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1505610105 FICI SE N Y PA Department cif Revenue pennsytvania ~- ~~~ ~ ~~, Q OF AL U L County Cade Year File Number Bureau of Indtvtduat faxes INHERITANCE TAX RETURN PC} Box zso6o~ 21 11 1336 Harrisburg, PA 1~~28-~Soi RESIDENT DECEDENT ENTER aECEDENT iN~0RfulATiC1N @ELO1N Social Security Number Date of Death hlMDl~l'YYY Date of Birth 119lvlDDYYYY 184-52-8436 12/08/2011 04/02/192$ Decedent's Last Name Suffix Decedent's First Name MI Weibley Pearl E (if Applicable) Enter surviving Spouse's information Below spouse's Last Name Suffix Spouse`s First Name MI Spouse's Socia! Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS fiiLL, iN APPROPRIATE QVALS BELOW (~ 1. Original Return Q 2. Supplemental Return O 3. Remainder Return (Date of Death Prior to 12-13-82} p 4. Limited Estate ® ~a. Future Interest Compromise (date of Q 5. Federal Estate Tax Return Required death after 12-12-82} t'#3 6. Decedent Died Testate Q 7. Decedent Maintained a Living Trust ~_~ 8. Total Number of Safe Deposit Boxes (Attach Copy of 4'~ili) (Attach Copy of Trust.) p 9. Litigation Proceeds Received Q 1Q. Spousal Poverty Credit (Date of Death Q 11. E{ection to Tax under Sec. 9113(A) Between 12-31-91 and 1-1-g5} (Attach Schedule O) C~RRESPQNDENT - THIS SECTION MUST BE Gt3MPt.ETED. ALL GARRESPDNDENCE ANT) CONFiDENTtAL TAX iNFQRMATiON SHOUT DIRECTED Tt~' Name Daytime Telephone r N ;~ - - Jane M. Alexander (717) 432-451 ~ ~ ' , ~ T } ~7 , ,' "f ` l... ~__ . ~ Y { .~.-~ REGISTER ® 't~$E ©N ~ i"" i i ~ p rt. r' ~"--~ i. w~ t First Line of Address ; Q ~ ~ ` ".-. ~~ 148 S. Baltimore Street ; ~ `~~ ~ J ~~ N Second Line of Address - .._ City or Post Office State SIP Code ~ ___. PATE FILED Dillsburg PA 17019 Correspondent°~ e•mail address: ~malexander.148@earthlink.net under penalties of perjury, !declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belie#, it is true, correct and complete. Declaration of preparer other than the rsonal representative is based on all information of which preparer teas any knowledge. SMGfyr'~TUf~E aF PERSON~E~NS! ~ E"~OR FI RE3URN DATE ,ADDRESS 17 Beidl r Drive Shippensburg, PA 257 SIc3NATUR OF PREPARER F~HAN NT TIVE ~ ATE . G~~«--~ J "~-- ADDRES 148 altimore Street, Dillsburg, PA 17019 PLEASE USE 0RIt31NAL L 15®5f~1®1r05 Side 1 oN~.Y 1505610105 J h~~ J 15C156~®2a5 REV'-150th EX (Fi) Decedent's Social Security Number De~eaent s Narr;~: Pearl E. Weibley 184-52-8436 REGAPiTULATIUN 1. Real Estate (Schedule A) .......... . ......... . , ... 1, 0.00 2. .................... Stocks and Bonds {Schedule B) .... . . ..... . ... . ... 2. 0.00 3. Closely Neld Corporation; Partnership or Sale-Proprietorship (Schedule C) .. ... 3. 0.00 4. Mortgages acid Notes Receivable SScheduie D) ................. . . ... . . ... 4. 0.00 5. Cash, Bank Deposits and Miscellaneous Personal Property {Schedule E).... ... 5. 61,097.37 6. Jointly t~wned Property (Schedule F) Q Separate Billing Requested . , .. ... 6. 44,500.00 .. inter-V'ivos Transfers ~ tvlisceilaneous Non-Probate Property 41 282 00 {Schedule G) ®Separate Billing Requested. , ... ... o. , . 8. Tatai Gross Assets ttotai Lines 1 through 71 ................. .. $. 146,879.53 9. Funeral Expenses and Administrative Casts {Schedule N) .......... ......... 9. 19,980.66 10.. Debts of Decedent; Mortgage Liabilities ar~d Liens {Schedule f) ...... ......... 1©. 2,538.60 11. Total Deductions (tata! Lines 9 and 10) .... . ................... ....... . . 11. 22,519.26 12. Net Value of Estate tLine 8 minus Line 11) ..................... ........ . 12. 124,360.27 13. Charitable and iSovernmenta! BequestslSec 9113 Trusts for 4vhich an election to tax has not beeoi made {Schedule J) ........ . ..... . ......... 13. 0.00 14. Net Value S~ubje~t to Tax (i_ine 1 ~ minus Line 13) ............ ..... 14. 124,360.27 TAX CALCULATlQN -SEE INSTRUCTi©NS FOR APRLiCABLE RATES 3 ~, Amount of Line 14 taxable at The spousal lax rate, or transfers under Sec. 9116 (a)(1.2) X .0~ 15. 16. Amount of Line 14 taxable at Linea! rate X .t~ 45 124,360.27 16. 1?. Amoun# of Line 1~ taxable at sibling rate X .12 17. 1;3. Amount of Line 1~ taxable at collateral rate X .15 18. 19. TAX DUE ........................................................ .19, 20. FILL IN THE OVAL IF YC}U ARE REQUESTING A REFUND C,~F AN C?VERPAYMENT ,5id~ Z ~,5~561,®2O5 I,5C156102(]5 5,596.21 5,596.21 +~ J REV-1500 EX (FI) Page 3 Decedent's Complete Address: File Number DECEDENT'S NAME Pearl E. Weibley STREETADDRESS 17 Beidler Drive CITY Shippensburg _ --- -.. _. _ I _.. _ _ _ _ _ . STATE--..._... ___... _ 'ZIP PA j 17257 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) 5, 596.21 2. CreditslPayments A. Prior Payments --.........._ ........_ __ _ 5, 319.46 B. Discount 276.75 Total Credits (A + B) (2) 5, 596.21 3. Interest (3) 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) 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 .......................................................................................... ^ 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 "in trust 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 tlesignation? ............................................................................... . ~ ^ ........................................ 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 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 stilt 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 far 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)J. • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. ~. penn~ytvania ~iEDtJL~ E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC. IB~NERIfiAN[E 1AX RrTURN PERSONAL PROPERTY RE_SID~NTE?EGEDENT ESTATE QF. _ FILE NUMBER. Pearl E. Weibley 21-11-1336 Include the proceeds of litigation and the date the proceeds were received by the estate. Ali property joirAtly awned with right of survivgr~hip must he disclosed on Schedule P. ITEM __ _ -VALUE AT DATE ___ NUMBER DESCRIPTION OF DEATH 1. Citizens Bank Circle Gold Checking Acct. # 610079494-6 Date of Death Vatue ~~,~~8,~~ 2, Citizens Bank Gold Savings Acct # XXXXXXX9882 Date of Death ~~,~ :) 8,11 3. Refund Erie Insurance Policy # Q04 0902317 H Auto 1 ~ 1.91 4. 1991 Oldsmobile Sedan VIN # 1G3NL51U6MM066395 1 ~~~.~® 5_ Personal Property Appraised 4111112 by Ike Eichelberger, Auctioneer 1 ~~~,A~ 6, Refund 2011 Federal Income Tax ,~~~ A® TQTAL (Also enter on Line 5, Recapitulation) $ ~ ~1,A~i,~~ ___ If mare space is needed; use additionai sheets of paper of the same size. =s1t 1,09 EX+ (ol-io) `~ ~~` ~~~"1~S~~:Vc~Clla INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F 70INTLY-OWNED PROPERTY ESTATE OF: FILE NUMBER: Pearl E. Weibley 21-11-1336 70INTLY OWNED PROPERTY: ITEM NUMBER LETTER FOR ]DINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSET °,~ OF DECEDENT'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1. A. 01/09/06 17 Beidler Drive Shippensburg, PA 17257 89,000.00 50 44,500.00 Deed Dated and Recorded January 9, 2006 Deed Book # 272 Page 3441 44, 500.00 TOTAL (Also enter on Line 6, Recapitulation) $ If more space is needed, use additional sheets of paper of the same size. If an asset became jointly owned within one year of the decedent's date of death, it must be reported on Schedule G. .E-V-:.~~ ..:~t~ ~v,~..Uy a Pennsylvania SCHEDULE G DEPARTP4ENT of aEVFNUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Pearl E. Weibley 21-11-1336 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 1NCLUUE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. ATTACH .4 COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST EXCLUSION ([F APPLICABLE; TAXABLE VALUE ~• Transamerica Annuity No: 26150220 Date of Transfer 3/10/01 41,282.16 41,282.1E Beneficiaries: Sarah M. Fisher daughter 16.67% Charles 0. Weibley son 16.67% Kay E. Boianelli daughter 16.67% Steward 0. Weibley, Jr. son 16.67% Ronnie L. Weibley son 16.66% Terry E. Weibley son 16.66% TOTAL {Also enter on Line 7, Recapitulation) $ I 41,282.16 If more space is needed, use additional sheets of paper of the same size. ,:~ r SCHEDULE H ~~ penlns~~va~ia DEP,gRTMENT OF REVENUE FUNERAL EXPENSES AND IN~IERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ~STAT~ OF _-- _ - FILE NUMBER _ _ Pearl E. Weibley 21-11-1336 - _ _ Decedent's debts must be reported on Schedule I, ITEM - - - - NUMBi=R DESCRIPTION AMQUNT A. FUNtRALFXR€N~~S; ~' Fo elsan er-Bricker Funeral Home 9 9 1 ~,~~~,~~ e~. ADMINISTRATIVE COSTS: 1, Personal Representative Commissions: Name(s) of Personal Representative(s) ~@f~~ ~~~fE'~~~~ Street Address City--- ------- _------_ _-- - -- _ _ _ _ __- - State----- SIP -_----- Year(sI Commission Paid: ~. Attarne_y ~ee5; Jane M Alexander 4,~Of~:OQ 3, Family Exemption; (If decedent`s address is not Et~e same as claimant`s, attach explanation,) Claimant ~~~Nt~~ ~-W~f~l~~+., ~~~: ___ _ _ _ --- ---- _ __- - - - -- Street Address ~ ~ ~~i~l~r- ~~i~~ City -~~11~-~~~1~-~~1"'~- . ___ __ _ --- - -_ __ _ _ _ _ State _-~~ 2IP ~~~t~~"--- ----- Relationship oT Claimant. to Decedenk ~~Ci y. Frabaie Fees; Register of Wills, Cwnberland County 2~~,~Q 5. Accountant Fees; 5, Tax Return Rreparer Fees: ~. Narumol Alexander-Witness Fee ~~:g~ $. The Sentinel- Advertise Grant of Letters 1 ~"~:~~ s. Cumberland Law Journal- Advertise Grant of Letters ~~x.OQ ~o. Cumberland County Register of Wills Filing Inheritance Tax and Inventory ~Q:~~ ~ ~. Notary Fees Amy Hanbright ~~:~R 12. Cumberland County Register of Wills Filing Release 1 ~.~~ TOTAL (Also enter on Line 9, Recapitulation) ~ ~~+~~~~~~ If more space is needed, use additional sheets of paper of the same size, Pennsylvania ~~NEDUL~ I @EPARTMEUT OF t~EVENUE DEBTS OF DECEDENT, ir~HE~rTANe~ ~Ax ~E~uRN MORTGAGE LIABILITIES & LYENS ftESIpENT DEGEa€NT -° F _ _ _ FILE NUMBER __ Pearl E. Weibley 21-11-1336 RQport debts incurred ~}~ the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses, if more space is needed, insert additional sheets of the same size. REV-1513 EX+ (01-10) ~ pennsylvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Pearl E. Weibley 21 11 1336 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• Sarah M. Fisher 49 Beetum Hollow Rd. Newville, PA 17241 daughter 1/6 residue 2. Charles 0. Weibley 155 Big Spring Terrace Newville, PA 17241 son 1/6 residue 3. Kay Boianelli 40 Baltrusol Drive, Mays Landing, NJ 08330 daughter 1/6 residue 4. Steward 0. Weibley, Jr. 17 Seidler Drive, Shippensburg, PA 17257 son 1/6 residue 5. Ronnie Weibley 4 Maizefield Drive, Shippensburg, PA 17257-8852 son 1/6 residue 6. Terry Weibley 1495 Orrstown Road, Shippensburg, PA 17257 son 1/6 residue ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN; 1. N/A B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. N/A TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. I $ If more space is needed, use additional sheets of paper of the same size. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 016479 WEIBLEY STEWARD O JR 17 BEIDLER DRIVE SHIPPENSBURG, PA 17257 ----- fold ACN ASSESSMENT AMOUNT CONTROL NUMBER REV-1162 EX(11-96) ESTATE INFORMATION: SSN: 184-52-8436 FILE NUMBER: 211 1-1336 DECEDENT NAME: WEIBLEY PEARL E DATE OF PAYMENT: 09/06/2012 POSTMARK DATE: 09/05/201 2 COUNTY: CUMBERLAND DATE OF DEATH: 12/08/201 1 101 ~ $61.21 TOTAL AMOUNT PAID: REMARKS: RECEIPT TO ATTY SEAL CHECK#1508 $61.21 INITIALS: DMB RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS TAXPAYER COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX(11-96) NO. CD 015636 WEIBLEY STEWARD 0 JR 17 BEIDLER DRIVE SHIPPENSBURG, PA 17257 -- ----- told ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ $5,258.25 ESTATE INFORMATION: SSN: 184-52-8436 FILE NUMBER: 21 1 1 -1336 DECEDENT NAME: WEIBLEY PEARL E DATE OF PAYMENT: 02/ 28/ 201 2 POSTMARK DATE: 02/27/201 2 COUNTY: CUMBERLAND DATE OF DEATH: 1 2/08/201 1 REMARKS: RECEIPT TO ATTY SEAL CHECK# 1000 TOTAL AMOUNT PAID: INITIALS: WZ RECEIVED BY: $5,258.25 GLENDA EARNER STRASBAUGH REGISTER OF WILLS TAXPAYER ~~~n . Account Number 6100794946 Account Title PEARL E WEIBLEY Date Opened 3/29/1980 Account Type Checking Principal Balance as of DOD $32767.64 Interest from Last Posting to DOD $ .62 Account Balance as of DOD $32768.26 YTD Interest to DOD $10.18 ~~ Citizens ~anl< Account Number ' 6140289882 Account Title PEARL E WEIBLEY Date Opened 2/17/1982 Account Type Principal Balance as of DOD Savings $24617.57 Interest from Last Posting to DOD $ .54 Account Balance as of DOD $24618.11 YTD Interest to DOD $39.08 CURRENCY ~ COIN - 3 i ~~ Citizens Bank Pennsylvania ® ~ ~' S!! IT TICKET j ~ i L~\ DATE ~ JJJJJJ CHECKS AND OTHER ITE~S ARE R CEIVED FOR DEPOSIT SUBJECT 70 THE PROVISIOIJS OF THE UNIFORM COM ERCIAL CODE OR ANV APPLICABLE COLLECTION AGREEMENT. DEPOSITS MAY NOT BE AVAILABLE FOP IMMEDIATE WITHDRAWAL. x:5600111 L L 5 5~: 6 2 3~, 29 ?00911' Erik Insurance ~~ Group 100 Erie Ins. PI. Erie, PA 16530 PAY ESTATE OF PEARL E WEIBLEY TO 17 BEIDL.ER DR THE SHIPPENSBURG PA 17257 ORDER OF VOID 180 DAYS AFTER DATE POSITIVE PAY PROTECTED CODE REASON POLICY NUMBER AGENT REF. NO. cFH~ECK ^1 Q04 0902317 H AA7401 B023575 Premium Refund Due to Code 1 • Policy Cancelled Code 2 • Policy Expired Code 3 • Premium Reduction Code 4 • Overpayment USE OTHER SIDE FOR ADDITIONAL LISTING. CHECKS ~ BE SURE EACH ITEM IS PROPERLY ENDORSED. TOTAL ITEMS TOTAL FROM ~ OTHER SIDE LIST CHECKS SINGLY OR ATTACH LIST -----~ .- - -- ~i-- Bank of America CustomerConnection 64-1278 Bank of America, N.Q. 611 Atlanta, Dekalb County, Georgia DATE CHECK N0. 02023575 MO. DAY YR. 12116 11 $151.00 S.curitr features inclutled Dehils on tuck. EXACTLY '~''`•~~ 151 DOLLARS AND 00 CENTS AUTHORIZED SIGNATURE 11'020235?511' ~:06~L~2788~: 329 999 65L~,11^ Williams ~I, easels s~~Ce a~~~ 811 Route 1 S N, Dillsburg, PA 17019 • Phone 432-2918 • wesselsusedcars.com Notary Public Temporary Tags '~ ! ~ ~~ C ~Ch~c.l¢ CkAsc~,(rf~(et I`I`I I UI~Srnich~ IC. S«{n~ U ~ N ~ I C-, 3 rte' ~- , `~ U i~vv~ vn Flo << 3 ~ 5 I'l'1~1C(tcJe J J' ~ / C' l QS-F~~~~GC~C ~-~tP 1'ak,LiP 0 +I1 C, rr ~ ~ (S~,l ~ ~ ~ ~,.~ ,' ~'~, C.; ~. ~~~ ~ i, ~o~~ C~' __ I ,~ ,~ ,~ ~ ti DEPARTMENT OF TRANSPORTATION CER'T'IFICATE OF `T'IT"LE FOR A VEHICLE 4 ~ 1r ~ 3 _~_______._______________~.._ N `N^ W ~M W ~?21t757,039000D60-00~ 1G3~~54u6r~~t066395 91 ®~DSr~oaI~E 4 3990258901 WE VEHICLE IDENTIFICATION NUMBER I YEAR I MAKE OF VEHICLE I TITLE NUMBER S D ~l I 2 I I I I BODY TYPE DUP SEAT CAP UNLADEN WEIGHT GVWR GCWR I TITLE BRANDS 4/23/92 I 6/2/92 I 6/23/92 I I 000032' I i] DATE PA TITLED DATE OF ISSUE PRIOR TITLE STATE ODOM. PROCD. DATE: - ODOM. MILES .. ODOM. STATUS u ODOMETER STA US ~ T 0 -ACTUAL MILEAGE •'~` ~ . ¢. 1 - MILEAGE EXCEEDS THE MECHANICAL t+. tM ~: -. ,..;:t 7 .€. ~:: .:'-... ". .. .';t.a}~.~ {...;' ,, .,-.. ,..~., .... r' .'~~ .,AS`°i.~E'.~ti-~, '.v~,} ..rr ."~t.L t ~~~~7~, :4F"~~".5:.:.Tia"~7~~.','S ~' . 2 -NOT THE AC ' , MILEAGE 3 NO7 THE ACTU SAGE -ODOMETER c /'` A G ? ~ ~ ~ ~ ~ E A G E - TAMPERING VERIFIE ~ 4 -EXEMPT FROM ODOMETER DISCLOSURE REGISTEfED OWNER(S) !! TITLE BRAND' S PER~L ~ ~EIBLEY A AN710UE VEHICLE ~' L ~~ ~ :> C G ASSIG VEHICLE ; .. 1,7 ~EI~L~f~ OR <: F QtIT.GFQ+CiVMTRY ~._ ,-SHI~'~P~N~B~1f~G' PA ~72'S7 - _ G bRIGiN1~LLYtyf~p FOR NQJ~-U:S. w .;. A~~~t" ' - i_; H . ~ FtAE EH ~ t-, L 4txiQ~G V~H1CL& -P ar FQRMF~fiEtk FIiBQL~~EHICL~ ~ " R ~ ~GONSI't9liCTED . . " S 3~`F'J~EET ROO. ' V +r SIE?HICIE C~tPt7AIN.^~iEISS`UED VIN FIRST Lt~! FAVOR OF: SECOND LIEN FAVOR OF: t" '': -i~ ~.l f~ . :. - .. ..: .. - y - ~~ ~~., ' If a-second lienholder is listed, upon satisfaction of the first lien, the fir 'c`;E lienholder must forward this Title to the bureau of-Motor Vehicles wil FIRST LIL~fI RELEASED appropriate form and fee. DATE F ~~` ` BY ' AUTHORIZED REPRESENTATIVE - "' ': . ' SECOND LIEN RELEASED ~;"~'~"3 Y, - ~ - ~ ' , " t~TE - .. A •~tG~ ~rC~3:;.YF 2'.5+~~ ~.i^~'~~X~:':-S§~~u'3~i.:~.:~t rt':f':'~."T"-'~t,.~°:c~'"t'+s~.~'Tro"'?~tX4R'S;a';.. tii~lE~~1 _~ ~'. MAILING ADDRESS BY _ - - ~ - - -AUTHORIZED-PEPRESENTATIVE - _ ~~ARL E WEIBLEY ~,~ BEIDP~Eft DR ~HI~~'ENSBURD ~'A 37257 ~y - r, ', ~~~~3~b ~ ~ ~f ' ~ ~~ r v r ~~~ ~ ,.~ ~ ~ ~', Lcertify as of the date of issue, the.official records of the Pennsylvania Department of - - , `Transportation reflect that. the person(s) or`company named herein is the lawful owner of the said vehicle,- _T_~~cret~ry of,,~ransporta _ ~ _ • . • ~ ,~. SUBSCRIBED AND SWORN TO BEFOR ME~ pp ppoo here b PPk 'Tenantstln G one of R n bi ock s heckedW tl to wl I ba hssued as ommon". E Mo. onv rEnlx N ~ c l A ^ Jdnt Tenants kh Rfg )t oiSurvivofshlp (on death o, ona owner, title goes he - - l` n o 9 B ^ Tenants In Common (on deatho( one owner, Interest of deceased owner goes to his other heirs or estate). ,. SIGNATURE OR PERSON ADMINISTERING OATH. LIEN - IFNO LIEN , DATE: CHECK BOX ' FIRST LIENHOLDER: " ° J ... NAME ~ - _ W a~ i i ~ ~ 3" ~. a~+ s... { Y S.~'s... ~ @" ~f^~ k~44i «<~ . P a ~'"k ~ STREET CITY - _ STATE. -. - ZIP LIEN- - IF NO LIEN ("'~ The undalsigned hereby makes application for Certificate of Title to the vehiclo described DATE; GyECK BOX u above, subject to the encumbrances and other legal claims set forth here. SECOND LIENHOLDER - NAME STREET .SIGNATURE OF APPLICANT OR AUTHORIZED SIGNER CITY ~~ ~ SIGNATURE OF..CO-APPLICANTITITLE OF AUTHORIZED SIGNER _ STATE ZIP ~ - - .. .:. IV APPRAISAL Appraisal done 4-11-2012 for the Estate of Pearl Weibley 17 Beidler Dr. Shippenburg Pa. . 17257 Items that were Appraised: Roll top desk Nick knacks figurines lot Leaf handle chest of drawers Mahogany chest of drawer 4 pc. Bedroom suite LJke tune instrument Round kitchen table & 6 chairs Safe toy money bank 2 oval picture frames lot Pig cookie jar 2 frog door stops pr. Blond bed Micro wave oven 2 glass bear banks pr. Oil light Dishes lot 4 newer doll babies lot Pocket watch Sewing machine Love seat & chair Pots & pans lot Glass duck $250.00 Washer & Dryer pr. $100.00 $100.00 Waterfall bed & chest of drawer $80.00 $75.00 Frigidaire refrigerator $75.00 $75.00 2-cast iron dog door stops pr. $70.00 $65.00 2 trunks pr. $50.00 $50.00 Hutch $50.00 $50.00 20 stuff animals & truck bank lot $35.00 $35.00 Decorated saw -blades & pans lot $30.00 $30.00 6 bow back chairs $25.00 $25.00 Every day dishes lot $20.00 $20.00 Christmas decorations $20.00 $20.00 Pr. Flower lamps $20.00 $15.00 Frying pans lot $15.00 $15.00 Deep frame $15.00 $15.00 Quilt rack $15.00 $15.00 2 storage boxes lot $10.00 $10.00 Harmonica in box $10.00 $10.00 Sofa & chair $10.00 $10.00 Dog figurines lot $10.00 $10.00 2 flat irons pr. $10.00 $10.00 T V -stereo $5.00 $5.00 Total $1,585.00 Little IKE Eichelberger Auctioneer PA. Lic. #AU.001954-L ,. J / ~~ ~ i ,!~ ~: _- ~. 01~o S b 7 4, 2 4 4, 3 3 4 ~;~r ta~„s~A, Check No. .µk ~':~-• ~~ ~ ~~ 0 4 17 1 2 3 2 S A N FRANCISCO, CA 3158 23793757 ~''H~ceµ~'~ 3158 23793757 20090800 I30 OWEIB ANDOVERTAX REFUND Payeo 1~~~~~ i.. ~I.I~I~ ~ ~ II ..1~~~..I. II ~~ •` 11 IIII I I I I IIII I I I I I I I I I I I i l I l i I I I -?%=~-~- the order of °/I,7STEWARD 0 WEIBLEY JR 12/11 /~/ .. BEI DLER DR 57 _~ SHIPPENSBURG PA 17257-9746 $****475*00 %' VOID AFTER ONE YEAR REOION AL LISBU RSING OFFfCER ~.• ~: _~~ II li1-I-'- I- _i ~I ~ ~ I~ ~li~lli_II~,~I~,._ .III ~_ 1= I~- _ I-_ I_I; ,~~11= , _454 i' i ~ _ I ~ N ~ i=,=,~ I- I' I- II- „-TI, ,_-,rte I-i'i=i~l-, Ili'i'II _~ ,II- ~ I '1= ~ I-TI-_ II'I=~='- -IIT=__I= ~T'ul 1= I'li_i - II I_i_ ,III I~I.I,. ,, I r. {-' 'r~: I.-I-, I- , '-II= -li I .I ,_ v ,I- 11~- ,' -11.'1_-1-1=!- i,- ICI'=1 IT, I,1~~1= _~~'--=i - i , -- i` -lil --11-I I' IIiT 'I~'i=,l_Ill,il'=,~I~~Irill~~l, ,_ ~II~,~-1~-'i~-I Flllp,i~~illlll=T,~-liill~_I I-1i_I i-I-,I,_i;_;;~_al, I ,~ ll_I=1=1t=I_-~i=i~-i-; I-!i-i=I III-~ ll'3 L5B Ln^ s:000000518: 23~937579n' 0,04 ~ 2 ~~ Citizens Bank Pennsylvania ~~ ~~~ ~~~~`~ USE OTHER SIDE FOR ADDITIONAL LISTING. _ ~ BE SURE EACH ITEM IS - '" PROPERLY ENDORSED. DATE ~ f TOTAL ITEMS CHECKS AND OTH ITEMS AR RE CEIVED FORDEPOSIT SUBJECT TO THE PROVISIONS GF THE UNIFORM OMMERCIAL CODE OR ANY APPLICABLE COLLECTION AGREEMENT. DEPOSITS MAY NOT BE AVAILABLE FOR IMMEDIATE WITHDRAWAL ESTATE OF ESTATE OF PEARL E WEIBLEY STEWARD O WEIBLEY JR EXEC 148 S BALTIMORE ST DILLSBURG PA 17019 LIST CHECKS SINGLY OR ATTACH LIST CURRENCY ~ COIN 4~ ~ -, >? CHECKS 6' f~ ~ ,- ~„r...-~°°`" TOTAL FROM ~ OTHER SIDE ~: 5 600i11 L L 5 5~: 6 2 3 4 2 9 X00 911' ~" . t ~ ~! Parcel Address: 30-25-011 G-014 17 Beidler Drive Shippei~tibtug, PA 17257 ~~jiS ~eeb . ~,~~ - ; Made this ~ / day of ~~~ ~1:,~` ~~~ in the ear of our Lord Two thousand five 2005 . ,~ y ~ ) BETWEEN CHARLES O. WEIBLEY, of the Township of North Newton, Count}' of Cumberland, Commonwealth of Pennsylvania, GRANTOR /_---~ AND PEARL E. WEIBLEY (mother of the within grantor) and STEWART O. WEIBLEY, JR. (brother of the within grantor), of the Township of North Newton, County of Cumberland, Commonwealth of Pennsylvania, as joint tenants with right of survivorship, GRANTEE S WITNES~SETH, that in consideration of One and no one-hundredths ($ l .00) Dollar, in hand paid, the receipt whereof is hereby acknowledged, the said grantor does hereby grant and convey to the said grantees, their heirs and assigns: ALL HIS UNDIVIDED ONE-THII2D INTEREST IN ALL THAT CERTAIN lot, piece or parcel of ground with all the improvements, situate in the Village of Oakville, Township of North Newton, County of Cumberland and Commonwealth of Pennsylvania, bounded and described as follows, to wit: BEGINNING at a post on lands of John K. Beidler; thence by lands now or formerly of O. fI. Hefflefinger, North 190 feet to a post, a corner of lands of said Hefflefinger; thence by lands of said Hefflefinger and lands now or formerly of Mrs. J_ T. Creamer, East 40 feet to a corner post; thence by lands now or formerly of Samuel J. Miller, South 193 feet to a corner post on lands of John K. Beidler; thence by the same, 40 feet West to the place of BEGINNIlVG. CONTAINING 7660 square feet. IT BEING the same premises which Pearl Allen Weibley a/k/a Pearl E. Weibley, by her deed dated August 16, 1995 and recorded in the office of the Recorder of Deeds in and for Cumberland County, Pennsylvania, in Record Book 127, page 1059, granted and conveyed unto Pearl E. Weibley, Charles O. Weibley, and Stewart O. Weibley, Jr., Grantors herein. Parcel ~(1-25-0116-t71 Address: 17 Beidler I?rive Shippei~.tibtu-g, PA 17257 r ~~ ~, ~.,~ r Made this ~~ / day of .'~~`` r ~.-u;~r,~+.=' ~, :'~ in the year of our Lord Two thousand five (2005). BBTWEEN CHARLES O. WEIBLE~'g of the Township of North Newton, County of Cumberland, Commonwealth of Pennsylvania, GRANTOR ~1V1) PEARL E. WEIBLEY (mother of the within grantor) and STEi~VART O. WEIBLEY, JR. (brother of the within grantor), of the Township of North Newton, County of Cumberland, Commonwealth of Pennsylvania, as joint tenants w ith right of survivorship, GRANTEES WfTNE,SSETH, that in consideration of One and no one-hundredths ($1.00} Dollar, in hand paid, the receipt whereof is hereby acknowledged, the said grantor does hereby grant and convey to the said grantees,. their heirs and assigns: ALL HIS UNDIVIDED ONE-THIRD INTEREST IN ALL THAT CERTAIN lot, piece or parcel of ground with all the improvements, situate in the Village of Oakville, Township of North Newton, County of Cumberland and Commonwealth of Pennsylvania, bounded and described as follows, to wit: BEGINNING at a post on lands of John K. Beidler; thence by lands now or formerly of O. H. Hefflefinger, North 190 feet to a post, a corner of lands of said Hefflefinger; thence by lands of said Hefflefinger and lands now or formerly of Mrs. J. T. Creamer, East 40 feet to a corner post; thence by lands now or formerly of Samuel J. Miller, South 193 feet to a corner post on lands of John K. Beidler; thence by the same, 40 feet West to the place of BEGINloTING. CONTAINING 7660 square feet. IT BEING the same premises which Pearl Allen V+leibley a/k/a Pearl E. Weibley, by her deed dated August 16, 1995 and recorded in the office o~ the Recorder of Deeds in and for Cumberland County, Pennsylvania, in Record Book 127, page 1059, granted and conveyed unto Pearl E. Weibley, Charles O. Weibley, and Stewart O. Weibley, Jr., Grantors herein. THIS IS A TRANSFER FROM SON TO MOTHER AND BROTHER AND THEREFORE IS NO'T` SUBJECT 'T`O ANY DEAL ESTATE TRANSFER `T'AXES. U1ITDER AND ~'~T~3JECT,1VEIlER7'HELES~`, to easements, conditions and restrictions of prior record pertaining to said premises. And the said, grantor will GENERALLY I~ARRANT AND F®~ZEVER DEFEND the property hereby conveyed. IN W.~TNES~' EREDF, said grantor has hereunto set his hand and seal the day and year first above written. Si;ned, Sealed and Delivered ~ In the Presence of ~f~ <~~I ~ r ~ °~r~:Y~/Y ~~.+~,~' ..~R. %4Jrr.t::~w~ / ~ ~ /~~ ~tbcR-An^~~~.0`°. ~, P (Sear} ~ ~' Charles O. Weibley ommonwealth of Pennsylvania County of Yorl+; On this, the ~ '~ day of , ~ ..~ ~c;1.~~,~;-~i_.~ , ?005, before me a Notary Public in and for said County and Commonwealth, the undersigned officer, personally appeared Charles O. Weibley 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 purpose therein contained. ~ ~TNESN W~YERE~F, I have hereunto set ~y hand and notarial seal. ;~~--~ .~+ ~<.~L~.~f d=~ ~=~~ My~~-~tiir[mission Certificate ®f Residence -s------ , ~ i ;,o?a~~;a, ~~~Lti F3S~1i? ~.. i~~Qll~lC}, ~~+~12:N t`~LiCi1G ~ r r~~G,'~ ' ;i'~IJ. ~Oi1C LOl.~fi~y IVar, i sviy C:~r~fs~i=;sic~~-: ~ x~ir~s ~cb. ~, 2~7 ry _. . t~ y ~~ . C' F'1 ~ 1~ir~~t ~'3~ ~I ~ ~.:)4~l X'.l`c3tSCIf! l~ ~C~~?(1~•$ I hereby certify that the precise address of the grantee herein is as f`~~ws: 17 Seidler Drive, Shippensburg, PA 17257 ,, . r 1 _' ``~yw ~,, i ~• i.. ~~~ttvrriey .Tctne:l~i: ,~lexa.nder. Esy?ure ,~ttuT•ney at ~:atii~ 148 S. Balt~nacn•e ~treel 1-Jillchurg, p~ 1 %Ul t~-U=121 F:'a;~ne: (717) 42-4514 TIZANSAMERICA ~. LIFE AND ANNUITY PEARL E WEIBLEY 17 BEIDLER DR SHIPPENSBURG,PA 1725 7 Product Name: SecurePath - 3 Year Plan Type: Non-Qualified Social Security or Tax ID Number: 184-52-8436 Annuitant: PEARL E WEIBLEY Mailing Address: Annuity Service Center P.O. Box 3183 Cedar Rapids, IA 52406-3183 QUESTIONS? Call us at 1-800-582-5268. MELLON INSURANCE AGENCY INC 153 W ORANGE ST SHIPPENSBURG, PA 17257 Dealer: 2337 Registered Representative: ANGELA M BARMONT Contract Issue Date: March 10, 2001 Confirmation as of: March 16, 2001 Contract Number: 26150220 Date Account Transaction Total Interest Rate First Year Transactions Additional Interes Rate 03/10/01 Purchase Payment 21,203.91 4.90 1.J5X * * First Year Additional Interest: The First Year Additional Interest rate is credited to each premium received for the first twelve months from date of receipt. Note: When the value of this contract is equal to or greater than $25,000.00 on the last day of any month, the Additior Interest will be credited to your Contract Value on the last day of that month. The Additional Interest will be credited a daily rate which is equivalent to the applicable Annualized Additional Interest rate of 0.25%. Information page Pages 2 and 3 confirm the information you gave us when you applied for this annuity contract,, and provide applicable financial information and contract limitations. Personal information Annuity Contract Joint Owner: Number: 26150220 Owner: Age of Joint Owner: PEARL E WEIBLEY Joint Annuitant: Age of Owner: 72 Annuitant: Age of Joint Annuitant: PEARL E WEIBLEY Beneficiary: Age of Annuitant: 72 Beneficiary: N/A N/A N/A N/A SARAH M FISHER CHARLES 0 WEIBLEY ADDITIONAL BENES ON FI 'financial information - - Initial Premium: 527,203.91 Annuity Date: Initial Interest Rate: 4.gp% Selected Settlement Option: Initial Interest Rate Guarantee Period: 3 Yearls) Date Settlement Option Payments Start: First Year Additional Interest Rate: 1 7 5% Annuity Contract Effective Date: Income Tax Status: Non-Qualified Annuity Contract Ongoing Additional Year: Interest Rate Threshold: 525,000 Ongoing Additional Interest Rate: 0.25% For inquiries regarding coverage or customer service, please call: 1-877-717-8861 April 02, 2023 Life Annuity with 120 month Period Certain March 02, 2023 March 10, 2001 March 10 to March 09 each year 4-531 44-199 Page 2 SecurePathSm Annuity Application/Information Page ANNUITY NUMBER: ~ ~ .:t ~F ~``~ ''~ ~'° :-;. 1 ~ ~ ~ ~ Will this contract replace any existing insurance or annuity? ^ Yes ,; o If Yes, use form TLA 74-199 B. ~:..=, Initial Premium $ Annuity Contract Effective Date: - Initial Interest Immediate Additional Rate .T~-:~ , ' . % Interest i Interest Rate Guaranteed Period: ^ 1 Yr. ,fl 3 Yrs. ^ 6 Y Ongoing Additional Interest Rate Threshold - $25,000.00 Ongoing Additional Interest Rate - 0.25% rs. ~• 2 The annuity contract is to be issued as a(n): ;0 Non-Qualified Annuity ^ Roth IRA ^ Individual Retirement Annuity (IRA) The initial premium includes a: O contribution for the year for $ and/or a ^ rollover or ^ transfer for $ from an: ^ IRA ^ Roth IRA ^ 401(a) Qualified Plan, which the owner irrevocably elects to treat as a rollover contribution. 3 ~ . Full Name ;;~ t ~ ~ ' - Address ) ~ ~ ( ~~_ -. SSNf'I'ax ID Number ~~ ' ~: - - ~' . Date of Birth -- 1' - ' } f`~r~,=Y~_ ^ Male Q Female s_ ~, The owner is:.<j, the Annuitant ^ a Trust holding the annuity as agent 'within the meaning of IRC Section 72 (u) (1) ^ Custodian ^ Other entity Has the owner purchased other non-qualified deferred annuities from Transamerica during the current calendar year? ^ Yeses No Is every person to be named on this application a citizen/resident of the United States? _lj Yes ^ No ~~~ Joint Owner (Optional -Not Available with Qualified Issues, Full Name Address SSN/Tax ID Number Date of Birth ^ Male ^ Female ® Remark , Tx~vs~Eiuc~. LIFE AND ANNLIITY Transamerica Life Insurance and Annuity Company 401 N. Tryon Street Charlotte, NC 28202 A Stock Compasay 6 '- ~ ~' S ~ Primary __ ~ •~ SSN/Tax ID Number _ ~ . Relationship to Owner Contingent Relationship to Owner 7 ~ ~ ~ Full Name Address SSN Date of Birth ^ Male ^ Female 8 ~ . I/We have applied for the annuity contract identified above. UWe understand that the Company will send me/us written confirmation of the initial premium, initial interest rate, interest rate guaranteed period, and annuity contract effective date. UWe declare that all statements made on the application are true to the best of my/our knowledge and belief. Any person who knowingly and with the intent to defraud any insurance company or other person files an application for insurance or settlement of claim containing any materially false information or conceals for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime and subjects such person to criminal and civil penalties. . ,. Signed at ~ ~ ~ _- ~ ~ on = ~~ City State Date Owner Joint Owner Licensed Agent's Signature (witness) - Printed Name of Agent ~ ~' ' . Agent's SSN/License ID Number Agent Code Solicitor Code 9 ~~• ~ ~ To the best of your knowledge, will the annuity applied for replace any insurance or annuity with another company? ^ Yes 0 No. If Yes, provide details in Remarks section o and complete any state replacement requirements. ,= .~ W Office Use Only ~ TLA 73-199 B **White copy (original) to Transamerica '~*Yellow and Pink to Agent **Blue Copy to Client Page 2 Mellon Insurance Agenc~.T 1~l' '' Cam(- rv . Fixed Annuity Disclosure Form Sales Represen ,~ s Iv;,n,c: ~ ~Y ~~ Customer's N ~ c -: ~t ~.~1 ~. ~Q ~~ ~~. Product Purchased: Initial Premium $: Contract #: I/We acknowledge that Uwe are purchasing a fixed annuity and understand the following: THE ANNUITY IS ISSUED BY AND IS AN OBLIGATION OF - ~~,/1S~/~'1,~~ l' C Gt L i~~ Mellon Bank does not tccue annuities. I UNDERSTAND THAT THE FIXED CONTRACT I AM PURCHASING: • IS NOT INSURED BY THE FDIC OR ANY OTHER AGENCY OR INSTRUMENTALITY OF THE FEDERAL GOVERNMENT. • Is not a deposit or obligation of any Mellon Bank. • Is not guaranteed by any Mellon Bank (or any affiliated bank). • Is subject to investment risks, including possible loss of the principal amount invested if the insurance company is unable to meet its financial obligations. YIELD/RATE GUARANTEES. The insurance company guarantees the initial interest yield rate for at least months. After the initial period, the interest yield/rate will be adjusted and automatically guaranteed for another term of ~_ months. The new interest yield/rate may be higher or lower than the initial interest yield/rate, and may be less than the interest yield/rate paid on new premiums. Fees And Withdrawal Penalties WITHDRAWALS MAY BE SUBJECT TO A PRODUCT PENALTY DURING THE FIRST _~ YEARS. A product penalty on withdrawals over permitted amounts may be assessed as follows: Year: 1 2 3 4 5 6 7 8 9 10 Penalty: ~ % ~ % ~ % ~ % ~ % ~ % ~ % .~~! % ~ % ~ % A penalty-free withdrawal (CHECK ONE) i~/ ^ is not available in the first c ntract year. If available, the penalty-free withdrawal to fl % of (CHECK ONE) ^ init al premium, ^ annuity value, or accrued interest may apply, beginning ~ _. Beginning the second contract year and through the prod t penalty period, penalty-free withdrawals of up to I10 0O % of (CH K ONE) ^ annuity value, accrued interest, or ^ accumulated value on latest contract anniversary may apply. DURING THE ACCUMULATION AND PAYOUT PHASES OF MY ANNUITY, MY ANNUITY MAY BE SUBJECT TO CERTAIN FEES, WHICH ARE DESCRIBED IN MY ANNUITY CONTRACT. Income Tax Information THE FOLLOWING FEDERAL INCOME TAX IMPLICATIONS MAY APPLY TO WITHDRAWALS. IT IS RECOMMENDED THAT I CONSULT A TAX ADVISOR PRIOR TO INITIATING A WITHDRAWAL. I UNDERSTAND: 1) Earnings are taxable upon withdrawal from the annuity. A 10% IRS early withdrawal penalty tax may be payable on interest received before age 59~z unless taken as income based on life expectancy, 2) For qualified annuities* (i.e., IRA, TSA, etc.), a 10% IRS early withdrawal penalty tax may be payable on earnings and principal received before age 591/z unless taken as income based on life expectancy, and 3) If more than one non-qualified annuity** is purchased during the same calendar year from the same insurance company, the interest earned on all annuities will be combined for the purpose of reporting the taxable portion of certain distributions. * Qualified annuities: Premiums not yet taxed; pre-tax dollars. ** Non-qualified annuity: Premiums already taxed; after-tax dollars. UWe authorize Mellon Insurance Agency, all other Mellon companies (including the Dreyfus companies), all mutual funds advised by a Mellon company (including The Dreyfus Family of Funds) and all distributors of those funds to share information about my relationships with any of these organizations. This includes all information that any of these organizations have or get about me or my account relationships with them. This authorization will continue in effect for as long as I have at least one open account with any of these organizations. Signatures UWe have read this disclosure and understand it. I/We acknowledge receipt of a copy of this disclosure. Signature of Owner: Date: Signature of Joint Owner: Date: TR•~a6a cs~,r.c. ~sise~ e.o. sroo Distribution: Original to MIA Yellow Copy to Customer Pink Copy to Talbot ~onn~ ow+r~t The right to name the Beneficiary belongs to the Owner and the Joint Owner. Use this form to designate an Annuitant's Beneficiary or an Owner's Beneficiary. The Owner's Beneficiary is only available on non-qualified annuities owned by individuals. If wore than one beneficiary is named, then benefits will be paid in equal shares to the survivors unless otherwise 7. O Chat>~e in Owner's Beaeifclary This beneficiary designation cancels all prior Owner's Beneficiary designations and scttlcmcnt agreements for the Contract. - The Owner's Benefuiary for the Contract shall bc: Q. T~~ ! ' S V~SL.rv~~~. D~~~L~k~ ll~'~U ~~ fV9~A~i~s -l c?'4~ Q O ~ ~ ~ ~ i~ ni ~ P ,/ /I. ~em-Q-i7 ~Z~~ r lQ.t - _, Qf~'i . - - - ,.Ib eLj. ~ . _ ,; sp,~~ ~r~ar~ ~.u; J~/Ca ) ~4/ CONT1Nf3ENT NA~mcs>. ADe+tessces~ AND soeu-i secZnvrY IQIJMBEJt(s~ ~~~~~ DATE OF Tt~ o~~tifc~' l0 / ~ C'~593 sow v7,_2_.l /~ 4 ? ~ U rG~ I _ 1t,-~ /Q~~ /9~S D s~Yl o i c~4/ t4s' 7 Sc~ ~J a~ ~ i ,S~ MRCFM OF SE/TnfEP/T~,T'S ~, ~j'`J ~~ /(!~'• 1(~ "~ GIG. "! 11 f- tva.AnorisHtr DATE or ~ RTH vESt~xr of ro oWt~e a~~ _1_J _.J_J e. O ~e in Annuitant's Benefidary (If available) This benef ciaty designation cancels all prior Annuitant's Beneficiary designations and scttlcmcnt agtrcmcnts far the Contract. Thee Annuitant's Beneficiary for the Contract shall bc: >~ ~>~ u+o scxw, secvitrnr auasrt __!_J RF],AT10NSt[[T TD DATE OF B(RT}I oWNBn 9. -OVYNER'S ~AHITAL STATUS a Martiad ~1 unntarri~d a ~o. - ~~. ~ ~~ ~~~ 10QrT OwN6A3 SIGNATURE DA~ 12. I acknowledge and agree to the beneficiary designation(s) made above by my spouse. I understand that unless I am named as the beneficiary. I may not receive any proceeds from the Contract in the event that my spouse predeceases me. 1tiu ~ ON?Ra arOUS6 DATE ~~~ 13. I ACKNOWLEDGE AND AGREE TO THIS BENEFICIARY DESIGNATION SiGNATUltB OF 1RRbtiOCABLb HFJ~7t~iARY, WHEN AYPLJCABL~ 'I~is ben~f'iciary designation has been rroorded by Transamerica. The Company assumes no responsibility for the sufficiency or v~lidiry of tht Bc®cficiary designation. s ~ ~ HATS sY Transamerica Life Insurance and Annuky Company, Annuity Service Center, P.O. Box 3l 848, Charlotte, NC 28231-1848, (800) 258-4260 • Transamerica OccidenW Life Insurance Company, Annuity Service Crnter, P.O. Box 31848, Charlotte, NC 28231-1848, (800) 258-4260 • Transamerika Lilt Insurance Company of New York, Annuity Service Center, P.O. Box 31848, Charlotu, NC 28231-18x8. (S00) 258-4260 0?Sa-S9i o~ ~/ 5~0~-D ° 2. TS Ntn~astt 6. AxNtlnf'AT~T Ow~-t D~AYTZ#iE'[BL~IiONE NVMaBit OWNER'S EYF]~IING TE1F?HONP NVM8F7t - ~ ro W r• R~ N N N N O cn C'1 td ~ rt a ° ~ ~ p o' ~ < ~ "~ ~ p cu a ~ ro ~ ~ a ~ ~ ~ < w ~ n 0 ~ a ~ ~ ~ ~ ~ ~ ~ m ~ p n r • °- ~ ~' C m ~ ~, ~ r-~ m ~ ~ ,_, ~ a ~' ~ ao co c a d c~ j G ~""~ ~ ~ CD '-. ~ ~ O i--~ cAO A. ~ ~ ~n -cn V V W W I ~ ~ O llt l,l1 I N N .L~ A -~~~zc~ o n cc E ~ rt rt to ~ m r•oo b fD rt rn ~C ~ cn r• -d O m xmv a o ~t m no z~• o n o ~ ~d w ~+ o~R r• ~t r• m r• ~ ~ ~ m 1r Vr ZJI V/ N ~ r ~ o W~ O O~ o ~ OO O O ~-- O ~ • • • • r-~+ ~ 1.T1 O O v O 9 0 0 0 ~ o r. ~ c cu o ~ c~ u' ~'. ~ ~ n ~ ~ o ~ c ~ . o ~ ~ `° '~' : Cn " A. ~ ~ ~ ~ ~ . C) ~ CD ~ M ~~ < ~ ~ ~. -a ~~ ~ ~ ~ ~ ~ 1/ Vr VJ 1J ~-+ W v lJ~ ~, V N lJt W lIt O ~O lI~ O O V1 O O O O O 0 0 0 0 ~n ~n ._.. o O N V ~ O ~ N O A O v cn ro --~ 7J .~ ~ .._. p ~! f-' • NUR b O m t_n 'd ~ ~ w m cn N p by py I m O x p N ~ 5C r • UR N G ~ m ~i W UO ri --- UR W rn Cl] W rt ~ ro ~ r• ~ ~ ~ -~ rr m ~ n N ~ G m w 0 m 0 z~~ E ~~ ~ t~ r• m -~ m v~ ~ n w m ~ n V ~ w ro x ~ O ''~ F-r r -- r cn N £ m ~ K r p~ a H f7 ~n ~. co ~ ~_ 0 ro d m m ~ ~ r~ m n ~ N (p N ~F..J~a• V V 1~ N m o r ~~,...j ~~ RECEIPT FOR PAYMENT ------------------- ------------------- GLENDA FARNER STRASBAUGH Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17613 WEIBLEY PEARL E Receipt Date: 12/15/2011 Receipt Time: 11:37:34 Receipt No.: 1068091 Estate File No. 2011-01336 Paid By Remarks: JANE M ALEXANDER HMW ------------------------ Receipt Distribution ----- Fee/Tax Description Payment Amount Payee Name PETITION LTRS TEST 210.00 CUMBERLAND COUNTY GENERAL FUN WILL 15.00 CUMBERLAND COUNTY GENERAL FUN SHORT CERTIFICATE 8.00 CUMBERLAND COUNTY GENERAL FUN JCS FEE 23.50 BUREAU OF RECEIPTS & CNTR M D AUTOMATION FEE 5.00 CUMBERLAND COUNTY GENERAL . FUN --- Check## 5191 ------------- $261.50 Total Received......... $261.50 0991 3-7615/360 ~~ ` 319 ' ~i~~ DA ' ~1l-~'L't~'~"~i~ ~i ~~ ` ~ ~ PAY TO THE ORDER OF. ~~~~~~ . ~ ~,f{. ~ -J ~~ Citizens Bank Pennsylvania r' FOR 1~~:~-~ sr~iC~t.~t.-~ (iG~~-~~~..~~~~'~~-~ ;. r il'00099 Lii' x:036076 ~ 50~: C.~Cl~' J 'J ~? s.0~.ny DOLLARS ~ `:`°'o~ o ~.;~, 6.ck_ '~ j 6 2 34 29 ?009ii' The Sentinel ATTORNEY AT LAW JANE M. ALEXANDER www.cumberlink.com 148 SOUTH BALTIMORE ST. ~~~~~~ P.O. BOX 421 DILLSBURG, PA-17019-0421 C/+RUS€F StiEt'r'FiV~EIiRG GEYKYCOUIV~Y 717-432-4514 AD NUMBER AD DESCRIPTION 405323 EXECUTOR'S NOTICE ESTATE OF PEARL Publication Insertions 3 THE SENTINEL -LEGAL 3 TOTAL AD CHARGE 3 MOBILE SITE 3 PROOF OF PUBLICATION Purchase Order Est. P.Welbley t. AD NUMBER PAGE NO. 405323 1 of.1 BILL DATE SALESPERSON 01/05/12 wolfs START DATE STOP DATE 12/22/11 01 /05/12 CLASS LINES 10 PUBLIC NOTICES 32 * 2 cols Rate Net Amount Gross Amount LGL $169.92 $169.92 MOB2 $2.00 01 PRF $7.00 PAY THIS- AMOUNT $„a9z $1.78.92 $214.~0* *AFTER 01/30!12 Thank you for advertising with The Sentinel! Deadline for - in-column legal ads is 4:00 p.m. two business days prior to date of insertion. For questions, call (717) 240-7130. , THE SENTINEL c/o LEE NEWSPAPERS PO BOX, 540 ' WATERLOO IA 50704-0540 Return th/s portion w/th your payment Legal ,_, _ ~~ ~ r~ ~~~ L ~ ~= r_1,f3~. cif 0998 3-1615/360 319 DATE ~ ORDER OF /~ r ~ ~ /'~ ~ /~1 ~~~f r~ '~~ ~ - ~ / ~ ~ ~ /'~ Sic urily o.uus on ~ ~ '~ I DOLLARS0 `°°'"`°' Bilk. Citizens Bank , Pennsylvania ; I wy,y..r ~'; ~- ~; ~ ij 1- f FOR I U' J ~ ~ 7 ~' ~ ~..~-%:~~=._._----___ _.-__ - 1 -T------ l II'00099811' ~:0 360 ~6 ~ 50~: 6 2 3~, 29 700911' PAY TO THE ORDER OF r DATE 09! 3-1615/36 31 $»s~~~ DOLLARS ~~ Citizens Bank ~ w Pennsylvania ~~ ~\ ~ J 1 f 11'00099 511' ~:0 360 76 1 50~: 6 2 34 29 700911' MAKE CHECKS PAYABLE TO: Heartland PHARMACY OF PENNSYLVANIA, LLC 7010 SNOWDRIFT RD ALLENTOWN, PA 18106 800-270-6351 EXT 6050 33978 RETURN SERVICE REQUESTED MAIL oozlso 0101 IF PAYING BY MASTERCARD, DISCOVER OR VISA, FILL OUT BELO CHECK CARD USING FOR PAYMENT (~ ^ ^ VISA _ ` MASTERCARD DISCOVER \ CARD NUMBER AMOUNT SIGNATURE SIG. CODE EXP DATE STATEMENT DATE 11 /30/2011 PAY THIS AMOUNT $17 5.4 6 CUSTOME! 42091 FACILITY: 53720 CARLISLE SHOW AMOUNT ~ l~~t PAGE NO. 1 Of 1 PAID HERE / PAY PLAN: PPPA PRIVATE PAY EASTERN PENNSYLVANIA IIII~I1~1~~1~1~11~1'IIIi~~~lli~l~l~~~~lll~l~lll~lll~l~llll~~~ll PEARL WEIBLEY C.O STEWARD WEIBLEY 17 BEIDLER DR SHIPPENSBURG, PA 17257-9746 Please check box if above address is incorrect or insurance information has changed, and I"I~~I""~I~I"~I~I'~'~I'I'~I"11'~~~I'~Iil~ll~l~l~~~llll~lll~ HEARTLAND PHARMACY OF PENNSYLVA PO BOX 72413 CLEVELAND, OH 44192-0002 33978'TDHOHWC3X00135 Q ~ ~ ~~n~ m '_ ~~~ . D m ~ ° mom'- ~~ ~ cnm~m cQ ~ ~ Cp~r-- ~~x ~ _~ m ~ W oo y ~` ~ m = ~ ~ N ~ ~~~ _ ~ N~Q ~~ ~ _ c~ ~ rn ~ _ ~ c~ _. ~~ rn Q ~. a~ ~ ~o - n. ~ _- .~ - r° m~D= <W m~~ ~. Z N Z ~ n ~~~= 2 n ~ W ,_ O = ~ ~ ~_ C ~ ~ co D ~ o - ~_ O v `"' ~ ~ ~. `° ~ O 1'1 _ N - ~ ~ o m- ~ ~ Z ~- ~" (n _ ~ 0 O < ° ~ w _ Z D -` ~ m D ~, Z -I ~ 0 0 w 0 0 ~ TI ~ o r o wDv ~ x -~ Z v r [~ C Z ~ o -~ Z ~ Wgg ~ D ~ Z n ~ N m ? o ..~ X ~ o D ~ ° ~ D oN m ~ ~- o ~ J~ ~ m p C ^ ~ C D m m ~ y m -I o r ~ (n ~ ~ D D D ~ ~ ~ r m m ~ Z' ~ O .. ~ m Z Z -< r D Z D 3 n w w ~o r Oo D ~ w z ~ m Z v> -~ n o Z Q ~ N "'~ ~ n ~ .n ~ ~ n o N ~ ~~ o ~ ~ ~ m ~ D ~ o ~ = n ~ ~ m n ~ D ~ ~ o ~ __ ° o _D = N ~ ~ D cn z (n n _ ~ c ~ o ° ~ ~~ ao ~ ~ ~ m ~ ~ { O m m fA Z Z D ~ X ~ ~ r ~ ~A c ~ ~Q O ~ y m ~ N o A^ %I ~ ~~ '• ~ ~. ~ p~. ~! ~ C~ ~~ ~ ~ O ~ ~ o ~~ ~ ~ ~~ ~ `~l _~' O -- W ~ ~ O Q~ `~` r LJl ^. 0~ rv W r ~ ~u O ~~ ~J f ~~~ O~-~ m= mm O m i'-' .-~ ~. c~--. 1j m '~.. ~i ~, `' m 0 v ~~ BOO rm w ~ _ ~o~ s ._ ~i. April 16 2012 Little IKE Eichelberger ,~. Auctioneer ~~~ AU-001954-L 12 Franklin Church Rd. Dillsburg, PA. 17019 Appraisal Fee for the Estate of Pearl Weibley 17 Beidler Dr. Shippensburg PA. 17257. Appraisal done on Wed. April 11 2012. Fee: $ 100.00 payable to IKE Eichelberger Thank you IKE Eichelb ~~ Citizens Bank Pennsylvania PAY TO THE ~ ~ f l ~~ ORDER OF -- -; Auctioneer ,~ =' _ ", ~/~.~~~. Da y S ~ r v i li ,r r ,l ,1 ~ ~ rr irr ~ it !. ti __-. _. (~ ~r i A / i~ r i1 i f it i f ESTATE OF PEARL E WEIBLEY ESTATE OF STEWARD O WEIBLEY JR EXEC ~'O- 1504 3-7615/360 DATE t~ ~ {~°~ 319 i ~ (~ ~~:~ DOLLARS ~ ~~~:~e~ / ;. f /F,? ~ /f / 148 S BALTIMORE ST ~ -t~+-~'-~ ~-' . ~/ f-~ r ~ ~f/' ~ DILLSBURG PA 17019 ~ ~~~~ FOR _ - - -- 11'00 L 50 411' ~:0 3 60 7 6 L 50~: 6 2 3 ~, 2 9 700 911' M' ~ EXECUTGR/ ADMINISTRATOR ~' / PERSONAL A REPRESENTATIVE M'J TRUSTEE o yet ~ -~- -~. ° a ~ ~~ _ __, 7 - m ~-~ = i r '`, 77 m ~ ~ N ~ J ~ ~ ~ ~i ~... . ! 0 ~• ~ ~ . . .. ~ / N ~ t '_ r F., ~L..~ a7 _...~-__ ~ Cf '' ~ ~ „ ~ ..3 ~ ~ ~" t -' _ .. ~ ~__~.. tom.' W ~~ ~ ~ ~;, - ^ ~.:.. ... 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N ~ o~ c. N ~ v a~ ~D '17 S31 W tD N QD O N --_ !~~`-~~r , ~! -_, ` _ g r ., ~. - 4~ J ~~ ~i ~ ~ ~ ,F~i T.~ P ~ Y .~h~ .~3 -~_ ?~ '~' Yom'. "nor.: ~3_iy ~~ ~ m ~^=~° . ~ 7 ~ ~ ~ ~ a~ ~ ~Fr ~ O i ~ ~'. ~ Y ' Jane Alexander Esq. 148 South Baltimore Street Dillsburg, Pa. 17019 Re: Pearl E. Weibley Estate 17 Beidler Drive Shippensburg, Pa 17257 Invoice for preparing CMA: Due upon receipt Thanks You: Citizens Bank Pennsylvania PAY TO THE ` ORDER OF_ Dillsburg Office 19 North Baltimore Street Dillsburg, PA 17019 (717) 432-0029 (717) 766-0055 (717) 432-0042 Fax March 8, 2012 $300.00 -- -- - _ ri !r ,i rr ~ ,i rr rrr r 1. ti i I' ,r i A i r~ r ,l , f ,r r / Ivo. 1503 3-7615/360 ~~ 319 DATE -, ESTATE OF ESTATE OF PEARL E WEIBLEY STEWARD O WEIBLEY JR EXEC 148 S BALTIMORE ST DILLSBURG PA 17019 FOR t1'00 L 50 311' i:0 3 60 ? 6 150: ~ ~ ~ ~ ~: M' EXECUTOR/ ADMINISTRATOR M' PERSONAL REPRESENTATIVE ~'T' TRUSTEE 6 23~ 29?00911' Your Leader for Exceptional Real Estate Service .if~j~/1?~ ~>/l~!/!!~ " f.?llc7/1/~(!l~ ~ SPtf1P//I(~??f P tIf1P " l11J1/lYI/1('P ~~n~1~12~ axed ~Jp ra~~~ ~y I~li~ i ~_,~,~ , _ ~. ~-LC, C_.~~~ ~~ L A R S 8~ ~MY r.a~w.a ,~a Oe,aM m pacts. ~~t~~ `z11 ~t~ `~e~t~t~tert~ ®f ~earr ~. ~ei~tep I, Pearl E. Weibley, of the Township of North Newton, County of Cumberland and Commonwealth of Pennsylvania, being of sound mind, memory and understanding, do hereby publish ~' and declare this to be my Last Will and Testament, hereby revokin and declarin null g g and void any and all Wills and Codicils heretofore written by me. ITEM I. I direct that all my just debts and funeral expenses be paid as soon after my demise as may be convenient to the proper administration of my estate. ITEM II. I duect that each of my children, living at the time of my death shall be entitled to select one item of personal property from my home as a memento. Selection shall be made beginning with the oldest child and then in order of age to the youngest. ITEM III. I give, devise, and bequeath the furnishings remaining after the selection are made as provided in Item II in my home located at 17 Beidler Drive, Shippensburg, PA to my son, Steward O. Weibley, Jr. If he should predecease me, the furnishing shall be divided as part of the residue. ITEM IV. I then order and direct my hereinafter named Executor/Executrix to convert my entire estate, except the above-mentioned specific bequest, into cash at either public or private sale, whenever in his/her discretion it may be most expedient for the proper administration of my estate. In the event of such conversion, I authorize my said Executor/Executrix to execute a good and sufficient Warranty Deed to the purchaser of any real estate of which I may die seized, in the same manner and capacity as I could if living. ITEM V. I direct that all inheritance and estate taxes be paid on the proceeds of the above conversion and on all the rest residue and remainder of my estate from the residue of my estate prior to further distribution. ITEM VI. I direct that my hereinafter named Executor/Executrix to distribute all the rest residue and remainder of my estate, including the proceeds of the aforementioned conversion in equal shares to my six (6) children, Sarah M. Fisher, Charles O. Weibley, Kay Boianelli, Steward O. Page ] of Weibley, Jr., Ronnie Weibley and Terry Weibley, per stirpes and not per capita. However, I duect that the share to Charles O. Weibley shall be given to Steward O. Weibley, Jr. in TRUST for Charles O. Weibley. Said Trustee shall distribute the proceeds of the trust to or on behalf of Charles as he may determine to be in Charles' best interest. At Charles' death the funds in the trust shall be equally distributed among my children living at the time of his death. ITEM VII. I nominate, constitute and appoint my son, Steward O. Weibley, Jr., as Executor of this my Last Will and Testament. Should he predecease me or be unable or unwilling to serve I then nominate, constitute and appoint my daughter, Sarah M. Fisher, as Executrix in his place and stead. I direct that my Executor/Executrix shall not be required to post bond other than his/her personal assurance for his/her duties as Executor/Executrix. IN WITNESS WHEREOF, I, pearl E. Weibley, have hereunto subscribed my hand to this my Last Will and Testament, this ; ~~~::. _ ; day of -~ ~ ~ ,' '~ - '~ ' -~-~/ r' 2007. - f~ , :` ~_) ~ . Pearl E. Weibley ~- SIGNED, PUBLISHED and DECLARED by the above-named, Pearl E. Weibley, as and for her Last Will and Testament in the presence of us, who at her request and in her presence and in the presence of each other, have signed our names as attesting witnesses hereto. ~', ' ~ - r" ' - ~ ! ~~ ~.-. :1~~ . ;,<--'~-~~" residing at `~ '~~ .~~~_' - -- ~- ---~- __ .. _. _.__ residing at ~~= .. ~ _ . . _-. . - _, Page ? of i