Sister 25% of residuary 61,794.11 10B Ardsley Avenue Estate** Whiting, NJ 08759 2 Kaye Ream Friend 2 paintings of 30,997.0; 163 Easterly Drive flowers, framed ' Mechanicsburg, PA 17050 picture of dog on bed, 12.5% of residuary Estate 3 Barrie Hunkins Friend 1,000.0( 1 East Schoolside Drive Mechanicsburg, PA 17055 Enter dollar amounts for distributions shown above on lines 1 5 through 18 on Rev 1500 cover sheet, as appropriate. II, NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN 1 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1 Helen O. Krause Animal Foundation (12.5% of residuary Estate) 30,897.05 2 West Shore Humane Society (12.5% of residuary Estate) 30,897.05 3 Best Friends Animal Society (12.5% of residuary Estate) 30,897.05 "*Note: Paragraph Second D, 20% to Marion Patricola, fails and this share was redistributed proportionately. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEETI 92,681.15 REV-161~EX+(y.pp) _ ~ SCHEDULE) COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES continued INHERITANCE TAX RETURN RE8IDENT DECEDENT ESTATE OF Webb, Florence FILE NUMBER 21 -11 - 00486 RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Wonis) ($$$) RECEIVING PROPERTY Do Not Llat Tnate~(s) I+ TAXABLE DISTRIBUTIONS [include outright spousal di ib i d f t r ons an trans ers s ut under Sec. 5116 (a) (1.2)] 4 Jeremy Hunkins Friend 1,000.0( 1 East Schoolside Drive Mechanicsburg, PA 17055 5 Susan M. Grothe Friend 12.5% of residuary 30,897.0; 5402A Oxford Drive Estate Mechanicsburg, PA 17055 6 Linda Queen Goddaughter 12.5% of residuary 30,897.0; 31 Woodland Avenue Estate Lititz, PA 17543 Page 2 of Schedule J LAST SILL AND T~STi~1VI~NT 0~ ~LO~~NC~ ~lf~~$$ I, FLORENCE WEBB, of Mechanicsburg, Cumberland County, Pennsylvania, being of sound and disposing mind, memory, and understanding, do hereby make, publish, and declare this to be my Last Will and Testament and hereby revoke all other Wills and Codicils that I have made, including the Will dated January 8, 2007. FIRST: I give and bequeath: A. My two paintings of flowers and one framed picture of a dog on a bed to my friend, KAYE REAM, of Mechanicsburg, Pennsylvania, so long as she shall survive me by thirty (30) days; B. The sum of One Thousand ($1,000) Dollazs to my friend's niece, BARRIE HUNKINS, of Mechanicsburg, Pennsylvania, so long as she shall survive me by thirty (30) days; C. The sum of One Thousand ($1,000) Dollazs to my friend's nephew, JEREMY HUNKINS, of Mechanicsburg, Pennsylvania, so long as he shall survive me by thirty (30) days. SECOND: I give, devise, and bequeath all the rest, residue, and remainder of my Estate, of whatever nature and wherever situate, as follows: A. Ten (10%) percent to my friend, SUSAN M. GROTHE, of Mechanicsburg, Pennsylvania, so long as she shall survive me by thirty (30) days; B . Ten (10 h) percent to my friend, KAYE REAM, so long as she shall survive me by thirty (30) days; C . Twenty (20 !)percent to my sister, JEAN HOIN, of Whiting, New Jersey, so long as she shall survive me by thirty (30) days; D. Twenty (20%) percent to my sister, MARION PATRICOLA, of Whiting, New Jersey, so long as she shall survive me by thirty (30) .days; E. Ten (10 ~) percent to my goddaughter, LINDA QUEEN, of Lititz, Pennsylvania, so long as she shall survive me by thirty (30) days; F. Thirty (30%) percent, in equal shares, to: THE HELEN O. KRAUSE ANIMAL FOUNDATION, INC., in Mechanicsburg Pennsylvania; the WEST SHORE HUMANE SOCIETY, in Mechanicsburg, Pennsylvania; and BEST FRIENDS ANIMAL SOCIETY, of Kanab, Utah. THIRD: All interests of any beneficiary in the income or principal of this Estate, while undistributed and in the possession of my Executrix, even though vested and distributable, shall not be subject to attachment, execution or sequestration for any debt, contract, obligation or liability of any beneficiary and, furthermore, shall not be subject to pledge, assignment, conveyance, or anticipation. FOURTH: All inheritance, estate, and succession taxes (including interest and any penalties thereon) payable by reason of my death shall be paid out of and be charged generally against the principal of my residuary estate, without apportionment or right of reimbursement from any person. In the event that a substantial portion, as determined in the sole and absolute judgment and discretion of my Executrix, of the non-probate assets such as an annuity or mutual funds are directed to be paid to a beneficiary or beneficiaries, so that the taxes referred to herein would be paid out of the probate residue passing to the beneficiary or beneficiaries of this wi11(whether or not the same as the beneficiary or beneficiaries under the non-probate assets), my Executrix, in the Executrix's sole and absolute judgment and discretion, shall have the right to allocate the full or partial payment of the taxes to the beneficiary or beneficiaries of the non-probate assets. FIFTH: In addition to all rights and powers conferred by law, I authorize and empower my Executrix and her successors, in her absolute discretion and without necessity of obtaining court approval: _ A. B. C. D. E. plan, or any other respect thereto. F. G. H. To buy investments at a premium or discount. To hold property unregistered or in the name of a nominee. To give proxies, both ministerial and discretionary. To compromise claims. To join any merger, consolidation, reorganization, voting trust • concerted action of security holders and to delegate discretionary duties with To lend to, and buy from, my estate. To borrow and to pledge real and personal property as security therefor. To sell at public or private sale for cash or credit or partly for each, to exchange, or to lease for any period of time, any real or personal property, and to give options for sales, exchanges, or Leases. I. To exercise any option permitted by law which she believes to be advantageous from the viewpoint of overall tax reductions, including, without limitation of the foregoing, power and authority to claim administration or other expenses either as income tax deductions or inheritance or estate tax deductions, without regard to whether they were paid from principal or income and without requiring adjustments between principal and income for any resulting effect on income. or estate taxes, and a .deduction of such expenses forvncome tax purposes shall be given effect in computing the respective shares of all persons interested in my estate set forth herein, even though the effect is to increase the share of one beneficiary or class of beneficiaries hereunder at the expense of another; and to make such adjustments, if any, between beneficiaries with respect thereto as she shall deem appropriate in view of the nature of the transaction and the amounts involved. J. To distribute in cash or in kind or partly in each. K. To employ agents, legal counsel, brokers, and assistants, and to pay their c~ fees and expenses as he may deem necessary or advisable to carry out the provisions of this Will or any Trust. The powers granted hereunder shall be exercisable with respect to all real and personal ~~ property, including, but not limited to, income and principal held for minors or disabled '~..1_ beneficiaries at any time, until the actual distribution of all property. All powers, authorities and discretion granted here shall be in addition to those granted by law and shall be exercisable without leave of court. However, nothing hereut shall be interpreted or construed to encourage, authorize, empower, or permit the Executrix to act or cause anyone to act in a manner contrary to or inconsistent with accepted standards of portfolio diversification and risk management. SIXTH: I nominate, constitute, and appoint my sister, JEAN HOIN, as Executrix of this, my Last Will and Testament. In the event of the renunciation, death, resignation, or inability of my sister to act for whatever reason in this capacity, then I nominate, constitute, and appoint my friend, KAYE REAM, as Executrix of this, my Last Will and Testament. I direct that no representative named above shall be required to post security for the faithful performance of her duties in any jurisdiction insofaz as I am able by law to relieve her of such obligation. Any of my representatives shall be entitled to reasonable compensation for the performance of the duties set forth here. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~ r` day of ~q~,N. , 2008, on this, the fifth of five typewritten pages. I have also signed the left-hand margin of the first four of these pages for purposes of identification only. ~: ., FLORE CE WEBB SIGNED, PUBLISHED, and DECLARED by the Testatrix, FLORENCE WEBB, as her Last Will 'and Testament, in the presence of us, who at her request, in her presence, and in the presence of each other, have hereunto subscribed our names as witnesses. 1~MN, it.1,J.a~s...r. '4lSb A rr.~..~ ~:.,f ~t . ~~~~.~, ~ j?~ ACKNOWLEDGMENT Commonwealth of Pennsylvania County of Cumberland I, FLORENCE. WEBB, Testatrix, whose name is signed to the attached instrument, having been duly qualified according to law, do hereby aclrnowledge that I signed and executed the instrument as my Last Wi11 and Testament; that I signed it willingly; and that I signed it as my .free and voluntary act for the purposes therein expressed. FLORENCE WEBB Sworn or affirmed to and subscribed before me by FLORENCE WEBB, the Testatrix, this ~_day of ~Qrc~, , 2~g• ,` Notary Publ ~ of ~s~nvara Novi sar ~~~,~~ pmp N1 Bow. t?un+bslard tbungr My Ca,,,ib,lonF~pMasoct?l, 2ot1 Msn~sr, Pamsykania Atsodadon d NotaAss AFFIDAVIT Commonwealth of Pennsylvania County of Cumberland We, Debra K. Wallet and ~y7p ~.. ~'tst~ ~ ,the witnesses whose names are signed to the attached instrument, being duly qualified according to law, depose and say that we were present and saw the Testatrix, FLORENCE WEBB, sign and execute the instrument as her Last Will and Testament; that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the Will as witnesses; and that, to the best of our knowledge, the Testatrix was at that time 18 years of age or older, of sound mind, and under no constraint or undue influence. d,,p.~e u. ~~- ~~ti~~ ~, . ~n~ ~ Sworn or affirmed to and subscribed before me by ~~j,r~ ~. - ,l~G~) ~~ and ~~~ L . ~C Cs 1 ~ ~ ,witnesses, this ~n~ day of ~(~ ~~ , 2008. /!1 Notary Publi co~ormr~a.Tr+oF ~- r~~ ~~++ Member, Psmsylva+fa 1lssoctsuon d Notaries Q~Q~~~~,~Nr~~oG~ y j~ ~ * * ~ «. Q ~~~'gRN•p.EN~CyO~~= OMB Approval No. 2502-0265 HUD-1 A. Settlement Statement (HUD-1) Page 1 of 3 B. Type of Loan __ -- 1. ^ FhIA 2. RHS 3. ^X Conv. Unins. 6. Flle Number: 7. Loan Number: 8. Mortgage Insurance Case Number:. 4.O VA 5. ~ Gnv. Iro. 401101814-CL 7122616175 NOTE:. Thb fom- k furnished to give you. a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked '(p.o.c.)' were paW outside the Nosing; they arc shown here for informational purposes and are not included in the Is: D. Name and Addrap of Borrower L L THOMAS 17 W. PERRY ST. APT B. ENOLA, PA 17025 E. Nsma and Address of Seller ]EAN HOIN, IXECUTRIX OF THE ESTATE OF FLORENCE WEBB 5237 WINDSOR BOULEVARD MECHANICSBURG,PA 17055 F. Name and Address of Lender ERA HOME LOANS 1 MORTGAGE WAY, MOUNT LAUREL, N] 08054 G. Property Loeatlon 5237 WINDSOR BOULEVARD, MECHANICSBURG, PA 17055 COUNTY CUMBERLAND H. Settlement Agent SECURED LAND TRANSFERS, LLC 485 ST. ]OHNS CHURCH ROAD , .. SHIREMANSTOWN , PA 17011 Phone : (717) 901-8342 : PARCEL ID: 13-23-0561-019 ~ OWNSHIP: LOWER ALLEN TOWNSHIP place of Settlement 19 NORTH BALTIMORE ST DILLSBURG, PA 17019-1354 I. Settlement Date 10/28/2011 Disbursement Dbte 10/28/2011 ]: Summa of Borrower's Transaction K. Summa of Seller's Transaction 100. Gross Amowtt DNe from Borrower 4 00. Grosso Amount Duo to Seller 101. Sales Pike 138 000.00 4 01. Contract Sales Prkx 138 000.00 102. P I 4 02. Personal Pro 103. S merit es to borrower Ifne 1400 4 534.42 4 03. 104. 4 04. 305. 4 0 . u rK fo M b seller in sdvsnce ustment for items ld b seller in advanee 106. own 406. own Taxes 1 7: T 70 .9 r 10 28 2011 to 1 1 2012 125.18 407. Cou Taxes 702.9 r 10 28 2011 to 1 1 2012 125.18 108 408. Assessrrrents 1 i . 9 28 2011 to 7 2012 938.59 409. School Taxes 1 390.79 r 10 28 2011 ib 7 1 2012 93 .59 110. er BN S0. for 10 8 2011 to 1 1 2012 35.33 410. Sewer BNlin 50.00 tr for 10 28 2011 to 1 1 2012 35.33 Refige Bluing 53.95/gtr for 10/28/2011 to 111. 20 2' #38.12 Refuse Billing 3.95/qtr for 10/28/2011 to 411.1 1 012 #38.12 1 2. 412. 120. from Borrower 143 671.64 420. Gross Amount Due to Seller 139 137.22 200. Anwunts PNd Ny ~ in Nha1t of Borrower 500. Reductlons In Amount Due to Seller 201'. G m0 1 500.00 501. Excess t7e sits 202: Frigid 1 n from EM Home Loans 110 400.00 502. Settlement Cha es to Seller 17 830.55 203: Ex ben S taken su act >p 503. Exisdn bans taken sub act to 204. 504. 205. 505. 206. 506. 207. 507. 208. 508. - 209. 509. for ibrlN d seller Ad ustmeMs for items un aid seller 210. T es 510. own Taxes 211. Cou 511. Coun Taxes 21 512. Assessments 213. Seller 4640.00 513. Seller Paid dosin Costs 640.00 214. 514. 215. 515. 216. 516. 217. 517. 216. 516. 219.- 519. 220, t grower 118 540.00 520. Total Reductlon Amount Due Seller 450.55 300. Cas11 sS 8efltRfronr/to Borrower 600. Gsh at Settlement bo/from Seller 30 Noe 120 143 671:64 601. Gross amount due to seNer Ifne 420 139 137.22 302. borrower Ifne 220 116 540.00 602. Less reductlons in amount due seller Ifne 520 22 450.55 303. Gsh X From To Borower 27,131.64 603. Cash X To From Seller 116,686.67 The PUtrIC ReporBrlg 4u(nsrr lbr Ose 00eeCT10n OT eear111aaW1 R esanrsrse In Ja rrlMrulae per rssprarwe,or wYSCw~y, rsvRwuq, aY~u Ior,W W y Y R wY... w .~Y.r ..Rr ..,,. coNscl this Irdorrrrdiort, sod you sn rra rpuked b eomplets tlds form. uNses N dbpisys s artently vaNd OMB control number. No cordidentiaNly 4 sawred; tMs diedosuro k mandatory. TMs k desgrrsd b provide the partles to a RESPA covered transactbn with kdamafbrr during the settlement process. Initials 401101814-Q Huo-i 801. Our 585.00 from GFE rF1 802. Your nts for the s fk interest rate chosen - 828.00 from GFE rk2 803. Your tiort cha from GFE A - 243.00 804• Fie t0 ARS from GFE S3 410.00 805. Credit Irtrtovis Inc, from GFE ~3 6.20 806. Tax from GFE i3 807. Flood Cert. from GFE *3 808. Credit. 15.95 O you have arty 4 about Ote seOlsrnerd cirRpss and ban temp Ibted on ttds form, pbees contactyour bnder. Settbmerit agent N not rogxztsibb for wntem of tinders aaweeflrerds tM FiUD. JFte aeMsr's and'botrower'i eiptrglrae hxeon addtowNdps Oath approwl and egnify Otek underomndbtp Owl tax and Insurance proro0ons and reserves aro based on ~bsiwesn aynd canter dkeoOy ~ sRcO daArrqu~ad Woes or mort~ apayolk v~ be promptlmy~rehr~ursed to Ote eel ~t agent by thrye selbrualmsnb w01 De 1 have eersUdy rwiawed fife HUD1 SeWarrmnt Statement-and to the tied of my knovAedpe and beNSf, ri b true and acwrots ehtemant of at receipts and disbursements made on mY aemunt a by me N Odsiranswibn. l fixtlter c>erOfy Oast I have received a copy of Ote HUD-1 Settlement Statement. 8 SELLERS Tfro Estate of F ronce Webb ~~ L Y~ C x.. By: Jean H zecrdrbr TM HUD-7 Ssttlsmsrk ShEsmsrR vrldeh I have propared b a true and aaxeate account of Ods tre ctlon. I have caused or wid cause tha funds to be disbursed in Dab 10/2li@Ot t JUN 2~~ 20~~ Elmer Murry Auctions, Inc. Richard P. Murry, Aucfiioneer Lic# 649--L FINAL ACCOUNTING SUMl~ZA.RY .Seller Jean Hoin 10 B Ardsley Avenue _ Whiting, NJ 08759 Total .Sale Automobile Commission: 10°/ Sub Total (less commission) Total of Items Sold Commission: 20% Sub Total (less commission) NET TOTAL EXPENSES TO SELLER Fry (Advertis%ng) Engle Printing & Publishing Co. .The Paxton Herald Ducannon News (rrrv. xot available) Prep Runners: 3 Q 6 hr. * S15 Auction Runners: 2 Qa 6 hr. * $15 Toilet ~ Expense Total {~ . Date of Sale: June 2, 2011. Location of Sale: 5237 Windsor Blvd. Mechanicsburg, PA 17055-3546 $8,600.00 Detailed items list attached $860.00 $7,740.00 .-. $2,763.50 Detailed items list atta_ ched $552.70 $2,210.80 ~. $9,950.80 $144.00 $427.00 $69.50 $129.50 $270.00 $180.00 $115..75 $1,335.75 Total Payout to Seller. $8,615.05 Ck # 1303 www. richard mu rryauctioneer. com 2nd Floor East 14 N. Walnut St Mechanicsburg, PA 17055 717-790-2240