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Home My WebLink About08-20-12J 1505610140 REV-1500 Ex `°'-'°' PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number Po sox 2aosot INHERITANCE TAX RETURN 2 1 1 1 1 3 3 0 _ Harrisburg PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDVYYV Date of Birth MMDDYYVY Decedent's Last Name Suffx Decedent's First Name MI C A L L A G H A N J A C K K (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 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 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust ~ (Attach Copy of Trust) 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-96) ;I. Remainder Return (dale of death prior to 12-13-82) :i. Federal Estate Taz Retum Required f!. Total Number of Safe Deposit Boxes 1'I. Election to tax under Sec: ~9113(A) (Attach S,ehr 0) `~~" CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTVIL TAX INFOI Name Daytime Te E L I Z A B E T H H F E A T H E R 7 1 7 REGISTER First line of address 3 6 3 1 N O R T H Second line of address City or Post Office H A R R I S B U R G P A 1 7 1 1 0 peer i -r Ln '-i a 7 rD~rr ; ~ _y. y ~ k6'IUSE _ Y -.r_ ~~' N5. _ J ~7 _~~ tV . {'TI --r -!J ~} ' D T (.ll C: DATE FILED correspondent's e-man address: efeather(o~cklegal.net Under penalties of perjury, I declare that I have examined this return, including accompanying schedules antl statements, antl to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSAN RESPONSIBLE FOR FILING RETURN DATE ADDRESS ~/ ' - 4949 BERKLEY STREET HARRISBURG PA 17109 SIGNATURE OF P~Epi(tER gTHER THAN REPRESENTATIVE _ tDATrEj 3631 NORTH FRONT STREET HARRISBURG PA 17112 PLEASE USE ORIGINAL FORM ONLY F R O N T S T R E E T State ZIP Code Side 7 1505610140 1505610140 J 1505610240 REV-1500 EX Decedent's Social Security Number Decedent's Name: JACK K. CALLAGHAN RECAPITULATION t 2 6 5 0 0 0. 0 0 1. Real Estate (Schedule A) ..................................... .... . .. 2 1 1 1 6 2 4 0, 1 4 2. Stocks and Bonds (Schedule e) ................................ .... . .. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ... .. 3. 4. Mortgages and Notes Receivable (Schedule D) .................... .... .. 4. 5. Cash, Bank De osits and Miscellaneous Personal Pro e ) p p rty (Schedule E . .... .. 5. 4 3 1 8 9 , 5 4 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested . .... .. 6. 3 7 9 5 9 8 2 7. Inter-Vivos Transfers & Miscellaneous N -Probate Property (Schedule G) ~ Separate Billing Requested . .... .. 7. $ 9 8 3 2 , 9 4 8. Total Gross Assets (total Lines 1 through 7) ..................... .... .. 8. 1 5 2 2 2 2 2, 4 4 9. Funeral Expenses and Administrative Costs (Schedule H) ............ .... .. 9. 5 1 8 2 9 . 5 4 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ....... .... .. 10. 2 9 3 7 . 6 3 11. Total Daductlons (total Lines 9 and 10) ......................... .... .. 11. 5 4 7 6 7 . 1 7 12. Net Value of Eafate (Line 8 minus Line 11) ...................... .... .. 12. 1 4 6 7 4 5 5 . 2 7 13. Charitable and Governmental BequestslSec 9113 Trusts for which an election to tax has not been made (Schedule J) ................ .... .. 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ................ .... .. 14. 1 4 6 7 4 5 5 . 2 7 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(t.2)x.o_ 0. 0 0 t5. 0. 0 0 16. Amount of Line 14 taxable at lineal rate x .045 1 4 6 7 4 5 5. 2 7 ig, 6 6 0 3 5. 4 9 17. Amount of Line 14 taxable at sibling rate X .12 0. 0 0 i7. 0. 0 0 16. Amount of Line 14 taxable at collateral rate x .ts 0. 0 0 t8. 0. 0 0 19. TAX DUE ................................................ .... .. 19. 6 6 0 3 5. 4 9 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1505610240 1!i05610240 J REV-1500 Ex Page 3 Decedent's Complete Address: Flle Number 21 11 1330 DECEDENT'S NAME JACK K. CALLAGHAN STREET ADDRESS 1002 ARMSTRONG ROAD CITY CARLISLE STATE PA ZIP 17013 Tax Payments and Credits: f. Tax Due (Page 2, Line 19) 2. CreditslPayments A. Prior Payments 65,000.00 B. Discount 3,301.77 3. Interest 4. If Line 2 is greater than Line 1 +Line 3, enter the difference. This is the OVERPAYMENT. FIII In oust on Page 2, Llne 20 to request a rotund. 035.49 Total Credits (A +EI) (2) 68,301.77 (3) (4) 2,266.28 5. If Line 1 +Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00 Make check payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred : ................................................................. ..... ^ ^X b. retain the right to designate who shall use the property transfened or its income; .. ..... X c. retain a reversionary interest; or ........................................................................................... ..... ^ d. receive the promise for life of either payments, benefits or care? .................................................. ..... ^ ^X 2. If death occuned after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration? ................................................................................. ...... ^ 3. Did decedent own an "in trust for" orpayable-upon-death bank account or security at his or her death? ... ...... ^ ^X 4. Did decedent own an individual retirement account, annuity or other non-probate property, which contains a beneficiary designation? ............................................................................................ ...... ~ ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE ~ AND FILE R AS PART OF THE RETURN. For dates of death on or after July 1, 1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only benefciary. For dates of death on or after July 1, 2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an adoptive parent or a stepparent of the child is 0 percent [72 P.S. §9116(a)(1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1502 E%+ (01-10) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAx RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE JACK K. CALLAGHAN 21 11 1330 All real properly owned solely or as a tenant In common must be reported at fair market value. Fair market value is defined as the puce 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 fads. Real properly that b lolnftyowned with rlpht of sunrNorehlp must be dlaeloaed 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 Real estate owned solely by Decedent known as 1002 Armstrong Road, Carlisle Borough Pennsylvania, which was sold on August 24, 2012 to a third party via a realtor for the sales price of $265,000. A copy of the Deed and a copy of the Settlement Statement are attached as F_xhibit 1. 265, 000.00 TOTAL (Also enter on Line 1 If more space is needed, use additional sheets of paperof the same size. REV-1503 EX + (8-9a) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS E~ BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT JACK K. CALLAGHAN 21 11 1330 All property Jointly-owned whh rlpM o(survhronhip murrl be dbclorrrrd on SeheduN F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH Morgan Stanley Smith Barney Investment Account No. 73H-C name of Decedent A copy of the date of death valuation is attached as Exhibit 2. Savings Bond TOTAL (Also enter on line 7, Recapitulation) ~ S 30.92 (If more space Is needed, Insert additional sheets of the same size) REV-1508 EX+ (11-10) Pennsylvania SCHEDULE E DEPARTMENT OE REVENUE CASH, BANK DEPOSITS, 8 MISC. RESIDENT DECEDENTTURN PERSONAL PROPERTY ESTATE OF: FILE NUMBER: JACK K. CALLAGHAN 21 11 1330 Include the proceeds of litigation and the date the proceeds were received by the estate. All property Jolndy owned whh Apht of eurvNonhlp mutt he dbelwM on SehMule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 2004 Ford Hurricane Motorhome- sold to thrid party for fair market value 31,000.00 2. 1999 Mercury Grand Marquis Automobile- sold to third party for fair market value 4,300.00 A copy of the valuations for the mobile home and car are attached as Exhibit 3. 3. Proceeds from sale of household goods and furniture sold at auction by Rowe's Auction 4,255.95 4. Family Home Medical refund 84.60 5. VA- reimbursement for burial costs 100.00 6. VFW- death benefit 250.00 7. insurance refunds 466.49 8. magazine refunds 105.49 9. AARP refund 14.37 10. Walmart refund 36.30 11. Hippensteel's RV storage refund 254.40 12. 2010 and 2011 IRS federal income tax refunds 823.40 13. 02 Concentrator sold at fair market value 1,200.00 14. gold sold to Mountz Jewelers 248.00 15. Good Sam refund 50.54 TOTAL (Also enter on Line 5, Recapitulation) S 43 189.54 If more space is needed, insert additional sheets of paperof tha same size REV-1509 Ext (01-10) Pennsylvania SCHEDULE F DEPARTMENT OF REVENUE JOINTLY•OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: JACK K. CALLAGHAN 21 11 1330 H sn easel was made Jointly owned wkhln one year of the dacedenfs date of death, h must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME(S) A. s. C. JOINTLY-lTA1NED PROPERTY: PA 17015 ADDRESS RELATIONSHIP TO DECEDENT hter ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIALINSTITUTION AND BANKACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FORJOINTLY-HELD REALESTATE. DATE DF DEATH VALUE OFABSET %OF DECEDENT'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1. A. 11/3/99 Metro Bank Checking Account No. 513130609 964.78 50. 482.39 2. A 5/24/11 Metro Bank Checking Account No. 2633768062 37,477.43 100. 37,477.43 A copy of the date of death valuation is attached as Exhibit 4. TOTAL(AlsoenteronLine6,Recapitulation)I S ,~ncnoo If more space is needed, use additional sheets of paper of the same size. REV-1510 EX+ (OB-08) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS AND MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER JACK K. CALLAGHAN 21 11 1330 This schedule must be completed and filed'd the answerto any of questions i through 4 on page three of the REV-1500 is yes. ITEM NUMBER DESCRIPTION OF PROPERTY INCLUDETHE NAME OF THE TRANSFEREE, THEIR RElAT10NSHIPTO DECEDEM AND THE DATE OF TRANSFER. ATfACHACOPV OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET °h OF DECD'S INTEREST EXCLUSION of AVCUCASI<i TAXABLE VALUE 1. Fidelity Platinum Plus 10 Individual Retirement Annuity 59,832.94 1C10.00 0.00 59,832.94 Policy No. L9153663 A copy of the date of death valuation is attached as Exhibit 5. TOTAL (Also enter on Line 7 more space is needed, use additional sheets of paper of the same s¢e. REV-1511 EX+ (10-09) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS JACK K. CALLAGHAN 21 11 1330 Deeedenl'e debts must be nported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: t. Hoffman Roth Funeral Home, honor guard, and food 9,640.36 B. 1 ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City Year(s) Commission Paid: 2. 3. a, AttomeyFees: Caldwell & Kearns Family Exemption: (If decedents address is not the same as claimanCs, attach explanatien.) Claimant Street Address City State Relationship of Claimant to Decedent Probate reel: Cumberland County Register of Wills 6 I Accountant Fees: 6. ~ Tax Ratum Preparer Feas: 3,000.00 1,050.00 7. Metro Bank- checks for estate bank account 37.75 8. Costs for cleaning out of house 4,953.91 9. Cost for preparing house for sale including paint and carpet 6,920.31 10. Lawn Care until house sold 1,016.50 11. Advertising costs for sale of personal property 481.35 12. Storage cost for RV until sold and sale costs 1,577.35 13. Executrix postage 25.35 14. Federal and state income tax preparation and tax payments 2,418.57 15. Utilities for house until sold 1,129.34 16. Settlement costs to Estate for sale of house per HUD-1 Settlement Stateiment 19,578.75 TOTAL (Also enter on line 9, Recapitulation) S 51.829.54 State ZIP ZIP If more space is needed, use addftional sheets of paper of the same size REV-15t 2 Ex+ (~ p.08) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TA%RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES, S LIENS JACK K. CALLAGHAN 21 11 1330 Report debts Incurred by the deadard prlorto death lhst remained unpaid at the date of death, Including unrelmbuned medial expanses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH Medical bills 2. Attorney fees for Adminsitration of Estate of Velma Callaghan 1,321.19 1,616.44 TOTAL (Also enter on Line 10, Recapitulation) I E If more space is needed, insen additional sheets of the same size. REV-1513 EXa (°t-1 °) Pennsylvania ~ SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILF. NUMBER: JACK K. CALLAGHAN 21 11 1330 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 Ilndude outright spousal distributions and transfers under Sec. 9116 (a) (1.2).) 1. Mary A. Callaghan Lineal 4949 Berkley Street 25% Harrisburg, PA 17109 2. Kathleen C. Zarnowski Lineal 250 Campground Road 25% Carlisle. PA 17015 3. William H. Callaghan Lineal 848 Hays Circle 25% Longmont, CO 80501 4. Patricia C. Miller Lineal 2988 Weber Road 25% Chambersburg, PA 17201 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF RE\/-1500 COVER S HEET, AS APPROPRIATE. II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: TOTAL Of PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. S If more space is needed, use additional sheets of paper of the same size. REV-1500 Discount, Interest and Penalty Worksheet Discount Calculation Total Amount Paid within three calendar months of the decedent's date of death: 65.000.00 Discount: 3 301.77 Interest Table Year Days Delinquent this time period Balance Due this year Interest this period Before 1sa1 1a8z 1883 1884 1985 1986 1987 1988 through 1991 __. 1992 1993 throw h 1894 1885 throw h 1998 _ 1898 2000 2001 2002 2003 2004 2005 2008 2007 2008 2009 2010 2011 throw h 2012 I TOTALS Penalty Calculation If the decedent's date of death was on or before March 31, 1993, insert the applicable amount: Total Balance Due on January 17, 1996: Penalty: Last Will and. Testament of ,LACK K. CALLAGHAN 1, JACK IC CALLAGHAN, oTCarlisle, Cumberland County, Pennsylvania, do make, publish and declare this to be my Last Will and "Testament, hereby revoking all Wills and Codicils by me at any time made. ITEM I: 1 direct that all my just debts raid funeral expenses be paid as soon after my decease as may be practicable. I"fEM II: Al] the rest. residue and remainder of my property and estate, both real and persona}, of whatsoever kind and wheresoever situated. which I may own at the time of my death, I give, devise and bequeath unto my wife; V1LMA C. CALLAGHAN, provided she survives me by more than thin:y (30) days. ITEM III: In the event my wife shall not survive me by more than thirty (30) days, I then give, devise and bec}ueath all the rest residue and remainder of my property and estate to my children, MARY .ANN CALLAGHAN. KATHLEEN C. ~ARNOWSKI, WILLIAM H. CALLAGHAN and PATRICIA C. MILLER, in equal shares, share and share alike, or to their living issue per stirpes. 1"fI:M IV: I hereby nominate, constitute and appoint my wire, VELMA C. CALLAGHAN, to be the Executrix of my estate. In the event that my wife shall not survive me, or shall otherwise fail to qualify as Executrix, 1 then nominate, constitute and appoint my daughters, MART ANN CALLAGHAN and KAT7-II,EEN C. ZARNOWSI<I, to serve as alternate co-Executrices to serve in her place and stead. 1 direct that neither my Executrix nor my alternate Executrices shall be required to give a bond for the performance of duties in this or any other jurisdiction. __ Yage 1 ~._ . ~, IN WITNESS WHF,REOP, I, JACK K. CALLA~GHAN, the Testator, have to this my Last Will and Testament, written on one side only of iwo (2) sheets oi'paper, set my hand and sea] this ~ ~' day of ~ ~^-'~--ti , 2007. .~ f 7 c~S);AL) ""G~ACK K. CALLAiJHA- Signed, sealed, published and declared as and for the Last Will and Testament of the "Testator, in our presence, who in his presence, and in the presence of each other, and at his request, have hereunto sei our hands and seals as subscribing witnesses. ~~ ~~"` 9 residing at 2 ~- 2 (,u ~/.,,..~ ~< C...~, H, ii ~~ ~~o,~ ~~(~ residing at //~ ,LUC.~NOt~ /P.4o~ ~Yf7~~P.6S.~.@~. ~i7 Page 2 COMMONWEALTH OP PENNSYLVANIA COUN"1"Y OE DAUPI-U1~ SS.: The Testator and the witnesses whose names are subscribed to the foregoing instrument, being first duly sworn and qualified according to law, do hereby aclozowledge and declare to the undersigned authority that the Testator signed and executed the instrument as his last Will in the presence of the ~n~itnesses, that he signed willingly or willingly directed another to sign for hvn, that he executed ii as his tiee and volurttary act for the purposes therein expressed, that each of the witnesses, in the presence and hearing of the "testator, signed the Will as witnesses, and that to the best of their knowledge, the Testator was at that time eighteen years of age or older, of sound mind and tinder no constraint or undue influence. Sworn to, subscribed and acknowledged before me by the above named Testator and witnesses this -7 rh day of Yyovc„-,tiei __ , 2007. Notary Public COMMONWEALTH OF PENNSYLVANIA 124702 McNas M.. Lurea, N~oWry WbFc Susquehanna Twp, DauPnin Caunty My Ctxmnlsslort E>r~ Oct. 13, 2011 Member, Pennaylvanla AssoGatlon of Notanes Page 3 - ~ ~ - Tstator EXECUTOR'S DEED TAX PARCEL NO. OS-19-1649-146 Made the l o~ day of August, 2012, BETWEEN MARY A. CALLAGHAN, Executrix of the ESTATE OF JACK K. CALLAGHAN, herein designated as the Grantor, AND TONY N. DEN HOED and ANGELA T. DEN HOED, husband and wife, herein designated as the Grantees, WHEREAS, the said Velma C. Callaghan died on May 4, 2011. WHEREAS, the said Jack K. Callaghan died on December 3, 2011. WHEREAS, the Register of Wills of Cumberland County, Pennsylvania, duly granted Letters Testamentary to Mary A. Callaghan, the Grantor herein, on January 18, 2012 and filed to No. 21- 11-01330, thereby granting her authority to grant and convey interest in s~~id premises pursuant to Section 3351 of the Pennsylvania Probate, Estate and Fiduciary Code (20 Pa.C.S.A., Section 3357). WITNESSETH, that the Grantor, for and in consideration of TWO HUNDRED AND SIXTY- FIVETHOUSAND DOLLARS ($265,000.00) lawful money of the United States of America, to the Grantors in hand well and truly paid by the Grantees, at or before the sealing and delivery of these presents, the receipt whereof is hereby acknowledged and the Grantors being therewith fully satisfied, do by these presents grant, bargain, sell and convey unto t}ie Grantees forever, their heirs and assigns, as tenants by the entireties ~x Y I ALL THAT CERTAIN tract of land situate in the Borough of Cazlisle, Cumberland County, Pennsylvania, more fully described as Lot No. 46 of the Final Subdivision Plan for Phase I of Tire Highlands, prepared by Stephen G. Fisher, R.S., dated July 5, 1988 and recorded in Cumberland County Plan Book 56, Page 43 and being more fully bounded and described as follows, to wit: BEGINNING at a point on the southern dedicated right of way line of 60 foot wide Armstrong Road at the dividing line between Lots Nos. 45 and 46 on the aforementioned subdivision plan; thence along said right of way line by a curve [o the left with a radius of 150.00 feet an arc distance of 20.61 feet to a point, thence along same North 75 degees 11 minutes 15 seconds East 78.35 feet to a point; thence by a curve to the right with a radius of 15.00 fa;et an azc distance of 23.56 feet to a point on the western dedicated right of way line of Meeting House Spring Road, thence along said right of way line South 14 degrees 48 minutes 45 seconds East 100.00 feet to a point; thence along the dividing line between Lots Nos. 33 and 46 on said Plan South 75 degrees 11 minutes I S seconds West 127.28 feet to a point, thence along the dividing line between Lots Nos. 45 and 46 on said plan North 08 degrees 15 minutes 08 seconds West 116.94 feet to a point, the Place of BEGINNING, HAVING THEREON erected a dwelling being known and numbered as 1002 Armstrong Road, Carlisle, Pennsylvania. UNDER AND SUBJECT, nevertheless, to any conditions, easements, res~sictions, reservations and rights of way of recorder or that which a survey or physical inspection of the premises would disclose. WHEREAS, BEING the same premises in which Dorothy A. Ross and Samuel D. Ross, Jr., wife and husband, by their Deed dated and recorded on September 30, 1997 in the Office of the Recorder of Deeds in and for Cumberland County, Pennsylvania in Deed Book 165, Page 289, granted and conveyed unto Jack K. Callaghan and Velma C. Callaghan, as tenants by the entireties. TOGETHER with all and singular the buildings, improvements, ways, woods, waters, watercourses, rights, liberties, privileges, hereditaments and appurtenances to the same belonging or in anywise appertaining; and the reversion and reversions, remainder and remainders, rents, issues and profits thereof, and of every part and parcel thereof; AND also all the estate, right, title, interest, use, possession, property, claim and demand whatsoever of the Grantors both in law and in equity, of, in and to the premises herein described and every part and parcel thereof with the appurtenances. TO HAVE AND TO HOLD all and singular the premises herein described together with the hereditaments and appurtenances unto the Grantees and to Grantees' proper use and benefit forever. AND the Grantor covenant that, except as maybe herein set forth, they do and will FOREVER SPECIALLY WARRANT AND DEFEND the lands and premises, hereditaments and appurtenances hereby conveyed, against the Grantors. In all references herein to any parties, persons, entities or corporations, the use of any particular gender or the plural or singular number is intended to include the appropriate gender or number as the text of the within instrument may require. Wherever in this instrument any party shall be designated or referred to by name or general reference, such designation is intended to and shall have the same effect as if the word "heirs, executors, administrators, personal or legal representatives, successors and assigns" had been inserted after each and every such designation. IN WITNESS WHEREOF, the Grantor has hereunto set her hands and seals the day and year first above written. SIGNED, SEALED AND DELIVERED in the presence of o TTESTED by ITNNE S /y~~+12 ~9G MARY CALLA HAN, Executrix Of the Estate of Jack K. Callaghan COMMONWEALTH OF PENNSYLVANIA, COUNTY OF ~ :ss BE IT REMEMBERED, that on August ~, 2012, before me, the subscriber, personally appeared, MARY A. CALLAGHAN, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within deed and acknowledged that she executed the foregoing Fiduciary Warranty Deed in her capacity as Executrix of the Estal:e of Jack K. Callaghan, deceased, as stated therein, for the purposes therein contained WITNESS my hand and seal the day and yeaz aforesaid. NOTARY PUBLIC ~ ~ J - Notr d Sal Kathy L. Mummert, NoLtY Public My Commission Expires: ~ ,arlisle Borough, (~twrlaod County, PA (SEAL) My Commisatoa E•xpirae August ] 1, 2015 The undersigned certifies that the precise residence' and complete post office address of the Grantees is: ~nUU acQ L~~ 9o i 3 i~~ ~ "~~j '° A. Settlement Statement (HUD-1) OMB Approval No. 2502-0265 be ~Ii~jlll B. 'type of Loan 1_^ FHA 2.^ RHS 3.O Conv. Unins 4.D VA 5.^ Conv. ins 6. File Number: RE12-201 7. Loan Number: 293848909 8. Mortgage Insurance Case Number; C. Note: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "(p.o. c.)" were paid outside the closing; they are shown here for informational purposes and are not included in the totals. D. Name & Address of Borrower: Tony N. den Hoed Angela T. den Hoed 9067 N. Westbrook Court Maize, KS 67101 E. Name & Address of Seller: Estate of Jack K. Callaghan 1002 Armstrong Road Carlisle, PA 17013 F. Name & Address of Lender: Bank of America 7105 Corporate Drive Plano, TX 75029 G. Property Location: 1002 Armstrong Road Carlisle Borough Carlisle, PA 17013 H. Settlement Agent: Orchard Settlement Services, LLC 1 Irvine Row, Suite B Carlisle, PA 17013 TIN: Phone: (717) 299-7867 Parcel: OS-19-1697-196 County: Cumberland Place of Settlement: 1 Irvine Row, Suite B Carlisle, PA 17013 I. Settlement Date: 8/10/2012 Funding Date: 8/10/2012 J. Summary of Borrower's Transaction K. Summary of Seller's Transaction 100. Gross Amount Due From Borrower 400. Gross Amount Due To Sf!Iler 101. Contract sales price 265, 000.00 401. Contract sales price 265, 000.00 102. Personal property 402. Personal property 103. Settlement charges to borrower (line 1400) 17, 052.98 403. 104. 404. 105. 405. Adjustments for items paid by seller in advance Adjustments for items paid by seller in advance 106. City/town taxes: 406. City/town taxes: to to 107. County taxes:8/10/2012-12/31/2012 562.73 407. County taxes: 8/10/2012-12/31/2012 562.73 to to 108. Assessments: 408. Assessments: to to 109. 409. 110. 410. 111. 411. 112. 412. 120. Gross Amount Due From Borrower 282, 615.71 420. Gross Amount Due To Seller 265, 562.73 200. Amounts Paid By Or In Behalf Of Borrower 500. Reductions In Amount Due To Seller 201. Depositor earnest money 3, 500.00 501. Excess deposit (see instructions) 202. Principal amount of new loan(s) 212, 000.00 502. Settlement charges to seller (line 1400) 17, 100.36 203. Existing loan(s) taken subject to 503. Existing loan(s) taken subject to 204. 504. Payoff of first mortgage loan 505. Payoff of second mortgage loan L Settlement Charges File Number: RE12-201 Loan Number 293898909 700. Total Real Estate Broker Fees Paid From Paid From Division of Commission {line 700) as follows: Borrower's Seller's 701. $7, 950.00 to Century 21: A Better Way Funds at Funds at 702. $7, 950.00 to Hooke, Hooke b Eckman Settlement Settlement 703. Commission paid at settlement 15, 900.00 704. 800. Items Pa able In Connection With Loan 801. Our origination charge $ (from GFE: #1) 802. Your credit or char a oints) for the specific interest rate chosen $1, 855.00 from GFE: #2 803. Your adjusted origination charges (from GFE A) 1, 855.00 804. Appraisal fee to Landsafe Appraisal Services (from GFE: #3) 405.00 805. Credii report to Landsafe Credit, Inc. (from GFE:#3) 35.00 806. Tax service to BAC Tax Service Corp. (from GFE:#3) 89.00 807. Flood certification to Landsafe Flood Determination (from GFE: #3 26.00 808. 809. 810. 811. 900. Items Re ulred B Lender To Be Paid In Advance 901. Daily interest charges from 8/10/2012 to 9/1/2012 @ $18.88/day (from GFE #10) 915.36 902. Mortgage insurance premium for 0 months to (from GFE: #3) 903. Homeowners insurance for 1 years to USAA from GFE #11) 1, 920.15 904. 905. 1000. Reserves De osiled Wlth Lender 1001. Initial de osit for our escrow account from GFEI #9 1, 631.99 1002. Homeowner's insurance 3 months @ 118.35 per mo $355.05 1003. Mortgage insurance months @ per mo $ 1004. Property taxes 7 months @ 139.72 per mo $993.09 1005. School taxes 3 monlhs@ 290.96 per mo $872.88 1006. months @ er mo $ 1007. A re ate Ad'ustment $-538.98 1100. Title Char es 1101. Title services and lender's title insurance (from GFE #4) 1, 959..00 1102. Settlement or closing fee 1103. Owner's title insurance Old Republic Title Co. (from GFE #5) 265.00 1104. Lender's title insurance Old Republic Title Co. $1, 960.00 1105. Lenders title policy limit $212, 000.00 1106. Owner's title policy limit $265, 000.00 1107. Agent's portion of the total insurance premium $1, 593.75 1108. Underwriters portion of the total insurance premium $281.25 1109. End. 100, 300, 8.1 to Old Republic Title Company $150.00 1110. Closing Protection Ltr to Old Republic Title Company $75.00 1111. TOtal from addendum $279.00 160.00 +~nn r;overnmen[ Recordlnq and Transfer Charges Charges That Cannot Increase HUD-1 Llne Number Our origination charge #801 Your credit or charge (points) for the specific rate chosen #802 Your adjusted origination charges #803 Transfer taxes #1203 Government recording charges #1201 Appraisal fee #804 Credit report #805 Tax service #806 Flood certifcalion #807 Initial deposit for your escrow account #1001 Daily interest charges #901 Homeowner's insurance #903 Title services and lender's title insurance #1101 Owner's title insurance #1103 Loan Terms _ i ;_ ~t. ~ __.l I~ ~~, 595 .00 0. 00 1,855. 00 1,855. 00 2,450. 00 1,655. 00 5,300, 00 5,300. 00 € _ ~$.~. 210. 00 ~ ~i. ~ 160. 00 405. 00 405. 00 35. 00 35 .00 89. 00 89. 00 26. 00 26. 00 r 765.00 715.00 C -50.00 or -6.598 2,951 .00 1,631 .99 151 .09 915 .36 809 .00 1,420. 15 523 .38 1,959. 00 1,733. 75 265. 00 Your initial loan amount is $212, 000.00 Your loan term is 30 Years Your initial interest rate is 3.250% Your initial monthly amount awed for principal, interest, and $922.64 includes any mortgage insurance is O Principal ~ Interest ^ Mortgage Insurance Can your interest rate rise? O No. O Yes, it can rise to a maximum of %. The frst change will be on and can change again every afl:er . Every change date, your interest rate can increase or decrease by %. Over the life of the loan, your interest rate is guaranteed to never be lower than %or higher than %. Even if you make payments on time, can your loan balance rise? ~ ~ No. ~ Yes, it can rise to a maximum of $ . ' Even if you make payments on time, can your monthly O No. O Yes, the first increase can be on and the monthly amount amount owed for principal, interest, and mortgage insurance rise? owed can rise to $ . T._ ................ a ..~., a„o. .,tee r,. ,~ x ADDENDUM PAGE for HUD-1 Name and Address of Additional Borrower(s) Name and Address of Additional Seller(s) 1100. Title Charges (Addendum) 1112.NOtary fee $20.00 10.00 1113.Overnight fee to Orchard Settlement Services $15..00 0.00 1119.Emai1 fee to Orchard Settlement Services $90.00 0.00 1115.Wire fee to Orchard Settlement Services $29..00 0.00 1116.Attorney fees to Duncan & Hartman, PC $175..00 0.00 1117.Deed prep to Century 21 $0..00 150.00 Total $279..00 160.00 CERTIFICATION: I have carefully reviewed the HUD-1 Settlement Statement and to the best of my knowledge and belief, it is a true and accurate statement of all receipts and disbursements made on my account or by mein this transaction. I further certify that I receiv[~d a copy of the HUD-1 Settlement Statement. Estate Valuation Date of Oea*_h: 12/03/2011 Estate of: Estate of Jack Callaghan Valuation Date: 12/03/2011 Account: 73H-02222 Processing Date: 12/29/2011 Report Type: Date of Death Number of Securities: 23 File ID: Callaghan holdings Shares Security Mean. and/or Div and Int Security or Par Description High/Ask Low/Bid Adjustments Accruals Value 1) 56 ZL0.6 Cash (CASH) 56,710. 60 2) 100 BUCKEYE PARTNERS L P (118230101) UNIT LTD PARTN New York Stock Exchange 12/02/2011 65.05000 63. 85000 H/L 12/05/2011 64.33000 63. 33000 H/L 69,.190000 6,414. 00 3) 100000 ALLEGHENY CNTY PA HIGHER ED BL (0172BRFG9) Financial Times Interactive Data DTD: 06/19/2008 Mat: 03/01/2019 4.375& 12/02/2011 108. 64900 Mkt 12/05/2011 108. 76500 Mkt 10f1.707000 108,707. 00 Int: 09/01/2011 to 12/03/2011 1,118.06 4j 35000 ALLEGHENY CNTY PA (01728VKJ8) Financial Times Interactive Data DTD: 08/12/2009 Mat: 11/01/2029 5& 12/02/2011 102. 75300 Mkt 12/05/2011 102. 81900 Mkt 102.786000 35,975 .10 Int: 11/01/2011 to 12/03/2011 155.56 5) 35000 ALLENTCWN PA WTR REV GTD (0184791CD6) Financial Timea Interactive Data DTD: 09/01/2004 Mat: 10/01/2018 4$ 12/02/2011 102 .51500 Mkt 12/05/2011 102 .56700 Mkt 102.541000 35,889 .35 Int: 10/01/2011 to 12/03/2011 241.11 6) 95000 CUFIDERLAND CNTY PA MUN AUTH CO (23061NBX4) - Financial Times Interactive Data - DTD: 06/01/2007 Mat: 05/01/2037 4.5& 12/02/2011 97 .33700 Mkt 12/05/2011 97 .48300 Mkt 97.910000 92,539 .50 Int: 11/01/2011 to 12/03/2011 380.00 71 20000 DANIEL BOONE PA AREA SCH DIST (236222ET8) Financial Times Interactive Data DTD: 08/15/2008 Mat: 08/15/2032 6& 12/02/2011 104 .85500 Mk[ 12/05/2011 104 .91300 Mkt 104.884000 20,976 .80 Int: 08/15/2011 Ito 12/03/2011 300.00 8) ::5000 DEER LAKES SCH DIST PA (243859HN8) Financial Times Interactive Data DTD: 02/26/2009 Mat: 04/01/2034 5.375& 12/02/2011 107 .98300 Mkt 12/05/2011 108 .04600 Mkt 108.014500 27,003 .63 Int: 10/01/2011 to 12/03/2011 231.42 Page 1 Please be aware of the following important information: The attached valuation provides you with the value of the assets of the estate shown on page 1 of this document held through Morgan Stanley Smith Barney LLC, member SIPC (MSSB) as of the date shown on page 1 of this document. The valuation is provided to you ua ing softwax'e by Estate Valuations and Pricing Systems, Inc. (EVP), a separate company Chat is not part of MSSH. MSSB provides tY..e EVP service to you at cost. The references to EVP should in no way be considered to be an endorsement of EVP by MSSE~. The purpose of this valuation is solely to assist you in preparing required eat ate (Form 706) and gift tax returns for' submission to the Internal Revenue Service. This report ie not an official acconfat statement and while it may contain data regarding income, liabilities, capital gains and losses, it is not an official tax statement. Please refer to the ox'iginal statement for current account information and any Form 1099.9 and related materials. All data is believed to be reliable, however, i[ is not guaranteed for accuracy, or completeness. MSSH and its affiliates do not provide tax or legal. advice. To the extent that this material or any attachment concerns tax mattes, it is not intended to be ueed and cennot be used by a taxpayer for the purpose of avoiding penalties that may be imposed by law. Any such taxpayer should seek advice based on the taxpayer's par[icular circumstances from an independent tax advisor. Acceae to this information by MSSB, and your FA, does not imply or create new or additional duties to you, new or additional knowledge or information about you, your relationships or your accounts i ~~ X~~ z Date of Death: 12/03/2011 listate of: Estate of Jack Callaghan Valuation Date: 12/03/2011 Account: 73H-02222 Processing Date: 12/29/2011 Report Type: Date of Death Number of Securities: 23 File ID: Callaghan holdings Shares Security Mean and/or Div and Int Security or Par Description High/Ask Low/Bid Adj uatmenta Accruals Value 9) 25000 DISCOVER BK GREENWOOD DEL (25969JBH1) Financial Times Interactive Data DTD: 03/19/2008 Mat: 03/19/2012 9k 12/02/2011 100. 98870 Mkt 12/05/2011 100. 98050 Mkt 100.989600 25,296.15 Int: 09/19/2011 to 12/03/2011 205.56 10) 4',1000 JONNSTOWN PA REDEV AUTH SWA RE (979694AY7) Financial Times Interactive Data DTD: 11/01/2004 Mat: 08/15/2023 4.5& 12/02/2011 110. 94300 Mkt 12/05/2011 110. 43200 Mkt 110.437500 49,696.88 Int: 08/15/2011 to 12/03/2011 607.50 11) 120000 JOHNSTOWN PA REDEV AUTH SWR RE (479694AZ4) Financial Times Interactive Data DTD: 11/01/2004 Mat: 08/15/2023 4.5& 12/02/2011 104. 41400 Mkt 12/05/2011 109. 98900 Mkt 109.451500 125,341.80 Int: 08/15/2011 to 12/03/2011 1,620.00 12) 35000 KISRI PA AREA SCH DIST (497752EE1) Financial Times Interactive Data DTD: 03/15/2003 Mat: 03/01/2025 4.75& 12/02/2011 102 .92200 Mkt 12/05/2011 102 .95200 Mkt 102.937000 36,027.95 Int: 09/01/2011 to 12/03/2011 424,86 13) 25000 LANCASTER PA (514282QN5) Financial Times Interactive Data DTD: 05/01/2009 Mat: 05/01/2028 4.7& 12/02/2011 104 .83400 Mkt 12/05/2011 105 .02900 Mkt 104!.931500 26,232.88 Int: 11/01/2011 to 12/03/2011 104.49 14) 20000 PENNRIDGE PA SCH DIST (708349AJ6) Financial Times Interactive Data DTD: 03/15/2003 Mat: 02/15/2017 4.35t 12/02/2011 103 .87600 Mkt 12/05/2011 103 .87900 Mkt 103.877500 20,775.50 Int: 08/15/2011 to 12/03/2011 261.00 15) 50000 PENNSYLVANIA BT (7091416Q3) Financial Times Interactive Data DTD: 12/21/2006 Mat: 03/01/2026 4.58 12/02/2011 105 .67100 Mkt 12/05/2011 105 .76600 Mkt 103.718500 52,859.25 Int: 09/01/2011 to 12/03/2011 575.00 Page 2 Please be aware of the following important information: The attached valuation provides you with the value of the assets of the estate shown on page 1 of this document held through Morgan Stanley Smith Barney LLC, member SIPC (MSSB) as of the date shown on page 1 of this document. The valuation is provided to you using software by Estate valuations and Pricing Systems, Inc. (EV% , a separate company that is not part of MSSB. MSSB provides the EVP service Co you a[ cost. T71e references to EVP should in no way be considered to be an endorsement of EVP by MSSB, The purpose of this valuation is solely to assist you in preparing required ea rate (FOxm 706) and gift tax returns fox submission to the Internal Revenue Service. This report is not an official account statement and while it may contain data regarding income, liabilities, capital gains and losses, it is not an official Cax statement. Please refer Co the original statement for current account information and any Form 1099's and related materials. All data is believed to be reliable, however, it is not guaranteed for accuracy, or completeness. MSSB and its affiliates do not provide tax or legal advice. To the extent that this material or any attachment concerns tax matters, it is not intended to be used and cannot be used by a taxpayer for the purpose of :avoiding penalties that may be imposed by law. Any such taxpayer should seek advice based on the taxpayer's particular circumstances from an independent tax advisor. Access to this information by MSSB, and your FA, does not imply or create new or additional duties to you, new or additional knowledge or informal icn about you, your relationships or your accounts Date of Death: 12/03/2011 Valuation Date: 12/03/2011 Processing Date: 12/29/2011 Shares Security or Par Description igh/Ask ow/Bid Estate of: Eet ate of Jack Callaghan Account: 73H-02222 Report Type: Date of Death Number of Securities: 23 File ID: Callaghan holdings Mean and/or Div and Int Security Adjumtments Accruals Value 16I 3°1000 PENNSYLVANIA ST HIGHER EDL FAC (70917RMC6) Financial Times Interactive Data DTD: 07/01/2007 Mat: 06/15/2032 5& 12/02/2011 105. 01100 Mkt 12/05/2011 105. 06000 Mkt 105.035500 36,762.43 Int: 06/15/2011 to 12/03/2011 816.67 17) 20000 PENNSYLVANIA ST TPK COMA OIL (709221JY2) Financial Times Interactive Data DTD: 08/01/1998 Mat: 12/01/2027 4.756 12/02/2011 100. 03400 Mkt 12/05/2011 100. 03700 Mkt 100.035500 20,007.10 Int: 12/01/2011 Co 12/03/2011 5.28 18) 3!i000 PITTSBURGH PA WTR & SWR AUTH W (725304NMB) Financial Times Interactive Data DTD: 09/15/2003 Mat: 09/01/2023 4.75& 12/02/2011 103. 69200 Mkt 12/05/2011 103. 68800 Mkt 103.665000 36,282.75 Int: 09/01/2011 to 12/03/2011 424.86 19) 25000 PLUM BOAO PA SCH DIST (729212RW9) Financial Times Interactive Data DTD: 09/01/2005 Mat: 09/15/2027 4.56 12/02/2011 101 .09700 Mkt 12/05/2011 101 .06200 Mkt 101.054500 25,263.63 Int: 09/15/2011 to 12/03/2011 243.75 20) 100000 POCONO MTN PA SCH DIST (730436E73) Financial Times Interactive Data DTD: 07/27/2009 Mat: 03/01/2032 St 12/02/2011 102 .96300 Mkt 12/05/2011 103 .00400 Mkt 10::.983500 102,983.50 Int: 09/01/2011 to 12/03/2011 1,277.78 21) 40000 WESTMORELAND CNTY PA (960895UZ1) Financial Times Interactive Data DTD: 01/15/2003 Mat: 12/01/2016 4,2& 12/02/2011 102 .92200 Mkt 12/05/2011 102 .91700 Mkt 10:?.919500 41,167.80 Int: 12/01/2011 to 12/03/2011 9.33 22I 100000 WESTMORELAND CNTY PA MUN AUTH (961017MV9) Financial Times Interactive Data DTD: 11/01/2006 Mat: 08/15/2025 4.25& 12/02/2011 103 .12600 Mkt 12/05/2011 103 .21100 Mkt 103.168500 103,168.50 Int: 08/15/2011 to 12/03/2011 1,275.00 Page 3 Please be aware of the following important infoxmation: The attached valuation provides you with the value of the assets of the estate shown on page 1 of Chia document held through Morgan Stanley Smith Barney LLC, member SIPC (MSSB) ae of the date shown on page 1 of this document. The valuation is provided [o you using software by Estate Valuations and Pricing Systems, Inc. (EVP), a separate company that is not pact of MSSB. MSSB provides the EVP service to you a[ coat. The references to EVP should in no way be considered io be an endorsement of EVP by MSSB. The purpose of Chia valuation is solely to assist you in preparing required estate (Form 706) and gift tax returns for eubmiesion to the Internal Revenue Service. Tlzis report ie not an official account statement and while it may contain data regarding income, liabilities, capital gains and losses, it ie not an official tax statement. Please refer to the original statement for current account information and any Form 1099's and related materials. All data is believed to be reliable, however, it is not guaranteed for accuracy, or completeness. MSSB and its affiliates do not provide tax or legal advice. To the extent that this material or any attachment concerns tax matters, it is not intended to be used and cannot be used by a taxpayer for the purpose of avoiding penalties that may be imposed by law. Any such taxpayer should seek advice based on the taxpayer's particular circumstances from an independent tax advisor. Access to this infoxmation by MSSB, and your FA, does not imply or create new or additional duties to you, new or additional knowledge or information about you, your relationships ox your accounts Date of Death: 12/03/2011 Valuation Date: 12/03/2011 Processing Date: 12/29/2011 Shares Security or Par Description 23) 20000 YORK CNTY PA (986370H56) Financial Times Interactive Data DTD: 10/01/2010 Mat: 03/01/2031 9& 12/02/2011 12/05/2011 Int: 09/01/2011 to lz/o3/z all Total Value: Total Accrual: Total: $1,116,209.22 High/Ask Low/Bid 98.91200 Mkt 98,59300 Mkt E:st ate of: Estate of Jack Callaghan Account: 73H-02222 Report Type: Date of Death Number of Securities: 23 File ID: Callaghan holdings Mean and/or Div and Int Security Adjustments Accruals Value 9E ,977500 204.44 19.695.50 $1,105,727.60 $10,481.62 Page 9 Please be aware of the following important information: The attached valuation provides you with the value of the assets of the estate shown on page 1 of this document held through Morgan Stanley Smith Barne;r LLC, member SIPC (MSSB) as of the date shown an page 1 of this document. The valuation is provided to you using software by Estate Valvat ions and Pricing Systems, Inc. (EVP), a separate company that is not part of MSSB. MSSB provides the EVP service to you at coat. The references to EVP should in no way be considered to be an endorsement of EVP by MSSB. The purpose of this valuation is solely to assist you in preparing required estate (Form 706) and gift tax returns for submission to the Internal Revenue Service. This report ie not an official account statement and while it may contain data regarding income, liabilities, capital gains and losses, it ie not an official tax statement. Please refer to the original statement for current account information and any Form 1099's and related materials. All data ie believed Co be reliable, however, it is not guaranteed for accuracy, or completeness. MSSE and its affiliates do not provide tax or legal advice. To the extent that this material or any attachment concerns tax matters, i[ is not intended to be used and cannot be used by a taxpayer for the purpose of avoiding penalties that may be imposed by law. Any such taxpayer should seek advice based on the taxpayer's particular circumstances from an independent tax advisor. Access to this information by MSSB, and your FA, does no[ imply or create new or additional duties Co you, new or additional knowledge or information about you, your relationships or your accounts ~~--- i/!/~. Body Style BILL OF SALE ~~~ ~ , Make M del _~ UVi'E do hereby sell to . s D~ = . For the total sum.of $- ~ ba ~ , whrcb~lras been received.. This sum represents the mutually agreed upon purchase price of then vehic ~ ~e buyer(s) andthe seller(s). The reason the: vehicle may be purohased for a price less ilran d]e fair market value is as follows. Uwe certify Hader penalty of per}nry,that tbestatements nee ~ tree and correctto the best of my/onr lmowhs>ge, information and belief, I understand that giving a false statement(s) is a misdemeanor and snbjed to 5nes not exceeding 5500.00, imprisonment for not more than 2 months, or both. This~(Li -dayof~-(Y~~' ~ This /(n day of~` ~/`~(y )°~.~-( ~~ Seller(s) snignatme(sj Buyers(s) si~gnatrne~s(s) ' '--~_- Seller(s) printed names(s) Buyers(s)`printed names(s) pp~~~ /1 /~ r otary P c signatur~ ` - My commissi expue~ ~ ~U~.J CAMMONWEALTH Of PENNSYLVANIA Ndanal Seal Beverty D. Sanders, Notary Public - - SG Thomas Twp., Franldln County ' -- - - _ - My CpnmL~lon Expires ]an. 7, 211r7 Member: PennsvManla AsSOdatlon of~Notarle5 v ~xl~ ~ ~ 1~rrsday of~~~, `1 /1 / `l ~ No: ~~6'752 N1'L031U-:;?~2.1i-UU0647~ .. A PATITLF. NUMBER (A SHOWN ON ATTACHED 11TLE) ~ MAKE OF VENICE[ MODEL YEAR pURGFJASE PRICE ) / C / '~ ~ I (Sae Nole an Havaree.) ~ A z U VENICE[- IOENUIFICATIOIJ NUMBER ~ CONDITI ON ~ ° ( ~ i // / - ~~ \ ; ~ ~ ( h l i ; a ~ •• / GV ~ n- R ^ POOR ~ LEB6'FRADEIN ; ; I ~ c ~, . B LAST~NAME (CIR FULL BUGINEGS NAME) FIRST NAME MIDDLE NAME W TA%AEILE AMOUNT m COSELLER 1. SALES TA%DUE / /; O X 6Y•(A61,XT%. (0])OH V C LAST IJAME (Oli FULL BUSINESS NAME) FIRST NAME MIDDLE NAME PA UL/PHOTO IDq DATE OF BIRTH *OS°~J O ! ~ ' oR B US IDu N Ia ar RevarseJ ~ J (- / ~ // _ ~ 7 G' ~~l ~ ~T P ~ L' ~/ ~ ~ C~ I ,., t~ 4 ~ ~ x~ i ~ / l/ L. r . ~~ I JC Z- /< /"r L EASI]N CdDE'~YLe I ~ ' . ~ i CO-PURCHASER LAST N E FIRST NAME MIDDLE NAME PAUL/PHOTO LDP ATE 0 BIRTH bal,a pl4flbpl froKl)110 'll f+ / I ~.~ i~ K _ 2S0/C 1 - y ~~/ .{/ i ~ / ~r ~, /l ~ L ~ /''7 ,/ / ! G'G Z l ' ! ~ ~ J ~ i ! ~ T "T / S I eBi FIRST ;. 1& SECON O7 4^'B T / / : ! / ~ / l ASSIGNMENT r ASSIGNME NT, -' ~ n STREET COUNT Y CODE EXEMPTION NO E%EMPTION NO "~~ r ~ / ~ /Sox /3//3 /GC ~r ~` / l, ~~ / , v,,. . ~ 2. TITLE FEE ~ / ~ CITY STATE ZIP CODE DATE ACOUIREDI REFER TO COUNTY CODES .~ ~/'. ~ J PURCHASED RBE SIDE Y ~ ~~~~ / ~/ ~ ~ ELLOW COP OF ~/l j [Ar C L ~ LIEU FEE D LAST NAME (OR FULL BUS E55 NAME) FIRST NAME MIDDLE NAME PA DLIPHOTO IDH GATE OF BIRTH OR BUS. IDN 4. REG'~ISTRATtON OR ' PROCESSING FEE GO~PURCHASEF LAST IJAME HRST NAME MIDDLE NAME PA ULIPHOTO IDp DATE QF--BIB`[ w w tI '. ~ ~ FEE E};EMPT NUMBER - 2 = ' ( { ~1 I. AS ASSIGNED BY THE ~ DEPARTMENT m rc STREET I~ ' COUNTY CODE 5 DUPLICATE REG a u v . ~ . . FEE Nb. OF i z CARDS'._ CITY STATE 21P CODE PATE ACOUIREDI PURCHASED REFER TO COUNTY CODES LISTING ON REVERSE SIDE 6. TRANSFER FEE ~~^ _~ C j OF YELLOW DOPY E MAKE OF VEHICLE VEHICLE IDENTIFICATION NUMBER T. INCREASE FEE ~D Vp t w ~ >r MODEL YEAR BODY TYPE (CP, TK, ETC.) CONDITION -- B. REPLACEMENT FEE O GOOD O FAIR O POOR TOTAL PAID 9% / ('^ 1 10. F, O PLATE TO BE ISSUED BY DEPARTMENT PROOF OF TRANSFER OF PREVIOUSLY ISSUED PLAT[ (ADD `. THRU 6) Q ( INSURANCE MUST BE TRANSFER 8 RENEWAL OF PLATE Q TRANSFER 8 REPLACEMENT OF PLATE 11. GRAND TOTAL 9END ONE CHECK IN ATTACHED.) O EXCHANGE PLATE TO DE MENT OF STICKER O TRANSFER OF PLATE 8 REPLACE (ADD Y 810) THIS AMOUNT'S ' ISSUED BY DEPARTMENT pCATE.NO 1~ /~:~'±'F' ( 'r~ . ~ I REASON FOR REPLACEMENT O TEMPORARY PLATE ISSUED 1 V O LOST O DEFACED O STOLEN O NEVER RECEIVED (LOST in Mall) ¢ BY FULL AGENT (Nola: TM1S plate will expire 9D Days from 1 tl l EXPIRES Monlh Yaer ~ NOTE: If'NEVER RECEIVED" block Is chackee, appbcant mael complete Form MVJ4. o Z O sspance ) a e p TR~~ EO FRO I.E~ ~~ VIN / ~ f/~ ^ ~) J / q ~~ /~ ~ /`/ // ~ / ~ m -~ ~ SIGNATURE OF PERSON FROM WHOM SIGN HERE RELATIONSHIP TO APPLICA o O I .TEMP PLATE NU ' ~ , PLATE IS BEING TRANSFERRED (IF urc OTHER THAN APPLICANT) ' a VEHI0.E PURCHASED WEIGHT GVWR UNLADEN WEIGHT REO REG GROSS WT REO REG. GROSS COMB. WL INFORMATION (IF APPLICABLE) INCLUDING LOAD (IF APPLICABLE) INS N E COMPgNY NAME POLICY N0. (OR ~ POLICY EFFE TIVE POLICY EXP RATION ~ - ^' F ~ 3 - 4n GATE ~ / GF(E " / , _. ,~ !- _ k.~1 .L ATT.ICH DIHDGR' O S - ? 3?'~ A 2 I TIFV THAT ON MONTH DAY YEAR ISSUING AGENT (PRINT NAME) AGENT N . ISSUING I HAVE CHECKED TO DETERMINE THAT THE VEHICLE IS INSURED AND N TO THE ABOVE APPLICANT IN I T T AGENT SSUED . EMPORARY REGIS RATIO ISSUING AGENT SIGNATURE TELEPHONE N0 INFORMATION COMPLIANCE WITH ALL APPLICABLE PROVISIONS OF THE VEHICLE . CODE AND DEPARTMENT REGULATIONS. ( )' Cj M'E CERTIFY THAT LANE HAVE E%AMINED AND SIGNED THIS APPLICATION AFTER ITS COMPLETION. IWE FURTHER CERTIFY THA' ALL STATEMENTS HEREIN ARE TRUE AND CORRECT AND MAKE APPLICATION FDR CERTIFICPTE OF TITLE FOR THE VEHICLE DESCRIBED IN SECTION A. IF ANY EXEMPTION IS CLAIMED, THE PURCHASER FURTHER CERTIFIES THAT FIEISHE IS AUTHORRED TD CLAIM THIS EXEMPTION. INJE ACKNOWLEDGE THAT LANE MAV LOSE MYIOUR OPERATING PRIVILEGE(S) OR VEHICLE REGISTRATION FOR FAILURE TO MAINTAIN FINANCIAL z RESPONSIBILITY ON THE CURRENTLY REGISTERED VEHICLE FOR THE PERIOD OF REGISTRATION. LANE ACINOWLEDGE THAT IM/E MAY BE SUBJECT TO A FINE NOT EXCEEDING 85000 AND O IMPRISONMENT OF NOi MORE THAN TWO YEARS FOR ANY FALSE STATEMENT THAT IMlE MAKE ON TH'9 APPLICATION. iSi Signalure of First Purchaser orAWhorizetl Signer tY,_.y- f -// `_`~~~~' l I.//~~CI.. Telephone NO. LL ASSIGN MENT Signalure of Co~PUrchaser/lltle of AWhorizetl Bigne/ - _~ i ( ) W '" \7 L. / V ' YND S 1 ISeaintl Purchaser or AUlhorize0 51 ner ~ Igne umo g Tele hone No. p ASSIGN MENT ignalure OI Co~PUrcbaser ille o Aulhorizetl Signer ( ) H. ~ z NOTE'. IF A CO~PURCHASER OTHER THAN YOUR SPOUSE IS LISTED AND YOU WANT THE TITLE TO BE LISTED AS "JOINT TENANTS WITH RIGHT OF SURVIVORSHIP' (ON DEATH OF ONE O i w r OWNER, TITLE GOES TO SURVIVING OWNER.) CHECK HERE ^. OTHERWISE, THE TITLE WILL BE ISSUED AG'TENANTB IN COMMON' (ON DEATH OF ONE OWNER, INTEREST OF DECEASED t Y OWNER GOES TO HISIHER HEIRS OR ESTATE.) K v ~ ~ NOTE If THE VEHICLE IS TO BE USED AS ADAILY RENTAL OR (EASED VEHICLE, CHECK THIS BLDCK ^. IF BLOCrc IS CHECKED, COMPLETE AND ATTACH FORM MV-i L. ¢ 2 F w n MEtl St NGER NO. 3. APPLICANT'S COPYlTEMPORARV RFGISTR ATION'lVAI In Ff1R 4n nAV C) METRO BANK December 16, 2011 Caldwell & Kearns Attention: Elizabeth H Feather 3631 North Front St Harrisburg PA 17110 3801 Paxton Street 888.937.0004 Harrisburg, PA 17111 mymetrobank.c:om RE: Estate of: Jack K Callaghan Tax Identification Number: 441-20-6131 Date of Death: December 03, 2011 To Whom It May Concern: This letter is in reference to decedent account information you requested for the individual listed above. We are able to provide the following: Account Type: Checking Account Number: 513130609 Date Opened: November 03, 1999 Primary Owner: Jack K Callaghan Secondary Owner: Velma C Callaghan Secondary Owner: Kathleen Zarnowski Date of Death Balance: $964.78 Account Type: Checking Account Number: 2833768062 Date Opened: May 24, 2011 Primary Owner: Jack K Callaghan Secondary Owner: Kathleen Zarnowski Date of Death Balance: $37,477.43 Please feel free to contact me at (717) 412-6126 if I may be of further assistance. Sincerely, \\ii ,,~~~~~ ~~-- Pamela Lighty Savings/CIF Associate Metro Bank Ek~~ ~f <\ Fidelity & J Guaranty Life'"" FIDELITY & GUARANTY LIFE INSURANCE COMPANY 777 Research Drive, Lincoln, NE 68521 P O Box 82068, Lincoln, NE 68501 866-702-2194 (Office) 402-479-0198 (Fax) www.fglife.com January 18, 2012 Elizabeth H. Feather 3631 North Front Street Harrisburg, PA 17110-]533 Policy: L9153663 Insured: Jack Callaghan Dear Ms. Feather: Per your request the date of death value for this policy was $59,832.94. If we can be of any assistance, please do not hesitate to contact us at 1-866-702-2194. Sincerely, Lisa Antonson Senior Life Claims Examiner Fidelity & Guaranty Life Insurance Company ~ x~, S F'itlelity 8 Guaranty Life is the marketing name of Fidelity 8 Guaranty Ll/e Insurance Company and, in New York only, Fidelity 8 Guaranty Life Insurance Company of New York. Only Fitlellty 8 Guaranty Life Insurance Company of New Vork is authorized to sell insurance and annuities in New York. CALDWELL &KEARNS LAMES R. CLIPPINOER JAMES L GOLDSMRN A PROFESSIONAL CORPORATION OF COUNSEL 3TAXLEYI.A. LASXOWSNI ATTORNEYS AT LAW JAMES D. CAMPBELL, JR. DDDDLA$ K. MAR$ICA CHANCES 1. DEHART, III BRETT M. WOODBDRN MICHAEL D. REED MICHAEL A. FARRELL THOMAS D. CALDWELL, IR. THOMAS M. FRATICELLI 3631 NORTH FRONT STREET (19ss~sool> PETER M. GDDD HARRISBURG, PENNSYLVANIA 17110.1533 ELITABETN N. FEATHER CARL G. WA55 GREGORY D. GEISS (1937~Y010) THOMAS S. LEE 717-232-7661 DAVID J. EVEHHVIS FAX: 717.232-2766 RICHARD L KEARNS JESSICA E. MERCY RETIRED THEFIRMCLS'CKLEGAL.N ET August 15, 2012 > ~ Glenda Earner Strasbaugh, Register of Wills ~ ~ ~x'~~(`; Cumberland County Courthouse rp ~ ~~~; l'~', 1 Courthouse Square, Room 102 ^' ~{: iV j a `I Carlisle, PA 17013 ~ o ,; car; c 'o --~, G fV Y-`'T Re: Estate of Jack K. Callaghan g . 7i A.n~ Cumberland County No. 2011-01330 -~'' ~ Dear Ms. Strasbaugh: Enclosed please find the original and one (1) copy of the Pennsylvania Inheritance Tax Return. Please file the same. I have also enclosed a copy of the front page of the Inheritance Tax Retum for you to time-stamp and return to me in the enclosed self-addressed, stamped envelope. A check payable to your office in the amount of $15.00 is enclosed to cover the cost of filing the Inheritance Tax Return. Thank you for your assistance with this matter. If you have any questions, please contact me. Very truly yours, ~.~ ~ ~~ Elizabeth H. Feather CALDWELL &KEARNS, P.C. efeather@cklegal.net EHF:nb /Enclosures cc: Mary Callaghan w/o enclosure 11410-001/193623 ioo 00 (o~h.~ m >~y~w W ~o liao~a ¢a o~ ~o N ~ ~~,il ~ " LL T Q ~ a o w A o J ~11Nf1 0 0 ~ ~' (} tO "~ j Uy ~ ;_~ T.y ~L ~-. ~. Li a JU _. :. .~ ..~,~ . ., ~ ~ J .?- LJ L . , 1 yy C/~ ~ m w m w ~ ~ o N ~ n z o a ~a ~~ a = ~ ~~ 0 z a c~ ~ ~ a h-~-~ ~' _ U F t,N S N .~ ~ O N ~ O Q a Q U ` A~~M N~Q~ ~U~o a~ N Q 'fl 7 a vg'~°-N' ~E~~~ d~U~ (7 V ~ V