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HomeMy WebLinkAbout12-05-1211 1505610101 OFFICIAL USE ONLY J REV-1500 °` 01-10' 1~' PA Department of Revenue pennsylvarria County Code Year File Number ENT OF REVENUE Bureau of Individual Taxes f ' - ~~ ~ ' ' ` R INHERITANCE TAX RETURN PO BOX 280601 ~ / / / Q~ ~ . 31 ~~ 23 Harrisburg PA 1128-o6oi RESIDENT DECEDENT ~w._. _. _ ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth A1A1DD1'YYY ,.,. -~ - ti ,~. Decedent's Last Name Suffix Decedent's First Name MI 8,4>< s~ s .~ ' . T° ~,.X .,~.® c'i,',s-ice ~ ~ ~ F° (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouses social security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE .. ® ,~#. : ,~; REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ~ 1. Original Return O 2. Supplemental Return O 3. Remainder Return (date of dealh prior to 12-13-82) O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required death after 12-12-82) ~ 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust ~ 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT - THIS SECT{ON MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number C N~ R L ES E ~~H__i EL ~ S " l 1~ 7 1 7 ~~~ ~ ,~ o First line of address Co CL ~ u SEA Rod' b Second line of address nJ f ,g- City or Post Office State ~- C ~ ~''~ / ' C S B u rz ~' ~+~' ZIP Code ~~ ~ OREGISTE~F WIRE E ONLY s~ ~' c;~ n r' `~' ~I f"rl x a c, e, ~, ""_` -~ -e1 5~.1 -"M"} ~ YTS '~ C„. ."` ~ ' ~ ~# D 7E E ~. < 7 a'SS`'9735 Correspondent's a-mail address: Ce~1/L~~S.3 ®CO/rICQSf, h2t Under penalties of perjury, I declare that I have examined this return, inGuding accompanying schedules and statements, and 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. SIGNAT E O PER ON RESP IBL R FILING RETURN DATE x X ~ ADDRESS ,$ Ey O ~ ~p,tJ~'~ LFF $~4SSE TT aas o~ 4k ~ma~ ZJi//S6N P/~ /'70 / O ar r~~~ ~ 1 SIGNATU PREPARER OTHER T I~EP ESENTATIVE DATE ADDRESS CHA-~LES F: SH/ELDS 6 0 /bass PLEASE USE ORI INAL FORM ONLY Side 1 1505610101 1505610101 J J REV-1500 EX 1505610105 De c edent' s Social Securi ty Number c Decedent's Name: C~QY~(,~ ,e~, ~QSSe~' 11 - 7 ty ~ ~: rO ~~ ~ O c. / r7. 6 RECAPITULATION 1. Real Estate (Schedule A) ......................................... .... 1. ,. ., ,'< ~ ~ ~ t ~ p ~ ~ - 2. Stocks and Bonds (Schedule B) ...... ........................... .... 2. ~ ~ ~ O .S3~z $ ~~ 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . .... 3. Q ~-.. „ . 4. Mortgages and Notes Receivable (Schedule D) ....................... .... 4. O D 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)... .... 5. I E, f ~ Q 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ... - .... 6. ., ~ ,~:4~~~, i,?F'^ is-`- ~' 7. Inter-Vivos Transfers t£ Miscellaneous Non-Probate Property ~`` ~*" °°''x-`~ `~~~ " ' (Schedule Gj O Separate Billing Requested.... .... 7. i ~ t ~ : ,'~ ~ ~ z 8. Total Gross Assets (total Lines 1 through 7) ......................... .... 8. _ w ,.~ ~ . G 7 oZ ' ~ 7 ! `J 9. Funeral Expenses and Administrative Costs (Schedule H) ............... .... 9. ~ ; ~ : L.1 q (~ $' 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) .......... .... 10. ~ . ~ ~ oZ (.{ ~ (J .• -. : a-~-.jai-u~ 11. Total Deductions (total Lines 9 and 10) ... .... : ~ ~ ~ /~'-~ ~ l a ~ 3 12. Net Value of Estate Line 8 minus Line 11 { ) ............ .......... .... .... 12. ~~u ~ I D ~ O 7 2'' 13. Charitable and Governmental BequestslSec 9113 Trusts for which ~" "~`~-~ an election to tax has not been made (Schedule J) .................... .... 13. ~ -~.} ~ ,, 14. Net Value Subject to Tax (Line 12 minus Line 13) .................... .... 14. ~, ~ : ~ ; ~ ~ 4 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 -~! ~ "'*~ =.~1~-+~ (a)(1.2) X .0 D ' Q~d 15. 16. Amount of Line 14 taxable '~='~'"'` ~~~"~''~=~"' at lineal rate X .0 ~$ ~ ~ Q / ~ 16. 17. Amount of Line 14 taxable `r"°RY'= '`b'-- at sibling rate X .12 ~ ~ D O 17. 18. Amount of Line 14 taxable at collateral rate X .15 s I! (~ ~ ~ D D 1 g . 19. TAX DUE ....................................................... .. 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 L 1505610105 1505610105 J COMMONWEALTH Of PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: STONER SHIRLEY ANN 225 ORE BANK RD DILLSBURG, PA 17019 fold PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ESTATE INFORMATION: ssN: 2os-~o-s~sa FILE NUMBER: 211 1-1362 DECEDENT NAME: BASSETT CHARLES E DATE OF PAYMENT: 03/02/2012 POSTMARK DATE: 03/02/201 2 COUNTY: CUMBERLAND DATE OF DEATH: 1 2/03/2011 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 ~ 54,275.00 TOTAL AMOUNT PAID: REMARKS: RECEIPT TO ATTY SEAL CHECK#1273 INITIALS: WZ RECEIVED BY: 54,275.00 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REV-17&2 EXI11-96) NO. CD 015653 TAXPAYER REV-1500 EX Page 3 flenerlnn4~c (_mm~tla4o Otlrlrrcacc• File Number ~ ~- I / - /36 Z. DECEDENTS NAME _rL. C~iar~BS ~ ~4SSG' ~! STREET ADDRESS 380 Gtiesthuf ~treef ____ __ _ __ __ -- CITY ~~~ ~J // STATE n~ ZIP j7 D,/ Tax Payments and Credits: 1. Tax Due (Page 2, line 19) 2. Credits/Payments ~~ oZ~s ~ A. Prior Payments _ ~ B. Discount _ 2~s.0D 3. Interest 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) ~~~ Z Z lr . o I 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 :.................................................................................... i ...... ^ ncome : ...................................... b. retain the right to designate who shall use the property transferred or its ...... c. retain a reversionary interest; or .................................................................................................................... ...... ^ ^ 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? ....................................................................................................... th? i h d " " ....... ^ Wx ....... s or er ea or payable-upon-death bank account or security at h in trust for 3. Did decedent own an ....... I,d 4. Did decedent own an individual retirement account, annuity or other non-probate property, which ,~{ ^ contains a beneficiary designation? ................................................................................................................. ....... Ilsi 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 still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an adoptive parent or a stepparent of the child is 0 percent [72 P.S. §9116(a)(1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. (,) ~! 2, (~ ~ 3, o y Total Credits (A + B) (2) ~~~ SOD . Oa (3> ~ ~• 9Z (4) a REV=1502 EX+ (6-98) SCNEDVLE A COMMONWEALTH OF PENNSYLVANIA REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survlvorshlp must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH ,. A// oaf Ccrf;~/~ ~rcGf v~ /a~~l i~ ~arn~dcn Tecvn Ship, ~um bar /an q~ (:ouq~, /~eh~l, , i~t~rcvea~ 6~. ~ a~w~l/.:,~ douse ~nawn a~sd /1 u n, latrs~ as 380/ t!'~sfna~ c5t., ~a/~r~ h/.%/~ ~i9~ /7D!/. ~3t~.r, l.t No. ~ A . ~cGf: ~, ?/~n Z s~ !!a-,•rrd~rt G~rdcn6 ~ as iS Slown %~ l~/4n /s~~~l ~, p~ ~-1, ~n flu Of~'ce >{' ,yic ~eeordtr ef' Deeds ~ 4~td ~,~ L'ar„b - u-/MS.r ~ount`r, ~tnn a . ~~r/ng ~rct,/ No. ~!- o ~7s- ~3~ / cSoJ~l por (~kbl~c auc~on -~„ '~a, F;tz~lol.tric~',,.}7: I~ l~lar Jane Casavant', See ~eft/ernent Shad o~ ,Y ,AP~~ / ~~, ao~a 4~aclie.l. ~ ~Ka ate( ebrrt~ f ~'y ~ died Q~so ~1~kchegl, TOTAL (Also enter on line 1, Recapitulation) I S q ~ voa• ~~ (If more space is needed, insert additional sheets of the same size) Tax Parcel Number: THIS INDENTURE MADE THE ~ day of ~~/~ , in the year of our Lord two thousand and twelve (2012). BETWEEN SHIRLEY ANN STONER and DONALD LEE BASSETT, as Co-Executors of the Estate of CHARLES E. BASSETT, deceased, late of Camp Hill, Hampden Township, Cumberland County, Pennsylvania, Grantors, and BARCLAY W. FITZPATRICK, JR. and MARY JANE CASAVANT, husband and wife, currently of 125 North 30s' Street, Borough of Camp Hill, Cumberland County, Pennsylvania, Grantees. WHEREAS, the said Charles E. Bassett, was vested in his lifetime with title to the premises hereinafter described, in the Township of Hampden, County of Cumberland and Commonwealth of Pennsylvania; and WHEREAS, the said Charles E. Bassett, departed this earthly life, testate, on the 3rd day of December, 2011, and Letters Testamentary were duly issued to the said Shirley Ann Stoner and Donald Lee Bassett, by the Register of Wills of said Cumberland County, docketed to No. 21-11-1362; and WHEREAS, the lands herein-mentioned were not specifically devised: NOW, THEREFORE, THIS INDENTURE WITNESSETH, that the said Shirley Ann Stoner and Donald Lee Bassett, Co-Executors, as aforesaid, for and in consideration of the sum of NINETY-FOUR THOUSAND and No/100ths ($94,000.00) DOLLARS, and other good and valuable considerations, to them in hand paid by the said Grantee, at and before the ensealing and delivery hereof, the receipt whereof is hereby acknowledged, have granted, bargained, sold, aliened, released, and cbhfirmed, and by these presents, by virtue of the power and authority in them vested by the Fiduciaries Act of the Commonwealth of Pennsylvania, do grant, bazgain, sell, alien, release, and confirm unto the said Grantees, their heirs and assigns: ALL THAT CERTAIN HOUSE AND LOT of ground situate in the Township of Hampden, County of Cumberland, and Commonwealth of Pennsylvania, bounded and described as follows, to wit: BOUNDED on the South by Lot No. 13 of Section "P" as shown on the hereinafter mentioned Plan of Lots; bounded on the West by Lot Nos. 14 and 11 of Section "P" as shown on said Plan; bounded on the North by Chestnut Street as shown on the said Plan; and bounded by the East by 38a' Street as shown on the said Plan. Said tract of land is one hundred twenty (120) feet in length on its southern boundary along Lot No. 13, is one hundred two and twenty one- hundredths (102.20) feet in length on its western boundary along Lot Nos. 14 and 11, is one hundred (100) feet in length on its northern boundary along Chestnut Street, and is sixty-seven and nine-tenths (67.9) feet in length on its eastern boundary along 38"' Street. HAVING THEREON ERECTED a one story brick dwelling house. THE SAID LOT of ground herein described and conveyed is Lot No. 12 of Section "P" on a Plan of Lots known as Hampden Gardens, Plan No. 2, as laid out by Joseph A. Wagner and Leroy A. Kohler, which Plan was, on November 8, 1948, filed of record in the Office of the Recorder of Deeds in and for Cumberland County, and recorded in Plan Book No. 4, Page 71. BEING the same premises which Robert H. Wentz and Hilda O. Wentz, his wife, by their deed dated January 21, 1955 and recorded in the Office of the Recorder of Deeds in and for Cumberland County, Pennsylvania, in Deed Book "F," Volume 16, Page 124, granted and conveyed unto Charles E. Bassett and Edith E. Bassett, his wife. The said Edith E. Bassett departed this earthly life on February 2, 2009, whereupon full and absolute title vested in her surviving husband, Charles E. Bassett, by the laws of this Commonwealth incident to tenancy by the entirety. His Estate is the Grantor herein. UNDER AND SUBJECT to those certain BUILDING AND OTHER RESTRICTIONS, acknowledged on April 17, 1948 and which are attached to and recorded with that Certain PLAN OF HAMPDEN GARDENS in the Recorder's Office aforesaid in Plan Book 4, at Page 71. TO HAVE AND TO HOLD the said messuage or tenement and tract of land, hereditaments and premises hereby granted and released, or mentioned and intended so to be, with the appurtenances, unto the said Grantees, their heirs and assigns, to and for the only proper use and behoof of the said Grantees, their heirs and assigns, forever. AND THE SAID GRANTORS, Co-Executors, as aforesaid, their successors and assigns do covenant, promise and agree to and with the said Grantees, their heirs and assigns, by these presents, that the Grantors have not done, committed any act, matter or thing whatsoever whereby the premises hereby granted, or any part thereof, is, aze, shall or may be impeached, charged or encumbered in title, or otherwise howsoever. IN WITNESS WHEREOF, the said Co-Executors of the Estate of Charles E. Bassett, deceased, Grantor herein, have hereunto set their hands and seals the day and yeaz first above written. Signed, Sealed and Delivered in the Presence of: ~~./~a~e!s ~~ S~,e~as ^ ~~.~'~~/ay ~~ J1b4ar' (SEAL) HIRLE ANN STONER, Co-Executor of the Estate of CHARLES E. BASSETT, Deceased $ f / ?iru~ ti/~~Son v~~~/~/ ~C~ ~SSC7~ (SEAL) DONALD LEE BASSETT, Co-Executor of the Estate of CHARLES E. BASSETT, Deceased COMMONWEALTH OF PENNSYLVANIA ) SS: COUNTY OF CUMBERLAND ) On this, the day of , A.D. 2012, before me a notary public, in and for the Commonwealth of Pennsylvania, personally appeared SHIRLEY ANN STONER and DONLAD LEE BASSETT, known to me (or satisfactorily proven) to be the persons whose name are subscribed as Co-Executors of the Last Will and Testament of Charles E. Bassett, and acknowledged that they executed the same in such capacity. IN WITNESS WHEREOF, I hereunto set my hand an official seal. Notary Public My commission expires: (SEAL) CERTIFICATE OF RESH)ENCE I do hereby certify that the precise and exact post office address of the within Grantee is: Attorney for Grantee A. Setttemeflt Statement u.s. Depaftmemt of Housing and Urban Development OMH Approval No. 2502A265 (expires 71!30/2009) B. Tape of Loan___.._ _...~...__.-._- --... _._._..._.__._. _ _.___. __ ._..__-•-------._._._~._.._._._......_.....__._._ _ _s.~_._....A_._._.___~_:.7. Loan N.nrtber:. .. - i e. h4ongage tnwrance Case Number. e. File Numltet. t. ^ FHA 2. ^ FmHA 3. ^ Cam. Unirts. 4. ^ VA 5. ^ Conv.Ims. ±014-12 1P146153 C. Note: This form is tumished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent arc shown. Items marked _ `(p.o.c.)_ were paid outside closing; they are shown here foc infornational purposes and not included in the totals. - , _ _ D. Name and Address of Borrower. ! E. Name and Address of Seller. . F. Name and Address of Lender. Barclay Fitipatrick, Jr. ;Estate of Charles E. Bassett Mary Jane Casavant s 125 N. 30th Street . _ .i......_.-.__..___..__--_--r.._._.__.-__..___--f......Y._....___-_-----°--.___._~.... __. Ca~,Hill---~_,._ PA ...17011 . -- .._ G. PropeM Locaaon: j H. Setaemem Agent 3801 Chestnut Street 'Peter R. VYison, Esq+._.. -_.____._-._ _.__ ____._.....__._ Pace or 5eUlen7eM: ~ i. Seltiement Date: Hampden Township, Cumberland County ~~ i Camp Hill PA 17011 71700 Bent Creek Boulevard, Suite 140 .4/12/12 +Mechanicsburg PA 17050 !DiSbursemanl Dat° ~ loose 14/12/12 J. Summary of 13orrovreta Transaction K. Summary of Seller's Transaction 100. Oroas Amount Due Flom Borrower _.___,_... __._~.~- __ ~• G~ Amount Due To Seiler ~_ _ ___ _ - --z--- ----'----- to1. Conltacisak9 ~i 94 000.00 40,. conbactsates~rr~ce-- -._...____.~.._.~ j_.__ ~a~0;O0 --~-__..J~ _....._ _.-_...._._..----~-.~_. .~--- AdJustmenta for items paid by seller In 106_ Cd~rltown taxes _.._~____ ~o..___ tor.. coin, uues_._ .4/12/12._ to 12/31! 106. Assessments ____....__.___.!o_._.__._.___._._..._.._.~._;._. tos. Sewer 4/12!12 b 6130112 ` tto. Trash 4!12/12 b 6/30/12 ,.__-___.._~ _ n, School 4/12/12_~g6/3O/12 ___ _-_..,;__ tt2--- ___..... - to 719. b l t 74.. _..._ _ __,_.-._.__-. __~?______.....~_._.-.... 775. _..._. _-_...__ to_.___~......._~'___.~i.. 120. Gross Amount Due From Borrower 200; Amounts Paid By Or In Behalf Of Borrower_ __ _ 20,. Deposs a earnest mone1r_. .. _ 202 Pnr7G__~il arnormt of new /earl s . 4/1 seller in - __1412. __.__. .__...._..._.._... _.___...._ro.. 415. to 96,410.59 420. Gross Amount Due To Sower 500: Reductions In Amount Due 7o Seller -9,4OO.bO~sot. Exceesdep~d seeutstruc,tonsJ. ~~ 502. Seidement Utarges ro serer (lens 1400) .. 212.06 100.44 94,585.84 nr~. cx~s°i'Q._'na!'laL_aL'_!o_-.-".- ---' ~ _. _°•c,.....,..,z=it~_:--~_-`..___.___....__'-. 204. _ .........__.... _. - ._____.._.__._ _. ..__ _..__.___ ' .--~_._...~_~._._ _....._ 504. PaYotS or fins ma}Aaya ban .,.- _- __.._ __.__ .. .._.._....___ __-_ - T_ ~. ...... __ 205..____._.____.___.._.___..__._.____.__.._... ..._..__..__~.__~_.._A__~_.. 505. Pa of aecond_rttor_yt acme loaniY~___-._-_._.._' 205. ~ . 207_~__..___...__'_.__...~..__..._.. __.__....__ ~ _..____._. ~7-._..-._._._.__.._-._._.~._.._..__._.~...._,__._._j..__.__._.-....____. 206. i_.__._ 208. i `~~__ __~_... _.__...___..._.._~__.__~.____.__..._..~_~....__.._.....__~-_. Adjustments for items unpaid fir seller. -- ~ .________, ___ _,~__ Adjgstments for llama unpaid bar seller ,__. ___._____„__ _,_._._ 210. Crt flown razes b } 570. CilYrtown taxes _._._. _..___ ~ . __,._ 21t. " taxes to ( 511_ CotM~iaxea `.-.~_.%_.._...___------._-_"._'.._---'.^-_'._.-- 211. Asseaamenta to ! - ... 512. Aseessments tO ... 213. b .... _..--' -__.___ _ i -`.__..~L_.,__.-- ---- b 513_ .~..---.. _._.__. ..._ __ _.. ___. __ -.-.. _--'---_..__. . . _._._~.,.~..._._._._ ._ , 214. ~ b 514. `~ Its. b _--._`--..___ - __._~....~..~..~_..~ _. m -,._ 515__.____.___.__.___ __._ ,.. _.._ ~- _._.____ ...._ __--.__._-_._-__....._.._ .~ b 218. .---------_-___..__--._.- i ._.-.._.`._.~._..._._..._ 510. to ~....___ ._..___...____._~~--...ro.~--.._~. _~...___~-_ -- to .___. ~_...~ 517;_^1..._____-_-..._.-___ ___.~,_.~_.__..___._..-__ 21 A. b "; ~-._ to 518. _ ~ . .. .._...._..__. __._...._..-...__ ____. ___~.~_ 21 a. _ 10 ~. W ~ 518 ___... ._.....___ ~ T. _...._____._.. 220. Total Paid ByfFor Borrower j 9,400.00 520• Total Reduction Amount Due Setter 10,340.00 302. Less amoums ~tty!ta renewer ins na) _..`-- ~y~svv_vv _ ouz.- Bess ~eauaAns ~~ aim. vw aaR, t....= y~~L.,._-_--_.,-;7-_.__.__~.r=_-==.- 303 Cash ©From ^ To HOrrowor $7 010 59 ~ 803. Cash ®To ^ From Seiler i 84,245.84 Section 5 of the Real Estate Settlerrtertt Procedures Ad (RESPA} requires Section 4(a) of RESPA mandates that HUD detretop and prescribe this the following: • HUD must devebp a Special Information Booklet to help atarulard form to be used at the time of ban settlement to provide full persons bottowing money to finance the purchase of residential real estate disclosure of all charges imposed upon the borrower and seller. These are to ttettor understand the nature and cosh of real estate setlement services: third party discbsurcs that are designed to provitle the borrower with Each lender must provide the booklet to elf applicants from whom it pertinent information durirg the settlement process in order to DB a better receives or for whom d prepares a written application to bortow money to shopper, finance the purchase of residential real estate; • Lenders must prepare and The Public Reponirrg Burden for this wllecbon of informaton is estimated tlisVmute with the BOOklet a Good Faith Estimate of the settlement costs to average one hour per response, inGuding the time (or reviewing instruo- that the borrower is Iikey to incur in connecbon wltlt the settlement These lions, searching existing data sources, gathering aril maintaining the data disclosures are mandatory. needed. and corrgrkling and reviewing the coilectbn of information. This agency may not collect this information, antl you are rwt required fo congtiete this form, unless it displays a curtent7y valid OMB control number. The information requested does not Tend itself to confidentiality. Prevbus edRions aro obsolete Page 1 of 2 form HUD-1 (3l8fi) ref Handbook 4305.2 L. Settlement Charles DivistOn a Commission Wte 700 as folbws: ._.._.._. _.~.t-__~_---~.___.___._._._.__.__.~_.. 701>_5_....___.._~_._-__'-._.._-....__.__ 14..._.._._....-_.~._ 7D3. Commission paid at Sedlemonl _.... _.._.._ ~_. 800. kerns Pa~nble In ConrtecNon With Loan __ _._~_,__ 801. Loan Ort~tnatbn Fee___. _.-_.-_...__.~_..-.._--.._,~_ % - O.DI 503, A~ainal Fee ~~.._.~___ _.___fQ___-____.... ____.._._. 805. Lenders InapecGon Fee 805, Mon(Lage_ Ir!suronce App!kalbn Fee!o _.-_.__.-_.____~_~~._-__- 807. Aswm Fee 809. 900. Items Required 8 Lender To BB Paid in Advance Exdtrde test to oaks -Gne sot X~...---- --_ ~_ _.~ __ --_-_ ~---..___, _...- 901, tmerestho!n ,..._..__.. to __._..._.-,..~s_...-__...~...-__!~J._~__...__._...___. 902, M Msurortee Prom um (or .____,__~_ . ___ months to 903. Hazard Inwtance Premium for years to Paid Fmm Pad From BdlfOWer'S seeer5 Funds Al ' Funds At Settement Settlement 1000_ Reserves OeQositad With Lender _ ._..~...__--_-_-_-----.....__~..._._ _~__.,_~. : -...___Y_-._.._--_-___._-. loot HazaMirtwrance 1 S r r~„d,_ -r-._..._...____ . 7002_...M~.aQe insurance.___-~-- nt-°nihs~t..~_.......__~_._Per nw^d' __-_....-._.__._.._---..__._...._.___._.-._. 7003. C1M_~o~enY_~!??`e? _. ~ ~^~._.._..~......___._.._. __P?~_.ma1m -_~__. __.._ ' 7004. Coun taxes 1 nqn a f month 7905. Annual assessments 1 trtonM a r mortM -.._._.___._..._-.~~_.__-.---_.._..---__~-__-.-_..---._P? ___.__._.-__._.___.__.__.~..._...__..------_._.-..._ __.._.....-_- i too5. 1 montha~3 __...____...~°L^_1O_!!u7 _ _ .. _... ___. __ - ~_- ~._._. _ -_ -. __t- __ ,007. , months~S.' "'-'-- r nanM_ - r----'-_-'-- __ _ ,___ 1100. TRIe Cha gea_ __ _~.----._ _._ . --- _-_ __ _.__.....--- -'--__.._.._. ~ _. __.. __..._.-.....--- 7101. SMkmem or ddeu79 fee to 1702. ADSaact or titre search ___..._._....~ _-~__ _.-.w_.~. t0 -.,._.~_._._._. _~...__----._..__~.._.._.__... _.__ _._~.._~__ 7705. Tide examination ____._.__---.__......------_-_____~ _.-la _._______..__.__._.-------------..._..... 1104. Title insurance Wt7der to i 705. DOCLmBnt PrWaiation__. .. t0 1700, Nota_r~fecs ,__-.__.._..~.___...._ ..__._.____„_.__..__.___T._ _ _ _._...___. _.._...!o______.-- 1107. A '9 IC0S ___! ___ _.,.__-...__....___ t0 ..r_.... _~.. ~_._......____~-.______.__...,.-_..._._... (InGudes above~items numbers: ....~._,___-__..~.___...__ 7,08. rme insurance_.._.- t~ Latsha Davis & McKenna, P.C. -_~(InGudea a0ove ilertu nmMters: 7110. 7111. 1200_GOVernment Racordingand Transfer Charg_ea __ _~ . _ , t 2o7 _ Recadin tees: t0eed, s R.-_. __ 62.00 . wwrtga4e S _._.. __ .._ - - vRebases f _.._, _ ..,....~ _._ 62 00f _„ . 72(72 _.c0.yrcounty tar7atamPs.._~_S _~_.__.___.---_~._.~9? _?_...__-__.__ ___-.._....._. -.._ .. ._.___. 94000_. _... . __ . 7203_Sta~tax/st~_Deed s. ~ _._._.._---..__ ....~.M~~.._?_.. ....---~------~ -_.._ ..---~ --`---- - ! .. 940.00 1204. (. __._._._._ i 1205. p ' 1300._Additional SattlemaM Cha~aa__ taot._sunieY_--.._._.__._ ro __ __..-. _..._..... 1302. Pest tnspeUton io .. 7303. t3W.~.____...__.___~.......__-.. .._. -.___..v..__..__..-. 1400. Total SetllemsM Chames tenter on Ones 103, SacNon J and 502, Secflon K) 1,524, 75 j _ _ _ y4U.VU t have carehily reviewed the HUO-t $wtanam and p tf» best.of my krtowkW9e and beliU, It o a true am7 accurate statement a all retxrpls and tlisbursemantt on ~ 1 p in tl+is I nher rxrtlry 9+at t have reeervad a copy M rho HUD-1 Settlement Ste q~ .-_. SedM ~ J . • ~~t.L._ BOrrOWOr S Irl f Sjo er, o-Ex for ~BY~arcMlay Fi ric , ' °' _._~ ~ .. . ' _ serer , v..' ~ --.. ._.._.__.___._...._--._--..~.,._~-._ t3rxrower Donald Le Bassett, Go-Ex~utor Mary a e Casavant To the Oast a my krtowled9e ute HUD-1 Settlement Statement wt7idt 1 have prepared is a Vue and to account of the funds which were reeetvsd aiM save been or w,d De dksixused M Ure underelyned as part a the settl enl a Uac tronaacson. 9 _ __y.L~ z. --- _-- _-.__._-_.___.__~ ...._.. ...._..._._.~._._._._..,__.._ Sed7ementA ant -_._.._~.__.._._. Dare Peter R. Witson WARNING: a is a ,o Prevbus editions ate obsolete make false statemems ~ d7e United States rx+ lies or arty oNer similar form. Penadles upon convictbn can Irxiude a (u7e and I U S COtte Section t 007 end Section 1010. ~~~ form HUD•t (3186) Page 2 of 2 ref Handbook x305.2 REV-1503 EX+ (6-98) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Cl~~/mss /~. ~itSS~/~ Z/- !!-/3GZ All property Jointly-owned wkh rlgM of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH ,. pNC S.tv,C' .Znre~fi~eat ~~ tim vo/- 3564/ ~J /, oY3. 010 fc9era~d ~i~:~~ /N~ixt` abl,;~~,o~-rs ~ (c~PSscp) x d o,d it/xe /.~ ~ /, 05~3.oz ~,B•~ .?~ X91. oS7 Pkt~am ~JO/ur f~Gftcrn Sao F~d_ (pTRtiX~ x a! ad. va/ue ~/o,1,S' .-- ~~9, 589, 83 t~5ee !ia/uafiaa ~B~i" a~aclrca/)_ TOTAL (Also enter on line 2, Recapitulation) I $ 3 p~ S3 ,~ 8 S (If more space is needed, insert additional sheets of the same size) -c~-c.ae ~/a~rz January 11, 2012 Holly O'Hara hollv.oharaCa~onc. com RE: 001-356891 /Charles Bassett (Individual) Dear Holly: The value of the above-referenced account on December 3, 2011 is as follows: ._ Amount , Description ~ ' ' Symbol / ~ CWSi DOD Price:- DOD,Valuer Accrued Interest ~ 1,043.020 Federated Prime Mgmt Obligations QPSSQ $ 1.00 $ 1,043.02 2,877.057 Putnam Absolute Retum 300 Fund PTRNX $10.25 $ 29,489.83 $ 30,532.85 $ - Grand Total (Market Value + Accrued Interest) $ 30,532.85 If you have any questions, please contact our Estate Resolution Desk at 800-822-7086. Sincerely, PNC Investments, LLC. Estate Resolution Desk KSJ The summaries, prices, quotes and/or statistics contained herein have been obtained from sources believed to be reliable but are not necessarily complete and cannot be guaranteed. They are provided for informational purposes only. Past performance does not guarantee future results. REV-1508 EX ~ (ib~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, 8 MISC. PERSONAL PROPERTY ESTATE OF / C/!R~'%lS F ~QSSG~ FILE NUMBER Indude the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be discbsed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH a- I ONE B~ivK (/~-~ Ch~akin~ /~iA.t` No. S/y~ 000 3 /93 ~~8, 3 z p, ~S (~~ .~ t. Oacor. r4~ do. a~. an 1""fin>r ~~) {D. 6 i (C~ S2,lii4~S /~~' /Yo, SDO 3S/ 5~6 9/ ~/ 7, iT 3 /. 4uf ~~ .cif acs= ~+ d--o•4! an .~'~ti,- ~C~ ~O. 40 ~S~ `a/aa~on c~JeGf tll~ucl~ea/J 3. ~ ~oo~f Chevrol%~F man , //N / G/ NDSZ Fs~fm '707 'f79 G, s~0, 3,3 (S~~ 3 v~/ua/i'snS and Calcafaho.~s af/~~/,~c! {Tern ,nr•~~o~r, ~~r~u,~ds, ~d k~iky z~w~ Boek ) '~ 1 fans of /~u°.so~a/l~ Kr,~t 6 f D.a~ /~ L~ /3ast~fl` ~5ee i1`tlliis'agi va/tt4/Sei1 ~ll'Ztc~td ~x Ht~ys /f~Sias) ~3Za~ .5. ~ ft'N1S Of /Z~'SO/1R/~r ~t~ ~y S`f ir/GY /¢/1/I ~~I7C~" ~s« ifC.ey:zsd ~'a/ua;~'aa «~clcc+~ fi,e~n fla~dys /~irie/i'a~u~ ~(o SD.oo 6- i¢t*_~rrt~q/ b~re d.o.d. rar~rncnf 1iro~ ~/~-S~~ i4nnuat ~.?36.3b '7 /'Zt/'fia/ /ft;tu44~ ~oAf /yiUY%S~JA/~ ~~Trof A~Cl~tt / ~~8 )O ~: /"/Y7-/Yj~ii/ls ~i cSU~ `~ /~P5.4~~/l tt PCr ~1~ ~j~. !~ • ~i~e 'Koh C'vuw~, T.~s g. ~.'nc ~f®9 ~.vcr ~~.~ nG 4. ~i e/u.nd {~v/~l ///~nsrican ~JC~flr ~'o • X37, f+~7 ~~u Co/1JSi~~a/~o~i c~et /t>~itclt~~) ~~. ~q TOTAL (Also enter on line 5, Recapitulation) I ; ~' ~ 5"'~a $ ~ i (If more space Is needed, insert additional sheets of the same size) ~.z !o. __!~. /~. .............. /3.. EST, O~ Cy/~Q,CEj E, 8~ls5 ~ ~ T Fi~E nro. • Ha~~o ' l~c~-d ~~ ~n Na~io~la1 ~nsur, ,~. ~ne.~5 Teswr. ~~ 00 ~~.vnd ~M flit _N~'.K4/ Tisur. ~/3 9.00 ~¢~n'ys ~uC~ien ~~ o~ G~i~sona /`fy • f a /o- wiz ~« e1 ~ f _ 2, QOo. ~' __ ~r~~~.r) ~1~tn~ ~~ ~/~ o,~ /~fs'sn ~ ~ -.2~f- Zo/L (-gee c 6. ~ _ ~ 7fS~ ~S cS~CG~S 4'~ ~1 __ Feb, 10. 2012 10:11AM PNC BANK ~~ LE»THEWAY February 10, 2012 Charles E Shields III Esq. 6 Clouser Rd Mechanicsburg, PA 17055 RE: Charles E Bassett SSN: 206-10-9764 DOD: 12-03-2011 Dear Mi. Shields: No, 1502 P. 1 In response to your request for Date of~Death (DOD) balances far the customer noted above, our records show the following: Checking Account Account # 5140003193 Established: 01-01-1962 CHARLES E BASSETT DOD balance: $ 88,329.15 + 0.62 accrued interest Interest mid 01-O1-2011 thru ] 2-03-2011 $ 27.29 Y'TD Savings Account Account # 5003514691 Established: 11-142002 CHARLES E BASSETT DOD balance: $17,231.44 + 0.90 accrued interest Interest paid Ol-O1-2011 thru 12-03-2011 $ 2S.4S YTD Investment Account The decedent maintained Investment Account # 1356891. For further information, you may call the Brokerage Department at 1-800-762-6111. please note that this office provides date of death balances for deposit accounts (IltAs, CDs, Checking and Savings). We do not process any financial transactions or provide statements. if you need assistance with any of these items, please call 1-888-PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch office. Sincerely, National Financial Services Center PNC Bank, N.A. Member FDIC Page 1 of 2 ~. 2012 10:12AM PNC BANK n. No, 1502 P. 2 This message is intended for the use of the individual or entity to which it is addressed and may ! contain information that is privileged, confidential and exempt from disclosure under applicable law. f If the reader of this message is not the intended recipient or the employee or agent responsible for delivering this message to the intended recipient, you are hereby notified that airy dissemination, distribution or copying of this communications is strictly prohibited. If you have received this communication in error, please notify me immediately by repty or by telephone at 800-762-177 and ~ immediately destroy this faxed document. Page 2 of 2 ~_ ITEMS APPRAISED FOR CHARLES E BASSETT GOING TO SHIRLEY STONER ITEM AMOUNT FRANCISCAN SET OF DISHES SERVICE FOR 8 250.00 HO SCALE TRAIN SET W/PLATFORM & ACCESSORIES 175.00 CORNER HUTCH 175.00 GLASS FRON SLIDE DOOR CABINET 30.00 BELL COLLECTION 20 00 TOTAL 650.00 1 ITEMS APPRA{SED FOR CHARLES E BASSETT GOING TO DONALD BASSETT ITEM AMOUNT MAPLE CHEST OF DRAWERS 50.00 BELL COLLECTION _ 20•QO JOHN DEERE GX85 30" CUT REAR ENGINE 13 HP 250.00 TOTAL 320.00 1 1~vo,~-~s~~ ~ ~ boo. o~ /~"~ ~ f ~ Sa • oa ~4U s s, `~ ~ ~~~ NA - X ~~ o ~~ - Oo lG~u-~'r ~~~~ao ~~ ~~~-~a a ~ 3 0 ~~ ~~ ,` v~ P~I~ --~ { ~t 4 ~ ] 1 i! i': t~ !,' iS 1 2004 Chevrolet Classic Standard Equipment, Pricing and Information - NADAguides.com i- - I1te Pbwsr of Yedticie Ittionmatiwt ': HOME AUTOS CLASSIC CARS MOTORCYCLES i2l~i"''fliEF3#~I+CdYIA~.i~E: .__., ~ BOATS RVs MAFIUFACTURECr HOMES . BUlr A PRICE GUIi3E ADVERTISEMENT ~Y .,~I' F 2oE2 aratt Fcn fkl C~arwrM~l~-Srr StW _. ~ .. _. Chance Make > CiiaDae Year 8 Model > Chance Tnm > Chance Mileaoe & Ootions > Standard Equipment 2004 Chevrolet CLASSIC-L4 Sedan 4D Pricing Roaegh Average L'tean Trade-In Trade-In trade-At Vebide History Report .Check for Accidents Now'.. ::Press GO or Enter VI Ftnd Your tsar !~ehevrorar.-...v. ~ a _~ ': ZIP.~7055 - a~..,..AM _ _. Aa Sell Your Cer Sell it Now -'. Free Insurance Quote -. Get discounts uo to 40% Extended Auto WarrarriY, ': Free Instant Ouote ltrlcrlarAide" ;Free Auto Loan Quote I'. Bad Credit OKI sgii~iairs Know your Credit '. History See your Smre Ins[antiv - '.SIl ~e pie $2,150 ;2,950 .$3,600 Mileage: 16,050 $1,800 ;1,800 $1,800 Options: ;~ ~% a. _~.:V:ni TOTAL PRICE #3,950 j4,750 \ 7tris Retail price b basal on a dean vefYda trktnrv retort . Don'C Get a Frei VIN [Tntlr today. Rrd arR why AutaQadc h Kenner tllan __ PricirSg & SpeCS PiCtUrPJS & VidEOS ReYiEWS ~ Ratir4gs r~ ~~-.~ E - s.,;ent Pictures Expert Revtews ': C Spec & Performance : Available Cdors Consumer Reviews h 360° Views Conwmer Ratings T Crash Test Videos Safety Ratings y ReollInfarmatlon J Stnndaro warranty Standard Equipment Details Engine SpecHicatfons Type: Gas I4 Size: 2.2L/134 Horsepower: 140 O 5600 RPM Torque: 150 0 4000 RPM n .1 A Drive Train ~ ` - Dnve Train: Front Wheel Drive Q Transmission: 4 speed Automatic w/OD ~~~ 0 Saf~y ~ 0 Alr eag•Frontal-Dever Ak Bag-Frontal-Passenger DO Brakes-ABS Brakes-Type-Front DISC1Rear Drum ` V ~ Daytime Running Lights Engine Immobilizer Heedtig ht5-Automatic Comfort • Convenience / ~ O Alr Conditioning-Front (~ ~ / Cruise Control ~/ Keyless Entry Max Searing Capacity: 5 Mirror(s)-Power Mirrors-V anlty-Driver Power Locks Seat Trim-Goth Seat-Power Driver Seat-Rear PASS-Through Seats-Front Bucket Steenng Wheel-Adjustable Steenng-Power Trunk-Release-Remote Windows-Power Musie !~ Entertainment Audio-AM/FM Stereo AUdiO-Ca55ette Player Audio-CD Player Email lean RotaiS ;5,600 ;1,800 __ / Wa found 11 2004 Chevrolet listings within 25 miles of your zip code ADVERnsEMENr +.~+.~ CHi~1iROliET Vehieb Linsup Red a Deakar Request a Quots Curtent OINK Chevy Culture ~~..~~~ADVFATISEMENT '. ""~~ ~ 20i2Equinox ~ rpere V Nas 1 . Sedan I . 1o ns :EPA-EST9ulATED 32 d HI ~ IAPG NVlY ~ UP 70 A ~fl0 FAILE NtGHWiY 1 DA1V1N0 Rf Nf~E `, 4 ~ k 1/16/12 10:01 AN http://www.nadaguides.com/Cars/2004/Chevrolet/CLASSIC-L4/Sedan-4D/Standard-Equipment Page 1 of 2 : View Pictures 2004 ~ .hevrolet Malibu Sedan Base What Your Car is Worth Welcome, Guest ~ n n 'SEW CAR5 ( USED CARS ( CAR RPV:itiWS , 'P5 &ADVICE ~ NsANTENANGE , PORU'r!5 Home > Used Cars > h yr I > Malibu > 2004 Malibu Sedan > Prices with Ootlons > Prices with Options Results 11~>~ E~lnzunei=:,com ic3 arcurai:f~iy appraise yai.#r u7eii tsar. Zip Code & Style Cotors & Options Condition ~ Mileage True Market Value° 2004 Chevrolet Malibu Sedan -What Your Car is Worth 17055 uroAre Pntlnq !or Mechanlcsbura, PA Trve Market Yalue° Trade-in $4,297 _. Private Party Sale $5,252 Dealer Retail $6,370 Search 2004 Cnevroiet Malibu Sedan Ustinos Near __ Trade-In Private Party Dealer Retail National Base Price $3,082 $3,990 $5,013 Optional Equipment.. $258 $306 $401 AM/FM/Cassette/CD Audio System _ _ $26 $31 $41 16 Inch Steel Wheels _ __ _ _ __. $46 $55 _ _ $72 Cruise Control $44 $52 _$68 Remote Power Door Locks $41 $49 $64 Premium Cloth Seating $40 $47 ;62 .Power Adjustable Pedals $61 $72 $94 Color Adjustment - Red $19 $24 $31 Regional Adjustment - for Zip Code 17055 _. $-19 _. Mileage Adjustment - 16,050 miles $957 $957 _ __ $957 Condition Adjustment - Clean __ _ _ _ _ ;0 _ __ $0 $0 Total $4,297 $5.252 _ __ _. 56,370 Buying a Certified Used Vehicle Dealer Retail Certified Used Price Vehicle not eligible for certiflwtlon. 1/16/12 9:56 AM facebook Sian in I Account I Mobile I Helo I Inside Line Search Site sS~vg I m it i ~~ I C I Newsletter Tips and Advice Yep, it's tru~ll `` . Sottte NE1N cars Gast less dean last year`s USEp tars. ;~ ~~ •. i . ~ t5. ~~. a '~ _ .'?: ~, . _ New Car Inventory http: J /www.edmunds.com/chevrolet/malibu /2004/tmv-appraise-results.html Page 1 of 3 Customized Trrue Market Yatue® Prices 2004 Chevrolet Classic Sedan 4D Trade In Values -Kelley Blue Book ~r7 71iE 1RU3T[d RltfbN,rBCE Used Car~Private~ Party Values ,- ~~~ 2004 Chevrolet Classic Sedan 4D Mileage: 16,050 Private Party Value Vehicle Highlights Excellent $7,519 Very Good $7,219 Good $7,069 Fair $6,344 1/16/12 9:47 Ah MPG: City 21/Hwy 31 Doors: 4 Drivetrain: FWD EPA Class: Midsize Cars f i f Country of Origin: United States Max Seating: 5 a ` Engine: 4-Cyl, 2.2 Liter Transmission: Automatic Body Style: Sedan Country of Assembly: United States Your Configured Options Our pre-selected options, based on typical equipment for this car. J Options that you added while configuring this car. i. Engine t Comfort and Convenience Safety and 4-Cyl, 2.2 Liter j Air Conditioning Duai Af Transmission € Power Windows Wheels ant Automatic ~ ~~ Do01' Locks Steel y Cruise Control Drivetrain i Steering FWD 4 } Power Steering ~ Tik Wheel Entertainment snd Instrumentation AM/Fhi Stereo co (sh-g~e Disc) Glossary of Terms Kelley Biue Book® Trade-in Value -This is the amount you can expect to receive when you trade in your car to a dealer. This value is determined based on i the style, condition, mileage and options indicated. http://www.kbb.com/chevrolet/classic/2004-chevrolet-classic/sedan-4d/••.t=trade-in-sellbmileage=16050bpricetype=private-partybprintable=true Page 1 of 2 American Water -' ~ ~ ~~ ~ `~'``;' Check No. - ?4034554 fl~:''~ Check Date - 05/23/12 PO Box 5600 Cherry Hill, Nl 08034 Call Center Phone 1-800-652-6987 Stub 1 of i INVOICE NO. COMPANY NO./NAME REMARKS INY~ICE AMOUNT 0638651 050112 24 Pennsylvania AWW CREDIT REFUND 2.29 2.29 50649352 C S Bassett Cam Hill, PA 27011 American V~ater ~~ ~, ,u, 55-177. NO. 74034554 PO Box 5600.. rrEw JsRSSSr s11 Cherry Hill. Nl 08034 DATE 0 5 / 2 3 / 12 TWO AND 29100 +++++++++++++++++sr++++++++++++++r++++++++++++++++++++++++++++*+++++++ $++++++++*2.29 PAY TO THB vale A~rsx 9o HAYS ORDBR OF C E Bassett 225 Orebank Rd DilTsburg PA 17019 ~~Vv1FR(CAi~ bVATF"k _ ADTHO SI :. w?4034554' x:03 ~ 20 277D~: 80 26 2 3 749 1' M CD N 0 ~ X O n La.l r+ ~ X L o r. ° ~ O X~ ~ m o ~ ~M ° a a a O ~ w ~ W~ Q Z m v K ~ - v ~. a ~ .... N 2 -- o ° ° w m • V c v° o ~~~ X N ++ m ° OOQ~ O O ° ° a+ ° U m= t N N a ~ °c c° N . ~~ s _J=~ N O O a. ~~jj N e E ~D:JU t m r p O Z p U L N Z N Q Q o +°+ ~ °s r Cti L O S O ~ v n° ~s O U ~ E ++ O `c o s° a v Z~ N i--~ Vl ++ E O C 3 ~ ° O Y Y ° L Q p n° c ++ N O. O C V ° O U ~O N ++ to ~ a m ~ _ i E ~ Q F- 3' m ~~ +_+ ~~ Per~nsyivania American Water F'O Bax 371412 Pittsburgh, Pa. 15250-7412 DOD24D63B651~L1000UUUUUUUUUUUUUy~ For Service To: 3801 Chestnut S1 Illl~~lllitiiliiil~iiit~~iili.liiil...i..i~illii~IlNi~..li.i.i.i oa~3+e r aro.ar~ 331ag13•&~3te in ~ NCOFnG C E BASSETT _ SHtRLEY STONER 225 OREBANlC RD DIt1SBURG PA 17019-3:it9 f; ~.~ rI PEt~tSYLY/4tiR JUi WIlTB PO t#2X S71«41R2` PtTTSBt1f~l-i, PA. 1525ty-7412 li'~PP~1't'1"~HI!'~'~'~'!'~II'I..111 Pleave duck Gene k+a~di tb dNers aaNlrieAfon b~nur ~' 6i .Qtt~~!?,~'~.'~c~:4~~~____ __H!A! f_~4t~nrer±~!o!iae,_--s_-,->~ - -,.___ - --- - tamar Aex~unt IIfnn Brig Swnntary For Sasvke Ta: C E Bait -~.:n. BaMr~ee- 3801 Chestrrt St Priar t1YSaeiar AcconaR Nuarber: ~1-08351-2 Piinr Ba~cs OtMr Premi®e Nu~ebar_ 24-Q3T~931 PaXtnents Pniar b A~ 1~,10"t2 flrankst T~1 Nrier itt~ 1E4,. Btt~g Pleri0d lr A~ wrNan 9 ~= ~y ~, 2Q2 SFh-~.7t~f2~12-~tTJt2 ToW Yay t4,~ ifale Type: Resider~tiat Wa19m' U~sags C.wnp~sOr1 18r ~ ie krr~d geMons. /WOtlNT F)tlE (a+sdi Mares Ow fibt ~ IO~Of{f iilOA1 PBl1/fS~IYBIIEB Anti! 1' • ~__..-..:~,.•..w. ~ CT »...~......- ..~ 4A ..f C1hAe Mvoc sro «+rk rLvJ in rrn.-NMI.oHI IfV( O a ~~ 9 P~ o e ~ g a~ g AMERICAN ~IVAE~F~. ,v~vooa roPCeti oooo~zm C E Bassett 225 Orebank Rd Dillsbnrg PA 17019 Dear Customer: Pennsylvania American Water Y.o. sox sus, nlwn u, 62002 ~-soo-s65-nom 05/11/2012 ~. Account Number: 24-0638651-2 Premisc Numbfx: 24f1a77531 3801 Chestnut St It is itnpc>rtant ~r us, as we know it is to yon, theet your b~i~ be a$ ac:catrate as possible. When an error in yore- tn'lling is found, we iiretnetli~ely talcs wir~evr.~- seeps a~+e needed is ~aloc sere are trilled properly for only the services we provide you. We }' ns~stiga~-your' avct a~debered tlee~ ~ ire-b~ied~~- O~ Fridaey, -- May l l ,2012, we r~cle a ~'L.29 credet m your ac~coant. This ~t c dues b~. after April 12, 2012. We hope you we71 fend the ~~ satisfaExory. A cawed br~liw~ seat wi$ be mailed to you in the nett few days. If yon have any gae,~ions oc coneerns, Please c~ ns ~ y~-caoenoe at 1-~ffEEi~-Sfi~~-729"2. C~ v~ere it is convenient for Iran, onf ~~ ane available 24 hours a day to serve you. Sincerely, Customer Service PENN NATIONAL a,o. 9oX 238z3alNaliemsbulg, PAei7 os-23878nce Company INSURANCE ~~~ 23+-~e~7 'olicy DisburNing DATE 05/11/2012 PAY THREE AND 00/100 DOLLARS -- . -_~ ez-2z 91t POSITIVE PAY CNECKNUMBER 00676200 ***3.00 RETURN TNIS C11EC1C IF INCORRECT. TO THE **BASSETT CHARLES $** raaw.I. e.nw THIS CHECK wID IP NOT PRSSBNTSD ORDER •~ ttb~ POR PAYMENT NSTHIN 90 DAYS OF 3801 CHESTNUT ST y~~/~y.~ CAMP HILL PA 17011 ~~ "O _/ ~ f~ AtHltaiud SipnNtws p a0•..,~. er ,,pp L!J SECURRY PBATURF-8 INCLUDED. DETAN.i ON BACK. lCl ~'006762CI0~ ~:03ii0D225~:20 799 500 29 7 3 3~' pE~OSylYiO~ r1111r10B8~ A'I~tus1 GSII>tily I>osnraace COdlpa9y PLEASE DETACH AT PERFORATION LINE EEPDRS DBPOSITINc THi PAYii ACR7AYLNOiB 7711 Uii OP THi ATTACHED CHBCi 7tl 8i 967TLBI<aNT IN PULL OP ACCOUNT A8 E(iREIN STATED '~74499F,df,9 nr-c~c~nn INNOM;E NUMBER PURCHASE ORDER DATElfWICE AMOUNT DISCOUNT NETAMOUNT 2012 OS 078P I~iI1D Q1 AQ~LNS 37559 69 05 07 2012 3.00 0.00 3.00 TOTALS 3.00 0.00 3.00 PNC~t~NI~, C~ewnl DANA. N~ DATE ~ I'Q'!~/'L3~ G~°2 CNECKS AND OTHER ITEA18 RECENED F011 DEPOSR 9UB~ JECT TO THE RULES AND RE TN)NS OF TINE N18T1TVTIDN. t1YONRf YAr 1107 NN AYAILARN troN IMM[OIATN W/TMORAMAL. DEPOSIT TICKET ESTATE OF ~~. ~/~,Q,Q~~ Dotl•n CMU cuRRENCr ~_ COINS CNECKS t l•Ft Singly 2 8• wn 9. ••Ch ipm is MdOrNd ~ ToMI Flom outs sla. TdN II•m• TOTAL UN rerorN •ida for Wditlonal lislinp or •IUth t•tN. .•c I.nn..,l-n ln1• ~fl(1 7 L ~RC,~ ~r• \ / to ~]~ f'~ W ~xC p O 1'_ ^yO XX Xt9 g W W ~ Q " s ~a~ N V J ~~ p N O ~p hJi F=-JU OS~-J-1 `++~~' O O'7 N L } V o v ~ " T i-f G H -L ~I L iF ~Qt~ Y \ l0 ~. m Yi r e ~Q e f3 ~. ~ o ~ ~ o $ ~ ~ ~~~~ ~' ~°+ ~ i r a~~~~ r_ ~ ~ T 8 ~ ~_ N ~ LL_Y ~ ~CC H ~ Y ~J eai2T~s7s PBVN NATIONAL INSURANCE PamnyM..i.lifn.ilMrrdC~IMrra~ce Cow~sp Pere !M"od Send/ inw~ea Canpey P.O. Bex 229 • Fir~ie6~g, PA 17106 RAIL T0: BASSETT CHARLES E 3$01 CHESTNUT ST CAtiP HILL PA 17011 1 NStHtED COPY ~ ~ ~' "`"~~ G `L l~'T AGENT: GUNK-NOMEttY LLG PO BOX CARP HIlL PA 17001 TELEPHONE 717 7614600 DATE of Ttds Nom t34/~1/12 ~~ 355o9gb469 og 10 ppt,~y TH~1 01120/ 12 TO 01 /20/ 13 pf~€NCY 1211134 I NS1DtED: BASSETT Ctt4RLES E 3801 CHESTNUT ST CAPIP HILL PA . `t1 4 ~~;h s,~A.,~-~ ~ ; .~;_. ., a..`..~? :ry..~~ __. .. ~Y~S ..,~. y.~la. w3 :.~r.R:~~is.,.~Z`:*~' ~ .i HO!!1EIIf1itERS POLICY r}~j 0996469 P1~Q-RATA CAiICE LL.ATi ON EF f ECT 1 YE tN~/ 13/ 12 l'C. '.. C ~ 'L'LL -~L. "t ~L't~:.L 'sV=PtNI. i':~~-'':~s C.t.~;l+ 1-SA}'111` ~• }-1`+rTIG?I~; ixi i _.. 4t..:e:_.~ _i:~f_ r'• iJ .L ' - ~~ tY l l_'S't`'I S LY 5!' I [:t~E~t ~3T1!L'SE 4'. f' ~7 ~ ~ ~7e i Z er s ~~c E}'; ~ E5T DF CHAF<:~Et E ~4"a:;SET" Cr G RE £ANI : °~~ L~ ZLLSBUFtG F'A 17ti i 1 Z :Em L~~ .;c~^iptiun . Z*tLOL~'d CEI,iT POD:-:°~ 1 ~. ;~~ ~EE~'ER~ON h3ICIiLE ~.~GGl'-,5 i ice. Y3s~= ~ r~cRCU~~ DZ~*tES - 1 1 .:t~• ~~' : J1^1LJ 1 1. ~~ .~ 1. ~ L 1 i'L, t.ENTC i _ L•,_ i>Ert I:L'tJSE ~tL_T i~11'=L~ .' ^1! ~ .. L.J ~u ~`~' ~ ~ oiL.:'ER WASt#ih.IG' ~=rY t~':T 5~ - ~}..:+Z+• Z+IL - ~ ~~-Lr.IN~ LIi~En--1r ^,r,;; ~. i ~~. ~~ ' ..._ a .=Ei~~ DAL~Grt~ i k7r. ti~'ti - i~Gb~I~='s}=?tv ~IL4'CR ~.=Z''i1 ? ::~.+~~'_' -- P'~tREIGN CGINS i E• ~'ti -- 1 c~'s'r;. MANS RING i ^5. ~`~ - 1:3~: GOLD c ILLED ri4=:`1;= ~{i[~lG i ;`k?+. +Zts-tt - qtr?A~TEF5 ~ b. ~Y~ - r'F=f;~i AI'rl f-''LANE i 4. iZ++Z~ •- k~EADED FRUIT i 1:. ~ti - ;~Gr.,`AL _ 11.4+~ Tft};;~fSE"t~RtdEf~S 1 ic. u++ _ FsLNNN:ET - LJ5 NA'la;' _ 1 ~. ~++~ ,_ -- Ri=d ; 5 - ~;~ ! . ~. ,c' _ GL~-~'~ s LOT ... FL^I~:ER;~ i i . ~~ .. 1.1EL WEE l~iRN 1 6. ~k . L Z P•lEt1;5 1 17. .- :ELLS 1 Y+. E~~ - 5i'i'`~DGE F'GT E. ~~ KET 5 _ BL ~ t t 1 i ?. ~ '~ { ~j''~ ~/ ~ ~ ~{ 7 y ~ ~ - LAriTER~v .. -'. ~ - :ri~' w {~ ~'-~ 5 A h~D i- G n T ~ i% k' 1 ~! "{ i 1 i.. ~+i . _r~ ; L5 A"dB BOI„~L i ti . ~Oti'+~? _~ 5}'ALT Rt'~iD F`Ep'PERS i '~. ~~ rAMERa 1 ~ ~. ti+ ~~t- T ~sL " itINJLI NL"i LI GF-IT i t:.~. ~ ~ ~ ~r -- +?IAt~2L i 1. ~~ r, ~- ~ " ~- ti• -• - . r iIf 'ti'sJi~i. ': i ~3Y" _ . -~.~~~~ ~ f~~tr~v}~ -' 1-'~ _..fr..ii_-' 8c_ fF~ pp ~ry E. ~~~ J.t ~~SE ~:'L~ (; gg S,IILE~L~Ft tY CL:I ~i~L :r yTf ~~•Ii.=. F: t`'Cl~C: JE' i 1 [?'f': a=J f ~}i ~ tJ 1 'Sr ' 7--itS!^~_i •-. ~i-!~?.rrET-r ~i:~ ta'~r }•~r'~t'i s'li UILL~EU;~G r'R i?sL i 1 I'~~eiii DQ 9CY'7. ~i't<]. Ui, r'[".i{."F ir.~F; Total -- GLASS D i a~ +=£~ i :. Q+~ - RED GLflSE LC,-}- 1 .. ;intis - LIGHT HL'LR 1 ~. ~Q _ t306JL, VRSE t=;}~-ID Cr~t`~7 LE CT I i:;} _ ~. +~-s~ ;-ID! DFRS - STI~tE W~`DEE; i 5. ~:sQs -- rEtJTt3Pd £~•AS}~,ET i 5. s.'~!Z~ - G CU F 'IE'7 J=~r~A~r '•__ . C 'i '~. ~sL .. ~~ AA ~~}} ( LfS1~H1'ILt~T.~ is "{' 1 "{'• }~t l'~ -- GRf~DLE HCLuE}i:a ~=tti~' .,i S i 1 ~. ~~ . CRPIDLEC~ i :. G. f[i~s ~- EEri1TC}}~} C:=,,IDLE. } tCsLD}~F i ?. Q+~ . TOP'P'ER At~tD dTG.,t~:ii'du~? i ~:•. c:SsZssc - MUSI CRL ST I I•JE 1 ~+. sc7~ __ F'EDI5TGCL E~IG1; i c. sc3ol -- t/RDC}~ i 5. d~ - DERDS i %~. ~5~2 ._ EAULE i 15. sls~ - r'RINCES£~ t-~v~'.~Ji_DT ~. i~s2` - f=RiDGE DI^oNE~ f ~C. fLsc~ uLr~ti~ LdT ti. ~>Z -- F'ITCHE~: RrJD uL ASE=-; i t',. sZ+st~ - I TRLY i:I S':": i L:+~. sZs~ -- CD' S i 4. ~:~ C3Rt`dAiYlEt'•'.3'i~i i isc. k-Z - ='RII~iCESS HDUDE LwT i 5. sZ+~b -- IM}=~ERIRL SWFIT-:i 1 1 i. 4~k -- L I h1dGE5 W I'•_D tDS_ D I S~-i £~ET i i t 2+. ~4'+ - DRtifll~iEtdT`~, 1 7. Qs~~ '- h~ I GC LDT 1 1. ~S0 -- GLRSS D}•2ESSE t ^ET i ~ ~. sZs~! ~_ L I t7i-dTS ~ 4. sZs;~ - F~~zlra c LSs '-}cU~i= L_T i ~. e~~~ y .~ :rdNAME1+iT~ ,. C. ~;~~ - EL T~ZIC CLdCf', E G i ~'s 1 . @ ~ y1 1 f ~ ~ ~ - WEST a;C RLR'<dD i 5. ~SSZ - METi=~L LCT i i?. ~k - R I i~lv'~ 1 6Q-. ~s~s 'vJW3N. !:^9 +~:~.., r't ill 1`if'1!'T t•'~ J f'i iJL ~LJ/V %1 ~ ... 6i'i•%:.' SG"l~1.1 Oettlrezreri_ ~.RLLl` :J:•::_~ ~i-~~$•~R t~Si - i i'~,~e: Jc"i1Ls'^: i'`i_J t - + r~i i E5T C~ ~'f'i t-i F:LES i.. LA;:]~LT! "~ ORE DAN±: ~» DiLLE~$URG FA i ;k f =% i f_. Eni i_ii: script ion Price ~l~: y Totai '- LI i <FiT 5 ~J I Thi ~' t :ADES 1 ~.~. ~~1 - (( ^^ ~ { y~ ~ 'y I~L UeREA1•i Jt~.rir'L3~• 1 .Jw ~:~ ... C~, iR i OTMAO LCt T i .~~. QiQi r' ATWARE LuT i ~;. r<uZi _ i...AU`! SELLS f 6. ~~ !~ n ~3 .. - .,.,i;LE GLHa~.'! Ai~~~ r.S^. z.? ~'I J._i ."t fy U:. ~:... . 1 i. ti+k ._ BAF2OMETtR f J. ~Qi _ lttE!'~i5 ,.Itb,iELRY LOT 1 1 ~~•. ~:,3?. - CLUC4~r5 _ 1. ~~ tt r r-., •.. J E L.1_~~I OLJ~ LGF'iLLL E W r i,~C•. ~'L' . n ' r iiiLi2 i-E _ J. Y~~ T'.._t= Ti~Ai`cE LOT I ^~ ;:..~~SE i ~;c. @0 - ;SLUE D I S?-iE8 ~ 3. +~~ -- L I uNT ~. i i . ~Q3 - p'LATE AND PO.,?L _ 6. ~+4~ -- ;=Lass LOT ~ ~,. ~¢, - L,OAi75 LOT i 4. ~37 -- Oi=RA'iIC TREE ~ f ~. ~~3 _ DER AI'~iD '.=LA3`~TEti 1. ~'ik "' F'iJrkET i~JATCfd f irJ. ~~ - !-L~Twai~E LDT a ~w ~~ ~~ALT aivn piEGF'ERS ~ ~. ~~,~~ . Sr;LT AND p'EF°F'Ef? l-Ehl?Oi•, 1 5. ~c~~ - ,`ASE aPJD DISH 1 f.4'+~ - It~;RERIAL ~I'•"O}{Fr _ 1i'_. +Z3~[3 -- ~L A T W€~R E L O T f lI. 1Z3~ .. 11 ~ F t ~ ' [- 1- I 1f r R1tY~ESS HOU.r]E T>=;-: ~~~._'i .. i.:t. ~li~ ._ TEf-~ ~E i 1 ~,,. ~ ~ _ rH f R'f LAMP i lV . 434' r' I1~fERp'F'LE f ;=. k Q3 -- OLASOEO/GLOREO _ L. k34~ i~i':E i`'LATE, 5ALT .~`nhiii a G. >~+~ _ L+Ii L~ii1 ~~ 1 . ~~ O - .. L' Li K 1 ~ ~. -- L (? G 1 ~ i ~ h Y.• . 3L~ ([I _ Tray 1uf -- toil=_ f ~.~+ic '" ~Gli I'~~ -- 5G':155GT'S .' Cis i i I f i::. ~~ v i 't' c ` T Y'' ~~ ~ D F - CST` 1 V ~' Y' S ~ ii G =? :L , 1 C:r. Q37Jt J C. _ [ u ....... .-_'-~ ~ - i...'L~ .I f.... °~i^~:~. F..l '.{C{: .. . _.. J ~ 1"~~~t"'I t'?' '..J ~~~~T i V1Y ^ 1 ~' :'.J L..... ~..~1~"~'C .sL-~ 1E~i&'_~Il ~2.Ti~~~~.~'t is;s'"~ii'{~r i ..3 .r~:f•I~~ J f?ll~: .,.:.J 4.:}'. .:: ~:.]! ~i' r:-iH1.Li..J tiJ.7 i ci_~.r DRS it=t=yl: Ru r t ! C r ri { --r { ~ t r~ -F~ ~(il Y.t2~r`Y'1~~ 7.4 r] r'i''.LCir~,~ ~ ~Ct=11 T Y' c3 j: 11! 1 5 •. 'r i7 +J i 5 - f"i ct l'" G iN c4 Y' Q i C: J , ~Y• ,. TY st y i i~ t~ '._ ~ c~T' ~ lt: %33' B '-' L'~ 7-~ i i i t t '+~ tT / , lt. L' J1t5 .' S Cl c K E''~ '.+ ~ r . ~t ti~ iiGX l: i - ~ct'vJ ~'i Ci ~:altE t i C7. tG.ttLl ... .. :. _. ~_..._ ~I:1C=ti ivvV c~i-'T"U4~lS i ~.t_. L~~ ... ~ c~' ci Y-' . .- a i'4l }i 1 rt a'-3.- ~ ~ i.' i' ~ t i t ~ s ~ . t~: -_ ~ G >i ? i f 1- - F'j G ~ = -' j3 c-1 t'"t g f ~ -~,~ s_ . ti a~ - Lt C} X i ;! t. -• i i 5 i'1 c. U _i t' U - +- ~ • ~t'L G=:='~: cT' ~1~~='t':cz -- g ' ~~ ~~ - .1 `~,` ." ..;-l i ` i :, t 1u cl i t C tIt'-. ,_ . ~K~ -- i~cYle o~~n'-- io•a~ieu f 5.~k's - r=Y_Gg i ~ ~. ~t4 i ~ '- -t l~ ~.3 lot -- f ~_i t` = o ~ ~ i 1. l - 'vi.~tc'r" glasses _ ~ GL>: lot ~ f 3. ~s _ Aloney :pox I 11. ~~ _.. ~Oii lL°V .... ss.7'ctlT'i tr°a}c ~ f. ~~~ -- ~oX lot -- ~~tinpkin _ f 4. ~~ ._ t~ra5 - pox let _ f >;. ~4?~ i•Ok ?Ci '°' t.`1i15}1£'S - t'GC`G'f-i 1 ~. l~tti1 r,~a~ -- E,oX lat -' eii iiy:`it -- lit~ert f 8-@~+ - r- aci i o . L~G?< to#: C'~1it-c'i'~'cZ5 --' ~. i!. ~~ movielig;t ' Ei O X ? U v ~- ~-k"1 "[ ' 1 5 t. i& ct S i 1 J. ~1 Qt i i /:' l r_'. c i -- ~"' .i 2 :a. iI !li et :_ it 1 t l E' F4D'r: 1+~~. -- ~Gt.:-5 ..r.i5ii 1 l..r~4~ '- tit Q : L 1 ~.) i - 3 ~i ~'1:' S •- Lt .Z ~ ~•_' ~ -.~ i ~ • ~L~ Y.• ._ 7C~t_(1) ~1 1 inc. ~iL' -•- !'.nicklknac4s -- bells :. c:~.ZF~7 - ',-:nick;'ktiatks -- tells f 5~:.~Z~ - 1?ux lUt com~or--t '-• f 15. ~~ coo; er f~. _ fox lo+ toas{:er- - '-ci'tt:hen i c~. Y'2 itE'ctl_ - Uoi::_ -- snoxmar~ _ ice c~'2a:n+=-:, nfar.?~'' --- boek~ •- 1 f~:. ~~ dd I J ~_i l.! Al ' G•U): lct _. tlL''lii.flP.t~. _- 21gj1~5 1 li.~tti ~Ok '1u~ ~ t7G'~C~K - .-Ec?tllB,_ f .~.~ti game- -- fox lc•!.~ '•- fan - !_, ,an lat - f 2~+.~~~ _, .. ~ ~ 4..~ L L't L.. ti~ .~ .- ,`..~c'~~~~'lEiilE~rt~ Ylit_E~LtR ici~~~~~~i~ ~T~i~~R rd E;: ~~~ ~] (•) 1 ), G^ 1~ u L- L :J l L t.. J V t }"3 . S L_ J L_ ~~~~ ~~'~~~L r't=i ~ i ~~~ Ztea~ ue4cr~i~;tiort f'ric_~ r;~~y Toga; ;::~tr-i~L*t~s beddlny ~_ i~ox lot -- iso'.:, p~~ate - pasts 1 i5. ~4~ - ulo~-k :mit=e set - bas~:ets r ~ t- 1l: 1 ~ ~ 1 V f i G'. ~~ '~'Y~. • 44'~L~'L~ f 1) ~L iUiroih. t':aa:-~. i •j~[~ 'if=tAf+t? ~ H~~Ti~7N ~'! E._t}::rte-~~='~'tt"' Date : 2~E -- i;~, ._`2+1 www. h a ar s. c o m HAAR' S Al.lCT I ON 717 --4:~E-5~4r~ 5ettiemer-~t WILBUR /SHIRLEY STONER F'age: Seller,: c:`5 CK EST CHAf2_L_E5 E E1+=~tSSETT 2~5 ORE f'~ANK RL~ U I LLSBURG F'A 17d+ 1 S Item Description F'rice wty Total - Stool 1 ~. @@ -- Bird bath 1 10. -r-r - Fireplace set 1 5.02' - Stool 1 4. ~~ -- Step ladder 1 °,. ~~ -- Log holder 1 3. ~~ - Lights i 4.0~C - Tv 1 70. ~~ - Sun twin heater 1 X7.0@ -- Bookcase 1 i7. ~~ - Cedar, chest 1 4.00 -- Wardr-obe i 3+~.2ti-Z~ - Shelf 1 4.00 - iV i ght stand 1 ~• ~~~~ - Sweeper i 1.2~-D - Fan 1 20.00 - Night stand 1 i7. ~+~ - Dress form 1 70.00 - Card table-chair= 1 12.20 - Radio 1 8. 00 - Frame 1 0.250s~ - Seat 1 1.00 - Shelf i 4. 0$ - Humidifier 1 3.00 -- Step stool 1 7. ~+~ - Stool 1 17.02+ - Light 1 3.00 - Light 1 0. c500 Led fr an~e 1 ~. +~2- - Cabinet 1 17.00 -- Cabinet 1 5.2-0 - Refrigerator 1 50.00 - Fan i 0. ~2i2+0 - Microwave 1 4.00 - t*licr-owave cart i i. 00 Wing back chair i 1.00 - Fishing rod= 1 5.00 - Laed frame I 4. 00 - Cherry table .:~`.2~0 ~ 96. ~D0 - Lave seat 1 20. c~0 - Swivel rocker- 1 5.02 - Jacks and stand 1 1.50 - Lights 1 5.00 - Collapse shovel 1 `. 00 - Sweeper-- 1 1.5~~ www. ?wars. com Haag' S AUCTI~IN ? i r -~-C~-~S~~rb Sett l ereent WILDUR lSHI F2LEY STONER Page 5e i 1 er~: 2 5 CF4 EST CHARLES E HASSETT 225 ORE PAAIFS RD D T LLSBUR6 F'A 17~ 19 Item Description F'rice qty Tatai - Steam wrerrch i E. ~+Q+ - Limb saws 1 ~.7~0~- - Radio 1 S. ~fi - Tubs 1 t~. ~~~~ Heater i ~. Q~Q+ - Shovels, clipper=_ i ,Y.~'+il -- Light 1 1. ~-Z: - Garden tools i 1. ~~ - Dr°ill and sander 1 1. ~~- - Bedr~aam shit 1 ~L~. ~+0 - Mist •tools 1 4.+T~~'~ - Level i ,='. Q+0 - Bax spring--mater~e=_= G7. ~1~2~ ;~ ~%+, ~~r - Shop vacs 1 {~,, try - Table--chaff:°=_ 1 45, ~~- -- Rench spI ice 1 iQ~. Q~+2- - Electric trimmer 1 3.0-D - Doakcase-desk 1 ~. @~ -• Driver` 1 1. 5k - Wrenches i D, ~~ -- Clock 1 55.+~k - Toal box, jumper cables i y., tZc~s - Heater 1 1. ~~ - Misc •taU1 lat 1 1Q~.~0 -- T~lb chair-pate ie 1 i. ~~ - Vice grips i 5. ~~ -- Safe bax 1 LtZ~, ~~ - Wrenches 1 ~, ~~ - Cti 1 heat er 1 15. fZ~Q1 -- Car cttshian 1 ~.75f1-+~ - Table 1 1. ~~ - Sewing bax 1 1~.+nQ~ - Heat er° 1 i5. ~Dw - Roak rack 1 ~. ~~ - Chainsaw 1 ~,, ~~ - Hedge trimmers 1 1, Q-Q, - Light 1 ~. 5~~-~ - Bot•t 1 e caPPeY' i 1@. ~~ - Heater° i E. ~~ - Air eompressor~ 1 17. ~~ - Coffee table 1 ?,~. ~~ - Battery charger 1 `7, ~~ - End table 1 ;`C, ~,~ - Plack and decker- i 7. ~~ - Hand Saws, sq~ar•e 1 1.5~ ~~?? ,,~~~~~~,,,,,, '7, ll C>te: L`L-1~~"'LY 1L www. t~aars. tom HAAR' S AUCTION 71i-4JL--t3~46 Settlement WILRUR lSHIRLEY STONER Page: Seller: C25 Ct; EST CHARLES E BA55ETT ~~5 ORE BANI'. RU DILLSRURG F'A 174+19 Item Description Price - Rook rack - Tacklebox - Bedroom suit -- Cedar chest - Luggage - Night =_ t anti - Table - Shovels - Stoal-table -- Snow shovels - Pict!ires Rake, edger-, si~ovei Folding table ` - Misc tools rl ,,y,. - Ladder n~ `,, - Weed whacker Iot _(~~7- ~~C" Flower bucket ~`' _ Love seat-table 9. ~~ ~fC~' Suitcase ~~( -- Grill and tank - Chair - Leaf blower- - Tree cutter-, rakes - Patia table - Broom - Chair - Ei cFialr`5 - David[on stepladder - Lawn rocker- - Snowblower-- - Lounger - ~ wheel cart - Do!~ble ladder - Dr op spreader' - Pawermower - Wheel barrow Commission at 4tZi.0+Z+0r FUEL SURCHARGE Qt y i 1 1 1 1 1 i 1 1 1 1 i 1 1 1 1 i 1 1 1 i 1 i 1 1 1 1 1 1 1 1 1 1 1 1 Items: iS8 Amarnt; 800. ~0 10. 00 Less adj+~stments; Net d+.~e }o eller-; Total b. 00 ;.'7v. 0~d S5. ~~ ~Z+.:500 3. ~~ 3. 00 "c:. ~-k~ 0.:_'.500 `2. ~+~ Ei. 1Z~Qi 1. 4-0 fs . 00 5. ~~ 11.00 J. ~~ `. 00 16. ~~- i `. ~~- 6. ~+~ 1 c. 00 1. ~+~ J . 00 1 ~. 00 .~. 00 i . 0s~ 11.00 ra. ~~ ~. 041 .30. 00 1.00 4. +~~? 10. 0Q~ ~. 00 ~0. 00 ,~.+. 00 , 000. 50 --E3141. ~0 1, 190. s0 www, haar-s. cam HAAR' S AUL`TION 717-4.?, °-B~` REV4510IX+(1~9~ COMMONWEALTH OF PENNSYLVANIA INHEWTANCE iAX RETURN SCHEDULE G INTER-VIVOS TRANSFERS 8~ MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER ~N~Q,Q.G~S ~. ~ASS~TT a!- ~I - I3b2 This schedule must be completed and filed 'rf the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER DESCRIPTION OF PROPERTY ~NCLUbE7HENMffOFTHETRANSFEREE,iHEIRRELATIONSHiPTOUECEDENTANDTHEDATEOFTRANSFER nrracNncoProFn+eoEeoFORRFxesrnre. DATE OF DEATH VALUE OFASSE7 ~ ~ DECD'S fNTEREST EXCLUSION Fu~icne~ TAXABLE VALUE ,. /f!/-~Sftitr f~nns~-t-~ ~R ~~a 386 was , t ~ at{- 'few ~ ~ ~~ 34.36 ~,r!iv gton.~ .`~- d~cc~ ~ ~ ~2' e d ~1 ! S'' .! ~ eat '~ de~;edue~ ~o~n- aw a,~t a % ~p ~kc~rlleN~ .~ -sic- °~ ~ ' o/~ ~ env, en ~C~bt,>i. ~. ~ . J~~-u~ ~ d.eai~. Ua~uo.*ru~ /,~ 'rltas~L ~i'L °~ u~' c~..~iaue motto-f- ~ .~~:e~~ CQ C~u-~- a~n b aaeiL ~ use ~ ~h ~tt.~ a~• ~S, 6T~.9y~ loa~~ -a - iS ~7d.g4 ..1 ~r .- //Aw Ys~. ~~IG -~'4Sl!/YtnGG ,~/1/l~i~/~/ .~?5'4l~3~`f • TI~s artru' j t~s~~~ ~ ~~~,~-~;~fS~ look -G ~~.Sl~y~ i/1 ~u~ ~y~~ ~ ~~,~~ ct.o.~i - ~` ~' Sd,` 'f~~f 2~• 2~ ~' ~ ~~ QdyLLlit~ ~GL ~ ~ ~ . ~ umQrQ ~~ l~~I~~'w~a ~y~ i~+~.rl~l~ G~G~~ 0 y~~ ~ '~' TOTAL (Also enter on line 7, Recapitulation) 15 6 `~ 02 ~/~, T ~' (If more space is needed, insert additional sheets of the same size) ~~~,~,, I~ ~ ~ ~, j -1l''13 ©7 ~~3~~~. ~ ~~4. OL'f'• z' j2 ~~,,~~j ~, ~ s ~f /~Z~l z 13 ~ t o.~ Cj~~ } ~. ,Z I / ~~ d~ ~~zfi3 fry 'j2 ~ j~l z =~js _ ~ 1 v y ~~6 i4 _ l ~ v ~~ ..~ ~ / l `~l ~ ' ~° o~ ~~~~~ ~ - ~~, s~ ~.~~" 5~0 Q~~ ~~~' A'X1 ~~~ A~~ ~~~` ~ ~x~~ ~I~O f 5 ~S_, Za 81~ ~e REV-1511 EX+ (10-06) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE N FUNERAL EXPENSES 8~ ADMINISTRATNE COSTS ESTATE OF FILE NUMBER ~' ~ ar/c,c F. ~4 S s~1>` a / - // - /3G 2 Debts of decedent must be reported on ScheduleZ ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: ~. h'lt/u^3- Harncr ~tnGra.~ F~ome, n~ C4»~p f/;Il (Scc~tHxt~ics~~ ~S, 966. °D ~• ~i!rMl~Krsemen f ~o ~~~a1d L.t~ ~asSCff ~Di- Gsrs off' -~•~ B. 1 ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) _ Street Address City Year(s) Commission Paid: State Zip /tjR / trED 2- 3. Attorney Fees CQR!'~6s ~ • QJ~i~~P'S ~ Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant _ Al9 ONE CLl~+/r8L E T ~ ~~ /00. ~ O /Ir'D~/E Street Address City State Zip Relationship of Claimant to Decedent 4• ( Probate Fees ~i,„p Oriq~~4~ J53kG o~ S~lr'rt CBrt~,{Ga,~"GS T ~S7 S~ 5• Accountant's Fees ~ ~artef' ~h~tel~b~)l, ~{1~ 731oe.K e~ h'1eehaA- ~13D•OD 6• p ~J csburoJ P/t< Cldseowt- /v~Fr~ P,R-9o /es~/ AtSli Tax Return Pre arer's Fees ~ i ~ ~ ¢ ~{g'p•oo ~. udd: h'cna/ sl~o~t cer~i~i"ca~s ~a?o.oa T!'. /~drer/isiaq C[cm bu-land La,•,, T N real '~7$, OD 9. ~dver/i'snc g ytrti36N~ `~~7'vof- /~Ctr/S /fl~to ~sf mod„ . p ~ / 3'f 3/ /o ~eii~~ars cmt~t ~- ~tir/~s F: ~'h: e/ds rr rSr psy~- to Trr - eoun y /~3fi~trtc~ ~er`;tc ~r fii5~e SPitlr~ ~/ 3 S.OD (see Conte. She~'~ TOTAL (Also enter on line 9, Recapitulation) $ 6/.9t/vED Br ~~ ~ (If more space is needed, insert additional sheets of the same size) ~z 5~~~-~ ~sT.~ _~'~ta~/es ~ _ ~assef'`_ _ _ _ ~' % No. .Z/- ~/ /36z _ _ _ __ ____ .. ~l. /~ da~: final _ w~•6.~ T _ ~ _~? --~i-o ~' lr~~%/s _ . _ _ _ _ ~~~ o. ~ ___ ' ~` .~_..._~%!J_~HC~'~~~1G/1_Z-.__.~ ~-/Ct/~c~S_.~ c]/1iG~4rS dL y~~' C'cI'/i~e~ _ _ _ _ _ __ _ /~. __/~G./_Es~,tG _ _ /r.~nSlri- % _._ett ~l. ef' ~s~q~~.~~.~~v~•~. _ __ _ _r,~+~.00._._ __ _ _ _._1,5: --P~!~-t~t.-_~ ~/Iid~~ ,¢irC1'i.~cu" ,Cr _~~'y~_ 1I3!s._ ~-~i./f1A2/~siev _ __ r7~r- - ~ _ _ on ~alC e,~_/r4lf_ js~ s~nfc,~reo~ a/i'a~lrcd~ _ _ _ __ 3, z9S bS _ l~. _~G!~C11N~,~G~l~_ r+ ~~~i~~/c~. Slrncr fvr ps'f4,t~ ~_[.~w-f'r.:~~c, ~t.?~ __ _- . _ ¢Y7. ~a !~ _/Y-~i~i/SQA4j _~n~ L',rji,~e4a~s _ ~d,oo _ _/8 /~1..~,~~fi'axta fJ~i1l~/'ic¢st `+J~tfcr _ _ .?o•lb- ab. ~Brc~ ~f~i~/er, _/P~/. ,~s}~t /Ypp~a:~s~/ _ _ '~3c~.oo _ _ -- _ _ _ . -_ 2~ ~3einl~~r+-!~' ~ _ ~/t~~d L. ~SSGi/ ~i' _~St' ~ ~t2q/i~oN~ _W~~i~ __ .__ ___ __ _ .~. _ ~ 23. _ _ y,~ta/~ys iawe~o~i_-.no~x.17/3Jioi1 0/1 Q~/L_ e~ z /~'Z~/L ... _ _. _ _ --.~DD.10 _ O.Ob r ~ ~i.~o~_- FNS-/ ~~r~u_i~~rc s,~r-_ ~_ o~ d /0~_2o~z '~ _/Y~c_ _ __ __ __ _ _ _ _~ ... ___ _ / _ ¢ _~5._ ___./~lar~d~S _AuG!4!n-__ ~o~A-.a~ss~~.__a~ 9~~ ~~ _ 2-~y-Zo/~ 1..P}7 90_ _ _ __ _ -- _ o~R ~wix~irr.,/~f!/IJEAf'_ ~' ~.~/ _ _~ S%ur_ ~r ` t~_ {u/~/!ie_rt,_c._ _ - a~ ~ , ~- 3 ~ e66666?A',i~ ~~~~~ ~. ~ 27658 0727) ~'~ Sale c,erk m: ~~ ~:~ ~~~ 14:57:69 RetrleYSl Aef It: 54436399 yy1yy~I L6{!7 I~tlp6. ~J14.9 M I~r Cady, 9~5~ I~r ~: 6 tai: s ~.~ >~ 6C6 ~i3161W1ICS6116s 6666666113 266 61tIDWY oR 27668 rnn 6~-8Z94 Sale Clerk ID: i lkrci+ank 1~ 666966661638 ~2 1396 24:57:68 BeteM: 3p~2 6letrieva! 6lef r. 59436399 iJ~ Ei~r1- M~hod: Sriped ia~: s ~,~ >~ ~ ~ 4 ~ tr ~- k ~ r"+, f ~ ~ r1 ~ r.+ ~': fi~ x : ~ ~ ~,5 ,' "'~,:{c,~ Vim' ~ t °9r~'• ~ ~. . QED C~.~:Y SE~ET ~~~~{~ ~~~~ ~.3 l~~Gi-Ir=~dI~~tG 1 ~ E~! :~ ~' 1 l..:f 1 8 PEV INCLElI~ED ~ yy'~~ U RGC7 E.t~f ~ CC~~ `~ a JL 1 L.~'~ED b L :.'~? BEV Fh~E~# 8 L- 14.32 TXTz i f . 45 TC~~'i .s ~~~ ,. Q-.~ E i Aim 'f~ ~'Li~f1~`i ~rQ ~1~{1~1 Pte:; #1$Q ~.~i~i ~'~`s ,R3 'I!S+G JGI:.f~~~1 t-SLIf'1i~~t ~.. _ ; ~= / < .~. ~-16 GLENDA EARNER STRASBAUGH REGISTER OF WILLS AND CLERK OF ORPHANS COURT MARJORIE A. WEVODAU FIRST DEPUTY KIRK S. SOHONAGE, ESQ SOLICITOR REGISTER OF WILLS AND CLERK OF THE ORPHANS' COURT' COUNTY OF CUMBERLAND ONE COURTHOUSE SQUARE CARLISLE, PA 17013 (717) 240-6345 FAX (7 i 7'')2407797 INVOICE Bill To: InvoiceNo: 3876 CHARLES E SHIELDS III Invoice Date: 3/21/2012 Estate of: CHARLES E BASSETT 6 CLOUSER RD Estate No: 21-11-1362 OMB MECHANICSBURG, PA 17055 _ Qty Fee Description Fee Total 2 Short Certificates 4.00 $8.00 TotaL• $8.00 Checks should be made payable to the Register of Wills. Terms: Net 30. Please return one copy of this invoice with your payment. Thank you. 3/9/12 Receipt ~ VT ~ Chase Paymentech Solutions PSC,LLC 5151 SAN FELIPE, STE 1600 HOUSTON, TX77056 Sale -Approved ,~c'ct ~l/L1/ z Card Type Visa Card Number XXXXXXXXXXXX8016 Expiration Date X)CXXIXX Customer Name DONALD BASSETT Date 03/09/2012 Time 14:02:12 Entry Source Manual OrderlD 30518 Order Description 57700504952 Authorization # 040129 Amount 20.00 I agree to pay the above total amount according to the card issuer agreement. (Merchant agreement if credit voucher) X Customer Copy https://secure.paymentech.com/manager/vt opebat vieord_crecar recpri.jsp?recp_option=C ~/ FINAL SETTLEMENT SELLER NAME ~`_t1~ t 1 P~ ~ ~C.~ SS ~ ~ C~ t~S~~ DATE OF SALE / ~ ~`~ ADDRESS n U~ (~~~ /eS 1~~'`'~' J~ PHONE ~rn~ fir ll l~~ / 2011 zIP LOCATION OF SALE j ~e' AUCTIONEER u" "`~' ~ ~ `' r " "~' v x ;:4 ``~', PROFESSIONAL FEES A CTIONEER ~ ~V ~, '- CLERK ;;~' CASHIER ' L/s~e~ ~' OTHER XPE S S~~~I/ /nom. ~~ ~uil~e'/s w/Pi~'~~N~1~ Gt1 ebs ~e _;~ i s. p~-Gr,~~N~~s ~~ ~.: ,:: ~ ~' .(~ r~ PHONE (~v '3 ~ ~7 CASH $ CHECKS $ $ ~,~~ 'fi "";< t.. (;;> ~ 0. U J ~', $ 3/y.~ln $ `~/l~U~ Uo ``4 $ ~` ~s $ ~~~~- $ $ $ TOT ®( ~ ~ t~ }ti;, °.x r , LESS TOTAL EXPENSES $ I (or wed, the seller, accept this settlement and ocknowledge receipt of the obove specified net proceeds from the auction of my goods and properly sold on the obove date. I accept al{ responsibility for providing merchants title to all goad ,and property sold, and for delivery of title ro the purchaser. /\ ~.%v "C/C.t G' ~ j G,/ X S~ ~h ~ ~ Vg ~,~,~+~ ~' _' ' .~ Date ~~ ° Q'-'i:~-~ A~o r or Coshier's Signature (Seller,; ~~gn r ( ~` v Dote ~ ~ ~ Date 3 _ ~ - I Z (Se er's Signature OTHER RECEIPTS R $ /^~~~ $ .1~ ~~2.eh~~~~~ ~jG~, ~,~ ?Ul $ $ $ TOTAL RECEIPTS $ CGI 1 RR'_4 r`.APV t f -ya M i~ ~_~ $ ~ ~; ~ -, ~ S ~, -~ ~ ~ i ~o i ct7 1Y1 .~ !L 0 r f'fl C~ RJ .-A rf1 M1 ~a r a0 ~ 4 ~+ W c a , -~ o ~ ~~ LL O F F N j ~~j ~I ~x ~~ =o ~ oQ ~o y - eltMS: Payment due 10 days J. J. S KE I.T~ N ~ ~Nk~noa Rued ~~' ,~ „f a ~~, from receipt of statement ~, ~ pnu~- ~vstowt-. PA 19083 /"~ (610) 525-3600 e 'ttZ~t.:Rl ~~. ~ + ;~ , ~ ~;{ t? ,~ , ~~~ *** CREDIT NOTICE *** CEARLBS HA88$T'P B ACCT:27384 3801 CSSSTIQUT ST CAa[P HILL, Plti 17 011 ~~ 12/06/11 0506027384 000000 5 000021600 000000000 ~f ~o'Z 14` F~ ~CORRt~(:TIONO / ere ... __ __ _ ~_ ____ is. nJn'C~L1Y.a~d .. }-cfh t, :,~,. ~'•µ <'aS ~ M,~~~ ,,r *~. .' H tie x~y~~ I'FiOPF_p CREDIT TEAR OFF AND nE71JFiN ZOP PORT1pN WRFIYOUR A~fTUNCE,~ _ ., . __ ~..f_.'~'+ .....*efii..,. z '.';,.~ x This trill confirm a telephone conversation, I have placed the <<:~~ oil account on "grill call". tie gill not return to fill the. heating oil tank unless som~eoae calls for oil. 1Phen calling, please give us 48 hours notice (~+i.ater 72 hours) . let us kao~r~ement does got meet frith your ,approval please AN~3I8 FASICR CREDIT DBPARTIii~N'P Z16 (717)737-9745 If • ' I . ~O ~ Y 1['11.4' ~'~1~~~ l/' ~ ~~~~ ~, -`'~ ACCOUtIt Numt~r . _- [hle Date Amrxsrt t]~ v~, '~ 717737-9745 ~310~31Y `~~ 12128/11 $'18.50 j~'~' j~ ~' r , Het NBW Offal's Calf t-877-514-7588 and take advardage ~ fftis month's hot offers. Ask about ~ the great new Mardle opikxs awe. FiOS Triple Play 8 NNif1VR bet FiOS TV Prime t1D, kdemel speeds up to t515 Mops & home pMrre for 599.99hno. k~r t year with t~ TFRM tY3PffRl-C7 HC-0Uif~. Plus get a SYhliti-Room DLR FREE for the ii#e of your i~wxiled Sr!fuir~+e Tali hu tYttx~ a~ --X77-u'~x~r-3'r`.^i"z..=:'_'~il8i"i%'t;t :e:'s;S iaaiS, ir6er^e and ;ees a~iy. F4t1_S D+»~b!t± Pl~v ~74491trt2-: bet reritorc r"iv"S 15i5 iYPir~ f€cierr~E ar?+r1 ur>rimiierl Cat6ng tar' S1 i.93fsrro- thElt}t t Yr PR[CE GtIARAfdi€ erxi nKl TF€i~ GOt~RACr RECNIIRl=tt elf T;~es, e£rriss ar»i fees a~i~r, . ~°~` ~~a b ~'' ~ ~~ ,~,7„ MR CFWiLES t: BASSETT Ptrana_ 717-737-4745 lbxotrllt Swllmazy Previous l~larrce 528.50 _. ...--. -- - _ _ PayrrreM f;eceived Wov 21 ~ _ -- --- - . - -- -------- -- - -- ----- 50 ' -_- Balaooe Falurard 5.00 liar t3rargr+s - -... _ . G1crel4 AttFrity - ------ -- -- - --- ------- ---------_ _._ -: Stso7 razes. f~ and 0ltrer crterges .. -- ... __ 69.43 Total Naw !xlarges atue b7 Deeem6er 2R, 20i1 asp Alnc~ultf Due by l2ecelnbe3 28, Z'D3i ;~8,5Et , 1 _ ! ~.. ~. _ ~ Y -~...'r.'i-.. 5:--~2~?_A'7~/lk ..~' : 11.i_., ..{:~...rY'`Z--t-i ' J.. a ~BRi!~rrt4l±Eatt+~ P4~~+flr281? ~~~ #it y9itt- ~$f>` ~?€ ~'9tE?'-49~ cool; below ar at Verizoacom la arttharite lroru financial Yfew your bi0s in deiait aF verrzonerun rx rrll t-@40-VE.RtZftM ~?-8f34-837- 43E6;. stitcerlnrr to do4imi tlm arriaarit of y0~ir monlhty hilt tram inter yr>rr ter, dig8 rxmrber It: ?37--3745. Ilse 31C !i s~ced iar the tt~e digits to ~DrSrt aisteu ta°itl: ycrc crcR ,xr ;~aek arrC k.Rcwirig your 3G'.oiiit rsimlrer. :~# iiaytr~ni d're~lly fo Verizon. Tv dlsFVniirnae Customers with disaGiiitises can reach us by ~i (ai 1--800-974--f~006. i$urrE8=i% z ~{tIl~nt, ti€t! "1~itri Fi°3~ RE~'~; :5 CSI}" iii ila autltoriz~ion. r~kn te!;i-Pw4:Yi:.;( >'Ya v!ti:3 rvn.~~~:f!i CfUOI{N1 /tUt<3lI181fC FBMlTAf-'Flt (JNl<18i1(1!/!/3fC fACIPWI` ~I ~'Y ~6~5 scan r eaiy ~ r ~s+a s.,c.:a3 a:C v~f24?!.1'A!!ih~Fk+~.pr!t1Q a!~,Lq":!l~Et fy9,~2yi*,:n! u IY iG~` --- __ _-- _ -_ - - 3n01 L~TM_rf t>T .. _:.#_rl~t.t......il....gl..lt!l.....!l..f~fi flit l~rc ~[¢ _ _= _::E ~_~:- rFs"F"s""-~l--Eli!! l~l i i ~ ~ f+tuarker. 717 737-3745 3t0 31Y fiEW Charges i3-F~: t~et:21~, 2tl1i ~!lwurit Bras: 5s 31 ~ c~ ~ b ~ ~.a~e `!(.k "sY'"# -#u Yerf2eir: .. ~-~~w..~.~._ ~.».:?'~-'~~ " ~ ~ f z !"'t ~~~ i](ir~~r€~~ f ltfit#~#"~=$g€lt~lt':#~[~.a#8~1~"~x1~#~f~lte~~~®sa~la f itCilpl;~Oy{lle~p~y~y~. ~.L~Pfil+ii wiR.R-R.! - w }ej.1k~_s -ei.~}!w REV-1512 EX+ (12-03) SCHEDULE 1 COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES, $c LIENS RESIDENT DECEDENT ESTATE OF ~y~L~ ~ tg/~Ss~Tr FILE NUMBER Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH ,. Penn3r~/~ia ~irJer;cam kJa->f~- ~o. '`a ~, 6z 2 . J~pl ~/e~~^i~ k fili fi-~ts jJ 3.33 ,~. P.e+,.t NwS o~/ ~tisuran « ft o S, o0 ~f. ~annPa~Gll ~sv/><s6i,~J, cSe•~cr ~ Trasti ~ ~ SS. oS S. YP,I~jZOn , f7h oAL fly, o g 7 PPL ~~S,ss ~. P~~~sr~~~~ ,~~-~ wd~ G. ~.~o.~~ TOTAL (Also enter on line 10, Recapitulation) ; (If more space is needed, insert additional sheets of the same size) REV-1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCNEDI~LE J BENEFICIARIES ESTATE OF FILE NUMBER RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Llst Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)J 1. Spousc Eden ~. ~as5~#(' ~ete~Sava} .S(~ous~ _. o _.._ r '}'G~T~TD by apse ~. sh,~~iy. ~ ~~~ daK~ti~ Y~ ? 2 S fJ/~ ~k bad, I~i/156K~, ~~ /'!e/~' 773n Frt~'m c~rt /~ ~i'ei /S~~/Y~is6ir•~, p~ / 7//L ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 TH ROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert addstional sheets of the same size) LAST' WILL AND TESTAMENT OF CHARLES E. BASSETT I, CHARLES E. BASSETT, of the Township of Hampden, County of Cumberland and State of Pennsylvania, being of sound and dis- posing mind, memory and understanding, do make, publish and de- clare this my Last Will and Testament. 1. I direct the payment of all my just debts and funeral expenses as soon after my decease as the same can conveniently be done. 2. I give, devise and bequeath all the rest, residue and remainder of my estate, of whatsoever nature and wheresoever the same may be situated, to my wife, Edith E. Bassett, absolutely and unconditionally. 3• In the event that my wife, Edith E. Bassett, should predecease me, or should she die at about the same time as I do, such as in an accident common to both of us, then in such event, I give, devise and bequeath my entire estate, real, personal and mixed, whatso- ever and wheresoever the same may be situated, to my daughter, Shirley Ann Stoner, and my son, Donald Lee Bassett, share and share alike, per stirpes. LASTLY, I nominate, constitute and appoint my wife, Edith E. Bassett, Executrix of this my Last Wi11 and Testament, and in the event that my said wife should predecease me, or should she be unable or unwilling to serve in such capacity for any reason, then in such event, I nominate, constitute and appoint my daughter, Shirley Ann Stoner, and my son, Donald Lee Bassett, Co-Executors of this my Last Will and Testament in her place and Stead. -1- IN WITNESS WHEREOF, I have hereunto set my hand and seal this day of August, A. D. 1979. ~,} 1 / U ~~ -~~ (SEAL) ar es assett Signed, sealed, published and declared by the above named Charles E. Bassett, as and for his Last Will and Testament, in the presence of us who have subscribed our names hereto as witnesses, at the request of said testator, in his presence and in the presence of each other. -2-