HomeMy WebLinkAbout05-08-13 (2) Ex�a,-,o� 1505610143
� REV-15►00 ; �
PA De artment oC Revenue � 4FFICIAI USE ONl.Y
p pennsyivania co�my ooaa vear Foe rv�moe�
Bureau of Individual Taxes �EP^a^^E�*�FwE�E��E
ao sax.zaoso� INHERI7ANCE TAX RETURN 2 Z 12 �
Harrisburg,PA 17i28-OS41 RESIDENT QECE4ENT
I ^t '� �
ENTER DECEDENT INFORMAT�QN BELOW �' (—
11 10 2012 04 23 191$
pecedenYS last Name Suffix Decedent's First Name MI
HENDERSON VICTORIA W
(tf Appticabie}Enter 5urviving Spouse's tnformation Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Securi[y Number
THIS RETURN MUST BE FII.ED IN DUPLICATE WITH TWE
REGISTEft OF WILLS
FILL IN APPR6PRIATE OVALS BELOW
� i. Original Retum ❑ 2. Supplemenfal Return [] 3. Remainder ReWm(date of de8lh
priorto 12-13-82)
� 4. LimiSetl Estate � �a.wwrs 1nre�est cmnpromiss � 5. Federai Estate Ta�Retum Requiretl
ttlate W daatn afier t2-52-82j
� 6, Oecadent oietl Taetele � � Decedant Maintainetl a Living Tmst 8, TO121 NumbEr Of Safe DEp05it BOxes
(M�ach Copy o(lMll) (Al�dtJ+Capy ot Trubq
� 9. Litigaticn Prvrseds Received ❑ ���be�,een t�'1-35i ar�id�-�i t�5#desth � �.� E��yy�on tp t8x under Sec.9113(A}
(Aitach Sch.O)
CORRESPpNDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDEN7IAL TAX INFORMATIpN SHOULD 9E DIRECTED TO:
NOme Da time T
y eQBphone Numi�
ROBE1tT P KLINE 71? '7�Qa 2546> � �'
� � � m �
R£GIS'�2�ywiLS U�sE Ok�PY°
Lw 'd"TM— � " r�;r
-c_ U1 w.t � �� ,::J
FlrstlineaFaddress ,j " �=� '�"
c'.s —. T± b ��;:
?14 SRZD�E STREET � � -''+
_,r
$etond line of address - � 1 ~' -' �'
_ n�
PO B4X 461 ' c'."� ' v� a
City or Post O�ce g},�te Z�p C�g
DATE FIIE� �'�
NEW CVMBEF2LAND PA 17070
COrrespondenPSe•mailaddress:
Under penallies of peryury,I declare that I have examined this relurn,including accompanying schedules 6ntl slalemenls.and to Ihe besl of my knowledge antl belief,
it is true cprr&ct and rnmpiete. larati n ot preparer other than the persorial represe�tadve�9 6ased on sil informatian of which preparer has any knowiedge.
Si E OP PER IBlE F FliiNG RE N 6
April V. Stambaugh y�
ADDR
19 Hiiiside Qrive, Nalifax, PA 17032
SIG TUftE O PREPARl�fj pT�REPRESENTATNE OATE
\J
4 3 Robert P Kline � �.y��� ��
ADDRESS
714 Bridge Street, New Cumberland, PA 17070
Side 1
� 1505610143 1505610143 �
'`�''
' � 1545610243
REV-1500 EX
__ __ _ __..._ ____ __ __ _ _ . _ _ _
RECAPITULATION
1. Reai Estate{ScheduleA}........._...............__.................._._._..........._._._........._.... i. 12 5 , o a o . a o
2. Stocks and Bonds(Schedule B)...................................._.............._......................... 2.
3. Closeiy Heid Corporation,Partnership or Sole-Proprietorship{Schedule C},,.,..,... 3.
4. Mortgages 8 Notes Receivable(Schedule D)................................._....................._ 4.
�� Cash,Bank Deposits&Misaetlaneous Personal Property{Schedule E}....._......._ 5. 3 , 6 2 fi . 6 7
6. Jointly Owned Property(Schetlule F) ❑ Separate Billing Requested............. 6. � 7 , 2 7 4 . 4 6
7. inter-Vivas Transfers&Misceilaneaus Non-Probate PropeRy
{SCheduia G} ❑ Separate 6itting Requested...._....... 7,
8. Total Gross Aesets(total Lines 1-7)........._....................._..........._...._.................. q. 1 E 5 , 9 0 1 . 1 3
_ . ___.. . . - � ----.. _._... . .. .. _. . . ..____- _ . .___ .. . . .
S. Wnerel Expenses&Administretive Costs{Schedule H} ....... .............. 9. 2� � ��� • 4$
10. Debts of Decedent,Mortgage Liabilities,S Liens(Schedule I)...._....................._... 10,
17_ Totai Deductlons(tota!Lines 9 8 t0}..................................................................._q 7. 2$ , 8 7 6 . 4$
12. Net Value of E5tate(Line$minus Line 11)...................................._.......................12. 1 3 7 , 0�9 . 1 9
33. Charitabie and Gavemmentai 8equeststSec 91�3 Trusts for which
an efection to tax has not been made(SchedWe J)............_................._................ 13,
14. Net Value SubJett to Tax{I.ine 72 minus Line 73)................................................. 14. 1 3 7 , 0 2 4 . 1 9
---._. __._.._. .. .__.. . .._..
TAX COMPUTATI4N-SEE INSTRUCTIONS FOR APPLICABIE RATES
15. Amount of Line 14 taxable
atChe spousaltax rate,or
transfers under Sec.4t 16
{a}(1.2}R_00 76.
16. Amount of Line 14 tazable
at lineal rete x oa5 13 7 , 0 2 4 . 19 �� 6 , 16 6 . 0 9
17. Amount of Line 14 taxable
atsibiingrateX _j2 �7.
18. Amount of line 14 tazable
at callateral rate X .15 �$�
�9. Tax Due..._._............. .............................................................................................19. 6 , 16 6 . 0 9
20. Fll�iN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ❑
$1dB 2
� 15d5610243 150561p243 �
� REV-1500 EX Page 3 File Number 21 - 12 - 00124
DacedenYs Complete Address:
N
Henderson, Victaria W.
STREETAOORESS ... . . .. .. . ... . - . . ... .. .. . . .
5400 G Qxford Drive
CITY . . . . _ _.... . . . . . . .. _ ... .. __ . _� gTATE �ZtP
Mechanicsburg PA 1�455
Tax Payments and Credits:
1. Tax Due(Page 2, Line 19) (t} 6,166.09
2. Credits/Payments �
A. PriarPayme�ts 3�Q�Q���
B. Discount 263.16
7otalCredits(A +B) (z) 5�263.16
3. interest {3) 4.OQ
4, tf Line 2 is greater than Li�e� +Line 3,enter the difference. This is the OVERPAYMENT. {4)
Check box an Page 2 tine 20 ta request a refund
5. If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX PUE. (5) 902.93
Make Check Payable to: REGISTER OF WILLS, AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPC20PRIATE BLOGKS
t. Did decedent make a transfer and: Yas No
a. retain the use or income of the prqPerty transferred:..........................._......................_.........._.........._...!, .. �,,z'I
b. retain the right to designate who shall use the property transferred or its income;........_..................._...., �'���x
a retain a reversianary interest:oc.........._...................................._............................_........_....._......_._..... '�: x�
d. receWethepromiseforiifeofeitherpaymeMS,benafitsorcara?.._._....___._..........._.__...._......._.__....; � x
2. If death occurred after December 12, 1982, did deoedent transfer property within one year of death without
receiving adequate consideration?................................._._...._...._..................._...__..............__.............._....!. � ;x I,
3. Did decedent own an"in trust far' or payabie upon death bank accAUnt or security at his ar her deaih?_........ ' z
4. Did deCedent own an Individual Retirement Account, ennuity,Gr other non�probate property which
contains a benePiciary designetion?................_................._.................._,............_...........................,......_.........._, ��..�..x���.
IF THE AN$WER TO ANY OP THE ABOVE QUES7tONS IS YES,YOU MUST COMPLETE SCHEDU�£G AND FILE IT AS PART OP THE RE7UR
For dates af death on or aker 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 9 percent p2 P.S.§9116(a)(1.7)Q)J.
For dates of death an or efter January�, 1995,the tax rate imposeci on the net vaiue of transfers ta or for the use of the surv3ving spause is 0 percent
(72 P.S.§9115(a}(�.i)(if)). The statute daes not exempt a transter to a surviving spouse from tax,and the statutory requirements for disGosure of
essets and filing a taz return are atill applicable even if the surviving spouse is the only benefciary.
For dates of death on or after July 1,2000:
•The t�rate imposed on the net vatue of transfers from a deceased chiid 21 ysars af age or younger at death ta or far the use of a natural parent,an
adoptive parent,or a stepparent at the chiid is 0 percent[72 P.S.§9116(a}(7.2)�.
•7he tax rate imposetl on the net velue of trensfers to or for the use of the decedenPs linesl baneficiaries is 4.5 peraent,except 2s noted in
72 P.S.§9116 12)[72 P.S.§911@{a}(1)1.
•The tax rate imposed on the net value of transfers to or for the use of the decadenYS si6iings is 12 pament(72 P.S.§9176 ta}(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 bloo�or adoptinn.
SGHEDUcLE A�^ �
COMMONWERLTHOFPENNSYLVANIN I REAL �4lTAT.�-i
INHERRqNCETAXRETUPN
0.ESIpENT pECE�ENT .
_ , - _ '- _ _ __ _ _ - FILE NUMBER
ESTATE OF Henderson, Victoria W.
21 - 12 - 00124
_ _ ____ ._ _ _ __ __. _
A{!rea{praperty owned salely or as a tenant in cammon must be reported at fair_market va3ue. Feir market value is defined es the price
at which property would be exchanged between a willing buyer and a wiiting seller, nedher being compelied to buy or se11,both having
reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survrvorship must be disclosed on
schedule F.
Attach a copy of the settiemeat sheet if the praperty has been soi6.
include a copy o#khe deed showing decedanYs interest if owned as tenant in common.
. _.. _ .__ _. . .__. _.. ___. __ .____.
ITEM pESCRIPTION VALUE AT DATE OF
NUMBER DEA7H
__ _ _ __ ___ . _..__.
1 5400-G dxford Drive, Mechanicsburg, PA 17055; Tax parcei# 13-24-0791-048 (Lower AIIen 125,000.60
Twp, Cumberland Co.) sale price based upon HUD-1 attached
_ .
_--- -_..... _. _. _ __ __ _ _. _
TOTAL(Aiso enter on line t, Reaapitulatian) � 125,040.64
SCHEDULE E
CASH, BANIt DEPOSITS, & MISC, �
=o^^^^a��A�rHOFPE��sv��^N�^ i pERSONAL PROPERTY
INHERITANCE TA%REiUPN
RES�OENTOECEOENT
. _ . ._. . . � ._...: _.__ . __ . . _ .._._. . _ __ -_
._ .. ._. .. .. . . _.. _ . ..... ... .--':.. _ .. _ ._ _-__:' _ .. .._..
FILE NUMBER
ESTATE OF Henderson, �/ICtOCl2 W. 121 - 12 - 00124
Indude the proceeds of Iitigation and the date the proceeds were received by the estate. Aii property jointty-owned witfi the right of
survivorship must be disclased on schedule F.
_ _ _._ _ . _ _ .
ITEM DESCRIPTION VALUE AT DATE OF
NUMBER DEA7H
_ _ - - __ _ _.
1 Welis Fargo Brokerage Acct#41749643 1,075.21
2 Auto insurance proceeds 2,551.48
_ _ -_ -- -- _ __ --_ _ �_ }
TpTAL{Aiso enter an Line 5, Reca �tulation 3,626.67
SCHEDULE F
COMN°E�ANCET�RE7URN""�" JOINTLY'OWNEDPROPERTY
RESIDENT�ECEDENT
. .. . .._.. . .. . . ... .. _ ._. . _ . . .. .. . .. . . . .
. . . _ _...... .. . _ ___ . .. ._.. . _.__ ._ . . .
ESTATE OF ��nderson,Victoria W. FILE NUMBER
� 21 - 12-00124
If an asset was made joint within one year of the decedenYs date af death, it must ba reported on schedule G.
SURVIVING JdINT TENANT(S)NAME ADDRESS RELATIONSHiP TO�ECE6ENT
. . .. . _ . . .._.__ . .. --.. . _. ......_ ... . _ . .. . . .
April V. Stambaugh 19 Hillside Drive Daughter
p Halifax, PA 17032
__
JOINTLY OWNED PROPERTY:
__ _
� �ETTER � DATE C��.SCRI.PT.Iq�)C�F PR ERTY %OF �' onre oF oeniH
ITEM -lnclude name o manciai ins�tu ian an trank accaunt number6A7E OF DEATH - vawe oF
NUMBEf2 FOR JpiNT MADE io�54miiar identifying number,Attach deed for jaintiy-hetd reei.VALUE OF ASSE7� DECDS QpceoeNrs�wTeResT
TENANT JOINT �estate. � 'INTEREST
1 ' A , Wells Fargo#247402302891314 � n,3ss.ss 5p% ' 8,685.00
2 i A Weiis Fargo#2554243228 � aa,531.�a 50°!0 ! 20,085.50
3 � A � Wells fargo#3548600457 � �9,59�.so � 50% � 8,498.95
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4 A I W�IIs Fargo#3000248389085 I 5o.oi 50% 25.01
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TOTA�(Aiso enter on line 6, Recapitulation) 37,27A.46
SCHE�.J�H �
i F�VERALEXF'�]VSES& (
COMMONWEAITMOFPENNSYLVANIA �����
INHERITANCE TA%ftETURN �
RESIpENT�ECE�ENY ��.
_ _._ FILE NUMBER
ES7ATE OF Henderson, Victoria W. , 21 - 12 -00124
_ ___ . _. _._ _ __. _ _ _ _ __
Debts of decedent muat be reporked on Schedule I,
ITEM _ __ __ _ . _ _
N��gER� FUNERAt EXPENSES: DE5CREPT(C}N AMOUNT
__ _ _
A. 1 Giffen Funeral Home 7,168.22
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8. �RDMINISTRATIVE COSTS:
�, i Personei Representative's Commissione
� Name of Personal Representetive(s) '
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� Street Address
� City Stete Zip ��,
! Year{s)Commissian paid
2. attarney's Fee� Kiine Law Office 6,000.00
g, � Pamily Exemptipn: (If decedenPs address is not the same as cl2imanCs,attach explanation)
Gaimant
� StreetAddress .
i City State Zip ���
� Retatianship of Giaimant to Decedent �
4. I Prqbate Fees Register of WIIIS 426.56
5. Accountant's Fees
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6. ' Tax Return Preparer's Feas
7. I Dther Administrative Costs �
1 i P. Scott Archibaid Rea1 Estate Appraisals 250.00
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. . . .. .. �_ . . .. .. . ... . . .. .._.. _ . _ . ..._.... ..___.. ___.. . ...___. ...__--- ___ . .. . . . . . .
TOTAL(Aiso enter on line 9, Recapituiatian} 4$,876.94
Sd�du�H
Funeral E�erues&
COMMONWEALTH OF PENNSVLVANIA �� A�'n�N^��Y.� I.
INHERITANCETfJ(RETURN ' /�,a�l IJYQYVCIAAIa Illlta�
RESIDENTDECEDENT . . -.. _ ..
. ... . _._ __.._ .____ .. .._.._ ._ . _ ___. _ . .. r_ .. . . . : .. .... . .
.__. _ . __ ___.
_ -r - .._.. ._ .... .. ___ . . . . .... _.__. . .. . _ . ..___-
i FILE NUMBER
ESTATE OF Henderson, Victoria W 21 - 12 -00124
_ _ -- ---- _ --- _ _—_ _ ._ _ _
2 Settlement charges related to sale of real estate, adjusted for tax prorations, etc, per 16,032.22
I attached HUD-1 '
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Page 2 of Schedule H
REV�7573 EX+�71-Oe)
� SCHEDU�E J
COMMOM1'WEA�THOPPENNSYLVANIA , gENEFIClARIES �
INHEftITANCETAXRE7URN �, ;
RES@FNT DECEDENT' � �
'_._... '.. . .._ . .
ESTATE OF Nenderson, ViCtaria W. Fi�E NUMBER
21 - 12-00124
� � � �� �� RELATIONSHIP TO I SHARE OF ESTATE AMOUNT pF ESTATE.
NUMBER ! NAME ANC7 ADDRESS OF PERSON(S) DECEDENT �' (Words} ($$$)
� RECENING PROPERTY . Do Not tist 7msree(s� �
... _ . _ . .... ... ... . .. .. .. ...... _ . . . _: _ . _ . . . ,
I, TAXABLE DISTRIBUTIONS(include outtighk spousal i �
� distributions and transfars
' under Sea$176(a)(1.2)J
1 Ross Hendersan � Son one-faurth
28 Park Drive j
I GranNille, PA 17028 ii
�
2 f Kurt Henderson � Son one-fourth �
54DOG Oxford Drive i
Mechanicsburg, PA 17055
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3 � Michael Henderson Son ', one-fourth
1950 Highway 109 Norkh
i Lebanon, TN 37a90 � i
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�Entec doliar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet.�s approprsate. �
II. NON-7AXABLE pISTRIBUTIQNS: ��
�A. SPqUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION 70 TAX IS NOT TAKEN
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B.CHARITABLE RNC3 GOVERNMENTAL DISTRI6UTIONS �
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TQTAI 6F PAftT II-EfiJTER TOTAL NON-TAXABI.E DISTRIBUTt4tJS t}N ItNE�3 QF REV-1506 COVER SHEE�T {I.00
aev-ae�s ez.�s-0a!
SGHEDULEJ
COMMONY4EALTN OF PENN$Y�VANIA �+ Cp �
INHERITANCETAXftETUftN ��. �E�EF��w�AR�Gp L'Qnt�nued
RESI�FNT�ECEpENT I
._ . . __. . _._
_.._ ._ .r.� -_. ._. .._.__ .__._
ESTATE OF
Henderson, Victoria W. �FtIE NUPABER
__ _ _ _ _ _ _ -- ' 21 - 12 - d0124
__ _
RELA710NSHIP TO I SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER ' NAME AND ADDRESS dF PERSON(S} DECE�ENT
- RECHIVINGPROPERTY ' ooNOtustTrustaets) (Words) (g$g�
j, -TAXABLE DISTRIBUTIpNS[indude outright spousal � � i `
distributions, and trensfers
under Sec.9718(a)(L2jj - �
4 � Aprii Stambaugh ! Daughter i one-fourth
19 Hillside Drive
; Halifax, PA 17032 i
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Page 2 of Schedule J
LAST WILL AND TESTAMENT � �,
z O N 'v
�a-2T', " `-�r-?'��-.
OF ��_ ;-: o - ��
�. r
C�j'['-. N �__� � ,
. rZO= .� � („rr�
i �_7
VICTORIA W. HENDERSON °`;; ' `-, .
�� y �'� �:
;, _. -. _� �,
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O T�
I,VICTORIA W.HENDERSON,of Lower Allen Township, Cumberland County,
Pennsylvania,being of sound and disposing mind,memory and understanding, do make,publish
and declare this to be my Last Will and Testament,hereby revoking and making void all previous
� Wills and Codicils heretofore made by me.
FII2ST
I order and direct my personal representarive hereinafter named to pay all of my just debts,
funeral expenses and expenses involved or connected with the adminisiration of my estate as soon
�
� � after my death as is reasonably possible. However,my personal representative need not accelerate
� and pay those unmatured obligations which,in his,her or its opinion,it might be proper and more
`� advantageous to retain or renew and pay as they become due and payable. If I do not own a burial
�
\� plot or a grave marker at the time of my death,I authorize my personal representative, in his,her,or
+� its sole discretion,to purchase a burial plot and to erect a suitable marker at my grave, and to
expend sums from my estate for tlris purpose.
SECOND
I give,devise,and bequeath my entire estate together with all insurance proceeds thereon of
whatever nature and wheresoever situate in equal shares to my children,APRIL STAMBAUGH, '
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Page 1 of 6 Pages �
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NIICHAEL HENDERSON,KiJRT HENDERSON and ROSS HENDERSON,or their
surviving issue,providing that they survive me by sixty(60)days,per stirpes.
T'HmD
If, at the time of my death, any beneficiary of this my Last Will and Testament is under the
age of twenty-five(25)years or is, in the judgment of my personal representative,mentally
disabled,I give,devise and bequeath said beneficiary's share to my Trustee,who shall be the
surviving spouse,if any,of my deceased child from whom said beneficiary shall have descended,in
Trust for said beneficiary,in accordance with the paragraplvs below. In the event that there is not a
� surviving spouse,the surviving spouse is deceased,or the surviving spouse is otherwise unable to
� perform as Trustee,then I appoint my daughter,APRIL STAMBAUGH,to serve as altemate
Tn�stee. In the event that my daughter,APRIL STAMBAUGH, is deceased or unable to serve as
�� Trustee,then I appoint my son,ROSS HENDERSON,to serve as altemate Trustee.
3 FOURTH
During the terms of any trust created pursuant to tlus Will the Tn�stee is authorized to
�� expend and apply so much of the net income and principal of each such hvst as the Trustee shall
'�� consider advisable for the health,maintenance, support, and education(including college education,
undergraduate and graduate) of each such beneficiary until he or she attains riventy-five(25)years
of age, or until all such amounts aze paid out of the Trust. When the beneficiary attains the age of
twenty-five(25)yeazs or is in the judgnent of my Tnistee mentally sound whichever event occurs
later,the Trust shall terminate and the remainder thereof shall be paid to said beneficiary. If said
beneficiary shall die before the termination of said Trust,the Trust shall temunate and the
remainder thereof shall be paid in accordance with the paragraphs above. I direct that no Trustee j
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Page 2 of 6 Pages i
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shall be required to give or post bond for the faithfiil performance of the Trustee's duties in this or
any other jurisdiction.
FIFTH
My Executor and Tnutee are authorized and empowered to exercise from time to time in
his, her or its sole discrefion and without prior authority from any Court, in respect of any properry
� fomring part of any trust hereby created or otherwise in its possession hereunder all powers
conferred by law upon tnastees or executors and I intend that such powers be construed in the
broadest possible manner.
SIXTH
�
I nominate, constitute and appoint my children,APRIL STAMBAUGH,NIICHAEL
� HENDERSON,KURT HENDERSON,and ROSS IiENDERSON,or the survivors thereof,to
� serve as Co-Executors of this my Last Will and Testament. I direct that my personal representatives
shall not be required to give or post bond for the faithful performance of his,her or its duties in this
�
� or any other jurisdiction.
SEVENTH
I hereby declare it to be my expressed desire that my personal representative employ
Kline Law Office of New Cumberland,Pennsylvania,for legal advice and assistance regazding this
my Last Will and Testament, said attomeys having considerable knowledge of my affairs,views
and wishes respecting any matters that may arise at the probate of ttris instrument,the
administrafion of my estate, and the execufion of the powers herein menfioned.
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Page 3 of 6 Pages �
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IN WI7NESS WHEREOF,I have hereunto set my hand to this my Last Will and
Testament this�day of Q ' , 2007.
- ���l�tt�` .��;�'�-����
Wifiess VICTORIA W.AENDERSON
Wi ess
Page 4 of 6 Pages
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ACKNOWLEDGEMENT
COMMONWEALTH OF PENNSYLVANIA .
: SS
COUNTY OF CUMBERLAND .
I,VICTORIA W. HENDERSON,the Testatrix whose name is signed to the attached or
foregoing inshument,having been duly qualified according to the law,do hereby aclmowledge that
I signed and executed the insfiunent as my Last Will and Testament;that I signed it wiilingly,and
that I signed it as my&ee and voluntary act for the purposes therein expressed,
.��,--�.f�,���,� �
VICTORiA R'. I�NDERSON
Swom or affiirmed and acl�owledged before me by VICTORIA W. IiENDERSON,the
Testatrix,tkris�day of a�70� , 2007.
7C_ �..r<.a.�-�i
OTARY PUBLIC
COMMONWEALTH OF PENNSYLVANIA
NOTARIAL SEAL
SHARON R: FEISTER, Not�ry Pubik
NewCurt�baAmdBoro.,CumbeAend Ca.
My�omml�sfon Expires Apr�15,2011
Page 5 of 6 Pages
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AFFIDAVTT
COMMONWEALTH OF PENNSXLVANIA .
: SS
COTINTY OF CUNIBERLAND .
We,��e3 aa�z� �75"t.i.0 v and 1��.,������L/ !J J the
witnesses whose names aze attached to ihe foregasng document,being duly qualified according to
the law,do depose and say that we were present and saw Testatrix sign anfl eacecute the instruxnent
as her Last Will and Testament;that she signed willingly and that she executed it as her free and
voIuntary act for tFie pt�OSes therein e�cpressed;that each subscribing witness in the heaziag and
sight of the testator signed the Last Will and Testarnent as witnesses and that to the best of our
knowledge the Testatrix was at the time 18 or more years of age, of sound znind and under no
cons�raint or undue influence.
�
��
Swarn or affumed aad sabscribed before me by��-�7 �''G s�3� and
�;tl.v� � �'Gt :Ui this ,�`f' ` dayaf �G7e�c-"�i ,20Q7.
/c .��
N01'ARY PTJBLIC ;
COMMONWEALI"H OF PENNSYLVANU
NOTARIA� SEAL j
StiARON R.FElSiER,N�ry P�c i
NewCumberWndBmo..CUmberlurd Co. i
MY Commt�sion rsi ApAI 15.2011 i
Page 6 of 6 Pages
� -,, _ . __ _ __
. _ __
W.,�� �.�.��..
�� _ WNldpan,ri.1TT01 ��
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il mena�� �� a.�� �c�-�z.� '�
in the yeec ninuaa hundmd and E I GHTY FOUR (1984)
BETWEEN �ERNON M. WOOD AND ELLEN T. WOOD, his wife, GRANTORS ���',
� , �
AND ^�
` �
VICTORIA W. HENDERSON, GRANTEE �- il
.,.. � � �'i�I
-� I
. - N � ' �����"�
I � �
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I
�
" 4ViT'NESSETH,Tha�imm�sidQanonoE SIXTY ONE THOUSAND NINE HUNDR€D ($61,soc.oe) II
------- I
��, � Dollm ���
j. in Land paid the receipt whereoF is Laeby admowledged� the said gtanrot s do Le[eb�.gnnt . .
�dmnveymcLesaidg�nex , her heirs and assigns
,'�i' � '
� �AI.L that certain piece or parcel of land, with improvements thereon erected,
Ii situate in the Township of Lower Allen, County of Cumberland>. Comnonwealth of
PennsyTvania, bounded and described as shown on the final site plan of Mid- �I
Eastern Development Corporation prepared by Buchart-Horn, Consulting Engineers i,�
and Planners, and bearing date of March 24, 1975, as latest revised January 15, '
1979, said plan being recorded in the Office of the Recorder of Deeds in and for '
Ii Cumberland County in Plan Book Volume 34, Page 126, and being further known as
Williamsburg North, more particularly described as follows to wit:
!I . Beginning at a point on the southern right-of-way line of Oxford Drive at the
intersection of the southern right-of-way line of Oxford Drive and a line 39.03 ''
feet east of, and parallel to, the eastern right-of-way line of Gloucester Street; l
thence from said point in an easterly direction along the southern right-of-way
line of Oxford Drive on a curve curving to the right having a radius of 125.00
feet and an arc length of 25.54 feet to a point; thence along the same north 68 i'
i� d rees 56 minutes 38 seconds east a distance of 93.65 feet to a oint; thence I%
e P
along lands now or late of Cynwood Investments south 20 degrees 41 minutes 17 !i
�', seconds east a distance of 54.57 feet to a point; thence through the Party Wall ofii
Nouse #5400G and #5400F south 69 degrees 18 minutes 43 seconds west a distance
of 119.00 feet to a point; thence north 20 degrees 41 minutes 17 seconds west a jl
distance of 51.20 feet to a point. the place of beginning. Said tract
containing 6426.45 square feet.
t
BEING Lot #118, Building #7 on Plan of Williamstiurg North Plan Book 26, Page 47 �!
�'' .also in accordance with a Plan of Survey by Gerrit d. Betz Associates, Inc.,
dated May 9, 1980 and bearing drawing #80-103, known and numbered as 5400 G
Oxford Drive, Lower A11en Township.
I
UNDER and subject to the terms and conditions of the Trust Deed from
i �Williamsburg North Associates to W. R. Poynter, Trustee, dated May 14> 1980, �;,
�I and recorded May 14, 1980 and all amendments and supplements thereto in Deed
�'�.� Book "7" Volume 28, page 632. ��'�'�'
ii 'i
'�� �AL50 under and subject to all easements, covenants, conditions, affirmative
!i� � obligations and restrictions of record. J �',
!�� � RESERVING unto Grantor its respective successors and assfgns, owning land in
�ii Williamsburg North, the full right and priviledge to amend, modify or cancel
,� any subdivision or other plans applicable to Williamsburg North and to devote the 1�'.
j, land covered thereby to any use whatsoever.
�IiI BppY./I 3Q PAGE �� ����j
!� �~
_ _ .
BEING the same premises which Independence Building, P1umDing & Electrical
Supply, Inc., by their deed dated June 29, 1983 and recorded in the office
of the Recorder of Deeds in and for Cumberland County, in Deed Book H, VoL
30, Page 1D80, Granted and Conveyed unto Vernon M. Wood and Ellen T. Wood,
his wife, GRANTORS HEREIN.
�. TSvinFh!C Of. ' c� �C:'U`�• �!`_!_ ,� {_---�y""�'�
C � � �,_,p� CK� Cv
� ':�i'? � D 'd. �..Real Esbte rransf�Tax S'�;� .
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� ANI�rhe said granc« 5 w;ll general ly WARRANT AND FORHVER DEFEND the propny
� hereby caaveyed. .
IN WITNFSS WHEREOF, said gnueots h. ve hereunw sn their Laad s and eal s , cLe
�., dey end}rou fint above-wdttm. �
�� Srded�nd delivaed iv tha paaam�d� �
/,�`� �.....5.�1.`...G�.1/�!o.�.�//,, -�u�?:..l�-.G�.�............. c�.,
� J�"1 VERNON M. WOOD .
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5"`/C?O �7' �G`�y� .7/�ri� `'��G�a'--ec- 7�er�. /705 S
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Oa t}tiS dw lst �p( June 19 fl4 , bdu¢e me _.. i, ..
a notary public �
tLe undemi�ed o6.ac, pcsonally appaied VERNON M. WOOD AND ELLEN T. WOOD, his wife ^
Imorvn co me Coc satisFeco�lY P'°°m) ro bc the p�am 5 whae aame 5 sulxai6ed to tLe �vithin �.
!� iuctrumw4 end eclmawledged tLat they e:avtcd t6e rme fot tLe pucpou tha� ,
� cmhm�d. ,:ti".dF",�•:+.� �
i�, IN WSTNESS WHF.REOF, I 6eve henunro+et my 6.nd nnd official i ,pa� �s}'�;
J " y
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..1%�N����Notar Publ� 7 �, y�4 ,
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My C�mWon Hspha 6/9/84 ' �i . �I -.
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On t6n,the da oE 14 ii
tLe wdasignod o9'iar� P��9 •PP0°'�
knaw ro me C@ �acshcmi�ly p�wea) to be t6e pecwn whne mme wbsmbed m t6e witL'm ��'��..
�'��� iaea��ent, md edmowledged tLat acm:uced ehe ume Eo� the puiporc ehaan �I'.
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���: IN WITNESS WHEREOF, I Lave haewro tet m�6and end wl. l'
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Reewder af ISeed�
.,.'W�.{•, OMBApprovatNO.2502-0265 .. _. _. .���
;-�������� A. Settlement Statement tHUD-9)
,w .,
L[�FHA 2 Q ftHS 3.Q Conv.Unins. 8,File Number: 7.l.pan Numher, 8.MoAgage Insurence Case Number�.
N¢�-#19 1368378
4.[�VA S,QCOnv.lna
C.Note:This fam is fumshod to giv<YOU a statement of acWSI settiement cosiS.Amounts paid;o snd by the settbment agerts are shrnvn items mareed
"(p.o.c)"were paitl outsitle the dpsing;they are ehown here for Informational purposas anC are not inclutletl in the btals.
D.Name&Address af Borzower. E.Name 8 Atldress of Seliec F.Name 8 Address af Lender:
Leah H.CamD�l Esta�e oi Victona W.Henderson Susquehanna Bank
295 Somerset BaY Drive,Apt.303,Gien 3umie,MD 54CIX',Os.twd Dttve,MecharecsGUrg,PA t7�5 3501 Crncard Road,Yak.PA 17462-E6�J7
21061
G.Property Location: H.SeNlemen�Agent I.Settlement Dale:04/'L9I2013
b400G OxfoN Drive Canmuniry Seqie?rent!tC Disbursement Date:q4t242013
Mechanicsburg,PA 17055 N2 Market Street,51h Floor,Harrisbu�g,PA 171p1-2015
Cumbertand County,Lawer Atien Township
717230.2666
Piace ot SettiemenT. TitipEzgress
Susquehenna Bank,201 SlJOhns Churoh Roaq Camp HIII, Printed 04/262q73 at 3:19 Rm
PA 17�11 hy KJB
100. GrosaAmouot0uefromeorrovrer 400. GroasAmountDuetoSeller -�
7�3. Co:i{rzp sales pri�z �S25,p .00 401. ConVaq sales pnce ���" 125.OpR.00
102. Personalo�opuny � 40Z. Person0l ro rt �
�.. - .. �...
tfl3. SeWemen{chargesto6ortower{lirw_74Dp) 7A96.34 a03.
104. 4M.
195. 405.
Ad'uahnenla for items aiG b seller fn advence Ad'u&Immts Mr items aid b seller in sdvance
10fi. Cttyham�es to 406. CitY��es to
107. Couniytazes 04I23i2073fa12131YL0Y3 450.tA 407. Countytaxes 04@912013to12131l2013 A50,14
108. ScAOW Taxes D429f207310 O6l302013 2U8.93 408. School?ares 04/29Y2013 to D613012p7a 2�8.43
108. Sewerlfresh 04129I2013�006130l2013 81.48 409. Sewer7Trash 04129V20131006l30t2013 B1.A8
910. Mocwnmonexp.ass 04R9l2013to77J372q13 182.41 470. Mo.commonexp.ass 04129I2013to92Y51/20K3 182.41
171. 4t1.
H2. 412.
110. GrosapmouM�uefromBorrovxr 132,989.30 4T0. GroasAmouMUuekSefier 125,§02.96
24U. AmountsPaidb orinBeheNOfBOrrovrer 500. Raduqlonsl�AmountDuetnSeller
ZOt. Depoait or eamest money 5ai. E�ccess de�osi;(s�instructlons}
202. PnndpalamountNnswloan(s) 98,400.00 502. Setllemantchargestosellerpine1400) 1,935.18
203. Exisiin loa s taken sub�ed to 503. �isfin Ioa s taken suti ett to
1A4. 504. PayoHaffrstmwlgageloantoNONE
205. 505. PaydfMsemndmort9ageioeq
206. 506.
20). Se1ler G'rfi af Equity i5,p6d.06 507. Seller�ifl W Equity t5,t�0.IX'i
208. 508.
204. 569.
Ad uetmentu tor Itema un aitl b seller Ad'ustments lor item9 unpaid b seller
270. CdyRo'antaYes tn 510. CiryRamtaxes t�
211. Coun�yt�es to 511. Countyt�es to
212. Schwi Ta�s to 542 Scfioai Tzees !c
213, 513.
z�a. sta.
215, 515.
2t8. 5?8.
217. 517.
21$, $i8.
219. 519.
2n'. 7chl Paitl 6 BorccKSr ti3,4Q4.� i29. Tatai Reduc6on Amount Dua Setin 16.933.18
500. Cash et Settlement homtto Bortower 600. Cash at Settlemmt toHrom Seller
3pt, �g�ntdoe6omtKVrrnrer{Iirre120} 132,989.30 �1. Gr�samouotd�tasdter{6ne42Q) 125,9�2�
342. Less emounis paitl 6yMor bortqwer(line 220) 113,400.00 602. Less retluctions in amwn�due seller Qine 520) 16,935.18
#�'3. Cash Q From ❑ Ta Bmroxer 19,589.36 SO3, Cash [�S To ❑ From Scikr t08�967.78
IW lorm unMellO pl�y��attMrynW OM9mnlrq numY�.XO funM1]eTMIA�b u�urM',��40bGaun 4 mPMnory.llib Y Wq�N io poW�NepWOab�P[S�I.w�nmi Wna tlnnwM Inbmulbn uuhq i�p yimmenl
pocta
Previous etlitions 3re obsolete Vag¢1 of 4 HUD-1
700. TofalReai taie&akerFees Paid FrOm Paid From
DivisionofCtlmmisSiO� Iine700 asiollows: BOffOW0f�5 3eller's
���- Sa�� tQ Punds at Funds at
702. $o.00 to Settlement Settlement
7il3. wmmission�aid at seitiemer„
800. Items pa able in Connedion wdh Loan
$Ot. Ouroriginationcha.ge {(nc7udesQriginationPantt.�OC%a$484�q) $7,879.00 {EramGFE#7}
802. Youreretli�orpharge�pqiNS�forthespecifcinteresiratechosen $984.00 ((romGFEN2)
8�3. Youradjustednlg�nationchar�es {from FEA} 2,&53A0
804. Appreisa�fee toA raisalLoisficsSoWPipn $480.00P.O.C.B'(�romGFE#3)
805, Credit report !o GareL k Credca $28.00 P.QG B`(tmm GFE q3)
SO6. Tax service to First Amarican fteaf Estate Tax Service (trom GFE#3) 93.60
B07. Flooticertifica�ion toCnreL icFloodServices (fromGFE#3) 12b�
80B. to
900. ttems uiretl b Lantlerto be Paidln AGVartce
901. Oaiiyinreresicnargesfrom irom64I252073ro05rtN/[073@81025007tlay (frwnGFE#1p} 20.50
902. Mon a elnaucance cemium monthsto fromGFE#3
9�. HomeowneYS�reuronce �r ears to State Farm (irom GFE#t1} 435.G0
904. months ta from GFE N11
1000. Reserves De osded vrilh Lcntler
1001.INtlal deposi�for your escrow acwunt (from GFE#9) 825.34
16�72.Homeownzrs insorance 3 montfis $ 3825/monih 5108.75
1003. Mon a einsurance months $ /month
1004.Propsriytaees d months $ 55,437monih 316fi.�9
1005. months $ O.DO/month $
iCC&.Schcoi Taxes 10 mon[hs $ 4W.&7imonin gj,����
1007.Aggregate Adjus�ment $-058.40
1700.TNeCha es
1101.Title services and lendefs title insurance from GFE k4 1,288.5
i102. Settlementaclosingfee �a $
1703. Ownar's ti�le insurance (rom GPE#5 13D.50
f5a4. LetMBrsiitleineurence g1,143.W
11�6. Lender'stitlepoliqfimlt$98,0.D0.00 LendefsPolicy
11G6.Ovmets tltla policy iimii§725,006.00 Ownets Policy
1707.AgenTsportlonofUe�otaltipeinsurencepremium $1,122.00
5108. Underwn,etspoNOnofiheNialti0einwraircepremium $753.�
1109. Line 1104ISale RalelSFlEnd 900,820,710 to S
751C,. Insured Gosing letter ta Firsi American TNIe lnsuran S7`�.W
1111, Notary fees to Lauren E.Tnmmer 5z5.W 10.00
iti2. ElectrpnicTransmissionFee toCotrmuni SeqlementtLC 53`s.W
1119. ReimbforTaeCeNfcations roCommunit Set�emen�LLC $ 10.W
tt 54. Reimb Exp MaiUtamr Package N Communi Seti�ement LLC 5���4
ttOp.Govemme�lRecoNin andTrensfetCha es
1201. Governmem remang charges $ (fmm GFE k7} 188.�
�2�2,Deed$6200 Mprt e$706.00 Release$
t203. Transfertaxes $ (#:wnGGE§Bj 5,256.W
12D4, CirylCaunty fav/stamps Deed$1260.00 Mor� e$
1205. StaietaxlstamPS Deed$1,250A6 Mo a $ 1,256.00
�206, I7eed E Mon e b
1267. g
130p. AtldtOonalSettlementCha es
1301.Requited services thffi you c&n shoD er (from GFE )
5362. to
7303. to
93C4. Ceuntyliwp.Real Estaie Ta�tes ta emmie K.Mi�er Treasurer 6fi5.5
1305. 201 School .E.Taxes �o Bonnie K.Miller TreOSUrer $1,210.48 P.p.C.S'
� • � 7,OS6.34 1�935.18
'Paitl outside�f dosing by(B)arower,{S)eller,{L)erMer;(1)rnestor,Bro{K)er."Gedi�py Iende�shown an oage 7."'Credit by selier shrnm on page 1,
Previpus etlition5 are o 5ole[e PagE 2 Of 4 HUD-7
Com arison of Good FaiN Es6mate GPE and HUU1 Charges ! Good FaiN Estimate ` HUO�1
Cha ts That Cmfnat krcrease NU6t linc Number
._. _.—... .—_
Ouro ginationcharge q 801 i,W9.00 i,B79.00
'—'--.——'—.�.—.—,�...
Yauraedit�charge(�intstforNespecdfic�ntemstratechosen � 902 9tl4.Q0 90a.Q�
Your adjusted ongination charges �� q 803 2,869.06 2,883.00
Transferta<es g 1293 2,500.00 1,250.00
Gh s That in Total CannM i�rease More iha�19% � Good Faith Estlmafe HU61
--..�..—.... ,
Govemmenirecordingchargas g 1207 166.00 166A0
Appraisalfee g 904 46 .GO 460.00
�—�...—'—'�_�. .—_
Creditreprnt # 805 2 .W 28.00
—"—'—"—'_'—...—'—..�..—,...
Taxservice g BO6 inn.00 9300
Fto-x'certficafion g 8�7 72.5D 1250
Tille Bervices end lentlers title insurance g 1101 1,408.00 1,2&850
Ownetstitiensurznce # tifl3 7?5.9P 130.5�
d
2,29L5Q 2,180.60
� -��1Ador -0Sb40k
Cha es TFat Can Chan e Goud Fa�h EalimaM HU6�1
IniGaldepositforyouresaowacownt� p 1001 0.00 B'5,34
Oa1y{nteresi char�as(rom �01 $1025GG+oa 153.75 ' .�
Homeowne$insurance p 03 O.W 435.00
_ �
#
#
Loan Terms
Your Initiaf Iogn amount Is $98,406.00
Ya�r ioan te�m is 3R.yeaB
Your inifial interest rate is 3.7500%
Your initial monthly amount owed for pnncipal,interest,and any morig8ge $455.71 inGudes
insucance is O pMp�
❑X Interest
�MMg2ge ir�s,a2nce
Can your:nterest rate rise? ❑No. QX Yes,it can nse to a macirswm ot 8.7500%. The first change
wili be on 05NtP1618 antl can chanqe again every 12 Months attar d5Af7261B. Every
change date,your i0terest tate cao increase or deCrease by 2.00%. Over the IHe of ihe
ban,ywr intams{2te is guaranteetl ta never 6e bvxrihan 2.75�%x htgher thazi
B,T500%.
Even if you make payments On tlme,Can your loan palance dse? �X No. ❑Yas,it can dse to&maeimum M$
Even K}rou make Payments on time.Can your monthty�rount aved fw [�Na QX Yes,tl�e flr5t increase can be m 6&t4112018 and Ne mm�tNy
pnnoipal,Interesl,antl mortgage insurance rise? amounf owed can dse m$732.15,
irie maKUmm it cen ever dse ta is$732.�5. '
Doe5yQUr1o8nharpaprepeymentpenalty7 [�X No. QYee,yourmazimumyrepeymentpenaltyls$ .
Oces your laan have e ballonn payment? Q No. ❑Ves,you Asve a 6alloon payment of$ due in
yeas an 1 ! .
Total monthly amount owed Including escrow account paymenis ❑You tlo not h9ve a mtlNhly egaow peyment for item8,such as property taxes
aM haneownets ins�ear�ce.Yau rtwst pay these ftems c§tectiy y0u�seli.
❑X You have an atldi6onel monMly escrow payment of$i92.55
that resuft5 in a tot�initfai rtronthiy�nount cwed a'$6A8.?6. This iodudes priricipz�interest,any
motlgage insurance antl any items checketl�elow;
�Ptor.Ctty tazBS �Hbme�wnets insur8t',ce
�Flondlnsu2nce ❑
QSthooita�es �
Nate: if you have any ques6a�s abcut the Setdement Charge,s and l.oan Terms 6sted 4n this fam,please contzd your lendet.
Previous eqition5 are obsoletE PagC 3 of 4 HUD-1
HU�CERTIFICATION aF BIfYER AND SELIER
I haveFarefully reviewed the HU61 Settiement Statement and ta the best of my knowtedge and belief,It is a true and aecurate stafemeni ot aii recCipts antl
tlisbur92ment5 matle on my account or by me in ihis tronsaction I(urthe�certify lhal I have receivetl a ctlpy of ihe HU61 SeHlemen4Staterrient.
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'�(.eah H,Campbell " ,
�ATE OF VICTORIA W.HENDERSOhh
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:Apri15(am�6augh,�ecutnx";' �
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T�a HU6t Settlement Statement which I have prepared is a tme and eCCUrote ecyount otthis.tronsaCtlon.I have cduseC orwill cause lhe(untls tu Oe
aisburscv5inacwrdancewiNmisstsremcnt. �y'�:,I71LtY?� �j-.�' . �,.`��-���'t ���-.
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�3�,)-(�ticX� �', �`-l�.V Nt(�'1P� �2--�_"I'� .
SETTLEMENTAGENT DATE
WARNMG:(T IS A tRtME TO KNOW}NGLY MAKE PAI.5E STAT£A{EHTS TO TH6 UNITE6 STATES 6N THtS OR ANY SIMitAR FORM PENALTiES UPON
CpNVICT10N CAN INCLUDE A FWE AND IMPRISONMENT.FOR DETAILS SEE TITLE 18:U.S.CODE SECTION 1001 AND SECTION 1010.
PrCVious¢tlition5 areObsolek2 PagE 4 0 4 HUPI