HomeMy WebLinkAbout05-21-13 J i � 1505610105
REV�i�70o E%(aau)(Fq 'Y7
OFfICIAL USE ONLV
PA Department of Revenue Pennsylvania
6ureau of Individual Taxes �•••��� County Coda Year File Number
Po Box zso6oi INHERITANCE TAX RETURN
Harrisburo PA i7ta8-o6oi RESIDENT DECEDENT � ` I `�` I����
ENTER DECEDENT INFORMATION BELOW
Social Securiry Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
09/17/2012 11l09/1942
Decedenfs Last Name Suffz DecedenPs First Name MI
Bradshaw Mrs Karen A
(If Applicable)Enter Surviving Spouse's Intormation Below
Spouse's Last Name Suffiz Spouse's First Name MI
Bradshaw Mr John F
Spouse's Social Secunry Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
10034-7721 REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
� 7. Original Retum O 2.Supplemental Retum O 3. Remaindar Retum(Date of Death
Pnorto 12-13-82)
p 4. Limited Estare O 4a.PuNre Interest Compromise(date of O 5. Federal Estate Tax Retum Required
deaM after 12-12-82)
� 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust _ 8. Tolal Number o/Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust.)
O 9. Litigation Proceeds Received O 70.Spousal Poverty Credit(Date of Death O 1L Election to Tax under Sec.9113(A)
Belween 12-31-91 and L7-95) (Attach Schedule O)
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONUENCE AN�CONFIDENTIAL TAX INFORMATION SHOULD BE OIRECTED T0:
Name Daytime�ephone Numbec _.:, %��
Kimberly Weindorf (631)486-?��30 - `"'
r •
REGISTER O WILLS USE ONLY:.'
First Line of Address � � � _ , � �
11 Alma Lane
Second Line ofAddress � ' ��� � .. '
,.�n
.I
City of POS[OffiCe Sta[e ZIP Code DATE FILED
East Northport NY 11731
correspondenc�s e•mau address:kweindorf@weindorFcpas.com
Untler panalties of ' ry, eclare that I have e ' ed ihis retum,including acmmpanying schedules and statements,end to the best of my knowledge and belieC
it is Irue,corr co lele.Declaration of prepare other th he personal representative is basea on all intormation of which preparer has any knowledge.
SIGNAT F ON R ONSIBLE F FILI � ATE
A D ES �
�
SIGNATURE PREPARER OTHER THAN R PRESENTA IVE DATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
Side 1
L 1505610105 1505610105 �
--- �
_
� Lsos6lazos
REV-1500 EX(R)
DecedenPS Social Secunty Number
oe�ede�es Name �REN A. BRADSHAW
RECAPITULATION
1. RealEstate (Schedule A). . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . .. L . . . .
... . . . .. .. . .. . . . . .._ . . . .
2 Stocks and Bonds(Schedule B) . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . 2. �
3. Closely Held Corporation, Partnership or Sole-Prop�ietorship(Schedule C) . . . . . 3. � ,
4. Mortgages and Notes Receivable(Schedule D) . . . . . . . . . . . . . . . . . . . . . . .. . . . 4 �.
5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E). . . . . . . 5. � ��
6. Jointly Owned Property(Schedule F) O Separate Billing Requested . . . , . . . 6. ZOH,414.00 '�
7. Inter-Vivos Transfers 8 Miscellaneous Non-Probale Property � � � �
(Schedule G) O Separate Billing Requested.. . . . . . . Z ' 128,222.00 ��
8. Total Gross Assets(total Lines 1 through 7). . . .. . . . . .. . . . . . . . . . . . . . . . . . . 8. 336,636.00 ��,
9. Funeral Expenses and Administrative Costs(Schedule H). . . . . . . . . . . . . . . . . . . 9. �� 12,399.00 ��
... . .. . ._.. .. ...... .. . ...__ . .._�:
10. Debts oi Decedent, Mortgage Liabilities and Liens(Schedule I). . . . . . . . . . . . . . . 10. ��
. . .. .__. .. . ,__ ._ . _.. ..._. ._.
11. Total Deductions (total Lines 9 and 10). . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . 11. , 'I E,399.00 i
. _. . _.. .... . ... .... .__. _
12. Net Value of Estate(Line 8 minus Line 11) . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . 12. ' 324,237.00 ��
13. CharitableandGovemmentalBequests/Sec9113Trustsforwhich ����'-" `� '���"� "� "���' ' ���� ��' �"��
an election to tax has not been made(Schedule J) .. . . . . . . . . . . . . . . . . . . . . . . 13. � ,
14. Net Value Subject to Tax(Line 12 minus Line 13) . . . . .. . . . . . . . . . . . . . .. . . . 14. � 324,237.00 !�
TAX CALCULATION• SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at[he spousal tax rate, or
transfers under Sec. 9116 � � � �� - � �-� � - � - -� � ��- � � � � � � - �- � � �� � � � � � -� �- � �
(a)(t2)X o0 324,237.00 �5. O.00 I
16. Amount of Line 14 taza6le . .. . . .. . . . . .... . ... . . . . .. . ... .. . . ... . . . .... ... . . . - . ... ..
at lineal rate X A_ . �g. ,
_ .. _... _.. _... _ . ... . .
. .... ._._..__....
. mount of Line 14 t2xable � � � � � �� � ����� �� ���"� � �- � `�
at sibling rate X .12 � �7. �.
18. Amount of Line 14 taxable . . .. . . ... . . .. . .. .. .. .. . .. . � .. . . ..... . .. . . . .. ... .. . ..
at collaterel rete X .15 � �g_ � �
19. TNC DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. . . _ .0.00 �
20. FILL IN THE OVAL IF YOU ARE RE�UESTING A REFUND OF AN OVERPAYMENT p
$ide 2
� 1505610205 15�5610205 �
REV-1500 EX(FI) Paga 3 Flle Number
DecedenYs Complete Address:
DECEDENT'SNAME
Karen A Bradshaw _ _.
STREETADORE55
2738 Rosegarden Blvd South _
CIN �—�— - �— STATE � ... i ZIP
Mechanicsburg PA I 17055
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 0.00
2. Credits�Payments
A. Prior Payments ..
B.Discount
—�-- Total Credits(A+B) (2)
3. Interesl
(3)
4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENi.
Fill in oval on Page 2,Line 20 to request a refund. (4)
5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 0.00
Make check payable to: REGISTER OF WILLS, AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a iransfer and: Yes No
a. retain the use or income of the propeAy transferred.......................................................................................... ❑ �
b. retain the right to designate who shall use the property transferred or its inwme ..............._........................... ❑ �
c. retain a reversionary inlerest.............................................................................................................................. ❑ �
d. receive lhe promise for life of either payments,benefits or care?...................................................................... ❑ �
2. If death occuned aker Dec.12,1982,did decedent transfer property within one year of death
without receiving adequate consideration?.............................................................................................................. ❑ �
3. Did decedent own an"in lrust for"or payable-upon-0eath bank accounl or security at his or her deaih?_............ ❑ �
4. Did decedent own an individual retiremenl accouM,annuity or other non-probate property,which
containsa beneficiary designation? ........................................................................................................................ � ❑
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND fILE IT AS PART OF THE RETURN.
For dates of death on or after July 1, 1994,and before Jan. 1, 1995,the tax rate imposed on the net value of hansfers 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 retum are sfill 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
adopfive parent or a stepparent of fhe child is 0 percent[72 P.S.§9116(a�(12)].
• The tax rate imposed on ihe net value of transfers to or for the use of the decedent's lineal beneficianes is 4.5 percent,except as noted in[72 P.S.§9116(a)(1)].
• The tax rate imposed on the net value of transfers to or for the use of the decedenPs siblings is 12 percent[72 P.S.§9116(a)(13)].A sibling is defined,
under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption.
. . . .
, REV-�SOgF.1(+(oi-iol
�;� pennsylvania SCHEDULE F
DEP�PTMENT OF PEVFNUE
�NHFR�TANCETAxRET�RN ]OINTLY-OWNED PROPERTY
RESIDEM DECEDEM
ESTATE OF: FILE NUMBER:
Karen A. Bradshaw 2112-01050
It an asset became jointly owned within one year of the decedenYs date ot death,it must be reported on Schedule G.
SURVIVING)OINT TENANT(S) NAME(S) ADDRESS RELATIONSHIP TO DECEDENT
q,John F. Bradshaw 2736 Rosegarden Blvd South Husband
Mechanicsburg, PA 17055
B.
C.
]OINTLY OWNED PROPERTY:
LEffER DA1E DESCRIPTION OF PROPERTY %Of DFTE OFDEATH
ITEM FOR]OIM M4DE INCLUDE NAME OF RNANCIAL INSTITIfiION AND d4NK ACCOUM Nl1MBER OR SIMIIAR DATE OF DEFTH DECEDENi'S VFWE OF
NUMBER TENHIJT ]OIM IDENiIFYING NUMBER.qTfNCH DFED FOR%IINTLV HELD REAL ES�ATE VAWE OF ASSET INTEREST DECEOEM'S IMEREST
1. A. pNCBankAcct#50-0598-4654 31,084.00 50 15,542.00
2. A. PNCBankAcct#50-0613-1784 13,822.00 50 6,911.00
3. A. PNCBankAcct#51-N99d848 18,753.00 50 9,377.00
4. A. PNC BankPcct#004-375055 12,735.00 50 6,368.00
5. A. Merr�ers 1st FCU#261756-0000 105.00 50 53.00
6. A. MemberslstFCU#261756-0005 8,230.00 50 4,115.00
7. A. Members1stFCU#261756-0041 19,142.00 50 9,571.00
8. A. ColumbiaManagementAcct#00590134795 3,390.OD 50 1,695.00
9. A. ColumbiaManagementAcd#00210031624 3,390.00 50 1,695.00
10 A. MorganStanleySmithBarneyAcd3617-099613-039 55,624.00 50 27,812.00
11 A. 2738 Rosegarden Blvd South,Mechanicsburg,PA 17055 216,550.00 50 108,275.00
12 q. 2012BuicklD#5GAKVCED1CJ209786 34,000.00 50 17,000.00
TOTAL(Also enter on Line 6, Recapitulation) ; 208,414.00
IF more space is needed,use additional sheets of paper oF the same size.
t � � PNC
'_EkDtN�THE Nt,Y'
October _'9. '?O1?
Itimberl� .A V�'iendorf
l 1 Alma Lane
East Northport. N�' 1 17�l
RE: }�aren .Ann Bradshaw
SSN: 077-34-3�06
DOD: 09-17?012
Dear Ms. N icndorf:
In response to your request for Date of Death (DOD) balances for the customer noted abo�e, our
records show the following:
Checl:ing Account
Account# �00>9846�4 Established: OS-02-2011
.IOHN F BRADSH.AV✓
• KAREN ANN BRADSHAW
DOD balance: $ 31,084.09 + 0.00 accrued interest
lnterestpaid 01-01-2012 thru 09-17-2012 $ 1.59 YTD
Sarings Account
Account # �006li 178�4 Established: 06-07-2011
JOHN F BRADSHAW
KAREN AN?�I BRADSHAW
DOD balance: $ 13_821.71 + 0.00 accrued interest
Interest paid 01-01-2012 thru 09-17-2012 $ 14.63 YTD
Account # 5] 11994848 Established: 07-]0-2001
KAREN ANN BRADSHAVJ
JOI-II�' F BRADSHA�'
DOD balance: $ 18.7�2.57 + 0.09 accrued interest
Interest paid Ol-01-301? thru 09-17-3012 $ 1.18 YTD
Please note that this office provides date of death balances for deposit accounts (IRAs, CDs. Checking and
Savin�sl. V1'e do not process an� financial transactions or pro��ide statements. If you need assistance H ith
an}� of these items, please call 1-888-PNGBANI: (1-885-762-2265) or stop bl' your local PNC Bank branch
o�ce.
Sincerel�.
National Financial Seraices Center
PNC Bank. I�.A. Member FDIC
Paee 1 of?
.
This� message is imended,/or the use qf t/ie indiridual or e��1ih� to N�hich i! is� addressed ai�d mqr
ron�ain in/ormalion tha� is p��ivileged. co��fide��tial and exentpl frorn disclosure under applicable IaN�.
1�Yhe reader o�this me.csage is �ao! �he inlended recipient a� dze enzplovee o�� a�ent responsible,�or
delirerirr� ihrs ntessage ro !he irtlended reczpienL i�ou arc herehi�nolified lhar a�ar dis.cemirsatio�r.
disn�ihurion or copi�in�qllhis comnrunications is sn•ictlr prohihited I/you have receired�his
conimunicatinn in error. please notrfi� nze immedimelt' hr rcph' or hr lelephone ai 800--62-1--.i aisd
immediaieh� destr•or this laxed documen�.
Paee 2 of 2
OcTOber 19, 2012
Donna Pollock
donna.pollock C�pnc.com
RE: 004-375055/John F& Karen A Bradshaw (Joint With Rights of Survivorship)
The value of the above-referenced account on September 17, 2012 is as follows:
� SymboU DOD Accrued ',,
Amount Uescri fon Cusi Price DOD Value interest
0.010',Federated Prime Management Obli�ations �PSSQ I $ 1.00 $ _ 0.01
� 1,203.649',MFS Municipal Pennsylvania Bond MFPAX $10.58 $12,734.61
—.---------- — $12,734.62 $
�— — —
� � Grand Total(Market Value+Accrued Interest $12,734.62
— -- ----
�f you have any questions, please contact our Estate Resolution Desk at 800-622-7086.
Sincerely,
PNC Investments, LLC.
Estate Resolution Desk
JEO
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 guarenteed.They are provided for informational
purposes only. Past performance does not guarantee future results.
' O�:T'- �� :012 �r , [�9 �� 2` �'M M1ST h,1ARKri PtA�p FA=�' �J�. 1' 76�'�80t F� 0'�J1
St
�
MBMBERSI"
PEDkRALCR6DfC UNION
October l9, 2012
To W(�oin It N[ay Conceraz:
Tl�is letter is to ve�7fy decedents Jo]u1 aud Karen Bradshaw's account ending
balances. As of the datcs 9-17-Z 2 and 9-19-12 the account holdars' regular savings,
nioney inanagement, and cartificate aceauut obtained the balances as shown below.
�.
Regu]ar Savings: $ ]05.23
.
Nloney IvIanagement: $ 8,229.89
Certificate of Deposit#0041: $ 19,142.09
I�you have any questions, please £ee] £ree to contact me at (717) 697-1884.
I'hatilc you,
\"'� I��J
�
Ashley Zimmemaa�n
Meinber Seivice Rept-esentative
Met�tbers ]"FCU
IvIarket Plaza Branch
717-697-I884
5000 Louise Drive � P.O.Hox 40 • Mechanicsburg,Pennsylvania 17055 • (800) 283-2328 • wwwmumberslst.org
__
ColumbiaManagement ��i Th=� �hP�k �d d�aw� on the account of
� KIMBERLY A WEINDORF EXEC
ESTATE OF JOHN F BRADSHAW
ocmber 10, �o1a 11ALMALN
E NORTHPORT NY 11731-3708
l]20]J F001 65 10Z 1/1— 63
ESTIITE OF JOHN F BRADSHAW
11 ALMA LN
E NORTHPORT NY 11731-3708
This check haa been een[ to you at the requeet of the ehareholder or an au[horized Eiduciary.
CHECK AMOUNT ;6,780.96 �
f
R. F I A A N K. L T p T
. .,. . � ��. ,�. r , . .': ., , �. , � , ,. ... .., ...
3
� ' � 005875704 .
� REDEMPTION � . � � � ..�DATE � � � .. . . � � ..e � � �. .
. . . . . . , . � .. � � tio �.�� .� .
PAY TO THE ORDER OF 10/10/12 �� '
AMOUNT
ESTATE OF JOHN F BRADSHAW � $6,780.96
11 ALMA LN
e NoATNPOR2 NY 11731-37ae ACCOUNT NUMBER
0227-02270002052
aavae�e qr Sqte Sheet 8ank&Tmst `�
I IIIIII I III IIIII IIIII I I II I II� — 8°ston,MA 02171 —
AUiHORIZEO SIGNATURE
�i•DO 58 7 5 70 4�i' �:0 i 10000 28�: 990 5 70 2 8i�'
ColumbiaMan�gement �,�
� Year-End Statement P,�, �ra
Statemerrt Period January 1,2012-DecemGer 31,2072
Contact Tour Financial Professional
BRIAN S EA60N
MORC�W STANLEI'SMfTH BARNEY LLC
AT 01 028162 934758 92 B"3DGT 1 PPG PL STE 1300
PfTTSBURGH PA 15222-5401
ContactUS
JOHN F BR4DSHAW 8 �P��
KAREN A BRADSHAW JIWROS 800.345.6611
11 ALMA LN
E NORTHPORT NY 117313708 Ofl UIB IIILBIMt
��ul����d���ull'lI���I�L��'�'��I�I���II�J���I'�III�IIJ���I� columbiamanagement.com
By Mail
Columbia Managemerrt Irnestrnerrt Services Corp.(Agent}
P.O.Box 8081
Boston,MA 02266-8081
c
�
�
Value of Your Portfolio 50.00
Portfolio Overview
Beginning Value 56,064.42
+ Inveshnerrts +$0.00
+ Earnings +$101.64 _
- Redemptloru -$6,780.46 �
+/-Change In Value +$614.40 �
Ending Value f0.00 �
irdn9ers me MchMed m hrvestrnen6 a Iledertptlu�s Ywr Chaige m V�ue is ihe �
hicre�e a decre�e b the rdue d your sl�eres pMis�he net afiect d s�es charges �
IX CVILY 1P¢5. y�
G
Acoount Summary
Bepinning Yalue Changes frrding Yalue
on,lanuary 1,2012 * Investments + Eamings - Redempfions +/- in Velue .as ofOecember 31,2017
Non-fletiremeirt
AceouM Numbar.00590734795
COLUMBUI DMDEND INCOME Fl1ND-A Fund Number:0227
JOHN F BRADSFWW 8
KAREN A BRADSHAW JTWROS
53,007.96 r$0.00 +55720 -$3,396.30 +5331.14 50.00
AxouM Number:00210031624
COLUMBIA CAPTL ALLOC MOD AGGRESSIVE PORTFOLIO-A Fund Number:0592
JOHN F BRADSHAW&
I(AREN A BRADSHAW JIWROS
53,056.46 +50.00 +544.44 .y3,364.16 +5283.26 $0.00
NOT FDIC INSURED Ma Lae Value
No Bank GuaraMee
Page I of 5
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JOHN F BRADSNAW 6 qpm�;(���)B91-98/B iIER: Sune�k ALLT 00�
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jEraCN�wlJ�vaiixOnnet
Unrealized Gain/LOSS tor Year]013
SECUflRY ♦ OURNTIiY ppiE�COUWEO pNITCOST�i� T�GLCOSi�f� ROJUSTEOCOSTISI NPRI(fTVRWE�q GM1AMOUHT�b� MOLOIHppERl00
Q S�acb lOVtlon� Mv4��V�WC 35!!]I,tl �
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09-21
5.000 09Ii92012 52.11 2fiJ.53 A 183.SJ 2)0.85 ]3J Ionga��Y012
09Q1
S�p�o�ai I0.000 352.11 f1,05�d1 31,054.11 N,OBJ.10 f29.t9
A¢her�anrois Mbiane 25.000 09/19I201Y 2l.]1 681.63 A 681.6] ]O6�J p150 long adj Y012 .
-09-41
t0.000 09It912012 Y].21 2]2.55 A 2)2.65 28245 4N0 Ion9a41Y0i2 �
09-21
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0941
SubTOtal 43.000 531.31 f1,3@6.9] St.]28.B] 51,2]LO] iM.10
Avon Products Inc 35.000 O9I1912012 16.01 560.]5 A 580.]5 601 fi5 qt�0 long aEj 2012
0941
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09-21
5.000 09A9l201P � 9.30 46.B0 A 46.80 d]SB OlB Iong atlj 2012
0&21
25.000 p9l192012 9.78 23A.00 A 234.W � 231.91 3gt Ion9a4jY0t2 .
0&21
. 15000 09/19/2012 9.36 . i<0.00 A 1d0.40 162J4 2.3J Iongetl1201P �
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09-21
8o5lon SGentific CoR 75000 . 09/19IP012 5.81 4J5.38 A 4]5 3B '� J35.00 -0.36 Iong etlj 2012 .�
-09 P1
�. 40.000 09119/2p12 5.91 . 23I.2� A 23210 232.00 -020 long atlj 2012 .
� � ' -09-21 .
fi5.000 � 09I19I2012 � SB1 . 3T1.33 A ]9]33 � 3l].0p -033 Ionpatlj2012 �
� � . � -09-]1
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U9.21
C�esapeakeEneigyCOry 5A00 09/19I2012 � 19.94 99.68 A 99.68 98.15 -3.SJ lonqaEj2012
-09-21
15000 WI1912012 � 19.94 299.03 A � 299.03 i88A5 -10.58 IorgaGj2012 ��
09 21
500� 09/19I20R I9.9< 99.68 A � 99.68 96.15 3.51 IongaC1�012
0321
5.000 O9I19Ii012 1980 ' 99.BB A 99.68 96.15 �3.53 long edj 2012
-09-21
5.000 09I19/Y012 19.96 99.68 A 99.68 96.15 �].53 iong ad)2012
09 21
15000 09I19I201P 19.90 � 299.03 A 299.OJ 18895 4058 IongaCj2012
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Distlaimar �
A�PnceE Assals calculation inclWOa all aefele eetluaing CasM1.MMF d Deposils.This eggrugxte number la not Euplkaled In To�aY.9ccounl V&ue calalalion.
P�Vou�ave pmvidetl Ne Yade M1istory lor thls vanuclion:R was no!evailable Nmugh Morgan Stanley SmiM 9amey LLC remrES. � ""�
T�e gain ana loss inbrmation ia O�heed for informa4onal purposes oniy,Is not a subsuWle 10991ortn(or any other apP�W���e IaR lorm),anE should not be used for tax preparatlon.
Unraalizea gain an�lov valuee am nstimeloa anC s�oulC pe inUepentlantly verilieE.We remmmenE that you contacl yoor ixx ativsor b tlelermine roa appropriate use ol tl�ia
inlormafion.Pael parl0rmanca tloee nol gua�anlae Nlwe raNms. �
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hansaclione o�rnnsVUClive salas.AIIM1OUgM1 we make every eXOR lo aCjust Me cosl basis br uarRiaa capilal changea,we do nat aEjust Uie cwt Gasis la ail evonb.Coniact your
Financul Advisor la B��dance on particuler Questiona.
For acwuntv witti C�oim Selecl0zing,I�e wmmissians paM on your eligi�le epuily anE opGOn Oum�asas antl salee are epP����o Ne Tolal Cosl on a monrMy basis. �
WiM raspem to estimateC pains enE losses lor IistaE equiry opnona,we�ave taken mto account opGOn premiums paiE w recelveE anC,in respac�b multiple purcbasea anNOr sales,
r,alr,ulaietl msl usinq an average unn pnw�or eil Ilke pasitiona.
We a�e rol responsibla lor any gain and loss iMO�malbn provitletl Cy you a anoNer fnanciel instiW6on:you am rtsponaide lor ensuring t�e accuracy of sut�inlormalpn.WheViai
proviEe�by you anM�er Inancial insGwnon or MSSB,if is you�msponeidlily m emure Na xcurary af all ol Iha EslimaleC Gan anE Loss infortnatbn.
Por dienb wis�inq m make versos purc�asx salna Mat Inlorma6on neaEa to ba mnvayetl at the Ume o(t�e sale.Unleaa you iaN us oMeiwise,we use first in lint out IiIFO)
accounling.
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2738 ROSEGAR�EN BLVD.S 696.Pm SraEET,CnursLE Ps vOt3 pvl 711tit�i3 I 1122/n713
MECHANICSBURG,PA 17055(CUMBERUND) Za�'2111
(42�31-2153-001) Race0�5enkment 595.PITTST0.EET,CARLISLE,PA 17013
�
100.Gross Amaunt Du�Fmm Bortowv 100.Gmas Maunt Du�To SNMr
107.Coniraci ules Pnce 8235.000.�0 401.Coniract sala nce 5235.000.00
102.PBrsp�alPrOpeiy 102.PersdlalPrope
10J.SeNement C�ar es to Bortower line 1100 58,652.01 403.
104. 404.
ias. aas
AdusMen4 br itemf id 6 sellar in advanc� Ad usimenb k�ibmt id 6 saller in advance
106.Ciryttownlaces 40fi.Ci IWVnlaxes
1W.CanN�� 407.Canry laxg
108.Sclwol Ta�7J17120ll to&30I2017 2653.661YPar 8933.16 dOA.School Taz 1f1712013 W 613W2013 2653.66lYear $973.76
109. 7121/2013m313112017 E112.00IOuaner 546.Sfi 409, 712712073to313112013 5112.00l�uarler 8a656
110 410.
111 dH.
112 412.
120.GmssAmount�ueFmmBortowu S1M,637.TJ �20.GmnAmounlDueTOStllar f375,777]I
200.MqunbPaiOB OrInBMa1101BOrtow�r 500.RMUCtbminMaunlOwToSaller
207.DaposttaEameslMOn E1.50000 501.ExcassEe M1seeimWCtims
202.Pn�palamounto�nexlwn 8788,00000 502.SettlemenlC�a eSloSellerline1400 $16,81700
203.Eustin Iwn�aken 5u�M�a 503.F_risti laan�aken su�ecl to
ppd 504.P ollWfrsimo eloan
205. 505.Payofl M secan0 malqage loan
206.SeIlerASSis�ance 52,500.00 SO6.SeeAOdenGUm506 52.SW00
pp� SO7.�isburse0 at praead5 51,500 00
2�8. SOB.
209. `�9.
AOjustmanbkriUmaunpaidbycelNr noustmmntorimrounpaio cxier
210.C� llavntazes S10.Ci Ilowntax�
Yn.Counhtaxec1I120131071272013 5790.d1fYear 8n2.61 511.COUn �es111/2013�021�12013 879041/Year 8712.61
t12.0.ssessmen6 572.ASSessmrnls
213. 51J.
p�d 51d
215. 515.
21fi 516.
217. 577.
218. 518.
419 519.
720.TOhIPaid8ylFOrBOrtavor 5792,112.61 40.TObIRWUCtIonMwuntDu�Stllar 519.129.67
70U.Cxh At Setllaront FroMto Borrowx 600.Cn�nt SNtlammtTOlfrom Sellar
J01.Gross Amant Oue From Bartower line 120 8244.637 73 601.Grcas Amaunt Due Ta Seller line 440 8P35,91912
7(14.LessAmanisPaiEBy/FaBwroxer(�ine420) 5192,11261 602.Less0e0uctiminAmtDUeTaSellerline520 E19429.61
303.Cas� ✓QFrom �TOBOrtowrt 552,519.12 fiO3.Qah J❑TO ❑FmmSelkr 8216,550.11
PreviouseCitionsareobsdete Page 1 d 4 01![2R0171149AM HU�4
T00.Totll Ral E�iria Brolur Fau Pab Fmn PaiC Frwn
DivisionofComm6sianQine700 asidlm+s: Barovrefs Selle�s
701.Sfi,975 00 to Cddwell Banker Homesteatl Group FunCa at Fun05 a�
702. lo ERA NAT Sattlement Sedlement
703.Cpnmission itl a�Setllement 813,950.00
�01.Broker Fee m ERA NRT $�9`'��
705.T2nsaclio0.Fee�o CdCwall Banker HomeSteaG Grou $2���
BW.henq P abb N ConnKtlon WM Lwn ..: . .. . .
BOt.Ouf agina0an CAarye E695.00 Qmm GFE#1)
802.VOUrcreEilacl�a epainisiwtl�espedfcinterrst2lechosen QromGFElt4)
807.Vour adl���a-ination tlw es irom GFE A 5695A0
804.A raisa�Fee to Premier A raisals irom GFE#J 8110.00
BOS.Cre7i�ReportbCretlstar QromGFE71J) 8Y4.N
BO6.Tar urvice to Ful�on Bank,NA (hom GFE p3)
807.Flootl CeNfKation W Corel ic Flootl Services �rom GFE N3 811.50
.Ilem� � ulntlB LaIMrTOB�PYtlInAtivma � . .
907.Dai interesl cla Imm 71711201310 7/1Y[013 18.OY741da W Fullon Bank,NA Qrqn GFE p10) 81Y6.19
90Y.Mo e Insurance Premlum Irom GfE M3
903.Hqnevxnefs insu2nca ta 12.00 manW m Sla�e Farm(POCB 5702.00) (�rom GFE#it)
1000.RaxvaUWU�X�6WIMLmMr �� � � . .
1001.IniGalOepaitiwyaurescrowxmunl QmmGFE#9� 82.540.98
100T.Haneownels insurance 3 monNS 558 50 per monN 5175.50
1003.M e insu2nce�.00 manMS per monU
1004.Pro tare513 monMS E S�09 monU 5859.17
1005.Schod Tax 9 monNS E235.71 pel rtanih S2,1Pt.fi6
1W7.A9 ateAClustment(f615.J5) �
NOO.TNMCG
1107.Title serviros antl IeMefs tltle insuana�� (fram GfE W) $1 893.04
110P.SeNemeni orG�l �68�a MaOison Satliemen�Service6-Callisle,LLC
1103.OxnefstitleireurdnceWMadisanSeltlemenl5ervxes�CarlBIe,LLC iromGFEttS 8275.00
1104.Lendefstitleimura�ceNMadisonSetllemen�ServicesCaAisk,LLC E7,725.00
1105.LenONsGtlepdicylimM1 E1BB,OOO.W
7106.Ox�/s Gtle pdi limtt 5235,OW.00
1107. enCS 'an M�he blal title insu2nce ium ro MaOSan SeNement Serrices-Carlisle,LLC E1,666 00
1708.UikemiM1efspalimol�heWalWeireu2ncepremiumloOMRepuWicNatianalTi�lelnsuanceCanpany E294.00
1109.CPL Fee ta OIC ReDuElic Na6onal 7tle Insuance Campany 575.00
71W.GOwmmmtR�mrEfn mtlTr�wNrt ��a .
1201.Govemment reca0i cha es (hdn GFE%7) 821100
1202.Dce0$70.00 M e$704.00 ftel�es S
1403.T2nstet�azes tromGFEttB 87.750A0 Sz,350Ao
1204.CirylCanrytaUStamps Oeetl52,350.W N�atgageE
1205.S�ateteWS�amps Oea752,350.00 M age§
1Y06.Recordin o�POA M Madison Carlisle Recatlin Acmunl 537.00
300.AtltlltlonalSYtl�mxilCM1 a . .. . . .. . .
7301.RequireE services ihat ya an shop fa (trwn GFE p6) I
1307.Surv
1307.Pestlnspec�bn
1705.Taz Ceh b Matlison Settlement Services-Cariisle,LLC $10.00
130fi.FinalSewetJaNFeWMarcAWU e�Flkn7owrehip $��Z-�
1307.De�P taGuaMianTrs�ferCO ratian $�ZS'00
1308.Adomey Fea to'Mm.ZuW&Seibr,t 570.0�
.�� . � , � 58,652.01 f16,817.00
Previous e0itions are obsdete Page 2 M E �7/21I2013 11:49 nM HUD-1
' `Camprlwno/GooEFtlM6tlm�h�GF�andHUO•1C�a�gw � �GootlFaMEstlmate HUO-1
Charya Thrt tannot Incraase HUD•1 Llne Numher
OuraginationcMrye k 801 $fi95.00 8695D0
VouraeGtlatlimge(pdnE)faNespacificinte2s�iatectiosen %804
Ywr aE�ustetl aiginatirn cAaya #&13 8695.00 3695.00
Tanskrim�a N1203 52,750.00 $2,350A0
C�aryes T�rt in Tobl Gnnot Incnas�Mon Tlun 70% �?:�.�ppe Fadh Estlmala � HUD-1
Grnremmer2 tecortling charyg k 1207 5158.50 8211.00
ADG�%al Fee lo Premier Appraisals #804 $M150.40 837400
CreOi�RepqiWCreEStar %805 840.W E14.34
FIOOO Cenificaliw to Corebgic Flootl Servites % 807 $fl.50 $1150
p
x �
a
a
, 866000 8616.Ba
� -54JA6 a �6.53939% I
Gh�qnThrtCanChang� 7:��.GOOEFailhEstimale� HUO-0
InNalGepoSiiforyouresaoxacwunt %1001 84,700.00 $2,540.98
Daityinterastcharya � b 9�� S1B.0274/tlay 550477 8126.19
Hcmeownelsinsurana Il903 5750.00 5�02.00
TitleserncrsanElenCehti9einsurance k1101 81,990D0 $1.893D0
Ownefs litle insuraze to MaOaon Setllement Services-Carlisle,LLC k 1103 82�5 00 8275.W
#
Loan Terms
vour initial loan amouM is 8 188.W0.00
Your loan�m is 30.0�years
Vwr initial iMerest 2te is 7.5%
Your ini�ial moMlily amoum o�vetl for pnncipal,interest,an0 any $ 844.40 induGes
mortgage insu2nce is
�✓Pn�ipal
II �✓In�e25�
� �MOrigage Insu2nce
Canyourinteresiralerise? �✓NO. �Ves,i�wnnsetaamaaimumol %.Thefrstchangexillbe
on an0 Cdn change again every attM
.Euery c�ange Oate,your interest rate can increase or Exrease Dy
� %Orer Na lile M Ihe loan,yaur interest rate is guaranteM lo never be lower than
%ahgherthan %.
E�mn tl yw make paymen6 on Hme,fan yom kan Dalance rise? QNa QVes,A can nse to a mazimum oi b �
Even Hyau make paymeMS m tima,wn yaur mon0ly amant �✓No. Qves.�he frs�increaze can�e on and I�e mont�ly amounl
oweC la pnncipal,interest,antl moit9age imu2nce�e? pwp�q����o E
The marimum il wn¢ver nse lo is 8 .
OorsyourbanAaveaprepaymentpenalf�? QNO.❑Yes,yourmaximump�epaymentpenalryis8 -
Oors yaur Iwn have a balloon paymmY? QNo. �Ves,you haue a balloon payment of E Cue in
years on
TMaI monMry amaunt wretl inGu�ing acrar acmunt paymen6 �YOU Eo nb�ave a monihly wcrve paymenl la items,such as pmpeily
Wrzes antl nomernvnefs insurance.Vau musl pay inese ilems Elreclty yourself.
�✓You have an aGOi�ional monMly escrcw payment N S 360.73
Ihdt�resulG in a rotal i,-��al mon,Bh amuun�uwM uf"a 1,30C.53 .T�is induCes
pnncipal,inleres(any matlgage in5u2M¢anG any items c�eckeE belvx:
�✓Prope�y�ates �✓Homeownefs insurance
�Flootlinsurance QSc�oa'Tazes
❑ ❑
Note'.If you�ave any questions aEaut Ihe Settkmmt C�aryes anE Loan Terms IisleE an t�is tarm,please conWd your IeMer.
PrenasetliGon5aR0GSdele Page J W 4 02R7/P01311:49AM HUDd
Supplemental Page
HUD-1 Settlement Statement
Aeeendumf br Page 1 Amounl
AtlEenCUm`A6
a.Eamest mmey retaine0 Ey CoIRNelI Banker HomesteaG Group 5�.00
b SNIerASS¢lance I 82,500.00
Tabl: f7.500.00
i nare wreiwM rear,ea me Huai sememeoi sianmm�ana w ma exiamywm.neoqe ana miei n�.we.na xinare:wumemm ai rec.�a,.na a�:eurs�mam:saee o�my acro�m or ey me��in�:ia�:xuon.
I IuMerceMy Na11 Am mxiueU a mry ol Ne MU61 Sepbmeni Slabment
BORROWFRS SELLERS
�
�d
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CHA 7RU%TON ' KimEeAyA.weinCad,Execumz ?
� � � ..J
BEVERLVTRO%T6N �
RVAN N. ON
�� /�j��/������{`.4 'L�l.w��� �2C"e�
fM1e11HB�f5emeTan�SWeirenir,n'cninx+eortw�eeaaeueaneaaunrcaaoumMmisransacoo�UUSeami�urau:.meWnas eaisourseammvmancewnntni::iaiemen�.
Settl t � \ Date
/ / , 71271P013
<b �—
PrEVbusetlitionsareoDSOle�e Page 4 W E 0112 7/2 01 3 11 6 9AM HUD�1
�.,,....� ��, :v _ _� __. : . �,� �._ .�._. �, �._.�. �.�.. _
r�'��.���
,�;,_
'--'�-'�� 9 � �'—+�-+��-+'-+�-+ 720 E. Maln Strer.^� • ��'a^m ir,. F:4 '-�078
(717) 838-13E3 0 -�Oi�, 2:?-'18?3
Y� CHEVROLE'7 �k BUICK r PONTfAC �r
k CHEVV'TRUCK`i k - �
����
,
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Cr✓. '��'lri.'� �`S�°'f �'"l`l//�'�c-�C �.r'/ —�"�/f�'"Gfa.c.�
,�� o�i� �'�� ��-/.�.�, s��'d'; ���`�
� y�Y�3 �'���" 7">,r.� � G�'`�5.,� �'r/�.d r�,
,�f�Yri/if�„i /�cl� ,C�/�.e .���, 4J�� /';3� ��r
,�r�, ���' �s� ��/ -� �.�"�"��'��.�1�G�.--'�'��'
,�s o�.� G,�r
i�y- ,�--�-� ��: t�� :��-
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KLICK LEW/S...GO1Np& QROW/NQ WITH YC)UI
R C'J 15I O C x+ i 0H '1,��
� pennsylvania SCHEDULE G
�E�,ATME"*�F AF�E"�" INTER-VIVOS TRANSFERS AND
'""ER„""�E'""RE'ua" MISC. NON—PROBATE PROPERTY
aesmFnr oeceoerrr
ESTATE OF FILE NUMBER
Karen A. Bradshaw 2112-01050
This schedule must 6e mmpleted and fled if the answer to any of questions 1 through 4 on page three of the REVd500 is yes.
DESCRIP�ION Of PROPERTY
�M �n;woe rne nuie or me iavism+Ee,*xEia na�nor�sn�r*o oFCEOe+r u�o DAiE OF DEATH %Of DECD'S EXCLUSION TAXABLE
NUMBER NEwho�rannsrEa. nnaa�roworTMEceEOrona�uES*�h. VAWEOFASSET INTE0.EST pF�wuae�� VALUE
1. Morgan Stanley Traditional/Rollrner IRA Acct#617-099618-039 108,623 00 100 108,623.00
z TIAA-Traditional Acct#C4053405 6,628.00 100 6,628.00
3 TIAA-CREF Acd#U4053403 12,971.00 100 12,971 00
TOTAL(Also enter on Line 7, Recapitulation) ; �28�222.00
If more space is needed,use additional sheMS of paper of the same size.
� � Page I of 2
I,�,�l� ���7
MSSBC/F Hwnc(]I]j69b9B16 TIER: SUnCartl ACCT81]�09961&q39TRAKFUnOSoWironlRA
NAREN A BM�SIW W Sxa� Furb BDPS
4J]BROSEGARDENBLVDSOUTH Mobilc�1ti)3�}q85 P �
MECHANICSBU0.GPA1]055-5]OS Bu�in�o:pi]�9J9-9551
j�ra0sbaw03�ver�on.nel
Unrea�izeE Gain/LOSS for Year 2012
BECUR?Y♦ aIIqNT11Y 04IEAGQUWE� UNrtC09T(5) iOTP�COSi(5) qpJV6TE000YT�F) MRRKEIYqLUE�%j (LLqMOUNi(q rvDLDINpPERIDD
Q MUi�AL FUNOS MarAe1 Value'.5100fi$].10
AineriranBtlFdOfAmn.ica ]]2665 09H]/2012 12P0 9.9Ed.5i � 9.98A.54 �OOt8B1 S.Irp Ionga412012
F1
05-21
LipivioentlReinvextmem tfi3_5�3 p9/�]I'tOt2 t29p 2,122.10 A 2,1?11A 2,13356 �i�{q Iongatlj20�Y
04.L1
FunilT�ixl q3696B 12.90 �2.OBG64 12.08B,ft1 12,1521] .,_�,
MkLVaWeva.Tolal 59,964.5! 313.152.1]
Purcl�aaea
Ne�Valuelncreasel 52,18].6)
(Decreaea)#
AmoricnnG�FaOtAmenca tp.661 09�1�I2012 }4.L0 6fMA1 A 6fW.Ot 604.1H p.S] iongatl�2012
Fi
09 21
30048J 09�iL2012 3420 19,28503 A 1�285.J3 1J2B9.32 9Er) Ionpad2012
092t
To1alPUrchasetl5hares 406.1Y/ SL1.20 513,889./9 513,809.N St].893.50 �.Ofi
�1'UivitlantlROinrasimant Yv,>i3 09/VI2012 Jn.10 i,569.31 A 1,5538'! 1,SG3tl6 O�19 Iongatl�2012
09 21
FuntlTOtal a5t03] 3a20 15,452.61 15,452.B1 i5p5].3fi 1i5
MkLValoevs.Tdal f13,889.M Si5A5l.]6
PurcM1ases
NvlVeluelncreasel 51,58).92
(oecreaee�.Y
�avisNewVOrkVenwreA 421.3]0 09/1112012 3]At ti816.96 A 15,81G96 I5,)3169 -854'! IonqaJ1�012
-09-21
L T Oiviocna Retnvostmonl 10961 0911]I2012 3]A1 1,615-98 A 1,516.96 1,50]]8 J3.18 iong aQ 2012
-09-21
FunCTO�aI 468.331 JJ.01 1],3329Y 1],332.52 1]2392� -93.Fi5
MkL Value vn.Tolal 515,818.98 S1t.2J9.3]
Purchasas
Net Value Incmaael 51,{22.11
(Oecnaseq
Lu.aMEmergin9Markms iG9820 09!1]I20t2 20.13 3,JYS.J2 A 3.3&1.32 3.3'!).afi -1(iH9 Ion9atl120i1
OVen
09-21
LTDivi4entlReinves[menl 952]] 99I1]/Y012 20.13 1,51]94 q 1,91]91 1,908.10 A5i iongatlj2012
09-21
FundTOtal 253.89] 20.13 5,31226 5.3122fi 5.18586 -2na0
Mkf.Value v�,total 50.39�.3I 55,285.66
PurcM1asen
Net Value Increanel 51,891.50
�oecnaseW
Mana9ersCatlencoM�Cp 2]0.005 09/ill"1012 2636 ).tt].Ji A ].it].]3 6995.P9 -11!.50 Ion9�4120�2
A
D9-21
319.658 0911]/2012 26 36 8.626.18 A BA26.18 8,28234 -tJ3 B4 Iong aaj 2012
09-21
TotalParchaaetl5hares 589.863 f26.16 j15,513.51 f15,5,3.51 515.218.1] �265.9<
LTplvi�entlReimestment 0]89 091�]20t2 16.3fi 1�.80 A 2O.tl0 20A4 �03fi Iongxtlj20i2
W-tt
FuntlTOlal 590G52 2836 15.56431 15.56631 15,298.61 -295]0
Mk1.Velue vs.Tota1 f15,543.51 515,298.81
Pu�cheaae
Net Value Increaspl SPM.90
(Decneae�M
RsPannersA 220265 09H]I2012 39A6 ],310-W A 7,3]0.0] 1,G03.11 390a IongeG�2012
0421
L T Dimtlen�Remvestmem 56141 Oor»/2012 33.66 1,898.5'! A 1,B9B.51 1.90�09 41 SJ long adj 2012
09-Lt
FunaTntai 2]Zp06 33A8 9,28PBa 9,26N.6d 9,310.iB <i5a
Mkl.Value v�.Total f],J]O.Ol 59.310.10
Purchases
Nel Value Inereasel 51.9�04i
(�scruse�N
TpnmburginuValueA �]J230 04I1112012 26]0 11.0]5.24 N 1),W524 t�]59tl1 -b.`i43 �onBa�12012
09-21
�T pivltlena Reinvestmem 4290 09/t�/2012 26.90 11256 A 1129a 11�59 -!35 long ad�2012
0&21
5 T Dlvqen�Reinvestment 1921 09/2i2012 26A5 W.Bt SO.Bt SR9d -G U shon
http://ideas.msdwis.com/Site/Secure/GainandLoss/ExportForm.aspx 10/5/2012
� � Page 2 of 2
F���,drori o�v�e� le�o io,i3a.�o ie.i3e.y9 v.92zoe �ro�n
MN�.Value vs.To�al 51]9]S.l< 51],91T00
Pumhases
NetValualn<reasal -55].16
�DecreaeepY
VirwsMU�tISemSM1iTrmB4 i]99.Bb] 05/1]/2012 G93 R.0]334 A 8.B]33J 8,091.�4 id0�] iongedj2012
� 09di
�i�ivitlen�Reinvcstmont 0]BiN] 0911]/2012 a.PB 2.35]A'! � 2.39a1 2?�t.'12 31S iongatl�2�12
(l9 2t
FundTOlal 29905G 4.93 11,130.81 11230.BI 1125356 �_.�
MkLVaWeve.TOtal 58,8)J.3C Si1.Y59.58
Pum�axes
NeWalue In<reasel S],]00.3Y
(�ecrease�p
VlnusRUaiES�2iaEac� 105152 �9/1]i2G1G 3592 4.T1].�6 A 3.T]].OG 3,594t0 -I+1S95 Iongatlj2012
09-21
LTDioitlentlReiovcsonent :I26]9 p9/iJ/201'1 9592 1,18P4! A 1,166a3 1,10991 -5R51 Ion9ed12012
0&21
Fun�(olol tJ]616 3v92 4,94349 <,9J344 Y10401 2�HA5
MXL VaWe ve.Total f�,�7��Ofi 30704.01
Pirt<hases
Net Value Inmeasel 5936.95
(OecreaseWl
TotalMUtualFUnCS E109,3]O.Bi f109,�30.81 �9�T3,10 -�09]]
TotalUnrealizeCGaiNLOes 5109,330.8] f109,]30.81 f108,62340, -510]T]
Disclaimnr ��
A-Pnce�Assets caiculalion incWdes all assels excluding Cesh,MMF 8 Deposils.This agqroGale nwnber is not tluplica�etl In Tolal�ccnunNaiue Qalculation.
N-NeNalue in��seqUecreese)wmpares your Total Purchases(exduding Dividentl Reinveshnents7 willi t�e Markei Value oi all sqares you holE of Iha Nntl.tliis calculation is for
ininrmationai pury�osas only,tloes nat repect your lolal imrealize�gain or loss antl sM1OUItl not be useE br tax puryoses. ..
T�e qain an0 ioss in(om�a�ion ls provieetl for inlortnational purposes only,is not a subslilvle 10991ortn(or any other appropriate�ax fonnl,antl s�ou10 not be used for tax preparation.
Umealiie�gain antl loss valu�z am eslimates and shoultl�n Intl�pontlantly verdied Wa mr,Ommontl Iha[you r,ontac�your�ax a�visor to detercnine Ne appmpriat�use of(FL
Information.Past pertormance tloes not guaranlaa lulure returns.
Gein antl bss Inforrtr,alion is calculaled based upon unilorm slantlards and�oes no[acmunl lor each intlividual dlenl's particular circumstances such as[he enistence ol hetlqinq
Iransac[ions or wnetrudive sales.All�ougb we make every Nlort to atljus[t�e mst basis lor secunlies'wpilal clienges,we tlo not a0jusl Ihe msl Easis lor all evenis.Contacl your
F�inan<ial ACvisor lor guiAaoce on particWar questions.
Foraccounis wit�Choice Seleclpricing,the mmmissions peitl on youreliB�ble equily end option purchasas antl sales are applietltotbe TotalCOSton a monlhly oasis.
WiIM1 respect to estimaletl gains an�lossas lor Ilsted equlty o0�ions.we bave�aken inta accounl option premiums paitl or receivetl antl,in res0ect lo multiple puahases and/or sales.
cakWatetl mst usinfl en averape unit prica tor all Gke positions.
We am nm responsi�ie for any gain antl loss Information pmvioctl�y you nr anot�er financial instiwtion;you are,re.sponsiblm for vnsuriny the ar.r.urar,y of amh inlormation.Wherocr
provi�e0 bY Vou,another fnancial instiWtion or MSSB.It is your responsibiliry lo ensure Ihe accuraq ot ell ol Me Estimated Gain an�luss inlormafion.
For r.iienls wisning to mako vcrsus purchase sabs t�al information noetls ro be comeyW at t0e time ot Iho sale.Unlass you tell us othervisn,we uso tirst in flrst om iFlFO)
a<counting.
http://ideas.msdwis.com/Site/Secure/GainandLoss/ExportFortn.aspx 10/5/2012
TIAA
CREF
FlNANCIIL SEPWCES
Octobcr 18, 2012
rsi,.n:nrau
Estate of'John Bradshaw
C/O Kimberly Weindorf
II Alma Lane
Eatit Northport NY I 1731
Rc: Karcn A Bradshaw
TIAA Contract - C4053405 IH5354B0
CREF Certificatc - U4053403
= Dear Kimbcrly Wcindort':
� Wc recently received notification of death for Karen A Bradshaw and are now contacting you since Es[ate
= of John Bradshaw is a namcd beneficiary for the abovo-listed TIAA-CREF retiremen[ aceounts.
� The survivor benefit that Estatc of John Bradshaw is entitled to receive is listed below. Any balances in the
° TIAA Traditional Annuity will continue to earn interest, and balances in the variable annuity accounts
� and/or mutual funds will fluctuate based on investmcnt performance. In addition, this value can bc subject
= to changc duc to special spouse provisioos or State Statutes.
= Account Value as of 09/17/2012
� TIAA Traditional $6,6 6
CREF $12,971.4�
Tatal $19,599.86
For your convcnience, we have listed the materials the authorizcd representativc, guardian, executor or
au[horizcd power of attomey, as applicablc, will need to provide to reccivc thc bencfits:
� New York: Allows for electivc withholding. If you wish to elect state withholding, please indicatc
Ihc amounts on your application.
❑ SURVIVOR BENEFITS DISTRIBUTION Request Form
❑ Proceeds Plus Supplemental Contract- if payee option selected, this needs to be signed
and returned in order to complete your request.
� A statement signed by the executor(s) or administrator(s) of Ihe Estate confirming that the Will
has becn preseoted for probatc and providing thc name(s) of the qualificd Irustce(s).
• AJ'ter n Loved Oi�e Passes Aitiar booklct
. The booklet TAltING THE NEXT STEP describes the annuity income options available to you
and contains instructions to completc your fortn.
. Sing/e Sr�m Pqvmenrs...At a Glance which provides answers to frequently asked qucstions
about your paymcnt.
TIAA-CREF Individual & Institutional Services, LLC Member FINRA, SIPC BENEBIJND-[G
Headquarters: 730 Third Avenue,New York 100173206 Tcl: 212-090-9000
� RE1'-7511 EXi (10-091
��i`':': pennsylvania SCHEDULE H
DEVAPTMENTOiNEVENUE FUNERAL EXPENSES AND
���ER,,^"�E T^X R��R�� ADMINISTRATIVE COSTS
R�SIDENT DKEDHJT
ESTATE Of FILE NUMBER
KAREN A. BRADSHAW 2112-01050
Decedent's deb[s must be reported on Schedule I.
ITEM
NUMBER DESCRIPT[ON AMOUNT
A. FUNERALEXPENSES:
�' PATHEMORE FUNERAL HOME&CREMATION SERVICES INC 11,384.00
e. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s)of Personal Representative(s) ____
Street Address
City _ ._State_. __. ZIP .
Year(s) Commission Paid: ._
925.00
2. Attorney Fees:
3. Family Exemption: (If decedent's address is not[he same as daimant's, attach explanation.)
Llaimant
Street Address
Lily _State____ZIP
Relationship of Claiman[to Decedent
4. Probate Fees:
90.00
5. Acmuntan[Pees:
6. Tax Retum Preparer Fees:
7.
TOTAL(Also enter on Line 9, Recapitulation) $ �2�399•00
[f more space is needed, use additional sheets of paper oF the same size.
��, , ( , ,//
_���� A Falnily Tradition Of Caring"
_ ���''�-,
PARTHEMORE Funeral Home & Cremation Services, Inc.
Mrs Kimbedy A.WcindorC 9119/2012
11 Alma Lane
East Northport,NY 11731
For the Service of Karen A.Bradshaw
I 303 I3rid�e S�rcct We sincerely appreciare[he confidence you have placed in us and will continue to asist you in every way
Y.Q. F3ox d3 I we caa Please feel free to contact us if you have any questions in regard to this stntemenL Thc following
New Cumbet'land_ PA 1 7070 �s an itemized statement of the services,facilities,aotomotive equipment and merehandise that yoo selected
when making the funeral arrangements.
f717j 774-7721
l��an) 774-55d6 �7e�ms �—�� Due� qccount# �
�+•H�ti�.parthemorceom Ne[30 �� 10/19/2012 2012077.0
-�
Description _ _ Amount
....� __.�...____ SERVICES&MERCHANDISE
• Traditional Funeral Service 6,395.00
Dove Stationery Set I 165.00
Gilbert W. Parthemure, 18 Gauge Steel Casket,Bronze 2,650.00
I ounder 12 Gauge Galvauized Steel Vault I 1,345.00
To[al Services and Merchandise 1 Q555.00
Gilbert J. Parthemore,
Supervisor
CASH ADVANCE ITEMS
Stephen K. Parthemorc.
CFSP Death Notice,Harrisburg Patriot I 257.87 I
Death Notice,Binghamton Pmss 206.00
20 CeRifieti Copies of Death Cectificate 120.00 J
f3ruce R. Parihemore, Hairdresscr 45.00
Pre-Need Coordittator, CP(� I Tent&Cemetery Equipment 200.00 I
�
I Total Cash Advances 82g'87 I
�� 'I I
�
Professional Memberships � �
NFDA • PFDA �
DCFDA •CCFDA
G/iw„m � M�w
\��� ��� � �
I
7hr AW: )i�u 6'rinn�. �
llic Pcup(e lFiu 97'�mt � �
�
Total 511,383.87 .
Payments/Credits so.00�
, � " ������ Balance Due $��,383.8��
�-'�'6�1 b--c—:� �i4�' -`
� �8� �u T n i r i: �/�,�j �E�
j�
LAST WILL AND TESTAMENT
OF
KARENA. BRADSHAW
I, KAREN A. BRADSHAW, of 2738 S. Rosegarden Boulevard, Upper Allen Township,
Cumberland County, Pennsylvania, being of sound and disposing mind and memory, do make,
publish and declare this to be my Last Will and revoke any Wills and codicils previously made
by me.
ARTICLE ONE
Sneci�c Beauest of Taneible Personal Propertv
] give and bequeath all of my tangible personal property, including, but not limited to, all
my automobiles, fumiture, fiunishings, books, pichues, jewelry, china, linen, silver, clothing,
household effects and personal effects, and other tangible personal properiy of like nature (not
including cash, securities and other property used for the production of income), together with any
existing insurance thereon to my spouse, JOHN F. BRADSHAW (hereinafter my"Spouse"), if my
Spouse survives me by thirty (30) days. In the event that my Spouse predeceases me or does not
survive me by thirry (30) days, my tangible personal property shall be divided by my executor into
as nearly equal shazes as practical giving due regazd for their personal preferences and distributed
among my children, HIMBERLY ANN WEINDORF and HEATHER L. SCHENK, who so
survive me,per stirpes.
ARTICLE TWO
Residuarv Estate
I give, devise and bequeath all of the rest, residue and remainder of my estate, of whatever
nature and wherever situated, to my Spouse, .TOHN F. BRADSHAW (hereinafter my"Spouse"), if
my Spouse survives me by thirty (30) days; or, if my Spouse predeceases me or does not so survive
me, in equal shazes to my children, HIMBERLY ANN WEINDORF and HEATAER L.
SCHENK, who so survive me,per stirpes.
WION ZUI,LI& SEIBERT LAST WILL & TESTAMENT
OFKARENA. BRADSHAW
Page 1 o,jl0
��
____
ARTICLE THREE
Grandchildren's Trust
In the event that my spouse and children have predeceased me or not survived me by
thirty (30) days and one or more of my beneficiaries is a grandchild who has not attained the age
of twenty-five (25) years at the time of my death, the shares of my residuary estate payable to
those grandchildren shall instead be payable to my Trustee, hereinafter named, in trust
nevertheless, to be divided into equal separate shares so that there is one share representing each
grandchild who survives me and who is under the age of twenty-five (25). Each such separate
share shall be retained by my trustee, in trust nevertheless, as a separate trust estate to be held,
managed, administered and distributed for the benefit of that grandchild as set forth herein.
During the term of any Trust created pursuant to this Paragraph, my Trustee is authorized
to expend and apply, from time to time, so much of the net income and principal of said trust as
my Trustee, in his sole discretion, shall consider, advisable for the health, maintenance, support,
and education (including college education, undergraduate and graduate) of my said grandchild
until the attainment of twenty-five (25) years of age, or until all such amounts are paid out of the
Trust. It is my intention that the expenditures to be made on behalf of my said beneficiaries will
vary as the needs of the respective grandchildren change.
At or upon a grandchild attaining eighteen (18) years of age, tl�e Trustee shall distribute
up to 1/3 of the principal and accumulated income to or for the benefit of and upon request of the
said grandchild; 1/2 of the then remaining principal and accumulated income at or after my
grandchild attains twenty-one (21) years of age; and the then remaining balance of principal and
accumulated income upon my grandchild's attainment of twenty-five (25) years of age,
whereupon any Trust created hereunder shall be terminated.
If a grandchild should die before final distribution of the trust assets, I direct thaY the
affected Trust shall terminate and any remaining Trust assets shall be redistributed in accordance
with the priority of beneficiaries I have established for my residuary estate which is set forth in
ARTICLE TWO hereinabove.
ARTICLE FOUR
Pavment of Taxes and Administrative Exnenses
I direct that all estate, inheritance and other death taxes (other than generation-skipping
transfer taxes), and all interest and penalties thereon imposed by reason of my death with respect
to property subject to such taxes by reason of my death, whether such property passes through my
probate estate or outside of my probate estate, and payable to any federal, state or foreign taxing
WION 'LULLI&SEIBERT LAST WILL & TESTAMENT
OF KAREN A. BRADSHAW
Page l of IO
/"�
authority, whether payable by my estate or by any recipient of sucll property, and all estate
administration expenses, shall be paid to the extent possible out of my residuary estate passing
under ARTICLE TWO hereinabove.
ARTICLE FIVE
Protective Provisions
The principal of my estate and the income therefrom, so long as the same are held by my
Executor, shall not be subject to anticipation, assignment, pledge, sale or transfer in any manner,
nor shall any beneficiary have power in any manner to charge or encumber his/her interest in my
estate, nor shall the said interest of any beneficiary be liable or subject in any manner while in the
possession of my Executor for any liability of said beneficiary, whether such liability arises from
said beneficiary's debts, contracts, torts, or other engagements of any type.
ARTICLE SIX
Powers of Fiduciaries
In addition to and without limiting the powers conferred by case law, by statute, and by
other provisions hereof, my Executor and any Trustee or other fiduciary appointed hereunder
shall have the following rights and powers exercisable without the need for court approval:
(A) Accent and Retain Investments. To accept and retain any form of real or
personal property received by transfer, devise, bequest or otherwise without being required to
diversify and without being limited to the types of investments in which fiduciaries are
authorized by law to invest. This authority shall specifically include the authority to accept and
retain any stock of a corporate fiduciary hereunder, ar in any corporation which controls or is
controlled by it, or any other corporation in which it holds any ownership interest, together with
any stock dividends received thereon, or any stock acquired in the exercise of subscription rights,
or received by reason of any consolidation, merger or reorganization, without liability for such
retention.
(B) Invest. To invest and reinvest in any form of real or personal property without
limitation by any law applicable to investments by fiduciaries.
(C) Voting Ri�. To vote a security in person or by proxy, to participate in or
consent to any merger, reorganization, dissolution, liquidation, voting trust plan, or other action
affecting any securities held hereunder, and; to exercise conversion, subscription, and other rights
of whatever nature.
WION ZULLI& SEIBERT LAST WILL & TESTAMENT
OF KAREN A. BRADSHAW
/��
Page 3 oJ 10
K
(D) Title To Propertv. To register or hold securities and/or other property in the
name of a nominee or nominees, including that of a clearing corporation, a depository, in book
entry for�n, or to retain securities and/ox other property u�uegistered or in a form permitting
transfer by delivery.
(E) Sale, Lease and Other Dealings with Property. To sell, from time to time, at
public or private sale, exchange, lease, encumber, option or otherwise dispose of all or any
portion of assets held hereunder; to make, execute and deliver deeds, mortgages, leases,
assignments and other documents necessary to carry out any of the powers granted hereunder,
which shall specifically include the authority to grant leases which extend beyond the period
authorized by law, and; to partition, subdivide, improve and impose any restrictions on real estate
held hereunder and enter into agreements concerning the partition, subdivision, improvement,
zoning or management of any such real estate.
(F) Borrow. To borrow money from any person or institution and pledge property
as security for repayment of fiznds.
(G) Distributions in Kind. To make distributions in cash or in kind, or partly in
each, and; to allot different kinds of property to different shares without regard to differences in
the income tax basis of such property. Any such designation, division, allocation, apportionment
or valuation of property shall be binding and conclusive on all parties.
(I�) Power to Distribute Outright. In any instance where property would be
immediately distributable to a beneficiary of a trust, distribution may be made directly to such
beneficiary without funding such trust. The receipt of any such distribution by any such
beneficiary shall be a full acquittance of the fiduciary making such distribution as to any amounts
so distributed.
(I) Settle Claims. To institute, prosecute and defend any and all legal proceedings;
and compromise, release, adjust and/ar settle any debt or claim.
(J) Emplovment of AQents. To employ agents including attorneys, accountants, and
others to perform administrative duties.
(K) Disclaimer. To disclaim any interest in pxoperty which would devolve to me or
to my estate by whatever means, including but not limited to the following means: as a
beneficiary under a will, as an appointee under the exercise of a power of appointment, as a
person entitled to take by intestacy, as a donee/beneficiary of an inter vivos transfer, as a
beneficiary under any insurance policy, as a beneficiary under an individual retirement account or
annuity, and as a beneficiary under any qualified or non-qualified retirement plan.
(L) Propertv Distributable to Minors and Persons Under a Disabilitv. Any property
(whether income or principal) distributable to a beneficiary of my estate who is under a disability
may be paid directly to such beneficiary, to the parent or guardian of such beneficiary, to a
WION ZULLI& SEIBERT LAST WILL & TESTAMENT
OF KAREN A. BRADSHAW
Page 4 of/0
/��J
_ ._
custodian selected by my Executor (other than my Executor) under the Pe�nsylvania Uniform
Transfers to Minors Act or under a similar act of any other state, or to persons caring for or
having custody of such beneficiary (other than my Executor), or inay be applied for such
beneficiary's benefit by payment to such other persons, organizations or institutions (other than
my F,xecutor) as my Executor may select, and the receipt of any such payee shall be a full release
therefor. The receipt of any such payments by any such person shall be a full acquittance of my
Executar as to any amounts so paid. Any beneficiary hereunder shall be considered to be under a
disability while under the age of twenty-one (21) years or at any time when, in Yhe opinion of my
Executor, such beneficiary is incapacitated in any way so as to be unable to properly manage
his/her affairs.
(M) Closelv Held Business InCerests. With respect to any interest in a sole
proprietorship or closely held businesses, including but not limited to corporations, partnerships
and limited liabiliTy companies (any such sole proprietorship or closely held businesses is
hereinafter called a `Business"), my Executor shall have the following rights and powers in
addition to and without limiting the powers conferred by case law, by statute, and by other
provisions hereof, exercisable without the need for court approval:
(1) To retain and continue to operate a Business for such period as my
Executor may deem advisable without regard to the general fiduciary principle of
investment diversification
(2) To acquire interests (including minority interests) in a Business either for
cash or with borrowed funds and to retain all or part of any such investment in a Business
for such period as my Executor may deem advisable without regard to the general
fiduciary principle of investment diversification.
(3) To control, direct and manage a Business. In this connection, my Executor
shall determine the manner and extent of their active participation in the operation and
supervision, and my Executor may delegate all or any part of their power to supervise and
operate, to such person or persons as they may select, including any associate, partner,
officer or employee of a Business.
(4) To hire and discharge officers and employees, fix their compensation and
define their duties; and similarly to employ, compensate and discharge agents, attorneys,
consultants, accountants and such otber representatives as �ny Executor may deem
appropriate; including the right to employ any beneficiary or Trustee in any of the
foregoing capacities.
(5) To take any action required to change or to participate in the organization
of a Business to a corporation, limited liability company or partnership, partnership,
limited partnership, or other organizational form.
WION ZULLI&SEIBERT I,AST WILL & TESTAMENT
OF KAREN A. BRADSHAW
Page 5 of IO
��%
(6) To elect or consent to the election to be taxed in accordance with the
provisions of Subchapter K or S of the Code.
(7) To execute or consent to the execution of shareholder, joint venture and
partnership agreements and amendments thereto and to participate in the recapitalization,
merger, consolidation, reorganization, liquidation or dissolution of a Business.
(8) To treat a Business as an entity separate from any trust hereunder. In their
acaountings to the court (if any are made) and to any beneficiaries, my Executor shall
only be required to report tl�e earnings and condition of a Business in accordance with
standard accounting practice.
(9) To retain in a Business such amount of the net earnings for working
capital and other purposes of the Business for working capital and other purposes of the
Business as my Executor may deem advisable.
(10) To diminish, enlarge or change the scope or nature of a Business.
(11) To purchase, process and sell merchandise of every kind and description;
and to purchase and sell machinery and equipment, furniture and fixtures and supplies of
all kinds.
(12) To sell or liquidate all or any part of a Business at such time and price and
upon such terms and conditions (including credit) as my Executor may deem advisable.
(13) To exercise any of the rights and powers herein conferred in conjunction
with another or others.
ARTICLE SEVEN
Fiduciaries
(A) Appointment of Executor. I appoint my spouse, JOHN F. BRADSHAW, as
Executor of this Will (my said Executor and any successor Executor or co-Executors shall be
referred to herein as my "Executors" or "Executor"). Upon the death, renunciation or resignation
of my spouse, I appoint my daughter, HIMBERLY ANN WEINDORF, as successor Executor.
(B) Apuointment of Trustees. In the event that my daughter, Kimberly A.
Weindorf, predeceases me or does not survive me by thirty (30) days and leaves minar issue to
inherit a share of my estate by representation, I nominate, constitute, and appoint her spouse and
my son-in-law, JASON J. WEINDORF, of East Northport, New York, as Trustee of any trust
created hereunder for the benefit of those minor grandchildren who are children of Kimberly A.
Weindor£ Alternately, in the event that my daughter, Heather L. Schenk, predeceases me or does
not survive me by thirty (30) days and leaves minor issue to inherit a share of my estate by
representation, I nominate, constitute, and appoint her spouse and my son-in-law, TIMOTHY
WIDN ZULLI& SEIBERT LAST WILL & TESTAMENT
OFKARENA. BRADSHAW
Page 6 oJlO
�V
M. SCHENK, of Montgomery, Texas, as Trustee of any trust created hereunder for the benefit of
those minor grandchildren who are children of Heather L. Schenk. In [he event of the death,
resignation, refusal or inability of either JASON J. WEINDORF or TIMOTHY M. SCHENK to
serve as my Trustees, I nominate, constitute and appoint JOHN CAFFREY, of Hauppauge, New
York, to fill such vacancy and to serve as my successor Trustee for the affected trust only. The
last acting Trustee as named above in this Will shall have the power to designate his successor
which shall take effect in the event of the deatl�, resignation, refusal or inability of the last acting
Trustee to so serve.
(C) Miscellaneous. Any successor Executor or Trustee named hereunder shall
succeed to the capacity of its predecessor without re-conveyance or transfer of property and have all
of the rights, powers, authorities and discretion conferred upon the original fiduciary. No successor
Executor or Trustee shall be obligated to examine the accounts, records, or acts of a previous
Executor, as fhe case may be, nor shall any such successor Executor or Trustee in any way or
manner be responsible for any act or omission to act on the part of any such previous fiduciary, as
the case may be. No Executor or Trustee serving hereunder at any time shall be required to file any
bond or enter security in any Court or jurisdiction in which such fiduciary may be called upon to
act.
ARTICLE EIGHT
Interoretation
(A) Child, Children. Grandchild Grandchildren and Issue. Whenever the terms
"child," "children," "grandchild," "grandchildren" and "issue" are used herein, such terms shall
be interpreted to include adopted persons as well as natural persons, provided in each instance
that the adoptee is under the age of eighteen (18) years at the time of adoption. Such terms are
also intended to include persons in gestation at any pertinent time under this Will, provided such
persons survive birth by thirty (30) days. In applying any provision of my Will which refers to a
person's "issue, per stirpes", the children of such person are heads of their respective stocks of
issue, whether or not any child of such person is then living.
(B) Survival Clauses. If any beneficiary hereunder should die within thirty (30)
days a$er my death or within thirty (30) days after any other person the survival of whom
determines such beneficiary's rights hereunder, then such beneficiary shall be deemed to have
predeceased me or such other person, as the case may be, for all purposes hereunder.
(C) Governing Law. This Will shall be construed and governed in all respects by
and in accordance with the laws of the Commonwealth of Pennsylvania.
WION ZULLI& SEIBERT LAST WILL & TESTAMENT
OFKARENA. BRADSHAW
Page 7 of!0
���
(D) Gender and Number. Where appropriate except where the covtext othcrwise
requires, whenever used herein, the singular includes and plural, the plural the singular and
words of any gender shall be applicable to all genders.
(E) Headin sg /Captions. The headings/captions of Articles, Sections and Paragraphs
used herein are for convenience of reference only and shall have no significance in the
conshuction or interpretation of this Will.
IN WITNESS WHEREOF, I have hereunto set my hand and seal and caused this my
Last Will and Testament, consisting of ten (10) typewritten pages, including this attestation clause
and the following Acknowledgment and Affidavit, Yo be esecuted, declared and published this
� � day of C u.u.�w+ 2012, at Harrisburg, Pennsylvania.
�
ri�/� 0 �z��,a,��-
KAREN A. BRADSHAW
On this a7�' day of , 2012, KAREN A. BRADSHAW declared
to us, the undersigned, that the f regoing mstrument was her Last Will, and she requested us to act
as witnesses to the same and to her signature thereon. She thereupon signed said Will in our
presence, we being present at the same time. We now, at her request, in her presence, and in the
presence of each of us, hereby subscribe our names as witnesses thereto. By so doing, each of us
declares that he or she believes this Testatrix to be of sound mind and memory.
Witnesses: Address:
��Y'�-- ��"7l /�.�� �
Witness
�-/t,� i°�r l7/la
��' �,�--G�� _ 3� �6 � ����, �Sp
Witness ��/A:,E�-�/'�av'i' /"�
/73/'a
WlON ZULLI& SElBERT LAST WILL & TESTAMENT
OFKARENA. BRADSHAW
� Page 8 of/0
�
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA .
SS:
COUNTY OF DAUPHIN
I, KAREN A. BRADSHAW, the Testatrix, whose name is signed to the attached or
foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I
signed and executed the instrument as my Last Will; that I signed it willingly and that I signed it as
my free and voluntary act for the purposes therein expressed.
n�.,,,, � ,�,z���.���q--
KAREN A. BRADSHAW
Sworn or affirmg_d to and acl- owledged before me by KAREN A. BRADSHAW, the
Testatrix this a.27 YL`day of 2p�2,
� �
(SEAL)
No � Public
COMMOtJy✓EALTH OF pENNSYLVANIq
NOTP,RIAL SEAL My Commission Expires:
JEAN D.SEIBERT,Not^rv PuGiic
City of Harrisburg,pauFhin County
My Commission Expires Au ust 17,2014
WION ZULLI&SEIBERT LAST WILL & TESTAMENT
OFKARENA. BRADSHAW
�� Page 9 af l 0
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA .
. SS:
COiJi�ITY OF DAUPHIN
We, �h�7 �. I�.,.,E��. , and ���G� ��I.�CI�—�P.�_- , the
witnesses, whose names are signed to the attached or foregoing instn�ment, being duly qualified
according to law, do depose and say that we were present and saw KAR�N A. BRADSHAW, sign
and execute the instrument as the Testatrix's free and voluntary act for the purposes therein
expressed; that each of us in the hearing and sight of the Testatrix signed the Will as witnesses; and
that to the best of our knowledge, the Testatrix was at the time twenty-one (21) or more years of
age, of sound mind and under no constraint or undue influence.
�_
Witness
� �
Witness
Swo/,m or affirmed to and acknowledged before me by �i'�ll� J. K��
and EG<Z�-�`/1 f l,�,�S� —U(�c� , the witnesses, this�day of �a„�, , 2012.
�
.�a�n<ara•�,,��,� � (SEAL)
� ""'----�_LTH nF�wr��N� �
���OIF^�� V `'�.;•tr� N Public
��.a��n s_ir�� , '"'-
4i�Y��h�rrisbuq � �'"''uL�c µ� MyCommissionExpires:
�ti 1,5�Commi,�;�on rxr�,t, �, d:i r.ounty
__""---'�•=�'_:.''-�i i�1
WION Z(ILLI&SEIBERT LAST WILL& TEST,9MENT
OFKARENA. BRADSHAW
��� Page 10 oj/0
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