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Home My WebLink About04-05-12 (2)J 1505610105 REV-1500 ex toz_n) tFt, enn lvanfa OFFICIAL USE ONLY PA Department of Revenue P sY o~P..,„~,.,,,.w.~. County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOX 28o6oi LI Harrisburg PA i7i28-0601 RESIDENT DECEDENT X / / ' / ~ ~ ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 193-12-8641 10/08/2011 11/03/1921 Decedent's Last Name Suffix Decedent's First Name MI Keck _ _ Ruth W (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE _ REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW OD 1. Original Return O 2. Supplemental Retum O 3. Remainder Retum (Date of Death Prior to 12-13-82) O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Retum Required death after 12-12-82) O1D 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (Date of Death O 11. Election to Tax under Sec. 9113(A) Between 12-31-91 and 1-1-95) (Attach Schedule O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTWL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number _. _ __ _ Ronald E. Johnson,Esq ',(717)243-0123 First Line of Address 78 West Pomfret Street Second Line of Address City or Post Office Carlisle State ZIP Code REGISTE~F WILLS US .... LY N ~ y. rn ( ~ n ~ , ~ ~ ~ .j ~ ~ : J~ - ~ . ~77 - TEFILED W ~--_, U'1 PA j17013 "~ Correspondent's e-mail address: rejohnSOn@pa.rlet Under penalties of perjury, I deGare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, tort t and complete. Dedaretion of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNAIU OF PERSON RESPOy41BLE R FILING RETURN DATE _ c/o 78 VIIESt Pomfret Street, Carlisle, PA 17013 ~~ L ra~ 78 West Pomfret,$tF~et, Carlisle, PA 17013 PLEASE 1505610105 Side 1 1505610105 J J 15D5610205 REV-1500 EX (FI) Decedent's Soc(al Security Number Decedent's Name: Ruth W. Keck '., 193-12-8641 RECAPITULATION 1. Real Estate (Schedule A) ...................................."...... ... t. ' 142,000.00 2. Stocks and Bonds (Schedule B) .................................... ... 2 0.00 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) .. ... 3. ' 0.00 4. Mortgages and Notes Receivable (Schedule D) ........................ ... 4. ! 0.00 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E).... ... 5. ' 10,252.70 6. Jointly Owned Property (Schedule F) O Separate Billing Requested .... ... 6. i 0.00 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested..... ... 7. ! 0.00 8. Total Gross Assets (total Lines 1 through 7) .......................... ... 8. 152,2$2.70 9. Funeral Expenses and Administrative Costs (Schedule H) ................ ... 9. ', 22,547.15 10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) ............ ... 10. ', 527.61 11. Total Deductions {total Lines 9 and 10)...... ......................... ... 11. ! 23,074.76 12. Net Value of Estate (Line 8 minus Line 11) ........................... ... 12. j 129,177.94 13. Charitable and Governmental BequestslSec 9113 Trusts for which °"' "" an election to tax has not been made (Schedule J) ........ . ............ ... 13. ' 0.00 I 14. Net Value Subject to Tax (Line 12 minus Line 13) ............ . ........ ... 14. 129,177.94 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 .t)_ 0.00 15. 0.00 16. Amount of Line 14 taxable at lineal rate X .0 45 129,177.94 16. ' 5,813.01 17. Amount of Line l4 taxable °" "" °' at sibling rate X J2 0.00: 17. ' 0.00 i 18. Amount of Line 14 taxable 0.00 at wllaterel rate X .15 18, 0.00 19. TAX DUE ....................................................... ..19.' 5,813.01 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 150561D205 1505610205 REV-1500 EX (FI) Page 3 Decedent's Complete Address: FileNUmber ~/~//` //v~ DECEDENTS NAME Ruth W. Keck STREET ADDRESS 35 Abbey Court CITE Carlisle STATE PA ZIP 17015 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) 5,813.01 2. Credits/Payments A. Prior Payments 0.00 B. Discount 0.00 Total Credits (A+ g) (2) 0.00 3. Interest (3) 0.00 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. (4) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 5, 813.01 Make check payable to: REGISTER OF WILLS, AGENT. r PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred .......................................................................................... ^ b. retain the right to designate who shall use the property transferred or its income ............................................ ^ c. retain a reversionary interest .............................................................................................................................. ^ d. receive the promise for life of either payments, benefits or care? ...................................................................... ^ 2. If death occurred after Dec. 12,1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. ^ 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. ~ ,.~~~('-. t ~~„ lt~ '~ r t ~ Ea iY ~~itP ,'1 ~ ~xM, six,' .. ,. ~ !rl Y.': ,,, 111 i .~~~ i~ "+?.~. 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 far the use of the surviving spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S. §9116 (a} (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: • The tax rate imposed on the net value of 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(a)(1)]. • The tax rate imposed on the net value of transfers to or for the use of the deceden!'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. LAST WILL AND TESTAMENT OF RUTH E. KECK I, RUTH E. KECK, of South Middleton Township, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking all other wills and codicils heretofore made by me. FIRST: I direct that all my just debts and funeral expenses, including my grave marker, shall be paid from the assets of my estate as soon as practicable after my decease. SECOND: I give, devise and bequeath the residue of my estate, of every nature. and wherever situate, to my children, equally, namely, VIONA NISLEY, DONNA GRESHAM, JACQUELINE BALLEW and ROBERT L. KECK, providing that the shaze of any child who predeceases me or dies on or before the thirtieth day following my death, shall be distributed to his or her issue, per stirpes, living on the thirty-first day following my death, and in default of such then living issue, such share shall be added to the share or shares for my other children. THIRD: I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of the administration of my estate. FOURTH: I nominate, constitute and appoint, VIONA NISLEY, Executrix of this my Last Will and Testament. Should VIONA NISLEY, fail to qualify or cease to act as Executrix, I appoint DONNA GRESHAM, Executrix of this my Last Will and Testament. FIFTH: I direct my Executrix and her successors shall not be required to give bond for the faithful performance of their duties in this or any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Test~ment, consisting of one (1) typewritten pages, each identified by my signature, this ~S day of May, 2001. .~~~!~~t (SEAL) ~ Ruth E. Keck Signed, sealed, published and declazed by the above-named Testatrix, RUTH E. KECK, as and for her Last Will and Testament, in the presence of us, who, at her request, in her sight and presence, and in the sight and presence of each other, have hereunto subscribed our names as -. "rte- -~ COMMONWEALTH OF PENNSYLVANIA ) COUNTY OF CUMBERLAND ) SS. I, RUTH E. KECK, Testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Swop or affirmed to and acknowledged before me by RUTH E. KECK, the Testatrix, this a.,S~ day of May, 2001. N07ARIAL SEAL SHELLY SEXTON, NOTARY PUBLIC CARLISLE BORO, GUMBERLAND COUNTY MY COMMISSION EXPIRES APRIL 28, 2003 Memtrer, Pennsylvani2 Assoclatfon of Naterles AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ) COUNTY OF CUMBERLAND SS. We, RONALD E. JOHNSON and tom.:. ~ ~ . ~ ' - ~ the witnesses _~t--~ c r,.~ ~_ ~ Imo, E~ ~ ~ , whose names are signed to the attached or foregoing rnstrument, being d y qualified according to law, do depose and say that we were present and saw Testatrix sign and execute the instrument as her Last Will and Testament; that Ruth E. Keck, signed willingly and that she executed it as her free and voluntary act for the purpose therein expressed; that each of us in the hearing and sight of the Testatrix signed the Will as witnesses; and that to the best of our knowledge the Testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. ~ Sworn or affirmed to and subscribed to before me by RONALD E. JOHNSON and ~~.t?,~rF'~C~ E. 5,,.:tcj y-• ,witnesses, this cy?5`~"~'` day q~M~, 001. _~1/~ _ -/ L ! / NOTARIAL SEAL SHELLY SEXTON, NOTARY PUBLIG CARLISLE BORO, CUMBERLAND COUNTY MY COMMISSION EXPIRES APRIL 26, 2003 Member, Pennsylvar ;Association n! Notaries Notary Public COMMONWEALTH OF PENNSYLVANIA ) SS. COUNTY OF CUMBERLAND ) I, RUTH E. KECK, Testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affumed to and acknowledged before me by RUTH E. KECK, the Testatrix, this ~.5~ day of May, 2001. NOTARIAL SEAL SHELLY SEXTON, NOTARY PUBLIC CARLISLE BORO, CUMBERLAND COUNTY MY COMMISSION EXPIRES APRIL 26, 2003 Member, Pennsylvania Association of Natariee AFFiDA ViT COMMONWEALTH OF PENNSYLVANIA ) COUNTY OF CUMBERLAND ) SS. We, RONALD E. JOHNSON and t•~:~~•tr~ ~-.~.,~.~ ~. ,~iti'e£~' ~~F' ~, the witnesses whose names are signed to the attached or foregoing instrument, being dfrly qualified according to law, do depose and say that we were present and saw Testatrix sign and execute the instrument as her Last Will and Testament; that Ruth E. Keck, signed willingly and that she executed it as her free and voluntary act for the purpose therein expressed; that each of us in the hearing and sight of the Testatrix signed the Will as witnesses; and trat to the best of our knowledge the Testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn or affumed to and subscribed to before me by RONALD E. JOHNSON ands^~, Cr~,~~F~ rj E. ~;~..;~e~ ~~ , witn~~this a?<5`~~y} d -y q~ 001. ___., nald E. Johnson, NOTARIAL SEAL SHELLY SEXTON, NOTARY PUBLIC CARLISLE BORO, CUMBERLAND COUNTY MY COMMISSION EXPIRES APRIL 26, 2003 ~! Member, Pennsvlr, 'a Associaton of Notaries €~, ~ ~~ ' .__-_._ ...........,.. ~ ~l_.~ ~~ r n Notary Public COMMONWEALTH OF PENNSYLVANIA ) COUNTY OF CUMBERLAND ) SS. I, RUTH E. KECK, Testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sw.o~ or affirmed to and acknowledged before me by RUTH E. KECK, the Testatrix, this !`..5~ ~f day of May, 2001. NOTARIAL SEAL SHELLY SEXTON, NOTARY PUBLIC CARLISLE BORO, CIIMBERLAND COUNTY MY COMMISSION EXPIRES APRIL 28, 2003 Member, pennsyiv2nla Association al Notaries COMMONWEALTH OF PENNSYLVANIA ) SS. COUNTY OF CUMBERLAND ) We, RONALD E. JOHNSON and ~ rti ~ E. G~' ~: : ~' ,the witnesses whose names are signed to the attached or foregoi g instrument, being d y qualified according to law, do depose and say that we were present and saw Testatrix sign and execute the instrument as her Last Will and Testament; that Ruth E. Keck, signed willingly and that she executed it as her free and voluntary act for the purpose therein expressed; that each of us in the hearing and sight of the Testatrix signed the WiII as witnesses; and that to the best of our knowledge the Testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed to before me by RONALD E. JOHNSON and__ kc.~e~,E~t~~ E• w~ct . ,r NOTARIAL SEAL SHELLY SEXTON, NOTARY PUBLIC CARLISLE BORO, Cl7MBERLAND COUNTY MY COMMISSION EXPIRES APRIL 2fi, 2003 Member, Pennsyhr;,n!a Association of Notaries AFFIDAVIT LAST WILL AND TESTAMENT OF RUTH E. KECK I, RUTH E. KECK, of South Middleton Township, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking all other wills and codicils heretofore made by me. FIRST: I direct that all my just debts and funeral expenses, including my grave mazker, shall be paid from the assets of my estate as soon as practicable after my decease. SECOND: I give, devise and bequeath the residue of my estate, of every nature and wherever situate, to my children, equally, namely, VIONA NISLEY, DONNA GRESHAM, JACQUELINE BALLEW and ROBERT L. KECK, providing that the share of any child who predeceases me or dies on or before the thirtieth day following my death, shall be distributed to his or her issue, per stirpes, living on the thirty-first day following my death, and in default of such then living issue, such share shall be added to the share or shazes for my other children. THIRD: I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of the administration of my estate. FOURTH: I nominate, constitute and appoint, VIONA NISLEY, Executrix of this my Last Will and Testament. Should VIONA NISLEY, fail to qualify or cease to act as Executrix, I appoint DONNA GRESHAM, Executrix of this my Last Will and Testament. FIFTH: I direct my Executrix and her successors shall not be required to give bond for the faithful performance of their duties in this or any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Test~ment, consisting of one (1) typewritten pages, each identified by my signature, this Z$~ day of May, 2001. ~' ~~ (SEAL) ~- Ruth E. Keck Signed, sealed, published and declared by the above-named Testatrix, RUTH E. KECK, as and for her Last Will and Testament, in the presence of us, who, at her request, in her sight and presence, and ui the sight and presence of each other, have hereunto subscribed our names as C~ ~~~~.` r REV-1502 Ex+ (i1-08) ~ pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT scHeuu~~ a REAL ESTATE ESTATE OF FILE NUMBER Ruth W.Keck 21-11-1104 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 orsell, both having reasonable knowledge of the relevant fads. Real property tlrot 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 DESCRIPRON 1' ALL THAT CERTAIN tract of land with the improvements thereon erected situate in South Middleton Township, Cumberland County, PA being designated as Lot H-2 on the Plan of The Villas and known and numbered as 35 Abbey Court, Carlisle, PA 17013 See Cumberland County Deed Book 243, Page 705 Property sold (see settlement sheet attached) 142,000.00 TOTAL (Also enter on Line 1, Recapitulation,) $ 142,000.00 If more space is needed, insert additional sheets of the same size. ~ f ~Q'P~yeeroFtica OMB Approval No, 2502-0285 * * a a. Settlement Statement (HUD-1) 's~ ~w~ GgB.W DEVE'9 B.Typ•ofLOan 1. ~ FMA 2. ^ RHS 3. ^ Conv. Unins. 4. ~ VA x5. Com. ma. 6. File Number. 105-998 7. Loan Number: WA 5. Mortgage Insurona Cess Number: WA C. Note: Thb form b flunishsd to give you a statement of adual seltlemerq cosh. Amounts Pea to and by the setlbnrent agsm aro stwwn. ftems marked '(p.o.Gy were pakl ouhWe the dosing; they aro shown Mro for informatlonel WrPOeas and aro not inducted in the tomb. D. Name 6 Address d Borrower. Dorottry P. Carew 1249 Kuhn Road Ool9ng Springs, PA (7007 E. Name a Address of SsBSr. Estate of Ruth W Keck 35 AbWy Court Carlbb, PA 17019 F. Name b Addrees of Lender. WA G. Property Loratbn: H. SetllsmeM Agent: 1. Setlbmsnt Date: March 20, 2012 35 Abbey Court Caribb, PA 17013 Anthony L Deluca, Esquire 113 Front Street Bo9ing Sprtngs, PA 17007 Place of Seltbment 113 Front Street Bo01ng Sprkgs, PA (7007 J. Summary of Borrower's Traraaetlon IC of Seller's Transaction 100. Grow Amount Dw from Borrower 400. Grow Amourd Dw to Selbr 101. Contract sales prke 5142,000.00 401. Comrsd wlw Drks 5142,000.00 102. Personal 402. Personal P 103. Setllemenl dr b borrower (Wn 1400) 2,443.88 103. 104. P b: 404. 105. 405. Ad)uabr»nb for ttsms wlbr In advance Ad)uebaellb for Ile7tls pdd seller In advance 108. C flown hxw 3/20/12 to 12!31/72 19.17 408. C Aourrr taxes 3/20112 >b 12/31/12 19.17 107. Cou taxes 320/12 to 12!31!12 230.80 407. Cw hxw 320112 to 72x31/12 230.88 108. Asseesmenb to 405. Aswasnrenb to 108. Scholl taxes 320!12 to 6730112 3'23.39 409. School te7oet 3/20/12 to 8/30!12 323.33 170. Homeowner Assoc. 320/12 to 3!31/12 41.49 410. Homeamers Asaoa 320/12 to 3!91!12 41.43 111. 411. 112. 412. 113. 419. 120. Gross Amount Mrs troth tborrovrer =145,058.49 120. Grow Amount Dw to Selbr 5742,614.81 200. Amourds Pant or in Behalf ~ Borto4ver: 600. Rsduatlorm M Amours! Ow m Setier. 201. Dspos6s or wmeat money - REJIAAX 2,000.00 501. Exaew depose (see kurtrudions) 202. PrMdpal smarm of rrew ban(s) 502. Settlement ch fo aelbt (8ne 1400) 510,980.27 203. Fxishtp ban(ri) taken s to 503. s taken subject t0 204.1.erWsrCrodkfarFew 504. dust ban 205. App9catlon Fw b 505. of aeoortd age ban 208. Sa6sr Awbhnoa w9h dos coats 1,500.00 506. Ss6sr AwManca ar8tr daing cosh 1,500.00 207. ~, 208. 508. 208. 509. A uatmads for Ibma unpaid setler A uesnsnh for Ibme u id selbr 210. C flown taxes to 510. CAyAam taxes to 211. Cou taxes tc 511. CW texea to 212. Nssumanb to 512. Asaeesmems to 213. to 513, to 274 614. 215. 515. 216. 518. 277. 517. 218. 518. 218. 519. 220. ToW Paid by/for Borrovwr (3,500.00 520. Tohl RWuctlon Amount Des SNbr 48027 12 300. Cesh at SNtlwnenthomAm Borroswr 600. Cwh at SetWrrrtertt to/from 9NNr , 307. Gras amWm des from borrower 9rN 720) 5145,058.48 007. Gross emoum des b aeibr (W~a 420} 5142,814.81 302. Less amounts pakl byXOr borrower (9ne 220) 3,500.011 602. Less radudbrq in amount des wibr (0ns 520) 12 480 27 903.Cwh ~X from ~to torrower 5141,558.49 803. Cash ^X t0from S611er , . $130,134,34 The Puble Repodaq Burden for ihb eolbctlon of )nfomwlion b estFnaled at 35 minutes per response for to0ecting, reviewing, and reporting the data. Thb e9~1' may rrW co6ed tlda infomation, and you are not required to oompble thb form, unbss A dbpbya a currently wild OMB aomrd number. No l7orrflde116691y k essured; this diaclwltre is Inandafory. TBIS b designed to provide the parties W a RESPA covered tronsadion wOh information during the settbment prooesa. ~. aervemenc ~.~w~yw 700. Total RW Estate BrokerS142,000.00 5 .°l6 Pakl From Paid From S ll r Div4bn of Commissbn IMe 700 as tauows: 707 $3,035.00 to REIMAX Rea pasociates, Inc. 702. 54,455.00 to Jadr Ga henlERA 703. Commbsbn kl at Ssatement Borrowers Funds at Settlement e e s Funds at Sattement 57,490.00 704. 800. Rams P abM In Connection with Loan 801.Our kralbn d.. a a natbn oint from GFE i 1 502. Your crodR a charye (points) for the spedfb interest rate drown (hom GFE • 2) 9 0.25% of ban amount 805. Your ad'used tbn cha to: (fran GFE A 804. Appraisal fee to: sal Fee from GFE ~ 3) 805. CredR b: from GFE 8 3 BOB. Tax servlu to: horn GFE fi 3 807. Food eentlba0on b: from GFE f 3 808. b: Chrk Wiss Man eM 585.00 608. 810. 511. Lender In bra Fee 812. 873. 814. 900, fterna alrod Lander m BO Paid In Advance 901. Da Interest ch Nom b d from GFE • 10 902. irouroncs remlum ror months to from GFE M 3 903. Hanwwnsrs Insurance for errs to from GFE i 11) 904. 805. 1000. Rssarvea ralHt Lender ; t00i. InRel R for escrow aooouM from GFE 8 9 7002. Homeowners Msuronoe moMne S month S 1003. Mo s Insurance months S month S 0.00 1004. P taxes C months S madh S 1005. Coun Pro axes months S r month S 1006. Scholl taxes months S r month 5 0.00 1007. 7008. ate uslmeM solar as e n aWe 1100.TItle C ~~- 1701. TRIS aervkes ant erWers the Insurance from GFE N 4 t 102. Ssatement or dosin fee to: 1103.Owners tRe Msuronco b: Sew Tkb Guerentee Co . of BaRimore Iran GFE 8 5 961.88 1104. Lenders flue insurorxra b: tto5. else tlmRt-0- 1108.Osmars IYIe poRCy IImR 5142,000.00 1107. s bra o<Uts total title kauronce lam 1108. Urtdaravlers of the total tltle Insurarta bm 1109. Endorssmsnb 1110. ProNctlon Leger 70: 7 717. TRb Search To: 1112.0 MMa' sTo: 1200. Govemmerd Rwordln and Transfer C 1201. Govamrrtent b: Recorder of Oseds GFE i 1202. Deed 562.00 M a Rebases 1203. Transfer taxes b: from GFE aY 8 1204. C /COU ex/atam Deed 51,420.00 Mo a 1,420.00 1205.~3tab taxlstam Deed 51420.00 M • 1,420.00 1208. Ass' mrtsnt of Mo e 1207. Subordination of Lien 7208. 1300. AddPoonal 9sttement Ch 1307. uksd aarvbes that ou can for from GFE to 6 1302.8 Prolsdbn Pen b: Fkst American Hann B ro Prokdbn Co 3~•~ 1303. Pest Fee b: Sudden Deatli TsrmRs 8 Post Control - 889.00 1304. Nome 1 te: MRce S Hans I or - 5260.00 P.O.C. 1305. Termite 1 n b: MRts Sh Home Ina r -540.00 P.O.C. 1308. Radon kq t0: Mks Shee Nome I - 595.00 P.O.C. 7307.Waerandtiswsrb: SMTMA 88.40 1308.2012 CoJLD7f h7tes b: Robert C. Calms, Tax Coledor 318.87 7400_ Total Setdsmant Chases (enter on Iines 103. Seefbn J and 502, Sattlen K) _ _ _ 52.443.88 510,980.27 CERTIFICATK)N , I have carMutly ro tlla HU0.1 SsttbmeM Statement and b the beat Of my knowledge and tNlbf, d 4 a true and aCwroU shtamont of all readplb and disbursame ads on my ac cunt a e i b bansactbn. I furtlter certlly that I haw reoeiwd a copy of the HU0.1 Se6bmen( Statement. ~1 , Selbr ~ Borrower F_stad ulh ck Do .Carew To the boat of my knowlsOpe the HUD-1 Settlement SWtamenl which i have prepared b true and eccuMe aawunt of the funds which wero raceiwd and haw been a wYl W dfsburssd ills as part of lheof the setlbmeM of fhb tnmacdon. ~/ ~ -_~ nlC ent Agent /~/~ (~~ f~'D f~G' oeto Antt DaLun, Eaqu ro WARNING: k e a aY s to knowingly make false statsme b Ns UnRSd Stabs on th4 or any otEler similar form. Penahba upon conviction can Inducts a n.,...,n w.,..4.,r,,.,..u c,,, nrss....• Tar 7a r l c rw c.n~n 7m7 .M RnrlM 7n7n RECEIPTS AND DISBURSEMENTS OF DOROTHY P. CAREW INCOME 1. Deposit $2,000.00 2. Cash at Settlement $141,558.49 Total Income $143,558.49 DISBURSEMENTS Check # Amount 1. Recorder of Deeds 2287 $2,902.00 2. RE/MAX Reaalty Associates, Inc. 2288 3,035.00 3. ERA NRT LLC 2289 4,455.00 4. Anthony L. DeLuca, Esquire, Agent for 961.88 Security Title Guarantee Corp. of Baltimore 5. First American Home Buyers 2290 399.00 Protection Co. 6. Sudden Death Termite & Pest Control 2291 689.00 7. SMTMA 2292 98.40 8. Robert C. Cairns, Tax Collector 2293 318.87 9. Estate of Ruth W. Keck 2294 130,134.34 10. Chris Wise Property Management 2295 565.00 Total Disbursements $143,558.49 REV-i5o8 EX+ (Ii-io) ~ ~ ' pennsylvania SCHEDULE E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Ruth W. Keck alk/a Ruth E. Keck 21-11-1104 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. REM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Checking account no: 9838785716-M8~T Bank (see letter attached) 7,117.83 2 Hoffman-Roth Funeral Home -partial refund of prepared funeral expenses 353.47 3 Blue Cross -premium refund 249.79 4 Furniture -proceeds from sale 1 917.00 5 Dorothy P. Carew - reimbursement for real estate taxes and homeowners association fee paid in ' advance (see settlement sheet attached to Schedule A) 614.61 TOTAL (Also enter on Line 5, Recapitulation) $ 10,252.70 If more space is needed, use additional sheets of paper of the same size. p B~ 499 Mitchell Road, Millsboro, DE 19966 Adjustment Services Phone 888-5021349 F ax (302) 934-2955 November 2, 2011 Andrews and Johnson 78 West Pomfret Street Carlisle, PA 17013 Re: Estate of Ruth E Keck Social Securit~+: 193-12-8641 Date of Death: October 8.2011 ,. . . Dear Sir or Madam: Per your inquiry on October 21, 2011, please be advised that at the time of death, the above-Warned decedent had on deposit with this bank the following: 1. Type of Account Checking Account Accoura Number 9838785716 Ownership (Names of) Ruth E Keck Viona J Nisley (POA) Opening Date 03/IOiUS Balance on Date of Death $7,117.82 Accrued Interest $ .01 Total $7,117.83 For any additional information on the above accounts, induding ownership and any changes, dosures and/or reimbursement of funds, please wll the spring Garden l)~oe at #'11'7-1A0.4575. We were unable to locate any safe deposit box for the above-mentioned decedent. Ibis Ietter does not indude any aceamts in which the deceeged may bare be® livted as Power a[ Attorney, (~Stodien of Udform Trandas, Repr+tlve Payee, or lyvstee uada a Written Agieema~t sincerely, ,~ Tammy Spencer Adjustment Services REV-1511 EX+ {SO-09) ~' ~' ~~ ';~ pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Ruth W. Keck a/k/a Ruth E. Keck 21-11-1104 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A, FUNERAL EXPENSES: L e. ADMINISTRATNE COSTS: 1. Personal Representative Commissions: 1,500.00 Name(s) of Personal Representative(s) VlOrla NlSley street address 9 Marcella Way ~;ry Carlisle state PA ztP 17015 Year(s) Commission Paid: 2012 2. Attorney Fees: 6,550.00 3. Family Exemption: ([f decedent's address is not the same as claimant's, attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4. Probate Fees: 315.50 5. Accountant Fees: 6. Tax Retum Preparer Fees: ~• Met Ed -electric bill 85.50 & The Villas -homeowners association 113.00 s Met Ed -electric bill 56.70 i o The Villas -homeowner association 113.00 11 South Middleton Twp Municipal Authority - waterlsewer 10.30 12 Med Ed -electric bill 172.87 TOTAL (Also enter on Line 9, Recapitulation) ; If more space is needed, use additional sheets of paper of the same size. SCHEDULE H -continued Funeral Expenses, Administration Costs and Miscellaneous Expenses ESTATE OF FILE NUMBER Ruth W. Keck a/k/a Ruth E. Keck 21-11-1104 13. The Villas -homeowners association 14. The Villas -homeowners association 15. Sherwin-Williams -paint 16. Met Ed -electric bill 17. Robert C. Cairns, Tax Collector - 2011 county/twp real estate taxes 18. ReMax/Jack Gaughen ERA- real estate commission 19. Recorder ofDeeds - 1 % transfer tax 20. First American Home Buyers Protection Co-buyers protection plan 21. Pest inspection to Sudden Death Termite & Pest Control -treatment 22. South Middleton Twp Authority-final water/sewer 23. Dorothy P. Carew -sellers assistance 24. Chris Wise Property Management-painting and repairs (see settlement sheet attached to Schedule A for items 11-18 above) 25. Met Ed -final electric bill 26. Register of Wills -filing fee 27. Reserve for closing and accounting $113.00 $'113.00 $66.00 $207.32 $319.87 $7,490.00 $.1,420.00 $399.00 $689.00 $98.40 $1500.00 $'565.00 $36.69 $15.00 $500.00 TOTAL (also inter on line 9, Recapitulation) $22,547.15 REV-1512 EX+ (12-08) Pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERRANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Ruth W. Keck 21-11-11Q4 RepoK debts incurred by the deeedeM prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. Il more space is needed, insert additional sheets of the same size. REV-1513 EX+ (O1-30) ~ pennsytvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE 7 BENEFICIARIES ESTATE OF: FILE NUMBER: Ruth W. Keck 21-11-1104 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 Set. 9116 (a) (1.2).] 1. Viona Nisely, 9 Marcella Way, Carlisle, PA 17015 daughter 25% 2 Jacqueline Bollew, 26 Mel-Ron Court, Carlisle, PA 17013 daughter 25% 3 Robert L. Keck, 687 Shippensburg Road, Newville, PA 17241 son 25% 4 Debbie Keck, 202 Conodoquinet Mobile Estates, Newville, PA 17241 granddaughter 6.25% 5 Jerry Anderson, 32 Center Street, Lot 30, Mt. Holly Springs, PA 17065 grandson .6.25% 6 Criss Anderson, 127 Meadow View, Dover, PA 17315 grandson 6.25% 7 Dale Anderson, PO Box 89564, Tampa, FL 33689 grandson 6.25% ENTER DOLLAR AMOUNTS FOR DISTRIBUT10N5 SHOWN ABOVE ON LINES 15 THROUG H 18 OF REV-1500 COVER SHEET, A S 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. $ If more space is needed, use additional sheets of paper of the same size.