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HomeMy WebLinkAbout01-20-12 (2)~4 1505610140 REV-1500 EX ~°'-'°' PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN _ Hamsburg, PA 17128-0601 RESIDENT DECEDENT 2 1 1 1 0 1 0 0 2 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 2 0 1 1 8 2 4 8 7 D 8 2 7 2 0 1 1 0 9 1 9 1 9 2 3 Decedent's Last Name Suffix Decedent's First Name MI S T A N S F I E L D A R D E L L A V (if Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 0 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Retum (date of death 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ prior to 12-13-82) 5. Federal Estate Tax Return Required OX 6. Decedent Died Testate ~ death after 12-12-82) 7. Decedent Maintained a Living Trust 1 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTUIL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number R O G E R B I R W I N E S Q U I R E 7 1 7 2 4 9 2 3 5 3 ~: REGISTER O ~ .USE ONI~c~ ~ W 4- ~} First line of address _ ~ !('~~ ,~ %+ t.~3 ~~ 7 c' ~ j `C,~ I R W I N & M c K N I G H T P C "'~ ° ~"' ``-' Second line of address ~~~ ~ '~~ ~'~ 6 D W E S T P O M F R E T S T R E E T t-_ City or Post Office State ZIP Code DA E FILED ~- C A R L I S L E P A 17 0 1 3 Correspondent's a-mail address: Under penaltie of rjury, I declare that I have examined tum, mGuding ac~companymg schedules and statements, and to the best of my knowledge and belief, it is true, rA d complete. Declaration of preparer er th the pemonal representative is based on all information of which preparer has any knowledge. SIG PERSON RESPONSIBLE FO FIL G RET N DATE . i zo/lz ~110/W~T`~PRINGVILLE ROAD BOILING SPRINGS PA 17007 TURE OF PREPARER OTHER THAN PRESENTATIVE DATE ADDRE / ~~ /L 60 WEST PO ET STREET CARLISLE PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 7 L 150561014D 1505610140 J 1505610240 REV-1500 EX Decedent's Social Security Number ~ecedenrsName: ARDELLA V- STANSFIELD 2 0 1 1 8 2 4 8 7 RECAPITULATION 1. Real Estate (Schedule A) ....................... 9 5 0 0 0, 0 0 .................... 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. 1 3 4 5 9 , 2 7 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 6. • 7. Inter-Vivos Transfers & Miscellaneous N n-Probate Property (Schedule G) ~ Separate Billing Requested ....... 7. , 8. Total Gross Assets (total Lines 1 through 7) ........................... 8. 1 O 8 4 5 9 , 2 7 9. Funeral Expenses and Administrative Costs (Schedule H) .... ....... ..... .. 9. 3 4 1 6 5. 8 4 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ...... ..... .. 10. 1 4 6 4 . 9 9 11. Total Deductions (total Lines 9 and 10) ................. ....... ..... .. 11. 3 5 6 3 0. 8 3 12. Net Value of Estate (Line 8 minus Line 11) ............... ...... ..... .. 12. 7 2 8 2 8. 4 4 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ........ ....... ..... .. 13. , 14. Net Value Subject to Tax (Line 12 minus Line 13) ......... ...... ..... .. 14. 7 2 8 2 8. 4 4 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2)x.o _ 0. 0 0 15. 0. O D 16. Amount of Line 14 taxable at lineal rate x .045 7 2 8 2 8. 4 4 1s. 3 2 7 7. 2 8 17. Amount of Line 14 taxable at sibling rate X .12 0. 0 0 17. 0. 0 0 18. Amount of Line 14 taxable at collateral rate X .15 0. 0 0 1 g, 0. 0 0 19. TAX DUE ........................................ ...... ..... ..19. 3 2 7 7. 2 8 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 1505610240 1505610240 J r REV-100 EX Page 3 Decedent's Complete Address: File Number 21 11 01002 DECEDENT'S NAME ARDELLA V. STANSFIELD STREET ADDRESS 1395 CREEK ROAD CITY BOIL{NG SPRINGS STATE PA ZIP 17007 Tax Payments and Credits: ~. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 3,500.00 163.86 (1) 3,277.28 3. Interest 4. If Line 2 is greater than line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. Total Credits (A + B) (2) 3,663.86 (3} (4) 386.58 (5) 0.00 Make check payable to: REGISTER OF WILLS, AGENT i; ..:a.ate ek' ;~ ~~~; -.,.F..., .,,~,.. .... ~iS~:...,,fr~ ~:.. tt'r ,_`" ~w"'.~affi.~.Y...~v~°~ ~ * s ~ ~ PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" 1N 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 property transferred or its income; ::::::::::::::::::::::::::::::: ^ ^X c. retain a reversionary interest; or ................................................... ... ^ ^X d. receive the promise for life of either payments, benefits or care? ....................................................... ^ ^X 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................... ^ 3. Did decedent own an "intrust for" orpayable-upon-death bank account or security at his or her death? ......... ^ ^X 4. Did decedent own an individual retirement account, annuity or other non-probate property, which contains a beneficiary designation? .................................................................................................. ^ 0 IF 7HE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. ;r . 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 ftom 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 transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an adoptive parent or a stepparent of the child is 0 percent [72 P.S. §9116(a)(1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent (72 P.S. §9116(a)(1,3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1F>02 EX+ (01-10) Pennsylvania SCHEDULE A DEPARTMENT OF REVENUE INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT ESTATE OF: FILE NUMBER: ARDELLA V. STANSFIELD 21 11 01002 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 joiMy-owned witft right of survivorship must be disclosed on Schedule F. Attach a cepy 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 DESCRIPTIQN 1. 1395 CREEK ROAD, BOILING SPRINGS, PENNSYLVANIA 95,000.00 SOLD -SETTLEMENT SHEET ATTACHED TOTAL (Also enter on Line 1, Recapitulation.) ~ S 95,000.00 If more space is needed, use additional sheets of paper of the same size. REV-1508 EX + (8-98) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. IN RESIDENT DECEDEN RN PERSONAL PROPERTY ESTATE OF FILE NUMBER ARDELLA V. STANSFIELD 21 11 01002 Include the proceeds of litigation and the date the proceeds were received by the estate. All properly jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. M&T BANK -CHECKING ACCOUNT #1337424 11,513.53 2. IM&T BANK -SAVINGS ACCOUNT #15004200904967 3. (CASH ON HAND 745.74 1,200.00 TOTAL (Also enter on line 5, Recapitulation) ~ 5 (If more space is needed, insert additional sheets of the same size) REV-1611 EX+ (10-09) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE Of FILE NUMBER ARDELLA V. STANSFIELD 21 11 01002 Decederrt's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. EWING BROTHERS FUNERAL HOME 5,105.00 B. ADM{NISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address Ciry State ZIP Year(s) Commission Paid: 2. AttomeyFees: IRWIN 8~ McKNIGHT, P.C. 6,000.00 3, Family Exemption: (if deceden4s address ~ not the same as daimanYs, attach explanation.) Claimant Street Address Ciry State ZIP Relationship of Claimant to Decedent 4. Probate Fees: REGISTER OF WILLS 257.50 5 Accountant Fees: 6. Tax Retum Preparer Fees: PATRICIA A. ROSENDALE, CPA 375.00 7. REGISTER OF WILLS -FILING FEE 30.00 8. CUMBERLAND LAW JOURNAL -ESTATE NOTICE 75.00 9. THE SENTINEL -ESTATE NOTICE 189.54 10. CLOSING COSTS ON SALE OF REAL ESTATE 15,079.50 11. CHARLES K. MYERS AND WAYNE E. MYERS -EASEMENT 5,000.00 12. PENN PEST, LLC -PEST CONTROL 625.40 13. BURGET 8~ ASSOCIATES -SURVEY/EASEMENT 1,393.90 14. M&T BANK -DRILL SAFE DEPOSIT BOX 10.00 15. NOTARY 25.00 tOTAI (Also enter on Line 9, Recapitulation) S 34.165.84 if more space is needed, use additional sheets of paper of the same size REV-?512 EX+ (12-08) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES, 8~ LIENS ESTATE OF FILE NUMBER ARDELLA V. STANSFIELD 21 11 01002 Report debt incurced by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. CENTURYLINK -TELEPHONE 56.46 2. MET-ED -ELECTRIC 265.53 3. M&T BANK -REIMBURSEMENT OF SOCIAL SECURITY 968.00 4. CARLISLE MEDICAL PATHOLOGY -MEDICAL 175.00 TOTAL (Also enter on Line 10, Recapitulation) I S 1 If more space is needed, insert additional sheets of the same size. REV-1 ra13 EX+ (01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: ARI~FI I A V STANSFIEI n 71 11 nlnm RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustees) OF ESTATE I TAXABLE DISTRIBUTIONS [Indude ouU' htspousal distributions and transfers under Sec. 91 f6 (a) (1.2).] 1. ROBERT L. STANSFIELD Lineal 18,207.11 400 HOLLOW BROOK DRIVE 114TH REMAINDER CARLISLE, PA 17015 2. NANCY L. SHOEMAKER Lineal 18,207.11 404-A NORTH BEDFORD STREET 1/4TH REMAINDER CARLISLE, PA 17013 3. EDWARD L. STANSFIELD Linea{ 18,207.11 2340 RITNER HIGHWAY 1/4TH REMAINDER CARLISLE, PA 17015 4. SUZANNE DIEHL Lineal 18,207.11 110 W. SPRINGVILLE ROAD 1/4TH REMAINDER BO{LING SPRINGS, PA 17007 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER S HEET, 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. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. s It more space is neeae0, use aaaltlonal sneers or paper or the same s+ze. LAST WILL AND TESTAMENT I, ARDELLA V. STANSFIELD, of Monroe Township, Cumberland County, Pennsylvania, declare this to be mY Last Will and Testament, hereby expressly revoking all Wills and Codicils heretofore made by me. 1. I direct my executrix to pay all of my debts, funeral and administrative expenses as soon as may be done comeniemly after my decease. 2. I authorize and empower my executrix to sell any realty owned by me at my death and not specifically devised herein, at either public or private sale, and to give good and sufficient deeds therefor, in fee simple, as I could do if living. 3 . I give, devise and bequeath all of my estate of every nature and wherever situate to my four children, Robert L. Stansfield, Nancy L. Shoemaker, Edward L. Stansfield and Suzanne Diehl, share and share alike, the child or children of any deceased child taking the share their parent would have taken if living. 4. I nominate and appoint Suzanne Diehl to be the executrix of this my Last Will and Testament;. she is to serve as such without bond. Should she die before my death, renounce or refuse to serve for any reason, or die leaving any of my estate unadministered, Inominate and appoint Robert L. 5tansfield, as substitute executor, also to serve as such without bond, with the same powers as are given herein to my executrix. 5. I hereby suggest that my personal representatives retain the services of Irwin, McKnight & Hughes, as attorneys is the settlement of my estate. IlN WITNESS WHEREOF, I have hereunto set my hand and seal this W r=' day of January, 1996. p f ; 'l~r~ e~ EAL) ARDE]LLA V. STAN LD Signed, sealed, published and declared by ARDELLA V. 5TANSFIELD, the testatrix above named, as and for 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 subscribed our names as witnesses hereto. 2 ACg1VOWLEDGMENTRND AFFIDAVIT WE, ARDELL~A V. STANSFIELD, BETZI A. MORRISON and CHERYL L. CLELAND, the testatrix and witnesses respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testatrix signed and executed the inst<vment as her Last Will and that she had signed willingly, and that she executed it as her free and voluntary act for the purpose herein expressed, and that each of the witnesses, in the presence and hearing of the testatrix, signed the Will as a witness and that to the best of their knowledge the testatrix was, at that time, eighteen years of age or older, of sound mind and under no constraint or undue influence. COMMONWEALTH OF PENNSYLVANIA . SS: COUNTY OF CUMBERLAND Subscribed, sworn to and acknowledged before me by ARDELLA V. STANSFIELD, the testatrix herein and subscribed and sworn to before me by BETZI A. MORRISON and CHERYL L. CLELAND, witnesses, this ciY day of January, 1996. ~.- :, Nota~rv Public ~, ARDELLA V. STANS rQtMENtOfi Q y0. o`~ _. Ga * * ~ y~C _ G9Q'~.PE~~~ A. Settlement Statement (HUD-1) OMB Approval No. 2502-0265 HUD-1 Page 1 of 3 B..Type of loan 1. ^X FHA 2. ^ RHS 3. ~ Conv. Unins. 6. Flle Number: 7. Loan Number: 8. Mortgage Insurance Case Number: 4. ^ VA 5. ^ Conv.Ins. 401101887-CB 446-0974754-703 . NOTE: This form is 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 paid outskle the closing; they are shown here for informational purposes and are not nGuded in the totals. D. Name and Address of Borrower JACOB M. STANSFIELD BB BEARD ROAD ENOLA, PA 17025 E. Name and Address of Seller SUZANNE DIEHL, EXECUTRIX OF THE ESTATE OF ARDELLA V. STANSFIELD PA F. Name and Address of Lender COLE TAYLOR BANK 2350 GREEN RD. SUITE 100, ANN ARBOR, MI 48105 G. Property Location 1395 CREEK ROAD, BOILING SPRINGS, PA 17007 COUNTY: CUMBERLAND H. Settlement-Agent SECURED LAND TRANSFERS, LLC 485 ST. JOHNS CHURCH ROAD , SHIREMANSTOWN ,. PA 17011 Phone : (717) 901-8342 PARCEL ID: 22-12-0348-008 TOWNSHIP: MONROE TOWNSHIP Place of Settlement 485 ST, JOHN'S CHURCH ROAD SHIREMANSTOWN, PA 17011 I. Settlement Date 12/29/2011 Disbursement Date 12/29/2011 7. Summa of Borrower's Transaction K. Summa of Seller's Transaction 100. Gross Amount Due from Borrower 400. Gross Amount Due to Seller 101. Contract Saks Price 95 000.00 401. Contract Sales Price 95 000.00 102. Personal Pro 402. Personal Pro 103. Settlement eha es to borrower Ilse 1400 559.27 403. 104. 404. 105. 405. Ad uatment for igms aid b seller in advance Ad ustmant for Items eld b seller In advance 106. CI own Taxes 406. C own Taxes 107. Coun Taxes 420.5000 r 1 29 11 to 01 01 12 3.46 407. Coun Taxes 420.5000 r 1 29 11 to 01 O3 12 3.46 108. Assessments 408. Assessments 109. School Taxes 1371.7000 r 1 29 11 to 07 01 12 693.35 409. School Taxes 1371.7000 r 12 29 11 to 07 01 12 693.35 110. 410. 111. 411. 112. 412. 120. Gross Amount Due from Borrow®r 100 256.08 420. Gross Amount Due to Seller 95 696.81 200. Amounq Paid by or In BehaH of Borrower 500. Reductions In Amount Due to Seller 201. De ft or earnest mon 501. Excess De ossts 202. Print I Loan Amount from Cole Ta for Bank 81 557.00 502. Settlement'Cha es to Seller 10 079.50 203. Existln loans taken sub cct to 503. Existln loans taken sub act to 204. 504. 205. 505. 206. 506. 207. 507. Ioe. sos. 209. 509. A ustments for items tin aid seller Ad ustmenq for Items tin old b seller 210. CI own Taxes 510. CI own Taxes 211. Coun Taxes 511. Coun Taxes 212. Assessments 512. Assessments 213. Seller Assist 5 000.00 513. Seller Assist 5 000.00 214, 514. 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. 220. Total Paid b for Borrower 88 557.00 520. Togl Reduction Amount Due Seller 35 079.50 300. Cash at Settlement from/W Borrower 600. Cash at Settlement to/from Seller 301. Grass amount due from borcower line 120 100 256.08 601. Gross amount due to seller Ilne 420 95 696.81 302. Less amounts aid b for borrower line 220 86 557.00 602. Less reductlons in amount due seller line 520 15 079.50 303. Cash X From To Borrower 13,699.08 803. Cash X To From Seller 80,~3K31 r ne ruonc rcapoinrp nuroen ror mrs conecuon or mrormetion rs esnmaroc a[ ao mmutea per response ror cotiecting, revrewrng, one reporting me oats. This age t tolled this Information, and you are not inquired to complete this form, unless Il displays a currently valid OMB control number. No confidentiality is assured; is mandatory. Thie is designed to provide the parties to a RESPA covered trerresction with information during the senlement process. Initials 401101887-CB wrn_~ ~ ~a~ L. Settlement Charoes 700. Total Raal Estate Broker Faes Division of Commisslon line 700 as follows: Paid Prom Paid From 701. Commisslon Listin Borrower's Punds Seller's Punds 702. Commisslon Sellin At Settlement At Settlement 703. Commission aid at settlement 704. 800. Items Payable in Connection with Loan 801. Our on ination cha e 2 756.64 from GFE #1 802. Your credit or cha a olnts for the s eclFlc Interest rate chosen - 1 783.65 from GFE #2 803. Your ad usted on ination cha es from GFE A 804. A ralsal Fee to Cod Financial Mort a e Services Inc, Reimburse POC from GFE #3 972.99 430.00 805. Credit rc rt to Cod Flnandal Mort a e Services Inc. Reimburse POC from GFE #3 50.00 806. Tax Service from GFE #3 807. Flood Cert. Fee to Core is Flood Services from GFE #3 11.00 808. 900. Items Required by Lender to M Paid in Advance 901. Dally Interest charges from 12/29/11 to 01/01/12 @ 8.6584/day Cole Ta for Bank (from GFE #10) ;25.98 902. Ma a e Insurance Premium to HUD from GFE #3 807.50 903. Homeowner's Insurance Motorists Ir~urance Com nles POC 373.00 from GFE #li 904. 1OOO.Resarves Dapositxd with Lender 1001. Initlal d osit for our escrow account from GFE #9 890.05 1002. Bankrd Ins. Reserve 3.0000 month(s) @ 31.08 /month(s) to Cole Taylor $83.24 1003. Mo a e Ins. Reserve Cole Ta for Bank 1004.~nk roperty Taxes 11.0000 month(s) @ 8.57 /month(s) to Cole Taylor $84.27 1005. County Property Taxes 11.0000 month(s) @ 26.47 /month(s) to Cole ;291.17 Ta for Bank 1006. School Taxes 7.0000 months 114,31 months to Cole Ta for Bank 800.17 1007. A ate Attountin Ad ustment to Cole Ta for Bank - 388.80 11OO.Titie Charges 1101, Title services and lender's title Insurance to Secured Land Transfers LLC from GFE #4 1 150.75 1102. Settlement or closin fee 3303.Owner's title Insurance to Seared Land Transfers LLC from GFE #5 78.00 1104. Lender's tide insurance to Secured Land Transfers LLC 900.75 1105. Lender's tithe II IimiC 81 557.00 1106.Owner's title oli limit 95 000.00 1107. Agent's portion of the total title insurence premium to Secured Land ;880 87 Transfers LLC 1108. Underwriter's ortlon of the total title insurance remium to TRGC 97.88 1109. Note fee to Colleen Blume Nota Public 20.00 1110. Insured Closin Protection Letter to TRGC 75.00 1111. Wire Transfer Fee to Secured Land Transfers LLC 45.00 1112. Electronic Delive & Handlin Fee to Seared Land Transfers LLC 75.00 1113.Ovemi ht Mail to Secured Land Tran rs LLC 35.00 12OO.Oovernmant Recording and Transfer Charges 1201. Government recordin cha es from GFE #7 143,00 1202. Deed 65.00 Mort a e 12 Pa es 78.00 Releases 54.50 1203. Transfer taxes from GFE #8 1204. CI Coun to slam s Deed Mo a e 1205. State to slam Deed Mo e 1206. Easement 54.50 13OO.Additionai Settlement Charges 1301. ulred services that ou can sho far from GFE #6 ' 1302. Nola Fee to Colleen Blume Nota Public 1303. Tax Cart Processin Fee to Secured Land Transfers - Mechaniabu 1304. Inheritance Tax Escrow to Secured Wnd Transfers - Mechanlabu 1305. 10.00 30 000.0 14OO.Total Settlement Charges (enter on lines 103, Section ]and 502, Section K) ;4,559.27 ;10,079.50 If you have arty questions about ttre settlement charges and loan tertna listed on this form, please cooled your lender. Settlement agent Is not responsible for content of lender's asaeasmenta on HUD. The seller's and borrower's signatures hereon acknowledge their approval and signdy their understanding that tax and insurance proradons and reserves are based on figures for the preceding year Of suppled by others or eadmatsd for the anent year, and in the event of arty change for the anent year, all neceawry adjustments will be made between borrower and aelkr diredly. Any defldt delinquent taxes or mortgage payoffs will be promptly reimbursed to dre aettlsmeM agent by the seller. I have carefully reWewed the HUD-1 Settlement Statement and to the best of my knowbdge and belief, ft is true and accurate statement of all receipts and disbursements made on my account or by me in this action. I fY er have received a copy of the HUD-1 Sedlement Statement. BUYERS /~e SELLE / The to of Ardella V. Stanafle Jacob Stanafleld By: S ann I, Executrix Tne HUD-1 Settlement Statement which I have prepared isa true and accurate a unt of this section. I have caused orwill cause the funds to be disbursed in accordance with this statement. Settlement Agent / Date ~~ p ~D "~ri. IYL~r~.L D _ 12/28/2011 EASEMENT AGREEMENT BETWEEN CHARLES K. MYERS, JR. AND WAYNE E. MYERS, of Monroe Township, Cumberland County, Pennsylvania, hereinafter called GRANTORS; AND ARDELLA V. STANSFIELD ESTATE, of Monroe Township, Cumberland County, Pennsylvania, hereinafter called GRANTEE. NOW THIS AGREEMENT WITNESSETH THAT: WITNESSETH that in consideration, the GRANTORS have granted, bargained, and by these presents do grant and bargain unto the said GRANTEE, its successors and assigns, the perpetual, permanent, free and uninterrupted use, liberty, and privilege of, and passage in and along a certain easement, right-of--way or passageway, extending from Creek Road, as set forth in Exhibit A, attached hereto; WHEREAS the GRANTEE desires an easement to and from its property as mentioned above via a twenty five (25) foot easement across the land owned by the GRANTORS; NOW THEREFORE IT IS AGREED AS FOLLOWS: 1. That for and in consideration of the sum of Five Thousand and no/100 ($5,000.00) Dollars, in hand paid by the GRANTEE to the GRANTORS, receipt of which is hereby acknowledged, and the mutual promises contained herein and agreeing to be legally bound hereby, the GRANTORS, for themselves, their heirs and assigns, do hereby grant and convey to 1 the GRANTEE, its, successors and assigns, the right of ingress, egress and regress, over and upon a 25 foot easement crossing over the lands of GRANTOR as shown on said Plan, a copy of a portion of which is attached hereto as Exhibit "A." (Said "easement" is also referred to herein as the "lane" or "right-of-way.") 2. It is understood and agreed by the parties that this easement includes the purpose of ingress, egress and regress to access lands owned by GRANTEE. GRANTEE shall have full rights to use the land covered by this agreement as it so desires. 3. Improvement and maintenance of said lane shall be the responsibility of GRANTEE. The lane shall be improved and maintained by the GRANTEE to the extent necessary to accommodate all vehicular (automobile and truck) traffic making use of the lane at any time. At all times, GRANTEE shall maintain the lane in a neat and attractive manner suitable as an entrance to a private residence. GRANTEE shall insure, defend and indemnify Grantor from any liability whatsoever in connection with the use, of the right-of--way, by any part3'• 4. This easement shall be for the benefit of the said land of GRANTEE, its successors and assigns. If, infact, the well of GRANTEE is actually within this easement, GRANTORS approve of the said placement and have no problem with its remaining there indefinitely. 5. This Agreement shall run with the land and be binding upon or to the benefit of the successors in title of the GRANTORS and the GRANTEE, as the case may be, and their heirs, successors and assigns. 2 IN WITNESS WHEREOF, the parties hereto have hereunto set their hands and seals this ~~ day of December, 2011. WITNESS: GRANTORS: a v (SEAL) CHARLES K. MYE , JR. v ~ C (SEAL) A E E. MYE WITNESS: GRANTEE: -, ESTATE OF ARDELLA V. STANSFIELD COMMONWEALTH OFPENNSYLVANL4 :SS: COUNTY OF CUMBERLAND Personally appeared before me this ~ ~ day of December, 2011, Charles K. Myers, Jr. and Wayne E. Myers, known to me or satisfactorily proven to be the persons whose names are subscribed to the within instrument, and acknowledged that they executed this easement for the purposes therein contained. ~~-, Notary Public COMM ~I~ BF PENNSYLVANIA Notarial Seal Roger B. Irwin, Notary Public Carlisle Boro, Cumberland County My Commission Expires Oct. 3, 2012 Member, Pennsylvania ASeodatlon of Notaries 3 COMMONWEALTH OFPENNSYLVANIA :SS: COUNTY OF CUMBERLAND Personally appeared before me this y,~ day of December, 2011, SUZANNE DIEHL, Executrix, known to me or satisfactorily proven to be the person whose name is subscribed to the within instrument, as Executrix of the Estate of ARDELLA V. STANSFIELD, and acknowledged that she executed this easement, in her capacity for the purposes therein contained. Notary Public COMMr~1 gLfiM ~~ ~ENNSYLVANiA Notarial Seal Roper B. Irwin, Notary Public Carlisle Boro, Cumberland County My Commission Expires pet 3, 2012 Member, Pennsylvania Association of Notaries 4 ' m AUF ° De/ber1H. Sm/8~ Jr, B WalterJ. Sm/U~ Tax Parce/12-011-0348.011 Deed Book29G, Page 834 ~ ~ ~ ~ n - -~ ~ N~ nk II ° w A ~'O -~ r:. ° ~h M O ~ S ~ ~. , ~ v A ~ C ,~, L7 o mN Z v {~N~ o D r z o- i"' ~ 25' l :~N = ~ T ~ ~ ~ m ~ ~ ~ ~ y A Z ~m U, ~Z ~s~ t N O D Z v ~ ' J ~ ,~ I ~ ~k (;J 1 O D $ ~ ~i . D N ~ N $ ~° < ~ y ~ ~ ~~n e ~ ~ ~& ~ T < a ~ ~ ~ Q x O b~ f I'.. ~ g I ~_ ~ ~ 1 l ~I D r b~ ~ ~ ~a .2 , C T r v ~~l N ~ k e X400 a~y N X ~ y ~. $~ ~c \ ~b~ m ro y i ~~~~ ~ b I ~ ~ \ ~'s ~ ~ z n 0 m A O y C ~' Zvi w poZ ~' D-n~ ~OZ 3~ i 0 ti ~ Z m f ~ $u V t ~ ~/=a I~a~' aul~'~DM g~ a`qn p~0~ ~aBJ~ '~ ZED ~~~ 4 ` Z ° ~ ~ r ~~m N < "~~ 0-l N~ Z m m ' BURGET & ASSOCIATES, iNC. ' EASEMENT PLAT ProPosslorral LarM Surveyors' • CADOTrainingandSupport OVER LANDS • ALTA Surveys • Topographical Surveys P`°°°"''S°~ Charles K M • FEMA Ele„atla, CedKCetea . yers • GPS Meppbg and Control Surveys • MBJoraM Mlnor SubdHhbnc Web SNe: wwwbwge~ 1797 N8. Faed New gporn~d Pennsylvania 17085 Monroe Township Phone: 717-552-7071 Fa>C maeza~7 Cumberland County, Pa. ~ ~ • • OD Z ~ ~ Z Z~ ~m ORAN9/ BY`. /.A.B. r~~x~ BY~ J.sl.e. /QB NO.: 111ZJr oA~. 11232011 ORANlNG NO.: 111Z~OOZ Sh'E£T 1 OF 1 Existing lands owned by Charles K. Myers Easement All that certain tract of land situate in Monroe Township, Cumberland County, Pennsylvania, more specifically bounded and described as follows, to wit: BEGINNING at a Iron Pin, said pin being the southern most point of the herein described easement; said pin also being a corner in common with lands N/F of Robert V. & Ardella V. Stansfield; Thence along said lands, North 27 degrees 22 minutes 17 seconds West, while passing over an Mag Nail being six hundred seventy-eight and sixty-nine one-hundredths (b78.69) feet from the prior call, for a total distance of six hundred ninety-six and seventeen one-hundredths (696.17) feet to a point, being in the middle of Creek Road; Thence over said lands of Charles K. Myers and along said centerline of Creek Road, North 48 degrees 09 minutes 49 seconds East, a distance of twenty-five and eighty-two one-hundredths (25.82) feet to a point; Thence continuing over said lands, South 27 degrees 22 minutes 17 seconds East, while passing over an Iron Pin being seventeen and ninety one-hundredths (17.90) feet, for a total distance of seven hundred one and thirty-one one-hundredths (701.31) feet to an Iron Pin, being on the line of lands now or formerly of Delbert H. & Walter J. Smith; Thence along said lands, South 59 degrees 37 minutes 46 seconds West, a distance of twenty-five and three one- hundredths (25.03) feet to an Iron Pin, also being the point of BEGINNING. CONTAINING a total gross acreage of 17,468 Sq. Ft. or 0.40 Acres. ~~~~ © l~i~C]Li ~~~K~ii,i~ 499 Mitchell Road, Millsboro, DE 19966 Adjustment Services Irwin and McKnight PC 60 West Pomfret Street Carlisle, PA 17013 Re: Estate of Ardella V Stansfield Social Security: 201-18-2487 Date of Death: August 27.2011 Phone 888-502-4349 F ax (302) 934-2955 October 25, 2011 ~iVE~ OCT 2 8 Z' IRWIN & McKN1GHT LAW OFFICES Deaz Sir or Madam: Per your inquiry on October 5, 2011, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type of Account Checking Account Account Number 1337424 Ownership (Names o, fl Ardella V Stansfield Suzanne Dehl (POA) Opening Date 09/06/76 Balance on Date of Death $11,513.53 Accrued Interest $ .00 Total $11,513.53 2. Type of Account Savings Account Account Number 15004200904967 Ownership (Names ofj Ardella V Stansfield Suzanne Dehl (POA) Opening Date 09/06/76 Balance on Date of Death $745.73 Accrued Interest $ .01 Total - --------------- $745.74 ,~ September 6, 2011 Suzanne Diehl 110 West Springville Rd. Boiling Springs, PA 17007 ~.wing >firothers Funeral Home, Inc. 630 South Hanover Street Carlisle, PA 17013- (717)243-2421 The Funeral Service for Ardella V. Stansfield We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way we can Please feel free to contact us if you have any questions in regard to this statement. . THE FOLLOWING IS AN ITEMIZED STATEMENT OF THE SERVICES, FACILITIES, AUTO MOTIVE EQUIPMENT , AND MERCHANDISE THAT YOU SELECTED WHEN MAKING THE FUNERAL ARRANGEMENTS. 1. PROFESSIONAL SERVICES Services of Funeral Director/Staff , $1865.00 Embalming. $895.00 Dressing, Casketing, Cosmo etc. $295.00 2. FACILITIES AND SERVICES One day event , $895.00 3. AUTOMOTNE EQUIPMENT Vehicle to transfer remains to Funeral Home, _ $275.00 Hearse (Casket Coach) _ $275.00 Safety/Lead car/Clergy $125.00 Utility vehicle for DC retrieval/filing , $125.00 FUNERAL HOME SERVICE CHARGES $4750.00 SELECTED MERCHANDISE: Acknowledgement cards, $10.00 Register Book(s) , _ $40.00 Memorial folders , $85.00 THE COST OF OUR SERVICES, EQUIPMENT, AND MERCHANDISE THAT YOU HAVE SELECTED $4885.00 Cash Advances Clergy/Mass Offering, $125.00 Certified Copies of the Death Certificate , $36.00 Flowers. $159.00 TOTAL CASH ADVANCES AND SPECIAL. CHARGES . $320.00 Total Total Cost , $5205.00 ~ Vey ~t e a¢.~ '-' SUB-TOTAL INITIAL PAYMENT /DISCOUNT /CREDITS ' TOTAL AMOUNT DUE G_> The unpaid balance over 30 days is subjected to a 1.50 % service charge per month - 18.0000 % per annum. $5205.00 loo.oo . ~.Jhb- cou,.ri c~uirf~~ $5105.00 0 ~ d ~ ~~~' ~ Ta B.e~~3v~( *** This is an Advice *** P.O. Box 4650 ACH/EDI Services Buffalo, NY 14240-9975 (800)724-2240 Date: Tuesday, September 06, 2011 ARDELLA V STANSFIELD SUZANNE DIEHL 1395 CREEK RD BOILING SPRGS PA 17007-9656 Subject: Notification of Death /Reclamation Case Number: 36678 Funds Deposited to Account: ******7424 Funds Deducted from Account(s): ******7424 $968.00 This is to advise you that on 9/6/2011 we deducted from the account(s) shown above the amount of $968, for the SSA Direct Deposit of 9/2/2011. Due to the fact that ARDELLA V STANSFIELD has passed away prior to the issuance of the credit, the Treasury of the United States is requesting reimbursement. In accordance with Federal Regulations, direct deposits may not be retained by the beneficiary unless the beneficiary lived through the entire month prior to the date of issuance. If the number of the 'account deducted from' is different from the account into which the funds were originally deposited, the deduction is authorized under the bank's rules for right of offset because one or more of the owners on both accounts are the same. Should you have any further questions about this charge, please call and refer to the case number above. This advice is provided to facilitate the reconcilement of your monthly account statement. Respectfully, ACHlEDI Services M&T M~rTBank October 13, 2011 Roger B. Irwin Irwin & McKnight, P.C. West Pomfret Professional Building 60 West Pomfret Street Cazlisle, PA 17013 Deaz Mr. Irwin, ~- ~~~~~ OCT ~ 4 LO i'i IfiVUt'IN ~ i~lct(NIG)-f; Is1W QEEI%ES This letter is an invoice for the $10.00 fee for the lost key of Ardella V. Stansfield's safe deposit box # 27 at the Boiling Springs branch of MBrT Bank. If you have any questions, please call me at (717) 241-7790. Sincerely, ~- Jennifer Rhodes Relationship Banker II M&T Bank Boiling Springs Branch (717) 241-7790 Phone (717) 241-7792 Fax Manufacturers and Traders Trust Company • One Forge Road, Boiling Springs, PA 17007 • (717) 241-7790 • Fax: (717) 241-7792 PE PEST 1250 N. Mo fain Road Suite 306 Harrisburg, PA 17112 Phone # 717-540-5554 Fax # 717-5dn_~G17 Invoice Date Invoice # 11/2/2011 3829 Bill To Estate of Ardella Stansfield 1395 Creek Road Boiling Springs, PA 17007 Service Location 1395 Creek Road Boiling Springs, PA 17007 Target Pests Technician P.O. # Termites & Carp. Ants RZ Quantity Description Price Each Amount 1 Termite & Carpenter Ant Treatment Thank you for your business. It was a pleasure working with you. 590.00 590.OOT Subtotal $590.00 Please make checks payable to Penn Pest. Sales Tax (6.0%) $35.40 All Invoices are due upon receipt. Total x625.40 ~- BURGET 8 ASSOCIATES, INC. October 25, 2011 Inv. No. 11161 Job No. 11125 ~~dOo DEC Sheri Stansfield 88 Beans Road Enola, PA 17025 For professional services: October 1 -24, 2011 1797 New Bloomfield Road New Bloomfield, PA 17068 Phone: 717-582-7011 Fax: 717-582-3557 * Creek Road, Monroe Township, Cumberland County * Prepare boundary survey Total 5800.00 TERMS: PAYMENT DUE WITHIN 30 DAYS; INTEREST ADDED AFTER 30 DAYS BURGET 8 ASS0~4TES, INC. December 12, 2011 Inv. No. 11215 Job No. 11125 U(i11"~'®0~1~ Sheri Stansfield 88 Beard Road Enola, PA 17025 For professional services: November 2011 * Creek Road, Monroe Township, Cumberland County 1797 New Bloomfield Road New Bloomfield, PA 17068 Phone: 717-582-7011 Fax: 717-582-3557 Mark 25 foot easement - 4 hours $360.00 2 pins, 8 stakes $11.40 Prepare final easement plat -1.5 hours $82.50 Prepare legal description $85.00 Review final document 8 coordination of easement with client -1 hour $55.00 Total $593.90 TERMS: PAYMENT DUE WITHIN 30 DAYS; INTEREST ADDED AFTER 30 DAYS 'r COLLECTION CENTER INDUSTRIES, INC. CCI PO Box 8666 ' LancasXer, ~'A 17604-8666 September 28, 2011 (717) 569=5515 • (800) 260-8264 Ardella V Stansfield 1395 Creek Rd Boiling Springs PA 17007-9656 Dear Ardella V Stansfield, How can we help you resolve the matter listed below: OUR CLIENT CARLISLE MEDICAL PATHOLOGY claims that you owe them $175.00 for service on : 04/20/2011 Their account# is 15521-002, our ag# is 620303-1 Please send payment in full today or comact our office so we can: • Help you resolve any outstanding issues like health insurance if this is a medical bill. • Help you make payment over the phone using our free check by phone service. • Help you come up with an acceptable arrangement, if needed. Send paymem to the address above or call 800.-260-8264 Sincerely, The Collection Staff Unless you notify this office within 30 days after receiving this notice that you dispute the validity of this debt or any portion thereof, this office will assume this debt is valid. If you notify this office in writing within 30 days from receiving this notice, this office will: obtain verification of the debtor obtain a copy of a judgment and mail you a copy of such judgment or verification. If you request this office in writing within 30 days after receiving this notice, this office will provide you with the name and address of the original creditor, if different from the current creditor. This is an attempt to collect a debt by a debt collector. Any information obtained will be used for that purpose. "' Please detach below and return in the e r "' oa o~z of iFYOU WISH 70 PAY BY CREDIT CARD PLEASE CHICLE ONE Please send this statement with your payment to the above address. Include the account number on your payment to insure proper credit to your account. IF YOU HAVE ANY QUESTIONS, WRITE OR TELEPHONE US Il~Il~~DIATELY, OTHERWISE, PLEASE RENIIT PAYMENT. BALANCE DUE: $175.00 ACCOUNT # 0267-0015521-002 DATE OF SERVICE: 04-20-11 PIN#: 026702033223 CARLISLE MEDICAL PATHOLOGY PC 175.00 P.O. BOX 188 ARDELLA V. STANSFIELD IRS#: 26-1186991 LANDISVILLE PA 17538-0188 ACCT NO: 0267-0015521-002 97] 0101 R107-]06 L106999 STOCR + F-LPW