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HomeMy WebLinkAbout02-24-12J 1505610140 RED-1500 EX (°'.'°' PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number Po Box 2sosol INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 RESIDENT DECEDENT 2 1 1 1 0 6 4 2 ENTER DECEDENT INFOR"RATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 2 9 3 2 2 7 6 0 5 0 5 2 4 2 0 1 1 0 3 0 8 1 9 2 5 Decedent's Last Name Suffix Decedent's First Name MI C O B L E M A R Y C (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 1. Original Return O 4. Limited Estate ^X 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 2. Supplemental Return ^X 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust 0 (Attach Copy of Trust) 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes 11. Election to tax under Sec. 9113(A) (Attach Sch. O) CORRESPONDENT -THIS £ECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number D A V I D H S T O N E E S Q U I R E 7 1 7 7 7 4 7 4 3 5 First line of address 4 1 4 B R I D G E S T R E E T Second line of address City or Post Office N E W C U ~" B E R L A N D __. - - REGISTE~OF WILLS US~NLY ~ r~~ ,~7 ~ ~' 7 ~ ~ ~~~ ..r ~ ~ ~~ ~ \~i - ~~7 C~ `~~ -'t7 _... ~~ ti.~ ;, -r-~ _.~ - -_ -{DATE FILED ~ State ZIP Code - - -~ - - r-- ` , .._ . ~ P A 1 7 0 7 0 ~'~ Correspondent's a-mail ac)d're~s: / D S T O N E a1 S T O N E L A W• N E T Under pe of perjury, `lave t at h ve examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is tr , co ect a omelet . ecl at n f preparer other than the personal representative is based on all information of which preparer has any knowledge. SIG ,TU E OF PER N ES'0 , SI FOR FILING RETURN DATE ~ ~ 7.7\/_i'~ ADDRESS u Vp 414 BRIDGE STRE NEW CUMBERLAND PA 17070 SIGNATURE OF PREPARER OTHE THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 1505610140 1505610140 ~ \® J 1505610240 REV-1500 EX Decedent's Social Security Number Decedent's Name: MARY C• C O B L E 2 9 3 2 2 7 6 0 5 RECAPITULATION 1 1 4 1 0 0 0. 0 0 1. Real Estate (Schedule A) ........................................ ... 2. Stocks and Bonds (Schedule B) ................................... ... 2~ 1 0 9 7 7 . 5 4 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) .. ... 3. 4. Mortgages and Notes Receivable (Schedule D) ....................... ... 4. 2 8 1 9 9 7 . 9 9 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E).... ... 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested .... ... 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property 7 8 0 6 2 3 6 3 (Schedule G) ^ Separate Billing Requested .... ... 7. . 8. Total Gross Assets (total Lines 1 through 7) ........................ ... 8. 1 2 1 4 5 9 9. 1 6 9. Funeral Expenses and Administrative Costs (Schedule H) ............... ... 9. 6 3 3 9 8 . 4 8 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) .......... ... 10. 1 5 2 5 • 5 6 11. Total Deductions (total Lines 9 and 10) ............................ ... 11. 6 4 9 2 4 . 0 4 12. Net Value of Estate (Line 8 minus Line 11) ......................... ... 12. 1 1 4 9 6 7 5 . 1 2 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ................... ... 13. 4 9 6 9 5 1 . 7 2 14. Net Value Subject to Tax (Line 12 minus Line 13) ................... ... 14. 6 5 2 7 2 3 . 4 0 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• 0 0 0 0 15. 16. Amount of Line 14 taxable at lineal rate X• 0 0. 0 0 16. 17. Amount of Line 14 taxable 2 4 5 0 1 6 3 0 17 at sibling rate X .12 . . 18. Amount of Line 14 taxable 4 0 7 7 0 7 1 0 at collateral rate X .15 18. 19. TAX DUE ......................................................19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 0. 0 0 o. 0 0 2 9 4 0 1. 9 6 6 1 1 5 6. 0 7 9 0 5 5 8. 0 3 ^X Side 2 1505610240 1505610240 REV-1500 EX Page 3 File Number Decedent's Complete Address: 21 11 0642 __ DECEDENT'S NAME MARY C• COBLE - -- STREET ADDRESS 207 N• 17TH STREET __ - __ CITY CAMP HILL __ STATE PA ZIP_-__ 17011- Tax Payments and Credits: 1 Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments 10 0, 0 0 0. 0 0 B, Discount 4, 5 2 7. 9 0 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. 90,558.03 Total Credits (A + B) (2) 10 4 , 5 2 7 • 9 0 (3) 0 •0 0 (4) 13,969.87 (5) 0 • 0 0 Make check payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Ditl decedent make a transfer and: Yes No a. retain the use or income of the property transferred : ...................................................................... ^ X^ b. retain the right to designate who shall use the property transferred or its income; ............................... c. retain a reversionary interest; or ................................................................................................ ^ d. receive the promise for life of either payments, benefits or care? ....................................................... ^ ^X 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................... ^ ^X 3. Did decedent own an "intrust for" or payable-upon-death bank account or security at his or her death? ......... ^ 4. Did decedent own an individual retirement account, annuity or other non-probate property, which contains a beneficiary designation? .................................................................................................. ~ ^ 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 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 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, undE Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1502 EX+ (01-10) pennsylvania SCHEDULE A DEPARTMENT OFREVENUE REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: MARY C• COBLE 21 11 0642 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 jointly-owned 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 Property located at 207 N ],7th St Camp Hill, 141,000.00 Cumberland County, PA sold to David Shultz on September 15, 201,1 TOTAL (Also enter on Line 1, Recapitulation.) I $ 141, 0 0 0 If more space is needed, use additional sheets of paper of the same size. REV-1503 EX + (6-98) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER MARY C- COBLE 21 11 0642 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 177 shares Prudential Financial Inc stock a $62.020 10,977.54 each TOTAL (Also enter on line 2, Recapitulation) I $ 10 , 9 7 7 • 5 4 (If more space is needed, insert additional sheets of the same size) REV-1508 EX+ (11-10) pennsylvania SCHEDULE E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN RESIDENT DECEDENT PERSONAL PROPERTY --_ ESTATE OF: FILE NUMBER: MARY C• COBLE 21, 11 0642 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1• 1997 Mercury Grand Marquis bequeathed to Katherine 2,595•DO Anne Hilton as mentioned under Item I of Will at Kelly Bluebook value 2 Capital B1ueCross-refund 11,2.75 3 Fulton Bank-Cert of Deposit #022-0194375 25,300.00 Princ• $25,300.00, Int• $18.03 4 Fulton Bank-Cert of Deposit #022-0194375 - Accrued L8-D3 Interest 5 Fulton Bank-Cert of Deposit #022-D194418 20,000•DO Princ- $2D,000.00, Int• $8.22 6 Fulton Bank-Cert of Deposit #022-0194418 - Accrued 8.22 Interest 7 Golden Living-Reimb on prior payment of serv rend 1„440.69 8 Insurance refund 197.00 9 M&T Bank-Cert of Deposit #31003913916193 29,500.00 Princ• $29,500.00, Int• $91.56 LO M&T Bank-C.ert of Deposit #31003913916193 - Accrued 91.56 Interest 11 M&T Bank-Cert of Deposit #31003914613269 15,000.00 Princ• $],5,000.00, Int• $•58 12 M&T Bank-Cert of Deposit #31003914613269 - Accrued 0.58 Interest 13 f1&T Bank-Savings Acct #15004208629434 5D,670.00 Princ• $50,670•D0, Int• $1.46 ],4 M&T Bank-Savings Acct #15004208629434 - Accrued 1.46 Interest 15 Personal property sold by Cordier Auctions 3,741.00 on December 3, 4, and ],6, 2011 (net proceeds) 16 PNC Bank-Cert of Deposit #21,001018205 25,000.00 Princ• $25,000.00, Int• $3.39 TOTAL (Also enter on Line 5, Recapitulation) S 2 81, 9 9 7.9 9 If more space is needed, insert additional sheets of paper of the same size Continuation of REV-1500 Inheritance Tax Return Resident Decedent MARY C. COBLE Decedent's Name Page 1 21 11 0642 File Number Schedule E -Cash, Bank Deposits, 8~ Misc. Personal Property ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 17 PNC Bank-Cert of Deposit #21,001018205 - Accrued 3.39 Interest 18 PNC Bank-Checking Acct #5140118441 27,209.49 Princ• $27,209.49, Int• $•62 1,9 PNC Bank-Checking Acct #5140118441 - Accrued Int 0.62 20 PNC Bank-Savings Acct #51300712?2 80,421.68 Princ- $80,421.68, Int• $8.81 21 PNC Bank-Savings Acct #5130071272 - Accrued Int 8.81 22 Prudential Ins-monthly annuity payment rec• 193.61 Contract #ROS854003 23 Prudential Insurance-monthly annuity payment rec• 450.10 Contract #DOY133148 24 RLI-liability insurance refund 34.00 SUBTOTAL SCHEDULE E 10 8 , 3 21.7 0 GRAND TOTAL SCHEDULE E $ 281,997.99 REV-1510 EX+ (08-09) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS AND MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER MARY C• COBLE 21 1], 0642 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 INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER.ATTACHACOPYOFTHEDEEDFDRREALESTATE. DATE OF DEATH VALUE OF ASSET %OFDECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE L• M&T Bank-IRA Acct #35004202598388 332,465.26 100.00 32,465.26 Princ• $332,194.39, Int• $270.87 w/Mary Catherine Coble Rev Trust as beneficiary 0.00 2• PNC Wealth Management-Revocable Trust 448,158.37 100.00 48,158.37 Agreement dtd July 21, 1972 and amended March 4, 2002 with Mary Catherine Coble Settlor and CCNB now PNC Bank as Trustee with Suzanne Elizabeth Coble Hilton and Katherine Anne Hilton as primary beneficiaries TOTAL (Also enter on Line 7, Recapitulation) I$ 7 8 0, 6 2 3. 6 3 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 MARY C• COBLE 21 L1 0642 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1 Parthemore Funeral Home-funeral expenses 4,523.12 Parthemore Funeral Home-addrl funeral expenses 584.57 B. ADMINISTRATIVE COSTS; 1. Personal Representative Commissions: Name(s) of Personal Representative(s) D a v i d H S ton e Street Address 414 B r i d g e S t r e e t C;ty New Cumberland State PA ziP 17070 Year(s) Commission Paid: 2 011 / 2 012 2 • Attorney Fees: Stone LaFaver 8 Shekletski 3, Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4- I Probate Fees: S e e # 11 b e l o w 5 - I Accountant Fees: 6 - I Tax Return Preparer Fees: 7• Interest withheld on interest on PNC Chkg 2 Tax withheld on PNC interest 3 American Modern Select Ins-property insurance 4 Penn National In s homeowners insurance 5 Check written pr ior to death by decedent 6 PNC Bank-service charge on est account 7 PNC Bank-service charge on est account 8 Penn Waste Inc-s ervices at residence 9 PNC Bank-service charge on est account 10 PNC Bank-service charge on est account 11 Stone LaFaver & Shekletski-Reimb for probate 12 Stone LaFaver & Shekletski-Reimb for advertisin 25,000.00 14,145.00 0.34 4.07 936.00 29.00 19.59 2.00 2.00 48.75 2.00 2.00 593.50 75.00 TOTAL (Also enter on Line 9, Recapitulation) I $ 6 3 , 3 9 8 • 4 8 If more space is needed, use additional sheets of paper of the same size. Continuation of REV-1500 Inheritance Tax Return Resident Decedent MARY C. COBLE 21 Decedent's Name Page 2 Schedule H -Funeral Expenses 8~ Administrative Costs - B7. 11 0642 File Number ITEM NUMBER DESCRIPTION AMOUNT 13 PAWC-water service at property 14 Prudential Ins-Returning check plus bank charge 15 PAWC-water service at residence 16 The Sentinel-advertising grant of letters 17 The Borough of Camp Hill-sewer serv at residence 1,8 Janet L Miller-tax certification fee 19 PAWC-water service at residence 20 Penn Waste Inc-garbage pickup at residence 2l, PAWC-water service at residence 22 PAWC-water service at residence 23 E K Services Inc-water pipe repairs 24 Elwood G Kline-lawn service June to September 25 Janet L Miller-real estate taxes at residence 26 Selling costs ($12,788.05) less reimb ($2,262.28) 27 UGI-gas service at residence 28 PPL Corp-electric service at property 29 UGI-gas service at residence 30 PPL Corp-electric service at residence 31 UGI-gas service at residence 32 UGI-gas service at residence 33 PPL Corp-electric service at residence 34 UGI-gas service at residence 35 Register of Wills-filing Inh Tax Return & Inv 36 Reserve for closing expenses SUBTOTAL SCHEDULE H-B7 15.14 235.05 14.36 147•D6 150.OD 5•DO 13.54 48.75 16.83 2.71 2,335.69 340.00 2,413.73 10,525.77 10.84 22.90 10.94 22.33 9.71 10.95 40.99 9.25 30.00 1,000.00 17,431.54 REV-1512 EX+ (12.08) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER MARY C• COBLE 21 11, 0642 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Verizon-telephone service at residence 120.44 2 Elwood G• Kline-lawn service for April and May 1,50.00 3 PharMerica-medication received 238.82 4 Golden Living-services rendered 70.46 5 Golden Living Center-service rendered 10.84 6 Holy Spirit Hospital-services rendered for 201,1 935.00 TOTAL (Also enter on Line 10, Recapitulation) I $ 1 5 2 5 • 5 6 If more space is needed, insert additional sheets of the same size. REV-1513 EX+ (01-10) pennsylvania ~ SCHEDULE J DEPARTMENT OF REVENUE I BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: MARY C • COBLE a~, i. i. nt_ua RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1• Suzanne Elizabeth Coble Hilton* Sibling 1,870.5D 420 Paige Hill Road PProp Landisburg, PA 1,7D40 2 Katherine Anne Hilton** Car & PProp Collateral 4,465.50 42D Paige Hill Road Landisburg, PA 17040 *Annuity Interest Calculation as per Schedule M $243,145.80 ** Life estate Interest Calculation as per Schedule M $403,241.6D 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 TAXIS NOT TAKEN: 1• B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1• Value to Charities as per Schedule M $496,951.72 See list attached TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ 0 - D 0 It more space is needed, use additional sheets of paper of the same size. REV-1514 EX+ (4-09) pennsylvania DEPARTMENT OFREVENUE Bureau of Individual Taxes PO Box 280601 Harrisburg PA 17128-0601 SCHEDULE K LIFE ESTATE, ANNUITY 8r TERM CERTAIN (CHECK BOX 4 ON REV•1500 COVER SHEET) ESTATE OF FILE NUMBER MARY C• COBLE 21, 11 0642 This schedule should be used for all single-life, joint or successive life estate and term-certain calculations. For dates of death prior to 5-1-89, actuarial factors for single-life calculations can be obtained from the Department of Revenue. Actuarial factors can be found in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death from 5-1-89 to 4-30-99, and in Aleph Volume for dates of death from 5-1-99 and thereafter. Indicate below the type of instrument that created the future interest and attach a copy of it to the tax return. ® Will ^ Intervivos Deed of Trust ^ Other NAME OF LIFE TENANT DATE OF BIRTH • NEAREST AGE AT DATE OF DEATH TERM OF YEARS LIFE ESTATE IS PAYABLE Katherine Anne Hilton 1/3/1951 60 ®Lifeor ^TermofYears ^ Life or ^Term of Years ^ Life or ^Term of Years ^ Life or ^Term of Years ^ Life or ^Term of Years 1. Value of fund from which life estate is payable . . . . . . .... . ..... . . ....................... $ 9 0 0 , 19 3 - 3 2 2. Actuarial factor per appropriate table . . . . . . .. . . . . . . . . . . ................ . ........ . .... . 4 4 7 9 5 Interest table rate - ^3.5% ^ 6% ^ 10% X^Variable Rate 3 • 0 3. Value of lifeestate(LinelmultipliedbyLine2) ......................................$ 403,241.60 NAME OF LIFE ANNUITANT DATE OF BIRTH NEAREST AGEAT DATE OF DEATH TERM OF YEARS ANNUITY IS PAYABLE Suzanne Elizabeth Hilton 6/27/1,923 88 ®Lifeor ^TermofYears ^ Life or ^Term of Years ^ Life or ^Term of Years ^ Life or ^Term of Years 1. Value of fund from which annuity is payable .. . . . . . . . . ................................ $ 1 , 14 3 , 3 3 9 • 12 2. Check appropriate block below and enter corresponding number . . . . . . ... . .. . .. . . .......... 1, 2 Frequency of payout - ^ 1.Neekly (52) ^ Bi-weekly (26) ®Monthly (12) ^ Quarterly (4) ^ Semi-annually (2) ^ Annually (1) ^ Other ( ) 3. Amount of payout per period ...................................................... $ 4 , 5 0 0 • 0 0 4. Aggregate annual payment, Line 2 multiplied by Line 3 .... . . . . . . . . . . . . . . . . . . .. . . ......... 5 4 , 0 0 0 . 0 0 5. Annuity Factor (see instructions) Interest table rate - ^ 3.5% ^ 6% ^ 10% ®Variable Rate 3 • 0 % 4 • 5 0 2 7 6. AdjustmentFactor(Seeinstructions) ................................................ ]r 7. Value of annuity - If using 3.5%, 6%, 10%, or if variable rate and period payout is at end of period, calculation is: Line 4 x Line 5 x Line 6 ...........................$ 2 4 3 ,14 5 • 8 0 If using variable rate and period payout is at beginning of period, calculation is (Line4xLineSxLine6)+Line3 .................................................$ NOTE: The values of the funds that create the above future interests must be reported as part of the estate assets on Schedules A through G of the tax return. The resulting life or annuity interest should be reported at the appropriate tax rate on Lines 13 and 15 through 18 of the return. If more space is needed, use additional sheets of the same size. REV-1647 EX+ (02-10) INHERITANCE TAX RETURN RESIDENT DECEDENT pennsylvania DEPARTMENT OF REVENUE SCHEDULE M FUTURE INTEREST COMPROMISE (Check Box 4a on REV-1500) ESTATE OF MARY C• COBLE 21 11 0642 This schedule is appropriate only for estates of decedents who died after Dec.12, 1982. This schedule is to be used for all future interests where the rate of tax which will be applicable when the future interest vests in possession and enjoyment cannot be established with certainty. Indicate below the type of instrument that created the future interest and attach a copy to the tax return. ^ Will ^X Trust ^ Other I. Beneficiaries NAME OF BENEFICIARY RELATIONSHIP DATE OF BIRTH AGE TO NEAREST BIRTHDAY ~~ Suzanne Elizabeth Hilton Sister 6/27/1923 88 2~Katherine Anne Hilton Niece 1/3/1951 60 3. 4. 5. II. For decedents who died on or after July 1, 1994, if a surviving spouse exercised or intends to exercise a right of withdrawal within nine months of the decedent's death, check the appropriate block and attach a copy of the document in which the surviving spouse exercises such withdrawal right. ^X Unlimited right of withdrawal ^ Limited right of withdrawal [ 11.1 IV. Explanation of Compromise Offer: SEE ATTACHED EXPLANATION FILE NUMBER 496,951.72 0.00 0.00 243,145.80 403,241.60 7. Total value of future interest (sum of Lines 2 thru 6 must equal Line 1) ..................... $ Summary of Compromise Offer: 1. Amount of future interest .......................... .... . 2. Value of Line 1 exempt from tax as amount passing to charities, etc. (Also include as part of total shown on Line 13 of REV-1500.) ... ... $ 3. Value of Line 1 passing to spouse at appropriate tax rate Check one. ^ 6%, ^ 3%, ^ 0% ............. ... $ (Also include as part of total shown on Line 15 of REV-1500.) 4. Value of Line 1 taxable at lineal rate Check one. ^ 6%, ^ 4.5% ................... ... $ (Also include as part of total shown on Line 16 of REV-1500.) 5. Value of Line 1 taxable at sibling rate (12%) (Also include as part of total shown on Line 17 of REV-1500.) ... ... $ 6. Value of Line 1 taxable at collateral rate (15%) (Also include as part of total shown on Line 18 of REV-1500.) ... ... $ 1,143,339.12 1,143,339.12 If more space is needed, use additional sheets of paper of the same size. Estate of Mary C. Coble File Number 21-11-0642 Attachment to Schedule M III. Explanation of Compromise Offer: The reasoning behind the compromise offer is as follows: The trust provides for discretionary payments of principal and income to the deceased' 88 year old sister and 60 year old niece. Upon the death of both, the remainder passes to numerous charities. Since the inception of the estate, payments of $4500 per month have been made to the sister for nursing home expenses. We do not expect the niece to make any significant or regular invasions into principal. Accordingly, we have calculated an annuity interest for the sister based on her receiving $4500 per month for the remainder of her life. We then calculated a life estate interest for the balance of the fund for the niece. The difference between the total value of the future interest and the sum of the values of the annuity and life estate interests is being taken as a charitable deduction. The actuarial factor and annuity factor were obtained from the Department of Revenue (Holly Moore) using the 3% variable rate table. hJ -^ ~1 r Q ~_. ~1 ~'r"7 LAST WILL AND TESTAMENT n ~ ~ ~? i-n ~ ~ ~ . „ _~-~ MARY CATHERINE COBLE ~ ~ ~"~ `' ; ~,~~ _, .~0~ ~ _- _~ ~ ~ `~ O I, MARY CATHERINE COBLE, of the Borough of Camp Hill, County of Cumberland, and Commonwealth of Pennsylvania, declare this to be my last will and revoke any will previously made by me. ITEM I: I bequeath my automobiles, household and personal effects and other tangible personalty of like nature (not including cash or securities) together with any existing insurance thereon, to my sister, SUZANNE ELIZABETH COBLE HILTON, and my niece, KATHERINE ANNE HILTON, or to the survivor of them. ITEM II: I devise and bequeath the residue of my estate, of every nature and wherever situate, including any property over which I shall have any power of appointment, to the then acting Trustee under that certain trust created by me on July 21, 1972, as amended, in which I am the Settlor to have and to hold, IN TRUST, for the uses and purposes and subject to the terms and provisions thereof, including any alterations or amendments thereto, or any other trust which may hereafter be substituted therefor. ITEM III: All federal, state and other death taxes payable because of my death, with respect to the property forming my gross estate for tax purposes, whether or not passing under this will, together with any interest or penalty imposed in connection with such Page 1 of 4 tax, shall be considered a part of the expense of the administration of my estate and shall be paid from my residuary estate without apportionment or right of reimbursement, provided that any taxes on the trust created by me on July 21, 1972, as amended, may be paid from the assets of that trust as provided therein. ITEM IV: I direct that in the administration of my estate, my Executor not sell my real estate at public auction. ITEM V: I appoint DAVID H. STONE, Executor of this my last will. Should DAVID H. STONE, fail to qualify or cease to act as Executor, I appoint CHARLES H. STONE, Executor of this my last will. ITEM VI: I direct that my Executor and Trustee shall not be required to give bond for the faithful performance of his duties in any jurisdiction. IN WITNESS WHEREOF, I, MARY CATHERINE COBLE, have hereunto set my hand and seal this ~ day of ~ ~t(ydc-~ 2002 . P9AR CATHERINE COBLE SIGNED, SEALED, PUBLISHED and DECLARED by MARY CATHERINE COBLE, the Testatrix above named, as and for her Last Will and Testament, and Page 2 of 4 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. ~~ ~i~~"f~ Witness Address Witness Address COMMONWEALTH OF PENNSYLVANIA) SS. COUNTY OF CUMBERLAND ) I, MARY CATHERINE COBLE, the Testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law do hereby acknowledge that I signed and executed this instrument as my last will; that I signed it willingly and that I signed it as my free and voluntary act for the purposes therein contained. Gi.-L~h'fiv~F MA CATHERINE COBLE Sworn to or affirmed to and acknowledged before me by MARY CATHERINE COBLE, the Testatrix, this -~ day of 1~ 2002. No ary Pu is Page 3 o f 4 . ~~ NOTARIAL SEAL KAYI: R. Lt1CKEY, PubIIC ~ku~ Curflberiartd Born. Cumberland Co. 14ty Ca omission Expires I~h 27, 2006 COMMONWEALTH OF PENNSYLVANIA) SS. COUNTY OF CUMBERLAND ) We , ~ .r ~~~ ~--~,~-~_ and ~ ` ~ ' ~~ 1~ . ~ ~~:~c«, the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, depose and say that we were present and saw Testatrix sign and execute the instrument as her last will; that Testatrix signed willingly and 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; that to the best of our knowledge, the Testatrix was at that time eighteen or more years of age, of sound mind and under no constraint or undue influence. Witness Witness Sworn to or affirmed to d acknowledged before me by ~: ~ ~ and ~~i;tDt.. ~ a ~ ~,t_l this ~_ day of i!7y~~.r(h 2002. witnesses, tart' Pu lic Page 4 of 4 ~ O ~'~ ~~ KAYE R LUCf~1; ~~ ~ CORtiTt~ pn~pnl d ~qC _ _~" ~ 8~rh 27, 20x5 THE MARY CATHERINE COBLE R B THIS AGREEMENT OF TRUST executed in duplicate this Z~/~day of , 1972, between MARY CATHERINE COBLE, of the Borough of Camp Hill, Cumberland County, Pennsylvania (hereinafter called Settlor), and CUMBERLAND COUNTY NATIONAL ;3ANK AND TRUST COMPANY, of New Cumberland, Pennsylvania (hereinafter called Trustee), W I T N E S SET H: I. Settlor grants, assigns, and sets over to Trustee and its successors all the property described in Schedule A annexed hereto and said property, together with all other property, real or personal, that may be added to the trust (such property and additions being hereinafter called principal), shall be held by Trustee, IN TRUST, upon the following terms. II. During Settlor's lifetime, to pay to her the net income therefrom and so much of the principal as shall be re- quested by Settlor or as Trustee in its discretion from time to time thinks advisable for Settlor's support t,o maintain her in the standard of living to which Settlor was accustomed at creation of the trust. If Settlor is, in the opinion of Trustee, disabled by reason of age, illness or any other cause, Trustee shall apply for Settlor's benefit as much of the net income and principal of this trust as Trustee may from time to time think advisable fcr Settl~_ ;;.rFcrt to maintain Settlor in the standard of living to which Settlor was accustomed at creation Page 1 of the trust. III. Upon the death of Settlor, Trustee shall hold the remaining principal in further trust as follows: A. Trustee shall pay the net income and as much of the principal of this trust to Settlor's father, RAYMON ~D" ~"~ COBLE, or to apply such net income and principal directly for his benefit, as in the sole and absolute discretion of the Trustee, may be advisable for his support. B. Upon the death of Settlor's father, RAYMOND DAVID COBLE, or upon Settlor's death if she survives him, Trustee shall pay the net income and as much of the principal of this ~c~ trust to Settlor's aunts, MRS. G~„~,.-~963NI~Jof Harrisburg, ~ ~. Pennsylvania, and MRS. IDMUND M D~~' , SR, of Camp Hill, Pennsylvania, and to the survivor of them, or shall apply such net income and principal directly for the benefit of them or either of them, as in the sole and absolute discretion of the trustee may be advisable for their support or the support of the survivor of them. Trustee shall make or apply such pay- ments for Settlor's said aunts according to their needs and shall not be obligated to make payments in equal shares. C. Upon the death of the survivor of Settlor's father, RAYMOND DAVID COBLB, and Settlor's aunts, MRS. GRACE K. DOWNIE and MRS. IDMUND M. DEFTER, SR., the remaining trust estate shall be distributed as follows: c~~,~ 1. One-third to Settlor's cousin, MRS. CRl~F9KU', now living in Mechanicsburg, Pennsylvania, 2. One-third to Settlor's cousin, MISS ELIZABETH JEAN DEFTER, now living in Camp Hill, Pennsylvania. Page 2 3. One-third to be divided equally among Settlor's cousins, MR, ED1~'![JND M, DEFTER, JR., MISS EMILY FRANCES DEFTER, and MISS MAR'Y' ELIZABE NIE. dp'd~ 4. Should any of Settlor's said cousins not be living at the time of the death of the survi- vor of Settlor's father, RAYMOND DAVID COBLE, and Settlor's aunts, MRS, GRACE K. DOWNIE and MRS. EDMUND M. DEFTER, SR,, then the share of the said deceased cousin shall be distributed as follows: a, One-half to A, BICKFORD CRAWFORD; b. One-half to the trustee, in further trust nevertheless, to pay the net income and as much of the principal of said further trust to EDMUND D. CRAWFORD or to apply such net income and principal directly for his bene- fit as in the sole aid absolute discretion of the trustee may be advisable for his support and welfare for and during the term of his natural life and upon the death of the said EDMUND D. CRAWFORD the remaining principal and undistributed income held in trust for him shall be paid to his issue per atirpes, if any then living and if not to A. BICKFORD CRAWFORD or his issue per atirpes. During the lifetime of EDMUND D. CRAWFORD, should Trustee at any time deem it suitable, in its sole discretion, Trustee may terminate said trust and distribute the balance remain- ing therein to EDMUND D. CRAWFORD, absolutely. Page 3 IV. Should any person entitled to distribution from this trust be, in the opinion of the Trustee, incapable of disbursing it because of age, illness, or any other cause, and should it be impossible or inadvisable in the opinion of the Trustee for such share to be awarded to such person or dis- tributed to another for such person's benefit, the share of such person shall be held, IN FURTHER TRUST, and the Trustee shall accumulate the income and shall apply from time. to time such portion of income, accumulated income, and principal as it thinks proper for that person's support and education (includ- ing college education, both graduate and undergraduate) without regard to his or her parent's ability to provide for such support or education, or to make payment for these purposes, without further responsibility, to the beneficiary or to the beneficiary's parent, or to any person taking care of the bene- ficiary. Any principal or income not so applied shall be distributed to the beneficiary when he or she becomes of age or competent, or to the personal representative of the benefi- ciary's estate in case of death during minority or before becoming competent. V. The principal and income of this trust shall be free from anticipation, assignment, pledge or obligation of Settlor or of any beneficiary and shall not be subject to any execution or attachment or to voluntary or involuntary alienation. VI. Trustee shall have the power, but not the duty, Page 4 to make such expenditures out of this trust as it, in its uncontrolled discretion, may consider desirable in order to faciliate the settlement of Settler's estate. In exercising such power, Trustee may pay, in whole or in part, any or all of the following items: the expenses of Settlor's last ill- ness and burial, including cost of gravemarker; her debts; her income taxes; the death taxes on any and all property included in her gross estate for tax purposes; and all other items in connection with the settlement of her estate. Any such items may be paid directly by Trustee or the funds for their payment may be transferred by Trustee to Settlor's executor or administrator; and neither such executor or admin- istrator nor any beneficiary of Settlor's estate shall be required to reimburse Trustee for any funds so paid or transferred. All such death taxes on present or future interests shall be paid at such time or times as Trustee may think proper, regardless of whether such taxes are then due, provided that any postponed taxes on future interests shall be charged against the particular share with respect to which the taxes are imposed. VII. Trustee shall have the following powers in addition to those vested in it by law and by other provisions of this trust, applicable to all lroperty, whether principal or income, including property held for minors, exercisable without court approval, and effective until actual distribution of all property: A. To retain any or all of the assets of this trust, real or persona, including stock of the corporate trustee or of any holding company owning or controlling stock of the corporate trustee. B. To invest in all forma of property, including Page 5 X. Trustee shall receive compensation for the performance of its functions hereunder in accordance with its standard schedule of fees in effect from time to time during the period over which its services are performed. XI. •The situs of this trust for administrative and accounting purposes shall be in the County of Cumberland and Commonwealth of Pennsylvania, and all questions pertaining to the construction or validity of the provisions of this instru- ment shall be governed by the laws of that Commonwealth. IN WITNESS WHEREOF, Settlor has hereunto set her hand the day and year first above written and Trustee has executed this instrument and caused its corporate seal to be affixed hereto. Mary at er3.ne oble t~ CUMBERLAND COUNTY NATIONAL BANK AND TRUST COMPANY ATTEST: ''1, BY _~~~~ ~~Z~ ~ ~ (SEAL ) ' >sBIdTANTBECRETARY '"~F r'RESIDENI 2 T'".';_"~ ~ ~':-i;-F.R COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND ))) On this, the ~c~day of 1972, before me a Notary Public, the un ersigned o ce , personally ap eared MARY CATHERINE COBLE known to me (or satis actorily proven to be the person whose name ie subscribed to the within instrument and acknowledged said instrument to be her free act and deed. IN WITNESS WHEREOF, I have hereto set my hand and notarial seal. _ iJ~~'-nuC~ U~ ~5 ,..~- rJ~'trY ". ,Hill. Com~• ' ^,nunty My Commission ExplresSeptember24, 1913 Page 7 ~~ >c:~rs1~G2LEmar,-a~.._^aA~-02 ~ ~ ,, FIRST AMENDMENT TO THE MARY CATHERINE COBLE REVOCABLE TRUST AGREEMENT Ng1RCii 4, 2002 This First Amendment to a certain agreement of trust executed on July 21, 1972, between MARY CATHERINE COBLE of the Borough of Camp Hill, County of Cumberland and Commonwealth of Pennsylvania, (herein- after called "Settlor"), and CUMBERLAND COUNTY NATIONAL BANK AND TRUST COMPANY, now by merger PNC BANK, N.A., of Camp Hill, Pennsylvania (hereinafter called "Trustee"). W I T N E S S E T H: 1. I hereby revoke item III of my trust and in its place there shall be a new item III as follows: III Upon the death of the Settlor, Trustee shall hold the remaining principal in further trust as follows: A. Trustee shall pay the net income and as much of the principal of this trust to Settlor's sister, SUZANNE ELIZABETH COBLE HILTON, and Settlor's niece, KATHERINE ANN HILTON, or to the survivor of them, or to apply such net income and principal directly for the benefit of them or either of them, as in the sole and absolute discretion of the Trustee, may be advisable for the support of the survivor of them. Trustee shall make or apply such payments for Page 1 of 4 Settlor's said sister and niece according to their needs and shall not be obligated to make payments in equal shares. B. Upon the death of the survivor of Settlor's sister, SUZANNE ELIZABETH COBLE HILTON, and Settlor's niece, KATHERINE ANN HILTON, the remaining trust estate shall be distributed as follows: (1) 15a thereof to the CAMP HILL FIRE COMPANY. (2) 7~o thereof to HOSPICE OF CENTRAL PENNSYLVANIA. (3) 7~% thereof to PROFESSIONAL HOSPICE CARE. (4) 15% thereof to THE HARRISBURG CEMETERY. (5) 15o thereof to the CAMP HILL PUBLIC LIBRARY, now known as the FREDERICKSON LIBRARY. (6) 5o thereof to the local chapter of the AMERICAN CANCER SOCIETY. (7) 5o thereof to the local chapter of the ARTHRITIS FOUNDATION. (8) 5o thereof to SAVE THE REDWOODS LEAGUE. (9) 15% thereof to MESSIAH VILLAGE. (10) 5% thereof to the CAMP HILL POLICE DEPARTMENT. (11) 5% thereof to MESSIAH COLLEGE. In all other respects Settlor hereby ratifies and confirms the Mary Catherine Coble Revocable Trust Agreement dated July 21, 1972, together with this amendment, which now constitute the entire Mary Catherine Coble Revocable Trust Agreement. Page 2 of 4 ' ~ , IN WITNESS WHEREOF, intending to be legally bound hereby, the parties have executed this First Amendment to the Mary Catherine Coble Revocable Trust Agreement the day and year above written. i ~Gt,.c~~Y~-u-~ ~Q~"1~-~ ( SEAL ) W' ness MARY C HERINE COBLE ATTEST: (SEAL) dent COMMONWEALTH OF PENNSYLVANIA) SS. COUNTY OF CUMBERLAND ) On this, the ~~ day of 2002, before me the undersigned officer, a Notary Public, personally appeared MARY CATHERINE COBLE, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and official seal the day and year first above written. Nota Publi .~_~. Page 3 of 4 ~'~~' sue' KAYE R. LUCKY, Pubifc thew Cumberland Bao. t~~~ Co. My_Canmission Ezplres A~nch Z7, ZOOS .. COMMONWEALTH OF PENNSYLVANIA) SS. COUNTY OF '~DF,nL~,.~L ) ~~~ Y On this the ~_ day of 2002, before me, the undersigned officer, a Notary Pubic, personally appeared ~ ~~ n ~ ~ M who acknowledged himself to be the Vice President of PNC Bank, N.A., successor by merger to Cumberland County National Bank and Trust Company, and that he as such Vice President, being authorized to do so, executed the foregoing instrument by signing the name of the corporation by himself as Vice President. IN WITNESS WHEREOF, I have her o set my ha and notarial seal. Notary Public Notarial 3ee- Exe I. TtMOwar, NoMry PtbHC MY ~ E Nov~.12 002 11AN11()9f, Pgnneyhroriia M~ooielbn Ot NOleAes Page 4 of 4 RI DFD',Coble.Marv Catherine - Z07 N 17th Street wpd Taz Parcel f#: O1-Z1-0269-140 Address: 207 North 17'" Street Camp Hill, PA 17011 DEED THIS INDENTURE made the ~ ~ day of ~eQ~~e' , in the year 2011, between DAVID H. STONE, F,xecutor of the Last Will and Testament of MARY CATHERINE COBLE, late of Camp Hill Borough, County of Cumberland, and Commonwealth of Pennsylvania, of the first part, hereinafter called the Grantor, -AND- DAVID SCI-IULTZ, of the second part, hereinafter called the Grantee; WHEREAS, the said MARY CATHERINE COBLE became in her lifetime seised, as of fee; of and in a certain tract of land, together with the improvements thereon erected, situate in the Borough of Camp Hill, County of Cumberland, and Commonwealth of Pennsylvania, and more particularly described hereinafter; and being so thereof seised, died on May 24, 2011, having first made her Last Will and Testament in writing dated March 4, 2002, duly probated and registered in the Office of the Register of Wills of Cumberland County on June 3, 2011, wherein and whereby she appointed as Executor, the said DAVID H. STONE, to whom Letters Testamentary were duly issued by said Register of Wills on June 3, 2011, wherein and whereby said premises hereinafter described were not specifically devised, all as in and by said Will and the records of said Register of Wills, recourse thereunto being had, appears: NOW THIS INDENTURE WITNESSETH, that the said Grantor, for and inconsideration of the sum ofONE I IUNDREDFORTY-ONE THOUSAND and NO/100-----------($141,000.00)---------Dollars, which has been paid to they by the said Grantee at or before the sealing and delivery hereof, receipt whereof is hereby acknowledged, has granted, bargained, sold, aliened, released and confirmed, and by these presents does grant, bargain, sell, alien, release and confirm unto the said Grantee, -1- 4 ALL THAT CERTAIN piece or parcel of land situate in the Borough of Camp I-till, County of Cumberland and Commonwealth of Pennsylvania, and more particularly bounded and described as follows, to wit: BEGINNING at apoint on the eastern line of Seventeenth Street, formerly Long Street, at the line of lands now or formerly ofMatcom M. Simons and Ida L. Simons, his wife, said point being fifty (50) feet North from the northeast corner of Seventeenth and High Streets; thence in an easterly direction along said lands now or formerly of Malcom M. Simons and wife one hundred sixty (160) feet to Rover Alley; thence in a northerly direction along the western line of Rover Alley fifty (50) feet to a point; thence in a westerly direction along a line parallel with the northern line of High Street one hundred sixty (160) feet to Seventeenth Street; thence in a southerly direction along the eastern line of Seventeenth Street fifty (50) feet to a point or place of BEGINNING. HAVING THEREON erected a 2-1/2 story frame dwelling house known and numbered as 207 North I7`h Street. BEING the same premises which Mary Catherine Coble and Suzanne I-Tilton, Co-Executrices of the Last Will and Testament of Raymond Coble, a/k/a R. D. Coble, and Mary Catherine Coble, single woman, and Suzanne Hilton and William G. Hilton, Jr., her husband, by Deed dated September 17, 1974, and recorded September 24, 1974, in the Office ofthe Recorder of Deeds of Cumberland County in Deed Book U, Vol. 25, Page 651, granted and conveyed unto Mary Catherine Coble, the deceased. TOGETHER with all and singular the buildings, improvements, ways, streets, alleys, passages, waters, water-courses, rights, liberties, privileges, hereditaments and appurtenances whatsoever, thereunto belonging or in any wise appertaining and the reversions and remainders, rents, issues and profits thereof, and all the estate, right, title, interest, property, claim and demand whatsoever of her, the said MARY -2- CATHERINE COBLE, at and immediately before the time of her decease, in law, equity, or otherwise howsoever, of, in, to or out of the same. TO HAVE AND TO HOLD the said lot or piece of ground above described, with the buildings and improvements thereon erected, hereditaments and premises hereby granted or mentioned, and intended so to be, with the appurtenances unto the said Grantee, to and for the only proper use and behoof of the said Grantee, forever, AND the said Grantor, for himself and his respective heirs, executors and administrators, does covenant, promise and agree to and with the said Grantee, his heirs and assigns, that he, the said Grantor, has not heretofore done or committed any act, matter or thing whatsoever whereby the premises hereby granted, or any part thereof, is, are, shall or may be impeached, charged, or encumbered in title, charge, estate or otherwise howsoever. IN WITNESS WHEREOF, the said Grantor has hereunto het }pis hand and seal the day and year first above written. ,. _~ ,/~.-~ ,, f (SEAL) Witness ~- DAVID H. ST ,Executor of the Last Will and Testament of MARY CATHERINE COBLE COMMONWEALTH OF PENNSYLVANIA 1 SS: COUNTY OF r' ~nb-~aY-c~ On this, the ~Skrday of ~Q~~+^~' , 2011, before me a Notary Public, the undersigned officer, personally appeared DAVID H. STONE, Executor of the Last Will and Testament of MARY CATHERINE COBLE, known to me or satisfactorily proven to be the person whose name is subscribed to the within instrument, and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereto set my hand and notarial seal. r' ~/ ~~. COMMONWEALTH OF PENNSYLVANIA Notary Public NOTARIAL SEAL JENNIFER A. MEARKLE, Notary Public New Cwmberland Boro. Cumberland Co. My Commission Expires July 7, 2012 _ 3 _ b I hereby certify that the precise address of the Grantee is DATE: ~ ~ ~ ~~ Attorney' for ~" -9- Prudential Financial Inc., PRU Historical Quote - (NYSE) PRU, Prudential Financial Inc.... 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All quotes are b total exchange time. http://bigcharts.marketwatch. tom/historical/default.asp?symb=PRU&closeDate=S%2F24... 12/ 13/2011 1997 Mercury Grand Marquis LS Sedan 4D Trade In Values, Reviews -Kelley Blue Book Page 1 of 2 t ~.~~ ,r.~ Kelley ~I.Ie BOQk THE raus~en EtESOUacf' .~ ~~ j, Used Car Private Party Values Private Party Values Excellent $3,395 Good $3,095 Fair $2,595 / ~~ - 1997 Mercury Grand Marquis LS Sedan 4D Mileage: 90,000 Vehicle Highlights MPG: City 15/Hwy 23 Max Seatin Doors: 4 Engine: V8 Drivetrain: RWD Transmissi EPA Class: Large Cars Body Style Country of Origin: United States Country o1 Your Configured Options Our pre-selected options, based on typical equipment for this car. /Options that you added while configuring this car. Engine Comfort and Convenience Safety a V8, 4.6 Liter Air Conditioning Du~ Transmission Power Windows Seats Power Door Locks Automatic Cruise Control Poi Drivetrain Steering Wheels RWD Power Steering Allc Tilt Wheel Entertainment and Instrumentation AM/FM Stereo Cassette http: //www. kbb.com/mercury/grand-marquis/ 1997-mercury-grand-marquis/ls-sedan-4d/?v... 8/ 18/2011 1997 Mercury Grand Marquis LS Sedan 4D Trade In Values, Reviews -Kelley Blue Book Page 2 of 2 Glossary of Terms Kelley Blue Book® Private Party Value: This is the starting point for negotiation of a used-car sale between a privab does not include any warranties. The final price depends on the car's actual condition and local market factors. Excellent Condition: 3% of all cars we value meet this criteria. This car looks new and is in excellent mechanical condi bodywork, does not need reconditioning and is free of rust. The engine compartment is clean and free of fluid leaks, and defects. It has a clean title history and will pass a safety and smog inspection. It also has complete and verifiable service Good Condition: 82% of all cars we value meet this criteria. This car is free of any major defects and major mechanica only minor (if any) blemishes and there is little or no rust on the car. The tires match and have substantial tread left. The clean title history. Fair Condition: 15% of all cars we value meet this criteria. This car has some mechanical or cosmetic defects and need and has a clean title history. The paint, body and/or interior may need professional servicing. The tires may need replacir damage. © 1995-2011 Kelley Blue Book Co.®, Inc. All rights reserved. Copyright & Trademarks ~ Terms of Service ~ Privacy Policy © 2011 Kelley Blue Book Co., Inc. All rights reserved. 8/12/2011-8/18/2011 Edition. The specific information required to determine the value for th particular vehicle was supplied by the person generating this report. Vehicle valuations are opinions and may vary from vehicle to vehicle. Actual valuations will vary based upon market conditions, specifications, vehicle condition or other particular circumstances pertinent to this particular veh~ the transaction or the parties to the transaction. This report is intended for the individual use of the person generating this reporC only and sha/I not sold or transmitted to another party. Kelley Blue Book assumes no responsibility for errors or omissions. (v.11082) http://www.kbb. com/mercury/grand-marquis/ 1997-mercury-grand-marquis/ls-sedan-4d/?v... 8/ 18/2011 F~1t~nBarik LISTENING IS JUST THE BEGINNING." June 17, 2011 Stone, LaFaver & Shekletski Attorneys at Law 414 Bridge Street P.O. Box E New Cumberland, PA 17070 Dear Mr. Stone, RE: Mary Catherine Coble, deceased May 24, 2011 In response to your recent inquiry concerning the accounts maintained in the name of the decedent, please be advised that the following accounts were open at the date of death: DATE OF DEATH ACC CDC BALANCE INT RATE OPEN ROLL OVER MATURITY 022-0194375 $25,300.00 $18.03 1.00% 6/28/03 12/28/10 6/28/13 * Titled in her name alone 022-0194418 $20,000.00 $8.22 0.75% 8/4/03 2/4/11 8/4/12 * Titled in her name abne If you have any other questions, please feel free to contact me at (717) 291-2436. Sincerely, ~G~ Joshua A. Groff Credit Confirmation Processor ~~g~ ~~ This ir:`n,!?-,'iin~ is `ur,~i4h~:~; ~s a ma;.~r ~f ausiress cnurtcsy jn SnS:sl2t ~G ~'nl!! ~!1ni~j!`/, ~n~~ i5 f,~r ~t,-1u;r C~I1s1~6ntic3l U58 Gn~y Ti?$ bBniC ~Gt(li7~lir} t't115 Itli~vfi'!c"~.tlGl1 iiJir'S RG~t rcpC@8°fit GC gua!-aria~ tsle ~ccur~ary°, ~'`~~ ~ ~,cnsihilty is ass bi`+r~i by ttte i!?fcrr!tsti`~! pro~,ld~ . i~u 1' nts. A.e ~ o rnon bank er Gny a4 is c:it ~Ers, ,r~:.oy~ ur ark ~ Pl herzin 8,~p;eSSSd is sub~gyt to change vJithcut notic® 1.800.FULTON.4 fultonbank.com Fulton Bank, N.A. Member FDIC. Member of the Fulton Financial Family. p~ 499 Mitchell Road, Millsboro, DE 19966 Adjustment Services Phone 888-502349 F ax (302) 934-2955 June 20, 2011 Stone LaFaver and Shekletski 414 Bridge Street POBoxE New Cumberland, PA 17070 Re: Estate of Mary Catherine Coble Social Security: 293-22-7605 Date of Death: May 24, 2011 Dear Sir or Madam: Per your inquiry on June 8, 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 Account Number Ownership (Names oj~ Opening Date Balance on Date of Death Accrued Interest Total 2. Type of Account Account Number Ownership (Names o~ Opening Date Balance on Date of Death Accrued Interest Total Savings Account 15004208629434 Mary Catherine Coble Charles H Stone (POA) David H Stone (POA) 02/032 $S0, 670.00 $ 1.46 ------------------------------------- $50,671.46 Individual Retirement Account 35004202598388 Mary Catherine Coble Revocable Trust at CCNB (Beneficiary) 1127/06 $332,194.39 $ 270.87 $332, 465.26 3. Type of Accoiuit Certificate of Deposit Account Number 31003914613269 Ownership (Names o~ Mary Catherine Coble Charles H Stone (POA) David H Stone (POA) Opening Date 06/19/98 Balance on Date of Death $15,000.00 Accnied Interest $ .58 Total $IS 000.58 4. Type of Account Certificate of Deposit Account Number 31003913916193 Ownership (Names oj~ ~ Mary Catherine Coble Charles H Stone (POA) David H Stone (POA) Opening Date OS/I S/00 Balance on Date of Death $29,500.00 Accrued Interest $ 91.56 Total $29,591.56 For any additional information on the above accounts, including ownership and any changes, closures and/or reimbursement of funds, please call the West Shore Plate Olfice at 4Y117-731-1730. We were unable to locate any safe deposit box for the above-mentioned decedent This letter does not indude any aaroimts in which the deceased may have been listed as Power of Attorney, Custodian of Uniform Transfers, Representative Payee, or Trustee under a Written Agreement Sincerely, Tammy Spencer Adjustment Services Jun. 23. 2011 12:07PM PNC BANK 412-705-2747 ~~ tL~AD1N8 TlIE 1NAY June 23, 2011 David H Stone, Esq. Stone Lafaver & Shekletski 414 Bridge St POBoxE New Cumberland, PA 17070 RE: Macy Catherine Coble SSN: 293-22-7605 DOD: OS-24-2011 Dear Mr, Stone: No. 8720 P, 1/2 In response to your request far Date of Death (DOD) balances far the custanner Hated above, our records show the following: Certificate of Deposit Account # 21001018205 MARY CATHERINE COBLE DOD balance: $ 25,000.00 + 3.39 accrued interest Interest paid 01-01-2011 thru OS-24-2011 $ 95.61 YTD Checking Account Account # 5140118441 MARY CATHERINE COBLE DOD balance: $ 27,209.49 + 0.62 accrued interest Interest paid 01-01-2011 thru 05-24-2011 $11.59 YTD . Savings Account Account # 51300?1272 MARY CATHERINE COBLE DOD balance: $ 80,421.68 + 8.81 accrued interest Interest paid 01-01-2011 thru OS-24-2011$ 74.05 YTD Established: 04-13-1992 Established: 07-01-1981 Established: 02-01-1983 Page i of 2 ~un,23, 2011 12:O7PM PNC BANK 412-705-2747 No, 8720 P, 2/2 Please ante that this office provides date of death balances for deposit accounts (IRAs, CDs, Checking and Savings). We do not process any financial transactions or provide statements, if you need assistance with any of these items, please call 1-888-PNC-BANK (1-888.762-2265) or stop by your local PNC Bank bramcb office. Sincerely, National Fiztancial Services Center PNC Bank, N.A. Member FDIC This message is intended for the use of the individual or entity to which it is addrexsed and may contain information that is privileger~ confidential and exemptfrom disclosure under applicable law. If the reader of this message is not the intended recipient or the employee or agent responsible for delivering this message to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communications is strictly prohibited If you have received this communication in error, ,please notify me immediately by reply or by telephone at 800-7d2-1775 and immediately destroy this faxed document. Page 2 of 2 David Stone From: jason.camilloC~pnc.com Sent: Monday, June 20, 2011 12:08 PM To: David Stone Subject: DOD valuation for Mary Coble Attachments: COBLE, MARY C 5-24-11 16270273106857.pdf Mr. Stone. Attached is the DOD valuation for the account. Thank you Jason Camillo Trust Officer PNC Wealth Management 620 Liberty Avenue, 5th FI. Pittsburgh, PA 15222 Office: 412-768-3716 Fax: 412-762-0080 Email: iason.camilloC~3pnacom .--. The contents of this email are the property of PNC. If it was not addressed to you, you have no legal right to read it. If you think you received it in error, please notify the sender. Do not forward or copy without permission of the sender. This message may contain an advertisement of a product or service and thus may constitute a commercial electronic mail message under US Law. The postal address for PNC is 249 Fifth Avenue, Pittsburgh, PA 15222. If you do not wish to receive any additional advertising or promotional messages from PNC at this a-mail address, click here to unsubscribe. https://pnc.p.delivery.net/m/u/pnc/uni/n.asp By unsubscribing to this message, you will be unsubscribed from all advertising or promotional messages from PNC. Removing your a-mail address from this mailing list will not affect your subscription to alerts, e-newsletters or account servicing e-mails. Issues sorted by security. a9TATt TAX SLCVRITIa3 VALUATION ACCOUNT: 3106857-027-16-27A Name of aatate: MAAY 0. COHLa DATA OF DLATH: Tuesday, May 24 2011 ITLM CUBIP NO. 9NAAa9/ Da9CRIPTION PRICa HZOH/A3K LOW/HID MaAN pAR VALVa DATA PAICa PAICa PRSCa 1) 999527641 48,771.4300 HLACKAOCK LIQ 7'DH TaMPlVND ADO) 9H8 YH1 INC024a CASH 2) 999527641 399,386.5100 BLACKAOCR LIQ TDS Tat~l'UND ADM 8H9 /Hl PRINCI P7IL CASH Oraad Totals Total Principal plus Accrued interest sad dividends PAOa NO. 1 sacviuTx AccavaD coranNTs vALVa Drv/INT 48,771.43 0.09 MANUAL 399,386.51 0.39 MANUAL ________________ ____________ 448,157.94 0.43 448,158.37 This report was prepazed using APYA7l29a Ver. 7.6.0 software, an aVALUATION 9aRVICZS, INC. product. Phone 201 7B4 8500. Visit our web sites at NWW.APPAAI9LNJ.COM and WWN.CAPITALCHANOa90NLZNa.COM. Please compare the data oa this document carefully with your source document to verity its accuracy. y A. Settlement Statement U.S. Department of Housing OMS Approval No. 2502-0265 and Urban Development B. Type of Loan 1.0 FHA 2.^ FmHA 3.^ Conv. Unina. B. tk Number: 7. loan Number: 8. MortOaQs Insuronu Cass Number: 4. ^ VA 5. ~ Conv. Ins. ^ Other 20110120 C. Nob: Is Is miahad to pNe you a statement o actual settlement coats. Amounts paW to and by the settlement spent are shown. Items marked'(POC)' were paid outsWs the Goakq; they aro shown hers for informatlonal purposes and aro not Included In the totab. D. Name li Addrea David u Box 93, amp HiN, PA 17001 of Bortovwr: E. Name It Address Da tats, Esq., Executor o the state o ary Catharine Coble, 207 N. 17th treat, amp HiN, PA 17011 of Seller. F. Name d Addnas of Lender. Q. Property Locatlon: Property Address 207 N 17th St. Camp HiN, PennayNanie 17011 PIN Oi-21-0289-140 H. Settlement Agent James A. Mlikr, Esq., i- roat Road Se ant ices, LL .17th treat, Camp HIN, PA 7701 t, (717)731-1040 Place Of Settlement 8 S. 17th Street, Camp Hill, PA 17011 1.3ettlement Dab: 9/15/2011 Proratlon Dab: 9/15/201 t plsbursement Dab: 9/15/2011 „w'9SftltiHtat~f d~rak!~tli~`o ' :>xtkfNliafk~' ... { ~.:<< .. -- 101. Cattreet aahs prke 5141,000.00 401. Confrect salsa prig (141,000.00 102. PersonN properly ~ 402. Paaonal property 103. Settkmartl charyas to twrrower Oins 1400) (2,547.25 403. 104. 40d. 105. 405. 108.... CityAown tars 406. CityROwn texas .: . 107. County taxes 9/15/2011 to 17/31/2011 (324.83 407. County faze 9/15/2011 b 12/31/2011 (324.83 108. Aaaptrtrortb 408. AasesarneMs 109. Scholl Taxes 9y75/201i to 8/30/2012 f1,911.15 409. SrJtod Taxes 9!7512011 to 8130/1012 i1,9t 1.15 t 70. 3b Qtr Sewer 9!14/2011 to 9/30/2011 (28.30 410. 3rd ptr Sewer 9/74/2011 to 9/30/2011 528.30 111. 4t 1. 112. ~ 412. 120. Grog Amount Dt» ham BorrowNr 5146,606.53 420. Gran Amount Dw to Seller f 743,262.26 201. DeposN a camas! money (5,000.00 501. Fxaw deposN (ass instructions) -~ - - 202. Pnrtdpal amount of Mw ban(s) 502. . Seldsmsnt charyss po saner (Nne 1400) f 12.788.05 203. E:datkq ban(s) lakes wttject to 503. E:dsfktp ban(s) hkan wbject to 2W. 504. Payoff of first mortgage loan 205. 505. Payoff of ascaW mortgage ban 208. r,~, 207. 507. 208. ypg. 209. rrpg. 210. Cityrtown taxes 510. City/towrt taxes ._... . . 21 t. County taxes 51 t. Courriy taxes 212. Asssssrttenb 512. Aseawnarty 213. 513. 214. 514. 215. 515. 218. 518. 217. 517. 218. 518. 219. 519. 220. Total Paid by(for Bonawar (6,000.00 520. ToW Redustlon Amount Dua Seller 112,766.05 301. Gress amoutt des kom borrower (Rne 120) (145,809.53 601. Gras amount due to aeNer (Nrte 420) ,. .., ~ 3143,282.28 302. Leas artiorutb paid bylfa borrower (tins 220) (f5,000.00) 802. Less redllCtlOne h amount due aeNer (NrM 520) (112,788.05) 703. Cash ®From l]To Borrower (140,606.63 603. Cash ®TopFrom Seller f130,474.23 c'~<<'~ P~~«.~ '~l4l,000.00 Ex(1enSes' r(ai74~.05 ~5s ~~ t"~ 4LtxrS ;~, ~.6a . ~-B ~ ~~ Sa5,77 --- ~~3oy7~ya3 9/15/2077 9:58:52 AM tails IUumr...• ~nunr L SettttxnsM C*;argss- ~:. _ ,,. ., .. _ :. ., 700. Total Salea/Brokara Commisabn based on price (141,000.00 ®7.000000% • 59,870.00 Paid From Paid From Divlsbn of commission (Ilne 700) as follows: Borrower's Sellers 701. (5,840.00 to ReMax Really Associates, Inc. Funds at Funds at 702. (4,230.00 to Remax 1st Advantage Setement Settlement 703. Commission paW at seltk~ment (9,870.00 f9 870 00 7a. 708. Brdtst Fae to ReMax Really Asaodatss, lnc (395.00 801. loan aigktatlon tae . ~ s. _. 802 loan d4couM 803. Appraisal fee 804. Grad6 report 805. larders inapactbn lee 808. Mortgsga insurance applir~tlon fee 80T. Assumptlon fee 808. 809. 810. 811. et2. 813. .. ~,. ,_ _. .- ;, 901. Interest Fran 902. Mortgage insurerres premium for 903. Hazard insurance premium for 1001. Hanrd insurerrce - _ 1002. Mortgage klnuertce 1003. City property taxes 7004. County property taxes 1005. Annual asweentsMa 1008. 1007. 1008. 1009. 1_. t 701. Sealernard or ebairq tee t t 02. AWtreet err 8tN search t 703. Title axaminatlon 7101. title insurance bkder 1105. Oocumarp prspara0on 1 Tae. Notary tees to cash sto.ao fs.oo 1707. Attorney's tees to Irxiudss above item numbers: i.wr. __ 1100. Total 9atltemarrt Cha error on Ilnea 103, 8aetlon J and 602, Seetlon (2,647.26 f12,T6a.06 Items merked'POC' ware paid outside the cbakp by: Barroww (POCK), Larder (POOL). Mortpape Broker (POCMj, Other (POGO). Rssl Estab Agerd (POOR). a SNNr (FOGS). y/ts/LUt1 8:58:52 AM File Number. 20110120 CERTiFN:ATN~N: I had carohrlty reviewed the HU0.1 Setlement Statement and to the best of my knowbdpe and belief, it is a true end aaurab statement of all recaipb and disbursement; made on rtry account a 6y mein Chia trensaction. I further certrry that I have received s copy of HU0.1 Settlement Sbtsmant. The Settlement Agent doss not warrant or reprsaanl Ns acwrery of intormatan provided by any party, InGWinp information conceminp POC itsma and intametron supplied M the IerWer In thle trensactron appearing on this HU0.1 Seltlemsm Sbtemant psrtalninp to'Comperieon of Good Faith Eatlmeb (GFE) and HU0.1 Charpss' end'Loan Terms', and the parose hold hsrmiese the Settement^ApeM as m any inaauradee in such matters. \ \\~JJJ Est of Mary C David Schultz Davitl,~ late, Ex~ ~ To Ute beet of my knowledge. Me~iUD-t Settlement StaMnerH which I have prepared is a true and aauraq accou o s halls wsrs rscelvsd and haw been or wfN Ds dlsburaW by 1M undersigned u pa f tM eetllerttertt W thb traneaetlon. .mTaAA~1i ~ ~'/~'- // .b W ~ NIN9: • alms to k(tr make tabs atetsntenb to the Unibd Stabs on Mb ar arry other similar tam. PetwlBSa upm wnvictlon can frtUWa i fkte and im Fa debae aee: 111: U.S. Coll Sectlat 1001 end Sectlon 1010. REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT Estate of Mary C. Coble Schedule J Beneficiaries Cont File No. 21-11-0642 IINon-Taxable Distributions -Charitable and Government Distributions Camp Hill Fire Department 2198 Walnut Street Camp Hill, PA 17011 Hospice of Central Pennsylvania 1320 Linglestown Road Harrisburg, PA 17110 Professional Hospice Care (Status and address unknown at this time) The Harrisburg Cemetery 110 Bergner Street Harrisburg, PA 17110 Cleve J. Fredricksen Library 100 N. 19"' Street Camp Hill, PA 17011 American Cancer Society, Inc. National Office of Probate & Trust Management Services Attn: Bill M. Roberts P.O. Box 720366 Oklahoma City, OK 73162 Arthritis Foundation of Central Pennsylvania 3544 N. Progress Avenue STE 204 Harrisburg, PA 17110 Save the Redwoods League 114 Sansome Street Suite 1200 San Francisco, CA 94104 Schedule J Beneficiaries Cont Messiah Village 100 Mount Allen Drive Mechanicsburg, PA 17055 Camp Hill Police Department 2145 Walnut Street Camp Hill, PA 17011 Messiah College Office of Development One College Avenue Grantham, PA 17027